bluuebunny/crossref_metadata_2025_split huggingface dataset:
Urology Individual Critical Task List: Creation and Validation of a Simulation Curriculum
Authors: Hertz Alexandria M , Devasahayam Rebekah , Brand Timothy C , Caras Ronald J 
Published: July 2020

Abstract

Introduction
Individual critical task lists (ICTLs) are skills identified by the U.S. Army for the maintenance of combat readiness in each military occupational specialty, including physicians. These lists vary by medical and surgical specialties and are being utilized by leaders to determine individual deployment capability. The lists for urologists include broader tasks that are not routinely performed in a urology practice. Our goal was to create a simulation curriculum to train urologists and to perform validation testing.

Materials and Methods
Urology staff and residents at a single military treatment facility underwent a simulation event of urology ICTLs: chest tube, needle decompression, intubation, cricothyroidotomy, and extended focused assessment with sonography for trauma. The simulation was broken down into a pretest, cognitive acquisition, in-person training with subject matter experts for skills acquisition, and a posttest. Content validity questionnaires were administered to participants after the training session. Cognitive acquisition consisted of a series of videos demonstrating task execution and in-person demonstration of tasks and clinical scenarios of when they would be needed. In-person simulation was performed on training mannequins and a sonography simulation trainer.

Results
There were a total of nine participants: three residents and six staff urologists, ranging from postgraduate year 2 to more than 10 years out of residency. The total simulation time was 120 min, including 30 min for pretest and viewing of videos. Knowledge-based questions improved from pretest to posttest significantly (mean of 1.2 to 0.1, P &lt; .001). Confidence performing tasks improved significantly on all tasks (P ≤ .01). All participants felt the simulation to be beneficial and had more comfort with the tasks.

Conclusions
The novel urology ICTL curriculum using simulation is a feasible and well-received way to keep competency on these tasks and maintain readiness. Face and content validity was established for the urology ICTL simulation curriculum, and the curriculum is exportable to equip urologists at other facilities for the urology ICTLs and for deployments, where life-saving interventions may be necessary from urologists that may be outside their ordinary scope of practice.
Long-Term Outcomes of Thoracic Trauma in U.S. Service Members Involved in Combat Operations
Authors: Hughes Stephen M , Borders Charles W , Aden James K , Sjulin Tyson J , Morris Michael J 
Published: July 2020

ABSTRACTIntroductionNearly 10% of all combat injuries during the most recent conflicts in Iraq and Afghanistan involve thoracic trauma. The long-term outcomes of these combat-related injuries with respect to lung function have not been fully evaluated. Limited research in civilian polytrauma patients have shown significant obstructive physiology in nearly half of their population without clear etiology. We sought to further characterize the extent to which these active duty service members (ADSM) are chronically affected by their thoracic injuries.Materials and MethodsWe conducted a retrospective chart review and analysis of ADSM who sustained thoracic injuries while deployed in support combat operations from 2003 to 2013. Using the Department of Defense Trauma Registry, 2,049 patients were found to have sustained thoracic trauma during these conflicts, of which we were able to identify 298 patients with postinjury pulmonary function testing (PFT) available for analysis. Following standardization of these tests using the established reference values, PFT was compared to a representative population of ADSM. Additional analysis was completed to detect incidence of abnormal PFTs when compared to both type of injury (burn, blunt, penetrating, and other) and also Injury Severity Score.ResultsIn our patient population, there was a significant increase in abnormal PFTs when compared to a representative population. Of these, 31.8% of patients displayed obstructive physiology versus 3.7% in the control (P &lt; 0.001), 24.5% displayed restrictive or restrictive pattern (those without full lung volumes available utilizing forced vital capacity) versus 4.9% (P &lt; 0.0001), and 7.9% displaying mixed pattern. Further, increasing rates of abnormal PFTs were identified in comparison to Injury Severity Score (odds ratio 1.03). There was no significant increase in abnormal PFTs when stratified by type of injury. Finally, there was no significant change identified in pulmonary function before and after injury in our limited population of 19 patients.ConclusionsThere is a significant increase in the percent of abnormal PFTs in ADSM following thoracic injury when compared to patients with similar risk factors and baseline health. It is unclear why the rates of obstruction are high in our population as previous research has not definitively shown increased rates of asthma in previously deployed, uninjured ADSM; however, this finding is consistent with limited previous research in civilian trauma patients. Further research into the long-term outcomes of thoracic trauma and occupational exposures of combat is paramount for improved outcomes going forward.
Total Joint Arthroplasty Volume in the Military Health System
Authors: Anderson Ashley B , Balazs George C , Brooks Daniel I , Dickens Jonathan F , Potter Benjamin K 
Published: July 2020

