bluuebunny/crossref_metadata_2025_split huggingface dataset:
Renal manifestations of severe Rabson-Mendenhall syndrome: a case report
Authors: Chong Yih Harng , Taylor Barry J , Wheeler Benjamin J 
Published: January 2013

Abstract
Introduction
Rabson-Mendenhall Syndrome (RMS) is a rare form of severe insulin resistance due to a recessive mutation of the insulin receptor. Associated manifestations include facial dysmorphism, skin abnormalities, and renal anomalies.

Case presentation
We report a case of a 13 year old African female with RMS, severe insulin resistance, and a cluster of renal pathologies including nephromegaly, nephrolithiasis, hydronephrosis, and medullary sponge kidney.

Conclusion
This is the first case of severe insulin resistance associated with the collection of renal conditions described. We postulate that renal conditions present in RMS may be under recognised, and recommend screening for the above conditions. This case adds to the scarce body of literature of associated renal manifestations with RMS, including medullary sponge kidney, across the spectrum of insulin resistance.
Association of metabolic syndrome with inflammatory mediators in women with previous gestational diabetes mellitus
Authors: Edalat Banoo , Sharifi Farshad , Badamchizadeh Zohre , Hossein-Nezhad Arash , Larijani Bagher , Mirarefin Mojde , Fakhrzadeh Hossein 
Published: January 2013

Abstract
Background
An increased risk of metabolic syndrome (MS) has been observed among women with previous gestational diabetes mellitus (pGDM). Increased inflammatory markers such as C-reactive protein (CRP) and interleukin 6 (IL-6) usually accompany. We performed this survey to examine the relationship between pGDM and MS, CRP and IL-6.

Methods
77 women with pGDM and 67 randomly sampled women free from GDM participated in this study, 2–3 years after index pregnancy. Laboratory and anthropometric measurements were performed. MS was defined according to ATP III criteria. Statistical analyses were conducted using SPSS 18.

Results
CRP were different between groups with and without pGDM [2.69 (2.86 mg/dl and 1.56 (1.39) mg/dl, respectively; p < 0.01]. The presence of each MS component by itself was associated with significantly higher CRP Levels, except for fasting blood glucose. In linear regression models, CRP and IL-6 were significantly associated with BMI (β =0. 25, 0.23; p < 0.01), waist circumference (β=0. 27, 0.05; p < 0.01) and HOMA-IR (β=0. 39, 0.39; p < 0.01). After adjustment for age and BMI the occurrence of pGDM in the group with both high CRP and MS was significantly associated with CRP level (OR= 5.11; CI=1.59-16.43; p < 0.01).

Conclusion
Since CRP and Il-6 were higher in women with both pGDM and MS it appears that the presence of pGDM with MS components have a synergistic effect on the elevation of serum levels of inflammatory markers which can be partly as a result of visceral obesity. Further long-term studies are necessary to confirm the relationship between CRP, IL-6 and MS in women with pGDM.
Impaired beta cell function is present in nondiabetic rheumatoid arthritis patients
Authors: Ferraz-Amaro Iván , García-Dopico Jose A , Medina-Vega Lilian , González-Gay Miguel A , Díaz-González Federico 
Published: January 2013

Abstract
Introduction
To investigate how markers of β-cell secretion (proinsulin-processing metabolites) are expressed in rheumatoid arthritis (RA) patients and their potential relation with the insulin resistance (IR) observed in these patients.

Methods
The 101 RA patients and 99 nondiabetic sex- and age-matched controls were included. IR by homeostatic model assessment (HOMA2), and β-cell secretion, as measured by insulin, split and intact proinsulin, and C-peptide levels were determined for both groups. Multiple regression analysis was performed to compare IR between groups and to explore the interrelations between RA features, proinsulin metabolites, and IR. Data were adjusted for glucocorticoids intake and for IR classic risk factors.

Results
Compared with controls, RA patients showed higher HOMA-IR (β coef., 0.40 (95% CI, 0.20 to 0.59); P = 0.00). When data were adjusted for glucocorticoids intake, noncorticosteroid patients maintained a higher IR index (β, 0.14 (0.05 to 0.24); P = 0.00). Impaired insulin processing in RA patients was detected by the onset of elevated split proinsulin levels (β, 0.70 pmol/L (0.38 to 1.02); P = 0.00). These data remained significant also when adjusted for prednisone intake (β, 0.19 (0.00 to 0.36) pmol/L; P = 0.04). Split proinsulin-to-C-peptide ratios were higher in RA patients undergoing corticosteroid therapy (β, 0.25 (0.12 to 0.38); P = 0.03) and were nearly significant in comparison between noncorticosteroids patients and controls (β, 0.16 (-0.02 to 0.34); P = 0.08). Interestingly, the impact of HOMA-IR on the ratio of intact proinsulin to C-peptide was higher in controls compared with patients (β, 6.23 (1.41 to 11.06) versus 0.43 (-0.86 to 1.71); P = 0.03).

