bluuebunny/crossref_metadata_2025 huggingface dataset:
Joint Product Improvement by Client and Customer Support Center: The Role of Gain-Share Contracts in Coordination
Authors: Bhattacharya Shantanu , Gupta Alok , Hasija Sameer
Published: November 2013

We study the role of different contract types in coordinating the joint product improvement effort of a client and a customer support center. The customer support center's costly efforts at joint product improvement include transcribing and analyzing customer feedback, analyzing market trends, and investing in product design. Yet this cooperative role must be adequately incentivized by the client, since it could lead to fewer service requests and hence lower revenues for the customer support center. We model this problem as a sequential game with double-sided moral hazard in a principal-agent framework (in which the client is the principal). We follow the contracting literature in modeling the effort of the customer support center, which is the first mover, as either unobservable or observable; in either case, the efforts are unverifiable and so cannot be contracted on directly. We show that it is optimal for the client to offer the customer support center a linear gain-share contract when efforts are unobservable, even though it can yield only the second-best solution for the client. We also show that the cost-plus contracts widely used in practice do not obtain the optimal solution. However, we demonstrate that if efforts are observable then a gain-share and cost-plus options- based contract is optimal and will also yield the first-best solution. Our research provides a systematic theoretical framework that accounts for the prevalence of gain-share contracts in the IT industry's joint improvement efforts, and it provides guiding principles for understanding the increased role for customer support centers in product improvement.
Should Sellers Prefer Auctions? A Laboratory Comparison of Auctions and Sequential Mechanisms
Authors: Davis Andrew M. , Katok Elena , Kwasnica Anthony M.
Published: November 2013

When bidders incur a cost to learn their valuations, bidder entry can impact auction performance. Two common selling mechanisms in this environment are an English auction and a sequential bidding process. Theoretically, sellers should prefer the auction, because it generates higher expected revenues, whereas bidders should prefer the sequential mechanism, because it generates higher expected bidder profits. We compare the two mechanisms in a controlled laboratory environment, varying the entry cost, and find that, contrary to the theoretical predictions, average seller revenues tend to be higher under the sequential mechanism, whereas average bidder profits are approximately the same. We identify three systematic behavioral deviations from the theoretical model: (1) in the auction, bidders do not enter 100% of the time; (2) in the sequential mechanism, bidders do not set preemptive bids according to the predicted threshold strategy; and (3) subsequent bidders tend to overenter in response to preemptive bids by first bidders. We develop a model of noisy bidder-entry costs that is consistent with these behaviors, and we show that our model organizes the experimental data well.

Data, as supplemental material, are available at http://dx.doi.org/10.1287/mnsc.2013.1800.

This paper was accepted by Teck Ho, behavioral economics.
Saving Seats for Strategic Customers
Authors: Çil Eren B. , Lariviere Martin A.
Published: November 2013

We consider a service provider in a market with two segments. Members of the first request a reservation ahead of service and will not patronize the firm without one. Members of the second walk in and demand service immediately. These customers have a fixed cost of reaching the firm and may behave strategically. In equilibrium, they randomize between walking in and staying home. The service provider must decide how much of a limited capacity to make available to advance customers. When the advance demand segment offers a higher per customer margin, the firm may opt to decline some reservation requests in order to bolster walk-in demand. When walk-in customers are more valuable, classical revenue management models would dictate that at least some capacity be set aside for high-value later arrivals. Here it is possible that the optimal policy saves no capacity for walk-ins. Thus, it may be better to ignore rather than pamper walk-in customers. This outcome is robust to changes in the model.
Risky Business: Talking about Children in Children’s Literature Criticism
Authors: Gubar Marah
Published: November 2013

Embracing a critical paradigm that holds that children do not participate in the realm of children’s literature and culture has itself caused scholars to ignore what young people have said, written, and done in the realm of children’s literature and culture. This essay contends that the time has come to articulate not only new theories about what it means to be a child, but also a new paradigm for how to do children’s literature criticism, one that builds on but also decisively departs from Jacqueline Rose’s vision of children’s literature as an adult practice.
“And stay, a minute more, alone”: Time and Subjectivities in Gwendolyn Brooks’s Bronzeville Boys and Girls
Authors: Conrad Rachel
Published: November 2013

This essay explores Gwendolyn Brooks’s use of temporality in crafting multiple childhood subjectivities in Bronzeville Boys and Girls , a collection of poetry for children published in 1956 and reillustrated by Faith Ringgold in 2007. Brooks’s treatment of child characters’ engagements in and with time, including their active roles in relation to time and the varied implications of time for self-experience, contributes to the plurality of representations of childhood subjectivities. Focusing on how temporality structures and complicates considerations of childhood subjectivity in poetry for children can contribute to our thinking about poetry for children and our theorizing of childhood subjectivity.
Beyond Periodization: Children’s Literature, Genre, and Remediating Literary History
Authors: Westman Karin E.
Published: November 2013

