bluuebunny/crossref_metadata_2025_split huggingface dataset:
An unusual cause of adrenal insufficiency with elevation of 17-hydroxyprogesterone: case report
Authors: Teti Claudia , Bezante Giampaolo , Gatto Federico , Khorrami Chokami Keyvan , Albertelli Manuela , Falchi Marco , Bovio Giulio , Nati Sandro Teresio , Ferone Diego , Boschetti Mara 
Published: May 2023

Abstract
Background
We present an intriguing case of primary adrenal lymphoma, with associated primary adrenal insufficiency (PAI), in a patient presenting a transitory partial 21-hydroxylase deficiency during the active phase of the adrenal disease.

Case presentation
An 85-years old woman was referred because of worsening asthenia, lumbar pain, generalized myalgia and arthralgia. During investigations a computed tomography (CT) scan evidenced two large bilateral adrenal masses, highly suspicious for primary adrenal tumor. The hormonal assessment revealed very low levels of morning plasma cortisol and 24-h urinary cortisol, elevated ACTH levels with low plasma concentration of aldosterone, pointing to the diagnosis of PAI. After diagnosis of PAI our patient started glucocorticoid and mineralcorticoid replacement therapy with clinical benefit. In order to further characterize the adrenal lesions, adrenal biopsy, was performed. The histology revealed a high grade non-Hodgkin lymphoma with an immunophenotype consistent with intermediate aspects between diffuse large B-cell and Burkitt lymphoma, with a high proliferation index (KI-67 > 90%). The patient received chemotherapy with epirubicin, vincristine, cyclophosphamide, and rituximab, associated with methylprednisolone that resulted in a complete clinical and radiological remission within one year. After 2 years from the diagnosis and a total of 6 cycles of rituximab, the patient was in good clinical condition and was taking only the replacement therapy for PAI. The patient initially presented also a slight increase of 17-hydroxyprogesterone (17-OHP) for age that normalize after resolution of lymphoproliferative disease.

Conclusions
In the presence of bilateral adrenal disease and/or in the presence of signs and symptoms of PAI clinicians must exclude the presence of PAL. The evidence of elevated ACTH-stimulated 17-OHP levels also in patients with other adrenal masses, together with the detection of elevated basal 17-OHP levels in our patient make it more plausible, in our view, an effect of the lesion on the “healthy” adrenal tissue residue than a direct secretory activity by the adrenal tumor.
The nonlinear correlation between alanine aminotransferase to high-density lipoprotein cholesterol ratio and the risk of diabetes: a historical Japanese cohort study
Authors: Cao Changchun , Hu Haofei , Han Yong , Yuan Shuting , Zheng Xiaodan , Zhang Xiaohua , Zan Yibing , Wang Yulong , He Yongcheng 
Published: May 2023

Abstract
Background
Low levels of high-density lipoprotein cholesterol (HDL-C) and high levels of alanine aminotransferase (ALT) are related to insulin resistance, metabolic syndrome, and diabetes mellitus (DM). However, evidence on the connection between the alanine aminotransferase to high-density lipoprotein cholesterol (ALT/HDL-C) ratio and diabetes mellitus (DM) risk was limited. The study aimed to investigate the relationship between baseline ALT/HDL-C ratio and DM among Japanese individuals.

Methods
This second analysis was based on a cohort study using open-source data. Data from 15,342 individuals who participated in the medical examination program were recorded at Murakami Memorial Hospital in Japan between 2004 and 2015. Smooth curve fitting, subgroup analysis, Cox proportional-hazards regression, and a series of sensitivity analyses were conducted to examine the relationship between ALT/HDL-C ratio and incident diabetes. The ability of the ALT/HDL-C ratio to predict diabetes was evaluated using a receiver operating characteristic curve analysis.

Results
After controlling for confounding covariates, the ALT/HDL-C ratio was found to be positively correlated to the DM risk in Japanese adults (HR: 1.01, 95%CI: 1.00–1.02, P = 0.049). This study also found a stable relationship between ALT/HDL-C ratio and diabetes after employing a series of sensitivity analyses. Additionally, there was a non-linear association between the ALT/HDL-C ratio and incident diabetes, and the ALT/HDL-C ratio inflection point was 30.12. When the ALT/HDL-C ratio was below 30.12, the present study discovered a significant positive association between the ALT/HDL-C ratio and incident diabetes (HR: 1.04, 95%CI: 1.02–1.06, P = 0.001). Furthermore, among liver enzymes, blood lipids, and anthropometric indicators, the ALT/HDL-C ratio best predicts DM (AUC = 0.75, 95%CI: 0.73–0.78).

