Notes

Adjustments to the human being foot print close to Indonesia's terrestrial nature between 2012 along with 2017.
Racial-ethnic disparities in diabetes technology use are well documented in young adults (YA) with type 1 diabetes (T1D), but modifiable targets for intervention still need to be identified. Our objective was to explore YA perspectives on technology access and support in routine clinical care.

Participants were YA with T1D of Hispanic or non-Hispanic Black race-ethnicity from pediatric and adult endocrinology clinics in the Bronx, NY. We conducted semi-structured individual interviews to explore how healthcare and personal experiences affected technology use. IPI-145 ic50 Interviews were audio-recorded and transcribed for analysis. We used a modified-inductive coding approach with two independent coders and iterative coding processes to improve data reliability and validity.

We interviewed 40 YA with T1D mean age 22 years; 62% female; 72% Medicaid-insured; 72% Hispanic; 28% non-Hispanic Black; mean HbA1c 10.3%. Themes were categorized into potentially exacerbating and alleviating factors of racial-ethnic disparitieshholding of information and prescription access to technology. Provider approaches that address YA technology concerns and promote shared decision-making help to mitigate racial/ethnic disparities in technology use.Aim To investigate the role of tissue dielectric constant (TDC) in the detection and assessment of breast cancer-related lymphedema (BCRL) and to determine whether the TDC could potentially be used as a complementary method for arm volume measurement. Methods Sixty-nine patients with BCRL were enrolled in this study. Local tissue water was assessed bilaterally by using the TDC method in four sites upper arm, forearm, hand, and lateral thorax. Arm circumferences were measured at the 4-cm interval, starting from the shoulder to the wrist by using a tape measure. The arm volume was calculated by a standard formula. Patients' demographic information and clinical characteristics were also recorded. Results Fifty-one of the 69 patients were diagnosed with clinical lymphedema. Using a TDC ratio of 1.2 or a diagnostic reference standard of ≥2 cm arm circumference, the sensitivity of these two methods was found to be identical at 73.9%. The TDC values in four sites on the affected side were significantly higher (p  less then  0.05) relative to the unaffected side. The inter-side TDC ratio of upper arm and forearm was substantially higher than that of lateral thorax and hand (p  less then  0.05). The TDC ratio of upper arm, forearm, and hand, especially of the upper arm and forearm, was positively correlated with inter-limb volume difference and stage of lymphedema. Conclusion The TDC method elucidated a meaningful clinical correlation to the arm volume measurement. Applying those two methods together showed promise in the detection and assessment of BCRL. The forearm and upper arm were reliable examination sites for TDC measurements in the clinic.Background High blood insulin levels, insulin resistance (IR), and obesity are components of metabolic syndrome (MetS). The literature has indicated a high risk of breast cancer in patients with MetS. However, no studies have been conducted evaluating the relationship between breast cancer-related lymphedema (BCRL), one of the most frequently encountered postbreast cancer treatment conditions, and IR. Therefore, the aim of this study was to evaluate whether there is a relationship between BCRL and IR. Methods and Results A total of 28 patients diagnosed with breast carcinoma were included in this preliminary study. Patients were divided into BCRL (n = 15; mean age 55.2 ± 11.2 years) and non-BCRL (control) groups (n = 13; mean age 55.17 ± 6.57 years). Body mass index (BMI), waist and hip circumference, and fasting blood glucose and blood insulin levels of all patients were recorded. The Homeostasis Model Assessment (HOMA) test was used for the calculation of IR measurement with a value of 2.5 taken as an indicator of IR. Parameters were compared between groups. BMI, waist circumference measurements, blood insulin, and HOMA-IR levels were statistically significantly higher in the BCRL group than the control group (p  0.05). Conclusions BCRL appears to be associated with waist circumference, fasting blood insulin level, and HOMA-IR levels. In routine clinical practice, evaluation of IR may be important in the follow-up of this patient population.Background Many methods can quantitatively assess limb lymphedema, but methods to assess breast edema/lymphedema are quite limited. Thus, there is a need for a convenient and accurate way to quantify and track changes in this condition. Herein, breast tissue dielectric constant (TDC) values that depend on tissue water were used to obtain reference TDC values and interbreast TDC ratios. Methods and Results TDC was measured in both breasts of 61 women who were about to undergo an ultrasound-guided diagnostic biopsy of a single mass (tumor) in 1 breast. Patient age and body mass index were (mean ± SD) 65.1 ± 11.6 (41-87 years) and 28.9 ± 5.1 (19.1-43.7 kg/m2). TDC was measured at a standardized site (12 o'clock position) with the TDC probe placed with its outer edge at the periphery of the subareolar region. TDC values of healthy breasts versus tumor breasts showed tumor breasts 3% greater (30.4 ± 4.6 vs. 29.5 ± 4.6, p = 0.02). Patients with benign tumors (N = 33) showed no difference between breasts (30.5 ± 4.4 vs. 30.8 ± 4.6 p = 0.434) and had an interbreast TDC ratio (tumor breast/healthy breast) of 1.013 ± 0.077. Patients with malignant tumors (N = 28) had tumor breast values 5% greater (29.8 ± 4.8 vs. 28.4 ± 4.6, p = 0.018) and an interbreast ratio of 1.056 ± 0.117. The overall interbreast ratio (N = 61) was 1.033 ± 0.099. Conclusion Breast TDC values from nonedematous breasts provide the basis for calculating potential edematous/lymphedematous threshold values based on the measured means +2.5 standard deviation (SD). Accordingly, a TDC threshold value of 41 and an interbreast ratio of 1.28 were determined. These parameters have potential applicability for early detection in at-risk patients and those suspected of having breast edema/lymphedema.
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