bluuebunny/crossref_metadata_2025_split huggingface dataset:
Sex-Specific Differences in Potent P2Y
12
Inhibitor Use in British Cardiovascular Intervention Society Registry STEMI Patients
Authors: Burgess Sonya N. , Shoaib Ahmad , Sharp Andrew S.P. , Ludman Peter , Graham Michelle M. , Figtree Gemma A. , Kontopantelis Evangelos , Rashid Muhammad , Kinnaird Tim , Mamas Mamas A. 
Published: September 2023

BACKGROUND:

Sex-based outcome differences for women with ST-segment–elevation myocardial infarction (STEMI) have not been adequately addressed, and the role played by differences in prescription of potent P2Y
12
inhibitors (P-P2Y
12
) is not well defined. This study explores the hypothesis that disparities in P-P2Y
12
(prasugrel or ticagrelor) use may play a role in outcome disparities for women with STEMI.

METHODS:
Data from British Cardiovascular Intervention Society national percutaneous coronary intervention database were analyzed, and 168 818 STEMI patients treated with primary percutaneous coronary intervention from 2010 to 2020 were included.

RESULTS:

Among the included women (43 131; 25.54%) and men (125 687; 74.45%), P-P2Y
12
inhibitors were prescribed less often to women (51.71%) than men (55.18%;
P
<0.001). Women were more likely to die in hospital than men (adjusted odds ratio, 1.213 [95% CI, 1.141–1.290]). Unadjusted mortality was higher among women treated with clopidogrel (7.57%), than P-P2Y
12
-treated women (5.39%), men treated with clopidogrel (4.60%), and P-P2Y
12
-treated men (3.61%;
P
<0.001). The strongest independent predictor of P-P2Y
12
prescription was radial access (adjusted odds ratio, 2.368 [95% CI, 2.312–2.425]), used in 67.93% of women and 74.38% of men (
P
<0.001). Two risk adjustment models were used. Women were less likely to receive a P-P2Y
12
(adjusted odds ratio, 0.957 [95% CI, 0.935–0.979]) with risk adjustment for baseline characteristics alone, when procedural factors including radial access were included in the model differences were not significant (adjusted odds ratio, 1.015 [95% CI, 0.991–1.039]).

CONCLUSIONS:

Women were less likely to be prescribed prasugrel or ticagrelor, were less likely to have radial access, and had a higher mortality when being treated for STEMI. Improving rates of P-P2Y
12
use and radial access may decrease outcome disparities for women with STEMI.
Reducing Catastrophic Forgetting With Associative Learning: A Lesson From Fruit Flies
Authors: Shen Yang , Dasgupta Sanjoy , Navlakha Saket 
Published: September 2023

Abstract
Catastrophic forgetting remains an outstanding challenge in continual learning. Recently, methods inspired by the brain, such as continual representation learning and memory replay, have been used to combat catastrophic forgetting. Associative learning (retaining associations between inputs and outputs, even after good representations are learned) plays an important function in the brain; however, its role in continual learning has not been carefully studied. Here, we identified a two-layer neural circuit in the fruit fly olfactory system that performs continual associative learning between odors and their associated valences. In the first layer, inputs (odors) are encoded using sparse, high-dimensional representations, which reduces memory interference by activating nonoverlapping populations of neurons for different odors. In the second layer, only the synapses between odor-activated neurons and the odor’s associated output neuron are modified during learning; the rest of the weights are frozen to prevent unrelated memories from being overwritten. We prove theoretically that these two perceptron-like layers help reduce catastrophic forgetting compared to the original perceptron algorithm, under continual learning. We then show empirically on benchmark data sets that this simple and lightweight architecture outperforms other popular neural-inspired algorithms when also using a two-layer feedforward architecture. Overall, fruit flies evolved an efficient continual associative learning algorithm, and circuit mechanisms from neuroscience can be translated to improve machine computation.
Fear of the Wolf: Are Human-Wildlife Conflicts Actually Human-Human Feuds?
Authors: Märcz Lisa , Gibbert Michael 
Published: September 2023

