bluuebunny/crossref_metadata_2025_split huggingface dataset:
1670-P: Demographic and Clinical Correlates of Diabetes Autoantibody Positivity among 20- to 45-Year-Olds with New-Onset Diabetes
Authors: LAWRENCE JEAN M. , SLEZAK JEFF , LI XIA , YU LIPING , REWERS MARIAN , TAKHAR HARPREET S. , SRIDHAR SNEHA B. , VEGA-DAILY LETICIA I. , ALEXANDER JANET G. , RITCHIE JENNA , SAYDAH SHARON , IMPERATORE GIUSEPPINA , FERRARA ASSIAMIRA ,   FOR THE DIABETES IN YOUNG ADULTS (DIYA) STUDY
Published: June 2019

Little is known about the prevalence of diabetes autoantibodies (DAA) among young adults newly diagnosed with diabetes (DM). Our objective was to identify patient characteristics associated with presence of DAA among 20-45-year-olds with new-onset DM from 2.3 million Kaiser Permanente California members.
Patients underwent research testing for GADA, ZnT8A, IA2A and IAA. IAA results were not counted for patients with prior insulin use. Demographic and clinical data were from electronic health records. Models predicting any DAA positivity were trained on 70% of cases and validated on the remaining 30%. The best predictive logistic regression model was based on area under the receiver operating characteristic curve (AUC), parsimony and interpretability.
Of 7,862 patients with incident DM (mean age 36.8±6.0 years, BMI 37.1 ±8.7), 1,669 (mean age 36.9 ±6.0 years, BMI 37.2 ±9.2) were tested for DAA ∼9.5 (±3.6) months post-diagnosis; 130 (7.8%) were positive (5.4% single DAA, 2.4% multiple DAA). Prevalence of GADA was 6.1%, IA2A 2.0%, IAA 1.9%, and ZnT8A 1.7%. The best model (Table) yielded AUCs of 0.74 and 0.68 in training and validation datasets, respectively. Association with DAA was positive for younger age, lower BMI, and glucagon prescription and negative for Asian race.
These findings provide insights into patient characteristics associated with antibody positivity in young adults.

Disclosure
J.M. Lawrence: None. J. Slezak: None. X. Li: None. L. Yu: None. M. Rewers: None. H.S. Takhar: None. S.B. Sridhar: None. L.I. Vega-Daily: None. J.G. Alexander: None. J. Ritchie: None. S. Saydah: None. G. Imperatore: None. A. Ferrara: None.

Funding
Centers for Disease Control and Prevention (1U18DP006289); JDRF (2-SRA-2018-533-S-B)
1681-P: Polyendocrinopathy in Type 1 Diabetes: A Transatlantic Comparison
Authors: HERMANN JULIA , MILLER KELLEE , SZINNAI GABOR , FOSTER NICOLE C. , KAPELLEN THOMAS M. , DIMEGLIO LINDA , FRÖHLICH-REITERER ELKE , MCGILL JANET B. , HOLL REINHARD W. , MAAHS DAVID M. ,   FOR THE T1D EXCHANGE CLINIC NETWORK, FOR THE DPV INITIATIVE
Published: June 2019

Type 1 diabetes (T1D) is associated with additional autoimmune and endocrine disorders; however, their prevalences internationally are poorly understood. We analyzed 22,632 patients from the U.S. T1D Exchange (T1DX) registry (median age 18 years) and 38,470 patients from the German/Austrian DPV registry (median age 16 years) with T1D duration ≥1 year (median duration 10 and 6 years, respectively) with data between 01/2016 and 03/2018. Reported prevalences of thyroid disease, arthritis, Addison’s disease, and atrophic gastritis were compared using logistic regression models with registry, age group, and sex as covariates. Thyroid disease was more frequent in the T1DX, whereas arthritis was more frequent in the DPV. Prevalence increased with age in both registries. We found no significant differences between T1DX and DPV for Addison’s disease (Figure). Atrophic gastritis was rare in both registries (T1DX: n=3, DPV: n=21). After adjustment for age, thyroid disease was about twice as frequent in females compared with males (T1DX: 25 vs. 13%, DPV: 15 vs. 7%, both p&lt;0.001). Likewise, arthritis was more frequent in females (T1DX: 0.23 vs. 0.16%, p=0.034; DPV: 1.45 vs. 0.88%, p&lt;0.001), whereas Addison’s disease did not differ significantly by sex. Despite different prevalences, patterns of disease frequencies by age and sex were comparable in both registries. However, standardized clinical diagnoses are needed for valid comparisons between countries.

