bluuebunny/crossref_metadata_2025_split huggingface dataset:
8178 Uncontrolled Diabetes Mellitus Presenting As Chronic Diarrhea
Authors: Nguyen Huong D 
Published: October 2024

Abstract
Disclosure: H.D. Nguyen: None.
Introduction: Majority of patients with newly diagnosed diabetes mellitus present with well-known symptoms and signs of hyperglycemia, including polydipsia, polyuria, visual disturbances, fatigue, weight loss. Fewer than one percent of patients present with chronic diarrhea (1). We hereby present a case of uncontrolled DM presenting as chronic diarrhea. Case: A 44-year-old male with history of post-ablative hypothyroidism, class I obesity, vitamin D deficiency reported 4 to 5 months history of increased stool frequency 4-5 times a day and intermittent watery, non-bloody, non-tarry diarrhea 2 times a week. No fever, chills, weight loss, or recent travel. Diarrhea had not improved with a 2-month trial of low FODMAP diet. On the physical exam, height 177cm, weight (wt) 97kg, BMI 30.56 in 11/2023 (wt 98 kg in 4/2023). Laboratory work-up showed wbc 7.4K (4.2-9.2), CRP 0.4 mg/dl, ESR 15mm/hr, TSH 0.943 mcIU/ml (.45-4.5), tTG IgA &lt;2U/ml, deamidated gliadin IgA 6 units (0-19), IgA 159 mcg/dl (90-386), fecal calprotectin 74 mcg/g (0-120), HIV negative, stool H pylori negative. BG 287 mg/dl, A1c 10.2% 11/29/23 (was 5.6% 2020). He was started on insulin glargine and aspart. At the 6-week follow-up, blood glucose improved to 70s to low 100s, and stool frequency improved to 2 times/day and diarrhea had resolved. Discussion: Chronic diarrhea, defined as having 3 or more stools a day for more than 4 weeks, can affect about 10% of patients with diabetes mellitus. Many of these patients have associated conditions such as celiac disease, food intolerance, chronic pancreatitis with pancreatic exocrine insufficiency, bacterial overgrowth, inflammatory bowel disease, bacterial or parasitic infections, or medication adverse side effects. Some studies have attributed diarrhea of unknown causes in patients with DM to autonomic dysfunction (2). Other studies have shown diarrhea may be due to increased colonic transit time and altered intestinal pH rather than autonomic dysfunction (3). Since the underlying cause of diabetic diarrhea is not always clear, empiric symptom treatment may be indicated. Transdermal clonidine may be helpful in controlling diarrhea without causing orthostatic hypotension. In this case, as the stool frequency and diarrhea improved without any other treatment after diabetes control improved, we believe the underlying cause was uncontrolled DM. Conclusion: Uncontrolled DM should be on the differential diagnosis for chronic diarrhea of unclear etiology. References: 1. Miller, LJ. Small intestinal manifestations of diabetes mellitus. The Yale Journal of Biology and Medicine.1983; 56:189-193,1983. 2. Ogbonnaya, KI et al. Diabetic diarrhea. Pathophysiology, diagnosis, and management. Arch Intern Med. 1990; 150:262-267. 3. Sangnes DA et al. Diabetic diarrhea: a study on gastrointestinal motility, pH levels and autonomic function. Journal of Internal Medicine. 2021; 290:1206-1218.
Presentation: 6/3/2024
6562 Understanding The Role Of The Novel Hexokinase HKDC1 In Alzheimer’s Disease
Authors: Farooq Zeenat , Jorgensen Julianne , Layden Brian T 
Published: October 2024

