bluuebunny/crossref_metadata_2025_split huggingface dataset:
Tele-ECG improves diagnosis of acute coronary syndrome and ST-elevation myocardial infarction in Côte d’Ivoire
Authors: Diby K. F. , Gnaba A. , Ouattara P. , Ayegnon G. , Coulibaly A. , Tro G. , Dakoi S. A. , Sall F. , Adoubi A. , N’guessan K. E. , Ehua S. F. , Ohannessian R. , Moulin T. 
Published: June 2024

Introduction The emergence of cardiovascular risk factors in sub-Saharan Africa suggests an increasing incidence of acute coronary syndromes and STEMI. The aim of the study was to define the prevalence of STEMI and to describe the characteristics of patients diagnosed with STEMI within the tele-electrocardiogram (ECG) network in Côte d’Ivoire. Method A retrospective study was conducted from January 2015 to August 2019. All adult patients managed by one of the six hospitals within the telemedicine network who benefited from a remote interpretation of their ECG by the cardiology department of Bouaké University Hospital were included. The main reason for ECG interpretation, patient and ECG characteristics, diagnosis, response time and treatment were described. Results A total of 5649 patients were included. The prevalence of STEMI was 0.7% ( n = 44 cases) with a mean age of 58.6 ± 11.8 years and a M/F sex ratio of 1.93. Among STEMI patients, chest pain was the main reason for ECG testing (56.8%). Most ECGs were interpreted within 12 hours (72.8%). The anterior inter-ventricular artery location (59.1%, n = 26) was predominant. The Q wave of necrosis was absent in 18% ( n = 8) of cases. All patients received double anti-platelet aggregation and 50% ( n = 22) additional heparin therapy. No patient underwent primary angioplasty or thrombolysis, 65.9% ( n = 29) were referred to the Bouaké Cardiology Department and 34.1% ( n = 15) to the Abidjan Heart Institute. Scheduled angioplasty was performed in 20% ( n = 3) of patients in Abidjan. Conclusion Tele-ECG was an effective means of STEMI screening in Côte d’Ivoire. Systematic telethrombolysis of all patients diagnosed could improve their prognosis.
Nerva, a mobile application of gut-directed hypnotherapy for irritable bowel syndrome: User characteristics, patterns of use, and predictors of persistence
Authors: Simicich Lauren , Muniz Vanessa , Scheffrahn Katherine , Elkins Gary 
Published: June 2024

Background Hypnotic intervention for irritable bowel syndrome (IBS), or gut-directed hypnotherapy (GDH), is an effective treatment for improving IBS symptoms with minimal burden and risk in delivery to patients. The Nerva app, developed by Mindset Health, shows promise for dissemination and implementation of evidence-based GDH intervention for IBS. Objectives This study aimed to describe the demographic and clinical characteristics of Nerva app users, examine usage patterns, and explore potential factors associated with Nerva app usage. Methods A retrospective analysis of data was conducted of 14,898 individuals who downloaded and used the Nerva app between January 2022 and September 2022. Descriptive statistics and Chi-square tests of independence were calculated to examine demographic/clinical characteristics, usage patterns, and their associations to program persistence. Simple linear regression models were used for correlations of GI symptoms severity scores to user persistence. Results Users predominantly identified as female (77.2%; n = 11,503) and had a mean age of 38.59 years old ( SD = 13.38). Thirty-one percent of users persisted with the program, and a small statistically significant association was found between Nerva app program persistence and age, χ2 (6, N = 6745) = 164.82, p < 0.001, V = .16. Conclusions The present study found promising adherence rates for the Nerva app program within the first six weeks of use. Statistics in prevalence estimates of IBS agree with previous literature and significant associations were found between user/clinical characteristics and Nerva app program persistence.
A gamified cognitive behavioral therapy for Arabs to reduce symptoms of depression and anxiety: A case study research
Authors: Amer Nourhan A. , Shohieb Samaa M. , Eladrosy Waleed , Liu Shilong , Nam Yunyoung , Abdelrazek Samir 
Published: June 2024

