bluuebunny/crossref_metadata_2025_split huggingface dataset:
Acute exacerbation of congestive heart failure following intranasal cocaine use
Authors: Ali Ramesha 
Published: October 2024

Background: Most presentations of decompensated congestive heart failure occur in patients diagnosed with pre-existing heart failure. Decompensation presents as progressive dyspnea, abdominal and peripheral congestions, as well as neurological symptoms. It typically occurs following physiological stressors such as infection, arrhythmia, or medical non-adherence. Chronic heart failure may result from cardiovascular comorbid conditions, such as coronary artery disease, valvular disease, and long-standing hypertension.
Long term cocaine use also results in adverse cardiovascular health. Cocaine use can augment pre-existing risk factors for both chronic congestive heart failure and acute decompensations - namely, coronary artery disease, congestive heart failure, and peripheral vascular disease. It can also independently pose a cardiovascular risk by causing acute ischemia, vasoconstriction, tachycardia, systolic dysfunction, and cardiac remodeling.
The Case: the case of a 49-year-old Caucasian male, who presented with worsening dyspnea on exertion and bilateral peripheral edema extending to his abdomen. His symptoms worsened over the preceding week and began after three consecutive days of intranasal cocaine use. He presented with a background history of congestive heart failure, coronary artery disease, peripheral vascular disease, a 30 pack-year smoking history, and weekly cocaine use for the past 12 years.
Conclusion: Cocaine use can lead to decompensation of congestive heart failure in patients with extensive cardiac and vascular disease. Cocaine use can also acutely worsen systolic function and cause demand ischemia, on a background of chronic remodelling and atherosclerotic changes.
Patient Consent Obtained: Yes
The effects of postoperative delirium on outcomes in hip fracture patients
Authors: FitzGerald Kieran , O'Donnell Brian 
Published: October 2024

Background: Hip fractures have reached epidemic levels in an ever-ageing population. Based on this increase, the rate of postoperative delirium (POD) is simultaneously expected to rise as it seems to be a disproportionate hazard post-hip surgery. POD is purported to have detrimental effects, but prevention and screening efforts remain inadequate. Therefore, examination of recent evidence for negative outcomes, including decreased survival and increased complications, is critical if we seek best practice.
Objectives: This review examines the most recent evidence for the effect of POD on mortality of hip fracture patients and other outcomes such as length of stay, discharge destination and functional outcomes.
Methods: Two electronic database searches resulted in selection and critical appraisal of ten studies.
Results: Across the ten articles selected for review, the prevalence of POD ranged from 18-53.3%. Nine studies focused on mortality. In unadjusted analysis, mortality was found to have a significantly increased association with POD. However, several papers showed with effective adjustment for confounding or contributory variables, no independent association was observed. Medical complications was a focus in four of the articles, and the association with POD was observed following adjustment. Similar results were reported for increased non-home discharge and length of hospital stay.
Conclusion: POD has some effect on outcomes in hip surgeries but future research needs coherence of methods across the field and comprehensive accounting for the increased age and comorbidities of POD patients. Determining whether factors like increased length of stay are themselves the cause, rather than the result, is imperative. The lack of consistent high-quality research frustrates the validity of many of the papers conclusions on increased mortality. While we await such research an effort still needs to be made to prevent POD, especially given the more valid evidence of other less fatal effects.
High salt diet accelerates skin aging in wistar rats: an 8-week investigation of cell cycle inhibitors, SASP markers, and oxidative stress
Authors: Peng Xile , Liu Nannan , Zeng Baihan , Bai Yilin , Xu Yang , Chen Yixiao , Chen Li , Xia Lina 
Published: October 2024

