bluuebunny/crossref_metadata_2025_split huggingface dataset:
Conjunctival Microbiota and Blepharitis Symptom Scores in Patients With Ocular Rosacea
Authors: Mergen Burak , Onal Irem , Gulmez Abdurrahman , Caytemel Ceyda , Yildirim Yusuf 
Published: June 2023

Purpose:
Investigation of the relationship between blepharitis-related symptom scores, tear film functions, and conjunctival microbiota in patients with ocular rosacea (OR) compared with healthy controls was aimed.

Methods:
Consecutive 33 eyes of 33 patients with OR who were admitted from the dermatology clinic and age-matched and gender-matched 30 healthy controls were included in the study. Tear breakup time (TBUT), Schirmer score, and blepharitis symptom score (BLISS) were recorded for each patient. For the bacteriological examination, bacterial culture was obtained by inoculating the samples on chocolate agar, blood agar, and fluid thioglycollate medium. The growth of different colonies of bacteria was identified using matrix-assisted laser desorption or ionization time-of-flight mass spectrometry.

Results:
Bacterial culture positivity was observed in 13 eyes (39.4%) in the patients with OR and 10 eyes (33.3%) in the controls (P=0.618). Patients with OR showed worse TBUT and Schirmer scores, and higher BLISSs (P=0.005, P=0.007, and P=0.001, respectively). Patients with OR with conjunctival culture-positive results showed higher BLISSs (8.0±4.7) compared with those with negative results (4.7±2.3; P<0.001). The most frequent bacteria was Micrococcus luteus (18.2%) in patients with OR and Staphylococcus epidermidis (20.0%) in the controls.

Conclusion:
This pilot study showed that patients with OR had similar conjunctival culture positivity compared with healthy controls. However, the observation of different dominant bacterial species in conjunctival microbiota and the observation of worse BLISSs in patients with OR with positive culture might suggest a potential role of conjunctival microbiota in the pathogenesis of OR.
Occult Cytomegalovirus Cholangitis and Pancreatic Adenocarcinoma
Authors: Mastroianni Antonio , Greco Sonia , Vangeli Valeria , Mauro Maria Vittoria , Greco Francesca , Manfredi Roberto 
Published: June 2023

Abstract
A rare case of occult cytomegalovirus (CMV) cholangitis along with an updated literature review is presented. The patient had not undergone solid organ–bone marrow transplantation and had no chronic autoimmune biliary tract disorder or obvious immunodeficiency. The patient had underwent a pyloric-sparing duodenocephalopancreasectomy, and the postoperative histopathologic examination revealed multiple ulcerative lesions and an occult CMV infection. The copy number of CMV DNA was high (38,000 copies/μg DNA) in common bile duct surgical specimens measured by real-time quantitative polymerase chain reaction. CMV was not detected in blood and urine samples from the patient after full doses of intravenous ganciclovir and full doses of oral valganciclovir antiviral therapy. This report recapitulates the role of CMV in causing severe cholangiopathy in the absence of obvious immunosuppression or autoimmune disorder of the biliary tract.
Safety and Efficacy of SARS-CoV-2 Vaccination in Patients With Chronic Liver Disease
Authors: Mao Yu-Feng , Gao Lin , Li Yuan-Yuan , Wang Fu-Sheng 
Published: June 2023

Abstract
Patients with chronic liver diseases (CLDs) have high hospitalization and mortality rates when combined with severe coronavirus disease 2019 (COVID-19) because of defects in humoral and cellular immunity, known as immune dysfunction. COVID-19 vaccines effectively reduce the risk of severe illness and mortality caused by the virus. Several studies have confirmed the safety and efficacy of the COVID-19 vaccine in patients with CLD, and the existing expert consensus recommends that patients with stable CLD be prioritized for the COVID-19 vaccine. In addition, clinical trials are ongoing to determine the optimal strategy for patients with CLD to receive the COVID-19 vaccine. In this study, we review the progress of research on the safety and efficacy of COVID-19 vaccination in patients with CLD, aiming to provide better recommendations for the vaccination in this population.
Fatal Thyroid Storm in the Setting of Untreated Graves Disease and Use of the Synthetic Cannabinoid MDMB-4en-PINACA
Authors: Ricciardo Sean , Hastings Stephen 
Published: June 2023

