bluuebunny/crossref_metadata_2025_split huggingface dataset:
Molecular Characterization of Insulin-Mediated Suppression of Hepatic Glucose Production In Vivo
Authors: Ramnanan Christopher J. , Edgerton Dale S. , Rivera Noelia , Irimia-Dominguez Jose , Farmer Ben , Neal Doss W. , Lautz Margaret , Donahue E. Patrick , Meyer Catalina M. , Roach Peter J. , Cherrington Alan D. 
Published: February 2010

OBJECTIVE
Insulin-mediated suppression of hepatic glucose production (HGP) is associated with sensitive intracellular signaling and molecular inhibition of gluconeogenic (GNG) enzyme mRNA expression. We determined, for the first time, the time course and relevance (to metabolic flux) of these molecular events during physiological hyperinsulinemia in vivo in a large animal model.

RESEARCH DESIGN AND METHODS
24 h fasted dogs were infused with somatostatin, while insulin (basal or 8× basal) and glucagon (basal) were replaced intraportally. Euglycemia was maintained and glucose metabolism was assessed using tracer, 2H2O, and arterio-venous difference techniques. Studies were terminated at different time points to evaluate insulin signaling and enzyme regulation in the liver.

RESULTS
Hyperinsulinemia reduced HGP due to a rapid transition from net glycogen breakdown to synthesis, which was associated with an increase in glycogen synthase and a decrease in glycogen phosphorylase activity. Thirty minutes of hyperinsulinemia resulted in an increase in phospho-FOXO1, a decrease in GNG enzyme mRNA expression, an increase in F2,6P2, a decrease in fat oxidation, and a transient decrease in net GNG flux. Net GNG flux was restored to basal by 4 h, despite a substantial reduction in PEPCK protein, as gluconeogenically-derived carbon was redirected from lactate efflux to glycogen deposition.

CONCLUSIONS
In response to acute physiologic hyperinsulinemia, 1) HGP is suppressed primarily through modulation of glycogen metabolism; 2) a transient reduction in net GNG flux occurs and is explained by increased glycolysis resulting from increased F2,6P2 and decreased fat oxidation; and 3) net GNG flux is not ultimately inhibited by the rise in insulin, despite eventual reduction in PEPCK protein, supporting the concept that PEPCK has poor control strength over the gluconeogenic pathway in vivo.
Mortality Associated With Acute Charcot Foot and Neuropathic Foot Ulceration
Authors: van Baal Juliette , Hubbard Richard , Game Fran , Jeffcoate William 
Published: February 2010

OBJECTIVE
To compare the mortality of patients with an acute Charcot foot with a matched population with uninfected neuropathic foot ulcers (NFUs).

RESEARCH DESIGN AND METHODS
Data were extracted from a specialist departmental database, supplemented by hospital records. The findings were compared with the results of earlier populations with Charcot foot and uninfected NFUs managed from 1980. Finally, the results of all patients with acute Charcot foot and all control subjects managed between 1980 and 2007 were compared with normative mortality data for the U.K. population.

RESULTS
A total of 70 patients presented with an acute Charcot foot (mean age 57.4 ± 12.0 years; 48 male [68.6%]) between 2001 and 2007; there were 66 matched control subjects. By 1 October 2008, 13 (eight male; 18.6%) patients with a Charcot foot had died, after a median of 2.1 years (interquartile range 1.1–3.3). Twenty-two (20 male; 33.3%) control subjects had also died after a median of 1.3 years (0.6–2.5). There was no difference in survival between the two groups (log-rank P &gt; 0.05). Median survival of all 117 patients with acute Charcot foot managed between 1980 and 2007 was 7.88 years (4.0–15.4) and was not significantly different from the control NFU patients (8.43 years [3.4–15.8]). When compared with normative U.K. population data, life expectancy in the two groups was reduced by 14.4 and 13.9 years, respectively.

