bluuebunny/crossref_metadata_2025_split huggingface dataset:
Outcome of Medical and Psychosexual Interventions for Vaginismus: A Systematic Review and Meta-Analysis
Authors: Maseroli Elisa , Scavello Irene , Rastrelli Giulia , Limoncin Erika , Cipriani Sarah , Corona Giovanni , Fambrini Massimiliano , Magini Angela , Jannini Emmanuele A. , Maggi Mario , Vignozzi Linda 
Published: November 2018

Abstract

Introduction
Although vaginismus is a condition with a great impact on psychosexual well-being, the evidence on the efficacy of interventions is lacking.

Aim
To review all information on vaginismus treatment, including data from randomized clinical trials (RCTs) and observational studies.

Methods
A systematic search was conducted of MEDLINE, EMBASE, PsycINFO, and ClinicalTrials.gov. 2 Independent meta-analyses of RCTs and observational studies were performed. For RCTs, only those having no treatment as the comparator were considered eligible.

Main Outcome Measure
The primary outcome was the success rate (number of successes/total sample) in the completion of sexual intercourse.

Results
43 Observational studies (n = 1,660) and 3 RCTs (n = 264) were included in the final analyses, respectively. In the meta-analysis of RCTs, the use of psychological interventions showed a trend toward a significantly better result vs waiting list control (OR 10.27 [95% CI 0.79–133.5], P = .075). The combination of the results obtained from the observational studies showed that treating vaginismus is associated with the completion of sexual penetrative intercourse in 79% of cases, independently of the therapy used (success rate 0.79 [0.74–0.83]). When only moderate- or strong-quality studies were considered, the success rate was 0.82 (0.73–0.89). As for the different definitions of vaginismus, studies with unconsummated marriage as the inclusion criterion showed the worst success rate (0.68). The origin of vaginismus (primary, secondary, or both), its duration, the mean age of the participants, the involvement of the partner in the intervention, or the geographic setting did not exert a significant effect on the outcome. Studies enrolling women with unconsummated marriage showed a significantly worse success rate.

Clinical Implications
No approach is superior to the others in allowing the achievement of penetrative intercourse in women with vaginismus.

Strength & Limitations
Only studies specifically enrolling patients with vaginismus were selected, and analyses were performed on an intention-to-treat approach. The main limitations are the small number of trials in the meta-analysis of RCTs and the lack of a comparison group in the meta-analysis of observational studies, which cannot rule out a placebo effect. Due to the limited evidence available, great caution is required in the interpretation of results. Further well-designed trials, with more appropriate outcomes than penetrative sex, are required.

Conclusion
The meta-analysis of RCTs documented a trend toward higher efficacy of active treatment vs controls, whereas the meta-analysis of observational studies indicated that women with vaginismus benefit from a range of treatments in almost 80% of cases.
Structure of Epithelial and Stromal Compartments of Vulvar and Vaginal Tissue From Women With Vulvo-Vaginal Atrophy Taking Ospemifene
Authors: Alvisi Stefania , Baldassarre Maurizio , Gava Giulia , Mancini Ilaria , Gagliardi Martina , Seracchioli Renato , Meriggiola Maria Cristina 
Published: November 2018

Abstract

Introduction
Vulvo-vaginal atrophy affects the daily lives of most post-menopausal women. We know that ospemifene intake can induce vaginal epithelial improvements within a few weeks; however, direct evidence of the effects of ospemifene on the human vulva and on connective tissue of both the vagina and vulva are lacking.

Aim
To evaluate the changes induced by ospemifene on epithelium thickness, glycogen content proliferation index, collagen content, and type I/III collagen ratio in vulvar and vaginal tissue of post-menopausal women.

Methods
20 women who attended our gynecologic clinic for planned surgery were recruited for the study. 11 subjects were taking ospemifene at the time of inclusion, and 9 subjects who were not taking ospemifene were selected as control group. Vaginal and vulvar biopsies were taken during surgery. Histological features and glycogen content were evaluated by standard hematoxylin-eosin and periodic acid–Schiff staining, total collagen and collagen type I/III ratio were evaluated by hydroxyproline assay and Sirius red staining, while the expression of Ki67 was evaluated by immunohistochemistry.

