VIP Sensors (United States)

Introduction and Objective: The prevalence of PD and T2D has been steadily increasing. Thus, early risk markers for PD and T2D in individuals with NG are critically important. We asked whether Insulin Resistance Risk Score (IRRS) could be an early risk marker for future PD or T2D. Methods: Individuals with NG (FPG <100 mg/dL and HbA1c <5.7%) were followed-up for 3 years for incident composite events of PD or T2D. IRRS was assessed from intact insulin and C-peptide levels in fasting participants at baseline and in the first 2 of 3 follow-up years. Results: Participants (n=16,333, 69% women) had mean (SD) age of 44 (12) years and median (IQR) IRRS of 12% (6 - 28). 23.5% (n =3,838) had incident events (IE) (n=865 in the bottom tertile of IRRS, 1269 in middle tertile, and 1704 in the top tertile, P <0.001). IE increased across the entire range of IRRS (Figure 1A). Participants with IEs had higher median IRRS at baseline and a greater rate of IRRS increase than those who did not (P interaction < 0.001). IRRS elevation was observed up to 3 years prior to IEs. Participants without IEs had a consistent low IRRS during follow-up (Figure 1B). Conclusion: IRRS elevation was observed early and increased more rapidly in participants with IEs. Those who maintained low IRRS levels did not experience events during a 3-year follow up. Disclosure J.Z. Louie: None. D. Shiffman: Other Relationship; Quest Diagnostics. O. Melander: None. F. Abbasi: None. L.A. Bare: Employee; Quest Diagnostics. J.B. Meigs: Consultant; Quest Diagnostics. M.J. McPhaul: Consultant; Quest Diagnostics.

This paper addresses the critical gap in public knowledge and skill in performing Cardiopulmonary Resuscitation (CPR), a key factor in increasing survival rates in cardiac arrest scenarios [1]. Despite the importance of CPR, traditional training methods often fail to reach or engage the general population effectively. Our proposal introduces an innovative, interactive digital CPR training platform that combines the latest in educational technology with the principles of gamification and simulation-based learning [2]. Key components include a user-friendly interface, real- time feedback mechanisms, and scenario-based simulations that cater to a wide range of learning styles and environments. Challenges such as ensuring the physical accuracy of CPR techniques and broadening accessibility were addressed through the integration of adaptive learning algorithms and offline functionalities [3]. Experimentation across various settings demonstrated significant improvements in users' CPR knowledge, skills, andconfidence. The results underscore the platform's potential to democratize CPR training, making it more accessible, engaging, and effective. Our project offers a scalable solution to a widespread public health issue, advocating for itsadoption as a standard in CPR education.

Patients with T2D remain at high risk of cardiovascular (CV) events despite adequate glycemic and LDL-C control. Changes in HDL particle composition and function may explain part of this increased CV risk. The aim of this study was to determine the proteomic composition of isolated HDL particles in T2D patients, and establish which factors contribute to these abnormalities. Patients (n=213) with and without T2D were included in the study and underwent an OGTT, liver MRS, and routine blood chemistries. Advanced lipid testing and lipoprotein subfractions were measured by ion mobility. ApoA-I containing particles (i.e., HDL) were isolated and a novel targeted proteomic approach using multiple reaction monitoring (MRM) by liquid chromatography and tandem mass spectrometry (LC-MS/MS) was undertaken to measure HDL-bound proteins. Patients with (n=146) vs. without (n=67) T2D were older (56±9 vs. 47±12) , more obese (34.2±4.7 vs. 32.6±5.3 kg/m2) , but had no significant differences in other important clinical characteristics, such as gender or race. Patients with T2D had lower HDL-C (38±9 vs. 43±13 mg/dl, p<0.001) , but no difference in the number of HDL particles. A panel of 28 HDL-bound proteins were targeted and quantified by MRM LC-MS/MS. After correction for multiple comparisons (false discovery rate set at 5%) and adjustment for obesity and NAFLD, 4 proteins were found to be decreased in T2D patients (ApoA-I, ApoC-I, ApoM, and PON3; all p<0.0015) . The pCAD index (well-validated score for coronary artery disease and CV mortality based on HDL-bound proteins) was increased in patients with T2D, irrespectively of obesity or NAFLD (93±15 vs. 61±38, p<0.0001) . In conclusion, patients with T2D showed significant differences in the apolipoproteomic composition of HDL particles, and this translated into increased CV risk based on pCAD index. Different HDL composition and function may explain the residual CV risk of patients with T2D optimally treated for hyperglycemia and LDL-C. Disclosure F.Bril: None. R.Pearce: Employee; Quest Diagnostics. T.S.Collier: Employee; Quest Diagnostics, Stock/Shareholder; Quest Diagnostics. S.Kalavalapalli: None. M.J.Mcphaul: Employee; Quest Diagnostics. K.Cusi: Consultant; Altimmune, Arrowhead Pharmaceuticals, Inc., AstraZeneca, Boehringer Ingelheim International GmbH, Bristol-Myers Squibb Company, Eli Lilly and Company, Fractyl Health, Inc., Genentech, Inc., Hanmi Pharm. Co., Ltd., Intercept Pharmaceuticals, Inc., Novo Nordisk. Funding American Diabetes Association (1-08-CR-08) ; The Obesity Society (Early-Career Research Grant) Veterans Affairs (1 I01 CX000167-01) . UF CTSI (UL1TR001427)

