bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cholesterol Absorption and Synthesis in Children With Type 1 Diabetes
Authors: Järvisalo Mikko , Raitakari Olli , Gylling Helena , Miettinen Tatu A. 
Published: September 2006

OBJECTIVE—The levels of the surrogate markers of cholesterol absorption (cholestanol and plant sterols) and synthesis (cholesterol precursors) in serum have suggested that in adult type 1 diabetes, cholesterol absorption is high and synthesis is low compared with type 2 diabetic or control subjects. Accordingly, these findings were further studied in children with type 1 diabetes.
RESEARCH DESIGN AND METHODS—Forty-eight children with diabetes were compared with 79 age- and sex-matched control subjects. The serum ratios of cholesterol absorption and synthesis markers were measured with gas-liquid chromatography. The study population was divided into triads (combining the two lowest triads) by serum cholestanol ratios of the control subjects indicating low to high cholesterol absorption efficiency.
RESULTS—The ratios of the absorption and synthesis markers were similar in case and control subjects, and they were negatively related to each other in control subjects, being less consistent in diabetic patients. Thus, high cholesterol absorption was associated with low synthesis. Plant sterol ratios increased significantly with increasing cholestanol triads in both groups, but the values in the lowest triads were higher in case versus control subjects.
CONCLUSIONS—Homeostasis between cholesterol absorption and synthesis is maintained in control children and somewhat less consistently in those with diabetes. The higher plant sterol ratios in diabetic versus control subjects in the lowest cholestanol triads suggest that cholesterol absorption is higher in children with diabetes versus control subjects but only within the range of low cholesterol absorption.
A Double-Blind, Placebo-Controlled Trial Assessing Pramlintide Treatment in the Setting of Intensive Insulin Therapy in Type 1 Diabetes
Authors: Edelman Steve , Garg Satish , Frias Juan , Maggs David , Wang Yan , Zhang Bei , Strobel Susan , Lutz Karen , Kolterman Orville 
Published: September 2006

OBJECTIVE—To assess safety, efficacy, and tolerability of pramlintide dose escalation with proactive mealtime insulin reduction, followed by insulin optimization, in patients with type 1 diabetes.
RESEARCH DESIGN AND METHODS—This 29-week, double-blind, placebo-controlled study randomized 296 patients to pramlintide or placebo as an adjunct to insulin. During initiation, pramlintide was escalated from 15 to 60 μg/meal (15-μg increments) with recommended reductions (30–50%) in mealtime insulin. Insulin was subsequently adjusted to optimize glycemic control. End points included safety and change in HbA1c (A1C), postprandial glucose, insulin, weight, and tolerability.
RESULTS—Baseline A1C was 8.1% for both groups and at week 29 had decreased comparably (pramlintide −0.5% [95% CI −0.61 to −0.33]; placebo −0.5% [−0.63 to −0.35]). Pramlintide treatment significantly reduced postprandial glucose excursions (incremental area under the curve [AUC]0–3h: pramlintide −175 ± 40, placebo −64 ± 38 mg · h−1 · dl−1; P &lt; 0.0005) and weight (pramlintide −1.3 ± 0.30, placebo +1.2 ± 0.30 kg; P &lt; 0.0001). At week 29, insulin dose decreased by 28 and 4% in pramlintide- and placebo-treated groups, respectively. Nausea, reported by 63 and 36% of patients in pramlintide and placebo groups (P &lt; 0.01), respectively, was predominately mild to moderate in intensity. Severe hypoglycemia rates were low in both groups (pramlintide 0.57 ± 0.09, placebo 0.30 ± 0.06 event rate/patient-year; P &lt; 0.05), with increased rates observed in patients remaining at 30 μg pramlintide.
CONCLUSIONS—Pramlintide dose escalation with reduced mealtime insulin was effective during therapy initiation in patients with type 1 diabetes. While both groups experienced equivalent A1C reductions relative to placebo, pramlintide-treated patients experienced reductions in postprandial glucose excursions and weight, not achievable with insulin therapy alone.
Modeling Chronic Glycemic Exposure Variables as Correlates and Predictors of Microvascular Complications of Diabetes
Authors: Dyck Peter J. , Davies Jenny L. , Clark Vicki M. , Litchy William J. , Dyck P. James B. , Klein Christopher J. , Rizza Robert A. , Pach John M. , Klein Ronald , Larson Timothy S. , Melton L. Joseph , O’Brien Peter C. 
Published: September 2006

