Analysis Of Group Interaction Research Articles

Leveraging Cooperative Intent and Actuator Constraints for Safe Trajectory Planning of Autonomous Vehicles in Uncertain Traffic Scenarios

This study explores the integration of dynamic vehicle trajectories, vehicle safety factors, static traffic environments, and actuator constraints to improve cooperative intent modeling for autonomous vehicles (AVs) navigating uncertain traffic scenarios. Existing models often focus solely on interactions between dynamic trajectories, limiting their ability to fully interpret the intentions of surrounding vehicles. To address this limitation, we present a more comprehensive approach using the Cooperative Intent Multi-Layer Graph Neural Network (CMGNN) model. The CMGNN analyzes not only the dynamic trajectories but also the lane position relationships, vehicle angle changes, and actuator constraints and performs group interaction analysis. This richer information allows the CMGNN to more accurately capture the cooperative intent and better understand the surrounding vehicle behavior. This study investigated the impact of the CMGNN in the Carla simulator on surrounding vehicle trajectory prediction and AV safe trajectory planning. An innovative mechanism for dynamic trajectory risk assessment is introduced, which takes into account the constraints of the actuators when evaluating trajectory planning metrics. The results show that incorporating cooperative intent and considering the actuator limitations enhanced the CMGNN’s safety and driving efficiency in uncertain scenarios, significantly reducing the probability of AVs colliding. This is achieved as the model dynamically adapts its driving strategy based on the real-time traffic conditions, the perceived intentions of the surrounding vehicles, and the physical constraints of the vehicle actuators.

How to Analyze Focus Group Interactions – Development of a Coding Scheme

The value of taking advantage of the participants’ interactions when analyzing focus group data is often stressed. However, there is a lack of detailed descriptions of how focus group data can be merged with interview data, and considered throughout a thematic analysis process. This article describes a systematic way to include focus group interactions in data analysis, using a coding scheme. The aim was threefold: to develop a coding scheme for focus group interactions; to test and describe a process for interaction analysis, merged into the thematic data analysis process, and to test the coding scheme on another dataset. Based on focus group literature a comprehensive coding scheme for analyzing focus group interactions, was developed, including symbols for these interactions. Data from five focus group interviews involving adolescents were subsequently coded using this scheme. Further analysis of the identified interactions was conducted simultaneously with thematic data analysis, using Systematic Text Condensation (STC) as an illustrative method. The coding scheme was then tested on data from a different focus group involving adolescents in another setting. A comparison between the two coders was made, leading to a slight modification of the coding scheme. The resulting coding scheme is a practical tool adding to the previous knowledge on focus group interaction analysis. More specifically, the scheme facilitates focus group interactions to be visible and accounted for thought the thematic analysis process.

Longitudinal Changes of Functional Connectivity Dynamism Are Relevant for Disability Worsening in Multiple Sclerosis: A 2.5-Year Study (P10-3.018)

