bluuebunny/crossref_metadata_2025_split huggingface dataset:
A New Look at Screening and Diagnosing Diabetes Mellitus
Authors: Saudek Christopher D. , Herman William H. , Sacks David B. , Bergenstal Richard M. , Edelman David , Davidson Mayer B. 
Published: May 2008

Abstract
Objective: Diabetes is underdiagnosed. About one third of people with diabetes do not know they have it, and the average lag between onset and diagnosis is 7 yr. This report reconsiders the criteria for diagnosing diabetes and recommends screening criteria to make case finding easier for clinicians and patients.
Participants: R.M.B. invited experts in the area of diagnosis, monitoring, and management of diabetes to form a panel to review the literature and develop consensus regarding the screening and diagnosis of diabetes with particular reference to the use of hemoglobin A1c (HbA1c). Participants met in open session and by E-mail thereafter. Metrika, Inc. sponsored the meeting.
Evidence: A literature search was performed using standard search engines.
Consensus Process: The panel heard each member’s discussion of the issues, reviewing evidence prior to drafting conclusions. Principal conclusions were agreed on, and then specific cut points were discussed in an iterative consensus process.
Conclusions: The main factors in support of using HbA1c as a screening and diagnostic test include: 1) HbA1c does not require patients to be fasting; 2) HbA1c reflects longer-term glycemia than does plasma glucose; 3) HbA1c laboratory methods are now well standardized and reliable; and 4) errors caused by nonglycemic factors affecting HbA1c such as hemoglobinopathies are infrequent and can be minimized by confirming the diagnosis of diabetes with a plasma glucose (PG)-specific test. Specific recommendations include: 1) screening standards should be established that prompt further testing and closer follow-up, including fasting PG of 100 mg/dl or greater, random PG of 130 mg/dl or greater, or HbA1c greater than 6.0%; 2) HbA1c of 6.5–6.9% or greater, confirmed by a PG-specific test (fasting plasma glucose or oral glucose tolerance test), should establish the diagnosis of diabetes; and 3) HbA1c of 7% or greater, confirmed by another HbA1c- or a PG-specific test (fasting plasma glucose or oral glucose tolerance test) should establish the diagnosis of diabetes. The recommendations are offered for consideration of the clinical community and interested associations and societies.
Growth Hormone Signaling in Vivo in Human Muscle and Adipose Tissue: Impact of Insulin, Substrate Background, and Growth Hormone Receptor Blockade
Authors: Nielsen Charlotte , Gormsen Lars C. , Jessen Niels , Pedersen Steen Bønløkke , Møller Niels , Lund Sten , Jørgensen Jens Otto L. 
Published: May 2008

Abstract
Context: GH induces insulin resistance in muscle and fat, and in vitro data indicate that this may involve cross-talk between the signaling pathways of the two hormones.
Objective: Our objective was to investigate GH and insulin signaling in vivo in human muscle and fat tissue in response to GH, GH receptor blockade, and insulin stimulation.
Design: We conducted two randomized crossover studies.
Participants: Sixteen healthy males participated.
Intervention: GH was administered as a bolus (n = 8) and constant infusion (n = 8). The bolus study included three arms: 1) control (saline), 2) GH (0.5 mg iv), and 3) GH blockade (pegvisomant 30 mg sc), each combined with a hyperinsulinemic glucose clamp. The infusion study included two arms: 1) GH infusion (45 ng/·kg·min, 5.5 h) and 2) saline infusion (5.5 h) combined with a hyperinsulinemic glucose clamp during the final 2.5 h.
Main Outcome Measures: Muscle and fat biopsies were subjected to Western blotting for expression of Stat5/p-Stat5, Akt/p-Akt, and ERK1/2/p-ERK1/2 and to real-time RT-PCR for expression of SOCS1–3 and IGF-I mRNA.
Results: GH significantly reduced insulin sensitivity. The GH bolus as well as GH infusion induced phosphorylation of Stat5 in muscle and fat, and SOCS3 and IGF-I mRNA expression increased after GH infusion. Hyperinsulinemia induced Akt phosphorylation in both tissues, irrespective of GH status. In muscle, ERK1/2 phosphorylation was increased by insulin, but insulin per se did not induce phosphorylation of Stat5.
Conclusions: GH exposure associated with insulin resistance acutely translates into GH receptor signaling in human muscle and fat without evidence of cross-talk with insulin signaling pathways. The molecular mechanisms subserving GH-induced insulin resistance in humans remain unclarified.
Plasma Resistin Levels and Risk of Myocardial Infarction and Ischemic Stroke
Authors: Weikert Cornelia , Westphal Sabine , Berger Klaus , Dierkes Jutta , Möhlig Matthias , Spranger Joachim , Rimm Eric B. , Willich Stefan N. , Boeing Heiner , Pischon Tobias 
Published: May 2008

