bluuebunny/crossref_metadata_2025_split huggingface dataset:
Acute Myocardial Infarction in a Young Lady with Mitral Stenosis – Uncommon Presentation of a Common Problem
Authors: Bhuiyan AKM Mohiuddin , Hasan ATM Iqbal , Rahman Md Mukhlesur , Saha Partha Pratim 
Published: June 2022

Chronic rheumatic heart disease is the major contributor of valvular heart disease in this subcontinent. It can affect all the four valves. Among them mitral valve is affected most of the time. Involvement of the mitral valve could be presented in various nonspecific way like chest pain, palpitation, shortness of breath, difficulty in swallowing, change in voice and so on. There are few causes behind the chest pain. Myocardial infraction is one of the important cause.
University Heart Journal Vol. 17, No. 1, Jan 2021; 76-78
‘The Eliminated Gods’: The Christian Reconfiguration of Jukun Theism
Authors: Irmiya Elawa Nathan 
Published: June 2022

This article looks at an aspect of the cosmology of the Jukun of north-central Nigeria, specifically their theism, and how it has changed through their encounter with Christian monotheism. Many contemporary Jukun people assume that their indigenous cosmology has always been anchored on a Supreme Being akin to the Christian God. In this study I show that this currently held belief is largely due to the theological framework which Christian missionaries sought to make the Jukun worldview fit into. And even prior to the first Christian contact, Jukun indigenous cosmology had been in contact with Islam.I give a very brief history of the Jukun and of the Christian missionary efforts among them starting in 1906 and, starting from my own questions growing up as a Jukun, look at how indigenous concepts and categories for deities were adapted over the course of time as the majority of Jukun became Christian.
Intradermal Testing With COVID-19 mRNA Vaccines Predicts Tolerance
Authors: Stehlin Florian , Mahdi-Aljedani Rima , Canton Loris , Monzambani-Banderet Véronique , Miauton Alix , Girard Cedric , Kammermann Kevin , Meylan Sylvain , Ribi Camillo , Harr Thomas , Yerly Daniel , Muller Yannick D. 
Published: June 2022

BackgroundThe newly developed mRNA-based COVID-19 vaccines can provoke anaphylaxis, possibly induced by polyethylene glycol (PEG) contained in the vaccine. The management of persons with a history of PEG allergy or with a suspected allergic reaction after the first dose remains to be defined.MethodsIn this real-life study, we defined two cohorts of individuals: one pre-vaccination including 187 individuals with high-risk profiles for developing anaphylaxis and a second post-vaccination including 87 individuals with suspected allergic reactions after the COVID-19 mRNA vaccine. Upon negative skin test with an mRNA vaccine, a two-step (10–90%) vaccination protocol was performed. Positive skin tests were confirmed with the basophil activation test (BAT).ResultsAmong 604,267 doses of vaccine, 87 suspected allergic reactions (5 after the booster) were reported to our division for further investigations: 18/87 (21%) were consistent with anaphylaxis, 78/87 (90%) were female, and 47/87 (54%) received the BNT162b2 mRNA vaccine. Vaccine skin tests were negative in 96% and 76% of the pre- and post-vaccination cohorts, respectively. A two-step vaccination was tolerated in 232/236 (98%) of individuals with negative tests. Four individuals experienced isolated asthmatic reactions during the two-step challenge. Vaccine-positive skin tests were consistently confirmed by BAT; CD63 and CD203c expression was selectively inhibited with ibrutinib, suggesting an IgE-dependent mechanism.ConclusionSensitization to SARS-CoV-2 mRNA vaccines can be detected with intradermal testing. Significantly more individuals were sensitized to mRNA vaccines in the post-vaccination cohort. A two-step 10–90%-vaccination protocol can be safely administered upon negative skin testing.
Valsalva Maneuver Decreases Liver and Spleen Stiffness Measured by Time-Harmonic Ultrasound Elastography
Authors: Meyer Tom , Tzschätzsch Heiko , Wellge Brunhilde , Sack Ingolf , Kröncke Thomas , Martl Alma 
Published: June 2022

