bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Impact of Demographics and Comorbidities on Fall Incidence and Prevalence in Older Adults
Authors: Namoos Asmaa M , Thomson Nicholas , Bradley Sarah , Aboutanos Michel 
Published: July 2024

Abstract

Introduction: Falls among older adults are more than mere accidents; they are a silent epidemic, profoundly impacting the health and well-being of millions of older adults worldwide. This study examines the incidence and prevalence of falls among individuals aged 65 and above, focusing on the influence of demographic factors and comorbid conditions such as hypertension, diabetes mellitus, cancer, and obesity.
Methods: A retrospective cohort study was conducted using data from the TriNetX network at Virginia Commonwealth University Health System (VCUHS) from 2019 to 2023. The study population included 16,400 individuals aged 65 and above who presented with fall-related trauma. Data on demographics, clinical diagnoses, procedures, and comorbid conditions were analyzed using descriptive statistics to evaluate the incidence and prevalence of falls.
Results: The mean age of the study population was 77.3 years, with a higher proportion of females (60.97%) compared to males (39.02%). Despite the larger number of female participants, incidence and prevalence of falls were highest among individuals aged 65-69 years, and fall rates were notably higher among males compared to females. This suggests that while fewer in number, males in our study experienced falls more frequently. Patients with hypertension had the highest incidence proportion (56.67%) and prevalence (75.75%) among comorbid conditions.
Conclusions: Falls among older adults are significantly influenced by demographic factors and comorbid conditions. Hypertension, in particular, is associated with the highest fall risk. These findings highlight the need for targeted interventions to manage comorbidities and reduce fall risks among older adult patients.
Impact of Masculine Identity on Racing Engagement Among Young Motorcyclists in Penang, Malaysia
Authors: Hussin Zalmizy , Ahmad Siti Rohana 
Published: July 2024

Background
Illegal motorcycle racing has become increasingly prevalent among young individuals as a means of seeking excitement and self-expression. This research aimed to explore the prevalence of self-perceived illegal motorcycle racers and the impact of masculine identity on their participation in racing activities.

Methods
This cross-sectional study was conducted from November 2020 to January 2021. Participants completed self-administered questionnaires, including the Conformity to Masculine Norms Inventory-22 (CMNI-22), to measure masculine identity levels. Multiple logistic regression was used to determine the association between masculine identity and participation in illegal racing.

Results
A total of 400 individuals with a mean age of 18.5 years (SD ± 13.4) participated in the study. The average duration of engagement in street racing was 1.3 years (SD ± 1.13). Among the participants, 57.5% identified themselves as active racers, while the remaining 42.5% either observed the races or took part in convoys exclusively. The mean score for masculine identity was 31, with scores ranging from 21 to 45.2. The results showed that participants with high levels of masculine identity were four times more likely to engage in racing (95% confidence interval (CI) 3.57, 6.12; P = 0.001) compared to those with low levels of masculine identity.

Conclusion
Promoting positive masculinity through education, engagement in safe activities, and highlighting role models with qualities like kindness and responsibility may help foster healthy behaviours and well-being among youth.
Algorithmic Spaced Retrieval Enhances Long-Term Memory in Alzheimer Disease: Case-Control Pilot Study
Authors: Smith Amy M , Marin Anna , DeCaro Renee E , Feinn Richard , Wack Audrey , Hughes Gregory I , Rivard Nathaniel , Umashankar Akshay , Turk Katherine W , Budson Andrew E 
Published: July 2024

Background
Spaced retrieval is a learning technique that involves engaging in repeated memory testing after increasingly lengthy intervals of time. Spaced retrieval has been shown to improve long-term memory in Alzheimer disease (AD), but it has historically been difficult to implement in the everyday lives of individuals with AD.

Objective
This research aims to determine, in people with mild cognitive impairment (MCI) due to AD, the efficacy and feasibility of a mobile app that combines spaced retrieval with a machine learning algorithm to enhance memory retention. Specifically, the app prompts users to answer questions during brief daily sessions, and a machine learning algorithm tracks each user’s rate of forgetting to determine the optimal spacing schedule to prevent anticipated forgetting.

