bluuebunny/crossref_metadata_2025 huggingface dataset:
Evaluating Financial Performance of Mining Companies Listed on Jakarta Islamic Index
Authors: Ajuna Luqmanul Hakiem , Yusuf Sri Dewi
Published: June 2024

In Indonesia, mining companies play a crucial role in supporting government economic initiatives. Consequently, assessing their financial performance becomes vital to ensure their viability and contribution to national economic goals. This study investigates the financial performance of mining companies listed on the Jakarta Islamic Index (JII) from 2017 to 2020. Utilizing purposive sampling, financial statements for four companies were obtained from their official websites, the OJK (Financial Services Authority), and the IDX (Indonesia Stock Exchange). A one-way ANOVA test was employed to compare the financial ratios across these companies. The analysis focused on liquidity, activity, solvency, and profitability ratios. The findings reveal that PT. Adaro Energy Tbk (ANDRO) achieved the highest performance, meeting five out of ten industry standard ratios. PT. Aneka Tambang Tbk (ANTM) and PT. Bukit Asam Tbk (PTBA) followed, each meeting four ratios. PT. Vale Indonesia Tbk (INCO) demonstrated the lowest performance, achieving only two industry standard ratios. This research contributes to the understanding of financial performance variations within the JII's mining sector, highlights areas for potential improvement, and offers valuable insights for investors and policymakers.==============================================================================================================ABSTRAK – Mengevaluasi Kinerja Keuangan Perusahaan Pertambangan yang Terdaftar pada Jakarta Islamic Index. Di Indonesia, perusahaan pertambangan memiliki peran penting dalam mendukung inisiatif ekonomi pemerintah. Konsekuensinya, penilaian kinerja keuangan mereka menjadi vital untuk memastikan kelangsungan hidup dan kontribusi mereka terhadap tujuan ekonomi nasional. Penelitian ini menyelidiki kinerja keuangan perusahaan pertambangan yang terdaftar di Jakarta Islamic Index (JII) dari tahun 2017 hingga 2020. Penelitian ini menggunakan metode purposive sampling untuk memilih empat perusahaan pertambangan yang terdaftar di JII. Laporan keuangan perusahaan diperoleh dari situs web resmi mereka, OJK (Otoritas Jasa Keuangan), dan IDX (Bursa Efek Indonesia). Analisis data menggunakan uji ANOVA satu arah untuk membandingkan rasio keuangan antar perusahaan, dengan fokus pada rasio likuiditas, aktivitas, solvabilitas, dan profitabilitas. Hasil penelitian menunjukkan bahwa PT. Adaro Energy Tbk (ANDRO) mencapai kinerja tertinggi, dengan memenuhi lima dari sepuluh rasio standar industri. Diikuti oleh PT. Aneka Tambang Tbk (ANTM) dan PT Bukit Asam Tbk (PTBA) yang masing-masing memenuhi empat rasio. PT. Vale Indonesia Tbk (INCO) menunjukkan kinerja terendah, hanya mencapai dua rasio standar industri. Penelitian ini memberikan gambaran yang jelas mengenai kinerja keuangan perusahaan pertambangan yang terdaftar di JII. Hasil penelitian ini dapat membantu investor dan pembuat kebijakan dalam mengambil keputusan terkait sektor pertambangan.
Measurement of Tremors for the Seismic Station of Gllogovc-Kosovo
Authors: HASI Nazmi , HASI Latif , CENA Besire
Published: June 2024

To select a potential location for a future seismological station properly, it is of crucial importance to explore the existing local seismic tremor recorded by seismographs. This tremor/noise is referred to as seismic tremor, whereas it is necessary to define as precisely as possible its spectral characteristics. It is very important that the station location be as quiet as possible because the seismic noise can obscure the records at the selected location for seismic station. Therefore, in addition to other geophysical methods, it is of particular importance to define the spectral characteristics of the local tremor at the investigated sites.Seismic noise measurements were made at seismic station of Gllogovc - Kosovo. It is very important that the station location be as quiet as possible because the seismic noise can obscure the records at the selected 8 locations for seismic stations.Seismologists are necessary for such investigations.Considering the requirement regarding their sensitivity and resolution,geophones are not recommended to be used. Still, geophones were also used in these measurements for the purpose of comparing the obtained results.  The most important requirement that should be fulfilled is that the instrumental noise of the seismometres be much lower than the level of the natural seismic noise at the location.
Preservação da Fertilidade Masculina em Pacientes Oncológicos:
Authors: De Almeida Silva Francine , Luiz Albuquerque Vieira Renan , Da Cruz Pena Laiane , Bastos dos Santos Lucas , Da Silva Oliveira Costa Thaise , de Oliveira Almeida Vanessa , Silva dos Santos Adriene , Ribeiro de Souza Hanilton
Published: June 2024

A oncofertilidade abrange áreas da oncologia e reprodução, visando estratégias de prevenção da fertilidade em pacientes oncológicos. As terapias antitumorais podem ocasionar infertilidade em pacientes, contudo, a criopreservação seminal apresenta-se como uma alternativa para garantir a preservação da fertilidade. Neste sentido, objetivou-se investigar os impactos do tratamento oncológico na fertilidade masculina, bem como biotécnicas para a preservação da fertilidade nestes pacientes. Trata-se de um estudo qualitativo de revisão integrativa da literatura, utilizando descritores relacionados ao tema. Foram incluídas publicações em português e inglês, no período de 2012 a 2022. Ao total, 15 artigos foram selecionados. A eficácia da terapia anticancerígena não implica na redução das funções reprodutivas, contudo, para o sexo masculino, a infertilidade é uma complicação potencial. A quimioterapia e radioterapia podem danificar o epitélio seminífero e prejudicar a espermatogênese. Para preservação da fertilidade masculina, a criopreservação de sêmen e tecido testicular são alternativas, estando a última em fase experimental. Deste modo, conclui-se que a infertilidade masculina é um possível efeito decorrente das terapias contra o câncer. Não obstante, é importante a informatização dos pacientes acerca dos riscos oferecidos em sua capacidade reprodutiva, adicionalmente, trazendo à luz das biotécnicas de preservação da fertilidade desses pacientes.
The human-specific nicotinic receptor subunit CHRFAM7A reduces α7 nAChR function in human iPSC-derived and transgenic mouse neurons
Authors: Görgülü Ilayda , Jagannath Vinita , Pons Stephanie , Koniuszewski Filip , Groszer Matthias , Maskos Uwe , Huck Sigismund , Scholze Petra
Published: June 2024

