bluuebunny/crossref_metadata_2025_split huggingface dataset:
PSUN167 Diabetic retinopathy and diabetes-related renal disease, either isolated or both associated, and the impact on the 10-year risk of cardiovascular disease: are we dealing with similar conditions?
Authors: Maraschin Clara , Alessi Janine , Reis Mateus , Teló Gabriela , Schaan Beatriz 
Published: November 2022

Abstract
Diabetes complications, which includes diabetes-related renal disease (DRD) and retinopathy (DR), may result in worse quality of life, disability and premature death, mainly due to cardiovascular disease. In this context, there has been a growing focus on diabetes-related complications and their impact on chronic outcomes. To assess the association between DR, DRD and the 10-year risk of atherosclerotic cardiovascular disease in patients with diabetes. A cross-sectional study was performed including patients with type 1 diabetes (T1DM) and type 2 diabetes (T2DM) under outpatient follow-up in Southern Brazil. Participants’ data were extracted from medical records between 2019 to 2020. Patients included were stratified into 4 groups: G1(no diabetes-related complications); G2 (RD only); G3 (DRD only); G4 (presence of both RD and DRD). The presence of RD was defined as any alteration related to diabetes identified using a retinal scanning device in the period. For DRD, the presence of reduced estimated glomerular filtration rateand/or albuminuria was considered. The primary outcome was the 10-year risk assessment of cardiovascular events based on the American Heart Association ASCVD score. One-way ANOVA with post hoc Tukey test was used for comparisons. A total of 571 patients were included, of which 128 had T1DM (mean age of 39.4 ± 15.1 years and 48.4% were women) and 443 had T2DM (mean age of 59.5 ± 11.9 years and 66.4% were women). Among T1DM participants, the 10-year risk of a cardiovascular event was 6.1 ± 8.9% in the G1 (124, no diabetes-related complications), 8.9 ± 11.8% in the G2 (54, with RD), 5.4 ± 8.8% in the G3 (149, with DRD), and 6.1 ± 9.5% in the G4 (n=116, with RD and DRD). The mean difference between the groups was not significant. Among T2DM participants, the 10-year risk of a cardiovascular event was 15.2 ± 14.6% in the G1, 15.7 ± 10.7% in the G2, 22.5 ± 16.7% in the G3, and 21.5 ± 15.1% in the G4, reflecting a significantly higher cardiovascular risk in the groups with renal involvement (P &lt;0.001). Post hoc analyses showed that the G3 (with DRD) and G4 (with RD and DRD) had a higher 10-year cardiovascular risk compared to the groups without complications and with RD isolated. This difference persists even when corrected for age, sex, ACE inhibitors use and hypertension [R +4.7 (1.2 a 8.4)and R +3.8 (0.01 a 7.6) in the G3 and G4, respectively]. In T2DM, the presence of specific microvascular complications affects the 10-year cardiovascular risk differently, and the renal involvement seems to be associated with a greater theoretical cardiovascular risk when compared to the presence of RD alone.
Presentation: Sunday, June 12, 2022 12:30 p.m. - 2:30 p.m.
PSUN168 The relationship between vitamin C concentrations and reduced red blood cell deformability in diabetes
Authors: Violet Pierre-Christian , Ebenuwa Ifechukwude , Wilkins Kenneth , Parrow Nermi , Wang Yu , Levine Mark 
Published: November 2022

Abstract

Background
Microvascular angiopathy is a common complication for patients with diabetes. Reduced red blood cell (RBC) deformability in diabetes has been associated with micro- and macrovascular complications such as diabetic nephropathy and coronary artery disease. Preliminary studies in mice have shown an inverse relationship between RBC vitamin C concentrations and RBC deformability measures. This study investigated the relationship between RBC vitamin C concentration and cell deformability measures.

Methods
We analyzed RBC deformability and vitamin C level in a cross-sectional cohort study of individuals with diabetes (n=82) and non-diabetic controls (n=80). Subjects were studied outpatient, with samples obtained following an overnight fast. RBC rigidity parameters defined as SS1/2 (shear stress at which half of the maximum deformability occurs) was assessed using the laser diffraction viscometry ektacytometer (LORRCA, Mechatronics, Netherland). We also quantified osmotic sensitivity by measuring deformability under an osmotic gradient (osmoScan, o-hyper; osmolality corresponding to 50% of the Elmax). Vitamin C in plasma was measured using coulometric electrochemical detection with high performance liquid chromatography. We evaluated the association between these deformability parameters, vitamin C concentration.