OBJECTIVE—The degree to which chronic glycemic exposure (CGE) (fasting plasma glucose [FPG], HbA1c [A1C], duration of diabetes, age at onset of diabetes, or combinations of these) is associated with or predicts the severity of microvessel complications is unsettled. Specifically, we test whether combinations of components correlate and predict complications better than individual components.
RESEARCH DESIGN AND METHODS—Correlations and predictions of CGE and complications were assessed in the Rochester Diabetic Neuropathy Study, a population-based, cross-sectional, and longitudinal epidemiologic survey of 504 patients with diabetes followed for up to 20 years.
RESULTS—In multivariate analysis, A1C and duration of diabetes (and to a lesser degree age at onset of diabetes but not FPG) were the main significant CGE risk covariates for complications. A derived glycemic exposure index (GEi) correlated with and predicted complications better than did individual components. Composite or staged measures of polyneuropathy provided higher correlations and better predictions than did dichotomous measures of whether polyneuropathy was present or not. Generally, the mean GEi was significantly higher with increasing stages of severity of complications.
CONCLUSIONS—A combination of A1C, duration of diabetes, and age at onset of diabetes (a mathematical index, GEi) correlates significantly with complications and predicts later complications better than single components of CGE. Serial measures of A1C improved the correlations and predictions. For polyneuropathy, continuous or staged measurements performed better than dichotomous judgments. Even with intensive assessment of CGE and complications over long times, only about one-third of the variability of the severity of complications is explained, emphasizing the role of other putative risk covariates.
Efficacy and Safety of Angiotensin II Receptor Blockade in Elderly Patients With Diabetes
Authors: Winkelmayer Wolfgang C. , Zhang Zhongxin , Shahinfar Shahnaz , Cooper Mark E. , Avorn Jerry , Brenner Barry M. 
Published: September 2006

OBJECTIVE—While national guidelines recommend ACE inhibitor (ACEI) or angiotensin receptor blocker (ARB) therapy in patients with diabetes and nephropathy, guidelines concerning elderly patients with diabetes have not endorsed these drugs. We sought to assess the nephroprotective efficacy and safety of ARB therapy in elderly patients by conducting age-specific subgroup analyses using data from the Reduction of Endpoints in NIDDM with the Angiotensin II Antagonist Losartan (RENAAL) study.RESEARCH DESIGN AND METHODS—We studied 1,513 patients with type 2 diabetes and nephropathy who randomly received either losartan or placebo. We tested for effect modification by age of the effect of losartan on the incidence of the predefined end points (doubling of serum creatinine, end-stage renal disease [ESRD], or death) and the risk of adverse events.RESULTS—Of 1,513 participants, 421 (27.8%) were aged &gt;65 years (maximum age 74 years). Age did not modify the efficacy of losartan in reducing the risk of the primary outcome, a composite of doubling of serum creatinine, ESRD, or death (Pinteraction = 0.66) or its individual components (all Pinteraction &gt; 0.44). In patients aged &gt;65 years, losartan reduced the risk of ESRD by 50% (95% CI 30–81, P = 0.005). We found no evidence that older patients were more likely to experience adverse events from losartan such as a rise in serum creatinine or hyperkalemia than younger patients.CONCLUSIONS—Elderly patients had the same level of benefits and risks as younger patients from treatment with losartan. Underuse of ACEI and ARB therapy in elderly patients because of the perceived lack of efficacy or a greater risk of adverse events appears unjustified.
Assessing Regimen Adherence of Adolescents With Type 1 Diabetes
Authors: Iannotti Ronald J. , Nansel Tonja R. , Schneider Stefan , Haynie Denise L. , Simons-Morton Bruce , Sobel Douglas O. , Zeitzoff Linda , Plotnick Leslie P. , Clark Loretta 
Published: September 2006

