bluuebunny/crossref_metadata_2025 huggingface dataset:
An Ambulatory Blood Pressure Monitor Mobile Health System for Early Warning for Stroke Risk: Longitudinal Observational Study (Preprint)
Authors: Wang Guangyu , Zhou Silu , Rezaei Shahbaz , Liu Xin , Huang Anpeng
Published: June 2019

BACKGROUND

Stroke, as a leading cause of death around the globe, has become a heavy burden on our society. Studies show that stroke can be predicted and prevented if a person’s blood pressure (BP) status is appropriately monitored via an ambulatory blood pressure monitor (ABPM) system. However, currently there exists no efficient and user-friendly ABPM system to provide early warning for stroke risk in real-time. Moreover, most existing ABPM devices measure BP during the deflation of the cuff, which fails to reflect blood pressure accurately.

OBJECTIVE

In this study, we sought to develop a new ABPM mobile health (mHealth) system that was capable of monitoring blood pressure during inflation and could detect early stroke-risk signals in real-time.

METHODS

We designed an ABPM mHealth system that is based on mobile network infrastructure and mobile apps. The proposed system contains two major parts: a new ABPM device in which an inflation-type BP measurement algorithm is embedded, and an abnormal blood pressure data analysis algorithm for stroke-risk prediction services at our health data service center. For evaluation, the ABPM device was first tested using simulated signals and compared with the gold standard of a mercury sphygmomanometer. Then, the performance of our proposed mHealth system was evaluated in an observational study.

RESULTS

The results are presented in two main parts: the device test and the longitudinal observational studies of the presented system. The average measurement error of the new ABPM device with the inflation-type algorithm was less than 0.55 mmHg compared to a reference device using simulated signals. Moreover, the results of correlation coefficients and agreement analyses show that there is a strong linear correlation between our device and the standard mercury sphygmomanometer. In the case of the system observational study, we collected a data set with 88 features, including real-time data, user information, and user records. Our abnormal blood pressure data analysis algorithm achieved the best performance, with an area under the curve of 0.904 for the low risk level, 0.756 for the caution risk level, and 0.912 for the high-risk level. Our system enables a patient to be aware of their risk in real-time, which improves medication adherence with risk self-management.

CONCLUSIONS

To our knowledge, this device is the first ABPM device that measures blood pressure during the inflation process and has obtained a government medical license. Device tests and longitudinal observational studies were conducted in Peking University hospitals, and they showed the device’s high accuracy for BP measurements, its efficiency in detecting early signs of stroke, and its efficiency at providing an early warning for stroke risk.
The Impact of Equating on Detection of Treatment Effects
Authors: Choi Youn-Jeng , Kim Seohyun , Cohen Allan S. , Lu Zenqiu
Published: June 2019

Equating makes it possible to compare performances on different forms of a test. Three different equating methods (baseline selection, subgroup, and subscore equating) using common-item item response theory equating were examined for their impact on detection of treatment effects in multilevel models.
A Retrospective Audit of the TURBT Quality in Two Major Cancer Centres in Lancashire
Authors: Hosny Khaled , Clark Jennifer , Nosseir Mahmoud , Al-Attar Maithem , Masaarane Mohammad , Cockburn Neil , Samsudin Izzati
Published: June 2019

Transurethral resection of bladder tumour (TURBT) is the first step in management of bladder cancers. A urology trainee in the UK must do at least 120 procedures during their training years before being a consultant. In our article, we are reporting a retrospective audit of the quality of TURBT across 2 major cancer centres in Lancashire. We assessed the adherence of surgical procedure to the national and international guidelines among different grades of urological surgeons who work in the 2 trusts.
Estórias Gerais e Primeiras Estórias: o sertão em imagens, o sertão em palavras. Uma proposta de leitura para a Educação Básica.
Authors: Becker Caroline Valada
Published: June 2019

Trabalhar as obras de Guimarães Rosa, no Ensino Médio, sem dúvida, é um desafio, pois a linguagem roseana e seu universo temático podem distanciar leitores ainda em formação. Tendo em vista essas especificidades estéticas, proponho um trabalho intertextual para apresentar Guimarães ao alunos. Trata-se da leitura de duas obras: a graphic novel “Estórias Gerais”, de Wellington Srbek (roteiro) e Flavio Colin (ilustrações), cujo conteúdo é autoral e revisita, assim como Rosa, o sertão e sua cultura; e o livro de contos “Primeiras Estórias”, de Guimarães Rosa. Pretende-se, por meio do conceito de Letramento Literário, aproximar os alunos do ato de ler, partindo de um gênero híbrido – uma graphic novel –, para, em seguida, chegar na obra canônica de Guimarães.
O diagnóstico de TDAH: implicações na aprendizagem escolar da criança
Authors: Forteski Rosina , Pufal Fabiane , Da Costa Maira Maria , Michalak Ricardo , Nüssner Tânia Mara
Published: June 2019

O Transtorno de Déficit de Atenção e Hiperatividade (TDAH) inscreve-se no conjunto das problemáticas identificadas no ambiente escolar na contemporaneidade. Fator sabidamente promotor de sofrimento, conflitos e defasagens em diversos contextos, o TDAH tende a se apresentar como uma condição contribuinte para o fracasso escolar. Para a construção deste artigo buscou-se investigar as relações entre o diagnóstico de TDAH e suas implicações na aprendizagem escolar. Conclui-se com este artigo que o diagnóstico pode ser utilizado como justificativa para o fracasso escolar por um viés que culpabiliza a criança e isenta os demais responsáveis. Neste sentido uma preocupação consistente diz respeito à capacitação dos profissionais envolvidos no tratamento da criança e nas demais pessoas responsáveis pelo seu cuidado, pois o uso tendencioso e irresponsável do diagnóstico e dos meios de tratamento pode contribuir para a aniquilação das expressões idiossincráticas da criança.
O Cotidiano visto através das Notícias e Crônicas
Authors: Fernandes Carolina
Published: June 2019

