bluuebunny/crossref_metadata_2025 huggingface dataset:
Technical Communication across Cultures
Authors: WEISS EDMOND H.
Published: March 2007

Technical communication, to be more effective in international business, must attempt to be culture free (without cultural impediments and irrelevancies) and culture fair (adjusted to meet local cultural expectations and communication styles). Both requirements raise serious philosophical questions of strategy and style: (1) Are the principles associated with North American-style technical writing in any sense universal? (2) Is it possible to write natural English documents that are univocal and reliably translatable? (3) Does the characterization of cultural differences lead inevitably to stereotyping and condescending tolerance? (4) Does the business motivation driving much international communication promote situations that may be exploitative of, and disadvantageous to, the targeted cultures? and (5) Does a postmodern approach to technical communication undervalue Western methods and the English language?
2 + 2 = 5 If 2 Is Large Enough
Authors: ORNATOWSKI CEZAR M.
Published: March 2007

This article suggests a perspective on rhetoric of technology as discursive exploitation of the margins of indeterminacy affecting the development of technologies and technical artifacts. It examines such margins by examining the development of an aircraft auxiliary engine in a California aerospace company, focusing especially on how engines are tested. It examines technical documents associated with testing as arenas for rhetorical transactions involving various factors and interests vested in a technology and as residua of compliance and negotiation. It suggests that margins of indeterminacy in technology development provide critical rhetorical spaces for agency and decision making, spaces that engineers and technical communicators must be trained to appreciate and exploit appropriately.
Congruence and Differentiation as Predictors of Workers' Occupational Stability and Job Performance
Authors: Meir Elchanan I. , Esformes Yehuda , Friedland Nehemia
Published: March 2007

This study examined the relation between vocational interests and job congruence and (a) stability at work and (b) supervisors' evaluations. Congruence scores were based on a comparison between interest scores, as measured before employment, and occupational field after 1 year. Significant correlations (.19 to .31, n = 774) were found between congruence and job stability (persistence) and between congruence and performance (.09 to .27, for 90 males employed in the Business or Technology occupational fields), but not among 51 employed in the Organization field. Differentiation was found to make a negligible contribution in predicting stability and performance evaluations. The findings are discussed in light of the size of the correlation coefficients, the diversity of the Organization field, the Courses Inventory as a means for measuring vocational interests, and the method of measuring congruence differentiation.
Career Maturity in Adolescence: Reliability and Validity of Self-Ratings of Abilities by Gender and Ethnicity
Authors: Westbrook Bert W. , Buck R.W. , Wynne D. Carol , Sanford Eleanor
Published: March 2007

To obtain reliable and valid self-ratings of abilities of adolescents, a self-rating instrument was designed to incorporate six of Maybe and Wests' (1982) measurement conditions. The instrument was administered to 210 ninth-graders. Test-retest reliability coefficients are mostly in the .70s and .80s for self-ratings and accuracy of self- ratings. Coefficient alphas and test-retest correlations for composite scores range from .74 to .90. For the total sample of students, the major findings are: (a) Correlations between self-rated abilities and measured abilities range from the .30s to the .60s, with medians in the .50s; (b) Students overrated all of their abilities except scholastic aptitude and Space Relations; (c) Students were most accurate in rating their scholastic aptitude and least accurate in rating their special aptitudes; (d) and self-ratings of some abilities were inaccurate, although they were reliable and substantially correlated (.63, .61) with measured ability. Ethnic differences were found on all ability scores, all self-ratings, and all accuracy of self-rating scores. Gender differences were found on some special abilities, some self-ratings, and some accuracy of self-rating scores. The self-rating instrument does not show evidence of differential validity across different ethnic and gender groups.
Personality Correlates of Jones' Three-Dimensional Model of Career Indecision
Authors: Lucas Jennifer L. , Wanberg Connie R.
Published: March 2007

Jones recently developed the Career Decision Profile (CDP; 1989). The CDP assesses career indecision, how comfortable individuals are with their career-decision status, and reasons for career indecision. According to Jones' vocational decision-status model, the CDP can be used to categorize individuals into four subtypes: decided- comfortable, decided-uncomfortable, undecided-comfortable, and undecided-uncomfortable. This study investigated the personality correlates of the CDP and the utility of Jones' scale for identifying the career subtypes. The CDP subscales correlated with several personality variables in the expected directions, and results indicated some support using the CDP to categorize individuals into the four decidedness-comfort subtypes.
International Trade in Hazardous Wastes: A Global Problem with Uneven Consequences for the Third World
Authors: Sánchez Roberto
Published: March 2007

Despite international attention to global environmental problems, direct and indirect exports and dumping of hazardous waste represent an unprecedented threat to the health and environment of millions of inhabitants in developing countries. The explanation lies in the perception of the problem. Since damages are concentrated mainly in developing countries and the sources in industrialized countries, hazardous waste exports are not given the same priorityas other global environmental problems affecting industrialized and nonindustrialized societies alike. Developed nations have succeeded in limiting several efforts to ban the export of hazardous wastes. The fact that developing nations have few resources to guarantee the safe management of hazardous waste makes its legal and illegal export equally dangerous.
Caring for the home-bound elderly client with diabetes mellitus
Authors: Hempy Ann
Published: March 2007

