bluuebunny/crossref_metadata_2025 huggingface dataset:
O uso da realidade aumentada na educação básica brasileira: um mapeamento sistemático
Authors: César da Silva Dantas Júlio , Ferreira de Andrade Adja
Published: September 2022

A realidade aumentada sai das obras de ficção científica e entra, cada vez mais, no cotidiano imediato das pessoas; e, espelhando as mudanças que sofre a sociedade, a escola também acolhe essa tecnologia. Destarte, esse trabalho busca compreender como tem se dado a implementação de práticas que lancem mão da realidade aumentada no contexto da educação básica brasileira, conhecendo os seus instrumentos, métodos de ensino, avaliação, áreas do conhecimento e níveis de educação em que ocorre o uso. Para isso, usa o método de mapeamento sistemático de literatura e justifica-se não só em conhecer o paradigma de aplicações, mas em identificar lacunas de pesquisa pouco exploradas que podem ser endereçadas por estudos posteriores. As principais conclusões deste estudo versam sobre o grande número de trabalhos que usa a realidade aumentada de maneira demonstrativa, que poucos trabalhos avaliam o conteúdo trabalhado, escassez de trabalhos que versam sobre a área de linguagens ou as ciências humanas e a preferência pelo uso dos smartphones, pela tecnologia baseada em marcadores, os conteúdos de Física e o ensino médio como contexto de aplicação. Como resultado, essa pesquisa visa difundir e incentivar os professores que pretendem usar a realidade aumentada em suas práticas pedagógicas.
O uso da realidade virtual no ensino de biologia: análise de tours do aplicativo google expedições.
Authors: Ramos Fonseca Kristyelem , Cabral de Oliveira Carlos Bruno , Guelero do Valle Mariana
Published: September 2022

Este trabalho objetivou investigar o uso da Realidade Virtual (RV) no contexto do ensino de Biologia, com foco na análise de tours do aplicativo Google Expedições. Trata-se de uma pesquisa documental de abordagem qualitativa. Foram analisados quarenta e quatro tours do aplicativo Google Expedições de diferentes áreas da Biologia. Para a análise de dados, foram adaptados os elementos-chave Mundo Virtual e Imersão de Sherman e Craig (2019). Na categoria Mundo Virtual, pode-se destacar a importância dos objetos virtuais para aproximação do conteúdo através da visualização e contextualização. Na categoria Imersão, constatou-se que os elementos audiovisuais são um complemento para a interpretação de informações acerca do ambiente em que o aluno está imerso.
Análise automática de atividades de introdução à programação com o scratch
Authors: Alves de Souza Franciely , Pontual Falcão Taciana , Ferreira Mello Rafael
Published: September 2022

O objetivo do presente artigo é propor visualizações automáticas de avaliações de atividades feitas no Scratch, a fim de dar suporte para os professores no acompanhamento do aprendizado dos alunos. Foram geradas visualizações gráficas a partir de atividades de programação básica realizadas no Scratch com alunos do 2º ao 5º ano do ensino fundamental. As atividades foram avaliadas automaticamente através de uma versão modificada da ferramenta Dr. Scratch, e foram geradas visualizações gráficas na ferramenta online Data Studio. Os resultados apresentam as análises das atividades, onde o professor pode visualizar o desenvolvimento do aprendizado do aluno, e analisar quais são as possíveis dificuldades apresentadas por cada aluno ou turma, e consequentemente adaptar as aulas a fim de supri-las.
Scratch nas Engenharias: Alunos desenvolvedores de experimentos para laboratório virtual
Authors: Nuernberg Sartor Vidotto Kajiana , Rockenbach Tarouco Liane Margarida , Fernanda da Silva Patrícia , Nuernberg Sartor Faraco Morgana
Published: September 2022

Em busca de novas práticas educacionais para a disciplina de Estática dos cursos de Engenharias da UNISATC, esta pesquisa descreve uma atividade cujo objetivo é analisar as condições para o desenvolvimento de experimentos para laboratórios virtuais (LVs), utilizando a ferramenta Scratch 3.0 on-line, e envolvendo os estudantes de forma ativa e participativa, tornando-os protagonistas do próprio conhecimento. Utilizou-se a Aprendizagem Criativa e atividades de experimentação para desenvolver a autonomia, a criatividade, a motivação e o trabalho colaborativo. A metodologia da pesquisa se caracterizou por um estudo de caso aplicado com resultados assertivos, pois, mesmo sem saber programar, os estudantes construíram experimentos de forma autônoma, intuitiva, criativa e divertida, atingindo os objetivos do componente curricular.
As inteligências múltiplas e as ferramentas educacionais desenvolvidas para auxiliar os processos de ensino-aprendizagem de Lógica de Programação
Authors: Godoy Martins Corrêa Deborah , De Oliveira Tiago
Published: September 2022

Este estudo busca identificar as ferramentas e os softwares educacionais direcionados à programação, desenvolvidos entre os anos de 1981 e 2019, visando analisá-los em relação à teoria das inteligências múltiplas. O mapeamento dessas ferramentas e softwares baseou-se na correlação entre o conteúdo didático que apresentam e as inteligências múltiplas mais aderentes a elas. Para isso, foi realizada uma pesquisa em bases de dados para identificar as ferramentas existentes e, a partir de parâmetros pré-definidos, buscou-se associar o estímulo da habilidade a cada inteligência. Como principais resultados, verificou-se que entre as ferramentas há um déficit principalmente em relação a contemplar estudantes que apresentam de maneira mais aflorada as inteligências naturalista, interpessoal e intrapessoal. A análise dos dados permite, além de auxiliar os professores na escolha de ferramentas educacionais mais adequadas a cada perfil de estudantes, repensar o desenvolvimento de ferramentas ou softwares mais personalizados, que efetivamente desenvolvam competências e habilidades, e que possuam diversidade na apresentação de conteúdos o suficiente para atender aos diversos tipos de inteligências.
Pensamento Computacional e o Ensino de Matemática: um relato sobre as percepções de estudantes de um curso de formação de professores
Authors: Bezerra Nunes de Farias Matheus Felipe , Almeida Ferreira Mariana , Barbosa Coutinho Ana Emília Victor , Gonçalves Coutinho Brauner
Published: September 2022

