bluuebunny/crossref_metadata_2025_split huggingface dataset:
SAT-117 Refractory Paraneoplastic Non Islet Cell Tumor Hypoglycemia (NICTH) from Hepatocellular Carcinoma Managed with Somatostatin Analogue and Glucocorticoids
Authors: Siddiqui Mahwash Fatima , Vora Amy , Ali Sadia , Mirfakhraee Sasan 
Published: May 2020

Abstract
Non islet cell tumor hypoglycemia (NICTH) is a rare paraneoplastic syndrome generally seen in tumors of mesenchymal and hepatic origin. This syndrome is characterized by life threatening hypoglycemia caused by over expression of high molecular weight insulin-like growth factor 2 (IGF 2). The main stay of treatment is surgical resection of the tumor with no clear medical management being reported as standard of care.
We present the case of a 72 year old Cambodian man with no history of diabetes mellitus who presented to our institution with severe hypoglycemia complicated by a seizure and was found to have hepatocellular carcinoma (HCC). Hypoglycemia occurred during times of fasting. Laboratory evaluation revealed a serum glucose of 30mg/dl with insulin level of 2.2 mcIU/mL [2.6 - 24.9 mcIU/ml], C-Peptide of 0.17 ng/mL [0.80 - 3.85 ng/ml], BHB &lt;0.1 mmol/L [0.0 - 0.3 mmol/L] and Proinsulin of &lt;0.4 pmol/L [&lt; or = 18.8 pmol/L]. Hypoglycemic agents screening was negative. Insulin Antibody was negative &lt;0.4 U/mL [&lt;0.4 U/mL] and adrenal insufficiency and hypothyroidism was ruled out. Patient was found to have an elevated IGF 2: IGF 1 ratio of 78 confirming the diagnosis of NICTH. IGF 2 level was 780 ng/ml [333 - 967 ng/ml] while IGF-1 was &lt; 10 ng/ml [32-200 ng/ml] He was not a candidate for surgery due to portal vein involvement and tumor radioembolization was unsuccessful. Despite Prednisone dose of 10 mg twice daily and frequent complex carbohydrate meals, he still continued to have hypoglycemia ultimately requiring hospitalization. During hospitalization, he was treated with 50% dextrose infusion, 37.5 grams of dextrose gel every three hours and frequent small meals. Hypoglycemia remained refractory and a trial of diazoxide was ineffective. He was then started on octreotide with titration to 100mg every 8 hours with significant reduction in hypoglycemic episodes. He continues to remain on octreotide, Prednisolone 20mg twice a day, dextrose gel and dextrose infusion. Goal is to wean dextrose infusion and transition him to Pasireotide 40mg monthly.
Hepatocellular carcinoma has been associated with NICTH in the literature. NICTH is characterized by an IGF2:IGF1 ratio &gt;10 as there is no commercially available assay for big IGF II. Definitive treatment involves surgical resection or tumor debulking. Octreotide has antiangiogenic and antineoplastic properties and unfortunately, few studies have shown improved survival and quality of life in patients with advanced HCC. In the case of our patient, tumor was unresectable and NICTH improved with octreotide and prednisolone.
SUN-566 Metabolic Effects of Cross-Hormone Treatments in Transgender Individuals in Taiwan
Authors: Lin Liang-Yu , Liu Yu-Hsien , Wu Tsung-Hui , Lin Yi-Chun 
Published: May 2020

