Vice President and New Executive Vice

Case Analysis ReportFMB&T Bank I. Statement of the Problem The new Executive Vice President and Chief Information Officer of FMB&TBank have no clear authority and responsibility. II. Objective There should be a clear authority and responsibility for the new IT Executivein order for her to be effective and efficient. III. Analysis of the Causes a. Relationship between IT Department and other bank business units ismixed up causing considerable confusion, friction and inefficiency. . Work request are vague and not coordinated and consolidated to reflect aclearer picture of the problem making it hard to formulate a quick solutionwhich the bank’s other business units require. c. The presence of the new IT executive was not welcomed by the unitmanagers of other business units of the bank making it harder for her tofacilitate solutions for IT problems. d. IT staff responsibilities are limited only to application works.They are notgiven the freedom to explore and apply new development s in the ITindustry. e. There is considerable influence from other regional executives todecentralize IT operations to regional branches because they feel thatresponse will be faster to meet their requirements. IV. Choices a. Define an explicit authority and responsibility of the new IT executive. Thespan of authority should include all business units involve in the use IT toensure that all will follow IT processes and procedures. . The new IT executive must formulate strict IT policies and procedureswhich have the approval of the CEO and all IT users are required to follow Failure to follow IT policies and procedure should be dealt with inaccordance with company’s existing rewards and punishment policies. c. Involve IT staffs in a more flexible working environment and give them thefreedom to take advantage on new IT innovations and apply it to thecompany’s IT system. d.Re-organize the company’s whole organizational structure to adapt intothe new requirement of IT technology rather than remain as rigid as thecurrent vertical structure. e. Decentralize the whole IT department operations to regional branches inorder that implementation will be faster. V. Selection from the Choices As a CEO, I will reorganize the whole organizational structure of the companyand include IT as a major division in the implementation of companystrategies. If a bank wanted to grow in this generation, it must be willing toadapt to technological innovations.Task the new IT executive to formulate ITpolicies and procedures that will be implemented company wide where all ITusers are required to follow. VI. Implementation IT department should be given blanket authority in terms of implementing ITstrategies of the company and this should be understood by all departmentsand divisions. The new IT executive should create a company wide IT helpdesk where allwork requests are consolidated, analyzed and collated to come up with anintelligent solution to all IT problems.This wi ll also eliminate confusion;friction and inefficiency since all information needed to create a solution arealready consolidated. The only thing that IT will do is to design a frameworksolution to any imaginable IT problems that were presented based on the IThelpdesk consolidated information. With this strategy, IT will have moreefficient control of its resources and channel saved resources in developingnew IT innovations that they can apply for the development of the company. 2 VII. Work place applicationIn our company, the IT department has full control of all IT related issues. ITdepartment has regional helpdesk to cater to all IT related work requests. TheIT helpdesk will in turn consolidate all work requests and assign qualifiedtechnical staffs that can best address the problem. For minor IT problems,the helpdesk will address it immediately by giving direct instructions to theuser. If technical intervention is required, a district IT technical staff will beimmediately dispatched to address the problem

Lord Of the Flies Mood Essay

With close reference to the extract, show how William Golding creates mood and atmosphere here. (10) In this extract, we notice that it is the ending events of the novel. So, we can identify that all chaos and destructive events have taken place; as a result, their impacts upon the characters have taken their toll. In the opening lines of the extract, Golding (straight away) creates a sombre mood towards Ralph, when the officer said ‘How many of you are there’ and Ralph responded by shaking ‘his head.’ What this shows is that Ralph is clearly astonished and mesmerized – as if he had a flashback- by all the misfortune that occurred on the island. He does not reply verbally, but, by the absence of this, Golding creates an additional distressful mood between Ralph and the reader; which in turn creates a sorrowful atmosphere. This atmosphere is prolonged through when we see the description on the appearance of Ralph. When asked about authority, Ralph says that he is in charge, ‘I am,’ however after this; a sense of visual cleansing effect emerges. In other words, as a reader, it is like the wool has been taken away from Ralph’s eyes, as he realises who he really is, ‘A little boy,’ with a ‘black cap’ and ‘red hair.’ Next we see that the mood changes into a remorseful one when in this section; Ralph may have been reminded of the withdrawal of an adult figure. Yet, when reminded of piggy through the ‘spectacles’ he ‘changed his mind’ and ‘stood still.’ What I infer from this is that Ralph is reminded from the rational and parent like figure of Piggy: which in turn creates a despairing atmosphere. This atmosphere is maintained throughout the extract. We see next that the officer is quite disappointed as a group of ‘British Boys’ would have put on a ‘better show.’ This disappoin ted mood, created by Golding, is inserted to show the escalation of violence and change that has commenced on the island. Also, the removal of law and justice in which the British are popularised to uphold. Ralph himself realises this and through his response, we see his how this was to be, but later, this ‘British society’ had fallen out of hand. ‘It was like that at first,’ ‘we were together then.’ Golding shows this disappointed atmosphere through Ralph’s unfinished sentences. In the last two paragraphs, realisation, of their surroundings, between all the characters have been distinguished. This atmosphere is seen as the island was once a ‘strange glamour,’ now its ‘scorched up.’ Furthermore, with the deaths of Simon, and ‘jack had†¦Ã¢â‚¬â„¢ killed Piggy, tears and sobbing took them  all. In this, we see that there are contrasts to the father and child theme. We see this by the words ‘filthy body’ and ‘unwiped nose’ which can relate to childish features. As a result, this creates a heartfelt mood towards the characters. In the ending, we see that the officer looks at the tri m cruiser in the distance. Why Golding created this is possibly (in my speculation) as a new leaf/page, a symbol for freedom, in turn, creates a positive atmosphere.

The Theme of Perfection and Imperfect in the Poem ‘God’s Grandeur’

In the poem ‘God’s Grandeur’ by Gerard Manley Hopkins, the theme of imperfection and perfection is highlighted. The majority of the poem is a contrast between imperfection and perfection. The first stanza discusses the contrast between the two themes; perfection and imperfection, while in the second stanza; God’s perfection is mainly spoken about. Perfection The mere title of this poem suggests the poem is about something great and powerful. The word ‘grandeur’ is defined as splendour and impressiveness. This word is frequently used when referring to appearance or style and is a synonym and implication of perfection.Therefore, the poem’s title is suiting and signifies God’s perfection and His grace. In the poem, the earth and nature is also seen as a symbol of perfection, as it is made and controlled by God. This is evident in line one, which quotes â€Å"The world is charged with the grandeur of God. † This shows that natu re is seen as pure and it is renewed at this point to be slowly changed by imperfections such as man. In line six it is stated that ‘all is seared with trade; bleared, smeared with soil; And wears man’s smudge and man’s smell. However nature is relentless and proves itself to always be perfect, no matter how many attempts man tries to destroy it, it just always finds a way bounce back what harm man does to it. Lines nine and ten state ‘†¦nature is never spent; there lives the dearest freshness deep down things. ’ These phrases clearly prove that the earth will not lose its purity due to man. The Holy Ghost’s presence with vitality and life and al luminous things are what keep the earth together, with warm breath and bright wings. ImperfectionIn the poem ‘God’s Grandeur’ the theme of imperfection directly deals with the attitude and the action of man. God has blessed man with a wonderful earth, a natural home with abund ant resources to help man to survive, but unfortunately man has become blind and ungrateful. For centuries man has destroyed the earth for selfish gain. This can be shown by the phrase ‘the soil is now bare’, which gives the image of a desolate, dry earth whose resources were used for the wrong purposes. The phrase ‘nor can foot feel’ hich contains an example of alliteration and also imagery, shows how man has separated himself both physically and spiritually from nature and the earth which God has blessed them with and consequently they are also separating themselves from God. The poet’s tone of gratitude and awe throughout most of the poem clearly shows his disappointment of man’s treatment to the earth due to ignorance selfishness and ingratitude which contribute to man’s imperfection. Even the phrase ‘why do men then now not reck his rod? ’ show that the poet does not understand why man does not give God the thanks and respect that He is due.Unfortunately man does not realize that by trying to help themselves , they are actually hurting themselves , since they are destroying something that is keeping them alive. Most of the book of Matthew chapter five , especially Matthew 5:48 which states ‘you therefore must be perfect as your Heavenly Father is perfect’ clearly shows that due to man’s sin , such as selfishness, hatred, ignorance and in relation to the poem the misuse of God’s blessings , which contribute to man’s imperfection, can resultantly separate us from God.

Business law Essay Example | Topics and Well Written Essays - 1500 words

Business law - Essay Example Under the element of ‘agreement’, several aspects must be established to activate demonstrate a consensus on some of the major terms of the exchange: 1. Offer. There must be an offer for sale under clearly stipulated terms which includes a full description of the item(s) of exchange.The offer must be complete. Ordinarily this would include a description of the item(s) for exchange, nature of the item(s), the cost or price and any other sale-related features such as payment details. 2. Acceptance. The parties involved in the intended exchange must accept the offer as stipulated and communicate this acceptance within the period in which the offer still exists. Acceptance of the offertory terms becomes invalid when a counter-offer is made and allowed by the parties involved. 3. Genuine consent. Parties to the contract must have contractual capacity an additionally must freely enter into the contract. Elements of duress, mistakes and misrepresentation may render the acceptan ce void and thus, the contract too. Step III: Applications of the Rule of Law to Case Facts 1. Offer. Sally’s initial offer is for a dashing green Cadel Evans â€Å"GF† model bicycle at a cost of $6,000 payable upon delivery. The offer’s duration has not been expressively stated. ... Peter’s acceptance is conditioned on acceptance of his counter-offer and a communication thereof within the closure of business the following day. His liability becomes questionable at this juncture. 3. Genuine consent. By responding to the offer, both Peter and Burt are aware that they are entering into contractual obligations. There is however an element of duress on Sally’s part that may render her consent void. She hastens the delivery of the bicycle to Peter’s premises to make the amount duly payable for fear of foreclosure by the bank on her outstanding mortgage payment amounting to $4,000. 4. Contractual capacity. Their contractual capacity is valid as they have both attained the majority age. Conclusion Sally cannot draw a suit against Burt for any breach of contract since he expressly denied acceptance of the adjusted $5,000 for the bicycle and communicated it in reasonable time to sally.The contract therefore does not exist between the two individuals.S he might have had a claim against Peter except that it might be proved that there was lack of a genuine intent by sally to provide reasonable time for Peter to communicate and finalize the sale agreement i.e. It can be interpreted that Sally only entered into the contract to transfer her liability from the due mortgage and foreclosure to Peter. At Law, no contract can be valid if it is entered into with malicious intentions. However, ignoring the performance of the contract, Sally can enforce legal action against Peter as per the $ 4,000 under the contract for sale since there was implied agreement through their email discussion that instructed the seller to make delivery of the bicycle as soon as his

Managing change Essay Example | Topics and Well Written Essays - 1000 words

Managing change - Essay Example When an organization changes its overall strategy for success, adds or removes a major section or practice. It also occurs when an organization evolves through various life cycles, just like people must successfully evolve through life cycles. â€Å"For organizations to develop, they often must undergo significant change at various points in their development. Thats why the topic of organizational change and development has become widespread in communications about business, organizations, leadership and management† (Organizational Change and Development).There are different types of organizational change, including planned and unplanned, Wide and partial changes of the organization, slow and gradual change, fundamental changes, etc.. Organization-wide change in corporations should involve the Board of Directors. Whether their members are closely involved in the change or not, they should at least be aware of the change project and monitor if the results are being achieved or not. Changes in management can be divided into two categories. One is based on individual change while the other is based on the organization. Normally the organizations won’t change. But the individuals can change. A large project usually associated with lot of individuals. The success of the project depends on the collective efforts of the employees. Even one employee’s negligence can spoil a large project. The individual change management principle lies in the understanding and appreciation of how one person makes a change. I know a person who is working in a tire manufacturing company as a tire builder. Though this fellow don’t have much education he has found out a new way to make use of the scrap rubber materials in the tire manufacturing unit. The company has promoted him as a manger and now he is working on scraps to make it again useful to the company. The new methodology adopted by this fellow has been properly rewarded by the company both of them have