Methods
In this pilot study, 61 participants (young adults: n=21, 34%; healthy older adults: n=20, 33%; people with MCI due to AD: n=20, 33%) used the app for 4 weeks to learn new facts and relearn forgotten name-face associations. Participation during the 4-week period was characterized by using the app once per day to answer 15 questions about the facts and names. After the 4-week learning phase, participants completed 2 recognition memory tests approximately 1 week apart, which tested memory for information they had studied using the app as well as information they had not studied.

Results
After using the mobile app for 1 month, every person with MCI due to AD demonstrated improvements in memory for new facts that they had studied via the app compared to baseline (P<.001). All but one person with MCI due to AD (19/20, 95%) showed improvements of more than 10 percentage points, comparable to the improvements shown by young adults and healthy older adults. Memory for name-face associations was similarly improved for all participant groups after using the app but to a lesser degree. Furthermore, for both new facts and name-face associations, we found no memory decay for any participant group after they took a break of approximately 1 week from using the app at the end of the study. Regarding usability, of the 20 people with MCI due to AD, 16 (80%) self-adhered to the app’s automated practice schedule, and half of them (n=10, 50%) expressed an interest in continuing to use it.

Conclusions
These results demonstrate early evidence that spaced retrieval mobile apps are both feasible for people with early-stage AD to use in their everyday lives and effective for supporting memory retention of recently learned facts and name-face associations.
1004-P: Remote Initiation of Continuous Glucose Monitoring in Older Adults Using Insulin
Authors: MAHONEY CATHERINE , SLYNE CHRISTINE , MUNSHI MEDHA , CONERY COLIN D. , BRABANT HALEY , KRAKOFF NOA , BULGER JANE D. , WEINSTOCK RUTH S. , TOSCHI ELENA 
Published: July 2024

Background & Objective: Initiation of continuous glucose monitoring (CGM) remotely in adults with diabetes (DM) has been shown beneficial. However, this model has not been evaluated in older adults. The objective of this study was to assess the benefit and challenges encountered by older patients on multiple daily insulin injections (MDI) initiating CGM using a virtual platform.
Methods: Older adults with DM who are participating in an ongoing study on initiation CGM remotely between January-December 2023 were interviewed. Interviews were transcribed, de-identified, coded, and qualitatively analyzed. Baseline demographic characteristics were collected.
Results: Interim analysis of 24 interviews was conducted: age 72 ± 4 years, duration of diabetes 30 ± 15 years, 52% female, 76% white, 52% having type 1 diabetes (T1DM), 72% CGM naïve, HbA1C 8.1 ± 1.6, 92% on MDI, and 84% utilizing Medicare as primary insurance. Overarching themes were the use of remote education, initiation of CGM remotely, and ongoing use of CGM. All 100% surveyed participants favorably rated the remote education and its ease of scheduling as well as the overall value of CGM. All participants were able to initiate and maintained CGM use successfully with remote education assistance, with 95% of participants planning to continue to use CGM after study completion. The challenges reported with the CGM use included difficulty with mobile application (33%), annoyance with alarms (50%), and concerns for Medicare coverage (42%).
Conclusions: The results of this qualitative analysis show that in our cohort, remote initiation of CGM in older adults was perceived positively, despite some challenges.

Disclosure
C. Mahoney: None. C. Slyne: None. M. Munshi: Consultant; Sanofi. C.D. Conery: None. H. Brabant: None. N. Krakoff: None. J.D. Bulger: None. R.S. Weinstock: Research Support; Eli Lilly and Company, Tandem Diabetes Care, Inc., Diasome, Amgen Inc., MannKind Corporation, Insulet Corporation, Novo Nordisk. Other Relationship; Dexcom, Inc. E. Toschi: Consultant; Vertex Pharmaceuticals Incorporated, Sanofi.

