bluuebunny/crossref_metadata_2025_split huggingface dataset:
960-P: The Usefulness of CGMS in Identifying and Treating Suboptimal Blood Glucose Patterns in In Vitro Fertilization Pregnancies with Normal OGTT and Increased Amniotic Fluid
Authors: THOMAKOS PETROS , BARETTO CAROL , ZOUPAS CHRISTOS S. 
Published: June 2021

IVF pregnancies have an increased incidence of polyhydramnios. Increased amniotic fluid has been considered an indicator to test the mother for Gestational Diabetes Mellitus. Furthermore, IVF pregnancies are associated with a higher prevalence of GDM. In this study, suboptimal BG patterns were detected by CGMS in 19 singleton IVF pregnancies with a 4 quadrant Amniotic Fluid Index (AFI) ≥20cm and a normal OGTT. Clinical characteristics include the following; age: 35±3.7 years, BMI: 25.2±3.8 kg/m2, OGTT: 0’=83.6±7.3, 60’=157.5±19.3, 120’=129±30 mg/dL, HbA1c: 5.3±0.2%, Hadlock (BPD-HC-AC-FL) percentile: 59.7±12.1%, AFI: 21.7±1.6 cm, U/S polyhydramnios confirmation: 21.1±4.7 week. A blind recording of BG patterns was accomplished using a CGMS for 7 days. Mean Sensor BG: 104.2±5 mg/dL, time&gt;120 mg/dL: 221±61 min/24h, time&lt;63 mg/dL: 93.2±81 min, Fasting BG: 90.7±6 mg/dL, 1h-Postprandial BG: 116.6±11 mg/dL, CV: 18.6±3. Mitigation of polyhydramnios was obtained through tight glycemic control using insulin therapy (mean dosage: 32±10.7 IU). Insulin treatment was adjusted to reach the BG target &lt;95 fasting and &lt;120 mg/dL 1-h postprandial. After a treatment duration of 8-weeks, the AFI in 16 of the cases was reduced to less than the 20cm threshold. The decrease noted in the other 3 cases did not reach a level below the 20cm threshold. Pregnancy outcome; Week of delivery: 37.4±1.5, birth weight: 2990±425 g, Small for Gestational age: 2 cases, Large for Gestational age: 1 case, Caesarean Section: 84.2%, there were no cases of congenital malformations. Increased amniotic fluid maybe an indicator of abnormal BG patterns in IVF pregnancies. CGMS is a useful technology to identify suboptimal BG levels which the OGTT may be unable to detect. Timely insulin treatment targeting tight glycemic control could assist in decreasing amniotic fluid. Aggressive and prompt GDM screening in IVF pregnancies is recommended.

Disclosure
P. Thomakos: None. C. Baretto: None. C. S. Zoupas: None.
966-P: Glucose Control and Cognitive Function in Older Adults with Diabetes or Prediabetes: Results from the 2011-2014 National Health and Nutrition Examination Survey (NHANES)
Authors: KIM MIN JUNG , FRITSCHI CYNTHIA 
Published: June 2021

Objective: Poor glucose control (A1c) has been associated with cognitive impairment in adults with diabetes, but it is unknown whether people with prediabetes who have elevated A1c are also at risk. Our aims were to 1) examine the relationships between A1c and cognitive function in older adults with diabetes or prediabetes and 2) explore whether body mass index (BMI) and functional disability affect cognitive function.
Method: We extracted data of adults aged ≥ 60 years with self-reported diabetes or prediabetes from the 2011-2014 NHANES database. Variables included the Digit Symbol Substitution Test (DSST) for attention and processing speed; the Animal Fluency (AF) test for semantic fluency, and the Consortium to Establish a Registry for Alzheimer’s Disease (CERAD) Word Learning subtest for delayed and immediate memory. BMI, activities of daily living (ADL), instrumental ADL (IADL), and A1c were examined. Chi-square, t-test, and multivariate linear regressions were used.
Results: A total of 1,070 older adults were included (age 69.94±6.73 years, male 50.65 %, diabetes=870, prediabetes=200). Diabetes group had significantly lower scores for all cognitive assessments, higher A1c values, more ADL disability, and were more obese than prediabetes group. A 1% increase in A1c decreased DSST score by 1.24, AF by .29, and CERAD delayed memory by .17. Being underweight decreased cognitive function (DSST=-13.15, AF=-2.97), while obesity had a protective effect (DDST=3.18). Having at least one ADL or IADL disability also decreased cognitive function (DSST=-6.19; AF=-1.47, CERAD delayed=-.60, and CERAD immediate=-1.08).
Conclusions: Our findings suggest that higher A1c, being underweight, and functional disability are associated with cognitive impairment, which highlights the need for regular cognitive testing in older adults with higher A1c, especially those with high BMI and reduced functional ability.

