bluuebunny/crossref_metadata_2025_split huggingface dataset:
Specialist-Led Diabetes Registries and Prevalence of Poor Glycemic Control in Type 2 Diabetes: The Diabetes Registry Outcomes Project for A1C Reduction (DROP A1C)
Authors: Aronson Ronnie , Orzech Naomi , Ye Chenglin , Brown Ruth E. , Goldenberg Ronald , Brown Vivien 
Published: August 2016

OBJECTIVETo highlight the utility of a large patient registry to identify functionally refractory patients (persistent HbA1c ≥75 mmol/mol [9.0%]) with type 2 diabetes, identify their barriers to glycemic control, and implement barrier-specific care path strategies to improve glycemic control.RESEARCH DESIGN AND METHODSA working group developed a structured tool to optimize the collection of information on barriers to glycemic control and designed structured care paths to address each barrier. Participants were identified from a large Canadian registry and were assigned to a certified diabetes educator (CDE) as their case manager for a 12-month period to coordinate assessment of their barriers and to implement appropriate care path strategies. The primary outcome measure was the mean change in HbA1c from baseline at 12 months.RESULTSOverall, 3,662 refractory patients were initially identified of whom 1,379 were eligible for inclusion and 155 enrolled. The most common barrier categories participants identified were psychological/support (93%), socioeconomic (87%), and accessibility (82%), with high concordance (75–94%) between participant and CDE. No specific barriers were predictive of hyperglycemia. After implementation of barrier-specific care paths, the mean reduction in HbA1c at 12 months was 17 mmol/mol (1.5%; P &lt; 0.01 vs. baseline) versus only 5 mmol/mol (0.5%) in the source cohort (n = 966) who continued with standard care. The incidence of severe hypoglycemia did not change significantly during the study.CONCLUSIONSIn registry-identified hyperglycemic patients with type 2 diabetes, the use of barrier-specific care paths significantly improved glycemic control in otherwise refractory patients with persistently elevated HbA1c. Further studies using this strategy in other practice settings are warranted.
Intensification of Diabetes Therapy and Time Until A1C Goal Attainment Among Patients With Newly Diagnosed Type 2 Diabetes Who Fail Metformin Monotherapy Within a Large Integrated Health System
Authors: Pantalone Kevin M. , Wells Brian J. , Chagin Kevin M. , Ejzykowicz Flavia , Yu Changhong , Milinovich Alex , Bauman Janine M. , Kattan Michael W. , Rajpathak Swapnil , Zimmerman Robert S. 
Published: August 2016

OBJECTIVE
“Clinical inertia” has been used to describe the delay in the intensification of type 2 diabetes treatment among patients with poor glycemic control. Previous studies may have exaggerated the prevalence of clinical inertia by failing to adequately monitor drug dose changes and nonmedication interventions. This project evaluated the intensification of diabetes therapy and hemoglobin A1c (A1C) goal attainment among patients with newly diagnosed type 2 diabetes when metformin monotherapy failed.

RESEARCH DESIGN AND METHODS
The electronic health record at Cleveland Clinic was used to identify patients with newly diagnosed type 2 diabetes between 2005 and 2013 who failed to reach the A1C goal after 3 months of metformin monotherapy. A time-dependent survival analysis was used to compare the time until A1C goal attainment in patients who received early intensification of therapy (within 6 months of metformin failure) or late intensification. The analysis was performed for A1C goals of 7% (n = 1,168), 7.5% (n = 679), and 8% (n = 429).

RESULTS
Treatment was intensified early in 62%, 69%, and 72% of patients when poor glycemic control was defined as an A1C &gt;7%, &gt;7.5%, and &gt;8%, respectively. The probability of undergoing an early intensification was greater the higher the A1C category. Time until A1C goal attainment was shorter among patients who received early intensification regardless of the A1C goal (all P &lt; 0.05).

