bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Risk Adjustment of Required Rate of Return for Supply Chain Infrastructure Investments
Authors: MOON GISUNG , LeBLANC LOUIS A. 
Published: June 2022

Abstract
The purpose of this article is to apply a risk-adjusted required rate of return to evaluate supply chain capital investments. As part of the design methodology, a computer simulation provides expected cash flows resulting from alternative supply chain investments. These cash flows are discounted at a risk-adjusted required rate of return. The analysis represents a process to measure the risk inherent in supply chain investments. The logistics and supply chain literature has not addressed this problem of the risk inherent in a specific supply chain project. A corporate-wide hurdle rate applied to usually conservative supply chain investments may result in less than adequate investments in supply chain infrastructure. Prior studies have determined risk-adjusted required rate of return for the entire firm, an enterprise's entire supply chain network, but not an individual project within the supply chain. This study calculates a required rate of return for a specific supply chain investment project using a discrete simulation model rather than the more common mathematical model. Individual supply chain investment projects may have less risk or possibly more risk than reflected by a corporate hurdle rate or a supply chain hurdle rate. Using a standard required rate of return could result in too little or too much investment in supply chain facilities. In this study, when the risk-adjusted rate was employed to discount expected cash flows, only two of eleven alternatives evaluated were acceptable investments. The best investment with the highest return was a 12 percent increase in ship loading rate combined with a 33 percent increase in rail unloading capacity. It provided a benefit-cost ratio of 1.25. The limited availability of publicly traded firms that invest in supply chain projects represents a constraint, limiting the accuracy of estimating the market risk factor. Nevertheless, the practical implication is that, when making supply chain infrastructure investment decisions, it is advisable to adjust risk factors in evaluating such capital investments. This approach is preferable to using a corporate-wide hurdle rate, typically too high for such conservative investments. A firm-wide hurdle rate might result in under investment in supply chain facilities.
Real-Time Trailer Scheduling for Crossdock Operations
Authors: WANG JIANA-FU , REGAN AMELIA 
Published: June 2022

Abstract
Crossdocks play an important role in supply chain operations. Due to the need to decrease transportation lead time to coordinate with other supply chain activities such as just-in-time, make-to-order, or merge-in-transit strategies, shortening the total transfer time at crossdocks is increasingly important. In this research, we use real-time information about freight transferring within a crossdock to schedule waiting inbound trailers in order to reduce the time freight spends in a crossdock. We use dynamic simulation models to compare the performance of several strategies. These are first-come, first-served, look-ahead, minimum processing time, and minimum total time policies. We examine these under different trailer arrival headways, crossdock layouts, and destination distributions. Our simulation results show that our time-based algorithms save more time than the first-come, first-served and look-ahead policies. In addition, these algorithms appear to result in higher service reliability and productivity.
1480-PUB: Relationship between Sodium Intake with Atherogenesis in Type 1 Diabetes
Authors: KUMAR SUBHASH 
Published: June 2022

Objectives: Accelerated atherogenesis can be defined as a complex procedure where the addition of facilitatory and pathogenic factors activates molecular pathways leading to the development and progression of atherosclerotic plaque. Patients diagnosed with Type-1 Diabetes bring control over the amount of sodium they consume. Despite the fact that salt intake is corresponding with blood pressure, it also partly determines the activation state of the RAAS. This study aims to determine the relationship between sodium intake and adverse outcomes among patients with diabetes. Methods: A total of 912 participants who regard their dietary intake at baseline is analyzed and assessed by the Food Frequency Questionnaire based on food groups. Results: This study found that in adults with Type-1 diabetes, low sodium intake was connected with increased risks of new-onset cardiovascular events and all-cause mortality. High sodium intake was often blamed for drastic outcomes, which leads to a “J-shaped relationship” overall. Even though BP-lowering is considerably a crucial objective for the management of diabetes, off-target actions that would help in activating the RAAS might contribute to lack of protection from CVD complications among patients with Type-1 diabetes with low levels of sodium intake.
Conclusion: This study suggested that the relationship between cardiovascular outcomes in diabetes and the amount of sodium intake is more complicated than simply being a cause of high BP.

