bluuebunny/crossref_metadata_2025_split huggingface dataset:
Chronic kidney disease care program improves quality of pre‐end‐stage renal disease care and reduces medical costs
Authors: WEI SHU‐YI , CHANG YONG‐YUAN , MAU LIH‐WEN , LIN MING‐YEN , CHIU HERNG‐CHIA , TSAI JER‐CHIA , HUANG CHIH‐JEN , CHEN HUNG‐CHUN , HWANG SHANG‐JYH 
Published: May 2009

ABSTRACT:Aim:  Multidisciplinary care of patients with chronic kidney disease (CKD) provides better care outcomes. This study is to evaluate the effectiveness of a CKD care program on pre‐end‐stage renal disease (ESRD) care.Methods:  One hundred and forty incident haemodialysis patients were classified into the CKD Care Group (n = 71) and the Nephrologist Care Group (n = 69) according to participation in the CKD care program before dialysis initiation. The ‘total observation period’ was divided into ‘6 months before dialysis’ and ‘at dialysis initiation’. Quality of pre‐ESRD care, service utilization and medical costs were evaluated and compared between groups.Results:  The mean estimated glomerular filtration rates at dialysis initiation were low in both groups; but the levels of haematocrit and serum albumin of the CKD Care Group were significantly higher. The percentages of patients initiating dialysis with created vascular access, without insertion of double‐lumen catheter and without hospitalization were 57.7%, 50.7% and 40.8%, respectively, in the CKD Care Group, and 37.7%, 29.0% and 18.8% in the Nephrologist Care Group (P < 0.001). Participation in the CKD care program, though with higher costs during the 6 months before dialysis ($US1428 ± 2049 vs US$675 ± 962/patient, P < 0.001), was significantly associated with lower medical costs at dialysis initiation ($US942 ± 1941 vs $US2410 ± 2481/patient, P < 0.001) and for the total period of observation ($US2674 ± 2780 vs $US3872 ± 3270/patient, P = 0.009). The cost‐saving effect came through the early preparation of vascular access and the lack of hospitalization at dialysis initiation.Conclusion:  CKD care programs significantly improve quality of pre‐ESRD care, decrease service utilization and save medical costs.
Review article: Managing bone complications after kidney transplantation
Authors: MAINRA RAHUL , ELDER GRAHAME 
Published: May 2009

SUMMARYChronic kidney disease mineral and bone disorder (CKD‐MBD) describes the laboratory, bone and vascular abnormalities that exist in patients with CKD stages 3–5D and that may persist after transplantation. Persisting abnormalities of bone turnover and abnormal mineralization, together with bone mineral density (BMD) loss from glucocorticoids, may all predispose to a loss of structural integrity and increased fracture risk in kidney and kidney pancreas recipients. Vitamin D, calcitriol, calcitonin and bisphosphonates have all been used to preserve BMD following transplantation, despite a lack of safety data and the potential for some of these drugs to cause harm. A limited number of post‐transplant studies utilizing these drugs have not yet documented improved fracture prevention or fracture‐related mortality and have not considered allocation based on risk factors for fracture or markers of bone turnover. Targeted allocation of the available therapies based on a stratification of risk appears warranted. This might be achieved using an algorithm incorporating BMD, X‐ray evaluation, laboratory investigations including bone turnover markers and the assessment of standard fracture risk factors at the time of and soon after transplantation. This approach, which is similar to protocols used in the general population, may result in more effective management of patients and fewer adverse effects such as adynamic bone disease. Although BMD is a surrogate for fracture risk in the general population it is not validated in this transplant population. Consequently, such an approach should be confirmed by studies that include bone biopsy data and an evaluation of patient level outcomes.
Prevalence of known diabetes in German adults aged 25–69 years: results from national health surveys over 15 years
Authors: Heidemann C. , Kroll L. , Icks A. , Lampert T. , Scheidt‐Nave C. 
Published: May 2009

