bluuebunny/crossref_metadata_2025_split huggingface dataset:
Gap Analysis of Swine-Based Hemostasis Research: “Houses of Brick or Mansions of Straw?”
Authors: Reynolds Penny S , Garvan Cynthia S 
Published: February 2020

ABSTRACTIntroductionHemorrhage control is the top priority in far-forward care. Preclinical studies are essential for determining safety and efficacy before novel therapeutics can be tested in humans. Unfortunately, poor methodological quality jeopardizes translational potential.MethodsWe systematically reviewed 136 recent publications describing swine models of hemostasis and hemorrhage reduction to assess compliance with established standards for scientific reporting. Quality measures were summarized by descriptive statistics; randomization was assessed by using baseline group differences to test the uniform distribution assumption for observed P-values.ResultsMost articles did not report information essential to assess study validity and reliability of experimental results. Studies claiming random allocation showed clear evidence of systematic bias. Sample sizes were small, but nearly all studies reported statistically significant effects in the direction of “benefit.” Excessive hypothesis testing increased the risk of false positives.ConclusionsMethodological quality was poor. Although funding agencies actively promote good scientific practice, investigators have been slow to comply. Poorly executed and reported animal research is an ethical and translational issue, wasting animals and potentially harming patients. To properly assess the therapeutic benefit of novel interventions, investigators must rely less on rote hypothesis testing, develop skills in experimental design and quantitative analysis, and comply with best-practice reporting guidelines.
A Randomized Trial of Mentored vs Nonmentored Military Medics Compared in the Application of a Wound Clamp Without Prior Training: When to Shut Up and Just Watch!
Authors: Kirkpatrick Andrew W , Mckee Jessica L , Netzer Itamar , Mckee Ian A , McBeth Paul , Wachs Juan P , Ball Chad G , Glassberg Elon 
Published: February 2020

ABSTRACTIntroductionHemorrhage control is a basic task required of first responders and typically requires technical interventions during stressful circumstances. Remote telementoring (RTM) utilizes information technology to guide inexperienced providers, but when this is useful remains undefined.MethodsMilitary medics were randomized to mentoring or not from an experienced subject matter expert during the application of a wound clamp (WC) to a simulated bleed. Inexperienced, nonmentored medics were given a 30-second safety briefing; mentored medics were not. Objective outcomes were time to task completion and success in arresting simulated bleeding.ResultsThirty-three medics participated (16 mentored and 17 nonmentored). All (100%) successfully applies the WC to arrest the simulated hemorrhage. RTM significantly slowed hemorrhage control (P = 0.000) between the mentored (40.4 ± 12.0 seconds) and nonmentored (15.2 ± 10.3 seconds) groups. On posttask questionnaire, all medics subjectively rated the difficulty of the wound clamping as 1.7/10 (10 being extremely hard). Discussion: WC application appeared to be an easily acquired technique that was effective in controlling simulated extremity exsanguination, such that RTM while feasible did not improve outcomes. Limitations were the lack of true stress and using simulation for the task. Future research should focus on determining when RTM is useful and when it is not required.
Utilization of 19F MRI for Identification of Iraq-Afghanistan War Lung Injury
Authors: Mammarappallil Joseph G , Shofer Scott , Carraway Martha S , Tucker Jesse , Womack Samantha , Ainslie Maureen , Charles H Cecil 
Published: February 2020

ABSTRACT

Introduction
There is mounting evidence of respiratory problems related to military service in the Middle East in the past two decades due to environmental exposures during deployment (eg, sand storms and burn pits). This pilot study tests the hypothesis that regional lung function in subjects with prior deployment in Iraq and/or Afghanistan with suspected War Lung Injury (WLI) would be worse than subjects with normal lung function.

Materials and Methods
Five subjects meeting the inclusion and exclusion criteria were recruited for this pilot study. All subjects underwent spirometry, high-resolution chest computed tomography imaging, and 19F MRI.

Results
While the WLI subjects had normal pulmonary function tests and normal high-resolution chest computed tomography evaluations, their regional lung function from 19F MRI was abnormal with compartments with poor function showing slower filling time constants for ventilation. The scans of suspected WLI subjects show higher fractional lung volume with slow filling compartments similar to patients with chronic obstructive pulmonary disease in contrast to normal subjects.

