Hand Washing, Outcomes & Safety / 30.05.2013

Sarah Edmonds, Scientist at GOJO.MedicalResearch.com eInterview with: Sarah Edmonds, Scientist at GOJO. MedicalResearch.com: What are the main findings of the study? Answer: Implementation of electronic hand hygiene compliance monitoring with a clinical hand hygiene program significantly increased hand hygiene compliance rates, with rates during the study period being 92% higher than at baseline. MedicalResearch.com: Were any of the findings unexpected? Answer: While not necessarily unexpected we did find that electronic compliance monitoring alone may not be sufficient to raise compliance rates for a sustained period of time. After the clinical program concluded there was a significant drop in compliance rates so it is important to continue to monitor hand hygiene rates and continue to promote the program to sustain increased hand hygiene compliance. (more…)
ADHD, Author Interviews, JAMA, Mental Health Research, Pediatrics / 30.05.2013

Kathryn L. Humphreys, M.A., Ed.M. Clinical Psychology Doctoral Student UCLA Department of Psychology 1285 Franz Hall, Box 951563 Los Angeles, CA 90095MedicalResearch.com eInterview with Kathryn L. Humphreys, M.A., Ed.M. Clinical Psychology Doctoral Student UCLA Department of Psychology 1285 Franz Hall, Box 951563 Los Angeles, CA 90095 MedicalResearch.com: What are the main findings of the study? Response: Our primary question was to answer whether the use of stimulant medication in the treatment of ADHD was associated with increased or decreased risk for a variety of substance use (ever tried) and substance use disorder (abuse or dependence) outcomes (alcohol, cocaine, marijuana, nicotine, and non-specific drug use). Prior research from individual studies of children have provided mixed evidence (i.e., some found medication increased later risk, some found medication decreased risk, and still others found no difference in risk). We examined available longitudinal studies (i.e., medication treatment preceded measurement of substance outcome) together using meta-analysis, a technique that aggregates findings from a number of studies, in order to examine this question in a much larger sample of individuals. Our main finding was that children with ADHD who received medication treatment did not differ in risk for lifetime substance use or abuse or dependence compared to those children with ADHD who did not receive medication treatment. (more…)
Author Interviews, Neurological Disorders, Parkinson's / 29.05.2013

MedicalResearch.com eInterview with Dr. Emanuele Cereda Nutrition and Dietetics Service, Fondazione IRCCS Policlinico San Matteo Viale Golgi 19, 27100 Pavia, Italy MedicalResearch.com: What are the main findings of the study? Dr. Cereda: A large analysis of more than 100 studies shows that exposure to pesticides, or bug and weed killers, and solvents is likely associated with a higher risk of developing Parkinson’s disease. MedicalResearch.com: Were any of the findings unexpected? Dr. Cereda: In first instance I can say no as in every day clinical practice we frequently see patients reporting such exposure. Accordingly, it appears quite obvious to look at these exposures as risk factors. Unfortunately, from an epidemiologic point of view this is not enough! That's why we did this study. Amazing rather than surprising was the fact that commonly the sources of funding in the studies we retrieved and included in meta-analysis were health or health-related institutions, private foundations (mainly Parkinosn’s disease foundations), or government or para-government companies. No study acknowledged the involvement of any chemicals manufacturer! (more…)
Author Interviews, Cancer Research, Prostate Cancer, Stanford / 29.05.2013

MedicalResearch.com eInterview with Timothy J. Daskivich, MD Robert Wood Johnson Foundation Clinical Scholars® University of California Los Angeles Division of General Internal Medicine and Health Services Research 10940 Wilshire Blvd, 7th Floor Suite 710, Room 721 Los Angeles, California 90024 MedicalResearch.com: What are the main findings of the study?  Were any of the findings unexpected? Dr. Daskivich:  We found that age and a simple count of comorbidities were strongly predictive of likelihood of dying of causes other than prostate cancer.  When we put numbers to it, it was surprising how often older men with multiple comorbidities were dying of something else than their prostate cancer within 14 years of diagnosis.  For example, a 75-year old man with 3 or more comorbidities—diabetes, high blood pressure, and history of heart attack—had a probability of death from something other than CaP of 71% at 10 years.  For a 71-year old man with 3 or more comorbidities, the probability was 60%.  We compared that to the amount of time they were dying of prostate cancer, which was 3% for low-risk disease and 7% for intermediate-risk disease. (more…)
Author Interviews, Brigham & Women's - Harvard, Diabetes, Kidney Disease, Medical Research Centers, Mediterranean Diet, Nutrition / 29.05.2013