Conclusion
Increased ALT/HDL-C ratio levels at baseline correlated to incident DM. The relationship between ALT/HDL-C ratio and incident DM was also non-linear. When the ALT/HDL-C ratio is below 30.12, there is a statistically significant positive correlation between the ALT/HDL-C ratio and incident DM.
Organ donation after euthanasia starting with anesthesia at home is legal in The Netherlands, Belgium, Canada and Spain
Authors: Mulder Johannes , Sonneveld Hans 
Published: May 2023

AbstractWe would like to respond to the article “Organ donation after euthanasia starting at home in a patient with multiple system atrophy Tajaâte et al., [2021] 22:120” on organ donation after euthanasia from home [ODEH]. Although we welcome the performance of ODEH, we would like to make some critical comments regarding the article, both in relation to factual inaccuracies and in terms of the vision expressed on this subject. In this letter we stress the protection of autonomy of vulnerable euthanasia patients, we contradict the assumption of illegality, we question if the anesthesia method utilized is optimal and correct a mistake in regard to an article to which is referred of ourselves.
Reply to reaction on ‘Organ donation after euthanasia starting at home in a patient with multiple system atrophy – case report’
Authors: Tajaâte Najat , van Dijk Nathalie , Pragt Elien , Shaw David , Kempener-Deguelle A , Jongh Wim de , Bollen Jan , van Mook Walther 
Published: May 2023

AbstractWe would like to respond to the comment we received from our colleagues on our case report about organ donation after euthanasia starting at home. We reply to their statements on medical and legal aspects, and provide more information on our view of informed consent.
The impact of the COVID-19 pandemic on the health and working conditions of nurses and its implications for policies: a cross-sectional study in Slovakia
Authors: Putekova Silvia , Martinkova Jana , Urickova Alena , Kober Lukas , Reichertova Stanislava , Plancikova Dominika , Majdan Marek 
Published: May 2023

Abstract
Background
Increased workload and of the health workforce (HW) strained the capacity to maintain essential health services (EHS) during the Coronavirus Disease 2019 (COVID-19) pandemic, while putting them at increased risk of COVID-19 and other consequences to their health. The aim of this study was to assess the impact of COVID-19 on the health, wellbeing, and working conditions of nurses in Slovakia and to identify gaps in policies to be addressed to increase preparedness of the HW for future emergencies.

Methods
A nation-wide cross-sectional study was conducted among nurses during November–December 2021, referring to the period of January 2021 to November 2021. To assess the differences between impact on HW on various levels of care, respondents were grouped by type of facility: hospital-COVID-19 wards; Hospital–non-covid ward; Outpatient or ER; Other care facilities.

Results
1170 nurses participated, about 1/3 of them tested positive for COVID-19 by November 2021, mostly developing mild disease. Almost 2/3 reported long-covid symptoms and about 13% reported that they do not plan to get vaccinated against COVID-19. The median of the score of the impact of workload on health was 2.8 (56% of the maximum 5), the median score of mental health-wellbeing was 1.9 (63% of a maximum of 3). The studied impacts in all domains were highest in nurses working in COVID-19 hospital wards. Significant disruptions of health care were reported, with relatively high use of telemedicine to mitigate them. Overall, about 70% of the respondents thought of leaving their job, mostly due to working stress or inadequate pay.

Conclusions
Our study showed that the COVID-19 pandemic poses a substantial burden on the health, wellbeing and working conditions of nurses in Slovakia and that a large proportion of nurses considered leaving their jobs because of work overload or low salaries. Human resource strategies should be adopted to attract, retain and continuously invest in HW development including in emergency preparedness and response. Such an approach may improve the resilience and preparedness of the health system in Slovakia for future emergencies.
Perioperative and oncologic outcomes of transperitoneal versus retroperitoneal laparoscopic nephroureterectomy for upper urinary tract urothelial carcinoma: a systematic review and pooled analysis of comparative outcomes
Authors: Zhu Ping-yu , Wang Li , Li Kun-peng , Yin Shan , Chen Xiao-bin 
Published: May 2023

