bluuebunny/crossref_metadata_2025_split huggingface dataset:
Differential Associations of Oral Glucose Tolerance Test–Derived Measures of Insulin Sensitivity and Pancreatic β-Cell Function With Coronary Artery Calcification and Microalbuminuria in Type 2 Diabetes
Authors: Mulvey Claire K. , McNeill Ann M. , Girman Cynthia J. , Churchill Timothy W. , Terembula Karen , Ferguson Jane F. , Shah Rachana , Mehta Nehal N. , Qasim Atif N. , Rickels Michael R. , Reilly Muredach P. 
Published: August 2013

OBJECTIVE
We evaluated relationships of oral glucose tolerance testing (OGTT)–derived measures of insulin sensitivity and pancreatic β-cell function with indices of diabetes complications in a cross-sectional study of patients with type 2 diabetes who are free of overt cardiovascular or renal disease.

RESEARCH DESIGN AND METHODS
A subset of participants from the Penn Diabetes Heart Study (n = 672; mean age 59 ± 8 years; 67% male; 60% Caucasian) underwent a standard 2-h, 75-g OGTT. Insulin sensitivity was estimated using the Matsuda Insulin Sensitivity Index (ISI), and β-cell function was estimated using the Insulinogenic Index. Multivariable modeling was used to analyze associations between quartiles of each index with coronary artery calcification (CAC) and microalbuminuria.

RESULTS
The Insulinogenic Index and Matsuda ISI had distinct associations with cardiometabolic risk factors. The top quartile of the Matsuda ISI had a negative association with CAC that remained significant after adjusting for traditional cardiovascular risk factors (Tobit ratio −0.78 [95% CI −1.51 to −0.05]; P = 0.035), but the Insulinogenic Index was not associated with CAC. Conversely, the highest quartile of the Insulinogenic Index, but not the Matsuda ISI, was associated with lower odds of microalbuminuria (OR 0.52 [95% CI 0.30–0.91]; P = 0.022); however, this association was attenuated in models that included duration of diabetes.

CONCLUSIONS
Lower β-cell function is associated with microalbuminuria, a microvascular complication, while impaired insulin sensitivity is associated with higher CAC, a predictor of macrovascular complications. Despite these pathophysiological insights, the Matsuda ISI and Insulinogenic Index are unlikely to be translated into clinical use in type 2 diabetes beyond established clinical variables, such as obesity or duration of diabetes.
Risk of Metabolic Syndrome and Diabetes Among Young Twins and Singletons in Guinea-Bissau
Authors: Bjerregaard-Andersen Morten , Hansen Lone , da Silva Leontina I. , Joaquím Luis C. , Hennild Ditte E. , Christiansen Lene , Aaby Peter , Benn Christine S. , Christensen Kaare , Sodemann Morten , Jensen Dorte M. , Beck-Nielsen Henning 
Published: August 2013

OBJECTIVE
Twins in Africa may be at increased risk of metabolic disorders due to strained conditions in utero, including high exposure to infections. We studied metabolic syndrome (MS) and diabetes mellitus (DM) among young twins and singletons in Guinea-Bissau.

RESEARCH DESIGN AND METHODS
The study was cross-sectional and occurred from October 2009 until August 2011 at the Bandim Health Project, a demographic surveillance site in the capital Bissau. Twins and singleton controls between 5 and 32 years were visited at home. Fasting blood samples for metabolic measurements were collected. Zygosity was established genetically for a subset. DM was defined as HbA1c ≥6.5% (48 mmol/mol) and MS by the International Diabetes Federation criteria.

RESULTS
HbA1c was available for 574 twins and 463 singletons. Mean age was 15.3 years versus 15.8 years, respectively. Eighteen percent of twins were monozygotic. There were no DM cases among twins but one among singletons. A total of 1.4% (8 of 574) of twins had elevated HbA1c (6.0–6.4%, 42–46 mmol/mol) compared with 2.4% (11 of 463) of singletons (P = 0.28). Mean HbA1c was 5.3% (34 mmol/mol) for both groups. MS data were available for 364 twins and 360 singletons. The MS prevalence was 3.0% (11 of 364) among twins and 3.6% (13 of 360) among singletons (P = 0.66). The prevalence of fasting blood glucose (F-glucose) ≥5.6 mmol/L was 34.9% (127 of 364) for twins versus 24.7% (89 of 360) for singletons (P = 0.003). Median homeostasis model assessment–insulin resistance did not differ (P = 0.34).

