bluuebunny/crossref_metadata_2025_split huggingface dataset:
Multifaceted support to improve clinical decision making in diabetes care: a randomized controlled trial in general practice
Authors: Frijling B. D. , Lobo C. M. , Hulscher M. E. J. L. , Akkermans R. P. , Braspenning J. C. C. , Prins A. , Van Der Wouden J. C. , Grol R. P. T. M. 
Published: March 2003

AbstractAims To evaluate the effectiveness of a multifaceted intervention to improve the clinical decision making of general practitioners (GPs) for patients with diabetes. To identify practice characteristics which predict success.Methods Cluster randomized controlled trial with 124 practices and 185 GPs in The Netherlands. The intervention group received feedback reports and support from a facilitator; the control group received no special attention. Outcome measures were the compliance rates with evidence‐based recommendations pertaining to discussion of body weight control, discussion of problems with medication, blood pressure measurement, foot examination, eye examination, initiating anti‐diabetic medication or increasing the dosage in cases of uncontrolled blood glucose, and scheduling a follow‐up appointment.Results The GPs reported on their clinical decision making in 1410 consultations with Type 2 diabetic patients at baseline and 1449 consultations after the intervention period. The intervention resulted in statistically significant improvement for two of the seven outcome measures: foot examination (odds ratio 1.68; 95% confidence interval 1.19–2.39) and eye examination (1.52; 1.07–2.16). Discussion of problems with medication showed a near significant trend towards increased benefit for the intervention group (1.52; 0.99–2.32). Practice characteristics were not found to be related to the success of the intervention.Conclusions Feedback reports with support from facilitators appear to increase rates of foot examination and eye examination in general practice. Alternative interventions should be explored to improve the pursuit of metabolic control by GPs.
A time‐limited, problem‐orientated psychotherapeutic intervention in Type 1 diabetic patients with complications: a randomized controlled trial
Authors: Didjurgeit U. , Kruse J. , Schmitz N. , Stückenschneider P. , Sawicki P. T. 
Published: March 2003

AbstractAims To examine the effects of a time‐limited, problem‐orientated psychotherapeutic intervention on self‐defined psychological problems and metabolic control in Type 1 diabetic patients with microvascular complications.Design Randomized wait‐list controlled trial with a follow‐up of 6 months.Setting Out‐patient clinic of a university diabetes centre.Participants Forty‐six Type 1 diabetic patients with intensified insulin therapy and presence of microvascular diabetic complications. Twenty‐four patients were randomly allocated to the intervention group and 22 patients to the control group.Intervention Participation in a structured, problem‐orientated, time‐limited psychotherapeutic intervention (IG). The control group (CG) patients received routine diabetes care in a specialized diabetes university clinic.Outcome measures Degree of change of three self‐defined main psychological and psychosocial problems (no. 1, no. 2 and no. 3) on a 1–10 graded scale and glycosylated haemoglobin HbA1c values.Results Two patients (one in each group) died during the study period. All remaining patients were followed for 6 months. Problem scores were high at baseline in both groups: IG/CG (mean values, standard deviation in parentheses): problem no. 1, 7.8 (2.0)/8.3 (1.7); problem no. 2, 7.7 (2.3)/7.6 (1.8); and problem no. 3, 7.7 (2.3)/7.4 (2.6). At follow‐up, all problems were significantly lower in the intervention group (IG) when compared with the CG: IG/CG: problem no. 1, 4.3 (2.9)/6.8 (3.0), P

=
0.03; problem no. 2, 3.9 (2.4)/5.8 (2.8), P

=
0.03; problem no. 3, 4.7 (2.4)/6.8 (2.4), P

=
0.02. Mean HbA1c decreased in the intervention group by 0.6 (1.2)% and increased in the control group by 0.1 (0.7)%, P

=
0.016. In patients with suboptimal metabolic control, i.e. HbA1c
> 8%, mean HbA1c decreased by 1.0 (1.2)% in the IG and increased by 0.1 (0.7)% in the CG, P = 0.011.Conclusion A time‐limited, structured, problem‐orientated psychotherapeutic intervention decreases the severity of psychological problems and improves metabolic control in Type 1 diabetic patients with microvascular complications and self‐management of intensified insulin therapy.
Interleukin‐6 polymorphism (–634C/G) in the promotor region and the progression of diabetic nephropathy in Type 2 diabetes
Authors: Kitamura A. , Hasegawa G. , Obayashi H. , Kamiuchi K. , Ishii M. , Yano M. , Tanaka T. , Yamaguchi M. , Shigeta H. , Ogata M. , Nakamura N. , Yoshikawa T. 
Published: March 2003

