bluuebunny/crossref_metadata_2025_split huggingface dataset:
Hyperthyroidism in non-seminomatous testicular germ cell tumors: two case reports and literature review
Authors: Favero Diletta , Oing Christoph , Seidel Christoph , Rescigno Pasquale , Catalano Fabio , Cremante Malvina , Rebuzzi Sara Elena , Gatto Federico , Rosti Giovanni , Ferone Diego , Fornarini Giuseppe , Cocchiara Francesco 
Published: March 2024

BackgroundHuman chorionic gonadotropin (hCG)–induced hyperthyroidism is a rare paraneoplastic syndrome observed in non-seminomatous testicular germ cell tumors, due to a cross-reaction between the β-subunit of hCG with the thyroid-stimulating hormone receptor. The precise prevalence of this paraneoplastic phenomenon is unclear as, in the majority of cases, hyperthyroidism remains subclinical.Case presentationHere, we present two cases of advanced metastatic non-seminomatous testicular germ cell tumors where patients exhibited signs and symptoms of thyrotoxicosis at primary diagnosis due to excessive serum β-hCG elevation, with complete remission of symptomatology after the start of oncological treatments and no signs of relapse at the time of publication of this report. Additionally, we provide a comprehensive review of the existing literature concerning this uncommon occurrence.ConclusionDespite being a rare event, the presence of hyperthyroidism or thyrotoxicosis without clear etiology in a young man should lead to consider less frequent causes such as testicular tumors. Even if patients typically have mild symptoms that resolve after chemotherapy, in rare cases, it can be a life-threatening condition that requires prompt recognition and specific intervention.
A real-world retrospective, observational study of first-line pembrolizumab plus chemotherapy for metastatic non-squamous non-small cell lung cancer with PD-L1 tumor proportion score < 50% (PEMBROREAL)
Authors: Cafaro Alessandro , Foca Flavia , Nanni Oriana , Chiumente Marco , Coppola Marina , Baldo Paolo , Orzetti Sabrina , Enrico Fiorenza , Ladisa Vito , Lerose Rosa , Nardulli Patrizia , Maiolino Piera , Gradellini Federica , Gasbarro Anna Rita , Carrucciu Gisella , Provasi Riccardo , Cappelletto Paola Cristina , Pasqualini Alessandra , Vecchia Stefano , Veraldi Marianna , De Francesco Adele Emanuela , Crinò Lucio , Delmonte Angelo , Masini Carla 
Published: March 2024

IntroductionThe phase III Keynote-189 trial established a first-line treatment combining pembrolizumab with pemetrexed and platinum as a standard treatment for patients with stage IV non-small cell lung cancer (NSCLC) without known EGFR and ALK driver mutations and independent of programmed cell death ligand 1 (PD-L1) expression. However, in Italy, eligibility for the National Health Service payment program is limited to patients with PD-L1 &lt;50%. The PEMBROREAL study assesses the real-world effectiveness and safety of pembrolizumab in patients eligible for the National Health Service payment program.MethodsPEMBROREAL is a retrospective, observational study on patients with NSCLC who started pembrolizumab combined with pemetrexed and platinum within the reimbursability time window, considered as December 2019 to December 2020. The primary endpoints were to assess progression-free survival (PFS) and overall survival (OS; using the Kaplan–Meier method), response to therapy, and tolerability.ResultsUntil February 2022, 279 patients (median follow-up: 19.7 months) have been observed. The median PFS was 8.0 months (95% confidence interval: 6.5–9.2). OS was not reached, but we can estimate a 12- to 24-month survival rate for the combined treatment: 66.1% and 52.5%, respectively. PD-L1 expression and Eastern Cooperative Group (ECOG) Performance Status were both associated with PFS and OS. Overall, only 44.4% of patients reported an adverse event, whereas toxicity led to a 5.4% discontinuation rate.ConclusionThe results of the PEMBROREAL study have shown that the combined treatment of pembrolizumab with pemetrexed and platinum is effective for metastatic non-squamous NSCLC, even for patients with PD-L1 levels below 50%, despite the differences in patient demographics and pathological features compared to the Keynote-189 study. The adverse events reported during the study were more typical of chemotherapy treatment rather than immunotherapy, and physicians were able to manage them easily.
Case report: Response to everolimus in a patient with platinum resistant, high grade serous ovarian carcinoma with biallelic TSC2 inactivation
Authors: Peterson Mariko , Kolin David L. , Konstantinopoulos Panagiotis A. 
Published: March 2024

