bluuebunny/crossref_metadata_2025_split huggingface dataset:
Blockchain-enabled digital twin system for brain stroke prediction
Authors: Upadrista Venkatesh , Nazir Sajid , Tianfield Huaglory 
Published: January 2025

Abstract
A digital twin is a virtual model of a real-world system that updates in real-time. In healthcare, digital twins are gaining popularity for monitoring activities like diet, physical activity, and sleep. However, their application in predicting serious conditions such as heart attacks, brain strokes and cancers remains under investigation, with current research showing limited accuracy in such predictions. Moreover, concerns around data security and privacy continue to challenge the widespread adoption of these models. To address these challenges, we developed a secure, machine learning powered digital twin application with three main objectives enhancing prediction accuracy, strengthening security, and ensuring scalability. The application achieved an accuracy of 98.28% for brain stroke prediction on the selected dataset. The data security was enhanced by integrating consortium blockchain technology with machine learning. The results show that the application is tamper-proof and is capable of detecting and automatically correcting backend data anomalies to maintain robust data protection. The application can be extended to monitor other pathologies such as heart attacks, cancers, osteoporosis, and epilepsy with minimal configuration changes.
Long-term effects of institutional quality on financial inclusion in Asia–Pacific countries
Authors: Vo Duc Hong 
Published: January 2025

Abstract
Financial inclusion has recently emerged as an important pillar for sustainable economic growth, poverty eradication, and social transformation globally. While the effects of institutional quality on financial inclusion have been widely investigated, their long-term effects have largely been underexplored, particularly for the Asia–Pacific region. We are especially interested in these long-term effects because institutional reforms require time for implementation and their impacts on various socioeconomic issues are only gradually observed. This paper has developed a new index of institutional quality for countries in the Asia–Pacific region from 2004 to 2020 using the principal component analysis. We estimate the long-term effects of institutional quality on financial inclusion using long-term estimators, including the augmented mean group and the common correlated effects mean group estimators. In our study, institutional quality is proxied by the new index developed in this paper and then by each of the five fundamental aspects of institutional quality: (i) business freedom, (ii) regulatory quality, (iii) investment freedom, (iv) government effectiveness, and (v) the rule of law. We find that improved institutional quality is fundamental to achieving financial inclusion in the region. These effects are particularly prominent in high-income countries in the Asia–Pacific region. However, a closer look at these long-term effects reveals that this effect is conditional on the income level. Interestingly, this long-term effect can be established for high-income countries such as Australia and Japan but not for Singapore. In addition, in the case of middle-income countries, the long-term effect can be confirmed for countries such as Malaysia, Indonesia, and the Philippines but not for Thailand and Vietnam. Our results show that institutional reform, albeit very important, should not be considered the only fundamental pillar ensuring financial inclusion, sustainable economic growth, and social transformation in the long run.
Alu insertion polymorphisms and susceptibility to metabolic syndrome in a Moroccan population
Authors: Farhane Hamid , Motrane Majida , Soufaine Karchali , Anaibar Fatima-Ezzahra , Motrane Aïcha , Abeid Said Nassor , Hilali Abderraouf , Harich Nourdin 
Published: January 2025

Abstract

Background
Metabolic syndrome (MetS) is a multifaceted disorder that significantly elevates the cardiovascular disease risk. The diversity of the combination of its main components, conditioned by genetics and environmental risk factors, contributes to the complexity of this health condition and increases the difficulty of its diagnosis and treatment.

Objective
Our study aimed to explore the association between four Alu insertion polymorphisms and the risk of MetS as well as its components in the Doukkala population of Morocco.

Methods
A case–control study was conducted on 175 cases of MetS and 252 controls. Four Alu insertion polymorphisms (Alu-ACE, Alu-TPA25, Alu-PV92, and Alu-APOA1) were genotyped using Polymerase Chain Reaction followed by direct electrophoresis of its products.

Results
Our results showed that the Alu-PV92 and Alu-APOA1 Ins/Del polymorphisms are significantly associated with MetS, the patients are characterized by higher frequencies of genotype II (OR = 6.96, 95% CI [4.12–11.75], p < 0.0001) and *Ins allele for Alu-PV92, and DD genotype (OR = 3.32, 95% CI [1.57–7.00], p = 0.001) and *Del allele for Alu-APOA1 compared to controls. Additionally, a significant association was revealed with MetS in men carrying the *Ins allele and the Alu-TPA25 II genotype (OR = 2.11, 95% CI [1.00–4.44], p = 0.0487). Furthermore, our study concluded that the Alu polymorphisms analyzed were linked to several MetS components, such as hyperglycemia, obesity, hypertension, hyperglycemia, and abnormal lipid levels.

