bluuebunny/crossref_metadata_2025_split huggingface dataset:
Non-Battle Injuries presenting to the Force Medical Rehabilitation Team on Operation GRITROCK
Authors: Scott P J I 
Published: January 2021

AbstractNon-Battle Injuries (NBI) represent a significant attritional threat to personnel deployed on operations. Operation (Op) GRITROCK involved personnel deployed across both land and maritime environments and was the first deployment of the Primary Casualty Receiving Facility (PCRF) on contingency operations of this type. This article outlines the incidence, demographics and functional outcome of individuals assessed for NBI by the embarked rehabilitation team. A total of 138 injured individuals were assessed over the period Oct 2014 - Mar 2015. ARGUS personnel made up 83.3% (n=115) of the injured population. Most common presentations were low back pain (LBP) (21%) and soft tissue lower limb injuries (14.5%), primarily occurring through individual sport (42.8%) or normal duty (34.8%). The Force Medical Rehabilitation Team (FMRT) effectively retained troops in theatre; although 22.5% (n=31) were considered urgent cases, only one individual required medical evacuation. 53.6% of presentations were exacerbations of a previous injury. Future work will examine the long-term outcome of these injuries.
An unusual rash for Royal: a case series
Authors: Booth B , Furzeland J 
Published: January 2021

AbstractEight patients, whilst on exercise in Albania, presented with a blistering, erythematous and itchy rash, consistent with caustic burns, after living in dense vegetation for a few days. All patients were found to have been living and operating under fig trees and had come into contact with the sap ofFicus carica, which on exposure to ultraviolet A (UVA) radiation, can cause a process of phytophotodermatitis leading to a blistering rash.
High altitude adaptation and illness: military implications
Authors: Bakker-Dyos J , Vanstone S , Mellor AJ 
Published: January 2021

AbstractBritish military personnel are frequently exposed to high altitude (HA) (>1500m). Operations in Afghanistan have occurred at altitudes of up to 3000m and there remains the possibility of rapid deployment of non-acclimatised troops to HA areas. British military personnel also deploy to HA frequently on Adventurous Training (AT) and there are numerous expeditions every year to the Greater Ranges. As such, there remains a reasonable likelihood of the development of high altitude illness (HAI) with potentially life-threatening consequences. This article aims to provide an overview of the adaptive (acclimatisation) and pathological (acute HAI) responses to HA exposure, with particular reference to military deployments.
The Medical Reception Station: a new primary care capability for 3 Commando Brigade
Authors: McMenamin D , Baker J , Middleton M 
Published: January 2021

Abstract3 Commando Brigade’s delivery of pre-hospital (Role 1) care has until now largely been based around junior doctors delivering trauma-based resuscitation and limited primary care from small self-contained Regimental Aid Posts (RAPs). With the drawdown of large scale operations in Iraq and Afghanistan, and the diversity of potential future military operations, the deficiency of General Practitioner(GP)-led care in the deployed setting has become more evident, and this has driven the requirement for a deployable primary care facility in the form of a Medical Reception Station (MRS). This paper describes the evolution of this project, the realities of deploying a new medical capability for the first time, some of the issues faced, and the potential utility of such a medical facility in future.
The athletic ECG
Authors: Proffitt A , Rees P 
Published: January 2021

AbstractThe electrocardiogram (ECG) is the most frequently performed basic cardiology investigation. Correct interpretation of the ECG is vital, both to confirm acute diagnoses such as myocardial infarction, and in the elective setting to diagnose previous or underlying cardiac abnormalities. Normal electrocardiographic parameters for the multiple components of the ECG have been identified and are applied to the general population, but it is acknowledged that cardiac conditioning occurs with frequent and sustained aerobic exercise, in turn leading to physiological changes in the ECG. Service personnel may perform exercise at a level that leads to cardiac conditioning with associated ECG changes. This clinical review will briefly address the normal ECG and consider changes associated with aerobic cardiac conditioning. By identifying what constitutes physiological non-pathological changes in the athletic ECG, this clinical review aims to assist those who interpret ECGs in Service personnel.
Winter Deployment 14 and 15: an audit of injury and illness rates in an Arctic environment
Authors: Patel PJ , Bakker-Dyos J , McMenamin D 
Published: January 2021

