bluuebunny/crossref_metadata_2025_split huggingface dataset:
Gender-based time discrepancy in diagnosis of coronary artery disease based on data analytics of electronic medical records
Authors: Panahiazar Maryam , Bishara Andrew M. , Chern Yorick , Alizadehsani Roohallah , Islam Sheikh M. Shariful , Hadley Dexter , Arnaout Rima , Beygui Ramin E. 
Published: November 2022

BackgroundWomen continue to have worse Coronary Artery Disease (CAD) outcomes than men. The causes of this discrepancy have yet to be fully elucidated. The main objective of this study is to detect gender discrepancies in the diagnosis and treatment of CAD.MethodsWe used data analytics to risk stratify ~32,000 patients with CAD of the total 960,129 patients treated at the UCSF Medical Center over an 8 year period. We implemented a multidimensional data analytics framework to trace patients from admission through treatment to create a path of events. Events are any medications or noninvasive and invasive procedures. The time between events for a similar set of paths was calculated. Then, the average waiting time for each step of the treatment was calculated. Finally, we applied statistical analysis to determine differences in time between diagnosis and treatment steps for men and women.ResultsThere is a significant time difference from the first time of admission to diagnostic Cardiac Catheterization between genders (p-value = 0.000119), while the time difference from diagnostic Cardiac Catheterization to CABG is not statistically significant.ConclusionWomen had a significantly longer interval between their first physician encounter indicative of CAD and their first diagnostic cardiac catheterization compared to men. Avoiding this delay in diagnosis may provide more timely treatment and a better outcome for patients at risk. Finally, we conclude by discussing the impact of the study on improving patient care with early detection and managing individual patients at risk of rapid progression of CAD.
Production of biodiesel and analysis of exhaust particulate emissions and metal concentration of lubricant oil of the compression ignition engine
Authors: Bhangwar Sajjad , Liaquat Ali Memon , Luhar Muhammad Ramzan , Abbasi Aijaz , Kumar Laveet , Rajput Umair Ahmed , Mastoi Sanaullah 
Published: November 2022

In this research, biodiesel fuel is produced using potassium hydroxide (KOH) as a catalyst and methanol as a co-solvent through the transesterification process. The analysis of particulate matter emissions from a compression ignition (CI) engine with pure diesel fuel (D100), biodiesel-mixed (B30), and clove oil (CL3000 ppm) was carried out. The findings obtained revealed 5.27% reduction of particulate matter in biodiesel-blended fuel, and furthermore, when clove was added to the biodiesel-blended fuel, 11.61% reduction of particulate matter was observed as compared to pure diesel. It may be due to the higher oxygen ratio present in clove oil. The engine was run for 100 h on each fuel sample, and the data were taken and tested per 25 h for elemental analysis. The results manifest that the metal concentration found different elements in lubricant oil, i.e., lead (51.84), (24.89%), and (23.255%); copper (47.41%), (28.71%), and (23.86%); nickel (37.88%), (32.32), and (29.78%); and cadmium (46.12), (29.87%), and (24.01%) in diesel, biodiesel-blended fuel, and biodiesel blended with clove oil, respectively. This study found better results for engine life, which shows the lower metal concentration in biodiesel-blended fuel and clove oil than diesel. Furthermore, the fuels investigated in this research can reduce the wear of engine parts because biodiesel and clove oil contain a high oxygen ratio. Moreover, it has been found that biodiesel and clove oil as an antioxidant have a positive impact on noise emission levels for the CI engine.
Spatial distribution and influencing factors of mountainous geological disasters in southwest China: A fine-scale multi-type assessment
Authors: Shu Bo , Chen Yang , Amani-Beni Majid , Zhang Ruizhi 
Published: November 2022

