bluuebunny/crossref_metadata_2025_split huggingface dataset:
Polygenic Risk Score Associates With Atherosclerotic Plaque Characteristics at Autopsy
Authors: Cornelissen Anne , Gadhoke Neel V. , Ryan Kathleen , Hodonsky Chani J. , Mitchell Rebecca , Bihlmeyer Nathan A. , Duong ThuyVy , Chen Zhifen , Dikongue Armelle , Sakamoto Atsushi , Sato Yu , Kawakami Rika , Mori Masayuki , Kawai Kenji , Fernandez Raquel , Ghosh Saikat Kumar B. , Braumann Ryan , Abebe Biniyam , Kutys Robert , Kutyna Matthew , Romero Maria E. , Kolodgie Frank D. , Miller Clint L. , Hong Charles C. , Grove Megan L. , Brody Jennifer A. , Sotoodehnia Nona , Arking Dan E. , Schunkert Heribert , Mitchell Braxton D. , Guo Liang , Virmani Renu , Finn Aloke V. 
Published: November 2023

BACKGROUND:
Polygenic risk scores (PRSs) for coronary artery disease (CAD) potentially improve cardiovascular risk prediction. However, their relationship with histopathologic features of CAD has never been examined systematically.

METHODS:
From 4327 subjects referred to CVPath by the State of Maryland Office Chief Medical Examiner for sudden death between 1994 and 2015, 2455 cases were randomly selected for genotyping. We generated PRS from 291 known CAD risk loci. Detailed histopathologic examination of the coronary arteries was performed in all subjects. The primary study outcome measurements were histopathologic plaque features determining severity of atherosclerosis, including %stenosis, calcification, thin-cap fibroatheromas, and thrombotic CAD.

RESULTS:

After exclusion of cases with insufficient DNA sample quality or with missing data, 954 cases (mean age, 48.8±14.7 years; 75.7% men) remained in the final study cohort. Subjects in the highest PRS quintile exhibited more severe atherosclerosis compared with subjects in the lowest quintile, with greater %stenosis (80.3%±27.0% versus 50.4%±38.7%; adjusted
P
<0.001) and a higher frequency of calcification (69.6% versus 35.8%; adjusted
P
=0.004) and thin-cap fibroatheroma (26.7% versus 9.5%; adjusted
P
=0.007). Even after adjustment for traditional CAD risk factors, subjects within the highest PRS quintile had higher odds of severe atherosclerosis (ie, ≥75% stenosis; adjusted odds ratio, 3.77 [95% CI, 2.10–6.78];
P
<0.001) and plaque rupture (adjusted odds ratio, 4.05 [95% CI, 2.26–7.24];
P
<0.001). Moreover, subjects within the highest quintile had higher odds of CAD-associated cause of death, especially among those aged ≤50 years (adjusted odds ratio, 4.08 [95% CI, 2.01–8.30];
P
<0.001). No statistically significant associations were observed with plaque erosion after adjusting for covariates.

CONCLUSIONS:
This is the first autopsy study investigating associations between PRS and atherosclerosis severity at the histopathologic level in subjects with sudden death. Our pathological analysis suggests PRS correlates with plaque burden and features of advanced atherosclerosis and may be useful as a method for CAD risk stratification, especially in younger subjects.
Endothelial YAP Mediates Hyperglycemia-Induced Platelet Hyperactivity and Arterial Thrombosis
Authors: Li Zhiyu , Zhang Jiachen , Ma Zejun , Zhao Guobing , He Xue , Yu Xuefang , Fu Qiang , Wu Naishi , Ding Zhongren , Sun Haipeng , Zhang Xu , Zhu Yi , Chen Liming , He Jinlong 
Published: November 2023

BACKGROUND:
Hyperglycemia—a symptom that characterizes diabetes—is highly associated with atherothrombotic complications. However, the underlying mechanism by which hyperglycemia fuels platelet activation and arterial thrombus formation is still not fully understood.

METHODS:

The profiles of polyunsaturated fatty acid metabolites in the plasma of patients with diabetes and healthy controls were determined with targeted metabolomics. FeCl
3
-induced carotid injury model was used to assess arterial thrombus formation in mice with endothelial cell (EC)–specific YAP (yes-associated protein) deletion or overexpression. Flow cytometry and clot retraction assay were used to evaluate platelet activation. RNA sequencing and multiple biochemical analyses were conducted to unravel the underlying mechanism.