Disclosure
J. Hermann: None. K. Miller: None. G. Szinnai: None. N.C. Foster: None. T.M. Kapellen: None. L. DiMeglio: Research Support; Self; Amgen Inc., Caladrius Biosciences, Inc., Janssen Research & Development, Medtronic, Sanofi. Other Relationship; Self; Dexcom, Inc. E. Fröhlich-Reiterer: None. J.B. McGill: Advisory Panel; Self; Boehringer Ingelheim Pharmaceuticals, Inc., Gilead Sciences, Inc., Novo Nordisk Inc., Sanofi US. Research Support; Self; Dexcom, Inc., Medtronic, Novartis AG, Sanofi US. Speaker's Bureau; Self; Aegerion Pharmaceuticals, Dexcom, Inc., Janssen Pharmaceuticals, Inc., MannKind Corporation. R.W. Holl: None. D.M. Maahs: Advisory Panel; Self; Novo Nordisk Inc. Consultant; Self; Abbott, Sanofi. Research Support; Self; Dexcom, Inc., Tandem Diabetes Care.

Funding
German Center for Diabetes Research; The Leona M. and Harry B. Helmsley Charitable Trust; German Center for Diabetes Research; German Diabetes Association; European Foundation for the Study of Diabetes; INNODIA
1840-P: Pioglitazone Increases Metabolic Insulin Clearance (MCRI) in IGT Subjects: The ACT NOW Study
Authors: GASTALDELLI AMALIA , TRIPATHY DEVJIT , DEFRONZO RALPH A. ,   NOW ACT INVESTIGATORS
Published: June 2019

Recent studies have documented that the MCRI plays a major role in determining the plasma insulin response to ingested glucose. We evaluated the long-term effect of pioglitazone (PIO) on MCRI in 441 IGT subjects (ACT NOW study) who were randomized to PIO (45 mg/day) or placebo and followed for an average of 2.4 years. OGTT was performed at baseline and study end. 50 placebo-treated subjects developed type 2 diabetes versus 15 PIO-treated subjects (p&lt;0.005). Insulin secretion rate (ISR) was measured from deconvolution of plasma C-peptide curve. MCRI was measured as ISR/mean insulin conc during OGTT. Data were correlated with changes in liver enzymes and peripheral insulin sensitivity measured with the Matsuda index (MI).
Results: PIO improved MI from to 3.9 ±1 to 7.5 ±3 (p&lt;0.0001), glucose tolerance (mean glucose OGTT from 172±2to 148±1mg/dl, p&lt;0.0001) and reduced ALT(from 30±1 to 24±1, p&lt;0.0001). Fasting insulin secretion increased in the placebo group (420 ±14 to 558 ±21 pmol/min, p &lt; 0.0001 vs. baseline) and did not change in the PIO group (411 ±14 to 446 ± 19; p &lt;0.0001, PIO vs. placebo). During the OGTT (0- 120 min) ISR increased in both groups (PIO, 165 ±3 to 189 ± 5 nmol; placebo, 167 ±3 to 202 ±6; p &lt; 0.0001 vs. baseline in both groups; p = NS, PIO vs. placebo).The MCRI increased in both groups but the increase was much greater in PIO (3.5 ± 0.2 to 6.0±0.2 ml/min; placebo, 3.5 ± 0.1 to 4.7±0.2; p &lt; 0.0001 vs. baseline in both groups; p &lt;0.0001, PIO vs. placebo). In the whole dataset the improvement in insulin clearance was associated with improvement in peripheral insulin sensitivity (r=0.62, p&lt;0.0001), the reduction in mean plasma glucose concentration during OGTT (r=-0.31, p&lt;0.0001) and decrease in ALT (r=-0.14, p&lt;0.009).
Conclusion: PIO treatment results in an increase in MCRI that is associated with improved hepatic function, glucose metabolism and peripheral insulin sensitivity.

Disclosure
A. Gastaldelli: Consultant; Self; A. Menarini Diagnostics, Eli Lilly and Company, Genentech, Inc., Gilead Sciences, Inc., Inventiva Pharma. D. Tripathy: None. R.A. DeFronzo: Advisory Panel; Self; AstraZeneca, Boehringer Ingelheim Pharmaceuticals, Inc., Elcelyx Therapeutics, Inc., Intarcia Therapeutics, Inc., Janssen Pharmaceuticals, Inc., Novo Nordisk Inc. Research Support; Self; AstraZeneca, Boehringer Ingelheim Pharmaceuticals, Inc., Janssen Pharmaceuticals, Inc., Merck & Co., Inc. Speaker's Bureau; Self; AstraZeneca, Novo Nordisk Inc.
Urinary nephrin is earlier, more sensitive and specific marker of diabetic nephropathy than microalbuminuria
Authors: Kostovska Irena , Trajkovska Tosheska , Topuzovska Sonja , Cekovska Svetlana , Spasovski Goce , Kostovski Ognen , Labudovic Danica 
Published: June 2019

