bluuebunny/crossref_metadata_2025 huggingface dataset:
Development of Dehydrator for Domestic Use of Fruits
Authors: Jena Basista Narayan , Saily A. S. , Nanda Shiti Prangya , Madhusmita Prof. Monali , Swain Dr. Satyananda
Published: May 2022

Abstract: Fruits and vegetables are perishable in nature; spoilage is more due to high moisture loss. To preserve fruits for a longer duration we need to control the moisture loss and restrict respiration rate. Dehydrators available in the market are very expensive & can’t be afforded by all. The Dehydrator that we developed is both economically and environmentally friendly and able to dehydrate various fruits in a very short span of time. A food dehydrator is an appliance that has a compact space and hot ventilation that can be used as a dehydrator. Dehydration of foods has two primary purposes: to prolong the shelf life of the food products to be stored and reduce the water content to prevent the growth of microorganisms. The objective of the study based on the machine we created is to use it as a source for humans to know that food can last longer by using the machine. It shows the best effect on the food. This aims to preserve food products from the growth of bacteria and yeast through water removal. The study's findings conclude that this food dehydrator can clearly reduce the burden on consumers, especially in businesses that use food dehydrators to produce sales results. Therefore, consumers who use these food dehydrators can produce more quality and durable food product results. Our developed dehydrator can help in economic terms that can further process food products that are more durable with high quality as well as can save time. Keywords: Dehydrator, Preservation, Storage.
Utilization of Silica Fume and Steel Powder as an Additive in Concrete
Authors: Kumar Vishal , Soni Dr. Sharad Kumar
Published: May 2022

Abstract: Cement concrete are designed to resist the disastrous surrounding effects such as high temperature variations, high humid environments, coastal areas, industrial areas and other pollutant types. Engineers are continuously studying its properties and performance by blending several waste and modern materials in cement or other aggregates. The major advantage of these materials is the replacement of cement or other ingredients partially in concrete and presenting the comparable cementitious property. The use of waste material can consume these materials and also saves the principle ingredients of concrete. This can also improves the properties of concrete in fresh and hydrated states or may presents the properties comparable to the basic properties of concrete. In the current study a set of experiments had been performed to compare the use of 3 different types of mixes formed by replacing cement by silica fume, sand by steel powder and in third mix both the materials are used together. Cement and sand were replaced in different proportions such as 10%, 15%, 20%, 25%, and 30% by these materials. The ingredients are mixed in 1:1:2 proportions. The properties studied are 3 days, 21 days and 28 days compressive strengths and compaction factor. The main conclusions drawn are inclusion of silica fume increases the compressive strength up-to a certain proportions and then reduces the strength, it also effects the setting time and consistency. Steel powder increases the strength but reduces the compaction factor. Comparatively higher early strength gain (3-days) is obtained with steel powder concrete.
Smart Health Care
Authors: Bansal Tanushka
Published: May 2022

Abstract: Artificial intelligence (AI) has been widely used in many sectors like Agriculture and Farming, Autonomous Flying, Security and Surveillance, Clinical Medicine etc, and one such important sector is healthcare where there is a tremendous increase in innovations in the fields of AI.Medical facilities need to be really advanced so that better decisions can be made for patient diagnosis and treatment options. Machine learning in healthcare helps humans to process huge and complex medical datasets and then analyse them into clinical insights. This can be later used by the physicians in providing suitable medical care. Hence machine learning and artificial intelligence when implemented in healthcare can lead to increased patient satisfaction. Disease Prediction using AI is the system that is used to predict the diseases from the symptoms which are given by the patients or any user. The system then processes the symptoms provided by the user be it image or details as an input and gives the required output depending upon the probability of the disease. With an increase in biomedical and healthcare data, accurate analysis of medical data benefits early disease detection and patient care. By using this, we are predicting diseases like Diabetes, Malaria, Heart disease and many more. Keywords: Artificial intelligence, machine learning, deep learning, disease prediction, healthcare
Powder Mixed Electric Discharge Machining of Hastelloy
Authors: E Sudhir. S, Angeshwaran , N Sathiya Prakash , M Bharath
Published: May 2022

Abstract: The main goal of the project is to research and analyze the surface finishing of Hastelloy and surface Modification by electrical discharge coating. Machining is done by Electric Discharge Coating processes using EDM Oil as the dielectric liquid and copper as the electrode. The conventional EDM oils are kerosene, paraffin and transformer Oil extracted from petroleum oil. Electric discharge coating (EDC) is an emerging surface modification Technology to create such hard coatings by using electrical discharges to apply a layer of material to a workpiece Surface to modify and enhance surface properties or create new surface features. The analysis report of this project includes peak current, pulse duration (TOn) and tip wear rate (EWR). Material Removal Rate (MRR), Tool Wear Rate (TRR) and Surface Roughness (Ra), Discharge Voltage, Duty Cycle and the weight of the workpiece before and after machining. Keyword: Hastelloy; Dielectric; Modification; MRR; TWR; Ra
Architecture of Death: Multifaith Burial and Cemetery Centre
Authors: Srivastava Anushka
Published: May 2022

Abstract: Life and death are perpetual topics for human beings to investigate. The basic kind of funeral architecture is cemeteries, which serve as the final resting place for humans and their final homes. The demand for cities has been highlighted as a result of population growth. This research focuses on the spaces linked to a multi-faith cemetery as well as the types of spaces that evoke emotions throughout the death process. For the research, four main religions were chosen: Hinduism, Islam, Christianity, and Zoroastrianism. The aim of the research is to find out the emotional aspect and spatial character of the space associated with deceased. The main research topic was: what effect do emotional elements have on death places and what are the design criteria for highrise cemeteries in metropolitan areas? According to the findings of this study, emotions such as mourning or grief, as well as remembrance processes, were major preoccupations. It also indicates that all faiths' funeral practises and ceremonies have a similarity, as well as shared concepts about death. The study's result offers a fresh perspective on how the architectural character of spaces aids in coping with the emotions associated with death. Keywords: Cemetery, Multi-faith, Emotions, Religion, Death, Spaces, Architecture & High-Rise
A Study of Design and Analysis of Automobile Wheel Rim Using Different Fillet Radius and Different Y Spoke Angle
Authors: Namdev Monika , Malviya Prof. Arun Kumar
Published: May 2022

