bluuebunny/crossref_metadata_2025_split huggingface dataset:
Do the Survivin (BIRC5) Splice Variants Modulate or Add to the Prognostic Value of Total Survivin in Breast Cancer?
Authors: Span Paul N , Tjan-Heijnen Vivianne CG , Heuvel Joop JTM , de Kok Jacques B , Foekens John A , Sweep Fred CGJ 
Published: July 2006

Abstract
Background: A total of 4 additional splice variants (survivin-ΔEx3, survivin 2α, survivin-2B, and survivin-3B) have been described for survivin [baculoviral IAP repeat-containing protein (BIRC-5), approved gene symbol BIRC5], which has been implicated in both inhibition of apoptosis and regulation in mitosis in many tumor types. In this study, we assessed whether the survivin splice variants modulate or add to the prognostic value of total survivin in breast cancer.
Methods: With quantitative reverse transcription-PCR, we measured mRNA concentrations of survivin and all variants in tumor tissue from 275 patients with breast cancer and associated these with clinicopathologic characteristics and relapse-free survival.
Results: Total survivin, survivin-ΔEx3, and survivin 2α mRNA levels were associated with young age and ductal histology. Total survivin and survivin-ΔEx3 were highest in samples with advanced histological grade, whereas patients with 4–9 involved lymph nodes expressed less survivin-2B mRNA than those with 1–3 involved nodes. All variants were higher in tumors negative for steroid hormone receptors. Total survivin, survivin 2α, and survivin-3B were associated with poor relapse-free survival in univariate analyses. Survivin 2α and survivin-3B added to the prognostic value of total survivin in multivariate analyses. In addition, the prognostic value of total survivin was evident only in the presence of higher expression levels of these 2 variants.
Conclusions: All variants of survivin exhibited particular associations with clinicopathologic characteristics (age, histology, grade, and steroid hormone receptor status) of breast cancer patients. Survival analyses suggest a modulating role of survivin 2α and survivin-3B on the biological function of total survivin.
Invasion Patterns along Elevation and Urbanization Gradients in Hawaiian Streams
Authors: Brasher Anne M. D. , Luton Corene D. , Goodbred Steven L. , Wolff Reuben H. 
Published: July 2006

AbstractHawaii's extreme isolation has resulted in a native stream fauna characterized by high endemism and unusual life history characteristics. With the rapid increase in the human population, the viability of Hawaiian stream ecosystems is threatened by development and the associated habitat alteration. Thirty‐eight sites on three islands (Oahu, Kauai, and Hawaii) were sampled to determine how habitat alteration resulting from urbanization and development was associated with the establishment of introduced species. Undeveloped sites had higher streamflow velocities, more riffles, lower embeddedness, deeper water, larger substrate, and lower water temperature than developed sites. Developed sites additionally had more pools and greater sparseness of riparian canopy cover. Overall, 23 fish species from 11 families and 5 crustacean species from 3 families were collected. Of these, 16 fish species and 3 crustacean species were introduced. Developed sites had on average almost twice as many species as undeveloped sites and were dominated by introduced species. Low‐elevation sites were the most developed and supported the highest number of introduced species. However, species composition at some relatively undeveloped sites was impacted by downstream habitat alteration, since all native species must pass through the lower reaches to complete their life cycles. With increasing urbanization and development, the habitat features required by native species are disappearing and streams are becoming more suitable for generalist introduced species, which are typically better adapted for altered habitats than are native species. As development pressures in tropical island ecosystems increase worldwide, this will become an increasingly important issue globally. An understanding of which habitats are most likely to support nonnative species provides information necessary for developing a management strategy to protect aquatic ecosystems from invasive nonnative species.
Comparison of Life History Traits between First‐Generation Hatchery and Wild Upper Yakima River Spring Chinook Salmon
Authors: Knudsen Curtis M. , Schroder Steve L. , Busack Craig A. , Johnston Mark V. , Pearsons Todd N. , Bosch William J. , Fast David E. 
Published: July 2006