Abstract
Objective:
Many biological differences seen in men and women are driven by relative different level of estrogen and testosterone. Transgender individuals may need gender-affirming intervention like inhibiting of endogenous sex hormones or replenishing cross-hormone to induce physical change to stimulate their expressed or experienced gender. However, recent study has concluded that the incidences of acute cardiovascular events are higher in transwomen receiving transgender hormone therapy (1). Transgender therapy for adults with Testosterone in female to male (FtM); with Estrogen and anti-androgen in male to female (MtF) are frequently prescribed in Taiwan. The aim of this study is to investigate metabolic effects of an altered sex hormone profile on different gender.
Methods:
The study is a retrospective study conducted in a tertiary medical center in Northern Taiwan analyzing biological differences over time for 65 FtM and 45 MtF patients in our endocrine out-patient department. The results from the exams are analyzed separately using paired t-test compared to baseline visit. The transgender individuals are examined at four time points; before the cross-hormone therapy, three, six, and twelve months following sex hormone treatment.
Results:
The primary outcome was that FtM patients showed significant increases in BMI (22.6±0.3 v.s. 23.3±0.4 kg/m2; P&lt;0.001; t=6M), low density lipoprotein cholesterol (124±3 vs.131±3 mg/dL; P=0.03; t=12M), creatinine (0.75±0.01 vs.0.83±0.14 mg/dL; P&lt;0.001; t=12M), and hemoglobin (13.5±0.7 v.s. 15.2±0.19 g/dL; P&lt;0.001; t=12M) compared to the baseline; decreases of high density lipoprotein cholesterol (57±2.1 v.s. 51±2.0 mg/dL; &lt;0.001; t=12M) was also revealed. Patients in MtF group disclosed declines in low density lipoprotein cholesterol (104±3 v.s. 100±3 mg/dL; P=0.05; t=3M), hemoglobin (14.0±0.1 v.s. 13.5±0.1 g/dL; P=0.008; t=12M), uric acid (5.3±0.2 v.s. 4.7±0.2mg/dL; P=0.03; t=12M) and creatinine (0.82±0.01 v.s. 0.79±0.14 mg/dL; P&lt;0.001; t=6M) compared to baseline data. In addition, most of these metabolic effects persisted the follow-up period.
Conclusion:
This observational study revealed the role of cross-hormone treatment in increasing relative cardiovascular risk in FtM transgender individuals.
Reference:
1. Nota, N. M., et al. (2019). “Occurrence of Acute Cardiovascular Events in Transgender Individuals Receiving Hormone Therapy: Results From a Large Cohort Study.” Circulation 139(11): 1461-1462.
Nothing to Disclose: LYL, YHL, THW, YCL
SUN-604 U.S. Prevalence & Mortality of Prader-Willi Syndrome: A Population-Based Study of Medical Claims
Authors: McCandless Shawn E , Suh Marissa , Yin David , Yeh Michael , Czado Shawn , Aghsaei Sina , Li Justin W , Francis Kevin , Hadker Nandini , Stafford Diane E J 
Published: May 2020