Results
Compared to the non-diabetic cohort, the diabetes cohort had significantly lower RBC vitamin C concentration, respectively 28.1µM and 42.9µM (p=0.0013). Low RBC vitamin C concentration was significantly associated with reduce RBC deformability measured by increased SS1/2 (p=0.009). Additionally, low RBC vitamin C was associated with decreased o-hyper, suggesting a decrease dehydration of RBC (p=0.0250).

Conclusion
Our data demonstrate reduced vitamin c levels in the diabetic cohort. Reduced RBC deformability is associated with reduced RBC vitamin C concentration. Thus, reduced vitamin C levels in diabetic patients might increase red blood cell rigidity and reduce deformability.
Presentation: Sunday, June 12, 2022 12:30 p.m. - 2:30 p.m.
PSUN173 Factors determining insulin dose while transitioning from intravenous insulin infusion to subcutaneous insulin in patients with type 2 diabetes following cardiac bypass surgery.
Authors: Bansal Beena , Bansal Manish , Mehta Yatin 
Published: November 2022

Abstract

Introduction
In patients with type 2 diabetes undergoing cardiac bypass surgery, data regarding the factors predicting insulin dose while transitioning from intravenous insulin infusion to subcutaneous insulin are scarce. This study was therefore planned to determine the factors that predict postoperative subcutaneous insulin dose, basal-to-bolus insulin ratio and the factors determining this ratio.

Methods
This is a single centre prospective observational study in 280 consecutive cardiac bypass surgery patients with type 2 diabetes at a tertiary care facility in India.

Results
In linear regression analysis, the subcutaneous insulin dose following cardiac surgery was determined by glycated hemoglobin (HbA1c) at admission (beta 0.34, p &lt;0.0001), insulin dose before surgery (beta 0.33, p &lt;0.0001), sulphonylurea (beta 0.19, p = 0.002), and metformin doses (beta 0.14, p = 0.017) before surgery, and intravenous insulin dose (beta 0.11, p =0.041) after surgery. The basal-to-bolus ratio of insulin after surgery was 0.9, and was negatively predicated by serum creatinine levels and age, and positively by body weight of the patients.

Conclusions
In our study, post-surgery subcutaneous insulin dose after transitioning from intravenous insulin infusion depends on several factors, such as HbA1c and insulin dose before surgery, metformin and sulfonylurea use before surgery and intravenous insulin infusion dose during surgery.
Presentation: Sunday, June 12, 2022 12:30 p.m. - 2:30 p.m.
PSUN174 A Microbiome Targeted Nutraceutical that Induces Endogenous Glucoregulatory Peptide Hormones
Authors: Palmissano Salvator , Ruan Jingyi , Saberi Maziyar 
Published: November 2022

Abstract
Maintaining a narrow and healthy blood glucose range is essential for preventing the progression of microvascular and macrovascular complications associated with glucose dysregulation. It has now been established that secondary metabolites derived from colonic microbiota potentially serve as endogenous secretagogues for glucoregulatory hormone peptides. Specifically, metabolites such as short and medium-chain fatty acids and indole derivatives trigger the secretion of GLP-1 and PYY from the colonic L cells that improve gut motility, modulate insulin, and promote anorexigenic effects. However, secondary metabolites are significantly down-regulated in diets that lack complex carbohydrates and polyphenols, leading to hormonal dysbiosis. To address this need, we developed structural, chemical, and cell-based functional assays to screen a library of prebiotic fibers, polyphenols, and probiotics aimed at the induction of glucoregulatory peptides. Precisely, these ingredients were put through a series of microbiological fermentation assays to produce postbiotic secondary metabolites and subsequently tested as secretagogues on specialized human primary enteroendocrine cells. Prebiotics that significantly induced GLP-1 and PYY in these functional cells were formulated into a lead cocktail: JAN-1000. As a proof of concept, JAN-1000 was tested against an equal dose of single fibers to demonstrate superiority in secondary metabolite production and the induction of key metabolic peptides. JAN-1000 increased SCFAs by 7.9-fold (p&lt;0.0001), indoles by 28.4% (p&lt;0.0001), GLP-1 by 4.7-fold (p&lt;0.0001), and PYY by 3.3-fold (p&lt;0.0001). Furthermore, we initiated a pilot clinical study with healthy volunteers to demonstrate tolerability and efficacy on glucose and lipid homeostasis. A one-month supplementation of JAN-1000 lowered fasting glucose by 10% (p&lt;0.001), lowered iAUC postprandial glucose by 42% (p=n.s.), reduced hypo and hyper-glycemic events, and improved HDL cholesterol by 5% (p&lt;0.01). These results suggest that JAN-1000 is an effective and safe nutrition-based intervention that mediates communication between the gut microbiome with colonic cells and effectively improves hallmarks of diabetes complications and comorbidities. Studies are underway to confirm and expand on these results in people with type 2 diabetes and pre-diabetes.
Presentation: Sunday, June 12, 2022 12:30 p.m. - 2:30 p.m.
PSUN192 Therapeutic Benefit of GLP-1 Agonists in Patients with Type 1 Diabetes on Insulin Therapy: an Updated Systematic Review and Meta-analysis
Authors: Park Jeayoung , Ntelis Spyridon , Downton Katherine , Yip Cheuk Fung , Munir Kashif , Haq Nowreen 
Published: November 2022

