bluuebunny/crossref_metadata_2025_split huggingface dataset:
THU421 Utility Of Forearm DXA As A Tool For Identification Of Osteoporosis: A Cleveland Clinic Experience
Authors: Ishola Adeola F , Alsibai Khaled , Iqbal Anira , Elsherif Ayat , Rao Pratibha , Khan Leila Zeinab 
Published: October 2023

Abstract
Disclosure: A.F. Ishola: None. K. Alsibai: None. A. Iqbal: None. A. Elsherif: None. P. Rao: None. L.Z. Khan: None.
Background: Osteoporosis is a preventable and treatable condition with a significant impact on the quality of life. According to the National Osteoporosis Foundation, 10.2 million Americans have osteoporosis. In addition, more than 2 million osteoporosis-related fractures occur annually in the US and &gt;70% of these occur in women. Unfortunately, most individuals at risk do not undergo appropriate assessment or treatment. Clinically osteoporosis may be diagnosed if there is a fragility fracture, independent of bone mineral density (BMD) T-score value. Diagnosis based on BMD can also be made with a T-score of − 2.5 or below in the lumbar spine, femoral neck, total proximal femur, or distal 1/3 radius. Due to the limitations in interpreting BMD values in patients with degenerative joint disease (DJD), using the forearm (distal 33% radius) as an alternative skeletal site could serve as a more sensitive screening test. Our study primary aims were to assess the frequency at which females age ≥ 65 undergoing BMD testing had DJD of the spine, to determine the frequency at which BMD testing of the forearm was performed in patients with DJD of the spine, and to assess skeletal site-specific rates of osteoporosis. Methods: This is a large, single-center, retrospective, IRB- approved study conducted at Cleveland Clinic Foundation. Postmenopausal female patients above the age of 65 who underwent DXA scans between January 2018 and December 2019 were identified. Manual chart reviews were performed. Patients receiving osteoporosis treatment and those with hyperparathyroidism were excluded. Results: 195 patients were eligible for the study. The mean age was 73.4 ± 8.2 years. DJD of spine and osteoarthritis were present in 74.5% and 58.2% of patients respectively. Forearm BMD testing was only performed in 18.9% of patients with DJD of the spine. Osteoporosis was diagnosed in 39.1 % at the femoral neck, 35.4% of patients at the lumbar spine, 9.3 % at the distal 1/3 radius, and 6.8% at the total hip. Conclusion: DJD of the spine and hip osteoarthritis often lead to falsely elevated T-scores resulting in under-diagnosis and under-treatment of osteoporosis. Although there is a higher sensitivity of using forearm BMD values to diagnose osteoporosis in patients with DJD of spine and/or osteoporosis, our preliminary data show that the forearm DXA scan is an under-utilized clinical tool in cases of DJD of spine, osteoarthritis, and hip replacement.
Presentation: Thursday, June 15, 2023
THU425 Brief, Low-impact, High-intensity Osteogenic Loading Training Utilizing Proprietary Osteostrong Devices With Once-A-Week, 10 Minute Treatments Improves Bone Mineral Density In Women With Osteoporosis Of The Lumbar Spine
Authors: Papadopoulou-Marketou Nektaria , Papageorgiou Anna , Vavetsis George , Panagiotis Tsiamyrtzis , Chrousos George P 
Published: October 2023

