bluuebunny/crossref_metadata_2025_split huggingface dataset:
PSUN181 Diabetes-related outcomes following use of basal-bolus insulin vs. premixed insulin in a VA population with Type 2 diabetes: A retrospective chart review.
Authors: Izuora Kenneth , Batra Kavita , Bai Ravisha , Yap Charmaine 
Published: November 2022

Abstract

Background
Treatment of diabetes mellitus (DM) with basal bolus insulin analogs (BB) requires up to five injections a day. The complexity of BB therapy may adversely influence patient compliance. A simpler and cheaper regimen with premixed insulin (PM) typically involves two injections a day but is perceived to be less effective in managing DM. The purpose of this research project was to compare DM-related outcomes between BB regimens (insulin detemir or glargine plus aspart, lispro or regular insulin) and PM insulin regimens (70/30 insulin NPH/regular) among our veteran population with type 2 DM.

Research design and Methods
This is a retrospective chart review that included 140 veterans (70 in BB group and 70 in PM group) with type2 DM. Subjects aged 18 years or above and those having A1C level ≥ 8% were included. Subjects with type 1 diabetes or who switched their insulin regimen during the follow-up period were excluded. The included subjects were followed for a year, after the start of respective insulin therapies to examine change in A1c (primary outcome) levels across groups. Data were analyzed using Chi-square/Fisher exact tests and logistic regression. All analyses were conducted using SPSS version 27 and SAS9.4.

Results
Out of 140 enrolled subjects, 94% were males with average age of 65.7 ± 10.1 years and DM duration of 12.9±9 years. There was no significant difference in age, gender, baseline A1c, BMI or duration of DM between the two groups. Following treatment initiation, there was no statistically significant difference between the BB and PM insulin groups for change in A1c (-1.9±1.8 vs -2.1±1.9%, p = 0.3) or for the rate of hypoglycemia (30% vs 21.4%, p = 0.3) respectively. Although the average BMI increased in both groups, the change was similar for both BB and PM groups (0.84±3.1 vs 0.4±2.2 kg/m2 respectively, p = 0.2). A logistic regression controlling for the confounders of hypoglycemia, found that the type of insulin used did not predict the development of hypoglycemia [OR 0.594, (0.251, 1.404)].

Conclusion
There were no significant differences in A1c change, rate of hypoglycemia, and change in body mass index in patients treated with either BB or PM insulin among our study population. These results suggest that PM insulin is equally effective as the BB and its use can potentially improve patient compliance and reduce the cost of care.
Presentation: Sunday, June 12, 2022 12:30 p.m. - 2:30 p.m.
PSUN186 Comparison of Thyroid Function Test Screening in Patients with Diabetes Mellitus Type 2 versus Patients with Diabetes Mellitus Type 1
Authors: Aasim Alina , Cruz Maria , Potluri Sai Deepika , Schroeder Pamela , Yi Crystal 
Published: November 2022