Disclosure
M. Kim: None. C. Fritschi: None.
97-OR: Relationship between Time-in-Range and Laboratory HbA1c in Pregnant Women with Type 1 Diabetes Mellitus
Authors: LING PING , WANG CHAOFAN , YANG DAIZHI , LUO SIHUI , ZHENG XUEYING , LV JING , YAN JINHUA , XU WEN , YAO BIN , WENG JIANPING 
Published: June 2021

Aims: To investigate the relationship between time-in-range (TIR) and laboratory glycated hemoglobin A1c (HbA1c) in pregnant women with type 1 diabetes mellitus (T1DM).
Methods: An observational study enrolled pregnant women with T1DM who wore continuous glucose monitoring (CGM) system devices (iProTM2 system) in the first, second, third trimesters and postpartum from 11 hospitals in China from January 2015 to June 2018. Data derived from the CGM system were used to calculate TIR, time above range (TAR), time below range (TBR), mean glucose (MG), and glycemic variability (GV) parameters. Relationships were explored between the CGM metrics and HbA1c. Linear and curvilinear regressions were conducted to investigate the best-fitting model to account for the influence of gestational changes in HbA1c on the TIR- HbA1c relationship.
Results: A total of 272 CGM data and corresponding laboratory HbA1c from 98 pregnant women with T1DM, as well as demographic and clinical characteristics were analyzed. Mean HbA1c and TIR were 6.49±1.29% and 76.16±17.97% during pregnancy, respectively. HbA1c was moderately correlated with TIR3.5-7.8(R=-0.429, P=0.001), mean glucose (R= 0.405, P=0.001) and the TAR7.8 (R=0.435, P=0.001), but was weakly correlated with TBR3.5 (R=0.034, P=0.001) during pregnancy. On average, a 1% (11 mmol/mol) difference in HbA1c corresponded to an 8.5% difference in TIR3.5-7.8. During pregnancy, HbA1c of 6%, 6.5% and 7% were equivalent to a TIR3.5-7.8 of 78%, 74%, and 69%, respectively.
Conclusions: We found a moderate correlation between HbA1c and TIR3.5-7.8 during pregnancy. To achieve the HbA1c target &lt;6% for pregnant women with T1DM, women and clinicians should aim for TIR3.5-7.8 &gt;78% (18h 43min/per day), during pregnancy.

Disclosure
P. Ling: None. J. Weng: None. C. Wang: None. D. Yang: None. S. Luo: None. X. Zheng: None. J. Lv: None. J. Yan: None. W. Xu: None. B. Yao: None.

Funding
National Health and Family Planning Commission of the People’s Republic of China; Foundation for Public Welfare Industry Research Project (201502011); National Key Research and Development Program of China (2017YFC1309600); National Natural Science Foundation of China (81941022)
979-P: The Relationship between Physical Activity (PA) and Coronary Artery Calcification (CAC) by Sex in Adults with Impaired Glucose Tolerance (IGT) or Diabetes
Authors: ROCKETTE-WAGNER BONNY , KRISKA ANDREA , YOUNES NAJI , EDELSTEIN SHARON , ORCHARD TREVOR J. , ARMSTRONG MARNI , BROWN ANGELA L. , DABELEA DANA , GADDE KISHORE M. , HORTON EDWARD , HOSKIN MARY A. , IBEBUOGU UZOMA N. , SCHLÖGL MATHIAS , GOLDBERG RONALD B. ,   DPP RESEARCH GROUP
Published: June 2021

