Background/AimsWe evaluated whether serum bilirubin levels can predict the development of chronic kidney disease (CKD) in patients with type 2 diabetes mellitus (T2DM).MethodsThis was a retrospective observational longitudinal study of patients presenting at the Pusan National University Hospital. A total of 349 patients with T2DM and preserved kidney function (estimated glomerular filtration rate ≥ 60 mL/min/1.73 m2) were enrolled. The main outcome was the development of CKD stage 3 or greater. The patients were divided into four groups according to the quartiles of the total serum bilirubin levels at baseline.ResultsThe group with the lowest range of total serum bilirubin level (Q1) showed the highest cumulative incidence of CKD stage 3 or greater than that of the other lower quartiles (Q1 vs. Q4; hazard ratio [HR], 6.75; 95% confidence interval [CI], 1.54 to 29.47; p = 0.011). In multivariate analysis, the risk of developing CKD stage 3 or greater was higher in the second lowest quartile of the serum bilirubin level than that in the highest quartile of the serum bilirubin level (Q2 vs. Q4; HR, 9.36; 95% CI, 1.33 to 65.73; p = 0.024). In the normoalbuminuria subgroup (n = 236), multivariate analysis showed that the risk of developing CKD stage 3 or greater was higher in the lowest quartile of the serum bilirubin level than that in the highest quartile of the serum bilirubin level (Q1 vs. Q4; HR, 7.36; 95% CI, 1.24 to 35.82; p = 0.019).ConclusionsSerum bilirubin might be an early clinical marker for predicting the progression of CKD in patients with T2DM and preserved renal function.
Educational learning methods that take advantage of a robot provide opportunities for students to develop high dimensional thinking, a creative expression and discovery learning opportunity. It is also perceived as a suitable tool for STEAM systems which can be used in a variety of school curriculums. Therefore we designed and developed STEAM educational contents using robots in this study. This study analyze elementary text books and design the convergence contents from various subjects such as math, science, engineering and art through a robot. This study has developed educational materials by making a robot based on the designed contents. They have been applied to after school materials and then evaluated for comprehension, interest and participation. The results of this study have shown very encouraging evaluations from participating students. Accordingly, this study has shown that STEAM contents that take advantage of a robot have improved student participation, interests, and comprehension in the curriculums. Additionally, integrating STEAM educational content has proved more effective in contrast to being separated
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