Criteria for flatness and injectivity

Let $R$ be a commutative Noetherian ring. We give criteria for flatness of $R$-modules in terms of associated primes and torsion-freeness of certain tensor products. This allows us to develop a criterion for regularity if $R$ has characteristic $p$, or more generally if it has a locally contracting endomorphism. Dualizing, we give criteria for injectivity of $R$-modules in terms of coassociated primes and (h-)divisibility of certain \Hom-modules. Along the way, we develop tools to achieve such a dual result. These include a careful analysis of the notions of divisibility and h-divisibility (including a localization result), a theorem on coassociated primes across a \Hom-module base change, and a local criterion for injectivity.Comment: 19 page

Gender differences in the association between education and the incidence of cardiovascular events in Northern Italy.

Background: The educational differences in the incidence of major cardiovascular events are under-studied in Southern Europe and among women. Methods: The study sample includes n\u2009=\u20095084 participants to 4 population-based Northern Italian cohorts, aged 35-74 at baseline and with no previous cardiovascular events. The follow-up to ascertain the first onset of coronary heart disease (CHD) or ischaemic stroke ended in 2002. At baseline, major cardiovascular risk factors were investigated adopting the standardized MONICA procedures. Two educational classes were obtained from years of schooling. Age- and risk factors-adjusted hazard ratios of first CHD or ischaemic stroke were estimated through sex-specific separate Cox models (high education as reference). RESULTS: Median follow-up time was 12 years. Event rates were 6.38 (CHD) and 2.12 (ischaemic stroke) per 1000 person-years in men; and 1.59 and 0.94 in women. In men, low education was associated with higher mean Body Mass Index and prevalence of diabetes and cigarette smokers; but also with higher HDL cholesterol and a more favourable alcohol intake pattern. Less-educated women had higher mean systolic blood pressure, Body Mass Index and HDL cholesterol and were more likely to have diabetes. Men and women in the low educational class had a 2-fold increase in ischaemic stroke and CHD incidence, respectively, after controlling for major risk factors. Education was not associated with CHD incidence in men. Higher ischaemic stroke rates were observed among more educated women. Conclusion: In this northern Italian population, the association between education and cardiovascular risk seems to vary by gender

Influence of single nucleotide polymorphisms in factor VIII and von Willebrand factor genes on plasma factor VIII activity: the ARIC Study

Factor VIII (FVIII) functions as a cofactor for factor IXa in the contact coagulation pathway and circulates in a protective complex with von Willebrand factor (VWF). Plasma FVIII activity is strongly influenced by environmental and genetic factors through VWF-dependent and independent mechanisms. Single nucleotide polymorphisms (SNPs) of the coding and promoter sequence in the FVIII gene have been extensively studied for effects on FVIII synthesis, secretion, and activity, but impacts of non–disease-causing intronic SNPs remain largely unknown. We analyzed FVIII SNPs and FVIII activity in 10 434 healthy Americans of European (EA) or African (AA) descent in the Atherosclerosis Risk in Communities (ARIC) study. Among covariates, age, race, diabetes, and ABO contributed 2.2%, 3.5%, 4%, and 10.7% to FVIII intersubject variation, respectively. Four intronic FVIII SNPs associated with FVIII activity and 8 with FVIII-VWF ratio in a sex- and race-dependent manner. The FVIII haplotypes AT and GCTTTT also associated with FVIII activity. Seven VWF SNPs were associated with FVIII activity in EA subjects, but no FVIII SNPs were associated with VWF Ag. These data demonstrate that intronic SNPs could directly or indirectly influence intersubject variation of FVIII activity. Further investigation may reveal novel mechanisms of regulating FVIII expression and activity

Carotid Artery Wall Thickness and Risk of Stroke Subtypes: The Atherosclerosis Risk in Communities Study

Understanding associations of carotid atherosclerosis with stroke subtypes may contribute to more effective prevention of stroke

Common carotid artery intima-media thickness is as good as carotid intima-media thickness of all carotid artery segments in improving prediction of coronary heart disease risk in the Atherosclerosis Risk in Communities (ARIC) study

Carotid intima–media thickness (CIMT) and plaque information can improve coronary heart disease (CHD) risk prediction when added to traditional risk factors (TRF). However, obtaining adequate images of all carotid artery segments (A-CIMT) may be difficult. Of A-CIMT, the common carotid artery intima–media thickness (CCA-IMT) is relatively more reliable and easier to measure. We evaluated whether CCA-IMT is comparable to A-CIMT when added to TRF and plaque information in improving CHD risk prediction in the Atherosclerosis Risk in Communities (ARIC) study

Association of Circulating Matrix Metalloproteinases With Carotid Artery Characteristics: The Atherosclerosis Risk in Communities Carotid MRI Study

To examine the relationship of plasma levels of matrix metalloproteinases (MMPs) and tissue inhibitor of metalloproteinase-1 (TIMP-1) with carotid artery characteristics measured by magnetic resonance imaging (MRI) in a cross-sectional investigation among Atherosclerosis Risk in Communities (ARIC) Carotid MRI Study participants

Training Models in Counseling Psychology: Scientist-Practitioner Versus Practitioner-Scholar