Abstract
This qualitative study explores the opinions of people who criticize the presence of wolves in Germany to understand what lies behind their concerns. It provides an intimate insight into the lives and fears of people and their relation to wolves and contributes to understanding the less considered critics of wolf management. By discussing the links between a fear of wolves, rural identity, and perceptions of nature, this paper proposes to explain how a human-wolf coexistence could still function for those who fail to be included in wolf management endeavors if wolf management added a social guideline on the basis of the presented problems. While a fear of wolves is generally ingrained in German society and wolves pose a real threat to farmed animals, for many people it is dysfunctional interhuman relations that pose a challenge in their coexistence with wolves, and less so the wolves themselves.
Direct Dependence on Philo in the Epistle to the Hebrews
Authors: Grindheim Sigurd 
Published: September 2023

Abstract
The near consensus opinion that the author of Hebrews was not directly influenced by Philo needs to be reevaluated. Even though there are no obvious cases of borrowing, the cumulative weight of the evidence indicates a more linear relationship than what may be accounted for by situating them both within Hellenistic Judaism. A number of parallels are sufficiently detailed to suggest direct dependence. These parallels are of a formal character, such as the metaphor of the dagger and the particular use of the terms ὑπόστασις, ἀρχηγός, τελειόω, ἄθλησις, τεχνίτης, and δημιουργός, as well of a material nature, concerning the development of key ideas, such as the eternal nature of the Son, his Melchizedekian high-priesthood, and the perception of the heavenly sanctuary.
Regulating Surrogacy as a Reproductive Practice in India and Sri Lanka
Authors: Jolly Stellina , Abeyrathna Danushika 
Published: September 2023

Abstract
Sri Lanka and India are desirable surrogacy destinations for various reasons. Although surrogacy can generate greater foreign revenue, it raises ethical and legal difficulties. India enacted the Surrogacy (Regulation) Act 2021 after decades of effort, whereas Sri Lanka continues with unregulated practice. This paper assesses to what extent Sri Lanka may learn from India. To that end, this paper investigates (i) the signifigance of Sri Lanka as a surrogacy destination and the surrounding ethical and legal issues; (ii) the legal validity and the legal framework governing surrogacy in Sri Lanka; (iii) the main characteristics of the legal landscape of surrogacy in India; and (iv) the adequacies and inadequacies of Indian legal approach to the surrogacy to determine the extent to which the Indian model can serve as a template for Sri Lanka. This paper concludes by proposing certain guiding principles for Sri Lanka in developing a legal framework for surrogacy.
Comparative Study of Selected Nigerian and Indian Labour Practices and the Law
Authors: Aina-Pelemo Adetutu Deborah 
Published: September 2023

Abstract
Labour practices include workplace routines like, the conditions of employment, remuneration, trade union, industrial relations, safety and welfare of workers, labour rights and responsibilities, etc. Labour relations are laced with both fair and unfair practices. This study examines the differences and similarities of labour practices in Nigerian and Indian industries, and how their respective courts interpreted their labour laws. The doctrinal research methodology involving systematic review of current legal propositions, cases, statutes, legislation, policies relating to labour practice in Nigeria and India was adopted. The study finds amongst others that both the Nigerian and Indian Labour industries are fraught with unfair labour practices and the rights of workers are the same, but India explicitly provides imprisonment for employer found guilty of unfair labour practices, and Nigerian labour legislation is silent on that. It concludes by recommending a review of Nigerian labour practice legal framework, reflecting some India’s advancement in labour practice.
Popular Participation in Renaissance Siena’s Romanitas Program
Authors: Perez Samantha 
Published: September 2023

Abstract
With no clear textual or physical proof of an ancient Roman settlement, Siena faced considerable challenges to its assumed antiquity in the trecento and quattrocento. The damaging insistence by Giovanni Villani, Leonardo Bruni, and Flavio Biondo, among others, of Siena’s Gallic—and thus non-Roman—origins prompted the Sienese state to develop an elaborate civic program in defense of its antiquity and Roman-ness, or Romanitas. Building upon expanding literature of the republic’s endeavor to manufacture evidence of a Roman foundation, this paper examines the ways in which the general Sienese population engaged this state-endorsed effort to promote classical origins and participated in communal performances that popularized Siena’s Roman identity. Through the celebration of the she-wolf as a symbol of Siena, the continuation of key Roman practices, and spiritual devotion to patron saints selected from the early centuries of the church, the Sienese public proved critical to the success of the Renaissance city’s claim to antiquity.
On the Roles of Precipitation and Entrainment in Stratocumulus Transitions between Mesoscale States
Authors: Hoffmann Fabian , Glassmeier Franziska , Yamaguchi Takanobu , Feingold Graham 
Published: September 2023

