bluuebunny/crossref_metadata_2025_split huggingface dataset:
The newly proposed International Endocervical Adenocarcinoma Criteria and Classification and its relevance to cervical cytology screening assessed in a prospective 2‐year study of 118 cases
Authors: Ondič Ondrej , Němcová Jana , Alaghehbandan Reza , Černá Kateřina , Gomolčáková Barbora , Kinkorová‐Luňáčková Iva , Chytra Jan , Šidlová Henrieta , Hósová Marta , Bouda Jiří 
Published: April 2020

AbstractBackgroundIt is generally acknowledged that interobserver variability for the histological diagnosis of endocervical adenocarcinoma (EA) subtypes is suboptimal. The recently proposed International Endocervical Adenocarcinoma Criteria and Classification (IECC) system is based on the presence of associated human papilloma virus (HPV) infection. It recognises HPV‐associated EAs and non‐HPV‐associated EAs.MethodsThis prospective cytology‐histology and molecular genetics‐based study investigated the potential effect of IECC being applied to Papanicolaou (Pap) test with regard to the diagnostic accuracy of severe glandular lesions reported at least as adenocarcinoma in situ (AIS).ResultsOut of 118 liquid‐based cytology Pap tests with AIS+ lesion, complete information on follow‐up biopsy and HPV status was available in 51 cases. AIS and EA category correlated with histologically confirmed AIS/EA in 88.5% (23/26) and 70.5% (12/17) of cases, respectively. Interestingly, 93% (40/43) of cases diagnosed as AIS/EA were HPV positive and 7% (3/43) were HPV negative (originating in the cervix, endometrium and adnexa).ConclusionsOur findings suggest that this approach could possibly divide Pap tests containing severe glandular lesion into two groups: (a) robust diagnosis of HPV‐associated EA and (b) non‐HPV associated glandular lesions of heterogeneous origin, requiring further clinical preoperative diagnostic workup.
Evaluating the effectiveness of a large multi‐use MPA in protecting Key Biodiversity Areas for marine predators
Authors: Handley Jonathan M. , Pearmain Elizabeth J. , Oppel Steffen , Carneiro Ana P. B. , Hazin Carolina , Phillips Richard A. , Ratcliffe Norman , Staniland Iain J. , Clay Thomas A. , Hall Jonathan , Scheffer Annette , Fedak Mike , Boehme Lars , Pütz Klemens , Belchier Mark , Boyd Ian L. , Trathan Phil N. , Dias Maria P. 
Published: April 2020

AbstractAimMarine protected areas can serve to regulate harvesting and conserve biodiversity. Within large multi‐use MPAs, it is often unclear to what degree critical sites of biodiversity are afforded protection against commercial activities. Addressing this issue is a prerequisite if we are to appropriately assess sites against conservation targets. We evaluated whether the management regime of a large MPA conserved sites (Key Biodiversity Areas, KBAs) supporting the global persistence of top marine predators.LocationSouthwest Atlantic Ocean.MethodWe collated population and tracking data (1,418 tracks) from 14 marine predator species (Procellariiformes, Sphenisciformes, Pinnipedia) that breed at South Georgia and the South Sandwich Islands, and identified hotspots for their conservation under the recently developed KBA framework. We then evaluated the spatiotemporal overlap of these sites and the different management regimes of krill, demersal longline and pelagic trawl fisheries operating within a large MPA, which was created with the intention to protect marine predator species.ResultsWe identified 12 new global marine KBAs that are important for this community of top predators, both within and beyond the focal MPA. Only three species consistently used marine areas at a time when a potentially higher‐risk fishery was allowed to operate in that area, while other interactions between fisheries and our target species were mostly precluded by MPA management plans.Main conclusionsWe show that current fishery management measures within the MPA contribute to protecting top predators considered in this study and that resource harvesting within the MPA does not pose a major threat—under current climate conditions. Unregulated fisheries beyond the MPA, however, pose a likely threat to identified KBAs. Our approach demonstrates the utility of the KBA guidelines and multispecies tracking data to assess the contributing role of well‐designed MPAs in achieving local and internationally agreed conservation targets.
Cardiovascular protection with sodium‐glucose co‐transporter‐2 inhibitors in type 2 diabetes: Does it apply to all patients?
Authors: Giorgino Francesco , Vora Jiten , Fenici Peter , Solini Anna 
Published: April 2020

