bluuebunny/crossref_metadata_2025 huggingface dataset:
Hyperactivity in the Hypothalamic-Pituitary-Adrenal Axis: An Invisible Killer for Anxiety and/or Depression in Coronary Artherosclerotic Heart Disease
Authors: Feng Lan-Shuan , Wang Yi-Ming , Liu Huan , Ning Bo , Yu Hu-Bin , Li Shi-Lin , Wang Yu-Ting , Zhao Ming-Jun , Ma Jing
Published: December 2024

The coexistence of anxiety or depression with coronary heart disease (CHD) is a significant clinical challenge in cardiovascular medicine. Recent studies have indicated that hypothalamic-pituitary-adrenal (HPA) axis activity could be a promising focus in understanding and addressing the development of treatments for comorbid CHD and anxiety or depression. The HPA axis helps to regulate the levels of inflammatory factors, thereby reducing oxidative stress damage, promoting platelet activation, and stabilizing gut microbiota, which enhance the survival and regeneration of neurons, endothelial cells, and other cell types, leading to neuroprotective and cardioprotective benefits. This review addresses the relevance of the HPA axis to the cardiovascular and nervous systems, as well as the latest research advancements regarding its mechanisms of action. The discussion includes a detailed function of the HPA axis in regulating the processes mentioned. Above all, it summarizes the therapeutic potential of HPA axis function as a biomarker for coronary atherosclerotic heart disease combined with anxiety or depression.
Current Progress on Postoperative Cognitive Dysfunction: An Update
Authors: Sun Jing , Du Xiaohong , Chen Yong
Published: December 2024

Postoperative cognitive dysfunction (POCD) represents a significant clinical concern, particularly among elderly surgical patients. It is characterized by a decline in cognitive performance, affecting memory, attention, coordination, orientation, verbal fluency, and executive function. This decline in cognitive abilities leads to longer hospital stays and increased mortality. This review provides a comprehensive overview of the current progress in understanding the relevant pathogenic factors, possible pathogenic mechanisms, diagnosing, prevention and treatment of POCD, as well as suggesting future research directions. It discusses neuronal damage, susceptible genes, central cholinergic system, central nervous system (CNS) inflammation, stress response and glucocorticoids, and oxidative stress in the development of POCD, aiming to uncover the pathological mechanism and develop effective treatment strategies for POCD.
Pre-ablation and Post-ablation Factors Influencing the Prognosis of Patients with Electrical Storm Treated by Radiofrequency Catheter Ablation: An Update
Authors: Cojocaru Cosmin , Dorobanțu Maria , Vătășescu Radu
Published: December 2024

Catheter ablation-based management strategies for the drug-refractory electrical storm (ES) have been proven to abolish acute ventricular arrhythmic episodes and improve long-term outcomes. However, this effect is highly influenced by multiple independently acting factors, which, if identified and addressed, may allow a more tailored management to each particular case to improve results. This review synthesizes existing evidence concerning ES outcome predictors of patients undergoing ablation and introduces the role of novel scoring algorithms to refine risk stratification. The presence of these factors should be assessed during two distinct phases in relation to the ablation procedure: before (based on preprocedural multimodal evaluation of the patient’s structural heart disease and comorbidities) and after the ablation procedure (in terms of information derived from the invasive substrate characterization, procedural results, postprocedural recurrences (spontaneous or during non-invasive testing), and complications).
Recent Advances in the Treatment of Coronary In-Stent Restenosis
Authors: Sartore Luca , Gitto Mauro , Oliva Angelo , Kakizaki Ryota , Mehran Roxana , Räber Lorenz , Spirito Alessandro
Published: December 2024

In-stent restenosis (ISR) remains the predominant cause of stent failure and the most common indication for repeat revascularization. Despite technological advances in stent design, ISR continues to pose significant challenges, contributing to increased morbidity and mortality among patients undergoing percutaneous coronary interventions. In the last decade, intravascular imaging has emerged as an important method for identifying the mechanisms behind ISR and guiding its treatment. Treatment options for ISR have expanded to include balloon angioplasty, cutting or scoring balloons, intravascular lithotripsy, atheroablative devices, drug-eluting stents, drug-coated balloons, surgical revascularization, and intravascular brachytherapy. The aim of the current review is to describe the classification and mechanisms of ISR, provide a comprehensive and updated overview of the evidence supporting different treatment strategies, suggest a management algorithm, and present insights into future developments in the field.
Diabetes Mellitus and Cardiovascular Disease: Exploring Epidemiology, Pathophysiology, and Treatment Strategies
Authors: Siam Nawfal Hasan , Snigdha Nayla Nuren , Tabasumma Noushin , Parvin Irin
Published: December 2024

