bluuebunny/crossref_metadata_2025_split huggingface dataset:
Ketamine Use in Operation Enduring Freedom
Authors: Leslie Eric , Pittman Eric , Drew Brendon , Walrath Benjamin 
Published: April 2021

ABSTRACTIntroductionKetamine is a dissociative anesthetic increasingly used in the prehospital and battlefield environment. As an analgesic, it has been shown to have comparable effects to opioids. In 2012, the Defense Health Board advised the Joint Trauma System to update the Tactical Combat Casualty Care Guidelines to include ketamine as an acceptable first line agent for pain control on the battlefield. The goal of this study was to investigate trends in the use of ketamine during Operation Enduring Freedom (OEF) and Operation Freedom’s Sentinel (OFS) during the years 2011-2016.Materials and MethodsA retrospective review of Department of Defense Trauma Registry (DoDTR) data was performed for all patients receiving ketamine during OEF/OFS in 2011-2016. Prevalence of ketamine use, absolute use, mechanism of injury, demographics, injury severity score, provider type, and co-administration rates of various medications and blood products were evaluated.ResultsTotal number of administrations during the study period was 866. Ketamine administration during OEF/OFS increased during the years 2011-2013 (28 patient administrations in 2011, 264 administrations in 2012, and 389 administrations in 2013). A decline in absolute use was noted from 2014 to 2016 (98 administrations in 2014, 41 administrations in 2015, and 46 administrations in 2016). The frequency of battlefield ketamine use increased from 0.4% to 11.3% for combat injuries sustained in OEF/OFS from 2011 to 2016. Explosives (51%) and penetrating trauma (39%) were the most common pattern of injury in which ketamine was administered. Ketamine was co-administered with fentanyl (34.4%), morphine (26.2%), midazolam (23.1%), tranexamic acid (12.3%), plasma (10.3%), and packed red blood cells (18.5%).ConclusionsThis study demonstrates increasing use of ketamine by the U.S. Military on the battlefield and effectiveness of clinical practice guidelines in influencing practice patterns.
Sexsomnia in Active Duty Military: A Series of Four Cases
Authors: Fernandez Juan D , Soca Rodolfo 
Published: April 2021

ABSTRACT
Sexsomnia is a type of non-rapid eye movement (NREM) parasomnia in which sexual behaviors arise during sleep; these behaviors are varied and can include masturbation, orgasms with or without self-stimulation, sexual vocalizations and talking, and sexual fondling and/or intercourse with the bed partner. The military creates a challenging environment, with sleep deprivation, shift work, and increased psychosocial stress that may predispose service members to an increased risk for all NREM parasomnias, including sexsomnia. Given that sexsomnia is sometimes invoked in sexual assault military lawsuits, it may behoove the military community to understand how this condition usually manifests so that its medicolegal implications can be addressed more clearly. Here, we present the largest case series of sexsomnia to date in active duty military service members, which adds to the limited literature on such cases in the military and to the broader but still growing literature on this rare disorder. We compare and contrast these cases with the available literature to highlight their similarities and differences in addition to commenting on the relevance of these cases in forensic investigations. As none of these cases were involved in legal issues, they could provide useful information about this rare condition in individuals who are less likely to be affected by the biases that are inherent to litigation.
octo-tiger: a new, 3D hydrodynamic code for stellar mergers that uses hpx parallelization
Authors: Marcello Dominic C , Shiber Sagiv , De Marco Orsola , Frank Juhan , Clayton Geoffrey C , Motl Patrick M , Diehl Patrick , Kaiser Hartmut 
Published: April 2021

ABSTRACT
octo-tiger is an astrophysics code to simulate the evolution of self-gravitating and rotating systems of arbitrary geometry based on the fast multipole method, using adaptive mesh refinement. octo-tiger is currently optimized to simulate the merger of well-resolved stars that can be approximated by barotropic structures, such as white dwarfs (WDs) or main-sequence stars. The gravity solver conserves angular momentum to machine precision, thanks to a ‘correction’ algorithm. This code uses hpx parallelization, allowing the overlap of work and communication and leading to excellent scaling properties, allowing for the computation of large problems in reasonable wall-clock times. In this paper, we investigate the code performance and precision by running benchmarking tests. These include simple problems, such as the Sod shock tube, as well as sophisticated, full, WD binary simulations. Results are compared to analytical solutions, when known, and to other grid-based codes such as flash. We also compute the interaction between two WDs from the early mass transfer through to the merger and compare with past simulations of similar systems. We measure octo-tiger’s scaling properties up to a core count of ∼80 000, showing excellent performance for large problems. Finally, we outline the current and planned areas of development aimed at tackling a number of physical phenomena connected to observations of transients.
Long-term measurements of the erosion and accretion of dust deposits on comet 67P/Churyumov–Gerasimenko with the OSIRIS instrument
Authors: Cambianica P , Cremonese G , Fulle M , Simioni E , Naletto G , Pajola M , Lucchetti A , Penasa L , Massironi M , Frattin E , Güttler C , Sierks H , Tubiana C 
Published: April 2021

