bluuebunny/crossref_metadata_2025 huggingface dataset:
An Open Interface for the On-Line Monitoring of Parallel and Distributed Programs
Authors: Ludwig Thomas , Wismüller Roland , Oberhuber Michael , Bode Arndt
Published: March 2007

The on-line monitoring interface specification (OMIS) pro vides means for developing more powerful interoperable and portable tool environments for parallel and distributed systems. It specifies the interaction between any tool and a monitoring system that is responsible for observing and manipulating the programs' execution. This well- defined interface makes it possible to concurrently use several tools of possibly different developers with the same program run and to port tools onto various target architec tures and software environments. As a starting point, the research group at LRR-TUM is designing an OMIS com pliant monitoring system (OCM) for Parallel Virtual Machines (PVM) to run on workstation clusters. Tool de velopers can use this implementation to attach their own on-line tools to the system.
Software Tools for Scalable Multilevel Application Engineering
Authors: Decker Karsten M. , Wylie Brian J. N.
Published: March 2007

Contemporary activities at CSCS/SCSC have resulted in two complementary software systems for practical parallel programming. Both developments are user oriented and application driven, efficiently exploiting and reusing dem onstrated portable technologies at multiple levels that we have proven to scale to systems with large numbers of processors. The Annai parallel application engineering environment supports existing standards for portable pro gram development (HPF, Fortran, C, MPI) and offers con venient program browsing and navigation, execution con trol, and interaction mechanisms. Specific functionality for parallel programming includes high-level language sup port for unstructured computations, interactive source- level symbolic debugging with deadlock detection and deterministic execution replay, SPMD/data-parallel debug ging with distributed breakpoints and array visualization, scalable profile summary displays of execution statistics accumulated at runtime, and detailed program evolution and processor interaction charts. The intelligent program development environment (PDE) is typified by four char acteristics supporting programming at a very abstract level, closer to the scientist's perspective: application- oriented problem description formalisms, the use of design skeletons and templates, an interactive user guidance mechanism, and automatic program synthesis tech niques. Ongoing work aims at the integration and further development of sofar demonstrated results with additional advanced technologies into comprehensive application engineering and problem-solving environments for pro ductive parallel computing with distributed resources.
The Nature of Action Learning
Authors: Revans R.W.
Published: March 2007

Action Learning has now developed to an extent that there is now a demand to 'know' what it is. There is one way, and one way alone, of getting to 'know' what action learning is, and that is by doing it. For those who most clamour to 'know' what something might be are usually the victims of an educational system that leaves the vast majority who pass through it ignorant of the meaning of the verb to 'know' ... If, for example, I am asked 'Do you know that woman?' it is most probable that the questioner does not 'know' what he is asking me. Does he mean 'Do I know her name? Or where she lives? Or am I able to introduce him to her? Or what she does for a living? Or do I recognise her by sight? Or have I been to bed with her? And, if so, what progress did I make? ...' Thus, with action learning: 'Have I read a book about it? Or attended a seminar at which somebody was trying to sell places on an action learning programme? Or visited a set of participants meeting as part of such a programme? Or tried to organise real persons tackling real problems in real time, and trying thereby to learn with and from each other? Or been an active participant myself in such a programme? ...' To 'know' what action learning is one must have been responsibly involved in it; since this cannot have been done merely by reading about action learning, it is impossible in this, or any other, note to convey more than the vaguest impression of what this educational approach may be. The day action learning becomes explicable in words alone will be the day to abandon the practice of it.
The Educational Dimension of the Management Process
Authors: Berry A.J.
Published: March 2007

This paper is concerned with the nature of education which may be undertaken within the process of managing. Following Bateson, four levels of learning are examined in relation to education within the managing role and through disengaging from the immediate managing role, i.e. education 'out of role'. Both of these approaches require that attention be given to the micro-political and social contexts of managers in organisations. From a perspective that organisations exist to serve the needs of persons it is argued that the educational task is to accentuate the personal role in relation to the institutional role, to permit learning at all four levels.
5. South America
Authors: Warnes H.
Published: March 2007

F. SAFADI studied the delusional content of lower-class schizophrenic patients hospitalized in Guayaquil, Ecuador. Significant differences were found between patients of different cultural and geographic origin. Three papers by M. DOBKIN deal with folk medicine in Peru.
5. Middle East
Authors: Racy J.
Published: March 2007

Two psychologists, I. AL-ISSA and B. AL-ISSA, present an overview of mental illness and of the care of the mentally ill in Iraq. In a second paper I. AL- ISSA deals with the bearing of literacy on schizophrenic symptoms. He com pared literate with illiterate chronic Iraqui schizophrenics. J. T. SHUVAL and her coworkers tested the hypothesis that physicians in Israel provide more status and catharsis to some ethnic groups than to others, and that rural clinics will serve these latent functions of a medical institution better than urban clinics. J. PH. HES reports on the use of Catha edulis by Yemenite Jews who immigrated to Israel. Its somatic and psychological effects are described.
1. Far East
Authors: Ellenberger Henri F.
Published: March 2007