AbstractAims Interleukin‐6 (IL‐6) is a multifunctional cytokine produced by many different cell types, including glomerular mesangial cells. Recently, a novel C/G polymorphism at position −634 in the promotor region of the IL‐6 gene has been reported. The aim of this study was to investigate whether the −634C/G polymorphism is associated with an increased risk for progression to diabetic nephropathy as well as elevated levels of IL‐6 secretion by peripheral blood mononuclear cells.Methods The frequency of the −634C/G polymorphism was determined in Japanese patients with Type 2 diabetes and either normoalbuminuria (n = 162), microalbuminuria (n = 138), or macroalbuminuria (n = 154) by polymerase chain reaction‐restriction fragment length polymorphism analysis. The level of IL‐6 secretion in relation to genotype was assessed in lipopolysaccharide or advanced glycation end products‐stimulated IL‐6 secretion by peripheral mononuclear cells.Results The frequency of the −634G/G genotype and −634*G allele was significantly increased in the patients with macroalbuminuria compared with patients with normoalbuminuria (genotype: χ2 = 6.787, Pc = 0.0368; allele: χ2 = 9.080, Pc = 0.0104). Stepwise multiple regression analysis in these patients showed that hypertension (F = 40.48) and IL‐6‐634 gene polymorphism (F = 5.48) were the relevant variables for the progression of Type 2 diabetic nephropathy. Analysis of the IL‐6 secretion data revealed that individuals carrying the −634*G allele had a higher IL‐6 secretion capacity than those without the *G allele (P < 0.05).Conclusions These results suggest that the IL‐6‐634C/G polymorphism may be a possible genetic susceptibility factor for the progression of diabetic nephropathy.Diabet. Med. 19, 1000–1005 (2002)
High incidence of Type 2 diabetes mellitus in South African Indians: a 10‐year follow‐up study
Authors: Motala A. A. , Pirie F. J. , Gouws E. , Amod A. , Omar M. A. K. 
Published: March 2003

AbstractAims Previous cross‐sectional studies have established that South African Indians have a high prevalence of Type 2 diabetes mellitus. A prospective community study was undertaken to determine the incidence of Type 2 diabetes and the risk factors associated with its development in a cohort of South African Indians who had been studied 10 years previously.Methods This is a report on 563 subjects who participated both at baseline and at the 10‐year follow‐up study. In the baseline study, 2479 subjects (> 15 years) were studied; using 1985 World Health Organization criteria for glucose tolerance based on 75 g oral glucose tolerance tests (OGTT), the crude prevalence of diabetes mellitus (Diabetes) was 9.8% and of impaired glucose tolerance (IGT) 5.8% (age and sex‐adjusted prevalence 13% and 6.9%, respectively).Results At the 10‐year follow‐up study, 563 of the subjects who could be traced consented to a repeat OGTT; of these, 91 (16.2%) were classified as Diabetes and 41 (7.3%) as IGT. Of the subjects who did not have diabetes at baseline (n = 517), 49 (9.5%) progressed to diabetes (PTD) and 40 (7.7%) had IGT. The crude cumulative incidence of diabetes was 9.5% (rate of progression 0.95% per annum; incidence density 9.5/1000 person years) with an age and sex‐adjusted cumulative incidence of 8.3% (rate of progression 0.95% per annum; incidence density 8.3/1000 person years). Examination of risk factors predictive of subsequent diabetes development was undertaken by analysis of baseline (year 0) variables in the 517 subjects who did not have diabetes at baseline. In multivariate analysis using a logistic regression model, the significant predictive risk factors for future diabetes included 2‐h post load plasma glucose (2 PG) (P < 0.0001, odds ratio (OR) 1.7, 95% confidence interval (CI) 1.4–2.1), body mass index (BMI) (P < 0.006, OR 1.1, 95% CI 1.0–1.3) and obesity (P < 0.01, OR 4.6, 95% CI 1.4–14.7).Conclusions This long‐term study has shown that in South African Indians there is a high incidence of Type 2 diabetes, and in this population significant predictors include higher baseline blood glucose, BMI and obesity.
Constraints on modelling the deforestation and degradation of tropical open woodlands
Authors: Grainger Alan 
Published: March 2003

