bluuebunny/crossref_metadata_2025_split huggingface dataset:
Success of Online Education Related to New Data in T2D Management
Authors: Larkin Amy , Schrand Julie , Le Anne 
Published: May 2021

Abstract
We sought to determine if online continuing medical education (CME) could improve the knowledge and confidence of multiple specialties related to CVOT data for T2D therapies. The CME activity was a 30-minute online video panel discussion with synchronized slides focusing on new data at ADA 2020. A repeated pairs pre-/post-assessment study design and chi-square test (P &lt;.05 is considered significant) assessed educational effect. The activity launched June 25, 2020 and data were collected through September 3, 2020. In total, 212 PCPs and 72 D/Es were included in the analysis. Overall, there were knowledge and confidence improvements seen among all groups from pre- to post-assessment: • 23% of PCPs (P&lt;.01) and 24% of D/Es (P&lt;.05) improved at recognizing the benefits of SGLT2 inhibitors across the class • 20% of PCPs (P=.NS) and 17% of D/Es (P&lt;.05) improved at identifying new data presented at a conference • 15% of PCPs (P=.NS) and 13% of D/Es (P=.NS) improved at identifying class effect of SGLT2 inhibitors on hospitalizations for heart failure • 36% of PCPs and 25% of D/Es had measurable increases in confidence in treating patients with T2D and CVD Continued educational gaps: • 62% of PCPs and 39% of D/Es failed to identify benefits of SGLT2 inhibitors across the class • 45% of PCPs and 19% of D/Es failed to recognize new data presented at a conference • 58% of PCPs and 31% of D/Es failed to identify class effect of SGLT2 inhibitors on hospitalizations for heart failure This study demonstrates the success of online CME on improving knowledge and confidence of a multi-specialty group on CVOT data. Continued gaps were identified for future educational targets.
The Association Between Time in Range %, and Physical & Functional Indices Amongst Older People With Type 2 Diabetes: A Cross Sectional Study
Authors: Basson-Shleymovich Yamit , Cukierman-Yaffe Tali , Yahalom-Peri Tal , Azmon Michal 
Published: May 2021

Abstract
Diabetes is a major public health burden associated with high mortality, morbidity, hospitalization and health care services utilization rates. People with diabetes have an increased risk for mobility disability compared to those without diabetes, after controlling for age. People with diabetes also have a higher risk for falls and fractures. Data from the last several years suggests that this increased risk is not only due to diabetes co-morbidities but also due to an accelerated decline in physical capacity due to lower muscle quality and a more rapid decline in muscle mass (sarcopenia) and lower extremity strength over time. HBA1C is a measure of average glucose levels; however, it does not provide information about glycemic variability, or daily patterns of glycemia. In the last several years, several organizations have published consensus statements on the role of continuous glucose monitoring (CGM) in glucose control. The use of CGM has brought about the development of many glucose indices, amongst them is: Time In Range% (TIR) of 70–180 mg/dL (3.9–10 mmol/L). Less is known regarding the association between TIR and sarcopenia, muscle mass loss that leads to deterioration in mobility, disabilities and decline in physical indices in older people with diabetes. Aims: To assess among older people with diabetes type 2, the cross sectional association between: TIR and aerobic capacity, gait speed, strength, balance and frailty indices. Methods: A cross sectional study, conducted amongst people with diabetes over the age of 60. Participants were provided with a blinded CGM system- (I Pro2 carelink, Medtronic) for 1 week and underwent elaborate physical-functional assessment in the beginning and at the end of that week. The association between the % of time in range (Time in Range-TIR) and several physical indices was determined using linear regression.
Results: This analysis pertains to 55 men and women who completed the evaluation. After adjustment for age and gender, we found that 1% increase in TIR was associated with a 0.341 higher score on the 30 second Sit to Stand score (a measure of lower extremity strength) (P-value=0.02), a 0.351 higher score on the BERG scale (a measure of balance) (P-value=0.01), a 0.271 lower score on the timed up and go score (a measure of fall risk and balance) (P-value=0.008), a 0.289 higher score on the 6-minute walk score (a measure of aerobic capacity and endurance) (P-value=0.02) and a 0.261 lower score on the 360 turn test (a measure of dynamic balance) (P-value=0.0004). The same was not observed for the relationship between HGA1C & physical indices.
The Effect of Proton Pump Inhibitors on Insulin-Glucose Homeostasis in Patients With Type 2 Diabetes Mellitus
Authors: Verma Vipin , Cromer Mark , Riddick Blocker , O’Steen Jordan M , Antony Mc Anto , Chandra Lakshya , Kant Ravi 
Published: May 2021