AbstractIntroductionArduous military training in a cold weather environment is likely to lead to a variety of injuries to the population at risk (PAR). This paper examines injury rates and medical presentations over the two years of Winter Deployments in 2014 and 2015 (WD14 and WD15) and proposes recommendations for future WDs.MethodData on injury rates, number of aeromedical evacuations, and number of days of restricted duties allocated were collected prospectively for all patients presenting to Asegarden Medical Centre, Norway, during WD14 and WD15. The data were calculated as a percentage of the total PAR on each deployment to allow meaningful comparison.ResultsDuring WD14, 22.8% of the PAR presented to the Medical Centre compared to 26.9% during WD15. WD15 saw a reduction in the presentation of musculoskeletal (MSK) injuries, cold weather (CW) injuries and burns. Skin problems and diarrhoea and vomiting (D&V) remained similar in both years. An increase in dental and other presentations was seen in WD15. A reduction in the overall aeromedical evacuations and number of patients requiring a light duties (LD) chit was seen during WD15.ConclusionWD15 has seen a decrease in injury rates, the number of aeromedical evacuations and LD chits issued. It is difficult to know whether these changes are a result of improved medical support, training or equipment. The liaison between the command, medical and training elements has led to improvements and should now concentrate on ways to further reduce injury rates whilst maximising arduous training benefits in an Arctic environment.
A guide to managing anaphylaxis for General Duties Medical Officers
Authors: Butterworth SJ , Hindmarsh DG , Mellor A 
Published: January 2021

AbstractAnaphylaxis is a severe, life-threatening, generalised hypersensitivity reaction. It affects 1 in 1,333 (~0.08%) of the English population during their lives, with 1% of cases being fatal. Management, underpinned by guidance from the Resuscitation Council (UK), focuses on a thorough clinical assessment and prompt administration of intramuscular adrenaline. Symptoms may recur, so patients must be observed for a period of no less than six hours. In a deployed environment evacuation must be swift and into a safe environment capable of providing critical care support. There are clear occupational implications following a case of anaphylaxis, and a confirmed case may affect service personnel’s fitness to deploy. This article will summarise the management of anaphylaxis in Royal Naval personnel.
From the black hole conundrum to the structure of quantum gravity
Authors: Nomura Yasunori 
Published: January 2021

We portray the structure of quantum gravity emerging from recent progress in understanding the quantum mechanics of an evaporating black hole. Quantum gravity admits two different descriptions, based on Euclidean gravitational path integral and a unitarily evolving holographic quantum system, which appear to present vastly different pictures under the existence of a black hole. Nevertheless, these two descriptions are physically equivalent. Various issues of black hole physics — including the existence of the interior, unitarity of the evolution, the puzzle of too large interior volume, and the ensemble nature seen in certain calculations — are addressed very differently in the two descriptions, still leading to the same physical conclusions. The perspective of quantum gravity developed here is expected to have broader implications beyond black hole physics, especially for the cosmology of the eternally inflating multiverse.
On two-bridge knots and a conjecture of Hirasawa–Murasugi
Authors: Chen Wenzhao 
Published: January 2021

Fox conjectured the Alexander polynomial of an alternating knot is trapezoidal, i.e. the absolute values of the coefficients first increase, then stabilize and finally decrease in a symmetric way. Recently, Hirasawa and Murasugi further conjectured a relation between the number of the stable coefficients in the Alexander polynomial and the signature invariant. In this paper we prove the Hirasawa–Murasugi conjecture for two-bridge knots.
The story of post-Variscan lamprophyres of the Bohemian Massif: from ultramafic (Upper Cretaceous–Paleocene) to alkaline (Eocene–Oligocene) types
Authors: Ulrych Jaromír , Krmíček Lukáš , Adamovič Jiří , Krmíčková Simona 
Published: January 2021

