bluuebunny/crossref_metadata_2025_split huggingface dataset:
975-P: Simplifying Therapy to Assure Glycemic Control and Engagement (STAGE) for Patients with Clinic Refractory Diabetes
Authors: ALEXOPOULOS ANASTASIA-STEFANIA , SOLIMAN DIANA , LEWINSKI ALLISON , STRAWBRIDGE ELIZABETH , STEINHAUSER KAREN , EDELMAN DAVID , CROWLEY MATTHEW J. 
Published: May 2022

Patients with type 2 diabetes (T2D) who maintain poor glycemic control despite use of complex insulin regimens may not benefit from this costly and burdensome treatment approach. In a 16-week feasibility pilot, we proactively simplified the insulin regimens of patients with clinic refractory T2D, or maintenance of an HbA1c ≥8.5% for ≥1 year despite engagement with Primary or Endocrinology care. We recruited 12 patients with clinic-refractory T2D on 3-4 daily insulin injections. Using an algorithm created for this study, insulin regimens were simplified to 2 daily injections of pre-mixed 70/30 insulin (NPH/regular vial and syringe or Aspart 70/30 Flexpen) or U-500 regular insulin pens. Simplification was followed by weekly telephone calls for 4 weeks to ensure safety and continued insulin adjustments. The next and final scheduled follow-up was at 16 weeks. Primary feasibility and acceptability outcomes were treatment acceptability by the Treatment Acceptability and Preferences (TAP) measure, adherence by the Voils Medication Nonadherence measure and T2D distress by the Diabetes Distress Scale. HbA1c was examined as a secondary outcome at baseline and 16 weeks. Mean patient age was 68.8 (SD 8.9) , 2/12 were female, and 7/12 were African American. At baseline, mean HbA1c was 9.5%, 6/12 reported nonadherence to insulin and 5/12 reported high regimen-related T2D distress. At 16 weeks, retention rate was 100% and 2/12 patients had reverted back to a 3-4 shot regimen due to development of a diabetic foot infection (as a precaution) and gastrointestinal side effects. Mean TAP score was 3.33 (range 0-4) ; 1 less patient reported nonadherence to insulin and 4 less patients reported regimen-related distress at study conclusion. Mean HbA1c improved by 0.66% during the study period. This pilot study demonstrates feasibility and acceptability of insulin simplification for patients with clinic refractory T2D on complex insulin regimens.

Disclosure
A.Alexopoulos: None. D.Soliman: None. A.Lewinski: Other Relationship; Otsuka America Pharmaceutical, Inc., PhRMA Foundation. E.Strawbridge: None. K.Steinhauser: None. D.Edelman: None. M.J.Crowley: None.

Funding
Durham VA ADAPT (internal pilot funding)
978-P: Rare Variants in Melanocortin 4 Receptor Gene (MC4R) Are Associated with Increased Visceral Fat and Altered Glucose Metabolism Independent of the Effect of Obesity in Children
Authors: GALUPPO BRITTANY , MANNAM PRABHATH , TRICO DOMENICO , BALE ALLEN E. , CAPRIO SONIA , SANTORO NICOLA 
Published: May 2022

Melanocortin 4 receptor gene (MC4R) mutations result in early-onset obesity, but it is unclear how they affect abdominal fat distribution, intrahepatic fat, and related metabolic sequelae. 484 overweight/obese (BMI &gt;85th percentile for age, sex, and height) youth (6-21 years) were screened for functionally damaging, rare variants (minor allele frequency &lt;0.01) in the coding region of MC4R and were assigned to a Pathogenic Variant (n=10) or No Variant (n=474) group. Participants underwent MC4R sequencing, abdominal MRI, and a 180-minute oral glucose tolerance test (OGTT) with mathematical modeling of insulin kinetics and β cell function. Compared to No Variant group, the Pathogenic Variant group showed greater visceral fat (Figure 1A) , intrahepatic fat (Figure 1B) , and higher plasma glucose (Figure 1C) and insulin (Figure 1D) during the OGTT, as well as a delayed glucose peak (65.4 ± 3.71 vs. 58.8 ± 0.417 minutes; P=0.036) , insulin resistance (WBISI: 0.9± 0.163 vs. 1.82 ± 0.051; P=0.0006) , and lower insulin clearance (0.441 ± 0.065 vs. 0.6± 0.012 µU/mL/min; P=0.033) despite similar BMI z-scores (P=0.189) and body fat percentage (P=0.704) between groups. These results show that rare variants in MC4R are associated with increased visceral fat, intrahepatic fat, and insulin resistance, independent from the effect of obesity.

