bluuebunny/crossref_metadata_2025_split huggingface dataset:
FRI404 CNS Manifestations Are Linked With Hot Flashes: Analysis Of Real World Data From A Social Network
Authors: Shaklai Sigal , Greenman Yona , Yom-Tov Elad 
Published: October 2023

Abstract
Disclosure: S. Shaklai: None. Y. Greenman: None. E. Yom-Tov: None.
Background: Hot flashes, a hallmark of the menopausal transition, frequently coincides with CNS manifestations of disturbed sleep, cognition, and mood. How these relate is an active area of research. Objective: To evaluate the association of hot flashes with specific CNS manifestations, as expressed by women on one of the largest social media platforms (Reddit). Methods: We downloaded 4772 posts from Reddit’s Menopause group. 586 randomly sampled posts were labelled for their relevancy to menopause. Relevant posts were further labelled for mentions of hot flashes, cognition, reports of adverse mood, sleep problems and reported age. A random forest model for identifying relevant posts from words and bigrams of the posts was trained using the labelled samples and its performance evaluated using 10-fold cross-validation. The model reached an Area Under Curve (AUC) of 0.77. The model was used to filter the remaining posts by selecting posts classified as having a 75% or more likelihood of being about menopause\perimenopause. This resulted in 3546 posts from 1854 users. Models for the remaining labels were trained, reaching AUCs of 0.70 to 0.79. The models were applied to the unlabeled posts. Labels with a prediction in the range of 33-66% were removed to keep only those for which models provided strong indications. Posts were aggregated by user and the average score for each predicted label was computed. Main Outcome Measures: The ratio of women reporting one of three outcomes; disturbances in cognition, mood, or sleep, from all women with or without hot flashes. Results: The average stated age was 44.3 years (range: 21-59, N=165). In the whole cohort, hot flashes were reported in 32%, adverse mood in 40%, impaired sleep in18% and cognitive disruption in 15% of women. In women with hot flashes, adverse mood occurred in 46.9%, impaired sleep in 27.2%, and cognitive disruption in 25.3%. In women without hot flashes adverse mood occurred in 4.3%, impaired sleep in 0.7% and cognitive disruption in 0.7%. Results are statistically significant (chi2 test) at P&lt;10^(-10). Conclusions: Hot flashes, which occurred in a third of the women, were individually associated with disturbances in mood, sleep and cognition. Adverse mood was highly prevalent and should be actively sought and addressed.
Presentation: Friday, June 16, 2023
FRI407 Identification Of AIPB Expression For Early Breast Cancer Prediction
Authors: Doetch Nicole Elizabeth , Bose Himangshu S 
Published: October 2023

Abstract
Disclosure: N.E. Doetch: None. H.S. Bose: None.
The incidence of developing invasive breast cancer in women is about 14% during their lifetime and accounts for over 16% of all female cancers. Breast cancer is categorized based on the presence and absence of receptors including Estrogen Receptor (ER+/-), Progesterone Receptor (PR+/-), and Human Epidermal Growth Factor 2 Receptor (HER2+/-). Patients with Estrogen Receptor (ER+) and Progesterone Receptor (PR+) can participate in treatment catered to targeting both hormonally regulated receptors. Estradiol or estrogen are required and promote the growth of 80% of hormone receptor positive breast cancers which is regulated by Aromatase, a rate-limiting enzyme catalyzing the conversion of testosterone to estradiol. By decreasing estradiol synthesis, reduction in the progression of ER+/PR+ breast cancer is attainable.The expression of aromatase is increased in the ovaries of pre-menopausal women with substantial increase in peripheral and breast tissue in post-menopausal women contributing to tumor growth. “Aromatase Interacting Partner in Breast” (AIPB) has an inhibitory effect on aromatase causing a reduction in estradiol synthesis. AIPB is stimulated by detectable estrogen levels but remains unaffected by cAMP and inactivated cycloheximide. Expressed levels of AIPB were similar in unaffected breast tissue and WT MCF-12A breast cells. Western blot with tumorigenic human breast tissues showed decreased AIPB expression in ER+/PR+/HER2- tumors. We created conditional overexpression of AIPB under Tetracycline control that synthesized 3.52 pg/mL of estradiol. This was a 3-fold reduction in comparison to unaffected breast tissue and WT MCF-12A suggesting a leaky expression in tumorigenic breast cells. Findings led to hypothesis that AIPB stabilization is essential in promoting AIPB-Aromatase interaction resulting in decreased estradiol synthesis. The standard treatment for ER+/PR+ tumors, Tamoxifen, was incubated with MCF-12A cells overexpressing AIPB at varying Tamoxifen concentrations for different timed intervals and compared to untreated MCF-12A cells overexpressing AIPB and WT MCF-12A cells. Results yielded that AIPB expression in cells treated with Tamoxifen were substantially increased and no significant AIPB expression in untreated cells. MCF-12A-AIPB cells underwent incubation with Tamoxifen for 24h, soluble complex isolation, and a density gradient centrifugation. Western blotting with the CT antibody yielded one region in the density gradient fractionation in treated cells as compared to no complex formation in untreated cells. Therefore, AIPB confirmed crucial role in the pathophysiology of breast tumor development and maintenance of proper estradiol levels during post-menopause and tumorigenesis. The findings emphasize ability for future advancements in the early prediction of breast cancer with the identification of AIPB expression.
Presentation: Friday, June 16, 2023
FRI426 Raised Thyroid Stimulating Hormone In Girls With Polycystic Ovary SyndromeEffects Of Randomized Interventions
Authors: Ibanez Lourdes , Garcia-Beltran Cristina , Bassols Judit , Carreras-Badosa Gemma , Lopez-Bermejo Abel , de Zegher Francis Edouard 
Published: October 2023