Far from continuing as the disempowered step-child of literary history, absent from survey courses and discussions of literary periods, children’s literature could become an organizing principle for literary history – if we act on its generic potential and its proclivity towards remediation. . Through generic remediation, children’s literature – more than other literatures – eludes conventions of periodization. As a result, by attending to genre, the very category which has relegated children’s literature beyond the canonical pale, scholars of children’s literature can revise existing narratives of literary history. The narratives of modernism offer a test case.
“A Fine Old Tale of Adventure” : Beowulf Told to the Children of the English Race, 1898–1908
Authors: Jaillant Lise
Published: November 2013

When publishers started marketing the tale of Beowulf to a large audience of children (and adults) in the 1880s, they capitalized on the aura of the Middle Ages by selling editions with golden titles, decorated initials and reproductions of medieval drawings. The medievalizing aspect of these children’s books offered a suitable format for a tale presented as the founding text in English literature. This article argues that the heroic and nationalistic ideology of these early versions is anchored in their material aspect. The analysis of three juvenile adaptations first published between 1898 and 1908 – A. J. Church’s Heroes of Chivalry and Romance , Thomas Cartwright’s Brave Beowulf , and H. E. Marshall’s Stories of Beowulf Told to the Children – shows that their ‘bibliographic code’ was closely intertwined with archaic translations inspired by nineteenth-century Anglo-Saxon scholarship.
Taking Children’s Literature Scholarship to the Public
Authors: Schwebel Sara L.
Published: November 2013

This manifesto affirms the importance and uniqueness of literary scholarship and calls for children’s literature critics to bring their research to the public through digital humanities initiatives and collaboration with museums, archives, and children’s literature colleagues in Schools of Education and Library Science.
Banish the Books: Horatio Alger, Jr., the Censors, the Libraries, and the Readers, 1870–1910
Authors: Young Arthur P.
Published: November 2013

This study of a late nineteenth century book banning episode focuses on juvenile author Horatio Alger, Jr., and on the relationship between advocacy rhetoric and verifiable outcomes. By investigating user behavior as associated with library holdings and loan transactions the effectiveness of the campaign can be ascertained. A survey of public library book catalogs reveals that the number of Alger holdings stayed remarkably stable during the period. Muncie, Indiana’s database of loan transactions confirms Alger as the most frequently borrowed author. Censorship activity, while drawing public attention, failed to significantly alter either library holdings or children’s reading patterns.
Growing Meat in Laboratories: The Promise, Ontology, and Ethical Boundary-Work of Using Muscle Cells to Make Food
Authors: Stephens Neil
Published: November 2013

Over the last decade, several clusters of scientists have been using animal cells in an attempt to grow meat. Known as in vitro, or cultured, meat, the technology involves tissue engineering muscle cells for potential consumption as food. Those supporting the technology articulate a diversity of potential benefits in producing meat in this way, which include environmental-, health-, innovation-, and animal-welfare-related benefits. This essay reports on interviews with scientists and animal activists involved in making and promoting in vitro meat (IVM). While the technology remains in its infancy, its promotion has assertively been pursued with a set of promissory narratives designed to enroll potential funders, commercial investors, and consumers. The essay explores the ethical boundary-work —the drawing of boundaries around what constitutes ethical scientific practice—pursued in the creation of socio-technical expectations around IVM. In particular, it focuses on the emergence of an animal-libratory promissory narrative by exploring how ethically correct practice toward animals is constructed and used to underpin notions of what IVM is and what it can do . The key contributions of the essay are to provide a detailed analysis of the situated ethics of IVM, and to make explicit the relatedness among ethics, promise, and ontology.
A Journal of the Plague Year : Defoe’s Grammatology and the Secrets of Belonging
Authors: Cruise James
Published: November 2013

This essay examines, via the agency of “writing,” the uneven modernity of Defoe’s generically unstable A Journal of the Plague Year (1722). Two types of writing figure in this narrative. The first is the linear “Art of Writing,” which Defoe first spells out in An Essay on the Original of Literature (1726) and defines as an ensemble of graphic practices that plot the progress of civilization. Within this “Art” two discrete and segregated forms of writing obtain: “Apertus” (“common and apparent writing”) and “Opertus” (“occult, or secret [writing]”). When integrated, however, apertus and opertus create a dialectically charged second type of writing—here called grammatology—that reveals the inner workings of so-called linear modernity. In reconstructing the Great Plague, Defoe’s narrator H. F. assumes that his histoire événementielle is only that: a reconstruction of a once terrible time, yet careful examination discloses how secret writing insinuates itself into apparent writing. His blindness to the complexities of writing enables him to consent tacitly to the fiction of liberal belonging as its modes of subjugation, long thought past, escape his notice.
Eighteenth-Century England’s Chinese Taste
Authors: Chen Jeng-Guo S.
Published: November 2013

Commenting on David Porter’s The Chinese Taste in Eighteenth-Century England (Cambridge University Press, 2010), this review article argues that the book, by excavating the suppressed memory and history of English receptions of things Chinese, defamiliarizes and problematizes our common notions of early modern English culture. It effectively challenges whiggish historiography of England and reinstates the importance of foreign or Chinese constituents in the making of English culture. Nevertheless, this article also suggests that although Porter has successfully showed the dynamic force of Chinese things in English society and exposed ambivalent desires of English men for those things, there remain critical issues of gender differences in attitudes to Chinese things, the geography of English orientalism, and methodologies of reception history worthy of further investigations.
From José de Acosta to the Enlightenment: Barbarians, Climate Change, and (Colonial) Technology as the End of History
Authors: del Valle Ivonne
Published: November 2013