Disclosure
D. Trico: None. A.E. Bale: None. S. Caprio: None. N. Santoro: None.
982-P: Perfect Storm in Mississippi: High Rate of Obesity Leading to Surge in Pediatric Diabetes during the COVID-Pandemic
Authors: DIXIT NAZNIN , PASHA SIMEEN , SUKUMARAN ANJU P. , ARMSTRONG KATELYN , TOPALOGLU KEMAL , GHOLSON LAUREN , KAMRAN FARIHA 
Published: May 2022

Background: Mississippi ranks second for childhood obesity prevalence (22%) above the national average of 16 % with significant racial and health disparities. Since March 2020, stay-at home orders, virtual learning, stress, and poor lifestyle may have provided a perfect setup leading to new diagnosis of diabetes and accounting for record high hospitalizations. Objective: To determine the impact of the COVID-pandemic on the rate and clinical characteristics of newly diagnosed pediatric diabetes at University of Mississippi Medical Center.
Methods: Chart review and data comparison completed for patients with new-onset-diabetes between January 20-February 2020 (pre pandemic) ; and between March 2020-October 2020 (pandemic) .
Results: Table 1. African Americans were disproportionately diagnosed with diabetes (64%) . Eighty percent of obese patients had type 2 diabetes with 38% presenting in DKA, 3 patients in HHS. Four patients were COVID-positive on admission.
Conclusions: Our observations corroborate the steep rise in the number of new-onset type 1 and type 2 diabetes, particularly in African Americans, in a highly prevalent obese pediatric population. Additional studies are required to determine the detailed effects of SARS-CoV-2 infection and pandemic associated psychosocial, clinical and biochemical effects on development of diabetes in the pediatric population.

Disclosure
N.Dixit: Research Support; Ascendis Pharma A/S, Boehringer Ingelheim International GmbH, Speaker's Bureau; Ascendis Pharma A/S. S.Pasha: None. A.P.Sukumaran: None. K.Armstrong: None. K.Topaloglu: None. L.Gholson: None. F.Kamran: None.
987-P: Cost-Effectiveness of a Diabetes Prevention Program among Latino Youth with Prediabetes
Authors: OLSON MICAH , PENA ARMANDO , PUTZ MARY E. , AYERS STEPHANIE , KNOWLER WILLIAM C. , MCCULLOUGH MAC , SHAIBI GABRIEL Q. 
Published: May 2022

Introduction: Lifestyle intervention is a cost-effective approach for preventing type 2 diabetes among adults with prediabetes. Little is known about the cost effectiveness of lifestyle programs for children with prediabetes. The purpose of this study was to examine the cost and incremental cost effectiveness of an adapted diabetes prevention intervention compared to usual care among Latino youth with prediabetes.
Methods: Latino youth (age 13.5±1.4 years, mean±SD) with obesity and prediabetes were randomized to a community-based lifestyle intervention (INT, N=79) or usual care (UC, N=38) . The 6-month INT was delivered at a YMCA and included 1 d/wk of lifestyle education for families and 3 d/wk of physical activity. UC included 2 visits with a pediatric endocrinologist and registered dietician to discuss diabetes risks and healthy lifestyle changes. Data on health care costs and resource utilization were collected prospectively. Efficacy was examined as changes in 2-hr glucose concentrations during an OGTT. Cost analyses were performed from health care sector and societal perspectives.
Results: The INT led to decreases in 2-hr glucose (144.5±3.4 to 132.2±3.4 mg/dL, p=0.002) but these changes were not significantly different from changes in 2-hr glucose observed in UC participants (144.1±4.6 to 139.0±4.6; interaction p=0.260) . The average health care costs per participant were $1,032 for the INT and $1,251 for the UC. Total societal costs (health care plus patient and family opportunity costs) per participant were $3,641 for the INT and $1,331 for the UC. For health care costs alone, the incremental cost-effectiveness ratio (ICER) for 2-hr glucose was -$30.3 per mg/dL. When taking total costs into account, the ICER for 2-hr glucose was $320.8 per mg/dL.
Conclusion: From a health care sector perspective, INT led to greater reductions in 2-hr glucose at a lower cost compared to UC among Latino youth with prediabetes. The cost-effectiveness of INT decreases when total societal costs are included.

