Search

Revisiting, from a Marxist perspective, the World Bank's discourse on Social Funds, we highlight three findings. One, Social Funds gets deployed in the context of a larger Third Worldist discourse of poverty management, which in turn helps deepen the logic of capitalist development. Two, generating a class-focused understanding of Social Funds (via the concept of social surplus), we argue that class processes and need processes constitute one another and through this conduit emerges a relation between global capital and the poverty alleviation programme of Social Funds. Lastly, interrogating the management approach underlying Social Funds leads us to question claims of decentralisation and participation. Our analysis exposes an underlying process of subjectification by way of a control mechanism exercised through the code of conduct encapsulated in that managerial approach. Copyright , Oxford University Press.

The MIC 90 of RBx 14255, a novel ketolide, against Clostridium difficile was 4 μg/ml (MIC range, 0.125 to 8 μg/ml), and this drug was found to be more potent than comparator drugs. An in vitro time-kill kinetics study of RBx 14255 showed time-dependent bacterial killing for C. difficile . Furthermore, in the hamster model of C. difficile infection, RBx 14255 demonstrated greater efficacy than metronidazole and vancomycin, making it a promising candidate for C. difficile treatment.

A simple and efficient access to highly functionalized isoindolone derivatives via a [3+2] cycloaddition process between in situ generated azomethine ylides with various stable (isolable) masked o-benzoquinones is described. This approach allows a rapid and general synthesis of isoindolones with substituents to further manipulate and elaborate the structural complexity.

Faced with the assault of neoliberal globalization and internecine struggle, the Indian communist movement is shown to be facing a series of inherent contradictions and an identity crisis that has dented its influence and stifled its growth. Maoism and mainstream communist trends functioning with different goals and strategies exhibit a common commitment to state-centric politics and a vanguardist party structure that comes at the expense of advancing the Marxian project of nonexploitation, fair distribution, and democracy.

This paper examines nationalism as the ‘modern idea of a collective’ or the ‘ideal of a modern collective’ that struts out universally and that ceaselessly tightens its footwear in the face of recalcitrant gravels, gravels that are representative of either extant or possible ideas of alternative collectivity. Against this background, we show how a new nationalism in India encapsulated by the economic Utopia of ‘inclusive development’ is emerging in the contemporary landscape of global capitalism under neoliberal conditions. This Utopia is shown to be marked by a fundamental split that helps secure and facilitate the reorganization of India's national cartography into the ‘expanding circuits of global capital’ and its constitutive outside: ‘world of the third’. Highlighted are the encounters with flashpoints of conflict emanating from nationalism's intricate encounter with the contemporary ‘gravel in the shoe’: world of the third.

2-Chloropyridines and an aryl bromide underwent palladium-catalyzed intramolecular C–O bond forming reactions to provide 2,3-dihydrospiro[1,4]dioxino[2,3-b]pyridine derivatives and a benzodioxin, regioselectively.

Using class-focused Marxist theory we examine the received category of the informal sector in order to demonstrate two results. First, we explicate the process of ‘making’ the informal sector in terms of the formal sector. Derived from a centrist logic that shapes the mainstream development paradigm, this involves a process of its devaluation in terms of the norm of the formal sector. Moreover, attempts to introduce heterogeneity within an already homogeneously defined informal sector are shown to be failing. Second, we show how placing the concept of the informal sector within the non-centric class-focused economic terrain fundamentally displaces, indeed ‘unmakes’, the received definition of the informal sector. Our analytical frame of a non-centric class-focused economic terrain reveals, on one hand, how the ‘making’ of the informal sector serves as a political rationale for shaping societal transition in favor of modern capitalism, and on the other, the problematical nature of the rationality.

Banking sector loans are the principal source of capital for small and medium business ventures in India, comprising firms that are not large enough to be registered with stock exchanges. Non-performing assets (NPAs) are an important measure of the success of these businesses, as well as of their levels of discretion in carrying out their commercial activities conditional on their role in developing India's entrepreneurship outside the stock markets. In this article we analyze certain properties of NPAs in Indian Banks over the 1990s, when liberalization was introduced by opening up a significant portion of the public sector, allowing private banks to do business. We arrive at three conclusions for emerging India's banking sector. First, NPAs (as a ratio of loans and advances) are significantly sticky over time. Second, larger NPAs are associated with larger advances and vice-versa. Third, NPAs do not seem to have spiraled out of control over the 1990s. A simple cointegration test is carried out and a set of dynamic graphs, using notions of ‘fibration’, is presented to support the results.