Conclusions
β-Cell function is impaired in nondiabetic and in RA patients not taking corticoids by a mechanism that seems to be, at least in part, independent of IR.
Reversal of Diet-Induced Obesity Increases Insulin Transport into Cerebrospinal Fluid and Restores Sensitivity to the Anorexic Action of Central Insulin in Male Rats
Authors: Begg Denovan P. , Mul Joram D. , Liu Min , Reedy Brianne M. , D'Alessio David A. , Seeley Randy J. , Woods Stephen C. 
Published: January 2013

Abstract
Diet-induced obesity (DIO) reduces the ability of centrally administered insulin to reduce feeding behavior and also reduces the transport of insulin from the periphery to the central nervous system (CNS). The current study was designed to determine whether reversal of high-fat DIO restores the anorexic efficacy of central insulin and whether this is accompanied by restoration of the compromised insulin transport. Adult male Long-Evans rats were initially maintained on either a low-fat chow diet (LFD) or a high-fat diet (HFD). After 22 weeks, half of the animals on the HFD were changed to the LFD, whereas the other half continued on the HFD for an additional 8 weeks, such that there were 3 groups: 1) a LFD control group (Con; n = 18), 2) a HFD-fed, DIO group (n = 17), and 3) a HFD to LFD, DIO-reversal group (DIO-rev; n = 18). The DIO reversal resulted in a significant reduction of body weight and epididymal fat weight relative to the DIO group. Acute central insulin administration (8 mU) reduced food intake and caused weight loss in Con and DIO-rev but not DIO rats. Fasting cerebrospinal fluid insulin was higher in DIO than Con animals. However, after a peripheral bolus injection of insulin, cerebrospinal fluid insulin increased in Con and DIO-rev rats but not in the DIO group. These data provide support for previous reports that DIO inhibits both the central effects of insulin and insulin's transport to the CNS. Importantly, DIO-rev restored sensitivity to the effects of central insulin on food intake and insulin transport into the CNS.
An Improved Model for the Performance Estimation of an H-Darrieus Wind Turbine in Skewed Flow
Authors: Bianchini Alessandro , Ferrara Giovanni , Ferrari Lorenzo , Magnani Sandro 
Published: January 2013

Small turbines are considered one of the most promising technologies for an effective diffusion of renewable energy sources in new installation contexts with a high degree of integration with human activity (e.g. the urban environment). In these new installations, however, the real working conditions can be far from the nominal ones. In particular, the turbine functioning can be noticeably affected by misalignments between the oncoming flow and the axis of the rotor; differently from horizontal-axis wind turbines, whose performance is decreased by a skew angle, H-Darrieus turbines are thought to take advantage from this condition in some cases. In this study, an improved model for the performance prediction of H-Darrieus rotors under skewed flow was developed. In detail, a theoretical approach based on Momentum Models was properly modified to account for the variations induced by the new direction of the flow which invests the rotor. In particular, the modifications in the aerodynamic characteristics of the airfoils, the swept area and the streamtubes distribution were modeled. The performance predictions of the new model were compared both with experimental data available in the technical literature and with the results of wind tunnel tests purposefully carried out on a full scale model of an H-Darrieus turbine. Notable agreement has been constantly obtained between simulations and experiments.
Interactions between TiAl Alloy and Different Oxide Moulds under High-temperature and Long-time Condition
Authors: Cui Yongshuang , Tang Xiaoxia , Gao Ming , Ma Limin , Hu Zhang 
Published: January 2013

