bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Impact of Transportation Infrastructure on Manufacturing Energy Intensity: Micro Evidence from High-Speed Railway in China
Authors: Yang Mian , Wang En-Ze 
Published: September 2024

This paper examines the potential of infrastructure improvements, particularly the operation of High-speed railway (HSR), to enhance the energy efficiency of firms. By regarding the operation of the China’s HSR as an exogenous shock, this paper relies on a difference-in-differences estimation to isolate the causal effect of the infrastructure improvement on manufacturing firms’ energy intensity. This paper finds that the operation of HSR has improved the manufacturing firms’ energy intensity through the catalyzing the proliferation of advanced management techniques, and this effect gradually decreases with the increase in distance between the firm and the HSR station. Moreover, HSR indirectly decreases energy intensity by fostering technological innovation, decreasing debt financing costs, and extending debt financing magnitude. The study also uncovers heterogeneous effects of HSR connectivity on manufacturing firms’ energy intensity, which are more pronounced in smaller cities and industries characterized by high concentration and low agglomeration. Furthermore, the impact of HSR connectivity on reducing energy intensity is more substantial in state-owned and larger firms compared to non-state-owned and smaller firms. JEL Classification: Q43, O13, R41, L60
Sexual Knowledge, Attitude and Behaviors of Medical Students: A Cross-sectional Study
Authors: Patel Sahil H. , Desai Nimisha D. , Shah Sandip H. 
Published: September 2024

Introduction: Exposure to sexually explicit media influences the sexual knowledge, attitudes, and behavior of youth, so studying this among medical students is of utmost importance. Aim: To study sexual knowledge, attitudes, behaviors, and sources of influence among medical students. Methodology: A descriptive, cross-sectional, analytical, web-based study was conducted to assess sexual knowledge, attitudes, behaviors, and sources influencing sexuality in medical students via Google Forms. The form consisted of three parts: the first part was an information sheet and consent form, the second part included the participant’s sociodemographic data and the third part related to two study tools, the Sexual Knowledge and Attitude Questionnaire-II (SKAQ-II) and the sexual behavior and sources of influence scale. Result: A total of 300/950 (31.5%) medical students responded to the Google questionnaire. Their mean age was 20.43 ± 1.87 years (range: 18–26 years). The mean score for sexual knowledge and attitude was 24.35 ± 4.93 and 23.79 ± 4.87, respectively, which suggested that they had good sexual knowledge and liberal attitudes toward sexuality with female preponderance. As student’s academic year progresses, their sexual knowledge improves. There was a significant strong positive correlation between sexual attitude and knowledge with a Pearson correlation of r = 0.95, P = 0.004, which means the higher the knowledge, the better the attitude. Medical student’s engagement in sexual behaviors with self- and others was at age 18.45 years. The internet was the major source for getting information related to sexual behaviors for them, but they relied on doctors and friends for guidance. Conclusion: Medical students had adequate sexual knowledge, which was the reason for their liberal attitude toward sexuality. Their major source of sexual knowledge was the internet, although they confided in doctors for sexual doubts.
Towards precision dosing in psychiatry: Population pharmacokinetics meta-modelling of clozapine and lithium
Authors: Lereclus Aurélie , Welzel Julien , Belzeaux Raoul , Korchia Théo , Dayan Frédéric , Blin Olivier , Benito Sylvain , Guilhaumou Romain 
Published: September 2024