Abstract: Geological disasters have long been a constant threat to socioeconomic development and human life and property. Many studies focus on the occurred geological disasters and ignore the potential risk events. Fine-scale multi-type analysis of Potential Geological Disasters Spots (PGDSs) is a necessary but insufficiently explored research field in China’s mountainous areas. Taking Meigu County (Sichuan Province, Southwest China), a typical disaster-prone region, as the study area. Average nearest neighbor (ANN), standard deviational ellipse (SDE), kernel density estimation (KDE), and ordinary least squares (OLS) regression are used to assess the spatial distribution of potential geological disasters spots and their influencing factors. The findings show that: potential geological disasters spots have a significant spatial heterogeneity and exhibited a prominent clustering characteristic. They were distributed in an elevation range of 1,500–2000 m, which receives an average monthly rainfall of more than 240 mm, as well as in highly foliated (0.6 &lt; Normalized Difference Vegetation Index (NDVI) &lt; 0.8), west-facing (247.5–292.5°), and slopes of 10–20°. In addition, slope, aspect, population density, and rainfall were found as the main influencing factors. The results provide practical rural development measures with support for potential geological disasters spots avoidance and preparedness.
Clinical heterogeneity of hyperornithinemia-hyperammonemia-homocitrullinuria syndrome in thirteen palestinian patients and report of a novel variant in the SLC25A15 gene
Authors: Dweikat Imad , Khalaf-Nazzal Reham 
Published: November 2022

Background: Hyperornithinemia-Hyperammonemia-Homocitrullinuria (HHH) syndrome, is a rare autosomal recessive disorder characterized by impaired ornithine transport across the inner mitochondrial membrane. HHH is caused by biallelic disease-causing variants in the SLC25A15 gene. The clinical presentation of HHH is highly variable ranging from severe neonatal encephalopathy and hepatic failure to a milder form with corresponding learning difficulties.Methods: In this study, data from thirteen patients with HHH syndrome, diagnosed between the age of 1 week–29 years at two tertiary care centers in Palestine, is presented. The clinical, biochemical, and molecular data are reviewed.Results: Analysis of the SLC25A15 gene sequence revealed a novel homozygous frameshift deletion in exon 5, NM_014252.4:c.552-555delTTTC; p (Phe185SerfsTer8) in nine patients. The remaining four patients had a recurrent homozygous frameshift variant; NM_014252.4:c.446delG, (p.Ser149ThrfsTer45). The major acute clinical presentation found was encephalopathy and liver dysfunction. Nervous system involvement was common, progressive, and presented with signs of upper motor neuron disease as well as variable degrees of cognitive impairment. One patient had an initial presentation in adulthood with acute encephalopathy that responded well to treatment. There was no clear genotype-phenotype correlation.Conclusion: Our results confirm the marked clinical heterogeneity of HHH including severe neonatal presentation, hepatic failure, and progressive pyramidal tract dysfunction in all age groups. The disease progression was variable, even in patients with the same genetic variant, and in patients with severe neonatal-onset hepatic encephalopathy. We report a novel pathogenic variant in the SLC25A15 gene, further expanding the molecular spectrum of the disease.
Exposure to endosulfan can cause long term effects on general biology, including the reproductive system of mice
Authors: Sharma Anju , Kaninathan Arigesavan , Dahal Sumedha , Kumari Susmita , Choudhary Bibha , Raghavan Sathees C. 
Published: November 2022

Increased infertility in humans is attributed to the increased use of environmental chemicals in the last several decades. Various studies have identified pesticides as one of the causes of reproductive toxicity. In a previous study, infertility was observed in male mice due to testicular atrophy and decreased sperm count when a sublethal dose of endosulfan (3 mg/kg) with a serum concentration of 23 μg/L was used. However, the serum concentration of endosulfan was much higher (up to 500 μg/L) in people living in endosulfan-exposed areas compared to the one used in the investigation. To mimic the situation in an experimental setup, mice were exposed to 5 mg/kg body weight of endosulfan, and reproductive toxicity and long-term impact on the general biology of animals were examined. HPLC analysis revealed a serum concentration of ∼50 μg/L of endosulfan after 24 h endosulfan exposure affected the normal physiology of mice. Histopathological studies suggest a persistent, severe effect on reproductive organs where vacuole degeneration of basal germinal epithelial cells and degradation of the interstitial matrix were observed in testes. Ovaries showed a reduction in the number of mature Graafian follicles. At the same time, mild vacuolation in liver hepatocytes and changes in the architecture of the lungs were observed. Endosulfan exposure induced DNA damage and mutations in germ cells at the molecular level. Interestingly, even after 8 months of endosulfan exposure, we observed increased DNA breaks in reproductive tissues. An increased DNA Ligase III expression was also observed, consistent with reported elevated levels of MMEJ-mediated repair. Further, we observed the generation of tumors in a few of the treated mice with time. Thus, the study not only explores the changes in the general biology of the mice upon exposure to endosulfan but also describes the molecular mechanism of its long-term effects.
Tumor immune microenvironment in endometrial cancer of different molecular subtypes: evidence from a retrospective observational study
Authors: Dai Yibo , Zhao Luyang , Hua Dingchao , Cui Lina , Zhang Xiaobo , Kang Nan , Qu Linlin , Li Liwei , Li He , Shen Danhua , Wang Zhiqi , Wang Jianliu 
Published: November 2022