AbstractPatients with type 2 diabetes (T2D) are at an increased risk of cardiovascular disease (CVD). Cardiovascular risk in these patients should be considered as a continuum, and comprehensive treatment strategies should aim to target multiple disease risk factors. Large‐scale clinical trials of sodium‐glucose co‐transporter‐2 (SGLT2) inhibitors have shown an impact on cardiovascular outcomes, including heart failure hospitalization and cardiovascular death, which appears to be independent of their glucose‐lowering efficacy. Reductions in major cardiovascular events appear to be greatest in patients with established CVD, particularly those with prior myocardial infarction, but are independent of heart failure or renal risk. Most large‐scale trials of SGLT2 inhibitors predominantly include patients with T2D with pre‐existing CVD and high cardiovascular risk at baseline, limiting their applicability to patients typically observed in clinical practice. Real‐world evidence from observational studies suggests that there might also be beneficial effects of SGLT2 inhibitors on heart failure hospitalization and all‐cause mortality in various cohorts of lower risk patients. The most common adverse events reported in clinical and observational studies are genital infections; however, the overall risk of these events appears to be low and easily managed. Similar safety profiles have been reported for elderly and younger patients. There is still some debate regarding the safety of canagliflozin in patients at high risk of fracture and amputation. Outstanding questions include specific patterns of cardiovascular protection according to baseline risk.
Prevalence and risk factors of fatty liver in Portuguese adults
Authors: Leitão Jorge , Carvalhana Sofia , Cochicho Joana , Silva Ana Paula , Velasco Francisco , Medeiros Isabel , Alves Ana Catarina , Bourbon Mafalda , Oliveiros Bárbara , Rodrigues Vitor , Sousa Rita , Sampaio Filipa , Carvalho Armando , Cortez‐Pinto Helena 
Published: April 2020

AbstractBackgroundPrevalence of fatty liver (FL) and nonalcoholic fatty liver disease (NAFLD) depends mainly on obesity, diabetes and genetic factors. FL and NAFLD prevalence was evaluated in Portuguese adult population and correlated with several risk factors and related mortality data, within the same period.Materials and methodsA cross‐sectional, population‐based multicenter study, voluntary and randomly selected in 834 Portuguese adults (18‐79 years). Participants were evaluated after 12‐hour fasting. Anthropometric data, past history including alcohol consumption, and associated diseases were registered. Blood samples were collected for biochemical testing. Dietary intake was evaluated using a semi‐quantitative food frequency questionnaire. Presence of FL was evaluated using ultrasound, and NAFLD was diagnosed after exclusion of other causes for liver disease.ResultsAdjusted prevalence of FL and NAFLD was 37.8% and 17.0%, respectively. FL individuals were older, more frequently males, with increased probability of having obesity, diabetes or harmful alcohol consumption (HAC). NAFLD individuals were also older, but had a similar sex distribution and an increased probability of obesity and diabetes. In both groups, no differences were found regarding dietary pattern or physical activity. During the same time period, nonalcoholic steatohepatitis (NASH) liver‐related deaths in Portugal were 0.105/100 000, while alcohol‐related liver disease mortality was 6.790/100 000.ConclusionThe large spectrum of FL was present in more than one third of the population, although only less than half could be classified as NAFLD. Other significant risk factors, such as HAC, are probably implicated in FL, explaining the low NASH‐related mortality compared with the high alcohol‐related mortality during the same time period.
Cost‐effectiveness of Anti‐CD19 chimeric antigen receptor T‐Cell therapy in pediatric relapsed/refractory B‐cell acute lymphoblastic leukemia. A societal view
Authors: Thielen Frederick W. , van Dongen‐Leunis Annemieke , Arons Alexander M. M. , Ladestein Judith R. , Hoogerbrugge Peter M. , Uyl‐de Groot Carin A. 
Published: April 2020