Abstract
Stratocumulus occur in closed- or open-cell states, which tend to be associated with high or low cloud cover and the absence or presence of precipitation, respectively. Thus, the transition between these states has substantial implications for the role of this cloud type in Earth’s radiation budget. In this study, we analyze transitions between these states using an ensemble of 127 large-eddy simulations, covering a wide range of conditions. Our analysis is focused on the behavior of these clouds in a cloud fraction (fc) scene albedo (A) phase space, which has been shown in previous studies to be a useful framework for interpreting system behavior. For the transition from closed to open cells, we find that precipitation creates narrower clouds and scavenges cloud droplets for all fc. However, precipitation decreases the cloud depth for fc > 0.8 only, causing a rapid decrease in A. For fc < 0.8, the cloud depth actually increases due to mesoscale organization of the cloud field. As the cloud deepening balances the effects of cloud droplet scavenging in terms of influence on A, changes in A are determined by the decreasing fc only, causing a linear decrease in A for fc < 0.8. For the transition from open to closed cells, we find that longwave radiative cooling drives the cloud development, with cloud widening dominating for fc < 0.5. For fc > 0.5, clouds begin to deepen gradually due to the decreasing efficiency of lateral expansion. The smooth switch between cloud widening and deepening leads to a more gentle change in A compared to the transitions under precipitating conditions.

Significance Statement
By reflecting a substantial fraction of solar shortwave radiation back to space, shallow clouds constitute a major cooling agent in Earth’s radiation budget. To constrain this effect, a profound understanding of cloud cover and cloud albedo is necessary. In this study, we analyze the processes that drive the variability in these cloud properties in stratocumulus clouds, a very common cloud type covering approximately 20% of the globe. For these clouds, we show that changes from low to high or high to low cloud cover are different due to the underlying cloud micro- and macrophysics, elucidating this crucial aspect of aerosol–cloud–climate interactions.
Performance characteristics of a prototype dialysate turbidity monitoring system to detect peritonitis in patients receiving peritoneal dialysis
Authors: Briggs Benjamin , Garcia-Garcia Guillermo , Ibarra-Hernandez Margarita , Alcantar-Vallin Luz , Walker Gary , Yu Eric , ElBadry Aly , Fisher Brian , Williamson Don , Chertow Glenn M 
Published: September 2023

Background: The risk of peritonitis has limited wider adoption of peritoneal dialysis (PD) in the United States. We developed a prototype bedside dialysate turbidity monitoring system, aiming to improve diagnostic accuracy relative to conventional approaches which depend on visual inspection and reporting of insensitive and non-specific symptoms. Methods: The prototype system was tested in a single-centre, proof-of-principle clinical study in patients receiving intermittent PD. We obtained multiple effluent dialysate samples from each consenting participant. We compared turbidity measurements with diagnostic criteria endorsed by the International Society of Peritoneal Dialysis (ISPD). Results: Overall, we analysed 983 specimens from 65 patients, including 105 samples from patients with peritonitis and 878 samples from patients without peritonitis. An operating point derived from a previous in vitro study yielded an unadjusted sensitivity and specificity of 95.2% and 91.5%, respectively. The majority of samples that did not meet ISPD diagnostic criteria were either cases detected before criteria were met or were related to active peritonitis treatment and resolution. Conclusion: This proof-of-principle study demonstrates the feasibility and diagnostic accuracy of a prototype dialysate turbidity monitoring system for peritonitis surveillance.
Sexual partner referral and associated factors among patients with sexually transmitted disease in Jabi Tehnan district and Finote Selam town
Authors: Dagnew Zewdu , Mistir Limenih , Abebe Nurlign , Alemayehu Mulunesh , Tegegne Eniyew 
Published: September 2023