Disclosure
M.Olson: None. A.Pena: None. M.E.Putz: None. S.Ayers: None. W.C.Knowler: None. M.Mccullough: None. G.Q.Shaibi: None.

Funding
National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Disease (R01DK10757901)
993-P: Cell-Free DNA Methylation as a Biomarker of Islet-Cell Death in Youth with Type 2 Diabetes
Authors: STAIMEZ LISA R. , HAM J. NINA , DALEY TANICIA , VELLANKI PRIYATHAMA , SMITH ALICIA K. , NARAYAN K.M. VENKAT , BACCARELLI ANDREA , CONNEELY KAREN 
Published: May 2022

Type 2 diabetes (T2D) in youth is diagnosed after irreparable islet damage. Cell-free DNA methylation can be used as a marker of islet cell death after islet transplantation. We assessed the performance of cell-free (cf) DNA in the discrimination of T2D and as a circulating biomarker of islet cell death. Methods: We recruited 72 youth 10-20 years old through provider networks in Atlanta, Georgia. Participant groups were (a) new onset T2D (n=21, within 16 weeks of diagnosis) ; (b) healthy, normal weight (n=23, no family history of diabetes) ; and (c) High Risk (HR, n=31, BMI ≥ 95th %ile or acanthosis nigricans; with family history) . All participants had an oral glucose tolerance test. Based on genes uniquely unmethylated in islets, plasma was analyzed at 9 CpG sites across 3 genes (INS, GCK, IADD) using bisulfite conversion and next generation sequencing. T2D and HR were grouped and compared to Healthy by (a) linear regression of % methylation on group, and (b) area under the curve (AUC) ROC analysis, adjusted for age and BMI %ile. Results: Mean age was higher among healthy participants (17yr SD±3) vs. T2D+HR (14±2) . Age- & BMI %ile- adjusted methylation of INS GRCh38 CpG Chr11:2160843 was highest in T2D+HR (94.8%, 95%CI: 93.5, 96.1) and lowest in Healthy (90.0%, 95%CI: 87.7, 92.2) , p=0.0051. Secondly, at CpG Chr11:2160806, methylation was highest in T2D+HR (85.6%, 95%CI: 83.3, 87.8) vs. Healthy (83.1%, 95%CI: 79.1, 87.1) , p=0.0409. Cell-free INS methylation improved the AUC for T2D or severe prediabetes (i.e., combined impaired fasting glucose + impaired glucose tolerance, per ADA cutpoints) from 0.72 in models of age and BMI %ile to 0.81 in models also including cfINS methylation. Conclusions: Higher % methylated cfINS was found in T2D+HR youth, rather than hypothesized lower levels. It is possible that during T2D onset, non-islet apoptosis occurs in larger concentration than islet cell apoptosis. Methylated cfINS improved discrimination of T2D and severe prediabetes by nearly 10% beyond age and BMI.

Disclosure
L.R.Staimez: None. J.Ham: None. T.Daley: None. P.Vellanki: n/a. A.K.Smith: None. K.Narayan: n/a. A.Baccarelli: None. K.Conneely: None.

Funding
Georgia CTSA UL1 (UL1TR002378) and KL2 (KL2TR002381) ; Emory University Woodruff Health Sciences Center Foundation
996-P: Systolic Blood Pressure (BP) Is Associated with Carotid Intima-Media Thickness (CIMT) Independently of Type 2 Diabetes Predisposition in Minority Children
Authors: NUNEZ VELIA , WEIGENSBERG MARC , TOLEDO-CORRAL CLAUDIA M. 
Published: May 2022

