As a Matter of Factions: The Budgetary Implications of Shifting Factional Control in Japan’s LDP

For 38 years, the Liberal Democratic Party (LDP) maintained single-party control over the Japanese government. This lack of partisan turnover in government has frustrated attempts to explain Japanese government policy changes using political variables. In this paper, we look for intraparty changes that may have led to changes in Japanese budgetary policy. Using a simple model of agenda-setting, we hypothesize that changes in which intraparty factions “control” the LDP affect the party’s decisions over spending priorities systematically. This runs contrary to the received wisdom in the voluminous literature on LDP factions, which asserts that factions, whatever their raison d’être, do not exhibit different policy preferences. We find that strong correlations do exist between which factions comprise the agenda-setting party “mainstream” and how the government allocates spending across pork-barrel and public goods items

Occurrence and predictors of retinopathy and visual acuity in type 2 diabetic patients and control subjects 10-year follow-up from the diagnosis

Rozwój retinopatii i zaburzeń ostrości widzenia oraz czynniki ryzyka ich wystąpienia u pacjentów z nowo rozpoznaną cukrzycą i w grupie kontrolnej u osób bez cukrzycy. Prospektywne, 10-letnie badanie objęło reprezentatywną grupę 133 chorych (70 mężczyzn i 63 kobiety) na cukrzycę typu 2, świeżo rozpoznaną w latach 1979-1981, oraz 144 osoby (62 mężczyzn i 82 kobiety) z grupy kontrolnej bez cukrzycy, wyłonione z populacji ogólnej. Częstość retinopatii oraz stopień jej zaawansowania oceniano na podstawie 45o zdjęć dna oka wykonywanych na początku badania oraz po 5 i 10 latach. Po 10 latach obserwacji u chorych na cukrzycę stwierdzono gorszą ostrość wzroku niż u osób z grupy kontrolnej. Upośledzenie ostrości widzenia wykazywało odwrotną korelację z wartościami HbA1c oznaczonymi po 5 latach. Częstość retinopatii u chorych na cukrzycę typu 2 wzrastała gwałtownie po 5 latach, a po 10 latach obserwacji już u 55% stwierdzano cechy retinopatii. Natomiast u osób z grupy kontrolnej częstość retinopatii była niewielka, lecz wykrywalna. Zła kontrola glikemii była u chorych na cukrzycę najistotniejszym czynnikiem pozwalającym przewidywać rozwój retinopatii. Wartości ciśnienia tętniczego były wyższe, a mikroalbuminuria częstsza u osób z grupy kontrolnej, u których stwierdzano retinopatię. U chorych ze świeżo rozpoznaną cukrzycą typu 2 ostrość widzenia ulegała pogorszeniu, a częstość retinopatii rosła wraz z czasem trwania choroby oraz złą kontrolą glikemii. Wyższe ciśnienie tętnicze oraz mikroalbuminuria pozwalały przewidywać rozwój retinopatii u osób z grupy kontrolnej.The evolution of visual acuity and retinopathy and their risk factors in patients with newly diagnosed type 2 diabetes and in control subjects. A 10-year prospective study consisting of a representative group of 133 (70 men, 63 women) newly diagnosed type 2 diabetic patients diagnosed at health centers between 1979 and 1981 and 144 (62 men, 82 women) non-diabetic control subjects recruited from the population register. The frequency of retinopathy was determined by grading of 45° fundus photographs at baseline and after 5 and 10 years. By the 10-year follow-up the diabetic patients had lower visual acuity than the control subjects. The im-pairment of the visual acuity correlated inversely to HbA1c value of the 5-year examination. The frequency of retinopathy in type 2 diabetic patients increased sharply after 5 years and at 10-year 55% of diabetic patients had signs of retinopathy. The frequency of retinopathy in the control subjects was low, but detectable. In the diabetic patients poor glycemic control was the most important predictive factor for the development of retinopathy. In the control subjects blood pressure levels were higher and microalbuminuria more common in those with than in those without retinopathy. The visual acuity deteriorated and the frequency of retinopathy increased in newly diagnosed type 2 diabetic patients with duration of disease and poor glycemic control. Interestingly, higher blood pressure levels and microalbuminuria predicted retinopathy in control subjects

Abdominal Subcutaneous Adipose Tissue: A Protective Fat Depot?

