bluuebunny/crossref_metadata_2025_split huggingface dataset:
Outcome of microscopically non-radical oesophagectomy for oesophageal and oesophagogastric junctional cancer: nationwide cohort study
Authors: Hollertz P , Lindblad M , Sandström P , Halldestam I , Edholm D 
Published: March 2021

Abstract

Background
Microscopically non-radical (R1) oesophageal cancer resection has been associated with worse survival. The aim of this study was to identify risk factors for R1 resection and to investigate how this affects long-term survival.

Methods
The Swedish National Register for Oesophageal and Gastric Cancer was used to identify all patients who underwent oesophageal cancer resection with curative intent between 2006 and 2017. Risk factors for R1 resection were assessed by multivariable logistic regression analysis, and factors predicting 5-year survival identified by multivariable Cox regression.

Results
The study included 1460 patients. Surgical margins were involved microscopically in 142 patients (9.7 per cent). The circumferential resection margin was involved in 114 (7.8 per cent), the proximal margin in 53 (3.6 per cent), and the distal margin in 29 (2.0 per cent). In 30 specimens (2.1 per cent), two or all three margins were involved. Independent risk factors for R1 resection were male sex, low BMI, absence of neoadjuvant treatments, and clinical T4 disease. The 5-year survival rate for the entire cohort was 42.2 per cent, but only 18.0 per cent for those who had an R1 resection. Independent risk factors for death within 5 years of resection were male sex, age above 60 years, normal BMI, ASA fitness grade III, intermediate-level education, R1 resection (hazard ratio 1.80, 95 per cent c.i. 1.40 to 2.32), clinical T3 disease, and clinical lymph node metastasis.

Conclusion
R1 resection is common and predicts poor 5-year survival. Absence of neoadjuvant treatment is a risk factor for R1 resection.
Global decrease in brain sodium concentration after mild traumatic brain injury
Authors: Gerhalter Teresa , Chen Anna M , Dehkharghani Seena , Peralta Rosemary , Adlparvar Fatemeh , Babb James S , Bushnik Tamara , Silver Jonathan M , Im Brian S , Wall Stephen P , Brown Ryan , Baete Steven H , Kirov Ivan I , Madelin Guillaume 
Published: March 2021

Abstract
The pathological cascade of tissue damage in mild traumatic brain injury is set forth by a perturbation in ionic homeostasis. However, whether this class of injury can be detected in vivo and serve as a surrogate marker of clinical outcome is unknown. We employ sodium MRI to test the hypotheses that regional and global total sodium concentrations: (i) are higher in patients than in controls and (ii) correlate with clinical presentation and neuropsychological function. Given the novelty of sodium imaging in traumatic brain injury, effect sizes from (i), and correlation types and strength from (ii), were compared to those obtained using standard diffusion imaging metrics. Twenty-seven patients (20 female, age 35.9 ± 12.2 years) within 2 months after injury and 19 controls were scanned with proton and sodium MRI at 3 Tesla. Total sodium concentration, fractional anisotropy and apparent diffusion coefficient were obtained with voxel averaging across 12 grey and white matter regions. Linear regression was used to obtain global grey and white matter total sodium concentrations. Patient outcome was assessed with global functioning, symptom profiles and neuropsychological function assessments. In the regional analysis, there were no statistically significant differences between patients and controls in apparent diffusion coefficient, while differences in sodium concentration and fractional anisotropy were found only in single regions. However, for each of the 12 regions, sodium concentration effect sizes were uni-directional, due to lower mean sodium concentration in patients compared to controls. Consequently, linear regression analysis found statistically significant lower global grey and white matter sodium concentrations in patients compared to controls. The strongest correlation with outcome was between global grey matter sodium concentration and the composite z-score from the neuropsychological testing. In conclusion, both sodium concentration and diffusion showed poor utility in differentiating patients from controls, and weak correlations with clinical presentation, when using a region-based approach. In contrast, sodium linear regression, capitalizing on partial volume correction and high sensitivity to global changes, revealed high effect sizes and associations with patient outcome. This suggests that well-recognized sodium imbalances in traumatic brain injury are (i) detectable non-invasively; (ii) non-focal; (iii) occur even when the antecedent injury is clinically mild. Finally, in contrast to our principle hypothesis, patients’ sodium concentrations were lower than controls, indicating that the biological effect of traumatic brain injury on the sodium homeostasis may differ from that in other neurological disorders.
Note: This figure has been annotated.
Predictors of sinus rhythm 6 weeks after cardioversion of atrial fibrillation: a pre-planned post hoc analysis of the X-VeRT trial
Authors: Cappato Riccardo , Ezekowitz Michael D , Hohnloser Stefan H , Meng Isabelle Ling , Wosnitza Melanie , Camm , and Arthur John ,   the X-VeRT Steering Committee and Investigators
Published: March 2021

