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{\u0022basePath\u0022:\u0022\\\/\u0022,\u0022pathPrefix\u0022:\u0022\u0022,\u0022highwire\u0022:{\u0022markup\u0022:[{\u0022requested\u0022:\u0022full-text\u0022,\u0022variant\u0022:\u0022full-text\u0022,\u0022view\u0022:\u0022full\u0022,\u0022pisa\u0022:\u0022spmdc;10\\\/7\\\/18\u0022},{\u0022requested\u0022:\u0022long\u0022,\u0022variant\u0022:\u0022full-text\u0022,\u0022view\u0022:\u0022full\u0022,\u0022pisa\u0022:\u0022spmdc;10\\\/7\\\/18\u0022}],\u0022ac\u0022:{\u0022spmdc;10\\\/7\\\/18\u0022:{\u0022access\u0022:{\u0022reprint\u0022:true,\u0022full\u0022:true},\u0022pisa_id\u0022:\u0022spmdc;10\\\/7\\\/18\u0022,\u0022atom_uri\u0022:\u0022\u0022,\u0022jcode\u0022:\u0022spmdc\u0022}}},\u0022googleanalytics\u0022:{\u0022trackOutbound\u0022:1,\u0022trackMailto\u0022:1,\u0022trackDownload\u0022:1,\u0022trackDownloadExtensions\u0022:\u00227z|aac|arc|arj|asf|asx|avi|bin|csv|doc(x|m)?|dot(x|m)?|exe|flv|gif|gz|gzip|hqx|jar|jpe?g|js|mp(2|3|4|e?g)|mov(ie)?|msi|msp|pdf|phps|png|ppt(x|m)?|pot(x|m)?|pps(x|m)?|ppam|sld(x|m)?|thmx|qtm?|ra(m|r)?|sea|sit|tar|tgz|torrent|txt|wav|wma|wmv|wpd|xls(x|m|b)?|xlt(x|m)|xlam|xml|z|zip\u0022,\u0022trackUrlFragments\u0022:1},\u0022ajaxPageState\u0022:{\u0022js\u0022:{\u0022sites\\\/all\\\/libraries\\\/cluetip\\\/jquery.cluetip.js\u0022:1,\u0022sites\\\/all\\\/libraries\\\/cluetip\\\/lib\\\/jquery.hoverIntent.js\u0022:1,\u0022sites\\\/all\\\/libraries\\\/cluetip\\\/lib\\\/jquery.bgiframe.min.js\u0022:1,\u0022sites\\\/all\\\/modules\\\/highwire\\\/highwire\\\/plugins\\\/highwire_markup_process\\\/js\\\/highwire_at_symbol.js\u0022:1,\u0022sites\\\/all\\\/modules\\\/highwire\\\/highwire\\\/plugins\\\/highwire_markup_process\\\/js\\\/highwire_article_reference_popup.js\u0022:1,\u0022sites\\\/all\\\/modules\\\/contrib\\\/google_analytics\\\/googleanalytics.js\u0022:1,\u00220\u0022:1}}});\n\/\/--\u003E\u003C!]]\u003E\n\u003C\/script\u003E\n\u003Clink type=\u0022text\/css\u0022 rel=\u0022stylesheet\u0022 href=\u0022\/\/d282kpwvnogo5m.cloudfront.net\/sites\/default\/files\/advagg_css\/css__ce2QY63WIanKyr8eSq7eavr1XQRRmFD6ZSmwpyJi8lM__zXwFqpqmxrZOXXcd_TpBQpjuELbmIP9wBR5UuTDWAO4__YJWWMMdfCJuAFm5cUEp88OsodhO3ZA-2lzRfoBsSlk4.css\u0022 media=\u0022all\u0022 \/\u003E\n\u003Clink rel=\u0027stylesheet\u0027 type=\u0027text\/css\u0027 href=\u0027\/sites\/all\/modules\/contrib\/panels\/plugins\/layouts\/onecol\/onecol.css\u0027 \/\u003E\u003C\/head\u003E\u003Cbody\u003E\u003Cdiv class=\u0022panels-ajax-tab-panel panels-ajax-tab-panel-sageoa-tab-art\u0022\u003E\u003Cdiv class=\u0022panel-display panel-1col clearfix\u0022 \u003E\n  \u003Cdiv class=\u0022panel-panel panel-col\u0022\u003E\n    \u003Cdiv\u003E\u003Cdiv class=\u0022panel-pane pane-highwire-markup\u0022 \u003E\n  \n      \n  \n  \u003Cdiv class=\u0022pane-content\u0022\u003E\n    \u003Cdiv class=\u0022highwire-markup\u0022\u003E\u003Cdiv xmlns=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022 id=\u0022content-block-markup\u0022 xmlns:xhtml=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022\u003E\u003Cdiv class=\u0022article fulltext-view \u0022\u003E\u003Cspan class=\u0022highwire-journal-article-marker-start\u0022\u003E\u003C\/span\u003E\u003Cdiv class=\u0022section abstract\u0022 