O presente relato de experiência apresenta a prática pedagógica desenvolvida em estágio de Língua Portuguesa, utilizando os gêneros discursivos notícias e crônicas como motivadores tanto da leitura como da escrita. A escolha desses gêneros se deve aos seguintes aspectos: são textos curtos, por isso de fácil manuseio em aula, podem ser encontrados em jornais e revistas, assim, sendo de fácil acesso aos alunos, e, ainda, abordam assuntos do cotidiano, possibilitando que os alunos identifiquem-se com o texto e queiram interpretá-lo e refletir sobre sua realidade. Na prática, percebemos que os alunos sentiram-se estimulados a ler, interpretar e escrever textos nesses dois gêneros, o que possibilitou também a reflexão sobre a realidade que vivem, o cotidiano do jovem, seus desafios e suas impressões sobre o mundo e as relações humanas.
Medindo a altura da escola com trigonometria e teodolitos
Authors: Silva Giselle Anna Oliveira , Vargas Samantha Da Silva , Santos Verônica Ferreira dos , Santos Josivaldo Gonçalves dos , Souto Kelling Cabral , Castro Denise Leal de , Pinto Karla Gomes de Alencar , Jesus Vitor Luiz Bastos de
Published: June 2019

Neste trabalho será apresentada a experiência vivenciada por bolsistas do Programa Institucional de Bolsas de Iniciação à Docência (PIBID) do IFRJ, na aplicação da atividade “Medindo com o Auxilio do Teodolito”. Ela consistiu de uma prática em que os alunos puderam medir a altura do prédio da escola, utilizando um teodolito confeccionado com materiais de baixo custo. O experimento carrega o objetivo de mostrar aos estudantes uma aplicação da Trigonometria no cotidiano, utilizando a relação trigonométrica tangente para medir uma distância inacessível com instrumentos de medida convencionais, levando aos alunos a uma aula mais dinâmica. Durante esta experiência foram aplicados dois testes que puderam verificar quantitativamente a contribuição da atividade, que foi considerada satisfatória ao final do experimento, pois atingiu o seu objetivo de contribuir de forma significante para o aprendizado dos alunos sobre as relações trigonométricas, em especial a tangente. Além de ter possibilitado a detecção de algumas outras dificuldades em matemática apresentadas pelos alunos.
Os desdobramentos do Pacto Nacional pelo Fortalecimento do Ensino Médio nas ações educativas da Escola Sales Campos
Authors: Cavalcante Francisca Hisllya Bandeira
Published: June 2019

O presente texto apresenta uma reflexão sobre a execução da primeira etapa do programa de formação continuada dos professores do Ensino Médio denominado Pacto Nacional pelo Fortalecimento do Ensino Médio (PNEM) e os resultados que o referido programa gerou na prática educativa dos professores participantes na Escola Estadual de Ensino Fundamental e Médio Sales Campos, localizada em Fortaleza – Ceará, na qual atuei como Orientadora de Estudos (OE) durante o intervalo de abril a dezembro de 2014, que corresponde ao período de realização da primeira etapa do PNEM no Ceará. Ao longo do processo formativo uma infinidade de discussões e atividades foram realizadas. Deparamo-nos com entendimentos, desentendimentos, construções, desconstruções, barreiras a serem superadas, aprendizado e diversas oportunidades de pensar e repensar nossa prática educativa na Escola.
Lei 10.639/03, formação docente e NEABs: a democratização do currículo como um desafio para a educação brasileira
Authors: Alves Marta Mariano
Published: June 2019

Este ensaio pretende apresentar uma reflexão sobre a Lei nº 10.639/03 que inclui no currículo oficial da rede de ensino nacional a obrigatoriedade da temática história e cultura afro-brasileira; a formação docente; as Instituições de Educação Superior (IES) e os Núcleos de Estudos Afro-Brasileiros (NEABs) no processo de democratização do currículo da educação brasileira. Para esta reflexão inicialmente apresenta o histórico da Lei nº 10.639/03 e a proposta de formação docente presente na legislação brasileira. Na sequência, tendo como referência a Lei 10.639/03, busca refletir a respeito da democratização do currículo como um desafio para a educação brasileira e para as IES e o papel dos NEABs na implementação da Lei nº 10.639/03.
Construindo outras histórias da África e do negro no Brasil: um relato de experiência.
Authors: Just Blanco Mariana , De Medeiros Silva Taís , Tonini Ivaine Maria , Nedel Oliveira Victor Hugo
Published: June 2019

O tema do estudo sobre o continente africano está cada vez mais em voga na atualidade. Este artigo apresenta reflexões sobre um trabalho pedagógico desenvolvido com os alunos do 7º ano do Colégio de Aplicação da Universidade Federal do Rio Grande do Sul, que tinha como objetivo principal promover uma conversa sobre a África e o Brasil, destacando sua diversidade cultural e étnica, além de questões históricas, para ações de reconstruções identitárias. São apresentados os momentos pedagógicos desenvolvidos com os alunos, a saber, no dia 4 de junho de 2018, para atender ao currículo de Estágio Supervisionado em Geografia II, que busca desenvolver aprendizagens ligadas ao ensino não formal. A partir da realização desta atividade é possível considerar que a educação vai além do espaço delimitado pelos muros escolares e salas de aula.
The yield and growth characteristics of thymus (Thymus daenensis L.) treated with different fertilizers and plant densities
Authors: Jasemi Babak , Shabani Ghobad , Chaichi Mohammad , Khoshkhoi Shahab , Norozi Negin
Published: June 2019

