bluuebunny/crossref_metadata_2025_split huggingface dataset:
969-P: Changes in Patterns of Care in Diabetes via Virtual Care Delivery Prior to and During COVID-Pandemic
Authors: PALCU PATRICIA , MUKERJI GEETHA , CHU CHERRY , PENDRITH CIARA 
Published: May 2022

Background: The COVID-pandemic and virtual care has impacted the care delivery of many health care conditions including diabetes. This study aimed to compare how patterns of care for diabetes have changed as a result of virtual care and the COVID-pandemic at a large academic ambulatory care facility in Toronto, Canada.
Methods: Patients were included who had an initial diabetes visit between September 15, 20 and September 20, 2020. Fisher's exact test was used to determine differences in care patterns between visits pre and during COVID- (after March 14, 2020) .
Results: Pre-COVID-19, there were 240 (72.7%) completed initial visits and 90 (27.3%) follow-up visits, including 27.5% and 36.7% for type 1 diabetes, respectively. During COVID-19, there were 235 (44.1%) initial visits and 298 (56%) follow-up visits including 29.4% and 27.2% for type 1 diabetes, respectively. Including all visits, there were more no-shows during COVID-19, 4.5% vs. 1.5%; p&lt;0.05. Out of 330 pre-COVID-visits, all (100%) were done in-person. During COVID-19, out of 533 visits, 89.3% were done by phone, 7.5% by video, and only 3.2% in-person.
Conclusion: During COVID-19, there were more follow-up diabetes visits seen compared to initial visits and more no-shows. Most diabetes visits were done by phone during COVID-19. More data is needed to understand how diabetes care delivery has changed as a result of virtual care during COVID-19.

Disclosure
P.Palcu: None. G.Mukerji: n/a. C.Chu: None. C.Pendrith: None.
971-P: Use of Telemedicine for Type 1 Diabetes Care in the T1D Exchange Quality Improvement Collaborative (T1DX-QI) in 2021
Authors: LEE JOYCE M. , OSPELT EMMA L. , MUNGMODE ANN , EBEKOZIEN OSAGIE , GUPTA MEENAL , MALIK FAISAL , FOGEL NAOMI R. , ACCACHA SIHAM , HSIEH SUSAN , WILKES MEREDITH , NEYMAN ANNA , VENDRAME FRANCESCO 
Published: May 2022

Background: The COVID-pandemic accelerated adoption of telemedicine for diabetes care in 2020. We sought to describe the utilization of telemedicine across the T1DX-QI in 2021.
Methods: Twenty four pediatric and nine adult clinics completed a survey about the proportion of televisits performed, center goals and processes in fall of 2021.
Results: The majority of clinics reported performing between 11-25% (n=16, 48%) and 0-10% televisits (n=9, 27%) . The majority reported a pre-visit preparation workflow (n=24, 73%) , but most sites reported not having a staff member dedicated to supporting televisits (n=21, 64%) . No major differences in televisit use, goals, and processes were observed between pediatric and adult sites. For diabetes technology data downloads, the majority of clinics integrated data automatically into the EHR (n=25, 73%) . The major barriers to sustaining telemedicine practice across clinics were patient internet access, patient health disparities and access to device data (Figure 1) .
Conclusion: More than one year into the pandemic the proportion of televisits performed by the T1DX-QI collaborative is modest. Clinic workflows have been implemented to support telemedicine but insufficient institutional support and technology barriers still represent an obstacle.

Disclosure
J.M.Lee: Advisory Panel; GoodRx, Consultant; Tandem Diabetes Care, Inc. M.Wilkes: None. A.Neyman: None. F.Vendrame: None. E.L.Ospelt: None. A.Mungmode: None. O.Ebekozien: None. M.Gupta: None. F.Malik: n/a. N.R.Fogel: None. S.Accacha: None. S.Hsieh: None.
973-P: By How Much Does Red Blood Cell Status Affect the Accuracy of HbA1c?
Authors: KARWATH ANDREAS , WILLIAMS JOHN A. , ROUND RACHEL A. , STRATTON IRENE M. , GKOUTOS GEORGIOS , MOSTAFA SAMIUL , ROBERTS GRAHAM , WEBBER JONATHAN , MANLEY SUSAN E. 
Published: May 2022