Benjamin Franklin and the Economy of the Colonies Essay

Benjamin Franklin and the Economy of the Colonies - Essay Example Reacting to the advocates of the Stamp Act who claimed that the Seven Years War had been waged to the detriment of Britain to protect the interests of Native Americans, Franklin referred once again to the fur trade subject: â€Å"The last war was begun, not ‘for the immediate protection’ of all Americans, but for the protection of British trade, carried on with British manufactures among the Indians in America† (Greene 1995, 261). Franklin also commented on the dispatching of Braddock’s army by the Crown to America as a way to safeguard British trade and that the â€Å"trade with the Indians, though carried on in America, is not an American interest† (Greene 1995, 261). The war had been waged to create new markets for English producers and traders, and, as argued by Franklin, should justly shoulder the burden of maintaining the army (Isaacson 2003) that at the time inhabited the colonized lands. Economic Structure of the Colonies In a working colonia l economy, the capitalist interconnectedness of the colonies and the mother country generally resulted in a colonial imbalance of trade. The colonies pay for the products of the mother country and are pushed to produce those unprocessed materials needed by the colonial capitalists. In this process they are backed up by the new capital and investment of the balances of the mother country (Beer 1958). Hence, in the southern settlements, tobacco mostly was being generated to supply revenues for the British products the plantation owners needed; yet, since the trade left the British with a positive balance, its capitalists had by the 1770s at least ?4,000,000 spent in southern planting activities (Wahlke 1962, 1). To pay for the fees on these arrears, according to Wahlke (1962), southern planters were forced to continuously broaden their agricultural activities and to take part in the secondary operations of the fur trade and land assessment. Evidently, the northern colonies were a sour ce for iron, whale products, furs, and lumber, and these Britain greatly required sustaining her autonomy of European supplies. Through payments, the loosening of trade limitations and the rewarding of preferred places in the main market, Britain tried to persuade these businesses, in part because it needed these materials and in part to deflect northern capital from reaching into manufacturing, shipping, and shipbuilding (Greene 1995). Yet, the policy was a failure. The northern colonies were purchasing more and more volumes of British products and services, and were hence heavy debtors in the direct trade (Greene 1995). Obviously, these economic systems only benefited the British capitalists and merchants in terms of favorable balances. The colonies in turn were increasingly buried in debt. In the system of mercantilism, colonies were obliged to support the mother country in gaining an export surplus, economic independence, and favorable balance of trade. Colonies were obliged to provide supplies which would otherwise have to be acquired from non-colonial reservoirs, produce exports by the manufacture and trade of goods in high demand in other markets, and supply a market for the exports of the mother country (Greene 1995). In return, the mother country would furnish the settlements with military protection, and centralized regulation of the economy. But mercantilism was ‘not an American interest’

Sunbelt South Essay Example | Topics and Well Written Essays - 1000 words

Sunbelt South - Essay Example The book continues in this vein moving along the time line until the second world war from whence a tremendous change starts sweeping through the south; altering its identity amid strong global influences. This change is witnessed amid strong resistance from the south’s white leadership who try to stem the new influences that threaten to change the status quo that has existed and given the south its distinct identity up to that point in time. Cobb uses a huge base of historical and literary references to illustrate his points and succeeds in providing a very balanced and unbiased account of the state of the south. The only criticism that can be leveled his way is the lack of reference to the medical situation through out the narration. The health maladies that plagued the south at various durations over time have also had an impact on the self- identity of the south and deserved some mention as well. To illustrate the state of the south since the Second World War, we have to r ely on the available literature and Cobb is a renowned historian of repute especially concerning the south. The study of the south is intricately interwoven with the history of America and its only fitting we look at it to understand the state of America since the end of the second world war. ... The image of the south has undergone change all through its existence and none is more profound than the change experienced after the Second World War and intensified during the civil rights era. The white supremacists fought hard to cling on to the status quo from this period but the winds of change were blowing harder and getting even harder to ignore. The very definitions of the southern way of life as it was known up till then were shaken to the core. The African Americans were at this time examining their southern heritage more keenly and openly and beginning to embrace their southern heritage amid their championing of their black identity. There is a distinct feel of the south’s development and evolution being dissected in the book and its wide array of relevant topics got fromfrom the national ascendance of southern culture and music, to a globalized Dixie's allure for foreign factories and a flood of immigrants, to the roles of women and an increasingly visible gay pop ulation in contemporary southern life. The heart of the book illuminates the struggle for Civil Rights. For instance the author refers to a time when Jim Crow still towered over the South in 1945, but Cobb shows that Pearl Harbor unleashed forces that would ultimately contribute to its eventual downfall. Rising black political influence outside the South and the incongruity of combating racist totalitarianism overseas while condoning the same at home, created the opportunity for returning black veterans to organize the NAACP's postwar attack on the South's racial system. This assault elicited not only vocal white opposition but also led to increasing violence that climaxed in the murder of young Emmett

Best theories explain crime Essay Example | Topics and Well Written Essays - 1000 words

Best theories explain crime - Essay Example There are numerous theories such as rational choice theory, strain theory, social disorganization theory, social learning theory, and social control theory, labeling theory as well as biology, genetics and evolution. Although there are many theories that have been put forward to explain why some people have high propensity to commit crime, I find strain theory to be the most suitable for explaining crime. Robert Merton, a sociologist from the United States, was the first to assess criminal behavior using Strain Theory in 1938. According to Merton’s Strain theory, all members of the society have the same aspirations, but have varying opportunities or abilities to achieve their aspirations (Agnew & Brezina, 2010). Consequently some people will fail to achieve what the society expects of them through accepted ways like embracing hard work first then enjoying the fruits of labor later in life. Merton identified and explored five basic adaptations of people who cannot legitimately achieve the societal aspirations. These include: innovation, rebellion, conformity, retreatism and ritualism (Rios, 2007). Conformity is where a person acknowledges that he or she cannot attain goals expected by the society and embrace the limited opportunities within their reach. Innovation is where an individual resort to illegal means to attain societal goals. Rebellion is where an individual disowns b oth societal goals as well as the means of achieving them and decides to give life a different approach. Retreatism also rejects societal goals and means of attaining them while ritualism is where an individual gives up hope on societal goals, but still embraces the means of achieving them (Rios, 2007). The choice of Merton’s Strain theory as the most appropriate for explaining crime is informed by its pragmatic approach and coverage. Strain theory further takes into consideration cognitive dissonance for every societal member in examining the tendency of

Sales Management Essay Example | Topics and Well Written Essays - 1500 words - 2

Sales Management - Essay Example However, such a powerful sales campaign could only be launched successfully provided the members of team obtain respectable and considerable remunerations against the efforts they make while performing their professional obligations. In other words, if the members of sales team are offered a handsome salary package, along with incentives on the sales item they is expected to sell, there would be smile on their faces because of the financial satisfaction they gain in the wake of achieving their goals and targets. On the contrary, if the sales staff is offered low salary package, with no or least incentives on meeting with the targets, the sales staff would remain extremely worried, disturbed and dissatisfied, and hence will not be in a position to demonstrate his professional skills in an adequate manner. According to the motivation-hygiene theory of job satisfaction (1959), articulated by German-American psychologist Frederick Irving Herzberg, pertinently lays stress upon the fulfilm ent of the hygienic or financial needs of the staff in order to let them work under the state of great satisfactions. It not only help the company to make tremendous achievements, but also the sales staff will work more diligently for the progress of the organisation (Stello, 2009:5). On the contrary, lack of financial growth and denial of providing them with sufficient salary package, the sales personnel will undergo dissatisfaction, due to its being a negative motivation. Q1: It has pertinently be observed that sometimes the organisations earn great profits against the investments they have made; similarly, they also undergo losses or low profit margin, which force the management to introduce... According to the research findings sales department is rightly stated to be maintaining central place in every organisation of the world at large because of its imperative significance in the growth and development of the organisation. The researcher states that sales personnel that play front at the behalf of the company and they are actually the reflection of their workplace, where the society gets oriented with the company through their behavior, proficiencies and professional skills. Since every activity performed at corporate scale is made with the purpose of financial benefits and pecuniary gains in mind. Being one of the most dynamic parts of corporate organisations, sales staff also embarks upon the corporate venture for meeting their financial needs. Because of the crucial significance of the sales function, the sales manager occupies a key position in the management hierarchy of the sales organisation. This essay also looks into the exploring the ways for motivating the sales force, different methods are applied for increasing sales volume. Author claims, that one of the most important steps to be taken by the managers for motivating the sales force includes the fulfillment of their physiological needs, along with assuring them of the job security, social respect, and safeguarding the issues related to ego and self-actualizing. As a conclusion, the essay paper highlights, that the selling operation of a business firm does not exist in isolation and sales management has to work in a broader and newer environment.

Patent Litigation and the Internet Article Example | Topics and Well Written Essays - 750 words

Patent Litigation and the Internet - Article Example It is evidently clear from the discussion that 21 smartphones in Samsungs lineup, including the newest iteration of its Galaxy line the Galaxy S III, are being targeted for the ban. The goal, it seems clear, is to shut out Samsung from this important market, and in other key markets around the world. Taking a step back, differentiation for Samsung comes, first from the scale and the ability to compete on scale economics rather than design, and later with innovations around design, manufacturing, software and apps, new materials, further improvements in scale for component parts. The case highlights the notion of the smartphone industry in general as being an area that is fraught with litigation, where patents are being used as weapons in a kind of arms race for supremacy in the space. The estimates at present are that about 250,000 different patents cover a smartphone from the skin to the electronic board, and each of those patents can be used to claim some stake in the whole technol ogy. That claim can be used to ignite patent litigation. It is noteworthy that Apple's patents cover areas tied to design, which moving forward are considered to be harder to enforce in comparison to the nuts and bolts engineering and technological patents that other patent holders, such as Nokia and Samsung, hold. In the fray too, are patents from other major players, such as Microsoft, and to a lesser extent, Google, the latter being the indirect target of the Apple patent suits against Samsung. Experts note that Google is really the ultimate target of the Apple suits, and linked to Google, all the other major players in the Android ecosystem, including HTC. Yet smartphones technologies and patents differ too, in one crucial respect, in that while patent lawsuits can temporarily derail market advancement, in the long run, engineers are able to create workarounds that skip using contested technologies and patents altogether, or else manufacturers such as Samsung are forced to enter into   patent licensing agreements when the patents in question are essential and irreplaceable.

Chester Company Essay Example for Free

Chester Company Essay A unique and interesting problem arose when one company, a monopoly within the business-to-business (B2B) sensor market, split into six companies with identical products and equal footing within the market. As Director of Finance for Chester Company, one of the newly formed entities, it is important for me to identify a strategy that will enable the company to remain viable and be successful in the future. An in-depth analysis of the industry situation report provided good metrics to project future customer desires and total market potential. In order to be successful, the strategy that the management team develops must work within the identified parameters while attempting to predict how the other five companies in the B2B sensor market will proceed. There are only two segments of the B2B sensor market: low technology and high technology. The only product Chester Company offers currently fulfills the needs of both markets but this will change as the newly formed entities revise and develop products to meet customer needs. The high tech segment is appealing but will require continual investment in research and development to maintain the standards that customers expect. It will be easier to meet the needs of the customers within the low tech segment but there will likely be more competition for market share. 1. The strategy that I would like to see the management of Chester Company adopt over the next five years is that of â€Å"niche cost leader† (Capsim Management Simulations, 2012) for the low technology segment of the B2B sensor market and to obtain thirty-five percent of that market. This will be achieved by appealing to customers’ sense of thrift. To cut prices below the competition, management should retain the current product and not invest much in research and development. Production costs must also be greatly reduced. To do this, an early investment in automation is necessary as it will reduce labor expenses in future years which will increase the margin and profitability of the company. This investment will be financed through the issuance of stock and long term bonds. I also plan to provide the marketing department with a very generous budget in the first couple of years to aggressively target the market and increase the awareness and accessibility of the product early on. Short term borrowing will be necessary to finance operations and provide a cash cushion to prevent the need for an emergency loan. 2. There is a great chance for Chester Company to earn good profits within the low tech segment over the next five years. Although the price of the product must be kept to a minimum this will be offset by decreasing costs which increases the contribution margin. Also, there is greater demand for products in the low technology segment of the B2B sensor market which is expected to increase approximately ten percent each year. However, Chester Company shareholders may realize a loss in the first year due to the high marketing budget and cost of labor because the automation rating is low. Unfortunately, some sacrifices will need to be made early on to realize greater profits in the long term. 3. The product that is most important to the success of Chester Company is Cake; the product currently being produced. During the first year of business, this product will have the ability to appeal to customers across both segments of the B2B sensor market and will ultimately become the favored product of the low tech segment. Management will take advantage of the dual appeal of Cake in the first year by taking a portion of both the low tech and high tech markets in an attempt to retain some profitability. Ultimately, the product will be positioned so that it takes a large portion of the low tech market and will likely not take any portion of the high tech market by the fifth year. The plan that I developed focuses primarily on the success of the company for the next five years as there will be a lot of volatility in the market and further projections are impossible to make at this time. It is difficult to predict how the competitors within the B2B sensor market will be positioned which makes it essential for management to decrease costs as much as possible and increase market share within the low technology segment of the market. My advice to the rest of the management team is to avoid the appeal of developing a new product for either market early on and to avoid the high tech market altogether within the first five years because it will be difficult enough to remain profitable and succeed without squandering business assets on developing a product which will have little chance of being profitable within that timeframe.