Abstract
Post-Variscan lamprophyres of the Bohemian Massif hold the potential for the understanding of deep-mantle processes beneath the Bohemian Massif in association with mantle metasomatism as a consequence of Variscan subduction and Late Paleozoic extension in Central Europe, and tectonic processes between Variscan blocks. Two principal types of post-Variscan lamprophyres occur in the Bohemian Massif, contrasting in their age and composition: ultramafic lamprophyres of Late Cretaceous to Paleocene age and alkaline lamprophyres of Mid Eocene to Late Oligocene age. Combination of published and new whole-rock, isotope (Sr–Nd–Pb) and radiometric (K/Ar) data on lamprophyres of both types (including new data from samples from the deep boreholes) significantly contributes to the understanding of the changing tectonomagmatic position of post-Variscan volcanism in the Bohemian Massif. The striking shift in lamprophyre geochemistry is paralleled by a change in their structural position from the initial pre-rift period of volcanism to the developed syn-rift period and the related change in their mantle sources beneath the Bohemian Massif. The Late Cretaceous and Cenozoic volcanism is explained as related to lithospheric flexuring during the Alpine orogeny, resulting in an asthenospheric upwelling, or associated with the lithosphere deformation and perturbation of the thermal boundary layer.
Phase II Single-arm Study of Durvalumab and Tremelimumab with Concurrent Radiotherapy in Patients with Mismatch Repair–proficient Metastatic Colorectal Cancer
Authors: Segal Neil H. , Cercek Andrea , Ku Geoffrey , Wu Abraham J. , Rimner Andreas , Khalil Danny N. , Reidy-Lagunes Diane , Cuaron John , Yang T. Jonathan , Weiser Martin R. , Romesser Paul B. , Stadler Zsofia K. , Varghese Anna M. , Ganesh Karuna , Yaeger Rona , Connell Louise C. , Faleck David , Abou-Alfa Ghassan K. , Mcauliffe Kathleen C. , Vaiskauskas Pamela , Solter Mark L. , Ogle Martinique , Adamow Matthew J. , Holland Aliya , Vedantam Pallavi , Wong Phillip , Merghoub Taha , Vakiani Efsevia , Hollmann Travis J. , Juluru Krishna , Chou Joanne F. , Capanu Marinela , Erinjeri Joseph , Solomon Stephen , Yamada Yoshiya , Kemeny Nancy , Crane Christopher H. , Saltz Leonard B. 
Published: January 2021

AbstractPurpose:Immune checkpoint inhibition (ICI) alone is not active in mismatch repair–proficient (MMR-P) metastatic colorectal cancer (mCRC), nor does radiotherapy alone result in objective systemic benefit. However, combined radiotherapy plus ICI can induce systemic antitumor immunity in preclinical and clinical models.Patients and Methods:In this single-center, phase II study, patients with chemotherapy-refractory MMR-P mCRC received durvalumab 1,500 mg plus tremelimumab 75 mg every 4 weeks plus radiotherapy. The primary endpoint was objective response rate (ORR) in nonirradiated lesions. Treatment and efficacy were correlated with peripheral immune cell profiles.Results:We enrolled 24 patients, and report outcomes after a median follow-up of 21.8 (range: 15.9–26.3) months. The ORR was 8.3% (2 patients) [95% confidence interval (CI), 1.0–27.0]. The median progression-free survival was 1.8 (95% CI, 1.7–1.9) months, median overall survival was 11.4 (95% CI, 10.1–17.4) months. Twenty five percent of patients (n = 6) had treatment-related grade 3–4 adverse events. We observed increased circulating CD8+ T lymphocyte activation, differentiation, and proliferation in patients with objective response.Conclusions:This combination of radiotherapy plus ICI study did not meet the prespecified endpoint criteria to be considered worthwhile for further study. However, rare instances of systemic immune augmentation and regression in nonirradiated lesions were observed (an abscopal response). Combination durvalumab and tremelimumab plus radiotherapy is feasible in MMR-P mCRC with a manageable safety profile. Further studies of novel immunotherapy combinations, and identification of biomarkers predictive of abscopal response are warranted.
STK11/LKB1 Mutations in NSCLC Are Associated with KEAP1/NRF2-Dependent Radiotherapy Resistance Targetable by Glutaminase Inhibition
Authors: Sitthideatphaiboon Piyada , Galan-Cobo Ana , Negrao Marcelo V. , Qu Xiao , Poteete Alissa , Zhang Fahao , Liu Diane D. , Lewis Whitney E. , Kemp Haley N. , Lewis Jeff , Rinsurongkawong Waree , Giri Uma , Lee J. Jack , Zhang Jianjun , Roth Jack A. , Swisher Stephen , Heymach John V. 
Published: January 2021