Abstract: Wheel rims are the most important part of automobile, in an automobile there are fatigue loads and static loads which are actively participated in design. There are several ways of failure of wheel rim like critical stresses and material failure due to design, dimension and shape of wheel also play vital role in its dimensions and shape vehicle rim design. Present paper studied the Y angle optimization in alloy wheel rim. The present design analysed by ANSYS software. For the structural analysis for the remote force the magnitude applied is 1000N and for the pressure which applied on the wheel is 245kPa. Therefore, so comparing the wheels with the total deformation occurred alloy wheels are better than the steel wheel and comparing the both the alloy wheels multi-spoke alloy wheel is better than the 6-spoke alloy wheel. The total deformation of 8 spoke alloy wheel with 55° Y spoke angle, figure clearly depicted the total deformation maximum value 0.00155mm maximum at base of wheel or outer periphery of wheel rim. Keywords: Wheel Rim, Y Spoke Angle of rim, fillet radius of rim, total deformation occurring, ANSYS
concepto antropológico de campo de investigación y su aplicación a una investigación histórica: el caso de los baqueanos y los lenguaraces en el Virreinato del Río de La Plata (1750-1810)
Authors: Lorena Vollweiler Sabrina
Published: May 2022

El objetivo de esta contribución es realizar una reflexión sobre el concepto antropológico de “campo” que resulte útil para una investigación realizada desde la perspectiva de la Antropología Histórica o Etnohistoria. Presentaré un ejercicio ensayado para aplicar ese concepto a los recaudos metodológicos sobre el tema-problema de investigación elegido para mi tesis de grado, explicitando los diversos actores, lugares y procesos que tuve en consideración para pensar el “campo” de mi indagación, mostrando que es una construcción a diseñar en cada caso y que es posible desligar su identificación con la noción de territorio.
Turkey and Europe data comparison in terms of the course of the COVID-19 pandemic and health expenses
Authors: TURAN SÖNMEZ Feruza , SÖNMEZ Cemil Işık
Published: May 2022

Introduction: The COVID-19 pandemic has affected the entire world and has been a challenge to the health prospects of the nations infected. The elderly population of the nations and parameters like the countries' health system and the allocation of budget to health are critical factors for explaining the epidemic's development with different mortality rates in various countries. The purpose of the study was to assess the characteristics of the Turkish population, COVID cases, the progression of diseases, and health expenditures compared to those in Europe.Methods: For this study, we used the following databases: the Worldometer digital database, the database of the Organization for Economic Cooperation and Development, and the Turkish National Databases on Economic and Finance references, such as the Turkish National Strategy and Budget Presidency and the database of the Turkish Statistical Institute. The data was for the date 15.12.2021 and the general annual for 2020.Results: By the investigation date as of 15/12/2021, the total number of COVID-19 cases was 9209740 in Turkey and 81556853 in the European Union countries. The incidence of the disease was 107.500 in Turkey and 135.525 in Europe. While the total change/ increase in last-week-new cases was -5% and 8% in Turkey and Europe, respectively, the real change/ increase in last-week-deaths was -1% to -8% in Turkey and Europe. The number of COVID screening tests per one million population was higher in Europe (1.343.256 to 8.790.27 in Turkey and Europe, respectively). The GDP and health expenditure per capita were distinctly higher in Europe.Conclusion: The fact that there is a higher percentage of elderly residents in European countries than in Turkey, that the number of new cases detected every week is higher, and that the death rate and the gradual decline in cases are linked to the large share of health expenditures distributed by nations for the fight against the disease.
Fungsi Badan Pengawasan Keuangan dan Pembangunan (BPKP) Berdasarkan Peraturan Presiden Nomor 192 Tahun 2014
Authors: Fitri Irawan Nadia , Syarif Afif , Fitria Fitria
Published: May 2022

Hasil Kewenangan Badan Pengawasan Keuangan dan Pembangunan Berdasarkan Peraturan Presiden Nomor 192 tahun 2014 tentang Badan Pengawasan Keuangan dan Pembangunan. Pengawasan terhadap  perencanaan dan pelaksanaan program dan/atau kegiatan yang dapat menghambat  kelancaran pembangunan, audit atas penyesuaian harga, audit klaim,  audit investigasi  terhadap kasus-kasus penyimpangan yang berindikasi merugikan keuangan negara/daerah, audit penghitungan kerugian keuangan negara/daerah, pemberian  keterangan ahli, dan upaya pencegahan korupsi. Bahwa untuk melaksanakan fungsi pengawasan sebagaimana tercantum dalam  Pasal 3 huruf e tersebut, sesuai Pasal 27 Perpres Nomor 192 Tahun 2014 dilakukan melalui Deputi Bidang Investigasi BPKP. yang berbunyi Deputi Bidang Investigasi melaksanakan tugas membantu Kepada di bidang pelaksanaan pengawasan kelancaran pembangunan termasuk program lintas sektoral, pencegahan korupsi, audit atas penyesuaian harga, audit klaim, audit investigatif terhadap kasus-kasus penyimpangan yang berindikasi merugikan keuangan negara, audit pengitungan kerugian keuangan negara dan pemberian keterangan ahli. Mekanisme Badan Pengawasan Keuangan dan Pembangunan (BPKP) Menentukan Kerugian Keuangan Negara Berdasarkan Peraturan Presiden Nomor 192 Tahun 2014 tentang BPKP. Kewenangan BPKP dalam peraturan perundang-undangan berdasar fungsi BPKP sebagaimana disebutkan dalam Pasal 3 huruf e  maka BPKP termasuk lembaga yang berwenang melakukan penghitungan (penilaian) kerugian keuangan negara, khususnya BPKP juga berwenang penilaian kerugian keuangan negara dalam upaya pencegahan korupsi karena BPKP juga berwenang melakukan audit investigatif terhadap kasus-kasus yang berindikasi merugikan keuangan negara (korupsi).  Apabila meninjau sumber wewenang yang dimiliki oleh BPKP,  maka  wewenang  yang  dimiliki  oleh  BPKP  ini  termasuk  dalam wewenang delegatif.
Evaluación de la carga académica docente: génesis y evolución
Authors: Villalobos-Mora Alejandro
Published: May 2022