Conclusion
The Alu-PV92 and Alu-APOA1 Ins/Del polymorphisms were associated with an elevated MetS risk and its components in both women and men from the Doukkala population, while the Alu-TPA25 Ins/Del polymorphism are associated only in men with only some components. These findings hold considerable public health implications, indicating that Alu polymorphisms could serve as biomarkers for identifying individuals at risk of developing MetS.
Novel tetracycline hybrids: synthesis, characterization, docking studies and in-vitro evaluation of antibacterial activity
Authors: Shah Mansi , Suhagia Bhanubhai , Goswami Sunita , Sagar Sneha , Patwari Arpit 
Published: January 2025

Abstract

Background
The biggest menace in the world today is the infection caused by pathogenic bacteria in humans, where majority of the available antibiotics fail to provide therapeutic results due to resistance. The discovery of new molecules is the need of the hour and several research groups worldwide are contributing to fight this scare. This work highlights our efforts towards discovering novel tetracycline hybrids that could serve as potent agents against several pathogenic bacterial strains causing infections. In total, ten compounds were synthesized which were chemically conjugates of Minocycline, an age-old tetracycline, and naturally occurring aldehydes and ketones available from the plant sources. Structural characterization of these compounds was done using Mass and 1HNMR. Molecular docking was carried out in order to predict the binding affinity of these compounds to various bacterial enzymes and known protein targets and to establish the structure–activity relationships. Molecular dynamic simulation studies and in silico pharmacokinetic and toxicity prediction studies were done to determine in silico pharmacokinetics and toxicity of compounds. In-vitro antibacterial activities were done using standard protocols against gram positive bacteria like Enterococcus faecalis, Staphylococcus aureus and gram-negative bacteria like Klebsiella pneumoniae, Pseudomonas aeruginosa and Escherichia coli.

Results
Promising results were obtained viz. compound 1,2 and 10 were found to be more potent against Staphylococcus aureus, compound 1 against Enterococcus faecalis, compound 2 and 3 against Escherichia coli, compound 7 and 8 against Pseudomonas aeruginosa and compound 7 against Klebsiella pneumoniae when compared with minocycline as standard compound.

Conclusion
All the synthesized compounds were screened for their anti-bacterial activity against gram positive and gram negative microorganisms. Amongst the ten synthesized minocycline hybrids, four minocycline hybrids exhibited potent antibacterial activity as compared to minocycline. These hybrids can serve as a promising lead compound for antibiotic drug discovery.
Relation between pulmonary function changes and diaphragmatic ultrasound in patients with idiopathic pulmonary fibrosis
Authors: Ibrahim Alaa Ahmed , Abd-Eldayem Aya Mohamed Mohamed , Hamid Hossam Eldin Mohamed Abdel 
Published: January 2025

Abstract

Background
IPF is a chronic disease with impaired diaphragmatic function. In the vast majority of patients, lung function gradually deteriorates until intractable respiratory failure occurs.

Aim of work
To assess diaphragmatic ultrasound in IPF patients and its relation to functional parameters.

Subjects and methods
This study used a case–control design and involved IPF patients who were either attending an outpatient clinic or admitted to a ward at Ain Shams University Hospitals and Abbassia Chest Hospital. Forty-five participants were included and split up into 3 groups: group A: 15 IPF cases suffering from hypoxia. Group B: 15 IPF patients without hypoxia or respiratory failure. Group C: 15 healthy participants as controls.

Result
Groups A and B had considerably decreased diaphragm excursion (QB), thickness of diaphragm at the end of inspiration, diaphragm thickness fraction, and diaphragm thickness fraction % when compared to the control group. Patients' diaphragm excursion during deep breathing was significantly smaller in group A than it was in the controls.
The diaphragm excursion (QB and DB), the thickness of the diaphragm at the end of inspiration, the thickness fraction, and the fraction % were positively associated with FVC, FEF 25–75, FEV1, 6MWT, the O2 sat before, the O2 sat after, and the O2 at RA, while they were negatively correlated with FEV1/FVC. There was no difference between groups in diaphragm thickness at the end of expiration.