Abstract
Disclosure: N. Papadopoulou-Marketou: None. A. Papageorgiou: None. G. Vavetsis: None. T. Panagiotis: None. G.P. Chrousos: None.
Introduction: Osteoporosis is a chronic condition characterized by a decrease in bone density and deterioration of microarchitecture. It has been associated with a high bone-fracture risk, an increased mortality, and vast health-care costs. Pharmaceutical treatment along with resistance exercise are usually prescribed. “Osteostrong” is a type of bone strengthening that uses brief (12 min), weekly, low-impact, high-intensity osteogenic loading. Aim: to investigate the therapeutic impact of Osteostrong in people with osteoporosis. Methods: In total, 140 postmenopausal women with osteoporosis of the lumbar spine, followed at the Unit on Clinical and Translational Research in Endocrinology, University of Athens, Athens, Greece, were enrolled. They were divided into 2 groups. Group A (GA) included 70 women who were treated with Osteostrong (mean age: 57,7 y, 95% CI 54, 9-60,6 y); Group B (GB) included 70 women who had no exercise intervention (mean age 59,2 y, 95% CI 55,6-61,9 y). All the participants had a complete physical examination, an assessment for exclusion of secondary osteoporosis, bone markers CTX1 and PINP, and a DXA examination [Horizon W (S/N 300472M], twice, at the time of inclusion in the trial, at 9 and 12 months after onset of intervention. Preliminary data at 9 months are shown. Statistical analysis, Medcalc version 20.2. Results: Paired Student t-test (chi-squared) of Bone Mass Density (BMD) and T-score before (1) and after intervention (2) in GA and GB showed: BMD lumbar spine (L1-L4) and T-score L1-L4: GA1 (mean:0.815), GA2 (mean:0.833) (p&lt;0.0007) and GA1 (mean: −2.27), GA2 (mean: −1.93) (p&lt;0.0001)/ GB1 (mean: 0.852), GB2 (mean: 0.851) (p=0.93) and GB1 (mean: −1.98), GB2 (mean: −1.80) (p=0.054), respectively. Trabecular bone score (TBS) and T-score TBS: GA1 (mean: 1.217), GA2 (mean: 1.238), (p=0.036) and GA1 (mean: −2.76), GA2 (mean: −2.52), (p=0.045)/ GB1 (mean:1.22), GB2 (mean: 1.204) (p=0.14) and GB1 (mean: −2.75), GB2 (mean: −2.85), (p= 0.560), respectively. The CTX1 and PINP values were within normal reference range at 9 months. Discussion: The study showed a statistically significant improvement of BMD in the lumbar spine and TBS in people with osteoporosis treated with Osteostrong. The Osteostrong method may have a synergistic effect with anti-osteoporotic medication, significantly reducing bone fracture risk. Conservative therapeutic interventions are important challenges to minimize the osteoporosis-related poor quality of life and mortality.
Presentation: Thursday, June 15, 2023
FRI661 Assessing The Current State Of Screening And Managementof Non-alcoholic Fatty Liver Disease In An Academic Endocrinology Clinic
Authors: Matthew Myers Kyle , Dean Hendrickson Chase 
Published: October 2023

