Investigational agents that protect pancreatic islet β-cells from failure

Type 2 diabetes is associated with insulin resistance and reduced insulin secretion, which results in hyperglycaemia. This can then lead to diabetic complications such as retinopathy, neuropathy, nephropathy and cardiovascular disease. Although insulin resistance may be present earlier in the progression of the disease, it is now generally accepted that it is the deterioration in insulin-secretory function that leads to hyperglycaemia. This reduction in insulin secretion in Type 2 diabetes is due to both islet β-cell dysfunction and death. Therefore, interventions that maintain the normal function and protect the pancreatic islet β-cells from death are crucial in the treatment of Type 2 diabetes so that plasma glucose levels may be maintained within the normal range. Recently, a number of compounds have been shown to protect β-cells from failure. This review examines the evidence that the existing therapies for Type 2 diabetes that were developed to lower plasma glucose (metformin) or improve insulin sensitivity (thiazolidinediones) may also have islet-protective function. Newer emerging therapeutic agents that are designed to increase the levels of glucagon-like peptide-1 not only stimulate insulin secretion but also appear to increase islet β-cell mass. Evidence will also be presented that the future of drug therapy designed to prevent β-cell failure should target the formation of advanced glycation end products and alleviate oxidative and endoplasmic reticulum stress.

Enhancing the failure mode and effect analysis methodology with fuzzy inference techniques

Traditional Failure Mode and Effect Analysis (FMEA) adopts the Risk Priority Number (RPN) ranking model to evaluate failure risks, to rank failures, as well as to prioritize actions. Although this approach is simple, it suffers from several shortcomings. In this paper, we investigate a number of fuzzy inference techniques for determining the RPN scores, in an attempt to overcome the weaknesses associated with the traditional RPN model. The main objective is to examine the possibility of using fuzzy rule interpolation and reduction techniques to design new fuzzy RPN models. The performance of the fuzzy RPN models is evaluated using a real-world case study pertaining to the test handler process in a semiconductor manufacturing plant. The FMEA procedure for the test handler is performed, and a fuzzy RPN model is developed. In addition, improvement to the fuzzy RPN model is proposed by refining the weights of the fuzzy production rules, hence a new weighted fuzzy RPN model. The ability of the weighted fuzzy RPN model in failure risk evaluation with a reduced rule base is also demonstrated.

Giving a state a bad name? Kyrgyzstan and the risk of state failure

The article discusses the possible state failure of Kyrgyzstan and the implications of the label of a failed sate. A brief history of the events that have led to failed state status include the Tulip Revolution in 2005, political protests, presidential election protests, and ethnic violence. The response of the U.S., the European Union, and Russia to the events and the national interests of labeling the state as failed are discussed. It is suggested that instead of establishing security other countries have labeled Kyrgyzstan as a failed state which has led to a lack of political legitimacy, an expansion of neoliberalism, and has dangerous implications for the success of the country.

I vote and tote : moral panics, resistance and the failure of quiet regulation

The term moral panic has entered the media and popular culture lexicon, but retains a particular meaning for sociologists. This chapter expands on existing models of moral panics and outlines a case study that illustrates that folk devils have fought back in recent years, using technologies such as social media to present their arguments (in this instance, turning a local political controversy in Melbourne, the Australian state of Victoria, to their advantage). The battle began over a classice law-and-order issue, that is, the problem of  alcohol-related violence, expecially as it involves young people. However, the conflict took an unexpected turn when the fold devils successfully used the media to prosecute their case and force the state government's hand.

Comparisons of seismic rock slope stability assessments between the Hoek-Brown and Mohr-Coulomb failure criteria

Current investigations have shown that earthquakes can trigger significant damages of equipment, property infrastructure and environment. This is a persistent cause of economic loss for any country, especially for the loss of life. The conventional method for slope stability design is to utilize limit equilibrium method (LEM) in conjunction with the pseudo-static (PS) approach. However, the LEM has a significant drawback which is to determine the slip surface before factor of safety calculation. The numerical upper and lower bound limit analysis method employed in this paper can avoid this limitation. In this study, the presented slope stability evaluations considering earthquake effects based on the finite difference method will be discussed and compared with the results from the numerical limit analysis methods.

Complexity of management and health outcomes in a prospective cohort study of 573 heart failure patients in Australia : does more equal less?

Aims and objectives : To compare the efficacy of chronic heart failure management programmes (CHF-MPs) according to a scoring algorithm used to quantify the level of applied interventions–the Heart Failure Intervention Score (HF-IS).

Background : The overall efficacy of heart failure programmes has been proven in several meta-analyses. However, the debate continues as to which components are essential in a heart failure programme to improve patient outcomes.

Design : Prospective cohort study of patients participating in heart failure programmes.

Method : Forty-eight of 62 (77%) programmes in Australia participating in a national register of CHF-MPs were evaluated using the HF-IS: derived from a summed and weighted score of each intervention applied by the CHF-MP (27 interventions overall). The CHF-MPs were prospectively categorised as relatively low (HF-IS < 190 – n = 39 programmes & 407 patients) or high (HF-IS ≥ 190 – n = 9 programmes & 166 patients) in complexity. Six-month morbidity and mortality rates in 573 consecutively recruited patients with systolic dysfunction and in New York Heart Association Class II–IV were prospectively examined.

Results : Patients exposed to CHF-MPs with a high HF-IS had a lower rate of unplanned, all-cause hospitalisation (n = 24, 14% vs. n = 102, 25%) compared with CHF-MPs with a low HF-IS within six months. On an adjusted basis, CHF-MPs with a high HF-IS were associated with a reduced risk of unplanned hospitalisation and/or death within six months and remained event-free longer.

Conclusion : High complexity CHF-MPs applying more evidence-based interventions are associated with a higher event-free survival over six months.

Relevance to clinical practice : The HF-IS is an easy-to-use evidence-based tool to assist programme coordinators to improve the quality of their heart failure programme which may also improve patient outcomes.

'Catastrophic failure' theories and disaster journalism : evaluating media explanations of the Black Saturday bushfires

 In recent decades, academic researchers of natural disasters and emergency management have developed a canonical literature on ‘catastrophe failure’ theories such as disaster responses from US emergency management services (Drabek, 2010; Quarantelli, 1998) and the Three Mile Island nuclear power plant (Perrow, 1999). This article examines six influential theories from this field in an attempt to explore why Victoria’s disaster and emergency management response systems failed during Australia’s Black Saturday bushfires. How well, if at all, are these theories understood by journalists, disaster and emergency management planners, and policy-makers? In examining the Country Fire Authority’s response to the fires, as well as the media’s reportage of them, we use the 2009 Black Saturday bushfires as a theory-testing case study of failures in emergency management, preparation and planning. We conclude that journalists can learn important lessons from academics’ specialist knowledge about disaster and emergency management responses.

Are policy makers,researchers and educators 'addicted' to the equity failure cycle?’

Introduction : In this paper,  I suggest part of the key to equity progress is to remove our gaze from the equity defined ‘others’ to focus on recognising and transforming the ‘privilege- benefit loop’ (author’s term) that underpins the creation and maintenance of hegemonic Western educational institutions. As a modest contribution to the efforts to address the ‘equity failure cycle’ (author’s term, later expanded on), I suggest three combined approaches (drawing from critical theory and critical pedagogy ) that incorporate and illustrate the interconnected, usually concurrent and complementary political, cultural/institutional and personal levels of understanding, experience and action that I think are necessary ingredients for change. Each of the three levels or domains are inter-related and ‘co-constructive’ and therefore, potentially ‘de-constructive’ .