Summary

Background
Diabetic nephropathy (DN) is a leading cause of end-stage renal disease. Progressive damage and decline in the number of podocytes often occur in the early stages of DN. Thus, nephrin as a podocyte-specific protein may be regarded as a potential biomarker of early detection of DN. The aim of this study is to determine whether urinary nephrin is an earlier marker in DN than microalbuminuria and to test the significance of urinary nephrin as a marker for early detection of DN.

Methods
Our cross-sectional study included 90 patients with type 2 diabetes mellitus (T2DM), 30 patients with diagnosed DN and 60 patients without diagnosed DN. As a control group, we used 30 healthy subjects. All patients with T2DM were classified into three subgroups according to urinary microalbumin/creatinine ratio (UMCR): normoalbuminuric, microalbuminuric and macroalbuminuric patients. Nephrin in urine was measured by immunoenzyme assay, microalbumin with turbidimetric and creatinine with the photometric method. In blood sera, we measured a few standard biochemical parameters.

Results
Nephrinuria was found to be present in 100% of patients with T2DM and macroalbuminuria, in 88% with microalbuminuria, as well as 82% of patients with T2DM and normoalbuminuria. A concentration of urinary nephrin was significantly increased in all groups of subjects with T2DM compared to the control group (p<0.05). Nephrinuria correlated statistically negative with eGFR (r=-0.54). ROC analysis showed that nephrin has a total predicted probability of 96% in patients with DN.

Conclusions
Urinary nephrin is earlier, more specific and sensitive marker than microalbumin in early detection of DN.
The Effect of Zero Copayments on Medication Adherence in a Community Pharmacy Setting
Authors: Jimenez Melissa , Alvarez Goar , Wertheimer Albert , Lai Leanne , Koh Leroy , Martinez Dainelys , Hijazi Bushra , Weinstein Mark 
Published: June 2019

Background: Prescription medication copayments can be a financial burden to many patients. When patients cannot afford their medications, they may become nonadherent, and as a result, this can lead to an increase in chronic disease complications and healthcare costs.
Objective: The objective of this study was to determine if zero copayments have an effect on medication adherence in a community pharmacy.
Methods: This retrospective cohort study examined the prescription refill records of patients who filled specific generic medications for hypertension, hyperlipidemia, and gastroesophageal reflux disease (GERD) in 2016 at the NSU Clinic Pharmacy. The adherence rates of patients with zero copayments were compared to the adherence rates of patients with copayments greater than $0. Adherence was determined by calculating the proportion of days covered (PDC). Patients were considered adherent if their PDC was greater than or equal to 80%.
Results: GERD patients with no copayments had average PDC ratios of 87.4% and were statistically significantly more adherent than GERD patients with copayments, who had average PDC ratios of 76.7% (P = 0.042). Hyperlipidemia and hypertension patients with no copayments had average PDC ratios of 89.3% and 90.3%, respectively, and those with copayments had PDC ratios of 85.3% (P = 0.314) and 87.9% (P = 0.534).
Conclusion: Overall, patients with $0 copayments had higher adherence rates than patients with copayments greater than $0. GERD patients with no copayments were significantly more adherent than GERD patients with copayments. However, no statistically significant difference was found between patients with or without copayments in the hyperlipidemia and hypertension cohorts. Further studies are recommended to analyze additional factors that may influence medication adherence.

Article Type: Original Research
Geração de si mesmo
Authors: Wiebe Sean , Sameshima Pauline 
Published: June 2019

Neste artigo, os autores ilustram como os sujeitos criativos podem usar um aspecto específico do modelo Praxis Parallaxic da PaulineSameshima, o “Processo de Catequização”. Eles descrevem os passosprocessuais e as possibilidades de catequese, um processo que a Sameshima desenvolveu para promover o significado e a geração de criatividade na pesquisa. O processo beneficia sujeitos criativos em vários campos e pode ser aplicado sempre que as investigações ocorrem por meio da criação em artes. Nesta explicação, os autores compartilham sete poemas de resposta criados no Processo de Catequização para teorizar o espaço imaginativo de produzir conhecimento por meio da investigação. Quando pesquisadores podem se imaginar como sujeitos criativos e experimentam mais estratégias para gerar novas ideias, seu trabalho abre novas possibilidades de compreensão.
РАЗВИТИЕ АГРОТУРИЗМА В ТЮМЕНСКОЙ ОБЛАСТИ
Authors: Дегтярева Екатерина Владимировна , Куприна Анна Викторовна , Лейман Галина Евгеньевна 
Published: June 2019

