bluuebunny/crossref_metadata_2025_split huggingface dataset:
Burden of mesothelioma in the Middle East and North Africa: a 32-year analysis of the Global Burden of Diseases Study 2021
Authors: Ghiasvand Mohammad , Fooladi Sarabi Shahnaz , Salehi Asal , Seyedi Asl Fatemeh Sadat , AlJasem Mohamad , Yaghoubi Mohammad , Ehsani Zunuz Babak , Sanatian Zahra , Alaghi Parisa , Khadembashiri Mohammad Amin 
Published: February 2025

Background:
Mesothelioma, a cancer primarily caused by asbestos exposure, has been increasing in the Middle East and North Africa (MENA), raising concerns about the region’s occupational and environmental health landscape. With varying Sociodemographic Index (SDI) and differing asbestos regulations across MENA, understanding mesothelioma trends over time is crucial.

Methods:
Using data from the Global Burden of Disease (GBD) Study 2021, we analyzed mesothelioma incidence, mortality, and disability-adjusted life years (DALYs) in MENA from 1990 to 2021. Age-standardized incidence rate (ASIR), mortality rate (ASMR), and disability rate (ASDR) were assessed by age, sex, and country. Trend analyses were conducted using joinpoint regression to identify significant shifts in disease burden over the study period.

Results:
Between 1990 and 2021, mesothelioma cases rose from 597 to 1365, with ASIR declining at an average annual percent change (AAPC) of −0.49% (P < 0.001). Countries like Oman and Saudi Arabia exhibited rising burdens, while the United Arab Emirates and Turkey saw declines. Males and older age groups had higher ASIR, ASMR, and ASDR rates, indicating gender- and age-based disparities.

Conclusion:
While the mesothelioma burden in MENA has declined overall, significant increases in certain countries highlight the need for uniform asbestos regulations and targeted health interventions, especially among high-risk demographics. Further research on occupational exposure and Sociodemographic Index (SDI) improvements could help reduce mesothelioma rates across the region.
Bibliometric analysis of artificial intelligence applications in cardiovascular imaging: trends, impact, and emerging research areas
Authors: Alotaibi Hadi , Contreas Rafael , Thakker Nisarg , Mahapatro Abinash , Adla Jala Saisree Reddy , Mohanty Elan , Devulapally Pavan , Mirchandani Mohit , Marsool Marsool Mohammed Dheyaa , Jain Shika M , Joukar Farahnaz , Alizadeh Asl Azin , Hosseini Jebelli Seyedeh Fatemeh , Amini-Salehi Ehsan , Ameen Daniyal 
Published: February 2025

Background:
The application of artificial intelligence (AI) in cardiac imaging has rapidly evolved, offering enhanced accuracy and efficiency in the diagnosis and management of cardiovascular diseases. This bibliometric study aimed to evaluate research trends, impact, and scholarly output in this expanding field.

Methods:
A systematic search was conducted on 14 August 2024, using the Web of Science Core Collection database. VOSviewer, CiteSpace, and Biblioshiny were utilized for data analysis.

Results:
The findings revealed a significant increase in publications on AI in cardiovascular imaging, particularly from 2018 to 2023, with the United States leading in research output. England and the United States have emerged as central hubs in the global research network, highlighting their role in generating high-quality and impactful publications. The University of London was identified as the top contributing institution, while Frontiers in Cardiovascular Medicine was the most prolific journal. Keyword analysis highlighted machine learning, echocardiography, and diagnosis as the most frequently occurring terms. A time trend analysis showed a shift in research focus towards AI applications in cardiac computed tomography (CT) and magnetic resonance imaging (MRI), with recent keywords like ejection fraction, risk, and heart failure reflecting emerging areas of interest.

Conclusion:
Healthcare providers should consider integrating AI tools into cardiovascular imaging practice, as AI has demonstrated the potential to enhance diagnostic accuracy and improve patient outcomes. This study highlights the rising importance of AI in personalized and predictive cardiovascular care, urging healthcare providers to stay informed about these advancements to enhance clinical decision-making and patient management.
Directly acting antivirals improve insulin resistance in nondiabetic patients with hepatitis C: a systematic review and meta-analysis
Authors: Lamichhane Pratik , Makhlouf Saed S.K. , Saleem Kanza , Jitendrabhai Senjaliya Darshakkumar , Wajid Afreen , Khanal Kapil , Agrawal Anushka 
Published: February 2025

Aims:
Insulin resistance, beta-cell dysfunction, and diabetes mellitus (DM) are the extrahepatic complications of chronic hepatitis C virus (HCV) infection. The aim of the study was to determine the effects of novel directly acting antivirals (DAAs) on insulin resistance and insulin sensitivity parameters in nondiabetic patients with chronic HCV infection.