AbstractLife history traits in hatchery and wild spring Chinook salmon Oncorhynchus tshawytscha from the upper Yakima River were compared to determine whether locally adapted traits had diverged after one generation of state‐of‐the‐art artificial propagation. Sex composition in wild‐ and hatchery‐origin fish differed in three of four brood years (P ≤ 0.01). The proportion of hatchery males, primarily age 3, increased from 38% to 49% over time. Conversely, the sex composition of wild fish did not exhibit a similar linear trend. Most hatchery‐ and wild‐origin fish reached maturity at age 4 (≥76%), followed in magnitude by ages 3 and 5. Wild mean age at maturation demonstrated no significant trend over time, while hatchery mean age at maturation declined (P = 0.05). Mean lengths of 3–5‐year‐old hatchery fish were shorter than those of wild fish of the same age (differences of 2.7 cm for age 3, 1.7 cm for age 4, and 1.9 cm for age 5). Likewise, body weights of hatchery fish were lower than those of wild fish (differences of 0.3 kg for age 3, 0.3 kg for age 4, and 0.6 kg for age 5), representing a change in body size of between 0.5 and 1.0 standard deviation (SD). Median arrival timing of hatchery and wild fish at a broodstock collection site just downstream of ancestral spawning grounds showed no consistent difference. However, the median arrival date of age‐3 fish was 19–20 d later than that for fish of ages 4 and 5 (P < 0.01). Mean spawn timing of hatchery fish was significantly earlier (5.1 d) than that of wild fish in a “common‐garden” experiment (P < 0.05). We estimate that fitness could be reduced by as much as 1–5% for traits diverging from their optima by 0.5–1.0 SD. The degree of genetic determination of the divergence is unknown, but future monitoring will help clarify this. Perhaps the most important conclusion of our study is that even a hatchery program designed to minimize differences between hatchery and wild fish did not produce fish that were identical to wild fish.
Assessment of Patients’ Level of Satisfaction with Cleft Treatment Using the Cleft Evaluation Profile
Authors: Noor Siti Noor Fazliah Mohd , Musa Sabri 
Published: July 2006

Objectives: Determination of the psychosocial status and assessment of the level of satisfaction in Malaysian cleft palate patients and their parents. Design: Cross-sectional study. Participants and Methods: Sixty cleft lip and palate patients (12 to 17 years of age) from Hospital Universiti Sains Malaysia and their parents were selected. The questionnaires used were the Child Interview Schedule, the Parents Interview Schedule, and the Cleft Evaluation Profile (CEP), administered via individual interviews. Results: Patients were teased because of their clefts and felt their self-confidence was affected by the cleft condition. They were frequently teased about cleft-related features such as speech, teeth, and lip appearance. Parents also reported that their children were being teased because of their clefts and that their children's self-confidence was affected by the clefts. Both showed a significant level of satisfaction with the treatment provided by the cleft team. There was no significant difference between the responses of the patients and their parents. The features that were found to be most important for the patients and their parents, in decreasing order of priority, were teeth, nose, lips, and speech. Conclusions: Cleft lip and/or palate patients were teased because of their clefts, and it affected their self-confidence. The Cleft Evaluation Profile is a reliable and useful tool to assess patients’ level of satisfaction with treatment received for cleft lip and/or palate and can identify the types of cleft-related features that are most important for the patients.
An Open, Randomized, Parallel-Group Study to Compare the Efficacy and Safety Profile of Inhaled Human Insulin (Exubera) With Glibenclamide as Adjunctive Therapy in Patients With Type 2 Diabetes Poorly Controlled on Metformin
Authors: Barnett Anthony H. , Dreyer Manfred , Lange Peter , Serdarevic-Pehar Marjana ,   on behalf of the Exubera Phase III Study Group
Published: July 2006

OBJECTIVE—To compare the efficacy and safety profile of adding inhaled human insulin (INH) (Exubera) or glibenclamide to metformin monotherapy in patients with poorly controlled type 2 diabetes.
RESEARCH DESIGN AND METHODS—We conducted an open-label, parallel, 24-week multicenter trial. Patients uncontrolled on metformin were randomized to adjunctive INH (n = 243) or glibenclamide (n = 233). Before randomization, patients were divided into two HbA1c (A1C) arms: ≥8 to ≤9.5% (moderately high) and &gt;9.5 to ≤12% (very high). The primary efficacy end point was A1C change from baseline.
RESULTS—Mean adjusted A1C changes from baseline were −2.03 and −1.88% in the INH and glibenclamide groups, respectively; between-treatment difference −0.17% (95% CI −0.34 to 0.01; P = 0.058), consistent with the noninferiority criterion. In the A1C &gt;9.5% arm, inhaled insulin demonstrated a significantly greater reduction in A1C than glibenclamide, between-treatment difference −0.37% (−0.62 to −0.12; P = 0.004). In the A1C ≤9.5% arm, between-treatment difference was 0.04% (−0.19 to 0.27; P = 0.733). Hypoglycemia (events per subject-month) was greater with INH (0.18) than glibenclamide (0.08), risk ratio 2.24 (1.58–3.16), but there were no associated discontinuations. Other adverse events, except increased cough in the INH group, were similar. At week 24, changes from baseline in pulmonary function parameters were small. Insulin antibody binding increased more with INH but did not have any associated clinical manifestations.
CONCLUSIONS—In patients with type 2 diabetes poorly controlled on metformin, adding INH or glibenclamide was similarly effective in improving glycemic control, and both were well tolerated. A predefined subgroup with very high A1C (&gt;9.5%) was more effectively treated with the addition of INH.
A Risk Score for Predicting Incident Diabetes in the Thai Population
Authors: Aekplakorn Wichai , Bunnag Pongamorn , Woodward Mark , Sritara Piyamitr , Cheepudomwit Sayan , Yamwong Sukit , Yipintsoi Tada , Rajatanavin Rajata 
Published: July 2006

