bluuebunny/crossref_metadata_2025 huggingface dataset:
765-P: Effects of an Advanced Carbohydrate Counting Course on Diet Composition in Insulin-Treated Type 2 Diabetes
Authors: CHRISTENSEN MERETE B. , HALLDORSSON THORHALLUR I. , GOTFREDSEN ANDERS , HOMMEL EVA , GÆDE PETER , OLSEN SJURDUR F. , NØRGAARD KIRSTEN
Published: June 2019

Background and Aim: Training in advanced carbohydrate counting improves glycemic control in type 1 diabetes and type 2 diabetes. We aimed to investigate, whether a course in advanced carbohydrate counting reduced intake of carbohydrates and glycemic index of carbohydrates in persons with basal-bolus insulin treated type 2 diabetes.

Material and Methods: We conducted a 24-week open-label, randomized controlled study in 79 participants with basal-bolus insulin treated type 2 diabetes. Participants were randomized 1:1 into two groups. ABC group received 6-hour training in advanced carbohydrate counting and use of an automated bolus calculator. MC group also received 6-hour training in advanced carbohydrate counting but was trained in manual calculation of insulin bolus. Diet composition and intake of macronutrients were assessed at baseline, week 12 and week 24 using a validated electronic food frequencies questionnaire.

Results: Baseline characteristics were similar between groups (mean age 62.5 ± 9.6 years, mean HbA1C 72 ± 11 mmol/mol, mean diabetes duration 18.7 ± 7.6 years, mean BMI 33 ± 6 kg/m2). Mean energy intake was significantly reduced in the ABC group from baseline to week 24 (P=0.03), primarily due to significantly reduced intake of carbohydrates in form of cereals (P=0.005). No significant changes in energy intake were seen in the MC group (P=0.62). Further, glycemic index of ingested carbohydrates was reduced significantly in the ABC group (P=0.03), but not in the MC group (P=0.09). As previously reported HbA1c had decreased significantly by 9.0 mmol/mol in both groups at week 24. There were no significant changes in BMI throughout the study.

Conclusion: Advanced carbohydrate counting with the use of an automated bolus calculator may help to reduce energy intake and glycemic index of ingested carbohydrates in basal-bolus insulin treated type 2 diabetes.

Disclosure

M.B. Christensen: None. T.I. Halldorsson: None. A. Gotfredsen: None. E. Hommel: None. P. Gæde: None. S.F. Olsen: None. K. Nørgaard: Advisory Panel; Self; Abbott, Medtronic, Novo Nordisk A/S. Speaker's Bureau; Self; Bayer US, Medtronic, Roche Diabetes Care, Rubin Medical, Sanofi, Zealand Pharma A/S. Stock/Shareholder; Self; Novo Nordisk A/S.

Funding

Roche A/S
791-P: Patient Preferences for Medical Nutrition Therapy
Authors: CLERC PHILIP G. , WARDIAN JANA L.
Published: June 2019

Introduction: Medical nutrition therapy (MNT) can have a profound impact on diabetes prevention and treatment. However, most patients with diabetes do not receive MNT interventions. The aim of this survey was to identify current and desired usage of MNT interventions.

Methods: Surveys were distributed to adults at San Antonio Military Medical Center and Wilford Hall Medical Center in the fall of 2018. Data included self-reported comorbidities, a validated dietary assessment, current and desired usage of MNT interventions, and current and desired nutrition recommendations from primary care providers.

Results: 446 surveys were collected. Self-reported prevalence of diabetes and prediabetes were 23% and 5% respectively. Most respondents (79%) stated they need to eat healthier. Only 41% of respondents ate home-cooked meals at least once daily. Current and desired MNT utilization ranged from 3-15% and 10-26% respectively. The largest gaps between current and desired MNT utilization were nutritional cooking classes (19.3%) and grocery store tours (9.9%). Most respondents (69%) desired an online nutritional cooking class. Most respondents (58%) stated they would cook at home more often if they knew how to cook quick, healthy, inexpensive meals. Frequency of nutrition recommendations by primary care providers ranged from 0.4-6.1%. Results were similar among those with the least and most healthy diets, and when only including patients with diabetes and prediabetes.

Conclusion: Most surveyed patients recognize the need to eat healthier. Desired MNT utilization is relatively low, but higher than current MNT utilization. Primary care provider nutrition recommendations are rare. Online nutritional cooking classes may provide a novel and highly desired form of nutrition therapy. Our institution is currently developing an online nutritional cooking class.

Disclaimer: The views expressed are those of the authors and do not reflect the official views or policy of the Department of Defense or its Components.

Disclosure

P.G. Clerc: None. J.L. Wardian: None.
827-P: Prevalence and Clinical Characteristics of Sleep Disorders in Japanese Patients with Type 2 Diabetes: A Case-Control Study
Authors: MURAKAMI HIROSHI , DAIMON MAKOTO , MIZUSHIRI SATORU
Published: June 2019

Background: Sleep disorders are associated with type 2 diabetes, and result in a low quality of life. However, there are few reports on the prevalence and correlates of sleep disorders in diabetics. This study investigated the prevalence and factors, including personality traits, associated with sleep disorders in type 2 diabetics.

Research Design and Methods: A case-control study was performed in patients with type 2 diabetes mellitus (223 males, 208 females; age 60.8 ± 12.8-years-old; HbA1c, 7.2 ± 0.9%) compared with age-/sex-matched healthy controls (219 males, 217 females; age 60.8 ± 13.0-years-old; HbA1c, 5.6 ± 0.3%). Participants used self-administered questionnaires on sleep attitude (Pittsburgh Sleep Quality Index; PSQI), quality of life (SF-36), depression (CES-D), and personality (Ten Item Personality Inventory).

