Target Goals Research Articles

Lipid Management in Korean People with Type 2 Diabetes Mellitus: Korean Diabetes Association and Korean Society of Lipid and Atherosclerosis Consensus Statement.

Dyslipidemia in patients with diabetes is an important treatment target as a modifiable risk factor for cardiovascular disease (CVD). Although the primary treatment goal for dyslipidemia is to control low-density lipoprotein cholesterol (LDL-C), achieving this goal remains suboptimal according to recent studies. It is important to set the target goal for LDL-C control based on an accurate risk assessment for CVD. Here, we summarize the latest evidence on lipid management in patients with diabetes and present a consensus of the Korean Diabetes Association and Korean Society of Lipid and Atherosclerosis on the treatment goals of LDL-C according to the duration of diabetes, presence of CVD, target organ damage, or major cardiovascular risk factors. In patients with type 2 diabetes mellitus (T2DM) and CVD, an LDL-C goal of <55 mg/dL and a reduction in LDL-C level by 50% or more from the baseline is recommended. For the primary prevention of CVD in patients with T2DM with a duration of diabetes ≥10 years, major cardiovascular risk factors, or target organ damage, an LDL-C goal of <70 mg/dL is recommended. In patients with T2DM with a duration of diabetes <10 years and no major cardiovascular risk factors, an LDL-C goal of <100 mg/dL is recommended.

Heart failure (MYHF) registry: shedding light on lipid profiles and in-hospital outcome of heart failure patients

Abstract Funding Acknowledgements Type of funding sources: Private company. Main funding source(s): Novartis Corporation Sdn Bhd Background Heart failure is a debilitating disease associated with multiple comorbidities and poor prognosis. Dyslipidemia, is the top 5 most common comorbidities, including HF patients. Nonetheless, the lipid profiles in HF population is scarcely available and poorly understood. Purpose This report aimed to describe the lipid profiles and in-hospital outcome of hospitalized HF patients. Methods MYHF registry is a prospective, observational study of symptomatic HF patients (NYHA II-IV) hospitalized in 18 tertiary care centers in Malaysia over a period of 3 years starting in 2019. Lipid profiles will be described, and in-hospital outcome will be analyzed using univariate and multivariate models. Results In MYHF registry, 1 out of 2 hospitalized HF patients (55.7%) had ischemic heart disease, significantly higher in patients with HFrEF and HFmrEF, as compared to HFpEF (p&amp;lt;0.001). Similarly, 1 in 2 (46.6%) patients had dyslipidemia as comorbidity but was comparable across EF subgroups (p=0.365). Statin utilization at discharge increased by 20% from admission (from 62.2% to 74.6%), indicating that hospitalization provides good opportunity for statin initiation in indicated HF patients. At admission, the mean total cholesterol, LDL-C, HDL, and TG levels were 4.30 mmol/L (SD 1.66), 2.62 mmol/L (SD 1.34), 1.05 (SD 0.46), and 1.37 (SD 1.08), respectively. Of those with measured LDL-C level, only 31.4% achieved LDL-C goal of &amp;lt;1.8 mmol/L and 39.8% of patients had LDL-C ≥2.6 mmol/L. With univariate analysis, patients with LDL-C goal of ≥ 1.8 mmol/L had lesser risk of in-hospital mortality [OR 0.42 (0.21,0.86), p-value = 0.018], indicating LDL-C paradox. Further analysis with multivariate model revealed that patients with LDL-C goal of ≥ or &amp;lt; 1.8 mmol/L did not differ in in-hospital mortality outcome (p-value = NS). Conclusion Dyslipidemia is highly common in general population and in HF patients. With statin therapy, only 31.4% achieved LDL-C &amp;lt; 1.8 mmol/L at admission. The finding highlights the unmet need for combination lipid lowering therapies to get patient to LDL-C target goal. Hospitalization also provided good opportunity of statin therapy initiation. The knowledge gained will be crucial for guiding management of HF patients with common comorbidity like dyslipidemia.