id=\u0022abstract-1\u0022\u003E\u003Ch2\u003ESummary\u003C\/h2\u003E\n            \u003Cp id=\u0022p-1\u0022\u003ECardiovascular disease, now the leading cause of death both in the United States and worldwide, is responsible for approximately 16.7 million deaths per year. In the past decade, widespread interventions, such as aspirin and statin therapy and smoking cessation, have contributed to a 29% reduction in the risk of cardiovascular mortality [Lloyd-Jones D et al. \u003Cem\u003ECirculation\u003C\/em\u003E 2010]. However, the increased prevalence of obesity, diabetes, and sedentary lifestyle has outpaced other benefits, leading to an increased risk for coronary heart disease (and myocardial infarction. This article discusses emerging trends in intensive lipid management.\u003C\/p\u003E\n         \u003C\/div\u003E\u003Cul class=\u0022kwd-group\u0022\u003E\u003Cli class=\u0022kwd\u0022\u003ELipid Disorders\u003C\/li\u003E\u003C\/ul\u003E\u003Cp id=\u0022p-2\u0022\u003ECardiovascular disease (CVD), now the leading cause of death both in the US and worldwide, is responsible for approximately 16.7 million deaths per year. In the past decade, widespread interventions, such as aspirin and statin therapy and smoking cessation, have contributed to a 29% reduction in the risk of cardiovascular (CV) mortality [Lloyd-Jones D et al. \u003Cem\u003ECirculation\u003C\/em\u003E 2010]. However, the increased prevalence of obesity, diabetes, and sedentary lifestyle has outpaced other benefits, leading to an increased risk for coronary heart disease (CHD) and myocardial infarction (MI). In this session, Robert P. Giugliano, MD, SM, Brigham and Women\u0027s Hospital, Boston, Massachusetts, USA, discussed emerging trends in intensive lipid management.\u003C\/p\u003E\u003Cp id=\u0022p-3\u0022\u003ETraditional risk factors, including high cholesterol, smoking, hypertension, diabetes, and obesity, explain the majority of the risk for CV events. Accordingly, therapeutic lifestyle changes form the basis of modern treatment strategies. Patients with a higher baseline risk also need pharmacological therapy for effective risk factor reduction. Yet, for many patients, efforts toward CV risk reduction are insufficient to prevent major cardiac events. In a review of 231,986 hospitalizations for an acute coronary event, only 21% of all patients were taking lipid-lowering medications prior to admission. Among those with a prior history of coronary artery disease (CAD), only 29% had been taking lipid-lowering therapy at the time of their acute coronary event [Sachdeva A et al. \u003Cem\u003EAm Heart J\u003C\/em\u003E 2009].\u003C\/p\u003E\u003Cdiv class=\u0022section\u0022 id=\u0022sec-1\u0022\u003E\n         \u003Ch2 class=\u0022\u0022\u003EAggressive Lipid Lowering with Therapy\u003C\/h2\u003E\n         \u003Cp id=\u0022p-4\u0022\u003ETo date, statins are the best studied options for lipid-lowering therapy. Statin monotherapy can reduce low-density lipoprotein cholesterol (LDL-C) levels by 38% to 49%, while statin-based combination regimens can lower LDL-C by 62% [Hochhlozer W, Giugliano R. \u003Cem\u003ETher Adv Cardiovasc Dis\u003C\/em\u003E 2010]. How much LDL-C reduction is enough? Data modeling suggests that the incidence of CV events can be reduced to almost zero with LDL-C targets of \u0026lt;60 mg\/dL for primary prevention and \u0026lt;30 mg\/dL for secondary prevention [Hochhlozer W, Giugliano R. \u003Cem\u003ETher Adv Cardiovasc Dis\u003C\/em\u003E 2010]. Achieving these goals will require much more potent lipid-lowering regimens. Aggressive lipid-lowering therapy can be particularly beneficial among patients with high pretreatment LDL-C values [Giraldez RR et al. \u003Cem\u003EJ Am Coll Cardiol\u003C\/em\u003E 2008].