Abstract

Aims
Using a pre-planned post hoc analysis of patients included in X-VeRT, we evaluated predictors of sinus rhythm at 6 weeks after planned cardioversion.

Methods and results
Receiver operating characteristic curves and logistic regression models were used to evaluate continuous and categorical variables as predictors of sinus rhythm 6 at weeks from cardioversion (end of study). The primary analysis was performed in successfully cardioverted patients with an evaluable electrocardiogram at end of study. A second analysis evaluated additional patients who spontaneously restored sinus rhythm before planned cardioversion. Of the 1504 patients with atrial fibrillation of &gt;48 h or of unknown duration who were randomly assigned to either rivaroxaban or vitamin K antagonist, 1039 (64.6 ± 10.3 years, 73.4% male) underwent planned cardioversion and were included in this study. Patients receiving early cardioversion (i.e. between 1 and 5 days from hospitalization) had a 67% higher probability to have sinus rhythm at end of study than those who received delayed cardioversion (i.e. between 21 and 56 days from hospitalization) [odds ratio (OR) 1.67, confidence interval (CI) 1.27–2.18; P &lt; 0.0001]. In a multivariate analysis of 17 baseline variables, patients with a CHADS2 score of 0 were 33% less likely to be in sinus rhythm than those with a CHADS2 score ≥2 (OR 0.66, CI 0.47–0.94; P = 0.0225). In the secondary analysis, spontaneous restoration of sinus rhythm was also found to predict sinus rhythm at end of study (OR 8.62, CI 1.54–48.16; P = 0.0142).

Conclusion
In X-VeRT, early cardioversion and high CHADS2 scores predicted sinus rhythm at 6 weeks from cardioversion.
A meta-analysis of clinical risk factors for stroke in anticoagulant-naïve patients with atrial fibrillation
Authors: Noubiap Jean Jacques , Feteh Vitalis Fambombi , Middeldorp Melissa E , Fitzgerald John L , Thomas Gijo , Kleinig Timothy , Lau Dennis H , Sanders Prashanthan 
Published: March 2021

Abstract

Aims
The aim of this study is to summarize data from prospective cohort studies on clinical predictors of stroke and systemic embolism in anticoagulant-naïve atrial fibrillation (AF) patients.

Methods and results
EMBASE, MEDLINE, Global Index Medicus, and Web of Science were searched to identify all studies published by 28 November 2019. Forty-seven studies reporting data from 1 756 984 participants in 15 countries were included. The pooled incidence of stroke in anticoagulant-naïve AF patients was 23.8 per 1000 person-years (95% CI 19.7–28.2). Older age was associated with incident stroke or systemic embolism, with a pooled hazard ratio (HR) of 2.14 (95% CI 1.85–2.47), 2.83 (95% CI 2.27–3.51), and 6.87 (95% CI 6.33–7.44) for age 65–75, ≥75, and ≥85 years, respectively. Other predictors of stroke or systemic embolism included history of stroke or TIA (HR 2.84, 95% CI 2.19–3.67), hypertension (HR 1.60, 95% CI 1.37–1.86), diabetes (HR 1.28, 95% CI 1.20–1.37), heart failure (HR 1.25, 95% CI 1.11–1.40), peripheral artery disease (pooled HR 1.35, 95% CI 1.04–1.75), vascular disease (pooled HR 1.21, 95% CI 1.06–1.39), and prior myocardial infarction (pooled HR 1.08, 95% CI 1.03–1.14). Female sex was a predictor of thromboembolism in studies outside Asia (HR 1.35, 95% CI 1.15–1.59), but not in those done in Asia (HR 0.95, 95% CI 0.81–1.10).