Subclinical markers of atherosclerosis, including CAC, are less favorable in adults with IGT. In previous adult studies, higher PA has been associated with lower CAC with findings varying by age and sex. PA and CAC were examined by age and sex in the diverse Diabetes Prevention Program Outcomes Study (DPPOS) cohort with IGT who were randomized at baseline to lifestyle intervention, metformin, or placebo groups for a mean of 3.2 years, and subsequently observed in DPPOS for follow-up.
PA was measured via questionnaire (annually); accelerometry once at 11-13yrs and CAC Agatston score (AS) using chest computed tomography at 13-15 yrs from randomization. The relationship between PA and CAC was examined using Tobit regression models in 1434 participants with valid PA and CAC data (mean age 63±9.5 yrs; 70% female; 54% with diabetes) adjusted for treatment group, age, sex, race/ethnicity, lipid medication use, diabetes status, and cumulative metformin exposure; pairwise and three-way interactions were examined.
Accelerometry-assessed median (IQR) daily step counts and moderate+ PA (MVPA) minutes were 5302 (3576, 7104) and 21 (9, 41), respectively. Median (IQR) AS was 9 (0, 151). In fully adjusted models, each 1000 steps /day was associated with lower CAC (p=0.024). Results were examined by sex and age subgroups (&lt;65 and ≥65 yrs) with significant inverse associations found in women (&lt;65 and ≥65 yrs; both p&lt;0.001) but not in men (&lt;65 and ≥65 yrs; both p&gt;0.05). Similarly, significant inverse associations between MVPA minutes and CAC AS were found in women (&lt;65 yrs p=0.003; ≥65 yrs p=0.012) but not in men (&lt;65 yrs p=0.91 and ≥65 yrs p=0.056). Questionnaire-measured PA and CAC associations showed similar trends. In contrast, minutes of sedentary and light PA were not significantly associated with CAC.
Suggested sex differences in the PA-CAC association in adults with initial glucose intolerance was found and should be investigated in other studies.

Disclosure
B. Rockette-wagner: None. E. Horton: None. M. A. Hoskin: None. U. N. Ibebuogu: None. M. Schlögl: None. R. B. Goldberg: None. D. Research group: None. A. Kriska: None. N. Younes: None. S. Edelstein: None. T. J. Orchard: None. M. Armstrong: None. A. L. Brown: Research Support; Self; Medtronic, National Heart, Lung, and Blood Institute, National Institute of Diabetes and Digestive and Kidney Diseases. D. Dabelea: None. K. M. Gadde: Other Relationship; Self; AstraZeneca, Research Support; Self; BioKier, National Institute of Diabetes and Digestive and Kidney Diseases.

Funding
National Institute of Diabetes and Digestive and Kidney Diseases (U01DK048489)
981-P: Truncal Fat-to-Leg Fat Ratio in Relation to Cardiovascular Disease in Patients with Type 2 Diabetes
Authors: SHIN JANG YEL 
Published: June 2021

Truncal fat has been reported to be positively associated with the risk of metabolic syndrome (MS), type 2 diabetes (T2D), and cardiovascular disease (CVD). Meanwhile, leg fat was inversely related to MS, T2D, and CVD. This study examined the association between truncal fat to leg fat ratio (TLR) and the prevalence of CVD in patients with T2D. A total of 1,728 individuals with T2D were enrolled. Truncal fat, leg fat, and appendicular muscle mass (ASM) were assessed using dual-energy X-ray absorptiometry. All subjects were divided into 3 groups according to the tertile of TLR. CVD was defined as either coronary heart disease (CHD), ischemic stroke (IS), peripheral artery disease (PAD), or a combination these conditions. The prevalence of CVD, CHD, IS, and PAD were 24.8%, 17.4%, 7.5%, and 3.3%, respectively. Individuals with CVD were highly likely to be older, male, and hypertensive and had higher values for diabetic duration (DD), waist circumference (WC), and TLR, but lower values for diastolic blood pressure, HDL cholesterol, and estimated glomerular filtration rate (eGFR) than those without CVD. Patients with the highest TLR tertile were more likely to be elderly and hypertensive and had higher values for DD, WC, BMI, triglycerides (TG), HbA1c, and HOMA-IR, but lower values for HDL cholesterol, eGFR, and ASM/BMI, compared with those with the lowest tertile. The prevalence of CVD progressively increased with greatening tertile of TLR (the lowest vs. the middle vs, the highest = 19.4% vs. 26.0% vs. 29.1%, p = 0.001). The odd ratios (ORs) and 95% confidence intervals (IC) for the presence of CVD after adjusting age and sex, were 1.25 (0.93 - 1.69) in the middle and 1.51 (1.13 - 2.02) in the highest, respectively. The ORs and 95% CI in the highest tertile remained significant, further adjusting for WC, BMI, current smoker, DD, hypertension, HDL, TG, HOMA-IR, HbA1c, CRP, and eGFR.
In conclusion, we found that TLR was significantly associated with CVD in patients with T2D independently of potential confounders.