Marxism and poverty have always lived a contradictory existence, especially in the global South. While socialism/communism's ethical imperative aspires to create a nonexploitative society, poverty eradication has been concerned with overcoming the material threat to people's livelihoods. An exploitation-free world does not necessarily mean the eradication of poverty, while the eradication of poverty does not automatically entail the erasure of exploitative relations. Struggles to eradicate poverty are distributional problems pertaining to the allotment of social surplus, which is also a class question since production surplus originates there. Correcting the injustice of poverty is not simply a distributional question, as most discourses on poverty tend to emphasize. Not only is it also a question of production, but it is very much a class question as well.

This paper rediscovers Rabindranath Tagore as delivering an innovative understanding of economy and a critique of the mainstream ideas of development and capitalism. Demonstrating that capitalism appears through the logic of development, his intervention finds fault with individualism, income fetishism, progress, capitalist ideological apparatuses, and bourgeois subjectivity. In contrast, he lays down an alternative idea(l) of ethical economy founded on the template of cooperation. Tagore's ethical economy is read as pointing toward a communist form of living that is holistic, balanced, and responsible.

Using a class focused Marxist approach, we elucidate the adopted position of Indian small-scale sector as a devalued other within the adopted development paradigm that accords primacy to Capital and West. In the background of this understanding of small-scale sector, we demonstrate how the New Economic Policy in the era of globalization could be theorized as a tool to obtain the (post) colonial hegemony of capital over the small-scale sector. Copyright The Author 2008. Published by Oxford University Press on behalf of the Cambridge Political Economy Society. All rights reserved., Oxford University Press.

We begin by thanking the reviewers for their thoughtful comments and critiques of our attempt to recast Marxist theories of transition and development. More broadly, we took on the rather ambitious...

In mainstream approaches, children’s labour is either to be banned or is not recognised. As a result, their association with the process of wealth creation and its distribution is occulted. In this paper, taking a classfocused Marxian approach, we question and critique the premise of this supposition on children's working world. As against the received rendition of children's working world, we offer an alternative method of locating and analysing the relation of children with the process of wealth creation and its distribution. Rehabilitating the children as an economic actor in the class-focused terrain opens up new avenues to ask and offer questions including policy-related ones that have hitherto been put aside from the discussion on children's working world.

India needs less Government and more Governance Narendra Modi, Prime Minister of India, 2014 Neo-liberalism, like ‘globalization’ in the early 1990s, is a term that has come to hog much of Indian intellectual space. The term however needs a much clearer positing. Moreover, the term needs to be understood in the context of its appearance and evolution in the Indian context; all the more, because ‘India’ is the window through which we are trying to understand contemporary (global) capitalism. In further examining the relation between neo-liberalism and globalization, we will forward ‘neo-liberal globalization’ (as against other forms of globalization), as one of the important axis of India's transitional logic. We have seen in Chapters 2 and 3 how the South is looked at through a dualistic framework (p, ∼p) with the destitute/devalued ‘third world’ represented by, first, traditional pre -capitalist agriculture (∼p) and modern capitalist industrial economy (p), and later on, additionally by in formal economy (∼p) and formal capitalist economy (p). Correspondingly, development came to be understood as a transition from an overwhelmingly pre-capitalist agrarian economy to a capitalist industrialized economy. Before the advent of the current phase of globalization, the adopted developmental strategy split typically, into ‘state planning’ and the ‘market route’; some countries even combined with whatever unease both state planning and market. In the course of their evolution, two further strategies (or strategic nodal points) became a matter of choice: imported substitution industrialization strategy or ISI (adopted by countries like India, Brazil and Mexico) and the export-led industrialization strategy or ELI (adopted by countries such as South Korea, Taiwan, Hong Kong and Singapore). In India's context, state sponsored planning (within a market economy) combined with ISI gave form to the strategy of facilitating the transition towards industrial capitalism. The ‘choice’ between planning and market, and that between ISI and ELI has become irrelevant since the advent of globalization and the end of the cold war; this is what has changed ; the choice between these have now become redundant. Given the reconfigured setting that took shape with the advent of the new economic policies (also known as liberalization policies), a new strategy has evolved to transit towards a modification of the capitalist economy.