AbstractAims  The few studies examining the secular trend in diabetes prevalence in Germany have yielded conflicting results. Therefore, using nationally representative samples of adults, we investigated whether the prevalence of known diabetes has changed over 15 years.Methods  Study participants were 25‐ to 69‐year‐old residents participating in nationally representative health surveys performed in the following time periods: 1990–1992, 1997–1999, 2002–2003, 2003–2004 and 2004–2005. Prevalences of diabetes, standardized to the population structure of 2004, and trends over time were assessed for the total study population as well as by gender and other diabetes‐associated factors.Results  Between 1990–1992 and 2002–2005, no statistically significant trend in the total (5.16 and 5.34%, P trend = 0.68) or sex‐specific diabetes prevalence (men: 5.43 and 5.73, P trend = 0.62; women: 4.88 and 4.95%, P trend = 0.94) was observed. For each time period, prevalence rose substantially with increasing age, increasing body mass index, lower sporting activity and lower education.Conclusions  Our findings reflect no temporal increase in the total prevalence of known diabetes in German adult men and women. However, prevalence estimates were relatively high when compared with other European studies and call for continued efforts for the prevention and management of diabetes.
Impact of diabetes and gender on survival after acute myocardial infarction in the Province of Quebec, Canada—a population‐based study
Authors: Ouhoummane N. , Abdous B. , Émond V. , Poirier P. 
Published: May 2009

AbstractAims  To examine the impact of diabetes, gender and their interaction on 30‐day, 1‐year and 5‐year post‐acute myocardial infarction (AMI) mortality in three age groups (20–64, 65–74 and ≥ 75 years).Methods  Retrospective analysis including 23 700 patients aged ≥ 20 years (22% with diabetes) admitted to hospital for a first AMI in any hospital in the Province of Quebec, Canada, between April 1995 and March 1997. Administrative databases were used to identify patients and assess outcomes.Results  Regarding 30‐day mortality, there was non‐significant interaction between diabetes and gender. Women aged < 75 years had, independently of diabetes status, at least a 38% (P < 0.05) higher mortality than their male counterparts after adjustment for socio‐economic status and co‐morbid conditions. Gender difference disappeared, however, after controlling for in‐hospital complications. Regarding 1‐year mortality (31–365 days), there was no significant gender disparity for all age groups. During the 5‐year follow‐up, no gender differences were seen in any age group, except for younger (< 65 years) women with diabetes, who had a 52% (P = 0.004) higher mortality than men after controlling for co‐variables. This female disadvantage was demonstrated by a significant interaction between diabetes and gender in patients aged < 65 years (P = 0.009).Conclusions  The higher 30‐day mortality post‐AMI in younger (20–64 years) and middle‐aged (65–74 years) women compared with men was not influenced by diabetes status. However, during the 5‐year follow‐up, the similar gender mortality observed in patients without diabetes seemed to disappear in younger patients with diabetes, which may be explained by the deleterious, long‐term, post‐AMI impact of diabetes in younger women.
The relationship between depression and diabetes mellitus: findings from the Hertfordshire Cohort Study
Authors: Holt R. I. G. , Phillips D. I. W. , Jameson K. A. , Cooper C. , Dennison E. M. , Peveler R. C. ,   The Hertfordshire Cohort Study Group
Published: May 2009

AbstractAims  To assess the relationship between depression scores and diabetes, glucose and insulin in a cross‐sectional population‐based study.Methods  One thousand, five hundred and seventy‐nine men and 1418 women from the Hertfordshire Cohort Study were assessed for diabetes. Plasma glucose and insulin concentrations were measured at 0, 30 and 120 min during a standard 75‐g oral glucose tolerance test. Depressive and anxiety symptoms were measured using the Hospital Anxiety and Depression Scale (HADS).Results  Overall, 431 (14.6%) were diagnosed with diabetes [232 men (14.9%) and 199 women (14.3%)]. One hundred and eight (47%) men and 74 (37%) women had known diabetes. The remainder were previously undiagnosed. Fifty‐nine (3.7%) men and 65 (4.6%) women had possible depression (HAD‐D scores 8–10) and 17 (1.1%) men and 20 (1.4%) women had probable depression (HAD‐D scores ≥ 11). Probable depression was associated with an adjusted odds ratio for diabetes of 3.89 [95% confidence interval (CI) 1.28–11.88] in men and 1.51 (95% CI 0.47–4.84) in women. In men without previously diagnosed diabetes, fasting insulin (P = 0.035), 2‐h glucose concentrations (P = 0.028) and insulin resistance (P = 0.032) were significantly associated with HAD‐D scores. With the exception of 2‐h glucose concentrations (P = 0.034), the associations were not significant in women.Conclusions  These data support the hypothesis that depression may increase the risk for diabetes. The relationship between depression score and metabolic variables extends across the whole population and is not confined to those with either diagnosed depression or diabetes. This relationship should lead clinicians to consider screening for diabetes in those with depression and vice versa.
The effect of anti‐inflammatory (aspirin and/or statin) therapy on body weight in Type 2 diabetic individuals: EAT, a retrospective study
Authors: Boaz M. , Lisy L. , Zandman‐Goddard G. , Wainstein J. 
Published: May 2009