INTRODUCTION: In August of 2020, the 4th International Neuroscience Nursing Research Symposium was held. The purpose of the symposium was to share neuroscience nursing research from around the world. One of the topics thought most notable that stimulated a crucial conversation was how different countries assessed pain and their use of opioids for pain management. BACKGROUND: Neuroscience nurses are global. What is not known is their experience with and what challenges exist with pain management for human beings in their country. Crossing geographic and cultural boundaries, pain affects all human beings. Each culture has unique values and beliefs regarding pain. Patient barriers, pivotal in this article, included poverty, poor health literacy, opioid phobia, and cultural as well as social beliefs. RESULTS: Neuroscience nurses from Australia, Brazil, Germany, Singapore, India, Ghana, Kenya, Philippines, South Africa, and the United States each collaborated to provide a short summary of assessing pain and use of opioids for pain management for the neuroscience patient. CONCLUSION: Neuroscience patients have varying degrees of pain based on many factors. Various countries have religious, spiritual, and cultural traditions that influence the reporting and management of pain. Pain assessment and management can be challenging, especially for the neuroscience nurses around the world.

This report describes the case of an individual who was clinically diagnosed with Lyme borreliosis and initially responded to standard antibiotic therapy. Subsequent to treatment cessation, the patient experienced symptomatic rebound and failed to respond to a second course of the same antibiotic. The patient was eventually diagnosed with both Borrelia and Anaplasma infections by serological testing performed in a private laboratory. Following a two-month course of combination antibiotic therapy, the patient responded clinically, with a return to almost normal functioning. We discuss this case in the context of recent pre-clinical research examining potential Borrelial persistence despite antibiotic therapy.

Background: We asked whether the integration of digital behavioral counseling with employer-sponsored annual biometric screening could reduce the risk of obesity-related chronic disease in a U.S. workforce. Methods: We evaluated a cohort (n=113) who participated in an employer-sponsored annual wellness program with year-end biometric screening and enrolled in a digital behavioral counseling program. Individuals were included in the analysis if they participated in the wellness program in 2015, had prediabetes (fasting glucose (FG) 100 to 125mg/dL or Hb1Ac 5.7 to 6.4%) and a BMI ≥25 kg/m2 in 2016, and agreed to participate in a digital behavioral counseling program followed by year-end biometric screening in 2017. Results: The participants were 75% women and 61% Caucasian, 28% African American. At the 2016 year-end biometric screening, which preceded digital behavioral counseling, the characteristics of the cohort (mean± sd) were age, 50.0±9.9 years; BMI, 37.1±8.6 kg/m2; Hb1Ac, 6.1±0.6%; and FG, 106.9±24.2 mg/dL. Following behavioral counseling, 28% of the participants lost 5% or more of body weight. Hb1Ac and FG levels both fell below prediabetic thresholds for 32% of the participants. Other biometric outcome measures improved (Table). Conclusions: Digital behavioral counseling was effective in reducing risk for both diabetes and cardiovascular disease in a workforce cohort.Change in annual biometric screening resultsThe year preceding counseling (2015 to 2016)The year counseling received (2016 to 2017)P value (paired t-Test)BMI (kg/m2)+0.66-1.18<0.0001Hb1Ac (%)+0.06-0.220.001Fasting Glucose (mg/dL)+5.85-2.840.02Triglycerides (mg/dL)+12.0-17.20.0110-year ASCVD risk* (%)+1.83-0.480.01*Atherosclerotic Cardiovascular Disease risk (2013 ACC/AHA Cardiovascular Risk Guideline) Disclosure C.E. Birse: Employee; Self; Quest Diagnostics. Stock/Shareholder; Self; Quest Diagnostics. R.J. Lagier: Employee; Self; Quest Diagnostics. P. Chew: Employee; Self; Omada Health, Inc. C.B. Jasik: Employee; Self; Omada Health, Inc. E.N. Madero: Employee; Self; Omada Health, Inc..

A 4-year-old female spayed domestic longhair cat was referred for dyspnea. Further diagnostics revealed severe pleural effusion and a peritoneopericardial diaphragmatic hernia (PPDH). Following surgical correction of the PPDH the pleural effusion persisted. Re-check echocardiogram 4 weeks after initial evaluation revealed leftward deviation of the interventricular septum and interatrial septum occurring with inspiration. There were also exaggerated phasic changes in trans-tricuspid flow velocities suggestive of constrictive pericardial disease. Cardiac catheterization was performed and revealed elevated pressures in the right atrium and right ventricle. Constrictive pericarditis (CP) and epicarditis was confirmed at surgery, where subtotal pericardiectomy was performed with epicardial decortication. The cat continued to develop recurrent pleural effusion after surgery, although the volume and frequency of recurrence slowed over time. This is the first reported case of CP following PPDH repair in a cat.

In 2009, Aetna, Inc., invited Gary Kraftsow and the American Viniyoga Institute (AVI) to contribute to a research study on modulating stress. This partnership represented the first formal recognition of the potential role of yoga therapy in modern healthcare by an insurance company. This project exemplified the power and value of a collaboration in which yoga therapists made the ancient yoga teachings relevant to healthcare research. We must under-stand our own ancient traditions, learn the language of Western medicine, and recognize opportunities to build bridges to medical disciplines, academic partners, insurers, funders, and policy makers.