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Mortality in adults with and without diabetes in a national cohort of the U.S. population, 1971-1993. K Gu , C C Cowie and M I Harris National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD 20892, USA. Abstract OBJECTIVE: To examine 22-year mortality (1971-1993), causes of death, life expectancy, and survival in a national sample of diabetic and nondiabetic adults according to age, sex, and race. RESEARCH DESIGN AND METHODS: A representative national cohort of 14,374 adults aged 25-74 years was identified in 1971-1975 in the First National Health and Nutrition Examination Survey (NHANES I). Diabetes was ascertained by medical history interview. The cohort was followed for mortality through 1992-1993, with verification of vital status for 96.2% (n = 13,830). Causes of death were determined from death certificates. RESULTS: Diabetic subjects comprised 5.1% of the cohort and accounted for 10.6% of the deaths. Mortality for diabetic subjects increased from 12.4 per 1,000 person-years for those aged 25-44 years at baseline to 89.7 per 1,000 person-years for those aged 65-74 years. The age-adjusted mortality rate was 57% higher for diabetic men than for diabetic women; the rate was 27% higher for diabetic non-Hispanic blacks than for diabetic non-Hispanic whites. Mortality rates were highest for insulin-treated subjects and for those with > or = 15 years' duration of diabetes. Diabetes was listed on the death certificate as the underlying cause of death for only 7.7% of diabetic men and 13.4% of diabetic women. Considering multiple causes of death, heart disease was listed the most frequently and was present on 69.5% of death certificates of people with diabetes. Death rates were higher for diabetic than for nondiabetic subjects in all age, sex, and race groups. The relative risk of death (diabetic versus nondiabetic subjects) declined with age from a value of 3.6 for those aged 25-44 years at baseline to 1.5 for those aged 65-74 years. The relative risk was elevated in diabetic subjects for all major causes of death except malignant neoplasms. Survival of diabetic subjects was lower than that of nondiabetic subjects in all age, sex, and race groups. Median life expectancy was 8 years lower for diabetic adults aged 55-64 years and 4 years lower for those aged 65-74 years. CONCLUSIONS: In this representative national sample of adults, mortality rates were higher for diabetic men than for diabetic women and for diabetic blacks than for diabetic whites. The study confirms the substantially higher risk of death, lower survival, and lower life expectancy of diabetic adults compared with nondiabetic adults.

Compared with those without the hypertension, the new cases in 2011 had higher mean values in age, BMI, Uric Acid, Urea, Cholesterol, Alanine Aminotransferase, Glucose, Low Density Lipoprotein, Aspartate Aminotransferase, Lactate dehydrogenase, Triglyceride, Ferritin, Red Blood Cell, Hemoglobin, Activated Clotting Time, Systolic Blood Pressure (SBP), Diastolic blood pressure (DBP) and Waist size but lower mean value in High Density Lipoprotein from 2006 baseline measurement.

本研究開發了一種多重聚合酶連鎖反應(multiplex PCR)方法，用以篩選和檢測六株澳門常見的食源性致病菌。此方法使用六對引子對，可自混有數株參考菌株之食物樣本或單一菌種之純培養中，擴增產生特定大小之複製子(amplicon)。多重聚合酶連鎖反應方法所檢測的六個目標基因包括：大腸桿菌O157:H7之verocytotoxin (stx)基因、李斯特菌之hemolysin (hly)基因、沙門氏桿菌之invasion (invA)基因、霍亂弧菌之cholera toxin (ctx)基因、副溶血性弧菌之thermolabile hemolysin (tlh)基因，以及金黃色葡萄球菌之thermostable nuclease (nuc)基因。此檢測法之靈敏度爲1~100 CFU/mL。此多重聚合酶連鎖反應方法可檢測下列三類食物所含之病菌：肉類及肉類產品中之沙門氏桿菌、李斯特菌和大腸桿菌O157:H7；海鮮及海鮮產品中之霍亂弧菌和副溶血性弧菌；即時食品中之金黃色葡萄球菌。綜上所述，本研究結果顯示，多重聚合酶連鎖反應爲一快速之食源性致病菌檢測方法，可用於例行監測食物之安全，或評估其風險。

