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Home Culture Cinema Sexual Harassment At Workplace: When Kamal Hassan Forced A Kiss On Rekha
Sexual Harassment At Workplace: When Kamal Hassan Forced A Kiss On Rekha
Posted By Pavithra Raman
According to most actresses, sexual harassment in the south Indian film industry is nothing new. Unlike in Hollywood, when Indian actresses speak out against this, they were either ignored, berated, or accused of being hungry for fame and money, which, as a consequence will have their reputation trashed. Indian actresses are also afraid to speak out against this because of the power and fame that their offender holds towards the south Indian society.
Varalaxmi Sarathkumar, a south Indian actress who appears predominantly in Tamil films expressed in an interview on The News Minute, "Everybody is ashamed of it. They don't want to admit to the things they have to do to get work. And half of them don't have the choices that I or a few others have. Things like this are hushed up, and we're taught not to talk about it. They say it will tarnish your image. So, when they say all this, no woman is going to come out and tell these stories."
When men, especially actors, loudly confront and call out injustice as they see it, they are praised for it. They're viewed as heroes and saviors. They're lauded for speaking up and telling their stories. How brave, we say. However, when an actress voice out against abuse, injustice, and share her traumatic stories, people tend to cover their ears. Society silences these women by saying that they're only seeking attention, money, and fame. Women are blamed for stepping outside of the boundaries that have been created for them by men. People bully and call these actresses names for naming their offenders who are very powerful in this industry. Most South Indians are not even ready to accept or listen to any accusations against their favorite actors; therefore, in anger, they shame the women for voicing out.
Society silences these women by saying that they're only seeking attention, money, and fame. Women are blamed for stepping outside of the boundaries that have been created for them by men. People bully and call these actresses names for naming their offenders who are very powerful in this industry.
A genuinely devastating and unsettling example to prove my point above is the story behind this iconic scene in Tamil cinema starring Kamal Hassan, who is often referred to as pride of the South Indian film industry. Rekha is a very dedicated actress who became one of the leading and gorgeous South Indian actresses of the '90s. This scene is from a movie called Punnagai Mannnan, which shows two people in love who are separated by the society and have decided to jump off a waterfall to die together. The couple seems to kiss each other in tears before jumping off the waterfall. During the shooting of this movie, Kamal Hassan was 32, and Rekha was 16 years old. At first glance, this scene may seem tragic yet beautiful for most viewers who have watched and cried along with it until Rekha revealed the dark backstory of this scene this year in an interview.
This would have made the headlines if it happened in Hollywood. This is proper 'sexual harassment at the workplace'. Worst is, they've even planned it.
But since it's Kamal saaaaar and Balachandar saaaaar, it should be fine I guess. pic.twitter.com/alPAC7eXJy
— Sangeeth (@Sangeethoffcl) February 23, 2020
Rekha shared that the director of the movie, K. Balachander, instructed her to close her eyes before jumping off the waterfall so it will seem more natural given the situation. Considering her age and acting experience at that time, she didn't find anything weird or odd about his direction and did as he said. She said, before they started the scene, the director reminded Kamal Hassan about something that he has spoken to him privately earlier.
As the scene began, Rekha closed her eyes while Kamal grabbed and kissed her without her knowledge and/or consent. Rekha was in shock as much as she was in fear of what her father might think of this. She told the director that her father will never approve of this scene, and in an attempt to justify his disgusting and unethical behavior, he responded, "Don't think of it as something predatory or vulgar, think of it as some big king kissing a small child." He went on and added that the kiss will not look forced and aggressive but romantic and innocent instead, even though it was forced and aggressive.
Also read: Silk Smitha: South India's Ill-Fated Superstar | #IndianWomenInHistory
The saddest part of this interview is Rekha trying to justify K. Balachander and Kamal Hassan's actions to herself as she goes on with the conversation. Rekha ended the interview by saying that both K. Balachander and Kamal Hassan might be infuriated with her for sharing this story. She also expressed that she has said this in many interviews as it is the truth, but no one believed her. The internal conflict of her trying to rationalize that incident and her indignation that people didn't believe her when she said, "Sollitum nambala" (they didn't believe me even when I spoke out) is both painful and sad to watch.
The saddest part of this interview is Rekha trying to justify K. Balachander and Kamal Hassan's actions to herself as she goes on with the conversation. Rekha ended the interview by saying that both K. Balachander and Kamal Hassan might be infuriated with her for sharing this story.
She was 16 at the time, and he was 32. They fooled a 16-year-old and made him kiss her without her consent. The gravest part is that they planned beforehand on how to take advantage of a young woman who has little to no experience in this industry. Yet they are one of many celebrated and glorified celebrities in South India. There are no stains on their names. They walk out freely with their head high among us, but Rekha is still getting judged for telling the truth and is always called out for being an attention seeker whenever she brings up this issue.
Parvathy Thiruvothu, a South Indian actress who's known for her work in Bangalore Days, explained, "We don't have a culture of supporting each other when we go through horrendous experiences. And we never will. It is difficult – the survivor is always alone. And I'd like to state this in this interview – this question that several people have asked me, why don't I name those who have molested me. Because I know I will be the only one standing. Everyone will go behind the curtain. Until I create that army for us to come out, I can't. Because I don't have proof, do I? We need people to come out and say yes, this man is a repeat offender."
Also read: 4 South Indian Movies That Start A Conversation About Caste
This is the society we live in right now. On a day when the world is dealing and celebrating with the news of Harvey Weinstein being sentenced to 23 years in prison, we have a group of people who have vast influence and power get their ways with women whenever and however they want and walk out with no consequences.
Pavithra Raman is an aspiring writer and is currently doing her studies in her native country, Malaysia. She feels unexplainable joy every time she writes about something she's passionate about. She works with Google Docs because she can't afford Microsoft Word. You can follow her on Twitter and Instagram.
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Kamal Hassan
south Indian movies
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Film Review: 'Arishadvarga' Traverses The Gendered Ego And Beyond
vivek March 16, 2020 At 11:50 AM
shame on you, kamal! this is a necessary article.
Lol March 16, 2020 At 11:43 PM
These are the articles where some nobody tries to write about an outdated, long gone incident for the sake of publicity. Even the actress has told that this is a very old issue and please don't make it big.
You suck. Whoever you are and whoever is your editor
pri March 17, 2020 At 12:20 AM
This is absolutely horrendous. I knew never Kamal did this. Lost my respect for him. Thanks for bringing up this issue, its much needed now more that ever. He should be taken accountable for this.
kunal March 17, 2020 At 12:22 AM
he should be in jail
Swami.shiva March 17, 2020 At 10:16 AM
All those who are commenting here above are numskull idiots! It is baseless remark on a very genuine actor of the world. He dont need to do that, unless the acting advice have come from Director Balachander. Rekha knew the situation, as she was well informed too! So stop all your bullshits here.
Jagadeesh March 17, 2020 At 10:41 AM
After such a long years gap what is the point of blaming anybody for their own convince now
Pavithra Raman March 17, 2020 At 1:22 PM
some people in the comments are just proving my point in the article further. the fact that you care more about the timeline of the victim's confession more than you do about the sexual assault committed by the offender shows a lot about you and this society. no one can help y'all. i hope you guys seek help, thanks
Pannirselvamshree March 17, 2020 At 5:10 PM
Brutal behavior… What is going to happen mam??? Open sexual harassment is happening in the name of flilm industry..court needs proof. Where to go for it??? Any how thanks for showing the bad faces…
smitha June 24, 2020 At 5:16 PM
Everyone knows that to get a role as a heroine, the subject has to surrender to the "casting couch". My Q is why do women want to get into the film industry knowing that it is a totally shameless field? best avoided.
But having said that, one can't blame rekha for speaking out now.
Knowing kamal, I am not surprised.
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The New Yorker Blog
Mother Convicted in MySpace Suicide Hoax Case
By Adam Rose
Megan Meier was thirteen years old when, two years ago, she hanged herself in her bedroom closet. Hours earlier, a boy she'd met online had told her the world was better off without her.
Although Megan didn't know it, the boy was a cyber-charade. One of her neighbors—a mother of a girl she knew—had invented him by creating a MySpace profile for him as a way to find out if Megan had been spreading rumors about her daughter. The daughter and a couple of friends had taken turns playing the boy, who's name was "Josh Evans." Megan's death became known as the MySpace Suicide Hoax.
On Friday, a jury in L.A. found the mother, Lori Drew, guilty of misdemeanor charges in the case, but not guilty on a felony count. Even so, she faces up to three years in prison. In January, Lauren Collins reconstructed the events before and after Megan's suicide. Below, Collins elaborates on Drew:
Public opinion against the Drews had been harsh, verging on violent. Much of the outrage was directed at Lori Drew as an exemplar of the micromanaging "helicopter parent," a familiar image at least since the Wanda Holloway case. In Channelview, Texas, in 1991, Holloway, a homemaker, attempted to hire a hit man to eliminate a neighbor, Verna Heath, the mother of a girl, Amber, who had twice been elected cheerleader over Holloway's daughter, Shanna. But Channelview and Dardenne Prairie, where teen-agers still have after-school jobs, are not type-A parent/overscheduled kid kinds of towns. Like Wanda Holloway, Lori Drew may not have represented a helicopter parent so much as a more ancient archetype: the resentful neighbor.
Lori Drew has shown little remorse, contending, through a lawyer, that she is the undeserving victim of an "avalanche of criticism." Her statement suggests that she may have been less an overbearing parent than an indifferent one:
Although she was aware of the account, Lori Drew never sent any messages to Megan or to anyone else using this MySpace account. . . . Lori Drew was not aware of any mean, nasty or negative comments made by anyone against Megan until after Megan took her own life. . . .

