bluuebunny/crossref_metadata_2025_split huggingface dataset:
979-P: Glycemic Improvements in CGM-Naïve Patients during SMBG and Implantable CGM Use
Authors: TWEDEN KATHERINE S. , ROMAROWSKI BEN , MDINGI COLLEEN , KAUFMAN FRANCINE R. 
Published: June 2023

Background: Multiple pivotal and post market studies have confirmed the safety and accuracy of implantable Eversense CGM Systems. A post market study was initiated to compare Eversense 90-day and 180-day systems to SMBG in CGM naïve patients. Methods: This post market study is a prospective, multicenter, one year comparison of SMBG to Eversense in CGM naïve adults with diabetes in US sites (up to 925 users). After baseline assessment including HbA1c, patients used SMBG for 6 months (phase 1) followed by Eversense for 6 months (phase 2). Sensors were inserted at the start of phase 2. Visits occurred q 90 days to collect SMBG or CGM data and assess adverse events. HbA1c was measured at 6 and 12 months. Glucometrics were calculated in both phases. Enrollment and follow-up visits are ongoing.
Results: In 15 sites, 84 users have completed the study (mean 47.6% male, 90.5% type 2 diabetes, 57.2 years age). In the initial users, reductions in HbA1c were seen in both phases and improvements in glucometrics were observed (Table) with CGM compared to SMBG.
Conclusion: In a CGM naïve population, 6 months of SMBG use reduced HbA1c. There was a further significant reduction after 6 months of using Eversense CGM, as well as significant improvement in glucometrics - an increase in Time in Range (70-180 mg/dL) with no increase Time below Range. These data suggest that Eversense CGM improves glucose management compared to SMBG.

Disclosure
K.S.Tweden: Employee; Senseonics. B.Romarowski: Employee; Senseonics. C.Mdingi: Employee; Senseonics. F.R.Kaufman: Consultant; MannKind Corporation, Twin Health, Stock/Shareholder; Senseonics.
980-P: Quantitatively Integrating Carbohydrate Counting, Insulin (I), and Continuous Glucose Monitoring (CGM)
Authors: MELISH JOHN S. 
Published: June 2023

Introduction: Diabetes Care Education Specialists teach patients with insulin requiring Type 1 and 2 diabetes to develop CHO/I ratios to manage mixed diet glucose (G) excursions and improve A1c. and qualitatively examine summary CGM data when available. Conversely, medical scientists have used complex mathematical models, with/without radiolabeled glucose to describe meal-related glucose excursions.
Method: This study bypasses the above complexities as CGM regularly measures interstitial fluid glucose (ISFG) over time. CGM can define an individual’s meal specific G/I ratio as well as define Glucose Clearance (GCL) and Insulin Sensitivity Index (Si}. The approach uses referenced meal carbohydrate information (mg CHO). CGM frames the timing (T = t1 - t0) and amount (I) administered before the timed glucose excursion and return to baseline (t2 - t1). This and an Interstitial fluid (ISF) Volume of Distribution (Vd in dL) = 0.15*kg body weight*10 corrected for blood glucose values defines Timed Insulin Glucose Clearance ((T,I)GCL) = (T,I)Vd/(t2 - t1) and (T,I)Si = (T,I)GCL/I). (ISF) glucose for that meal.: Gisf = dietary glucose (Gd)/1.1. Rate Glucose disappearance from ISF space Gisf/(t2 - t1).
Discussion: The above parameters are patient specific and refer to the insulin related glucose disposal for that meal. They assess the glucose excursion using the timing and amount of insulin as well the inferring effect of the other dietary components, e.g., protein and fat that contribute to T, and t2 - t1. It avoids complicated descriptions of the glucose curve as it begins with glucose input. It includes hepatic glucose uptake and glucose production, as well as insulin resistance as these are reflected in prolonging of t1-t0 and t2 - t1.
Conclusion: CGM has provided the time values for the onset and duration of the meal-related glucose concentration curve. As with Vg, this will assist a patient to develop individualized (I) responses to complex meals using parameters unavailable before CGM.