According to B. KIMURA, a Japanese psychiatrist, transcultural psychiatry should reconsider old problems in the light of foreign concepts and ways of experiencing. By means of a brief semantic analysis of some fundamental Japanese words, he shows how interhuman relationships are experienced differently in Japan and how this influences the perception of mental disease and psychotherapeutic rela tions. J. R. AVERILL, E. M. OPTON, JR, and R. S. LAZARUS report on psychophysio logical differences found between Japanese and white American groups in their reactions to a silent film considered as highly threatening. According to Y. S. MATSUMOTO, the low rate of coronary disease observed in Japan, even in indus trialized regions, is related not only to low intake of dietary fat but also to such sociocultural factors as the continuing emphasis on group welfare, group consen sus, paternalistic enterprises, frequent opportunities for recreation among men, and a relatively weak sense of individuality. The most detailed description and analysis ever written in English of present-day Morita therapy and theory, by D. K. REYNOLDS, is reviewed. This study concludes with an analysis of Japanese national character in relation to the shinkeishitsu neurosis, for which Morita therapy was developed and in relation to some child-raising practices. W.-S. TSENG, after a brief description of shamanistic curing techniques in Taiwan, gives a good illustration of how a man can become a shaman. Shamanism is the subject of another study by B.-Y. RHI, who compares the therapeutic process of Jungian analytic psychology with that of shamanistic healing in Korea. A shamanistic ceremony called zinoki is described as an equivalent to making the unconscious conscious, to experiencing the archetypal complex for conflictual resolution, and to sending the purifled product of the archetype once again to the collective unconscious. This section ends with J. WESTERMEYER's descrip tion of a new form of amok, called grenade- amok, which recently appeared in Laos.
4. Middle East
Authors: Racy John
Published: March 2007

S. ISMAIL reports on neurotic patients treated at the outpatient psychiatric unit of the Kuwait Psychiatric Hospital. Significant symptomatological differences were noted on comparison of Bedouins with the urban population. An attempt is made to interpret these differences in psychocultural terms.
6. South America
Authors: Opler M.K.
Published: March 2007

R. RIBEIRO provides a preliminary report based on his study of limited samples of males belonging to six Afro-Brazilian cult groups in Recife. He emphasizes the fact that sexual maladjustments listed as homosexuality and problems of sexual inadequacy were detected in 57 percent of the sixty subjects interviewed. F. KATZ and M. DOBKIN DE RIOS analyze the therapeutic functions of whistling which seems to be an adjunct to hallucinogenic healing in the Peruvian Amazon.
Review : Post-renal transplant compliance
Authors: Bell Fiona
Published: March 2007

■ A selective review was undertaken to identify factors which may affect a child's compliance with immunosuppressive therapies, post-renal transplant.

■ Studies were categorised as either examining compliance from an experiential or selective attribution approach.

■ There are multiple reasons for non- compliance.

■ Children and families require much more support than previously recognised.
Review : Information giving can be painless
Authors: Jonas Denise , Worsley-Cox Kay
Published: March 2007

■ Pain is an inevitable consequence following day surgery, but with effective regular pain relief minimal discomfort can be achieved.

■ An information leaflet produced by a pain nurse specialist in collaboration with a multidisciplinary team ensures that comprehensible and non-contradictory information is given to parents.

■ With the increased trend towards paediatric day surgery parents are significant contributors to their child's care in the postoperative period.

■ Written information on pain relief after discharge can help parents make decisions about their child's pain management.
Review : Consent in children: legal and ethical issues
Authors: Clayton Michael
Published: March 2007

■ Children's wishes are often not respected.

■ The law does not support children's involvement in consent.

■ Nurses can be influential in supporting patients during the process of consent.

■ Decisions may be made based upon ethical principles, which tend not to respect individual rights.
Pain at home: children's experience of tonsillectomy
Authors: Swallow Janet , Briggs Michelle , semple Pete
Published: March 2007

■ Earlier discharge following tonsillectomy increases the need for good pain management advice and effective analgesia.

■ An audit determined the nature of children's pain experiences at home following tonsillectomy and identified pain management strategies used.

■ Combined analgesia and formal pain assessment significantly reduced the number of children in moderate or severe pain on discharge.

■ Pain could worsen following discharge, persist for three to ten days and be at times moderate to severe.

■ 50% of parents contacted their GP and 75% of children required paracetamol and ibuprofen concurrently.

■ Audit data was utilised to develop comprehensive written pain management advice and a discharge protocol for combined analgesia.
Review : Anthropology and children's nursing
Authors: Littlewood Jenny
Published: March 2007

■ Children's nurses have become more involved in the provision of culturally sensitive care

■ There has been a search for a more meaning centred (or hermeneutic) method in exploring children's worlds

■ The possible relevance of anthropology as an approach to both the culture of children's nursing and the cultures in which children's nurses find themselves is explored.
Munchausen Syndrome by Proxy Abuse
Authors: Bennett Karen , Nurse Staff
Published: March 2007

■ The difficulties in diagnosing Munchausen Syndrome by Proxy Abuse (MSbPA) are examined.

■ The perpetrators of MSbPA are usually the victim's primary care giver.

■ The warning signs of MSbPA include unexplained, prolonged and extraordinary illness with the signs and symptoms only being evident when the suspected perpetrator is present.