Disclosure
S.Kumar: None.
1499-PUB: Increasing Utilization of SGLT2 Inhibitors for Cardiac Patients
Authors: RIVERA ANDREA V. , WANG XUEJUN A. , GRODSKY MICHAEL , GANDHI SHIFA , KARAISZ FRED , LEV YAIR 
Published: June 2022

It is increasingly evident that SGLT2 inhibitors (SGLT2i) provide benefits for both patients with diabetes and with heart disease, however these medications are under-prescribed. Over the last few years, an interdepartmental coalition at our hospital has led to several quality improvement projects aimed at increasing SGLT2i use. Our first project focused on increasing prescription of SGLT2i by outpatient cardiologists. Our cardiology department hired a nurse practitioner to review the cardiology patient panels and identify people who might benefit from SGLT2i therapy. She assessed the percent utilization of these drugs - by the end of 24 weeks, she had reviewed 1561 charts and had increased the percentage of patients on an SGLT2i from 9.4% to 10.9%. More importantly, she created a protocol for sending informational messages to providers whose patients were eligible for SGLT2i therapy. Our team also led a project to increase inpatient SGLT2i prescriptions, evaluate barriers to their use, and assess physician comfort with inpatient initiation of therapy. To assess physician comfort with prescribing SGLT2i, we surveyed cardiologists, endocrinologists, and hospitalists regarding prescribing habits and factors preventing SGLT2i inpatient prescription. The most common factors for preventing initiation of SGLT2i therapy included unfamiliarity with evidence for SGLT2i, preference of outpatient initiation, lack of inpatient availability, and cost. To assess whether formulary availability was a barrier to inpatient use, we queried our hospital’s EMR to find the number of inpatient SGLT2i prescriptions before and after dapagliflozin and canagliflozin were added to the hospital formulary. We discovered that adding SGLT2i to our hospital formulary resulted only in a modest increase in the number of SGLT2i prescriptions. Further work needs to be done to increase the utilization of these medications.

Disclosure
A.V.Rivera: None. X.A.Wang: None. M.Grodsky: None. S.Gandhi: None. F.Karaisz: None. Y.Lev: None.
1500-PUB: Characteristics of Inpatients with DKA and SGLT2i Use at a Tertiary Hospital
Authors: WILLIAMSON SHELLEY , TAHA MOHAMAD B. , BROWN TIMOTHY R. , HEBERT SEAN , PATEL KERSHAW , NARCISSE, III VICTOR J. , SADHU ARCHANA R. 
Published: June 2022

Background: SGLT-2 inhibitors (SGLT2i) have cardiovascular and renal benefits but pose an increased risk of DKA. The risk factors for developing DKA while on SLGT2i therapy have not been fully characterized.
Methods: A retrospective, observational chart review was performed to include patients admitted to Houston Methodist in 20with DKA and SGLT2i use. DKA was confirmed using standard laboratories. Potential causes of DKA were categorized based on prior published associations.
Results: Among the 61 patients with DKA, SGLT2i therapy was used at home but discontinued on admission in 46 (75%) , initiated during the hospitalization in 6 (10%) , and continued throughout the hospitalization in 9 (15%) . Potential causes of DKA were infections in 23 (38%) patients, gastrointestinal etiologies in 21 (34%) , NPO and/or perioperative status in 4 (7%) , acute cardiovascular events in 3 (5%) , and (16%) patients had no identifiable etiology.
Conclusions: Among hospitalized patients with DKA and SGLT2i use, we observed poorly controlled diabetes mellitus, with infection and GI disease being the most common associations. This description could help inform strategies to guide safe use of SGLT2i therapy.

Disclosure
S.Williamson: None. M.B.Taha: None. T.R.Brown: None. S.Hebert: None. K.Patel: None. V.J.Narcisse, iii: None. A.R.Sadhu: Advisory Panel; Abbott Diagnostics.
1502-PUB: Intensive vs. Conventional Insulin Therapy Treatment for Paediatric Diabetes
Authors: DAS A K 
Published: June 2022

Background: Intensive insulin therapy is progressively replacing conventional therapy in young children to improve diabetes control. However, the specific skills required to manage insulin pumps may hamper social integration as the fear of severe hypoglycemia using conventional therapy.
Methods: Influences of a continuous education program targeting parents and their substitutes in their living places, was evaluated in 23 subjects aged 2.3 ± 0.2 years treated by insulin pump (CSII) for 3.2 ± 0.6 years and compared to 23 subjects aged 3.2 ± 0.2 years treated by conventional therapy (CV) for 3.5 ± 0.3 y.
Results: HbA1c levels were undistinguishable in both groups throughout the study period, remaining within recommended ADA target. Whereas a greater escalation of insulin dose was witnessed amongst the CV group (0.57 ± 0.to 0.79 ± 0.03 U/kg/day) versus 0.64 ± 0.to
0.70 ± 0.U/kg/day (ns) in the CSII group over time, inter-group differences failed to reach significance. BMI SDS increased significantly in the CSII group. No significant difference had been seen in the number of days of admission/ subject and the number of admissions for severe hypoglycemia. The number of admissions for ketoacidosis was high in the CSII group (p = 0.027) .
Conclusions: Externalizing targeted education programs on the child's living place allows minimizing hypoglycaemia risks of CV. This result may be particularly relevant for under-developed countries and contribute to the reduction of the costs of diabetes management without increasing side effects.