Diabetes mellitus (DM) affects 537 million people as of 2021, and is projected to rise to 783 million by 2045. This positions DM as the ninth leading cause of death globally. Among DM patients, cardiovascular disease (CVD) is the primary cause of morbidity and mortality. Notably, the prevalence rates of CVD is alarmingly high among diabetic individuals, particularly in North America and the Caribbean (46.0%), and Southeast Asia (42.5%). The predominant form of CVD among diabetic patients is coronary artery disease (CAD), accounting for 29.4% of cases. The pathophysiology of DM is complex, involving insulin resistance, β-cell dysfunction, and associated cardiovascular complications including diabetic cardiomyopathy (DCM) and cardiovascular autonomic neuropathy (CAN). These conditions exacerbate CVD risks underscoring the importance of managing key risk factors including hypertension, dyslipidemia, obesity, and genetic predisposition. Understanding the genetic networks and molecular processes that link diabetes and cardiovascular disease can lead to new diagnostics and therapeutic interventions. Imeglimin, a novel mitochondrial bioenergetic enhancer, represents a promising medication for diabetes with the potential to address both insulin resistance and secretion difficulties. Effective diabetes management through oral hypoglycemic agents (OHAs) can protect the cardiovascular system. Additionally, certain antihypertensive medications can significantly reduce the risk of diabetes-related CVD. Additionally, lifestyle changes, including diet and exercise are vital in managing diabesity and reducing CVD risks. These interventions, along with emerging therapeutic agents and ongoing clinical trials, offer hope for improved patient outcomes and long-term DM remission. This study highlights the urgent need for management strategies to address the overlapping epidemics of DM and CVD. By elucidating the underlying mechanisms and risk factors, this study aims to guide future perspectives and enhance understanding of the pathogenesis of CVD complications in patients with DM, thereby guiding more effective treatment strategies.
Inverted U-Shaped Association of Soluble Transferrin Receptor Concentrations with Risks of Cardiovascular Diseases in Overweight Individuals: A Cross-Sectional Study
Authors: Hu Xiao , Xu Jing , Gu Yang
Published: December 2024

Background: Iron metabolism may play a role in cardiovascular disease (CVD) pathogenesis. The association between iron metabolism and CVD has yet to be fully investigated. This study evaluated whether iron metabolism was associated with CVD risk and whether the body mass index (BMI) of US adults varied the association. Methods: A cross-sectional study was performed using the National Health and Nutrition Examination Survey (NHANES), conducted from 2017 to 2018. Generalized additive models (GAMs) and multivariable logistic regression were adopted to analyze the association between iron metabolism (serum iron (SI), serum ferritin (SF), transferrin saturation (TSAT), and soluble transferrin receptor (sTfR)) and CVD risk. Further, stratified analysis was conducted to identify patients with high CVD risk. Results: Participants with CVD tended to have significantly increased levels of sTfR (p < 0.001) and decreased levels of TSAT (p < 0.001) and SI (p < 0.001). After adjusting for confounding factors, sTfR levels had a significant positive association with CVD risk (Q1 as reference, Q4 odds ratio (OR) 2.1, 95% CI 1.54–2.87, p < 0.001). Notably, the association between sTfR and CVD risk differed in the BMI subgroup (p for interaction < 0.05). We identified an inverted U-shaped relationship between sTfR and the CVD risk in the group of overweight individuals (non-linear p < 0.001). When the sTfR level was below the turning point (sTfR = 5.35 mg/L), a per unit increase in the sTfR level was correlated with a 78% greater adjusted OR of CVD risk (OR, 1.78 [1.44, 2.19]). Conclusions: Increased sTfR levels were non-linearly related to the CVD risk in the overweight population.
Ferroptosis: A Key Driver in Atherosclerosis Progression and Arterial Disease
Authors: Elkammash Amr , Zaki Abrar , Tawfik Omar , Gouda Sherif
Published: December 2024

Atherosclerosis (AS) is a growing global health epidemic and is the leading cause of cardiovascular health problems, including ischemic stroke, coronary artery disease, and peripheral vascular disease. Despite extensive research on the underlying mechanisms of AS, iron remains an under-investigated mediator in the atherosclerotic process. Iron’s involvement in AS is primarily linked to the iron-induced programmed cell death process known as ferroptosis. Ferroptosis is initiated in endothelial cells when iron overload triggers the Fenton reaction, resulting in the production of reactive oxygen species (ROS) and lipid peroxides. This oxidative stress damages cellular components, ultimately leading to cell death. The review examines the role of iron overload and ferroptosis in the progression and instability of atherosclerotic plaques. Additionally, we explore the potential therapeutic roles of iron chelators and ROS scavengers in mitigating the adverse effects of ferroptosis. The findings indicate that ferroptosis contributes significantly to the progression and instability of atherosclerotic plaques by promoting oxidative damage and cellular dysfunction. Iron chelators and ROS scavengers have shown promise in reducing ferroptosis-induced damage in endothelial cells. These therapeutic agents can potentially stabilize atherosclerotic plaques and prevent the progression of AS. Ferroptosis is a critical yet under-explored pathway in the development and progression of atherosclerosis. Targeting iron-induced oxidative stress through iron chelation and ROS scavenging presents a promising therapeutic strategy for mitigating the adverse effects of ferroptosis on atherosclerotic plaque stability. Further research is needed to validate these therapeutic approaches and better understand the molecular mechanisms underlying ferroptosis in atherosclerosis.
Outcomes of Optical Coherence Tomography-Guided and Angiography-Guided Primary Percutaneous Coronary Intervention in Patients with ST-Segment Elevation Myocardial Infarction
Authors: Li Jiannan , Wang Xiaoli , Chen Runzhen , Zhou Peng , Liu Chen , Song Li , Chen Yi , Yan Hongbing , Zhao Hanjun
Published: December 2024