Methods:
A systematic search of medical databases (Pubmed, Scopus, and Google Scholar) was conducted for studies published until July 2024. Studies investigating the effect of any DAA on insulin resistance and insulin sensitivity parameters in non-diabetic patients with chronic HCV and sustained virologic response were included. Our study assessed the Homeostasis Model Assessment for Insulin Resistance (HOMA-IR) as the primary outcome. The pooled outcomes were compared pretreatment and posttreatment with DAAs using Hedges’ g (HG) with a 95% confidence interval (CI).

Results:
A total of 10 studies (1309 participants) were included in the meta-analysis. Insulin resistance measured by the HOMA-IR was significantly reduced with DAA therapy (HG = 0.86, 95% CI: 0.48–1.25, P < 0.001). A similar significant reduction in fasting insulin levels was observed following DAA therapy (HG = 0.88, 95% CI: 0.51–1.25, P < 0.001). However, no significant differences were seen in Homeostasis model assessment for beta-cell function (HOMA-B) (HG = 0.12, 95% CI: −0.0 to 0.24, P = 0.06) before and after DAAs use.

Conclusions:
The use of DAAs in nondiabetic chronic HCV patients with a sustained virologic response also significantly reduces insulin resistance and fasting insulin levels.
Deep brain stimulation (DBS) in movement disorders management: exploring therapeutic efficacy, neurobiological mechanisms, and clinical implications
Authors: Hussein Abbas F. Abdul , Imran Wafa Mohammad , Serag Ibrahim , Abbas Abdallah , Mohamed Hammad Elsayed , Al-Aish Sandra Thair , Mahmoud Dina , Zazo Hassan Ahmed Mostafa , Ghattas Amr S. , Megali Mohamed H. , Muthana Ahmed , Hashim Almusawi Ali Abbas , Chaurasia Bipin 
Published: February 2025

Introduction:
Deep brain stimulation (DBS) has emerged as a promising therapeutic approach, offering targeted neuromodulation for movement disorders refractory to medical management or stereotactic surgery. However, assessing its benefits against potential risks is essential. This meta-analysis aims to evaluate the efficacy and safety of DBS in movement disorders, shedding light on its role as an alternative therapeutic option.

Methods:
A comprehensive search of databases after systemic review yielded studies published in English from 2000 to the present. Data selection, screening, extraction, and risk of bias assessment were performed meticulously. Statistical analysis was conducted using RevMan 2.0, with significant heterogeneity addressed through appropriate methods.

Results:
Our meta-analysis included 40 studies assessing the Unified Parkinson’s Disease Rating Scale Part III, revealing a significant improvement in motor symptoms (mean difference [MD]: −18.05, 95% confidence interval [CI] [−20.17, −15.93], P < 0.00001). Hoehn and Yahr Stage analysis demonstrated a reduction in disease severity (MD: −0.58, 95% CI [−1.05, −0.12], P = 0.01). Tremor severity (MD: −8.22, 95% CI [−12.30, −4.15], P < 0.0001), overall tremor (MD: −2.68, 95% CI [−4.59, −0.77], P = 0.006), gait velocity (MD: 0.13, 95% CI [0.08, 0.18], P < 0.00001), and Yale Global Tic Severity Scale score (MD: −9.75, 95% CI [−14.55, −4.96], P < 0.0001) also showed significant improvements with DBS.

Conclusion:
DBS demonstrates efficacy in improving motor symptoms, disease severity, tremor, gait, and tic severity in movement disorders. However, further research is needed to elucidate long-term efficacy and safety outcomes.
Unveiling the hidden danger: a rachnoid cyst in the fourth ventricle: a rare case report and review of the literature
Authors: Bukhari Syed Mohsin Raza , Yadav Dipesh Kumar , Mehdi Hassan , Baig Mirza Subhan Ali , Raza Mohsin , Abbas Jalil , Mehdi Ali , Anjum Abdul Sattar 
Published: February 2025

Introduction and importance:
Arachnoid cysts are benign CSF-filled sacs that commonly develop in the regions of the Sylvian fissure and cerebellopontine angle. Their occurrence in ventricles especially in the fourth ventricle is rare. These cysts can have a gamut of neurological symptoms. Surgical intervention is usually required to manage symptomatic cysts.