As we enter the 21st century, a significant number of American elders with diabetes mellitus or impaired glucose tolerance will need and benefit from home health care services. This article examines significant trends, the role and responsibilities of home health care nurses, and the clinical problems of glycemic control and prebreakfast hyperglycemia. Key words: nursing role and responsibilities, glycemic control-assessment, prebreakfast hyperglycemia assessment and management
Simple procedures make major changes
Authors: Gunter Karen South , Peifer Natasha
Published: March 2007

This article outlines the steps taken by Concerned Care, a private duty home care company, to decrease the number of rehospitalizations for the children we serve. The client population at our company is primarily children who are respiratory compromised and technology depen dent. This group is particularly at risk for pneumonia. The article covers a three-year study, the fact finding and subsequent changes made to decrease overall hospitalization. Key words: pedi atrics, pneumonia, quality, rehospitalizations
Solid Modeling On a Massively Parallel Processor
Authors: Strip David , Karasick Michael
Published: March 2007

Solid modeling underlies many technologies that are key to modern manufacturing. These range from com puter-aided design systems to robot simulators, from finite element analysis to integrated circuit process modeling. The accuracy, and hence the utility, of these models is often constrained by the amount of com puter time required to perform the desired operations. We present a family of algorithms for solid modeling operations using the Connection Machine, a massively parallel SIMD processor. We describe a data structure for representing solid models and algorithms that use the representation to implement efficiently a variety of solid modeling operations. We give a sketch of the al gorithm for intersecting solids and present computa tional experience using these algorithms. The data structure and algorithms are contrasted with those of serial architectures, and execution times are compared.
Pvmgeant- a Parallel Simulation Code for the Clas Detector At Cebaf
Authors: Dragovitsch P. , Zhao X. , Dennis L.C. , Riccardi G.A.
Published: March 2007

Due to the need for extensive and detailed simulations of the CEBAF Large Acceptance Spectrometer (CLAS), the Monte-Carlo code CLASGeant was transferred to a heterogeneous computing cluster and has been linked to the Parallel Virtual Machine (PVM) message-passing library. The resulting simulation package, PvmGeant, achieves an almost linear speedup in physics-event simulation. This article describes modifications to the original GEANT code, its integration with PVM, and performance tests that were conducted at the comput ing cluster at The Supercomputing Computations Re search Institute at Florida State University. Particular attention has been given to measuring the effect of different data structures on the cost of network com munication between nodes.
The Chesapeake Bay Virtual Environment (CBVE): Initial Results From the Prototypical System
Authors: Wheless Glen H. , Lascara Cathy M. , Valle-Levinson Arnoldo , Brutzman Donald P. , Sherman William , Hibbard William L. , Paul Brian E.
Published: March 2007

The authors develop a modeling framework that integrates hydrodynamic circulation models and various biological models with the computer visualization paradigm of the virtual world to investigate coupled linkages between physics and biology within the Chesapeake Bay ecosystem. These initial efforts, demonstrated at Supercomputing '95 on the ImmersaDesk, focus on how environmental forcing affects the flow in the Chesapeake Bay and how biological distributions change in response to this circulation. The authors use the virtual environment to visualize time- dependent, three-dimensional, multivariate ecological data sets. This visualization process greatly aids in the interpretation and synthesis of the supercomputer-based numerical simulations and provides new insights into the ecological consequences of physical and biological inter actions. Viewing, navigating through, and interacting with multidimensional fields (e.g., salinity, circulation vectors, larval fish distributions) in the virtual environment provides a sense of presence that greatly improves one's ability to understand inherently complex processes, thereby ad vancing the implementation of coupled physical-biological models. The use of data sonification to portray modeled data in the virtual environment also improves one's ability to interpret the numerical results.
Local Basic Linear Algebra Subroutines (LBLAS) for the CM-5/5E
Authors: Kramer David , Johnsson S. Lennart , Yu Hu
Published: March 2007

The Connection Machine Scientific Software Library (CMSSL) is a library of scientific routines designed for distributed memory architectures. The basic linear algebra subroutines (BLAS) of the CMSSL have been imple mented as a two-level structure to exploit optimizations local to nodes and across nodes. This paper presents the implementation considerations and performance of the local BLAS, or BLAS local to each node of the system. A wide variety of loop structures and unrollings have been implemented in order to achieve a uniform and high performance, irrespective of the data layout in node mem ory. The CMSSL is the only existing high performance library capable of supporting both the data parallel and message-passing modes of programming a distributed memory computer. The implications of implementing BLAS on distributed memory computers are considered in this light.
Globus: a Metacomputing Infrastructure Toolkit
Authors: Foster Ian , Kesselman Carl
Published: March 2007