ABSTRACT
We monitor the seasonal erosion and accretion of dust deposits in the Imhotep, Hatmehit, and Ma’at regions of comet 67P/Churyumov–Gerasimenko with OSIRIS Narrow Angle Camera images. The vertical accuracy of such measurements is 0.2 m and the spatial scale of the images we used is lower than 0.60 m pixel−1. We calculate the height of 21 boulders by applying a tool that allows to measure the shadow length of a boulder projected on the surrounding dust deposit, assuming that any height variation is not due to boulder intrinsic change. Any boulder height variation provides a direct measurement about the thickness variation of the surrounding dust layer due to the occurring erosion and/or accretion. The analysis concerns the period from 2014 August, inbound to perihelion, to 2016 September, outbound. We measured the erosion in the Ma’at region of 0.6 ± 0.2 m from 2014 September 12 to December 2, and an erosion of 0.4 ± 0.3 m from 2014 December 3 to 2015 February 15. Then, we measured a dust deposition of 0.7 ± 0.3 m during the following perihelion phase, until 2016 May–September. This result confirms the link between the erosion of the Southern hemisphere and the fallout in the northern regions. The Imhotep and Hatmehit regions are characterized by a negligible erosion during the inbound orbit, consistent with pebble-made nucleus models predicting no erosion when the temperature of the nucleus surface is Ts &lt; 205 K.
Organic residues in astrophysical ice analogues: Thermal processing of hydrogenated glyoxal ices under interstellar conditions
Authors: Leroux Killian , Guillemin Jean-Claude , Krim Lahouari 
Published: April 2021

ABSTRACT
Organic residues are considered as part of the chemical composition of the interstellar dust grains. They are formed under the extreme conditions of the interstellar medium and play an important role in exobiology. They may contain pre-biotic organic species such as amino acids, constituents of proteins and building blocks of DNA and RNA, key elements of life. By investigating the formation of organic residues in an astrophysical context, many groups have been focusing in the UV irradiation and subsequent warm-up of astrophysical ice analogues. This aims to suggest that organic residues are mainly formed in regions of molecular clouds exposed to UV light or cosmic rays. This study shows an organic residue formation involving glyoxal ice and H atoms. While the hydrogenation of glyoxal at 10 K leads mainly to small molecules such as CO and H2CO and CH3OH, we show that the heating of the hydrogenated ice in the 10–300 K temperature range leads to solid residues whose structure is similar to that of glycolaldehyde but they remain stable in solid phase at 300 K and atmospheric pressure. The analysis of the IR data shows that the organic residues formed through the thermal processing of CHOCHO + H reaction would be a mixture of hydroxypyruvaldehyde and methyl glyoxylate, two solid organics whose formation starts with an H-abstraction from glyoxal to form CHOCO• radical which recombines to •CH2OH and •OCH3 radicals. These latter may be formed and trapped in glyoxal ice as secondary products from H2CO + H secondary reaction.
Interpreting the variation phenomena of B2 1633+382 via the two-component model
Authors: Wang Yi-Fan , Jiang Yun-Guo 
Published: April 2021

ABSTRACT
Blazars are variable targets in the sky, whose variation mechanism remains an open question. In this work, we make a comprehensive study of the variation phenomena of the spectral index and polarization degree to deeply understand the variation mechanism of B2 1633+382 (4C 38.41). We use the local cross-correlation function to perform a correlation analysis between multiwavelength light curves. We find that both the γ-ray and the optical V band are correlated with the 15-GHz radio at beyond the 3σ confidence level. Based on the lag analysis, the emitting regions of the γ-ray and optical are located at $14.2_{-2.4}^{+0}$ and $14.2_{-8.3}^{+8.3}$ pc upstream of the core region of the15-GHz radio, and are far away from the broad-line region. The broad lines in the spectrum indicate the existence of an accretion disc component in the radiation. Thus, we consider a two-component model, which includes the relative constant background component and the varying jet component to study the variation behaviours. The Markov Chain Monte Carlo procedure is adopted to study the physical parameters of the jet and the background components. To some extent, the study of normalized residuals indicates that the two-component model fits better than the linear fitting model. The jet with a helical magnetic field is promising for explaining the variation, and the shock-in-jet model is not completely ruled out.
Artificial intelligence and quasar absorption system modelling; application to fundamental constants at high redshift
Authors: Lee Chung-Chi , Webb John K , Carswell R F , Milaković Dinko 
Published: April 2021