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Just as our physical strength decreases with age, our eyes also exhibit an age-related decline in performance - particularly as we reach our 60s and beyond.
Some age-related eye changes, such as presbyopia, are perfectly normal and don't signify any sort of disease process. While cataracts can be considered an age-related disease, they are extremely common among seniors and can be readily corrected with cataract surgery.
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For a time, you can compensate for this decline in focusing ability by just holding reading material farther away from your eyes. But eventually, you'll need reading glasses, multifocal contact lenses or multifocal eyeglasses. Some corrective surgery options for presbyopia also are available, such as monovision LASIK and conductive keratoplasty (CK).
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Be sure to discuss with your eye doctor all concerns you have about your eyes and vision. Tell them about any history of eye problems in your family and any health problems you may have. Also, let your eye doctor know about any medications you take, including non-prescription vitamins, herbs and supplements.


How to force MySensors to start setup and loop before connect to Gateway?
the reliability is the key of the system for me. So I decide to have local functions, that do not need gateway/HUB to be usable. I use Domoticz. In my primary setup, there is my Domoticz server on RPi 3 and multiple Arduino Mega as Serial Gateway. These Mega are controlling lights and Roller Shutters in my house. Every light/blind has it own button, connected to Mega's Input pin. The same Mega is controlling also the relays. The adventage is that no metter if there is Internet or even if Domoticz Server is running, the local buttons and relays are always working - domoticz is just an "extra feature" for my system.
The problem is, when I would like to add some extra devices connected by nrf24l+ and have the same functionality (this means, that the local function is always available, also without connection to gateway), there is a problem. As long, as the slave cannot reach the gateway, the arduino's loop function is not running. Is it possible to get the loop function running even without the gateway on the slave?


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Varun Sharma: I got to explore a lot with Sonam Kapoor & Rajkummar Rao in DOLLY KI DOLI
While Varun Sharma, FUKREY fame, has already shot 80% of his part for the upcoming film DOLLY KI DOLI, the Arbaaz Khan produced film is set to tentatively wrap-up by July end.
view VARUN SHARMA AT FUKREY TEAM LAUNCHES A NEW SONG
'JUGAADU' photo gallery
Varun discloses, "I am almost done with the film (around 80% of the shoot). I am currently doing the last schedule of the film. However, the film will wrap-up tentatively by July end."
Besides Varun, DOLLY KI DOLI also stars Sonam Kapoor, Rajkummar Rao, and Pulkit Samrat.
"It was a great experience working with Sonam Kapoor and Rajkummar Rao. They are wonderful people. I got to explore a lot with them, especially Rajkummar, who I think is one of the finest actors around. While Pulkit is like a brother! I had fun working with all of them," adds Varun
Sonam plays a runaway bride, who cons men to marry her and then runs away with their money, in DOLLY KI DOLI.
CHECK OUT: 'Fukra' Varun Sharma matures with Arbaaz Khan's DOLLY KI DOLI
As the name suggests, ask Varun if it has typical wedding hungama like in most Bollywood flicks and he shares, "Though the film has marriage set-up and wedding is essentially a part of it, DOLLY KI DOLI is more about human relationships. It's about finding a right partner. It's a plain beautiful story."
While Varun hesitates to disclose anything about his role in the film at this stage, he reveals that there are four different tracks of each of the actors. They are not united in the film. "There are four different tracks in the film. We are not related or united in anyway but there are certain situations which bring us together and how it moves ahead," affirms Varun.
DOLLY KI DOLI is directed by Abhishek Dogra and produced by Arbaaz Khan.
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I want to end female genital mutilation (or cutting), I want to see it happen within a generation. I've just been with hundreds of people who share this ambition, including the first lady of Burkina Faso and the women's minister of Niger. The annual meeting of the UN Commission of the Status of Women in New York has brought us together today.
Female genital cutting (FGC) has been neglected by the international community – and international development – for too long. Too little has been invested in stopping this practice – too little money, too little research, too little attention.
Niger has just seen a reduction of incidents of FGC by 50%. In Senegal, thousands of villages have abandoned the practice entirely. National laws have been put in place making FGC illegal in 25 African countries. And in December last year the UN General Assembly passed a resolution calling for a global ban on FGC – a resolution championed by African countries.
The UK has a duty to get behind this momentum and do all we can to keep it going. We owe it to the millions of girls who are at risk of being cut every year. And this is why the UK, through the Department for International Development, will this year become the largest single investor in ending FGC.
I pay homage to the tireless efforts of NGOs and other governments who have fought FGC for years. Because of them, we're at a tipping point. And I hope the UK's new commitment will deliver the final blow.
Find out what the UK is doing to end FGC within a generation.
Take a look at this map which shows UK government action to support and empower women across the globe.
Join our Facebook campaign to end violence against girls and women and call on the UN to take action.


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Historical globalization and its effects: a study of Sylhet and its people, 1874-1971
Hossain, Ashfaque (2009) Historical globalization and its effects: a study of Sylhet and its people, 1874-1971. PhD thesis, University of Nottingham.
This thesis examines the effects of 'Historical Globalization' on Sylhet and its people from 1874 to 1971. The aim of the thesis is to show two intersecting worlds within which the people of Sylhet lived their lives. At the local level they have responded to the introduction of the capitalist tea plantation. At the global level they established a 'diaspora' and social networks that maintained contact with the homeland. The dissertation considers the reshaping of Sylhet and its role as buffer zone between Assam and Bengal - the biggest province of British India. Thus it looks at Sylhet's place as the producer of global commodity tea - interfacing capital and labour that left long-term impact. It explores how local people itself becoming global for seeking economic fortune. The dissertation further examines identity politics from 1870s to 1971 as these events shaped political mobilizations at home and abroad that ended up the creation of Bangladesh. The study begins in 1874, when Assam Province was created taking Sylhet from Bengal and ends in 1971, when Bangladesh emerged where Sylhetis played a key role at home and across the globe. The chapter one traces the distinctive nature of Sylhet as a frontier, a meeting point of cultures even before the opening of Sylhet for tea capitalism. Chapter two examines the local and overseas entrepreneurs involved in the development of the plantation. Chapter three focuses on the phenomenon of labour migration within the South Asian context created by the plantation, the recruitment of tea labourers from other regions up to 1000 kilometres away, some affected by famine and a sharp termination of the contacts with their homeland following the partition in 1947. Chapter four explores mobility of labour created by the merchant marine, drawing in Sylheti seafarers with a tradition of migration and involvement in water transport and taking them across the globe. It considers the impact of 1947 partition, cutting off Sylhetis from Calcutta and ships - out migration not only continues but become torrent. Chapter five goes on to examine social improvement through communication, education and public health. Chapter six looks at the political mobilization in Sylhet, the reaction of the Hindu elites to the prospect of decolonization and the displacement of this elite following partition in 1947 and trans-national network of Diaspora nationalism. The Sylhet referendum in 1947 emerged as a watershed needs emphasising more strongly as a structuring element in the overall study.
Haywood, C.M.
Meller, H.E.
Globalization, Bangladesh, Sylhet District, History, Tea trade, Emigration and immigration
D History - General and Old World > DS Asia
UK Campuses > Faculty of Arts > School of History


I still remember when I was very happy to see Souq acquired in 2017 anticipating the potential, this will bring to the region.
Now, after the acquisition of Careem, this will create a ripple effect which will isA change the whole region. It won't just open the door for a lot of new tech startups to grow and flourish and exit on high valuations but many will continue till their IPO.
These 3.1 B$ will massively motivate many people to come to the region to build and innovate new solutions for our problems. We already may have a couple of companies that got millions in funding but surely this will turn on the green light for more and more successes.
Careem has set an example for how to build a successful tech startup in the region and certainly, there are a lot of lessons that will guide a lot of aspiring entrepreneurs towards more similar success stories.


