Diabetes research failing to address prevention

Laura Dobberstein

The prevention of diabetes is being overlooked by diabetes researchers, according to a recent study. “Our descriptive analysis found that the majority of registered [diabetes] trials involve drug therapies rather than preventative or non-drug interventions,” said study author Dr. Jennifer Green of Duke University Medical Center in Durham, North Carolina, US, and colleagues. Green and her team examined 2,484 interventional diabetes trials registered on the ClinicalTrials.gov website between 2007 and 2010, to better understand which aspects of the disease were being addressed. [Diabetologia 2013; doi:10.1007/s00125-013-2890-4] While 75 percent of the trials had a primarily therapeutic purpose, only 10 percent focused on prevention. Sixty-three percent of interventions used drugs and only 12 percent looked at modifiable behaviors. Their findings also indicated some important demographic disparities of trials, which tended to exclude children and the elderly, were often small in size and duration, did not geographically represent populations of those living with diabetes, and did not focus on significant cardiovascular outcomes like heart attack and stroke. Twenty percent of adults over age 65 have diabetes, but less than 1 percent of the trials included patients in this age group. Most trials excluded patients over 75 years of age and 30.8 percent excluded those over the age of 65. Four percent of trials targeted those under the age of 18. This low number of pediatric trials may accurately reflect the proportion of people in this age group affected by diabetes. However, arguments exist as to why this group should be better represented in research. A 3 percent annual increase in type 1 diabetes currently exists among those under the age of 18. In addition, children have a higher chance of developing complications during their disease course and benefit more from better disease management than their older counterparts. The small size and duration of the trials concerned the researchers. The average length of a trial was less than 2 years. Over half of all trials had fewer than 100 participants and 91 percent had fewer than 500 participants. Complications like diabetic retinopathy, lower extremity amputation and end-stage renal disease vary among ethnic groups, making it important to include a diverse background of people in diabetes research. Study populations were overrepresented by patients from North America, Western Europe and certain Asian countries, but underrepresented by patients from other important regions such as Russia, Brazil and the Middle East. Cardiovascular complications related to diabetes have become an important research topic, particularly in relation to medication development. Yet mortality and cardiovascular complications were only reported in 1.4 percent of trials. The researchers concluded that current clinical trials on diabetes research do not adequately address disease prevention, management or therapeutic safety. The results from this study build a better understanding of ongoing research and could help direct future research activities and resources. source: CIMS India (MedicalTribune)

An Affair to remember

(The Hindu column April 24 2013)

So, we didn’t think it would come to this, did we? It did not ever occur to us that some day we’d get here — more importantly, that some day, he would get here?

Of course, it is not as if Sachin Tendulkar woke up this morning to find out that he had just come out of a decades-long dream that was straight out of a fairytale, and discovered that he was not the original Sachin anymore.

The fault may lie in us; somehow it had seemed impossible to believe that The Boy Wonder would be a Forty-Something some time.

“Art is a lie that helps us see the truth,” said Pablo Picasso.

The Boy Wonder image in which we collectively enshrined Sachin was something that some of us, in our sober moments, knew was a make-believe; knew, too, that we would sometime in the future, have to face the truth.

Through one man’s journey from teen prodigy to Indian icon and cultural touchstone, many of us have lived out our own dreams. It has been a great ride lasting almost a quarter of a century.

GENTLE REMINDER

But like all such journeys, this one has to end. And so it will, sooner than later. As the great man turns 40, it is a gentle reminder to his tens of millions of fans that getting mentally prepared for Life After Tendulkar in the world of cricket might actually be a sane thing to do.

As tributes pour in to celebrate one of the most astounding careers in the game’s long history, pointing to the very existence of a sunset might sound like heresy. But truth has to be confronted head on; and Sachin will probably do it sooner than his diehard fans would like him to.

Sachin has certainly withstood top level sport’s harsh winnowing process much better than most great cricketers. But the last year and a half have not been kind to him and to believe that age has nothing to do with this would be a fallacy. Sporting narratives cannot be reordered to suit our own fantasies.

