bluuebunny/crossref_metadata_2025_split huggingface dataset:
Synthesis of Material Composite rGO-TIO2 From Coconut Shells by Sol-Gel Methods as Photocatalyst
Authors: Hikmah Utiya , Yanti Diah Risma , Axala David Lee Giant 
Published: May 2024

<p>The rGO- TiO<sub>2</sub> composite photocatalyst is receiving great attention because of its high performance. But the study of rGO- TiO<sub>2</sub> composite with sources of rGO material derived from the utilization of organic waste such as coconut shells is limited. In this study, the synthesis of nanocomposite rGO- TiO<sub>2</sub> was described with rGO obtained from coconut shells. The rGO samples produce through the oxidation and reduction process. The transformation of graphene oxide into reduced graphene oxide was assisted by microwave irradiation. The obtained rGO was then composite with Titanium tetraisopropoxide (TTIP) by the sol-gel method. The composite of rGO- TiO<sub>2</sub> was characterized by XRD, FTIR, UV-Vis, and SEM. The photocatalytic performance of the rGO- TiO<sub>2</sub> composite was conducted on Methylene blue. The result shows that rGO- TiO<sub>2</sub>composite has a good photocatalytic performance with the highest number at 96%.<strong></strong></p>
Achieving health equity through conversational AI: A roadmap for design and implementation of inclusive chatbots in healthcare
Authors: Nadarzynski Tom , Knights Nicky , Husbands Deborah , Graham Cynthia A. , Llewellyn Carrie D. , Buchanan Tom , Montgomery Ian , Ridge Damien 
Published: May 2024

Background
The rapid evolution of conversational and generative artificial intelligence (AI) has led to the increased deployment of AI tools in healthcare settings. While these conversational AI tools promise efficiency and expanded access to healthcare services, there are growing concerns ethically, practically and in terms of inclusivity. This study aimed to identify activities which reduce bias in conversational AI and make their designs and implementation more equitable.

Methods
A qualitative research approach was employed to develop an analytical framework based on the content analysis of 17 guidelines about AI use in clinical settings. A stakeholder consultation was subsequently conducted with a total of 33 ethnically diverse community members, AI designers, industry experts and relevant health professionals to further develop a roadmap for equitable design and implementation of conversational AI in healthcare. Framework analysis was conducted on the interview data.

Results
A 10-stage roadmap was developed to outline activities relevant to equitable conversational AI design and implementation phases: 1) Conception and planning, 2) Diversity and collaboration, 3) Preliminary research, 4) Co-production, 5) Safety measures, 6) Preliminary testing, 7) Healthcare integration, 8) Service evaluation and auditing, 9) Maintenance, and 10) Termination.

Discussion
We have made specific recommendations to increase conversational AI’s equity as part of healthcare services. These emphasise the importance of a collaborative approach and the involvement of patient groups in navigating the rapid evolution of conversational AI technologies. Further research must assess the impact of recommended activities on chatbots’ fairness and their ability to reduce health inequalities.
A randomised Trial of Autologous Blood products, leukocyte and platelet-rich fibrin (L-PRF), to promote ulcer healing in LEprosy: The TABLE trial
Authors: Napit Indra B. , Shrestha Dilip , Choudhury Sopna , Gkini Eleni , Ilozumba Onaedo , Gill Paramjit , Bishop Jon , Neupane Karuna , Adhikari Anju , Sartori Jo , Watson Samuel I. , Lilford Richard 
Published: May 2024

Introduction
Autologous blood products like Platelet Rich Plasma (PRP) and Leukocyte and Platelets Rich Fibrin (L-PRF) have been used for many years across many types of skin ulcers. However, the effectiveness of autologous blood products on wound healing is not well established.

Methods
We evaluated the ‘second generation’ autologous product- Leukocyte and Platelet- Rich Fibrin (L-PRF). Our trial was undertaken on patients suffering from neuropathic leprosy ulcers at the Anandaban hospital which serves the entire country of Nepal. We conducted a 1:1 (n = 130) individually randomised trial of L-PRF (intervention) vs. normal saline dressing (control) to compare rate of healing and time to complete healing. Rate of healing was estimated using blind assessments of ulcer areas based on three different measurement methods. Time to complete healing was measured by the local unblinded clinicians and by blind assessment of ulcer images.

