bluuebunny/crossref_metadata_2025_split huggingface dataset:
How do healthcare providers use national audit data for improvement?
Authors: Antonacci Grazia , Whitney Julie , Harris Matthew , Reed Julie E. 
Published: October 2022

Abstract
Background:
Substantial resources are invested by Health Departments worldwide in introducing National Clinical Audits (NCAs). Yet, there is variable evidence on the NCAs’ effectiveness and little is known on factors underlying the successful use of NACs to improve local practice.
This study explores: (i) features of NCA reports, local feedback characteristics and actions undertaken following the feedback underpinning the effective use of NCA feedback to improve local practice; (ii) observed changes in local practice following the NCA feedback in England and Wales.
Methods:
Front-line staff perspectives on a single NCA (the National Audit of Inpatient Falls -NAIF 2017) were gathered through interviews. An inductive qualitative approach was used. Eighteen participants were purposefully sampled from 7 of the 85 participating hospitals in England and Wales. Analysis was guided by constant comparative techniques.
Results:
Regarding the NAIF annual report, interviewees valued performance benchmarking with other hospitals, the use of visual representations and the inclusion of case studies and recommendations. Participants agreed that feedback should target front-line healthcare professionals, be straightforward and focused, and be delivered through an encouraging and honest discussion. Interviewees highlighted the value of using other relevant data sources alongside NAIF feedback and the importance of continuous data monitoring. Participants believed that engagement of front-line staff in the audit and following improvement activities was critical. Leadership, ownership, management support and communication at different organisational levels were perceived as enablers, while staffing level and turnover, and poor quality improvement (QI) skills, were perceived as barriers to improvement. Observed changes in practice included increased awareness and attention to patient safety issues and greater involvement of patients and staff in falls prevention activities.
Conclusions:
There is scope to improve the use of NCAs by front-line staff. NCAs should not be seen as isolated interventions but should be fully embedded and integrated into the QI strategic and operational plans of NHS trusts.
The use of NCAs could be optimised, but knowledge of them is poor and distributed unevenly across different disciplines. More research is needed to provide guidance on key elements to consider throughout the whole improvement process at different organisational levels.
Risk Assessment for Artificial Intelligence Applications in Manufacturing
Authors: Jaekel Frank-Walter , Nieto Maria Teresa Alvela , Scholz Julia-Anne , Bode Dennis 
Published: October 2022

Abstract
This paper proposes an approach for assessing the risk associated with the deployment of models based on artificial intelligence methods in manufacturing environments. A technique for defining deployment scenarios, identifying perturbations of the models in the training and deployment phase under particular conditions, and an estimation of the damage associated with the model output is developed. As a result, measures for minimizing the risks are assessed under consideration of the likelihoods. For validation purposes, two real manufacturing scenarios are defined, and possible errors of their existing models are weighted by their likelihood, allowing consistent risk assessment across various manufacturing domains. In particular, the robustness of two artificial-intelligence-based models to changing industrial environments and fluctuating product properties are assessed.
Bifunctional integration of La-Ni diatomic sites with optical and catalytical activity for efficient CO2 photoreduction
Authors: Zhou Min , Wang Zhiqing , Mei Aohan , Yang Zifan , Chen Wen , Ou Siyong , Qi Kun , Ma Jingyuan , Wang Shengyao , Chen Keqiang , Reiss Peter , Liu Yueli 
Published: October 2022