We investigated the impact of the human-specific protein CHRFAM7A (also
referred to as “dupα7”) on the function of α7 nicotinic acetylcholine
receptors (nAChRs) in two different types of neurons: human induced
pluripotent stem cell (hiPSC)-derived cortical neurons, and superior
cervical ganglion (SCG) neurons, taken from transgenic mice expressing
CHRFAM7A. CHRFAM7A co-assembles with α7 (also referred to as CHRNA7) but
lacks a major part of the extracellular N-terminal ligand-binding
domain. We assessed the function of α7 in these preparations with Fura-2
calcium imaging and three different α7-specific ligands: PNU282987,
choline, and 4BP-TQS. Given the short-lived open state of α7 receptors,
we combined the two orthosteric agonists with the type-2 positive
allosteric modulator (PAM II) PNU120596. In line with different cellular
models used previously we demonstrate in primary human iPS-derived and
in mouse neurons that CHRFAM7A has a major impact on nicotinic α7
receptors by reducing calcium transients in response to all three
agonists.
Analysis of Seasonal H3N2 Influenza Virus Epidemic Characteristics and Whole Genome Features in Jining City from 2018 to 2023
Authors: Jiang Yajuan , Dou Huixin , Wang Xiaoyu , Song Tongyun , Jia Yongjian , Yue Ying , Li Libo , Feifei * , Liang Yu-Min , Jiao Bo-Yan , Jiao Baihai
Published: June 2024

Background: Seasonal H3N2 influenza virus, known for its rapid
evolution, poses a serious threat to human health. This study focuses on
analyzing the influenza virus trends in Jining City (2018-2023) and
understanding the evolving nature of H3N2 strains. Methods:
Data on influenza-like cases was gathered from Jining City’s sentinel
hospitals: Jining First People’s Hospital and Rencheng Maternal and
Child Health Hospital, using the Chinese Influenza Surveillance
Information System. Over the period from 2018 to 2023, 7,844 throat swab
specimens were assessed using real-time fluorescence quantitative PCR
for influenza virus nucleic acid detection. For cases positive for
seasonal H3N2 influenza virus, virus isolation was followed by whole
genome s
Neighbouring mode-dependent dynamic event-triggered control for Markov jump interconnected systems with unknown interconnections
Authors: Li Liwei , Lv Huifang , Shen Jie , Shen Mouquan
Published: June 2024

This work is absorbed in the neighboring mode-dependent event-triggered
control scheme for Markov jump systems with unknown interconnections. A
dynamic event-triggered mechanism composed of neighboring modes
parameters is provided to save communication resources and reduce the
number of solution parameters. Distinguished from existing version, the
global operating modes are required to be unknown for each local
subsystem. Resorting to neighboring modes information, an
event-triggered state feedback controller is established to assure
system stability. The cyclic-small-gain criterion is used to tackle the
unknown interconnections so that novel stability criteria are obtained
for the closed-loop systems with H ∞ performance. Finally, an
illustrative example is employed to confirm the proposed method in the
aspect of validity.
Experimental Validation of a Kalman Observer using Linearized OpenFAST and a Fully-instrumented 1:70 Model
Authors: Ammerman Ian , Alkarem Yuksel , Kimball Richard , Huguenard Kimberly , Hejrati Babak
Published: June 2024

To enable real-time monitoring and control strategies for floating
offshore wind turbines, accurate information about the state of the
system is needed. This paper details the application of a Kalman filter
to the UMaine VolturnUS-S floating wind platform to provide accurate
state estimates in real-time using minimal system measurements. The
mid-fidelity non-linear simulation tool OpenFAST was used to generate
the underlying linear state-space model for the Kalman filter. This
linear model and its limitations are demonstrated through comparison
with experimental data collected on a 1:70 froude-scaled model of the
floating platform and tower. Using a selection of 5 measurements from
the real system, a Kalman filter was developed to provide estimates for
the remaining system states and measurements. These estimates were then
validated against the experimental values collected from testing of the
scale model. Validation of the Kalman filter produced accurate estimates
of surge, heave, and tower base bending moment, measurements of which
were not available to the Kalman filter. Performance of the Kalman
filter was tested and validated over a range of sea conditions from
rated wind speed to storm events and demonstrated robustness in the
Kalman filter to maintain accuracy across all operating conditions
despite significant error in the underlying linear model for extreme
conditions.
Detection of various local anesthetic ingredients such as tetracaine and prilocaine in illegally distributed drugs through GC-TOF MS and GC-MS.
Authors: Han Kyoung-Moon , Seo Min Kyeong , Bae Hye Min , Yang Yoon Ji , Baek Sun Young , Kim Hyungil
Published: June 2024

