bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clustering of Risk Factors in Parents of Patients With Type 1 Diabetes and Nephropathy
Authors: Thorn Lena M. , Forsblom Carol , Fagerudd Johan , Pettersson-Fernholm Kim , Kilpikari Riika , Groop Per-Henrik ,   on behalf of the FinnDiane Study Group
Published: April 2007

OBJECTIVE—To assess the impact of parental risk factors for diabetic nephropathy.
RESEARCH DESIGN AND METHODS—This cross-sectional study included 2,355 type 1 diabetic patients from the FinnDiane (Finnish Diabetic Nephropathy) study. Diabetic nephropathy was defined as macroalbuminuria (urinary albumin excretion rate &gt;200 μg/min or &gt;300 mg/24 h) or end-stage renal disease. Information was available from 4,676 parents. Parental scores were calculated based on the number of various traits in the parents.
RESULTS—Patients with diabetic nephropathy, compared with those without diabetic nephropathy, had a higher prevalence of maternal (41 vs. 35%, P = 0.046) and parental (62 vs. 55%, P = 0.044) hypertension, maternal stroke (7.6 vs. 5.1%, P = 0.044), and maternal (1.4 vs. 0.7%, P = 0.058) and parental (4.3 vs. 2.9%, P = 0.030) type 1 diabetes. If both, compared with none, of the parents had hypertension, the adjusted odds ratio (OR) for diabetic nephropathy in offspring was 1.56 (95% CI 1.13–2.15). The adjusted OR for diabetic nephropathy was 2.13 (1.36–3.33) for the parental hypertension–diabetes score (3–4 vs. 0 points) and 2.13 (1.37–3.33) for the parental hypertension–cardiovascular disease (CVD)–diabetes score (4–6 vs. 0 points). Fathers of patients with diabetic nephropathy, compared with those without diabetic nephropathy, had reduced overall survival (log-rank P = 0.04) and reduced cardiovascular survival (log-rank P = 0.03).
CONCLUSIONS—A cluster of parental hypertension, CVD, and diabetes is associated with diabetic nephropathy in type 1 diabetes, as is paternal mortality.
Benefits of Information Technology–Enabled Diabetes Management
Authors: Bu Davis , Pan Eric , Walker Janice , Adler-Milstein Julia , Kendrick David , Hook Julie M. , Cusack Caitlin M. , Bates David W. , Middleton Blackford 
Published: April 2007

OBJECTIVE—To determine the financial and clinical benefits of implementing information technology (IT)-enabled disease management systems.
RESEARCH DESIGN AND METHODS—A computer model was created to project the impact of IT-enabled disease management on care processes, clinical outcomes, and medical costs for patients with type 2 diabetes aged &gt;25 years in the U.S. Several ITs were modeled (e.g., diabetes registries, computerized decision support, remote monitoring, patient self-management systems, and payer-based systems). Estimates of care process improvements were derived from published literature. Simulations projected outcomes for both payer and provider organizations, scaled to the national level. The primary outcome was medical cost savings, in 2004 U.S. dollars discounted at 5%. Secondary measures include reduction of cardiovascular, cerebrovascular, neuropathy, nephropathy, and retinopathy clinical outcomes.
RESULTS—All forms of IT-enabled disease management improved the health of patients with diabetes and reduced health care expenditures. Over 10 years, diabetes registries saved $14.5 billion, computerized decision support saved $10.7 billion, payer-centered technologies saved $7.10 billion, remote monitoring saved $326 million, self-management saved $285 million, and integrated provider-patient systems saved $16.9 billion.
CONCLUSIONS—IT-enabled diabetes management has the potential to improve care processes, delay diabetes complications, and save health care dollars. Of existing systems, provider-centered technologies such as diabetes registries currently show the most potential for benefit. Fully integrated provider-patient systems would have even greater potential for benefit. These benefits must be weighed against the implementation costs.
A1C and Survival in Maintenance Hemodialysis Patients
Authors: Kalantar-Zadeh Kamyar , Kopple Joel D. , Regidor Deborah L. , Jing Jennie , Shinaberger Christian S. , Aronovitz Jason , McAllister Charles J. , Whellan David , Sharma Kumar 
Published: April 2007