Main Outcome Measure
We analyzed histological features of the epithelial and stromal layer of the vaginal and vulvar vestibule mucosa.

Results
Vaginal and vulvar biopsies from women taking ospemifene showed an increased epithelium thickness, glycogen content, and proliferation index compared with the control group. Collagen content was also higher in women taking ospemifene, while an increased ratio between type I and III collagen fibers was found only at vaginal level.

Clinical Implications
Our study shows that the effectiveness of ospemifene on vaginal tissue also extends to the vulvar vestibule.

Strength & Limitations
This study provides direct evidence of the impact of ospemifene on vaginal and vulvar tissue. A specifically designed longitudinal study may further support our findings.

Conclusion
Ospemifene intake is associated with a marked improvement of various morphological and physiological features of both vaginal and vulvar vestibule epithelium, including the collagen content of the tissues.
A prospective study of transmission of Multidrug-Resistant Organisms (MDROs) between environmental sites and hospitalized patients—the TransFER study
Authors: Chen Luke F. , Knelson Lauren P. , Gergen Maria F. , Better Olga M. , Nicholson Bradly P. , Woods Christopher W. , Rutala William A. , Weber David J. , Sexton Daniel J. , Anderson Deverick J. ,   for the CDC Prevention Epicenters Program
Published: November 2018

AbstractObjectiveHospital environmental surfaces are frequently contaminated by microorganisms. However, the causal mechanism of bacterial contamination of the environment as a source of transmission is still debated. This prospective study was performed to characterize the nature of multidrug-resistant organism (MDRO) transmission between the environment and patients using standard microbiological and molecular techniques.SettingProspective cohort study at 2 academic medical centers.DesignA prospective multicenter study to characterize the nature of bacterial transfer events between patients and environmental surfaces in rooms that previously housed patients with 1 of 4 ‘marker’ MDROs: methicillin-resistant Staphylococcus aureus, vancomycin-resistant enterococci, Clostridium difficile, and MDR Acinetobacter baumannii. Environmental and patient microbiological samples were obtained on admission into a freshly disinfected inpatient room. Repeat samples from room surfaces and patients were taken on days 3 and 7 and each week the patient stayed in the same room. The bacterial identity, antibiotic susceptibility, and molecular sequences were compared between organisms found in the environment samples and patient sources.ResultsWe enrolled 80 patient–room admissions; 9 of these patients (11.3%) were asymptomatically colonized with MDROs at study entry. Hospital room surfaces were contaminated with MDROs despite terminal disinfection in 44 cases (55%). Microbiological Bacterial Transfer events either to the patient, the environment, or both occurred in 12 patient encounters (18.5%) from the microbiologically evaluable cohort.ConclusionsMicrobiological Bacterial Transfer events between patients and the environment were observed in 18.5% of patient encounters and occurred early in the admission. This study suggests that research on prevention methods beyond the standard practice of room disinfection at the end of a patient’s stay is needed to better prevent acquisition of MDROs through the environment.
Does Maimonides'sMishneh TorahForbid Reading theGuide of the Perplexed? On Platonic Punishments for Freethinkers
Authors: Halper Yehuda 
Published: November 2018

AbstractIn one passage of theMishneh Torah, Maimonides explicitly forbids Jews from philosophical inquiry or even freethinking. This prohibition apparently includes a ban on reading or thinking about the topics of theGuide of the Perplexed. This paper argues that Maimonides'sMishneh Torahpresents a consistent rejection of open philosophical inquiry. However, what is prohibited in theMishneh Torahis not only permitted in theGuide, but the terms of the prohibition can be used as an outline of the structure of theGuide. That is to say, theGuidein a sense covers precisely the topics whose inquiry is forbidden to Jews in theMishneh Torah. In theMishneh TorahMaimonides does not suggest a punishment in this world for freethinkers, but in theGuidehe punishes freethinkers with more study, especially metaphysical inquiry. It is possible that theGuideitself is the punishment for freethinking as defined by theMishneh Torah. This kind of intellectual punishment has a parallel in Plato'sLaws, where freethinkers are sentenced to spend five years living in the center of the city, studying physics and metaphysics with city elders.
Investigating multilevel pathways of developmental consequences of maltreatment
Authors: DePasquale Carrie E. , Handley Elizabeth D. , Cicchetti Dante 
Published: November 2018