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Lady Jackets cruise past Clemson
CLEMSON, S.C. — Deja Foster and Iasia Hemingway each registered a double-double as the Georgia Tech women's basketball team (19-8, 6-6 ACC) ran past Clemson (13-15, 2-11), 89-54, Sunday afternoon at Littlejohn Coliseum.
Foster finished with a career-high 24 points and 11 rebounds and Hemingway added 15 points and 10 boards to lead the Lady Yellow Jackets to their largest margin of victory over an ACC opponent in school history.
Alex Montgomery also scored 24 points in Tech's seventh straight win over the Tigers.
"I was very pleased with our defensive intensity, especially in the first half," Georgia Tech coach MaChelle Joseph said. "I thought we were aggressive on both ends of the floor, especially on the offensive end in transition. This team is hitting its stride at the right time."
The Lady Yellow Jackets held the Tigers to only four points over the final 10 minutes of the first half to enter the locker room with a commanding 43-15 lead. Tech registered only two turnovers and held Clemson to zero second-chance points. Foster led all scorers with 14 points before the half.
Clemson picked up its offense in the second half but were still outscored by the Lady Yellow Jackets, 46-39. Tech shot 59 percent from the field and outrebounded the Tigers, 19-11, in the final 20 minutes.
The Jackets finished the game with 50 points in the paint and a season-high 48 rebounds against an ACC opponent.
Lele Hardy, the fourth-leading scorer in the ACC, led Clemson with 17 points and six boards.
TCU takes down Georgia Tech in NIT championship game
Georgia Tech handles Cal State Bakersfield, 76-61, in NIT semifinal
Georgia Tech evaluating quarterback options in spring practice
Georgia Tech's tournament hopes take huge hit in 61-59 loss to Pittsburgh in ACC Tournament


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If you are a blogger, then the Consensus autoresponder of choice used to be Aweber or even MailChimp. Sign up to some email list, and there was a fantastic chance they had been using one of the two.
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A/B testing is also a really important Feature to have for almost any email services. Doing this regularly will help you better your open and conversion rates.
However, the form editor is very Restricted. Besides color, there's not much you can alter. By way of example, there's no way to alter the font for any one of the text.
This is not a big deal for me, as I utilize Thrive Leads for my forms. However, for folks who don't use a third party instrument, the absence of customization might be a problem.
ConvertKit includes a few email Templates, but the process of using them is quite dull. You will need to muck around with HTML and CSS which not everyone wishes to do.
Let us say one of the measures in Your automation is sending an emailaddress. With other services, editing the email will take you from this automation editor and into another email editor page. This may allow you to lose context of what you're doing.
It's a great experience and it Sets additional automation editors to shame.
The syntax might look a little Odd to non-techies and you also may have a hard time remembering exactly what to type if you go to use it.
To help with this, you can click On the Personalize menu in the editor toolbar and click the Subscriber's labels menu item. ConvertKit will then insert the right code snippet template directly into your email.
Perhaps you didn't write a great Headline, or else they had been too busy in the opportunity to take a look.
Pressing It's Going to allow you to Re-send your email again, where you're able to make modifications to your Subject Line if you wish.
I like this because you can Maximize the eyeballs you receive for every broadcast you ship out.
The main reason why you want Double opt-in is the fact that it is going to enhance your email listing quality. Nevertheless, the principal argument against is that the extra measure will hurt your conversions.
Forms are the way you get readers Into your account. ConvertKit permits you to create both kinds and landing pages.
Types may be embedded on any page Of your website, or through a typical modal popup. Landing pages are its own dedicated page hosted on ConvertKit's servers or your own site with a WordPress plugin.
As Stated above, the kind Editor doesn't give you lots of customization options, even though the built-in fashions do have a nice clean look to them.
Through a form, getting tagged, Possessing a custom area updated, or by a purchase.
Actions are the simplest to understand. The most common actions are incorporating a contributor to one of your email sequences, remove or add a tag, setting a custom area, or introducing a delay.
Let us say one of the subscribers Is on day two of your 5 part email arrangement, which is trying to get them to purchase your merchandise.
You can add an event to your Automation using the Add tag event. If on day two, the subscriber buys your product (and you tag them as a client ), it is going to pull them out of the current email order they had been in.
That is handy because you won't Invite them together with the previous 3 mails on your sequence (by asking them to purchase ) because they're now a customer of yours.
ConvertKit's automation editor is Very fast and simple to use. As stated previously, I really like the capability to edit forms and emails right within the editor .
Since there are no lists in ConvertKit, if you send a broadcast email you will want to use their filter mechanism to target who you will be sending your broadcast to.
The email editor is just your Standard HTML email editor, using a few additional choices. Click the A/B button near the subject line and you can start a split test between a few different headlines.
Sequences are at which you can Create autoresponders, a series of emails that get delivered to your subscribers in a predefined schedule of your own choice.
On the left, you'll notice all of the Emails on your show and when they will be routed out. You may drag mails around on the left to rapidly change the order they are sent.
To the right, you'll see the same Email editor as you get for Broadcasts. So the same features apply, except you can not split test subject lines here.
Unlike MailChimp or Aweber, ConvertKit is label and not record predicated. This usually means that you have a single database of readers in your ConvertKit account.
To group subscribers together, You are able to use tags or make sections. With sections, you can do things such as developing a set of contacts that subscribed before a certain date.
ConvertKit also lets you drill Down to any specific subscriber you've got. You're able to see things like what sequences they are on, what emails you've sent , and if you are performing e-commerce, what goods they have bought from you.
ConvertKit's support is great from My experience. While there is no telephone support like Aweber has, they provide email and live chat 365 days a year, 24 hours every day.
ConvertKit is amazing for direct magnets. Not only will it host your lead magnets to you, the automatic dual breasted is a great feature.
It is only working together with Shopify and Teachable at The second, but that has a great deal of potential once they get things working together with e-commerce integrations.
To handle live events and Webinars, you have to have the ability to send mails out at a particular time and date. It's typical for webinars to send multiple emails at specific times until it starts, like 24 hours before, 8 hours before, 10 minutes earlier, etc..
ConvertKit can manage live events And webinars through broadcasts only. Which is not very convenient because then you have to schedule all your mails manually.
ConvertKit has been rising by Leaps and bounds, and I am studying about people switching over to ConvertKit every day.
MailChimp includes a few Things going for this versus ConvertKit. It's cheaper, and it's better email templates.
However, for everything else, ConvertKit certainly wins out. Especially when you compare MailChimp's crappy automation editor versus the amazing ConvertKit one.
The only reason I would Urge Aweber versus ConvertKit is if you are purely doing affiliate marketing/CPA offers. Then, it may be more difficult to get approval on ConvertKit, and Aweber are your very best option.
This is a much tougher comparison. ActiveCampaign is a great email marketing program, with a lot of features for power users. You can do more with its automations, and it's better divide testing capacities.
That one you should pick depends On your business requirements. Would you like something that just works for regular email marketing activities, without a whole lot of work? Afterward ConvertKit would make a great option.
ConvertKit's uses the same tiered Pricing model as most other email services do. Hence the price goes up the more subscribers you have.
However, as you get beyond 10,000 Readers and beyond, ConvertKit actually does not jump up as much in cost as a number of the remainder.
Prices below are if you cover Monthly, but if you pre-pay annual, you get two months of service free.
ConvertKit does not normally Offer a free trial. But sometimes for promotions that are different, you may see them promoting a 30-day free trial.
Marketing automation is the Future for email. It can help you target your clients better, resulting in higher conversion and sales.
What ConvertKit does is make Marketing automations really accessible to even non-techie people. It also provides you with a headache-free consumer experience.
While it may not be the Strongest email marketing software out there, it does not aim to be. You have to know it is an email service that's geared towards bloggers and other content creators.
Just Be Sure You understand its Limitations, and choose whether you are ok with it.