Conclusion
This study confirms age and prior stroke as the strongest predictors of stroke or systemic embolism in anticoagulant-naive AF patients. Other predictors include hypertension, diabetes, heart failure, and vascular disease. Female sex seems not to be universally associated with stroke or systemic embolism.
The relationship between duration and quality of sleep and upper respiratory tract infections: a systematic review
Authors: Robinson Charlotte H , Albury Charlotte , McCartney David , Fletcher Benjamin , Roberts Nia , Jury Imogen , Lee Joseph 
Published: March 2021

AbstractBackgroundUpper respiratory tract infections (URTIs) are common, mostly self-limiting, but result in inappropriate antibiotic prescriptions. Poor sleep is cited as a factor predisposing to URTIs, but the evidence is unclear.ObjectiveTo systematically review whether sleep duration and quality influence the frequency and duration of URTIs.MethodsThree databases and bibliographies of included papers were searched for studies assessing associations between sleep duration or quality and URTIs. We performed dual title and abstract selection, discussed full-text exclusion decisions and completed 50% of data extraction in duplicate. The Newcastle–Ottawa Quality Assessment Scale assessed study quality and we estimated odds ratios (ORs) using random effects meta-analysis.ResultsSearches identified 5146 papers. Eleven met inclusion criteria, with nine included in meta-analyses: four good, two fair and five poor for risk of bias. Compared to study defined ‘normal’ sleep duration, shorter sleep was associated with increased URTIs (OR: 1.30, 95% confidence interval [CI]: 1.19–1.42, I2: 11%, P &lt; 0.001) and longer sleep was not significantly associated (OR: 1.11 95% CI: 0.99–1.23, I2: 0%, P = 0.070). Sensitivity analyses using a 7- to 9-hour baseline found that sleeping shorter than 7–9 hours was associated with increased URTIs (OR: 1.31, 95% CI: 1.22–1.41, I2: 0%, P &lt; 0.001). Sleeping longer than 7–9 hours was non-significantly associated with increased URTIs (OR: 1.15, 95% CI: 1.00–1.33, I2: 0%, P = 0.050, respectively). We were unable to pool sleep quality studies. No studies reported on sleep duration and URTI severity or duration.ConclusionsReduced sleep, particularly shorter than 7–9 hours, is associated with increased URTIs. Strategies improving sleep should be explored to prevent URTIs.
Magmatic channelization by reactive and shear-driven instabilities at mid-ocean ridges: a combined analysis
Authors: Rees Jones D W , Zhang H , Katz R F 
Published: March 2021

Summary
It is generally accepted that melt extraction from the mantle at mid-ocean ridges (MORs) is concentrated in narrow regions of elevated melt fraction called channels. Two feedback mechanisms have been proposed to explain why these channels grow by linear instability: shear flow of the partially molten mantle and reactive flow of the ascending magma. These two mechanisms have been studied extensively, in isolation from each other, through theory and laboratory experiments as well as field and geophysical observations. Here, we develop a consistent theory that accounts for both proposed mechanisms and allows us to weigh their relative contributions. We show that interaction of the two feedback mechanisms is insignificant and that the total linear growth rate of channels is well-approximated by summing their independent growth rates. Furthermore, we explain how their competition is governed by the orientation of channels with respect to gravity and mantle shear. By itself, analysis of the reaction-infiltration instability predicts the formation of tube-shaped channels. We show that with the addition of even a small amount of extension in the horizontal, the combined instability favours tabular channels, consistent with the observed morphology of dunite bodies in ophiolites. We apply the new theory to MORs by calculating the accumulated growth and rotation of channels along streamlines of the solid flow. We show that reactive flow is the dominant instability mechanism deep beneath the ridge axis, where the most unstable orientation of high-porosity channels is subvertical. Channels are then rotated by the solid flow away from the vertical. The contribution of the shear-driven instability is confined to the margins of the melting region. Within the limitations of our study, the shear-driven feedback does not appear to be responsible for significant melt focusing or for the shallowly dipping seismic anisotropy that has been obtained by seismic inversions.
Male Aggregation in Dwarf Tyrant-Manakins and What It Tells Us about the Origin of Leks
Authors: Foster Mercedes S 
Published: March 2021