Local anesthetic compounds are mixed with counterfeit products, which
are claimed to be pharmaceuticals. Gas chromatography-time-of-flight
mass spectrometry (GC-TOF MS) and GC-MS methods were used to
simultaneously determine 18 local anesthetics and to identify illegal
products. The GC-TOF MS method was first performed to determine the
fragmentation patterns and structures of the 18 compounds and to
qualitatively screen the samples. The GC-MS method was thoroughly
validated for specificity, linearity, limit of detection, limit of
quantification, accuracy, precision, and recovery. The samples were
divided into liquid, cream, and other forms for testing, 65.6% (40/61)
of which were adulterated with local anesthetics. Lidocaine was
frequently identified in the analyzed samples, with a detection range of
0.153–164.0 mg/g. Furthermore, linearity was observed within the
concentration range of 0.41–1.28, 2.29–2.43, and 1.83–16.3 mg/g for
prilocaine, procaine, and tetracaine, respectively. Eugenol was detected
in a single sample at 3.45 mg/g. In addition, three components were
detected in one sample, posing adverse repercussions to human health
when used in combination. Therefore, our analytical methods could
contribute to the removal of illegal products containing pharmaceutical
compounds.
Elastic properties of hanging wall rock at the seismogenic zone and critical nucleation length for megathrust earthquakes
Authors: Okuda Hanaya , Akamatsu Yuya , Kitamura Manami , Sawai Michiyo
Published: June 2024

Elastic properties of rocks in subduction zones are indicators of stress
states and play important roles in earthquake nucleation. We measured
elastic properties of core samples taken from Susaki area in the
Shimanto accretionary complex, SW Japan, which experienced the depth
condition of the seismogenic zone. We found that the samples have higher
P- and S-wave velocities of 5.4-5.8 km/s and lower porosities of 1-2.5
% than other sedimentary rocks in the Shimanto accretionary complex.
This may be caused by tight contacts among grains due to pressure
solution processes according to microstructural observations. Comparison
with seismological observations in the present Nankai Trough indicated
that the samples correspond to the hanging wall rocks of the megasplay
fault where now a high velocity body is resolved. We further considered
velocity-porosity relation using both the samples in this study and the
drilled samples from the Nankai Trough, and proposed a model explaining
from low to high porosities that is applicable to shallow to deep depths
toward the seismogenic zone. The obtained elastic properties provided a
critical nucleation length for an earthquake along the plate boundary
fault of ~0.5 m. Material and structural heterogeneities
below this length scale have the potential to modulate earthquake
nucleation processes and future studies on this length scale will be
necessary to bridge between laboratories and natural conditions.
Fluid-fluid immiscibility induces fast mass segregation in hydrothermal fluids
Authors: Wan Ye , Chou I-Ming , Shang Lin-Bo , Zheng Zhi , Chen Jiangzhi , Wang Xiaolin
Published: June 2024

An unusual salt-rich (SR) and salt-poor (SP) fluid immiscibility (FFI)
could occur in a variety of hydrothermal fluids. The segregation of SR
fluid from SP fluid provides a potential mechanism for substantial mass
enrichment during some ore forming processes. However, the physical
properties of SR and SP fluids, which determine the hydrodynamic
behaviors of unmixed fluids, have not been well constrained. This study
adopted in situ optical observation, quantitative Raman analysis, and
the mass conservation law to derive the density of the SR and SP fluids.
On this basis, falling sphere viscometry was employed to determine the
viscosity of the SR fluid. Results showed that SR fluid exhibited an
obviously higher density but comparable viscosity to SP fluid, favoring
its high mobility and strong tendency to segregate from SP fluid.
Consequently, the FFI could contribute tremendously to mass enrichment
during fluid evolution.
1006-P: Continuous Glucose Monitoring for High-Risk Type 2 Diabetes in the Hospital—The Cyber GEMS Randomized Controlled Trial Protocol
Authors: SPIERLING BAGSIC SAMANTHA R. , FORTMANN ADDIE L. , BASTIAN ALESSANDRA , BELASCO REBEKAH , SANDOVAL HALEY , LOHNES SUZANNE , TALAVERA LAURA , PHILIS-TSIMIKAS ATHENA
Published: June 2024

Introduction & Objective: Continuous glucose monitoring (CGM) for inpatient management of type 2 diabetes (T2D) has been supported by small pilot studies but lacks confirmation by large randomized controlled trials. The Cloud-Based Real-Time Glucose Evaluation and Management System (Cyber GEMS) trial tests whether real-time CGM can improve time in, above, and below target glycemic range, and reduce hospital acquired infections.

Methods: This in-progress study is enrolling at 2 large disproportionate-share hospitals in Southern CA. Eligible patients are ≥18 years with T2D and on subcutaneous insulin with 3+ glucose ≥ 200 mg/dL. The CGM device is placed and validated against POCT using the %20/20 rule. The CGM transmitter sends data to a smartphone in a lock box at bedside that, in turn, transmits values to platforms for clinical management and evaluation purposes. Participants are randomized to usual care (UC) with point of care glucose testing (POCT) or Cyber GEMS with real-time CGM for glucose monitoring and management. In Cyber GEMS, CLARITY is used for clinical optimization by a remote diabetes RN specialist, the FOLLOW app on a unit iPad is used for real-time management by bedside RN, and a digital dashboard is used for real-time alert monitoring by a remote team. Blinded CGM is utilized in the UC group for outcome evaluation purposes only.

Results: N = 209 of 554 participants have completed the study. Participants are M = 61.3 ± 13.1 years of age, 59% male, 75% Hispanic; 58% reported an annual income < $20,000. Participants had an average maximum glucose of M: 315 ± 80.6 mg/dL prior to enrollment, an T2D duration of M = 17.3 ± 12.1 years; 92% were CGM naive. Average duration in the study was 3.7 days.

Conclusion: The Cyber GEMS protocol is uniquely designed to evaluate the value and utility of real-time CGM for optimizing hospital glucose management in a high-risk, underserved T2D population. Lessons learned and implications for hospital based CGM use will be presented.