Abstract
Disclosure: K.M. Myers: None. C.D. Hendrickson: None.
Background: Nonalcoholic fatty liver disease (NAFLD) is the most common cause of liver disease and the second most common cause of liver failure leading to transplantation. NAFLD is strongly associated with factors of metabolic syndrome including diabetes mellitus (DM), with which it shares a strong bi-directional relationship. Up to 70% of patients with DM also have NAFLD, and DM is a risk factor for higher rates of NAFLD progression leading to steatohepatitis, fibrosis and cirrhosis. In September 2021, the American Gastroenterological Association published recommendations including endocrinology in the screening and management of NAFLD patients. Screening for NAFLD involves computing a FIB-4 score to risk-stratify patients into low, intermediate or high risk of having liver fibrosis. The FIB-4 score is calculated using patient age, AST, ALT and platelet count. Further management is determined by the level of risk identified, with some indeterminate-risk and all high-risk patients needing referral to hepatology clinic. Methods: Deidentified patient data was abstracted from an electronic health record registry associated with a large academic medical center. Patient qualifiers included: age over 18 years, diagnosis of type 2 DM, a prior visit within 5 years at one of two endocrinology clinic locations and having a primary care physician associated with the system. Of these patients, lab data was obtained for AST, ALT and platelet count. Additionally, the presence or absence of a prior hepatology clinic encounter was assessed. Two endocrinology clinics were analyzed, including one clinic at the main hospital campus and a second, smaller clinic located in an adjacent county. Results: Within the larger clinic, 16,398 patients met the above criteria; however, only 1797 (11.0%) had all lab components evaluated within 5 years to calculate a FIB-4 score, largely due to only 11.3% of total patients having platelet count data available. Of patients with a FIB-4 score, 342 had a score over 2.67, indicating high-risk for liver fibrosis. Of these 342 patients, 181 (53.0%) had an associated hepatology visit. Within the smaller clinic, 3844 patients met the above criteria; however, only 1055 (274%) had all lab components evaluated within 5 years to calculate a FIB-4 score, again largely due to only 30.0% of total patients having platelet count data available. Of the patients with a FIB-4 score, 148 had a score ≥ 2.67, indicating high-risk for liver fibrosis. Of these 148 patients, 47 (31.8%) had an associated encounter with hepatology. Conclusion: This study highlights a need for improved screening and risk-stratification of diabetic patients for NAFLD, including the increased awareness of screening with appropriate lab evaluation and subsequent referral to hepatology when appropriate.
Presentation: Friday, June 16, 2023
OR12-02 NRF2 Is Essential For Expanding Pancreatic Beta-Cell Mass During Pregnancy
Authors: Baumel-Alterzon Sharon , Garcia-Ocana Adolfo , Scott Donald K 
Published: October 2023

Abstract
Disclosure: S. Baumel-Alterzon: None. A. Garcia-Ocana: None. D.K. Scott: None.
The late stages of the mammalian pregnancy are accompanied with increased insulin resistance due to the increased glucose demand of the growing fetus. Therefore, as a compensatory response, in order to maintain the maternal normal blood glucose levels, maternal beta-cell mass expands leading to increased insulin release. Beta-cell proliferation, beta-cell neogenesis, and decreased beta-cell apoptosis, are major contributors for the beta-cell adaptive response during pregnancy. Defects in these cellular processes can lead to gestational diabetes mellitus (GDM). GDM, which occurs in ∼7-8% of the total pregnancy cases within the U.S, results in adverse outcomes for both the mother and newborn. This highlights the urgent need for exploring the yet undefined intracellular mechanisms that regulate functional beta-cell mass expansion during pregnancy. GWAS analysis revealed several mutations in the Nrf2 antioxidant pathway that are associated with diabetes. Additionally, we previously found that Nrf2 is required for adaptive beta-cell expansion after high fat feeding via stimulation of beta-cell proliferation, increased beta-cell survival, and maintenance of beta-cell identity. Interestingly, Nrf2 expression levels are increased by 4.3-fold (+/- 6.60, p&lt;0.05, n=3-4) in maternal beta-cells during pregnancy, peaking at gestational day (GD)19, while returning to normal levels postpartum. Based on these observations, we hypothesize that Nrf2 might play an important role in expanding beta-cell mass during pregnancy and that disruption of Nrf2 expression or function might lead to GDM. In order to test our hypothesis, we generated tamoxifen (Tam)-induced beta cell-specific deletion of Nrf2 in female mice by crossing MIP-CreERTTAM with Nrf2lox/lox mice (βNrf2KO). In order to exclude any effect of Tam on pregnancy outcomes, females mice were injected with Tam (or vehicle control) a month before gestation. Pancreata were harvested at GD15 or GD19 and immunolabeled with Ki67 and insulin (proliferation assay), TUNEL and insulin (apoptotic assay) or insulin alone (beta-cell mass analysis). Our results show that βNrf2KO mice exhibit 70% reduction (+/- 0.25, p&lt;0.01, n=4-6) in beta-cell proliferation and a 0.13% increase in beta-cell death (+/- 0.03, p&lt;0.05, n=4-6) at GD15 compared to littermate controls. Importantly, βNrf2KO pregnant mice display a remarkable decrease in beta-cell mass at GD19 (50%) (+/- 0.68, p&lt;0.05, n=4) compared with control mice, accompanied by a trending decrease in plasma insulin and increase in blood glucose. No changes were observed in the average number of embryos between βNrf2KO and control pregnant mice. We conclude that Nrf2 is required for beta-cell mass expansion during pregnancy by controlling beta-cell proliferation and survival and alterations in Nrf2 action could potentially lead to development of GDM.
Presentation: Friday, June 16, 2023
SAT045 Sexually Dimorphic Effects Of CCN5/WISP2 Overexpression On HFD-STZ Induced Diabetes And Glucose Intolerance
Authors: Alami Tara , Zakikhani Mahvash , Xega Viktoria , Liu Jun-Li 
Published: October 2023