ABSTRACT

Introduction
The relationship between volume and outcome of total knee arthroplasties is a concern in both the civilian and military patient populations. We sought to compare surgeons and hospital procedure volumes performed on military service members and define factors leading to increased civilian referrals.

Materials and Methods
The Military Health System Data Repository (MDR) contains patient information on all healthcare beneficiary encounters, including care provided both in Military Health System (MHS) facilities and in civilian network facilities. The Military Analysis and Reporting Tool (M2) queried the MDR for all patients between 2011 and 2015 with a CPT code for hip or knee arthroplasty associated with a provider HIPAA taxonomy code for orthopedic surgery. M2 enrollee encounters were used to calculate the total number of arthroplasty procedures performed by both military and civilian orthopedic surgeons on MHS enrollees as well as the incidence rate of arthroplasty procedures. Logistic regression was used to predict which cases were more likely to have been treated at military treatment facilities using patient gender, sponsor service branch, age, and beneficiary category.

Results
During the study period, a total of 12,627 military facility arthroplasty cases and a total of 142,637 civilian facility arthroplasty cases were performed on TRICARE enrolled patients. The total number of military surgeons performing arthroplasty on TRICARE enrolled patients was 323, while the total number of civilian surgeons performing arthroplasty was 10,245 during the same time period; the number of military surgeons performing arthroplasty on active duty patients was 176, and the total number of civilian surgeons performing arthroplasty on military patients was 1045. Overall, including retirees and activity duty service members, more procedures are performed by civilian network surgeons than military surgeons in all states. In an adjusted model, male patients were slightly more likely to receive care at an military treatment facilitie than female patients (OR = 1.47, 95% CI: 1.41–1.53). Furthermore, with respect to service, patients with Air Force (OR: 1.08, 95% CI: 1.02–1.15) and Navy sponsors (OR: 1.61, 95% CI: 1.51–1.71) were more likely to receive military care than patients with Army sponsors.

Conclusions
Based on our findings, we recommend the MHS focus attention to recapturing the Army active duty male patients who are more likely to receive care outside of the military healthcare network. Further analysis of the many factors including, but not limited to, referral process for total joint arthroplasty, time to procedure, and facility resources is required, in addition to assessing patient outcomes following the procedures.
Strong chemical tagging with APOGEE: 21 candidate star clusters that have dissolved across the Milky Way disc
Authors: Price-Jones Natalie , Bovy Jo , Webb Jeremy J , Allende Prieto Carlos , Beaton Rachael , Brownstein Joel R , Cohen Roger E , Cunha Katia , Donor John , Frinchaboy Peter M , García-Hernández D A , Lane Richard R , Majewski Steven R , Nidever David L , Roman-Lopes Alexandre 
Published: July 2020

ABSTRACT
Chemically tagging groups of stars born in the same birth cluster is a major goal of spectroscopic surveys. To investigate the feasibility of such strong chemical tagging, we perform a blind chemical tagging experiment on abundances measured from APOGEE survey spectra. We apply a density-based clustering algorithm to the 8D chemical space defined by [Mg/Fe], [Al/Fe], [Si/Fe], [K/Fe], [Ti/Fe], [Mn/Fe], [Fe/H], and [Ni/Fe], abundances ratios which together span multiple nucleosynthetic channels. In a high-quality sample of 182 538 giant stars, we detect 21 candidate clusters with more than 15 members. Our candidate clusters are more chemically homogeneous than a population of non-member stars with similar [Mg/Fe] and [Fe/H], even in abundances not used for tagging. Group members are consistent with having the same age and fall along a single stellar-population track in log g versus Teff space. Each group’s members are distributed over multiple kpc, and the spread in their radial and azimuthal actions increases with age. We qualitatively reproduce this increase using N-body simulations of cluster dissolution in Galactic potentials that include transient winding spiral arms. Observing our candidate birth clusters with high-resolution spectroscopy in other wavebands to investigate their chemical homogeneity in other nucleosynthetic groups will be essential to confirming the efficacy of strong chemical tagging. Our initially spatially compact but now widely dispersed candidate clusters will provide novel limits on chemical evolution and orbital diffusion in the Galactic disc, and constraints on star formation in loosely bound groups.
Hyper-Eddington accretion flows on to black holes accompanied by powerful outflows
Authors: Takeo Eishun , Inayoshi Kohei , Mineshige Shin 
Published: July 2020