■ Confrontation, exclusion and covert video surveillance are all possible routes to gaining further evidence.

■ The problems associated with covert video surveillance are explored.
Princess Diana's celebrity in freeze-frame
Authors: Brauer Lydia , Shields Vickie Rutledge
Published: March 2007

This essay analyzes the relationship between Princess Diana's celebrity and her photographed image in two popular, posthumous media constructions of Diana's life. Utilizing Richard Dyer's work on Hollywood stars and identity authenticity, both works are contextuahzed in tabloid journalism and its ambivalent authority in the construction of celebrity image. The paper then applies a semiotic lens to each publication's construction of the relationship between photograph and language, exploring how these joined symbolic systems generate and authorize a crucial sense of the 'real' Diana. Finally, the essay explores how the mediation of the narrative source is a critical factor in determining the stability and signification of Diana's photographs.
Cultural studies in Germany (and Austria
Authors: Horak Roman
Published: March 2007

This article will examine some reasons why until recently cultural studies did not have much of an importance in the academia of both Germany and Austria. It will give a brief overview of the reception of cultural studies' work on youth culture in the early eighties which led to the wrong impression that cultural studies was basically about the study of youth. It will then be argued that the importance of the concept of 'high culture' (the fine arts, the refined etc.) as well as the traditional opposition of literature and the social sciences and the impact of the Frankfurt School proved to be major factors to hinder a broad reception of cultural studies.
Agreement on Agriculture: Issues of Market Access for South Asian Countries
Authors: Pandey Posh Raj
Published: March 2007

The Uruguay Round achieved a historic turning point in the reform of agricultural trade system through adoption of the Agreement on Agriculture (AoA). The AoA lays firm foundation for strengthening multilateral discipline on agriculture trade by bringing the agriculture sector under GATT disciplines. It prohibits the use of non-tariff barriers and obliges members to reduce tariff barriers in the agriculture sector, and also establishes rules to restrain the use of domestic policy measures in the form of domestic support and export subsidies that have trade-distorting effects.

Against these backgrounds, the paper delves into critical assessment of opportunities emanating from the AoA for the export of agriculture products by South Asian countries. The paper shows that member countries, in particular developed ones altogether, have not respected the agreement fully and faithfully, and tend to exploit the grey areas of the text to deny market access. As a result, new threats have been emerged. Since the agricultural export structure of South Asian countries are highly concentrated in a few products and markets, market access conditions even for few products would play a decisive role in terms of their export development potentials.

The paper suggests that the ongoing negotiation on agriculture is an opportune venue for South Asia to correct the unbalanced provisions and modalities of implementation, and tilt the international agriculture market in their favour. For this, South Asian countries need to devise a common minimum position and put forward such position collectively along with forging issue-based alliances with other countries/groups. Given the limited usage of domestic supports and export subsidies coupled with fiscal constraints to introduce new ones, the level ofdispar ities in bound and applied tariffs of South Asian countries, the depth of market access barriers in other WTO members and the extent of price fluctuation ofagri cultural products in international market, the paper argue that South Asian coun tries should focus aggressively on expanding market access opportunities for their exportable products in the negotiations rather than protecting domestic market except for rural development and food security concern.
Financial Sector Reforms and Corporate Governance of Banks in Developing Economies: The Indian Experience
Authors: Arun T.G. , Turner J.D.
Published: March 2007

The corporate governance of banks in developing economies is important, if for no other reason than the prevalence and severity of banking instability in many of these economies. In India, although the issues of corporate governance have not received much attention in the first generation of financial sector reforms, this issue will become a natural choice in the second set of reforms. The article finds that the partial divestment of Public Sector Banks (PSBs) has not brought about any significant changes in the quality of corporate governance mechanisms. This study also confirms the urgent need to review the size and composition of the PSB boards in India, particularly on adequate board-level representation for private shareholders when there is mixed ownership between the government and the private sector. The considerations of the Government of India (GOI) in making board-level appointments and the degree of transparency in the appointment process requires adequate attention. The issues of limited operational autonomy and inadequate representation for private shareholders in the boards could affect the recapitalization strategy of PSBs.
India's Informal Trade with Sri Lanka and Nepal: An Estimation
Authors: Taneja Nisha , Sarvananthan Muttukrishna , Karmacharya Binod K. , Pohit Sanjib
Published: March 2007

India has signed bilateral free trade agreements (FTAs) with both Sri Lanka and Nepal. Despite such agreements, informal trade continues to thrive in the South Asian region. Not much empirical evidence seems to exist on the magnitude and composition of such trade. Using the Delphi technique, the study makes an attempt to estimate India's informal trade with Sri Lanka and Nepal through an extensive primary survey conducted in the three countries, covering several cities. Corresponding country estimates of Indo-Sri Lanka and Indo-Nepal informal trade, provide a possible range within which the estimates are likely to lie. The study shows that total two-way informal trade between India and Sri Lanka is almost a third of formal trade, while that between India and Nepal is almost as large as formal trade. The study also points out the lacunae in the Indo-Sri Lanka and Indo-Nepal FTAs and suggests how they can be addressed so that informal trade can be brought within the ambit of formal trade.
The Family Learning Center Charter School: Leadership and Accountability at a Crossroads
Authors: Detert James R. , Detert Natalie R.
Published: March 2007

The Family Learning Center Charter School case details the start-up and first year of operations of an elementary charter school in a diverse and relatively low-income area of St. Paul, Minnesota. The school's founder, Dr. Wayne Jennings, established the school to test hismodel for Community Learning Centers, designed around nineteen research-based principles. Jennings struggles to implement the model faithfully, dealing with all the other challenges of starting a new charter school, including funding problems, an inexperienced staff, and the lack of an established curriculum.

