Sex differences in muscle morphology of the knee flexors and knee extensors

Introduction Females experience higher risk of anterior cruciate ligament (ACL) injuries; males experience higher risk of hamstring strain injuries. Differences in injury may be partially due to sex differences in knee flexor (KF) to knee extensor (KE) muscle size ratio and the proportional size of constituent muscles. Purpose To compare the absolute and proportional size, and mass distribution, of individual KE and KF muscles, as well as overall size and balance (size ratio) of these muscle groups between the sexes. Methods T1-weighted axial plane MR images (1.5T) of healthy untrained young males and females (32 vs 34) were acquired to determine thigh muscle anatomical cross-sectional area(ACSA). Maximal ACSA (ACSAmax) ofconstituent muscles, summated for KF and KE muscle groups, and the KF:KE ratio were calculated. Results Females had 25.3% smaller KE ACSAmax (70.9±12.1 vs 93.6±10.3 cm2; P<0.001) and 29.6% smaller KF ACSAmax than males (38.8±7.3cm2 vs 55.1±7.3cm2; P<0.001).Consequently, females had lower KF:KE ACSA ratio (P = 0.031). There were sex differences in the proportional size of 2/4 KE and 5/6 KF. In females, vastus lateralis (VL), biceps femoris long-head (BFlh) and semimembranosus (SM) were a greater proportion and sartorius(SA), gracilis (GR) and biceps femoris short-head (BFsh) a smaller proportion of their respective muscle groups compared to males (All P<0.05). Conclusion Sex differences in KF:KE ACSAmax ratio may contribute to increased risk of ACL injury in females. Sex discrepancies in absolute and proportional size of SA, GR, VL and BFlh may contribute further anatomical explanations for sex differences in injury incidence

TparvaDB: a database to support Theileria parva vaccine development

We describe the development of TparvaDB, a comprehensive resource to facilitate research towards development of an East Coast fever vaccine, by providing an integrated user-friendly database of all genome and related data currently available for Theileria parva. TparvaDB is based on the Generic Model Organism Database (GMOD) platform. It contains a complete reference genome sequence, Expressed Sequence Tags (ESTs), Massively Parallel Signature Sequencing (MPSS) expression tag data and related information from both public and private repositories. The Artemis annotation workbench provides online annotation functionality. TparvaDB represents a resource that will underpin and promote ongoing East Coast fever vaccine development and biological research

Climatically controlled reproduction drives interannual growth variability in a temperate tree species

Climatically controlled allocation to reproduction is a key mechanism by which climate influences tree growth and may explain lagged correlations between climate and growth. We used continent‐wide datasets of tree‐ring chronologies and annual reproductive effort in Fagus sylvatica from 1901 to 2015 to characterise relationships between climate, reproduction and growth. Results highlight that variable allocation to reproduction is a key factor for growth in this species, and that high reproductive effort (‘mast years’) is associated with stem growth reduction. Additionally, high reproductive effort is associated with previous summer temperature, creating lagged climate effects on growth. Consequently, understanding growth variability in forest ecosystems requires the incorporation of reproduction, which can be highly variable. Our results suggest that future response of growth dynamics to climate change in this species will be strongly influenced by the response of reproduction.Additional co-authors: Ernst van der Maaten, Marieke van der Maaten‐Theunissen, Lena Muffler, Renzo Motta, Catalin‐Constantin Roibu, Ionel Popa, Tobias Scharnweber, Robert Weigel, Martin Wilmking, Christian S Zan