AbstractIntroductionIn several studies, the chimeric antigen receptor T‐cell therapy tisagenlecleucel demonstrated encouraging rates of remission and lasting survival benefits in pediatric patients with relapsed/refractory (r/r) acute lymphoblastic leukemia (ALL). We assessed the cost‐effectiveness of tisagenlecleucel (list price: 320 000 EUR) among these patients when compared to clofarabine monotherapy (Clo‐M), clofarabine combination therapy (Clo‐C), and blinatumomab (Blina) from both a healthcare and a societal perspective. We also assessed future medical and future non‐medical consumption costs.MethodsA three‐state partitioned survival model was used to simulate a cohort of pediatric patients (12 years of age) through different disease states until the end of life (lifetime horizon). Relevant outcomes were life years, quality‐adjusted life years (QALYs), healthcare costs, societal costs, and the incremental cost‐effectiveness ratio (ICER). Uncertainty was explored through deterministic and probabilistic sensitivity analyses as well as through several scenario analyzes.ResultsTotal discounted costs for tisagenlecleucel were 552 679 EUR from a societal perspective, which was much higher than the total discounted costs from a healthcare perspective (ie, 409 563 EUR). Total discounted societal costs for the comparator regimens ranged between 160 803 EUR for Clo‐M and 267 259 EUR for Blina. Highest QALYs were estimated for tisagenlecleucel (11.26), followed by Blina (2.25), Clo‐C (1.70) and Clo‐M (0.74). Discounted societal ICERs of tisagenlecleucel ranged between 31 682 EUR/QALY for Blina and 37 531 EUR/QALY for Clo‐C and were considered cost‐effective with a willingness‐to‐pay (WTP) threshold of 80 000 EUR/QALY. None of the scenarios exceeded this threshold, and more than 98% of the iterations in the probabilistic sensitivity analysis were cost‐effective.DiscussionAt the current price and WTP threshold, tisagenlecleucel is cost‐effective from both a healthcare and a societal perspective. Nevertheless, long‐term effectiveness data are needed to validate the several assumptions that were necessary for this model.
Enforcing social norms: The morality of public shaming
Authors: Billingham Paul , Parr Tom 
Published: April 2020

AbstractPublic shaming plays an important role in upholding valuable social norms. But, under what conditions, if any, is it morally justifiable? Our aim in this paper is systemically to investigate the morality of public shaming, so as to provide an answer to this neglected question. We develop an overarching framework for assessing the justifiability of this practice, which shows that, while shaming can sometimes be morally justifiable, it very often is not. In turn, our framework highlights several reasons to be concerned about the increasingly widespread phenomenon of online public shaming.
Grain Size Analysis and Permeametry for Estimating Hydraulic Conductivity in Engineered Porous Media
Authors: Cormican Allison , Devlin J.F. , Divine Craig 
Published: April 2020

AbstractGrain size analysis and permeametry are common methods for estimating the hydraulic conductivity (K) of porous media. It is well known that these methods have limited accuracy when they are used to characterize natural sediments. However, hydrogeological research has increasingly introduced technologies dependent on engineered porous media that may be less problematic because complex geologic structures are eliminated in the lab and field‐scale packings. The recently introduced Horizontal Reactive Media Treatment Wells (HRX® Wells), for in situ, passive remediation of groundwater is one such example. The HRX Well passively collects groundwater and directs it through a horizontal pipe packed with an engineered porous medium. In this project, grain size analysis was conducted for sand and sand‐iron mixtures to estimate K using the 16 algorithms provided in the HydrogeoSieveXL2.3.2 software. The results were compared to K determined by permeametry and a field‐scale column, 30 cm long and 25 cm in diameter, representing an HRX Well. The best comparability of K estimates from grain size analysis and permeametry were obtained using the USBR, Slichter, and Shepherd K estimation methods. These also showed good agreement between lab‐scale and field‐scale K estimations, with reproducibility within the range ±20%. This study shows that laboratory K estimations can be representative across various relevant scales, including the field‐scale, for engineered porous media. This finding extends to filter packs, and other engineered porous media design methods by emphasizing and demonstrating one case of accuracy in lab‐scale permeability estimation for field‐scale implementations.
Detection of phases in Fe‐doped YSZ by XRD and Raman spectroscopy
Authors: Satardekar Pradnyesh , Naik Kiran , Sglavo Vincenzo M. 
Published: April 2020

AbstractSamples of 8 mol% Y2O3‐stabilized ZrO2 (8YSZ) doped with Fe were prepared and sintered at 1350°C in air or argon atmosphere. The sintered samples were characterized by SEM, XRD, and Raman spectroscopy. Raman spectroscopy and XRD were found to complement each other in phase identification; all the sintered samples were shown to possess tetragonal phase (t”) whose axial ratio (c/a) is equal to 1 in the cubic matrix. The Raman peak at 616 cm−1, in general, was seen to broaden with increase in Fe concentration for both sintering atmospheres.
Sex differences in metabolic syndrome components in adolescent military dependents at high‐risk for adult obesity
Authors: Shank Lisa M. , Higgins Neyland M. Katy , Lavender Jason M. , Schindler Rachel , Solomon Senait , Hennigan Kathrin , Leu William , Schvey Natasha A. , Sbrocco Tracy , Jorgensen Sarah , Stephens Mark , Olsen Cara H. , Haigney Mark , Klein David A. , Quinlan Jeffrey , Yanovski Jack A. , Tanofsky‐Kraff Marian 
Published: April 2020

