bluuebunny/crossref_metadata_2025 huggingface dataset:
Características de usabilidade digital com maior impacto comportamental
Authors: Honorato Eduardo Jorge SantAna , Martins Kenne Samara Andrade
Published: June 2018

É um estudo de abordagem quantitativa do tipo exploratório descritivo fundamentado no método de revisão integrativa de literatura, cujo objetivo foi analisar as publicações científicas sobre as características de usabilidade digital com maior impacto comportamental, por meio de revisão integrativa de literatura de 2000 – 2014 na Biblioteca Virtual de Saúde (BVS). Foram analisadas 26 produções através de uma planilha e um roteiro elaborado para extrair as informações. O ano de maior publicação sobre a temática foi 2012 representando 19%, o periódico com mais frequência de publicações foi a Revista Escola Ciência da Informação, as publicações por grau de titulação do autor foram graduandos, mestres e doutores no ano 2012. As produções foram didaticamente expostas em tabelas e gráficos conforme os objetivos propostos. A literatura reconhece a importância dos avanços tecnológicos e todo impacto que tem na vida das pessoas e dos seus usuários e busca novos artifícios que venham a contribuir com o uso benéfico de toda tecnologia.    DOI: http://dx.doi.org/10.22169/revint.v13i28.1253
Motivação e docência: uma aproximação entre gestão escolar e comportamento organizacional
Authors: Feldhues Paulo Raphael
Published: June 2018

Neste artigo pretende-se aproximar os estudos em Comportamento Organizacional ao campo da educação, visando identificar possibilidades de prática de gestão escolar que impactem positivamente sobre problemas comuns à docência, como a baixa motivação e o elevado stress. Para tal, realizou-se uma revisão da literatura sobre o tema, estabelecendo diálogos entre teorias motivacionais e do aprendizado. Conclui-se que as teorias abordadas são complementares e apresentam potencial de contribuição à gestão escolar, desde que não tomadas isoladamente.     ABSTRACT The objective of the following article is to approach studies in Organizational Behavior towards education, aiming to identify possibilities of school management practice that positively impact teaching common problems, such as low motivation and high stress. Thus, there was a review of the literature on the subject establishing the connection motivational and learning theories. It is concluded that the theories addressed are complementary and have a potential contribution to school management, if not taken separately.   Keywords: Education. Teaching. Motivation. School management. Organizational behavior.   RESUMEN En este artículo se pretende aproximar los estudios en Comportamiento Organizacional al campo de la educación, buscando identificar posibilidades de práctica de gestión escolar que impacten positivamente sobre problemas comunes a la docencia, como la baja motivación y el elevado stress. Así, se realizará una revisión de la literatura sobre el tema, estableciendo diálogos entre teorías motivacionales y del aprendizaje. Se concluye que las teorías abordadas son complementarias y presentan potencial de contribución a la gestión escolar, siempre que no se toman aisladamente.   Palabras clave: Educación. Docencia. Motivación. gestión escolar. Comportamiento organizacional. DOI: http://dx.doi.org/10.22169/revint.v13i28.1263
A relação simbiótica entre a educação escolar e as novas tecnologias digitais
Authors: Proto Vinicius Gorla , Inforsato Edson do Carmo , Chediak Sheylla
Published: June 2018

RESUMO Atualmente as relações de socialização, comunicação, consumo e até de aquisição de conhecimentos são mediadas por tecnologias digitais e, neste contexto, ainda nos deparamos com escolas e educadores negando tanto a importância quanto à utilidade da presença de tais tecnologias em suas práticas. Este trabalho intenta, a partir de diferentes referenciais teóricos, abordar a questão da importância de se atribuir à escola a função de promover a fluência digital em seus alunos. Para tanto, foram tensionadas ideias de alguns autores otimistas em relação ao tema, como Kenski (2003) e Lévy (1993), e outros críticos, como Flusser (1985) e Türcke (2009, 2010).   Palavras-chave: Novas tecnologias digitais, Escola, Sociedade do conhecimento. ABSTRACT Nowadays socialization, communication, consumption and even knowledge acquisition relationships are mediated by digital technologies and, in this context, one comes across schools and educators denying both the importance and the usefulness of such technologies in their practices. This paper attempts, from different sources of theoretical frameworks, to address the importance of assigning schools the responsibility of promoting digital fluency among their students. Therefore, ideas from some authors in favor of such topic like Kenski (2003) and Lévy (1993), as well as some critics like Flusser (1985) and Türcke (2009, 2010) have been used. Keywords: New digital technologies, School, Knowledge society.   RESUMEN Actualmente socialización relaciones, la comunicación, el consumo e incluso la adquisición de conocimientos están mediadas por las tecnologías digitales y, en este contexto, todavía encontramos con escuelas y educadores que niegan la importancia y la utilidad de la presencia de dichas tecnologías en sus prácticas. Este trabajo intenta, a partir de diferentes referenciales, abordar la cuestión de la importancia de atribuir a la escuela la función de promover la fluencia digital en sus alumnos. Por lo tanto, nos tensado ideas de algunos autores optimistas en relación con el tema, como Kenski (2003) y Lévy (1993), y otra crítica como Flusser (1985) y Türcke (2009, 2010).   Palabras clave: Nuevas tecnologías, Escuela, Sociedad del conocimiento. DOI: http://dx.doi.org/10.22169/revint.v13i28.1371
O Desenvolvimento Profissional Docente e o PNE (2014-2024)
Authors: Jardilino José Rubens Lima , Sampaio Ana Maria Mendes
Published: June 2018

