bluuebunny/crossref_metadata_2025_split huggingface dataset:
The effect of letrozole as an adjunct in GnRH-antagonist protocol on IVF/ICSI outcome in women with endometriosis: a randomized clinical trial
Authors: Mojtahedi Maryam Farid , Moini Ashraf , Kashani Ladan , Mirzarahimi Tiba 
Published: November 2023

Abstract
Background
To evaluate the effect of adding letrozole to the antagonist ovarian stimulation protocol (COS) on in-vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) outcome in endometriosis patients.

Methods
This randomized clinical trial was carried out in the department of infertility treatment at Arash Women’s Hospital from May 2019 to May 2021. The eligible women with normal ovarian reserve tests who had endometriosis diagnosis and underwent IVF/ICSI cycles were evaluated. A flexible regimen of GnRH-antagonist protocol was used for COS. In the experimental (n = 34), the patients received 5 mg letrozole daily for the first 5 days in combination with 150 IU of recombinant follicle-stimulating hormone (rFSH). In the control group (n = 30), the patients received only the same dose of rFSH. The treatment cycle was compared between groups.

Results
Analysis of demographic characteristics, severity of endometriosis, and baseline hormonal tests of patients showed that the two groups were similar and comparable. The means of total used gonadotropins ampoules and serum E2 level on oocyte trigger day in the letrozole group were significantly lower than those of in the control group (P = 0.03 and P = 0.004, respectively). No statistically significant difference in terms of the total number of retrieved and MII oocytes as well as the total numbers of obtained and top-quality embryos, and cryopreserved embryos was found.

Conclusion
The co-treatment of letrozole with gonadotropins during the antagonist protocol was associated with a reduction in the total dose of gonadotropins, although it had no effect on the oocyte or embryo yield in patients with endometriosis.

Trial registration
The study was registered in the Iranian Registry of Clinical Trials on 2018 -07-13 (IRCT20150310021420N4 at www.irct.ir, registered while recruiting).
Pengaruh pemberian media poster kesehatan terhadap minat remaja mengikuti posbindu PTM
Authors: Wijayanti Anisa Catur , Edita Enggin Putri 
Published: November 2023

Non-communicable diseases (NCD) are still a health problem in Indonesia in recent years. Non-communicable diseases often go undetected because no symptoms are found, so they are difficult to cure or will end in disability or death. There has been an epidemiological transition by shifting morbidity and mortality rates from infectious diseases to non-communicable diseases at a young age. The Indonesian government has created a program to overcome the problem of NCDs with the existence of NCDs Posbindu aimed at people over 15 years old who are still healthy and people with NCDs. There is a need to provide information using poster media regarding NCDs and NCDs Posbindu problems in adolescent understanding to prevent and control NCDs now and in the future. This study aims to determine the effect of giving poster media on teenagers' interest in participating in Posbindu at Ambarawa 1 High School. The results of the analysis showed that there was an influence of poster media on teenagers' involve in participating in NCDs Posbindu (p:0,001). The results showed a decrease in the average interest of adolescents in participating in the NCDs Posbindu by 3.15. This happened because adolescents objected to the implementation of the NCDs Posbindu, which was held one a month. Adolescents need to know that participating in Posbindu is an effort to prevent and control NCDs in the future. The data can be provided through cooperation between schools and community health centers that can involve existing extracurriculars and provide a better understanding of the importance of NCDs prevention and control efforts to adolescents, teachers and parents.
Maternal mortality and morbidity in Pakistan: a situational analysis
Authors: Asif Nimira , Adnan Farzana , Ali Shahnaz Shahid , Memon Zahid , Ali Tazeen Saeed 
Published: November 2023

Background The maternal mortality rate in Pakistan is high, which has been attributed partly to delays in accessing healthcare for women who are pregnant and in labour. This study aimed to explore the community's perspectives of delays to use of health services in pregnancy and labour, using the ‘three delays’ model and the framework for determinants of maternal mortality. Methods An explorative-descriptive approach was used, with purposeful sampling of 382 participants selected from across Pakistan. Four groups of participants were selected: married women, married men, adolescent girls and adolescent boys. Results Several factors led to delays seeking healthcare. Women were unable to decide for themselves whether to attend a healthcare facility, there were issues reaching a facility in time and at the facility, either the resources or healthcare workers were lacking. Conclusions Women must be given education and access to healthcare in order to reduce maternal mortality and morbidity.
Carbetocin vs oxytocin in third stage labour: a quantitative review of low- and middle-income countries
Authors: Jacob Danielle 
Published: November 2023