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Share this Story: Small-town boy makes good in the big city
Small-town boy makes good in the big city
Don Fentie, originally from Fairview, recently was the recipient of "The lifetime surgical teaching award" for the entire department of surgery at University of Saskatchewan.
This article about him is reprinted with permission of the author Mike Leonard, courtesy of the CUA
Seminal Moments in Canadian Urology
When one thinks of the Canadian prairies, a vision of endless fields of grain stretching west to the foothills of the majestic Rockies comes to mind. Perhaps a student of popular music would know the region as the origin of such artists as Joni Mitchell and The Guess Who. Those with political interests would recognize the prairies as the cradle of Canadian socialism and universal health care.
However, how many realize that Saskatchewan was the epicentre of urological laparoscopy in our country?
Don Fentie was born on January 2, 1955 in Fairview Alberta, in the heart of the aspen parkland of Peace River Country.
His father operated a business which sold fuel to farmers in the area. Don's brothers still run the business, but he was encouraged to take a different path.
Fentie graduated medical school at the University of Alberta in 1979.
After an internship in Victoria, Don returned to Alberta to start the General Surgery program. Always a man with an eye for talent, Bill Lakey, invited Don to consider Urology instead. Don switched over to complete his Urology training in 1985.
He briefly considered an academic career but chose to move to Saskatoon to join his co-resident Saul Gonor in practice.
Don developed an interest in the use of laparoscopy to manage the impalpable undescended testis (UDT).
With the assistance of a gynaecology colleague, he developed the necessary skills and technique.
Don then went on to engage a urological colleague, Peter Barrett in the use of laparoscopy for impalpable UDT and for pelvic lymph node dissections in men with prostate cancer who were planned to have radiotherapy.
Don's laparoscopy skills were further advanced by his collaboration with a General Surgeon, Demetrius Litwin, who had set up a pig lab at the Saskatchewan Veterinary College after his return from a fellowship in France. Don assisted Litwin with porcine laparoscopic cholecystectomies, but in addition started to perform laparoscopic nephrectomies in these same animals.
In January 1993 Litwin approached Fentie with a clinical case they could collaborate on. A woman required a right hemi-colectomy for bowel cancer, but at the same time was noted to have a right renal mass on imaging. Thus, history was made when Fentie performed the first laparoscopic radical nephrectomy. Although Ralph Clayman from St. Louis had performed the first laparoscopic nephrectomy in 1991, it was for a benign tumour (oncocytoma), and thus Fentie can stake claim to the first laparoscopic nephrectomy for a renal malignancy.
Along with his partner, Peter Barrett, Don continued to perform laparoscopic nephrectomies for renal cell carcinoma, and they published the outcome of their first 200 cases in 2002. Don estimates that their numbers had topped out at approximately 1000 laparoscopic nephrectomies by his time of retirement from full time practice. Concurrently Fentie and Barrett had also initiated a laparoscopic program for radical prostatectomy and used laparoscopy for benign indications such as pyeloplasty. Their efforts resulted in several publications and invited speaking engagements at international meetings.
Don is now semi-retired and passing on his laparoscopy skills to junior colleagues in his role as a surgical assistant. He is a humble man and truly one of the unsung heroes in the advancement of Urological laparoscopy not only in his own country, but worldwide. To have achieved this out-side of an academic Urology centre is truly remarkable. His accomplishments should make all Canadian urologists rightfully proud and start "Runnin' Back to Saskatoon" (The Guess Who 1972).
Small-town boy makes good in the big city Back to video


