bluuebunny/crossref_metadata_2025_split huggingface dataset:
Atrial fibrillation screening in Syrian patients reporting to the emergency department during the ongoing conflict: a cross-sectional study
Authors: Antoun Ibrahim , Alkhayer Alkassem , Jalal Eldin Aref , Alkhayer Alamer , Salama Ibrahim , Yazji Khaled , Somani Riyaz , Ng G. André , Zakkar Mustafa 
Published: February 2025

BackgroundAtrial fibrillation (AF) is the most common arrhythmia worldwide. Data regarding AF screening in conflict countries’ emergency departments (ED) is lacking.MethodsWe included consecutive patients &gt;40 years old who reported to the ED of a Syrian tertiary centre between July 2024 and September 2024. Patients had routine 12-lead electrocardiograms (ECGs) regardless of presenting complaints. Two cardiology consultants blindly verified ECG findings. We excluded critically unwell patients and ECG discrepancies between the two consultants. Data were taken from patients’ medical notes.ResultsThe final analysis included 694 patients, 101 (15%) had AF on the ECG. The most common presenting complaints and ECG abnormality were trauma (44%) and sinus tachycardia (15%), respectively. Compared to the rest of the patients, AF patients were older (66 vs. 59 years; p &lt; 0.001), had a lower proportion of males (39% vs. 54%; p = 0.01), a higher prevalence of diabetes mellitus (49% vs. 21%; p = 0.01), and more cases of congestive cardiac failure (CCF) (38% vs. 17%; p &lt; 0.001). AF patients also had a higher CHA₂DS₂-VASc score (3 vs. 2; p &lt; 0.001). CCF [odds ratio [OR]: 3.3, 95% confidence interval [CI]: 1.5–6.4, p &lt; 0.001] and a higher CHA₂DS₂-VASc score(OR: 4, 95% CI: 1.6–7.7, p &lt; 0.001) were independently associated with positive AF screening.Conclusion15% of patients reporting to this Syrian ED had positive AF screening. CCF and CHA₂DS₂-VASc scores are predictive of AF.
Antiplatelet strategy for patients with acute coronary syndrome and chronic kidney disease: a systematic review and meta-analysis
Authors: Li Siqi , Wang Dayang , Han Xiaowan , Zhang Diying , Deng Hongxiao , Pan Guozhong 
Published: February 2025

BackgroundPatients with both acute coronary syndrome (ACS) and chronic kidney disease (CKD) face heightened risks of adverse cardiovascular events and bleeding. An optimal antiplatelet strategy for this patient population is needed.MethodsWe conducted a systematic review and meta-analysis to evaluate comparative advantages of clopidogrel vs. ticagrelor in the choice of dual antiplatelet therapy (DAPT) strategies for patients with ACS combined with CKD, while also exploring the appropriate duration of DAPT in the presence of CKD. Relevant studies were retrieved from PubMed, Embase, Cochrane Library, and Web of Science. The primary outcomes were all-cause mortality, major adverse cardiovascular events (MACE), and major bleeding. Data were analyzed using RevMan 5.4.1, and STATA 14 was used to assess publication bias. This study was registered with PROSPERO (CRD42024593764).ResultsSix studies involving 9,947 patients met the inclusion criteria. Compared with clopidogrel, ticagrelor was associated with a reduced risk of MACE (RR: 0.89, 95% CI: 0.80–0.99; P = 0.04) and stroke (RR: 0.66, 95% CI: 0.45–0.96; P = 0.03) in patients receiving DAPT. No significant differences were observed in all-cause mortality, major bleeding, cardiovascular death, or acute myocardial infarction. Three studies on DAPT duration showed a consistent trend, indicating that shortening DAPT duration did not benefit patients.ConclusionsIn patients with ACS combined with CKD, ticagrelor-based DAPT has advantages over clopidogrel-based DAPT, which is associated with a lower incidence of MACE. And shortening the duration of DAPT does not improve clinical outcomes.
Five-year evaluation of bone health in liver transplant patients: developing a risk score for predicting bone fragility progression beyond the first year
Authors: Abate Ejigayehu G. , McKenna Amanda , Yang Liu , Ball Colleen T. , Kearns Ann E. 
Published: February 2025

