bluuebunny/crossref_metadata_2025_split huggingface dataset:
Low-Dose Aspirin Therapy in Patients With Type 2 Diabetes and Reduced Glomerular Filtration Rate
Authors: Saito Yoshihiko , Morimoto Takeshi , Ogawa Hisao , Nakayama Masafumi , Uemura Shiro , Doi Naofumi , Jinnouchi Hideaki , Waki Masako , Soejima Hirofumi , Sugiyama Seigo , Okada Sadanori , Akai Yasuhiro ,   on behalf of the Japanese Primary Prevention of Atherosclerosis With Aspirin for Diabetes (JPAD) Trial Investigators
Published: January 2011

OBJECTIVE
Type 2 diabetes accompanied by renal damage is a strong risk factor for atherosclerotic events. The purpose of this study was to investigate the efficacy of low-dose aspirin therapy on primary prevention of atherosclerotic events in patients with type 2 diabetes and coexisting renal dysfunction.

RESEARCH DESIGN AND METHODS
The Japanese Primary Prevention of Atherosclerosis With Aspirin for Diabetes (JPAD) trial was a prospective, randomized, open-label trial conducted throughout Japan that enrolled 2,539 type 2 diabetic patients without a history of atherosclerotic diseases. Patients were assigned to the aspirin group (81 mg/day or 100 mg/day) or the nonaspirin group and followed for a median of 4.37 years. The primary end points were atherosclerotic events of fatal and nonfatal ischemic heart disease, stroke, and peripheral arterial disease.

RESULTS
The analysis included 2,523 patients who had serum creatinine measured. In 1,373 patients with baseline estimated glomerular filtration rate (eGFR) 60–89 mL/min/1.73 m2, the incidence of primary end points was significantly lower in the aspirin group than in the nonaspirin group (aspirin, 30/661; nonaspirin, 55/712; hazard ratio 0.57 [95% CI 0.36–0.88]; P = 0.011). Low-dose aspirin therapy did not reduce primary end points in patients with eGFR ≥90 mL/min/1.73 m2 (aspirin, 9/248; nonaspirin, 11/270; 0.94 [0.38–2.3]) or those with eGFR &lt;60 mL/min/1.73 m2 (aspirin, 29/342; nonaspirin, 19/290; 1.3 [0.76–2.4]). The Cox proportional hazard model demonstrated a significant interaction between mild renal dysfunction (eGFR 60–89 mL/min/1.73 m2) and aspirin (P = 0.02).

CONCLUSIONS
These results suggest a differential effect of low-dose aspirin therapy in diabetic patients with eGFR 60–89 mL/min/1.73 m2.
The DURAbility of Basal versus Lispro mix 75/25 insulin Efficacy (DURABLE) Trial
Authors: Buse John B. , Wolffenbuttel Bruce H.R. , Herman William H. , Hippler Stephen , Martin Sherry A. , Jiang Honghua H. , Shenouda Sylvia K. , Fahrbach Jessie L. 
Published: January 2011

OBJECTIVE
This study compared the durability of glycemic control of twice-daily insulin lispro mix 75/25 (LM75/25: 75% insulin lispro protamine suspension/25% lispro) and once-daily insulin glargine, added to oral antihyperglycemic drugs in type 2 diabetes patients.

RESEARCH DESIGN AND METHODS
During the initiation phase, patients were randomized to LM75/25 or glargine. After 6 months, patients with A1C ≤7.0% advanced to the maintenance phase for ≤24 months. The primary objective was the between-group comparison of duration of maintaining the A1C goal.

RESULTS
Of 900 patients receiving LM75/25 and 918 patients receiving glargine who completed initiation, 473 and 419, respectively, had A1C ≤7.0% and continued into maintenance. Baseline characteristics except age were similar in this group. Median time of maintaining the A1C goal was 16.8 months for LM75/25 (95% CI 14.0–19.7) and 14.4 months for glargine (95% CI 13.4–16.8; P = 0.040). A1C goal was maintained in 202 LM75/25-treated patients (43%) and in 147 glargine-treated patients (35%; P = 0.006). No differences were observed in overall, nocturnal, or severe hypoglycemia. LM75/25 patients had higher total daily insulin dose (0.45 ± 0.21 vs. 0.37 ± 0.21 units/kg/day) and more weight gain (5.4 ± 5.8 vs. 3.7 ± 5.6 kg) from baseline. Patients taking LM75/25 and glargine with lower baseline A1C levels were more likely to maintain the A1C goal (P = 0.043 and P &lt; 0.001, respectively).

