Contraindications to metformin therapy in patients with NIDDM

OBJECTIVE: Treatment with metformin is occasionally associated with the development of severe lactic acidosis. However, this is usually observed in patients with major contraindications to the drug. In this study, we aimed to determine the prevalence of conditions currently regarded as either contraindications or cautions to the use of metformin in patients with NIDDM. RESEARCH DESIGN AND METHODS: The case notes of metformin-treated NIDDM patients (mean age 62 years) attending a United Kingdom university hospital diabetes clinic over a 3-month period were reviewed according to criteria reflecting a pragmatic view of current prescribing recommendations. RESULTS: Of 89 consecutive patients whose notes could be evaluated in detail, only 41 (46%) had no contraindications or cautions to metformin whatsoever. Concomitant chronic disorders associated with a potentially increased risk of hyperlactatemia were renal impairment (n = 2; plasma creatinine concentrations 1.7 and 2.3 mg/dl, respectively), cardiac failure (n = 2), and chronic liver disease (n = 2). Other potentially relevant disorders included ischemic heart disease (n = 20), clinical proteinuria (n = 14), peripheral vascular disease (n = 22), and pulmonary disease (n = 7). Multiple conditions (i.e., two, three, or four) were present in eight, five, and one patient(s), respectively. CONCLUSIONS: More than half the patients in our series had concomitant conditions or complications conventionally regarded as cautions or contraindications to metformin; approximately 10% had a multiplicity of such conditions. Regular surveillance is necessary to detect the development of complications such as renal impairment. Vigilance is also required in view of the increased risk of major intercurrent illnesses, which may independently disturb lactate metabolism in patients with NIDDM. Metformin should be withdrawn promptly under such circumstances.     

Building Community Places — Machizukuri — Neoliberalism,Suburbanization and ‘Americanization’

This research maps some of the debates on community building in the planning of suburban developments. Particular reference is made to Kokoku New Town in Yokohama, Japan, and the Golden Grove Development in Adelaide, Australia. These two developments emerged in the early 1980s and the histories related suggest significant similarities, although they grew out of different regimes of power. Drawing upon Foucault and other governmentality thinkers, this study focuses on the relationships between neoliberalism and suburbanization. The primary concern is the exercise of government (the conduct of conduct) and how this exercise is carried out and maintained.     

Novel diffusion cell for in vitro transdermal permeation, compatible with automated dynamic sampling

The development of a new diffusion cell for in vitro transdermal permeation is described. The so-called Kelder cells were used in combination with the ASPEC system (Automatic Sample Preparation with Extraction Columns), which is designed for the automation of solid-extractions (SPE). Instead of SPE columns, 20 Kelder cells were placed in the racks. This allowed automatic sampling of up to 20 cells for 24 h in a dynamic mode. The cells consist of an inlet compartment, a donor compartment and a receptor compartment. The size and the depth of the inlet compartment were important to avoid entrapment of air bubbles in the receptor compartment. The Kelder cells mimic blood flow beneath the skin by replacement of the permeating drug every 2 min. Hence sink condition are more easily maintained than with the static Franz diffusion cell. The performance of the cells was tested with permeation experiments using atropine as a model drug permeating through an artificial membrane (Silastic). The use of this skin model minimized the variability in permeation of atropine as compared with human skin.     

Executive Self, Self-Esteem, and Negative Affectivity: Relations at the Phenotypic and Genotypic Level.

Complementary approaches examined the relations among executive self, self-esteem, and negative affectivity. A cross-sectional (N = 4,242) and a longitudinal (N = 158) study established that self-esteem mediated the relation between executive self and negative affectivity. A 3rd study (N = 878 twin pairs) replicated this pattern and examined genetic and environmental influences underlying all 3 phenotypes. Covariation among the 3 phenotypes reflected largely common genetic influences, although unique genetic effects explained variability in both executive self and negative affectivity. Executive self was influenced by shared environmental influences unique from those affecting self-esteem and negative affectivity. Nonshared environmental influences accounted for the majority of variance in each construct and were primarily unique to each. The unique genetic and nonshared environmental influences support the proposition that the executive self, self-esteem, and negative affectivity capture distinct and important differences between people. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Measuring experiential qualities of urban public spaces: users’ perspective

This paper presents an index for measuring experiential qualities (EQs) of urban public spaces through users’ perspective. The index is underpinned by interrelated qualities of comfort, diversity and vitality, inclusiveness, and image and likeability. It is then applied to two public spaces in the Australian city of Brisbane: Queen Street Mall and South Bank Parklands. The index extends the user-centred measuring tools and can be used by practitioners, authorities and scholars to highlight users’ needs and concerns. Findings from case spaces revealed deficiencies and provided a deeper insight into EQs through integrating urban design qualities, perception and management measuring items.     

Surfactant‐Free Sub‐2 nm Ultrathin Triangular Gold Nanoframes

Ultrathin triangular gold nanoframes are synthesized in high yield through selective gold deposition on the edges of triangular silver nanoprisms and subsequent silver etching with mild wet etchants. These ultrathin gold nanoframes are surfactant‐free with tailorable ridge thickness from 1.8 to 6 nm and exhibit adjustable and distinct surface plasmon resonance bands in the visible and near‐IR region. In comparison, etching of the nanoprism template by galvanic replacement can only create frame structures with much thicker ridges, which have much lower catalytic activity for 4‐nitrophenol reduction than the ultrathin gold nanoframes.     

Building a Golden Grove ‘community’: a study of suburban production processes in South Australia, 1970s–1980s

Ideals of community have been associated with the practice of planning for over a century. Proponents of the Golden Grove Development considered particular ideals of community to be fundamental to the financial and social success of the new suburban development. This paper will analyse the early planning processes that underpinned the production of community ideals and argue that these planning processes took place at the transition between welfarism and neo‐liberalism. This study will offer provocative glimpses into late twentieth century suburban planning practices; practices that establish the Golden Grove Development as a model of late twentieth century suburban production processes.     

A qualitative exploration of arts-based neighbourhood revitalization: The case of ‘The Space at 2106 Main’ in West Tampa,Florida

As cities are compelled to compete for new sources of investment and revenue, arts-based economic development strategies have become the norm. The purpose of this paper is to revisit and reevaluate some of the conventional claims about the arts as an important economic development strategy by exploring a case study called “The Space at 2106 Main” in a rapidly gentrifying neighbourhood called West Tampa. The results of this study suggest that the arts are indeed assuming a greater role in economic policy under the auspices of West Tampa community redevelopment areas (CRA) and the direct actions of various arts related entrepreneurs. The results however, point to a mixed picture that raises difficult questions about the medium to long-term effects of this urban redevelopment strategy, especially on the poor and mostly minority residents of West Tampa.     

Removal of sulphate from mine water with barium sulphide

The Barium Sulphide Process removes sulphates from mine water by precipitating BaSO₄ with BaS. Barium sulphide is regenerated thermally by reducing the BaSO₄ with coal at 1000–1100°C for about 15 minutes. The process produces elemental sulphur and CaCO₃ as by-products. Laboratory studies achieve typical sulphate reductions of about 95%. Metals such as Fe, Ni, Co and Mn are also removed and pH can be increased from 1,4 to 8,3. The process has a water recovery of about 70%. For a 25 Ml/d plant (2g/l SO₄ ^2?), the capital cost is estimated at US$ 0,48m/Ml/d, while the detailed running costs amount to a net value of 27 c/m³. This compares well with that of other processes for desalination and is less than the fresh water price for new mines in South Africa, viz. 30c/m³.