Abstract
Context: Resistin is a hormone that has been linked to insulin resistance, inflammatory processes, and coronary heart disease in case-control studies; however, prospective data on the association between plasma resistin levels and future risk of cardiovascular disease are lacking.
Objective: The objective of the study was to investigate the association between plasma resistin levels and risk of future myocardial infarction (MI) and ischemic stroke (IS) in a large prospective cohort.
Methods: We investigated the association between plasma resistin levels and risk of MI and IS in a case-cohort design among 26,490 middle-aged subjects from the European Investigation into Cancer and Nutrition-Potsdam Study without history of MI or stroke at time of blood draw. Plasma resistin levels were measured in baseline blood samples of 139 individuals who developed MI, 97 who developed IS, and 817 individuals who remained free of cardiovascular events during a mean follow-up of 6 yr.
Results: After multivariable adjustment for established cardiovascular risk factors including C-reactive protein, individuals in the highest compared with the lowest quartile of plasma resistin levels had a significantly increased risk of MI (relative risk 2.09; 95% confidence interval 1.01–4.31; P for trend = 0.01). In contrast, plasma resistin levels were not significantly associated with risk of IS (relative risk 0.94; 95% confidence interval 0.51–1.73; P for trend = 0.88).
Conclusion: Our data suggest that high plasma resistin levels are associated with an increased risk of MI but not with risk of IS. Further studies are needed to evaluate the predictive value of plasma resistin levels for cardiovascular disease.
The Insulin-Sensitizing Effect of Rosiglitazone in Type 2 Diabetes Mellitus Patients Does Not Require Improved in Vivo Muscle Mitochondrial Function
Authors: Schrauwen-Hinderling Vera B. , Mensink Marco , Hesselink Matthijs K. C. , Sels Jean-Pierre , Kooi M. Eline , Schrauwen Patrick 
Published: May 2008

Abstract
Aims: Our objective was to investigate whether improved in vivo mitochondrial function in skeletal muscle and intramyocellular lipids (IMCLs) contribute to the insulin-sensitizing effect of rosiglitazone.
Methods: Eight overweight type 2 diabetic patients (body mass index = 29.3 ± 1.1 kg/m2) were treated with rosiglitazone for 8 wk. Before and after treatment, insulin sensitivity was determined by a hyperinsulinemic euglycemic clamp. Muscular mitochondrial function (half-time of phosphocreatine recovery after exercise) and IMCL content were measured by magnetic resonance spectroscopy.
Results: Insulin sensitivity improved after rosiglitazone (glucose infusion rate: 19.9 ± 2.8 to 24.8 ± 2.1 μmol/kg·min; P &lt; 0.05). In vivo mitochondrial function (phosphocreatine recovery half-time: 23.8 ± 3.5 to 20.0 ± 1.7 sec; P = 0.23) and IMCL content (0.93 ± 0.18% to 1.37 ± 0.40%; P = 0.34) did not change. Interestingly, the changes in PCr half-time correlated/tended to correlate with changes in fasting insulin (R2 = 0.50; P = 0.05) and glucose (R2 = 0.43; P = 0.08) levels. Changes in PCr half-time did not correlate with changes in glucose infusion rate (R2 = 0.08; P = 0.49).
Conclusion: The rosiglitazone-enhanced insulin sensitivity does not require improved muscular mitochondrial function.
Influence of Ultrasound Treatment on Assembling Structures and Properties of Supramolecular Hydrogels Formed from 1,3,5-Benzenetricarboxylic Acid and 4-Hydroxypyridine
Authors: Cao Yu , Tang Li Ming , Wang Yu Jiang , Zhang Bo Yuan , Jia Lian Kun 
Published: May 2008

Abstract
A new gelator synthesized from 1,3,5-benzenetricarboxylic acid (BTA) and 4-hydroxypyridine (PHP) was capable of gelling water under different ultrasound power. The resulting gels were investigated by gel-to-sol dissociation temperature (Tgel), SEM, DSC, and rheology measurement, which showed that the assembling structures and gel properties were correlated to the ultrasound power.
Cholesterol Suppresses Pressure-induced Interdigitation of Dipalmitoylphosphatidylcholine Bilayer Membrane
Authors: Tamai Nobutake , Matsui Takayuki , Moribayashi Nobutaka , Goto Masaki , Matsuki Hitoshi , Kaneshina Shoji 
Published: May 2008

