bluuebunny/crossref_metadata_2025_split huggingface dataset:
910-P: Effectiveness of Randomized Controlled Trials to Improve A1C in Hispanic Populations with Type 2 Diabetes: A Systematic Review and Meta-analysis
Authors: URANGA SOFIA , BIANCO LAURA , DECKARD AMBER , WAN WEN , ALEXANDER JASON , STAAB ERIN M. , RODRIGUEZ ALEX W. , SHETTY RAJ , LAITEERAPONG NEDA 
Published: May 2022

Objective: In the US, Hispanic persons have a higher rate of Type 2 diabetes (T2D) than the national average, as well as experience more diabetes-related complications than non-Hispanic whites (NHWs) . This increased prevalence can be attributed to social and biological factors, like access to care and increased predisposition to pre-diabetic conditions. Currently, limited evidence exists for the effectiveness of randomized controlled trials (RCTs) at improving A1C levels in this population with T2D.
Methods: A systematic search focused on T2D interventions published from 1985 to 20was conducted using PubMed, Scopus, PsycInfo, and CINAHL. Search terms were structured around five broad concepts: diabetes, study design, language, race/ethnicity, and disparities. We focused on non-pharmacologic interventions, and included RCTs with ≥18.5% Hispanic persons, utilizing the 2020 US Census as standard. A random effects meta-analysis was performed to calculate the pooled effect size to provide summary estimates.
Results: Of the 111,289 articles reviewed, 28 trials met inclusion criteria. Participants were 90% Hispanic and 70% female with a mean age of 55.8 years. Most interventions used cultural tailoring, lifestyle and behavioral changes, or telehealth support and included bilingual nurses, Spanish educational materials, or community health workers. Compared to control, these interventions were associated with a 0.19% (95% confidence interval: -0.39% to 0.01%; p&lt;0.01) reduction in A1c.
Conclusion: This meta-analysis examined non-pharmacologic interventions in Hispanic persons with T2D and found that they reduced A1c to a small degree. This finding is important for future T2D interventions tailoring to this population, as well as future health policy. Future analyses will examine which type of interventions (i.e. individual, community, societal, or multi-level) are most successful at reducing A1c among Hispanic persons.

Disclosure
S.Uranga: None. L.Bianco: None. A.Deckard: None. W.Wan: n/a. J.Alexander: None. E.M.Staab: None. A.W.Rodriguez: None. R.Shetty: None. N.Laiteerapong: None.
912-P: Integrating CGM Use into Primary Care Practice: A Diabetes Quality Improvement Project
Authors: MAMTANI RAASHI , WOLINSKY TAMAR , SIMON BARBARA 
Published: May 2022

Background: Continuous glucose monitoring (CGM) is a powerful tool to help manage diabetes. Primary care providers (PCPs) have been slow to incorporate CGM into practice, representing a significant gap in healthcare delivery. We implemented a quality improvement intervention at our primary care clinic to increase utilization of CGM.
Methods: We conducted a pre-intervention survey with PCPs to assess baseline knowledge and comfort with CGM, followed by a 6 month post-intervention survey. Our interventions included the creation of a CGM toolkit, provider education, and implementation of an office workflow for prescribing CGM and educating patients. Our primary outcome measure was the number of CGM prescriptions written. Secondary outcome measures included change in provider knowledge and comfort with CGM use, and change in hemoglobin A1c after 3-6 months of CGM use.
Results: Our survey asked providers to rate their comfort and familiarity with CGM along with questions regarding barriers to CGM use. The baseline survey showed that provider familiarity and comfort explaining CGM to patients was poor, frequently rated as a 1 or 2 (1= not at all familiar, 5= very familiar) . Six months after implementation of our toolkit and education, 70% of providers responded with a 4 or 5. We identified 41 clinic patients who had CGM prescriptions in the six month time period prior to our study initiation. Six months after intervention, a total of 1patients had CGM prescriptions (146% increase) . Of the 60 patients newly prescribed CGM, we obtained retrospective data on patients. Mean hemoglobin A1c of was 9.96% at baseline and improved to 8.29% after 3-6 months of CGM use (change of 1.67%) .
Conclusion: Implementation of a toolkit focusing on provider education and an organized workflow for prescribing can increase the use of CGM in primary care practice, as well as positively affect provider knowledge and comfort with CGM use. Our preliminary data indicates that patients may also benefit from improved glycemic control.