Clinical Nursing Essay Example for Free

Clinical Nursing Essay Introduction Nurses utilize multiple theories daily to care for patients and their families, though these theories range from grand, to situation-specific, to mid-range the nurse tends to focuses on which theory will provide the best care to his/her patient. Perhaps in my opinion mid-range theories with their growing frequency of use are best suited for nursing in the 21st century. Mid-range theories are said to be middle rather than ordinary but they are specific enough to evaluate observed situations (McCurry, Revell, Roy, 2009). There are multiple reasons why mid-range theories offer some of the most up to date information when it comes to the care of our patients and families, but let’s just break it down to three; interpersonal relations, family, and health promotion. The middle range theories of these three examples will provide a set of assumptions and/or predictions from specific situations confirmed by research (Nolan Grant, 1991). Interpersonal relations First, Hildegard Peplau’s Theory of Interpersonal Relations has influenced patient care in the 21st century worldwide. What is so crucial and probably most significant with this mid-range theory is its focus on human issues and its value of future generations (Barker, 1998). Nurses utilize this theory to treat each patient as an individual realizing that each person and their situation are unique. By applying this knowledge to each patient the nurse is able to develop a therapeutic relationship, which will promote the planning and implementation of nursing care. For nursing care to be successful they must view the nurse/patient relationship as a partnership being aware both are working together for a common goal (Barker, 1998). Also, interpersonal relations are used in all areas of nursing, which is why it is so important for the future of nursing, because without these relationships we would not be effective in our profession. These relationships are needed to expand our know ledge of each patient and their situation. By establishing trust the patients are encouraged to express themselves openly and honestly. Therefore the relationship built bridges barriers that may have hindered the patient outcome. Family Second, Hildegard Peplau’s mid-range theory of family systems has revolutionized the nursing approach in which families are incorporated into decision makers. Currently, families are viewed as the most influenecial person when it comes to the care of their loved one, meaning not only are nurses to build a therapeutic relationship and trust with the patient but with their family as well (Forchuck Dorsay, 1995). This theory molds nurses into advocates for the family unit, which in turn influences the patient’s quality of life. These relationships with families are crucial when it comes to care, for example, if a patient was unable to provide the nurse with health history or tell them when they are in pain the family is able to be the eyes, ears and speech of their loved one. This action improves the care for the patient and nurses need the families as much as the patient needs the nurse. This is one of the reason’s why this theory works in the 21st century even wi th all the technology in the world, we as nurses still need the human interaction to open our eyes to the patient/family dynamic. Family system nursing is both the individual and the family simultaneously instead of just merely family nursing where the nurse takes care of the patient within the context of the family (Forchuck Dorsay, 1995). This practice focuses on the interactions and relationships made between the nurse, individual and family. In order for this theory to be successful the nurse must be aware of the range of choices and downfalls associated with family system nursing. Also it is necessary to build on these relationships to provide creative personal choice and consistent flow of care for the patient to enhanced achievable goals. This engagement of nursing with family systems opens the door for problem solving of patient situations, which implements structure in the nurse/individual/family relationship (Forchuck Dorsay, 1995). Health promotion Third, is the promotion and maintenance of health by utilizing Nola Pender’s Health Promotion Model. Health promoting behavior is enhanced through nursing practice, which enhances the patient’s overall well being. This mid-range theory is important today because it guides a supportive and educative system in health promotion in a patient who needs teaching and  demonstration in performing self-care. By applying this method the nurse is able to identify patient’s health promoting behavior’s such as, health importance, self-efficacy, perceived control of health and perceived health status to find any gaps and/or barriers to their health promoting behavior (Simmons, 1990). By promoting health the nurse seeks to care for the individual by developing these behaviors of healthy living, which sets the stage for the individuals to gain knowledge to care for themselves. This applies to all nurses who actively promote healthy living by becoming an active influence in developing healthy living behaviors through education and guidance. Conclusion These middle range theories set the groundwork for research. Each are utilized daily in clinical practice to provide the best patient care. The rationale for considering the middle range theories is an important factor when considering a care plan, which requires the use of the nursing process. These theories follow the nursing process and help guide our responses to promote, educate, integrate and build relationships with these individuals and their families with the same common goal of promoting health. These authors point out how the nursing profession is influential in the care of other and how their actions influence health beliefs. These middle range theories build on other theories, which is why they are so important in nursing practice today. These theories can be used in different areas of nursing as well as using multiple theories in one area of nursing such as mental health. Also, middle range theories have identified multiple interventions for health related issues throug h simple research (McCurry et al., 2009). Nurses like myself have adopted these theories and incorporate them into daily practice to increase my own understanding of my patient and their situations and this is why I chose middle range theories. References Barker, P. (1998). The future of the Theory of Interpersonal Relations? A personal reflection on Peplau’s legacy. Journal of Psychiatric and Mental Health Nursing, 5, 213-220. doi:10.1046/j.1365-2850.1998.00128.x Forchuk, C. Dorsay, J. (1995). Hildegard Peplau meets family systems nursing: innovation in theory-based practice. Journal of Advanced Nursing, 21, 110-115. doi:10.1046/j.1365-2648.1995.21010110.x McCurry, M. Roy, C. (2009). Knowledge for the good of the individual and society: linking philosophy, disciplinary goals, theory, and practice. Nursing Philosophy, 11, 42-52. doi:10.1111/j.1466769X.2009.00423.x Nolan, M. Grant, G. (1992). Mid-range theory building and the nursing theory-practice gap: a respite care case study. Journal of Advanced Nursing, 17, 217-223. doi:10.1111/j.1365-2648.1992.tb01876.x Simmons, S. (1990). The Health-Promoting Self-Care System Model: directions for nursing research and practice. Journal of Advanced Nursing, 15, 1162-1166. doi:10.1111/j.1365-2646.1990.tb01708.x

Advantages and disadvantages of the different economic types

Advantages and disadvantages of the different economic types What is economics? Economics is the study of the forces of supply and the demands allocate deficient resources. Economics is divided into microeconomics and macroeconomics. Microeconomics is something doing with the behavior of firms, consumers, and also about the role played by the government. Macroeconomics is more to inflation, industrial production, unemployment and the role played by the government. Microeconomics is the study about the behavior of small economics unit, for an example, individual consumers or households. Microeconomics is behavior of individual units. Microeconomics main concern is about the factors that affects an individual economics choice. Other than that, economics also can be said as branch of social science that can read the production distribution and the consumption of goods and service. Economics also include scarcity, choice, households, goods and productions as a definition. Economics system are studies of the method and institution where societies determine about the ownership, direction and allocation of economics. There are three types of economics system; Socialist system is a system that can be defined as a centrally planned or can be said as command economics. This system is fully controlled by the government. All the choice about resources are all made by the government. Capitalist system means free market economics. This system is like a freedom economy. This is because of the decisions made by the people. This system is mainly about the people in the country. Mixed economy Mixed economy is an economy based on the free enterprise principle. There is still some form of direct intervention and it is controlled by the government. Mixed economy can be said as a form of organization where both capitalist economy and socialist economy are found. In mixed economy there is the presence of private economic freedom with centralized planning and the common goal of avoiding the problems which comes because of capitalism and socialism. In the mixed economy system the main authorization of the economic activities are mainly by the governmentà ¢Ã¢â€š ¬Ã¢â€ž ¢s regulation and the licensing policies. For an example, if someone wants to open a business, they must register and take license from the government for that particular business. So in this way, the government becomes a big power in the country. Mixed economy is also known as dual economy. In a mixed economy, the government runs things as post office, libraries, hospital and many more. Even when there is an industry which is not run by the business, still government get taxes and regulation like wage controls. Most of the people all over our country have no problem with the government take control of things like highway construction, birth certificate, national service economy may seem to be very easy as it is but there are some disadvantages in mixed economy also. The biggest disadvantage is between the public and private sector because they easily get blurred or sometimes shift one way or another from time to time mixed economy usually increase more government control and less individual freedom. This is why mixed economy is always in an evolutionary process. Mixed economy involve in two sectors which are public sector and private sector. Both of these sectors exists and function to achieve the national objectives. Both of these sectors is the one make the economic system in the country. Mixed economy is the combination of private enterprise with the government enterprise. There is also freedom of enterprise, private ownership and profit earning in this economy. This economy is used in most of the countries in the world. There are a lot of advantages in mixed economy, for instance, mixed economy help in increasing the national production in the country. In mixed economy, both the public and the private sectors work hard to bring out more good production. The entire problem which is created by the free enterprise and the public control are solved through the mixed economy. Mixed economy provides freedom of enterprise ownership and also the profit earning. There is also social welfare and political freedom in mixed economy. Other than that, all the national resources are utilized under the mixed economy. Most countries in the world have mixed economy. The mixture of two economic can imply a variety of difference for the country. Some of the differences are beneficial and some are neutral. Mixed economy can keep the workforces employed and provide a market for the raw material that they consume in the production. Additionally, mixed economy has the ability to ensure production of social goods. Disadvantages of mixed economy are that it is a half way house. Mixed economy is not very helpful in access optimal use of national resources. Other than that, mixed economy also suffers from disadvantage of both the capitalism and the socialism. Mixed economy is said seldom to achieve progress. Mixed economy also has unsuccessful regulations that may paralyze features of production. Mixed economy also has a problem such as lack of price control management that can cause shortage in goods and this can result in a recession. The disadvantage of a mixed economy really depends on how it is. For an example, if the mixed economy is more to the command economy, it is not too good also. Mixed economy also has many different characteristics. For a example, mixed economy, A might have high tax low regulation while mixed economy B might have mow tax high regulation. This shares a different set of disadvantage because set A gets more profits because of the high tax but as for B it will get lesser profit of the lower tax. Free enterprise system is an economic system where individuals can make their own economic decision. Because it is said free from government constraints. The advantage of free enterprise system is because there are no government restrictions and this makes more opportunities for the individuals. Therefore, in free enterprise system are more potential for private business. Individuals get more freedom and business opportunity because of the enterprise systems. There are more profit in free enterprise system and less competition and also there are more demands in the production and distribution of goods and services. As there is always a advantage, there is also disadvantage in free enterprise system. The disadvantages are lack of government control, for example, corruption and bribery. In free enterprise system this is the main problem, bribery. The control of that state goes to few hands and the economy move more towards monopoly system. Moreover, there are no reforms in the state an d there is also income gap that increases which paralyze the economy in a country. Central command system refers to a system which is organized by a government. Central command system usually determines how a countryà ¢Ã¢â€š ¬Ã¢â€ž ¢s resources should be exploited. Other than that, it also shows how goods and services should be produced and how it should be distributed. Most industrialized countries practices some form of government oversight. Central command system can be said as a true planned economics. Some of the central command system has permit transactions on a small scale but some larger industries are either managed directly. This is why mixed economy is said to have the combination if the free enterprise system and the central command system. The advantage of both the free enterprise system and the central command system is the combination of the mixed economy .In mixed economy, price mechanism plays a part. Price mechanism is allowed to operate but sometimes in some cases the price mechanism fails or can say that it fails to work against public interest. What is price mechanism? Price mechanism is system of interdependence between the supply of a good or service and the price. Price mechanism is basically about the price up when supply is below demand and price down when the supply exceeds demand. Price mechanism also stops supply when suppliers leave the price when the supplies when suppliers leave the market due to the low prices and increases the price there is more suppliers enter the market due to the high price. Price mechanism is also called price system. Price mechanism operates in a free market situation where their forces of petition and supply mechanism prices. Both the producers and the consumers base their specific production and the consumption plans on the current market price. When the consumers pay the price foe a commodity, they motivate the producer of that commodity. The entire price that is paid becomes a vote for more production. Prices are determined by the shortage and surpluses. Sometimes there is shortage of product. This is because of the price to rise, whereas the surplus causes the price to fall. The price is the one which determine how much of a product a producer decides to supply. When the product price is high, the profit also gets greater and more products profit motive. When the consumer needs more goods or product, the demands get higher and this makes shortage of product or goods and this also causes the price to rise. This makes the consumers to be discouraged but the producers are encouraged to supply more. The price of the good will continue o tries until the shortage problem is solved. When this problem comes, how does the government play a part? The government plays a part by fixing the prices above or below the free market equilibrium. They also put tax on the production or the sale of the carious goods. Other than that, they also subsidize the production or the sale of the various goods. Price control is the clear example where the government intervention disrupts the price mechanism. The government subsidy will artificially reduce the price and boost the demand of the goods and as foe the government tax, it increases the productà ¢Ã¢â€š ¬Ã¢â€ž ¢s price to the consumer and decreases the demand also. This explains how government can help to sort out the problem of shortage of product and the raised up price. In a nutshell, mixed economy there is many advantages and also mixed economy helps to run a better country. Mixed economy makes a better economy in a country because of the give and take policy by the government and the people in the country. Economics should be stable as that the people in the country wonà ¢Ã¢â€š ¬Ã¢â€ž ¢t have any problems. Free enterprise system and central command system is the combination of the mixed economy. Both the system has a lot of advantages. Price mechanism must also be stable so that the mixed economy is stable. Price mechanism plays a big part because it can make havoc in the government and the consumers. Therefore, price mechanism works for mixed economy.