OBJECTIVE—The optimal target for glycemic control has not been established in diabetic dialysis patients.
RESEARCH DESIGN AND METHODS—To address this question, the national database of a large dialysis organization (DaVita) was analyzed via time-dependent survival models with repeated measures.
RESULTS—Of 82,933 patients undergoing maintenance hemodialysis (MHD) in DaVita outpatient clinics over 3 years (July 2001 through June 2004), 23,618 diabetic MHD patients had A1C measurements at least once. Unadjusted survival analyses indicated paradoxically lower death hazard ratios (HRs) with higher A1C values. However, after adjusting for potential confounders (demographics, dialysis vintage, dose, comorbidity, anemia, and surrogates of malnutrition and inflammation), higher A1C values were incrementally associated with higher death risks. Compared with A1C in the 5–6% range, the adjusted all-cause and cardiovascular death HRs for A1C ≥10% were 1.41 (95% CI 1.25–1.60) and 1.73 (1.44–2.08), respectively (P &lt; 0.001). The incremental increase in death risk for rising A1C values was monotonic and robust in nonanemic patients (hemoglobin &gt;11.0 g/dl). In subgroup analyses, the association between A1C &gt;6% and increased death risk was more prominent among younger patients, those who had undergone dialysis for &gt;2 years, and those with higher protein intake (&gt;1 g · kg−1 · day−1), blood hemoglobin (&gt;11 g/dl), or serum ferritin values (&gt;500 ng/ml).
CONCLUSIONS—In diabetic MHD patients, the apparently counterintuitive association between poor glycemic control and greater survival is explained by such confounders as malnutrition and anemia. All things equal, higher A1C is associated with increased death risk. Lower A1C levels not related to malnutrition or anemia appear to be associated with improved survival in MHD patients.
Knowledge on Inpatient Diabetes Among Fourth-Year Medical Students
Authors: Lansang M. Cecilia , Harrell Heather 
Published: April 2007

OBJECTIVE—The importance of proper management of inpatient hyperglycemia is increasingly being recognized. However, the curriculum for 4th-year medical students has lagged behind current clinical recommendations. The aim of this study was to assess the baseline knowledge of medical subinterns on inpatient diabetes.
RESEARCH DESIGN AND METHODS—In the 2005–2006 school year, subinterns were given a pretest on inpatient diabetes. Descriptive analysis was used.
RESULTS—Students frequently recommended the sole use of sliding scale for diabetes management. Hyperglycemia in patients not known to have diabetes is less likely to be recognized. The students were more likely to provide appropriate management for chest pain than diabetes. Students were otherwise knowledgable about the recognition of type of diabetes and the pharmacology of the medications.
CONCLUSIONS—This study demonstrates the gaps in knowledge about inpatient diabetes that exist before internship and residency. The findings can be used to design a curriculum appropriately targeted to the level of 4th-year medical students.
Chromium Treatment Has No Effect in Patients With Type 2 Diabetes in a Western Population
Authors: Kleefstra Nanne , Houweling Sebastiaan T. , Bakker Stephan J.L. , Verhoeven Simon , Gans Rijk O.B. , Meyboom-de Jong Betty , Bilo Henk J.G. 
Published: April 2007

OBJECTIVE—Chromium treatment has been reported to improve glycemic control in patients with type 2 diabetes. However, concern exists about the possible toxic effects of chromium picolinate. The aim of this study was to determine the effect of chromium treatment in the form of chromium yeast on glycemic control in a Western population of patients with type 2 diabetes who were being treated with oral hypoglycemic agents.
RESEARCH DESIGN AND METHODS—In this 6-month, double-blind study, patients with moderate glycemic control, being treated with oral hypoglycemic agents, were randomly assigned to receive either a placebo or treatment with 400 μg of chromium daily in the form of chromium yeast. The primary efficacy parameter was a change in A1C. Secondary end points were changes in lipid profile, BMI, blood pressure, body fat, and insulin resistance.
RESULTS—No differences were found for the change in A1C between the intervention and placebo groups, nor were any differences found between the groups for the secondary end points.
CONCLUSIONS—There is no evidence that chromium in the form of chromium yeast is effective in improving glycemic control in Western patients with type 2 diabetes who are taking oral hypoglycemic agents.
Identification of Distinct Self-Management Styles of Adolescents With Type 1 Diabetes
Authors: Schneider Stefan , Iannotti Ronald J. , Nansel Tonja R. , Haynie Denise L. , Simons-Morton Bruce , Sobel Douglas O. , Zeitzoff Linda , Clark Loretta , Plotnick Leslie P. 
Published: April 2007

