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type=\u0022text\/css\u0022 rel=\u0022stylesheet\u0022 href=\u0022\/\/d282kpwvnogo5m.cloudfront.net\/sites\/default\/files\/cdn\/css\/http\/css_Xg7z6oCTVgud_Q0huYz9x9iiD5H_2YPSJ5z2ZViSWdY.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\u003EVisceral fat accumulation has been correlated with the development of many common diseases, including type 2 diabetes mellitus (T2DM), and has been shown to be a more important contributor than body mass index to obesity-related metabolic risk factors [Okauchi Y et al. \u003Cem\u003EDiabetes Care\u003C\/em\u003E 2007]. This article discusses the trends in metabolic syndrome and diabetes in both Korea and China.\u003C\/p\u003E\n         \u003C\/div\u003E\u003Cul class=\u0022kwd-group\u0022\u003E\u003Cli class=\u0022kwd\u0022\u003ECardiometabolic Disorder\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EObesity\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EDiabetes Mellitus\u003C\/li\u003E\u003C\/ul\u003E\u003Cul class=\u0022kwd-group clinical-trial\u0022\u003E\u003Cli class=\u0022kwd\u0022\u003EEndocrinology\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EDiabetes \u0026amp; Metabolic Syndrome\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EObesity\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003ECardiometabolic Disorder\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EDiabetes Mellitus\u003C\/li\u003E\u003C\/ul\u003E\u003Cp id=\u0022p-2\u0022\u003EVisceral fat accumulation (VFA) has been correlated with the development of many common diseases, including type 2 diabetes mellitus (T2DM; \u003Ca id=\u0022xref-fig-1-1\u0022 class=\u0022xref-fig\u0022 href=\u0022#F1\u0022\u003EFigure 1\u003C\/a\u003E), and has been shown to be a more important contributor than body mass index (BMI) to obesity-related metabolic risk factors [Okauchi Y et al. \u003Cem\u003EDiabetes Care\u003C\/em\u003E 2007].\u003C\/p\u003E\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\/13\/16\/4\/F1.large.jpg?width=800\u0026amp;height=600\u0026amp;carousel=1\u0022 title=\u0022Visceral Fat Accumulation Contributes to Disease Development\u0022 class=\u0022fragment-images colorbox-load\u0022 rel=\u0022gallery-fragment-images-477815883\u0022 data-figure-caption=\u0022Visceral Fat Accumulation Contributes to Disease Development\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\/13\/16\/4\/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\/13\/16\/4\/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\/13\/16\/4\/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\/13631\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-3\u0022 class=\u0022first-child\u0022\u003EVisceral Fat Accumulation Contributes to Disease Development\u003C\/p\u003E\n         \u003Cq class=\u0022attrib\u0022 id=\u0022attrib-1\u0022\u003EKanai H et al. \u003Cem\u003EHypertension\u003C\/em\u003E 1990; Kanai H et al. \u003Cem\u003EHypertension\u003C\/em\u003E 1996; Nakamura T et al. \u003Cem\u003EAtherosclerosis\u003C\/em\u003E 1994; Nakamura T et al. \u003Cem\u003EInt J Obes Relat Metab Disord\u003C\/em\u003E 1997; Shinohara E et al. \u003Cem\u003EJ Intern Med\u003C\/em\u003E 1997.\u003C\/q\u003E\u003Cq class=\u0022attrib\u0022 id=\u0022attrib-2\u0022\u003EReproduced with permission from Y Matsuzawa, MD, PhD.