Background: Despite the administration of timely reperfusion treatment, patients with acute myocardial infarction have a high mortality rate and poor prognosis. The potential impact of intraluminal imaging guidance, such as optical coherence tomography (OCT), on improving patient outcomes has yet to be conclusively studied. Therefore, we conducted a retrospective cohort study to compare OCT-guided primary percutaneous coronary intervention (PCI) versus angiography-guided for patients with ST-segment elevation myocardial infarction (STEMI). Methods: This study enrolled 1396 patients with STEMI who underwent PCI, including 553 patients who underwent OCT-guided PCI and 843 patients who underwent angiography-guided PCI. The clinical outcome was a composite of cardiovascular death, myocardial infarction, admission due to heart failure, stroke, and unplanned revascularization at the 4-year follow-up. Results: The prevalence of major adverse cardiovascular events in OCT-guided group was not significantly lower compared to those without OCT guidance after adjustment (unadjusted hazard ratio (HR), 1.582; 95% confidence interval (CI), 1.300–1.924; p < 0.001; adjusted HR, 1.095; adjusted 95% CI, 0.883–1.358; p = 0.409). The prevalence of cardiovascular death was significantly lower in patients with OCT guidance compared to those without before and after adjustment (unadjusted HR, 3.303; 95% CI, 2.142–5.093; p < 0.001; adjusted HR, 2.025; adjusted 95% CI, 1.225–3.136; p = 0.004). Conclusions: OCT-guided primary PCI used to treat STEMI was associated with reduced long-term cardiovascular death.
Long-term Follow-up Optical Coherence Tomography Assessment of Primary Percutaneous Coronary Intervention for Unprotected Left Main
Authors: Mehmedbegovic Zlatko , Vukcevic Vladan , Stojkovic Sinisa , Beleslin Branko , Orlic Dejan , Tomasevic Miloje , Dikic Miodrag , Tesic Milorad , Milasinovic Dejan , Aleksandric Srdjan , Dedovic Vladimir , Zivkovic Milorad , Juricic Stefan , Jelic Dario , Mladenovic Djordje , Stankovic Goran
Published: December 2024

Background: Elective unprotected left main (ULM) percutaneous coronary intervention (PCI) has long-term mortality rates comparable to surgical revascularization, thanks to advances in drug-eluting stent (DES) design, improved PCI techniques, and frequent use of intravascular imaging. However, urgent PCI of ULM culprit lesions remains associated with high in-hospital mortality and unfavourable long-term outcomes, including DES restenosis and stent thrombosis (ST). This analysis aimed to examine the long-term outcomes and healing of DES implanted in ULM during primary PCI using high-resolution optical coherence tomography (OCT) imaging. Methods: A total of 15 consecutive patients undergoing long-term OCT follow-up of ULM primary PCI from a high-volume center were included in this analysis. During the index primary PCI all subjects underwent angio-guided DES implantation, and follow-up was uneventful in all but one subject who had a non-target PCI lesion. The primary endpoint was the percentage of covered, uncovered, and malappossed stent struts at long-term follow-up. Secondary endpoints included quantitative and qualitative OCT measurements. For the left main bifurcation, a separate analysis was performed for three different segments: left main (LM), polygon of confluence (POC) and distal main branch (dMB), in all cases. Results: The average follow-up interval until OCT was 1580 ± 1260 days. Despite aorto-ostial stent protrusions in 40% of patients, optimal image quality was achieved in 93.3% of cases. There were higher rates of malapposed (11.4 ± 16.6 vs. 13.1 ± 8.3 vs. 0.3 ± 0.5%; p < 0.001) and lower rates of covered struts (81.7 ± 16.8 vs. 83.7 ± 9.2 vs. 92.4 ± 6.8%; p = 0.041) observed for the LM and POC segment compared to the dMB. Significantly malapposed stent struts (>400 μm) were less likely to be covered at follow-up, than struts with a measured strut to vessel wall distance of <400 μm (15.4 ± 21.6 vs. 24.8 ± 23.9%; p = 0.011). Neoatherosclerosis was observed in 5 (33.3%) and restenotic neointimal hyperplasia (NIH) in 2 (13.3%) patients, requiring PCI in 33.3% of patients. Conclusions: Long-term OCT examination of DES implanted during primary PCI for culprit ULM lesions demonstrated high rates of incomplete strut coverage, late malapposition, and high subclinical DES failure rates. These negative OCT results highlight the need for image optimization strategies during primary PCI to improve DES-related long-term outcomes.
The Effect of Percutaneous Coronary Intervention on Patients with Acute Myocardial Infarction and Cardiogenic Shock Supported by Extracorporeal Membrane Oxygenation
Authors: Wang Yan , Fu Hongfu , Li Jin , Xie Haixiu , Li Chenglong , Du Zhongtao , Hao Xing , Wang Hong , Wang Liangshan , Hou Xiaotong
Published: December 2024

Background: Patients suffering from acute myocardial infarction complicated by cardiogenic shock (AMICS), who undergo veno-arterial extracorporeal membrane oxygenation (VA-ECMO) therapy, typically exhibit high mortality rates. The benefits of percutaneous coronary intervention (PCI) in these patients remains unclear. This study aims to investigate whether PCI can mitigate mortality among patients with AMICS supported by ECMO. Methods: Data from patients ≥18 years, who underwent VA-ECMO assistance in China between January 1, 2017, and June 30, 2022, were retrieved by searching the Chinese Society of Extracorporeal Life Support (CSECLS) Registry. A total of 1623 patients were included and categorised based on whether they underwent PCI. Using propensity score matching, 320 patient pairs were successfully matched. The primary outcome was in-hospital mortality rate. The secondary outcomes included VA-ECMO duration, Hospital stay, ECMO weaning and ECMO related complications. Results: In the cohort of 1623 patients, 641 (39.5%) underwent PCI. Upon conducting multivariate logistic regression analysis, it was observed that those who underwent PCI had a lower prevalence of hyperlipidemia (13.1% versus [vs.] 17.8%), chronic respiratory disease (2.5% vs. 4.3%) and lower lactic acid (5.90 vs. 8.40). They also had a more significant history of PCI (24.8% vs. 19.8%) and were more likely to be smokers (42.6% vs. 37.0%). Patients in the PCI group exhibited lower in-hospital mortality before and after matching (40.3% vs. 51.6%; p = 0.005), which persisted in multivariable modeling (adjusted odds ratio [aOR]: 0.69; 95% confidence interval 0.50–0.95; p = 0.024). Patients who received PCI were more successfully weaned from ECMO (88.6% vs. 75.8% before matching). PCI was not a risk factor for ECMO related complications. Conclusions: Among patients who received ECMO support for AMICS, PCI was associated with a lower rate of in-hospital mortality.
Management Status of Myocarditis-Related Sudden Cardiac Death
Authors: Yan Ping , Yang Shujun , Wang Tong
Published: December 2024