Background: Treatment optimization is mandatory in psychiatric diseases and the use of population pharmacokinetics (popPK) models through model informed precision dosing (MIPD) has the potential to improve patient medical care. In this perspective, meta-modelling methods could provide popPK models with improved predictive performances and most of covariates of interest. The aims of this study were to develop meta-models of clozapine and lithium, assess their predictability and propose optimized dosing regimens for both drugs. Methods: Two popPK models for each drug were retained to develop the meta-models. For clozapine, the model with the best predictive performances and gender as a covariate and one with smoking status were retained. For lithium, the model with the best predictive performances and fat-free mass as covariate and one with glomerular filtration rate were retained. Results: Both meta-models showed improved predictability compared to the original models. Clozapine meta-model simulations allowed us to propose dosing regimen according to gender and smoking status. Steady-state doses ranged from 375 to 725 mg/day for clozapine once daily, and from 350 to 650 mg/day for clozapine twice daily. Lithium meta-model simulations allowed us to propose dosing regimen according to weight, body mass index, gender and GFR. Our steady-state dose propositions ranged from 625 to 1125 mg/day for males, and from 375 to 750 mg/day for females. Conclusion: Both meta-models met the acceptability criteria for use in clinical practice on all subpopulations of interest. Those models could be used in the perspective of MIPD for clozapine and lithium.
Choice Cuts for Khakaura: New Kingdom Captions in the North Chapel of Senwosret III, Dahshur
Authors: Navratilova Hana 
Published: September 2024

The paper analyses a group of New Kingdom hieratic ink-written labels added to the Middle Kingdom relief figures of offering bearers in the North Chapel of the pyramid precinct of King Senwosret III of the 12th Dynasty at Dahshur. It applies a close observation of the spatial properties of the secondary epigraphy combined with contexts of the Egyptian written culture. To a large extent, it is a beginning, rather than a fixed and detailed outline, of a more differentiated, location-specific interpretation of secondary texts and figures added to the decoration of various parts of the royal pyramid complexes. The interpretation of this specific scene suggests that the visitors articulated their status alongside a personal involvement with this prestigious site by labelling the offering bearers in order to achieve a purposeful revivification, and an arrogation, of the offering scene performance. [Formula: see text]
Sjögren’s disease, occupational performance and quality of life
Authors: Carneiro Cintra Beatriz , Marzola Mateus Maia , Dakuzaku Carretta Regina Yoneko , Reis Oliveira Fabíola , Melani Rocha Eduardo 
Published: September 2024

Introduction: Sjögren’s disease is an autoimmune disease with dry eyes and mouth and chronic pain, more frequent in middle-aged women. The aim of this study is to understand the impact of Sjögren’s disease on quality of life and occupational health. Method: Quantitative and qualitative comparative study, with 20 Sjögren’s disease and 25 healthy controls. Questionnaires and interviews were applied to assess occupational performance, quality of life, mood disorders, and sleep. Results: The combined major diagnostic parameters for Sjögren’s disease (focus score and anti-SSA/Ro positivity) were present in 85% of the Sjögren’s disease group. There was a correlation between the sicca symptom measured by the European League Against Rheumatism Sjögren’s Syndrome Patient Reported Index (ESSPRI), anxiety, and depression measured by the Hospital Anxiety and Depression Scale (HADS; r = 0.56; p = 0.009), as well as fatigue measured by the Profile of fatigue and discomfort questionnaire (PROFAD) ( r = 0.78; p < 0.0001). Sjögren’s disease patients reported a loss of physical abilities, sleep disturbance, change in mood, social and occupational participation, and lower quality of life. Conclusions: Sjögren’s disease patients have poorer quality of life, loss of competencies, and sleep disturbances compared to controls. Novel strategies are necessary to improve occupational health in SjD.
Comparison of the incidence of clinically significant prostate cancer in patients with isolated peripheral versus transitional zone PIRADS 3 lesions
Authors: Malshy Kamil , Ochsner Anna , Ortiz Rebecca , Ahn Benjamin , Glebocki Richard , Liu Matthew , Golijanin Borivoj , Eaton Samuel , Pareek Gyan , Hyams Elias , Golijanin Dragan , Khaleel Sari 
Published: September 2024