Abstract

Purpose:
Radiotherapy with or without chemotherapy is a mainstay of treatment for locally advanced non–small cell lung cancer (NSCLC), but no predictive markers are currently available to select patients who will benefit from these therapies. In this study, we investigated the association between alterations in STK11/LKB1, the second most common tumor suppressor in NSCLC, and response to radiotherapy as well as potential therapeutic approaches to improve outcomes.

Experimental Design:
We conducted a retrospective analysis of 194 patients with stage I–III NSCLC, including 164 stage III patients bearing mutant or wild-type STK11/LKB1 treated with radiotherapy, and assessed locoregional recurrence (LRR), distant metastasis rates, disease-free survival (DFS), and overall survival (OS), and we investigated the causal role of LKB1 in mediating radiotherapy resistance using isogenic pairs of NSCLC cell lines with LKB1 loss or gain.

Results:
In stage III patients, with 4 years median follow-up, STK11/LKB1 mutations were associated with higher LRR (P = 0.0108), and shorter DFS (HR 2.530, P = 0.0029) and OS (HR 2.198, P = 0.0263). LKB1 loss promoted relative resistance to radiotherapy, which was dependent on the KEAP1/NRF2 pathway for redox homeostasis. Suppression of the KEAP1/NRF2 pathway via KEAP1 expression, or pharmacologic blockade of glutaminase (GLS) 1 sensitized LKB1-deficient tumors to radiotherapy.

Conclusions:
These data provide evidence that LKB1 loss is associated with LRR and poor clinical outcomes in patients with NSCLC treated with radiotherapy and that targeting the KEAP1/NRF2 pathway or GLS inhibition are potential approaches to radiosensitize LKB1-deficient tumors.
On the occurrence and distribution of the narrowly endemic Andaman Lantern Flower Ceropegia andamanica (Apocynaceae: Ceropegieae)
Authors: Maheshwari M. Uma , Karthigeyan K. 
Published: January 2021

Ceropegia andamanica is a herbaceous plant which is narrowly endemic to South Andaman Island in India. It is assessed as critically endangered per IUCN Red List criteria using primary and secondary information on EOO, AOO and number of collection.
On the epidemiology of helminth parasites in Hangul Deer Cervus hanglu hanglu (Mammalia: Artiodactyla: Cervidae) of Dachigam National Park, India
Authors: Khurshid Naziya , Tak Hidayatullah , Nazir Ruqeya , Bhat Kulsum Ahmad , Manzoor Muniza 
Published: January 2021

