bluuebunny/crossref_metadata_2025_split huggingface dataset:
Trunk strength and mobility changes in children with slow transit constipation
Authors: Chase Janet W , Stillman Barry C , Gibb Susan M , Clarke Melanie CC , Robertson Val J , Catto‐Smith Anthony G , Hutson John M , Southwell Bridget R 
Published: August 2009

AbstractBackground and Aim:  It appears that there are no published reports on childhood slow transit constipation (STC) that have considered the state of the musculoskeletal components of the trunk in these children. The present study aimed to determine whether children with STC have different trunk musculoskeletal characteristics that might be related to their defecation difficulties, compared to controls.Methods:  With the aid of computer‐analyzed photographs and clinical testing, 41 children with STC and 41 age‐matched controls were examined for Marfanoid features, sitting posture, spinal joint mobility and trunk muscle strength. The latter was assessed by measuring maximum voluntary abdominal bulging and retraction in sitting, and active trunk extension in prone‐lying. Levels of general exercise and sedentary activities were evaluated by questionnaire.Results:  STC subjects were more slumped in relaxed sitting (P ≤ 0.001), less able to bulge (P ≤ 0.03) and less able to actively extend the trunk (P = 0.02) compared to controls. All subjects sat more erect during abdominal bulging (P ≤ 0.03).Conclusion:  The results show that STC children have reduced trunk control and posture, which indicates that clinicians should include training of trunk muscles and correction of sitting posture. There was no evidence that children with STC exercised less than the controls.
Cecal intubation rate with the double‐balloon endoscope after incomplete conventional colonoscopy: A study in 45 patients
Authors: Moreels Tom G , Macken Elisabeth J , Roth Bernard , Van Outryve Marc J , Pelckmans Paul A 
Published: August 2009

AbstractBackground and Aim:  Conventional colonoscopy is the gold standard for colorectal cancer screening. However, a failure rate to complete conventional colonoscopy of more than 10% is reported in the literature. We evaluated whether the therapeutic Fujinon double‐balloon endoscope EN‐450T5/20 is a valuable tool to intubate the cecum and to carry out all conventional endoscopic procedures after incomplete conventional colonoscopy.Methods:  Forty‐five consecutive patients with prior incomplete conventional colonoscopy were prospectively enrolled. All but three procedures were carried out under conscious sedation with the patient in the left lateral decubitus position without fluoroscopic guidance.Results:  The cecum was reached in 42 of 45 patients (93%) and in 62% additional therapeutic interventions were carried out. Double‐balloon colonoscopy required less conscious sedation compared to conventional colonoscopy. No external abdominal compression nor fluoroscopic control was used. The insertion depth of the double‐balloon endoscope did not exceed the working length of a conventional colonoscope.Conclusions:  The present study illustrates that the concept of double‐balloon endoscopy is a valuable alternative to reach the cecum after prior incomplete conventional colonoscopy, especially due to redundant colon and colonic loop formation. The procedure requires less conscious sedation and no fluoroscopic control, but allows all conventional endoscopic interventions.
Serum apolipoprotein C‐III in high‐density lipoprotein: a key diabetogenic risk factor in Turks
Authors: Onat A. , Hergenç G. , Ayhan E. , Uğur M. , Kaya H. , Tuncer M. , Can G. 
Published: August 2009

AbstractAims  We studied determinants of serum apolipoprotein C‐III (apoC‐III) and whether levels of apoC‐III or its fractions predict metabolic syndrome (MetS), Type 2 diabetes and coronary heart disease (CHD).Methods  The predictive value of apoC‐III, measured by immunoturbimetric immunoassay in 802 tracked individuals of a Turkish general population in determining cardiometabolic risk was assessed over 4.4 ± 1.2 years’ follow‐up. Patients with MetS, Type 2 diabetes and CHD at baseline were excluded.Results  Total apoC‐III, as well as both fractions, was significantly, linearly and inversely related to smoking status, positively to alcohol usage and to levels of complement C3. Mid and high tertiles of total or non‐high density lipoprotein (HDL) apoC‐III predicted significantly and independently incident MetS; they predicted CHD with risk ratios of 1.6 [95% confidence intervals (CI) 1.02–2.5], for 1 sd increment, after adjustments that included HDL cholesterol and body mass index (BMI). The highest tertile of HDL apoC‐III was a major independent predictor of new‐onset diabetes with a 2.5‐fold risk ratio for 1 sd increment (95% CI 1.5–4.0) in combined sexes, after adjustment for waist circumference, HDL cholesterol and other confounders and was a better predictor than waist girth.Conclusions  Serum total apoC‐III or its fractions are linearly and inversely associated with smoking, positively with alcohol usage and serum complement C3. The presumably dysfunctional HDL apoC‐III is a stronger predictor of Type 2 diabetes than waist girth in Turks. Non‐HDL apoC‐III predicts strongly the development of MetS as well as incident CHD, independent of HDL cholesterol, BMI and non‐lipid factors. The atherogenicity of apoC‐III and dysfunctionality of HDL apoC‐III carry huge public health implications in Turks.
Long‐term glycaemic control with metformin–sulphonylurea–pioglitazone triple therapy in PROactive (PROactive 17)
Authors: Scheen A. J. , Tan M. H. , Betteridge D. J. , Birkeland K. , Schmitz O. , Charbonnel B. ,   on behalf of the PROactive investigators
Published: August 2009

