bluuebunny/crossref_metadata_2025 huggingface dataset:
Understanding the Impact of Equitable Collaborations between Science Institutions and Community-Based Organizations: Improving Science through Community-Led Research
Authors:   The ICBOs and Allies Workgroup, Ricalde María Cecilia Alvarez , Annoni John , Bonney Rick , Bonta J Marcelo , Campbell Patricia B , Castelli Mateo Luna , Cheatom Makeda , Crum Catherine , Valadez Juan Flores , Foli Yao Augustine , González José , Hurtado José Miguel Hernández , Horace Sister Sharon , Kitchen Karen , Fretts Marilú López , Lucey Brigid , Marcos-Iga Pepe , Purcell Karen , Rodriguez Berenice , Schuh Tanya , Turner Phyllis Edwards , Villarreal Fanny , Wilson Bobby
Published: January 2022

To advance justice, equity, diversity, and inclusion in science, we must first understand and improve the dominant-culture frameworks that impede progress and, second, we must intentionally create more equitable models. The present authors call ourselves the ICBOs and Allies Workgroup (ICBOs stands for independent community-based organizations), and we represent communities historically excluded from the sciences. Together with institutional allies and advisors, we began our research because we wanted our voices to be heard, and we hoped to bring a different perspective to doing science with and not on communities. We created a community framework to guide our research and we led all aspects of our work, from creating research protocols to analyzing and interpreting the data to disseminating the results. We share our research framework, methods, and results so that science institutions can better understand how to intentionally create more equitable research partnerships with our communities.
Post-stroke outcomes predicted from multivariate lesion-behaviour and lesion network mapping
Authors: Bowren Mark , Bruss Joel , Manzel Kenneth , Edwards Dylan , Liu Charles , Corbetta Maurizio , Tranel Daniel , Boes Aaron D
Published: January 2022

Clinicians and scientists alike have long sought to predict the course and severity of chronic post-stroke cognitive and motor outcomes, as the ability to do so would inform treatment and rehabilitation strategies. However, it remains difficult to make accurate predictions about chronic post-stroke outcomes due, in large part, to high inter-individual variability in recovery and a reliance on clinical heuristics rather than empirical methods. The neuroanatomical location of a stroke is a key variable associated with long-term outcomes, and because lesion location can be derived from routinely collected clinical neuroimaging data there is an opportunity to use this information to make empirically based predictions about post-stroke deficits. For example, lesion location can be compared to statistically weighted multivariate lesion-behaviour maps of neuroanatomical regions that, when damaged, are associated with specific deficits based on aggregated outcome data from large cohorts.

Here, our goal was to evaluate whether we can leverage lesion-behaviour maps based on data from two large cohorts of individuals with focal brain lesions to make predictions of 12-month cognitive and motor outcomes in an independent sample of stroke patients. Further, we evaluated whether we could augment these predictions by estimating the structural and functional networks disrupted in association with each lesion-behaviour map through the use of structural and functional lesion network mapping, which use normative structural and functional connectivity data from neurologically healthy individuals to elucidate lesion-associated networks. We derived these brain network maps using the anatomical regions with the strongest association with impairment for each cognitive and motor outcome based on lesion-behaviour map results. These peak regional findings became the ‘seeds’ to generate networks, an approach that offers potentially greater precision compared to previously used single-lesion approaches. Next, in an independent sample, we quantified the overlap of each lesion location with the lesion-behaviour maps and structural and functional lesion network mapping and evaluated how much variance each could explain in 12-month behavioural outcomes using a latent growth curve statistical model.

We found that each lesion-deficit mapping modality was able to predict a statistically significant amount of variance in cognitive and motor outcomes. Both structural and functional lesion network maps were able to predict variance in 12-month outcomes beyond lesion-behaviour mapping. Functional lesion network mapping performed best for the prediction of language deficits, and structural lesion network mapping performed best for the prediction of motor deficits. Altogether, these results support the notion that lesion location and lesion network mapping can be combined to improve the prediction of post-stroke deficits at 12-months.
Increased brain volume from higher cereal and lower coffee intake: shared genetic determinants and impacts on cognition and metabolism
Authors: Kang Jujiao , Jia Tianye , Jiao Zeyu , Shen Chun , Xie Chao , Cheng Wei , Sahakian Barbara J , Waxman David , Feng Jianfeng
Published: January 2022

It is unclear how different diets may affect human brain development and if genetic and environmental factors play a part. We investigated diet effects in the UK Biobank data from 18,879 healthy adults and discovered anticorrelated brain-wide gray matter volume (GMV)-association patterns between coffee and cereal intake, coincidence with their anticorrelated genetic constructs. The Mendelian randomization approach further indicated a causal effect of higher coffee intake on reduced total GMV, which is likely through regulating the expression of genes responsible for synaptic development in the brain. The identified genetic factors may further affect people’s lifestyle habits and body/blood fat levels through the mediation of cereal/coffee intake, and the brain-wide expression pattern of gene CPLX3, a dedicated marker of subplate neurons that regulate cortical development and plasticity, may underlie the shared GMV-association patterns among the coffee/cereal intake and cognitive functions. All the main findings were successfully replicated. Our findings thus revealed that high-cereal and low-coffee diets shared similar brain and genetic constructs, leading to long-term beneficial associations regarding cognitive, body mass index (BMI), and other metabolic measures. This study has important implications for public health, especially during the pandemic, given the poorer outcomes of COVID-19 patients with greater BMIs.
Histologic and proteomic remodeling of the pulmonary veins and arteries in a porcine model of chronic pulmonary venous hypertension
Authors: Fayyaz Ahmed U , Sabbah Michael S , Dasari Surendra , Griffiths Leigh G , DuBrock Hilary M , Wang Ying , Charlesworth M Cristine , Borlaug Barry A , Jenkins Sarah M , Edwards William D , Redfield Margaret M
Published: January 2022

Aims

In heart failure (HF), pulmonary venous hypertension (PVH) produces pulmonary hypertension (PH) with remodeling of pulmonary veins (PV) and arteries (PA). In a porcine PVH model, we performed proteomic-based bioinformatics to investigate unique pathophysiologic mechanisms mediating PA and PV remodeling.

