bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cybersecurity and International Law
Authors: Schmitt Michael N. 
Published: March 2021

Abstract
This chapter discusses the international law of cybersecurity, which, at just over two decades old, remains in a relative state of infancy. States continue to struggle with such basic issues as sovereignty in cyberspace. In great part, the challenge is that many States are conflicted over the application and interpretation of key aspects of international law in the cyber context. After all, although international law can serve as a normative firewall against hostile cyber operations, the principle of sovereign equality means that protective norms also can act as barriers to a State&apos;s own cyber operations, some of which may be deemed essential to the State, especially with respect to national security. These differences in normative perspective often play out domestically in disagreements between ministries with different roles vis-à-vis cyberspace, and internationally between States wielding offensive cyber capability and those that see themselves primarily as victims thereof. To examine the relationship between cybersecurity and international law, the chapter begins by cataloguing the development of the international law of cyberspace. It then turns to the substantive legal issues, paying particular attention to those matters that presently are the source of contention amongst States.
Criminal Prosecution
Authors: Pocar Fausto 
Published: March 2021

Abstract
This chapter focuses on criminal prosecution. Traditionally, in domestic law, criminal prosecution has been regarded as a tool capable of contributing to peaceful and secure governance. Under international law, however, recourse to criminal prosecution as a safeguard for maintaining international peace and security is very recent and still limited, and in many respects disputed. This is the case both when international rules are applied by international jurisdictions and when they are directed at soliciting the exercise of criminal prosecution by domestic courts. The chapter looks at the Rome Statute of the International Criminal Court (ICC Statute), which expressly provides that the jurisdiction of the Court ‘shall be limited to the most serious crimes of concern to the international community as a whole’, and identifies these crimes as the crime of genocide, crimes against humanity, war crimes, and the crime of aggression. Given that the ICC Statute does not merely codify customary international law, but also partially develops or restricts it, its adoption has produced some degree of fragmentation of international criminal law, which further impacts on the existing international case law.
Queer kinship and the rights of refugee families
Authors: Ritholtz Samuel , Buxton Rebecca 
Published: March 2021

AbstractOver the past decade, the refugee protection regime has supposedly become more inclusive of queer and trans* people. Much literature has focused on the expansion of refugee status determination and the inclusion of LGBTQ asylum seekers. However, there are many areas of refugee policy that remain dependent on cisheteronormative assumptions and therefore exclude the queer and trans* forcibly displaced. This paper considers the concept of ‘the family’ and how it is used and understood in refugee protection. We make the normative argument that queer and trans* family units ought to qualify for refugee family reunion and group status determination. We do so by considering the concept of queer and trans* ‘chosen families’, arguing that these queer articulations of kinship are functionally and morally comparable to cisheteronormative conceptions of the family. We contend that considering the cisheteronormative underpinnings of the family in this way opens up the potential to queer other areas of refugee policy, and therefore paves the way to a more inclusive refugee protection regime.
New NEO Detection Techniques using the FPGA
Authors: Yanagisawa Toshifumi , Kamiya Kohki , Kurosaki Hirohisa 
Published: March 2021

AbstractWe have developed a new method for detecting near-Earth objects (NEOs) based on a Field Programmable Gate-Array (FPGA). Unlike conventional methods, our technique uses 30–40 frames to detect faint NEOs that are almost invisible on a single frame. To reduce analysis time, image binarization and an FPGA-implemented algorithm were used. This method has aided in the discovery of 11 NEOs by analyzing frames captured with 20 cm class telescopes. This new method will contribute to discovering new NEOs that approach the Earth closely.
Veterans’ Experiences of an Opioid Specialty Clinic
Authors: Sowicz Timothy Joseph , Hausmann Leslie R M 
Published: March 2021

Abstract

Objective
Opioid specialty clinics have emerged as an approach for mitigating the risks associated with opioid therapies. Many opioid specialty clinics within the Department of Veterans Affairs (VA) have been described in the extant literature, yet veterans’ experiences of these remain absent. This research study was undertaken to describe veterans’ responses (e.g., knowledge, attitudes, and beliefs) toward being evaluated in an opioid specialty clinic.

Design
Qualitative descriptive research study.

Setting
A VA medical center in the northeast United States.