SummaryEcosystem heterogeneity and lack of data on areas and deforestation rates have constrained the modelling of deforestation in tropical open woodlands. Smaller and more continuous changes in ecosystem quality attributes (e.g. canopy cover, tree density and biomass density) are best described as degradation, not deforestation. Suggestions are made for constructing degradation models by relaxing some assumptions of deforestation models to cope with the multiple uses of multiple vegetation layers by multiple users. Employing biomass as a dependent variable would account for biomass reductions caused by changes in woodland area, tree density and the biomass of retained trees and shrubs, and overcome the problem of how to aggregate changes in woodland area and tree density. Disaggregating models by woodland type is also recommended.
Ploidy race distributions since the Last Glacial Maximum in the North American desert shrub, Larrea tridentata
Authors: Hunter Kimberly L. , Betancourt Julio L. , Riddle Brett R. , Van Devender Thomas R. , Cole Kenneth L. , Spaulding W. Geoffrey 
Published: March 2003

Abstract

A classic biogeographic pattern is the alignment of diploid, tetraploid and hexaploid races of creosote bush (Larrea tridentata) across the Chihuahuan, Sonoran and Mohave Deserts of western North America. We used statistically robust differences in guard cell size of modern plants and fossil leaves from packrat middens to map current and past distributions of these ploidy races since the Last Glacial Maximum (LGM).
Glacial/early Holocene (26–10 14C kyr bp or thousands of radiocarbon years before present) populations included diploids along the lower Rio Grande of west Texas, 650 km removed from sympatric diploids and tetraploids in the lower Colorado River Basin of south‐eastern California/south‐western Arizona. Diploids migrated slowly from lower Rio Grande refugia with expansion into the northern Chihuahuan Desert sites forestalled until after ~4.0 14C kyr bp. Tetraploids expanded from the lower Colorado River Basin into the northern limits of the Sonoran Desert in central Arizona by 6.4 14C kyr bp. Hexaploids appeared by 8.5 14C kyr bp in the lower Colorado River Basin, reaching their northernmost limits (~37°N) in the Mohave Desert between 5.6 and 3.9 14C kyr bp.
Modern diploid isolates may have resulted from both vicariant and dispersal events. In central Baja California and the lower Colorado River Basin, modern diploids probably originated from relict populations near glacial refugia. Founder events in the middle and late Holocene established diploid outposts on isolated limestone outcrops in areas of central and southern Arizona dominated by tetraploid populations.
Geographic alignment of the three ploidy races along the modern gradient of increasingly drier and hotter summers is clearly a postglacial phenomenon, but evolution of both higher ploidy races must have happened before the Holocene. The exact timing and mechanism of polyploidy evolution in creosote bush remains a matter of conjecture.
Effects of body mass, climate, geography, and census area on population density of terrestrial mammals
Authors: Silva Marina , Brimacombe Michael , Downing John A. 
Published: March 2003

AbstractAimThe aim of this study was to investigate the effects of climate, geography, census area and the distribution of body mass on the mass : density relationship in terrestrial mammal populations.LocationThe areas covered include most major terrestrial biomes including the tropics, savannas, and temperate forests.MethodData on population density and body mass from 827 populations belonging to 330 different terrestrial mammal species were derived from a review of the literature.ResultsLOWESS and polynomial regression analysis indicated that the overall mass : density relationship on log‐log scales was not linear and that the slope of this relationship behaves differently across the range of body mass. Body mass explained between 37 and 67% of the variability in population density depending upon the dietary category or the biome group. We also developed two multivariate models that can explain up to 65% of the variability in population density in terrestrial mammals. We also tested for a confounding effect of census area on the mass : density relationship on log‐log scales in terrestrial mammals.ConclusionsOur findings support previous studies suggesting that body mass is a major predictor of the variance in population density in terrestrial mammals. We suggest that the non‐linearity of the mass : density relationship may result from the fact that the overall distribution of body mass is a mixture of distributions across dietary groups and biomes. In contrast to body mass, our results indicate that climatic and geographical factors have a minor effect on population density. Although census area was closely correlated with body mass, body mass was generally a better predictor of population density than was census area.
Range size and its ecological correlates among the pteridophytes of Carrasco National Park, Bolivia
Authors: Kessler Michael 
Published: March 2003