Myocarditis, a life-threatening disease that can result in cardiac arrest and sudden cardiac death, has garnered significant attention in recent years. This review provides a comprehensive overview of the management of myocarditis-related sudden cardiac death, encompassing its pathology, diagnostic methods, therapeutic strategies, preventive measures, prognostic factors, and risk stratification. Additionally, the review highlights current challenges and future directions in this field. The aim is to enhance understanding of myocarditis-related sudden cardiac death and inform clinical practice, ultimately leading to improved patient outcomes.
Deep Learning-Based Carotid Plaque Ultrasound Image Detection and Classification Study
Authors: Zhang Hongzhen , Zhao Feng
Published: December 2024

Background: This study aimed to develop and evaluate the detection and classification performance of different deep learning models on carotid plaque ultrasound images to achieve efficient and precise ultrasound screening for carotid atherosclerotic plaques. Methods: This study collected 5611 carotid ultrasound images from 3683 patients from four hospitals between September 17, 2020, and December 17, 2022. By cropping redundant information from the images and annotating them using professional physicians, the dataset was divided into a training set (3927 images) and a test set (1684 images). Four deep learning models, You Only Look Once Version 7 (YOLO V7) and Faster Region-Based Convolutional Neural Network (Faster RCNN) were employed for image detection and classification to distinguish between vulnerable and stable carotid plaques. Model performance was evaluated using accuracy, sensitivity, specificity, F1 score, and area under curve (AUC), with p < 0.05 indicating a statistically significant difference. Results: We constructed and compared deep learning models based on different network architectures. In the test set, the Faster RCNN (ResNet 50) model exhibited the best classification performance (accuracy (ACC) = 0.88, sensitivity (SEN) = 0.94, specificity (SPE) = 0.71, AUC = 0.91), significantly outperforming the other models. The results suggest that deep learning technology has significant potential for application in detecting and classifying carotid plaque ultrasound images. Conclusions: The Faster RCNN (ResNet 50) model demonstrated high accuracy and reliability in classifying carotid atherosclerotic plaques, with diagnostic capabilities approaching that of intermediate-level physicians. It has the potential to enhance the diagnostic abilities of primary-level ultrasound physicians and assist in formulating more effective strategies for preventing ischemic stroke.
Hemodynamics in Left-Sided Cardiomyopathies
Authors: Del Monaco Guido , Amata Francesco , Battaglia Vincenzo , Panico Cristina , Condorelli Gianluigi , Pinto Giuseppe
Published: December 2024

Cardiomyopathies, historically regarded as rare, are increasingly recognized due to advances in imaging diagnostics and heightened clinical focus. These conditions, characterized by structural and functional abnormalities of the myocardium, pose significant challenges in both chronic and acute patient management. A thorough understanding of the hemodynamic properties, specifically the pressure-volume relationships, is essential. These relationships provide insights into cardiac function, including ventricular compliance, contractility, and overall cardiovascular performance. Despite their potential utility, pressure-volume curves are underutilized in clinical settings due to the invasive nature of traditional measurement techniques. Recognizing the dynamic nature of cardiomyopathies, with possible transitions between phenotypes, underscores the importance of continuous monitoring and adaptive therapeutic strategies. Enhanced hemodynamic evaluation can facilitate tailored treatment, potentially improving outcomes for patients with these complex cardiac conditions.
Risk Factors and Incidence for In-Stent Restenosis with Drug-Eluting Stent: A Systematic Review and Meta-Analysis
Authors: Liu Birong , Li Meng , Liu Jia , Xie Lihua , Li Jiaqi , Liu Yong , Niu Chaofeng , Xiao Di , Li Jingen , Zhang Lijing
Published: December 2024

