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Diabetes Overview
- What Is Diabetes?
- What Are the Types of Diabetes?
- Other Types of Diabetes
- How Is Diabetes Diagnosed?
- What Is Pre-Diabetes?
- What Are the Scope and Impact of Diabetes?
- Who Gets Diabetes?
- How Is Diabetes Managed?
- Hope Through Research
- What Will the Future Bring?
- Points to Remember
- For More Information
|Source: 2003-2006 National Health and Nutrition Examination Survey estimates of total prevalence -- both diagnosed and undiagnosed -- were projected to year 2007.
Almost everyone knows someone who has diabetes. An estimated 23.6 million people in the United States -- 7.8 percent of the population -- have diabetes, a serious, lifelong condition. Of those, 17.9 million have been diagnosed, and 5.7 million have not yet been diagnosed. In 2007, about 1.6 million people ages 20 or older were diagnosed with diabetes. For additional statistics, see the National Diabetes Statistics, 2007 fact sheet online at www.diabetes.niddk.nih.gov/dm/pubs/statistics or call the National Diabetes Information Clearinghouse (NDIC) at 1-800-860-8747 to request a copy.
What Is Diabetes?
Diabetes is a disorder of metabolism -- the way the body uses digested food for growth and energy. Most of the food people eat is broken down into glucose, the form of sugar in the blood. Glucose is the main source of fuel for the body.
After digestion, glucose passes into the bloodstream, where it is used by cells for growth and energy. For glucose to get into cells, insulin must be present. Insulin is a hormone produced by the pancreas, a large gland behind the stomach.
When people eat, the pancreas automatically produces the right amount of insulin to move glucose from blood into the cells. In people with diabetes, however, the pancreas either produces little or no insulin, or the cells do not respond appropriately to the insulin that is produced. Glucose builds up in the blood, overflows into the urine, and passes out of the body in the urine. Thus, the body loses its main source of fuel even though the blood contains large amounts of glucose.
What Are the Types of Diabetes?
The three main types of diabetes are
- type 1 diabetes
- type 2 diabetes
- gestational diabetes
Type 1 Diabetes
Type 1 diabetes is an autoimmune disease. An autoimmune disease results when the body's system for fighting infection -- the immune system -- turns against a part of the body. In diabetes, the immune system attacks and destroys the insulin-producing beta cells in the pancreas. The pancreas then produces little or no insulin. A person who has type 1 diabetes must take insulin daily to live.
At present, scientists do not know exactly what causes the body's immune system to attack the beta cells, but they believe that autoimmune, genetic, and environmental factors, possibly viruses, are involved. Type 1 diabetes accounts for about 5 to 10 percent of diagnosed diabetes in the United States. It develops most often in children and young adults but can appear at any age.
Symptoms of type 1 diabetes usually develop over a short period, although beta cell destruction can begin years earlier. Symptoms may include increased thirst and urination, constant hunger, weight loss, blurred vision, and extreme fatigue. If not diagnosed and treated with insulin, a person with type 1 diabetes can lapse into a life-threatening diabetic coma, also known as diabetic ketoacidosis.
Type 2 Diabetes
The most common form of diabetes is type 2 diabetes. About 90 to 95 percent of people with diabetes have type 2. This form of diabetes is most often associated with older age, obesity, family history of diabetes, previous history of gestational diabetes, physical inactivity, and certain ethnicities. About 80 percent of people with type 2 diabetes are overweight.
Type 2 diabetes is increasingly being diagnosed in children and adolescents, especially among African American, Mexican American, and Pacific Islander youth.
When type 2 diabetes is diagnosed, the pancreas is usually producing enough insulin, but for unknown reasons the body cannot use the insulin effectively, a condition called insulin resistance. After several years, insulin production decreases. The result is the same as for type 1 diabetes -- glucose builds up in the blood and the body cannot make efficient use of its main source of fuel.
The symptoms of type 2 diabetes develop gradually. Their onset is not as sudden as in type 1 diabetes. Symptoms may include fatigue, frequent urination, increased thirst and hunger, weight loss, blurred vision, and slow healing of wounds or sores. Some people have no symptoms.
Gestational Diabetes
Some women develop gestational diabetes late in pregnancy. Although this form of diabetes usually disappears after the birth of the baby, women who have had gestational diabetes have a 40 to 60 percent chance of developing type 2 diabetes within 5 to 10 years. Maintaining a reasonable body weight and being physically active may help prevent development of type 2 diabetes.
About 3 to 8 percent of pregnant women in the United States develop gestational diabetes. As with type 2 diabetes, gestational diabetes occurs more often in some ethnic groups and among women with a family history of diabetes. Gestational diabetes is caused by the hormones of pregnancy or a shortage of insulin. Women with gestational diabetes may not experience any symptoms.
Diabetes in Youth
The SEARCH for Diabetes in Youth multicenter study, funded by the Centers for Disease Control and Prevention (CDC) and the National Institutes of Health (NIH), has determined that
- based on data from 2002 to 2003, a total of 15,000 youth in the United States were newly diagnosed with type 1 diabetes each year. In addition, about 3,700 youth were newly diagnosed with type 2 diabetes each year.
- non-Hispanic white youth had the highest rate of new cases of type 1 diabetes.
- type 2 diabetes was rarely diagnosed among youth younger than 10 years of age.
Additional information about specific rates of new cases of type 1 and type 2 diabetes among youth younger than age 20 can be found in the fact sheet National Diabetes Statistics, 2007, available online at www.diabetes.niddk.nih.gov/dm/pubs/statistics.
Other Types of Diabetes
A number of other types of diabetes exist. A person may exhibit characteristics of more than one type. For example, in latent autoimmune diabetes in adults (LADA), also called type 1.5 diabetes or double diabetes, people show signs of both type 1 and type 2 diabetes.
Other types of diabetes include those caused by
- genetic defects of the beta cell -- the part of the pancreas that makes insulin -- such as maturity-onset diabetes of the young (MODY) or neonatal diabetes mellitus (NDM)
- genetic defects in insulin action, resulting in the body's inability to control blood glucose levels, as seen in leprechaunism and the Rabson-Mendenhall syndrome
- diseases of the pancreas or conditions that damage the pancreas, such as pancreatitis and cystic fibrosis
- excess amounts of certain hormones resulting from some medical conditions -- such as cortisol in Cushing's syndrome -- that work against the action of insulin
- medications that reduce insulin action, such as glucocorticoids, or chemicals that destroy beta cells
- infections, such as congenital rubella and cytomegalovirus
- rare immune-mediated disorders, such as stiff-man syndrome, an autoimmune disease of the central nervous system
- genetic syndromes associated with diabetes, such as Down syndrome and Prader-Willi syndrome
Latent Autoimmune Diabetes in Adults (LADA)
People who have LADA show signs of both type 1 and type 2 diabetes. Diagnosis usually occurs after age 30. Researchers estimate that as many as 10 percent of people diagnosed with type 2 diabetes have LADA. Some experts believe that LADA is a slowly developing kind of type 1 diabetes because patients have antibodies against the insulin-producing beta cells of the pancreas.
Most people with LADA still produce their own insulin when first diagnosed, like those with type 2 diabetes. In the early stages of the disease, people with LADA do not require insulin injections. Instead, they control their blood glucose levels with meal planning, physical activity, and oral diabetes medications. However, several years after diagnosis, people with LADA must take insulin to control blood glucose levels. As LADA progresses, the beta cells of the pancreas may no longer make insulin because the body's immune system has attacked and destroyed them, as in type 1 diabetes.
Diabetes Caused by Genetic Defects of the Beta Cell
Genetic defects of the beta cell cause several forms of diabetes. For example, monogenic forms of diabetes result from mutations, or changes, in a single gene. In most cases of monogenic diabetes, the gene mutation is inherited. In the remaining cases, the gene mutation develops spontaneously. Most mutations in monogenic diabetes reduce the body's ability to produce insulin. Genetic testing can diagnose most forms of monogenic diabetes.
NDM and MODY are the two main forms of monogenic diabetes. NDM is a form of diabetes that occurs in the first 6 months of life. Infants with NDM do not produce enough insulin, leading to an increase in blood glucose. NDM can be mistaken for the much more common type 1 diabetes, but type 1 diabetes usually occurs after the first 6 months of life. More information about the two types of NDM, permanent neonatal diabetes and transient neonatal diabetes mellitus, is provided in the fact sheet Monogenic Forms of Diabetes, available online from the NDIC at www.diabetes.niddk.nih.gov/dm/pubs/mody. For printed copies of the fact sheet, call the NDIC at 1-800-860-8747.
MODY usually first occurs during adolescence or early adulthood. However, MODY sometimes remains undiagnosed until later in life. A number of different gene mutations have been shown to cause MODY, all of which limit the pancreas' ability to produce insulin. This process leads to the high blood glucose levels characteristic of diabetes. More information about specific types of MODY is provided in the fact sheet Monogenic Forms of Diabetes.
Diabetes Caused by Genetic Defects in Insulin Action
A number of types of diabetes result from genetic defects in insulin action. Changes to the insulin receptor may cause mild hyperglycemia -- high blood glucose -- or severe diabetes. Symptoms may include acanthosis nigricans, a skin condition characterized by darkened skin patches, and, in women, enlarged and cystic ovaries plus virilization and the development of masculine characteristics such as excess facial hair. Two syndromes in children, leprechaunism and the Rabson-Mendenhall syndrome, cause extreme insulin resistance.
Diabetes Caused by Diseases of the Pancreas
Injuries to the pancreas from trauma or disease can cause diabetes. This category includes pancreatitis, infection, and cancer of the pancreas. Cystic fibrosis and hemochromatosis can also damage the pancreas enough to cause diabetes.
Diabetes Caused by Endocrinopathies
Excess amounts of certain hormones that work against the action of insulin can cause diabetes. These hormones and their related conditions include growth hormone in acromegaly, cortisol in Cushing's syndrome, glucagon in glucagonoma, and epinephrine in pheochromocytoma.
Diabetes Caused by Medications or Chemicals
A number of medications and chemicals can interfere with insulin secretion, leading to diabetes in people with insulin resistance. These medications and chemicals include pentamidine, nicotinic acid, glucocorticoids, thyroid hormone, phenytoin (Dilantin), and Vacor, a rat poison.
Diabetes Caused by Infections
Several infections are associated with the occurrence of diabetes, including congenital rubella, coxsackievirus B, cytomegalovirus, adenovirus, and mumps.
Rare Immune-mediated Types of Diabetes
Some immune-mediated disorders are associated with diabetes. About one-third of people with stiff-man syndrome develop diabetes. In other autoimmune diseases, such as systemic lupus erythematosus, patients may have anti-insulin receptor antibodies that cause diabetes by interfering with the binding of insulin to body tissues.
Other Genetic Syndromes Sometimes Associated with Diabetes
Many genetic syndromes are associated with diabetes. These conditions include Down syndrome, Klinefelter's syndrome, Huntington's chorea, porphyria, Prader-Willi syndrome, and diabetes insipidus.
How Is Diabetes Diagnosed?
The fasting blood glucose test is the preferred test for diagnosing diabetes in children and nonpregnant adults. The test is most reliable when done in the morning. However, a diagnosis of diabetes can be made based on any of the following test results, confirmed by retesting on a different day:
- A blood glucose level of 126 milli grams per deciliter (mg/dL) or higher after an 8-hour fast. This test is called the fasting blood glucose test.
- A blood glucose level of 200 mg/dL or higher 2 hours after drinking a beverage containing 75 grams of glucose dissolved in water. This test is called the oral glucose tolerance test (OGTT).
- A random -- taken at any time of day -- blood glucose level of 200 mg/dL or higher, along with the presence of diabetes symptoms.
Gestational diabetes is diagnosed based on blood glucose levels measured during the OGTT. Glucose levels are normally lower during pregnancy, so the cutoff levels for diagnosis of diabetes in pregnancy are lower. Blood glucose levels are measured before a woman drinks a beverage containing glucose. Then levels are checked 1, 2, and 3 hours afterward. If a woman has two blood glucose levels meeting or exceeding any of the following numbers, she has gestational diabetes: a fasting blood glucose level of 95 mg/dL, a 1-hour level of 180 mg/dL, a 2-hour level of 155 mg/dL, or a 3-hour level of 140 mg/dL.
What Is Pre-Diabetes?