Abstract
Dual-atom catalysts possess a significant potential for promoting CO2 photoreduction to lucrative solar fuels. However, the precise construction of the diatomic sites that simultaneously foster light absorption and catalytic activity is a formidable challenge, as both processes follow distinct pathways in the photocatalyst. Herein, a facile electrostatic-driven self-assembling approach is employed to realize a bifunctional architecture of a diatomic LaNi-Phen (Phenanthroline)/covalent organic framework (COF-5) photocatalyst. The La site acts as an optically active center for the photoinduced generation of carriers, while the Ni site serves as the catalytically active center for highly selective CO2-to-CO reduction enabled by directional charge transfer via COF-5. Density functional theory (DFT) calculations and in-situ characterization reveal the efficient synergistic effect of the La-Ni double-atomic sites, leading to decreased reaction energy barriers of *COOH intermediate and enhanced CO2-to-CO conversion. As a result, in the absence of any additional photosensitizers, a 15.2 times enhancement of the CO2 reduction rate (605.8 µmol·g− 1·h− 1) over that of pristine COF-5 colloid (39.9 µmol·g− 1·h− 1) and an improvement in CO selectivity to 98.2% are achieved. This work presents a novel strategy for integrating optically and catalytically active centers, which results in a diatomic synergy effect enabling high-performance photocatalytic CO2 reduction.
Environmental toxins and molar incisor hypo-mineralisation among children: A cohort study
Authors: Winkler James R. , Dixon Barbara L. , Singh Ishita , Soto Ray , Qiu Yuqing , Zhang Yue , Porucznik Christina A. , Stanford Joseph B. 
Published: October 2022

Abstract
Environmental toxins are known to have many impacts on growth and development in humans, starting in utero. Alterations in amelogenesis, caused by chemical and physical trauma that occur during the antenatal, perinatal and postnatal time periods, can result in developmental defects in deciduous and permanent tooth enamel. These defects can be clinically visible and result in a variety of morphological and functional problems in the dentition. Since enamel does not remodel after formation, it may be used as a permanent record of insults during organ development. A cohort of children from the Utah Children’s Project (N = 356) that had full phenotyping, comprehensive medical and family histories and available biospecimens were given extraoral and intraoral examinations. Standardized intraoral photographs were taken of the teeth and viewed by standardised examiners and the dental observations were recorded on a range of findings, including: tooth morphology, caries, restorations, colorations, attrition, erosion, fractures and hypomineralization. Perinatal maternal urine samples were assessed for the concentration of fluoride, phenols and phthalates, including bisphenol A (BPA). Pairwise statistical analyses were done to correlate the dental findings with one another and the presence of environment chemicals found in the urine samples. Hypomineralization was the most common finding and was strongly correlated with tooth attrition. The hypomineralization observed was consistent with molar incisor hypomineralization (MIH) described in other human populations. In animal studies, BPA concentration has been correlated with increased levels of MIH. No significant correlations were seen between dental findings and the presence of environmental chemicals in prenatal urine, but the number of samples available for the assessment was limited (n = 35).
Developing a plant-based yoghurt recipe that has the same high-quality characteristics as conventional yoghurt
Authors: Adeyanju Adeyemi Ayotunde , Adejuyitan Johnson A. , Ogunsimiro Oluwabukola , Adebowale Olalekan J. , Akinsanola Bolanle 
Published: October 2022

Abstract

Interest in using plant-based milk to make yoghurt has increased in recent times due to the prevalence of lactose intolerance and the exorbitant cost of importing milk in the majority of sub-Saharan African nations. In this study, the qualitative characteristics of yoghurt made from tigernut, soybean, and powder milks were examined and compared with yoghurt made from whole powder milk (cow milk) as the control. Tigernut, soybean, and powder milk were used to make five distinct milk formulations, which were subsequently fermented with Lactobacillus bulgaricus and Streptococcus thermophilus to make yoghurt. The yoghurt samples' proximate composition, physicochemical characteristics, total phenolic content, radical-scavenging ability, and microbial loads as well as sensory attributes were assessed. The study showed that the proximate composition and physicochemical properties of the yoghurt samples were within acceptable limits. The total phenolic content and DPPH radical scavenging capacity of the plant-based yoghurts were significantly (p < 0.05) higher than 100% powder milk yoghurt by 161–273% and 42–106%, respectively. The sensory attributes showed that while 100% powder milk yoghurt was the most preferred, plant-based yoghurt formulations were able to achieve good ratings in most of the measured qualities. Therefore, Soybean and tigernut milks can be utilized to make yoghurt with the same high-quality characteristics as conventional yoghurt.
Demonstration of solute-specific synergism in binary solvents
Authors: Ali Habib , Goswami Debabrata 
Published: October 2022