Case presentation:
A 55-year-old man presented with occipital headaches for 6 months, followed by increasing lower limb weakness, gait abnormalities, and cognitive impairments. Investigations revealed a cyst in the fourth ventricle extending into the foramina of Luschka, causing obstructive hydrocephalus, 8 mm tonsillar herniation, and brainstem compression. The surgical procedure involving a midline suboccipital craniotomy, cyst decompression, removal of adhering walls, and restoration of cerebrospinal fluid flow was performed, leading to the restoration of neurological functions.

Clinical discussion:
Arachnoid cysts can cause neurological symptoms as a result of pressure exertion on adjacent brain structures. Symptoms such as cognitive impairment, limb weakness, and obstructive hydrocephalus can occur due to the presence of fourth ventricular cysts, which are a rarity. The standard approach for managing a symptomatic cyst is surgical removal, which aims to relieve pressure and restore cerebrospinal fluid flow. Postoperative monitoring is essential to reduce the risk of recurrence and development of complications.

Conclusion:
The presence of an arachnoid cyst should be considered in atypical locations like the fourth ventricle in adults presenting with progressive neurological deficits. Timely surgical intervention is critical for symptom relief and avoiding complications. Long-term monitoring remains critical for detecting recurrence or treatment failure.
Primary hydatid cyst in rectus abdominis muscle: a rare presentation on an unusual location
Authors: Acharya Rabin , Saud Gaurav Singh , Bista Bindu , Mishra Bhola , Yadav Shashi Deo , Mahato Santosh Kumar 
Published: February 2025

Introduction:
Hydatid disease, caused by Echinococcus granulosus, commonly affects the liver (80%) and lungs (15%). Muscular involvement is rare, with primary hydatid cysts in skeletal muscles comprising only 2–3% of cases. This report presents the first documented case of a primary hydatid cyst in the rectus abdominis muscle in Nepal, and the 11th case globally.

Case presentation:
A 38-year-old female presented with a progressively enlarging epigastric swelling and localized pain over 1 year. On examination, a firm, non-tender 5 × 5 cm mass was palpated in the left rectus abdominis muscle. Imaging, including ultrasonography and contrast-enhanced CT, showed a well-defined cystic lesion without involvement of other organs. Serology for hydatid disease was negative. The cyst was excised surgically under general anesthesia, ensuring no spillage, and the surgical site was irrigated with hypertonic saline. Histopathology revealed acellular laminated keratin, protoscolices, and inflammatory infiltrates. Postoperatively, the patient received albendazole for 4 weeks and recovered uneventfully, with no recurrence on follow-up.

Discussion:
Primary muscular hydatid cysts are rare, as muscle contraction and lactic acid provide an unfavorable environment for the parasite. Imaging plays a vital role, as serology often yields false negatives. Surgical excision is the gold standard treatment, supported by anthelmintic therapy to prevent recurrence.

Conclusion:
This case highlights a rare presentation of hydatid disease in the rectus abdominis muscle, underscoring the importance of considering atypical locations in diagnosis. Early surgical intervention and postoperative medical therapy ensure positive outcomes.
Cell Free DNA-Based Prediction of Prognosis for Patients on Veno-Arterial Extracorporeal Membrane Oxygenation
Authors: Li Jin , Li ChengLong , Wang Liangshan , Wang Xiaomeng , Xu Bo , Jiang Chunjing , Xin Meng , Guo Dong , Chen Jing , Du Zhongtao , Wang Hong , Hao Xing , Hou Xiaotong 
Published: February 2025

ABSTRACT

Introduction
Elevated cell-free DNA (cfDNA) was observed in patients receiving venoarterial (VA) extracorporeal membrane oxygenation (ECMO), but the clinical relevance of cfDNA is still not clear. We aimed to establish an predictive model based on the cfDNA to predict the prognosis for patients on ECMO, and reveal the values of cfDNA for complications of limb ischemia and bleeding/thromboembolic events.

Methods
Single-center, retrospective evaluation of patients with ECMO support from 2018 through 2023. The derivation cohort included 133 adults diagnosed with cardiogenic shock who received VA-ECMO for circulatory support. We developed three independent features and combined them with a logistic model to predict mortality. Predictive performance was assessed through Bootstrap analysis and validated by another cohort of 27 patients. The values of cfDNA for complications were analysised by restricted cubic spline (RCS) analysis, receiver-operating characteristic curves (ROC) and multivariate regression analyses.

