bluuebunny/crossref_metadata_2025_split huggingface dataset:
Human Coronary Plaque T Cells Are Clonal and Cross-React to Virus and Self
Authors: Chowdhury Roshni Roy , D’Addabbo Jessica , Huang Xianxi , Veizades Stefan , Sasagawa Koki , Louis David M. , Cheng Paul , Sokol Jan , Jensen Annie , Tso Alexandria , Shankar Vishnu , Wendel Ben Shogo , Bakerman Isaac , Liang Grace , Koyano Tiffany , Fong Robyn , Nau Allison N. , Ahmad Herra , Gopakumar Jayakrishnan , Wirka Robert , Lee Andrew S. , Boyd Jack , Woo Y. Joseph , Quertermous Thomas , Gulati Gunsagar Singh , Jaiswal Siddhartha , Chien Yueh-Hsiu , Chan Charles Kwok Fai , Davis Mark M. , Nguyen Patricia K. 
Published: April 2022

Background:
Coronary artery disease is an incurable, life-threatening disease that was once considered primarily a disorder of lipid deposition. Coronary artery disease is now also characterized by chronic inflammation‚ notable for the buildup of atherosclerotic plaques containing immune cells in various states of activation and differentiation. Understanding how these immune cells contribute to disease progression may lead to the development of novel therapeutic strategies.

Methods:
We used single-cell technology and in vitro assays to interrogate the immune microenvironment of human coronary atherosclerotic plaque at different stages of maturity.

Results:

In addition to macrophages, we found a high proportion of αβ T cells in the coronary plaques. Most of these T cells lack high expression of
CCR7
and
L-selectin
, indicating that they are primarily antigen-experienced memory cells. Notably, nearly one-third of these cells express the
HLA-DRA
surface marker, signifying activation through their TCRs (T-cell receptors). Consistent with this, TCR repertoire analysis confirmed the presence of activated αβ T cells (CD4<CD8), exhibiting clonal expansion of specific TCRs. Interestingly, we found that these plaque T cells had TCRs specific for influenza, coronavirus, and other viral epitopes, which share sequence homologies to proteins found on smooth muscle cells and endothelial cells, suggesting potential autoimmune-mediated T-cell activation in the absence of active infection. To better understand the potential function of these activated plaque T cells, we then interrogated their transcriptome at the single-cell level. Of the 3 T-cell phenotypic clusters with the highest expression of the activation marker
HLA-DRA
, 2 clusters expressed a proinflammatory and cytolytic signature characteristic of CD8 cells, while the other expressed AREG (amphiregulin), which promotes smooth muscle cell proliferation and fibrosis, and, thus, contributes to plaque progression.

Conclusions:
Taken together, these findings demonstrate that plaque T cells are clonally expanded potentially by antigen engagement, are potentially reactive to self-epitopes, and may interact with smooth muscle cells and macrophages in the plaque microenvironment.
Need for Better and Broader Training in Cardio‐Obstetrics: A National Survey of Cardiologists, Cardiovascular Team Members, and Cardiology Fellows in Training
Authors: Bello Natalie A. , Agrawal Akanksha , Davis Melinda B. , Harrington Colleen M. , Lindley Kathryn J. , Minissian Margo B. , Sharma Garima , Walsh Mary Norine , Park Ki 
Published: April 2022

Background
Team‐based models of cardio‐obstetrics care have been developed to address the increasing rate of maternal mortality from cardiovascular diseases. Cardiovascular clinician and trainee knowledge and comfort with this topic, and the extent of implementation of an interdisciplinary approach to cardio‐obstetrics, are unknown.

Methods and Results
We aimed to assess the current state of cardio‐obstetrics knowledge, practices, and services provided by US cardiovascular clinicians and trainees. A survey developed in conjunction with the American College of Cardiology was circulated to a representative sample of cardiologists (N=311), cardiovascular team members (N=51), and fellows in training (N=139) from June 18, 2020, to July 29, 2020. Knowledge and attitudes about the provision of cardiovascular care to pregnant patients and the prevalence and composition of cardio‐obstetrics teams were assessed. The widest knowledge gaps on the care of pregnant compared with nonpregnant patients were reported for medication safety (42%), acute coronary syndromes (39%), aortopathies (40%), and valvular heart disease (30%). Most respondents (76%) lack access to a dedicated cardio‐obstetrics team, and only 29% of practicing cardiologists received cardio‐obstetrics didactics during training. One third of fellows in training reported seeing pregnant women 0 to 1 time per year, and 12% of fellows in training report formal training in cardio‐obstetrics.