CONCLUSIONS
A substantial number of patients with newly diagnosed type 2 diabetes fail to undergo intensification of therapy within 6 months of metformin monotherapy failure. Early intervention in patients when metformin monotherapy failed resulted in more rapid attainment of A1C goals.
Endoscopic Duodenal Mucosal Resurfacing for the Treatment of Type 2 Diabetes: 6-Month Interim Analysis From the First-in-Human Proof-of-Concept Study
Authors: Rajagopalan Harith , Cherrington Alan D. , Thompson Christopher C. , Kaplan Lee M. , Rubino Francesco , Mingrone Geltrude , Becerra Pablo , Rodriguez Patricia , Vignolo Paulina , Caplan Jay , Rodriguez Leonardo , Galvao Neto Manoel P. 
Published: August 2016

OBJECTIVE
To assess procedural safety and glycemic indices at 6 months in a first-in-human study of duodenal mucosal resurfacing (DMR), a novel, minimally invasive, upper endoscopic procedure involving hydrothermal ablation of the duodenal mucosa, in patients with type 2 diabetes and HbA1c ≥7.5% (58 mmol/mol) on one or more oral antidiabetic agents.

RESEARCH DESIGN AND METHODS
Using novel balloon catheters, DMR was conducted on varying lengths of duodenum in anesthetized patients at a single medical center.

RESULTS
A total of 39 patients with type 2 diabetes (screening HbA1c 9.5% [80 mmol/mol]; BMI 31 kg/m2) were treated and included in the interim efficacy analysis: 28 had a long duodenal segment ablated (LS; ∼9.3 cm treated) and 11 had a short segment ablated (SS; ∼3.4 cm treated). Overall, DMR was well tolerated with minimal gastrointestinal symptoms postprocedure. Three patients experienced duodenal stenosis treated successfully by balloon dilation. HbA1c was reduced by 1.2% at 6 months in the full cohort (P &lt; 0.001). More potent glycemic effects were observed among the LS cohort, who experienced a 2.5% reduction in mean HbA1c at 3 months postprocedure vs. 1.2% in the SS group (P &lt; 0.05) and a 1.4% reduction at 6 months vs. 0.7% in the SS group (P = 0.3). This occurred despite net medication reductions in the LS cohort between 0 and 6 months. Among LS patients with a screening HbA1c of 7.5–10% (58–86 mmol/mol) and on stable antidiabetic medications postprocedure, HbA1c was reduced by 1.8% at 6 months (P &lt; 0.01).

CONCLUSIONS
Single-procedure DMR elicits a clinically significant improvement in hyperglycemia in patients with type 2 diabetes in the short-term, with acceptable safety and tolerability. Long-term safety, efficacy, and durability and possible mechanisms of action require further investigation.
Benefits of LixiLan, a Titratable Fixed-Ratio Combination of Insulin Glargine Plus Lixisenatide, Versus Insulin Glargine and Lixisenatide Monocomponents in Type 2 Diabetes Inadequately Controlled on Oral Agents: The LixiLan-O Randomized Trial
Authors: Rosenstock Julio , Aronson Ronnie , Grunberger George , Hanefeld Markolf , Piatti PierMarco , Serusclat Pierre , Cheng Xi , Zhou Tianyue , Niemoeller Elisabeth , Souhami Elisabeth , Davies Melanie ,   on behalf of the LixiLan-O Trial Investigators
Published: August 2016

OBJECTIVE
To evaluate efficacy and safety of LixiLan (iGlarLixi), a novel titratable fixed-ratio combination of insulin glargine (iGlar) and lixisenatide (Lixi), compared with both components, iGlar and Lixi, given separately in type 2 diabetes inadequately controlled on metformin with or without a second oral glucose-lowering drug.