<h3>Objective:</h3> To investigate changes in time-varying functional connectivity (TVFC) over 2.5 years of follow-up in multiple sclerosis (MS) patients and their association with disability progression. <h3>Background:</h3> In MS patients, TVFC analysis showed abnormalities of the main functional networks, correlated with more severe clinical and cognitive disability. Preliminary evidence showed that MS-related cognitive decline was associated with progressive TVFC destabilization. However, the clinical relevance of longitudinal TVFC changes has not been investigated yet. <h3>Design/Methods:</h3> 3T-MRI scans and clinical evaluations were obtained at baseline and at median follow-up of 2.5 years from 129 right-handed MS patients (103 relapsing-remitting [RR] and 26 progressive [P]) and 28 matched healthy controls (HC). At 2.5-year follow-up, patients were classified as clinically stable/worsened according to their disability change. TVFC was quantified at voxel-wise level as the coefficient of variation (CoV) across sliding-windows of degree centrality. <h3>Results:</h3> At follow-up, 25/129 (19.3%) MS patients worsened clinically. At baseline, MS patients showed reduced TVFC <i>vs</i> HC in the bilateral orbitofrontal cortex (p&lt;0.05, family-wise error corrected), left cerebellum, right precuneus and left thalamus. At 2.5-year follow-up, a widespread reduction of TVFC over time (p&lt;0.05, family-wise error corrected) was found in MS patients in temporal, parietal, occipital and frontal lobes, as well as in the cerebellum. Such a pattern of TVFC reduction was also found when looking at clinically stable MS patients. Clinically worsened MS presented peculiar TVFC reductions in areas of the default-mode network and basal ganglia. Reduced TVFC in the left putamen in clinically worsened <i>vs</i> stable MS patients was significant at time <i>x</i> group interaction analysis. <h3>Conclusions:</h3> After 2.5 years of follow-up, MS patients showed widespread TVFC reduction in cortical lobes and cerebellum. A peculiar involvement of deep grey matter was found in clinically worsened MS patients. Accrual of TVFC abnormalities in deep grey matter regions may represent a biological substrate of disability worsening. <b>Disclosure:</b> Dr. D’Amore has nothing to disclose. Paola Valsasina has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for ACCMED. Mr. Preziosa has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Bristol Myers Squibb . Mr. Preziosa has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Sanofi Genzyme. Mr. Preziosa has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Novartis. Mr. Preziosa has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Roche. Mr. Preziosa has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Merck. Monica Margoni has received research support from MAGNIMS. Dr. Filippi has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Bayer, Biogen Idec, Merck-Serono, Novartis, Roche, Sanofi Genzyme, Takeda, and Teva Pharmaceutical Industries. Dr. Filippi has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Bayer, Biogen Idec, Merck-Serono, Novartis, Roche, Sanofi Genzyme, Takeda, and Teva Pharmaceutical Industries. Dr. Filippi has received personal compensation in the range of $5,000-$9,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Springer Nature. The institution of Dr. Filippi has received research support from Biogen Idec, Merck-Serono, Novartis, Roche, Teva Pharmaceutical Industries, Italian Ministry of Health, Fondazione Italiana Sclerosi Multipla, and ARiSLA (Fondazione Italiana di Ricerca per la SLA). Maria Assunta Rocca has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Bayer, Biogen, Bristol Myers Squibb, Celgene, Genzyme, Merck Serono, Novartis, Roche, and Teva. The institution of Maria Assunta Rocca has received research support from Italian Ministry of Health, MS Society of Canada and Fondazione Italiana Sclerosi Multipla.

POLA KOMUNIKASI KELOMPOK FATAYAT NU TANGERANG DALAM PEMBENTUKAN KARAKTER HIDUP SEHAT PADA KEGIATAN “SHARING SEHAT BERSAMA FATAYAT”

The family is the foundation of the formation of a healthy living character, because it is from the family that the formation of a healthy living character actually begins. Good or bad a person's healthy way of life is clearly determined by the parenting pattern developed in the family. A mother becomes a good uswatun hasanah for her children, in realizing the child into a whole person who brings goodness to himself, his family, society, country, and the universe (maslahah). Approach The group communication pattern applied is an approach that can be better understood as a pattern of interaction than as a set of specific skills. This study aims to determine the pattern of communication in Healthy Sharing activities with Fatayat. This study was dissected based on the concept of group communication patterns, using a qualitative approach research method with a descriptive method. The results of the research are communication patterns, communication patterns, network communication schemes, all channels or star patterns and communication patterns, group interaction analysis, and character education by interacting and sharing education.

How to Get a Grip on Processes of Communalization and Distinction in Group Interactions-An Analytical Framework.

This article proposes an analytical framework that combines Conversation Analysis, Positioning Theory, and Stance Analysis to study communalization and distinction as basic interactive mechanisms within group interactions. The framework is based on the premise that participants in multi-party interactions constantly manage the local demands of the ongoing conversation and turn-by-turn talk as well as implicitly or explicitly evoked references to global discourses, which in turn are closely related to the topic currently discussed. By considering both micro- and macro-contextual features in the analysis of group interactions, it is possible to reach a deeper understanding of dynamic group activities. The framework has been empirically developed based on data from a study on epistemic positioning practices in adolescents’ group interactions about popular TV series in Germany. The data comprises ten videotaped focus group discussions that have been elicited in a school context. By applying the framework to the analysis of a single case from the corpus, insights can be gained, both on how group members’ finely adjust their epistemic and evaluative stances as well as on how the participants themselves interactively link their stances to broader discourses.

Evaluation of masticatory behavior and taste sensitivity after pacifier removal in preschool children: a 1-year follow-up.