Abstract
Prader-Willi syndrome (PWS) is a complex developmental genetic disorder associated with hypotonia, poor feeding in neonates, onset of hyperphagia in early childhood, and shorter overall life expectancy. Prior epidemiology studies of PWS have examined smaller populations, with limited research in a US population. The aim of this study was to provide a contemporary estimate of PWS prevalence and annual all-cause mortality in the US using a large administrative medical claims dataset.
Methods: PWS patients were identified between 2012-2014 via the presence of ≥2 claims with a diagnosis code for PWS on medical claims provided by IQVIA™ Health Plan Claims Data and CMS Medicare fee-for-service claims. Patients were grouped into age bands including: 0-2, 3-8, 9-17, 18-26, 27-49, and ≥50. PWS prevalence and mortality rates were calculated for 2014, then 2018 US census data was used to project rates for the total US population. The presence of select diagnoses and procedures suggestive of a life-threatening event (e.g., mechanical ventilation) with a patient’s prompt disenrollment defined as death in the IQVIA data; vital status is indicated in Medicare data.
Results: Overall US diagnosed PWS prevalence was 2.7 per 100k persons (or 1 per 37,037), a prevalence of 8,870 patients in the US in 2018. Diagnosed PWS prevalence 3.9, 5.2, 4.5, 4.2, 2.5, and 1.1 per 100k persons respectively for age bands 0-2, 3-8, 9-17, 18-26, 27-49, and ≥50. The median age of PWS patients was 21 years. The mortality rate was highest among diagnosed PWS patients aged 0-2 years and lowest among those aged 9-17 years and the overall mortality rate was 2.7%. For all respective age bands 0-2, 3-8, 9-17, 18-26, 27-49, and ≥50, the all-cause mortality rate was 5.4%, 3.0%, 1.4%, 2.1%, 2.4%, and 4.5%. The observed median age of death was 23 years (IQR 6-36)
Conclusions: The diagnosed PWS prevalence of 1 per 37,037 persons estimated for the 2018 US population is comparable to the other reported US prevalence estimate. As the current study describes diagnosed patients, it likely represents a lower bound of true PWS prevalence. Annual PWS mortality is ≥3 times higher than the overall US population (2.7% vs 0.8%). This rate appears unchanged from mortality estimates reported for PWS populations in the last several decades despite significant advances in genetic testing and the availability of growth hormone therapies in the US. Aggressive management of serious comorbid conditions, especially in younger PWS patients, should be a clinical priority.
Frailty Is Associated With Postoperative Delirium But Not With Postoperative Cognitive Decline in Older Noncardiac Surgery Patients
Authors: Mahanna-Gabrielli Elizabeth , Zhang Kathy , Sieber Frederick E. , Lin Hung Mo , Liu Xiaoyu , Sewell Margaret , Deiner Stacie G. , Boockvar Kenneth S. 
Published: May 2020

BACKGROUND:
Postoperative cognitive dysfunction (POCD) and delirium are the most common perioperative cognitive complications in older adults undergoing surgery. A recent study of cardiac surgery patients suggests that physical frailty is a risk factor for both complications. We sought to examine the relationship between preoperative frailty and postoperative delirium and preoperative frailty and POCD after major noncardiac surgery.

METHODS:
We performed a prospective cohort study of patients >65 years old having major elective noncardiac surgery with general anesthesia. Exclusion criteria were preexisting dementia, inability to consent, cardiac, intracranial, or emergency surgery. Preoperative frailty was determined using the FRAIL scale, a simple questionnaire that categorizes patients as robust, prefrail, or frail. Delirium was assessed with the Confusion Assessment Method for the intensive care unit (CAM-ICU) twice daily, starting in the recovery room until hospital discharge. All patients were assessed with neuropsychological tests (California Verbal Learning Test II, Trail Making Test, subtests from the Wechsler Adult Intelligence Scale, Logical Memory Story A, Immediate and Delayed Recall, Animal and Vegetable verbal fluency, Boston Naming Test, and the Mini-Mental Status Examination) before surgery and at 3 months afterward.

RESULTS:
A total of 178 patients met inclusion criteria; 167 underwent major surgery and 150 were available for follow-up 3 months after surgery. The median age was 70 years old. Thirty-one patients (18.6%) tested as frail, and 72 (43.1%) prefrail before surgery. After adjustment for baseline cognitive score, age, education, surgery duration, American Society of Anesthesiologists (ASA) physical status, type of surgery, and sex, patients who tested frail or prefrail had an estimated 2.7 times the odds of delirium (97.5% confidence interval, 1.0–7.3) when compared to patients who were robust. There was no significant difference between the proportion of POCD between patients who tested as frail, prefrail, or robust.

CONCLUSIONS:
After adjustment for baseline cognition, testing as frail or prefrail with the FRAIL scale is associated with increased odds of postoperative delirium, but not POCD after noncardiac surgery.
Functional Outcomes of Frail Patients After Cardiac Surgery: An Observational Study
Authors: Nakano Mitsunori , Nomura Yohei , Suffredini Giancarlo , Bush Brian , Tian Jing , Yamaguchi Atsushi , Walston Jeremy , Hasan Rani , Mandal Kaushik , Schena Stefano , Hogue Charles W. , Brown Charles H. 
Published: May 2020

BACKGROUND:
Although frailty has been associated with major morbidity/mortality and increased length of stay after cardiac surgery, few studies have examined functional outcomes. We hypothesized that frailty would be independently associated with decreased functional status, increased discharge to a nonhome location, and longer duration of hospitalization after cardiac surgery, and that delirium would modify these associations.

