bluuebunny/crossref_metadata_2025_split huggingface dataset:
Pleomorphic Xanthoastrocytoma: Multi-Institutional Evaluation of Stereotactic Radiosurgery
Authors: Düzkalir Ali Haluk , Samanci Yavuz , Nabeel Ahmed M. , Reda Wael A. , Tawadros Sameh R. , Abdelkarim Khaled , El-Shehaby Amr M. N. , Emad Reem M. , Martínez Moreno Nuria , Martínez Álvarez Roberto , Mathieu David , Niranjan Ajay , Lunsford L. Dade , Wei Zhishuo , Shanahan Regan M. , Liscak Roman , May Jaromir , Dono Antonio , Blanco Angel I. , Esquenazi Yoshua , Dayawansa Samantha , Sheehan Jason , Tripathi Manjul , Shepard Matthew J. , Wegner Rodney E. , Upadhyay Rituraj , Palmer Joshua D. , Peker Selcuk 
Published: June 2024

BACKGROUND AND OBJECTIVES:
Pleomorphic xanthoastrocytoma (PXA) is a rare low-grade glial tumor primarily affecting young individuals. Surgery is the primary treatment option; however, managing residual/recurrent tumors remains uncertain. This international multi-institutional study retrospectively assessed the use of stereotactic radiosurgery (SRS) for PXA.

METHODS:
A total of 36 PXA patients (53 tumors) treated at 11 institutions between 1996 and 2023 were analyzed. Data included demographics, clinical variables, SRS parameters, tumor control, and clinical outcomes. Kaplan-Meier estimates summarized the local control (LC), progression-free survival, and overall survival (OS). Secondary end points addressed adverse radiation effects and the risk of malignant transformation. Cox regression analysis was used.

RESULTS:
A total of 38 tumors were grade 2, and 15 tumors were grade 3. Nine patients underwent initial gross total resection, and 10 received adjuvant therapy. The main reason for SRS was residual tumors (41.5%). The median follow-up was 34 months (range, 2-324 months). LC was achieved in 77.4% of tumors, with 6-month, 1-year, and 2-year LC estimates at 86.7%, 82.3%, and 77.8%, respectively. Younger age at SRS (hazard ratios [HR] 3.164), absence of peritumoral edema (HR 4.685), and higher marginal dose (HR 6.190) were significantly associated with better LC. OS estimates at 1, 2, and 5 years were 86%, 74%, and 49.3%, respectively, with a median OS of 44 months. Four patients died due to disease progression. Radiological adverse radiation effects included edema (n = 8) and hemorrhagic change (n = 1). One grade 3 PXA transformed into glioblastoma 13 months after SRS.

CONCLUSION:
SRS offers promising outcomes for PXA management, providing effective LC, reasonable progression-free survival, and minimal adverse events.
Stress granule-mediated sequestration of EGR1 mRNAs correlates with lomustine-induced cell death prevention
Authors: Leśniczak-Staszak Marta , Pietras Paulina , Ruciński Marcin , Johnston Ryan , Sowiński Mateusz , Andrzejewska Małgorzata , Nowicki Michał , Gowin Ewelina , Lyons Shawn M. , Ivanov Pavel , Szaflarski Witold 
Published: June 2024

ABSTRACT
Some chemotherapy drugs modulate the formation of stress granules (SGs), which are RNA-containing cytoplasmic foci contributing to stress response pathways. How SGs mechanistically contribute to pro-survival or pro-apoptotic functions must be better defined. The chemotherapy drug lomustine promotes SG formation by activating the stress-sensing eIF2α kinase HRI (encoded by the EIF2AK1 gene). Here, we applied a DNA microarray-based transcriptome analysis to determine the genes modulated by lomustine-induced stress and suggest roles for SGs in this process. We found that the expression of the pro-apoptotic EGR1 gene was specifically regulated in cells upon lomustine treatment. The appearance of EGR1-encoding mRNA in SGs correlated with a decrease in EGR1 mRNA translation. Specifically, EGR1 mRNA was sequestered to SGs upon lomustine treatment, probably preventing its ribosome translation and consequently limiting the degree of apoptosis. Our data support the model where SGs can selectively sequester specific mRNAs in a stress-specific manner, modulate their availability for translation, and thus determine the fate of a stressed cell.
Contemporary Issue: Health and Safety of Female Wrestlers
Authors: Jagim Andrew R. , Moschelli Jill S. , Woodroffe Lisa M. , Horswill Craig A. , Bloomfield Susan A. , Oppliger ∗Robert A. 
Published: June 2024

