bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinical inertia in the management of Type 2 diabetes metabolic risk factors
Authors: Grant R. W. , Cagliero E. , Dubey A. K. , Gildesgame C. , Chueh H. C. , Barry M. J. , Singer D. E. , Nathan D. M. , Meigs J. B. 
Published: December 2004

AbstractAims  Delays in the initiation and intensification of medical therapy may be one reason patients with diabetes do not reach evidence‐based goals for metabolic control. We assessed intensification of medical therapy over time, comparing the management of hyperglycaemia, hypertension, and hyperlipidaemia.Methods  Prospective cohort study of 598 adults with Type 2 diabetes receiving primary care in an academic medical centre from May 1997 to April 1999. We assessed whether patients failing to achieve standard treatment goals for haemoglobin A1c (HbA1c), systolic blood pressure (SBP), or low density lipoprotein (LDL) cholesterol when last measured during 12 months (Year 1, 5/97–4/98) had increases in their corresponding medical regimen during the following 12 months (Year 2, 5/98–4/99).Results  Among untreated patients in Year 1, seven of 12 (58%) of those above goal for HbA1c were initiated on medical therapy in Year 2, compared with 16 of 48 (34%) above SBP goal (P = 0.02) and 26 of 115 (23%) above LDL cholesterol goal (P = 0.02). Among patients on therapy and above goal, 124 of 244 (51%) patients with elevated HbA1c had their regimen increased in Year 2, compared with 85 of 282 (30%) with elevated SBP (P < 0.001) and 22 of 79 (30%) with elevated LDL cholesterol (P < 0.001). From Year 1 to Year 2 there was a decline in the overall proportion of patients above goal for LDL cholesterol (from 58% to 45%, P = 0.002) but not for HbA1c or blood pressure.Conclusions  Greater initiation and intensification of pharmaceutical therapy, particularly for elevated blood pressure or cholesterol, may represent a specific opportunity to improve metabolic control in Type 2 diabetes.Diabet. Med. 21, 150–155 (2004)
Trends in diabetes management practices of patients from an Australian insulin‐treated diabetes register
Authors: Sale M. M. , Hazelwood K. , Zimmet P. Z. , Shaw J. E. , Stankovich J. M. , Greenaway T. M. , Dwyer T. 
Published: December 2004

AbstractAims  To compare diabetes management practices in 2001 among individuals from Tasmania, Australia, with a previous management survey conducted in 1995–7.Methods  Subjects were ascertained through the Tasmanian Insulin‐Treated Diabetes Register. General demographic data were collected by telephone interview, and participants mailed a questionnaire on their diabetes management practices.Results  The response rate in 2001 was 80.8% (n = 1336). There was a trend to more frequent blood glucose self‐monitoring, notably in those less than 25 years (P < 0.001 for monitoring > 2 times/day), together with continued uptake of the pen system of insulin administration. More intensive shared management by general practitioner and diabetes specialist was noted, including a greater proportion visiting their doctor more than five times per year (P = 0.006 for those < 50 years). Most patients continue to be appropriately screened for hypertension and retinopathy. Dietitian visits declined overall (P = 0.03 for at least annual visits), and there appeared to be an inadequate level of foot examination by patients and doctors.Conclusions  The survey indicated that most patients were taking greater responsibility for their metabolic control, and intensive management practices and more convenient methods of administration may be contributors. Two areas of possible concern are access to dietitian services, and patient and health provider education on appropriate foot care.Diabet. Med. 21, 165–170 (2004)
Angiotensin receptor blockers as anti‐hypertensive treatment for patients with diabetes mellitus: meta‐analysis of controlled double‐blind randomized trials
Authors: Siebenhofer A. , Plank J. , Horvath K. , Berghold A. , Sutton A. J. , Sommer R. , Pieber T. R. 
Published: December 2004