The Singapore Impaired Glucose Tolerance Follow-Up Study Does the ticking clock go backward as well as forward? Moh-Sim Wong , MD 1 2 , Ken Gu , PHD 3 , Derrick Heng , MD 3 , Suok-Kai Chew , MD 4 , Loy-Soong Chew , MD 2 and E. Shyong Tai , MD 5 1 National University Hospital, Singapore 2 Alexandra Hospital, Singapore 3 Clinical Trials and Epidemiology Research Unit, Singapore 4 Epidemiology and Disease Control Division, Ministry of Health, Singapore 5 Department of Endocrinology, Singapore General Hospital, Singapore Address correspondence and reprint requests to E. Shyong Tai, Department of Endocrinology, Block 6 level 6, Singapore General Hospital, Outram Road, Singapore 169608, Republic of Singapore. E-mail: eshyong{at}pacific.net.sg Abstract OBJECTIVE —To 1 ) document the change in glucose tolerance for subjects with normal glucose tolerance (NGT) and impaired glucose tolerance (IGT) over time, 2 ) identify baseline factors associated with worsening of glucose tolerance, and 3 ) determine whether cardiovascular disease (CVD) risk factors associated with IGT improved in tandem with glucose tolerance. RESEARCH DESIGN —Subjects with IGT and NGT (matched for age, sex, and ethnic group) were identified from a cross-sectional survey conducted in 1992. Subjects with IGT (297) and NGT (298) (65.0%) were reexamined in 2000. Glucose tolerance (assessed by 75-g oral glucose tolerance test), anthropometric data, serum lipids, blood pressure, and insulin resistance were determined at baseline and at the follow-up examination. RESULTS —For NGT subjects, 14.0% progressed to IGT and 4.3% to diabetes over 8 years. For IGT subjects, 41.4% reverted to NGT, 23.0% remained impaired glucose tolerant, and 35.1% developed diabetes. Obesity, hypertriglyceridemia, higher blood pressure, increased insulin resistance, and lower HDL cholesterol at baseline were associated with worsening of glucose tolerance in both IGT and NGT subjects. Those with IGT who reverted to NGT remained more obese and had higher blood pressure than those with NGT in both 1992 and 2000. However, serum triglyceride, HDL cholesterol, and insulin resistance values in 2000 became indistinguishable from those of subjects who maintained NGT throughout the study period. CONCLUSIONS —Some, but not all, CVD risk factors associated with IGT and with the risk of future diabetes normalize when glucose tolerance normalizes. Continued surveillance and treatment in subjects with IGT, even after they revert to NGT, may be important in the prevention of CVD. CVD, cardiovascular disease IGT, impaired glucose tolerance NGT, normal glucose tolerance Footnotes A table elsewhere in this issue shows conventional and Système International (SI) units and conversion factors for many substances. Accepted August 5, 2003. Received June 24, 2003. DIABETES CARE

Background Macau has recently experienced expansive socioeconomic growth, leading to lifestyle changes that could have contributed to the development of certain diseases. Little information exists on the prevalence of metabolic syndrome (MetS) and associated risk factors. This information is important, since the management of MetS is tightly connected with prevention of cardiovascular diseases in the population. Methods This study is based on the cross-sectional Macau Health Survey 2006. Information on anthropometry, physical measurements, socio-demographics, laboratory tests and life-style habits was collected by trained health professionals from a random sub-population sample, aged 18-44 (32.6 ± 8.3). Body Mass Index (BMI) cut-offs were based on WHO criteria for Asian population. The prevalence of MetS, as defined by the International Diabetes Federation was calculated and the associated lifestyle factors were analysed. Results Among Macau’s adults (n = 1592), the age-adjusted prevalence of MetS was over two times higher in men (10.5%) than in woman (3.7%), (p <0.01). 15.8% were overweight (BMI ≥23 < 25) and 18.8% were obese (BMI ≥25). Man had significantly higher risk profile in almost all components of MetS (p <0.001), except the waist circumference and HDL. BMI, age and education were significantly related to MetS in both genders (p <0.001). Conclusions We found significant gender differences in MetS among the 18 – 44 year old population of Macau, which should be addressed separately in the gender-specific preventive strategies.