Abstract
Diabetes mellitus (DM) and thyroid dysfunction (TD) are common endocrine diseases that often coexist in clinical practice. Prevalence of TD in individuals with DM type 2 ranges from 9.9 to 48%. There are no screening guidelines for thyroid function in patients with DM type 2 as there are in patients with DM type 1. Our previous electronic medical record (EMR) included an aid that imported diabetes metrics, but the current system does not. A previous study at our institution revealed TSH screening rate to be 86.2% in DM type 1 patients. We examined the rate of screening for TD in patients with DM type 2 versus DM type 1 based on the general population guidelines, and we evaluated the effect of EMR aid versus no aid on screening rate. We also analyzed the underlying etiology of thyroid dysfunction in patients with DM type 2 found to have an abnormal TSH.
We compared practice patterns with Centricity (EMR aid; from June 1, 2013 to May 30, 2016) and MedConnect (no EMR aid; from January 1, 2017 to December 31, 2019) in both primary care and endocrinology clinics in the MedStar hospital system in Baltimore, MD. A retrospective review was performed on 949 patient charts (MedConnect 498, Centricity 451). Inclusion criteria were DM type 2 diagnosis (ICD code E 11.0 to E 11.9) and age ≥18 years with at least one outpatient clinic visit.
Baseline TSH was done in 551 of overall 949 patients (58.1%), with 249 of 451 (55.2%) in Centricity and 302 of 498 (60.4%) in MedConnect. This difference was not significant (P = 0.5). Of the total 551 patients with baseline TSH, 48 (8.7%) had abnormal TSH, of which 35 patients (11.5%) were in MedConnect and 13 (5.2%) were in Centricity (P = 0.01). Of the overall abnormal results, 35 patients (6.3%) had hypothyroidism, 10 (1.8%) had hyperthyroidism, 2 (0.4%) had subclinical hyperthyroidism, and 1 (0. 2%) had subclinical hypothyroidism results. Logistic regression analysis found that the adjusted odds of baseline TSH screening with endocrinologists was 1.54 times higher than with primary care physicians.
No significant difference was found in TSH screening in patients with DM type 2 irrespective of EMR aid. A larger proportion of abnormal results were found in MedConnect than in Centricity. Endocrinologists ordered TSH screening more often than primary care physicians. The screening rate of TSH in patients with DM type 2 was lower than that found in our previous study of TSH screening in patients with DM type 1. This was expected as there are no current screening guidelines for TD specific to DM type 2 patients. Further studies are needed, and consideration should be given to screening all DM type 2 patients with symptoms.
Presentation: Sunday, June 12, 2022 12:30 p.m. - 2:30 p.m.
PSUN187 Validation of a multi-frequency bioelectrical impedance analysis device for the assessment of body composition in older adults with type 2 diabetes
Authors: Buch Assaf , Eldor Roy , Greenman Yona , Izkhakov Elena , Rouach Vanessa 
Published: November 2022

Abstract

Background
Aging and type 2 diabetes (T2DM) are associated with an increased risk of developing sarcopenia which is associated with poor outcomes and may necessitate specific treatment. Diagnosis of sarcopenia often requires the referral of patients to dual-energy X-ray absorptiometry (DXA) in specialized settings. Another available method for assessing body composition is direct segmental multi-frequency bioelectrical impedance analysis (DSMF-BIA). In this study, we examine the accuracy of a DSMF-BIA (InBody 770) for assessing body composition in older adults with T2DM when compared to DXA.

Methods
84 older adults (49 women, age 71 ± 5 years. Body mass index 30 ± 5.6 kg /m2) with T2DM who were recruited for the CEV-65 study and had both DSMF-BIA and DXA assessments at baseline were included in the analysis. The main analysis included Bland-Altman plots and Intra Class Correlation Coefficients (ICC). Sub-analyses were performed according to gender and following 10 weeks of intervention (diet, circuit resistance training, and Empagliflozin).

Results
The leg lean mass results according to DSMF-BIA and DXA were 14.76 ± 3.62 kg and 15.19 ± 3.52 kg respectively, however, did not differ between devices according to Bland-Altman analyses (p=0.353). Assessment of appendicular skeletal mass index did not differ between DSMF-BIA and DXA (7.43 vs. 7.47 kg/m2; p=0.84; ICC=0.965, p&lt;0.0001; bias of -0.068, p =0.595). The accuracy of DSMF-BIA was limited when estimating fat mass indices reflected by significant biases according to Bland-Altman analyses.

Summary
In a sample of older adults with T2DM the degree of agreement between DSMF-BIA and DXA, was high, supporting the use of DSMF-BIA for the diagnosis of low muscle mass. Better accuracy was observed when comparing parameters of lean mass versus parameters of fat mass. Gender as well as three common treatment modalities for T2DM did not modify the accuracy of the DSMF-BIA when compared to DXA.
Presentation: Sunday, June 12, 2022 12:30 p.m. - 2:30 p.m.
The philanthropy's crucial role in alleviating stunting in Indonesia through research funding: A policy brief
Authors: Morasa Jenny , Nurkolis Fahrul , Narasiang Bezaliel R. , Visnu Jodi , Mayulu Nelly , Taslim Nurpudji Astuti , Gunawan William Ben , Handoko Matthew Nathaniel , Hardinsyah Hardinsyah 
Published: November 2022