Introduction: We sought to investigate the association between isolated PIRADS 3 lesions of the transitional zone (TZ) versus the peripheral zone (PZ) and the incidence of clinically significant prostate cancer (csPCa) on systematic and targeted prostate biopsy (SB, TB). Methods: We retrospectively reviewed our tertiary institutional database of patients who underwent mpMRI-fusion followed by TB + SB between 2016 and 2021. We compared the incidence of csPCa (Gleason Grade Group ⩾ 2) in patients with solitary TZ-only PIRADS 3 and PZ-only PIRADS 3 on SB and TB. We excluded patients with (1)known PCa, (2)PIRADS 4–5 and/or (3)lesions in both TZ and PZ. T-tests, Chi-square tests, were conducted to compare between the groups. Results: Of 1913 patients, we identified 110 with PZ-only and 38 with TZ-only PIRADS 3 lesions. 73 patients in PZ-only and 19 in TZ-only met inclusion criteria. No statistically significant differences were observed between PZ and TZ groups in terms of age, median prostate-specific antigen (PSA), prostate volume, median PSA-density, or median number of targeted cores obtained, all with p > 0.05. On SB, the incidence of csPCA was higher in patients with PZ rather than TZ PIRADS-3 lesions (10/73 vs 1/19, p = 0.28). Similarly, csPCA was more common in TB of PZ versus TZ PIRADS 3 lesions (7/73 vs 0/19, p = 0.33). Based on these results, the positive predictive values of PIRADS3 as a marker of csPCA were 5.3% and 0% for TZ lesions on SB versus TB, respectively, compared to 17.7% and 9.6% in the PZ. Conclusions: PIRADS 3 lesions are rarely associated with csPCA on SB and TB, particularly when located in the TZ, which is an important factor to consider when deciding on a biopsy in patients with isolated TZ lesions.
Usefulness of Platelet-rich Fibrin in Open Fractures of Tibia: A Randomised Comparative Pilot Study
Authors: Sural Sumit , Mandal Subhashis 
Published: September 2024

Background and Aims: Platelet-rich fibrin (PRF), rich in growth factors and cytokines, found useful for bone healing in animal studies, has paucity of literature on open fractures in humans. This randomised comparative interventional study aimed to find out the role of PRF in wound healing and fracture union in open fractures of tibia. Material and Methods: Random computerised allocation of 14 open tibial shaft fractures managed with an external fixator were done into PRF and non-PRF groups. Autologous PRF injected at fracture site, with PRF gel over open wounds in the PRF group, was compared with conventional standard treatment in the non-PRF group. Wound assessment on day 3, day 7 and weekly till complete wound healing and radiographs for fracture union at 3, 6, and 12 months were done in both groups. The statistical analysis was done using an unpaired t-test (wound size assessment) and chi-squared test (fracture union), using SPSS version 25. Results: Fractures union in PRF group 7/8 (87.5%) was better than 3/6 (50%) in non-PRF group. External fixators were removed 4 weeks earlier in PRF group. Wound healing time, though not statistically significant, was faster in PRF group (36.25±3.03 days) compared to non-PRF (42±7 days), even with larger wound size in PRF group (7.87±1.43 cm 2 ) than non-PRF group (7.5±1.5 cm 2 ). Conclusions: Results of injectable PRF at fracture site and PRF gel over the wound are encouraging, found to be safe, with faster wound healing and better fracture union in the small sample size of this pilot study.
Correlation of Hypothyroidism with Age and Comorbidities Among Women: A Cross-Sectional Study
Authors: Ifthikhar Mufida Begum , Dhamotharaswamy Kumudha 
Published: September 2024

Background Hypothyroidism, an endocrine disorder caused by thyroid dysfunction found to be more prevalent globally in females than in males. Young females are more prone to subclinical hypothyroidism (SCH). The study aimed to estimate the different types of hypothyroidism based on the clinical profile of thyroid hormone and to detect various comorbidities in correlation with age in women. In female patients with hypothyroidism, there is a significant association between age groups and the type of hypothyroidism (subclinical, clinical, overt), with younger age groups showing a higher prevalence of SCH. Additionally, comorbidities, such as polycystic ovarian disorder (PCOD), are more prevalent in hypothyroidism patients, particularly in those with SCH. Materials and Methods A prospective cross-sectional study executed in a tertiary care hospital for one year with an inclusion of female hypothyroid patients above 18 years of age. An informed written consent form was received from each patient with clarification of the protocol. Results A total of 44.6% women were in the 18–28 years of age group (young females) and 42.8% of women with SCH. PCOD (38.2%) was a predominant comorbid condition among hypothyroidism women. In the age group of 18–28 years, there were significantly more patients 114 (81.4%) with SCH ( p < 0.01) than those with clinical 22 (18.4%) and overt hypothyroidism 10 (14.7%). The hypothyroidism of women with PCOD 95 (67.8%) was significantly ( p < 0.01) more in subclinical than clinical 28 (23.5%) and overt hypothyroidism 2 (2.9%). Conclusion Thyroid dysfunction is uncertain in females, bulges to complications of maternal and fetal outcomes, and is associated with other comorbidities, leading to an increase in the mortality rate. Hypothyroidism is a growing burden for other comorbidities. Pharmaceutical care by healthcare professionals is to be adopted with prompt diagnostic and screening techniques.
Potential promises and perils of artificial intelligence in psychotherapy –The AI Psychotherapist (APT)
Authors: Jurblum Marc , Selzer Rob 
Published: September 2024