Casablanca :: essays research papers

Casablanca was a very interesting film. The first time that I watched it, I really had no idea what was going on. I found it a little hard to follow. But, after the second time around, a good portion of the movie became very clear to me. The setting takes place in Casablanca, Morocco and in Paris, France. At first the movie takes place in December 1941 at Rick Blaine's saloon in Casablanca. Rick has to deal with some illegal visa papers that he was given, and he hides them in the piano. Rick's former lover Ilsa comes with her husband Victor Laslo to the saloon. She is friends with the piano player Sam, and tells him to play the song As Time Goes By; Rick and Ilsa's "song." Rick comes in and yells at Sam to stop, and then he sees Ilsa. Then next scenes Rick is having a flashback to all the good times he had with Ilsa when they were in Paris, France. Rick and Ilsa are in love and plan to leave on a train to get married. Ilsa is really married to Victor, but she believes that he's dead. She finds out that he's alive and in a concentration camp right before she plans to leave with Rick. She doesn't go with Rick on the train and leaves him heartbroken. Then back in Casablanca Rick discovers that he's still in love with Ilsa. Rick tells his friend Louie, the police chief, about the illegal papers and plans to have him set up Victor to go to jail for having the papers so Ilsa and Rick can go to America. Rick decides that he can't go to America with Ilsa, because she'll regret it. Victor and Ilsa end up going to America on an airplane together. The most memorable scene of the film for me was when Ilsa comes back into Rick's life. She begs Sam to play As Time Goes By. He won't so she keeps saying, "Play it Sam..." When Sam does play the song Rick storms in and says, "I thought I told you to never play that again!" Then he looks up and sees Ilsa. They make eye contact and they remember all of their old feelings for each other. This scene is very emotional and you can tell exactly what they're both feeling. I think a filmmaker wanted to make this film to show what war can do to two people.

Lord of The Rings :: essays research papers

J.R.R. Tolkien's concept of too much power is summed up by Lord Acton when he once said, "Power corrupts, but absolute power corrupts absolutely." In Tolkien's first book of his fantasy based trilogy, Lord of the Rings, the Fellowship of the Rings tells a story of a quest to destroy a powerful ring throughout Tolkien's created "Middle Earth". This quest was headed by a "Hobbit" named Frodo Baggins who, in the end, becomes corrupted by power himself. This corruption begins when Frodo uses his ring to become invisible over and over again to escape certain situations. The quest to destroy the powerful "Ruling Ring" forms the basis for this story. The book begins with Bilbo Baggins celebrating his one hundred and eleventh birthday. Many "Hobbits" show up at his party including his third cousin, Frodo, which is the main character of the novel and a powerful wizard named Gandalf. Biblo possed a powerful ring known as the "Ruling Ring" which gives "Supreme Power" to whoever has possession of it. At the end of the party, Bilbo uses his magical ring to turn invisible and stun his guests. Gandalf, the powerful wizard, then meets up with Biblo at his house and takes the ring from Bilbo, which is corrupting him. Gandalf examines it, realizing that the ring Bilbo has is the powerful "Ruling Ring". Knowing that the forces of evil are in search of the ring, Gandalf sends Frodo, a relative of Biblo, to destroy the ring in the only place it can be destroyed, "Mt. Doom". Overhearing the talk between Gandalf and Frodo, Sam, a "Hobbit", that is good friends with Frodo is forced on the quest to aid Frodo. The two Hobbits set off on a journey in which they meet up with others that join them on their journey such as Gimli the "Dwarf", Legolas the "Elven" archer, Boromir a "Human" tracker, Aragorn the heir to the "Human" throne, two more "Hobbits" Merry, Pippin and the powerful "Wizard" Gandalf. They travel across "Middle Earth" fighting off many "Orcs" and "Black Riders" which are in search of the ring by the orders of the powerful evil "Wizard" Sauron. During their quest, they encounter many ambushes by the "Orcs" which they overcome and usually slay. In some of the ambushes, Frodo uses his ring to become invisible to escape from the "Orcs" and "Black Riders". Boromir asks to see Frodo's ring because he has a yearning for power and authority and then tries to take it from him.

Definition of Leadership :: Leadership Traits

In its simplest terms, leadership is the process of influencing the behavior of another person while fully respecting the freedom of that person (Encarta). Two aspects of this definition are important. First, a significant part of effective leadership is the close connection between the leader and the follower, which often determines the success of the leader's mission. Unfortunately, this leader-follower relationship cannot be created according to some simple formula. Without inspiration, involvement, and encouragement from both participants, the relationship can not be effective. Leaders, in particular, must give an extra effort to reach out to followers in order to initiate and develop this alliance that is so critical to the achievement of goals. The leaders face special challenges as they try to communicate and interact with their followers and potential followers to understand and know what they think and what they do. Developing their leadership style in response to diversity , and ethics will give them an edge as they build relationships with their subordinators. Secondly, leaders who begin to use force, coercion, and manipulation must later use more force, coercion, and manipulation precisely because their ability to influence - truly lead - is diminished. In my company I have never seen our lead to use any force to associates for achieving goals, because he’d like to be a true leader for a long time. I believe that there are times in the life of a team or organization when the formula leader appropriately exercises the authority of his or her position or deal with organizational issues. Leaders should know that creativity and innovation are the life blood of their organization. New ideas can lead to programs that are already going on or planned in the organization .So, the mission of every leader should be to search continually for ideas and programs that are superior to the organization is currently committed to. In a word, it's called progress. Leaders respect the dignity and worth of each follower. There are two behaviors which are keys to this. First, the director of our company has done everything possible to reduce status differentials in team, which had been based on socioeconomic factors and job titles. Secondly, he has made clear by his behavior that he valued and respected all followers, especially those who were less powerful, less healthy, less educated, younger, older, poorer, less skillful in communication, and different in race, language, religion, gender or sexual orientation from the majority.

Cosi Shows Us That ‘Fairytale Endings’ Do Not Reflect Real Life Essay

Cosi is a play set in the 1970s, when Australia and the world were facing political complexities, such as the conflict against the communist government and the happenning of the Vietnam War. It was a time when people had to choose their loyalties, causing great frustration and tearing the community apart. We are able to see this in Cosi in the lives of two best mates Nick and Lewis, as their priorities and commitments during that period of time, as well as conflicting social views with the rise of different social conventions such as ‘free love’ during the 1970s. It is a play within a play with parallel runnings with Mozart’s opera ‘Cosi Fan Tutte’, both plays explore the meanings of love and fidelity and how Lucy parallels the infidelity of the women in ‘Cosi Fan Tutte’. Nowra also allows us to see how the theatre works its magic, as a therapy not only for the insane but as well as the sane. As we slowly see the cast blossoming towards the end of the play, Lewis ends it by announcing some fateful happenings of the cast such as the deaths of Julie and Henry, giving an unfairytale like ending to the play. However not all had the same fate, we see how Ruth’s obsessive compulsive disorder allowed her to become a â€Å"time and motion expert† and Zac’s eccentricity making him a â€Å"rock and roll† player. ‘Cosi fan Tutte’ main theme is about a woman’s infidelity towards man. Despite the opera being set in the 1700s and facing problems with love and fidelity, it proves that society still hasn’t changed in that perspective with the characters in Cosi mirroring some of it’s values. The ‘free love’ movement during the 1970s also shows how society is becoming much more liberal in character and less conservative. The influence also caused a seperation between the community as some still stick to their conservative views such as Lewis, Nick and Lucy. Lucy redefined the modern meaning of fidelity by claiming she â€Å"only had sex with Nick, but slept with Lewis. † Lewis himself also holds his very bias view on fidelity, despite his obvious attraction towards Julie, he still claims his fidelity by â€Å"not having sex† with Julie even though he kissed her. This shows the society’s gradual evolvement by beginning to define it’s meaning of fidelity with the references to sex only. Nowra allows us to observe the discrimination and social defining ways of the people by beginning the play in a â€Å"burnt out theatre†, displaying the neglect shown towards the mental patients and the seperation it had formed between the sane and insane people. â€Å"They are just people who have done extraordinary things, thought extraordinary thoughts. † Nowra shows the fine line drawn between the sane and insane, and that those in the institution are not always as what the society defines them. The act of isolating mental patients shows the people’s way of dealing with kinks in the society, an easy solution. Julie for instance, is completely sane however has an addiction to drugs, â€Å"They don’t know how to deal with drug users† shows how the people had either the lack of knowledge or wasn’t eager enough to dwell into and solve the problem. Instead, Julie was prescribed more drugs for her habit, which did not break and caused her death in the future with an overdose. Zac also displays the extremities of drug consumption, causing him to have no control over himself and later not being able to appear in the opera. Such as ‘Cosi Fan Tutte’s’ use of Mesmer magnets and Cosi’s use of shock treatment for magnets showed the society’s inefficient way of dealing with problems. Through Cosi, whether insane of sane, the cast blossomed as they progressed on into the play and just like Justin’s main aim â€Å"to bring them out of their shells†, Lewis suceeded. Not only with them but from a shy and confused young man, Lewis came out with a stronger sense of leadership and confidence. He was more certain on what he wanted compared to earlier where he allowed Roy to grab his glory. Lewis broke up with Lucy and learned to console Roy before the opera showing a huge improvement from his character before, he â€Å"proved Roy wrong†. The cast showed lots of gratitude towards him in the end of the play even with Henry stuttering a â€Å"Tttthank you†, who before this could only communicate with the form of â€Å"shaking his head†. Despite his improvement in speech and confidence, Nowra made his fate a sad one showing the unrealistic ‘fairytale endings’, along with Julie’s overdose despite being discharged. Roy had showed no improvement with his continuous enthusiasm over the wards where â€Å"his fellow patients took petitions to get rid of him†. But with Ruth and Zac’s improved careers, Nowra shows that there are still hopes in ‘fairytale endings’.

Wishes

Let’s say, one day, you’re granted three wishes. Your first two wishes were used wisely, but you killed yourself using the third one. Or, let’s say you get three wishes, and you died before you could use the third one. Well, in the stories, â€Å"These Three Wishes†, and, â€Å"The Third Wish†, both of these things happened. And as you can see, they have similarities and differences. One of the main differences between these two stories is how both characters died. In â€Å"Those Three Wishes†, Melinda Alice killed herself by wishing herself dead.According to the story she quotes, â€Å"I wish I were dead. † (Gorog 124). In â€Å"The Third Wish†, Mr. Peters died from old age, and didn’t get to use his third wish. â€Å"In the morning Mr. Peters was found peacefully dead in his bed with a smile of great happiness on his face. † (Aiken 107). For these reasons, the stories differ. Another difference between these two stories is the personalities of the two characters. Melinda Alice was a clever, but cruel girl who thought of no one but herself. For example, in the story it quotes, â€Å"No, she was lever, even witty. † (Aiken 122). But, Mr. Peters was a kind and loving man. He even offered to use one of his wishes on his new wife, and turn her back into the swan that she originally was.In the story, Mr. Peters quotes, â€Å"Then shall I use my second wish to turn you back into a swan again? † (Aiken 105). There are also similarities between these stories. They have very important morals to them. In â€Å"Those Three Wishes†, the moral is, â€Å"Be careful what you wish for. † Melinda Alice saying, â€Å"I wish I were dead. (Aiken 124) maybe wasn’t the best thing to do. In â€Å"The Third Wish†, the moral of the story is, â€Å"If you really love someone, let them be happy. † Mr. Peters showed this by offering his wife one of his three wishes. Get ting wishes is not all what it’s cracked up to be. Yes, it’s fun to wish for everything that we want in life but, sometimes, they can cause more trouble than needed. And we don’t want to end up in a mistake that we can’t turn around.Comparison/Contrast Essay: â€Å"Those Three Wishes† â€Å"The Third Wish† Jordan M. Beard 8-04 September 16, 2010