Funding
The Leona M. and Harry B. Helmsley Charitable Trust
1020-P: Evolution over Time of the Discrepancy between HbA1c and Glucose Management Indicator—Findings from a Franco-Belgian Cohort of 347 Patients
Authors: RIVELINE JEAN-PIERRE , PREVOST GAETAN , ANDRIEU ANAIS , JOUBERT MICHAEL , ORIOT PHILIPPE , PENFORNIS ALFRED , PHILIPS JEAN-CHRISTOPHE , JULLA JEAN-BAPTISTE , COSSON EMMANUEL 
Published: July 2024

A discrepancy between laboratory-measured HbA1c and Glucose Management Indicator (GMI), estimated from continuous glucose monitoring, is frequently encountered in clinical practice. However, its evolution over time is not yet known.
Methodology: We conducted a multicenter retrospective study (9 centers) that collected pairs of HbA1c and GMI (calculated over 90 days) at T0, T1 year, T2 years of follow-up in patients with diabetes, all users of FreeStyleLibre®. The primary study endpoint was the analysis of the mean HbA1c-GMI differences at the 3 time points. Glucose data, clinical parameters, and complications were also analyzed. Patients were classified based on the HbA1c-GMI discrepancy: positive (PosD, HbA1c-GMI&gt;+0.3%), neutral (NullD, HbA1c-GMI from -0.3 to +0.3%), negative (NegD, HbA1c-GMI&lt; -0.3%) at each time point, and with the average differences over the 3 time points. Group comparisons were assessed using ANOVA.
Result: We included 347 patients (82% type 1 diabetes), mean age of 51±17 years, diabetes duration 20±13 years, HbA1c 7.6±1.0%, 90±9% CGM data collected, Time in Range 70-180 mg/dl (TIR) 57±17%, GMI 7.4±0.8%. The mean HbA1c-GMI differed over time (T0: 0.27%, T1 year: 0.16%, T2 years: 0.04%, P&lt;0.0001). Considering the mean HbA1c-GMI differences over the 3 time points for all patients, PosD individuals were statistically older, had higher BMI and HbA1c compared to NegD patients. At T0, the patients were distributed as follows: 168 PosD (48.4%), 129 NullD (37.2%), 50 NegD (14.4%). The 121 patients (only 34.8% of the cohort) who stayed in the same group at the three time-points were 44.6% PosD, 38% NullD and 17.4% NegD.
Conclusion: In only 1/3 of patients does the difference between HbA1c and GMI appear to be stable over time. This should be taken into account when analyzing the supposed poor prognosis associated with PosD.

Disclosure
J. Riveline: Board Member; Abbott, Novo Nordisk A/S, Sanofi, Eli Lilly and Company, Medtronic, Dexcom, Inc., Insulet Corporation, Air Liquide, AstraZeneca. G. Prevost: Board Member; Abbott. A. Andrieu: None. M. Joubert: Consultant; Abbott, Medtronic, Dexcom, Inc. P. Oriot: Research Support; Abbott. A. Penfornis: Speaker's Bureau; Sanofi, Dexcom, Inc., Diabeloop SA. Board Member; AstraZeneca. Speaker's Bureau; Novo Nordisk, Lilly Diabetes. Board Member; Novo Nordisk, Bayer Inc. Advisory Panel; Abbott, Sanofi. J. Philips: Consultant; Sanofi, Novo Nordisk, Abbott, Avazzia, Boehringer-Ingelheim, Eli Lilly and Company. J. Julla: Speaker's Bureau; Lilly Diabetes, Novo Nordisk. Board Member; Sanofi. E. Cosson: Advisory Panel; Abbott, AstraZeneca, Lilly Diabetes, Novo Nordisk, Sanofi, Roche Diagnostics, Novartis AG, Amgen Inc.