Ultrasound elastography quantitatively measures tissue stiffness and is widely used in clinical practice to diagnose various diseases including liver fibrosis and portal hypertension. The stiffness of soft organs has been shown to be sensitive to blood flow and pressure-related diseases such as portal hypertension. Because of the intricate coupling between tissue stiffness of abdominal organs and perfusion-related factors such as vascular stiffness or blood volume, simple breathing maneuvers have altered the results of liver elastography, while other organs such as the spleen are understudied. Therefore, we investigated the effect of a standardized Valsalva maneuver on liver stiffness and, for the first time, on spleen stiffness using time-harmonic elastography (THE). THE acquires full-field-of-view stiffness maps based on shear wave speed (SWS), covers deep tissues, and is potentially sensitive to SWS changes induced by altered abdominal pressure in the hepatosplenic system. SWS of the liver and the spleen was measured in 17 healthy volunteers under baseline conditions and during the Valsalva maneuver. With the Valsalva maneuver, SWS in the liver decreased by 2.2% (from a median of 1.36 m/s to 1.32 m/s; p = 0.021), while SWS in the spleen decreased by 5.2% (from a median of 1.63 m/s to 1.51 m/s; p = 0.00059). Furthermore, we observed that the decrease was more pronounced the higher the baseline SWS values were. In conclusion, the results confirm our hypothesis that the Valsalva maneuver decreases liver and spleen stiffness, showing that THE is sensitive to perfusion pressure-related changes in tissue stiffness. With its extensive organ coverage and high penetration depth, THE may facilitate translation of pressure-sensitive ultrasound elastography into clinical routine.
Effects of 4 Weeks of High-Definition Transcranial Direct Stimulation and Foot Core Exercise on Foot Sensorimotor Function and Postural Control
Authors: Xiao Songlin , Wang Baofeng , Zhang Xini , Zhou Junhong , Fu Weijie 
Published: June 2022

Objective: This study aimed to examine the effects of 4 weeks of high-definition transcranial direct current stimulation (HD-tDCS) and foot core exercise (FCE) on foot sensorimotor function (i.e., toe flexor strength and passive ankle kinesthesia) and postural control.Methods: In total, 36 participants were randomly assigned into three groups as follows: HD-tDCS, FCE, and the control group. A total of 12 training sessions were performed over 4 weeks (i.e., three sessions per week) in the laboratory. The HD-tDCS group received 20-min HD-tDCS with a current density of 2 mA, and the FCE group completed short foot exercise, towel curls, toe spread and squeeze, and balance board training. Participants in the control group just maintained the activities what they usually did and did not receive any interventions. Foot muscle strength, passive ankle kinesthesia, and postural control were assessed at baseline and post-intervention.Results: HD-tDCS induced a greater decrease in the percentage changes in the passive kinesthesia thresholds of ankle inversion (p &lt; 0.001) and eversion (p = 0.013) than the control group. Compared with the control group, a significant increase in the percentage change in the metatarsophalangeal joint flexor strength was found in the HD-tDCS group (p = 0.008) and the FCE group (p = 0.027), and a significant increase in the percentage change in toe flexor strength was observed in the FCE group (p = 0.015). Moreover, FCE induced a greater reduction in the percent changes in the medial–lateral average center of gravity sway velocity in one-leg standing with eyes open (p = 0.033) and the anteroposterior average center of gravity sway velocity in one-leg standing with eyes closed (p &lt; 0.001) than control.Conclusion: This study demonstrated that 4 weeks of HD-tDCS and FCE induced distinct benefits on foot sensorimotor function and the standing postural control performance in healthy young adults. HD-tDCS could improve the metatarsophalangeal joint flexor strength and the passive kinesthesia thresholds of ankle inversion and eversion. Meanwhile, FCE could also enhance foot muscle strength and enhance postural control performance in one-leg standing.
Construction and Optimization of the de novo Biosynthesis Pathway of Mogrol in Saccharomyces Cerevisiae
Authors: Wang Siyu , Xu Xianhao , Lv Xueqin , Liu Yanfeng , Li Jianghua , Du Guocheng , Liu Long 
Published: June 2022