Aims  To assess the evidence for possible reduction of all‐cause mortality, cardiovascular morbidity and mortality, and end‐stage renal disease in diabetic patients treated with angiotensin II type 1 receptor blockers (ARBs) as an anti‐hypertensive treatment.Methods  Systematic review and meta‐analysis of randomized, double‐blind controlled trials of at least 1 year's duration. ARBs were used in the intervention group vs. placebo or standard anti‐hypertensive treatment in the control group. The main outcome measures were all‐cause mortality, cardiovascular morbidity and mortality, and end‐stage renal disease.Results  Three studies fulfilled the inclusion criteria. Separate analyses were conducted for comparisons of ARBs with groups given placebo and those given standard anti‐hypertensive treatment. There was no significant difference in mortality between the ARBs and placebo groups, with an estimated odds ratio (OR) of 0.99 [95% confidence interval (CI) 0.81, 1.20]. There was a non‐significant difference in patients treated with ARBs compared with standard anti‐hypertensive treatment, with an OR of 0.78 (95% CI 0.45, 1.36). No statistically significant difference in cardiovascular morbidity and mortality between the intervention and placebo groups was found, with an OR of 0.91 (95% CI 0.77, 1.08). When ARBs were compared with standard treatment, the OR was estimated at 0.85 (0.54, 1.33). Data on end‐stage renal disease were available for two studies comparing ARBs vs. placebo and showed a statistically significant advantage of ARBs, with an OR of 0.73 (95% CI 0.6, 0.89). As only one study compared end‐stage renal disease outcome for ARBs vs. standard treatment, a meta‐analysis was not possible. This study reported a considerable benefit of ARBs [OR = 0.73 (0.54, 1.01)] compared with the calcium channel blocker amlodipine.Conclusions  ARBs failed to show significant reduction in total mortality and cardiovascular morbidity and mortality in diabetic patients. The only statistical benefit was the reduction of end‐stage renal disease compared with placebo. Therefore, at this time ARBs have not proved to be superior to standard anti‐hypertensive treatment in diabetic patients.
Zinc and nitrate in the ground water and the incidence of Type 1 diabetes in Finland
Authors: Moltchanova E. , Rytkönen M. , Kousa A. , Taskinen O. , Tuomilehto J. , Karvonen for the Spat Study Group M. 
Published: December 2004

AbstractAims  In Finland, the risk of childhood Type 1 diabetes varies geographically. Therefore we investigated the association between spatial variation of Type 1 diabetes and its putative environmental risk factors, zinc and nitrates.Methods  The association was evaluated using Bayesian modelling and the geo‐referenced data on diabetes cases and population.Results  Neither zinc nor nitrate nor the urban/rural status of the area had a significant effect on the variation in incidence of childhood Type 1 diabetes.Conclusions  The results showed that although there was no significant difference in incidence between rural and urban areas, there was a tendency to increasing risk of Type 1 diabetes with the increasing concentration of NO3 in drinking water. The fact that no significant effect was found may stem from the aggregated data being too crude to detect it.
Coverage in screening for diabetic retinopathy according to screening provision: results from a national survey in England and Wales
Authors: Wilson A. , Baker R. , Thompson J. , Grimshaw G. 
Published: December 2004

AbstractAim  To assess the proportion of people with diabetes screened for retinopathy according to provision of screening services.Methods  Twenty‐five health authorities in England and Wales were sampled after stratification by type of screening provision for diabetic retinopathy. Nine did not have a population‐based screening scheme, six had an optometry scheme, six had a camera scheme and four had schemes with more than one method of screening (‘mixed schemes’). Within each authority general practices were randomly sampled, 129 in total, and in each the records of a sample of diabetic patients examined.Results  Of the 9200 records examined, 5812 (63.2%) had a record of one or more retinal examinations from any source in the year before the survey. This proportion did not differ significantly according to type of screening provision. The proportion of people with one or more retinal examinations by an ‘expert’ (defined as ophthalmologist, diabetologist, optometrist or screening scheme) in the last year was 44.7% where there was no screening scheme and 62.2%, 59.4%, and 61.6%, respectively, where optometry, camera and mixed schemes were present. Adjusted relative odds (95% confidence interval) for a retinal examination from any source in the last year compared with areas with no screening schemes were 1.19 (0.73, 1.93), 1.26 (0.80, 1.98), and 1.19 (0.77, 1.84) for camera, optometry and mixed schemes, respectively. Equivalent figures for an expert retinal examination were 2.30 (1.51, 3.49), 1.86 (1.25, 2.78) and 2.13 (1.32, 3.45). Coverage by schemes themselves did not differ according to type of scheme. Highest coverage rates, including examinations by screening schemes, were achieved in those treated with insulin, and the lowest rates found in those treated with diet alone.Conclusions  Screening schemes have had a small impact on overall retinal examinations, but a higher impact on the coverage of examinations performed by experts.
Preprandial vs. postprandial insulin lispro—a comparative crossover trial in patients with Type 1 diabetes
Authors: Schernthaner G. , Wein W. , Shnawa N. , Bates P. C. , Birkett M. A. 
Published: December 2004