Conclusions
This is consistent with our premise that WLI results in abnormal lung function and reflects small airways dysfunction and suggests that we may be able to provide a more sensitive tool for evaluation of WLI suspected cases.
Dynamic Postural Stability in Active, Adolescent Males Following Repeated Bouts of Aerobic Exercise in Hot and Temperate Environments: A Pilot Study
Authors: Bond Colin W , Dorman Jason C , MacFadden Lisa N , Munce Thayne A 
Published: February 2020

ABSTRACT

Introduction
Proper jump-landing neuromuscular control is crucial in mitigating lower-extremity musculoskeletal injuries. The presence of fatigue, especially in extreme environments, may degrade dynamic postural stability (DPS) and result in lower-extremity injuries. This study aimed to evaluate the influence of moderate intensity exercise in hot (HOT) and temperate (TEMP) ambient temperatures and residual effects of a previous bout on DPS during a single-legged jump-landing. It was hypothesized that the participants would display worse DPS after HOT compared to TEMP.

Methods
Six recreationally active young males (16.8 ± 0.7 year, 1.88 ± 0.12 m, 83.8 ± 19.8 kg) completed two, 60-minute bouts of exercise with 60 minutes of rest between bouts in both HOT (35°C) and TEMP (22.2°C). Heart rate and core body temperature (Tc) were monitored continuously, and DPS was assessed before and after each bout.

Results
The DPS time and condition effects were not identified (p &gt; 0.05), but HOT elicited some notable (d &gt; 0.20) increases in heart rate, Tc, and DPS compared to TEMP.

Conclusions
The DPS decrements varied between subjects suggesting individual-specific etiology. Repeated bouts of exercise in HOT may place an individual at a greater risk for injury than TEMP if proper prevention strategies are not used.
Tactical Combat Casualty Care Training, Knowledge, and Utilization in the US Army
Authors: Gurney Jennifer M , Stern Caryn A , Kotwal Russ S , Cunningham Cord W , Burelison Dallas R , Gross Kirby R , Montgomery Harold R , Whitt Edward H , Murray Clinton K , Stockinger Zsolt T , Butler Frank K , Shackelford Stacy A 
Published: February 2020

AbstractIntroductionTactical Combat Casualty Care (TCCC) is the execution of prehospital trauma skills in the combat environment. TCCC was recognized by the 2018 Department of Defense Instruction on Medical Readiness Training as a critical wartime task. This study examines the training, understanding, and utilization of TCCC principles and guidelines among US Army medical providers and examines provider confidence of medics in performing TCCC skills.Materials and MethodsA cross-sectional survey, developed by members of the Committee on TCCC, was distributed to all US Army Physicians and Physician Assistants via anonymous electronic communication.ResultsA total of 613 completed surveys were included in the analyses. Logistic regression analyses were conducted on: TCCC test score of 80% or higher, confidence with medic utilization of TCCC, and medic utilization of ketamine in accordance with TCCC.Conclusions&lt;60% of respondents expressed confidence in the ability of the medics to perform all TCCC skills. Supervising providers who that believed 80 to 100% of their medics had completed TCCC training had more confidence in their medic’s TCCC abilities. With TCCC, a recognized lifesaver on the battlefield, continued training and utilization of TCCC concepts are paramount for deploying personnel.
Applied machine learning and artificial intelligence in rheumatology
Authors: Hügle Maria , Omoumi Patrick , van Laar Jacob M , Boedecker Joschka , Hügle Thomas 
Published: February 2020

Abstract
Machine learning as a field of artificial intelligence is increasingly applied in medicine to assist patients and physicians. Growing datasets provide a sound basis with which to apply machine learning methods that learn from previous experiences. This review explains the basics of machine learning and its subfields of supervised learning, unsupervised learning, reinforcement learning and deep learning. We provide an overview of current machine learning applications in rheumatology, mainly supervised learning methods for e-diagnosis, disease detection and medical image analysis. In the future, machine learning will be likely to assist rheumatologists in predicting the course of the disease and identifying important disease factors. Even more interestingly, machine learning will probably be able to make treatment propositions and estimate their expected benefit (e.g. by reinforcement learning). Thus, in future, shared decision-making will not only include the patient’s opinion and the rheumatologist’s empirical and evidence-based experience, but it will also be influenced by machine-learned evidence.
Distinction through Religious Activism: How Capital Shapes the Organizational Repertoires of Transnational Protestant Outreach
Authors: Bok Jared 
Published: February 2020