OBJECTIVE—Using a profile-based approach to the assessment of diabetes management, the purpose of this study was to identify and evaluate an empirically derived classification system of distinct self-management styles.
RESEARCH DESIGN AND METHODS—Youth with type 1 diabetes (n = 156) aged 10–16 years and their parents were administered a modified version of the Diabetes Self-Management Profile (DSMP). Cluster analyses were performed independently on parent and youth report forms to categorize patients based on their patterns of scores in five diabetes self-management areas.
RESULTS—Cluster analyses revealed three self-management styles that emerged from both youth and parent report: a “methodical style” (33%) with an emphasis on careful meal planning and correct insulin administration; an “adaptive style” (46%), characterized by high rates of blood glucose testing, exercise, and self-care adjustments; and an “inadequate style” (21%) with moderate rates of self-care adjustments and otherwise low DSMP scores. Convergence between parent and youth report classifications was moderate (Cohen's κ = 0.47, P &lt; 0.0001). A1C was 1.6% higher in the inadequate style group than in both other groups (P &lt; 0.0001), and the classification significantly accounted for differences in A1C above what was explained by an overall DSMP score.
CONCLUSIONS—The findings provide support for recognizing subgroups of patients with unique multidimensional patterns of self-care behaviors. The assessment of self-management styles may prove useful for customized treatments that are targeted directly to the patients’ needs.
Androgenicity of Progestins in Hormonal Contraceptives and the Risk of Gestational Diabetes Mellitus
Authors: Hedderson Monique M. , Ferrara Assiamira , Williams Michelle A. , Holt Victoria L. , Weiss Noel S. 
Published: April 2007

OBJECTIVE—There is some evidence that use of hormonal contraceptives, particularly the more androgenic formulations, can alter a woman's glucose tolerance. We examined the association between hormonal contraceptive use, categorized by the androgenicity of the progestin component, and risk of gestational diabetes mellitus (GDM) in a nested case-control study.
RESEARCH DESIGN AND METHODS—Case (n = 356) and control (n = 368) subjects were selected from a multiethnic cohort of 14,235 women who delivered a singleton live birth between 1 January 1996 and 30 June 1998, who were screened for GDM at 24–28 gestational weeks, and who were members of Kaiser Permanente for at least 5 years before pregnancy. GDM was defined using the National Diabetes Data Group plasma glucose cutoffs. Information concerning hormonal contraceptive use during the 5 years before pregnancy was obtained from medical charts and some pharmacy data.
RESULTS—There was a suggestion that compared with no hormonal contraceptive use, use of a low-androgen hormonal contraceptive before pregnancy was associated with a slight reduction in risk of GDM (odds ratio 0.84 [95% CI 0.58–1.22]), whereas use of a high-androgen hormonal contraceptive was associated with a modest increase in GDM risk (1.43 [0.92–2.22]).
CONCLUSIONS—The effects of hormonal contraceptive use on GDM risk may vary by the androgenicity of the progestin component.
Prevalence of Nonalcoholic Fatty Liver Disease and Its Association With Cardiovascular Disease Among Type 2 Diabetic Patients
Authors: Targher Giovanni , Bertolini Lorenzo , Padovani Roberto , Rodella Stefano , Tessari Roberto , Zenari Luciano , Day Christopher , Arcaro Guido 
Published: April 2007

OBJECTIVE—To determine the prevalence of nonalcoholic fatty liver disease (NAFLD) in type 2 diabetic population and to compare the prevalence of cardiovascular disease (CVD) and its risk factors between people with and without NAFLD.
RESEARCH DESIGN AND METHODS—The entire sample of type 2 diabetic outpatients (n = 2,839) who regularly attended our clinic was screened. Main outcome measures were NAFLD (by patient history and liver ultrasound) and manifest CVD (by patient history, review of patient records, electrocardiogram, and echo-Doppler scanning of carotid and lower limb arteries).
RESULTS—The unadjusted prevalence of NAFLD was 69.5% among participants, and NAFLD was the most common cause (81.5%) of hepatic steatosis on ultrasound examination. The prevalence of NAFLD increased with age (65.4% among participants aged 40–59 years and 74.6% among those aged ≥60 years; P &lt; 0.001) and the age-adjusted prevalence of NAFLD was 71.1% in men and 68% in women. NAFLD patients had remarkably (P &lt; 0.001) higher age and sex-adjusted prevalences of coronary (26.6 vs. 18.3%), cerebrovascular (20.0 vs. 13.3%), and peripheral (15.4 vs. 10.0%) vascular disease than their counterparts without NAFLD. In logistic regression analysis, NAFLD was associated with prevalent CVD independent of classical risk factors, glycemic control, medications, and metabolic syndrome features.
CONCLUSIONS—NAFLD is extremely common in people with type 2 diabetes and is associated with a higher prevalence of CVD. Follow-up studies are needed to determine whether NAFLD predicts the development and progression of CVD.
High Circulating Retinol-Binding Protein 4 Is Associated With Elevated Liver Fat but Not With Total, Subcutaneous, Visceral, or Intramyocellular Fat in Humans
Authors: Stefan Norbert , Hennige Anita M. , Staiger Harald , Machann Jürgen , Schick Fritz , Schleicher Erwin , Fritsche Andreas , Häring Hans-Ulrich 
Published: April 2007