IntroductionLiver transplant (LT) recipients have a substantial risk of bone loss and fracture. An individual’s risk is highest before and within the first year after transplantation and returns to baseline in some patients but not all. We aim to identify risk factors for bone loss and fracture beyond the first year LT and to create a risk-scoring tool to aid clinicians in identifying those at high risk for bone loss and fracture.MethodsWe conducted a retrospective review of 264 liver transplant recipients between 2011 and 2014, who were followed in our transplant clinic for an additional five years. Clinical records were evaluated at the one-year post-LT visit and subsequently on an annual basis for up to five years.ResultsOver a median follow-up of 3.6 years post-liver transplantation, 40 out of 264 patients experienced disease progression, defined as worsening bone mineral density (BMD), initiation of osteoporosis treatment, or a new fracture. Factors associated with BMD progression included female sex, Caucasian race, new fractures, number of acute rejection events requiring treatment, and lower dual energy X-ray absorptiometry (DXA) scores after the first year post-LT. A risk model was developed using multivariable analysis, with a risk score based on BMD categories. The concordance index was 0.771, indicating good discrimination between those who progressed and those who did not. Risk categories were defined as low (0-4 points), medium (5 points), and high (6-9 points) based on model coefficients. The probability of progression-free survival at two years post-LT was 96.7% for low-risk, 83.1% for medium-risk, and 59.1% for high-risk groups.ConclusionWe developed a simple, clinically applicable risk score that predicts bone disease progression beyond the first year after LT. This tool may help guide appropriate bone health follow-up, although prospective validation is necessary.
Ultrasound speckle tracking imaging measurement of endocardial longitudinal strain for evaluation of prognostic value of “new quadruple” therapy in patients with chronic heart failure
Authors: Tang Man , Zeng Yuwei , Zhao Ping , Zhao Qianlei 
Published: February 2025

PurposeThis study aimed to evaluate the effectiveness of the “new quadruple” therapy in chronic heart failure (CHF) patients with metabolic syndrome using 2D speckle tracking imaging (2D-STI) stratified strain imaging to measure endocardial longitudinal strain while exploring its underlying neuroendocrine mechanisms.Patients and methodsThe study retrospectively analyzed 158 patients with heart failure with reduced ejection fraction [HFrEF; left ventricular ejection fraction (LVEF) &lt; 40%] treated with the “new quadruple” therapy (angiotensin receptor neprilysin inhibitor (ARNI), sacubitril/valsartan, dapagliflozin, bisoprolol, and spironolactone) for 8 weeks. Conventional ultrasound indices, left ventricular global longitudinal strain (LVGLS), and subendocardial longitudinal strain (LS) were measured pre- and post-treatment. Follow-up for 15 months recorded major adverse cardiac events (MACEs).ResultsThe 158 patients were divided into two groups: MACEs (n=25) and no MACEs (n=133). Univariate comparisons revealed significant differences between groups in coronary artery diameter stenosis percentage; admission LVEF and brain natriuretic peptide (BNP); LVGLS and subendocardial LS; post-treatment LVEF, LVGLS, and subendocardial LS, ΔLVGLS; and subendocardial ΔLS (P &lt; 0.05). Multifactorial Cox regression modeling showed that coronary artery diameter stenosis, admission LVEF, BNP, subendocardial LS, post-treatment LVEF, and subendocardial LS were predictive factors for MACEs in HFrEF patients following “new quadruple” therapy (P &lt; 0.05). ROC analysis indicates that post-treatment subendocardial LS predicts MACEs with an AUC of 0.871, which was significantly higher than other single metrics (P &lt; 0.05).ConclusionsUsing 2D-STI layer-specific strain imaging to measure endocardial longitudinal strain serves as a significant non-invasive indicator in predicting MACEs during 1-year follow-up after “new quadruple” therapy in HFrEF patients with metabolic syndrome, highlighting substantial clinical applicability. Additionally, our findings suggest that the therapy may improve prognosis through the modulation of neuroendocrine mechanisms.
Unlocking the fog: assessing fog collection potential and need as a complementary water resource in arid urban lands–the Alto Hospicio, Chile case
Authors: Carter Virginia , Verbrugghe Nathalie , Lobos-Roco Felipe , del Río Camilo , Albornoz Francisco , Khan Ahmed Z. 
Published: February 2025