Disclosure
R.Mamtani: None. T.Wolinsky: Other Relationship; Pfizer Inc. B.Simon: None.

Funding
American Diabetes Association
92-OR: Persistence of Impaired Awareness of Hypoglycemia, Severe Hypoglycemic Events, and Suboptimal Glycemic Control Despite Advanced Diabetes Technologies
Authors: PETTUS JEREMY , LIU JINGWEN , TITIEVSKY LINA , HAGAN KAITLIN , LIU TINA , CHANDARANA KEVAL , GAGLIA JASON L. , WOLF WENDY , BISPHAM JEOFFREY , CHAPMAN KATHERINE S.M. , FINAN DANIEL , SHERR JENNIFER 
Published: May 2022

Trials of continuous glucose monitors (CGMs) and hybrid closed-loop systems (HCLS) demonstrate improvements in glycemia with reductions in hypoglycemia in T1D, but there is limited real-world data on how these technologies impact the prevalence of impaired awareness of hypoglycemia (IAH) , severe hypoglycemic events (SHEs) , and glycemic control. We conducted a one-time online survey of adults with T1D in the T1D Exchange Registry and online communities. Self-reported medical histories (insulin delivery method, HbA1c, IAH, SHEs) and CGM data were collected. 2044 patients (mean age 43 y, mean T1D duration 26 y, 72% female, 95% White) completed the survey. Most reported using CGMs (92%) ; 953 also used HCLS. Mean HbA1c was 6.89%; 41.5% had an HbA1C of ≥7%; 30.7% reported IAH; 19.8% had ≥1 SHE in the prior year; 12.0% had ≥2 SHEs in the prior year; 9.6% had IAH + ≥1 SHE; and 6.6% had IAH + ≥2 SHEs (Table) . Rates of SHEs and IAH + SHEs were lower in CGM users and CGM + HCLS users than in non-CGM users; however, among CGM + HCLS users, 16.6% reported ≥1 SHE, 8.7% ≥2 SHEs, 7.8% IAH + ≥1 SHE, and 4.7% IAH + ≥2 SHEs. Also, 35.6% of CGM + HCLS users had an HbA1C of ≥7%. In a patient cohort with high rates of technology adoption, rates of SHEs and IAH remained high, with a significant proportion of patients not achieving targeted glycemic control, indicating the need for novel T1D treatments.

Disclosure
J. Pettus: Advisory Panel; Lilly, MannKind Corporation, Novo Nordisk, Sanofi. Consultant; Carmot Therapeutics, Inc., Diasome. L. Titievsky: Employee; Intercept Pharmaceuticals, Inc., Pfizer Inc., Vertex Pharmaceuticals Incorporated. Stock/Shareholder; Intercept Pharmaceuticals, Inc., Pfizer Inc., Vertex Pharmaceuticals Incorporated. K. Hagan: Employee; Vertex Pharmaceuticals Incorporated. T. Liu: Employee; Takeda Pharmaceutical Company Limited, Vertex Pharmaceuticals Incorporated. Stock/Shareholder; Seattle Genetics, Inc. K. Chandarana: Employee; Vertex Pharmaceuticals Incorporated. J.L. Gaglia: Advisory Panel; Dompé, Regeneron Pharmaceuticals Inc. Consultant; Vertex Pharmaceuticals Incorporated. Research Support; Avotres Inc., Dompé, Janssen Research & Development, LLC, Provention Bio, Inc. Stock/Shareholder; Vertex Pharmaceuticals Incorporated. W. Wolf: None. J. Bispham: Employee; PPD Inc., T1D Exchange. K.S.M. Chapman: None. D. Finan: None. J. Sherr: Advisory Panel; Bigfoot Biomedical, Inc., Cecelia Health, Insulet Corporation, Medtronic, Vertex Pharmaceuticals Incorporated. Consultant; Insulet Corporation, Lexicon Pharmaceuticals, Inc. Research Support; Dexcom, Inc., Insulet Corporation, Jaeb Center for Health Research, JDRF, Medtronic, National Institute of Diabetes and Digestive and Kidney Diseases. Speaker's Bureau; Lilly Diabetes.
924-P: Effectiveness of Interventions to Improve Hemoglobin A1c among Black Persons with Type 2 Diabetes Mellitus: A Meta-analysis of Randomized Controlled Trials
Authors: OSMAN FAWSIA , JIANG CHERRY , DECKARD AMBER , WAN WEN , ALEXANDER JASON , STAAB ERIN M. , RODRIGUEZ ALEX W. , SHETTY RAJ , LAITEERAPONG NEDA 
Published: May 2022