Comparing unfractionated heparin dose for VTE in obese versus non-obese patients

Background: Venous thromboembolism (VTE) is treated based on body weight to determine unfractionated heparin (UFH) dosage. However, this approach has not been thoroughly studied in obese patients. We aimed to determine the optimal infusion rate of UFH in obese patients using the weight-based dosing nomogram. Methods: A retrospective review was conducted on adult patients treated with heparin per VTE protocol with activated thromboplastin time (aPTT) of 60-80 seconds. We calculated the median heparin infusion rate (units/kg/hour) required to achieve the first therapeutic aPTT in obese and non-obese patients. We also investigated the median time required to achieve the first therapeutic aPTT in both groups, the percentage of aPTT at the target goal within the first 24 hours of treatment, the percentage of sub and supra-therapeutic aPTT at 24 hours after initiation of heparin infusion, and incidence of thrombosis and bleeding during heparin treatment. Results: We included 70 patients with confirmed VTE diagnosis. Obese patients required a lower UFH infusion rate (units/kg/hour) compared to non-obese patients (16.5 vs. 18, p = 0.24). The time to reach the first therapeutic aPTT was longer in obese patients compared to non-obese (17.7 hours vs. 15 hours respectively, p = 0.7). Major bleeding events were higher in the obese patients compared to the non-obese (6.25% vs. 2.6%, p = 0.44). In contrast, minor bleeding events were higher in the non-obese group (28.1% vs. 36.8%, p = 0.46). The overall rate of thrombotic events occurring during heparin treatment was 6.2% in obese patients and 5.3% in non-obese patients (p = 0.86). Conclusion: Dosing of UFH in obese patients using the weight-based nomogram was associated with over-anticoagulation and demonstrated no significant difference in UFH dosing to reach the goal of aPTT in obese or non-obese patients.

НЕОМОДЕРНІЗАЦІЙНА КОНЦЕПЦІЯ ФОРМУВАННЯ ІНВЕСТИЦІЙНОЇ СТРАТЕГІЇ ТРАНСПОРТНИХ ПІДПРИЄМСТВ

The article analyzes the peculiarities of the concept of investment strategy of transport enterprises. A number of tasks are defined for which the orientation of management of investment activity in the context of strategic goals of enterprise development is directed. The target goals in the context of formation of investment strategy of enterprises to which are given are justified: Increase of market value of business with the purpose of attraction in perspective of investment value of enterprise; creation of new enterprises through acquisition or merger; diversification of directions of activity of enterprise or scale of business under conditions of expansion of production; obtaining additional investment income from investment operations in order to increase the company’s operating capital; increasing the efficiency of the company’s operations through the introduction of a number of organizational and technological activities. The basic principles of formation of investment strategy of transport enterprises are defined. The structure of capital investments of enterprises is analyzed. The conceptual scheme of formation of investment strategy of the enterprise under conditions of non-modern renewal is outlined. A number of tasks for which the development of investment strategy of transport enterprises should be directed, taking into account the non-modern tendencies, have been identified: Ensuring of coordination of investment needs with the state of transport industry development and the position of the enterprise in it, technical and technological demands, peculiarities of innovative direction of enterprise development; ensuring strategic and current maximization of investment profit of the transport enterprise; putting investment risks to a minimum; ensuring optimal financial condition of the transport enterprise in the process of investment activity; maintaining the appropriate level of liquidity of transport enterprise investments; providing selection of effective tools of estimation, forecasting and adjustment and appropriate ways in the direction of effective investment activity. It is justified that the non-modern concept of formation of investment strategy of transport enterprises should be as close to the innovative component in the context of taking into account in the general strategic goals of the enterprise innovative-digital-modernization vector of changes at the present stage.

A model of formation of patriotic ideals of students of agricultural institutions of professional prehigher education

The article is devoted to the problem of the formation of patriotic ideals of students of agricultural institutions of vocational prehigher education. The essence of this concept has been clarified. The author's structural and functional model of the formation of patriotic ideals of students of agricultural institutions of vocational pre-higher education is presented. The following blocks of the model are distinguished and substantiated: target (goal and task), content (structural components of patriotic ideals of students of agricultural institutions of vocational higher education), theoretical and methodological (approaches, principles), procedural (stages of deploying the methodology, methods, forms, means of work), evaluation-resultative (criteria and indicators, levels of formation of patriotic ideals of students of agricultural institutions of vocational higher education).