Disclosure
J.S.Melish: None.
982-P: Effects of Digitization of Self-Monitoring of Blood Glucose Records Using a Mobile Application and the Cloud System on Glycemic Control and Self-Management in Outpatients with Diabetes
Authors: HANDA TOMOKO , ONOUE TAKESHI , KOBAYASHI TOMOKO , MAEDA RYUTARO , ARIMA HIROSHI 
Published: June 2023

Objective: In this study, we evaluated the impact of an application-cloud cooperation system with feedback from the attending physician during face-to-face visits on outpatient management of diabetes.
Research Design and Methods: In this multicenter, open-label, single-armed prospective study, 48 patients with diabetes treated with insulin or GLP-1 receptor agonists and performing self-monitoring of blood glucose (SMBG) at three medical centers in Japan used the Smart e-SMBG system, an application-cloud cooperation system, for 24 weeks. The SMBG data were automatically uploaded to the cloud via the application. The patients could check their data, and their attending physicians reviewed the data through the cloud prior to the patients’ regular visits. The primary outcome was changes in HbA1c levels.
Results: While HbA1c levels did not change significantly in total patients, it significantly decreased at 12 weeks in 21 patients whose antidiabetic medication had not been adjusted during the intervention period (−0.26%, 95% confidence interval [CI], −0.47 to −0.05; p = 0.018). The frequency of SMBG was increased significantly at 12 weeks (+0.60/day, 95%CI, 0.19-1.00; p = 0.002) and 24 weeks (+0.43/day, 95%CI, 0.02-0.84; p = 0.039) compared to that before inducing the system. The Diabetes Treatment Satisfaction Questionnaire total score and “Q4; convenience” and “Q5; flexibility” scores significantly improved after using the Smart e-SMBG system, and 71.7% patients and 76.1% physicians reported that the Smart e-SMBG system helped them adjust insulin doses.
Conclusions: Digitization of SMBG records and sharing of the results with attending physicians during face-to-face visits improved glycemic control and self-management in patients with diabetes.

Disclosure
T.Handa: None. T.Onoue: None. T.Kobayashi: None. R.Maeda: None. H.Arima: None.
993-P: Changes in Medical Expenditures and Out-of-Pocket Costs in Medicare Beneficiaries with Diabetes during the COVID-19 Pandemic
Authors: WANG YU , ZHANG PING , ZHOU XILIN , ROLKA DEBORAH B. , IMPERATORE GIUSEPPINA 
Published: June 2023

How COVID-19 has affected payers and persons with diabetes mellitus (DM) is not well understood. We compared total and per capita medical expenditures and out-of-pocket (OOP) costs during and before the pandemic periods among Medicare beneficiaries with DM. We used data from all Medicare fee-for-service claims from 03/2019 to 02/2022. We identified 9,376,546 persons with DM using International Classification of Diseases codes. We calculated quarterly population total, per capita total, per capita OOP cost, and then per capita expenditure by service type. Changes in expenditure were calculated as the difference in the same quarter between the pandemic (03/2020~02/2022) and the pre-pandemic (03/2019~02/2020) periods. Population total and total per capita expenditure decreased sharply during the first few months of the pandemic (Figure). Population total expenditure had not returned to the pre-pandemic level while per capita total expenditure reached a higher than the pre-pandemic level by 02/2022. Changes in OOP costs had a similar pattern as the changes in total per capita expenditure, however, OOP costs in the pandemic were lower than the pre-pandemic level during the entire study period. Changes in per capita expenditure varied by service type. COVID-19 had different effects on total and per capita expenditure overall and by service type in Medicare beneficiaries with DM.