Background Depression and anxiety are prevalent mental health issues addressed by online cognitive behavioral therapy (CBT) via mobile applications. This study introduces Sokoon, a gamified CBT app tailored for Arabic individuals, focusing on alleviating depression and anxiety symptoms (DASDs). Objectives The objectives of this study were to: Evaluate the effectiveness of Sokoon in reducing symptoms of depression and anxiety. Assess the usability of the intervention through user engagement and adherence to CBT skills. Methods A single-group pre–post design evaluated Sokoon's impact on adults with DASDs. In consultation with psychiatrists, Sokoon integrates evidence-based skills such as relaxation, gratitude, behavioral activation, and cognitive restructuring, represented by planets. Its design incorporates Hexad theory and gamification, supported by a dynamic difficulty adjustment algorithm. The study involves 30 participants aged 18–35 (86.7% female), specifically those with mild to moderate depression and anxiety. Results Based on a sample of 30 participants, Sokoon, a smartphone-based intervention, significantly reduced symptoms of depression and anxiety (d = 2.7, d = 3.6, p < 0.001). Over a two-week trial, participants experienced a notable decrease in anxiety and depressive symptoms, indicating the effectiveness of the model. Sokoon shows potential as a valuable tool for addressing DASDs. Conclusion Sokoon, the gamified CBT application, offers an innovative approach to increasing CBT skills adherence and engagement. By leveraging Hexad theory and gamification, Sokoon provides an enjoyable and engaging user experience while maintaining the effectiveness of traditional CBT techniques. The study findings suggest that Sokoon has a positive impact on reducing symptoms of depression and anxiety.
Association between elevated fibrosis-4 index of liver fibrosis and risk of hemorrhagic stroke
Authors: Parikh Neal S. , Zhang Cenai , Bruce Samuel S. , Murthy Santosh B. , Rosenblatt Russell , Liberman Ava L. , Liao Vanessa , Kaiser Jed H. , Navi Babak B. , Iadecola Costantino , Kamel Hooman 
Published: June 2024

Background: Cirrhosis is associated with an increased risk of hemorrhagic stroke. Liver fibrosis, typically a silent condition, is antecedent to cirrhosis. The objective of this study was to test the hypothesis that elevated Fibrosis-4 (FIB-4) index, indicating a high probability of liver fibrosis, is associated with an increased risk of hemorrhagic stroke. Methods: We performed a cohort analysis of the prospective United Kingdom Biobank cohort study. Participants 40–69 years old were enrolled between 2007 and 2010 and had available follow-up data until March 1, 2018. We excluded participants with prevalent hemorrhagic stroke or thrombocytopenia. High probability of liver fibrosis was defined as having a value >2.67 of the validated FIB-4 index. The primary outcome was hemorrhagic stroke (intracerebral or subarachnoid hemorrhage), defined based on hospitalization and death registry data. Secondary outcomes were intracerebral and subarachnoid hemorrhage, separately. We used Cox proportional hazards models to evaluate the association of FIB-4 index >2.67 with hemorrhagic stroke while adjusting for potential confounders including hypertension, alcohol use, and antithrombotic use. Results: Among 452,994 participants (mean age, 57 years; 54% women), approximately 2% had FIB-4 index >2.67, and 1241 developed hemorrhagic stroke. In adjusted models, FIB-4 index >2.67 was associated with an increased risk of hemorrhagic stroke (HR, 2.0; 95% CI, 1.6–2.6). Results were similar for intracerebral hemorrhage (HR, 2.0; 95% CI, 1.5–2.7) and subarachnoid hemorrhage (HR, 2.2; 95% CI, 1.5–3.5) individually. Conclusions: Elevated FIB-4 index was associated with an increased risk of hemorrhagic stroke.
α-Ketoglutarate alleviates osteoarthritis by inhibiting ferroptosis via the ETV4/SLC7A11/GPX4 signaling pathway
Authors: He Rong , Wei Yuchi , Peng Zeyu , Yang Jie , Zhou Zhenwei , Li Ailin , Wu Yongji , Wang Mingyue , Li Xiangyan , Zhao Daqing , Liu Zhonghua , Dong Haisi , Leng Xiangyang 
Published: June 2024

