bluuebunny/crossref_metadata_2025_split huggingface dataset:
Association of Prehospital Step 1 Vital Sign Criteria and Vital Sign Decline with Increased Emergency Department and Hospital Death
Authors: Warwick James W. , Davenport Daniel L. , Bettis Amber , Bernard Andrew C. 
Published: December 2020

BACKGROUND:
This study analyzed data from the 2017 American College of Surgeons National Trauma Data Bank to examine the effects of pre-hospital Field Triage Decision Scheme Step 1 vital sign criteria (S1C) and vital sign decline on subsequent emergency department (ED) and hospital death in emergency medical services (EMS) transported trauma victims.

STUDY DESIGN:
Patient and injury characteristics, transport time, and ED and hospital disposition were collected. S1C (respiratory rate [RR]<10, RR>29 breaths/min, systolic blood pressure [SBP]<90 mmHg, Glasgow Coma Scale [GCS]<14) were recorded at the injury scene and hospital arrival. Decline was defined as a change ≥ 1 standard deviation (SD) into or within an S1C range. S1C and decline were analyzed relative to ED and hospital death using logistic regression.

RESULTS:
Of 333,213 included patients, 54,849 (16.5%) met Step 1 criteria at the scene, and 21,566 (6.9%) declined en route. The ED death rate was 0.4% (n = 1,188), and the hospital death/hospice rate was 4.0% (11,624 of 287,675). Patients who met S1C at the scene or who declined were more likely to require longer hospital lengths of stay, ICU admission, and surgical intervention. S1C and decline patients had higher odds of death in both the ED (S1C odds ratio [OR] 15.1, decline OR 2.4, p values < 0.001) and hospital (S1C OR 4.8, decline OR 2.0, p values < 0.001) after adjusting for patient demographics, transport time and mode, injury severity, and injury mechanism. Each S1C and decline measure was independently predictive of death.

CONCLUSIONS:
This study quantifies the mortality risks associated with individual S1C and validates their use as an indicator for injury severity and pre-hospital triage tool.
Study of Spatiotemporal Development of Global Distribution of Magnetospheric ELF/VLF Waves Using Ground‐Based and Satellite Observations, and RAM‐SCB Simulations, for the March and November 2017 Storms
Authors: Takeshita Yuhei , Shiokawa Kazuo , Miyoshi Yoshizumi , Ozaki Mitsunori , Kasahara Yoshiya , Oyama Shin‐ichiro , Connors Martin , Manninen Jyrki , Jordanova Vania K. , Baishev Dmitry , Oinats Alexey , Kurkin Vladimir 
Published: December 2020

AbstractMagnetospheric Extremely Low‐Frequency/Very Low‐Frequency (ELF/VLF) waves have an important role in the acceleration and loss of energetic electrons in the magnetosphere through wave‐particle interaction. It is necessary to understand the spatiotemporal development of magnetospheric ELF/VLF waves to quantitatively estimate this effect of wave‐particle interaction, a global process not yet well understood. We investigated spatiotemporal development of magnetospheric ELF/VLF waves using 6 PWING ground‐based stations at subauroral latitudes, Exploration of energization and Radiation in Geospace and RBSP satellites, POES/MetOp satellites, and the RAM‐SCB model, focusing on the March and November 2017 storms driven by corotating interaction regions in the solar wind. Our results show that the ELF/VLF waves are enhanced over a longitudinal extent from midnight to morning and dayside associated with substorm electron injections. In the main to early storm recovery phase, we observe continuous ELF/VLF waves from ∼0 to ∼12 MLT in the dawn sector. This wide extent seems to be caused by frequent occurrence of substorms. The wave region expands eastward in association with the drift of source electrons injected by substorms from the nightside. We also observed dayside ELF/VLF wave enhancement, possibly driven by magnetospheric compression by solar wind, over an MLT extent of at least 5 h. Ground observations tend not to observe ELF/VLF waves in the post‐midnight sector, although other methods clearly show the existence of waves. This is possibly due to Landau damping of the waves, the absence of the plasma density duct structure, and/or enhanced auroral ionization of the ionosphere in the post‐midnight sector.
Correlation Between GNSS‐TEC and Eruption Magnitude Supports the Use of Ionospheric Sensing to Complement Volcanic Hazard Assessment
Authors: Manta Fabio , Occhipinti Giovanni , Hill Emma M. , Perttu Anna , Assink Jelle , Taisne Benoit 
Published: December 2020

