bluuebunny/crossref_metadata_2025 huggingface dataset:
Investigating the Persistence of Touch DNA on Human Skin in Violent Crime Investigations
Authors: Alketbi Salem K
Published: July 2024

This study investigates the persistence of touch DNA on human skin to enhance forensic methodologies in violent crime investigations. Touch DNA, a crucial piece of forensic evidence, can link suspects to crimes through genetic material recovered from skin surfaces. However, the recovery of touch DNA presents unique challenges, particularly concerning the temporal window for effective collection and the influence of environmental factors on DNA preservation. Through a controlled experimental setup, this research explored how the quantity and detectability of touch DNA change over time, with particular attention to the effects of post-deposition activities such as washing. The findings indicate that while the quantity of DNA increases over time, the recovery of alleles from mixed DNA profiles, comprising both victim and perpetrator DNA, faces significant challenges. Notably, alleles from the perpetrator become undetectable after 72 hours (p < 0.05), and environmental interactions further complicate DNA recovery. This study underscores the critical importance of timely evidence collection and introduces considerations for forensic protocols to optimize the recovery and analysis of touch DNA. It also highlights the need for further investigation into how different skin types and individual shedding rates affect touch DNA persistence. Ultimately, this research contributes to the forensic science field by providing insights that can improve the resolution of violent crime investigations through more effective touch DNA recovery strategies.
Alterations of upper-extremity functional muscle networks in chronic stroke survivors
Authors: Reilly David O' , Delis Ioannis
Published: July 2024

Current clinical assessment tools don’t fully capture the genuine neural deficits experienced by chronic stroke survivors and, consequently, they don’t fully explain motor function throughout everyday life. Towards addressing this problem, here we aimed to characterise post-stroke alterations in upper-limb control from a novel perspective to the muscle synergy by applying, for the first time, a computational approach that quantifies diverse types of functional muscle interactions (i.e. functionally-similar (redundant), -complementary (synergistic) and -independent (unique)). From single-trials of a simple forward pointing movement, we extracted networks of functionally diverse muscle interactions from chronic stroke survivors and unimpaired controls, identifying shared and group-specific modules across each interaction type (i.e redundant, synergistic and unique). Reconciling previous studies, we found evidence for both the concurrent preservation of healthy functional modules post-stroke and muscle network structure alterations underpinned by systemic muscle interaction reweighting and functional reorganisation. Cluster analysis of stroke survivors revealed two distinct patient subgroups from each interaction type that all distinguished less impaired individuals who were able to adopt novel motor patterns different to unimpaired controls from more severely impaired individuals who did not. Our work here provides a nuanced account of post-stroke functional impairment and, in doing so, paves new avenues towards progressing the clinical use case of muscle synergy analysis.
Governmental approaches to food security management: A bibliometric analysis
Authors: Guliyev Eldar , Atashov Bayali , Guliyeva Aygun
Published: July 2024

The government’s duty is to guarantee unimpeded access to food. Thus, relevant public policies, individual methods and tools, approaches, and strategic decisions are always the focus of attention of scientists, politicians, and government officials. Recognizing the critical importance of this imperative, this study aims to conduct a bibliometric analysis that sheds light on the scientific landscape of strategic public administration of food security. The paper conducts a bibliometric analysis of scientific publications (using VosViewer – from 1990 to February 2024 using Scopus and WoS scientometric databases); monographs/textbooks (using Google Books and Ngram Viewer – for 1990–2019); and trend analysis (using Google Trends – from 2004 to February 2024). The analysis showed an exponential increase in the number of publications since 2000, with peaks in 2008 (financial crisis), 2019–2020 (COVID-19), and 2023 (threat to food security due to military conflicts). The clustering of scientific papers by content showed that the most significant (red) cluster unites research that links food security to agricultural development, sustainable development, climate change, and water supply. The spatial clustering of scientific publications revealed that scientific leadership belongs to scientists from the United States and China. The largest research funders are Chinese scientific institutions. It also reflected regional differences in research focus. In particular, Italy, Switzerland, and France emphasize agricultural innovation and quality standards, while China and Australia focus on increasing yields and food storage technologies.
Sustainable tourism trends in heritage sites, a bibliometric analysis
Authors: Carrillo-Acosta Natalia , Alarcón-Rivera Zulay , Valderrama-López Christian Felipe
Published: July 2024

Regions with cultural sites hold substantial potential in the tourism industry, offering an allure that captivates a broad audience; this appeal is not merely superficial; the influx of tourists revitalizes local economies and fosters community prosperity. The impact of tourism on these heritage-rich locales has been the subject of academic inquiry for over two decades; nevertheless, a comprehensive analysis is required to assess the long-term viability of tourism in these culturally significant areas. This study seeks to analyze the evolution of sustainable tourism at heritage sites through a scientometric analysis of academic literature through meticulous reviews of the Web of Science (WoS) and Scopus databases, mapping meticulously the intellectual landscape of the field by employing the innovative methodology of the 'Tree of Science' as a representational framework; the findings reveal complex relationships among various factors, including the roles of local gastronomy, the preservation of cultural integrity, tourists' quest for authenticity, and the fundamental influence of local communities in shaping tourism dynamics. This study's insights enrich the discourse on sustainable tourism practices in heritage settings, paving the way for a future where cultural preservation and tourism coexist harmoniously.
BaZrO3-Based Ceramics and Ceramic Composites as Smart Materials for Advanced Applications
Authors: Vignesh D. , Rout Ela
Published: July 2024