Abstract
Introduction: Gastrin release from G cells stimulates cholecystokinin (CCK2) receptors throughout the body, most of which promote gastric acid secretion. However, gastrin also stimulates CCK2 receptors located elsewhere, including the islet of the pancreas. In turn, gastrin increases insulin secretion1. Gastrin also promotes pancreatic β cell neogenesis and replication. Proton pump inhibitors (PPIs) decrease the pH of the stomach and stimulate gastrin secretion, which may indirectly promote insulin secretion and improve hemoglobin A1c (HbA1c).
Objective: To understand the effect of PPIs on insulin-glucose homeostasis (c-peptide, HbA1c, and glucose) in patients with type 2 diabetes mellitus (T2DM).
Methodology: We retrospectively reviewed the charts of patients with T2DM at least 18 years of age who received care at AnMed Health facilities from Jan. 1, 2018 through Dec. 31, 2018 to compare HbA1c, C-peptide, and glucose levels in patients with and without active PPI therapy. Slicer-dicer software was used to identify study population with diagnosis of T2DM and labs including both HbA1c and C-peptide. Out of total 215 patients satisfying inclusion criteria, 71 patients were on PPI. Statistical analyses were performed using SPSS version 20.0 (SPSS, Armonk, NY: IBM Corp). All values are presented as means ± SD. A p value of &lt; 0.05 was considered to be significant. Independent T-test and chi-square test were performed to compare parameters in between groups.
Results: The PPI and non-PPI groups had no statistical difference regarding age, sex, race and BMI. There was no significant difference in HbA1c levels between PPI and non-PPI groups (8.6% ± 2.1 vs 8.3% ± 2.0, respectively; p value = 0.37). However, we found a significant increase in C-peptide levels (3.1 ng/mL ± 2.4 vs 2.4 ng/mL ± 2.3; p value = 0.037) and decrease in LDL levels (79.6 mg/dL ± 34.0 vs 89.73 mg/dL ± 32.9; p value = 0.046) in the PPI group compared to non-PPI group. In addition, there was a significantly greater prevalence of coronary artery disease in the PPI group (p = 0.01).
Conclusion: PPI therapy in patients with T2DM was not associated with improved glycemic control. However, C-peptide levels were significantly higher in patients with T2DM who were on PPI therapy suggesting higher insulin secretion. The lack of difference in HbA1c levels may be a result of aggressive diabetic management by treating clinicians to achieve similar goal HbA1c in both groups. Further research is needed to understand the gastrin pathway as a potential option for improving glycemic control.
References: 1. Rehfeld JF. Incretin physiology beyond glucagon-like peptide 1 and glucose-dependent insulinotropic polypeptide: cholecystokinin and gastrin peptides. Acta Physiol (Oxf). 2011 Apr;201(4):405–11.
Effects of Gestational Bisphenol A Exposure on Hypothalamic Vasopressinergic Neurons
Authors: Zheng Jing , Baimoukhametova Dinara , Bains Jaideep , Lebel Catherine , Kurrasch Deborah Marie 
Published: May 2021