Subjects
Twenty veterans were interviewed between December 2017 and May 2018.

Methods
Veterans’ characteristics were extracted from the VA’s electronic health record and analyzed with descriptive statistics. Qualitative data about veterans’ experiences with the opioid specialty clinic were collected via semistructured interviews (in person or via telephone) and were analyzed with qualitative content analysis.

Results
Most participants were older, non-Hispanic or non-Latino white men. Generally, veterans had positive experiences in the opioid specialty clinic. However, there was wide variation in their understanding of the purpose of the clinic, who staffed the clinic, and why they had been referred to the clinic.

Conclusions
For veterans prescribed opioid therapies, this clinic served as an adjunct service for ensuring appropriate and safe prescribing. Data from this study can be used to inform interventions to promote veterans’ understanding across the total opioid safety clinic experience—referral, actual visit, and follow-up.
Assessment of Professional Quality of Life in the Alabama Physical Therapy Workforce
Authors: Bowens Andrea N , Amamoo M Ahinee , Blake Dana Daniel , Clark Bethany 
Published: March 2021

Abstract

Objective
The purposes of this study were to 1) determine the level of professional quality of life among physical therapists and physical therapist assistants in Alabama and 2) to identify personal or professional factors that may contribute to compassion satisfaction (CS), burnout, and secondary traumatic stress (STS).

Methods
This study used a cross-sectional design and mixed-methods survey methodology to calculate odds ratios for factors affecting professional quality of life. Respondents completed a survey that included the Professional Quality of Life (ProQOL) scale, an open-ended question regarding their experience with professional burnout, and personal and professional demographics.

Results
Of the 742 physical therapists and physical therapist assistants in Alabama who completed the survey, the majority experienced moderate-high levels of CS and moderate-low levels of burnout and STS. Regression analyses indicated clinicians working 40 or more hours per week in patient care had greater odds for low-moderate CS and moderate-high burnout and STS subscale scores. Clinicians in our sample licensed between 6 to 15 or more than 30 years and those working in private outpatient settings had reduced odds of having moderate-high burnout, whereas those working 16 or more years had significantly increased odds for high CS scores. Responses to the open-ended question indicated workload demands and documentation as the top factors contributing to clinician burnout, while the connections with patients and coworkers help minimize such feelings.

Conclusion
Individuals later in their career may develop protective factors to mitigate feelings of burnout compared to those early in their career. Also, clinicians working 40 or more hours per week may be more vulnerable to experiencing low-moderate CS and moderate-high burnout. Thus, individual clinicians and employers must evaluate personal, occupational, and systemic factors that contribute to reduced professional quality of life to inform preventive strategies for mitigating burnout.
The association between body mass index and fibromyalgia severity: data from a cross-sectional survey of 2339 patients
Authors: Atzeni Fabiola , Alciati Alessandra , Salaffi Fausto , Di Carlo Marco , Bazzichi Laura , Govoni Marcello , Biasi Giovanni , Di Franco Manuela , Mozzani Flavio , Gremese Elisa , Dagna Lorenzo , Batticciotto Alberto , Fischetti Fabio , Giacomelli Roberto , Guiducci Serena , Guggino Giuliana , Bentivegna Mario , Gerli Roberto , Salvarani Carlo , Bajocchi Gianluigi , Ghini Marco , Iannone Florenzo , Giorgi Valeria , Farah Sonia , Bonazza Sara , Barbagli Stefano , Gioia Chiara , Marino Noemi Giuliana , Capacci Annunziata , Cavalli Giulio , Cappelli Antonella , Carubbi Francesco , Nacci Francesca , Riccucci Ilenia , Cutolo Maurizio , Sinigaglia Luigi , Sarzi-Puttini Piercarlo 
Published: March 2021

Abstract

Objective
Various studies have shown that overweight and obesity are central features of FM, but the real impact of a high BMI on clinical severity in patients with FM is still controversial. The aim of this study was to analyse the relationships between BMI categories and measures of symptom severity and functional impairment using data from a Web-based registry of patients with FM.