The case is useful for administrators-in-training, administrators already in leadership positions in traditionalpublic schools, and individuals interested in exploring the establishment of a charter school. In particular, it addresses three significant questions. First, what are charter schools? Fundamentally, the case serves to clear up general misconceptions about charter schools and offer a concrete illustration. Second, how should new and innovativeprograms be evaluated? The case provides a format to discuss the standards, means, and length of evaluation of a program's performance. Finally, how should leadership respond as it strives to meet its goals with limited resources? Charter schools provide an exceptional level of autonomy while also demanding an unparallel demonstration of accountability.
Burnout: Steve Watson's First Year As An Inner City Teacher
Authors: Fossey Richard , Angelle Pamela S. , McCoy Mary Helen
Published: March 2007

This case describes a beginning teacher’s first year in an inner city school. Steve Watson, the case’s main actor, exhibits some of the signs of teacher burnout as he struggles with difficult teaching conditions and lack of administrative and peer support. The case provides an opportunity to discuss the value of effective teacher induction activities and mentoring programs. In addition, students can relate the extensive literature on teacher burnout to the case and can explore ways that institutions and individuals can reduce the likelihood of teacher burnout. Finally, the case provides a vehicle for discussing the impact of collective bargaining agreements and court-imposed school desegregation plans on teacher recruiting.
Re-Affirming Outreach: A University/High School Partnership Program
Authors: Rose Linda P.
Published: March 2007

This case addresses the state-mandated end of discrimination and preferential treatment and the subsequent use of university outreach programs to increase the college eligibility of underrepresented students. The principal of an inner city high school asks for help from a state university to increase his students' eligibility to Tier I public universities. The university sets up outreach programsat his school but the administrators, the teachers, parents and students are dissatisfied with them. This case illustrates leadership issues that may arise in connection with university outreach programs as well as pre-existing leadership issues at a school.
The Accountablity Challenge
Authors: Lyons James E.
Published: March 2007

This case decribes a large urban school district that faces the usual challenges found in these districts such as poverty, deteriorating school facilities, school integration, bussing, and student academic performance in the state's high stakes accountability program. The former superintendent, who did not particularly like the state's accountibility program, abruptly resigned after two years in the position when the district's test results were received. As a result, the school district is scheduled to be placed on warning status by the state. The school board is left with a public relations problem, a staff morale problem, the problem of nine low performing schools, and the challege to immediately select an interim superintendent. However, the central focus of the case is educational accountability as measured by student performance on the state's high stakes testing program.
Academic Staffing Schemes Reconsidered
Authors: Crispin Alan
Published: March 2007

This paper attempts to widen the scope of the review by Birch and Calvert (Vol.3, No.l) into academic staffing formulae by considering approaches based on student enrolment and by adding a further workload model which lends itself to graphical presentation. Criticisms of workload schemes are examined and comments made on the applicability of staff entitlement schemes.
Heparanase influences expression and shedding of syndecan-1, and its expression by the bone marrow environment is a bad prognostic factor in multiple myeloma
Authors: Mahtouk Karène , Hose Dirk , Raynaud Pierre , Hundemer Michael , Jourdan Michel , Jourdan Eric , Pantesco Veronique , Baudard Marion , De Vos John , Larroque Marion , Moehler Thomas , Rossi Jean-Francois , Rème Thierry , Goldschmidt Hartmut , Klein Bernard
Published: March 2007

The heparan sulfate (HS) proteoglycan, syndecan-1, plays a major role in multiple myeloma (MM) by concentrating heparin-binding growth factors on the surface of MM cells (MMCs). Using Affymetrix microarrays and real-time reverse transcriptase–polymerase chain reaction (RT-PCR), we show that the gene encoding heparanase (HPSE), an enzyme that cleaves HS chains, is expressed by 11 of 19 myeloma cell lines (HMCLs). In HSPEpos HMCLs, syndecan-1 gene expression and production of soluble syndecan-1, unlike expression of membrane syndecan-1, were significantly increased. Knockdown of HPSE by siRNA resulted in a decrease of syndecan-1 gene expression and soluble syndecan-1 production without affecting membrane syndecan-1 expression. Thus, HPSE influences expression and shedding of syndecan-1. Contrary to HMCLs, HPSE is expressed in only 4 of 39 primary MMC samples, whereas it is expressed in 36 of 39 bone marrow (BM) microenvironment samples. In the latter, HPSE is expressed at a median level in polymorphonuclear cells and T cells; it is highly expressed in monocytes and osteoclasts. Affymetrix data were validated at the protein level, both on HMCLs and patient samples. We report for the first time that a gene's expression mainly in the BM environment (ie, HSPE) is associated with a shorter event-free survival of patients with newly diagnosed myeloma treated with high-dose chemotherapy and stem cell transplantation. Our study suggests that clinical inhibitors of HPSE could be beneficial for patients with MM.
Construction of Fine Metallic Lattice Framework by Magneto-plating
Authors: Yonemochi Shinichi , Kondo Takuji , Kubo Shiori , Kawasaki Mikio , Nagoya Toshio
Published: March 2007