A one-year study conducted to ascertain the prevalence and risk factors associated with helminth infection in Hangul Deer Cervus hanglu hanglu at Dachigam National Park revealed that 40.45% (89 of 220 samples) were infected with four helminth species including Heamonchus contortus, Trichuris ovis, Dictyocaulus viviparus, and Moneizia expansa. The study signified that the infection was more prevalent during the dry season (summer and autumn) as compared to the wet season (winter and spring). The overall prevalence of Heamonchus contortus was the highest (23.18%) followed by Trichuris ovis (8.18%), followed by Dictyocaulus viviparus (5.45%), and Moneizia expansa (3.63%). The present study should be of importance in conserving the erstwhile state animal, listed as Critically Engendered in 2017 by IUCN.
Ibadi Manuscripts in a European Collection
Authors: Brugnatelli Vermondo 
Published: January 2021

Abstract
Within the framework of studies concerning the importance of European manuscript collections for Ibadi history, this article aims at retracing the history of an archive put together by the French scholar Auguste Bossoutrot (1856–1937). This archive gathered a quantity of materials on the Arabic and Berber languages collected during his life. In particular, some of the manuscripts contain parts of a long religious work in Berber (Kitāb al-Barbariyya), discovered in the island of Djerba (Tunisia) among the Ibadi community of the island towards the end of the nineteenth century. This text was firstly discovered and reported to the scientific community by another French scholar, A. De Calassanti-Motylinski (1854–1907), but his untimely death prevented him from publishing it and the whereabouts of the manuscripts that contained it remained unknown until the discovery of Bossoutrot’s papers, which contained the longest extant copy of the work (about 900 pages).
From Djerba to Warjalān
Authors: Neji Mohamed , Love Paul M. 
Published: January 2021

Abstract
This article focuses on letters in private Ibadi libraries and their importance for understanding the primary means of communication among Ibadi communities in the premodern Maghrib. Using the example of a letter from the 7th/13th-century Ibadi Shaykh Abū ʿAbdallāh al-Ṣidghiyānī from the island of Djerba (Tunisia) to the Ibadis of Warjalān (Algeria), it seeks to highlight the importance of the archive of unedited Ibadi manuscript letters. This corpus of correspondences has not received the care and maintenance it merits because these letters do not belong to a recognized volume or book and are today located in private libraries unavailable to the public. The article also uses the example of al-Ṣidghiyānī’s letter to emphasize the importance of the manuscript letters and their role in maintaining intellectual ties among the Ibadi cities of the Maghrib. This brief article consists of two parts. The first part offers a general presentation of the archive where the letter is today held: the El Barounia Library in Djerba, Tunisia. The second part presents the manuscript and its author in their historical context.
‮مجموعة المخطوطات الإباضيّة بمكتبة الباسيّين بجربة‬‎
Authors: ‮البوجديديّ‬‎ ‮د. علي‬‎ 
Published: January 2021

‮الملخص‬‎
‮يمكن أن تُسهم دراسة مخطوطات الباسي الإباضيّة منها، رغم ما شابها من ضياع، في إعادة تأريخ المكتبة، كما يمكنها أن تلقي ضوءا على تاريخ العائلة في علاقتها بالإباضيّة مدّا وجزرا. فضلا عن أهميّة دراسة المجموعات الإباضيّة في الكشف عن حركة صور تلقّي العلوم والمعارف وتبادلها داخل الفضاء الجزيريّ وتأثرها بالفضاءات المتاخمة لها وعن علاقات الجوار والتّثاقف بين إباضيي جربة مع غيرهم مغربا ومشرقا، وتشي بعمق تواصلهم المغاربيّ والمتوسطيّ. ويصير المخطوط تبعا لذلك خزّانا للأفكار والرّؤى والتصوّرات، لا يقلّ أهميّة عن التّحف المتحفيّة والمباني المعماريّة، ومختلف مكوّنات التّراث الماديّ وغير الماديّ الأخرى. تلك هي ملامح الحركة الدّؤوب التي تتكشّف من خلال دراسة مجموعات المخطوطات الإباضيّة بجربة، والتي تنمّ عن ثقافة المخطوط عند الإباضيّة، وتبرز مكانة العلم والتعلّم في الجزيرة، وفي حوض البحر الأبيض المتوسّط عموما. وقد أسهم مشروع رقمنة مكتبة الباسيّين بجربة في التفطّن إلى مجموعة من المخطوطات الإباضيّة على جانب كبير من الطّرافة والقيمة العلميّة تبرز هذا التّفاعل الحيّ بين إباضيّة جربة وغيرها من مناطق العلم والمعرفة، كما تؤكّد على علوّ شأن آل الباسي ومؤسّسيها الحاج سالم وعثمان تحديدا، وتكشف عن تنوّع مصادر مخطوطات الباسي وحرص القائمين عليها على جلبها ونسخها وعنايتهم بتجليدها وحفظها‬‎
Perforated Carcinoid Tumor of the Appendix: Need for Guidelines for Management With Respect to Prognostic Factors
Authors: McCann Charles , Schwartz Jandie , Perry Luke , Cheng Elaine 
Published: January 2021