Background/Aims Postpartum haemorrhage is a global concern and is a leading cause of maternal mortality in low- and middle-income countries. Oxytocin is the preferred prophylactic uterotonic; however, it is heat sensitive and therefore may not be suitable in low- and middle-income countries, which are often warm climates. An alternative is carbetocin, which is heat stable and longer acting. Methods Literature was sourced from the EBSCO, CINAHL, Medline and Global Health databases. Studies written in English in the last 10 years, that compared carbetocin to oxytocin in management of postpartum haemorrhage were selected. An ABCDFIX mnemonic tool was used to individually critique each study. Results The key themes were postpartum haemorrhage over 500ml, postpartum haemorrhage over 1000ml, need for blood transfusion, retained placenta, haemoglobin levels and need for additional uterotonics. The use of carbetocin may reduce the risk of postpartum haemorrhage and the need for additional uterotonics in low- and middle-income countries. Conclusions The use of carbetocin, instead of oxytocin, in low- and middle-income countries may reduce the risk of postpartum haemorrhage after vaginal birth and the need for more uterotonics. However, more research is needed in these settings.
Photocurrent Density Enhancement of DSSC with Existence of ZnO in TiO2 Based Photoanode
Authors: Safriani Lusi , Nurfitriani Nurfitriani , Celline Ayunita Chintia , Aprilia Annisa , Furukawa Yukio 
Published: November 2023

<p class="Abstract"><span lang="EN-US">One of the important components of a dye-sensitized solar cell (DSSC) is photoanode which plays a critical role serving as the center of conversion energy. Photoanode consists of transparent conducting substrate, a semiconductor layer, and dyes molecules as sensitizers. Titanium dioxide (TiO<sub>2</sub>) is widely used as a photoanode because it is a mesoporous and stable material despite its high recombination rate. To reduce the recombination rate and improve electron transport, TiO<sub>2</sub> is combined with other materials such as ZnO to form TiO<sub>2</sub>/ZnO composites. ZnO is a good choice because it has higher electron mobility than TiO<sub>2</sub> to inhibit recombination. The synthesis process of TiO<sub>2</sub>/ZnO composites was carried out using the sol-gel method with variations in the weight percentage of ZnO. The TiO<sub>2</sub>/ZnO composite was then applied as a photoanode in DSSC. The J-V measurement results shows that the DSSC with TiO<sub>2</sub>/ZnO 25wt% composite layer as the photoanode produced the highest efficiency of 0.86%. This increase in efficiency was due to an increase in the photo-current of photoanodes that have more ZnO content. The presence of ZnO leads to faster-moving electron transport, therefore reducing recombination and increasing efficiency.</span></p>
Longitudinal association between positive affect and blood lipids in patients following acute myocardial infarction
Authors: Princip Mary , von Känel Roland , Sivakumar Sinthujan , Jellestad Lena , Pazhenkottil Aju P. , Langraf-Meister Rebecca E. , Znoj Hansjörg , Schmid Jean-Paul , Barth Jürgen , Schnyder Ulrich , Zuccarella-Hackl Claudia 
Published: November 2023

Objective
Unfavorable blood lipid profiles are robust risk factors in predicting atherosclerotic disease. Studies have shown that positive affect (PA) is associated with a favorable lipid profile. However, longitudinal studies regarding the course of PA and lipid profiles in myocardial infarction (MI) patients are lacking. Therefore, the aim of this study was to prospectively explore the association between PA and blood lipid levels across three inv estigations over 12 months following acute MI.

Methods
Patients following an acute MI were examined at hospital admission (n = 190), and at 3 months (n = 154) and 12 months (n = 106) thereafter. Linear mixed effect regression models were used to evaluate the relation between PA, assessed with the Global Mood Scale, and blood lipid levels. Potential confounding variables were controlled for in the analysis.

