Patient Empowerment Programme in primary care reduced all-cause mortality and cardiovascular diseases in patients with type 2 diabetes mellitus: a population-based propensity-matched cohort study

Aims: To assess whether a structured diabetes education programme, Patient Empowerment Programme (PEP), was associated with a lower risk of first cardiovascular disease (CVD) event and all-cause mortality in a population-based cohort of type 2 diabetes mellitus (T2DM) patients in primary care. Materials and Methods: A Chinese cohort of 27,278 T2DM patients without prior occurrence of CVD events on or before baseline study recruitment date was linked to the Hong Kong administrative database from 2008 to 2013. PEP was provided to T2DM patients treated at primary care outpatient clinics through community trained professional educators. Non-PEP participants were matched one-to-one with the PEP participants using propensity score method with respect to their baseline covariates. Cox proportional hazard regressions were performed to estimate the associations of PEP with the occurrence of first CVD event, coronary heart disease, stroke, heart failure and death from any cause, controlling for baseline characteristics. Results: During a median of 21.5 months follow-up, 795 (352 PEP participants and 443 non-PEP participants) patients suffered a first CVD event. After adjusting for confounding variables, PEP participants had a lower incidence of all-cause mortality (hazard ratio: 0.564; 95%CI:0.445-0.715; P < 0.001), first CVD (hazard ratio: 0.807; 95%CI:0.696-0.935; P = 0.004) and stroke (hazard ratio: 0.702; 95%CI:0.569-0.867; P = 0.001) events than those without PEP. Conclusions: Enrolment in PEP was associated with reduced all-cause mortality and first CVD events among T2DM patients. The CVD benefit of PEP might be attributable to improving metabolic control through empowerment of self-care and enhancement of quality of diabetes care in primary care.postprin

A Geopolitical Perspective into the Opposition to Globalizing State-Owned Enterprises in Target States

Plain language summaryGeopolitical concerns are one of the important factors influencing multinational enterprise (MNE) location choices. This is particularly true for globalizing state‐owned enterprises (SOEs) because of their direct ties with governments. Because of geopolitical concerns, SOEs may face a strong level of opposition in foreign countries which neighbor SOEs’ home countries, have different religious beliefs and political regimes from SOEs’ home countries or countries do not lack resources that SOEs can provide. Such opposition is particularly strong in countries where domestic politicians find it in their interests to arouse nationalistic feelings and oppose foreign SOEs’ investments. This study highlights the importance of considering geopolitical factors in MNE location choices.Technical summaryThe emergence of globalizing state‐owned enterprises (SOEs) requires revisiting the assumption that multinational enterprises (MNEs) are focused on economic not political objectives because SOEs tend to be perceived as political entities as well. We develop a geopolitical perspective into how geographic distance, religious similarity, and political regime similarity between two nation states, as well as resource complementarity between globalizing SOEs and target states, explain the level of opposition that globalizing SOEs face in target states. We also investigate how the salience of nationalist politics moderates the influence of these geopolitical factors on the level of opposition that globalizing SOEs face. This theoretical model developed in this study sheds new light on understanding the role of geopolitics in affecting MNEs’ location choices. Copyright © 2016 Strategic Management Society

Smu1 and RED are required for activation of spliceosomal B complexes assembled on short introns

Human pre-catalytic spliceosomes contain several proteins that associate transiently just prior to spliceosome activation and are absent in yeast, suggesting that this critical step is more complex in higher eukaryotes. We demonstrate via RNAi coupled with RNA-Seq that two of these human-specific proteins, Smu1 and RED, function both as alternative splicing regulators and as general splicing factors and are required predominantly for efficient splicing of short introns. In vitro splicing assays reveal that Smu1 and RED promote spliceosome activation, and are essential for this step when the distance between the pre-mRNA's 5' splice site (SS) and branch site (BS) is sufficiently short. This Smu1-RED requirement can be bypassed when the 5' and 3' regions of short introns are physically separated. Our observations suggest that Smu1 and RED relieve physical constraints arising from a short 5'SS-BS distance, thereby enabling spliceosomes to overcome structural challenges associated with the splicing of short introns.Work in the J.V. laboratory was supported by Fundación Botín, Banco de Santander through its Santander Universities Global Division, the European Research Council (ERC AdvG 670146), AGAUR, Spanish Ministry of Economy and Competitiveness (BFU 2014-005153 and BFU 2017 89308-P) and the Centre of Excellence Severo Ochoa. Work in the R.L. laboratory was supported by a grant from the Deutsche Forschungsgemeinschaft SFB 860