AbstractThyroid storm, or thyrotoxic crisis, is a rare but well-described and potentially lethal exacerbation of thyrotoxicosis, characterized by multisystem effects due to failure of the hypothalamic-pituitary-thyroid axis. Thyroid storm is seen most frequently in the setting of inadequately treated Graves disease; however, it may also be triggered or exacerbated by infection, trauma, childbirth, radioiodine treatment, and pharmacologic agents. While there are rare reports of cases in which illicit drug use may have triggered or exacerbated thyroid storm, none specifically involving synthetic cannabinoids have been previously described. We present the case of a 25-year-old man who presented with thyroid storm in the setting of poorly controlled Graves disease and synthetic cannabinoid use.
Gluten-Free Diet Knowledge and Adherence in Adolescents with Celiac Disease: A Cross-Sectional Study
Authors: Pohoreski Katherine , Horwitz Simonne L , Gidrewicz Dominica 
Published: June 2023

Objectives:
This study examined the relationship between knowledge of, and adherence to, the gluten-free diet (GFD) in a local population of adolescents with celiac disease (CD). The secondary objectives were to identify information sources used to learn about the GFD and to compare adolescents’ and parents’ knowledge of the GFD.

Methods:
Adolescents (12–17 years) with CD and their parents from pediatric gastroenterology clinics in Calgary, Alberta, completed an online survey containing a knowledge assessment (Gluten-Free Diet Quiz [GFD-Q]), an adherence scale, questions about GFD information sources, and demographic/clinical information. GFD-Q scores were deemed “sufficient knowledge” with correct identification of 3/3 gluten-containing foods, ≥4/7 gluten-free foods, and ≥ 4/7 foods that may contain gluten; otherwise, scores were termed “insufficient knowledge”.

Results:
Of the 40 adolescent-parent pairs, 15 of 40 adolescents (37%) had sufficient knowledge, and 25 of 40 adolescents (63%) had insufficient knowledge. Within the insufficient knowledge group, 14 of 25 (56%) did not correctly identify enough allowed gluten-free foods. Parents scored higher on the GFD-Q (67% had sufficient knowledge). Adolescents reported overall adherence to the GFD (88%), with adherence being similar between the sufficient and insufficient knowledge groups (80% versus 92%). The most helpful information sources included physicians, another person with CD, parent(s), and Google; apps were infrequently used.

Conclusion:
Adolescents report good adherence; however, they struggle with GFD knowledge, particularly in identifying gluten-free foods. Further research is required to explore GFD educational tools, including mobile apps and dietician-led teaching sessions.
Outcomes of Tofacitinib Use in an Irish Pediatric Cohort
Authors: Ryan Niamh , Cooper Sarah , Dominik Anna , Quinn Shoana , Broderick Annemarie , Bourke Billy , Hussey Séamus 
Published: June 2023

Background:
Pediatric ulcerative colitis (UC) is typically more extensive and severe at diagnosis compared with adult disease. Tofacitinib, a Janus kinase inhibitor, has been used since 2018 to induce and maintain remission in UC. There are limited pediatric data regarding its use, either as a monotherapy or in combination with other treatments.

Objectives:
To determine the real-world experience and outcomes of tofacitinib therapy in the Irish national cohort with pediatric UC.

Methods:
A retrospective study of tofacitinib outcomes was undertaken at Ireland’s single national center for pediatric inflammatory bowel disease. All patients commenced on tofacitinib since its availability in 2019 were included. Baseline and follow-up clinical characteristics, phenotype, Pediatric Ulcerative Colitis Activity Index (PUCAI) scores, and treatments before and after tofacitinib commenced were recorded. The primary outcome was remission by 8 weeks, with other clinical outcomes being recorded to maximal available follow-up.