Disclosure
Y.Wang: None. P.Zhang: None. X.Zhou: None. D.B.Rolka: None. G.Imperatore: None.
996-P: Cost-Effectiveness of Sugar-Sweetened Beverage Tax Policies in California—A Microsimulation Study
Authors: CHEN YU , IMPERATORE GIUSEPPINA , ROLKA DEBORAH B. , ALLAIRE BENJAMIN T. , ONUFRAK STEPHEN J. , HOLLIDAY CHRISTOPHER S. , ZHANG PING 
Published: June 2023

Sugar-sweetened beverage (SSB) consumption is associated with increased risk of diabetes and cardiovascular diseases. In California, state-wide SSB taxes were proposed to reduce its consumption. We projected the health and economic consequence of imposing a state-wide SSB excise tax of $0.01/ounce over 10 years in California, using the Microsimulation of Nutrition, Diabetes and Cardiovascular Disease (MONDAC) developed by Centers for Disease Control and Prevention and RTI International. The MONDAC model is a validated microsimulation model to track user-defined dietary changes on downstream outcomes: body-mass index, diabetes incidence, cardiovascular disease (CVD) incidence, all-cause mortality, quality-adjusted life-years (QALYs), direct medical costs, and cost-effectiveness. We generated a California representative sample aged ≥ 18 years based on data from the 2011-2014 National Health and Nutrition Examination Survey and 2018 census. Data on reduction of the SSB consumption (by 20%) and program’s costs resulting from the $0.01/ounce SSB taxes were from published literature. We found that imposing a $0.01-per-ounce excise SSB tax in California would reduce diabetes, CVD, deaths and healthcare costs but increase QALYs, thus this policy would be cost-saving (Table).

Disclosure
Y.Chen: None. G.Imperatore: None. D.B.Rolka: None. B.T.Allaire: None. S.J.Onufrak: None. C.S.Holliday: None. P.Zhang: None.
997-P: Social Risk Domains and Emergency Room Visits among Adults with Diabetes and Low Income
Authors: WILLIAMS JONI S. , XU YILIN , BHANDARI SANJAY , OZIEH MUKOSO N. , AKINBOBOYE OLAITAN J. , EGEDE LEONARD E. 
Published: June 2023

Background: In the U.S., more than 34 million adults ≥18 years of age are estimated to have diabetes. Adults with low-income levels are disproportionately impacted. Adverse social conditions associated with poor health, or social risk factors, contribute to poorer access to care, lower quality of care, and worsened clinical outcomes among these adults. The objective of this study was to assess the relationship between social risk domains and hospital utilization among adults with diabetes and low income.
Methods: Data of 5,077 adults with diabetes and income &lt;$50,000 or receiving income or assistance from welfare programs or disability insurance (weighted sample = 41,735,609) from the National Health Interview Survey (NHIS) were analyzed. The outcomes were “Have visited the Emergency Room (ER) about own health in past 12 months (yes/no)”, and “Number of times visited ER in past 12 months”. The independent variables were five social risk domains (economic instability, neighborhood and built environment, education access, food insecurity, social and community context). Covariates included age, sex, race/ethnicity, insurance, marital status, employment, comorbidity, region. Logistic regression models were used to assess the independent association between each outcome and each social risk domain.
Results: In the fully adjusted model, adults with social and community context risks had a 76% higher risk of visiting the emergency room for their own health in the past 12 months. Also, for each unit increase in the number of times an adult visited the emergency room, there was a significant association with economic instability (βeta (β) coefficient=0.39, (95% CI 0.14, 0.64)), food insecurity (β=0.31, (95% CI 0.13, 0.50)), and social/community risk (β=0.54, (95% CI 0.38, 0.70)).
Conclusions: These findings suggest the need for mitigating the influence of social and community factors, economic instability, and food insecurity among adults with diabetes and low income to reduce ER visits.

Disclosure
J.S.Williams: None. Y.Xu: None. S.Bhandari: None. M.N.Ozieh: None. O.J.Akinboboye: None. L.E.Egede: None.