METHODS:
This was an observational study nested in 2 trials, each of which was conducted by the same research team with identical measurement of exposures and outcomes. The Fried frailty scale was measured at baseline. The primary outcome (defined before data collection) was functional decline, defined as ≥2-point decline from baseline in Instrumental Activities of Daily Living (IADL) score at 1 month after surgery. Secondary outcomes were absolute decline in IADL score, discharge to a new nonhome location, and duration of hospitalization. Associations were analyzed using linear, logistic, and Poisson regression models with adjustments for variables considered before analysis (age, gender, race, and logistic European Score for Cardiac Operative Risk Evaluation [EuroSCORE]) and in a propensity score analysis.

RESULTS:
Data were available from 133 patients (83 from first trial and 50 from the second trial). The prevalence of frailty was 33% (44 of 133). In adjusted models, frail patients had increased odds of functional decline (primary outcome; odds ratio [OR], 2.41 [95% confidence interval {CI}, 1.03–5.63]; P = .04) and greater decline at 1 month in the secondary outcome of absolute IADL score (−1.48 [95% CI, −2.77 to −0.30]; P = .019), compared to nonfrail patients. Delirium significantly modified the association of frailty and change in absolute IADL score at 1 month. In adjusted hypothesis-generating models using secondary outcomes, frail patients had increased discharge to a new nonhome location (OR, 3.25 [95% CI, 1.37–7.69]; P = .007) and increased duration of hospitalization (1.35 days [95% CI, 1.19–1.52]; P < .0001) compared to nonfrail patients. The increased duration of hospitalization, but no change in functional status or discharge location, was partially mediated by increased complications in frail patients.

CONCLUSIONS:
Frailty may identify patients at risk of functional decline at 1 month after cardiac surgery. Perioperative strategies to optimize frail cardiac surgery patients are needed.
Between Publics and Privates
Authors: Solana Vivian 
Published: May 2020

AbstractThis article discusses the hypervisibility of the Sahrawi munaḍila (female militant) within dominant representations of a Sahrawi revolutionary nationalism. Drawing connections between nation-state building processes, the production of space, and gendered subjectivities, it destabilizes assumptions of institutions as devoid of political movement and shows how the spaces of the National Organization of Sahrawi Women allow women to inhabit the position of loyal critic toward their movement's dominant model of female empowerment. These positions reveal transformations to the way in which space is inhabited intragenerationally, and they reflect the regeneration of a Sahrawi female militancy under the conditions of a protracted struggle for decolonization.
The Price of Blood
Authors: Junaid Mohamad 
Published: May 2020

Abstract
The discourse of loyalty produces tense predicaments for those living under counterinsurgency regimes. The essay explores this theme by analyzing the case of a Kashmiri woman who found herself in a political drama when she accepted “blood money” from the person accused of causing her husband's death. The woman's decision accompanied moral turmoil in her village, and rumors of her “betrayal” circulated. However, the turmoil threatened to go beyond this localized setting. It brought to fore the fraught implications of “loyalty” shaped by India's occupation in Kashmir, its nationalist staging of Kashmiris as the subversive other, and schisms within Kashmir's historical independence movement. By tracing how rumors of individual betrayal were laced onto narratives of political treason in the case, the essay reveals the counterinsurgency as the operative context of broken intimate and intercommunity relations in which the personal is always at the threshold of becoming intensely public.
An Islam of One's Own
Authors: Zaman Taymiya R. 
Published: May 2020