AbstractAims  Obesity is associated with inflammation. Anti‐inflammatory interventions such as aspirin and statins (anti‐IFRx) might be a novel approach to the treatment of obesity and Type 2 diabetes mellitus (T2DM). The present study was designed to determine whether exposure to anti‐IFRx is associated with weight loss in T2DM patients.Methods  Exposure to anti‐IFRx was compared between T2DM patients with a history of weight loss (n = 100) and those with no weight loss or with weight gain (n = 102) during a 1‐year follow‐up period. Logistic regression was used to develop odds ratios for weight loss status.Results  Subjects who lost weight were more frequently exposed to anti‐IFRx (85.0 vs. 71.5%, P = 0.018) than subjects who maintained or gained weight during follow‐up. The 158 subjects exposed to anti‐IFRx were older (64.2 ± 9.4 vs. 60.6 ± 11.2 years, P = 0.04), had longer duration T2DM (14.5 ± 9.5 vs. 9.0 ± 9.4 years, P = 0.001), had greater prevalence of dyslipidaemia (72 vs. 19%, P < 0.0001) hypertension (57.3 vs. 38.1%, P = 0.03) and cardiovascular disease (37.7 vs. 9.5%, P < 0.0001) than subjects not exposed to anti‐IFRx. In a logistic regression model for weight change status, anti‐IFRx exposure was significantly associated with weight status (odds ratio = 2.3, 95% confidence interval 1.1–4.8, P = 0.02, an association that persisted), even after controlling for age, sex, baseline body mass index, years since diagnosis, OHA therapy and co‐morbidities.Conclusions  Exposure to anti‐IFRx more than doubled the odds of weight loss in T2DM patients. Results of this study justify a randomized clinical trial to determine definitively the role of anti‐IFRx in weight loss in subjects with T2DM.
Investigation of the effect of oral metformin on dipeptidylpeptidase‐4 (DPP‐4) activity in Type 2 diabetes1
Authors: Cuthbertson J. , Patterson S. , O’Harte F. P. M. , Bell P. M. 
Published: May 2009

AbstractAims  Glucagon‐like peptide‐1 (GLP‐1) is an insulinotropic hormone and major component of the enteroinsular axis. Its therapeutic potential in human diabetes is limited by rapid degradation and inactivation by the enzyme dipeptidylpeptidase‐4 (DPP‐4). We investigated the acute effects of metformin with and without food on DPP‐4 activity in Type 2 diabetes.Methods  Ten subjects with Type 2 diabetes (6 male/4 female, age 65.8 ± 2.6 years, body mass index 30.0 ± 1.2 kg/m2, glycated haemoglobin (HbA1c) 6.3 ± 0.2%, mean ± sem) received metformin 1 g orally or placebo together with a standard mixed meal (SMM) in a random crossover design. Six subjects re‐attended fasting and received metformin 1 g without a SMM.Results  Following SMM (n = 10), DPP‐4 activity was not suppressed by metformin compared with placebo [area under curve (AUC)0–4 h 1574 ± 4 vs. 1581 ± 8 μmol/ml/min, respectively]. Plasma glucose, insulin and active GLP‐1 were not different. However, DPP‐4 activity was suppressed with metformin following fasting compared with a SMM (n = 6) (AUC0–4 h 1578 ± 4 vs. 1494 ± 9 μmol/min, P < 0.02). Metformin serum levels were significantly lower (P < 0.001) after SMM than fasting (AUC0–4 h 350 ± 66 vs. 457 ± 55 mg/ml/min).Conclusion  Metformin inhibits DPP‐4 activity in Type 2 diabetic patients in the fasting state but not when taken with a standard mixed meal. Metformin serum concentrations are lower if the drug is taken with food. These findings should be taken into account in establishing how to maximize efficacy of the drug.
Future Directions in the Study of Close Relationships: Conflict Is Bad (Except When It's Not)
Authors: Laursen Brett , Hafen Christopher A. 
Published: May 2009