AbstractDespite the global threat posed by large‐scale eruptions to communities, to the climate, and to the consequent impacts on the world economy, many active volcanoes still lack of adequate ground‐based instrumentation. Satellite‐based remote sensing has been used to complement volcano monitoring and risk assessment for volcanic ash, but this technique is often limited by weather conditions. In this work, we explore the ionospheric total electron content (TEC) perturbations measured by GNSS to provide additional information and complement conventional monitoring systems. To this end, we measure the GNSS TEC perturbation associated with the acoustic‐gravity waves generated by 22 volcanic explosions. We introduce a new metric—the Ionospheric Volcanic Power Index (IVPI)—to quantify the energy transferred to the ionosphere by volcanic explosions. We evaluate the IVPI against several well‐established metrics from seismic and infrasonic volcano monitoring as well as satellite remote sensing. Our results show that the IVPI successfully correlates with the Volcanic Explosivity Index (VEI) for events larger than VEI 2. Moreover, the IVPI shows strong correlation with both the acoustic source power and the ash plume height, from which depends the style of volcanic activity. Moderate correlation between IVPI and peak ground velocity (PGV) requires further study in order to evaluate the role of different parameters (seismic magnitude, attenuation, style of faulting, crustal structure, etc.). Our results suggest that ionospheric monitoring by GNSS TEC can help to characterize volcanic eruptions, opening new exciting avenues for continuous volcano monitoring and warning systems by remote sensing.
Assessment of Tidal Range Changes in the North Sea From 1958 to 2014
Authors: Jänicke Leon , Ebener Andra , Dangendorf Sönke , Arns Arne , Schindelegger Michael , Niehüser Sebastian , Haigh Ivan D. , Woodworth Philip , Jensen Jürgen 
Published: December 2020

AbstractWe document an exceptional large‐spatial scale case of changes in tidal range in the North Sea, featuring pronounced trends between −2.3 mm/yr at tide gauges in the United Kingdom and up to 7 mm/yr in the German Bight between 1958 and 2014. These changes are spatially heterogeneous and driven by a superposition of local and large‐scale processes within the basin. We use principal component analysis to separate large‐scale signals appearing coherently over multiple stations from rather localized changes. We identify two leading principal components (PCs) that explain about 69% of tidal range changes in the entire North Sea including the divergent trend pattern along United Kingdom and German coastlines that reflects movement of the region’s semidiurnal amphidromic areas. By applying numerical and statistical analyses, we can assign a baroclinic (PC1) and a barotropic large‐scale signal (PC2), explaining a large part of the overall variance. A comparison between PC2 and tide gauge records along the European Atlantic coast, Iceland, and Canada shows significant correlations on time scales of less than 2 years, which points to an external and basin‐wide forcing mechanism. By contrast, PC1 dominates in the southern North Sea and originates, at least in part, from stratification changes in nearby shallow waters. In particular, from an analysis of observed density profiles, we suggest that an increased strength and duration of the summer pycnocline has stabilized the water column against turbulent dissipation and allowed for higher tidal elevations at the coast.
Complex Basement‐Involved Contractional Structures in the Pre‐Andean Basins of Northern Chile: A Review From Seismic Data
Authors: Martínez F. , Muñoz B. , López C. , González R. , Parra M. , Riquelme R. 
Published: December 2020