OBJECTIVE: Obesity is associated with increased metabolic and cardiovascular risk. The ectopic fat hypothesis suggests that subcutaneous fat may be protective, but this theory has yet to be fully explored. RESEARCH DESIGN AND METHODS: Participants from the Framingham Heart Study (n = 3,001, 48.5% women) were stratified by visceral adipose tissue (VAT) into sex-specific tertiles. Within these tertiles, age-adjusted abdominal subcutaneous adipose tissue (SAT) tertiles were examined in relation to cardiometabolic risk factors. RESULTS: In the lowest VAT tertile, risk factor prevalence was low, although systolic blood pressure in women and rates of high triglycerides, impaired fasting glucose, hypertension, and the metabolic syndrome in men increased with increasing SAT tertile (all P < 0.04). In contrast, in the top VAT tertile, lower triglycerides were observed in men with increasing SAT (64.4% high triglycerides in SAT tertile 1 vs. 52.7% in SAT tertile 3, P = 0.03). Similar observations were made for women, although results were not statistically significant (50.6% high triglycerides in SAT tertile 1 vs. 41.0% in tertile 3, P = 0.10). Results in the highest VAT tertile were notable for a lack of increase in the prevalence of low HDL in men and women and in rates of impaired fasting glucose in men with increasing subcutaneous fat, despite sizable differences in BMI across SAT tertiles (27.1 to 36.3 kg/m$^2$ [women]; 28.1 to 35.7 kg/m$^2$ [men]). CONCLUSIONS: Although adiposity increases the absolute risk of metabolic and cardiovascular disease, abdominal subcutaneous fat is not associated with a linear increase in the prevalence of all risk factors among the obese, most notably, high triglycerides

Interactions between cortisol and lipids in human milk

Background Human breast milk is one of the key early postnatal biological exposures for the developing child. It includes bioactive compounds, such as cortisol and fatty acids, which may be linked via the mother's lipid metabolism. Methods This study investigated the associations between cortisol and lipids in human milk at the infant age of 2.5 months. Human milk cortisol concentrations were measured using luminescence immunoassay, and two groups of milks (n = 50 each) were formed based on either high (> 10 nmol/L) or low (Results The percentage of phospholipid-rich lipids of total lipids was 33.08% +/- 1.33%. In triacylglycerol-rich lipids, high cortisol level in milk was associated with higher lauric (12:0, mass % and mg/mL), myristic (14:0, mass % and mg/mL), eicosenoic (20:1n - 9, mass %), docosenoic (22:1n - 9, mass %, and mg/mL) acids, and to lower palmitic acid (16:0, mass %) compared with low cortisol levels in milk. In phospholipid-rich lipids, high cortisol level was associated with higher myristic (14:0, mass %) and docosenoic (22:1n - 9, mass %) acids. After adjusting for pre-pregnancy BMI and sampling time by linear regression, the milk cortisol remained a significant predictor for lauric and myristic acids in triacylglycerol-rich lipids, and myristic and docosenoic acid in phospholipid-rich lipids (beta = 0.23 to 0.38 andp Conclusions This study revealed certain significant associations between milk cortisol and the fatty acid composition of human milk, indicating that cortisol might be one of the factors affecting the origin of the lipids in human milk.</div

Ten-Year Mortality and Cardiovascular Morbidity in the Finnish Diabetes Prevention Study—Secondary Analysis of the Randomized Trial

The Finnish Diabetes Prevention Study (DPS) was a randomized controlled trial, which showed that it is possible to prevent type 2 diabetes by lifestyle changes. The aim of the present study was to examine whether the lifestyle intervention had an effect on the ten-year mortality and cardiovascular morbidity in the DPS participants originally randomized either into an intervention or control group. Furthermore, we compared these results with a population-based cohort comprising individuals of varying glucose tolerance states.Middle-aged, overweight people with IGT (n = 522) were randomized into intensive intervention (including physical activity, weight reduction and dietary counseling), or control "mini-intervention" group. Median length of the intervention period was 4 years and the mean follow-up was 10.6 years. The population-based reference study cohort included 1881 individuals (1570 with normal glucose tolerance, 183 with IGT, 59 with screen-detected type 2 diabetes, 69 with previously known type 2 diabetes) with the mean follow-up of 13.8 years. Mortality and cardiovascular morbidity data were collected from the national Hospital Discharge Register and Causes of Death Register. Among the DPS participants who consented for register linkage (n = 505), total mortality (2.2 vs. 3.8 per 1000 person years, hazard ratio HR = 0.57, 95% CI 0.21-1.58) and cardiovascular morbidity (22.9 vs. 22.0 per 1000 person years, HR = 1.04, 95% CI 0.72-1.51) did not differ significantly between the intervention and control groups. Compared with the population-based cohort with impaired glucose tolerance, adjusted HRs were 0.21 (95% CI 0.09-0.52) and 0.39 (95% CI 0.20-0.79) for total mortality, and 0.89 (95% CI 0.62-1.27) and 0.87 (0.60-1.27) for cardiovascular morbidity in the intervention and control groups of the DPS, respectively. The risk of death in DPS combined cohort was markedly lower than in FINRISK IGT cohort (adjusted HR 0.30, 95% CI 0.17-0.54), but there was no significant difference in the risk of CVD (adjusted HR 0.88, 95% CI 0.64-1.21).Lifestyle intervention among persons with IGT did not decrease cardiovascular morbidity during the first 10 years of follow-up. However, the statistical power may not be sufficient to detect small differences between the intervention and control groups. Low total mortality among participants of the DPS compared with individuals with IGT in the general population could be ascribed to a lower cardiovascular risk profile at baseline and regular follow-up.ClinicalTrials.gov NCT00518167