bluuebunny/crossref_metadata_2025_split huggingface dataset:
Glucose and Insulin Measurements from the Oral Glucose Tolerance Test and Mortality Prediction
Authors: Metter E. Jeffrey , Windham B. Gwen , Maggio Marcello , Simonsick Eleanor M. , Ling Shari M. , Egan Josephine M. , Ferrucci Luigi 
Published: April 2008

OBJECTIVE—To verify what information from oral glucose tolerance tests (OGTTs) independently predicts mortality.
RESEARCH DESIGN AND METHODS—A total of 1,401 initially nondiabetic participants from the Baltimore Longitudinal Study of Aging aged 17–95 years underwent one or more OGTTs (median 2, range 1–8), with insulin and glucose measurements taken every 20 min over the course of 2 h included in this study. Proportional hazards using the longitudinally collected data and Bayesian model averaging were used to examine the association of OGTT measurements individually and grouped with mortality, adjusting for covariates.
RESULTS—Participants were followed for a median 20.3 years (range 0.5–40). The first-hour OGTT glucose and insulin levels increased only modestly with age, whereas levels during the second hour increased 4% per decade. Individually, 100- and 120-min glucose measures and fasting and 100-min insulin levels were all independent predictors of mortality. When all measures were considered together, only higher 120-min glucose was a significant independent risk factor for mortality.
CONCLUSION—The steeper rise with age of the OGTT 2-h glucose values and the prognostic primacy of the 120-min glucose value for mortality is consistent with previous reports and suggests the value of using the OGTT in clinical practice.
Variation in TCF7L2 and Increased Risk of Colon Cancer
Authors: Folsom Aaron R. , Pankow James S. , Peacock James M. , Bielinski Suzette J. , Heiss Gerardo , Boerwinkle Eric 
Published: April 2008

OBJECTIVE—The purpose of this study was to determine whether a variation in the transcription factor 7-like 2 (TCF7L2) gene, which influences diabetes risk, is associated with incidence of cancers.
RESEARCH DESIGN AND METHODS—We related diabetes and TCF7L2 variation with occurrence of several common cancers in a prospective cohort study of 13,117 middle-aged adults initially free of cancer in 1987–1989. We assessed five single nucleotide polymorphisms (SNPs) in TCF7L2 including the putative SNP (rs7903146) for diabetes. We identified incident cancers through 2000 via cancer registries, supplemented by hospital records.
RESULTS—Diabetes was associated marginally inversely with incidence of prostate cancer but not with incidence of colorectal, colon, lung, or breast cancer. The T allele of rs7903146 (frequency 30%) was associated with increased risk of colorectal cancer and, more specifically, colon cancer, with adjusted hazard ratios (95% CI) of 1.0 for CC, 1.25 (0.85–1.83) for CT, and 2.15 (1.27–3.64) for TT genotypes (Ptrend = 0.009). TCF7L2 variation also was associated with lung cancer incidence in whites but not blacks, but residual confounding by smoking may be present.
CONCLUSIONS—Subjects who were initially cancer-free and carrying certain genetic variants of TCF7L2, most notably the T allele of rs7903146, have an increased risk of colon cancer. This association appears to be an independent gene effect not explained by diabetes. Because the T allele of rs7903146 is common, if a causal link is established, this variant could account for a sizable proportion (∼17% here) of cases of colon cancer in the general population.
Plasma Adiponectin as a Marker of Insulin Receptor Dysfunction
Authors: Semple Robert K. , Cochran Elaine K. , Soos Maria A. , Burling Keith A. , Savage David B. , Gorden Phillip , O'Rahilly Stephen 
Published: April 2008

OBJECTIVE—Severe insulin resistance is associated with high morbidity. Identification of severely insulin-resistant patients who have genetic or acquired insulin receptor dysfunction may aid therapeutic decision making; however, onerous diagnostic tests allied to a low frequency of insulin receptor dysfunction often preclude formal diagnosis. Our previous observation of paradoxical hyperadiponectinemia in insulin receptoropathy provides a possible basis for a simpler and cheaper screening test.
RESEARCH DESIGN AND METHODS—Receiver operating characteristics analysis was used to determine diagnostic thresholds for insulin receptoropathy in severe insulin resistance for adiponectin and for the insulin-regulated hepatic proteins sex hormone–binding globulin (SHBG) and IGF binding protein-1 (IGFBP-1).
RESULTS—Adiponectin &gt;7 mg/l in severe insulin resistance had a 97% positive predictive value for insulin receptoropathy and &lt;5 mg/l a 97% negative predictive value. IGFBP-1 and SHBG had lesser, though still significant, utility.
CONCLUSIONS—Use of these markers is likely to have significant value in accelerating the diagnosis of insulin receptoropathies.
Effect of Race/Ethnicity and Persistent Recognition of Depression on Mortality in Elderly Men With Type 2 Diabetes and Depression
Authors: Richardson Lisa K. , Egede Leonard E. , Mueller Martina 
Published: April 2008