During Spain’s colonization of the Americas and its striving to “civilize” peoples considered barbarians, the idea of a world in which a single way of life was compulsory emerged for the first time. By making European cultural norms a requirement for Christianization, José de Acosta, a 16th century Spanish Jesuit historian and philosopher, diluted religion into civilization and framed the colonial enterprise as a clash between civilization and barbarism, a relationship necessarily mediated by technology. Acosta is a precursor of Enlightenment thinkers (Smith, Gibbon) for whom European technology guaranteed self-preservation and hegemony in a world comprised of nations they still considered barbarian. Even when there were critics of this will to transform the world into a place suited for a European way of life (Herder), or those who saw this transformation not as self-preservation but as an extension of benefits that ought to be universal (Condorcet), uneven development and climate change are the salient consequences of this history dating back to the 16th century.
Collective Commerce and the Problem of Autobiography in Olaudah Equiano’s Narrative
Authors: Kopec Andrew
Published: November 2013

This essay examines Olaudah Equiano’s use of novelistic types in light of his vision for collective commerce between Britain and Africa. Both in Equiano’s own day and in our own, criticism of his Narrative (1789) has emphasized his transition from the general to the particular, from the slave to the subject. Engaging the longstanding autobiographical reading, this essay identifies instead Equiano’s interests in types of and groups of people. In doing so, it finds the transformation from a pre-commercial type of African to a commercial one that occurs in the text to reflect Equiano’s economic worldview. As it draws on what one scholar terms the “speculative discourse” of eighteenth-century finance, a discourse that was linked with the early realist novel, the Narrative helps us to apprehend how Equiano hoped to change the terms of global commerce.
Identity, Placement, and Circulation of the Children of Christ’s Hospital
Authors: Manzione Carol Kazmierczak
Published: November 2013

Drawing upon the admission records of Christ’s Hospital, an orphanage and school founded in London in 1552, thirteen tables of basic data were formulated to gain insight into the lives of non-elite children. As tabulated, the profile of the children shows that two-thirds of them were male; one-third died; and less than twenty percent were infants. Eight out of ten children’s parents were identified at least by having their names recorded, and more than half had fathers who belonged to guilds and therefore were respectable citizens. More than half of the children were placed two or more times, with more than one-third having their final placement with a foster parent or in an apprenticeship; only slightly more than one tenth were permanently reunited with their parents or relatives. The families of the 3,095 children served by Christ’s Hospital had collapsed to the point that the children’s basic needs were not met and family wealth was not inherited. With the assistance of caretakers and sponsors, Christ’s Hospital supplied food, clothing, and shelter to help disadvantaged children who were educated and trained as productive citizens, enabling them to be integrated into the increasingly complex economic structure of London and thereby prevented from sinking into the criminal underclass.
Gender and Discipline in the Finnish Reformatories of the 1920s
Authors: Vehkalahti Kaisa , Hoikkala Susanna
Published: November 2013

By focusing on the everyday disciplinary practices in the early-20 th -century Finnish reformatories this article analyzes the gendered nature of residential child protection. It discusses some preliminary findings of two research projects. The institutional examples represent two different types of institutions for young people deemed as “delinquent” or “wayward”: a state-run reformatory for girls and a municipal reformatory for boys. What kinds of gender specific implementations of control existed and what kinds of gendered identities were constructed through the disciplinary practices? This article argues that in the reformatory context care and discipline are not necessarily opposite elements. Rather, they may be perceived as two sides of the same coin. Furthermore, disciplinary practices should not be discussed as separate acts of power. Rather, they have formed an integral part of residential reeducation and their cultural meaning can be understood only in relation to this wider context.
Critical Oversights: The Aesthetics and Politics of Reading The Bostonians
Authors: Funchion John
Published: November 2013

This essay argues that The Bostonians exposes the formal logic of the Reconstruction romance as a genre that embraces the ethics of reunion by abandoning the politics of Radical Republicanism. Pairing the Southern Basil Ransom with the Bostonian Verena Tarrant, the novel imagines a reunited nation, but their anticipated marriage requires Verena to abandon her career as a reformer and orator. Readers of the novel must imagine a culturally Reconstructed Union at the very moment that Verena’s futurity becomes foreclosed and must reconcile the novel’s depictions of the revolutionary potential of the aesthetic with its content’s strategies of containment.
Representation and the Novel
Authors: Gibson John
Published: November 2013

This essay uses The American to stage a discussion of the vexed notion of novelistic representation. What does it mean to say that a novel represents the real, and under what conditions must we say, as James did of The American , that it fails to do so? This essay suggests that, contrary to a popular myth, the notion of representation has little to do with mimesis and the question of whether a novel “copies” reality and much to do with how a novel can come to achieve a special kind of status within a culture.
Lao She, James, and Reading Time
Authors: Da Nan Z.
Published: November 2013