Ancient human history invites significant learning with unknowing facts and
fascinations. Significant development and transitions in the human lifestyle are
visualized from the capitalized materials. “Ceramics”, as antique as it sounds, is
frequently used for innumerable applications. From pottery to pellets, ammunition to
antennas, electrolytes to electronics, all exist under the radar of ceramic materials. The
dominant trait of ceramic materials for advanced applications is constantly replenished
to extract peerless products for future utilization. Ionic or covalent bonding in ceramic
microstructures administers their suitable mechanical, electrical and chemical
characteristics. Pristine ceramics display low conductivity and chemical stability, while
doped ceramics via implanted impurities empower their characteristics. The nature of
dopants and defect substitution differs on the target application. The vastly introspected
energy sector is permeated with acceptor-doped perovskite ceramics, while the defense
sector inquests over piezoelectric ceramics and ceramic composites. The trivial facet
amongst all is the use of Barium Zirconate (BaZrO3
) based ceramic compositions. It
has been substantially contemplated to visualize the role played by BaZrO3
in multiple
domains. Either as a parent material or as an additive, BaZrO3
attracts research groups
from diverse sectors. Compiled with innumerable advantages, it accompanies a few
limitations. The vital thing is the high sintering temperature along with the trade-off
between proton conductivity and chemical stability. However, BaZrO3
-based ceramics
are keenly monitored and tailored in an attempt to subsidize the maximum possible
drawback with a simultaneous improvement in their properties. In the following
chapter, we emphasize BaZrO3
-based ceramic and ceramic composites as smart
materials for advanced applications. The extended applications in the energy sector,
photocatalysts for hydrogen production, smart bullet systems in defense and microwave
dielectric resonators for wireless communications are elaborately introspected with key
insights. 
Surface Segregation in Pt3Nb and Pt3Ti using Density Functional Theory-based Methods
Authors: Obodo Kingsley O. , Kima Lalrin , Adeyinka Adedapo S. , Rai Dibya Prakash
Published: July 2024

First-principles DFT calculations were used to investigate surface
segregation processes in ordered Pt3X (where X=Nb, Ti) alloys. Using pristine Pt (111)
surface as a reference, the effect of surface segregation on the adsorption energy of O2
atoms in Pt3X alloys was evaluated. Our results showed that surface segregation due to
direct exchange is only feasible for the Pt3Nb alloy (Esegr = - 0.3833 eV) but not for its
Ti analogue (Esegr = 0.516 eV). In contrast, for both Pt3X alloys, surface segregation due
to antisite migration and leading to the formation of a Pt-skin or overlayer, favouring
oxygen atom adsorption, an essential step in ORR, is possible. Interestingly, reverse
migration of X atoms from the bulk to replace Pt atoms on the surface is an
endothermic process and is thus very unlikely. Analysis of the surface segregation
energy for configurations involving a direct exchange of Pt atoms located beyond the
third layer in the slab model with Nb atoms at the surface indicates the formation of
pristine bulk like Pt (111) surface from Pt3Nb surface is unlikely. The energy of
adsorption for the O-atom on pristine Pt (111) surface shows that the presence of
minute quantities of dopant Nb atoms in the sub-surface layer could enhance its
suitability for ORR. Comparison of O-atom adsorption energy on the various surface
segregation models of Pt3X alloys to that of pristine Pt (111) surface shows that the
formations of a Pt-skin or overlayer on the Pt3Nb surface due to surface segregation
change the O-atom adsorption energy on this surface to 0.34 eV which is just 0.14 eV
higher than the optimal value of 0.20 eV. Our results also show that the binding of an
oxygen atom to the fcc Pt site in Pt3Ti is lower in energy compared to its binding on a
pristine Pt (111) surface. In comparison, the binding of an oxygen atom to the fcc Pt
site in Pt3Ti is of the same magnitude as that of the pristine Pt (111) surface.
Nanoparticles and Environmental Health
Authors: Roy Aparna , Mandal Kumaresh , Tamang Shishir , Subba Soni , De Saptaparni , Rai Divya , Roy Biswajit , Tamang Rakesh
Published: July 2024

The size range of nanoparticles between 1-100nm is unique because of their
extremely small structure with a very high surface area to volume ratio. Besides
naturally produced nanoparticles, there is a huge worldwide demand for synthetic
nanoparticles. These synthetic nanoparticles are modified to some extent according to
the specific need. These manipulations at the nano-scale paved the way for a popular
branch of science called nanotechnology. However, with the massive use of
nanoparticle-based industrial products in our day-to-day lives, we knowingly or
unknowingly ignore their impact on the environment. The air, water, and soil quality
determines environmental health, which is reflected by a healthy ecosystem and its
biodiversity. The existing intricate interaction between humans and their surrounding
environment is important for maintaining a fine balance in the ecosystem. Any change
in this interaction may lead to adverse consequences. The nanoparticles released in the
environment cause a varying degree of effects on the ecosystem based on the type,
surface coating, and degree of its environmental transformation. Some nanoparticles
are harmful to the environment and some are beneficial. Some of the nanoparticles in
the environment get bioaccumulated in plants and animals, disturbing their growth and
productivity. Remediation by nanoparticles has been effective in removing some toxic
compounds from the environment, thereby providing a way to minimize pollution
efficiently. Thus, in this review, we have tried to present an overview of the sources,
fate, and effects of nanoparticles available in air, water, and soil. We strongly advocate
for the long-term assessment of nanoparticles, and the formulation of strict guidelines
for their usage by the concerned industries for better environmental health, and in turn
a healthy ecosystem.
Investigation for Optimum Site for Adsorption and Population Effect of Lithium on Silicene Monolayer
Authors: Lalhumhima  , Lalmuanchhana  , Gurung Shivraj , Pachuau Lalrinthara , Vanchhawng Lalmuanpuia , Zodinmawia  , Zuala Lalhriat
Published: July 2024

