Glargine and detemir: Safety and efficacy profiles of the long-acting basal insulin analogs

Diabetes mellitus is a growing public health concern in the US and worldwide. Insulin therapy is the cornerstone of diabetes therapy, and the use of basal insulins will increase as clinicians strive to help their patients reach glycemic goals. Basal insulins have been continually improved upon over the years, and the long-acting basal insulin analogs, glargine and detemir, have many pharmacokinetic and pharmacodynamic advantages over neutral protamine Hagedorn insulin, namely, less variable absorption profiles, a less pronounced peak in effect, and a longer duration of action. Overall, glargine and detemir do not differ greatly in their safety and efficacy profiles. Major differences between the two include lower within-subject variability, lower risk of hypoglycemia, and a weight-sparing effect with insulin detemir. This review summarizes data from the key pharmacokinetic and pharmacodynamic studies, as well as clinical and observational studies to elucidate the role of each basal insulin analog in therapy

A Review of Insulin-Dosing Formulas for Continuous Subcutaneous Insulin Infusion (CSII) for Adults with Type 1 Diabetes

Dosing guidelines for patients with type 1 diabetes using continuous subcutaneous insulin infusion (CSII), which are historically based on clinical experience and retrospective studies of patients consuming an American diet, recommend that basal insulin should represent approximately 50 % of the total daily dose (TDD). Recent prospective studies in the USA and Japan conclude that the more appropriate proportion is closer to 30–40 % of TDD. In addition, currently used formulas for calculating the carbohydrate-to-insulin ratio (CIR) and correction factor (CF) may lead to underdosing of bolus insulin by as much as 12.8–50 % for a hypothetical patient. The discrepancies between traditional formulas and data from newer studies can be accounted for by the more rigorous design of the newer studies (e.g., prospective design, controlled diets, meal omission, and frequent glucose monitoring). International differences in diet composition may also be important to consider when developing dosing recommendations for CSII

Soybean production in Missouri

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The role of mentorship in protege performance

The role of mentorship on protege performance is a matter of importance to academic, business, and governmental organizations. While the benefits of mentorship for proteges, mentors and their organizations are apparent, the extent to which proteges mimic their mentors' career choices and acquire their mentorship skills is unclear. Here, we investigate one aspect of mentor emulation by studying mentorship fecundity---the number of proteges a mentor trains---with data from the Mathematics Genealogy Project, which tracks the mentorship record of thousands of mathematicians over several centuries. We demonstrate that fecundity among academic mathematicians is correlated with other measures of academic success. We also find that the average fecundity of mentors remains stable over 60 years of recorded mentorship. We further uncover three significant correlations in mentorship fecundity. First, mentors with small mentorship fecundity train proteges that go on to have a 37% larger than expected mentorship fecundity. Second, in the first third of their career, mentors with large fecundity train proteges that go on to have a 29% larger than expected fecundity. Finally, in the last third of their career, mentors with large fecundity train proteges that go on to have a 31% smaller than expected fecundity.Comment: 23 pages double-spaced, 4 figure

EMIC Waves in the Outer Magnetosphere: Observations of an Off-Equator Source Region.

Electromagnetic ion cyclotron (EMIC) waves at large L shells were observed away from the magnetic equator by the Magnetospheric MultiScale (MMS) mission nearly continuously for over four hours on 28 October 2015. During this event, the wave Poynting vector direction systematically changed from parallel to the magnetic field (toward the equator), to bidirectional, to antiparallel (away from the equator). These changes coincide with the shift in the location of the minimum in the magnetic field in the southern hemisphere from poleward to equatorward of MMS. The local plasma conditions measured with the EMIC waves also suggest that the outer magnetospheric region sampled during this event was generally unstable to EMIC wave growth. Together, these observations indicate that the bidirectionally propagating wave packets were not a result of reflection at high latitudes but that MMS passed through an off-equator EMIC wave source region associated with the local minimum in the magnetic field

New Lithium Measurements in Metal-Poor Stars

We provide *lambda*6708 Li 1 measurements in 37 metal-poor stars, most of which are poorly-studied or have no previous measurements, from high-resolution and high-S/N spectroscopy obtained with the McDonald Observatory 2.1m and 2.7m telescopes. The typical line strength and abundance uncertainties, confirmed by the thinness of the Spite plateau manifested by our data and by comparison with previous measurements, are <=4 mAng and <=0.07-0.10 dex respectively. Two rare moderately metal-poor solar-Teff dwarfs, HIP 36491 and 40613, with significantly depleted but still detectable Li are identified; future light element determinations in the more heavily depeleted HIP 40613 may provide constraints on the Li depletion mechanism acting in this star. We note two moderately metal-poor and slightly evolved stars, HIP 105888 and G265-39, that appear to be analogs of the low-Li moderately metal-poor subgiant HD 201889. Preliminary abundance analysis of G 265-39 finds no abnormalities that suggest the low Li content is associated with AGB mass-transfer or deep mixing and p-capture. We also detect line doubling in HIP 4754, heretofore classified as SB1.Comment: Accepted for publication in PASP, volume 912 (Feb 2012) 15 pages, 3 figures, 2 table

Stages of the Demographic Transition from a Child's Perspective: Family Size, Cohort Size, and Children's Resources

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/71989/1/j.1728-4457.2008.00218.x.pd