La administración eficiente de los recursos públicos y del capital humano docente han sido temas de interés permanente en la Universidad de Costa Rica; empero, en una coyuntura presupuestaria enrevesada e incierta como la que enfrenta actualmente la Institución y, en general, el país, este tópico adquiere mayor relevancia y donde la evaluación de cargas académicas del profesorado se convierte en un instrumento vital para la toma de decisiones por parte de las autoridades superiores.

Avanzada la década de 1970, la administración universitaria implementó un sistema de evaluación permanente de las actividades asignadas al profesorado, mediante el cual se pretendía, además de sistematizar información objetiva y precisa respecto al quehacer de las unidades académicas, la dinámica institucional y el servicio brindado por la Universidad; determinar las necesidades presupuestarias relacionadas con la contratación de personal académico y, en el marco del contrato social que la Universidad mantiene con la sociedad costarricense, transparentar la gestión universitaria, robustecer el sistema institucional de control interno y coadyuvar en el proceso de rendición de cuentas.

A pesar de que el objetivo principal de la evaluación de las cargas académicas docentes no ha experimentado variaciones significativas en el tiempo, en el curso de su existencia, ha registrado importantes modificaciones operativas debido, principalmente, a tres elementos: la diversificación de las actividades realizadas por el personal académico; la incorporación gradual de la tecnología en el proceso evaluativo; y la modificación del marco normativo institucional que regula la asignación y administración de la carga académica docente, aspecto que, dada su relevancia, es repasado en este artículo, el cual, concomitantemente, pretende dilucidar algunos elementos conceptuales fundamentales para comprender esta evaluación y señalar la vinculación existente entre este ejercicio valorativo y el constructo de calidad educativa.
El problema: su importancia dentro de la gestión educativa
Authors: Catty Orellana-Guevara
Published: May 2022

El ensayo presenta el problema como objeto de estudio debido a su incidencia dentro de las organizaciones. No obstante, para tratarlo, requiere ser comprendido, lo que conlleva todo un planteamiento que tiene como fin clarificar una situación.  Razón por la cual se busca demostrar que el análisis del problema genera información suficiente para diseñar acciones de mejora, esto, usando como método la estrategia basada en problemas. Se concluye que la gestión educativa se sirve del conocimiento científico para conocer a profundidad los problemas, así como esclarecer el proceso que debe llevarse a cabo hacia la construcción de sus soluciones; por consiguiente, lograr la mejora en el funcionamiento institucional.
“All-on-4” and “All-on-6” Treatment Concept Applied Using Computer-Guided Surgery in a Patient: Case Report with a 2-Years Follow-up
Authors: Albaqawi Ahmed heji
Published: May 2022

Computer software was used for implant planning and guided surgery. A
provisional prosthesis was loaded on the day of surgery; the definitive
prosthesis with a milled titanium framework was loaded one year later.
There were no clinical or radiographic changes around the dental
implants at two-years post- surgery.
Vogt-Koyanagi-Harada syndrome in the setting of COVID-19 infection
Authors: Eatz Tiffany , Charles Jude
Published: May 2022

To report a case of Vogt-Koyanagi-Harada disease (VKH) in a 27-year-old
male two weeks proceeding COVID-19 infection onset. Severe complications
of VKH can be avoided by early diagnosis and adequate treatment with
corticosteroids and immunosuppressants. It is possible that COVID-19 was
a potential immunological trigger of VKH in our patient.
EUROPEAN OAK METABOTYPES SHAPE DIGESTION AND FITNESS OF THE HERBIVORE TORTRIX VIRIDANA
Authors: Bertic Marko , Orgel Franziska , Gschwendtner Silvia , Schloter Michael , Moritz Franco , Schmitt-Kopplin Philippe , Zimmer Ina , Fladung Matthias , Schnitzler Joerg-Peter , Schröder Hilke , Ghirardo Andrea
Published: May 2022

Plants harbor a wide range of leaf-feeding insects. Insect survival and
fitness are influenced by both energy-rich molecules and phytochemicals
in the host foliage. Yet, how leaf chemical diversity and insect
microbiota - key factors in ecological and physiological processes –
shape insect nutrition and impact insect performance is still poorly
understood. Here we forced Tortrix viridana larvae, an oak-specialized
herbivore, to feed on two Quercus robur susceptible and resistant
metabolic phenotypes (metabotypes) and examined leaf, salivary, and
fecal metabolomes associated with larval performance, mortality, and
fecal microbiota. We show that host chemical diversity affects larval
development and that the distinct signatures of oak metabotypes are
maintained in the insect digestive system. Larvae were highly efficient
in nutrient assimilation and able to minimize plant chemical defenses,
thanks in part to the adaptation of the gut microbiota to the different
food qualities.
Barium swallow - a useful investigation in otolaryngology? A systematic literature review.
Authors: Arvidsson Alice , Dwamena Samuel , Davies Huw , Prabhu Vinod
Published: May 2022