Results
Higher PA was significantly associated with higher high-density lipoprotein cholesterol (HDL-C) levels and a lower total cholesterol (TC)/HDL-C ratio over time, independent of demographic factors, indices of cardiac disease severity, comorbidity, medication use, health behaviors, serum cortisol and negative affect (p≤0.040). No association was found between PA and the two blood lipids low-density lipoprotein-cholesterol (LDL-C) and triglycerides (TG).

Conclusions
Positive affect was independently associated with HDL-C levels and the TC/HDL-C ratio in patients up to 1 year after MI. The findings support a potential role of PA for cardiovascular health through an association with a favorable blood lipid profile.
Data sharing practices in collaborative human genomic research in low- and middle-income countries: A systematic review protocol
Authors: Ekusai-Sebatta Deborah , Ocan Moses , Singh Shenuka , Kyaddondo David , Akena Dickens , Nakalembe Loyce , Apunyo Robert , Kinengyere Alison Annet , Namisango Eve , Obuku Ekwaro A. , Mwaka Erisa 
Published: November 2023

Introduction
The practice of creating large databases has become increasingly common by combining research participants’ data into larger repositories. Funders now require that data sharing be considered in newly funded research project, unless there are justifiable reasons not to do so. Access to genomic data brings along a host of ethical concerns as well as fairness and equity in the conduct of collaborative research between researchers from high- income and low-and middle-income countries.

Materials and methods
This systematic review protocol will be developed in line with PRISMA -guidelines which refers to Open Science Framework, registered in PROSPERO (https://www.crd.york.ac.uk/prospero/) record CRD42022297984 and published in a peer reviewed journal. Data sources will include PubMed, google scholar, EMBASE, Web of science and MEDLINE. Both published and grey literature will be searched. Subject matter experts including bioethicists, principal investigators of genomic research projects and research administrators will be contacted. After de-duplication, titles and abstracts will be screened for eligibility. Data extraction will be undertaken using a piloted form designed in EPPI-Reviewer software before conducting risk of bias assessments by a pair of reviewers, acting independently. Any discrepancies will be resolved by consensus. Analysis will be done using a structured narrative synthesis and where feasible metanalysis. This review will attempt to highlight the context of data sharing practices in the global North-South and South-South collaborative human genomic research in low- and middle-income countries. This review will enhance the body of evidence on ethical, legal and social implications of data sharing in international collaborative genomic research setting criteria for data sharing. The full report will be shared with relevant stakeholders including universities, civil society, funders, and departments of genomic research to ensure an adequate reach in low-and middle-income countries (LMICs).
Ventilatory support and inflammatory peptides in hospitalised patients with COVID-19: A prospective cohort trial
Authors: Gysan Maximilian Robert , Milacek Christopher , Bal Christina , Zech Andreas , Brugger Jonas , Milos Ruxandra-Iulia , Antoniewicz Lukasz , Idzko Marco , Gompelmann Daniela 
Published: November 2023

Purpose
Several studies have shown that SARS-CoV-2 can induce a massive release of cytokines which contributes to disease severity and mortality. Therefore, cytokine levels in the serum may help to predict disease severity and survival in COVID-19 patients.

Methods
In this prospective trial, 88 patients who were hospitalised for COVID-19 were enrolled. Blood samples for serum peptide measurements were taken at the time closest to hospitalisation, at day 5, 9 and 13 (±1). The concentrations of cytokines (IL-1α, IL-1β, IL-1RA, IL-6, L-7, L-10, IFN-γ and TNF-α), chemokines (CCL-3, CCL-4 and CCL-7) and growth factors (G-CSF, GM-CSF and VEGF) were assessed and correlated with the type of ventilation, occurrence of consolidations on imaging and the level of care.

Results
COVID-19 patients (median age 68 years, IQR 55–77) stayed in hospital between 5–171 days. Compared to patients in the general care unit, patients in the intermediate care unit (IMCU) and intensive care unit (ICU) presented significantly elevated serum IL-6 (p = 0.004) and lower IFN-γ levels (p = 0.005), respectively. The peak inspiratory pressure in ventilated patients correlated positively with IL-1RA, G-CSF and inversely with IFN-γ serum levels (all p<0.05). VEGF serum levels inversely correlated with the fraction of inspired oxygen in patients receiving high-flow nasal canula oxygen therapy (p = 0.047). No significant correlation between serum concentrations of the measured peptides and the type of ventilation, occurrence of radiological consolidations or in-hospital mortality has been observed.