The Globus system is intended to achieve a vertically integrated treatment of application, middleware, and net work. A low-level toolkit provides basic mechanisms such as communication, authentication, network information, and data access. These mechanisms are used to con struct various higher level metacomputing services, such as parallel programming tools and schedulers. The long- term goal is to build an adaptive wide area resource environment (AWARE), an integrated set of higher level services that enable applications to adapt to heteroge neous and dynamically changing metacomputing environ ments. Preliminary versions of Globus components were deployed successfully as part of the I-WAY networking experiment.
Template Numerical Toolkit for Linear Algebra: High Performance Programming With C++ and the Standard Template Library
Authors: Pozo Roldan
Published: March 2007

We present a new C++ library design for linear algebra computations on high performance architectures. The template numerical toolkit (TNT) for linear algebra is a successor to the Lapack++, Sparselib++, and IM L++ pack ages, providing support for direct and iterative solvers. Its goal is to formally integrate these ideas into a generic algorithm library supporting user-defined data types and data neutrality. The design of the core library uses compo nents from the C++ standard template library (STL) and the basic parallel extensions defined in High Performance C++ (HPC++).
With the background in the foreground - Music among young Danes with immigrant backgrounds
Authors: Fock Eva
Published: March 2007

'Cry, cry, cry, cry just a little bit...'

With a tight rock beat and a backing group including choir and brass, the familiar sound of Shaky Steven comes out of the Copenhagen Channel of the Danish Radio on a warm summer afternoon in 1996. News items and short interviews alternate with music-easy-listening, Anglo-American, mainstream pop music. As Shaky Steven fades out the speaker says: 'Well, that was a pop song like pop songs are mostly. Like we are used to hearing them. Now you will hear an Arab love song'.

The sound of a string instrument, probably a lotar, a four-string lure, takes over. In the background, one can hear the sounds of an informal gathering-this is not a real concert. A musician plays a simple melody a couple of times, then vocally joins in unison with the melody instrument. Another singer with a rough but relaxed voice takes over. The two singers alternate for a while, then the music fades out and the speaker re-enters, introducing the subsequent interview.

This last piece of music creates a striking contrast in the soundscape. After hours of modern mainstream pop, a 20-year-old recording of traditional Moroccan folk music from the Southern part of the country really sounds strange. Without being rude, two words probably come into mind of the listener; folkloric and exotic.

Why did the soundscape change so radically? The subsequent interview was about immigrants or more correctly about youngsters in Copenhagen with immigrant background. What made the speaker choose this kind of music as introduction to an interview about young people? When asked afterwards, she answered that 'she hadn't thought about it that way'.
An Approach to the Teaching of Business Policy through Case Studies
Authors: Edwards J.P.
Published: March 2007

In a recent issue this Journal published an article by J. R. Nicholls of the School of Management of Bath University about the preparation of new case material. This article describes something of the methods of use of such case material within the Business Administration degree scheme. The theme is one of inculcating a sensitivity to the style and culture of the enterprise within its industrial context as a basis for better strategic management.
Review : Excessive infantile crying: a review of the literature
Authors: long Tony
Published: March 2007

■ Excessive infantile crying is a widespread problem which exerts a serious impact on families' lives.

■ The prevalence, cause, and treatment of the problem have been addressed in the literature for many years but with varying degrees of success.

■ Variation in definition of excessive crying leads to difficulty when comparing results between studies.

■ Flawed method and inadequate sampling characterise many studies in this field, often seriously limiting the usefulness of the findings.

■ Progress has been made in some aspects of excessive crying, and other approaches hold promise of success, but wide gaps remain with regard to cause and treatment.
The Corporate Pharmaceutical Model and the Legacy of Doha: Whither a Global Consensus on Public Health Governance?
Authors: Savirimuthu Joseph
Published: March 2007

This paper attempts to demonstrate that the present governance challenges facing policy makers in the WTO and its member states with regard to the public health crises in developing countries cannot be simply overcome by modifying the TRIPs Agreement. One argument pursued in this paper is that any move towards an ex peditious solution must first of all acknowledge the significance of market con straints for the corporate pharmaceutical supply model; and, second, that public health governance policies formulated by governments in both developing and developed countries revolve around the ideological and political preference for market norms and values as operatives of distributive justice. Whilst it is true that TRIPs does constrain the autonomy of governments in developing countries to better manage their public health needs, the paper poses the question as to whether the time is right to rethink the concept of public health and essential medicines in the age of globalization.
The Impact of Policy Reforms on Labour Productivity, Price Cost Margin and Total Factor Productivity: The Nepalese Experience
Authors: Sharma Kishor
Published: March 2007

Using data from the Nepalese manufacturing sector, this article examines whether the policy reforms improve efficiency (productivity) and benefit the poor in least developed countries (LDCs) with weak institutions and poor physical infrastruc ture. Results indicate some improvements in all indicators of productivity following policy reforms, but the Nepalese manufacturing sector remains fragile due to rigidity in the factor market. Our analysis suggests that despite an increase in labour productivity, increased proportion of manufacturing value added has not been passed on to workers, indicating that the poor have not benefited much from the reform process. Total Factor Productivity (TFP) continued to decline even after the reforms, but at a lower rate. There is an urgent need to introduce further reforms in the labour market and the infrastructure sector. The econometric evidence suggests higher productivity growth in those industries which are able to produce on a large scale, have higher protection and semi-skilled workforce, but lower capital intensity and no public sector domination.
A Review of Academic Staffing Formulae
Authors: Birch Derek W , Calvert John R
Published: March 2007