The aim was to investigate the influence of pacifier removal on the development of masticatory function and taste sensitivity in preschool children. Sixty children (mean age 48.2months) were divided into two groups: pacifier group (n = 28) and a control group (n = 32), which were evaluated and followed up for a period of 12months (at baseline, 6months, and 1year). Masticatory and swallowing functions were assessed using the Mastication Observation and Evaluation (MOE) protocol and Orofacial Myofunctional Rating (MBGR), respectively. Detection thresholds for sucrose and urea were measured by the staircase method. The two-way ANOVA mixed model was used for time*group interaction analysis. MOE scores improved significantly over time in both groups, although a significant difference between groups persisted after 1year. On the other hand, swallowing scores were significantly different at baseline, but within 1year, the scores were no longer different between groups. Chewing time and the number of cycles were not different between groups and both decreased after 1year. Sucrose sensitivity was significantly greater in the control group at baseline and changed over time (p < 0.05), being no longer different between groups after 6months. Bitter sensitivity did not differ over time nor between groups. Detection threshold for sucrose differed significantly between children with and without pacifier habit at a mean age of 42months. Total masticatory function did not self-correct after sucking habit removal within a 1-year period. Children with pacifier habit showed important changes in masticatory function that did not self-correct 1year after cessation of the habit, highlighting the need for prevention and habit interruption as early as possible.

Effects of a WhatsApp-Delivered Education Intervention to Enhance Breast Cancer Knowledge in Women: Mixed-Methods Study

BackgroundBreast cancer is the leading cause of cancer-related death in the female population. Health education interventions based on the use of mobile technologies enable the development of health self-care skills and have emerged as alternative strategies for the control of breast cancer. In previous studies, WhatsApp has stood out as a useful tool in health education strategies; however, it has not yet been applied for breast cancer education.ObjectiveThis study aimed to analyze the potential of WhatsApp as a health education tool used to improve women's knowledge on the risk reduction of breast cancer. It also aimed to understand how women feel sensitized within the WhatsApp group throughout the intervention and how they incorporate information posted to improve knowledge about early detection and risk reduction methods.MethodsThe study involved a pre-post health educational intervention with 35 women (aged 45-69 years) included in a WhatsApp group to share information (audio, video, text, and images) over 3 weeks on the early detection and risk reduction of breast cancer. Data were collected through questionnaires on topics related to risk reduction, as well as qualitative content analysis of group interactions. Effectiveness and feasibility were analyzed through conversations and the comparison of the scores obtained in the questionnaires before and after the intervention.ResultsA total of 293 messages were exchanged (moderator 120 and users 173). The average scores of the participants were 11.21 and 13.68 points before and after the educational intervention, respectively, with sufficient sample evidence that the difference was significant (P<.001). The intervention enabled women to improve their knowledge on all topics addressed, especially “myths and truths,” “incidence,” “clinical manifestations,” and “protective factors.” Some themes emerged from the interactions in the group, including group dynamics, general doubts, personal narratives, religious messages, daily news, and events.ConclusionsThe use of groups for women in WhatsApp for health education purposes seems to be a viable alternative in strategies on breast cancer control, especially as it provides a space for the exchange of experiences and disinhibition. However, the need for a moderator to answer the questions and the constant distractions by members of the group represent important limitations that should be considered when improving this strategy.

Enter the WhatsApper: Reinventing digital activism at the time of chat apps

This paper investigates how the appropriation of chat apps by social actors is redesigning digital activism and political participation today. To this end, we look at the case of #Unidos Contra o Golpe (United Against the Coup), a WhatsApp “private group” which emerged in 2016 in Florianópolis, Brazil, to oppose the controversial impeachment of the then-president Dilma Rousseff. We argue that a new type of political activist is emerging within and alongside with contemporary movements: the WhatsApper, an individual who uses the chat app intensely to serve her political agenda, leveraging its affordances for political participation. We explore WhatsApp as a discursive opportunity structure and investigate the emergence of a repertoire specific to chat apps. We show how recurrent interaction in the app results into an all-purpose, identity-like sense of connectedness binding social actors together. Diffuse leadership and experimental pluralism emerge as the bare organizing principles of these groups. The paper is based on a qualitative analysis of group interactions and conversations, complemented by semi-structured interviews with group members. It shows how WhatsApp is more than a messaging app for “hanging out” with like-minded people and has come to constitute a key platform for digital activism, in particular in the Global South.