Taking the period following the advent of liberalization, this book explains the transition of the Indian economy against the backdrop of development. If the objective is to explore the new economic map of India, then the distinct contributions in the book could be seen as twofold. The first is the analytical frame whereby the authors deploy a unique Marxist approach consisting of the initial concepts of class process and the developing countries to address India's economic transition. The second contribution is substantive whereby the authors describe India's economic transition as epochal, materializing out of the new emergent triad of neo-liberal globalization, global capitalism and inclusive development. This is how the book theorizes the structural transformation of the Indian economy in the twenty-first century. Through this framework, it interrogates and critiques the given debates, ideas and policies about the economic development of a developing nation.

Promoting social inclusion is an important objective of the World Bank. While the social, cultural, and political determinants of social inclusion may be beyond the scope of social risk management, it is essential to recognise the causes and consequences of social exclusion and to design strategies that address these issues. World Bank, 2001: 11 Exclusion and inclusion are perhaps two concepts most in vogue presently, certainly in development and especially in the context of India. In fact, the concepts of exclusion and inclusion are being deployed to redefine in turn the concept development, and in the process form an axis in the transition path of India. This will form the backdrop to the interrogation of ‘inclusive development/growth’ in Chapter 8. Our examination concerns interrogating exclusion and inclusion in relation to the concept development, and demonstrates how the three come to intersect and reinforce one another. Exclusion and inclusion are intimately connected to the way the idea of the other/Other has taken shape. At a somewhat preliminary level, the ‘small other’ is that which is included in discourse; it is inclusion in terms of the logic-language-ethos of the Self that makes it ‘small other’; while the ‘big Other’, one could call it the Levinasian Other, is that which exceeds inclusion in discourse. At another level, the former is the citation of the Self, the latter is not; the former is assimilated in the discourse of the Self, the latter is that which remains inassimilable, which limits assimilation; more on this as we go along. Preliminarily, let us denote third world as the ‘small other’ and world of the third as the ‘big Other’. Specifically, one could say development fundamentally works over (not with ) the other/Other where the other/Other is modelled into various kinds of developmental configurations, inclusion and exclusion being one. However, the concepts of exclusion and inclusion, at least in development literature, seem to rely on some simple, at times naive conception of the other. The domination of the idea of empirical exclusion in institutionalized literature (such as the World Bank) sets the terms of locating, marking and including the excluded; the ‘excluded other’ is as if just ‘out there’ (it is a list, changing with time but a list nevertheless), and so, include ‘it’.

Women with systemic lupus erythematosus (SLE) are at risk for premature atherothrombosis independent of Framingham risk factors. We investigated whether endothelial cell (EC) apoptosis predicts abnormal vasomotor tone and contributes to circulating tissue factor (TF) levels in this disease. Brachial artery flow-mediated dilation (FMD) and nitroglycerin-mediated dilation were determined in women with SLE, healthy control subjects, and subjects with coronary artery disease (CAD) (n = 43/group). Quantification of circulating apoptotic ECs was performed by flow cytometry (CD146+ cells that stained for Annexin V [CD146AnnV+]) and immunofluorescent microscopy. Plasma TF was measured by enzyme-linked immunosorbent assay (ELISA). Compared with healthy control and CAD subjects, patients with SLE had higher numbers of circulating CD146AnnV+ cells (10 ± 3, 18 ± 5, and 89 ± 32 cells/mL, respectively, mean ± SEM; P < .01). Increased CD146AnnV+ cells correlated strongly with abnormal vascular function (P = .037). After adjusting for known predictors of endothelial function, CD146AnnV+ was the only variable that predicted FMD (β = –4.5, P < .001). Increased CD146AnnV+ was strongly associated with elevated levels of circulating TF (r = .46, P = .002). Circulating apoptotic ECs are elevated in young women with SLE and strongly correlate with markedly abnormal vascular function and elevated TF levels. Heightened endothelial apoptosis may represent an important mechanism for development of atherothrombosis in SLE.