On the other hand, the fact that he is closer to the exit door than ever before in an extraordinary life in cricket is hardly a reason not to celebrate a memorable landmark in the maestro’s life.

A SYMBOL

For, Sachin is as much a symbol as a person. He has helped millions of Indians over three decades to construct their national identity — to weave their own proud narratives — in the bright light of his own personal success.

It is because of this the man has inspired not mere admiration, but a kind of reverence that is rarely witnessed in sport. And this is also the reason why the emotional bond between Sachin and his fans is of a kind never before seen in Indian sport — and it is unlikely to be recreated anytime in the near future.

In the recent Test series against Australia, fans were actually applauding the departure from the crease of a brilliant young man merely because the one walking in to take his place happened to be Sachin. Those fans knew that such moments may be vanishingly rare in international cricket.

INSEPARABLE

Sachin and Sachin’s fans; they are as inseparable as Romeo and Juliet. You can’t think of one without thinking of the other. And the love has been unconditional. No other superstar-fan love affair in contemporary sport might have quite the same emotional valence to it.

This brings me to the heart of this column. Records apart, fame and money apart, even the famous Aristotelian ideal of self-actualisation — eudaimonia — apart, what is the meaning of a good sporting life?

I’d settle for happiness, not merely the champion’s own but the happiness he has provided to tens of millions of fans through his deeds — however transient, however illusory that emotion might be.

The late Douglas Adams, one of the greatest science fiction writers of all time, said that the meaning of life was 42. He also came up with something called the Infinite Improbability Drive in the all-time classic The Hitchhiker’s Guide to the Galaxy.

To many in this country, now and again, the very meaning of life might have been Sachin; and they might have believed that it was some kind of Infinite Improbability Drive that helped produce a Sachin for Indian cricket. 

The Story of Tata- Infosys Lady.... An Inspiration

It was probably the April of 1974. Bangalore was getting warm and gulmohars were blooming at the IISc campus. I was the only girl in my postgraduate department and was staying at the ladies' hostel. Other girls were pursuing research in different departments of Science.

I was looking forward to going abroad to complete a doctorate in computer science. I had been offered scholarships from Universities in the US. I had not thought of taking up a job in India. One day, while on the way to my hostel from our lecture-hall complex, I saw an advertisement on the notice board. It was a standard job- requirement notice from the famous automobile company Telco (now Tata Motors). It stated that the company required young, bright engineers, hardworking and with an excellent academic background, etc. At the bottom was a small line: "Lady candidates need not apply." I read it and was very upset. For the first time in my life I was up against gender discrimination.

Though I was not keen on taking up the job, I saw it as a challenge. I had done extremely well in academics, better than most of my male peers. Little did I know then that in real life academic excellence is not enough to be successful. After reading the notice I went fuming to my room. I decided to inform the topmost person in Telco's management about the injustice the company was perpetrating. I got a postcard and started to write, but there was a problem: I did not know who headed Telco.

I thought it must be one of the Tatas. I knew JRD Tata was the head of the Tata Group; I had seen his pictures in newspapers (actually, Sumant Moolgaokar was the company's chairman then). I took the card, addressed it to JRD and started writing. To this day I remember clearly what I wrote. "The great Tatas have always been pioneers. They are the people who started the basic infrastructure industries in India, such as iron and steel, chemicals, textiles and locomotives. They have cared for higher education in India since 1900 and they were responsible for the establishment of the Indian Institute of Science. Fortunately, I study there. But I am surprised how a company such as Telco is discriminating on the basis of gender." I posted the letter and forgot about it. 

Less than 10 days later, I received a telegram stating that I had to appear for an interview at Telco's Pune facility at the company's expense. I was taken aback by the telegram. My hostel mate told me I should use the opportunity to go to Pune free of cost and buy them the famous Pune saris for cheap! I collected Rs.30 each from everyone who wanted a sari. When I look back, I feel like laughing at the reasons for my going, but back then they seemed good enough to make the trip. It was my first visit to Pune and I immediately fell in love with the city. To this day it remains dear to me. I feel as much at home in Pune as I do in Hubli, my hometown. The place changed my life in so many ways. 