A fine metallic lattice framework was constructed by forming many fine projections on the upper and lower surfaces of a metal mesh by magnetoplating, in order to be used as an air purification material or a supporting material of a catalyst.
Preparation of Silica Microcapsules Containing Octadecane as Temperature-adjusting Powder
Authors: Miao Chunyan , Lü Gang , Yao Youwei , Tang Guoyi , Weng Duan , Qiu Jianhui , Mizuno Mamoru
Published: March 2007

Spherical microcapsules of silica-shelled octadecane are prepared in the presence of polyvinyl alcohol in an O/W emulsion. The silica shell forms via hydrolysis and condensation from tetraethyl silicate with acetatic acid as catalyst. The thermogravimetric curves show that the microcapsules have thermal stability superior to that of octadecane. The latent heat and the melting point of microcapsule are 162 J·g−1 and 30 °C, respectively.
New Non-platinum Cathode Based on Chromium for PEFC
Authors: Kim Jin-Hwan , Ishihara Akimitsu , Mitsushima Shigenori , Kamiya Nobuyuki , Ota Ken-ichiro
Published: March 2007

Chromium-based electrocatalysts which were prepared using an R.F. sputter with CrC target under Ar or Ar + N2 atmosphere with or without heating a substrate at 1073 K were evaluated as a cathode of polymer electrolyte fuel cells (PEFCs). Heating the substrate during the sputtering was found to be very useful to enhance the catalytic activity for oxygen reduction reaction (ORR). It is considered that nitride (CrN) and/or carbonitride (Cr2C0.39N0.61) may have high catalytic activity for the ORR.
Improving Linkage of Web Pages
Authors: Gupta Rakesh , Bagchi Amitava , Sarkar Sumit
Published: March 2007

Organizations maintain informational websites for wired devices. The information content of such websites tends to change slowly with time, so a steady pattern of usage is soon established. User preferences, both at the individual and at the aggregate level, can then be gauged from user access log files. We propose a heuristic scheme based on simulated annealing that makes use of the aggregate user preference data to re-link the pages to improve navigability. This scheme is also applicable to the initial design of websites for wireless devices. Using the aggregate user preference data obtained from a parallel wired website, and given an upper bound on the number of links per page, our methodology links the pages in the wireless website in a manner that is likely to enable the “typical” wireless user to navigate the site efficiently. Later, when a log file for the wireless website becomes available, the same approach can be used to refine the design further.
Jet Injection of Insulin During Self-Monitoring of Blood Glucose
Authors: Danowski T S , Sunder J H
Published: March 2007

Insulin-dependent diabetes mellitus has been treated with four jet injections of insulin (regular insulin before each meal and intermediate insulin at bedtime) during self-monitoring of blood glucose levels. The blood glucose levels generally remain within 60 and 150 mg/dl.
Fructose as a Dietary Sweetener in Diabetes Mellitus
Authors: Koivisto Veikko A
Published: March 2007

Human beings, including those with diabetes, have a desire for sweetness in the diet that cannot be ignored. The Food and Drug Administration ban of cyclamates and possible ban of saccharin have raised the question of alternative sweeteners for diabetic persons. Considerable interest has been focused on fructose, and both basic and clinical research has delineated its metabolic effects. This paper reviews the characteristics of fructose, as well as its physiology and metabolism in both normal and diabetic man. Findings seems to indicate that, in controlled diabetes, chronic or limited consumption of fructose at moderate doses has no adverse effects on the levels of blood glucose, cholesterol, or tryglycerides.
Joint Contractures in Patients with Juvenile Diabetes and Their Siblings
Authors: Traisman Howard S , Traisman Edward S , Marr T J , Wise Joyce
Published: March 2007

Six hundred fifteen children (310 with diabetes, 106 nondiabetic siblings, and 199 nonsibling controls) were examined for the presence of joint contractures. Forty children had contractures: 8.4 per cent of those with diabetes and 4.6 per cent of those without diabetes. Contractures were present, however, in 9.4 per cent of nondiabetic siblings, and only 2 per cent of nonsibling controls, suggesting a familial tendency to joint contractures. The older the patient, the more likely he was to have contractures. There was no correlation with sex, race, or age at onset of the disease.
Obesity in Offspring of Diabetic Pima Indian Women Despite Normal Birth Weight
Authors: Pettitt David J , Knowler William C , Bennett Peter H , Aleck Kirk A , Baird H Robert
Published: March 2007