A feminist geographic analysis of perceptions of food and health in Ugandan cities

This article contributes to a feminist geographic analysis of how urban food and health environments and non-communicable disease experience may be being constructed, and contested, by healthcare professionals (local elites) in two secondary Ugandan cities (Mbale and Mbarara). I use thematic and group interaction analysis of focus group data to explore material and discursive representations. Findings make explicit how healthcare professionals had a tendency to prescribe highly classed and gendered assumptions of bodies and behaviours in places and in daily practices. The work supports the discomfort some have felt concerning claims of an African nutrition transition, and is relevant to debates regarding double burden malnutrition. I argue that a feministic analysis, and an intersectional appreciation of people in places, is advantageous to food and health-related research and policy-making. Results uncover and deconstruct a dominant patriarchal tendency towards blaming women for obesity. Yet findings also exemplify the co-constructed and malleable nature of knowledge and understandings, and this offers encouragement.

A cognitive model of social preferences in group interactions

Modeling the interactions in groups is becoming increasingly important in many application domains such as the design of interactive systems and social robots. Since human interactants do not always make rational choices, a good model of their social motivations is needed to explain the strategies of the interactants that are often influenced by social factors and preferences, the feeling of fairness and understanding the need for cooperation. We propose a cognitive model of social preferences of three or more interactants that are engaged in a collaborative game. The game strategies of the interactants are modeled with cooperation ratios and utility functions. We developed a new generalized utility-based approach to model the cooperation and fairness in multiplayer interactions, which uses three utility parameters. In two-person games, as it has been investigated by others, it is impossible to distinguish between fairness and cooperation in the decisions of a given player. We show that in n-person games (n> 2), and with the use of the proposed utility-based approach, it is possible to distinguish between fairness and cooperation. This makes the proposed approach suitable for more detailed analysis of group interactions in a game setting, which can better explain the social motivation of the interactants, than existing utility models and models that utilize on cooperation ratios. We show that the proposed generalization makes the newly proposed utility function less sensitive to the payoffs of one player if the size of the group grows, and test it with data from the MARS-500 isolation experiment.

The Role of Regulatory, Social, and Dialogic Dynamics on Young Children's Productive Collaboration in Group Problem Solving.

This qualitative study explored the interactions of six triads of Year One students in the United Kingdom (n = 18; mean age = 5 years, 7 months; 9 female) investigating interpersonal regulation of learning, social dynamics, and group dialogue, evident in instances of productive collaboration during problem-solving activities. Group activity was captured through video (total footage = 8 hours) and subjected to two sequential phases of qualitative analysis, undertaken by three researchers: (1) comprehensive qualitative descriptions of group activity, and (2) multidimensional analysis of group interaction with a focus on interpersonal regulation of learning, social dynamics, and group dialogue. Consistent with prior research, the findings show that productive collaboration, though prevalent only in some groups, was characterized by (a) distributed forms of co-regulation where all members took turns in taking regulatory roles; (b) positive social dynamics marked by equitable patterns of participation, playful interludes, uptake of contributions, and use of persuasive language in the event of disagreements; and (c) use of exploratory forms of talk (e.g., asking questions and volunteering reasons) directed toward the achievement of task goals. Different positional preferences were identified among the most regulated students, who consistently assumed leading roles in their groups.

Engaging Undergraduate Biology Students in Scientific Modeling: Analysis of Group Interactions, Sense-Making, and Justification.

National calls for improving science education (e.g., Vision and Change) emphasize the need to learn disciplinary core ideas through scientific practices. To address this need, we engaged small groups of students in developing diagrammatic models within two (one large-enrollment and one medium-enrollment) undergraduate introductory biology courses. During these activities, students developed scientific models of biological phenomena such as enhanced growth in genetically modified fish. To investigate whether undergraduate students productively engaged in scientific practices during these modeling activities, we recorded groups of students as they developed models and examined three characteristics: how students 1) interacted with one another, 2) made sense of phenomena, and 3) justified their ideas. Our analysis indicates that students spent most of the time on task, developing and evaluating their models. Moreover, they worked cooperatively to make sense of core ideas and justified their ideas to one another throughout the activities. These results demonstrate that, when provided with the opportunity to develop models during class, students in large-enrollment lecture courses can productively engage in scientific practices. We discuss potential reasons for these outcomes and suggest areas of future research to continue advancing knowledge regarding engaging students in scientific practices in large-enrollment lecture courses.