Methods
Adult patients with an ACR 2010/2011 diagnosis of FM underwent a complete physical examination and laboratory tests and were asked to complete a package of questionnaires covering their sociodemographic and treatment details, in addition to the following disease-specific questionnaires: the revised Fibromyalgia Impact Questionnaire (FIQR), the modified Fibromyalgia Assessment Status questionnaire (ModFAS) and the Polysymptomatic Distress Scale (PDS).

Results
A total of 2339 patients were recruited and divided into two weight categories, underweight/normal (U/N, n = 1127, 48.2%) and overweight/obese (O/O, n = 1212, 51.8%). The total and subscales of FIQR, ModFAS and PSD scores were significantly higher in the O/O patients, as were all the mean scores of the individual FIQR items (P &lt; 0.001 for all).

Conclusion
Our findings demonstrate that O/O patients with FM are significantly more impaired than U/N patients in all the symptomatological and functional domains as measured using the FIQR, ModFAS and PDS, thus suggesting that being O/O has an additional effect on symptoms and function.
RADIATION EXPOSURE TO THE BACK WITH DIFFERENT TYPES OF APRONS
Authors: Hong Seung Wan , Kim Tae Won , Kim Jae Hun 
Published: March 2021

Abstract
Physicians and nurses stand with their back towards the C-arm fluoroscope when using the computer, taking things out of closets and preparing drugs for injection or instruments for intervention. This study was conducted to investigate the relationship between the type of lead apron and radiation exposure to the backs of physicians and nurses while using C-arm fluoroscopy. We compared radiation exposure to the back in the three groups: no lead apron (group C), front coverage type (group F) and wrap-around type (group W). The other wrap-around type apron was put on the bed instead of on a patient. We ran C-arm fluoroscopy 40 times for each measurement. We collected the air kerma (AK), exposure time (ET) and effective dose (ED) of the bedside table, upper part and lower part of apron. We measured these variables 30 times for each location. In group F, ED of the upper part was the highest (p &lt; 0.001). ED of the lower part in group C and F was higher than that in group W (p = 0.012). The radiation exposure with a front coverage type apron is higher than that of the wrap-around type and even no apron at the neck or thyroid. For reducing radiation exposure to the back of physician or nurse, the wrap-around type apron is recommended. This type of apron can reduce radiation to the back when the physician turns away from the patient or C-arm fluoroscopy.
Late sequelae of osteoarticular infections in pediatric patients
Authors: Saad Lydia , Hupin Mathilde , Buteau Chantal , Nault Marie-Lyne 
Published: March 2021

Abstract
To review the orthopedic sequelae of pediatric patients diagnosed with osteoarticular infections (OAIs) and identify significant differences between those with and without sequelae.
Medical charts between 2010 and 2016 from a tertiary-care pediatric hospital were reviewed to collect demographic and clinical data for this retrospective case series. The main inclusion criteria were:
The following late sequelae were observed and aggregated: osteal deformations that led to limb-length discrepancies (LLD) superior to 5 mm, abnormal articular angulations of more than 5°, and symptomatic chondropathies visible on imaging studies after 1 year. The patients were divided into 2 subgroups: with and without sequelae. Chi-Squared tests were used for categorical variables and Mann–Whitney U tests for continuous data to identify statistically significant differences between the 2 subgroups.
Among 401 patients with osteomyelitis and/or septic arthritis, 50 (12.5%) were included (24 girls and 26 boys). There were 36 (72%) cases of osteomyelitis, 8 (16%) cases of septic arthritis, and 6 (12%) cases of combined infection (3 acute/subacute and 3 chronic cases). Five (10%) patients had orthopedic sequelae at the latest follow-up. The total duration of antibiotic treatment (P = .002), infectious disease follow-up (P = .002), and the presence of sequestra (P = .005) were significantly different between subgroups. There were no statistically significant differences between the 2 subgroups for the other variables, but some trends could be discerned. Only 4/50 patients developed a sequestrum, 2 of which were in the orthopedic sequelae subgroup. Furthermore, initial C-reactive protein (CRP) values were higher in the sequelae subgroup, as were the CRP values at hospital discharge. The orthopedic follow-up was also longer in the sequelae subgroup. Finally, the delay between the onset of symptoms and the beginning of antibiotic treatment was longer in the sequelae group.
Patients with orthopedic sequelae had a longer antibiotic treatment and infectious disease follow-up, and were more likely to have presented with a sequestrum.
Level of evidence: IV – case series.
Rapid degradation of psychomotor memory causes poor quality chest compressions in frequent cardiopulmonary resuscitation providers and feedback devices can only help to a limited degree
Authors: Lim Wan Yen , Ong John , Ong Sharon , Teo L.M. , Fook-Chong S. , Ho V.K. 
Published: March 2021

