bluuebunny/crossref_metadata_2025_split huggingface dataset:
A clinicopathological study of 39 cases of atypical polypoid adenomyoma of the uterus
Authors: Zhu Honglan , Bai Taji , Tian Zhao , Lu Shanshan , Bao Dongmei , Cui Heng 
Published: August 2021

AbstractObjectiveTo clarify the clinical and pathological characteristics of atypical polypoid adenomyoma (APA) in order to improve the criteria used to diagnose and treat this disease.Study designIn 39 cases of APA, retrospective analysis was performed of theclinical data, pathological characteristics, and the follow-up findings in patients admitted to the Peking University People's Hospital from 2007 to 2019.ResultsThe median age was 39.6 years (range 24–60 years). Thirty seven patients were premenopausal (i.e.94.9 ​%) and eighteen patients were nullipara (i.e. 46.2 ​%). Abnormal uterine bleeding was the most common presenting symptom. Hysteroscopic transcervical resection (i.e.TCR) identified lesions in 35 cases whereas: a) hysterectomy identified them in 3 cases; b) dilatation and curettage (D&C) identified them in 1 case. Immunohistochemical analysis was performed on 24 samples. In the glandular component, hormone receptors were positively expressed. In all cases, Ki67 expression was detectable in approximately 50 ​% of the cases. In those samples, its presence was definitive in eighteen of the nineteen cases (94.7 ​%,18/19), p53 positive expression was present in most cases (68.8 ​%,11/16), and PTEN positive expression was detected in 40 ​% (4/10). Stroma immunophenotype expression was exhibited as follows: a)CD10-(12/12), Desmin +(6/7); b) Vimentin +(4/4); c) α-SMA+ (3/3) and; d) p16 positve staining in of 80 ​%(4/5).The concurrent amount of atypical endometrial hyperplasia with atypical polypoid adenomyoma was 23.1 ​%(9/39), while its concurrent level of endometrial carcinoma with atypical polypoid adenomyoma was 7.7 ​% (3/39). Fertility preserving treatments were performed in 20 patients with strong childbearing desires. Their pregnancy success was 15 ​%(3/20) and the live birth frequency was 10 ​%(2/10). Follow-up findings were available in 36 cases (92.3 ​%) with a medial follow-up of 48.1 months (range 4–122 months). Its pathological recurrence and frequency of progression into endometrial carcinoma were both 5 ​%(1/20). One case died of another type of malignancy, while the other patients were alive.ConclusionsAPA occurs mostly during the years of a women's reproductive period. Its diagnosis is based on the analysis of pathological and immunohistochemical findings. Individuals diagnosed with APA are at risk to coexist with endometrial carcinoma and atypical endometrial hyperplasia. For those individuals who desire retaining fertility, the treatment strategy involves performing TCR completely remove the lesions and close follow-up for surveillance of possible progressive APA recurrence. For those individuals who have no fertility desire, hysterectomy may be a preferred option.
Use of contrast-enhanced ultrasound during preoperative evaluation of endometrial carcinoma
Authors: Tian Zhao , Yao Hui-Min , Wang Yi-Qin , Chen Na-Ze , Tang Jun , Geng Jing 
Published: August 2021

AbstractObjectiveTo explore the clinical role of contrast-enhanced ultrasound (CEUS) in a preoperative evaluation of early endometrial carcinoma.MethodsThis study included 14 patients who underwent preoperative CEUS and contrast-enhanced magnetic resonance imaging (CEMRI) and were ultimately diagnosed with stage I endometrial carcinoma from December 2019 to December 2020. The parameters of the time-intensity curve (TIC) were compared with the endometrial carcinoma group, the invaded myometrium group, and the normal myometrium group.ResultsTIC parameters between the endometrial carcinoma group and the invaded myometrium group were similar. Compared with the normal myometrium group, the time to peak (TTP) was significantly shorter and the ascending slope (AS) was significantly higher in the endometrial carcinoma group. The TTP of the invaded myometrium group was shorter than that of the normal myometrium group and the peak intensity (PI) was higher than that of the normal myometrium group. We then compared the TIC parameters between the endometrial carcinoma group and the invaded myometrium group after adjusting for the normal myometrium group, and the results still did not show any difference. Of the 14 cases of endometrial carcinoma, 9 cases were diagnosed by CEMRI and were consistent with the pathology results, 1 case was underestimated, and 4 cases were overestimated; while 11 cases diagnosed were diagnosed by CEUS and were consistent with the pathology results, 1 case was underestimated, and 2 cases were overestimated.ConclusionsThe contrast pulse sequencing technique used in the CEUS examinations performed well in evaluating the extent of the endometrial carcinoma. Future studies with larger sample sizes are needed to determine the applicability and value of this new procedure during preoperative assessments of early endometrial carcinoma.
Air refueling optimisation for more agile and efficient military deployment operations
Authors: Toydas M. , Malyemez C. 
Published: August 2021