People with pre-diabetes have blood glucose levels that are higher than normal but not high enough for a diagnosis of diabetes. This condition raises the risk of developing type 2 diabetes, heart disease, and stroke.
Pre-diabetes is also called impaired fasting glucose (IFG) or impaired glucose tolerance (IGT), depending on the test used to diagnose it. Some people have both IFG and IGT.
- IFG is a condition in which the blood glucose level is high -- 100 to 125 mg/dL -- after an overnight fast, but is not high enough to be classified as diabetes. The former definition of IFG was 110 mg/dL to 125 mg/dL.
- IGT is a condition in which the blood glucose level is high -- 140 to 199 mg/dL -- after a 2-hour OGTT, but is not high enough to be classified as diabetes.
Pre-diabetes is becoming more common in the United States. The U.S. Department of Health and Human Services estimates that at least 57 million U.S. adults ages 20 or older had pre-diabetes in 2007. Those with pre-diabetes are likely to develop type 2 diabetes within 10 years, unless they take steps to prevent or delay diabetes.
The good news is that people with pre-diabetes can do a lot to prevent or delay diabetes. Studies have clearly shown that people can lower their risk of developing diabetes by losing 5 to 7 percent of their body weight through diet and increased physical activity. A major study of more than 3,000 people with IGT found that diet and exercise resulting in a 5 to 7 percent weight loss -- about 10 to 14 pounds in a person who weighs 200 pounds -- lowered the incidence of type 2 diabetes by nearly 60 percent. Study participants lost weight by cutting fat and calories in their diet and by exercising -- most chose walking -- at least 30 minutes a day, 5 days a week.
What Are the Scope and Impact of Diabetes?
Diabetes is widely recognized as one of the leading causes of death and disability in the United States. In 2006, it was the seventh leading cause of death. However, diabetes is likely to be underreported as the underlying cause of death on death certificates. In 2004, among people ages 65 years or older, heart disease was noted on 68 percent of diabetes-related death certificates; stroke was noted on 16 percent of diabetes-related death certificates for the same age group.
Diabetes is associated with long-term complications that affect almost every part of the body. The disease often leads to blindness, heart and blood vessel disease, stroke, kidney failure, amputations, and nerve damage. Uncontrolled diabetes can complicate pregnancy, and birth defects are more common in babies born to women with diabetes.
In 2007, diabetes cost the United States $174 billion. Indirect costs, including disability payments, time lost from work, and reduced productivity, totaled $58 billion. Direct medical costs for diabetes care, including hospitalizations, medical care, and treatment supplies, totaled $116 billion.
Who Gets Diabetes?
Diabetes is not contagious. People cannot "catch" it from each other. However, certain factors can increase the risk of developing diabetes.
Type 1 diabetes occurs equally among males and females but is more common in whites than in nonwhites. Data from the World Health Organization's Multinational Project for Childhood Diabetes indicate that type 1 diabetes is rare in most African, American Indian, and Asian populations. However, some northern European countries, including Finland and Sweden, have high rates of type 1 diabetes. The reasons for these differences are unknown. Type 1 diabetes develops most often in children but can occur at any age.
Type 2 diabetes is more common in older people, especially in people who are overweight, and occurs more often in African Americans, American Indians, some Asian Americans, Native Hawaiians and other Pacific Islander Americans, and Hispanics/Latinos. National survey data in 2007 indicate a range in the prevalence of diagnosed and undiagnosed diabetes in various populations ages 20 years or older:
- Age 20 years or older: 23.5 million, or 10.7 percent, of all people in this age group have diabetes.
- Age 60 years or older: 12.2 million, or 23.1 percent, of all people in this age group have diabetes.
- Men: 12.0 million, or 11.2 percent, of all men ages 20 years or older have diabetes.
- Women: 11.5 million, or 10.2 percent, of all women ages 20 years or older have diabetes.
- Non-Hispanic whites: 14.9 million, or 9.8 percent, of all non-Hispanic whites ages 20 years or older have diabetes.
- Non-Hispanic blacks: 3.7 million, or 14.7 percent, of all non-Hispanic blacks ages 20 years or older have diabetes.
Diabetes prevalence in the United States is likely to increase for several reasons. First, a large segment of the population is aging. Also, Hispanics/Latinos and other minority groups at increased risk make up the fastest-growing segment of the U.S. population. Finally, Americans are increasingly overweight and sedentary. According to recent estimates from the CDC, diabetes will affect one in three people born in 2000 in the United States. The CDC also projects that the prevalence of diagnosed diabetes in the United States will increase 165 percent by 2050.
How Is Diabetes Managed?
Before the discovery of insulin in 1921, everyone with type 1 diabetes died within a few years after diagnosis. Although insulin is not considered a cure, its discovery was the first major breakthrough in diabetes treatment.
Today, healthy eating, physical activity, and taking insulin are the basic therapies for type 1 diabetes. The amount of insulin must be balanced with food intake and daily activities. Doctors may also prescribe another type of injectable medicine. Blood glucose levels must be closely monitored through frequent blood glucose checking. People with diabetes also monitor blood glucose levels several times a year with a laboratory test called the A1C. Results of the A1C test reflect average blood glucose over a 2- to 3-month period.
Healthy eating, physical activity, and blood glucose testing are the basic management tools for type 2 diabetes. In addition, many people with type 2 diabetes require one or more diabetes medicines -- pills, insulin, and other injectable medicine -- to control their blood glucose levels.
Adults with diabetes are at high risk for cardiovascular disease (CVD). In fact, at least 65 percent of those with diabetes die from heart disease or stroke. Managing diabetes is more than keeping blood glucose levels under control -- it is also important to manage blood pressure and cholesterol levels through healthy eating, physical activity, and the use of medications, if needed. By doing so, those with diabetes can lower their risk. Aspirin therapy, if recommended by a person's health care team, and smoking cessation can also help lower risk.
People with diabetes must take responsibility for their day-to-day care. Much of the daily care involves keeping blood glucose levels from going too low or too high. When blood glucose levels drop too low -- a condition known as hypoglycemia -- a person can become nervous, shaky, and confused. Judgment can be impaired, and if blood glucose falls too low, fainting can occur.
A person can also become ill if blood glucose levels rise too high.
People with diabetes should see a health care provider who will help them learn to manage their diabetes and who will monitor their diabetes control. Most people with diabetes get care from primary care physicians -- internists, family practice doctors, or pediatricians. Often, having a team of providers can improve diabetes care. A team can include
- a primary care provider such as an internist, a family practice doctor, or a pediatrician
- an endocrinologist -- a specialist in diabetes care
- a dietitian, a nurse, and other health care providers who are certified diabetes educators -- experts in providing information about managing diabetes
- a podiatrist -- for foot care
- an ophthalmologist or an optometrist -- for eye care
The team can also include other health care providers, such as cardiologists and other specialists. The team for a pregnant woman with type 1, type 2, or gestational diabetes should include an obstetrician who specializes in caring for women with diabetes. The team can also include a pediatrician or a neonatologist with experience taking care of babies born to women with diabetes.
The goal of diabetes management is to keep levels of blood glucose, blood pressure, and cholesterol as close to the normal range as safely possible. A major study, the Diabetes Control and Complications Trial (DCCT), sponsored by the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), showed that keeping blood glucose levels close to normal reduces the risk of developing major complications of type 1 diabetes.
This 10-year study, completed in 1993, included 1,441 people with type 1 diabetes. The study compared the effect of two treatment approaches -- intensive management and standard management -- on the development and progression of eye, kidney, nerve, and cardiovascular complications of diabetes. Intensive treatment aimed to keep A1C levels as close to normal -- 6 percent -- as possible. Researchers found that study participants who maintained lower levels of blood glucose through intensive management had significantly lower rates of these complications. More recently, a follow-up study of DCCT participants showed that the ability of intensive control to lower the complications of diabetes has persisted more than 10 years after the trial ended.
The United Kingdom Prospective Diabetes Study, a European study completed in 1998, showed that intensive control of blood glucose and blood pressure reduced the risk of blindness, kidney disease, stroke, and heart attack in people with type 2 diabetes.
Hope Through Research
The NIDDK conducts research in its own laboratories and supports a great deal of basic and clinical research in medical centers and hospitals throughout the United States. It also gathers and analyzes statistics about diabetes. Other Institutes at the NIH conduct and support research on diabetes-related eye diseases, heart and vascular complications, autoimmunity, pregnancy, and dental problems.
Other Government agencies that sponsor diabetes programs are the CDC, the Indian Health Service, the Health Resources and Services Administration, the Department of Veterans Affairs, and the Department of Defense.
Many organizations outside the Government support diabetes research and education activities. These organizations include the American Diabetes Association (ADA), the Juvenile Diabetes Research Foundation International (JDRF), and the American Association of Diabetes Educators.
In recent years, advances in diabetes research have led to better ways of managing diabetes and treating its complications. Major advances include
- development of quick-acting and long-acting insulins
- better ways to monitor blood glucose and for people with diabetes to check their blood glucose levels
- development of external insulin pumps that deliver insulin, replacing daily injections
- laser treatment for diabetic eye disease, reducing the risk of blindness
- successful kidney and pancreas transplantation in people whose kidneys fail because of diabetes
- better ways of managing diabetes in pregnant women, improving their chances of a successful outcome
- new drugs to treat type 1 and type 2 diabetes and better ways to manage these forms of diabetes through weight control
- evidence that intensive management of blood glucose reduces and may prevent development of diabetes complications
- demonstration that two types of antihypertensive drugs, angiotensin-converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARBs), are more effective than other antihypertensive drugs in reducing a decline in kidney function in people with diabetes
- advances in transplantation of islets -- clusters of cells that produce insulin and other hormones -- for type 1 diabetes
- evidence that people at high risk for type 2 diabetes can lower their chances of developing the disease through diet, weight loss, and physical activity
What Will the Future Bring?
Researchers continue to look for the cause or causes of diabetes and ways to manage, prevent, or cure the disorder. Scientists are searching for genes that may be involved in type 1 or type 2 diabetes. Some genetic markers for type 1 diabetes have been identified, and it is now possible to screen relatives of people with type 1 diabetes to determine whether they are at risk.
Type 1 Diabetes
A number of federally funded research studies and clinical trials are under way. Studies focus on the prevention and causes of type 1 diabetes as well as experimental treatments such as islet transplantation.
Diabetes Prevention Trial-Type 1 (DPT-1)
The NIDDK and other groups sponsored DPT-1, which showed that people at risk for developing type 1 diabetes can be identified. The DPT-1 researchers discovered ways to identify two populations at risk of developing type 1 diabetes within 5 years -- those at high risk, with at least a 50 percent chance, and those at intermediate risk, with a 25 to 50 percent risk. Then researchers explored possible ways of preventing type 1 diabetes in both groups. Although the study found that neither low-dose insulin injections nor insulin capsules taken orally prevented or delayed type 1 diabetes in the study population, research that follows up on DPT-1 findings is under way. For more information about DPT-1, see www.niddk.nih.gov/patient/dpt_1/dpt_1.htm.
The Environmental Determinants of Diabetes in the Young (TEDDY) Consortium
The main mission of the TEDDY consortium, an international group of clinical centers, is to identify infectious agents, dietary factors, or other environmental factors -- including psychosocial events -- that trigger type 1 diabetes in those who are genetically susceptible. In addition, the consortium aims to