RESUMO Este artigo tem por objetivo refletir sobre a discussão em torno do desenvolvimento profissional docente em consonância com as metas e ações de formação e condições de exercício profissional, trazidas pelo novo Plano Nacional de Educação (PNE 2014-2024 – Lei 13.005/2015). O artigo focaliza o atual PNE, bem como algumas das dificuldades que o tem caracterizado, apenas, como uma carta de intenções naquilo a que se propõe principalmente no que toca aos desafios de colaboração entre os entes federativos da República Federativa do Brasil.   Palavras-Chave: Plano Nacional de Educação; Desenvolvimento Profissional Docente; Colaboração Federativa.   ABSTRACT The following paper aims to reflect on the discussion on teacher professional development aligned with the goals and training activities and professional practice conditions brought by the new National Education Plan (PNE 2014-2024 – Lei 13.005/2015). It focuses on the current PNE, as well as some of its peculiar difficulties due to that fact that it is considered only as a letter of intent in its proposal, especially regarding the collaboration challenges among the Brazilian states.   Keywords: National Education Plan; Professional Development of Teachers; Federal collaboration.     RESUMEN Este artículo tiene por objetivo reflexionar sobre la discusión en torno al desarrollo profesional docente en consonancia con las metas y acciones de formación y condiciones de ejercicio profesional, presentada en el nuevo Plan Nacional de Educación (PNE 2014-2024 - Ley 13.005 / 2015) . Se enfoca el actual PNE, así como algunas de las dificultades que lo han caracterizado, apenas, como una carta de intenciones en lo que se propone principalmente en lo que se refiere a los desafíos de colaboración entre los entes federativos de la República Federativa de Brasil.   Palabras clave: Plan Nacional de Educación; Desarrollo Profesional Docente; Colaboración Federativa.   DOI: http://dx.doi.org/10.22169/revint.v13i28.1381
Editorial
Authors: Shaw John
Published: June 2018

No abstract
Gaelic Rèiteach: Symbolism and Practice
Authors: Martin Neill
Published: June 2018

No abstract
Differentiating the Gaelic Landscape of the Perthshire Highlands
Authors: Murray John Stuart
Published: June 2018

No abstract
Variation in Gaelic Storytelling
Authors: Zall Carol
Published: June 2018

No abstract
Rev. William Matheson and the Performance of Scottish Gaelic ‘Strophic’ Verse
Authors: Blankenhorn V.S.
Published: June 2018

The late Rev. William Matheson's lifelong fascination with the performance of Gaelic songs in so-called 'strophic' metres ultimately resulted in his recording seventeen such songs for the album Gaelic Bards and Minstrels, No. 16 in the Scottish Tradition series of recordings from the School of Scottish Studies Archive. Strophic metre, used largely for clan eulogy, elegy, and other praise-poetry in the period after the decline of the syllabic metres, is remarkable in that the final line of each stanza contrasts metrically and ornamentally with all of the preceding lines in that stanza. This article examines Matheson's sources, methodology, and performance; evaluates his rationale; and assesses the likely authenticity of his performances of six songs in which the number of lines varies from one stanza to the next.
Reeling in the Strathspey: The Origins of Scotland’s National Music
Authors: Lamb William
Published: June 2018

According to the conventionally held view, the strathspey or 'strathspey reel' was an eighteenth century innovation instigated by fiddlers of the Speyside region, such as the Browns of Kincardine and the Cummings of Grantown. However, the basic rhythmic characteristics inherent to the strathspey – a series of long and short notes, organised within two or four strong beats per bar – are found in Gaelic songs thought to be much older. Using a range of data from early fiddle collections and transcriptions of twentieth century audio recordings, this paper explores the musical and semantic connections between the strathspey and Gaelic song, suggesting an alternative developmental path for Scotland’s national music.
O encarceramento feminino Uma história de vida de uma detenta do presídio Nilza da Silva Santos
Authors: Carvalhido Maria Luiza Lacerda
Published: June 2018

O presente artigo é um desdobramento da dissertação de mestrado em Sociologia Política apresentado à Universidade Estadual do Norte Fluminense Darcy Ribeiro no ano de 2016 e tratará da história de vida de uma detenta do presídio feminino Nilza da Silva Santos, localizado em Campos dos Goytacazes. Esse presídio é o único presídio feminino no norte e noroeste fluminense. Através da metodologia de história de vida com abordagem qualitativa, pretende-se compartilhar a experiência dessa mulher no cárcere, com a intenção de contribuir para o debate da criminalidade feminina e a visibilidade das mesmas.
Gestão Social, Territórios Pacificados e os Desafios da Articulação Institucional
Authors: Misse Daniel Ganem
Published: June 2018

Os programas de gestão social em territórios pacificados surgem com a proposta de articular ofertas de serviços públicos a demandas comunitárias por esses serviços em localidades com Unidades de Polícia Pacificadora (UPP). Após grande expansão nos anos de 2011 e 2012, a partir de 2013 a estratégia desses programas passa a ser reduzida em número de gestores e territórios cobertos pela política, até ser descontinuada em 2014. A partir da teoria do triângulo de governo de Carlos Matus e de problematizações acerca da conjugação entre políticas sociais e de segurança pública nas favelas pacificadas, em um sistema político multipartidário de ampla coalizão, procura-se explicar as dificuldades e os desafios da articulação institucional de políticas sociais nesses territórios. Avalia-se o possível legado em termos de tecnologia social produzido pelos programas de gestão social e os desafios na articulação de projetos sociais como forma de se observar os processos e resultados desses programas.
Lógicas corporativas, particularismos e os processos de administração institucional de conflitos no Rio de Janeiro
Authors: Pires Lenin Dos Santos , Eilbaum Lucia , Lima Roberto Kant de
Published: June 2018

Neste artigo propomos pensar questões sobre “Segurança Pública” a partir das políticas vinculadas à área, focalizando na forma em que a mesma é concebida como um campo de intervenção política. Buscamos relacionar essas concepções com a constituição da “Segurança Pública” como um campo de conhecimento, partindo da análise do que chamamos de lógicas corporativas, argumentando que elas tendem a favorecer certos particularismos em torno das formas como são concebidas as formas de administrar os conflitos, favorecendo a adoção de estratégias repressivas, de matriz militar ou do direito. Isso ocorre em um contexto no qual não se pode pensar em sistemas de integração de instituições, mas em formas competitivas de lidar com a informação e, dessa maneira, construindo saberes particulares sobre os fenômenos da criminalidade e da violência, redundando em formas igualmente particularizadas para lidar com os mesmos.
Padrões de Dinamismo Inovativo e Estratégias Empresariais de Inovação no Sistema de Inovação do Rio de Janeiro
Authors: Marcellino Israel Sanches , Santos Guilherme Oliveira
Published: June 2018