THE METHODOLOGY OF USING THE EUROPEAN OPEN SCIENCE CLOUD IN THE PROCESS OF EDUCATION AND PROFESSIONAL DEVELOPMENT OF TEACHERS

The statement of basic materials. The structure of the methodology for using the European Open Science Cloud in the process of teaching and professional development of teachers consists of the following components: target (goal, target group), content, technological (methods, forms and means of training) and effective. An approximate plan of training sessions is given. The main steps of conducting the master class “Organization of training using European Open Science Cloud” are described.

Особливості функціювання прийменникових еквівалентів із семантикою власне-мети в сучасній українській мові

The article singles out the preposition equivalents with the meaning of the actual purpose from the general prepositional structures: with the purpose + Subst2, for the subject + Subst2, to perform + Subst2, in the performance + Subst2, for the performance + Subst2, to complete + Subst2, to acquire + Subst2, in case of + Subst2, to replace (change) + Subst2, in hope of + Subst4, in the fight with + Subst5, to pursuit + Subst5, in pursuit of + Subst5, in search of + Subst2, at the call of + Subst2. The author clarifies the motivational basis of the lexical units, which come from the lexemes with target (goal, agreement) semantics, and from those abstract lexical units for which this semantics is indifferent (name, memory, struggle, completion). It has been determined that the actual purpose prepositions are regularly combined with verbs of creation, various types of activity (build, work, create), movement, spatial movement (go, carry, fly), coordinated interpersonal actions (fight, vote, defend) and nouns which name various actions (receiving, checking, creating), food, drinks (snack, water, bread), manifestations of feelings, mental states (will, love, anxiety), etc. The conditions under which intentional preposition equivalents show specificity at the level of conjugability are established (for each meaning variety of the studied units, a lexical-semantic set of main valence carriers (verbs in particular) and valence partners (nouns in particular) is fixed, all of which together constitute the corresponding type of semantic-syntactic relations).

Abstract A124: Disparities in HPV vaccine uptake and provider recommendation by provider facility type

Abstract Background: Approximately 46,000 cases of human papillomavirus (HPV) attributable cancers are diagnosed annually in the United States. The HPV vaccine can prevent over 90% of HPV-attributable cancers, yet national uptake remains lower than the Healthy People 2030 target goal of 80% completion. To devise targeted interventions to increase the uptake of HPV vaccines, it is crucial to understand the vaccination rates across various health care settings. We examined the association between provider facility type and provider recommendation and HPV vaccine uptake among adolescents in the US. Methods: We conducted secondary data analysis of the 2020 National Immunization Survey–Teen data (n=20,162), which provides current, population-based estimates of vaccination coverage among adolescents. Provider facility type was classified as public facilities (i.e., public health department-operated clinic, community health center, rural health clinic, tribal/Indian health facility), hospital-based facilities, private facilities, and mixed facilities (i.e., vaccination provided in more than one of the above-mentioned locations). Self-reported provider recommendation was dichotomized as yes/no. HPV vaccine initiation was defined as the receipt of ≥1 dose of the HPV vaccine, and completion was defined as the receipt of ≥2 doses (if the adolescent received first dose before age 15) or ≥3 doses (if the adolescent was at least 15 years old). Weighted, multivariable logistic regression models estimated the odds of receiving provider recommendation and initiating and completing the HPV vaccine by provider facility type, adjusting for adolescents age, gender, race, poverty level, number of doctor visits per year, and mother’s age, marital status, and education. Results: Approximately 81% of adolescents received a provider recommendation for the HPV vaccine and 47.5% received their vaccination at providers based in private facilities. The prevalence of HPV vaccine initiation was 75.1% and completion was 58.6%. In the adjusted analyses, adolescents who received their vaccination from public facilities (aOR=0.63; 95% CI: 0.51–0.78) were less likely to receive provider recommendation for the vaccine compared to those who received their vaccination at private facilities. Similarly, adolescents who received their vaccination from public facilities were less likely to initiate (aOR=0.73; 95% CI: 0.59–0.90) and complete (aOR=0.62; 95% CI: 0.52–0.77) the HPV vaccination compared to those who received their vaccination at private facilities. There was no difference between hospital and mixed vs. private facilities for both provider recommendation and vaccination. Conclusions: Both the recommendation for and uptake of the vaccine regimen were less common in public facilities than private facilities. Given the populations served in public facilities and the health disparities that exist in these populations, a greater focus is needed on recommendation for vaccination and follow through. Citation Format: Eric Adjei Boakye, Mrudula Nair, Amy Williams, Elizabeth Alleman, Christine Joseph, Dina Abouelella, Oluwole A. Babatunde, Nosayaba Osazuwa-Peters. Disparities in HPV vaccine uptake and provider recommendation by provider facility type [abstract]. In: Proceedings of the 15th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2022 Sep 16-19; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr A124.