This investigation holds the search for optimum sites for Lithium on Silicene
Monolayer, by studying the adsorption energy on putting the Lithium atom on different
possible sites. The center of the hexagonal structure in silicene was found to be the
most favourable site. Using transition state search (TSS) the optimized stable state is
confirmed. A low Diffusion Energy Barrier (DEB) of 0.348 eV indicates that the
adsorption of Li over silicene can occur easily. Multiple adsorptions are considered, up
to 4 Li atoms upon silicene substrate. The metallic property of pristine silicene is
maintained throughout Li atom adsorption. Large adsorption energy in each of the
adsorption suggests that silicene may be promising for Li-based battery material. 
Data mining based on dynamic waste information system in Surakarta City
Authors: Suryanti Tri , Setyono Prabang , Ramelan Ari Handono
Published: July 2024

The waste problem is a problem for all parties because the negative impacts caused by waste are very diverse. Increase in waste volume caused by community activities. Research related to waste management that utilizes information technology and data mining is currently still widely open. It is hoped that the use of this technology can support decision-making in sustainable development. As a complement to this research, it also reveals that the public's perception of waste management regarding waste volume is a negative perception, which shows that the more people know about information about waste management, it has an impact on reducing waste volume. On the other hand, the positive perception shows that there is less Information about waste management has an impact on increasing the volume of waste. Both the results of the data mining process and public perception are in agreement. It is hoped that this suitability can be used as support for decision-making regarding waste management to maintain the sustainability of abiotic, biotic and cultural factors
Effect of addition of glutamic acid-producing lactic acid bacteria isolate on the sensory properties of Sere Kedele
Authors: Wipradnyadewi P A S
Published: July 2024

Sere kedele is a traditional Balinese fermented food. We often find this food in the Gianyar and Klungkung Regencies. Sere kedele is made through spontaneous fermentation, meaning no microbes are added to the process. The addition of lactic acid bacteria (LAB) isolates that produce glutamic acid during fermentation can affect the sensory properties of sere kedele. This research aimed to determine the effect of adding lactic acid bacteria isolates that produce glutamic acid on the sensory properties of sere kedele. The research used 4 treatments with 4 replications using the Completely Randomized Design (CRD) method. The addition of lactic acid bacteria isolates that produce glutamic acid did not have a significant effect on the sensory properties of soybean sere with the results being a yellowish brown color with a normal rating, a pleasant aroma, a savory taste with a favorable rating and overall acceptance of liking.
Arquivologia e processo eletrônico: uma análise de aderência do SIPAC-UFPA ao e-ARQ Brasil 2
Authors: Costa Cristian Mayko Carvalho da , Mariz Anna Carla Almeida
Published: July 2024

This article presents a report on a dissertation developed in the Postgraduate Programmein Recordsand ArchivesManagement (PPGARQ), at the Federal University of the State of Rio de Janeiro (UNIRIO), which aimed to demonstrate the theoretical and methodological importance of Archival Science and theinstitutional archival services to the computerization process of Brazilian public institutions, through electronic process systems. Thus, based on a broad literature review on the principles, methods and treatments ofthe records (digital and non-digital), it wasanalysed the level of adherence of the electronic processsystem used at the Federal University of Pará (UFPA) to the Model of Archival Requirements for Computerized Archival Management Systems in Brazil. It was found that there was a high level of adherence to the Requirements Model, demonstrating the importance of Archival Science knowledge for the use of electronic processes in Brazilianpublic institutions.
Arquivologia como elemento integrador para o acesso à universidade pública de qualidade
Authors: Melo Katia Isabelli , Saliba Artur , Alencar Livia Ketley Campos de
Published: July 2024

Based on the extension project “Archival Science as an integrative element for access to high-quality public universities”, the goal was to connect the academic world of the Archival Science programmeat the University of Brasília with students from public high schools in remote areas of the Federal District. The methodology was implemented to conduct educational presentations on the role of an archivist and the demands of the workforce, drawing from the research of Souza (1997; 2011) and Andrade (2016). Escape Room, the interactive activity that emerged from an original proposal, was a highlight of the ‘University of Brasilia Week 2023: the future is feminine’, incorporating both theoretical knowledge and archival practice by Prof. Heloísa Bellotto has made a valuable contribu-tion. The results of the analysis showed a significant impact of the activity, proving its effectiveness in engaging and promoting the Archival Science programmeto high school students in an entertain-ing way.
Enhancing personalized learning with deep learning in Saudi Arabian universities
Authors: Smirani Lassaad K. ,   Deanship of Information Technology and Elearning, Umm Al-Qura University, Makkah, Saudi Arabia, Yamani Hanaa A. ,   InnovCom, SUPCOM, Carthage University, Carthage, Tunisia,   College of Computers, Umm Al-Qura University, Makkah, Saudi Arabia
Published: July 2024