AbstractFor many years, the geometry, kinematic, and the age of the basement‐involved structures of the Pre‐Andean basins of northern Chile have been debated. Even, many tectonic models supported by surface geological data have ignored how is the continuity of these structures in the subsurface, and also their possible relation with ancient preorogenic structures, thus difficulting the understanding of the main tectonic mechanisms that acted during the Andean uplift. To solve this problem, we discussed in this study the geometry and timing of the basement‐involved contractional structures present in the Pre‐Andean basins of northern Chile. We present field and seismic evidences of different basement‐involved structural styles, including reverse faults, inverted normal faults, basement thrust ramps, and rotated and reworked basin margins, and use it them to produce three large structural cross‐sections showing the geometries and distribution of structures along the inner forearc region. The structures are interpreted to have resulted from basin inversion, which was followed by large reverse faulting accumulating 43 km in the Salar de Atacama, 10 km in the Salar de Punta Negra, and 27 km in the Salar de Pedernales. Major reverse faults are predominantly located along the western and eastern edges of the basins, whereas inverted normal faults, basement thrust ramps, and other structures are confined to the central sections. In this context, large basement thrust ramps and reverse faults are the most effective structures for generating crustal thickening. Previous analyses (U‐Pb dating) of synorogenic deposits over inverted structures and apatite fission track data from Paleozoic basement prerift rocks suggest that contraction in the region began in the Late Cretaceous‐Paleocene and continued throughout the Cenozoic; however, basement rocks experienced rapid cooling due to tectonic uplift during the Eocene. Further, the results indicate that basement‐involved contractional structures are not only generated by flat‐slab subduction processes, but also observed in other regions of northern Chile (e.g., Frontal Cordillera). Finally, we conclude that the observed structural complexity predominantly results from the initial distribution of preorogenic extensional structures.
Narkolepsie im Erwachsenenalter: Definition, Ätiologie und Behandlung
Authors: Malter Michael , Neuneier Janina , Triller Annika , Kallweit Ulf 
Published: December 2020

ZusammenfassungNarkolepsie ist eine Hypersomnolenz-Erkrankung, die mit einer Störung der Wach-Schlaf-Regulation einhergeht. Leitsymptome sind exzessive Tagesschläfrigkeit und Kataplexien. Zudem treten hypnagogene/hypnopompe Halluzinationen, Schlaflähmungen und gestörter Nachtschlaf auf. Es werden zwei Formen unterschieden. Bei der Narkolepsie Typ 1, früher Narkolepsie mit Kataplexie, besteht eine Hypocretin-Defizienz. Die Ursache der Narkolepsie Typ 2, früher Narkolepsie ohne Kataplexie, ist im Wesentlichen ungeklärt. Zur Diagnosestellung ist ein multimodaler Ansatz notwendig. Die Latenz zwischen Erkrankungsbeginn und Diagnosestellung in Europa beträgt im Mittel 14 Jahre. Es bestehen erhebliche Probleme in der Versorgung von Menschen mit Narkolepsie. Die in aller Regel lebenslange Behandlung der Narkolepsie umfasst sowohl nichtmedikamentöse Strategien als auch die symptomatische medikamentöse Behandlung.
The Age-Specific Impact of Cellular Immunity on Long-Term Outcome after Acute Coronary Syndrome
Authors: Kazem Niema , Hofer Felix , Koller Lorenz , Hammer Andreas , Hengstenberg Christian , Niessner Alexander , Sulzgruber Patrick 
Published: December 2020

Abstract
Background Personalized risk stratification after acute coronary syndrome (ACS) remains a challenging field in the aging society. Easily applicable strategies for risk prediction of adverse events from an age-specific perspective are needed. Considering the association of cellular immunity with coronary vessel disease, these cell lines mirror a reasonable value for risk assessment. Therefore, we aimed to elucidate the prognostic value of cellular immunity on long-term outcome after ACS from an age-specific perspective.
Methods Patients presenting with ACS at the Vienna General Hospital admitted between December 1996 and January 2010 were enrolled within a clinical registry including standardized assessment of peripheral blood samples and immune phenotyping. Cox-regression hazards analysis was performed to elucidate the impact of cellular immunity on survival.
Results A total of 832 patients were included within the final analysis and stratified according to age into individuals <65 years (n = 416) and ≥65 years (n = 416). After a median follow-up time of 8.6 years, a total of 516 (62.0%) individuals died. We found that the fraction of lymphocytes (adjusted hazard ratio [HR] of 0.61 [95% confidence interval, CI: 0.45–0.82]; p = 0.001), the fraction of neutrophil granulocytes (adjusted HR of 5.01 [95% CI: 1.62–15.46]; p = 0.005), and the neutrophil-to-lymphocyte ratio (NLR; adjusted HR of 1.47 [95% CI: 1.16–1.87]; p = 0.002) showed a strong and independent association with mortality in individuals ≥65 years. Notably, there was no effect on outcome observed for any of the tested cell lines in patients <65 years.
Conclusion The present investigation highlighted a strong and independent age-specific effect of both the fraction of neutrophil granulocytes and lymphocytes as well as the NLR on outcome. Considering an age-dependent risk stratification, these routinely available values can be easily used to identify patients at risk for fatal events and contribute to proper secondary prevention after ACS.
Medical Student Ophthalmic Knowledge Proficiency after Completing a Clinical Elective or an Online Course
Authors: Abou-Hanna Jacob J. , Yousif Jonah E. , Kaplan Ariane D. , Musch David C. , Trobe Jonathan D. 
Published: December 2020