Methods and results

Large PV were banded (PVH, n = 10) or not (Sham, n = 9) in piglets. At sacrifice, PV and PA were perfusion labelled for vessel-specific histology and proteomics. The PA and PV were separately sampled with laser-capture micro-dissection for mass spectrometry. Pulmonary vascular resistance [Wood Units; 8.6 (95% confidence interval: 6.3, 12.3) vs. 2.0 (1.7, 2.3)] and PA [19.9 (standard error of mean, 1.1) vs. 10.3 (1.1)] and PV [14.2 (1.2) vs. 7.6 (1.1)] wall thickness/external diameter (%) were increased in PVH (P < 0.05 for all). Similar numbers of proteins were identified in PA (2093) and PV (2085) with 94% overlap, but biological processes differed. There were more differentially expressed proteins (287 vs. 161), altered canonical pathways (17 vs. 3), and predicted upstream regulators (PUSR; 22 vs. 6) in PV than PA. In PA and PV, bioinformatics indicated activation of the integrated stress response and mammalian target of rapamycin signalling with dysregulated growth. In PV, there was also activation of Rho/Rho-kinase signalling with decreased actin cytoskeletal signalling and altered tight and adherens junctions, ephrin B, and caveolae-mediated endocytosis signalling; all indicating disrupted endothelial barrier function. Indeed, protein biomarkers and the top PUSR in PV (transforming growth factor-beta) suggested endothelial to mesenchymal transition in PV. Findings were similar in human autopsy specimens.

Conclusion

These findings provide new therapeutic targets to oppose pulmonary vascular remodeling in HF-related PH.
4D-flow cardiac magnetic resonance imaging after aortic root replacement with long-valved decellularized aortic homografts: comparison to valve-sparing aortic root replacement and healthy controls
Authors: Cvitkovic Tomislav , Bobylev Dmitry , Horke Alexander , Avsar Murat , Beerbaum Philipp , Martens Andreas , Böthig Dietmar , Petenà Elena , Gutberlet Marcel , Beyer Frerk Hinnerk , Wacker Frank , Cebotari Serghei , Haverich Axel , Vogel-Claussen Jens , Sarikouch Samir , Czerner Christoph
Published: January 2022

OBJECTIVES

Long-valved decellularized aortic homografts (DAH) may be used in young patients to treat aortic valve disease associated with aortic root dilatation, thereby eliminating the need for prosthetic material and anticoagulation.

METHODS

Thirty-three male subjects in 3 equally sized cohorts were compared: patients following DAH implantation with a median age of 29 years [interquartile range (IQR) 27.5–37.5], patients post-valve-sparing aortic root replacement (VSARR), median 44 years (IQR 31.5–49) and healthy controls, median 33 years (IQR 28–40, P = 0.228). Time-resolved three-dimensional phase-contrast cardiac magnetic resonance imaging was performed to assess maximum blood flow velocity, pulse wave velocity, mechanical energy loss (EL), wall shear stress and flow patterns (vorticity, eccentricity, helicity) in 5 different planes of the aorta.

RESULTS

The mean time between surgery and cardiovascular magnetic resonance was 2.56 ± 2.0 years in DAH vs 2.67 ± 2.1 in VSARR, P = 0.500. No significant differences in maximum velocity and pulse wave velocity were found between healthy controls and DAH across all planes. Velocity in the proximal aorta was significantly higher in VSARR (182.91 ± 53.91 cm/s, P = 0.032) compared with healthy controls. EL was significantly higher in VSARR in the proximal aorta with 1.85 mW (IQR 1.39–2.95) compared with healthy controls, 1.06 mW (0.91–1.22, P = 0.016), as well as in the entire thoracic aorta. In contrast, there was no significant EL in DAH in the proximal, 1.27 m/W (0.92–1.53, P = 0.296), as well as in the thoracic aorta, 7.7 m/W (5.25–9.90, P = 0.114), compared with healthy controls. There were no significant differences in wall shear stress parameters for all 5 regions of the thoracic aorta between the 3 groups. DAH patients, however, showed more vorticity, helicity and eccentricity in the ascending aorta compared with healthy controls (P < 0.019).

CONCLUSIONS

Decellularized long aortic homografts exhibit near to normal haemodynamic parameters 2.5 years postoperatively compared with healthy controls and VSARR.
Inhibition of aryl hydrocarbon receptor signaling promotes the terminal differentiation of human erythroblasts
Authors: Chen Yijin , Dong Yong , Lu Xulin , Li Wanjing , Zhang Yimeng , Mao Bin , Pan Xu , Li Xiaohong , Zhou Ya , An Quanming , Xie Fangxin , Wang Shihui , Xue Yuan , Cai Xinping , Lai Mowen , Zhou Qiongxiu , Yan Yan , Fu Ruohan , Wang Hong , Nakahata Tatsutoshi , An Xiuli , Shi Lihong , Zhang Yonggang , Ma Feng
Published: January 2022