AbstractThe impact of maltreatment spreads across many developmental domains and extends across the entire life span. Identifying unidirectional or bidirectional drivers of developmental cascades of the effects of maltreatment experiences is critical to efficiently employing interventions to promote resilient development in maltreated children. This 1-year longitudinal study utilized a multiple-levels approach, investigating “bottom-up” and “top-down” cascades using structural equation modeling between cortisol regulation, externalizing behavior, and peer aggression. Neither a bottom-up model driven by cortisol regulation nor a top-down model driven by peer aggression fit the data well. Instead, lower rates of externalizing behavior at Year 1 most strongly predicted improvements at all levels of analysis (reduced cortisol, externalizing behavior, and peer aggression) at Year 2. These results provide initial indication of a mechanism through which interventions for maltreated children may be most effective and result in the most substantial positive changes across developmental domains.
Head Growth and Intelligence from Birth to Adulthood in Very Preterm and Term Born Individuals
Authors: Jaekel Julia , Sorg Christian , Baeuml Josef , Bartmann Peter , Wolke Dieter 
Published: November 2018

AbstractObjectives:The aim of this study was to investigate the effects of infant and toddler head growth on intelligence scores from early childhood to adulthood in very preterm (<32 weeks gestational age; VP) and/or very low birth weight (<1500 g; VLBW) and term born individuals.Methods:203 VP/VLBW and 198 term comparisons were studied from birth to adulthood as part of the prospective geographically defined Bavarian Longitudinal Study (BLS). Head circumference was assessed at birth; 5, 20 months; and 4 years of age. Intelligence was assessed with standardized tests in childhood (6 and 8 years: K-ABC) and at 26 years (Wechsler Adult Intelligence Scale, WAIS). Structural equation modeling (SEM) was used to model the effect of head growth on IQ.Results:On average, VP/VLBW had lower head circumference at birth (27.61 cmvs. 35.11 cm, mean difference 7.49, 95% confidence interval [7.09–7.90]) and lower adult intelligence scores (88.98vs. 102.54, mean difference 13.56 [10.59–16.53]) than term born comparison individuals. Head circumference at birth (e.g., total effect β=.48;p<.001 for adult IQ) and head growth in childhood predicted intelligence development from age 6 to 26 years in both VP/VLBW and term born individuals (70% of variance in adult IQ explained by full model). Effects of gestation and birth weight on intelligence were fully mediated by head circumference and growth.Conclusions:This longitudinal investigation from birth to adulthood indicates head growth as a proxy of brain development and intelligence. Repeated early head circumference assessment adds valuable information when screening for long-term neurocognitive risk. (JINS, 2019, 25, 48#x2013;56)
Selection of patient for gated treatment based on the information from 4DCT imaging in stereotactic body radiotherapy of non-small cell lung cancer
Authors: Sresty N. V. N. Madhusudhana , Raju A. Krishnam , Sharma S. D. , Kumar T. Anil , Ahamed Shabbir , Bajwa Harjot Kaur 
Published: November 2018

AbstractPurposeStereotactic body radiotherapy (SBRT) is widely used for the treatment of stage-I non-small cell lung cancer (NSCLC). Patient-specific motion correlated with 4DCT could be essential for hypofractionated SBRT. All patients undergoing SBRT do not require motion management during the dose delivery. The objective of this study was to evaluate which patient may benefit from Gated SBRT.Materials and methodsTreatment planning of 20 patients of stage-I NSCLC was analysed. Conventional and 4DCT scans were taken. Internal target volume as well as planning target volume (ITV and PTV) were determined in the CT data sets. PTVall phases created using 4DCT data sets and PTV15mm created using conventional CT data were compared. Also, ITVall phases were compared with ITV created from maximum intensity projections (ITVMIP). Suitability of patients for motion management-based treatment delivery was also evaluated.ResultsThe average ITVMIP to ITVall phases ratio is 1·06 indicating good agreement between them. Based on the ratio of intensity projections, 9 out of 17 patients were found suitable for our existing gated treatment.Conclusion4D CT is the main requirement in SBRT to identify the patients who can benefit from motion management during the dose delivery.
Introducing Computer Science to High School Students Through Logic Programming
Authors: YUEN TIMOTHY T. , REYES MARITZA , ZHANG YUANLIN 
Published: November 2018