RESEARCH DESIGN AND METHODS
After a 4-week run-in to optimize metformin and stop other oral antidiabetic drugs, participants (N = 1,170, mean diabetes duration ∼8.8 years, BMI ∼31.7 kg/m2) were randomly assigned to open-label once-daily iGlarLixi or iGlar, both titrated to fasting plasma glucose &lt;100 mg/dL (&lt;5.6 mmol/L) up to a maximum insulin dose of 60 units/day, or to once-daily Lixi (20 μg/day) while continuing with metformin. The primary outcome was HbA1c change at 30 weeks.

RESULTS
Greater reductions in HbA1c from baseline (8.1% [65 mmol/mol]) were achieved with iGlarLixi compared with iGlar and Lixi (−1.6%, −1.3%, −0.9%, respectively), reaching mean final HbA1c levels of 6.5% (48 mmol/mol) for iGlarLixi versus 6.8% (51 mmol/mol) and 7.3% (56 mmol/mol) for iGlar and Lixi, respectively (both P &lt; 0.0001). More subjects reached target HbA1c &lt;7% with iGlarLixi (74%) versus iGlar (59%) or Lixi (33%) (P &lt; 0.0001 for all). Mean body weight decreased with iGlarLixi (−0.3 kg) and Lixi (−2.3 kg) and increased with iGlar (+1.1 kg, difference 1.4 kg, P &lt; 0.0001). Documented symptomatic hypoglycemia (≤70 mg/dL) was similar with iGlarLixi and iGlar (1.4 and 1.2 events/patient-year) and lower with Lixi (0.3 events/patient-year). iGlarLixi improved postprandial glycemic control versus iGlar and demonstrated considerably fewer nausea (9.6%) and vomiting (3.2%) events than Lixi (24% and 6.4%, respectively).

CONCLUSIONS
iGlarLixi complemented iGlar and Lixi effects to achieve meaningful HbA1c reductions, close to near normoglycemia without increases in either hypoglycemia or weight, compared with iGlar, and had low gastrointestinal adverse effects compared with Lixi.
Homogenization via unfolding in periodic layer with contact
Authors: Griso Georges , Migunova Anastasia , Orlik Julia 
Published: August 2016

The elasticity problem for two domains separated by a heterogeneous layer of the thickness ε is considered. The layer has an ε-periodic structure, [Formula: see text], including a multiple cracks and the contact between the structural components. The inclusions are surrounded by cracks and can have rigid displacements. The contacts are described by the Signorini and Tresca-friction conditions. In order to obtain preliminary estimates, a modification of the Korn inequality for the ε-dependent periodic layer is performed. An asymptotic analysis with respect to [Formula: see text] is provided and the limit elasticity problem is obtained, together with the transmission condition across the interface. The periodic unfolding method is used to study the limit behavior.
NEW LIMITS ON THERMALLY ANNIHILATING DARK MATTER FROM NEUTRINO TELESCOPES
Authors: Lopes J. , Lopes I. 
Published: August 2016

ABSTRACT
We used a consistent and robust solar model to obtain upper limits placed by neutrino telescopes, such as IceCube and Super-Kamiokande, on the dark matter-nucleon scattering cross-section, for a general model of dark matter with a velocity dependent (p-wave) thermally averaged cross-section. In this picture, the Boltzmann equation for the dark matter abundance is numerically solved, satisfying the dark matter density measured from the cosmic microwave background. We show that for lower cross-sections and higher masses, the dark matter annihilation rate drops sharply, resulting in upper bounds on the scattering cross-section that are one order of magnitude above those derived from a velocity independent (s-wave) annihilation cross-section. Our results show that upper limits on the scattering cross-section obtained from dark matter annihilating in the Sun are sensible to the uncertainty in current standard solar models, fluctuating by a maximum of 20% depending on the annihilation channel.
SYNTHETIC HYDROGEN SPECTRA OF OSCILLATING PROMINENCE SLABS IMMERSED IN THE SOLAR CORONA
Authors: Zapiór M. , Oliver R. , Ballester J. L. , Heinzel P. 
Published: August 2016