Medical conditions can affect haematological factors altering relationship between HbA1c and glucose. Patients were recruited at hospital over 3 visits (*1/**2&3 only) comprising 20 with diabetes and in Fig 1 with liver disease (LD) & hepatitis C (HC) on ribavirin*, on dapsone*, with macrocytosis, and in Fig 2 LD & HC off ribavirin**, LD with nonalcoholic steatohepatitis and cirrhosis, rheumatoid arthritis, renal disease on erythropoietin (EPO) , renal disease off EPO and with microcytosis. Glucose and full blood count were measured with HbA1c on Tosoh G8 analysers, ref range 20-42mmol/mol.
In Fig 1 HbA1c was more depressed relative to glucose than Fig 2, both p&lt;0.001, with a combination of lower red blood cell (rbc) count & higher mean cell volume. The macrocytic nature of rbc implies faster turnover and less contact of haemoglobin with circulating glucose.

Disclosure
A. Karwath: None. J.A. Williams: None. R.A. Round: None. G. Gkoutos: None. G. Roberts: None. J. Webber: None.

Funding
Medical Research Council (MR/S003991/1) , MRC HDR UK (HDRUK/CFC/01) , NIHR Birmingham ECMC, NIHR Birmingham SRMRC, Nanocommons H2020-EU (731032) , MAESTRIA (Grant agreement ID 965286)
980-P: Continuous Glucose Monitor Improves Glycemic Control in Youth-Onset Type 2 Diabetes
Authors: CHANG NANCY T. , SMITH JOSEPHINE ANDREA , CHAO LILY 
Published: May 2022

Background: Youth with type 2 diabetes (T2D) develop early treatment failure. Most patients do not self-monitor blood glucose (SMBG) levels at recommended frequency. Continuous glucose monitor (CGM) has been shown to improve glycemic control in pediatric T1D and adult T2D. Its feasibility and efficacy in youth-onset T2D is unknown.
Hypothesis: Participants who wear the CGM &gt;85% of the time will lower their HbA1c by at least 0.5%.
Methods: T2D patients prescribed insulin were eligible to participate if their HbA1c was at least 8%. Participants were randomized to 3-months of SMBG or Dexcom G6 CGM, followed by 3 months of washout (SMBG) and 3-month crossover to the other treatment arm. Participants and their clinical providers agreed to not start new diabetes medications but could adjust insulin dosing or add on rapid-acting insulin if HbA1c &gt;9% at follow-up. A nurse care manager provided coaching for the first 30 days of CGM use. The CGM-SAT satisfaction survey was administered at the end of CGM wear. Student t-test and Fisher’s exact test were used to compare differences in continuous and categorical variables between groups, respectively. A 5% level of significance was used.
Results: out of 14 participants completed the study. Our cohort was 55% female. At enrollment, mean age was 17.4±2.0 years, diagnosis duration was 4.0±2.8 years, and HbA1c was 11.5±2.5%. The percentage of days with CGM data trended from 89% down to 73% between the 1st and 3rd month of CGM use (not statistically significant) . CGM use lowered HbA1c by 2.8% for the cohort (SMBG: -0.1%, CGM: -3.1%, P=0.005) and by 3.8% for those who wore the CGM &gt;85% of the time (P=0.01) . The mean CGM item score was 3.7 ± 0.5, comparable to prior results reported in T1D youth.
Conclusion: Consistent CGM use improves glycemic control in youth-onset type 2 diabetes in this pilot study. Not all patients experienced an improvement in HbA1c. A larger study is warranted to validate the findings of this study and to identify patients who are most likely to benefit from CGM use.

Disclosure
N.T.Chang: None. J.Smith: None. L.Chao: None.