O pensamento computacional é considerado em vários países como uma das habilidades essenciais para os cidadãos do século XXI. No Brasil, a sua recente inclusão na Base Nacional Comum Curricular tem motivado reflexões acerca da necessidade de sua inclusão na formação inicial e continuada de professores da Educação Básica, especialmente na área da matemática. Nessa perspectiva, apresentamos no presente trabalho uma avaliação das percepções dos participantes de um curso introdutório de formação para licenciandos e professores de matemática que visa articular o pensamento computacional com conteúdos matemáticos a partir da proposta do desenvolvimento de desafios, simulações e jogos lúdicos utilizando a plataforma Scratch. Para isto, um questionário baseado na escala Likert foi aplicado junto aos participantes ao final do curso visando analisar as suas percepções em relação ao objeto de estudo. O engajamento dos participantes nas atividades desenvolvidas bem como a análise das respostas ao questionário indicam que se trata de uma temática motivante e atraente, sendo essencial o desenvolvimento de ações que visem associar de modo mais efetivo o pensamento computacional à formação de professores de matemática.
Seguridad y soberanía alimentaria frente al COVID-19
Authors: Carazo Vargas Eva , Muñoz Calvo Francis , Gatica López Gustavo , García Fonseca Tanya
Published: September 2022

Este documento incorpora introducciones conceptuales sobre la Soberanía Alimentaria y la Economía Solidaria, una reflexión sobre la urgencia de fortalecerlas en este contexto, y una serie de propuestas de política pública, acciones institucionales y desde la sociedad civil para avanzar en esa dirección.
Covid-19 y crisis económica: Diez apuntes para un programa económico diferente
Authors: Vargas Solís Luis Paulino
Published: September 2022

Este escrito forma parte de una serie de documentos elaborados por investigadoras e investigadores del Centro de Investigación en Cultura y Desarrollo de la UNED, donde a manera de ensayo se presentan análisis y reflexiones sobre el cómo diversos aspectos de nuestra realidad cotidiana se han visto afectados a partir de la aparición del COVID-19.
El costo del privilegio: masculinidad, heterosexualidad, y el encierro del querer vivir
Authors: Sancho Quirós Valeria
Published: September 2022

En los últimos años, el lenguaje de los privilegios se ha popularizado como medio de expresión y registro de las desigualdades radicales que organizan la vida en la modernidad tardía. Personas estudiosas del privilegio han instado en este marco al examen y explicitación pública de los propios privilegios, como condición previa para la colaboración y el diálogo entre grupos sociales sistemáticamente aventajados por las jerarquías coloniales, patriarcales, heterosexistas y de clase, y aquellos grupos a los que perjudican. Me distancio de esta apuesta para argumentar que la multiplicidad de identificaciones con los lugares del privilegio y del desprivilegio, fundadas en una economía simbólica de la deuda, obturan la posibilidad de una subjetivación política en ambos extremos de la conversación.
Soñando y construyendo otra educación: Características de la propuesta curricular y pedagógica progresista en Costa Rica en la segunda mitad del siglo XX e inicios del siglo XXI
Authors: Toruño Arguedas César
Published: September 2022

El presente ensayo es el primero de una tríada de publicaciones académicas “Soñando y construyendo otra educación” orientadas al análisis curricular y pedagógico de propuestas. Para realizar estas publicaciones, se analizaron las propuestas alternativas de educación en el período en estudio, mediante las publicaciones y entrevistas con participantes en la formulación de esas alternativas educativas. La metodología se sustentó en fuentes documentales secundarias y las entrevistas semi estructuradas. La información recabada fue analizada mediante un análisis de contenido, lo cual permitió establecer las características del currículum alternativo construido desde este movimiento pedagógico. El estudio concluye la existencia de elementos estructurantes de la propuesta curricular y pedagógica progresista en Costa Rica al finalizar el siglo XX e inicios del siglo XXI.
Mechanical cyclic tensile behavior of the flax/PP biocomposite Using DIC Technique
Authors: Messadi Rihab , abid sana , hassine Tarek , Daly Hachemi Ben
Published: September 2022

Nowadays, the high pollution rate in many industrialized countries
requires the implementation of environmental standards in the industrial
process. But most composite materials have a very low recyclability rate
based on thermosetting polymers. As a result, the world of research is
now interested in the development of biocomposites based on natural
resources, several recent studies of which have highlighted the
environmental benefits (low ecotoxicity, biodegradability). Currently,
plant fibers such as flax, sisal and hemp are used and can compensate
for the disadvantages of using traditional fibers. In this context, the
work presented in this article is part of a project to develop
biocomposite materials based on high-performance mechanical flax fibers
for the manufacture of automotive parts. Hence, the current paper
presents results from the experimental study as well as encountered in
the literature. The objective is to understand on the one hand the state
of damage and the evolution of rigidity relative to the knee point
position identified in the stress tensile curves of woven fabric flax/PP
and on the other hand the evolution of dissipative phenomena that may
take place depending
Dissecting the effect of soil on berry transcriptional plasticity in two Italian grapevine varieties ( V. vinifera L.).
Authors: Vannozzi Alessandro , Corrado Perin , Fabio Palumbo , Sandri Marco , Zuccolotto Paola , Zenoni Sara , Barcaccia Gianni , Massimo Pindo , Sonego Paolo , Alessandro Cestaro , Margherita Lucchin
Published: September 2022