ABSTRACT
We study the behavior of Hα and Hβ spectral lines and their spectral indicators in an oscillating solar prominence slab surrounded by the solar corona, using an MHD model combined with a 1D radiative transfer code taken in the line of sight perpendicular to the slab. We calculate the time variation of the Doppler shift, half-width, and maximum intensity of the Hα and Hβ spectral lines for different modes of oscillation. We find a non-sinusoidal time dependence of some spectral parameters with time. Because Hα and Hβ spectral indicators have different behavior for different modes, caused by differing optical depths of formation and different plasma parameter variations in time and along the slab, they may be used for prominence seismology, especially to derive the internal velocity field in prominences.
COMPLEX HYDROCARBON CHEMISTRY IN INTERSTELLAR AND SOLAR SYSTEM ICES REVEALED: A COMBINED INFRARED SPECTROSCOPY AND REFLECTRON TIME-OF-FLIGHT MASS SPECTROMETRY ANALYSIS OF ETHANE (C2H6) AND D6-ETHANE (C2D6) ICES EXPOSED TO IONIZING RADIATION
Authors: Abplanalp Matthew J. , Kaiser Ralf I. 
Published: August 2016

ABSTRACT
The irradiation of pure ethane (C2H6/C2D6) ices at 5.5 K, under ultrahigh vacuum conditions was conducted to investigate the formation of complex hydrocarbons via interaction with energetic electrons simulating the secondary electrons produced in the track of galactic cosmic rays. The chemical modifications of the ices were monitored in situ using Fourier transform infrared spectroscopy (FTIR) and during temperature-programmed desorption via mass spectrometry exploiting a quadrupole mass spectrometer with electron impact ionization (EI-QMS) as well as a reflectron time-of-flight mass spectrometer coupled to a photoionization source (PI-ReTOF-MS). FTIR confirmed previous ethane studies by detecting six molecules: methane (CH4), acetylene (C2H2), ethylene (C2H4), the ethyl radical (C2H5), 1-butene (C4H8), and n-butane (C4H10). However, the TPD phase, along with EI-QMS, and most importantly, PI-ReTOF-MS, revealed the formation of at least 23 hydrocarbons, many for the first time in ethane ice, which can be arranged in four groups with an increasing carbon-to-hydrogen ratio: C
n
H2n+2 (n = 3, 4, 6, 8, 10), C
n
H2n
(n = 3–10),

(n = 3–10), and

(n = 4–6). The processing of simple ethane ices is relevant to the hydrocarbon chemistry in the interstellar medium, as ethane has been shown to be a major product of methane, as well as in the outer solar system. These data reveal that the processing of ethane ices can synthesize several key hydrocarbons such as C3H4 and C4H6 isomers, which haÂ­ve been found to synthesize polycyclic aromatic hydrocarbons like indene (C9H8) and naphthaÂ­lene (C10H8) in the ISM and in hydrocarbon-rich atmospheres of planets and their moons such as Titan.
THE ROLE OF COSMIC-RAY PRESSURE IN ACCELERATING GALACTIC OUTFLOWS
Authors: Simpson Christine M. , Pakmor Rüdiger , Marinacci Federico , Pfrommer Christoph , Springel Volker , Glover Simon C. O. , Clark Paul C. , Smith Rowan J. 
Published: August 2016

ABSTRACT
We study the formation of galactic outflows from supernova (SN) explosions with the moving-mesh code AREPO in a stratified column of gas with a surface density similar to the Milky Way disk at the solar circle. We compare different simulation models for SN placement and energy feedback, including cosmic rays (CRs), and find that models that place SNe in dense gas and account for CR diffusion are able to drive outflows with similar mass loading as obtained from a random placement of SNe with no CRs. Despite this similarity, CR-driven outflows differ in several other key properties including their overall clumpiness and velocity. Moreover, the forces driving these outflows originate in different sources of pressure, with the CR diffusion model relying on non-thermal pressure gradients to create an outflow driven by internal pressure and the random-placement model depending on kinetic pressure gradients to propel a ballistic outflow. CRs therefore appear to be non-negligible physics in the formation of outflows from the interstellar medium.
QUASI-PERIODIC PULSATIONS DURING THE IMPULSIVE AND DECAY PHASES OF AN X-CLASS FLARE
Authors: Hayes L. A. , Gallagher P. T. , Dennis B. R. , Ireland J. , Inglis A. R. , Ryan D. F. 
Published: August 2016