Abstract

Introduction
Glucagon-like Peptide 1 (GLP-1) agonists are efficacious glycemic control and weight loss agents for obese patients with or without type 2 diabetes mellitus. Use of GLP-1 agonists for patients with type 1 diabetes mellitus (T1DM), on the other hand, is an evolving area of research. Our present meta-analysis aims to critically evaluate existing evidence and provide an estimated average therapeutic effect.

Methods
PubMed, Embase, and Cochrane libraries were searched for randomized controlled trials comparing major efficacy and safety endpoints for 12 weeks or longer administration of GLP-1 agonists compared to placebo in T1DM patients on insulin. Main endpoints for analysis included glycated hemoglobin (A1c) level, body weight, and change in total insulin dose. Study was done in accordance with the Preferred Reporting Items for Systematic reviews and Meta-Analysis (PRISMA) statement.

Results
Of 3736 reports identified on search, 8 studies involving liraglutide 1.8mg daily (total 1415 patients) and 5 studies involving any dosage of exenatide (total 221 patients) were included. Liraglutide 1.8mg overall produced greater decrease in A1c (MD = -0.28%, 95% CI -0.41 to -0.16, I2=42%), body weight (MD = -4.84kg, 95% CI -5.25 to -4.44, I2=0%), and total daily insulin per kilogram body weight (MD = -0.08u/kg, 95% CI -0.10 to -0.06, I2=55%) compared to placebo. Exenatide regimen as a whole also overall produced decreased A1c (MD = -0.17%, 95% CI -0.38 to -0.00, I2=0%), body weight (MD = -4.05kg, 95% CI -14.3 to -3.45, I2=0%), total daily insulin (MD = -0.08u/kg, 95% CI -0.15 to -0.01, I2=0%) compared to placebo. However, 3 out of 5 exenatide trials were open label and studies used multiple doses and formations (short-release and extended release), which limited the interpretation of results in clinical practice.

Conclusion
Our meta-analysis supports the therapeutic benefits of GLP-1 agonists for patients with T1DM. Daily 1.8mg liraglutide injections for at least 12 weeks appear to be a promising adjunct to insulin therapy for T1DM patients, resulting in decreased A1c levels, body weight, and total daily insulin requirements.
Presentation: Sunday, June 12, 2022 12:30 p.m. - 2:30 p.m.
PSUN219 Increasing Frequency of Hemoglobin A1c (Hba1c) Measurements in Hospitalized Patients With Diabetes: A Quality Improvement Project Using Lean Six Sigma
Authors: Khan Sara A , Demidowich Andrew P , Tschudy Megan M , Wedler Joyce , Lamy Wilson , Sidhaye Aniket , Alexander Lee Ann , Misra Isha , Zilbermint Mihail 
Published: November 2022

Abstract

Background
Studies have shown the predictive value of hemoglobin A1c (HbA1c) on inpatient glycemic control, and its value for discharge planning. There is little data on HbA1c testing adherence to American Diabetes Association (ADA) guidelines among inpatient providers, and anecdotal evidence suggests that most inpatient providers do not have a standardized approach to HbA1c measurement. The Lean Six Sigma method is a management system that originated in the automobile industry and has become widely used in healthcare to improve the efficiency of processes. The objective of this study was to determine the impact utilizing Lean Six Sigma methodology to increase frequency of HbA1c measurements among hospitalized patients with a known history of diabetes, in line with ADA guidelines.

Methods
This was a quality improvement study performed in a 240-bed community hospital, evaluating inpatients (≥16 years) consecutively admitted with a diagnosis of diabetes (ICD-10 code E8-E13 and O24) between January 2016-June 2021. Patients were excluded if they had a HbA1c in the health system electronic health record (EHR) in the prior 3 months. The Lean Six Sigma approach was utilized to define the problem and implement solutions. The intervention bundle delivered between November 2017 and February 2018 included 1) provider and nursing education on the utility of HbA1c in patient care, 2) change in laboratory protocols for more rapid turnaround of HbA1c, 3) modifications to the EHR including a glucose management tab and insulin order set that included HbA1c. Hospital encounter and patient-level data were extracted from the EHR via bulk query. Demographic characteristics were calculated. Frequency of HbA1c lab sent while inpatient was compared pre- (Jan 2016-Nov 2017) and post-intervention (March 2018-June 2021) using chi-square analysis.