Background: Blood pressure and cholesterol levels have been associated with risk for atherosclerosis in youth. Family history of type 2 diabetes mellitus (DMFam Hx) , and/or exposure to gestational diabetes mellitus (GDM) have also been linked to higher cardiovascular disease (CVD) susceptibility. We investigated whether CVD predictors including systolic and diastolic BP, HDL-cholesterol (HDL-c) , LDL-cholesterol (LDL-c) , and triglycerides (Tg) were associated with CIMT and whether these relationships were influenced by DMFam Hx or exposure to in-utero GDM among children and adolescents with overweight and obesity.
Methods: Participant data (N=209; age range 8-17; 38% African American and 62% Latino; BMI percentile ≥85th) were used for cross-sectional analysis. Status of DMFam Hx and GDM and were self-reported during an interview with a clinician. Systolic and diastolic BP were taken in a seated position in triplicate readings. Total cholesterol, HDL-c and Tg levels were determined via assays on fasting blood samples, while LDL-c was calculated using the Friedewald equation. CIMT was measured in millimeters with high-resolution B-mode ultrasound. Multivariable linear regression models were used to assess if the each of the CVD predictors was associated with CIMT while accounting for GDM and DMFam Hx, and adjusting for a priori covariates of age, sex, ethnicity, and height.
Results: Higher systolic BP was associated with higher CIMT when adjusted for a priori covariates (β= 0.00092; 95% CI: 0.00004, 0.00181; p=0.04) . In further adjusted models, GDM and DMFam Hx did not contribute to, nor did it moderate this relationship (p&gt;0.05) . Diastolic BP, HDL-c, LDL-c, Tg, were not associated to CIMT in adjusted models (p&gt;0.05) .
Conclusion: Independent of genetic predisposition, systolic BP may be a salient contributor of atherosclerosis risk in minority youth with overweight and obesity living in urban environments.

Disclosure
V.Nunez: None. M.Weigensberg: None. C.M.Toledo-corral: None.

Funding
NIH P60MD00254
Historic Residential Redlining and Present-Day Diabetes Mortality and Years of Life Lost: The Persistence of Structural Racism
Authors: Linde Sebastian , Walker Rebekah J. , Campbell Jennifer A. , Egede Leonard E. 
Published: May 2022

<p> </p>
<p><strong>Background:</strong> The association between structural racism, as captured by historic residential redlining practices under the Home Owners’ Loan Corporation (HOLC), and present-day diabetes mortality, and years of life lost, remains unknown. </p>
<p><strong>Methods: </strong>Age standardized mortality and years of life lost were combined with historic HOLC redlining data for the city of Seattle, Washington (109 census-tract level sample of observations) for each of the years 1990 through 2014 (25 years). Spatial autoregressive regression analyses to assess the association between an areas’ historic HOLC redlining score and diabetes (and all cause) mortality, and years of life lost were used. </p>
<p><strong>Results: </strong>Spatial autoregressive model estimates indicate that an area’s HOLC redlining score explains 45 to 56% of the variation in the census tract level diabetes mortality rate; and 51 to 60% of the variation in the census tract diabetes years of life lost rate, between the years of 1990 and 2014. For 2014, estimates indicate that areas with a unit higher HOLC grade are associated with a 53.7% (95% CI: 43.3-64.9%; p<0.01) higher diabetes mortality rates; and a 66.5% (95% CI: 53.7-80.4%; p<0.01) higher diabetes years of life lost rate. Magnitudes of marginal effects were consistently larger for diabetes than for all-cause outcomes. </p>
<p><strong>Conclusions: </strong> Results indicate sizable, and statistically significant, associations between historic redlining practices and present-day diabetes mortality and years of life lost rates. In addition, the persistence of these associations across the 1990 – 2014 period, highlight a need for targeted action to undo the impact of historical redlining on current health. </p>
PENGARUH MODEL THINK PAIR SHARE TERHADAP KEMAMPUAN BERPIKIR KRITIS SISWA TEMA PAHLAWANKU KELAS IV SD UNGGULAN MUSLIMAT NU
Authors: Dewi Aulia Shinta , Purbasari Imaniar , Khamdun Khamdun 
Published: May 2022