Disclosure

S.R. Spierling Bagsic: None. A.L. Fortmann: None. A. Bastian: None. R. Belasco: None. H. Sandoval: None. S. Lohnes: Consultant; Dexcom, Inc. L. Talavera: None. A. Philis-Tsimikas: Advisory Panel; Dexcom, Inc., Lilly Diabetes, Novo Nordisk, Sanofi, Medtronic, Bayer Inc.

Funding

NIH NIDDK (1R01 DK124427-01A1)
1023-P: Predictive Value of Admission Plasma Glucose and Hemoglobin A1c on Inpatient Glycemic Control Assessed by Continuous Glucose Monitoring (CGM) in Medicine and Surgery Persons with Diabetes
Authors: CASTRO-REVOREDO IRIS A. , ZHOU SIYU , URRUTIA MARIA A. , VELLANKI PRIYATHAMA , IDREES THAER , ZABALA ZOHYRA , GALINDO RODOLFO J. , PENG LIMIN , UMPIERREZ GUILLERMO
Published: June 2024

Predictive Value of Admission Plasma Glucose and Hemoglobin A1c on Inpatient Glycemic Control Assessed by Continuous Glucose Monitoring (CGM) in Medicine and Surgery Persons with Diabetes

To determine the predictive value of admission blood glucose (BG) and A1C on inpatient glycemic control assessed by CGM in general medicine and surgery persons with T2D, we combined data from two randomized controlled trials of insulin-treated patients wearing a Dexcom G6 CGM. The primary outcome was optimal glycemic control defined as the percent time in range (TIR, 70-180 mg/dL) ≥70% without hypoglycemia (<70 mg/dL). Logistic regression models were used to evaluate the predictive role of admission BG < 180, 181-250, and >251 mg/dL as well as A1C (<7, 7-9, and >9%).

Among 262 persons (medicine 73%, admission BG 222.4±121 mg/dL, A1C 9.4±2.4%), good glycemic control was achieved in 24%, 7.7%, and 7.5% of patients with admission BG <180, 181-250 and >251 mg/dL; and in 26%, 19%, and 8.6% in those with admission A1C <7%, 7-9%, and >9%, respectively. There were no differences in the rate of hypoglycemia, length of hospital stay (LOS), or hospital complications, Table.

Conclusion: Persons with higher admission BG and HbA1c levels had lower odds of achieving good glucose control (TIR 70-180 mg/dL ≥70% without hypoglycemia); however, there were no differences in hypoglycemia, LOS, or hospital complications compared to those with admission glucose <180 mg/dl or HbA1c <7%.

Table. Hospital glycemic control according to admission glucose and A1C values.

*Good Control: Mean daily glucose 70-180 mg/dL, without hypoglycemia < 70 mg/dLTIR: Time in range; TAR: time above range; TBR: time below range; LOS: length of stay

Disclosure

I.A. Castro-Revoredo: None. S. Zhou: None. M.A. Urrutia: None. P. Vellanki: Consultant; Eli Lilly and Company. T. Idrees: None. Z. Zabala: None. R.J. Galindo: Consultant; Abbott. Other Relationship; Dexcom, Inc. Consultant; Bayer Inc. Other Relationship; Novo Nordisk, Eli Lilly and Company. Consultant; Boehringer-Ingelheim, AstraZeneca. L. Peng: None. G. Umpierrez: Research Support; Abbott, Bayer Inc., Dexcom, Inc., AstraZeneca. Advisory Panel; Dexcom, Inc.
1035-P: Cost-Effectiveness of Real-Time CGM vs. Self-Monitoring of Blood Glucose in People with Insulin-Treated Type 2 Diabetes from a U.S. Payor Perspective
Authors: ALSHANNAQ HAMZA , NORMAN GREGORY J. , LYNCH PETER M.
Published: June 2024

Introduction: Diabetes and its complications cost the US healthcare system $412.9 billion in 2022. The use of RT-CGM systems in diabetes management is associated with improvements in glycemic outcomes for people with insulin-treated T2D. We aim to investigate the cost-effectiveness of RT-CGM systems from a US payor perspective.

Methods: Using the IQVIA Core Diabetes Model v10.0, we projected clinical outcomes and direct medical costs over a lifetime horizon from a US payor perspective. Cohort characteristics and clinical inputs were sourced from a large US retrospective cohort study. Clinical parameters include an A1C effect of -0.56% favoring RT-CGM, severe hypoglycemic events rates of 0.04 and 0 Per Person-Year (PPY) for SMBG and RT-CGM, respectively, and DKA rates of 0.025 and 0 PPY, respectively. The costs of glucose monitoring are based on Medicare pricing and 80% reimbursement (HCPCS codes A4239 and A4253). A utility for the avoidance of finger sticks (0.03) and fear of hypoglycemia reduction (0.025) were applied to users of RT-CGM.

Results: The model projects RT-CGM users to have higher quality-adjusted life years by 0.769 with incremental costs of $16,019, and an incremental cost-effectiveness ratio (ICER) of 20,825, which is below the willingness to pay threshold (WTP) of $50,000. The relative reduction in the total number of events due to RT-CGM use for diabetes eye, renal, neuropathy, and cardiovascular complications was 17.0%, 20.0%, 8.7%, and 2.4% respectively. RT-CGM remained cost-effective under the $50,000 WTP even when its cost was increased by 85% (+$2,097). Sensitivity analysis for reducing RT-CGM costs by 10%, 20%, and 30% resulted in ICERs of 17,425, 14,020, and 10,616 respectively.

Conclusions: RT-CGM systems are cost-effective and project cost-savings due to a reduction in acute diabetes events, and microvascular and macrovascular complications. Our findings support access to RT-CGM in US payor policies.