To study the effect of plant density and different nutritional systems
(chemical, biological, and integrated) on the quantitative and qualitative
performance of Thymus daenensis L. in Mahidasht Agricultural Training
Center, Kermanshah/Iran, in 2017, an experiment was conducted in a
split-plot design based on a randomized complete block with four
replications. The first variable involved two planting distances in the row
of 15 and 30 cm (the main factor), and the subsidiary factor comprised four
different nutritional systems including control (no-fertilizer), chemical
(100 kg superphosphate, 100 kg potassium sulfate, 150 kg urea per ha),
biological (8 tons of cattle manure/ha), and integrated (50% cattle manure +
50% chemical) fertilizers. The results showed that the integrated fertilizer
treatment produced the highest shoot dry weight (789.1 kg/ha), essential oil
content (3.35%) and root length (15.97 cm). The integrated fertilizer
treatment along with the 30-cm planting density resulted in the highest
essential oil content of 3.35%. The results of this project have suggested
that the integrated fertilizer and the 30-cm planting interval is the
optimal treatment in thymus production due to the higher chemical fertilizer
efficiency and better crop quality.
The assessment of effects of partialling out of socially desirable responding variance on personality traits scores in instructed applicant situations
Authors: Opacic Goran , Mentus Tatjana
Published: June 2019

The aim of this study was to examine the extent to which the socially desirable responding (SDR) distorts results of HEDONICA personaliy inventory (acronim based on eight dimensions of this inventory: Honesty, Disintegration, Impulsiveness, Openness, Extraversion, Neuroticism, Conscientiousness, and Agreeableness). The inventory HEDONICA was merged with components of the Balanced Inventory of Desirable Responding (BIDR) as a control inventory and was administered to a sample of 227 students under two experimental situations/ contexts, operationalized by two instructions: the standard (S) one (such as ?be honest?) and the ?fake good? (FG) one (such as ?portray yourself in a most positive way?). Comparing scores in S and FG situations by using MANOVA, a clear distortion on all personality traits in socially desirable directions were evidenced. When, however, the BIDR subscales in the FG situation were entered into MANOVA as covariates, differences between personality scores in S and FG sitautions were considerably reduced, and became statistically insignificant on five personality dimensions. When the variance of dimensions of the BIDR inventory was removed from the variance of HEDONICA traits in FG situation, the change between intercorrelations of personality dimensions in S and FG situations did not attain statistical significance. This lead to the conclusion that the SDR bias, if even does affect test results (i.e., enhances scores in FG situation), does not affect the scale structure and predictive validity of the examined personality inventory.
Body mass index, personality traits, and body image in Italian pre-adolescents: An opportunity for overweight prevention
Authors: Rosa Veronica , Tomai Manuela , Lauriola Marco , Martino Gabriella , Di Trani
Published: June 2019

We investigated the relationship between body mass index (BMI) and personality traits, socioeconomic status (SES), and body image (BI) at the beginning of preadolescence. Data were collected from 238 Italian children aged 10?11 years using self-report scales. Information about SES was derived from parental education and professional status. BI was the variable the most strongly associated with BMI. Controlling for BI, SES, and gender, Agreeableness was inversely associated with BMI, whilst Extroversion was related to BMI in girls only. Gender did not moderate the associations between BI and BMI at this age. The relationship of certain personality traits with BMI is likely to emerge during preadolescence. Early interventions to reduce overweight and obesity could consider the interplay of Agreeableness and Extroversion with gender, BI, and SES.
Metastatic atypical lung carcinoid treated with combined therapeutic modalities
Authors: Lalic Nensi , Tegeltija Dragana , Kuhajda Ivan , Tomic Sanja , Lalic Ivica
Published: June 2019

Introduction. Lung carcinoids are considered a rare and uncommon group of lung tumors, making about 1% of all primary lung tumors. Atypical carcinoids are more aggressive than typical ones, with higher metastatic potential and worse prognosis and a 10-year survival rate of less than 60%. Case outline. In 2012, a 61-year-old male underwent the right lower lobectomy and the histopathological finding was an atypical lung carcinoid tumor. At the beginning of 2016, radiological and bronchoscopic progression of the disease was reported. Magnetic resonance imaging revealed enhanced nodular lesions compatible with liver metastases. The patient received endoluminal brachytherapy. Subsequently, the first line chemotherapy according to the cisplatin/etoposide (PE) protocol was applied. In August 2016, the somatostatin receptor scintigraphy (SRS) revealed secondary deposits with somatostatin receptor (SR) expression in the liver and lungs. The treatment with lanreotide injections was initiated. After five treatment courses, progression of the disease in the bronchial tree was verified and electro-cauterization and argon plasma cauterization of the tumor in the right main bronchus were performed. In September 2017, progression of the disease was verified again. The Oncology Board introduced the third line therapy with everolimus. Conclusion. The evidence supporting optimal treatment strategies for an atypical lung carcinoid tumor is lacking, but some recent publications indicate that multimodal treatment is associated with prolonged survival.
1192-P: Dapagliflozin Reduces Intrahepatic Triglyceride Content in Japanese Patients with Type 2 Diabetes Treated with Oral Antidiabetic Agents: A Randomized, Clinical Trial
Authors: MORINO KATSUTARO , KONDO KEIKO , TANAKA SACHIKO , MIYAZAWA ITSUKO , FUSE KEIKO , IDA SHOGO , ARIMA HISATOMI , MIURA KATSUYUKI , OHASHI NATSUKO , UGI SATOSHI , MAEGAWA HIROSHI ,   SUMS-ADDIT-2 RESEARCH GROUP
Published: June 2019

Objective: SGLT2 inhibitors reduce body weight (BW) due to negative energy balance. Although previous reports suggested that SGLT2 inhibitor improved liver dysfunction and steatosis, the efficacy of SGLT2 inhibitor on intrahepatic triglyceride (IHTG) were merely quantified.

Methods: The study was an open label randomized controlled trial. Fifty-two overweight patients (BMI > 23) who had inadequate glycemic control with oral antidiabetic agents were randomly assigned to dapagliflozin (Dapa) or standard treatment (Con) and followed for 24 weeks. The Primary endpoint was the change in BW from baseline to week 24 between the two groups. The secondary endpoint was IHTG which was assessed by magnetic resonance spectroscopy (MRS).