Conclusions
Formalized training in cardio‐obstetrics is uncommon, and limited access to multidisciplinary cardio‐obstetrics teams and large knowledge gaps exist among cardiovascular clinicians. Augmentation of cardio‐obstetrics education across career stages is needed to reduce these deficits. These survey results are an initial step toward developing a standard expectation for clinicians’ training in cardio‐obstetrics.
Cerebral Venous Sinus Thrombosis in Preterm Infants
Authors: Christensen Rhandi , Krishnan Pradeep , deVeber Gabrielle , Dlamini Nomazulu , MacGregor Daune , Pulcine Elizabeth , Moharir Mahendranath 
Published: April 2022

Background:
Neonatal cerebral venous sinus thrombosis (CVST) can lead to brain injury and neurodevelopmental impairments. Previous studies of neonatal CVST have focused on term infants, and studies of preterm infants are lacking. In this study, we examined the clinical and radiological features, treatment and outcome of CVST in preterm infants.

Methods:
This was a retrospective, consecutive cohort study of preterm infants (gestational age <37 weeks) with radiologically confirmed CVST. All magnetic resonance imaging/MRV and CT/CTV scans were re-reviewed to study thrombus characteristics and pattern of brain injury. Outcome was assessed by the validated pediatric stroke outcome measure at the most recent clinic visit.

Results:
Twenty-six preterm infants with CVST were studied. Of these, 65% were moderate-late preterm (32–37 weeks), 27% very preterm (28–32 weeks), and 8% extreme preterm (<28 weeks). Most (73%) were symptomatic at presentation with seizures or abnormal exam. Transverse (85%) and superior sagittal (42%) sinuses were common sites of thrombosis. Parenchymal brain injury was predominantly periventricular (35%) and deep white matter (31%) in location. Intraventricular hemorrhage occurred in 46%. Most infants (69%) were treated with anticoagulation. No treated infant (including eleven with pretreatment hemorrhage) had new or worsening post-treatment hemorrhage. Outcomes ranged from no deficits (50%), mild-moderate (25%), and severe (25%) impairment.

Conclusions:
In our sample of preterm infants with CVST, more than one-quarter were asymptomatic. White matter brain lesions predominated and one-half had neurological deficits at follow-up. Anticoagulation of preterm CVST in this small cohort appeared to be safe. Larger studies of preterm CVST are needed.
Prehospital Tourniquets Placed on Limbs Without Major Vascular Injuries, Has the Pendulum Swung Too Far?
Authors: Legare Timothy , Schroll Rebecca , Hunt John P. , Duchesne Juan , Marr Alan , Schoen Jonathan , Greiffenstein Patrick , Stuke Lance , Smith Alison 
Published: April 2022

Background Combat applications of tourniquets for extremity trauma have led to increased civilian prehospital tourniquet use. Studies have demonstrated that appropriate prehospital tourniquet application can decrease the incidence of arrival in shock without increasing limb complications. The aim of this study was to examine outcomes of prehospital tourniquet placement without definitive vascular injury. Methods Retrospective review was performed of a prospectively maintained database by the American Association for the Surgery of Trauma from 29 trauma centers. Patients in this subset analysis did not have a significant vascular injury as determined by imaging or intra-operatively. Patients who received prehospital tourniquets (PHTQ) were compared to patients without prehospital tourniquets (No-PHTQ). Outcomes were amputation rates, nerve palsy, compartment syndrome, and in-hospital mortality. Results A total of 622 patients had no major vascular injury. The incidence of patients without major vascular injury was higher in the PHTQ group (n = 585/962, 60.8 vs n = 37/88, 42.0%, P < .001). Cohorts were similar in age, gender, penetrating mechanism, injury severity scores (ISS), abbreviated injury score (AIS), and mortality ( P > .05). Amputation rates were 8.3% (n = 49/585) in the PHTQ group compared to 0% (n = 0/37) in the No-PHTQ group. Amputation rates were higher in PHTQ than No-PHTQ with similar ISS and AIS ( P = .96, P = .59). The incidence of nerve palsy and compartment syndrome was not different ( P > .05). Conclusions This study showed a significant amount of prehospital tourniquets are being placed on patients without vascular injuries. Further studies are needed to elucidate the appropriateness of prehospital tourniquets, including targeted education of tourniquet placement.
Mental Fatigue Prior to Aerobic Exercise Reduces Exercise Pleasure and Negatively Affects Implicit Attitudes Toward Future Exercise
Authors: Pessoa Felipe de Azevedo , Pereira Lucas Camilo , de Oliveira Araújo Andressa , Oliveira Gledson Tavares Amorim , Pereira Daniel Carvalho , Elsangedy Hassan Mohamed 
Published: April 2022