Background: Developing countries need funding for researchers to maximize the evidence base, especially in stunting research. This short policy is expected to provide opportunities for Indonesia to receive more research funding to stunt philanthropists. Policy and implications: Multi-sector cooperation is arguably the leading player in acceleration programs to reduce growth delays. The Stunted Reduction Acceleration Program, complemented by higher research and development expenditures (RDEs) and open policies to support philanthropic activities in Indonesia, will help improve the efficiency of stunted stunt reduction through adequate funding and investment. As evidenced by Singapore and Thailand, the increase in government budgets focused on research and development (R&D) and supportive environments, as shown by Global Philanthropy Environment Index (GPEI), prove that evidence-based and practical researches can lead to the reduction of estimated prevalence of stunting rather than innovation-stage research. Recommendations: Attention needs to be directed in proposing major changes in law and policy which regulate the allocation of research-development expenditure, which will initiate the creation of a supportive environment for philanthropy acts regarding stunting. The challenges associated with these issues are: (1) Stunted research and innovation are still left behind, (2) The availability of data and the lack of transparency, (3) Subpar performance in relation to philanthropists, (4) Inconsistent legal definitions and a lack of industry-specific guidelines, (5) Inadequate law enforcement, (6) Local leaders must engage in evidence-based advocacy, (7) Philanthropists have limited opportunities to learn.
Ex vivo comparative investigation of suprachiasmatic nucleus excitotoxic resiliency
Authors: Acharyya Debalina , Cooper Joanna , Prosser Rebecca 
Published: November 2022

Background: Glutamate signaling in the brain is regulated by release, reuptake, and receptor responsiveness. In diseased conditions, glutamate signaling can exceed normal regulatory processes, giving rise to a condition called excitotoxicity. Although regional differences in the excitotoxic effects of glutamate in the brain have been reported, the extent and characteristics of these potential differences are not clear. Here we compared the excitotoxic resiliency of the suprachiasmatic nucleus (SCN), anterior hypothalamus (AH) and cortex. Methods: We treated acute brain slices containing either the SCN and AH or the cortex from adult male mice at different times across the diurnal cycle with varying concentrations of N-methyl-D-aspartate (NMDA), NMDA+ α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid (AMPA) or control medium. The extent of cell damage was assessed using propidium iodide (PI), a cell death marker. Results: The results indicate that all three brain regions exhibited increasing cell damage/death when treated with increasing concentrations of NMDA. However, higher concentrations of NMDA were needed to significantly increase cell damage in the SCN compared to the cortex and AH. All three brain regions also exhibited greater cell death/damage when treated in the nighttime compared to the daytime, although the SCN exhibited increased cell death during a more restricted time interval compared to the AH and cortex. Conclusions: Together, these data confirm previous studies showing excitotoxic resiliency in the SCN, while extending them in two ways. First, we demonstrate a dose-dependency in excitotoxic susceptibility that differentiates the SCN from the surrounding AH and the cortex using a brain slice preparation. Second, we demonstrate a diurnal rhythm in excitotoxic susceptibility with a broadly similar phase across all three brain regions. These data increase our understanding of the extent and nature of the SCN excitotoxic resiliency, which will inform future studies on the cellular mechanisms underlying this phenomenon.
Improving the Quality of Learning Content for Teachers of SMK Windusari Magelang
Authors: Hendradi Purwono , Yudatama Uky , Nuryanto Nuryanto , Ratna Arumi Endah , Nugroho Setiya 
Published: November 2022

Background: The need to increase the mastery of Information and Computer Technology (ICT) in teaching and learning activities is essential and urgent, especially during the COVID-19 pandemic. The PowerPoint application is a popular application for creating learning content, but most teachers are only at the level of "powerpointers". SMK Negeri Windusari, as a vocational high school, requires an increase in the level of its educators, namely those who can increase learning outcomes, one of which is by developing multimedia content based on PowerPoint. This training was in collaboration with UNIMMA Informatics Engineering. It was attended by twenty-four teachers starting with a pre-test and ending with a post-test to measure the level of success.
Contribution: Improving the quality of content to support learning outcomes.
Method: The training on the use of ICT for learning begins with observation through a pre-test and ends with a presentation of the training results, and then measures progress using a post-test.
Results: The results of the training showed that most of the participants showed improvement.