Results
The point estimates for both outcomes were favourable to L-PRF but the effect sizes were small. Unadjusted mean differences (intervention vs control) in mean daily healing rates (cm2) were respectively 0.012 (95% confidence interval 0.001 to 0.023, p = 0.027); 0.016 (0.004 to 0.027, p = 0.008) and 0.005 (-0.005 to 0.016, p = 0.313) across the three measurement methods. Time to complete healing at 42 days yielded Hazard Ratios (unadjusted) of 1.3 (0.8 to 2.1, p = 0.300) assessed by unblinded local clinicians and 1.2 (0.7 to 2.0, p = 0.462) on blind assessment.

Conclusion
Any benefit from L-PRF appears insufficient to justify routine use in care of neuropathic ulcers in leprosy.

Trial registration
ISRCTN14933421. Date of trial registration: 16 June 2020.
Hepcidin, in contrast to heparin binding protein, does not portend acute kidney injury in patients with community acquired septic shock
Authors: Olinder Jon , Stjernqvist Matilda Jovanovic , Lindén Albin , Salomonsson Evelina Thaphikul , Annborn Martin , Herwald Heiko , Rydén Cecilia 
Published: May 2024

Background
Acute kidney injury (AKI) is a common and severe complication in patients treated at an Intensive Care Unit (ICU). The pathogenesis of AKI has been reported to involve hypoperfusion, diminished oxygenation, systemic inflammation, and damage by increased intracellular iron concentration. Hepcidin, a regulator of iron metabolism, has been shown to be associated with sepsis and septic shock, conditions that can result in AKI. Heparin binding protein (HBP) has been reported to be associated with sepsis and AKI. The aim of the present study was to compare serum hepcidin and heparin binding protein (HBP) levels in relation to AKI in patients admitted to the ICU.

Methods
One hundred and forty patients with community acquired illness admitted to the ICU within 24 hours after first arrival to the hospital were included in the study. Eighty five of these patients were diagnosed with sepsis and 55 with other severe non-septic conditions. Logistic and linear regression models were created to evaluate possible correlations between circulating hepcidin and heparin-binding protein (HBP), stage 2–3 AKI, peak serum creatinine levels, and the need for renal replacement therapy (RRT).

Results
During the 7-day study period, 52% of the 85 sepsis and 33% of the 55 non-sepsis patients had been diagnosed with AKI stage 2–3 already at inclusion. The need for RRT was 20% and 15%, respectively, in the groups. Hepcidin levels at admission were significantly higher in the sepsis group compared to the non-sepsis group but these levels did not significantly correlate to the development of stage 2–3 AKI in the sepsis group (p = 0.189) nor in the non-sepsis group (p = 0.910). No significant correlation between hepcidin and peak creatinine levels, nor with the need for RRT was observed. Stage 2–3 AKI correlated, as expected, significantly with HBP levels at admission in both groups (Odds Ratio 1.008 (CI 1.003–1.014, p = 0.005), the need for RRT, as well as with peak creatinine in septic patients.

Conclusion
Initial serum hepcidin, and HBP levels in patients admitted to the ICU are biomarkers for septic shock but in contrast to HBP, hepcidin does not portend progression of disease into AKI or a later need for RRT. Since hepcidin is a key regulator of iron metabolism our present data do not support a decisive role of initial iron levels in the progression of septic shock into AKI.
Association of chest computed tomography severity score at ICU admission and respiratory outcomes in critically ill COVID-19 patients
Authors: Esper Treml Ricardo , Caldonazo Tulio , Barlem Hohmann Fábio , Lima da Rocha Daniel , Filho Pedro Hilton A. , Mori Andréia L. , S. Carvalho André , S. F. Serrano Juliana , A. T. Dall-Aglio Pedro , Radermacher Peter , Silva João M. 
Published: May 2024

Objective
To evaluate the association of a validated chest computed tomography (Chest-CT) severity score in COVID-19 patients with their respiratory outcome in the Intensive Care Unit.

Methods
A single-center, prospective study evaluated patients with positive RT-PCR for COVID-19, who underwent Chest-CT and had a final COVID-19 clinical diagnosis needing invasive mechanical ventilation in the ICU. The admission chest-CT was evaluated according to a validated Chest-CT Severity Score in COVID-19 (Chest-CTSS) divided into low ≤50% (<14 points) and >50% high (≥14 points) lung parenchyma involvement. The association between the initial score and their pulmonary clinical outcomes was evaluated.