ABSTRACT
Quasi-periodic pulsations (QPPs) are often observed in X-ray emission from solar flares. To date, it is unclear what their physical origins are. Here, we present a multi-instrument investigation of the nature of QPP during the impulsive and decay phases of the X1.0 flare of 2013 October 28. We focus on the character of the fine structure pulsations evident in the soft X-ray (SXR) time derivatives and compare this variability with structure across multiple wavelengths including hard X-ray and microwave emission. We find that during the impulsive phase of the flare, high correlations between pulsations in the thermal and non-thermal emissions are seen. A characteristic timescale of ∼20 s is observed in all channels and a second timescale of ∼55 s is observed in the non-thermal emissions. SXR pulsations are seen to persist into the decay phase of this flare, up to 20 minutes after the non-thermal emission has ceased. We find that these decay phase thermal pulsations have very small amplitude and show an increase in characteristic timescale from ∼40 s up to ∼70 s. We interpret the bursty nature of the co-existing multi-wavelength QPPs during the impulsive phase in terms of episodic particle acceleration and plasma heating. The persistent thermal decay phase QPPs are most likely connected with compressive magnetohydrodynamic processes in the post-flare loops such as the fast sausage mode or the vertical kink mode.
Patients with Systemic Sclerosis/polymyositis Overlap Have a Worse Survival Rate Than Patients Without It
Authors: Bhansing Kavish J. , van Riel Piet L.C.M. , van Engelen Baziel G.M. , Fransen Jaap , Vonk Madelon C. 
Published: August 2016

Objective.Studies on mortality associated with patients with systemic sclerosis (SSc) and myopathy have been limited by heterogeneous definitions of muscle involvement. The objective of this study is to determine whether homogeneous-defined SSc/polymyositis overlap (SSc-PM overlap) is associated with a worse survival rate compared with SSc without PM.Methods.Data from the Nijmegen Systemic Sclerosis cohort were used. Incidence rates were calculated from the observed number of deaths and followup time. Survival analysis using Cox proportional hazard modeling was performed to compare survival among patients with SSc and patients with SSc-PM overlap, including controlling for confounders. All patients with SSc-PM fulfilled the Bohan and Peter criteria for PM.Results.There were 24 patients with SSc-PM (5.7%) and 396 patients with SSc (94.2%). The 5- and 10-year cumulative survival rates from diagnosis were 82% and 68% for the SSc-PM group and 93% and 87% for the SSc group, respectively. Multivariate survival analysis revealed an adjusted HR of 2.34 (95% CI 1.09–5.02) for SSc-PM compared with SSc, with age at diagnosis, modified Rodnan skin score, diffuse cutaneous subtype, and male sex included as confounders. The most common cause of death among patients with SSc-PM overlap was cardiopulmonary involvement (63%), which was similar to the patients with SSc (51%).Conclusion.Patients with SSc-PM overlap have a worse survival rate compared with patients with SSc.
Cutting Edge: Marginal Zone Macrophages Regulate Antigen Transport by B Cells to the Follicle in the Spleen via CD21
Authors: Prokopec Kajsa E. , Georgoudaki Anna-Maria , Sohn Silke , Wermeling Fredrik , Grönlund Hans , Lindh Emma , Carroll Michael C. , Karlsson Mikael C. I. 
Published: August 2016

