Erythema annulare centrifugum activated simply by SARSCoV2 vaccination

How predictable are life trajectories? We investigated this question with a scientific mass collaboration using the common task method; 160 teams built predictive models for six life outcomes using data from the Fragile Families and Child Wellbeing Study, a high-quality birth cohort study. Despite using a rich dataset and applying machine-learning methods optimized for prediction, the best predictions were not very accurate and were only slightly better than those from a simple benchmark model. Within each outcome, prediction error was strongly associated with the family being predicted and weakly associated with the technique used to generate the prediction. Overall, these results suggest practical limits to the predictability of life outcomes in some settings and illustrate the value of mass collaborations in the social sciences. Copyright © 2020 the Author(s). Published by PNAS.Calendar-dated tree-ring sequences offer an unparalleled resource for high-resolution paleoenvironmental reconstruction. Where such records exist for a few limited geographic regions over the last 8,000 to 12,000 years, they have proved invaluable for creating precise and accurate timelines for past human and environmental interactions. To expand such records across new geographic territory or extend data for certain regions further backward in time, new applications must be developed to secure "floating" (not yet absolutely dated) tree-ring sequences, which cannot be assigned single-calendar year dates by standard dendrochronological techniques. This study develops two approaches to this problem for a critical floating tree-ring chronology from the East Mediterranean Bronze-Iron Age. The chronology is more closely fixed in time using annually resolved patterns of 14C, modulated by cosmic radiation, between 1700 and 1480 BC. This placement is then tested using an anticorrelation between calendar-dated tree-ring growth responses to climatically effective volcanism in North American bristlecone pine and the Mediterranean trees. Examination of the newly dated Mediterranean tree-ring sequence between 1630 and 1500 BC using X-ray fluorescence revealed an unusual calcium anomaly around 1560 BC. While requiring further replication and analysis, this anomaly merits exploration as a potential marker for the eruption of Thera. Copyright © 2020 the Author(s). Published by PNAS.Traumatic injuries to the torso account for almost a quarter of all injuries seen in combat and are typically secondary to blast or gunshot wounds. Injuries due to road traffic collisions or violence are also relatively common during humanitarian and disaster relief efforts. There may also be multiple injured patients in these settings, and surgical care may be limited by a lack of facilities and resources in such a non-permissive environment. The first responder in these scenarios should be prepared to manage patients with severe injuries to the torso. We aim to describe the management of these injuries in the military and austere environment, within the scope of practice of a level 5 registered prehospital practitioner. © Author(s) (or their employer(s)) 2020. No commercial re-use. See rights and permissions. Published by BMJ.Acute aortic occlusion (AAO) is an uncommon but potentially devastating vascular emergency with reported perioperative mortality rates of up to 75%. We present the case of AAO in a 69-year-old woman who was transferred to our institution after presenting with sudden onset bilateral acute limb ischaemia. Imaging showed a completely obstructed aortoiliac segment with renal infarcts. She was treated successfully with aortoiliac over the wire thrombectomy. selleck chemicals llc © BMJ Publishing Group Limited 2020. No commercial re-use. See rights and permissions. Published by BMJ.On the day of scheduled debridement for a persistent pin tract infection, a 23-year old man presented himself carrying a small bony ring sequestrum that had spontaneously ejected from his tibial wound 1 week earlier. Eight years prior to presentation, he was treated for an open crural fracture which was stabilised with an external fixator. Revision of the operation notes revealed that the placement of this external fixator was performed without predrilling. © BMJ Publishing Group Limited 2020. No commercial re-use. See rights and permissions. Published by BMJ.A 61-year-old male patient being treated with intravenous antibiotics for left foot osteomyelitis presented to the hospital septic, with several days of worsening abdominal pain, bloating and watery bowel movements. Investigation revealed that the patient had severe, treatment-resistant Clostridioides difficile colitis. He was initially treated with oral vancomycin and intravenous metronidazole, which was switched to oral fidaxomicin. After no improvement in the patient's symptoms, he was treated with two faecal microbiota transplants. He was offered a third faecal microbiota transplant but declined. The patient was placed back on oral fidaxomicin and saw ultimate resolution of his symptoms. This case provides an example of a treatment pathway for refractory C. difficile infection. © BMJ Publishing Group Limited 2020. No commercial re-use. See rights and permissions. Published by BMJ.OBJECTIVE Vaccination against hepatitis B virus (HBV) confers protection from subsequent infection through immunological memory that is traditionally considered the domain of the adaptive immune system. This view has been challenged following the identification of antigen-specific memory natural killer cells (mNKs) in mice and non-human primates. While the presence of mNKs has been suggested in humans based on the expansion of NK cells following pathogen exposure, evidence regarding antigen-specificity is lacking. Here, we demonstrate the existence of HBV-specific mNKs in humans after vaccination and in chronic HBV infection. DESIGN NK cell responses were evaluated by flow cytometry and ELISA following challenge with HBV antigens in HBV vaccinated, non-vaccinated and chronic HBV-infected individuals. RESULTS NK cells from vaccinated subjects demonstrated higher cytotoxic and proliferative responses against autologous hepatitis B surface antigen (HBsAg)-pulsed monocyte-derived dendritic cells (moDCs) compared with unvaccinated subjects.