The current drug treatment landscape for diabetes and perspectives for the future

The escalating global epidemic of type 2 diabetes mellitus has focused attention on the devastating consequences of protracted hyperglycemia. Early and effective intervention to control blood glucose is a fundamental principle of treatment guidelines, requiring assiduous use of current therapies. However, many patients do not achieve or maintain glycemic targets, emphasizing the need for further therapies. This narrative review assesses the available medicinal options to address hyperglycemia and the opportunities to develop novel agents.

Plasma membrane abundance of human aquaporin 5 is dynamically regulated by multiple pathways

Aquaporin membrane protein channels mediate cellular water flow. Human aquaporin 5 (AQP5) is highly expressed in the respiratory system and secretory glands where it facilitates the osmotically-driven generation of pulmonary secretions, saliva, sweat and tears. Dysfunctional trafficking of AQP5 has been implicated in several human disease states, including Sjögren’s syndrome, bronchitis and cystic fibrosis. In order to investigate how the plasma membrane expression levels of AQP5 are regulated, we studied real-time translocation of GFP-tagged AQP5 in HEK293 cells. We show that AQP5 plasma membrane abundance in transfected HEK293 cells is rapidly and reversibly regulated by at least three independent mechanisms involving phosphorylation at Ser156, protein kinase A activity and extracellular tonicity. The crystal structure of a Ser156 phosphomimetic mutant indicates that its involvement in regulating AQP5 membrane abundance is not mediated by a conformational change of the carboxy-terminus. We suggest that together these pathways regulate cellular water flow.

Developmental dissociation of analytical and holistic object recognition in adolescence

Previous research (e.g., Jüttner et al, 2013, Developmental Psychology, 49, 161-176) has shown that object recognition may develop well into late childhood and adolescence. The present study extends that research and reveals novel di erences in holistic and analytic recognition performance in 7-11 year olds compared to that seen in adults. We interpret our data within Hummel’s hybrid model of object recognition (Hummel, 2001, Visual Cognition, 8, 489-517) that proposes two parallel routes for recognition (analytic vs. holistic) modulated by attention. Using a repetition-priming paradigm, we found in Experiment 1 that children showed no holistic priming, but only analytic priming. Given that holistic priming might be thought to be more ‘primitive’, we confirmed in Experiment 2 that our surprising finding was not because children’s analytic recognition was merely a result of name repetition. Our results suggest a developmental primacy of analytic object recognition. By contrast, holistic object recognition skills appear to emerge with a much more protracted trajectory extending into late adolescence

Developmental commonalities between object and face recognition in adolescence

In the visual perception literature, the recognition of faces has often been contrasted with that of non-face objects, in terms of differences with regard to the role of parts, part relations and holistic processing. However, recent evidence from developmental studies has begun to blur this sharp distinction. We review evidence for a protracted development of object recognition that is reminiscent of the well-documented slow maturation observed for faces. The prolonged development manifests itself in a retarded processing of metric part relations as opposed to that of individual parts and offers surprising parallels to developmental accounts of face recognition, even though the interpretation of the data is less clear with regard to holistic processing. We conclude that such results might indicate functional commonalities between the mechanisms underlying the recognition of faces and non-face objects, which are modulated by different task requirements in the two stimulus domains.

Mental health tribunals: a significant medico-legal change

After lengthy delays and protracted debates, the Mental Health Act 2001 was finally enacted and commencement of its substantive sections appears to be imminent. One crucial cornerstone of the new regime introduced by the Act will be automatic periodic reviews of patients' detentions by Mental Health Tribunals. This article will focus on the background to the new tribunal system, the statutory rules for its operation, and case law of relevance from Strasbourg and England.

The acquisition of abstract words by young infants.

Young infants' learning of words for abstract concepts like 'all gone' and 'eat,' in contrast to their learning of more concrete words like 'apple' and 'shoe,' may follow a relatively protracted developmental course. We examined whether infants know such abstract words. Parents named one of two events shown in side-by-side videos while their 6-16-month-old infants (n=98) watched. On average, infants successfully looked at the named video by 10 months, but not earlier, and infants' looking at the named referent increased robustly at around 14 months. Six-month-olds already understand concrete words in this task (Bergelson & Swingley, 2012). A video-corpus analysis of unscripted mother-infant interaction showed that mothers used the tested abstract words less often in the presence of their referent events than they used concrete words in the presence of their referent objects. We suggest that referential uncertainty in abstract words' teaching conditions may explain the later acquisition of abstract than concrete words, and we discuss the possible role of changes in social-cognitive abilities over the 6-14 month period.