After his trip to London, Lao She wrote essays and fiction about the Pacific Islands. In one of these essays, he commented on the nature of duration in Henry James’ fiction, which Lao She felt that, by avoiding temporal shortcuts such as “many years later,” commensurated reading time to narrative time. This essay rereads Lao She’s transpacific novel, Little Po’s Birthday , under this borrowed experimentation with diegetic duration. I note the impact of what Lao She perceived as Jamesian duration on his anticolonialist metafiction of the 1930s as well as its unanticipated implications for his Chinese nationalism.
Henry James’s Rat-tat-tat-ah: Insidious Loss, Disguised Recovery and Semi-Detached Subjects
Authors: Plotz John
Published: November 2013

This essay argues that one way to understand James’s late novels is as experiments with depicting his characters in states of semi-detachment. They are neither entirely removed from nor entirely immersed in their social and physical surroundings. James’s distinctive use of free indirect discourse and shifting focalization, along with some other strategies this article explores, introduce an abiding and productive uncertainty about where and when a particular sentence--and the thought that accompanies it--is taking place. That uncertainty is tellingly signposted not just in The Ambassadors (1903) and in the dictated notes that accompany The Sense of the Past .
Is There a Beast in This Class?: The Pragmatics and Ethics of Dialogic Reading
Authors: Izzo Donatella
Published: November 2013

This essay takes a teaching experience—a collective close reading of “The Beast in the Jungle”—as a starting point to investigate the pragmatic effect produced by three features of the text: its pervasive use of catachresis, the prominence of speculation (both in the financial and in the conceptual sense) in its economy, and its creation of an analytic setting both for its characters and for its readers. Through the evasive, speculative quality of its central object, the story—itself the scene of an obstinately sought but ultimately frustrated dialogue—fosters an intense, ethically charged intersubjective engagement in dialogic reading.
Green James?: Reading Ecologies
Authors: Hannah Daniel
Published: November 2013

While recent critical approaches to Henry James have explored his responses to questions about history, class, sexuality, gender, and race, James’s work has often been imagined as inimical to ecocritical concerns, to questions about ecology. This essay contests this assumption by examining how James’s works insistently analogize reading as the means by which humans comprehend and construct ecologies. Immersed as his writings are in navigating consciousness as relational and charting space as readable, James’s oeuvre provides surprisingly fertile ground for examining the ways in which “ecology,” as a current critical term, reads the relationships between organisms and their environments.
Shaken Spirits: Cherokees, Moravian Missionaries, and the New Madrid Earthquakes
Authors: Hancock Jonathan
Published: November 2013

From December 1811 through March 1812, a series of earthquakes rattled the eastern half of North America. This essay uses Cherokee and Moravian missionary interpretations of the earthquakes as windows into early nineteenth-century ideas about the links between natural and social disorder. It argues that in their mutual search for explanations of the disorder, Moravians and Cherokees came to emphasize their cultural and epistemological differences. Furthermore, as Cherokees gravitated to their own prophets’ calls for ritual and reform, Moravians increasingly seized on apocalyptic understandings of the tremors, disguising their concerns under a front of dismissal of Cherokee explanations. For the Cherokees, contemporary concerns, grounded in long-standing beliefs about the mechanisms responsible for natural disorder, framed a vigorous debate about how to respond not only to the earthquakes but to major geopolitical and cultural transformations. Cherokees embedded their debates within their efforts to check United States expansionism and determine the utility of white people and their goods in Cherokee country. Amid internal problems in mission governance and a lack of Cherokee receptiveness to their evangelism, Moravians grew uncertain about the tremors’ meaning over time. As the earth continued shaking, they began to ponder whether the end of the world was soon at hand. They masked their private fears about both the meaning of the earthquakes and the status of their mission by denouncing Cherokee prophets. Struggling to interpret the same disturbing phenomenon in mutually troubling times, Cherokees and Moravians rejected one another’s earthquake explanations and prescriptions for the future.
“Know All Men By These Presents”: Bonds, Localism, and Politics in Early Republican Mississippi
Authors: Mathisen Erik
Published: November 2013

This article examines local politics in Mississippi during the early to mid-nineteenth century, by examining the bonds that officeholders were required to post to hold their positions in county government. The article argues that while states like Mississippi remain at the forefront of the history of American mass democracy, the existence of this election ritual paints a complicated picture of political practice. By requiring officeholders to post hundreds and even thousands of dollars to hold office, and by requiring that political friends vouch for them with their money and their reputations, bonds dampened democratic elections at every turn. In so doing, bonds suggest just some of the ways in which Americans practiced a much more complex politics than current paradigms allow.
El arte de irse por las ramas: la digresión en La novela luminosa de Mario Levrero
Authors: Oliver María Paz
Published: November 2013

This article examines the use of digression in La novela luminosa (2005), by the Uruguayan writer Mario Levrero, as a narrative strategy that constantly suspends and displaces the main story. On the border between fiction and diary, Levrero's discourse tends to dialogue with an incomplete novel that he must finish after obtaining a Guggenheim Fellowship. Considering digression also as a transgressive practice aimed at questioning the construction of discourse itself, I analyze how in his daily records the detours and wanderings introduced by this technique define a hybrid aesthetic. Furthermore, I focus on the subversive dimension of digression and how, like desire, it tends to destabilize the order of the story.
Lezama, Novalis y las vicisitudes de la futuridad
Authors: Lupi Juan Pablo
Published: November 2013