Background: Despite significant reductions in in-stent restenosis (ISR) incidence with the adoption of drug-eluting stents (DES) over bare metal stents (BMS), ISR remains an unresolved issue in the DES era. The risk factors associated with DES-ISR have not been thoroughly analyzed. This meta-analysis aims to identify the key factors and quantify their impact on DES-ISR. Methods: We conducted comprehensive literature searches in PubMed, EMBASE, Cochrane, and Web of Science up to 28 February 2023, to identify studies reporting risk factors for DES-ISR. Meta-analysis was performed on risk factors reported in two or more studies to determine their overall effect sizes. Results: From 4357 articles screened, 17 studies were included in our analysis, evaluating twenty-four risk factors for DES-ISR through meta-analysis. The pooled incidence of DES-ISR was approximately 13%, and significant associations were found with seven risk factors. Ranked risk factors included diabetes mellitus (odds ratio [OR]: 1.46; 95% confidence interval [CI]: 1.14–1.87), stent length (OR: 1.026; 95% CI: 1.003–1.050), number of stents (OR: 1.62; 95% CI: 1.11–2.37), involvement of the left anterior descending artery (OR: 1.56; 95% CI: 1.25–1.94), lesion length (OR: 1.016; 95% CI: 1.008–1.024), medical history of myocardial infarction (OR: 1.79; 95% CI: 1.12–2.86) and previous percutaneous coronary intervention (OR: 1.97; 95% CI: 1.53–2.55). Conversely, a higher left ventricular ejection fraction was identified as a protective factor (OR: 0.985; 95% CI: 0.972–0.997). Conclusions: Despite advancements in stent technology, the incidence of ISR remains a significant clinical challenge. Our findings indicate that patient characteristics, lesion specifics, stent types, and procedural factors all contribute to DES-ISR development. Proactive strategies for early identification and management of these risk factors are essential to minimize the risk of ISR following DES interventions. The PROSPERO Registration: CRD42023427398, https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=427398.
Clinical Prognostic Impact of the Serum C-reactive Protein-to-albumin Ratio (CAR) in Chronic Heart Failure Patients: A Retrospective Study
Authors: Xu Chenggong , Zhang Ningli , Rong Wei , Dong Ling , Gu Wenyi , Zou Jie , Zhu Na , Shi Tao , Li Hao , Chen Lixing
Published: December 2024

Background: The serum C-reactive protein-to-albumin ratio (CAR) has been identified as an adverse prognostic indicator in a variety of diseases. Nevertheless, there have been not been any studies reporting a relationship between CAR and the prognosis of chronic heart failure (CHF). This study was designed to evaluate the association between CAR and all-cause mortality in CHF patients with different ejection fractions. Methods: A total of 1221 heart failure (HF) patients were enrolled at the First Affiliated Hospital of Kunming Medical University due to acute exacerbation of chronic HF from January 2017 to October 2021. The main outcome was all-cause mortality. After collecting baseline characteristics and laboratory results from all patients, we classified all participants into four groups based on CAR quartile (G1–G4). Kaplan-Meier survival curves and multivariate Cox proportional hazard models were employed to investigate the association between CAR and all-cause mortality in the patients. Furthermore, receiver operating characteristic (ROC) curves were constructed for CARs, and the area under the curve (AUC) was calculated. Results: After excluding ineligible patients, we ultimately included 1196 patients with CHF. The mean age was 66.38 ± 12.521 years, and 62% were male. According to the Kaplan‒Meier analysis, with different ejection fractions, the risk of all-cause mortality was always highest for G4 (CAR >63.27) and lowest for G1 (CAR ≤7.67). Cox multivariate regression analyses indicated that the CAR was an independent predictor of all-cause mortality in all HF patients and in patients with different HF subtypes. According to the ROC curves, the AUC for the CAR was 0.732 (p < 0.001), with a sensitivity of 66.2% and the specificity of 72.7%. CAR had a greater predictive value for all-cause mortality than did C-reactive protein (CRP). Conclusions: An elevated serum CAR was independently associated with an increased risk of all-cause death, regardless of heart failure subtype.
Progress Analysis of Personalized Antiplatelet Therapy in Patients with Coronary Heart Disease Undergoing Interventional Therapy
Authors: Yang Ji-tong , Zhang Qiu-juan , Li Hua , Liu Ming-wei
Published: December 2024

Coronary atherosclerosis (or coronary heart disease [CHD]) is a common cardiovascular disease that seriously damages human health. Percutaneous coronary stent implantation represents the primary treatment option for severe CHD in clinical practice; meanwhile, dual antiplatelet therapy (DAPT) is widely used to reduce the risk of postoperative thrombosis. Although the mechanisms of action of the two most commonly used antiplatelet drugs, aspirin and clopidogrel, remain unclear, clinical studies have shown that some patients are susceptible to stent thrombosis—antiplatelet resistance (high on-treatment platelet reactivity [HTPR])—despite using these drugs. Therefore, screening for HTPR and formulating personalized antiplatelet therapies is necessary. Ticagrelor, indobufen, and rivaroxaban are the most common and safe antiplatelet drugs used in clinical practice, with broad application prospects. This review summarizes the mechanisms of action of existing antiplatelet drugs, reasons for personalized treatment, screening of antiplatelet reactions, and development of novel antiplatelet drugs.
An Artificial Intelligence-Based Non-Invasive Approach for Cardiovascular Disease Risk Stratification in Obstructive Sleep Apnea Patients: A Narrative Review
Authors: Saba Luca , Maindarkar Mahesh , Khanna Narendra N. , Puvvula Anudeep , Faa Gavino , Isenovic Esma , Johri Amer , Fouda Mostafa M. , Tiwari Ekta , Kalra Manudeep K. , Suri Jasjit S.
Published: December 2024