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Pathophysiology| August 01 2001
Low Acute Insulin Secretory Responses in Adult Offspring of People With Early Onset Type 2 Diabetes
Jean-François Gautier;
Jean-François Gautier
1Phoenix Epidemiology and Clinical Research Branch, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Phoenix, Arizona
Charlton Wilson;
Charlton Wilson
2Phoenix Indian Medical Center, Indian Health Service, Phoenix, Arizona
Christian Weyer;
Christian Weyer
Dave Mott;
Dave Mott
William C. Knowler;
William C. Knowler
Melissa Cavaghan;
Melissa Cavaghan
3Department of Medicine, University of Chicago, Chicago, Illinois
Kenneth S. Polonsky;
Kenneth S. Polonsky
Clifton Bogardus;
Clifton Bogardus
Richard E. Pratley
Jean-François Gautier, Charlton Wilson, Christian Weyer, Dave Mott, William C. Knowler, Melissa Cavaghan, Kenneth S. Polonsky, Clifton Bogardus, Richard E. Pratley; Low Acute Insulin Secretory Responses in Adult Offspring of People With Early Onset Type 2 Diabetes. Diabetes 1 August 2001; 50 (8): 1828–1833. https://doi.org/10.2337/diabetes.50.8.1828
The offspring of Pima Indians with early onset type 2 diabetes are at high risk for developing diabetes at an early age. This risk is greater among those whose mothers were diabetic during pregnancy. To define the metabolic abnormalities predisposing individuals in these high-risk groups to diabetes, we conducted a series of studies to measure insulin secretion and insulin action in healthy adult Pima Indians. In 104 normal glucose-tolerant subjects, acute insulin secretory response (AIR) to a 25-g intravenous glucose challenge correlated with the age at onset of diabetes in the mother (r = 0.23, P = 0.03) and, in multiple regression analyses, the age at onset of diabetes in the father (P = 0.02), after adjusting for maternal age at onset and after allowing for an interaction between these terms. In contrast, insulin action (hyperinsulinemic glucose clamp) did not correlate with the age at onset of diabetes in the parents. To determine whether early onset diabetes in the parents affected insulin secretion in the offspring across a range of glucose concentrations, responses to a stepped glucose infusion were measured in 23 subjects. Insulin secretion rates were lower in individuals whose mothers had developed diabetes before 35 years of age (n = 8) compared with those whose parents remained nondiabetic until at least 49 years of age (n = 15) (average insulin secretory rates: geometric mean [95% CI] 369 [209–652] vs. 571 [418–780] pmol/min, P = 0.007). Finally, the AIR was lower in individuals whose mothers were diabetic during pregnancy (n = 8) than in those whose mothers developed diabetes at an early age but after the birth of the subject (n = 41) (740 [510–1,310] vs. 1,255 [1,045–1,505] pmol/l, P < 0.02). Thus, insulin secretion is lower in normal glucose tolerant offspring of people with early onset type 2 diabetes. This impairment may be worsened by exposure to a diabetic environment in utero.
Type 2 diabetes is common among the Pima Indians of Arizona (1). In this population, individuals at a particularly high risk include those whose parents developed diabetes at an early age (2) and those whose mothers were diabetic during pregnancy (3,4). The mechanisms causing these individuals to be at increased risk for diabetes are unknown.
Substantial evidence indicates that genetic factors contribute to the high prevalence of diabetes in Pima Indians. Diabetes is a familial trait in this population, as it is in others (2,5). Moreover, segregation analyses are consistent with a major gene affecting the age at onset of diabetes (2). Risk factors for developing diabetes among the Pima Indians include obesity, insulin resistance, and a low acute insulin response (AIR) to an intravenous glucose challenge (6,7). These traits are also familial (8,9,10,11). Thus, genetic transmission of a prediabetic trait, such as insulin resistance or impaired insulin secretion, could contribute to the higher risk for diabetes in the offspring of individuals with early onset diabetes.
Environmental or acquired factors also contribute to the high prevalence of diabetes in Pima Indian. Exposure to a diabetic environment in utero is associated with a substantially higher risk of diabetes in offspring than would be expected based on genetics alone (3,4). Among 20- to 24-year-old Pima Indians, 45% of individuals whose mothers were diabetic during pregnancy developed diabetes compared with only 9% of 20- to 24-year-olds whose mothers became diabetic subsequent to delivery (3). Furthermore, Pima Indians who were born after their mother developed diabetes have a 3.7-fold higher risk of developing diabetes than their full siblings who were born before their mother developed diabetes (4). These findings indicate that in utero exposure to a diabetic environment increases the risk for developing diabetes beyond that attributable to genetic factors.
To investigate the metabolic factors increasing the risk for diabetes in the offspring of Pima Indians with early onset diabetes, we conducted a series of studies to measure insulin secretion and insulin action in these individuals. First, measures of insulin secretion and insulin action in normal glucose-tolerant adult Pima Indians were compared with the age at onset of diabetes in their parents. Second, insulin secretory responses to graded glucose infusions were compared in the offspring of women with early onset diabetes and the offspring of those who developed diabetes at a later age. Finally, the effects of exposure to a diabetic environment in utero were examined by comparing the metabolic characteristics of the offspring of women who were diabetic during pregnancy with those of the offspring of women who had developed diabetes at an early age but after the birth of the subject.
Epidemiological studies of type 2 diabetes have been conducted since 1965 among the Pima and Tohono O'odham Indians of the Gila River Indian Community (1). Approximately every 2 years, community residents over 5 years of age are asked to undergo an examination that includes anthropometric measurements and a 2-h 75-g oral glucose tolerance test (OGTT). Since 1983, more detailed studies of the metabolic predictors of diabetes have been performed on a subset of community members (7). Data from the epidemiological study were used to establish whether the parents of the subjects participating in the detailed metabolic studies had developed diabetes and, if so, the age at onset. Because even mild degrees of glucose intolerance can be associated with impairments in insulin secretion and insulin action (12), only subjects with normal glucose tolerance (13) and detailed metabolic studies were selected from the cohort for further analyses.
In the first analysis, insulin secretion and insulin action were examined in relation to the age at onset of diabetes in the parents. All parents of the individuals in this subset were diabetic or had been examined and found to not have diabetes when they were at least 50 years of age. Only subjects with at least one diabetic parent were included in the analysis. The offspring of mothers who were diabetic before pregnancy and those with incomplete parental information were excluded. A total of 104 offspring from 39 nuclear families (ranging in size from 1 to 3 offspring) met these criteria and were included in this analysis.
Next, a group of unrelated Pima Indians was specifically recruited to study insulin secretory responses to graded glucose infusions. This group included 8 individuals whose mothers had developed diabetes before 35 years of age and 15 individuals whose parents had been tested and were nondiabetic until at least 49 years of age (although 6 mothers and 4 fathers subsequently developed diabetes). These age criteria were chosen based on previous segregation analyses to maximize the likelihood that individuals in these two groups either did or did not have a major gene affecting the age at onset of diabetes (2). None of the individuals in this analysis were the offspring of a diabetic pregnancy.
Finally, the 8 individuals whose mothers were known, based on glucose tolerance testing, to be diabetic before pregnancy were compared with 41 individuals whose mothers had at least one nondiabetic glucose tolerance test after the birth of the subject and who developed diabetes before 40 years of age. The latter criterion was included to minimize potential confounding differences in the age at onset of diabetes of the mothers in the two groups.
All studies were approved by the Institutional Review Board of the National Institutes of Health and by the Tribal Council of the Gila River Indian Community, and all subjects gave written informed consent before participation. All subjects were in good health, as determined by a comprehensive medical evaluation including medical history, physical examination, and routine laboratory testing. Subjects were admitted to the Clinical Research Unit of the National Institute of Diabetes and Digestive and Kidney Diseases in Phoenix, Arizona, for 8–15 days and were provided a standard weight-maintaining diet containing 50% of calories as carbohydrate, 30% as fat, and 20% as protein for at least 3 days before metabolic testing. While in the unit, subjects were restricted to sedentary activities.
Anthropometric measurements.
Fat mass, fat-free mass, and percent fat were calculated from body density measurements obtained by underwater weighing, with simultaneous determination of residual lung volume by helium dilution (14) or by dual-energy X-ray absorptiometry using a total-body scanner (DPX-L; Lunar Radiation, Madison, WI) (15). Measurements of body composition from the two methods were made comparable using an equation derived in our laboratory (15).
Metabolic measurements.
All metabolic testing was performed in the morning after a 12-h overnight fast. After at least 3 days in the research ward, a 2-h 75-g OGTT was performed. The AIR was calculated as the mean increment in plasma insulin concentration above basal for samples obtained 3, 4, and 5 min after an intravenous injection of 25 g glucose (7). Approximately 7 days after admission, a 2-step hyperinsulinemic-euglycemic glucose clamp was performed. As detailed elsewhere (7), primed-continuous infusions of regular insulin (Novo-Nordisk, Bethesda, MD) were administered at rates of 240 pmol/m2 body surface area per min for 100 min and 2,400 pmol/m2 per min for an additional 100 min. These infusions produced mean ± SD steady-state plasma insulin concentrations of 720 ± 305 and 13,800 ± 10,402 pmol/l, respectively. Endogenous glucose production was measured for 2 h at baseline and during the low-dose infusion using a primed-continuous infusion of [3-3H]glucose. Glucose disposal rates during the low- and high-dose insulin infusions (Mlow and Mhigh, respectively) were adjusted for differences in steady-state plasma glucose concentrations, expressed per kilogram of estimated metabolic body size (fat-free mass + 17.7), and corrected for endogenous glucose production (assumed to be 0 during the high dose) (16).
Insulin secretory responses to a graded glucose infusion were measured in a group of individuals using a sequential euglycemic-hyperinsulinemic step-hyperglycemic protocol. For the first 100 min of this study, insulin action was measured during an infusion of insulin at a rate of 240 pmol/m2 body surface area per min. Glucose disposal during this phase was calculated as described above. The insulin infusion was then discontinued, and plasma insulin concentrations were allowed to return to basal levels over 60 min. This was followed by a stepped glucose infusion administered at rates of 11, 17, 22, 33, and 44 μmol · kg−1 · min−1 (2, 3, 4, 6, and 8 mg · kg−1.min−1) for 40 min per step. Three blood samples for measurement of insulin, C-peptide, and glucose concentrations were obtained at baseline and during the last 10 min of each glucose step. The insulin secretion rate (ISR) was derived by deconvolution assuming a two-compartmental model of C-peptide clearance kinetics (17,18,19). At baseline and during each glucose infusion period, the average glucose concentration and ISR were calculated.
Data were analyzed using the procedures of the SAS Institute (Cary, NC). Plasma insulin concentrations, AIR, and Mlow were log10 transformed to normalize their distributions before parametric analyses. Pearson's correlation coefficients were calculated to determine the relation between selected variables. The relation of AIR (adjusted for age, sex, percent body fat, and Mlow) to the age at onset of diabetes in the parents was analyzed using multivariate linear regression models that included both maternal and paternal age at onset and an interaction term between maternal and parental age at onset (i.e., maternal age at onset × paternal age at onset). Because many of the subjects in this analysis were full siblings, the effect of parental age at onset of diabetes on AIR was also examined using a general estimating equation procedure to control for the nonindependence of family members. Changes in glucose, insulin, and ISR during the graded glucose infusion were compared in the offspring of mothers with early onset diabetes (<35 years of age) and in those whose mothers and fathers remained nondiabetic until at least 49 years of age using repeated measures analysis of variance (ANOVA). Average ISRs over the entire glucose infusion procedure were compared between groups using ANOVA after adjustment (using linear regression) for average glucose concentrations. Differences between the group of subjects whose mothers were diabetic during pregnancy and the group of subjects whose mothers subsequently developed diabetes were tested using Student's t test or the nonparametric Wilcoxon's rank-sum test. Group differences were also tested after adjusting the dependent variables for age, sex, percent body fat and, for measures of insulin secretion, insulin action (Mlow) using multivariate linear regression analyses. Data are expressed as means ± SD (or geometric means ± 95% CI for log-transformed variables), and P values <0.05 are considered significant.
Effects of parental age at onset of diabetes.
Parental age at onset of diabetes was not related to body composition or insulin action in 104 subjects with normal glucose tolerance (58 men and 46 women, age 29 ± 10 years, body fat 33 ± 10%). Log-transformed AIR, adjusted for age, sex, percent body fat, and insulin action, correlated with the age at onset of diabetes in the mother (r = 0.23, P = 0.03, among 85 subjects whose mothers had diabetes) but not with the age at onset of diabetes in the father (r = −0.02, among 72 subjects whose fathers had diabetes). In 64 subjects in whom the age at onset of diabetes was known in both parents, offspring whose mother's and father's age at onset of diabetes were both above the median (>41 and >46 years of age, respectively) had the highest AIR (geometric mean 1,530 pmol), whereas those with at least one parent whose age at onset of diabetes was below the median (early onset diabetes) had a lower AIR (geometric mean 1,040 and 1,280 pmol in those with maternal and paternal early onset diabetes, respectively) (Fig. 1). However, having two parents with early onset diabetes did not seem to further impair the AIR (geometric mean 1,155 pmol). Although there were no significant differences between groups when subjects were classified according to median age at onset of diabetes of their parents in this manner, multiple regression analyses, in which parental age at onset of diabetes was treated as a continuous variable, showed that both maternal and paternal age at onset were related to adjusted AIR (P = 0.06 and P = 0.02, respectively), and a significant interaction was observed between the age at onset of diabetes in the mother and the age at onset of diabetes in the father (P = 0.02). Similar results were obtained using the general estimating equation procedure to control for family membership. These results suggest that both maternal and paternal age at onset of diabetes affect AIR in the offspring and that the effects depend on the age at onset of diabetes in the other parent.
To determine whether maternal age at onset of diabetes affected insulin secretory responses in the offspring over a range of glucose concentrations, insulin secretion rates were measured during graded glucose infusions in 23 Pima Indians, for whom physical and metabolic characteristics are summarized in Table 1. Subjects were divided into two groups: those whose mothers developed diabetes before 35 years of age (n = 8) and those whose parents were both known to be nondiabetic until at least 49 years of age (n = 15). Mean age, percent body fat, glucose tolerance, and insulin action were similar in the two groups. Insulin secretion rates increased with progressively increasing glucose infusions; however, this increase was less pronounced in the offspring of women who developed diabetes before 35 years of age (overall time × group effect: P = 0.03, Fig. 2). The mean ISR over the entire infusion period, adjusted for the average glucose concentration, was ∼35% lower in the offspring of women with early onset diabetes compared with those subjects with parents who had not developed diabetes before 49 years of age (Table 1). The difference in mean ISR between groups remained significant (P = 0.02) after adjusting for insulin action (Mlow) and percent body fat.
Effects of a diabetic in utero environment.
The physical and metabolic characteristics of the adult offspring of women who were diabetic during pregnancy and women who developed diabetes after pregnancy are compared in Table 2. There were no differences in the mean age at onset of diabetes in the mothers (31 ± 6 vs. 34 ± 6 years, P = 0.17 in the groups with and without in utero exposure to diabetes, respectively). Mean BMI, percent body fat, glucose tolerance, and insulin concentrations during the OGTT were also similar between the two groups, and there were no differences in insulin action between the two groups, as judged by the M values during the euglycemic clamp. The mean AIR was ∼40% lower in the offspring of women who were diabetic during pregnancy compared with that of the offspring of women who subsequently developed diabetes, even after adjusting for age, sex, percent body fat, Mlow, and age at onset of diabetes in the mother (P = 0.018, Table 2). Data on paternal diabetes status were available for only 4 of the 8 individuals whose mothers were diabetic during pregnancy (although it was available for all of the 41 control subjects). Consequently, it was not possible to control for possible paternal influences in these analyses.