Synopsis
Despite considerable research on lek-breeding birds, many aspects of the evolution of the lek social system, including the origin of male aggregation, remain unresolved. Originally, clusters may have formed passively as a by-product of independent but concurrent responses by males to some external stimulus (e.g., a concentration of display sites, prominent food source, or a travel corridor commonly used by females) that drew them at a particular time to a site where they might increase their probabilities of encountering females. In contrast, male aggregation may have been active, with a male purposely seeking to associate with another male (or males) because proximity to that male allowed him to enhance his own reproductive success by improving his ability to attract females (i.e., learning from his associate) or to intercept females attracted to that male. To identify factors important in the formation of male aggregations, I studied these alternatives in the Dwarf Tyrant-Manakin (Tyranneutes stolzmanni), a species in which some breeding males occupy solitary courts where they attempt to attract females for reproduction, whereas other males occupy courts clustered into leks, where they interact to attract females. I compared habitat characteristics and resource availability at courts of grouped and solitary males as well as certain traits of the males in an attempt to distinguish between passive or active lek formation in this species. Little evidence suggests that Dwarf Tyrant-Manakins are passively clustered as a result of common attraction to or use of a limited or unevenly distributed resource. Several observations suggest the contrary. Evidence for the active aggregation of males is more promising, suggesting that males may associate with other males on the basis of their vocal behavior. The issue is confounded, however, by the observation that male call behavior appears to change with a change in social status. A definitive answer for T. stolzmanni will require additional analyses of vocal behavior as well as of the characteristics of the vocalizations themselves. Finally, the behavior and social organization of this species may reflect characteristics of the ancestral manakin line that gave rise to both the Tyrant and Core clades of modern manakins.
Right-wing populism, the reasonable, and the limits of ideal theory: A reply to Gila Stopler
Authors: Prieto Rudolphy Marcela 
Published: March 2021

Abstract
This article replies to Gila Stopler’s critique of John Rawls’s Political Liberalism. It argues that there are two strands in Stopler’s arguments. The first is Stopler’s critique of Political Liberalism for its accommodation of “right-wing populism.” This article argues that “right-wing populism” is not a “reasonable comprehensive view” under Rawls’s theory. Thus, Political Liberalism does not accommodate this view; it excludes it from the possibility of a reasonable overlapping consensus. The second strand in Stopler’s article can be interpreted as an invitation to think about the value of idealization in political theory. More concretely, this article argues that Stopler’s claims can be read as suggesting that political liberalism’s flaw is not that it tolerates illiberal views, but that it tells us little about how to achieve and maintain an overlapping consensus about justice in the kind of societies we actually inhabit. This article briefly argues that this critique deserves attention, especially given the circumstances of today’s societies, where extreme views are not uncommon and the effects of climate change threaten the very possibility of justice.
The bind of tolerance and a call to feminist thought: A reply to Gila Stopler
Authors: Michelman Frank 
Published: March 2021

Abstract
There are no spaces or spheres of the personal or the private that are not also fraught with political potential and consequence. That insistent lesson from feminist thought is these days instanced, truly writes Gila Stopler, by the bafflements faced by liberal democracies confronting severe threat from illiberal ideas and incitements gathering steam under shelter of liberal basic-liberties guarantees. My questions here are whether the problem’s root in liberalism runs deeper than any ideology of a “private sphere,” and whether it is aggravated by a turn in John Rawls’s defense of liberal principles from a “comprehensive” to a “political” justificatory strategy.
Unexpected Cytomegalovirus (CMV) Replication Kinetics in CMV Donor-Seropositive, Recipient-Seronegative Liver Transplant Recipients Receiving Preemptive Antiviral Therapy
Authors: Singh Nina , Winston Drew J , Razonable Raymund R , Marshall Lyon G , Silveira Fernanda P , Wagener Marilyn M , Limaye Ajit P 
Published: March 2021

Abstract

Background
Detailed cytomegalovirus (CMV) kinetics in donor CMV-seropositive, recipient CMV-seronegative (D+/R–) transplant recipients receiving preemptive therapy (PET) have not been fully defined.

Methods
The study population consisted of the PET arm of a randomized CMV prevention trial in D+/R– liver transplant recipients. CMV DNA polymerase chain reaction (PCR) assays were performed weekly for 100 days using a sensitive assay. Viral load and clinical parameters were compared for patients with or without high-level increase (defined as higher than the group median log10 increase in viral load from baseline after PET initiation).