CONCLUSIONS
A modestly longer durability of glycemic control was achieved with LM75/25 compared with glargine. Patients with lower baseline A1C levels were more likely to maintain the goal, supporting the concept of earlier insulin initiation.
Structured Self-Monitoring of Blood Glucose Significantly Reduces A1C Levels in Poorly Controlled, Noninsulin-Treated Type 2 Diabetes
Authors: Polonsky William H. , Fisher Lawrence , Schikman Charles H. , Hinnen Deborah A. , Parkin Christopher G. , Jelsovsky Zhihong , Petersen Bettina , Schweitzer Matthias , Wagner Robin S. 
Published: January 2011

OBJECTIVETo assess the effectiveness of structured blood glucose testing in poorly controlled, noninsulin-treated type 2 diabetes.RESEARCH DESIGN AND METHODSThis 12-month, prospective, cluster-randomized, multicenter study recruited 483 poorly controlled (A1C ≥7.5%), insulin-naïve type 2 diabetic subjects from 34 primary care practices in the U.S. Practices were randomized to an active control group (ACG) with enhanced usual care or a structured testing group (STG) with enhanced usual care and at least quarterly use of structured self-monitoring of blood glucose (SMBG). STG patients and physicians were trained to use a paper tool to collect/interpret 7-point glucose profiles over 3 consecutive days. The primary end point was A1C level measured at 12 months.RESULTSThe 12-month intent-to-treat analysis (ACG, n = 227; STG, n = 256) showed significantly greater reductions in mean (SE) A1C in the STG compared with the ACG: −1.2% (0.09) vs. −0.9% (0.10); Δ = −0.3%; P = 0.04. Per protocol analysis (ACG, n = 161; STG, n = 130) showed even greater mean (SE) A1C reductions in the STG compared with the ACG: −1.3% (0.11) vs. −0.8% (0.11); Δ = −0.5%; P &lt; 0.003. Significantly more STG patients received a treatment change recommendation at the month 1 visit compared with ACG patients, regardless of the patient’s initial baseline A1C level: 179 (75.5%) vs. 61 (28.0%); &lt;0.0001. Both STG and ACG patients displayed significant (P &lt; 0.0001) improvements in general well-being (GWB).CONCLUSIONSAppropriate use of structured SMBG significantly improves glycemic control and facilitates more timely/aggressive treatment changes in noninsulin-treated type 2 diabetes without decreasing GWB.
Use of Dipeptidyl Peptidase-4 Inhibitors and the Reporting of Infections: A Disproportionality Analysis in the World Health Organization VigiBase
Authors: Willemen Marjolein J. , Mantel-Teeuwisse Aukje K. , Straus Sabine M. , Meyboom Ron H. , Egberts Toine C. , Leufkens Hubert G. 
Published: January 2011

OBJECTIVE
Dipeptidyl peptidase-4 (DPP-4) inhibitors are a new class of antidiabetic drugs. They inactivate incretin hormones but also have many other effects throughout the body, among which are effects on the immune system. This might result in an increased infection risk. This study assessed the association between use of DPP-4 inhibitors and the reporting of infections.

RESEARCH DESIGN AND METHODS
A nested case-control was conducted using VigiBase, the World Health Organization-Adverse Drug Reactions (WHO-ADR) database. The base cohort consisted of ADRs for antidiabetic drugs (Anatomical Therapeutic Chemical code A10). Cases were defined as ADRs of infection according to the Medical Dictionary for Regulatory Activities (MedDRA) classification system. All other ADRs were considered controls. Reporting odds ratios (RORs) were calculated to estimate the strength of the association between different classes of antidiabetic drugs and the reporting of infections.

RESULTS
We identified 305,415 suspected ADRs involving antidiabetic drugs in 106,469 case reports, of which 8,083 involved DPP-4 inhibitors monotherapy. Overall, the reporting of infections was higher for patients using DPP-4 inhibitors compared with users of biguanides (ROR 2.3 [95% CI 1.9–2.7]). Reporting of upper respiratory tract infections (ROR 12.3 [95% CI 8.6–17.5]) was significantly associated with use of DPP-4 inhibitors.