Цель работы. Целью работы является анализ состояния и перспектив развития агротуризма на территории Тюменской области. Метод и методология проведения работы. Исследование базируется на методах анализа, сопоставления данных. Основой работы послужили исследования в данной отрасли как отечественных, так и зарубежных практиков и ученых. Результаты. Сегодня на рынке туристских услуг существует много различных видов, которые довольно необычны по форме и предназначению. Каждый может выбрать на свой цвет и вкус. Достаточно новое и необычное для среднестатистического туриста направление – это сельскохозяйственный или аграрный туризм. Для внутреннего потребителя, абсолютно необычного и диковинного, сельский туризм может быть не совсем понятен, поэтому требует более пристального рассмотрения. В этой статье авторы рассматривают понятие сельского туризма, а также оценивают потенциал территории Тюменской области в развитии аграрного туризма. Область применения результатов. Результаты данного исследования могут использоваться органами государственной власти на уровне муниципальных образований, а также регионов при формировании системы управления развитием рынка туруслуг на своей территории. Также данные статьи будут полезны и представителям хозяйствующих субъектов, желающим заниматься оказанием туруслуг в сфере агробизнеса. Выводы. Агротуризм является малозатратной и весьма рентабельной сферой туриндустрии. Для его развития необходимо решить следующие моменты: разработать комплекс экскурсионных программ, ориентированных на различных посетителей; обеспечить обустройство экологических маршрутов, разработать и внедрить систему их сертификации; учитывать международный опыт при разработке и реализации проектов аграрного туризма, создавать единое рекламно-информационное пространство; разработать программу господдержки хозсубъектов сферы аграрного туризма.
СРАВНИТЕЛЬНЫЙ АНАЛИЗ СОСТОЯНИЯ МОЛОЧНОЙ ОТРАСЛИ
Authors: Андреев Кирилл , Киселица Елена Петровна , Селюк Александр Владимирович , Куприна Анна Викторовна 
Published: June 2019

Цель работы. Целью работы является сравнительный анализ состояния молочной отрасли в Тюменской, Курганской, Свердловской областях, а также в Ханты-Мансийском автономном округе-Югре и Ямало-Ненецком автономном округе.
Метод и методология проведения работы. Исследование базируется на методах анализа, сопоставления данных. Основой работы послужили исследования в данной отрасли как отечественных, так и зарубежных практиков и ученых. Результаты. Снижению покупательской способности населения страны способствует сложная экономическая обстановка и девальвационные риски. Кроме того, цены на молочную продукцию в 2015–2017 гг. повысились в результате роста себестоимости производства молочной продукции. Данные факторы привели к сокращению потребительского спроса на продукцию молочной отрасли. Низкий спрос на продукты переработки молока и рост импортных поставок более дешевой продукции в первом полугодии 2016 г. способствовали сокращению темпов наращивания производства отечественных молочных продуктов. В частности, сокращение объемов отечественного производства таких относительно дорогих молочных продуктов, как сливочное масло и сыр, связано с ростом импортных поставок более дешевых аналогов и невысоким платежеспособным спросом. Область применения результатов. Результаты данного исследования могут использоваться органами государственной власти на уровне муниципальных образований, а также регионов при формировании системы управления развитием молочной отрасли на своей территории. Выводы. Снижение объема потребления молочной продукции и, соответственно, спроса на нее связано с негативными тенденциями в экономике, в частности, снижение покупательной способности граждан, рост цен на молочную продукцию, повышение себестоимости производства молока и молочных продуктов. Для решения выявленных проблем необходим комплексный подход, который обеспечит устойчивое развитие молочной отрасли, создаст условия для повышения качества и увеличения объемов производства молока и молочных продуктов.
Identifikasi Staphylococcus aureus dan Uji Sensitivitas terhadap Antibiotik dari Sampel Darah Pasien Sepsis di RSUD Dr. Moewardi
Authors: Elvira Elvira , Puspawati Nony , Wibawa Dionysius Andang Arif 
Published: June 2019