SummaryBackgroundMetabolic syndrome in adolescence has been associated with adverse cardiometabolic outcomes in adulthood. Preliminary data suggest that boys may have worsened metabolic syndrome components compared to girls. Yet, little is known about the physical health of military dependents, a potentially at‐risk population.ObjectiveExamine sex differences in metabolic syndrome components in a sample of adolescent military dependents.MethodsParticipants were adolescents (N = 139; 14.4 ± 1.6 years; 45.3% male; 41.0% non‐Hispanic White, 19.4% non‐Hispanic Black; BMI‐z: 1.9 ± 0.4) at‐risk for adult obesity and binge‐eating disorder due to an age‐ and sex‐adjusted BMI ≥85th percentile and loss‐of‐control eating and/or elevated anxiety. A multivariate analysis of covariance was conducted to compare objectively measured metabolic syndrome components across boys and girls. Covariates were age, race, loss‐of‐control eating status, anxiety symptoms, and BMI‐z.ResultsMetabolic syndrome components differed by sex (P = .01). Boys had higher systolic blood pressure (P = .049), lower high‐density lipoprotein cholesterol (P = .01), and higher glucose (P = .001) than girls. Waist circumference, diastolic blood pressure, and triglycerides did not differ between boys and girls (P > .05).ConclusionsFuture research should prospectively examine these relationships into adulthood. If the current findings are supported, prevention programs should consider targeting cardiometabolic health particularly among male adolescent military dependents.
Prospective clinical study on the efficacy of bacterial removal with mechanical debridement in and around chronic leg ulcers assessed with fluorescence imaging
Authors: Moelleken Maurice , Jockenhöfer Finja , Benson Sven , Dissemond Joachim 
Published: April 2020

AbstractBacterial colonisation in wounds delays healing, mandating regular bacterial removal through cleaning and debridement. Real‐time monitoring of the efficacy of mechanical debridement has recently become possible through fluorescence imaging. Red fluorescence, endogenously produced during bacterial metabolism, indicates regions contaminated with live bacteria (>104 CFU/g). In this prospective study, conventional and fluorescence photos were taken of 25 venous leg ulcers before and after mechanical debridement, without use of antiseptics. Images were digitally segmented into wound bed and the periwound regions (up to 1.5 cm outside bed) and pixel intensity of red fluorescence evaluated to compute bacterial area. Pre‐debridement, bacterial fluorescence comprised 10.4% of wound beds and larger percentages of the periwound area (~25%). Average bacterial reduction observed in the wound bed after a single mechanical debridement was 99.4% (p<0.001), yet periwound bacterial reduction was only 64.3%. On average, across bed and periwound, a single mechanical debridement left behind 29% of bacterial fluorescence positive tissue regions. Our results show the substantial effect that safe, inexpensive, mechanical debridement can have on bacterial load of venous ulcers without antiseptic use. Fluorescence imaging can localise bacterial colonised areas and showed persistent periwound bacteria post‐debridement. Fluorescence‐targeted debridement can be used quickly and easily in daily practice.
PredyCLU: A prediction system for chronic leg ulcers based on fuzzy logic; part II—Exploring the arterial side
Authors: Serra Raffaele , Bracale Umberto M. , Barbetta Andrea , Ielapi Nicola , Licastro Noemi , Gallo Alessandro , Fregola Salvatore , Turchino Davide , Gasbarro Vincenzo , Mastroroberto Pasquale , de Franciscis Stefano 
Published: April 2020