Disclosure
J. Shin: None.
99-OR: Effects of Early Time-Restricted Feeding during Gestation on Offspring Glucose Homeostasis in Mice
Authors: CARTER MOLLY E. , HABBAL NOURA EL , SNYDER DETRICK S. , REDD JEANNA R. , GREGG BRIGID , BRIDGES DAVE 
Published: June 2021

Time-Restricted Feeding (TRF) is an increasingly common diet that may improve insulin sensitivity. This practice merits study in the setting of pregnancy, as the diet is common, pregnancy represents a critical period for the health of both mother and offspring, and the effects of TRF during pregnancy on maternal gestational health and long-term offspring consequences remain unexamined.
To test these effects, female mice were randomized to 6 hours of food availability in the dark cycle (early-time restricted feeding, eTRF), or given 24-hour ad libitum (AL) food access. After one week of acclimatization, females were mated. Food intake and body composition were measured weekly throughout gestation; insulin sensitivity was assessed at day 16 of pregnancy. Offspring birth rate, survival, birthweight, and gestational age were assessed. Body composition and food intake were assessed weekly. After 70 days on a normal diet, all offspring were switched to a 45% high-fat diet (HFD) with continued weekly monitoring. Glucose tolerance and insulin tolerance tests were conducted before and after 10 weeks of HFD feeding. Our data suggests that maternal eTRF does not affect birth weight or gestational age, but does reduce litter size (7.7 pups vs. 6.0 pups) and 3-day pup survival (95% vs. 58%) compared to AL. eTRF offspring had similar insulin and glucose tolerance compared to AL counterparts until adulthood (70 days of age). After 12 weeks of high-fat diet feeding, eTRF males develop concomitant glucose intolerance (auc, p&lt;0.0001) and insulin sensitivity (auc, p=0.006), which was absent in females. These metabolic changes were present despite eTRF males having similar fat mass, body weight, and food intake when compared to AL males. Taken together, these data suggest that eTRF during pregnancy followed by offspring HFD feeding results in male-specific impaired glucose metabolism. Further work planned will evaluate the role of pancreatic islet insulin secretion in vivo and in vitro in future cohorts.

Disclosure
M. E. Carter: None. N. El habbal: None. D. S. Snyder: None. J. R. Redd: None. B. Gregg: None. D. Bridges: None.

Funding
National Institute of Diabetes and Digestive and Kidney Diseases (R01DK107535); University of Michigan
999-P: A Study to Assess Occurrence of NAFLD and Liver Fibrosis in Patients with T2DM and Associated Factors
Authors: NAWAL C.L. , YADAV ABHISHEK , MANGAL PANKAJ , SINGH ARADHANA 
Published: June 2021

Introduction: NAFLD has become the most common cause of chronic liver disease worldwide. With increase in DM patients, incidence of NAFLD has been on the rise. AIM of our study is to assess frequency and severity of NAFLD and liver fibrosis among T2DM patients using non-invasive approach by ultrasonography (USG) and Fibroscan.
Materials and Methods: We conducted a hospital based, observational and cross-sectional study on 100 patients aged &gt;18 years, diagnosed with T2DM based on ADA 2018 criteria. USG and Fibroscan were used for assessment of frequency and severity of steatosis and liver fibrosis.
Results and Discussion: NAFLD was detected on USG in 52 out of 100 T2DM patients. These 52 patients were further evaluated for presence of liver fibrosis via Fibroscan, where 27 patients (51.9%) had mild fibrosis, 14 patients (26.9%) had significant fibrosis and 11 patients (21.2%) had severe liver fibrosis, thus revealing high proportion of NAFLD patients with significant and severe liver fibrosis. Proportion of NAFLD was more in patients with T2DM having high BMI (≥25kg/m2) and high waist circumference (WC) (p value &lt;0.001) as compared to T2DM patients with normal BMI and WC.
Conclusion: NAFLD and liver fibrosis adds to the burden of disease in people living with diabetes. Early detection of steatosis and liver fibrosis using non-invasive techniques as USG and Fibroscan, aids in early detection of the condition, enabling early appropriate interventions to prevent or manage its grave complications.

Disclosure
C. Nawal: None. A. Yadav: None. P. Mangal: None. A. Singh: None.
Pengembangan Modul Termokimia Berbasis Inkuiri Terstruktur untuk Kelas XI SMA
Authors: Novia Novia , Azhar Minda 
Published: June 2021

