bluuebunny/crossref_metadata_2025_split huggingface dataset:
Coexistence of TSH-secreting adenoma and primary hypothyroidism: a case report and review of literature
Authors: Ren Xiaolu , Wang Xu , Chen Ge , Liu Xiaohai , Guo Hongchuan , Li Mingchu 
Published: May 2023

Abstract
Background
Thyrotropin-secreting adenoma (TSHoma) is the least common type of pituitary adenoma, these patients often present with symptoms of hyperthyroidism. When TSHoma patients combined with autoimmune hypothyroidism, it is critically difficult to diagnose for the specific confusion in the results of thyroid function test.

Case presentation
One middle-aged male patient was presented with a sellar tumor on cranial MRI for headache symptoms. After hospitalization, a significant increase in thyrotropin (TSH) was revealed by the endocrine tests, while free thyronine (FT3) and free thyroxine (FT4) decreased, and the diffuse destruction of thyroid gland was revealed by thyroid ultrasound. Based on the endocrine test results, the patient was diagnosed as autoimmune hypothyroidism. After the multidisciplinary discussion, the pituitary adenoma was removed by endoscopic transnasal surgery, until the tumor was completely excised, for which TSHoma was revealed by postoperative pathology. A significant decrease of TSH was revealed by the postoperative thyroid function tests, the treatment for autoimmune hypothyroidism was conducted. After 20 months of follow-up, the thyroid function of patient had been improved significantly.

Conclusion
When the thyroid function test results of patients with TSHoma are difficult to interpret, the possibility of combined primary thyroid disease should be considered. TSHoma combined with autoimmune hypothyroidism is rare, which is difficult to diagnose. The multidisciplinary collaborative treatment could help to improve the outcomes of treatment.
Late postpartum depression and associated factors: community-based cross-sectional study
Authors: Wedajo Lema Fikadu , Alemu Solomon Seyife , Jarso Mohammedamin Hajure , Golge Aman Mamo , Dirirsa Dejene Edosa 
Published: May 2023

Abstract
Background
Late postpartum depression is the presence of depressive symptoms beyond the early postpartum period and is a significant mental health problem that has a devastating impact on mothers, infants, partners, family members, the healthcare system, and the world’s economy. However, there is limited information regarding this problem in Ethiopia.

Objective
To assess the prevalence of late postpartum depression and associated factors.

Method
the community-based cross-sectional study was employed among 479 postpartum mothers in Arba Minch town from May 21 to June 21, 2022. The pre-tested face-to-face interviewer administered a structured questionnaire used to collect the data. A bivariate and multivariable analysis was done using a binary logistic regression model to identify factors associated with late postpartum depression. Both crude and adjusted odds ratios with 95% CI were calculated, and a p-value of < 0.05 was used to declare statistically significant factors.

Result
The prevalence of late postpartum depression was 22.98% (95% CI: 19.16, 26.80). Husband Khat use (AOR = 2.64; 95% CI: 1.18, 5.91), partner dissatisfaction with the gender of the baby (AOR = 2.53; 95% CI: 1.22, 5.24), short inter-delivery interval (AOR = 6.80; 95% CI: 3.34, 13.84), difficulty to meet husband sexual need (AOR = 3.21; 95% CI: 1.62, 6.37), postpartum intimate partner violence (AOR = 4.08; 95% CI: 1.95, 8.54), and low social support (AOR = 2.50; 95% CI: 1.25, 4.50) were significantly associated factors at p-value < 0.05.

Conclusion
Overall, 22.98% of mothers suffered from late postpartum depression. Therefore, based on the identified factors, the Ministry of Health, Zonal Health Departments, and other responsible agencies should establish effective strategies to overcome this problem.
The mediating effect of coping styles between self-compassion and body image disturbance in young breast cancer survivors: a cross-sectional study
Authors: Zhu Fei , Liu Chunlei , Zhang Wan , Qiang Wanmin , Yin Xiaoping , Lu Qian 
Published: May 2023

Abstract
Background
Young breast cancer survivors with body image disturbance have poor quality of life. Self-compassion and different coping styles can influence their body image. The purpose of the study was to investigate the relationship between self-compassion, coping styles, and body image disturbance, and examined the mediation role of coping styles between self-compassion and body image disturbance among young breast cancer survivors in China.