AbstractBeneficial and detrimental correlates of interpersonal disagreement have been postulated and documented. The conclusion: conflict is both bad and good. The evidence for these paradoxical effects is summarized. In this article, we argue that the consequences of conflict for individuals depend on its frequency, the way in which it is managed, and the quality of the relationship in which it arises. Non‐linear patterns of association are hypothesized such that constructive conflicts, particularly those arising in supportive relationships, should (up to a limit) predict more beneficial and fewer detrimental outcomes. In contrast, coercive conflicts, particularly those arising in unsupportive relationships, should predict more adverse and fewer favorable outcomes.
Tasteless profits and vexed moralities: assessments of the present in rural Rajasthan
Authors: Gold Ann Grodzins 
Published: May 2009

At a micro level and in a single locality, this article explores an overworked topic: the transformation from (moral) subsistence economy to (amoral) market economy, and its associations with the difference between need and desire. Ethnographic research among farmers and herders in the Banas Basin region of Rajasthan, North India, unfolds expressions of physical and moral discomfort with conditions of rural livelihoods in the present. Older persons portray the nature of modern times as characterized by overwhelming desire for profit and the things it can buy. Thus they explain willing sacrifice of flavourful indigenous grain species as well as the ascent of selfishness and violence, exemplified by the selling to slaughter of unwanted farm animals. Although young adults frequently echo their elders’ views on deteriorating relationships, their attitudes and actions also point towards potential reconstitutions of responsibility in altered social and economic contexts. This article's central aim is to portray the richness and depth of a vanishing interdependency among human and non‐human beings as recollected by an ageing generation or imagined by the young; it also engages an anthropology of emerging civic participation in the wake of acknowledged losses.RésuméAu niveau micro, dans une seule localité, le présent article explore un sujet souvent traité : le passage de l'économie de subsistance (morale) à l'économie de marché (amorale) et ses associations avec la différence entre besoins et désirs. Les recherches ethnographiques parmi les agriculteurs et éleveurs du bassin de la rivière Banas, au Rajasthan, révèlent des expressions de malaise physique et moral liées aux conditions de vie rurales présentes. Les personnes âgées décrivent les temps modernes comme caractérisés par le désir écrasant du profit et des choses qu'il peut apporter. C'est ainsi qu'elles expliquent le sacrifice volontaire des savoureuses espèces de céréales indigènes, mais aussi la montée de l'égoïsme et de la violence, illustrée par la vente aux abattoirs des animaux de ferme surnuméraires. Bien que les jeunes adultes fassent souvent écho aux propos des anciens sur la détérioration des relations, leur attitude et leurs actions laissent aussi poindre des possibilités de reconstruction de la responsabilité dans un contexte social et économique altéré. Le but central de l'article est de décrire la richesse et la profondeur d'une interdépendance en voie de disparition entre êtres humains et non humains, telle que les anciens se la remémorent et que les jeunes l'imaginent. Ceci engage également une anthropologie de l'émergence de la participation civique suivant la reconnaissance de ce qui est perdu.
Intrahousehold Welfare in Rural Ethiopia*
Authors: Fafchamps Marcel , Kebede Bereket , Quisumbing Agnes R. 
Published: May 2009

AbstractWe examine the relationship between bargaining power and intrahousehold welfare in rural Ethiopia. The relative nutrition of spouses is associated with differences in cognitive ability, independent income and asset devolution upon divorce. Female empowerment benefits child nutrition and education. Spouses’ health, leisure and consumption of assignable goods show no association with differences in bargaining power. The relative nutrition and health of spouses varies across villages, but not in ways predicted by anthropological accounts of female empowerment. Bargaining variables may be weakly associated with intrahousehold welfare because surveyed households are poor and have little room for disagreement over consumption.
Reductions in HIV transmission risk behaviour following diagnosis of primary HIV infection: a cohort of high‐risk men who have sex with men
Authors: Fox Julie , White Peter J , Macdonald Neil , Weber Jonathan , McClure Myra , Fidler Sarah , Ward Helen 
Published: May 2009