Results: The number of subjects with sleep disorders (PSQI > 5) was higher in diabetic patients (26.9%) than control subjects (17.4%) (p < 0.01). Sleep latency was longer in diabetic patients (20.2 ± 0.8 minutes) than control subjects (13.7 ± 0.5 minutes) (p < 0.01). Among diabetic patients, patients with sleep disorders were significantly younger (p = 0.04) and showed higher body mass index (p=0.04), higher percentages of females (p = 0.03), depression (p < 0.01), overactive bladder (p = 0.01), and benign prostatic hyperplasia (p < 0.01). Diabetic patients with sleep disorders scored higher neuroticism (p < 0.01), lower agreeableness (p = 0.01) and lower conscientiousness (p < 0.01) scale than patients without sleep disorders. All SF-36 scores were lower in patients with sleep disorders. No differences were found in HbA1c, stage of diabetic retinopathy and nephropathy between patients with the presence or absence of sleep disorders.

Conclusions: The prevalence of sleep disorders was high in patients with type 2 diabetes, and their quality of life was impaired. Therefore, clinicians should monitor sleep disorders among these patients.

Disclosure

H. Murakami: None. M. Daimon: None. S. Mizushiri: None.

Funding

Japan Society for the Promotion of Research
839-P: Outcomes of Systematic User Involvement and User Research in a National Patient-Reported Outcomes Diabetes Initiative
Authors: SKOVLUND SOREN E. , NØRGAARD LISE MELLERGAARD , STEFANSEN SIMON , DE LICHTENBERG TRINE HONNENS , TROELSEN LISE , PIETRASZEK ANNA , KJÆR PERNILLE H. , LARSEN HANNE RAVN , JAKOBSEN POUL ERIK O. , EJSKJAER NIELS
Published: June 2019

Background: Involvement of People With Diabetes (PWD) is important for diabetes research and care, yet there is a lack of evidence-based and systematic methodologies.

Aim: To evaluate the quality and value of a novel User Involvement (UI) process for people with diabetes (PWD) and caregivers in a national project to develop a new Patient Reported Outcomes (PRO) questionnaire for routine diabetes care.

Methodology: 56 PWD (type 1 and 2) and 9 caregivers were recruited for individual and group UI activities with consideration of age, gender, diabetes type, duration, complications, treatment, geographic region and patient advocacy experience. Analyses were done on qualitative data from interviews, focus groups and workshops over 1 year. 7 UI quality criteria were used for planning and evaluation: 1) Shared purpose, 2) Respect and Accessibility, 3) Representativeness, 4) Roles, 5) Capacity and Capability, 6) Transparency and Documentation, 7) Continuity.

Results: UI generated multiple insights which impacted A) Aims and focus for PRO, B) PRO content and C) PRO implementation. Key insights included: A) PWD priority aims for use of PRO: To enable PWD to take more active role (incl. vulnerable groups), ensure all priority topics (incl e.g., sexual dysfunction) are covered consistently in visits, focus on what matters most to each PWD (use care resources where they add most value). B) PWD preferences for items: Simple, brief, relevant (individualized), supportive of autonomy, non-stigmatizing, non-paternalistic and not overly negative, C) PWD insights for implementation: PWD and care providers to be able to act on all PRO outputs (e.g., web tool and training). Stakeholders found the 7 quality criteria relevant for UI planning and evaluation.

Conclusions: Systematic UI led to major new insights that impacted outcomes of a national PRO diabetes program. The systematic diabetes UI process is recommended for further use in diabetes research and care improvement.

Disclosure

S.E. Skovlund: Stock/Shareholder; Self; Novo Nordisk A/S. L. Nørgaard: None. S. Stefansen: None. T. Honnens de Lichtenberg: None. L. Troelsen: None. A. Pietraszek: None. P.H. Kjær: None. H. Ravn Larsen: None. P.O. Jakobsen: None. N. Ejskjaer: None.

Funding

National Health Data Authority Region, Northern Denmark
911-P: Are New Metrics for Glucose Management Needed in Older Adults?
Authors: TOSCHI ELENA , SLYNE CHRISTINE , ATAKOV-CASTILLO ASTRID , GREENBERG JORDAN , SIFRE KAYLA , CARL SAM , DUFOUR ALYSSA B. , MUNSHI MEDHA
Published: June 2019

With the increasing use of continuous glucose monitoring (CGM), it is now known that A1c derived from venous blood often poorly correlates with estimated A1c derived from CGM. Recently, a new formula was developed, termed Glucose Management Indicator (GMI), for connecting CGM metrics to venous A1c. However, there is no data on this new measure in older population with type 1 diabetes (T1D).

Methods: We analyzed data from older adults (age ≥65 years) with T1D with stable health and medications within past 3 months. We used A1c value from venous blood, and CGM data over a 14-day period performed concurrently. We calculated GMI based on the published data by Bergenstal et al (Diabetes Care 2018) and showed the degree to which GMI and A1C agree in our older cohort versus their historical cohort.

Results: We evaluated 76 participants mean age of 71 years. As shown in the Table, in both the historical and older cohort, GMI and A1c values are identical in 19% and 17% of the time, respectively. However, the percentage of absolute values between GMI and A1c differ by ≥0.6% in 19% of the historical cohort and 33% of the older cohort. These values differ by an entire 1% in only 3% of the historical cohort while 16% of the older cohort.

Conclusions: Compared to the historical cohort, greater difference between A1C and GMI values might be more common in older adults with T1D. Larger studies are needed to understand the use of new metrics in the older population.

Disclosure

E. Toschi: Advisory Panel; Self; Lexicon Pharmaceuticals, Inc. C. Slyne: None. A. Atakov-Castillo: None. J. Greenberg: None. K. Sifre: None. S. Carl: None. A.B. Dufour: None. M. Munshi: Consultant; Self; Lilly Diabetes, Sanofi.