AbstractBackgroundThe debate on whether to choose a transperitoneal (TP) or retroperitoneal (RP) approach for treating upper urinary tract urothelial carcinoma (UTUC) with laparoscopic surgery has been drawing attention. This study aimed to systematically review and meta-analyze the existing evidence regarding oncologic and perioperative outcomes of transperitoneal laparoscopic radical nephroureterectomy (TLNU) and retroperitoneal laparoscopic radical nephroureterectomy (RLNU) in managing UTUC.MethodsA comprehensive literature search was conducted using PubMed, Scopus, Embase, and Google Scholar for identifying randomized controlled trials (RCTs) and observational studies that evaluated the outcomes of TLNU and RLNU for UTUC. Continuous variables were represented by weighted mean difference (WMD) and standard mean difference (SMD), while binary variables were represented by odds ratio (OR), with 95% confidence intervals (CIs). The quality was assessed using the Newcastle–Ottawa scale. A sensitivity analysis was performed to evaluate the robustness of the estimates.ResultSix observational studies were incorporated into this meta-analysis. The overall TLNU was associated with significantly shorter operating time (WMD − 19.85; 95% CI − 38.03 to − 1.68;P = 0.03); longer recovery time of intestinal function (SMD 0.46; 95% CI 0.08 to 0.84;P = 0.02). However, the terms of estimated blood loss (WMD − 5.72; 95% CI − 19.6 to − 8.15;P = 0.42); length of stay (WMD − 0.35; 95% CI − 1.61 to 0.91;P = 0.59), visual analog pain scale (WMD − 0.38; 95% CI − 0.99 to 0.84;P = 0.22); drainage duration (WMD − 0.22; 95% CI − 0.61 to 0.17;P = 0.26); overall complication rates (OR 1.24; 95% CI 0.58 to 2.63;P = 0.58); local recurrence rate (OR 0.6; 95% CI 0.3 to 1.21;P = 0.16); distant metastasis (OR 0.94; 95% CI 0.04 to 20.77;P = 0.97); 1-year overall survival (OS) (OR 0.45; 95% CI 0.1 to 2.01;P = 0.3) showed no difference between TLNU and RLUN.ConclusionTLNU provides similar surgical outcomes and oncologic results compared to RLUN; however, TLNU has a shorter procedure time and prolonged intestinal function recovery time. Due to the heterogeneity among the studies, randomized clinical trials with follow-ups in the long term are required to obtain more definite results.Trial registrationwww.crd.york.ac.uk/prospero/, identifier CRD42023388554.
Vitamin D receptor (VDR) on the cell membrane of mouse macrophages participates in the formation of lipopolysaccharide tolerance: mVDR is related to the effect of artesunate to reverse LPS tolerance
Authors: Zhang Yu , Zhou Jun , Hua Ling , Li Pan , Wu Jiaqi , Shang Shenglan , Deng Fei , Luo Jing , Liao Mengling , Wang Nuoyan , Pan Xichun , Yuan Yue , Zheng Yue , Lu Yonglin , Huang Yasi , Zheng Jiang , Liu Xin , Li Xiaoli , Zhou Hong 
Published: May 2023

AbstractIt is unclear whether membrane vitamin D receptor (mVDR) exists on the macrophage membrane or whether mVDR is associated with lipopolysaccharide (LPS) tolerance. Herein, we report that interfering with caveolae and caveolae-dependent lipid rafts inhibited the formation of LPS tolerance. VDR was detected as co-localized with membrane molecular markers. VDR was detected on the cell membrane and its level was higher in LPS-tolerant cells than that in only LPS treatment cells. Anti-VDR antibodies could abolish the effect of artesunate (AS) to reverse LPS tolerance, and the wild-type peptides (H397 and H305) of VDR, but not the mutant peptide (H397D and H305A), led to the loss of AS’s effect. AS decreased the mVDR level in LPS-tolerant cells. In vivo, AS significantly reduced VDR level in the lung tissue of LPS-tolerant mice. In summary, mVDR exists on the cell membrane of macrophages and is closely associated with the formation of LPS tolerance and the effects of AS.
Discovery of CLEC2B as a diagnostic biomarker and screening of celastrol as a candidate drug for psoriatic arthritis through bioinformatics analysis
Authors: Niu Min , Yuan Jingman , Yan Meixi , Yang Ge , Yan Ziyi , Yang Xichao 
Published: May 2023