The diagnostic and prognostic value of growth differentiation factor-15 in systemic lupus erythematosus-associated pulmonary arterial hypertension.

Growth-differentiation factor (GDF)-15 is a member of transforming growth factor-β-related cytokine and may respond to right ventricular overload. The objective of this article was to assess the diagnosis and prognostic value of GDF-15 in systemic lupus erythematosus-associated pulmonary arterial hypertension (SLE-PAH). Serum samples were obtained from 65 patients with SLE-PAH, 51 sex and age matched patients of SLE without PAH (SLE-non-PAH), and 32 healthy controls. Serum GDF-15 level was detected by enzyme-linked immunosorbent assayand the optimal cut-off point was determined by receiver operating characteristiccurve. The primary end-point was death from any cause and the secondary end-point was target goal achievement (TGA). Cox regression analyses and Kaplan-Meier method were performed to identify the prognostic value of GDF-15. Serum GDF-15 levels were significantly higher in SLE-PAH patients (1112.14 ± 781.80 pg/mL) than SLE-non-PAH patients (810 ± 408 pg/mL) and healthy controls (442 ± 139 pg/mL) at baseline. The optimal cut-off value of GDF-15 in the diagnosis of SLE-PAH was 733 pg/mL (AUC = 0.84). In patients with SLE-PAH, GDF-15 level was associated with 6 minwalking distance (ρ = -0.385, p = 0.017) and higher serum N terminal-pro brain natriuretic peptide (NT-proBNP) (ρ = 0.605, p < 0.001). Patients with GDF-15 > 733 pg/mL were more likely to death (adjusted hazard ratio[HR] = 4.01, 95% confidence intervals[CI]:1.23-6.27, p = 0.041) and less likely to achieve treatment goal (adjusted HR = 0.57, 95% CI:0.23-0.79, p = 0.028). In addition, patients with simultaneous elevation of GDF-15 and NT-proBNP showed lower proportion of TGA (p = 0.046). In conclusion, GDF-15 is a new and promising biomarker of development and prognosis in SLE-PAH. The combination of GDF-15 and NT-proBNP may provide more accurate prognostic information.

Lipid Management in Korean People With Type 2 Diabetes Mellitus: Korean Diabetes Association and Korean Society of Lipid and Atherosclerosis Consensus Statement.

Dyslipidemia in patients with diabetes is an important treatment target as a modifiable risk factor for cardiovascular disease (CVD). Although the primary treatment goal for dyslipidemia is to control low-density lipoprotein cholesterol (LDL-C), achieving this goal remains suboptimal according to recent studies. It is important to set the target goal for LDL-C control based on an accurate risk assessment for CVD. Here, we summarize the latest evidence on lipid management in patients with diabetes and present a consensus of the Korean Diabetes Association and Korean Society of Lipid and Atherosclerosis on the treatment goals of LDL-C according to the duration of diabetes, presence of CVD, target organ damage, or major cardiovascular risk factors. In patients with type 2 diabetes mellitus (T2DM) and CVD, an LDL-C goal of <55 mg/dL and a reduction in LDL-C level by 50% or more from the baseline is recommended. For the primary prevention of CVD in patients with T2DM with a duration of diabetes ≥10 years, major cardiovascular risk factors, or target organ damage, an LDL-C goal of <70 mg/dL is recommended. In patients with T2DM with a duration of diabetes <10 years and no major cardiovascular risk factors, an LDL-C goal of <100 mg/dL is recommended.