AbstractInteractions between Ti-47Al-2Cr-2Nb (at.%) alloy and alumina, zirconia and yttria moulds were studied under high-temperature and long-time condition, and the reaction mechanisms were explored. The moulds were prepared by traditional precision casting technique, and the experiments were carried out in a carbon resistance furnace at 1550°C for 30 min. The results indicated that the interfacial reactions between TiAl alloys and alumina and zirconia moulds were serious. Obvious reaction layers composed of Ti-rich phases and Al2O3 inclusions were formed on the alloy-mould interfaces, and a large amount of dark Al2O3 inclusions were found in the alloy matrixes. Interaction between TiAl and yttria mould was mild. No obvious reaction layer was formed on the alloy-mould interface, and only a small amount of white inclusions inferred as Al-Y oxide were found in the alloy matrix. Al2O3 and ZrO2 cannot be used as mould materials for the directional solidification of TiAl alloys. Y2O3 mould possesses a higher stability, which can be used in the directional solidification of TiAl alloys by the proper choice of more stable binder.
Thermodynamic Database of P2O5-containing Oxide Systems for the Dephosphorization Process in Steelmaking
Authors: Jung In-Ho , Hudon Pierre , Kim Wan-Yi , van Ende Marie-Aline , Rahman Miftaur , Curiel Gabriel Garcia 
Published: January 2013

AbstractThe Na2O-MgO-CaO-FeO-Fe2O3-Al2O3-SiO2-P2O5 system is a basic oxide system for the Basic Oxygen Furnace (BOF) process as well as the hot metal dephosphorization process. Numerous experimental investigations on this oxide system are being carried out to find out an advanced process route for P removal from molten iron. In spite of their industrial importance, however, phase equilibria in oxide systems containing P2O5 have not been well investigated due to the complexity of their chemistry. No systematic thermodynamic modeling of these systems has been conducted to date, either. In order to meet the strong demands of steelmaking and other industries, new systematic thermodynamic modeling of the P2O5-containing oxide systems (Na2O-MgO-CaO-FeO-Fe2O3-Al2O3-SiO2-P2O5) and key phase diagram experiments have been carried out over the past years. In the present study, the results of the thermodynamic modeling of unary, binary and ternary P2O5-containing systems and the applications of the thermodynamic database to the dephosphorization by multi-component slag in BOF process are presented in comparison with experimental data. All thermodynamic calculations were performed using FactSage thermodynamic software.
Analysis of the Raman Frequency Shifts for the Lattice Modes and Vibrons Related to the Thermodynamic Quantities in the η Phase of Solid Nitrogen
Authors: Yurtseven Hamit , Akay Özge 
Published: January 2013

AbstractThe thermodynamic quantities of the isothermal compressibility, thermal expansion and the specific heat are calculated here as a function of pressure by using the observed Raman frequencies of the lattice modes and vibrons in the η phase of solid nitrogen. The Pippard relations and their spectroscopic modifications are constructed, and the slope dP/dT is deduced from the Raman frequency shifts in this phase of N2. It is shown that the thermodynamic quantities can be predicted from the Raman frequency shifts, in particular, in the η phase of solid nitrogen.
Playground Safety and Quality in Chicago
Authors: Allen Erin M. , Hill Amy L. , Tranter Erma , Sheehan Karen M. 
Published: January 2013

OBJECTIVES:
To assess playground safety and quality in Chicago, Illinois, identify disparities in access, and use the data to inform collaborative improvement.

METHODS:
A cross-sectional survey of public park playgrounds in Chicago, Illinois, was conducted in 2009, 2010, and 2011 by using the National Program for Playground Safety Standardized Survey. All playgrounds were surveyed in 2009 and 2010; those that failed in 2010 were resurveyed in 2011. Playgrounds were assessed in 4 main categories: age-appropriate design, fall surfacing, equipment maintenance, and physical environment. Safety scores were generated from the assessment. Geographic information system mapping provided a visual description of the playground pass/fail rate based on neighborhood, child population, race/ethnicity, and poverty level.

RESULTS:
Of the ∼500 playgrounds, 467 were assessed in 2009, and 459 were assessed in 2010. In 2009, half of all playgrounds (55%) and in 2010, nearly two-thirds (61%) earned scores consistent with safe playgrounds (P &lt; .001). Playgrounds scored poorest in fall surfacing and equipment maintenance. Geographic information system mapping showed neighborhoods with a higher percentage of children and impoverished families had fewer playgrounds and more failing playgrounds. In 2011, 154 (85%) of the playgrounds that failed in 2010 were surveyed. The mean playground score among failing playgrounds improved significantly between 2010 (61%) and 2011 (67%, P &lt; .001).