The aryl hydrocarbon receptor (AHR) plays an important role during mammalian embryo development. Inhibition of AHR signaling promotes the development of hematopoietic stem/progenitor cells. AHR also regulates the functional maturation of blood cells, such as T cells and megakaryocytes. However, little is known about the role of AHR modulation during the development of erythroid cells. In this study, we used the AHR antagonist StemRegenin 1 (SR1) and the AHR agonist 2,3,7,8-tetrachlorodibenzo-p-dioxin during different stages of human erythropoiesis to elucidate the function of AHR. We found that antagonizing AHR signaling improved the production of human embryonic stem cell derived erythrocytes and enhanced erythroid terminal differentiation. RNA sequencing showed that SR1 treatment of proerythroblasts upregulated the expression of erythrocyte differentiation-related genes and downregulated actin organization-associated genes. We found that SR1 accelerated F-actin remodeling in terminally differentiated erythrocytes, favoring their maturation of the cytoskeleton and enucleation. We demonstrated that the effects of AHR inhibition on erythroid maturation were associated with F-actin remodeling. Our findings help uncover the mechanism for AHR-mediated human erythroid cell differentiation. We also provide a new approach toward the large-scale production of functionally mature human pluripotent stem cell-derived erythrocytes for use in translational applications.
Low abundance but high land snail diversity in montane rainforest on the western slope of the Andes in Ecuador
Authors: Ramirez Perez Maria Camila , Hausdorf Bernhard
Published: January 2022

We investigated the land snail fauna along an altitudinal transect in the Los Cedros Biological Reserve on the western slope of the Andes in Ecuador. A total of 510 individuals were collected in 40 plots between c. 1,100 and 2,000 m a.s.l. and assigned to 80 land snail species. The mean iChao1 estimate of species richness was with 109 species (with a 95% confidence interval from 97 to 130 species) much higher because many species were represented only by one or two specimens. On the basis of available data, Los Cedros is the most species-rich locality for land snails in South America. Almost half of the land snail species and 75% of the sampled individuals belong to the carnivorous Scolodontidae, most of which are likely to be new to science. In comparison with an Amazonian rainforest, the proportion of tropical groups such as the Helicinoidea or the Achatinidae is reduced, whereas the proportions of the Labyrinthidae and Charopidae are higher at higher elevations in the Andes than at the margin of the Amazonas basin. Beckianum beckianum, Hirtudiscus sp., Pupisoma mediamericanum, Guppya gundlachii, Eobania vermiculata and Thysanophora plagioptycha are new records for Ecuador. The finding of the Mediterranean Eobania vermiculata in cultivated areas adjacent to the reserve is the first record of this species in South America.
Dissection of nanoconfinement and proximity effects on the binding events in DNA origami nanocavity
Authors: Jonchhe Sagun , Pandey Shankar , Beneze Christian , Emura Tomoko , Sugiyama Hiroshi , Endo Masayuki , Mao Hanbin
Published: January 2022

Both ligand binding and nanocavity can increase the stability of a biomolecular structure. Using mechanical unfolding in optical tweezers, here we found that a DNA origami nanobowl drastically increased the stability of a human telomeric G-quadruplex bound with a pyridostatin (PDS) ligand. Such a stability change is equivalent to >4 orders of magnitude increase (upper limit) in binding affinity (Kd: 490 nM → 10 pM (lower limit)). Since confined space can assist the binding through a proximity effect between the ligand-receptor pair and a nanoconfinement effect that is mediated by water molecules, we named such a binding as mechanochemical binding. After minimizing the proximity effect by using PDS that can enter or leave the DNA nanobowl freely, we attributed the increased affinity to the nanoconfinement effect (22%) and the proximity effect (78%). This represents the first quantification to dissect the effects of proximity and nanoconfinement on binding events in nanocavities. We anticipate these DNA nanoassemblies can deliver both chemical (i.e. ligand) and mechanical (i.e. nanocavity) milieus to facilitate robust mechanochemical binding in various biological systems.
Early Switch to Fulvestrant Plus Palbociclib Improves Outcomes in ESR1-Mutated, Estrogen Receptor-Positive Metastatic Breast Cancer
Authors: Jacobson Anne
Published: January 2022

For patients with estrogen receptor-positive metastatic breast cancer who are treated with palbociclib plus an aromatase inhibitor, the strategy of switching to palbociclib plus fulvestrant upon detection of a resistance mutation more than doubled progression-free survival, according to results from the phase III PADA-1 trial.
Autoantibodies against four-and-a-half-LIM domain 1 (FHL1) in inflammatory myopathies: results from an Australian single-centre cohort
Authors: Galindo-Feria Angeles S , Horuluoglu Begum , Day Jessica , Fernandes-Cerqueira Catia , Wigren Edvard , Gräslund Susanne , Proudman Susanna , Lundberg Ingrid E , Limaye Vidya
Published: January 2022

Objectives

To determine the prevalence and associations of autoantibodies targeting a muscle-specific autoantigen, four-and-a-half-LIM-domain 1 (FHL1), in South Australian patients with histologically-confirmed idiopathic inflammatory myopathies (IIM) and in patients with SSc.

Material and methods

Sera from patients with IIM (n = 267) from the South Australian Myositis Database (SAMD), SSc (n = 174) from the Australian Scleroderma Cohort Study (ASCS) and healthy controls (HC, n = 100) were analysed for anti-FHL1 autoantibodies by Enzyme-Linked ImmunoSorbent Assay (ELISA).