Disclosure

H. Alshannaq: Employee; Dexcom, Inc. Stock/Shareholder; Unicycive Therapeutics. G.J. Norman: Employee; Dexcom, Inc. P.M. Lynch: Employee; Dexcom, Inc. Stock/Shareholder; Dexcom, Inc.
1040-P: The Value of the Guideline-Recommended Management of Type 2 Diabetes—A Novel Population-Level System Dynamics Approach
Authors: MCEWAN PHILIP , PADGETT THOMAS , GOULDEN SCOTT R. , CHUBB BARRIE , MANSINHO JOANA N. , REN HONGYE
Published: June 2024

Introduction and Objectives: Current clinical guidelines advocate a holistic approach (HA) to type 2 diabetes (T2D) management based on glucose control, cardiovascular (CV) risk, chronic kidney disease (CKD) progression and body weight. Conventional approaches to quantifying value are likely to underestimate the benefit of treating diabetes in line with guideline recommendations due to the narrow focus of traditional health economic evaluations. With the prevalence of T2D projected to rise, we quantified the value of adopting a HA strategy across the health care system compared with a traditional glucose management (GM) strategy, from a multi-stakeholder perspective.

Methods: We developed a population-level T2D system dynamics model calibrated to UK incidence and prevalence data. T2D outcomes were predicted to 2040, using rates from UKPDS. The cardiorenal benefits of HA were incorporated using odds ratios from meta-analysis of contemporary CV outcomes trials. The impact of population growth, an ageing population, and the adoption of a HA versus GM strategy on healthcare resource use, patient outcomes, societal productivity, environment, and total costs were assessed.

Results: Modelled UK prevalence of diagnosed T2D in adults is expected to increase from 3.4M to 4.0M between 2023 and 2040; a GM strategy estimates an 18.6% and 17.5% increase in CV and microvascular (MV) complications, respectively, with 46.16 CV events and 4.88 MV events annually per 1,000 patients, by 2040. Applying a HA strategy to eligible patients reduced this to 42.11 CV events and 4.86 MV events annually per 1,000 patients, resulting in a reduction in direct healthcare costs of £1.68B, 171,225 fewer hospitalizations and 1.32M bed days saved, a reduction in lost income of £266.20M and a gain of 2.18M workdays.

Conclusion: The cardiorenal protection offered by new T2D therapies has the potential to confer benefits to multiple stakeholders across the healthcare system.

Disclosure

P. McEwan: Consultant; AstraZeneca, Novo Nordisk A/S, Boehringer-Ingelheim, GlaxoSmithKline plc, Bristol-Myers Squibb Company, Rocket Pharmaceuticals Inc. T. Padgett: Stock/Shareholder; GlaxoSmithKline plc, Novo Nordisk A/S. S.R. Goulden: Employee; Novo Nordisk A/S. Stock/Shareholder; Novo Nordisk A/S. B. Chubb: Employee; Novo Nordisk A/S. J.N. Mansinho: Employee; Novo Nordisk A/S. H. Ren: Employee; Novo Nordisk.
1041-P: Assessing the Value of Managing Diabetic Kidney Disease from a U.S. Health Care Perspective
Authors: MCEWAN PHILIP , PADGETT THOMAS , EVANS MARC
Published: June 2024

Introduction: The management of diabetic kidney disease (DKD) is associated with considerable resource utilization. The objective of this study was to estimate the economic value associated with modifying the progression of DKD by attenuating the rate of decline of eGFR.

Methods: We developed a deterministic model utilizing published estimates of type 2 diabetes and chronic kidney disease (CKD) stratified by stages: stage 1/2, stage 3a, stage 3b and stage 4/5. Patient characteristics and mean annual decline in eGFR were aligned to the placebo arm of DECLARE-TIMI 58 (-2.44 ml/min/1.732). Diabetes-specific and all-cause mortality were captured using UKPDS risk equations. CKD stage-specific costs and changes in health utility were drawn from US published sources. Costs (indexed to 2023) and quality adjusted life years (QALYs) were both discounted at 3%.

Results: The table illustrates the absolute lifetime costs/QALYs associated with the natural history of DKD, and the change in costs/QALYs from attenuating the rate of eGFR decline.

Discussion: Attenuating the decline of eGFR in DKD at the population level has the greatest health gain and cost saving in early disease stages. On an individual basis, optimal cost saving and health gains occur at stage 3; in stage 4/5 attenuating eGFR decline results in health gain, but also additional costs due to the cost of managing advanced DKD.

Disclosure

P. McEwan: Consultant; AstraZeneca, Novo Nordisk A/S, Boehringer-Ingelheim, GlaxoSmithKline plc, Bristol-Myers Squibb Company, Rocket Pharmaceuticals Inc. T. Padgett: Stock/Shareholder; GlaxoSmithKline plc, Novo Nordisk A/S. M. Evans: Consultant; Novo Nordisk A/S, AstraZeneca, Eli Lilly and Company, Boehringer-Ingelheim, Sanofi.
1045-P: Cost-Effectiveness of Adjuvanted RSVPreF3 Vaccination in Adults Aged 50–59 Years with Diabetes in the United States
Authors: SINGER DAVID , LA ELIZABETH , GRAHAM JONATHAN , GRACE MEI , POSTON SARA , MOLNAR DANIEL
Published: June 2024

Introduction & Objective: Older adults and adults with comorbidities, such as metabolic diseases, are at increased risk of severe respiratory syncytial virus (RSV) disease. This study assessed the cost-effectiveness of adjuvanted RSVPreF3 vaccination in adults 50-59 years of age (YOA) with diabetes in the US.

Methods: A Markov model was used to estimate costs and health outcomes over a 3-year time horizon from a societal perspective, comparing scenarios with and without one-time adjuvanted RSVPreF3 vaccination. Indirect costs and quality-adjusted life year (QALY) losses due to RSV-related death were modeled over the remaining lifetime. The population included 5,617,227 US adults 50-59 YOA with diabetes. Vaccination coverage of 50.1% was assumed, based on influenza vaccination coverage. Scientific literature and public sources were used to inform model inputs. Incremental cost and health outcomes were reported along with the incremental cost-effectiveness ratio (ICER), comparing adjuvanted RSVPreF3 vaccination to no vaccination.