The question of tradition in Cuba, understood both as absence and as potential, was a preoccupation that spanned the whole intellectual career of José Lezama Lima. This article analyzes Lezama's eccentric use of the term and idea of "Absolute," borrowed from theology (Nicholas of Cusa), transcendental philosophy (Kant), and early German Romanticism (Novalis), and its application to Lezama's reflection on tradition in the 1966 essay "Paralelos: la pintura y la poesía en Cuba (siglos XVIII y XIX)." As the article shows, Lezama appropriates the concept of Absolute found in these philosophers and displaces it to strange verbal and epistemic territories, such as his aesthetico-historiographical theory known as the "imaginary eras." In "Paralelos," aided by these philosophical borrowings, Lezama formulates a theory of tradition that is radically open to futurity—the elements of tradition are not found in the static objects of the past, but rather in the unforeseeable and contingent ways in which the future will make sense of the past. This way of conceptualizing tradition and cultural history is politically significant, for it can be seen as a critique of the teleological and historicist assumptions that underlie Cuban nationalist and revolutionary hegemonic discourses.
Implementation of Diabetes Mellitus Program in the Tyumen region
Authors: Suplotova Lyudmila Alexandrovna , Belchikova L N , Brynza N S
Published: November 2013

Aim. To assess results of realization of the regional Diabetes Mellitus Program in the Tyumen region. Materials and methods. Materials of the regional Diabetes Mellitus Registry for 1999-2007 were analysed. Results. DM1 and DM2 morbidity increased from 6.6 to 8.16 and from 97.3 to 216.96 per100,000 population respectively. Primary disability rate among DM1 and DM2 patientsdecreased by a factor of 2. The fraction of patients with severe diabetic complications also decreased (1.3 times for blindness, 1.8 times for amputations). The frequency of diabeticcoma decreased by a factor of 2. Thirty five Diabetes School were organized. Mean life expectancy of DM1 and DM2 subjects increased from 49.55?5.43 to 50.11?2.96 years(p = 0.0001) and from 68.00?1.79 to 71.52?0.39 years (r = 0.0001) respectively. Mortality rate in DM1 and DM2 patients dropped by a factor of 5 and 3. All DM patients use onlymodern insulin formulations, with analogs accounting for 39.5% and human recombinant insulins for the rest of the total. Therapeutic use of secretagogues for the managementof DM2 decreased from 84.8 to 49.1% (p = 0.0001) and that of metformin increased form 6.8 to 28% (p = 0.0001); the need in insulin therapy also increased. Conclusion. Elaboration and implementation of the program contributed to the decreased occurrence of diabetic coma, blindness, and amputations in DM1 and DM2 patients,their longer life expectancy, and improved availability of high-quality oral hypoglycemic agents.
Assessment of quality of life as an element of monitoring health status in children and adolescents with type 1 diabetes mellitus
Authors: Bolotova Nina Viktorovna , Kompaniets Olga Viktorovna , Filina Natalya Yur'evna , Nikolaeva Natalya Valer'evna
Published: November 2013

Aim. To assess quality of life (QL) in children and adolescents with type 1 diabetes mellitus (DM1) depending on its duration, mode of insulin administration,and degree of social adaptation. Materials and methods. Generic Core Scale and Diabetes Module of Pediatric Quality of Life Questionnaire were used to estimate QL in 72 diabeticchildren and adolescents aged 5-18 yr with the participation of one of the parents. Patients with severe concomitant pathology were not includedin the study. Results. Overall QL score in children and adolescents with DM1 was 73,043?1,24. The psycho-social activity of most patients in all age groups was ratherhigh in contrast to suppressed physical functions due to complications of DM1 ten or more years in duration (51,4?9,19 scores). The psycho-emotionalstate was less dependent on negative effects of the disease. Patients using an insulin pump had on the whole better QL than those receiving intensiveinsulin therapy (82 and 72 points respectively, p
Danger of multiple use of insulin pen needles for diabetic patients
Authors: Misnikova Inna Vladimirovna , Dreval' Alexander Vasil'evich , Gubkina Valeria Alekseevna , Rusanova Irina Vladimirovna
Published: November 2013

Aim. To evaluate the risk of multiple use of BD Micro-Fine Plus insulin pen needles in terms of their contamination with microflora, pain and localreaction at the injection site. Materials and methods. The study included 45 patients aged above 18 yr with type 1 and 2 diabetes mellitus (DM1 and DM2) treated with shortorultrashort-acting insulins TID. Account was taken of the time each needle was used (once, for 4 and 7 days). Microbiological analysis was madeat the respective time points. Pain sensation after injection was evaluated by patients themselves using a visual-analog scale and severity of local reactionsby the physician. Results. Microbial growth was documented in 20 and 33,3% of the patients who used needles ones or many times respectively. Patients of the lattergroup more frequently complained of pain after injection (on day 4, p=0,08) compared with those of the former one (on day 7, p=0,03). Hyperemicfoci at injection sites developed only in case of using the same needle for 4 and 7 days (13,3 and 26,6% respectively). Conclusion. Multiple use of insulin pen needles by patients with DM should be avoided since it leads to hyperemia at injection sites, pain sensation,and risk of microbial contamination.
The role of regulatory CD4+CD25+high T-lymphocytes and their functional activity in the development of type 1 diabetes mellitus
Authors: Nikonova Tatiana Vasil'evna , Apanovich Pavel Vasil'evich , Pekareva Elena Vladimirovna , Gorelysheva Vera Anatol'evna , Prokof'ev Sergey Alexandrovich , Karpukhin Alexander Vasil'evich , Dedov Ivan Ivanovich
Published: November 2013