Funding
Dexcom
99-OR: HbA1c Variability Predicts Both Coronary Atherosclerosis and CVD Events in Type 1 Diabetes
Authors: HORTON WILLIAM B. , SNELL-BERGEON JANET K. 
Published: May 2022

Introduction: Interventions that decrease mean glucose have reduced rates of type 1 diabetes (T1D) vascular complications, but the difference in cardiovascular disease (CVD) risk between people with T1D and the general population endures. This suggests that factors beyond hemoglobin A1c (HbA1c) normalization may drive T1D CVD outcomes. HbA1c variability is an established predictor of T1D microvascular disease, but thus far only the FinnDiane Study has implicated it as a risk factor for T1D CVD events. No studies have examined the relationship of HbA1c variability to both CVD risk factors and events in a prospective T1D cohort.
Methods: We used multivariable logistic regression to analyze the Coronary Artery Calcification in Type 1 Diabetes (CACTI) T1D cohort (N=597) . Primary outcomes were square root-transformed coronary artery calcium (CAC) volume and CVD events. CVD events were defined as myocardial infarction, coronary artery bypass grafting, angioplasty, or cardiovascular death. HbA1c variability was defined as a 1-standard deviation increment in HbA1c and calculated as standard deviation of all HbA1c values for each subject.
Results: After adjustment for age, sex, and T1D duration, HbA1c variability predicted both CVD events (HR: 1.562, 95% CI: 1.052-2.318, P=0.0269) and CAC volume (rpartial= 0.3346, P&lt;0.001) , while mean HbA1c predicted CVD events (HR: 1.399, 95% CI: 1.079-1.816, P=0.0114) but not CAC volume (rpartial= 0.0934, P=0.2886) . Further investigation revealed that the relationship between HbA1c variability and CVD events was strongest in those with good glycemic control (HR: 6.330 at mean HbA1c of 6.0%, HR: 3.920 at mean HbA1c of 7.0%, HR: 2.428 at mean HbA1c of 8.0%, HR: 1.5at mean HbA1c of 9.0%, and HR: 0.931 at mean HbA1c of 10.0%) .
Conclusion: HbA1c variability may be a risk factor for both coronary atherosclerosis and CVD events in T1D, and the appropriate care strategy for this population may include maintaining an HbA1c value over time that is both at-target and stable.

Disclosure
W.B.Horton: None. J.K.Snell-bergeon: Stock/Shareholder; GlaxoSmithKline plc.

Funding
National Institutes of Health (R01DK116731) National Institutes of Health (R01HL113029)
990-P: Prebiotics and Metformin: A Pilot Randomized Controlled Trial in Youth-Onset Type 2 Diabetes
Authors: DIXON SYDNEY A. , MEYERS ABBY , TUTTLE KUNANI , MABUNDO LILIAN , STAGLIANO MICHAEL S. , VILLALOBOS-PEREZ ALFREDO , DIETSCHE KATRINA B. , COURVILLE AMBER B. , ESTRADA DORIS E. , CHUNG STEPHANIE T. 
Published: May 2022

Metformin is the only first-line oral agent for youth with type 2 diabetes mellitus (Y-T2D) , but efficacy and adherence is complicated by gastrointestinal (GI) side effects. Prebiotic microbiome modulators (MM) may reduce side effects by shifting the microbial flora and promoting metabolism of short-chain fatty acid producing bacteria. The feasibility and tolerability of prebiotic use in Y-T2D is unknown. We hypothesized that a prebiotic MM would be safe, tolerable, and decrease GI symptoms in youth. We compared lower GI symptoms and glycemia in Y-T2D at initiation of daily metformin therapy in a 1-week, randomized, double-blind, crossover trial of a daily prebiotic MM versus placebo shake (Phase 1) followed by a 1 month open-labeled extension (Phase 2) . We assessed stool frequency, stool consistency (King’s Stool Chart) , and used principal component analysis to create a composite GI symptom score (urgency, bloating, flatulence, consistency) . Mixed effects models were used to compare continuous glucose monitor profiles and quality of life metrics (Pediatric Quality of Life Inventory™) . In six Y-T2D (17.2±1.7y (mean±SD) , 66% female, BMI 42±9 kg/m2, HbA1c 6.4±0.6%) stool frequency was assessed every 1-2 days. Stool frequency, stool composition, GI symptom score, and quality of life scores were not different by group or study phase. There were no severe adverse effects during the trial. One youth had increased bloating and discontinued the prebiotic in Phase 2. During phase 1, prebiotic MM tended to have lower average glucose (122±26 vs. 135±23 mg/dL, P=0.07) but this was not sustained in phase 2 (136±31 vs.135±23, P=0.8) . Time in range, standard deviation, and coefficient of variation of glucose were similar during the study.
In summary, the prebiotic MM was well tolerated during short-term metformin therapy in Y-T2D, but was not associated with GI symptom, quality of life, or metabolic changes. Future studies should explore localized gut and systemic metabolic effects of prebiotics in youth.

