bluuebunny/crossref_metadata_2025_split huggingface dataset:
SUN-663 Dietary Coconut Oil Mitigates Features of Metabolic Syndrome in Obese Females
Authors: Skenandore Cassandra , Ali Anisah , Gil Lesly , Schwartz Rani , Goblet Camille , Kothmann Kadden , Browning Luke , Newell-Fugate Anne Elizabeth 
Published: May 2020

Abstract
Forty percent of American women are obese and at risk for metabolic syndrome. Coconut oil alters circulating lipid levels and improves glucose homeostasis in lean individuals, yet, whether it can exert these same beneficial effects on cardiometabolic health in obese individuals is unknown. We hypothesized that female pigs fed a high fat diet with 5% coconut oil would have improvements in features of metabolic syndrome (i.e., dyslipidemia) compared to female mini-pigs fed a high fat diet with 5% lard. We fed female pigs 2200 kcal of a control (n=6), 5000 kcal of a lard high fat (WSD; n=5), or 5000 kcal of a coconut oil high fat (COC; n=6) diet for a total of 9 estrous cycles (~ 7.5 months). Fasting blood was collected at the 1st, 7th (C 7), and 9th (C 9) estrous cycle. After C 7, an intravenous glucose tolerance test (IVGTT) was performed. Weights and morphometric measurements were taken weekly. Tissue was collected for histology at C 9. WSD females (15.14 ± 1.85 mg/dL) had a greater increase in fasting glucose as compared to COC (3.51 ± 4.31 mg/dL) and C females (0.45 ± 3.32 mg/dL; p&lt;0.05). COC females tended to be more glucose tolerant (p=0.07) and had lower serum insulin concentrations in response to a glucose bolus (p&lt;0.001) than WSD females. COC (82.6 ± 1.1 kg) and WSD females (85.4 ± 1.0 kg) weighed more (C: 61.9 ± 1.1 kg; p&lt;0.0001) and had larger abdominal circumferences (COC: 122.4 ± 0.8 cm; WSD: 117.4 ± 1.0 cm) than control females (102.6 ± 1.0 cm; p&lt;0.0001). WSD females were the most dyslipidemic, with the greatest increase in triglycerides (C: 0.33 ± 1.5 mg/dL; COC: 7.71 ± 3.0 mg/dL; WSD: 17.25 ± 3.0 mg/dL; p=0.03) and HDL:cholesterol (C: 3.44 ± 0.22; COC: 5.00 ± 0.36; WSD: 6.00 ± 0.42; p=0.05) as compared control and COC females. COC females had increased plasma docosahexaenoic acid (C: -0.128 ± 0.291; COC: 0.262 ± 0.260; WSD: -0.732 ± 0.274; p&lt;0.01) and decreased arachidonic acid (C: 2.418 ± 0.744; COC: -4.561 ± 0.666; WSD: -2.068 ± 0.702; p&lt;0.01). COC females (131.26 ± 10.0 μm) had a decreased average omental adipocyte diameter as compared to WSD females (160.06 ± 10.31 μm; p=0.05). COC females (7.3 ± 0.80 %) had less hepatic lipid accumulation as measured by oil red o stain than WSD females (9.2 ± 1.1 %; p=0.05). These data demonstrate that small amounts of dietary coconut oil, even as a part of a high fat diet, can mitigate features of metabolic syndrome and decrease hepatic and visceral adipose tissue lipid accumulation in obese females.