CONCLUSIONS:
Since the playground improvement initiative began in 2009, considerable progress has been made in the safety scores, although access to high-quality playgrounds varies by neighborhood. Many failing playgrounds can be brought up to standard with improvement in fall surfacing and equipment maintenance.
A Quality Improvement Intervention to Increase Access to Pediatric Subspecialty Practice
Authors: Heptulla Rubina A. , Choi Steven J. , Belamarich Peter F. 
Published: January 2013

OBJECTIVE:
To improve access to new pediatric endocrinology appointments in an urban academic hospital faculty-based practice.

METHODS:
Three strategies were implemented to increase the number of appointment slots: new patient appointments were protected from conversion to follow-up appointments; all physicians, including senior faculty, were scheduled to see 3 to 4 new patients per session; and sessions devoted exclusively to follow-up appointments were added based on demand. The main outcomes for this quality improvement activity were waiting times for new and follow-up appointments, monthly visit volume, the per-provider visit volume, differences in the proportion of new visits, and clinic arrival rates pre- and postintervention.

RESULTS:
Thirteen months after the intervention, average wait for a new patient appointment decreased from 11.4 to 1.7 weeks (P &lt; .001) and follow-up appointment wait time decreased from 8.2 to 2.9 weeks (P &lt; .001). Mean monthly total visit volume increased from 284 to 366 patient visits (P &lt; .01) and mean monthly visit volume per provider increased from 36.8 to 41.0 patients (P = .08). New patients were 27% of the visit volume and 35% after the intervention.

CONCLUSIONS:
Access to our pediatric specialty care clinic was improved without increasing the number of providers by improved scheduling.
Newborn Mortality and Fresh Stillbirth Rates in Tanzania After Helping Babies Breathe Training
Authors: Msemo Georgina , Massawe Augustine , Mmbando Donan , Rusibamayila Neema , Manji Karim , Kidanto Hussein Lesio , Mwizamuholya Damas , Ringia Prisca , Ersdal Hege Langli , Perlman Jeffrey 
Published: January 2013

BACKGROUND:
Early neonatal mortality has remained high and unchanged for many years in Tanzania, a resource-limited country. Helping Babies Breathe (HBB), a novel educational program using basic interventions to enhance delivery room stabilization/resuscitation, has been developed to reduce the number of these deaths.

METHODS:
Master trainers from the 3 major referral hospitals, 4 associated regional hospitals, and 1 district hospital were trained in the HBB program to serve as trainers for national dissemination. A before (n = 8124) and after (n = 78 500) design was used for implementation. The primary outcomes were a reduction in early neonatal deaths within 24 hours and rates of fresh stillbirths (FSB).

RESULTS:
Implementation was associated with a significant reduction in neonatal deaths (relative risk [RR] with training 0.53; 95% confidence interval [CI] 0.43–0.65; P ≤ .0001) and rates of FSB (RR with training 0.76; 95% CI 0.64–0.90; P = .001). The use of stimulation increased from 47% to 88% (RR 1.87; 95% CI 1.82–1.90; P ≤ .0001) and suctioning from 15% to 22% (RR 1.40; 95% CI 1.33–1.46; P ≤ .0001) whereas face mask ventilation decreased from 8.2% to 5.2% (RR 0.65; 95% CI 0.60–0.72; P ≤ .0001).

CONCLUSIONS:
HBB implementation was associated with a significant reduction in both early neonatal deaths within 24 hours and rates of FSB. HBB uses a basic intervention approach readily applicable at all deliveries. These findings should serve as a call to action for other resource-limited countries striving to meet Millennium Development Goal 4.
Randomized Trial of Iron Supplementation versus Routine Iron Intake in VLBW Infants
Authors: Taylor Tiffany A. , Kennedy Kathleen A. 
Published: January 2013

OBJECTIVE:
To determine if iron supplementation of 2 mg/kg per day, in addition to routine iron-fortified formula or mother's milk, increased the hematocrit (Hct) at 36 weeks' postmenstrual age (PMA).

METHODS::
Infants with a birth weight &lt;1500 g who reached 120 mL/kg per day of feedings before 32 weeks' PMA were randomly assigned to iron (multivitamin with iron) or control (multivitamin) from enrollment until 36 weeks' PMA (or discharge, if sooner). Investigators and caregivers were masked. Transfusion guidelines were used. The primary outcome was Hct at 36 weeks' PMA. A nonparametric rank sum analysis was performed so that infants who died before 36 weeks and infants who were transfused could be included in an intention-to-treat analysis. Infants were ranked by death (lowest rank) then by number of transfusions (next lowest ranks). For infants who survived and were not transfused, the 36-week PMA Hct was used for the rank.