Results:
Between November 1, 2019 and June 30, 2022, 15 children (M:F 1:2) were prescribed tofacitinib, 5 as monotherapy. Thirteen had baseline pancolitis at diagnosis and all patients had prior infliximab exposure. The mean time from diagnosis to starting tofacitinib was 381 days (±SD 265). Dual therapy included 5 with infliximab, 4 with vedolizumab, and 1 with adalimumab. The average length of treatment on tofacitinib was 232 days (±SD 170) with 2 patients transitioning to adult services while in remission on tofacitinib therapy. The mean PUCAI score was 48.7 (±SD 14.1) pre-tofacitinib, 16.7 (±SD 15.6) at week 8, and 22.5 (±SD 29.6) by week 16, with a significant reduction in PUCAI by week 16 (P = 0.0004). Eight patients (3 monotherapy) achieved clinical remission, with 4 of the 5 dual therapy patients on infliximab. There were no significant outcome differences between those on mono- or dual therapy. Three patients with combined vedolizumab therapy did not achieve remission, 2 of whom required colectomy by week 24. There were no malignancies, 1 patient developed shingles and another developed herpangina post-tofacitinib. Failure to achieve clinical remission by week 16 was seen in all children who progressed to colectomy (n = 4).

Conclusion:
Combining tofacitinib with other biologics is effective in select children with refractory UC. Early responders were more likely to achieve a sustained response at week 16. Failure to achieve remission by week 16 of tofacitinib therapy was strongly associated with progression to colectomy.
Laxative Abuse Is Associated With a Depleted Gut Microbial Community Structure Among Women and Men With Binge-Eating Disorder or Bulimia Nervosa: The Binge Eating Genetics Initiative
Authors: Igudesman Daria , Abbaspour Afrouz , Reed Kylie K. , Flatt Rachael E. , Becken Bradford , Thornton Laura M. , Bulik Cynthia M. , Carroll Ian M. 
Published: June 2023

ABSTRACT

Objective
This study assessed the associations of binge eating, compensatory behaviors, and dietary restraint with the composition and diversity of the intestinal microbiota among participants with binge-eating disorder or bulimia nervosa.

Methods
We analyzed data from 265 participants aged 18 to 45 years with current binge-eating disorder or bulimia nervosa enrolled in the Binge Eating Genetics Initiative study. We evaluated the associations of binge-eating frequency; presence/absence and frequency of vomiting, laxative use, and compulsive exercise; and dietary restraint with abundances of gut microbial genera, species, and diversity (Shannon diversity, Faith phylogenetic diversity, and Peilou’s evenness) from 16S rRNA gene sequencing. General linear regression models adjusted for potential confounders, including age and current body mass index, were used to test associations; p values were corrected for the false discovery rate.

Results
The normalized abundance of four genus- and species-level gut microbes and three diversity indices were lower among Binge Eating Genetics Initiative participants who reported any laxative use compared with those who reported no laxative use. Vomiting frequency was positively associated with the normalized abundance of the genus Escherichia-Shigella, a potential pathobiont, although the association was attenuated to nonsignificance after adjustment for age, body mass index, and binge-eating episodes.

Conclusions
Laxative use was highly and uniformly predictive of a reduced gut microbial diversity including potential commensals and pathobionts, and should be assessed and accounted for in all future studies of eating disorders and the gut microbiota. Future studies should collect data on specific medications—particularly laxatives—and dietary intake to obtain unbiased estimates of the effect of eating disorders on the gut microbiota and identify potential downstream clinical implications.

Trial Registration:
ClinicalTrials.gov identifier: NCT04162574.
Recovery Sleep After Sleep Restriction Is Insufficient to Return Elevated Daytime Heart Rate and Systolic Blood Pressure to Baseline Levels
Authors: Reichenberger David A. , Ness Kelly M. , Strayer Stephen M. , Mathew Gina Marie , Schade Margeaux M. , Buxton Orfeu M. , Chang Anne-Marie 
Published: June 2023

ABSTRACT

Objective
Sleep restriction alters daytime cardiac activity, including elevating heart rate (HR) and blood pressure (BP). There is minimal research on the cumulative effects of sleep loss and the response after subsequent recovery sleep on HR and BP. This study examined patterns of HR and BP across baseline, sleep restriction, and recovery conditions using multiple daytime cardiac measurements.

Methods
Participants (15 healthy men, mean [standard deviation] = 22.3 [2.8] years) completed an 11-day inpatient protocol with three nights of 10 hours/night baseline sleep opportunity, five sleep restriction nights (5-hour/night sleep opportunity), and two recovery nights (10-hour/night sleep opportunity). Resting HR and BP were measured every 2 hours during wake. Multilevel models with random effects for individuals examined daytime HR and BP across study conditions and days into the study.