Background: The prevalence of Type 2 diabetes (T2D) is high among non-Hispanic Black persons. This population also has a high rate of poorly controlled T2D and a high burden of T2D related complications. To address this, various interventions have been studied to improve glycemic control. We performed a meta-analysis of published interventions on Black persons with T2D and their effects on HbA1c outcomes.
Methods: An electronic search of literature in PubMed, Scopus, CINAHL, PsycINFO, and Medline was conducted from 1985 to 20for studies evaluating T2D interventions among predominantly minority populations. This analysis was limited to non-pharmacologic randomized controlled trials (RCTs) and studies that had an average ≥12.5% of total participants identifying as Black, utilizing the 2020 US Census as standard. Interventions were aimed at improving outcomes including blood pressure, weight, and lipids. For this analysis, we focused on the outcome HbA1c and its differences between experimental and control groups. A random effects meta-analysis was performed to calculate the pooled effect size of the various outcomes. Results: For this analysis, 35 RCTs were included (n=6467) . The participants were 61% Black and 65% female with a mean age of 56 years. Interventions included interdisciplinary T2D management, telehealth-based support, lifestyle focused programs, and peer support programs. There was a statistically significant reduction in HbA1c in the experimental group when compared to the control group (-0.17, 95% CI -0.28 to -0.06, p&lt;0.01, I2=70%) .
Conclusion: This meta-analysis found non-pharmacologic interventions were effective in reducing HbA1c among Black persons to a small degree. Future research is needed to estimate the effects of the level of intervention (i.e. individual, community, societal, or multi-level) in reducing HbA1c among this population to inform future public health programming and policy.

Disclosure
F.Osman: None. C.Jiang: None. A.Deckard: None. W.Wan: n/a. J.Alexander: None. E.M.Staab: None. A.W.Rodriguez: None. R.Shetty: None. N.Laiteerapong: None.
928-P: Dysglycemia in Patients without Diabetes after Renal Transplantation
Authors: SEGGELKE STACEY A. , GRIFF MEGAN , HAWKINS R. MATTHEW , CRAWLEY SVITLANA , WANG CECILIA C. LOW 
Published: May 2022

Background: Patients without a prior history of diabetes often experience post-operative hyperglycemia after undergoing renal transplantation. Hyperglycemia in the immediate post-transplant period has been associated with increased risk for infection, graft failure and hospital readmission.
Methods: We performed a retrospective review of all adult patients undergoing renal transplantation at a single tertiary referral center from January 1 - December 31, 2019.
Results: Of the 292 patients, 191 (65.2%) did not have a history of diabetes. Of these, 83 (43.5%) were female (mean ±SD age 46.3 ±14.7 years) while 1 (56.5%) were male (mean ±SD age 47.9 ±15.5 years) . The percentage of post-operative days (POD) while hospitalized with any hyperglycemia (≥180 mg/dL) was 55.5% (female 51.8%, male 58.3%) with the highest average blood glucose on POD1 among all patients. The mean±SD point of care (POC) glucose on POD0, 1, 2 and 3 was 123.4±31.5, 151.1±28.6, 139.8±29.7, and 117.4±28.9 mg/dL, respectively (n = 181, 145, 141, and 126 for respective days) . As compared with those without hyperglycemia, patients with any detected hyperglycemia up to POD5 had numerically higher percentage of hospital acquired infection (2.1% vs. 1%) , admission to the intensive care unit (7.9% vs. 3.7%) , and 30-day readmission (20.4% vs. 10.5%) . The percentage of post-operative days with POC glucose &lt;70 mg/dl was 7.9% (female 8.4%, male 7.4%) .
Conclusions: Patients without a history of diabetes who undergo renal transplantation experience hyperglycemia during the majority of days while hospitalized peri-transplant. Further analysis is needed to determine optimal insulin dosing strategies to improve glycemic control in this population.