Background: Obstructive sleep apnea (OSA) is a severe condition associated with numerous cardiovascular complications, including heart failure. The complex biological and morphological relationship between OSA and atherosclerotic cardiovascular disease (ASCVD) poses challenges in predicting adverse cardiovascular outcomes. While artificial intelligence (AI) has shown potential for predicting cardiovascular disease (CVD) and stroke risks in other conditions, there is a lack of detailed, bias-free, and compressed AI models for ASCVD and stroke risk stratification in OSA patients. This study aimed to address this gap by proposing three hypotheses: (i) a strong relationship exists between OSA and ASCVD/stroke, (ii) deep learning (DL) can stratify ASCVD/stroke risk in OSA patients using surrogate carotid imaging, and (iii) including OSA risk as a covariate with cardiovascular risk factors can improve CVD risk stratification. Methods: The study employed the Preferred Reporting Items for Systematic reviews and Meta-analyses (PRISMA) search strategy, yielding 191 studies that link OSA with coronary, carotid, and aortic atherosclerotic vascular diseases. This research investigated the link between OSA and CVD, explored DL solutions for OSA detection, and examined the role of DL in utilizing carotid surrogate biomarkers by saving costs. Lastly, we benchmark our strategy against previous studies. Results: (i) This study found that CVD and OSA are indirectly or directly related. (ii) DL models demonstrated significant potential in improving OSA detection and proved effective in CVD risk stratification using carotid ultrasound as a biomarker. (iii) Additionally, DL was shown to be useful for CVD risk stratification in OSA patients; (iv) There are important AI attributes such as AI-bias, AI-explainability, AI-pruning, and AI-cloud, which play an important role in CVD risk for OSA patients. Conclusions: DL provides a powerful tool for CVD risk stratification in OSA patients. These results can promote several recommendations for developing unique, bias-free, and explainable AI algorithms for predicting ASCVD and stroke risks in patients with OSA.
PENGARUH INFORMASI BERLEBIHAN TERHADAP KEPUTUSAN PEMBELIAN BARANG IMPOR E-COMMERCE DENGAN FISKAL IMPORT BARRIER SEBAGAI VARIABEL MODERASI: PERSPEKTIF MODEL HEURISTIK-SISTEMATIS
Authors: Yusuf Himawan , Wibowo Imam Tri
Published: December 2024

E-commerce memudahkan masyarakat membeli barang, termasuk dari luar negeri. Penelitian ini bertujuan untuk menguji pengaruh informasi berlebihan terhadap keputusan pembelian barang impor melalui e-commerce dengan variabel fiscal import barrier sebagai variabel moderasi. Metode analisis data pada penelitian ini adalah Struktual Equation Modeling dengan menggunakan software Smart PLS 3.0. Pemilihan sampel menggunakan metode purposive sampling. Berdasarkan hasil dan pembahasan, efek moderasi dari  fiscal import barrier berupa pengenaan bea masuk beserta batas pembebasannya tidak berpengaruh signifikan terhadap keputusan pembelian. Hal ini dapat dipengaruhi oleh latar belakang responden yang memiliki penghasilan menengah keatas, sehingga beban untuk membayar bea masuk tidak memperkuat ataupun memperlemah niatan responden untuk membeli barang impor melalui e-commerce. Novelty dari penelitian ini adalah penggunaan variabel fiscal import barrier sebagai variabel moderasi untuk keputusan pembelian.
Kata Kunci : e-commerce, purcahse intention, fiscal import barrier, impor
Impact of Haikal Hassan Endorsement on Repurchase Intention of Pizza Hut Muslim Consumers: Mediated by Religiosity
Authors: Bahri Syamsul , Nasution Juliana , Marliyah Marliyah
Published: December 2024

The controversy surrounding Haikal Hassan's endorsement of Pizza Hut products in Indonesia has sparked debates about the intersection of religious influence and consumer behaviour in the Muslim market, particularly following public concerns about the brand's perceived connection to Israel through its parent company's business relations. This situation raises questions about how religious figures' endorsements impact Muslim consumers' purchasing decisions, especially when promoting international food brands that face scrutiny over their global business affiliations. This research aims to quantitatively measure the effect of Haikal Hassan's endorsement on Muslim consumers' repurchase intention for Pizza Hut products, considering religiosity as an intermediary variable. Using a quantitative method with an explanatory design, this research involved 100 respondents of Pizza Hut Muslim consumers in Indonesia, which were determined using a purposive sampling approach. Information was obtained from a structured questionnaire and then examined using Path Analysis with SmartPLS version 4. According to the results, endorsement has a positive and significant effect on repurchase intention but a negative and significant effect on religiosity. On the other hand, religiosity has a negative and significant impact on repurchase intention and also significantly mediates the effect of endorsement on repurchase intention. These findings contribute to the understanding of Muslim consumer behaviour and the role of religiosity in marketing, and this can be a reference for companies in developing more appropriate marketing tactics that are sensitive to the religious values of Muslim consumers in Indonesia.
The Role of Waqf in Promoting Family-Owned Businesses among Married Women in Northeastern Nigeria
Authors: Muhammad Adamu Abubakar , Ardo Adam Muhammad , Aliyu Shafa’at Ahmad , Tafida Adama Lawal
Published: December 2024

This study investigates how waqf helps married women in northeastern Nigeria start family-owned enterprises. In the past, waqf, an Islamic charitable endowment, has supported underprivileged communities financially and with resources, acting as a mechanism for socioeconomic development. In this regard, waqf institutions can enable married women to start and maintain family-owned enterprises, tackling issues like restricted financial resources, socio-cultural constraints, and unstable economic conditions. By offering interest-free loans, training courses, and infrastructure assistance, waqf can encourage married women to start their own businesses, increasing their financial independence and boosting household income. The study uses qualitative research methodology, reviewing relevant literature on the subject matter and stakeholder interviews. Findings revealed that integrating waqf with family-owned business initiatives improves economic stability, reduces poverty levels, and strengthens family cohesion. Additionally, the study highlighted the need for strategic collaboration between waqf institutions, government bodies, and community organizations to optimize resource allocation and expand the impact of waqf on women's entrepreneurship. This research underscores the transformative potential of waqf in advancing gender-inclusive economic development in Northeastern Nigeria and provides recommendations for policymakers and waqf administrators to enhance the effectiveness of their programs.
Oral Candidiasis in Diabetes Patients
Authors: Naeem Mustafa
Published: December 2024