BackgroundRecent studies have shown that the high salt diet (HSD) is linked to increased dermal pro-inflammatory status and reduced extracellular matrix (ECM) expression in inflamed skin of mice. Decreased ECM content is a known aging phenotype of the skin, and alterations in ECM composition and organization significantly contribute to skin aging. This study aimed to determine whether a high salt diet accelerates skin aging and to identify the time point at which this effect becomes apparent.MethodsWistar rats were randomly divided into normal diet and high salt diet groups and fed continuously for 8 weeks. Skin samples were collected at weeks 7 and week 8. Skin pathological sections were evaluated and levels of cell cycle inhibitors, senescence-associated secretory phenotype (SASP), oxidative stress and vascular regulatory factors (VRFs) were examined. Correlation analyses were performed to reveal the effect of a high salt diet as an extrinsic factor on skin aging and to analyse the correlation between a high salt diet and intrinsic aging and blood flow status.ResultsAt week 8, HSD rats exhibited thickened epidermis, thinned dermis, and atrophied hair follicles. The expression of cell cycle inhibitors and oxidative stress levels were significantly elevated in the skin of HSD rats at both week 7 and week 8. At week 7, some SASPs, including TGF-β and PAI-1, were elevated, but others (IL-1, IL-6, IL-8, NO) were not significantly changed. By week 8, inflammatory molecules (IL-1, IL-6, TGF-β), chemokines (IL-8), proteases (PAI-1), and non-protein molecules (NO) were significantly increased. Notably, despite elevated PAI-1 levels suggesting possible blood hypercoagulation, the ET-1/NO ratio was reduced in the HSD group at week 8.ConclusionThe data suggest that a high salt diet causes skin aging by week 8. The effect of a high salt diet on skin aging is related to the level of oxidative stress and the expression of cell cycle inhibitors. Additionally, a potential protective mechanism may be at play, as evidenced by the reduced ET-1/NO ratio, which could help counteract the hypercoagulable state and support nutrient delivery to aging skin.
Multi-resolution visual Mamba with multi-directional selective mechanism for retinal disease detection
Authors: Zuo Qiankun , Shi Zhengkun , Liu Bo , Ping Na , Wang Jiangtao , Cheng Xi , Zhang Kexin , Guo Jia , Wu Yixian , Hong Jin 
Published: October 2024

IntroductionRetinal diseases significantly impact patients’ quality of life and increase social medical costs. Optical coherence tomography (OCT) offers high-resolution imaging for precise detection and monitoring of these conditions. While deep learning techniques have been employed to extract features from OCT images for classification, convolutional neural networks (CNNs) often fail to capture global context due to their focus on local receptive fields. Transformer-based methods, on the other hand, suffer from quadratic complexity when handling long-range dependencies.MethodsTo overcome these limitations, we introduce the Multi-Resolution Visual Mamba (MRVM) model, which addresses long-range dependencies with linear computational complexity for OCT image classification. The MRVM model initially employs convolution to extract local features and subsequently utilizes the retinal Mamba to capture global dependencies. By integrating multi-scale global features, the MRVM enhances classification accuracy and overall performance. Additionally, the multi-directional selection mechanism (MSM) within the retinal Mamba improves feature extraction by concentrating on various directions, thereby better capturing complex, orientation-specific retinal patterns.ResultsExperimental results demonstrate that the MRVM model excels in differentiating retinal images with various lesions, achieving superior detection accuracy compared to traditional methods, with overall accuracies of 98.98\% and 96.21\% on two public datasets, respectively.DiscussionThis approach offers a novel perspective for accurately identifying retinal diseases and could contribute to the development of more robust artificial intelligence algorithms and recognition systems for medical image-assisted diagnosis.
Maintenance of sinus rhythm after electrical cardioversion to identify patients with persistent atrial fibrillation who respond favorably to pulmonary vein isolation: the pre-pacific study
Authors: Limite Luca Rosario , Laborie Guillaume , Ramirez F. Daniel , Albenque Jean-Paul , Combes Stephane , Lagrange Philippe , Khoueiry Ziad , Bortone Agustín 
Published: October 2024