ABSTRACT
We have developed a new fully automated Artificial Intelligence (AI)-based method for deriving optimal models of complex absorption systems. The AI structure is built around VPFIT, a well-developed and extensively tested nonlinear least-squares code. The new method forms a sophisticated parallelized system, eliminating human decision-making and hence bias. Here, we describe the workings of such a system and apply it to synthetic spectra, in doing so establishing recommended methodologies for future analyses of Very Large Telescope (VLT) and Extremely Large Telescope (ELT) data. One important result is that modelling line broadening for high-redshift absorption components should include both thermal and turbulent components. Failing to do so means it is easy to derive the wrong model and hence incorrect parameter estimates. One topical application of our method concerns searches for spatial or temporal variations in fundamental constants. This subject is one of the key science drivers for the European Southern Observatory’s ESPRESSO spectrograph on the VLT and for the HIRES spectrograph on the ELT. The quality of new data demands completely objective and reproducible methods. The Monte Carlo aspects of the new method described here reveal that model non-uniqueness can be significant, indicating that it is unrealistic to expect to derive an unambiguous estimate of the fine structure constant α from one or a very small number of measurements. No matter how optimal the modelling method, it is a fundamental requirement to use a large sample of measurements to meaningfully constrain temporal or spatial α variation.
Molecular structure, DNA binding mode, photophysical properties and recommendations for use of SYBR Gold
Authors: Kolbeck Pauline J , Vanderlinden Willem , Gemmecker Gerd , Gebhardt Christian , Lehmann Martin , Lak Aidin , Nicolaus Thomas , Cordes Thorben , Lipfert Jan 
Published: April 2021

AbstractSYBR Gold is a commonly used and particularly bright fluorescent DNA stain, however, its chemical structure is unknown and its binding mode to DNA remains controversial. Here, we solve the structure of SYBR Gold by NMR and mass spectrometry to be [2-(4-{[diethyl(methyl)ammonio]methyl}phenyl)-6-methoxy-1-methyl-4-{[(2Z)-3-methyl-1,3-benzoxazol-2-ylidene]methyl}quinolin-1-ium] and determine its extinction coefficient. We quantitate SYBR Gold binding to DNA using two complementary approaches. First, we use single-molecule magnetic tweezers (MT) to determine the effects of SYBR Gold binding on DNA length and twist. The MT assay reveals systematic lengthening and unwinding of DNA by 19.1° ± 0.7° per molecule upon binding, consistent with intercalation, similar to the related dye SYBR Green I. We complement the MT data with spectroscopic characterization of SYBR Gold. The data are well described by a global binding model for dye concentrations ≤2.5 μM, with parameters that quantitatively agree with the MT results. The fluorescence increases linearly with the number of intercalated SYBR Gold molecules up to dye concentrations of ∼2.5 μM, where quenching and inner filter effects become relevant. In summary, we provide a mechanistic understanding of DNA-SYBR Gold interactions and present practical guidelines for optimal DNA detection and quantitative DNA sensing applications using SYBR Gold.
Successful Treatment of Chronic Back and Leg Pain With Lower Than Usual Placement of High-Frequency Spinal Cord Stimulation in a Patient With Uncorrected Tethered Cord: Case Report
Authors: Musick Shane , Ferguson Jessalyn , Muizelaar Jan Paul 
Published: April 2021

ABSTRACT

BACKGROUND AND IMPORTANCE
Tethered cord syndrome (TCS) often leads to severe back and leg pain. The typical treatment to stall disease progression is untethering surgery, but this is not always effective for pain. Spinal cord stimulation (SCS) is an efficacious treatment for neuropathic pain. However, it has seldom been utilized in TCS cases. Moreover, with cord elongation, ideal paddle placement is not certain.