Mogrol plays important roles in antihyperglycemic and antilipidemic through activating the AMP-activated protein kinase pathway. Although the synthesis pathway of mogrol in Siraitia grosvenorii has been clarified, few studies have focused on improving mogrol production. This study employed a modular engineerin g strategy to improve mogrol production in a yeast chassis cell. First, a de novo synthesis pathway of mogrol in Saccharomyces cerevisiae was constructed. Then, the metabolic flux of each synthetic module in mogrol metabolism was systematically optimized, including the enhancement of the precursor supply, inhibition of the sterol synthesis pathway using the Clustered Regularly Interspaced Short Palindromic Repeats Interference system (CRISPRi), and optimization of the expression and reduction system of P450 enzymes. Finally, the mogrol titer was increased to 9.1 μg/L, which was 455-fold higher than that of the original strain. The yeast strains engineered in this work can serve as the basis for creating an alternative way for mogrol production in place of extraction from S. grosvenorii.
Capillary Microreactor for Initial Screening of Three Amine-Based Solvents for CO2 Absorption, Desorption, and Foaming
Authors: Ashok Anchu , Ballout Jaafar , Benamor Abdelbaki , Al-Rawashdeh Ma’moun 
Published: June 2022

Microreactor is a very attractive laboratory device for screening conditions and solvents in an efficient, safe and fast manner. Most reported work on microreactors for CO2 capturing deals with absorption and mass transfer performance with a limited number of studies on solvent regeneration. For the first time, foaming, which is a major operational challenge of CO2 capturing is being studied in combination with absorption and desorption in a capillary microreactor setup. To demonstrate the setup capabilities, three known amine-based solvents (MEA, MDEA, and AMP) were selected for the screening and evaluation studies. MEA had the highest CO2 absorption efficiency while MDEA had the lowest one. CO2 absorption efficiency increased with temperature, liquid flow rate, and amine concentration as per the literature. During the absorption work, the Taylor flow regime was maintained at the reactor inlet. CO2 desorption of loaded amine solutions was investigated at different concentrations and temperatures up to 85°C. MDEA solution had the highest desorption efficiency, followed by AMP and the least desorption efficiency was that of MEA. Foaming experimental results showed that MEA had a larger foaming region compared to AMP. However, more foaming happened with AMP at higher gas and liquid flow rates. A plug flow mathematical reactor model was developed to simulate the MEA-CO2 system. The model captured well the performance and trends of the studied system, however the absolute prediction deviated due to uncertainties in the used physical properties and mass transfer correlation. Selecting a solvent for chemical absorption depends on many more factors than these three studied parameters. Still, microreactor proves a valuable tool to generate experimental results under different conditions, with the least amount of consumables (less than 1 L solvents were used), in a fast manner, combined with a knowledge insight because of the uniqueness of the Taylor flow regime.
Design of Ni(OH)2/M-MMT Nanocomposite With Higher Charge Transport as a High Capacity Supercapacitor
Authors: Xu G. M. , Wang M. , Bao H. L. , Fang P. F. , Zeng Y. H. , Du L. , Wang X. L. 
Published: June 2022

Nano-petal nickel hydroxide was prepared on multilayered modified montmorillonite (M-MMT) using one-step hydrothermal method for the first time. This nano-petal multilayered nanostructure dominated the ion diffusion path to be shorted and the higher charge transport ability, which caused the higher specific capacitance. The results showed that in the three-electrode system, the specific capacitance of the nanocomposite with 4% M-MMT reached 1068 F/g at 1 A/g and the capacity retention rate was 70.2% after 1,000 cycles at 10 A/g, which was much higher than that of pure Ni(OH)2 (824 F/g at 1 A/g), indicating that the Ni(OH)2/M-MMT nanocomposite would be a new type of environmentally friendly energy storage supercapacitor.
Angiopoietin-Like Protein 4 May Be an Interplay Between Serum Uric Acid and Triglyceride-Rich Lipoprotein Cholesterol
Authors: Peng Yani , Hu Die , Luo Qingting , Peng Daoquan 
Published: June 2022

