Mortality of South Asian patients with insulin-treated diabetes mellitus in the United Kingdom: a cohort study

Aims To investigate mortality in South Asian patients with insulin-treated diabetes and compare it with mortality in non South Asian patients and in the general population.

Racism and young girls' peer group relations: the experiences of South Asian girls

This article draws upon data from an indepth ethnographic study of five- and six-year-old children in an English multi-ethnic, inner city primary school. It focuses on the significance of ‘race’ within young girls’ peer group relations and the ways in which the social dynamics that underlie those relations provide the context for understanding the particular nature and form that racism takes among the girls. This is done through a focus on the experiences of South Asian girls within the group. Within this, the article has two main aims. First, it aims to contribute to the literature within the sociology of education by extending the existing research focus on racism within teacher/pupil interactions to include an understanding of racism as it manifests itself among the children’s peer-group relations. Second, in adapting and applying Pierre Boudieu’s concepts of capital and field, the article also offers a contribution to the literature within the sociology of ‘race’ and ethnicity by suggesting one potentially fruitful way in which racism can be understood within specific social contexts.

Sphingosine Kinase 1 Promotes Malignant Progression in Colon Cancer and Independently Predicts Survival of Patients With Colon Cancer by Competing Risk Approach in South Asian Population

OBJECTIVES: Sphingosine kinase 1 (SphK1) phosphorylates the membrane sphingolipid, sphingosine, to sphingosine-1-phosphate (S1P), an oncogenic mediator, which drives tumor cell growth and survival. Although SphK1 has gained increasing prominence as an oncogenic determinant in several cancers, its potential as a therapeutic target in colon cancer remains uncertain. We investigated the clinical relevance of SphK1 expression in colon cancer as well as its inhibitory effects in vitro.

METHODS: SphK1 expression in human colon tumor tissues was determined by immunohistochemistry and its clinicopathological significance was ascertained in 303 colon cancer cases. The effects of SphK1 inhibition on colon cancer cell viability and the phosphoinositide 3-kinase (PI3K)/Akt cell survival pathway were investigated using a SphK1-selective inhibitor-compound 5c (5c). The cytotoxicity of a novel combination using SphK1 inhibition with the chemotherapeutic drug, 5-fluorouracil (5-FU), was also determined.

RESULTS: High SphK1 expression correlated with advanced tumor stages (AJCC classification). Using a competing risk analysis model to take into account disease recurrence, we found that SphK1 is a significant independent predictor for mortality in colon cancer patients. In vitro, the inhibition of SphK1 induced cell death in colon cancer cell lines and attenuated the serum-dependent PI3K/Akt signaling. Inhibition of SphK1 also enhanced the sensitivity of colon cancer cells to 5-FU.

CONCLUSION: Our findings highlight the impact of SphK1 in colon cancer progression and patient survival, and provide evidence supportive of further development in combination strategies that incorporate SphK1 inhibition with current chemotherapeutic agents to improve colon cancer outcomes.

'When I Land in Islamabad I Feel Home and When I Land in Heathrow I Feel Home': Gendered Belonging and Diasporic Identities of South Asian British Citizens in London, in Leicester and in North England

According to Deleuze and Guattari (1987) ‘de-territorialization’ is followed by a moment of re-territorialization. This moment, however, has to be regarded as a continuing educational process that becomes a different spatial site of social practices. It is argued in this chapter that regional, local as well as global identification override national and mono-ethno cultural identities, while shaping particular notions of gendered belonging and creating specific diasporic practices. Based on a sample of interviews with professional and academic South Asian British citizens in London, in Leicester, and in a number of Northern English cities gendered and generational patterns in terms of local diasporic identities are explored. Apart from multiple cultural belonging, foremost, territorial bonds and notions of group loyalty collapse at a point where temporary migration and settlement alternate in individual biographies.

