bluuebunny/crossref_metadata_2025_split huggingface dataset:
Determinants of Whole-Body Protein Metabolism in Subjects With and Without Type 2 Diabetes
Authors: Gougeon Réjeanne , Morais José A. , Chevalier Stéphanie , Pereira Sandra , Lamarche Marie , Marliss Errol B. 
Published: December 2007

OBJECTIVE—Whole-body protein metabolism is abnormal in suboptimally controlled type 2 diabetes and obesity. We hypothesized that glycemia, insulin resistance, and waist circumference modulate these alterations in type 2 diabetes and, to a lesser extent, in individuals without type 2 diabetes.
RESEARCH DESIGN AND METHODS—In 88 lean and obese subjects without and 40 with type 2 diabetes on an inpatient protein-controlled isoenergetic diet for 7 days, whole-body protein turnover was measured using the fed-fasted 60-h oral 15N-glycine method. Nitrogen flux was determined from urinary 15N urea and protein synthesis, breakdown and net balance calculated. Indexes of diabetes control, resting energy expenditure (REE), and body composition were assessed.
RESULTS—Higher protein turnover in obese subjects was further increased, and net balance was lower in type 2 diabetes. Waist-to-hip ratio and ln homeostasis model assessment of insulin resistance (HOMA-IR) explained 40% of the variance in flux in type 2 diabetes; fat-free mass and lnHOMA-IR explained 62% in subjects without type 2 diabetes. Overall, fasting glucose explained 16% of the variance in net balance. In type 2 diabetes, net balance correlated negatively with fasting glucose in men and positively with hip circumference in women.
CONCLUSIONS—Kinetics of whole-body protein metabolism are elevated, and net balance is diminished in type 2 diabetes, independently of obesity. Elevated flux is associated with greater visceral adiposity, REE, and insulin resistance of glucose. In type 2 diabetic men, these alterations worsened with magnitude of hyperglycemia. In type 2 diabetic women, larger hip circumferences may protect against such alterations. Our findings suggest that dietary protein requirements may be greater in type 2 diabetes to offset a reduced net balance, aggravated as glycemia increases, especially in men.
Reevaluating the Way We Classify the Diabetic Foot
Authors: Lavery Lawrence A. , Peters Edgar J.G. , Williams Jayme R. , Murdoch Douglas P. , Hudson Amanda , Lavery David C. 
Published: December 2007

OBJECTIVE—To separately evaluate peripheral arterial occlusive disease (PAOD) and foot ulcer and amputation history in a diabetic foot risk classification to predict foot complications.
RESEARCH DESIGN AND METHODS—We evaluated 1,666 diabetic patients for 27.2 ± 4.2 months. Patients underwent a detailed foot assessment and were followed at regular intervals. We used a modified version of the International Working Group on the Diabetic Foot's (IWGDF's) risk classification to assess complications during the follow-up period.
RESULTS—There were more ulcerations, infections, amputations, and hospitalizations as risk group increased (χ2 for trend P &lt; 0.001). When risk category 2 (neuropathy and deformity and/or PAOD) was stratified by PAOD, there were more complications in PAOD patients (P &lt; 0.01). When risk group 3 patients (ulceration or amputation history) were separately stratified, there were more complications in subjects with previous amputation (P &lt; 0.01).
CONCLUSIONS—We propose a new risk classification that predicts future foot complications better than that currently used by the IWGDF.
Ten-Year Trends in Self-Rated Health Among Spanish Adults With Diabetes, 1993–2003
Authors: Jiménez-Garcia Rodrigo , Jiménez-Trujillo Isabel , Hernandez-Barrera Valentin , Carrasco-Garrido Pilar , Lopez Ana , Gil Angel 
Published: December 2007

