bluuebunny/crossref_metadata_2025_split huggingface dataset:
Appropriate dose of tranexamic acid in the topical treatment of anterior epistaxis, 500 mg vs 1000 mg: A double-blind randomized controlled trial
Authors: Arikan Cüneyt , Akyol Pınar Yeşim 
Published: October 2024

Aims: Patients with epistaxis typically visit the emergency department for initial treatment. According to recent studies, tranexamic acid (TXA) is effective in the treatment of epistaxis. This study compared the therapeutic superiority of saline to that of 500 and 1000 mg doses of topical TXA for the treatment of anterior epistaxis. Materials and methods: This phase 4 clinical trial was a randomized, controlled, and double-blind trial. A total of 152 patients were divided into three groups. Group 1 was treated with 1000 mg TXA, Group 2 with 500 mg TXA, and Group 3 with saline. Results: Based on multinomial logistic regression analysis, the bleeding frequency at the 5th minute was 2.9 times and rebleeding status was 4.3 times less in Group 1 (1000 mg TXA) than in Group 3 (saline). There were no differences between the three groups in terms of side effects or salvage therapy. Conclusion: In addition to its superiority in treatment, 1000 mg of TXA is recommended because of the decreased rate of recurrent bleeding and low incidence of side effects.
Influence of nano industrial waste and short coir fiber filler on hybrid inter and intra yarn bio fiber composites
Authors: Kar Sasmita , Pattnaik Sarojrani , Sutar Mihir Kumar 
Published: October 2024

Bio-polymer composites are emerging as a feasible substitute for conventional polymers in various major fields of applications. In the current research, the impact of hybridization of inter and intra-woven natural engineering fibers namely, brown flax, white flax, and jute of different amalgamations along with commingled SCF and novel nano IW filler has been studied. The composites are manufactured by hand layup process and physical and thermomechanical characteristics of the composites are experimentally studied. The composites mingled with IW filler demonstrated better dimensional stability and mechanical properties such as maximum tensile strength of 36.74 MPa, bending strength of 82.53 MPa, and hardness of 84.89 D compared to other composites. However, elastic and flexural modulus are maximum for composite without any filler. The composites mingled with SCF filler demonstrated the highest impact strength, energy absorption, and elongation. Thermogravimetric analysis and thermal conductivity study demonstrated that the composite with SCF filler exhibited better thermal stability and thermal resistance than the other hybrid composites. Fourier transform infrared spectroscopy study confirms the interaction of hydrogen bonds with different polymers, matrices, and fillers. It is established that the weaving pattern and the filler types greatly influences the mechanical and thermal characteristics of the composites. Filler addition and fabric hybridization optimizes the catastrophic failures and enhances the thermal stability, hence becoming more suitable for small interior structural components in aerospace and automobile applications.
Comprehensive secondary analysis of thrombotic events in pediatric patients receiving extracorporeal membrane oxygenation: A prospective cohort study
Authors: Hughes Tyler B , Treffalls Rebecca N , Koek Wouter , Dalton Heidi , Karam Oliver , Meyer Andrew D 
Published: October 2024

Introduction This study aims to describe laboratory and clinical factors associated with thrombotic events during prolonged pediatric extracorporeal membrane oxygenation. Methods A secondary analysis of a multi-center prospective study performed between 2012 and 2014. Patients under the age of 19 years that received extracorporeal membrane oxygenation for at least 4 days of therapy were included ( n = 385). Univariable analysis and binomial regression were performed to evaluate predictive factors of single and multiple thrombotic events. A posteriori scoring tool was created to categorize thrombotic event severity. Results Over 39% of children receiving prolonged ECMO experienced a thrombotic event (TE). Binomial regression demonstrated an association between higher transfused platelet volume (mL/kg) (OR 1.04, CI: 95% 1.01–1.06, p = 0.003), Anti-Xa (OR 5.38, CI: 95% 1.22–23.8, p = 0.026) and aPTT (OR 1.01, CI: 95% 1.00–1.02, p = 0.032) the day prior to TE. Patients experiencing multiple TEs were associated with higher platelet transfusion volume (mL/kg) (OR 1.08, CI: 95% 1.05–1.12, p =< 0.001), antithrombin III (OR 1.03, CI: 95% 1.01–1.04, p = 0.001) and aPTT (OR 1.02, CI: 95% 1.01–1.03, p = 0.009). Patients experiencing multiple thrombotic events had a higher risk of 28-day mortality based on a cumulative clot severity score >4 (OR 2.37 (CI: 95% 1.32–4.24). Conclusions Current lab tests show limited sensitivity to predict these events the day prior in a vulnerable patient group, leading to potential ECMO circuit failures. Patients with multiple thrombotic events during ECMO therapy face increased mortality risks, highlighting the need for dynamic reporting tools like clot severity scores and detailed documentation of interventions to enhance understanding and improve outcomes.
Overview of Reviews of Peer-mediated Interventions for Young Children With Disabilities
Authors: Reichow Brian , Song Jinwei 
Published: October 2024