Funding

National Institute of Diabetes and Digestive and Kidney Diseases
915-P: Characteristics Associated with Improved Blood Glucose Control for a Large Diabetes Population Using a Connected Blood Glucose Meter with CDE Support
Authors: LU WEI , WHALEY CHRISTOPHER , PAINTER STEFANIE L. , BOLLYKY JENNIFER
Published: June 2019

Background: Managing blood glucose (BG) values within target range (80-180 mg/dL) decreases the risk for acute and chronic complications of diabetes. The Livongo for diabetes Program provides a connected blood glucose meter, unlimited glucose test supplies, digital one-to-one coaching from CDEs.

Methods: Medical claims, pharmacy claims, Livongo program use and demographic data for members who had been in the Livongo program for > 3 months with continuous health benefits eligibility 1 year before and after launches of the Livongo program through large self-insured employers (N=1480) were obtained. Hemoglobin A1c was estimated (eA1c) based on BG values captured over 90 days for each member at 3, 6, 9 and 12 months after program activation and compared with HbA1c self-reported at baseline. Associations between eA1c improvements and BG checking patterns, coach interactions, medication adherence, medical spending and demographic characteristics at various time points were assessed using logistic regression models.

Results: The odds of improvement in eA1c was significantly higher for people who are older (OR=1.02, p<0.01, CI(1.01-1.03)), have higher self-reported A1c value (OR=1.31, p<0.01, CI(1.22-1.40)), are African American (OR=1.81, p<0.01, CI(1.24-2.64)) and not on medication (OR=1.67, p<0.05, CI(1.005-2.77)). With other characteristics controlled, having more coaching sessions and BG alert contact with coaches was associated with improved eA1c (OR=1.62, p<0.1, CI (0.95-2.76)) and future low BG alerts (OR=1.21, p<0.05, CI(1.04-1.41)) at 12 months.

Conclusions: Clinical impact of the Livongo for diabetes program varies based on demographics, clinical and program feature usage. Understanding these associations can improve personalization, member experience and clinical outcomes. These results suggest that real-time technology solutions can improve health for patients.

Disclosure

W. Lu: None. C. Whaley: Consultant; Self; Livongo Health. S.L. Painter: Employee; Self; Livongo Health. J. Bollyky: Employee; Self; Livongo Health. Stock/Shareholder; Self; Livongo Health.
96-OR: Epigenetic Regulation of the TLR4 Pathway in Macrophages via S-adenosyl Methionine Results in Impaired Wound Healing in Diabetes
Authors: DAVIS FRANK M. , DENDEKKER AARON D. , KIMBALL ANDREW S. , BONIAKOWSKI ANNA , JOSHI AMRITA , ELAZZOUNY MAHMOUD , BURANT CHARLES , GALLAGHER KATHERINE
Published: June 2019

Macrophage (Mφ) plasticity, allowing the transition of Mφs from an inflammatory to a reparative phenotype, is critical for normal wound healing. In pathologic conditions, such as type 2 diabetes (T2D), wounds fail to heal due to impaired resolution of Mφ inflammation. Although the mechanisms responsible for the persistent inflammatory phenotype in T2D wounds are unknown, recent investigations have revealed that cellular metabolites can alter Mφ function providing a link between metabolism and innate immunity. Further, there is increasing evidence that epigenetic mechanisms control Mφ function. The purpose of this study was to investigate if altered Mφ metabolism in T2D induces epigenetic modifications resulting in derangements in Mφ inflammation and impaired wound healing. Using the murine diet induce obesity (DIO) wound model, we demonstrate that diabetic bone marrow derived macrophages (BMDM) and wound Mφs display a hyperinflammatory phenotype following injury with increased expression of toll-like receptor (TLR) 4 signaling and proinflammatory cytokines (IL-1β and TNFα). Given that histone methylation has previously been shown by our group to influence Mφ phenotype, we examined H3K4 trimethylation on the TLR4 promoter and found a significant increase in DIO BMDMs and wound Mφs. To evaluate the impact of Mφ metabolites on inflammation we performed a LC-MS metabolite expression analysis demonstrating significant upregulation of the methyl donor, S-adenosyl methionine (SAM), which participates in histone methylation, and its rate limiting enzyme, MAT2a, in diabetic BMDMs.

In summary, these results suggest that increased levels of the metabolite SAM in diabetic Mφs contribute to an inflammatory Mφ phenotype via increased H3K4 methylation at the TLR4 promoter.

Disclosure

F.M. Davis: None. A.D. denDekker: None. A.S. Kimball: None. A. Boniakowski: None. A. Joshi: None. M. ElAzzouny: Employee; Self; Agilent Technologies. C. Burant: Stock/Shareholder; Self; Metabolic Solutions Development Company. K. Gallagher: None.

Funding

National Institutes of Health
Dapagliflozin Plus Saxagliptin Add-on Therapy Compared With Insulin in Patients With Type 2 Diabetes Poorly Controlled by Metformin With or Without Sulfonylurea Therapy: A Randomized Clinical Trial
Authors: Vilsbøll Tina , Ekholm Ella , Johnsson Eva , Dronamraju Nalina , Jabbour Serge , Lind Marcus
Published: June 2019

OBJECTIVE

This study evaluated whether an oral combination of a sodium–glucose cotransporter 2 inhibitor and a dipeptidyl peptidase 4 inhibitor achieved glycemic control similar to basal insulin in patients with type 2 diabetes, poorly controlled with metformin, without increasing hypoglycemia or body weight.

RESEARCH DESIGN AND METHODS

In a multinational, open-label, randomized, phase 3 trial (ClinicalTrials.gov reg. no. NCT02551874), adults with type 2 diabetes inadequately controlled on metformin, with or without sulfonylurea, were randomized (1:1) to receive dapagliflozin (DAPA) plus saxagliptin (SAXA) or titrated insulin glargine (INS). The primary end point was change in glycated hemoglobin A1c (HbA1c) from baseline to week 24. DAPA + SAXA treatment was tested for noninferiority versus INS.