ABSTRACT
We perform two-dimensional radiation hydrodynamical simulations of accretion flows on to black holes (BHs) at the nuclei of protogalaxies, and study the impact of mechanical and radiative feedback on rapid growth of BHs. The outflows deposit mass, momentum, and energy into the surrounding medium and prevent mass accretion on to the BH, resulting in the reduction of radiative output. We find that when the BH is embedded in a dense gas core, ionizing radiation attenuated by inefficient BH feeding owing to mechanical feedback hardly affects the gas dynamics at the BH gravitational sphere of influence, from which intense inflows of neutral gas occur at rates substantially exceeding the Eddington limit without impeded by photoionization and heating. Since mechanical power of outflows driven by the rapidly accreting BH is sufficiently strong, bipolar outflows completely evacuate the surrounding gas in the polar region but mass inflows through the equatorial region maintain the BH accretion rate as high as $\sim 300\!-\!10^3~\dot{M}_{\rm Edd}$, which is reduced by one order of magnitude from those with radiative feedback alone. Furthermore, we find that the critical gas density required for rapid accretion is lower by a factor of ∼3, when mechanical feedback is considered. By studying the dependence on outflow parameters (e.g. opening angle, mass loading degree into outflows, velocity), we conclude that contrary to naive expectation, the stronger outflow leads to the transition to rapid accretion more efficiently. Rapidly growing BHs inject mechanical power with $\sim 0.1\!-\!1{{\ \rm per\ cent}}$ of the radiative luminosity into their host galaxy scales, which is used for cosmological simulations.
Enhancement of the tidal disruption event rate in galaxies with a nuclear star cluster: from dwarfs to ellipticals
Authors: Pfister Hugo , Volonteri Marta , Dai Jane Lixin , Colpi Monica 
Published: July 2020

ABSTRACT
We compute the tidal disruption event (TDE) rate around local massive black holes (MBHs) with masses as low as $2.5\times 10^4\, \mathrm{M}_{\odot }$, thus probing the dwarf regime for the first time. We select a sample of 37 galaxies for which we have the surface stellar density profile, a dynamical estimate of the mass of the MBH, and 6 of which, including our Milky Way, have a resolved nuclear star cluster (NSC). For the Milky Way, we find a total TDE rate of ${\sim}10^{-4}\, \mathrm{yr}^{-1}$ when taking the NSC in account, and ${\sim}10^{-7} \, \mathrm{yr}^{-1}$ otherwise. TDEs are mainly sourced from the NSC for light (${\lt}3\times 10^{10}\, \mathrm{M}_{\odot }$) galaxies, with a rate of few $10^{-5}\, \mathrm{yr}^{-1}$, and an enhancement of up to two orders of magnitude compared to non-nucleated galaxies. We create a mock population of galaxies using different sets of scaling relations to explore trends with galaxy mass, taking into account the nucleated fraction of galaxies. Overall, we find a rate of few $10^{-5}\, \mathrm{yr}^{-1}$ which drops when galaxies are more massive than $10^{11}\, \mathrm{M}_{\odot }$ and contain MBHs swallowing stars whole and resulting in no observable TDE.
A search for the modern counterparts of the Far Eastern guest stars 369 CE, 386 CE and 393 CE
Authors: Hoffmann Susanne M , Vogt Nikolaus 
Published: July 2020