CONCLUSIONS
The MS and DM prevalences among young individuals in Guinea-Bissau were low. Twins did not have a higher MS and DM burden than singletons, though elevated F-glucose was more common among twins.
Chronic Fatigue in Type 1 Diabetes: Highly Prevalent but Not Explained by Hyperglycemia or Glucose Variability
Authors: Goedendorp Martine M. , Tack Cees J. , Steggink Elles , Bloot Lotte , Bazelmans Ellen , Knoop Hans 
Published: August 2013

OBJECTIVE
Fatigue is a classical symptom of hyperglycemia, but the relationship between chronic fatigue and diabetes has not been systematically studied. We investigated prevalence, impact, and potential determinants of chronic fatigue in patients with type 1 diabetes mellitus (T1DM).

RESEARCH DESIGN AND METHODS
Out of 324 randomly selected T1DM outpatients, 214 participated in this cross-sectional observational study. Participants were compared with age- and sex-matched population-based controls. Chronic fatigue, functional impairments, current health status, comorbidity, diabetes-related factors, and fatigue-related cognitions and behaviors were assessed with questionnaires, and HbA1c values and comorbidity were assessed with medical records. Sixty-six patients underwent continuous glucose monitoring combined with an electronic fatigue diary for 5 days. Acute fatigue and four glucose parameters were determined: mean, variability, and relative time spent in hypoglycemia and hyperglycemia.

RESULTS
T1DM patients were significantly more often chronically fatigued (40%; 95% CI 34–47%) compared with matched controls (7%; 95% CI 3–10%; P &lt; 0.001). Chronically fatigued patients had significantly more functional impairments. Fatigue was the most troublesome symptom. Age, depression, pain, sleeping problems, low self-efficacy concerning fatigue, and physical inactivity were significantly associated with chronic fatigue. Chronically fatigued patients spent slightly less time in hypoglycemia (proportion 0.07 ± 0.06 vs. 0.12 ± 0.10; P = 0.025). Glucose parameters were not related to acute fatigue.

CONCLUSIONS
Chronic fatigue is highly prevalent and clinically relevant in T1DM. Its significant relationship with cognitive behavioral variables and weak association with blood glucose levels suggests that behavioral interventions could be helpful in managing chronic fatigue in T1DM.
Intraventricular and lumbar intrathecal administration of antibiotics in postneurosurgical patients with meningitis and/or ventriculitis in a serious clinical state
Authors: Remeš František , Tomáš Robert , Jindrák Vlastimil , Vaniš Václav , Šetlík Michal 
Published: August 2013

Object
To date, reports on the clinical efficacy of intraventricularly and intrathecally administered antibiotics for the treatment of neurosurgical ventriculitis and meningitis in adults are limited. The authors aimed to evaluate the efficacy and safety of the intraventricular (IVT) and lumbar intrathecal (IT) administration of antibiotics in critically ill neurosurgical patients.

Methods
Thirty-four postneurosurgical patients with meningitis and ventriculitis were studied. Intraventricular/lumbar intrathecal antibiotics were administered due to positive CSF cultures persisting despite the use of intravenous antibiotics. The time period until CSF sterilization, changes in clinical state, and efficacy of different routes of antibiotic administration were evaluated.

Results
The mean time necessary to obtain CSF sterilization was 2.9 ± 2.7 days (range 1–12 days). The CSF cultures became negative within 24 hours after the administration of IVT/IT antibiotics in 17 patients (50%) and up to 48 hours in a further 6 patients (18%). The clinical outcome of patients assessed by the modified Rankin Scale improved in 17 patients (50%), stayed unchanged in 10 patients (29%), and was impaired in 1 patient (3%). Six patients (18%) died; however, 2 of them died due to reasons not directly related to meningitis or ventriculitis, so the overall mortality rate for meningitis and/or ventriculitis was 11.8% in this group of patients. All patients with ventriculitis (n = 4) were treated by antibiotics administered via the IVT route. The average time to CSF sterilization was 6.5 days in the patients with ventriculitis. Thirty patients had clinical signs of meningitis without ventriculitis. Despite the higher ratio of unfavorable Gram-negative meningitis in the subgroup of patients treated via lumbar drainage, the mean duration of CSF sterilization was 2.2 days compared with 2.6 days in the subgroup treated via external ventricular drainage, a difference that was not statistically significant (p = 0.3). Adverse effects of IVT/IT antibiotics appeared in 3 of 34 patients and were of low clinical significance.