This study explores the use of deep learning methods in personalized learning environments to improve educational outcomes. We collaborated with four major universities in Saudi Arabia and used data from the Blackboard Learning Management System to gather insights on various personalized learning approaches. This helped us develop a flexible model that is suitable for different learning environments, guided by the VARK model. We used a hybrid deep learning model combining Convolutional Neural Networks (CNNs), Long Short-Term Memory (LSTM) networks, and Recurrent Neural Networks (RNNs) to classify students based on their learning preferences and engagement patterns. Our analysis showed significant improvements in student motivation and engagement with personalized learning materials. The results indicated high satisfaction levels among students and faculty, with the model achieving 85% accuracy in predicting student engagement and recommending personalized learning paths. Training the model on a dataset of 10,000 student records took about 12 hours, with 80% GPU utilization during training and 30% during inference. Precision and recall rates were 82% and 88%, respectively, with an F1-score of 0.85. Mean Absolute Error (MAE) and Root Mean Squared Error (RMSE) were low at 0.15 and 0.20, respectively. Integrating deep learning methods into personalized learning environments represents a significant shift in education, enabling educators to enhance student engagement and performance effectively. Collaboration with faculty members highlights the importance of interdisciplinary approaches in advancing educational technology and pedagogy, ensuring stakeholder satisfaction and success.
Association between Protein-Energy Malnutrition (PEM) and Natriuretic Peptide (NP) Deficiency Prevalence among the Elderly: A Cross-Sectional Study from NHANES 1999-2004 (Preprint)
Authors: Yang Guangyi , Wang Runze , Xu Botan , Zhang Yaqi , Zhang Rong , Xu Wenjing , Li Pengwei , Yu Aotian , Ning Simin , Fu Qixuan
Published: July 2024

BACKGROUND

The natriuretic peptide (NP) family is a kind of hormones essential for cardiometabolic health，while Protein-Energy Malnutrition (PEM) represents a significant risk factor for cardiometabolic diseases. However, the relationship between PEM and NP deficiency remains unclear.

OBJECTIVE

This study aims to examine the relationship between PEM and the prevalence of NP deficiency in the older population.

METHODS

In this study, we investigate associations between PEM and NP deficiency in a robust, ethnically diverse sample of 3011 participants from the National Health and Nutrition Examination Survey (NHANES) between 1999 and 2004.

RESULTS

Our findings reveal that PEM is a risk factor for NP deficiency, with an association persisting even after adjusting for a wide array of potential confounders (low risk vs major risk: OR = 0.0000022038, 95% CI: 0.0000007555, 0.0000064287; no risk vs major risk: OR = 0.0000018288, 95% CI: 0.0000005588, 0.0000059850; P for trend = 0.22). Furthermore, we observe a U-shaped nonlinear association between PEM and NP deficiency. Subgroup analysis and interaction testing reveal significant correlations between this positive association and stratification variables including age, gender, race, alcohol status, poverty income ratio, education level, and hypertension (p for interaction < 0.05).

CONCLUSIONS

Our research demonstrates a significant association between PEM and NP deficiency. Further investigations could focus on determining the causal relationship between PEM and NP deficiency.
Ubiquitous News Coverage and its Varied Effects in Communicating Protective Behaviors to American Adults in Infectious Disease Outbreaks: Evidence from a National Longitudinal Panel Survey (Preprint)
Authors: Shao Anqi , Chen Kaiping , Johnson Branden , Miranda Shaila , Xing Qidi
Published: July 2024

BACKGROUND

Effective communication is essential for promoting preventive behaviors during infectious disease outbreaks like COVID-19. While consistent news can better inform the public about these health behaviors, the public may not adopt them.

OBJECTIVE

This study aims to explore the role of different media platforms in shaping public discourse on preventive measures to infectious diseases such as quarantine and vaccination, and how media exposure influences individuals' intentions to adopt these behaviors.

METHODS

This study uses data from legacy media in the U.S., Twitter discussions, and a U.S. nationwide longitudinal panel survey from February 2020 to April 2021. We employed Intermedia Agenda Setting Theory and the Protective Action Decision Model to develop the theoretical framework.

RESULTS

We found a two-way interactive agenda flow between legacy media and social media platforms, particularly in controversial topics like vaccination (F = 16.39, p < .001 for newspapers; F = 44.46, p < .001 for Twitter). Exposure to media coverage increased individuals' perceived benefits of certain behaviors like vaccination but did not necessarily translate into behavioral adoption. For example, while individuals’ media exposure increased perceived benefits of mask-wearing (β=0.057, p<0.001 for household benefits; β=0.049, p<0.001 for community benefits), it was not consistently linked to higher intentions to wear masks (β = -0.026, p < .001).

CONCLUSIONS

Our study integrates media flow across platforms with national panel survey data, offering a comprehensive view of communication dynamics during the early stage of an infectious disease outbreak. The findings caution against a one-size-fits-all approach in communicating different preventive behaviors, especially where individual and community benefits may not always align.
Factors Affecting Clinician Readiness to Adopt Smart Home Technology for Remote Health Monitoring: Systematic Review (Preprint)
Authors: Dermody Gordana , Wadsworth Daniel , Dunham Melissa , Glass Courtney , Fritz Roschelle
Published: July 2024

BACKGROUND

The population of older adults worldwide continues to increase, placing higher demands on primary health care and long-term care. The costs of housing older people in care facilities have economic and societal impacts that are unsustainable without innovative solutions. Many older people wish to remain independent in their homes and age in place. Assistive technology such as health-assistive smart homes with clinician monitoring could be a widely adopted alternative to aged-care facilities in the future. While studies have found that older persons have demonstrated a readiness to adopt health-assistive smart homes, little is known about clinician readiness to adopt this technology to support older adults to age as independently as possible.