Abstract
Disclosure: L. Ibanez: None. C. Garcia-Beltran: None. J. Bassols: None. G. Carreras-Badosa: None. A. Lopez-Bermejo: None. F.E. de Zegher: None.
Introduction: Polycystic ovary syndrome (PCOS) in women associates with raised levels of circulating thyroid stimulating hormone (TSH) and with high rates of gestational complications. A low range of preconception TSH is followed by low rates of gestational complications. It is unknown whether TSH levels are elevated in adolescents with PCOS and, if so, whether traditional or exploratory treatments can lower them into safe preconception range. We investigated TSH in non-obese adolescents with PCOS, including the effects of randomized interventions. Methods: Morning TSH was a safety marker in randomized pilot studies comparing the effects of an oral contraceptive (OC) versus those of a low-dose combination of spironolactone-pioglitazone-metformin (SPIOMET, aiming at a reduction of ectopic fat without necessarily lowering body weight) in non-obese adolescents with PCOS. A post-hoc analysis compared: TSH levels in PCOS (N= 62) vs controls; TSH changes on treatment (1 year); TSH levels post treatment (1 year). Results: Mean TSH levels were higher in PCOS patients than in control girls (P&lt;0.01). On-treatment TSH levels diverged (P&lt;0.001), remaining elevated on OC, and descending swiftly on SPIOMET, well into safe preconception range. Post-treatment TSH levels were stable in both subgroups. On-treatment changes of circulating TSH associated to those of liver fat (R= 0.307, P= 0.017). Conclusion: The endocrine signature of early PCOS is herewith extended to include modestly raised levels of circulating TSH; the normalizing effects of SPIOMET intervention in non-obese adolescents with PCOS are herewith extended to include on- and post-treatment TSH.
Presentation: Friday, June 16, 2023
FRI432 An Interesting Case Of Primary Hypogonadism In A Patient With Multiple Sclerosis
Authors: Ahsun Sana , Lekprasert Patamaporn , Win Kay K 
Published: October 2023

Abstract
Disclosure: S. Ahsun: None. P. Lekprasert: None. K.K. Win: None.
Introduction: As per the recent data there is an association between low levels of testosterone in men and the risk for multiple sclerosis (MS). Most recent practice involves checking testosterone levels for male patients with newly developed MS and treating with testosterone supplementation if levels are low. CASE PRESENTATION: A 65-year-old male with medical history of multiple sclerosis, prediabetes, hypogonadism, squamous cell carcinoma of left ear, thyroid cancer (unknown type) status post total thyroidectomy and radioiodine therapy; presented to our endocrine office for an initial visit. Patient had been following with Endocrinologist at different state in the past and did not have much of his prior records since that practice closed. He has been on 150 mcg of levothyroxine and his TSH was stable at 1.2 (0.4-4.5 mIU/L). He also had a history of hypogonadism and had been on testosterone supplementation since the age around 50. Patient did not know the underlying cause for his hypogonadism. He has 3 biological children and the youngest one is 26 years old. He had been off of testosterone therapy for 3 months prior to our initial visit. We did some workup which showed total testosterone level of &lt;20 (250-1100 ng/dL). Free testosterone 2.2 (46-224 pg/mL). FSH and LH levels were elevated at 27.1 (1.6-8 mIU/mL) and 17.3 (1.6-15.2 mIU/mL). Prolactin level was 5.1 (5.2-26.5) ng/mL. These labs were consistent with Primary hypogonadism. Repeat testing was done and the patient had redemonstration of very low testosterone levels. Further checking of the karyotype analysis revealed normal male karyotype testing. His physical exam showed normal sized testicles at 20 cc and no gynecomastia. Body hair distribution was normal but there was decreased shaving frequency with decreased muscle strength. Patient never had any chemotherapy or the radiation therapy to the pelvic area. No known history of chronic infection or trauma. Currently, he is on Ocrelizumab for Multiple Sclerosis. His testosterone level is now in the normal range with the testosterone therapy after the work up. CONCLUSION: As per the above case, our patient has an interesting presentation of primary hypogonadism with multiple sclerosis. He has no known reason for his primary testicular failure. We know that testosterone deficiency has been linked to development of MS and MS can lead to secondary hypogonadism. But Primary hypogonadism has not yet been seen with MS although autoimmunity can be postulated to lead to primary testicular failure in these patients, but more studies and investigation will need to be done to establish this cause and effect relationship.
REFERENCE: Chitnis T. The role of testosterone in MS risk and course. Mult Scler. 2018 Jan;24(1):36-41. doi: 10.1177/1352458517737395. PMID: 29307293
Presentation: Friday, June 16, 2023
FRI435 A Grave Case Of Gynecomastia
Authors: Seltzer Sean , Williams Ashley , Kader Tina 
Published: October 2023

