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Context: Oral once-daily dual-release hydrocortisone (DR-HC) replacement therapy has demonstrated an improved metabolic profile compared to conventional 3-times-daily (TID-HC) therapy among patients with primary adrenal insufficiency. This effect might be related to a more physiological cortisol profile, but also to a modified pattern of cortisol metabolism.Objective: This work aimed to study cortisol metabolism during DR-HC and TID-HC.Design: A randomized, 12-week, crossover study was conducted.Intervention and Participants: DC-HC and same daily dose of TID-HC were administered to patients with primary adrenal insufficiency (n = 50) vs healthy individuals (n = 124) as controls.Main Outcome Measures: Urinary corticosteroid metabolites were measured by gas chromatography/mass spectrometry at 24-hour urinary collections.Results: Total cortisol metabolites decreased during DR-HC compared to TID-HC (P < .001) and reached control values (P = .089). During DR-HC, 11β-hydroxysteroid dehydrogenase type 1 (11β-HSD1) activity measured by tetrahydrocortisol + 5α-tetrahydrocortisol/tetrahydrocortisone ratio was reduced compared to TID-HC (P < .05), but remained increased vs controls (P < .001). 11β-HSD2 activity measured by urinary free cortisone/free cortisol ratio was decreased with TID-HC vs controls (P < .01) but normalized with DR-HC (P = .358). 5α- and 5β-reduced metabolites were decreased with DR-HC compared to TID-HC. Tetrahydrocortisol/5α-tetrahydrocortisol ratio was increased during both treatments, suggesting increased 5β-reductase activity.Conclusions: The urinary cortisol metabolome shows striking abnormalities in patients receiving conventional TID-HC replacement therapy, with increased 11β-HSD1 activity that may account for the unfavorable metabolic phenotype in primary adrenal insufficiency. Its change toward normalization with DR-HC may mediate beneficial metabolic effects. The urinary cortisol metabolome may serve as a tool to assess optimal cortisol replacement therapy. [ABSTRACT FROM AUTHOR]

A range of literature has attempted to reconceptualize union agendas for firm-level restructuring by identifying variety in local union strategic responses. This article explores the conditions under which local unions respond strategically to company restructuring in the Netherlands, Italy and Ireland. Two distinct types of union strategies are identified: confrontation based on ‘job protection’; cooperation based on ‘job transition’. Evidence suggests that different combinations of structural and socio-political firm-level conditions encourage the choice of specific union strategy. Understanding the nature and the interactions between firm-level contextual factors, within a broader institutional setting during restructuring, is important to provide a fuller explanation for the variety of strategic choices facing local unions. [ABSTRACT FROM AUTHOR]

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Abstract Linear or despotic dominance hierarchies are common in carnivore societies. However, in feeding experiments in the field with wild European badgers, Meles meles , we found no compelling evidence for any such hierarchies within badger groups, or even between the members of neighbouring groups. The outcome of dyadic encounters within groups was partly determined by asymmetries in weight and length, but these predictors were readily confounded by ownership. Aggression between members of neighbouring groups during encounters at feeding sites at territorial borders was extremely rare. These rather ad hoc aspects of social organization reinforce the view that badger societies are somewhat loosely structured. [ABSTRACT FROM AUTHOR]

The authors discuss the advantage of using the European Emergency Card in saving the lives of patients with adrenal insufficiency (AI) in Europe. They recognize the medical processes used in the region to effectively administer the condition through cortisone. However, the authors the benefits of coordinating the card in the process to provide quick and easy information to healthcare workers in an emergency situation.

Polychlorinated biphenyls (PCBs) are persistent pollutants that are ubiquitous in the food chain, and detectable amounts are in the blood of almost every person in most populations that have been examined. Extensive evidence from animal studies shows that PCBs are neurotoxins, even at low doses. Interpretation of human data regarding low-level, early-life PCB exposure and subsequent neurodevelopment is problematic because levels of exposure were not similarly quantified across studies. We expressed the exposure levels from 10 studies of PCB and neurodevelopment in a uniform manner using a combination of data from original investigators, laboratory reanalyses, calculations based on published data, and expert opinion. The mainstay of our comparison was the median level of PCB 153 in maternal pregnancy serum. The median concentration of PCB 153 in the 10 studies ranged from 30 to 450 ng/g serum lipid, and the median of the 10 medians was 110 ng/g. We found that (a)) the distribution of PCB 153 exposure in most studies overlapped substantially, (b)) exposure levels in the Faroe Islands study were about 3-4-fold higher than in most other studies, and (c)) the exposure levels in the two recent U.S. studies were about one-third of those in the four earlier U.S. studies or recent Dutch, German, and northern Québec studies. Our results will facilitate a direct comparison of the findings on PCBs and neurodevelopment when they are published for all 10 studies.