TZDs and Bone: A Review of the Recent Clinical Evidence

Over the past two years, evidence has emerged that the currently available thiazolidinediones (TZDs), rosiglitazone, and pioglitazone have negative skeletal consequences, at least in women, which are clinically important. Increased fracture risk in women, but not men, was reported for both TZDs, based on analyses of adverse event reports from clinical trials. In short-term clinical trials in women, both TZDs caused more rapid bone loss. In these trials, changes in bone turnover markers suggest a pattern of reduced bone formation without a change in resorption. Although limited, these results support the hypothesis based on rodent and in vitro models that reduced bone formation resulting from activation of peroxisome proliferator-activated receptor-γ (PPARγ) is a central mechanism for TZDs' effect on bone. Research is needed to better understand the mechanisms of bone loss with TZDs, to identify factors that influence susceptibility to TZD-induced osteoporosis, and to test treatments for its prevention

Diabetes, TZDs, and Bone: A Review of the Clinical Evidence

Evidence from rodent and in vitro models suggests that activation of PPAR-γ by thiazolidinediones (TZDs) causes increased bone marrow adiposity and decreased osteoblastogenesis, resulting in bone loss. TZDs are prescribed for the treatment of diabetes, providing an opportunity to determine whether PPAR-γ activation also impacts bone in humans. In addition, since type 2 diabetes is associated with higher fracture risk, an understanding of the clinical impact of TZDs on bone is needed to guide fracture prevention efforts in this population. This review summarizes current findings regarding type 2 diabetes and increased fracture risk and then considers the available evidence regarding TZD use and bone metabolism in humans

Operas by women in twentieth century America

textWhile hundreds of operas were composed by American women during the twentieth century, very few people, even seasoned operatic performers and audiences, know of their existence. Most of these operas have not been performed beyond their regional or private premieres, and little is written about them in sources addressing the topics of women composers, twentieth century opera, or American opera. Therefore, those responsible for programming them in educational and professional opera companies have had limited exposure to these works. My focus is on ten composers and a total of nineteen of their operas, providing short biographies about these women (Joyce Barthelson, Mary E. Caldwell, Vivian Fine, Eleanor Everest Freer, Miriam Gideon, Libby Larsen, Mary Carr Moore, Julia Smith, Faye-Ellen Silverman, and Nancy Van de Vate) and entries for each of their featured works. These listings detail the resources required for programming the operas, such as the types of voices and instruments needed, as well as musical styles and salient features within the work. In addition to addressing the components of the operas as a whole, six arias extracted from the nineteen works are examined closely, illuminating common themes that unite these operas. Prejudices and stereotypes concerning the perceived inferiority of the creations of women composers have helped to keep these works unknown, but by making these operas more accessible, by analyzing their possible performance difficulties and by simply bringing these works into the light, it is hoped that they may have a greater chance of being performed and studied in the future.Musi

Evaluation of African-American and White Racial Classification in a Surveillance, Epidemiology, and End Results Cancer Registry

Objectives: This study evaluated the validity of registry-reported race for individuals who participated in research studies conducted since 1980 through the Metropolitan Detroit Cancer Surveillance System (MDCSS), a Surveillance, Epidemiology, and End Results (SEER) Program registry. Methods: 5329 individuals who self-identified as African American or White and were classified in the MDCSS registry as African American or White were included. Self-identified and registry-reported race were compared, and associations between demographics and racial misclassification were examined. Results: Most self-identified African Americans and Whites were correctly classified (sensitivity= 98.5%, specificity=99.7%). Males were two times more likely to be misclassified than females [odds ratio (OR)=2.13, 95% confidence interval (CI): 1.06-4.29]. Individuals diagnosed with cancer after 1990 were two times more likely to be misclassified than those diagnosed before 1990 (OR= 2.17, 95% CI: 1.07--4.42). African Americans were four times more likely to be misclassified than Whites (OR=4.39, 95% CI: 2.24-8.60). Conclusions: Misclassification in the MDCSS registry of African Americans as Whites, and vice versa, is relatively low. Additional studies should evaluate misclassification of African Americans and Whites as other races and/or ethnicities in the SEER registry

The Risk of Cancer for Patients on Dialysis: A Review

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/72354/1/j.1525-139X.1991.tb00104.x.pd

Cognitive-Behavioral Therapy For Adults With Panic Disorder: Who Does Not Benefit, And Why?