Abstract
We investigated the effect of cholesterol on the pressure-induced interdigitation of dipalmitoylphosphatidylcholine (DPPC) bilayer membrane by fluorescence technique using 6-propionyl-2-(dimethylamino)naphthalene (Prodan) as a probe. The interdigitation pressure (IP), minimum pressure required for the bilayer interdigitation, was elevated with increasing cholesterol composition (Cch) up to ca. 2 mol %. Further increase of Cch did not give any effect on the IP value. Finally, the interdigitation could not be observed at Cch=8 mol %. Constructed pressure–Cch phase diagram at 50 °C suggests that the retardation and the abolition of the interdigitation are attributable to an interference effect and eventual formation of ordered molecular orientation induced by cholesterol.
Effect of Surface Structure on Wettability of TiO2 Nanofibrils Prepared in Aluminum Oxide Template
Authors: Zhang Ya-nan , Chen Miao , Liang Shan , Zhao Yanchun 
Published: May 2008

Abstract
Porous anodic alumina (PAA) with regular channel structure was chosen as a template, and highly ordered TiO2 nanofibrils arrays were fabricated within the pores of PAA by a sol–gel process. A series of TiO2 nanostructures obtained after the TiO2/Al2O3 composite film was treated with the NaOH for different times. Contact angle measurements indicated that the surface structure strongly affected the wetting behavior of the TiO2 nanofibrils. The wettability of the surface changed from hydrophilic to hydrophobic when the structure of aligned nanofibrils with end tips was obtained.
Functionalized Silver Nanowires for Live Cell Study
Authors: Kuo Chiung-Wen , Shiu Jau-Ye , Wei Kung Hwa , Chen Peilin 
Published: May 2008

Abstract
The biocompatibility of the surface-functionalized silver nanowires has been investigated in two cell lines. It was found that the functionalized silver nanowires with 200 nm diameter and length up to a few μm can be internalized by cells. The cytotoxicity of the silver nanowires was found to depend on their surface modifications. It was also demonstrated that the surface-enhanced Raman scattering (SERS) could be measured on the silver nanowires, which added additional functionality to the silver nanowires.
The Inhibition Effect of Potassium Addition on Methane Formation in Steam Reforming of Acetic Acid over Alumina-supported Cobalt Catalysts
Authors: Hu Xun , Lu Gongxuan 
Published: May 2008

Abstract
The inhibition effect of potassium addition on methane formation in steam reforming of acetic acid over alumina-supported cobalt catalyst has been studied. Co–K/Al2O3 catalyst showed much higher activity for hydrogen generation and much lower selectivity for methane than Co/Al2O3. Potassium addition resulted in the inhibition of methanation process. The similar effect was also observed in methanol and ethanol reforming reactions.
Preparation and Characterization of a π-Conjugated Donor–Accepter-type Ligand Molecule with Redox Abilities
Authors: Katoh Keiichi , Sato Naoki 
Published: May 2008

Abstract
We have synthesized a zwitterion-like molecule 1 having an N,N,N-tridentate ligand site for metal complexation. Compound 1 exhibited negative solvatochromism of the intramolecular charge-transfer (ICT) band in its UV–visible absorption spectrum for different polarity of solvents. Its anion radical (1−•) was generated from both electrical and chemical reduction of the p-naphthoquinone moiety.
Alumina-supported Molybdenum (VI) Oxide: An Efficient and Recyclable Heterogeneous Catalyst for Regioselective Ring Opening of Epoxides with Thiols, Acetic Anhydride, and Alcohols under Solvent-free Conditions
Authors: Singhal Sweety , Jain Suman L , Sain Bir 
Published: May 2008

Abstract
An efficient and simple protocol for regioselective ring opening of epoxides with thiols, acetic anhydride, and alcohols using 16 wt % MoO3 supported on alumina as a recyclable catalyst is described.
Facile Synthesis of Novel Nonplanar Arylamine-centered Oligofluorenes Based on Complicated 9,9-Diarylfluorene Building Blocks by Friedel–Crafts Reaction
Authors: Zhao Bao-Min , Fu Ni-Na , Xie Ling-Hai , Wang Lian-Hui , Huang Wei 
Published: May 2008

Abstract
The syntheses of two well-defined organic nanomaterials, TDFF-TPA and TDFF-FBCz, with highly nonplanar structures, based on complicated 9,9-diarylfluorenes (DAF) by BF3·OEt2-mediated Friedel–Crafts reactions are presented.
Applicants regard structured interviews as a fair method of selection: an audit of candidates
Authors: Westwood Mark A , Nunn Laurence M , Redpath Calum , Mills Peter , Crake Tom 
Published: May 2008