Diabetes Type 1: Stem Cell Research

Stem cell therapy involves the direct transplant of islet cells to potential areas in the pancreas that have the ability to store and facilitate the differentiation of beta cells in the body. Such treatment is currently under progressive study in terms of its effectiveness and the possibility of fortifying the islet transplant’s resistance to autoimmune attacks antibodies. We discuss the actual procedures and different alternatives of stem cell therapy for DMT1 patients. The discussion covers the potential problems being confronted by such treatment, such as stem cell scarcity, autoimmune attacks against the islet transplants, etc.Lastly, discussion also covers the potential alternatives of the treatment, specifically (1) human embryonic stem cells, (2) cultured stem cells and (3) potential xenogeneic resources. In the conclusion, we have found several problems currently being faced by stem cell therapy. These problems include the scarcity of available islet grafts or transpla nts and the autoimmune risks that can dramatically hinder to the success of the therapy. However, various studies are currently being explored in order to obtain potential alternatives, such as xenogeneic stem cell resources, embryonic or progenitor alternatives, etc.Furthermore, we discover different methodologies in stem cell culturing and preparation techniques that confront the immunity problems most especially in post-transplant phase. These include the usage of different immuno-suppressing drugs, such as gastrin, etc. 2. Introduction 1. 1 . Type 1 Diabetes DMT1 is essentially the absence or severe insufficiency of insulin due to the autoimmune (e. g. CD4 interleukin attacks, cellular necrosis, macrophagial reactions, etc. ), environmental or viral destruction of beta cells (e. g. iral infections from mumps, etc. ) or insulin-secreting cells in the pancreas. Although, autoimmune reasons are the most commonly associated etiology that cause DMT1 condition. Apparently, the body an tibodies, specifically interleukins and minor interferons, recognize the antigenicity present on pancreatic islets as foreign substances, which consequently triggers autoimmune responses. The prevalence of DMT1 in United States is approximately 1 in 2500 for the age group of 5 years old, which 1 in 300 for every 20 years of age group.Although the most considerable nature of DMT1 is its autoimmune nature, prevalence of DMT1 in United States and European nations largely depends on two causations: (1) genetics and (2) lifestyle. According to the EURODIAB collaborative study, a registry involving 44 countries in Europe, states an annually increasing rate of DMT1 with approximately 3 to 4%, with a larger increase in some central and eastern European countries . The prevalence of DMT1 among 191 World Health Organization (WHO) member states and for all age groups worldwide is estimated to be 2. % in 2000 and 4. 4% in 2030 . DMT1’s beta cell destruction does not only consider the neg ative effects towards insulin production. Deficiency in insulin can directly lead to moderate to severe hyperglycemia that can further trigger problems, especially in (1) neural systems, (2) peripheral and central vascular regions, (3) cardiac and (4) kidney areas. Vascular complications among DMT1 are associated to different cellular dysfunctions, such as Endothelial Progenitor Cells (EPC) that induce metabolic stress and vascular angiogenicity especially when the cells are decreased.The primary principle that explains the metabolic and cardiovascular dangers of this illness is the increased of tonicity in the blood or also known as fluid hypertonicity. Due to the increased surge of blood glucose levels, fluids, such as blood, lymph, interstitial fluid, etc. , become thicker than its normal viscosity. With this fluid condition, the circulation exerts tremendous vascular and hyperosmolar pressure from major vessels to minor arterioles and veinuoles. Eventually, the prolonged pressur e can lead to various complications, such as eye retinopathy, nephronic damage, nerve ending necrosis, etc.The common treatment being prescribed among DMT1 patients is the continuous administration of insulin injectables in order to fill in the body’s insulin requirements. This is done to temporarily replace or fill in the insulin insufficiency of the body. However, insulin therapy and maintenance are lifetime measures that require continuous commitment, which can greatly interfere in the person’s self-esteem and lifestyle progression. To resolve these potential emotional and psychosocial damages of the temporary insulin therapy, permanent treatments, such as stem cell implants, autoimmune suppressors, etc. are currently being studied with hopes of permanently curing the disease. Stem cell studies have carefully focused in determining the potential strategies in order to induce beta cell differentiation and cellular regeneration, especially among those damaged or destr oyed islet cells. Clearly, with cellular differentiation and regeneration s the goal of stem cell treatment, vast numbers of research discussed in the latter part of the studies have intensively focused their explorations in the disease’s autoimmune nature.Modern studies of beta cells have always been associated to the macrophagial and lymphocytic activities of T-cell mediated antibodies, such as CD4+CD25+, CD+ T-cells, etc. Most studies are determined in configuring the possible strategies of resolving, preventing and/or countering the DMT1’s autoimmune response on both original islets and implant islet grafts. In animal trials, most commonly rodents, autoimmune elements of the disease are somehow resisted when significant dosage of immune-inhibiting drugs (e. g. nfliximab, daclizumab and sirolimus, etc. ) are applied on the islet implants prior to the commencement of stem cell implantation.Several studies (e. g. Gastrin applicationetc. ) have found promising strategi es that can immunize the transplant grafts and possibly the original islets themselves from the autoimmune destruction rendered by the disease; although, modern science has not yet considered the safe applicability and effectiveness among human trials due to the conflicts encountered by the studies, such variations of drug responses or autoimmune actions. On the other hand, the signs and symptoms of DMT1 and DMT2 are both related to the two principal components of diabetes: (1) hyperglycemia and (2) hypoinsulinemia.DMT1 commonly presents its condition with the classic manifestations of polydipsia, polyphagia and polyuria . Physiologically, the three principal signs of DMT1 are extremely integrated and fostered by the body’s sympathetic natural response. For example, due to the hyperglycemic state of the body, the satiety centers of the brain triggers polydipsia in order for the body to increase its fluid intake aiming to dilute the tonicity or increased blood glucose levels. In the process, the body increases the fluid contents in the blood increasing as well the kidney workload in processing urinary output; therefore, producing polyuria.Consequently, fluid loss also causes significant electrolyte losses and glucose malabsorption that trigger body weakness. In order to compensate, the body triggers polyphagia that aims to increase food consumption. The three latter manifestations are considered the cardinal or principal manifestations of DMT1 common to all patients. Weight loss, fatigue, blurred vision, pruritis and muscle wastage are the secondary symptoms that follow with the continuous manifestations of DMT1 cardinal signs .The secondary complications of DMT1 can further aggravate if the physiological hyperglycemia and other associated signs and symptoms are not resolved. Tertiary complications involve severe manifestations that can be fatal in nature, such as diabetic ketoacidosis and possibly diabetic coma. 1. 2. Causes of DMT1 DMT1 has three poten tial origins that are currently under extensive study, namely (1) chronic autoimmune destruction of beta cells, (2) environmental destruction of beta cells that is commonly viral in nature, and (3) genetic abnormality in beta cells and/or insulin receptors .The autoimmune etiology of DMT1, as discussed earlier, involves the activity of interleukin-1 protein cytokine that principally triggers the immunologic response of CD4+ T cells against beta cells. The autoimmune nature has proven the relationship between beta cell destruction and islets’ inflammation due to interleukin invasion; however, studies have not yet determined the principal source of this cytokine production . The issues surrounding the autoimmune proposition in the DMT1 condition is the communicating element/s induced by the disease that activates antibodies’ response against the islet cells.As of the recent studies, no specific communicating agent has been discovered linking both DMT1 condition and its a utoimmune reaction towards islet cells; although, there are numerous evidences that reveal the exact autoimmune attacks against pancreatic islet cells, most significantly on the beta cells. Meanwhile, viral causations have also been associated to the occurrence of DMT1. Common viruses, such as mumps, rubella and coxsackie, have been associated to the destruction of beta cells, which eventually triggers the chronic drop of insulin production .Cytokine-interferon alpha (IFN-alpha) has been associated with the occurrence of DMT1 with hypothetical viral origin. According to clinical reports, IFN-alpha is brought by environmental viruses (enteroviruses) that trigger immune-mediated beta cell destruction. Significantly, therapeutic agents targeting IFN-a may potentially be beneficial in the prevention of type 1 diabetes and autoimmunity . Lastly, genetic abnormalities min beta cell progenitors and cellular differentiations are also becoming part of the controversial cause of DMT1.The idea of genetic causation of DMT1 involves the reduced activity of embryonic progenitors in pancreatic endothelial, which consequently lessens the cellular differentiation of beta cells. With small beta cell count in the body, insulin production becomes insufficient causing cellular tension for insulin production. Prolonged state of hypoinsulinemia or complete absence of insulin in the blood usually results to DMT1 complications. Islet transplantation or stem cell therapy considers the destroyed islet areas that need replacement.According to Rother and Harlan, if patients with greater body mass indices and/or with insulin resistance were also considered for an islet transplant, the 3,000 transplantable islet preparations presently achievable would likely be sufficient to restore euglycemia to fewer than 1,000 patients per year, or less than 0. 1% of patients with T1DM, or approximately 0. 005% of those with either form of diabetes. Despite of the technological advancements of stem cells and islet transplants, most parts of DMT1 condition and autoimmune functionalities are still left undetermined.The scarcity of islet stem cells is not the only problems being faced by islet transplant therapy but also the impending variations of autoimmune activities of the body. Controlled experiments have been conducted on both rodents and primates; however, the results most of the time vary when applied to human samples. Although, such islet therapy have already been applied to human sample and proven to cause independent insulin production; although, medical issues, such as alternative stem cell or islet graft sources, risk of anaphylactic rejections, etc, are still being studies extensively.Therefore, scarcity and further study of the procedure are necessary to further the application of islet stem cell therapy among DMT1 patients. 1. 3. Therapy for DMT1 Stem cell transplant of islets of langerhans, specifically the ß -cells, is now considered as alternative treatment in tr eating Diabetes Mellitus Type 1 (DMT1); although, not all DMT1 patients are applicable candidates of stem cell therapy. Antigenicity testing and severity of DMT1 manifestations as well as autoimmune response to the treatment are usually evaluated before considering stem cell transplant.Through the process of genetic engineering, the autoimmune response of DMT1 towards the islet cells can now be countered by replacing the cellular necrosis of ß-cells. The study explores the different sections of ß–cells stem cell transplant, particularly on (1) the actual procedure, (2) allogeneic and xenogeneic possibilities, (3) the actual condition of DMT1 and (4) the pathophysiological principles involved in the process of disease progress and stem cell therapy.The case of DMT1 is autoimmune by nature wherein the body acts negatively to the islet cells by recognizing these cells as a form of foreign objects. Theoretically, the body’s macrophages and interleukins are alarmed by the foreign or abnormal structuring of islet antigens, which probably resulted due to the extensive response of the cells thriving within high insulin-needing environment. In response, the body’s immunologic centers trigger macrophagial and anti-body mediators (e. g. GAD65 Ab – Glutamic Acid Decarboxylase Antibodies, Iinsulinoma Antigen 2, etc. attacking and destroying the body’s own pancreatic tissues . During these conditions, islet cells chronically declines in number as macrophagial actions subdue and destroy both progenitor cells in the pancreas and those differentiated islet cells, which include the beta cells. With the destruction of progenitor cells, the rate of cellular differentiations for further beta cells and other islet cell types (e. g. alpha cells, etc. ) decline leaving the body deficient of these endocrine hormones.Furthermore, as the existing and pre-existing beta cells die due to autoimmune damages, the capacity of the islet cells to regener ate also decline, which eventually decreases the number of existing beta cells within the islets. Theoretically, According to Xu, Wang and Hou (2008), as the body’s insulin requirement heightens and prolonged, the remaining beta cells experience physiological stress in insulin production, which, if not prevented, can lead to a negative feedback mechanism wherein insulin production complete shuts off its production.DMT1 patients experience decreased and/or absence of insulin production, and usually peaks between early adolescence (10 to 14 years of age) to middle adulthood (30 and above) . Pancreas manifests lymphocytic infiltration and destruction of islets of langerhans, which consequently causes depletion of insulin production. During the past few decades, studies on islet transplantation through mesenchymal stem cells (MSC) have shown to improve the metabolic conditions of DMT1 patients. However, the performances and study results using MSC remains to be questionable.Trans -differentiation of MSCs into insulin-producing cells (IPCs) is considered the principal concept of the therapy; however, other reports have negated these results claiming that it is too difficult to assume and determine the timing and extent of improvement by only analyzing the effects through trans-differentiation. Cellular differentiation and self renewal can greatly vary depending on various conditions, such as existing drug therapies, immunologic sensitivity, duration of the illness, other existing disorder including complications dealt by DMT1, etc.Similar to other beta-stimulating treatments, MSC is considered growth factor stimulant of the surrounding beta cells, which aids in the mechanism of self duplication rather than cellular proliferation. According to Xu, Wang and Hou (2008), â€Å"MSCs transplantation into diabetic animals may prevent apoptosis of injured pancreatic beta cells and enhance regeneration of endogenous progenitor cells through paracrine actions† ( e. g. angiogenic, cytoprotective, anti-inflammatory, mitogenic and anti-apoptotic effects, etc. ). MSC studies are still on the process of development along with animal trials.MSC therapy alternative is process for treating principally the occurrence of hyperglycemia in DMT1; however, the process remains an assumption and currently being studied. In the study of Ezquer, Ezquer and Parrau (2008), MSC procedure has been detected to also contribute to tissue regeneration (e. g. bones, cartilage, infracted heart, brain and kidney). In the study, a test subject with streptozotocin (STZ)-induced type 1 diabetes (C57BL/6 mice) has shown significant cellular neogenesis on pancreatic and renal function as well structure.Somehow, MSC has triggered a potential role of becoming a promising alternative as pancreatic progenitor cells that possess the capacity to initiate cellular differentiations. After the subject received a 0. 