- create a central repository of data and biological samples for use by researchers
- develop novel approaches to finding the causes of type 1 diabetes
- find ways to understand how the disease starts and progresses
- discover new methods to prevent, delay, and reverse type 1 diabetes
TEDDY is funded by the NIDDK, the National Institute of Allergy and Infectious Diseases (NIAID), the National Institute of Child Health and Human Development (NICHD), the National Institute of Environmental Health Sciences, the CDC, the JDRF, and the ADA. For more information, see http://teddy.epi.usf.edu.
Type 1 Diabetes Genetics Consortium (T1DGC)
The T1DGC is a group of researchers from around the world who are studying the genetics of type 1 diabetes. They are studying families with siblings who have type 1 diabetes to look for genes that may show a person's risk of getting type 1 diabetes or might keep someone from getting type 1 diabetes. For more information, see www.t1dgc.org.
Type 1 Diabetes TrialNet
Type 1 Diabetes TrialNet is a network of experts and facilities dedicated to developing new approaches to the understanding, prevention, and treatment of type 1 diabetes. Clinical centers are located in the United States, Canada, Europe, and Australia.
TrialNet studies are focusing on
- understanding the natural history of type 1 diabetes to determine its causes and progression
- preventing type 1 diabetes in those at risk
- developing ways to preserve the function of the insulin-producing cells in the pancreas in people recently diagnosed with type 1 diabetes
For more information, see www.DiabetesTrialNet.org or call 1-800-HALT-DM1 (425-8361).
TrialNet will identify people at risk who may be eligible for clinical trials. In addition, TrialNet will conduct trials to save beta cell function in those with new onset type 1 diabetes.
TrialNet is funded by the NIDDK, NICHD, and NIAID. The JDRF and ADA also support this effort.
The Immune Tolerance Network
TrialNet works closely with the Immune Tolerance Network, another international, collaborative consortium. Its goal is to find safe and effective ways to induce long-term immune tolerance -- prevention of an unwanted immune response by the body. For example, type 1 diabetes might be prevented if scientists could learn how to prevent the immune system from mistakenly attacking the insulin-producing cells in the pancreas. Effective immune tolerance could possibly
- prevent the body's rejection of organ or tissue transplants
- prevent or treat autoimmune diseases
- prevent or treat allergies and asthma
For more information, see www.immunetolerance.org or call 415-514-2530.
The Trial to Reduce IDDM in the Genetically at Risk (TRIGR)
The TRIGR study will help determine whether delayed exposure to cow's milk can prevent type 1 diabetes in infants at risk of developing the disease. Instead of receiving cow's milk, infants in the TRIGR study will primarily breastfeed. Babies whose mothers cannot breastfeed will be given a special formula made with milk proteins that may be easier for babies to tolerate. The TRIGR study will help clarify whether infant feeding practices are related to the development of diabetes. For more information, see www.trigrnorthamerica.org or call 1-888-STOP-T1D (786-7813).
Islet Transplantation
Researchers are working on a way for people with type 1 diabetes to live without daily insulin injections. In an experimental procedure called islet transplantation, islets are taken from a donor pancreas and transferred into a person with type 1 diabetes. Once implanted, the beta cells in these islets begin to make and release insulin.
Although scientists have made many advances in islet transplantation in recent years, transplanted islets tend to lose function over time, and few transplant recipients are able to stop using insulin for very long. But even partial islet function can help patients reduce their need for insulin, achieve better glucose stability, and reduce problems with hypoglycemia.
Problems with islet transplantation include the severe shortage of islets available for transplants and the need for patients to take drugs with significant side effects to stop the immune system from rejecting the transplanted islets. Researchers are seeking solutions to these problems.
For more information about islet transplantation, see the fact sheet Pancreatic Islet Transplantation at www.diabetes.niddk.nih.gov/dm/pubs/pancreaticislet.
Type 2 Diabetes
Diabetes Prevention Program
In 1996, the NIDDK launched its Diabetes Prevention Program (DPP). The goal of this research effort was to learn how to prevent or delay type 2 diabetes in people with impaired glucose tolerance, a strong risk factor for type 2 diabetes.
The findings of the DPP, released in August 2001, showed that people at high risk for type 2 diabetes could sharply lower their chances of developing the disorder through diet and exercise. In addition, treatment with the oral diabetes drug metformin also reduced diabetes risk, though less dramatically. Metformin lowers the amount of glucose released by the liver and also fights insulin resistance, a condition in which the body doesn't use insulin properly.
Participants randomly assigned to intensive lifestyle intervention reduced their risk of getting type 2 diabetes by 58 percent. On average, this group maintained their physical activity at 30 minutes per day, usually with walking or other moderate intensity exercise, and lost 5 to 7 percent of their body weight. Participants randomized to treatment with metformin reduced their risk of getting type 2 diabetes by 31 percent.
Of the 3,234 participants enrolled in the DPP, 45 percent were from minority groups that suffer disproportionately from type 2 diabetes: African Americans, Hispanics/ Latinos, Asian Americans and Pacific Islanders, and American Indians. The DPP also recruited other groups known to be at higher risk for type 2 diabetes, including individuals ages 60 or older, women with a history of gestational diabetes, and people with a first-degree relative with type 2 diabetes.
Participants are still being followed to check for long-term effects of the interventions, including the effects on CVD. Recent analyses of data from the DPP have added to the evidence that lifestyle changes are especially effective in helping to reduce the risk of developing conditions associated with type 2 diabetes, including high blood pressure and the metabolic syndrome. Researchers also confirmed that study participants carrying two copies of a gene variant that significantly increased their risk of developing diabetes benefited from lifestyle changes as much as or more than those without the gene variant.
Type 2 Diabetes in Children and Teens
Two studies focusing on type 2 diabetes in children and teens are under way. The Treatment Options for type 2 Diabetes in Adolescents and Youth (TODAY) study, a 13-site study sponsored by the NIDDK, will compare treatments for type 2 diabetes in children and teens. Participants will undergo one of three treatments:
- taking one diabetes medication -- metformin
- taking two diabetes medications -- metformin and rosiglitazone, another medication that fights insulin resistance
- taking metformin and participating in an intensive lifestyle change program designed to promote weight loss by cutting calories and increasing physical activity
The main goal of the study is to determine how well each type of treatment controls blood glucose levels. The study also will evaluate how long each type of treatment is effective.
Current NIDDK-sponsored research includes the HEALTHY study, which is part of a broad research initiative called STOPP T2D (Studies to Treat or Prevent Pediatric Type 2 Diabetes). The study explores whether improving nutrition, promoting physical activity, and making changes in behavior can lower risk factors for type 2 diabetes in children from 42 middle schools across the country. Participating schools are randomly assigned to a program group, which implements the changes, or to a comparison group, which continues to offer food choices and physical education programs typically found in middle schools across the country. Students in the program group will have healthier choices available in the cafeteria and vending machines; longer, more intense periods of physical activity; and activities and awareness campaigns that promote long-term healthy behaviors. Results from the HEALTHY study are expected in 2009.
Preventing and Treating CVD in People with Type 2 Diabetes
CVD is the main killer of people with type 2 diabetes. For this reason, the NIH is studying the best strategies to prevent and treat CVD in people with diabetes in three major studies. These studies are all joint efforts of the NIDDK and the National Heart, Lung, and Blood Institute (NHLBI).
The Look AHEAD (Action for Health in Diabetes) trial is the largest clinical trial to date to examine the long-term health effects of voluntary weight loss. This multicenter, randomized clinical trial is studying the effects of a lifestyle intervention designed to achieve and maintain weight loss over the long-term through decreased caloric intake and increased exercise. Look AHEAD will focus on the disorder most associated with being overweight or obese, type 2 diabetes, and on the outcome that causes the greatest morbidity and mortality in people with type 2 diabetes, CVD. Results after 1 year of the study show that people receiving the lifestyle intervention lost an average of 8.6 percent of their initial body weight. In addition, they showed improved control of diabetes as well as improvements in cardiovascular risk factors, such as high blood pressure and blood fat levels.
The Action to Control Cardiovascular Risk in Diabetes (ACCORD) trial, a multicenter, randomized trial, is studying three approaches to preventing major cardiovascular events in individuals with type 2 diabetes. ACCORD was designed to compare current practice guidelines with more intensive glycemic control in 10,000 individuals with type 2 diabetes, including those at especially high risk for cardiovascular events because of age, evidence of subclinical atherosclerosis, or existing clinical CVD. More intensive control of blood pressure than is called for in current guidelines and a medication to reduce triglyceride levels and raise HDL, or "good," cholesterol levels will also be studied in subgroups of these 10,000 volunteers. Each treatment strategy will be accompanied by standard advice regarding lifestyle choices, including diet, physical activity, and smoking cessation, appropriate for individuals with diabetes.
The primary outcome to be measured is the first occurrence of a major cardiovascular event, specifically heart attack, stroke, or cardiovascular death. In addition, the study will investigate the impact of the treatment strategies on other cardiovascular outcomes; total mortality; limb amputation; eye, kidney, or nerve disease; health-related quality of life; and cost-effectiveness.
In February 2008, the NHLBI decided to stop one part of the study -- the intensive glycemic control treatment -- before the end of the entire trial because of safety concerns. However, the trial will continue with the other treatments until the planned end in 2009.
The Bypass Angioplasty Revascularization Investigation 2 Diabetes (BARI 2D) trial, a 5-year, multicenter clinical trial, is comparing medical versus early surgical management of patients with type 2 diabetes who also have coronary artery disease and stable angina or ischemia. At the same time, BARI 2D will study the effect of two different strategies to control blood glucose -- providing insulin versus increasing the sensitivity of the body to insulin -- on the risk of cardiovascular mortality and morbidity.
Participants in clinical trials can play a more active role in their own health care, gain access to new research treatments before they are widely available, and help others by contributing to medical research. For information about current studies, visit www.ClinicalTrials.gov.
Points to Remember
What is diabetes?
- a disorder of metabolism -- the way the body uses or converts food for energy and growth
What are the main types of diabetes?
- type 1 diabetes
- type 2 diabetes
- gestational diabetes
What is the impact of diabetes?
- It affects 23.6 million people -- 7.8 percent of the U.S. population.
- It is a leading cause of death and disability.
- It costs $174 billion per year.
Who gets diabetes?
- people of any age
- people with a family history of diabetes
- others at high risk for type 2 diabetes: older people, overweight and sedentary people, African Americans, Alaska Natives, American Indians, Asian Americans, Native Hawaiians, some Pacific Islander Americans, and Hispanics/Latinos
The U.S. Government does not endorse or favor any specific commercial product or company. Trade, proprietary, or company names appearing in this document are used only because they are considered necessary in the context of the information provided. If a product is not mentioned, the omission does not mean or imply that the product is unsatisfactory.
For More Information
To learn more about type 1, type 2, and gestational diabetes, as well as diabetes research, statistics, and education, contact
National Diabetes Education Program
1 Diabetes Way
Bethesda, MD 20814-9692
Phone: 1-888-693-NDEP (6337)
Email: firstname.lastname@example.com
Internet: www.ndep.nih.gov
American Diabetes Association
National Service Center
1701 North Beauregard Street
Alexandria, VA 22311
Phone: 1-800-DIABETES (342-2383)
Email: email@example.com
Internet: www.diabetes.org
Juvenile Diabetes Research Foundation International
120 Wall Street
New York, NY 10005
Phone: 1-800-533-CURE (2873)
Email: email@example.com
Internet: www.jdrf.org