CONCLUSIONS
These data confirm that the mortality in patients presenting to our unit with either an acute Charcot foot and an uninfected neuropathic ulcer was unexpectedly high.
Racial Disparity in A1C Independent of Mean Blood Glucose in Children With Type 1 Diabetes
Authors: Kamps Jodi L. , Hempe James M. , Chalew Stuart A. 
Published: February 2010

OBJECTIVE
Mean blood glucose (MBG) and MBG-independent factors both influence A1C levels. Race was related to A1C independent of MBG in adults. The goal of this study was to determine if racial disparity exists in A1C independent of MBG in children with diabetes.

RESEARCH DESIGN AND METHODS
Participants included 276 children with type 1 diabetes. A1C and MBG were obtained from multiple clinic visits, and a hemoglobin glycation index (HGI) (an assessment of A1C levels independent of MBG) was calculated. A1C and HGI were analyzed controlling for age, diabetes duration, and MBG.

RESULTS
African Americans had statistically significantly higher A1C (9.1 ± 0.1) and HGI (0.64 ± 0.11) than Caucasians (A1C 8.3 ± 0.1, HGI −0.15 ± 0.07) independent of covariates.

CONCLUSIONS
Because of racial disparity in A1C, which is independent of MBG, we recommend that A1C and MBG be used together to make therapeutic decisions for children with diabetes.
Is Pulse Pressure a Predictor of New-Onset Diabetes in High-Risk Hypertensive Patients?
Authors: Yasuno Shinji , Ueshima Kenji , Oba Koji , Fujimoto Akira , Hirata Masakazu , Ogihara Toshio , Saruta Takao , Nakao Kazuwa 
Published: February 2010

OBJECTIVE
Hypertensive patients have an increased risk of developing diabetes. Accumulating evidence suggests a close relation between metabolic disturbance and increased arterial stiffness. Here, we examined the association between pulse pressure and the risk of new-onset diabetes in high-risk Japanese hypertensive patients.

RESEARCH DESIGN AND METHODS
The Candesartan Antihypertensive Survival Evaluation in Japan (CASE-J) trial examined the effects of candesartan and amlodipine on the incidence of cardiovascular events in 4,728 high-risk Japanese hypertensive patients. In the present study, we analyzed the relationship between pulse pressure at baseline and new-onset diabetes in 2,685 patients without diabetes at baseline (male 1,471; mean age 63.7 years; mean BMI 24.8 kg/m2) as a subanalysis of the CASE-J trial.

RESULTS
During 3.3 ± 0.8 years of follow-up, 97 patients (3.6%) developed diabetes. In multiple Cox regression analysis, pulse pressure was an independent predictor for new-onset diabetes (hazard ratio [HR] per 1 SD increase 1.44 [95% CI 1.15–1.79]) as were male sex, BMI, and additional use of diuretics, whereas age and heart rate were not. Plots of HRs for new-onset diabetes considering both systolic and diastolic blood pressure (DBP) revealed that a higher pulse pressure with a lower DBP, indicating that the increased pulse pressure was largely due to increased arterial stiffness, was strongly associated with the risk of new-onset diabetes.

CONCLUSIONS
Pulse pressure is an independent predictor of new-onset diabetes in high-risk Japanese hypertensive patients. Increased arterial stiffness may be involved in the development of diabetes.
Association of Diabetes, Comorbidities, and A1C With Functional Disability in Older Adults
Authors: Kalyani Rita Rastogi , Saudek Christopher D. , Brancati Frederick L. , Selvin Elizabeth 
Published: February 2010

OBJECTIVE
To examine the relationship of diabetes and functional disability in older adults and the possible mediating roles of comorbidities and A1C.

RESEARCH DESIGN AND METHODS
We analyzed data from a nationally representative sample of 6,097 participants aged ≥60 years in the National Health and Nutrition Examination Survey, 1999–2006. Diabetes was defined by self-report. Disability was defined as difficulty performing a physical task. We evaluated disability by grouping 19 physical tasks into five functional groups: lower-extremity mobility (LEM), general physical activities (GPA), activities of daily living (ADL), instrumental activities of daily living (IADL), and leisure and social activities (LSA).