ObjectiveTumor immune microenvironmental features may predict survival and guide treatment. This study aimed to comprehensively decipher the immunological features of different molecular subtypes of endometrial cancer.MethodsIn this retrospective study, 26 patients with primary endometrial cancer and four with recurrent disease treated in our center from December 2018 to November 2021 were included. Next-generation sequencing was performed on tumor samples. Patients were classified into four subtypes, including POLE mutant, microsatellite instability high (MSI-H), no specific molecular profile (NSMP) and TP53 mutant subtypes. Tumor-infiltrating immune cells were quantified using multiplex immunofluorescence assays.ResultsOf the 26 primary endometrial cancer cases, three were POLE mutant, six were MSI-H, eight were NSMP and nine were TP53 mutant. Of the four recurrent cases, two belonged to the NSMP subtype and two belonged to the TP53 mutant subtype. The tumor mutation burden (TMB) levels of POLE mutant and MSI-H cases were significantly higher than that of the other two subtypes (p&lt; 0.001). We combined POLE mutant and MSI-H subtypes into the TMB high (TMB-H) subtype. The TMB-H subtype showed a high degree of infiltration of CD8+ T cells. In the NSMP subtype, the overall degree of intra-tumoral infiltrating immune cells was low. In the TP53 mutant subtype, the densities of both PD-L1+ macrophages (p = 0.047) and PD-1+ T cells (p = 0.034) in tumor parenchyma were the highest among the four subtypes.ConclusionEndometrial cancer of TMB-H, NSMP and TP53 mutant subtypes displayed phenotypes of normal immune response, absence of immune infiltration, and suppressed immune response, respectively. These features may provide mechanistic explanations for the differences in patients’ prognosis and efficacy of immune checkpoint blockade therapies among different endometrial cancer subtypes.
Clinical analysis of 45 cases of perforation were identified during endoscopic retrograde cholangiopancreatography procedure
Authors: Miao Yin-Shui , Li Yuan-Yuan , Cheng Bo-Wen , Zhan Yan-Fang , Zeng Sheng , Zhou Xiao-Jiang , Chen You-Xiang , Lv Nong-Hua , Li Guo-Hua 
Published: November 2022