Abstract
Background: Bisphenol A (BPA), a well-recognized endocrine disruptor that has been linked to numerous adverse outcomes, is ubiquitously detected in humans, including pregnant women. Emerging epidemiological and animal studies showed associations between prenatal BPA exposure and social-behavioral issues in childhood, including aggression and anxiety.
Methods: Since vasopressinergic circuits play important roles in regulating social behaviors, and our previous studies showed that prenatal exposure to BPA altered vasopressin development in offspring, here we evaluated effects of BPA on the number of arginine vasopressin (AVP) neurons in hypothalamic subregions, including the supraoptic nucleus (SON), suprachiasmatic nucleus (SCN) and paraventricular nucleus (PVN), using immunohistochemistry, and assessed the intrinsic electrophysiological properties as well as synaptic transmission of AVPPVN neurons using whole-cell patch-clamp.
Results: We observed increased number of AVP neurons in SON, SCN, and PVN in BPA treated group compared with the control group. Lower spontaneous action potentials the frequency was found in the BPA group compared to the control group, demonstrating disruption in AVP biophysical properties. Current clamp experiments also showed that BPA treated AVPPVN neurons were less responsive to current injections than control AVPPVN neurons, including fewer neuronal spikes, delayed latency to the first spike, and less responsive overall were observed in the BPA group. Spontaneous excitatory postsynaptic currents frequency but not amplitude was also altered by BPA gestational exposure, while no significant changes were found for spontaneous inhibitory post-synaptic currents.
Conclusion: Collectively, our results suggest that gestational BPA expose might disturb hypothalamic AVP circuits, as indicated by increased AVP neurons in hypothalamic nuclei and disrupted excitability and synaptic transmission of/onto AVP neurons.
Estrogen Activity of OTC Topical Medications Containing Parabens Depends on Paraben Type and Concentration
Authors: Allen Brianna , Ma Peng , Zhang Changde , Wiese Thomas E 
Published: May 2021

Abstract
Methylparaben, ethylparaben, and propylparaben are widely used as preservatives in food, cosmetics, and pharmaceutical products. Parabens are also known to bind the estrogen receptor and induce weak estrogen activity in laboratory bioassays. Many OTC topical medications contain one or more parabens as preservative ingredients. In this study, we surveyed the estrogen activity of extracts from OTC topical medications and tested the hypothesis that a combined threshold concentration of particular parabens is required to induce estrogen activity in human breast cancer cell bioassays. Ethanol extracts (1 gm:1 ml) were prepared from OTC topical medications containing parabens (including: Olay Quench Lotion, CeraVe Daily Moisturizing Lotion and Cortizon-10 Lotion). The estrogen agonist and antagonist activity of each extract was determined using the T47dkbluc estrogen reporter gene and the MCF-7 E3 estrogen responsive proliferation assays. The extracts from Olay Quench Lotion and CeraVe Daily Moisturizing Lotion induced estrogen agonist activity in the MCF-7 proliferation assay. The extract from the Cortizon-10 Lotion did not induce significant estrogen activity. The product ingredients of each OTC topical medications tested listed ethyl and propyl parabens while the Olay Quench Lotion also contained the least estrogenic paraben methylparaben. We propose that the estrogenic potential of OTC topical medications can be estimated with LC-MS analysis determination of paraben content and concentration. This study illustrates that measurable estrogen activity from OTC topical medications requires the presence of estrogenic parabens (ethyl and propyl) at total concentrations that exceed a threshold. Thus, estrogen activity depends on the type and concentration of paraben present in the OTC topical products. While the capacity for these OTC topical medications to induce estrogen activity in individuals using the products is unclear, consumers may benefit from more information about the paraben type and concentration present.
Changing Stride Frequency Alters Average Joint Power and Power Distributions during Ground Contact and Leg Swing in Running
Authors: SWINNEN WANNES , MYLLE INE , HOOGKAMER WOUTER , DE GROOTE FRIEDL , VANWANSEELE BENEDICTE 
Published: May 2021

ABSTRACT

Purpose
Runners naturally adopt a stride frequency closely corresponding with the stride frequency that minimizes energy consumption. Although the concept of self-optimization is well recognized, we lack mechanistic insight into the association between stride frequency and energy consumption. Altering stride frequency affects lower extremity joint power; however, these alterations are different between joints, possibly with counteracting effects on the energy consumption during ground contact and swing. Here, we investigated the effects of changing stride frequency from a joint-level perspective.

Methods
Seventeen experienced runners performed six running trials at five different stride frequencies (preferred stride frequency (PSF) twice, PSF ± 8%, PSF ± 15%) at 12 km·h−1. During each trial, we measured metabolic energy consumption and muscle activation, and collected kinematic and kinetic data, which allowed us to calculate average positive joint power using inverse dynamics.