\u003C\/p\u003E\n         \u003Cp id=\u0022p-5\u0022\u003EFor patients who fail to reach LDL-C targets with statin therapy alone, statin-based combination therapy may provide additional incremental benefits in CV risk reduction. In the Ezetimibe and Simvastatin in Dyslipidemia of Diabetes (ESD) trial, the addition of ezetimibe to simvastatin provided significantly greater LDL-C reduction than simvastatin alone in patients with diabetes and dyslipidemia (\u003Ca id=\u0022xref-fig-1-1\u0022 class=\u0022xref-fig\u0022 href=\u0022#F1\u0022\u003EFigure 1\u003C\/a\u003E) [Ruggenenti P et al. \u003Cem\u003EDiabetes Care\u003C\/em\u003E 2008]. Various statin-based combination therapies are also being studied in patients with ACS, CAD, kidney failure, and established vascular disease (\u003Ca id=\u0022xref-table-wrap-1-1\u0022 class=\u0022xref-table\u0022 href=\u0022#T1\u0022\u003ETable 1\u003C\/a\u003E).\u003C\/p\u003E\n         \u003Cdiv id=\u0022T1\u0022 class=\u0022table pos-float\u0022\u003E\u003Cdiv class=\u0022table-inline\u0022\u003E\u003Cdiv class=\u0022callout\u0022\u003E\u003Cspan\u003EView this table:\u003C\/span\u003E\u003Cul class=\u0022callout-links\u0022\u003E\u003Cli class=\u00220 first\u0022\u003E\u003Ca href=\u0022\/\u0022 class=\u0022table-expand-inline\u0022 data-table-url=\u0022\/highwire\/markup\/11436\/expansion?postprocessors=highwire_figures%2Chighwire_math%2Chighwire_inline_linked_media%2Chighwire_embed\u0026amp;table-expand-inline=1\u0022 html=\u00221\u0022 fragment=\u0022#\u0022 external=\u00221\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView inline\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00221\u0022\u003E\u003Ca href=\u0022\/highwire\/markup\/11436\/expansion?width=1000\u0026amp;height=500\u0026amp;iframe=true\u0026amp;postprocessors=highwire_figures%2Chighwire_math%2Chighwire_inline_linked_media\u0022 class=\u0022colorbox colorbox-load table-expand-popup\u0022 rel=\u0022gallery-fragment-tables\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView popup\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00222 last\u0022\u003E\u003Ca href=\u0022\/highwire\/powerpoint\/11436\u0022 class=\u0022highwire-figure-link highwire-figure-link-ppt\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EDownload powerpoint\u003C\/a\u003E\u003C\/li\u003E\u003C\/ul\u003E\u003C\/div\u003E\u003C\/div\u003E\u003Cdiv class=\u0022table-caption\u0022\u003E\u003Cspan class=\u0022table-label\u0022\u003ETable 1.\u003C\/span\u003E \n               \u003Cp id=\u0022p-6\u0022 class=\u0022first-child\u0022\u003EOngoing Trials of Statin-Based Combination Therapy.