RESULTS
Older U.S. adults with diabetes had the greatest disability in GPA (prevalence 73.6% [95% CI 70.2–76.9]), followed by LEM (52.2% [48.5–55.9]), IADL (43.6% [40.1–47.2]), ADL (37.2% [33.1–41.3]), and LSA groups (33.8% [30.8–36.9]). Diabetes was associated with two to three times increased odds of disability across functional groups (all P &lt; 0.05). Comorbidities, mostly cardiovascular disease and obesity, and poor glycemic control (A1C ≥8%) together explained up to 85% of the excess odds of disability associated with diabetes, whereas poor glycemic control alone explained only ∼10% of the excess odds. Adjustment for comorbidities, A1C, and diabetes duration fully attenuated the associations of diabetes with disability in all functional groups (all P &gt; 0.05).

CONCLUSIONS
Older adults with diabetes have a high prevalence of disabilities with variable associations attributable to comorbidities and A1C. Aggressive management of cardiovascular risk factors and obesity may significantly reduce the burden of disability in this population.
Health-Related Quality of Life, Treatment Satisfaction, and Costs Associated With Intraperitoneal Versus Subcutaneous Insulin Administration in Type 1 Diabetes
Authors: Logtenberg Susan J. , Kleefstra Nanne , Houweling Sebastiaan T. , Groenier Klaas H. , Gans Reinold O. , Bilo Henk J. 
Published: February 2010

OBJECTIVE
To investigate the effects of continuous intraperitoneal insulin infusion (CIPII) compared with subcutaneous insulin on health-related quality of life (HRQOL) and treatment satisfaction, and to perform a cost analysis in type 1 diabetes.

RESEARCH DESIGN AND METHODS
We used an open-label, prospective, crossover, randomized, 16-month study (N = 24). HRQOL and patient satisfaction were assessed with questionnaires (the 36-item short-form health survey [SF-36], the World Health Organization-Five Well-Being Index [WHO-5], and the Diabetes Treatment Satisfaction Questionnaire [DTSQ]). Direct costs of CIPII and continuous subcutaneous insulin infusion (CSII) were compared.

RESULTS
Questionnaire scores were higher with CIPII than with subcutaneous therapy. Yearly direct pump- and procedure-associated costs for CIPII were estimated at €10,910 compared with €4,810 for CSII.

CONCLUSIONS
Apart from improving glycemic control, CIPII improved HRQOL and treatment satisfaction compared with subcutaneous insulin. Direct pump- and procedure-associated costs are considerably higher for CIPII, however.
High Baseline Insulin Levels Associated With 6-Year Incident Observed Sleep Apnea
Authors: Balkau Beverley , Vol Sylviane , Loko Sandrine , Andriamboavonjy Tiana , Lantieri Olivier , Gusto Gaelle , Meslier Nicole , Racineux Jean-Louis , Tichet Jean ,   and the Data from an Epidemiologic Study on the Insulin Resistance Syndrome (D.E.S.I.R.) Study Group
Published: February 2010

OBJECTIVE
Obstructive sleep apnea is common in patients with type 2 diabetes, and its association with insulin and insulin resistance has been examined in cross-sectional studies. We evaluate risk factors for incident observed sleep apnea in a general population not selected for sleep disturbances.

RESEARCH DESIGN AND METHODS
A total of 1,780 men and 1,785 women, aged 33 to 68 years, from the cohort Data from an Epidemiologic Study on the Insulin Resistance Syndrome (D.E.S.I.R.) responded to the question, “Has someone said to you that you stop breathing during your sleep?” at baseline and 6 years. Anthropometric, clinical, and biological factors were recorded at both time points.