Conclusion
IL1-RA, IL-6, IFN-γ, G-CSF, CCL-7 and VEGF serum levels could prove helpful as biomarkers to assess disease severity and the need for intensive care in COVID-19 patients.
Non-linear association between aspartate aminotransferase to alanine aminotransferase ratio and mortality in critically ill older patients: A retrospective cohort study
Authors: Yang Hua , Meng Limin , Xin Shuanli , Chang Chao , Zhao Xiufeng , Guo Bingyan 
Published: November 2023

Background
The aspartate aminotransferase to alanine aminotransferase (AST/ALT) ratio has been shown to be associated with poor clinical outcomes across various patient groups. However, little is unclear about the association between the two in critically ill older patients. Therefore, we aim to investigate the association of the AST/ALT ratio with hospital mortality in this special population.

Methods
In this retrospective cohort study, we extracted elderly patients (age ≥ 65 years) from the Medical Information Mart for Intensive Care IV (MIMIC-IV) database. The primary outcome was in-hospital mortality. The association between the AST/ALT ratio and hospital mortality was studied using univariable and multivariable Cox regression analysis, as well as restricted cubic splines (RCS). Survival analysis was performed using the Kaplan-Meier (KM) method according to the AST/ALT ratio.

Results
Among the 13,358 eligible patients, the mean age was 77.6 years, 7,077 patients (52.9%) were male, and 2,511 patients (18.8%) died in hospital. The AST/ALT ratio was found to be independently associated with in-hospital mortality (HR = 1.05, 95% CI: 1.01–1.09, P = 0.022) after adjusting for potential confounders. Furthermore, a non-linear relationship and saturation effect were observed between them, with the inflection point being 1.80. When the AST/ALT ratio was less than 1.80, we found that every 1 unit increase in the AST/ALT ratio resulted in a 39% increased risk of in-hospital mortality (HR = 1.39, 95% CI: 1.18–1.64, P < 0.001). However, when the AST/ALT ratio was greater than 1.80, the association became saturated (HR = 1.01, 95% CI: 0.96–1.07, P = 0.609). Sensitivity and subgroup analyses showed the results were robust.

Conclusion
In critically ill older patients, the association between the AST/ALT ratio and in-hospital mortality was non-linear and showed a saturation effect. An elevated AST/ALT ratio was significantly associated with increased in-hospital mortality when the AST/ALT ratio was less than 1.80.
Path analysis model for preventing stunting in dryland area island East Nusa Tenggara Province, Indonesia
Authors: Picauly Intje , Adi Anak Agung Ayu Mirah , Meiyetriani Eflita , Mading Majematang , Weraman Pius , Nashriyah Siti Fadhilatun , Hidayat Ahmad Thohir , Boeky Daniela L. Adeline , Lobo Varry , Saleh Asmulyati , Peni Jane A. 
Published: November 2023

Background
The problem of stunting is still a fundamental problem in Indonesia’s human development. East Nusa Tenggara Province is an archipelago dryland area where in 2007–2021 it has contributed to the highest number of stunting children prevalence in Indonesia. This study aims to determine the relationship of variables in individual, household and district level with the prevalence of stunting.

Methods
This type of research is observational study with a cross sectional design. This study used individual secondary data from the Indonesian Nutritional Status Survey in 2021 consisting of 7,835 toddlers and National Social Economics Survey 2021.

Results
This research found that both specific & sensitive intervention programs had an influence in accelerating the decline in stunting prevalence (higher score on Z Score). Results also revealed the positive influence of the food access variable on nutritional intake. The results of the path analysis test showed that sensitive intervention program variables have a positive effect on food access variable and environmental variable (environmental sanitation) such as the habit of open defecation and healthcare. There was significant relationship on disease history, environment and intake to Height for Age (HAZ) score.