OBJECTIVE—The objective of this study was to develop and evaluate a risk score to predict people at high risk of diabetes in Thailand.
RESEARCH DESIGN AND METHODS—A Thai cohort of 2,677 individuals, aged 35–55 years, without diabetes at baseline, was resurveyed after 12 years. Logistic regression models were used to identify baseline risk factors that predicted the incidence of diabetes; a simple model that included only those risk factors as significant (P &lt; 0.05) when adjusted for each other was developed. The coefficients from this model were transformed into components of a diabetes score. This score was tested in a Thai validation cohort of a different 2,420 individuals.
RESULTS—A total of 361 individuals developed type 2 diabetes in the exploratory cohort during the follow-up period. The significant predictive variables in the simple model were age, BMI, waist circumference, hypertension, and history of diabetes in parents or siblings A cutoff score of 6 of 17 produced the optimal sum of sensitivity (77%) and specificity (60%). The area under the receiver-operating characteristic curve (AUC) was 0.74. Adding impaired fasting glucose or impaired glucose tolerance status to the model slightly increased the AUC to 0.78; adding low HDL cholesterol and/or high triglycerides barely improved the model. The validation cohort demonstrated similar results.
CONCLUSIONS—A simple diabetes risk score, based on a set of variables not requiring laboratory tests, can be used for early intervention to delay or prevent the disease in Thailand. Adding impaired fasting glucose or impaired glucose tolerance or triglyceride and HDL cholesterol status to this model only modestly improves the predictive ability.
Prepregnancy Care and Pregnancy Outcomes in Women With Type 1 Diabetes
Authors: Temple Rosemary C. , Aldridge Vivien J. , Murphy Helen R. 
Published: July 2006

OBJECTIVE—The objective of this study was to examine the relationship between prepregnancy care, glycemic control, maternal hypoglycemia, and pregnancy outcomes in women with type 1 diabetes.
RESEARCH DESIGN AND METHODS—This was a prospective observational cohort study of women with type 1 diabetes who delivered from 1991 to 2002. Outcome measures were attendance at a clinic for prepregnancy care, maternal HbA1c (A1C) throughout pregnancy, maternal severe hypoglycemic episodes, macrosomia, preeclampsia, premature delivery (delivery before 37 weeks), very premature delivery (delivery before 34 weeks), spontaneous abortion, and adverse pregnancy outcome (defined as major malformation, stillbirth, and neonatal death).
RESULTS—There were 290 pregnancies, in which 110 (38%) women had prepregnancy care. The prepregnancy care group contained more primiparous women (54.7 vs. 40.6%; P = 0.021) and fewer smokers (9.4 vs. 28.7%; P &lt; 0.0001). They registered earlier (6.6 vs. 8.3 weeks, P &lt; 0.0001) and had a lower A1C at the initial visit (6.5% vs. 7.6%; P &lt; 0.0001). Adverse pregnancy outcomes and very premature deliveries were significantly lower in women who received prepregnancy care (2.9 vs. 10.2%; P = 0.03 and 5.0 vs. 14.2%; P = 0.02, respectively). In contrast, between groups, there was no difference in A1C after 24 weeks or in the rates of macrosomia, preeclampsia, or maternal severe hypoglycemic episodes.
CONCLUSIONS—Prepregnancy care was associated with improved glycemic control in early pregnancy and significant reductions in adverse pregnancy outcome (malformation, stillbirth, and neonatal death) and very premature delivery. However, prepregnancy care failed to have an impact on glycemic control in later pregnancy or to reduce the risk of macrosomia and preeclampsia.
Health Behaviors Among Women of Reproductive Age With and Without a History of Gestational Diabetes Mellitus
Authors: Kieffer Edith C. , Sinco Brandy , Kim Catherine 
Published: July 2006