Disclosure
A.Das: None.
1504-PUB: Whole-Body Bioelectrical Impedance Analysis Reflects Levels of Hemoglobin and Hematocrit in Patients with Diabetes Mellitus
Authors: HORI TAIKI , YAMAGAMI HIROKI , YASUI SAYA , HOSOKI MINAE , HARA TOMOYO , KURAHASHI KIYOE , YOSHIDA SUMIKO , NAKAMURA SHINGEN , OTODA TOSHIKI , YUASA TOMOYUKI , ENDO ITSURO , ABE MASAHIRO , AIHARA KEN-ICHI 
Published: June 2022

Aims/Introduction: Anemia is one of the common complications of diabetes mellitus (DM) and is associated with an increased risk of death. In recent years, phase angle (PhA) and the ratio of extracellular water to total body water (ECW/TBW) measured by bioelectrical impedance analysis (BIA) have been commonly used for estimating body composition. Since PhA and ECW/TBW have been reported to be useful as prognostic indicators for various chronic disease, we aimed to clarify the clinical significance of PhA and ECW/TBW in anemia of patients with DM.
Materials and Methods: The values of PhA and ECW/TBW were measured by a portable BIA device (Inbody S10, Inbody Japan, Tokyo, Japan) and blood samples were collected in 403 Japanese patients with DM (217 males and 186 females) atAnan Medical Center, Tokushima Japan. The relationships of PhA and ECW/TBW with hematocrit (Ht) and hemoglobin (Hb) were statistically evaluated.
Results: The level of PhA was decreased with age, whereas the value of ECW/TBW was increased with age. There was close inverse relationship between PhA and ECW/TBW (R2=0.7540, p&lt; 0.001) . PhA was positively correlated with Hb and Ht levels (p &lt;0.001, p &lt;0.001, respectively) . In contrast, ECW/TBW was negatively correlated with Hb and Ht levels (p &lt;0.001, p &lt;0.001, respectively) . Multivariate regression analysis including confounding factors showed that both PhA and ECW/TBW independently contributed to Hb and Ht levels (p &lt;0.0 and p &lt;0.001, respectively) .
Conclusions: PhA and ECW/TBW were associated with levels of Hb and Ht in patients with diabetes. The results suggest that BIA parameters reflect red blood cell lifespan and erythropoiesis.

Disclosure
T. Hori: None. H. Yamagami: None. S. Yasui: None. M. Hosoki: None. T. Hara: None. K. Kurahashi: None. S. Yoshida: None. M. Abe: None.
1507-PUB: Degree of Glycemic Control Does Not Correlate with Nausea and Vomiting in Diabetic Gastroparesis Patients in a Phase 2 Clinical Trial
Authors: CARLIN JESSE L. , FISHER MICHAELA , MADONICK DARBY S. , KUPERSMITH CALEIGH , MOSZCZYNSKI PAULA , XIAO CHANGFU , BIRZNIEKS GUNTHER , POLYMEROPOULOS MIHAEL H. 
Published: June 2022

Background: Gastroparesis is a serious medical condition characterized by delayed gastric emptying and symptoms of nausea, vomiting, bloating, fullness after meals, and abdominal pain (Camilleri et al., 2018) . One-third of gastroparesis cases are related to uncontrolled diabetes (Young et al., 2020) . HBA1C levels in diabetic gastroparesis are not associated with more or less severe vomiting episodes (Parkman et al., 2016) . Individual signs and symptoms may occur more often or with greater severity in one population compared with the other due to the degree of diabetic control. Here we did a post-hoc analysis in a phase 2 study to see if there is a correlation between baseline HBA1C and baseline gastroparesis symptoms.
Methods: Diabetic and idiopathic gastroparesis patients were screened to enroll in a phase 2 clinical trial. Patients with moderate to severe nausea and delayed gastric emptying would go onto be randomized to tradipitant 85mg BID or placebo for 4 weeks. Baseline clinical symptoms were measured by the Gastroparesis Core Symptom Daily Diary (GCSDD) . A post-hoc analysis was performed to correlate HBA1C with baseline gastroparesis symptoms in patients with diabetic gastroparesis.
Results: Patients with diabetic gastroparesis and sufficient baseline data (n=106) had baseline nausea severity of 2.5 (1.175) and baseline HBA1C of 7.366 (1.373) . There was no correlation of baseline nausea and HBA1C levels for diabetic gastroparesis (0.021) . There was no correlation of average daily vomiting, fullness, early satiety, or abdominal pain and HBA1C levels in the diabetic gastroparesis population.
Conclusion: Patients with diabetic gastroparesis experience the core signs and symptoms of gastroparesis. HBA1C levels in this population do not appear to be correlated with severity of nausea and vomiting and other core symptoms of gastroparesis.

