bluuebunny/crossref_metadata_2025_split huggingface dataset:
The history and homology of the os paradoxum or dumb-bell-shaped bone of the platypus Ornithorhynchus anatinus (Mammalia, Monotremata)
Authors: Wible John R. 
Published: March 2022

AbstractThe os paradoxum or dumb-bell-shaped bone is a paired bone occurring in the middle of the specialized bill of the platypusOrnithorhynchus anatinus. It has been variously considered as a neomorph of the platypus, as the homologue of the paired vomer of sauropsids, or as a part of the paired premaxillae. A review of the near 200-year history of this element strongly supports the os paradoxum as a remnant of the medial palatine processes of the premaxillae given its ontogenetic continuity with the premaxillae and association with the vomeronasal organ and cartilage, incisive foramen, and cartilaginous nasal septum. In conjunction with this hypothesis, homologies of the unpaired vomer of extant mammals and the paired vomer of extant sauropsids are also supported. These views are reinforced with observations from CT scans ofO. anatinus, the Miocene ornithorhynchidObdurodon dicksoni, and the extant didelphid marsupialDidelphis marsupialis. At the choanae,Obdurodonhas what appears to be a separate parasphenoid bone unknown in extant monotremes.
Presence of Autoantibodies in Males and Females With Rheumatoid Arthritis: A Systematic Review and Metaanalysis
Authors: Hadwen Brook , Yu Richard , Cairns Ewa , Barra Lillian 
Published: March 2022

Objective.Rheumatoid arthritis (RA) is more common in females, and although the cause of RA is unknown, it is characterized by the production of autoantibodies. The aims of this study were to determine whether RA-associated autoantibodies are more often found in females than males and to identify factors that influence the relationship between sex and seropositivity.Methods.Databases were searched and studies of RA (N ≥ 100) were included if they reported proportion of seropositive patients with RA by sex. Metaanalyses and metaregression were conducted using the random-effects model. Covariates regressed were smoking, age, BMI, Health Assessment Questionnaire–Disability Index (HAQ-DI), and the Disease Activity Score in 28 joints (DAS28).Results.Eighty-four studies with a total of 141,381 subjects with rheumatoid factor (RF) seropositivity and 95,749 subjects with anticitrullinated protein antibody (ACPA) seropositivity met inclusion criteria. The mean age of participants ranged from 37 to 68 years and the proportion of female subjects ranged from 9% to 92%. Results indicated that females were less likely than males to be seropositive: odds ratio (OR) 0.84 [95% CI 0.77–0.91] for RF and OR 0.88 [95% CI 0.81–0.95] for ACPA. BMI, smoking, mean age, DAS28, and HAQ-DI did not affect the relationship between sex and seropositivity.Conclusion.Although studies report that females have higher RA disease activity than males and that seropositivity predicts worse outcomes, females were less likely to be seropositive than males.
Hospitalizations for Acute Gout: Process Mapping the Inpatient Journey and Identifying Predictors of Admission
Authors: Russell Mark D. , Nagra Deepak , Clarke Benjamin D. , Balachandran Sathiyaa , Buazon April , Boalch Amy , Bechman Katie , Adas Maryam A. , Alveyn Edward G. , Rutherford Andrew I. , Galloway James B. 
Published: March 2022