Methods
In the cross-sectional study, a total of 310 young women with breast cancer were assessed on self-compassion, coping styles, and body image disturbance by self-reported questionnaires in China. Spearman’s correlation was used to test the links between variables and to verify the indirect effects between variables by constructing a structural equation model.

Results
There were correlations between self-compassion, different coping styles, and body image disturbance. Confrontation, avoidance, and acceptance-resignation coping had significant mediation effects on the association between self-compassion and body image disturbance. The mediation effects of confrontation coping were greater than avoidance, and acceptance-resignation coping.

Conclusions
In this study, different coping styles acted as mediators between self-compassion and body image disturbance, providing support for further understanding the mechanism between self-compassion and body image disturbance, and developing comprehensive interventions for body image disturbance. Oncology nurses should pay attention to the breast cancer survivors’ self-compassion and coping styles and encourage them to adopt adaptive coping strategies, which can reduce body image disturbance.
What drives the adoption of online health communities? An empirical study from patient-centric perspective
Authors: Zhang Qianyao , Zhang Runtong , Lu Xinyi , Zhang Xijing 
Published: May 2023

Abstract
Background
Online health communities (OHCs) provide platforms for patients to seek advice from physicians and receive professional suggestions online. It can improve the efficiency of patients’ diagnosis of simple diseases and alleviate hospital congestion. However, few empirical studies have comprehensively explored the factors influencing patients’ intention to use OHCs through objective data. This study aims to fill this gap by identifying key factors that influence patients’ acceptance of OHCs and proposing effective ways to promote the applications of OHCs in China.

Methods
Based on the Unified Theory of Acceptance and Usage of Technology (UTAUT), extended with additional constructs identified with patients’ information demands in OHCs, this study developed a research model and proposed nine hypotheses. An online survey involving 783 valid responses was conducted in China to collect data to validate the proposed model. Confirmatory factor analysis and partial least squares (PLS) path model were conducted for instrument validation and hypothesis testing.

Results
Price value, eHealth literacy, and performance expectancy are the most prominent constructs in the study context. Interestingly, relation quality was also found to have a significant positive relationship with behavioral intention.

Conclusions
Based on these findings, OHC operators need to create a user-friendly platform, improve information quality, set reasonable prices, and establish consummate security systems. Physicians and related organizations can raise awareness and assist patients in developing the skills to appropriately comprehend and utilize information in OHCs. This study contributes to both technology adoption theory and practice.
The effects of electronic nursing handover on patient safety in the general (non-COVID-19) and COVID-19 intensive care units: a quasi-experimental study
Authors: Tataei Azadeh , Rahimi Bahlol , Afshar Hadi Lotfnezhad , Alinejad Vahid , Jafarizadeh Hossein , Parizad Naser 
Published: May 2023

Abstract
Background
The unprecedented increase in the nurses’ workload is one of the issues affecting the quality and safety of patient care in the Intensive Care Units (ICUs). The electronic nursing handover can share sufficient, relevant, and necessary data about patients with greater efficiency and accuracy and prevent their information from being deleted. Therefore, this study aimed to determine and compare the effect of the Electronic Nursing Handover System (ENHS) on patient safety in General ICU and COVID-19 ICU.

Method
This is a quasi-experimental study conducted during an 8-month period from 22 to 2021 to 26 June 2022 using a test-retest design. A total of 29 nurses working in the General and COVID-19 ICUs participated in this study. Data were collected using a five-part questionnaire consisting of demographic information, handover quality, handover efficiency, error reduction, and handover time. Data analysis was conducted in IBM SPSS Statistics for Windows, version 26 (IBM Corp., Armonk, N.Y., USA) using the chi-squared test, paired t-test, and Analysis of Covariance (ANCOVA).

Results
The results showed that the mean scores of handover quality and efficiency, reduction of clinical error, and handover time in the electronic handover were significantly higher than those obtained in the paper-based method. The results showed that the mean score of patient safety in the COVID-19 ICU was 177.40 ± 30.416 for the paper-based handover and 251.40 ± 29.049 for the electronic handover (p = .0001). Moreover, the mean score of patient safety in the general ICU was 209.21 ± 23.072 for the paper-based handover and 251.93 ± 23.381 for the electronic one (p = .0001).