The relationships of birth weight and maternal diabetes to the development of obesity were examined at 5–19 yr of age in the offspring of Pima Indian women. At each age, offspring of diabetic women, even those who were of normal birth weight, had a higher mean weight relative to height than offspring of nondiabetic and prediabetic women. Birth weight was predictive of relative weight in 5- to 9- and 10- to 14-yr-old offspring of nondiabetic women but not in the oldest group. In contrast, for offspring of prediabetic and diabetic women, birth weight was not predictive of subsequent obesity at any age studied. Offspring of diabetic women were heavier than offspring of nondiabetic and prediabetic women regardless of birth weight. Thus, maternal diabetes was important in predicting body size in the offspring even after accounting for the effects of the birth weight and maternal body size.
Insulin and Glucose Responses to Various Starch-Containing Foods in Type II Diabetic Subjects
Authors: Krezowski Phillip A , Nuttall Frank Q , Gannon Mary C , Billington Charles J , Parker Shirley
Published: March 2007

The circulating insulin and glucose responses in type II diabetic subjects were determined for 5 h after ingestion of various meals, each containing 50 g carbohydrate. The purpose of the study was to 1) systematically study the insulin response to several different high-starch foods, 2) determine whether this insulin response could be predicted by the glucose response, and 3) determine whether the glucose response could be predicted by the physical structure and digestibility of the ingested carbohydrate. Each subject served as his own control. Carbohydrate was given in the form of potatoes, bread, oatmeal, rice, lentils, kidney beans, cornflakes, high-amylose corn muffins, and low-amylose corn muffins. Bread, oatmeal, rice, lentils, kidney beans, and high-amylose corn muffins resulted in a significantly lower glucose area than 50 g glucose, and the glucose response generally could be predicted by the physical structure and the known digestibility of the ingested carbohydrate. The insulin rise was statistically significantly greater than would be predicted from the glucose response for oatmeal, lentils, kidney beans, and high-amylose corn muffins. Although not statistically significant, the mean was greater than predicted for every other food except potatoes when the insulin response to 50 g glucose was used as a standard. These results indicate that the insulin response cannot be predicted by the glucose response.
Islet Cell Autoantibodies: Pathobiology and Clinical Applications
Authors: Vardi Pnina , Dibella Elsie E , Pasquarello Timothy J , Srikanta Sathyanarayana
Published: March 2007

Autoimmunity directed against pancreatic islet cells results in slowly progressing β-cell destruction, culminating over years in clinically manifested insulin-dependent diabetes mellitus (IDDM). Circulating serum autoantibodies directed against the endocrine cells of the islets of Langerhans arean important hallmark of this disease. Assays for these islet cell antibodies (ICA) have facilitated the investigation and understanding of several facets in the pathogenesis of autoimmune diabetes. Their applications have begunto extend into clinical practice and have opened new avenues for early preclinical prediction and preventive prophylaxsis in IDDM.
Putative Determinants of Arterial Wall Compliance in NIDDM
Authors: Wahlqvist Mark L , Lo Che Sam , Myers Kenneth A , Simpson Richard W , Simpson Judy M
Published: March 2007

Aortoiliac arterial wall compliance was measured in apparently healthy subjects and in patients with noninsulin-dependent diabetes (NIDDM), on diet alone, who had no clinical evidence of peripheral arterial disease. Compliance was significantly lower in patients with diabetes. The two clinical groups were combined to provide as wide a range of blood glucose values as possible. After allowing for the influence of age, there were significant negative correlations between compliance and free fatty acid and insulin levels. These were almost completely accounted for by differences in blood glucose levels. Therefore, arterial compliance was best predicted on the basis of age and the area under the blood glucose curve.
Incidence of Diabetic Retinopathy and Relationship to Baseline Plasma Glucose and Blood Pressure
Authors: Teuscher Arthur , Schnell Hans , Wilson Peter WF
Published: March 2007

A nationwide, stratified population sample of 534 diabetic Swiss men and women, aged 35–54 yr, participated in a study of vascular disease. The study was based on a common protocol, standardized examination procedures, and centralized laboratory methods. Patients were chosen from a pool of diabetic Swiss with diabetes ≥1 yr. After selection, the participants were classified into groups according to age at diabetes onset (>30 or <30 yr) and insulin treatment status. Several variables thought to be related to retinopathy incidence were analyzed at the initial examinations: onset of diabetes before age 30, duration of disease, fasting plasma glucose, blood pressure, and insulin therapy. Follow-up examinations of 358 of 458 survivors, with a diabetes duration that averaged 20 yr, showed retinopathy significantly and independently associated with initial fasting plasma glucose, systolic blood pressure, and insulin use but not with diabetes duration. Lower rates of retinopathy development were observed during the follow-up period in diabetic patients on antihypertensive therapy at the baseline examination, suggesting that not only lower fasting plasma glucose and systolic blood pressure levels but also blood pressure therapy itself decreases the incidence of retinopathy.
Evaluation of Comprehensive Program for Diabetes Care at Primary Health-Care Level
Authors: Rosenqvist Urban , Carlson Anita , Luft Rolf
Published: March 2007