Abstract
The structure and solvation behaviour of binary liquid mixtures of Methanol (MeOH) and N, N-Dimethylformamide (DMF) are explored by ascertaining their intermolecular interactions with either Rhodamine-B (RhB) or Rhodamine101 (Rh101) dye through steady-state absorption, emission, and two-photon induced fluorescence. Specifically, in the present investigation, we examine the strong synergistic solvation observed for the combinations of hydrogen bond donating (MeOH) and accepting (DMF) solvent pairs. Solvatochromism causes the solvatochromic probe molecules to sense increased polarity compared to their bulk counterparts. The origin of synergism was explained in terms of solute-solvent and solvent-solvent interactions in binary solvent mixtures interactions, as evidenced by probe dependence. The solvation behaviour of the Methanol and DMF binary solvent mixture shows strong probe dependence, with Rh101 showing synergism while RhB does not.
A cuproptosis-related lncRNA signature for predicting prognosis and immune response in hepatocellular carcinoma
Authors: Wu Jingyi , Yao Jianzuo , Jia Shu , Yao Xiaokun , Shao Jingping , Yao Xiaomin , Li Hong 
Published: October 2022

Abstract
Background: Hepatocellular carcinoma (HCC) has a high incidence and poor prognosis. Cuproptosis is a novel type of cell death, which differs from previously reported types of cell death such as apoptosis, autophagy, proptosis, ferroptosis, necroptosis, etc. Long non-coding RNAs (lncRNAs) play multiple roles in HCC. To improve the prognosis of HCC, it is necessary to construct a signature using cuproptosis-related lncRNAs.
Methods: We downloaded information including RNA-seq transcriptome, clinical data and simple nucleotide variation data from The Cancer Genome Atlas (TCGA) database, and obtained cuproptosis-related genes from published studies. The cuproptosis-related lncRNAs were obtained by correlation analysis, and subsequently used to construct a prognostic cuproptosis-related lncRNA signature. Analyses of overall survival (OS) and progression-free survival (PFS) were used to evaluate prognostic validity. The receiver operating characteristic (ROC) curve with the area under the curve (AUC) values and the index of concordance (c-index) curve were drawn to evaluate the accuracy of the signature. The tumor microenvironment (TME) was analyzed by ESTIMATE algorithm. The immune cell data with various algorithms was downloaded from the Tumor Immune Estimation Resource (TIMER) 2.0 database. Immune-related pathways were analyzed by single-sample gene set enrichment analysis (ssGSEA) algorithm. Immunophenoscore (IPS) scores from The Cancer Immunome (TCIA) database were used to evaluate immunotherapy response. The "pRRophetic" R package was employed to screen drugs for high-risk patients.
Results: We constructed a cuproptosis-related lncRNA signature containing 11 lncRNAs: AC125437.1, PCED1B-AS1, PICSAR, AP001372.2, AC027097.1, LINC00479, and SLC6A1-AS1 to predict the prognosis of HCC patients. This signature had excellent accuracy, and was independent of the stratification of clinicopathological features. Further study showed that high-risk tumors under this signature had higher TMB, fewer TME components and higher tumor purity. The immune-related analysis showed that the tumors with high risk were not enriched in immune cell infiltration or immune process pathways, and high-risk patients had a poor response to immunotherapy. Finally, 29 drugs such as sorafenib, dasatinib and paclitaxel were screened for high-risk HCC patients to improve their prognosis.
Conclusion: Our prognostic cuproptosis-related lncRNA signature was accurate and effective for predicting the prognosis of HCC. The immunotherapy was unsuitable for high-risk HCC patients with this signature.
Prevalence of Undiagnosed Hypertension and Associated Factors among Adults in Mizan Aman Town, Bench Sheko Zone, Southwest Ethiopia: A Community-based Cross-sectional Study
Authors: Elias Sebsibe , Dadi Teshome Kabeta 
Published: October 2022