A 3.6 Ma sedimentological, geochemical and palynological record of sediment core ICDP5011-1 in Lake Elgygytgyn, NE Russia

Understanding the evolution of Arctic polar climate from the protracted warmth of the middle Pliocene into the earliest glacial cycles in the Northern Hemisphere has been hindered by the lack of continuous, highly resolved Arctic time series. Evidence from Lake El'gygytgyn, NE Arctic Russia, shows that 3.6-3.4 million years ago, summer temperatures were ~8°C warmer than today when pCO2 was ~400 ppm. Multiproxy evidence suggests extreme warmth and polar amplification during the middle Pliocene, sudden stepped cooling events during the Pliocene-Pleistocene transition, and warmer than present Arctic summers until ~2.2 Ma, after the onset of Northern Hemispheric glaciation. Our data are consistent with sea-level records and other proxies indicating that Arctic cooling was insufficient to support large-scale ice sheets until the early Pleistocene.

Disorder and disconnection: parent experiences of liminality when caring for a dying child

Parents caring for a child with a life threatening or life limiting illness experience a protracted and largely unknown journey, as they and their child oscillate somewhere between life and death. Using an interpretive qualitative approach, interviews were conducted with parents (n = 25) of children who had died. Findings reveal parents’ experiences to be characterised by personal disorder and transformation as well as social marginalisation and disconnection. As such they confirm the validity of understanding these experiences as, fundamentally, one of liminality, in terms of both individual and collective response. In dissecting two inter-related dimensions of liminality, an underlying tension between how transition is subjectively experienced and how it is socially regulated is exposed. In particular, a structural failure to recognise the chronic nature of felt liminality can impede parents’ effective transition.

Desire and Divorce in Serglige Con Culainn

This paper examines the expression of ideas about love, marriage and divorce in Serglige Con Culainn. It is argued that the two versions of the tale, both of which are incomplete, exhibit distinctive approaches to love and the portrayal of the female characters. The earlier recension depicts male desire as a violent attack by Otherworld women that renders the man incapacitated. The later version provides a radically different view, offering a strikingly sympathetic portrait of the two female protagonists which may suggest a female audience. This version gives a remarkable insight into sexual mores and marital breakdown in a protracted and detailed negotiation involving the three main characters. It reveals tensions between male and female views of marriage and particularly of the practice of concubinage. It values loyalty between married partners over the fulfilment of desire and demonstrates the enduring and destructive effects of passion which are healed here only through magical interventions.

Revisiting Politicide: State Annihilation in Israel/Palestine

State annihilation is a persistent concern in Israel/Palestine. While the specter of Israel’s destruction increasingly haunts Israeli public political debates, the actual materialization of Palestinian statehood seems to be permanently suspended, caught in an ever-protracted process of state-building. The current paper claims that to understand the unfolding of the discursive formations, as well as the spatial dimensions of conflict and control in Israel/Palestine, we should explicate the workings of the processes of politicide. Politicide, in this regard, denotes the eradication of the political existence of a group and sabotaging the turning of a community of people into a polity. This analysis suggests that the insistence that the State of Israel is under threat of extinction should be understood as a speech act, a performative reiteration, which allows for the securitization of Israeli rule in the occupied Palestinian territory, a securitization which then serves to rationalize the ongoing concrete politicide of the Palestinians. Elaborating on the concept of politicide, and diverging from defining it solely through the use of brute violence, this examination suggests that what is often overlooked in discussions of politicide are the seemingly more benign means of its implementation, the micro-power mechanisms of spatial control, prohibitions and regulations.

HSP70 abundance and antioxidant capacity in feeding and fasting gray seal pups: suckling is associated with higher levels of key cellular defenses

Heat shock proteins (HSPs) and antioxidants are key cellular defenses against stress. Seals routinely undergo protracted fasting, which is normally associated with physiological stress in other animals. We tested the hypotheses that (1) relative HSP70 protein abundance is higher in liver and blubber of fasting relative to suckling wild gray seal pups; (2) differences in HSP70 are mirrored in tissue superoxide dismutase (SOD) and catalase activity, as well as glutathione levels; (3) extracellular HSP70 correlates with hepatic and blubber HSP70 abundance; and (4) protein carbonylation, an index of oxidative damage, is lower in tissues with higher levels of these cellular stress markers. In contrast to our expectation, suckling pups had higher relative HSP70 abundance and glutathione levels in liver and blubber and higher hepatic catalase activity. Plasma HSP70 did not correlate with liver or blubber abundance of the protein. Suckling pups did not experience greater protein carbonylation, suggesting that cellular protective mechanisms prevent protein damage despite an apparent increase in cellular stress. SOD activity was not affected by nutritional state, but in blubber tissue, it was positively correlated with blubber thickness. Greater requirements for antioxidants and HSPs in suckling pups or in animals with thicker blubber could arise from rapid protein synthesis, high metabolic fuel availability, and/or exposure to lipophilic toxins. Developmental and nutritional changes in cellular defenses have important implications for gray seals’ susceptibility to additional stress exposure.

A longitudinal qualitative exploration of healthcare and informal support needs among survivors of critical illness: the RELINQUISH protocol.