Abstract
Disclosure: S. Seltzer: None. A. illiams: None. T. Kader: None.
Background: Gynecomastia is a common endocrinology referral. Our team saw a patient in the clinic with an unusual presentation.
Clinical Case: A 28 year old male presented with worsening painful gynecomastia affecting one breast initially but eventually progressing to both breasts. His secondary concern was a 40lb weight loss and new onset tremor. He declined hypogonadal symptoms, palpitations, or new testicular growth. Exam revealed a resting pulse of 120 b.p.m., a palpable goiter, visible tremor, hyperdynamic heart sounds and bilateral tender gynecomastia. Labs revealed normal FSH, LH and hCG, high total testosterone (TT), thyroxine (T4) and triiodothyronine (T3) with positive thyroid receptor antibodies. Methimazole and beta blockade were started. He did develop an episode of atrial fibrillation requiring admission. Due to medication intolerance and patient preference the decision was made for total thyroidectomy. Three months post-surgery there was complete resolution of hyperthyroidism and gynecomastia.The differential for true gynecomastia is broad. The initial diagnostic approach includes a thorough history and physical exam followed by measuring serum testosterone (T), LH, hCG and estradiol (E2). Increased LH and low T indicates hypogonadism. Normal values may suggest an idiopathic cause. Elevated hCG warrants testicular imaging and if negative, chest and abdominal imaging to rule out extragonadal germ cell tumors. Elevated total T and LH should prompt measurement of TSH and T4 and if normal androgen resistance should be suspected. Elevated E2 and low/low normal LH should prompt testicular imaging and if normal an adrenal CT to rule out an adrenal neoplasm. If LH and T are low, prolactin should be measured as well as dedicated pituitary imaging.Any state which induces an increased E to T ratio may cause gynecomastia. The true pathophysiology in hyperthyroidism driving the increased sex hormone binding globulin (SHBG) production is unknown. It is postulated that this increase is driven by increased transcription and translation of hepatocyte nuclear factor-4ɑ secondary to elevated T41. SHBG more readily binds androgens than estrogens leading to a relative decrease in free T (FT). The lower FT levels result in negative feedback to the pituitary gland which causes increases in LH resulting in production of androgens, estradiol and peripheral aromatases. The increase in peripheral aromatization of testosterone leads to further elevation of the free estrogen levels.
Conclusion: Hyperthyroidism should always be in the differential of gynecomastia as in our case the presentation may be atypical.
References: Selva DM, Hammond GL. Thyroid hormones act indirectly to increase sex hormone-binding globulin production by liver via hepatocyte nuclear factor-4α. Journal of Molecular Endocrinology. 2009;43(1):19-27. doi:10.1677/jme-09-0025
Presentation: Friday, June 16, 2023
FRI437 Regenerative Treatment With Platelet-rich Plasma In Patients With Refractory Erectile Dysfunction: The Predictive Value Of Mean Platelet Volume
Authors: Francomano Davide , Iuliano Stefano , Condorelli Rosita Angela , Cannarella Rossella , La Vignera Sandro , Calogero Aldo E , Greco Emanuela A , Antonini Gabriele , Aversa Antonio 
Published: October 2023

