bluuebunny/crossref_metadata_2025 huggingface dataset:
Development of Chat Application
Authors: Kasetwar Dr. Abhay , Gajbhiye Ritik , Papewar Gopal , Nikhare Rohan , Warade Priya
Published: May 2022

Abstract: Conversation is a way of using technology to connect people with ideas outside of local boundaries. The technology has been available for years but adoption has only recently taken place. Our project is an example of a chat server. It is made up of two applications - the client application, which runs on the user's web browser and the server application, running on any network servers. To start chatting the client must be connected to a server where they can conduct private and group chat. Safety measures were taken at the last moment. The latest developments in the internet have brought the world into our hands. Everything happens online from information transfer to purchasing. The internet makes the world a little round. This project is also online. This paper highlights the importance of the use of dialogue in everyday life and its impact on the world of technology. This project is for the development of a chat system based on Javascript programming language and network concept. The app allows people to transmit messages both privately and publicly .It also enables the feature to share resources such as files, photos, videos, etc. This online application is designed to communicate or chat with others online. It is more reliable and secure than any other traditional system available. Javascript, React.js and the client server concept were used to develop a web-based chat app. This app is built with the right structures for future development. It can be planted in all private organizations such as Colleges, IT parks, etc. Keywords: Javascript , React.js, Internet.
The Need to Codify Law of Tort
Authors: Mangla Prachi
Published: May 2022

Abstract: Law of tort is the branch of law dealing with cases where one party suffers from a legal damage and as a remedy, compensation is provided to that party. Law of Tort in India, is one such branch which has high influence from foreign law , making a deep impact on Indian Judiciary for how to deal with Tort cases. In India, Law of Tort is currently uncodified due to it’s dynamic nature and such differentiability in the nature of it’s cases. The branch is also not very popular among people and it’s Litigation is low in the country primarily because of it’s uncodified nature. Although whatever number of Tort cases the Judicial system of India have witnessed, it is shaping the future of Law of Tort .With hundreds of years of Law being the sole protector of people’s rights , the shifting times demand notable changes in it , and one step closer in achieving it is to codify Law of Tort
Can AI replace Human? A Study on Customer Perception and Attitude towards AI-Based Chatbot in Food Service
Authors: Saxena Dr. Vikas , Gautam Amardeep
Published: May 2022

Abstract: When interaction comes in digital world means interacting with AI- enabled chatbot, this study focuses on customer perception and attitude to conclude can AI replaced the human? Primary survey was done for collected the customer data, 300 people were targeted out of which 219 responds. The study concludes that customer still prefer human interaction over chatbot even chatbot provides many benefits like quick response, easy to use and convenient to interact at any time. After conclusion there is future scope of this study and some recommendation for food service providers in India. Keywords: Chatbot, Food Service, Artificial Intelligence, Food Industry
Unique Brain Wave Pattern Detection Using Brain Electrical Oscillation Signature Profiling (BEOSP)
Authors: L Ashish , A Dilna
Published: May 2022

Abstract: When a person experiences a familiar stimulus, the brain emits a unique brain wave pattern, which is known as brain fingerprinting. The use of functional magnetic resonance imaging in lie detection stems from studies that reveal that people who are asked to lie have distinct patterns of brain activity than people who are telling the truth. The use of such evidence in courts is examined in detail. The author concludes that neither approach has adequate evidence of accuracy in identifying fraud to be used in court at this time. A new lie detector has been developed in the field of criminology in the United States of America. This is referred to as "brain fingerprinting." This innovation is said to be the greatest lie detector on the market right now. When a person experiences a familiar stimulus, the brain emits a unique brain wave pattern, which is known as brain fingerprinting. In order to identify lies, functional magnetic resonance imaging is used. This innovation is believed to be the finest lie detector accessible to date, detecting even slick crooks who easily pass the polygraph exam (the traditional lie detector test). The new technology uses brain waves to determine whether or not the person being tested remembers the finer details of the incident. According to scientists who are very pleased about the new kid on the block, even if the person voluntarily suppresses the vital knowledge, the brain wave will undoubtedly catch him. Keywords: Brain finger printing, sources of EEG, EEG Vs FMRI & PET, Four phases of brain fingerprinting, Applications
A Case Study of Planning, Design and Construction Strategies for Green Buildings
Authors: Shimpi Prof. A. L. , Baviskar Prof. V. K. , Aher T. A. , Nagade A. A. , Durde G. B. , Khatal A. S.
Published: May 2022

Abstract: A green building is concerned with the energy, thermal, visual aspect of built environment. Such buildings have minimum energy consumption and the carbon emissions generated annually are also minimum. A green building can be autonomous and independent from the energy grid supply. The energy required can be harvested on-site; usually through a combination of renewable sources like Solar, Wind and Bio-mass. The overall use of energy can also be minimized by the use of extremely efficient Heating Ventilation and Air Conditioning (HVAC) and Lighting technologies. While a green building focuses on the aspects such as waste reduction, use of recycled building materials, site sustainability etc If we look at a building site as a closed system and the electric and fuel meters as the entry and exit points for all energy used or generated on the site including in and on the building, we can define the minimum site energy target. Further, as the intent of a green building is to reduce CO2 emissions from burning fossil fuels, the site energy must be from renewable sources. So, a green building is one whose amount of energy “imported” into the site is nearly equal to the amount of renewable energy generated on site that is “exported” off the site. For electricity this would be equivalent to the electric meter rotating backward, electricity to the grid, and equal number of forward rotations, electricity from the grid, over the course of a year. Keywords: Heating Ventilation and Air Conditioning, waste reduction, sustainable construction
Attendance System Based On Facial Recognition
Authors: Shivam K . , Bharadwaj Ms. Bhanu
Published: May 2022