Thermochemistry is a topic of many chemical reaction equations and calculations so that students experience difficulties in learning. The purpose of this research is to develop a structured inquiry-based thermochemistry module 11th grade and reveal the validity and practice of developed modules. Research and development (R&D) is a type of research that is developed. There are 4 4-D models: Define; design; develop; and disseminate. This study only up to the stage of development, the test validity and practical.The research instrument used an observation sheet questionnaire The results of the analysis of the validity test data obtained kappa moment of 0.76 which is categorized as high. Obtained the mean kappa moment from the teacher of 1 is categorized as very high in the analysis of practicality test data and from students 0.94 is category as very high. Based on the results of this study, the structured inquiry-based thermochemistry module for 11th grade is valid and practical. Materi termokimia adalah materi yang banyak persamaan reaksi dan perhitungan kimia sehingga siswa kesulitan belajar. Tujuan penelitian ini ialah untuk mengembangkan modul termokimia berbasis inkuiri terstruktur kelas XI SMA dan mengungkapkan valid dan praktisnya modul yang dikembangkan. Penelitian dan pengembangan (R&D) adalah jenis penelitian yang dikembangkan. Ada 4 model 4-D yaitu: pendefisian (define); perancangan (design); pengembangan (develop); dan penyebaran (disseminate). Penelitian ini hanya sampai tahap pengembangan, yaitu uji kevalidan dan kepraktisan. Instrumen penelitian menggunakan angket lembar observasi. Hasil analisis data uji kevalidan diperoleh momen kappa rata-rata sebesar 0,76 dikatergorikan tinngi. Diperoleh momen kappa rata-rata dari guru sebesar 1 dikategorikan sangat tinggi analisis data uji kepraktisan dan dari siswa 0,94 dikategorikan sangat tinggi. Berdasarkan hasil penelitian tersebut maka modul termokimia berbasis inkuiri terstruktur kelas XI SMA sudah valid dan praktis.
Blood serum amino acid pool violation of in patients with liver cirrhosis
Authors: Balazh O. P. 
Published: June 2021

Objective. To investigate serum amino acid pool changes in patients with liver cirrhosis.
Materials and methods. 95 patients with liver cirrhosis were participated in the study. In the 1st group (class A disease severity according to Child- Pugh score) there were 18 (18.95%) patients, in the 2nd group (class B) - 25 (26.3%), in the 3rd groups (class C) - 52 (54.7%) patients. The amount of free amino acids in blood serum was determined by reversed-phase high-performance liquid chromatography in isocratic elution mode with electrochemical detection.
Results. Violations of free amino acid reserves were revealed in patients with cirrhosis of the liver with a predominant accumulation of aromatic amino acids: phenylalanine - (162.45 ± 14.12) nmol/ml, tyrosine - (99.05 ± 10.07) nmol/ml, tryptophan - (76.10 ± 12.40) nmol/ml, as well as an increase in the content of proline, lysine, cysteine (p <0.05) . In parallel, the decreasing of free serum amino acids with branched side chain levels were observed: valine - up (150.10 ± 8.92) nmol/ml leucine - up (75.14 ± 5.12) nmol/ml (p < 0.05) and isoleucine - up to (80.40 ± 8.01) nmol/ml.
Conclusions. The correlation between the second degree of thick guts dysbiosis and increased levels of tryptophan was determined (r = 0.77; p <0.01). III degree thick dysbiosis was correlated with increasing levels of phenylalanine (r = 0.71; p <0.01). In patients of 2nd group the correlations between levels of tryptophan and II degree of intestinal dysbiosis (r = 0.58; p <0.01) and the levels of tyrosine in phenylalanine in III stage intestinal dysbiosis were detected.
Risk stratification in patients with coronary heart disease before cardiac surgery
Authors: Gogayeva O. K. , Rudenko A. V. , Lazoryshynets V. V. 
Published: June 2021

Objective. To analyse the risk stratification effectiveness for calculators EuroSCORE I, EuroSCORE II, STS in patients with ischemic disease before cardiac surgery.
Materials and methods. Retrospective analysis of data was conducted from randomized 194 patients with coronary artery disease who were discharged from the Amosov National Institute of Cardiovascular Surgery after coronary artery bypass surgery in the period 2009 - 2019. An average age of patients was (64.2 ± 8.9). In all patients clinical and laboratory studies, echocardiography, electrocardiography, coronary angiography as well as surgical revascularization were conducted. Preoperative risk stratification was performed using three available calculators Euro SCORE I, EuroSCORE II and STS.
Results. There was no mortality in the study group of patients, while the predicted surgical mortality on the EuroSCORE I scale was 25.02%, EuroSCORE II - 7.78%, STS - 2.84%. According to the results of twenty years period of the Amosov National Institute of Cardiovascular Surgery in the surgical treatment of coronary heart disease in more than 15,000 patients, mortality from coronary heart disease was less than 0.6%, which is much less than the predicted mortality rates.
Conclusions. Prior to surgery, risk stratification of patients should be performed on appropriate scales to understand their baseline status. The EuroSCORE II scale is optimal for use in modern cardiac surgery. Surgery in patients with a high estimated risk (EuroSCORE II> 5%) should be performed by an experienced cardiac surgeon with more than 10 years of cardiac surgery experience.