Objective Since the release of ChatGPT, popular demand has driven the use of social chatbots as pseudo-AI psychotherapists. With time, it is inevitable that these technologies will be deployed in some form as dedicated psychotherapy interventions. Here, we attempt to forecast the implications for psychotherapy including the unique benefits to distributive justice as well as concerns for the quality of the therapy and its societal impact. Conclusion An AI psychotherapist (APT) has the potential to provide engaging clinical interactions given its capacity for highly realistic interaction as well as its high level cognitive and emotional capabilities. Moreover, it can potentially address financial and workforce limitations on access to therapy. However, an APT may cause significant iatrogenic harm if released without adequate quality control and oversight by trained psychotherapists. If not appropriately designed and regulated, APTs have potential to mislead and reinforce maladaptive coping behaviours. Given societal drivers and possible benefits, these technologies will inevitably be deployed; thus, it is incumbent upon us as a professional body to consider their regulation.
Optimizing Stroke Care Transitions: A Patient-Centered Discharge Program for Caregivers
Authors: Bhatt Anshika , Kaur Sukhpal , Dhandapani Manju , Banumathy N , Khurana Dheeraj 
Published: September 2024

Inadequate discharge planning can worsen long-term outcomes for patients with stroke, delaying their recovery. Equipping caregivers with the knowledge to manage rehabilitation needs is crucial for facilitating a smooth hospital-to-home transition. The study aims to assess the effectiveness of a “Patient-Centered Discharge Program for Caregivers” on the comprehensiveness and clarity of discharge advice provided to caregivers of stroke survivors. Using a quasi-experimental design, the study compared a control group receiving standard discharge planning and an experimental group receiving the “Patient-Centered Discharge Program for Caregivers.” 62 caregivers of stroke survivors formed the participant pool. The program focused on various comprehensive discharge advice domains delivered to the caregivers. The discharge advice, knowledge, and skills of caregivers regarding stroke care were assessed on the day of discharge through questionnaires and checklists. Compared to the control group, the discharge instructions of the experimental group became more comprehensive and clear, with a significant improvement in knowledge and skills regarding stroke care ( p < .05). The knowledge scores of the caregivers showed a statistically significant difference from the control group, with a mean difference of 8.78. ( p < .05). The experimental group demonstrated good skills in nearly all procedures compared to the control group, including oral care, range of motion exercises, feeding, suctioning, and back care ( p < .05). The “Patient-Centered Discharge Program for Caregivers” led to the delivery of more comprehensive discharge instructions, subsequently increasing caregivers’ knowledge. It highlights the benefits of such programs in equipping caregivers for effective discharge planning, with future research needed to evaluate long-term benefits. Trial/Protocol Registration: Clinical Trials Registry India (CTRI) CTRI/2023/07/055602 Link: https://ctri.nic.in/Clinicaltrials/rmaindet.php?trialid=89913&EncHid=35558.64662&modid=1&compid=19
Clinical outcome of cats with suppurative otitis media and intact tympanum submitted to myringotomy: retrospective findings from 26 cases
Authors: Deleporte Sébastien , Briand Amaury , Prelaud Pascal 
Published: September 2024