Background Partner referral (or contact tracing) is an essential approach for preventing sexually transmitted infections. Even though this approach has been used in Ethiopia, there is a scarcity of evidence in Ethiopia particularly in this study area. Methods A cross-sectional study was conducted among 397 patients with curable sexually transmitted diseases. Factors associated to the practice of sexual partner referral were explored where variables having a p-value of <0.05 in multivariable analysis were considered statistically significant. Result Referrals for sexual partners were found to be 42.4% in this study (95% CI: 35.3, 45.3). Not expecting the end of the relationship among regular partnerships (AOR: 4.8; 95% CI: 1.9, 12.4), perceived risk of reinfection (AOR: 3.0; 95% CI: 1.8, 5.3), perceived self-efficacy (AOR: 3.8; 95% CI: 2.4, 6.3), intention to refer partners (AOR: 3.7; 95% CI: 2.0, 6.4), and knowledge of sexually transmitted infections (AOR: 3.0; 95% CI: 1.8, 5.0) were significantly associated with sexual partner referral. Conclusions This study showed that sexual partner referral was low. Perceived risks of reinfection, perceived self-efficacy, anticipating the end of a relationship, intention to refer partners, and knowledge of sexually transmitted infections were significant predictors of sexual partner referral. Intervention endeavors need to consider factors pointed out in this study to improve sexual partner referral.
Comparative Efficacy of Conservative Surgery vs Minor Amputation for Diabetic Foot Osteomyelitis
Authors: Schöni Madlaina , Soldevila-Boixader Laura , Böni Thomas , Muñoz Laguna Javier , Uçkay Ilker , Waibel Felix W. A. 
Published: September 2023

Background: There is uncertainty regarding the optimal surgical intervention for diabetic foot osteomyelitis (DFO). Conservative surgery—amputation-free resection of infected bone and soft tissues—is gaining traction as an alternative to minor amputation. Our primary objective was to explore the comparative effectiveness of conservative surgery and minor amputations in clinical failure risk 1 year after index intervention. We also aimed to explore microbiological recurrence at 1 year, and revision surgery risk over a 10-year study period. Methods: Retrospective, single-center chart review of DFO patients undergoing either conservative surgery or minor amputation. We used multivariable Cox regression and Kaplan-Meier estimates to explore the effect of surgical intervention on clinical failure (recurrent diabetic foot infection at surgical site within 1 year after index operation), microbiological recurrence at 1 year, and revision surgery risk over a 10-year follow-up period. Results: 651 patients were included (conservative surgery, n = 121; minor amputation, n = 530). Clinical failure occurred in 34 (28%) patients in the conservative surgery group, and in 111 (21%) of the minor amputation group at 1 year ( P = .09). After controlling for potential confounders, we found no association between conservative surgery and clinical failure at 1 year (adjusted hazard ratio [HR] 1.3, 95% CI 0.8-2.1). We found no between-group differences in microbiological recurrence at 1 year (conservative surgery: 8 [6.6%]; minor amputation: 33 [6.2%]; P = .25; adjusted HR 1.1, 95% CI 0.5-2.6). Over the 10-year period, the conservative group underwent significantly more revision surgeries (conservative surgery: 85 [70.2%]; minor amputation: 252 [47.5%]; P < .01; adjusted HR 1.3, 95% CI 0.9-1.8). Conclusion: We found that with comorbidity-based patient selection, conservative surgery in the treatment of DFO was associated with the same rates of clinical failure and microbiological recurrence at 1 year, but with significantly more revision surgeries during follow-up, compared with minor amputations. Level of Evidence: Level III, retrospective comparative effectiveness study.
Residential overcrowding in relation to children’s health, environment and schooling – a qualitative study
Authors: Lorentzen Johnny C. , Georgellis Antonios , Albin Maria , Jonsson Marina 
Published: September 2023