Peer-mediated interventions are interventions in which peers without disabilities are systematically taught to engage children with disabilities in positive social interactions, with the aim of helping children with disabilities acquire new, targeted social skills. Peer-mediated interventions have been used to enhance the social and play skills of young children with disabilities for many years and continues to be commonly used with young children with disabilities in classroom settings. Because of the frequent use of peer-mediated interventions, it is important to know the level of empirical support for this instructional practice. The objective of this overview was to evaluate systematic reviews of peer-mediated interventions for young children with or at risk for disabilities under the age of five years old. This synthesis is an overview of reviews, which is a review method used for evaluating existing research reviews. To complete this overview, we searched electronic databases and other sources for published articles presenting the results of reviews of studies on peer-mediated interventions for young children with or at risk for disabilities under the age of five years old. We then synthesized the findings across reviews to formulate conclusions on the effects of the intervention to make practice recommendations. We searched the literature in October 2023 for articles that presented findings of a systematic review on peer-mediated interventions for young children with or at risk of disabilities under the age of five years old. We located 10 reviews. In the 10 reviews there were 47 studies with 114 young children with a variety of developmental disabilities. In the studies included in the reviews, the peer-mediated interventions typically occurred in natural settings including inclusive classrooms and children’s homes. The findings from all 10 included reviews suggested that peer-mediated interventions were an effective intervention for improving the social development of young children with disabilities. Over 80% of the 47 studies included in the 10 reviews had positive findings. Three reviews conducted a meta-analysis, which is a statistical technique of combining results across studies. All three meta-analyses showed robust results of the peer-mediated intervention. Thus, the use of peer-mediated interventions for children with or at risk of disabilities under the age of five is strongly supported by empirical research. Therefore, peer-mediated interventions should be considered an evidence-based practice for young children with disabilities. As demonstrated in the reviews, the use of peer-mediated interventions was most robust when used with preschool-aged children in inclusive (natural) settings.
Contact-implicit Model Predictive Control: Controlling diverse quadruped motions without pre-planned contact modes or trajectories
Authors: Kim Gijeong , Kang Dongyun , Kim Joon-Ha , Hong Seungwoo , Park Hae-Won 
Published: October 2024

This paper presents a contact-implicit model predictive control (MPC) framework for the real-time discovery of multi-contact motions, without predefined contact mode sequences or foothold positions. This approach utilizes the contact-implicit differential dynamic programming (DDP) framework, merging the hard contact model with a linear complementarity constraint. We propose the analytical gradient of the contact impulse based on relaxed complementarity constraints to further the exploration of a variety of contact modes. By leveraging a hard contact model-based simulation and computation of search direction through a smooth gradient, our methodology identifies dynamically feasible state trajectories, control inputs, and contact forces while simultaneously unveiling new contact mode sequences. However, the broadened scope of contact modes does not always ensure real-world applicability. Recognizing this, we implemented differentiable cost terms to guide foot trajectories and make gait patterns. Furthermore, to address the challenge of unstable initial roll-outs in an MPC setting, we employ the multiple shooting variant of DDP. The efficacy of the proposed framework is validated through simulations and real-world demonstrations using a 45 kg HOUND quadruped robot, performing various tasks in simulation and showcasing actual experiments involving a forward trot and a front-leg rearing motion.
Association Between Antipsychotic Medication Use and Dementia Risk in Patients With Schizophrenia or Schizoaffective Disorder
Authors: Veeramachaneni Kirti , Wang Yuzhi , Grossberg George , Salas Joanne , Scherrer Jeffrey F. 
Published: October 2024