AbstractStrategic airlift is a crucial capability for any country that wants to protect its global interests around the world. Air refueling may offer more agile and efficient airlift capabilities by increasing cargo aircraft payload and shortening airlift time. We investigated whether air refueling can shorten the total time of an airlift operation and decrease the number of cargo aircraft sorties required in a deployment scenario, especially where the distance between origin and destination is within the range of cargo aircraft. We introduced two mathematical models to compare the total airlift time and number of cargo aircraft required for given origin-destination and tanker base locations and total freight to be moved. We optimised initial cargo and fuel amount for cargo aircraft along with rendezvous point coordinates to minimise total airlift time. We used a numerical example to show that substantial airlift time and cargo aircraft sortie savings are possible through air refueling.
A prospective epidemiological analysis of controlling nutritional status score with the poor functional outcomes in Chinese patients with haemorrhagic stroke
Authors: Zhu Bei Lei , Wu Yan Zhi , Cai Zhong Ming , Liao Cheng-Wei , Sun Le Qiu , Liu Zhi Peng , Chen Hao Man , Huang Xue Rong , Feng Ren Qian , Ye Sheng Lie , Lin Qun Li , Zhou Xu Dong , Wang Liang , Zhang Man Man , Yang Bo 
Published: August 2021

AbstractNutritional Risk Screening index is a standard tool to assess nutritional risk, but epidemiological data are scarce on controlling nutritional status (CONUT) as a prognostic marker in acute haemorrhagic stroke (AHS). We aimed to explore whether the CONUT may predict a 3-month functional outcome in AHS. In total, 349 Chinese patients with incident AHS were consecutively recruited, and their malnutrition risks were determined using a high CONUT score of ≥ 2. The cohort patients were divided into high-CONUT (≥ 2) and low-CONUT (< 2) groups, and primary outcomes were a poor functional prognosis defined as the modified Rankin Scale (mRS) score of ≥ 3 at post-discharge for 3 months. Odds ratios (OR) with 95 % confidence intervals (CI) for the poor functional prognosis at post-discharge were estimated by using a logistic analysis with additional adjustments for unbalanced variables between the high-CONUT and low-CONUT groups. A total of 328 patients (60·38 ± 12·83 years; 66·77 % male) completed the mRS assessment at post-discharge for 3 months, with 172 patients at malnutrition risk at admission and 104 patients with a poor prognosis. The levels of total cholesterol and total lymphocyte counts were significantly lower in high-CONUT patients than low-CONUT patients (P = 0·012 and < 0·001, respectively). At 3-month post discharge, there was a greater risk for the poor outcome in the high-CONUT compared with the low-CONUT patients at admission (OR: 2·32, 95 % CI: 1·28, 4·17). High-CONUT scores independently predict a 3-month poor prognosis in AHS, which helps to identify those who need additional nutritional managements.
The development of spicules inHeligmosomoides bakeri(Nematoda, Heligmosomidae)
Authors: Musah-Eroje M. , Burton L. , Behnke J.M. 
Published: August 2021