Abstract: The face is the most important part of a person's identity. This physical characteristic has undergone a major change in methodology. Since the advent of image-processing technology, the goal of recognizing people is the only thing you can accomplish with a face recognition system. After recognizing someone, you can use more detailed processing to identify them. Traditional face recognition systems are not as accurate as you might want them to be. The system described in the present document is intended to deviate from this point of view. Introduce a traditional system to track students' faces and a new, more modern approach to identifying students. Keywords: SMART ATTENDANCE SYSTEM, A.I., FACIAL RECOGNITION, OPENCV, PCA
Sea Water Converted into Usable and Emergency Drinkable Water
Authors: Sawant Manisha , Deore Vishwanath , Chaure Ashwini , Khan Irfan , Momin Ashfaq
Published: May 2022

Abstract: Water could be very important for all residing beings. It covers almost 70% of earths surface. Even alevin though the principal part of earth is included via way of means of water, there's extreme scarcity of consuming water in maximum of the international locations throughout the world. Safe consuming water is crucial for all kinds of lifestyles alevin though it does now no longer offer any calories. Desalination of sea water seems as an answer for this problem. Advanced desalination technology which are carried out to seawater and brackish water show to be powerful options in a whole lot of situations. This take a look at in particular makes a speciality of upcoming traits in current desalination technology and emphasizing the alternatives supplied via way of means of them. Desalination is a way wherein the extra salts are eliminated from sea water or brackish water changing it into secure potable or usable water. Desalination techniques are labelled into thermal procedures and membrane procedures. In this bankruptcy we speak approximately special thermal procedures like multistage flash distillation, a couple of impact distillation, vapour compression evaporation, cogeneration and sun water desalination Keywords: Water management project, Desalination, Salt remova
Cooling of Photovoltaic Panel with Water Spray Technique
Authors: Kajale Ganesh G. , Dhanvijay Pooja C. , Shahakar Harshal B. , Khandekar Pratik H. , Chaudhari Yash T. , Vaidhya Chaitali A. , Yeole S. P
Published: May 2022

Abstract: The main aim of this experiment is to show that the use of water spray technique for the cooling of Photo-voltaic Panel to improve its performance parameters. The increase in temperature of Photo-voltaic panel due to accumulation of heat affects the performance parameters of it negatively. It also focuses on the why adaption of water spray technique cooling method over the other conventional cooling methods is effective. The effective design of the cooling system for Photo-voltaic panel was made and the procedure to carry out the experiment is describe. Experiment was carried out to check the performance of Photo-voltaic panel. The data was collected and is mentioned accordingly, analysis of experimental data and the calculations were done to show the improvement in performance parameter. Improvement in the efficiency by using water spray technique cooling system is found to be 2.14%. At last the results are shown in accordance with performance of Photovoltaic panel and discussions is made. It can be concluded that cooling of Photovoltaic panel using water spray technique can be one of the effective methods to improve its performance.
Universal Entanglement Transitions of Free Fermions with Long-range Non-unitary Dynamics
Authors: Zhang Pengfei , Liu Chunxiao , Jian Shao-Kai , Chen Xiao
Published: May 2022

Non-unitary evolution can give rise to novel steady states classified by their entanglement properties. In this work, we aim to understand the effect of long-range hopping that decays withr−αin non-Hermitian free-fermion systems. We first study two solvable Brownian models with long-range non-unitary dynamics: a large-NSYK2chain and a single-flavor fermion chain and we show that they share the same phase diagram. Whenα>0.5, we observe two critical phases with subvolume entanglement scaling: (i)α>1.5, a logarithmic phase with dynamical exponentz=1and logarithmic subsystem entanglement, and (ii)0.5<α<1.5, a fractal phase withz=2α−12and subsystem entanglementSA∝LA1−z, whereLAis the length of the subsystemA. These two phases cannot be distinguished by the purification dynamics, in which the entropy always decays asL/T. We then confirm that the results are also valid for the static SYK2chain, indicating the phase diagram is universal for general free-fermion systems. We also discuss phase diagrams in higher dimensions and the implication in measurement-induced phase transitions.
Formação Econômico-Social
Authors: Mantuano Thiago
Published: May 2022

Este artigo tem como objetivo aclarar e divulgar a categoria Formação Econômico-Social para sua instrumentalização na Ciência Histórica. Neste texto, buscaremos demonstrar como a tradição marxista a formulou para capturar a unidade coerente na diversidade social, ressaltando a multiplicidade de fatores, esferas e dimensões que sua pretensão abarca. Importa, também, pontuar a sua diferença e complementariedade ao conceito de Modo de Produção. Por último, teceremos algumas distinções entre formações pré-capitalistas e capitalistas.
Walter Benjamin y el sentido mesiánico de la revolución
Authors: Rodríguez Martínez Jorge
Published: May 2022

En las Tesis sobre el concepto historia, Walter Benjamin construyó un marco teórico para criticar la modernidad. En la primera tesis sostiene que el materialismo histórico podría triunfar si ponía a su servicio la teología. Aunque esta afirmación se opone a las interpretaciones ortodoxas del marxismo, comparte la necesidad de establecer las condiciones necesarias para la revolución. Benjamin reconoce la importancia de entender la historia a partir de las condiciones materiales, pero también, la necesidad de rescatar la dimensión metafísica de la experiencia. En ese sentido, la concepción teológica de la modernidad es una herramienta que aporta al materialismo histórico para su crítica.
Juicio y Enfermedad: aproximación a las dinámicas de las enfermedades en la Real Audiencia de Santa Fé. 1571
Authors: Grajales Rivera Alejandro
Published: May 2022