AbstractHow religious organizations distinguish themselves from one another influences the extent to which they compete (or cooperate) with other similar organizations, thus serving to shape both their survivability and efficacy in achieving their goals. Although theological differences provide one source of distinction, organizations also strategically distinguish themselves not only by what they do but also what they avoid doing. Adopting a Bourdieu(s)ian field theory approach to the study of transnational American Protestant mission agencies, this article explores how agencies’ ministry activities are organized into symbolically distinctive repertoires of activism that vary by agencies’ differing levels of religious and economic capital. Based on how these repertoires are diversified (versus concentrated) and focused on inner- (as opposed to other-worldly) goals, the article discusses the implications of these organizational patterns for the survivability and efficacy of agencies in the transnational missions field, as well as their prospects for interorganizational cooperation and coordination.
The Influence of Social Exclusion on Posttraumatic Stress Reactions in Older Adult Veterans
Authors: Olson Mark D 
Published: February 2020

AbstractThe relationship between social exclusion and posttraumatic stress reactions in aging veterans is a particularly timely issue, warranting greater attention in the social work literature. Research with military veterans indicates that the social marginalization resulting from racial and ethnic discrimination can exacerbate posttraumatic stress symptoms. This marginalization suggests an increased potential for emergent or recurrent trauma reactions in aging military veterans, as previous research has documented older adults’ unique risk for social exclusion. The issue takes on greater relevance as increased numbers of Vietnam veterans enter older adulthood. Professionals working with military veterans should be aware of the social and cultural factors that play a critical role in posttrauma response and recovery.
VALIDATION OF THE RECENTLY DEVELOPED ATN CLASSIFICATION AND GRADING SYSTEM FOR MYOPIC MACULOPATHY
Authors: Ruiz-Medrano Jorge , Flores-Moreno Ignacio , Ohno-Matsui Kyoko , Cheung Chui Ming Gemmy , Silva Rufino , Ruiz-Moreno José M. 
Published: February 2020

Purpose:
To validate the recently developed ATN grading system for myopic maculopathy to classify eyes with pathologic myopia.

Methods:
Cross-sectional study. A series of consecutive eyes diagnosed with pathologic myopia and signs of myopic maculopathy (grade ≥1 for atrophic, tractional, or neovascular components of the ATN), with a refractive error > −6.0 diopters (D), were included. All patients underwent complete ophthalmological examination including fundus photography and swept-source optical coherence tomography. Six observers graded each eye twice using the ATN system (≥15 days between assessments) based only on the aforementioned data.

Results:
Sixty eyes from 47 patients (61.7% female) were graded. Mean patient age was 63.2 ± 11.7 years. The mean spherical equivalent was −13.8 ± 6.5 D. Mean axial length was 28.6 ± 2.16 mm. Overall, the mean intraobserver agreement (%) for the same image was 92.0%, and the mean interobserver agreement for the second image was 77.5%. The weighted Fleiss k showed excellent correlation (k > 0.8) for the traction and neovascularization components and good correlation (0.75) for atrophy. Interobserver agreement for each of these three components was 95.2%, 98.4%, 95.0%, respectively.

Conclusion:
Application of the ATN resulted in high intraobserver and interobserver correlation, underscoring the reproducibility of the system.
Herpes Simplex DNA in Tears of Atypical Dendritic Keratitis and Multiple Punctate Subepithelial Stromal Opacity: A Case Report
Authors: Hirota Akira , Inada Noriko , Shiraki Yukiko , Shoji Jun , Yamagami Satoru 
Published: February 2020

Purpose:
To report an atypical presentation of herpes simplex virus (HSV) keratitis followed up using expression levels of HSV DNA in tears.