Tujuan dari penelitian ini adalah untuk menganalisis perbedaan kemampuan berpikir kritis antara siswa yang menggunakan model Think Pair Share dengan siswa yang menggunakan model konvensional. Jenis penelitian ini adalah penelitian eksperimen berupa Quasi Eksperimental Desain dengan tipe Pretest-Posttest Control Group Design. Sampel penelitian adalah siswa kelas IV SD Unggulan Muslimat NU tahun pelajaran 2018/2019 yang terdiri dari 36 siswa (kelas eksperimen) dan 35 siswa (kelas kontrol). Pengambilan sampel dilakukan dengan teknik random sampling. Teknik pengumpulan data yang digunakan dalam penelitian ini adalah soal tes, lembar observasi serta dokumentasi. Analisis data awal meliputi uji normalitas dan uji homogenitas, sedangkan analisis data akhir meliputi uji normalitas, uji homogenitas, dan uji hipotesis penelitian menggunakan uji t. Hasil analisis data menunjukkan bahwa terdapat perbedaan kemampuan berpikir kritis antara siswa yang menggunakan model Think Pair Share dengan siswa yang menggunakan model konvensional. Hal itu ditunjukkan dengan nilai rata-rata posttest kelas eksperimen sebesar 88,97 dan pada kelas kontrol sebesar 75,06. Hasil uji-t menunjukkan bahwa thitung sebesar 9,828 lebih besar daripada ttabel sebesar 1,98 (9,828 bigger than 1,98).
Peningkatan Disiplin Berseragam Siswa Melalui Bimbingan Kelompok
Authors: Wasono Muhammad Putro Joko 
Published: May 2022

Tujuan penelitian ini adalah mengetahui peningkatan kedisiplinan berseragam melalui layanan bimbingan kelompok pada siswa kelas VIII SMP 1 Tengaran Kabupaten Semarang. Penelitian dirancang dengan pendekatan penelitian tindakan kelas. Subjek yang dipilih adalah siswa kelas VIII C SMP Negeri Tengaran Kab. Semarang. Dari hasil pengamatan yang dilakukan penulis pada keseharian siswa di sekolah, dan catatan panggilan siswa serta catatan kasus siswa menunjukkan penurunan dalam hal pelanggaran siswa dalam memakai seragam sekolah khususnya siswa kelas 8 c semester I Tahun Pelajaran 2016/2017. Hasil penelitian ini dapat digunakan sebagai tambahan khasanah pengetahuan bagi para pembaca pada umumnya, dan sekaligus sebagai dasar penelitian bagi guru khususnya dalam rangka peningkatan dan perbaikan kualitas layanan bimmbingan dan konseling.
Meningkatkan Aktivitas Belajar dan Hasil Belajar IPA Standar Kompetensi Dasar Getaran dan Gelombang Serta Parameter-Parameternya Melalui Pembelajaran Kooperatif Pada Siswa
Authors: Suhartatik Endang 
Published: May 2022

Tujuan penelitian tindakan ini adalah untuk meningkatkan aktivitas dan hasil belajar IPA SKD getaran dan gelombang serta parameter-parameternya melalui pembelajaran kooperatif pada siswa kelas VIII A Semester II, SMP Negeri 5 Ungaran tahun pelajaran 2017/2018. Penelitian ini dilakukan pada semester II tahun pelajaran 2017/2018 dan mengambil tempat di kelas VIII A SMP Negeri 5 Ungaran, Kecamatan Ungaran Timur Kabupaten Semarang dengan subyek seluruh siswa kelas VIII A tersebut yaitu 32 siswa. Metode penelitian ini menggunakan metode penelitian tindakan kelas, dengan tindakan sebanyak dua kali dalam dua siklus teknik pengumpulan data menggunakan teknik dokumentasi, observasi dan test. Alat pengumpuklan data berupa dokumen daftar nilai, lembar observasi dan butir soal. Validasi menggunakan triangulasi sumber atau kolaborasi dan kisi-kisi. Analisis data menggunakan analisis deskriptif komparatif yang dilanjutkan refleksi. Hasil penelitian setelah dilakukan dua kali tindakan dalam dua siklus menunjukkan bahwa nilai rata-rata kelas yang diperoleh dari kondisi awal sebelum dilaksanakan penelitian sebesar 63,8 meningkat pada siklus I nilai rata-rata ulangan harian menjadi 64,8 dan hasil ulangan harian pada siklus II nilai rata-rata menjadi 71,4
Meningkatkan Prestasi Belajar Seni Budaya Materi Seni Lukis Aplikatif Menggunakan Teknik Pointilis
Authors: Kismartanto Edij 
Published: May 2022