Funding
National Institute of Diabetes and Digestive and Kidney Diseases (K24DK093699, R01DK118038, R01DK120861, R21DK123720)
Metformin for treatment of acute COVID-19: systematic review of clinical trial data against SARS-CoV-2
Authors: Erickson Spencer M. , Fenno Sarah L. , Barzilai Nir , Kuchel George , Bartley Jenna M. , Justice Jamie Nicole , B. Buse John , Bramante Carolyn T. 
Published: June 2023

<p> </p>
<p><strong>Objective: </strong>Observational and preclinical data suggest metformin may prevent severe COVID-19 outcomes. We conducted a systematic review of randomized, placebo-controlled clinical trials of metformin treatment for COVID-19 to determine whether metformin affects clinical or laboratory outcomes in individuals infected with SARS-CoV-2 and a structured summary of pre-clinical data.</p>
<p><strong>Research Design and Methods: </strong>Two independent reviewers searched PubMed, Scopus, Cochrane Covid-19 Study Register, and ClinicalTrials.gov on February 1, 2023 with no date restrictions for trials which randomized adults with COVID-19 to metformin versus control and assessed clinical and/or laboratory outcomes of interest. The Cochrane Risk of Bias 2 tool was used to assess bias. The synthesis plan was developed a priori and was guided by SWiM guidelines. Summary tables and narrative synthesis were used. (PROSPERO 2022 CRD42022349896)</p>
<p><strong>Results: </strong>Three randomized trials met inclusion criteria. Two of the trials found metformin improved clinical outcomes (prevented need for oxygen; and prevented need for acute healthcare use), and the third trial enrolled a larger portion of adults with diabetes but did show a direction of benefit similar to the other trials in the per-protocol group. The largest trial enrolled during the delta and omicron waves and included vaccinated individuals. The certainty of evidence that metformin prevents healthcare utilization due to COVID-19 was moderate per GRADE criteria. Many preclinical studies have found metformin to be effective against SARS-CoV-2. Limitations include inclusion of only three trials and heterogeneity between trials. </p>
<p><strong>Conclusions:</strong> Future trials will help define the role of metformin in COVID-19 treatment guidelines.</p>
Ritual <em>Penti</em> di Tanah Diaspora: Komunitas Manggarai di Kalimantan Barat
Authors: Sunarti Felomena 
Published: June 2023

In order to unite the Manggarai people in West Kalimantan, the Manggarai community leaders on behalf of the “Manggarai people” invited all Manggarai people to discuss the Penti ritual. The meeting resulted in an agreement to hold the Penti ritual. They received support from the Dayak Mualang community, so that the ritual could be carried out. This study describes the similarities and differences of the Penti rituals practiced in Flores and in West Kalimantan. The Penti ritual is held as a form of gratitude for the Manggarai people to God (Mori Keraeng) and their ancestors for their success abroad. The methodology used in this study is the ethnographic imagination methodology introduced by Paul Willis. Concepts used in the analysis of this study are the concepts of crossing and dwelling from Thomas A. Tweed and of liminality and communitas from Victor Turner. This study shows that the Penti ritual practiced by Manggarai people living outside their West Kalimantan hometowns contains important aspects, namely giving thanks to Mori Keraeng (God) and ancestors, fostering family relationships, and introducing the ritual to the younger generation of Manggarai in West Kalimantan.
Politica Uniunii Europene în domeniul concurenței în context pandemic și strategii de adaptare a întreprinderilor
Authors: Lazar Laura 
Published: June 2023