INTELLECTUAL ARCHITECTONICS OF REGIONAL INFORMATION AND EDUCATION SPACES IN THE NEW REALIA OF PROFESSIONAL POTENTIAL DEVELOPMENT

This study is a continuation of longitudinal research in the problem area of humanistic activities of the regional information and education environment, which is currently undergoing significant changes due to the actual value aspects of the polyphony of innovative theoretical research and pedagogical findings. The authors see the mission and goals of this article in presenting some novel results of the investigation of regional peculiarities in the aspect of integrated modeling and design. Based on theoretical, methodological and practical search of modern realities the article focuses on the environmental and cultural approaches as the leading ones. The latter helps to formulate the following methodological message: the constructive self-development of the region professional potential is possible if focused on leadership and communicative strategic guidelines. Modeling and designing of the humanitarian trends of the regional information and educational spaces are to develop the research array in terms of the use of systemic humanistic, humanitarian and communicative strategies. It means the reflexive activity on cultural self-determination of a personality who turns/goes professional, and then is in need of the basic intellectual skill set as a priority. As a result of developing the axiology context of the current target study, this project reflects the innovative dominant value trends integrated into the sociocultural and professional system of the region within the threefold intellectual architectonics covering the findings for professional potential development in terms of a) psychological balance; b) the intellectual component of a goer professional c) the communication management of professionals. In conclusion, the authors state the significance of the target goals and devices to systematically develop, test and implement optimal models of communication models for the existence of the participants of a secure information and communication environment, taking into account regional specifics.

The Efficacy of Single-pill Combination of Olmesartan Medoxomil and Amlodipine Besylate on Office Blood Pressure in Hypertensive Patients who did not Respond to Amlodipine Besylate Monotherapy.

As combination therapy, switching to single-pill combination (SPC) medication after a short period of monotherapy is helpful because reducing pill numbers can improve patients' adherence to medications. This study was aimed to assess the effect of the single-pill combination (SPC) of olmesartan medoxomil 20 mg and amlodipine besylate 5mg (OLM 20 mg/AML 5 mg) on blood pressure (BP) reduction in hypertensive patients who did not respond to amlodipine besylate 5 mg (AML 5 mg) monotherapy for 4 weeks. This study was a prospective, open-label, multi-center, non-comparative study. Patients whose BP was not got the target BP (≥140 mmHg and if diabetic patients ≥130 mmHg) after 4 weeks treatment with AML 5 mg, were enrolled. AML 5 mg was switched to the SPC (OLM 20 mg/AML 5 mg) treatment for 8 weeks. The primary effectiveness endpoint was the reduction of seated systolic blood pressure (SeSBP) after SPC (OLM 20 mg/AML 5 mg) treatment for 8 weeks. The changes of brachial-ankle pulse wave velocity (baPWV), central BP (CBP), and augmentation index (AIx@75) were evaluated also. Forty-seven patients were enrolled (mean age = 52±9 years, 36 men). After the SPC treatment for 8 weeks, SeSBP was reduced from 153±9 mmHg to 131±18 mmHg and seated diastolic BP (SeDBP) from 95±8 mmHg to 81±11 mmHg (p<0.001 and p<0.001, respectively). The reduction of SeSBP/SeDBP were 22 mmHg and 14 mmHg, respectively. The target goal BP achievement rate was 74.5%, and baPWV, CBP, and AIx@75 were improved. SPC (OLM 20 mg/AML 5 mg) treatment for 8 weeks was effective in reducing BP, achieving target BP goal, and also improving arterial stiffness in uncontrolled hypertensive patients with AML 5 mg monotherapy.

PS-P13-7: O.N.E. (ONWARD NONCOMMUNICABLE DISEASE EDUCATION) CAVITE INITIATIVE: A COLLABORATIVE PROJECT TO IMPLEMENT PHILPEN AMONG PRIVATE PRACTITIONERS