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KUM Memory Point® Flat
Memory Point® Flat Brushes by KUMThe unique synthetic fibres used in the Memory Point® brushes were developed by KUM and, along with superb craftsmanship, surpass conventional synthetic brushes in a multitude of ways:
- An always perfectly formed brush tip
- The exceptionally elastic fibres provide outstanding shape retention characteristics
- The possibility to paint even the finest lines with all brush sizes
- Optimal colour intake, storage capacity and pay-off characteristics
Handmade in Germany, you will be very impressed with the quality, versatility and value that these unique brushes provide.
Click here for a solid review of the Memory Point® brushes by Leisure Painter magazine.
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subset: commoncrawl


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For reference, previous threads of particular relevance:
Original Combat Rewrite Notice (Jan. 4, 2005)
Original Skill and Equipment Changes (Jan. 4, 2005)
Updated Skill and Equipment Changes (Sep. 9, 2006)
Here's where we stand on the rewrite (updated Feb. 19, 2007):
LARGE PROJECTS (can take months per item)
- Code: Select all
100% done re-writing core combat mechanics
100% done writing compatible cross-over code (see "hybrid" below)
100% done writing equipment identification code (min./max. protective values, etc.)
95% done writing new messaging engine
MEDIUM PROJECTS (often take a few weeks per item)
- Code: Select all
100% done rebalancing player vital combat statistics (health, damage, etc.)
100% done adjust existing ability and spell effects
80% done rebalancing NPC vital statistics (health, damage, etc.)
50% done creating flavor messaging (making combat more exciting and engaging)
35% done building new hunting areas for dozens of new NPCs
10% done developing shops that carry new equipment suited for the rewrite
SMALL PROJECTS (often take a few days to a week per item)
- Code: Select all
10% done building more rare and unique creature spawns
0% done writing skill conversion code
0% done writing skill training locations
0% done updating treasure system to drop equipment suited for the rewrite
0% done updating crafting system with recipes suited for the rewrite
0% done rebalancing magic/spell damage
0% done implementing NPC damage
The combat rewrite features a hybrid technology that allows us to treat players and NPCs equally in most situations, which effectively fixes problems stemming from player-versus-player combat and also allows us to easily write support for NPCs to behave much more like players, including preparing and casting spells in a shared magic system, dynamic roundtimes assignment, using physical equipment (weapons/armor), etc.
As you all know, this project has been ongoing for nearly three years (and is almost done, thankfully), so I am probably forgetting a lot of stuff I have developed, re-written, fixed, and recalculated during that time that isn't on the list above. Therefore, the list above should serve more as a guide to how much longer you should expect to it to be until the system is released rather than exactly what it contains (other threads will have more information on that).
I will be adding to this list any sub-projects I have forgotten or feel is required before the release of the rewrite as well as updating the list with progress towards a project. If you notice the progress lowers by any reason, it's because it is either being re-done or an unexpected factor has increased the amount of work involved in that project. Although at this point, it's very unlikely either will be the case since most of the development is all literal/technical and almost none of it's conceptual anymore.