Criza economică declanșată de pandemia COVID-19 și de conflictul armat inițiat de Rusia în Europa a generat provocări fără precedent pentru întreprinderile active pe piața internă europeană și pentru decidenții politici la nivel european.
Politica Uniunii Europene în domeniul concurenței, asemeni politicilor economice ale statelor membre a trebuit să se adapteze la necesitățile de colaborare a întreprinderilor pentru prevenirea perturbărilor majore în lanțul de producție, precum și în vederea asigurării accesului echitabil al consumatorilor la produsele și serviciile esențiale în această perioadă.
Asigurarea aplicării flexibile a normelor politicii UE în domeniul concurenței, precum și găsirea unor strategii noi ai întreprinderilor de adaptare la criza economică, cum ar fi investițiile în activitățile de responsabilitate socială, activități de cercetare dezvoltare pentru crearea unor produse inovative și eficiente, respectiv în marketing poate constitui cheia gestionării situației economice dificile de către întreprinderi și în același timp, o oportunitate de creștere pentru acestea în contextul recesiunii economice.
Articolul redă modificările majore aduse politicii UE în domeniul concurenței în contextul crizei economice și importanța pe care implicarea în activitățile de responsabilitate socială o poate prezenta din perspectiva gestionării crizei de către întreprinderile active la nivel european.
Changes in thrust force in swimmers in the annual training cycle
Authors: Stachowicz Małgorzata , Milde Katarzyna 
Published: June 2023

Abstract

Study aim: Determination of changes in thrust force and effect size of training load in swimmers using four swimming strokes monitored 4 times a year.

Material and methods: Five elite male swimmers were examined in a training macrocycle of 9 months. The swimmers were examined four times: at baseline (September), immediately after the winter Polish Championships (December), at the end of the transition period (March), and immediately after the summer Polish Championships (late May).

Results: In all participants, significant differences in strength (p < 0.001) were observed between measurements I and II (p < 0.001) and between measurements I and IV (p < 0.001). Athletes specializing in the 200 m were characterized by a smaller decline in thrust force. Athletes specializing in breaststroke had significantly higher (p < 0.001) thrust values than the other participants.

Conclusions: It is suggested that the trainers measure the thrust during the preparatory period in order to verify the applied training loads aimed at developing strength, as well as during the starting period to verify the competitor’s strength level in correlation with the sports result.
PENDEKATAN DAKWAH RASULULLAH SAW DI ERA MEKKAH DAN RELEVANSINYA DI ERA MODERN
Authors: Choirin Muhammad 
Published: June 2023

Rasulullah SAW melewati dua fase perjalanan dakwah; Era Madinah dan Era Mekkah. Jika Era Madinah disebut sebagai puncak kesuksesan dakwah Rasullah SAW yang ditandai dengan berdirinya negara berdaulat dibawah fondasi Piagam Madinah, Era Mekkah dinyatakan sebagai era pengokohan; khususnya dalam membangun paradigm ke-Tuhan-an (Theologi Concept) dan pandangan hidup (World View). Makalah ini bertujuan untuk menyelami pendekatan dakwah Rasulullah SAW di era Mekkah. Selain itu juga akan menganalisis sejauhmana relevansi pendekatan tersebut dengan kondisi saat ini. Untuk menjawab persoalan di atas, kajian ini menggunakan metode kualitatif dengan bertumpu pada pendekatan sejarah. Penelitian ini mendapati bahwa berbagai pendekatan efektif telah digunakan oleh Rasulullah SAW. Pendekataan tersebut diambil berdasarkan kesesuian situasi dan kondisi. Hasil dari penelitian yang dilakukan, semua pendekatan Rasulullah SAW masih relevan untuk digunakan pada era kekinian.
Abordagens educacionais para uma arqueologia parente com comunidades tradicionais da RDS Amanã e da FLONA Tefé, Amazonas.
Authors: Silva Mauricio André da 
Published: June 2023

