Common variants of the TCF7L2 gene are associated with increased risk of type 2 diabetes mellitus in a UK-resident South Asian population

Background Recent studies have implicated variants of the transcription factor 7-like 2 (TCF7L2) gene in genetic susceptibility to type 2 diabetes mellitus in several different populations. The aim of this study was to determine whether variants of this gene are also risk factors for type 2 diabetes development in a UK-resident South Asian cohort of Punjabi ancestry. Methods We genotyped four single nucleotide polymorphisms (SNPs) of TCF7L2 (rs7901695, rs7903146, rs11196205 and rs12255372) in 831 subjects with diabetes and 437 control subjects. Results The minor allele of each variant was significantly associated with type 2 diabetes; the greatest risk of developing the disease was conferred by rs7903146, with an allelic odds ratio (OR) of 1.31 (95% CI: 1.11 – 1.56, p = 1.96 × 10-3). For each variant, disease risk associated with homozygosity for the minor allele was greater than that for heterozygotes, with the exception of rs12255372. To determine the effect on the observed associations of including young control subjects in our data set, we reanalysed the data using subsets of the control group defined by different minimum age thresholds. Increasing the minimum age of our control subjects resulted in a corresponding increase in OR for all variants of the gene (p ≤ 1.04 × 10-7). Conclusion Our results support recent findings that TCF7L2 is an important genetic risk factor for the development of type 2 diabetes in multiple ethnic groups

LNCS

We present layered concurrent programs, a compact and expressive notation for specifying refinement proofs of concurrent programs. A layered concurrent program specifies a sequence of connected concurrent programs, from most concrete to most abstract, such that common parts of different programs are written exactly once. These programs are expressed in the ordinary syntax of imperative concurrent programs using gated atomic actions, sequencing, choice, and (recursive) procedure calls. Each concurrent program is automatically extracted from the layered program. We reduce refinement to the safety of a sequence of concurrent checker programs, one each to justify the connection between every two consecutive concurrent programs. These checker programs are also automatically extracted from the layered program. Layered concurrent programs have been implemented in the CIVL verifier which has been successfully used for the verification of several complex concurrent programs

Musculoskeletal consultations from childhood to adulthood: a longitudinal study

BACKGROUND: The Global Burden of Disease reports indicate that musculoskeletal conditions are important causes of disability worldwide. Such conditions may originate in childhood, but studies investigating changes longitudinally and from childhood to adulthood are infrequent. METHODS: Nine birth cohorts of children (starting at ages 7-15 years) were followed. Participants were identified from Consultations in Primary Care Archive, an electronic health record database of 11 English general practices. Musculoskeletal consultation prevalence figures were calculated, and reasons for consultation evaluated. RESULTS: Annual musculoskeletal consultation prevalence was similar across cohorts for each age. Prevalence increased from 6 to 16% between ages 7 and 22 and was higher in males until age 15, after which prevalence was higher in females. Pain was the most common reason for consultation. Back pain consultations increased from 1 consultation/1000 7 year olds to 84 consultations/1000 22 year olds. Lower limb pain consultations increased from 21 consultations/1000 7 year olds to 56 consultations/1000 22 year olds. CONCLUSIONS: This study shows that from childhood, individuals are more likely to seek healthcare for musculoskeletal consultations as they age, but rates are not increasing over time. Changes in consultation rates by age, gender and pain region may inform studies on the development of chronic musculoskeletal pain over the life-course

Individuals with unilateral transtibial amputation exhibit reduced accuracy and precision during a targeted stepping task

Accurate foot placement is important for dynamic balance during activities of daily living. Disruption of sensory information and prosthetic componentry characteristics may result in increased locomotor task difficulty for individuals with lower limb amputation. This study investigated the accuracy and precision of prosthetic and intact foot placement during a targeted stepping task in individuals with unilateral transtibial amputation (IUTAs; N=8, 47±13 yrs), compared to the preferred foot of control participant’s (N=8, 33±15 yrs). Participants walked along a 10-metre walkway, placing their foot into a rectangular floor-based target with dimensions normalised to a percentage of participant’s foot length and width; ‘standard’ = 150%x150%, ‘wide’ = 150%x200%, ‘long’ = 200%x150%. Foot placement accuracy (relative distance between foot and target centre), precision (between-trial variability), and foot-reach kinematics were determined for each limb and target, using three-dimensional motion capture. A significant foot-by-target interaction revealed less mediolateral foot placement accuracy for IUTAs in the wide target, which was significantly less accurate for the intact (28±12mm) compared to prosthetic foot (16±14mm). Intact peak foot velocity (4.6±0.8m.s-1) was greater than the prosthetic foot (4.5±0.8m.s-1) for all targets. Controls were more accurate and precise than IUTAs, regardless of target size. Less accurate and precise intact foot placement in IUTAs, coupled with a faster moving intact limb, is likely due to several factors including reduced proprioceptive feedback and active control during prosthetic limb single stance. This could affect activities of daily living where foot placement is critical, such as negotiating cluttered travel paths or obstacles whilst maintaining balance