Grapevine embodies a fascinating species as regards phenotypic
plasticity and genotype-per-environment interactions. The terroir,
namely the set of agri-environmental factors to which a variety is
subjected, can influence the phenotype at the physiological, molecular,
and biochemical level, representing an important phenomenon connected to
the typicality of productions. We investigated the determinants of
plasticity by conducting a field-experiment where all terroir variables,
except soil, were kept as constant as possible. We isolated the effect
of soils collected from different areas, on phenology, physiology, and
transcriptional responses of skin and flesh of a red and a white variety
of great economic value: Corvina and Glera. Molecular results, together
with physio-phenological parameters, suggest a specific effect of soil
on grapevine plastic response, highlighting a higher transcriptional
plasticity of Glera in respect to Corvina and a marked response of skin
compared to flesh. Using a novel statistical approach, we identified
clusters of plastic genes highly subjected to the specific influence of
soil. These findings represent an issue of great applicative value,
posing the basis for targeted agricultural practices to enhance the
desired characteristics for any soil/cultivar combination, to improve
vineyards management for a better resource usage and to valorize
vineyards uniqueness maximizing the terroir-effect.
Hemophagocytic lymphohistiocytosis and acute myeloid leukemia. A case report from Madagascar
Authors: Randrianarisoa Rova Malala Fandresena , Andrianandrasana Ny Ony , Rahantamalala Marie , Vololontiana Hanta Marie Danielle , Rafaramino Florine
Published: September 2022

We report a case of hemophagocytic lymphohistiocytosis associated with
acute myeloid leukemia. The usual etiologies of hemophagocytic
lymphohistiocytosis were absent. Hemophagocytic lymphohistiocytosis
secondary to acute myeloid leukemia is rare and deserves the attention
of clinicians. Hemophagocytic lymphohistiocytosis may be masked by the
tumour process, often making the diagnosis difficult.
Expression of AQP8 in serum of patients with Meniere's disease and its value in evaluating the degree of hydrolabyrinth and predicting prognosis
Authors: Zhao Rui , Yi Tianhua , Wu Qinqin , Liu Xuemei , He Jianqiao , Tan Yufang
Published: September 2022

Abstract Objective To explore the value of serum aquaporin 8 (AQP8)
expression in evaluating the degree of hydrolabyrinth and predicting
prognosis in patients with Meniere’s disease. Methods 105 patients with
Meniere’s disease in our hospital were included in the Meniere’s disease
group.Another 102 healthy subjects in our hospital were included as the
control group. The multivariate Logistic regression was used to analyze
the influencing factors of poor prognosis in patients with Meniere’s
disease. Results The expression of serum AQP8 mRNA in the Meniere’s
disease group was greatly higher than that in the control group
(P<0.05). Serum AQP8 mRNA expression in severe hydrops group
was greatly higher than that in mild hydrops group and no endolymphatic
hydrops group, and serum AQP8 mRNA expression in mild hydrops group was
greatly higher than that in no endolymphatic hydrops group
(P<0.05). The course of disease, the proportion of severe
hydrops and the expression of serum AQP8 mRNA in the poor prognosis
group were greatly higher than those in the good prognosis group
(P<0.05). The area under the curve (AUC) of serum AQP8 mRNA
for predicting poor prognosis in Meniere’s disease patients was 0.812
(95%CI: 0.702-0.922), with a sensitivity of 81.0% and a specificity of
70.2%. AQP8 mRNA was an independent risk factor for poor prognosis in
patients with Meniere’s disease (P<0.05). Conclusion AQP8 mRNA
is associated with the degree of hydrolabyrinth in patients with
Meniere’s disease, and has a high performance in predicting prognosis.
TRANSIÇÃO PROGRESSIVA DOS MODELOS EXPLICATIVOS DE ESTUDANTES DO NÍVEL MÉDIO SOBRE A NATUREZA DAS FORÇAS INTERMOLECULARES
Authors: Miranda Ana Carolina Gomes , Pazinato Maurícius Selvero , Braibante Mara Elisa Fortes
Published: September 2022

O foco de investigação desta pesquisa foi o processo de ensino e aprendizagem de forças intermoleculares no nível médio. O principal objetivo foi investigar a evolução conceitual, por meio de modelos explicativos de estudantes da 1ª série do ensino médio, sobre a natureza das forças intermoleculares. Para isso o conteúdo foi desenvolvido por intermédio de uma sequência didática (SD). Baseando-se na perspectiva de Lakatos, procurou-se verificar se os modelos explicativos dos sujeitos formam sequências de transição progressiva, similares ao que Lakatos, na História da Ciência, se refere a "problemática" que aumenta o poder explanatório/heurístico do modelo. A evolução dos modelos, que geralmente consiste em transições progressivas, está relacionada ao entendimento sobre o conteúdo de forças intermoleculares e a capacidade de transitar entre os níveis de representação da matéria em relação ao entendimento sobre a natureza das forças intermoleculares. O acompanhamento das ideias dos estudantes ao longo do estudo do conteúdo revelou que houve um número significativo deles que conseguiu progredir conceitualmente. De forma geral, é possível afirmar que as atividades desenvolvidas na SD contribuíram significativamente para a transição progressiva dos modelos explicativas da maioria dos participantes. Além disso, a abordagem do conteúdo de forças intermoleculares na SD desenvolvida capacitou os estudantes a interpretarem os fenômenos em estudo, por meio dos níveis de representação da matéria.
CONTEXTUALIZANDO CONTEÚDOS CIENTÍFICOS FUNDAMENTAIS À COMPREENSÃO DOCENTE E ESTUDANTIL DA RELAÇÃO TERRA-UNIVERSO SOB A LENTE EPISTEMOLÓGICA DA SOLUÇÃO DE PROBLEMAS DE LARRY LAUDAN
Authors: Batista Carlos Alexandre dos Santos , Peduzzi Luiz Orlando Quadro
Published: September 2022