Results

Autoantibodies to FHL1 were more frequent in patients with IIM (37/267, 13.8%) compared with SSc (12/174, 7%) (P < 0.02) and HC (2/100, 2%) (P < 0.001). The most common IIM subtypes among FHL1+ IIM patients were (32%) and IBM (2/37, 32%). No statistically significant differences in muscular or extra-muscular manifestations of IIM were found when comparing patients who were anti-FHL1+ with their anti-FHL1– counterparts. In 29/37 (78%) anti-FHL1+ patients, no myositis-specific autoantibodies (MSA) were present. In FHL1+ muscle biopsies, there was less frequent infiltration by CD45+ cells (P = 0.04). There was a trend for HLA alleles DRB1*07 and DRB1*15 to be more frequent in anti-FHL1+ compared with anti-FHL1– patients (9/25 vs 19/113, P = 0.09 and 8/25 vs 15/114, P = 0.09, respectively).

Conclusions

We report a substantial prevalence (13.8%) of anti-FHL1 autoantibodies in a large cohort of patients with histologically confirmed IIM; 75% of these cases did not have a detectable myositis-specific autoantibody. Anti-FHL1 autoantibodies were also detected in a subgroup of patients with SSc (7%), indicating that anti-FHL1 autoantibodies may not be myositis-specific. The trend towards an HLA-DR association might indicate a specific immune response to the FHL1 protein.
Drug levels, anti-drug antibodies and B-cell counts were not predictive of response in rheumatoid arthritis patients on (ultra-)low-dose rituximab
Authors: Wientjes Maike H M , Gijzen Titia M G , den Broeder Nathan , Bloem Karien , de Vries Annick  , van den Bemt Bart J F , den Broeder Alfons A , Verhoef Lise M
Published: January 2022

Objectives

The REDO trial (REtreatment with Rituximab in RhEumatoid arthritis: Disease Outcome after Dose Optimisation) showed that ultra-low-dose rituximab (500 mg or 200 mg) was similarly effective to a 1000 mg dosage in the majority of RA patients. This pre-planned secondary analysis investigated (1) associations between rituximab dosage, drug levels, anti-drug antibodies (ADAs) and B-cell counts and (2) the predictive value of pharmacokinetic and pharmacodynamic parameters, and of patient, disease and treatment characteristics in relation to response to ultra-low-dose rituximab.

Methods

For 140 RA patients from the REDO trial, differences in drug levels, ADAs and B-cell counts were examined at baseline, and at 3 and 6 months after dosing. Treatment response was defined as absence of flare and no extra rituximab or >1 glucocorticoid injection received during follow-up. The association between potential predictors and response was investigated using logistic regression analyses.

Results

Lower doses of rituximab resulted in lower drug levels but did not significantly affect ADA levels or B-cell counts, and 3 (10.7%), 12 (20.7%) and 7 (13.0%) patients failed to meet the response criteria in, respectively, the 1000 mg, 500 mg and 200 mg dosage groups. Drug levels, ADAs, B-cell counts, and patient, disease and treatment characteristics were not predictive for response to ultra-low-dose rituximab.

Conclusion

The results of this study further support the hypothesis that continued treatment with 500 or 200 mg rituximab is similarly effective to a 1000 mg dosage in RA patients doing well on rituximab. These results, combined with lack of finding a clinical dose–response relationship in the original REDO study, suggest that 200 mg rituximab is not yet the lowest effective rituximab retreatment dose in RA.
Unidroit Principles and the COVID-19 Economy
Authors: Garcia Sanjur Augusto
Published: January 2022

The international economy was drastically changed by COVID-19. As the pandemic is causing similar problems in different jurisdictions, uniformized solutions are required to have more certainty in a global economy. This is an opportunity for the uniform regulation of international contracts such as the Unidroit Principles. The provisions of the Unidroit Principles, such as force majeure and hardship, may provide parties, adjudicators, and legislators with uniform solutions to common problems caused by the pandemic.
From the Blood-Brain Barrier to Childhood Development: A Case of Acute-Onset Psychosis and Cognitive Impairment Attributed to Systemic Lupus Erythematosus in an Adolescent Female
Authors: Johnson Matthew C. , Sathappan Aakash , Hanly John G. , Ross Gail S. , Hauptman Aaron J. , Stone William S. , Simon Kevin M.
Published: January 2022

Learning objectives

After participating in this CME activity, the clinician will be better able to:

• Interpret classifications of neuropsychiatric systemic lupus erythematosus (NPSLE).

• Identify determining factors of neuropsychiatric events.

• Analyze current evidence regarding disease pathways for NPSLE.
Perfluoroalkyl Substances and Abdominal Aortic Calcification
Authors: Koskela Antti , Ducatman Alan , Schousboe John T. , Nahhas Ramzi W. , Khalil Naila
Published: January 2022

Objective:

To evaluate if serum perfluoroalkylated substances (PFAS) were associated with abdominal aortic calcification (AAC).

Methods:

We used weighted logistic regression to investigate the gender-specific association between PFAS serum levels and AAC more than or equal to 6 from dual-energy X-ray absorptiometry (DXA) scans of the thoraco-lumbar spine from National Health and Nutrition Examination Survey 2013–2014 survey participants aged more than or equal to 40 years.

Results:

After adjusting for confounding, none of log-transformed perfluorooctanoic acid (PFOA), perfluorooctane sulfonate (PFOS), perfluorohexane sulfonic acid (PFHxS), or perfluorononanoic acid (PFNA) were significantly associated with AAC for either men or women (adjusted odds ratios [ORs] ranged from 0.80 to 1.33, P 
> 0.05 each). For PFOA and PFOS, the association was positive only in women (although the difference was not statistically significant in either case).