5 x 10(6) MSCs via ex vivo expansion, the sample has shown significa nt reduction in blood glucose levels and euglycemic values after a month. With MSC acting as the islet’s alternative progenitor cells, beta cell differentiation can progress to the development of other beta cells, which if continued can trigger cellular regeneration among produced existing beta cells.According to final conclusions of Ezquer, Ezquer and Parrau (2008), â€Å"MSC administration resulted in beta-pancreatic islets regeneration and prevented renal damage in diabetic animals. † This evidence shows the possibility of using MSC in initiating both cellular differentiation and self-duplication. Altthough, Xu, Wang and Hou (2008) still consider this process as an experimental alternative therapy for DMT1 condition. However, the study sample did not consider the potential effects of human autoimmune responses against these MSC grafts.Autoimmune responses can risk the success of graft transplant considering the increased antigenicity present among these islet transp lants, which is a considerable issue that arises in the results of their study. Meanwhile in the study of Feng, De-quan and Yan-hua (2008), they have focused on MSCs derived from human umbilical cord blood (UCB) in order to facilitate cellular transdifferentiation into beta cell alternatives via in vitro. In the study, UCB samples are obtained, while presenting MSCs are isolated for analysis via flow cytometer.In the process, islet-cellular differentiation has been induced for 15 days with or without extracellular matrix gel. This extracellular matrix gel provides an enriched environment that nourishes cellular requirements aiding in their differentiation and consequent self-duplication. With the help of chemiluminescent immunoassay system (CIS) in detecting glucose activity and insulin response, the studied found out that insulin positive cells (25. 2 ±3. 4%; UCB n=42) within ECM gel have produced functional islet proteins after 9 days of pancreatic differentiation.Considering th e feasible environment setup by ECM, the possibility of creating a zone wherein autoimmune reactions are considered nullified has also become one of the propositions that theoretically explained the results of the study. According to the conclusion of their study, MSC can actually differentiate into islet like cells in vitro and ECM gel. Fortunately, with the advent of modern technology and introduction of somatic stem cell transplant, the depletion of ß–cells can now be replaced with new generating ß–cells through stem cell implantation.In 1990, Scharp et al. has brought reports of success in the process of transplanting islet cells to patients with DMT1 through the process of improved islet isolation techniques (developed by Ricordi, Lacy and Finke et al. 1988) . Isolation techniques aim in discovering alternative progenitor sources of progenitor cells that possess the capacity to differentiate into insulin-producing cells that can serve as essential alternativ e for beta cells.Aside from pancreatic progenitor cells, the study has also discovered potential sources in the kidney, liver, bone marrow and other vital organs of the body. Isolation techniques usually require individualized culturing of islet transplants prior to the actual therapy. With the introduction of ß–cells implantation, different forms of islet transplant (e. g. billiary installation of islet cells, xenogeneic sources of islets, etc. ) have been considered throughout the process of stem cell therapy. On the other hand, certain reaction problems produced during the process (e. . anaphylactic response, incompatible cellular transplant, insulin-sensory impairment, etc. ) have also been observed in throughout the process of therapy. Despite of the potential therapeutic permanence of islet transplant therapy against DMT1 condition, most medical specialists (Kabelitz, Geissler and Soria, 2008; Xu, Wang and Hou, 2008) consider this treatment as last resort therapy for severe cases of DMT1. Stem cell therapy is not yet considered as a general treatment applicable for all sorts of DMT1 conditions.According to Kabelitz, Geissler and Soria (2008), the concepts in the cellular treatment of DMT1 are (1) the replacement of islet cells by islet-like cells derived from embryonic or adult stem cells, and (2) promotion and establishment of immunological tolerance of islet cells towards self-antigens through regulatory T cells and/or tolerance-promoting monocyte-derived cells. Studies have explored possible ways in dealing with the confronting problems of the procedures, such as scarcity, autoimmune sensitivity, etc.In the preceding sections of the discussion, the two concepts are further explained considering the possibility of merging the two procedures in order to attain maximum efficiency in the DMT1 cellular therapy. 3. Modern Techniques in Treatments of DMT1 1. 1 Islet Cell Transplant The principal concept of stem cell therapy is the harvesting of pot ential and/or adult health cells that are transferred to failing or degenerating organs. As for DMT1 conditions, islet transplantation, specifically on ß–cells implantation, is the most impressive treatment that shows promising permanent cure for islets’ autoimmune degradation.According to Hussain and Theise, â€Å"stem-cell therapy here implies the replacement of diseased or lost cells from progeny of pluripotent or multipotent cells. † According to Haller, Viener and Wasserfall et al (2008), UCB-derived MSCs are significant autologous progenitor inducers that can initiate cellular self duplication or regeneration. In their study using 12 autologous UCB infusions, preliminary results show significant slowing of endogenous loss of beta cell degradation among DMT1 children subjects.Aside from the slowing of hyperglycemic actions induced by DMT1, Keymeulen (2008) has proposed the possibility of actually blocking or preventing the autoimmune destruction of beta cells in DMT1 conditions. In the study, Keymeulen (2008) proposes the short-term humanized anti-T-cell antibody treatment that aim to inhibit the t-cell activities and preserve the residual beta-cells for at least 18 months in order to induce cellular regeneration and stabilize metabolic control of the body over the rising glucose levels.By applying Anti-Thymocyte-Globulin, tacrolimus and mycophenolate mofetil to a non-uremic C peptide negative DMT1 patient, marked decrease in autoimmune activities has risen to more than 80%. Another principle of stem cell transplant in islet cell therapy is biologic differentiation wherein a pool of undifferentiated precursors (e. g. Human Islet-derived Precursor Cells or hIPCs, etc. in pancreas appears to be a series of stem cell that further differentiate to islet-endocrine cellular population: (1) Glucagon-producing alpha-cells, (2) insulin-producing beta-cells, (3) somatostatin-producer in Delta cell, (4) pancreatic polypeptide secreting cells . Both of these cellular somas act as the cellular surrogate of ß–cells that shall replace the depleted or damaged cellular source in the pancreas . Cellular differentiation holds the key in inducing growth to the depleted beta cells in the islet of langerhans.According to the study of Abdi, Fiorina and Adra (2008), islet transplantation (ppluripotent stromal cells) provides great potential for diversifying the cellular lineage even with postnatal damaged tissues. The study of of Abdi, Fiorina and Adra (2008) support the idea of cellular renewal and differentiation giving more emphasis on the mesodermal origin. In such case, the study introduces the concept similar to other studies (e. g. immuno suppression of T-cell activity, increasing beta cell antigenitcity resistance, etc. wherein the introduction of MSCs or islet transplant pluripotent cells may induce an immunomodulatory effect, which eventually facilitates cellular regeneration. The study of Seissler and Schott (20 08) also supports the idea of cellular differentiation and self-renewal; however, they have questioned the capacity of supporting the cellular capabilities of stem cells derived from adult pancreas or non-pancreas. During cellular differentiation of endocrine tissue, precursor cells secrete multiple hormones prior to final maturation of differentiated cells that secret single classification of hormone.Most of these hormones are actual growth hormones that enhance cellular differentiations and regeneration. Although these actions are most of the time slow-phased and are very much vulnerable to immunologic attacks, some studies (e. g. Piper, Brickwood and Turnpenny, 2004; Lai, Schneider and Kidszun, 2005) suggest that once islet cells have regained its stable cellular disposition, which can varies depending on the prevailing physiological atmosphere (e. g. decreased immune activity, prolonged hypoinsulinemia, etc. , the cellular proliferation and restorative scheme can pursue more rap idly than its common phasing. In the process of islet transplant, beta cells are produced as part of the general cellular differentiation produced by broad cellular differentiations . According to Rosenburg, Lipsett and Yoon et al (2004), once islet cell quantity have increased to a stable position and the environment requires extensive insulin production, autoimmune response of the body against these cells are seen to decline dramatically.Once islets have differentiated from progenitor populations, the cells migrate towards the surrounding exocrine tissues. With the help of angiogenesis resulted by vascularization of islet’s arteriolar blood flow, specific cells present in the islet progenitors, beta cell progenitor, increase its differentiation phase, which consequently increases the number of beta cells present in the pancreas . As beta cells increase, the body’s glucose-perception also enhances considering the increased quantity of glucose sensing beta cells.The di fferentiated beta cells react against the decreased body insulin levels by producing insulin, which further stimulate beta cell’s massive proliferation in islets of langerhans . Upon stimulation of cellular differentiation under insulin deficient environment, islet transplant may significantly continue with its differentiation and regeneration schemes without the heightened danger of autoimmune attacks. This theoretical physiology can serve as the actual basis for considering the value of restoring stable beta cell count within the body.However, the conflict that needs resolution is the safety of islet grafts upon its initial stage of transplant. Differentiation of beta cells is the primary target of islet stem cell therapy among DMT1 patients. These cells are highly specialized cell type, phylogenetically developed, and regulators of glucose homeostasis in higher forms of organisms. However, some studies suggest (Montanya, 2004; Vinik, Rosenberg and Pittinger, 2004; Hermann, Margreiter and Hengster, 2007) the inverse relationship present between cellular proliferation and differentiation of islet implanted stem cells.The most common problem that arises during post-transplant phase is the decreased differentiation of beta cells, which, in some cases, are not enough to fill in the body’s insulin requirements . However, Dor, Brown and Martinez (2004) assert that Beta cells, during post-stem cell therapy, do not base the production of additional beta cells in the rate of differentiation; rather, beta-cells proliferate through the process of self-duplication .This is considered as an argument in the idea proposed in the latter section wherein it proposes the nullity in achieving cellular stability in both differentiation and regeneration once specific rate of beta cells are reached in the process. Although the proposed theory does not entirely in-distant with the latter, the argument suggests that beta cell proliferation solely derives from the pre-e xisting beta cells obtained via transplant, which further proliferates via the process of cellular regeneration and not entirely differentiation.As for the critique, cellular differentiation is regarded as of little importance due to its low contribution in cellular proliferation. According to Dor, Brown and Martinez (2004), â€Å"Our analysis shows that pre-existing beta-cells, rather than pluripotent stem cells, are the major source of new beta-cells during adult life and after pancreatectomy in mice†¦ These results suggest that terminally differentiated beta-cells retain a significant proliferative capacity in vivo and cast doubt on the idea that adult stem cells have a significant role in beta-cell replenishment. Xunrong, Hua and Soo (2005) support the argument through their study indicating the process of autoimmune blockage (Transforming Growth Factor-TGF-[beta]1) rather than the concept of cellular differentiation brought by stem-cell therapy . In the study, they have m ention the capacity of growth factors, such as TGF, to provide temporary autoimmune suppression that blocks the hazardous effects of this bodily responses.With increased angiogenesis or vascularization, the newly introduced cells (beta cells) can rapidly and freely proliferate as long as adequate oxygenation from rapid blood supply is present, and autoimmune suppression is being facilitated by the growth factors. According to Xunrong, Hua and Soo (2005), â€Å"Syngeneic islet grafts failed by day 17 in all untreated mice, whereas Ad-hTGF- [beta]1 therapy prolonged survival of islet grafts. Our data demonstrate that systemic TGF-[beta]1 gene therapy blocks islet destructive autoimmunity, facilitates islet regeneration, and cures diabetes in diabetic NOD mice†.TGF-[beta]1 possesses the functions of temporarily blocking the autoimmune response against the transplanted islet graft as well as triggering cellular regeneration channeled through self-duplication. Considering the argu ments propose by the two latter studies, this study still concludes the essential contributions of cellular differentiations brought by pre-existing progenitor cells from stem transplant or original sources; since, these component holds the appropriate physiological distribution of islet cell re-categorization and reproduction. 