Carcinoid tumors, one of the most common malignant lesions involving the appendix, are typically found incidentally during routine appendectomies. While up to 20% of acute appendicitis cases present with perforation, the incidence of perforation among patients with undiagnosed carcinoid tumors of the appendix is unknown. In addition, there is no consensus on the management of carcinoid tumors in the perforated appendix or its impact on prognosis. We present a case of a 42-year-old woman presented with perforated appendicitis. Final pathology demonstrated the presence of a 1.1 cm, well-differentiated grade 1 neuroendocrine tumor at the tip of the appendix extending into the subserosa, without evidence for lymphovascular invasion. Given the depth of tumor invasion and the relatively young age of the patient, the decision was made to perform an interval completion right hemicolectomy for lymph node sampling. Only a few cases have been reported in the available literature, and it remains unclear whether appendiceal perforation represents an independent negative prognostic factor for patient survival. Additional data from cohort studies are needed to determine the true incidence, prognosis, and optimal management of newly diagnosed carcinoid tumors in the perforated appendix. Furthermore, clear consensus guidelines are needed to identify the subgroup of patients who would benefit from interval or primary right hemicolectomy.
Merendino Resection vs. Transhiatal Gastric Conduit After Resection of the Cardia and the Gastroesophageal Junction
Authors: Eichelmann Ann-Kathrin , Nikitina Milana , Bahde Ralf , Mardin Wolf A. , Slepecka Patrycja , Kebschull Linus , Senninger Norbert , Pascher Andreas , Palmes Daniel 
Published: January 2021

Background Reconstruction after combined cardia resection and removal of the gastroesophageal junction can be carried out by the Merendino procedure or via a gastric conduit. This study compares postoperative complications and quality of life for both approaches. Methods All patients who underwent Merendino or gastric conduit reconstruction from 2011-2017 were included. Both groups were investigated regarding postoperative length of stay, complications, and gastrointestinal quality of life. Results 45 patients were identified, of which, 39 remained for analysis: 22 patients in the Merendino group and 17 patients in the gastric conduit group. The median age of patients in the gastric conduit group (71 (53-92) years) was significantly higher than in the Merendino group (58 (19-75) years), P = .0002. Hospital stay was significantly longer in the gastric conduit group (35.9 (11-82) days vs. 18.2 (7-43) days, P = .0299) and incidence of anastomotic leakage was higher (24% vs. 9%, P = .0171). General incidence of complications (Clavien-Dindo) did not vary ( P = .1694). However, grade 5 complications only occurred in the Merendino group (n = 1). Evaluation of long-term outcome and quality of life showed dysphagia to only have occurred in the Merendino group (n = 3, 14%). Discussion Both approaches have advantages and disadvantages: The Merendino procedure showed reduced incidence of anastomotic leakage and shorter hospital stay but was associated with a higher in-hospital mortality rate. Discrepancies in subgroup populations as well as small patient numbers limit the interpretation of the findings. This study does however provide a first comparison of these surgical approaches and may serve as a basis for further investigation.