Abstract
Background As more information is being packed into medical school curricula, mainstream medical topics legitimately receive more attention than specialty topics such as ophthalmology. However, general practitioners, as gatekeepers of specialty care, must attain competency in ophthalmology. We have investigated whether an online ophthalmology course alone would be noninferior to the same online course plus an in-person clinical elective in providing ophthalmic knowledge.
Methods Students at the University of Michigan Medical School voluntarily enrolled in one of two groups: an Online Only group requiring satisfactory completion of an online course entitled “The Eyes Have It” (TEHI) or a Clinical + Online group requiring students to complete a 2-week clinical rotation and the TEHI online course. The outcome metric was the score on an independent 50-question written examination of ophthalmic knowledge. Students also completed a survey assessing confidence in managing ophthalmic problems.
Results Twenty students in the Clinical + Online group and 59 students in the Online Only group completed the study. The Clinical + Online group slightly outscored the Online Only group (86.3 vs. 83.0%, p = 0.004). When the two outlier questions were removed from the analysis, there was no difference in mean scores between the two groups (85.8 vs. 85.4, p = 0.069). Students in the Clinical + Online group devoted 80 more hours to the experience than did the students in the Online Only group. The number of hours devoted to the course and interest in ophthalmology were weakly correlated with examination performance. After completion of the experiment, there was no difference in student-reported comfort in dealing with ophthalmic problems between the two groups.
Conclusion The examination scores of the students who completed the in-person alone were only slightly inferior to those of the students who completed the in-person clinical elective and the online course. These results suggest that an online course alone may provide a satisfactory ophthalmic knowledge base in a more compact timeframe, an alternative that should have appeal to students who do not intend to pursue a career in ophthalmology.
Dexmedetomidine Infusion as a Novel Supportive Therapy for Fluphenazine-Induced Neuroleptic Malignant Syndrome in a 10-Year-Old Boy: A Case Report and Review of Literature
Authors: Yu Caroline , Kaul Rajat , Ostwani Waseem 
Published: December 2020

AbstractA 10-year-old male child patient developed symptoms of neuroleptic malignant syndrome (NMS) 1 month following initiation of fluphenazine for behavioral therapeutic management. Dexmedetomidine infusion was able to adequately control the symptoms of NMS with resolution of encephalopathy. This was the first report of novel dexmedetomidine utilization for the treatment of NMS. We suggest using dexmedetomidine as an adjunctive agent to control NMS symptomatology without attendant risk of respiratory depression.
Critical Care Course of Pediatric Inflammatory Multisystem Syndrome Temporally Associated with SARS-CoV-2 and Response to Immunomodulation
Authors: Richens Nicholas , Kanthimathinathan Hari Krishnan , Sontakke Sanket , Chikermane Ashish , Jyothish Deepthi , Hackett Scott , Welch Steven B. , Al-Abadi Eslam , Duncan Heather P. , Richter Alex G. , Scholefield Barnaby R. 
Published: December 2020

AbstractWe describe the critical care course of children with a novel hyperinflammatory syndrome associated with coronavirus disease 2019 (COVID-19) pediatric inflammatory multisystem syndrome temporally associated with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), with focus on trajectory before and after immunomodulation. Overall, 10 patients who met the U.K. Royal College of Pediatrics and Child Health case definition during a 2-month study period were analyzed. All tested positive for SARS-CoV-2 IgG antibody. Although only 20% were ventilated, 100% required inotropic or vasopressor support. All children had significantly raised inflammatory markers with a median C-reactive protein of 248 (175–263) mg/L, ferritin of 1,561 (726–2,255) µg/L, and troponin-I of 723 (351–2,235) ng/L. Six patients had moderately impaired myocardial function and two had severe impairment. None needed extracorporeal membrane oxygenation. Despite severe illness only a brief period of critical care support of 3 to 5 days was required. Eight received at least one dose of intravenous immunoglobulin. Six received high-dose steroids. Clinical improvement including cardiovascular stability and reduction in inflammatory markers may have occurred with and without immunomodulation.
Neomarica caerulea (walking iris).
Authors: Rojas-Sandoval Julissa 
Published: December 2020