Considerando essa relação entre estratégias empresariais e sistemas de inovação definidos em contornos territoriais, o objetivo deste trabalho é analisar os padrões de dinamismo inovativo da economia fluminense a partir dos dados da PINTEC de 2014 à luz das estratégias de inovação das empresas fluminenses. Como principais resultados identificou-se uma dinâmica inovativa regional com duas vertentes. Dessa dualidade tem-se um padrão representado pela ‘ilha’ de dinamismo inovativo nucleada pelo complexo produtivo de petróleo e gás natural. Não há sinais, no entanto, de que essa ‘ilha’ seja capaz de dinamizar os demais segmentos do tecido produtivo fluminense por processos de difusão ou por spillovers de conhecimento. A outra face dessa dualidade aparece refletida nos dados da PINTEC por um conjunto de empresas industriais de baixo dinamismo inovativo com tendências associadas a estratégias de inovação defensiva, com perfil predominante de importação de máquinas e equipamentos mais modernos. Nos termos da colaboração para inovação, notou-se que, à semelhança da realidade nacional, a maior parte das empresas inovadoras adotam estratégias autocentradas. Ainda assim, com relação às empresas inovadoras, as evidências apontam dados coerentes com a dualidade estrutural identificada para o sistema regional de inovação do Rio de Janeiro. Mais além, outro fator preocupante compatível com os indícios apontados pelos dados da PINTEC 2014 é a possível inserção estrategicamente subordinada das empresas localizadas no Rio de Janeiro em cadeias de produção nacionais e globais.
O Processo de Industrialização Brasileiro: repercussões e perspectivas
Authors: Nunes Pereira Willian Eufrasio , Filho Ricardo Schmidt , Rodrigues Cryslãine Flavia da Silva
Published: June 2018

Motivado pelas discussões de desindustrialização no Brasil, este trabalho buscou analisar a influência/reflexos da dinâmica e direção do processo de industrialização brasileiro por substituição de importações (1930-1979) sobre o atual perfil (e perspectivas de desenvolvimento) da indústria brasileira. O método utilizado foi o analítico-descritivo. Constatou-se que a indústria brasileira vem apresentando, desde a década de 1980, uma significativa perda de dinamismo, acompanhada de um processo de especialização regressiva da sua estrutura produtiva. Conclui-se também que a definição de uma política macroeconômica compatível com políticas industriais e tecnológicas torna-se importante para fazer a indústria brasileira voltar a apresentar um maior dinamismo compatível com o estágio atual de desenvolvimento do país.
Hayek e a Nova Sociologia Econômica
Authors: Angeli Eduardo
Published: June 2018

O objetivo deste artigo é contribuir ao estudo do pensamento econômico e social de Hayek, focalizando em aspectos institucionais e cognitivos, em busca do estabelecimento de uma conexão entre a análise dos fenômenos sociais empreendida pelo austríaco e a Nova Sociologia Econômica. Para isso, o artigo busca esclarecer o que se entende por Nova Sociologia Econômica e qual a distinção entre esta abordagem e uma visão mais convencional da análise econômica. Também procura colocar em evidência pontos levantados por Hayek para entender como ele pensava que instituições e regras transmitidas pela cultura podem exercer importante influência sobre as pessoas. Por fim, o artigo considera a relação entre instituições e normas, para Hayek.
¿Cómo pueden afectar los valores faltantes la robustez de las estimaciones? Una aplicación práctica a partir de la Encuesta de Condiciones de Vida (EUROSTAT)
Authors: Mediavilla Mauro
Published: June 2018

Habitualmente, la literatura empírica en el campo de la economía aplicada basa sus estimaciones en bases de datos que sólo contienen las observaciones con información válida para todas las variables implicadas en el análisis. En la gran mayoría de los casos, esta práctica tiene como consecuencia una pérdida de información que, a su vez,puede originar dos problemas: una menor efectividad de la estimación y un incremento en la probabilidad de llegar a una mala especificación del modelo. El objetivo del trabajo es comprobar la importancia de la imputación de datos faltantes en la minimización de ambas problemáticas. Para ello se aplica la imputación múltiplecomo alternativa para obtener estimaciones más robustas que la generada por la simple no imputación.Los resultadosmuestran que la imputación mejora la efectividad de la estimación en términos de errores estándar más reducidos y; en relación con la especificidad del modelo, se constatan sensibles cambios en la significatividad de algunas variables según la muestra empleada para la estimación.
NEDDATE - NÚCLEO DE ESTUDOS, DOCUMENTAÇÃO E DADOS SOBRE TRABALHO E EDUCAÇÃO
Authors: Tiriba Lia , Rodrigues Maria Cristina Paulo , Antunes José Luiz Cordeiro
Published: June 2018

O Núcleo de Estudos, Documentação e Dados sobre Trabalho e Educação - NEDDATE, criado em 1985, por tempo indeterminado, está vinculado ao Programa de Pós-Graduação em Educação (Mestrado e Doutorado) e à Faculdade de Educação da Universidade Federal Fluminense. Edita a partir do ano de 2003 a revista online TrabalhoNecessário.
CIRCUITOS EDUCATIVOS: A ESCOLA MODERNA N. 1 E OS GINÁSIOS VOCACIONAIS NOTURNOS, UM ESTUDO COMPARATIVO
Authors: Moraes Carmen Sylvia Vidigal , E Silva Doris Accioly
Published: June 2018

O trabalho apresenta resultados iniciais de projeto de pesquisa mais amplo sobre práticas culturais e educativas desenvolvidas pelo movimento operário ou direcionadas aos trabalhadores pelos setores dominantes no decorrer do século XX, especificamente no estado de São Paulo. É nosso objetivo específico localizar/destacar o percurso do ideário anarquista, traduzido num conjunto de prescrições práticas para a organização da denominada Escola Moderna n.1 por grupos anarquistas, entre 1912 e 1919, tomado comparativamente ao projeto pedagógico dos Ginásios Vocacionais Noturnos, uma iniciativa de política pública de educação, nos anos 1960, destinada a jovens e adultos trabalhadores.
FORMAÇÃO INICIAL DE SOLDADOS DA POLÍCIA MILITAR DO ESTADO DO RIO DE JANEIRO NO CONTEXTO DA REFORMA GERENCIAL DO ESTADO
Authors: Veiga Célia Cristina Pereira da Silva , Souza José Dos Santos
Published: June 2018