AbstractAims  We assessed the long‐term glycaemic effects and the safety profile of triple therapy with the addition of pioglitazone vs. placebo in patients with Type 2 diabetes treated with combined metformin–sulphonylurea therapy in the PROspective pioglitAzone Clinical Trial In macroVascular Events (PROactive).Methods  In a post‐hoc analysis, we identified patients treated with metformin plus sulphonylurea combination therapy and not receiving insulin at baseline (n = 1314). In those patients, we compared the effects of pioglitazone (force‐titrated to 45 mg/day, n = 654) vs. placebo (n = 660) on glycated haemoglobin (HbA1c) reduction, concomitant changes in medications and initiation of permanent insulin use (defined as daily insulin use for a period of ≥ 90 days or ongoing use at death/final visit).Results  Significantly greater reductions in HbA1c and greater proportions of patients with HbA1c at target were noted with pioglitazone vs, placebo, despite a decrease in the use of other oral glucose‐lowering agents. There was an approximate twofold increase in progression to permanent insulin use in the placebo group vs. the pioglitazone group: 31.1 vs. 16.1%, respectively, when added to combination therapy. The overall safety of the metformin–sulphonylurea–pioglitazone triple therapy was good.Conclusions  Intensifying an existing dual oral therapy regimen to a triple oral regimen by adding pioglitazone to the classical metformin–sulphonylurea combination resulted in sustained improvements in glycaemic control and reduced progression to insulin therapy. The advantages and disadvantages of adding pioglitazone instead of adding basal insulin should be assessed further.
Persistent arterial stiffness and endothelial dysfunction following successful pancreas–kidney transplantation in Type 1 diabetes
Authors: Stadler M. , Theuer E. , Anderwald C. , Hanusch‐Enserer U. , Auinger M. , Bieglmayer C. , Quehenberger P. , Bischof M. , Kästenbauer T. , Wolzt M. , Wagner O. , Prager R. 
Published: August 2009

AbstractObjective  Successful simultaneous pancreas‐kidney transplantation (SPK) in Type 1 diabetic (T1DM) patients results in improved cardiovascular outcome and survival. However, it is doubtful whether the impairment of cardiovascular and endothelial function in T1DM can be completely reversed.Methods  Pulse‐wave velocity, stroke volume, heart rate, serological markers of endothelial dysfunction (soluble intercellular, vascular cell‐adhesion molecules, E‐selectin, and plasminogen‐activator‐inhibitor‐1) were measured in 10 T1DM patients after SPK with non‐diabetic glucose levels, 10 T1DM patients with poor [T1DM>8; glycated haemoglobin (HbA1c)>8%], and 10 with good glucose control (T1DM<7, HbA1c<7%), in 6 non‐diabetic patients after kidney transplantation (KT) and 9 non‐diabetic control subjects (CON), matching for major anthropometric characteristics.Results  Pulse‐wave velocity was increased in SPK (P < 0.02 vs. CON, KT, T1DM<7) and in T1DM>8 (P < 0.02 vs. T1DM<7). Systolic blood pressure was increased in SPK (P < 0.05 vs. CON). Stroke volume was reduced in SPK, T1DM>8 and T1DM<7 and KT (P < 0.01 vs. CON). Heart rate was elevated in SPK and in T1DM>8 (P < 0.0003 vs. CON and T1DM<7). In SPK, soluble intercellular and vascular cell‐adhesion molecules were 100% and 44% higher (P < 0.03 vs. CON), respectively, while plasminogen‐activator‐inhibitor‐1 was decreased in SPK (P < 0.02 vs. CON).Conclusion  T1DM patients after SPK experience arterial stiffness, a higher heart‐rate and blood pressure, reduced stroke volume and serological signs of endothelial dysfunction. Thus, functional and structural cardiovascular alterations as a result of glucotoxicity, uraemia and hypertension in T1DM might not be completely resolved by SPK.
Skeletal muscle microvascular exchange capacity is associated with hyperglycaemia in subjects with central obesity
Authors: Turzyniecka M. , Wild S. H. , Krentz A. J. , Chipperfield A. J. , Gamble J. , Clough G. F. , Byrne C. D. 
Published: August 2009