RESULTS

The efficacy data set included 643 patients (mean ± SD HbA1c, 9.1 ± 1.0% [75 ± 11 mmol/mol]). At week 24, DAPA + SAXA treatment versus INS resulted in noninferior reductions in HbA1c (adjusted mean ± SE change, −1.7 ± 0.1% vs. −1.5 ± 0.1% [18.3 ± 0.7 mmol/mol vs. 16.8 ± 0.7 mmol/mol]; P = 0.118), significantly different body weight change (between-group difference, −3.64 kg [95% CI −4.20 to −3.09]; P < 0.001), fewer patients with confirmed hypoglycemia (21.3% vs. 38.4%, P < 0.001), more patients achieving HbA1c <7.0% (53 mmol/mol) without hypoglycemia (20.9% vs. 13.1%, P = 0.008), and a similar proportion of patients achieving HbA1c <7.0% (33.2% vs. 33.5%, P = 0.924). Mean reductions in 24-h glucose measurements from baseline to week 2 were greater with DAPA + SAXA than with INS (P < 0.0001). No patients in the DAPA + SAXA group and three patients (0.9%) in the INS group experienced severe hypoglycemia.

CONCLUSIONS

Adding DAPA + SAXA to insulin-naive patients with poorly controlled type 2 diabetes achieved similar glycemic control, a lower risk of hypoglycemia, and a clinically relevant body weight difference compared with basal INS.
3D Printing in Dentistry—State of the Art
Authors: Kessler A , Hickel R , Reymus M
Published: June 2019

Three-dimensional (3D) printing is a rapidly developing technology that has gained widespread acceptance in dentistry. Compared to conventional (lost-wax technique) and subtractive computer numeric controlled methods, 3D printing offers process engineering advantages. Materials such as plastics, metals, and ceramics can be manufactured using various techniques. 3D printing was introduced over three decades ago. Today, it is experiencing rapid development due to the expiration of many patents and is often described as the key technology of the next industrial revolution. The transition to its clinical application in dentistry is highly dependent on the available materials, which must not only provide the required accuracy but also the necessary biological and physical properties. The aim of this work is to provide an up-to-date overview of the different printing techniques: stereolithography, digital light processing, photopolymer jetting, material jetting, binder jetting, selective laser sintering, selective laser melting, and fused filament fabrication. Additionally, particular attention is paid to the materials used in dentistry and their clinical application.
WARGA NEGARA MUDA ERA MODERN PADA KONTEKS GLOBAL-NATIONAL: PERBANDINGAN DUA NEGARA JEPANG DAN INGGRIS
Authors: Mona Adha Muhammad
Published: June 2019

Perkembangan dan peran serta warga negara muda di Jepang dan Inggris di dalam masyarakat telah mengalami perubahan secara signifikan dalam 30 tahun terakhir. Perkembangan yang lebih mengarah kepada perbaikan-perbaikan di berbagai bidang yang salah satunya adalah bagaimana meningkatkan peran serta para warga negara muda di kedua negara. Warga negara muda di Jepang dan Inggris melihat globalisasi dalam konteks perubahan sikap dan tanggung jawab individu secara signifikan untuk masa depan lebih baik. Kelompok warga negara muda merupakan potensi yang sangat penting untuk dikembangkan dan diarahkan, aspek pendidikan perlu menjadi perhatian khusus untuk membentuk warga negara muda menjadi warga muda yang berpotensi dan bermanfaat bagi negara. Disinilah pondasi yang sesungguhnya dibangun pada saat mereka berada dalam komunitas dan kehidupan masyarakat, karena disini kaum muda belajar secara spontan dan lebih natural. Warga negara muda muda harus mampu mengembangkan diri dan memiliki daya saing untuk mengikuti perkembangan globalisasi saat ini. Relasi-relasi sosial yang yang terbentuk dan menjadi bagian di aktivitas setiap individu telah mendorong warga muda di kedua negara yaitu Jepang dan Inggris memiliki rasa tanggung jawab sebagai warga negara.
Editorial
Authors: SAITO FUMIKAZU
Published: June 2019

Editoria
Contribuições do CHIC para identificar o significado do Pibid na formação inicial de professores de matemática
Authors: SOUZA MARIA APARECIDA SILVA DE , ALMOULOUD SADDO AG
Published: June 2019

ResumoEste trabalho objetiva mostrar parte dos resultados de uma pesquisa. Se insere no campo da formação inicial de professores e nasceu das reflexões acerca do Pibid (Programa Institucional de Bolsas de Iniciação a Docência) no curso de Licenciatura em Matemática. O programa, tem por finalidade apoiar a iniciação à docência de estudantes licenciandos, visando valorizar o magistério e contribuir para a elevação do padrão de qualidade da educação básica, pela integração: teoria, prática e universidade e escola. Para examinar os discursos, utilizamos a Análise de Dados Multidimensionais, empregando o método de análise de similaridade viabilizado pelo software CHIC: Classificação Hierárquica, Implicativa e Coesitiva. A análise pertmitiu afirmar que os significados são positivos para a formação inicial dos estudantes de Matemática. O Pibid contribuiu para o aprimoramento da formação desses sujeitos, oportunizando a prática, a reflexão sobre a prática, integrandotais significados em atividades de pesquisa e divulgação científica. Palavras-Chave: Pibid; Formação de professores; CHIC.AbstractThis work aims to show part of the results of a research. It is inserted in the field of initial teacher training and was born from the reflections about the Pibid (Institutional Scholarship Program) in the Mathematics Undergraduate course. The purpose of the program is to support the teaching of undergraduate students, in order to enhance the teaching profession and contribute to raising the standard of quality of basic education through integration: theory, practice and university and school. To examine the discourses, we used Multidimensional Data Analysis, using the method of similarity analysis made possible by the CHIC software: Hierarchical, Implication and Coefficient Classification. The analysis allowed affirming that the meanings are positive for the initial formation of the students of Mathematics. The Pibid contributed to the improvement of the training of these subjects, providing the practice, the reflection on the practice, integrating these meanings in activities of research and scientific dissemination.Keywords: Pibid; Teacher training; CHIC.
Effects of postprandial hydroxytyrosol and derivates on oxidation of LDL, cardiometabolic state and gene expression: a nutrigenomic approach for cardiovascular prevention
Authors: Perrone Marco A. , Gualtieri Paola , Gratteri Santo , Ali Wahid , Sergi Domenico , Muscoli Saverio , Cammarano Andrea , Bernardini Sergio , Di Renzo Laura , Romeo Francesco
Published: June 2019