As directed, I went to Telco's Pimpri office for the interview. There were six people on the panel and I realised then that this was serious business. "This is the girl who wrote to JRD," I heard somebody whisper as soon as I entered the room. By then I knew for sure that I would not get the job. The realization abolished all fear from my mind, so I was rather cool while the interview was being conducted. Even before the interview started, I reckoned the panel was biased, so I told them, rather politely, "I hope this is only a technical interview." They were taken aback by my rudeness, and even today I am ashamed about my attitude. The panel asked me technical questions and I answered all of them. Then an elderly gentleman with an affectionate voice told me, "Do you know why we said lady candidates need not apply? The reason is that we have never employed any ladies on the shop floor. This is not a co-ed college; this is a factory. When it comes to academics, you are a first ranker throughout. We appreciate that, but people like you should work in research laboratories." I was a young girl from small-town Hubli. My world had been a limited place. I did not know the ways of large corporate houses and their difficulties, so I answered, "But you must start somewhere, otherwise no woman will ever be able to work in your factories." 

Finally, after a long interview, I was told I had been successful. So this was what the future had in store for me. Never had I thought I would take up a job in Pune. I met a shy young man from Karnataka there, we became good friends and we got married. It was only after joining Telco that I realized who JRD was: the uncrowned king of Indian industry. Now I was scared, but I did not get to meet him till I was transferred to Bombay. One day I had to show some reports to Mr. Moolgaokar, our chairman, who we all knew as SM. I was in his office on the first floor of Bombay House (the Tata headquarters) when, suddenly JRD walked in That was the first time I saw "appro JRD". Appro means "our" in Gujarati. This was the affectionate term by which people at Bombay House called him I was feeling very nervous, remembering my postcard episode. SM introduced me nicely, "Jeh (that's what his close associates called him), this young woman is an engineer and that too a postgraduate. She is the first woman to work on the Telco shop floor." JRD looked at me. I was praying he would not ask me any questions about my interview (or the

postcard that preceded it). Thankfully, he didn't. Instead, he remarked. "It is nice that girls are getting into engineering in our country. By the way, what is your name?" "When I joined Telco I was Sudha Kulkarni, Sir," I replied. "Now I am Sudha Murthy." He smiled and kindly smile and started a discussion with SM. As for me, I almost ran out of the room. 

After that I used to see JRD on and off. He was the Tata Group chairman and I was merely an engineer. There was nothing that we had in common. I was in awe of him. One day I was waiting for Murthy, my husband, to pick me up after office hours. To my surprise I saw JRD standing next to me. I did not know how to react. Yet again I started worrying about that postcard. Looking back, I realise JRD had forgotten about it. It must have been a small incident for him, but not so for me. "Young lady, why are you here?" he asked. "Office time is over." I said, "Sir, I'm waiting for my husband to come and pick me up." JRD said, "It is getting dark and there's no one in the corridor. I'll wait with you till your husband comes." I was quite used to waiting for Murthy, but having JRD waiting alongside made me extremely uncomfortable. I was nervous. Out of the corner of my eye I looked at him. He wore a simple white pant and shirt. He was old, yet his face was glowing. There wasn't any air of superiority about him. I was thinking, "Look at this person. He is a chairman, a well-respected man in our country and he is waiting for the sake of an ordinary employee."