Abstract
Disclosure: T. Alami: None. M. Zakikhani: None. V. Xega: None. J. Liu: None.
Matricellular protein CCN5/WISP2 is a novel target of IGF-1 and WNT signaling within the pancreatic islets (1). Our previous works suggest that CCN5 promotes β-cell proliferation and survival via Akt/PKB and focal adhesion kinase. Last year, we reported sexually dimorphic effects of CCN5 knockout in glucose tolerance and insulin sensitivity in high-fat diet (HFD)-induced obesity, supporting a trophic role of endogenous CCN5 expression on pancreatic islets, albeit mostly in male mice (PSUN136, ENDO 2022). In order to further establish the in vivo effect of CCN5 in a gain-of-function approach, we assessed aP2-CCN5 transgenic mice which overexpress CCN5 in adipose tissues (2). These mice have increased serum level of CCN5, lean body mass and whole-body energy expenditure and hyperplastic adipose and cardiac tissues. Obese aP2-CCN5 mice remained insulin sensitive, glucose tolerant with a reduced insulin level. We first fed wild-type and transgenic mice, both male and female, a 60% HFD (Research Diets, D12492) for two weeks before administering 50 mg/kg streptozotocin (STZ) injections for 5 days, every other day. (i) In male mice, the HFD-STZ induced a steady elevation in glycemia from ∼9 to 25 mM in 7 weeks; CCN5 overexpression slowed down and curtailed the elevation to only 16 mM, and improved glucose tolerance at 48 days, suggesting a partial but significant protection from diabetes. (ii) Using the same dose of STZ, female wild-type mice exhibited only a slight elevation in glycemia from 8 to 12 mM. However, female aP2-CCN5 mice displayed a steady increase in glycemia to 18 mM and significantly impaired glucose tolerance at 16 and 48 days, suggesting rather worsening diabetes due to CCN5. In both male and female mice, there was no obvious difference in insulin sensitivity at 21 days nor in the overall weight loss caused by STZ injections. We are still analyzing the corresponding changes in serum insulin level and β-cell morphometry. Our results further support the notion that increased CCN5 level protects the β-cells, although only in male mice. The female environment, however, would abolish CCN5-induced protection.
(1) Chowdhury S, Wang X, Srikant CB, Li Q, Fu M, Gong YJ, Ning G, Liu JL. IGF-I stimulates CCN5/WISP2 gene expression in pancreatic beta-cells, which promotes cell proliferation and survival against streptozotocin. Endocrinology. 2014; 155: 1629-1642.
(2) Grunberg JR, Hoffmann JM, Hedjazifar S, Nerstedt A, Jenndahl L, Elvin J, Castellot J, Wei L, Moverare-Skrtic S, Ohlsson C, Holm LM, Backhed F, Syed I, Bosch F, Saghatelian A, Kahn BB, Hammarstedt A, Smith U. Overexpressing the novel autocrine/endocrine adipokine WISP2 induces hyperplasia of the heart, white and brown adipose tissues and prevents insulin resistance. Sci Rep. 2017; 7:43515
Presentation: Saturday, June 17, 2023
Great Britain and the War of the Triple Alliance: The Lincolnshire Farmers Colonization Scheme to Paraguay and the Fourth Ally Thesis
Authors: Nickson Andrew 
Published: October 2023