Funding
Abbott Diabetes Care
104-OR: State-Dependent Activity in Hindbrain Glucagon-Like Peptide 1—Producing Neurons Regulates Consummatory and Valence Behavior through Functionally Interconnected Hypothalamic and Limbic Circuits
Authors: DURAN MIGUEL , VIRKUS SONJA , MCMICHEN KYLIE A. , ANDRADE CAVALCANTE MORAES YASLLE , YADAV ESHITA , SINGH JAGJOT K. , FOKAKIS ZOE , STOCKING SAMANTHA Q. , POOLE SAMUEL O. , HUNTER CHAD S. , HABEGGER KIRK M. , HARDAWAY JAMES A. 
Published: July 2024

Introduction: Glucagon-like peptide 1 (GLP-1) therapeutics have experienced a meteoric rise in adoption, but our understanding of the endogenous systems that produce GLP-1 and how they regulate behavior remain incomplete. Preproglucagon neurons in the nucleus of the solitary tract (GcgNTS neurons) are the primary source of GLP-1 in the brain. In this study, we examined the neurophysiological and causal contributions of GcgNTS neurons to consummatory and valence behavior.
Methods: electrophysiology, in vivo optogenetics, fiber photometry.
Results: Using electrophysiology, we observed that GcgNTS neuron neural firing and excitability is reduced in response to 24-hour food deprivation that varied by sex. Conversely, GcgNTS neurons significantly increase their firing rate after a brief 1-hour chow refeed after food deprivation. Consistent with this, GcgNTS neurons display elevated Fos levels following binge-like consumption of palatable high-fat diet. Using in vivo optogenetics, we observed that optogenetic activation of GcgNTS neurons produced anxiety and negative valence that varied by sex. High-frequency activation of GcgNTS neurons also reduced feeding and appetitive behavior. Interestingly, high-frequency activation of GcgNTS neurons produced lasting effects that persisted after cessation of laser illumination. Using a novel transgenic mouse, Gcg-IRES-FlpO, crossed to Glp1r-Cre mice combined with viral and transgenic reporters, we found that GcgNTS neurons and Glp1r neurons in the hypothalamus and amygdala make reciprocal connections. Currently, we are measuring functional connections between GcgNTS neurons and Glp1r neurons in the paraventricular nucleus of the hypothalamus and amygdala.
Conclusions: GcgNTS neurons control valence and consumption, interacting with an interconnected GLP-1R-expressing network in the hypothalamus and amygdala.

Disclosure
M. Duran: None. S. Virkus: None. K.A. McMichen: None. Y. Andrade Cavalcante Moraes: None. E. Yadav: None. J.K. Singh: None. Z. Fokakis: None. S.Q. Stocking: None. S.O. Poole: None. C.S. Hunter: None. K.M. Habegger: Research Support; Eli Lilly and Company. Consultant; Glyscend Inc. Stock/Shareholder; Glyscend Inc. Consultant; Merck & Co., Inc. Research Support; Novo Nordisk. Advisory Panel; Abvance Therapeutics. J.A. Hardaway: None.

Funding
K01DK115902R03DK129561P30DK079626P30DK056336
1304-P: MODY Calculator Overestimates MODY Probability in Multiethnic Cohort with Youth-Onset Type 2 Diabetes Phenotype
Authors: KREIENKAMP RAYMOND J. , SHIELDS BEVERLEY , POLLIN TONI I. , TOSUR MUSTAFA , SHAH AMY S. , LIESE ANGELA D. , PIHOKER CATHERINE , SRINIVASAN SHYLAJA , HATTERSLEY ANDREW T. , UDLER MIRIAM , REDONDO MARIA J. 
Published: July 2024