Water scarcity is a rising issue in fast-growing cities in arid lands, where demand outpaces supply. This leads to non-renewable water systems and exacerbates social inequalities. This is the case for Alto Hospicio (AH), located in the northern Chilean Atacama Desert. Regarding its water availability, the main source of drinking water comes from underground aquifers, last recharged about 10,000 years ago. Nevertheless, atmospheric water such as fog, is present in this territory and offers an alternative, though its potential in large urban areas remains unexplored. This study assesses the fog water collection potential in AH and its surroundings using two methods: in-situ data collection using Standard Fog Collectors (SFCs) and the AMARU model, which estimates fog collection in space and time. This research concludes that fog water collection is feasible in the northeast and southeast areas surrounding the city, where fog collection rates reach up to 10 L m−2 day−1. Fog water has the potential to serve as an effective alternative water source for populations lacking access to drinking water from a public water source, and for activities such as irrigation of urban green spaces, human consumption, and hydroponic farming. Key recommendations for policymakers include incorporating atmospheric water into local city policies, promoting further research on estimating the fog water potential in the AH metropolitan zone, and rethinking water management strategies from nonconventional resources.
Multiscale impacts of landscape metrics on water quality based on fine-grained land use maps
Authors: Zhou Ya’nan , He Jinke , Feng Li , Wang Binyao , Chen Yuehong , Miao Lingzhan 
Published: February 2025

Quantifying the impact of landscape metrics on water quality can offer scientific supports for water conservation and land use planning. However, previous studies mainly relied on coarse land use maps, and were lack of understanding of effects from physiographic metrics. Here, based on the in-situ water quality monitoring data in the Fujiang river basin, we used redundancy analysis, variation partitioning analysis, and Shapley Additive exPlanations methods to assess the impact of landscape metrics on water quality. We use these analyses in the dry and wet season, in circular buffer zone, in riparian buffer zone, and at the sub-basin scale, we are able to analyze and understand the complex interactions between landscape features and water quality, as well as spatial and temporal scale effects. The results indicated that the impact of landscape metrics on water quality variation can be ranked in the following order: landscape composition (15.8%–32.2%) &gt; landscape configuration (1.2%–19.5%)&gt; physiographic metrics (−2.0%-0.6%). Forests and grasslands improved water quality, whereas farmland and impervious surfaces degraded water quality. At a finer scale of land use types, closed broadleaf evergreen forests improved water quality, while rainfed cropland had the opposite effect. The 1500 m circular buffer was the key scale with the highest rate of interpretation. The relationship between landscape metrics and water quality was marginally stronger during the wet season than the dry season. Water quality was improved by large relief amplitude and slope standard deviation. The water quality is not significantly affected by the river network density, the length of the river, or the basin area. These conclusions could provide science-informed information and support to the study between landscape metrics and water quality.
Instability and uncertainty of carbon storage in karst regions under land use change: a case study in Guiyang, China
Authors: Zhou Heng , Tang Mingdong , Huang Jun , Zhang Jinting , Huang Jingnan , Zhao Haijuan , Yu Yize 
Published: February 2025

IntroductionKarst regions are integral to the global carbon cycle. However, land use changes of karst regions driven by urbanization and desertification contribute to the instability of carbon storage, leading to uncertainties in the future. Understanding these instabilities and uncertainties is crucial for formulating carbon sequestration and land management strategies.MethodsThis study employed Patch-generating Land Use Simulation (PLUS) and Integrated Valuation of Ecosystem Services and Trade-offs (InVEST) to estimate carbon storage, and introduced the Coefficient of Variation (CV) to assess the instability and uncertainty. Multiscale Geographically Weighted Regression (MGWR) was applied to explore the mechanisms, while Polynomial Regression (PR) identified the stable intervals of factors, informing land-use policies.Results and Discussion(1) From 2000 to 2020, Guiyang’s carbon storage rose from 136.62 Tg to 142.13 Tg. By 2035, projections under natural development, urban expansion, and ecological protection scenarios estimate increases to 147.50 Tg, 147.40 Tg, and 147.82 Tg, respectively. (2) Carbon storage instability increased from 2000 to 2020, while uncertainty is expected to decrease by 2035. Instability was primarily due to transitions of Cropland-Forest, Forest-Cropland, Cropland-Grassland, and Cropland-Impervious, while uncertainties mainly arise from Cropland-Forest, Cropland-Impervious, and Grassland-Impervious transitions. (3) DEM, AI, Distance from national highways, SHDI, and Mean annual precipitation affected instability significantly. (4) Encouraging Shrub-Forest, Shrub-Cropland and Cropland-Forest conversions, and controlling Forest-Cropland, Forest-Shrub, and Cropland-Impervious conversions within the stable intervals of factors, can enhance carbon storage and reduce uncertainty. This study establishes a methodology for evaluating carbon storage instability and uncertainty in karst regions, which is an extension of carbon storage research.
Comprehensive systematic review and meta-analysis of the TGF-β1 T869C gene polymorphism and autoimmune disease susceptibility
Authors: Zhu Yawen , Qian Ai , Cheng Yuanyuan , Li Ming , Huang Chuanbing 
Published: February 2025