Interpreting and acting upon home blood pressure readings: A qualitative study

This article is made available through the Brunel Open Access Publishing Fund. Copyright @ 2013 Vasileiou et al.; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.Background: Recent guidelines recognize the importance of home blood pressure monitoring (HBPM) as an adjunct to clinical measurements. We explored how people who have purchased and use a home blood pressure (BP) monitor make sense of, and act upon, readings and how they communicate with their doctor about the practice of home monitoring. Methods: A qualitative study was designed and participants were purposively recruited from several areas in England, UK. Semi-structured in-depth interviews were conducted with 18 users of home BP monitors. The transcribed data were thematically analysed. Results: Interpretation of home BP readings is complex, and is often characterised by uncertainty. People seek to assess value normality using ‘rules of thumb’, and often aim to identify the potential causes of the readings. This is done by drawing on lay models of BP function and by contextualising the readings to personal circumstances. Based on the perceived causes of the problematic readings, actions are initiated, mostly relating to changes in daily routines. Contacting the doctor was more likely when the problematic readings persisted and could not be easily explained, or when participants did not succeed in regulating their BP through their other interventions. Most users had notified their doctor of the practice of home monitoring, but medical involvement varied, with some participants reporting disinterest or reservations by doctors. Conclusions: Involvement from doctors can help people overcome difficulties and resolve uncertainties around the interpretation of home readings, and ensure that the rules of thumb are appropriate. Home monitoring can be used to strengthen the patient-clinician relationship

Utility of salt-marsh foraminifera, testate amoebae and bulk-sediment δ13C values as sea-level indicators in Newfoundland, Canada

This is the author accepted manuscript. The final version is available from Elsevier via the DOI in this record.We investigated the utility of foraminifera, testate amoebae and bulk-sediment δ 13 C measurements for reconstructing Holocene relative sea level from sequences of salt-marsh sediment in Newfoundland, Canada. Modern, surface sediment was collected along transects from low to supra-tidal elevations in eastern (at Placentia) and western (at Hynes Brook and Big River) Newfoundland. Consistent with previous work, low-diversity assemblages of foraminifera display an almost binary division into a higher salt-marsh assemblage dominated by Jadammina macrescens and Balticammina pseudomacrescens and a lower salt-marsh assemblage comprised of Miliammina fusca. This pattern and composition resembles those identified at other high latitude sites with cool climates and confirms that foraminifera are sea-level indicators. The lowest occurrence of testate amoebae was at approximately mean higher high water. The composition of high salt-marsh testate amoebae assemblages (Centropyxis cassis type, Trinema spp., Tracheleuglypha dentata type, and Euglypha spp.) in Newfoundland was similar to elsewhere in the North Atlantic, but preservation bias favors removal of species with idiosomic tests over those with xenosomic tests. The mixed high salt-marsh plant community in Newfoundland results in bulk surface-sediment δ 13 C values that are typical of C 3 plants, making them indistinguishable from freshwater sediment. Therefore we propose that the utility of this proxy for reconstructing RSL in eastern North America is restricted to the coastline between Chesapeake Bay and southern Nova Scotia. Using a simple, multi-proxy approach to establish that samples in three radiocarbon-dated sediment cores formed between the lowest occurrence of testate amoebae and the highest occurrence of foraminifera, we generated three example late Holocene sea-level index points at Hynes Brook.This work was supported by NSF awards OCE-1458921, OCE-1458904 and EAR-1402017 and the Robert L. Nichols student research fund of the Department of Earth and Ocean Sciences at Tufts University. Foraminiferal data from Hynes Brook and Big River were collected as part of a series of projects including “Ocean-climate variability and sea level in the North Atlantic region since AD 0” funded by the Dutch National Research Programme (NRP) on Global air pollution and Climate Change; “Coastal Records” funded by the Vrije Universiteit Amsterdam and “Simulations, Observations & Palaeoclimatic data: climate variability over the last 500 years” funded by the European Union

American power and identities in the age of Obama

Although the election of Barack Obama to the US presidency represents a landmark event in the history of that country, questions remain over its broader political significance. What is the likelihood of Obama's foreign and national security policies differing fundamentally from those of the Bush administrations Does Obama's election signal a post-racial phase in American national life What are the factors that suggest opportunities to change and expand American identities as opposed to those that limit Obama's sphere of action This article introduces the special issue and suggests that although Obama's room for manoeuvre is limited by legacies inherited from the Bush administration, Obama's own appointments to high office as well as other actions, despite the availability of alternative courses, indicate that he is not the transformational president he claimed to be. American identities, therefore, are deeply embedded and remain heavily imbued with racial, religious and imperial features