Background and aim

Cardiovascular diseases (CVDs) are the most frequent causes of death in the world. Inflammation and oxidative damage contribute significantly to the development of atherosclerosis and CVDs. European Food Safety Authority scientific opinion has acknowledged that hydroxytyrosol (3,4-dihydroxyphenylethanol) and derivatives, contained in extra virgin olive oil (EVOO), typically used in Mediterranean diet may play a crucial role in the reduction of the inflammatory pathway and in the prevention of CVDs. The aim of the study was to determine the effect in healthy volunteers of 25 g of phenols-rich EVOO (p-EVOO).

Methods

The clinical study was a randomized, controlled trial to determine the acute effect in the postprandial time of 25 g of p-EVOO. We evaluated nutritional status using anthropometric parameters, body composition, serum metabolites, oxidative stress biomarkers and gene expression of eight genes related to oxidative stress and human inflammasome pathways, lasting 2 h after p-EVOO administration. Twenty-two participants resulted as eligible for the study.

Results

A significant reduction of oxidized LDL, malondialdehyde, triglycerides and visceral adiposity index was highlighted (P < 0.05). Significant upregulation of catalase, superoxide dismutase 1 and upstream transcription factor 1 were observed (P < 0.05).

Conclusion

The current study shows that intake of 25 g of p-EVOO has been able to be modulated, in the postprandial time, the antioxidant profile and the expression of inflammation and oxidative stress-related genes, as superoxide dismutase 1, upstream transcription factor 1 and catalase. We also observed a significant reduction of oxidized LDL, malondialdehyde, triglycerides and visceral adiposity index. We have demonstrated that a daily intake of phenols and antioxidants can reduce the inflammatory pathway and oxidative stress and therefore the risk of atherosclerosis and CVDs. More studies on a larger population are necessary before definitive conclusions can be drawn.

Trial registration ClinicalTrials.gov NCT01890070.
Evolution over 11 years of the characteristics of walk-in patients at the emergency department of a university hospital in Brussels
Authors: Hysenbegasi Merita ,   Department of Family Medicine and Chronic Care, Vrije Universiteit Brussel, Belgium, Hubloue Ives ,   Department of Emergency Medicine UZ Brussel and Research Group on Emergency and Disaster Medicine, Vrije Universiteit Brussel, Belgium, Vanobberghen Rita ,   Department of Family Medicine and Chronic Care, Vrije Universiteit Brussel, Belgium, Kartounian Jan ,   Department of Family Medicine and Chronic Care, Vrije Universiteit Brussel, Belgium, Devroey Dirk ,   Department of Family Medicine and Chronic Care, Vrije Universiteit Brussel, Belgium,   Corresponding Author: Dirk Devroey Vrije Universiteit Brussel (VUB), Head of the Dept of Family Medicine and Chronic Care, Laarbeeklaan 103, B-1090 Brussels, Belgium. Tel.: +32 2 477 43 11, Fax: +32 2 477 43 01; E-mail: dirk.devroey@vub.ac.be
Published: June 2019

Walk-in patients who do not require urgent treatment at an emergency department (ED) are a known and long-standing problem.

This study aims to investigate the characteristics of walk-in patients visiting the ED over time.

During four days in June 2012, all walk-in patients attending the ED of the University Hospital Brussels between 8 AM and 11 PM were recorded. A similar registration took place in the same ED in June 2001. Patients completed a questionnaire about their characteristics and the reason for the encounter. Data of both study periods were compared.

The mean age of the patients attending the ED was significantly lower in 2001 (40.9 years) than in 2012 (43.9 years) (p=0,02). In 2001, 81% of the participants had Belgian nationality, but in 2012 this proportion increased to 90% (p=0.008). In 2001 as well as in 2012, 21% of the participants had a referral from their family physician (FP) (p=0.9). The proportion of patients that were aware that FP could also handle some emergencies increased from 17% in 2001 to 29% in 2012 (p=0.003). More patients had complaints that begun less than 24h before they attended the ED (48% in 2001 and 58% in 2012) (p=0.03).

The walk-in patients at the ED are getting slightly older and are attending the ED faster after the onset of the complaints. More patients judge their complaints as urgent. However, more patients are getting aware that FP also could handle some emergencies.
Retraction Notice to "Congenital Double Scoliosis with 2 Bilaterally Alternant Supranumerary Hemivertebrae and 2 Supranumerary Vertebrae Treated by Growth Guiding Device" [J Med Life 12(2) (2019) 192-193]
Authors: Burnei Gheorghe ,   "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania.,   Macta Clinic, Constanta, Romania.,   Tinos Clinic, Bucharest, Romania., Tandea Viorel ,   Pediatric Surgery Department, "Grigore Alexandrescu" Clinical Emergency Hospital for Children, Bucharest, Romania., Muntean Iuliu Liviu ,   Pediatric Surgery and Orthopedy Department, Clinical Emergency Hospital for Children, Brasov, Romania., Moga Marius ,   "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania.,   Orthopedy and Traumatology Department, "Dr. Carol Davila" Central Military Emergency University Hospital, Bucharest, Romania., Raducan Ionut Daniel ,   "Vasile Goldis" Western University of Arad, Arad, Romania., Burnei Cristian ,   "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania.,   Clinical Emergency Hospital, Bucharest, Romania.
Published: June 2019