AbstractThe spicules of male parasitic nematodes are key morphological features, which vary between species in shape and length and are used often for species identification. However, little is known about spicules and particularly if/how their length varies during growth. We first assessed the degree of variation in spicule length of maleHeligmosomoides bakeri21 days post infection (PI), and then in two follow-up experiments measured spicule lengths at half daily/daily intervals between days 6 and 14 PI. Mean spicule length in 21-day worms was 0.518 mm with a range of 94 μm, and variation between the two spicules of individual worms from 2 to 32 μm. Spicules were first detectable on day 6–6.5, after which their lengths increased until day 7 PI (mean = 0.61 and 0.59). This was followed by significant contraction, initially relatively quickly over the following 48 h and then more slowly over a longer period, stabilizing by days 10–14, with only minor further reduction in length. We conclude that the length of spicules varies significantly over the first few days after they have formed, and, consequently, the age of worms is an important factor for consideration when spicule lengths are measured for experimental/diagnostic or taxonomical purposes.
Diagnostic application of sensitive and specific phage-exposed epitopes for visceral leishmaniasis and human immunodeficiency virus coinfection
Authors: Ramos Fernanda F. , Tavares Grasiele S. V. , Ludolf Fernanda , Machado Amanda S. , Santos Thaís T. O. , Gonçalves Isabela A. P. , Dias Ana C. S. , Alves Patrícia T. , Fraga Vanessa G. , Bandeira Raquel S. , Oliveira-da-Silva João A. , Reis Thiago A. R. , Lage Daniela P. , Martins Vívian T. , Freitas Camila S. , Chaves Ana T. , Guimarães Nathalia S. , Chávez-Fumagalli Miguel A. , Tupinambás Unaí , Rocha Manoel O. C. , Cota Gláucia F. , Fujiwara Ricardo T. , Bueno Lílian L. , Goulart Luiz Ricardo , Coelho Eduardo A. F. 
Published: August 2021

AbstractThe diagnosis of visceral leishmaniasis (VL) has improved with the search of novel antigens; however, their performance is limited when samples from VL/human immunodeficiency virus (HIV)-coinfected patients are tested. In this context, studies conducted to identify more suitable antigens to detect both VL and VL/HIC coinfection cases should be performed. In the current study, phage display was performed using serum samples from healthy subjects and VL, HIV-infected and VL/HIV-coinfected patients; aiming to identify novel phage-exposed epitopes to be evaluated with this diagnostic purpose. Nine non-repetitive and valid sequences were identified, synthetized and tested as peptides in enzyme-linked immunosorbent assay experiments. Results showed that three (Pep2, Pep3 and Pep4) peptides showed excellent performance to diagnose VL and VL/HIV coinfection, with 100% sensitivity and specificity values. The other peptides showed sensitivity varying from 50.9 to 80.0%, as well as specificity ranging from 60.0 to 95.6%. Pep2, Pep3 and Pep4 also showed a potential prognostic effect, since specific serological reactivity was significantly decreased after patient treatment. Bioinformatics assays indicated thatLeishmaniatrypanothione reductase protein was predicted to contain these three conformational epitopes. In conclusion, data suggest that Pep2, Pep3 and Pep4 could be tested for the diagnosis of VL and VL/HIV coinfection.
Association of trauma, post-traumatic stress disorder and non-affective psychosis across the life course: a nationwide prospective cohort study
Authors: Allardyce Judith , Hollander Anna-Clara , Rahman Syed , Dalman Christina , Zammit Stan 
Published: August 2021

AbstractBackgroundWe aimed to examine the temporal relationships between traumatic events (TE), post-traumatic stress disorder (PTSD) and non-affective psychotic disorders (NAPD).MethodsA prospective cohort study of 1 965 214 individuals born in Sweden between 1971 and 1990 examining the independent effects of interpersonal and non-interpersonal TE on incidence of PTSD and NAPD using data from linked register data (Psychiatry-Sweden). Mediation analyses tested the hypothesis that PTSD lies on a causal pathway between interpersonal trauma and NAPD.ResultsIncreasing doses of interpersonal and non-interpersonal TE were independently associated with increased risk of NAPD [linear-trend incidence rate ratios (IRR)adjusted = 2.17 [95% confidence interval (CI) 2.02–2.33] and IRRadjusted = 1.27 (95% CI 1.23–1.31), respectively]. These attenuated to a relatively small degree in 5-year time-lagged models. A similar pattern of results was observed for PTSD [linear-trend IRRadjusted = 3.43 (95% CI 3.21–3.66) and IRRadjusted = 1.45 (95% CI 1.39–1.50)]. PTSD was associated with increased risk of NAPD [IRRadjusted = 8.06 (95% CI 7.23–8.99)], which was substantially attenuated in 5-year time-lagged analyses [IRRadjusted = 4.62 (95% CI 3.65–5.87)]. There was little evidence that PTSD diagnosis mediated the relationship between interpersonal TE and NAPD [IRRadjusted = 0.92 (percentile CI 0.80–1.07)].ConclusionDespite the limitations to causal inference inherent in observational designs, the large effect-sizes observed between trauma, PTSD and NAPD in this study, consistent across sensitivity analyses, suggest that trauma may be a component cause of psychotic disorders. However, PTSD diagnosis might not be a good proxy for the likely complex psychological mechanisms mediating this association.
The Security Council's Role in Fulfilling the Responsibility to Protect
Authors: Welsh Jennifer M. 
Published: August 2021