Objectives: Barium studies are routinely requested to investigate a
range of conditions, however, its efficacy for several conditions is
unclear. Alongside findings from our audit in a district general
hospital, we aim to review current literature on the use of barium
swallow as an investigation for pharyngeal pouch, globus pharyngeus,
tertiary peristalsis and oesophageal malignancy in adults. Methods: A
systematic literature search was conducted on three databases for papers
published in English in the last ten years. Following screening, six
studies were included for pharyngeal pouch, five studies were included
for globus pharyngeus, seven studies were included for tertiary
peristalsis, and thirteen studies were included for oesophageal
malignancy. Results: Barium swallow is a useful and important
investigation in diagnosing pharyngeal pouch and can be useful to
investigate oesophageal dysmotility in tertiary peristalsis. Globus
pharyngeus patients do not clinically benefit from undergoing barium
swallow. Oesophagogastroduodenoscopy (OGD) should remain as first line
in diagnosing oesophageal malignancies. Conclusion: Barium swallow
should be used to investigate pharyngeal pouch and tertiary peristalsis,
but not used as the main investigation for globus pharyngeus or
oesophageal malignancy. There is a need to develop further guidelines
for investigations requested for dysphagia.
Precise regulating strategy based on multi-parameter fusion analysis applied to strengthen the coenzyme Q 10 biosynthesis of Rhodobater sphaeroides
Authors: Li Bo , Wang Ze-jian , Ge Yan , Liang Jianguang , Zhu Zhichun , Chen Biqin , Li Dan , Zhuang Ying-Ping
Published: May 2022

Multi-parameters of physiological metabolism, environmental state, cell
morphology, and manipulated variable, have mutual influences and
constraints on coenzyme Q (CoQ )
biosynthesis of Rhodobater sphaeroides. In this work, a
multi-parameter fusional correlation-analysis were applied to illuminate
and optimize the crucial metabolism on CoQ
biosynthesis. The quantitative response model for accurate living cells
concentration, morphological deformation, specific oxygen consumption
rate (Q ), and specific product biosynthesis rate were
established, the results revealed that maintain the optimal electrical
conductivity(Cond.) and Q at 9.0±0.5 mS/cm and
0.06-0.08±0.01×10 mmol/cell/h, respectively, by
adjusting the nutrient feeding and oxygen transfer rate, the cell’s
morphology and oxygen uptake rate were strengthened. CoQ
production in 50L bioreactors was successfully
improved by 35% to 3384mg/L than that of control, which would be more
powerful and effective for scale up in the large-scale production of CoQ
.
1002-P: Implementing Continuous Glucose Monitoring in Children with Type 2 Diabetes
Authors: MANFREDO JACQUELYN A. , LIN TYGER L. , GUPTA RADHIKA , ABIOLA KAI , WEST MARGARET , BUSIN KELLY , TRACEY JULIA , BROWN ELIZABETH A. , MAGGE SHEELA N. , WOLF RISA M.
Published: May 2022

Background: Continuous glucose monitor (CGM) is a widely accepted tool for managing glycemia in youth with type 1 diabetes (T1D) and adults with type 2 diabetes (T2D) ; however, studies exploring its use in T2D in youth are limited.

Objective: Determine if a day trial use of CGM in youth with T2D improves short term and long term glycemic control as measured by time in range (TIR = percentage of time blood glucose is 70-180 mg/dL) , and 3 mo hemoglobin A1c (HbA1c) , respectively.

Methods: Youth with T2D for more than 3 mos, on insulin therapy, with no prior CGM use were enrolled. Diabetes staff placed the CGM at the point of care and provided standardized education. At initial visit, HbA1c and demographic information were recorded. Participants received a 5 day and day follow up (FU) phone call from diabetes staff to review glucose and TIR data, with counseling and dose adjustments as needed. At 3 mos, HbA1c was recorded. We compared 5 day TIR and day TIR, and baseline and 3 mo HbA1c via paired t-test.

Results: Youth with T2D (n=35) enrolled had mean age of 15.9 y (SD 1.9 y) , 63% female, 83% black, and average diabetes duration of 1.8 y (SD 1.6 y) . A majority had household income <$50K (63%) and parental education level of HS degree or less (68%) . Average 5 day TIR 48% was similar to day TIR 51% (p=0.28) . There was no change in HbA1c after 3 months (10.3% v 11.1%, p=0.39) . Only 18 participants completed the full day CGM use; those that did not cited device connection issues (3) , device fell off early (8) , device removed early due to irritation (3) or lost to FU (3) . Of the 18 youth who completed day CGM use and nursing FU calls, 78% wanted to use a CGM long term.

Conclusion: Although a trial CGM use over days did not impact short term or long term glycemic control in youth with T2D, most participants who completed the full days wanted to continue using CGM. Issues with device connectivity and adhesion were barriers to consistent device use. Future larger studies with longer use of CGM may help clarify the potential impact of CGM in youth with T2D.

Disclosure

J.A.Manfredo: None. R.M.Wolf: Consultant; NEMA Research, Research Support; Dexcom, Inc. T.L.Lin: None. R.Gupta: Consultant; Cabaletta Bio. K.Abiola: None. M.West: None. K.Busin: None. J.Tracey: None. E.A.Brown: None. S.N.Magge: None.

Funding

Johns Hopkins Childrens Center Innovation Award Dexcom (investigator-initiated support)
1012-P: Neighborhood Disadvantage, Childhood Opportunity Index, and Glycemic Control for Children with Type 1 Diabetes?
Authors: CORIELL MEGAN B. , JAWAD KAHIR S. , FEYGIN YANA B. , WATSON SARA , STEVENSON MICHELLE D. , WATTLES BETHANY A. , JONES VERONNIE F. , PORTER JENNIFER , DAVIS DEBORAH W.
Published: May 2022

Background: Disparities in outcomes for children with type 1 diabetes (T1DM) are associated with poverty and race. However, little is known regarding the impact of systemic racism.