AbstractAims  Poor glycaemic control is associated with increased risk of microvascular disease in various organs including the eye and kidney, but the relationship between glycated haemoglobin (HbA1c) and microvascular function in skeletal muscle has not been described. We tested the association between HbA1c and a measure of microvascular exchange capacity (Kf) in skeletal muscle in people with central obesity at risk of developing Type 2 diabetes.Methods  Microvascular function was measured in 28 women and 19 men [mean (± sd) age 51 ± 9 years] with central obesity who did not have diabetes. We estimated insulin sensitivity by hyperinsulinaemic–euglycaemic clamp, visceral and total fatness by magnetic resonance imaging, fitness (VO2 max by treadmill testing), physical activity energy expenditure [metabolic equivalents of tasks (METS) by use of the SenseWear Pro armband] and skeletal muscle microvascular exchange capacity (Kf) by venous occlusion plethysmography.Results  In regression modelling, age, sex and fasting plasma glucose accounted for 30.5% of the variance in HbA1c (r2 = 0.31, P = 0.001). Adding Kf to this model explained an additional 26.5% of the variance in HbA1c (r2 = 0.57, P = 0.0001 and Kf was strongly and independently associated with HbA1c (standardized B coefficient −0.45 (95% confidence interval −0.19, −0.06), P = 0.001).Conclusions  We found a strong negative independent association between a measure of skeletal muscle microvascular exchange capacity (Kf) and HbA1c. Kf was associated with almost as much of the variance in HbA1c as fasting plasma glucose.
Initiating insulin therapy in elderly patients with Type 2 diabetes: efficacy and safety of lispro mix 25 vs. basal insulin combined with oral glucose‐lowering agents
Authors: Wolffenbuttel B. H. R. , Klaff L. J. , Bhushan R. , Fahrbach J. L. , Jiang H. , Martin S. 
Published: August 2009

AbstractAims  To compare starter insulins in the elderly subgroup of the DURABLE trial 24‐week initiation phase.Methods  In a post‐hoc analysis of the ≥ 65 years subgroup enrolled in the DURABLE trial, we compared the safety and efficacy of lispro mix 25 (LM25: lispro 25%/insulin lispro protamine suspension 75%), n = 258, vs. glargine, n = 222, added to oral glucose‐lowering agents.Results  Baseline glycated hemoglobin (HbA1c) was similar (LM25 8.7 ± 1.2, glargine 8.8 ± 1.1%, P = 0.612). At 24‐weeks, LM25 patients had lower HbA1c (7.0 ± 0.9 vs. 7.3 ± 0.9%, P < 0.001), greater HbA1c reduction (−1.7 ± 1.2 vs. −1.5 ± 1.1%, P < 0.001), and more patients reaching HbA1c < 7.0% (55.6 vs. 41.0%, P = 0.005). LM25 patients were on more insulin (0.40 ± 0.19 vs. 0.33 ± 0.19 u/kg/day, P < 0.001) and experienced more weight gain (3.6 ± 3.6 vs. 1.8 ± 3.2 kg, P < 0.001). Additionally, LM25‐treated patients reported a higher mean overall hypoglycaemia rate than glargine patients (40.8 ± 47.6 vs. 31.1 ± 48.5 episodes/patient/year, P = 0.037), while nocturnal hypoglycaemia rates were similar. Over 24 weeks, incidence of severe hypoglycaemia was higher for LM25 (4.3% vs. 0.9%, P = 0.018); however, by 24‐week endpoint incidence was similar (0.8% vs. 0.0%P = 0.125).Conclusions  In this elderly subgroup post‐hoc analysis, LM25 demonstrated a lower endpoint HbA1c and a higher % of patients reaching HbA1c target of < 7.0%, but with more weight gain and higher rates of hypoglycaemia compared to glargine.
Oil accumulation in leaves directed by modification of fatty acid breakdown and lipid synthesis pathways
Authors: Slocombe Steve P. , Cornah Jo , Pinfield‐Wells Helen , Soady Kelly , Zhang QianYi , Gilday Alison , Dyer John M. , Graham Ian A. 
Published: August 2009

