Diabetic gastroparesis: Therapeutic options

Gastroparesis is a condition characterized by delayed gastric emptying and the most common known underlying cause is diabetes mellitus. Symptoms include nausea, vomiting, abdominal fullness, and early satiety, which impact to varying degrees on the patient’s quality of life. Symptoms and deficits do not necessarily relate to each other, hence despite significant abnormalities in gastric emptying, some individuals have only minimal symptoms and, conversely, severe symptoms do not always relate to measures of gastric emptying. Prokinetic agents such as metoclopramide, domperidone, and erythromycin enhance gastric motility and have remained the mainstay of treatment for several decades, despite unwanted side effects and numerous drug interactions. Mechanical therapies such as endoscopic pyloric botulinum toxin injection, gastric electrical stimulation, and gastrostomy or jejunostomy are used in intractable diabetic gastroparesis (DG), refractory to prokinetic therapies. Mitemcinal and TZP-101 are novel investigational motilin receptor and ghrelin agonists, respectively, and show promise in the treatment of DG. The aim of this review is to provide an update on prokinetic and mechanical therapies in the treatment of DG

Supporting industrial cooperatives in developing countries: some Tanzanian experiences

This paper draws upon both case-study and statistical materials, gathered in Tanzania, in an attempt to determine how industrial producer cooperatives might be promoted. A logistic pattern of cooperative growth is tested and found to dominate a view that the number of coops grows because of support organizations. Drawing upon an ecological model it is suggested that the factor which limits growth is the availability of management and, further, that the growth of the competing 'small-scale sector' is at the expense of the cooperative sector. Management nurtured in the cooperative sector moves into the small-scale sector. Case-study analysis using a Boolean analysis suggests that legitimate and capable management are essential to success of cooperatives particularly with technologies which generate production interdependencies. Finally, supporting evidence for the significance of management competence and interdependence in explaining performance is outlined using an augmented CobbDouglas production function framework

Flux dynamics and irreversibility in YBa sub 2 Cu sub 3 O sub 7 with Y sub 2 BaCuO sub 5 inclusions and in single crystal YBa sub 2 Cu sub 3 O sub 7

We have measured the ac magnetic permeability response function {mu} = {mu}{prime} + i{mu}{double prime} in melt-processed melt grown YBa{sub 2}Cu{sub 3}O{sub 7} with Y{sub 2}BaCuO{sub 5} inclusions (MPMG) and in single crystal YBa{sub 2}Cu{sub 3}O{sub 7} (SC) in applied magnetic fields up to 8 Tesla oriented either parallel or perpendicular to the crystalline c-axis. The ac response of the two samples has been mapped out as a function of temperature, frequency, ac field amplitude, dc applied field, and field orientation. The peak in the lossy part of the susceptibility {mu}{double prime} is used to probe the flux dynamics in the vicinity of the irreversibility line. The data are interpreted by comparison with expectations of an anisotropic vortex glass- to -liquid transition. The inferred melting lines as well as the frequency dependence and non-linear response are in overall agreement with the expected behavior. In the range of available parameters and variables we find the system to be in the solid vortex phase for H{perpendicular}c since there is a strong H{sub ac} dependence and only a weak frequency dependence on the temperature position of the loss peak. For H{parallel}c, the situation is reversed, and the loss peak depends only weakly on H{sub ac} and strongly on the frequency

Entrepreneurship as a process : toward harmonizing multiple perspectives

Are there any common denominators within the diversity of entrepreneurship literature that may serve as foundations for understanding the entrepreneurial process in a systematic and comprehensive way that is useful to both scholars and practitioners? The objective of this paper was to discover about the entrepreneurial process what, if anything, is both generic (all processes that are “entrepreneurial” do this) and distinct (only entrepreneurial processes do this). Our approach was to evaluate published models of entrepreneurial process to discover what scholars have argued about what entrepreneurs do and how they do it (the processes they use) and to seek out any key commonalities that scholars claim are associated with the phenomenon. Unfortunately for the field, the investigation demonstrates that, as at the time of our investigation, the 32 extant models of entrepreneurial process are highly fragmented in their claims and emphases and are insufficient for establishing an infrastructure upon which to synthesize an understanding of entrepreneurial process that is both generic and distinct. Insights gained in the study lead to suggestions for future research and theory development of which the most urgent is the need to develop a single harmonized model of entrepreneurial process capable of embracing the best of what is on offer and adding new theoretical arguments in areas where practice shows that they are lacking