OBJECTIVE—To determine whether mortality risk from depression among elderly men with type 2 diabetes differs by ethnicity and persistent recognition of depression.
RESEARCH DESIGN AND METHODS—Data on a cohort of 14,500 male veterans with type 2 diabetes were analyzed. Diagnoses of depression and diabetes were based on ICD-9 codes. Persistent recognition was defined as an ICD-9 code for depression documented in at least the second or third visit after the initial diagnosis of depression. Hazards of death were compared using Cox proportional hazards regression models adjusting for relevant covariates.
RESULTS—Over 10 years, 2,305 deaths were documented. Mortality risk was higher for depressed than nondepressed veterans with diabetes (hazard ratio [HR] 1.6 [95% CI 1.3–1.8]). Among those with depression, mortality risk was lower with persistent recognition (0–2 visits vs. ≥3 visits after initial diagnosis, HR 0.58 [0.40–0.89]) but higher for whites than blacks (1.60 [1.11–2.31]).
CONCLUSIONS—Increased mortality from depression differs by ethnicity and persistent recognition.
Age, BMI, and Race Are Less Important Than Random Plasma Glucose in Identifying Risk of Glucose Intolerance
Authors: Ziemer David C. , Kolm Paul , Weintraub William S. , Vaccarino Viola , Rhee Mary K. , Caudle Jane M. , Irving Jade M. , Koch David D. , Narayan K.M. Venkat , Phillips Lawrence S. 
Published: April 2008

OBJECTIVE—Age, BMI, and race/ethnicity are used in National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) and American Diabetes Association (ADA) guidelines to prompt screening for pre-diabetes and diabetes, but cutoffs have not been evaluated rigorously.
RESEARCH DESIGN AND METHODS—Random plasma glucose (RPG) was measured and 75-g oral glucose tolerance tests were performed in 1,139 individuals without known diabetes. Screening performance was assessed by logistic regression and area under the receiver operating characteristic curve (AROC).
RESULTS—NIDDK/ADA indicators age &gt;45 years and BMI &gt;25 kg/m2 provided significant detection of both diabetes and dysglycemia (both AROCs 0.63), but screening was better with continuous-variable models of age, BMI, and race and better still with models of age, BMI, race, sex, and family history (AROC 0.78 and 0.72). However, screening was even better with RPG alone (AROCs 0.81 and 0.72). RPG &gt;125 mg/dl could be used to prompt further evaluation with an OGTT.
CONCLUSIONS—Use of age, BMI, and race/ethnicity in guidelines for screening to detect diabetes and pre-diabetes may be less important than evaluation of RPG. RPG should be investigated further as a convenient, inexpensive screen with good predictive utility.
Custom Therapeutic Insoles Based on Both Foot Shape and Plantar Pressure Measurement Provide Enhanced Pressure Relief
Authors: Owings Tammy M. , Woerner Julie L. , Frampton Jason D. , Cavanagh Peter R. , Botek Georgeanne 
Published: April 2008

OBJECTIVE—The purpose of this study was to determine whether custom insoles tailored to contours of the barefoot pressure distribution and shape of a patient's foot can reduce plantar pressures in the metatarsal head (MTH) region to a greater extent than conventional custom insoles.
RESEARCH DESIGN AND METHODS—Seventy regions of elevated barefoot pressures (mean peak 834 kPa under MTHs) were identified in 20 subjects with diabetes. Foam box impressions of their feet were sent to three different orthotic supply companies for fabrication of custom insoles. One company was also given plantar pressure data, which were incorporated into the insole design. Measurements of in-shoe plantar pressures were recorded during gait for the three custom insoles in a flexible and a rocker-bottom shoe. Peak pressure and force-time integral were extracted for analysis.
RESULTS—In 64 of 70 regions, the shape-plus-pressure–based insole in the flexible shoe achieved superior unloading compared with the two shape-based insoles. On average, peak pressure was reduced by 32 and 21% (both P ≤ 0.0001) and force-time integral by 40 and 34% (both P &lt; 0.0001) compared with the shape-based insoles. At the midfoot, force-time integral was increased by 51 and 33% (both P &lt; 0.01). Similar trends were found using the rocker-bottom shoe.
CONCLUSIONS—Compared with insoles based only on shape, the use of foot shape with barefoot plantar pressure measurements in designing custom insoles results in enhanced offloading of high-pressure areas under the forefoot. This offloading was achieved by a greater transfer of load to the midfoot without additional loading of other forefoot structures.
Inverse Correlation Between Heart Rate Recovery and Metabolic Risks in Healthy Children and Adolescents
Authors: Lin Lian-Yu , Kuo Hsu-Ko , Lai Ling-Ping , Lin Jiunn-Lee , Tseng Chuen-Den , Hwang Juey-Jen 
Published: April 2008