Summary Objective To discover whether applicants regard structures interviews as a fair method of selection for jobs. Design Audit study of short-listed candidates for postgraduate specialty training programmes in the London Deanery. Setting Postgraduate applications for the London Deanery. Main outcome measures Satisfaction or otherwise with the application and selection process for postgraduate specialty training programmes amongst short-listed candidates in the London Deanery. Questions were asked under five categories: the applicant, the advertisement, the application form, the short-listing process, and the interview. Results 89 of 118 forms were completed and analysed. Candidates thought the advertisement was clear on who to contact (97%), when short-listed candidates would be notified of their interview (66%) and when interviews would occur (93%). The design of the application form and the short-listing process both scored a median of 1 or 2 (strongly agree or agree) on all points. The interview process itself also scored well, with most candidates scoring broadly positively. Conclusions As in the previous study, the overall response was broadly a positive one from the candidates' perspective, with the majority of candidates finding the system fair and objective.
Vascular Surgery, ICU and HDU: A 14-Year Observational Study
Authors: Teli Mary , Morris-Stiff Gareth , Rees John R , Woodsford Paul V , Lewis Michael H 
Published: May 2008

INTRODUCTION Over the course of the past decade, numerous changes have occurred in the management of patients undergoing vascular surgical operations. The introduction of high dependency units (HDUs) has meant that many patients previously requiring observation in intensive care units (ICUs) are now managed in this new environment. In addition, many vascular patients may now be suitable for management on a vascular ward immediately following their surgery. This study reports the chronological changes in resource utilisation of patients undergoing major vascular surgery in a district general hospital over a 14-year period. PATIENTS AND METHODS Details of all patients admitted to either the ICU or HDU under the care of a single vascular surgeon during the period 1991–2004 were extracted from a prospectively maintained anaesthetic department database. Details of the age and gender of the patients were obtained together with source of admission, place of discharge and need for re-admission. Operative details for each patient were extracted from a prospectively maintained vascular surgery database including type of procedure undertaken and degree of urgency. RESULTS During the 14-year period under study, there was a dramatic decrease in the use of ICU facilities for the management of vascular patients from 100% in 1991 to 36% in 2004. There was a corresponding increase in the use of HDU for major vascular cases during the same period from 0% to 66%. However, despite a significant increase in the total number of major vascular operations performed, from 67 in 1991 to 185 in 2004 as a result of sub-specialisation, overall use of all high-care facilities fell as the number of patients returned directly to the vascular ward increased from 34% in 1991 to 64% in 2004. The efficacy of the choice of management venue was confirmed by the observation that only 7.7% of those managed on ICU had been initially managed at a lower level of care. In addition, only 1.8% of patients managed on HDU had been admitted after initially being managed on the vascular ward. CONCLUSIONS Sub-specialisation over the past decade has meant a significantly increased major vascular work-load. Since the introduction of the HDU, there has been a significant fall in the use of ICU facilities for routine cases. These changes in resource utilisation have significant implications in terms of budget allocation. It would appear that finances, in relation to vascular surgery, should be concentrated on expanding HDU facilities and ensuring vascular surgery expertise amongst ward nursing staff.
Clinical Utility of Peri-Operative C-Reactive Protein Testing in General Surgery
Authors: Cole Duncan S , Watts Andrew , Scott-Coombes David , Avades Tony 
Published: May 2008

INTRODUCTION C-reactive protein (CRP) is an acute-phase protein used clinically to diagnose infectious and inflammatory disease and monitor response to treatment. CRP measurement in the peri-operative period was audited and patterns of change analysed for elective general surgical patients. PATIENTS AND METHODS General surgical patients (201) admitted for elective general surgery over a 3-month period were considered for the study. CRP results pre- and postoperatively were recorded, and data on co-morbid conditions and surgical procedure were noted. RESULTS CRP was requested pre-operatively on 84% of patients. A high CRP was more likely to be found in patients with co-morbidity. Postoperatively, CRP was requested during the first 3 days on 69% of patients. CRP peaked at postoperative days two or three, and then fell. In patients who had a high pre-operative CRP, the peak CRP was higher and occurred later, than those who had a normal pre-operative CRP. CONCLUSIONS CRP requesting pre-operatively is common, but is not recommended in NICE guidelines. Postoperatively, CRP levels rise; as a result, its use as a tool to screen for infection is limited. CRP has a role in diagnosis of infection after the first three postoperative days and in monitoring response to treatment. Therefore, routine use of CRP measurements pre-operatively and in the first 2 or 3 days post-operatively is not recommended. A peri-operative CRP should only be requested if there is a clear clinical indication.
Primary Anastomosis Without Colonic Lavage for the Obstructed Left Colon
Authors: Cross KLR , Rees JR , Soulsby RHR , Dixon AR 
Published: May 2008