O objeto de investigação deste artigo é o Curso de Formação de Soldados (CFSd) da Polícia Militar do Estado do Rio de Janeiro (PMERJ), condicionado pelas mudanças na política de segurança pública a partir da reforma gerencial do Estado. O objetivo do texto é explicitar contradições existentes na configuração do CFSd determinadas pela atual política de segurança pública. Os resultados da pesquisa permitem afirmar que as mudanças ocorridas na política de segurança pública, a partir da Reforma do Estado, sofisticaram o discurso de mediação do conflito de classes propondo modelos de policiamento pautado na concepção de polícia cidadã, embora a formação dos policiais da PMERJ continue pautada na coerção.
MAIS O PROGRAMA EDUCAÇÃO E A GESTÃO DO TRABALHO ESCOLAR: UM ESTUDO EM DUQUE DE CAXIAS/RJ
Authors: Costa Regis Arguelles
Published: June 2018

O objetivo geral desse artigo é contribuir para a compreensão crítica dos rebatimentos de políticas de inspiração neoliberal de Terceira Via na gestão do trabalho escolar docente, ao nível da rede escolar municipal. Analisamos a implantação e gestão do Programa Mais Educação (PME) em uma escola de Duque de Caxias, município do estado do Rio de Janeiro. Concluímos que as condições estruturantes para a ampliação da jornada ao nível da gestão do trabalho escolar – financiamento da política, formação do profissional e condições do espaço escolar – foram bem articuladas pela escola pesquisada, ainda que com limitações.
INTEGRAÇÃO CURRICULAR NO IFES: LIMITES E POSSIBILIDADES DA PESQUISA-AÇÃO
Authors: Lima Marcelo , Sperandio Renan , Maciel Samanta , Teixeira Zilka
Published: June 2018

Neste trabalho, foi analisado a pesquisa-ação no contexto da integração curricular do ensino médio à educação profissional na Rede Federal. Identificou-se a emergência de uma “resistência muda” dos sujeitos envolvidos que por meio de discursos e práticas destoantes apoiaram, mas também boicotaram a pesquisaação, resultando na descontinuidade da mobilização e do envolvimento dos grupos focais. De todo modo, houve êxito no campo do diagnóstico e da formação docente e os resultados futuros são promissores para os objetivos do estudo.
Corporate governance and internal controls: A case study from Greece
Authors: Koutoupis Andreas G. , Pappa Evangelia
Published: June 2018

The objective of this paper is twofold. Firstly, it portrays and evaluates the existing corporate governance structure and secondly, highlights its connection with internal audit function and management practices. It is adopted a descriptive research analysis using the quantitative approach on a sample of listed companies in Athens Stock Exchange for the year 2016. Our methodological research instrument is based on COSO (2013) Internal Control - Integrated Framework. The paper concludes that corporate governance is driven to managerial excellence and effective governance because of internal audit processes, risk assessment, control activities, information and communication, and monitoring activities. The research contributes to the corporate governance literature by providing valuable insights into the major aspects of a well-functioning internal control system and its relevance to management performance. Proposed areas for future research directions should be discussed.
Hereditary Spherocytosis
Authors: Koju Surendra , Makaju Ramesh
Published: June 2018

Introduction: Hereditary spherocytosis is a red cell membrane disorder that causes hemolytic anemia. Due to defective cell membrane, red cells are spherical shaped and result in their early lysis. Osmotic fragility of spherocytic red cell is increased.

Case report: A 22 year old female presented with chief complain of abdominal pain. Initially she was diagnosed as cholelithiasis. Under laboratory evaluation she was found to be anemic with reticulocytosis. In peripheral blood smear, spherocytes were moderately distributed. Antihuman globulin test was negative but osmotic fragility was high. Hence, she was confirmed as case of hereditary spherocytosis.

Conclusion: Hereditary spherocytosis is a rare red cell disorder and its diagnosis can be made by osmotic fragility test.
Accounting History Research Topics—An Analysis of Leading Journals, 2006–2015
Authors: Spraakman Gary P. , Quinn Martin
Published: June 2018

This paper analyzes and categorizes published research papers in three specialist accounting history journals—Accounting History, The Accounting Historians Journal, and Accounting History Review. A key objective is to highlight under-represented areas for future research. We inductively derive a categorization system, and classify over four hundred papers from 2006–2015 according to twelve categories. The results show some rather under-researched areas, namely religion and accounting education. Using statistical analysis techniques, we note similarities and differences across the three journals and suggest avenues for future researchers.
Does Stewardship Still Have A Role?
Authors: Miller Anthony D. , Oldroyd David
Published: June 2018

The paper analyzes the decision of the FASB and IASB not to treat the motivational and control aspects of stewardship as a separate and distinct reporting objective to that of facilitating investment decisions. It does so first by considering the demand for information to control agents, and second by assessing the capacity of decision-useful information to replicate stewardship effects. The paper finds an essence to accounting based on the legal protection of property rights, encompassing stewardship, which has remained constant since earliest times. The decision taken by the boards on stewardship also appears disconnected from changes in the capital markets, as well as the writings on reporting objectives that preceded it.
Opioid Receptor Blockade with Intranasal Naloxone Prevents the Development of Hypoglycemia-Associated Autonomic Failure
Authors: ALEKSIC SANDRA , LONTCHI-YIMAGOU ERIC , HULKOWER RAPHAEL , CAREY MICHELLE , UDE MERCY , MITCHELL WILLIAM G. , SANDU OANA , TOMUTA NORICA , SHAMOON HARRY , HAWKINS MEREDITH
Published: June 2018

Attainment of near-normal glycemic goals in type 1 diabetes (T1D) is limited by iatrogenic hypoglycemia. Repeated episodes of hypoglycemia lead to Hypoglycemia-Associated Autonomic Failure (HAAF), with blunted counter-regulatory hormone responses. We previously reported that pharmacologic activation of opioid receptors experimentally recapitulates some features of HAAF (Diabetes 66:2764; 2017), and opioid antagonism with intravenous naloxone prevents experimentally induced HAAF in healthy subjects. We therefore hypothesized that intranasal naloxone would augment central blockade of opioid receptors by bypassing the blood-brain barrier, and would provide a feasible outpatient approach to prevent HAAF.