\u003C\/q\u003E\u003Cdiv class=\u0022sb-div caption-clear\u0022\u003E\u003C\/div\u003E\u003C\/div\u003E\u003C\/div\u003E\u003Cp id=\u0022p-4\u0022\u003EGene expression profiling of human adipose tissue through the BODYMAP project revealed adipose tissue, especially visceral fat contains growth factors, cytokines, and complement factors, among others, that have been associated with the development of atherosclerosis [Maeda K et al. \u003Cem\u003EGene\u003C\/em\u003E 1997]. Adiponectin maybe the most important gene identified by the BODYMAP program, said Yuji Matsuzawa, MD, PhD because it has been hypothesized to be protective and associated with less insulin resistance, vascular stenosis, thrombosis, and inflammation.\u003C\/p\u003E\u003Cp id=\u0022p-5\u0022\u003EVFA is a key player in the metabolic syndrome (MetS) inducing low adiponectin levels (ie, hypoadiponectin), which is associated with the development of T2DM, hypertension, atherosclerosis, cardiac dysfunction, and some malignancies. The precise mechanism for reduced adiponectin production by VFA is not fully elucidated although it has been hypothesized that increased production of TNF-alpha or reactive oxygen species and hypoxia maybe part of the pathway.\u003C\/p\u003E\u003Cp id=\u0022p-6\u0022\u003ESeveral lines of research have shown a relationship between insulin resistance and low plasma levels of adiponectin in mice [Maeda N et al. \u003Cem\u003ENat Med\u003C\/em\u003E 2002], a negative correlation between plasma adiponectin and blood pressure (BP) in humans, regardless of insulin resistance, suggesting hypoadiponectin may be involved with the development of hypertension in MetS [Iwashima Y et al. \u003Cem\u003EHypertension\u003C\/em\u003E 2004]; and a close correlation between adiponectin and endothelium-dependent vasodilation [Ouchi N et al. \u003Cem\u003EHypertension\u003C\/em\u003E 2003].\u003C\/p\u003E\u003Cp id=\u0022p-7\u0022\u003EIn patients with coronary artery disease (CAD), adiponectin levels are lower than in age- and BMI-adjusted control subjects [Ouchi N et al. \u003Cem\u003ECirculation\u003C\/em\u003E 1999]. In contrast, high levels of adiponectin were associated with a lower prevalence of cardiovascular (CV) death in chronic renal failure patients, and another study found that patients with higher adiponectin were associated with a 30% lower incidence of myocardial infarction (MI) [Kumada M et al. \u003Cem\u003EArterioscler Thromb Vase Biol\u003C\/em\u003E 2003]. The possible relation between lifestyle factors, visceral fat, and atherosclerotic disease is summarized in \u003Ca id=\u0022xref-fig-2-1\u0022 class=\u0022xref-fig\u0022 href=\u0022#F2\u0022\u003EFigure 2\u003C\/a\u003E.\u003C\/p\u003E\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\/13\/16\/4\/F2.large.jpg?width=800\u0026amp;height=600\u0026amp;carousel=1\u0022 title=\u0022Visceral Fat Accumulation Leads to Atherosclerosis\u0022 class=\u0022fragment-images colorbox-load\u0022 rel=\u0022gallery-fragment-images-477815883\u0022 data-figure-caption=\u0022Visceral Fat Accumulation Leads to Atherosclerosis\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\/13\/16\/4\/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\/13\/16\/4\/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\/13\/16\/4\/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\/13633\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-8\u0022 class=\u0022first-child\u0022\u003EVisceral Fat Accumulation Leads to Atherosclerosis\u003C\/p\u003E\n         \u003Cq class=\u0022attrib\u0022 id=\u0022attrib-3\u0022\u003EBP=blood pressure; BS=blood sugar; HDL-C=high-density lipoprotein cholesterol; TG=triglycerides.\u003C\/q\u003E\u003Cq class=\u0022attrib\u0022 id=\u0022attrib-4\u0022\u003EReproduced with permission from Y Matsuzawa, MD, PhD.