SAT-684 A Deadly Triad: Coexistence of Acute Pancreatitis, Hypertryglyceridemia and Diabetic Ketoacidosis
Authors: Torres Torres Marina T , Padilla Rodriguez Kimberly C , Vergne-Santiago Norma , Garcia Michelle Marie Mangual 
Published: May 2020

Abstract
The coexistence of diabetic ketoacidosis (DKA), hypertriglyceridemia and acute pancreatitis (AP) represent a complex phenomenon described as the enigmatic triad. The exact initial culprit and pathophysiologic mechanism of this chain of events are still unclear posing a challenge in management. DKA may lead to glucose and lipid metabolism dysregulation which can result in hypertriglyceridemia leading to AP. On the other hand, hypertriglyceridemia may induce AP which may decompensate diabetes and lead to DKA. In both scenarios, this triad results in an uncommon clinical presentation with up to 80% mortality rate. Most frequently reported in children, this entity accounts for only a handful of cases reported in the literature.
Case of an obese, non alcoholic 57 year old male without history of systemic illness who visits the emergency room due to mid-upper abdominal pain for the past day. Pain radiates to the back, worsens upon laying flat, and is associated with bloating and nausea. He denies previous similar episodes, vomiting, fever or bowel habit changes. Laboratory workup revealed lipidemic sample with hyperglycemia, metabolic acidosis, positive serum ketones, and normal amylase and lipase. Lipid panel revealed hypertriglyceridemia at 6,260 mg/dL (35-150). Glycated hemoglobin at 14.7%. Abdominal computed tomography showed peripancreatic inflammation consistent with pancreatitis. Given clinical and imaging criteria the diagnosis of severe hypertriglyceridemia induced AP and DKA were made. The patient was admitted to ICU and treated with intravenous insulin drip and supportive management. Resolution of DKA and successful decrease in triglycerides to less than 500 mg/dL was achieved by the third day of admission. After six days, the patient was discharged home with insulin and lipid lowering regimens.
This case demonstrates an extremely rare initial presentation of diabetes mellitus. This triad is the result of a toxic chain of events that may be lethal if not promptly identified. This case makes an exemplary lesson as to always take under consideration atypical etiologies to potentially life threatening conditions and also remarks that while uncommon, pancreatitis with normal pancreatic enzymes is a possible phenomenon. Even though false negative amylase has been associated with hypertriglyceridemia induced AP, only a few cases with negative lipase have been described. While no definite explanation has been yet discovered, negative lipase may be explained by early acinar cell apoptosis in AP. More research efforts are necessary in order to improve early diagnosis, treatment, and mortality rate for this rare but potentially deadly triad and to better understand the mechanisms underlying AP and the role that digestive enzymes play.
SUN-184 Pseudohypoaldosteronism Presenting with Salt Wasting Crisis
Authors: Babar Ghufran S 
Published: May 2020

Abstract
Pseudohypoaldosteronism (PHA) is due to end organ resistance to mineralocorticoids. It is usually inherited in an autosomal recessive or autosomal dominant pattern, and rarely can a result of the mutation de novo. Zennaro MC, Hubert EL, Fernandes-Rosa FL. Aldosterone resistance: structural and functional considerations and new perspectives. Mol Cell Endocrinol. 