MedicalResearch.com eInterview with Iris Shai, RD, PhD PI of the DIRECT trial Ben Gurion University of the Negev, Israel MedicalResearch.com: What are the main findings of the study? Dr. Shai: Low-carbohydrate is as effective as Mediterranean or low-fat diets in improving renal function among moderately obese participants with or without type 2 diabetes, with baseline serum creatinine<176µmol/L (not sever renal stage).  The effect is likely to be mediated by weight-loss induced improvements in insulin sensitivity and blood pressure. (more…)
Author Interviews, Blood Pressure - Hypertension, Diabetes, Kidney Disease, Pediatrics / 28.05.2013

MedicalResearch.com eInterview with: Dr. Jane L Lynch MD School of Medicine Pediatrics University of Texas Health Science Center at San AntonioDr. Jane L Lynch MD School of Medicine Pediatrics University of Texas Health Science Center at San Antonio MedicalResearch.com: What are the main findings of the study? Dr. Lynch: American youth with type 2 diabetes who received the best currently available treatment and close monitoring of their diabetes experienced a more rapid progression of co-morbidities far more aggressive than what is typically seen in adults with type 2 diabetes. MedicalResearch.com: Were any of the findings unexpected? Dr. Lynch: Youth with type 2 diabetes enrolled in the TODAY study developed early and rapidly progressing signs of heart and kidney disease, poor glycemic control and diabetes-related eye disease; even in the group receiving more intensive two-drug therapy, shown in previously released results to be the most effective treatment for maintenance of glycemic control. (more…)
Author Interviews, BMJ, Brigham & Women's - Harvard, Cancer Research, CT Scanning, Medical Imaging, Medical Research Centers / 27.05.2013

prof_john_d_mathewsJohn D. Mathews, MBBS, MD, PhD, DSc Hon, DMedSc Hon, Professor of epidemiology at the School of Population and Global Health, University of Melbourne, Carlton, Victoria, Australia Cancer risk in 680 000 people exposed to computed tomography scans in childhood or adolescence: data linkage study of 11 million Australians MedicalResearch.com: What are the main findings of the study? Prof Mathews: We found that for persons having at least one CT scan before the age of 20 years, and followed for an average period of 10 years, the average risk of cancer was increased by 24% compared with unexposed persons matched for age, sex and year of birth. The cancer risk increased by 16% for each CT scan that preceded the cancer by more than one year. The proportional increase in risk was greater for persons exposed at younger ages. (more…)
Asthma, Author Interviews / 26.05.2013

MedicalResearch.com eInterview with: Stefan Worgall Ph.D., M.D
Department of Genetic Medicine and 4Department of Pediatrics Weill Cornell Medical College, New York, NY 10021, USA.
MedicalResearch.com: What are the main findings of the study? Dr. Worgall: Asthma is a common disease and large genome-wide association studies  found variation in the gene for ORMDL3, in to up to 30 percent of asthma cases. The over-production ORMDL3 was connected to childhood asthma. ORMDL3 protein inhibits the new production of sphingolipids. Our study connects sphingolipid metabolism mechanistically to human asthma for the first time. We found that inhibition of the enzyme that is critical to sphingolipid synthesis, serine palmitoyl-CoA transferase (SPT),  produced asthmatic lungs in mice and in human bronchi, as it did in mice that had a genetic defect in SPT. When these mice were given methacholine their airways constricted further. We further determined that the airway hyperactivity seen in the mice was not linked to increased inflammation, which is a target for most asthma therapies. (more…)
Author Interviews, Cancer Research, Genetic Research, Lung Cancer / 26.05.2013