AbstractAims  Administration of bolus insulin after eating may be a useful therapeutic option for some patients. This 6‐month, crossover study compared metabolic effects of routine use of preprandial vs. postprandial injection of bolus insulin lispro.Methods  Thirty‐one patients with Type 1 diabetes injected insulin lispro either preprandially or postprandially for a 3‐month period followed by the alternate regimen for a further 3 months. HbA1c, fructosamine and eight‐point self‐determined blood glucose profiles were measured and analysed using an anova model appropriate for a crossover design.Results  Mean HbA1c decreased slightly from baseline with preprandial (−0.15 ± 0.41%) and increased slightly with postprandial (0.11 ± 0.48%) insulin lispro so that there was a significant (P = 0.008) difference between treatments in final HbA1c level. Mean fructosamine also decreased slightly with preprandial (−15 ± 31 µmol/l) but was almost unchanged (1 ± 39 µmol/l) with postprandial insulin lispro. Overall daily blood glucose was not different (P = 0.312) for preprandial compared with postprandial administration. However, mean preprandial glucose was lower (7.5 ± 2.01 vs. 6.6 ± 1.22 mmol/l; P = 0.026), whereas mean postprandial glucose was higher (7.7 ± 1.8 vs. 8.7 ± 2.1 mmol/l; P = 0.031) with postprandial insulin lispro administration. Mean blood glucose excursions were higher with postprandial compared with preprandial insulin lispro, indicating greater daily fluctuations. No difference in incidence of hypoglycaemia was observed with the two treatment regimens.Conclusions  Postprandial insulin lispro administration appeared to be an acceptable treatment regimen and may be of benefit in certain situations. However, the benefits of postprandial administration may have to be balanced against poorer glycaemic control with continuous long‐term use.
Long‐term memory for music: infants remember tempo and timbre
Authors: Trainor Laurel J. , Wu Luann , Tsang Christine D. 
Published: December 2004

Abstract We show that infants’ long‐term memory representations for melodies are not just reduced to the structural features of relative pitches and durations, but contain surface or performance tempo‐ and timbre‐specific information. Using a head turn preference procedure, we found that after a one week exposure to an old English folk song, infants preferred to listen to a novel folk song, indicating that they remembered the familiarized melody. However, if the tempo (25% faster or slower) or instrument timbre (harp vs. piano) of the familiarized melody was changed at test, infants showed no preference, indicating that they remembered the specific tempo and timbre of the melodies. The results are consistent with an exemplar‐based model of memory in infancy rather than one in which structural features are extracted and performance features forgotten.
Attention and inhibition in bilingual children: evidence from the dimensional change card sort task
Authors: Bialystok Ellen , Martin Michelle M. 
Published: December 2004

AbstractIn a previous study, a bilingual advantage for preschool children in solving the dimensional change card sort task was attributed to superiority in inhibition of attention (Bialystok, 1999). However, the task includes difficult representational demands to encode and interpret the task stimuli, and bilinguals may also have profited from superior representational abilities. This possibility is examined in three studies. In Study 1, bilinguals outperformed monolinguals on versions of the problem containing moderate representational demands but not on a more demanding condition. Studies 2 and 3 demonstrated that bilingual children were more skilled than monolinguals when the target dimensions were perceptual features of the stimulus and that the two groups were equivalent when the target dimensions were semantic features. The conclusions are that bilinguals have better inhibitory control for ignoring perceptual information than monolinguals do but are not more skilled in representation, confirming the results of the original study. The results also identify the ability to ignore an obsolete display feature as the critical difficulty in solving this task.
Perceptual complexity and form class cues in novel word extension tasks: how 4‐year‐old children interpret adjectives and count nouns
Authors: Sandhofer Catherine M. , Smith Linda B. 
Published: December 2004