2012;350:206-15.10.1016/j.mce.2011.04.023[Crossref], [PubMed], [Web of Science ®] It can be sub-classified into two forms PHA type 1 A involving the kidneys or PHA-1 B which effects multiple organs. PHA type 2 (Gordon syndrome) presents with hyperkalemia and hypertension. Case: Our patient is a 5 week old male who admitted for significant electrolyte abnormalities. He was followed by PCP for failure to thrive. The child was referred to ED with increased difficulty in feeding, lethargy and episodes of emesis. In the ED, the child was in a compensated shock and had a low normal BP: 76/35, HR: 169/min and fast breathing R/R: 80/minute and afebrile. P.E: showed signs of dehydration. Lab work showed: Na: 110 mEq/L, K: 9.3 mEq/L, low Chloride and Ca: 11.1 mEq/L. Endocrinology recommended IVF supplementation with 2 x NS bolus followed by IVF’s at 1.5 times maintenance (D5 + NS), along with administration of Florinef 0.2 mg suspecting CAH. Renin, 17-OHP, random cortisol level and thyroid hormone levels were ordered. Results showed: TSH of 5.30 mcIU/mL and Free T4 of 2.2 ng/dL. Cortisol: 20.5 mcg/dL. He was subsequently admitted to PICU. Septic work-up was negative. He became hemodynamically stable after hydration and did not require the stress dose of hydrocortisone. Repeat Na: 133 mEq/L, K: 4.7 mEq/L, Cl: 102 mEq/L and Glucose: 90 mg/dL. ACTH stimulation test for CAH evaluation was performed, stimulated 17OHP: 88 ng/dl, cortisol: 27.1 mcg/d and normal DOC. Elevated Aldosterone: 632 ng/dl (5-80) and renin level: 351 (6.5-86). A diagnosis of PHA was made and florinef was stopped and the child was started on NaCl supplementation which normalized the electrolytes. Genetic testing was negative for NR3C2, CUL3, KLHL3, SCNN1A, SCNN1B, SCNN1G, WNK4 and showed that the patient is a heterozygous for a variant of unknown significance, c.6276T&gt;A (p.Ser2092Arg) in the WNK1 gene. However, the patient did not have hypertension and urine electrolytes were also normal did not show signs of PHA 2. Conclusion: PHA can present with severe salt wasting crisis. It can be diagnosed clinically. The relationship of mutation and phenotype can be elusive. Course was uncomplicated and he was discharged from the PICU in 6 days. Sodium doses were titrated based on serum levels with eventual dose of 22.5mEq/kg/day and sodium level was 139 mEq/L.
MON-516 Quantitative Analysis of Differential Enigma/PDLIM7 Gene Expression in Thyroid Cancer vs. Benign Nodules
Authors: Roberts Kari , Choi Sang Hee K , Frank Ethan , Foulad David , Mirshahidi Saeid , Perez Mia C , Simental Alfred A , Khan Salma 
Published: May 2020

Abstract
Thyroid cancer incidence is rising worldwide. Although fine-needle aspiration biopsy (FNAB) is an accurate modality for evaluating thyroid nodules, up to 25% of FNABs still yield indeterminate results. There is a considerable number of diagnostic thyroidectomies for benign disease as a result of indeterminate FNAB. A more accurate and time-efficient diagnostic approach for analyzing indeterminate thyroid nodules may reduce diagnostic thyroidectomy. Recently, the osteogenic protein, Enigma, has been associated with different cancer types, including thyroid cancer progression and calcification through its interaction with bone morphogenic protein-1 (BMP-1), and tyrosine kinases linked to mitogenic signaling pathways [1, 2]. Our published data on Enigma protein analysis with immunohistochemistry showed promising results in discriminating between malignant versus benign thyroid nodules and demonstrated a correlation with thyroid cancer staging [3]. In this study, we are investigating Enigma at a gene expression level by real-time (RT-qPCR), which is a quantitative and more time-efficient method that requires smaller samples (FNA) than immunohistochemistry. We analyzed Enigma mRNA expression levels to determine if Enigma-qPCR could be used as a diagnostic tool to improve the accuracy of FNAB in both malignant and benign thyroid tissues. We extracted mRNA/DNA/proteins from fresh malignant and benign thyroid nodules using a QIAGEN DNA/RNA/Protein Kit. We ran isolated pure mRNA through Enigma-qPCR. The results showed that the Enigma-mRNA expression was 3-fold higher in malignant as compared to benign thyroid tissues. This finding supports our previous Enigma immunohistochemistry data and shows a relative quantitative difference in Enigma-mRNA expression level between malignant and benign thyroid nodules. We conclude that Enigma-RT-qPCR can be used to effectively determine malignancies in FNAB samples derived from thyroid nodules. This method could potentially enhance the diagnostic accuracy of indeterminate nodules and decrease diagnostic thyroidectomies and associated morbidity.