Abstract

Background: Undiagnosed hypertension is the leading risk factor for death and disability globally. Its prevalence is increasing worldwide, especially in low and middle-income countries. It is considered a silent killer because it can exist without specific signs and symptoms for many years while once happening with serious complications. Hence, this study aimed to assess the prevalence of undiagnosed hypertension and associated factors among 18 years and above in Mizan Aman town of Bench Sheko Zone in Southwest Ethiopia.
Methods: A community-based cross-sectional study design was carried out among people aged 18 years old and above from April 1 to 30,2021, in Mizan Aman town. Seven hundred fifty-nine subjects were selected by multistage sampling technique. A structured pretested WHO STEPS-wise questionnaire was used to interview the participants. Data entry and analysis were done using EPI data 3.1 and SPSS version 25 statistical software respectively. Descriptive analysis was undertaken and the results were presented using frequency tables, graphs, and statistical summaries. The dependent variable has dichotomized response of yes and no and hence binary logistic regression was used to predict a dependent variable based on independent variables and predictors having P ≤ 0.25 on the bivariable analysis were considered as candidates for the multivariable analysis. Odds ratios with their 95% confidence intervals were calculated to measure the strength of association and finally a p-value < 0.05 was considered statistically significant.
Result: The prevalence of undiagnosed hypertension was 14.8% with 95% CI [12.3-15.6]. Older age (AOR =3.1, 95% CI [1.5-6.5]), male (AOR=2.2, 95%CI [1.3-3.9] low physical activity (AOR=3.9, 95% CI. [1.8-8.3]), less serving fruit and vegetable (AOR=4.5, 95%CI. [2.4-8.8]), and higher BMI (AOR=2.7, 95% CI. [1.6-4.6) were significantly associated with undiagnosed hypertension.
Conclusion: The current study outlined that the prevalence of undiagnosed hypertension was high in the study area. In addition, most of the risk factors identified were modifiable, and hence community-based preventive approaches like lifestyle modification, increasing awareness, and strengthening routine screening at primary health service facilities resulted in a substantial change in tackling the burden effectively.
The Perception of the Medical Student About Realistic Simulation in Pediatrics
Authors: Veiga-Moliterno Nathalia , Veiga Eneida Quadrio de Oliveira , Tempski Patrícia Zen , Cunha Antônio José Ledo Alves , Prata-Barbosa Arnaldo , de Magalhães-Barbosa Maria Clara 
Published: October 2022

Abstract

Background: The use of realistic simulation in pediatric emergencies is particularly valuable, as it allows the training of technical, attitudinal, and cognitive skills helping to ensure patient safety. This study aims to describe the student's perception of using the High-Fidelity Realistic Simulation in the pediatric emergency modules during the internship.
Methods:Observational, descriptive study with a quantitative and qualitative approach. A semi-structured questionnaire was applied to sixth-year medical students at the end of pediatric internship modules, eight weeks long, from August to December 2020. All participated in two types of activities on 14 themes: high fidelity simulation (HFS) and structured discussion of clinical cases (SDCC).
Results: Of the 33 participants, 29 answered the questionnaire. The mean age was 24 ± 1.8 years, and 58.6% were female. All agreed that the experience with HFS contributed to safer performance in pediatric emergencies, considered optimal by 76% and good for the rest. Most thought the association of HFS and SDCC was the ideal method (96%). The content analysis of the responses on HFS highlighted thematic units in five categories: significant learning, contribution to professional training, skills, attitude/behavior, and quality of the activity.
Conclusions: Students' reaction to using HFS in pediatric emergencies was very positive, and its association with SDCC was considered the ideal teaching method. Knowing students' reactions helps teachers plan their activities to improve the teaching-learning method.
Examining the effects of strength training with load progression on sleep parameters in university students
Authors: Fernandes Katarina Kelly , Santiago Ladyodeyse , Lira Camila Tenório , Silva José Francisco , Henrique Rafael dos Santos , Junior Marco Aurélio Correia , Santos Marcos 
Published: October 2022