Conclusions
In conclusion, direct and indirect factors have important roles to prevent stunting. Sensitive and specific intervention program, food access, macro determinants and environment are the indirect indicators which contribute significantly to the stunting. The risk of children under five years old experiencing malnourished nutritional status increases with a history of infectious disease (diarrhea, ARI, worms). The risk of children under five years experiencing malnourished nutritional status decreases with adequate nutritional intake. It is hoped that there will be a special model of stunting control interventions at the individual level and at the family, household and district level that are integrated and of high quality through multisectoral cooperation in the dryland areas of the islands of East Nusa Tenggara Province.
The enhanced adsorption properties of phosphorus from aqueous solutions using lanthanum modified synthetic zeolites
Authors: He Dongsheng , Chen Beibei , Tang Yuan , Li Qianqian , Zhang Kecheng , Li Zhili , Xu Changming 
Published: November 2023

Abstract
In this study, a modified synthetic zeolite adsorbent was synthesized by the hydrothermal method using coal fly ash as the main raw material, and the enhanced phosphorus adsorption properties from aqueous solutions were then evaluated. The modification parameters were specifically studied and optimized. Moreover, the effects of initial phosphorus concentration, adsorption time, and pH value on phosphorus absorption were also investigated. The adsorbent was characterized by the energy-dispersive spectrometer analysis, scanning electron microscopy, and Fourier transform infrared spectroscopy. Furthermore, the phosphorus adsorption properties of the zeolite adsorbent were preliminarily discussed through the perspectives of isothermal adsorption experiments, adsorption kinetics experiments, and adsorption thermodynamics calculations. The results show that the lanthanum ions were physically loaded on the surface and micropores of the adsorbent after modification, which helps to enhance the adsorption effect of phosphorus components from the aqueous solution. The phosphorus removal rate has been increased by about 65%. The adsorption process better fitted the Langmuir and Elovich equations. The theoretical calculation and analysis of adsorption thermodynamics showed that the adsorption and removal of phosphorus in water happens spontaneously.
Green ultrasound-assisted extraction and life cycle assessment of lutein from marigold flowers using biocompatible surfactants
Authors: Maheshwari Neha , Khanpit Vishal V. , Kannan Ashwin 
Published: November 2023

Abstract
The objective of this work is to extract lutein from marigold petals by the ultrasound assisted extraction employing surfactant based aqueous solution. In this study the effect of various parameters i.e. different biocompatible surfactants, temperature, extraction time, pulse mode (ON/OFF), ultrasonicator power, solid/liquid (S/L) ratio, surfactant concentration were investigated. Under the optimum conditions (temperature: 35 °C, extraction time: 20 min, pulse mode (ON/OFF): 20 s ON/OFF, surfactant concentration: 1 % (v/v), S/L: 7.5, ultrasonicator power: 370 W), the maximum lutein content of 12.18 ± 0.39 mg/g was obtained. Further, the comparative study was done for the conventional extraction (CE) and the ultrasound assisted extraction (UAE), both using surfactants aqueous solution as solvent for the extraction of lutein. The results revealed that the amount of lutein obtained using UAE method was notably higher than the CE method. Furthermore, CE and UAE methods were compared in terms of their environmental impact by life cycle assessment approach. Global warming potential (GWP) was found to be lower for UAE (0.91 kg CO2/kg of lutein extract) than CE (1.55 kg CO2/kg of lutein extract). An antioxidant activity of lutein extract was studied using 1,1-diphenyl-2-picrylhydrazyl (DPPH). The results revealed that lutein can be extracted by UAE without affecting the antioxidant activity of lutein extract. The aforesaid results suggest that UAE employing surfactant based aqueous solution method is suitable for the extraction of lutein from marigold petals.
Papal Nuncios in Prague as Part of the Imperial Court: The Significance of Integration, Sociability, and Credibility of Papal Diplomats at the Turn of the Sixteenth and Seventeenth Centuries
Authors: Černušák Tomáš 
Published: November 2023

Abstract
Papal nuncios at the imperial court in Prague were diplomats who represented their ruler – the sovereign of the Papal States and the head of the Catholic Church. Yet they became a distinctive fixture of the imperial court in the places they served. In order for their integration into the structure of the court to be fluid, their personality traits and character had to fit the universally accepted models that applied to courtiers, namely those pertaining to social background, education, conduct, and disposition. At the same time, they had to possess a sufficient degree of sociability and a capacity to earn trust both in their relationship with the sovereign and with the courtiers. Among the primary instruments of this integration process were a wide variety of social activities, some of which were identical for the entire social group, and others unique to the papal nuncios alone.