ObjectiveAutoimmune diseases (ADs) result from an aberrant immune response, in which the body mistakenly targets its own tissues. The association between TGF-β1 gene polymorphisms and risk of developing autoimmune diseases remains to be established. This meta-analysis aimed to reassess the relationship between TGF-β1 T869C gene polymorphisms and susceptibility to autoimmune diseases.MethodsWe conducted a comprehensive search of seven electronic databases for case-control studies investigating the TGF-β1 T869C polymorphism in relation to autoimmune diseases, including rheumatoid arthritis, systemic lupus erythematosus, systemic sclerosis, Sjögren’s syndrome, and juvenile idiopathic arthritis. The search encompassed publications published up to June 2024. Studies were categorized by ethnicity into three groups: Asian, Caucasian, and mixed-ethnicity groups. Five different genetic models were assessed, and the quality of the included studies was evaluated using the Newcastle-Ottawa Scale (NOS). Statistical analyses were performed using Stata 14.0, by calculating the odds ratio (OR) and 95% confidence interval (CI).ResultsA total of 32 case-control studies (31 articles), comprising 4,304 cases and 4,664 controls, were included in this meta-analysis. The overall analysis indicated no significant association between TGF-β1 T869C gene polymorphism and susceptibility to autoimmune diseases. However, subgroup analyses based on race and disease status revealed significant associations. Ethnic subgroup analysis showed that the TGF-β1 T869C allele model (T vs C: OR = 1.422, 95% CI = 1.109–1.824, P = 0.006), homozygous model (TT vs CC: OR = 1.923, 95% CI = 1.232–3.004, P = 0.004), and dominant model (TT + TC vs CC: OR = 1.599, 95% CI = 1.164–2.196, P = 0.004) were associated with autoimmune disease susceptibility in Asians. In the disease subgroup analysis, the results showed that the TGF-β1 T869C allele model (T vs C: OR = 1.468, 95% CI = 1.210–1.781, P = 0.000), recessive model (TT vs TC + CC: OR = 1.418, 95% CI = 1.097–1.832, P = 0.008), dominant model (TT + TC vs CC: OR = 1.747, 95% CI = 1.330–2.295, P = 0.000), homozygous model (TT vs CC: OR = 1.937, 95% CI = 1.373–2.734, P = 0.000), and heterozygous model (TC vs CC: OR = 1.555, 95% CI = 1.199–2.016, P = 0.001) were associated with rheumatoid arthritis susceptibility.ConclusionThe findings of this meta-analysis suggest that carrying the T allele of the TGF-β1 T869C polymorphism increases the risk of autoimmune diseases in Asian populations. Moreover, individuals carrying the T allele are at higher risk of developing rheumatoid arthritis.
Interaction between nasal epithelial cells and Tregs in allergic rhinitis responses to allergen via CCL1/CCR8
Authors: Sha Jichao , Yang Maolin , Lei Yashu , Sun Liwei , Meng Cuida , Zhu Dongdong 
Published: February 2025

BackgroundThe airway epithelial barrier is the first defence against aeroallergens. Nasal epithelial cells (NECs) are vital in regulating innate and adaptive mucosal immunity in allergic rhinitis (AR). Tregs produce cytokines essential for the immunomodulatory activities in allergen immunotherapy. Understanding the relationship between NECs and Tregs in the airway hyperresponsiveness network is essential for developing novel treatments.MethodsUsing an in vitro human Treg-NEC co-culture system of AR and health control group, the chemokine expression profiles of NECs were examined using immunohistochemistry, RT-PCR, and ELISA, and functional surface markers of Tregs were detected using flow cytometric analysis. Correlation analysis was performed between cytokines derived from NECs and surface markers of CD4+CD8+Foxp3+ Tregs in the AR group after co-culture, including TSLP/CTLA4, CCL1/CTLA4, TSLP/CTLA4, TSLP/CCR8, and CCL1/CCR8.ResultsCCR8 and CTLA-4 expressions after co-culturing were higher than single culture. Following Derp1 stimulation, TSLP, IL-25 and TGF-β expressions in the AR + Derp1 group were increased. CCL1 mRNA was lower in the AR + Derp1 group than control group. In the AR + Derp1 group, TSLP was higher, and CCL1 protein levels were decreased. There were no significant differences in IL-25, TGF-β and IL-10. When Treg co-culture group added, changes were similar to that observed in pNECs. After co-culture, CCL1/CCR8 was positively correlated in AR.ConclusionHuman pNECs can communicate with Tregs directly, CCL1/CCR8 may be the pathway between NECs and Tregs in vitro and may play a key role in the immune network of AR.
Super-resolution of nodal and paranodal disruption in anti-pan-neurofascin-associated autoimmune nodopathy
Authors: da Cruz Neris Geßner Vinicius , Linke Janis Theobald , Peulen Thomas-Otavio , Appeltshauser Luise , Sommer Claudia , Brämer Dirk , Geis Christian , Heinze Katrin Gertrud , Doppler Kathrin 
Published: February 2025