Sepsis adalah sindroma klinis yang disebabkan oleh infeksi dan ditandai dengan beberapa gejala klinis meliputi hipotermia, leukositosis atau lekopenia, takikardi dan takipnea. Sepsis dapat disebabkan oleh bakteri Gram negatif, bakteri Gram positif, jamur, virus dan parasit. Staphylococcus aureus merupakan salah satu bakteri penyebab sepsis. Terapi utama penderita sepsis yaitu dengan antibiotik. Penelitian ini bertujuan untuk mengetahui adanya Staphylococcus aureus pada sampel darah pasien sepsis di RSUD Dr. Moewardi dan uji sensitivitas terhadap antibiotik.
Penelitian ini menggunakan metode analitik observasional dengan pendekatan Cross-Sectional yaitu pengujian sensitivitas bakteri terhadap antibiotik dengan metode difusi. Penelitian ini dilakukan dengan cara mengisolasi bakteri Staphylococcus aureus dalam sampel darah pasien sepsis di RSUD Dr. Moewardi yang kemudian diuji sensitivitasnya terhadap antibiotik.
Hasil penelitian menunjukkan dari 30 sampel darah pasien sepsis di RSUD Dr. Moewardi didapatkan 16 sampel teridentifikasi positif Staphylococcus aureus (53%). Hasil uji sensitivitas menunjukkan bahwa Staphylococcus aureus 100% sensitif terhadap antibiotik vankomisin dan kloramfenikol; 50% sensitif, 31% intermediate dan 19% resisten terhadap antibiotik tetrasiklin; 6% sensitif, 44% intermediate dan 50% resisten terhadap antibiotik eritromisin; 100% resisten terhadap antibiotik amoksisilin dan linezolid.
Improvement of motor performance in children with cerebral palsy treated with exoskeleton robotic training: A retrospective explorative analysis
Authors: Digiacomo Fabio , Tamburin Stefano , Tebaldi Stefano , Pezzani Marco , Tagliafierro Mario , Casale Roberto , Bartolo Michelangelo 
Published: June 2019

Background: Robot-assisted gait training (RAGT) is widely used in children with cerebral palsy (CP), but information about optimal intervention frequency and duration is still lacking and the current evidence about effect of RAGT on motor endurance and fitness is very preliminary. Objective: To investigate the effect of RAGT on motor performance and endurance in children affected by CP. Methods: Data from 14 consecutive children (6 females, age range: 4.6–15.8 years) affected by CP, who underwent a multidisciplinary rehabilitation program during a 18–24 month period, were retrospectively collected. Rehabilitation program included conventional physical therapy and RAGT (60/60 minutes, 20 daily sessions, 5 days/week). CP severity was stratified according to the Gross Motor Function Classification System. Clinical evaluation was performed by means of the six-minute walking test, the modified Ashworth scale, and RAGT measures (total distance, mean distance for session and speed). Results: Clinical outcomes and speed did not improve after treatment, while total distance ( p = 0.006) and mean distance for session ( p = 0.007) significantly improved. Conclusions: Our preliminary study suggests that RAGT combined with conventional treatment may improve motor performance and endurance in children with CP. Future randomized controlled trials comparing RAGT to conventional treatment are needed.
Skill-mix change in general practice: a qualitative comparison of three ‘new’ non-medical roles in English primary care
Authors: Nelson Pauline A , Bradley Fay , Martindale Anne-Marie , McBride Anne , Hodgson Damian 
Published: June 2019

BackgroundGeneral practice is currently facing a significant workforce challenge. Changing the general practice skill mix by introducing new non-medical roles is recommended as one solution; the literature highlights that organisational and/or operational difficulties are associated with skill-mix changes.AimTo compare how three non-medical roles were being established in general practice, understand common implementation barriers, and identify measurable impacts or unintended consequences.Design and settingIn-depth qualitative comparison of three role initiatives in general practices in one area of Greater Manchester, England; that is, advanced practitioner and physician associate training schemes, and a locally commissioned practice pharmacist service.MethodSemi-structured interviews and focus groups with a purposive sample of stakeholders involved in the implementation of each role initiative were conducted. Template analysis enabled the production of pre-determined and researcher-generated codes, categories, and themes.ResultsThe final sample contained 38 stakeholders comprising training/service leads, role holders, and host practice staff. Three key themes captured participants’ perspectives: purpose and place of new roles in general practice, involving unclear role definition and tension at professional boundaries; transition of new roles into general practice, involving risk management, closing training–practice gaps and managing expectations; and future of new roles in general practice, involving demonstrating impact and questions about sustainability.ConclusionThis in-depth, in-context comparative study highlights that introducing new roles to general practice is not a simple process. Recognition of factors affecting the assimilation of roles may help to better align them with the goals of general practice and harness the commitment of individual practices to enable role sustainability.