Disclosure
J.L.Carlin: Employee; Vanda Pharmaceuticals, Inc. M.Fisher: Employee; Vanda Pharmaceuticals, Inc. . D.S.Madonick: Employee; Vanda Pharmaceuticals Inc. C.Kupersmith: Employee; Vanda Pharmaceuticals. P.Moszczynski: Employee; Vanda Pharmaceuticals, Inc. C.Xiao: None. G.Birznieks: Employee; Vanda Pharmaceuticals. M.H.Polymeropoulos: Other Relationship; Vanda Pharmaceuticals, Inc. .
1512-PUB: Glucose Removal Rate in Patients with APECED
Authors: SANDINI ERIK R. , LAAKSO SAILA , MAKITIE OUTI , PALDANIUS PAIVI M. 
Published: June 2022

Background: Autoimmune polyendocrinopathy-candidiasis-ectodermal dystrophy (APECED or APS-1) is a rare autosomal recessive disorder and diabetes (DM) is one of its more rare manifestations. Earlier, we have showed that reduction in fractional glucose removal rate (KG) , a known precursor of increased peripheral insulin resistance over time, was the only predictor candidate of abrupt, atypical APECED DM onset. We now explored if these changes in KG were age-dependent, and independent of DM status in all patients with APECED.
Materials and Methods: Bi-annually conducted intravenous glucose tolerance tests (ivGTT) and calculated KG values (0.693/T1/2Gluc*100) were reviewed for the Finnish APECED cohort (children and adults screened for DM in 1972-2000) . Pearson correlation coefficients (r) for KG and age at ivGTT were calculated with 2-sided p-values. A Fisher t to z transformation and a z-test were performed to investigate the difference between the groups (with DM diagnosis: DM+; without: DM-) .
Results: A total of 258 ivGTTs were performed on 13 DM+ (mean age at DM onset 27.8 ±11.7 years) and 46 DM- patients. KG values decreased over time in both groups (Figure) , with no statistical difference in the r-values between the groups (z=0.763, p=0.22) .
Conclusion: As markers of peripheral glucose uptake decline similarly over time in all patients with APECED, independent of DM status, we still lack accurate predictors of atypical DM onset in APECED.

Disclosure
E.R.Sandini: None. S.Laakso: None. O.Makitie: Advisory Panel; Kyowa Kirin Co., Ltd., Consultant; BridgeBio Pharma, Inc., Speaker's Bureau; Merck & Co., Inc. P.M.Paldanius: Consultant; Glyconics Ltd, UPM Biomedicals, Speaker's Bureau; Novartis AG, UPM Biomedicals.

Funding
Helsinki University Hospital; Foundation for Pediatric Research
1518-PUB: Role of PPARd in Regulating Autophagy Pathway in Improving Islet ß-Cell Function with GLP-1 Receptor Agonist
Authors: SU YANNA , LIN BEISI , CHEN YALAN , LIU ZIYU , GAN LU , XU WEN 
Published: June 2022

Aim: To investigate the effect and mechanism of glucagon-like peptide-1 receptor agonist (GLP-1 RA) on the function of islet β cells.
Methods: Type 2 diabetes C57BL/6J mice were successfully induced by high fat diet (HFD) feeding for 12 weeks then were randomly divided into HFD+NaCl group (n=5) , HFD+Exenatide group (n=5, 24 nmol•kg-1­•d‑1) and NC group (n=5) . Tolerance tests and insulin measurement were performed after 8 weeks of drug therapy. Weight was measured weekly and fasting blood glucose was measured every 4 weeks. The pancreas were stained with LC3B Immunofluorescence at the end of the experiment. The PA induced primary islet β cells were treated with exendin-4 and PA induced Min6 cells were treated with exendin-4, GW501516 for 24h, which BSA as the control group, then detected the protein levels of PPARδ, LC3B-II and P62. At the same time, PA induced MIN6 cells were treated with GSIS. What's more, we silenced PPARδ transfected with siRNA to verify the role of PPARδ in GLP-1 receptor agonist activation of β-cell autophagy.
Results: Compared with the normal control group, the body weight and fasting blood glucose increase and significant peripheral insulin resistance in the high fat group, while the above indexes are significantly improved in the high-fat fed mice after GLP-1 RA treatment. Immunofluorescence biopsies of pancreatic tissue show that LC3B expression decrease after high fat diet, while GLP-1 RA intervention significantly increase. In addition, GLP-1 RA not only can promote the expression of PPARδ and LC3B-II protein and inhibit the expression of P62 protein in primary islet β cells and MIN6 cells, but also significantly increase glucose stimulation insulin secretion in MIN6 cells. More importantly, GW501516 is found to be consistent with GLP-1 RA in MIN6 cells, while GLP-1 RA promote autophagy disappeare after PPARδ expression is silenced.
Conclusion: GLP-1 RA can improve the function of islet β cells by activating the autophagy pathway through PPARδ.