Objective: This aim of this study is to determine if neighborhood concentrated disadvantage index (NCDI) or Childhood Opportunity Index (COI) are associated with HbA1c and diabetes ketoacidosis (DKA) in children ≤ 18 years of age with type 1 diabetes.

Methods: The retrospective secondary data analysis included data from children ≤ 18 years of age with a diagnosis of T1DM for ≥ 6 months seen in 2017 who reside in Kentucky (n=675) . NCDI scores were calculated based on the NIH PhenX Toolkit protocol. The tool was developed from a principal components analysis of six variables at the census tract level. COI was obtained from diversitydatakids.org. Univariate analyses were performed using Kruskal-Wallis test or Pearson’s correlation. Multiple linear regression analysis was conducted to to evaluate HbA1C and multivariate Poisson model was used for DKA.

Results: Prior to controlling for age, race, and insurance type, NCDI (p<0.001) and COI (p< 0.001) were significant predictors for HbA1c. For every 1 unit increase in COI, the predicted value of AIc level decreased by 8.66 (p=0.0004) . NCDI and COI were not significant when controlling for age, race, and insurance. NCDI and COI were not significant predictors of DKA episodes.

Conclusions: This study identified NCDI and COI as predictors of HbA1c in children and adolescents with T1DM only in univariate analysis. While NCDI and COI have been shown to correlate with structural racism, these findings suggest that more research is needed in larger and more diverse samples to disentangle the complex relationships among race, racism, and poverty. Understanding the mechanisms through which racism impacts outcomes for children with T1DM is essential to improving health equity.

Disclosure

M.B.Coriell: None. K.S.Jawad: None. Y.B.Feygin: None. S.Watson: None. M.D.Stevenson: None. B.A.Wattles: Research Support; Merck & Co., Inc. V.F.Jones: None. J.Porter: None. D.W.Davis: None.
1016-P: Equitable Glycemic Improvement in Youth with T1D during COVID-19
Authors: OJUKWU SANDO , ADAM ATIF , KAUSHAL TARA , TINSLEY LIANE J. , VOLKENING LISA K. , CHEN CHARLOTTE , LAFFEL LORI M.
Published: May 2022

Aim: Despite disruptions caused by the COVID-pandemic, prior studies suggest some improvements in glycemic control. We investigated whether this improvement was equitable and seen across socioeconomic status (SES) groups in youth with T1D.

Method: Using EHR-extracted visit and CGM data, we geocoded patient addresses linked with census-tract derived education from the 20American Community Survey and a composite measure of SES, the Neighborhood Deprivation Index (NDI) . Analyses included youth ≤18 years old using CGM with T1D duration ≥6 months (age <6 yrs) or ≥1 yr (age ≥6 yrs) . We performed t-tests and regressions comparing SES and CGM metrics during the pandemic (4/1/20-3/15/21) with pre-pandemic (4/1/19-3/15/20) .

Results: The pre-pandemic sample had 641 youth (52% female, age 12.5±3.5, T1D 6.2±3.5 yrs) and the pandemic sample had 650 youth (52% female, age 13.5±3.6, T1D 6.8±3.8 yrs) ; 86% were common to both samples. Addresses allowed for geocoding of 98%; 44% of youth lived in low education census tracts where ≥30% of adults in the census tract had no more than a high school education. Mean CGM-derived glucose management indicator (GMI) improved during the pandemic for both those living in lower (8.07±0.05% pre vs. 7.91±0.% during, p<0.05) and higher SES education tracts (7.82±0.% pre vs. 7.69±0.% during) . There was similar improvement in GMI in lower vs. higher SES education tracts (0.16±.vs. 0.13±.06) . Other CGM metrics similarly improved during the pandemic, mean CGM glucose decreased by 6.7 mg/dL and 5.4 mg/dL in low and high SES education tract patients respectively (both p<.05) . Those living in the most deprived NDI areas had the highest GMI both pre and during the pandemic (p<0.05) and demonstrated similar or greater improvements than those from Iess deprived areas.

Conclusion: Equitable improvements in CGM metrics during the pandemic was evident in youth with T1D. Future studies can assess how changes in healthcare delivery during the pandemic can reduce disparities and sustain benefits to all patients.

Disclosure

S.Ojukwu: None. A.Adam: None. T.Kaushal: None. L.J.Tinsley: None. L.K.Volkening: None. C.Chen: None. L.M.Laffel: Advisory Panel; Medtronic, Roche Diabetes Care, Consultant; Boehringer Ingelheim International GmbH, Dexcom, Inc., Dompé, Insulet Corporation, Janssen Pharmaceuticals, Inc., Lilly Diabetes, Novo Nordisk, Provention Bio, Inc.

Funding

National Institutes of Health (K12DK094721, P30DK036836)
102-LB: Retrospective Comparison of A1C between Hybrid Closed Loop Technology—Is There a Difference in Insulin Pump Type?
Authors: REH CHRISTINA S. , THOMPSON SAMANTHA
Published: May 2022

Background: Insulin pumps with and without hybrid closed loop technology (HCL) are now mainstream in the treatment of type 1 diabetes (T1D) . These technologies are well known to improve diabetes glucose control, safety, and quality of life.

Objective: To determine if there is a difference in overall glucose control between the current FDA approved brands of pumps including those with HCL.

Methods: A retrospective chart review was performed at Children’s Hospital Orange County to assess subjects with T1D who upgraded a device during the study period of Jan. 2021 to Dec. 2021. Subjects were divided by brand of pump (Omnipod, Medtronic 670G and Tandem Control IQ) and further categorized by upgrade device type. A1c was documented at baseline and within 3 to 6 months after pump upgrade. Statistics performed with the sign test (exact method) for paired data and Wilcoxon rank sum test comparing difference in A1c at baseline and after upgrade.