Catching Element Formation In The Act

Gamma-ray astronomy explores the most energetic photons in nature to address some of the most pressing puzzles in contemporary astrophysics. It encompasses a wide range of objects and phenomena: stars, supernovae, novae, neutron stars, stellar-mass black holes, nucleosynthesis, the interstellar medium, cosmic rays and relativistic-particle acceleration, and the evolution of galaxies. MeV gamma-rays provide a unique probe of nuclear processes in astronomy, directly measuring radioactive decay, nuclear de-excitation, and positron annihilation. The substantial information carried by gamma-ray photons allows us to see deeper into these objects, the bulk of the power is often emitted at gamma-ray energies, and radioactivity provides a natural physical clock that adds unique information. New science will be driven by time-domain population studies at gamma-ray energies. This science is enabled by next-generation gamma-ray instruments with one to two orders of magnitude better sensitivity, larger sky coverage, and faster cadence than all previous gamma-ray instruments. This transformative capability permits: (a) the accurate identification of the gamma-ray emitting objects and correlations with observations taken at other wavelengths and with other messengers; (b) construction of new gamma-ray maps of the Milky Way and other nearby galaxies where extended regions are distinguished from point sources; and (c) considerable serendipitous science of scarce events -- nearby neutron star mergers, for example. Advances in technology push the performance of new gamma-ray instruments to address a wide set of astrophysical questions.Comment: 14 pages including 3 figure

Patient involvement in medical decision-making and pain among elders: physician or patient-driven?

BACKGROUND: Pain is highly prevalent among older adults, but little is known about how patient involvement in medical decision-making may play a role in limiting its occurrence or severity. The purpose of this study was to evaluate whether physician-driven and patient-driven participation in decision-making were associated with the odds of frequent and severe pain. METHODS: A cross-sectional population-based survey of 3,135 persons age 65 and older was conducted in the 108-county region comprising West Texas. The survey included self-reports of frequent pain and, among those with frequent pain, the severity of pain. RESULTS: Findings from multivariate logistic regression analyses showed that higher patient-driven participation in decision-making was associated with lower odds (OR, 0.82; 95% CI, 0.75–0.89) of frequent pain, but was not significantly associated with severe pain. Physician-driven participation was not significantly associated with frequent or severe pain. CONCLUSIONS: The findings suggest that patients may need to initiate involvement in medical decision-making to reduce their chances of experiencing frequent pain. Changes to other modifiable health care characteristics, including access to a personal doctor and health insurance coverage, may be more conducive to limiting the risk of severe pain

Beyond outputs: pathways to symmetrical evaluations of university sustainable development partnerships

As the United Nations Decade of Education for Sustainable Development (2005–2014) draws to a close, it is timely to review ways in which the sustainable development initiatives of higher education institutions have been, and can be, evaluated. In their efforts to document and assess collaborative sustainable development program outcomes and impacts, universities in the North and South are challenged by similar conundrums that confront development agencies. This article explores pathways to symmetrical evaluations of transnationally partnered research, curricula, and public-outreach initiatives specifically devoted to sustainable development. Drawing on extensive literature and informed by international development experience, the authors present a novel framework for evaluating transnational higher education partnerships devoted to sustainable development that addresses design, management, capacity building, and institutional outreach. The framework is applied by assessing several full-term African higher education evaluation case studies with a view toward identifying key limitations and suggesting useful future symmetrical evaluation pathways. University participants in transnational sustainable development initiatives, and their supporting donors, would be well-served by utilizing an inclusive evaluation framework that is infused with principles of symmetry

Oral abstracts 3: RA Treatment and outcomesO13. Validation of jadas in all subtypes of juvenile idiopathic arthritis in a clinical setting