RESULTS:

The plasma PGE
2
(prostaglandin E
2
) concentration was elevated in patients with diabetes with thrombotic complications and positively correlated with platelet activation. The PGE
2
synthetases COX-2 (cyclooxygenase-2) and mPGES-1 (microsomal prostaglandin E synthase-1) were found to be highly expressed in ECs but not in other type of vessel cells in arteries from both patients with diabetes and hyperglycemic mice, compared with nondiabetic individuals and control mice, respectively. A combination of RNA sequencing and ingenuity pathway analyses indicated the involvement of YAP signaling. EC-specific deletion of YAP limited platelet activation and arterial thrombosis in hyperglycemic mice, whereas EC-specific overexpression of YAP in mice mimicked the prothrombotic state of diabetes, without affecting hemostasis. Mechanistically, we found that hyperglycemia/high glucose–induced endothelial YAP nuclear translocation and subsequently transcriptional expression of COX-2 and mPGES-1 contributed to the elevation of PGE
2
and platelet activation. Blockade of EP3 (prostaglandin E receptor 3) activation by oral administration of DG-041 reversed the hyperactivity of platelets and delayed thrombus formation in both EC-specific YAP-overexpressing and hyperglycemic mice.

CONCLUSIONS:

Collectively, our data suggest that hyperglycemia-induced endothelial YAP activation aggravates platelet activation and arterial thrombus formation via PGE
2
/EP3 signaling. Targeting EP3 with DG-041 might be therapeutic for diabetes-related thrombosis.
Wasta and Democratic Attitudes in the Middle East
Authors: Ridge Hannah M. 
Published: November 2023

Abstract
The Middle East faces ongoing challenges in democratization and in corruption. This article examines the influence of wasta – a Middle Eastern form of clientelism – on citizens’ political attitudes. Although wasta is situated between citizen services and corruption, many citizens view wasta as corrupt. Using Arab Barometer survey data, this article shows that the widespread use of wasta in the Middle East makes citizens less satisfied with their current largely non-democratic governments. Wasta also increases their interest in democracy as an egalitarian alternative regime structure. Wasta users, however, are protective of the personal advantages that wasta networks afford them. Widespread wasta thus represents a challenge to democratization.
Latewood intra-annual density fluctuations indicate wet summer conditions and enhanced canopy activity in a Mediterranean ring-porous oak
Authors: Camarero J. Julio , Serra-Maluquer Xavier , Colangelo Michele , Gazol Antonio , Pizarro Manuel 
Published: November 2023

Summary
The climatic significance and ecosystem implications of latewood intra-annual density fluctuations (IADFs) are still not fully understood in Mediterranean ring-porous oak species. To solve this issue, we investigated: (i) the climate drivers of radial growth and latewood IADFs in the Mediterranean oak Quercus faginea, and (ii) whether they were correlated to increased canopy cover and greenness as recorded by the Normalized Difference Vegetation Index (NDVI). IADFs were formed in the mid to late latewood and they were characterized by rows of parenchyma cells. Such IADFs were uncommon and only present in 30–50% of sampled trees during 1999 and 2014, both years characterized by high precipitation in late July and early August. This relationship between IADFs formation and summer wet conditions differed from the conditions that enhance Q. faginea annual growth, wet winter-spring conditions, and low summer temperatures. Furthermore, IADFs formation showed a positive relationship with August NDVI values, indicating a correspondence of canopy greenness with secondary growth reactivation. We conclude that latewood IADFs in Q. faginea are a robust proxy of rare late-summer wet conditions and enhanced canopy activity as reflected by increased August NDVI values. Further monitoring of xylogenesis in other Mediterranean hardwoods along climatic gradients is suggested to mechanistically explain IADF production in seasonally dry biomes.
Seasonal Variations in Eddy-Induced Atmospheric Perturbations in the South China Sea
Authors: Zhang Ningning , Lan Jian , Yu Yi , Zhang Youguang , He Yijun 
Published: November 2023