El objetivo de esta disertación es evidenciar y analizar, por medio de una transcripción documental, el proceso sobre un aparente envenenamiento por yerbas, que reposa en el fondo Caciques e Indios en el Archivo General de la Nación (Bogotá). El escrito está dividido en dos partes: la primera es un breve análisis sobre la importancia, diferencia y algunas consideraciones historiográficas en torno a las enfermedades, las relaciones sociales y estereotipos en el choque cultural colonial presentes en el documento; la segunda parte consta de la trascripción documental sobre el proceso judicial a Isabel y Catalina, indígenas ladinas, por el supuesto envenenamiento con yerbas a dos niñas y un indio panche. Se espera que este aporte pueda servir de insumo e incentivo para el desarrollo y entendimiento de algunas de las temáticas y dinámicas coloniales en lo que actualmente es Colombia.
Evaluation of whole blood, mean platelet volume (MPV) and neutrophil-lymphocyte ratios (NLR) in people with B12 vitamin deficiency
Authors: DURMAZ Adem
Published: May 2022

Introduction: It was aimed to investigate the effects of vitamin B12 deficiency on blood tests, mean platelet volume (MPV), and neutrophil-lymphocyte ratio (NLR), which is one of the inflammation markers.Methods: Our study is a case-control study of 375 patients. 170 patients with low B12 (<130 pg/dL) were accepted as the experimental group, and 205 individuals with normal B12 levels were accepted as the control group. Between these two groups, white blood cells (WBC), platelet count (Plt), hemoglobin (Hgb), mean erythrocyte volume (Mean Corpuscular Volume-MCV), mean platelet volume (Mean Platelet Volume-MPV), neutrophil, lymphocyte counts, and neutrophil -lymphocyte ratios (NLR) were examined.Results: The mean age was 48.45 ±17.497 years in the B12 deficient group and 51.93 ±16.175 years in the control group. The mean of vitamin B12 in the deficient group was 101.41 ± 20.50 pg/mL (min-max 37-130), while it was 257.24 ± 88.13 pg/mL (131–498) in the control group. It was observed that there was no statistically significant difference between WBC, Hgb, Plt, neutrophil, lymphocyte, MVC, MPV and NLR values.Conclusion: In our study, we could not find a significant relationship between B12 deficiency and blood tests. In previous studies, there has been information that MPV values are affected by B12 deficiency. In our study, we found that there was no significant relationship between B12 deficiency and MPV or NLR (p > 0.05). There is a need for new studies on how B12 deficiency will change as the degree and duration of B12 deficiency increases, especially its effect on atherogenic events.
Menciptakan Aparatur Yang Profesional Untuk Penyelenggaraan Birokrasi Dalam Pelayanan Publik
Authors: Anugrah Dwinda , Satoto Sukamto , Hartati Hartati
Published: May 2022

Artikel ini dibuat untuk mengetahui permasalahan mengenai aparatur yang tidak profesional dalam melakukan pelayanan publik kepada masyarakat, serta mengetahui bagaimana cara menciptakan aparatur yang profesional. Aparatur sipil negara adalah para pegawai yang berkedudukan sebagai aparatur negara yang bertugas memberikan pelayanan kepada masyarakat. Aparatur yang Profesional artinya menekankan kepada kemampuan,  keterampilan  dan  keahlian aparatur pemerintah  dalam  memberikan pelayanan publik yang responsif, transparansi, efektivitas dan efesien.
Kewenangan Lembaga Ombudsman Terhadap Kategori Rumah Sakit Publik Dan Rumah Sakit Privat di Bidang Kesehatan
Authors: Tumangger Elfi Nola , Satoto Sukamto , Hartati Hartati
Published: May 2022

Artikel ini membahas mengenai kewenangan ombudsman sebagai pengawas pelayan publik di bidang kesehatan (Studi Undang-Undang NO. 37 TAHUN 2008 Tentang Ombudsman Terhadap Rumah Sakit  Publik dan Rumah Sakit  Privat). kategori pelayanan kesehatan tidak lepas dengan fasilitas tempat yang namanya rumah sakit. Menurut Undang-Undang Nomor 44 Nomor Tahun 2009 tentang Rumah Sakit.  Rumah sakit merupakan organisasi yang bergerak di bidang pelayanan publik, secara khusus kesehatan. Dalam perbuatan maladamisnistrasi maka dibutuhkan keberadaan dari lembaga pengawas penyelenggara pelayanan publik secara khusus dibidang kesehatan. Dalam artikel ini akan di bahas mengenai kewenangan Ombudsman dalam konsep rumah sakit publik dan rumah sakit privat sesuai dengan ketentuan ketentuan pasal   1   angka   1 Undang-Undang  Nomor  37 Tahun  2008  tentang Ombudsman Republik Indonesia.
La educación continua como agente para la mejora profesional y competitividad en México
Authors: Cantú-Martínez Pedro César
Published: May 2022

La educación continua se ha caracterizado, en la actualidad, por una oferta educativa bastante amplia en el concierto internacional en forma de cursos, talleres y diplomados, entre otras modalidades, que imparten principalmente las instituciones de educación superior. No obstante, el papel importante que representa esta actividad para la sociedad, en el marco de la globalización, aún cuenta con desafíos que residen en la acreditación, adecuación a los nuevos medios de comunicación y sortear las limitantes de los idiomas. Sin embargo, la educación continua se constituye en uno de los caminos para empoderar y mejorar la práctica profesional en México. En la presente contribución, mostramos en que consiste la educación continua, su relevancia y los retos que afrontará en México
Desafíos de la rendición de cuentas en la educación superior
Authors: Abellán-López Maria Angeles
Published: May 2022