Then I saw Murthy and I rushed out. JRD called and said, "Young lady, tell your husband never to make his wife wait again." In 1982 I had to resign from my job at Telco. I was reluctant to go, but I really did not have a choice. I was coming down the steps of Bombay House after wrapping up my final settlement when I saw JRD coming up. He was absorbed in thought. I wanted to say goodbye to him, so I stopped. He saw me and paused. Gently, he said, "So what are you doing, Mrs. Kulkarni?" (That was the way he always addressed me.) "Sir, I am leaving Telco." "Where are you going?" he asked. "Pune, Sir. My husband is starting a company called Infosys and I'm shifting to Pune." "Oh! And what will you do when you are successful." "Sir, I don't know whether we will be successful." "Never start with diffidence," he advised me. "Always start with confidence. When you are successful you must give back to society. Society gives us so much; we must reciprocate. I wish you all the best." Then JRD continued walking up the stairs. I stood there for what seemed like a millennium. That was the last time I saw him alive. 

Many years later I met Ratan Tata in the same Bombay House, occupying the chair JRD once did. I told him of my many sweet memories of working with Telco. Later, he wrote to me, "It was nice hearing about Jeh from you. The sad part is that he's not alive to see you today." I consider JRD a great man because, despite being an extremely busy person, he valued one postcard written by a young girl seeking justice. He must have received thousands of letters everyday. He could have thrown mine away, but he didn't do that. He respected the intentions of that unknown girl, who had neither influence nor money, and gave her an opportunity in his company. He did not merely give her a job; he changed her life and mindset forever. 

Close to 50 per cent of the students in today's engineering colleges are girls. And there are women on the shop floor in many industry segments. I see these changes and I think of JRD. If at all time stops and asks me what I want from life, I would say I wish JRD were alive today to see how the company we started has grown. He would have enjoyed it wholeheartedly. My love and respect for the House of Tata remains undiminished by the passage of time. I always looked up to JRD. I saw him as a role model for his simplicity, his generosity, his kindness and the care he took of his employees. Those blue eyes always reminded me of the sky; they had the same vastness and magnificence.

click is the world...

Tribute to Legends By Sonu Nigam... 

Saluting the womanhood .. 

The forgotten story behind IBM's 'first mainframe

 Thus, small sweet sherries all round for the birthday of IBM's S/360 mainframe, launched 40 years ago.

The venerable machine is being feted around the world as the grandfather of modern computing: it brought such innovations as lookahead, pipelining, branch prediction, multitasking, memory protection, generalised interrupts, and the 8-bit byte to the commercial market. For those of us who've been brought up on a diet of microprocessor roadmaps, it's a welcome reminder that the latest, greatest chips depend on inventions dating back to the days when the Beatles still wanted to hold your hand.

t is no coincidence that the end of the Second World War saw the start of digital computing. As well as the now-famous work done by Turing and others at Bletchley Park, atomic weaponry research in the US had proved two things -- that nuclear and thermonuclear bombs would define the course of the rest of the century, and that designing the things required more sums to be done than was humanly possible. The push for high-powered computation was on.

By 1955, the University of California Radiation Lab was looking for a computer faster than ever before. IBM bid but lost to Univac -- then the biggest computer company -- and IBM hated to lose. The company came back a year later with a proposal for Los Alamos labs for a computer with "a speed at least a hundred times greater" than existing machines. It won that one, and had four years to deliver the beast. The project was officially called the 7030, but was far better known as Project Stretch -- it would stretch every aspect of computing.

The innovations began right at the start. Stretch would be built with a brand-new invention, the transistor, and it was the first design to rely on a simulator. This was built by John Cocke and Harwood Kolsky early on, and let the designers try out new ideas before committing them to the final machine -- a method of working that has since become universal.

It's hard to list all the ideas that Stretch embodied and that have since become canon law in processor design. It could fetch and decode multiple instructions simultaneously -- remember the superscalar hype of the late 90s? -- and pipelined them, decoupling decoding and execution. It could predict the results of calculations and speculatively execute code depending on its best guess, and could look ahead to unexecuted instructions to make the best use of its internal resources.

So, while you toast the success of the S/360 -- another small sherry? -- remember that it and almost everything else you'll touch with a chip inside is the inheritor of a burst of unmatched innovation, one that flowered years before, in the unholy light of Trinity.