Methods:
A 22-year-old Japanese woman with hyperemia and foreign body sensation in her left eye was diagnosed with atypical dendritic keratitis. A slit-lamp examination at presentation indicated the presence of a rush of dendritic lesions with a sparse branching pattern and poor development of terminal bulbs; follicular conjunctivitis was also observed. Positivity for house-dust-mite- and cedar pollen-specific IgE antibodies in her serum indicated atopic diathesis. The HSV DNA levels in her tears were measured by a real-time polymerase chain reaction.

Results:
At the initial visit, the HSV DNA levels in tears were 6.4 × 102 copies/sample in the right eye and 1.6 × 105 copies/sample in the left eye. The keratitis improved after treatment with topical acyclovir ointment, 5 times a day for 7 days, and systemic valacyclovir 1000 mg/d for 5 days. Multiple punctate subepithelial opacities developed in her left eye on day 7, with undetectable HSV DNA in tears, bilaterally.

Conclusions:
We have successfully monitored the HSV DNA levels in tears using quantitative real-time polymerase chain reaction in HSV keratitis where the corneal findings progressed from atypical dendritic keratitis to multiple punctate corneal subepithelial opacities during the treatment period.
MicroRNAs as potential therapeutic targets for muscle wasting during cancer cachexia
Authors: Sannicandro Anthony J. , McDonagh Brian , Goljanek-Whysall Katarzyna 
Published: February 2020

Purpose of review
Muscle wasting in cancer cachexia remains an unmet clinical need due to lack of effective therapies associated with the complexity of the disease. Here, we discuss microRNAs, robust regulators of the expression of multiple genes, only recently characterized in cancer cachexia in humans and their therapeutic potential for muscle wasting.

Recent findings
Changes in microRNAs in muscle of cancer patients have been demonstrated for the first time and these are associated with dysregulated signalling networks during muscle wasting. These data, together with studies in animal models, indicate that microRNAs are attractive therapeutic candidates for maintaining muscle mass, both during and following cancer treatment ultimately improving patient outcomes.

Summary
Cancer cachexia is a complex metabolic condition associated with muscle wasting. Maintenance of muscle mass in cancer patients can improve their response to therapy and prognosis. microRNAs, which can act as oncogenes or tumour suppressors, are also dysregulated in muscle of cachexia patients. Studies in animal models of muscle wasting have demonstrated that microRNAs regulate muscle mass and strength. With more microRNA-based therapeutics in clinical trials and first RNA drugs approved, microRNAs present an attractive novel therapeutic avenue for maintaining muscle homeostasis in cachexia patients to improve their prognosis.
Increased-risk donors and solid organ transplantation: current practices and opportunities for improvement
Authors: Brown Craig S. , Wakam Glenn K. , Englesbe Michael J. 
Published: February 2020

Purpose of review
The development and implementation of ‘increased risk donor’ (IRD) status by the Centers for Disease Control (CDC) was intended to guide patients and providers in decision making regarding risk of infectious transmission via solid organ transplantation. Several contemporary studies have shown underutilization of these organs. This review summarizes the issues surrounding IRD status as well as recent advances in our understanding of the risks and benefits of increased risk organs and their appropriate utilization.

Recent findings
Risk of window-period infection remains exceedingly low, and implementation of nucleic acid testing for HIV and hepatitis C virus (HCV) has resulted in decreasing risk of window-period infection often by an order of magnitude or more. Surgeons remain hesitant to utilize IRD organs. In addition, surgeon assessment of risk by donor behaviour was often discordant with known risks of those behaviours. Studies investigating outcomes of utilization of IRD organs suggest long-term mortality and graft survival is at least equivalent to non-IRD organs. Contemporary results suggest that IRD organs continue to be underutilized, particularly adult kidneys and lungs, with hundreds of wasted organs per year.