OBJECTIVE—To estimate the prevalence of several health-related behaviors among women of reproductive age with and without a history of gestational diabetes mellitus (hGDM).
RESEARCH DESIGN AND METHODS—We performed a cross-sectional study using the 2001–2003 Behavioral Risk Factor Surveillance System, a national population-based random sample telephone survey. Participants were 177,420 women aged 18–44 years with and without self-reported hGDM. Outcome measures included meeting physical activity and fruit and vegetable guidelines, sedentary activity level, and current smoking.
RESULTS—Approximately 3% (n = 4,718) of women aged 18–44 years reported physician-diagnosed hGDM. Women with hGDM had higher BMIs, were significantly older, were less often educated or employed, and were more often Hispanic or African American, married, and living with children. Women with hGDM reported worse self-rated health than women without hGDM. In unadjusted and multivariate adjusted comparisons, there were no significant differences in levels of physical activity, fruit and vegetable consumption, or smoking among women with and without hGDM. However, women with hGDM who lived with children were significantly less likely to meet fruit and vegetable consumption guidelines (odds ratio 0.78 [95% CI 0.63–0.97]; P &lt; 0.05) and more likely to smoke (1.21 [1.01–1.47]; P &lt; 0.05) than their counterparts without hGDM.
CONCLUSIONS—Despite their elevated risk for future diabetes, women with hGDM who lived with children were less likely to meet fruit and vegetable consumption guidelines and more likely to smoke than women with children who did not have hGDM.
Chromium Picolinate Supplementation Attenuates Body Weight Gain and Increases Insulin Sensitivity in Subjects With Type 2 Diabetes
Authors: Martin Julie , Wang Zhong Q. , Zhang Xian H. , Wachtel Deborah , Volaufova Julia , Matthews Dwight E. , Cefalu William T. 
Published: July 2006

OBJECTIVE—Chromium picolinate (CrPic) supplementation has been suggested to improve glycemia, but there are conflicting reports on efficacy. We sought to determine the effect of CrPic on insulin sensitivity, glycemic control, and body composition in subjects with type 2 diabetes.
RESEARCH DESIGN AND METHODS—Thirty-seven subjects with type 2 diabetes were evaluated. After baseline, subjects were placed on a sulfonylurea (glipizide gastrointestinal therapeutic system 5 mg/day) with placebo for 3 months. Subjects were then randomized in a double-blind fashion to receive either the sulfonylurea plus placebo (n = 12) or the sulfonylurea plus 1,000 μg Cr as CrPic (n = 17) for 6 months. Body composition, insulin sensitivity, and glycemic control were determined at baseline, end of the 3-month single-blind placebo phase, and end of study.
RESULTS—Subjects randomized to sulfonylurea/placebo, as opposed to those randomized to sulfonylurea/CrPic, had a significant increase in body weight (2.2 kg, P &lt; 0.001 vs. 0.9 kg, P = 0.11), percent body fat (1.17%, P &lt; 0.001 vs. 0.12%, P = 0.7), and total abdominal fat (32.5 cm2, P &lt; 0.05 vs. 12.2 cm2, P &lt; 0.10) from baseline. Subjects randomized to sulfonylurea/CrPic had significant improvements in insulin sensitivity corrected for fat-free mass (28.8, P &lt; 0.05 vs. 15.9, P = 0.4), GHb (−1.16%, P &lt; 0.005 vs. −0.4%, P = 0.3), and free fatty acids (−0.2 mmol/l, P &lt; 0.001 vs. −0.12 mmol/l, P &lt; 0.03) as opposed to sulfonylurea/placebo.
CONCLUSIONS—This study demonstrates that CrPic supplementation in subjects with type 2 diabetes who are taking sulfonylurea agents significantly improves insulin sensitivity and glucose control. Further, CrPic supplementation significantly attenuated body weight gain and visceral fat accumulation compared with the placebo group.
Is Self-Monitoring of Blood Glucose Appropriate for All Type 2 Diabetic Patients?
Authors: Davis Wendy A. , Bruce David G. , Davis Timothy M.E. 
Published: July 2006