CONCLUSIONS
This study indicates an increased reporting of infections, in particular upper respiratory tract infections, for users of DPP-4 inhibitors compared with users of other antidiabetic drugs. However, the limitations of spontaneous reporting systems (e.g., underreporting, the Weber-effect, reporting bias) should be taken into account. Therefore, further research is needed to evaluate this suspicion and the underlying mechanism.
Illness and Treatment Perceptions Are Associated With Adherence to Medications, Diet, and Exercise in Diabetic Patients
Authors: Broadbent Elizabeth , Donkin Liesje , Stroh Julia C. 
Published: January 2011

OBJECTIVE
To investigate diabetic patients’ perceptions of illness and treatments, and explore relationships to adherence and blood glucose control.

RESEARCH DESIGN AND METHODS
Forty-nine type 1 and one hundred and eight type 2 diabetic patients completed questionnaires assessing illness perceptions, treatment beliefs, and adherence to medications, diet, and exercise. Blood glucose control was assessed from blood tests.

RESULTS
Patients rated medication more important than diet and exercise, and reported higher adherence to medications. Insulin was perceived as more helpful for diabetes, while antihypertensives and cholesterol medication were perceived more helpful for preventing heart problems. Perceptions were associated with adherence to insulin, cholesterol and antihypertensive medications, exercise, and diet. Blood glucose control in type 1 diabetic patients was associated with insulin adherence and perceived personal control, and in type 2 diabetic patients to being prescribed insulin or antihypertensives, and perceived personal control.

CONCLUSIONS
Patients hold specific mental models about diabetes treatments, which are associated with adherence.
Breastfeeding in Women With Type 1 Diabetes
Authors: Sparud-Lundin Carina , Wennergren Margareta , Elfvin Anders , Berg Marie 
Published: January 2011

OBJECTIVE
To identify predictive factors for initiation and maintenance of breastfeeding with a focus on mothers with type 1 diabetes.

RESEARCH DESIGN AND METHODS
This is a prospective observation survey, using a case-control design, comparing the outcomes of 108 mothers with type 1 diabetes with 104 mothers without diabetes that were matched for parity and gestational age. Mother and infant outcomes were collected from medical records and through telephone interviews 2 and 6 months after delivery. Predictive factors were calculated by logistic regression analyses.

RESULTS
Mothers with diabetes were less likely to partly or exclusively breastfeed their children at 2 months (OR 0.42 [95% CI 0.18–0.96], P = 0.041) and 6 months (0.50 [0.27–0.90], P = 0.022) than mothers without diabetes. On multivariable analysis, type 1 diabetes did not remain an independent predictive factor. Instead, higher education level and breastfeeding at discharge from hospital were predictive factors for breastfeeding at 2 months postpartum. These variables as well as delivery &gt;37 weeks and early breastfeeding predicted breastfeeding 6 months postpartum.

CONCLUSIONS
Factors associated with maternal diabetes, such as problems with establishing breastfeeding in the early postpartum period, affects the likelihood of long-term breastfeeding.
Ethno-cultural diversity in home care work in Canada
Authors: Martin-Matthews Anne , Sims-Gould Joanie , Naslund John 
Published: January 2011

Worldwide, immigrant workers are responsible for much of the care provided to elderly people who require assistance with personal care and with activities of daily living. This article examines the characteristics of immigrant home care workers, and the ways in which they differ from non-migrant care workers in Canada. It considers circumstances wherein the labor of care is framed by ethno-cultural diversity between client and worker, interactions that reflect the character of this ethno-cultural diversity, and the strategies employed by workers to address issues related to this diversity. Findings from a mixed methods study of 118 workers in the metropolitan area of Vancouver, British Columbia, Canada, indicate that while the discriminatory context surrounding migrant home care workers persists, issues of ethno-cultural diversity in relationships are complex, and can also involve non-foreign born workers.
Multi-cultural home care is not always framed in a negative context, and there often are positive aspects.
Root system architecture of Kosteletzkya pentacarpos (Malvaceae) and belowground environmental influences on root and aerial growth dynamics
Authors: Halchak Jennifer L. , Seliskar Denise M. , Gallagher John L. 
Published: January 2011