Este artigo apresenta uma contextualização histórico-filosófica sobre alguns conteúdos científicos fundamentais para a compreensão docente e estudantil da relação Terra-Universo. Suas justificativas encontram-se nos benefícios que a visão epistemológica de Larry Laudan tem proporcionado para o ensino de ciências/física, especialmente, na fundamentação das investigações acadêmico-científicas de questões relativas ao processo de ensino-aprendizagem, em todos os níveis de ensino. Fundamentando-se nesse referencial, particularmente, nos seus conceitos de problemas empíricos, problemas conceituais e de tradição de pesquisa, este trabalho propicia uma ressignificação histórico-filosófica de alguns conteúdos científicos da astronomia, da cosmologia e da física, considerados essenciais à compreensão docente e estudantil da relação Terra-Universo. Esses conteúdos são: a confecção de calendários, as distâncias orbitais dos planetas, as fases da Lua, as estações do ano, o fenômeno do dia e da noite, o movimento de rotação da Terra, os modelos cosmológicos, o movimento de translação dos planetas e a gravidade. Como resultado, essa contextualização histórico-filosófica pode contribuir para a superação dos problemas relativos: às concepções de senso comum; à correção dos erros conceituais encontrados nos livros didáticos da educação básica; bem como na construção do saber docente do conteúdo disciplinar da história conceitual da ciência, mediante uma viagem prazerosa pela história da ciência. Portanto, defende-se que somente um diálogo contínuo com os resultados de pesquisas, integrado com uma atenta vigilância epistemológica, educacional, didática e pedagógica, sobre o processo de ensino-aprendizagem; com a mediação da construção do conhecimento disciplinar, dentre outros; e uma apropriada transposição didática dos conteúdos científicos para os livros didáticos da educação básica; torna possível o trabalho efetivo em prol de uma substantiva melhoria da educação e do progresso do ensino de ciências.
PROCESSO DE REFLEXÃO ORIENTADA COMO METODOLOGIA PARA A FORMAÇÃO INICIAL DOCENTE: PROPOSTA PARA A PROMOÇÃO DA ALFABETIZAÇÃO CIENTIFICA POR MEIO DA ABORDAGEM DE ENSINO POR INVESTIGAÇÃO
Authors: Suart Rita de Cassia , Marcondes Maria Eunice Ribeiro
Published: September 2022

Pesquisas têm demonstrado a necessidade de mudanças urgentes na formação inicial de professores, na perspectiva de uma formação mais crítica e autônoma dos estudantes da educação básica, por meio da abordagem de ensino por investigação. Neste sentido, o processo de Reflexão Orientada (PRO) tem se demonstrado uma metodologia potencializadora para possibilitar uma reflexão mais crítica de futuros professores sobre suas ações docentes. Assim, esta pesquisa teve como objetivo investigar quais elementos precisam estar presentes durante um PRO para que ações relacionadas à prática docente sejam elaboradas e desenvolvidas por professores em formação inicial, visando a abordagem do ensino por investigação para estudantes do ensino médio. Por meio dos materiais produzidos por três licenciandos e dos encontros reflexivos com o grupo, durante o PRO, identificamos uma evolução de suas ideias quanto a compreensão do ensino por investigação na educação básica, o que possibilitou uma reinterpretação dos principais aspectos para o desenvolvimento de um PRO, inicialmente proposto por Abell e Bryan. Por meio de três eixos estruturantes propostos nesta pesquisa, os resultados mostram como o PRO pode contribuir para os cursos de formação inicial de professores ao promoverem diferentes momentos de reflexão, relacionando teoria e prática, visando a promoção de um ensino para uma formação mais crítica dos alunos do ensino médio.
Case 2: Diagnosis of Coexistent Maturity-Onset Diabetes of the Young in a Patient with Type 1 Diabetes
Authors: Azmi Shazil , Malik Rayaz
Published: September 2022

A 23-year-old Caucasian woman was seen in the diabetes clinic. She was diagnosed with type 1 diabetes (T1D) at the age of 11 years following a history of polyuria, polydipsia, lethargy, and dramatic weight loss. She was started on a multidose insulin injection (MDI) regime. Her glycemic control was generally poor and required hospitalization due to diabetic ketoacidosis at the age of 19 years.
Case 103: Gastroparesis and Pregnancy
Authors: Peters Carl , Taylor Roy
Published: September 2022

ype 1 diabetes was diagnosed in a 13-year-old girl in 1990. Blood glucose control remained poor during adolescence. Proliferative retinopathy was identified by retinal screening 7 years later, and bilateral panretinal photocoagulation was applied. Persistent proteinuria was first noted in 2004. Insulin therapy was continued as twice-daily Mixtard 30.
Case 11: From a Total Daily Dose of Insulin of 415 Units to No Insulin: A Case of Ketosis-Prone Diabetes
Authors: Nguyen Caroline , Mestman Jorge
Published: September 2022