Objective.To identify predictors of admission following emergency department (ED) attendances for gout flares and to describe barriers to optimal inpatient gout care.Methods.ED attendances and hospital admissions with primary diagnoses of gout were analyzed at 2 UK-based hospitals between January 1, 2017, and December 31, 2020. Demographic and clinical predictors of ED disposition (admission or discharge) and reattendance for gout flares were identified using logistic regression and survival models, respectively. Case note reviews (n = 59), stakeholder meetings, and process mapping were performed to capture detailed information on gout management and to identify strategies to optimize care.Results.Of 1220 emergency attendances for gout flares, 23.5% required hospitalization (median length of stay: 3.6 days). Recurrent attendances for flares occurred in 10.4% of patients during the study period. In multivariate logistic regression models, significant predictors of admission from ED were older age, overnight ED arrival time, higher serum urate (SU), higher C-reactive protein, and higher total white cell count at presentation. Detailed case note reviews showed that only 22.6% of patients with preexisting gout were receiving urate-lowering therapy (ULT) at presentation. Initial diagnostic uncertainty was common, yet rheumatology input and synovial aspirates were rarely obtained. By 6 months postdischarge, 43.6% were receiving ULT; however, few patients had treat-to-target dose optimization, and only 9.1% achieved SU levels ≤ 360 μmol/L.Conclusion.We identified multiple predictors of hospitalization for acute gout. Treat-to-target optimization of ULT following hospitalization remains inadequate and must be improved if admissions are to be prevented.
Using FibroScan to Assess for the Development of Liver Fibrosis in Patients With Arthritis on Methotrexate: A Single-center Experience
Authors: Darabian Saman , Wade John P. , Kur Jason , Wade Stefanie D. , Sayre Eric C. , Badii Maziar 
Published: March 2022

Objective.Methotrexate (MTX) is often the primary medication to treat various rheumatic diseases (RDs) because of its low cost and its demonstrated efficacy in controlling disease activity. However, a concern has been the potential for hepatic fibrosis associated with long-term MTX usage. This study investigated the association between cumulative MTX intake and development of liver fibrosis by utilizing noninvasive transient elastography (FibroScan).Methods.All patients with inflammatory arthritis treated with MTX were offered screening with FibroScan. A certified technician measured liver stiffness after patients adhered to a fast. Relevant clinical information was obtained by patient survey and medical records review. The population was divided into quartiles based on participants’ cumulative dosage of MTX.Results.Five hundred twenty patients with RD were included in this study. The prevalence of stages F3 or F4 liver fibrosis was 13.3% in the control group and 12.7% in the entire sample. Compared with subgroup 1 (control with cumulative MTX exposure of ≤ 499 mg), MTX subgroups 2 to 4 were not significantly correlated with higher FibroScan scores (P= 0.82, 0.59, and 0.18, respectively). In multivariable linear regression analysis, statistically significant factors for liver stiffness were BMI, waist circumference, male sex, and age.Conclusion.No significant correlation between the cumulative MTX dosage and liver stiffness, even at high MTX doses, was observed. The analyses showed significant correlations between the FibroScan score and BMI. These findings were reassuring in that current rheumatology practice appears to be safe and effective in screening for liver fibrosis in patients on long-term low-dose MTX therapy.
Le changement de paradigme de la politique de sécurité et de défense de l’Allemagne après l’invasion russe de l’Ukraine
Authors: Stark Hans 
Published: March 2022

Le gouvernement allemand a longtemps hésité à prendre position face à la crise entre la Russie et l’Ukraine. Il a refusé de remettre en question le projet de mise en service de Nord Stream 2 et d’approvisionner l’Ukraine en armes. Cette attitude était certainement motivée par la crainte d’une baisse sensible de l’approvisionnement d’énergie et d’une nouvelle hausse de l’inflation. En outre, Berlin ne voulait pas non plus mettre en péril le dialogue avec le Kremlin, dans l’espoir de ne pas compromettre les accords de Minsk de 2014 et 2015. Berlin ne s’attendait certainement pas non plus à une invasion de l’Ukraine par les troupes russes, en tout cas pas au-delà de la région du Donbass. L’invasion russe de l'Ukraine à partir du 24 février 2022 et le bombardement de villes ukrainiennes par l’armée russe dans le but de renverser le gouvernement ukrainien librement élu ont eu un impact massif sur le gouvernement fédéral. Un changement complet de paradigme a été amorcé à Berlin. Cela concerne l’aide militaire à l’Ukraine, la politique énergétique et surtout la politique de défense allemande. Les dépenses pour l’armée allemande vont augmenter massivement à partir de cette année. Le budget de la défense dépassera 2 % du produit intérieur brut. La politique étrangère et de sécurité allemande est entrée dans une nouvelle réalité et Berlin s’y adapte.
La tendresse, un fil tissé de soi(e)
Authors: Cludy Régine 
Published: March 2022