Conclusion
The use of ENHS significantly improved the quality and efficiency of shift handover, reduced the possibility of clinical error, saved handover time, and finally increased patient safety compared to the paper-based method. The results also showed the positive perspectives of ICU nurses toward the positive effect of ENHS on the patient safety improvement.
Oral contraceptive pills shortage in Lebanon amidst the economic collapse: a nationwide exploratory study
Authors: Itani Rania , Khojah Hani MJ , Karout Samar , Abu-Farha Rana , Mukattash Tareq L. , Rahme Deema , Housary Khouloud , Achi Hiam El , Safar Ali O. , Al Hajj Ismail Karam , El-Lakany Abdalla 
Published: May 2023

Abstract
Background
The political instability, economic crisis, and devaluation of the national currency left Lebanese females suffering from a scarcity of oral contraceptive pills (OCPs). Therefore, we aimed to identify the incidence of OCPs shortage in Lebanon and its impact on women’s sexual and reproductive health, as well as physical and psychological well-being.

Methods
Community pharmacies were selected randomly across Lebanon, using a stratified sampling approach, where female clients asking for OCPs were interviewed using a standardized data collection form.

Results
A total of 440 females were interviewed. More than three-quarters of the participants (76.4%) reported not finding their preferred OCPs brands, almost 40% were affected by the increased prices, and 28.4% declared stockpiling OCPs. More than half of the participants using OCPs for pregnancy prevention reported adopting alternative traditional contraceptive methods (55.3%). Unplanned pregnancy was reported by 9.5% of participants, where 75% of them disclosed intentional abortion while the remaining (25%) reported experiencing a spontaneous miscarriage. Other consequences of OCPs shortage included mood disturbances (52.3%), dysregulation of menses (49.7%), dysmenorrhea (21.1%), weight gain (19.6%), acne (15.7%), and hirsutism (12.5%). Of the participants taking OCPs for birth control, 48.6% reported a reduced frequency of sexual intercourse, which led to conflicts with their partners (46%) and a decreased libido (26.7%).

Conclusions
OCPs shortage has seriously and negatively exposed women to various undesirable consequences including unplanned pregnancy and dysregulation of menses. Therefore, there is an urgent need to bring the attention of healthcare authorities to support the national pharmaceutical industry in manufacturing affordable OCPs generics to meet women’s reproductive health demands.
Association between circulating fatty acid metabolites and asthma risk: a two-sample bidirectional Mendelian randomization study
Authors: Huang Tingting , Long Yichen , Ou Yang , Li Jia , Huang Yilin , Gao Jinming 
Published: May 2023

Abstract
Background
Fatty acids are involved in a wide range of immunological responses in humans. Supplementation of polyunsaturated fatty acids has been reported to help alleviate symptoms and airway inflammation in asthma patients, whereas the effects of fatty acids on the actual risk of asthma remain controversial. This study comprehensively investigated the causal effects of serum fatty acids on asthma risk using two-sample bidirectional Mendelian Randomization (MR) analysis.

Methods
Genetic variants strongly associated with 123 circulating fatty acid metabolites were extracted as instrumental variables, and a large GWAS data of asthma was used to test effects of the metabolites on this outcome. The inverse-variance weighted method was used for primary MR analysis. The weighted median, MR-Egger regression, MR-PRESSO, and leave-one-out analyses were utilized to evaluate heterogeneity and pleiotropy. Potential confounders were adjusted by performing multivariable MR analyses. Reverse MR analysis was also conducted to estimate the causal effect of asthma on candidate fatty acid metabolites. Further, we performed colocalization analysis to examine the pleiotropy of variants within the fatty acid desaturase 1 (FADS1) locus between the significant metabolite traits and the risk of asthma. Cis-eQTL-MR and colocalization analysis were also performed to determine the association between RNA expression of FADS1 and asthma.

Results
Genetically instrumented higher average number of methylene groups was causally associated with a lower risk of asthma in primary MR analysis, while inversely, the higher ratio of bis-allylic groups to double bonds and the higher ratio of bis-allylic groups to total fatty acids, were associated with higher probabilities of asthma. Consistent results were obtained in multivariable MR when adjusted for potential confounders. However, these effects were completely eliminated after SNPs correlated with the FADS1 gene were excluded. The reverse MR also found no causal association. The colocalization analysis suggested that the three candidate metabolite traits and asthma likely share causal variants within the FADS1 locus. In addition, the cis-eQTL-MR and colocalization analyses demonstrated a causal association and shared causal variants between FADS1 expression and asthma.