OBJECTIVE—Improving health-related quality of life among individuals with diabetes is a public health goal. This study sought to assess trends in self-rated “fair” and “poor” health among Spanish adults with diabetes and to identify factors associated with fair and poor health using data from all five National Health Surveys conducted from 1993 to 2003.
RESEARCH DESIGN AND METHODS—Poisson regression analysis was used to assess the trend in fair or poor health status during the period 1993–2003 and to compare prevalences between diabetes and nondiabetes sufferers.
RESULTS—The most relevant finding of this study is that, among Spanish adults with diabetes, prevalence of fair or poor heath is more than double that of individuals without diabetes and that overall prevalence did not vary during the decade 1993–2003 (71.2 to 70.5%). The variables associated with an increased risk of self-rated fair or poor health were as follows: age 54–64 years (odds ratio [OR] 1.5) or ≥65 years (2.1), presence of comorbidity (4.3), female sex (1.2), lower educational level (1.7), obesity (1.3), and no physical activity (1.6).
CONCLUSIONS—The lack of improvement in self-rated health among Spanish adults with diabetes calls for urgent implementation of health-promotion, prevention, and diabetes-management strategies aimed at enhancing the quality of life of such individuals.
The Dipeptidyl Peptidase-4 Inhibitor Vildagliptin Improves β-Cell Function and Insulin Sensitivity in Subjects With Impaired Fasting Glucose
Authors: Utzschneider Kristina M. , Tong Jenny , Montgomery Brenda , Udayasankar Jayalakshmi , Gerchman Fernando , Marcovina Santica M. , Watson Catherine E. , Ligueros-Saylan Monica A. , Foley James E. , Holst Jens J. , Deacon Carolyn F. , Kahn Steven E. 
Published: December 2007

OBJECTIVE—To evaluate the effect of treatment with the dipeptidyl peptidase (DPP)-4 inhibitor vildagliptin on insulin sensitivity and β-cell function in subjects with impaired fasting glucose (IFG).
RESEARCH DESIGN AND METHODS—A total of 22 subjects with IFG (11 female and 11 male, mean ± SD age 59.6 ± 11.5 years) were treated orally with 100 mg vildagliptin once daily in a single-blind study. Subjects received placebo for 2 weeks (run-in) followed by vildagliptin for 6 weeks (treatment) and then placebo for 2 weeks (washout). A frequently sampled intravenous glucose tolerance test (FSIGT), followed by a 2-h meal tolerance test (MTT), was performed at 2, 8, and 10 weeks. From the FSIGT, the acute insulin response to glucose (AIRg) and insulin sensitivity index (SI) were determined and used to compute the disposition index (AIRg × SI) as a measure of β-cell function.
RESULTS—Fasting plasma glucose did not change after 6 weeks of vildagliptin treatment. With treatment, mean ± SEM AIRg increased from 224 ± 44 to 286 ± 52 pmol/l (P &lt; 0.05), and SI improved from 2.8 ± 0.5 to 3.5 ± 0.5 × 10−5 · min−1 · pmol−1 · l (P &lt; 0.01), resulting in an increase in the disposition index from 688 ± 180 to 1,164 ± 318 × 10−5/min (P &lt; 0.05). These effects were not sustained after washout. During the MTT, the incremental area under the glucose curve was significantly decreased after treatment (240 ± 15 vs. 191 ± 14 mmol · l−1 · min−1; P = 0.002), but this effect was not sustained after washout.
CONCLUSIONS—The DPP-4 inhibitor vildagliptin improves insulin sensitivity and β-cell function, leading to improved postprandial glycemia in subjects with IFG, who are known to have β-cell dysfunction. Thus, vildagliptin may prevent progression to diabetes in high-risk subjects.
Five-Year Impact of a Continuous Quality Improvement Effort Implemented by a Network of Diabetes Outpatient Clinics
Authors:   Club Diabete Sicili@
Published: December 2007

OBJECTIVE—To evaluate the impact of a continuous quality improvement effort implemented by a network of diabetes outpatient clinics in Sicily, Italy.
RESEARCH DESIGN AND METHODS—Twenty-two clinics adopted the same electronic medical record system. Process and intermediate outcomes indicators were identified and software was developed, enabling the extraction of the information needed for the profiling of quality of care. Data were centrally analyzed anonymously every year, and results were discussed in meetings with the participants. The performances of the different centers were ranked against the “best performers,” and the reasons for variation were discussed.
RESULTS—From 2001 to 2005, a total of 26,782 patients aged ≥18 years have been seen in the participating clinics. Rates of monitoring of A1C, blood pressure, lipid profile, and microalbuminuria constantly increased over the years. The percentage of individuals with A1C values ≤7.0% increased by 16.6%, while the proportion of patients with blood pressure ≤130/85 mmHg increased by 10.7%. The percentage of individuals with LDL cholesterol levels &lt;100 mg/dl had a marked increase from 19.4 to 44.1%. Rates of use of lipid-lowering drugs, antihypertensive drugs, and aspirin also substantially raised over the years.
CONCLUSIONS—We found a strong consistency between increasing rates of monitoring, increasing drug prescription, and better levels of intermediate outcomes. Despite the satisfactory achievements, a substantial room for improvement in the care of diabetes still persists.
Oral Glucose Tolerance Test: A Reliable Tool for Early Detection of Glucose Abnormalities in Patients With Acute Myocardial Infarction in Clinical Practice
Authors: Wallander Märit , Malmberg Klas , Norhammar Anna , Rydén Lars , Tenerz Åke 
Published: December 2007