Abstract
Female wrestling has grown exponentially over the past decade. Within the United States, 46 states now recognize female high school wrestling, and 153 colleges have programs. It is on track to become an NCAA championship-level sport in 2026. A primary health and safety risk among this cohort pertains to rapid weight loss strategies. These can lead to intentional caloric restriction and decreased body fatness, with the perceived goal of attaining a competitive advantage. Low energy availability and low body fatness are associated with a number of health concerns including menstrual dysfunction and loss of bone mineral density in girls and women. The current recommendation of 12% as a minimum for percentage body fat is very likely too low, opening the door for health perturbations among this population. The minimum threshold might more appropriately fall within the range of 18% to 20%. Body fat assessment methods, primarily skinfold measures that are used to guide weight class selection, have not been adequately validated among this population and therefore should be an area of research focus, while also exploring alternative assessment techniques. Further, we recommend that weight cycling, restrictive energy intake, and intentional dehydration be avoided. Research should assess the effects of frequent weight cycling (to “make weight”) and prolonged periods of low body fat on the reproductive and bone health of these athletes. Finally, research and clinical evaluations on female wrestlers are limited, and we offer a list of research priorities for future investigation into this contemporary issue.
Relationships between glomerular filtration rate and HRV/EEG parameters
Authors: Ruzhylo Sofiya , Popovych Dariya , Duzhar Viktor , Żukow Xawery , Zakalyak Nataliya , Kovalchuk Halyna , Rohalya Yuriy , Masnyi Oleg 
Published: June 2024

Background. Sympathetic outflow may be capable of selectively increasing or decreasing glomerular capillary pressure and hence glomerular filtration rate (GFR) by differentially activating separate populations of renal nerves. Sympathetic outflow to the kidney is regulated by major cortical, brainstem and medullary areas. The purpose of this study is to find out the relationship between GFR and HRV/EEG parameters as markers of the neural regulation of the kidney.
Materials and Methods. The object of observations were 10 men aged 37-69 years without clinical diagnosis tested twice with 7-days interval. The rate of glomerular filtration was calculated according to endogenous creatinine clearance and the Cockcroft & Gault formula. The state of the autonomic nervous system was assessed by the HRV method. Simultaneosly qEEG recorded.
Results. For the sample as a whole, a weak (r=0.396; p>0.05) correlation was found between HRV-marker of sympathetic tone and GFR. However, two clusters of individuals can be distinguished: with a strong correlation (r=0.852; n=12) and its complete absence (n=8). The qEEG method revealed neural structures generating delta and theta rhythms that upregulate GFR, and generating beta rhythm that downregulate GFR. The regression model, which includes 16 EEG parameters, allows estimating GFR with a standard error of 3,4 mL/min.
Conclusion. Glomerular filtration rate is subject to the modulatory regulatory influence of the nervous system and can be estimated with high accuracy by EEG parameters.
Failure of the PD-1 blocking agent pembrolizumab to benefit a patient with renal squamous cell cancer
Authors: Khan Salman , Yetiskul Ekrem , Khattar Georges , Ghada Araji , Afif Sarah , Khan Malik Waleed Zeb , Manchandani Umesh 
Published: June 2024

Introduction: Renal squamous cell carcinoma (SCC) is a neoplasm with an extremely rare occurrence compared to other renal malignancies. The classic presentation includes a palpable mass and flank pain; however, the presentation is seldom non-specific. Our study describes the significance of programmed death ligand-1 (PD-L1) expression in renal cancer and its association with clinical outcomes, alongside available treatment options. Case description: An 80-year-old female with a history of hypertension and cerebral aneurysm presented with right flank pain and blood in urine and was diagnosed with pyelonephritis and left renal mass/phlegmon. A biopsy revealed SCC of the kidney with metastasis to the lung and aortocaval lymph node. Positron emission tomography (PET) scan confirmed malignancy in the kidney and lung. Treatment with pemrolizumab and carboplatin plus paclitaxel was initiated but poorly tolerated as the haemoglobin dropped rapidly. Conclusion: SCC poses a diagnostic challenge due to its rarity and non-specific symptoms, often leading to advanced stage diagnosis. PD-L1 expression is pivotal in assessing tumour aggressiveness and prognosis. PD-L1 inhibitors offer promise, but their efficacy in renal SCC warrants further investigation. Radical nephrectomy and systemic chemotherapy show potential in advanced cases, necessitating vigilant management of treatment-related side effects. This case emphasises the need for ongoing research to refine therapeutic approaches and enhance outcomes in renal SCC patients.
Right atrial thrombus masquerading as myxoma
Authors: Alchalabi Shahad , Museedi Abdulrahman S. 
Published: June 2024