Among the Pima Indians of Arizona, the offspring of individuals with early onset type 2 diabetes and the offspring of women who were diabetic during pregnancy are at increased risk for developing diabetes (2,3,4). The present study was undertaken to characterize the metabolic abnormalities underlying the increased risk for diabetes in offspring. Our analyses indicate that the AIR to an intravenous glucose challenge is related to the age at onset of diabetes in the parents. Thus, individuals whose parents had early onset diabetes manifest an impairment in insulin secretion relative to those whose parents developed diabetes at a later age. Using a stepped glucose infusion to define the dose-response relationship between plasma glucose and insulin secretion, we confirmed that insulin secretory rates were lower across a range of glucose concentrations in individuals whose mothers had early onset diabetes than in those whose parents developed diabetes at a later age. Finally, we observed that the mean AIR to intravenous glucose was lower in the offspring of women who were diabetic during pregnancy compared with the offspring of women who had also developed diabetes at an early age but after the birth of the subject.
The correlation between adjusted AIR and the age at onset of diabetes in the mothers could be caused by an inherited impairment in insulin secretion in the offspring of women with early onset diabetes, or it could reflect a unique effect of the maternal-fetal environment. The finding that paternal age at onset of diabetes was associated with insulin secretory function in the offspring after adjusting for the maternal effect is consistent with the former interpretation. Thus, individuals who had at least one parent with an age at onset of diabetes below the median had a lower AIR than individuals who had two parents with an age at onset of diabetes above the median (Fig. 1). The interaction of maternal and paternal age at onset is evident in that the effect of early onset parental diabetes is not additive—the AIR in those with two parents with early onset diabetes was comparable with that in those who had just one parent with early onset diabetes. One possible explanation for this is that the selection criteria for inclusion in these analyses biased the data against demonstrating an additive defect, i.e., those individuals manifesting a more severe impairment in insulin secretion may have been excluded because they had already developed impaired glucose tolerance or diabetes.
Segregation analyses suggest that a major gene contributes to the risk of developing type 2 diabetes by influencing the age at onset of the disease in Pima Indians (2). These models predict a greater genetic component among those with early onset diabetes compared with those with later onset diabetes (2). Because insulin secretion is a familial trait in Pima Indians (10,11) and because defects in the acute insulin response predict diabetes in this population and others (7,20,21), it is possible that inherited defects in insulin secretion could account for the familial nature of early onset type 2 diabetes in Pima Indians. The significant association of AIR with age at onset of diabetes in the parents observed in the present study is consistent with this hypothesis. Studies in other populations support this as well. European subjects who had a first-degree relative with type 2 diabetes had reduced first-phase insulin secretion (22,23), as did insulin-resistant offspring of diabetic patients (24). Furthermore, recent studies in maturity-onset diabetes have firmly established that mutations in genes that affect pancreatic β-cell development or function can cause diabetes (25,26,27). Thus, our findings of an association between age at onset of diabetes in the parents and insulin secretion in the offspring suggest a possible physiological mechanism for a major gene affecting the age at onset of diabetes in this population. However, the possibility that shared behavioral and/or environmental factors are responsible for this association cannot be excluded.
A slightly greater risk for developing diabetes is conferred by maternal rather than paternal diabetes (3,28,29). Because the offspring of women who were diabetic during pregnancy are at higher risk for diabetes than can be explained based solely on genetics (3,4), we also sought to determine the effects of a diabetic in utero environment on metabolic risk factors for diabetes. Human studies are limited (30,31) and, to date, have not addressed the effects of a diabetic pregnancy on direct measures of insulin secretion and insulin action in offspring. The present results suggest that in utero exposure to a diabetic environment is associated with a defect in the AIR to intravenous glucose, which was ∼40% lower in the offspring of women who were diabetic during pregnancy than in the offspring of women who subsequently developed diabetes. This difference cannot be ascribed to an impairment in insulin secretion associated with early onset diabetes because the mean maternal age at onset of diabetes was similar in the two groups and because the effect persisted even after adjusting for maternal age at onset of diabetes. Based, in part, on the observation that the offspring of rats made mildly diabetic during pregnancy have reduced insulin output in response to glucose (32), it has been hypothesized that exposure to hyperglycemia during critical periods of fetal development "programs" the developing pancreas in a way that affects subsequent insulin secretory function. Our findings in the offspring of diabetic women are consistent with this notion.
A significant limitation of the present series of studies is that glucose tolerance tests were not performed during pregnancy in the majority of the mothers. Consequently, it was impossible to examine the relation of maternal glycemia during pregnancy to subsequent insulin secretory function in the offspring. Therefore, it is unknown whether the offspring of mothers with early and late-onset diabetes were exposed to comparable ambient glucose concentrations in utero. It is possible that women predisposed to early onset diabetes might have had higher plasma glucose concentrations during pregnancy, which could have affected fetal β-cell development, than women lacking a predisposition to early diabetes. Transient gestational diabetes or impaired glucose tolerance also would not have been detected in women who did not have a glucose tolerance test during pregnancy. Undiagnosed gestational diabetes could have led to the stronger correlation between AIR in the offspring and the age at onset of diabetes in the mother compared with the father. Thus, an alternative interpretation of the data are that an inherited factor causing early onset diabetes impairs metabolic function but not necessarily insulin secretion. When this factor is present in mothers, the developing fetus can be exposed to higher (although not necessarily diabetic) ambient glucose concentrations that can, in turn, affect subsequent insulin secretory function in the offspring. The impairments of insulin secretion in the offspring of women with early onset diabetes and the offspring of mothers who were diabetic during pregnancy would thus represent different degrees of severity in a spectrum of defects caused by a common underlying abnormality. This mechanism could contribute to the different relation between AIR and age at onset of diabetes in the mothers and fathers as well. Finally, considering the limitations of the present series of studies, it is important to acknowledge that some of the comparisons may have been constrained by small sample sizes, and no attempt was made to account for multiple comparisons. Further studies that include indexes of maternal glycemia during pregnancy will be required to resolve the relative contributions of genetic factors and exposure to hyperglycemia in utero to the increased risk for diabetes in the offspring of individuals with early onset diabetes.
In conclusion, the results of the present analyses indicate that insulin secretory responses to glucose are lower in the offspring of individuals with early onset diabetes. This impairment is worse in individuals exposed to a diabetic environment in utero. These data suggest that strategies aimed at preventing type 2 diabetes might include therapeutic approaches to augment early insulin secretory responses to glucose and the early diagnosis and aggressive treatment of hyperglycemia during pregnancy. Before clinical implementation of these strategies can be recommended, however, trials should be undertaken in carefully selected groups at high risk for developing type 2 diabetes.
Geometric mean AIR in four groups of normal glucose-tolerant offspring as defined by parental age at onset of diabetes above (late) or below (early) the median in mothers and fathers and the adjusted AIR in four groups as defined by median maternal and paternal age at onset of diabetes (41 and 46 years of age, respectively).
Relation between average plasma glucose concentrations and ISRs during the stepped glucose infusion studies in offspring of women who developed diabetes before 35 years of age (•, n = 8) and offspring of people who did not develop diabetes before 49 years of age (○, n = 15). Glucose concentrations and ISRs were measured under basal conditions and at glucose infusion rates of 11, 17, 22, 33, and 44 μmol· kg−1 · min−1.
Characteristics of subjects in the stepped glucose infusion study according to the age at onset of diabetes in the parents
Diabetes onset .
<35 years of age .
>49 years of age .
P .
n (M/F) 4/4 7/8
Age (years) 32 ± 6 32 ± 4 0.9
BMI (kg/m2) 31 ± 8 36 ± 8 0.3
Body fat (%) 31 ± 8 34 ± 8 0.5
Glucose (mmol/l)
Fasting 5.4 ± 0.6 4.9 ± 0.4 0.08
2-h 7.3 ± 1.76 6.8 ± 1.9 0.5
Mlow (μmol/kg · metabolic body size−1 · min−1) 20 (10–33)  17 (13–21)  0.6
Average glucose (mmol/l) 9.4 ± 1.7 9.0 ± 1.2 0.4
Average ISR (pmol/min) 369 (209–652) 571 (418–780) 0.007
Data are means ± SD or geometric means (95% CI). Mlow, glucose disposal rate at a mean plasma insulin concentration of 780 pmol/l expressed as micromoles per kilogram of estimated metabolic body size (kg fat free mass + 17.7) per minute. The average glucose is the mean of glucose concentrations during the entire glucose infusion period. The average ISR, mean of insulin secretion rates (measured by deconvolution of C-peptide concentrations) during the entire glucose infusion period.
Comparison of the offspring of diabetic pregnancies and those whose mothers developed diabetes after pregnancy
Maternal diabetes during pregnancy .
Yes .
No .
n 8 41
Age (years) 22 ± 3 27 ± 6 0.03
Sex (M/F) 4/4 24/17 0.7
Mothers' age at onset of diabetes (years) 31 ± 6 34 ± 6 0.17
Fasting 4.8 ± 0.6 4.9 ± 0.6 0.8
2-h 6.4 ± 1.1 6.4 ± 0.6 0.8
Insulin (pmol/l)
Fasting 215 (155–300) 220 (200–260) 0.8
2-h 790 (510–1,240) 910 (755–1,105) 0.5
M (μmol/kg · metabolic body size−1 · min−1)
Mlow 15 (13–19) 15 (14–16) 0.6
Mhigh 55 ± 6 50 ± 6 0.17
AIR (pmol/l) 740 (510–1,310) 1,255 (1,045–1,505) 0.018
Data are means ± SD or geometric means (95% CI). M, glucose disposal rate at mean plasma insulin concentrations of 720 pmol/l (Mlow) and 13,800 pmol/l (Mhigh) expressed as micromole per kilogram of estimated metabolic body size (kg fat free mass + 17.7) per min. AIR, acute insulin response expressed as the mean of the change in plasma insulin levels relative to basal value from the 3rd to the 5th min after the intravenous glucose injection. AIR is adjusted for age, sex, percent body fat, Mlow, and age of onset of diabetes in the mother.
This work was supported in part by the Diabetes Research and Training Center at the University of Chicago (DK 20595).
We thank the members and leaders of the Gila River Indian Community, without whose cooperation and support this study would not have been possible; the technical and nursing staffs of the Clinical Research Unit and the Diabetes and Arthritis Epidemiology Section for their excellent work and dedication; and Paul Rue and Kimberly Fox from the University of Chicago for their excellent technical support.
Knowler WC, Bennett PH, Hamman RF, Miller M: Diabetes incidence and prevalence in Pima Indians: a 19-fold greater incidence than in Rochester.
Am J Epidemiol
Hanson RL, Elston RC, Pettitt DJ, Bennett PH, Knowler WC: Segregation analysis of non-insulin-dependent diabetes mellitus in Pima Indians: evidence for a major-gene effect.
Pettitt DJ, Aleck KA, Baird HR, Carraher MJ, Bennett PH, Knowler WC: Congenital susceptibility to NIDDM: role of intrauterine environment.
Dabelea D, Hanson RL, Lindsay RS, Pettitt DJ, Imperatore G, Gabir MM, Roumain J, Bennett PH, Knowler WC: Intrauterine exposure to diabetes conveys risks for type 2 diabetes and obesity: a study of discordant sibships.
DeFronzo RA: Pathogenesis of type 2 diabetes: metabolic and molecular implications for identifying diabetes genes.
Diabetes Metab Rev
Pratley RE, Weyer C, Bogardus C: Metabolic abnormalities in the development of type 2 diabetes mellitus. In
Diabetes Mellitus: A Fundamental and Clinical Text
. 2nd ed. LeRoith D, Taylor SI, Olefsky JM, Eds. Philadelphia, PA, Lippincott-Raven,
Lillioja S, Mott DM, Spraul M, Ferraro R, Foley JE, Ravussin E, Knowler WC, Bennett PH, Bogardus C: Insulin resistance and insulin secretory dysfunction as precursors of non-insulin-dependent diabetes mellitus: prospective studies of Pima Indians.
Lillioja S, Mott DM, Zawadzki JK, Young AA, Abbott WGH, Knowler WC, Bennett PH, Moll P, Bogardus C: In vivo insulin action is familial characteristic in nondiabetic Pima Indians.
Knowler WC, Pettitt DJ, Saad MF, Charles MA, Nelson RG, Howard BV, Bogardus C, Bennett PH: Obesity in the Pima Indians: its magnitude and relationship with diabetes.
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–1551S,
Janssen RC, Bogardus C, Takeda J, Knowler WC, Thompson DB: Linkage analysis of acute insulin secretion with GLUT2 and glucokinase in Pima Indians and the identification of a missense mutation in GLUT2.
Sakul H, Pratley R, Cardon L, Ravussin E, Mott D, Bogardus C: Familiality of physical and metabolic characteristics that predict the development of non-insulin-dependent diabetes mellitus in Pima Indians.
Weyer C, Bogardus C, Pratley RE: Metabolic characteristics of individuals with impaired fasting glucose and/or impaired glucose tolerance.
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Diabetes Mellitus: Report of a WHO Study Group.
Geneva, World Health Org.,
(Tech. Rep. Ser., no. 727, p.
Siri W: Body composition from fluid spaces and density: analysis of methods. In
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. Brozek J, Herschel A, Eds. Washington, DC, National Academy of Sciences,
Tataranni PA, Ravussin E: Use of dual-energy X-ray absorptiometry in obese individuals.
Lillioja S, Bogardus C: Obesity and insulin resistance: lessons learned from the Pima Indians.
Diabete Metab Rev
Eaton RP, Allen RC, Schade DS, Erickson KM, Standefer J: Prehepatic insulin production in man: kinetic analysis using peripheral connecting peptide behavior.
Polonsky KS, Licinio-Paixao J, Given BD, Pugh W, Rue P, Galloway J, Karrison T, Frank B: Use of biosynthetic human C-peptide in the measurement of insulin secretion rates in normal volunteers and type I diabetic patients.
Van Cauter E, Mestrez F, Sturis J, Polonsky KS: Estimation of insulin secretion rates from C-peptide levels: comparison of individual and standard kinetic parameters for C-peptide clearance.
Efendic S, Luft R, Wajngot A: Aspects of the pathogenesis of type 2 diabetes.
Skarfors ET, Selinus KI, Lithell HO: Risk factors for developing non-insulin dependent diabetes: a 10 year follow up of men in Uppsala.
O'Rahilly SP, Nugent Z, Rudenski AS, Hosker JP, Burnett MA, Darling P, Turner RC: Beta-cell dysfunction, rather than insulin insensitivity, is the primary defect in familial type 2 diabetes.
Pimenta W, Korytkowski M, Mitrakou A, Jenssen T, Yki-Jarvinen H, Evron W, Dailey G, Gerich J: Pancreatic beta-cell dysfunction as the primary genetic lesion in NIDDM: evidence from studies in normal glucose-tolerant individuals with a first-degree NIDDM relative.
Perseghin G, Ghosh S, Gerow K, Shulman GI: Metabolic defects in lean nondiabetic offspring of NIDDM parents: a cross-sectional study.
Froguel P, Zouali H, Vionnet N, Velho G, Vaxillaire M, Sun F, Lesage B, Stoffel M, Takeda J, Passa P, Permutt MA, Beckman JS, Bell GI, Cohen D: Familial hyperglycemia due to mutations in glucokinase. Definition of a subtype of diabetes mellitus.
Yamagata K, Oda N, Kaisaki PJ, Menzel S, Furata H, Vaxillaire M, Southam L, et al: Mutations in the hepatocyte nuclear factor-1-alpha gene in maturity onset diabetes of the young (MODY3).
Yamagata K, Furata H, Oda N, Kaisaki PJ, Menzel S, Cox NJ, Fajans SS, et al: Mutations in the hepatocyte nuclear factor-4-alpha gene in maturity onset diabetes of the young (MODY1).
Alcolado JC, Alcolado R: Importance of maternal history of non-insulin dependent diabetic patients.
Thomas F, Balkau B, Vauzelle-Kervroedan F, Papoz L: Maternal effect and familial aggregation in NIDDM: the CODIAB Study: CODIAB-INSERM-ZENECA Study Group.
Silverman BL, Metzger BE, Cho NH, Loeb CA: Impaired glucose tolerance in adolescent offspring of diabetic mothers: relationship to fetal hyperinsulinism.
Plagemann A, Harder T, Kohlhoff R, Rohde W, Dorner G: Glucose tolerance and insulin secretion in children of mothers with pregestational IDDM or gestational diabetes.
Aerts L, Holemans K, Van Assche FA: Maternal diabetes during pregnancy: consequences for the offspring.
Address correspondence and reprint requests to Richard E. Pratley, MD, Novartis Pharmaceuticals, 59 Rt. 10, East Hanover, NJ 078936. E-mail: richard.pratley@pharma.novartis.com.
Received for publication 30 June 1999 and accepted in revised form 24 April 2001.
AIR, acute insulin secretory response; ANOVA, analysis of variance; ISR, insulin secretion rate; OGTT, oral glucose tolerance test.