Conclusions
Intraventricular/lumbar intrathecal antibiotics can lead to very quick CSF sterilization in postneurosurgical patients with meningitis and ventriculitis. The relapse rate of meningitis and/or ventriculitis is also very low among patients treated by IVT/IT antibiotics. Intraventricular/lumbar intrathecal administration of antibiotics appears to be an effective and safe treatment for infections of the CNS caused by multidrug-resistant organisms. In patients with signs of ventriculitis, the authors prefer the IVT route of antibiotics. This study did not prove a lower efficacy of administration of antibiotics via lumbar drainage compared with the ventricular route in patients with meningitis.
Phase II clinical study on intraoperative photodynamic therapy with talaporfin sodium and semiconductor laser in patients with malignant brain tumors
Authors: Muragaki Yoshihiro , Akimoto Jiro , Maruyama Takashi , Iseki Hiroshi , Ikuta Soko , Nitta Masayuki , Maebayashi Katsuya , Saito Taiichi , Okada Yoshikazu , Kaneko Sadao , Matsumura Akira , Kuroiwa Toshihiko , Karasawa Katsuyuki , Nakazato Yoichi , Kayama Takamasa 
Published: August 2013

Object
The objective of the present study was to perform a prospective evaluation of the potential efficacy and safety of intraoperative photodynamic therapy (PDT) using talaporfin sodium and irradiation using a 664-nm semiconductor laser in patients with primary malignant parenchymal brain tumors.

Methods
In 27 patients with suspected newly diagnosed or recurrent primary malignant parenchymal brain tumors, a single intravenous injection of talaporfin sodium (40 mg/m2) was administered 1 day before resection of the neoplasm. The next day after completion of the tumor removal, the residual lesion and/or resection cavity were irradiated using a 664-nm semiconductor laser with a radiation power density of 150 mW/cm2 and a radiation energy density of 27 J/cm2. The procedure was performed 22–27 hours after drug administration. The study cohort included 22 patients with a histopathologically confirmed diagnosis of primary malignant parenchymal brain tumor. Thirteen of these neoplasms (59.1%) were newly diagnosed glioblastomas multiforme (GBM).

Results
Among all 22 patients included in the study cohort, the 12-month overall survival (OS), 6-month progression-free survival (PFS), and 6-month local PFS rates after surgery and PDT were 95.5%, 91%, and 91%, respectively. Among patients with newly diagnosed GBMs, all these parameters were 100%. Side effects on the skin, which could be attributable to the administration of talaporfin sodium, were noted in 7.4% of patients and included rash (2 cases), blister (1 case), and erythema (1 case). Skin photosensitivity test results were relatively mild and fully disappeared within 15 days after administration of photosensitizer in all patients.

Conclusions
Intraoperative PDT using talaporfin sodium and a semiconductor laser may be considered as a potentially effective and sufficiently safe option for adjuvant management of primary malignant parenchymal brain tumors. The inclusion of intraoperative PDT in a combined treatment strategy may have a positive impact on OS and local tumor control, particularly in patients with newly diagnosed GBMs. Clinical trial registration no.: JMA-IIA00026 (https://dbcentre3.jmacct.med.or.jp/jmactr/App/JMACTRS06/JMACTRS06.aspx?seqno=862).
Hemorrhage risk, surgical management, and functional outcome of brainstem cavernous malformations
Authors: Li Da , Yang Yang , Hao Shu-Yu , Wang Liang , Tang Jie , Xiao Xin-Ru , Zhou Hui , Jia Gui-Jun , Wu Zhen , Zhang Li-Wei , Zhang Jun-Ting 
Published: August 2013

Object
The aim of this study was to evaluate the pre- and postoperative rehemorrhage risk, neurological function outcome, and prognostic factors of surgically treated brainstem cavernous malformations (CMs) with long-term follow-up.

Methods
The authors conducted a retrospective review of the clinical data from 242 patients with brainstem CMs that were surgically treated between 1999 and 2010. Patient charts, imaging findings, and outcomes were examined.