BackgroundPatients with platinum-resistant recurrent high grade serous ovarian carcinoma have poor outcomes and limited treatment options.Case presentationWe present a case of a 48-year-old woman with platinum-resistant high grade serous ovarian carcinoma harboring the pathogenic TSC2 R611Q variant with concomitant single copy loss of TSC2 (suggesting biallelic TSC2 inactivation) identified in targeted tumor sequencing. The patient was treated with the mTOR inhibitor everolimus, with an excellent response by imaging and a marked decrease in CA125; she remained on everolimus for 19 months until she developed progressive disease.ConclusionsWhile mTOR inhibition is frequently used in tumors associated with tuberous sclerosis complex (TSC), such as lymphangioleiomyomatosis and malignant perivascular epithelioid cell tumors, this is the first case of a patient with ovarian cancer harboring TSC1/2 mutations who responded to mTOR inhibition. This case highlights the utility of targeted DNA sequencing in the management of ovarian carcinoma and demonstrates the value of tumor-agnostic targeted therapies.
Influence of the combination of SGLT2 inhibitors and GLP-1 receptor agonists on eGFR decline in type 2 diabetes: post-hoc analysis of RECAP study
Authors: Muta Yoshimi , Kobayashi Kazuo , Toyoda Masao , Tone Atsuhito , Suzuki Daisuke , Tsuriya Daisuke , Machimura Hideo , Shimura Hidetoshi , Takeda Hiroshi , Yokomizo Hisashi , Takeshita Kei , Chin Keiichi , Kanasaki Keizo , Tamura Kouichi , Miyauchi Masaaki , Saburi Masuo , Morita Miwa , Yomota Miwako , Kimura Moritsugu , Hatori Nobuo , Nakajima Shinichi , Ito Shun , Tsukamoto Shunichiro , Murata Takashi , Matsushita Takaya , Furuki Takayuki , Hashimoto Takuya , Umezono Tomoya , Takashi Yuichi , Kawanami Daiji 
Published: March 2024

Accumulating evidence has demonstrated that both SGLT2 inhibitors (SGLT2i) and GLP-1 receptor agonists (GLP1Ra) have protective effects in patients with diabetic kidney disease. Combination therapy with SGLT2i and GLP1Ra is commonly used in patients with type 2 diabetes (T2D). We previously reported that in combination therapy of SGLT2i and GLP1Ra, the effect on the renal composite outcome did not differ according to the preceding drug. However, it remains unclear how the initiation of combination therapy is associated with the renal function depending on the preceding drug. In this post hoc analysis, we analyzed a total of 643 T2D patients (GLP1Ra-preceding group, n = 331; SGLT2i-preceding group, n = 312) and investigated the differences in annual eGFR decline. Multiple imputation and propensity score matching were performed to compare the annual eGFR decline. The reduction in annual eGFR decline in the SGLT2i-preceding group (pre: −3.5 ± 9.4 mL/min/1.73 m2/year, post: −0.4 ± 6.3 mL/min/1.73 m2/year, p &lt; 0.001), was significantly smaller after the initiation of GLP1Ra, whereas the GLP1Ra-preceding group tended to slow the eGFR decline but not to a statistically significant extent (pre: −2.0 ± 10.9 mL/min/1.73 m2/year, post: −1.8 ± 5.4 mL/min/1.73 m2/year, p = 0.83) after the initiation of SGLT2i. After the addition of GLP1Ra to SGLT2i-treated patients, slower annual eGFR decline was observed. Our data raise the possibility that the renal benefits—especially annual eGFR decline—of combination therapy with SGLT2i and GLP1Ra may be affected by the preceding drug.
Genome-wide association studies identified OsTMF as a gene regulating rice seed germination under salt stress
Authors: Liu Lifeng , Ma Yanling , Zhao Heng , Guo Lin , Guo Yan , Liu Chun-Ming 
Published: March 2024

IntroductionSalt tolerance during seed germination is an important trait for direct seeding and low-cost rice production. Nevertheless, it is still not clear how seed germination under salt stress is regulated genetically.MethodsIn this study, genome-wide association studies (GWAS) were performed to decipher the genetic basis of seed germination under salt stress using 541 rice varieties collected worldwide.Results and discussionThree quantitative trait loci (QTLs) were identified including qGRG3-1 on chromosome 3, qGRG3-2 on chromosome 5, and qGRG4 on chromosome 4. Assessment of candidate genes in these loci for their responses to salt stress identified a TATA modulatory factor (OsTMF) in qGRG3-2. The expression of OsTMF was up-regulated in both roots and shoots after exposure to salt stress, and OsTMF knockout mutants exhibited delayed seed germination under salt stress. Haplotype analysis showed that rice varieties carrying OsTMF-Hap2 displayed elevated salt tolerance during seed germination. These results provide important knowledge and resources to improve rice seed germination under salt stress in the future.
Association of sugar-sweetened beverage consumption and sleep quality with anxiety symptoms: a cross-sectional study of Tibetan college students at high altitude
Authors: Qiu Qin , Chai Guangxin , Xie Shiming , Wu Tianyu 
Published: March 2024