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Category Archives: milksharing
New Jersey's Proposed Anti-Milksharing Campaign—the Next Attack on Parental Informed Choice?
A proposed bill (NJ A3702) in New Jersey has its sights on the informal milksharing community. This bill: "Establishes public awareness campaign advising pregnant women, new parents, and women who are breast feeding about dangers of casual milk sharing." After I … Continue reading


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#254 - Click the thumbnails below for full-size pictures:
#254 is a soprano scale, 8" dia. head banjolele. Tunable head (w/ tuning wrench), geared tuners and polished aluminum armrest. Spalted sycamore neck & peghead, spalted sycamore finger board with 13 frets. Sounds great!
Fits in a Hohner Lanikai concert size ukulele case, probably others (no case included).
Click here for a video sound sample. NOTE: This is a video of another, virtually identical banjolele, #49. Since the sound of the banjos is almost entirely dependent on the drum head, and since I'm using the same drum on all of them, they all really sound pretty much exactly the same! My verbal description of the wood used, etc. in the video may not match #254 (see above for that).
Click here for a video review by someone else of another virtually identical one :-)
Click here for a video review by someone else of another virtually identical one :-)


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Biological Sciences
Research Highlights
May 2005
New biological consortium featured in The Scientist
A new international biological consortium co-sponsored by Pacific Northwest National Laboratory and the RIKEN Genomic Science Center is featured in the April 25 issue of The Scientist. The Receptor Tyrosine Kinase (RTK) Consortium was formed in January to facilitate and coordinate international efforts for the continued understanding of RTK signaling pathways and its relationship to human pathologies.
Steven Wiley, Director of PNNL's Biomolecular Systems Initiative, is on the Consortium's executive committee, which includes scientists from the United States, Japan, the United Kingdom, The Netherlands, Denmark, and Israel. The Consortium is developing the framework necessary to understand RTK signaling networks central to major human pathologies and therapies. The first workshop of the Consortium will be held in June at the Northwest Symposium for Systems Biology at PNNL.
The RTK website was developed by PNNL staff Kavita Patel-Stenoien, Mary Ace, Marla Seguin, Cameron Bates, Tyler Borders, Stacy Berg, and Julie Gephart, and it will contain links to models and tools that will help disseminate information on RTK networks to the scientific community.