Results
The study included 242 patients, with a male-to-female ratio of 1.3 and mean age of 32.6 years. The mean modified Rankin Scale scores on admission, at discharge, at 3 and 6 months after surgery, and at recent evaluation were 2.2, 2.6, 2.3, 1.8, and 1.5, respectively. The preoperative calculated annual hemorrhage and rehemorrhage rates were 5.0% and 60.9%, respectively. The complete resection rate was 95%. Surgical morbidity occurred in 112 patients (46.3%). Eighty-five patients (35.1%) demonstrated worsened condition immediately after surgery; 34 (41.0%) and 51 (61.4%) of these patients recovered to their baseline level within 3 and 6 months after surgery, respectively. At a mean follow-up of 89.4 months, the patients' condition had improved in 147 cases (60.7%), was unchanged in 70 cases (28.9%), and had worsened in 25 cases (10.3%). A total of 8 hemorrhages occurred in 6 patients, and the postoperative annual hemorrhage rate was 0.4%. Permanent morbidity remained in 65 patients (26.9%). The adverse factors for preoperative rehemorrhage were age ≥ 50 years, size ≥ 2 cm, and perilesional edema. The risk factors for postoperative hemorrhage were developmental venous anomaly and incomplete resection. The independent adverse factors for long-term outcome were increased age, multiple hemorrhages, ventral-seated lesions, and poor preoperative status. Favorable, complete improvement in the postoperative deficits over time was correlated with good preoperative neurological function and continuing improvement thereafter.

Conclusions
Favorable long-term outcomes and significantly low postoperative annual hemorrhage rates were achieved via surgery. Total resection should be attempted with an aim of minimal injury to neurological function; however, postoperative deficits can improve during the postoperative course. Close follow-up with radiological examination is proposed for patients with adverse factors predictive of rehemorrhage.
A novel 3D guidance system using augmented reality for percutaneous vertebroplasty
Authors: Abe Yuichiro , Sato Shigenobu , Kato Koji , Hyakumachi Takahiko , Yanagibashi Yasushi , Ito Manabu , Abumi Kuniyoshi 
Published: August 2013

Augmented reality (AR) is an imaging technology by which virtual objects are overlaid onto images of real objects captured in real time by a tracking camera. This study aimed to introduce a novel AR guidance system called virtual protractor with augmented reality (VIPAR) to visualize a needle trajectory in 3D space during percutaneous vertebroplasty (PVP).
The AR system used for this study comprised a head-mount display (HMD) with a tracking camera and a marker sheet. An augmented scene was created by overlaying the preoperatively generated needle trajectory path onto a marker detected on the patient using AR software, thereby providing the surgeon with augmented views in real time through the HMD. The accuracy of the system was evaluated by using a computer-generated simulation model in a spine phantom and also evaluated clinically in 5 patients.
In the 40 spine phantom trials, the error of the insertion angle (EIA), defined as the difference between the attempted angle and the insertion angle, was evaluated using 3D CT scanning. Computed tomography analysis of the 40 spine phantom trials showed that the EIA in the axial plane significantly improved when VIPAR was used compared with when it was not used (0.96° ± 0.61° vs 4.34° ± 2.36°, respectively). The same held true for EIA in the sagittal plane (0.61° ± 0.70° vs 2.55° ± 1.93°, respectively).
In the clinical evaluation of the AR system, 5 patients with osteoporotic vertebral fractures underwent VIPAR-guided PVP from October 2011 to May 2012. The postoperative EIA was evaluated using CT. The clinical results of the 5 patients showed that the EIA in all 10 needle insertions was 2.09° ± 1.3° in the axial plane and 1.98° ± 1.8° in the sagittal plane. There was no pedicle breach or leakage of polymethylmethacrylate.
VIPAR was successfully used to assist in needle insertion during PVP by providing the surgeon with an ideal insertion point and needle trajectory through the HMD. The findings indicate that AR guidance technology can become a useful assistive device during spine surgeries requiring percutaneous procedures.
Disease Factors in Early Rheumatoid Arthritis Are Associated with Differential Risks for Cardiovascular Events and Mortality Depending on Age at Onset: A 10-year Observational Cohort Study
Authors: Ajeganova Sofia , Andersson Maria L.E. , Frostegård Johan , Hafström Ingiäld 
Published: August 2013