Results: Over the 3-year time horizon, adjuvanted RSVPreF3 vaccination avoided an estimated 180,546 symptomatic RSV acute respiratory illnesses, including 144,676 lower respiratory tract disease cases, 108,392 RSV-related outpatient visits, and 7,841 RSV-related hospitalizations. Vaccination resulted in incremental total societal costs of -$39 million (M), including incremental direct and indirect costs of $623M and -$662M, respectively. Adjuvanted RSVPreF3 vaccination avoided 10,290 QALY losses and 551 RSV-related deaths. With improved health outcomes and lower societal costs, adjuvanted RSVPreF3 vaccination was dominant versus no vaccination (ICER <$0 per QALY gained).

Conclusion: One-time adjuvanted RSVPreF3 vaccination resulted in improved health outcomes and reduced societal costs compared to no vaccination, suggesting it is cost-effective for the prevention of RSV in adults 50-59 YOA with diabetes.

Disclosure

D. Singer: Employee; GlaxoSmithKline plc. Stock/Shareholder; GlaxoSmithKline plc. E. La: Employee; GlaxoSmithKline plc. Stock/Shareholder; GlaxoSmithKline plc. J. Graham: Research Support; GlaxoSmithKline plc. M. Grace: None. S. Poston: Employee; GlaxoSmithKline plc. D. Molnar: Employee; GlaxoSmithKline plc.

Funding

GlaxoSmithKline Biologicals SA (VEO-000556)
1057-P: Improving Outcomes for People with Diabetes through Value-Based Endocrinology
Authors: TERRY DAVID
Published: June 2024

Healthcare services for people with diabetes (PWD) in the US are fragmented and uncoordinated, leading to broad variability in outcomes and annual healthcare costs per PWD, on a risk adjusted basis. The objective of our work is to test the hypothesis that PWD do better and utilize less resources, i.e. fewer complications, ER visits and hospitalizations, when cared for by an Endocrinologist, than when they are cared for by other types of clinicians.

To test our hypothesis we analyzed 100% of the Medicare Part A & B claims data from January 2021 through June of 2023. Using this data we identified 12 million Medicare PWDs, and we attributed each of them to an Endocrinologist, a PCP, an Other physician type, or No physician. We then risk adjusted the population based on the CMS Risk Adjustment Factor (RAF) methodology, and assessed risk-adjusted complication rates and resource utilization by physician, and physician attribution type (Endocrinologist, PCP, Other, None).

Through our analysis we found that PWD who regularly see an Endocrinologist throughout the year have fewer complications and utilize significantly less expensive healthcare resources than PWD who don’t regularly see an Endocrinologist. Preliminarily, PWD regularly cared for by an Endocrinologist spend $3,120 per year less than those not regularly cared for by an Endocrinologist, on a risk adjusted basis.

Based on these findings it is important to increase Endocrinology clinical capacity and access by creating multi-disciplinary clinical teams led by Endocrinologists that include Diabetes Educators, Dietitians, Nurse Practitioners and Nurses with expertise in diabetes who can care for many more PWDs. It is also important to incentivize the development of this model by moving Endocrinology care away from FFS into Value-Based Care arrangements that reward Endocrinologists for improving care and reducing costs rather than for generating more visits.

Disclosure

D. Terry: Employee; Valendo Health.
1058-P: The Relationship between Health Insurance Coverage and Clinical Outcomes among People with Diabetes in Saudi Arabia
Authors: AL-SOFIANI MOHAMMED , ALZAMIL YARA
Published: June 2024

Objectives: To study the relationship between social determinants of health (SDH), including health insurance status; accessibility to novel diabetes medications and technology; and health outcomes in people with diabetes (PWD).

Methods: A retrospective analysis of data from 311 PWD, who visited the same endocrinologist at either his public clinic (King Saud University) or private clinic (AlHabib Group) between Nov 2021 & Nov 2022 in Saudi. Metrics of glycemic control, cardiometabolic health, and utilization of diabetes medications and technology were compared by health insurance status.

Results: The median (IQR) age of the study participants was 40 (24, 60) years. Of them, 40.2% were insured. Most insured PWD (85.60%) were seen at the private clinic; and 97.85% of uninsured PWD were seen at the public clinic. Use of GLP-1 RA, SGLT-2 inhibitors, and combined diabetes medications were more prevalent among insured PWD (21.6%, 18.4%, and 15.2%, respectively) than uninsured PWD (8.60%, 5.38%, and 2.15%, respectively, all p<0.01). The insured group had a higher proportion of PWD with A1C of ≤8% compared to the uninsured group (64.66% vs 31.84%, respectively, p<0.01). Being insured was associated with greater odds of achieving an A1C of ≤8% [OR (95% CI): 6.07 (1.85, 19.91)] after adjusting for potential confounders, including sociodemographics, select SDH, and utilization of novel diabetes medications and technology. Among the 163 people with type 1 diabetes (PWT1D), use of insulin pumps was more common in insured versus uninsured PWT1D (28.57% vs 2.80%, respectively, p<0.01). The use of insulin pump was associated with greater odds of achieving an A1c of ≤8% in PWT1D [OR (95% CI): 4.28 (1.44, 12.72)].