Introduction: In-situ right atrial (RA) thrombus is a rare occurrence typically associated with heightened inflammatory or hypercoagulable states. Here, we present a case of in-situ RA thrombus mimicking atrial myxoma in a patient with sepsis and bacteraemia. Case description: A 41-year-old man presented with septic arthritis and bacteraemia caused by methicillin-resistant Staphylococcus aureus (MRSA). A transoesophageal echocardiogram revealed a large pediculated mass resembling atrial myxoma, which was not visible on transthoracic echocardiography performed four days earlier. Cardiac magnetic resonance (CMR) imaging strongly suggested a thrombus, leading to the patient undergoing transcatheter aspiration. Subsequent pathology confirmed an organised fibrin thrombus without evidence of infection. Discussion: The patient’s in-situ RA thrombus likely developed in response to a heightened inflammatory state associated with sepsis. Limited data exist on in-situ RA thrombi in the absence of atrial fibrillation, though some reports suggest a correlation between heightened inflammation and a hypercoagulable state. Conclusion: CMR imaging is invaluable for characterising such masses and can aid in distinguishing a thrombus from a myxoma.
Anal metastasis in esophageal cancer: A case report
Authors: Xu Lu , Xu Rui , Sun Jing 
Published: June 2024

BACKGROUND
Esophageal cancer is the sixth leading cause of cancer-related death and eighth most common cancer, affecting > 450000 people worldwide. Esophageal squamous cell carcinoma is the most common histological type, whereas esophageal adenoid cystic carcinoma (EACC) is rare. The liver is the most common distant metastatic site in esophageal cancer. Anal metastasis is rare and has not been reported in clinical practice before. Here, we report anal metastases in a patient with EACC after regular chemotherapy and surgical resection.
CASE SUMMARY
A 61-year-old esophageal cancer patient was found to have lung and brain metastases during standardized treatment. The patient’s treatment plan was continuously adjusted according to the latest treatment guidelines. However, the patient subsequently noticed rectal bleeding and itching, and after obtaining pathology results at the local hospital, anal metastasis of esophageal cancer was diagnosed.
CONCLUSION
Postoperative pathology and immunohistochemistry confirmed EACC with rare anal metastasis. More exploration of EACC diagnosis and treatment is needed.
Special stent for draining the abdominal abscess respectively from colon and duodenum: A case report
Authors: Zhang Fu-Long , Xu Jing , Jiang Yu-Hong , Zhu Yuan-Dong , Wu Qian-Neng , Shi Yan , Zhan Zong-Yuan , Wang Hai 
Published: June 2024

BACKGROUND
Postoperative abdominal infections are an important and heterogeneous health challenge. Many samll abdominal abscesses are resolved with antibiotics, but larger or symptomatic abscesses may require procedural management.
CASE SUMMARY
A 65-year-old male patient who suffered operation for the left hepatocellular carcinoma eight months ago, came to our hospital with recurrent abdominal pain, vomit, and fever for one month. Abdominal computed tomography showed that a big low-density dumbbell-shaped mass among the liver and intestine. Colonoscopy showed a submucosal mass with a fistula at colon of liver region. Gastroscopy showed a big rupture on the submucosal mass at the descending duodenum and a fistula at the duodenal bulb. Under colonoscopy, the brown liquid and pus were drained from the mass with “special stent device”. Under gastroscopy, we closed the rupture of the mass with a loop and six clips for purse stitching at the descending duodenum, and the same method as colonoscopy was used to drain the brown liquid and pus from the mass. The symptom of abdominal pain, vomit and fever were relieved after the treatment.
CONCLUSION
The special stent device could be effectively for draining the abdominal abscess respectively from colon and duodenum.
Analysis of an adult diabetes mellitus caused by a rare mutation of the gene: A case report
Authors: Li Wen-Xuan , Xu Li-Li , Liu Chuan-Feng , Dong Bing-Zi , Wang Yun-Yang 
Published: June 2024