ABSTRACT
In this study, we apply our previously developed method to investigate ancient transient sightings in order to derive consequences for modern astrophysical problems. We present case studies of three observations of so-called guest stars in the fourth century CE, which lasted several months each. These three observations had been discussed and suggested as possible supernovae, but slow novae are also viable alternatives. Our careful re-interpretation of the historical texts and the currently known objects in the given fields shed new light on this topic. In particular, for the two events in 386 and 393 CE we suggest possible supernova identifications, while in all three cases there are interesting candidates for past classical or recurrent nova eruptions among known cataclysmic variables (CVs) and/or symbiotic stars. We suggest that the transient of 369 can be explained as a classical and possibly recurrent nova instead of a supernova. The most plausible candidates are BZ Cam, a CV with a possible nova shell, or CQ Dra, a naked-eye multiple system perhaps able to permit an overwhelmingly bright nova with day-time visibility.
The Current Status of Research on Gibberellin Biosynthesis
Authors: Hedden Peter 
Published: July 2020

AbstractGibberellins are produced by all vascular plants and several fungal and bacterial species that associate with plants as pathogens or symbionts. In the 60 years since the first experiments on the biosynthesis of gibberellic acid in the fungus Fusarium fujikuroi, research on gibberellin biosynthesis has advanced to provide detailed information on the pathways, biosynthetic enzymes and their genes in all three kingdoms, in which the production of the hormones evolved independently. Gibberellins function as hormones in plants, affecting growth and differentiation in organs in which their concentration is very tightly regulated. Current research in plants is focused particularly on the regulation of gibberellin biosynthesis and inactivation by developmental and environmental cues, and there is now considerable information on the molecular mechanisms involved in these processes. There have also been recent advances in understanding gibberellin transport and distribution and their relevance to plant development. This review describes our current understanding of gibberellin metabolism and its regulation, highlighting the more recent advances in this field.
A familial cluster of coronavirus disease 2019 (COVID-19) caused by one family member during his asymptomatic incubation period
Authors: Sang Hao , Cui Yan , Lai Xiaobin , Zhang Yuyan , Kong Lingna , Jiang Xiaoli , Liu Hui , Zhang Jie , Ye Jun , Gu Wenchao , Fang Chenfei , Zhang Huansheng 
Published: July 2020

Abstract
An ongoing outbreak of coronavirus disease 2019 (COVID-19) has rapidly spread in the world, whereas asymptomatic carriers may also play a critical role in the pandemic. We report a familial cluster of COVID-19 caused by one family member before his onset of illness, indicating that it seems to be potentially infectious during the incubation period, even earlier than we expected. Close contact, especially in a small enclosed space, might be the cause of familial transmission. The unsynchronized changes in the clinical symptoms and COVID-19 nucleic acid were found in this case, so consecutive nucleic acid detection of pretty suspected cases was recommended. Family members, especially of whom the confirmed cases contacted with since one incubation period before onset rather than 2 days before onset, should be regarded as close contact and centrally isolated in case of asymptomatic infection already existed in the family.
Skyrmions, Tetrahedra and Magic Numbers
Authors: Manton Nicholas S 
Published: July 2020

Abstract
Michael Atiyah’s interest in Skyrmions and their relationship to monopoles and instantons is recalled. Some approximate models of Skyrmions with large baryon numbers are then considered. Skyrmions having particularly strong binding are clusters of unit baryon number Skyrmions arranged as truncated tetrahedra. Their baryon numbers, $B = 4 \,, 16 \,, 40 \,, 80 \,, 140 \,, 224$, are the tetrahedral numbers multiplied by four, agreeing with the magic proton and neutron numbers $2 \,, 8 \,, 20 \,, 40 \,, 70 \,, 112$ occurring in the nuclear shell model in the absence of strong spin-orbit coupling.
The management of neuropsychiatric lupus in the 21st century: still so many unmet needs?
Authors: Govoni Marcello , Hanly John G 
Published: July 2020

AbstractNeuropsychiatric (NP) events occur in the majority of patients with SLE and predominantly affect the CNS in addition to the peripheral and autonomic systems. Approximately 30% of all NP events are attributable to SLE (NPSLE) and present most frequently around the time of SLE onset. NPSLE is associated with increased morbidity and mortality and the proposed pathogenesis includes both ischaemic and neuroinflammatory mechanisms. Following diagnosis and causal attribution, the treatment of NPSLE is tailored to the type of NP event, the predominant putative pathogenic pathway and the activity and severity of the clinical event. There is a dearth of controlled clinical trials to guide management, but therapeutic options include symptomatic, antithrombotic and immunosuppressive agents that are supported by observational cohort studies. Our objective was to review what is currently known about NPSLE and to identify deficiencies in diagnostic biomarkers, novel therapies and clinical trials for this manifestation of SLE.
Variation in the pharmacokinetics of glucosamine in healthy individuals
Authors: Asthana Chhavi , Peterson Gregory M , Shastri Madhur D , Patel Rahul P 
Published: July 2020