We investigated the effects of mental fatigue (MF) on affective responses during an aerobic exercise session at moderate intensity. We submitted 12 insufficiently active adults (50% women; M age = 24.9 years, SD = 3.0; M BMI = 24.3 kg/m2; SD = 2.6) to two 30-minute pre-exercise conditions: an MF condition (Stroop Color-Word task) and a control condition (watching a documentary) prior to their performance of 20 minutes of aerobic treadmill exercise at 40–59% of heart rate reserve. The minimum washout interval between conditions was two days. Perceived MF and motivation to perform physical exercise were assessed before and after conditions with a visual analog scale of 100 mm. We assessed participants’ affective and exertion responses with the Feeling Scale, Rating of Perceived Exertion (RPE) and heart rate during every two minutes of physical exercise. Implicit attitudes toward physical exercise were assessed by the Implicit Association Test before the MF and control conditions and after the physical exercise session. The participants in the MF condition reported lower pleasure ( M difference = −1.57, 95% CI = −2.64 to −0.50, d = 0.93, p = .008) and higher exertion (RPE) ( M difference = 1.16, 95% CI = 0.04 to 2.27, d = 0.66, p = .043) compared to those in the control condition. Participants who experienced MF also reported a more negative implicit attitude toward physical exercise than in the control condition ( β = −0.47, 95% CI= −0.73 to −0.21, d = 1.41, p < .001). While these findings should be cross-validated in subsequent research with a larger and more diverse participant sample, there appears to be value in minimizing pre-exercise mental fatigue to avoid negative MF effects on the exercisers’ affective experience.
The ‘Three RS’ in Malaysia’s Struggle for Constitutional Democracy
Authors: Shah Dian 
Published: April 2022

AbstractRace, religion and royalty (the Three ‘Rs’) have been salient aspects of Malaysia’s constitutional struggle. These elements have defined the country’s constitutional settlements during the pre-independence constitution-making process, generated constitutional crises and continued to figure into day-to-day governance and constitutional practice. There have been instances where operation of and compromises around the Three Rs have facilitated constitution-building. Yet, more often than not, as this article illustrates, the constellation of these three forces have challenged the building and sustaining of a constitutional democracy. Since the historic political change in May 2018 in particular, the Three Rs have become even more significant in shaping the critical junctures in Malaysia’s constitutional journey. To illuminate a more comprehensive understanding of the role of race, religion and royalty in Malaysia’s struggle for constitutional democracy, this article explains how these elements have defined (and continued to define) controversies relating to the distribution of political power and the protection of fundamental rights. Fundamentally, these aspects implicate checks and balances and constraints on political power. This article also demonstrates the ways in which the struggle for constitutional democracy implicates a range of actors and interests: aside from individual citizens, there are the monarchy, the elected government, the courts and group (ethnic) interests. This article then draws on institutional and political explanations in accounting for Malaysia’s constitutional struggle. In particular, aside from changing political fundamentals, it argues that the Constitution provides the opportunity structure and institutional resources for the Three Rs to shape Malaysia's struggle for constitutional democracy.
Causal association pathways between fetuin-A and kidney function: a mediation analysis
Authors: Bassey Philip Etabee , Numthavaj Pawin , Rattanasiri Sasivimol , Sritara Piyamitr , McEvoy Mark , Ongphiphadhanakul Boonsong , Thakkinstian Ammarin 
Published: April 2022