Abstract
This study investigates the impact of eddy-induced sea surface temperature (SST) anomalies on the overlying atmosphere in the South China Sea, utilizing observational and reanalysis datasets. The results reveal that SST anomalies caused by anticyclonic or cyclonic eddies have a significant impact on the acceleration or deceleration of surface winds, with a stronger response in summer compared to winter. Moreover, atmospheric responses, such as heat flux, precipitation, and marine atmospheric boundary layer (MABL) depth above anticyclonic or cyclonic eddies, exhibit in-phase seasonal variations as surface winds. The study also explores the mechanisms leading to atmospheric response, pointing toward the vertical mixing mechanism as the dominant cause, supported by both the in-phase relationship between SST and surface wind anomalies and the linear relationship between the wind stress divergence anomaly and downwind SST gradient anomaly. Seasonal variations in coupling intensity are attributed to varying background atmospheric conditions, with more effective vertical turbulence mixing and stronger coupling intensity caused by more unstable MABL and enhanced large-scale vertical wind shear during summer than winter. Besides, the atmosphere above eddies is under a quasi-equilibrium condition, in which the surface wind stress increases monotonically with the depth of MABL. Given that the MABL depth response to eddy-induced SST anomaly is stronger in summer than in winter, it is reasonable to expect a more intense wind response during this season. Thus, the MABL depth coupling works together with the vertical mixing mechanism to explain the proportional relationship between SST and wind anomalies, and why the atmospheric response is stronger in summer than in winter.

Significance Statement
The atmosphere exerts a significant influence on the ocean, with strong winds cooling the sea surface temperature on a large scale (more than 1000 km). Conversely, the ocean tends to drive the atmosphere at a mesoscale level (10–1000 km), whereby a warm sea surface temperature causes surface wind to accelerate. This study aims to better understand how mesoscale eddies in the South China Sea influence the overlying atmosphere in different seasons. Our research explores factors that control mesoscale air–sea coupling, and highlights the importance of stability and depth change of marine atmospheric boundary layer. These results will establish a foundation for future research examining how the atmospheric perturbations caused by mesoscale eddies can in turn impact both ocean circulation and eddies.
Long-Term Evaluation of Revascularization Strategies for Medina 0.1.0 Left Main Bifurcation Lesions: The LM-CROSSOVER Registry
Authors: Güner Ahmet , Akman Cemalettin , Çiloğlu Koray , Gökçe Kaan , Uzun Fatih , Can Cemil , Kahraman Serkan , Çizgici Ahmet Yaşar , Güler Arda , Demirci Gökhan , Güner Ezgi Gültekin , Ertürk Mehmet 
Published: November 2023

The present study aimed to compare long-term outcomes of patients with Medina 0.1.0 left main (LM) bifurcation lesions treated by crossover stenting (COS) versus accurate ostial stenting (AOS). A total of 229 consecutive eligible patients with Medina 0.1.0 LM bifurcation lesions were enrolled and were stratified according to the stenting techniques. The primary end-point was major cardiovascular and cerebral events (MACCE), defined as the combination of all-cause death, target vessel related-myocardial infarction (MI), clinically driven target lesion revascularization (TLR), stroke, or stent thrombosis. COS and AOS were applied to 78 (34%) and 151 (66%) patients, respectively. During a mean of 40.6 ± 21.1 months of follow-up, the rate of MACCE (27.8 vs 12.8%; P=.007) was higher in patients treated with AOS than those treated with the COS technique, mainly driven by more frequent all-cause death (13.9 vs 3.8%, P = .013) and TLR (6.4 vs 15.9%; P = .029). In multivariable Cox regression analysis, AOS strategy was one of the independent predictors of MACCE (odds ratio: 2.166; 95% confidence interval, 1.080–4.340; P = .029). The current study suggests that COS was associated with a better long-term MACCE rate and lower all-cause mortality rate than AOS in patients with Medina 0.1.0 LM bifurcation disease.
Financial autonomy in Spanish local governments: Empirical evidence of beta and sigma convergence
Authors: Cifuentes-Faura Javier , Fülöp Melinda Timea , Topor Dan Ioan 
Published: November 2023