OBJECTIVE—Retinol-binding protein 4 (RBP4) is an adipokine that induced insulin resistance in mice, and high plasma RBP4 levels were associated with insulin-resistant states in humans. To determine which fat compartments are associated with elevated RBP4 levels in humans, we measured circulating RBP4 in 75 healthy subjects and used state-of-the-art measurements of body fat distribution.
RESEARCH DESIGN AND METHODS—Total body, visceral, and subcutaneous abdominal fat were determined by magnetic resonance tomography and liver fat and intramyocellular fat by localized proton magnetic resonance spectroscopy. Insulin sensitivity was measured by the euglycemic-hyperinsulinemic clamp and, together with insulin clearance, estimated from the oral glucose tolerance test (OGTT).
RESULTS—Adjusted circulating RBP4 correlated negatively with insulin sensitivity (clamp: r = −0.33, P = 0.005; OGTT: r = −0.36, P = 0.002) and positively with parameters in the fasting state as insulin levels (r = 0.35, P = 0.003) and homeostasis model assessment of insulin resistance (r = 0.34, P = 0.004). In addition, circulating RBP4 correlated negatively with hepatic insulin clearance (r = −0.25, P = 0.04). Circulating RBP4 was not associated with total body, visceral, or subcutaneous abdominal fat (all P ≥ 0.29). Plasma RBP4 levels were also not associated with intramyocellular fat or circulating adiponectin or leptin. In contrast, plasma RBP4 levels correlated positively with liver fat in cross-sectional (r = 0.27, P = 0.03) and longitudinal (r = 0.37, P = 0.04) analyses.
CONCLUSIONS—Circulating RBP4 is not associated with the amount of fat in the classical depots or in the ectopic depots in muscle. However, it correlates positively with liver fat. Furthermore, metabolic parameters support the close relationship between circulating RBP4 with liver fat and, presumably, hepatic insulin resistance.
Noninvasive Type 2 Diabetes Screening
Authors: Maynard John D. , Rohrscheib Mark , Way Jeffrey F. , Nguyen Catriona M. , Ediger Marwood N. 
Published: April 2007

OBJECTIVE—This study compared the performance of a novel noninvasive technology to fasting plasma glucose (FPG) and A1C tests for detecting undiagnosed diabetes and impaired glucose tolerance.
RESEARCH DESIGN AND METHODS—The design was a head-to-head evaluation in a naïve population. Consented subjects received FPG and A1C tests and an oral glucose tolerance test (OGTT). Subjects were also measured by a noninvasive device that detects the fluorescence of skin advanced glycation end products. A total of 351 subjects participated.
RESULTS—Subjects with 2-h OGTT values ≥140 mg/dl defined the positive screening class. A total of 84 subjects (23.9% prevalence) screened positive. The performances of the noninvasive device, FPG, and A1C were evaluated for sensitivity and specificity against this classification. At the impaired fasting glucose threshold (FPG =100 mg/dl), the FPG testing sensitivity was 58% and the specificity was 77.4%. At that same specificity, the sensitivity for A1C testing was 63.8%, while the noninvasive testing sensitivity was 74.7%. The sensitivity advantage of the noninvasive device over both blood tests for detecting diabetes and precursors was statistically significant (P &lt; 0.05).
CONCLUSIONS—The noninvasive technology showed clinical performance advantages over both FPG and A1C testing. The sensitivity differential indicated that the noninvasive device is capable of identifying 28.8% more individuals in the OGTT-defined positive screening class than FPG testing and 17.1% more than A1C testing. The combination of higher sensitivity and greater convenience—rapid results with no fasting or blood draws—makes the device well suited for opportunistic screening.
Procaspase-9 is attached to the mitochondrial outer membrane in the early stages of apoptosis
Authors: Milisav Irina , Šuput Dušan 
Published: April 2007