AbstractThe principle of the responsibility to protect (RtoP) conceives of a broad set of measures that can be employed in preventing and responding to atrocity crimes. Nevertheless, the UN Security Council remains an important part of the implementation architecture, given what the International Commission on Intervention and State Sovereignty referred to as its authoritative position in international society as the “linchpin of order and stability.” As part of the roundtable “The Responsibility to Protect in a Changing World Order: Twenty Years since Its Inception,” this review of the Council's role in fulfilling its responsibility to protect advances two somewhat contrasting arguments about the original ICISS report. First, it suggests that the commissioners may have underestimated the Council's potential contribution, by concentrating on the authorization of coercive means to address crises of human protection. Over the past two decades, the Security Council has not only employed various diplomatic, political, and humanitarian measures to address atrocity crimes but also adjusted the purposes and practices of peace operations to advance protection goals and more subtly shaped discourses and expectations about state responsibilities for protection. However, I also argue that the willingness of the ICISS to identify potential alternatives to the Security Council when its members are paralyzed appears in retrospect to have been both bold and forward looking, in light of the Council's failures to act in a timely and decisive manner to protect amid crises and the contemporary realities of geopolitical rivalry. The article concludes by suggesting that future efforts to protect populations from atrocity crimes should focus not only on the herculean task of trying to change the behavior of P5 members of the Council but also on encouraging a new institutional balance between the Security Council and other intergovernmental bodies.
Toward a Normative Model of Meaningful Human Control over Weapons Systems
Authors: Amoroso Daniele , Tamburrini Guglielmo 
Published: August 2021

AbstractThe notion of meaningful human control (MHC) has gathered overwhelming consensus and interest in the autonomous weapons systems (AWS) debate. By shifting the focus of this debate to MHC, one sidesteps recalcitrant definitional issues about the autonomy of weapons systems and profitably moves the normative discussion forward. Some delegations participating in discussions at the Group of Governmental Experts on Lethal Autonomous Weapons Systems meetings endorsed the notion of MHC with the proviso that one size of human control does not fit all weapons systems and uses thereof. Building on this broad suggestion, we propose a “differentiated”—but also “principled” and “prudential”—framework for MHC over weapons systems. The need for a differentiated approach—namely, an approach acknowledging that the extent of normatively required human control depends on the kind of weapons systems used and contexts of their use—is supported by highlighting major drawbacks of proposed uniform solutions. Within the wide space of differentiated MHC profiles, distinctive ethical and legal reasons are offered for principled solutions that invariably assign to humans the following control roles: (1) “fail-safe actor,” contributing to preventing the weapon's action from resulting in indiscriminate attacks in breach of international humanitarian law; (2) “accountability attractor,” securing legal conditions for international criminal law (ICL) responsibility ascriptions; and (3) “moral agency enactor,” ensuring that decisions affecting the life, physical integrity, and property of people involved in armed conflicts be exclusively taken by moral agents, thereby alleviating the human dignity concerns associated with the autonomous performance of targeting decisions. And the prudential character of our framework is expressed by means of a rule, imposing by default the more stringent levels of human control on weapons targeting. The default rule is motivated by epistemic uncertainties about the behaviors of AWS. Designated exceptions to this rule are admitted only in the framework of an international agreement among states, which expresses the shared conviction that lower levels of human control suffice to preserve the fail-safe actor, accountability attractor, and moral agency enactor requirements on those explicitly listed exceptions. Finally, we maintain that this framework affords an appropriate normative basis for both national arms review policies and binding international regulations on human control of weapons systems.
Parents’ decision-making for their foetus or neonate with a severe congenital heart defect
Authors: Delaney Rebecca K. , Pinto Nelangi M. , Ozanne Elissa M. , Brown Heather , Stark Louisa A. , Watt Melissa H. , Karasawa Michelle , Patel Angira , Donofrio Mary T. , Steltzer Michelle M. , Miller Stephen G. , Zickmund Susan L. , Fagerlin Angela 
Published: August 2021