\u003C\/p\u003E\n            \u003Cdiv class=\u0022sb-div caption-clear\u0022\u003E\u003C\/div\u003E\u003C\/div\u003E\u003C\/div\u003E\n         \u003Cdiv id=\u0022F1\u0022 class=\u0022fig pos-float  odd\u0022\u003E\u003Cdiv class=\u0022highwire-figure\u0022\u003E\u003Cdiv class=\u0022fig-inline-img-wrapper\u0022\u003E\u003Cdiv class=\u0022fig-inline-img\u0022\u003E\u003Ca href=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/10\/7\/18\/F1.large.jpg?width=800\u0026amp;height=600\u0026amp;carousel=1\u0022 title=\u0022Improved LDL Reduction with Combination Ezetimibe\/Simvastatin.\u0022 class=\u0022fragment-images colorbox-load\u0022 rel=\u0022gallery-fragment-images-1741676279\u0022 data-figure-caption=\u0022Improved LDL Reduction with Combination Ezetimibe\/Simvastatin.\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003E\u003Cimg class=\u0022fragment-image\u0022 alt=\u0022Figure 1.\u0022 src=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/10\/7\/18\/F1.medium.gif\u0022\/\u003E\u003C\/a\u003E\u003C\/div\u003E\u003C\/div\u003E\u003Cul class=\u0022highwire-figure-links inline\u0022\u003E\u003Cli class=\u00220 first\u0022\u003E\u003Ca href=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/10\/7\/18\/F1.large.jpg?download=true\u0022 class=\u0022highwire-figure-link highwire-figure-link-download\u0022 title=\u0022Download Figure 1.\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EDownload figure\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00221\u0022\u003E\u003Ca href=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/10\/7\/18\/F1.large.jpg\u0022 class=\u0022highwire-figure-link highwire-figure-link-newtab\u0022 target=\u0022_blank\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EOpen in new tab\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00222 last\u0022\u003E\u003Ca href=\u0022\/highwire\/powerpoint\/11427\u0022 class=\u0022highwire-figure-link highwire-figure-link-ppt\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EDownload powerpoint\u003C\/a\u003E\u003C\/li\u003E\u003C\/ul\u003E\u003C\/div\u003E\u003Cdiv class=\u0022fig-caption attrib\u0022\u003E\u003Cspan class=\u0022fig-label\u0022\u003EFigure 1.\u003C\/span\u003E \n               \u003Cp id=\u0022p-8\u0022 class=\u0022first-child\u0022\u003EImproved LDL Reduction with Combination Ezetimibe\/Simvastatin.\u003C\/p\u003E\n            \u003Cq class=\u0022attrib\u0022 id=\u0022attrib-1\u0022\u003EReproduced with permission from R. Giugliano, MD, SM.\u003C\/q\u003E\u003Cdiv class=\u0022sb-div caption-clear\u0022\u003E\u003C\/div\u003E\u003C\/div\u003E\u003C\/div\u003E\n      \u003C\/div\u003E\u003Cdiv class=\u0022section\u0022 id=\u0022sec-2\u0022\u003E\n         \u003Ch2 class=\u0022\u0022\u003ENon-LDL-C Treatment Targets\u003C\/h2\u003E\n         \u003Cp id=\u0022p-9\u0022\u003EAccording to data from the Framingham Heart Study, high-density lipoprotein cholesterol (HDL-C) is a predictor of risk for CHD, even among patients with low LDL-C levels [Gordon T et al. \u003Cem\u003EAm J Med\u003C\/em\u003E 1977]. Non-HDL lipoproteins, including very low-density lipoprotein cholesterol (VLDL-C), are also atherogenic [Grundy SM et al. \u003Cem\u003ECirculation\u003C\/em\u003E 2004]. Current guidelines from the Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (ATP III) recommend lowering elevated HDL and non-LDL cholesterol levels as part of a comprehensive strategy to reduce the risks that are associated with a proatherogenic lipid profile [NCEP. \u003Cem\u003EJAMA\u003C\/em\u003E 2001]. In patients with triglyceride (TG) levels \u2265200 mg\/dL, LDL-C reduction remains the primary goal of treatment. In these patients, non-HDL-C is a secondary target of treatment, with a goal of 30 mg\/dL higher than the LDL-C goal. In contrast, when TG levels are \u0026gt;500 mg\/dL, non-HDL-C should be the primary target of treatment [NCEP. \u003Cem\u003EJAMA\u003C\/em\u003E 2001].