bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinical Significance of Anti-Modified Citrullinated Vimentin Antibodies in Palindromic Rheumatism
Authors: Malek Mahdavi Aida , Rashtchizadeh Nadereh , Khaknejad Mahsanam , Sakhinia Ebrahim , Khabbazi Alireza , Kolahi Sousan 
Published: October 2020

Abstract

Objective
This study evaluated anti-modified citrullinated vimentin (anti-MCV) performance in determining the clinical picture and outcomes of palindromic rheumatism (PR).

Methods
In a retrospective study, patients with PR with at least 1 year of follow-up diagnosed according to clinical criteria were enrolled. Anti-MCV antibodies were measured, and levels &gt;20 IU/mL were considered positive. Disease prognosis was assessed according to patients acquiring remission and preventing PR from developing into rheumatoid arthritis (RA) or other diseases.

Results
Seventy-six patients with PR with a mean follow-up of 30.57 months (median = 21 months; minimum = 12 months; maximum = 48 months) were included in the study. Anti-MCV antibodies were positive in 69.7% of patients. Metacarpophalangeal (MCP) joint involvement and positive anti-cyclic citrullinated peptides were significantly higher in patients who were anti-MCV-positive, whereas ankle joint involvement was significantly lower. No significant correlation was observed between the anti-MCV titer and the severity of attacks. Remission in patients who were anti-MCV-positive and negative was 75.5% and 78.3%, respectively, with no significant difference. Evolution to RA was observed in only 3.8% of patients who were anti-MCV-positive. No patients who were anti-MCV-negative developed RA.

Conclusion
Except for MCP and ankle joint involvement, anti-MCV was not helpful in determining the clinical picture and outcome of PR.
Obstacles to an Effective Low-Titer O Walking Blood Bank: A Deployed Unit’s Experience
Authors: Gaspary Micah J , Kyle Adrianna I , Lawson Scott M , Birkla James , Bolton Elisha D , Bergeron Kyle P , Tiller Michael M 
Published: October 2020

ABSTRACTIntroductionWe present the experience of our U.S. Navy Role 2’s deployment to the U.S. Central Command area of responsibility in support of Operation Inherent Resolve and serving a multinational, joint-service military base. We detail our efforts to establish a low-titer O (LTO) walking blood bank (WBB) in an effort to prepare for potential combat casualties.Materials and MethodsWe decided on an LTO WBB based on our available resources and a review of the literature. We collected blood samples from volunteer O-type donors throughout deployment. We conducted some titers locally and sent all samples to the ASBP in San Antonio for confirmatory testing. We conducted internal training on the WBB to improve our efficiency. We conducted monthly base-wide drills and blood drives to increase our donor pool and improve coordination between the multiple units on base.ResultsWe were able to collect samples from 108 military members during our deployment. Because of cold chain and shipping issues, by the time we departed theater, we had confirmation of 31 LTO donors from the Armed Services Blood Program. Thanks to local titers and units arriving to theater with titers complete; we were able to maintain an LTO donor pool close to our intended target of 50 available donors through most of our deployment.ConclusionsA WBB based on LTO blood is possible in theater. In order to maximize donor pools, it is imperative that units deploying to forward areas complete titer and transfusion transmissible disease testing before arrival in theater.
“Road Rash” and Dizziness: A Case of Hemodynamically Significant Topical Clonidine Toxicity
Authors: Downs John W , Cumpston Kirk L 
Published: October 2020

ABSTRACT
Clonidine is a central alpha-2 agonist well known to produce a syndrome of bradycardia and hypotension in overdose. However, few examples of overt clinical clonidine toxicity secondary to cutaneous absorption have been reported. We report a case of unintentional systemic clonidine toxicity in an adult because of a compounded preparation of clonidine applied to a degraded skin barrier. A 35-year-old male suffered a motorcycle accident 48 hours before presentation resulting in an abrasion to his distal left leg. On the day of presentation, he self-treated the wound by repeated application of a family member’s pain-relieving cream. Later he was found confused and unable to stand by a family member. The family member recognized the thick visible coat of cream as the likely cause and decontaminated the patient while calling 911. Prehospital vitals were notable for a blood pressure of 80/30 mm Hg and heart rate of 38 beats per minute. In the emergency department, the patient was resuscitated with intravenous fluids with resultant normalization of blood pressure. Upon later review, the cream was determined to have been created by a local compounding pharmacy for the use in neuropathic pain and was labeled to contain clonidine, lidocaine, ketamine, and gabapentin. Cutaneous absorption of the pain cream was greatly increased because of loss of skin integrity. Military physicians and compounding pharmacies should ensure that patients are aware of the proper application of compounded creams and the potential risk for systemic toxicity with overuse or degraded skin.
An Assessment of Pre-deployment Training for Army Nurses and Medics
Authors: Suresh Mithun R , Valdez-Delgado Krystal K , Staudt Amanda M , Trevino Jennifer D , Mann-Salinas Elizabeth A , VanFosson Christopher A 
Published: October 2020