AbstractPeripheral arterial disease (PAD) and its most severe form, critical limb ischaemia (CLI), are very common clinical conditions related to atherosclerosis and represent the major causes of morbidity, mortality, disability, and reduced quality of life (QoL), especially for the onset of ischaemic chronic leg ulcers (ICLUs) and the subsequent need of amputation in affected patients. Early identification of patients at risk of developing ICLUs may represent the best form of prevention and appropriate management. In this study, we used a Prediction System for Chronic Leg Ulcers (PredyCLU) based on fuzzy logic applied to patients with PAD. The patient population consisted of 80 patients with PAD, of which 40 patients (30 males [75%] and 10 females [25%]; mean age 66.18 years; median age 67.50 years) had ICLUs and represented the case group. Forty patients (100%) (27 males [67.50%] and 13 females [32.50%]; mean age 66.43 years; median age 66.50 years) did not have ICLUs and represented the control group. In patients of the case group, the higher was the risk calculated with the PredyCLU the more severe were the clinical manifestations recorded. In this study, the PredyCLU algorithm was retrospectively applied on a multicentre population of 80 patients with PAD. The PredyCLU algorithm provided a reliable risk score for the risk of ICLUs in patients with PAD.
Autologous platelet‐rich plasma injection enhances healing of chronic venous leg ulcer: A prospective randomised study
Authors: Elbarbary Ahmed H. , Hassan Hassan A. , Elbendak Elsayed A. 
Published: April 2020

AbstractOur aim was to compare the efficacy and safety of platelet‐rich plasma (PRP) application versus PRP injection for chronic venous leg ulcer (VLU) healing compared with compression therapy as a control. From July 2018 to December 2019, 90 chronic VLU patients were randomly assigned to PRP dressings (n = 30), local PRP injections (n = 30), and compression therapy alone (n = 30). Standard compression accompanied both PRP groups. The main endpoints were ulcer healing and area reduction within 3, 6, and 12 months. Complications and ulcer recurrence were also recorded. The study included 72 (80.0%) males and 18 (20.0%) females aged 22 to 66 years, having VLUs for 1 to 11 years. PRP injection promoted healing (24/30, 80%) more than PRP application (20/30, 66.7%) and compression (14/30, 46.7%), P = .007. Healing time was significantly shorter after PRP injection compared with the other two groups. A greater area reduction was observed after PRP injection compared with compression at all follow‐up visits, P = .013, .002, and < .001, and compared with PRP application only at 3 months post‐treatment, P = .016. Recurrence and complications were comparable among the groups. PRP injection enhances the healing of chronic venous ulcers more than each of PRP application and compression therapy. All had comparable recurrence and safety.
Prevalence of acute and chronic wounds – with emphasis on pressure ulcers – in integrated continuing care units in Alentejo, Portugal
Authors: Furtado Kátia A. X. , Infante Paulo , Sobral Ana , Gaspar Pedro , Eliseu Graça , Lopes Manuel 
Published: April 2020

AbstractThe aim of the study was to describe the prevalence and general characteristics of acute and chronic wounds in 2018 in Alentejo (Portugal) continuing care units. In order to look at associations, wound characteristics studied were location, type, place of acquisition, number, and duration, and patient characteristics were sex, age, and presence of risk factors. During the first 2 weeks of February 2018, a total of 770 patients were assessed at continuing care units of Alentejo. Of these, 135 exhibited wounds, a prevalence of 17.5%. Almost two out of three patients (63%) had arterial hypertension, slightly more than one in three (37%) had a stroke and/or immobility and 30% had diabetes. Of the total wounds identified, 18% were acute wounds and 82% were chronic wounds. Of the 24 acute wounds, traumatic wounds (76%), and surgical wounds (22%) were the most prevalent. The four types of pressure ulcers represented 80% of the chronic wounds. The median duration of the pressure ulcers was 5.5 months and 25% had duration over 10 months.
Durability of YSZ coated Ti2AlC in 1300°C high velocity burner rig tests
Authors: Smialek James L. , Cuy Michael D. , Harder Bryan J. , Garg Anita , Rogers Richard B. 
Published: April 2020

AbstractA thermal barrier coating (TBC) system survived 500 hours in aggressive, 1300°C burner rig testing. The yttria‐stabilized zirconia (7YSZ) TBC was plasma sprayed on an oxidation‐resistant Ti2AlC‐type MAX phase and tested in a jet fuel burner at 100 m/s, using 5 hours cycles. No coating spallation or surface recession was observed; Al2O3‐scale growth produced a slight 2.4 mg/cm2mass gain. The coating surface exhibited craze‐cracked colonies of [111]flouritetextured columns, with no visible moisture attack. The 20 μm alumina scale remained intact under the YSZ face, about twice that producing failure for TBC/superalloy systems. TiO2nodules, initially formed on the uncoated backside, were removed, and Al2O3was etched through volatile hydroxides formed in water vapor (~10%). Overall, the test indicated exceptional stability of the YSZ/Al2O3/Ti2AlC system under turbine conditions due in large part to close thermal expansion matching.