Objective :1. Identification and isolation of candida spp in Patients with diabetes mellitus (DM). 2.To identify the relationship between some important parameters (age , gender , Glycosylated hemoglobin (HbA1c) ) Associated with diabetes and oral candidiasis .
This study was performed in AL- Zahraa Teaching Hospital (Diabetic Center )  Wasit Governorate during the period from the first of December 2018 to the end of July 2019.The samples were collected from oral swabs ,then cultured on sabouraud dextrose agar (SDA) , examined under microscope to show hypha and pseudohypha of Candida spp and cultured on chrom agar for identifying the Candida spp. The molecular methods that used in this study were vitek 2 system and Polymerase chain reaction(PCR). The results showed that from 50 oral sample from Patients with diabetic mellitus   showed  23 (46.6%) infected with candidiasis ,22 (95.6%) of them were C.albicans and 1(4.4 %) was other Candida spp (C.Dubliniensis) , while 27 (53.4%) were not infected. The Current study found a significant correlation between glycosylated hemoglobin and oral Candidiasis when the HbA1c was ranging from (6.5-8.5).
SOME KINDS OF SEPARATION AXIOMS ON APPROXIMATION SPACES
Authors: Jasim Hisham
Published: December 2024

This paper investigates topological features of rough sets and deals with approximation spaces through topological approaches.The traditional separation axioms for topological spaces are extended to approximation spaces. We investigate the connections between the separation axioms for approximation spaces and topological spaces, as well as the approximation spaces they imply.
Dual-Language Sentiment Analysis: A Comprehensive Evaluating SVM, Logistic Regression, XGBoost, and Decision Tree Using TF-IDF On Arabic and English Dataset
Authors: Ali Taher Hawraa
Published: December 2024

Sentiment analysis (SA) is a growing area of study that straddles a number of disciplines, including machine learning, data mining, and natural language processing. It is focused on the automatic extraction of viewpoints presented in a certain text. Many studies have been conducted in the area of sentiment analysis because to its broad uses, particularly on texts in English, whereas other languages like Arabic have gotten less attention. The Arabic language presents several difficulties, such as its rich morphology and the difficulty of tracing words back to their original roots. Arabic comments have been analyzed and categorized into good and negative attitudes using a framework. With the aim of evaluating any tweet, opinion, purpose, or reputation, such as a university, company, mobile, and others, the research analyzes the comments made by users of the social networking site Twitter. It does this by using classification technology and machine learning, which are among the fundamental tasks of the data mining process used in the larger process, which is to explore knowledge . This search helps the user to access the evaluation of other users through their tweets and comments on the social networking site for an opinion immediately and automatically, and then the process of uploading and evaluating the opinions using appropriate algorithms for this purpose as(Decision Tree classifier DTC , XGboost, Logistic Regression LR, Support Vector Machine SVM )with Term Frequency-Inverse Document Frequency TF_IDF
A Successful Approach to Extracted Human mtDNA and Amplify some Genes from FFPE Samples
Authors: Abdulkadhim Hanoush Nisreen , E.Dhamad Ahmed
Published: December 2024

Tissues that have been paraffin-embedded and fixed in formalin (FFPE) are a significant diagnostic resource for molecular and pathophysiological methods of cancer and numerous other illnesses. The most difficult obstacle is obtaining high-quality of DNA from FFPE tissues, especially mitochondrial DNA (mtDNA), as formalin fixation significantly compromises the integrity of DNA. To extract mtDNA, the Geneaid gSYNCTM DNA kit (cat#GS100) was used with fifty breast cancer tissues (block). To check the mtDNA quality, specific primers for the following genes, ATP6 gene (8527-9024) and D-Loop region (256-16277), were used to run a PCR reaction. Our data showed that the mtDNA was successfully extracted with high quantity and quality. The two genes were amplified via PCR with very high rate (97% average). In conclusion, the method described here has many possibilities for applications in various molecular research projects involving FFPET substances. It can be used to obtain a high quantity and quality of mtDNA from FFPE samples for different molecular diagnostic and research methods such as PCR, qPCR, Sanger sequencing, and whole genome sequencing.
C-Reactive Protein is the Main Factor for Prediction of Fatigue in Preeclampsia Women
Authors: Jasim Hanan
Published: December 2024

Preeclampsia is associated with many neuropsychiatric symptoms including fatigue. Many biomarkers are correlated with fibro fatigue (FF) scores.  The present study aims to examine the changes in the advanced-glycated end-products (AGEs) and its receptor (RAGE), Vascular endothelial growth factor (VEGF) and its receptor (VEGFR1), C-reactive protein (CRP) and lipid profile and atherogenic indices in preeclampsia as predictors for preeclampsia patients with higher FF score. Preeclampsia patients were divided according to the FF score into high-FF (FF≥25) and low-FF (FF<25). The biomarkers and FF scores were measured in the patient groups and compared with healthy pregnant controls. PE women had higher levels of AGEs, RAGE, VEGF, and VEGFR1 than control women, and the rise is greater in the high-FF PE group compared with the low-FF group. PE women also have dyslipidemia and low-grade inflammation (high serum CRP), which rise with FF score. The multivariate generalized linear model (GLM) analysis showed no significant effect of the covariates (age, gestational age, gravidity, age of onset, and duration of PE) on the measured biomarkers. The study found significant differences in all parameters for high-FF PE patients (Partial η² = 0.727). CRP is the only receiver-operating characteristics (ROC) variable distinguishing high-FF PE women from low-FF PE women. The high-FF scores in PE are related to the lipid profile and atherogenic indices as well as dyslipidemia and low-grade inflammation.  PE patients with high-FF can be significantly predicted by high-CRP levels.
Isolation and identification different type of fungi from skin in Tikrit city
Authors: Adnan Khattab Ali , Ahmed Abid Hawazin , Dalaf Khalaf Sarab
Published: December 2024