Results
A total of 133 adults who underwent VA-ECMO for refractory cardiogenic shock were entered into the derivation cohort. The logistic model, consisted of cfDNA, the worst mean arterial pressure (MAP) before ECMO and the worst lactate within 24 h of VA-ECMO implantation was predictive and performed similarly for validation cohorts (AUROC:0.768 vs 0.747). RCS analysis revealed a positive linear relationship for the risk of limb ischemia (linear, P = 0.006; AUROC of 0.75 [95% CI, 0.656-0.848]), a U-shaped trend for bleeding events (nonlinear, P = 0.214), and a negative trend for thrombotic events (linear, P = 0.552).

Conclusions
In addition to MAP and lactate levels, elevated cfDNA levels within 48 h of ECMO support were highly associated with mortality for patients. Additionally, cfDNA is predictive of limb ischemia.
Polymerase chain reaction for early identification of bacteria causing pneumonia in ventilated surgical and trauma patients
Authors: Pollock Aaron , Bailey Justin , Parmer Hunter , Stowe Alicia , Thelen Mitch , Carter Breanna , Sizemore Jay , Maxwell Robert 
Published: February 2025

INTRODUCTION
Ventilator-associated pneumonia occurs in 20% to 25% of intubated trauma patients, and early effective antibiotic treatment decreases morbidity and mortality. We sought to determine the sensitivity and specificity of multiplex polymerase chain reaction amplification of bacterial DNA (Biofire FilmArray Pneumonia Panel [BFPP]) obtained during fiberoptic bronchoscopy in predicting the causative bacteria the day of bronchoalveolar lavage (BAL).

METHODS
This diagnostic accuracy study compared results of BAL with quantitative culture and BFPP testing on all intubated trauma and surgery patients suspected of developing pneumonia. Demographics, clinical data, BAL culture results, and BFPP results were recorded. McNemar analysis was performed.

RESULTS
Over a 3-year study period, 151 intubated surgical critical care patients suspected of developing pneumonia underwent 238 BALs with quantitative culture and BFPP testing. Bronchoalveolar lavages that had ≥105 colony-forming units/mL growth were considered consistent with the diagnosis of pneumonia. Of the 238 BALs, 82 (34.5%) were considered positive and then correlated to the genomic copy number per milliliter (GCN/mL) reported by BFPP testing.

CONCLUSION
In ventilated patients with high clinical suspicion for pneumonia, a BFPP cutoff value of 106 GCN/mL is a sensitive and specific test for initiating antibiotics targeted to the identified organism(s). In addition, a negative BFPP result may limit unnecessary and potentially harmful empiric antibiotic coverage, as its negative predictive value is 99.8%.

LEVEL OF EVIDENCE
Guide Clinical Decision-making, Health Policies, and Preventive Strategies; Level III.
Rethinking intensity: Repetitive transcranial magnetic stimulation across ethnic populations
Authors: Zhang Bella B B , Lin Tim T Z , Qin Penny P , Jin Minxia , Xia Adam W L , Kan Rebecca L D , Zhu Frank F , Kranz Georg S 
Published: February 2025

SummaryRepetitive transcranial magnetic stimulation (rTMS) targeting the left dorsolateral prefrontal cortex is a widely used adjunctive therapy for various neurological and psychiatric disorders. Traditionally, the standard practice for dosing rTMS has involved adjusting the intensity to a defined percentage of the motor threshold. However, we perceive anatomical differences among ‘White’, ‘Han Chinese’ and ‘Black or African American’ethnic groups that result in unequal doses of stimulation at the left dorsolateral prefrontal cortex, a prime target for therapeutic rTMS. Therefore, we hypothesize that diverse ethnic populations experience different therapeutic effects with FDA-approved rTMS protocols that have been adopted globally. This also raises concerns about varying therapeutic effects and potential biases in existing research comparing efficacy across ethnicities. More importantly, our hypothesis emphasizes the need to tailor rTMS safety guideline for diverse ethnic populations. We call for well-powered clinical trials to systematically examine the effects of rTMS intensity in diverse ethnic groups.
Warmer climate threatens the occurrence of giant trees in the Amazon basin
Authors: de Lima Robson Borges , de Oliveira Cinthia Pereira , S. da Silva Diego Armando , de Souza Daniela Granato , Gonçalves Lorraine Aparecida , Vasconcelos Caroline da Cruz , Batista Anderson Pedro B. , de Matos Filho João R. , da Silva Joselane P. Gomes , Lopes Iran Jorge Correa , de Abreu Jadson Coelho , Aparício Perseu da Silva , de Souza Carla S. Campelo , Ometto Jean Pierre , Görgens Eric Bastos 
Published: February 2025