OBJECTIVE

The purpose of this systematic review was to identify the factors that affect clinician readiness to adopt smart home technology for remote health monitoring.

METHODS

This review was conducted in accordance with the Joanna Briggs Institute methodology for systematic Reviews and followed the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines for reporting.

RESULTS

Several factors affected clinicians’ perspectives on their readiness to adopt smart home technology for remote health monitoring, including challenges such as patient privacy and dignity, data security, and ethical use of “invasive” technologies. Perceived benefits included enhancing the quality of care and outcomes.

CONCLUSIONS

Clinicians, including nurses, reported both challenges and benefits of adopting smart home technology for remote health monitoring. Clear strategies and frameworks to allay fears and overcome professional concerns and misconceptions form key parts of the Readiness for Adoption Pathway proposed. The use of more rigorous scientific methods and reporting is needed to advance the state of the science.

CLINICALTRIAL

PROSPERO International Prospective Register of Systematic Reviews CRD42020195989; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=195989
Respiratory system pocket book with android-based augmented reality technology
Authors: Siburian Jodion , Dina Rini Rahma , Sanjaya M. Erick , Sembiring Dian Arisandy Eka Putra , Contreras Jehlie Alaisa Marasigan
Published: July 2024

Biology is an abstract, elusive science, one of which is respiratory material. It requires a media that can visualize objects on a two-dimensional book of biology to a three-dimensional one with a learning video. Research aims to develop, describe kal, and describe the teacher's assessment and student response to the results of the product developed. This research and development using model 4D consists of define, design, foresight, and develop ate. The result of this realization is the production of a medium of pocket books and apps downloaded on android smartphone platforms, able to present in real, tangible, three-dimensional objects to respiratory matter. The media was declared worthy by the validator of materials and media experts with an average rating score on final validation at 84.68% and 93.17%. Trials in the field as practical tests were obtained an assessment result from teachers by 85.36%, student responses of small groups and large groups are 86% and 83.65%. Also, it is also noted that a media pocket book and applications using this augmented reality technology are worthy to be used by students in studying the human respiratory system for grade 11th  MIPA SMAN 1 Kota Jambi.
Utilizing GeoGebra-assisted model-eliciting activities (MEAs) in mathematics instruction enhances students' comprehension of concepts and improves their problem-solving abilities
Authors: Febriani Putri Ayu , Mandailina Vera , Abdillah Abdillah , Syaharuddin Syaharuddin , Mehmood Saba
Published: July 2024

A key goal of teaching math is for students to develop a deep understanding of concepts. This understanding is the foundation for all future learning in math. The purpose of this study was to improve students' conceptual understanding and problem-solving skills in GeoGebra-assisted mathematics learning with Model Eliciting Activities (MEAs). The quantitative method with a nonequivalent (pre-test and post-test) group design was used to answer the hypothesis. The instruments used were pre-test and post-test in the form of descriptions consisting of 5 questions. The participants in this study were 26 junior high school students. Data analysis used Paired Sample T-tests (t-test) to determine the level of conceptual understanding and problem-solving ability of students. The results of data analysis obtained that the application of Model Eliciting Activities (MEAs) assisted by GeoGebra is effective in increasing student’ understanding of mathematical concepts and student problem-solving skills. So, it is concluded that learning with the Eliciting Activities Model (MEAs) assisted by GeoGebra can improve students' conceptual understanding and problem-solving skills. In the future teachers are recommended to use Model Eliciting Activities (MEAs) assisted by GeoGebra in learning mathematics.
Postsurgical rhabdomyolysis
Authors: Robles Pérez Jessica Cecilia , Jaramillo Orellana Gabriel Sebastián , Martínez Torres Paúl Santiago
Published: July 2024

Introduction: Rhabdomyolysis is an entity that can present as a low-incidence postoperative complication characterized by myonecrosis with release of toxins into the bloodstream. There are predisposing factors and the majority of post-surgical rhabdomyolysis have a multifactorial etiology. It generally presents with acute kidney injury and the need for dialysis, which increases the days of hospital stay and mortality.
Purpose: The purpose of this article is to report on the clinical case of a patient diagnosed with rhabdomyolysis after a surgical intervention, in addition to providing relevant information on early diagnosis and timely treatment.
Case presentation: It is about a 69-year-old male patient who undergoes surgery for shoulder arthroscopy, repair of the rotator cuff due to previous and superior injury, plus biceps tenotomy with subdeltoideal acromioclavicular decompression. During the postoperative period, he presents asthenia, nausea, and 12 hours of anuria. There is evidence of elevation in azotemia and muscle enzymes (Creatine phosphokinase (CPK): 10,519U/L), and the diagnosis of rhabdomyolysis is established. He remains hospitalized with an infusion of crystalloids and furosemide, in addition to steroids (methylprednisolone), N-acetylcysteine, and bicarbonate, without improvement, requiring hemodialysis. Subsequently, he evolves favorably with a gradual decrease in azotemia and muscle enzymes, and is discharged after 14 days of hospitalization.
Discussion and conclusion: Post-surgical rhabdomyolysis is frequently a multifactorial pathology, influenced by predisposing elements directly related to the patient, the surgical process, and drugs. A rare case of multifactorial postsurgical RML is presented in an elderly male patient, considered as risk factors, who required RRT and therefore, it increased hospitalization´s days.
Heroes and Identity: Two-Hundred Years in the Making
Authors: MacDonald Heather
Published: July 2024