Results
17,869 patients were included (7,332 pre- and 10,537 post-intervention). Demographics did not differ between pre and post intervention periods (mean age [range]: 78.1 [16-106] years, sex: 52.3% male, race: 52.1% White, 25.1% Black). Only 53.5% of patients who met criteria had a HbA1c measured during hospitalization before intervention. This frequency increased to 70.2% postintervention. The improvement in the frequency of HbA1c measurement was sustained more than two years following the initial interventions and continued to improve over time.

Conclusion
This novel approach was successful in improving adherence to guideline-based measurement of HbA1c in hospitalized patients. This is the first quality improvement project in a community hospital utilizing the Lean Six Sigma process for this purpose and may represent a valuable methodology for community hospitals to improve inpatient diabetes care.
Presentation: Sunday, June 12, 2022 12:30 p.m. - 2:30 p.m.
PSUN220 Audit on Variable Rate Intravenous Insulin Infusion (VRIII) in inpatients in Scarborough General Hospital
Authors: Abraham Santhosh , Pawlak Tadeusz , Humphriss David , Uddin Mohd , Singh Anjali , Aniq Sana 
Published: November 2022

Abstract

Introduction
A Variable Rate Intravenous Insulin Infusion (VRIII) is an infusion of insulin at an interchangeable rate. It involves taking regular capillary blood glucose levels, aiming to control the serum glucose levels with in a specific range and an infusion of glucose containing fluid to prevent insulin induced hypoglycaemia (1). A VRIII is used in patients with known diabetes or with hospital related hyperglycaemia who are unable to take oral fluids/food and for whom adjustment of their own insulin regime is not possible (1). The advantage of a VRIII is the fact is that it involves target driven glucose control for specified indications and avoids metabolic decompensation.

Aim
To test the compliance of the ward medical staff with VRIII protocol against the local trust policy and the Joint British Diabetes Society guidelines (JBDS).

Methodology
A retrospective audit on sample of 15 patients at Scarborough General Hospital receiving VRIII on medical and surgical wards. Data was collected over a period of a month. Data collection and analysis performed utilising Microsoft Excel. Audits standards based on trust guidelines and JBDS guidelines.

Results
Most patients were above age of 60 years, female and type 2 diabetic. 100% of patients had daily electrolytes monitoring, 27% had hypoglycaemia, 13% did not have long-acting insulin started before stopping the VRIII. In 40% of patients, blood glucose levels were not maintained between 6-12 mmol/L. Furthermore, in 13% of patients, blood glucose was not monitored hourly.

Conclusion
This audit showed a good compliance with daily electrolytes measurement, early referral to diabetic team as well as starting the VRIII with dextrose. It is concerning however that integral measures such as ruling out DKA, not prescribing the correct fluid, not checking blood glucose levels and lowering the incidence of hypoglycaemia were not always present. Overall, this audit has identified areas required for improvement to optimise our compliance with VRIII protocol against local and national guidelines. We hope this can be improved via spreading greater awareness of the VRIII protocol, to promote early recognition of DKA and ensure safety checks occur when applying the VRIII protocol.

References
George, S., 2022. JBDS-IP The use of Variable Rate Intravenous Insulin Infusion (VRIII) in medical patients. Joint British Diabetes Society.
Presentation: Sunday, June 12, 2022 12:30 p.m. - 2:30 p.m.
PSUN231 Adoptive Cell Transfer for Type 1 Diabetes Reversal
Authors: Imam Shahnawaz , Jaume Alexa , Jaume Juan 
Published: November 2022