OBJECTIVE—Previously undetected glucose abnormalities are common in patients with acute myocardial infarction (AMI). We evaluated long-term reliability of early glucometabolic classification of patients with AMI by repeated oral glucose tolerance tests (OGTTs).
RESEARCH DESIGN AND METHODS—A glucometabolic OGTT-based classification was obtained in 122 patients by measuring capillary whole-blood glucose. The classification was performed on three occasions, before hospital discharge and 3 and 12 months thereafter.
RESULTS—At discharge, 34, 31, and 34% were classified as having normal glucose tolerance, impaired glucose tolerance (IGT), or type 2 diabetes, respectively, and 93% of all patients with type 2 diabetes were still classified with type 2 diabetes (n = 27) or IGT (n = 12) after 12 months. The agreements between the OGTTs at discharge and 3 and 12 months were κ = 0.35, P &lt; 0.001, and κ = 0.43, P &lt; 0.001, respectively.
CONCLUSIONS—The outcome of an OGTT performed in AMI patients at hospital discharge reliably informs on long-term glucometabolic state.
Reduced Vascular Endothelial Growth Factor Expression and Intra-Epidermal Nerve Fiber Loss in Human Diabetic Neuropathy
Authors: Quattrini Cristian , Jeziorska Maria , Boulton Andrew J.M. , Malik Rayaz A. 
Published: December 2007

OBJECTIVE—To assess the relevance of vascular endothelial growth factor (VEGF) in the maintenance of peripheral nerve integrity in diabetic neuropathy we have assessed the expression of VEGF and intra-epidermal nerve fiber density (IENFD) in skin biopsy samples from diabetic patients.
RESEARCH DESIGN AND METHODS—Fifty-three diabetic patients and 12 nondiabetic control subjects underwent neurological evaluation, electrophysiology, quantitative sensory, and autonomic function testing. Dermal blood flow responses were evaluated with laser Doppler flowmetry. Skin biopsies were performed on the dorsum of the foot, and IENFD was quantified and compared with the expression of vascular endothelial growth factor A (VEGF-A), its receptor vascular endothelial growth factor receptor 2 (VEGFR-2), hypoxia-inducible factor 1α (HIF-1α), and microvessel density.
RESULTS—IENFD decreased progressively with increasing severity of diabetic neuropathy (P &lt; 0.001). The dermal blood flow response to acetylcholine was reduced in diabetic patients with mild and moderate neuropathy (P &lt; 0.01), and the intensity of staining for epidermal VEGF-A was significantly reduced in diabetic patients compared with control subjects (P &lt; 0.01). Epidermal HIF-1α and VEGFR-2 expression did not differ between groups.
CONCLUSIONS—Progressive endothelial dysfunction, a reduction in VEGF expression, and loss of intra-epidermal nerve fibers occurs in the foot skin of diabetic patients with increasing neuropathic severity.
Effect of Cinnamon on Glucose Control and Lipid Parameters
Authors: Baker William L. , Gutierrez-Williams Gabriela , White C. Michael , Kluger Jeffrey , Coleman Craig I. 
Published: December 2007

OBJECTIVE—To perform a meta-analysis of randomized controlled trials of cinnamon to better characterize its impact on glucose and plasma lipids.
RESEARCH DESIGN AND METHODS—A systematic literature search through July 2007 was conducted to identify randomized placebo-controlled trials of cinnamon that reported data on A1C, fasting blood glucose (FBG), or lipid parameters. The mean change in each study end point from baseline was treated as a continuous variable, and the weighted mean difference was calculated as the difference between the mean value in the treatment and control groups. A random-effects model was used.
RESULTS—Five prospective randomized controlled trials (n = 282) were identified. Upon meta-analysis, the use of cinnamon did not significantly alter A1C, FBG, or lipid parameters. Subgroup and sensitivity analyses did not significantly change the results.
CONCLUSIONS—Cinnamon does not appear to improve A1C, FBG, or lipid parameters in patients with type 1 or type 2 diabetes.
Climatic analysis of Sea-ice variability in the Canadian Arctic from operational charts, 1980–2004
Authors: Kinnard Christophe , Zdanowicz Christian M. , Fisher David A. , Alt Bea , Mccourt Steve 
Published: December 2007