Heather MacDonald is a fourth year history major at the University of Waterloo, specializing in Canadian Social History. Heather plans on continuing in History at the graduate level in the Waterloo area at either Laurier University or the University of Waterloo.
Gradu
Dubrovniku pripojen (je) drugi, novi grad koji se dosad zvaše predgrađem…:
Authors: Benyovsky Latin Irena , Haničar Buljan Ivana
Published: July 2024

Na temelju dosadašnjih istraživanja, prostorne analize, pisanih izvora i rezultata arheoloških istraživanja u ovom ćemo radu ponuditi hipotezu o fazama oblikovanja prostora dubrovačkoga predgrađa koji se transformira u središte grada tijekom 13. stoljeća, a danas u sebi nosi veliku slojevitost stoljetnih promjena. Komunalno planiranje predgrađā počinje već u prvoj polovini 13. stoljeća, prije promjena zabilježenih u regulacijama ulica 1272. i 1296. godine, a na prijelazu u 14. stoljeću kulminira unificiranjem različitih cjelina u jedinstveni prostor.
1073-P: Trends in Guideline-Directed Medication Therapy for Type 2 Diabetes in a Statewide Quality Collaborative between 2018–2023
Authors: MIZOKAMI-STOUT KARA R. , OSHMAN LAUREN , DIEZ HEIDI L. , GRIAUZDE DINA H. , LEE JOYCE M. , KHOSROVANEH KATHERINE L. , BHOMIA NEHA , KIM NOA , RAU JACQUELINE , REISS JACOB , BUSUI RODICA
Published: July 2024

Introduction and Objective: Since 2021, the Michigan Collaborative for Type 2 Diabetes (MCT2D) aims to improve guideline-directed medication therapies (GDMT) for type 2 diabetes (T2D). We examined trends in glucagon-like peptide-1 receptor agonist (GLP-1RA) and sodium-glucose transport protein 2 inhibitor (SGLT2i) prescribing rates comparing primary care (PC) and endocrinology (Endo) practices enrolled in MCT2D.

Methods: We analyzed pharmacy claims data from adults with T2D insured by Blue Cross Blue Shield of Michigan Preferred Provider Organization and Medicare Advantage plans who received care in an MCT2D-participating practice (PC=300; Endo=19) between 2018-2023. Descriptive statistics were used to examine differences in pharmacy claims for anti-hyperglycemic medications.

Results: From June 2022-June 2023, among 38,437 persons with T2D (PC=37,361; Endo=1,076), 26% and 41% had claims for GLP-1RA and 19% and 37% for SGLT2i, respectively. Compared to 2018 prescription rates, GLP-1RA increased by 17% and 22%, while SGLT2i prescriptions increased by 15% and 28% in PC and Endo practices respectively (Figure 1).

Conclusion: Among practices participating in a statewide collaborative to improve treatment and outcomes for people with T2D, the use of GDMT has increased since 2018. SGLT2i use is similar and GLP-1RA use is 2-3-fold higher than rates reported in other studies.

Disclosure

K.R. Mizokami-Stout: None. L. Oshman: Stock/Shareholder; Procter & Gamble, Johnson & Johnson Medical Devices Companies, Merck & Co., Inc., AbbVie Inc., Eli Lilly and Company, Abbott. H.L. Diez: None. D.H. Griauzde: None. J.M. Lee: Board Member; GoodRx. Advisory Panel; Sanofi. Consultant; Tandem Diabetes Care, Inc. K.L. Khosrovaneh: None. N. Bhomia: None. N. Kim: None. J. Rau: None. J. Reiss: None. R. Busui: Board Member; American Diabetes Association. Consultant; Procter & Gamble, AstraZeneca, Averitas Pharma, Inc., Bayer Inc., Lexicon Pharmaceuticals, Inc., Nevro Corp., Ono Pharmaceutical Co., Ltd., Novo Nordisk, Roche Diagnostics. Advisory Panel; ADA/ACC Diabetes by Heart Program.
1135-P: Pigment Epithelium–Derived Factor, Diabetic Kidney Disease, and Hypertension—Deciphering the Proteomic Response to Metabolic Bariatric Surgery in Adolescents
Authors: NARONGKIATIKHUN PHOOM , JI CHOI YE , NGUYEN NHUNG , NASH KELLY , TOMMERDAHL KALIE L. , KRETZLER MATTHIAS , INGE THOMAS , RYDER JUSTIN R. , PYLE LAURA , BJORNSTAD PETTER
Published: July 2024

Introduction & Objective: This study aims to explore the effects of metabolic bariatric surgery (MBS) on plasma proteins linked to diabetic kidney disease and hypertension in youth with type 2 diabetes (T2D).

Methods: We measured 7604 proteins in 326 plasma samples from severely obese youth, both with and without T2D, in the Teen-LABS study, examining pre- and post-MBS changes (6 month, 1, 2-, 3-, 4-, and 5-year follow-up). This analysis focused on proteins identified in the TODAY cohort as predictors of severe albuminuria (ACR ≥300 mg/g) and hypertension (SBP≥130/80 mm Hg), in youth with T2D (n=374), using Cox proportional hazard models adjusted for age, sex, HbA1c, log-transformed triglycerides and estimated insulin sensitivity. A mixed model evaluated proteomic changes post-MBS, maintaining a 5% false discovery rate with reported q-values.