RESULTS
At baseline, 14% of men and 7% of women reported having observed sleep apnea (positive response to question); 6-year incidences were 14 and 6%, respectively. Age, anthropometric parameters, blood pressure, and sleep characteristics were all associated with prevalent, observed apnea episodes, in both sexes. Baseline waist circumference was the strongest predictor of incident apnea: standardized odds ratio (OR), adjusted for age and sex, 1.34 (95% CI 1.19–1.52). After adjustment for age, sex, and waist circumference, the standardized ORs for incident observed apnea were identical for fasting insulin and the homeostasis model assessment of insulin resistance: 1.31 (1.13–1.51) and 1.24 (1.09–1.41) for triglycerides and 1.52 (1.12–2.05) for smoking. Observed apnea at baseline was not associated with changes in anthropometric or biological parameters over the 6-year follow-up.

CONCLUSIONS
The most important baseline risk factor for incident apnea was adiposity. After accounting for adiposity, other risk factors were high insulin, insulin resistance, high triglycerides, and smoking, factors amenable to lifestyle intervention.
Long-Acting Insulin Analogs and the Risk of Diabetic Ketoacidosis in Children and Adolescents With Type 1 Diabetes
Authors: Karges Beate , Kapellen Thomas , Neu Andreas , Hofer Sabine E. , Rohrer Tilman , Rosenbauer Joachim , Wolf Johannes , Holl Reinhard W. ,   for the Diabetes Prospective Documentation (DPV) Initiative and the German Federal Ministry for Education and Research (BMBF) Competence Network of Diabetes Mellitus
Published: February 2010

OBJECTIVE
To investigate if long-acting insulin analogs decrease the risk of diabetic ketoacidosis (DKA) in young individuals with type 1 diabetes.

RESEARCH DESIGN AND METHODS
Of 48,110 type 1 diabetic patients prospectively studied between 2001 and 2008, the incidence of DKA requiring hospitalization was analyzed in 10,682 individuals aged ≤20 years with a diabetes duration of ≥2 years.

RESULTS
The overall rate of DKA was 5.1 (SE ± 0.2)/100 patient-years. Patients using insulin glargine or detemir (n = 5,317) had a higher DKA incidence than individuals using NPH insulin (n = 5,365, 6.6 ± 0.4 vs. 3.6 ± 0.3, P &lt; 0.001). The risk for DKA remained significantly different after adjustment for age at diabetes onset, diabetes duration, A1C, insulin dose, sex, and migration background (P = 0.015, odds ratio 1.357 [1.062–1.734]).

CONCLUSIONS
Despite their long-acting pharmacokinetics, the use of insulin glargine or detemir is not associated with a lower incidence of DKA compared with NPH insulin.
Age at Onset and the Risk of Proliferative Retinopathy in Type 1 Diabetes
Authors: Hletala Kustaa , Harjutsalo Valma , Forsblom Carol , summanen Paula , Groop Per-Henrik ,   on behalf of the flnndlane study Group
Published: February 2010

OBJECTIVE
Age at onset of type 1 diabetes influences the risk of microvascular complications. However, the long-term risk of proliferative retinopathy within the wide spectrum of age at onset of type 1 diabetes is less well known.

RESEARCH DESIGN AND METHODS
A sample of 1,117 consecutively recruited patients was drawn from the FinnDiane Study population (4,800 patients). Type 1 diabetes was defi ned as age at onset ≤40 years, insulin treatment initiated within 1 year, and C-peptide ≤0.3 nmol/1. Retinopathy status was graded based on ophthalmic records and/or fundus photographs. The risk of proliferative retinopathy was studied in age-at-onset groups 0–4, 5–14, and 15–40 years.