AbstractOsteoarthritis (OA) is the most common degenerative joint disorder that causes disability in aged individuals, caused by functional and structural alterations of the knee joint. To investigate whether metabolic drivers might be harnessed to promote cartilage repair, a liquid chromatography–mass spectrometry (LC–MS) untargeted metabolomics approach was carried out to screen serum biomarkers in osteoarthritic rats. Based on the correlation analyses, α-ketoglutarate (α-KG) has been demonstrated to have antioxidant and anti-inflammatory properties in various diseases. These properties make α-KG a prime candidate for further investigation of OA. Experimental results indicate that α-KG significantly inhibited H2O2-induced cartilage cell matrix degradation and apoptosis, reduced levels of reactive oxygen species (ROS) and malondialdehyde (MDA), increased superoxide dismutase (SOD) and glutathione (GSH)/glutathione disulfide (GSSG) levels, and upregulated the expression of ETV4, SLC7A11 and GPX4. Further mechanistic studies observed that α-KG, like Ferrostatin-1 (Fer-1), effectively alleviated Erastin-induced apoptosis and ECM degradation. α-KG and Fer-1 upregulated ETV4, SLC7A11, and GPX4 at the mRNA and protein levels, decreased ferrous ion (Fe2+) accumulation, and preserved mitochondrial membrane potential (MMP) in ATDC5 cells. In vivo, α-KG treatment inhibited ferroptosis in OA rats by activating the ETV4/SLC7A11/GPX4 pathway. Thus, these findings indicate that α-KG inhibits ferroptosis via the ETV4/SLC7A11/GPX4 signaling pathway, thereby alleviating OA. These observations suggest that α-KG exhibits potential therapeutic properties for the treatment and prevention of OA, thereby having potential clinical applications in the future.
The immune factors have complex causal regulation effects on kidney stone disease: a mendelian randomization study
Authors: Yuan Dongfeng , Yang Junyi , Wu Weisong , Amier Yirixiatijiang , Li Xianmiu , Wan Wenlong , Huang Yisheng , Li Jiabo , Yu Xiao 
Published: June 2024

Abstract
Purpose
Previous studies have reported the potential impact of immune cells on kidney stone disease (KSD), but definitive causal relationships have yet to be established. The purpose of this paper is to elucidate the potential causal association between immune cells and KSD by Mendelian randomization (MR) analysis.

Methods
In our study, a thorough two-sample Mendelian randomization (MR) analysis was performed by us to determine the potential causal relationship between immune cell traits and kidney stone disease. We included a total of four immune traits (median fluorescence intensity (MFI), relative cellular (RC), absolute cellular (AC), and morphological parameters (MP)), which are publicly available data. GWAS summary data related to KSD (9713 cases and 366,693 controls) were obtained from the FinnGen consortium. The primary MR analysis method was Inverse variance weighted. Cochran’s Q test, MR Egger, and MR-Pleiotropy RESidual Sum and Outlier (MR-PRESSO) were used to assess the stability of the results.

Results
After FDR correction, the CD8 on HLA DR + CD8br (OR = 0.95, 95% CI = 0.93–0.98, p-value = 7.20 × 10− 4, q-value = 0.088) was determined to be distinctly associated with KSD, and we also found other 25 suggestive associations between immune cells and KSD, of which 13 associations were suggested as protective factors and 12 associations were suggested as risk factors. There was no horizontal pleiotropy or significant heterogeneity in our MR analysis, as determined by the p-value results of our Cochrane Q-test, MR Egger’s intercept test, and MR-PRESSO, which were all > 0.05.

Conclusions
Our study has explored the potential causal connection between immune cells and KSD by Mendelian randomization analysis, thus providing some insights for future clinical studies.
Exploring the decolorization efficiency and biodegradation mechanisms of different functional textile azo dyes by Streptomyces albidoflavus 3MGH
Authors: El Awady Mohamed E. , El-Shall Fatma N. , Mohamed Ghada E. , Abd-Elaziz Ahmed M. , Abdel-Monem Mohamed O. , Hassan Mervat G. 
Published: June 2024