Objective Body mass index (BMI), uric acid, diabetes mellitus, and hypertension are risk factors for reduced kidney function and are associated with fetuin-A levels, but their causal pathways remain unclear. The objective of this study was to investigate this knowledge gap. Methods A repeated cross-sectional design was used to assess causal pathway effects of fetuin-A on the estimated glomerular filtration rate (eGFR), which is mediated through BMI, uric acid, diabetes mellitus, and hypertension. Results Among 2305 participants, the mean eGFR at baseline decreased from 98.7 ± 23.6 mL/minute/1.73 m2 in 2009 to 92.4 ± 22.9 mL/minute/1.73 m2 in 2014. Fetuin-A was significantly associated with eGFR , suggesting that increasing fetuin-A levels predict a decrease in eGFR. Additionally, the indirect effect of fetuin-A on eGFR, as assessed through BMI, was also significant. The effects of fetuin-A on eGFR through other mediation pathways showed variable results. Conclusions Our study revealed a possible role of fetuin-A in the etiology of declining renal function through mediating body mass index, uric acid, diabetes mellitus, and hypertension via complex causal pathways. Further studies to clarify these mediated effects are recommended.
The relationship between Motivation for Occupation and Pattern of Occupation scores of the MOHOST and types of discharge placement from a mental health rehabilitation unit
Authors: Wisniewski Victoria , Akintomide Gbolagade S 
Published: April 2022

Introduction Model of Human and Occupational Screening Tool (MOHOST) is a scale used to assess occupational functioning in mental health inpatients which can inform suitable post-discharge placements. However, there is little research on the relationship between scores on Motivation for Occupation (MO) and Pattern of Occupation (PO) subscales of the MOHOST and types of discharge placement. Method The records of all patients discharged over a 2-year period from a male psychiatric rehabilitation unit were examined. All patients had undergone MOHOST assessments; however, these scores were not a factor in their discharge placement selection. Analyses were done on types of discharge placements (transfer to another psychiatric unit or community discharge) versus predischarge scores in MO and PO of MOHOST. Results N = 20 and average length of stay was 23 months. There was positive correlation between MO and PO scores and discharge placements (rs = 0.66, p = 0.002; rs = 0.67 and p = 0.001, respectively). Using ordinal logistic regression, for each unit increase of negative score in PO, there was 0.68 increase in the log odds of more restrictive discharge placements, p = 0.008. Conclusion The study suggests that MOHOST is a useful tool in determining suitable placements for patients being discharged or transferred from psychiatric rehabilitation units.
Signature involved in immune-related lncRNA pairs for predicting the immune landscape of cervical cancer
Authors: Liu Xueting , Wang Zhao , Wang Le , Wang Ying , Wang Yuan , Yang Shanshan , Zhang Yunyan 
Published: April 2022

Background Immune-related long non-coding RNAs (irlncRNAs) are known to hold great promise as superior biomarkers for cervical cancer-related immunotherapeutic response and the tumor immune microenvironment. Here, we constructed a prognostic signature based on irlncRNA pairs (IRLPs). Methods The samples were downloaded from The Cancer Genome Atlas and the Genotype-Tissue Expression databases. The least absolute shrinkage and selection operator Cox regression was performed to construct the prognostic model. Receiver operating characteristic (ROC) curve and nomogram were plotted to validate accuracy of the model. Next, we estimated the immune cell infiltration and the correlation between risk score and the expression of genes related to immune checkpoint. Finally, we calculated the score of the Tumor Immune Dysfunction and Exclusion (TIDE) algorithm and the half maximal inhibitory concentration of the chemotherapeutic agent to evaluate the response to immunotherapy and chemotherapy. Results We constructed a prognostic signature that consisted of 11 irlncRNAs. The area under the curve values of the 1-, 3-, and 5-year ROC curves were 0.844, 0.891, and 0.871, respectively. The expression of CTLA-4, HAVCR2, IDO1, LAG3, and PDCD1 were negatively correlated with risk scores. The score of TIDE in the high-risk group was significantly higher than in the low-risk group ( P < 0.01). Patients in the low-risk subgroup were more sensitive to chemotherapeutic agents, such as axitinib and docetaxel, whereas patients in the low-risk subgroup were more sensitive to mitomycin C. Conclusion Our study highlighted the value of the 11 IRLPs signatures to predict the prognosis and the response to immunotherapy and chemotherapeutics for patients with cervical cancer.
Chitosan-platelet-rich plasma implants improve rotator cuff repair in a large animal model: Pilot study
Authors: Chevrier Anik , Hurtig Mark B , Lavertu Marc 
Published: April 2022