A number of recent studies in the UK have developed academic staffing formulae on the basis of the institution's teaching commitment rather than its recruitment of students. We review these formulaea and examine their uses and limitations and conclude that they are useful more as situation analysis tools than as resource allocation devices.
A Heuristic Approach to the Multi-Period Single-Sourcing Problem with Production and Inventory Capacities and Perishability Constraints
Authors: Ahuja Ravindra K. , Huang Wei , Romeijn H. Edwin , Morales Dolores Romero
Published: March 2007

The multi-period single-sourcing problem that we address in this paper can be used as a tool for evaluating logistics network designs in a dynamic environment. We consider the assignment of retailers to facilities, taking into account the timing, location, and size of production and inventories, in the presence of various types of constraints. We formulate the problem as a nonlinear assignment problem, and develop efficient algorithms for solving the capacitated lot-sizing subproblems that form the objective function of this formulation. We propose a greedy heuristic, and prove that this heuristic is asymptotically optimal in a probabilistic sense when retailer demands share a common seasonality pattern. In addition, we develop an efficient implementation of the very-large-scale-neighborhood-search method that can be used to improve the greedy solution. We perform extensive tests on a set of randomly generated problem instances, and conclude that our approach produces very high quality solutions in limited time.
Performance Guarantees of Local Search for Multiprocessor Scheduling
Authors: Schuurman Petra , Vredeveld Tjark
Published: March 2007

Increasing interest has recently been shown in analyzing the worst-case behavior of local search algorithms. In particular, the quality of local optima and the time needed to find the local optima by the simplest form of local search has been studied. This paper deals with worst-case performance of local search algorithms for makespan minimization on parallel machines. We analyze the quality of the local optima obtained by iterative improvement over the jump, swap, multi-exchange, and the newly defined push neighborhoods. Finally, for the jump neighborhood we provide bounds on the number of local search steps required to find a local optimum.
Enumeration of Pareto Optima for a Flowshop Scheduling Problem with Two Criteria
Authors: T’kindt Vincent , Croce Federico Della , Bouquard Jean-Louis
Published: March 2007

We consider a two-machine flowshop-scheduling problem with an unknown common due date where the objective is minimization of both the number of tardy jobs and the unknown common due date. We show that the problem is NP-hard in the ordinary sense and present a pseudopolynomial dynamic program for its solution. Then, we propose an exact ϵ-constraint approach based on the optimal solution of a related single-machine problem. For this latter problem a compact ILP formulation is explored: a powerful variable-fixing technique is presented and several logic cuts are considered. Computational results indicate that, with the proposed approach, the pareto optima can be computed, in reasonable time, for instances with up to 500 jobs.
Travelocity Becomes a Travel Retailer
Authors: Smith Barry C. , Darrow Ross , Elieson John , Guenther Dirk , Rao B. Venkateshwara , Zouaoui Faker
Published: March 2007

In 2002, Travelocity lost revenue and market share to competition as the business environment changed. Travelocity and Sabre collaborated to develop the enterprise network model (ENM). The ENM combines discrete choice customer modeling with simulation and large-scale optimization to improve Travelocity’s management supplier agreements, customer marketing, and product pricing. The ENM has helped Travelocity become a more effective retailer and has contributed over $54 million to Travelocity earnings, at a current rate of $43 million per year.
Evolutionary selection pressure and family relationships among connexin genes
Authors: Cruciani Véronique , Mikalsen Svein-Ole
Published: March 2007

We suggest an extension ofconnexinorthology relationships across the major vertebrate lineages. We first show that the conserved domains of mammalianconnexins(encoding the N-terminus, four transmembrane domains and two extracellular loops) are subjected to a considerably more strict selection pressure than the full-length sequences or the variable domains (the intracellular loop and C-terminal tail). Therefore, the conserved domains are more useful for the study of family relationships over larger evolutionary distances. The conserved domains ofconnexinswere collected from chicken,Xenopus tropicalis, zebrafish, pufferfish, green spotted pufferfish,Ciona intestinalisandHalocynthia pyriformis(two tunicates). A total of 305connexinsequences were included in this analysis. Phylogenetic trees were constructed, from which the orthologies and the presumed evolutionary relationships between the sequences were deduced. The tunicateconnexinsstudied had the closest, but still distant, relationships to vertebrateconnexin36,39.2,43.4,45and47. The main structure in theconnexinfamily known from mammals pre-dates the divergence of bony fishes, but some additional losses and gains ofconnexinsequences have occurred in the evolutionary lineages of subsequent vertebrates. Thus, theconnexingene family probably originated in the early evolution of chordates, and underwent major restructuring with regard to gene and subfamily structures (including the number of genes in each subfamily) during early vertebrate evolution.
Chemokines and chemokine receptors in the brain: implication in neuroendocrine regulation
Authors: Callewaere Céline , Banisadr Ghazal , Rostène William , Parsadaniantz Stéphane Mélik
Published: March 2007