Introduction & Objective: Identifying monogenic diabetes (MODY) remains a challenge for clinicians. Shields and colleagues developed a widely used MODY probability calculator (https://www.diabetesgenes.org/) based on clinical measures to assist in this decision. Because the calculator was developed in a predominantly adult White European population without any pediatric T2D cases, we sought to test its accuracy in ProDiGY, a multiethnic cohort with clinician-diagnosed T2D under age 20.
Methods: MODY calculator probabilities were computed for 615 youth with clinician-diagnosed T2D (n=147 in SEARCH, n=468 in TODAY; overall, &gt;60% non-White), including 20 participants with MODY (3%). Given the longitudinal design of these studies, MODY probability was calculated for each participant at multiple time points, allowing maximum and median probabilities.
Results: Of the 20 individuals with MODY, 19 (95%) had a &gt;60% median probability of having MODY. However, this calculator overestimated the probability in participants with no MODY variant detected. In fact, 85% of individuals without MODY had a maximum probability &gt;60% of having MODY, and 67% had a median probability &gt;60%. Family history of diabetes did not discriminate diabetes type with more T2D patients having a parent affected (64% v 55% in MODY). In contrast, HbA1c and BMI each had discriminatory capacity (ROC AUC &gt;0.67).
Conclusion: In a group of multi-ethnic youth with diabetes, the MODY calculator correctly identified those with MODY but overestimated the probability for those with a clinical phenotype of T2D, likely due to young age at diagnosis and high proportion with positive family history of diabetes.

Disclosure
R.J. Kreienkamp: None. B. Shields: None. T.I. Pollin: None. M. Tosur: None. A.S. Shah: None. A.D. Liese: None. C. Pihoker: None. S. Srinivasan: None. A.T. Hattersley: None. M. Udler: Other Relationship; Up-To-Date. M.J. Redondo: None.

Funding
RJK is supported by NIH T32DK007699. SS is supported by NIH K23DK120932 and R03DK138213. MJR is supported by NIH NIDDK R01DK124395.
1552-P: Mutations with Residual CFTR Function Are Associated to Better Glucose Tolerance and Insulin Secretion in Patients with Cystic Fibrosis
Authors: FOPPIANI ANDREA , CICIRIELLO FABIANA , ALGHISI FEDERICO , LUCIDI VINCENZINA , SILEO FEDERICA , CRISTINA LUCANTO MARIA , CORTI FABIOLA , COLOMBO CARLA , BATTEZZATI ALBERTO 
Published: July 2024

People with Cystic Fibrosis (pwCF) exhibit a defect of insulin secretion[1], potentially leading to Cystic Fibrosis Related Diabetes. Little information exists about the molecular mechanism that links the defect of insulin secretion to the CF-causing variants of the CFTR gene[2,3]. We sought to describe the relationship between the CFTR function and β-cell function in pwCF. We studied 341 patients (193 (57%) females, 271 (79%) pancreatic insufficient, median (IQR) age 19 (15, 24) years) with the oral glucose tolerance test (OGTT), sampling glucose, insulin, and C-peptide before and every 30 minutes over the 2 hour OGTT, modeling β-cell function expressed by the β-cell glucose sensitivity[4]. Each patient was characterized by either having at least one allele with a residual function mutation (group 1, 85 (25%)), or a minimal function mutation on both alleles (group 2, 255 (75%) ). After adjusting for sex, pancreatic insufficiency (PI), and age, patients in group 1 displayed better glucose tolerance at all OGTT timepoint (all p=&lt;0.05), and better β-cell glucose sensitivity (22 pmol×min⁻¹×m⁻²×mM⁻¹; 95% CI 9.6, 34; p=&lt;0.001).Within the whole sample, 162 patients (82 (51%) females, 136 (84%) of group 2, 139 (86%) pancreatic insufficient, median (IQR) age 20 (15, 25) years) carried variants on both alleles that had been tested for chloride conductance in the Fischer Rat Thyroid cell line (http://cftr2.org). The mean chloride conductance of the most functional allele was positively related to β-cell glucose sensitivity (0.96; 95% CI 0.13, 1.8; p=0.025), with no PI interaction (interaction term -0.63; 95% CI -3.7, 2.4; p=0.7), and adjusting for differences in sex and age.
In conclusion, we have shown that CFTR function is quantitatively related to β-cell function in pwCF. Even though exocrine PI is associated with worse β-cell function, the association of CFTR residual function and β-cell glucose sensitivity is not necessarily mediated by exocrine PI.