Results
With decreasing stride frequency, average positive ankle and knee power during ground contact increased (P < 0.01), whereas average positive hip power during leg swing decreased (P < 0.01). Average soleus muscle activation during ground contact also decreased with increasing stride frequency (P < 0.01). In addition, the relative contribution of positive ankle power to the total positive joint power during ground contact decreased (P = 0.01) with decreasing stride frequency, whereas the relative contribution of the hip during the full stride increased (P < 0.01) with increasing stride frequency.

Conclusions
Our results provide evidence for the hypothesis that the optimal stride frequency represents a trade-off between minimizing the energy consumption during ground contact, associated with higher stride frequencies, without excessively increasing the cost of leg swing or reducing the time available to produce the necessary forces.
Improvement in outpatient services using the WeChat calling system in the Shanghai Children’s Hospital
Authors: Wu Dan , Cui Wenbin , Wang Xiulian , Huo Yanyan , Yu Guangjun , Chen Jinjin 
Published: May 2021

Objectives: We explored the utility of WeChat applet as part of the Outpatient Department (OPD) to provide patients with timely queuing information and compared it with the traditional calling system.
Methods: Data for the WeChat calling system was extracted for the period of May 2018 to September 2018. Data for the traditional system was extracted for the same period from the year 2017. We compared the effective patient waiting time and nurse idle time i.e. nonproductive time spent on factors outside of employees’ control with the two systems. We also analyzed the relationship between the length of waiting time and conflicts between doctors and patients.
Results: The mean wait time for the traditional calling system was 126 minutes, while the average idle time for nurses was 96 minutes/day. On the other hand, the mean wait time for the WeChat calling system was 33 minutes, and the average idle time for nurses was 72 minutes/day. The incremental profit (cost of traditional calling system – cost of WeChat calling system) achieved from switching systems was 13,879 yuan/month. Behavioral observations showed that wait time (OR=2.745, 95%CI 1.936~3.892 P<0.0001) was a risk factor for staff-patient conflict.
Conclusion: The cost of the WeChat calling system was significantly lower than the traditional system. Also, the traditional calling system was time-consuming. Longer waiting time was the main factor affecting OPD quality and caused conflicts between doctors and patients.
doi: https://doi.org/10.12669/pjms.37.4.4301
How to cite this:Wu D, Cui W, Wang X, Huo Y, Yu G, Chen J. Improvement in outpatient services using the WeChat calling system in the Shanghai Children’s Hospital. Pak J Med Sci. 2021;37(4):993-1000. doi: https://doi.org/10.12669/pjms.37.4.4301
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Das Anna und ihr Hund.
Authors: Baumgartner Gerda , Busley Simone , Fritzinger Julia , Martin Sara 
Published: May 2021

In numerous German dialects and in Luxembourgish women or girls are referred to in the neuter. This raises the question whether this is also the case for female animals. Based on data from the research project “Das Anna und ihr Hund – Weibliche Rufnamen im Neutrum”, the present article examines the gender of names and pronouns referring to dogs. Dogs today are no longer kept primarily to perform functions (guard dog, herding dog) but rather as pets and companions. This is also reflected in the fact that dogs are given names. In general, these clearly mark the sex of the dog.
In the dialects we investigated pronouns, which refer to female dogs, are predominantly masculine, not feminine or neuter. Sex-specific appellatives are not used either. In addition, the assignment of the neuter gender to dogs’ names (e. g. s Frida) occurs much less frequently than to first names of women (e. g. s Anna). The functions of the socio-pragmatic neuter when referring to women, such as marking age, status, or gender roles, rarely appear to play a role when referring to dogs. Only in Luxembourgish, where the neuter primarily marks female sex, are female animals referred to more often with neuter forms.
Der onymische Artikel im Schweizerdeutschen in seiner Funktion als Genusmarker
Authors: Bösiger Melanie 
Published: May 2021