Este artículo presenta un análisis de la rendición de cuentas, conocida en inglés como accountability, y su expansión en los sistemas académicos. Con base en la investigación bibliográfica y documental, este trabajo enfatiza los dos sentidos de accountability: el normativo y el tecnocrático. La hegemonía del sentido tecnocrático sobre el normativo tiene implicaciones para el modelo de rendición de cuentas que se está consolidando y no favorece una responsabilidad inteligente de los sistemas de educación superior.
El Aprendizaje Basado en Proyectos y su aplicación didáctica en la enseñanza de las medidas de localización
Authors: Zorrilla-Pacheco Silvana C. , Flores-Samaniego Ángel H. , Jiménez-Gaona Yuliana C.
Published: May 2022

En los últimos años se han evidenciado muchas dificultades en la enseñanza-aprendizaje de la matemática, ante ello surge la necesidad de buscar prácticas innovadoras de enseñanza-aprendizaje que ubiquen al estudiante en el centro del proceso educativo. El Aprendizaje Basado en Proyectos (ABP) es una metodología activa que facilita la interacción docente-estudiante y consigue aprendizajes significativos. El objetivo de este trabajo es determinar la incidencia del ABP y su aplicación en las medidas de localización a nivel básico. La metodología aplicada describe una investigación cuantitativa de tipo exploratorio-descriptivo. Los resultados indican una diferencia considerable antes y después de la aplicación del ABP.
Modeling Habitat Suitability of Hippophaerhamnoides L. Using MaxEnt under Climate change in China: A Case Study of H. r. sinensis and H. r. turkestanica
Authors: HE Xiaohui , H. Si J. , Zhou Dongmeng , Zhu Li , zhao chunyan , jia bin , wang chunlin , qin jie , zhu xinglin
Published: May 2022

Hippophaerhamnoides is widely known for its important ecological,
economic, and social benefits. It is known as the pioneer plant of soil
and water conservation, with homology in food and medicine. Here we used
occurrence data and environmental (climate and soil) variables to
simulate and predict the habitat distribution for H. r. sinensis and H.
r. trkestanica in China, both at the current time and in the 2050s
(2041-2060). Our aim was to analyze the dominant factors effecting its
distribution using MaxEnt and the spatial analysis of geographic
information system. The results indicated that H. r. sinensis is mainly
distributed in Shaanxi, Shanxi, Sichuan, Qinghai, Gansu, Ningxia, Tibet,
and Inner Mongolia, and is mainly affected by bio13 (precipitation of
the wettest month), bio11 (mean temperature of the coldest quarte) and
bio3 (Isothermality). The suitable habitat of H. r. trkestanica is
mainly distributed in Xinjiang, and Tibet, and is mainly affected by
bio13 (precipitation of the wettest month), bio2 (mean diurnal range)
and bio15 (precipitation seasonality). Although, the two subspecies tend
to expand and migrate toward lower latitude under future climate
scenarios, there are some differences. H. r. sinensis will migrate
westward, while H. r. trkestanica will migrate eastward as a whole. They
have a high stability of suitable habitat and are not at risk of
extinction in the future. The study’s findings help to clarify the
resource reserve of Hippophaerhamnoides L. in China, which will help to
guide the protection of wild resources and to popularize artificial
planting in suitable areas, and provides scientific basis for the
protection of ecological environment.
Prescribing trends in older patients with multimorbidity and significant polypharmacy recruited to the SPPiRE trial
Authors: McCarthy Caroline , Flood Michelle , Clyne Barbara , Smith Susan , Wallace Emma , Boland Fiona , Moriarty Frank
Published: May 2022

Aims Medication count and appropriateness are often used as outcome
measures to evaluate the effectiveness of deprescribing interventions.
The aim of this study was to evaluate changes in prescribing,
potentially inappropriate prescriptions (PIP) and use of low value
medicines during the SPPiRE trial. Methods We retrospectively analysed
trial prescription data from 51 general practices with 404 participants
aged ≥65 years and prescribed ≥15 repeat medicines. A dataset was
created with 7,051 ATC coded medicines at baseline. Outcomes were the
most commonly prescribed and potentially inappropriately prescribed drug
groups, the most frequently stopped or started drug groups and the
number of changes per person between baseline and follow-up. Results
There were 7,051 medicines prescribed to 404 participants at baseline.
The most commonly prescribed drug group were proton pump inhibitors
(82% participants) and statins (77%). There was a median of 17
medicines (IQR 15-19) at baseline and 16 (IQR 14-19) at follow-up. PIP
represented 17.1% of prescriptions at baseline and 15.7% (n=6,777) at
follow-up. There were reductions in the prescription of most drug groups
with the largest reduction in antiplatelet prescriptions. Considering
medication discontinuations, initiations and switches, there was a
median of five medication changes per person (range 0-30, IQR 3-9) by
follow-up. There were 95 low value prescriptions at baseline reducing to
78 at follow-up. Conclusions The number of medication changes per person
was not reflected by summarising medication count at two time points,
highlighting the need for repeated measurements of prescribing outcomes
especially for populations with high degrees of polypharmacy.
Investigation and optimization of thin film lithium niobate grating couplers with slanted sidewall
Authors: Liu Jiacheng , Du Jiangbing , Qu Minni , He Zuyuan
Published: May 2022

In this letter, we investigate and analyse the effect of sidewall angle
on the performance of lithium niobate grating couplers. We proposed a
method to calculate the mode effective index of grating couplers with
slanted sidewall, and analyse the relationship between the mode
effective index with different sidewall angle under the same grating
period and etching depth. A lithium niobate grating coupler is designed
and optimized by using the proposed calculation method. A coupling
efficiency of 40% was obtained for each fiber/lithium niobate waveguide
interface. Focus ion beam etching was used to fabricate the optimized
structure. Experimental results show that the proposed method features
great accuracy for obtaining desired transmission spectrum, indicating
great potential for thin film lithium niobate platforms.
Intracellular CHO cell metabolite profiling and in vivo monitoring of redox state unravel the effect of temperature downshift on cell growth, antibody titer and product quality
Authors: Zhu Ziyu , Chen Xiaoqian , Li Wenhao , Zhuang Ying-Ping , Zhao Yuzheng , Wang Guan
Published: May 2022