BackgroundPulmonary vein isolation (PVI) is successful in approximately 50% of patients with persistent atrial fibrillation (PsAF) at one year. Identifying pre-procedurally the patients who respond favorably to a PVI alone strategy could improve their management. The present study aims to assess the predictive value of clinical response to pre-ablation electrical cardioversion (ECV) to identify the responders to PVI.MethodsConsecutive patients undergoing catheter ablation for PsAF were retrospectively classified, as “ECV successful” vs. “ECV failure”, according to the rhythm of presentation after an ECV performed ≥4 weeks. Clinical and procedural data were analyzed in both groups according to the ablation strategy applied (PVI vs. PVI + substrate modification).ResultsIn total, 58 patients (39.4%) had successful ECVs and 89 (60.6%) had failed ECV. Preprocedural characteristics were similar in both groups. Compared to the ECV failure group, patients with successful ECV presented less frequently (34% vs. 60%; P = 0.004) and less extended (21.3 ± 22.2% vs. 38.9 ± 27.4% of LA surface, P = 0.008) low-voltage areas. Over 55 ± 19 weeks of follow-up, AF-free survival was similar in both groups (72.7% vs. 67.8%, p = 0.39). PVI alone resulted in 83% AF-free survival among patients in the ECV successful group at 13 months.ConclusionIn approximately 40% of patients with PsAF, sinus rhythm can be restored by ECV and maintained for at least 1 month prior to catheter ablation. This clinical response is associated with less abnormal substrate as identified by left atrial voltage mapping and a procedural success rate of &gt;80% with PVI alone.
Integrating longitudinal mental health data into a staging database: harnessing DDI-lifecycle and OMOP vocabularies within the INSPIRE Network Datahub
Authors: Mugotitsa Bylhah , Bhattacharjee Tathagata , Ochola Michael , Mailosi Dorothy , Amadi David , Andeso Pauline , Kuria Joseph , Momanyi Reinpeter , Omondi Evans , Kajungu Dan , Todd Jim , Kiragga Agnes , Greenfield Jay 
Published: October 2024

BackgroundLongitudinal studies are essential for understanding the progression of mental health disorders over time, but combining data collected through different methods to assess conditions like depression, anxiety, and psychosis presents significant challenges. This study presents a mapping technique allowing for the conversion of diverse longitudinal data into a standardized staging database, leveraging the Data Documentation Initiative (DDI) Lifecycle and the Observational Medical Outcomes Partnership (OMOP) Common Data Model (CDM) standards to ensure consistency and compatibility across datasets.MethodsThe “INSPIRE” project integrates longitudinal data from African studies into a staging database using metadata documentation standards structured with a snowflake schema. This facilitates the development of Extraction, Transformation, and Loading (ETL) scripts for integrating data into OMOP CDM. The staging database schema is designed to capture the dynamic nature of longitudinal studies, including changes in research protocols and the use of different instruments across data collection waves.ResultsUtilizing this mapping method, we streamlined the data migration process to the staging database, enabling subsequent integration into the OMOP CDM. Adherence to metadata standards ensures data quality, promotes interoperability, and expands opportunities for data sharing in mental health research.ConclusionThe staging database serves as an innovative tool in managing longitudinal mental health data, going beyond simple data hosting to act as a comprehensive study descriptor. It provides detailed insights into each study stage and establishes a data science foundation for standardizing and integrating the data into OMOP CDM.
Mitochondrial haplogroup R offers protection against obesity in Kuwaiti and Qatari populations
Authors: Dashti Mohammed , Ali Naser M. , Alsaleh Hussain , John Sumi Elsa , Nizam Rasheeba , Al-Mulla Fahd , Thanaraj Thangavel Alphonse 
Published: October 2024