[1] C.R. Jung, J.H. Lim, Y. Choi, D.G. Kim, K.J. Kang, S.M. Noh, D.S. Im, Enigma negatively regulates p53 through MDM2 and promotes tumor cell survival in mice, The Journal of clinical investigation 120(12) (2010) 4493-506.
[2] Y.J. Kim, H.J. Hwang, J.G. Kang, C.S. Kim, S.H. Ihm, M.G. Choi, S.J. Lee, Enigma Plays Roles in Survival of Thyroid Carcinoma Cells through PI3K/AKT Signaling and Survivin, Anticancer research 38(6) (2018) 3515-3525.
[3] A.A. Firek, M.C. Perez, A. Gonda, L. Lei, I. Munir, A.A. Simental, F.E. Carr, B.J. Becerra, M. De Leon, S. Khan, Pathologic significance of a novel oncoprotein in thyroid cancer progression, Head & neck 39(12) (2017) 2459-2469.
SUN-089 Novel Genetic and Biochemical Findings of DLK1 Deficiency in Children with Central Precocious Puberty - a Collaborative Brazilian-Spanish Study
Authors: Montenegro Luciana Ribeiro , Labarta José , Piovesan Maiara , Canton Ana Pinheiro Machado , Collado Raquel Corripio , Soriano-Guillén Leandro , Barrios Vicente , Seraphim Carlos Eduardo , Brito Vinicius Nahime , Latronico Ana Claudia , Argente Jesus 
Published: May 2020

Abstract
Background: Delta-like 1 homolog (DLK1), also known as pre-adipocyte factor 1 (Pref-1), is part of the Notch signaling pathway that controls many developmental processes. Loss-of-function mutations of DLK1 have been identified in children with central precocious puberty (CPP), as well as in women who had precocious menarche (≤ 9 years) with an unfavorable metabolic profile. Objective: To investigate genetic and biochemical aspects of DLK1 in a cohort of children with CPP. Patients: A large cohort of Spanish children with idiopathic CPP (Spanish PUBERE Registry) was studied. Genomic DNA was obtained from 444 individuals, including 168 index cases with CPP and their close relatives. Automatic sequencing of the coding region (5 exons) of DLK1 was performed in all index cases. Serum DLK1 levels were measured by using a soluble DLK1 enzyme-linked immunosorbent assay (ELISA). Results: A rare allelic deletion (c.401_404 + 8del) of a splice site junction of DLK1 was identified in a girl with sporadic CPP. Pubertal signs appeared at 5.7 years of age with progressive puberty (basal LH: 1.7 mIU/mL, peak LH: 32.77 mIU/mL; basal FSH: 6.32 mIU/mL, peak FSH: 19.89 mIU/mL), BA/CA 1.7 years; normal cranial MRI). She received LHRH analogues (6.3 - 10.1 years of CA) with no side effects. At 14.9 years of age height and BMI are 152.9 cms and 18 kg/m2, respectively, presenting regular menses. Familial segregation analysis showed that the affected child was the only carrier of this deletion characterizing a de novo mutation (biological paternity and maternity were confirmed by microsatellite analysis). Serum DLK1 levels were undetectable (&lt;0.4 ng/mL) in this girl, supporting that the deletion lead to complete lack of DLK1 production. Her father, mother and sister had normal serum DLK1 levels (ranged 6.36 ng/mL to 8.98 ng/mL). Two rare consecutive nucleotide changes in the promoter region of the DLK1 gene (c.-222 C&gt;A and c.-223 G&gt;A) were also identified in an adopted child with CPP. They are located in a transcription factor binding site for SP1 (a zinc finger transcription factor). Pubertal signs appeared at 6.7 years of age with progressive puberty (Basal LH: 0.5 mIU/mL, peak LH: 15.9 mIU/mL, basal FSH: 1.52 mIU/mL, peak FSH: 6.56 mIU/mL, BA/CA 1.4 years; normal cranial MRI). She is under therapy with LHRH analogues with no side effects. Conclusion: Novel DLK1 findings were identified in the Spanish cohort of children with CPP, reinforcing a significant role of this factor in human pubertal timing.