AbstractThis paper investigates how high school students in an introductory computer science (CS) course approach computing in the logic programming (LP) paradigm. This qualitative study shows how novice students operate within the LP paradigm while engaging in foundational computing concepts and skills: students are engaged in a cyclical process of abstraction, reasoning, and creating representations of their ideas in code while also being informed by the (procedural) requirements and the revision/debugging process. As these computing concepts and skills are also expected in traditional approaches to introductory K-12 CS courses, this paper asserts that LP is a viable paradigm choice for high school novices.
Web-STAR: A Visual Web-based IDE for a Story Comprehension System
Authors: RODOSTHENOUS CHRISTOS T. , MICHAEL LOIZOS 
Published: November 2018

AbstractWe present Web-STAR, an online platform for story understanding built on top of the STAR reasoning engine for STory comprehension through ARgumentation. The platform includes a web-based integrated development environment, integration with the STAR system, and a web service infrastructure to support integration with other systems that rely on story understanding functionality to complete their tasks. The platform also delivers a number of “social” features, including a community repository for public story sharing with a built-in commenting system, and tools for collaborative story editing that can be used for team development projects and for educational purposes.
The Internationalistsas grand narrative: Key elements and dilemmata
Authors: DIGGELMANN OLIVER 
Published: November 2018

Abstract:In this contribution, the key elements of the book’s progress narrative will be discussed. The focus will be set on the ‘backbone’ of the book, which consists of three ideas or elements: the periodisation decision (II), the claim of a specific conception of social change (III), and a specific understanding of international law (IV). In regard to each of those elements it will be asked how they are justified, what insights they provide and whether there are blind spots.
From law to history: The politics of war and empire
Authors: BARKAWI TARAK 
Published: November 2018

Abstract:The Internationalistsargues that the outlawry of war in 1928 created the modern international order. This review essay critiques this single-cause account of world history. It shows howThe Internationalistsrelies on statistics that obfuscate the character of war and on a juridical model of international politics that makes liberal empire invisible. I argue that war making by Asian and African peasants played more of a role in bringing about decolonisation than peacemaking by Western lawyers.
Separating Geophysical Signals Using GRACE and High‐Resolution Data: A Case Study in Antarctica
Authors: Engels Olga , Gunter Brian , Riva Riccardo , Klees Roland 
Published: November 2018

AbstractTo fully exploit data from the Gravity Recovery and Climate Experiment (GRACE), we separate geophysical signals observed by GRACE in Antarctica by deriving high‐spatial resolution maps for present‐day glacial isostatic adjustment (GIA) and ice‐mass changes with the least possible noise level. For this, we simultaneously (i) improve the postprocessing of gravity data and (ii) consistently combine them with high‐resolution data from Ice Cloud and land Elevation Satellite altimeter (ICESat) and Regional Atmospheric Climate Model 2.3 (RACMO). We use GPS observations to discriminate between various candidate spatial patterns of vertical motions caused by GIA. The ICESat‐RACMO combination determines the spatial resolution of estimated ice‐mass changes. The results suggest the capability of the developed approach to retrieve the complex spatial pattern of present‐day GIA, such as a pronounced subsidence in the proximity of the Kamb Ice Stream and pronounced uplift in the Amundsen Sea Sector.
Crustal Deformation and Seismicity Modulated by Groundwater Recharge of Karst Aquifers
Authors: D'Agostino N. , Silverii F. , Amoroso O. , Convertito V. , Fiorillo F. , Ventafridda G. , Zollo A. 
Published: November 2018