Introduction and background: Survival following critical illness is associated with a significant burden of physical, emotional and psychosocial morbidity. Recovery can be protracted and incomplete, with important and sustained effects upon everyday life, including family life, social participation and return to work. In stark contrast with other critically ill patient groups (eg, those following cardiothoracic surgery), there are comparatively few interventional studies of rehabilitation among the general intensive care unit patient population. This paper outlines the protocol for a sub study of the RECOVER study: a randomised controlled trial evaluating a complex intervention of enhanced ward-based rehabilitation for patients following discharge from intensive care. Methods and analysis: The RELINQUISH study is a nested longitudinal, qualitative study of family support and perceived healthcare needs among RECOVER participants at key stages of the recovery process and at up to 1 year following hospital discharge. Its central premise is that recovery is a dynamic process wherein patients’ needs evolve over time. RELINQUISH is novel in that we will incorporate two parallel strategies into our data analysis: (1) a pragmatic health services-oriented approach, using an a priori analytical construct, the ‘Timing it Right’ framework and (2) a constructivist grounded theory approach which allows the emergence of new themes and theoretical understandings from the data. We will subsequently use Qualitative Health Needs Assessment methodology to inform the development of timely and responsive healthcare interventions throughout the recovery process. Ethics and dissemination: The protocol has been approved by the Lothian Research Ethics Committee (protocol number HSRU011). The study has been added to the UK Clinical Research Network Database (study ID. 9986). The authors will disseminate the findings in peer reviewed publications and to relevant critical care stakeholder groups.

Variation of cutting rooting ability in cultivated and wild species of Macadamia

In Australia, macadamia trees are commonly propagated by germinating rootstock seed and grafting when seedlings reach a suitable size. The production of grafted trees is a protracted and complex process, however, propagation of macadamia via cuttings represents a simpler and faster method of multiplication. Macadamias have traditionally proven difficult to propagate from cuttings, and while recent developments in the process have improved success rates, substantial variation in rooting ability between cultivars and species has been reported. The cultivar 'Beaumont' (Macadamia integrifolia × M. tetraphylla) is commonly propagated by cutting for use as a rootstock, and is relatively easy to strike while other cultivars are more difficult. There is speculation that Hawaiian cultivars are more difficult to strike from cuttings than Australian cultivars due to species and genetic composition. In this experiment, cuttings of 32 genotypes were evaluated for rooting ability. Each genotype's species profile was estimated using historical data, and used to determine species effects on survival (percentage) and rooting ability (rating 0-2). M. jansenii (100%), M. tetraphylla (84%) and M. integrifolia/tetraphylla hybrids (79%) had the highest success rates while M. integrifolia (54%) and M. ternifolia (43%) had the lowest survival. Rooting ability of M. jansenii (1.75) was significantly higher than M. ternifolia (0.49) but not significantly higher than M. tetraphylla × M. integrifolia with (1.09), M. tetraphylla (1.03) or M. integrifolia (0.88).

Assessing nut germination protocols for macadamia cultivar 'Beaumont'

A rapid rate and high percentage of macadamia nut germination, together with production of vigorous seedlings, are required by nurseries and breeding programs. Germination of nuts is typically protracted, however, and rarely reaches 100%. Many studies have been conducted into macadamia germination, but most have assessed percent germination only. This study investigated the effects of various treatments on percent germination, germination rate, and plant, shoot and root dry weights. The treatments tested were combinations of: (i) soaking or not soaking seeds in a dilute fungicide solution prior to planting; (ii) four different planting media; and (iii) leaving seed trays open or placing them inside clear plastic bags. For freshly harvested nuts, sowing in potting mix under clear plastic and without soaking produced the highest percent germination and germination rate, the largest shoots, and longest lateral roots.

Chronic respiratory diseases and quality of life in elderly nursing home residents

Few studies have assessed the quality of life (QOL) related to chronic respiratory diseases in the elderly. In the framework of the geriatric study on the health effects of air quality in elderly care centers (GERIA) study, a questionnaire was completed by elderly subjects from 53 selected nursing homes. It included various sections in order to assess respiratory complaints, QOL (World Health Organization QOL (WHOQOL)-BREF), and the cognitive and depression status. The outcome variables were the presence of a score lower than 50 (<50) in each of the WHOQOL-BREF domains (physical health, psychological health, social relationships, and environmental health). Chronic bronchitis, frequent cough, current wheezing, asthma, and allergic rhinitis were considered as potential risk factors. The surveyed sample was (n = 887) 79% female, with a mean age of 84 years (SD: 7 years). In the multivariable analysis, a score of <50 in the physical domain was associated with wheezing in the previous 12 months (odds ratio (OR): 2.03, confidence interval (CI): 1.25-3.31) and asthma (OR: 1.95, CI: 1.12-3.38). The psychological domain was related with a frequent cough (OR: 1.43, CI: 0.95-2.91). A score of <50 in the environmental domain was associated with chronic bronchitis (OR: 2.89, CI: 1.34-6.23) and emphysema (OR: 3.89, CI: 1.27-11.88). In view of these findings, the presence of respiratory diseases seems to be an important risk factor for a low QOL among elderly nursing home residents.