The strategy of temperature downshift has been widely used in the
biopharmaceutical industry to improve antibody production and
cell-specific production rate (q ) with Chinese hamster
ovary cells (CHO). However, the mechanism of temperature-induced
metabolic rearrangement, especially important intracellular metabolic
events, remains poorly understood. In this work, in order to explore the
mechanisms of temperature-induced cell metabolism, we systematically
assessed the differences in cell growth, antibody expression, and
antibody quality between high-producing (HP) and low-producing (LP) CHO
cell lines under both constant temperature (37°C) and temperature
downshift (37°C→33°C) settings during fed-batch culture. Although the
results showed that low-temperature culture during the late phase of
exponential cell growth significantly reduced the maximum viable cell
density (p<0.05) and induced cell cycle arrest in the G0/G1
phase, this temperature downshift leaded to a higher cellular viability,
and increased antibody titer by 48% and 28% in HP and LP CHO cell
cultures, respectively (p<0.001), and favored antibody quality
reflected in reduced charge heterogeneity and molecular size
heterogeneity. Combined extra- and intra-cellular metabolomics analyses
revealed that temperature downshift significantly downregulated
intracellular glycolytic and lipid metabolic pathways while upregulated
TCA cycle, and particularly featured upregulated glutathione metabolic
pathways. Interestingly, all these metabolic pathways were closely
associated with the maintenance of intracellular redox state and
oxidative stress-alleviating strategies. To experimentally address this,
we developed two high-performance fluorescent biosensors, denoted SoNar
and iNap1, for real-time monitoring of intracellular NAD
/NADH ratio and NADPH amount, respectively.
Consistent with such metabolic rearrangements, the results showed that
temperature downshift decreased the intracellular NAD
/NADH ratio, which might be ascribed to the
re-consumption of lactate, and increased the intracellular NADPH amount
(P<0.01) to scavenge intracellular reactive oxygen species
(ROS) induced by the increased metabolic requirements for high-level
expression of antibody. Collectively, this study provides a metabolic
map of cellular metabolic rearrangement induced by temperature downshift
and demonstrates the feasibility of real-time fluorescent biosensors for
biological processes, thus potentially providing a new strategy for
dynamic optimization of antibody production processes.
Quantifying spillover risk with an integrated bat-rabies dynamic modeling framework
Authors: Janoušková Eva , Rokhsar Jennifer , Jara Manuel , Entezami Mahbod , Horton Daniel L. , Dias Ricardo Augusto , Machado Gustavo , Prada Joaquin
Published: May 2022

Vampire bat-transmitted rabies has recently become the leading cause of
rabies mortality in both humans and livestock in Latin America.
Evaluating risk of transmission from bats to other animal species has
thus become a priority in the region. An integrated bat-rabies dynamic
modeling framework quantifying spillover risk to cattle farms was
developed. The model is spatially explicit, and is calibrated to the
state of São Paulo, using real roost and farm locations. Roosts and
farms characteristics, as well as environmental data through ecological
niche model, are used to modulate rabies transmission. Interventions in
roosts (such as culling or vaccination) and in farms (vaccination) where
considered as control strategies implemented to reduce risk. Both
interventions significantly reduce the number of outbreaks in farms and
disease spread (based on distance from source), with control in roosts
being a significantly better intervention. High risk areas where also
identified, which can support ongoing programs, leading to more
effective control interventions.
1006-P: Differences in Diabetes Technology Use Only Partially Explain Disparities in Type 1 Diabetes Outcomes in Minority Youth
Authors: STEIN CHERYL R. , ILKOWITZ JENIECE , GONZALEZ JUANA E. , GALLAGHER MARY PAT
Published: May 2022

Diabetes technology (DT) use is associated with lower HbA1c levels in type 1 diabetes (T1D) . Non-Hispanic Black (NHB) and Hispanic populations with T1D have higher HbA1c levels and lower DT use compared to non-Hispanic white (NHW) populations. At our Pediatric Diabetes Center, DT use is high across all race and ethnicity groups, but disparities in outcomes remain. We sought to examine the extent to which DT use accounts for disparities.

We abstracted EHR data for patients ages 2-25 with T1D >/= 12 month duration. HbA1c >9% was categorized as high. Patients identifying as non-white, Hispanic, or whose preferred language was not English were grouped and compared to the NHW, English speaking group. T-test and chi-square statistics compared demographic and clinical characteristics by HbA1c category. Binomial regression with generalized estimating equations estimated risk ratios (RR; 95% confidence intervals; CI) for the association between minority race/language (MRL) and high HbA1c. First, models were adjusted for age and insurance type, then for CGM and pump use.

Data was collected over 13 months (2020-21) from 264 patients over 549 visits (mean 2.1, SD 1.2) . Thirty-three percent of patients identified as MRL. At their most recent visit, 19% had HbA1c >9% (MRL 36% vs. non-MRL 11%) , 86% used CGMs (MRL 73% vs. non-MRL 93%) , and 80% were using pumps (MRL 76% vs. non-MRL 81%) ; 95% of pump users also used CGMs. There was no difference in HbA1c category by number of visits, time since diagnosis, age, or sex. In regression models, MRL youth were 2.7 (95% CI 1.7-4.4) times more likely to be in the high HbA1c category as compared to non-MRL youth, adjusted for age and insurance. When also adjusting for CGM and pump use, MRL patients remained twice as likely to be in the high HbA1c category (RR 2.0, 95% CI 1.2-3.3) . While the disparity in HbA1c between MRL youth compared to non-MRL youth can be partially attributed to DT use, disparity persists even after accounting for use of DT.