Conclusion:

These findings do not provide general support for a relationship of PFAS exposure to AAC, although the results show a need for gender-specific consideration in a larger dataset.
Intraspinal extradural gout tophus in the lumbar vertebral canal
Authors: Wu Zhiqiang , Liu Chunhua , Dai Kehui , Zheng Chunfeng
Published: January 2022

Rationale:

Intraspinal gout tophus in the lumbar vertebral canal associated with gouty arthritis is rare. We present 2 cases with the first manifestations of a sequestrated intervertebral disc and an extradural tumor, and histopathologically proven to be gouty deposits in the lumbar vertebral canal.

Patient concerns:

The 2 patients presented with typical radiculopathy symptoms and a positive straight leg raise. In 1 case, there was weakness of the left toe extensors, with a positive left femoral nerve traction test. Additionally, the left patellar tendon reflex was weak. In the other patient who was unable to walk, there was a sensory deficit in the saddle distribution.

Diagnosis:

Histopathological examination of the specimens taken from the operation confirmed the presence of gouty deposits.

Interventions:

Posterior decompression was performed in these 2 cases, and chalky-white materials were identified in the lumbar vertebral canal.

Outcomes:

No evidence of neoplasm, infection, or synovial cyst was found.

Lessons:

Definitive diagnosis of intraspinal extradural gout tophus, mimicking a sequestrated intervertebral disc or an extradural tumor, may be difficult. The initial suspicion of intraspinal gouty deposits, based on the diagnostic/management algorithm, may effectively avoid incorrect diagnosis via a less invasive procedure than explorative laminectomy.
Ulcer-like projections into the dilated false lumen after stent-graft placement for aortic dissection
Authors: He Xi , Sueyoshi Eijun , Nakaji Shun , Uetani Masataka
Published: January 2022

Rationale:

Acute type A aortic dissection and chronic type B aortic dissection (TBAD) occurs simultaneously in rare cases. Although the development of ulcer-like projection (ULP) is associated with an increase in adverse aorta-related events, the false-lumen enlargement caused by the ULP progression is uncommon.

Patient concerns:

A 72-year-old female with chronic TBAD was admitted to our unit with back and chest pain. Computed tomography revealed acute type A aortic dissection and a hematoma caused by rupturing of the descending aorta due to chronic TBAD. After endovascular intervention, the false lumen thrombosed and shrunk.

Diagnosis:

After 9 months, a developing ULP, which projected into a dilating false lumen, was found. An impending ruptured descending aortic aneurysm was confirmed.

Interventions:

Emergency Total arch replacement and thoracic endovascular aortic repair (TEVAR) was performed.

Outcomes:

The procedure was successful. One year later, regular follow-up showed that the false lumen had completely shrunk.

Lessons:

ULP can arise and cause progressive dilation of false lumen after TEVAR. Careful and regular computed tomography examinations are required for early diagnosis of false lumen becoming thrombosed after TEVAR. Close follow-up and timely intervention, including TEVAR, should be considered in cases of aortic enlargement due to a newly developed ULP.
Relationship between marital status and survival in patients with lung adenocarcinoma
Authors: Wu Ying , Zhu Pei-Zhen , Chen Yin-Qiao , Chen Jie , Xu Lu , Zhang Huayi
Published: January 2022

Numerous studies have focused on whether the marital status has an impact on the prognosis in patients with non-small cell lung cancer, but none have focused on lung adenocarcinoma.

We selected 61,928 eligible cases with lung adenocarcinoma from the Surveillance, Epidemiology, and End Results database from 2004 to 2016 and analyzed the impact of marital status on cancer-specific survival (CSS) using Kaplan–Meier and Cox regression analyses.

We confirmed that sex, age, race, cancer TNM stage and grade, therapeutic schedule, household income, and marital status were independent prognostic factors for lung adenocarcinoma CSS. Multivariate Cox regression showed that widowed patients had worse CSS (hazard ratio 1.26, 95% confidence interval 1.20–1.31, P < .001) compared with married patients. Subgroup analysis showed consistent results regardless of sex, age, cancer grade, and TNM stage. However, the trend was not significant for patients with grade IV cancer.

These results suggest that marital status is first identified as an independent prognostic factor for CSS in patients with lung adenocarcinoma, with a clear association between widowhood and a high risk of cancer-specific mortality. Psychological and social support are thus important for patients with lung adenocarcinoma, especially unmarried patients.
Obesity or increased body mass index and the risk of severe outcomes in patients with COVID-19
Authors: Yang Yaxian , Wang Liting , Liu Jingfang , Fu Songbo , Zhou Liyuan , Wang Yan
Published: January 2022

Background:

To assess the effect of obesity or a high body mass index (BMI) on the risk of severe outcomes in patients with coronavirus disease 2019 (COVID-19).

Methods:

Studies on the relationship between BMI or obesity and COVID-19 since December 2019. The odds ratio (OR) and weighted mean difference (WMD) with their 95% confidence intervals (CIs) were used to assess the effect size.