Territorially, Spanish public administrations are organized into State Administration, Autonomous Community Administration, and Local Administration. Local government has the closest contact with citizens and therefore the powers and decisions taken by local institutions have the greatest impact on the social welfare of citizens. To ensure this well-being, it is necessary to analyze and pay attention to the administrative and financial autonomy of local governments. Financial autonomy translates into the capacity of local entities to govern their respective finances, determining, within certain limits, the level of the volume of their own resources and organizing their expenditures. In this work, we study the Financial Autonomy Indicator, which aims to determine the tax resources available to the local entity. Taking into account that Spanish municipalities have, depending on their population size, different obligations when providing services to citizens, the convergence of financial autonomy is studied to detect whether there are common trends by applying the techniques of β-convergence and σ-convergence. It is analyzed whether municipalities starting from lower indicators achieve higher growth over time ( β-convergence), and whether dispersion between municipalities is reduced ( σ-convergence). Points for practitioners Local autonomy grants local entities the freedom to manage their own interests within the State's legal framework. Greater economic diversity and the ability to raise more money on their own through taxes, fees, and other sources characterize larger communities. They have a wider tax base thanks to their higher economic diversification, which opens up more opportunities for revenue collection. The speed of convergence is highest in the smallest municipalities. Knowing whether there is convergence or divergence in financial autonomy can help policy makers.
Comparative Chemical Profiling of a Polyherbal Formulation with Respect to its Ingredient Plants Using Spectrophotometric and High-performance Thin-layer Chromatographic Techniques
Authors: Sulaiman Cheruthazhakkat , Shafna Thankayathil , Advaya Geetha Raguthaman , Ramesh Poovathusseri Raghava Varier , Mahesh Kamalakshan Pillai , Praveen Mooriath , Anandan Erayur Mana , Balachandran Indira 
Published: November 2023

Background Guggulutiktam Kashayam (GTK) is a water decoction used in Ayurveda for the treatment of various diseases like skin diseases, ulcers, anemia, thyroid problems, stress, liver disease, and leucorrhoea. It is a polyherbal formulation prepared from specific parts of 28 medicinal plants. Objectives The study aimed at a comparative phytochemical evaluation of an important polyherbal formulation with its ingredient plants. Materials and Methods Chemical profiling of GTK has been carried out in comparison with its ingredient plants. Spectrophotometric estimation of major class compounds and high-performance thin-layer chromatography (HPTLC) profiling were done using a standardized protocol. Results The results of the study showed that the phytochemical contents of the finished formulation are different from those of the ingredient plants, which might be due to the numerous synergistic and antagonistic interactions of numerous chemical components extracted from different ingredient drugs. HPTLC-based comparative chromatograms showed the differences and similarities in certain compounds that are specific to some of the plant ingredients. Conclusion The study established the cumulative chemical interactions of various phytochemicals during the preparation of an important polyherbal formula used in Ayurveda.
Knowledge, Attitude and Practice Towards Milk Banking and Lactation Aids – Similarities and Differences of Medical and Nursing Staff in a Tertiary Care Hospital in India
Authors: Singh Srijan , Mane Sushant , Singh Srishti , Rai Rohit 
Published: November 2023

Introduction Lactation education is an integral part of healthcare. In order to recognise and address the inconsistencies in perceptions, attitudes and delivery of lactation care, we developed the Lactation Aids and Milk Banking (LAMB) survey. Aim The purpose of the study was to compare the knowledge, attitude and practices of doctors and nurses about human milk banking and lactation aids and to examine institutional and individual barriers to and facilitators of the delivery of lactation care. Methods It was a cross-sectional study, and the survey questionnaire was administered electronically to neonatal physicians and nurses in a tertiary care hospital in India. Results There were 86 participants, including 54 doctors (63%) and 32 (37%) nurses. There was no significant difference in the knowledge score of doctors and nurses ( p = .61), although doctors scored significantly higher on the attitude and practices score as compared to nurses ( p < .0001). Amongst the doctors, the knowledge score was higher for faculty than residents ( p < .0001), though residents scored significantly higher on the attitude and practices score than faculty ( p = .0002). This study highlighted five facilitators and two barriers to LAMB and also revealed that physicians and nurses have relatively inadequate knowledge about lactational aids and milk banking. Conclusion Lactation education for staff can reinforce support for milk banking and lactation aids, thereby achieving the goal of exclusive breastfeeding. It is also important to mitigate barriers by establishing policies and guidelines in the unit for milk banking and the use of lactation aids.
Sternoclavicular joint reconstruction for traumatic acute and chronic anterior and posterior instability: Patient-reported outcomes at a minimum of 2 years
Authors: Somerson Jeremy S , Parker Kate M , Warme Winston J 
Published: November 2023