text:
Women in SF&F Month: Susan Jane Bigelow
Today's guest is science fiction and fantasy writer Susan Jane Bigelow! She's the author of the Extrahuman Union series beginning with Broken, which was recently republished through Book Smugglers Publishing. The next two books will soon be re-released as well with Sky Ranger scheduled for this summer and The Spark for this fall, and a brand new fourth book in the series will be available toward the end of this year. She's also the author of the Grayline Sisters books starting with The Daughter Star and the upcoming young adult epic fantasy novel The Demon Girl's Song, as well as short fiction and nonfiction.
Finding Great SFF with Older Women as Protagonists
By Susan Jane Bigelow
Women in science fiction and fantasy have to constantly fight invisibility, but for older women this is especially true. I'm starting to be of an age where I very much want to see women over the age of 35 take powerful, dynamic, and interesting starring roles in genre, but there's sadly not a lot of that to be found.
And if I want to find stories about queer older women? Forget it.
Now, I deeply love stories about young women, and I read a ton of them! But these days, as I continue to grapple with the idea that I'm no longer young myself, I find the stories of women in their 40s, 50s, 60s, and beyond both compelling and comforting. Society doesn't make much room for women past a certain age, after all, unless they're in traditional roles as mothers, grandmothers, or teachers.
I've tried to weave the stories of older women into my own work; my novel Extrahumans, which is the fourth and final novel of the "Extrahuman Union" series about superheroes in the future fighting a totalitarian government, focuses on the relationship between two women—one in her late 30s, one in her early 50s. That book will be out late this year from Book Smugglers Publishing.
There are some great SFF books out there featuring older women as protagonists. Lois McMaster Bujold's recent novel Gentleman Jole and the Red Queen stars Cordelia Vorkosigan, who is one of my favorite heroines ever. Cordelia starred in some of the earliest Vorkosigan Saga novels, but was reduced to a background role as Miles Vorkosigan's mother for much of the rest of the series. It was awesome to see her back as the protagonist dealing with grief, loss, life, and love. It was also refreshing to explore the nontraditional relationship she had with her husband and Admiral Jole.
Bujold also wrote one of my favorite fantasy novels ever, Paladin of Souls. This book is set in her Chalion universe, and stars Ista as a woman in her 40s who sets out on pilgrimage after being freed from a curse. Her story is moving, compelling, and breathtaking, and I strongly recommend this book to anyone who loves fantasy.
Another book I love that sadly seems like it may be out of print is Silver Moon by Catherine Lundoff, a book about a pack of female werewolves whose powers only emerge after they hit menopause. The book is a lot of fun, and the concept is fantastic. Also, the main character is also in the process of discovering her own identity as a lesbian, which is even better.
Lastly, I've found a few real gems where the genres of cozy mystery and fantasy intersect. My favorite of these is the "Family Skeleton" mysteries by Leigh Perry, which stars a woman in her 40s raising her daughter while trying to put together a life as an adjunct at a local college. She also solves mysteries with her walking, talking skeleton pal Sid. The books are hilarious, the mysteries fun, and the glimpses into the familiar-to-me existence of adjunct faculty very satisfying.
I'd love to see even more books with older women as protagonists instead of background characters. What are your favorites?
Susan Jane Bigelow is a fiction writer, political columnist, and librarian. She mainly writes science fiction and fantasy novels, and her "Extrahuman Union" series is being republished by Book Smugglers Publishing in 2016. Her short fiction has appeared in Strange Horizons, Apex Magazine, Lightspeed Magazine's "Queers Destroy Science Fiction" issue, and the Lambda Award-winning "The Collection: Short Fiction from the Transgender Vanguard," among others. She lives with her wife in northern Connecticut, and is probably currently at the bottom of a pile of cats.
Tags: Susan Jane Bigelow, Women In Fantasy, Women in Science Fiction, Women in SF&F Month 2016
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Women in SF&F Month: Kari Sperring »