AbstractEfficiently mitigating and managing environmental pollution caused by the improper disposal of dyes and effluents from the textile industry is of great importance. This study evaluated the effectiveness ofStreptomyces albidoflavus3MGH in decolorizing and degrading three different azo dyes, namely Reactive Orange 122 (RO 122), Direct Blue 15 (DB 15), and Direct Black 38 (DB 38). Various analytical techniques, such as Fourier Transform Infrared (FTIR) spectroscopy, High-Performance Liquid Chromatography (HPLC), and Gas Chromatography-Mass Spectrometry (GC-MS) were used to analyze the degraded byproducts of the dyes.S. albidoflavus3MGH demonstrated a strong capability to decolorize RO 122, DB 15, and DB 38, achieving up to 60.74%, 61.38%, and 53.43% decolorization within 5 days at a concentration of 0.3 g/L, respectively. The optimal conditions for the maximum decolorization of these azo dyes were found to be a temperature of 35 °C, a pH of 6, sucrose as a carbon source, and beef extract as a nitrogen source. Additionally, after optimization of the decolorization process, treatment withS. albidoflavus3MGH resulted in significant reductions of 94.4%, 86.3%, and 68.2% in the total organic carbon of RO 122, DB 15, and DB 38, respectively. After the treatment process, we found the specific activity of the laccase enzyme, one of the mediating enzymes of the degradation mechanism, to be 5.96 U/mg. FT-IR spectroscopy analysis of the degraded metabolites showed specific changes and shifts in peaks compared to the control samples. GC-MS analysis revealed the presence of metabolites such as benzene, biphenyl, and naphthalene derivatives. Overall, this study demonstrated the potential ofS. albidoflavus3MGH for the effective decolorization and degradation of different azo dyes. The findings were validated through various analytical techniques, shedding light on the biodegradation mechanism employed by this strain.
Comparing the diagnostic considerations between general practitioners with a special interest in cardiovascular disease and those without in patients with symptoms suggestive of heart failure: a vignette study
Authors: Vermeer Cornelia J. C. , Groenewegen Amy , Hollander Monika , Schuring Janneke , Looijmans–van den Akker Ingrid , Oostindjer Andrew , van Duijn Huug , Nederend Ineke , Rutten Frans H. 
Published: June 2024

Abstract
Background
General practitioners (GPs) specialized in cardiovascular disease (GPSI-CVD) may suspect heart failure (HF) more easily than GPs not specialized in CVD. We assessed whether GPSI-CVD consider investigations aimed at detecting HF more often than other GPs in two clinical scenarios of an older male person with respiratory and suggestive HF symptoms.

Methods
In this vignette study, Dutch GPs evaluated two vignettes. The first involved a 72-year-old man with hypertension and a 30 pack-year smoking history who presented himself with symptoms of a common cold, but also shortness of breath, reduced exercise tolerance, and signs of fluid overload. The second vignette was similar but now the 72-year-old man was known with chronic obstructive pulmonary disease (COPD).
GPs could select diagnostic tests from a multiple-choice list with answer options targeted at HF, COPD or exacerbation of COPD, or lower respiratory tract infection. With Pearson Chi-square or Fisher’s exact test differences between the two GP groups were assessed regarding the chosen diagnostic tests.

Results
Of the 148 participating GPs, 25 were GPSI-CVD and 123 were other GPs. In the first vignette, GPSI-CVD more often considered performing electrocardiography (ECG) than other GPs (64.0% vs. 32.5%, p = 0.003). In the second vignette, GPSI-CVD were more inclined to perform both ECG (36.0% vs. 12.2%, p = 0.003) and natriuretic peptide testing (56.0% vs. 32.5%, p = 0.006).

Conclusions
Most GPs seemed to consider multiple diagnoses, including HF, with GPSI-CVD more likely performing ECG and natriuretic peptide testing in an older male person with both respiratory and suggestive HF symptoms.
The relationship between innate/adaptive immunity and gastrointestinal cancer : a multi-omics Mendelian randomization study
Authors: Lv Chen-Xi , Zhou Lin-Po , Yang Ye-Bing , Shi Jing , Dong Fan-He , Wei Hao-Ran , Shan Yu-Qiang 
Published: June 2024

Abstract
Background
Innate/adaptive immunity is the key to anti-tumor therapy. However, its causal relationship to Gastrointestinal (GI) cancer remains unclear.

Methods
Immunity genes were extracted from the MSigDB database. The Genome-wide association studies (GWAS) summary data of GI cancer were integrated with expression quantitative trait loci (eQTL) and DNA methylation quantitative trait loci (mQTL) associated with genes. Summary-data-based Mendelian randomization (SMR) and co-localization analysis were used to reveal causal relationships between genes and GI cancer. Two-sample MR analysis was used for sensitivity analysis. Single cell analysis clarified the enrichment of genes.

Results
Three-step SMR analysis showed that a putative mechanism, cg17294865 CpG site regulating HLA-DRA expression was negatively associated with gastric cancer risk. HLA-DRA was significantly differentially expressed in monocyte/macrophage and myeloid cells in gastric cancer.