La tendresse est abordée comme tonalité affective qui fonde notre humanité en tant que besoin vital favorisant l’attachement et aussi comme affection permettant de se sentir connecté, mettant un voile de douceur et d’apaisement dans nos explorations tourmentées du monde. Apparaissant en thérapie, elle permet de rejoindre l’essentiel de ce qui est en jeu : le besoin d’un contact relationnel fait de douceur et de délicatesse, pacifiant les efforts et les luttes pour conquérir et pour calmer les angoisses à être.
L’apprentissage par corps contraint
Authors: de Bisschop Hervé , Olry Paul 
Published: March 2022

Le rôle du corps dans les apprentissages a été étudié dans des univers de formations classiques (Faure, 2000), notamment à des fins d’acquisition de savoirs corporels 1 . Il est plus rare qu’il soit placé sous observation auprès de participants exposés à des sur-sollicitations physiques, psychiques et mentales, dans une visée de formation. Pour contribuer à comprendre comment les corps participent aux apprentissages, nous avons étudié un segment de dispositif de formation particulier : le stage d’aguerrissement suivi en Guyane par les élèves-officiers de l’EMIA 2 . L’ensemble de la formation vise l’acquisition de savoirs à la fois conceptuels et relationnels. L’intention pédagogique du stage observé repose sur un principe radical : épuiser les corps individuels pour « faire corps » au sein du groupe. Il s’agit en effet de susciter l’émergence d’un collectif indispensable dans l’exercice du métier en opérations extérieures. Le milieu du stage, épuisant et stressant pour le mental et pour le corps, est didactiquement pensé dans ce but. L’étude a consisté à caractériser le rôle joué par les dimensions sensorielles, émotionnelles et sensori-motrices au sein de ces apprentissages. Les résultats mettent en évidence qu’à côté des jugements de familiarité connus d’autres formes de typicalisation apparaissent lors de ces expériences sur-sollicitantes.
La motivation au pied de la lettre. Construction et expression des aspirations scolaires sur Parcoursup
Authors: Couto Marie-Paule , Valarcher Marion 
Published: March 2022

Cet article analyse les modalités de l’encadrement et de l’expression des aspirations des lycéens français. Il apporte un éclairage nouveau sur les inégalités de parcours entre filière générale versus filière technologique et professionnelle. À travers l’analyse d’une enquête nationale et d’un corpus de lettres de motivation rédigées par des candidats à une licence de sociologie, il montre que, faute de moyens, les enseignants disposent principalement de deux types de stratégies d’accompagnement à l’orientation.Les enseignants ont pour habitude de cibler et de concentrer leur soutien sur les « bons élèves » dans les filières technologiques et professionnelles, tandis que, dans les filières générales, ils délèguent certaines étapes des procédures de suivi aux familles. Ces différentes stratégies ont des effets sur la manière dont les lycéens intériorisent les prescriptions scolaires et les restituent dans des lettres de motivation. Par le soutien resserré dont ils bénéficient auprès des enseignants, les « bons élèves » des filières technologiques et professionnelles intériorisent fortement les consignes et leur place dans la hiérarchie scolaire. Dans les filières générales, l’expression des aspirations des étudiants est beaucoup plus dépendante de leur capital familial.
La prise de décision dans la normalisation technique Internet : l’exemple de DoH
Authors: Bortzmeyer Stéphane 
Published: March 2022

L’Internet repose sur de nombreuses techniques normalisées. C’est par exemple le cas du protocole HTTP, qui permet à un navigateur Web de visiter un site Web, même si les deux logiciels, le client et le serveur, ont été écrits par des équipes complètement différentes. C’est également le cas de protocoles plus techniques, comme IP ou le DNS. Mais qui décide de ces normes techniques et comment ? La question n’est pas de pure curiosité car les normes déterminent en grande partie ce qui sera facile ou au contraire difficile à faire sur l’Internet. Prenons l’exemple du protocole DoH qui a fait l’objet de vives controverses. Pourquoi ce qui semble un choix purement technique soulève des passions ? Quels sont les camps en présence, leurs opinions, et leurs moyens d’action ?Internet depends on standardised techniques. One example is HTTP, the protocol that allows a Web browser to visit a Web site. HTTP works even if the two programs, the client and the server, were written by different software teams. There are other, more technical protocols, like IP and DNS. Who decides on these protocols ? How is that decision taken ? It is not just idle curiosity since these standards will set what is easy to do or difficult to achieve on the Internet. As an exemple, we will study the design of the DoH protocol. Despite the fact that it may seen a purely technical subject, DoH raised some controversy. Who were the parties, what were the arguments and how the final outcome will be decided ?
Quality of life and Concerns of Parkinson's Disease Patients and their Caregivers during COVID-19 Pandemic
Authors: Banerjee Sourav , Mukherjee Adreesh , Bhattacharyya Bidisha , Mohanakumar Kochupurackal P. , Biswas Atanu 
Published: March 2022

