Glycaemic control and long-term outcomes following transition from modified intensive insulin therapy to conventional glycaemic control

This retrospective observational cohort study compared glycaemic control and long-term outcomes following transition from a modified intensive insulin therapy (mIIT) regimen to conventional glycaemic control (CGC) in adult patients admitted to a tertiary adult general intensive care unit, during two 24-month periods, before and after the publication of the Normoglycemia in Intensive Care Evaluation and Surviving Using Glucose Algorithm Regulation (NICE-SUGAR) trial. The before NICE-SUGAR cohort received mIIT (target glycaemic ranges 4.4 to 7.0 mmol/l), while the after NICE-SUGAR cohort received CGC (target glycaemic range 7.1 to 9.0 mmol/l). A total of 5202 patients were included in the study. With transition from mIIT to CGC, the mean time-weighted glucose increased from 6.94 mmol/l to 8.2 mmol/l (P <0.0001). A similar increase was observed in other glycaemic indices (mean, highest and lowest glucose values, P <0.0001 for all). The adjusted 90-day odds ratio for mortality decreased by 47% with transition from mIIT to CGC (odds ratio 1.47 (95% confidence interval, 1.22 to 1.78) (P <0.0001). The rate of severe and moderate hypoglycaemia also decreased from 1.2 to 0.4% (P=0.004) and from 23.3 to 5.9% (P <0.0001), respectively. mIIT was associated with an increased risk of moderate and severe hypoglycaemia compared to CGC (odds ratio 3.1 (1.51 to 6.39) (P=0.002), 6.29 (5.1 to 7.75) (P <0.0001)). Changes in recommended glycaemic control were translated into practice, with increased glycaemic indices and decreased rates of severe and moderate hypoglycaemia after the introduction of CGC. The associated decrease in 90-day mortality suggests mIIT was not superior to CGC, despite a lower hypoglycaemia rate than in previous IIT trials. Our findings support the continued use of CGC.

Changes in body mass index and health related quality of life from childhood to adolescence

<b>Objective .</b> To determine longitudinal relationships between body mass index (BMI) and health-related quality of life (HRQoL) in an adolescent population sample. <br /><b>Design.</b> Data collected in 2000 and 2005 within the Health of Young Victorians longitudinal cohort study. <br /><b>Setting.</b> Originally a community sample of elementary school students in Victoria, Australia. Follow-up occurred in either secondary schools or individuals homes. <br /><b>Participants.</b> Cohort recruited in 1997 via a random sampling design from Victorian elementary schools. Originally comprising 1 943 children, 1 569 (80.8%) participated in 2000 (wave 2, 8 &ndash; 13 years) and 851 (54%) in 2005 (wave 3, 13 &ndash; 19 years). <br /><b>Main outcome measures.</b> In both waves participants and their parents completed the PedsQL, a 23-item child HRQoL measure, and BMI z-scores and status (non-overweight, overweight or obese) were calculated from measured height and weight. Associations were tested cross-sectionally and longitudinally (linear regression, adjusted for baseline values) <br /><b>Results.</b> A total of 81.6% remained in the same BMI category, while 11.4% and 7.0% moved to higher and lower categories, respectively. Cross-sectional inverse associations between lower PedsQL and higher BMI categories were similar to those for elementary school children. Wave 2 BMI strongly predicted wave 3 BMI and wave 2 PedsQL strongly predicted wave 3 PedsQL. Only parent-reported Total PedsQL score predicted higher subsequent BMI, though this effect was small. Wave 2 BMI did not predict wave 3 PedsQL.<br /><b>Conclusions.</b> This novel study confi rmed previous cross-sectional associations, but did not provide convincing evidence that<br />BMI is causally associated with falling HRQoL or vice versa across the transition from childhood to adolescence.<br />

Understanding ring strain and ring flexibility in six - and eight-membered cyclic organometallic group 14 oxides