OBJECTIVE—Heart rate recovery (HRR) is a marker for survival. Little is known about the association between HRR and metabolic risks in healthy children or adolescents.
RESEARCH DESIGN AND METHODS—We examined 993 healthy children and adolescents aged 12–19 years with reliable measures of cardiovascular fitness from the National Health and Nutrition Examination Survey 1999–2002. HRR parameters 1–3 min after exercise were calculated from exercise test results. Anthropometric and metabolic risk factors as well as metabolic Z score were obtained.
RESULTS—The HRR parameters were inversely correlated with most of the metabolic risks, including waist circumference, systolic blood pressure (SBP), serum triglycerides, and serum C-reactive protein (CRP) levels, and were positively correlated with serum HDL levels. In multiple linear regression analysis, among the metabolic risks, waist circumference was the only parameter associated with HRR parameters (P = 0.038, 0.001, and 0.001 for 1-, 2-, and 3-min HRR, respectively) in boys. In girls, waist circumference (P = 0.001 and &lt;0.001 for 2- and 3-min HRR, respectively), SBP (P = 0.029 for 1-min HRR), serum glucose (P = 0.021 for 2-min HRR), and serum CRP (P = 0.007 for 2-min HRR) levels were the most important determinants of HRR parameters. The adjusted 1-min HRR did not change across four quartiles of metabolic Z score, while the adjusted 3-min HRR decreased significantly with four quartiles of metabolic Z score.
CONCLUSIONS—Metabolic risks are inversely associated with HRR in healthy children and adolescents. Our finding suggests that there is a link between metabolic risks and autonomic nervous system functions in healthy young ages.
Trends in the Prevalence of Preexisting Diabetes and Gestational Diabetes Mellitus Among a Racially/Ethnically Diverse Population of Pregnant Women, 1999–2005
Authors: Lawrence Jean M. , Contreras Richard , Chen Wansu , Sacks David A. 
Published: April 2008

OBJECTIVE—The purpose of this study was to assess changes in the prevalence of preexisting diabetes (diabetes antedating pregnancy) and gestational diabetes mellitus (GDM) from 1999 through 2005.
RESEARCH DESIGN AND METHODS—In this retrospective study of 175,249 women aged 13–58 years with 209,287 singleton deliveries of ≥20 weeks’ gestation from 1999 through 2005 in all Kaiser Permanente hospitals in southern California, information from clinical databases and birth certificates was used to estimate the prevalence of preexisting diabetes and GDM.
RESULTS—Preexisting diabetes was identified in 2,784 (1.3%) of all pregnancies, rising from an age- and race/ethnicity-adjusted prevalence of 0.81 per 100 in 1999 to 1.82 per 100 in 2005 (Ptrend &lt; 0.001). Significant increases were observed in all age-groups and all racial/ethnic groups. After women with preexisting diabetes were excluded, GDM was identified in 15,121 (7.6%) of 199,298 screened pregnancies. The age- and race/ethnicity-adjusted GDM prevalence remained constant at 7.5 per 100 in 1999 to 7.4 per 100 in 2005 (Ptrend = 0.07). Among all deliveries to women with either form of diabetes, 10% were due to preexisting diabetes in 1999, rising to 21% in 2005, with GDM accounting for the remainder.
CONCLUSIONS—The stable prevalence of GDM and increase in the prevalence of preexisting diabetes were independent of changes in the age and race/ethnicity of the population. The increase in preexisting diabetes, particularly among younger women early in their reproductive years, is of concern.
Use of the SINBAD Classification System and Score in Comparing Outcome of Foot Ulcer Management on Three Continents
Authors: Ince Paul , Abbas Zulfiqarali G. , Lutale Janet K. , Basit Abdul , Ali Syed Mansoor , Chohan Farooq , Morbach Stephan , Möllenberg Jörg , Game Fran L. , Jeffcoate William J. 
Published: April 2008