Conclusion
Diaphragmatic ultrasound parameters demonstrated strong correlations with pulmonary function parameters, 6-min walk test, and oxygen saturation levels.
Aortic valve repair with sinus plication for a regurgitant bicuspid aortic valve: a case report
Authors: Aratame Atsutaka , Kunihara Takashi , Baba Toshio , Sakaguchi Masanori , Sumii Yosuke , Fukuda Mikado , Takahashi Yosuke 
Published: January 2025

Abstract

Background
Repair of the regurgitant bicuspid aortic valve is an attractive alternative to valve replacement. Although good long-term outcomes have been reported, postoperative aortic stenosis remains a major late cause of repair failure in bicuspid aortic valves. Sinus plication is effective for creating a more symmetrical commissural angle, leading to a decrease in the mean transvalvular pressure gradient. Herein, we report a successful case of aortic valve repair with sinus plication for a regurgitant bicuspid aortic valve.

Case presentation
The patient was a 34-year-old man with bicuspid aortic valve, severe aortic regurgitation, and left ventricular dilatation. Echocardiography revealed an eccentric aortic regurgitation jet caused by a fused cusp prolapse. The commissural angle was approximately 136°, classified as asymmetrical. The patient underwent surgery via median sternotomy. Cardiopulmonary bypass was initiated using the ascending aortic and single two-stage atrial cannulation with left ventricular venting via the right superior pulmonary vein. After the ascending aorta was cross-clamped, transection was performed 5–10 mm above the sinotubular junction. Based on the valve configuration, annuloplasty, sinus plication, and ascending aortic replacement were planned in addition to triangular resection of the bulking raphe tissue with central cusp plication. Mattress sutures of 4–0 polypropylene, reinforced with autologous pericardium, were placed outside the fused cusp for sinus plication. The sutures extended from the basal ring to the sinotubular junction, reducing the sinus circumference by approximately 15 mm. Intraoperative transesophageal echocardiography revealed trivial aortic regurgitation and modified commissural angulation. The operation, cardiopulmonary bypass, and aortic cross-clamping times were 311, 129, and 95 min, respectively.
The clinical course was uneventful, without major complications. Postoperative echocardiography demonstrated an improved commissural angle. Follow-up echocardiography demonstrated trivial aortic regurgitation and a decreased mean transvalvular pressure gradient.

Conclusions
Sinus plication may be one of the most effective repair techniques for asymmetrical bicuspid aortic valves, especially in cases without Valsalva sinus dilation. This technique helps avoid postoperative aortic valve stenosis.
Traumatic Vertebral Artery Injury After Subaxial Cervical Spine Injuries: Incidence, Risk Factors, and Long-Term Outcomes: A Population-Based Cohort Study
Authors: El-Hajj Victor Gabriel , Habashy Karl J. , Cewe Paulina , Atallah Elias , Singh Aman , Fletcher-Sandersjöö Alexander , Bydon Mohamad , Fagerlund Michael , Jabbour Pascal , Gerdhem Paul , Elmi-Terander Adrian , Edström Erik 
Published: January 2025

BACKGROUND AND OBJECTIVES:
Vertebral artery injury (VAI) because of traumatic subaxial cervical spine injury is a rare but potentially devastating condition as it could lead to stroke. The aim of this study was to examine the incidence, risk factors, outcomes, and radiographic predictors of VAI in patients surgically treated for subaxial cervical spine injuries at a tertiary care trauma center.

METHODS:
This is a retrospective population-based cohort study, including all patients surgically treated for traumatic subaxial cervical spine injuries at the study center between 2006 and 2018. Primary outcomes included mortality and morbidity after the injury. Propensity score matching, survival, univariable, and multivariable analyses were used to study the outcomes of interest.

RESULTS:
Traumatic VAI primarily occurred after high-energy traumas such as motor vehicle accidents and falls from heights. The median age was 64.4 years (47.4-69.1), and 69% were male. In the cohort of patients with subaxial cervical injury, 54% had a spinal cord injury (SCI). In the subgroup with VAI, the frequency of SCI was 66% and a concomitant SCI and VAI were associated with a more severe American Spinal Cord Injury Association Impairment Scale grade (P = .015). However, after accounting for age, sex, and associated injuries, VAI did not affect postoperative complications, short- or long-term outcomes, or mortality rates. Facet joint dislocation was a unique radiographic predictor of VAI (odds ratio 3.8 [CI 1.42-10.7], P = .009).