Conclusion
This study provides evidence that upregulating the expression level of HLA-DRA can reduce the risk of gastric cancer.
Predictive values of an immunological fecal occult blood test for the diagnosis of colorectal cancer compared using colonoscopy in symptomatic patients in Yaounde (Cameroon)
Authors: Jovanka Tchuitcheu Ulrich , Wilson Ndjitoyap Ndam Antonin , Winnie Bekolo Nga , Paule Ngogang Marie , Paul Talla , Isabelle Dang Babagna , Magloire Biwole Sida 
Published: June 2024

Abstract
Introduction
The predictive value of immunological fecal occult blood (iFOB) testing for the screening of colorectal cancer has been well described in the Western world. However, its relevance in Sub-Saharan Africa (SSA) is not well evaluated. It could be altered by the other causes of lower gastrointestinal bleeding such as parasitic infections. The aim of this study was to highlight the performance of an iFOB test for the prediction of colorectal cancer (CRC) during colonoscopy in SSA.

Methodology
We conducted an analytical cross-sectional study in two digestive endoscopic centers of Yaoundé (Cameroon) from the 1st July to the 31 November 2022. Patients presenting with an indication for colonoscopy without any overt gastrointestinal bleeding were included. Sociodemographic and clinical data were collected. All consenting patients underwent a qualitative immunologic occult test through the iFOB test before colonoscopy. Data were analyzed using SPSS version 23.0 software. The performance of the iFOB test for the diagnosis of CRC during colonoscopy was evaluated in terms of sensitivity (Se), specificity (Sp), positive predictive value (PPV) and negative predictive value (NPV).

Results
We included 103 patients during the study period with a male predominance and a sex ratio of 1.7. The median age [IQR] was 52 [38—65] years (range 1 – 84 years). The most common colonoscopic lesions were polyps in 23 patients (22.3%), CRC in 17 patients (16.5%) and hemorrhoids in 15 patients (14.6%). Patients testing positive for iFOB test accounted for 43.7% (45 patients). Among these patients, 31.1% (14 patients) had a CRC. The Se of the occult blood test for CRC detection was calculated to be 82.3% (95%CI: 56.7—96.2); the Sp was 63.9% (95% CI: 53—74); the PPV was 31.1% (95% CI: 24—39) and the NPV was 94.8% (95% CI: 86.6—98.1).

Conclusion
The iFOB test has a good NPV, but a poor PPV for the diagnosis of CRC in our study.
NeuroBehcet’s-related intracranial hypertension without cerebral venous thrombosis: case report and review of literature
Authors: Shah Jinesh Mukesh , Fong Warren , De Silva Deidre Anne 
Published: June 2024

Abstract
Background
We present a rare case of NeuroBehcet’s-related intracranial hypertension without cerebral venous thrombosis (NBrIHwCVT), occurring as the first presentation of NeuroBehcet’s. In addition, we describe the novel use of subcutaneous tocilizumab for this indication. This is followed by a review of the literature on this topic.

Case
The patient was a 28-year-old lady of Southern Chinese origin with a known history of Behcet’s disease with oral ulcers and ocular findings for which she was on mycophenolate mofetil and adalimumab. She presented with a headache and bilateral disc swelling associated with an intracranial pressure (ICP) of > 40cmH20. There were no structural lesions or cerebral venous thrombosis (CVT) on imaging. Initial lumbar puncture had raised leucocytes and protein. We discuss diagnostic challenges given persistently elevated ICP despite subsequent non-inflammatory cerebrospinal fluid (CSF) profiles and non-response to acetazolamide. She eventually showed a response to immunosuppressant therapy in the form of pulsed methylprednisolone, cyclophosphamide and subsequently subcutaneous tocilizumab, supporting the diagnosis of NBrIHwCVT. Complete normalization of ICP remains challenging. Her disease course was severe, unusual for her ethnicity.

Literature review
We identified 34 patients (including ours) from 14 publications. We found that the majority of NBrIHwCVT patients were young (average age of 34 years), with a slight female preponderance. Of the 17 cases in the literature with available data on CSF profile, none had raised leucocytes whilst one patient had elevated protein. Patients were generally treated with steroids and occasionally azathioprine, in line with the suspected autoimmune pathophysiology. Of 22 patients with data on outcome, six (27%) were noted to have recurrence of symptoms generally occurring a few months later.

Conclusion
As demonstrated by this case, NBrIHwCVT can present with BD with raised ICP even if there is no prior history of NB, central Asian ethnicity, cerebral venous thrombosis or features of inflammation on the CSF. We demonstrated how novel use of Tocilizumab may have a role in the management of NBrIHwCVT. Based on our literature review, patients were more likely to be young, female, display a non-inflammatory CSF picture, be treated with steroids and harbour a possibility of recurrence.