The Swedish National Board of Health and Welfare published its first diabetes health-care program in 1977. The impact of the program was evaluated in the Stockholm County after 4 yr. The results showed that the educational program had reached ≥1 staff member in 86% of the 104 primary health-care centers (PHCCs). Several organizational changes had taken place as a result of the program. The 10 “best” PHCCs were compared with a random sample of the centers with regard to patient outcomes. Patients from the 10 best centers had gotten a more comprehensive education, were more knowledgeable about foot care, tested glucose more often, and used less medication. The metabolic control was the same for both groups of patients. The PHCC staffs reported the following roadblocks to change: lack of knowledge of diabetes care, insufficient cooperation between staff members, poor contact with specialists, and absence of guidelines for diabetes care. The staffs in the best centers spent twice as much time in staff meetings and continuing education as those from the random sample of centers. The findings led us to formulate a new strategy for the program. The main objective of the new approach is to create organizational changes within the centers. Thus, local knowledge and creativity can be utilized. Preliminary data demonstrate that 84% of the locally developed plans for reorganization of diabetes care had been accomplished within 1 yr.
Hormonal and Metabolic Effects of Enalapril Treatment in Hypertensive Subjects With NIDDM
Authors: Moore M Peter , Elliott Teresa W , Nicholls M Gary
Published: March 2007

The effects of enalapril treatment on blood glucose, insulin, and C-peptide levels and effects on the reninangiotensin aldosterone system were studied in 22 hypertensive patients with non-insulin-dependent diabetes. After a 4-wk run-in period during which all previous antihypertensive drugs were discontinued, treatment was commenced with one daily dose of 10 mg enalapril. The dose was adjusted upward at 3-wk intervals to a maximum of 40 mg daily. In 3 subjects, addition of a thiazide diuretic was required after 9 wk of treatment. At completion of run-in and after 9 and 13 wk of treatment, subjects had blood samples drawn after fasting and 2 h after a standardized 1.6-mJ mixed meal. Mean fasting blood glucose at the end of the run-in period was 8.3 ± 0.5 mM and at study completion was 7.3 ± 0.4 mM. Mean postprandial blood glucose was 10.8 ±1.0 mM before treatment and 9.8 ± 0.7 mM at study completion. The changes in fasting and postprandial blood glucose levels were not significant (P = .06 and P = .15, respectively). There was no significant change in glycosylated hemoglobin levels. Fasting and meal-stimulated insulin and C-peptide levels were not altered by enalapril treatment. Treatment was associated with a sustained reduction in plasma angiotensin-converting enzyme activity, an increase in plasma renin activity, reduced plasma aldosterone levels, and significant reductions in supine, seated, and standing arterial blood pressures. There was a small rise in mean plasma potassium from 4.0 ± 0.09 to 4.2 ± 0.09 mM after 3 wk of treatment, but after 9 wk, potassium levels had returned to pretreatment levels. Plasma creatinine levels did not change.
Flocculation and Loss of Potency of Human NPH Insulin
Authors: Benson Edward A , Benson James W , Fredlund Paul N , Mecklenburg Robert S , Metz Robert
Published: March 2007

In late 1986, several vials of Humulin N (NPH human insulin, recombinant DNA origin) came to our attention because of a clumped, white coating on the inside of the vials. To determine the frequency of this phenomenon, we surveyed 100 consecutive patients who used Humulin N. Ten patients had encountered 21 vials of flocculated insulin in the previous 12 mo, reflecting an incidence of 1 per 72 vials. Insulin drawn from affected vials was markedly reduced in potency: 20.9 ± 3.4 U/ml vs. the labeled potency of 100 U/ml. Several patients reporting flocculated insulin, including one hospitalized with ketoacidosis, experienced unusual and unexplained elevation in blood glucose concentration for several days before flocculation was observed. Patients who use NPH human insulin should be aware of this phenomenon and carefully inspect their vials for evidence of insulin precipitation before each injection.
Clinical Aspects of Sucrose and Fructose Metabolism
Authors: Bantle John P
Published: March 2007

The per capita consumption of sugars in the United States accounts for ∼21% of total calorie intake. Most Americans eat and enjoy sugar-containing foods every day, but the use of sugars in the diabetic diet has traditionally been proscribed for fear of aggravating hyperglycemia. However, short-term and most longerterm studies demonstrate that dietary sucrose does not cause a greater postprandial rise in plasma glucose than isocaloric amounts of other common carbohydrates. The available evidence suggests that sucrose has a glycemic effect similar to that of bread, potatoes, and rice. Dietary fructose, in contrast, may produce a lesser postprandial rise in plasma glucose than other common carbohydrates. There is considerable controversy aboutthe effects of dietary sucrose and fructose on serum lipids, and their effects on other metabolic events, such as the nonenzymatic glycosylation of proteins, are uncertain. Nevertheless, it is reasonable to allow diabetic patients to consume sugar-containing foods as long as they do so in a controlled fashion.
Factors Associated With Fasting and Postglucagon Plasma C-Peptide Levels in Middle-Aged Insulin-Treated Diabetic Patient
Authors: Laakso Markku , Rönnemaa Tapani , Sarlund Helena , Pyörälä Kalevi , Kallio Veikko
Published: March 2007

