Type 2 diabetes mellitus affects more than 7 million Americans,
1
leading annually to 2.8 million hospitalizations,
2
more than 300,000 deaths,
3
and more than $100 billion in total costs.
4
Improved ...glycemic control is known to slow the onset and progression of microvascular complications, but its effect on atherosclerotic cardiovascular disease has not been demonstrated conclusively.
5
,
6
In the absence of completely effective treatment, primary prevention is an attractive, though hypothetical, option. Prevention programs depend on the identification of potentially modifiable risk factors. For example, adiposity, physical inactivity, and insulin resistance, all of which were identified in epidemiologic studies as strong risk . . .
Despite increasing attention and investment for maternal, neonatal, and child health, stillbirths remain invisible—not counted in the Millennium Development Goals, nor tracked by the UN, nor in the ...Global Burden of Disease metrics. At least 2·65 million stillbirths (uncertainty range 2·08 million to 3·79 million) were estimated worldwide in 2008 (≥1000 g birthweight or ≥28 weeks of gestation). 98% of stillbirths occur in low-income and middle-income countries, and numbers vary from 2·0 per 1000 total births in Finland to more than 40 per 1000 total births in Nigeria and Pakistan. Worldwide, 67% of stillbirths occur in rural families, 55% in rural sub-Saharan Africa and south Asia, where skilled birth attendance and caesarean sections are much lower than that for urban births. In total, an estimated 1·19 million (range 0·82 million to 1·97 million) intrapartum stillbirths occur yearly. Most intrapartum stillbirths are associated with obstetric emergencies, whereas antepartum stillbirths are associated with maternal infections and fetal growth restriction. National estimates of causes of stillbirths are scarce, and multiple (>35) classification systems impede international comparison. Immediate data improvements are feasible through household surveys and facility audit, and improvements in vital registration, including specific perinatal certificates and revised International Classification of Disease codes, are needed. A simple, programme-relevant stillbirth classification that can be used with verbal autopsy would provide a basis for comparable national estimates. A new focus on all deaths around the time of birth is crucial to inform programmatic investment.
This book presents an analysis and synthesis of the key economic and management approaches to innovation, entrepreneurship, and technological change. The book provides precise definitions of key ...concepts, presents numerous historical examples to illustrate these concepts, outlines a framework for analyzing key topics, compares and contrasts different theoretical frameworks, and emphasizes international comparisons of innovation infrastructure and technology policy.
Phytoplankton responses to human impact at different scales provides a state-of-the-art review of changes in the phytoplankton assemblages determined by human alterations of lakes and rivers. A wide ...spectrum of case studies describe the effects due to eutrophication and climate change, as well as other impacts connected with watershed management, hydrological alterations and introduction of non-indigenous species. The volume also includes two wide reviews on planktonic coccoid green algae and planktic heterocytous cyanobacteria. This book is addressed to ecologists and scientists involved in phytoplankton ecology and taxonomy. Many case studies provide a sound scientific basis of knowledge for a wise management of water bodies.Previously published in Hydrobiologia, vol. 698, 2012
There has been continued interest in skew polynomial rings and related constructions since Ore's initial studies in the 1930s. New examples not covered by previous analyses have arisen in the current ...study of quantum groups. The aim of this work is to introduce and develop new techniques for understanding the prime ideals in skew polynomial rings $S=Ry;\tau, \delta$, for automorphisms $\tau$ and $\tau$-derivations $\delta$ of a noetherian coefficient ring $R$. Goodearl and Letzter give particular emphasis to the use of recently developed techniques from the theory of noncommutative noetherian rings. When $R$ is an algebra over a field $k$ on which $\tau$ and $\delta$ act trivially, a complete description of the prime ideals of $S$ is given under the additional assumption that $\tau {-1 \delta \tau = q\delta$ for some nonzero $q\in k$. This last hypothesis is an abstraction of behavior found in many quantum algebras, including $q$-Weyl algebras and coordinate rings of quantum matrices, and specific examples along these lines are considered in detail.
From the late eighteenth century through the end of the Civil War, Choctaw and Chickasaw Indians bought, sold, and owned Africans and African Americans as slaves, a fact that persisted after the ...tribes' removal from the Deep South to Indian Territory. The tribes formulated racial and gender ideologies that justified this practice and marginalized free black people in the Indian nations well after the Civil War and slavery had ended. Through the end of the nineteenth century, ongoing conflicts among Choctaw, Chickasaw, and U.S. lawmakers left untold numbers of former slaves and their descendants in the two Indian nations without citizenship in either the Indian nations or the United States. In this groundbreaking study, Barbara Krauthamer rewrites the history of southern slavery, emancipation, race, and citizenship to reveal the centrality of Native American slaveholders and the black people they enslaved. Krauthamer's examination of slavery and emancipation highlights the ways Indian women's gender roles changed with the arrival of slavery and changed again after emancipation and reveals complex dynamics of race that shaped the lives of black people and Indians both before and after removal.
Endometrial cancer is the most common invasive gynaecological cancer in women, and relatively little is known about inherited risk factors for this disease. This is the first genome-wide study to ...explore the role of common and rare germline copy number variants (CNVs) in predisposition to endometrial cancer. CNVs were called from germline DNA of 1,209 endometrioid endometrial cancer cases and 528 cancer-unaffected female controls. Overall CNV load of deletions or DNA gains did not differ significantly between cases and controls (
P
> 0.05), but cases presented with an excess of rare germline deletions overlapping likely functional genomic regions including genes (
P
= 8 × 10
−10
), CpG islands (
P
= 1 × 10
−7
) and sno/miRNAs regions (
P
= 3 × 10
−9
). On average, at least one additional gene and two additional CpG islands were disrupted by rare deletions in cases compared to controls. The most pronounced difference was that over 30 sno/miRNAs were disrupted by rare deletions in cases for every single disruption event in controls. A total of 13 DNA repair genes were disrupted by rare deletions in 19/1,209 cases (1.6 %) compared to one gene in 1/528 controls (0.2 %;
P
= 0.007), and this increased DNA repair gene loss in cases persisted after excluding five individuals carrying CNVs disrupting mismatch repair genes
MLH1
,
MSH2
and
MSH6
(
P
= 0.03). There were 34 miRNA regions deleted in at least one case but not in controls, the most frequent of which encompassed hsa-mir-661 and hsa-mir-203. Our study implicates rare germline deletions of functional and regulatory regions as possible mechanisms conferring endometrial cancer risk, and has identified specific regulatory elements as candidates for further investigation.
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