Abstract
Disclosure: Z. Farooq: None. B.T. Layden: None.
Alzheimer’s disease (AD) is a chronic neurodegenerative condition, clinically characterized by loss of neurons. AD is responsible for causing 70% of global cases of dementia and constitutes and huge health and socio-economic burden, with limited availability of therapeutic options. While loss of neuronal integrity in AD is known, studies thus far have focused only on the deposition of amyloid plaques, leaving a huge gap in our understanding of the role of metabolic regulation and inflammation associated with AD. Studies in the literature suggest a link between accumulation of amyloid beta plaques, altered insulin action, and perturbed hypothalamic glucoregulation in AD pathology leading to increased hepatic glucose production and hyperglycemia. However, the complex mechanisms underlying the deleterious impact of metabolic derangements and insulin resistance on AD pathogenesis are poorly characterized. HKDC1, the fifth hexokinase, is highly expressed in the normal brain, with decline in expression observed in aging and Alzheimer’s disease mice models, but its function remains entirely unexplored. However, it is known to be involved in gestational diabetes mellitus (GDM), type 2 diabetes (T2D), and fatty liver disease. In this study, we explored the role of brain specific HKDC1 in pathogenesis of AD with our brain specific HKDC1 knock out (KO) and other mice models. We have observed that loss of HKDC1 in the brain is accompanied by dysregulation of glucose metabolism, decline in memory and learning, and an increase in senescence and neuroinflammation in mice. Interestingly, we have also observed that HKDC1 is exclusively localized to mitochondria in the brain and its absence leads to a reduction in the expression of markers of mitochondrial biogenesis, while causing an increase in tau-phosphorylation and ER stress. Through RNA sequencing, we have also identified novel targets of HKDC1 in the brain related to metabolic networks, triggering the pathogenesis of AD downstream of HKDC1. These findings uncover a novel role for HKDC1 as a key metabolic gene involved in the pathogenesis of AD in a mitochondrial-dependent manner in mice. Further studies on dissecting the molecular mechanism of HKDC1 involvement in AD could define a novel strategy for timely intervention of Alzheimer’s disease and possibly other forms of dementia.
Presentation: 6/1/2024
12322 Unraveling The Complexity Of Stiff-Person Syndrome: A Case Of Ozempic-Induced Gastric Paralysis In A Patient With Comorbid Type 2 Diabetes Mellitus
Authors: Igburuke Loveth Eseoghene , Tawde Poonam , Oparaocha Victory , Horani Mohamad Hosam , Salim Yusuf , Salim Muhammad , Salim Omar 
Published: October 2024

Abstract
Disclosure: L.E. Igburuke: None. P. Tawde: None. V. Oparaocha: None. M.H. Horani: None. Y. Salim: None. M. Salim: None. O. Salim: None.
Stiff-Person Syndrome (SPS) is a rare neurological disorder characterized by persistent muscle stiffness and spasms, often triggered by emotional or physical stress. The condition, predominantly affecting adults with a slight female preponderance, is believed to result from autoimmune mechanisms targeting glutamic acid decarboxylase (GAD). Treatment usually involves symptomatic relief with medications like benzodiazepines, while immunomodulatory therapies are considered for refractory cases. Despite its low prevalence, SPS is noteworthy due to its association with autoimmune conditions. The clinical landscape of SPS is complicated by its link to gastrointestinal dysmotility, stemming from dysregulation in GABAergic pathways. Patients with SPS are predisposed to gastrointestinal issues, which can be exacerbated by certain medications, such as glucagon-like peptide-1 (GLP-1) receptor agonists like Ozempic (semaglutide). GLP-1 receptor agonists, although effective for managing type 2 diabetes, can rarely cause severe gastrointestinal complications, including gastric paralysis. This report details a case of a 55-year-old male with SPS and type 2 diabetes mellitus who developed gastric paralysis following Ozempic therapy. The patient presented with progressive muscle stiffness and spasms over six months, with a history of type 2 diabetes and hypertension. Despite treatment with diazepam and gabapentin, his symptoms persisted, leading to the addition of Ozempic. Shortly after starting Ozempic, he experienced severe gastrointestinal symptoms, including nausea, vomiting, and abdominal distension. Gastric paralysis was confirmed through gastric emptying studies and esophagogastroduodenoscopy. Despite stopping Ozempic and supportive care, the patient required prolonged hospitalization. Gradual improvement in gastric motility was observed, and the patient was eventually discharged with ongoing management of SPS and diabetes. This case highlights the diagnostic and therapeutic challenges in managing SPS, particularly with comorbidities like type 2 diabetes. While GLP-1 receptor agonists are beneficial for diabetes management, they can lead to severe gastrointestinal issues, especially in patients with underlying neurological conditions. Clinicians should carefully consider the risk of gastrointestinal complications when prescribing GLP-1 receptor agonists and monitor patients closely to optimize outcome.
Presentation: 6/1/2024
6992 Unveiling Factitious Hypoglycemia
Authors: Patel T A , Chlebek S , Porter T 
Published: October 2024