Results
Mean daytime HR was 1.2 (0.5) beats/min lower during sleep restriction compared with baseline (p < .001). During recovery, HR was 5.5 (1.0) beats/min higher (p < .001), and systolic BP (SBP) was 2.9 (1.1) mm Hg higher (p = .009). When accounting for days into the study (irrespective of condition) and measurement timing across the day, HR increased by 7.6 beats/min and SBP increased by 3.4 mm Hg across the study period (p < .001).

Conclusions
Our findings suggest that daytime HR and SBP increase after successive nights of sleep restriction, even after accounting for measurement time of day. HR and SBP did not recover to baseline levels after two recovery nights of sleep, suggesting that longer recovery sleep may be necessary to recover from multiple, consecutive nights of moderate sleep restriction.
Decreasing the incidence of central line-associated bloodstream infection in a medical intensive care unit: a best practice implementation project
Authors: Hsieh Hui-Chen , Hsieh Chih-Cheng , Chen Tzu-Ying , Cheng Chiao-Hua , Mu Pei-Fan , Chow Lok-Hi , Tsay Shwu Feng , Lee Huan-Fang 
Published: June 2023

ABSTRACT

Introduction and objectives:
Bloodstream infections are common in critically ill patients using central venous access devices (CVAD) in intensive care units (ICU). This project aimed to decrease the incidence of central line-associated bloodstream infections (CLABSI) by using evidence-based strategies.

Methods:
The project applied the JBI audit and feedback methods. Thirty-two nurses and five resident physicians from the medical ICU of a medical center participated in the project. Preintervention compliance was measured for the 11 key evidence-based criteria (six audit criteria of central venous catheter insertion and five audit criteria of dressing and catheter securement). Strategies were implemented to overcome the barriers identified in the baseline assessment. Impact evaluation and sustainability were conducted to change the CLABSI rate and the competence of healthcare professionals in providing CVAD care. The JBI Practical Application of Clinical Evidence System and Getting Research into Practice audit tools were used for the data collection, analysis, and implementation planning.

Results:
Barriers included insufficient knowledge among nurses and physicians, poor compliance with the standard CVAD insertion procedure by physicians, inadequate cooperation among the CVAD care team members, and lack of CVAD-related equipment. The strategies included education and training in CVAD care, the establishment of a team resource management program, and the provision of appropriate equipment. Following project implementation, the CLABSI rate decreased from 8.38 to 3.9 BSIs/1000 CVAD-days.

Conclusions:
The project successfully decreased the CLABSI rate and increased the competence of healthcare professionals. Implementation of best practices in clinical care should focus on leadership, team resource management, education, monitoring, and innovation.
A biological employment model of reproductive inequality
Authors: Bowles Samuel , Hammerstein Peter 
Published: June 2023

Continuing the centuries-long exchange between economics and biology, our model of reproductive skew is an adaptation of the principal–agent relationship between an employer and an employee. Inspired by the case of purple martins (Progne subis) and lazuli buntings (Passerina amoena), we model a dominant male whose fitness can be advanced not only by coercing a subordinate male but, where coercion is impossible or not cost-effective, also by providing positive fitness incentives for the subordinate that induce him to behave in ways that contribute to the dominant's fitness. We model a situation in which a dominant and subordinate contest over a variable amount of joint total fitness, both the level and division of which result from the strategies adopted by both. Thus there is not some given amount of potential fitness (or ‘pie’) that is to be divided between the two (or wasted in costly contests). The fitness incentives that in evolutionary equilibrium are conceded to the subordinate by the dominant maximize the dominant's own fitness. The reason is that the larger pie resulting from the subordinate's increased helping more than compensates for the dominant's reduced fitness share. But the conflict over fitness shares nonetheless limits the size of the pie.This article is part of the theme issue ‘Evolutionary ecology of inequality’.
The evolution of economic and political inequality: minding the gap
Authors: Carlisle Juliet E. , Maloney Thomas N. 
Published: June 2023