Conclusion: This training is expected to be sustainable as a form of support for improving the quality of learning content
Determining the Priority of Business Development Strategy for Kunir Jalak Business Unit, SMK Muhammadiyah 1 Moyudan, Sleman
Authors: Budijati Siti Mahsanah , Astuti Fatma Hermining , Jatiningrum Wandhansari Sekar , Ichwanudin Aziz 
Published: November 2022

Background: Kunir Jalak business unit is part of UPJ Surya Boga belonging to the Catering Department at SMK Muhammadiyah 1 Moyudan, Sleman. This unit produces a powder drink made from turmeric, ginger, and temulawak. This drink is intended to maintain immunity, considering the covid 19 pandemic. The Kunir Jalak business unit is relatively new, so it still needs assistance to develop its business. This community service activity aims to assist in determining business development strategies so that the Kunir Jalak business unit can be more developed.
Contribution: The impact of community service activities is shown by increasing partners’ empowerment in identifying strengths, weaknesses, opportunities, and threats (SWOT) for the Kunir Jalak business unit and determining the alternative business development strategy, which has never been done before.
Method: The method used is Focus Group Discussion (FGD) to determine strengths, weaknesses, opportunities, and threats (SWOT) and determine business development strategies. Furthermore, the Analytical Hierarchy Process (AHP) approach determines strategic priorities.
Results: AHP analysis shows three business development strategies with the highest priority, namely: Weakness-Treats-1 (WT-1), Strength-Treats-1 (ST-1), and Weakness-Opportunity-2 (WO-2).
Conclusion: Following the objectives of the community service program, it means that the priority of business development strategies can be determined, which can be used as guidelines for developing the business unit of Kunir Jalak.
Validating the use of 3D biplanar radiography versus CT when measuring femoral anteversion after total hip arthroplasty
Authors: Anderson Christopher G. , Brilliant Zachary R. , Jang Seong J. , Sokrab Ruba , Mayman David J. , Vigdorchik Jonathan M. , Sculco Peter K. , Jerabek Seth A. 
Published: November 2022

Aims Although CT is considered the benchmark to measure femoral version, 3D biplanar radiography (hipEOS) has recently emerged as a possible alternative with reduced exposure to ionizing radiation and shorter examination time. The aim of our study was to evaluate femoral stem version in postoperative total hip arthroplasty (THA) patients and compare the accuracy of hipEOS to CT. We hypothesize that there will be no significant difference in calculated femoral stem version measurements between the two imaging methods. Methods In this study, 45 patients who underwent THA between February 2016 and February 2020 and had both a postoperative CT and EOS scan were included for evaluation. A fellowship-trained musculoskeletal radiologist and radiological technician measured femoral version for CT and 3D EOS, respectively. Comparison of values for each imaging modality were assessed for statistical significance. Results Comparison of the mean postoperative femoral stem version measurements between CT and 3D hipEOS showed no significant difference (p = 0.862). In addition, the two version measurements were strongly correlated ( r = 0.95; p < 0.001), and the mean paired difference in postoperative femoral version for CT scan and 3D biplanar radiography was -0.09° (95% confidence interval -1.09 to 0.91). Only three stem measurements (6.7%) were considered outliers with a > 5° difference. Conclusion Our study supports the use of low-dose biplanar radiography for the postoperative assessment of femoral stem version after THA, demonstrating high correlation with CT. We found no significant difference for postoperative femoral version when comparing CT to 3D EOS. We believe 3D EOS is a reliable option to measure postoperative femoral version given its advantages of lower radiation dosage and shorter examination time. Cite this article: Bone Joint J 2022;104-B(11):1196–1201.
Spinal versus general anaesthesia in contemporary primary total knee arthroplasties
Authors: Owen Aaron R. , Amundson Adam W. , Larson Dirk R. , Duncan Christopher M. , Smith Hugh M. , Johnson Rebecca L. , Taunton Michael J. , Pagnano Mark W. , Berry Daniel J. , Abdel Matthew P. 
Published: November 2022