Case series summary The efficacy of medical treatment associated with single myringotomy in cats with suppurative otitis media (OM) and intact tympanum was retrospectively evaluated. Patients’ records were retrieved from cats with suppurative OM. Cats were included in this retrospective study based on fluid content within the tympanic cavity on imaging, intact tympanum on otoendoscopic examination and neutrophils on ear bulla exudate cytological examination. A total of 26 cats with middle ear suppurative otitis were included. Just over half of the cats (54%) presented bilateral involvement. Clinical signs included head tilt (13/26), otalgia (9/26), Horner’s syndrome (7/26), external ear discharge (5/26), and nystagmus and facial paralysis (1/26). Cocci were identified on cytological examination in 18/40 samples and rods in 2/40. Bacterial culture results were positive in 15/40 samples, with Pseudomonas species (4/15), Pasteurella multocida (3/15), Staphylococcus felis (3/15), Staphylococcus schleiferi (2/15), Staphylococcus canis (2/15), Escherichia coli (2/15), Staphylococcus pseudintermedius (1/15) and Serratia marcesens (1/15) isolation. After myringotomy and gentle flushing of middle ear bullae (0.5–2 ml saline per ear), all cats were treated with oral corticosteroids and a 1-month course of systemic antibiotics according to sensitivity testing. In total, 19 (73%) cats were clinically healed 60–240 days after treatment. One cat was euthanased because of failure to eradicate a Pseudomonas species infection. Another cat died a few hours after the procedure. The five remaining cats were cured after ventral bulla osteotomy. Relevance and novel information OM without an aural polyp is a frequent diagnosis in cats, but data on medical treatment are scarce. This simple therapeutic technique, single myringotomy procedure and mild ear flushing, offers a practical, safe and efficient first-line treatment of suppurative OM with an intact tympanum in cats with or without neurological signs.
Reduction of hemodialysis catheter-related blood stream infections in intensive care units after systematic use of taurolidine-citrate-heparin locking solution
Authors: del Risco Zevallos Jimena , Molina Andújar Alícia , Piñeiro Gastón , Morata Laura , Casals Joaquim , Jimenez Mario , Fontseré Néstor , Maduell Francesc , Soriano Alex , Poch Esteban 
Published: September 2024

Introduction: Dialysis catheter-associated bacteremia in Intensive Care Units (ICUs) increases morbidity and mortality, prolongs hospital admission and increases admission costs. Taurolidine-Citrate-Heparin Locking Solution (TCHLS) is a catheter-locking solution with a broad antimicrobial activity against gram-positive and gram-negative bacteria and fungi. The aim of this study was to analyze the effect of systematic sealing of hemodialysis catheters in the ICUs of the Hospital Clínic de Barcelona on the incidence of hemodialysis catheter-related blood stream infections (CRBSI). Material and methods: CRBSI episodes of patients who underwent intermittent hemodialysis (IHD) during ICU admission were reviewed. TCHLS was established as a routine dialysis catheter sealing solution in the hospital ICUs in 2015. As a control group an historic pre-TCHLS group from 2010 to 2014 was used. The post-TCHLS period comprised from 2015 to 2018. Results: A total of 243 and 266 patients required IHD in the pre- and post TCHLS periods, respectively. The number of CRBSI in the pre-TCHLS period was 18 (7.43%) as compared to 9 (3.38%) in the post-TCHLS period ( p = 0.043). All infections were from percutaneous catheters except for three catheters that were tunneled. There was no association between the location of the catheter and the incidence of CRBSI. The most frequent isolated microorganisms were Gram positive bacteria (48.38%), with a global predominance of Staphylococcus epidermidis (32.25%). There were no significant differences in the median days from the start of hemodialysis to the onset of bacteremia (23.5 days in pre-TCHLS group vs 21 days in the post-TCHLS). There were also no significant differences between the days of ICU stay in the CRBSI in both groups or in mortality, being the overall mortality of 65.9%. Conclusions: In our population, the systematic application of TCHLS in the sealing of dialysis catheters in critically ill patients reduces the incidence of CRBSI in ICUs.