AbstractAimTo identify the factors determining the range size of pteridophytes (ferns and allied plants) in an Andean region.LocationHumid eastern Andean slope in Carrasco National Park, Bolivia.MethodsI used a macroecological approach to search for correlations of range size to elevation, habitat type, life form, reproductive strategy, the species’ elevational range, and its frequency, among the 473 pteridophyte species recorded in the park.ResultsRange sizes were smallest at 1800–3500 m elevation and in localized habitats with little disturbance (ravines, ridges), while regularly disturbed habitats (pastures, roadsides) supported widespread species. Families and genera differed with respect to the range sizes of their species, but this pattern was not correlated to any other studied factor and could not be explained. Species with restricted ranges tended to be more frequent in the study area than widespread species. Widespread species tended to have large elevational ranges, implying that they are ecologically more adaptable than localized species. There was no relationship of range size to life form or to the studied reproductive aspects (sexual vs. asexual reproduction, chlorophyllous vs. achlorophyllous spores).ConclusionsThe above trends were mostly uncorrelated and explained a rather small portion of the observed range size variance. Thus, it is not yet possible to draw a cohesive picture of the factors determining pteridophyte range size. Intriguing questions for future research include the relationship of range size to dispersal, competitive ability, and taxonomic affinity.
Scale in macroecology
Authors: Blackburn Tim M. , Gaston Kevin J. 
Published: March 2003

AbstractThe past 15 years have seen the development of macroecology as a respectable discipline within the biological sciences. Initial concerns about the utility of a large‐scale approach to ecology have been quietened, if not eliminated, but other arguments about spatial scale in ecology have arisen to take their place. The situation has moved from the absolute advocacy of small‐scale over large‐scale studies to an advocacy of some large scales in preference to others. Here, we argue that there is no general sense in which one scale of study (either in terms of spatial extent or sampling resolution) is better than any other. As long as there are sensible reasons for using the scale chosen, studies at all scales have the potential to inform about the structure and function of the ecological systems that clothe this planet.
Phytogeographical relationships among high mountain areas in the Baetic Ranges (South Spain)
Authors: Mota J. F. , Pérez‐García F. J. , Jiménez M. L. , Amate J. J. , Peñas J. 
Published: March 2003

ABSTRACTThe Mediterranean area is regarded nowadays as one of the hot‐spots of world biodiversity. The Baetic ranges in Spain have such a large number of endemic plant taxa that the territory has been recognized as a well‐defined biogeographical unit. These endemic taxa tend to concentrate on disjunct highland areas that have been described consequently as ‘highland islands’. Despite the importance and complexity of these sites, the research carried out so far has produced only descriptive classifications. These approaches overlook the relationships between the sites and do not serve to identify the main centres of endemism. Herein, multivariate analysis techniques (cluster analysis and reciprocal averaging) and the parsimony analysis of endemicity (PAE), applied to the 222 orophilous endemic taxa of the Baetic ranges, have been used to reveal the floristic similarities between the areas involved, to identify the centres of endemism and to re‐assess the previous classifications. Four centres of endemism are defined, one siliceous and three calcareous. The most outstanding feature in the Baetic ranges is precisely the floristic difference between siliceous and calcareous mountains. Calcareous territories extend along a SW–NE axis in line with the oceanic–continental gradient. The nature of the soil in the vast siliceous and calcareous–dolomitic territories of the Sierra Nevada is probably the cause of the remarkable floristic diversity. Not surprisingly, in our analysis these areas stand out as centres of endemism. We conclude that previous biogeographical classifications of the ranges are too rigid and do not properly reflect the floristic similarities of the area under study.
Foliicolous lichens from Valdivian temperate rain forest of Chile and Argentina: evidence of an austral element, with the description of seven new taxa
Authors: Lücking R. , Wirth V. , Ferraro L.I. , Cáceres M.E.S. 
Published: March 2003