Aims Spinal anaesthesia has seen increased use in contemporary primary total knee arthroplasties (TKAs). However, controversy exists about the benefits of spinal in comparison to general anaesthesia in primary TKAs. This study aimed to investigate the pain control, length of stay (LOS), and complications associated with spinal versus general anaesthesia in primary TKAs from a single, high-volume academic centre. Methods We retrospectively identified 17,690 primary TKAs (13,297 patients) from 2001 to 2016 using our institutional total joint registry, where 52% had general anaesthesia and 48% had spinal anaesthesia. Baseline characteristics were similar between cohorts with a mean age of 68 years (SD 10), 58% female (n = 7,669), and mean BMI of 32 kg/m2 (SD 7). Pain was evaluated using oral morphine equivalents (OMEs) and numerical pain rating scale (NPRS) data. Complications including 30- and 90-day readmissions were studied. Data were analyzed using an inverse probability of treatment weighted model based on propensity score that included many patient and surgical factors. Mean follow-up was seven years (2 to 18). Results Patients treated with spinal anaesthesia required fewer postoperative OMEs (p < 0.001) and had lower NPRS scores (p < 0.001). Spinal anaesthesia also had fewer cases of altered mental status (AMS; odds ratio (OR) 1.3; p = 0.044), as well as 30-day (OR 1.4; p < 0.001) and 90-day readmissions (OR 1.5; p < 0.001). General anaesthesia was associated with increased risk of any revision (OR 1.2; p = 0.021) and any reoperation (1.3; p < 0.001). Conclusion In the largest single institutional report to date, we found that spinal anaesthesia was associated with significantly lower OME use, lower risk of AMS, and lower overall 30- and 90-day readmissions following primary TKAs. Additionally, spinal anaesthesia was associated with reduced risk of any revision and any reoperation after accounting for numerous patient and operative factors. When possible and safe, spinal anaesthesia should be considered in primary TKAs. Cite this article: Bone Joint J 2022;104-B(11):1209–1214.
Conversion of Oil Shale To Liquid Hydrocarbons as A New Energy Resources Using Iron (Fe)-Pillared Clay (Kaolinite) Catalyst
Authors: Dewanto Ordas , Ferucha Istifani , Darsono Darsono , Rizky Sri 
Published: November 2022

In the context of new energy exploration, oil shale is currently a source of energy that is being developed so that it can be used as an alternative energy in the future. Based on this background, it is important to research the conversion method of oil shale to liquid hydrocarbons. The method used is using clay (kaolinite) catalyst and iron (Fe)-pillared clay (kaolinite) catalyst. Clay catalyst products are capable of making organic mature faster and even requiring a lower temperature for the changes (through thermal cracking of non-volatile organic material). The addition of Fe metal in the clay catalyst product to oil shale, causing the surface area of the natural clays were significantly increased, then the volume of micro pore were also increased, it causes the organic material to mature faster and the temperature required for the change is less than the shale material without Fe. The catalyst method by the pillarization technique able to increase the surface area and pore volume, thus accelerating the reaction and changing the reaction rate to be greater. It is observed that clay catalyst products can serve as catalysts for accelerating organic maturation reactions. if compared between the clay material of OD1-Ast1 (50% clay-50% organic), OD1-Ast2 (33% clay-67% organic), and the OD1-Ast3 shale material (67% clay - 33% organic),then OD1-Ast3 has a faster reaction rate. Comparison of clay material is smaller than organic, then the properties of the catalyst product to accelerate the reaction are reduced, such as the OD1-Ast2 shale material has a slow reaction rate compared to the OD1-Ast3 shale material. The addition of Fe metal in the clay catalyst product to the OD1-Ast2 shale material, resulting in OD1-Ast2-Fe shale material (75% OD1-Ast2 and 25% Fe) having a faster reaction rate than before the addition of Fe metal.The design of heavy (%) clay (kaolinite) and Fe pilaration on oil shale were greatly influence the change of TOC values when heated,then affecting maturation and Tmax. The temperature of maturation and Tmax as the main parameters of conversion of oil shale to liquid hydrocarbon. This method supports the development of science and technology in the field of exploitation and processing of natural resources.