Conclusion: Social determinants of health, including health insurance, play a key role in determining the health outcomes of PWD in Saudi. Differences in health outcomes by insurance status are likely driven by differences in availability of healthcare resources and other SDHs

Disclosure

M. Al-Sofiani: Consultant; Eli Lilly and Company. Speaker's Bureau; Medtronic, Insulet Corporation, Abbott, Sanofi. Consultant; Medtronic. Y. Alzamil: None.
1067-P: Neural Network to Identifying Type 2 Diabetes (T2D) Progression Subphenotypes
Authors: HUANG YU , FAN ZHENGKANG , DONAHOO WILLIAM T. , GUO JINGCHUAN , BIAN JIANG
Published: June 2024

T2D is a heterogeneous disease with variations in presentation, progression, and response to treatments across individuals. We developed a novel GNN-based framework to identify distinct T2D progression pathways using electronic health records (EHR) data.We identified T2D patients using 2015-2020 EHR data from the University of Florida Health System. We extracted (1) demographics, labs, medications, and comorbidities; and (2) social determinants of health via natural language processing from clinical notes. Our novel GNN-based framework, including: (1) modeling T2D progression graphs based on the encounters in longitudinal EHRs, (2) learning outcome-oriented (i.e., glycemic control via HbA1c over time) latent T2D progression representations, and (3) learning T2D progression subphenotypes using Hierarchical Clustering algorithm.Of the 2,415 T2D patients, mean age was 59 (sd: 13) years, and 60 % were females. We identified 5 distincT2D progression subphenotypes (Figure, C1-C5). and they exhibited distinct sociodemographic and clinical characteristics. C1 had the slowest progression of T2D, with the lowest burden of hypertension. Compared to C1, C5 had a faster progression and suffered more from renal declines.C2 had the fastest progression, with the highest burden of obesity and neuropathy.Our GNN-based T2D progression subphenotypes may support precision treatment and disease management.

Disclosure

Y. Huang: None. Z. Fan: None. W.T. Donahoo: None. J. Guo: None. J. Bian: None.
1070-P: How Continuing Education (CE) Supported Guideline-Based Treatment among Patients with Obesity
Authors: ALLEN RUSSIE , WELCH LAUREN K.
Published: June 2024

Goal: To determine whether learners in a 2023 CE initiative increased their use of approved and recommended pharmacotherapies compared to a control group of non-learners for the medical management of obesity

Methods: Med Learning Group (MLG) conducted 34 CE activities in 2023 as part of an educational initiative supported by an independent educational grant from Novo Nordisk. The education focused on diagnosis of obesity and the multidimensional management of patients with obesity who would benefit from evidence-based pharmacotherapies. Learners in each activity completed pre-/post-tests. MLG also provided identifying data on 11,119 learners (primary care physicians, cardiologists and advanced practitioners) to IQVIA, who then compared 11,084 of these learners to non-learners as a matched pair control. Control match criteria included geography, specialty, and prescribing behavior. IQVIA used claims data from pre- and post-education to identify change in the use of guideline recommended and evidence-based therapies for patients among learners compared to control.

Results: Learners achieved a 31% gain in ability to identify patients who would benefit from evidence-based pharmacotherapies on pre-/post-test questions (N=3952). Via the claims analysis, learners also demonstrated increased appropriate application of guideline-recommended therapies in practice, with incremental new prescriptions of recommended therapies increasing significantly among learners compared to the matched control group of non-learners. Learners selected 290,322 new guideline-recommended pharmacologic interventions for obesity in the study period. This is 11,189 more (new) guideline-recommended treatments than the control group (p=0.002).

Conclusion: Learners enhanced their use of guideline-recommended therapies post-education compared to carefully matched controls, demonstrating how CE can positively impact real-world medical practice.

Disclosure

R. Allen: None. L.K. Welch: None.

Funding

Novo Nordisk
1071-P: Association of Race and Ethnicity with Net Promoter Score and Hemoglobin A1c in a Virtual Diabetes Management Program
Authors: JOHNSON HOPE , LIN JENNY J.Y. , KUMMARI ANJANA , BONACA MARC P. , TIBBELS JASON , LOEHRER SARANYA
Published: June 2024

Virtual solutions to chronic care management including care for diabetes mellitus hold promise for greater convenience, access, and scalability. Better understanding of the association of race and ethnicity on engagement, experience, and outcomes will offer opportunities to optimize health equity. Self-reported race and ethnicity was collected in the Teladoc Virtual Diabetes management program. Bayesian imputation was used to assign race and ethnicity where unreported. Rates of enrollment, net promoter score (NPS), and blood glucose measurements were systematically collected. The Nathan method was used to estimate HbA1c which includes at least 14 blood glucose readings within a 90-day period. Changes in HbA1c were adjusted for baseline. A total of 530,222 participants enrolled were available for analysis with race/ethnicity available in 444,716 (84%) after Bayesian imputation. Of those with available race/ethnicity, 70% were non-Hispanic white, 15% were Hispanic, 10% were black/African American, and 5% were American Indian, Alaskan Native, or Asian Pacific Islander. Overall enrollment was similar across groups. The proportion reporting a positive NPS was numerically higher in patients reporting as Hispanic, Black/African American, or Asian Pacific Islander. Baseline hemoglobin A1C was ~8.5% and similar by Race/Ethnicity. Over a 90-day period, A1C was observed to be lower in all groups and with the greatest numerical change in those reporting as Asian Pacific Islanders followed by Black/African American. In a virtual diabetes management program including 530,222 participants, 70% were non-Hispanic white. Participants had similar rates of enrollment and similar baseline HbA1C measures across reported race/ethnicity. Differences in Net Promoter Score and change in HbA1C were observed by race/ethnicity. These results highlight the importance of considering race/ethnicity in the design and content of virtual programs.