BackgroundEndoscopic retrograde cholangiopancreatography (ERCP) has become an important method to diagnose and treat biliary-pancreatic diseases. Perforations are infrequent but serious complications can occur during ERCPs. However, it is unclear which patients are suitable for surgery and when these patients should receive surgery.AimTo analyze the outcome of 45 patients with endoscopic retrograde cholangiopancreatography (ERCP) related perforation.Materials and methodsWe retrospectively reviewed all 45 patients with ERCP-related perforation between January 2003 and December 2017, and observed the location and causes of perforation, treatment strategies, and mortality.ResultsTwenty thousand four hundred and seventy-nine patients received ERCP procedures from January 2003 to December 2017 in our digestive endoscopy center. Forty-five patients suffered from ERCP-related perforations. The incidence rate of ERCP-related perforations was 0.22%. Twenty-six patients suffered from periampullary perforations, 15 patients suffered from duodenal wall perforations, 1 patient suffered from a fundus perforation, 1 patient suffered from a residual gallbladder duct perforation, 1 patient suffered from a papillary diverticulum perforation, and 1 patient suffered from an intrahepatic bile duct perforation. Six patients with duodenal perforations underwent surgery, and the other patients received conservative treatment. One patient with a duodenal perforation and ERCP-related pancreatitis died of heart failure, and all the other patients recovered. The mortality rate was 2.2%.ConclusionEndoscopic closure is seen as the first method for treating Stapfer type I perforations in the early phase, and surgery is seen as a remedial method when local treatment was failed. The Stapfer type II to type IV perforations can recover by conservative treatment.
Mild and moderate cardioembolic stroke patients may benefit more from direct mechanical thrombectomy than bridging therapy: A subgroup analysis of a randomized clinical trial (DIRECT-MT)
Authors: Cao Jie , Xing Pengfei , Zhu Xucheng , Chen Ronghua , Shao Huaming , Xuan Jinggang , Jiang Tianwei , Yang Pengfei , Zhang Yongwei , Li Zifu , Chen Wenhuo , Li Tianxiao , Wang Shouchun , Lou Min , Peng Ya , Liu Jianmin 
Published: November 2022

BackgroundThe benefit of intravenous alteplase before endovascular thrombectomy is unclear in patients with acute cardioembolic stroke.MethodsWe collected cardioembolic (CE) stroke patient data from the multicentre randomized clinical trial of Direct Intra-arterial Thrombectomy to Revascularize Acute Ischaemic Stroke Patients with Large Vessel Occlusion Efficiently in Chinese Tertiary Hospitals (DIRECT-MT). The primary outcome was the 90-day modified Rankin Scale (mRS) score. Five subgroups of cardioembolic stroke patients were analyzed. A multivariable ordinal logistic regression analysis analyzed the difference in the primary outcome between the direct mechanical thrombectomy (MT) and bridging therapy groups. An interaction term was entered into the model to test for subgroup interaction. The DIRECT-MT trial is registered with clinicaltrials.gov Identifier: NCT03469206.ResultsA total of 290 CE stroke patients from the DIRECT-MT trial were enrolled in this study: 146 patients in the direct MT group and 144 patients in the bridging therapy group. No difference between the two treatment groups in the primary outcome was found (adjusted common odds ratio, 1.218; 95% confidence interval, 0.806 to 1.841; P = 0.34). In the subgroup analysis, CE stroke patients with an NIHSS ≤ 15 in the direct MT group were associated with better outcomes (47 vs. 53, acOR, 3.14 [1.497, 6.585]) and lower mortality (47 vs. 53, aOR, 0.16 [0.026, 0.986]) than those in the bridging therapy group, while there were no significant differences between the two treatment groups in the outcome and mortality of CE stroke patients with an NIHSS &gt;15.ConclusionMild and moderate cardioembolic stroke patients may benefit more from direct mechanical thrombectomy than bridging therapy. This need to be confirmed by further prospective studies in a larger number of patients.
Efficacy of repetitive transcranial magnetic stimulation on chronic migraine: A meta-analysis
Authors: Zhong Jiugen , Lan Wanting , Feng Yanqing , Yu Ligen , Xiao Rang , Shen Yingying , Zou Zhi , Hou Xiaohui 
Published: November 2022

IntroductionMigraine is a neurovascular disorder that affects the quality of life of more than 1 billion people worldwide. Repetitive transcranial magnetic stimulation (rTMS) is a neuromodulation tool that uses pulsed magnetic fields to modulate the cerebral cortex. This meta-analysis ascertained the therapeutic or preventive effect of rTMS on chronic migraine.MethodsWe performed a database search of PubMed, Web of Science, Embase, and the Cochrane Library from January 2004 to December 2021. Eligible studies included randomized controlled studies of the analgesic effects of rTMS in patients with chronic migraine.ResultsEight studies were included. Random effects analysis showed an effect size of −1.13 [95% confidence interval (CI): −1.69 to −0.58] on the frequency of migraine attacks, indicating that rTMS was more effective for decreasing migraine attacks than the sham rTMS.ConclusionsThe meta-analysis revealed that rTMS is an effective approach for reducing migraine attack when the dorsolateral prefrontal cortex was stimulated. However, rTMS may not be suggested as a method to reduce the pain level.Systematic review registrationhttp://www.crd.york.ac.uk/PROSPERO/, identifier: CRD42021228344.
Development of nomogram to predict in-hospital death for patients with intracerebral hemorrhage: A retrospective cohort study
Authors: Hu Linwang , Yu Jie , Deng Jian , Zhou Hong , Yang Feng , Lu Xiaohang 
Published: November 2022