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The Arkansas land between the bridges across the Mississippi River at Memphis doesn't have a name, at least not yet.
On the other side of the Harahan Rail Bridge – the centerpiece of the $30 million Main Street to Main Street Multimodal Connector Project, which includes a pedestrian and bicycle boardwalk along the span – Arkansas officials are exploring the creation of an eco-park. (Memphis News/Andrew J. Breig)
If graffiti is any indication, lots of people go there. And they cross numerous boundaries on dirt and gravel roads and paths that can end abruptly and are posted with "no trespassing" signs and other warnings as well as railroad video cameras.
But many more have no idea what is on the other side of the Harahan Rail Bridge, the north side of which groups in Memphis and West Memphis want to build a pedestrian and bicycle boardwalk.
The bridge project is being rebid after the initial design proved too expensive by $7.5 million for the overall $30 million Main Street to Main Street Multimodal Connector Project that the boardwalk is a part of.
Boardwalk backers are also going back to potential private donors and looking for other sources of funding as the rebid and redesign is underway.
Views of the Memphis skyline await cyclists, walkers and joggers who venture across the Harahan Rail Bridge once the boardwalk is complete. (Daily News/Andrew J. Breig)
Downtown Memphis Commission president Paul Morris is overseeing the project that includes a revitalization of Main Street in Memphis and Broadway in West Memphis, streets that will be linked by the Harahan boardwalk. He has said the boardwalk won't go forward unless all of the money needed for the bridge is already in hand, but he is optimistic that will be the case once the new bids come in this summer.
With the second looks, questions have returned about what there is to see for those who cross from the Memphis side.
Preliminary ideas for the Harahan project treaded lightly on the idea of bike and pedestrian trails on the Arkansas levees. The idea is politically complex because the levees are governed by local boards whose duty is to maintain the levees as flood control. Any system of trails would involve negotiations with boards in each county who are each likely to have questions and concerns about paved or other types of surfaces atop the levees.
So the flood plain has emerged as a new possibility that it is hoped will sustain interest in the boardwalk.
The Arkansas end of the boardwalk, which is now a set of six steel girders where a paved road for first wagons and then automobiles once was, is a 1930s-era concrete viaduct off the Bridgeport Road exit of Interstate 55. Parts of the viaduct are crumbling or about to be hidden again by the seasonal return of kudzu.
Greg Maxted, the professional engineer leading the Harahan project, can already envision food trucks parked in an area that easily has the room for such gatherings and even a welcome center.
The curves and concrete borders of the old roads combined with the three bridge structures that run overhead give the area a feel that is somewhere between Atlantis and an abandoned amusement park where the sounds of traffic – rail and auto on the bridges – echo with a reliable rhythm.
As an engineer, Maxted's mind always goes to statistics and other facts about the building of the trio of bridges.
Paul Luker, director of planning and development for the city of West Memphis and point man for the "eco-park" effort, sees it as an attraction in and of itself for "tech heads."
"That area's almost like a museum because you are looking at the two historic rail bridges that have been there and then also the I-55 bridge," he said. "If you're an engineering type, those three bridges represent a different type of bridge building technology."
Before the kudzu comes back, the dark brown squares formed by the bridge supports and girders of the Harahan offer immense frames of shade and light. By summer, the frames will look like hanging gardens in a long corridor.
Cyclists would gain another place to ride once the Main to Main project is completed. (Daily News/Andrew J. Breig)
The stone bridge supports just south of that offer a different Stonehenge-like perspective in their symmetry from the green river's edge across the river itself.
This time of the year, the sandbar beaches with views of the Memphis skyline are lost to the rising river but not the grassy areas.
"It's a little bit challenging piece of property to work with because on average a month of the year it goes underwater," Luker said. "It's also a very wild and natural area. Most of it's been used for farming but some of it's not. There's some wetland areas out there. Part of this idea would turn some of that farmland back into nature. The idea is to have some trails that would go close to the top of the bank of the river. Others would traverse back into the areas towards the levee and go north to Dacus Lake as a destination point."
When most of the area is visible, taking it all in requires permission to cross numerous boundaries from farmers and at least two railroads. Some of it is paved. Some of it is gravel. But most of the network of roads and trails are dirt – mud when the river recedes.
The riverside area is about two and a half miles from the levee that protects the town of West Memphis.
While Luker hasn't talked with all of the landowners and farmers involved, he's found many of those he has spoken with are supportive. His idea is to form a conservancy similar to the Shelby Farms Park or Wolf River conservancies.
"This is going to be paved?" asked Bill Privette, who owns flood plain land near the Harahan as well as the Hernando DeSoto Bridge to the north, as he looked over a map of possible trails.
Privette's question indicates his approval. He is also a frequent bike rider of the Shelby Farms Greenline.
The $30 million Main Street to Main Street Multimodal Connector Project will include a pedestrian and bicycle boardwalk across the Harahan Rail Bridge. Arkansas officials hope to develop an eco-park on their side. (Daily News/Andrew J. Breig)
"I like the idea," he said. "I think it should incorporate the Military Road and the Trail of Tears, make sure that is pointed out to the bikers as a draw. … It could have a draw across the country. I believe that bicyclists would like to do that – ride the Trail of Tears."
The Trail of Tears is the route of the forced march Native Americans on the other side of the Mississippi River took to what is now western Arkansas and Oklahoma where they were exiled and confined in the 1830s. The river crossing by ferry long before any of the bridges at Memphis were built was near the Hernando DeSoto Bridge. The area is also where the Esperanza Trail used by Native Americans pre- and post-DeSoto, the explorer, also ran.
The area also includes the site of Hopefield, the Arkansas settlement before West Memphis, and the levee that keeps West Memphis from flooding like the land between the bridges.
A trail system would connect to all of those historical sites as well as Dacus Lake and Dacus Junior Lake. A man-made mound near the river's edge could become an amphitheater.
Katie McKeel is among the University of Memphis students who have talked with landowners and others and sketched out some ideas including the mound amphitheater that mix the appeal of the area's natural setting with the history washed away over the decades and even centuries.
"We're trying to focus on the natural environment there. I think some of these concepts we see how we can celebrate the nature and history of the area without compromising any of the ecosystems," she said. "How do you really bring attention to and recognize and celebrate the history that is there? … Signage is of the utmost importance when you are doing projects like that."
Flooding is a factor some other parks and natural areas deal with routinely and they were the example for the students.
"It could be removable so the parks department could come and take it off," Amy Collier said of the signage. "Or we have some examples of big stones and you carve into them. That would never be harmed by flooding."
Austin Johnson, a student from Appalachia, brought some ideas from that region that would give visitors an alternative during the floods – a treetop trail system for the parts of the area that include stands of large trees that coexist with the farmland and serve as natural boundary markers along the farmland.
"We don't really have anything like that in the Mid-South," Johnson said of the treetop trails, which would be wooden boardwalks. "It's a great bird-watching opportunity. It's a different viewpoint, a different perspective on nature. It may be an opportunity to let people use the park when there's some water on the site."
The river itself at whatever level the muddy waters take and allowing people to get close to it with another view many on the Memphis side have not considered remains the draw, said Guy Headland of the National Park Service river trails and conservation assistance department.
"The main focus is a vista back to the Downtown Memphis skyline. Getting people to the river's edge is the most important thing according to all of the stakeholders and participants in the meetings," he said. "That's priority No. 1. Then if that could happen … then a lot of these other things can be generated and talked about."
That includes access to Broadway, West Memphis's Main Street, which is the other Main Street in the Main to Main project.
Broadway's eastern end, which skirts the flood plain, includes the first Pancho's Mexican restaurant, part of which was the legendary Plantation Inn, an integral nightspot in Memphis music heritage.
A historical marker tells the story of the inn, which had the Broadway frontage in a row of nightspots that stretched further north of it in a row.
These days the area's age is showing and Luker says the recent roadside metal tubing in the shape of a bicycle is something of a sentinel of things to come.
"The east end of West Memphis that's in need of being redeveloped has lots of potential," he said. "We're looking at trying to build out from there. I think once the private market starts to see the numbers of people coming across the Harahan Bridge that that will start to trigger the idea that we need to provide more things for people to do when they get there. That will further entice them to come on into West Memphis."
Anthony Raciti, a visiting professor at the University of Memphis from Italy who supervised the students who came up with different ideas, said the eco-park isn't just about access on the way to other points.
"It's a way to engage the community in activity in the area," he said. "We have a lot of observation points from West Memphis to Downtown Memphis but also the opportunity to have outdoor classes and involve local schools. … There is Dacus Lake, which could be like a recreational space. We have Hopefield. There is a huge interest. It's a combination of different projects."
Copyright 1995 -
by The Daily News Publishing Co. Inc. - All Rights Reserved


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Miniature End Mills
Carbide End Mills - Made in the USA
Miniature Metric Flat End Mills
2 flute solid carbide end mills used in milling applications such as milling molds, profile milling, face milling, engraving, and drilling. These Miniature End Mills can cut and mill various materials such as plastic, aluminum, brass, wax, even stainless steel. The bottom of the tool is 'flat or square' so it mills a square slot, edge or pocket in the part or mold.
Miniature Decimal Ball End Mills
Miniature Metric Ball End Mills
The Ball End Mill is ideal for machining three dimensional contoured shapes in molds and dies. They leave a nice finish in the part or mold. A ball end mill is used for milling many types of materials, from plastics to steel alloys and titanium. The toughness and durability of the cutting edge is very high in ball end mills because of the rounded edge design. It was originally designed for a specialized purpose, namely for milling grooves with a semi-circular cross-section. This type of groove is needed in many mold applications.
Our miniature end mills are made from a sub micron carbide giving the tools hardness and toughness with minimal breakage. We use 1000 grit diamond wheels to grind crisp sharp edges. It is extremely important that the grinding wheels be perfectly balanced to maintain true accuracy. If you do not see the size you are looking for call or send us an email and we can quote it for you. We can ship most orders the same day.


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This black and white picture of Jupiter, taken in green light at 1:14 a.m. on the 11th March, 1991 by the Planetary Camera on NASA's Hubble Space Telescope, shows a wealth of fine detail in the clouds that cover the planet. The Great Red Spot is seen at the lower right, also on the right near the equator the satellite Europa is disappearing behind the limb of the planet. The dark 'j' shaped clouds along the equator are the result of a pattern of intense jet streams in the Jovian atmosphere. This picture is as sharp as the Voyager pictures taken five days before the closest approach in 1979.
Detailed comparison with the Voyager pictures shows that a totally different cloud structure has formed over the past twelve years. An HST investigator group is planning to collect Jupiter images using the Planetary Camera on a regular basis over the next several years to record the detailed evolution of Jovian weather. These data will be taken in several colors to study the weather at different altitudes in the atmosphere.
This will allow meteorologists to apply the complex computer programs used to make weather predictions for the very different atmospheric conditions found on Jupiter. Comparison of the computer predictions with the new HST results can be used to refine the computer atmospheric models in a way which will help make improved forecasts of the weather on Earth.
The HST Wide Field Planetary Camera was designed and built at the Jet Propulsion Laboratory of the California Institute of Technology in Pasadena, California.
Credit: NASA