Results: The change in BW was significantly larger in Dapa group compared to Con. The mean difference in changes between two groups was -1.72 kg (95% CI: -2.85, -0.59, p = 0.004) which was comparable with the previous studies of Caucasians. IHTG measured with MRS was significantly reduced in Dapa group (p = 0.033).

Conclusion: Dapagliflozin treatment for 24 weeks resulted in reduction of BW and IHTG. These findings suggest the therapeutic potential of dapagliflozin for patients with NAFLD.

Clinical study registration number: UMIN000020239.

Disclosure

K. Morino: Research Support; Self; Astellas Pharma Inc., AstraZeneca, CMIC Pharma Science, Miki Corp., Ono Pharmaceutical Co., Ltd., Sunstar Inc. K. Kondo: None. S. Tanaka: None. I. Miyazawa: None. K. Fuse: None. S. Ida: None. H. Arima: Consultant; Self; Kyowa Hakko Kirin Co., Ltd. Speaker's Bureau; Self; Bayer Yakuhin, Ltd., Daiichi Sankyo Company, Limited, Takeda Pharmaceutical Company Limited, Teijin Pharma Limited. K. Miura: None. N. Ohashi: None. S. Ugi: None. H. Maegawa: Research Support; Self; Antares Pharma, Boehringer Ingelheim Pharmaceuticals, Inc., Daiichi Sankyo Company, Limited, Mitsubishi Tanabe Pharma Corporation, Takeda Pharmaceutical Company Limited. Speaker's Bureau; Self; Astellas Pharma Inc., Boehringer Ingelheim Pharmaceuticals, Inc., Daiichi Sankyo Company, Limited, Merck Sharp & Dohme Corp., Mitsubishi Tanabe Pharma Corporation, Takeda Pharmaceutical Company Limited.

Funding

AstraZeneca; Ono Pharmaceutical Co., Ltd.
1515-P: Thai Diabetes Risk Score Performed Less Well in Predicting Incident Diabetes in a General Population: External Validation in the HCUR Cohort
Authors: CHAMNAN PARINYA , WARASOOK PISSAMAI , SRISAWANG ORATHAI , PHROMMACHART NUMFON , WETTANA BENJAWEN ,   HCUR INVESTIGATORS
Published: June 2019

Background: An existing Thai diabetes risk score was developed using data from a worker cohort and has been advocated as a tool to predict diabetes risk in a Thai population. However, the risk score has not been validated in an external cohort, so its accuracy in risk prediction remained uncertain. Aim: To validate the Thai diabetes risk score in an external cohort of Thai general population in the Health Checks Ubon Ratchathani (HCUR) cohort.

Methods: The Thai diabetes risk score was externally validated against incident cases of diabetes developed over 6 years in a cohort of 332,038 individuals aged >=30 years free of clinically and/or biochemically diagnosed diabetes. Published coefficients for the Thai diabetes risk score were used to compute risk score for each individual. Incident diabetes was defined as physician diagnosed diabetes. We computed standard measures of predictive ability including discriminatory ability measured by the area under the receiver operating characteristic curves (aROC) and calibration, as well as the sensitivity, specificity, positive/negative predictive values, and false negative for cut-off points indicating high risk groups.

Results: Over a 6-year period between 2007 and 2012, 7,372 new cases of diabetes developed (an incidence of 2.2%). The Thai risk score showed low discriminative ability and was poorly calibrated for predicting diabetes, with the aROC of 0.574 (95% CI 0.567 - 0.581) and Hosmer-Lemeshow chi-square statistic of 70.04 (p<0.001). A cut-off point for very high risk group (risk score>=8) had low sensitivity and high specificity (18% and 90% respectively), albeit a satisfactorily low false negative of 2%.

Discussion: The current Thai diabetes risk score performed poorly in predicting incident diabetes in a general population and hence requires re-calibration.

Disclosure

P. Chamnan: None. P. Warasook: None. O. Srisawang: None. N. Phrommachart: None. B. Wettana: None.
1670-P: Demographic and Clinical Correlates of Diabetes Autoantibody Positivity among 20- to 45-Year-Olds with New-Onset Diabetes
Authors: LAWRENCE JEAN M. , SLEZAK JEFF , LI XIA , YU LIPING , REWERS MARIAN , TAKHAR HARPREET S. , SRIDHAR SNEHA B. , VEGA-DAILY LETICIA I. , ALEXANDER JANET G. , RITCHIE JENNA , SAYDAH SHARON , IMPERATORE GIUSEPPINA , FERRARA ASSIAMIRA ,   FOR THE DIABETES IN YOUNG ADULTS (DIYA) STUDY
Published: June 2019

Little is known about the prevalence of diabetes autoantibodies (DAA) among young adults newly diagnosed with diabetes (DM). Our objective was to identify patient characteristics associated with presence of DAA among 20-45-year-olds with new-onset DM from 2.3 million Kaiser Permanente California members.

Patients underwent research testing for GADA, ZnT8A, IA2A and IAA. IAA results were not counted for patients with prior insulin use. Demographic and clinical data were from electronic health records. Models predicting any DAA positivity were trained on 70% of cases and validated on the remaining 30%. The best predictive logistic regression model was based on area under the receiver operating characteristic curve (AUC), parsimony and interpretability.

Of 7,862 patients with incident DM (mean age 36.8±6.0 years, BMI 37.1 ±8.7), 1,669 (mean age 36.9 ±6.0 years, BMI 37.2 ±9.2) were tested for DAA ∼9.5 (±3.6) months post-diagnosis; 130 (7.8%) were positive (5.4% single DAA, 2.4% multiple DAA). Prevalence of GADA was 6.1%, IA2A 2.0%, IAA 1.9%, and ZnT8A 1.7%. The best model (Table) yielded AUCs of 0.74 and 0.68 in training and validation datasets, respectively. Association with DAA was positive for younger age, lower BMI, and glucagon prescription and negative for Asian race.