Abstract

Neomarica caerulea is a clumping perennial herb often cultivated as an ornamental for its attractive, light green leaves and colourful flowers. It is native to Brazil and also widely cultivated. It has escaped from cultivation and can be found naturalized along roadsides, in abandoned farms and pastures and in disturbed sites in Central America, the Caribbean and South Africa. This species propagates by seed, but also by rhizomes and plantlets. Once established it can form dense colonies that prevent the regeneration of native vegetation and displace native species reducing native plant species richness. Currently it is listed as invasive in Cuba, though its impact is unknown.
Site-specific conjugation of native antibody
Authors: Sadiki Amissi , Vaidya Shefali R , Abdollahi Mina , Bhardwaj Gunjan , Dolan Michael E , Turna Harpreet , Arora Varnika , Sanjeev Athul , Robinson Timothy D , Koid Andrea , Amin Aashka , Zhou Zhaohui Sunny 
Published: December 2020

ABSTRACT
Traditionally, non-specific chemical conjugations, such as acylation of amines on lysine or alkylation of thiols on cysteines, are widely used; however, they have several shortcomings. First, the lack of site-specificity results in heterogeneous products and irreproducible processes. Second, potential modifications near the complementarity-determining region may reduce binding affinity and specificity. Conversely, site-specific methods produce well-defined and more homogenous antibody conjugates, ensuring developability and clinical applications. Moreover, several recent side-by-side comparisons of site-specific and stochastic methods have demonstrated that site-specific approaches are more likely to achieve their desired properties and functions, such as increased plasma stability, less variability in dose-dependent studies (particularly at low concentrations), enhanced binding efficiency, as well as increased tumor uptake. Herein, we review several standard and practical site-specific bioconjugation methods for native antibodies, i.e., those without recombinant engineering. First, chemo-enzymatic techniques, namely transglutaminase (TGase)-mediated transamidation of a conserved glutamine residue and glycan remodeling of a conserved asparagine N-glycan (GlyCLICK), both in the Fc region. Second, chemical approaches such as selective reduction of disulfides (ThioBridge) and N-terminal amine modifications. Furthermore, we list site-specific antibody–drug conjugates in clinical trials along with the future perspectives of these site-specific methods.
You Name It: On the Cross-Border Regulation of Names
Authors: Shakargy Sharon 
Published: December 2020

Abstract
Is your name “yours”? Are you free to choose a name for yourself? Does a name withstand border crossing and even the acquisition of new citizenships? In the common law world, the unequivocal answer is yes. However, in civil law, this answer is not so clear. While the global tendency over the last few decades has been towards relaxing the norms governing names, old traditions die hard, and in some cases now re-emerge in other parts of the world. In an ever more globalized world, given widespread immigration, refugees, and people with dual (or even multiple) citizenship, the different national attitudes towards names and the lack of proper cross-border regulation of names is becoming a relevant and pressing question. This Article maps out and conceptualizes the challenge of names by demonstrating the different approaches toward names and suggesting possible cross-border regulation (i.e., choice-of-law rules) that would address this issue for the benefit of the individuals and countries involved.
All or nothing belief updating in patients with schizophrenia reduces precision and flexibility of beliefs
Authors: Nassar Matthew R , Waltz James A , Albrecht Matthew A , Gold James M , Frank Michael J 
Published: December 2020

Abstract
Schizophrenia is characterized by abnormal perceptions and beliefs, but the computational mechanisms through which these abnormalities emerge remain unclear. One prominent hypothesis asserts that such abnormalities result from overly precise representations of prior knowledge, which in turn lead beliefs to become insensitive to feedback. In contrast, another prominent hypothesis asserts that such abnormalities result from a tendency to interpret prediction errors as indicating meaningful change, leading to the assignment of aberrant salience to noisy or misleading information. Here we examine behaviour of patients and control subjects in a behavioural paradigm capable of adjudicating between these competing hypotheses and characterizing belief updates directly on individual trials. We show that patients are more prone to completely ignoring new information and perseverating on previous responses, but when they do update, tend to do so completely. This updating strategy limits the integration of information over time, reducing both the flexibility and precision of beliefs and provides a potential explanation for how patients could simultaneously show over-sensitivity and under-sensitivity to feedback in different paradigms.