Abstract
Disclosure: D. Francomano: None. S. Iuliano: None. R.A. Condorelli: None. R. Cannarella: None. S. La Vignera: None. A.E. Calogero: None. E.A. Greco: None. G. Antonini: None. A. Aversa: None.
Objective: Refractory erectile dysfunction (ED) is a common disorder in men regardless of the presence of late-onset hypogonadism. Being rich in growth factors, chemokines, and angiogenic factors, platelet-derived biomaterials contained in platelet-rich plasma (PRP) are particularly useful as some of the major therapeutic regenerative agents. PRP plays a crucial role in nerve cell regeneration, axon myelinization, progenitor cell homing and migration, and anti-fibrosis and anti-apoptosis of damaged cavernous nerve, and vascular corporal tissues (J Endocrinol 2001;170:395). Based on these findings, this study aimed to evaluate whether the mean platelet volume (MPV) may predict the efficacy of PRP before its intracavernous injection in patients with ED poorly responsive to phosphodiesterase type 5 inhibitors (PDE5i) and normal testosterone levels. Methods: 150 ED patients [age: 51±16.7 years; mean international index of erectile function (IIEF)-5: 12±2.6; mean peak systolic velocity (PSV): 32±5.5 cm/sec; and MPV=9.3±1.1 fl) underwent a single-shot treatment of PRP for their inability to respond to oral PDE5i. All patients were evaluated at baseline for MPV, at baseline and 1 month after intracavernous PRP injection for IIEF5, and dynamic penile duplex ultrasound (d-PDU) according to our previously published procedure (Andrology, 2021; 9:1457). Results: All patients had a significant improvement in ED symptoms (IIEF5: 12±2.6 vs. 19±3.0; p&lt;0.0001) and a significant improvement in d-PDU (PSV: 32±5.5 vs. 42±7.6 cm/sec; p&lt;0.0001). ROC curve analysis showed a significant accuracy (72.1%, C.I. 64.0 - 80.2, p&lt;0.0001) for MPV in identifying clinically PRP-responsive patients with favorable outcomes (≧ +4 points in the IIEF5 score). In particular, an MPV &lt;8.95 was recognized as the best threshold with a sensitivity of 90% and a specificity of 54.1%. Conclusion: This study provides the first evidence that the efficacy of a single PRP injection correlates with baseline MPV in patients with ED and poor response to PDE5i. An MPV value of less than 8.95 fl. identifies patients with a lower response to treatment who could benefit from re-treatments with more PRP injections.
Presentation: Friday, June 16, 2023
OR19-03 SIK2 Regulates Granulosa Cell Response to Exogenous Gonadotropins
Authors: Hayes Emily , Lakomy Oliwia , Hassan Mariam , Filzen Rachael , Esquivel Miriam Rodriguez , Foretz Marc , Stocco Carlos Oscar 
Published: October 2023

Abstract
Disclosure: E. Hayes: None. O. Lakomy: None. M. Hassan: None. R. Filzen: None. M. Rodriguez Esquivel: None. M. Foretz: None. C.O. Stocco: Grant Recipient; Self; NIH R01HD097202.
Forty percent of cases of infertility are attributed to ovulatory defects. Successful ovulation requires the coordinated development of the ovarian follicle, the functional unit of the ovary that is composed of the oocyte surrounded by steroidogenic granulosa cells. However, the mechanisms that govern follicle development remain incompletely understood. Previously, our group showed that loss of salt-inducible kinase 2 (SIK2) in a murine knockout model resulted in a significantly increased number of ovulated oocytes in response to an ovarian hyperstimulation protocol. Here, we aimed to further characterize the reproductive phenotype of SIK2 knockout mice, as well as to understand the role of SIK2 in granulosa cells by creating and characterizing a granulosa cell-specific knockdown of SIK2 using the Cre-Lox system. Loss of SIK2 resulted in no changes in the number of litters or litter size as well as a normal estrus cycle. Interestingly, granulosa cell-specific knockdown of SIK2 resulted in a significantly increased number of ovulated oocytes in response to ovarian hyperstimulation. However, SIK2 knockout mice do not ovulate more oocytes under physiologic conditions. Furthermore, knockdown of SIK2 in granulosa cells resulted in significantly increased Cyp19a1 gene expression and serum estradiol concentration. The data reveal that SIK2 plays an important role in the regulation of the response of granulosa cells to gonadotropins. These data support the potential of SIK2 as a pharmacologic target for improving oocyte yield for women receiving gonadotropins during in vitro fertilization as a treatment to trigger follicular maturation and ovulation. SIK2-regulated mechanisms could reveal new targets for the development of innovative methods of contraception.
Presentation Date: Saturday, June 17, 2023
SAT354 Molecular and Histological Characterization of a Guinea Pig Model of Mild Hyperandrogenemia
Authors: Tanori Rosalia N , Barboza Sagrero Juriana E , Noll-Bader Kayla , Chandu Sarpana , Chappell Patrick E , Bishop Cecily Vauna 
Published: October 2023