Results:

BMI was significantly increased in COVID-19 patients with severe illness (WMD: 1.18; 95% CI: 0.42–1.93), who were admitted to an intensive care unit (ICU) (WMD: 1.46; 95% CI: 0.96–1.97), who required invasive mechanical ventilation (IMV) (WMD: 2.70, 95% CI: 1.05–4.35) and who died (WMD: 0.91, 95% CI: 0.02–1.80). In Western countries, obesity (BMI of ≥30 kg/m2) increased the risk of hospitalization (OR: 2.08; 95% CI: 1.22–3.54), admission to an ICU (OR: 1.54; 95% CI: 1.29–1.84), need for IMV (OR: 1.73, 95% CI: 1.38–2.17), and mortality (OR: 1.43; 95% CI: 1.17–1.74) of patients with COVID-19. In the Asian population, obesity (BMI of ≥28 kg/m2) increased the risk of severe illness (OR: 3.14; 95% CI: 1.83–5.38). Compared with patients with COVID-19 and a BMI of <25 kg/m2, those with a BMI of 25–30 kg/m2 and ≥30 kg/m2 had a higher risk of need for IMV (OR: 2.19, 95% CI: 1.30–3.69 and OR: 3.04; 95% CI: 1.76–5.28, respectively). The risk of ICU admission in patients with COVID-19 and a BMI of ≥30 kg/m2 was significantly higher than in those with a BMI of 25–30 kg/m2 (OR: 1.49; 95% CI: 1.00–2.21).

Conclusion:

As BMI increased, the risks of hospitalization, ICU admission, and need for IMV increased, especially in COVID-19 patients with obesity.

Ethics and dissemination:

This systematic review and meta-analysis does not require an ethics approval as it does not collect any primary data from patients.
Medial patellofemoral ligament reconstruction
Authors: Zhang Yong-qiang , Zhang Zhao , Wu Meng , Zhou Ya-dong , Tao Sheng-lin , Yang Ya-long , Li Yang , Liu Jun-liang , Li Peng , Teng Yun-sheng , Guo Yong-ming
Published: January 2022

Introduction:

Reconstruction of the medial patellofemoral ligament (MPFL) is an effective surgical method for the treatment of lateral patellar instability. At present, there is not much controversies regarding the femoral attachment, however, the controversies regarding patellar attachment versus attachment, number of graft strands, tension, isometry and so on. The following electronic databases will be searched: PubMed, the Cochrane Library, Embase, Web of Science, Medline. We will consider articles published between database initiation and March 2021. MPFL in the subject heading will be included in the study. Language is limited to English. Research selection, data extraction, and research quality assessment were independently completed by 2 researchers.

Conclusions:

MPFL reconstruction is a reliable technique for the treatment of patellofemoral instability. The Schöttle point is still the mainstream method for locating the femoral attachment, the patellar attachment for single-bundle is located at the junction of the proximal one third and the distal two third of the longitudinal axis of the patella. For double-bundles, one is located in the proximal one third of the medial patellar edge and another is in the center of the patellar edge. Meanwhile, the adjustment of graft tension during operation is very important.
Long-term outcomes of large artery thromboangiitis obliterans and comparison with small artery thromboangiitis obliterans
Authors: Lee Sang Ah , Jeong Min-Jae , Ko Gi-Young , Hwang Hee Sang , Gwon Dong Il , Choi Eol , Kwon Tae-Won , Cho Yong-Pil
Published: January 2022

Although the distribution of arterial involvement is still the subject of controversy for defining the diagnostic criteria for thromboangiitis obliterans (TAO), several reports have described TAO involving the more proximal arterial segment. This study aimed to investigate the clinical characteristics and outcomes of large artery TAO in comparison with those of small artery TAO.

Between January 2007 and July 2019, 83 consecutive symptomatic patients with a diagnosis of lower extremity TAO were stratified according to the most proximal arterial involvement, with the cutoff level of the adductor canal as a reference (large artery TAO versus small artery TAO), and analyzed retrospectively. The study outcomes included any amputations and major amputations.

The large artery TAO group consisted of 30 patients (36.1%), and the small artery TAO group consisted of 53 patients (63.9%). In terms of clinical symptoms and signs, the proportion of major tissue loss (Rutherford class 6) was significantly higher among patients with large artery TAO than among those with small artery TAO (13.3% versus 0%, P = .02). Any amputation rate was similar between the large and small artery TAO groups during the median follow-up period of 148 months (range, 0–376 months) (43.3% versus 28.3%, P = .16). However, the major amputation rate was significantly higher among patients with large artery TAO (13.3% versus 0%, P = .02). On Kaplan–Meier survival analysis of the cumulative event-free rates, although there was a similar 10-year amputation-free survival rate (P = .24) between the 2 groups, the large artery TAO group had a significantly lower 10-year major amputation-free survival rate (P < .01) than the small artery TAO group.

Large artery TAO is a limb-threatening condition and had a worse prognosis than small artery TAO.
Compensatory swallowing methods in a patient with dysphagia due to lateral medullary syndrome—vacuum and prolonged swallowing
Authors: Kunieda Kenjiro , Sugiyama Junya , Nomoto Akiko , Ohno Tomohisa , Shigematsu Takashi , Fujishima Ichiro
Published: January 2022

Introduction:

The nature of pharyngeal swallowing function during the course of recovery of dysphagia due to lateral medullary syndrome (LMS) is unclear. Vacuum swallowing is a compensatory swallowing method that improves the pharyngeal passage of a bolus by creating negative pressure during swallowing in the esophagus in patients with dysphagia due to LMS. We present a case involving a patient with dysphagia due to LMS who involuntarily acquired a swallowing method with prolonged and increased pharyngeal contraction and vacuum swallowing.

Patient concerns:

We report a unique case involving a 52-year-old patient with dysphagia due to LMS. His dysphagia was severe but improved gradually with swallowing rehabilitation. The patient involuntarily acquired a swallowing method with prolonged and increased pharyngeal contraction and vacuum swallowing.

Diagnosis:

The patient presented with dysphagia due to left LMS. A videofluoroscopic examination of swallowing revealed pharyngeal residue.

Interventions:

Forty-five days after the onset of the dysphagia, the swallowing pressure along the pharynx and esophagus was measured using high-resolution manometry.