OBJECTIVE—To compare populations with and outcomes of diabetic foot ulcers managed in the U.K., Germany, Tanzania, and Pakistan and to explore the use of a new score of ulcer type in comparing outcomes among different countries.
RESEARCH DESIGN AND METHODS—Data from a series of 449 patients with diabetic foot ulcers managed in the U.K. were used to evaluate the new simplified system of classification and to derive an aggregate score. The use of the score was then explored using data from series managed in Germany (n = 239), Tanzania (n = 479), and Pakistan (n = 173).
RESULTS—A highly significant difference was found in time to healing between ulcers of increasing score in the U.K. series (Kruskal-Wallis test; P = 0). When data from all centers were examined, a step-up in days to healing was noted for those with scores of ≥3 (out of 6). Examination of baseline variables contributing to outcome revealed the following differences among centers: ischemia, ulcer area, and depth contributing to outcome in the U.K.; ischemia, area, depth, and infection in Germany; depth, infection, and neuropathy in Tanzania; and depth alone in Pakistan.
CONCLUSIONS—Any system of classification designed for general implementation must encompass all the variables that contribute to outcome in different communities. Adoption of a simple score based on these variables, the Site, Ischemia, Neuropathy, Bacterial Infection, and Depth (SINBAD) score, may prove useful in predicting ulcer outcome and enabling comparison among different centers.
Synthesis and monolayer film of a series of new twin-tailed gemini cationic surfactants at the air/water interface
Authors: Chen Zhi , Feng Yujun , Zhou Dongliang , Zhu Puxin , Wu Dacheng 
Published: April 2008

Abstract
A series of new dimeric surfactants, twin-tailed gemini surfactants, 2(12)-s-2(12), were successfully prepared and characterized, and their monolayer films investigated by the measurement of surface pressure-area (π-A) and surface pressure-time (π-t) isotherms at the air/water interface by a Langmuir film balance. Compared to their monomeric counterparts, their collapse pressure (γcollapse) is smaller, whilst all the molecular area parameters are larger. The limited area (Alimited) and the initial area (Ainitial) of these twin-tailed gemini surfactants change with increasing spacer length s, and the surface pressure decreases with increasing time. It was also found that the higher the initial surface pressure, the larger the attenuation.
Minifragment Screw Fixation of the Scarf Osteotomy
Authors: Gupta Sanjay , Ali Fazal Mohammad , Williams Lloyd 
Published: April 2008

Background Various techniques have been used for internal fixation of Scarf osteotomies. Stability of fixation plays an important role in determining the outcome. We prospectively studied 23 consecutive cases of hallux valgus treated with a scarf osteotomy, which were internally fixed with AO mini fragment screws. The aim of our study was to evaluate the clinical efficacy of the AO mini fragment screw used as fixation device in Scarf osteotomy. Materials and Methods Twenty-three feet (1 male, 16 female) were evaluated. Bilateral procedures were performed on six patients. Mean age was 46 years. The mean followup was 18 months. One surgeon performed all the procedures. Results 43.5% of the patients were very satisfied, 52.2% were satisfied and 4.34% were not satisfied. All osteotomies united without any hardware complications. The mean global AOFAS score improved significantly from a preoperative score of 55 points to 91.95 ( p < 0.001). The intermetatarsal, hallux valgus angle, and DMMA improved from the mean preoperative values of 15.9 degrees, 31.2 degrees, and 14.1 degrees to 9.1 degrees, 15.2 degrees, and 8.4 degrees, respectively ( p < 0.001 for all). One patient developed a superficial wound infection, which responded to antibiotics and one patient developed a painful spur at first MTPJ. Conclusion We conclude that this is a safe and simple technique of fixing a Scarf osteotomy. It is cost effective, provides stable fixation and maintains correction until the osteotomy unites.
Subtalar Release in Clubfeet: A Retrospective Study of 10-Year Outcomes
Authors: Henn R. Frank , Crawford Dennis C. , Eberson Craig P. , Ehrlich Michael G. 
Published: April 2008