Abstract
Studies report a decline in the psychomotor memory of cardiopulmonary resuscitation (CPR) providers within months of training, but they are prone to subject bias. We hypothesized that this degradation is faster and more prevalent in real world practice. The aims of our study were to
Forty anaesthetists and intensivists participated in a voluntary, half-day, randomized crossover study using case-based simulation. Participants were paired and randomly assigned into 2 groups; each receiving automated feedback either in the first or second cycle of CPR. Two cycles of CC and defibrillation (ACLS protocol) were administered on a manikin. CC parameters including overall quality were measured by a feedback device.
The median proportion of good quality CC was poor at baseline but improved with feedback; 38.2% (IQR 27.7, 58.7) to 57.7% (IQR 38.0, 68.7), P < .05. The median proportion of good quality CC fell after feedback withdrawal; 50.5% (IQR 24.5, 67.7) to 25.6% (9, 37.6), P < .05. No carryover effect was observed. Treatment effect and period effect were detected.
Baseline quality of CC amongst frequent CPR providers is poor, and can be improved partly by feedback devices. As psychomotor memory of good quality CCs degrades rapidly after removal of feedback, a multimodal approach is required for CPR skill retention. Future research on the optimal frequency of CPR training, including the use of feedback devices in clinical practice should be explored.
The clinical course and prognostic factors of severe COVID-19 in Wuhan, China
Authors: Liu Jiacheng , Tu Chao , Zhu Muxin , Wang Jianwen , Yang Chongtu , Liu Wei , Xiong Bin 
Published: March 2021

Abstract
With the surge of newly diagnosed and severe cases of coronavirus disease 2019 (COVID-19), the death toll is mounting, this study is aimed to explore the prognostic factors of severe COVID-19. This retrospective study included 122 inpatients diagnosed with COVID-19 from January 13 to February 25, 2020. Univariate and multivariate analysis were used to identity the risk factors, receiver operating characteristics curve (ROC) analysis was used for risk stratification. The baseline neutrophil-to-lymphocyte ratio (NLR) (OR = 1.171, 95%CI = 1.049–1.306, P = .005) and Lactate dehydrogenase (LDH) (OR = 1.007, 95%CI = 1.002–1.011, P = .004) were identified as the independent risk factors for severe COVID-19 conditions, and the NLR-LDH grading system was developed to perform risk stratification. The baseline C-reactive protein (CRP) (OR = 1.019, 95%CI = 1.004–1.306, P = .016) and B-type natriuretic peptide (BNP) (OR = 1.018, 95%CI = 1.004–1.035, P = .007) were identified as the independent predictors for disease progression of severe patients. Accordingly, The NLR-LDH grading system was a useful prognostic tool for the early detection of severe COVID-19. And in the severe patients, CRP and BNP seemed to be helpful for predicting the disease progression or death.
Prognostic significance of the expression of metastasis-associated in colon cancer-1 in gynecologic cancers and breast cancer
Authors: Wang Lijun , Fan Liying , Xu Hongyan , Jiang Haiyuan 
Published: March 2021

Abstract

Background:
The prognostic role of the expression of metastasis-associated in colon cancer-1 (MACC1) in gynecologic cancers and breast cancer remains unclear. The aim of this systematic review and meta-analysis was to determine the prognostic significance of MACC1 expression in gynecologic cancers and breast cancer.

Materials and methods:
PubMed, Web of Science and Embase were comprehensively searched up to February 9, 2020. Studies focusing on the relationship between the expression of MACC1 and prognosis in gynecologic cancers and breast cancer were included into the analysis. Pooled hazard ratio (HR) or odd ratio with 95% confidence interval (CI) was used to estimate the prognostic value of the expression of MACC1.