BACKGROUND
This study presents the clinical and genetic mutation characteristics of an unusual case of adult-onset diabetes mellitus occurring in adolescence, featuring a unique mutation in the peroxisome proliferator-activated receptor gamma (PPARG) gene. Data Access Statement: Research data supporting this publication are available from the NN repository at www.NNN.org/download/ .
CASE SUMMARY
The methodology employed entailed meticulous collection of comprehensive clinical data from the probands and their respective family members. Additionally, high-throughput sequencing was conducted to analyze the PPARG genes of the patient, her siblings, and their offspring. The results of this investigation revealed that the patient initially exhibited elevated blood glucose levels during pregnancy, accompanied by insulin resistance and hypertriglyceridemia. Furthermore, these strains displayed increased susceptibility to diabetic kidney disease without any discernible aggregation patterns. The results from the gene detection process demonstrated a heterozygous mutation of guanine (G) at position 284 in the coding region of exon 2 of PPARG , which replaced the base adenine (A) (exon2c.284A>Gp.Tyr95Cys). This missense mutation resulted in the substitution of tyrosine with cysteine at the 95th position of the translated protein. Notably, both of her siblings harbored a nucleotide heterozygous variation at the same site, and both were diagnosed with diabetes.
CONCLUSION
The PPARG gene mutation, particularly the p.Tyr95Cys mutation, may represent a newly identified subtype of maturity-onset diabetes of the young. This subtype is characterized by insulin resistance and lipid metabolism disorders.
Luspatercept enhances hemoglobin levels in a Chinese boy with congenital sideroblastic anemia: A case report
Authors: Li Yuan , Ye Lei , Zhou Kang , Fan Hui-Hui , Li Jian-Ping , Xiong You-Zhen , Yang Yang , Peng Guang-Xin , Yang Wen-Rui , Zhao Xin , Jing Li-Ping , Zhang Li , Zhang Feng-Kui 
Published: June 2024

BACKGROUND
Congenital sideroblastic anemia (CSA) is a rare and heterogeneous group of genetic disorders. Conventional treatment include pyridoxine (vitamin B6) and allogeneic hematopoietic stem cell transplantation (allo-HSCT), and can alleviate anemia in the majority of cases. Nevertheless, some CSA cases remain unresponsive to pyridoxine or are unable to undergo allo-HSCT. Novel management approaches is necessary to be developed. To explore the response of luspatercept in treating congenital sideroblastic anemia.
CASE SUMMARY
We share our experience in luspatercept in a 4-year-old male patient with CSA. Luspatercept was administered subcutaneously at doses of 1.0 mg/kg/dose to 1.25 mg/kg/dose every 3 wk, three consecutive doses, evaluating the hematological response. Luspatercept leading to a significant improvement in the patient's anemia. The median hemoglobin during the overall treatment with three doses of luspatercept was 90 (75-101) g/L, the median absolute reticulocyte count was 0.0593 (0.0277-0.1030) × 1012/L, the median serum ferritin was 304.3 (234.4-399) ng/mL, and the median lifespan of mature red blood cells was 80 (57-92) days. Notably, no adverse reactions, such as headaches, dizziness, vomiting, joint pain, or back pain, were observed during the treatment period.
CONCLUSION
We believe that luspatercept might emerge as a viable therapeutic option for the maintenance treatment of CSA or as a bridging treatment option before hematopoietic stem cell transplantation.
Piezoelectrically tunable, narrow linewidth photonic integrated extended-DBR lasers
Authors: Siddharth Anat , Attanasio Alaina , Bianconi Simone , Lihachev Grigory , Zhang Junyin , Qiu Zheru , Bancora Andrea , Kenning Scott , Wang Rui Ning , Voloshin Andrey S. , Bhave Sunil A. , Riemensberger Johann , Kippenberg Tobias J. 
Published: June 2024

Recent advancements in ultra-low-loss silicon nitride (Si3N4)-based photonic integrated circuits have surpassed fiber lasers in coherence and frequency agility. However, high manufacturing costs of DFB and precise control requirements, as required for self-injection locking, hinder widespread adoption. Reflective semiconductor optical amplifiers (RSOAs) provide a cost-effective alternative solution but have not yet achieved similar performance in coherence or frequency agility, as required for frequency modulated continuous wave (FMCW) LiDAR, laser locking in frequency metrology, or wavelength modulation spectroscopy for gas sensing. Here, we overcome this challenge and demonstrate an RSOA-based and frequency-agile fully hybrid integrated extended distributed Bragg reflector (E-DBR) laser with high-speed tuning, good linearity, high optical output power, and turn-key operability. It outperforms Vernier and self-injection locked lasers, which require up to five precise operating parameters and have limitations in continuous tuning and actuation bandwidth. We maintain a small footprint by utilizing an ultra-low-loss 200 nm thin Si3N4 platform with monolithically integrated piezoelectric actuators. We co-integrate the DBR with a compact ultra-low-loss spiral resonator to further reduce the intrinsic optical linewidth of the laser to the Hertz-level—on par with the noise of a fiber laser—via self-injection locking. The photonic integrated E-DBR lasers operate at 1550 nm and feature up to 25 mW fiber-coupled output power in the free-running and up to 10.5 mW output power in the self-injection locked state. The intrinsic linewidth is 2.5 kHz in the free-running state and as low as 3.8 Hz in the self-injection locked state. In addition, we demonstrate the suitability for FMCW LiDAR by showing laser frequency tuning over 1.0 GHz at up to 100 kHz triangular chirp rate with a nonlinearity of less than 0.6% without linearization by modulating a Bragg grating using monolithically integrated aluminum nitride (AlN) piezoactuators.
Metabolic and genetic risk factors associated with pre-diabetes and type 2 diabetes in Thai healthcare employees: A long-term study from the Siriraj Health (SIH) cohort study
Authors: Mongkolsucharitkul Pichanun , Surawit Apinya , Manosan Thamonwan , Ophakas Suphawan , Suta Sophida , Pinsawas Bonggochpass , Pongkunakorn Tanyaporn , Pumeiam Sureeporn , Ratanasuwan Winai , Homsanit Mayuree , Charoencholvanich Keerati , Udomphorn Yuthana , Suktitipat Bhoom , Mayurasakorn Korapat 
Published: June 2024