AbstractBackground:Parents who receive a diagnosis of a severe, life-threatening CHD for their foetus or neonate face a complex and stressful decision between termination, palliative care, or surgery. Understanding how parents make this initial treatment decision is critical for developing interventions to improve counselling for these families.Methods:We conducted focus groups in four academic medical centres across the United States of America with a purposive sample of parents who chose termination, palliative care, or surgery for their foetus or neonate diagnosed with severe CHD.Results:Ten focus groups were conducted with 56 parents (Mage = 34 years; 80% female; 89% White). Results were constructed around three domains: decision-making approaches; values and beliefs; and decision-making challenges. Parents discussed varying approaches to making the decision, ranging from relying on their “gut feeling” to desiring statistics and probabilities. Religious and spiritual beliefs often guided the decision to not terminate the pregnancy. Quality of life was an important consideration, including how each option would impact the child (e.g., pain or discomfort, cognitive and physical abilities) and their family (e.g., care for other children, marriage, and career). Parents reported inconsistent communication of options by clinicians and challenges related to time constraints for making a decision and difficulty in processing information when distressed.Conclusion:This study offers important insights that can be used to design interventions to improve decision support and family-centred care in clinical practice.
Integrating motivational interviewing with cognitive behavioural therapy for anxiety disorders, depression and co-morbid unhealthy lifestyle behaviours: a randomised controlled pilot trial
Authors: Ghaderi Ata , Rosendahl Ingvar , Bohman Benjamin 
Published: August 2021

AbstractBackground:A substantial proportion of patients receiving cognitive behavioural therapy (CBT) do not achieve remission, and drop-out is considerable. Motivational interviewing (MI) may influence non-response and drop-out. Previous research shows that MI as a pre-treatment to CBT produces moderate effects compared with CBT alone. Studies integrating MI with CBT (MI-CBT) are scarce.Aims:To test the feasibility of MI-CBT in terms of therapist competence in MI and various participant measures, including recruitment and retention. In addition, separate preliminary evaluations were conducted, exploring the effects of CBT alone for anxiety disorders and depression, and of MI-CBT for anxiety disorders, depression and unhealthy lifestyle behaviours.Method:Using a randomised controlled parallel trial design, participants were recruited in routine psychiatric care and allocated to CBT alone or MI-CBT. Means in feasibility measures and within-condition Hedges’ g effect sizes in treatment outcome measures were calculated. Authors were not blind to treatment allocation, while independent raters were blind.Results:Seventy-three patients were assessed for eligibility, and 49 were included. Participant perceptions of treatment credibility, expectancy for improvement, and working alliance were similar for both conditions. Overall, effect sizes were large across outcome measures for both conditions, including anxiety and depressive symptoms and functional impairment. However, therapists did not acquire sufficient competence in MI and the drop-out rate was high.Conclusions:MI-CBT proved feasible in some respects, but the present study did not support the progression to a randomised controlled trial designed to assess the effectiveness of MI-CBT. Additional pilot studies are needed.
The role of legal intermediaries in the dispute pyramid: inequalities before the French legal system
Authors: Lejeune Aude , Spire Alexis 
Published: August 2021

AbstractThis paper shows that social inequalities are cumulative and occur at each stage of the dispute pyramid, from the identification of a conflict through to satisfaction with its outcome. Based on a large and original survey on ordinary people's representations of and practices within the legal system in France (N= 2,660), our study finds that an individual's contact, or lack of contact, with a legal intermediary, who may be a legal professional or a non-legal professional, has a very significant impact on the decision to take a case to court. Contact with a legal intermediary also influences the individual's satisfaction with the outcome, but not in the same way for all plaintiffs: income is a more determining factor in satisfaction with the outcome in cases where the judge makes a decision than in cases where a solution is found outside the courtroom.