RESULTS:
One hundred fifty infants were enrolled (76 iron, 74 controls). There were 2 deaths (1 in each group). One hundred other infants (47 iron, 53 controls) received transfusion(s). There was no significant difference in the primary outcome ranking (P = .59), in the number of transfusions per subject (P = .64), or in 36-week Hct (iron mean ± SD, 29.2% ± 4.0%; control, 28.3% ± 4.5%; mean difference and 95% confidence interval 0.9 [−0.5 to 2.3]; P = .21) or reticulocyte count among survivors. No short-term adverse effects of iron supplementation were observed.

CONCLUSIONS:
Among infants &lt;1500 g birth weight, iron supplementation, in addition to routine iron intake, did not significantly increase the 36-week Hct or the decrease number of transfusions.
Stillbirth and Newborn Mortality in India After Helping Babies Breathe Training
Authors: Goudar Shivaprasad S. , Somannavar Manjunath S. , Clark Robert , Lockyer Jocelyn M. , Revankar Amit P. , Fidler Herta M. , Sloan Nancy L. , Niermeyer Susan , Keenan William J. , Singhal Nalini 
Published: January 2013

OBJECTIVE:
This study evaluated the effectiveness of Helping Babies Breathe (HBB) newborn care and resuscitation training for birth attendants in reducing stillbirth (SB), and predischarge and neonatal mortality (NMR). India contributes to a large proportion of the worlds annual 3.1 million neonatal deaths and 2.6 million SBs.

METHODS:
This prospective study included 4187 births at &gt;28 weeks’ gestation before and 5411 births after HBB training in Karnataka. A total of 599 birth attendants from rural primary health centers and district and urban hospitals received HBB training developed by the American Academy of Pediatrics, using a train-the-trainer cascade. Pre-post written trainee knowledge, posttraining provider performance and skills, SB, predischarge mortality, and NMR before and after HBB training were assessed by using χ2 and t-tests for categorical and continuous variables, respectively. Backward stepwise logistic regression analysis adjusted for potential confounding.

RESULTS:
Provider knowledge and performance systematically improved with HBB training. HBB training reduced resuscitation but increased assisted bag and mask ventilation incidence. SB declined from 3.0% to 2.3% (odds ratio [OR] 0.76, 95% confidence interval [CI] 0.59–0.98) and fresh SB from 1.7% to 0.9% (OR 0.54, 95% CI 0.37–0.78) after HBB training. Predischarge mortality was 0.1% in both periods. NMR was 1.8% before and 1.9% after HBB training (OR 1.09, 95% CI 0.80–1.47, P = .59) but unknown status at 28 days was 2% greater after HBB training (P = .007).

CONCLUSIONS:
HBB training reduced SB without increasing NMR, indicating that resuscitated infants survived the neonatal period. Monitoring and community-based assessment are recommended.
Hospital Admissions for Childhood Asthma After Smoke-Free Legislation in England
Authors: Millett Christopher , Lee John Tayu , Laverty Anthony A. , Glantz Stanton A. , Majeed Azeem 
Published: January 2013

OBJECTIVE:
To assess whether the implementation of English smoke-free legislation in July 2007 was associated with a reduction in hospital admissions for childhood asthma.

METHODS:
Interrupted time series study using Hospital Episodes Statistics data from April 2002 to November 2010. Sample consisted of all children (aged ≤14 years) having an emergency hospital admission with a principle diagnosis of asthma.

RESULTS:
Before the implementation of the legislation, the admission rate for childhood asthma was increasing by 2.2% per year (adjusted rate ratio 1.02; 95% confidence interval [CI]: 1.02–1.03). After implementation of the legislation, there was a significant immediate change in the admission rate of −8.9% (adjusted rate ratio 0.91; 95% CI: 0.89–0.93) and change in time trend of −3.4% per year (adjusted rate ratio 0.97; 95% CI: 0.96–0.98). This change was equivalent to 6802 fewer hospital admissions in the first 3 years after implementation. There were similar reductions in asthma admission rates among children from different age, gender, and socioeconomic status groups and among those residing in urban and rural locations.

CONCLUSIONS:
These findings confirm those from a small number of previous studies suggesting that the well-documented population health benefits of comprehensive smoke-free legislation appear to extend to reducing hospital admissions for childhood asthma.