BackgroundResearch on the association between sugar-sweetened beverages (SSBs) consumption and sleep quality with anxiety symptoms has been highly emphasized. However, past studies have focused on college students in plains areas, while fewer research studies have been conducted on Tibetan college students at high altitudes. Whether this association changes due to ethnicity or altitude is unclear. The present study will contribute to the prevention and intervention of depressive symptoms among Tibetan college students at high altitude.MethodsA self-assessment questionnaire was administered to 3,026 university students (1,491 boys students, 49.27%) on SSBs consumption, sleep quality and anxiety symptoms status in the Tibetan Plateau, a high-altitude region of China. Logistic regression analysis and ordered logistic regression analysis in generalized linear model were used to analyze the association between SSBs consumption and sleep quality with anxiety symptoms.ResultsThe prevalence of anxiety symptoms among Tibetan college students at high altitude was 26.9%. SSBs consumption of ≤1 times/week, 2–5 times/week, and ≥ 6 times/week were 20.7, 28.1, and 45.7%, respectively, with statistically significant differences (χ2 value of 134.353, p &lt; 0.001). Anxiety detection rates for Sleep quality of Good (PSQI ≤5), Moderate (PSQI 6–7), and Poor (PSQI &gt;7) were 16.8, 19.8, and 32.0%, respectively, and the difference was also statistically significant (χ2 value was 73.761, p &lt; 0.001). The ordered logistic regression analysis in the generalized linear model showed that, overall, the group of college students with SSBs ≤1 times/week and sleep quality of Good served as the reference group, and the group with SSBs ≥6 times/week and sleep quality of Poor (OR: 5.06, 95% CI: 3.75–6.83) had the highest risk of anxiety symptoms.ConclusionSSBs consumption and sleep quality were associated with anxiety symptoms, and there was an interaction effect. Effective control of SSBs consumption and improvement of sleep quality may be important factors in preventing and reducing the occurrence of anxiety symptoms.
Understanding stigma of dementia during COVID-19: a scoping review
Authors: Bacsu Juanita-Dawne R. , Spiteri Raymond J. , Nanson Kate , Rahemi Zahra , Webster Claire , Norman Myrna , Stone Chantelle 
Published: March 2024

IntroductionStigma of dementia is one of the greatest challenges for people living with dementia. However, there is little research on the different types of stigma of dementia in the COVID-19 pandemic. The purpose of this scoping review is to synthesize the existing literature on dementia-related stigma (self, public, and structural stigma), during the pandemic.MethodsGuided by Arksey and O’Malley’s scoping review framework and PRISMA guidelines, CINAHL, EMBASE, Google Scholar, Medline, PsycINFO, and Web of Science were searched for English language literature from January 2020 to June 2023. Inclusion criteria consisted of peer-reviewed, original research articles addressing stigma of dementia during the COVID-19 pandemic. Thematic analysis was used to analyze the data and steps were taken to ensure rigor.ResultsFifteen articles met our inclusion criteria. Four primary themes were identified including: 1) COVID-19 stereotypes and assumptions of dementia; 2) human rights issues and deprived dignity; 3) disparate access to health services and supports; and 4) cultural inequities and distrust.DiscussionThe COVID-19 pandemic has contributed to the stigmatization of people living with dementia. Further research is needed to develop, implement, and evaluate interventions targeted towards the different types of dementia-related stigma (including self, public, and structural stigma). Moreover, our findings highlight the need for more collaborative research that prioritizes the lived experience and input of diverse people living with dementia. Research partnerships with diverse people living with dementia are vital to improving future pandemic planning. Only through evidence-informed research and lived experience can we begin to fully address the different types of dementia-related stigma and enhance the quality of life of people living with dementia.
The impact of grandparenting on mental health among rural middle-aged and older adults in China: exploring the role of children’s support
Authors: Wang You-Hua , Hu Xiao-Liang , Li Yue 
Published: March 2024