Using a randomized, double-blinded placebo-controlled study design, 7 healthy subjects (7M; age 43±3 year; BMI 25.9±0.9 kg/m2) participated in paired two-day studies, 5 weeks apart. Day 1 consisted of two 120 minute hypoglycemic (∼54 mg/dl) hyperinsulinemic clamps, with hourly intranasal administration of either saline (placebo) or naloxone (4 mg hourly). On day 2, subjects underwent one 120 minute hypoglycemic clamp (∼54 mg/dl). As expected, HAAF was experimentally induced in the placebo studies, based on lower peak epinephrine levels (mean±SEM: first hypoglycemic episode=1375±182 vs. third episode=858±235, pg/ml, p=0.004). With intranasal naloxone, epinephrine levels did not differ from the first to the third hypoglycemic episode (first=942±190 vs. third episode=857±134 pg/ml, p=0.4). Naloxone did not alter the responses of plasma glucagon, cortisol or growth hormone, or hypoglycemic symptoms.

These findings suggest that HAAF can be prevented by acute blockade of opioid receptors during hypoglycemia, presumably by inhibiting opioid receptor activation by circulating endorphins. Thus, acute self-administration of intranasal naloxone could be an effective and feasible ’real-world’ approach to ameliorate HAAF in T1D.

Disclosure

S. Aleksic: None. E. Lontchi-Yimagou: None. R. Hulkower: None. M. Carey: None. M. Ude: None. W.G. Mitchell: None. O. Sandu: None. N. Tomuta: None. H. Shamoon: None. M. Hawkins: None.
Better Postprandial Glucose (PPG) Control with BioChaperone Combo (BC Combo) than with Lispro Mix25 (LMx) or Separate Glargine and Lispro (G+L) Administrations in Subjects with Type 2 Diabetes (T2DM)
Authors: HEISE TIM , MOERSCHEL LEONA PLUM , MÉGRET CLAIRE , HERBRAND THERESA , VACHER VÉRONIQUE , ANASTASSIADIS ERNESTOS , KLEIN OLIVER , GAUDIER MARTIN , SOULA OLIVIER , GLEZER STANISLAV , ALLUIS BERTRAND , MEIFFREN GRÉGORY
Published: June 2018

BC Combo is a co-formulation of prandial insulin lispro (25%) and basal insulin glargine (75%) with a rapid “prandial“ insulin component and prolonged flat “basal“ component compared to LMx. In this study the effects of BC Combo on PPG vs. LMx and G+L were investigated. Thirty-nine T2DM subjects (mean±SD age 60.8±7.5 years and HbA1c 7.97±0.6%) were randomized to receive the three insulin combinations immediately before a standardized solid meal test (MMT, 20% protein 30% fat 50% carbohydrates) in a double-blind, double-dummy, cross-over design. The individual insulin dose was the same for each visit day (mean 0.62 U/kg). BC Combo demonstrated improved PPG compared to LMx (Figure, reduction ∆AUCBG,0-2h of 18%, p=0.0009) and G+L (reduction ∆AUCBG,0-2h of 10%, p=0.0450). The proportion of subjects experiencing documented symptomatic hypoglycemic events (plasma glucose <70 mg/mL) over 24h was numerically lower with BC Combo (15.8%) vs. LMx (32.4%) and G+L (21.6%). The total insulin PK profile of BC Combo showed a faster time to insulin peak and a lower exposure in the late prandial phase (2-6 h) than LMx and G+L.

In conclusion, BC Combo demonstrated superior PPG control in T2DM subjects with numerically fewer subjects experiencing symptomatic hypoglycemia compared to both LMx and separate G+L.

Disclosure

T. Heise: Research Support; Self; ADOCIA, Boehringer Ingelheim GmbH, Dance Biopharm, Eli Lilly and Company, Janssen Research & Development, MedImmune, Merck Sharp & Dohme Corp., Mylan, Nordic Bioscience, Novo Nordisk A/S, Poxel SA, Roche Diagnostics Corporation, Saniona, Sanofi, Senseonics, Zealand Pharma A/S. Advisory Panel; Self; Novo Nordisk A/S, Mylan. Speaker's Bureau; Self; Dexcom, Inc., Eli Lilly and Company, Novo Nordisk A/S, Sanofi. L. Plum-Moerschel: None. C. Mégret: Employee; Self; ADOCIA. Stock/Shareholder; Self; ADOCIA. T. Herbrand: None. V. Vacher: Employee; Self; ADOCIA. E. Anastassiadis: None. O. Klein: None. M. Gaudier: Employee; Self; ADOCIA. Stock/Shareholder; Self; ADOCIA. O. Soula: Board Member; Self; ADOCIA. Stock/Shareholder; Self; ADOCIA. Employee; Spouse/Partner; ADOCIA. S. Glezer: Stock/Shareholder; Self; Sanofi. Stock/Shareholder; Spouse/Partner; Sanofi. Employee; Self; ADOCIA, Novo Nordisk Inc.. Employee; Spouse/Partner; Pfizer Inc., Teva Pharmaceutical Industries Ltd.. Stock/Shareholder; Spouse/Partner; Teva Pharmaceutical Industries Ltd.. B. Alluis: None. G. Meiffren: Employee; Self; ADOCIA. Stock/Shareholder; Self; ADOCIA.
Follow-On Basal Insulin—Can Online CME Improve Clinical Knowledge and Ability to Use Effectively?
Authors: LARKIN AMY , DROPKIN JESS , LE ANNE
Published: June 2018