CONCLUSION:
The findings suggest that clinical outcomes of patients with traumatic cervical spine injuries were not negatively affected by the presence of a VAI. Several radiographic factors were associated with VAI; however, only facet joint dislocation remained as an independent predictor of this injury.
Lymphogranuloma venereum proctosigmoiditis misdiagnosed as inflammatory bowel disease: A case report
Authors: Khoury Kaline Maya , Jradi Ahmad , Karam Karam , Fiani Elias 
Published: January 2025

BACKGROUND
There has been a rise in the number of cases diagnosed as lymphogranuloma venereum (LGV), caused by the transmission of Chlamydia trachomatis, specifically serotypes L1, L2, and L3, mostly in men who have sex with men (MSM). LGV can clinically manifest as rectal discomfort, bleeding, and mucoid discharge mimicking inflammatory bowel disease (IBD). Therefore, the role of a wholesome collection of patient history along with gaining patient trust and ease in reporting different elements of their life— whether social or sexual history-could greatly guide physician’s investigations leading to timely and more efficient diagnosis.
CASE SUMMARY
A 38-year-old male presenting with symptoms of rectal bleeding, mucoid discharge, and abdominal pain during the past month. Initial treatment for hemorrhoids given at an outpatient clinic did not improve the patient’s complaints warranting further examinations, whereby endoscopy revealed the presence of mucosal edema and ulcerations in the rectosigmoid area rendering IBD a plausible diagnosis theoretically, but practically refuted due to the negative biopsy results, and positive result of nucleic acid amplification testing of the rectal swab sample for Chlamydia trachomatis. The latter results are in accordance with the diagnosis of LGV proctosigmoiditis. Accordingly, medical therapy with doxycycline was instituted, which yielded a notable symptomatic relief, and an education on safe sexual practices.
CONCLUSION
LGV proctosigmoiditis is a crucial differential diagnosis in high risk patients, such as MSM that should be differentiated from IBD. Obtaining a thorough sexual history is pivotal to prevent misdiagnosis and guarantee prompt, effective therapy.
Diffuse panbronchiolitis in children misdiagnosed as asthma: A case report
Authors: Klubdaeng Anuvat , Tovichien Prakarn 
Published: January 2025

BACKGROUND
Diffuse panbronchiolitis (DPB) is a rare, chronic inflammatory lung disease marked by chronic cough, breathlessness, and preceding sinusitis. Symptoms often persist for years and can be misdiagnosed as asthma, particularly in children. This report describes a DPB case resolved with long-term azithromycin therapy, emphasizing the need for a timely and accurate diagnosis.
CASE SUMMARY
A 12-year-old girl, diagnosed with asthma at age five and managed with inhaled corticosteroids and long-acting beta-2 agonists, developed a history of chronic productive cough and chronic sinusitis for a year. On examination, she exhibited wheezing and coarse crackles. Despite receiving treatment for an asthma exacerbation, her symptoms did not improve. A chest X-ray revealed reticulonodular infiltration in both lower lungs, prompting further evaluation with high-resolution computed tomography (HRCT). The HRCT confirmed centrilobular nodule opacities, a 'tree-in-bud' pattern, and non-tapering bronchi, suggesting DPB. Elevated cold hemagglutinin titers at 128 further supported the diagnosis. Her cough and sinusitis resolved within a month after starting azithromycin therapy, chosen for its anti-inflammatory and immunomodulatory effects. Follow-up HRCT scans after 1 year of continuous treatment showed complete normalization.
CONCLUSION
This case highlights the importance of early diagnosis and prompt treatment in achieving favorable outcomes for DPB.
Association between cardiometabolic index and overactive bladder in adult American women: A cross-sectional study
Authors: Li Junhua , He Min , Zhou Yu 
Published: January 2025

Background
Overactive bladder (OAB) is a common disorder, particularly in women, and its symptoms, including urgency, frequency, and nocturia, can significantly affect quality of life. The cardiometabolic index (CMI) is a novel metabolic risk indicator that has been receiving more attention lately. This study investigated the association between CMI and OAB in adult women.