Results: 125 subjects upgraded pumps in the study period. 84 subjects were included in the A1c analysis due to data availability. Subjects ranged in age from 5 to 24 years, 48% were female, and 83% used HCL. Most subjects chose to upgrade to Tandem Control IQ (73%) vs. Omnipod (16%) or Medtronic 770G (11%) . Difference in pre-A1c to post-A1c of subjects who upgraded from Medtronic 670G [ A1c 7.9% (7.2-8.7) ] to Tandem Control IQ [A1c 7.3% (6.95-7.7) ] was statistically significant (p<0.0003) . Although other groups had mild changes in A1c, they did not reach statistical significance.

Conclusions: The majority of subjects preferred Tandem Control IQ HCL technology to other FDA approved devices. Tandem Control IQ showed significant improvement in A1c compared to Medtronic 670G in clinical practice. Further research is needed to determine if changes in A1c are sustained overtime.

Disclosure

C. S. Reh: None. S. Thompson: Other Relationship; Insulet Corporation, Medtronic, Tandem Diabetes Care, Inc.
1020-P: Racial Disparity in Glycemic Outcome during Real-World Use of an Advanced Hybrid Closed-Loop System (AHCL) among Youth with Type 1 Diabetes (T1D)
Authors: CHRISTAKIS NICHOLAS J. , CHALEW STUART
Published: May 2022

Background: African-American (AA) youth with T1D consistently have higher A1c than White (W) patients, even when using open-loop insulin pumps. AHCL technology utilizes glucose sensor data to guide automatic adjustments of insulin by the pump to mitigate hyper and hypoglycemia. Potentially AHCL could reduce or eliminate disparity in glycemic outcome.

Methods and Results: We performed a chart review of patients using Tandem Control IQ. trained in its use by the manufacturer’s rep and then followed routinely in clinic (n=62) . 9 patients self identified as AA, A1c=9.2%±1; 37 identified as W, A1c=8.23%±1.5. 6 AA patients and 27 W had used AHCL > 60 days and had follow up data. There was statistical and clinically significant reduction in A1c (-1.0%±1.4, p=0.0016) for W patients but not AA. AA patients had higher A1c and sMBG with lower TIU during AHCL use than W patients. (See table below) .

Conclusions: Clinically significant disparity in glycemic outcome persists between AA and W youth during real world use of AHCL. Although this initial report has a relatively small number of participants, the glycemic disparity is consistent with many prior studies using older insulin delivery methods. We conclude that AHCL technology by itself may not be sufficient to overcome racial disparity in glycemic outcome. Additional innovations and support may be required for high-risk patients.

Disclosure

N.J.Christakis: None. S.Chalew: Advisory Panel; Medtronic.

Funding

National Institutes of Health (U54GM1O4940) National Institutes of Health (1R21DK118643-O1A1)
1022-P: Youth from High-Poverty Neighborhoods Demonstrate Higher HbA1c within Year after Diagnosis of T1D
Authors: TREMBLAY ELISE S. , LIU ENJU , LAFFEL LORI M.
Published: May 2022

Background: T1D management and control in the year after diagnosis often establish long-term patterns for pediatric patients. Disparities in HbA1c based on race, ethnicity, and socioeconomic status (SES) are documented in the pediatric literature; yet there is limited description of the timeline in which these disparities appear.

Study Design: We conducted a retrospective chart review of patients diagnosed with T1D at a tertiary children’s hospital between 1/1/16 and 2/20/20 who received follow-up care for at least 1 year. Using zip-code level geocoding, we obtained community-level SES data based on American Community Survey (ACS) measures and classified patients according to the percent of families in census tract living in poverty, defined as 200% of the federal poverty level (FPL) .

Results: Of 758 patients, 15.6% (median, IQR 10.53, 24.01) of households were living in poverty; poor patients were defined as those in the upper quartile (>24.0% of households living below 200% of FPL) and rich patients in the lower quartile (<10.5%) . Patients from households in poor communities had higher HbA1c levels compared with their rich counterparts from baseline to 1-year post-diagnosis, although statistical differences emerged after 9 months between poor vs. rich groups: baseline 11.5% vs. 11.2%, p=0.10; 3 months 7.4% vs. 7.3%, p=0.62; 6 months 7.5% vs. 7.3%, p=0.24) ; 9 months 8.1% vs. 7.6%, p=0.01; and 1 year 8.2% vs. 7.8%, p=0.05.

Discussion: These data highlight the early origin of disparities in glycemic control in pediatric patients with T1D based on community-level SES. Understanding the time course of these disparate outcomes helps to inform the need for early intervention, particularly in low-income groups, to provide support likely needed to optimize glycemic control and long-term health outcomes. Further research can assess the overlapping axes of disparities that include race, ethnicity, and education level.

Disclosure

E.S.Tremblay: None. E.Liu: None. L.M.Laffel: Advisory Panel; Medtronic, Roche Diabetes Care, Consultant; Boehringer Ingelheim International GmbH, Dexcom, Inc., Dompé, Insulet Corporation, Janssen Pharmaceuticals, Inc., Lilly Diabetes, Novo Nordisk, Provention Bio, Inc.

Funding

NIDDK (K12DK094721)
103-OR: Coronary Plaque and Stenosis across Glycemic States among Asymptomatic Adults: The Miami Heart Study at Baptist Health South Florida
Authors: PATEL KERSHAW , CAINZOS-ACHIRICA MIGUEL , VALERO-ELIZONDO JAVIER , ALI SHOZAB S. , SHAPIRO MICHAEL D. , PANDEY AMBARISH , ARIAS LARA L. , BUDOFF MATTHEW , NASIR KHURRAM
Published: May 2022

Introduction: Diabetes mellitus (DM) and pre-DM are associated with elevated risk of atherosclerotic cardiovascular disease events. However, characterization of coronary plaque and stenosis across glycemic states among asymptomatic adults has not been fully evaluated.

Methods: Adults enrolled in the community-based Miami Heart Study with available data on glycemic status and coronary CTA were included. Among individuals with DM, pre-DM, and euglycemia, the prevalence of coronary plaque (any, any non-calcified, any high-risk) and stenosis ≥50% was assessed overall and stratified by coronary artery calcium (CAC) categories (0, 1-99, ≥100) .