Aim: To explore how overcrowding affects children’s health, environment and schooling. Methods: A qualitative study was conducted with individual interviews among 20 participants with occupational experience from overcrowded Stockholm areas but diverse in professions, locations and employers. The interviews were recorded, transcribed and analysed with Systematic Text Condensation. Results: Almost all participants expressed that overcrowding has a negative impact on children’s health, environment and schooling – based on perceptions of precarious and different living conditions for children in overcrowded areas, for example, substandard homes, vulnerability, stress, exclusion, limited resources, lack of learning opportunities, gender differences, confinement, shame, insecurity, conflicts, risk of criminality, and bodily impact, both physical and psychological. Conclusions: Our qualitative evidence suggest that overcrowding has a negative impact on children’s health, environment and schooling.
Short (23-hour)-stay robotic-assisted radical prostatectomy in a state-funded national health service – Is it safe and feasible?
Authors: Tay Li June , Gilanliogullari Kemal , Maitra Neil , Samson Lourdes , Patil Vishal , Lamb Benjamin W , Shah Nimish 
Published: September 2023

Objectives: The COVID-19 pandemic has led to a long waiting list for elective surgery and increasing bed pressures from acute admissions. This led to widespread cancellations on the day of surgery even for cancer procedures. To address this, all inpatient stay robotic-assisted radical prostatectomy (RARP) cases were managed via our day surgery unit as a 23-hour stay. We report the safety and feasibility of our initial implementation. Methods: A standard operating procedure for admission via the day surgery unit, including a modified enhanced recovery pathway, for patients undergoing RARP with or without pelvic lymph node dissection (PLND) was devised. All pre-operative variables were collected, and all perioperative outcomes analysed. Primary outcomes were number of on the day cancellations, discharge failure as 23-hour stay and 30-day readmissions. Results: Between November 2021 and June 2022, 135 patients underwent RARP with or without PLND via the day surgery unit. Mean patient age was 65 (46–76) years. Mean operative time and estimated blood loss were 153 (67–281) minutes and 197 (50–700) mL, respectively. Concomitant lymph node dissection was performed in 32.7% of cases. No patient required blood transfusion or conversion to open. We had 3 (2.2%) discharge failures, all of which were due to clinical reasons. Our 30-day hospital readmission rate was 3.7%, while another 5.2% attended emergency department and were discharged without admission. Conclusion: Short (23-hour)-stay RARP is safe and feasible and reduces pressure on inpatient beds but requires a multidisciplinary approach and engagement from all stakeholders. Level of evidence: 2
Does a coaxial double pigtail stent reduce adverse events after lumen apposing metal stent placement for pancreatic fluid collections? A systematic review and meta-analysis
Authors: Giri Suprabhat , Harindranath Sidharth , Afzalpurkar Shivaraj , Angadi Sumaswi , Sundaram Sridhar 
Published: September 2023

Background: Lumen apposing metal stents (LAMSs) have a higher clinical success rate for managing pancreatic fluid collections. But they are associated with adverse events (AEs) like bleeding, migration, buried stent, occlusion, and infection. It has been hypothesized that placing a double pigtail stent (DPS) within LAMS may mitigate these AEs. The present systematic review and meta-analysis were conducted to compare the outcome and AEs associated with LAMS with or without a coaxial DPS (LAMS-DPS). Methods: A comprehensive literature search of three databases from January 2010 to August 2022 was conducted for studies comparing the outcome and AEs of LAMS alone and LAMS-DPS. Pooled incidence and risk ratios (RRs) with 95% confidence intervals (CIs) were calculated for all the dichotomous outcomes. Results: Overall, eight studies ( n = 460) were included in the final analysis. The clinical success rate (RR 1.00, 95% CI: 0.87–1.14) and the risk of overall AEs (RR 1.60, 95% CI: 0.95–2.68) remained comparable between both groups. There was no difference in the risk of bleeding between LAMS alone and LAMS-DPS (RR 1.80, 95% CI: 0.83–3.88). Individual analysis of other AEs, including infection, stent migration, occlusion, and reintervention, showed no difference in the risk between both procedures. Conclusion: The present meta-analysis shows that coaxial DPS within LAMS may not reduce AE rates or improve clinical outcomes. Further larger studies, including patients with walled-off necrosis, are required to demonstrate the benefit of coaxial DPS within LAMS.