OBJECTIVE—The purpose of this study is to evaluate two updated measures of diabetes regimen adherence. The Diabetes Self-Management Profile (DSMP) is a widely used, structured interview. Limitations include a substantial interviewer and respondent time burden and the need for well-trained interviewers to use appropriate prompts and score the open-ended responses. The Diabetes Behavior Rating Scale (DBRS) is a self-administered, fixed-choice survey.
RESEARCH DESIGN AND METHODS—Both measures were administered to 146 youth with type 1 diabetes (aged 11–18 years) and their parents. Items were added to the DBRS to allow for both flexible and conventional regimens, and the DSMP was modified to use standardized wording across items, accommodate flexible regimens, and permit administration by nonmedical interviewers.
RESULTS—Both measures had good evidence of internal consistency (for the DSMP: parent 0.75 and youth 0.70; for the DBRS: parent 0.84 and youth 0.84). Scores on the DSMP and the DBRS were significantly related (r = 0.72 for parents and 0.74 for youth). There was moderate agreement between parent and youth (DSMP, r = 0.51; DBRS, r = 0.48). The measures were correlated with HbA1c for both parent (DSMP, r = −0.35; DBRS, r = −0.35) and youth (DSMP, r = −0.36; DBRS, r = −0.34) reports.
CONCLUSIONS—Both measures exhibit good psychometric properties and good criterion validity but varied in terms of respondent and interviewer burden, issues that should be considered in selecting assessment procedures.
Flexible Intensive Insulin Therapy in Adults With Type 1 Diabetes and High Risk for Severe Hypoglycemia and Diabetic Ketoacidosis
Authors: Sämann Alexander , Mühlhauser Ingrid , Bender Ralf , Hunger-Dathe Wilgard , Kloos Christof , Müller Ulrich A. 
Published: September 2006

OBJECTIVE—Diabetes treatment and teaching programs (DTTPs) for type 1 diabetes, which teach flexible intensive insulin therapy to enable dietary freedom, have proven to be safe and effective in routine care. This study evaluates DTTP outcomes in patients at high risk for severe hypoglycemia and severe ketoacidosis.
RESEARCH DESIGN AND METHODS—There were 96 diabetes centers that participated between 1992 and 2004. A total of 9,583 routine-care patients with type 1 diabetes were examined before and 1 year after a DTTP. History of repeated severe hypoglycemia/severe ketoacidosis was an indication for DTTP participation. Before-after analyses were performed for subgroups of patients with three or more episodes of severe hypoglycemia or two or more episodes of severe ketoacidosis during the year before a DTTP. Main outcome measures were GHb, severe hypoglycemia, severe ketoacidosis, and hospitalization.
RESULTS—A total of 341 participants had three or more episodes of severe hypoglycemia the year before a DTTP. Mean baseline GHb was 7.4 vs. 7.2% after the DTTP, incidence of severe hypoglycemia was 6.1 vs. 1.4 events · patient−1 · year−1, and hospitalization was 8.6 vs. 3.9 days · patient−1 · year−1. In mixed-effects models taking effects of centers and diabetes duration into account, mean difference was −0.3% (95% CI −0.5 to −0.1%; P = 0.0006) for GHb and −4.7 events · patient−1 · year−1 (−5.4 to −4; P &lt; 0.0001) for severe hypoglycemia. A total of 95 patients had two or more episodes of severe ketoacidosis. GHb was 9.4% at baseline versus 8.7% after DTTP; incidence of severe ketoacidosis was 3.3 vs. 0.6 events · patient−1 · year−1, and hospitalization was 19.4 vs. 10.2 days · patient−1 · year−1. In linear models with diabetes duration as the fixed effect, the adjusted mean difference was −2.7 events · patient−1 · year−1 (95% CI −3.3 to −2.1; P &lt; 0.0001) for severe ketoacidosis and −8.1 days (−12.9 to −3.2; P = 0.0014) for hospitalization.
CONCLUSIONS—Patients at high risk for severe hypoglycemia or severe ketoacidosis may benefit from participation in a standard DTTP for intensive insulin therapy and dietary freedom.
Dietary Calcium and Magnesium, Major Food Sources, and Risk of Type 2 Diabetes in U.S. Black Women
Authors: van Dam Rob M. , Hu Frank B. , Rosenberg Lynn , Krishnan Supriya , Palmer Julie R. 
Published: September 2006