Disclosure
Y.Su: None. B.Lin: None. Y.Chen: None. Z.Liu: None. L.Gan: None. W.Xu: None.

Funding
Science & Technology Project of Guangzhou（202102010175）
Changes in Circulating miR-375-3p and Improvements in Visceral and Hepatic Fat Contents in Response to Lifestyle Interventions: The CENTRAL Trial
Authors: Heianza Yoriko , Krohn Knut , Meir Anat Yaskolka , Wang Xuan , Ziesche Stefanie , Ceglarek Uta , Blüher Matthias , Keller Maria , Kovacs Peter , Shai Iris , Qi Lu 
Published: June 2022

<p> </p>
<p><strong>Objective:</strong> To investigate whether changes in circulating levels of pancreatic islet-related microRNA-375 (miR-375) were related to improved visceral and intrahepatic fat accumulation. </p>
<p><strong>Research Design and Methods: </strong>This study included adults with abdominal obesity from an 18-month weight-loss lifestyle intervention trial. Circulating miR-375-3p was measured at baseline and 18 months. The magnetic-resonance-imaging (MRI) was performed (n=139) to assess 18-month changes in abdominal and intrahepatic fat depots.</p>
<p><strong>Results: </strong>Circulating miR-375-3p was related to fasting insulin and insulin resistance in participants with pre-diabetes. After the interventions, there was a significant increase of miR-375-3p (<em>p </em><0.001). Greater increase in miR-375-3p was associated with larger reductions of visceral (<em>p</em>=0.024) and deep subcutaneous adipose tissues (<em>p</em> <0.001), and intrahepatic fat content (<em>p</em>=0.012).</p>
<p><strong>Conclusions</strong>: Increases in circulating miR-375-3p were associated with visceral and intrahepatic fat reduction. Changes in circulating pancreatic islet-related miR-375-3p may be linked to improved diabetogenic fat depots during weight-loss lifestyle interventions. </p>
Investigation of Science Teachers’ Professional and Scientific Attitudes
Authors: KARAALİOĞLU ÇAKIR Serpil , KADIOĞLU AKBULUT Cansel 
Published: June 2022

Purpose: The aim of this study is to investigate the level of science teachers’ professional and scientific attitudes, whether these variables differ according to gender and the relationship between two variables.
Design/Methodology/Approach: It is conducted through survey design based on quantitative research. A total of 174 science teachers (91 females and 83 males) working in public middle schools participated. The data were collected using “Attitudes towards Teaching Profession Scale” and “Scientific Attitudes Scale”. Additionally, qualitative data were collected through “Demographic Information Form” to support quantitative findings. Descriptive statistics, independent samples t-test and Pearson correlation analysis techniques were used in quantitative data analysis. Besides, descriptive analysis technique was used to analyze qualitative data.
Findings: Results revealed that science teachers possessed highly positive attitudes towards teaching profession, and their scientific attitudes were at moderate level. While female teachers’ professional attitudes were found to be more positive, scientific attitudes did not change by gender. There was a moderate and positive relationship between two variables. Science teachers choose their profession mainly for affective reasons such as loving teaching. Moreover, although teachers mostly attended in-service training programs, they were not trained on nature, history or philosophy of science to improve scientific attitudes. Finally, it was discovered that TUBITAK publications were popular among science teachers.
Highlights: Although science teachers possess positive attitudes towards their profession, their scientific attitudes found to be moderate. In the Information Age, scientific attitudes of teachers are of great importance as well as their attitudes towards their profession. In order to support teachers’ scientific attitudes, in-service trainings on the nature, history, or philosophy of science can be developed, implemented, and evaluated.