Abstract Two experiments examined the role of perceptual complexity, object familiarity and form class cues on how children interpret novel adjectives and count nouns. Four‐year‐old children participated in a forced‐choice match‐to‐target task in which an exemplar was named with a novel word and children were asked to choose another one that matched the exemplar in either shape or material. In experiment 1, 56 children were provided with lexical form class cues suggestive of adjectives. The results of Experiment 1 showed that perceptual complexity and not object familiarity determined whether children made material or shape matches. In Experiment 2, 56 children were provided with lexical form class cues suggestive of count nouns. The results of Experiment 2 showed that neither perceptual complexity nor object familiarity affected children's selections in the matching task. When provided with lexical form class cues suggestive of a count noun, children selected shape matches. Thus the results suggest that the perceptual properties of the objects presented to children coupled with the particular lexical form class cue determine which features of objects children attend to when interpreting novel words.
SHRIMP II dating of zircons and monazites: reassessing the timing of high‐grade metamorphism and fluid flow in the Reynolds Range, northern Arunta Block, Australia
Authors: VRY J. , COMPSTON W. , CARTWRIGHT I. 
Published: December 2004

ABSTRACT Key insights into the timing of tectonometamorphic events in a complex high‐grade metamorphic terrane can be obtained by combining results from SHRIMP II ion microprobe studies of individual monazite grains with SHRIMP II studies and scanning electron microscope (SEM)‐based cathodoluminescence (CL) imaging of zircons. Results from the Reynolds Range region, Arunta Block, Northern Territory, Australia, show that the final episode of regional metamorphism to high‐T and low‐P granulite facies conditions is most likely to have occurred at c. 1580 Ma, not at 1785–1775 Ma, as previously accepted. The previous interpretation was based on zircon studies of structurally controlled granitoids, without SEM‐based CL imaging. Monazites in a 1806± 6 Ma megacrystic granitoid preserve rare cores that are interpreted to be inherited magmatic monazite, but record no evidence of another high‐T event prior to 1580 Ma. Most monazites from the region record only a single high‐T metamorphic event at c. 1580 Ma. Zircon inheritance is very common. Zircons or narrow overgrowths of zircon dated at c. 1580 Ma have only been found in two types of rocks: rocks produced by metasomatic fluid flow at high temperatures (≤750°C), and rocks that have undergone local partial melting. Previous explanations that attributed these 1580 Ma zircon ages to widespread hydrothermal fluid fluxing associated with post‐tectonic pegmatite emplacement at amphibolite facies conditions are not supported by the available evidence including oxygen isotope data.The observed high regional metamorphic temperatures require the involvement of advective heating. However, contrary to a previous tectonic model for the formation of this and other low‐P, high‐T metamorphic belts, the granites that are exposed at the present structural level do not appear to be the source of that heat, unless some of the granites were emplaced at c. 1580 Ma.
Rapid Variscan exhumation and the role of magma in core complex formation: southern Brittany metamorphic belt, France
Authors: BROWN MICHAEL , DALLMEYER R. DAVID 
Published: December 2004

ABSTRACT The high‐grade migmatitic core to the southern Brittany metamorphic belt has mineralogical and textural features that suggest high‐temperature decompression. The chronology of this decompression and subsequent cooling history have been constrained with 40Ar/39 Ar ages determined for multigrain concentrates of hornblende and muscovite prepared from amphibolite and late‐orogenic granite sheets within the migmatitic core, and from amphibolite of the structurally overlying unit. Three hornblende concentrates yield plateau isotope correlation ages of c. 303–298 Ma. Two muscovite concentrates record well‐defined plateau ages of c. 306–305 Ma. These ages are geologically significant and date the last cooling through temperatures required for intracrystalline retention of radiogenic argon. The concordancy of the hornblende and muscovite ages suggest rapid post‐metamorphic cooling. Extant geochronology and the new 40Ar/39Ar data suggest a minimum time‐integrated average cooling rate between c. 725 °C and c. 125 °C of c. 14 ± 4°C Ma‐1, although below 600 °C the data permit an infinitely fast rate of cooling. Mineral assemblages and reaction textures in diatexite migmatites suggest c. 4 kbar decompression at 800–750 °C. This must have pre‐dated the rapid cooling.Emplacement of two‐mica granites into the metamorphic belt occurred between 345 and 300 Ma. The youngest plutons were emplaced synkinematically along shallow‐dipping normal faults interpreted to be reactivated Eo‐Variscan thrusts. A penetrative, west‐plunging stretching lineation developed in these granites suggests that extension was orogen‐parallel. Extension was probably related to regional uplift and gravitational collapse of thermally weakened crust during constrictional (escape) tectonics in this narrow part of the Variscan orogen. This followed slab breakoff during the terminal stages of convergence between Gondwana and Laurasia; detachment may have been consequent upon a change in kinematics leading to dextral displacement within the orogen. Dextral ductile strike‐slip displacement was concentrated in granites emplaced synkinematically along the South Armorican Shear Zone. Rapid cooling is interpreted to have resulted from tectonic unroofing with emplacement of granite along decollement surfaces. The high‐grade migmatitic core of the southern Brittany metamorphic belt represents a type of metamorphic core complex formed during orogen‐parallel extensional unroofing and regional‐scale ductile flow.
Low Income and Education Levels May Cause Medication Overuse and Chronicity in Migraine Patients
Authors: Atasoy Huseyin Tugrul , Unal Aysun Eroglu , Atasoy Nuray , Emre Ufuk , Sumer Murat 
Published: December 2004