Article J Med Life 2019; 12(2): 192-193; doi: 10.25122/jml-2019-0057 has been retracted for legal reasons.
ANÁLISIS DEL DERECHO AL USO DE LA LENGUA ORIGINARIA: A PROPOSITO DE LA SENTENCIA DEL TRIBUNAL CONSTITUCIONAL EN EL CASO MARÍA ANTONIA DÍAZ CÁCERES DE TINOCO
Authors: Bonilla Sandra Yessy Rojas
Published: June 2019

Esta investigación es sobre la importancia de la identidad cultural del Perú, proponiendo como primer mecanismo de acercamiento hacia las poblaciones indígenas la revalorización de las lenguas originarias; para tal fin, analizamos la STC 00889-2017-PA/TC del Tribunal Constitucional, de fecha 24 de mayo de 2018, emitida en el caso de la ciudadana quecha hablante María Antonia Díaz Cáceres; desde una perspectiva crítica, confrontando como el latente incumplimiento de una norma constitucional puede facilitar la vulneración sus derechos fundamentales. Asimismo, se propone la viabilidad efectiva de las disposiciones contenidas en el artículo 48 de la Constitución Política el Perú, mediante mecanismos simples que dan a conocer con mayor precisión, el lugar donde se ubican o asientas las poblaciones con lenguas originarias; y de este modo, el estado no tenga dificultad en su identificación geográfica, y pueda entregar de servicios en su idioma originario.
Analysis and reporting recommendations for theoretical and experimental ionization potentials based on the study of 53 medium sized molecules using the IP-EOMCCSD method.
Authors: Buzzanca Marissa , Brummeyer Brandon , Gutow Jonathan
Published: June 2019

The precision and accuracy of theoretical vertical ionization potential calculations has improved to the point where more care is needed to make valid comparisons with experimental measurements then is currently the norm. Vertical ionization potentials (IPs) computed using the IP-EOMCCSD method are reported for 53 medium sized molecules (6 – 32 atoms) and compared with statistically evaluated experimental vertical IPs. Based on this comparison, theoretical IPs should be extrapolated to the complete basis set limit and corrected for vibrational zero-point energy, while for experimental data the intensity weighted mean band position should be reported as the vertical IP. Experimental data available for ethylene, E-2-butene, 2,5-dihydrofuran and pyrrole were re-analyzed and compared with zero-point energy corrected complete basis set theoretical estimates, yielding an average discrepancy of 0.05 eV between theory and experiment. In contrast the average of reported experimental vertical IPs (the comparison usually made) yielded an average discrepancy of 0.25 eV between theory and experiment for these molecules. Further analysis of the remaining molecules in the data set suggests that the majority of reported experimental vertical IPs are low because band asymmetries were not accounted for when assigning IP values. This leads to fortuitous good agreement between experiment and computations using the smaller aug-cc-pVDZ basis set without zero-point correction. In the case of 1,4-cyclohexadiene there is strong evidence for experimental uncertainty accounting for the discrepency between theory and experiment. The presented results provide a benchmark for evaluating both experimental and theoretical estimates of vertical ionization potentials for the 53 molecules studied.
Spectroscopic and Kinetic Insights into the Methane Reforming over Ce-pyrochlores
Authors: Jain Disha , Saha Shreya
Published: June 2019

In the present study, we have studied the effect of doping of noble metal ions in Ce-pyrochlores for dry reforming of methane (DRM). Two series of noble metal (Pt and Ru) doped pyrochlores i.e. Ce2Zr2O7 and Ce2Ti2O7 have been studied. Reducibility of the synthesized samples was measured to understand the interplay between the metal and support. A detailed material characterization was performed both pre-and post-reaction to highlight the changes on the surface of the catalyst. Further, the nature of surface intermediates was investigated by in situ FTIR studies. Based on these experimental insights, a comprehensive reaction pathway was developed and kinetic model was derived.
Facile Size-Controlled Synthesis of Fluorescent Carbon Nanoparticles with Size-Independent Optical Properties
Authors: Schwartz-Duval Aaron , Mistry Neal , Srivastava Indrajit , Singh Jasleena , Golk Kelsey , Pan Dipanjan
Published: June 2019

Nanoparticle imaging probes and drug delivery systems have distinct advantages over free or diffusive delivery in that they can concentrate the imaging contrast agent and/or drug, elicit controlled release/degradation, and have a high surface area to volume ratio beneficial for attaching targeting ligands. The size of these nanoparticles affects delivery, retention, degradation rate, and sometimes the radiological properties of the particles. For many optically active nanoparticles (such as gold, silver, and quantum dots), the optical properties are directly dependent on the size and shape of the nanoparticles. While this provides a simplistic outlet for modifying the optical properties of those nanoparticles, it is limiting in that their applications are also dependent on morphology. In these works, we aim to determine if the optical properties of fluorescent carbon nanoparticles are dependent on size through variations in synthetic parameters. Fluorescent carbon nanoparticles with hydrodynamic diameters ranging from 10 – 500 nm were prepared through variations of sugar source, concentration of agave (as a sugar source) and incubation time. Through comparisons made between these nanoparticles, we found no change in the local absorbance maxima and refractive index, with < 5 nm shifting in fluorescence maxima location. We have observed that fluorescent carbon nanoparticles can be prepared within a large range of sizes (10 – 500 nm) without considerable shift in optical properties. Because of this observation, we can infer that the optical properties of fluorescent carbon nanoparticles are largely size independent.
ANÁLISE DA DINÂMICA DELIBERATIVA DE CONSELHOS MUNICIPAIS DE SAÚDE DA REGIÃO CENTRAL DO BRASIL
Authors: De Moura Luciana Melo , Shimizu Helena Eri
Published: June 2019