Results
121 patients were clustered into the > 50% lung involvement group and 105 patients into the ≤ 50% lung involvement group. Patients ≤ 50% lung involvement (<14 points) group presented lower PEEP levels and FiO2 values, respectively GEE P = 0.09 and P = 0.04. The adjusted COX model found higher hazard to stay longer on invasive mechanical ventilation HR: 1.69, 95% CI, 1.02–2.80, P = 0.042 and the adjusted logistic regression model showed increased risk ventilator-associated pneumonia OR = 1.85 95% CI 1.01–3.39 for COVID-19 patients with > 50% lung involvement (≥14 points) on Chest-CT at ICU admission.

Conclusion
COVID-19 patients with >50% lung involvement on Chest-CT admission presented higher chances to stay longer on invasive mechanical ventilation and more chances to developed ventilator-associated pneumonia.
Continuity of care between dyslipidemia patients and multiple providers: A cohort study
Authors: Choi Eunyoung , Lee Juhee , Choo Eunjung , Jang Eun Jin , Lee Iyn-Hyang 
Published: May 2024

Objective
This study aimed to investigate the impacts of continuity of care (COC) between patients and multiple providers, i.e., doctors and community pharmacists, on clinical and economic outcomes.

Methods
This is a retrospective cohort study and analyzed Korean national claims data for ambulatory care setting between 2007 and 2018. Patients with dyslipidemia newly diagnosed in 2008 were identified. COC between providers and patients was computed using the continuity of care index (COCI). Based on COCIs, the study patients were allocated to four groups: HM/HP, HM/LP, LM/HP, and LM/LP. Each symbol represents H for high, L for low, M for doctor, and P for pharmacist. The primary study outcome was the incidence of atherosclerotic cardiovascular disease (ASCVD).

Results
126,710 patients were included. Percentages of patients in the four study groups were as follows: HM/HP 35%, HM/LP 19%, LM/HP 12%, and LM/LP 34%. During the seven-year outcome period, 8,337 patients (6.6%) developed an ASCVD, and percentages in the study groups were as follows; HM/HP 6.2%, HM/LP 6.3%, LM/HP 6.8%, and LM/LP 7.1%. After adjusting for confounding covariates, only the LM/LP group had a significantly higher risk of ASCVD than the reference group, HM/HP (aHR = 1.16 [95% confidence interval = 1.10~1.22]). The risk of inappropriate medication adherence gradually increased 1.03-fold in the HM/LP group, 1.67-fold in the LM/HP, and 2.26-fold in the LM/LP group versus the HM/HP group after adjusting for covariates. Disease-related costs were lower in the HM/HP and LM/HP groups.

Conclusions
The study shows that patients with high relational care continuity with doctors and pharmacists achieved better clinical results and utilized health care less, resulting in reduced expenses. Further exploration for the group that exhibits an ongoing relationship solely with pharmacists is warranted.
Vowel onset measures and their reliability, sensitivity and specificity: A systematic literature review
Authors: Chacon Antonia Margarita , Nguyen Duy Duong , Holik John , Döllinger Michael , Arias-Vergara Tomás , Madill Catherine Jeanette 
Published: May 2024

Objective
To systematically evaluate the evidence for the reliability, sensitivity and specificity of existing measures of vowel-initial voice onset.

Methods
A literature search was conducted across electronic databases for published studies (MEDLINE, EMBASE, Scopus, Web of Science, CINAHL, PubMed Central, IEEE Xplore) and grey literature (ProQuest for unpublished dissertations) measuring vowel onset. Eligibility criteria included research of any study design type or context focused on measuring human voice onset on an initial vowel. Two independent reviewers were involved at each stage of title and abstract screening, data extraction and analysis. Data extracted included measures used, their reliability, sensitivity and specificity. Risk of bias and certainty of evidence was assessed using GRADE as the data of interest was extracted.

Results
The search retrieved 6,983 records. Titles and abstracts were screened against the inclusion criteria by two independent reviewers, with a third reviewer responsible for conflict resolution. Thirty-five papers were included in the review, which identified five categories of voice onset measurement: auditory perceptual, acoustic, aerodynamic, physiological and visual imaging. Reliability was explored in 14 papers with varied reliability ratings, while sensitivity was rarely assessed, and no assessment of specificity was conducted across any of the included records. Certainty of evidence ranged from very low to moderate with high variability in methodology and voice onset measures used.