\u003C\/p\u003E\n         \u003Cp id=\u0022p-10\u0022\u003ESeveral drug classes appear to provide modest increases in HDL-C levels, including niacin (15% to 35%), fibrates (10% to 15%), estrogens (10% to 15%), and statins (5% to 10%) [Belacazar LM et al. \u003Cem\u003EProgr Cardiovasc Dis\u003C\/em\u003E 1998]. Investigational agents that are designed specifically to increase HDL-C levels, such as cholesteryl ester transfer protein (CETP) inhibitors, have not yet demonstrated clinical efficacy to date. In the Investigation of Lipid Level Management to Understand its Impact in Atherosclerotic Events (ILLUMINATE) trial, treatment with the CETP inhibitor torcetrapib, when added to atorvastatin, increased HDL-C levels by 72% at 12 months. However, the addition of torcetrapib to statin therapy \u003Cem\u003Eincreased\u003C\/em\u003E the risk of CV events by 25% (p=0.001) and \u003Cem\u003Eincreased\u003C\/em\u003E all-cause mortality by 58% (p=0.006) [Barter PJ et al. \u003Cem\u003EN Eng J Med\u003C\/em\u003E 2007]. Studies of two other investigational CETP inhibitors, dalcetrapib and anacetrapib, are currently underway.\u003C\/p\u003E\n         \u003Cp id=\u0022p-11\u0022\u003EAggressive statin therapy may provide important clinical benefits that are independent of LDL-C reduction. Mega and colleagues recently showed that high-dose statin therapy, before elective percutaneous coronary intervention (PCI), prevents myocardial damage and reduces the risk of postprocedure MI [Mega S et al. \u003Cem\u003ECrit Path Cardiol\u003C\/em\u003E 2010]. In the Justification for the Use of Statins in Prevention: an Intervention Trial Evaluating Rosuvastatin (JUPITER), reduction of high-sensitivity C-reactive protein (hsCRP) was an important indicator of treatment success. Rosuvastatin-treated patients who achieved low LDL-C levels (\u0026lt;70 mg) and low hsCRP levels (\u0026lt;2 mg\/L) had the best clinical outcomes (\u003Ca id=\u0022xref-fig-2-1\u0022 class=\u0022xref-fig\u0022 href=\u0022#F2\u0022\u003EFigure 2\u003C\/a\u003E) [Ridker PM et al. \u003Cem\u003EN Eng J Med\u003C\/em\u003E 2009]. These findings suggest the importance of targeting additional markers of CV risk in primary and secondary prevention. To close the major treatment gap toward reduced CV morbidity and mortality, future management of dyslipidemia promises to include more potent LDL-lowering regimens, as well as non-LDL targets, such as HDL-C, non-HDL-C, and CRP.\u003C\/p\u003E\n         \u003Cdiv id=\u0022F2\u0022 class=\u0022fig pos-float  odd\u0022\u003E\u003Cdiv class=\u0022highwire-figure\u0022\u003E\u003Cdiv class=\u0022fig-inline-img-wrapper\u0022\u003E\u003Cdiv class=\u0022fig-inline-img\u0022\u003E\u003Ca href=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/10\/7\/18\/F2.large.jpg?width=800\u0026amp;height=600\u0026amp;carousel=1\u0022 title=\u0022JUPITER: Incidence of CV Events According to Whether Reductions in Both LDL-C and hsCRP Are Achieved.