Outcomes:

Vacuum swallowing was observed in six out of 19 swallows (32.5%). The velopharyngeal contractile integral (CI) and mesohypopharyngeal CI values increased during swallowing, reflecting prolonged and increased pharyngeal contraction. We named this swallowing method “prolonged swallowing.”

Conclusion:

The findings in this case indicate that vacuum and prolonged swallowing may be compensatory swallowing methods observed in individuals recovering from dysphagia due to LMS. Further research is needed to clarify the relationship between these swallowing methods and the pathophysiology, prognosis, and treatment of dysphagia in patients with LMS.
Allocation of Pediatric Home Care Nursing Hours
Authors: Paitich Lindsey , Luedemann Chris , Giel Judy , Maynard Roy
Published: January 2022

Despite an increasing demand for pediatric home care nursing, there is no comprehensive or universal standard of care for prescribing pediatric home care nursing hours based on a child's medical complexity. Adoption of a qualification tool (QT) to allocate home care nursing hours based on the medical complexity of a child may mitigate inequality in access to care and improve the patient and family experience. A QT, developed in Minnesota, recommends home care nursing hours based on the level of medical complexity and need for skilled nursing interventions. Four hypothetical case studies demonstrate the use of the QT to calculate recommended nursing hours. To validate the tool, a survey of discharge planners found a percentage difference in calculated hours of 4.1, 5.7, 11.2, and 24.9 in the four case studies. Discharge planners rated the usability of the QT as favorable with a score of 3.6 on a Likert scale of 5. The recommended nursing hours prescribed for families, based on the QT, was perceived as meeting the needs of the child by 56% and 42% of surveyed parents and home care nurses (HCNs), respectively. The need for additional nursing hours was expressed by 33% and 50% of parents and nurses, respectively. In general, HCNs' assessment of allocated nursing hours paralleled that of parents. Further refinement and adoption of a standardized QT to allocate home care nursing hours may improve access and outcomes for children requiring home care nursing.
Using a Virtual Platform for Conducting Grandfamily Research
Authors: Song MinKyoung , Bessette Hannah C. , Hayman Laura L. , Lyons Karen S. , Winters-Stone Kerri M. , Roberts Davis Mary C. , Musil Carol M.
Published: January 2022

Background

Because of the COVID-19 pandemic, our research team quickly pivoted from planned face-to-face interaction with participants to virtual interactions. During this transition, we discovered invaluable new practices for conducting research remotely, including collecting physiological data.

Objective

Our objective was to describe the methodological challenges we encountered when conducting this research virtually with grandparent–grandchild dyads and describe the strategies we developed to overcome those challenges. Of primary focus were procedures for finger-stick blood sample collection. Of secondary focus were procedures for conducting virtual-based research with older adults and across multiple generations.

Methods

During an observational study utilizing a virtual platform with 11 grandparent–grandchild dyads (mean age: 64.2 ± 5.0 years for grandparents and 9.3 ± 1.9 years for grandchildren), we documented lessons learned (based on the discussion within our team and feedback we have received from participants) that could be applicable for other, similar research endeavors.

Results

We found several challenges in collecting blood samples, including staff were unfamiliar with providing online instruction and participants needed to develop familiarity with the blood sample collection process (without having in-person assistance), and we had to develop methods for delivering blood sample collection kits to participants safely. We also found that it took longer than expected to run procedures—a challenge that might be encountered when conducting any type of dyadic research utilizing a virtual platform—particularly involving older adults and across multiple generations. In addition, it was challenging to keep child participants engaged in the virtual interactions. We document how we employed targeted strategies to overcome those obstacles. Recommendations for strategies from our team include to provide comprehensive and clear instruction/materials on blood sampling procedure, offer generous support throughout the blood collection process, be prepared to divide study visits into more than one session as needed, proactively anticipate potential roadblocks, and carefully consider the participants’ developmental stages and attention span.

Discussion

The insights we gained will help inform future research with grandparent–grandchild dyads in remote or rural populations utilizing virtual platforms.
Brief Report: Insomnia and Risk of Myocardial Infarction Among People With HIV
Authors: Luu Brandon R. , Nance Robin M. , Delaney Joseph A. C. , Ruderman Stephanie A. , Heckbert Susan R. , Budoff Matthew J. , Mathews William C. , Moore Richard D. , Feinstein Matthew J. , Burkholder Greer A. , Mugavero Michael J. , Eron Joseph J. , Saag Michael S. , Kitahata Mari M. , Crane Heidi M. , Whitney Bridget M.
Published: January 2022

Background:

Insomnia is common among people with HIV (PWH) and may be associated with increased risk of myocardial infarction (MI). This study examines the association between insomnia and MI by MI type among PWH.

Setting:

Longitudinal cohort study of PWH at 5 Centers for AIDS Research Network of Integrated Clinical Systems sites.

Methods:

Clinical data and patient-reported measures and outcomes from PWH in care between 2005 and 2018 were used in this study. Insomnia, measured at baseline, was defined as having difficulty falling or staying asleep with bothersome symptoms. The Centers for AIDS Research Network of Integrated Clinical Systems centrally adjudicates MIs using expert reviewers, with distinction between type 1 MI (T1MI) and type 2 MI (T2MI). Associations between insomnia and first incident MI by MI type were measured using separate Cox proportional hazard models adjusted for age, sex, race/ethnicity, traditional cardiovascular disease risk factors (hypertension, dyslipidemia, poor kidney function, diabetes, and smoking), HIV markers (antiretroviral therapy, viral suppression, and CD4 cell count), and stimulant use (cocaine/crack and methamphetamine).