Disclosure
K. Tuttle: None. L. Mabundo: None. M.S. Stagliano: None. K.B. Dietsche: None. A.B. Courville: None. D.E. Estrada: None. S.T. Chung: None.

Funding
NIDDK/NIH Intramural Research Program
999-P: Associations between Perceived Stress and Morning Serum Cortisol with Glycemic Measures in Minority Youth with Overweight or Obesity
Authors: FELIX KIMBERLY , WEIGENSBERG MARC , TOLEDO-CORRAL CLAUDIA M. 
Published: May 2022

Background: In youth, higher morning serum cortisol has been associated with fasting glucose, however the direct role of psychosocial stress as risk factor type 2 diabetes has not been well established; therefore, in this study, we examined the associations between perceived stress and fasting serum cortisol with fasting and 2-hour post glucose challenge and hemoglobin A1c.
Methods: In this cross-sectional study among Latino and African American youth with overweight or obesity (n=195, age=14.6±2.8yrs) we measured psychosocial stress with the 14-item Perceived Stress Scale for children and glucose concentrations at fasting and 2-hour post glucose challenge (1.75g oral glucose solution/kg body weight to a maximum 75g) . Hemoglobin A1c (HbA1c) and morning serum cortisol were measured from the fasting blood draw. Linear regression models assessed the relationships between perceived stress and morning cortisol with fasting glucose, 2-hour glucose, and HbA1c. With logistic regression models, we tested if perceived stress and morning serum cortisol associated with impaired fasting glucose, impaired glucose tolerance, or impaired HbA1c status. A priori covariates included age, sex, and ethnicity.
Results: Perceived stress scores were not associated with any glycemic measures (all p&gt;0.05) . Morning serum cortisol was positively associated with HbA1c (β=0.016; 95%CI=0.002,0.030) and impaired HbA1c status (OR=1.090; 95%CI=1.006,1.181) in unadjusted models and results were largely unchanged in adjusted models.
Conclusion: Perceived stress, a common way to measure psychosocial stress, was not associated with any glycemic measures. Morning fasting cortisol was not associated with glucose levels, but was associated with HbA1c, a novel finding in this population of minority children. This finding adds to previous literature which showed that fasting serum cortisol associates with fasting glucose in children with overweight and obesity.

Disclosure
K.Felix: None. M.Weigensberg: None. C.M.Toledo-corral: None.

Funding
National Institutes of Health (P60 MD00254) National Institutes of Health (UL1GM118976) National Institutes of Health (RLGM118975) National Institutes of Health (TL4GM118977)
To elevers udvikling gennem vejledning i de store opgaver i gymnasiet
Authors: Bang-Larsen Anne , Dreyer Søren Nygaard 
Published: May 2022