Keberhasilan proses belajar mengajar tidak terlepas dari persiapan peserta didik dan persiapan tenaga pengajarnya. Untuk dapat mencapai tujuan pembelajaran seni budaya, diperlukan kerjasama dari semua komponen. Teknik pointilis adalah salah satu teknik lukis yang dikenal dalam menciptakan karya seni lukis. Dengan teknik pointilis diharapkan peserta didik dapat meningkatkan prestasi belajr seni budaya materi seni lukis aplikatif. Hasil prestasi belajar siswa masih ditemui siswa yang belum mencapai KKM. Berdasarkan kondisi tersebut peneliti bermaksud untuk melakukan penelitian dengan bentuk Penelitian Tindakan Kelas dengan materi Upaya Meningkatkan Prestasi Belajar Seni Budaya Materi Seni Lukis Aplikatif Menggunakan Teknik Pointilis Pada Siswa Kelas Ix C Smp Negeri 2 Tuntang. Jumlah siswa di Kelas IX C adalah 25 siswa. Dari hasil pelaksanaan 2 siklus dalam ptk dengan menggunakan teknik pointilis mampu meningkatkan prestasi belajar siswa sekitar 52% dari kondisi awal penelitian. Sementara itu sekitar 12% dari 25 orang siswa kelas IX C SMP N 2 Tuntang masih mendapatkan nilai lukis aplikatif di bawah KKM, sedangkan sisanya sekitar 88 siswa telah mencapai ketuntasan belajar.
Peningkatan Aktivitas dan Hasil Belajar Matematika Pada Materi Bangun Ruang Sisi Datar Melalui Model Pembelajaran Kooperatif Tipe STAD Berbantuan Alat Peraga
Authors: Legiman Andreas 
Published: May 2022

Tujuan penelitian ini adalah meningkatkan aktivitas dan hasil belajar peserta didik melalui model pembelajaran kooperatif tipe STAD berbantuan alat peraga materi bangun ruang sisi datar bagi siswa kelas VIIIA SMP Negeri 3 Pabelan Semester 2 tahun pelajaran 2017/2018. Penelitian ini dilaksanakan pada Semester 2 Tahun Pelajaran 2017/2018 selama 5 bulan, yakni mulai bulan Januari sampai dengan bulan Mei 2018. PTK ini dilaksanakan di Kelas VIII A SMP Negeri 3 Pabelan pada semester 2 tahun pelajaran 2017/2018. Subjek dalam penelitian ini adalah seluruh siswa kelas VIII A SMP Negeri 3 Pabelan pada semester 2 tahun pelajaran 2017/2018 yang berjumlah 20 siswa yang terdiri dari 10 siswa perempuan dan 10 siswa laki-laki. Metode yang digunakan dalam penelitian ini merujuk pada tujuan penelitian yang hendak dicapai dalam penelitian ini, yaitu metode Penelitian Tindakan Kelas. Aktivitas pada pra siklus dengan katagori baik 40% dan pada siklus I 65%. Terdapat peningkatan 25%. Aktivitas pada siklus I dengan katagori baik 65 % dan pada siklus II 80%. Terdapat peningkatan 15%. Aktivitas pada pra siklus 40 % dan pada siklus II 80%. Terdapat peningkatan 40 %. Aktivitas mengalami peningkatan dan target kinerja tercapai. Disimpulkan peningkatan siginfikan. Dari hasil penilaian harian pada pra siklus yang mencapai/melampaui KKM 60% dan pada siklus II 75 %. Terdapat peningkatan 15%. Dari hasil penilaian harian pada siklus I yang mencapai/melampaui KKM 65% dan pada siklus II 75%. Terdapat peningkatan 10 %. Dari hasil penilaian harian pada pra siklus yang mencapai/melampaui KKM 60 % dan pada siklus II 75 %. Terdapat peningkatan 15%. Hasil penilaian harian mengalami peningkatan dan target kinerja tercapai. Disimpulkan peningkatan siginfikan.