text:
Q: Flutter what does "Open for editing in Android Studio" do Perhaps this is a dumb question, but WTH... I've created a Flutter app in Android Studio, running it in AVD devices, etc. I've reached the stage where I'm looking to sign the app, and the docs tell you to use Tools> Flutter>Open for editing in Android Studio.
What exactly is this doing? What's the difference between the first editing session, and the newly created one? The new session has many more Build menu options, including the one necessary for signing, but why aren't these present in the first editing session?
I've tried looking for any explanations for this, and drawn a blank. Always keen to learn... :-)

A: Do it the simple way.
In android studio: File -> Open -> (your project's folder)/android and open it in a different window.

redpajama_set_name: RedPajamaStackExchange


text:
Die Schwedische Badmintonmeisterschaft 1945 fand in Stockholm statt. Es war die neunte Austragung der nationalen Titelkämpfe im Badminton in Schweden.

Titelträger

Referenzen
 Annual Handbook of the International Badminton Federation, London, 28. Auflage 1970, S. 289–291.

1945
Badminton 1945
Badmintonwettbewerb in Stockholm

redpajama_set_name: RedPajamaWikipedia


text:
Overland Park committee approves equipping officers with body cameras
Posted 10:06 pm, July 10, 2019, by Dave D'Marko
OVERLAND PARK, Kan. -- Overland Park moved closer to giving all its uniform officers body cameras Wednesday night.
Police pitched a plan that could ultimately cost up to $750,000 to the city's Public Safety Committee. The committee unanimously approved a $430,000 contract to purchase 200 body cameras. Additional money is being reserved for storage.
During an hour long discussion on the issue, the committee members had lots of questions about the policy, how police planned to use the cameras, when they'd be turned on and who could view the videos later.
Police showed a demonstration of how body cameras could help them in traffic stops and other interactions with the public.
They explained the body cameras, like dash cameras, are triggered by the vehicle's emergency lights, but they can go back and get unrecorded events for up to 24 hours if someone makes a complaint.
"This is important to us, but it's important to our citizens, it's transparency and accountability at it's best, and we have the resources to provide that and we are very interested in moving forward with the program," Chief Frank Donchez said.
Transparency is something the mother of John Albers says the city needs. Albers was killed by Overland Park Police as he backed out of his driveway where an officer was standing. FOX4 investigated the circumstances surrounding the case, relying on doorbell camera footage provided by neighbors and the police department's dash camera video.
Sheila Albers has since joined a program called JOCO United advocating for better training for officers responding to mental health calls.
"I don't know if body cameras would have necessarily saved John's life, but I do think it would have improved accountability and if we would have had some better de-escalation training and body cameras both, the outcome could have been different," Albers said.
The use of body cameras right now is mixed throughout the Metro. Johnson County, Olathe, and Grandview , for example, all have them. Lee's Summit has a few for K-9 and motorcycle officers, and will put the issue to buy more before voters next month in a bond issue.
Meanwhile ,Jackson County and cities like Kansas City, Missouri, Kansas City, Kansas, Independence, and Raytown don't have them right now. Spokespersons for each of the police departments have expressed interest if they could fit them into their budgets and work out factors like storage and policy.
If Overland Park City Council approves the body cameras, police expect to have the cameras in use by the end of the year.
Topics: Nightside
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Overland Park van thief also makes off with little girl's special blanket
Kelsey Smith's family says report of 'suspicious man' approaching women in Overland Park hits close to home
KCPD asking city for $7.2 million for new dash cameras for police cruisers
Sprint's new office culture: Less cubicles, more Kombucha
Bodycam shows Missouri officer rescue toddler as flames shoot out of house window
With police shootings in spotlight, FOX4 gets a first-hand look at technology helping train cadets
Overland Park armed robberies caught on camera
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Residents fail to save gazebo; Overland Park votes to replace it with airplane-shaped bandstand


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