RESULTS
The mean durations to proliferative retinopathy were 24.3 (22.7–25.9) years in the 0–4 years group, 20.1 (19.2–21.1) years in the 5–14 years group, and 21.6 (19.8–23.3) years in the 15–40 years group (P &lt; 0.001). In a Cox regression model, with A1C, blood pressure, sex, and BMI as covariates, the highest risk of proliferative retinopathy was observed in the 5–14 years group (hazard ratio 1.90 [95% CI 1.45–2.48], P &lt; 0.001). Diabetes onset 0–4 vs. 5–14 years made no difference in the long-term risk of proliferative retinopathy (P = 0.2). When split into two groups, age at onset &lt; 15 years was associated with a higher long-term risk than age at onset &gt;15 years (1.82 [1.40–2.36], P &lt; 0.001).

CONCLUSIONS
Age at onset significantly modifies the long-term risk of proliferative retinopathy. The highest risk is in age-at-onset group 5–14 years, whereas the lowest risk is in age-at-onset group 15–40 years.
The Latitude Wise Prevalence of the CCR5-Δ32-HIV Resistance Allele in India
Authors: Bhatnagar I , Singh M , Mishra N , Saxena R , Thangaraj K , Singh L , Saxena S 
Published: February 2010

The Latitude Wise Prevalence of the CCR5-Δ32-HIV Resistance Allele in IndiaThe chemokine receptor CCR5 plays a crucial role during CD4-mediated entry of HIV-1 in macrophages and a 32 bp deletion in the CCR5 gene (CCR5-Δ32) confers protection against HIV infection and AIDS progression. To evaluate the contribution of this host genetic factor in aggravating India's HIV/AIDS problem, we exclusively examined the frequency of CCR5-Δ32 in 43 different ethnic endogamous Indian populations comprising 1,882 individuals and its latitude-wise distribution in India. This is the first report of prevalence and latitude-wise distribution of CCR5-Δ32 in such large scale in India, which indicates that most of the Indian populations lack the CCR5-Δ32 mutation. This mutation was exhibited in only 13 out of the 43 ethnic populations of India studied with allelic frequency 0.62 - 5%. Southward decreasing cline was observed for frequencies of CCR5-Δ32 (0.79% to 5.0% in North vs. 0.62% to 1.4% South). These results are in accordance with HIV/AIDS prevalence in India, and suggest that absence of CCR5-Δ32 mutation may be one of the important factors for HIV/AIDS incidence in India.
Molecular Diagnostics of Duchenne/Becker Muscular Dystrophy Patients by Multiplex Ligation-Dependent Probe Amplification Analysis and Direct Sequencing
Authors: Todorova A , Guergueltcheva V , Genova J , Mihaylova V , Todorov T , Tchamova T , Georgieva B , Kremensky I , Tournev I , Mitev V 
Published: February 2010

Molecular Diagnostics of Duchenne/Becker Muscular Dystrophy Patients by Multiplex Ligation-Dependent Probe Amplification Analysis and Direct SequencingDuchenne/Becker muscular dystrophy (DMD/BMD), the most common X-linked muscular dystrophy is caused by mutations in the enormously large DMD gene. We screened this gene in 51 unrelated Bulgarian DMD/BMD patients and four families with no living index patient available, by multiplex ligation-dependent probe amplification (MLPA) analysis, which is a powerful tool for detecting deletion/duplication along the DMD gene. This, in combination with direct sequencing, characterized the mutation in all patients, which comprised 42 deletions (82%), six duplications (12%) and three point mutations (6%), and precisely determined all deletion/duplication borders. In all the families with no living index patient available, deletions were detected by direct analysis on the patients' mothers and sisters, proving the value of MLPA for carrier status determination.
Angiotensin-Converting Enzyme Genotype and Acute Pancreatitis in Turkey
Authors: Kasap E , Akyıldız M , Tekin F , Akarca U 
Published: February 2010