Type 1 diabetes mellitus (DM1) is associated with compromised (defective) immunologic tolerance to autoantigens and selective destruction of pancreatic B-cells by CD4+ (effector) and CD8 (cytotoxic) lymphocytes. The mechanisms of autotolerance involve CD4+CD25+high T-regulatory cells (Treg) whose suppressor activity depends on the expression of the FoxP3 gene. Aim. Detection of quantitative and functional alterations at the level of regulation of immunity in subjects at risk of DM1 and patients with different duration of DM1. Materials and methods. 116 patients (67 men and 49 women) with different duration of DM1. The risk group was comprised of 33 subjects (10 men and 23 women), control group included 16 subjects. In all cases, HLA genotyping was performed, autoantibodies to GDC, insulin and tyrosine phosphatase, islet cell antigens were determined, subpopulation composition of CD3+, CD4+, CD8+, CD38+, HLA DR+, CD25+, CD4+25+ lymphocytes and their functional activities (FoxP3 gene expression) studied, C-peptie and HbA1c levels measured. Results. A tendency toward a rise in Cd25+ and CD4+25+ T-lymphocytes and a decrease in FoxP3 expression was documented in the risk group compared with control (p0.05) but their functional activity was lower (p
Peculiarities of correction of sexual function in men presenting with diabetes mellitus
Authors: Rozhivanov Roman Viktorovich , Lepetukhin Alexander Evgen'evich , Dubskiy Sergey Anatol'evich , Kurbatov Dmitriy Gennad'evich
Published: November 2013

Diabetes mellitus (DM) is frequently associated with disturbances of the sexual function underlain by hypogonadism and neuropathy. These pathologicalconditions are successfully managed by androgens, alpha-lipoic acid, and phosphodiesterase type 5 inhibitors, besides compensation of carbohydratemetabolism. This paper reports results of evaluation of different methods for the treatment of erectile dysfunction in DM patients basedat Endocrinological Research Centre. Their combination ensured higher than 90% efficiency of therapy.
The injection technique: results of a questionnaire study of diabetic patients in Russia. New international guidelines on the injectiontechnique
Authors: Mel'nikova Olga Georgievna , Mayorov Alexander Yur'evich
Published: November 2013

Aim. To consider technical aspects of antihyperglycemic injection therapy in patients with type 1 and type 2 diabetes mellitus.Methods. The analysis included 200 adult patients (60 men and 140 women) receiving injection therapy for at least 6 months. They filled a 40-iremquestionnaire designed to estimate socio-demographic parameters, the use of different devices for insulin injection, and the most frequent mistakesmade by the patients. Their mean age was 51.7?15.1 years, duration of DM 11.9?9.1 years, mean HbA1c level 8.4?1.5%. Results. 130 (65%) patients used semiautomated injection pens, 39 (19.5%) disposable syringes, 31 (15.5%) both devices. Most patients (122, 61%)used 8 mm needles, 32 (16%) used 12.7 mm needles, 31 (15.5%) 10 mm, 28 (14%) 12 mm, 19 (9.5%) 6 mm, 18 (9.0%) 5 mm. 64 (32%) patientsused needles of different length, 25 (12.5%) could not give a definitive information about the needle length they used. Location of injection sites variedconsiderably in individual patients. 87 (43.5%) made injections within a single anatomic regions (62 into the anterior abdominal wall, 19 into theanterolateral surface of the thigh, 5 into shoulders, and 1 into buttocks. 113 (56.5%) patients made injections into two or more regions. 83 (41.5%)developed lipodystrophy at injection sites, 42 (50.6%) continued to use them for injections (12 did it on a regular basis and 30 occasionally). HbA1clevels were 9.5 and 8.2% in patients who made injections into affected sites and who had no lipodystrophic changes respectively (p=0.02). Over halfof the interviewed patients (106 or 53%) were informed about correct subcutaneous injection technique by the attending endocrinologist, 60 (30%)were taught by the nursing staff while staying in a hospital or visiting an endocrinological dispensary, 28 (14.%) were educated at Diabetes schools,9 (4.5%) when seeing the local therapist, and 19 (9.5%) by non-professionals. Conclusion. Many patients make serious mistakes when self-administering insulin. Incompliance with the guidelines on insulin injections leading tothe impairment of carbohydrate metabolism, the technical aspects of injections must be in the focus of attention of any practitioner. New (2010) internationalguidelines on the injection technique are overviewed.
Efficacy and safety of medical treatment of chronic anxiety disorders in diabetic patients
Authors: Starostina Elena Georgievna , Moshnyaga Elena Nikolaevna , Bobrov Aleksey Evgen'evich
Published: November 2013