\u003C\/q\u003E\u003Cdiv class=\u0022sb-div caption-clear\u0022\u003E\u003C\/div\u003E\u003C\/div\u003E\u003C\/div\u003E\u003Cdiv class=\u0022section\u0022 id=\u0022sec-1\u0022\u003E\n         \u003Ch2 class=\u0022\u0022\u003ETRENDS IN METABOLIC SYNDROME AND DIABETES IN KOREA\u003C\/h2\u003E\n         \u003Cp id=\u0022p-9\u0022\u003ESoo Lim, MD, PhD, Seoul National University College of Medicine, Seoul, South Korea, presented data from 3 national studies he conducted with his colleagues to characterize the prevalence of MetS and diabetes in Korea.\u003C\/p\u003E\n         \u003Cp id=\u0022p-10\u0022\u003EThe Korea Genomic Epidemiology Study (KOGES) began in 2001 and has enrolled approximately 10,000 Korean subjects aged 40 to 70 years with MetS (defined using the NCEP-ATP III criteria modified for waist circumference [\u0026gt;90 cm for men, \u0026gt;80 cm for women]) [Lim S et al. \u003Cem\u003EJ Endocrinol Invest\u003C\/em\u003E 2006]. The overall prevalence of MetS was 26.1% (20.0% in men and 31.7% in women). Menopause may account for the sex difference, said Prof. Lim. Of the 5 components of MetS, abdominal obesity (AO; high waist circumference) comprised the highest proportion contributing to MetS (55.9%), followed by low HDL-C at 49.4%, BP 34.3%, triglycerides (TG) 30.5%, and glucose 10.3%. A clear relationship between AO and an inflammatory process was found, with a significant association between AO and increased levels of the inflammatory marker C-reactive protein (OR, 2.36).\u003C\/p\u003E\n         \u003Cp id=\u0022p-11\u0022\u003EThe Korean National Health and Nutrition Examination Survey (KNHANES), using the 2004 NCEP-ATP III criteria modified for waist circumference, found the prevalence of MetS increased from 22.2% in 1998 (mean age 45 years; n=6907) to 31.5% in 2007 (mean age about 50 years; n=2890) [Lim S et al. \u003Cem\u003EDiabetes Care\u003C\/em\u003E 2011]. The prevalence of MetS increased with age, and it was higher in women than in men particularly in older ages. The leading causes of the increasing trend of MetS in Korea were AO, high TG and low HDL-C.\u003C\/p\u003E\n         \u003Cp id=\u0022p-12\u0022\u003EProf. Lim and colleagues investigated the prevalence of MetS in children and adolescents in the United States and Korea using NHANES data and a modified 2009 NCEP-ATP III criteria (waist circumference \u226590th percentile for age and sex; serum TG \u2265100 mg\/dL; HDL-C \u226440 mg\/dL, high BP \u226590th percentile for age, sex, and height or current use of BP medication; fasting glucose \u2265110 mg\/dL or current antidiabetic medication). Notably, there was a 95% increase in the prevalence of MetS from 1998 to 2007 in Korean youth (4.0% in 1998; 7.8% in 2007) [Lim S et al. \u003Cem\u003EPediatrics\u003C\/em\u003E 2013]. In contrast, the prevalence of MetS decreased by 11% in US youth during this time period (7.3% in 1988\u20131994; 6.5% in 2003\u20132006).\u003C\/p\u003E\n         \u003Cp id=\u0022p-13\u0022\u003EThis increase in MetS in Korean adolescents was driven by high TG, low HDL-C, and high waist circumference, stated Prof. Lim, and the reduction in US adolescents was driven by improvements in BP and HDL-C. Furthermore, he stated the rapid economic development in Korea has been accompanied by a high-calorie, high-fat diet, plus low physical activity, which have contributed to the increase in MetS. The proportion of fat in the daily calorie intake significantly increased from 7.2% in 1969 to 20.3% in 2005.\u003C\/p\u003E\n         \u003Cp id=\u0022p-14\u0022\u003EAO leads to a pathological accumulation of excess adipose tissue in various organs, and this ectopic fat deposition may lead to cardiometabolic disorders and other organ-specific diseases, stated Prof. Lim.