Angiotensin-Converting Enzyme Genotype and Acute Pancreatitis in TurkeyThe renin-angiotensin system (RAS) has been implicated in the pathogenesis of acute and chronic pancreatitis. Angiotensin-converting enzyme (ACE) is the key enzyme which activates RAS. The ACE intron 16 insertion/ deletion (I/D) polymorphism is associated with ACE activity and is considered to be a risk factor for several inflammatory processes. We investigated this polymorphism in 68 patients with acute pancreatitis (AP) and 157 healthy Turkish control subjects. Patients were evaluated with ultrasonography, abdominal tomography and laboratory markers and grouped by status for diabetes mellitus (DM), hypertension (HT), and both these diseases and by etiology. Genotyping of the I/D polymorphism was performed by polymerase chain reaction (PCR). The DD genotype was more prevalent in healthy controls, however, genotype II was significantly more frequent in AP patients (p <0.05). In severe AP patients, the genotype II frequency was significantly higher than in controls (p <0.05). Acute pancreatitis patients with both DM and HT had lower frequencies of genotype DD and of the D allele, and higher frequencies of genotype II and of the I allele than patients with either DM or HT (p <0.05).
The Prothrombin Factor II G20210A Mutation with Pulmonary Thromboembolism and a Normal Level of Fibrin Degradation Products
Authors: Nagorni-Obradovic Lj , Miljic P , Djordjevic V , Pešut D , Jovanovic D , Stojsic J , Stevic R , Radojkovic D 
Published: February 2010

The Prothrombin Factor II G20210A Mutation with Pulmonary Thromboembolism and a Normal Level of Fibrin Degradation ProductsDiagnosis of pulmonary thromboembolism (PTE) usually includes clinical pretest probability assessment, testing for specific degradation products of cross-linked fibrin (D-dimer) and imaging studies. Patients with radiological findings attributable to pulmonary infarction and normal D-dimer level, may present a diagnostic and therapeutic challenge. A 37-year-old Caucasian female had episodes of hemoptysis, and bilateral pulmonary nodular infiltrates on chest radiograph and computerized tomography. The plasma D-dimer level was normal, perfusion lung scan was not conclusive and histological examination of an open lung biopsy revealed recent thrombotic pulmonary infarction. She deteriorated and more perfusion defects were detected on perfusion lung scan. Genetic analysis revealed her to be a carrier of the prothrombin factor II (FII) G20210A mutation.
Salts Application for Suppressing Potato Early Blight Disease
Authors: El-Mougy Nehal , Abdel-Kader Mokhtar 
Published: February 2010

Salts Application for Suppressing Potato Early Blight DiseaseThe suppressive effect of sodium and calcium salts applied individually or combined with the yeastSaccharomyces cerevisiaeagainstAlternaria solanithe causal agent of early blight disease of potato was evaluated under laboratory, greenhouse and field conditions.In vitrotest a complete inhibition in fungal growth was observed at concentration of 30 mg/ml of both sodium bicarbonate and calcium chloride. The commercial backing yeastS. cerevisiae(CBY) enhanced the inhibitory effect of tested salts reflected in increasing mycelial fungal growth reduction when combined at the rate of 1:1 at each concentration tested. In pot experiment, under artificial infestation with pathogenic fungus, application of sodium bicarbonate or calcium chloride significantly reduced the early blight incidence and severity by increasing their concentrations. Their most effective concentration were 30 mg/ml that reduced the disease incidence by 50 and 62.4%, respectively. Superior effect of sodium bicarbonate or calcium chloride in disease reduction was observed when they combined with CBY. Field trails for evaluating the most promising greenhouse treatments were preformed under natural infestations during two successive summer seasons. Calcium chloride proved higher efficacy for reducing both disease incidence and severity than that of sodium bicarbonate when applied either alone or combined with CBY. Also, it is observed that increasing concentrations of both sodium bicarbonate or calcium chloride showed parallel decrease in disease incidence and severity. Application of (CBY) enhanced the efficacy of salts spraying against early blight disease. Similar trend was also observed with the increase of potato tubers yield. On the light of the present study it could be suggested that the usage of combined application of the yeastS. cerevisiaewith sodium bicarbonate or calcium chloride might be used as easily applied, safely and cost effective control methods against such plant diseases.