AbstractThis review article examines Shahab Ahmed's What Is Islam? The Importance of Being Islamic in light of the book's challenge to the notion that the sharia consists of Islam's orthodox core, and Muslim literary, artistic, and philosophical truths constitute a periphery. Written from a historian's perspective, it draws out the ways in which Ahmed is able to illuminate aspects of the past that might be unfamiliar to modern Muslim readers. It also shows how Ahmed's argument risks flattening Muslim pasts by failing to disengage with the dynamism of historical forces and with how historical texts are embedded in relations of gender and power.
Self-Sexual de jovens adultos brasileiros
Authors: Azevedo e Souza Leo Schuch de , Boeckel Mariana Gonçalves 
Published: May 2020

Self-sexual é um constructo auto percebido multifacetado, que inclui eficácia sexual, autoestima sexual-corporal, sensação de direito a receber prazer de si e do(a) parceiro(a), e autorreflexão-sexual. O presente estudo investigou o self-sexual de jovens adultos brasileiros, avaliando a correlação entre self-sexual e as escalas de satisfação com a vida e de autoestima geral, assim como o impacto da religiosidade no self-sexual. 1380 participantes, de 18 a 30 anos, completaram uma pesquisa online que incluiu o Inventário de Self-sexual. O delineamento foi quantitativo, descritivo e transversal. Todas subescalas do iss obtiveram correlação positiva com as escalas de satisfação com a vida e de autoestima geral. Algumas subescalas apresentaram correlação negativa com religiosidade, embora a subescala de auto-estima sexual tenha obtido correlação positiva. As mulheres obtiveram escores significativamente maiores nas subescalas de sensação de direito a receber prazer de si e do(a) outro(a). As mulheres bissexuais se destacaram com maiores resultados em comparação a homens e mulheres heterossexuais, apesar de apresentarem menores níveis de autoestima. Pesquisas futuras com variáveis e amostras mais diversas podem contribuir para a continuidade da compreensão desse constructo.
Networks and evidence-based advocacy: influencing a policy subsystem
Authors: Nichols Naomi , Malenfant Jayne , Schwan Kaitlin 
Published: May 2020

Background: Timely access to relevant and trustworthy research findings is an important facilitator of research use. But the relational aspects of evidence generation, mobilisation and use have been insufficiently explored.
Aims and objectives: Our aim is to describe the strategic communicative and relational work of two intermediary organisations playing thought leadership roles within a large, heterogeneous and loosely configured network comprised of individuals and organisations from the following sectors: academia, frontline service delivery, philanthropic funding, advocacy organisations and government.
Methods: The data for this project were generated as part of a study of the ways social science research influences policy, practice and systems-change processes. Proceeding from the standpoints of people who generate and/or engage with research in an effort to address homelessness in Canada, this article focuses on the intersections of research, strategic communication and policy making.
Findings: Our findings suggest that strategic communication and knowledge exchange play integral roles in efforts to create evidence-based policy change. These communicative activities take the form of public-facing political and/or media engagement strategies, traditional knowledge mobilisation activities and continuous informal and timely exchanges of information between trusted allies.
Discussion and conclusions: Our study reveals the importance of a heterogeneous network structure, with formal and informal alliances between individuals and organisations, as well as key intermediary organisations through which knowledge can be strategically mobilised within the network to serve policy change aims. Furthermore, our study suggests that interest in evidence-led governance is shifting the boundaries between research, advocacy and government action.
Effects of Various Forms of Unstable Load on Muscle Electromyography in the Stabilizing Musculature and Rating of Perceived Exertion in the Bench Press
Authors: Costello Kyle 
Published: May 2020