Results: In Teen-LABS, several proteins associated with a higher risk of severe albuminuria and hypertension in TODAY showed notable post-surgical downregulation. Higher pigment epithelium-derived factor (PEDF) at baseline predicted onset to severe albuminuria (HR: 1.63, 95% CI 1.12, 2.37, per 1 SD increment) and hypertension (HR: 1.41, 95% CI 1.22, 1.63, per 1 SD increment) over 15 years in TODAY after multivariable adjustments. In Teen-LABS, PEDF decreased post-MBS compared to baseline at 6 months follow-up (logFC: -0.30, q-value=1.24x10-31), year 1 (logFC: -0.28, q-value=2.35x10-29), year 2 (logFC: -0.32, q-value=1.85x10-34), year 3 (logFC: -0.28, q-value=6.95x10-29), year 4 (logFC: -0.30, q-value=4.13x10-28) and year 5 (logFC: -0.30, q-value=2.78x10-26).

Conclusion: These analyses show durable attenuation of plasma PEDF after MBS, a protein strongly associated with risk of severe albuminuria and hypertension in youth with T2D. PEDF is implicated in endothelial dysfunction and vascular damage through impaired angiogenesis and endothelial repair mechanisms.

Disclosure

P. Narongkiatikhun: None. Y. Choi: None. N. Nguyen: None. K. Nash: None. K.L. Tommerdahl: None. M. Kretzler: Research Support; Boehringer-Ingelheim, Certa, Traveere Pharmaceuticals, Maze Therapeutics, Roche Pharmaceuticals, AstraZeneca, Novo Nordisk, Moderna, Inc., Chinook Therapeutics Inc., angion, Lilly Diabetes, Renalytix, Gilead Sciences, Inc., Regeneron Pharmaceuticals Inc., Janssen Pharmaceuticals, Inc. T. Inge: Consultant; Medtronic, Eli Lilly and Company, Brainstorm Therapeutics. Stock/Shareholder; Standard Bariatrics. Consultant; Teleflex. J.R. Ryder: None. L. Pyle: None. P. Bjornstad: Consultant; AstraZeneca, Boehringer-Ingelheim. Advisory Panel; Lilly Diabetes, Novo Nordisk, Bayer Inc., Horizon Therapeutics plc.

Funding

National Institutes of Health
1248-P: Association of Oxidative Stress Markers with Incident Hyperglycemia in Gestational Diabetes Mellitus—Impact of a Diabetes Prevention Program
Authors: RUIZ MONICA L. , GOMEZ-DIAZ RITA A. , LETICIA VALDEZ GONZALEZ ADRIANA , ÁNGELES MEJÍA SELENE , DIAZ-FLORES MARGARITA , SALDAÑA ESPINOZA RICARDO C. , DÍAZ MARY F. , ANGELICA RAMIREZ GARCIA LUZ , WACHER NIELS H.
Published: July 2024

Introduction & Objective: Gestational Diabetes (GDM) poses risk for developing type 2 diabetes (T2D). The role of oxidative stress in GDM and its association with incident diabetes remains unclear. This study aimed to assess the link between oxidative stress markers and incident hyperglycemia in women with and without GDM.

Methods: Prospective cohort. Pregnant women with GDM (n=201) or without GDM (n=50) undergoing cesarean section participated in an 18-month postpartum prevention program. The program emphasized healthy practices, physical activity, and psychosocial support. Oxidative stress markers [malondialdehyde (MDA), reduced glutathione (GSH), antioxidant capacity (DPPH), carbonylated proteins], and adiponectin were measured at the end of pregnancy and at 18 months later. A control group (CG) (n=57) received standard care. Multiple linear regression identified intervention-related differences.

Results: Baseline GDM women exhibited elevated oxidative stress markers and adiponectin compared to non-GDM counterparts. Antioxidant capacity was lower in GDM (40 vs. 67.8%, p=<0.001). Post-intervention, GDM cases showed a greater reduction in MDA and adiponectin (-37.55 vs-34.08 nmol, p=0.021; -751.54 vs-210.31 pg/mL, p<0.001 respectively) and antioxidant capacity increased (in both groups: 1.0 - 0.28%, vs CG -7.23 p=0.009). At follow-up, 6% progressed to T2D, and 37.3% to prediabetes. Basal malondialdehyde concentrations, pregestational BMI, and HbA1c positively correlated with incident hyperglycemia. Conversely, the change in carbonylated proteins concentrations inversely correlated with incident hyperglycemia.

Conclusion: Oxidative markers are associated with T2D risk in GDM. The diabetes prevention program effectively reduced malondialdehyde and adiponectin levels. These findings highlight the role of oxidative stress in GDM prevention strategies.

Disclosure

M.L. Ruiz: None. R.A. Gomez-Diaz: None. A. Valdez Gonzalez: None. S. Ángeles Mejía: None. M. Diaz-Flores: None. R.C. Saldaña Espinoza: None. M.F. Díaz: None. L. Ramirez Garcia: None. N.H. Wacher: None.