I danske læreplaner for gymnasiet fremhæves det, at vejledning og skriftlighed er tæt forbundne. Vejledningsforskning har i nogen grad fokuseret på vejlederpositioner og modeller for vejledning, mens man i forskning i skrivning i gymnasiet i dansk kontekst har undersøgt skriverudviklinger i fag og i de store, flerfaglige opgaver. Imidlertid har koblingen mellem vejledning og skriverudvikling været underbelyst. I denne artikel undersøger vi med et sociokulturelt afsæt, hvordan vejledninge i de store skriftlige opgaver i gymnasiet i dansk kontekst påvirker elevernes udvikling som skrivere. Vi fokuserer på to elevskriveres erfaringer med vejledning gennem tre store opgaver. Analyserne, som er baseret på kvalitative data fra et casestudie, viser, at de to elevers udvikling er besværlig og kompleks. Eleverne efterspørger vejledning, der er tæt på deres tekst og skrivning, men dette imødekommes kun i begrænset omfang i vejledningen: Vejledningen er enten meget lokal eller meget generisk og overvejende færdighedsorienteret. Desuden peger analyserne på, at vejledningen kun i begrænset omfang inddrager det diakrone perspektiv i elevernes udvikling. Derved vises det, at det i høj grad overlades til eleverne selv at etablere sammenhæng i deres udvikling gennem vejledning og skrivning.
English abstract
Two pupils’ development through participation in supervision in connection with written projects as part of upper secondary school
The Danish upper secondary school curricula emphasise an interconnectivity of supervision and writing. Research has to some extent focused on supervisor positions and models for supervision, while the Danish research into upper secondary school literacy has focused on writer development in the individual disciplines as well as in the students’ three individual interdisciplinary written projects. The connection between supervision and writer development, however, has been overlooked. With a sociocultural basis, this article examines how supervision leading up to the individual interdisciplinary written projects influences the students’ development as writers. The article focuses on two student writers’ supervision experiences throughout all three obligatory written projects in Danish upper secondary school. Analyses, based on qualitative data, show that the developments of the two students are strenuous and complex. The students seek a type of supervision specifically aimed at their text and concrete writing process, but this is only seldom met during the supervisions. Rather, the supervision tends to be either very local or quite generic and predominately proficiency-oriented. In addition, the analysis shows that the observed supervision only to a limited extent includes the diachronic perspective in the students’ development. Thus, it is shown that it is the students themselves who are predominately responsible for establishing coherence in their own developments through supervision and writing.
KEMAMPUAN ALJABAR DITINJAU DARI SIKAP SISWA
Authors: Rohman Muhamad Gani , Mulyono Mulyono , Dwidayati Nurkaromah 
Published: May 2022

AbstractAlgebraic ability is an important part in mathematics. Someone with good algebraic ability will have good performancein mathematics. Math performance has related with attitudes toward mathematics. Someone with good math performance will have good math ability too. Algebraic ability can represent the quantitative situation so someone with good algebraic ability can see the relationship between variables clearly. Attitudes toward mathematics is positive or negative feelings toward math. The methods in this study uses a mixed methods with sequential explanatory design where research is conducted in two stages, followed by a quantitative research to know algebraic ability after learning with TAI’s Learning Model and followed with a qualitative research to analyze the algebraic in terms of attitudes toward mathematics. The quantitative research start with choosing sample students in XI IPA 5 of MAN 2 Kudus, when the qualitative research took seven students in that class. After all students in that class learned and participated in algebraic ablility test, there are correlation between attitute towards mathematics and algebraic ability.AbstrakKemampuan aljabar merupakan salah satu hal penting dalam matematika. Dengan kemampuan aljabar yang baik, performa matematika seseorang akan meningkat. Performa matematika memiliki kaitan dengan sikap terhadap matematika. Ketika performa matematika seseorang baik, maka kemampuan-kemampuan matematika dalam diri orang tersebut juga relatif baik. Kemampuan aljabar mampu merepresentasikan situasi kuantitatif sehingga seseorang yang memiliki kemampuan aljabar mampu melihat hubungan antar variabel menjadi jelas. Sikap terhadap matematika merupakan perasaan positif atau negatif seseorang terhadap matematika. Metode penelitian yang digunakan adalah mixed methods dengan menggunakan desain sequential explanatory dimana penelitian dilakukan dengan dua tahap yaitu penelitian kuantitatif dengan menguji kemampuan aljabar setelah diajar dengan model TAI dan selanjutnya akan dilanjutkan dengan analisis kemampuan aljabar bila ditinjau dari sikap siswa. Penelitian kuantitatif mengambil sampel siswa kelas XI IPA 5 di MAN 2 Kudus, sementara penelitian kualitatifnya mengambil subjek penelitian tujuh siswa dari kelas tersebut. Setelah siswa kelas tersebut menerima pembelajaran dan mengikuti tes kemampuan aljabar, ditemukan pengaruh sikap siswa terhadap matematika pada tingkat kemampuan aljabar yang dimiliki.
Struktur, Makna, Fungsi, Dan Nilai Budaya, Dalam Mantra Aji Pemikat di Desa Margotani II Kecamatan Madang Suku II Kabupaten Oku Timur
Authors: Evriana Anggun , Missriani Missriani , Fitriani Yessi 
Published: May 2022