Objective.To investigate, within the first 2 years of diagnosis with rheumatoid arthritis (RA), associations between disease-related measures and cardiovascular disease (CVD) and mortality in patients with RA onset before and after 65 years of age.Methods.The study population (n = 741; 67.5% women) was derived from the Better Anti-Rheumatic Pharmaco Therapy (BARFOT) early RA cohort, recruited 1993–1999. The mean age was 55 years (SD 14.7). The outcomes were incident CVD events and all-cause mortality until 2010. Area under the curve (AUC) for disease measures at inclusion, 1 and 2 years, and decrease in measures after 1 year were calculated.Results.In all, 177 CVD events and 151 deaths occurred over 10 years of observation. In adjusted Cox regression analyses, seropositivity for rheumatoid factor (RF) or anticitrullinated protein antibodies (ACPA); white blood (cell) count at diagnosis; and AUC of C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), and visual analog scale (VAS)-pain were associated with higher CVD risk among patients with disease onset before 65 years of age. Among patients with disease onset after 65 years, larger decreases in CRP, ESR, health assessment questionnaire (HAQ), and use of methotrexate decreased CVD risk, whereas use of glucocorticoids heightened CVD risk. AUC of CRP, ESR, HAQ, and HAQ after 2 years was related to risk of death in both age groups. Seropositivity and AUC for VAS-pain in the younger group and use of glucocorticoids in the elderly were associated with poorer survival.Conclusion.Early treatment of RA may improve longterm outcomes. Presence of RF or ACPA associates with CVD and mortality among RA patients with disease onset before 65 years. Age stratification may improve evaluation of risk for CVD and mortality in early RA.
Corneal Ectasia After LASIK in a Patient With Normal Scheimpflug Evaluation but a High Ectasia Risk Score
Authors: Goncalves Fauze Abdulmassih , Goncalves José Marcos Santos 
Published: August 2013

PURPOSE:
To present a case of ectasia after LASIK that developed in a patient with normal Scheimpflug imaging but a high Ectasia Risk Score System (ERSS) score.

METHODS:
Case report.

RESULTS:
A 24-year-old woman with no preoperative abnormalities on Scheimpflug evaluation but a cumulative ERSS risk of 4 (high risk) in the right eye and 3 (medium risk) in the left eye developed ectasia in both eyes 27 months after LASIK. She underwent ultraviolet-A corneal collagen cross-linking, with no signs of further progression.

CONCLUSIONS:
In this case, the ERSS was effective at predicting ectasia risk despite normal Scheimpflug imaging and only mild asymmetry on Placido topography.

[
J Refract Surg.
2013;29(11):792–795.]
Préparation à la certification en français dans le contexte universitaire tunisien. Quels dispositifs spécifiques pour les étudiants en mastère ?
Authors: Msalmi Mohamed 
Published: August 2013

Partant de la dynamique qui caractérise actuellement l’enseignement-apprentissage des langues étrangères dans le contexte tunisien, l’objectif de cet article est de présenter un projet d’implantation de la certification en langue française en milieu universitaire après l’adoption du système LMD.La présentation est suivie du compte rendu d’une expérimentation didactique que nous avons réalisée à la Faculté des sciences économiques et de gestion de Sfax (FSEGS) autour de l’élément constitutif d’une unité d’enseignement, intitulé « français : préparation à la certification » et intégré aux programmes de deux mastères en informatique appliquée.Les données ont été recueillies grâce à une double enquête menée auprès des étudiants des deux mastères (recherche et professionnel) et de leurs enseignants de français de spécialité, au cours du premier semestre de l’année universitaire 2010-2011.
Enhancing L2 learners’ noticing skills through self-confrontation with their own oral production performance
Authors: Guichon Nicolas , Cohen Cathy 
Published: August 2013

The central issue of the pilot study on which this article is based concerns the potential role of metacognition in the development of second language (L2) competence, specifically when L2 learners are confronted with their own videoed oral performance. An experiment was carried out at a French university with a group of first-year non-specialist undergraduate learners of English (N=12). The collected data for this research are comprised of (1) the filmed performance of learners carrying out an oral task in English, and (2) the filmed interview in French of the same participants engaged in metacognitive reflection upon samples of their own performance. The study thus endeavours to determine the potential of self-confrontation, represented here by retrospective interviews of learners based on their own video-recorded language performance, as a way to develop noticing skills in L2.
L’approche projet et la recherche en langues : quels enjeux ?
Authors: Bertin Jean-Claude 
Published: August 2013

Les modes de financement de la recherche s’appuient de plus en plus fortement sur ce que l’on a coutume d’appeler ‘l’approche projet’. L’auteur se propose d’en repérer les caractéristiques principales afin d’analyser la philosophie (l’idéologie ?) sous-jacente, en la comparant aux habitudes en la matière de la communauté des chercheurs en Sciences Humaines et Sociales (SHS). Après avoir pointé l’influence des sciences et techniques, en particulier, sur les représentations des financeurs, il commente la manière dont cette approche questionne nos disciplines et propose quelques pistes de réflexion pour une meilleure appropriation de cet outil imposé par la communauté des linguistes.