AbstractBackgroundPsoriatic arthritis (PSA) is a chronic, immune-mediated inflammatory joint disease that is liked to mortality due to cardiovascular disease. Diagnostic markers and effective therapeutic options for PSA remain limited due to the lack of understanding of the pathogenesis. We aimed to identify potential diagnostic markers and screen the therapeutic compounds for PSA based on bioinformatics analysis.MethodsDifferentially expressed genes (DEGs) of PSA were identified from the GSE61281 dataset. WGCNA was used to identify PSA-related modules and prognostic biomarkers. Clinical samples were collected to validate the expression of the diagnostic gene. These DEGs were subjected to the CMap database for the identification of therapeutic candidates for PSA. Potential pathways and targets for drug candidates to treat PSA were predicted using Network Pharmacology. Molecular docking techniques were used to validate key targets.ResultsCLEC2B was identified as a diagnostic marker for PSA patients (AUC > 0.8) and was significantly upregulated in blood samples. In addition, celastrol was identified as a candidate drug for PSA. Subsequently, the network pharmacology approach identified four core targets (IL6, TNF, GAPDH, and AKT1) of celastrol and revealed that celastrol could treat PSA by modulating inflammatory-related pathways. Finally, molecular docking demonstrated stable binding of celastrol to four core targets in the treatment of PSA. Animal experiments indicated celastrol alleviated inflammatory response in the mannan-induced PSA.ConclusionCLEC2B was a diagnostic marker for PSA patients. Celastrol was identified as a potential therapeutic drug for PSA via regulating immunity and inflammation.
A multi-center, randomized, parallel-group study to compare the efficacy of enhanced cognitive behavior therapy (CBT-E) with treatment as usual (TAU) for anorexia nervosa: study protocol
Authors: Nohara Nobuhiro , Yamanaka Yukari , Matsuoka Mikiko , Yamazaki Tadahiro , Kawai Keisuke , Takakura Shu , Sudo Nobuyuki , Ando Tetsuya , Matsuyama Yutaka , Byrne Susan , Dalle Grave Riccardo , Cooper Zafra , Yoshiuchi Kazuhiro 
Published: May 2023

Abstract
Background
The superiority of Enhanced Cognitive Behavior Therapy (CBT-E) with regard to weight gain and improvement of psychopathology of eating disorders for patients with anorexia nervosa (AN) over other psychotherapies and treatment as usual (TAU) has not been demonstrated in randomized controlled trials (RCTs). However, a previous RCT showed that patients with AN whose baseline body mass index (BMI) was less than 17.5 kg/m2 gained more weight when treated with CBT-E than with other psychotherapies. The aim of the study is to compare the efficacy of CBT-E and TAU for patients with AN. It was hypothesized that CBT-E would be superior to TAU, at least in terms of weight gain, as most patients with AN are likely to have a BMI lower than 17.5 kg/m2.

Methods/design
A randomized parallel-group multicenter trial will be conducted in three teaching hospitals in Japan between January 2023 and March 2026. Patients with DSM-5 AN, aged 16 years and older, with a BMI equal to or above 14.0 and below 18.5 will be eligible to participate. 56 patients will be randomly and evenly assigned to two intervention groups (CBT-E and TAU). Those assigned to CBT-E will be offered 25–40 sessions in accordance with their initial BMI. Patients assigned to TAU will have at least one session every 2 weeks, with the number of sessions and treatment period not fixed in advance. The primary outcome is BMI at 40 weeks after treatment initiation. The secondary outcomes are the results from the Japanese version of the Eating Disorder Examination Questionnaire and Clinical Impairment Assessment questionnaire to measure eating disorder psychopathology and psychological impairment. The follow-up assessment will be performed 6 months after the 40-week assessment.

Discussion
This multi-center randomized controlled study will probably evaluate the efficacy of CBT-E compared with TAU for patients with more severe AN than in previous studies since Japanese patients are likely to have a lower BMI than those in Western countries. While it may be difficult to generalize the results of a study conducted in Japan, it would be valuable to clarify the efficacy of CBT-E as a treatment package.

Trial registration
UMIN, UMIN000048847. Registered 12 Sep 2022.
Low electric field induction in BaTiO3-epoxy nanocomposites
Authors: Mishra Raghvendra Kumar , Li Danning , Chianella Iva , Goel Saurav , Lotfian Saeid , Yazdani Nezhad Hamed 
Published: May 2023

AbstractEpoxy is widely used material, but epoxy has limitations in terms of brittleness in failure, and thus researchers explore toughening and strengthening options such as adding a second phase or using electromagnetic fields to tailor toughness and strength, on demand and nearly instantaneously. Such approach falls into the category of active toughening but has not been extensively investigated. In this research, Si-BaTiO3 nanoparticles were used to modify the electro-mechanical properties of a high-performance aerospace-grade epoxy so as to study its response to electric fields, specifically low field strengths. To promote uniform dispersion and distribution, the Si-BaTiO3 nanoparticles were functionalised with silane coupling agents and mixed in the epoxy Araldite LY1564 at different content loads (1, 5, 10 wt%), which was then associated with its curing agent Aradur 3487. Real-time measurements were conducted using Raman spectroscopy while applying electric fields to the nanocomposite specimens. The Raman data showed a consistent trend of increasing intensity and peak broadening under the increasing electric field strength and Si-BaTiO3 contents. This was attributed to the BaTiO3 particles’ dipolar displacement in the high-content nanocomposites (i.e., 5 wt% and 10 wt%). The study offers valuable insights on how electric field stimulation can actively enhance the mechanical properties in epoxy composites, specifically in relatively low fields and thin, high-aspect-ratio composite layers which would require in-situ mechanical testing equipped with electric field application, an ongoing investigation of the current research.
Assessment of GNSS zenith tropospheric delay responses to atmospheric variables derived from ERA5 data over Nigeria
Authors: Nzelibe Ifechukwu Ugochukwu , Tata Herbert , Idowu Timothy Oluwadare 
Published: May 2023