Disclosure
S.A.Seggelke: None. M.Griff: None. R.Hawkins: None. S.Crawley: None. C.C.Low wang: Employee; CPC Clinical Research, Research Support; CellResearch Corporation, Virta Health Corp.
931-P: Characteristics and Outcomes of DKA Admissions Before and During COVID-Pandemic
Authors: KANSARA ABHISHEK , NGUYEN DUC T. , YARLAGADDA SRI LAKSHMI L. , GRAVISS EDWARD , SADHU ARCHANA R. 
Published: May 2022

Background: COVID-increases risk of DKA and poor outcomes in patients with diabetes.
Methods: A retrospective review was conducted of 4,959 DKA admissions from 1/1/2019-12/31/2021 at our hospital system. EHR data was collected on consecutive admissions coded with DKA for clinical characteristics, hospital outcomes of length of stay (LOS) , 30day readmission (30d RADM) and mortality. Data was analyzed for differences stratified by year 20vs. 2020 and 2021, and by COVID-infection.
Results: Compared to 2019, patients in 2020 were older, more Hispanic and had CHF. Compared to 2019, patients in 2021 had less HTN and kidney disease but similar rates of CHF; Table 1. Mortality and LOS were higher for 2020 and 2021 while 30d RADM was lower; Table 2.
Conclusion: Despite advancements in COVID-treatments, DKA patients have progressively poorer outcomes.

Disclosure
A.Kansara: None. D.T.Nguyen: None. S.L.Yarlagadda: None. E.Graviss: None. A.R.Sadhu: Advisory Panel; Abbott Diagnostics.
952-P: The Relationship between Weight Loss and HbA1c in People with Type 2 Diabetes
Authors: SHINDE SHRADDHA , THIEU VIVIAN , KWAN ANITA , HOUGHTON KATHERINE F. , SCHAPIRO DAVID , MEYERS JULIANA 
Published: May 2022

Limited US real-world evidence exists on the effect of substantial changes in weight on HbA1c among people with T2D. People with T2D were identified from 2010-2018 in the IQVIA Ambulatory EMR database. The date of the first observed weight value was defined as the index date and patients were required to have an additional weight value at 1 year (±90 days) post-index date. Patients were stratified by weight change between index and 1 year post-index date. HbA1c was evaluated at index, 6 months, and 1 year post-index date. Of the 1,061,354 patients evaluated, 20.2% gained weight, 53.9% had no weight change, and 10.6% lost 3-5%, 10.7% lost 5-10%, 2.8% lost 10-15%, and 1.7% lost ≥15% of their weight at the index date (i.e., index weight) at 1 year of follow-up. Of note, patients with the largest weight loss had the highest index weight (range: 203.7lb in patients with weight gain to 245.9lb in patients with ≥15% weight loss) . Mean index HbA1c was similar across subgroups as was the percent of patients with index HbA1c &lt;7.0%. At both 6 months and 1 year post-index date, patients with ≥15% weight loss had the largest reduction in HbA1c and the highest percent of patients with HbA1c &lt;7.0%.
In summary, HbA1c reduction was greater with increasing amount of weight lost during the one year of follow-up. Patients with weight loss ≥15% reduced HbA1c by an average of 1.2% of the index value at 1 year of follow-up.