This study was conducted in the postgraduate laboratory at the College of Science at Tikrit University from October 2023 to May 2024 with the aim of investigating fungi causing skin diseases Dermatomycosis. 100 samples were collected from patients visiting the dermatology consultant at Tikrit Teaching Hospital, Al-Elm General Hospital and some private clinics in Tikrit city for ages between 1 - 70 years. Laboratory culture showed positive results at a rate of 50% of the total samples, as the results showed that the most type of skin fungus isolated during the study was the fungus Trichophyton mentagrophytes at a rate of (16%) of the total number of positive samples, followed by the fungus Microsporum canis at a rate of (12%), while Candida albicans appeared at a rate of (10%), followed by Candida tropicals at a rate of (8%), Candida parapsilosis at a rate of (6%) and C. lipolatica at a rate of (4%), while T. verrucosum and Microsporum gypseum appeared at a rate of 2% each, and the molds Aspergillus niger and Aspergillus tubingenesis appeared at rates of (8%, 6%) each, respectively. The results showed that scalp ringworm (20%) and finger ringworm (16%) were the most common among patients, with the percentage of males (60%) higher than females (40%), and the ages of 10-30 years were the most affected at 40%.
The general public's knowledge, attitudes, and practices around hepatitis A and E prevention and control in Iraq
Authors: H.Raheema Rana
Published: December 2024

ABSTRACT: Both the hepatitis A and E viruses cause acute liver infections; however, only the hepatitis E virus has the potential to develop into an extrahepatic and chronic infection. The purpose of this study was to evaluate participants' practices for adopting a healthy lifestyle to prevent contracting hepatitis A and E, as well as the general population's knowledge and attitude towards these diseases. This cross-section observation study comprised 832 participants conducted between January and June 2024, the study population was Wasit University students from different colleges (scientific and humanitarian), also from secondary school students, and hospital patients. The majority of participants were between the ages of 18 and 30, with 554 (66.6%) females and 278 (33.4%) males, according to the individual's sociodemographic characteristics. Of the participants, 743 (89.3%) were aware that the virus causes hepatitis A and E. Additionally, 511 (61.4%), 698 (83.9%), and 565 (67.9%) of them correctly identified the virus's route of transmission, how to avoid infection, and if a vaccine was available for hepatitis A respectively. The results show that 814 (97.8%), 811 (97.5%), and 630 (75.7%) practiced excellent food hygiene, hand washing after using the restroom, and avoiding contact with those who had hepatitis A or E, respectively. This study shows a high level of basic knowledge especially regarding the viral causes and hygiene practices also, this study reveals significant gaps in the translation of knowledge into preventive actions such as testing and vaccination
Improved fatty acid extraction from microalgae with a novel combined process pulsed electric field-supercritical CO₂ extraction
Authors: Thabit Hadeel Mohammed
Published: December 2024

Microalgae are a sustainable alternative to source for high-value fatty acids (FAs) with production potential nutraceutical, pharmaceutical, and biofuel applications. Traditional extraction techniques, however, have faced challenges like low yields, solvent toxicity and energy-intensive operations. A novel integrated PEF-scCO2 extraction strategy promise to release the maximum fatty acids yield with optimal quality directly from Chlorella vulgaris without even needing organic extraction solvents. The FAs were selectively extracted from the PEF pre-treated cells as step 1 of the tri-extraction procedure using scCO2. Optimization of PEF and scCO2 conditions are being executed with response surface methodology (RSM) with a core integrated method, involving testing several process factors. The lowest Y selectivity (38.2% yield) was obtained with the integrated PEF-scCO2 technique, whereas use of the GC-MS technique for fatty acid analyses slightly improved Y selectivity (41.2% yield) over Y selectivity (41.1%) using the other techniques. Both were significantly higher in comparison with the values obtained by conventional solvent extractions (hexane and chloroform) and the standalone scCO2 extraction. The economic analysis revealed that cost-effectiveness was achievable if carried out in an industrial scale, suggesting high prospects of this integrated method for sustainable and high valuable FA production from microalgae.
The Deviation Issue and Total Completion Time on a Single Machine Scale Subject to Decreasing and Growing Linear Deterioration are Theoretically Addressed
Authors: Alsudani Mohammed , Ali Chachan Hanan
Published: December 2024

We addressed in this research the schedule of activities that are subject to the condition of linear degradation in declining and growing rate states, respectively, with the goal of guaranteeing that the primary process's duration would be fixed (ρ) and that its implementation would take place in a single machine. The objective was to find the optimal schedule for calculating the total completion time ∑_(ḭ=1)^ń▒C_ḭ , and the optimal schedule for the deviation problem (sum of squares of the difference between the tasks' total required time and the previously established due date time. where the objective is to minimize the squared deviation of job completion times from a due date), two theories that state as the Λ-shaped scheduling theory with increasing rate ƛ_ḭ of jobs and the v-shaped scheduling theory with decreasing rate đ_ḭ of jobs satisfy the conditions 0<đ_ḭ<1 ańd đ_ḭ<1/(ń-1), have been demonstrated in situations where the base is implemented at a constant basic processing time .