CLINICAL PRESENTATION
We present the case of a 77-yr-old male with severe chronic lower-back and lower-extremity pain. Magnetic resonance imaging (MRI) showed severe lumbar spine degenerative changes, along with a previously undiagnosed spina bifida and conus medullaris termination at L5. We felt that SCS would be the best treatment avenue for his chief complaint of pain. Due to cord elongation, we trialed lower placement of the high-frequency (HF)-SCS system at T11-T12, which led to 80% improvement in pain symptoms within 1 wk and ability to walk for the first time in a year. At his first follow-up appointment, the patient endorsed 80% to 90% relief of his lower-back and bilateral lower-extremity pain, which improved to 100% relief at 12 mo at last visit.

CONCLUSION
Only 4 other reports were identified in the literature utilizing SCS in TCS cases. Our case adds to the limited body of literature that SCS is an effective therapy for pain in TCS and degenerative spine disease. Only 2 other reports employed lower than usual lead placement. Our case demonstrates that lead placement may need to be changed to accommodate the elongated cord.
Net Drainage as a Novel Metric for Irrigating Drainage Systems in Chronic Subdural Hematoma Management: A Case Report
Authors: Himstead Alexander S , Davies Jordan , Tran Diem Kieu , Vadera Sumeet 
Published: April 2021

Abstract

BACKGROUND AND IMPORTANCE
Chronic subdural hematoma (cSDH) is a common neurosurgical pathology with a projected increase in prevalence as the elderly population grows. Traditional treatment for cSDH involves burr hole drainage or craniotomy with or without a subdural drain. This case describes a novel irrigation and drainage protocol using IRRAflow dual-lumen catheter system that utilizes early irrigation and measurement of the net fluid output to improve postoperative outcomes.

CLINICAL PRESENTATION
A 75-yr-old male presented to the emergency department with 2 wk of progressive dizziness, headache, confusion, and left-sided weakness over the past week. Computed tomography (CT) of the head showed 25-mm-thick, right-sided cSDH with 7 mm of right-to-left midline shift. The patient was taken to the operating room for right-sided craniotomy for subdural hematoma evacuation with placement of IRRAflow irrigating drain in the subdural space. The IRRAflow drain irrigated at 100 cc/h for 23 h with net output consistently greater than irrigation rate. Head CT the following day showed a progressive decrease in subdural collection. The patient was discharged on postoperative day 2 and had complete resolution of his neurological symptoms by postoperative day 11.

CONCLUSION
As cSDHs become more prevalent in the aging population, development of improved management strategies is imperative. This report describes the use of an IRRAflow dual-lumen catheter with a novel protocol consisting of a high rate of irrigation but net fluid output, which led to rapid recovery and resolution of neurological deficits in a patient with a cSDH.
Crossing the Carotid Siphon: Techniques to Facilitate Distal Access in Tortuous Anatomy: 2-Dimensional Operative Video
Authors: Hadley Caroline , Burkhardt Jan-Karl , Johnson Jeremiah N , Kan Peter ,   Endovascular Neurosurgery Research Group, Arthur Adam , Bain Mark , Bendock Bernard , Binning Mandy Jo , Boulos Alan S , Crowley Webster , Fessler Richard , Grande Andrew , Guterman Lee , Hanel Ricardo , Hoit Daniel , Hopkins III L Nelson , Howington Jay , James Robert , Jankowitz Brian , Kan Peter , Khalessi Alex A , Kim Louis , Langer David , Lanzino Giuseppe , Levitt Michael , Levy Elad , Lopes Demetrius , Mack William , Mericle Robert , Mocco J , Ogilvy Chris , Pandey Aditya , Replogle Robert , Riina Howard , Ringer Andrew , Rodriguez Rafael , Saugaveau Eric , Schirmer Clemens , Siddiqui Adnan , Spiotta Alex , Sultan Ali , Tawk Rabih , Thomas Ajith , Turner Raymond , Veznedaroglu Erol , Welch Babu , White Jonathan 
Published: April 2021