Esta tese tem como objetivo compreender o papel da socialização do patrimônio arqueológico com comunidades tradicionais inseridas em Unidades de Conservação de Uso Sustentável na Amazônia. Foram desenvolvidas ações com as comunidades de Boa Esperança, na Reserva de Desenvolvimento Sustentável Amanã (RDS Amanã), e de Tauary, na Floresta Nacional de Tefé (FLONA Tefé),ambas no Médio Solimões, estado do Amazonas. Foram realizadas escutas das histórias de vida de lideranças mais velhas, de professores/as e jovens, marcadas por um hibridismo entre a educação, a etnografia arqueológica e a história oral em decorrência da localização desta pesquisa na fronteira desses campos disciplinares. Também foram desenvolvidas práticas de educação patrimonial nas localidades, uma demanda constante e antiga das famílias e das escolas. Devido à organização de base comunitária das famílias, ao papel das relações de compadrio e ajuda mútua que mudaram suas histórias de vida, existe uma forte gramática local, que convida para a realização das pesquisas de forma colaborativa. Dessa forma, por meio dos aprendizados com as famílias, são apresentados alguns caminhos para uma tradução possível da arqueologia colaborativa, como uma “arqueologia parente”, que tem em sua centralidade a dialogia inerente aos trabalhos educativos. As ações de socialização se diluem nessa abordagem, pois são constitutivas de qualquer arqueologia realizada com essas comunidades. Também é favorecida a produção de histórias não lineares correlacionada às concepções e às memórias locais da materialidade com o tempo da história de longa duração indígena produzida pela arqueologia. Como resultado, é indicado o impacto latente de nossas práticas junto às famílias, o que faz emergir um rico contexto para a continuidade dos trabalhos, especialmente nessa perspectiva de se “tornar parente”. Também é discutido o contexto propício para a criação de museus comunitários, os quais podem contribuir para o gerenciamento dos referenciais culturais locais e para a gestão do patrimônio arqueológico, compreendido como um meio e não um fim em si mesmo.
Da pré-história à história indígena: (re) pensando a arqueologia e os povos canoeiros do pantanal – Reedição
Authors: Oliveira Jorge Eremites de 
Published: June 2023

Nota dos editores: Esta é a republicação do artigo original de 2003: EREMITES DE OLIVEIRA, J. Da pré-história à história indígena: (Re) pensando a arqueologia e os povos canoeiros do pantanal. Revista de Arqueologia, [S. l.], v. 16, n. 1, p. 71–86, 2003. DOI: 10.24885/sab.v16i1.180, que está entre os mais citados da Revista de Arqueologia da SAB. Realizamos essa republicação como parte da comemoração pelos 40 anos da revista.
Nesta tese de doutorado, o autor analisa criticamente a história e a historiografia da arqueologia pantaneira, desde a segunda metade do século XIX até fins do século XX, e aborda o processo de ocupação indígena das terras baixas do Pantanal, desde os primeiros pescadores-caçadores-coletores do período pré-colonial até os atuais canoeiros Guató. O objetivo maior é contribuir para a composição de uma história indígena total, em seus múltiplos aspectos e perspectivas espaço-temporais, a partir de uma abordagem interdisciplinar que emprega procedimentos teórico-metodológicos próprios da arqueologia, antropologia e história. Para tanto, foram utilizados dados contidos em fontes textuais diversas, informações recolhidas a partir da tradição oral dos Guató e os resultados de pesquisas arqueológicas, etnográficas e etnoarqueológicas. Foi possível demonstrar que a arqueologia pantaneira tem sido pautada pelo estudo de povos pescadores-caçadores-coletores – associados à macrotecnologia ceramista conhecida no Brasil como tradição Pantanal e a estruturas monticulares do tipo aterro – os quais se estabeleceram na região muito antes do início da Era Cristã. Nos dias de hoje, a arqueologia pantaneira reflete as mesmas mudanças de nuance constatadas para a arqueologia brasileira desde a década de 1980. Nos séculos XVI, XVII e XVIII, período de muitas disputas entre Espanha e Portugal pelo domínio do alto Paraguai, foram produzidos vários relatos que atestam a existência de um extraordinário mosaico sociocultural no centro da América do Sul, inclusive de um complexo de povos canoeiros formado por sociedades cultural e linguisticamente distintas. De todas essas sociedades, a dos Guató é a mais conhecida dos pontos de vista etno-histórico e etnológico, estando tradicionalmente organizada em grupos domésticos ligados por laços de consanguinidade, descendência e afinidade, relacionados a um particular sistema de patrilocalidade e patrilinearidade.