Tujuan penelitian ini untuk mendeskripsikan Struktur, Makna, Fungsi, Dan Nilai Budaya Dalam Mantra Aji Pemikat. Dalam mencapai validitasi, penelitian ini menggunakan jenis penelitian deskriptif dengan pendekatan kualitatif. Melalui metode pengumpulan data observasi, wawancara, rekam, pencatatatan, dan dokumentasi. Data dan sumber data dalam penelitian ini adalah mantra Aji Pemikat yang dimiliki oleh dukun atau paranormal yang terdapat di Desa Margotani II Kecamatan Madang Suku II Kabupaten Oku Timur. Sumber data dalam penelitian ini adalah penutur mantra yang terdapat yang terdapat di Desa Margotani II Kecamatan Madang Suku II Kabupaten Oku Timur. Makna yang muncul dari mantra Aji Pemikat yaitu penggunaan mantra sebagai ilmu keluhuran. Fungsi mantra Aji Pemikat yaitu sesuai kegunaan mantra.
DIRECTIVE AND EXPRESSIVE SPEECH ACTS USED BY TRAVIS PARKER IN THE CHOICE MOVIE
Authors: Wea Teofanne Nurinik , Bram Barli 
Published: May 2022

This paper aimed to explore the categories of speech acts used by Travis Parker as the main character of The Choice movie. Data were collected using a qualitative method and analyzed using a descriptive analysis technique. Results showed that the main character used directive and expressive speech acts. The directive ones included the acts of ordering, commanding, warning, suggestion, requesting, forbidding, and inviting. Specifically, the act of ordering something appeared once, commanding four times, giving a suggestion once, requesting twice, forbidding twice, and inviting someone once. Furthermore, the expressive function included the acts of apologizing, thanking, greeting, and compliment. Specifically, the act of apologizing for someone appeared six times, giving thanks once, greetings three times, and giving a compliment three times. Exploring the roles and context of speech acts in The Choice movie from a sociolinguistic perspective will contribute to English learning-teaching.
REPRESENTASI PEMAHAMAN SINTAKSIS MAHASISWA SAAT BELAJAR DARING
Authors: Nisa Khairun 
Published: May 2022

Tujuan penelitian ini dilakukan untuk dapat menjelaskan hasil pemahaman mahasiswa Universitas Asahan pada mata kuliah sintaksis selama tujuh pertemuan dengan pembelajaran daring. Metode penelitian yang digunakan adalah metode deskriptif dengan pendekatan kualitatif.. Teknik pengumpulan data dengan menggunakan google formulir dengan link https://forms.gle/qAwPr3NfSidbbN8ZA. Subjek penelitian adalah mahasiswa semester IV yang berjumlah 74 mahasiswa. Instrumen pengumpulan data menggunakan soal pilihan berganda sebanyak 7 pertanyaan dengan durasi pengerjaan selama 3 menit. Berdasarkan hasil analisis ditemukan data mahasiswa yang menjawab benar pada soal pertama sebanyak 51 (68,8%). Soal kedua sebanyak 52 (70,3%). Soal ketiga sebanyak 26 (53,1%). Soal keempat sebanyak 72 (93,7%). Soal kelima sebanyak 36 (48,6%). Soal keenam sebanyak 22 (22,9%). Soal ketujuh sebanyak 62 (83,8%). Berdasarkan data tersebut dapat disimpulkan bahwa pemahaman dasar mahasiswa pada materi sintaksis masih sangat rendah dengan menggunakan pembelajaran daring terutama pada materi kalimat pasif dan dalam mengkategorikan jenis kalimat.