Results:
A total of 1,811patients with gynecologic cancers or breast cancer were included into the analysis. Patients with high expression of MACC1 tended to suffer a shorter overall survival (HR = 2.76, 95%CI = 2.12–3.59, P < .01) and recurrence-free survival (HR = 2.37, 95%CI = 1.44–3.90, P < .01) compared to those with low expression of MACC1. High expression of MACC1 was significantly associated with worse tumor differentiation (P = .04), more advanced FIGO stage (P < .01) and earlier lymph node metastasis (P < .01) compared to low expression of MACC1.

Conclusion:
Compared to low expression of MACC1, high expression of MACC1 predicts a worse prognosis of gynecologic cancers and breast cancer. The expression of MACC1 can serve as a prognostic indicator of gynecologic cancers and breast cancer.
Long-term response with low-dose of apatinib combined with S-1 in pretreated patient with advanced squamous cell lung cancer
Authors: Chen Jianxin , Wang Junhui , Zou Yan 
Published: March 2021

Abstract

Rationale:
Squamous cell lung cancer is one of the major pathological types in patients with non-small cell lung cancer. Since treatment with angiogenic agents and target drugs in patients with advanced squamous cell lung cancer is not promising, there are limited strategies to improve the outcome in such patients. Herein, we report a pretreated patient with advanced squamous cell lung cancer, who received low-dose of apatinib combined with S-1 as salvage treatment, with good long-term response.

Patient concerns:
The patient complained of dry cough for one month without any relief by medication. Otherwise, she denied any other medical or family history.

Diagnosis:
According to the chest computed tomography, and pathologic findings from biopsy for lesion in lung, the patient was diagnosed with lung squamous cell lung cancer with enlargement of bilateral supraclavicular lymph nodes suggesting metastasis, staged as IIIb.

Interventions:
The patient received gemcitabine plus cisplatin as first line treatment, and gemcitabine as maintenance therapy. After progression, she received vinorelbine as second line treatment. After progression again, she received low-dose apatinib combined with S-1 as third line treatment.

Outcomes:
With the follow-up period from October 21, 2014, to April 6, 2019, there were 15 months, 9 months, and 24 months of progression-free survival time for first line (including maintenance therapy), second line, and third line treatment, respectively. The only adverse event was neutropenia at grade 2 (CTC AE) occurring during the maintenance treatment.

Lessons:
This case indicated that low-dose apatinib combined with S-1 might be effective and safe in selected pretreated patients with advanced squamous cell lung cancer. It might be worthy to conduct further researches to investigate the efficacy and safety of the combination therapy in such patients.
Hospital anxiety and depression scale exhibits good consistency but shorter assessment time than Zung self-rating anxiety/depression scale for evaluating anxiety/depression in non-small cell lung cancer
Authors: Guo Congying , Huang Xuan 
Published: March 2021

Abstract
This study aimed to compare Zung self-rating anxiety/depression scale (SAS/SDS) and hospital anxiety and depression scale (HADS) regarding the detection rate, detection consistency, and time of assessment in non-small cell lung cancer (NSCLC) patients.
Totally 290 NSCLC patients who underwent surgical resection were consecutively recruited and clinical data of patients were collected. Patients’ anxiety and depression were assessed using HADS and SAS/SDS when they were discharged from hospital and consumption of the time for completing HADS and SAS/SDS was recorded.
The anxiety detection rates by SAS (57.9%) and HADS-A (51.0%) were of no difference (P = .095). Also, there was no difference in anxiety severity detected by the 2 scales (P = .467). Additional correlation analysis revealed that both anxiety scores (r = 0.702, P < .001) and detected anxiety (Kappa = 0.626, P < .001) were consistent by SAS and HADS-A. Regarding depression, depression detection rate by SDS (47.6%) was higher than that of HADS-D (39.3%) (P = .044); the depression severity by SDS was more advanced than that by HADS-D (P = .002). The subsequent correlation analysis showed that both depression scores (r = 0.639, P < .001) and detected depression (Kappa = 0.624, P < .001) were consistent by SDS and HADS-D. In addition, the time for HADS assessment (7.6 ± 1.2 minutes) was shorter than SAS/SDS assessment (16.2 ± 2.1 minutes) (P < .001).
HADS could be a better choice for assessing anxiety and depression in NSCLC patients, benefiting from its shorter assessment time but consistent detection rate compared with SAS/SDS.