Objective: Cardiovascular diseases account for most noncommunicable disease (NCD) deaths about 17.9 million people annually. The Philippine Department of Health (DOH) began implementing the PhilPEN (Philippine Package of Essential Noncommunicable Disease interventions) nationwide in 2014. The protocol screens adult Filipinos seen in the public health facilities for major cardiovascular disease risk factors and includes interventions such as lifestyle advice and medications to achieve target goals. ONE Cavite Project is a collaboration between DOH, the Philippine Society of Hypertension (PSH), and private practitioners in Cavite- a densely populated semi-urbanized province in the Philippines. The primary objective of the One Cavite Project is to engage private medical practitioners in Cavite in screening, diagnosing, and managing adult patients (20 years old and above) for the following significant cardiovascular risk (CV) factors: hypertension, type 2 diabetes mellitus, dyslipidemia, smoking and to complement the PhilPEN implementation by the DOH in all its public health facilities in Cavite by private general physicians. Design and Methods: The first phase of the project is to organize a series of seminars to gather, enroll, and engage private doctors to ensure proper screening, monitoring, and follow up of patients with hypertension, diabetes, dyslipidemia, and other CV risk factors. The second phase is to enroll the patients of these private doctors, where patient data was collected, collated, and submitted to PSH for descriptive analysis by a third party. Results: A total of 680 doctors were engaged with a total of 41,477 patients screened. Preliminary data showed that out of the 41,477 patients, 61% have hypertension, 17% have diabetes, 22% have dyslipidemia, and 16% are smokers. Moreover, 21% have both hypertension and diabetes, 19% have hypertension and dyslipidemia, while 7% have hypertension, diabetes, and dyslipidemia. On follow-up after six months, out of 18,348 patients with hypertension, 88% of patients with hypertension had their blood pressure under control. For the 5,024 patients with diabetes, 15% had a fasting blood sugar &lt; 110 mg/dL, and 32% had an HBA1c&lt; 6.5 mg/dl. Out of 7,146 patients with dyslipidemia, 14% had an LDL &lt; 130 mg/dl, while for the 3,510 smokers, 56% quit smoking on follow-up. Conclusion: The One Cavite Project has shown that engagement of private medical practitioners in screening, diagnosing, and managing adult patients for significant cardiovascular risk (CV) factors have complemented the implementation of PhilPEN by the DOH and this led to active prevention and control of these risk factors.

Integrating HIV Pre-Exposure Prophylaxis (PrEP) Education During Medical Residency: Training Outcomes and Suggestions for Learning Effectiveness.

Human immunodeficiency virus (HIV) infection is now preventable with pre-exposure prophylaxis (PrEP) drugs, however, barriers to PrEP implementation include primary-care physician (PCP) knowledge-gap and lack of comfort prescribing and managing PrEP. We hypothesized that integrating HIV-PrEP education during medical-residency would help address these problems and developed a 40-minute case-based lecture focused on the 2021 United States Preventative Services Taskforce (USPSTF) oral HIV-PrEP guidelines and integrated this into our residency's core curriculum. We analyzed data from physician-trainees who voluntarily completed a pre- and post-lecture survey measuring HIV-PrEP "knowledge" and "self-assessed readiness to independently initiate and manage PrEP." Independent group analysis was completed via the Mann-Whitney U and Pearson Chi-square 2-sided test with P-value <0.05 deemed significant. Of the total of 189 residents invited to the lecture, 130 (69%) completed the pre-survey while 107 (57%) completed the post-survey. Per knowledge-assessment: the median number of correctly answered questions rose from a pre-lecture baseline of 4/9 (44%) to 8/9 (89%) following the education intervention (P < .001). When asked about comfort initiating and managing HIV-PrEP on their own, 7/130 (5.4%) responded in agreement pre-lecture, but this rose to 55/107 (51.4%) post-lecture (P < .001). Our study revealed PrEP training during residency was effective per stated objectives and may be an important tool to increase PrEP delivery/uptake to achieve the target goals for the National HIV/AIDS Strategy.

Residual Atherosclerotic Cardiovascular Disease Risk: Focus on Non-High-Density Lipoprotein Cholesterol.

Cardiovascular disease (CVD) caused by atherosclerosis is the leading cause of death worldwide. The level of low-density lipoprotein cholesterol (LDL-C), considered as the initiator of atherosclerosis, is the most widely used predictor for CVD risk and LDL-C has been the primary target for lipid-lowering therapies. However, residual CVD risk remains high even with very low levels of LDL-C. This residual CVD risk may be due to remnant cholesterol, high triglyceride levels, and low high-density lipoprotein cholesterol (HDL-C). Non-high density lipoprotein cholesterol (non-HDL-C), which is calculated as total cholesterol minus HDL-C (and represents the cholesterol content of all atherogenic apolipoprotein B-containing lipoproteins), has emerged as a better risk predictor for CVD than LDL-C and an alternative target for CVD risk reduction. Major international guidelines recommend evaluating non-HDL-C as part of atherosclerotic CVD risk assessment, especially in people with high triglycerides, diabetes, obesity, or very low LDL-C. A non-HDL-C target of <130 mg/dL (3.4 mmol/L) has been recommended for patients at very high risk, which is 30 mg/dL (0.8 mmol/L) higher than the corresponding LDL-C target goal. Non-HDL-C lowering approaches include reducing LDL-C and triglyceride levels, increasing HDL-C, or targeting multiple risk factors simultaneously. However, despite the growing evidence for the role of non-HDL-C in residual CVD risk, and recommendations for its assessment in major guidelines, non-HDL-C testing is not routinely done in clinical practice. Thus, there is a need for increased awareness of the need for non-HDL-C testing for ascertaining CVD risk and concomitant prevention of CVD.