Abstract
Disclosure: T.A. Patel: None. S. Chlebek: None. T. Porter: None.
Background: Factitious disorder causing hypoglycemia is a condition in which a patient intentionally uses a glucose-lowering agent without any apparent external gains. This is a rare and challenging clinical diagnosis, which often results in the use of unnecessary medical resources. Clinical Case: A 31-year-old woman, with a history of Type 1 Diabetes and Hypothyroidism, was admitted to the Intensive Care Unit (ICU) for persistent severe hypoglycemia. The patient reported an increase in the frequency and severity of hypoglycemic episodes despite a progressive reduction in her total daily insulin use; most recently, with complete cessation of insulin use for 2 months. A review of outside medical records revealed multiple emergency room visits and hospitalizations due to hypoglycemia. Notably, the patient was an emergency department registered nurse (RN). On admission, the patient was placed on a dextrose infusion with as needed dextrose boluses. Despite these interventions, she continued to become intermittently hypoglycemic. Initial tests were consistent with exogenous insulin use: critically low serum glucose (31 mg/dL, normal 60-99 mg/dL), undetectable C-peptide (&lt;0.1 ng/mL, normal 1.1-4.4 ng/mL), and elevated insulin (32.3 uIU/mL, normal 2.6-24.9 uIU/mL). The patient denied recently self-administering insulin and she was not treated with insulin in the hospital prior to obtaining these labs. Additionally, there was a significant rise in the glucose level (58 mg/dL, positive &gt;30 mg/dL) after intramuscular administration of 1 mg glucagon, which confirmed insulin mediated hypoglycemia. The remainder of the biochemical work-up was unremarkable. GAD65 and IA-2 autoantibodies were positive, confirming the patient’s history of type 1 diabetes. It was recommended that the patient have a one-to-one sitter for continuous direct observation. The patient, thereafter, became hyperglycemic with no further episodes of hypoglycemia for the remainder of the hospitalization. Psychiatry was placed on consult and diagnosed the patient with factitious disorder. Conclusion: Factitious disorder is a rare but important condition to be included in the differential diagnosis of recurrent hypoglycemia. Biochemical findings will include a low serum glucose, undetectable C-peptide, and an inappropriately elevated insulin. Psychiatric evaluation can, thereafter, support the diagnosis and clinical management. Establishing the diagnosis of factitious hypoglycemia is critical for appropriately treating these patients, minimizing unnecessary testing, and avoiding multiple hospitalizations.
Presentation: 6/3/2024
Benchmarking supply chain collaboration dimensions with insights from resource-based theories
Authors: Myamba Benitha Mhoka , Shatta Deus , Massami Erick 
Published: October 2024

Goal: Despite the increased attention to the role of supply chain collaboration on firm performance, insufficient evidence exists about the relative importance of each dimension of supply chain collaboration on manufacturing competitiveness. The purpose of this study is to examine the influence and relative importance of supply chain collaboration dimensions on manufacturing competitiveness based on resource-based theories.
Design/methodology/approach: This study employs a deductive approach to derive empirical evidence from the responses of 300 officials of manufacturing firms. The PLS-SEM is used to test the significance of conceptual predictions and IPMA is used to benchmark the most important collaborative dimensions.
Results: It is revealed that manufacturing firms capitalize on all supply chain collaboration dimensions. However, customer collaboration and supplier collaboration have a significant and positive direct influence while internal collaboration exhibits a complementary partial mediation effect. Customer collaboration is the most important dimension followed by internal collaboration and supplier collaboration.
Limitations of the investigation: This study employed a cross-section design lacking the longitudinal effect. Nevertheless, the identification, testing and validation of the conceptual model, backed up by an extensive literature review, could assist researchers in developing meaningful comparative studies.
Originality/value: The study applied PLS-SEM and IPMA to reveal the role and relative importance of supply chain collaborative dimensions on manufacturing competitiveness. Managers of manufacturing firms can emulate this knowledge within their settings and be able to compete amid increased competition and supply chain complexity.
Acute impact of inorganic nitrate supplementation after ischemia and during small muscle mass exercise in postmenopausal females: A pilot study
Authors: Caldwell Jacob T. , Koenke Alyssa , Zimmerman Lauren , Wahl Aaron E. , Fenn Sarah A. , Grammer Emily E. , Stahl Macy E. , Allen Jason D. , Jaime Salvador J. 
Published: October 2024