\u003C\/p\u003E\n      \u003C\/div\u003E\u003Cdiv class=\u0022section\u0022 id=\u0022sec-2\u0022\u003E\n         \u003Ch2 class=\u0022\u0022\u003ETRENDS IN CHINA IN METABOLIC SYNDROME AND DIABETES\u003C\/h2\u003E\n         \u003Cp id=\u0022p-15\u0022\u003EAn extensive study of 98,658 subjects from all 31 Chinese provinces by the Chinese Centers for Disease Control reported in 2013 provided new insights into the prevalence of MetS, diabetes, and prediabetes in China [Xu Y et al. \u003Cem\u003EJAMA\u003C\/em\u003E 2013]. Fasting plasma glucose (FPG), 2-hour plasma glucose (PG), and HbAlC \u0026lt;6.5% were used to diagnose diabetes and prediabetes. The majority of diabetes was detected by FPG (sensitivity) and HbAlC (specificity) in this study, thus confirming their utility to identify high-risk persons, said Juliana C. Chan, MD, Hong Kong Institute of Diabetes and Obesity, Hong Kong.\u003C\/p\u003E\n         \u003Cp id=\u0022p-16\u0022\u003EIn 2007, the estimated prevalence rates of T2DM was 11% and prediabetes 15% as determined from 4000 people in 21 Chinese provinces. In the 2013 study, 10% to 15% of men and women, urban or rural living, had T2DM, and nearly 50% had prediabetes. There was a tendency for the increase in T2DM to be higher in the more affluent areas. Of persons aged \u0026lt;30 years, 5% had T2DM and 40% had prediabetes. After the age of 50, there was a tendency for women to catch up in the rate of T2DM, while there was little sex difference in prediabetes.\u003C\/p\u003E\n         \u003Cp id=\u0022p-17\u0022\u003EIn a sample of 100,000 Chinese people in the CDC study, 30 to 35% were overweight, obese, or had central obesity. Of the obese persons, 25% had prediabetes and 10% had diabetes. In the obese population, 1 out of 5 subjects had T2DM. The prevalence of obesity was 2- to 3-times higher among those with central obesity. Nearly 14% of subjects had either a high fasting glucose or HbAlC between 5.5% and 6.5%. There was a direct relationship between increasing weight and the risk of diabetes. Obesity (OR, 2.03), central obesity (OR, 1.64), and being overweight (OR, 1.31) were all associated with the presence of diabetes in the 2013 study (\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\/13636\/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\/13636\/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\/13636\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-18\u0022 class=\u0022first-child\u0022\u003EClustering of Risk Factors and Impact on Diabetes and Prediabetes\u003C\/p\u003E\n            \u003Cdiv class=\u0022sb-div caption-clear\u0022\u003E\u003C\/div\u003E\u003C\/div\u003E\u003C\/div\u003E\n         \u003Cp id=\u0022p-19\u0022\u003EThe rate of smoking was high; 1 in 2 Chinese men were smokers. A meta-analysis showed that smoking was associated with a 44% increased risk of diabetes [Willi C et al. \u003Cem\u003EJAMA\u003C\/em\u003E 2007].\u003C\/p\u003E\n         \u003Cp id=\u0022p-20\u0022\u003EProf. Matsuzawa noted that in Japan the prevalence of MetS decreased from 2006 to 2008, as a result of an aggressive national public health campaign. In 2008, 29.6% of obese men and 21.7% of obese women had MetS.\u003C\/p\u003E\n      \u003C\/div\u003E\u003Cul class=\u0022copyright-statement\u0022\u003E\u003Cli class=\u0022fn\u0022 id=\u0022copyright-statement-1\u0022\u003E\u00a9 2013 MD Conference Express\u00ae\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\/13\/16\/4.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?nznlx1\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?nznlx1\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?nznlx1\u0022\u003E\u003C\/script\u003E\n\u003C\/body\u003E\u003C\/html\u003E"}