ABSTRACT

Introduction
Although military nurses and medics have important roles in caring for combat casualties, no standardized pre-deployment training curriculum exists for those in the Army. A large-scale, survey-based evaluation of pre-deployment training would help to understand its current state and identify areas for improvement. The purpose of this study was to survey Army nurses and medics to describe their pre-deployment training.

Materials and Methods
Using the Intelink.gov platform, a web-based survey was sent by e-mail to Army nurses and medics from the active and reserve components who deployed since 2001. The survey consisted of questions asking about pre-deployment training from their most recent deployment experience. Descriptive statistics were used to analyze the results, and free text comments were also captured.

Results
There were 682 respondents: 246 (36.1%) nurses and 436 (63.9%) medics. Most of the nurses (n = 132, 53.7%) and medics (n = 298, 68.3%) reported that they were evaluated for clinical competency before deployment. Common courses and topics included Tactical Combat Casualty Care, Advanced Cardiac Life Support, cultural awareness, and trauma care. When asked about the quality of their pre-deployment training, most nurses (n = 186; 75.6%) and medics (n = 359; 82.3%) indicated that their training was adequate or better. Nearly all nurses and medics reported being moderately confident or better (nurses n = 225; 91.5% and medics n = 399; 91.5%) and moderately prepared or better (nurses n = 223; 90.7% and medics n = 404; 92.7%) in their ability to provide combat casualty care. When asked if they participated in a team-based evaluation of clinical competence, many nurses (n = 121, 49.2%) and medics (n = 180, 41.3%) reported not attending a team training program.

Conclusions
Most nurse and medic respondents were evaluated for clinical competency before deployment, and they attended a variety of courses that covered many topics. Importantly, most nurses and medics were satisfied with the quality of their training, and they felt confident and prepared to provide care. Although these are encouraging findings, they must be interpreted within the context of self-report, survey-based assessments, and the low response rate. Although these limitations and weaknesses of our study limit the generalizability of our results, this study attempts to address a critical knowledge gap regarding pre-deployment training of military nurses and medics. Our results may be used as a basis for conducting additional studies to gather more information on the state of pre-deployment training for nurses and medics. These studies will hopefully have a higher response rate and better quantify how many individuals received any form of pre-deployment training. Additionally, our recommendations regarding pre-deployment training that we derived from the study results may be helpful to military leadership.
The Impact of a Virtual Radiology Medical Student Rotation: Maintaining Engagement During COVID-19 Mitigation
Authors: Adams Chad C , Shih Robert , Peterson Paul G , Lee Mike H , Heltzel David A , Lattin Grant E 
Published: October 2020

ABSTRACT

Introduction
The purpose of this study is to introduce a virtual radiology rotation curriculum that is being used to safely maintain medical student and intern education and engagement with the Department of Radiology at Walter Reed National Military Medical Center during coronavirus disease 2019 (COVID-19) mitigation.

Materials and Methods
The curriculum is designed as a 4-week block with each week representing one of the four highest yield radiology subspecialties for medical students; neuroradiology, thoracic radiology, body radiology, and musculoskeletal radiology. A subspecialist radiologist from each section was identified as a primary mentor and tasked with designing a daily schedule for medical students and interns. The first 2 months of virtual rotators were surveyed to assess the effectiveness of the course.