ObjectivesIn the rural regions of China, characterized by a pronounced aging demographic and limited resources, a substantial proportion of middle-aged and older adults engage in grandparenting roles. Yet, the literature lacks consistent evidence regarding the effects of grandparenting on the mental health of this cohort. Accordingly, this study aimed to explore the impact of grandparenting on the mental health of rural middle-aged and older adults, as well as the underlying mechanisms.MethodsThis analysis encompassed 10,881 middle-aged and older adults, utilizing data from the 2018 Harmonized China Health and Retirement Longitudinal Study (CHARLS). The mental health of participants was assessed using the Center for Epidemiological Studies Depression-10 (CESD-10) scale, while support from children was categorized into financial and emotional types. The study employed logistic and OLS regression models to identify the mediating role of child support and utilized the Karlson-Holm-Breen (KHB) method for decomposing this mediating effect.ResultsThe findings demonstrated that grandparenting had a significant negative impact on depression among rural middle-aged and older adults. Furthermore, children’s support played a vital role in mediating this relationship, accounting for approximately one-third of the overall influence. Moreover, the decomposition analysis revealed that both emotional and economic support from adult children equally contributed to the declination of depression among rural middle-aged and older adults.ConclusionGrandparenting significantly enhances mental well-being in rural middle-aged and older adults, with the support from adult children serving as a vital pathway for this positive impact. Both economic and emotional assistance from children hold equal importance in this dynamic. It underscores the necessity of fortifying the family support system to amplify the support provided by children, which in turn could significantly enhance the mental health of rural middle-aged and older adults.
Exploring hospital resilience protective or risk factors: lessons for future disaster response efforts
Authors: Shi Wenwen , Chen Rujie , Wang Kuan , Wang Yixin , Gui Li 
Published: March 2024

BackgroundHospital resilience is essential in responding to disasters, but current research focuses mainly on frameworks and models rather than the protection of resilience and analysis of risk factors during public health emergencies. This study aims to examine the development of resilience in Chinese frontline hospitals during the initial COVID-19 outbreak in 2020, providing insights for future disaster response efforts.ObjectivesWe conducted interviews with 26 hospital staff members who were involved in the initial response to the COVID-19 outbreak in China. We used a semi-structured interview approach and employed purposive sampling and snowball sampling techniques. The interview outline was guided by the ‘Action Framework’ proposed by the World Health Organization (WHO) for responding to infectious disease emergencies. This framework includes dimensions such as command, surveillance, risk communication, medical response, and public health response. We analyzed the collected data using Colaizzi’s seven-step data analysis method and the template analysis method.ResultsWHO’s ‘action framework’ effectively highlights the factors that contribute to hospital resilience. While medical response, including the availability of materials and facilities, the use of information technology, and the capacity for infectious disease diagnosis and treatment, remains crucial, other important aspects include awareness and beliefs about infections, treatment experience, interdisciplinary collaboration, and more. Additionally, it is essential to establish an intelligent command system, foster trusting partnerships between teams, improve monitoring capabilities for infectious disease agents, enhance risk communication through information synchronization and transparency, strengthen infection control planning, and improve environmental disinfection capabilities for effective public health emergency response. These contradictions significantly impact the enhancement of hospital resilience in dealing with major infectious disease outbreaks.ConclusionIn responding to sudden major infectious diseases, hospitals play a vital role within the healthcare system. Enhancing hospital resilience involves more than just improving treatment capabilities. It also requires effective command coordination at the hospital level, infection control planning, and the deployment of intelligent equipment. Additionally, planning for effective communication and coordination between hospitals, communities, and the national healthcare system can further enhance hospital resilience.
Exploring the path to polio eradication: insights from consecutive seroprevalence surveys among Pakistani children
Authors: Hussain Imtiaz , Umer Muhammad , Khan Ahmad , Sajid Muhammad , Ahmed Imran , Begum Kehkashan , Iqbal Junaid , Alam Muhammad M. , Safdar Rana M. , Baig Shahzad , Voorman Arie , Partridge Jeffrey , Soofi Sajid 
Published: March 2024