Background Instability of the sternoclavicular joint (SCJ) is a rare problem that is often treated closed, with few published outcomes of surgical treatment with tendon graft reconstruction. Methods We reviewed a consecutive series of patients who underwent tendon graft reconstruction for SCJ instability over a 7-year period. Cases with acute fractures or fewer than 2 years of follow-up were excluded. Pre- and postoperative function and pain were assessed using Single assessment numeric evaluation (SANE), simple shoulder test (SST), and visual analog scale (VAS) outcome measures. Results Thirty cases were included, with 27 (90%) available for follow-up at a minimum of 2 years postoperatively. SANE scores improved from a median of 40 to 90. SST scores improved from a median of 3 positive responses to a median of 12 on a 12-point scale. VAS scores decreased from a median of 7 to 0 points. One patient underwent reoperation for recurrent instability and wound dehiscence. Three (11%) patients did not achieve a minimum 30% of maximum possible improvement in SST scores. Conclusions Tendon graft reconstruction for SCJ instability is a safe procedure with a low complication rate and statistically and clinically significant improvements in patient-reported outcome measures at 2-year minimum follow-up. Level of evidence Level IV: Therapeutic.
Severity of white matter microstructural damage in a Brazilian relapsing-remitting multiple sclerosis cohort: A possible window to optimize treatment
Authors: Correia Rafael , Corrêa Diogo , Doring Thomas , Theodoro Carmem , Correia Aline , Coelho Valeria , Dib João Gabriel , Marchiori Edson , Alves Leon Soniza V , Rueda Lopes Fernanda C 
Published: November 2023

Background Multiple sclerosis (MS) is an important cause of acquired neurological disability in young adults, characterized by multicentric inflammation, demyelination, and axonal damage. Objective The objective is to investigate white matter (WM) damage progression in a Brazilian MS patient cohort, using diffusion tensor imaging (DTI) post-processed by tract-based spatial statistics (TBSS). Methods DTI scans were acquired from 76 MS patients and 37 sex-and-age matched controls. Patients were divided into three groups based on disease duration. DTI was performed along 30 non-collinear directions by using a 1.5T imager. For TBSS analysis, the WM skeleton was created, and a 5000 permutation-based inference with a threshold of p < .05 was used, to enable the identification of abnormalities in fractional anisotropy (FA), mean diffusivity (MD), radial diffusivity (RD), and axial diffusivity (AD). Results Decreased FA and increased RD, MD, and AD were seen in patients compared to controls and a decreased FA and increased MD and RD were seen, predominantly after the first 5 years of disease, when compared between groups. Conclusion Progressive WM deterioration is seen over time with a more prominent pattern after 5 years of disease onset, providing evidence that the early years might be a window to optimize treatment and prevent disability.
“Suspending Classes Without Stopping Learning”: An Initiative to Ensure Learning in Japan During the Pandemic
Authors: Yu (于普) Pu , Anezaki (姉崎敬吾) Keigo 
Published: November 2023

Purpose During Japan's initial pandemic prevention and control period, the Ministry of Education, Culture, Sports, Science, and Technology of Japan (MEXT) issued several notifications to ensure students’ continuous learning according to the “leave no one behind” philosophy. This study focused on the comprehensive measures comprising top-level arrangements to implement the “suspending classes without stopping learning” initiative. Design/Approach/Methods The study reviewed MEXT's guide on ensuring learning for Japanese primary and secondary school students during the pandemic. Findings The pandemic has accelerated the development of the information and communications technology educational environment and the implementation of the Global and Innovation Gateway for All (GIGA) schools initiative. These developments laid the foundation for the evolution of diverse pedagogical models and feasible methods for promoting equity. The home schooling experience during the pandemic provided a natural base for students to practice and foster survivability. Originality/Value This paper provides scholars with an understanding of the opportunities and challenges encountered in educational innovation in Japan. It provides insights into the future direction of pedagogical development, capability development, and effective educational arrangements for extraordinary circumstances to facilitate educational development from a broader perspective, particularly under the new normal.