MedicalResearch.com Authors’ Interview: Sophie Rousseaux and Saadi Khochbin INSERM, U823; Université Joseph Fourier, Grenoble 1; Institut Albert Bonniot, Grenoble F-38700, France. MedicalResearch.com: What are the main findings of the study? Answer: We first discovered that all cancer cells lose the ability to maintain gene silencing and therefore activate genes that should normally remain silent. Although present in all cells, some genes are normally expressed (or “active”) only in one cell type. For example, normal lung cells do not express genes that are only active in germ cells (i. e., cells that will become spermatozoa), but lung cancerous cells activate some of these germ cells-specific genes. In this work we designed a specific approach to detect these aberrant gene expressions and found that they occur in all cancers of all origins. We then decided to exploit this phenomenon to help the detection of cancers and predict their evolution. For this purpose, we chose to focus on lung cancer to establish “a proof of principle”. We found that, among all the genes wrongly expressed in the tumour cells, the activation of 26 of them enabled us to identify the most aggressive lung cancers. Compared with the existing information currently available for doctors (i.e.; tumour size, its pathological subtype…), our approach brings much more precision in predicting the evolution of the tumours and the prognosis of the patients. (more…)
Wake Forest / 23.05.2013

MedicalResearch.com eInterview with Dr. Giuseppe Orlando, M.D., Ph.D. Instructor, General Surgery Specialty Areas: Transplant Urology, Kidney Transplantation, Pancreas Transplantation, Transplant Immunology, Transplant Immunosuppression, Transplant Surgery Wake Forest Baptist Medical Center Medical Center Boulevard, Winston-Salem, NC 27157.MedicalResearch.com eInterview with Dr. Giuseppe Orlando, M.D., Ph.D.

Instructor, General Surgery Specialty Areas: Transplant Urology, Kidney Transplantation, Pancreas Transplantation, Transplant Immunology, Transplant Immunosuppression, Transplant Surgery Wake Forest Baptist Medical Center Medical Center Boulevard, Winston-Salem, NC 27157. MedicalResearch.com:  What are the main findings of the study? Dr. Orlando: Our study shows that we can use discarded kidneys from deceased human donors as platform for kidney regeneration investigations. As of now, we are using porcine models, after having developed smaller scale models (mainly in rodents, as it normally occurs in health science ie we need to provide the proof of concept in small animals before scaling up to larger animals which, for obvious reasons, are clinically more relevant). In regenerative medicine we know that cells do not survive if they are not seeded on supporting platforms which we call "scaffolds". There are several types of scaffolds, but probably the most effective are the ones that we can produce from animal/human organs. Basically, every organ consists of a cellular component which is endowed within the framework of the so-called extracellular matrix. When we strip cells out of an organ, what remains is the acellular extracellular matrix. Quite strikingly, the acellular organ in question maintains the same shape and volume that it had before stripping. What counts is that the so-obtained scaffold contains most information that cells require to grow, be viable and exert their function. It looks like this happens also for discarded human kidneys which may represent the most promising platform for our research (more…)
Author Interviews / 23.05.2013

MedicalResearch.com eInterview with  William A. Bauman, MD Veterans Affairs Rehabilitation Research and Development National Center of Excellence for the Medical Consequences of Spinal Cord Injury Suite 7A-13, James J. Peters Veterans Affairs Medical Center 130 West Kingsbridge Road, Bronx, NY 10468; Dr. William A. Bauman, MD Veterans Affairs Rehabilitation Research and Development National Center of Excellence for the Medical Consequences of Spinal Cord Injury Suite 7A-13, James J. Peters Veterans Affairs Medical Center 130 West Kingsbridge Road, Bronx, NY 10468; MedicalResearch.com: What are the main findings of the study? Dr. Bauman: In a prospective, randomized two-group, double-blind, placebo-controlled, intention-to-treat clinical trial, we determined whether SCI in-patients with a full thickness (Stage III or IV) pressure ulcers of the pelvic region who received 24 weeks or less of optimized clinical care and an oral anabolic steroid agent, oxandrolone, have a greater percent of healed target pressure ulcers than those who received placebo and the same clinical care. There was no significant difference in proportion of pressure ulcers that healed between the treatment and placebo groups [treatment recipients 24.1% (95% CI, 16.0% to 32.1%) and placebo recipients 29.8% (CI, 21% to 38.6%) with a difference, -5.7 percentage points (CI, -17.5 to 6.8 percentage points)]. Also, the rate of healing of wounds at 28 days was not significantly different between the groups (50.9% of the oxandrolone group and 43.3% of the placebo group had healing of ≥30.0%), nor was the number of wounds that remained closed at 8 weeks significantly different (16.7% of the oxandrolone group and 15.4% of the placebo group). No serious adverse events were related to drug administration but a significantly greater proportion of patients had elevated liver enzymes in the treatment group [treatment recipients 32.4% (95% CI, 23.6% to 41.2%) and placebo recipients 2.9%% (CI, 0.0% to 6.1%). Thus, oxandrolone showed no benefit over placebo for improving healing of chronic pressure ulcers of the pelvic region or the proportion that remained closed after 8 weeks of treatment. (more…)
Author Interviews, JAMA, Stroke / 22.05.2013