MON-703 Injection Technique over Insulin Dose - Nuances in Diabetes Therapy
Authors: Mehrotra Neha , Kotok Daniel , DeJesus Carla J , Korytkowski Mary T , Mon Sann Yu 
Published: May 2020

Abstract
Introduction
Optimal insulin injection technique is crucial for therapeutic success in patients with diabetes who require insulin therapy for glycemic control. One of the causes for failure to reach glycemic goals can be attributed to improper injection technique. Problems related to poor injection technique may arise at a later stage and hence, may lead to a major barrier to intended glycemic control. We present a patient with worsening glycemic control and significant insulin requirement due to ineffective injection technique. Our case highlights the importance of direct observation of the patient injecting insulin, even for those who have been on insulin therapy for years.
Case Presentation
A 55-year-old woman with T2DM and Class III obesity was referred for endocrine consultation with HbA1c &gt;12% for 9 months despite adhering to 4.7 unit/kg/day basal bolus daily Insulin, Metformin 1000 mg twice daily and liraglutide 1.8 mg daily. Secondary causes of insulin resistance were ruled out. Initial review of injection technique on an insulin-injection pad failed to identify the error. However, a leakage was observed when patient was asked to demonstrate injection technique on herself, using the BD AutoShield Duo needle, which she was using at that time. Patient was advised to switch to BD nano needles and given proper training. Following this adjustment, her HbA1c improved to 6.9% within 3 months with a decrease in daily insulin requirement to 1 unit/kg/day.
Discussion
In optimizing glycemic control, proper insulin injection technique is as essential as the appropriate type and dose of insulin; however, this is often overlooked. Studies assessing proper insulin injection technique by direct observation are limited. Problems experienced by patients are rarely brought up and often neglected during the follow-up visits. Supervision of injection technique periodically can help identify injection errors.
The BD AutoShield Duo offers the distinct advantages of concealing the needle which benefits those who have an aversion to needles and reduces the risks of accidental needlesticks. The force required to deliver a successful injection of insulin using this needle is greater in comparison to traditional needles. Such force and lack of direct visualization may potentially lead to failure of insulin delivery. Such challenges may be more obvious in patients with obesity.
Our case highlights the importance of periodic review of insulin injection technique, particularly when glycemic control is suboptimal, and emphasizes the correct choice of insulin pen needle.
References
1.King, Laila. “Subcutaneous insulin injection technique.” Nursing Standard, vol. 17, no. 34, 2003, p. 45+. Academic OneFile, https://link.galegroup.com/apps/doc/A130629162/AONE?u=googlescholar&sid=AONE&xid=5f28fd49. Accessed 18 Nov. 2018.