Chemokines are small secreted proteins that chemoattract and activate immune and non-immune cells both in vivo and in vitro. In addition to their well-established role in the immune system, several recent reports have suggested that chemokines and their receptors may also play a role in the central nervous system (CNS). The best known central action is their ability to act as immunoinflammatory mediators. Indeed, these proteins regulate leukocyte infiltration in the brain during inflammatory and infectious diseases. However, we and others recently demonstrated that they are expressed not only in neuroinflammatory conditions, but also constitutively by different cell types including neurons in the normal brain, suggesting that they may act as modulators of neuronal functions. The goal of this review is to highlight the role of chemokines in the control of neuroendocrine functions. First, we will focus on the expression of chemokines and their receptors in the CNS, with the main spotlight on the neuronal expression in the hypothalamo–pituitary system. Secondly, we will discuss the role – we can now suspect – of chemokines and their receptors in the regulation of neuroendocrine functions. In conclusion, we propose that chemokines can be added to the well-described neuroendocrine regulatory mechanisms, providing an additional fine modulatory tuning system in physiological conditions.
Self-esteem and Depression in Adolescent Diabetic Girls
Authors: Sullivan Barbara-Jean
Published: March 2007

This investigation was designed to examine self-esteem and depression in diabetic adolescent girls. One hundred nondiabetic girls age 12—16 and 105 diabetic girls age 12—16 were administered the Rosenberg Self-Esteem Scale and the Beck Depression Inventory. Results indicated no significant difference between diabetic and nondiabetic girls in self-esteem scores. Diabetic girls showed significantly more depression than nondiabetic girls. Close examination of results revealed that, in fact, diabetic and nondiabetic adolescent girls were very similar. A major finding was that depression in the diabetic group was expressed primarily through physiologic symptoms of depression as seen in the vital depression scores, rather than through the pessimism, indecision-inhibition, or self-debasement measures of depression. Results were interpreted to mean that diabetic girls did not manifest deeper depression than nondiabetic girls but, rather, a greater awareness of their physiologic status. Diabetes emerged as a focus for the expression of normal adolescent conflicts. The importance of integrating developmental issues into the treatment plans for diabetic patients is emphasized.
Diabetic Glucose Control: Matching Plasma Insulin Concentration to Dietary and Stress Hyperglycemia
Authors: Eaton R Philip , Spencer William , Schade David S , Shafer B P , Corbett W
Published: March 2007

Optimal management of the diabetic patient includes normalization of plasma glucose concentration. Attainment of this goal is difficult because both food and stress result in acute elevations of blood glucose that cannot be matched with a single subcutaneous injection of NPH insulin. This paper examines the currently available methods for delivery of insulin to the diabetic subject and the degree of metabolic control attained. It suggests that optimal diabetic control will be achieved only when newer methods of insulin delivery are available to the clinician that match plasma insulin requirements to the simultaneous plasma glucose concentration.
Cigarette Smoking and Prevalence of Microangiopathy in Juvenile-Onset Insulin-dependent Diabetes Mellitus
Authors: Christiansen Jens Sandahl
Published: March 2007

In order to evaluate a possible relation between cigarette smoking and prevalence of diabetic microangiopathy, a series of 180 consecutive patients suffering from insulin-dependent juvenile-onset diabetes mellitus with different durations of disease (60 patients each with diabetes for 10 to 19 years, 20 to 29 years, and 30 to 39 years, respectively) were examined for clinical signs of retinopathy, nephropathy, and peripheral neuropathy. The results were compared with the patients' previous and actual smoking habits. Cigarette smoking was defined as daily smoking of at least ten cigarettes for one year or more. Smoking habits of the total diabetic sample were not significantly different from those of a nondiabetic control sample. However, a decline in the number of cigarette smokers and a rising number of ex-smokers were noted with increasing duration of diabetes. In comparing smokers and nonsmokers, no difference was found in the prevalence of peripheral neuropathy, background retinopathy, and proliferative retinopathy. However, the prevalence of nephropathy (persistent proteinuria) was significantly higher (p < 0.05) among these patients who were or had been cigarette smokers. Thus, cigarette smoking might be considered a risk factor for the development of diabetic nephropathy.
Remissions of Diabetes Mellitus After Weight Reduction by Jejunoileal Bypass
Authors: Ahmad U , Danowski T S , Nolan S , Stephan T , Sunder J H , Bahl V K
Published: March 2007

Limited weight loss following jejunoileal bypass in 24 diabetic persons who were still distinctly overweight five to ten months after a mean weight decrease of 78 lbs. was accompanied by a return of normal fasting glucose and insulin levels, normal insulin responses, and a decrease in glucose intolerance. The glucose disappearance rate had improved in the majority of the subjects, but only three had attained values in the normal range. Concomitants of the undue hyperglycemia and/or obesity included labile and, rarely, sustained hypertension and/or cardiomegaly. The blood pressure returned to normal but heart size did not change. Electrocardiographic abnormalities noted in about one-half of the patients persisted after the operation. Triglyceride and cholesterol levels decreased. No patients had diabetic retinopathy visible on funduscopy. Proteinuria did not change in three patients. Neuropathy consisting of absent ankle reflexes and/or decreased vibration perception noted in one-half of the subjects persisted despite the improvement in carbohydrate metabolism.
Assessment of Diabetic Control: A Comparison Between Home and Clinic Blood Glucose Levels
Authors: Hayes T M , Hayes Eirlys
Published: March 2007