Objectives:
Parkinson's disease (PD) patients have suffered during the coronavirus disease 2019 pandemic, with worsening of both motor and nonmotor symptoms. We conducted this study to evaluate the quality of life (QoL) and concerns of PD patients and their caregivers.

Methods:
The study was conducted in mixed method, where the baseline data was taken by face-to-face interview during the unlock phase of December 2020 to March 2021, when there was no lockdown. This included demography, Hoehn and Yahr (HY) stage, Parkinson's Disease Questionnaire-8 (PDQ-8), and Parkinson's Disease Questionnaire for Carer (PDQ-Carer). During the second wave of COVID-19 (April–June 2021), telephonic interview was conducted using Depression, Anxiety Stress Scale- 21 Items (DASS-21), PDQ-8, PDQ-Carer, and open-ended questions regarding their concerns.

Results:
Compared with the baseline data, PDQ-8 and PDQ-Carer scores showed significant worsening during the second wave. DASS-21 scores had significant correlation with PDQ-Carer and PDQ-8 scores. Female patients reported poorer QoL. Caregivers of non-vaccinated patients had worse PDQ-Carer Strain scores. There was no significant association between worsening of motor symptoms and PDQ-8 and PDQ-Carer scores. More than 80% patients and 70% caregivers reported anxiety and depression. Their concerns were regarding difficulties due to social isolation, restriction of activity, and financial constraints. Additionally, there were worries about patient care, vaccination, and recurrence of the wave.

Conclusions:
The QoL of both patients and their caregivers were affected by the pandemic. A significant proportion had anxiety and depression, and this correlated with QoL. There were some important concerns on various aspects of the pandemic.
Randomized Controlled Trial to Compare Injection Ferric Carboxymaltose and Oral Iron in Reducing Postpartum Anemia
Authors: Chawla Sushil , Tangri Manoj Kumar , Srivastava Ajai K. , Bhardwaj Davinder , Indu  , Mishra Rajesh 
Published: March 2022

Introduction:
Iron-deficiency anemia (IDA) in pregnancy is common due to the increase demand for iron during pregnancy and is aggravated by blood loss associated with delivery. Intravenous iron formulations offer an alternative approach in the presence of moderate and severe anemia, due to intolerance of or nonadherence to oral iron and malabsorption status, to correct and prevent IDA. Ferric carboxymaltose (FCM) is a newer dextran-free iron formulation which allows for single and higher dose (up to 1000 mg) of IV iron infusion, making it a potentially ideal candidate for the treatment of postpartum anemia (PPA).

Materials and Methods:
A randomized control trial was conducted at two tertiary care centers involving 800 women (400 women in oral iron group and 400 women in the injection FCM group) to compare the efficacy of each in protecting the women from anemia in the postpartum period.

Results:
The compliance was 100% in the FCM group as the injection was given before the patient was sent on discharge after delivery. The mean rise in the hemoglobin levels in the FCM group and oral iron group was 3.76 g% and 2.476 g%, respectively. The mean rise in the serum ferritin levels in the FCM group was 214.265 mg% as noted at the end of 6 weeks.