Freeze-dried formulations of chitosan can be solubilized in platelet-rich plasma (PRP) to form injectable implants that are used as an adjunct treatment during surgical repair of the rotator cuff. The purpose of the current study was to assess chitosan-PRP implant residency, test safety, and assess efficacy over standard-of-care controls in a sheep model of rotator cuff repair. The infraspinatus tendon was transected unilaterally and immediately repaired with suture anchors in 22 skeletally mature ewes. In treatment groups, formulations containing chitosan, trehalose, and calcium chloride were solubilized with autologous leukocyte-rich PRP and injected at the tendon-bone interface and on top of the repaired site (1 mL or 2 mL doses). Implant residency was assessed histologically at 1 day. Outcome measures included MRI assessment at baseline, 6 weeks, and 12 weeks, histopathology and clinical pathology. Chitosan-PRP implants were resident at the injection site at 1 day and induced recruitment of polymorphonuclear cells. The tendon gap, which corresponds to the length of abnormally hyperintense tissue attached to the humeral head, was decreased by treatment with the 2 mL dose when compared to controls at 12 weeks on MRI images. Some histological features were improved by the 2 mL dose treatment compared to controls at 12 weeks. There was no treatment-specific effect on all standard safety outcome measures, which suggests high safety. This study provides preliminary evidence on the safety and efficacy of chitosan-PRP implants in a large animal model that could potentially be translated to a clinical setting.
Central Bank Independence, Inflation, and Poverty in Africa
Authors: Gyeke-Dako Agyapomaa , Agbloyor Elikplimi Komla , Agoba Abel Mawuko , Turkson Festus , Abbey Emmanuel 
Published: April 2022

This article discusses the extent to which central bank independence (CBI) can be used to mitigate the regressive nature of inflation. Using 44 Sub-Saharan African (SSA) countries from the period 1970–2012, the article first examines whether CBI has any influence on inflation by distinguishing between legal independence and governor turnover rates. The evidence shows that CBI helps control inflation, and that inflation generally reduces poverty, and this effect is even stronger, in an environment of low CBI. JEL Codes: E02, E58, E31, I32
Early evidence and lessons learnt from an NHS Wales Video Consulting Service
Authors: Johns Gemma , Khalil Sara , Ogonovsky Mike , Hesseling Markus , Wardhaugh Allan , Phipps Kerrie , Williams Jessica , Whistance Bethan , Ahuja Alka 
Published: April 2022

Background: The use of video consulting (VC) in Wales, United Kingdom (UK) has expanded rapidly during the COVID-19 pandemic. Traditionally, VC has been the subject of small-scale projects and evaluations. In response to the pandemic emergency, there was an opportunity to roll out and evaluate VC on a larger and more representative scale, across a wider range of National Health Service (NHS) specialities. Aims: This paper presents an overview of a dataset captured by the ‘The NHS Wales VC Service’. The purpose of this study was to capture perspectives of healthcare professionals only (including clinicians, administration and management) on the use of VC and explore lessons learnt from the national implementation process. Methodology: Using an online, mixed methods retrospective survey capturing descriptive and narrative data. Results: A total of 1256 NHS healthcare professionals shared their VC experience. Overall, responses were positive, and healthcare professionals expressed optimistic views regarding the use, value and benefit of VC, even when faced with challenges on occasions. Conclusions: A lesson learnt, is that difference occurs in innovation, even in a small country like Wales, yet it is not necessarily a negative outcome, but rather, respecting and incorporating difference, can improve long-term sustainability.