BackgroundThe Kuwaiti and Qatari populations have a high prevalence of obesity, a major risk factor for various metabolic disorders. Previous studies have independently explored mitochondrial DNA (mtDNA) variations and their association with obesity in these populations. This study aims to investigate the role of mtDNA haplogroups and variants in obesity risk among these Gulf populations.MethodsWhole exome sequencing data from 1,112 participants (348 Kuwaitis and 764 Qataris) were analyzed for mtDNA variants. Participants were classified as obese or non-obese based on body mass index (BMI). Association analyses were performed to examine the relationship between mtDNA haplogroups and obesity, adjusting for covariates such as age and sex.ResultsHaplogroup R was found to be protective against obesity, with an odds ratio (OR) of 0.69 (p = 0.045). This association remained significant after adjusting for age and sex (OR = 0.694; 95% CI: 0.482-0.997; p = 0.048). Several mtDNA variants, particularly those involved in mitochondrial energy metabolism, showed nominal associations with obesity, but these did not remain significant after correcting for multiple testing.ConclusionHaplogroup R consistently demonstrates a protective association against obesity in both Kuwaiti and Qatari populations, highlighting its potential as a biomarker for obesity risk in the Gulf region. However, further research with larger sample sizes is needed to validate these findings and clarify the role of mtDNA variants in obesity.
Estradiol-to-follicle ratio on human chorionic gonadotropin day is a novel predictor of gestational diabetes mellitus in women receiving fresh embryo transfer
Authors: Chen Huijun , Liu Yvonne , Xu Xiangwang , Hu Liang , Cai Sufen , Gong Fei , Lin Ge , Kalk Philipp , Krämer Bernhard K. , Hocher Berthold 
Published: October 2024

AimsTo assess the predictive value of estradiol (E2) related parameters on the incidence of gestational diabetes mellitus (GDM) in women undergoing fresh embryo transfer.Materials and methodsA Post-hoc analysis of a prospective cohort study.ResultsWe identified an optimal E2/follicle (E2/F) ratio threshold of 246.03 pg/ml on the day of human chorionic gonadotropin (hCG) administration. Women with an E2/F ratio exceeding this threshold had significantly lower rates of GDM (12.75% vs. 20.41%, P &lt; 0.001) and ovarian hyperstimulation syndrome (OHSS) (11.75% vs. 15.48%, P = 0.03). Additional E2 parameters were also evaluated: baseline E2, E2 on hCG day, E2 increase, and E2 fold change. Lower GDM rates were observed in women with baseline E2 above 31.50 pg/ml (13.51% vs. 19.42%, P &lt;0.01), E2 on hCG day above 3794.50 pg/ml (12.26% vs. 19.32%, P &lt; 0.001), and E2 increase above 3771.50 pg/ml (12.24% vs. 19.28%, P &lt; 0.001). There were no significant differences in OHSS rates for these additional E2 parameters. After adjusting for confounders, lower E2/F ratio (OR: 1.626, 95% CI: 1.229-2.150, P &lt;0.01), E2 on hCG day (OR: 1.511, 95% CI: 1.133-2.016, P = 0.01), and E2 increase (OR: 1.522, 95% CI: 1.141-2.031, P &lt;0.01) were identified as risk factors for GDM.ConclusionThis study demonstrates that an E2/F ratio over 246.03 pg/ml is significantly associated with a reduced risk of both GDM and OHSS in women undergoing fresh embryo transfer, highlighting the E2/F ratio as a superior predictive biomarker compared to other E2-related parameters.
Evolution of water technology from a structural perspective
Authors: Gan Lin , Wei Yongping , Wu Shuanglei 
Published: October 2024

Rivers are cradles of human civilisations and continual innovations in water technologies are the key to sustainable human development. Yet, limited research has explored the interactive dynamics among different technologies, hindering our ability to effectively manage technological transition. This paper presents a framework that conceptualizes water technology as a complex adaptive system containing three interrelated sub-systems: water demand, water supply, and water management. The interactions among these sub-systems were measured using three network-based metrics: intensity, brokerage, and efficiency. Patents registered in the World Intellectual Property Organization from 1863 to 2020 were used as the data source. It was found that 40,304 patents from 44 countries were registered, with 40% of them belonging to the water management sub-system, followed by water supply (35%), and water demand (25%). Technological development in the three sub-systems presented linear growth over the past 160 years, focusing on water treatment, hydroelectric power, hydraulic engineering and water monitoring. The water-demand sub-system was identified as the structural “bottleneck” with the highest brokerage value, which was considered crucial for knowledge transfer between the other two sub-systems. Overall, the water technology system is characterized by slow development, skewed spatial coverage, categorical homogeneity, and structural imbalances, limiting our ability to address the escalating global water threats.
Tertiary lymphoid structures and B-cell infiltration are IPF features with functional consequences
Authors: Cocconcelli Elisabetta , Balestro Elisabetta , Turato Graziella , Fiorentù Giordano , Bazzan Erica , Biondini Davide , Tinè Mariaenrica , Bernardinello Nicol , Pezzuto Federica , Baraldo Simonetta , Calabrese Fiorella , Rea Federico , Sanduzzi Zamparelli Alessandro , Spagnolo Paolo , Cosio Manuel G. , Saetta Marina 
Published: October 2024