Abstract
This article challenges the fourth ally thesis, which argues that Great Britain was a crucial actor underpinning the combined forces of Argentina, Brazil, and Uruguay that defeated Paraguay in the 1864–70 War of the Triple Alliance. To date, the debate has focused on British involvement in the genesis and financing of the allied war effort. This article instead focuses on the postwar behavior of the British government, exploring its attitude to the 892 mainly English colonists of the failed 1872–73 Lincolnshire farmers emigration scheme to Paraguay. The British government's open hostility to the scheme and its lack of concern for the plight of the colonists offer new evidence suggesting that the War of the Triple Alliance was of little interest to British imperialism in general and to settler colonialism in particular.
Medicaid Home and Community-Based Services in the Wake of the COVID-19 Pandemic
Authors: Miller Edward Alan , Beauregard Lisa Kalimon 
Published: October 2023

Abstract
The need to bolster Medicaid home and community-based services (HCBS) became more evident during the COVID-19 pandemic. This recognition stemmed from the challenges of keeping people safe in nursing homes and the acute workforce shortages in the HCBS sector. This article examines two major federal developments and state responses in HCBS options as a result of the pandemic. The first initiative entails a one-year increase of the federal Medicaid matching rate for HCBS included in the American Rescue Plan Act championed by the Biden administration. The second initiative encompasses administrative flexibilities that permitted states to temporarily expand and modify their existing Medicaid HCBS programs. The article concludes that the effects of the pandemic flexibilities and enhanced federal funding on most state HCBS programs will be limited without continued investment and leadership on the part of the federal government, which is a Biden administration priority. States that make the American Rescue Act and COVID-19 flexibilities initiatives permanent are states that have the fiscal resources and political commitment to expanding HCBS benefits that other states lack. States’ different approaches to bolstering Medicaid HCBS during the pandemic may contribute to widening disparities in access and quality of HCBS across states and populations who depend on Medicaid HCBS.
Actl7b deficiency leads to mislocalization of LC8 type dynein light chains and disruption of murine spermatogenesis
Authors: Merges Gina E. , Arévalo Lena , Kovacevic Andjela , Lohanadan Keerthika , de Rooij Dirk G. , Simon Carla , Jokwitz Melanie , Witke Walter , Schorle Hubert 
Published: October 2023

ABSTRACT
Actin-related proteins (Arps) are classified according to their similarity to actin and are involved in diverse cellular processes. ACTL7B is a testis-specific Arp, and is highly conserved in rodents and primates. ACTL7B is specifically expressed in round and elongating spermatids during spermiogenesis. Here, we have generated an Actl7b-null allele in mice to unravel the role of ACTL7B in sperm formation. Male mice homozygous for the Actl7b-null allele (Actl7b−/−) were infertile, whereas heterozygous males (Actl7b+/−) were fertile. Severe spermatid defects, such as detached acrosomes, disrupted membranes and flagella malformations start to appear after spermiogenesis step 9 in Actl7b−/− mice, finally resulting in spermatogenic arrest. Abnormal spermatids were degraded and levels of autophagy markers were increased. Co-immunoprecipitation with mass spectrometry experiments identified an interaction between ACTL7B and the LC8 dynein light chains DYNLL1 and DYNLL2, which are first detected in step 9 spermatids and mislocalized when ACTL7B is absent. Our data unequivocally establish that mutations in ACTL7B are directly related to male infertility, pressing for additional research in humans.
SciPROP-R: An Effective Bisphosphine Ligand for the Chemo-Selective Iron-Catalyzed Suzuki–Miyaura Coupling of Alkyl Chlorides
Authors: Nakajima Sho , Hashimoto Toru , Lu Siming , Hashizume Daisuke , Matsuda Hiroshi , Hatakeyama Takuji , Isozaki Katsuhiro , Takaya Hikaru , Nakamura Masaharu 
Published: October 2023

