Patients with type 2 diabetes and high cardiovascular risk were assigned to receive either the glucagon-like peptide 1 analogue liraglutide or placebo. The rate of first occurrence of cardiovascular ...death, nonfatal MI, or nonfatal stroke was lower with liraglutide.
Type 2 diabetes is a complex metabolic disorder that is characterized by hyperglycemia and associated with a high risk of cardiovascular, microvascular, and other complications.
1
,
2
Although glycemic control is associated with reductions in the risk of microvascular complications, the macrovascular benefits of glycemic control are less certain. Furthermore, concern has been raised about the cardiovascular safety of antihyperglycemic therapies.
3
Consequently, regulatory authorities have mandated cardiovascular safety assessments of new diabetes treatments.
4
,
5
Liraglutide, an analogue of human glucagon-like peptide 1 (GLP-1),
6
has been approved for the treatment of type 2 diabetes. Its efficacy in lowering glucose levels has been . . .
Power distance is a value that differentiates individuals, groups, organizations, and nations based on the degree to which inequalities are accepted either as unavoidable or as functional. ...Understanding power distance is especially important in organizational research because power is fundamental to all relationships, is inherent in hierarchical organizations, and affects many organizational processes and outcomes. We begin by reviewing existing value taxonomies and definitional elements of power distance. Next, we review theories and research linking power distance to micro and macro work-related outcomes. We conclude by identifying areas where additional organizational research on power distance is needed and, in doing so, provide an agenda for future research in this area. Our review highlights power distance as an important explanatory variable and boundary condition for many relations that organizational (not just cross-cultural) scientists examine.
Shame is a powerful and relevant discrete emotion in the workplace, as organizations are rife with potential to induce shame, and reactions to shame relate to important organizationally relevant ...outcomes. In this article, we review shame-related research from a variety of disciplines, integrating and identifying common patterns to better understand the shame process as it relates to organizational life. In doing so, we develop a framework that outlines the more internal psychological processes at the heart of the emotion of shame and situates these processes within the context of organizations. This framework highlights the organizational factors that help instigate shame in employees (i.e., unintentional shame triggers and purposeful shaming behaviors) as well as the behavioral outcomes important to organizations (i.e., prosocial, withdrawal, and aggressive behaviors) and provides insights regarding moderators that likely impact this process. In addition, we discuss future research implications as they pertain to each of the components in our framework, hoping that our article not only improves our understanding of organizational shame but encourages much-needed future research on it.
Research on emotional labor focuses on how employees utilize 2 main regulation strategies-surface acting (i.e., faking one's felt emotions) and deep acting (i.e., attempting to feel required ...emotions)-to adhere to emotional expectations of their jobs. To date, researchers largely have considered how each strategy functions to predict outcomes in isolation. However, this variable-centered perspective ignores the possibility that there are subpopulations of employees who may differ in their combined use of surface and deep acting. To address this issue, we conducted 2 studies that examined surface acting and deep acting from a person-centered perspective. Using latent profile analysis, we identified 5 emotional labor profiles-non-actors, low actors, surface actors, deep actors, and regulators-and found that these actor profiles were distinguished by several emotional labor antecedents (positive affectivity, negative affectivity, display rules, customer orientation, and emotion demands-abilities fit) and differentially predicted employee outcomes (emotional exhaustion, job satisfaction, and felt inauthenticity). Our results reveal new insights into the nature of emotion regulation in emotional labor contexts and how different employees may characteristically use distinct combinations of emotion regulation strategies to manage their emotional expressions at work.
Background Diabetes is a multisystem disorder associated with a nearly twofold excess risk for a broad range of adverse cardiovascular outcomes including coronary heart disease, stroke, and ...cardiovascular death. Liraglutide is a human glucagon-like peptide receptor analog approved for use in patients with type 2 diabetes mellitus (T2DM). Study Design To formally assess the cardiovascular safety of liraglutide, the Liraglutide Effect and Action in Diabetes: Evaluation of cardiovascular outcome Results (LEADER) trial was commenced in 2010. LEADER is a phase 3B, multicenter, international, randomized, double-blind, placebo-controlled clinical trial with long-term follow-up. Patients with T2DM at high risk for cardiovascular disease (CVD) who were either drug naive or treated with oral antihyperglycemic agents or selected insulin regimens (human NPH, long-acting analog, or premixed) alone or in combination with oral antihyperglycemics were eligible for inclusion. Randomized patients are being followed for up to 5 years. The primary end point is the time from randomization to a composite outcome consisting of the first occurrence of cardiovascular death, nonfatal myocardial infarction, or nonfatal stroke. Conclusions LEADER commenced in September 2010, and enrollment concluded in April 2012. There were 9,340 patients enrolled at 410 sites in 32 countries. The mean age of patients was 64.3 ± 7.2 years, 64.3% were men, and mean body mass index was 32.5 ± 6.3 kg/m2 . There were 7,592 (81.3%) patients with prior CVD and 1,748 (18.7%) who were high risk but without prior CVD. It is expected that LEADER will provide conclusive data regarding the cardiovascular safety of liraglutide relative to the current standard of usual care for a global population of patients with T2DM.
Necroptosis is a form of programmed cell death defined by activation of the kinase receptor interacting protein kinase 3 and its downstream effector, the pseudokinase mixed lineage kinase domain-like ...(MLKL). Activated MLKL translocates to the cell membrane and disrupts it, leading to loss of cellular ion homeostasis. In this study, we use a system in which this event can be specifically triggered by a small-molecule ligand to show that MLKL activation is sufficient to induce the processing and release of bioactive IL-1β. MLKL activation triggers potassium efflux and assembly of the NLRP3 inflammasome, which is required for the processing and activity of IL-1β released during necroptosis. Notably, MLKL activation also causes cell membrane disruption, which allows efficient release of IL-1β independently of the recently described pyroptotic effector gasdermin-D. Taken together, our findings indicate that MLKL is an endogenous activator of the NLRP3 inflammasome, and that MLKL activation provides a mechanism for concurrent processing and release of IL-1β independently of gasdermin-D.