A comparison between blood glucose levels in patients attending a diabetes clinic and in the same patients leading their normal lives showed that for maturity-onset diabetic patients on oral hypoglycemic therapy, the clinic levels were a poor guide to the patients' usual blood glucose. For insulin-treated patients and for those treated with diet alone, the clinic levels were not significantly different from those taken at home or work.
Metoclopramide for Gastroparesis Diabeticorum
Authors: Braverman D , Bogoch A
Published: March 2007

Three patients with uncontrolled diabetes mellitus and with symptoms due to gastric retention proved to have gastroparesis diabeticorum. The diagnosis was established by the beefsteak-barium meal. After the administration of metoclopramide, gastric emptying improved and the diabetes was easily controlled. Gastroparesis diabeticorum is one cause of uncontrolled diabetes mellitus and may be helped by the administration of metoclopramide.
Review of Drug Interference With Urine Glucose Tests
Authors: Rotblatt Michael D , Koda-Kimble Mary Anne
Published: March 2007

Many drugs have been reported to interfere with copper-reduction or glucose oxidase tests used to measure urine glucose. However, only a few drugs or drug classes have been well documented to clinically interfere with these tests. The interfering drugs include ascorbic acid, β-lactam antibiotics (e.g., cephalosporins and penicillins), levodopa, and salicylates. Several other drugs may also interfere with certain urine glucose tests, but the interactions are poorly documented. These drugs include chloral hydrate, hyaluronidase, nalidixic acid, nitrofurantoin, p-aminosalicylic acid, phenazopyridine, probenecid, and X-ray contrast media. Drugs or their metabolites that are strong reducing substances produce false-positive results by the copper-reduction method and false-negative results by the glucose oxidase method. The β-lactam antibiotics interfere with copper-reduction tests by producing copper compounds of various colors that confuse interpretation of test results. Tables are provided that summarize the drug interferences discussed.
Role of metformin in treatment of diabetes mellitus
Authors: Vigneri Riccardo , Goldfine Ira D
Published: March 2007

Metformin, a biguanide antidiabetic agent that can be administered either alone or in combination with sulfonylureas, has been extensively used in Europe and Canada. The mechanism of action of metformin and other biguanides is not completely understood, but recent in vitro and in vivo studies suggest that metformin may act in part by both increasing the binding of insulin to its receptor and potentiating insulin action. Metformin, because of its chemical structure, does not interact with the liver and has a short half-life. Consequently, lactic acidosis, which is a rare complication of metformin, has not been associated with the proper use of this drug. In addition to its antidiabetic actions, metformin causes weight loss in obese diabetic patients and may be useful in managing associated lipid disorders.
High Blood Pressure as Risk Factor in Diabetic Retinopathy Development in NIDDM Patients
Authors: Ishihara Masaki , Yukimura Yaichiro , Aizawa Toru , Yamada Takashi , Ohto Ken , Yoshizawa Kunio
Published: March 2007

The correlation between diabetic retinopathy and blood pressure was analyzed in 742 type II diabetic patients. Systolic and pulse blood pressures were significantly higher in the patients with retinopathy than in those without (mean systolic pressure 142 vs. 139 mmHg, P < .01; mean pulse pressure 60.5 vs. 56.4 mmHg, P < .001). There was no difference in the diastolic blood pressure between these two groups. The correlation between blood pressure and the components of retinopathy (including microaneurysms, hemorrhages, and exudates) was also analyzed. Even when the patient with microaneurysms or dot hemorrhages, blot hemorrhages, or hard or soft exudates were separately evaluated, systolic and pulse blood pressures were higher in those with one of these diabetic changes than in patients without them.

To avoid the influence of nephropathy, the patients were divided into nonproteinuric or proteinuric groups. In the nonproteinuric group, pulse blood pressure was higher in patients with retinopathy than in those without. In the proteinuric group, systolic blood pressure was also higher in patients with retinopathy than in those without. However, these observed differences in blood pressure were slight after the division of the patients. With respect to the components of retinopathy, systolic and pulse blood pressures were significantly higher in the patient with blot hemorrhages than in those without in both nonproteinuric and proteinuric groups (nonproteinuric: systolic pressure 142 vs. 137 mmHg, P < .005, and pulse pressure 60.4 vs. 55.5 mmHg, P < .001; proteinuric: systolic pressure 155 vs. 146 mmHg, P < 0.01, and pulse pressure 69.0 vs. 63.5 mmHg, P < .05) In regard to other components (microaneurysms, dot hemorrhages, or hard or soft exudates), no significant difference was found in blood pressure when analyzed in both nonproteinuric and proteinuric patients.