AbstractGiant trees in the Amazon play crucial ecological roles by acting as substantial carbon sinks and supporting diverse forest ecosystems. However, these emergent trees are increasingly vulnerable to climatic changes, and recent research suggests that the distribution and niche of many emergent species are severely threatened. This study employs ecological niche modeling using data LiDAR and forest inventory, global repository data, and bioclimatic variables to project the potential larger tree distributions under past, current, and future climate scenarios (SSP1-2.6 and SSP5-8.5) in different biogeographic provinces in the Amazon basin. We used algorithms MARS, RandomForest, MaxEnt, and GAM to assess the impact of critical climatic factors, including isothermality, maximum temperatures, and precipitation patterns, on the habitat suitability of these larger trees and speciesDinizia excelsaandGoupia glabra. Our results show that the tall trees dataset,Dinizia excelsaandGoupia glabraexhibit congruent distinct responses to climate variables, withDinizia excelsabeing more sensitive to increased temperature extremes, particularly in the Guiana Shield and Roraima Provinces. In contrast,Goupia glabradisplays a broader tolerance to precipitation variability. Under the high-emission scenario (SSP5-8.5), both species are projected to lose up to 45% of their suitable habitats by 2080, primarily in southern Amazon provinces like Xingu-Tapajós, where increased drought frequency and temperature extremes are expected. Conversely, the low-emission scenario (SSP1-2.6) suggests potential habitat stability or even slight expansions in the northern Amazon regions due to moderate temperature and rainfall conditions. These findings highlight the urgent need for conservation strategies to protect critical refugia and enhance ecosystem resilience. By integrating niche modeling with climate projections, our study provides vital insights into managing Amazonian giant trees, emphasizing their potential role in mitigating global climate change impacts.
Cryptic variation fuels plant phenotypic change through hierarchical epistasis
Authors: Zebell Sophia G. , Martí-Gómez Carlos , Fitzgerald Blaine , Pinto Da Cunha Camila , Lach Michael , Seman Brooke M. , Hendelman Anat , Sretenovic Simon , Qi Yiping , Bartlett Madelaine , Eshed Yuval , McCandlish David M. , Lippman Zachary B. 
Published: February 2025

ABSTRACTCryptic genetic variants exert minimal or no phenotypic effects alone but have long been hypothesized to form a vast, hidden reservoir of genetic diversity that drives trait evolvability through epistatic interactions. This classical theory has been reinvigorated by pan-genome sequencing, which has revealed pervasive variation within gene families and regulatory networks, including extensive cis-regulatory changes, gene duplication, and divergence between paralogs. Nevertheless, empirical testing of cryptic variation’s capacity to fuel phenotypic diversification has been hindered by intractable genetics, limited allelic diversity, and inadequate phenotypic resolution. Here, guided by natural and engineered cis-regulatory cryptic variants in a recently evolved paralogous gene pair, we identified an additional pair of redundant trans regulators, establishing a regulatory network that controls tomato inflorescence architecture. By combining coding mutations with a cis-regulatory allelic series in populations segregating for all four network genes, we systematically constructed a collection of 216 genotypes spanning the full spectrum of inflorescence complexity and quantified branching in over 27,000 inflorescences. Analysis of the resulting high-resolution genotype-phenotype map revealed a layer of dose-dependent interactions within paralog pairs that enhances branching, culminating in strong, synergistic effects. However, we also uncovered an unexpected layer of antagonism between paralog pairs, where accumulating mutations in one pair progressively diminished the effects of mutations in the other. Our results demonstrate how gene regulatory network architecture and complex dosage effects from paralog diversification converge to shape phenotypic space under a hierarchical model of epistatic interactions. Given the prevalence of paralog evolution in genomes, we propose that paralogous cryptic variation within regulatory networks elicits hierarchies of epistatic interactions, catalyzing bursts of phenotypic change.Keyword:cryptic mutations, paralogs, redundancy, cis-regulatory, tomato, inflorescence, gene regulatory network, modeling, epistasis