Meaning Search of Agricultural Technology Terms Internet Based-Learning in Translation and Learning English

The current development of technology has been instantly changing the whole society with the easy access for searching information through the internet. Using media support is a consideration to increase activities of learning and adapting the development of this era. The English learning desire creativity for teaching the students as their target goal. This research aims to analyze the meaning of the terms related to science agricultural technology by implementing Internet Based-Learning for students in the Department of Food Technology, including their translation. It was conducted with mixed methods (qualitative and quantitative). by giving guidance to first-year semester on how they could use the WebCorp media to search articles. Then, students instructed to find the translation and understanding of the meaning in each of the terms. This search engine is a machine that compiles Bing or big data capacity and collected as corpus. The texts can be found in various types and sources on the internet. The discussion of problems in the study covers description of understanding the meaning search for terms related to agricultural technology, evaluating parameter of ability to search meaning through internet based-learning by using WebCorp media and strategies implementation to learn English, mainly meaning related to agricultural technology. It showed that there were 47 terms equivalence based on their English terms meaning and translation of Indonesian related to agricultural technology, meanwhile, 7 were found inequivalence for their meanings and text chosen. So, 87% of their results relevant to the agricultural technology but 13% were not connected with the specification of terms and meaning. The students understood how to use the media of searching and gave experience to them.

The feasibility and efficacy of a community-based multifactorial intervention to improve the cardiovascular risk factor control among patients with type 2 diabetes: A 2-year cluster randomized trial.

Our study is to investigate the feasibility and effectiveness of multiple cardiovascular factors intervention (MFI) in type 2 diabetes patients in China's primary care setting. We performed a cluster randomized trial to compare the proportion of patients achieved the targets between usual care group (control, 9 sites, n = 868) and MFI group (8 sites, n = 739) among patients with type 2 diabetes in primary care setting. Logistic regression model with random effects was used to estimate the association of the effect of intervention and the proportion achieved the targets. At baseline, the end of 1 year, and 2 years follow-up, the proportion of patients achieved all 3 target goals (HbA1c < 7.0%, blood pressure < 130/80 mm Hg and low-density lipoprotein cholesterol < 2.6 mmol/L) were 5.7%, 5.9%, 5.7% in the control group and 5.9%, 10.6%, 12.3% in the MFI group. After adjusting sex, age, diabetes duration, body mass index, HbA1c, blood pressure, and low-density lipoprotein cholesterol at baseline, there was no difference between the 2 groups (OR (95% CI): 1.27 (0.38-4.27) and 1.86 (0.79-4.38) for the first year and second year, respectively). When stratified by payment method, the patients with medical insurance or public expenses had a higher proportion achieved target goals (6.9% vs 16.4%, OR (95% CI): 2.30 (1.04-5.08)) in the second year. The controlling of cardiovascular risk factor targets remains suboptimal among patients with type 2 diabetes in primary care setting. MFI in type 2 diabetes improved cardiovascular disease risk profile, especially in the patients with medical insurance.