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NEW YORK (MarketWatch) — European Central Bank President Mario Draghi did his best to talk down the euro on Thursday, touting discussions among policy makers on everything from rate cuts to negative deposit rates to, the big bazooka, quantitative easing.
Indeed, Draghi offered up virtually the whole arsenal of conventional and unconventional policy measures the central bank could use if it ever becomes convinced that inflation will remain too low for too long.
"There was an ample and rich discussion," Draghi said.
The euro EURUSD, +0.2415% which, to the ECB's apparent chagrin, had traded near a 30-month high in the wake of Draghi's news conference a month ago, duly fell, though it wasn't a complete rout. Stocks perked up on the prospect of the ECB finally joining the asset-purchase party as the Fed grabs its coat and prepares to leave.
Still, it's hard not to sense reluctance below the surface.
After all, while Draghi elaborated on the measures the ECB could deploy, an "ample and rich" discussion doesn't really seem to imply there was a broad agreement on the merits of undertaking radical action.
And while Draghi emphasizes that policy makers are on high alert over the perils of prolonged low inflation, his opening statement offered no change in language describing how policy makers view the price outlook, saying that inflation expectations "over the medium to long term continue to be firmly anchored."
An unexpected March drop in the annual euro-zone inflation rate to 0.5% -- well below the ECB's target of near but just below 2% -- was a jolt. Draghi didn't put the entire blame for the drop from 0.7% in February on special factors, but he did argue that low energy prices and the timing of Easter needed to be take into account.
Draghi said inflation is expected to pick up in April partly due to volatility around service prices in the months of around Easter. He said inflation is expected to remain low through 2015 before pushing back toward levels closer to 2% toward the end of 2016.
Draghi is the undisputed world champion of jawboning, as attested by the lasting drop in borrowing costs for Spain and Italy after his mid-2011 pledge to do "whatever it takes" to preserve the euro. (While that was followed by the creation of the ECB's Outright Monetary Transactions program, the OMT has yet to be used.)
But sometimes even champs have to put up or shut up. Draghi and the ECB appear to be running out of room. The ECB appears to hope the Easter Bunny will bring an uptick in inflation in April.
If that materializes, the ECB might hold off on action, but the true test is likely to come in June when ECB staff update their economic and inflation projections. A weak 2016 inflation outlook could be the last straw, but even then, the ECB sounds more likely to exhaust conventional measures before reaching for QE, economists say.
"From here on, a further verbal stepping up seems impossible. In a way it's a gamble, either the recovery continues and inflation picks up again, or the ECB will have to act in June, even if it's only a small refi rate cut," said Carsten Brzeski, economist at ING in Brussels.
More must-reads from MarketWatch:
Draghi: ECB discussed more easing measures
At last, China goes for mini-stimulus
Don't expect much of a rise in global rates: IMF


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Pet owners' hearts may cope better with change
Pet owners with chronic diseases appear to have healthier tickers than people living without an animal companion, a new study shows.
Monitoring the hearts of nearly 200 Japanese people, scientists found those who had a pet -- whether furry, scaly or feathery -- had higher heart rate variability than those who didn't.
That means their hearts respond better to the body's changing requirements, such as beating faster during stressful situations. Reduced heart rate variability, on the other hand, has been linked to a higher risk of dying from heart disease.
Erika Friedmann, a professor at the University of Maryland School of Nursing, said the study is a step forward from what is already known about the connection between pet ownership and a person's heart health -- although it's not clear how to explain the link.
"Here we're moving that into people's daily lives, and that's what's so exciting," said Friedmann, who wasn't involved in the new work, but has done similar research. "It really goes beyond what happens in a ten minute period in the lab."
For the new study, researchers at Kitasato University in Kanagawa, Japan, monitored 191 people with diabetes, high blood pressure or high cholesterol over 24 hours. The researchers also asked them about their daily activities and whether or not they owned a pet.
About four in 10 people owned a pet, but other than that the two groups were similar, Naoko Aiba and colleagues report in the American Journal of Cardiology.
Each person wore a heart monitor for 24 hours to determine the variation in their heart rate. For pet owners, about five percent of their heart beats differed by 50 milliseconds in length; for non-pet owners, that number was 2.5 percent, which means their heart rate changed less.
So far, nobody knows what's causing the difference between the two groups -- it could be due to the pets somehow, or it could be there are differences between people who choose to get a pet and those who don't.
"My guess is that pets are a form of social support, hence stress reduction, and they can satisfy some but not all social companionship needs," Judith Siegel, a professor at the UCLA School of Public Health, told Reuters Health by email.
But she added that earlier research on the topic has yielded conflicting results.
"I don't think anyone has a good handle yet on why these discrepancies exist," said Siegel, who was not involved with the new study.
The Japanese researchers also caution that they only looked at one day in the person's life. And other factors need to be considered in future research, such as potential differences between different types of pets.
Past research has shown that aerobic exercise can improve heart rate variability. As for whether a person should get a pet to protect their ticker, Friedmann said that's OK as long as they want one anyway.
But, she adds, "It's not going to cure someone."


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He has to win back traditional Tory support across the four Atlantic provinces, which voted solidly Liberal in 2015, if he hopes to unseat Prime Minister Justin Trudeau.
How should he go about it?
First, he has to distance himself from former party leader and mentor Stephen Harper. Suggestions that Scheer, who served four years as Speaker under Harper, is a clone of the former PM — but with a smile — sure as heck won't win him much support in this region.
The last federal election saw Atlantic Canada reject Harper and his policies. Harper alienated the region while he was leader of the Canadian Alliance with his comment that there was a "defeatist attitude" in Atlantic Canada. Many Progressive Conservatives felt Harper hijacked their party when it merged with his Canadian Alliance.
Frankly, Harper's policies as prime minister angered many Atlantic Canadians. Unpopular changes to employment insurance, which penalized those working in seasonal, primary industries, were among the most repressive.
Scheer has promised to stay away from divisive debates on subjects such as abortion and same-sex marriage, which he personally opposes.
That's wise. He promises to balance the books, strip the HST from home heating bills, lower business taxes, repeal the Liberal carbon tax plan, support the Energy East pipeline and deny funding to universities that don't allow full freedom of speech. He sees radical Islamic terrorism as a threat to all Canadians and promises to recommit Canadian fighters to the battle against ISIS.
Those positions should generally find a warm reception here. It's a good start for Scheer, but he needs to get his face known in the region. He can't be seen as a Western Canadian, right-wing extremist. He must address bread-and-butter issues here, express his position on fisheries matters and the region's role in the future of the country.
Despite his youth, the 38-year-old father of five is a Commons veteran, having won a seat at age 25 by defeating NDP stalwart Lorne Nystrom. He already has national appeal, as was evidenced when he carried the majority of convention delegates in B.C., Saskatchewan, Ontario and Atlantic Canada.
He's a solid, amiable leader — without political baggage — who can offer a clear choice to Canadians.
But he'd best quickly put aside any suggestion that he is heir to Harper's legacy. He must become a compassionate Conservative, able to bring Canadians of various regions and backgrounds into his big tent, and he needs to put a progressive element back into the Conservative party and develop a credible government-in-waiting.
And, he has two years to do it.


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Trailer Thrash 5: Silent Hill Revelations, Hitchcock, Movie 43
Every Saturday, Check the Reel features Trailer Trash, a close look at previews, trailer, and sneak peeks for films not yet released. What does the rest of the year promise for theatres and Netflix accounts? Which are the masterpieces? Which are the … Continue reading
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TECHNOLOGY UPGRADES – The Paradise School Board yesterday approved borrowing more than $250,000 through a Qualified Academy Zone Note to pay for 250 Mac Airbooks, software and related accessories. This latest laptop purchase is part of a larger push by the district to improve student engagement and improve the school's technology. The school has already rolled out several new items including iPads. Before the board's approval of the purchase, two junior high teachers demonstrated new teaching methods they have developed in two months utilizing the new Apple iPads and Mac computers.
WRECK VICTIM IDENTIFIED – The man killed in yesterday morning's single-car wreck on U.S. 81/287 in Alvord has been identified as Melton Tucker Jr., 45, of Montague. DPS Trooper Greg Reyero said Tucker was driving southbound on U.S. 81/287 when the vehicle veered left for unknown reasons and hit a guardrail one mile north of Alvord.
HPO COMMITTEE MEETING – The Decatur Historical Preservation Ordinance committee meets at 6 tonight at the Decatur Visitor Center (the old post office building) to review the document, strategize and select a sub-committee to work with city officials. If you cannot make the meeting but are still interested in serving on the committee, call Frieda Haley at (940) 399-9558 or email email@example.com.
CHAMBER LUNCHEON – The Bridgeport Area Chamber of Commerce luncheon is 11:30 a.m. Thursday at the Bridgeport Community Center. Mike McCoy with Weatherford College will speak on the "State of the Economy." Cost is $10. RSVP by Wednesday by calling (940) 683-2076 or email firstname.lastname@example.com.
BIKING FOR BREAST CANCER – The third annual Biking for Breast Cancer fun run and benefit concert is Saturday, Sept. 29. Registration is 10 a.m. at Decatur Power Sports with live music following at Bono's Saloon featuring Jeremy Martin Band, Brandon Gentry, Jamie Richards, Hollow Point, Dusty Baker, Fezzent, Terry Razor, Colt West and Brandon Jenkins. Cost is $25 per bike entry (includes entrance to concerts), $5 for extra poker hand and draw cards and $10 for concert admission for public. There will be cash prizes and a silent auction. For more information, call (940) 627-8804.
RED CROSS MEETING – The American Red Cross meets at 7 p.m. Thursday at the EMS Building, 1101 W Rose Ave. in Decatur.
READ TO JACK – The Decatur Public Library invites school-aged children to Story Tails with Jack, 3:30-5:30 p.m. Thursday. Children can sign up to read to Jack the dog for 15 minutes for fun and to practice reading skills. Call (940) 393-0290 or sign up at the library.
FOSSIL, ROCK, MINERAL – The Wise County Fossil, Rock, and Mineral Society will meet 6:30 tonight at the United Methodist Church Wesley Center. The program will be given by author Alan Farish on sharks of North Texas and how to identify the shark's teeth. Copies of his field book will be for sale. For information, call (940) 627-2329.
BLOOD DRIVE – Carter BloodCare will be at Wise Regional Health System in Decatur 8 a.m. to 5 p.m. Thursday. Call Annette Raley to pre-register at (940) 626-0167.
CASA TRAINING – CASA of Wise and Jack counties begins volunteer advocate training tonight. The five-week training is 5:30-9 p.m. each Tuesday and Thursday and includes dinner. For information, call the CASA office at (940) 627-7535.
FUNERALS – Service for James "Jay" Ensey, 90, of Fort Worth is 11 a.m. today at Hawkins Funeral Home Chapel in Bridgeport with burial at Chico Cemetery.