Summary
CDC IRD labelling has led to an underutilization of organs for transplantation. The risks associated with acceptance of an IRD organ are inflated by surgeons and patients, and outcomes for patients who undergo transplantation with increased risk organs are similar to or better than those for patients whom accept standard risk organs. The rate of transmission of window-period infection from IRD organs is exceptionally low. The harms regarding the utility of Public Health Service increased risk classification outweigh the benefits for patients in need of transplant.
Vaginal Microbiota and Mucosal Immune Markers in Women With Vulvovaginal Discomfort
Authors: Mitchell Caroline M. , Watson LaTina , Mitchell Alissa J. , Hyrien Ollivier , Bergerat Agnes , Valint D.J. , Pascale Alisa , Hoffman Noah , Srinivasan Sujatha , Fredricks David N. 
Published: February 2020

Background
Up to 30% of women with vaginal symptoms are not assigned a diagnosis after standard diagnostic assessment.

Methods
We compared premenopausal women with idiopathic vaginitis (IV) or vulvodynia (VVD) to healthy controls. Microbiota were characterized using rRNA sequencing. Cytokines/chemokines (IL-10, IL-1α, IL-1β, IL-6, IL-8, IL-2, IL-18, IL-4, IL-9, and IL-13) were measured in vaginal lavage fluid using the Meso Scale Discovery platform or ELISA (IL-1ra). Immunoglobulins were measured in vaginal lavage fluid using a bead-based immunoassay (Millipore). Cases and controls were compared using Kruskal-Wallis, analysis of variance, and linear regression or (for microbiome composition) the Bray-Curtis dissimilarity statistic.

Results
We compared 20 women with IV, 30 with VVD, and 52 controls. Most (80%) had greater than 90% 16S rRNA gene sequences from Lactobacillus crispatus, L. jensenii, L. gasseri, or L. iners. In analyses adjusted for age and hormonal contraception (HC), Gardnerella vaginalis was less prevalent and abundant in women with VVD (2/30, 7%) versus controls (16/52, 31%) or IV (5/20, 25%) (P = 0.030). Bray-Curtis dissimilarity was not significantly different between IV and controls or VVD. Fungal sequences were only detected in 5 participants: 2 control, 1 IV, 2 VVD. In univariate analysis, cytokines were not associated with diagnosis. Median vaginal concentration of IgE (but not other immunoglobulins) was lower in women with VVD (P = 0.006).

Conclusions
Minimal differences in vaginal microbiota and inflammatory markers between women with IV, VVD or controls suggest no striking association between vaginal bacteria, fungi or inflammation and diagnosis in these women.
Frequency of Sexually Transmitted Infection/HIV Testing Among Commercially Insured Patients With International Classification of Disease Tenth Revision Specified Sex Partners
Authors: Kumar Sagar , Patel Chirag , Tao Guoyu 
Published: February 2020

Background
High-risk sexual behaviors (HRSB) are associated with sexually transmitted infections (STIs). The Centers for Disease Control and Prevention and US Preventive Services Task Force recommend routine testing for patients with HRSB. Providers can classify patients with HRSB based on the sex of their sex partners using the International Classification of Disease Tenth Revision. We analyzed STI/human immunodeficiency virus (HIV) testing frequencies among patients with HRSB.

Methods
This study used a large US administrative outpatient medical claims data set from 2015 to 2017. Patients aged 15 to 64 years were identified with HRSB using International Classification of Disease Tenth Revision codes. An initial HRSB diagnosis in 2016 served as the index date. We assessed chlamydia, gonorrhea, syphilis, and HIV testing by HRSB at the index date, and 4 time intervals of 1 to 6 months, and 7 to 12 months before and after the index date.

Results
We identified 52,160 patients with HRSB: 90.3% were patients with opposite-sex partners, 7.7% patients with same-sex partners, and 2.1% patients with same- and opposite-sex partners. There were 77.5% and 82.1% of the patients insured 6 months before and after the index, respectively. On the index date, patients with opposite-sex partners tested most for chlamydia (65.3%) and gonorrhea (65.2%), patients with same-sex partners tested most for syphilis (51.5%) and HIV (57.8%). Among insured patients, follow-up STI/HIV testing was 89.5% during 1 to 6 months and 33.1% during 7 to 12 months after the index date. Patients tested on the index date were more likely to have an STI/HIV test within 1 to 6 months after the index date.

Conclusions
The STI/HIV testing among patients with HRSB could improve. It is important for patients identified as HRSB to get tested and continue testing patients based on recommendations.