BackgroundRisk‐reduction counselling is a standard preventive intervention, but behaviour change is difficult to sustain over the duration of HIV infection. However, primary HIV infection (PHI) is highly infectious and plays a key role in transmission – especially through dense sexual networks – but is short term, so even transient risk reduction can mitigate its high infectivity. Targeting behaviour‐change interventions at recently infected individuals may be highly effective, particularly in higher risk groups. We explored the potential impact on HIV transmission‐risk behaviour of PHI diagnosis in men who have sex with men (MSM).MethodsMSM with PHI were interviewed at diagnosis and after 3 months of follow‐up about their sexual behaviour in the 12‐week periods before and after diagnosis and standard counselling.ResultsA total of 98 of 104 eligible MSM (94%) participated in the study, with 100% follow‐up. PHI was associated with high levels of recreational drug use, low levels of condom use, high numbers of sexual partners and a history of sex work. In the 12 weeks post‐diagnosis, 76% of participants eliminated risk of onward transmission entirely and, overall, there was a significant reduction in transmission‐risk behaviour, with patients reporting greater condom use and fewer sexual partners. Those with continued transmission‐risk behaviour were more likely to have another sexually transmitted infection (STI), use ketamine and have more sexual partners at baseline.ConclusionsMost MSM recently diagnosed with PHI changed their behaviour to substantially reduce the risk of onward HIV transmission. Strategies are needed to (a) increase diagnoses of PHI to target prevention efforts effectively and (b) further reduce risk behaviours by targeting enhanced counselling to those most likely to continue with risk behaviours.
J. Cosmet. Sci., 59, 195–202 (May/June 2008)  The effects of placental extract on fibroblast proliferation
Authors: Cho H.‐R. , Ryou J.‐H. , Lee J.‐W. , Lee M.‐H 
Published: May 2009

SynopsisHuman placental extract is used in the treatment of skin wrinkles and wounds. To date, no studies have evaluated the effects of placental extract on dermal fibroblast proliferation. To investigate the effects of placental extract vs. ascorbic acid on fibroblast proliferation and transforming growth factor (TGF)‐β1 expression, cultured human fibroblasts were treated with placental extract (0%, 0.08%, 0.16%, 0.32%, and 0.64%) or L‐ascorbic acid‐2‐phosphate magnesium (0, 0.01, 0.1, 1.0, and 10 mmol L‐1). Fibroblast proliferation was determined by MTT assay, and TGF‐β1 protein expression was analyzed by ELISA. The proliferation of fibroblasts increased significantly after treatment with placental extract at concentrations of 0.32% and 0.64% and with L‐ascorbic acid‐2‐phosphate magnesium at concentrations of 1.0 and 10 mmol L‐1. Placental extract demonstrated no significant effects on TGF‐β1 expression; however, TGF‐β1 expression significantly increased after treatment with ascorbic acid at concentrations of 1.0 and 10 mmol L‐1. Placental extract and ascorbic acid had similar effects on fibroblast proliferation; however, placental extract did not significantly increase TGF‐β1 protein expression.
J. Cosmet. Sci., 59, 203–215 (May/June 2008)  Effects of permanent waving on changes of protein and physicomorphological properties in human head hair
Authors: Han M.‐O. , Chun J.‐A. , Lee J.‐W. , Chung C.‐H. 
Published: May 2009

SynopsisTwo types of permanent waving [digital perm (DP) and croquignole winding perm (CWP)] and two waving lotions [cysteamine‐HCl, pH 9.31, liquid type (lotion A) and sodium thioglycolate, pH 9.97, cream type (lotion B)] were used for this study. The protein content was decreased by permanent waving treatments on the whole, and the degree of reduction was dependent on the hair styling and waving lotion used. The greatest decrease (by 58%) was found in hairs processed with the three‐treatment performance of DP using lotion B. SDS‐PAGE identified the presence of the two most abundant polypeptides, with approximately 48 and 60 kDa, and two large polypeptides, with approximately 200 and 210 kDa, which would belong to the keratin family. Some physical properties of the hairs (tensile strength, diameter, swelling, and elongation) were examined with the permanent waving treatments. In general, the repeated waving treatment and the use of lotion B showed more negative effects on hair care than other treatments. Some morphological changes were observed with a scanning electron microscope (SEM). The most prominent change in the hair surface was observed in the hair specimen with the three‐treatment performance of DP using lotion B. More severe signs of damage appeared on the hair with lotion B than with lotion A. As the numbers of permanent waves increased, the degree of damage to the hair surface increased on the whole. However, there was no indication of changes to the hair surface with one permanent waving treatment, as determined by SEM analysis.