OBJECTIVE—Inverse associations between magnesium and calcium intakes and risk of type 2 diabetes have been reported for studies in predominantly white populations. We examined magnesium, calcium, and major food sources in relation to type 2 diabetes in African-American women.
RESEARCH DESIGN AND METHODS—This is a prospective cohort study including 41,186 participants of the Black Women’s Health Study without a history of diabetes who completed validated food frequency questionnaires at baseline. During 8 years of follow-up (1995–2003), we documented 1,964 newly diagnosed cases of type 2 diabetes.
RESULTS—The multivariate-adjusted hazard ratio of type 2 diabetes for the highest compared with the lowest quintile of intake was 0.69 (95% CI 0.59–0.81; P trend &lt;0.0001) for dietary magnesium and 0.86 (0.74–1.00; P trend = 0.01) for dietary calcium. After mutual adjustment, the association for calcium disappeared (hazard ratio 1.04 [95% CI 0.88–1.24]; P trend = 0.88), whereas the association for magnesium remained. Daily consumption of low-fat dairy (0.87 [0.76–1.00]; P trend = 0.04) and whole grains (0.69 [0.60–0.79]; P trend &lt;0.0001) were associated with a lower risk of type 2 diabetes compared with a consumption less than once a week. After mutual adjustment, the hazard ratio was 0.81 (0.68–0.97; P trend = 0.02) for magnesium and 0.73 (0.63–0.85; P trend &lt;0.0001) for whole grains.
CONCLUSIONS—These findings indicate that a diet high in magnesium-rich foods, particularly whole grains, is associated with a substantially lower risk of type 2 diabetes in U.S. black women.
FTIR study of gamma-irradiated cis-1,4-polyisoprene
Authors: Polovková J. , Klein E. , Cibulková Z. , Lukeš V. 
Published: September 2006

AbstractThe effect of γ-irradiation on the structure and oxidation of cis-1,4-polyisoprene is investigated by ATR-FTIR technique. This method provides the valuable insight into the type of oxidation products produced and the extent and nature of intramolecular cyclization and chain scission reactions. The formation of ketones, alcohols and/or ethers, and hydroperoxides is apparent already at small doses of γ-radiation and it increases with the exposure time significantly. At the highest dose of 309 kGy a decrease in the intensity of C=O stretching mode of ketones (1717 cm−1) was observed while the overall area of the band remained the same as in the case of 188 kGy dose. The shoulders observed at 1740 cm−1 and 1772 cm−1 could be assigned to C=O stretching frequency of esters and five-membered-ring lactones, respectively. Higher doses of γ-radiation also cause the formation of two relatively strong bands in the region of conjugated double bonds. These could origin from the aromatic products or cycloenes with one double bond formed by cyclization and chain scission processes.
Properties of Ni-W alloy coatings on steel substrate
Authors: Gáliková Z. , Chovancová M. , Danielik V. 
Published: September 2006

AbstractNi-W alloy coatings were prepared on the steel substrate at the temperature of 60°C. The content of tungsten in coatings was increased with the growing cathodic current density. The increase of the corrosion resistance of Ni-W alloy coatings with the rising content of tungsten was confirmed by the measurement of anodic polarization curves. Annealed coatings showed better antioorrosion properties than the non-annealed ones. The properties of annealed coatings including their corrosion resistance depend on the tungsten content, too.
Effect of chloride ions on the kinetics of nitrobenzene reduction by powdered iron
Authors: Heželová M. , Pikna L’. , Kladeková D. , Lux L. 
Published: September 2006

AbstractThe effect of different chloride ions concentrations on the reactivity of iron particles was studied using chronopotentiometry. It was found that the increase of Cl− ions concentration accelerated anodic dissolution of iron, thus enhancing its surface reactivity. This fact was confirmed also by the rate of nitrobenzene reduction by iron particles. The reactivity of powder particles of various sizes, hence of different specific surface, was investigated in chloride-free and chloride-containing acetate buffer electrolytes. Experimental results indicated that the rate of nitrobenzene reduction in the presence of chloride ions in the reaction system is faster in comparison with the rate in chloride-free medium for each studied grain fraction of particulate material.
Methane esterification in oleum
Authors: Michalkiewicz B. 
Published: September 2006