Aim. To study efficiency and safety of hydroxizine (H) and tofisopam (T) therapy in DM patients with generalized organic anxiety disorders and subsyndromicanxiety the overall prevalence of which among diabetic patients amounts to 45-50%. Materials and methods. This open prospective randomized comparative study included 60 DM patients with anxiety disorders (AD) of whom 95%presented with arterial hypertension. The medicines were prescribed at mean therapeutic doses for 3 months followed by 1 month withdrawal period.The efficiency of anxiolytics was estimated from dynamic patterns of reactive anxiety (RA), personal anxiety (PA, Spielberger scale), somatic anxietysymptoms (Giessen questionnaire), HbA1c level, systolic and diastolic AP (SAP, DAP), heart rate. Results. Therapy with anxiolytics for 3 months resulted in the decrease of the HbA1c level from 7.9?1.4 to 7.4?1.4%, total somatic anxiety scorefrom 38.0?13.2 to 31.5?12.2, PA from 52.5?9.7 to 47.1?8.8, RA from 32.3?9.0 to 25.5?9.3, SAP from 141.4?12.4 to 129.8?13.5 mmHg,DAP from 82.3?7.4 to 77.8?8.6 mm Hg, HR from 76.3?9.5 to 72.7-5.6 (in all cases p
Prospective study of efficacy and safety of insulin pump therapy in children and adolescents
Authors: Emel'yanov Andrey Olegovich , Kuraeva Tamara Leonidovna , Laptev Dmitriy Nikitich , Peterkova Valentina Alexandrovna
Published: November 2013

Adequate glycemic control remains an unresolved problem for children and adolescents with type 1 diabetes mellitus. The use of new insulin analogsand intense insulinotherapy does not always permit to achieve the target levels of glycemia and HbA1c. To-day insulin pump therapy is considered tobe the most efficacious tool for the improvement of glycemic control.Aim. To estimate results of glycemic control in children and adolescents treated by insulin pump therapy. Materials and methods. The study included 173 patients aged 1.5-22 years having the disease for 0.5-20 years. MiniMed 508, MiniMed 712,MiniMed 722, Accu Check Spirit, Accu check D-Tron, Dana Care IIs pumps, ultrashort-acting insulins aspart and lispro were used. The patientsperformed self-control of glycemia 4-8 times during 24 hours. HbA1c was measured before and 12, 24, 36, 48 months after the onset of therapy. Thefrequency of DKA and severe hypoglycemia was recorded. Results. The HbA1c before the onset of therapy was 9.8 ?2.0% and dropped to 8.6; 8.7; 8.7; 8.9 and 9% 12, 24, 36, 48 months after it respectively.DKA was diagnosed in 20 (2.4%) and severe hypoglycemia in 5 patients. All patients in the CSII group were content with the use of the pumps, theabsence of injections and flexible day regimen. Conclusion. One year after the beginning of therapy the level of HbA1c significantly decreased. However, it increased again during a follow-up of5 years probably because of impaired compliance. This fact implies the necessity to regular repeat patient education for raising awareness of and motivationfor self-management.
Project of Russian Consensus on gestational diabetes mellitus: diagnostics, treatment and postnatal care
Authors: Dedov Ivan Ivanovich , Krasnopol'skiy Vladislav Ivanovich , Sukhikh Gennadiy Tikhonovich
Published: November 2013

Current document presents a coherent viewpoint of Russian Association of Endocrinologists and Russian Association of Obstetriciansand Gynaecologists on diagnostic criteria of gestational diabetes mellitus (GDM) and other glycemic disorders during gestation. Currentapproach is based on analysis of high-profile multinational study HAPO (Hyperglycemia and Adverse Pregnancy Outcomes Study),which included more than 23 000 pregnant women. This project was repeatedly reviewed on workgroup sessions and presented orallyon 6th Russian Congress of Endocrinology with international participation, as well as Russian interdisciplinary educational congressGestational Complications and Premature Delivery.
Intracellular metabolism of neutrophils and risk for development of type 2 diabetes mellitus in patients with metabolic syndrome
Authors: Kratnov Andrey Evgen'evich , Lopatnikova Elena Nikolaevna , Kratnov Alexander Andreevich
Published: November 2013

77 male patients (mean age 47?7.4 years) without ischaemic heart disease were tested for metabolic syndrome factors, risk for developmentof type 2 diabetes mellitus (T2DM) according to FINDRISK questionnaire, following with assessment of intracellularmetabolism parameters of neutrophils. Increased risk for T2DM positively correlated in these patients with myeloperoxidase activity,level of hydrogen peroxide within neutrophils and BMI. We observed elevation of oxygen-dependent metabolism in neutrophils formpatients with morbid obesity, accompanied with decrease in antioxidant factors, which is suggestive of oxidative stress.
Humalog Mix 25 in the treatment of type 2 diabetes mellitus
Authors: Zoloedov Vladimir Ivanovich , Gorshkov Ivan Petrovich , Volynkina Anna Petrovna
Published: November 2013