Abstract
As capabilities for endovascular treatment of intracranial vascular pathologies continue to expand, the need for access to the distal internal carotid artery with rigid support catheter systems continues to increase. One of the dominant factors limiting this access is patient anatomy, specifically vessel tortuosity. Increased tortuosity of the carotid siphon is a frequently encountered anatomic variant and may complicate endovascular procedures in adults and children.
1,2
Failed attempts to navigate the carotid siphon with a distal access catheter carry a risk of vessel injury and treatment failure. For this reason, techniques that aid in supporting safe advancement of a distal access catheter across a tortuous carotid siphon are essential.
3,4
In this video, we demonstrate 2 ways in which this may be accomplished. The first technique uses a larger diameter microcatheter, such as the AXS Offset catheter (Stryker, Kalamazoo, Michigan), to increase support for the distal access catheter, while the second uses a buddy wire technique to accomplish this increased support. Both of these techniques can help increase the safety of navigating a tortuous carotid siphon and increase the likelihood of successful treatment.
The procedures shown were performed with the informed consent of the patients.
L5 Vertebral Column Resection for Correction of Severe Lumbar Hyperlordosis and Pelvic Anteversion in an Adolescent With Prior Myelomeningocele Repair and Lumbar Fusion: Case Report
Authors: Lai Christopher S , Cerpa Meghan , Zuckerman Scott L , Menger Richard , Lenke Lawrence G 
Published: April 2021

Abstract

BACKGROUND AND IMPORTANCE
Lumbar hyperlordosis in ambulatory children is an uncommon but potentially problematic spinal deformity, and the operative management has not been comprehensively described.

CLINICAL PRESENTATION
We report the case of a 14-yr-old girl presenting with severe progressive lumbar hyperlordosis (−122°) and sagittal imbalance (−6 cm). She had multiple prior surgeries, including myelomeningocele repair at 10 d old, midlumbar meningioma resection at 8 mo old, and posterior lumbar instrumented spinal fusion at 5 yr old. She presented with progressive lumbosacral back pain and intermittent numbness in her left lower extremity, and severe skin contractures over her prior posterior incisions. From an all posterior approach, prior implants and dural scar were removed and then an L5 vertebral column resection (VCR) was performed to disarticulate her lumbar spine from her anteverted pelvis, allowing for slow distraction forces to correct her lumbar hyperlordosis. This was followed by a T7-sacrum fusion using pedicle screws and iliac screws, with autologous bone graft and plastic surgery wound closure. Postoperatively, lumbar lordosis was corrected to −55° and sagittal balance reduced to −0.5 cm. At 10-wk and 14-mo follow-ups, the patient reported resolution of her back pain with no limitations in physical activities. Dramatic improvement was seen in both her preoperative to 14-mo postoperative Oswestry Disability Index (ODI) (54 to 12) and Scoliosis Research Society Scoliosis Research Society (SRS)-22r (54 to 93) scores.

CONCLUSION
This case highlights a rare presentation of severe progressive lumbar hyperlordosis in an ambulatory adolescent after myelomeningocele repair, meningioma resection, and posterior lumbar instrumented spinal fusion with subsequent surgical treatment incorporating important components of both spinal and plastic surgery involvement.
β-Amyrin Synthase1 Controls the Accumulation of the Major Saponins Present in Pea (Pisum sativum)
Authors: Vernoud Vanessa , Lebeigle Ludivine , Munier Jocelyn , Marais Julie , Sanchez Myriam , Pertuit David , Rossin Nadia , Darchy Brigitte , Aubert Grégoire , Le Signor Christine , Berdeaux Olivier , Lacaille-Dubois Marie-Aleth , Thompson Richard 
Published: April 2021

Abstract
The use of pulses as ingredients for the production of food products rich in plant proteins is increasing. However, protein fractions prepared from pea or other pulses contain significant amounts of saponins, glycosylated triterpenes that can impart an undesirable bitter taste when used as an ingredient in foodstuffs. In this article, we describe the identification and characterization of a gene involved in saponin biosynthesis during pea seed development, by screening mutants obtained from two Pisum sativum TILLING (Targeting Induced Local Lesions IN Genomes) populations in two different genetic backgrounds. The mutations studied are located in a gene designated PsBAS1 (β-amyrin synthase1), which is highly expressed in maturing pea seeds and which encodes a protein previously shown to correspond to an active β-amyrin synthase. The first allele is a nonsense mutation, while the second mutation is located in a splice site and gives rise to a mis-spliced transcript encoding a truncated, nonfunctional protein. The homozygous mutant seeds accumulated virtually no saponin without affecting the seed nutritional or physiological quality. Interestingly, BAS1 appears to control saponin accumulation in all other tissues of the plant examined. These lines represent a first step in the development of pea varieties lacking bitterness off-flavors in their seeds. Our work also shows that TILLING populations in different genetic backgrounds represent valuable genetic resources for both crop improvement and functional genomics.