Objective To determine the association between antipsychotic prescriptions and incident dementia in patients with schizophrenia or schizoaffective disorder. Methods In this retrospective cohort study, Cox Proportional hazard models estimated the association between antipsychotic prescriptions and incident dementia in participants ≥50 years of age with a schizophrenia/schizoaffective disorder diagnosis over 12 years. Confounding was controlled by E-balance. Results Cumulative dementia incidence was significantly greater among those with an antipsychotic prescription compared to those without (7.9% vs 5.5%, P < 0.0001). After controlling for confounding, antipsychotic prescriptions were associated with a 92% increased risk for dementia (HR = 1.92; 95% CI:1.13-3.27). This association was not significant among those aged ≥65 years. Antipsychotic prescription type (eg, first generation, yes or no) did not affect dementia risk but prescription number did. Conclusion Antipsychotic prescriptions were associated with almost twice the incidence of dementia compared to patients without in those with schizophrenia/schizoaffective disorder.
A Proposed Algorithm for the Pharmacological Treatment of Generalized Anxiety Disorder in the Older Patient
Authors: Chen Anderson , Metzger Eran , Lee Soyoung , Osser David 
Published: October 2024

Background This is a new algorithm from the Psychopharmacology Algorithm Project at the Harvard South Shore Program, focused on generalized anxiety disorder (GAD) in older adults. Pertinent articles were identified and reviewed. Results Selective serotonin reuptake inhibitors (SSRIs) are considered to be first-line medications, with a preference for sertraline or escitalopram. If avoiding sexual side effects is a priority, buspirone is an option for the relatively healthy older adult. If response is inadequate, the second recommended trial is with a different SSRI or one of the serotonin-norepinephrine update inhibitors (SNRIs), venlafaxine or duloxetine. For a third medication trial, additional alternatives added to the previous options now include pregabalin/gabapentin, lavender oil, and agomelatine. If there is an unsatisfactory response to the third option chosen, quetiapine may be considered. We recommend caution with the following for acute treatment in this population: benzodiazepines and hydroxyzine. Other agents given low priority but having some supportive evidence were vilazodone, vortioxetine, mirtazapine, and cannabidiol. Acknowledging that the median age of onset of GAD is in early adulthood, many patients with GAD will have been started on benzodiazepines (or other medications that require caution in the elderly) for GAD at a younger age. These medications may be continued with regular observation to see if the potential harms are starting to exceed the benefits and a switch to other recommended agents may be justified.
Newborn screening for biliary atresia using direct bilirubin: An implementation science study
Authors: Rabbani Tebyan , Shah Jay 
Published: October 2024

Objective Biliary atresia (BA) is a liver disease of infancy characterized by obstruction of the biliary tree. Infants with BA have the best outcomes when identified early and the Kasai portoenterostomy is performed before 45 days of life (DoL). In our hospital system, the average age at Kasai was 60 DoL. To address the problem of late presentation, we implemented a two-stage BA screening strategy utilizing direct bilirubin (DB). Methods New institutional policies were established that all newborns were tested at 24–48 h of life, and those with levels ≥0.5 mg/dL were followed further. The infant's primary care provider was contacted to recommend a repeat DB at 2 weeks of life. If the repeat DB was ≥1.0 mg/dL, the patient was evaluated by gastroenterology. Results Over the 16 months, 3880 infants were born and 3861 (99.5%) were screened; 53 infants (1.3%) had DB levels ≥0.5 mg/dL initially. Upon repeat testing at 2 weeks, there were three groups of infants: not retested ( n = 1), retested <1.0 mg/dL ( n = 40), and retested ≥1.0 mg/dL ( n = 12). The average time to be seen by gastroenterology was 4.3 days or 18.3 DoL. Discussion The screening included a series of steps that needed to be implemented effectively. Screening had a net false positive rate of 0.3% (12 out of 3861) and identified causes of cholestasis other than BA. BA was excluded by 28 DoL on average. Our results can provide a template for other institutions interested in implementing a BA screening protocol in their practice.
To Validate Use of Transmittance Sensor of Peripheral Pulse Oximeter for Forehead Pulse Oximetry in Newborns
Authors: Rehman Talha , Gupta Girish , Patra Saikat , Chetan Chinmay , Kumar Rakesh , Wasim Sanober 
Published: October 2024