Conclusions
Our study supports a negative association between several PUFA traits and the risk of asthma. However, this association is largely attributed to the influence of FADS1 polymorphisms. The results of this MR study should be carefully interpreted given the pleiotropy of SNPs associated with FADS1.
Targeting oral tumor microenvironment for effective therapy
Authors: Budi Hendrik Setia , Farhood Bagher 
Published: May 2023

AbstractOral cancers are among the common head and neck malignancies. Different anticancer therapy modalities such as chemotherapy, immunotherapy, radiation therapy, and also targeted molecular therapy may be prescribed for targeting oral malignancies. Traditionally, it has been assumed that targeting malignant cells alone by anticancer modalities such as chemotherapy and radiotherapy suppresses tumor growth. In the last decade, a large number of experiments have confirmed the pivotal role of other cells and secreted molecules in the tumor microenvironment (TME) on tumor progression. Extracellular matrix and immunosuppressive cells such as tumor-associated macrophages, myeloid-derived suppressor cells (MDSCs), cancer-associated fibroblasts (CAFs), and regulatory T cells (Tregs) play key roles in the progression of tumors like oral cancers and resistance to therapy. On the other hand, infiltrated CD4 + and CD8 + T lymphocytes, and natural killer (NK) cells are key anti-tumor cells that suppress the proliferation of malignant cells. Modulation of extracellular matrix and immunosuppressive cells, and also stimulation of anticancer immunity have been suggested to treat oral malignancies more effectively. Furthermore, the administration of some adjuvants or combination therapy modalities may suppress oral malignancies more effectively. In this review, we discuss various interactions between oral cancer cells and TME. Furthermore, we also review the basic mechanisms within oral TME that may cause resistance to therapy. Potential targets and approaches for overcoming the resistance of oral cancers to various anticancer modalities will also be reviewed. The findings for targeting cells and potential therapeutic targets in clinical studies will also be reviewed.
Associations between physical and mental health and the utilization of ambulatory and emergency healthcare among asylum-seekers: results from a cross-sectional survey in Berlin, Germany
Authors: Gottlieb Nora , Siegel Martin 
Published: May 2023

Abstract
Background
Despite a high burden of chronic and mental illness, asylum-seekers show low utilization of ambulatory specialist healthcare. Forgoing timely healthcare when facing access barriers may direct them toward emergency care. This paper examines interrelations of physical and mental health and utilization of ambulatory and emergency care, and explicitly addresses associations between the different types of care.

Methods
A structural equation model was applied to a sample of n = 136 asylum-seekers living in accommodation centers in Berlin, Germany. Utilization patterns of emergency care (outcome) and physical and mental ambulatory care (endogenous predictors) were estimated, while controlling for age, gender, chronic conditions, bodily pain, depression, anxiety, length of stay in Germany (exogenous predictors) and self-rated health (endogenous predictor).

Results
Associations were observed between ambulatory care utilization and poor self-rated health (0.207, CI: 0.05; 0.364), chronic illness (0.096, CI: 0.017; 0.175) and bodily pain (0.019, CI: 0.002; 0.036); between mental healthcare utilization and anxiety (0.202, CI: 0.051; 0.352); and between emergency care utilization and poor self-rated health (0.621, CI: 0.059; 1.183), chronic illness (0.287, CI: 0.012; 0.563), mental healthcare utilization (0.842, CI: 0.148; 1.535) and anxiety (0.790, CI: 0.141; 1.438) (values in parentheses show estimated regression coefficients and 95% confidence intervals). We found no associations between the utilization of ambulatory and emergency care.

Conclusions
Our study generates mixed results concerning associations between healthcare needs and ambulatory and emergency care utilization among asylum-seekers. We found no evidence that low utilization of ambulatory care contributes to emergency care utilization; neither did we find evidence that ambulatory treatment obviates the need to seek emergency care. Our results indicate that higher physical healthcare needs and anxiety are associated with more utilization of both ambulatory and emergency care; whereas healthcare needs related to depression tend to remain unmet. Both the undirected and under-utilization of health services may reflect navigation and accessibility issues. To facilitate more needs-based and effective healthcare utilization and thus contribute to health equity, support services such as interpretation and care navigation as well as outreach are warranted.
Fatty acids metabolism affects the therapeutic effect of anti-PD-1/PD-L1 in tumor immune microenvironment in clear cell renal cell carcinoma
Authors: Lin Hansen , Fu Liangmin , Li Pengju , Zhu Jiangquan , Xu Quanhui , Wang Yinghan , Mumin Mukhtar Adan , Zhou Xinwei , Chen Yuhang , Shu Guannan , Yao Gaosheng , Chen Minyu , Lu Jun , Zhang Lizhen , Liu YuJun , Zhao Yiqi , Bao Jiahao , Chen Wei , Luo Junhang , Li Xiaofei , Chen Zhenhua , Cao Jiazheng 
Published: May 2023