We assessed baseline knowledge of follow-on basal insulin and if an online, video-based, continuing medical education (CME) roundtable activity could improve the clinical knowledge and competence of primary care physicians (PCPs) and diabetologists/endocrinologists (D/Es) regarding follow-on basal insulin. A 3-question knowledge/competence and 1-question confidence linked pre-/post-assessment study design with McNemar’s chi-squared test (5% significance level, P <.05) and Cramer’s V (<0.no effect; 0.06-0.15 small effect; 0.16-0.30 medium effect; >0.30 large effect) assessed educational effect. The activity launched February 14, 2017, and data collected through March 20, 2017. PCPs (N=284) demonstrated a lower baseline knowledge level compared to D/Es (N=57): 9% of PCPs compared to 23% of D/Es correctly identified PK/PD data for follow-on insulin glargine 14% of PCPs compared to 30% of D/Es correctly identified a patient for whom follow-on basal insulin was a good therapeutic option Overall improvements were seen after participation in for both PCPs (n = 284; large effect of V= 0.329) and D/Es (n = 57; medium effect of V= 0.217). Improvements include: 56% more PCPs (P<.001) and 38% more D/Es (P<.001) accurately selected a patient for follow-on basal insulin use 30% more PCPs (P<.001) and 16% more D/Es (P=.082) correctly identified PK/PD data for follow-on insulin glargine 12% more PCPs (P=.001) and 10% more D/Es (P=.123) selected an effective strategy for overcoming a common barrier to insulin therapy 61% of PCPs and 37% of D/Es reported increased confidence switching patients with T2D from insulin glargine to follow-on insulin glargine This study demonstrates the success of online, video-based roundtable-style CME on improving clinical knowledge and competence of PCPs and D/Es related to follow-on basal insulin. As expected, PCPs had lower baseline knowledge compared to D/Es, and may need more foundational education related to newer therapeutic options for T2D.

Disclosure

A. Larkin: None. J. Dropkin: None. A. Le: None.
Human Regular U-500 Insulin via Continuous Subcutaneous Insulin Infusion vs. Multiple Daily Injections in Adults with T2D—The VIVID Study, Primary Population
Authors: GRUNBERGER GEORGE , BHARGAVA ANUJ , LY TRANG T. , ZISSER HOWARD , ILAG LIZA , MALONE JAMES K. , ZHANG SHUYU , JOHNSON JENNAL
Published: June 2018

VIVID is the first prospective, randomized controlled trial to assess efficacy and safety of U-500R (Humulin® R U-500) administered by CSII (using an investigational Omnipod U-500™ Insulin Management System) vs. MDI (TID). This 26-week, open-label, multicenter, parallel study (NCT02561078) enrolled adults with T2D on 201-600 units of insulin/day with or without other antihyperglycemic agents. We report data for the primary population (N=340), excluding participants on concomitant GLP-1 RAs or SGLT2 inhibitors. Data for the all-randomized population are reported separately. Baseline characteristics were similar between arms. CSII showed noninferior A1C reduction vs. MDI (primary objective) and superior FPG reduction at 26 weeks with adjustment for multiplicity. CSII showed significantly greater A1C reduction at a lower total daily dose with no multiplicity adjustment. Clinically important hypoglycemia rates (<54 mg/dL) and weight gain were similar; severe and nocturnal (≤70 mg/dL) hypoglycemia rates were statistically higher for CSII vs. MDI (Table). In this population, U-500R via CSII had greater efficacy at a lower dose vs. MDI with higher hypoglycemia rates for some categories. CSII with U-500R may be a viable option for T2D patients on high-dose insulin. Individualized dose titration will be important to safely achieve A1C targets.

Disclosure

G. Grunberger: Research Support; Self; Medtronic MiniMed, Inc., Novo Nordisk Inc.. Speaker's Bureau; Self; Eli Lilly and Company, Novo Nordisk Inc., Sanofi, Boehringer Ingelheim Pharmaceuticals, Inc., AstraZeneca, Janssen Pharmaceuticals, Inc.. A. Bhargava: None. T.T. Ly: Employee; Self; Insulet Corporation. H. Zisser: Employee; Self; Verily Life Sciences LLC.. Stock/Shareholder; Self; Verily Life Sciences LLC. L. Ilag: Employee; Self; Eli Lilly and Company. Stock/Shareholder; Self; Eli Lilly and Company. J.K. Malone: Employee; Self; Eli Lilly and Company. S. Zhang: Employee; Self; Eli Lilly and Company. Stock/Shareholder; Spouse/Partner; Eli Lilly and Company. J. Johnson: Employee; Self; Eli Lilly and Company.
Is It Possible to Predict the Onset of Nocturnal Severe Asymptomatic Hypoglycemia Using CGM Data of Previous Day and Next Morning in Type 1 Diabetic Patients Receiving Insulin Degludec?
Authors: TAKAHASHI HIROSHI , NISHIMURA RIMEI , UTSUNOMIYA KAZUNORI
Published: June 2018

The aim of this study to investigate whether the occurrence of nocturnal severe asymptomatic hypoglycemia (NH) may be predicted based on glycemic variability on the previous day and next morning on the day of onset. This study examined patients with type 1 diabetes (T1D) who underwent CGM assessments and received basal bolus therapy of insulin degludec (IDeg) in outpatient setting. NH was defined as glucose levels < 54 mg/dL detected between 12:00 and 6:00 AM. The subjects were evaluated for fasting glucose level, the range of post-breakfast glucose elevation, and glucose level at bedtime (12:00 AM) on the previous day. For comparison, the patients were divided into those with NH and those without by using t-test. Optimal cut-off values for the relevant parameters were determined in order to predict NH using ROC analysis. Thirty-one patients (mean HbA1c values, 7.8 ± 0.7 %) were selected for analysis. NH occurred in 8 patients (26%). Fasting glucose level was significantly lower in those with NH than in those without (61 ± 13 mg/dL vs. 130 ± 68 mg/dL; P = 0.001). The range of post-breakfast glucose elevation was significantly greater in those with NH. Again, the glucose level at bedtime was significantly lower in those with NH than in those without (88 ± 44 mg/dL vs. 144 ± 69 mg/dL; P = 0.044). The cut-off values for predicting NH determined for the relevant factors were as follows: fasting glucose level < 69 mg/dL (sensitivity 0.83/ specificity 0.75/ AUC 0.86, P = 0.003) and bedtime glucose level < 90 mg/dL (0.83/ 0.75/ 0.79, P = 0.017). The results suggest that fasting glucose level of < 69 mg/dL and bedtime glucose level < 90 mg/dL had approximately 80% probability of predicting the occurrence of NH in T1D receiving IDeg. While the post-breakfast glucose levels and the pre- and post-dinner glucose levels were not significantly different, the range of post-breakfast glucose increase was greater in those with NH than in those without.