Introduction Peripheral pulse oximeters with continuous monitoring of heart rate and saturation have revolutionized neonatal care. Motion artifacts, hypothermia, and poor perfusion are some of the barriers for reliable reading in the transmittance type of peripheral pulse oximeters. This study was planned to assess the effectiveness of transmittance sensors applied over the forehead for monitoring the heart rate and saturation. Material and Methods An observation study was conducted over a period of 1 month. Two pulse oximeters (Masimo RAD97) were applied simultaneously, one over the periphery (right hand/wrist) and the other over the forehead using an innovative headband. A total of 540 readings of heart rate and saturation (SpO2) from each site were recorded. A difference of more than 5 beats/minute in heart rate and 2% saturation were considered clinically significant. Results Forty-five neonates with mean gestational age of 35.3 ± 3.2 weeks and birth weight of 2109 ± 683 grams were enrolled. Forehead pulse oximeter could pick up the heart rate and SpO2 readings in all the babies. A statistically significant difference of 3.8 beats/minute in heart rate and 2.5% in SpO2 was noted ( p-value < 0.0001). The difference in heart rate was not clinically significant. Conclusion We propose that the transmittance type peripheral pulse oximeter sensors can be used over the forehead. It has the potential to avoid erroneous readings due to motion artifacts, hypothermia, or shock. Saturation nomograms for the forehead pulse oximetry need to be established before it can be used to monitor and manage the neonates for the same.
The Lack of Lewis Turning Point in India: Conceptualizing the Roles of Capital Intensity, Employment Opportunities, and Keynesian Investments
Authors: Padhi Satya Prasad 
Published: October 2024

This research study aims to explain why the higher-growth phase in India, witnessed in the post-reform period of 1991–2011, failed to have the impact of significant increases in formal, modern sector employment or a transition toward the Lewis turning point. The article illustrates that it is more realistic to view a transition toward the Lewis turning point as involving increases in capital intensity. A desired increase in demand for labor will follow if the increases in capital intensity are associated with productivity growth in terms of increases in the share of intermediate goods specializations as output is increased. Autoregressive distributed lagged regression has been used to analyze whether investment behavior captures Young–Kaldor investments that can indicate growth in intermediate goods specialization. This is key to a higher pace of investment and specialized employment outcomes. The findings support existing literature, highlighting that increases in capital intensity constitute a significant factor explaining the lack of proper employment growth and the Lewis turning point. However, they also show that the problem is not with increases in capital intensity per se. Rather, the increases do not indicate dynamism regarding investments associated with intermediate goods specializations. JEL Classification O11, O14, O31
Metallic Stearates: A Review of their Function and Use as Release Agents for Rubber Compounds*
Authors: O'Rourke Stephen E. , Morris Richard H. 
Published: October 2024