Systolic, diastolic, and pulse blood pressures did not correlate with blood glucose level in any of our patients. These data revealed that systolic hypertension is a risk for diabetic retinopathy, especially for blot hemorrhage.
Risk of Ketosis During Intensive Insulin Therapy in Pre-School-Age Diabetic Children
Authors: Brambilla Paolo , Artavia-Loria Efrain , Chaussain Jean-Louis , Bougneres Pierre-François
Published: March 2007

The risk of ketosis and its relationship to the mode of insulin therapy were studied in a subset of pre-school-age diabetic children. These five children, who initially responded poorly to standard in-hospital diabetes management, were selected for a program of intensified therapy directed at achieving more stable blood glucose control. Optimized conventional therapy was first employed for 16 ± 5 mo and did not improve substantially blood glucose level or stability. During this period, there was an average of almost one episode of ketonuria per patient per month, and three diabetic ketoacidosis episodes were observed. Because of its limited efficacy, the treatment was then changed to continuous subcutaneous insulin infusion. This mode of therapy had a rapid favorable effect on blood glucose control, with no concomitant increase of the frequencies of ketonuria or diabetic ketoacidosis, most of which occurred during the first months of insulin pump therapy.

Deliberate cessation of either conventional or subcutaneous insulin infusion therapy for 7 h under close in-hospital control resulted in similar metabolic changes: a slight nonconstant increase of blood glucose, and an abrupt rise of blood 3-hydroxybutyrate to 3 mM, with massive ketonuria.

The management of these young diabetic children with insulin pump therapy was thus not associated with an increased frequency or an accelerated rate of development of ketosis. However, the possible failures originating from the infusing device and the rapid increase of ketosis in young ages require special vigilance from the parents, based on twice-daily urine testing for ketones and appropriate insulin supplementation.
Hospitalization Patterns of Ethiopians With Diabetes Mellitus
Authors: Lester Frances T
Published: March 2007

A survey of diabetic patients of all inpatient services in Yekatit 12 Hospital, Addis Ababa, Ethiopia, was made for 6 mo in 1984. There were 121 hospitalizations of 116 diabetics in 3453 admissions to this 305-bed general hospital. Only 39 of the 116 were alreadyknown to its diabetes clinic; there were 24 new cases. Mean duration of hospitalization was 21.3 days, and 19.7% of bed use on medical wards during the survey was by diabetics. More than one-third of known diabetics rarely or never saw a physician until incapacitating symptoms or intercurrent illness resulted in hospitalization. Twenty-one (18%) died, one-third of chronic renal failure. I conclude that diabetes mellitus is a frequent cause of morbidity and mortality in an Ethiopian hospital, indicating that efficient facilities for outpatient education and stabilization are needed for Ethiopia's diabetics, particularly because inpatient facilities are scarce and resources limited. This is the firstreport from an African nation of hospitalization patterns of diabetic subjects.
Primary Prevention of Diabetes Mellitus
Authors: Tuomilehto Jaakko , Wolf Eva
Published: March 2007

Diabetes mellitus is one of the chronic noncommunicable diseases that have increased markedly in this century. The discovery of insulin and other drugs for lowering hyperglycemia have certainly reduced mortality from acute complications of diabetes and improved the quality of life of many diabetic patients. Recent advances in research into the etiology and natural history of diabetes have increased our knowledge about different types of diabetes to such an extent that primary prevention of diabetes mellitus is becoming a reality. Until now, few studies have attempted to test measures for primary prevention of diabetes. Therefore, the data supporting the possibility for primary prevention are largely indirect and need to be tested in preventive trials or in community-based prevention programs. We believe, however, that the time is right to start action in populations in whichthe prevalence of diabetes is known to have clearly increased recently. We summarize the evidence that can be used as the scientific basis of primary prevention of diabetes mellitus.
Race and Sex Differences in Metabolic Control of Adolescents With IDDM: A Function of Psychosocial Variables?
Authors: Hanson Cindy L , Henggeler Scott W , Burghen George A
Published: March 2007

Race and sex differences have been reported in the prevalence of complications from insulin-dependent diabetes mellitus (IDDM). Because metabolic control is assumed to be associated with the probability of developing future complications, race and sex differences in metabolic control were assessed in a group of adolescents. Subjects were 27 Black and 27 White adolescents who were similar in age, age at diagnosis, and social class. Girls did not differ on number of days since their last menses. A 2-by-2 (race-by-sex) analysis of variance revealed that the Black female group had worse HbAlc than each of the other groups (P < .012). Multivariate analyses of variance were conducted to determine whether the poor metabolic control of the Black girls was associated with pertinent psychosocial variables. The analyses revealed that their poor control was not associated with a deficiency in the girls' knowledge about IDDM, adherence to treatment, self-concept, coping patterns, family functioning, stress, social support, or involvement in the health-care system. If the poor control of the Black girls is not associated with psychosocial deficiencies, biological variables or psychosocial variables not assessed in this study are probably operative.
Abnormal Cardiac Function After Exercise in Insulin-Dependent Diabetic Children and Adolescents
Authors: Baum Victor C , Levitsky Lynne L , Englander Robert M
Published: March 2007