SummaryPlant oils in the form of triacylglycerol (TAG) are used for food, industrial feedstock and biofuel manufacture. Although TAG is typically harvested from the fruit or seeds of oil crop species, plants can also accumulate small amounts of TAG in the leaves and other vegetative tissues. Here we show that leaf TAG levels can be increased significantly (10–20 fold) by blocking fatty acid breakdown, particularly during extended dark treatments or leaf senescence in the model plant Arabidopsis. Generation of a double mutant in fatty acid breakdown and diacylglycerol acyltransferase 1 (DGAT1) resulted in a severe vegetative growth phenotype suggesting that partitioning of fatty acids to TAG in leaves is carried out predominantly by this acyltransferase. LEC2, a seed development transcription factor involved in storage product accumulation, was ectopically expressed during senescence in the fatty acid breakdown mutant COMATOSE (cts2). This resulted in accumulation of seed oil type species of TAG in senescing tissue. Our data suggests that recycled membrane fatty acids can be re‐directed to TAG by expressing the seed‐programme in senescing tissue or by a block in fatty acid breakdown. This work raises the possibility of producing significant amounts of oil in vegetative tissues of biomass crops such as Miscanthus.
The synthesis and accumulation of stearidonic acid in transgenic plants: a novel source of ‘heart‐healthy’ omega‐3 fatty acids
Authors: Ruiz‐López Noemí , Haslam Richard P. , Venegas‐Calerón Mónica , Larson Tony R. , Graham Ian A. , Napier Johnathan A. , Sayanova Olga 
Published: August 2009

SummaryDietary omega‐3 polyunsaturated fatty acids have a proven role in reducing the risk of cardiovascular disease and precursor disease states such as metabolic syndrome. Although most studies have focussed on the predominant omega‐3 fatty acids found in fish oils (eicosapentaenoic acid and docosahexaenoic acid), recent evidence suggests similar health benefits from their common precursor, stearidonic acid. Stearidonic acid is a Δ6‐unsaturated C18 omega‐3 fatty acid present in a few plant species (mainly the Boraginaceae and Primulaceae) reflecting the general absence of Δ6‐desaturation from higher plants. Using a Δ6‐desaturase from Primula vialii, we generated transgenic Arabidopsis and linseed lines accumulating stearidonic acid in their seed lipids. Significantly, the P. vialiiΔ6‐desaturase specifically only utilises α‐linolenic acid as a substrate, resulting in the accumulation of stearidonic acid but not omega‐6 γ‐linolenic acid. Detailed lipid analysis revealed the accumulation of stearidonic acid in neutral lipids such as triacylglycerol but an absence from the acyl‐CoA pool. In the case of linseed, the achieved levels of stearidonic acid (13.4% of triacylglycerols) are very similar to those found in the sole natural commercial plant source (Echium spp.) or transgenic soybean oil. However, both those latter oils contain γ‐linolenic acid, which is not normally present in fish oils and considered undesirable for heart‐healthy applications. By contrast, the stearidonic acid‐enriched linseed oil is essentially devoid of this fatty acid. Moreover, the overall omega‐3/omega‐6 ratio for this modified linseed oil is also significantly higher. Thus, this nutritionally enhanced linseed oil may have superior health‐beneficial properties.
Health Care Reforms in Developing Asia: Propositions and Realities
Authors: Wu Xun , Ramesh M. 
Published: August 2009

ABSTRACTMarket‐oriented reforms in the health sector continue to dominate health policy agendas in many developing countries despite growing evidence of their negative impacts. This article critically examines eight key arguments that are used to justify market‐oriented reforms and that continue to hold widespread appeal among policy makers and analysts. The authors conclude that although the axiom that health care is atypical due to pervasive market failures is widely acknowledged by reformers, the scope and depth of the negative consequences of market competition and private sector involvement are systematically underestimated in policy design and implementation, while the regulatory capacity to overcome them is overestimated. Their analysis suggests that while there is considerable scope for market‐oriented reforms, the success of such reforms depends on a tight set of conditions that are often absent in the health care sector, especially but not exclusively in developing countries.
The Kilosa Killings: Political Ecology of a Farmer–Herder Conflict in Tanzania
Authors: Benjaminsen Tor A. , Maganga Faustin P. , Abdallah Jumanne Moshi 
Published: August 2009