AbstractWe present a complete climatic analysis of Sea-ice conditions in the Canadian Arctic based on digitized operational charts from the Canadian Ice Service for the period 1980–2004. The Seasonal climatology, Spatial variance and linear trends in total ice concentrations (CT) were calculated. The maximum reduction rate in CT was found in the Beaufort Sea (>24% decade–1) and in the Davis Strait/Labrador Sea region (>18% decade–1) during Spring and Summer. Empirical orthogonal function (EOF) analysis performed on monthly CT deviations yielded four Significant EOF modes explaining 32% of the total variance. The Spatial pattern, temporal behaviour and Seasonality of these four EOF modes are discussed and correlated with fields of Sea-level pressure, Surface winds, Surface air temperature and Sea-surface temperature monthly anomalies. These results point to the dominant influence of the North Atlantic Oscillation on CT decadal anomalies during the cold Season, while climate variability in the Pacific influences CT variations in the Beaufort Sea region during Spring–summer.
Direct measurements of turbulent momentum, heat and salt fluxes under landfast ice in the Baltic Sea
Authors: Uusikivi Jari , Ehn Jens , Granskog Mats A. 
Published: December 2007

AbstractMeasurements of under-ice turbulence were performed using an acoustic three-dimensional current meter with an attached fast-repetition temperature–conductivity sensor at two coastal areas in the Baltic Sea during two winters. Observations covered both the ice-growth and spring-melt periods. The objective of these measurements was to obtain knowledge of under-ice turbulence and oceanic heat and salt fluxes to and from the ice in the coastal fast-ice region using eddy correlation techniques. The maximum observed daily average heat flux was 1 Wm–2, and the maximum for 10 min periods was an order of magnitude larger. Under-ice turbulence was much smaller than that recorded in the oceans and in coastal regions with tide. These results provide better knowledge of under-ice turbulence and heat-flux variations and are useful for the future development of a Baltic Sea ice salinity model.
Modeling M2 tidal variability in Arctic Sea-ice drift and deformation
Authors: Hibler W.D. , Roberts A. , Heil P. , Proshutinsky A.Y. , Simmons H.L. , Lovick J. 
Published: December 2007

AbstractSemi-diurnal oscillations are a ubiquitous feature of polar Sea-ice motion. Over much of the Arctic basin, inertial and Semi-diurnal tidal variability have Similar frequencies So that periodicity alone is inadequate to determine the Source of oscillations. We investigate the relative roles of tidal and inertial variability in Arctic Sea ice using a barotropic ice–ocean model with Sea ice embedded in an upper boundary layer. Results from this model are compared with ‘levitated’ ice–ocean coupling used in many models. In levitated models the mechanical buoyancy effect of Sea ice is neglected So that convergence of ice, for example, does not affect the oceanic Ekman flux. We use rotary Spectral analysis to compare Simulated and observed results. This helps to interpret the rotation Sense of Sea-ice drift and deformation at the Semi-diurnal period and is a useful discriminator between tidal and inertial effects. Results indicate that the levitated model generates an artificial inertial resonance in the presence of tidal and wind forcing, contrary to the embedded Sea-ice model. We conclude that Sea-ice mechanics can cause the rotational response of ice motion to change Sign even in the presence of Strong and opposing local tidal forcing when a physically consistent dynamic ice–ocean coupling is employed.
Data assimilation of Sea-ice motion vectors: Sensitivity to the parameterization of Sea-ice Strength
Authors: Dai Mingrui , Arbetter Todd E. , Meier Walter N. 
Published: December 2007