INTRODUCTION Resection, on-table lavage (OTL) and primary anastomosis is the treatment of choice for the obstructed left colon. OTL is time-consuming, requires considerable mobilisation/bowel handling, an enterotomy and potentially exposes the patient to mesenteric vascular injury, faecal contamination and a prolonged ileus. We have assessed outcome following primary resection and anastomosis without prior lavage. PATIENTS AND METHODS Twenty-four consecutive, obstructed patients underwent splenic flexure mobilisation and high anterior resection (concomitant small bowel resection in 2) with primary side-to-side colorectal anastomosis without either prior lavage or covering stoma. Outcome was audited. RESULTS Twenty-four patients, 17 female aged 48–92 years (median. 76 years) presented with left-sided obstruction due to carcinoma (Dukes' B [3], C [6], D [1]) or chronic diverticulitis (14). Median operative time was 85 min (range, 40–105 min). Colonic ileus resolved on day 2 (29%) and day 3 (58%). Median hospital stay was 7 days (range, 6–72 days); 92% discharged by day 10. There were no deaths or re-admissions. A return to theatre followed a reactionary haemorrhage in one. This latter patient's anastomosis leaked on day 4 (no faecal contamination) and was converted to an end stoma. Urinary and wound infections were seen in two. Late complications comprised two anastomotic strictures; both responded to balloon dilatation at 5 months. CONCLUSIONS Resection and primary anastomosis without on-table lavage is an easy, practical, predictable and safe treatment option for left-sided colonic obstruction with minimal complications.
Should Oesophagectomies be Performed by Trainees? – The Experience from a Single Teaching Centre Under the Supervision of One Surgeon
Authors: Baron Ryan , Sujendran Vijay , Maynard Nicholas 
Published: May 2008

INTRODUCTION Surgical training is threatened by anxieties about trainees performing major procedures. We have analysed the outcome of oesophagectomies performed by a consultant surgeon and compared these to the performance of trainees (years 4–6) operating under direct supervision. PATIENTS AND METHODS Data were collected retrospectively in a computerised database on all patients who underwent oesophagectomy at a teaching tertiary centre between December 1997 and April 2004 with a minimum 15 months' follow-up. Analysis of outcome was according to measures of technical adequacy, postoperative course, histological analysis, recurrence and survival. RESULTS During the study period, 241 oesophagectomies were carried out; 157 (65.1%) of these procedures were performed by the consultant and 84 (34.9%) were performed by surgeons-in-training under direct consultant supervision. Pre-operative, technical adequacy, postoperative course, histological analysis, recurrence and survival were comparable in both groups. CONCLUSIONS These data demonstrate comparable patient outcome when suitably experienced trainees are supervised in performing oesophagectomies and support its continued use in operative training.
The Long-Term Results of Percutaneous Drainage of Diverticular Abscess
Authors: Singh B , May K , Coltart I , Moore NR , Cunningham C 
Published: May 2008

INTRODUCTION Diverticulitis is a common condition occasionally complicated by abscess formation. Small abscesses may be managed by antibiotic therapy alone but larger collections require drainage, ideally by the percutaneous route. This minimally invasive approach is appealing but there is little information regarding the long-term follow-up of patients managed in this way. To address this question, we looked at a consecutive series of patients who underwent percutaneous drainage in our institution. PATIENTS AND METHODS A retrospective study was performed of patients undergoing percutaneous drainage of a diverticular abscess from 1999–2007. RESULTS A total of 26 abscesses were identified in 16 patients. In 69% of cases, the abscess was located in the pelvis. The mean size of the abscesses was 8.5 ± 0.9 cm. Drainage was performed under CT (83%) or ultrasound guidance. The mean duration of drainage was 8 days. Fistula formation following drainage occurred in 38% of cases. Eight patients (mean age, 71 years) underwent subsequent surgical resection 9 days to 22 months (mean, 7 months) following initial presentation. Eight patients with significant co-morbid conditions were managed by percutaneous drainage only. The 1-year mortality was 20% and resulted from unrelated causes. The long-term stoma rate was 13%. CONCLUSIONS Percutaneous drainage can safely be performed in patients with a diverticular abscess. It can be used as a bridge before definitive surgery but also as a treatment option in its own right in high-risk surgical patients. We believe percutaneous drainage reduces the need for major surgery and reduces the risk of a permanent stoma.