Results: Among 2,359 participants (49.6% women, 47.0% Hispanic/Latino) , the prevalence of DM, pre-DM, and euglycemia was 7%, 30%, and 63%, respectively. Participants with DM had the highest prevalence of any plaque (68%) followed by those with prediabetes (58%) and euglycemia (43%) . A similar graded association was observed across glycemic states with other plaque features and stenosis ≥50% (Figure) . In analyses stratified by baseline CAC burden, the prevalence of plaque features and stenosis ≥50% was low in those with CAC zero.

Conclusions: Among asymptomatic individuals from the general US population, worse glycemic status is associated with greater burden of coronary atherosclerosis and high-risk features.

Disclosure

K.Patel: None. M.Cainzos-achirica: None. J.Valero-elizondo: None. S.S.Ali: None. M.D.Shapiro: Advisory Panel; Amgen Inc., ESPERION Therapeutics, Inc., Novartis Pharmaceuticals Corporation, Novo Nordisk, Consultant; Regeneron Pharmaceuticals Inc. A.Pandey: Advisory Panel; Lilly, Consultant; Tricog, Research Support; Applied Therapeutics, Gilead Sciences, Inc. L.L.Arias: None. M.Budoff: Research Support; Amarin Corporation, Novo Nordisk, Speaker's Bureau; Boehringer Ingelheim International GmbH, Lilly. K.Nasir: Advisory Panel; Novartis AG, Novo Nordisk, Research Support; ESPERION Therapeutics, Inc., Novartis AG, Speaker's Bureau; Amgen Inc.
1034-P: No “Honeymoon” for Youth, in Particular Blacks, Diagnosed with Diabetes during the First Year of the COVID-Pandemic
Authors: MKPARU NKEIRUKA , COSTACOU TINA , BARINAS-MITCHELL EMMA , LIBMAN INGRID
Published: May 2022

Racial differences at onset of type 1 diabetes (T1D) in youth during the COVID-pandemic have been documented in the US. Limited data are available in type 2 diabetes (T2D) . No data are available to our knowledge at follow up (FU) . We compared characteristics at onset and 1 year FU in white vs. black children diagnosed with diabetes mellitus (DM) in 2020 at a large pediatric academic center. A total of 276 youth (53% male, 81% white, mean age at onset 10.8±4.5 years, mean HbA1c 12.1±2.7%, 45% with BMI ≥ 85th percentile, 43% presenting in DKA) , were identified via retrospective chart review. 78% were diagnosed with T1D, 21% with T2D and 1% with MODY. Age (10.8±3.9 vs. 10±4.5 years, p=0.5) , prevalence of BMI ≥ 85thile (47 vs. 28%, p=0.12) and mean HbA1c (12.3±2.5 vs. 12.1±2.7, p=0.84) were similar in blacks vs. whites at onset of T1D. In those diagnosed with T2D, blacks compared to whites had a higher mean HbA1c (11.9±2.9 vs. 9.7±2.3%, p=0.04) as well as prevalence of DKA (26 vs. 0% respectively, p=0.02) . Characteristics at 1 year FU by race and type of DM are presented below.

A year after onset, 2/3 of youth with T1D and half with T2D had HbA1c above target, more commonly in blacks, in spite of ˜ 90% of our patients having FU, albeit virtually, during the pandemic. Further research is needed to explore the reasons for the disparities and interventions should be implemented to improve DM control in youth diagnosed during the pandemic.

Disclosure

N.Mkparu: None. T.Costacou: None. E.Barinas-mitchell: None. I.Libman: Consultant; Novo Nordisk.
1035-P: Early Pregnancy Alterations in the Metabolome of Obese Women
Authors: BANDRES-MERIZ JULIA , KUNZ CHRISTINA , HAVELUND JESPER , FÆRGEMAN NILS J. , HURTADO DE MENDOZA IRENE , MAJALI-MARTINEZ ALEJANDRO , ENSENAUER REGINA , DESOYE GERNOT
Published: May 2022

Obesity in human pregnancy associates with changes in the glucose-insulin axis. We hypothesized that these changes affect the maternal metabolome already in the first trimester, and thus aimed to identify these metabolites. We performed untargeted metabolomics (HPLC-MS/MS) on maternal serum (n=111, gestational age week 4+0-11+6) . In addition to BMI and leptin as measures of obesity and adiposity, we metabolically phenotyped women by their fasting glucose, C-peptide and insulin sensitivity index (ISHOMA) . We identified 2449 serum metabolites of which 277 were annotated. After stringent filtering employing a combination of univariate and multivariate analyses with multiple confounders and machine learning methods (Partial Least Squares Discriminant Analysis, Random Forest and Support Vector Machine) we identified 14 metabolites robustly and significantly (FDR<0.1) associated with at least one exposure (BMI, leptin, glucose, C-peptide, ISHOMA) . Among these, palmitoleoyl ethanolamine (POEA) , an endocannabinoid-like lipid endogenously synthesized from palmitoleic acid, was consistently associated with C-peptide in all analyses explaining 21% of variance in POEA concentration. Decreased POEA levels in T2D and its affinity for the novel endocannabinoid GRP1receptor made it a strong candidate for further exploration. In network analysis most metabolites correlating with POEA and regulated by C-peptide, were amino acids or dipeptides (n=9, 35%) , followed by lipids (n=7, 27%) . We conclude that the metabolome of overweight/obese pregnant women is already altered early in pregnancy. Changes of POEA concentration in pregnant women with obesity-associated hyperinsulinemia may reflect dysfunctional endocannabinoid signalling and, thus, compromise pregnancy maintenance.