Disclosure

C.R.Stein: None. J.Ilkowitz: None. J.E.Gonzalez: None. M.Gallagher: None.
1010-P: Diabetes Distress in Younger vs. Older Emerging Adults: Confirmation of Content Validity of the Problem Areas in Diabetes—Emerging Adult Survey (PAID-EA)
Authors: WENTZELL KATHERINE , VITALE REBECCA J. , LAFFEL LORI M.
Published: May 2022

The developmental stage of emerging adulthood covers a wide age span (ages 18-30 years) with potential for differing emotional burdens for those living with type 1 diabetes (T1D) . To further confirm the content validity of the PAID-EA and to investigate differences between younger and older emerging adults, item responses on the newly developed, previously validated PAID-EA survey were examined by age group. Emerging adults (N=287) with T1D completed online measures of diabetes distress, depressive symptomology, and the PAID-EA. The PAID-EA has 25 items and uses a 5 point Likert-type response scale with options ranging from agree to disagree. The sample was split into 2 age groups: younger emerging adults (ages 18-24, N=143) and older emerging adults (ages 25-30, N=122) . Self-reported HbA1c was significantly worse in younger vs. older emerging adults (7.4% vs. 6.8%, p<.001) . Other demographic variables and total scores on measures were similar between age groups. Only 3 items on the PAID-EA differed by age group with younger emerging adults endorsing more diabetes distress: (1) Item 6: “I worry about being able to socialize because of how alcohol affects my blood sugar” (p=.03) , (2) Item 7: “I worry that a new romantic partner will see my diabetes devices or supplies” (p=.04) , (3) Item 25: I feel like I am trying my hardest to take care of diabetes, but it never works” (p=.02) . Experimentation with alcohol and intimacy with new partners may be experienced differently for younger compared with older emerging adults. Intense feelings of burnout and failure may also differ; this finding requires further exploration. Though emerging adulthood spans more than a decade, perceptions of the emotional burden of living with T1D appear consistent for the younger and older age groups, confirming the content validity of the PAID-EA throughout emerging adulthood.

Disclosure

K.Wentzell: None. R.J.Vitale: None. L.M.Laffel: Advisory Panel; Medtronic, Roche Diabetes Care, Consultant; Boehringer Ingelheim International GmbH, Dexcom, Inc., Dompé, Insulet Corporation, Janssen Pharmaceuticals, Inc., Lilly Diabetes, Novo Nordisk, Provention Bio, Inc.

Funding

Joslin DRC: P30DK036836 NIH: T32DK007260, T32DK007529
1017-P: Relationship between Parent Fear of Hypoglycemia and Diabetes Family Conflict in Adolescents with Type 1 Diabetes
Authors: MANIS HANNAH , O'DONNELL HOLLY K. , ALONSO GUY T. , MAJIDI SHIDEH , SNELL-BERGEON JANET K. , WADWA R. PAUL , DRISCOLL KIMBERLY A.
Published: May 2022

Few studies have examined the relationship between diabetes-related family conflict and parent fear of hypoglycemia (FOH) in adolescents, thus the current research evaluated this connection. This study specifically examined three subdimensions of FOH which parents of children with diabetes may experience: maintaining blood glucoses higher than medical recommendations, worrying about and/or feeling helplessness about preventing low blood glucoses, and worrying about social consequences associated with low blood glucoses.

At the baseline visit of an RCT aimed at improving health outcomes of youth with elevated A1C (9-12% in the last year) , caregivers completed the Diabetes Family Conflict Scale and the Parent Hypoglycemia Fear Survey. N=1child-caregivers dyads (child age=14.7±1.9 years, T1D duration=6.5±3.4 years, A1C=9.9±1.6%; 53% female; 77% continuous glucose monitor; 82% insulin pump) .

In three separate regression models, no child demographic or T1D clinical characteristics other than A1C were associated with family conflict. After controlling for A1C, only Worry/Helplessness About Low Blood Glucose (b=0.182; p=0.025) and Worry About Negative Social Consequences (b=0.532; p=0.008) significantly predicted parent-reported family conflict; Maintain High Blood Glucose (b=0.082; p=0.73) was not significant.

This is the first study to demonstrate that caregivers’ worry about their adolescents having low blood glucoses is associated with diabetes-specific family conflict- a common adherence barrier for adolescents with T1D and their families. This finding supports screening caregivers for fear of hypoglycemia and incorporating into treatment when providing intervention for families with high levels of conflict. Important next steps include dyadic data analysis to understand how fear of hypoglycemia symptoms among child-caregiver dyads affect family conflict.

Disclosure

H.Manis: Other Relationship; Abbott Diabetes. H.K.O'donnell: None. G.T.Alonso: None. S.Majidi: None. J.K.Snell-bergeon: Stock/Shareholder; GlaxoSmithKline plc. R.Wadwa: Advisory Panel; Dompé, Consultant; Beta Bionics, Inc., Other Relationship; Tandem Diabetes Care, Inc., Research Support; Dexcom, Inc., Eli Lilly and Company, Tandem Diabetes Care, Inc. K.A.Driscoll: None.

Funding

National Institute of Diabetes and Digestive and Kidney Diseases (DP3DK113363)
1019-P: Predictors of Response to Metformin in Youth with Type 1 Diabetes (T1D) and Increased BMI
Authors: WANG JOHNNY , BARUA SOUPTIK , TOSUR MUSTAFA , REDONDO MARIA J. , ISMAIL HEBA M.
Published: May 2022

Metformin used as adjuvant therapy in youth with T1D and elevated BMI decreased total daily insulin dose (TDID) and insulin resistance, although hemoglobin A1c (A1c) did not change. Yet, the factors that are associated with greater benefit from metformin are not well known. Here, we tested whether baseline measures predict response to metformin in youth with T1D and increased BMI-z score.