Abstract
Marginal zone macrophages (MZM) are strategically located in the spleen, lining the marginal sinus where they sense inflammation and capture Ag from the circulation. One of the receptors expressed by MZM is scavenger receptor macrophage receptor with collagenous structure (MARCO), which has affinity for modified self-antigens. In this article, we show that engagement of MARCO on murine macrophages induces extracellular ATP and loss of CD21 and CD62L on marginal zone B cells. Engagement of MARCO also leads to reduction of Ag transport by marginal zone B cells and affects the subsequent immune response. This study highlights a novel function for MZM in regulating Ag transport and activation, and we suggest that MARCO-dependent ATP release regulates this through shedding of CD21 and CD62L. Because systemic lupus erythematosus patients were shown to acquire autoantibodies against MARCO, this highlights a mechanism that could affect a patient’s ability to combat infections.
Essential Requirement for IFN Regulatory Factor 7 in Autoantibody Production but Not Development of Nephritis in Murine Lupus
Authors: Miyagawa Fumi , Tagaya Yutaka , Ozato Keiko , Asada Hideo 
Published: August 2016

Abstract
Systemic lupus erythematosus (SLE) is a prototypic systemic autoimmune disease characterized by the production of autoantibodies against nuclear components. Recent genetic studies of SLE patients have revealed that IFN regulatory factor (IRF) 7 gene polymorphisms are associated with an increased risk of SLE, but the precise role of IRF7 in SLE development is not fully understood. We investigated the role of IRF7 in the pathogenesis of SLE using a mouse model and saw a curious dissociation of autoantibody production and development of glomerulonephritis. SLE was chemically induced into IRF7-deficient mice, and glomerulonephritis with deposits of IgG and lipogranulomas were observed after 10 mo. However, these mice failed to produce anti-dsDNA, ssDNA, ribonucleoprotein, and Sm autoantibodies. Following the chemical induction, IRF7-deficient mice expressed substantially lower levels of IFN-stimulated genes than did wild-type mice, but NF-κB target genes were equally upregulated in both strains. Therefore, the type I IFN pathway seems critical for the autoantibody production, but the NF-κB activation is sufficient for the development of glomerulonephritis in this model. Our study thus demonstrates a specific requirement for IRF7 in autoantibody production and uncovers a new layer of complexity in the pathogenesis of SLE.
Attitudes of health service providers: the perspective of Persons with Disabilities in the Kumasi Metropolis of Ghana
Authors: Badu Eric , Opoku Maxwell P. , Appiah Seth C.Y. 
Published: August 2016

Introduction: Awareness of disability issues has gained considerable interest by advocacy groups in recent years. However, it is uncertain whether attitudes and perceptions of all service providers and society have adjusted accordingly towards the health care of people with disabilities. This study sought to examine the attitudes of health providers from the perspective of people with disabilities in the Kumasi Metropolis. Methods: A cross-sectional study using semi-structured questionnaires was conducted with people with disabilities (with physical, hearing and visual impairments,) in the Kumasi Metropolis. The study used a multi-stage sampling involving cluster and simple random sampling to select 255 respondents split amongst the following five clusters of communities; Oforikrom, Subin, Asewase, Tafo and Asokwa. Data were analysed using STATA 14 and presented in descriptive and inferential statistics. Results: The study found that 71% of the respondents faced some form of discrimination including the use of derogatory remarks, frustration and unavailable required services on the basis of their disability, the type of services they need and the location. Women were 3.89 times more likely to face discrimination; Adjusted odds ratio (AOR) = 3.89 (95% confidence interval [CI]; 1.41, 10.76), and visually impaired was more likely to be discriminated at the facility compared with physical disability; AOR = 5.05 (95% CI; 1.44, 17.65). However, respondents with some educational qualification and those who stayed with their family members were less likely to face discrimination; AOR = 0.08 (95% CI; 0.01, 0.39). Conclusion: The study recommends the provision of in-service training for service providers to update their knowledge on disability issues and improve access to services for people with disabilities.