Abstract
Background
Clear cell renal cell carcinoma (ccRCC) is a highly invasive and metastatic subtype of kidney malignancy and is correlated with metabolic reprogramming for adaptation to the tumor microenvironment comprising infiltrated immune cells and immunomodulatory molecules. The role of immune cells in the tumor microenvironment (TME) and their association with abnormal fatty acids metabolism in ccRCC remains poorly understood.

Method
RNA-seq and clinical data of KIRC from The Cancer Genome Atlas (TCGA) and E-MTAB-1980 from the ArrayExpress dataset. The Nivolumab group and Everolimus group of the CheckMate 025 study, the Atezolizumab arm of IMmotion150 and the Atezolizumab plus Bevacizumab group of IMmotion151 cohort were obtained for subsequent analysis. After differential expression genes identification, the signature was constructed through univariate Cox proportional hazard regression and simultaneously the least absolute shrinkage and selection operator (Lasso) analysis and the predictive performance of our signature was assessed by using receiver operating characteristic (ROC), Kaplan–Meier (KM) survival analysis, nomogram, drug sensitivity analysis, immunotherapeutic effect analysis and enrichment analysis. Immunohistochemistry (IHC), qPCR and western blot were performed to measure related mRNA or protein expression. Biological features were evaluated by wound healing, cell migration and invasion assays and colony formation test and analyzed using coculture assay and flow cytometry.

Results
Twenty fatty acids metabolism-related mRNA signatures were constructed in TCGA and possessed a strong predictive performance demonstrated through time-dependent ROC and KM survival analysis. Notably, the high-risk group exhibited an impaired response to anti-PD-1/PD-L1 (Programmed death-1 receptor/Programmed death-1 receptor-ligand) therapy compared to the low-risk group. The overall levels of the immune score were higher in the high-risk group. Additionally, drug sensitivity analysis observed that the model could effectively predict efficacy and sensitivity to chemotherapy. Enrichment analysis revealed that the IL6-JAK-STAT3 signaling pathway was a major pathway. IL4I1 could promote ccRCC cells’ malignant features through JAK1/STAT3 signaling pathway and M2-like macrophage polarization.

Conclusion
The study elucidates that targeting fatty acids metabolism can affect the therapeutic effect of PD-1/PD-L1 in TME and related signal pathways. The model can effectively predict the response to several treatment options, underscoring its potential clinical utility.
The role of mitochondria in the resistance of melanoma to PD-1 inhibitors
Authors: Du Fei , Yang Lu-han , Liu Jiao , Wang Jian , Fan Lianpeng , Duangmano Suwit , Liu Hao , Liu Minghua , Wang Jun , Zhong Xiaolin , Zhang Zhuo , Wang Fang 
Published: May 2023

AbstractMalignant melanoma is one of the most common tumours and has the highest mortality rate of all types of skin cancers worldwide. Traditional and novel therapeutic approaches, including surgery, targeted therapy and immunotherapy, have shown good efficacy in the treatment of melanoma. At present, the mainstay of treatment for melanoma is immunotherapy combined with other treatment strategies. However, immune checkpoint inhibitors, such as PD-1 inhibitors, are not particularly effective in the clinical treatment of patients with melanoma. Changes in mitochondrial function may affect the development of melanoma and the efficacy of PD-1 inhibitors. To elucidate the role of mitochondria in the resistance of melanoma to PD-1 inhibitors, this review comprehensively summarises the role of mitochondria in the occurrence and development of melanoma, targets related to the function of mitochondria in melanoma cells and changes in mitochondrial function in different cells in melanoma resistant to PD-1 inhibitors. This review may help to develop therapeutic strategies for improving the clinical response rate of PD-1 inhibitors and prolonging the survival of patients by activating mitochondrial function in tumour and T cells.