Metallic stearates have a long history of use in the rubber industry as release agents. They have been primarily used tkeeping uncured rubber from sticking to itself. Metallic stearates have also been used as mould release agents for cured rubber. The applications of these products are numerous and many rubber companies have found unique ways to utilise their physical and chemical properties. In this paper we will discuss these products in detail, including the following: chemistry, physical properties, compatibility with elastomers, environmental concerns, and their function as release agents for rubber. Metallic stearates can be supplied in various forms such as their dry neat state, dispersed in water and alcohol, and formulated with surfactants that provide a wettable grade. These various forms will be discussed as to their function and use in a rubber manufacturing facility.
Optimizing the combination of chemotherapeutic drugs along with radiotherapy for extranodal NK/T-cell lymphoma
Authors: Luo Fei , Zhong Qiu-Zi , Liu Xin , Hou Xiao-Rong , Qian Li-Ting , Qiao Xue-Ying , Wang Hua , Zhu Yuan , Cao Jian-Zhong , Wu Jun-Xin , Wu Tao , Zhu Su-Yu , Shi Mei , Zhang Hui-Lai , Zhang Xi-Mei , Su Hang , Song Yu-Qin , Zhu Jun , Zhang Yu-Jing , Huang Hui-Qiang , Wang Ying , He Xia , Zhang Li-Ling , Qu Bao-Lin , Yang Yong , Hu Chen , Deng Min , Wang Shu-Lian , Qi Shu-Nan , Li Ye-Xiong 
Published: October 2024

Background: Extranodal natural killer/T-cell lymphoma (ENKTCL) has a unique treatment principle. However, the optimal combination of drugs along with radiotherapy (RT) is unknown. Design: Retrospective cohort study. Objectives: We screened multiple drug combinations to identify the most efficacious therapeutic combinations. Methods: We reviewed 3105 patients who received 40 chemotherapy regimens with different combinations of 9 drug classes and/or RT. Least absolute shrinkage and selection operator and multivariable Cox regression analyses were used to screen efficacious single drugs and identify optimal combinations for overall survival (OS). Inverse probability of treatment weighting (IPTW) and multivariable analyses were used to compare survival between treatment regimens. Results: Screening and validation revealed RT, asparaginase (ASP), and gemcitabine (GEM) to be the most efficacious single modality/drug. RT remained an important component of first-line treatment, whereas ASP was a fundamental drug of non-anthracycline (ANT)-based regimens. Addition of RT to non-ANT-based or ASP/GEM-based regimens, or addition of an ASP-drug into ANT-based or GEM/platinum-based regimens, improved 5-year OS significantly. Use of ASP/GEM-based regimens was associated with significantly higher 5-year OS (79.9%) compared with ASP/ANT-based (69.2%, p = 0.001), ASP/methotrexate-based (63.5%, p = 0.011), or ASP/not otherwise specified-based (63.2%, p < 0.001) regimens. The survival benefit of ASP/GEM-based regimens over other ASP-based regimens was substantial across risk-stratified and advanced-stage subgroups. The survival benefits of a combination of RT, ASP, and GEM were consistent after adjustment for confounding factors by IPTW. Conclusion: These results suggest that combining ASP/GEM with RT for ENKTCL is an efficacious and feasible therapeutic option and provides a rationale and strategy for developing combination therapies.
Personalized messaging enhances hospital debt collection while prosocial appeals fail: Evidence from a field experiment
Authors: Saulitis Andris 
Published: October 2024

Objective This study aimed to understand how different communication strategies influence patients’ behaviour in paying unpaid hospital bills. The research focused on a healthcare system where patients have to pay a significant portion of their medical costs out-of-pocket. Methods The research was conducted in collaboration with a debt collection agency in Latvia. The field experiment involved 9196 individuals with unpaid hospital bills. These individuals received randomly assigned reminders through mobile text messages and e-mails. The study compared the effectiveness of personalized messages, which included the recipient's name, with generic reminders and messages that appealed to social norms or public good contributions. Results The findings revealed that personalized messages, specifically those that included the recipient's name, significantly improved payment rates compared with generic reminders. Conversely, messages that used social norms or public good appeals did not have a significant impact on payment rates. Conclusions The study highlights the importance of personalized communication strategies in improving hospital debt collection. Even simple, cost-effective modifications in communication, like adding the recipient's name, can significantly enhance payment compliance. This approach not only keep the financial books of healthcare providers balanced but also suggests that personalized strategies can be extended to other areas of healthcare management. However, while these findings are promising, they indicate that more personalized and nuanced communication strategies are needed to address the broader issue of unpaid hospital bills effectively.