The products of nitric oxide synthase (NOS) and angiotensin-converting enzyme (ACE) play a critical role in determining vessel wall structure and function. Polymorphisms in both genes have been independently demonstrated to influence propensity to cardiovascular events. The purpose of this study was to determine the influence of the homozygous G849T(Glu298 Asp) polymorphism in NOS III on peripheral conduit artery endothelial function and to elucidate the modifier role, if any, of a common ACE polymorphism. Three hundred and ninety-seven consecutive subjects presenting to the cardiac catheterization laboratory of the University of Michigan over a period of 18 months were recruited. DNA was extracted and polymerase chain reaction (PCR) analysis for ACE and NOS polymorphisms performed. Patients with homozygosity for G849T at both loci (TT) who belong to DD and II ACE genotype (groups 1 and 2) and those who are negative for this polymorphism (GG) and belong to either DD or II genotype (groups 3 and 4) were identified. The four groups then underwent determination of conduit endothelial function. Heterozygosity of Glu298-Asp or the ID variant of the ACE were not studied. Median FMD value in the TT-DD group was 0.20 (-3.17, 2.01) compared with 2.23% (-0.29, 4.17) in the GG-II group. Median values in the TT-II and the GG-DD groups were 3.04 (-1.16, 6.61) and 2.46% (-1.83, 6.52) respectively. These values were not statistically significant (p > 0.05 by one-way ANOVA). Median nitroglycerin-mediated dilation in the four groups did not differ between the four groups (p = NS by ANOVA). Atherosclerosis burdens as assessed by angiography were not different across the groups. In conclusion, the homozygous NOS III variant (GG) status does not seem to interact additively with the ACE homozygous DD genotype in determining flow-mediated vasodilation in individuals with established atherosclerosis and pre-existent endothelial dysfunction.

Synthesis and application of the cyclopropane incorporated sugar intermediate in the stereoselective synthesis of C7-C16 segment of lasonolide A is described.

This paper makes two related contributions. First, the dual economic structure underlying development is shown as producing a distinct conception of other comprising of a devalued third world which is foregrounded and world of the third which is excluded. This dyad of inclusion-exclusion of other is produced in relation to the centers of capitalism and modernism. The category of third world helps to displace the language-experience-logic-ethos of the other a la world of the third such that development works over and transforms world of the third, but via the trope of a devalued third world. We then use this framework to explore the relation of global capitalism with world of the third in the Indian context, a relation that is shown to be two fold. There is on one hand an attempt to dismantle world of the third as part of the development trope of overcoming the third world. On the other, through inclusive development, an attempt is made to directly intervene in the economy of world of the third so as to address the problems of income inequality and social exclusion, again under the trope of uplifting the devalued third world.

In this chapter, we argue that the rationale for the existence of the Indian state has undergone a fundamental displacement since the adoption of the New Economic Policy (NEP henceforth). This displacement is in alignment with the re-articulation of the Indian economic cartograph into the mutually constitutive triad of neo-liberalism, global capitalism and inclusive development that form the Order of Things (a la Foucault) at present. India’s economic transition now must take this historical conjecture as its point of reference and departure. In this regard, the theory of the Indian state must contend with (i) why and how it helped create this triad, (ii) what this triad entailed for its own existence, and (iii) how the state encounters and negotiates with new-fangled contradictions emanating from the triad and thereby transforms itself or gets transformed in the process. State as a transformative entity must thus be understood in relation to the new Order of Things in whose creation it plays a central role and which in turn affects it. There is one important thread that runs through the changes that has materialized with respect to Indian state in the last two decades: the rationale for the existence of Indian state has changed which implies in turn a different philosophy of governance.

A simple and efficient access to highly functionalized isoindolone derivatives via a [3+2] cycloaddition process between in situ generated azomethine ylides with various stable (isolable) masked o-benzoquinones is described. This approach allows a rapid and general synthesis of isoindolones with substituents to further manipulate and elaborate the structural complexity.

This paper makes two related contributions. First, the dual economic structure underlying development is shown as producing a distinct conception of other comprising of a devalued third world which is foregrounded and world of the third which is excluded. This dyad of inclusion-exclusion of other is produced in relation to the centers of capitalism and modernism. The category of third world helps to displace the language-experience-logic-ethos of the other a la world of the third such that development works over and transforms world of the third, but via the trope of a devalued third world. We then use this framework to explore the relation of global capitalism with world of the third in the Indian context, a relation that is shown to be two fold. There is on one hand an attempt to dismantle world of the third as part of the development trope of overcoming the third world. On the other, through inclusive development, an attempt is made to directly intervene in the economy of world of the third so as to address the problems of income inequality and social exclusion, again under the trope of uplifting the devalued third world.