The extent of economic and political inequality, their change over time, and the forces shaping them have profound implications for the sustainability of a society and the well-being of its members. Here we review the evolution of economic and political inequality broadly, though with particular attention to Europe and the USA. We describe legal/institutional, technological and social forces that have shaped this evolution. We highlight the cumulative effects of inequality across generations as channelled through wealth and inheritance but also through other intergenerational connections. We also review the state of research on the effects of inequality on economic growth, health and societal cohesion.This article is part of the theme issue ‘Evolutionary ecology of inequality’.
Inheritance and inequality among nomads of South Siberia
Authors: Hooper Paul L. , Reynolds Adam Z. , Jamsranjav Bayarsaikhan , Clark Julia K. , Ziker John P. , Crabtree Stefani A. 
Published: June 2023

At the headwaters of the Yenisei River in Tuva and northern Mongolia, nomadic pastoralists move between camps in a seasonal rotation that facilitates their animals' access to high-quality grasses and shelter. The use and informal ownership of these camps depending on season helps illustrate evolutionary and ecological principles underlying variation in property relations. Given relatively stable patterns of precipitation and returns to capital improvement, families generally benefit from reusing the same camps year after year. We show that locations with higher economic defensibility and capital investment—winter camps and camps located in mountain/river valleys—are claimed and inherited more frequently than summer camps and camps located in open steppe. Camps are inherited patrilineally and matrilineally at a ratio of 2 : 1. Despite its practical importance, camp inheritance is not associated with livestock wealth today, which is better predicted by education and wealth outside the pastoral economy. The relationship between the livestock wealth of parents and their adult children is significantly positive, but relatively low compared to other pastoralists. The degree of inequality in livestock wealth, however, is very close to that of other pastoralists. This is understandable considering the durability and defensibility of animal wealth and economies of scale common across pastoralists.This article is part of the theme issue ‘Evolutionary ecology of inequality’.
Gender disparities in material and educational resources differ by kinship system
Authors: Mattison Siobhán M. , Mattison Peter M. , Beheim Bret A. , Liu Ruizhe , Blumenfield Tami , Sum Chun-Yi , Shenk Mary K. , Seabright Edmond , Alami Sarah 
Published: June 2023

Contemporary inequality exists at an unprecedented scale. Social scientists have emphasized the role played by material wealth in driving its escalation. Evolutionary anthropologists understand the drive to accumulate material wealth as one that is coupled ultimately to increasing reproductive success. Owing to biological caps on reproduction for women, the efficiency of this conversion can differ by gender, with implications for understanding the evolution of gender disparities in resource accumulation. Efficiency also differs according to the type of resources used to support reproductive success. In this paper, we review evolutionary explanations of gender disparities in resources and investigate empirical evidence to support or refute those explanations among matrilineal and patrilineal subpopulations of ethnic Chinese Mosuo, who share an ethnolinguistic identity, but differ strikingly in terms of institutions and norms surrounding kinship and gender. We find that gender differentially predicts income and educational attainment. Men were more likely to report income than women; amounts earned were higher for men overall, but the difference between men and women was minimal under matriliny. Men reported higher levels of educational attainment than women, unexpectedly more so in matrilineal contexts. The results reveal nuances in how biology and cultural institutions affect gender disparities in wealth.
This article is part of the theme issue ‘Evolutionary ecology of inequality’.
Playing the political game: the coevolution of institutions with group size and political inequality
Authors: Powers Simon T. , Perret Cedric , Currie Thomas E. 
Published: June 2023

All societies need to form institutional rules to regulate their social interactions. These specify what actions individuals should take in particular situations, and what sanctions will apply if individuals violate these rules. However, forming these institutional rules involves playing a political game—a process of negotiation between individuals that is costly and time-consuming. Intuitively, this cost should be expected to increase as a group becomes larger, which could then select for a transition to hierarchy to keep the cost of playing the political game down as group size increases. However, previous work has lacked a mechanistic yet general model of political games that could formalize this argument and test the conditions under which it holds. We address this by formalizing the political game using a standard consensus formation model. We show that the increasing cost of forming a consensus over institutional rules selects for a transition from egalitarian to hierarchical organization over a wide range of conditions. Playing a political game to form institutional rules in this way captures and unites a previously disparate set of voluntary theories for hierarchy formation, and can explain why the increasing group size in the Neolithic would lead to strong political inequality.
This article is part of the theme issue ‘Evolutionary ecology of inequality’.