We analyzed publicly available data from the metformin treatment arm of the T1D Exchange Metformin Study (NCT01881828) , with 61 adolescents (median age 15.3 yrs, range 12-18.9; 36% males; 72% non-Hispanic Whites, 98% overweight or obese; median diabetes duration 7.4 yrs, range 1.7-15) . We assessed baseline age, sex, diabetes duration, race/ethnicity, BMI z-score, waist circumference, body fat percentage (BF%) measured by Dual-energy X-ray Absorptiometry (DXA) scan and serum adipokines. Outcome measures included changes in A1c, TDID and BF% at 13 and 26 weeks (wks) . After adjusting for baseline values, multiple linear regression models were used to identify predictors for the outcomes. Decreases in TDID at 13 and 26 wks showed a significant negative association with baseline leptin (p=0.0008, p=0.004, respectively) . Decreases in BF% at 26 wks were positively associated with baseline BMI z-score (p=0.03) and negatively associated with baseline BF% (p=0.0002) . Increase in A1c at 26 wks trended towards a positive association with baseline BF% (p=0.07) and a negative association with baseline adiponectin (p=0.06) . Compared to females, males showed a significant reduction in BF% at 26 wks (p<0.0001) and a trend towards a reduction in TDID at 13 wks (p=0.06) .In sum, in adolescents with T1D and elevated BMI treated with metformin as adjuvant to insulin, baseline leptin was the strongest predictor of decrease in TDID at 13 and 26 wks. Decrease in BF% was predicted by higher BMI z-score and lower BF% at baseline. These findings may aid a precision medicine approach in this population.

Disclosure

J.Wang: None. S.Barua: None. M.Tosur: Advisory Panel; Provention Bio, Inc. M.J.Redondo: Advisory Panel; Provention Bio, Inc. H.M.Ismail: n/a.
1021-P: Telehealth Benefits among Latinx Adolescents and Young Adults (AYA) with Type 1 Diabetes (T1D)
Authors: GARCIA JAQUELIN J. FLORES , REID MARK W. , PYATAK ELIZABETH , FOGEL JENNIFER L. , FOX D STEVEN , SALCEDO-RODRIGUEZ ELIZABETH , RAYMOND JENNIFER
Published: May 2022

Background: Historically disadvantaged, ethnically- and racially-diverse AYA experience significantly greater challenges with T1D management when compared to White peers. To address this inequity, the patient-centered CoYoT1 Care model was adapted and implemented at a T1D clinic serving primarily ethnically- and racially-diverse AYA.

Methods: In a randomized controlled 2x2 trial, 68 AYA received either CoYoT1 Care or Standard Care via in-person or Telehealth (TH) . Hemoglobin A1c (A1c) and T1D-related distress were measured at baseline and after four quarterly clinic visits, and analyzed via linear mixed models adjusting for age, sex, and attendance.

Results: At study end, participants in TH showed reduced A1c (p=0.01) and no changes in physician-related distress (p=0.04) , compared to increased A1c and distress in those randomized to in-person care. Secondary analyses revealed that these TH benefits were attributable to Latinx AYA subgroup. Compared to Latinx participants randomized to in-person care, those in TH showed significant reductions in A1c (p=0.003; Figure) and physician distress (p=0.008) . Among non-Latinx participants, no significant differences in A1c or distress were observed.

Conclusion: The TH CoYoT1 Care model engages underserved, ethnically-diverse AYA and leads to improved outcomes. Next steps include collaborating with stakeholders to adapt and implement the model nationwide.

Disclosure

J.J.Flores garcia: None. M.W.Reid: None. E.Pyatak: Research Support; Abbott Diabetes. J.L.Fogel: None. D.Fox: None. E.Salcedo-rodriguez: None. J.Raymond: None.
1025-P: Racial Disparities in Diabetes Distress and Technology Use in Adolescents with Type 1 Diabetes
Authors: WILCOX ANNABELLE , MENCHER SHANA , NALLY LAURA M. , WEINZIMER STUART A.
Published: May 2022

Objective: Racial and ethnic minority (REM) youth with type 1 diabetes (T1D) are less likely to use diabetes technology and are at higher risk for adverse short-term outcomes. Diabetes distress (DD) , associated with less engagement with management and elevated hemoglobin A1c (HbA1c) , may be an additional mediator of this disparity. However, no studies have specifically evaluated DD in REM youth. This study aims to evaluate racial and ethnic disparities in DD and diabetes technology use in adolescents with T1D.

Method: We recruited adolescents with T1D (age 13-17) and their parent to complete an online survey. Adolescents were categorized by self-report into Non-Hispanic White (NHW) or REM groups.

Result: Of 45 adolescent surveys completed, 62% identified as NHW and 38% as REM. REM adolescents were less likely to use both a continuous glucose monitor and an insulin pump (p=0.001) and had higher HbA1c (p<0.001) . There was a similarly high prevalence of DD (84%) in both groups of adolescents. Parents had a much lower rate of DD (14%, p<0.001) , similar in both racial/ethnic groups.

Conclusion: We found disparities in technology use and HbA1c between NHW and REM adolescents. However, the similarly high rate of clinically significant DD confirms the need to address DD to decrease the burden of diabetes and improve outcomes in all racial/ethnic groups.