Objetivo: avaliar os conselhos municipais de saúde da Região Integrada de Desenvolvimento do Distrito Federal e Entorno quanto à dinâmica deliberativa. Metodologia: Trata-se de um estudo exploratório com abordagem qualitativa. A coleta de dados ocorreu por meio dos documentos de oito conselhos municipais de saúde selecionados, do diário de campo fruto da observação participante das reuniões ordinárias e extraordinárias, bem como das entrevistas em profundidade com os presidentes dos conselhos municipais, cujo tema versou sobre a participação social. Os dados coletados foram organizados e submetidos a análise de conteúdo. Resultados: a síntese dos resultados prediz a existência de uma dinâmica deliberativa nos conselhos municipais de saúde estudados.  Contribuições: demonstrou-se que os conselhos municipais estudados têm potencial deliberativo e que podem contribuir para produzir políticas de saúde que atendem aos interesses de atores políticos.
Práticas Curriculares na formação profissional
Authors: Petrucci-Rosa Maria Inês
Published: June 2019

O presente artigo apresenta uma abordagem teórico metodológica apoiada nasnarrativas como método. São focalizadas práticas curriculares compreendidascomo forma de transgressão, à medida que retratam experiências daqueles quenas brechas de suas memórias ressignificam imagens de diferentes tempos elugares. A narrativa encontra-se intimamente relacionada ao ato de rememorar,a possibilidade de ressignificação da própria experiência através das memóriascheias de significados, sentimentos e sonhos. O narrador benjaminiano trazconsigo a característica do saber aconselhar, o que torna a experiência vividasignificativa, sendo este aconselhamento entendido menos como uma forma desaber responder perguntas, mas em dar sugestões. As mônadas, noção derivadada obra de Benjamin, são fragmentos de histórias que juntas narram a conjunturade tempos e lugares. São ouvido/as professore/as no sentido de adensar suasexperiências na produção de currículos em espaços escolares. Como conclusão, oartigo apresenta a possibilidade de se compreender as narrativas como expressãode práticas curriculares transgressoras que reinventam o cotidiano escolar.
Em gênero e sexualidade aprende-se pela repetição com diferença: cenas escolares
Authors: Picchetti Yara De Paula , Seffner Fernando
Published: June 2019

O artigo traz cenas ocorridas no ambiente escolar em que a heteronormatividade é propagada não só a partir da marginalização das expressões de gênero e sexualidade não-hegemônicas, mas principalmente pela minuciosa atuação da norma que induz pressupor a heterossexualidade como a sexualidade verdadeira. Há um conjunto sutil de pedagogias que nos convida a repetir a norma, acenando com benefícios de inserção social. Mas há contingências, indagações, interpelações, confrontos que nos fazem repetir com diferenças o que a norma prescreve, e este é o espaço da educação, sempre tensionada pela repetição da norma com diferenças, fruto dos novos contextos e das demandas das culturas juvenis.
Análise da discretização temporal para a simulação numérica de um espectro de ondas do tipo Pierson – Moskowitz
Authors: Rodrigues Luciano , Del Aghenese Ana Paula , Domingues dos Santos Elizaldo , André Isoldi Liércio , Oliveira Rocha Luiz Alberto , Das Neves Gomes Mateus
Published: June 2019

O presente trabalho apresenta uma metodologia para a simulação numérica de espectro de ondas em tanques. O objetivo é obter recomendações sobre a discretização temporal. Para tanto, o espectro de ondas de Pierson-Moskowitz utilizado no presente estudo possui algumas características como altura significativa da onda (HS) de 1,5 m e período significativo da onda (TS) de 7,5 s. O domínio computacional é bidimensional e representa um tanque de ondas numérico. Além disso, uma importante atualização no modelo computacional é a eliminação da reflexão das ondas através de uma região de amortecimento, chamada de praia numérica. Para a solução numérica foi empregado um código de dinâmica dos fluidos computacional, FLUENT® baseado no Método de Volumes Finitos (MVF). A geometria e a geração da malha são desenvolvidas no software GAMBIT®. O modelo multifásico Volume of Fluid (VOF) é aplicado no tratamento da interação água-ar. Os resultados obtidos indicam que é possível reproduzir numericamente a propagação de espectro de ondas em tanques com acurácia, sendo este um avanço em representar os fenômenos oceânicos de forma mais realística. Com isto, esses resultados poderão ser utilizados em trabalhos futuros, principalmente no estudo numérico de dispositivos conversores de energia das ondas do mar em energia elétrica, como por exemplo, os dispositivos de coluna de água oscilante (OWC) e de galgamento.
Estudo numérico das propriedades viscoelásticas no domínio do tempo em misturas asfálticas do tipo CPA
Authors: Medina Liosber , Farias M M , Recarey C M , Souza Marcus V. R.
Published: June 2019

O artigo apresenta as simulações numéricas do ensaio de fluência estática (Creep Compliance) para várias misturas asfálticas tipo CPA (camada porosa de atrito). Os ensaios de fluência estática foram realizados a 25°C e resultam nos parâmetros constitutivos representados pela série de Prony. Os parâmetros constitutivos viscoelásticos são obtidos a partir das relações entre as funções no domínio do tempo: a função fluência e o modulo de Relaxação. Para a modelagem numérica foi utilizado o método dos elementos finitos e são modelados em 3D corpos de prova com dimensões aproximadas de 66 a 62 mm de altura e 102 mm de diâmetro. Para realizar a modelagem numérica foi utilizado o elemento finito C3D20R, com integração reduzida, já que baseado em estudos de convergência anteriores mostrou resultados mais acurados para analises de problemas similares. Foram determinadas dois conjuntos de parâmetros e comparados os resultados de simulações numéricas em várias misturas asfálticas. Os resultados mostram que para as misturas estudadas a escolha do método para determinar os parâmetros constitutivos tem pouca influência nos resultados numéricos.
Contribuição para estimativa do grau de saturação a partir das condições ambientais aplicada à análise de confiabilidade de estruturas de concreto sujeitas ao ataque por cloretos
Authors: Favretto Felipe , Magalhães Fábio Costa , Real Mauro De Vasconcellos , Guimarães André Tavares da Cunha
Published: June 2019