Conclusions
A range of vowel-initial voice onset measurements have been applied throughout the literature, however, there is a lack of evidence regarding their sensitivity, specificity and reliability in the detection and discrimination of voice onset types. Heterogeneity in study populations and methods used preclude conclusions on the most valid measures. There is a clear need for standardisation of research methodology, and for future studies to examine the practicality of these measures in research and clinical settings.
A protocol of a pilot randomised trial (Action-RESPOND) to support rural and regional communities with implementing community-based systems thinking obesity prevention initiatives
Authors: Yoong Sze Lin , Brown Andrew D. , Leung Gloria K. W. , Hillenaar Monique , David Jennifer L. , Hayward Josh , Strugnell Claudia , Bell Colin , Brown Vicki , Jackson Michelle , Allender Steven 
Published: May 2024

Background
Over a quarter of children aged 2–17 years living in Australia are overweight or obese, with a higher prevalence reported in regional and remote communities. Systems thinking approaches that seek to support communities to generate and implement locally appropriate solutions targeting intertwined environmental, political, sociocultural, and individual determinants of obesity have the potential to ameliorate this. There have however been reported challenges with implementation of such initiatives, which may be strengthened by incorporating implementation science methods.

Methods
This pilot randomised controlled trial protocol outlines the development and proposed evaluation of a multicomponent implementation strategy (Action-RESPOND). to increase the implementation of community-based systems thinking child obesity prevention initiatives The target of this intervention is ten rural and regional communities (or local government areas as the unit of allocation) within Northeast Victoria who were participants in a whole-of-systems intervention (RESPOND). Action-RESPOND builds on this intervention by assessing the impact of offering additional implementation strategies to five communities relative to usual care. The development of the multicomponent implementation strategy was informed by the Promoting Action on Research Implementation in Health Services (PARIHS) framework and consists of seven implementation strategies primarily delivered via ‘facilitation’ methods. Implementation strategies aimed to ensure initiatives implemented are i) evidence-based, ii) address community’s specific needs and iii) are suitable for local context. Strategies also aimed to increase the community’s capacity to implement, through iv) improving the health promotion team’s implementation knowledge and skills, fostering v) leadership, vi) physical resources and vii) community culture to drive implementation. The feasibility, acceptability, potential impact, and cost of the strategy will be assessed at baseline and follow up using surveys administered to key representatives within the community and internal records maintained by the research team.

Discussion
By leveraging an existing community-based whole-of-systems intervention, Action-RESPOND offers a unique opportunity to collect pilot feasibility and early empirical data on how to apply implementation and systems science approaches to support obesity prevention in rural and regional communities in Victoria.
Propensity score matching as an effective strategy for biomarker cohort design and omics data analysis
Authors: Maekawa Masaki , Tanaka Atsushi , Ogawa Makiko , Roehrl Michael H. 
Published: May 2024

Background
Analysis of omics data that contain multidimensional biological and clinical information can be complex and make it difficult to deduce significance of specific biomarker factors.

Methods
We explored the utility of propensity score matching (PSM), a statistical technique for minimizing confounding factors and simplifying the examination of specific factors. We tested two datasets generated from cohorts of colorectal cancer (CRC) patients, one comprised of immunohistochemical analysis of 12 protein markers in 544 CRC tissues and another consisting of RNA-seq profiles of 163 CRC cases. We examined the efficiency of PSM by comparing pre- and post-PSM analytical results.

Results
Unlike conventional analysis which typically compares randomized cohorts of cancer and normal tissues, PSM enabled direct comparison between patient characteristics uncovering new prognostic biomarkers. By creating optimally matched groups to minimize confounding effects, our study demonstrates that PSM enables robust extraction of significant biomarkers while requiring fewer cancer cases and smaller overall patient cohorts.

Conclusion
PSM may emerge as an efficient and cost-effective strategy for multiomic data analysis and clinical trial design for biomarker discovery.
Assessment of antibiotic prescribing pattern and cost for hospitalized patients: A study from Palestine
Authors: Manassrah Rufayda Dawood , Al Ramahi Rowa 
Published: May 2024