1. 2 Stem Cell TransplantationContrary to the concept of cellular differentiation and proliferation, post-stem cell transplant on islet cell is said to induce aggressive self-renewal due to the presence of significant growth components (e. g. TGF-[beta] 1, hemo-erythropoetin,etc. ) that enhance pre-existing beta cell proliferation and protect the cells from autoimmune attacks. Through the use of a DNA analog-based lineage-tracing technique , the study has found that precursor cells do not actually contribute to further differentiation of adult beta cells, and not even during acute beta cell regeneration.Rather, beta cells are being produced through self-renew al or duplication wherein a programmed cell division occurs through a refractory period preventing excessive or massive beta cell proliferation. Although, as argued by various studies (Lee, Grossman and Chong, 2008; Gershengorn, Anandwardhan and Wei, 2004), theoretically, differentiation rate usually surges during the initial phase of cellular implantation; however, once the cellular count of these differentiated cells stabilize, self-renewal or cellular regeneration of the existing beta or islet differentiated cells follow.Thus, explaining the inverse relationship between beta-cell proliferation and differentiation. Current studies in both allogeneic and xenogeneic stem cell sources are now being studied with marked emphasis on autoimmunity reversal or even autoimmunity tolerance. According to Lee, Grossman and Chong (2008), â€Å"stem cells from hematopoietic sources, such as bone marrow and fetal cord blood, pancreas, intestine, liver, and spleen, promise either new sources of i slets or may function as stimulators of islet regeneration†.Through stem cell introduction of pancreatic cells, specifically islets of langerhans, the adult human beta cells pre-existing in the stem cell transplant exhibit hormonal expression . Contrary to the concept of cellular proliferation, stem cell transplant essentially increases beta-cell resistance to autoimmune destruction of DMT1, which consequently facilitates the proliferation of beta cell in the islets of langerhans.According to various studies (Linning and Madkuhar, 2004; Strobel, Yuval and Stirman, et al. 006), aggressive beta cell self-duplication is the actual cause of beta cell proliferation whether by implantation of TGF-[beta] 1- induced islet cells or the traditional islet replacement. Implanted islet progenitors, when cultured, expresses 1% of endocrine cell proliferation during the first 48 hours up to 6% after five days . According to Rosenberg, Lipset and Yoon (2004), increasing the mass of beta cells after the event of post-immune destruction induces a 175-amino acid pancreatic acinar cell protein called, Islet Neogenesis-Associated Protein (INGAP) peptide, which acts as a stimulator of beta cell mass stimulator.INGAP peptide, similar to TGF-Beta growth factor, triggers cellular neogenesis enabling the rapid rate of cellular regeneration after significant results from cellular differentiation. The production of INGAP protein is commonly cited during post-phase of islet transplant. However, according to Lai, Irina and Eugen et al. (2008), gene modification present in cell transplantation process is problem considering the extensive cellular processes involved in the adaptation and transplant reception.Although, applications of several viral vectors (e. g. adenovirus-associated vectors, etc. have proven to be successful, but hESC is considered a more potent alternative due to its feasibility for genetic manipulation and self-renewal. During the mass replication of beta cells, the small portion of the cells stops in the process of neogenesis, while other beta cells are reserved for continuous replication at a very slow phase. After this scenario, the counter-attack of autoimmunity is usually expected; hence, treatment regimen that suppresses immunologic reaction on islet grafts are usually being instilled to the transplant sample prior to the therapy.This procedure increases the resistance of the graft cells against the autoimmune reactions triggered by the body. With a disorder such as DMT1, the chances of beta cell recovery become lesser due to the persistent autoimmune destruction of beta cells . The decreased capacity cellular replication in the adult beta cell is very much limited to result in a significant regeneration rate following autoimmune damages . Likewise, chronically increased metabolic requirements, such as increased insulin demand, can cause beta cells’ incapacity to fully cope in the given physiologic environment.This gives the appro priate rationale for implanting islet cells in the area of depleting beta cell in order for the progenitors to differentiate and proliferate mass beta cells in the area. According to the study of Urban, Kiss and Kovacs et al. (2008), hematopoetin centers of the body, such as bone marrow, may harbor cells that can actually influence the self-duplication of beta cells. Such concept is greatly associated to the principle of angiogenesis implying the value of appropriate oxygenation in the area of developing cellular clusters.In the study, sex-mismatched bone marrow cells (BMCs) and syngeneic or allogeneic MSCs are administered to a mice sample with streptozotocin induced DMT1, and consequently led to the rapid tissue regeneration after a single injection of a mixture of 10(6) BMCs per 10(5) MSCs. Other agents that can forcefully differentiate beta cells during post-islet transplant are INGAP (Rosenberg, Lipset and Yoon et al. , 2004; Weir, Toschi and Inanda et al. , 2004), GLP-1 and GL P-1 receptor agonist exendin-4 (Li et al. , 2004), betacellulin and activin A (Brubaker and Drucker, 2004), and the combination of EGF and Gastrin (Rooman and Bouwens, 2004) .These agents can actually force the cellular differentiation providing immediate and ensured processing new beta cells with much more lessened risks of being attacked by immunologic elements. Betacellulin, Activin A and Gastrin are the common immuno-suppressants being applied to most controlled studies on islet transplants today due to its availability and decreased result variations; although, some studies still explore the applicability and effectiveness of these agents in the process of triggering cellular differentiation.Meanwhile, Melleoul (2006) suggests that cellular differentiation of beta cell during post-islet transplant is controlled by series of genetic activators and transcription factors . Its absence in mice and humans during embryogenic to postnatal development may actually lead to pancreatic ag enesis. After such condition, cellular differentiation becomes restricted principally to ß cells wherein cellular regulation of genetic expression in ß cell-specific genes occurs.Furthermore, such condition facilitates the mediation of the glucose effect on insulin gene transcription, which shows that any exposure of ß cells to high glucose even with short period of time can actually stimulates insulin gene expression. However, chronic exposure to high glucose levels can actually trigger negative effects, such as alteration in ß-cell functions and gene transcription. PDX-1 transcription breaks down upon exposure to chronic hyperglycemia, while stimulation of beta activity is seen during acute hyperglycemia.Such genetic modifications can actually enhance the survivability of islet transplants within a new host considering the autoimmune function being rendered by continuous DMT1-induced CD4 immunoglobulins. According to Phillips and Tang (2008), using cellular, molecular and gene manipulation strategies, each islet transplant can actually be guarded or attain enhanced resistance even with the hostile environment directing immune rejection, inflammation, hypoxia and apoptosis.Genetic engineering provides cellular modification for constructing gene sequences. Considering the conflict existing in mass beta cell replication and autoimmune destruction, high quantities of beta cell replication during post-islet transplant has been associated to the reduced impact of autoimmune damage. With the help of CTL antagonists in terms of restricting T-cell activity, the regenerative capacity and neogenesis of ß-cells are expected to progress through forced-differentiation therapies.Initial activities between autoaggressive Cytotoxic T-lymphocytes (CTL) and beta cells are terminal event leading to cellular agenesis of ß-cell, which consequently affects both progenitor beta cells and those potential self-replicating beta cells from the pool of potential ß-c ell replenishment . Progression of CTL is unlikely to be stopped; hence, the only appropriate idea of treating the pathogenesis of DMT1 is the replenishment of beta cells that have been damaged throughout the ongoing autoimmune attacks.According to Dor (2006), progenitor cells present in the pancreas, specifically on pancreatic ducts, acini, islets of Langerhans, and other parts of the body (e. g. bone marrow, spleen, etc. ) are even more potent source of beta differentiation . However, these progenitor cells provide variable cellular differentiation rate that can compromise the process of stem cell therapy especially if the non-ideal progenitor cell source are used in the procedure.To compensate, most studies have explored the possibility of using embryonic-obtained stem cells that contain the most feasible progenitor cells aside from the ideal pancreatic progenitors. Although beta cells are differentiated from progenitor cells during embryonic phase of pancreatic development, the progenitors (marked by expression of neurogenin 3 and the paired box protein Pax-4) are seen to disappear upon birth . Such disappearance actually implicates a significant process that are undergoing with beta cells, which actually trigger fundamental change in their mode of maintenance and expansion.The cellular process begins from the embryonic progenitor-cell-based differentiation and further progress to massive self-regeneration. In the study of Nagaoka, Fukuda and Hashizume (2008), betacellulin (BTC) is analyzed as another potential growth factor that can induce progenitor-cell-based differentiation and cellular self-duplication. BTC possesses ErbB receptor tyrosine kinases that induces differentiation and cellular mitosis, especially among acinar-derived AR42J cells, transforming these cells into insulin-producing or beta functioning cells. As supported by Parnaud, Bosco and Berney et al. 2008), BTC-induced purified beta cells within allogeneic islet transplant graft enhanced by ECM have yielded a population of 91. 4 ±2. 8%. Nagaoka, Fukuda and Hashizume (2008) mention that BTC â€Å"independently and preferentially binds to two type I tyrosine kinase receptors, the EGF receptor (ErbB1) and ErbB4†. Significantly, BTC induced graft transplants are seen to contain mutant protein that promotes the rapid differentiation of pancreatic acinar AR42J cells to insulin-producing cells, which is actually the opposite with AR42J cells that contain wild-type BTC protein.Rapid differentiation is not entirely beneficial in nature as this can cause hyperplasia. According to Min Cho, Lim and Yoo et al. (2008), BTC, together with Nicotinamide sustained PDX1 expressions, actually induced cellular differentiation C-peptide proteins; although, insulin mRNA is found to be very low. 4. New Advances in Stem Cell Research The theory between stem cell differentiations versus beta cell progenitor self-duplication still coincide the need to restore pre-existing beta cell p ool from the ongoing damage made by the autoimmune CTL.Stem cell is still an important consideration in replenishing these depleted resources. However, due to the extensive problem on stem cell donors and sources, stem cell therapy is not yet considered part of an ideal DMT1 treatment. According to Korsgren, Lundgren and Felldin (2008), new alternatives for stem cell therapy are currently being explored with aims of determining other contributing components that induce cellular graft survivability and reduction of immunoresponse against DMT1 mediated antibodies.During the process of transplantation, the isolated islets transplant grafts are induced to embolise the liver after its introduction via the hepatic portal vein, which is a procedure that is unique in the area of stem cell implantation. However, such procedure is only an example of low efficacy procedure. A novel view on the engraftment of intraportally transplanted islets is presented that could explain the low efficacy of the procedure. As supported by Rother and Harlan (2004), and Hardikar (2004), only 750 patients have already been treated using allogeneic islet transplants since 1974 despite of the billions of DMT1 cases worldwide.Various alternatives have been proposed in order to counter such scarcity, specifically: (1) embryogenic blastocyst and post-natal resources, (2) culturing of stem cells, and (3) stem cell grafting using xenogeneic resource (e. g. umbilical cord, etc). The isolation of human embryonic stem (hES) cells has been introduced as a potential prospect for filling in the scarcity of beta cells, specifically through islet transplantation . Embryonic stem cells are harvested from blastocysts, while adult stem cells are from postnatal organisms.The process involves (1) the culturing and plating of embryoid bodies in insulin-transferrin-selenium-fibronectin medium, (2) supplementation and maintenance using N2, B27, and basic fibroblast growth factor (bFGF), (3) lowering of glucose c oncentration to reduce the physiological pressure on premature beta cell, (4) bFGF is withdrawn to prevent excessive growth stimulation, and (5) nicotinamide addition . Counteracting transcription-polymerase chain reaction found out an enhanced cellular expression of pancreatic genetic chains within the site of cellular differentiated cells.Using the Immunofluorescence and in situ hybridization analysis, the findings have revealed a significantly increased percentile range of insulin-expressing cells within the cellular clusters. According to the study of Xia, Ayala and Thiede et al. (2008), hESCs, with the help of drug-inducing transgene expression (in vitro and in vivo) forms >95% purity level, which significantly implies the high possibility of regulating genetic expression of hESCs. After the islet transplantation, genetic expression of the cells remained stable and regulated with the help of an orally administered drug.Although, according to Chung and Stainer (2008), cellular o rigins that regulate pancreatic B cell induction and genetic expression is not yet fully understood. Differentiation of embryonic stem (ES) cells to islet phenotype, identification and utilization of pancreatic precursor/stem cell from adult sources, and the cultivation of new islets from adult stem cells obtained from various tissue types or directly form other terminally differentiated cell types are the common areas being covered by islet transplant or stem cell research for DMT1 immunogenetics research .In such case, cultured embryogenic or adult somatic islet cells are transferred from its original placement to appropriate locations in the body of a DMT1 patient. Human Embryonic Stem Cell (HESCs) or ES possesses the capacity to continuously differentiate to cells that express