Background
The study of non-communicable diseases (NCDs) in a developing country like Thailand has rarely been conducted in long-term cohorts, especially among the working-age population. We aim to assess the prevalence and incidence of risk factors and their associations underlying NCDs, especially type-2 diabetes mellitus (T2DM) among healthcare workers enrolled in the Siriraj Health (SIH) study cohort.

Methods
The SIH study was designed as a longitudinal cohort and conducted at Siriraj hospital, Thailand. A total of 5,011 participants (77% women) were recruited and follow-up. Physical examinations, blood biochemical analyses, family history assessments, behavior evaluations, and genetics factors were assessed.

Results
The average age was 35.44±8.24 years and 51% of participants were overweight and obese. We observed that men were more likely to have a prevalence of T2DM and dyslipidemia (DLP) compared to women. Aging was significantly associated with pre-diabetes and T2DM (P<0.001). Additionally, aging, metabolic syndrome, and elevated triglycerides were associated with the development of pre-diabetes and T2DM. The minor T allele of the rs7903146(C/T) and rs4506565 (A/T) were associated with a high risk of developing pre-diabetes with odds ratios of 2.74 (95% confidence interval [CI]: 0.32–23.3) and 2.71 (95% CI: 0.32–23.07), respectively; however, these associations were statistically insignificant (P>0.05).

Conclusion
The findings of the SIH study provide a comprehensive understanding of the health status, risk factors, and genetic factors related to T2DM in a specific working population and highlight areas for further research and intervention to address the growing burden of T2DM and NCDs.
Identifying stigmatizing language in clinical documentation: A scoping review of emerging literature
Authors: Barcelona Veronica , Scharp Danielle , Idnay Betina R. , Moen Hans , Cato Kenrick , Topaz Maxim 
Published: June 2024

Background
Racism and implicit bias underlie disparities in health care access, treatment, and outcomes. An emerging area of study in examining health disparities is the use of stigmatizing language in the electronic health record (EHR).

Objectives
We sought to summarize the existing literature related to stigmatizing language documented in the EHR. To this end, we conducted a scoping review to identify, describe, and evaluate the current body of literature related to stigmatizing language and clinician notes.

Methods
We searched PubMed, Cumulative Index of Nursing and Allied Health Literature (CINAHL), and Embase databases in May 2022, and also conducted a hand search of IEEE to identify studies investigating stigmatizing language in clinical documentation. We included all studies published through April 2022. The results for each search were uploaded into EndNote X9 software, de-duplicated using the Bramer method, and then exported to Covidence software for title and abstract screening.

Results
Studies (N = 9) used cross-sectional (n = 3), qualitative (n = 3), mixed methods (n = 2), and retrospective cohort (n = 1) designs. Stigmatizing language was defined via content analysis of clinical documentation (n = 4), literature review (n = 2), interviews with clinicians (n = 3) and patients (n = 1), expert panel consultation, and task force guidelines (n = 1). Natural language processing was used in four studies to identify and extract stigmatizing words from clinical notes. All of the studies reviewed concluded that negative clinician attitudes and the use of stigmatizing language in documentation could negatively impact patient perception of care or health outcomes.

Discussion
The current literature indicates that NLP is an emerging approach to identifying stigmatizing language documented in the EHR. NLP-based solutions can be developed and integrated into routine documentation systems to screen for stigmatizing language and alert clinicians or their supervisors. Potential interventions resulting from this research could generate awareness about how implicit biases affect communication patterns and work to achieve equitable health care for diverse populations.