A simple model was developed for the approximation of ring strain energies of homo- and heterometallic, six- and eight-membered cyclic organometallic group 14 oxides and the degree of puckering of their ring conformations. The conformational energy of a ring is modelled as the sum of its angular strain components. The bending potential energy functions for the various endocyclic M&ndash;O&ndash;M&prime; and O&ndash;M&ndash;O linkages (M, M&prime;=Si, Ge, Sn) were calculated at the B3LYP/(v)TZ level of theory using H3MOM&prime;H3 and H2M(OH)2 as model compounds. For the six-membered rings, the minimum total angular contribution to ring strain, ERSGmin was calculated to decrease in the order: cyclo-(H2SiO)3 (13.0 kJ mol&minus;1)&gt;cyclo-H2Sn(OSiH2)2O (7.0 kJ mol&minus;1)&gt;cyclo-H2Ge(OSiH2)2O (4.9 kJ mol&minus;1)&gt;cyclo-H2Si(OSnH2)2O (3.4 kJ mol&minus;1)&gt;cyclo-(H2SnO)3 (1.7 kJ mol&minus;1)&gt;cyclo-H2Si(OGeH2)2O (0.8 kJ mol&minus;1)&asymp;cyclo-H2Ge(OSnH2)2O (0.7 kJ mol&minus;1)&gt;cyclo-H2Sn(OGeH2)2O (0.1 kJ mol&minus;1)&asymp;cyclo-(H2GeO)3 (0 kJ mol&minus;1). All of the six-membered rings were predicted to adopt (nearly) planar conformations (a=0.996&lt;a&lt;1). By contrast, all eight-membered rings were predicted to adopt strainless, but puckered conformations. The degree of puckering was predicted to increase in the order: cyclo-(H2SiO)4 (a=0.983)&lt;cyclo-H2Sn(OSiH2O)2SiH2 (a=0.959)&lt;cyclo-(H2SiO)2(H2SnO)2 (a=0.942)&lt; cyclo-H2Si(OSnH2O)2SiH2 (a=0.935)&lt;cyclo-(H2SnO)4 (a=0.916)&lt;cyclo-(H2GeO)4 (a=0.885). The differences in ring strain and the degree of puckering were linked to the different electronegativities of Si, Ge and Sn. The results obtained are consistent with experimental ring strain energies; reactivities towards ring opening polymerizations or ring expansion reactions and observed ring conformations of cyclic organometallic group 14 oxides.

Mortality, malnutrition and the humanitarian response to the food crises in Lesotho

Background: At the height of the food crisis in southern Africa, the Government of Lesotho declared a state of famine and emergency in April 2002 and launched a Famine Relief Appeal for over $137 million. World Vision, in partnership with the World Food Program, became involved in December 2002 providing food aid to affected communities.<br />Objective: to document mortality rates, causes of death, malnutrition prevalence, and the proportion of lost pregnancies after almost three years of humanitarian response to the food crisis in Lesotho and to propose a way forward.<br />Design: A two-stage, 30 cluster household survey was undertaken in three districts from the 16th to the 26th of May 2005, with a sample size of 3610 people.<br />Results: The crude mortality rate (CMR) of 0.8/10,000/day (95%CI: 0.7-0.9). The reported CMR was significantly lower than the CMR emergency threshold (&lt;1/10,000/day). Using 2000 as a pre-drought baseline, 38528 excess deaths occurred between 2000 and 2005. The under-five mortality rate (U5MR) of 3.2 deaths/10,000/day (95%CI: 2.8-3.6/10,000/day) was 4 times the reported CMR and 1.4 times higher the U5MR emergency threshold for sub-Saharan Africa (2.3/10,000/day). CMR was lower among food aid beneficiaries (0.68; 95%CI: 0.57-0.79) than non-beneficiaries (1.42; 95%CI: 1.13-1.70). This was also true for U5MR (2.94; 95%CI: 2.39-3.50 versus 6.44; 95%CI: 5.21-7.68). The prevalence of wasting increased from 5.4% to 12% while that of stunting declined from 45.4% to 36.2% between 2000 and 2005, but the nutritional status did not vary by beneficiary status.<br />Conclusion: Despite the alarming U5MR, findings suggest that the food aid program ensured survival mainly among adults. The situation could have been catastrophic in the absence of humanitarian assistance.<br />

Long-term 5-year effects of a reduced-fat diet intervention in individuals with glucose intolerance