AbstractProcaspase-9 is the zymogen form of one of the apoptosis initiators, caspase-9. Its cellular location may differ depending on the cell type; it is found throughout the cytosol, although some of it may be associated with the mitochondria. Procaspase-9 relocates from the cytosol to the mitochondria shortly after the triggering of apoptosis in rat hepatocytes. We investigated whether the mitochondrial protein import machineries import procaspase-9. The combined results of protein import analyses, mitochondrial fractionation and protease treatments of intact and swollen mitochondria imply that procaspase-9 attaches to the outer surface of the mitochondrial outer membrane.
Two new cryptogonimid genera (Digenea, Cryptogonimidae) from Lutjanus bohar (Perciformes, Lutjanidae): analyses of ribosomal DNA reveals wide geographic distribution and presence of cryptic species
Authors: Miller Terrence , Cribb Thomas 
Published: April 2007

AbstractWe describe three new species of Cryptogonimidae belonging to two new genera, Caulanus gen. nov. and Latuterus gen. nov., from the large piscivorous reef fish Lutjanus bohar Forsskål, 1775, recovered from Heron and Lizard Islands off the Great Barrier Reef and Rasdhoo Atoll, Maldives. To support our morphologically based taxonomic approach, three nuclear ribosomal DNA regions (28S, ITS1 and ITS2) were sequenced and analysed to explore the geographic distribution and integrity of the putative species recovered from these widespread localities. Sequencing of the rDNA regions included multiple replicates and revealed three distinct genotypes. Two of the observed genotypes were associated with phenotypically similar specimens of Latuterus, but were each restricted to a single locality, Lizard Island, GBR or Rasdhoo Atoll, Maldives. A posteriori analysis of the associated morphotypes revealed distinct morphological differences and these consistent differences, in combination with the consistent genetic differences led to the recognition of two distinct species in the system. Caulanus is distinguished by having oral spines, caeca which open via ani at the posterior end of the body, tandem testes and uterus that extends from the posterior end of the body to the pharynx. Latuterus is distinguished by lacking oral spines, having multiple/follicular testes, a uterus that is extensive in both fore-and hindbody and vitelline follicles which are confined to the region from the pharynx to oral sucker. Caulanus thomasi sp. nov. had identical sequences for all of the rDNA regions examined from specimens recovered from all three localities, indicating that this species has a wide Indo-Pacific distribution. The species reported here are evidently restricted to Lutjanus bohar because they were never found in large numbers of other lutjanid species sampled at the same localities.
A Poly(3,4‐alkylenedioxythiophene) Electrochromic Variable Optical Attenuator with Near‐Infrared Reflectivity Tuned Independently of the Visible Region
Authors: Dyer A. L. , Grenier C. R. G. , Reynolds J. R. 
Published: April 2007

AbstractDisubstituted poly(3,4‐propylenedioxythiophene)s (PProDOTs) exhibit large electrochromic contrasts in the near infrared (NIR) while showing essentially no color change in the visible region when incorporated into a reflective device platform. The source of this is attributed to a conductive front that propagates through the insulating polymer film, extending from the polymer/electrode interface to the top of the polymer film. A utility of the large contrasts seen in the NIR region is demonstrated with application of the device as an electrochromic variable optical attenuator modulating fiber‐optic signals for optical telecommunications. With bis(ethylhexyloxy)‐substituted PProDOT as the active electrochromic polymer in the device, an optical attenuation of 11 dB at the telecommunications wavelengths of 1.31 and 1.55 μm is achieved with only a 0.1–0.2 dB optical loss in the bleached state. Other favorable properties include optical memory in the absorbing state, switching speeds of under 1 s, a low operating voltage of ±1.2 V, and an improved processability that allows spray‐casting from organic solvents.
Cover Picture: UV‐Light‐Induced Swelling and Visible‐Light‐Induced Shrinking of a TiO2‐Containing Redox Gel (Adv. Mater. 9/2007)
Authors: Tatsuma T. , Takada K. , Miyazaki T. 
Published: April 2007

AbstractPolyacrylate gels containing Ag+ and TiO2 nanoparticles are shown to swell under UV light and shrink under visible light in water. In work reported by Tetsu Tatsuma and co‐workers on p. 1249, the TiO2 absorbs UV light and reduces the Ag+, whereas the deposited Ag absorbs visible light and dissolves itself. These redox reactions change the interactions between the polymer chains and eventually the volume of the gel, as shown on the cover.