Echocardiographic evaluation of diastolic dysfunction in type 2 diabetes mellitus with normal systolic function and correlation with duration of diabetes mellitus and HbA1C

Background: The incidence of heart failure in diabetic subjects is high even in absence of hypertension and coronary artery disease. Studies have reported a high prevalence of preclinical diastolic dysfunction among subjects with diabetes mellitus. The aim of this study was to assess relationship of diastolic dysfunction with duration of diabetes mellitus and HbA1c level.Methods: This cross-sectional observational study was conducted in 200 consenting patients with diabetes mellitus without history of hypertension and established coronary artery disease with normal systolic function from the period of February 2013 to October 2014. All diabetic patients were studied for HbA1c level, time period since 1st diabetes was diagnosed, and echocardiography was performed and, diastolic function parameters were measured.Results: In this study, out of 32 subjects with HbA1c 7.1-8.0%, 25 (78.12%); out of 80 subjects with HbA1c 8.1-10.0%, 69 (86.25%); and out of 24 subjects with HbA1c >10%, 24 (100.0%) had diastolic dysfunction. Out of 88 subjects with duration of diabetic mellitus 0-5 years, 34 patients (38.63%); out of 64 subjects with duration of diabetic mellitus of 6-10 years, 53 patients (82.81%); out of 42 subjects with duration of diabetic mellitus 11-15 years, 38 patients (90.47%); and out of 6 subjects with duration of diabetic mellitus >15 years, 6 patients (100.0%) had diastolic dysfunction.Conclusions: Diastolic dysfunction is significantly associated with duration of disease and glycemic control assessed by HbA1c

Bridging the Distance: The Agencement of Complex Affordances on Social Media Platforms

This research focuses on the actualization of technological affordances in complex technological environments, such as social media, where in addition to human and material agents, algorithmic agents also proliferate. Unlike material agents, algorithmic agents can act in the absence of proximal instigation by human agents, and can influence the actions of other agents distanced in space and time. By borrowing from actor-network theory, this paper foregrounds the role of algorithmic agents in the actualization of complex affordances by advertisers on a social media platform. It is illustrated that a complex affordance is actualized through an agencement, that is, a collective enactment of heterogeneous agencies. Through such an enactment, human agents are able to act at a distance too. This research highlights that in addition to material features of the user-interface, the underlying algorithms of a complex technology also partake in the actualization of affordances