Background Optimal management of congenital talipes equinovarus continues to be controversial. There is a dramatically renewed emphasis on non-operative management partly because there has been a high recurrence rate among operated feet. Our hypothesis is that early, extensive subtalar ligament release as the cornerstone of aggressive hindfoot realignment prevents recurrence and retains mobility. Materials and Methods Twenty-two congenital clubfeet (14 patients) corrected by one surgeon were evaluated using two validated patient-based outcome instruments, dynamic pedobarographic analysis, hindfoot mobility, and weightbearing radiographs. Pedobarographic analysis consisted of quantifying peak plantar forces and pressures during the gait cycle in 22 corrected feet and 24 control feet using the FSCAN in-shoe device. Results The mean age at surgery was 8 months and mean followup was 10 years. No patients experienced recurrence of deformity. Reported foot function and satisfaction were very high for all patients and were comparable to reported normal population values. AP and lateral talocalcaneal angles for each foot were within normal limits for age. Hindfoot range of motion, including dorsiflexion, was preserved in all feet. Peak regional forces throughout the gait cycle and plantar pressures at foot flat were mildly, but statistically significantly, higher in the midfoot of corrected feet suggesting slight flattening of the arch. One patient had tendon transfers for bilateral calcaneal deformity and one patient had surgical correction of a bilateral valgus deformity. Conclusion Aggressive hindfoot realignment provides definitive treatment of an equinovarus deformity, but care must be taken to avoid overcorrection.
Correlation of Compensatory Alignment of the Subtalar Joint to the Progression of Primary Osteoarthritis of the Ankle
Authors: Hayashi Koji , Tanaka Yasuhito , Kumai Tsukasa , Sugimoto Kazuya , Takakura Yoshinori 
Published: April 2008

Background The etiology of primary osteoarthritis of the ankle is not well understood. The varus deformity of the ankle and the compensatory function of the subtalar joint are expected to be important factors in the progression of osteoarthritis. The purpose of this study was to document joint inclination at the various stages and to try to deduce the mechanism of primary, varus osteoarthritis of the ankle. Materials and Methods Weightbearing ankle anteroposterior (AP) views, lateral views and subtalar views were taken for 133 ankles in 80 patients (OA group) and 62 ankles in 50 subjects (control group). The OA group was divided into 5 radiographic stages. The inclination of the articular surface of the tibial plafond, the talar dome and the posterior facet of the calcaneus were measured from the radiographs. The inclination of the subtalar joint against the ankle was also calculated. At each stage, each value of the OA group was compared with the control group. Results The varus inclination of the articular surface of the tibial plafond progressed by stages; however, anterior opening was not significant at all stages. The valgus inclination of the subtalar joint progressed until the intermediate stage and converted to varus position at the later stage. Conclusion The compensatory function of the subtalar joint was most pronounced at the intermediate ankle arthritis stage.
Classification Systems for Hallux Rigidus: A Review of the Literature
Authors: Beeson Paul , Phillips Carol , Corr Susan , Ribbans William 
Published: April 2008

Background Hallux rigidus (HR) is one of the most common causes of forefoot pain. A number of classification systems have been developed to evaluate HR. These systems are based on either radiological parameters alone or a combination of radiological and clinical features. The purpose of this paper is to critically evaluate HR classification systems by undertaking a detailed review using English language medical and paramedical databases. Materials and Methods The authors identified 18 formal HR classification systems described in the literature, some of which are variations on a theme. Results No clear consensus on the construction of HR classification systems appears to exist. Different criteria and methods are used which make comparison difficult. Furthermore, it appears that, no serious consideration has been given to their reliability and validity. Criteria used to justify inclusion of these parameters have been based mainly on clinical experience rather than formal research. Conclusion For such a common condition, there is a need for a properly constructed, prospective study to develop a suitable classification system. It should include scientifically validated parameters to help stratify different stages of the disease and aid clinical and scientific communication.
Progress in secondary stroke prevention
Authors: Romano Jose G. , Sacco Ralph L. 
Published: April 2008

AbstractObjectivesThere are about 200,000 recurrent strokes each year in the United States. In addition, a large proportion of strokes are preceded by a transient ischemic attack. Therefore, secondary stroke prevention strategies are of great importance.MethodsSelect ongoing and recently completed studies were reviewed, with emphasis on those completed since the publication of secondary prevention guidelines. Ongoing studies that have the potential to modify existing recommendations are also mentioned.ResultsThis review discusses recently completed and ongoing studies that have the potential to impact clinical practice. The topics discussed include hypertension, dyslipidemia, extracranial carotid and intracranial atherosclerotic disease, and antithrombotic therapy.InterpretationRecent studies have provided evidence that impact secondary stroke prevention. Ann Neurol 2008;63:418–427