ABSTRACTFarmer–herder conflicts in Africa are often presented as being driven by ‘environmental scarcity’. Political ecologists, however, argue that these conflicts should be analysed within a broader historical and policy context. This article presents a case study of a local conflict in the Kilosa District in Tanzania that tragically culminated in the killing of thirty‐eight farmers on 8 December 2000. To understand the conflict, the authors argue that it is necessary to study the history of villagization and land use in the District, as well as national land tenure and pastoral policies. Attempts at agricultural modernization have fostered an anti‐pastoral environment in Tanzania. The government aim is to confine livestock keeping to ‘pastoral villages’, but these villages lack sufficient pastures and water supplies, leading herders to search for such resources elsewhere. Pastoral access to wetlands is decreasing due to expansion of cultivated areas and the promotion of agriculture. The main tool that pastoralists still possess to counteract this trend is their ability to bribe officials. But corruption further undermines people's trust in authorities and in the willingness of these authorities to prevent conflicts. This leads actors to try to solve problems through other means, notably violence.
Dealing with the Proliferation of Bilateral Free Trade Agreements
Authors: Menon Jayant 
Published: August 2009

AbstractBilateral free trade agreements (BTAs) have been proliferating. The outcome of this proliferation of often overlapping BTAs and plurilateral free trade agreements (PTAs) is described as the spaghetti bowl effect or, in the Asian region, the noodle bowl effect. This is costly, and welfare reducing. How do we remedy the situation? In this paper, we consider the various options proposed in dealing with the spaghetti bowl, and assess their ability to do so. A general limitation of these proposals is their tendency to group all kinds of BTAs together, treating them as a homogeneous group. Thus, the proposals ignore underlying differences in motivation in forming BTAs. To overcome this, we develop a taxonomy for classifying BTAs by motivation before considering the effectiveness of the different remedies proposed. We find that each proposal has its pros and cons, and can cater for different types of BTAs. Thus, a combination of the various proposals may be warranted, even in the event of an expeditious and bona fide conclusion to the Doha Round.
The EU Comitology System: Intergovernmental Bargaining and Deliberative Supranationalism?
Authors: BLOM‐HANSEN JENS , BRANDSMA GIJS JAN 
Published: August 2009

AbstractTwo images exist of the day‐to‐day practice of the EU comitology system. The first claims that comitology is deliberation by policy experts in which informal norms, deliberation and good arguments matter more than economic interests and formal voting rules. The second image portrays comitology as an arena for intergovernmental bargaining designed by the Member States to control the Commission. The article systematically investigates these images based on survey evidence from a questionnaire to the Danish and Dutch national representatives on nearly all comitology committees in 2006. The evidence suggests that both images hold and that their relative importance is determined by the nature of the issues dealt with by the individual comitology committees.
Everything But Arms: Much More than Appears at First Sight*
Authors: FABER GERRIT , ORBIE JAN 
Published: August 2009

AbstractThis article examines the impact of the EU's ‘Everything But Arms’ initiative. Starting from the observations that the effects in terms of trade flows have been modest and that EBA nevertheless sparked fierce debate within the EU, we argue that it has had broader ramifications beyond exports of least‐developed countries. Subsequently, we analyse the influence of EBA on three interrelated areas: reforming EU agricultural policy (internal), restructuring EU–ACP relations (regional) and forging a WTO round (global). We conclude that EBA has played a catalysing role in these issues, in line with the globalist‐liberal preferences which have become dominant in the EU.
From ‘Civilian Power’ to ‘Global Power’: Explicating the European Union's ‘Grand Strategy’ Through the Articulation of Discourse Theory
Authors: ROGERS JAMES 
Published: August 2009

AbstractBy articulating discourse theory to build on the concepts of ‘strategic culture’, ‘security culture’ and ‘grand strategy’, we argue that the European Union has adopted a ‘global power’ approach since approximately 1999, having been previously constituted as a ‘civilian power’ since the 1970s. We suggest this paradigmatic shift was influenced by a growing discourse coalition of ‘euro‐strategists’, which mobilized to prevent another European foreign policy failure like the Yugoslav Wars of the 1990s. While this project remains in its infancy, it has already led to the articulation and institutionalization of a new vision of security within the enlarged European community. Indeed, we contend that the continued expansion of this ‘global power’ approach is likely to have profound implications for the future of European integration, potentially leading to a deeper and more tightly unified European geopolitical space.