• Premise of the study: Root growth and architecture of Kosteletzkya pentacarpos and its response to nutrients and soil texture were studied to facilitate domestication of this plant as a biofuel crop (seeds for oil, stems for ethanol). Because it is salt tolerant, it does not compete with food crops for land.• Methods: Four soil treatments in the bottom chambers of two‐chambered growing units (three nutrient levels in sandy loam and saline, dredged material) were used to test substrate influences on root structure and aerial growth in a greenhouse study. Simultaneously, underground reserves were determined by collecting aerial biomass of dark‐grown plants. Root cores (15 × 50 cm) were taken to determine root architecture of 2‐year‐old field‐grown plants.• Key results: High nutrient availability increased the coarse root biomass (≥2 mm diameter) and increased capsule production. Plants grown in dredged sediment had no substantial growth differences from the controls. Underground reserves were significant. Field cores demonstrated that roots extended more than 50 cm with most of the coarse roots in the upper 20 cm and the coarse to fine root ratio decreasing with depth. Fine root surface area, measured using image‐analysis software, was substantially greater than many other crops, as was root mass density.• Conclusions: Root architecture of K. pentacarpos and its responses to various nutrient levels and soil types demonstrate that it is a promising species for further development as a crop on coastal saline land including dredged material sites. Its perennial taproot system stores carbon and will perform buffer functions between upland and wetlands as sea level rises.
Angiosperm leaf vein patterns are linked to leaf functions in a global‐scale data set
Authors: Walls Ramona L. 
Published: January 2011

• Premise of the study: Leaves are plants’ primary interface with the atmosphere and affect a range of ecological processes. Vein patterns are one of the most prominent aspects of leaf form, and the functional significance of different vein patterns is gaining increasing attention.• Methods: Phylogenetic and standard ANOVA and regression were used to provide the first global‐scale, phylogenetically based test of relations between angiosperm vein patterns and leaf functional traits. Pagel's λ was used to test for phylogenetic signal in all traits.• Key results: All leaf traits had significant phylogenetic signal. Significant phylogenetically based relations were found between secondary vein pattern and leaf functions, linking leaf form to the well‐known trade‐off between physiological activity and leaf life span. The relations between primary vein pattern and leaf functions were not found to be significant with phylogenetic tests, suggesting these relations may be the result of changes within a few lineages, followed by phylogenetic conservatism, rather than multiple instances of correlated trait evolution. The relation between minor vein density and maximum photosynthetic rate was found to be marginally nonsignificant with phylogenetic regression, which does not rule out coordinated evolution of hydraulic supply and demand.• Conclusions: Although phylogenetic conservatism may weaken statistical relations between vein patterns and leaf functions, phylogenetic relations can provide a complementary source of information for inferring unmeasured values of leaf traits. Relations among vein patterns, leaf functions, and phylogeny will be valuable for estimating functional attributes of living and fossil plant species and communities.
Species delimitation and evolution in morphologically and chemically diverse communities of the lichen‐forming genus Xanthoparmelia (Parmeliaceae, Ascomycota) in western North America
Authors: Leavitt Steven D. , Johnson Leigh , St. Clair Larry L. 
Published: January 2011

• Premise of the study: Accurate species delimitation is important for understanding the diversification of biota and has critical implications for ecological and conservation studies. However, a growing body of evidence indicates that morphology‐based species circumspection in lichenized fungi misrepresents fungal diversity. The foliose lichen genus Xanthoparmelia includes over 800 species displaying a complex array of morphological and secondary metabolite diversity.• Methods: We used a multifaceted approach, applying phylogenetic, population genetic, and genealogical analyses to delimit species in a single well‐supported monophyletic clade containing 10 morphologically and chemically diverse Xanthoparmelia species in western North America. Sequence data from four ribosomal and two low‐copy, protein‐coding markers, along with chemical and morphological data were used to assess species diversity.• Key results: We found that traditionally circumscribed species are not supported by molecular data. Rather, all sampled taxa were better represented by three polymorphic population clusters. Our results suggest that secondary metabolite variation may have limited utility in diagnosing lineages within this group, while identified populations clusters did not reflect major phylogeographic or ecological patterns.• Conclusions: In contrast to studies revealing previously undiscovered fungal lineages masked within lichen species circumscribed by traditional morphological and chemical concepts, the present study suggests that species diversity has been overestimated in the species‐rich genus Xanthoparmelia.
Les objectifs et les indicateurs de la LOLF, quatre ans après...
Authors: Brunetiere Jean-René 
Published: January 2011