BackgroundAlthough the available evidence has indicated a link between elevated serum uric acid (SUA) level and dyslipidemia, the potential contribution of SUA on lipid profiles remains unclear. Experimental and clinical studies have revealed several mechanisms through which high serum angiopoietin-like protein 4 (ANGPTL4) level exerts deleterious effects on lipid metabolism, but the role of ANGPTL4 in SUA-associated dyslipidemia has not been well studied, so far.MethodsA total of 80 subjects were classified into high SUA group (n = 40) and low SUA group (n = 40) by the median value of SUA in the whole study population. Serum ANGPTL4 levels were determined by enzyme-linked immunosorbent assays.ResultsIn our study, we observed that not only serum triglyceride level [1.03 (0.78, 1.50) mmol/L vs. 1.59 (1.18, 2.37) mmol/L, p = 0.001] but also serum triglyceride-rich lipoprotein cholesterol (TRL-C) level [0.38 (0.32, 0.45) mmol/L vs. 0.46 (0.34, 0.54) mmol/L, p = 0.012] were significantly elevated in high SUA group. Additionally, serum ANGPTL4 in high SUA group was higher than in low SUA group [15.81 (11.88, 20.82) ng/ml vs. 22.13 (17.88, 32.09) ng/ml, p = 0.000]. Moreover, in all subjects, TRL-C levels were positively associated with SUA (r = 0.26, p = 0.023, n = 80) and ANGPTL4 levels (r = 0.24, p = 0.036, n = 80). Using stepwise multiple regression analysis to adjust for potential confounders, SUA was discovered to be an independent contributor to serum ANGPTL4 (p = 0.023). At the same time, serum ANGPTL4 was an independent contributor to the level of TRL-C (p = 0.000). However, the correlation between SUA and TRL-C disappeared after controlling for ANGPTL4 level.ConclusionSerum uric acid was positively correlated to TRL-C. ANGPTL4 may be an interplay between SUA and associated elevation of TRL-C.
Unmet Needs in Patients With Heart Failure: The Importance of Palliative Care in a Heart Failure Clinic
Authors: Gonzalez-Jaramillo Valentina , Maessen Maud , Luethi Nora , Guyer Jelena , Hunziker Lukas , Eychmüller Steffen , Zambrano Sofia C. 
Published: June 2022

BackgroundThere are increasing calls to establish heart failure (HF) clinics due to their effectiveness in the interdisciplinary management of people living with HF. However, although a recommendation exists for palliative care (PC) providers to be part of the interdisciplinary team, few of the established HF clinics include them in their teams. Therefore, in this qualitative study, we aimed to understand the unmet PC needs of patients with HF attending an already established HF clinic.MethodsSecondary qualitative analysis of structured interviews undertaken within a larger study to validate the German version of the Needs Assessment Tool: Progressive Disease—Heart Failure (NAT: PD-HF). The NAT: PD-HF is a tool that aims to assess unmet needs in patients with HF. The interviews took place between January and March 2020 with patients from the ambulatory HF Clinic of a University Hospital in Switzerland. For this analysis, we transcribed and thematically analyzed the longest and most content-rich interviews until we reached data saturation at 31 participants. The interviews lasted 31 min on average (24–48 min).ResultsParticipants (n= 31) had a median age of 64 years (IQR 56–77), the majority had reduced ejection fraction, were men, and were classified as having a New York Heart Association functional class II. Participants were in general satisfied with the treatment and information received at the HF clinic. However, they reported several unmet needs. We therefore identified three ambivalences as main themes: (I) “feeling well-informed but missing essential discussions”, (II) “although feeling mostly satisfied with the care, remaining with unmet care needs”, and (III) “fearing a referral to palliative care but acknowledging its importance”.ConclusionAlthough patients who are receiving multidisciplinary management in ambulatory HF clinics are generally satisfied with the care received, they remain with unmet needs. These unmet needs, such as the need for advance care planning or the need for timely and tactful end-of-life discussions, can be fulfilled by PC providers. Including personnel trained in PC as part of the multidisciplinary team could help to address patients' needs, thus improving the quality of care and the quality of life of people living with HF.
A Nomogram for Predicting Survival in Patients With Colorectal Cancer Incorporating Cardiovascular Comorbidities
Authors: Wang Hao , Liu Dong , Liang Hanyang , Ba Zhengqing , Ma Yue , Xu Haobo , Wang Juan , Wang Tianjie , Tian Tao , Yang Jingang , Gao Xiaojin , Qiao Shubin , Qu Yanling , Yang Zhuoxuan , Guo Wei , Zhao Min , Ao Huiping , Zheng Xiaodong , Yuan Jiansong , Yang Weixian 
Published: June 2022