A novel series of acylides 4 were designed to overcome antibacterial resistance and evaluated for in vitro and in vivo activity. This series of acylides was designed from clarithromycin by changing the substitution on the desosamine nitrogen, followed by conversion to 3-O-acyl and 11,12-carbamate. These compounds showed significantly potent antibacterial activity against not only Gram-positive pathogens, including macrolide-lincosamide-streptogramin B (MLS(B))-resistant and efflux-resistant strains, but also Gram-negative pathogens such as Haemophilus influenzae. These acylides also showed better activity against telithromycin resistant Streptococcus pneumoniae strains.

N owadays we are often told that the third world is dead. This underlies another proposition that, with the third world as the Other disappearing, the Orientalist framework is no longer relevant. We consider the pronounced death of the third world and the implied irrelevance of the Orientalist framework as theoretically weak, premature, and politically counterproductive. With the new global order emerging, the third world gets displaced as its external Other into a new plane. We trace the economic history of India and deconstruct the mainstream Indian development paradigm to reveal this emerging contour of Orientalism. Specifically we attempt to read the economic history of India and its transition through different moments of Orientalism, moments that are distinct but each nevertheless help one space—the West, North, or New Global Order—define itself and protract its superiority by producing an external Other.

Honoring Keith Griffin’s more than 40 years of fundamental contributions to the discipline of economics, the papers in this volume reflect his deep commitment to advancing the well-being of the world’s poor majority and his unflinching willingness to question conventional wisdom as to how this should be done.

Raynaud's syndrome (RS), which is characterized by recurrent episodes of vasospasm with exposure to cold, may occur alone (primary RS) or in association with connective tissue diseases or other underlying conditions (secondary RS). We investigated the effect of cilostazol on vessel wall responses in RS. Patients were diagnosed (primary or secondary RS associated with connective tissue diseases) and randomized to placebo or cilostazol 100 mg twice daily for 6 weeks in a double-blind manner. Brachial artery vasoreactivity, laser Doppler fluxmetry, and cold pressor testing (CPT) were performed at study initiation and completion. Symptoms were assessed using standardized questionnaires. Forty subjects completed the study (19 with primary RS and 21 with secondary RS). Cilostazol significantly increased the mean brachial artery diameter at 6 weeks (primary RS, p = 0.006; secondary RS, p = 0.06). There was no change in median flow-mediated dilation (FMD) with cilostazol in primary RS (25th, 75th percentiles) (4.06% [2.5, 6.1] to -0.77% [-2.4, 3.4] or secondary RS (2.2% [0.05, 6.3] to 2.95% [1.7, 7.4]). There were no changes in nitroglycerin-mediated dilation or microvascular flow indexes in either cohort. In patients with primary RS, cilostazol treatment yielded a positive change in the slope of brachial responsiveness to CPT (increase of 0.32 mm/min; p = 0.002 vs placebo). Cilostazol treatment remained significantly associated with increased brachial artery diameter when controlling for baseline values (p = 0.018). Cilostazol increased conduit vessel diameter in patients with primary and secondary RS, with a favorable impact on conduit vessel responsiveness to cold in patients with primary RS without affecting microvascular flow or symptoms.