IntroductionAfter trivalent oral poliovirus vaccine (tOPV) cessation, Pakistan has maintained immunity to type 2 poliovirus by administering inactivated polio vaccine (IPV) in routine immunization, alongside monovalent OPV type 2 (mOPV2) and IPV in supplementary immunization activities (SIAs). This study assesses the change in poliovirus type 2 immunity after tOPV withdrawal and due to SIAs with mOPV2 and IPV among children aged 6–11 months.MethodsThree cross-sectional sequential serological surveys were conducted in 12 polio high-risk areas of Pakistan. 25 clusters from each geographical stratum were selected utilizing probability proportional to size.ResultsSeroprevalence of type 2 poliovirus was 49%, with significant variation observed among surveyed areas; &lt;30% in Pishin, &gt;80% in Killa Abdullah, Mardan &amp; Swabi, and Rawalpindi. SIAs with IPV improved immunity from 38 to 57% in Karachi and 60 to 88% in Khyber. SIAs with IPV following mOPV2 improved immunity from 62 to 65% in Killa Abdullah, and combined mOPV2 and IPV SIAs in Pishin improved immunity from 28 to 89%. Results also reflected that immunity rates for serotypes 1 and 3 were consistently above 90% during all three phases and across all geographical areas.ConclusionThe study findings highlight the importance of implementing effective vaccination strategies to prevent the re-emergence of poliovirus. Moreover, the results provide crucial information for policymakers working toward achieving global polio eradication.
Alterations in Gut Microbiota and Their Correlation with Brain Beta-Amyloid Burden Measured by 18F-Florbetaben PET in Mild Cognitive Impairment Due to Alzheimer’s Disease
Authors: Kim Geon Ha , Kim Bori R. , Yoon Hai-Jeon , Jeong Jee Hyang 
Published: March 2024

(1) Background: This study investigated changes in the gut microbial composition of individuals with mild cognitive impairment (MCI) due to Alzheimer’s disease (AD) and their relationship with positron emission tomography (PET) amyloid accumulation. (2) Methods: In total, 17 cognitively normal individuals without amyloid-beta (Aβ) accumulation (Aβ−NC) and 24 with Aβ-positive mild cognitive impairment (Aβ+MCI) who underwent 18F-florbetaben PET and fecal bacterial 16S ribosomal RNA gene sequencing were enrolled. The taxonomic compositions of the Aβ−NC and Aβ+MCI groups were compared. The abundance of taxa was correlated with the standardized uptake value ratio (SUVR), using generalized linear models. (3) Results: There were significant differences in microbiome richness (ACE, p = 0.034 and Chao1, p = 0.024), alpha diversity (Shannon, p = 0.039), and beta diversity (Bray–Curtis, p = 0.018 and Generalized UniFrac, p = 0.034) between the Aβ−NC and Aβ+MCI groups. The global SUVR was positively correlated with the genus Intestinibacter (q = 0.006) and negatively correlated with the genera Roseburia (q = 0.008) and Agathobaculum (q = 0.029). (4) Conclusions: In this study, we identified significant changes in the gut microbiota composition that occur in individuals with MCI due to AD. In particular, the correlation analysis results between PET amyloid burden and gut microbial abundance showed that amyloid deposition is associated with a reduction in specific taxa involved in butyrate production.
SNACK BAR SORGUM DAN KACANG MERAH RENDAH INDEKS GLIKEMIK SEBAGAI MAKANAN SELINGAN TINGGI SERAT PENDERITA DIABETES MELITUS
Authors: Simanjuntak Rossa Rosefa , Sulaeman Agus , Moviana Yenny , Judiono Judiono 
Published: March 2024

ABSTRAK
Pengelolaan diet pada penderita diabetes tidak hanya terbatas pada restriksi kalori dan asupan karbohidrat, namun juga harus memperhatikan aspek gizi kualitatif lainnya seperti indeks glikemik (IG) dan konsumsi serat. Makanan dengan IG rendah dapat meningkatkan rasa kenyang serta menunda lapar. Konsumsi serat yang cukup dapat membantu mengontrol kadar glukosa darah, mengontrol kegemukan, obesitas serta mengurangi kadar kolesterol dalam darah. Tepung sorgum dan kacang merah memiliki kandungan rendah indeks glikemik dan tinggi serat. Tujuan penelitian ini untuk mengetahui pengaruh snack bar tepung sorgum dan kacang merah rendah indeks glikemik terhadap sifat organoleptik dan kadar serat. Penelitian ini menggunakan desain studi eksperimental dengan Rancangan Acak Lengkap (RAL) RAL 1 faktor yaitu imbangan 65% : 35%, imbangan 70% : 30%, dan imbangan 80% : 20%. Pengujian mutu dilakukan dengan uji hedonik yang dilakukan oleh 30 panelis agak terlatih dan uji enzimatik gravimetrik untuk pengujian kadar serat pada formula yang paling disukai. Hasil uji kruskal wallis menunjukkan ada perbedaan yang bermakna pada aspek rasa, sedangkan pada aspek warna, aroma dan tekstur tidak ada perbedaan yang bermakna. Kadar serat snack bar tepung sorgum dan kacang merah dari formula 2 sebesar 6,08 gram/ 100 gram. Produk ini belum dapat diterapkan sebagai terapi diet diabetes melitus karena hanya diteliti aspek organoleptik dan kadar serat.