These findings provide insights into patient characteristics associated with antibody positivity in young adults.

Disclosure

J.M. Lawrence: None. J. Slezak: None. X. Li: None. L. Yu: None. M. Rewers: None. H.S. Takhar: None. S.B. Sridhar: None. L.I. Vega-Daily: None. J.G. Alexander: None. J. Ritchie: None. S. Saydah: None. G. Imperatore: None. A. Ferrara: None.

Funding

Centers for Disease Control and Prevention (1U18DP006289); JDRF (2-SRA-2018-533-S-B)
1681-P: Polyendocrinopathy in Type 1 Diabetes: A Transatlantic Comparison
Authors: HERMANN JULIA , MILLER KELLEE , SZINNAI GABOR , FOSTER NICOLE C. , KAPELLEN THOMAS M. , DIMEGLIO LINDA , FRÖHLICH-REITERER ELKE , MCGILL JANET B. , HOLL REINHARD W. , MAAHS DAVID M. ,   FOR THE T1D EXCHANGE CLINIC NETWORK, FOR THE DPV INITIATIVE
Published: June 2019

Type 1 diabetes (T1D) is associated with additional autoimmune and endocrine disorders; however, their prevalences internationally are poorly understood. We analyzed 22,632 patients from the U.S. T1D Exchange (T1DX) registry (median age 18 years) and 38,470 patients from the German/Austrian DPV registry (median age 16 years) with T1D duration ≥1 year (median duration 10 and 6 years, respectively) with data between 01/2016 and 03/2018. Reported prevalences of thyroid disease, arthritis, Addison’s disease, and atrophic gastritis were compared using logistic regression models with registry, age group, and sex as covariates. Thyroid disease was more frequent in the T1DX, whereas arthritis was more frequent in the DPV. Prevalence increased with age in both registries. We found no significant differences between T1DX and DPV for Addison’s disease (Figure). Atrophic gastritis was rare in both registries (T1DX: n=3, DPV: n=21). After adjustment for age, thyroid disease was about twice as frequent in females compared with males (T1DX: 25 vs. 13%, DPV: 15 vs. 7%, both p<0.001). Likewise, arthritis was more frequent in females (T1DX: 0.23 vs. 0.16%, p=0.034; DPV: 1.45 vs. 0.88%, p<0.001), whereas Addison’s disease did not differ significantly by sex. Despite different prevalences, patterns of disease frequencies by age and sex were comparable in both registries. However, standardized clinical diagnoses are needed for valid comparisons between countries.

Disclosure

J. Hermann: None. K. Miller: None. G. Szinnai: None. N.C. Foster: None. T.M. Kapellen: None. L. DiMeglio: Research Support; Self; Amgen Inc., Caladrius Biosciences, Inc., Janssen Research & Development, Medtronic, Sanofi. Other Relationship; Self; Dexcom, Inc. E. Fröhlich-Reiterer: None. J.B. McGill: Advisory Panel; Self; Boehringer Ingelheim Pharmaceuticals, Inc., Gilead Sciences, Inc., Novo Nordisk Inc., Sanofi US. Research Support; Self; Dexcom, Inc., Medtronic, Novartis AG, Sanofi US. Speaker's Bureau; Self; Aegerion Pharmaceuticals, Dexcom, Inc., Janssen Pharmaceuticals, Inc., MannKind Corporation. R.W. Holl: None. D.M. Maahs: Advisory Panel; Self; Novo Nordisk Inc. Consultant; Self; Abbott, Sanofi. Research Support; Self; Dexcom, Inc., Tandem Diabetes Care.

Funding

German Center for Diabetes Research; The Leona M. and Harry B. Helmsley Charitable Trust; German Center for Diabetes Research; German Diabetes Association; European Foundation for the Study of Diabetes; INNODIA
1840-P: Pioglitazone Increases Metabolic Insulin Clearance (MCRI) in IGT Subjects: The ACT NOW Study
Authors: GASTALDELLI AMALIA , TRIPATHY DEVJIT , DEFRONZO RALPH A. ,   NOW ACT INVESTIGATORS
Published: June 2019

Recent studies have documented that the MCRI plays a major role in determining the plasma insulin response to ingested glucose. We evaluated the long-term effect of pioglitazone (PIO) on MCRI in 441 IGT subjects (ACT NOW study) who were randomized to PIO (45 mg/day) or placebo and followed for an average of 2.4 years. OGTT was performed at baseline and study end. 50 placebo-treated subjects developed type 2 diabetes versus 15 PIO-treated subjects (p<0.005). Insulin secretion rate (ISR) was measured from deconvolution of plasma C-peptide curve. MCRI was measured as ISR/mean insulin conc during OGTT. Data were correlated with changes in liver enzymes and peripheral insulin sensitivity measured with the Matsuda index (MI).

Results: PIO improved MI from to 3.9 ±1 to 7.5 ±3 (p<0.0001), glucose tolerance (mean glucose OGTT from 172±2to 148±1mg/dl, p<0.0001) and reduced ALT(from 30±1 to 24±1, p<0.0001). Fasting insulin secretion increased in the placebo group (420 ±14 to 558 ±21 pmol/min, p < 0.0001 vs. baseline) and did not change in the PIO group (411 ±14 to 446 ± 19; p <0.0001, PIO vs. placebo). During the OGTT (0- 120 min) ISR increased in both groups (PIO, 165 ±3 to 189 ± 5 nmol; placebo, 167 ±3 to 202 ±6; p < 0.0001 vs. baseline in both groups; p = NS, PIO vs. placebo).The MCRI increased in both groups but the increase was much greater in PIO (3.5 ± 0.2 to 6.0±0.2 ml/min; placebo, 3.5 ± 0.1 to 4.7±0.2; p < 0.0001 vs. baseline in both groups; p <0.0001, PIO vs. placebo). In the whole dataset the improvement in insulin clearance was associated with improvement in peripheral insulin sensitivity (r=0.62, p<0.0001), the reduction in mean plasma glucose concentration during OGTT (r=-0.31, p<0.0001) and decrease in ALT (r=-0.14, p<0.009).