AbstractData assimilation techniques are one method by which to improve the quality of model Simulations of Sea ice. The availability of daily gridded fields of Sea-ice motion makes this field one that can be readily assimilated. These fields are generally of higher resolution than forcing values Such as atmospheric wind which are used to drive the model, and on any given day may depict ice circulation that is dramatically different than what the model Solution represents. Typically, a blending method Such as optimal interpolation (OI) is used and corrections are applied to the initial modeled velocity field Such that the new Solution corresponds better with actual observations. However, care must be taken in Such a technique, as the corrections are not applied directly to the model physics, and the underlying physical assumptions in the ice dynamics may be violated. Previous Studies have Shown that improvements in the ice-motion Solution come at the cost of the quality of other modeled fields. The Strength parameterization in Sea-ice models controls the ice velocity in the model, and is obtained in part by comparison with observed motions. Here we investigate the Sensitivity of the Sea-ice model to variations in the Strength parameterization, and determine the effect of using data assimilation to impose observed velocities. We find that the alternation of the frictional loss parameter has limited effect on model performance. Rather, it is the assimilated data that overwhelm and degrade the Solution, bringing into question whether underlying physical assumptions in the model may be compromised.
From points to Poles: extrapolating point measurements of sea-ice mass balance
Authors: Perovich Don , Richter-Menge Jacqueline A. 
Published: December 2007

AbstractThe amount of ice growth and ablation are key measures of the thermodynamic state of the ice cover. While ice extent and even ice thickness can be determined using remote-sensing techniques, this is not the case for the mass balance. Mass-balance measurements require an ability to attribute the change, establishing whether a change in the thickness of the ice cover occurs at the top or bottom surface and whether it is a result of growth or ablation. We have developed and implemented a tool that can be used to measure thermodynamic changes in sea-ice mass balance at individual locations: the ice mass-balance buoy (IMB). The primary limitation of the IMB is that it provides a point measurement of the ice mass balance, defined by a particular combination of snow and ice conditions. Determining if, and how, such point measurements can be extrapolated is critical to understanding the large-scale mass balance of the sea-ice cover. We explore the potential for extrapolation using mass-balance observations from the Surface Heat Budget of the Arctic (SHEBA) field experiment. During SHEBA, mass-balance measurements were made at over 100 sites covering a 100 km2area. Results indicate that individual point measurements can provide reasonable estimates for undeformed and unponded multi-year ice, which represented more than two-thirds of the ice cover at SHEBA and is the dominant ice type in the perennial pack. A key is carefully selecting a representative location for the instrument package. The contribution of these point measurements can be amplified by integrating them with other tools designed to measure ice thickness and assimilating these combined data into sea-ice models.
Solidification of leads: approximate solutions of non-linear problem
Authors: Alexandrov D.V. , Malygin A.P. , Alexandrova I.V. 
Published: December 2007

AbstractWe present new analytical results relating to the growth and evolution of sea ice. It is noteworthy that thin sea ice plays a central role in the surface heat and mass balance of the Arctic Ocean. In order to describe these balances, we analyze highly resolved temperature data taken through the air/sea/ice interface during the transition from an ice-free to an ice-covered Arctic Ocean surface. Our detailed analysis of the field data is based on the classical model of a mushy layer, which is modified in order to obtain analytical solutions in explicit form (so, for example, ice thickness and growth rate, temperature distributions, conductive and latent heat fluxes are determined). Furthermore, we find that the sea-ice growth is not simply a square-root function of time. It depends on the temperature variations in the atmosphere and lies between two square-root functions of time for the maximum and minimum temperatures found during observations. The theory under consideration is in good agreement with observations.
Effect of summertime wind conditions on lateral and bottom melting in the central Arctic
Authors: Inoue Jun , Kikuchi Takashi 
Published: December 2007

AbstractTo understand the role of wind conditions on the summertime surface ocean system, the ocean, ice and atmosphere in the central Arctic Ocean were observed using two drifting buoys, one in 2002 under stormy conditions, one in 2003 under calm conditions. Although the ice concentration near the North Pole was the same in 2002 and 2003 during early summer, the heat used in bottom melting in 2003 was only about half of that in 2002. To obtain the total heat input into the upper ocean, heat used in lateral melting was additionally derived from a time series of ice concentration in 2002. Assuming the same heat input into the upper ocean, the heat used in lateral and bottom melting was estimated and compared between the years. It is thought that the warm fresh water embedded within the ice cover was mixed downward during the frequently stormy mid-summer of 2002, enhancing bottom melting. By contrast, the warm water in 2003 tended to be used for lateral melting due to the relatively calm conditions, suggesting that a continuously weak wind favours ice-cover decrease during summer. A simple calculation of the ice-cover evolution reveals that the difference in ice concentration during August between 2002 and 2003 reached 10%, which is consistent with the satellite-derived ice concentration.