OBJECTIVE: To determine whether reducing dietary fat would reduce body weight and improve long-term glycemia in people with glucose intolerance. RESEARCH DESIGN AND METHODS: A 5-year Follow-up of a 1-year randomized controlled trial of a reduced-fat ad libitum diet versus a usual diet. Participants with glucose intolerance (2-h blood glucose 7.0-11.0 mmol/l) were recruited from a Workforce Diabetes Survey. The group that was randomized to a reduced-fat diet participated in monthly small-group education sessions on reduced-fat eating for 1 year. Body weight and glucose tolerance were measured in 136 participants at baseline 6 months, and 1 year (end of intervention), with follow-up at 2 years (n = l04), 3 years (n = 99), and 5 years (n = 103). RESULTS: Compared with the control group, weight decreased in the reduced-fat-diet group (P &lt; 0.0001); the greatest difference was noted at 1 year (-3.3 kg), diminished at subsequent follow-up (-3.2 kg at 2 years and -1.6 kg at 3 years), and was no longer present by 5 years (1.1 kg). Glucose tolerance also improved in patients on the reduced-fat diet; a lower proportion had type 2 diabetes or impaired glucose tolerance at 1 year (47 vs. 67%, P &lt; 0.05), but in subsequent years, there were no differences between groups. However, the more compliant 50% of the intervention group maintained lower fasting and 2-h glucose at 5 years (P = 0.041 and P = 0.026 respectively) compared with control subjects. CONCLUSIONS: The natural history for people at high risk of developing type 2 diabetes is weight gain and deterioration in glucose tolerance. This process may be ameliorated through adherence to a reduced fat intake

Effect of crude oil extracts from trout offal as a replacement for fish oil in the diets of the Australian native fish Murray cod Maccullochella peelii peelii

The efficacy of trout oil (TO), extracted from trout offal from the aquaculture industry, was evaluated in juvenile Murray cod Maccullochella peelii peelii (25.4-0.81 g) diets in an experiment conducted over 60 days at 23.7-0.8 &deg;C. Five isonitrogenous (48% protein), isolipidic (16%) and isoenergetic (21.8 kJ gm1) diets, in which the fish oil fraction was replaced in increments of 25% (0-100%), were used. The best growth and feed efficiency was observed in fish fed diets containing 50-75% TO. The relationship of specific growth rate (SGR), food conversion ratio (FCR) and protein efficiency ratio (PER) to the amount of TO in the diets was described in each case by second-order polynomial equations (P&lt;0.05), which were: SGR=-0.44TO2+0.52TO+1.23 (r2=0.90, P&lt;0.05); FCR=0.53TO2-0.64TO+1.21 (r2=0.95, P&lt;0.05); and PER=-0.73TO2+0.90TO+1.54 (r2=0.90, P&lt;0.05). Significant differences in carcass and muscle proximate compositions were noted among the different dietary treatments. Less lipid was found in muscle than in carcass. The fatty acids found in highest amounts in Murray cod, irrespective of the dietary treatment, were palmitic acid (16:0), oleic acid (18:1n-9), linoleic acid (18:2n-6) and eicosapentaenoic acid (20:5n-3). The fatty acid composition of the muscle reflected that of the diets. Both the n-6 fatty acid content and the n-3 to n-6 ratio were significantly (P&lt;0.05) related to growth parameters, the relationships being as follows. Percentage of n-6 in diet (X) to SGR and FCR: SGR=-0.12X2+3.96X-32.51 (r2=0.96) and FCR=0.13X2-4.47X+39.39 (r2=0.98); and n-3:n-6 ratio (Z) to SGR, FCR, PER: SGR=-2.02Z2+5.01Z-1.74 (r2=0.88), FCR=2.31Z2-5.70Z+4.54 (r2=0.93) and PER=-3.12Z2-7.56Z+2.80 (r2=0.88) respectively. It is evident from this study that TO could be used effectively in Murray cod diets, and that an n-3:n-6 ratio of 1.2 results in the best growth performance in Murray cod.<br />

Physical activity and television viewing in relation to risk and undiagnosed abnormal glucose metabolism in adults