Results
Thirty-five of 41 rotators responded to the survey, a response rate of 85%. Thirty-one of 35 (89%) of the rotators gave this virtual elective rotation a positive rating, with 16 trainees scoring the course as 4 out of 5 and 15 trainees selecting 5 out of 5. Four respondents selected 3 out of 5. Five out of 5 respondents who had experienced an in-person radiology elective rotation before this virtual rotation rated the virtual elective as more educational than the in-person rotation. We found the 4-week subspecialist mentor-based structure to be highly versatile, allowing us to simultaneously accommodate multiple groups of full or partial block rotators throughout COVID-19 mitigation.

Conclusion
A virtual rotation curriculum is a viable method of maintaining medical student and intern education and engagement with the department of radiology during COVID-19 mitigation.
Cosmological constraints from CODEX galaxy clusters spectroscopically confirmed by SDSS-IV/SPIDERS DR16
Authors: Ider Chitham J , Comparat J , Finoguenov A , Clerc N , Kirkpatrick C , Damsted S , Kukkola A , Capasso R , Nandra K , Merloni A , Bulbul E , Rykoff E S , Schneider D P , Brownstein J R 
Published: October 2020

ABSTRACT
This paper presents a cosmological analysis based on the properties of X-ray selected clusters of galaxies from the CODEX survey which have been spectroscopically followed up within the SPIDERS programme as part of the sixteenth data release (DR16) of SDSS-IV. The cosmological sub-sample contains a total of 691 clusters over an area of 5350 deg2 with newly measured optical properties provided by a reanalysis of the CODEX source catalogue using redMaPPer and the DESI Legacy Imaging Surveys (DR8). Optical richness is used as a proxy for the cluster mass, and the combination of X-ray, optical, and spectroscopic information ensures that only confirmed virialized systems are considered. Clusters are binned in observed redshift, $\tilde{z} \in \left[0.1, 0.6 \right)$ and optical richness, $\tilde{\lambda } \in \left[25, 148 \right)$ and the number of clusters in each bin is modelled as a function of cosmological and richness–mass scaling relation parameters. A high-purity sub-sample of 691 clusters is used in the analysis and best-fitting cosmological parameters are found to be $\Omega _{m_{0}}=0.34^{+0.09}_{-0.05}$ and $\sigma _8=0.73^{+0.03}_{-0.03}$. The redshift evolution of the self-calibrated richness–mass relation is poorly constrained due to the systematic uncertainties associated with the X-ray component of the selection function (which assumes a fixed X-ray luminosity–mass relation with h = 0.7 and $\Omega _{m_{0}}=0.30$). Repeating the analysis with the assumption of no redshift evolution is found to improve the consistency between both cosmological and scaling relation parameters with respect to recent galaxy cluster analyses in the literature.
The search for magnetic fields in two Wolf–Rayet stars and the discovery of a variable magnetic field in WR 55
Authors: Hubrig S , Schöller M , Cikota A , Järvinen S P 
Published: October 2020

ABSTRACT
Magnetic fields in Wolf–Rayet (WR) stars are not well explored, although there is indirect evidence, e.g. from spectral variability and X-ray emission, that magnetic fields should be present in these stars. Being in an advanced stage of their evolution, WR stars have lost their hydrogen envelope, but their dense winds make the stellar core almost unobservable. To substantiate the expectations on the presence of magnetic fields in the most-evolved massive stars, we selected two WR stars, WR 46 and WR 55, for the search of the presence of magnetic fields using FORS 2 spectropolarimetric observations. We achieve a formally definite detection of a variable mean longitudinal magnetic field of the order of a few hundred gauss in WR 55. The field detection in this star, which is associated with the ring nebula RCW 78 and the molecular environment, is of exceptional importance for our understanding of star formation. No field detection at a significance level of 3σ was achieved for WR 46, but the variability of the measured field strengths can be rather well phased with the rotation period of 15.5 h previously suggested by FUSE(Far Ultraviolet Spectroscopic Explorer) observations.
ERH facilitates microRNA maturation through the interaction with the N-terminus of DGCR8
Authors: Kwon S Chul , Jang Harim , Shen Siyuan , Baek S Chan , Kim Kijun , Yang Jihye , Kim Jeesoo , Kim Jong-Seo , Wang Suman , Shi Yunyu , Li Fudong , Kim V Narry 
Published: October 2020