Abstract

We have discovered a way to cure type 1 diabetes in a mouse model that closely resembles the human disease. Specifically, we are able to genetically modify blood cells from affected individuals and re-infuse them back to rescue insulin-producing beta cells being destroyed by the immune system.When autoimmune diabetes affects the youth, it is known as Juvenile or type 1 diabetes (T1D). It is named Latent Autoimmune Diabetes of Adults (LADA) when it affects adults. T1D affects about 1 million people in the USA. LADA is estimated to affect at least 10% of the type 2 diabetes population (about 30 million patients in the USA). Combined, 4 million people live with the condition.Can you imagine reversing type 1 diabetes at once?Autoimmune diabetes as a whole is a disease without a cure that is chronically managed with insulin replacement. Even under best management, diabetes complications shorten life expectancy, including blindness, amputations, and kidney failure. These are the population that will benefit from our technology. Starting with new-onset diabetes, the technology can benefit almost any patient with autoimmune diabetes.Our group has developed two currently patented technologies that achieve the goal of reversing type 1 diabetes (our value proposition). One is a new spontaneous, humanized, transgenic mouse model of human T1D (1). The other one is an adoptive cell transfer (ACT) therapeutic approach for T1D (2). A 30-day pre-clinical study in which animals with diabetes were treated with this therapeutic approach provided the proof-of-concept that diabetes CAN BE CURED.Our technology involves a standard-of-care approach already Federal Drug Administration (FDA) approved for cancer treatment (ACT of Chimeric Antigen Receptor, CAR, T cells). We have the materials and know-how needed for the large-scale pre-clinical trial we are currently running. This will generate the necessary data for Investigational New Drug, IND, FDA filing so human clinical trials can be carried out.

References
1. Imam, S., Alfonso-Jaume, M., Jaume, J.C. (2019). Spontaneous Autoimmune Diabetes in Humanized Mice Carrying Human Type 1 Diabetes Susceptibility and Uses Therefor. United States Application No. 16530452, Publication Number. US20200037586. https://patentscope.wipo.int/search/en/detail.jsf?docId=US283198965&tab=NATIONALBIBLIO
2. Imam, S., Jaume, J.C. (2020). Immunosuppressive Antigen-Specific Chimeric Antigen Receptor Treg Cells for Prevention and/or Treatment of Autoimmune and Alloimmune Disorders. International Application No. PCT/US2019/060593, Publication Number WO/2020/097546. https://patentscope.wipo.int/search/en/detail.jsf?docId=WO2020097546&_cid=P10-KHXN2B-33433-1
Presentation: Sunday, June 12, 2022 12:30 p.m. - 2:30 p.m.
NEDD1-S411 phosphorylation plays a critical function in the coordination of microtubule nucleation during mitosis
Authors: Timón Pérez Krystal , Scrofani Jacopo , Vernos Isabelle 
Published: November 2022

ABSTRACT
During mitosis, spindle assembly relies on centrosomal and acentrosomal microtubule nucleation pathways that all require the γ-Tubulin Ring Complex (γ-TuRC) and its adaptor protein NEDD1. The activity of these different pathways needs to be coordinated to ensure bipolar spindle assembly ( Cavazza et al., 2016) but the underlying mechanism is still unclear. Previous studies have identified three sites in NEDD1 (S377, S405 and S411) that when phosphorylated drive MT nucleation at the centrosomes, around the chromosomes and on pre-existing MTs respectively ( Lüders et al., 2006; Pinyol et al., 2013; Sdelci et al., 2012). Here we aimed at getting additional insights into the mechanism that coordinates the different MT nucleation pathways in dividing cells using a collection of HeLa stable inducible cell lines expressing NEDD1 phospho-variants at these three sites and Xenopus egg extracts. Our results provide further support for the essential role of phosphorylation at the three residues. Moreover, we directly demonstrate that S411 phosphorylation is essential for MT branching using TIRF microscopy in Xenopus egg extracts and we show that it plays a crucial role in ensuring the balance between centrosome and chromosome-dependent MT nucleation required for bipolar spindle assembly in mitotic cells.
Fuzzy Q-Learning interaction controller design for collaborative robot
Authors: Kaichen Ying , chin-yin Chen , Longxiang Wang 
Published: November 2022

Background: In physical human-robot interaction (pHRI), admittance control is widely used. The most critical thing in admittance control is the configuration of admittance parameters, but a constant admittance value can not meet the needs of interactive indicators smoothness especially. Variable admittance control is a method to overcome this limitation by adjusting the admittance value in real time. This paper proposes a fuzzy Q-learning (FQL) variable admittance control system, which integrates the fuzzy system (FIS) and reinforcement learning method Q-learning. Methods: FIS is used to turn a continuous input state into fuzzy set and Q-learning is used to train the premise strength of fuzzy rules to get the optimal policy of variable admittance value. To verify the performance of this method, an experiment was performed using an AUBO i5 robot. Training trajectory is point-to-point (PTP) trajectory, several interaction variables before and after training by the algorithm are compared to show the validity of algorithm. Results: Experimental results show that the reward converges to a smaller value in about 25 episodes, and the reward of the last five episodes reduces by 68%. The motion trajectory after algorithm training is closer to the ideal min-jerk trajectory and the deviation and mean value of interaction force become smaller. Conclusions: The proposed FQL method can converge in a few episodes and can improve the performance of pHRI by minimizing the jerk based cost function.