Transplantation of encapsulated insulin-secreting cell clusters represents a potential cure for type I diabetes, but development efforts so far have yet to live up to its promise. Recent studies have elucidated the importance of cluster size on the insulin response in a manner that affects viability and efficacy of transplanted clusters. Using microfabrication techniques, a method to fabricate uniformly-sized insulin-secreting cell clusters was developed and thoroughly characterized using water contact angle, x-ray photoelectron spectroscopy, Fourier transform infrared spectroscopy, and fluorescent microscopy. This technique enabled the formation of both monolayered and multilayered cell clusters of a predetermined size and shape. Subsequent evaluation of the impact that cluster size has on insulin expression, content and secretion using RT-PCR, ELISA, and confocal quantitative immunocytochemistry suggested that two cluster-size dependent behavioral changes relevant to transplant efficacy exist: First, glucose stimulation causes increased insulin production for clusters exceeding 40 µm in size. Second, cluster sizes greater than 60 µm secrete insulin more efficiently after production than smaller sized clusters. These results suggest that an optimal cluster size exists between 100-120 µm. Lastly, human embryonic stem cells were differentiated in patterned 120 µm clusters along the pancreatic lineage, an effort that could produce optimally sized insulin-secreting cell clusters from a renewable cell supply. The studies presented here may help overcome two remaining challenges preventing encapsulated cell transplantation therapy from truly providing a cure for type I diabetes.

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Pasture is a non-fiction film that moves between quiet places in Southern California, where in the mid-2000s a grassroots movement resisted private military development, and New York City, where the filmmaker is coming from. In pursuit of an unlikely coalition, Pasture reflects on relationships between passing, fantasy, and friendship.

This essay accompanies the film, addressing some of its driving concerns, and reflecting on my process as a filmmaker. The first section orients the two that follow, drawing from a transfeminist political framework. Here, I work towards a theory of “Fantasy and Activism,” that accounts for settler notions of belonging within a wish for coalition across lived experiences of difference. Laying the ground for future work, I ask: how can the tasks of political resistance be rescaled to recognize the roles that fantasy plays in the reality of power? “Mercenary” and “Quiet” combine critical analysis and personal narrative to: first, address the stakes of private military development as part of the settler project of racial capitalism. Following “Mercenary,” “Quiet” then assembles a series of reflections: I consider the depiction of Potrero and Nomirage, California as “quiet” places, and ways that some forms of resistance are described as “quiet.” I reflect on my own relationship to quiet, and on who I am in these places.

Introduction: Diabetic ketoacidosis (DKA) is a potentially life-threatening complication of diabetes mellitus. Less prevalent is euglycemic DKA (eDKA)—DKA with serum glucose less than 200 mg/dL; however, it is increasing in frequency with the introduction of sodium glucose cotransporter 2 (SGLT-2) inhibitors for treatment of type 2 diabetes.

Case Report: We report a case of SGLT-2 inhibitor-associated eDKA presenting with concurrent acute pericarditis.

Discussion: Our case suggests that the cause of eDKA can be multifactorial when decreased oral intake occurs in the setting of an acute cause of physiologic stress.

Conclusion: Prompt recognition of eDKA in the emergency department may allow earlier diagnosis and treatment directed at one or more of its underlying causes.