ABSTRACTAim To describe the composition, diversity and biogeographical affinities of the foliicolous lichen mycobiota in Valdivian temperate rain forest in southern South America.Location Seven localities in Chile (IX to XI region) and Argentina (Neuquén province).Methods Opportunistic sampling of leaf substrates, identification of taxa, and assignment to distribution types.Results Thirty‐seven species, including three lichenicolous fungi, were found in the studied collections, increasing the number of foliicolous taxa known from Valdivian temperate rain forest to 55. New records for the area include Arthonia cyanea, Byssoloma marginatum, B. subdiscordans, Fellhanera bouteillei, F. dispersa, F. subfuscatula, Gyalectidium caucasicum, G. ciliatum, Logilvia gilva, Porina thaxteri, Strigula nitidula and the lichenicolous A. microsticta, Helicobolomyces lichenicola and Opegrapha sipmanii. Seven taxa are described as new: Enterographa falcata, Gyalectidium chilense, G. plicatum, Gyalideopsis choshuencensis, Porina fulvelloides, Strigula wandae and Trichothelium meridionale ssp. austroamericanum.Conclusions There are unexpected floristic affinities in the foliicolous lichen mycobiota of Valdivian temperate rain forest with those of New Zealand and Tasmania. Three typically foliicolous species clearly belong to an austral element: Caprettia setifera and Badimiella pteridophila, both known previously from New Zealand and Tasmania; and Kantvilasia hians, known already from Tasmania and Valdivian temperate rain forest. Other Southern Hemisphere lichens, such as Parmeliella nigrocincta, P. thysanota and Psoroma caliginosum, are also found commonly on leaves. On the other hand, specific affinities of the foliicolous lichen mycobiota of Valdivian temperate rain forest with the Neotropics are absent: most of the species shared between the two regions belong to a cosmopolitan‐tropical or a circumpacific element. Thus far, nine taxa are endemic to Valdivia. The Valdivian temperate rain forest foliicolous lichen mycobiota is therefore regarded as one of six distinctive regions in the world.
Active habitat selection by pre‐settlement reef fishes
Authors: Montgomery John Charles , Tolimieri Nicholas , Haine Olivia Sophie 
Published: March 2003

AbstractOur understanding of habitat selection by reef fish larvae has changed dramatically in the last 10 years. Fish larvae have long been considered passive particles at the mercy of ocean currents, tides and weather events. For reef fishes, ecological evidence has shown that passive dispersal alone often cannot explain larval distributions, suggesting active behaviour by reef fish larvae. While behaviourally modified passive transport may be important, recent work demonstrates that some reef fish larvae have the capability to actively swim to settlement habitat. They can orientate to reefs from distances of at least 1 km and can swim at speeds of 13.5 cm s−1for several days. The question then becomes, what are the cues that fish larvae use to orientate to reefs? Ambient reef sound has been shown to be attractive to reef fish larvae, and current research aims to understand better the nature and use of these acoustic cues. Other potential cues include chemoreception/olfaction, wave cues and visual location of reefs. A better understanding of active habitat selection and the underlying sensory and behavioural mechanisms will improve our knowledge of recruitment processes in reef fish ecology, and may have implications for active management of reef fish populations.
Parallel speciation, despeciation and respeciation: implications for species definition
Authors: Turner George F 
Published: March 2003

AbstractCan the same species arise more than once in different places or at different times? Can a species go extinct by hybridization? If so, can it reappear afterwards? Biologists are used to thinking about species as historical events. They arise once (speciation), exist for a certain time (undergoing stasis or anagenetic change) and then disappear (extinction). Some people even like to think of them as ‘individuals’, although, whether the use of the technical philosophical definition of this word is helpful to many biologists, is perhaps debatable. By and large, our observations of real animal species are not at all incompatible with these ideas. But, recent studies on fishes are suggesting that we may need to rethink our views of the life of a species to include the concepts of parallel speciation, despeciation and respeciation.The ideas I discuss in this paper are not necessarily new, but many fish biologists, like myself, may not have found any particular reason to consider them until recently. There is a very large literature on species concepts, and in a short opinion piece, I could scarcely attempt to do justice to the breadth of the debate or the complexity of the arguments raised. I will focus on issues relating to practical implications of species concepts that have to come to my attention as a fish biologist working on evolutionary questions.