BackgroundCardiovascular comorbidities (CVCs) affect the overall survival (OS) of patients with colorectal cancer (CRC). However, a prognostic evaluation system for these patients is currently lacking.ObjectivesThis study aimed to develop and validate a nomogram, which takes CVCs into account, for predicting the survival of patients with CRC.MethodsIn total, 21,432 patients with CRC were recruited from four centers in China between January 2011 and December 2017. The nomogram was constructed, based on Cox regression, using a training cohort (19,102 patients), and validated using a validation cohort (2,330 patients). The discrimination and calibration of the model were assessed by the concordance index and calibration curve. The clinical utility of the model was measured by decision curve analysis (DCA). Based on the nomogram, we divided patients into three groups: low, middle, and high risk.ResultsIndependent risk factors selected into our nomogram for OS included age, metastasis, malignant ascites, heart failure, and venous thromboembolism, whereas dyslipidemia was found to be a protective factor. The c-index of our nomogram was 0.714 (95% CI: 0.708–0.720) in the training cohort and 0.742 (95% CI: 0.725–0.759) in the validation cohort. The calibration curve and DCA showed the reliability of the model. The cutoff values of the three groups were 68.19 and 145.44, which were also significant in the validation cohort (p &lt; 0.001).ConclusionTaking CVCs into account, an easy-to-use nomogram was provided to estimate OS for patients with CRC, improving the prognostic evaluation ability.
Comparative Safety and Effectiveness of Ticagrelor versus Clopidogrel in Patients With Acute Coronary Syndrome: An On-Treatment Analysis From a Multicenter Registry
Authors: Almendro-Delia Manuel , Blanco-Ponce Emilia , Carmona-Carmona Jesús , Arboleda Sánchez J. A. , Rodríguez Yáñez Juan Carlos , Soto Blanco José Manuel , Fernández García Isabel , Castillo Caballero José M. , García-Rubira Juan C. , Hidalgo-Urbano Rafael J. 
Published: June 2022

Background:The net clinical benefit of ticagrelor over clopidogrel in acute coronary syndrome (ACS) has recently been questioned by observational studies which did not account for time-dependent confounders. We aimed to assess the comparative safety and effectiveness of ticagrelor vs. clopidogrel accounting for non-adherence in a real-life setting.MethodsThis is a prospective, multicenter cohort study of patients with ACS discharged on ticagrelor or clopidogrel between 2015 and 2019. Major exclusions were previous intracranial bleeding, and the use of prasugrel or oral anticoagulation. Association of P2Y12 inhibitor therapy with 1-year risk of Bleeding Academic Research Consortium Type 3 or 5 bleeding; major adverse cardiac events (MACEs), a composite endpoint of all-cause death, nonfatal myocardial infarction (MI), nonfatal stroke, or urgent target lesion revascularization; definite/probable stent thrombosis; vascular death; and net adverse clinical event (a composite endpoint of major bleeding and MACE) were analyzed according to the “on-treatment” principle, using fully adjusted Cox and Fine-Gray regression models with doubly robust inverse probability of censoring weighted estimators.ResultsAmong 2,070 patients (mean age 63 years, 27% women, 62.5% ST-elevation MI), 1,035 were discharged on ticagrelor and clopidogrel, respectively. Ticagrelor-treated patients were younger and had few comorbidities, but high rates of medication non-compliance, compared with clopidogrel users. After comprehensive multivariate adjustments, ticagrelor did not increase the risk of major bleeding compared with clopidogrel [subhazard ratio, 1.40; 95% confidence interval (CI), 0.96–2.05], while proved superior in reducing MACE (hazard ratio 0.62; 95% CI, 0.43–0.90), vascular death (subhazard ratio, 0.71; 95% CI, 0.52–0.97) and definite/probable stent thrombosis (subhazard ratio, 0.54; 95% CI, 0.30-0.79); thereby resulting in a favorable net clinical benefit (hazard ratio 0.78; 95% CI, 0.60–0.98) compared with clopidogrel. Results from sensitivity analyses were consistent with those from the primary analysis, whereas those from the intention-to-treat (ITT) analysis went in the opposite direction.ConclusionAmong all-comers with ACS, ticagrelor did not significantly increase the risk of major bleeding, while resulting in a net clinical benefit compared with clopidogrel. Further research is warranted to confirm these findings in high bleeding risk populations.CREA-ARIAM Andalucía(ClinicalTrials.gov Identifier: NCT02500290); Current pre-specified analysis (ClinicalTrials.gov Identifier: NCT04630288).