Disclosure
S.Shinde: None. V.Thieu: None. A.Kwan: Employee; Eli Lilly and Company, Stock/Shareholder; Eli Lilly and Company. K.F.Houghton: None. D.Schapiro: Employee; Eli Lilly and Company. J.Meyers: Other Relationship; Eli Lilly and Company.
96-LB: Safety of Glucose Regulation by the Bionic Pancreas without Continuous Glucose Monitoring Input
Authors: BALLIRO COURTNEY A. 
Published: May 2022

The bionic pancreas (BP) continues to make all insulin dosing decisions autonomously when continuous glucose monitoring (CGM) data is not available. Basal insulin is given based on a profile determined autonomously by the BP when CGM data was available. Meals are announced as Breakfast, Lunch, or Dinner and by relative size (Usual, Less, More) ; insulin dosing is based on adaptation that occurred when CGM data was available. Insulin may be delivered, or temporarily suspended, autonomously by the BP in response to entered blood glucose (BG) values. At the end of the 13-week Pivotal RCT of the BP in type 1 diabetes, participants in the BP group could participate in a study testing the BP without CGM input. Unblinded CGM was replaced by blinded CGM not connected to the BP for ∼49.5 hours. Participants were to enter fingerstick BG values every ∼2 hours during the day and once overnight. Adherence with BG entry requirements by the 54 participants (aged 7-70) was high. There was no severe hypoglycemia or DKA. The frequency of CGM-measured hypoglycemia was similar during the BG Period to the RCT and Pre-Randomization periods. Hyperglycemia metrics were nominally higher during the BG Period than the RCT, but nominally lower than the Pre-randomization Baseline period. The BP can autonomously determine all insulin doses and achieve safe glucose control without CGM input when intermittent BG values are provided by the user.

Disclosure
C. A. Balliro: Consultant; Beta Bionics, Inc., Zealand Pharma A/S.

Funding
Funding from National Institute of Diabetes and Digestive and Kidney Diseases (#1UC4DK108612-01) . Funding and bionic pancreas devices from Beta Bionics, Inc. Fast-acting insulin aspart and insulin aspart provided by Novo Nordisk Insulin lispro by Eli LillyBlood glucose meters and test strips (Contour Next One Blood Glucose Monitoring System) provided by Ascensia Diabetes Care, Basel, CH. Continuous glucose monitor sensors and transmitters were purchased from Dexcom, Inc. at a discounted price.
PROSES PENALARAN DAN PEMBUKTIAN MATEMATIS PESERTA DIDIK DITINJAU DARI PERBEDAAN KEMAMPUAN SPASIAL
Authors: Maulana Aris 
Published: May 2022

Penelitian ini merupakan penelitian deskriptif kualitatif yang membahas mengenai proses penalaran dan pembuktian peserta didik yang ditinjau dari perbedaan tingkat kemampuan spasial. Kemampuan penalaran yang dimiliki peserta didik sangat penting dalam membantu peserta didik untuk berfikir secara mendalam mengenai suatu permasalahan matematika baik soal rutin maupun non rutin. Dalam penelitian ini proses penalaran akan diteliti dengan melihat perbedaan kemampuan spasial yang diiliki peserta didik, Penelitian ini berawal dari diberikannya permasalahan kepada peserta didik secara umum yakni sebanyak 32 peserta didik kelas VIII di MTs TMI Pujon. Kemudian diambil 2 peserta didik dengan kemampuan spasial yang tinggi, 2 peserta didik dengan kemampuan spasial yang sedang dan 2 peserta didik dengan tingkat kemampuan spasial yang rendah. Setelah didapat 6 subjek, kemudian dilakukan pemberian tes penalaran dalam materi persamaan garis lurus yang telah divalidasi oleh beberapa validator. Setelah pemberian soal tes penalaran, hasil pekerjaan peserta didik diidentifikasi dengan indikator penalaran. Proses identifikasi akan dilanjutkan dengan proses wawancara dengan peserta didik untuk mengetahui sejauh mana pembuktian matematis yang dimiliki peserta didik untuk memberikan alasan yang tepat untuk hasil pengerjaan peserta didik. Pada penarikan kesimpulan didapatkan bahwa peserta didik dengan kemampuan spasial yang tinggi akan mempengaruhi proses penalaran dan pembuktian matematis. Yakni peserta didik dengan kemampuan spasial yang tinggi memiliki proses penalaran dan pembuktian yang baik pada saat mengerjakan permasalahan mengenai materi persamaan garis lurus, begitupun dengan peserta didik yang memiliki tingkat kemampuan spasial yang sedang memiliki tingkat penalaran yang sedang pula. Sedangkan pada peserta didik yang memiliki tingkat kemampuan spasial yang rendah tidak terlihat proses penalaran dan pembuktian matematis saat mengerjakan permasalahan tersebut, juga saat melalui proses wawancara.Kata Kunci : Penalaran Matematis, Kemampuan spasial
Some observations on the numerical solution of the Ottosen-Stenström-Ristinmaa high-cycle fatigue model
Authors: Kaleva Osmo , Orelma Heikki 
Published: May 2022