Conclusion: PIO treatment results in an increase in MCRI that is associated with improved hepatic function, glucose metabolism and peripheral insulin sensitivity.

Disclosure

A. Gastaldelli: Consultant; Self; A. Menarini Diagnostics, Eli Lilly and Company, Genentech, Inc., Gilead Sciences, Inc., Inventiva Pharma. D. Tripathy: None. R.A. DeFronzo: Advisory Panel; Self; AstraZeneca, Boehringer Ingelheim Pharmaceuticals, Inc., Elcelyx Therapeutics, Inc., Intarcia Therapeutics, Inc., Janssen Pharmaceuticals, Inc., Novo Nordisk Inc. Research Support; Self; AstraZeneca, Boehringer Ingelheim Pharmaceuticals, Inc., Janssen Pharmaceuticals, Inc., Merck & Co., Inc. Speaker's Bureau; Self; AstraZeneca, Novo Nordisk Inc.
Calidad de la pregunta de investigación científica: análisis de los últimos 15 años de la Revista Medicina
Authors: Peñaherrera Oviedo Carlos
Published: June 2019

Introducción: la revista Medicina de la Facultad de Ciencias Médicas de la Universidad Católica de Santiago de Guayaquil (UCSG), recientemente cumplió 20 años de vida institucional; por esta eazón se realizara un análisis de los artículos publicados en la misma, haciendo énfasis en los estudios epidemiológicos y en la correcta elaboración de la pregunta de investigación, base fundamental para un buen estudio, mediante el acrónimo PICOT. Materiales y métodos: se recolectó la información de metadatos de todos los manuscritos publicados en la revista que están disponibles desde su archivo web, y se obtuvo el texto completo de todos los artículos originales de investigación. Resultados: de un total de 543 publicaciones en los últimos 15 años, 232 son artículos de investigación, siendo más frecuentes los de tipo transversal en un 71,6%. Más del 90% de los estudios analizados reportan adecuadamente la población, grupo de interés, resultados y tiempo del estudio, mientras que si va el 25,9% presentan un grupo para comparación, lo que puede ser explicado por la gran cantidad de estudios transversales encontrados. Discusión: los diseños de estudio donde se requirió necesariamente todos los componentes, cumplieron a cabalidad con los requisitos; sin embargo se trata de un pequeño número de artículos. La revista Medicina sigue la tendencia en proporción de artículos originales comparada con otras revistas médicas, y publica en su mayoría estudios con una buena base científica.
Urinary nephrin is earlier, more sensitive and specific marker of diabetic nephropathy than microalbuminuria
Authors: Kostovska Irena , Trajkovska Tosheska , Topuzovska Sonja , Cekovska Svetlana , Spasovski Goce , Kostovski Ognen , Labudovic Danica
Published: June 2019

Background

Diabetic nephropathy (DN) is a leading cause of end-stage renal disease. Progressive damage and decline in the number of podocytes often occur in the early stages of DN. Thus, nephrin as a podocyte-specific protein may be regarded as a potential biomarker of early detection of DN. The aim of this study is to determine whether urinary nephrin is an earlier marker in DN than microalbuminuria and to test the significance of urinary nephrin as a marker for early detection of DN.

Methods

Our cross-sectional study included 90 patients with type 2 diabetes mellitus (T2DM), 30 patients with diagnosed DN and 60 patients without diagnosed DN. As a control group, we used 30 healthy subjects. All patients with T2DM were classified into three subgroups according to urinary microalbumin/creatinine ratio (UMCR): normoalbuminuric, microalbuminuric and macroalbuminuric patients. Nephrin in urine was measured by immunoenzyme assay, microalbumin with turbidimetric and creatinine with the photometric method. In blood sera, we measured a few standard biochemical parameters.

Results

Nephrinuria was found to be present in 100% of patients with T2DM and macroalbuminuria, in 88% with microalbuminuria, as well as 82% of patients with T2DM and normoalbuminuria. A concentration of urinary nephrin was significantly increased in all groups of subjects with T2DM compared to the control group (p<0.05). Nephrinuria correlated statistically negative with eGFR (r=-0.54). ROC analysis showed that nephrin has a total predicted probability of 96% in patients with DN.

Conclusions

Urinary nephrin is earlier, more specific and sensitive marker than microalbumin in early detection of DN.
The Effect of Zero Copayments on Medication Adherence in a Community Pharmacy Setting
Authors: Jimenez Melissa , Alvarez Goar , Wertheimer Albert , Lai Leanne , Koh Leroy , Martinez Dainelys , Hijazi Bushra , Weinstein Mark
Published: June 2019

Background: Prescription medication copayments can be a financial burden to many patients. When patients cannot afford their medications, they may become nonadherent, and as a result, this can lead to an increase in chronic disease complications and healthcare costs.

Objective: The objective of this study was to determine if zero copayments have an effect on medication adherence in a community pharmacy.

Methods: This retrospective cohort study examined the prescription refill records of patients who filled specific generic medications for hypertension, hyperlipidemia, and gastroesophageal reflux disease (GERD) in 2016 at the NSU Clinic Pharmacy. The adherence rates of patients with zero copayments were compared to the adherence rates of patients with copayments greater than $0. Adherence was determined by calculating the proportion of days covered (PDC). Patients were considered adherent if their PDC was greater than or equal to 80%.