Results:

Among 12,448 PWH, 48% reported insomnia. Over a median of 4.4 years of follow-up, 158 T1MIs and 109 T2MIs were identified; approximately half of T2MIs were attributed to sepsis or stimulant use. After adjustment for potential confounders, we found no association between insomnia and T1MI (hazard ratio = 1.05, 95% confidence interval: 0.76 to 1.45) and a 65% increased risk of T2MI among PWH reporting insomnia compared with PWH without insomnia (hazard ratio = 1.65, 95% confidence interval: 1.11 to 2.45).

Conclusions:

PWH reporting insomnia are at an increased risk of T2MI, but not T1MI, compared with PWH without insomnia, highlighting the importance of distinguishing MI types among PWH.
A Case of Cystic Intrahepatic Cholangiocarcinoma Mimicking a Cyst
Authors: Chen Chun-Meng , Wang Jianqiang , Cao Chun-Xiao , Chen Min , Huang Bin
Published: January 2022

Intrahepatic cholangiocarcinoma (ICC) classically presents as irregular soft tissue lesions. Very rarely, ICC may manifest as a predominantly cystic mass. Here, we describe a 59-year-old man who was referred to the hospital due to abdominal pain. The presentation was highly suggestive of a hepatic cyst based on MRI. 18F-FDG PET/CT could not exclude a malignant hepatic tumor due to the high metabolism in the margin. Subsequently, the patient underwent a left hemihepatectomy. Histopathology revealed malignant ICC.
The centennial of the pecking order: current state and future prospects for the study of dominance hierarchies
Authors: Strauss Eli D. , Curley James P. , Shizuka Daizaburo , Hobson Elizabeth A.
Published: January 2022

A century ago, foundational work by Thorleif Schjelderup-Ebbe described a ‘pecking order’ in chicken societies, where individuals could be ordered according to their ability to exert their influence over their group-mates. Now known as dominance hierarchies, these structures have been shown to influence a plethora of individual characteristics and outcomes, situating dominance research as a pillar of the study of modern social ecology and evolution. Here, we first review some of the major questions that have been answered about dominance hierarchies in the last 100 years. Next, we introduce the contributions to this theme issue and summarize how they provide ongoing insight in the epistemology, physiology and neurobiology, hierarchical structure, and dynamics of dominance. These contributions employ the full range of research approaches available to modern biologists. Cross-cutting themes emerging from these contributions include a focus on cognitive underpinnings of dominance, the application of network-analytical approaches, and the utility of experimental rank manipulations for revealing causal relationships. Reflection on the last 100 years of dominance research reveals how Schjelderup-Ebbe's early ideas and the subsequent research helped drive a shift from an essentialist view of species characteristics to the modern recognition of rich inter-individual variation in social, behavioural and physiological phenotypes.

This article is part of the theme issue ‘The centennial of the pecking order: current state and future prospects for the study of dominance hierarchies’.
The build-up of dominance hierarchies in eusocial insects
Authors: Shimoji Hiroyuki , Dobata Shigeto
Published: January 2022

Reproductive division of labour is a hallmark of eusocial insects. However, its stability can often be hampered by the potential for reproduction by otherwise sterile nest-mates. Dominance hierarchy has a crucial role in some species in regulating which individuals reproduce. Compared with those in vertebrates, the dominance hierarchies in eusocial insects tend to involve many more individuals, and should require additional selective forces unique to them. Here, we provide an overview of a series of studies on dominance hierarchies in eusocial insects. Although reported from diverse eusocial taxa, dominance hierarchies have been extensively studied in paper wasps and ponerine ants. Starting from molecular physiological attributes of individuals, we describe how the emergence of dominance hierarchies can be understood as a kind of self-organizing process through individual memory and local behavioural interactions. The resulting global structures can be captured by using network analyses. Lastly, we argue the adaptive significance of dominance hierarchies from the standpoint of sterile subordinates. Kin selection, underpinned by relatedness between nest-mates, is key to the subordinates' acceptance of their positions in the hierarchies.

This article is part of the theme issue ‘The centennial of the pecking order: current state and future prospects for the study of dominance hierarchies’.
Dominance in a socially dynamic setting: hierarchical structure and conflict dynamics in ravens' foraging groups
Authors: Boucherie Palmyre H. , Gallego-Abenza Mario , Massen Jorg J. M. , Bugnyar Thomas
Published: January 2022

Dominance hierarchies typically emerge in systems where group members regularly encounter and compete for resources. In birds, the ‘open’ and dynamic structure of foraging groups may prevent the emergence of structured hierarchies, although this assumption have hardly been tested. We report on agonistic data for ravensCorvus corax, collected over two 18-month periods for 183 marked individuals of a wild (fluid) population and 51 birds from six captive (stable) groups. We show that the dominance structure (steep and transitive) in wild foraging groups is strikingly similar to that found in captivity. In the wild, we found that higher ranks are mainly occupied by males, older and more aggressive individuals that also tend to receive fewer aggressions. Exploring the mechanisms sustaining the wild dominance structure, we confirmed that males are more aggressive than females and, with age, tend to receive fewer aggressions than females. Males that are about to leave the foraging groups for some months are less aggressive than newcomers or locals, while newcomers are specifically targeted by aggressions in their first year (as juveniles). Taken together, our results indicate that the socially dynamic conditions ravens face during foraging do not hinder, but provide opportunities for, using (advanced) social cognition.

This article is part of the theme issue ‘The centennial of the pecking order: current state and future prospects for the study of dominance hierarchies’.