In Swiss German dialects first names are commonly used with a preceding article. Historically, the function of these so-called onymic articles was to show the name’s case. They first arose when inflection of first names had been omitted and case was thus no longer expressed in suffixes. The data gathered in 2016 in an online survey for the research project “Das Anna und ihr Hund” indicate that today the function of reflecting the case is hardly relevant. However, it is important to the speakers to emphasize the nameʼs grammatical gender. The three grammatical genders in (Swiss) German are feminine, masculine, and neuter. Typically, the ono­nymic articles’ grammatical gender corresponds to their referents’ biological gender, i. e. feminine articles for women’s names, masculine articles for men’s names. But sometimes neuter articles are used with female or, less often, with male names. Therefore, the same first name can have different grammatical genders that are indicated with an onymic article, e. g. d Anna (f.) or s Anna (n.). The choice of the article depends on the speaker, the situation, the referent, and other factors. Based on these observations, it is argued that marking grammatical gender is the onymic article’s main function and marking case is secondary.
Natural malaria infection in anophelines vectors and their incrimination in local malaria transmission in Darién, Panama
Authors: Torres-Cosme Rolando , Rigg Chystrie , Santamaría Ana María , Vásquez Vanessa , Victoria Carlos , Ramirez José Luis , Calzada José E. , Cáceres Carrera Lorenzo 
Published: May 2021

BackgroundMore than 85% of the malaria cases in Panama occur in poor, rural and indigenous regions like Darien Province. Vector diversity, infection rate and spatial distribution are important entomological parameters of malaria transmission dynamics. Their understanding is crucial for the development of effective disease control strategies. The objective of this study was to determine the composition ofAnophelesspecies, their natural infection rate and their geographic distribution to better understand the malaria transmission dynamics in Darién, Panama.MethodsAnophelines mosquitoes were captured during the rainy and dry season of 2016. We selected five communities where adult anophelines were collected using CDC light-traps, and through protective human-baited traps. Detection of natural infection andPlasmodiumgenotype were detected via nested PCR through the amplification of ssrRNA and the circumsporozoite protein gene (csp), respectively.ResultsA total of 1,063 mosquitoes were collected mosquitoes were collected for the detection of natural infection withPlasmodium spp. Nine Anophelines species were identified, with the predominant species being:An.(Nys.) darlingi(45.0%) andAn.(Nys.) albimanus(42.6%). Natural infection inAn.(Nys.) albimanuswithP.vivaxwas detected in one mosquito pool from the community Pueblo Tortuga (0.6%), three from Marraganti (1.7%), two from Bajo Chiquito (1.1%) and three pools from Alto Playona 3 (1.7%). ForAn.(Nys.) darlingimosquitoes, we detected seven positive pools from the community Bajo Chiquito (4.0%), two pools from Marraganti (1.1%) and two pools from Alto Playona (1.1%). TheP.vivaxallelic variant VK210 was detected in infected mosquitoes.ConclusionThe results from this study provide new information on the transmission dynamics associated with anophelines vectors in the Darién region. This is the first report of naturalP.vivaxinfection inAn.(Nys.) darlingiand its incrimination as a potential malaria vector in this region of Panama. Additional studies are necessary to expand our knowledge and determine crucial parameters in malaria transmission in Darién, which in turn will aid the National Malaria Program in attaining an adequate malaria control strategy towards malaria elimination.
Creative Care: A Revolutionary Approach to Dementia and Elder Care, Anne Basting (2020)
Authors: Smittle Ellen C. 
Published: May 2021

Review of: Creative Care: A Revolutionary Approach to Dementia and Elder Care, Anne Basting (2020)
New York: HarperCollins Publishers, 280 pp.,
ISBN 978-0-06290-617-5, h/bk, $27.99
Diners Dudes & Diets: How Gender and Power Collide in Food Media and Culture, Emily J. H. Contois (2020)
Authors: Elias Megan J. 
Published: May 2021

Review of: Diners Dudes & Diets: How Gender and Power Collide in Food Media and Culture, Emily J. H. Contois (2020)
Chapel Hill: University of North Carolina Press, 208 pp.,
ISBN 978-1-46966-074-5, p/bk, $22.95