OBJECTIVE—We sought to determine whether self-monitoring of blood glucose (SMBG) is associated with better glycemic control in type 2 diabetes.
RESEARCH DESIGN AND METHODS—We used cross-sectional and longitudinal data from type 2 diabetic participants in the observational, community-based Fremantle Diabetes Study (FDS) who reported SMBG status at study entry (n = 1,286) and annual reviews over 5 years (n = 531).
RESULTS—At study entry, 70% of patients performed SMBG, with a median of four tests per week (interquartile range two to seven). Patients with shorter diabetes duration; who were attending diabetes education, diabetes-related clinics, or medical specialists; who were taking insulin with or without oral hypoglycemic agents (OHAs); and who were self-reporting hypoglycemic events were more likely to use SMBG. Both cross-sectional and longitudinal FDS data showed that HbA1c (A1C) was not significantly different between SMBG users and nonusers, either overall or within diabetes treatment groups (diet, OHAs, and insulin with or without OHAs). There was also no independent cross-sectional relationship between A1C and SMBG frequency. The average annual societal cost of using SMBG (in year 2000 Australian dollars [A$], excluding glucometers) was A$162 per type 2 diabetic patient or A$51 million when projected to the Australian diagnosed type 2 diabetic population.
CONCLUSIONS—Neither SMBG testing nor its frequency was associated with glycemic benefit in type 2 diabetic patients regardless of treatment. Our data did not include methods of SMBG delivery and application, factors that require further assessment in the evaluation of SMBG utility in non–insulin-treated type 2 diabetes. SMBG may be still of value in the identification and prevention of hypoglycemia and in dose adjustment in insulin-treated patients.
Normotensive Women With Type 2 Diabetes and Microalbuminuria Are at High Risk for Macrovascular Disease
Authors: Zandbergen Adrienne A.M. , Sijbrands Eric J. , Lamberts Steven W. , Bootsma Aart H. 
Published: July 2006

OBJECTIVE—The excess risk of macrovascular disease and death associated with diabetes seems higher in women than in men. The pathogenesis for this risk difference has not been fully elucidated. We investigated whether female sex was associated with macrovascular disease and death, independently of known risk factors related to type 2 diabetes, nephropathy, or retinopathy in normotensive patients with type 2 diabetes and microalbuminuria.
RESEARCH DESIGN AND METHODS—We conducted a prospective, prolonged follow-up study of a subgroup of 67 diabetic patients (46 men and 21 women) without established cardiovascular disease who participated in a larger clinical trial. Data were collected on current and past health, medication use, blood pressure, renal function, and HbA1c during the follow-up period of 4.7 ± 0.8 (means ± SE) years. The end point was a composite of death, cardiovascular disease, cerebrovascular events, and peripheral artery disease.
RESULTS—Of the women, eight (38.1%) met the end point compared with six (13.4%) of the men (P = 0.02 for difference in event-free survival). The hazard ratio of women relative to men was 3.19 (95% CI 1.11–9.21), which further increased after adjusting for age, systolic blood pressure, BMI, smoking, total-to-HDL cholesterol ratio, urinary albumin excretion, and retinopathy.
CONCLUSIONS—In our study population of normotensive patients with type 2 diabetes and microalbuminuria, female sex was associated with increased risk of fatal and nonfatal cardiovascular disease, independent of the classical cardiovascular risk factors, the severity of nephropathy or presence of retinopathy, or health care utilization.
A Low-Fat Vegan Diet Improves Glycemic Control and Cardiovascular Risk Factors in a Randomized Clinical Trial in Individuals With Type 2 Diabetes
Authors: Barnard Neal D. , Cohen Joshua , Jenkins David J.A. , Turner-McGrievy Gabrielle , Gloede Lise , Jaster Brent , Seidl Kim , Green Amber A. , Talpers Stanley 
Published: July 2006

OBJECTIVE—We sought to investigate whether a low-fat vegan diet improves glycemic control and cardiovascular risk factors in individuals with type 2 diabetes.RESEARCH DESIGN AND METHODS—Individuals with type 2 diabetes (n = 99) were randomly assigned to a low-fat vegan diet (n = 49) or a diet following the American Diabetes Association (ADA) guidelines (n = 50). Participants were evaluated at baseline and 22 weeks.RESULTS—Forty-three percent (21 of 49) of the vegan group and 26% (13 of 50) of the ADA group participants reduced diabetes medications. Including all participants, HbA1c (A1C) decreased 0.96 percentage points in the vegan group and 0.56 points in the ADA group (P = 0.089). Excluding those who changed medications, A1C fell 1.23 points in the vegan group compared with 0.38 points in the ADA group (P = 0.01). Body weight decreased 6.5 kg in the vegan group and 3.1 kg in the ADA group (P &lt; 0.001). Body weight change correlated with A1C change (r = 0.51, n = 57, P &lt; 0.0001). Among those who did not change lipid-lowering medications, LDL cholesterol fell 21.2% in the vegan group and 10.7% in the ADA group (P = 0.02). After adjustment for baseline values, urinary albumin reductions were greater in the vegan group (15.9 mg/24h) than in the ADA group (10.9 mg/24 h) (P = 0.013).CONCLUSIONS—Both a low-fat vegan diet and a diet based on ADA guidelines improved glycemic and lipid control in type 2 diabetic patients. These improvements were greater with a low-fat vegan diet.