Abstract
Costello, K. Effects of various forms of unstable load on muscle electromyography in the stabilizing musculature and rating of perceived exertion in the bench press. J Strength Cond Res 36(4): 881–887, 2022—The purpose of the study was to determine whether unstable load training and the Swiss bar in the bench press can cause greater rating of perceived exertion (RPE) values and greater muscle activation in the stabilizing musculature and the same or greater in the primary movers with a decreased load. Division III college athletes (N = 24) performed 4 bench press interventions: stable bench press standard bar (SBp; 75% 1 repetition maximum), stable bench press Swiss bar (SwB; 65%), unstable bench press standard bar (UBp; 60%), and unstable bench press Bandbell bar (Bb; 60%). One-way repeated-measures analysis of variance was used to compare the average muscle activity values of pectoralis major (PM), triceps brachii (TB), anterior deltoid (AD), and biceps brachii (BB) and RPE values of each intervention. In the PM, mean muscle activity values were significantly (ps < 0.01) greater in the stable SwB and unstable Bb bar than the SBp. In the TB, mean muscle activity values were significantly (p < 0.001) greater in the stable SwB intervention than the SBp and UBp. Mean muscle activity values were significantly (p = 0.032) greater in the unstable Bb bar than the SBp intervention. In the AD, mean muscle activity values were significantly (p < 0.001) greater in the SBp than the stable SwB and significantly (p < 0.001) greater in the UBp and unstable Bb bar than the stable SwB. In the BB, mean muscle activity values were significantly (p < 0.001) greater in the UBp and unstable Bb than the SBp and significantly (p < 0.001) greater in the UBp and unstable Bb bar than the standard SwB. Mean muscle activity values were significantly (p < 0.001) greater in the unstable Bb bar than the UBp. The unstable Bb bar was perceived the most difficult when compared with other bars (ps < 0.01). The unstable interventions were viable options to replace the standard bench press as a method of upper-body resistance training.
Short-Term Blood Flow Restriction Increases Power Output and Bar Velocity During the Bench Press
Authors: Wilk Michal , Krzysztofik Michal , Filip Aleksandra , Zajac Adam , Bogdanis Gregory C. , Lockie Robert G. 
Published: May 2020

Abstract
Wilk, M, Krzysztofik, M, Filip, A, Zajac, A, Bogdanis, GC, and Lockie, RG. Short-term blood flow restriction increases power output and bar velocity during the bench press. J Strength Cond Res 36(8): 2082–2088, 2022—This study examined the effect of blood flow restriction (BFR) with 2 different types of cuffs on peak power output (PP), mean power output (MP), peak bar velocity (PV), and mean bar velocity (MV) in the bench press exercise (BP). Fourteen healthy strength-trained male athletes (age = 27.6 ± 3.5 years; body mass = 84.1 ± 8.0 kg; height = 175.8 ± 6.7 cm; BP 1 repetition maximum [RM] = 138.6 ± 17.8 kg) performed 3 different testing protocols as follows: without BFR (NO-BFR), BFR with a narrow cuff (BFRNARROW), and BFR with a wide cuff (BFRWIDE) in a randomized crossover design. During all sessions, subjects performed one set of 3 repetitions of the BP exercise using 70% 1RM. Cuff pressure was set to approximately 90% full arterial occlusion pressure of the upper limb at rest. Analyses of variance showed an increase in PP (by 21%, p < 0.01; effect size [ES] = 1.67), MP (by 16%, p < 0.01; ES = 0.93), PV (by 22%, p < 0.01; ES = 1.79), and MV (by 21%, p < 0.01; ES = 1.36) during BFRWIDE compared with NO-BFR and a significant increase in PP (by 15%, p < 0.01; ES = 1.07), MP (by 17%, p < 0.01; ES = 0.78), PV (by 18%, p < 0.01; ES = 1.65), and MV (by 13% p < 0.01; ES = 1.00) during BFRWIDE compared with BFRNARROW. There were no significant differences in any of the variable between NO-BFR and BFRNARROW. The results of the study indicate that short-term BFR training increases power output and bar velocity during the BP exercise. However, only BFRWIDE significantly influenced bar velocity and power output, which indicates that the width of the cuff is a critical factor determining acute exercise adaptation during BFR resistance training.