Medical Cost Associated with Prediabetes

Abstract In this article, we estimate national health care resource use and medical costs in 2007 associated with prediabetes (PD), defined as either fasting plasma glucose between 100 and 125 or oral glucose tolerance test between 140 and 200. We use Poisson regression with medical claims for an adult population continuously insured between 2004 and 2006 to analyze patterns of health care resource use by PD status. Combining rate ratios that reflect health care use patterns with national PD prevalence rates from the National Health and Nutrition Examination Survey, we calculate etiological fractions to estimate the portion of national health resource use associated with PD. The findings suggest that PD is associated with statistically higher rates of ambulatory visits for hypertension; endocrine, metabolic, and renal complications; and general medical conditions. PD is associated with a slight increase in visit rates for neurological symptoms, peripheral vascular disease, and cardiovascular disease, but the increase is not statistically significant. There is no indication that PD is associated with an increase in emergency visits and inpatient days. Extrapolating these patterns to the 57 million adults with PD in 2007 suggests that national annual medical costs of PD exceed $25 billion, or an additional$443 for each adult with PD. PD is associated with excessive use of ambulatory services for comorbidities known to be related to diabetes. Our findings strengthen the business case for lifestyle interventions to prevent diabetes by adding additional economic benefits that potentially can be achieved by preventing or delaying PD. (Population Health Management

Metaphors for the Nation: Conceptualization of Its BODY and/or PERSON

One of the key-complexes for conceptualizing national identity is that of the metaphor of the nation as a body or a person. Such nation-embodiment and -personalization have a long conceptual history in English-speaking cultures and still figure in present-day political discourse. However, do metaphor users from different cultures understand such metaphors in the same way as English-L1-speakers? Empirical evidence from an intercultural metaphor interpretation survey conducted in English-as-lingua franca provides evidence of variation in Nation-embodiment and-personalization on the reception-side. Five scenarios of interpretive conceptualization can be identified, which are variably distributed across different national/linguistic cohorts: nation as body, as geobody, as part of a larger body, as part of ego’s body and as a person. This chapter focuses on comparing such scenarios across the English-L1 and Chinese (Mandarin and Cantonese)-L1 cohorts. The results show differences in scenario distribution, as well as in the use of irony and humor and of topical references to socio-economic and political developments or national stereotypes. In conclusion, we discuss how these differences are related to culture-specific discourse traditions

Recql5 Plays an Important Role in DNA Replication and Cell Survival after Camptothecin Treatment

Disruption of replication can lead to loss of genome integrity and increase of cancer susceptibility in mammals. Thus, a replication impediment constitutes a formidable challenge to these organisms. Recent studies indicate that homologous recombination (HR) plays an important role in suppressing genome instability and promoting cell survival after exposure to various replication inhibitors, including a topoisomerase I inhibitor, camptothecin (CPT). Here, we report that the deletion of RecQ helicase Recql5 in mouse ES cells and embryonic fibroblast (MEF) cells resulted in a significant increase in CPT sensitivity and a profound reduction in DNA replication after the treatment with CPT, but not other DNA-damaging agents. This CPT-induced cell death is replication dependent and occurs primarily after the cells had exited the first cell cycle after CPT treatment. Furthermore, we show that Recql5 functions nonredundantly with Rad51, a key factor for HR to protect mouse ES cells from CPT-induced cytotoxicity. These new findings strongly suggest that Recql5 plays an important role in maintaining active DNA replication to prevent the collapse of replication forks and the accumulation of DSBs in order to preserve genome integrity and to prevent cell death after replication stress as a result of topoisomerase I poisoning