Some years ago, Ottosen, Stenström and Ristinmaa introduced a high-cycle fatigue model based on the continuum approach. The model is formulated as a fully implicit differential equation and an ordinary differential equation. The corresponding numerical solutions are compared. We demonstrate pitfalls in the process so that appliers are able to avoid these problems. Especially,we show that the results depend on the initial value of the evolution equation. We propose a method to choose such an initial value that the estimated Wöhler curve fits the measured data.
Electrocardiographic markers of ventricular repolarization in the obese population: A descriptive review
Authors: Topp-Zielińska Aleksandra , Szołkiewicz Marek 
Published: May 2022

Abstract
Obesity is a global epidemiological problem that significantly contributes to the development of cardiovascular diseases. It is a proven factor for an increased risk of overall mortality and the occurrence of sudden cardiac death (SCD). The disease is accompanied by a structural and functional myocardium remodeling, which often results in ventricular repolarization abnormalities and contributes to the triggering of life-threatening arrhythmias. This heightened state of readiness for proarrhythmia is the cause of the sudden cardiac deaths which are recorded in this group of patients and which often constitute the first manifestation of ongoing cardiac pathology. One of the reasons for these arrhythmias may be abnormalities of ventricular muscle repolarization. In this descriptive review, we demonstrate electrocardiographic markers of ventricular repolarization (J point, QT/QTc/QTc-d, JT/JTc/JTc-d, ST segment, T wave and Tp-e/Tp-ed/Tp-e/QT), analyze their abnormalities in the obese population, and discuss their changes after weight loss.
Phenotypic Correlations Between Egg Quality Traits Amid the Laying Phase of Broiler Breeder Hens
Authors: Vekić Marinko , Savić Đorđe , Jotanović Stoja 
Published: May 2022

Summary
In order to determine phenotypic correlations between the quality traits of eggs from 41-week-old broiler breeder hens (Cobb 500), a total of 105 eggs suitable for incubation were analyzed using descriptive statistics and Pearson’s correlation coefficient. The average values of egg weight, egg length, egg width, egg shape index, shell thickness, shell weight, and shell ratio were 66.90 g, 60.00 mm, 44.81 mm, 74.70%, 0.37 mm, 6.07 g, and 9.07%, respectively. Moreover, the average values of yolk weight, albumen weight, yolk ratio, albumen ratio, Haugh units, yolk index, and yolk-to-albumen ratio were 20.04 g, 40.80 g, 29.97%, 60.95%, 82.12, 46.17%, and 0.49, respectively. A significant positive correlation (p < 0.01) was found between the egg weight and the egg length (0.75), egg width (0.80), shell (0.55), yolk (0.60), albumen weight (0.91), and albumen ratio (0.25). However, a significant negative correlation (p < 0.01) was found between the egg weight and both the yolk ratio (-0.20) and yolk-to-albumen ratio (-0.23). The egg shape index proved not to be significantly correlated with any of the internal egg quality traits considered. The shell thickness was in a significant positive correlation (p < 0.01) with the shell weight (0.83) and ratio (0.86), whereas a significant negative correlation (p < 0.05) was found between the shell thickness and yolk ratio (-0.23). The Haugh units were in a significant positive correlation (p < 0.05) with the albumen ratio (0.24) and yolk index (0.27), whereas a significant negative correlation (p<0.05) was found between the Haugh units and both the yolk ratio (-0.22) and yolk-to-albumen ratio (-0.23). The results obtained confirm significant phenotypic correlations not only between egg weight and the egg quality traits considered, but also between a number of external and internal quality traits of broiler hatching eggs.