DEVELOPMENT OF ECOLOGICAL CULTURE OF STUDENTS IN THE PROCESS OF INTERCULTURAL COMMUNICATION IN FOREIGN LANGUAGE

Introduction. High level of ecological culture in modern society is the most important condition of self-preservation and sustainable development of a human civilization. The processes of globalization force to consider environmental problems with a support on polycultural practice, to take into account national and regional peculiarities in their integrity. Thus, there is the need of the international cooperation not only at the government level, but also at the levels of expert communities, separate groups of society and citizens of the country. Moreover, ecological culture is constantly highlighted in numerous studies, materials and documents of the international forums, summits and conferences of the UN and UNESCO. The aim of this publication is to present the authors’ didactic complex of development tools of ecological culture of students, and to show the potential of teaching foreign languages (on the example of French) for students’ ecological culture formation by means of development of cross-cultural communicative competence. Methodology and research methods. Culturological approach has been chosen as a key approach for creation of integrative model of development of ecological culture. The methods involve: the system-based analysis of the content of ecological education; generalization of the theory and practice of implementation of the international strategies of ecological culture development and the analysis of efficiency of the pedagogical technologies intended for this purpose; modeling of the process of formation of ecological culture of students. The diagnostics of components of students’ ecological culture has been performed by means of internal questioning, observation, and comparative analysis of group interactions. Also, pedagogical ascertaining experiments, methods of pedagogical design for forms of the educational environment organization, design of the educational programmes, and methods of graphical representation of the research results have been involved. Results and scientific novelty. New principles for the development of ecological culture are singled out. It is stated that intercultural communication is becoming the main mechanism for ecological culture development. Selection of the most productive innovative pedagogical technologies of ecological competence formation of students is carried out. Based on the obtained students’ questioning data, the factors promoting the increase of the individual ecological culture level are defined. It has become clear that pupils attach the greatest importance to the participation in international ecological projects, ecological tourism and acquaintance with traditions of different nationalities; at the same time, the role of foreign languages knowledge, reading foreign non-translated sources on environmental issues, and, in general, the importance of cross-cultural communication are estimated by students at a very low level. The authors conclude that relatively little attention is drawn to the issues of ecological culture in the process of foreign languages learning in higher education institutions; students practically do not get the experience of intercultural interaction. The integrative didactic model of ecological culture formation among students is offered. Consequently, intercultural communication plays an important part in the development of ecological culture formation. The educational programme of the course «Development of Ecological Culture of Students in the course of Intercultural Communication in French» is designed on the basis of the proposed model; the results of its approbation are described. Practical significance. The materials of the article can be useful when updating the content of the discipline «Foreign Language», and improvement of the educational process at higher school aimed at the development of students’ ecological culture as well.

Group interaction analysis of displacements in granular pile anchors (GPA)

Group interaction analysis of displacements in granular pile anchors (GPA)

Repetition, response mobilization, and face: Analysis of group interactions with a 19-year-old with Asperger syndrome

This Conversation Analytic study examined the talk of an adolescent with Asperger syndrome (under previously used diagnostic criteria), Nathan, as he interacts with peers in a small group setting. We focused on Nathan's repetition aimed at pursuing response, and rely on analytical frameworks including response mobilization, face-work, and agreement preference. We found that while Nathan's repetitions resembled ‘topic perseveration’ previously described in the literature, they showed evidence of interactional awareness as they were employed when peers offered little or no response to his original utterance. However, we also found that while much of Nathan's talk was sophisticatedly structured, his repetition to pursue response eschewed interaction rituals that work to maintain social cohesion. As a result, Nathan's interactional priorities appeared mis-aligned with those of his peers, and failed to produce extended interactions in most cases.Learning outcomes: Readers will be able to describe features of conversational interaction, including response mobilization, agreement preference, and face work. They will understand the relevance of conversation analysis to the study of interaction in individuals with autism spectrum disorder. Lastly, they will be able to describe the conditions under which the subject used repetition within peer interactions, and the effects of his repetition on interaction.

Students’ Experiences in Interdisciplinary Problem-based Learning: A Discourse Analysis of Group Interaction

Interdisciplinary problem-based learning (PBL) aims to provide students with opportunities to develop the necessary skills to work with different health professionals in a collaborative manner. This discourse study examined the processes of collective knowledge construction in Japanese students in the tutorials. Analyses of video-recorded data elicited from three multidisciplinary cohorts and their learning portfolios provided insights into their participation and introspection during the discussions. The results indicate there were two patterns of knowledge construction: (a) co-constructions between students from different disciplines and (b) elaborations between students from the same discipline. Their learning processes were mediated by their cultural assumptions, professional identities, understanding of other professionals, and perceptions of collaborative learning. The finding suggests that interdisciplinary PBL has the potential to enhance students’ collaborative learning skills, and students’ participation is situated within a cultural context.