Diabetes mellitus type 2 remains one of the most significant chronic diseases. More than 552 million individuals (one of every teninhabitants of the planet) are estimated to have diabetes mellitus to 2030. Early incapacitation and high mortality rates resulting fromlong-term diabetes complications constitute social significance of carbohydrate metabolism disorders. Despite modern advances intreatment, most diabetic patients are not adequately compensated, requiring intensification of insulin therapy. Pre-mixed insulins areone of the most advanced options of treatment intensification.
Vasculogenesis and angiogenesis in diabetes mellitus: novel pathogenetic concepts for treatment of vascular complications
Authors: Konenkov Vladimir Iosifovich , Klimontov Vadim Valer'evich
Published: November 2013

Hyperglycemia along with other metabolic disorders may disrupt the balance of pro- and antiangiogenic regulators, thus leading to a maladaptive formation of new blood vessels in the state of diabetes mellitus (DM). In their turn, aberrant angiogenesis and vasculogenesis are important mechanisms of vascular complications in DM. Activation of retinal angiogenesis is a cornerstone of proliferative diabetic retinopathy, though in diabetic nephropathy excessive angiogenesis is only seen at early stages. Quite on the contrary, macrovascular complications are characterized by certain inhibition of both angiogenesis and vasculogenesis. Novel therapeutic approaches, based on correction of angiogenesis, have emerged recently. Clinical trials have shown efficacy of angiogenesis inhibitors (the ?anti-VEGF? agents) for management of diabetic macular edema and proliferative retinopathy. Experimental evidence also indicates that this treatment may hinder the progress of diabetic nephropathy. In addition, stimulation of angiogenesis and vasculogenesis with stem cells or growth factors promise an option for treatment of large vessels in DM.
Glycated hemoglobin test: diagnostic difficulties in gestational diabetes
Authors: Saprina Tatiana Vladimirovna , Timokhina Ekaterina Sergeevna , Vorozhtsova Irina Nikolaevna
Published: November 2013

Aims. To determine sensitivity and specificity of glycated hemoglobin (HbA1c) test with direct immunoturbidimetry as a method to diagnose gestational diabetes (GD). Materials and Methods. 74 pregnant females were recruited during initial screening. Glycemic disorders were diagnosed with two methods: oral glucose tolerance test with 75 g of glucose and glycated hemoglobin test. Results. HbA1c test with direct immunoturbidimetry is a highly sensitive method for diagnosis of glycemic disorders of pregnancy, provided that cut-off level is lowered to 5.5%. Conclusion. Mild anemia was not found to have a significant impact on diagnostic value of HbA1c test.
Early insulin therapy Coordination Council
Authors: Shestakova Marina Vladimirovna
Published: November 2013

Coordination Council has denoted the importance of adherence to Russian and international guidelines and prominent role of insulin therapy in management of type 2 diabetes mellitus (T2DM). Insulin therapy in T2DM preserves endogenous insulin secretion, prevents or decelerates development of microvascular complications and is known to be the most effective glucose-lowering treatment.
Total glucose control: the role of post-prandial glucose
Authors: JELLINGER PAUL S
Published: November 2013

The basis of strict glucose control and the achievement of a favorable HgbAlc must involve the control of both fasting and post-prandial glucose levels. Most of the day is spent in the post-prandial state. The most important predictor of post prandial glycemia is the pre-prandial glucose. Glucose control in the United States is far from optimal with a minority of patients achieving either the ADA goal of 7.0% or the ACE/AACE goal of 6.5%. There is evidence that post-meal glucose has a better correlation with A1C than fasting glucose levels especially when the A1C is less than 8%. A reduced early insulin release leads to high postprandial glucose. The evidence that lowering Hgb A1C results in lower microvascular risk is substantial. The DCC T demonstrated a clear association, of retinopathy with A1C . The study also demonstrated that for the same Al C, intensive glucose control using short-acting insulin pre-meals was associated with reduced complications compared to conventional treatment without short acting insulin. Further evidence from the Kumamoto Study and the UKPDS confirm reduced microvascular complications with lower A1C levels. Elevated mealtime glucose is an unappreciated concern at all levels of A1C including A1C levels at normal or near normal values. Elevated mealtime glucose is of special concern in the elderly. There is strong epidemiologic evidence linking post challenge hyperglycemia to macro-vascular risk. These include the Rancho Bernardo study the Honolulu Heart Study, the Paris Prospective Heart Study, The Diabetes Intervention Study, and the DECODE Study. There are many other studies going back to the 1980s that relate post-challenge or post-prandial blood glucose to cardiovascular disease risk and mortality. Possible effects of acute hyperglycemia responsible for increased microvascular and macrovascular risk include endothelial dysfunction, increased oxidative load, a pro-inflammatory state, protein glycosylation and altered coagulation. There is evidence that oral glucose loading adversely affects endothelial function. Oxidative load in the form of reactive oxygen species is increased following a glucose challenge. The pro-inflammatory state relates to quintiles of dietary glycemic load as it does to the 2- hour post challenge glucose category. There is evidence that in intimal media thickness increases more with the 2 hour glucose than A 1С. In summary, post mealtime glucose spikes are to be prevented because lowering A1C reduces microvascular complications, A1C reflects post mealtime glucose as well as fasting plasma group glucose, elevated post-meal glucose is a highly prevalent issue and elevated blood glucose 2 hours after a glucose load is associated with increased risk of death independent of fasting blood glucose. The Epic- Norfork study raises questions as to the level of A1C associated with risk.