Results: GERD patients with no copayments had average PDC ratios of 87.4% and were statistically significantly more adherent than GERD patients with copayments, who had average PDC ratios of 76.7% (P = 0.042). Hyperlipidemia and hypertension patients with no copayments had average PDC ratios of 89.3% and 90.3%, respectively, and those with copayments had PDC ratios of 85.3% (P = 0.314) and 87.9% (P = 0.534).

Conclusion: Overall, patients with $0 copayments had higher adherence rates than patients with copayments greater than $0. GERD patients with no copayments were significantly more adherent than GERD patients with copayments. However, no statistically significant difference was found between patients with or without copayments in the hyperlipidemia and hypertension cohorts. Further studies are recommended to analyze additional factors that may influence medication adherence.

 

Article Type: Original Research
O PAPEL DAS PRÁTICAS JURÍDICAS NO PROCESSO DE FORMAÇÃO DO BACHAREL EM DIREITO
Authors: Brant Frederico Andrade
Published: June 2019

O presente trabalho tem como objetivo discutir a relevância das atividades práticas no meio acadêmico, na formação do bacharel em Direito, imprescindíveis ao ensino jurídico e auxiliares no processo de conhecimento do discente, dentro da temática ensino-aprendizagem. Para tanto, reflete-se sobre esse processo, relacionando-o com as práticas na educação superior, desenvolve-se uma discussão em torno da matriz básica curricular dos cursos de Direito no Brasil, evidenciando suas exigências e, apresenta, por fim, a importância dessa práxis na formação do futuro profissional dessa área. Optou-se pela pesquisa qualitativa, para verificar a relação da realidade com o objeto de estudo, através da colheita de dados que se deu via pesquisa documental e bibliográfica. Como resultado da pesquisa, verificou-se ser inegável o papel da prática acadêmica forense na formação do futuro jurisconsulto, vez que forma nele pensamento crítico e reflexivo, instiga seu entusiasmo, participação e interesse, de maneira a permitir que o processo de ensino seja completo, tornando-o mais bem preparado para enfrentar as adversidades no exercício de suas funções, conferindo a ele, assim, novas habilidades e competências.
SINDICABILIDADE DO ATO ADMINISTRATIVO EM PROVAS DE CONCURSO PÚBLICO
Authors: Michna Felipe Cesar
Published: June 2019

Este artigo apresenta uma visão geral acerca da sindicabilidade do ato administrativo em concursos públicos, baseado em julgamentos dos Tribunais Superiores, sob a exegese do que decidido em sede de Repercussão Geral no Recurso Extraordinário nº. 632.853 – Tema 485 do STF, com ênfase na ilegalidade proveniente de erro grosseiro.
Сакральные предметы и трансформации музейной этики: истоки, проблемы, решения
Authors: Pimenova Ksenia V.
Published: June 2019

В статье рассматриваются основные аспекты проблематики сакральных предметов в музеях, анализируются политические и интеллектуальные причины трансформаций музейной этики на Западе, разбираются примеры сложностей музейной работы с сакральными предметами.В первой части статьи резюмируются исторические причины маргинального положения, которое живая религия до недавнего времени занимала в музеях. Во второй и третьей частях анализируются факторы возрастающего присутствия религии в музее и трансформаций музейной этики в обращении с сакральными предметами в последние несколько десятилетий. Это, во-первых, деколонизация и связанное с ней переосмысление отношений между коренными народами и их наследием, а, во-вторых, эпистемологические сдвиги в социальных науках, которые с 1980-х годов формируют новое понимание музейных предметов как агентов социального мира. Таким образом, новая музейная этика опирается одновременно на принцип уважения к самим предметам и на признание за коренными народами прав на живые отношения со своим наследием, в первую очередь — с «чувствительными материалами», к которым относятся культовые предметы, а также человеческие останки. Тем не менее, внедрение этих принципов в работу музеев на практике нередко выявляет противоречия между универсалистскими ценностями музейного дела (например, сохранением наследия и обеспечением доступа к нему) и партикуляристской логикой религиозных и этнических групп.В четвертой части статьи на конкретных примерах описываются сложности, с которыми западные музеи сталкиваются в вопросах экспонирования, хранения и репатриации сакральных предметов, а также возможные пути их решения.В заключении отмечается особая роль региональных и республиканских музеев России в переосмыслении места религии в музее и во внедрении принципов этичного обращения с сакральными предметами.
Коллекция шаманских бубнов в фондах Национального музея Тувы
Authors: Bicheldey Ulyana P. , Dopay Anai-Khaak M. , Byrynnai Saida L.
Published: June 2019

В статье представлены материалы шаманской коллекции, в частности шаманских бубнов, из фондов Национального музея Республики Тыва. Предметов шаманского культа насчитывается здесь более 500 единиц, бубнов — 14. Имеются также и колотушки, неизменные спутники шаманского бубна. Все они принадлежали тувинским шаманам разных лет. Рассматриваются вопросы коллекционирования, комплектации, хранения бубнов. Источниковой базой стали сведения книги поступления, инвентарной книги. Статья сопровождается фотографиями бубнов. Предметы размещены в постоянной экспозиции музея.Сбором шаманских бубнов в музее начали заниматься с середины ХХ в. Первый поступил, предположительно, в 1951 г. Подробно описаны имеющиеся сведения по ряду бубнов: история поступления, датировки, изготовитель, материал, инвентарный номер, сохранность и пр.Авторами статьи выявлено, что бубны различаются по способу изготовления и по методике украшения разной специальной атрибутикой. Подтверждены предположения исследователей о различиях между бубнами в зависимости от места их происхождения — западная и восточная Тува. Главные различия в использовании шкур разных животных, составе деревянного остова бубна, в символике рукояти, в количестве резонаторов на ободе, особенностях дополнительных атрибутов во внутренней части бубна.Сам состав коллекции, ее характеристики, позволяют заключить, что она является одной из наиболее укомплектованных, представляющей практически всю культовую атрибутику тувинских шаманов. Коллекция продолжает дополняться теперь и атрибутикой неошаманов.
Лексема шаг ‘время’ и вопросы грамматикализации в тувинском языке
Authors: Shamina Lyudmila A.
Published: June 2019