IntroductionIn autoimmune nodopathies, autoantibodies target the nodes of Ranvier, impairing saltatory nerve conduction. Understanding the impact of autoantibody binding on protein assembly is crucial for gaining insights into the pathogenicity of different autoantibodies. We investigated nodal, paranodal, and cytoskeletal axonal proteins in teased fibers from a sural nerve biopsy of a patient with anti-pan-neurofascin autoantibodies. Conventional diagnostic tools, including fluorescence microscopy, often miss subtle alterations at the ultrastructural level.MethodsWe utilized direct stochastic optical reconstruction microscopy (dSTORM), a super-resolution fluorescence imaging technique, to assess the nanoscale architecture of nodal, paranodal, and cytoskeletal axonal proteins.ResultWhile conventional fluorescence microscopy revealed severe paranodal and nodal damage in 14% of the nodes, with 86% appearing normal at first glance, the super-resolved images revealed a decreased neurofascin-155 and Caspr-1 density, but preserved colocalization of these adhesion proteins in paranodes that initially seemed normal. At the nodes, sodium channel density and distribution remained intact, but neurofascin-186 density was reduced. Axonal beta-IV spectrin was altered only in severely damaged nodes. This indicates that axonal integrity is largely preserved, with a potentially reversible decrease in paranodal and nodal adhesion proteins in patients with nodopathy revealing subtle alterations in nodal integrity that are not apparent with conventional imaging.DiscussionThese likely reversible changes may explain the rapid recovery seen in patients with anti-pan-neurofascin autoantibodies following autoantibody depletion. Conversely, the small percentage of severely and axonally damaged nodes may account for the residual symptoms experienced by most patients.
Breaking new ground: machine learning enhances survival forecasts in hypercapnic respiratory failure
Authors: Liu Zhongxiang , Zuo Bingqing , Lin Jianyang , Sun Zhixiao , Hu Hang , Yin Yuan , Yang Shuanying 
Published: February 2025

BackgroundThe prognostic prediction of patients with hypercapnic respiratory failure holds significant clinical value. The objective of this study was to develop and validate a predictive model for predicting survival in patients with hypercapnic respiratory failure.MethodsThe study enrolled a total of 697 patients with hypercapnic respiratory failure, including 565 patients from the First People’s Hospital of Yancheng in the modeling group and 132 patients from the People’s Hospital of Jiangsu Province in the external validation group. The three selected models were random survival forest (RSF), DeepSurv, a deep learning-based survival prediction algorithm, and Cox Proportional Risk (CoxPH). The model’s predictive performance was evaluated using the C-index and Brier score. Receiver operating characteristic curve (ROC), area under ROC curve (AUC), and decision curve analysis (DCA) were employed to assess the accuracy of predicting the prognosis for survival at 6, 12, 18, and 24 months.ResultsThe RSF model (c-index: 0.792) demonstrated superior predictive ability for the prognosis of patients with hypercapnic respiratory failure compared to both the traditional CoxPH model (c-index: 0.699) and DeepSurv model (c-index: 0.618), which was further validated on external datasets. The Brier Score of the RSF model demonstrated superior performance, consistently measuring below 0.25 at the 6-month, 12-month, 18-month, and 24-month intervals. The ROC curve confirmed the superior discrimination of the RSF model, while DCA demonstrated its optimal clinical net benefit in both the modeling group and the external validation group.ConclusionThe RSF model offered distinct advantages over the CoxPH and DeepSurv models in terms of clinical evaluation and monitoring of patients with hypercapnic respiratory failure.