Disclosure

A.Wilcox: None. S.Mencher: None. L.M.Nally: Other Relationship; Novo Nordisk. S.A.Weinzimer: Consultant; Dompé, Research Support; Abbott Diabetes, Speaker's Bureau; Abbott Diabetes, Dexcom, Inc.
1028-P: Acute Kidney Injury in Youth with Diabetes Admitted with Isolated Diabetic Ketoacidosis, Isolated Hyperglycemic Hyperosmolar State, and Hyperosmolar Diabetic Ketoacidosis: A Single Center Experience
Authors: ZARSE ERICA , KNOLL MICHELLE , WILLIAMS DAVID D. , HALPIN KELSEE , KALLANAGOWDAR GOURI , TSAI SARAH
Published: May 2022

Background: Diabetic ketoacidosis (DKA) and hyperglycemic hyperosmolar state (HHS) are hyperglycemic emergencies. The objective was to compare acute kidney injury (AKI) between youth with isolated DKA to those with hyperosmolarity and explore associations to risk of AKI.

Methods: Charts were reviewed from 01/20through 12/2020 for youth admitted with DKA (serum bicarbonate ≤16 mEq/L) and/or HHS (blood glucose ≥600 mg/dL and osmolality ≥320 mOsm/kg) . Isolated HHS youth were combined with hyperosmolar DKA for analysis. AKI was defined as elevated creatinine level for age. The total amount of isotonic fluids administered was collected, both given as bolus or continuously within the first 12 hours after DKA and/or HHS confirmation. Identification of patients on an angiotensin-converting enzyme inhibitor (ACEI) was a marker for microalbuminuria.

Results: A total of 369 admissions were included: 334 (90.5%) had isolated DKA, 32 (8.7%) had hyperosmolar DKA, and 3 (0.8%) had isolated HHS. Median age was 14 years (IQR=11.2,16.8) and 60% were female. Ninety-six percent had type 1 diabetes mellitus (DM) ; 4% had type 2 DM. New onset DM accounted for 31% of admissions. More hyperosmolar youth had AKI compared to isolated DKA (63% vs. 15%, p<0.001) . Both received similar total volume of fluids; median was 33.6 ml/kg (IQR=28.0,39.5) for isolated DKA and 38.5 ml/kg (IQR=29.1,45.4) for hyperosmolar (p=0.09) . For each unit increase in serum osmolality, the odds of having AKI increase by a factor of 1. (p<0.001) . The odds of AKI for new onset DM is 0.68 compared to known DM diagnosis (p=0.005) . Of the 17 patients (5%) taking an ACEI during admission, three had AKI.

Conclusions: Higher serum osmolality or new onset DM are associated with increased odds of having AKI. Our findings will be useful to identify youth at risk for AKI and guide interventional studies for those with AKI and hyperosmolarity.

Disclosure

E.Zarse: None. M.Knoll: None. D.D.Williams: None. K.Halpin: None. G.Kallanagowdar: None. S.Tsai: Stock/Shareholder; Dexcom, Inc.
1042-P: Large-for-Gestational-Age Birthweight in Gestational Glucose Intolerance
Authors: MAYA JACQUELINE , SELEN DARYL J. , THAWEETHAI TANAYOTT , HSU SARAH , YU CHU , JAMES KAITLYN , KAIMAL ANJALI , HIVERT MARIE-FRANCE , POWE CAMILLE E.
Published: May 2022

Background: Treatment of gestational diabetes (GDM) reduces the risk of large for gestational age (LGA) birthweight and associated complications in infants. Pregnant people with gestational glucose intolerance (GGI, abnormal glucose loading test (GLT) without GDM) usually remain untreated. We examined the risk of LGA among women with GGI in a large cohort.

Methods: In a retrospective cohort study of 44,628 singleton pregnancies delivered at an academic center at >28 weeks' gestation, pregnancies with a GLT >140 mg/dl and either a normal 3-hour 100-gram oral glucose tolerance test (OGTT) or one abnormal OGTT value were classified as GGI, and those with 2 abnormal OGTT values as GDM. We used generalized estimating equations for logistic regression to examine the risk of LGA (birthweight >90th percentile for gestational age) in GGI versus normal glucose tolerance (NGT, GLT <140 mg/dl) pregnancies after adjustment for age, gender, 1st trimester BMI, parity, insurance, race/ethnicity, and marital status. A second model adjusted for gestational weight gain (GWG) .

Results: LGA was present in 7.7% of 36,964 pregnancies with NGT, 9.6% of 4357 with GGI and normal OGTT, 14.3% of 15with GGI and one abnormal OGTT value, and 14.5% of 1800 with GDM. The odds of LGA were higher in GGI than NGT pregnancies (adjusted OR 1.4 [1.3-1.5], p<0.001) . When compared separately with NGT, both types of GGI had elevated odds of LGA: normal OGTT adjusted OR 1.2 [1.1-1.4], p<0.001, one abnormal OGTT value adjusted OR 1.8 [1.5-2.1], p<0.001. The latter was similar to that in GDM compared to NGT: adjusted OR 1.8 [1.5-2.0], p<0.001. Increased odds of LGA were also present for GGI/GDM groups after GWG adjustment: normal OGTT OR 1.3 [1.2-1.5] p<0.001, 1 abnormal OGTT value OR 1.8 [1.5-2.1] p<0.0GDM OR 2.2 [1.9-2.5] p<0.001.

Conclusion: Infants of untreated people with GGI have increased risk of LGA birthweight. The risk of LGA in GGI pregnancies with one abnormal OGTT value was similar to that in GDM in a clinical setting where only GDM was treated.

Disclosure

J.Maya: None. D.J.Selen: None. T.Thaweethai: None. S.Hsu: None. C.Yu: None. K.James: None. A.Kaimal: None. M.Hivert: Advisory Panel; American Heart Association, Research Support; American Diabetes Association. C.E.Powe: None.

Funding

MGH (Physician Scientist Development Award and Claflin Distinguished Scholar's Award)