AbstractThe reactions taking place during methane esterification in oleum were investigated. It was found that the primary products were methyl bisulphate and formaldehyde, which was subsequently oxidized to carbon dioxide. The catalyst, Pd or PtCl4, was needed to activate methane and for its oxidation to the primary products. The formation of CO2 was not a catalytic process. It was found that the addition of either carbon dioxide or ester into the reaction mixture did not slow down the reactions. Methane oxidation in oleum is an irreversible process, during which water is produced and subsequently consumed to give sulphuric acid by the reaction with sulphur trioxide.
Momentum transfer in an agitated vessel with off-centred impellers
Authors: Cudak M. , Karcz J. 
Published: September 2006

AbstractMomentum transfer was investigated in an unbaffled agitated vessel of inner diameter 0.3 m equipped with different off-centred impellers. The distribution of the shear rate on the tank wall as a function of the impeller type and Reynolds number was studied in the turbulent regime of the Newtonian liquid flow. The dependences of the averaged dimensionless shear rate, friction coefficient, and dissipated energy on the Reynolds number and eccentricity ratio were approximated using four-parameter equations.
Phosphonium ionic liquids as new, reactive extractants of lactic acid
Authors: Marták J. , Schlosser Š. 
Published: September 2006

AbstractSolvent properties of ionic liquids with trihexyltetradecylphosphonium cation and bis(2,4,4-trimethylpentyl)phosphinate anion (Cyphos IL-104) or chloride anion (Cyphos IL-101) were studied. IL-104 effectively extracted lactic acid (LA) with distribution coefficients above 40 at low acid concentrations. IL-104 extracted only undissociated acid (LAH) what supported the coordination mechanism of lactic acid extraction via H-bonding. In the extraction of lactic acid by phosphonium chloride (IL-101) an ion-exchange mechanism contributed remarkably to the extraction especially at basic pH where anionic form of this acid predominated. A high solubility of water in hydrophobic IL-104 up to 14.4 mass % was connected with the formation of reverse micelles. A dual mechanism of water extraction to phosphonium ionic liquids was identified, which consisted of water incorporation into reverse micelles and the inclusion of water into the hydrated complex of lactic acid with ionic liquid (IL). The extraction of lactic acid caused splitting of reverse micelles with liberation of water from the solvent. In the saturated solvent only hydration water remained in the complex of lactic acid with phosphonium ionic liquid, with the suggested structure (LAH)p(IL)(H2O)2, where the value of p ranged from 1 to 3.
Approach to Obesity Treatment in Primary Care
Authors: Yanovski Susan Z. , Yanovski Jack A. 
Published: March 2024

ImportanceMore than 40% of US adults have obesity, which increases the risks for multiple chronic diseases and premature mortality. Historically, nonsurgical interventions often have not led to sufficient weight loss and maintenance to improve health, but highly effective antiobesity medications (AOMs) have recently become available, and additional effective therapeutics are under development. Given that most medical care for adults with obesity is delivered in primary care settings, guidance for integrating weight-management approaches is needed.ObservationsLifestyle interventions can lead to a mean weight loss of 2% to 9% of initial weight at 1 year and increase the likelihood of weight loss of 5% or more, but weight regain over time is common even with continued treatment. Adjunctive treatments, including AOMs and surgical approaches, can lead to larger, more sustained weight loss and improvements in numerous obesity-associated medical conditions. Highly effective AOMs, including nutrient-stimulated hormone-based therapies, induce mean weight loss of 15% or more. Barriers to intervention, including access to care, have a disproportionate influence on populations most affected by obesity and its consequences.Conclusions and RelevancePrimary care clinicians play a vital role in the assessment, management, and support of patients with obesity. With careful clinical assessment and shared decision-making, a flexible treatment plan can be developed that reflects evidence of treatment efficacy, patient preference, and feasibility of implementation. Adjunctive therapies to lifestyle interventions, including more effective pharmacotherapeutics for obesity, offer hope to patients and the potential for considerable improvements in health and quality of life.