MON-589 Studying Mechanisms of Satiety in the Human Ileum and Colon
Authors: Ramgulam Anya , Tashkova Martina , O’Driscoll Maeve , Becker Georgia Franco , Stephens Hannah , Blanco Jesus Miguens , Holmes Elaine , Marchesi Julian R , Blunt Dominic , Perez Isabel Garcia , Frost Gary , Murphy Kevin Graeme 
Published: May 2020

Abstract
Background The gut-brain axis plays important roles in the regulation of appetite and glucose homeostasis. The presence of nutrients and their digestive products in specific regions of the gastrointestinal tract modulates neuronal and hormonal signalling, including the release of the appetite-suppressing gut hormones glucagon-like peptide-1 (GLP-1) and peptide YY (PYY). While there has been significant research into the upper gut mechanisms behind satiation, i.e. the termination of meal, the role of the ileum and colon in satiety, i.e. the process which delays a subsequent meal, has been relatively little investigated, particularly in humans. Methods Ten healthy volunteers attended our Clinical Research Facility for two visits of four days each. At each visit they had either a nasoileal or a nasocolonic tube inserted under fluoroscopy. They were then provided a diet rich in protein and fibre to promote satiety. Gut contents and blood samples were taken before and during test meals at the start and end of the visit, and visual analogue scales were used to measure subjective feelings of appetite. Metabonomic analysis of gut fluid was carried out using a combination of in-house NMR and LC-MS-based methods. 16S rRNA gene sequencing was used to investigate effects on the colonic microbiome. Circulating levels of glucose, the gut hormones GLP-1 and PYY, and the pancreatic hormones insulin and glucagon were measured. Results and discussion The test meals resulted in sustained suppression of appetite and release of GLP-1 and PYY. Ileal and colonic microbial profiles were distinct from those identified in stool samples, and changed with adaptation to the high protein and fibre diet. Integrating hormonal, metabonomic and bacterial datasets from these human studies gives insight into how nutrient and metabolite sensing in the gastrointestinal tract regulates appetite and glucose homeostasis, and may suggest novel therapeutic targets for metabolic disease.
SAT-732 Historical Occurrence of Intersex in Largemouth Bass (Micropterus Salmoides) and Smallmouth Bass (Micropterus Dolomieu)
Authors: Norris David O , Geiger Angela , Vajda Alan Milan 
Published: May 2020

Abstract
The widespread occurrence of gonadal intersex (presence of testicular oocytes) has been recently reported in populations of Largemouth Bass (Micropterus salmoides) and Smallmouth Bass Micropterus dolomieu) from populations across North America. To evaluate the historical occurrence of intersex in bass species, gonads were examined visually and histologically from Largemouth Bass and Smallmouth Bass from museum specimens collected from 16 States. These fishes were collected between 1823-1965, before the widespread discharge of estrogenic chemicals to surface waters via wastewater effluents. All females examined had normal ovaries. Intersex gonads were identified in 17.8 % of male Largemouth Bass, and in 14.2% of male Smallmouth Bass. The intensity of testicular oocytes in some males was as great as observed since 2000. These results indicate that the occurrence of this form of intersex in these bass species is not a recent phenomenon.
SUN-587 IDH1-Dependent Alpha-KG Regulates Brown Fat Differentiation and Function by Modulating Histone Methylation
Authors: Kim Won Kon , Han Baek-Soo 
Published: May 2020

Abstract
Brown adipocytes play important roles in the regulation of energy homeostasis by uncoupling protein 1-mediated non-shivering thermogenesis. Recent studies suggest that brown adipocytes as novel therapeutic targets for combating obesity and associated diseases, such as type II diabetes. However, the molecular mechanisms underlying brown adipocyte differentiation and function are not fully understood. We employed previous findings obtained through proteomic studies performed to assess proteins displaying altered levels during brown adipocyte differentiation. Here, we performed assays to determine the functional significance of their altered levels during brown adipogenesis and development. We identified isocitrate dehydrogenase 1 (IDH1) as upregulated during brown adipocyte differentiation, with subsequent investigations revealing that ectopic expression of IDH1 inhibited brown adipogenesis, whereas suppression of IDH1 levels promoted differentiation of brown adipocytes. Additionally, Idh1 overexpression resulted in increased levels of intracellular α-ketoglutarate (α-KG) and inhibited the expression of genes involved in brown adipogenesis. Exogenous treatment with α-KG reduced brown adipogenesis during the early phase of differentiation, and ChIP analysis revealed that IDH1-mediated α-KG reduced trimethylation of histone H3 lysine 4 in the promoters of genes associated with brown adipogenesis. Furthermore, administration of α-KG decreased adipogenic gene expression by modulating histone methylation in brown adipose tissues of mice. These results suggested that the IDH1–α-KG axis plays an important role in regulating brown adipocyte differentiation and might represent a therapeutic target for treating metabolic diseases.