BackgroundRecent literature has shown the presence of B cells and autoantibodies in idiopathic pulmonary fibrosis (IPF) which would imply the presence of tertiary lymphoid structures (TLS, sites where the immune response is triggered), yet TLS are not considered features of the histological characteristics of IPF.AimThis study aims to quantify the presence, size, and degree of activation of TLS in biopsied and explanted lungs from patients with early- and late-IPF, never treated with antifibrotics, and relate their presence and activity to the clinical course, disease progression, and lung inflammation.MethodsImmunohistochestry for B cells and CD4, CD8, and CD45 cells was performed in lung tissue from IPF patients: 18 at diagnosis (early), 39 explanted (end-stage), and 12 smoking controls. TLS activation was assessed by CD40 expression. Spirometry along 31 (12–72) months of follow-up was used to characterize end-stage IPF as slow progressors or rapid progressors.ResultsB cells, along with other inflammatory cells, were higher in early- and end-stage IPF than in controls (p &lt; 0.001). In rapid progressors, all inflammatory cells were higher than in slow progressors (p &lt; 0.05). TLS were present in 100% of early- and end-stage IPF and in 50% of controls. In end-stage IPF, the TLS area and activation score were higher than in early IPF (p &lt; 0.0001; p = 0.005) and controls (p &lt; 0.04; p &lt; 0.002). TLS activation score correlated with FVC decline during follow-up in rapid progressors (r = 0.73; p = 0.007) but not in slow progressors.ConclusionsA prominent B-cell infiltration, along with the presence of TLS, the activity of which correlates with FVC decline, is an important component of IPF from the beginning of the disease, likely playing an important role on its mechanism and progression.
Integrating anoikis and ErbB signaling insights with machine learning and single-cell analysis for predicting prognosis and immune-targeted therapy outcomes in hepatocellular carcinoma
Authors: Fang Huipeng , Chen Xingte , Zhong Yaqi , Wu Shiji , Ke Qiao , Huang Qizhen , Wang Lei , Zhang Kun 
Published: October 2024

BackgroundHepatocellular carcinoma (HCC) poses a significant global health challenge due to its poor prognosis and limited therapeutic modalities. Anoikis and ErbB signaling pathways are pivotal in cancer cell proliferation and metastasis, but their relevance in HCC remains insufficiently explored.MethodsThis study evaluates the prognostic significance of anoikis and ErbB signaling pathways in HCC by utilizing data from The Cancer Genome Atlas (TCGA), the International Cancer Genome Consortium (ICGC), three additional independent validation cohorts, and an in-house cohort. Advanced bioinformatics analyses and 167 machine learning models based on leave-one-out cross-validation (LOOCV) were used to predict HCC prognosis and assess outcomes of immune-targeted therapies. Additionally, key biological processes of the anoikis and ErbB signaling pathways in HCC were further investigated.ResultsThe single sample Gene Set Enrichment Analysis revealed a strong correlation between upregulated ErbB signaling in high anoikis-expressing tumors and poor clinical outcomes. The development of the Anoikis-ErbB Related Signature (AERS) using the LASSO + RSF model demonstrated robust predictive capabilities, as validated across multiple patient cohorts, and proved effective in predicting responses to immune-targeted therapies. Further investigation highlighted activated NOTCH signaling pathways and decreased macrophage infiltration was associated with resistance to sorafenib and immune checkpoint inhibitors, as evidenced by bulk and single-cell RNA sequencing (scRNA-seq).ConclusionAERS provides a novel tool for clinical prognosis and paves the way for immune-targeted therapeutic approaches, underscoring the potential of integrated molecular profiling in enhancing treatment strategies for HCC.