South Asian Women's Identities: A Media and Personal Narrative Analysis

This study examines issues of racism and sexism through the lens of Critical Race Theory and the interaction of personal and composite narratives. Specifically, the study explores how mainstream media’s hegemonic portrayal of South Asian culture and the 2007 socalled honour killing of Aqsa Parvez contribute to post-9/11 Islamophobia. The researcher presents a personal narrative that draws upon her experiences growing up in Dubai, U.A.E., and in Ontario, Canada and critically analyzes majoritarian stories related to Parvez as well as “counter-perspectives” that challenge such views. Study findings highlight the impact of 9/11 and Parvez’s murder on the researcher’s identity formation, and how media portray Muslim women as oppressed beings who live under the yoke of patriarchy. Results also indicate that although certain articles offer a counter-perspective that challenge dominant narratives, most recent media representations of the Parvez story equate Islam with honour killings and thus foster continued Islamophobia.

How does a weakened Atlantic thermohaline circulation lead to an intensification of the ENSO-south Asian summer monsoon interaction?

This study investigates the change of the El Niño–Southern Oscillation (ENSO)-South Asian summer monsoon interaction in response to a weakened Atlantic thermohaline circulation (THC) by applying an additional freshwater flux into the North Atlantic. The simulated results indicate that the weakened THC leads to intensified ENSO-South Asian summer monsoon relationship and enhanced South Asian summer monsoon interannual variability. Furthermore, it is suggested that this intensification of the ENSO-monsoon relationship is likely due to the enhanced ENSO variability induced by the weakened THC. This study indicates that the low frequency fluctuation of Atlantic SSTs might have an influence on South Asian summer monsoon interannual variability and the ENSO-monsoon interaction, and suggests a nonlocal mechanism for the observed decadal-multidecadal modulation of ENSO-monsoon relationship.

Are definitions of adiposity appropriate for identification of cardiovascular disease risk in South Asian populations?

South Asian populations living in the UK have a high prevalence of the metabolic syndrome, cardiovascular disease (CVD) and type 2 diabetes which impacts greatly on the morbidity and mortality of this ethnic group. The identification of ‘at risk’ individuals is essential to initiate reventative treatment. However, this is considerably hindered by the lack of appropriate cut-off values for anthropometric measures. CVD risk is significantly higher at a lower body mass index (BMI) in many Asian groups compared with Caucasians and adiposity (particularly central deposition) is higher at similar BMI levels. The definition of adiposity in Asians needs to be firmly established and appropriate lower BMI and waist circumference cut-offs implemented in ethnic subpopulations to facilitate appropriate treatment strategies.

The effect of Arabian Sea optical properties on SST biases and the South Asian summer monsoon in a coupled GCM

This study examines the effect of seasonally varying chlorophyll on the climate of the Arabian Sea and South Asian monsoon. The effect of such seasonality on the radiative properties of the upper ocean is often a missing process in coupled general circulation models and its large amplitude in the region makes it a pertinent choice for study to determine any impact on systematic biases in the mean and seasonality of the Arabian Sea. In this study we examine the effects of incorporating a seasonal cycle in chlorophyll due to phytoplankton blooms in the UK Met Office coupled atmosphere-ocean GCM HadCM3. This is achieved by performing experiments in which the optical properties of water in the Arabian Sea - a key signal of the semi-annual cycle of phytoplankton blooms in the region - are calculated from a chlorophyll climatology derived from Sea-viewing Wide Field-of-View Sensor (SeaWiFS) data. The SeaWiFS chlorophyll is prescribed in annual mean and seasonally-varying experiments. In response to the chlorophyll bloom in late spring, biases in mixed layer depth are reduced by up to 50% and the surface is warmed, leading to increases in monsoon rainfall during the onset period. However when the monsoons are fully established in boreal winter and summer and there are strong surface winds and a deep mixed layer, biases in the mixed layer depth are reduced but the surface undergoes cooling. The seasonality of the response of SST to chlorophyll is found to depend on the relative depth of the mixed layer to that of the anomalous penetration depth of solar fluxes. Thus the inclusion of the effects of chlorophyll on radiative properties of the upper ocean acts to reduce biases in mixed layer depth and increase seasonality in SST.

Will the South Asian monsoon overturning circulation stabilize any further?