Dr. Rishi Gupta, MD Associate Professor of Neurology, Neurosurgery and Radiology Emory University School of Medicine Director, Vascular Neurology Fellowship Program Director, Multi-Hospital Acute Stroke Network Marcus Stroke and Neuroscience Center Grady Memorial Hospital MedicalResearch.com: What are the main findings of the study? Dr. Gupta: The main findings of this study are that patients with more proximal cerebral arterial occlusion involving the middle cerebral artery and internal carotid artery appear to be the targets for endovascular reperfusion therapy trials. Moreover, previous clinical trials have used a NIHSS > 8 or > 10 threshold to include patients into randomzed trials comparing endovascular therapy versus IV tPA. The threshold may need to be higher and in our analysis we found that threshold to be 14 or greater. (more…)
Author Interviews, Mental Health Research, Sleep Disorders, University of Pennsylvania / 18.05.2013

MedicalResearch.com eInterview with: Linden Oliver, MA, Clinical Research Coordinator University of Pennsylvania Behavioral Sleep Medicine Research Program Philadelphia, Pa MedicalResearch.com: What are the main findings of the study? Answer: We found that less sleep is associated with greater suicide risk in those with insomnia. Specifically, we looked at suicide risk in people with insomnia, and also asked how much sleep they got in the past month. In those with some suicide risk, the likelihood of being high risk (versus low risk) decreased by 72% for every hour of sleep that person reported getting at night. (more…)
Author Interviews, JAMA, Nutrition / 14.05.2013

MedicalResearch.com eInterview with: Mary Scourboutakos PhD student at the University of Toronto Mary R. L'Abbe, PhD Earle W. McHenry Professor, and Chair, Department of Nutritional Sciences Faculty of Medicine, University of Toronto FitzGerald Building, 150 College Street, Rm 315 Toronto, ON, Canada M5S 3E2 MedicalResearch.com: What are the main findings of the study? Answer: We found that chain restaurant meals on average contained half a day's worth of calories, almost a full day's worth of fat and saturated fat, and more than a day's worth of sodium. (more…)
JAMA, Macular Degeneration, Ophthalmology / 10.05.2013

MedicalResearch.com eInterview with: Emily Y. Chew, MD Division of Epidemiology and Clinical Applications National Eye Institute (NEI)/National Institutes of Health (NIH), Bethesda, Maryland MedicalResearch.com: What are the main findings of the study?
 Dr. Chew: For patients who have intermediate age-related macular degeneration (AMD) or those with advanced AMD in one eye, we have recommended a mixture of vitamins and minerals (vitamin C, E and beta-carotene, and zinc oxide and cupric oxide), known as Age-Related Eye Disease Study (AREDS) formulation.  We tested the effects of adding carotenoids, lutein/zeaxanthin, or omega-3 fatty acids or both to the AREDS formulation.  Omega-3 fatty acids did not have any effect on AMD.  Addition of lutein/zeaxanthin provided an additional 10% increase in the reduction of progression to advanced AMD.  In persons with the lowest dietary intake of lutein/zeaxanthin, supplementation with lutein/zeaxanthin provided 25% reduction in rates of developing advanced AMD When we tested lutein/zeaxanthin directly against beta-carotene, the risk of progressing to advanced AMD was reduced by 20%. Furthermore, beta-carotene was found to increase the risk of lung cancer.  To improve the safety and efficacy of the AREDS formulation, we would suggest the elimination of beta-carotene and adding lutein/zeaxanthin.  Omega-3 fatty acids added no further benefit. (more…)
Allergies, Author Interviews / 09.05.2013