Disclosure
A. Foppiani: None. F. Ciciriello: None. F. Alghisi: None. V. Lucidi: None. F. Sileo: None. M. Lucanto: None. F. Corti: None. C. Colombo: None. A. Battezzati: None.

Funding
Cystic Fibrosis Research Foundation FFC#16/2005, FFC#21/2013, FFC#20/2016, and FFC#24/2019
1563-P: High Fat and Fructose Feeding Severely Impairs Hepatic Glucose Effectiveness but Not Insulin Action Under Euglycemic Conditions
Authors: EDGERTON DALE S. , KRAFT GUILLAUME , WATERMAN HANNAH L. , FARMER BEN , YANKEY KALISHA , SMITH MARTA S. , HASTINGS JON R. , SCOTT MELANIE , CHERRINGTON ALAN D. 
Published: July 2024

Diets high in fat and fructose (HFHF) disrupt glucose metabolism. This study compared the effects of a HFHF diet on liver insulin action vs glucose effectiveness. Dogs were fed either a chow or HFHF diet for 1 month. At the start of each study, 3-3H-glucose was infused and after a basal sampling period, somatostatin and basal glucagon were given. During the experimental period (4h) either insulin was infused into the hepatic portal vein at 4 fold basal, while glucose was delivered to maintain euglycemia (CHOW-INS and HFHF-INS), or glucose was infused to increase its level 2.5 fold, while insulin was maintained at basal (CHOW-GLC and HFHF-GLC) (n=6/grp). Plasma insulin, glucagon, glucose, and hepatic glucose load were matched within the respective groups. In response to selective hyperinsulinemia, net hepatic glucose balance (NHGB) was suppressed from output to uptake (basal period to last h; 1.2±0.1 to -1.0±0.2 vs 1.7±0.2 to 0.0±0.1; deltas of 2.2±0.2 vs 1.6±0.3 mg/kg/min in CHOW-INS vs HFHF-INS, respectively; p=0.2). Selective hyperglycemia, on the other hand, caused changes in NHGB of 1.1±0.2 to -2.5±0.4 vs 1.4±0.1 to 1.7±0.6; deltas of 3.6±0.4 vs -0.3±0.6 mg/kg/min in CHOW-GLC vs HFHF-GLC, respectively (p&lt;0.001). Glucose turnover (Ra) was suppressed (basal period to last h) by 1.7±0.3 vs 1.3±0.1 mg/kg/min (p=0.4) in CHOW-INS vs HFHF-INS, and by 1.9±0.2 vs 0.5±0.1 mg/kg/min (p&lt;0.001) in CHOW-GLC vs HFHF-GLC, respectively. Thus, the HFHF diet had a small, non-significant effect on liver insulin action under euglycemic conditions, whereas it severely impaired the effect of hyperglycemia in the presence of basal insulin (i.e. hepatic glucose effectiveness). These data demonstrate that the “gold standard” hyperinsulinemic euglycemic clamp may overlook substantial diet induced liver dysfunction. Furthermore, Ra accounts for glucose production but not liver uptake, thus has the potential to miss critical and substantial changes in liver glucose metabolism.

Disclosure
D.S. Edgerton: None. G. Kraft: None. H.L. Waterman: None. B. Farmer: None. K. Yankey: None. M.S. Smith: None. J.R. Hastings: None. M. Scott: None. A.D. Cherrington: Consultant; Abvance Therapeutics. Research Support; Abvance Therapeutics. Advisory Panel; AdipoPharma. Research Support; Cellular Longevity, Inc. dba Loyal. Advisory Panel; Fractyl Health, Inc. Consultant; Fractyl Health, Inc. Research Support; Fractyl Health, Inc. Consultant; Novo Nordisk. Research Support; Novo Nordisk. Consultant; Paratus, Portal Insulin. Advisory Panel; Sekkei Bio, Sensulin Labs, LLC. Consultant; Thetis Pharmaceuticals, LLC.

Funding
R01DK18243