Abstract

Objectives
Clinical trial data for the efficacy of glucosamine in OA are conflicting. Reportedly, Rotta-manufactured glucosamine products are more likely to be effective, and a possible explanation is greater bioavailability than other brands. Specifically, the aim was to compare the steady-state pharmacokinetics of Rotta- and non-Rotta-manufactured glucosamine products in healthy volunteers and examine the interindividual variability.

Methods
In a crossover design, healthy adult participants ingested 1500 mg/day of a Rotta (DONA powder sachets; imported by Mylan Health, Carole Park, QLD, Australia) and a non-Rotta (glucosamine sulphate 1500 mg one-a-day tablet; Blackmores, Warriewood, NSW, Australia) glucosamine product/brand individually for 6 days. Blood samples were collected immediately before and for 12 h after the ingestion of the last dose of each brand and analysed to determine plasma levels of glucosamine. The pharmacokinetic parameters at steady state [including the minimum (Css min) and maximum (Css max) plasma concentration of glucosamine, time to reach Css max post-dosing (Tss max) and area under the plasma concentration vs time curve (AUCss 0–12)] for each brand were calculated and statistically compared.

Results
Fourteen participants [mean age 35.5 years (s.d. 8.8)] were recruited (64.2% males). No significant differences were observed in the pharmacokinetic parameters between the two brands. However, for both brands, the coefficient of variation for Css min, Tss max and AUCss 0–12 exceeded 20%, indicating considerable differences in the parameters between participants. No significant association of the pharmacokinetic parameters was observed with various dosing- and participant-related variables.

Conclusion
Substantial interindividual differences in the absorption and elimination of glucosamine could be a cause of variable clinical outcomes in OA.

Trial registration
The study was registered with the Australian New Zealand Clinical Trials Registry (http://www.ANZCTR.org.au/ACTRN12618000699268p.aspx), number ACTRN12618000699268p.
Elevated serum level of hepatocyte growth factor predicts development of new syndesmophytes in men with ankylosing spondylitis
Authors: Deminger Anna , Klingberg Eva , Nurkkala Merja , Geijer Mats , Carlsten Hans , Jacobsson Lennart T H , Forsblad-d’Elia Helena 
Published: July 2020

AbstractObjectivesTo study baseline serum hepatocyte growth factor (s-HGF) as a predictor of spinal radiographic progression overall and by sex and to analyse factors correlated to changes in s-HGF in patients with AS.MethodsAt baseline and the 5-year follow-up, s-HGF was analysed with ELISA. Spinal radiographs were graded according to modified Stoke Ankylosing Spondylitis Spinal Score. Radiographic progression was defined as ≥2 modified Stoke Ankylosing Spondylitis Spinal Score units/5 years or development of ≥1 syndesmophyte. Logistic regression analyses were used.ResultsOf 204 baseline participants, 163 (80%) completed all examinations at the 5-year follow-up (54% men). Baseline s-HGF was significantly higher in men who developed ≥1 syndesmophyte compared with non-progressors, median (interquartile range) baseline s-HGF 1551 (1449–1898) vs 1436 (1200–1569) pg/ml, P = 0.003. The calculated optimal cut-off point for baseline s-HGF ≥1520 pg/ml showed a sensitivity of 70%, a specificity of 69% and univariate odds radio (95% CI) of 5.25 (1.69, 14.10) as predictor of development of ≥1 new syndesmophyte in men. Baseline s-HGF ≥1520 pg/ml remained significantly associated with development of ≥1 new syndesmophyte in men in an analysis adjusted for the baseline variables age, smoking, presence of syndesmophytes and CRP, odds radio 3.97 (1.36, 11.60). In women, no association with HGF and radiographic progression was found. Changes in s-HGF were positively correlated with changes in ESR and CRP.ConclusionIn this prospective cohort study elevated s-HGF was shown to be associated with development of new syndesmophytes in men with AS.