AbstractThe microprocessor complex cleaves the primary transcript of microRNA (pri-miRNA) to initiate miRNA maturation. Microprocessor is known to consist of RNase III DROSHA and dsRNA-binding DGCR8. Here, we identify Enhancer of Rudimentary Homolog (ERH) as a new component of Microprocessor. Through a crystal structure and biochemical experiments, we reveal that ERH uses its hydrophobic groove to bind to a conserved region in the N-terminus of DGCR8, in a 2:2 stoichiometry. Knock-down of ERH or deletion of the DGCR8 N-terminus results in a reduced processing of suboptimal pri-miRNAs in polycistronic miRNA clusters. ERH increases the processing of suboptimal pri-miR-451 in a manner dependent on its neighboring pri-miR-144. Thus, the ERH dimer may mediate ‘cluster assistance’ in which Microprocessor is loaded onto a poor substrate with help from a high-affinity substrate in the same cluster. Our study reveals a role of ERH in the miRNA biogenesis pathway.
Histopathologic findings in malignant peripheral nerve sheath tumor predict response to radiotherapy and overall survival
Authors: Lucas Calixto-Hope G , Vasudevan Harish N , Chen William C , Magill Stephen T , Braunstein Steve E , Jacques Line , Dahiya Sonika , Rodriguez Fausto J , Horvai Andrew E , Perry Arie , Pekmezci Melike , Raleigh David R 
Published: October 2020

Abstract

Background
Malignant peripheral nerve sheath tumor (MPNST) is an aggressive and poorly understood malignant neoplasm. Even in the setting of multimodal therapy, the clinical course of MPNST is frequently marked by metastatic conversion and poor overall prognosis, with optimal treatment paradigms for this rare tumor unknown.

Methods
We reviewed the medical records and histopathology of 54 consecutive patients who were treated at University of California San Francisco between 1990 and 2018.

Results
Our cohort consisted of 24 male and 30 female patients (median age 38 years). Fédération Nationale des Centres de Lutte Contre Le Cancer (FNCLCC) sarcoma grading criteria segregated patients into groups with differences in overall survival (OS) (P = .02). Increasing Ki-67 labeling index was associated with poor OS (hazard ratio [HR] 1.36 per 10%, P = .0002). Unsupervised hierarchical clustering-based immunohistochemical staining patterns identified 2 subgroups of tumors with differences in H3K27me3, Neurofibromin, S100, SOX10, p16, and EGFR immunoreactivity. In our cohort, cluster status was associated with improved locoregional failure-free rate (P = .004) in response to radiation.

Conclusions
Our results lend support to the FNCLCC sarcoma grading criteria as a prognostic scheme for MPNST, although few cases of grade 1 were included. Further, we identify increased Ki-67 labeling as a strong predictor of poor OS from MPNST. Finally, we identify a subset of MPNSTs with a predictive immunohistochemical profile that has improved local control with adjuvant radiotherapy. These data provide insights into the grading and therapy for patients with MPNST, although further studies are needed for independent validation.
On the Moral Necessity of Tort Law: The Fairness Argument
Authors: Steel Sandy 
Published: October 2020

Abstract
Various theorists have claimed that by prohibiting certain responses to violations of rights by legal subjects, the legal system owes legal subjects something in return, and that something should take the form of tort law. My overall claim is that the best version of this ‘fairness argument’ for a duty to provide tort law is of limited success. The fairness argument, at best, shows that legal systems are under a pro tanto duty to provide only a highly limited form of tort law. The article first seeks to articulate the most powerful version of the fairness argument. It then argues, through consideration of four objections, that the argument justifies at best a pro tanto duty to provide a highly limited form of tort law, if it justifies a duty to provide tort law at all.
Vitamin D Status of Very Low Birth Weight Neonates at Baseline and Follow-up after Daily Intake of 800 IU Vitamin D
Authors: Choudhury Khurshed Alam , Kumar Mala , Tripathi Shalini , Singh S N , Singh Kalpana , Singh V K 
Published: October 2020

Introduction
Vitamin D deficiency (VDD) is rampant in neonates. Recommendations for supplementation are variable.