We evaluated the cardiac response to dynamic exercise in a group of otherwise healthy insulin-dependent older children and adolescents and in a nondiabetic control group by postexercise echocardiography. Both groups had similar left ventricular function at rest. After exercise we found abnormalities in the indicators of systolic function, fractional shortening (0.37 vs. 0.43) and rate-corrected velocity of circumferential fiber shortening (2.80 vs.3.35 circumferences/s). In addition, we found an association of flattened interventricular septal motion with finger contractures in the diabetic subjects. Echocardiographic abnormalities in asymptomatic young diabetic adolescents can be elucidated by postexercise echocardiography. Postexercise echocardiography is a noninvasive procedure that can easily be done in the adolescent population and is useful for evaluating subclinical cardiomyopathy.
Interaction Between Plastic Catheter Tubings and Regular Insulin Preparations Used for Continuous Subcutaneous Insulin-Infusion Therapy
Authors: Chantelau Ernst , Lange Gisela , Gasthaus Manfred , Boxberger Michael , Berger Michael
Published: March 2007

In search of possible interactions between plastic tubings used for insulin-pump treatment and commercial regular insulin preparations, various catheter sets made from polyvinyl chloride (PVC), polyethylene (PE), and nylon plastics were perfused at 30°C in a laboratory setting for up to 72 h. The perfused insulin solutions were analyzed by high-performance liquid chromatography and atomic absorption spectroscopy. Although no plasticizer, e.g., dioctyl phthalate, or nickel or chromium ions were found in the perfusates, substantial interactions between the plastics and the insulin solutions were detected, extraction of bacteriostatic additives from the insulin solutions in particular. The PVC retained up to 88% of the bacteriostatics from the insulin preparations, whereas PE tubings retained only 10–15%. Whether the loss of preservatives during perfusion through PVC catheters predisposes to cutaneous infections during insulin-pump therapy remains to be shown.
Acute Cutaneous Complications and Catheter Needle Colonization During Insulin-Pump Treatment
Authors: Chantelau Ernst , Lange Gisela , Sonnenberg Gabriele E , Berger Michael
Published: March 2007

Forty unselected type I (insulin-dependent) diabetic patients with insulin pumps were examined three times for cutaneous complications and bacterial colonization of their subcutaneous catheter needles. Fifty-eight of the 120 needles were contaminated, 42 of them with Staphylococcus epidermis. Cutaneous complications, i.e, erythema of ≥ 1-mm diam at the needle-insertion site, were seen with similar frequency. Significantly fewer (P < .001) cutaneous complications and contaminated needles were found when a disinfectant was sprayed on the skin before insertion of the needle. The results indicate that infection along the indwelling subcutaneous needle contributes substantially to cutaneous complications during continuous subcutaneous insulin infusion and that these complications can successfully be prevented by appropriate antiseptic measures.
Efficacy of Glyburide in Diabetics Poorly Controlled on First-Generation Oral Hypoglycemics
Authors: Cohen Kenneth L , Harris Susanne
Published: March 2007

Twenty-four type II (non-insulin-dependent) diabetic patients poorly controlled on maximum doses of first-generation oral hypoglycemic agents were switched to glyburide. There was a significant decrease in glycosylated hemoglobin, but the level was normalized in only four patients; there was no correlation with age, weight, or duration of diabetes. The best predictor for improvement was initial failure on tolbutamide, as opposed to the other first-generation drugs. Patients not controlled with 500 mg/day of chlorpropamide were less likely to benefit from glyburide therapy.
Reproducibility of βCell Function Estimates in Non-Insulin-Dependent Diabetes Mellitus
Authors: Gjessing Hans J , Damsgaard Else M , Matzen Lars E , Frøland Anders , Faber Ole K
Published: March 2007

We evaluated the reproducibility of different estimates of endogenous insulin secretion in 30 patients with non-insulin-dependent diabetes mellitus (NIDDM). Fasting blood glucose concentration was similar on the 2 days of study. The coefficients of variation of fasting plasma C-peptide, plasma Cpeptide 6 min after the injection of 1 mg i.v. glucagon, and the increment in plasma C-peptide after glucagon were 16.0, 14.8 and 24.1%, respectively. The coefficients of variation of the corresponding plasma insulin values were 19.2, 24.8, and 34.8%, respectively. The coefficient of variation of 24-h urinary C-peptide excretion was 22.1%. Because fasting plasma C-peptide correlated closely with plasma C-peptide 6 min after giucagon (test 1: r = .70, P < .01; test 2: r = .76, P < .01), it seems that these two values can be used equally well as assessment of (3-cell function in NIDDM. In conclusion, fasting plasma insulin, fasting plasma C-peptide, and plasma C-peptide 6 min after glucagon stimulation showed a similar and acceptable degree of reproducibility. Plasma insulin 6 min after glucagon and increments in plasma insulin and C-peptide, as well as urinary C-peptide, seem to be less reproducible.