Considerable discussion has occurred through the years regarding models of training. With the recent accreditation of counseling psychology programs espousing the practitioner-scholar model, the importance of reexamining the merits of this as well as the traditional scientist-practitioner is now very important for the future of the field. This article consists of two positions: One pro practitioner-scholar and the other pro scientist-practitioner and con practitioner-scholar. The first position (first part of the article) by Biever, Patterson, and Welch argues for inclusion of the practitioner-scholar model as an alternative for training in counseling psychology. The second position (in the second part of the article) by Stoltenberg, Pace, and Kashubeck reviews concerns with two competing models. These authors conclude that the scientist-practitioner model is a better fit for training in counseling psychology. Recommendations for training within models are presented.Yeshttps://us.sagepub.com/en-us/nam/manuscript-submission-guideline

Transcription Factor 7-Like 2 (TCF7L2) Polymorphism and Context-Specific Risk of Type 2 Diabetes in African American and Caucasian Adults: The Atherosclerosis Risk in Communities Study

OBJECTIVE-Although variants in the transcription factor 7-like 2 (TCF7L2) gene are consistently associated with type 2 diabetes, large population-based studies of African Americans are lacking. Moreover, few studies have investigated the effects of TCF7L2 on type 2 diabetes in the context of metabolic risk factors of type 2 diabetes. RESEARCH DESIGN AND METHODS-We investigated the association between the TCF7L2 rs7903146 polymorphism and type 2 diabetes in 2,727 African American and 9,302 Caucasian participants without diabetes who were inducted into the Atherosclerosis Risk in Communities study in 1987-1989 and followed for 9 years. RESULTS-A total of 485 and 923 cases of type 2 diabetes were identified in African Americans and Caucasians, respectively. Compared with homozygous CC individuals, heterozygous CT and homozygous TT individuals had higher cumulative incidence of type 2 diabetes over 9 years of follow-up: 11.3% (95% CI 10.2-12.4) vs. 21.1% (20.8-21.4) and 27.9% (19.3-36.5) in African Americans, respectively, and 9.7% (8.8-10.6) vs. 11.3% (10.2-12.4) and 13.6% (11.1-16.1), respectively, in Caucasians. Individuals with the risk allele had the highest hazards of diabetes if they were obese and had low HDL cholesterol, followed by individuals with any one and none of the traits. CONCLUSIONS-Our study provides the first significant evidence of association between the TCF7L2 rs7903146 polymorphism and type 2 diabetes risk in a large African American population and also demonstrates that the diabetes risk conveyed by the rs7903146 risk allele is substantially increased in the context of some metabolic risk factors for type 2 diabetes. Our study findings need to be replicated in other large, population-based studies

Carotid Arterial Wall Characteristics Are Associated With Incident Ischemic Stroke But Not Coronary Heart Disease in the Atherosclerosis Risk in Communities (ARIC) Study

Ultrasound measurements of arterial stiffness are associated with atherosclerosis risk factors, but limited data exist on their association with incident cardiovascular events. We evaluated the association of carotid ultrasound derived arterial stiffness measures with incident coronary heart disease (CHD) and ischemic stroke in the ARIC study

Finding Web-Based Anxiety Interventions on the World Wide Web: A Scoping Review

BACKGROUND: One relatively new and increasingly popular approach of increasing access to treatment is Web-based intervention programs. The advantage of Web-based approaches is the accessibility, affordability, and anonymity of potentially evidence-based treatment. Despite much research evidence on the effectiveness of Web-based interventions for anxiety found in the literature, little is known about what is publically available for potential consumers on the Web. OBJECTIVE: Our aim was to explore what a consumer searching the Web for Web-based intervention options for anxiety-related issues might find. The objectives were to identify currently publically available Web-based intervention programs for anxiety and to synthesize and review these in terms of (1) website characteristics such as credibility and accessibility; (2) intervention program characteristics such as intervention focus, design, and presentation modes; (3) therapeutic elements employed; and (4) published evidence of efficacy. METHODS: Web keyword searches were carried out on three major search engines (Google, Bing, and Yahoo-UK platforms). For each search, the first 25 hyperlinks were screened for eligible programs. Included were programs that were designed for anxiety symptoms, currently publically accessible on the Web, had an online component, a structured treatment plan, and were available in English. Data were extracted for website characteristics, program characteristics, therapeutic characteristics, as well as empirical evidence. Programs were also evaluated using a 16-point rating tool. RESULTS: The search resulted in 34 programs that were eligible for review. A wide variety of programs for anxiety, including specific anxiety disorders, and anxiety in combination with stress, depression, or anger were identified and based predominantly on cognitive behavioral therapy techniques. The majority of websites were rated as credible, secure, and free of advertisement. The majority required users to register and/or to pay a program access fee. Half of the programs offered some form of paid therapist or professional support. Programs varied in treatment length and number of modules and employed a variety of presentation modes. Relatively few programs had published research evidence of the intervention's efficacy. CONCLUSIONS: This review represents a snapshot of available Web-based intervention programs for anxiety that could be found by consumers in March 2015. The consumer is confronted with a diversity of programs, which makes it difficult to identify an appropriate program. Limited reports and existence of empirical evidence for efficacy make it even more challenging to identify credible and reliable programs. This highlights the need for consistent guidelines and standards on developing, providing, and evaluating Web-based interventions and platforms with reliable up-to-date information for professionals and consumers about the characteristics, quality, and accessibility of Web-based interventions