Rescue intravesical therapies for patients with bacillus Calmette-Guérin failure nonmuscle invasive bladder cancer remain a critical focus of ongoing research. Sequential intravesical gemcitabine and ...docetaxel therapy has shown safety and efficacy in 2 retrospective, single institution cohorts. This doublet has since been adopted as an intravesical salvage option at multiple institutions. We report the results of a multi-institutional evaluation of gemcitabine and docetaxel.
Each institution retrospectively reviewed all records of patients treated with intravesical gemcitabine and docetaxel for nonmuscle invasive bladder cancer between June 2009 and May 2018. Only patients with recurrent nonmuscle invasive bladder cancer and a history of bacillus Calmette-Guérin treatment were included in the analysis. If patients were disease-free after induction, maintenance was instituted at the treating physician's discretion. Posttreatment surveillance followed American Urological Association guidelines. Survival analysis was performed using the Kaplan-Meier method and risk factors for treatment failure were assessed with Cox regression models.
Overall 276 patients (median age 73 years, median followup 22.9 months) received treatment. Nine patients were unable to tolerate a full induction course. One and 2-year recurrence-free survival rates were 60% and 46%, and high grade recurrence-free survival rates were 65% and 52%, respectively. Ten patients (3.6%) had disease progression on transurethral resection. Forty-three patients (15.6%) went on to cystectomy (median 11.3 months from induction), of whom 11 (4.0%) had progression to muscle invasion. Analysis identified no patient, disease or prior treatment related factors associated with gemcitabine and docetaxel failure.
Intravesical gemcitabine and docetaxel therapy is well tolerated and effective, providing a durable response in patients with recurrent nonmuscle invasive bladder cancer after bacillus Calmette-Guérin therapy. Further prospective study is warranted.
Developed to address PTSD symptoms associated with sexual abuse, trauma-focused cognitive-behavioral therapy (TF-CBT) has been adapted to help children cope with physical or emotional abuse or ...neglect, community or domestic violence, traumatic loss, and war or natural disasters. Children who complete the program show consistent pre- to posttreatment decreases in PTSD symptomatology, according to the authors of this literature review. While acknowledging that TF-CBT is not as effective in treating depression, the authors conclude that it is a viable treatment for many types of trauma and should be a covered service in private and public health plans.
ObjectiveTrauma-Focused Cognitive-Behavioral Therapy (TF-CBT) is a conjoint parent-child treatment developed by Cohen, Mannarino, and Deblinger that uses cognitive-behavioral principles and exposure techniques to prevent and treat posttraumatic stress, depression, and behavioral problems. This review defined TF-CBT, differentiated it from other models, and assessed the evidence base.MethodsAuthors reviewed meta-analyses, reviews, and individual studies (1995 to 2013). Databases surveyed were PubMed, PsycINFO, Applied Social Sciences Index and Abstracts, Sociological Abstracts, Social Services Abstracts, PILOTS, the ERIC, and the CINAHL. They chose from three levels of research evidence (high, moderate, and low) on the basis of benchmarks for number of studies and quality of their methodology. They also described the evidence of effectiveness.ResultsThe level of evidence for TF-CBT was rated as high on the basis of ten RCTs, three of which were conducted independently (not by TF-CBT developers). TF-CBT has demonstrated positive outcomes in reducing symptoms of posttraumatic stress disorder, although it is less clear whether TF-CBT is effective in reducing behavior problems or symptoms of depression. Limitations of the studies include concerns about investigator bias and exclusion of vulnerable populations.ConclusionsTF-CBT is a viable treatment for reducing trauma-related symptoms among some children who have experienced trauma and their nonoffending caregivers. Based on this evidence, TF-CBT should be available as a covered service in health plans. Ongoing research is needed to further identify best practices for TF-CBT in various settings and with individuals from various racial and ethnic backgrounds and with varied trauma histories, symptoms, and stages of intellectual, social, and emotional development.
We introduce new leader humility scales capturing a theoretically rich conceptualization of leader-expressed humility aligned with traditional and ethically-grounded philosophies. These scales draw ...from recent inductive research (Oc et al., 2015) identifying nine dimensions of leader-expressed humility: (1) having an accurate view of self, (2) recognizing follower strengths and achievements, (3) modeling teachability and being correctable, (4) leading by example, (5) showing modesty, (6) working together for the collective good, (7) empathy and approachability, (8) showing mutual respect and fairness, and (9) mentoring and coaching. The first three dimensions overlap with the most prominent conceptualization of leader-expressed humility in the literature (i.e., Owens et al., 2013). However, the latter six dimensions are unique and represent an expanded understanding of the humble behaviors of leaders, which have implications for leaders and their ethical behavior in organizations. We conducted three studies resulting in two versions of the leader-expressed humility measure: 1) a 27-item scale with the nine dimensions (i.e., the “Leader-Expressed Humility” LEH scale) and 2) a 9-item brief scale (i.e., the “Brief LEH” scale) comprised of one item from each of the nine dimensions. As an initial step, we generated a pool of items that reflected each dimension. Next, we validated the LEH and Brief LEH scales in Study 1 and cross-validated the Brief LEH scale in Study 2 with two samples of subordinates in Singapore. As a final step, in Study 3, we cross-validated the Brief LEH scale with a sample of subordinates in the United States.
PDF