AbstractMenopause is associated with reduced endothelial‐dependent vasodilation and increased cardiovascular disease (CVD) risk. Dietary nitrate, a non‐pharmacological approach, may increase vasodilatory capacity consequentially reducing CVD risk. We investigated macro‐ and microvascular function after acute nitrate supplementation in postmenopausal females (PMF). Vascular function was studied with flow‐mediated vasodilation (FMD) and near‐infrared post occlusive reactive hyperemia (PORH). Incremental handgrip exercise was performed to investigate blood flow and tissue oxygenation. We hypothesized acute dietary nitrate would not impact resting endothelial measures but would increase post ischemic vasodilation and incremental exercise blood flow. Late‐phase PMF (n = 12) participated in a randomized crossover design with 140 mL of nitrate‐rich (NR) beetroot juice or nitrate‐poor black currant juice. Testing included a 5‐min FMD, a 3‐min ischemic exercise FMD, and incremental exercise at 10%, 15%, and 20% maximal voluntary contraction to measure blood flow and pressure responses. A p ≤ 0.05 was considered significant. One‐way ANOVA indicated lower resting pressures, but no change to FMD, or PORH in either protocol. Two‐way repeated measures ANOVA indicated NR supplementation significantly reduced mean arterial pressure at rest and during incremental exercise at all intensities without changes to blood flow. Acute nitrate is effective for resting and exercising blood pressure management in PMF.
Gender and Family Stereotypes in a Photograph: Research Using the Eye-Tracking Method
Authors: Labischová Denisa , Kalitová Kristina 
Published: October 2024

Abstract
The article presents the results of a 2022 study involving students training to be civic studies teachers. Three research goals were set: to determine which gender and family stereotypes burden the interpretation of a photograph; to identify qualitative differences in the perception, analysis, and interpretation of the photograph depending on the form of the questions asked; and to gain respondents’ feedback on the test. The test used a computer and was based on a family photograph and a series of questions. Three methods of data collection and analysis were used (audio recording analysis, eye-tracking, interview). The study found that future teachers are substantially influenced by gender stereotypes in Czech society. It also confirmed the importance of didactic structuring when analysing iconographic material. The findings show the importance of gender-sensitive education and the development of didactic skills for interpreting visual texts as part of undergraduate training for future civic studies teachers.
Florida’s agricultural inspection stations: focus on intercepting invasive Hemiptera in interstate truck shipments
Authors: Nance Catherine E. , Powell Erin C. , Russell Dyrana , Halbert Susan E. 
Published: October 2024

Abstract
The interstate highways I-10, I-75, and I-95 are key routes for long-distance truckers carrying agricultural products between states and countries. These products often carry pests. Inspectors from the Florida Department of Agriculture and Consumer Services, Division of Plant Industry (FDACS-DPI) work with Agricultural Law Enforcement officers at agricultural inspection stations along these interstate highways. Samples of suspect pests are collected by DPI inspectors and sent for identification. From 2009 to 2021, there were 5,408 samples submitted to entomologists at DPI from inspection stations. These samples resulted in 14,835 interception identifications, of which 1,466 (9.9 %) were pests of regulatory significance to Florida agriculture. Of the regulatorily significant pests, 61.3 % were hemipterans. Several regulated hemipterans, including the potato psyllid, Bactericera cockerelli (Šulc) (Triozidae), are known to be vectors of plant pathogens that do not occur in Florida. Inspection station interceptions are an important tool for monitoring potentially invasive pests, as is demonstrated in the case of the Ligurian leafhopper, Eupteryx decemnotata (Rey) (Cicadellidae), which was intercepted alive at the agricultural inspection stations several times and subsequently found to be established in Florida in 2021. Interceptions at Florida’s agricultural inspection stations can include pests that are not yet present in the United States, such as the armored scale Davidsonaspis aguacatae (Evans, Watson & Miller) (Diaspididae). This species is regularly intercepted alive on avocados and threatens domestically grown avocados. Our data illustrate the importance of interstate highways as a pathway for agricultural pests and of inspection stations as an early warning system for invasive insects.
New measurement indicator of ultrasound assessment of the fetal pancreas based on anatomical landmarks and its application to fetuses with gestational diabetes mellitus
Authors: Liao Ruibi , Zhang Zejian , Zhang Yuxia , Lin Yuanfeng , Chen Rongsen , Wang Lijun , Zhong Huohu , Lyu Guorong 
Published: October 2024