Lowering the Criterion for Impaired Fasting Glucose Impact on disease prevalence and associated risk of diabetes and ischemic heart disease E. Shyong Tai , MB, CHB 1 2 , Su Yen Goh , MB, BS 1 , Jeannette J.M. Lee , MB, BS 2 , Moh-Sim Wong , MB, BS 3 , Derrick Heng , MB, BS 4 5 , Kenneth Hughes , PHD 6 , Suok Kai Chew , MSC 4 , Jeffery Cutter , MSC 4 , William Chew , MB, BS 3 , Ken Gu , PHD 5 , Kee Seng Chia , MD 2 and Chee Eng Tan , PHD 1 2 1 Department of Endocrinology, Singapore General Hospital, Singapore 2 NUS-GIS Centre for Molecular Epidemiology, National University of Singapore, Singapore 3 Department of Medicine, Alexandra Hospital, Singapore 4 Epidemiology and Disease Control Division, Ministry of Health, Singapore 5 Clinical Trials and Epidemiology Unit, National Medical Research Council, Singapore 6 Department of Community, Occupational and Family Medicine, National University of Singapore, Singapore Address correspondence and reprint requests to Dr. E. Shyong Tai, Department of Endocrinology, Block 6 level 6, Room B35, Singapore General Hospital, Outram Road, Singapore 169608, Republic of Singapore. E-mail: eshyong{at}pacific.net.sg Abstract OBJECTIVE —To determine the effect of lowering the fasting plasma glucose (FPG) criterion for impaired fasting glucose (IFG) on the prevalence of IFG, the risks of diabetes, and cardiovascular disease (CVD) associated with IFG. RESEARCH DESIGN AND METHODS —Three studies were used: 1 ) the 1998 National Health Survey (NHS98), a randomly selected cross-sectional sample of 4,723 subjects; 2 ) the Singapore Impaired Glucose Tolerance (IGT) Follow-up Study, a cohort study comprising 295 IGT and 292 normal glucose tolerance subjects (frequency matched for age, sex, and ethnic group) followed up from 1992 to 2000; and 3 ) the Singapore CVD Cohort Study, comprising 5,920 subjects from three cross-sectional studies in whom the first ischemic heart disease (IHD) event was identified through linkage to registry databases. Risk of diabetes (Singapore IGT Follow-up study) was estimated using logistic regression adjusted for age, sex, and ethnicity. Risk of IHD (Singapore CVD cohort) was estimated using stratified (by study, from which data were derived) Cox’s proportional hazards models adjusted for age, sex, and ethnicity. RESULTS —Lowering the criterion for diagnosing IFG to 5.6 mmol/l increased the prevalence of IFG from 9.5 to 32.3% in the NHS98. The lower cutoff identified more subjects at risk of diabetes and IHD, but the relative risk was lower than that for IGT. CONCLUSIONS —Greater efforts to identify those with IGT, or a group at similar risk of diabetes and CVD, may be a more efficient public health measure than lowering the FPG criterion for diagnosing IFG. 2-h PG, 2-h postchallenge glucose CVD, cardiovascular disease FPG, fasting plasma glucose IFG, impaired fasting glucose IGT, impaired glucose tolerance IHD, ischemic heart disease NGT, normal glucose tolerance NHS92, 1992 National Health Survey NHS98, 1998 National Health Survey NNT, number needed to treat OGTT, oral glucose tolerance test ROC, receiver operating characteristic Footnotes Additional information for this article can be found in an online appendix at http://care.diabetesjournals.org . A table elsewhere in this issue shows conventional and Système International (SI) units and conversion factors for many substances. Accepted March 26, 2004. Received October 4, 2003. DIABETES CARE