Adriamycin (ADR) is a commonly used chemotherapeutic agent that is believed to exert its effects through the generation of oxygen free radicals. We hypothesized that administration of a single dose of ADR results in endothelial nitric oxide synthase (eNOS)-dependent generation of superoxide (O2·-) and acute endothelial dysfunction. A single dose of ADR (10 mg/kg i.v.) administered to rabbits resulted in rapid attenuation of agonist-dependent responses to acetylcholine and calcium ionophore (A23187). In vitro exposure of ring segments to ADR for 2·- generation measured by electron spin resonance (ESR) with the spin trap segments 5-tert-butoxycarbonyl-5-methyl-1-pyrroline N-oxide (BMPO) that was abolished by endothelial denudation and incubation with diphenyliodonium (DPI) (10 mM) but not L-NMMA (10 mM). Brachial artery flow-mediated dilation (FMD) in patients undergoing chemotherapy with ADR was markedly attenuated after a single dose of ADR (6.5 6 1.0 to 2.5 6 1.1% (p = 0.0004, time to end of infusion 27 6 8 min) while endothelial-independent dilatation with nitroglycerin was unchanged (16.3 6 3.1 and 14.33 6 2.1% respectively, p = 0.36). Serum nitrite and nitrate concentrations fell from 50 6 6 mmol/l pre-ADR to 33 6 6 mmol/l post-ADR infusion (p = 0.0005) while serum concentrations of CD141 thrombomodulin and von Wille-brand factor (vWF) activity remained unchanged after ADR infusion (36 6 13 to 52 6 22% ng/ml versus 3.25 6 0.98 to 3.01 6 0.91%, respectively, p = NS for pre versus post for both). Doppler indices of diastolic function (IVRT, DT and E/A ratios) were not altered in response to ADR. In conclusion, ADR administration results in rapid depletion of systemic NO· levels and attenuation of agonist-dependent responses in rabbits and flow-mediated dilation in the brachial artery of humans. ESR measurements in rabbit ring suggest an endothelial origin for radical production via flavin-containing oxido-reductases such as eNOS or NADPH cytochrome P450 reductase. These fi ndings may have implications for cardiovascular complications noted with ADR.

Objective To compare microvascular and macrovascular functions in a cohort of patients with primary and secondary Raynaud's phenomenon (RP) who were matched for demographic, risk factor, and severity profiles. Methods Forty patients with primary or secondary RP matched for vascular risk factors and severity scores underwent testing of endothelial function and cold pressor responsiveness of the brachial artery. Microvascular perfusion of the digital vasculature was assessed using laser Doppler fluxmetry in response to reactive hyperemia. Plasma was assayed for endothelin 1 (ET-1), asymmetric dimethylarginine (ADMA), intercellular adhesion molecule 1, vascular cell adhesion molecule 1 (VCAM-1), and monocyte chemoattractant protein 1 (MCP-1). Results Patients with RP had abnormal vasoconstrictor responses to cold pressor tests (CPT) that were similar in primary and secondary RP. There were no differences in median flow-mediated and nitroglycerin-mediated dilation or CPT of the brachial artery in the 2 populations. Patients with secondary RP were characterized by abnormalities in microvascular responses to reactive hyperemia, with a reduction in area under the curve adjusted for baseline perfusion, but not in time to peak response or peak perfusion ratio. Plasma ET-1, ADMA, VCAM-1, and MCP-1 levels were significantly elevated in secondary RP compared with primary RP. There was a significant negative correlation between ET-1 and ADMA values and measures of microvascular perfusion but not macrovascular endothelial function. Conclusion Secondary RP is characterized by elevations in plasma ET-1 and ADMA levels that may contribute to alterations in cutaneous microvascular function.

Objective measures of recruitable blood flow are of importance in angiogenesis trials. We validated a new PET-derived flow reserve (FR) measurement in healthy subjects and subjects with peripheral artery disease (PAD).Five healthy volunteers and 5 subjects with PAD underwent cannulation of the femoral artery and vein. Basal and maximal flow (100 micro g/kg/min of adenosine infused intraarterially) in the lower extremity was determined using thermodilution (TD) techniques. Subjects then underwent plethysmography (PL) followed by PET measurements of blood flow at the calf level. For the PET studies, a transmission scan followed by injection of 1.85 GBq (50 mCi) H(2)(15)O and dynamic scanning for 5 min were acquired in five 1-min frames. Regions of interest were drawn on successive PET image slices, and radioactivity was quantified from the first-minute scan after injection. FR for each of the 3 modalities was expressed as the ratio of adenosine to basal flow.PET-derived FR correlated strongly with TD (r = 0.82; P = 0.004) but not with PL (r = 0.17; P = 0.85). The mean average difference in FR between healthy volunteers and PAD subjects was 13.0 with PET and 4.5 with TD. The intra- and intersubject variability for PET expressed as the coefficient of variation was 10.5% and 29.0% for healthy subjects and 7.0% and 52.9% in PAD, respectively.As expected, FR was significantly lower in PAD subjects compared with healthy subjects as assessed with TD and PET but not with PL. PET-derived FR appears to be reproducible and generates sharper and higher indices of recruitable flow in healthy subjects and PAD. These findings have implications for the use of PET-derived FR as a sensitive index of recruitable flow in angiogenesis trials.