Structural brain plasticity in Parkinson's disease induced by balance training

We investigated morphometric brain changes in patients with Parkinson's disease (PD) that are associated with balance training. A total of 20 patients and 16 healthy matched controls learned a balance task over a period of 6 weeks. Balance testing and structural magnetic resonance imaging were performed before and after 2, 4, and 6 training weeks. Balance performance was re-evaluated after ∼20 months. Balance training resulted in performance improvements in both groups. Voxel-based morphometry revealed learning-dependent gray matter changes in the left hippocampus in healthy controls. In PD patients, performance improvements were correlated with gray matter changes in the right anterior precuneus, left inferior parietal cortex, left ventral premotor cortex, bilateral anterior cingulate cortex, and left middle temporal gyrus. Furthermore, a TIME × GROUP interaction analysis revealed time-dependent gray matter changes in the right cerebellum. Our results highlight training-induced balance improvements in PD patients that may be associated with specific patterns of structural brain plasticity. In summary, we provide novel evidence for the capacity of the human brain to undergo learning-related structural plasticity even in a pathophysiological disease state such as in PD.

Three-dimensional investigation of wave–pile group interaction using the scaled boundary finite element method—Part II: Application results

This paper is the second part of the study on three-dimensional wave–pile group interaction analysis using the scaled boundary finite element method (SBFEM). The verified SBFEM model is employed to investigate wave interaction with pile group foundations. The leading pile experiences greater wave forces and larger displacement magnitudes than other piles. Parametric analyses in terms of wave properties and structural layouts are carried out. Compared with the pile distance, the wave number is a dominant factor affecting wave and structural behaviours. This study is expected to provide valuable information for the design of pile group foundations.

Produção de sentidos sobre saúde em um grupo de discussão com adolescentes de Fortaleza

O artigo discute o processo de construção de sentidos sobre saúde/doença por adolescentes de um grupo de discussão sobre saúde, em uma escola de Fortaleza-CE. Alinhada à perspectiva da pesquisa-intervenção, a pesquisa se operacionalizou por meio de observações participantes e de um grupo de discussão, sob o formato de oficinas temáticas sobre saúde, em uma instituição escolar da capital cearense. Quanto ao tratamento dos dados, foi realizada uma análise microgenética das interações do grupo, enfocando condições imediatas e histórico-ideológicas ligadas às atividades discursivas entre os participantes, bem como indícios de continuidade e transformação do processo de significação naquelas interações. Os resultados denotam que, naquele grupo, "saúde" figurava como um signo em disputa. Por um lado, entre os próprios adolescentes integrantes do grupo, foi potente a circulação de sentidos que ligam a saúde aos signos do "equilíbrio" e da "prevenção". Por outro, a análise evidenciou reposicionamentos subjetivos mediados pelas interações.

Does High-Dose Metformin Cause Lactic Acidosis in Type 2 Diabetic Patients after CABG Surgery? A Double Blind Randomized Clinical Trial

Metformin is a dimethyl biguanide oral anti-hyperglycemic agent. Lactic acidosis due to metformin is a fatal metabolic condition that limits its use in patients in poor clinical condition, consequently reducing the number of patients who benefit from this medication. In a double blind randomized clinical trial, we investigated 200 type 2 diabetic patients after coronary artery bypass surgery in the open heart ICU of the Mazandaran Heart Center, and randomly assigned them to equal intervention and control groups. The intervention group received regular insulin infusion along with 2 metformin 500 mg tablets every twelve hours, while the control group received only intravenous insulin with 2 placebo tablets every twelve hours. Lactate level, pH, base excess, blood glucose and serum creatinine were measured over five 12 h periods, with data averaged for each period. The primary outcome in this study was high lactate levels. Comparison between the 2 groups was made by independent Student’s t-test. To compare changes in multiple measures in each group and analysis of group interaction, a repeated measurement ANOVA test was used.There was no significant difference between the 2 groups regarding pH, base excess, or bicarbonate intake (P>0.05). No patient showed lactic acidosis in either group. Lactate levels were 23.0 vs 23.4 in the insulin-metformin and insulin only groups when the study was started, respectively. At the end of the study, those levels were 18.7 vs 18.9, respectively. In addition, the ANOVA repeated measurement test did not show a significant difference in terms of changes in the amount of lactate level between the 2 groups during the five measurement tests of the study period (P>0.05).High-dose metformin (1,000 mg twice daily with insulin) does not cause lactic acidosis in type 2 diabetic patients after coronary artery bypass surgery.