We studied fasting and postglucagon plasma C-peptide levels and factors associated with them in two representative studies of middle-aged insulin-treated diabetic patients whose diabetes had been diagnosed after the age of 30 yr. Altogether, 75 men and 79 women from East Finland and 83 men and 62 women from West Finland aged 45–64 yr were studied. Of these patients, 44.4% had undetectable fasting and 38.5% undetectable postglucagon C-peptide concentrations. The φ coefficient expressing the concordance of fasting and postglucagon C-peptide concentrations in the classification of diabetic patients into nonresponders and responders was .75 in men and .91 in women. In multiple stepwise regression analyses, body mass index (BMI) and the period between diabetes diagnosis and the initiation of insulin treatment were positively and duration of diabetes inversely associated with fasting and postglucagon C-peptide levels in both sexes. We concluded that 7) insulin deficiency is not uncommon in middle-aged insulin-treated diabetic patients whose diabetes has been diagnosed after the age of 30 yr; 2) fasting C-peptide levels contain basically the same information as postglucagon C-peptide levels; and 3) a low BMI, a need for insulin treatment soon after the diagnosis of diabetes, and a long duration of diabetes are predictive of insulin deficiency.
Early-Morning Hyperglycemia in IDDM: Acute Effects of Cholinergic Blockade
Authors: Atiea Jameel A , Creagh Finuala , Page Michael , Owens David R , Scanlon Maurice F , Peters John R
Published: March 2007

Growth hormone (GH) hypersecretion in insulindependent diabetes mellitus (IDDM) subjects has been shown to be causally related to early-morning hyperglycemia. We studied the effect of nocturnal GH suppression on acute glycemic control in six IDDM patients during a constant overnight insulin infusion (0.075 mU · kg−1 · min−1). In control experiments (infusion of insulin alone), plasma glucose increased from 5.6 ± 0.6 mM at 2400 to 11.1 ± 1.3 mM at 0900 (P = .0024). When in addition the cholinergic muscarinic antagonist pirenzepine wasgiven (100 mg at 2200 and again at 2400), plasma glucose increased from 5.6 ± 0.3 mM at 2400 to 8.4 ± 1.4 mM at 0900 (P > .05). The nocturnal surges of GH that were demonstrated in all patients during the control nights were suppressed during the treatment nights. There were no significant changes in insulin, cortisol, orepinephrine concentrations. Mean glucagon and norepinephrine concentrations were reduced from 127 ± 2.7 ng/L and 8.7 ± 0.5 nM to 101 ± 1.9 ng/L (P < .001) and 3.5 ± 0.2 nM (P < .001) on control and treatment nights, respectively. Neither glucagon nor norepinephrine concentrations changed significantly between 2400 and 0900 on either control or treatment nights. We conclude that nocturnal GH suppression by pirenzepine during a constant low-rate insulin infusion is associated with an attenuation of the early-morning plasma glucose rise.
Analysis of Changes in Eating Behavior and Weight Loss in Type II Diabetic Patients: Which Behaviors to Change
Authors: Guare John C , Wing Rena R , Marcus Marsha D , Epstein Leonard H , Burton Lisa R , Gooding William E
Published: March 2007

To identify the behavior-change strategies that are most clearly related to weight loss, 106 patients with type II (non-insulin-dependent) diabetes completed the Eating Behavior Inventory (EBI) before and after participating in a behavioral weight-loss program and at 1-yr follow-up. The EBI is a standardized questionnaire that assesses behavioral strategies typically taught in a behavioral weight-loss program. Pretreatment scores on the EBI were not related to weight-loss outcome, but changes on the EBI in the direction of more frequent use of appropriate strategies were related to weight loss at both posttreatment and 1-yr follow-up. Specific strategies related to weight loss at both times were 7) eating foods that help in losing weight, 2) recording foods eaten, 3) refusing food offered by others, and 4) being able to stop eating when appropriate. However, few patients maintained frequent use of these strategies at follow-up. It is concluded that weight-loss programs should focus on the strategies most strongly related to weight loss and try to improve long-term use of these techniques.
Substrates for Insulin-Receptor Kinase
Authors: Kasuga Masato , Izumi Tetsuro , Tobe Kazuyuki , Shiba Teruo , Momomura Kaoru , Tashiro-Hashimoto Yuko , Kadowaki Takashi
Published: March 2007

Several studies suggest that the tyrosine-specific protein kinase activity of the β-subunit of the insulin receptor is necessary to mediate the biological effects of insulin. This conclusion leads to the hypothesis that the effect of insulin is mediated through the tyrosine phosphorylation of cellular substrates by the insulin-receptor tyrosine kinase. In this review, the experimental evidence regarding insulin-stimulated phosphorylation of proteins both in vitro and in vivo is evaluated. In a cell-free system, tubulin, microtubuleassociated protein 2, tau, fodrin, calmodulin-dependent kinase, calmodulin, and lipocortins 1 and 2 were reported to be good substrates for insulin-receptor kinase. However, none were found to be tyrosine phosphorylated in an intact-cell system. In intact-cell systems, proteins of M, 185,000 (pp185), 120,000 (pp120), 240,000 (pp240), 15,000 (pp15), 60,000 (pp60), and 62,000 (pp62) as well as several others were reported to be tyrosine phosphorylated in an insulin-dependent fashion. However, the function or functional alteration of these proteins induced by insulin-stimulated tyrosine phosphorylation is not clear. Therefore, physiologically relevant substrates for the insulin-receptor kinase have not been established, and more work is necessary to verify the phosphorylation cascade hypothesis of insulin action.