Cutaneous microvascular responses to physiological stimuli are currently being investigated as indices of vascular function and to monitor responses to therapy. We attempted to systematically assess various microvascular cutaneous flow indices in response to reactive hyperaemia in control subjects and in patients with coronary artery disease (CAD), and to correlate these with brachial artery flow-mediated dilation (FMD). Groups of 24 healthy controls and 24 subjects with CAD underwent sequential brachial FMD determination in the dominant arm, and laser Doppler imaging to assess skin blood flow in the contralateral arm in response to reactive hyperaemia induced by cuff inflation and release. Laser Doppler values were expressed as: (a) AUC5min (area under the curve over 5min of release), (b) time to peak response, (c) % reactive hyperaemia, and (d) peak perfusion ratio. As expected, FMD was attenuated in CAD patients compared with controls (1.85±4.29% compared with 4.30±4.00%; P = 0.05). Percentage reactive hyperaemia (CAD, 294±290%; controls, 501±344%; P = 0.04) and the time to peak response as measured by laser Doppler imaging (CAD, 16.84±9.61s; controls, 9.13±4.43s; P = 0.001) were significantly different between the CAD and control groups, while AUC5min and the peak perfusion ratio did not show significant differences. Receiver operator curves for sensitivity/specificity analysis suggested that the time to peak response derived by laser Doppler imaging was superior to FMD for the diagnosis of CAD, with an overall specificity of 91.3% (positive predictive value of 89.4%) and a sensitivity of 73.7% (negative predictive value of 77.6%). In conclusion, laser Doppler-derived indices of microvascular flow do not correlate with conduit vessel responses. However, a time to peak response of >10s as measured by laser Doppler imaging offers superior specificity for the diagnosis of CAD compared with brachial FMD.

A close look at the political history of Sikkim during monarchic rule unravels some disconcerting features. If the first phase of history (pre-British phase) showed marginalisation of the Lepchas and the Limboos by the immigrant Bhutias, the second phase of history (after the British became the de facto ruler) reflected the political hegemony of the minority Bhutia–Lepcha combination over the majority Nepalese who were mostly landless. The entry of the bulk of Nepalese did contribute to bring in changes in production techniques, especially in the agricultural sector, but appropriation of surplus by the landed gentry of Bhutias and Lepchas only helped to sustain feudalism. Demand for land rights and proportionate representation of the Nepalese paved way for integration of Sikkim with India, and monarchy was replaced by a democratic form of governance. By dint of absolute numerical majority, the Nepalese became the guiding force in shaping the economy of post state-hood Sikkim.

a Abstract: The products of nitric oxide synthase (NOS) and angiotensin-converting enzyme (ACE) play a critical role in determining vessel wall structure and function. Polymorphisms in both genes have been independently demonstrated to ine uence propensity to cardiovascular events. The purpose of this study was to determine the ine uence of the homozygous G849T(Glu298 ! Asp) polymorphism in NOS III on peripheral conduit artery endothelial function and to elucidate the modie er role, if any, of a common ACE polymorphism. Three hundred and ninety-seven consecutive subjects presenting to the cardiac catheteriz- ation laboratory of the University of Michigan over a period of 18 months were recruited. DNA was extracted and polymerase chain reaction (PCR) analysis for ACE and NOS polymorphisms performed. Patients with homozygosity for G849T at both loci (TT) who belong to DD and II ACE genotype (groups 1 and 2) and those who are negative for this polymorphism (GG) and belong to either DD or II genotype (groups 3 and 4) were identie ed. The four groups then underwent determination of conduit endothelial function. Heterozygosity of Glu298-Asp or the ID variant of the ACE were not studied. Median FMD value in the TT-DD group was 0.20 ( -3.17, 2.01) compared with 2.23% ( -0.29, 4.17) in the GG-II group. Median values in the TT-II and the GG-DD groups were 3.04 ( -1.16, 6.61) and 2.46% ( -1.83, 6.52) respectively. These values were not statistically signie cant ( p > 0.05 by one-way ANOVA). Median nitroglycerin-mediated dilation in the four groups did not differ between the four groups ( p = NS by ANOVA). Atherosclerosis burdens as assessed by angiography were not different across the groups. In conclusion, the homozygous NOS III variant (GG) status does not seem to interact addi- tively with the ACE homozygous DD genotype in determining e ow-mediated vasodilation in individuals with established atherosclerosis and pre-existent endothelial dysfunction.