A 29-year-old Mexican American man with no past medical history presented with an 8-day history of sore throat, intermittent subjective fevers, nausea, decreased PO intake, and a 1-day history of altered mental status. Review of systems revealed 3 weeks of polyuria, polydipsia, vision changes, fatigue, and weight loss. He denied recent trauma, surgery, alcohol, or drug use. He has no family history of diabetes.
Case 19: Almost All Nonobese Young People with an Acute Onset of Diabetes Have Type 1 Diabetes
Authors: Bell David
Published: September 2022

A 24-year-old college senior who was a starting linebacker on a Division 1 football team and who had an excellent chance of being drafted by the National Football League (NFL), developed polyuria, polydypsia, and weight loss. In spite of a blood glucose of >300 mg/dL (16.7 mmol/L) the team doctor decided that he had type 2 diabetes and started him on a low-calorie diet without either insulin or oral agents. This resulted in a catastrophic weight loss of >30 lb. He then was started on a sulfonylurea, which controlled his glucose to a range between 100 mg/dL and 150 mg/dL (5.5–8.3 mmol/L), but this did not decelerate his weight loss. The resultant severe weight loss ruined his chances of being drafted by the NFL and resulted in the loss of significant future income.
Case 20: Symptomatic Postprandial Hyperglycemia
Authors: Maturu Amita , McDermott Michael
Published: September 2022

A 54-year-old woman was referred to our clinic for evaluation of spells. The patient noted intermittent symptoms of palpitations, difficulty concentrating, and diaphoresis lasting several hours once or twice a week. For days following the spells she had anorexia and lost 15 lb during the course of a year. Her primary care physician completed an extensive spell workup before referral to endocrinology and no clear cause was identified.
Case 29: Effective Use of U-500 Insulin via Insulin Pump in a Type 2 Diabetes Patient with Severe Insulin Resistance
Authors: Balakrishnan Vijay , Siraj Elias
Published: September 2022

A 57-year-old man with a 25-year history of type 2 diabetes (T2D) presented to the endocrine clinic for a second opinion about recent worsening of glycemic control despite the use of increasing doses of insulin. He had been on various oral agents during the early years of his diabetes but for the past 15 years had been on insulin. In the past, he had been on various insulin regimens consisting of glargine, lispro, and premixed insulins, with an average total daily dose (TDD) of 270–300 units. About 2 years ago, his regimen was changed from premixed 70/30 insulin to U-500 regular insulin after his control continued to get worse despite appropriate increases in insulin doses.
Case 31: Difficulties in Managing Patients with Insulin Resistance: Alternatives to U-500 Insulin
Authors: Movva Narmada , Theckedath Boby , Gilden Janice
Published: September 2022

A 63-year-old Caucasian man was referred for management of uncontrolled type 2 diabetes (T2D) of 18 years’ duration. He was taking glipizide 20 mg twice daily and pioglitazone 15 mg daily. Metformin was not given because of his stage 3 chronic kidney disease. Three months of pioglitazone therapy resulted in weight gain of 27 lb (278 lb; BMI 35.5 kg/m2), and a hemoglobin A1c (HbA1c) of 7.7%. Other medical problems included hypertension, dyslipidemia, and depression. Other medications included clonidine 0.3 mg/day patch, losartan 100 mg daily, clopidogrel 75 mg daily, gemfibrozil 600 mg b.i.d, simvastatin 40 mg, gabapentin 600 mg twice daily, and aripiprazole 2.5 mg daily.
Case 33: Type B Insulin Resistance
Authors: Bincent Jacob Nisha , Trevino Hilary , Rhee Chanhaeng
Published: September 2022

A 24-year-old African American woman with a history of sickle cell trait anemia presented to an outside hospital with complaints of fever, chills, myalgia, and arthralgia. She had been treated with olsetamivir and antibiotics without improvement. After lymph node and bone marrow biopsy and a lumber puncture, she was diagnosed with disseminated cytomegalovirus (CMV). With 12 days of ganciclovir treatment, her symptoms improved for only a short time. She developed an erythematous rash on her face, chest, arms, hands, back, and upper legs; oral ulcers; acute kidney injury; pericardial effusion; and pleural effusions with consolidation. Upon admission to our hospital, the patient’s blood glucose (BG) was found to be >400 mg/dL (22.2 mmol/L) with a normal anion gap, and an HbA1c of 8.1%. Her skin biopsy revealed erythema multiforme, and she was empirically started on prednisone (70 mg/day), resulting in rapid improvement. The patient did not have any history of diabetes.
Case 44: Patient with Diabetes Who Has Hemiballismus
Authors: Padilla Miriam , Mestman Jorge
Published: September 2022

A 70-year-old Hispanic woman with a past medical history of type 2 diabetes, diabetic retinopathy, dementia, chronic kidney disease, depression, hyperlipidemia, and hypertension was brought into the emergency department by her family for multiple falls. Per the family, the patient was experiencing general lack of coordination, difficulty walking, difficulty speaking, and worsening confusion. It was noted that the patient had not taken her insulin for a few days before this presentation.
Case 45: A Case of Diabetic Myonecrosis
Authors: Azmat Umal , Payne Jason , Dungan Kathleen , Ing Steven
Published: September 2022

A 27-year-old African American man with type 1 diabetes since age 10 years old and multiple complications, including stage 5 chronic kidney disease, severe neuropathic pain, retinopathy, gastroparesis, and hypertension, as well as a recent left below-the-knee amputation for osteomyelitis, was being transferred to an inpatient rehabilitation hospital. He had a history of longstanding poor glycemic control but recent improvement with intensive insulin therapy in the inpatient setting. Three days before transfer, he was ambulating with a new orthotic device under supervision when he noted sudden onset of right thigh pain. The pain worsened over the next few days requiring addition of narcotics but with minimal effect.
Case 48: Glycogenic Hepatopathy in an Adolescent with Type 1 Diabetes
Authors: Zuckerman-Levin Nehama , Mordechai Oz , Shehadeh Naim
Published: September 2022