Funding

Fundación Gonzalo Río Arronte, Institution of Private Assistance (S.0634), and the Coordinación de Investigación en Salud (R2022-785-057)
1388-P: Risk of Diabetes among Children and Young Adults after COVID-19 Infection—The DiCAYA Study
Authors: CONDERINO SARAH , LESTER KIRCHNER H. , THORPE LORNA , DIVERS JASMIN , HIRSCH ANNEMARIE G. , NORDBERG CARA M. , SCHWARTZ BRIAN S. , CAI BO , RUDISILL CAROLINE , OBEID JIHAD S. , LIESE ANGELA D. , DIXON BRIAN E. , DABELEA DANA , BELLATORRE ANNA , SHAO HUI , BIAN JIANG , GUO YI , REYNOLDS KRISTI , MEFFORD MATTHEW T. , KAMBOJ MANMOHAN K. , MENDONCA ENEIDA A. , ALLEN KATIE , BURGETT SHAWNA , LUSTIGOVA EVA , BOST SARAH , MALTENFORT MITCH , UTIDJIAN LEVON H. , ZHOU MATT M. , CRUME TESSA L. , TITUS ANDREA
Published: July 2024

Introduction & Objective: The association between COVID-19 infection and incident diabetes remains unclear despite recent research. Using a multistate electronic health record-based surveillance approach, we examined the risk of new diabetes among children (<18) and young adults (18-44) post COVID-19 infection.

Methods: Pooled fixed-effects meta-analyses were performed. Patients (n=5,412,604) with no evidence of diabetes who received care in 2018-2019 were followed through diabetes diagnosis, death, or end of follow-up (12/31/22). COVID-19 infection was defined using labs or diagnoses from 6/1/20-12/31/21. Person-time was calculated from infection date for cases or a randomly selected visit date for controls. Propensity score-weighted Cox regression models were run at each site individually to estimate hazard ratios (HR) for diabetes risk for children and young adults.

Results: COVID-exposed individuals were at higher risk of incident diabetes compared to those with no documented infection (Children HR = 1.85 [1.69, 2.03]; Young Adult HR = 1.37 [1.31, 1.42]). All participating sites reported elevated risk but results were more heterogeneous across young adults (range 1.3-3.7, heterogeneity I2=94% vs. range 1.6-2.0, I2=0%, Figure 1).

Conclusion: These preliminary findings suggest COVID-19 infection is associated with increased risk of incident diabetes among children and young adults.

Disclosure

S. Conderino: None. H. Kirchner: None. L. Thorpe: None. J. Divers: None. A.G. Hirsch: None. C.M. Nordberg: None. B.S. Schwartz: None. B. Cai: None. C. Rudisill: None. J.S. Obeid: None. A.D. Liese: None. B.E. Dixon: Other Relationship; Elsevier. D. Dabelea: None. A. Bellatorre: None. H. Shao: Consultant; Eli Lilly and Company. J. Bian: None. Y. Guo: None. K. Reynolds: Research Support; Merck Sharp & Dohme Corp. M.T. Mefford: Research Support; Merck & Co., Inc. M.K. Kamboj: None. E.A. Mendonca: None. K. Allen: None. S. Burgett: None. E. Lustigova: None. S. Bost: None. M. Maltenfort: None. L.H. Utidjian: None. M.M. Zhou: None. T.L. Crume: None. A. Titus: None.
1555-P: Effects of 80% Pancreas Reduction on Beta-Cell Function and Glucose Metabolism
Authors: SOLDOVIERI LAURA , DI GIUSEPPE GIANFRANCO , CICCARELLI GEA , BRUNETTI MICHELA , MARI ANDREA , QUERO GIUSEPPE , ALFIERI SERGIO , GIACCARI ANDREA , MEZZA TERESA
Published: July 2024

Introduction and Objectives: Diabetes typically develops when the endocrine pancreas fails to cope to insulin demand with adequate insulin secretion. Many studies have shown that diabetes appears when the loss of pancreatic β cell mass is approximately between 41% and 65% in humans. Near total pancreatectomy (NTP) is a surgical procedure that removes 80% of pancreatic mass.To investigate the metabolic effects of NTP in a cohort of nondiabetic subjects.

Methods: We recruited 7 subjects who underwent an oral glucose tolerance test (OGTT) and a hyperglycemic clamp (HC) followed by arginine stimulation, before and 3 months after NTP. We calculated the area under the curve of glucose (AUC-Glu) and insulin (AUC-Ins) responses during OGTT. Therefore, we estimated the β cell glucose sensitivity (βCGS), an index of β cell function, and rate sensitivity (RS), an index of first phase insulin secretion. Further, we calculated the total area under the curve of insulin responses (AUC-Itot) and the area under the of the arginine-stimulated insulin secretion (AUC-Arg) during HC.

Results: Compared to presurgical OGTT, we observed a 18% increase in the mean glucose levels during OGTT after surgery (AUC-Glu 19761 vs 23421 mg/dl·min) with a 57% reduction of the mean insulin concentration (AUC-Ins 6499 vs 2788 μU/ml·min p<0.05). Further, we observed a 36% reduction βCGS (61.2 vs 38.7 pmol min-1m-2mmol-1L) and a 82% reduction in the RS (763 vs 139 pmol m-2mmol-1L p<0.05) after surgery. Both total insulin secretion and arginine-stimulated insulin secretion during HC were reduced (AUC-Itot 15776 vs 6489 μU/ml·min) (AUC-Arg 7144 vs 2520 μU/ml·min), respectively by 58.8% and 64.7%. According to the ADA diagnostic criteria 3 of the 7 subjects developed diabetes.

Conclusion: In conclusion, despite previous reports, 80% β cell mass loss is not always sufficient to develop hyperglycemia. Additional studies will be necessary to understand what mechanisms play a compensating role in the preservation of glucose tolerance in those patients.

Disclosure

L. Soldovieri: None. G. Di Giuseppe: None. G. Ciccarelli: None. M. Brunetti: None. A. Mari: Consultant; Lilly Diabetes. G. Quero: None. S. Alfieri: None. A. Giaccari: None. T. Mezza: None.