Background: Juvenile Arthritis Disease Activity Score (JADAS) is a 4 variable composite disease activity (DA) score for JIA (including active 10, 27 or 71 joint count (AJC), physician global (PGA), parent/child global (PGE) and ESR). The validity of JADAS for all ILAR subtypes in the routine clinical setting is unknown. We investigated the construct validity of JADAS in the clinical setting in all subtypes of JIA through application to a prospective inception cohort of UK children presenting with new onset inflammatory arthritis. Methods: JADAS 10, 27 and 71 were determined for all children in the Childhood Arthritis Prospective Study (CAPS) with complete data available at baseline. Correlation of JADAS 10, 27 and 71 with single DA markers was determined for all subtypes. All correlations were calculated using Spearman's rank statistic. Results: 262/1238 visits had sufficient data for calculation of JADAS (1028 (83%) AJC, 744 (60%) PGA, 843 (68%) PGE and 459 (37%) ESR). Median age at disease onset was 6.0 years (IQR 2.6-10.4) and 64% were female. Correlation between JADAS 10, 27 and 71 approached 1 for all subtypes. Median JADAS 71 was 5.3 (IQR 2.2-10.1) with a significant difference between median JADAS scores between subtypes (p < 0.01). Correlation of JADAS 71 with each single marker of DA was moderate to high in the total cohort (see Table 1). Overall, correlation with AJC, PGA and PGE was moderate to high and correlation with ESR, limited JC, parental pain and CHAQ was low to moderate in the individual subtypes. Correlation coefficients in the extended oligoarticular, rheumatoid factor negative and enthesitis related subtypes were interpreted with caution in view of low numbers. Conclusions: This study adds to the body of evidence supporting the construct validity of JADAS. JADAS correlates with other measures of DA in all ILAR subtypes in the routine clinical setting. Given the high frequency of missing ESR data, it would be useful to assess the validity of JADAS without inclusion of the ESR. Disclosure statement: All authors have declared no conflicts of interest. Table 1Spearman's correlation between JADAS 71 and single markers DA by ILAR subtype ILAR Subtype Systemic onset JIA Persistent oligo JIA Extended oligo JIA Rheumatoid factor neg JIA Rheumatoid factor pos JIA Enthesitis related JIA Psoriatic JIA Undifferentiated JIA Unknown subtype Total cohort Number of children 23 111 12 57 7 9 19 7 17 262 AJC 0.54 0.67 0.53 0.75 0.53 0.34 0.59 0.81 0.37 0.59 PGA 0.63 0.69 0.25 0.73 0.14 0.05 0.50 0.83 0.56 0.64 PGE 0.51 0.68 0.83 0.61 0.41 0.69 0.71 0.9 0.48 0.61 ESR 0.28 0.31 0.35 0.4 0.6 0.85 0.43 0.7 0.5 0.53 Limited 71 JC 0.29 0.51 0.23 0.37 0.14 -0.12 0.4 0.81 0.45 0.41 Parental pain 0.23 0.62 0.03 0.57 0.41 0.69 0.7 0.79 0.42 0.53 Childhood health assessment questionnaire 0.25 0.57 -0.07 0.36 -0.47 0.84 0.37 0.8 0.66 0.4

The impact of immediate breast reconstruction on the time to delivery of adjuvant therapy: the iBRA-2 study

Background: Immediate breast reconstruction (IBR) is routinely offered to improve quality-of-life for women requiring mastectomy, but there are concerns that more complex surgery may delay adjuvant oncological treatments and compromise long-term outcomes. High-quality evidence is lacking. The iBRA-2 study aimed to investigate the impact of IBR on time to adjuvant therapy. Methods: Consecutive women undergoing mastectomy ± IBR for breast cancer July–December, 2016 were included. Patient demographics, operative, oncological and complication data were collected. Time from last definitive cancer surgery to first adjuvant treatment for patients undergoing mastectomy ± IBR were compared and risk factors associated with delays explored. Results: A total of 2540 patients were recruited from 76 centres; 1008 (39.7%) underwent IBR (implant-only [n = 675, 26.6%]; pedicled flaps [n = 105,4.1%] and free-flaps [n = 228, 8.9%]). Complications requiring re-admission or re-operation were significantly more common in patients undergoing IBR than those receiving mastectomy. Adjuvant chemotherapy or radiotherapy was required by 1235 (48.6%) patients. No clinically significant differences were seen in time to adjuvant therapy between patient groups but major complications irrespective of surgery received were significantly associated with treatment delays. Conclusions: IBR does not result in clinically significant delays to adjuvant therapy, but post-operative complications are associated with treatment delays. Strategies to minimise complications, including careful patient selection, are required to improve outcomes for patients

Deciphering osteoarthritis genetics across 826,690 individuals from 9 populations