A 13-year-old adolescent with type 1 diabetes (T1D) was admitted to the hospital with fatigue, vomiting, and weight loss. He was a second twin, born after an uneventful pregnancy, with a birth weight of 1,900 g. His family history included a twin brother with bronchial asthma, and a grandmother with type 2 diabetes (T2D). T1D was diagnosed at the age of 9 years. No diabetic ketoacidosis (DKA) was noted at diagnosis. He had positive anti-GAD and anti-islet cell antibodies (ICA). He used an insulin pump for 2 years, but because of recurrent severe hypoglycemic episodes, his treatment was changed to multiple daily injections (MDI). On MDI, his blood glucose levels were high, and he developed repeated episodes of DKA. Recently, his DKA episodes were noted on a monthly basis. His glycemic control was very poor, with glycosylated hemoglobin levels between 8.5 and 13%. His height and weight curves were noted to follow the growth chart normally.
Case 50: Dizziness, Lightheadedness, and Syncope in a Patient with Type 2 Diabetes
Authors: Paturi Shalini , Gilden Janice
Published: September 2022

A 57-year-old man with type 2 diabetes (T2D) for 7 years and peripheral neuropathy was referred in 2008 for evaluation of episodic “hypoglycemic” symptoms (lightheadedness, dizziness, shakiness, sweating, headaches, tremors, and pallor), unrelated to position or meals, resulting in one episode of syncope and a fall. The episodes resolved with ingestion of glucose tablets or meals. These symptoms started 10 years ago, after an ablation for Wolff-Parkinson-White syndrome, and gradually increased in frequency.
Case 53: Glycemic Control in a Patient with Type 2 Diabetes Undergoing Cardiac Surgery
Authors: Figaro M. Kathleen
Published: September 2022

A 55-year-old woman with a past medical history of type 2 diabetes, tobacco abuse, dyslipidemia, and hypertension presents for cardiac surgery after initial presentation with a slow-healing right heel ulcer. As a part of the evaluation of her right heel ulceration, she underwent vascular testing that revealed decreased perfusion to the right lower extremity. The patient was referred to an endovascular specialist who attempted an endovascular revascularization. The patient was found to have a chronic total occlusion of the right superficial femoral artery with collateral reconstitution of the popliteal artery and tibial runoff. Attempts at bridging the superficial femoral artery occlusion were not successful.
Case 56: Combined Effect of Intravenous Insulin Infusion and Subcutaneous Rapid-Acting Insulin for Glycemic Control in Severe Insulin Resistance
Authors: Szkudlinska Magdalena , Hirsch Irl
Published: September 2022

A 60-year-old morbidly obese (BMI >40 kg/m2) Caucasian man with a 24-year history of type 2 diabetes and recent diagnosis of acute lymphocytic leukemia was admitted to the hematology/oncology service.
Case 61: New Diabetes Emergency: Acute Rhabdomyolysis Complicating Hyperglycemic Hyperosmolar Coma
Authors: Vaz Cherie , Chaudhuri Ajay
Published: September 2022

A 57-year-old man with a history of hypertension and recently diagnosed diabetes, presented with polyuria, polydipsia, generalized weakness, and confusion. He was drowsy on arrival and Glasgow Coma Scale (GCS) deteriorated to eye (E), motor (M), and verbal (V) responses E2M4V1 in a few hours. He was fully functional at baseline. He was brought in when his mental status deteriorated over just a few hours. He was started on metformin 500 mg twice daily for diabetes and was apparently taking it inconsistently since diabetes was diagnosed 1 week earlier.
Case 63: Failure to Coordinate Diabetes Care between Hospital and Ambulatory Settings: A Threat to Safe and Quality Patient Care
Authors: Peavie Shawn , Falciglia Mercedes
Published: September 2022

A 61-year-old man with a history of type 2 diabetes, chronic kidney disease, stroke, vascular dementia, hypertension, coronary artery disease, and depression presented to the hospital from a nursing home with altered mental status and weakness. The patient had been residing in a nursing home due mainly to dementia. On admission, he and his wife reported he had been experiencing altered mental status with increasing confusion over the past few months. On admission to the hospital, his ambulatory insulin regimen from the nursing home was continued. This regimen consisted of glargine 15 units subcutaneous every night and lispro 4 units subcutaneous with each meal, as well as a correction scale of 1 unit for every 50 mg/dL (2.8 mmol/L) >150 mg/dL (8.3 mmol/L).
Case 66: Do Many People with Type 2 Diabetes Really Need Insulin?
Authors: Schwartz Stanley
Published: September 2022

A 74-year-old woman was seen for endocrine consultation, after admission for bronchitis, type 2 diabetes, and hypertension. She had been treated for 35 years for her diabetes, with noninsulin therapy for her initial 15 years and with insulin for the past 20 years. She was taking 15 units U-500 insulin q.i.d. (= 300 units regular insulin), and eating concentrated sweets. Careful questioning revealed that she was having nocturnal hypoglycemia and awakening in the morning with sweats. She had gained 58 lb since starting insulin therapy, 30 of which she gained over the past 5 years that she was on U-500.
Case 72: Delayed Response to NPH Insulin By Mayer B. Davidson, MD
Authors: Davidson Mayer
Published: September 2022