Methods
A cross-sectional analysis was performed using data from the National Health and Nutrition Examination Survey (NHANES) covering the years 2007 to 2018, including 6323 female participants. CMI was calculated based on waist-to-height ratio, triglyceride, and HDL cholesterol levels, while OAB was assessed using the overactive bladder symptom score (OABSS). The association between CMI and OAB was evaluated through multivariate logistic regression, generalized additive models (GAM), smoothing curve fitting, and subgroup analysis. We finally included male participants for sensitivity analysis.

Results
A significant positive association was found between female CMI and OAB prevalence (OR = 1.46, 95% CI: 1.29–1.65). When compared to the lowest CMI quartile (Q1), women in the highest CMI quartile were 70% more likely to have OAB (OR = 1.70, 95% CI: 1.42–2.04). Smoothed curve fitting analysis showed a linear association between CMI and OAB. Subgroup analysis revealed that the association between CMI and OAB was stronger in women aged 20–50 years as well as in women without hypertension. Sensitivity analysis confirmed the robustness of our result.

Conclusion
CMI was significantly and positively associated with the prevalence of OAB, especially in women aged 20–50 years without hypertension. This finding provides a new perspective on metabolic risk management and may contribute to the early prevention and improvement of bladder function in women.
Screening for anxiety in patients with cancer: Diagnostic accuracy of GAD-7 items considering lowered GAD-7 cut-offs
Authors: Grapp Miriam , Bugaj Till J. , Terhoeven Valentin , Friederich Hans-Christoph , Maatouk Imad 
Published: January 2025

Background
A standard questionnaire for generalized anxiety disorders is the GAD-7. Attempts to improve its screening capacity in oncological settings resulted in a discussion about lowering its cut-off. This study examines the diagnostic accuracy of the GAD-7 items depending on applied cut-offs and whether, similar to depressive symptoms, a distinction between somatic-emotional and cognitive items might be relevant.

Patients and methods
Screening data from 4705 patients with cancer who were treated at the outpatient clinic of the National Centre for Tumour Diseases in Heidelberg were analysed. For the individual GAD-7 items sensitivity, specificity, positive and negative predictive values, and Clinical Utility Index were determined for cut-off ≥ 7, ≥ 8, ≥ 10 and ≥ 15 in the GAD-7 questionnaire.

Results
The best overall diagnostic accuracy was found for a cut-off ≥ 8. The cognitive items had the best diagnostic accuracy for identifying severe GAD (cut-off ≥ 15), and the somatic-emotional items had the best diagnostic accuracy for identifying mild to moderate GAD (cut-off ≥ 7, ≥ 8 and ≥ 10).

Conclusions
Our data support the recommendation of lowering the GAD-7 cut-off in oncology settings and suggest that in anxiety disorders, a symptom overlap between the physical illness and a possible mental disorder should be considered.
Analisis Pertanggungjawaban Hukum Terhadap Pengedaran Produk Skincare yang Terbukti Overclaim
Authors: Ngabito Rafyanka Ivana Putri 
Published: January 2025

Penelitian ini dilatarbelakangi oleh tindakan overclaim yang akhir-akhir ini sering ditemui dalam pasar skincare Indonesia. Tindakan overclaim ini dilakukan oleh produsen dan pelaku usaha guna meningkatkan penjualan yang mana dapat merugikan konsumen secara materil maupun inmateril sehingga perlu adanya pertanggungjawaban hukum atas pihak-pihak terkait. Penelitian ini menggunakan jenis penelitian normatif. Hasil penelitian ini menunjukkan bahwa dalam pengedaran produk skincare memiliki beberapa syarat dan ketentuan yang harus dipenuhi oleh para pihak terkait produk skincare yang akan diedarkan. Tindakan overclaim yang dilakukan oleh produsen, pelaku usaha, maupun influencer dapat diminta pertanggungjawaban hukum baik itu berupa sanksi administratif maupun sanksi pidana. Tindakan overclaim berkenaan langsung dengan beberapa peraturan perundang-undangan seperti Undang-Undang Kesehatan, Undang-Undang Perlindungan Konsumen, Undang-Undang ITE, Peraturan BPOM, bahkan Kitab Undang-Undang Hukum Pidana.