Understanding the response of the South Asian monsoon (SAM) system to global climate change is an interesting scientific problem that has enormous implications from the societal viewpoint. While the CMIP3 projections of future changes in monsoon precipitation used in the IPCC AR4 show major uncertainties, there is a growing recognition that the rapid increase of moisture in a warming climate can potentially enhance the stability of the large-scale tropical circulations. In this work, the authors have examined the stability of the SAM circulation based on diagnostic analysis of climate datasets over the past half century; and addressed the issue of likely future changes in the SAM in response to global warming using simulations from an ultrahigh resolution (20 km) global climate model. Additional sensitivity experiments using a simplified atmospheric model have been presented to supplement the overall findings. The results here suggest that the intensity of the boreal summer monsoon overturning circulation and the associated southwesterly monsoon flow have significantly weakened during the past 50-years. The weakening trend of the monsoon circulation is further corroborated by a significant decrease in the frequency of moderate-to-heavy monsoon rainfall days and upward vertical velocities particularly over the narrow mountain ranges of the Western Ghats. Based on simulations from the 20-km ultra high-resolution model, it is argued that a stabilization (weakening) of the summer monsoon Hadley-type circulation in response to global warming can potentially lead to a weakened large-scale monsoon flow thereby resulting in weaker vertical velocities and reduced orographic precipitation over the narrow Western Ghat mountains by the end of the twenty-first century. Supplementary experiments using a simplified atmospheric model indicate a high sensitivity of the large-scale monsoon circulation to atmospheric stability in comparison with the effects of condensational heating.

Ethnic differences in beta-cell function, dietary intake and expression of the metabolic syndrome among UK adults of south Asian, black African-Caribbean and white-European origin at high risk of metabolic syndrome

A cross-sectional analysis of ethnic differences in dietary intake, insulin sensitivity and beta-cell function, using the intravenous glucose tolerance test (IVGTT), was conducted on 497 healthy adult participants of the ‘Reading, Imperial, Surrey, Cambridge, and Kings’ (RISCK) study. Insulin sensitivity (Si) was significantly lower in African-Caribbean (AC) and South Asian (SA) participants [IVGTT-Si; AC: 2.13 vs SA: 2.25 vs white-European (WE): 2.84 (×10−4 mL µU min)2, p < 0.001]. AC participants had a higher prevalence of anti-hypertensive therapy (AC: 19.7% vs SA: 7.5%), the most cardioprotective lipid profile [total:high-density lipoprotein (HDL); AC: 3.52 vs SA: 4.08 vs WE: 3.83, p = 0.03] and more pronounced hyperinsulinaemia [IVGTT–acute insulin response (AIR)] [AC: 575 vs SA: 428 vs WE: 344 mL/µU/min)2, p = 0.002], specifically in female participants. Intake of saturated fat and carbohydrate was lower and higher in AC (10.9% and 50.4%) and SA (11.1% and 52.3%), respectively, compared to WE (13.6% and 43.8%, p < 0.001). Insulin resistance in ACs is characterised by ‘normal’ lipid profiles but high rates of hypertension and pronounced hyperinsulinaemia.

Role of genetic polymorphism peroxisome proliferator-activated receptor-gamma2 Pro12Ala on ethnic susceptibility to diabetes in South-Asian and Caucasian subjects: Evidence for heterogeneity

OBJECTIVE: To determine whether the peroxisome proliferator-activated receptor (PPAR)-gamma Pro12ala polymorphism modulates susceptibility to diabetes in South Asians. RESEARCH DESIGN AND METHODS: South Asians (n = 697) and Caucasians (n = 457) living in Dallas/Forth Worth, Texas, and South Asians living in Chennai, India (n = 1,619), were enrolled for this study. PPAR-gamma Pro12Ala was determined using restriction fragment-length polymorphism. Insulin responsiveness to an oral glucose tolerance test (OGTT) was measured in nondiabetic subjects. RESULTS: The Caucasian diabetic subjects had significantly lower prevalence of PPAR-gamma 12Ala when compared with the Caucasian nondiabetic subjects (20 vs. 9%, P = 0.006). However, there were no significant differences between diabetic and nondiabetic subjects with reference to the Pro12Ala polymorphism among the South Asians living in Dallas (20 vs. 23%) and in India (19 vs. 19.3%). Although Caucasians carrying PPAR-gamma Pro12Ala had lower plasma insulin levels at 2 h of OGTT than the wild-type (Pro/Pro) carriers (76 +/- 68 and 54 +/- 33 microU/ml, respectively, P = 0.01), no differences in either fasting or 2-h plasma insulin concentrations were found between South Asians carrying the PPAR-gamma Pro12Ala polymorphism and those with the wild-type genotype at either Chennai or Dallas. CONCLUSIONS: Although further replication studies are necessary to test the validity of the described genotype-phenotype relationship, our study supports the hypothesis that the PPAR-gamma Pro12Ala polymorphism is protective against diabetes in Caucasians but not in South Asians.