Disclosure

H. Takahashi: None. R. Nishimura: Speaker's Bureau; Self; Boehringer Ingelheim Pharmaceuticals, Inc., Astellas Pharma US, Inc., Eli Lilly and Company, Abbott, Medtronic, MSD K.K., Novo Nordisk A/S, Sanofi, Takeda Development Center Asia, Pte. Ltd., Kissei Pharmaceutical Co., Ltd., Taisho Pharmaceutical Co., Ltd., Sumitomo Dainippon Pharma Co., Ltd.. K. Utsunomiya: None.
BioChaperone 222 (BC222), the New Excipient Enabling the Ultra-rapid BioChaperone Lispro (BCLIS) Formulation, Is Completely Absorbed and Rapidly Excreted after Subcutaneous (s.c.) Injection
Authors: MEIFFREN GRÉGORY , PLUM-MOERSCHEL LEONA , RANSON AYMERIC , ANASTASSIADIS ERNESTOS , SEROUSSI CYRIL , CORREIA JOSÉ , ANDERSEN GRIT , GAUDIER MARTIN , SOULA OLIVIER , GLEZER STANISLAV , ALLUIS BERTRAND
Published: June 2018

BC222 is an oligosaccharide grafted with anionic charges and amino acid moieties designed to speed up the absorption of insulin lispro in the BCLIS formulation. Non-clinical data indicated that BC222 is rapidly excreted unchanged by the kidney. This open label clinical trial conducted in 12 healthy volunteers [mean±SD age 31.4±9.5 years; weight 95.3±16.8 kg; BMI 28.6±4.1 kg/m²] investigated the PK properties and safety and tolerability of a single s.c. dose of BC222 (equal to the BC222 content in 1.0 U/kg BCLIS) using validated liquid chromatography mass spectrometry assays for BC222 in plasma and urine samples. BC222 was rapidly absorbed, with a median plasma Tmax of 1.2 h (Figure). BC222 was rapidly cleared from the blood with a mean terminal half-life of 2.07 (±0.52) h reaching baseline levels 10-12 h after administration. Urinary BC222 concentrations reached 95.4±4.5% of the injected dose within 12 h post-dosing and was as high as 9 % ± 5% of the total dose after 48h indicating that BC222 was completely absorbed from the s.c. tissue into the blood and quickly cleared via the urine. BC222 was well tolerated and safe with only two mild adverse events occurring in the whole study.

In conclusion, BC222 is completely absorbed after s.c. injection and rapidly excreted by the kidneys.

Disclosure

G. Meiffren: Employee; Self; ADOCIA. Stock/Shareholder; Self; ADOCIA. L. Plum-Moerschel: None. A. Ranson: Employee; Self; ADOCIA. Stock/Shareholder; Self; ADOCIA. E. Anastassiadis: None. C. Seroussi: Employee; Self; ADOCIA. Stock/Shareholder; Self; ADOCIA. J. Correia: Employee; Self; ADOCIA. Stock/Shareholder; Self; ADOCIA. G. Andersen: None. M. Gaudier: Employee; Self; ADOCIA. Stock/Shareholder; Self; ADOCIA. O. Soula: Board Member; Self; ADOCIA. Stock/Shareholder; Self; ADOCIA. Employee; Spouse/Partner; ADOCIA. S. Glezer: Stock/Shareholder; Self; Sanofi. Stock/Shareholder; Spouse/Partner; Sanofi. Employee; Self; ADOCIA, Novo Nordisk Inc.. Employee; Spouse/Partner; Pfizer Inc., Teva Pharmaceutical Industries Ltd.. Stock/Shareholder; Spouse/Partner; Teva Pharmaceutical Industries Ltd.. B. Alluis: None.
Short-Term Effects of Basal-Plus Insulin Therapy on Early Remission of Newly Diagnosed Type 2 Diabetes
Authors: WOKS EMMA , ETOGA MARTINE CLAUDE ETOA NDZIE , NAMBA RAICHA , KATTE JEAN CLAUDE NJABOU , MBANYA JEAN CLAUDE , SOBNGWI EUGÈNE
Published: June 2018

Objective: Ketosis prone diabetes has been associated with prolonged normoglycemic remission after discontinuation of early intensive insulin therapy. However, it is unknown if such an approach can produce similar results in classical type 2 diabetes (T2DM). Therefore, our study sought to assess the effects of an outpatient regimen of basal-plus insulin therapy on early remission of newly diagnosed T2DM.

Research Methods: Newly diagnosed T2DM patients had an 8-week course of basal-plus insulin therapy which was then discontinued. Weekly 4-point glycemic profiles were done. HbA1c, lipid profile and insulin sensitivity, using the hyperinsulinemic euglycemic clamp were assessed at baseline and after the intervention. Early remission was defined as HbA1c < 48mmol / mol without treatment for at least 12 weeks

Results: Eleven patients were included on diagnosis. Fasting blood glucose decreased (12.7 [7.8-15.0] vs. 4.9 [4.2-6.2] mmol / l). HbA1c dropped from 101.0 [84.0 -108.0] to 42.0 [36.0-50.0] mmol / mol, after basal-plus insulin therapy and was maintained at 38.0 [33.0-43.0] mmol / mol after 12 weeks with no active treatment. Ten out of eleven subjects experienced early remission. Insulin sensitivity improved significantly after the intervention with a variation in the adjusted M-value from 7.95 [6.39-11.03] to 12.85 [10.24-14.92] mg / kg / min,. The distinctive feature of those who did not require antidiabetic medications was that their initial standardized M-value was > 5.0 mg / kg / min. A significant decrease in total cholesterol and LDLc was observed from 5.40 [5.17-5.87] to 4.45 [3.57-5.48] mmol / L, and 3.83 [2.82-4.37] to 1.[0.54-2.95] mmol / L, respectively. HDLc increased significantly from 1.14 [1.03-1.40] to 2.12 [1.86-2.69] mmol / L.