MedicalResearch.com eInterview with Author Peter S. Creticos, M.D. (corresponding author) Dr. Creticos' Comments: This paper reports the first successful randomized, double-blind, pivotal trial of sublingual immunotherapy with a ragweed tablet. The relevance of this lies in the recognition that ragweed is the dominant seasonal allergen in North America (~26% of US population is allergic to this noxious weed which pollinates from early August to early October). An alternate (sublingual) approach to immunotherapy for allergic respiratory disease would be a welcome addition to our armamentarium, as the current mode of treatment in the U.S., that of subcutaneous injection immunotherapy, is saddled with a burdensome injection regimen that requires frequent office visits over a 4-5 year course of treatment. (more…)
Author Interviews, Diabetes, Race/Ethnic Diversity, Stroke / 08.05.2013

MedicalResearch.com eInterview with Jane C Khoury, PhD

Associate Professor Division of Biostatistics and Epidemiology Cincinnati Children’s Hospital Medical Center MLC 5041, 3333 Burnet Avenue Cincinnati, Ohio 45229-3039 MedicalResearch.com: What are the main findings of the study? Dr. Khoury: Over all age groups, those with diagnosed diabetes have at least 3-fold increased risk of incident ischemic stroke compared to those without diabetes. This is even more pronounced in those less than 65 years of age, with 5-fold and 12-fold increase for those of black and white race respectively.  All rates are adjusted to the 2000 population. (more…)
Author Interviews, Hematology, Surgical Research, Transfusions / 08.05.2013

MedicalResearch.com eInterview with Luca Weltert, MD Cardiac Surgery Department of the European Hospital in Rome, Presentation during the Plenary Scientific Session of the 93rd AATS Annual Meeting in Minneapolis. MedicalResearch.com: What are the main findings of the study? Dr. Luca Weltert: This study illustrates the efficacy of Human Recombinant Erythropoietin (HRE) in avoiding blood transfusions in the heart surgery setting. And aside from complicated number, tables and statistics tells that HRE can reduce Blood Transfusions as much as 65%, while at the same time not exposing patients to any substantial added risk. (more…)
Author Interviews, Race/Ethnic Diversity / 08.05.2013

MedicalResearch.com eInterview with Annette Langer-Gould, MD, PhD From the Department of Research and Evaluation Kaiser Permanente, Southern California, Pasadena; and Neurology Department Kaiser Permanente, Southern California Los Angeles Medical Center, CA. MedicalResearch.com: What are the main findings of the study? Dr. Langer-Gould: The main findings of the study were that multiple sclerosis is more common in black women than in white women, which run contrary to the widely accepted belief that blacks are less susceptible to MS. In particular, we found that black patients had a 47 percent higher risk of MS than white patients, while Hispanic and Asian patients had a 50 percent and 80 percent lower risk compared to white patients, respectively. We also found that 70 percent of MS cases occurred in females, but this preponderance of females diagnosed was more pronounced among black patients than white patients. In addition, black women had a higher incidence of MS than white patients of both genders, while black men had a similar risk of being diagnosed with MS compared to white men. The lower risk among Hispanic and Asian patients was true for both sexes. (more…)
Author Interviews, Cancer Research, CT Scanning, Medical Imaging / 07.05.2013

MedicalResearch.com eInterview with Dr. Waël C. Hanna University of Toronto departments of Thoracic Surgery and Diagnostic Radiology, MedicalResearch.com: What are the main findings of the study? Dr. Hanna: By using Minimal Dose CT Scan (MnDCT) for surveillance of patients after lung cancer resection, we can detect 94.2% of recurrent or new lung cancer in this patient population. When we use chest x-ray (CXR) to conduct surveillance on the same cohort of patients, we can only detect 21.1% of new or recurrent lung cancer cases. Therefore, while MnDCT scan subjects the patient to a similar effective dose of radiation as CXR (0.2 mSV vs. 0.16 mSv), it is a vastly superior test for follow-up of this high risk population. More importantly, when we use MnDCT for surveillance, we can detect new or recurrent lung cancer at the asymptomatic locoregional stage in 78% of patients, and there quarters of those patients are candidates for further treatment in the form of surgery or radiation. In the patients who were treated, median survival was 69 months after initial operation, versus 25 months in those who received no treatment. (more…)
Heart Disease / 03.05.2013

MedicalResearch.com eInterview with: Dugald Seely ND, MSc, FABNO
 Founder & Executive Director; Ottawa Integrative Cancer Centre
Director; Research & Clinical Epidemiology; Canadian College of Naturopathic Medicine
Affiliate Investigator; Ottawa Hospital Research Institute 
29 Bayswater Ave Ottawa, ON, K1Y 2E5 www.oicc.ca