AimThis study aimed to investigate the association between systemic immune-inflammation (SII) and the risk of in-hospital death for patients with intracerebral hemorrhage (ICH) in the intensive care units (ICU) and to further develop a prediction model related to SII in predicting the risk of in-hospital death for patients with ICH.MethodsIn this retrospective cohort study, we included 1,176 patients with ICH from the Medical Information Mart for Intensive Care III (MIMIC-III) database. All patients were randomly assigned to the training group for the construction of the nomogram and the testing group for the validation of the nomogram based on a ratio of 8:2. Predictors were screened by the least absolute shrinkage and selection operator (LASSO) regression analysis. A multivariate Cox regression analysis was used to investigate the association between SII and in-hospital death for patients with ICH in the ICU and develop a model for predicting the in-hospital death risk for ICU patients with ICH. The receiver operator characteristic curve was used to assess the predicting performance of the constructed nomogram.ResultsIn the training group, 232 patients with ICH died while 708 survived. LASSO regression showed some predictors, including white blood cell count, glucose, blood urea nitrogen, SII, the Glasgow Coma Scale, age, heart rate, mean artery pressure, red blood cell, bicarbonate, red blood cell distribution width, liver cirrhosis, respiratory failure, renal failure, malignant cancer, vasopressor, and mechanical ventilation. A prediction model integrating these predictors was established. The area under the curve (AUC) of the nomogram was 0.810 in the training group and 0.822 in the testing group, indicating that this nomogram might have a good performance.ConclusionSystemic immune-inflammation was associated with an increased in-hospital death risk for patients with ICH in the ICU. A nomogram for in-hospital death risk for patients with ICH in the ICU was developed and validated.
SARS-CoV-2 infection increases risk of intracranial hemorrhage
Authors: Hawsawi Zuhair , Khan Dilaware , Fischer Igor , Cornelius Jan Frederick , Hänggi Daniel , Muhammad Sajjad 
Published: November 2022

IntroductionSARS-CoV-2 virus infection causes a dysbalanced and severe inflammatory response, including hypercytokinemia and immunodepression. Systemic inflammation triggered by a viral infection can potentially cause vascular damage, which may lead to cardiovascular and neurovascular events.Research questionThe aim was to investigate whether CNS complications are related to COVID-19.Materials and methodsWe examined 21 patients suffering from stroke and intracranial hemorrhage (ICH) and 9 (43%) of them were male. We compared relative frequencies using Fisher’s exact test. As we had few observations and many variables, we used principal component analysis (PCA) to reduce data dimensionality. We trained a linear support vector machine (SVM) on the first two PCs of the laboratory data to predict COVID-19.ResultsPatients suffering from stroke had either hypertension or SARS-CoV-2 infection, but seldom both (OR = 0.05, p = 0.0075). The presence of SARS-CoV-2 infection was strongly associated with the logarithm of CRP (p = 1.4e–07) and with D-DIMER (p = 1.6e–05) and moderately with PT (p = 0.0024). SARS-CoV-2 infection was not related to any other factor. CRP, D-DIMER, PT, and INR were all related to each other (R2 ranging from 0.19 to 0.52, p ranging from 0.012 to &lt; 0.0001). The first two PCs covered 96% of the variance in the four variables. Using them, perfect linear discrimination between patients suffering from COVID-19 and other patients could be achieved.Discussion and conclusionSARS-CoV-2 infection causes systemic inflammation, which is suggested as a predictor of the severe course of ICH. SARS-CoV-2 infection is an additional risk factor for vascular complications.