A 58-year-old lean woman with type 2 diabetes was referred to the diabetes clinic for control of her diabetes. Diabetes was diagnosed 12 years ago and she had been taking insulin for 1 year after failing oral medication. Her insulin regimen at the time of referral was 20 units of NPH insulin before breakfast and 12 units before supper. Her BMI was 25.1 kg/m2 and her HbA1c level was 9.5%. She was motivated to improve her control. Table 72.1 summarizes our initial experience with her. Glucose values (mg/dL) are the range (median). The interval between visits was 3 weeks unless otherwise noted.
Case 73: Reversal of Type 2 Diabetes by Weight Loss Despite Presence of Macro- and Microvascular Complications
Authors: Peters Carl , Steven Sarah , Taylor Roy
Published: September 2022

A 48-year-old man was diagnosed with type 2 diabetes in July 2008, presenting with marked hyperglycemia (blood glucose >500 mg/dL) and HbA1c of 12.9%. He was morbidly obese at 265 lb. Peripheral neuropathy was present at diagnosis, with pain sufficient to interrupt sleep becoming severe within 3 months. Over the following 2 years, metformin and glipizide were ineffective at maintaining glycemic control and not well tolerated because of gastrointestinal adverse effects. In July 2010, insulin was commenced (insulin glargine once daily with insulin lispro before meals). Glycemic control remained suboptimal, however, with HbA1c ~12.5%. Access to medical services was limited for the patient, who had no medical insurance.
Case 75: Blood Glucose Control of Patients with Hypertriglyceridemia
Authors: Beck-Nielsen Henning
Published: September 2022

Our patient was 48 years old when she was hospitalized the first time with acute abdominal pain. Until then she had been well and had not received any medication. She had never before been hospitalized except for the birth of her two children: a daughter and a son. Her abdominal pain started in the evening after a heavy meal. The pain was located in the middle of the abdomen and extended to her back. It had continued for 2 h when she was hospitalized with the diagnosis of appendicitis. A computed tomography scan of the abdomen showed an enlarged and echogenic pancreas, whereas the appendix and gallbladder appeared normal. An elevated amylase concentration was consistent with the diagnosis of acute pancreatitis. The patient also said that she had lost 4–5 kg during the last 6 months and also had developed a tendency to fall asleep when sitting in a chair. She denied drinking alcohol regularly. A blood glucose (BG) level was elevated at 12 mmol/l (216 mg/dL) and confirmed the diagnosis of diabetes.
Case 78: Psychosocial Stressors and Management in an Adolescent with Type 2 Diabetes
Authors: Nandagopal Radha , Rother Kristina
Published: September 2022

A 13-year-old African American girl presented to the pediatric emergency department at an urban hospital with complaints of vaginal pruritus and dysuria. She also noted that she has been drinking more water throughout the day and was awakening at night to urinate for the past month. Her BMI was 39 kg/m2. On examination, she was found to have severe cervical acanthosis nigricans and copious white vaginal discharge. Workup revealed a vaginal candida infection, 4+ urine glucose, 1+ urine ketones, and blood glucose (BG) of 563 mg/dL (31.3 mmol/L), but otherwise normal serum chemistries, including normal renal and liver function.
Case 79: Suicide, Homicide, or Diabetes-Related Incident?
Authors: Carter John
Published: September 2022

I was recently contacted by the police department from a western New South Wales town to assist in their determination of the cause of death of a 51-year-old male. The specific question I was asked was: “Is the cause of death suicide, homicide, or a diabetes-related incident?”
Case 82: Hypoglycemic Unawareness
Authors: Maturu Amita , Rasouli Neda
Published: September 2022

A 65-year-old man was referred to our clinic for management of type 1 diabetes. He was diagnosed with type 1 diabetes at age 18 years and has developed nonproliferative diabetic retinopathy and albuminuria. His insulin regimen consisted of insulin glargine 8 units in the morning and 6 units in the evening and insulin aspart with meals (6 units with breakfast, 6 units with lunch, 8 units with dinner, and a correction factor of 1:50 >150 mg/dL; 8.3 mmol/L). He also had a past medical history of depression, hypertension, hyperlipidemia, and coronary artery disease (CAD). His family history was significant for a father with CAD. He denied any tobacco, alcohol, or illicit drug use. At the time of consultation, his weight was 100 kg. He was afebrile, blood pressure was elevated at 152/86 mmHg, and pulse was 68. His physical exam was unremarkable. His most recent hemoglobin A1c (HbA1c) was 8.4%.
Case 84: Postprandial Hypoglycemia, an Uncommon Presentation of Type 2 Diabetes
Authors: Salam Muhammad , Sowers James
Published: September 2022

A 52-year-old white man presented to his primary care physician with neurogenic symptoms (sweating, palpitations, headache) accompanied by capillary blood glucose levels in the 40–60 mg/dL range. The symptoms would always occur 1–2 h after a meal and would resolve with ingestion of a sugar source (e.g., orange juice, regular soda). There was no history of neuroglycopenic symptoms (confusion, loss of consciousness, seizure) during any of these episodes. Patient’s prior history was notable for hypertension, hyperlipidemia, and gastroesophageal reflux disease (GERD). Physical examination was remarkable for central obesity with a BMI of 32 kg/m2.
Case 88: The Use of Medical Technologies for the Reduction of Hypoglycemia in Type 1 Diabetes: Technology for Hypoglycemia Reduction
Authors: Shah Viral , Michels Aaron , Garg Satish
Published: September 2022

A 37-year-old man, with type 1 diabetes for 17 years and celiac disease for 8 years, is physically very active at work (5 days/week, working in a warehouse in the morning shift between 5:00 a.m. to 1:00 p.m.). His BMI (24.8 kg/m2) is normal. He has maintained good glycemic control (A1C ranging from 7 to 7.8%) in the past 17 years with mean A1C of 7.2%. He does not have micro- or macrovascular complication. His lipid profile, thyroid stimulating hormone (TSH), and renal function are normal.
Case 91: Treatment of a Patient with Diabetes and Severe Hypoglycemia
Authors: Beck-Nielsen Henning
Published: September 2022