<b>OBJECTIVE--</b>The goal of this study was to assess the associations of physical activity time and television (TV) time with risk of &quot;undiagnosed&quot; abnormal glucose metabolism in Australian adults.<br /><b><br />RESEARCH DESIGN AND METHODS--</b>This population-based cross-sectional study using a stratified cluster design involving 42 randomly selected Census Collector Districts across Australia included 8,299 adults aged 25 years or older who were free from new type 2 diabetes and self-reported ischemic disease and did not take lipid lowering or antihypertensive drugs. Abnormal glucose metabolism (impaired fasting glycetnia [IFG], impaired glucose tolerance [IGT], or new type 2 diabetes) was based on an oral glucose tolerance test Self reported physical activity time and TV time (previous week) were assessed using interviewer administered questionnaires.<br /><br /><b>RESULTS--</b>Alter adjustment for known confounders and TV time, the odds ratio (OR) of having abnormal glucose metabolism was 0.62 (95% CI 0.41-0.96) in men and 0.71 (0.501.00) in women for those engaged in physical activity [greater than or equal to] 2.5 h/week compared with those who were sedentary (0 h/week). The ORs of having abnormal glucose metabolism were 1.16 (0.791.70) in men and 1.49 (1.12-1.99) in women who watched TV &gt; 14 h/week compared with those who watched [less than or equal to] 7.0 h/week. Higher TV viewing (&gt; 14 h/week) was also associated with an increased risk of new type 2 diabetes in men and women and IGT in women compared with those watching &lt; 14 h/week. Total physical activity of [greater than or equal to] 2.5 h/week was associated with a reduced risk of IFG, IGT, and new type 2 diabetes in both sexes: however, only the association with IGT in women was statistically significant.<br /><br /><b>CONCLUSIONS--</b>These findings suggest a protective effect of physical activity and a deleterious effect of TV time on the risk of abnormal glucose metabolism in adults. Population strategies to reduce risk of abnormal glucose metabolism should focus on reducing sedentary behaviors such as TV time, as well as increasing physical activity. <br />

Changes in body composition as determinants of longitudinal changes in bone mineral measures in 8 to 26 year old female twins

Between 1990 and 1998, we conducted a longitudinal study of 286 female twins aged 8 to 25 years at baseline (60 monozygotic (MZ) pairs, 44 dizygotic (DZ) pairs and 78 unpaired twins), measured on average 2.4 times (range 2&ndash;6) with an average of 1.8 years between measurements (range 0.7&ndash;6.7 years). Areal bone mineral density (ABMD) at the lumbar spine, total hip and femoral neck, total body bone mineral content (BMC), total body soft tissue composition (lean mass and fat mass) were measured by dual-energy X-ray absorptiometry, and height and menarchial status were also recorded. Median annual changes in height were negligible at 4 years post-menarche. During the &ldquo;linear growth&rdquo; period up to 4 years post-menarche, ABMD at the lumbar spine, total hip and femoral neck increased with annual change in lean mass by 1.7 (S.E.&thinsp;0.1), 1.4 (0.1) and 1.0 (0.1) percent per kilogram per year, respectively (all p&lt;0.001), independently of changes in fat mass or height. During the &ldquo;post-linear growth&rdquo; period, ABMD at the total hip and femoral neck increased with annual change in fat mass by 0.3 (0.1) and 0.5 (0.1) percent per kilogram per year (all p&lt;0.01), independent of change in lean mass. Annual changes in total body BMC were associated with annual changes in lean mass (1.9 (0.2) percent per kilogram), in fat mass (1.3 (0.2) percent per kilogram) and in height (0.7) (0.2) percent per centimeter) during linear growth, and in fat mass (1.0 (0.1)) and lean mass (0.6 (0.1)) percent per kilogram post-linear growth (all p&lt;0.001). We conclude that changes in bone mineral measures are strongly associated with changes in lean mass during linear growth, while post-linear growth, changes in fat mass are the predominant, although weaker, predictor. These findings suggest that the strong cross-sectional association between bone mineral measures and lean mass is established during growth and development, and that fat mass emerges as a more powerful determinant of bone change in healthy adult females. <br /><br />

Serum 25-hydroxyvitamin D, diabetes, and ethnicity in the third national health and nutrition examination survey