Background.—Frequent analgesic drug intake, especially in migraine patients, may induce the risk of medication overuse headache (MOH). The various conditions that may affect the development and the features of MOH have not been determined yet.Aim.—To compare MOH patients with migraine as pre‐existing headache and episodic migraine patients according to socioeconomic and educational variables.Methods.—Forty‐six MOH patients with migraine as pre‐existing headache and 61 migraine patients were included into study. The headache characteristics, socioeconomic and educational variables of MOH and migraine groups and subgroups divided according to the education (low/high education subgroups), and income (low/high income subgroups) levels were evaluated.Results.—We found that mean duration of education was shorter in MOH patients than migraine patients. There was a negative correlation between duration of education and duration of MOH. The mean duration of MOH was longer and rate of low‐income level was higher in patients with low‐education level. The duration of education was lower in MOH patients with low income. The frequency of migraine attacks and low‐income rate was also higher in low‐educated migraine patients. The duration of education was shorter in migraine patients with low income.Conclusion.—We report that migraineurs with low socioeconomic status may have risk of developing MOH. A better identification of patients at risk of drug‐associated headache may contribute to improved health in a group of patients with MOH.
The Influence of Anxiety on the Progression of Disability
Authors: Brenes Gretchen A. , Guralnik Jack M. , Williamson Jeff D. , Fried Linda P. , Simpson Crystal , Simonsick Eleanor M. , Penninx Brenda W. J. H. 
Published: December 2004

Objectives: To determine the influence of anxiety on the progression of disability and examine possible mediators of the relationship.Design: Community‐based observational study.Setting: Women's Health and Aging Study I, a prospective observational study with assessments every 6 months for 3 years.Participants: One thousand two functionally limited women aged 65 and older.Measurements: Anxiety symptoms were assessed using four questions from the Hopkins Symptom Checklist (nervous or shaky, avoidance of certain things, tense or keyed up, fearful). Participants who reported experiencing two or more of these symptoms at baseline were considered anxious. Anxiety as a predictor of the onset of four types of disability was examined using Cox proportional hazards models. Three models were tested: an unadjusted model, a model adjusted for confounding variables (age, race, vision, number of diseases, physical performance, depressive symptoms), and a mediational model (benzodiazepine and psychotropic medication use, physical activity, emotional support).Results: Nineteen percent of women reported two or more symptoms of anxiety at baseline. Unadjusted models indicate that anxiety was associated with a greater risk of worsening disability: activity of daily living (ADL) disability (relative risk (RR)=1.40, 95% confidence interval (CI)=1.10–1.79), mobility disability (RR=1.41, 95% CI=1.06–1.86), lifting disability (RR=1.54, 95% CI=1.20–1.97), and light housework disability (RR=1.77, 95% CI=1.32–2.37). After adjusting for confounding variables, anxiety continued to predict the development of two types of disability: ADL disability (RR=1.41, 95% CI=1.08–1.84) and light housework disability (RR=1.56, 95% CI=1.14–2.14). Finally, benzodiazepine and psychotropic medication use, physical activity, and emotional support were not significant mediators of the effect of anxiety on the development of a disability.Conclusion: Anxiety is a significant risk factor for the progression of disability in older women. Studies are needed to determine whether treatment of anxiety delays or prevents disability.