AbstractTriggered seismicity in karst regions has been explained assuming the existence of a hydraulically connected fracture system and downward diffusion of surface pore pressures. Karst systems are, in fact, able to swiftly channel large amount of rainfall through networks of conduits increasing the hydraulic head loading upon the fluid‐saturated, poroelastic crust. Here we use Global Positioning System and hydrological and seismicity data to show that poroelastic strain in the shallow crust (0–3.5 km) controls seasonal and multiannual modulation of seismicity along the Irpinia Fault Zone (Southern Italy) without requiring a hydraulically connected fracture system from the surface to hypocentral depths. We suggest that groundwater recharge of karst aquifers along the Irpinia Fault Zone produces stress perturbations large enough to modulate strain accumulation and seismicity and temporarily modify the probability of nucleation of seismic events such as the 1980 Irpinia, MS 6.9, earthquake.
Seismic Anisotropy Beneath the Pamir and the Hindu Kush: Evidence for Contributions From Crust, Mantle Lithosphere, and Asthenosphere
Authors: Kufner Sofia‐Katerina , Eken Tuna , Tilmann Frederik , Schurr Bernd , Yuan Xiaohui , Mechie James , Sippl Christian , Schneider Felix 
Published: November 2018

AbstractWe use local and teleseismic earthquakes to analyze shear wave splitting within the Pamir‐Hindu Kush region, north of the western syntaxis of the India‐Asia collision zone. These two data sets allowed us to map the distribution of azimuthal anisotropy, to put constraints on the depth range where it is accumulated, and to deduce characteristics of ongoing deformation. From 1,073 SKS (core‐mantle refracted phases) measurements at 107 stations, we derived time delays of 0.7–2.25 s and dominantly ENE‐WSW oriented fast polarization directions. Fast polarization directions only deviate adjacent to the subducting slabs and major strike‐slip faults, aligning parallel to these structures. From 461 direct S measurements along a transect perpendicular to the Pamir seismic zone, we obtain fast directions parallel to those from SKS measurements but smaller delay times (average 0.4 s), which vary depending on depth. Time delays exhibit 0.1–0.3 s crustal contribution and increase to 0.8 s in a narrow domain coinciding with the inferred subcrustal contact of the two colliding plates. We find measurements from the same event‐station paths at different filter frequencies to be frequency‐independent, allowing a comparison with SKS results along the studied profile. The smaller average time delays of local events imply that the crust and uppermost mantle only make a minor contribution to the SKS splitting. Thus, the coherent fast direction pattern suggests a strain field dominated by the indentation of India and the escape of sublithospheric material north of the indenter. Crustal anisotropy is likely also controlled by this regional deformation pattern with locally highest strain rates closest to the continental subduction front.
The Mesozoic Along‐Strike Tectonometamorphic Segmentation of Longmen Shan (Eastern Tibetan Plateau)
Authors: Airaghi L. , de Sigoyer J. , Guillot S. , Robert A. , Warren C. J. , Deldicque D. 
Published: November 2018

AbstractThe Longmen Shan belt (eastern border of the Tibetan plateau) constitutes a tectonically active region as demonstrated by the occurrence of the unexpected 2008 Mw 7.9 Wenchuan and 2013 Mw 6.6 Lushan earthquakes in the central and southern parts of the belt, respectively. These events revealed the necessity of a better understanding of the long‐term geological evolution of the belt and its effect on the present dynamics and crustal structure. New structural and thermobarometric data offer a comprehensive data set of the paleotemperatures across the belt and P‐T estimates for low‐grade metamorphic domains. In the central Longmen Shan, two metamorphic jumps of 150–200 °C, 5–6 kbar and ~50 °C, 3–5 kbar acquired during the Early Mesozoic are observed across the Wenchuan and Beichuan faults, respectively, attesting to their thrusting movement and unrevealing a major decollement between the allochtonous Songpan‐Garze metasedimentary cover (at T > 500 °C) and the autochtonous units and the basement (T < 400 °C). In the southern Longmen Shan, the only greenschist facies metamorphism is observed both in the basement (360 ± 30 °C, 6 ± 2 kbar) and in the metasedimentary cover (350 ± 30 °C, 3 ± 1 kbar). Peak conditions were reached at ca. 80–60 Ma in the basement and ca. 55–33 Ma in the cover, ca. 50 Ma after the greenschist facies metamorphic overprint observed in the central Longmen Shan (ca. 150–120 Ma). This along‐strike metamorphic segmentation coincides well with the present fault segmentation and reveals that the central and southern Longmen Shan experienced different tectonometamorphic histories since the Mesozoic.