BackgroundOne of the largest problems facing the world today is the morbidity and mortality caused by antibiotic resistance in bacterial infections. A major factor in antimicrobial resistance (AMR) is the irrational use of antibiotics. The objective of this study was to assess the prescribing pattern and cost of antibiotics in two major governmental hospitals in the West Bank of Palestine.MethodsA retrospective cohort study was conducted on 428 inpatient prescriptions containing antibiotics from two major governmental hospitals, they were evaluated by some drug use indicators. The cost of antibiotics in these prescriptions was calculated based on the local cost. Descriptive statistics were performed using IBM-SPSS version 21.ResultsThe mean ± SD number of drugs per prescription (NDPP) was 6.72 ± 4.37. Of these medicines, 38.9% were antibiotics. The mean ± SD number of antibiotics per prescription (NAPP) was 2.61 ± 1.54. The average ± SD cost per prescription (CPP) was 392 ± 744 USD. The average ± SD antibiotic cost per prescription (ACPP) was 276 ± 553 USD. The most commonly prescribed antibiotics were ceftriaxone (52.8%), metronidazole (24.8%), and vancomycin (21.0%). About 19% of the antibiotics were prescribed for intra-abdominal infections; followed by 16% used as prophylactics to prevent infections. Almost all antibiotics prescribed were administered intravenously (IV) 94.63%. In general, the average duration of antibiotic therapy was 7.33 ± 8.19 days. The study indicated that the number of antibiotics per prescription was statistically different between the hospitals (p= 0.022), and it was also affected by other variables like the diagnosis (p= 0.006), the duration of hospitalization (p< 0.001), and the NDPP (p< 0.001). The most commonly prescribed antibiotics and the cost of antibiotics per prescription were significantly different between the two hospitals (p < 0.001); The cost was much higher in the Palestinian Medical Complex.ConclusionThe practice of prescribing antibiotics in Palestine’s public hospitals may be unnecessary and expensive. This has to be improved through education, adherence to recommendations, yearly immunization, and stewardship programs; intra-abdominal infections were the most commonly seen infection in inpatients and ceftriaxone was the most frequently administered antibiotic.
Risk Factors for The Incidence of Acute Respiratory Infection (ARI) in Toddlers in The Working Area of Tarus Primary Health Center, Kupang District
Authors: Olang Eka Sukma Kumala Dewi , Adu Apris A. , Purnawan Sigit 
Published: May 2024

AbstractIntroduction: ARI is an acute infection that attacks one or more parts of the respiratory tract, from the nose to the deep tissues of the lungs. The number of ARI in toddlers in the Tarus primary health center in 2020 was 1.352 people and in 2021 there was a decrease of 97 people recorded, in January 2022 to February 2023, the number of ARI in toddlers increased by 1.141 cases.Methods: This research used a case-control study design. The case group is toddlers who experience ARI events, while the control group is toddlers who do not experience ARI events. The total population of toddlers in the Tarus Primary Health Center for the period January 2022 to February 2023 was 5,370 toddlers with a case group population of 1,141 toddlers and a control group population of 4,229 toddlers. The sample obtained for the case group was 117 toddlers and for the control group was 117 toddlers with a total of 234 samples.Results: The results showed no significant relationship between age (p=1.000; OR=1.000), and gender (p=0.428; OR=0.738) with the incidence of ARI in toddlers. There was a significant relationship between immunization status (p=0.000; OR=25.143), exclusive breastfeeding history (p=0.000; OR=25.016), house occupancy density (p=0.000; OR=15.416), house ventilation (p=0.000; OR=9.079) and smoking habits of family members (p=0.000; OR=9.775) with the incidence of ARI in toddlers.Conclusion : The incidence of ARI in toddlers can occur due to several risk factors such as immunization status, exclusive breastfeeding history, house occupancy density, house ventilation, and smoking habits of family members
Data-Driven Insight Synthesis for Multi-Dimensional Data
Authors: Xing Junjie , Wang Xinyu , Jagadish H. V. 
Published: May 2024

Exploratory data analysis can uncover interesting data insights from data. Current methods utilize "interestingness measures" designed based on system designers' perspectives, thus inherently restricting the insights to their defined scope. These systems, consequently, may not adequately represent a broader range of user interests. Furthermore, most existing approaches that formulate "interestingness measure" are rule-based, which makes them inevitably brittle and often requires holistic re-design when new user needs are discovered.
This paper presents a data-driven technique for deriving an "interestingness measure" that learns from annotated data. We further develop an innovative annotation algorithm that significantly reduces the annotation cost, and an insight synthesis algorithm based on the Markov Chain Monte Carlo method for efficient discovery of interesting insights. We consolidate these ideas into a system. Our experimental outcomes and user studies demonstrate that DAISY can effectively discover a broad range of interesting insights, thereby substantially advancing the current state-of-the-art.