ESTIMASI PARAMETER RANDOM EFFECT MODEL PADA REGRESI PANEL MENGGUNAKAN METODE GENERALIZED LEAST SQUARE (STUDI KASUS: KEMISKINAN DI PROVINSI KALIMANTAN SELATAN)

Poverty is a condition that concerns the inability to meet the most minimum demands of life, especially from the aspects of consumption, income, education, and health. The problem of poverty is very complex and multidimensional in nature, as it relates to social, economic, cultural and other aspects. This study focuses on observation areas in South Kalimantan Province, with the PPM value in 2021 reaching (4.83%) still above the target goal of the Regional Medium-Term Development Plan (RPJMD) of South Kalimantan Province (3.96- 4.01%), so that further interventions are still needed to be able to reduce PPM in poverty cases. This study aims to estimate the parameters of the panel regression model used to analyze factors that are suspected to affect poverty cases in South Kalimantan Province in 2016-2020. The Random Effect Model (REM) is the best model used in this study, assuming that there are differences in slopes and interceptions caused by residual due to differences between individual units and between time periods. The process of estimating parameters on REM is determined through the Generalized Least Squares (GLS) Estimator method . From the results of the data processing, it was obtained that the model is influenced by economic growth, life expectancy, open unemployment rate, and labor force participation rate. From the results of the analysis of 2 (two) models, it was tested significantly and affected poverty in South Kalimantan Province in 2016-2020. Keywords: Poverty, Data Regression Panel, Generalized Least Square Method (GLS).

Design and control of soft biomimetic pangasius fish robot using fin ray effect and reinforcement learning

Soft robots provide a pathway to accurately mimic biological creatures and be integrated into their environment with minimal invasion or disruption to their ecosystem. These robots made from soft deforming materials possess structural properties and behaviors similar to the bodies and organs of living creatures. However, they are difficult to develop in terms of integrated actuation and sensing, accurate modeling, and precise control. This article presents a soft-rigid hybrid robotic fish inspired by the Pangasius fish. The robot employs a flexible fin ray tail structure driven by a servo motor, to act as the soft body of the robot and provide the undulatory motion to the caudal fin of the fish. To address the modeling and control challenges, reinforcement learning (RL) is proposed as a model-free control strategy for the robot fish to swim and reach a specified target goal. By training and investigating the RL through experiments on real hardware, we illustrate the capability of the fish to learn and achieve the required task.

1862. Time to Therapeutic Goal is Faster with Continuous Infusion Vancomycin for Methicillin-Resistant Staphylococcus aureus Bloodstream Infections

Abstract Background Continuous infusion vancomycin (CIV) is an attractive alternative to intermittent infusion vancomycin (IIV) as it may result in more rapid attainment of target serum drug concentrations, provide ease of monitoring, and decreased risk of nephrotoxicity. At our institution CIV has been the preferred infusion method for over 20 years. The purpose of this study was to examine the time to therapeutic goal among patients receiving IIV compared to CIV for methicillin-resistant Staphylococcus aureus (MRSA) bacteremia. Secondary objectives included all-cause readmission, relapse, and mortality 30 days after completion of therapy. Methods This was a single-center, retrospective study of patients who received vancomycin for MRSA bacteremia between January 2018 and December 2021. Included patients were ≥ 18 years of age, had ≥ 1 blood culture positive for MRSA, received vancomycin for &amp;gt; 10 days, and had follow-up in the outpatient parenteral antimicrobial therapy clinic. Patients who were pregnant, received vancomycin for ≤ 10 days, or were diagnosed at an outside hospital were excluded. All patients were started on IIV then transitioned to CIV. Patients on IIV with an appropriately drawn trough between 15-20 mcg/mL were considered therapeutic. For patients on CIV, a single random level between 17-25 mcg/mL, corresponding to an AUC/MIC of 400-600 mcg·h/mL, was considered therapeutic. Results Sixty-three patients with 65 MRSA bacteremia episodes were included. Significantly fewer patients achieved a therapeutic goal on IIV compared to patients on CIV (52.3% vs. 83.1%, p-value &amp;lt; 0.01). Of the 31 patients who did not reach the IIV trough goal, 87.1% became therapeutic when switched to CIV. Patients on IIV took 3.6 days, on average, to reach the target goal, compared to 1.9 days when patients were switched to CIV (95% confidence interval 0.50 – 2.96, p-value &amp;lt; 0.01). No patients experienced relapse or mortality 30 days after completion of therapy. Six patients (9.2%) were readmitted 30 days after completion of therapy. Conclusion CIV enabled patients with MRSA bacteremia to achieve the AUC/MIC goal significantly faster than when receiving IIV. Patients who were unable to achieve a therapeutic goal on IIV became therapeutic once switched to CIV. Disclosures Martha Carvour, MD, PhD, The Suga Project/The Suga Project Foundation: I provide consultation and support but do not receive compensation.