Conclusion: Basal-plus insulin therapy is effective, feasible, and safe in newly diagnosed T2DM and can induce early remission as observed in ketosis prone diabetes.

Disclosure

E. Woks: None. M. Etoa ndzie Etoga: None. R. Namba: None. J. Njabou Katte: None. J. Mbanya: Advisory Panel; Self; GlaxoSmithKline plc.. Speaker's Bureau; Self; Novo Nordisk A/S, Sanofi, Servier. E. Sobngwi: None.
The Influencing Factors of Continuous Subcutaneous Insulin Infusion in Newly Diagnosed T2DM Patients
Authors: KE WEIJIAN , LIU LIEHUA , LI YANBING
Published: June 2018

In order to investigate the influencing factors of continuous subcutaneous insulin infusion (CSII) of 48 newly diagnosed T2DM patients without hypoglycemic agents were analyzed. The enrolled patients were 46.1±9.1 years in age, with a BMI of 25.2±2.8 kg/m2, FPG of 11.6±3.2mmol/L, PPG of 17.4±6.5mmol/L, and HbA1c of 10.8±2.1%. Glucose levels and beta cell function were measured at baseline. An intravenous glucose tolerance test (IVGTT) using 25g of glucose (50ml of 50% glucose) was conducted to assess acute insulin response (AIR) as beta cell function. Serum insulin levels before and 1, 2, 4, 6, and 10 min after glucose injection were measured, and AIR was calculated as the incremental trapezoidal area. The initial insulin dosages of CSII were 0.5-0.7IU/kg according to clinical experience. The insulin dosages were adjusted to achieve euglycemia which was defined as fasting glucose between 4.4 and 6.0 mmol/L and postprandial glucose between 4.4 and 8.0mmol/L as capillary blood glucose values were measured including fasting, premeal and postprandial. CSII therapies were maintained for 14 days and fasting C peptide was measured at 7th day after achieving glycemic targets. The patients achieved glycemic control in 3(3) days. Baseline FPG, PPG, HbA1c, and HOMA-IR were positive related to the days spent to euglycemia (r=0.402, p=0.0and r=0.334, p=0.029 and r=0.352, p=0.015, and r=0.306, p=0.035, respectively). AIR was negative related (r=-0.457, p=0.001). The initial insulin dosages were not associated with the days of achieving glycemic control. The incidents of hypoglycemia of all patients were 3(3) times, which were negative related to C peptide level at 7th day after achieving euglycemia (r=-0.333, p=0.021).

In conclusion, the patients with lower baseline glucose levels and better beta cell function were preferred to achieve glycemic control in shorter time during IIT. The suppression of endogenous insulin secretion was associated with exposure of hypoglycemia.

Disclosure

W. Ke: None. L. Liu: None. Y. Li: None.
Effect of Leptin Replacement Therapy (LRT) on Survival and Disease Progression in Generalized and Partial Lipodystrophy (GL, PL)
Authors: ALI OMER A. , COOK KEZIAH , GUPTA DEEPSHEKHAR , HOLMQVIST DAN , LEE DON , NG COURTNEY K. , BRADT PAMELA , BROWN REBECCA
Published: June 2018

Lipodystrophy (LD) is an ultra-rare disease associated with significant morbidity and mortality. Effects of LRT on metabolic disease in GL and PL have been studied; but effects on mortality are unknown. We investigated these effects using data from GL and PL patients treated with LRT at NIH (N=114) and cared for but not treated with LRT at 3 centers in the U.S. and Turkey (N=178).

Four abnormalities (liver, kidney, heart, and HbA1c ≥6.5%) were considered. LRT patients had a mean of 2.8 abnormalities prior to treatment, while the mean for untreated patients was 0.7 at a similar age. We used a matching approach to create comparable samples of treated and untreated patients. Each treated patient was matched (using Mahalanobis distance) to an untreated patient to balance across age, gender, type of LD, and number of abnormalities. LRT treatment effect was examined via Cox proportional hazards models of 1) mortality and 2) development of subsequent abnormalities. Additionally, the relationship between abnormalities and mortality was studied in the sample of untreated patients.

Results: A Cox proportional hazards model relating treatment to mortality yielded a hazard ratio (HR) for LRT of 0.34 (p=0.047), meaning that LRT was associated with a 66% decrease in mortality risk. Adjusting for covariates including gender, type of LD, and type of abnormality resulted in a larger decrease in mortality risk (HR 0.21, p<.01).

One possible mechanism for the effect of LRT on mortality is its role in mitigating or resolving abnormalities. A time-varying Cox proportional hazards model relating number of abnormalities present (0 to 4) to mortality among untreated patients found a positive relationship between additional abnormalities and mortality (HR 3.2, p<.01). Separately, we found that LRT reduced the likelihood of developing a third (HR 0.47, p<.01) or fourth abnormality (HR 0.46, p<.05).

In conclusion, these are the first data suggesting that LRT reduces mortality in LD.

Disclosure

O.A. Ali: Consultant; Self; Aegerion Pharmaceuticals. K. Cook: Consultant; Self; Aegerion Pharmaceuticals. D. Gupta: Consultant; Self; Aegerion Pharmaceuticals. D. Holmqvist: Consultant; Self; Aegerion Pharmaceuticals. D. Lee: Consultant; Self; Aegerion Pharmaceuticals. C.K. Ng: Consultant; Self; Aegerion Pharmaceuticals. P. Bradt: Employee; Self; Aegerion Pharmaceuticals. R. Brown: None.