Un premier article du même auteur dans le n o 117 de la RFAP consacré à la LOLF, en juin 2006, analysait un échantillon aléatoire de 32 indicateurs du Programme annuel de performance de la Loi de ﬁnances initiale 2006. Peu d’entre eux pouvaient être considérés comme satisfaisant au regard des principes énoncés lors de la mise en œuvre de la LOLF, la moitié d’entre eux pouvant même être regardés comme perturbateurs, voire dangereux pour l’action publique. En 2010, la vie de ces indicateurs (et la mort de quinze d’entre eux) au long de quatre exercices budgétaires, puis la comparaison avec deux exercices similaires (les Programmes de qualité et d’efficience des Projets de loi de ﬁnancement de la sécurité sociale et les indicateurs de la Stratégie nationale du développement durable) permettent de tirer de nouvelles conclusions, plus éclairantes sur les conditions de réussite de ces exercices inspirés par la « nouvelle gestion publique ».
La donnée n'est pas un donné
Authors: Salais Robert 
Published: January 2011

La rhétorique de la performance a occulté les enjeux politiques, éthiques et normatifs des réformes de la gestion publique (LOLF, RGPP) relativement au rôle de l’État et à son action. Une dérive essentielle réside dans le fait que, du haut en bas, les acteurs sont incités, non plus à améliorer les résultats des politiques menées vis-à-vis de leurs objectifs fondamentaux, mais à accroître directement, par tous les moyens, leur score sur les indicateurs selon lesquels ils sont évalués. L’article rappelle que l’objectivité du chiffre repose sur des conventions de mesure et reste subordonnée à l’usage politique qui en est fait. Il met en lumière les problèmes soulevés : conciliation entre performance et justice sociale ; comparabilité ; normativité cachée (et donc non débattue) au sein des indicateurs ; risque de fabrication politique des chiffres. Un registre politique nouveau apparaît, celui de la représentation cognitive des situations, trop peu investi par la recherche.
Donner sens aux méthodes de modernisation de l'administration
Authors: Trosa Sylvie 
Published: January 2011

La politique de modernisation de l’administration a été marquée par la mise en place d’outils ou de méthodes telles que la démarche de qualité, le contrôle de gestion, l’évaluation... qui sont souvent présentées comme la solution à l’ensemble des problèmes de management de l’administration publique. Or une méthode devient stérile quand elle est une ﬁnalité en elle-même et qu’elle prétend à être applicable de manière universelle, car l’administration n’est pas une machine fermée sur elle-même mais ouverte et en lien avec le politique, la société, l’économie. Il est donc nécessaire de donner sens aux méthodes de modernisation de l’administration : non seulement de les mettre explicitement au service d’une ﬁnalité politique et sociale plus large que la seule recherche d’efficience, mais aussi de permettre aux cadres et personnels de s’en approprier réellement la signiﬁcation. De la sorte, la méthode peut alors devenir une « démarche » au sens d’une culture de progrès partagé, clef de sa réussite.
La gouvernance des systèmes multi-organisationnels
Authors: Dupuis Alain , Farinas Luc 
Published: January 2011

–The governance of multi-organisational systems – The example of the health and social services system in Quebec – This article looks at the overall coordination of multi-organisational health and social services systems, and examines the specific case of Quebec. Written from the standpoint of organisational science and inspired mainly by Anglo-Saxon research, it analyses the hierarchical and formal “integration” of systems, which is a central principle in many structural reforms. This idea does not appear to have a great deal of support, and this article makes a critical analysis of it. It goes on to highlight some operational mechanisms based on mutual adjustment which serve to ensure the overall coordination of multi-organisational health and social services systems.
Le représentant territorial de l'Etat et le fait régional dans les Etats européens
Authors: Marcou Gérard 
Published: January 2011

L’article aborde d’un point de vue de droit et d’administration comparés la question de la place et du rôle de l’administration régionale de l’État et de son responsable (le représentant territorial de l’État) au sein des évolutions que connaissent aussi bien les Etats centralisés que les Etats à autonomie régionale ou même les Etats fédéraux. Dans les États centralisés, il met en lumière la tendance que les États ont à privilégier leurs administrations au niveau régional au détriment de celles longtemps prépondérantes au niveau départemental (pour utiliser la terminologie française). Dans les États fédérés ou à autonomie régionale, il montre que les administrations de l’État au niveau régional, sans forcément disparaître, sont fortement redimensionnées et qu’elles n’existent pas auprès des niveaux infra régionaux ; c’est la collectivité régionale ou l’État régional qui organise ses propres représentations aux niveaux infra-régionaux. L’article analyse également comment les administrations de l’État au niveau régional et leurs responsables dialoguent avec les régions en tant que collectivités publiques ou États à autonomie régionale (et avec les collectivités infra-régionales) et participent au rapport qu’elles entretiennent avec l’Union européenne.