<b>OBJECTIVE</b>&mdash; To determine the association between serum 25-hydroxyvitamin D (25OHD) and diabetes risk and whether it varies by ethnicity.<br /><b>RESEARCH DESIGN AND METHODS&mdash; </b>We performed an analysis of data from participants who attended the morning examination of the Third National Health and Nutrition Examination Survey (1988&ndash;1994), a cross-sectional survey of a nationally representative sample of the U.S. population. Serum levels of 25OHD, which reflect vitamin D status, were available from 6,228 people (2,766 non-Hispanic whites, 1,736 non-Hispanic blacks, and 1,726 Mexican Americans) aged &ge;20 years with fasting and/or 2-h plasma glucose and serum insulin measurements.<br /><b>RESULTS&mdash;</b> Adjusting for sex, age, BMI, leisure activity, and quarter of year, ethnicityspecific odds ratios (ORs) for diabetes (fasting glucose &ge;7.0 mmol/l) varied inversely across quartiles of 25OHD in a dose-dependent pattern (OR 0.25 [95% CI 0.11&ndash; 0.60] for non-Hispanic whites and 0.17 [0.08&ndash;0.37] for Mexican Americans) in the highest vitamin D quartile (25OHD &ge;81.0 nmol/l) compared with the lowest 25OHD (&ge;43.9 nmol/l). This inverse association<br />was not observed in non-Hispanic blacks. Homeostasis model assessment of insulin resistance (loge) was inversely associated with serum 25OHD in Mexican Americans (P &ge; 0.0024) and non-Hispanic whites (P&ge;0.058) but not non-Hispanic blacks (P&ge;0.93), adjusting for confounders.<br /><b>CONCLUSIONS&mdash; </b>These results show an inverse association between vitamin D status and diabetes, possibly involving insulin resistance, in non-Hispanic whites and Mexican Americans. The lack of an inverse association in non-Hispanic blacks may reflect decreased sensitivity to vitamin D and/or related hormones such as the parathyroid hormone.<br />

Feed intake, growth, plasma glucose and urea nitrogen concentration, and cacass traits of lambs fed isoenergetic amounts of canola meal, soybean meal, and fish meal with forage based diet.

This experiment was conducted to examine the effect of feeding small, isoenergetic amounts of supplements containing high protein and functional lipid components, rather than the greater amounts of cereal and/or legume grains usually fed during the dry season in Australia, on dry matter intake (DMI), growth performance, plasma metabolites, and fat deposition in lambs consuming low quality roughage. Thirty two crossbred wether lambs ([Merino &times; Border Leicester] &times; Poll Dorset) were divided into four groups by stratified randomization according to liveweight (26&ndash;33 kg). After a 7-day adaptation to a hay diet (lucerne hay:oaten hay; 30:70), lambs were allocated to four treatments consisting of (1) basal diet of lucerne hay:oat hay (20:80; metabolizable energy (ME) = 7.0 MJ/kg DM), Basal; (2) basal + canola meal (84 g per day), CM; (3) basal + soymeal (75 g per day), SM; or (4) basal + fishmeal (80 g per day), FM. Daily hay and supplement DMI, and weekly liveweight were recorded during a 53-day experimental study. Blood samples were taken on day 1 and pre- and post-feeding on days 30 and 53 to measure changes in plasma glucose and plasma urea nitrogen (PUN) concentration. At the end of the experiment, lambs were slaughtered and hot carcass weight (HCW) recorded; cold carcass fatness (total muscle and adipose tissue depth at 12th rib, 110 mm from midline; GR) was determined at 24 h postmortem. Total DMI was increased (<i>P</i> &lt; 0.001) in CM, SM and FM treatments, but basal hay DMI intake was only increased (<i>P</i> &lt; 0.01) in CM and FM treatments compared with Basal treatment. This resulted in significant (<i>P</i> &lt; 0.01) increases in metabolizable energy (ME) and crude protein (CP) intakes in all supplemented treatments, with the highest intakes recorded in the FM treatment. Liveweight gain (LWG) was significantly increased in CM and SM (<i>P</i> &lt; 0.05) and FM (<i>P</i> &lt; 0.01) treatments but HCW was significantly (<i>P</i> &lt; 0.01) heavier slaughter only in the FM treatment. Feed conversion efficiency <i>(P</i> &lt; 0.001) and GR fat at depth (<i>P</i> &lt; 0.05) was reduced in all supplement treatments compared with Basal. Plasma glucose concentration was significantly <i>(P</i> &lt; 0.05) increased after feeding in all treatments but there was no treatment effect. PUN was significantly increased over time in the supplemented treatments compared with the Basal treatment; there was no significant difference between supplement treatments by day 53. Results show that feeding small amounts of high protein and lipid-containing supplements improves production responses and are beneficial in producing carcasses with more lean compared with carcasses from lambs fed a low quality hay diet.<br /><br /><br />

Foraging behaviour and habitat utilisation of Australasian gannets determined using GPS loggers