Impacts of 20th century aerosol emissions on the South Asian monsoon in the CMIP5 models

Comparison of single-forcing varieties of 20th century historical experiments in a subset of models from the Fifth Coupled Model Intercomparison Project (CMIP5) reveals that South Asian summer monsoon rainfall increases towards the present day in Greenhouse Gas (GHG)-only experiments with respect to pre-industrial levels, while it decreases in anthropogenic aerosol-only experiments. Comparison of these single-forcing experiments with the all-forcings historical experiment suggests aerosol emissions have dominated South Asian monsoon rainfall trends in recent decades, especially during the 1950s to 1970s. The variations in South Asian monsoon rainfall in these experiments follows approximately the time evolution of inter-hemispheric temperature gradient over the same period, suggesting a contribution from the large-scale background state relating to the asymmetric distribution of aerosol emissions about the equator. By examining the 24 available all-forcings historical experiments, we show that models including aerosol indirect effects dominate the negative rainfall trend. Indeed, models including only the direct radiative effect of aerosol show an increase in monsoon rainfall, consistent with the dominance of increasing greenhouse gas emissions and planetary warming on monsoon rainfall in those models. For South Asia, reduced rainfall in the models with indirect effects is related to decreased evaporation at the land surface rather than from anomalies in horizontal moisture flux, suggesting the impact of indirect effects on local aerosol emissions. This is confirmed by examination of aerosol loading and cloud droplet number trends over the South Asia region. Thus, while remote aerosols and their asymmetric distribution about the equator play a role in setting the inter-hemispheric temperature distribution on which the South Asian monsoon, as one of the global monsoons, operates, the addition of indirect aerosol effects acting on very local aerosol emissions also plays a role in declining monsoon rainfall. The disparity between the response of monsoon rainfall to increasing aerosol emissions in models containing direct aerosol effects only and those also containing indirect effects needs to be urgently investigated since the suggested future decline in Asian anthropogenic aerosol emissions inherent to the representative concentration pathways (RCPs) used for future climate projection may turn out to be optimistic. In addition, both groups of models show declining rainfall over China, also relating to local aerosol mechanisms. We hypothesize that aerosol emissions over China are large enough, in the CMIP5 models, to cause declining monsoon rainfall even in the absence of indirect aerosol effects. The same is not true for India.

The resolution sensitivity of the South Asian monsoon and Indo-Pacific in a global 0.35◦ AGCM

The South Asian monsoon is one of the most significant manifestations of the seasonal cycle. It directly impacts nearly one third of the world’s population and also has substantial global influence. Using 27-year integrations of a high-resolution atmospheric general circulation model (Met Office Unified Model), we study changes in South Asian monsoon precipitation and circulation when horizontal resolution is increased from approximately 200 to 40 km at the equator (N96 to N512, 1.9 to 0.35◦). The high resolution, integration length and ensemble size of the dataset make this the most extensive dataset used to evaluate the resolution sensitivity of the South Asian monsoon to date. We find a consistent pattern of JJAS precipitation and circulation changes as resolution increases, which include a slight increase in precipitation over peninsular India, changes in Indian and Indochinese orographic rain bands, increasing wind speeds in the Somali Jet, increasing precipitation over the Maritime Continent islands and decreasing precipitation over the northern Maritime Continent seas. To diagnose which resolution related processes cause these changes we compare them to published sensitivity experiments that change regional orography and coastlines. Our analysis indicates that improved resolution of the East African Highlands results in the improved representation of the Somali Jet and further suggests that improved resolution of orography over Indochina and the Maritime Continent results in more precipitation over the Maritime Continent islands at the expense of reduced precipitation further north. We also evaluate the resolution sensitivity of monsoon depressions and lows, which contribute more precipitation over northeast India at higher resolution. We conclude that while increasing resolution at these scales does not solve the many monsoon biases that exist in GCMs, it has a number of small, beneficial impacts.