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Utica Police to use public's help searching for missing baby Levon
UTICA >> Utica Police are asking for volunteers to help find missing 9-month-old Levon Wameling.
Utica police Sgt. Steve Hauck said that since information was released, the public has been reaching out to police and through social media sites trying to help.
Now anyone who is interested can call 315-223-3510 to have their names put on a volunteer list to either pass out flyers or help in an organized search.
Those who call need to leave their name and a number with the officer. People will then be contacted when the search begins. The phone line will be open from 9 a.m. to 5 p.m.
Police said that people can help now by searching in their own homes and yards.
Hauck said police will organize a list of volunteers and then educate those people on proper searching techniques.
Currently, the Utica Police Department, New York State Police and members from the Utica Fire Department are working on the search.
The child's father, Jevon Wameling, of Utica, said the child vanished from the home at 748 Jay St. after Wameling left him unattended on the front porch
The baby has been missing since May 29, but his 27-year-old father didn't report the disappearance to police until almost two weeks later on Tuesday, June 11.
Wameling told police he was with Levon outside trying to get the child to go to sleep. When he decided to go back inside the house Wameling realized he was locked out.
In order to get back inside Wameling left the child on the porch while he went to the back of the house and climbed through a window. But when Wameling made it to the front door to bring Levon inside the child was gone, he told police
Levon was only wearing a diaper.
At the time of the disappearance Levon's mother was in a drug rehabilitation facility, she has since been released. Police said although Wameling hasn't been named a suspect, he is considered a person of interest. He has since obtained a lawyer and stopped talking to police
Police are asking anyone with information regarding Levon Wameling's disappearance or whereabouts to call the Utica Police Department at 315-223-3510 or 315-735-3301.


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"The wind sector is expected to grow at around 30% a year," says Antonio Carlos Tovar, head of the alternative power department at the government's national development bank BNDES. "This is because it has reached a scale that is allowing prices to fall to make wind power competitive."
Such optimism for the wind sector comes from declining prices of equipment, falling financing costs and government policies that allow renewable energy to connect to the grid at a 50% discount.
"Normally, about 20% of what is offered in the auctions is contracted and we are ready to finance these projects," says Tovar. The bank can finance 60-70% of the projects' values, he adds. BNDES offers rates of just over 6% a year, which is low in a country where basic interest rates are about 12% and financing from commercial banks tops 16%. Additionally, BNDES' loans can be repaid over 16 years, starting six months after commercial operations of the plant.
Consequently, the cost of installing one kilowatt of wind power has fallen 38%, from 5,500 reais (US$3,489) in 2004 to 4,000 reais in 2010 and wind power developers have been able to accept declining prices for the 20-year power contracts at competitive auctions. In 2010, the lowest price for a wind power project was 122 reais/MWh. This compares well with 83-116 reais/MWh from the hydroelectric plants that account for around 70% of Brazil's installed capacity.
Such optimism is a radical departure from the sluggish Proinfa renewable energy programme, launched in 2004, which contracted 1.4GW of wind projects. Most of these will probably only start commercial operations this year, six years after they were contracted.
Proinfa was rife with problems, including the price of 260 reais/MWh, which made wind power uncompetitive and forced government-controlled power company Eletrobras to buy up all the energy. A government demand for 60% local content and slow-moving environmental licensing processes also caused delays.
"Brazil's wind sector has learned from its experience both in engineering and contractual issues," says Monica Rodrigues de Souza, head of alternative energy at engineering and energy consulting firm Andrade & Canellas. "It has also benefited from the international financial crisis, when investment declined, forcing suppliers to look for new markets."
De Souza believes that, despite its pitfalls, Proinfa was important to get the wind power sector started in earnest. When the programme started, Brazil had only one wind power equipment supplier, Wobben Wind Power, a unit of Germany's Enercon. The lack of a domestic market meant that the company exported most of its production. Since then, Argentina's Impsa has opened manufacturing facilities in the country and will shortly be followed by Suzlon and Alstom.
New technology promises to allow expansion to other areas outside the north east and the windswept Pampas plains in the south. In May, Minas Gerais state power company Cemig unveiled a map that showed 40GW of wind potential in the inland state. Total wind resource in Brazil is estimated at 140GW.
However, while government auctions are good for wind in increasing competition, they could force prices lower since wind will compete with other power sources.


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Andrew Bailey (born March 30, 1959) is the current Executive Director Banking and Chief Cashier at the Bank of England. He was appointed to his current role in January 2004 and has several key responsibilities to fulfil. He is also a member of the Governor's Executive Team, which is the bank's senior management group. Bailey's signature appears underneath the amount in £ on the side with the Queen on all bank notes issued by the bank since his appointment.
Andrew has worked at the Bank for over 25 years in a number of areas, most recently as Executive Director for Banking Services and Chief Cashier, as well as Head of the Bank's Special Resolution Unit (SRU). Previous roles include Governor's Private Secretary, and Head of the International Economic Analysis Division in Monetary Analysis. Since the onset of the financial crisis in August 2007 and until April 2011, Andrew was responsible for the Bank's special operations to resolve problems in the banking sector, and in 2009 was Chairman and Chief Executive of Dunfermline Building Society Bridge Bank Ltd. His involvement in special operations also extended to taking responsibility for the so-called London Approach, in which the Bank uses its influence to seek resolution of problems in company refinancing and other such issues. At the Bank, Andrew remains a member of the Governor's Executive Team.
Before joining the Bank of England in 1985, he was Research officer at the London School of Economics. He had previously gained a BA and a Ph.D. whilst studying at Queens' College, Cambridge.


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1969 Ford Fairlane Squire station wagon
Pictures courtesy owner
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All Rights Reserved
Information in this document is subject to change without notice.
Other products and companies referred to herein are trademarks or registered trademarks of their respective companies or mark holders.
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Pablo Picasso's mural-sized painting Guernica commemorated the tragedy and chaos of the Spanish Civil War. Cynthia Rodgers' reinterpretation of the famous painting thrusts a very different set of subjects into that Cubist chaos: the X-Men.
Comic Book Resources latest "The Line is Drawn" art competition asked artists to imagine popular comic book characters redesigned by radically different artists Rodgers chose to draw the X-Men as Picasso might, casting them in one of his most famous works.
Head over to CBR to see the other entries, including Mike Mignola's Avengers and HR Giger's (pretty much NSFW) Catwoman. You can also see more of Rodgers' work on her deviantART page.
Alternate Reality Character Designs [CBR via Boing Boing]


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MADISON, Wis. — Gov. Scott Walker has signed a bill that lays out millions of dollars for job training grants and creates a new database to help job seekers find openings.
The measure makes $15 million available for job training grants over the next two years. Public and private organizations may be required to provide matching funds for the grants, which could be used to train both new and current employees.
The state Department of Workforce Development will administer the grants. The agency also will create the database by next year to help fill jobs in high-demand areas more quickly.
Walker, a Republican, signed the bill Wednesday during a visit to Jay Manufacturing Oshkosh, a metal fabricating company in Oshkosh.