Abstract

Objectives
To assess the best method for measuring the fetal pancreas, provide nomograms and evaluate the effect of GDM on it.

Methods
A total of 271 singleton fetuses (17–36 weeks) were included in this study. Measurements of pancreatic parameters established reference ranges. Repeatability and consistency analyzed. GDM impact on fetal pancreatic growth assessed.

Results
Measurements of fetal pancreatic parameters fell within the 95 % confidence interval when performed by the same or different physicians. Pancreatic midline longitudinal axis demonstrated the best intraclass correlation coefficients (ICC) and follow by the pancreatic circumference. The successful display rate and measured parameters of the integral fetal pancreas achieved 90.3 %. Pancreatic midline longitudinal axis and circumference increased with gestational age, with significant differences observed among fetuses at different gestational ages (F=2060 and F=2264, p<0.05). Pancreatic midline longitudinal axis and circumference in normal fetuses from 17 to 36 weeks of gestation were positively correlated with gestational age and abdominal circumference. Poorly controlled GDM fetuses exhibited significantly larger pancreatic midline longitudinal axis and circumference compared to the normal group fetuses (Z-values were −3.82 and −3.77, both p<0.01), while no significant differences were found between well-controlled GDM group fetuses and normal group fetuses (Z-values were −0.59 and −0.042, both p>0.05).

Conclusions
Ultrasound method using anatomical landmarks to measure the fetal pancreatic midline longitudinal axis and circumference is reliable. Pancreatic measurements increase with gestational age. Poorly controlled gestational diabetes can lead to enlargement of the fetal pancreas.
The stability of high ring homomorphisms and derivations on fuzzy Banach algebras
Authors: Chen Lin , Luo Xiaolin 
Published: October 2024

Abstract
In this article, we focus on exploring the fuzzy version of the Hyers-Ulam-Rassias stability of

n

n

-ring homomorphisms and

n

n

-ring derivations in the context of fuzzy Banach algebras. Our investigation utilizes the direct method.
MODIFIED FEM ALGORITHM WITH INTRODUCED ELASTIC BLOCKS FOR GEOMECHANICAL MODELING OF UNDERMINED ROCK MASS
Authors: ЖУРАВКОВ М.А. , НИКОЛАЙЧИК М.А. , КЛИМКОВИЧ Н.М. 
Published: October 2024

Рассмотрена задача численного моделирования геомеханического состояния породного массива при отработке пласта полезного ископаемого одиночным широким очистным забоем. Разработаны численные расчетные схемы, моделирующие геомеханическое состояние породной толщи от дневной поверхности до глубины ведения горных работ. Модельные задачи решены в двухмерной и трехмерной постановках. Полученные характеристики мульды оседаний дневной поверхности сравнивались с соответствующими характеристиками, рассчитанными с использованием инженерной методики. Результаты моделирования верифицировались данными натурных наблюдений за оседаниями реперов. Сравнительный анализ характеристик мульды оседания дневной поверхности, полученных в соответствии с построенной геомеханической моделью и согласно инженерной методике, показал корреляцию соответствующих значений для каждого из рассмотренных вариантов.
The authors attempt the numerical modeling of the geomechanical behavior of a rock mass in the course of single unit face longwall mining. The calculation models are constructed for the rock mass geomechanics from ground surface down to mining depth. The model problems are solved in two and in three dimensions. The resultant characteristics of a trough subsidence on ground surface were compared with the data of engineering analysis. The modeling results are verified using actual in-situ observations of check point subsidence. The comparative analysis of the trough subsidence characteristics on ground surface from the geomechanical modeling and engineering analysis show their correlation in case of all test alternatives.