MedicalResearch.com: What are the main findings of the study? Answer: A significant and measurable reduction in risk of developing cardiovascular disease when naturopathic care is provided alongside conventional care. This is  evidenced by a 17% reduction in prevalence of metabolic syndrome and over 3% reduction in the 10-year Framingham cardiovascular risk profile for patients receiving care from a regulated naturopathic doctor in addition to community based care with a general practitioner. (more…)
Author Interviews, Emergency Care, Stroke / 03.05.2013

MedicalResearch.com eInterview with with Dr. O. James Ekundayo, MD, DrPH Assistant Professor Department of Family & Community Medicine Meharry Medical College 1005 Dr. D.B. Todd Jr. Blvd. Nashville, TN 37208 Written Interview conducted with author by Editor Marie Benz, MD MedicalResearch.com What are the main findings of the study? Answer: The key findings are: ·         One third of stroke patients did not activate Emergency Medical Services (EMS). ·         Subgroups of patients who were less likely to use EMS include younger patients, patients of minority race or ethnicity, and those living in rural communities. ·         Prior history of stroke /TIA does not confer greater likelihood of EMS activation during subsequent stroke. ·         Patients who used EMS had shorter pre-hospital and in-hospital delay. They arrived early, had prompter evaluation, and received more rapid treatment. ·         More patients, who were eligible for clot-busting drug, received them. These happened because EMS gives the receiving hospital pre-notification about the arrival of the patient and the ER staff is ready to act as soon as the patient arrives. (more…)
Author Interviews, Cancer Research / 02.05.2013

MedicalResearch.com eInterview with Christian Löw, Ph.D. Department of Medical Biochemistry and Biophysics Karolinska Institutet SE-171 77 Stockholm Sweden MedicalResearch.com: What are the main findings of the study? Dr. Löw: In order to grow, cells need fuels such as sugars. Specialized proteins that reside in the cell envelope transport these nutrients into the cell; XylE is a bacterial transport protein that is highly similar to members of the human GLUT transporters. Our study describes for the first time the mechanistic details of how cells import sugars by resolving the different steps of the transport cycle at almost atomic resolution. Tumors are especially dependent on the uptake of sugars and other nutrients via these transporter systems in order to be able to grow rapidly. A possible strategy for cancer treatment therefore would be to block these transporters in the cell membrane, thus starving out and killing the cancer cells. Our structures can be used for initial structure based drug design studies to develop efficient and specific inhibitors against members of the GLUT family. We believe that our detailed mechanistic insights could become the basis for new strategies to fight cancer cells. Specialized proteins that reside in the cell envelope transport these nutrients into the cell; XylE is a bacterial transport protein that is highly similar to members of the human GLUT transporters (more…)
Author Interviews, Emergency Care, Nature, Weight Research / 02.05.2013

MedicalResearch.com eInterview with Professor David McDonald Taylor Emergency Department, Austin Health PO Box 5555, Heidelberg, Vic. 3084, Australia MedicalResearch.com: What are the main findings of the study? Answer: Overall, obese and non-obese patients have similar experiences during their ED stay. However, while obese patients tend to be younger and less sick, their more frequent presentation with potentially cardiac-related disease is reflected in their management. The excess of liver function tests and abdominal xrays performed on obese patients is likely to reflect examination difficulties and over investigation. Obese patients do experience more attempts at IV cannulation. (more…)
Author Interviews, Diabetes / 02.05.2013

MedicalResearch.com: Dr. Kyoung-bok Min Department of Occupational and Environmental Medicine, Ajou University School of Medicine, Suwon, Republic of Korea MedicalResearch.com: What are the main findings of the study? Answer: The aim of this study was to investigate the prospective association of serum C-peptide with all-cause, cardiovascular disease, and coronary heart disease mortality in a non-diabetic population. We also estimated the observed mortality as C-peptide increased across the strata of glycated hemoglobin and fasting blood glucose. We found a linear association between serum C-peptide levels and death from all-cause and cause-specific mortality among adults without non-diabetes mellitus at baseline. Our finding suggests that elevated C-peptide levels may be a marker of subsequent mortality in non-diabetic subjects. (more…)