Funding Information: T.R.G. and J.Z. receive research funding from GlaxoSmithKline. T.R.G. receives research funding from Biogen. U.S., K.S., L. Stefánsdóttir, G.B., S.H.L., U.T., and G. T. are employed by deCODE genetics/Amgen Inc. A.M.V. is a consultant for Zoe Global Ltd. All other authors report no competing interests. All Regeneron Genetics Center banner authors are current employees and/or stockholders of Regeneron Pharmaceuticals. Funding Information: We thank Nigel W. Rayner and Ahmed Elhakeem for their input. This research was conducted using the UK Biobank Resource under application numbers 9979 and 23359. G.D.S. and T.R.G. work in the Medical Research Council Integrative Epidemiology Unit at the University of Bristol MC_UU_00011/1&4. A.M.V. is funded by the NIHR Nottingham BRC. J.Z. is funded by a Vice-Chancellor Fellowship from the University of Bristol. This research was also funded by the UK Medical Research Council Integrative Epidemiology Unit (MC_UU_00011/4). Study design and project coordination, E. Zeggini; Writing Group, U.S. J.B.J.v.M. J.M.W. M.T.M.L. K.S.E.C. L.S. C.G.B. K.H. Y.Z. R.C.d.A. L. Stef?nsd?ttir, E. Zeggini, A.P.M. G.T. P.C.S. J.Z. and T.R.G.; Core Analyses, C.G.B. K. Hatzikotoulas, L. Southam, L. Stef?nsd?ttir, Y.Z. R.C.d.A. T.T.W. J.Z. A.H. M.T.-L. and J.M.W.; Individual Study Design and Principal Investigators, E. Zeggini, U.S. J.B.J.v.M. M.T.M.L. I.M. J.M.W. T.E. K. Hveem, S.I. K.S.E.C. A.T. A.M.V. K.S. P.E.S. P.C. G.D.S. J.H.T. T.R.G. S.A.L. G.C.B. A.G.U. U.T. P.K. J.H.K. arcOGEN Consortium, HUNT All-In Pain, ARGO Consortium, and Regeneron Genetics Center; Analyses, Genotyping, and Phenotyping in Individual Studies, C.G.B. K.H. L. Southam, J.M.W. L. Stef?nsd?ttir, Y.Z. R.C.d.A. T.T.W. J.Z. A.H. M.T.-L. A.H.S. C.T. E. Zengini, A.B. G.T. G.B. H.J. T.I. R.M. H.T. M.K. M.T. R.R.G.H.H.N. M.M. J.P.Y.C. D.S. J.-A.Z. A.L. M.B.J. L.F.T. B.W. M.E.G. J.S. M.S. G.A. A.G. S.H.L. arcOGEN Consortium, HUNT All-In Pain, ARGO Consortium, and Regeneron Genetics Center. All authors contributed to the final version of the manuscript. T.R.G. and J.Z. receive research funding from GlaxoSmithKline. T.R.G. receives research funding from Biogen. U.S. K.S. L. Stef?nsd?ttir, G.B. S.H.L. U.T. and G. T. are employed by deCODE genetics/Amgen Inc. A.M.V. is a consultant for Zoe Global Ltd. All other authors report no competing interests. All Regeneron Genetics Center banner authors are current employees and/or stockholders of Regeneron Pharmaceuticals. Funding Information: We thank Nigel W. Rayner and Ahmed Elhakeem for their input. This research was conducted using the UK Biobank Resource under application numbers 9979 and 23359. G.D.S. and T.R.G. work in the Medical Research Council Integrative Epidemiology Unit at the University of Bristol MC_UU_00011/1&4. A.M.V. is funded by the NIHR Nottingham BRC . J.Z. is funded by a Vice-Chancellor Fellowship from the University of Bristol . This research was also funded by the UK Medical Research Council Integrative Epidemiology Unit ( MC_UU_00011/4 ). Publisher Copyright: © 2021 The AuthorsOsteoarthritis affects over 300 million people worldwide. Here, we conduct a genome-wide association study meta-analysis across 826,690 individuals (177,517 with osteoarthritis) and identify 100 independently associated risk variants across 11 osteoarthritis phenotypes, 52 of which have not been associated with the disease before. We report thumb and spine osteoarthritis risk variants and identify differences in genetic effects between weight-bearing and non-weight-bearing joints. We identify sex-specific and early age-at-onset osteoarthritis risk loci. We integrate functional genomics data from primary patient tissues (including articular cartilage, subchondral bone, and osteophytic cartilage) and identify high-confidence effector genes. We provide evidence for genetic correlation with phenotypes related to pain, the main disease symptom, and identify likely causal genes linked to neuronal processes. Our results provide insights into key molecular players in disease processes and highlight attractive drug targets to accelerate translation.Peer reviewe