Abstract
Novel 2-substituted 1,3-bis[bis(3′,5′-di-tert-butylphenyl)phosphino]propanes (SciPROP-R; 1-R), as well as their iron complexes FeCl2(SciPROP-R) 2-R, are synthesized. Single-crystal X-ray analysis and solution-phase Fe K- and L-edge XAS of 2-R reveals that these complexes maintain tetrahedral geometry and hence paramagnetic high-spin properties both in the solid state and in the solution phase. 31P NMR results demonstrate that the superior coordination ability of SciPROP-TB (1-TB) is due to the bulky tert-butyl group at position 2 of the propane-1,3-diyl linker of the ligand. These novel iron-complexes catalyze Suzuki–Miyaura-type cross coupling under mild conditions. Notably, iron(II) chloride–1-TB complex (2-TB) exhibits excellent catalytic activity owing to the high coordination ability and electron-donating nature of 1-TB, being effective for chemoselective cross coupling between various alkyl chlorides and arylboron compounds.
Rehabilitation of Annular Pulley Injuries of the Fingers in Climbers: A Clinical Commentary
Authors: Ehiogu Uzo Dimma , Schöffl Volker , Jones Gareth 
Published: October 2023

AbstractThe annular pulley ligaments of the fingers are one of the most injured anatomical structures in those who participate in climbing. Despite this, there is a paucity of guidance clearly describing the rehabilitation and physical preparation parameters to return to sport following such injuries. The foundation of effective rehabilitation is the judicious application of progressive loading to increase the morphological and material properties of the damaged tissues. We maintain the optimal management of the climbing athlete after a traumatic annular flexor pulley system rupture should be grounded in the principles of strength and conditioning.
The altered sputum microbiome profile in patients with moderate and severe COPD compared to the healthy group in the Indian population
Authors: Hazra Druti , SM Fayaz , Chawla Kiran , Sintchenko Vitali , Martinez Elena , Magazine Rahul , Siddalingaiah Nayana 
Published: October 2023

Background: Microbial culture-independent sequencing techniques have advanced our understanding of host-microbiome interactions in health and disease. The purpose of this study was to explore the dysbiosis of airway microbiota in patients with moderate or severe chronic obstructive pulmonary disease (COPD) and compare them with healthy controls. Methods: The COPD patients were investigated for disease severity based on airflow limitations and divided into moderate (50%≤FEV1<80% predicted) and severe groups (FEV1<50% predicted). Spontaneous sputum samples were collected and, the V3-V4 regions of the 16S rRNA coding gene were sequenced to examine the microbiome profile of COPD and healthy participants. Results: A total of 45 sputum samples were collected from 17 severe COPD, 12 moderate COPD cases, and 16 healthy volunteers. The bacterial alpha diversity (Shannon and Simpson’s index) significantly decreased in the moderate and severe COPD groups, compared to healthy samples. A significantly higher proportion of Firmicutes and Actinobacteria were present in moderate COPD, and Proteobacteria numbers were comparatively increased in severe COPD. In healthy samples, Bacteroidetes and Fusobacteria were more abundant in comparison to both the COPD groups. Among the most commonly detected 20 bacterial genera, Streptococcus was predominant among the COPD sputum samples, whereas Prevotella was the top genus in healthy controls. Linear discriminant analysis (LDA>2) revealed that marker genera like Streptococcus and Rothia were abundant in moderate COPD. For severe COPD, the genera Pseudomonas and Leptotrichia were most prevalent, whereas Fusobacterium and Prevotella were dominant in the healthy group. Conclusions: Our findings suggest a significant dysbiosis of the respiratory microbiome in COPD patients. The decreased microbial diversity may influence the host immune response and provide microbiological biomarkers for the diagnosis and monitoring of COPD.