Australasian gannets (Morus serrator) breed in the cool temperate waters of south-eastern Australia and also at several localities around New Zealand, where they are a major marine predator feeding on commercially-exploited pelagic fish. This study investigated the foraging behaviour and habitat utilization of gannets at Pope&rsquo;s Eye Marine Reserve during the 2005-2005 breeding period using GPS-depth-loggers. GPS data were recorded for a total of 45 foraging trips from 20 individuals. Gannets were found to forage at average maximum distances of 52.7 km (&plusmn; 29.6 km) from the colony, with total foraging path lengths of 177.1 km (&plusmn; 93.4 km) and foraging trip durations of 16.5 h (&plusmn; 9.9 h). During foraging trips gannets spent on average 31.5% (&plusmn; 11.4) of the time flying at an average flight speed of 47.3 km h-1 (&plusmn; 2.9 km h-1). Gannets made an average of 39.8 (&plusmn; 35.2) dives per trip and 3.8 (&plusmn; 5.6) dives per daylight hour. Dives had an average depth of 3.5 m (&plusmn; 1.1 m) and a mean maximum depth of 7.0 m (&plusmn; 3.0 m), lasting for a mean dive duration of 5.3 sec (&plusmn; 1.3 sec). Gannets foraged predominantly in shallow coastal waters and there was some evidence for foraging site fidelity. Considerable individual variation in foraging strategies was also observed. The results highlight the potential of GPS technology to reveal the fine-scale foraging behaviour of marine predators, thereby improving our understanding the interaction between marine predator populations, commercially exploited fish stocks and the marine environment.<br />

Quality of reporting of randomized clinical trials in abstracts of the 2005 annual meeting of the American College of Rheumatology.

<b>Objective:</b> To determine the quality of abstracts reporting randomized clinical trials (RCT) at the 2005 Annual Scientific Meeting of the American College of Rheumatology. <br /><b><br />Methods:</b> All 2005 abstracts including late-breaking abstracts were assessed. An abstract was deemed to be reporting an RCT if it indicated that participants were randomized in the title or body of the abstract. RCT were excluded if they included only pharmacokinetic data. The CONSORT checklist was applied and relevant data extracted. We defined manufacturer support as acknowledgment of industry support or industry employee as co-author. <br /><br /><b>Results:</b> Of 2146 abstracts, 143 (6.7%) reported RCT. Of these, 78.3% were drug trials, and 63.6% indicated manufacturer support. Only 30.8% of abstracts used &quot;randomized&quot; in the title, 44.1% did not explicitly state whether blinding was undertaken, and only 7.0% clearly stated who was blinded. Thirty percent of studies did not give an explicit definition of eligibility criteria of participants. While 84.6% explicitly described the experimental intervention, only 37.1% explicitly described the comparator intervention. Only 21% explicitly stated that an intention to treat analysis was performed. Baseline demographic and clinical characteristics were reported in 48.3%. While most abstracts reported summary results for each treatment group, only 35.7% reported effect size with its precision. <br /><b><br />Conclusion:</b> The quality of reporting is suboptimal in many RCT abstracts. Abstracts reporting RCT would benefit from a structured approach that ensures more detailed reporting of eligibility criteria, active and comparator interventions, flow of participants, and adequate summary and precision of results. <br />

Cell disruption optimization and covalent immobilization of beta-D-galactosidase from kluyveromyces marxianus YW-1 for lactose hydrolysis in milk

&beta;-D-galactosidase (EC 3.2.1.23) from Kluyveromyces marxianus YW-1, an isolate from whey, has been studied in terms of cell disruption to liberate the useful enzyme. The enzyme produced in a bioreactor on a wheat bran medium has been successfully immobilized with a view to developing a commercially usable technology for lactose hydrolysis in the food industry. Three chemical and three physical methods of cell disruption were tested and a method of grinding with river sand was found to give highest enzyme activity (720 U). The enzyme was covalently immobilized on gelatin. Immobilized enzyme had optimum pH and temperature of 7.0 and 40 &deg;C, respectively and was found to give 49% hydrolysis of lactose in milk after 4 h of incubation. The immobilized enzyme was used for eight hydrolysis batches without appreciable loss in activity. The retention of high catalytic activity compared with the losses experienced with several previously reported immobilized versions of the enzyme is significant. The method of immobilization is simple, effective, and can be used for the immobilization of other enzymes.<br />