\u0022 class=\u0022fragment-images colorbox-load\u0022 rel=\u0022gallery-fragment-images-1741676279\u0022 data-figure-caption=\u0022JUPITER: Incidence of CV Events According to Whether Reductions in Both LDL-C and hsCRP Are Achieved.\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003E\u003Cimg class=\u0022fragment-image\u0022 alt=\u0022Figure 2.\u0022 src=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/10\/7\/18\/F2.medium.gif\u0022\/\u003E\u003C\/a\u003E\u003C\/div\u003E\u003C\/div\u003E\u003Cul class=\u0022highwire-figure-links inline\u0022\u003E\u003Cli class=\u00220 first\u0022\u003E\u003Ca href=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/10\/7\/18\/F2.large.jpg?download=true\u0022 class=\u0022highwire-figure-link highwire-figure-link-download\u0022 title=\u0022Download Figure 2.\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EDownload figure\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00221\u0022\u003E\u003Ca href=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/10\/7\/18\/F2.large.jpg\u0022 class=\u0022highwire-figure-link highwire-figure-link-newtab\u0022 target=\u0022_blank\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EOpen in new tab\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00222 last\u0022\u003E\u003Ca href=\u0022\/highwire\/powerpoint\/11430\u0022 class=\u0022highwire-figure-link highwire-figure-link-ppt\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EDownload powerpoint\u003C\/a\u003E\u003C\/li\u003E\u003C\/ul\u003E\u003C\/div\u003E\u003Cdiv class=\u0022fig-caption attrib\u0022\u003E\u003Cspan class=\u0022fig-label\u0022\u003EFigure 2.\u003C\/span\u003E \n               \u003Cp id=\u0022p-12\u0022 class=\u0022first-child\u0022\u003EJUPITER: Incidence of CV Events According to Whether Reductions in Both LDL-C and hsCRP Are Achieved.\u003C\/p\u003E\n            \u003Cq class=\u0022attrib\u0022 id=\u0022attrib-2\u0022\u003ECopyright \u00a9 2009 Massachusetts Medical Society. All rights reserved.\u003C\/q\u003E\u003Cdiv class=\u0022sb-div caption-clear\u0022\u003E\u003C\/div\u003E\u003C\/div\u003E\u003C\/div\u003E\n      \u003C\/div\u003E\u003Cul class=\u0022copyright-statement\u0022\u003E\u003Cli class=\u0022fn\u0022 id=\u0022copyright-statement-1\u0022\u003E\u00a9 2010 MD Conference Express\u003C\/li\u003E\u003C\/ul\u003E\u003Cspan class=\u0022highwire-journal-article-marker-end\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Cspan id=\u0022related-urls\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Ca href=\u0022http:\/\/mdc.sagepub.com\/content\/10\/7\/18.abstract\u0022 class=\u0022hw-link hw-link-article-abstract\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView Summary\u003C\/a\u003E\u003C\/div\u003E  \u003C\/div\u003E\n\n  \n  \u003C\/div\u003E\n\u003C\/div\u003E\n  \u003C\/div\u003E\n\u003C\/div\u003E\n\u003C\/div\u003E\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_figures.js?nzmpqp\u0022\u003E\u003C\/script\u003E\n\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_openurl.js?nzmpqp\u0022\u003E\u003C\/script\u003E\n\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_tables.js?nzmpqp\u0022\u003E\u003C\/script\u003E\n\u003C\/body\u003E\u003C\/html\u003E"}