both endoderm and pancreatic progenitor function, such as Foxa2, Sox17, Pdx1, and some islet endocrine hormones (e. g. beta cells) . According to Kroon, Martinson and Kadoya et al (2008), cellular therapy for DMT1 requires the renewal of human beta cells and not entirely the replacement of the degraded ones.In order to induce regeneration, pancreatic endoderm must be stimulated through the use cellular mediated glucose-responsive endocrine cells present within hESCs. The hESC-derived insulin-producing islet-like clusters (ILCs) comprises of 2 to 8% of human C-peptide-positive cells, glucagon-positive and somatostatin-positive cells. The study has detected a content of 70 ng of insulin/mug of DNA being produced through these hESC-derived ILCs, which is statistically higher than the innate fetal islets.In addition, cellular differentiation of hESCs induces the formation of Embryoid Bodies (EBs) that stimulate the gene expressions of POU5F1, nestin, FOXA2, ONECUT1, NEUROD1, PAX6, and insulin as long as the glucose environment is within 25mM levels . In the essence, implantation of hESCs in autoimmune-damaged islets can mobilize the islet cell differentiation through genetically expresse d progenitors from the islet transplant medium. Furthermore, continuous genetic expression is expected since the body’s glucose levels also influence the cellular differentiation of beta cells.Stem cells derived from hESCs places markers of development for endoderm, pancreatic and ß-cell development, glucose sensing, and production of mature insulin . Meanwhile, most studies have also centered in protein-based cellular communication involved during cellular differentiation phase after stem cell implants have been introduced. According to Kroon, Martinson and Kadoya (2008), therapeutic tests using a mice sample with 3000 transplanted human islet cells indicate that hESC derived pancreatic endoderm can actually aid in antibody resistance.In the study’s conclusion, they have pointed the definitive evidence proving the capacity of hESCs in generating glucose-responsive and insulin secreting implanted cells. Interestingly, in the study of Yu, Vodyanik and Smuga-Otto et a l (200), hESCs are found to be programmed by specific four genes, OCT4, SOX2, NANOG, and LIN28, which actually determines the pluripotent capacity of the embryonic stem cells and the characteristic of cellular differentiation. Although, the study concludes that the genetic mapping and processes involved within these newly discovered hESC genes are still in the process of intensive studies.Implanted stem cells actually integrate their needed functions for initiating the mechanism of glucose responsive regulation present as pre-proinsulin mRNA and expression of insulin C-peptide in vitro (Clark, Yochem and Axelman, 2007). Following transplantation into mice, cells become insulin and C-peptide immunoreactive and produce plasma C-peptide in response to glucose. The results of the study suggest that embryonic germ cell derivatives (e. g. ILCs, etc. ) may eventually function as a potent insulin producing cells .The use of islet-derived or stem cell therapy using embryonic cells remain exp erimental due to the challenges of cellular differentiation. Currently, the problems being faced by the treatment is the availability of stem cells that can possess the appropriate capacity to induce cellular differentiation and regeneration. According to the mentioned studies, simple cellular implantation is not entirely enough due to the greater risks imposed by the body’s physiological reaction against islet grafts.Hence, another issue arises in determining the best anti-immunity function or tolerance enhancer of islet graft transplants; although, latter studies have already discovered potential enhancers that can disregard or at least lessen the impact of cellular degradation brought by DMT1 immunity. Lastly, new advances of genetic modification techniques that shall increase cellular differentiation and renewal rates are already in the process of development. 5. Discussion In the research of Froud, Ricordi and Baidal, islet stem cells are cultured under steroid-free immu nosuppression and are transplanted to 16 DMT1 samples.The cultured islet stem cells have undergone a period of in vitro culture-process with heightened necrosis resistance through TNF- a (Tumor Necrosis Factor) blockade that aim to improve islet engraftment and provide alternative to fresh human islet transportation. The results of the study suggest that the implantation of cultured human islet allografts cause a reproducible insulin independence in all subjects under the series immunosuppressant infusions (a. intial Infliximab infusion, b. daclizumab and c. irolimus maintenance), comparable to that of freshly transplanted islets (Edmonton protocol) .In the absence of supplemental infusions (nfliximab, daclizumab and sirolimus), the results of the study have incurred 11/14 (79%) subjects that produced insulin independence at 1 year, while other 6/14 (43%) samples have gained this capacity after 18 months. Surprisingly, the same test subjects have maintained their insulin independenc e until 33  ± 6 month span. Furthermore, the findings have observed that patients are able to maintain their graft function while under the immunosuppressing infusions.According to the results, 8 out of 14 patients have suffered chronic partial graft losses that are likely immunological in nature considering that 5 of these already received supplemental infusions. Currently, 11 out of 14 subjects are in the receiving immunosuppressing infusions, and 8 (73%) of these are already manifesting insulin independence. The study significantly demonstrates the possibility of withholding the immunologic response upon exposure to certain immunosuppressant (e. g. nfliximab, daclizumab and sirolimus, etc. ).Although, the study has not mentioned the possible side effects and complications that such infusion can provide towards the body as a whole. However, since the stem cells are the only ones infused with these immunosuppressants, the chances of systemic immunosuppression are less likely as l ong as the dosage infused with the stem cells remain appropriate and feasible to the body’s normal function. In another culture study brought by Pinzon, Lakey and Brand (2005), they have used the combination of epidermal growth factor (EFG) and gastrin in order to induce beta cell neogenesis specifically on pancreatic exocrine duct cells .These growth factors also carry the risk of triggering extensive cellular neoplasia over-cellular multiplication; although, studies have already found drug induced techniques that can contain the cellular differentiation and regeneration upon introduction within the body system. In the study, human islet cells are placed under four weeks culture study in a serum-free medium with EGF (0. 3  µg/ml) as the control variable and gastrin content of 1. 0  µg/ml.Beta cells have shown significant increase in cultures with the combined medium of EGF and gastrin (+118%), while +81% for cultures with EGF alone. The EGF-gastrin culture has been obser ved again for the next four weeks, but without the said combination. Impressive results have shown beta cells progressive increase in quantity for the culture previously infused with both EGF and gastrin (+232%). Comparing these results from the latter discussed studies, EGF and gastrin have actually trigger cellular differentiation and self-duplication due to their growth factor properties.In the study of Suarez-Pinzon and Rabinovitch (2008), gastrin growth factor combined with epidermal growth factor (EGF) can actually restore pancreatic islet beta-cell mass and even reverse hyperglycemia even in the absence of immunotherapy in mice samples with artificially induced-DMT1. Reversal of hyperglycemia is most likely due to the increase in insulin production that counters the effects of DMS1. With the appropriate amounts of insulin secretion in the blood, the glucose tonicity will consequently be absorbed by the cells granted that the diabetic anomaly does not consider the insulin rece ptor functionalities within cellular surfaces.In the study, EGF dose of 10 microg/kg and gastrin dose of 30 microg/kg via intraperitoneally have been administered to 10 sample DMT1 mice. In terms of glucose levels, the samples have shown a marked decline from blood glucose of 23 +/- 2 mmol/L to 12 mmol/L within 36 days of individual EGF administration, while 19 days in individual gastrin administration. When combined, the decline in the samples’ glucose levels is already present within 11 days.In addition, the cellular islet counts have increased from 13. 0 +/- 0. x 10(5) cells to 29 +/- 2 x 10(5)cells, and considering the marked decrease of surrounding CD45+ leukocytes have also been observed. Therefore, such combination (EGF plus Gastrin) is confirmed to reduce blood glucose levels, prevent autoimmune activity of DMT1 mediated CD4 cells and increase cellular differentiation. Lastly, aside from hESC’s and cultured islet transplants, another potential source of stem ce lls currently being studied is from animals, known as xenogeneic sources . Pig islets are considered the best option available for xenogeneic transplants.According to Rother and Harlan (2004), such potential alternative are now being studied for different considered potentials, such as: Pig islets have been considered as potential source of islet stem cells aside from human source (a) The fact that humans had been treated with pig insulin for more than 60 years (b) Favorable husbandry — in that the species has large litters with offspring that attain adult size rapidly and with relatively robust islet numbers (c) The fact that pig islets respond to glucose in the same physiological glucose range as human islets (d) Existence of suitable societal-cultural relationship between the speciesDespite of the potential capacity of pig islets in acting as alternative stem cell resource, studies (Hering, Wijkstrom and Graham et al. , 2006; Rood, Buhler and Bottino, 2006) have identified its increased immuno-response towards CTL and autoimmune attacks initiated by DMT1 disease. Autoimmune attacks are the principal conflict considered in the process of islet transplantation wherein even if the graft has been successfully implanted, the risk of failure in the procedure is still considered possible considering the effects of autoimmunity triggered by increased antigenicity in the graft transplant.In one study, acute rejection caused the death of two macaque samples through cellular rejection mediated by CD4+ and CD*+ T cells and macrophages . In order to increase the effectiveness of xenografts after post-transplant phase, different culture infusions have been studied to prolong the life of pig islets xenografts. CD4 antibodies are usually being activated upon detecting significant system foreign antigens, which are usually introduced by bacteria, virus or any material that enters the body systems.In this principle, researchers (Kirchhof, Shibata and Wikkstrom et al. 004) have pointed their assumptions in the possible presence of antigens within xenotransplanted islet grafts. In addition, cellular infusions are considered to be at great risk due to the potential intrusion of incompatible antigens that might induce transplant rejection, and eventually autoimmune degradation of transplanted islet cells in the body. This condition is currently under extensive analysis and consideration since even with successful islet transplant, autoimmune response due to heightened cellular antigenicity can still pose the failure of the stem cell therapy.Due to this genetic dilemma, some studies (Kirchhof, Shibata and Wikkstrom et al. 2004; Komoda, S. Miyagawa and T. Omori et al. , 2004) have focused in determining the potential drug enhancers that can improve transplant antigenicity, especially among xenogeneic sources. First, with the infusion of islets from N-acetylglucosaminyltransferase-III (GnT-III) transgenic pigs, pig islet’s xenoantigenicity have significantly declined prolonging the survival of islets for the next five days of culture study. In another study, pig islets subjected for xenotransplantation are tested with alginate encapsulation.The transplant to tested in a primate, specifically a monkey-Cynomolgus maccacus . Adult pig islets encapsulated in alginate under optimal conditions (n=7) or not (n=5) are transplanted under the kidney capsule of the non-diabetic primate sample. Meanwhile, additional samples have received empty capsules (n=1) and non-encapsulated pig islets (n=2) as controls . The results of the study show the rapid inviability of non-encapsulated and encapsulated islets with no alginate and not in optimal condition.Implanted pig islets under optimum alginate encapsulation showing significant prolonged islet survival for as long as six months. However, despite of the experimental success, the study still regards the conflicts encountered by the processes (e. g. variations of graft antigenicity, etc). 6 . Conclusion DMT1 is a condition manifested by increased and frequent manifestations of hyperglycemia caused by the insufficient production or depleted insulin levels. The most universally recognized cause of beta cell destruction is the autoimmune etiology caused by CD4 interleukins, and other associate antibodies.The aims of the therapy are the induction of cellular differentiation while facilitating as well the renewal of the existing and pre-existing beta cells in the islet graft transplant or in the remaining original islets. However, the principal conflict of the procedure is the interference caused by the autoimmune reaction of the body towards the transplanted islet grafts; although, recent studies have continuously explored different possibilities of suppressing autoimmune responses and forcing cellular activities.Stem cell therapy is a potential prospect for permanently treating the condition of DMT1 considering the main concept involved in its pathogenesis – destru ction of beta cell or insulin producing cells. The processes, physiology and pathological considerations in the stem cell therapy of islet transplant involve the criticality of autoimmune response towards the islet transplant.The controversy of such treatment is the effectiveness of implanting whether the islet cells containing stem cells based on the concept of cellular differentiation or islet cells with pre-existing beta cells based on the concept of cellular self-renewal. Despite of the argument between the two perspectives involve, another main issue arises, specifically the scarcity of stem cell from allogeneic donors. According to the approximated statistics, only 750 cased of DMT1 have successfully obtained the stem cell transplant of islet cells considering the billions of other DMT1 patients existing.In order to resolve such scarcity, various forms of stem cell resources have been proposed and are currently under extensive studies, specifically (1) human embryonic stem cel ls, (2) cultured islet stem cells, and (3) xenogeneic sources specifically the pig islet stem cells. According to most studies, autoimmune damage progress if cell count of beta cells is introduced insufficiently to the recipient body; although, stem cell therapy is nearing towards its potential of being a significant cure as beta cell replacement and insulin producer.