Although cognitive-behavioral therapy (CBT) represented a breakthrough in efficacious treatment of panic disorder, a substantial minority of patients fail to respond. Identifying which individuals benefit from CBT and which do not—and why—facilitates efforts to tailor and develop treatments for those not currently being helped. Nevertheless, few replicated predictors of outcome have been identified, and little is understood about the mechanisms of known predictors. While the focus of Chapters 1 and 2 is on elucidating an established predictor of poor outcome—hostile resistance (combative behavior directed at therapists)—in Chapter 3 we seek to identify novel predictors. Specifically, in Chapter 1 we employed a mixed-method approach to understand which patients became hostilely resistant in CBT and why. Compared to their never-hostile counterparts, hostilely resistant patients had more personality pathology, found treatment less credible, and had lower expectancy for improvement. However, grounded theory analyses revealed that, while patient characteristics are important, most often patient factors interacted with therapist failures (particularly of empathy) and treatment factors to produce hostility. In Chapter 2, we examined how hostile resistance translates into worse outcomes by evaluating two putative mediators—therapist adherence and working alliance. Results indicated that neither accounted for hostility’s association with attrition or worse symptomatic improvement, nor were these factors independently predictive of CBT outcome. In Chapter 3 we sought to identify novel prognostic and prescriptive factors by testing hypotheses drawn from clinicians’ observations. Of 17 clinical intuitions about barriers to treatment progress examined, none were empirically borne out; in fact, clinicians’ agreement on a putative barrier was inversely related to the strength of a predictor and, contrary to clinicians’ beliefs, dissociation during panic predicted improved response. Moderation analyses revealed that CBT outperformed psychodynamic therapy for patients with posttraumatic-stress disorder and less severe panic. This research adds to the breadth and depth of the outcome prediction literature, testing a wider range of variables and elucidating the origins of a known predictor. Taken together, findings point to the importance of training in common factors, flexible applications of treatment manuals, therapists’ management of powerful emotional reactions, and skepticism of empirically untested clinical intuitions

Summer Garden Performance of Seed and Cuttingpropagated Geranium Cultivars as Influenced by Chlormequat Applied During Greenhouse Production and Summer Light Intensity

Horticultur

Comparisons of Hot Water Microclimate Heating and Conventional Overhead Heating on the Development and Nutritional Status of Seedling Geraniums as Well as Fuel Consumption of These Heating Regimes

This study was conducted to determine geranium performance under a warm growing medium, cool air temperature regime; and whether this is a viable method for commerciaI growers t o reduce production costs . Development patterns, flowering habit, nutritional status and the actual amount of fuel required to produce a crop was monitored.Horticultur

Application of a Multiplex Polymerase Chain Reaction Assay for the Simultaneous Confirmation of Listeria monocytogenes and Other Listeria Species in Turkey Sample Surveillance

A multiplex polymerase chain reaction was developed to simultaneously identify Listeria monocytogenes and species of the genus Listeria. Two sets of primers were used, with the first amplifying a 938-bp region of the 16S rRNA gene that is highly conserved in all Listeria species and the second amplifying a 174-bp region of the listeriolysin (hlyA) gene of L. monocytogenes. Thus, isolates of Listeria spp. yield a single 938-bp product, whereas L. monocytogenes isolates yield both the 938-bp product and a 174-bp product. The specificity of the assay was verified with all six Listeria species and 11 serotypes of L. monocytogenes, as well as nonrelated bacteria. The multiplex PCR assay was used to determine the incidence of Listeria spp., especially L. monocytogenes, in mechanically separated turkey samples (n = 150 samples). L. monocytogenes strains were selected by using the University of Vermont two-step enrichment protocol and plating to selective Palcam agar. The multiplex PCR assay was used for verification of presumptive Listeria colonies. Approximately 38% of mechanically separated turkey samples (57 of 150) yielded L. monocytogenes; an additional 18% of these samples (27 of 150) harbored other Listeria spp. Fifty-one percent (29 of 57) of the L. monocytogenes isolates were of serogroup 1, 44% (25 of 57) were of serogroup 4, and 2% (1 of 57) were assigned to serogroups other than 1 and 4