Disclosure

J.Bandres-meriz: None. C.Kunz: None. J.Havelund: None. N.J.Færgeman: None. I.Hurtado de mendoza: None. A.Majali-martinez: None. R.Ensenauer: None. G.Desoye: None.

Funding

Austrian Science Fund 339 FWF (DOC 31-B26) and the Medical University Graz through the PhD Program Inflammatory Disorders in Pregnancy (DP-iDP)
1038-P: Exposures to Hyperglycemia in the Embryonic Period and to Breast Milk from Mothers with Hyperglycemia Affect Glucose Tolerance with Higher Glucagon-Like Peptide-1 Secretion
Authors: ISHII KEITARO , SASAKI JUNKO , SUGAI KEIJI , ITO MARIKO , IWASAKI HAJIME , HARA NATSUKO , AIERKEN MAIERHABA , LI GUOJIAO , SUWANAI HIROTSUGU , ODAWARA MASATO , SUZUKI RYO
Published: May 2022

Exposure to hyperglycemia during pregnancy results in diabetes in offspring. However, its underlying mechanisms are unclear. We therefore focused on the glucose metabolism of the offspring who were exposed to hyperglycemia in uterus or who were breast-fed from mothers with hyperglycemia. ICR female mice received single intraperitoneal injection (i.p.) of streptozotocin at six weeks old as the model of mother with diabetes (MD) . An additional group of mice received citric acid buffer injection, instead, as the model of mother with normal glycemia (MNG) . We established the model exposed to hyperglycemia in the uterus (EHU) by switching offspring from MD to MNG right after birth. As the model exposed to the breast milk of mothers with hyperglycemia (EBM) , the offspring from MNG were moved to MD right after birth. To eliminate the effects of cross fostering, offspring from MNG were fostered by another MNG as the control group. In intraperitoneal glucose tolerance test (IPGTT) at P60, EHU and EBM didn’t show increase of blood glucose level (BG) nor decrease of plasma insulin level but showed in oral glucose tolerance test (OGTT) at P50 (AUC of BG: p < 0.in EHU, p < 0.00in EBM, AUC of plasma insulin level per BG: <0.00in EHU and EBM) . From these conflicting results, we suspected the participation of glucagon-like peptide-1 (GLP-1) . However, the AUC of plasma total GLP-1 and active GLP-1 levels were higher in OGTT. Since we didn’t observe any difference in beta cell area per whole pancreas section by immunostaining, EHU and EBM might have GLP-1 resistance.

Disclosure

K.Ishii: None. M.Odawara: Other Relationship; Astellas Pharma Inc., AstraZeneca, Daiichi Sankyo, Daiichi Sankyo, Dainippon Pharmaceutical Co., Ltd., Eli Lilly Japan K.K., Kowa Company, Ltd., Kyowa Kirin Co., Ltd., Merck & Co., Inc., Mitsubishi Tanabe Pharma Corporation, Nippon Boehringer Ingelheim Co. Ltd., Novartis Pharma K.K., Novo Nordisk, Omnipod, ONO PHARMACEUTICAL CO., LTD., Sanofi K.K., Taisho Pharmaceutical Holdings Co., Ltd., Takeda Pharmaceutical Co.,Ltd., Teijin Pharma Limited. R.Suzuki: Consultant; Novo Nordisk A/S, Other Relationship; Daiichi Sankyo, Eli Lilly Japan K.K., MSD K.K., Ono Pharmaceutical Co., Ltd., Sanofi K.K., Sumitomo Dainippon Pharma Co., Ltd., Research Support; Boehringer Ingelheim Japan, Inc., LifeScan, Mitsubishi Tanabe Pharma Corporation. J.Sasaki: None. K.Sugai: None. M.Ito: None. H.Iwasaki: None. N.Hara: None. M.Aierken: n/a. G.Li: None. H.Suwanai: None.
1046-P: Role of Serum C1q/TNF-Related Protein 9 in Predicting Gestational Diabetes Mellitus
Authors: LIU YUTING , SHI MIN , WANG ZIWEI , ZHENG XIYIN , ZHANG HONG
Published: May 2022

Background/Aims: C1q/TNF-related protein 9 (CTRP9) as a member of CTRP super family, participates in the regulation of glycolipid metabolism. However information regarding the role of CTRP9 in gestational diabetes mellitus (GDM) is scarce. The current study aims to ascertain the relationship between serum CTRP9 levels and GDM.

Methods: A total of 35 GDM patients and 37 normal pregnant women were enrolled in our study. Serum CTRP9 levels were measured via enzyme-linked immunosorbent assay (ELISA) . Fasting insulin (FINS) , IL-6, Leptin, MCP-1, TNF-α and IL-1β were quantified using Luminex-xMAP technology. Anthropometric data and biochemical parameters were also obtained or measured.

Results: The results showed that fasting plasma glucose (FPG) , one hour plasma glucose (1-h PG) , 2 hour plasma glucose (2-h PG) , FINS, IL-6, Leptin, TNF-α and CTRP9 during GDM group were significantly higher than the control group. In addition, serum CTRP9 levels had a significantly positive correlation with FPG (r = 0.559, P < 0.001) , 1h-PG (r = 0.539, P <0.0) , 2h-PG (r = 0.378, P = 0.001) , FINS (r = 0.253, P = 0.032) , HOMA-IR (r = 0.382, P = 0.001) , IL-6 (r = 0.283, P = 0.016) , and TNF-α (r = 0.266, P = 0.024) . Furthermore, binary logistic regression demonstrated that HOMA-IR and CTRP9 were independent risk factors for GDM. The AUC-ROC indicated that the diagnostic efficiency of combined CTRP9 and HOMA-IR was much higher than a single index.

Conclusions: The high level of serum CTRP9 is an independent risk factor for GDM. Moreover, the combination of serum CTRP9 and HOMA-IR were more efficient in diagnosing GDM.

Key words: Gestational diabetes mellitus, CTRP9, insulin resistance

Disclosure

H. Zhang: None.