To determine the effect of lowering the fasting plasma glucose (FPG) criterion for impaired fasting glucose (IFG) on the prevalence of IFG, the risks of diabetes, and cardiovascular disease (CVD) associated with IFG. Three studies were used: 1). the 1998 National Health Survey (NHS98), a randomly selected cross-sectional sample of 4723 subjects; 2). the Singapore Impaired Glucose Tolerance (IGT) Follow-up Study, a cohort study comprising 295 IGT and 292 normal glucose tolerance subjects (frequency matched for age, sex, and ethnic group) followed up from 1992 to 2000; and 3). the Singapore CVD Cohort Study, comprising 5920 subjects from three cross-sectional studies in whom the first ischemic heart disease (IHD) event was identified through linkage to registry databases. Risk of diabetes (Singapore IGT Follow-up study) was estimated using logistic regression adjusted for age, sex, and ethnicity. Risk of IHD (Singapore CVD cohort) was estimated using stratified (by study, from which data were derived) Cox's proportional hazards models adjusted for age, sex, and ethnicity. Lowering the criterion for diagnosing IFG to 5.6 mmol/l increased the prevalence of IFG from 9.5 to 32.3% in the NHS98. The lower cutoff identified more subjects at risk of diabetes and IHD, but the relative risk was lower than that for IGT. Greater efforts to identify those with IGT, or a group at similar risk of diabetes and CVD, may be a more efficient public health measure than lowering the FPG criterion for diagnosing IFG.

Conversational interfaces are increasingly used for data analysis, enabling data workers to express complex analytical intents in natural language. Yet, these interactions unfold as long, linear transcripts that are misaligned with the iterative, nonlinear nature of real-world analyses. Revisiting and summarizing conversations for different contexts is therefore challenging. This paper investigates how data workers navigate, make sense of, and communicate prior analytical conversations. To study behaviors beyond those supported by standard interfaces (i.e., scrolling and keyword search), we develop a design probe that supplements analytical conversations with structured elements and affordances (e.g., filtering, multi-level navigation and detail-on-demand). In a user study (n = 10), participants used the probe to navigate and communicate past analyses, fulfilling information needs (recall, reorient, prioritize) through navigation strategies (visual recall, sequential and abstractive) and summarization practices (adding process details and context). Based on these findings, we discuss design implications to support re-visitation and communication of analytical conversations.

To 1). document the change in glucose tolerance for subjects with normal glucose tolerance (NGT) and impaired glucose tolerance (IGT) over time, 2). identify baseline factors associated with worsening of glucose tolerance, and 3). determine whether cardiovascular disease (CVD) risk factors associated with IGT improved in tandem with glucose tolerance. Subjects with IGT and NGT (matched for age, sex, and ethnic group) were identified from a cross-sectional survey conducted in 1992. Subjects with IGT (297) and NGT (298) (65.0%) were reexamined in 2000. Glucose tolerance (assessed by 75-g oral glucose tolerance test), anthropometric data, serum lipids, blood pressure, and insulin resistance were determined at baseline and at the follow-up examination. For NGT subjects, 14.0% progressed to IGT and 4.3% to diabetes over 8 years. For IGT subjects, 41.4% reverted to NGT, 23.0% remained impaired glucose tolerant, and 35.1% developed diabetes. Obesity, hypertriglyceridemia, higher blood pressure, increased insulin resistance, and lower HDL cholesterol at baseline were associated with worsening of glucose tolerance in both IGT and NGT subjects. Those with IGT who reverted to NGT remained more obese and had higher blood pressure than those with NGT in both 1992 and 2000. However, serum triglyceride, HDL cholesterol, and insulin resistance values in 2000 became indistinguishable from those of subjects who maintained NGT throughout the study period. Some, but not all, CVD risk factors associated with IGT and with the risk of future diabetes normalize when glucose tolerance normalizes. Continued surveillance and treatment in subjects with IGT, even after they revert to NGT, may be important in the prevention of CVD.

Multiverse analysis, a paradigm for statistical analysis that considers all combinations of reasonable analysis choices in parallel, promises to improve transparency and reproducibility. Although recent tools help analysts specify multiverse analyses, they remain difficult to use in practice. In this work, we identify debugging as a key barrier due to the latency from running analyses to detecting bugs and the scale of metadata processing needed to diagnose a bug. To address these challenges, we prototype a command-line interface tool, Multiverse Debugger, which helps diagnose bugs in the multiverse and propagate fixes. In a qualitative lab study (n=13), we use Multiverse Debugger as a probe to develop a model of debugging workflows and identify specific challenges, including difficulty in understanding the multiverse's composition. We conclude with design implications for future multiverse analysis authoring systems.