Results
Among 79 patients, 93.6% (74/79) developed an increase from baseline viral loads of median 120 IU/mL to 3350 IU/mL; 25.7% (19/74) of the patients had peak levels &gt;10 000 IU/mL. None of the patients with rise in viral load underwent testing for CMV resistance, and viremia resolved with PET with valganciclovir. Patients with high-level increase in viral load had a significantly lower rate of recurrent viremia than those without such increase (16/40 [40%] vs 28/39 [71.8%], respectively; P = .004).

Conclusions
A majority of D+/R– recipients had a marked increase in viral load after initiation of PET before resolution of viremia. This phenomenon is associated with lower rates of subsequent recurrent viremia and does not necessarily imply antiviral resistance.
Using Innovation to Address Adolescent and Young Adult Health Disparities in Pelvic Inflammatory Disease: Design of the Technology Enhanced Community Health Precision Nursing (TECH-PN) Trial
Authors: Trent Maria , Perin Jamie , Rowell Julia , Shah Maunank , Anders Jennifer , Matson Pamela , Brotman Rebecca M , Ravel Jacques , Sharps Phyllis , Rothman Richard , Yusuf Hasiya E , Gaydos Charlotte A 
Published: March 2021

Abstract
New approaches to pelvic inflammatory disease (PID) care among adolescents and young adults (AYAs) that optimize self-care and personalize treatment are warranted to address age and racial-ethnic PID-related health disparities. Here we describe the 13-month preliminary feasibility and acceptability outcomes of recruitment, retention, and intervention delivery for Technology Enhanced Community Health Precision Nursing (TECH-PN) randomized controlled trial. Urban AYAs 13–25 years assigned female sex at birth with acute mild-moderate PID provided baseline and follow-up interview data and vaginal specimens for sexually transmitted infection (STI), cytokine, and microbiota assessment. All participants received medications and text-messaging support. Participants were block randomized to either control or intervention. Control participants received 1 community nursing visit with self-management for interim care per national guidelines. Intervention participants received unlimited precision care services driven by interim STI and macrolide resistance testing results by an advanced practice provider. In the first 13 months, 75.2% patients were eligible, and 76.1% of eligible patients enrolled. Of the participants, 94% completed the intervention and 96%, 91%, and 89%, respectively, completed their 14-, 30-, and 90-day visits. Baseline laboratory results revealed infection rates that were highest for Mycoplasma genitalium (45%) followed by Chlamydia trachomatis (31%). Preliminary enrollment, STI, intervention delivery, and retention data demonstrate the feasibility and acceptability of the TECH-PN intervention and support rationale for precision care for PID among urban AYAs.
ClinicalTrials.gov Identifier. NCT03828994.
Multi-Copy Gene Family Evolution on the Avian W Chromosome
Authors: Rogers Thea F , Pizzari Tommaso , Wright Alison E 
Published: March 2021

AbstractThe sex chromosomes often follow unusual evolutionary trajectories. In particular, the sex-limited chromosomes frequently exhibit a small but unusual gene content in numerous species, where many genes have undergone massive gene amplification. The reasons for this remain elusive with a number of recent studies implicating meiotic drive, sperm competition, genetic drift, and gene conversion in the expansion of gene families. However, our understanding is primarily based on Y chromosome studies as few studies have systematically tested for copy number variation on W chromosomes. Here, we conduct a comprehensive investigation into the abundance, variability, and evolution of ampliconic genes on the avian W. First, we quantified gene copy number and variability across the duck W chromosome. We find a limited number of gene families as well as conservation in W-linked gene copy number across duck breeds, indicating that gene amplification may not be such a general feature of sex chromosome evolution as Y studies would initially suggest. Next, we investigated the evolution of HINTW, a prominent ampliconic gene family hypothesized to play a role in female reproduction and oogenesis. In particular, we investigated the factors driving the expansion of HINTW using contrasts between modern chicken and duck breeds selected for different female-specific selection regimes and their wild ancestors. Although we find the potential for selection related to fecundity in explaining small-scale gene amplification of HINTW in the chicken, purifying selection seems to be the dominant mode of evolution in the duck. Together, this challenges the assumption that HINTW is key for female fecundity across the avian phylogeny.