A 52-year-old man was admitted to the emergency department after a car accident in which he went off the road and was found upside down in a cornfield. He was found in the driver’s seat with his seatbelt on, but he was unconscious. He had been diagnosed with type 1 diabetes at age 5 years and, for several years, he had problems with hypoglycemia. He was still unconscious after arriving at the hospital, and his blood glucose (BG) was measured at 4.5 mmol/L (81 mg/dL). His blood pressure was 150/90 mmHg, his pulse 90 bpm, and his electrocardiogram (ECG) did not indicate acute myocardial infarction (MI) or arrhythmia. An examination of the patient did not reveal any peripheral paresis. He immediately underwent a computed tomography scan of the head, but it showed no intracranial hemorrhage. The conclusion was that the patient had suffered from a hypoglycemic attack despite the normal BG value.
Case 92: Hypoglycemia with Use of Glargine Insulin in the Management of Type 2 Diabetes, Occurring with Titration Aimed at Achieving Prebreakfast Glucose Levels <100 mg/dL (5.6 mmol/L)
Authors: Adeel Saira , Phillips Lawrence
Published: September 2022

We describe two cases in which hypoglycemia occurred with addition and uptitration of glargine insulin.
Case 96: A Case of Acute Sensory Neuropathy in Type 1 Diabetes
Authors: Boulton Andrew
Published: September 2022

A 22-year-old woman attended the diabetes clinic complaining of increasingly severe pain in both legs and feet over the past 2 weeks. She found it difficult to describe the pain but said that it was of a burning, stinging character with occasional electrical shock sensations shooting down the lower legs to the feet. She stated that it felt as if her feet were on fire and that the pain was much worse at night: in fact, she was finding it increasingly difficult to sleep and found that the bedclothes and even her socks were irritating the skin of her feet. Until recently, her glycemic control had been poor; in her past history, she had frequent hospital admissions as a teenager with ketoacidosis and admitted that she had omitted insulin on occasions in the past to assist with her weight control. Four months previously, hemoglobin A1c (HbA1c) had been 10.1% (87 mmol/mol).
Case 97: Nondiabetic Neuropathy in a Patient with Type 2 Diabetes
Authors: Bell David
Published: September 2022

A 72-year-old white man with an 8-year history of type 2 diabetes under excellent glycemic control (HbA1c in the 5.5–6.5% range) on metformin monotherapy suddenly developed tingling in his feet, which he thought was due to diabetes.
The African Spider Plant (Gynandropsis pentaphylla – DC. Syn. Cleome gynandra Linn.) (Capparaceae): Phytochemistry, Pharmacological and Biotechnological Properties - A Review
Authors: R Lokesha
Published: September 2022

African Spider Plant or Cat’s Whisker (Gynandropsis pentaphylla syn to Cleome gynandra Linn. (Family: Capparaceae) is an important leafy vegetable that grows in wild form as a ruderal weed throughout tropical and sub-tropical regions of the world; mainly near human settlements. It is believed to have originated from African and Southeast Asia and might have spread to other parts of the world. It has been used as a medicinal plant in Ayurveda and other systems of medicine as a curative medicine for several ailments such as neuralgia, headache, cough, wounds, anthelmintic, rubefacient, counterirritant, anti-malarial, anti-cancer, anti-HIV and anti-fever etc. Even it has been widely used against snake bite and scorpion stings. Except stem, all other parts (leaves, seed, flowers, and roots) proved to have medicinal properties. In fact, the interest in Phytochemistry has began as early as 1906; so far more than 50 compounds have been isolated from different parts of the plant such as Saponnins, Glycosides, lectins, steroids, flavanoids, tannins, triterpenes, resins, phenolic compounds, Glucosinates and arthoquinones. Nutritionally the leaves are rich in Vitamin C, iron and Ca. The seed has high contents of glutamic acid, arginine, aspartic acid, lysine, tyrosine and histidine. Further, the seed also contain higher levels of polyunsaturated oils with high content of oleic and linoleic acids. It has rich anti-oxidants hence it helps in counteracting carcinogenesis. It has antimicrobial and anti-bacterial property with most species showing sensitivity including those that are highly problematic organisms such as Alternaria, Fusarium, Candida Colletotrichum etc. These properties have applications in the fields of Agriculture and human medicines. Biotechnologically it is promising because it is a C4 species that has high growth rate and has the ability to maintain high photosynthetic activity at elevated day temperature. It is closely related to Arabidopsis thaliana (a C3 species) and has NAD-ME type of photosynthesis mechanism. Through comparative analysis of genes and proteins, it is possible to understand the C4 photosynthetic pathway in general and gene expression and protein function that have altered the evolution of C3 to C4 pathway in particular. Further, the transfer of genes from G. pentaphylla to A. thaliana cannot be precluded and is theassertively investigating area of research globally. Genetic transformation using GUS for G. pentaphylla has been successful. Technique like RAPD has been used to assess the diversity of the morphotypes. The paper discusses the several of the issues related to its origin, Phytochemistry, pharmacological activities and biotechnological interventions
Gene Clusters from Plants to Microbes: Their Role in Specialized Metabolism and Drug Development
Authors: Chakraborty Prasanta
Published: September 2022

Most of the drugs we use as anticancer agents, antiinfective agents, heart protective and antidiabetic are secondary metabolites of plants or microbes or derived from natural products.