Conclusion :
Injection FCM in the dose of 1000 mg given in a single dose before discharge in postpartum women helps in reducing PPA without any significant adverse effects.
Can Titanium elastic nails deliver a knockout punch against precontoured locking plates in handling displaced middle third clavicle fractures?
Authors: Shaik Jameer , Paka Varun Kumar , Pilaka Ravi Sharma , Murthy Talluri Srivatsava S. Dakshina 
Published: March 2022

Background:
Plating is the gold standard for displaced middle third clavicle fractures, which holds true at least for comminuted fractures with a fair share of complications. For displaced fractures without comminution, intramedullary titanium elastic nailing system is an emerging option which claims similar success rates with fewer complications. There is a deficit in data pertaining to prospective trials supporting such claims which has propelled us to carry out this study. This study aims to compare the functional outcome and complication rates between precontoured locking plates and titanium elastic nails for displaced clavicle fractures.

Materials and Methods:
A prospective cohort study carried out on 56 patients with displaced clavicle fractures without comminution treated either by nailing (with open reduction through minimal incision at fracture site) or plating, and the results pertaining to their functional outcome and complication rates were compared.

Results:
Nottingham clavicle score and Constant Murley score were calculated at 6, 12, and 24 months along with comparison of complication rates.

Conclusion:
The functional outcome scores recorded significant differences at 6- and 12-month periods between the groups, which minimized at 24 months. Complication rates were significantly different between the groups. These results of functional outcome and complication rates point toward titanium nailing as an attractive alternative to plating for a comminuted displaced middle third clavicle fractures.
Does Operative Management Provide Better Outcome in Displaced Mid-Shaft Clavicle Fractures? A Randomized Control Study
Authors: Jain Deepak , Vieira Alfven , Mahajan Akshay , Naik Ashish , Kotecha Harsh , Issrani Mohit 
Published: March 2022

Background:
Mid-shaft clavicle fracture management has been inclined more toward osteosynthesis in recent times for better functional outcomes. The aim of the study was to find out does operative management in displaced mid-shaft clavicle fractures provide better outcomes than conservative?

Materials and Methods:
The randomized trial was conducted between December 2017 and July 2019 at a tertiary trauma center on 50 consecutive patients with displaced mid-shaft clavicle fracture. The inclusion criteria included age between 16 and 60 with acute isolated closed displaced mid-shaft clavicle fracture. Patients with neurovascular deficit, compound fractures, pathological fractures, and nonunion/malunited fractures were excluded. Group A had 25 patients who were treated with operative line of management and Group B had 25 patients who were treated with a conservative line of management; division was done on basis of odd (Group A)–even (Group B) technique.

Results:
Out of 50 patients, the mean age group of patients was 35.5 ± 1 years of life with others ranging from 16 to 60 years. Out of 50 patients, 45 (90%) patients were male and 5 (10%) were female. Out of 50 patients, 42 had a history of road traffic accidents, while 8 had a history of falls. The right side clavicle was affected in 18 patients and left was affected in 32 patients. Out of 50 patients, the mean time of union in operative group was 11.36 ± 2.56 and 11.36 ± 2.75 weeks in nonoperative group. Constant shoulder score was 85.16 ± 15.30 and 84.64 ± 13.52 in the operative group and nonoperative group, respectively.

Conclusion:
In this prospective cohort study, we have concluded that long-term functional outcomes of conservative versus operative management of displaced mid-shaft clavicle fracture are similar, but primary open reduction with internal fixation of displaced mid-shaft clavicle fracture in young adult patients ensures anatomical reduction, early mobilization, and faster recovery for functional activity while avoiding complications such as malunion.
Resolution of Posttraumatic Brown Syndrome in a Child Following Treatment with Oral Steroid
Authors: Murthy Sowmya Raveendra , Tripathi Prerna 
Published: March 2022

Aim:
To report a case of acquired Brown syndrome in a child following trauma and its response to oral steroids.

Case Report:
A 4-year-old child was brought to us with complaints of adopting abnormal head posture following a fall while playing and injuring his head. On examination, he had features of the acquired Brown syndrome of the right eye. Magnetic resonance imaging of the brain and orbits was normal. A course of oral steroids was given and the symptoms resolved after a month of treatment.

Conclusion:
Acute onset of abnormal head posture following trauma warrants keen evaluation of ocular movements and cover tests in all gazes to ascertain the cause. Acquired Brown syndrome should be considered in children following head trauma and it responds well to oral steroids.