Methods
An observational study was done on less than 32 weeks of very low birth weight neonates to find prevalence of VDD (&lt;20 ng/ml) at baseline; at 38 ± 2 weeks post-menstrual age (PMA) after daily intake of 800 IU vitamin D (vit D). Secondary objectives were to find determinants of VDD, to compare growth in deficient; vit D sufficient (VDS) neonates; to find vit D toxicity.

Results
Of 83 neonates, 81 (97.6%) were VDD at baseline and 5 (6%) at 38 ± 2 weeks PMA. Determinants for VDD at baseline were inadequate maternal sun exposure (p &lt; 0.001) and vit D supplementation (p = 0.007). Factors for VDD at 38 ± 2 weeks PMA were male gender (p = 0.049), morbidities (p = 0.006), ventilation &gt;24 h (&lt;0.001), sepsis (p = 0.032), caffeine (p ≤ 0.001) and missed supplements (p &lt; 0.001). Weight and length gain of VDD to VDS neonates were (6.70 ± 2.40 to 8.96 ± 2.21 g/day); (0.82 ± 0.34 to 1.08 ± 0.37 cm/week), respectively (p &lt; 0.001). Head circumference gain (cm/week) of VDS; VDD neonates was 0.58 ± 0.09; 0.54 ± 0.06 (p = 0.054), respectively. No neonates developed vit D toxicity.

Conclusions
In preterm VLBW neonates, the prevalence of VDD was 97.6% but decreased by &gt;90% at 38 ± 2 weeks with a daily intake of 800 IU vit D. Inadequate maternal vit D intake and sun exposure determined low baseline vit D status of neonates. Male gender, morbidities, ventilation, sepsis, caffeine, missed vitamin D supplements were determinants of poor vit D status at follow-up. Weight gain and length increments were more in the VDS group.
Geometric morphometrics of mandibular shape in the dwarf fat-tailed jerboa: relevancy for trinomial taxonomy
Authors: Kryštufek Boris , Shenbrot Georgy , Klenovšek Tina , Janžekovič Franc 
Published: October 2020

AbstractWe explore the pattern of spatial variation in mandibular morphology in relation to subspecific taxonomy in the dwarf fat-tailed jerboa, Pygeretmus pumilio. The unguided k-means clustering on mandible shape scores, partitioned populations into two clusters, corresponding to western and eastern populations. These clusters nearly perfectly matched the two subspecies groups (pumilio and potanini groups) recognized in an independent study based on the morphology of the glans penis. The mandible, although under environmental pressure, has retained a sufficient amount of taxonomic information to retrieve grouping closely resembling the one derived from a sexually selective trait. We recommend morphometrics of the mandible as a routine step in addressing variations in mammals at species and subspecies levels. We also stress the advantage of unsupervised k-clustering in testing null expectation in subspecies taxonomies. However, the power of this approach has its limitations and in our analysis, the k-clustering failed to retrieve subspecies in the potanini group.
Marzanoptera tersillae, a new balaenopterid genus and species from the Pliocene of Piedmont, north-west Italy
Authors: Bisconti Michelangelo , Damarco Piero , Pavia Marco , Sorce Barbara , Carnevale Giorgio 
Published: October 2020

AbstractMarzanoptera tersillae gen. & sp. nov., a new balaenopterid from the Pliocene of the Piedmont in north-west Italy, is described based on a partial skeleton and compared with other living and fossil baleen whales. Marzanoptera tersillae shares characters, such as the shape of the supraoccipital, glenoid fossa of the squamosal and zygomatic process of the squamosal, with ‘Balaenoptera’ bertae. We used a computed tomography scan to view parts of the skull that were otherwise impossible to observe, such as the periotic. A phylogenetic analysis based on 355 character states scored from 87 taxa revealed a well-resolved hypothesis of relationships for Balaenopteridae and a general phylogenetic hypothesis for chaeomysticetes. The monophyly of all superfamily- and family-rank clades and of crown balaenopterid species was confirmed. In addition, a monophyletic group including most basal thalassotherian taxa was recovered. The mollusc fauna associated with the specimen was autochtonous and constituted a residual fossil assemblage indicative of an environmental context located below the base of the storm wave, characterized by a low-energy hydrodynamic regimen. Many shark teeth have been found in close association or embedded within the bones, suggesting a possible scavenging action by two shark species on the whale carcass.