A durabilidade de elementos estruturais de concreto armado sujeitos a condições ambientais de severa agressividade apresenta-se como um dos principais problemas enfrentados na construção civil. Dentre os agentes de deterioração dessas estruturas destacam-se os íons cloretos, amplamente difundidos em ambiente marinho, que causam a corrosão de armaduras. A estimativa de vida útil de elementos de concreto armado surge como uma temática fundamental na avaliação da durabilidade das estruturas. Embora outros processos causem penetração de íons cloreto no concreto, é praticamente consenso que a difusão é o mecanismo predominante. Um modelo clássico de caracterização da penetração de cloretos é a 2ª Lei de Fick. Guimarães (2000) demonstrou que o grau de saturação (GS) do concreto é um parâmetro que exerce forte influência sobre o coeficiente de difusão de cloretos (D). Embora tenham sido desenvolvidas metodologias de medição do GS, estas se apresentam onerosas em termos de tempo e recursos. O objetivo deste trabalho é apresentar estimativas de GS com base nas condições ambientais a que o material é exposto e posteriormente analisar a influência deste parâmetro na avaliação da estimativa de vida de elementos estruturais através da confiabilidade. São utilizados dados meteorológicos e de medição do GS obtidas em duas regiões litorâneas: Rio Grande, Brasil e Santa Pola, Espanha. Obteve-se modelos de estimativa do GS a partir das variáveis ambientais de cada região e também de ambas em conjunto. Avaliou-se então a influência destes modelos na estimativa de vida útil através da probabilidade de falha da estrutura.
Rechazo y gestión en vacunaciones: sus claroscuros
Authors: Hortal María , Di Fabio José Luis
Published: June 2019

Durante muchos años, vacunar a los niños era una tradición incuestionable; sin embargo, en la actualidad hay gran preocupación por el creciente rechazo a las vacunas de la infancia, además de otros obstáculos que no son fáciles de visualizar y que afectan las coberturas por vacunación.

Se señalan múltiples factores intervinientes en los rechazos a una vacuna o a la vacunación en general por la acción de grupos antivacunas y por la desinformación o divulgación de datos erróneos. En algunos países, se agregan atrasos en el cumplimiento del esquema de inmunizaciones por posibles fallas en la gestión de los programas. Todo esto compromete el nivel efectivo de las coberturas de vacunación y constituye una seria amenaza para la salud pública.

Las poblaciones susceptibles se modifican de manera constante por cambios epidemiológicos determinados por fenómenos como la globalización o diferentes conflictos que interfieren el accionar sanitario. En época reciente, se han registrado brotes de enfermedades antes controladas como la difteria, la tos ferina y el sarampión, ya sea por casos importados o por fallas en los programas nacionales de inmunización.

Se intentó explorar distintos componentes que se suman a la frecuencia creciente de los rechazos a las vacunas, lo que obliga a una revisión de las causas y al diseño de estrategias y enfoques innovadores para recuperar la aceptación de la vacunación y su lugar como la herramienta más costo-efectiva en salud pública.
Das semantische Merkmal der Zustandsänderung und seine formdifferenzierende Wirkung am Beispiel des Deutschen und des Polnischen
Authors: Schwenk Hans‑Jörg
Published: June 2019

In dem vorliegenden Beitrag wurde das semantische Merkmal der Zustandsänderung auf seine wortbildenden Wirkung hin untersucht und dabei das Deutsche mit dem Polnischen verglichen. Es konnte gezeigt werden, dass im Polnischen sowohl Resultativität als auch Kausativität stets formdifferenzierend ausschlagen und zur Bildung eines perfektiven Verbs führen, während Zustandsänderung im Deutschen nicht unbedingt immer morphologisch markiert sein muss, sondern sehr wohl auch zusammen mit ihrem Gegenteil im Basisverb aufgehen kann.
Knowledge Sharing Process and Innovation Success: Evidence from Public Organisations in Southern Nigeria
Authors: Heman Ononye Uzoma , Igwe Anthony
Published: June 2019

Aim/Purpose: This study investigates the relationship between knowledge sharing process and innovation success with specific emphasis on tacit knowledge. Based on the literature review, we hypothesised that knowledge donating and collecting have a positive relationship with innovation success.

Methodology: The hypotheses were empirically tested using the partial least square path modelling with data collected from twelve state-owned public organisations operating in Southern Nigeria.

Contribution: The research made distinct empirical contributions to the burgeoning literature on knowledge sharing and innovation from the public sector and developing country context.

Findings: Knowledge donating and collecting contribute to innovation success positively and significantly. Knowledge donating effect on innovation success was found to be more significantly positive than the effect of knowledge collecting on innovation success.

Recommendations for Practitioners: Public organisations should promote a supportive culture to spur innovation through the frequent share of experiences, information and skills among the various knowledge actors. Public managers should convey the importance of knowledge sharing and its value to knowledge users in clear terms and attend to creating conditions or contexts that encourage people to share knowledge freely and willingly with others. It is apt to improve organisational commitment and support for knowledge sharing activities such as mentorship programs, workshops, conferences, seminars and other related training and development programs in order to provide opportunities for employees to develop innovation competencies from the transfer of tacit knowledge developed over time from experience. To optimise innovation outcomes from knowledge sharing practices, knowledge sharing should be in tandem with the industry or global best practices.

Future Research: Future studies should add interviews to provide depth in terms of insights and substance to the questionnaire, and may extend to public organisation with different ownership structure.