Abstract
Disclosure: R.N. Tanori: None. J.E. Barboza Sagrero: None. K. Noll-Bader: None. S. Chandu: None. P.E. Chappell: None. C.V. Bishop: Consulting Fee; Self; Oviva, Oxford Pharmaceuticals Inc.
There are several rodent models for polycystic ovarian syndrome (PCOS), but unlike primates, most rodents will not form a long-lived corpus luteum (CL) unless they experience cervico-vaginal stimulation/mating. Our research group has begun to determine if guinea pigs (Cavia porcellus), rodents with long-lived CL, are a suitable model for mild hyperandrogenemia, a risk factor for PCOS. The objective of this analysis was to determine the relative abundance of each follicle type within a cross-section of 20-week old guinea pig ovarian tissue from control and T-treated females after 3 months of androgen exposure. Ovarian tissues were collected from six guinea pigs treated with cholesterol implants (vehicle, n=4) or testosterone implants (n=3), which elevated androgen levels ∼2-fold above control females. Tissues were embedded in paraffin wax and cut into serial sections (5 μm) and placed onto glass slides (1 section/slide) for hematoxylin and eosin staining to identify follicle morphology within the ovarian tissue. Every fifth section was stained and analyzed using an ECHO Revolve microscope and follicles counted using ImageJ. Follicles of interest were primordial, primary, multi-layer, antral, and corpus luteum, and counts were normalized to ovarian area. All follicle types were found in all the ovaries imaged, as well as some corpora lutea. Multilayer follicles were significantly reduced by chronic exposure to mild hyperandrogenemia (p=0.01). These should provide needed baseline analyses for future experiments employing guinea pigs as a model of PCOS. In addition to histological analysis, we have begun quantifying gene expression changes for hormones and receptors throughout the reproductive axis. Preliminary studies using qPCR illustrate significantly elevated expression levels of hypothalamic kiss1, pituitary gnrhr, and ovarian fshr in T-treated females. No discernable differences were observed between treatment groups for kiss1r, gnrh, or fshb. Ongoing studies will explore differences in estrogen and androgen receptor expression throughout the reproductive axis, as well as any changes in metabolic regulators in liver and skeletal muscle that are associated with mild hyperandrogenemia in these animals.
Presentation Date: Saturday, June 17, 2023
FRI172 Assessment Of Plasma Dexamethasone Levels After 1-mg Dexamethasone Suppression Test In Adults With Obesity
Authors: Paopongpaiboon Pimonrat , Santisitthanon Prangareeya , Houngngam Natnicha , Snabboon Thiti , Boonchaya-anant Patchaya 
Published: October 2023

Abstract
Disclosure: P. Paopongpaiboon: None. P. Santisitthanon: None. N. Houngngam: None. T. Snabboon: None. P. Boonchaya-anant: None.
Background: The 1-mg overnight dexamethasone suppression test is the most frequently used screening test for Cushing’s syndrome. It has been proposed that obese patients may have insufficient plasma dexamethasone levels for the test which may result in false positives. We sought to compare the plasma dexamethasone levels after 1-mg DST in healthy obese participants and in normal-weight participants. Methods: A total of 30 normal-weight participants (BMI ≤ 25 kg/m2) and 62 obese participants (BMI &gt;25 kg/m2) were enrolled in the study. Obese patients were further divided into class 1 (25 - 29.9 kg/m2) and class 2 (&gt;30 kg/m2). After a standard overnight 1-mg dexamethasone suppression test, blood samples were obtained for serum cortisol and plasma dexamethasone levels. Plasma dexamethasone levels were quantified using liquid chromatography - mass spectrometry (LC-MS/MS). Results: No significant difference in plasma dexamethasone levels were found between obese and normal-weight participants (3.31 ± 1.35 vs 2.82 ± 1.11 nmol/L, mean ± SD; P=0.09 respectively). There were also no correlations found between sex, BMI, body surface area (BSA) and plasma dexamethasone levels. There was also no significant difference in the proportion of participants who achieved a plasma dexamethasone level &gt; 3.3 nmol/L in comparison between obesity class 1, obesity class 2, and normal-weight groups. Conclusion: We did not find a difference in plasma dexamethasone levels after 1-mg DST between obese and normal-weight participants. Our results suggest that BMI does not affect plasma dexamethasone levels and routine dexamethasone measurement may not help to identify false-positives using the 1-mg DST.
Presentation: Friday, June 16, 2023