AbstractTropospheric delay is a major error caused by atmospheric refraction in Global Navigation Satellite System (GNSS) positioning. The study evaluates the potential of the European Centre for Medium-range Weather Forecast (ECMWF) Reanalysis 5 (ERA5) atmospheric variables in estimating the Zenith Tropospheric Delay (ZTD). Linear regression models (LRM) are applied to estimate ZTD with the ERA5 atmospheric variables. The ZTD are also estimated using standard ZTD models based on ERA5 and Global Pressure and Temperature 3 (GPT3) atmospheric variables. These ZTD estimates are evaluated using the data collected from the permanent GNSS continuously operating reference stations in the Nigerian region. The results reveal that the Zenith Hydrostatic Delay (ZHD) from the LRM and the Saastamoinien model using ERA5 surface pressure are of identical accuracy, having a Root Mean Square (RMS) error of 2.3 mm while the GPT3-ZHD has an RMS of 3.4 mm. For the Zenith Wet Delay (ZWD) component, the best estimates are derived using ERA5 Precipitable Water Vapour (PWV). These include the ZWD derived by the LRM having an average RMS of 20.9 mm and Bevis equation having RMS of 21.1 mm and 21.0 mm for global and local weighted mean temperatures, respectively. The evaluation of GPT3-ZWD estimates gives RMS of 45.8 mm. This study has provided a valuable insight into the application of ERA5 data for ZTD estimation. In line with the findings of the study, the ERA5 atmospheric variables are recommended for improving the accuracy in ZTD estimation, required for GNSS positioning.
Optical spatiotemporal vortices
Authors: Wan Chenhao , Chong Andy , Zhan Qiwen 
Published: May 2023

AbstractSpatiotemporal vortices of light, featuring transverse orbital angular momentum (OAM) and energy circulation in the spatiotemporal domain, have received increasing attention recently. The experimental realization of the controllable generation of spatiotemporal vortices triggers a series of research in this field. This review article covers the latest developments of spatiotemporal vortices of light ranging from theoretical physics, experimental generation schemes, and characterization methods, to applications and future perspectives. This new degree of freedom in photonic OAM endowed by spatiotemporal vortices paves the way to the discovery of novel physical mechanisms and photonic applications in light science.
Electroencephalography microstates imbalance across the spectrum of early psychosis, autism, and mood disorders
Authors: Iftimovici Anton , Marchi Angela , Férat Victor , Pruvost-Robieux Estelle , Guinard Eléonore , Morin Valentine , Elandaloussi Yannis , D’Halluin Arnaud , Krebs Marie-Odile , Chaumette Boris , Gavaret Martine 
Published: May 2023

Abstract

Background
Electroencephalography (EEG) microstates translate resting-state temporal dynamics of neuronal networks throughout the brain and could constitute possible markers of psychiatric disorders. We tested the hypothesis of an increased imbalance between a predominant self-referential mode (microstate C) and a decreased attentional mode (microstate D) in psychosis, mood, and autism spectrum disorders.

Methods
We retrospectively included 135 subjects from an early psychosis outpatient unit, with available eyes-closed resting-state 19 electrodes EEG. Individual-level then group-level modified K-means clustering in controls provided four microstate maps that were then backfitted to all groups. Differences between microstate parameters (occurrence, coverage, and mean duration) were computed between controls and each group, and between disease groups.

Results
Microstate class D parameters were systematically decreased in disease groups compared with controls, with an effect size increasing along the psychosis spectrum, but also in autism. There was no difference in class C. C/D ratios of mean duration were increased only in SCZ compared with controls.

Conclusions
The decrease in microstate class D may be a marker of stage of psychosis, but it is not specific to it and may rather reflect a shared dimension along the schizophrenia-autism spectrum. C/D microstate imbalance may be more specific to schizophrenia.