Disclosure

H. Johnson: None. J.J.Y. Lin: None. A. Kummari: None. M.P. Bonaca: Other Relationship; CPC Clinical Research. J. Tibbels: Employee; Teladoc Health. S. Loehrer: None.
1128-P: Diabetes and Cardiovascular Disease Hospital Recognition Program Associated with Rapid Improvement in Guideline-Directed Medical Therapy
Authors: FONAROW GREGG C. , SEDNEW RENEE M. , OVERTON KATHERINE , PRESSLEY BIANCA , CONGDON MICHELLE
Published: June 2024

Background: Rapid implementation of guidelines is a challenge in health care. Recognition programs are a proven strategy to drive hospital performance. This analysis reviews guideline-directed utilization of sodium glucose cotransporter-2 (SGLT-2) and glucagon-like peptide-1 (GLP-1) therapies in eligible patients with diabetes hospitalized with heart failure (HF) or stroke, comparing the period when the measure was used for quality feedback only or quality feedback and award.

Methods: Hospitals participating in American Heart Association’s (AHA) Get With The Guidelines® (GWTG)-Stroke and GWTG-HF document guideline adherence, including appropriate prescribing of SGLT-2 or GLP-1 in patients with type 2 diabetes prior to discharge. AHA established Target: Type 2 Diabetes (TT2D) to recognize guideline adherence for diabetes and cardiovascular disease.

Results: While hospitals have been able to review performance of appropriate SGLT-2 or GLP-1 prescribing since TT2D launched, this measure was not part of award eligibility for the first 2 years of the program.

Conclusion: These findings show improvement from when the measure was used for quality feedback alone compared to use for recognition. Despite improvement, there remain significant opportunities to improve diabetes care and outcomes for patients hospitalized with diabetes along with HF or stroke.

Disclosure

G.C. Fonarow: None. R.M. Sednew: None. K. Overton: None. B. Pressley: None. M. Congdon: None.
1157-P: Facilitators, Attitudes, Barriers, and Behaviors (FABB) Related to Transition Diabetes Care in Emerging Adults
Authors: GLAROS SOPHIA B. , THOTA GEETHIKA P. , DIXON SYDNEY A. , CHOWDHURY ARUBA , DAVIS FAITH , KRENEK ANDREA , MALANDRINO NOEMI , MABUNDO LILIAN , MONAGHAN MAUREEN , CHUNG STEPHANIE T.
Published: June 2024

Introduction & Objective: Emerging young adults (YA) with diabetes have unique needs but there is few data on transition readiness to guide clinical programs. We assessed transition readiness, mood, and behaviors in YA at a multi-disciplinary diabetes transition clinic.

Methods: Adults ≥18y<30y with diabetes (78% youth-onset type 2 diabetes, 11% type 1 diabetes, 11% other) at a single center were invited at their initial visit to complete Endocrine Society “Self-assessment of Worries, Concerns, and Burdens Related to Diabetes and Transitioning”, Patient Health Questionnaire (PHQ-9), and General Anxiety Disorder (GAD-7) forms to assess transition readiness, depressive mood, and anxiety.

Results: In 37 YA (20.6±2.7y, 60% female, 58% Black, BMI:35.8±8.9 kg/m2, hemoglobin A1c 7.4±2.4%), 81% reported adequate diabetes knowledge. One in 4 YA had diabetes-related challenges (Table). PHQ-9 scores were >9 (moderate depression) in 27%; 50% had anxiety causing difficulty with activities of daily living. Transition or PHQ-9 scores did not differ by diagnosis or sex. Black YA had the lowest GAD scores (P=0.01). There were no relationships between transition scores with PHQ-9, GAD-7, or HbA1c.

Conclusion: YA reported adequate diabetes knowledge, but high rates of diabetes burdens distinct from mood symptoms. Social and supportive care resources are needed to improve transition care.

Disclosure

S.B. Glaros: None. G.P. Thota: None. S.A. Dixon: None. A. Chowdhury: None. F. Davis: None. A. Krenek: None. N. Malandrino: None. L. Mabundo: None. M. Monaghan: Employee; National Institute of Diabetes and Digestive and Kidney Diseases. S.T. Chung: None.

Funding

Intramural Research Program of National Institute of Diabetes & Digestive & Kidney Diseases
1159-P: CGM Use in Adolescents and Young Adults with Type 2 Diabetes
Authors: FENSKE RACHEL , MANN ELIZABETH A.
Published: June 2024

Introduction & Objective: There is a growing body of evidence supporting continuous glucose monitor (CGM) use in adults with Type 2 Diabetes (T2D), and recent evidence to suggest CGM use could also be beneficial to adolescents and young adults (AYA) with T2D. CGM use is presently limited in this population and a deeper assessment is needed to understand barriers to use. The objective of this study was to determine baseline CGM use in AYA with T2D cared for by the UW Health Pediatric Diabetes Clinic.

Methods: All individuals with T2D seen at least once by the UW Health Pediatric Diabetes Clinic since 2016 were included in this observational study. Electronic medical records were reviewed to collect pertinent demographic, laboratory, and diagnosis information, as well as, any documentation regarding barriers to receiving or using CGM. Parameters were compared between groups using t-test or nonparametric test, as appropriate.

Results: Of the AYA with T2D seen, 156 had complete information and were included. Per chart review, 17 of the 156 AYA were using CGM. There was no statistical difference in mean hemoglobin A1C at diagnosis between groups. When considering insurance coverage, 54% of those using CGM and 66% of those not using CGM reported having Medical Advantage (MA) or other managed plan. AYA with T2D reported various barriers to starting and using CGM including not wanting to wear something that would draw attention to themselves, prohibitive costs, and difficulty obtaining insurance coverage. Notably, for some AYA with T2D who were using CGM, the aforementioned issues continued after CGM initiation.

Conclusion: CGM use in AYA with T2D is limited for a variety of reasons. Understanding individual’s personal feelings around CGM will be helpful to determine how CGM use can be incorporated into their diabetes care. Insurance coverage of CGM for AYA with T2D was found to be variable. The role of CGM in the care and management of T2D in AYA continues to evolve; further exploration is needed to understand and address perceived barriers.

Disclosure

R. Fenske: None. E.A. Mann: None.