В статье представлен анализ семантики и функционирования грамматикализованных структур с лексемой шаг — ‘время’ в тувинском языке. На фоне имеющихся исследований, посвященных проблемам грамматикализации элементов разных уровней тувинского языка (фонетика, лексика, грамматика), специальное исследование структуры, семантики и функционирования грамматикализованных структур, создание классификационных схем для таких языковых единиц пока отсутствует.Цель данной статьи – описание нового коммуникативного поведения лексем в условиях культурной адаптации, обеспечившей выполнение ими вновь возникающих функций.Исследуются новые слова, значения слов, новые морфосинтаксические конструкции и новые значения существующих морфосинтаксических конструкций тувинского языка, которые добавились к уже имеющейся кодифицированной системе коммуникации. Для изучения проблемы были привлечены материалы из художественной литературы на тувинском языке, примеры из словарей и грамматик и полевые материалы, полученные автором во время экспедиций в Тувинскую АССР.В результате исследования была выявлена основная тенденция грамматикализации причастно-послеложных конструкций тувинского языка с темпоральными лексемами шаг — ‘время’, үе — ‘время’: фразеологизация некоторого набора слов, позволяющая стать регулярно воспроизводимым либо зачалом в фольклорном повествовании, либо концовкой предложения.Результаты исследования вносят вклад в развитие теории грамматикализации, вписывая материалы тувинского языка в группу языков, в которых данное явление уже исследовано.
Историческая живопись С. К. Ланзы в собраниях Национального музея Тувы
Authors: Naksyl Mariia D. , Sanchai Cheinesh O.
Published: June 2019

В статье рассмотрена роль Национального музея Республики Тыва, как хранителя исторической памяти народа и художественного наследия тувинского живописного искусства — на примере творчества первого профессионального художника Тувы С. К. Ланзы (1927–1977).Исследован творческий путь С. К. Ланзы. Его учителями были лучшие советские живописцы, и он в полной мере вобрал в себя искусство своего времени. Ведущее место в его произведениях занимает историческая живопись в жанре соцреализма.Восстановлена история комплектования коллекции С. К. Ланзы в фондах Национального музея Тувы, начиная с 1940-х гг. Рассмотрены наиболее известные полотна исторического жанра, а также жанра социалистического реализма; дана их искусствоведческая характеристика. Перечислены основные проблемы хранения и экспонирования картин.Источниковой базой исследования является внутренняя документация музея, приказы министерства культуры Тувинской АССР, личные документы С. К. Ланзы, документы правления Союза художников Тувинской АССР.
Графика Нади Рушевой в контексте экспозиционной деятельности Национального музея Тувы
Authors: Ayzhy Zhanna E. , Burbuzhep Dolaana D.
Published: June 2019

В статье рассматривается вопрос о состоянии коллекций графических рисунков Нади Рушевой в фондах Национального музея Республики Тыва, который является самым крупным обладателем произведений советской художницы в России. Проанализированы фондовая документация, архив семьи Рушевых и тематико-структурные планы персональных выставок художницы. На сегодня в основном фонде музея насчитывается 5380 единиц рисунков Н. Рушевой, образующие свыше 50 тематических разделов.Сравниваются выставочные проекты художницы советской эпохи с настоящим периодом, а также коллекции Национального музея Республики Тыва и Государственного музея А. С. Пушкина, в котором сосредоточены свыше 3000 рисунков художницы. В качестве особенности коллекции графики Нади Рушевой в тувинском музее можно отметить тематическое разнообразие, которое позволяет проследить эволюцию становления художественного языка художницы.Уделяется особое внимание интерпретации графики Нади Рушевой в выставочных проектах Национального музея Тувы. Ведь специфика графики художницы, связанная с юным возрастом и самой ее персоной, в контексте современной экспозиционно-выставочной деятельности является одним из главных приоритетных направлений музея. Международные и региональные персональные выставки, организованные Национальным музеем Республики Тыва, начиная с 1970-х годов по настоящее время, отражают постепенное изменение отношения к творчеству и персоне Нади Рушевой.
Toward Real-Time Monitoring and Control of Nanoparticle Properties with a Microbubble Resonator Spectrometer
Authors: Hogan Levi , Horak Erik , Ward Jonathan , Knapper Kassandra , Nic Chormaic Síle , Goldsmith Randall
Published: June 2019

Optical microresonators are finding widespread application at the frontiers of nanophotonic technology, driven by virtue of their ability to confine light to the nanoscale and enhance light-matter interactions. Recently, our group has developed a new method of photothermal absorption spectroscopy, whereby toroidal optical microresonators act as microscale thermometers to detect the thermal relaxation of optically pumped, nanoscopic analytes. However, translation of this technology to chemically dynamic systems requires a platform that is mechanically stable, amenable to solution, and visibly transparent. We here report microbubble absorption spectrometers as a new and exciting platform that meets these requirements. Microbubbles integrate a two-port microfluidic within a Whispering Gallery Mode (WGM) microresonator, allowing for the facile exchange of chemical reagents within the resonator’s interior while maintaining a solution-free environment on its exterior. Furthermore, their all-glass fabrication results in an ultra-low photothermal background at visible wavelengths. We first leverage these virtues to investigate the photo-activated etching of single gold nanorods by ferric chloride, providing a new method for rapid acquisition of spatial and morphological information about nanoparticles as they undergo chemical reactions. We then demonstrate the ability to control nanorod orientation within a microbubble through optically exerted torque, indicating new routes forward towards the controlled construction of hybrid photonic-plasmonic systems. Critically, the reported platform advances microresonator technology by permitting room-temperature, aqueous experimental conditions, ushering the possibility of time-resolved experiments on non-emissive, nanoscale analytes engaged in catalytically and biologically relevant chemical dynamics.