Abstract
Methods
Seventeen university students (11 girls), 18–21 years old, were randomly divided into two groups: strength training group (ST,n = 12) and control group (CG,n = 5). Anthropometric and body composition measures, one-repetition maximum test, and sleep parameters (Pittsburgh Sleep Quality Index [PSQI], insomnia (Insomnia Severity questionnaire), daytime sleepiness (Epworth Sleepiness Scale [ESS]), and chronotype were evaluated pre and post-intervention. Training consisted of 60 min·d− 1 (2 times/week, for 4-weeks), with 3 sets of 10–12 repetitions, and a 1-minute rest interval between sets and exercises.
Results
The results through a 2 × 2 (time×groups) repeated measures analysis variance demonstrated a significant time effect that improves lower limb performance (F = 11.82;p = < 0.01), with a significant interaction (F = 6.07;p = 0.05), and upper limb performance (F = 3.30;p = 0.025), and there was a significant time effect on the chronotype (F = 4.75;p < 0.05). Individual analyses in ST group, ~ 58.3% presented a reduction in the PSQI score; ~25% no change, and ~ 16. 6% showed an increased score. For the ESS, ~ 25% showed a reduction, ~ 58.3% no change, and ~ 16.6% an increase. In sleep efficiency, ~ 25% increase; ~41.6% a reduction, and ~ 33.3% had no change.
Conclusion
A short-term strength-training program with an increase in weekly load for four weeks is not able to modulate sleep quality, duration, efficiency, daytime sleepiness, or insomnia, independent of intensity, but, had influenced the chronotype.
A Novel ZMIZ1 Pathogenic Variant in a Chinese Girl with Neurodevelopmental Disorder and Review of the Literature
Authors: Deng Shuyun , Xia Dan , Hou Lele , Li Xiaojuan , Peng Xiaofang , Xiao Xiaoqin , Zhang Jieming , Ouyang Nengtai , Liang Liyang 
Published: October 2022

Abstract
Pathogenic variants in the ZMIZ1 gene have been associated with neurodevelopmental disorder with dysmorphic facies and distal skeletal anomalies (NEDDFSA). To date, only five reports have identified ZMIZ1 mutations in patients with neuropsychiatric alterations. Here we described a Chinese pediatric patient with intellectual disability (ID), early and fast puberty, growth restriction, and mild facial dysmorphisms, who had a novel pathogenic variant in ZMIZ1 (NM_020338.4:c.40C > T:p.Arg14*). Meanwhile, we demonstrated the molecular and phenotypic features of individuals carrying the ZMIZ1 heterozygous variants through a comprehensive literature review. ID (100%), facial dysmorphism (90.91%), speech developmental delay (90.48%), abnormal behaviors (85%), motor developmental delay (78.95%), and eye anomalies (71.43%) were identified as the most represented clinical features. Our findings present the second Chinese case of NEDDFSA and report a novel heterozygous ZMIZ1 mutation which expands the variant spectrum of the ZMIZ1 gene. Furthermore, we suggest that the penetrance of NEDDFSA is almost complete but with highly variable expressivity.
High prevalence of uncontrolled hypertension among patients with early chronic kidney disease attending tertiary hospitals in Dodoma, Tanzania
Authors: Katatwire Denis D. , Meremo Alfred 
Published: October 2022

Abstract

Background
The prevalence of uncontrolled hypertension has been increasing globally including Sub-Saharan Africa (SSA) accelerating the burden of chronic kidney disease (CKD), cardiovascular diseases (CVD) and non-communicable diseases (NCDs).
Methods
A cross-sectional study was conducted among adult patients with early-stage CKD attending the medical outpatient department (MOPD) clinics of two tertiary hospitals in Dodoma between November 2020 to March 2021. Descriptive and inferential statistics were performed using SPSS software version 26 and multivariable logistic regression analysis was used to identify variables associated with uncontrolled hypertension.
Results
A total of 352 patients were enrolled; 64 (18.2%) were in CKD stage 2 and 288 (81.8%) in CKD stage 3, median age was 54 (47–59) years, 182 (51.7%) were males, the prevalence of hypertension was 58.5% and the prevalence of uncontrolled hypertension was 58.3%. For patients with uncontrolled hypertension, the median SBP was 146 (142–150) mmHg, the median DBP was 86(82–90) mmHg, the median BMI was 26.1 (24.0-27.5) kg/m2, the median waist circumference was 97(90–104) cm, the median eGFR of 48 (43–55) mil/min/1.73m2. Among patients with uncontrolled hypertension; 88.3% patients had CKD stage 3, 80.0% patients reported non-adherence to antihypertensives, 76.7% patients had overweight/ obesity, 72.5% patients reported current alcohol use, 60.0% patients had dyslipidemia, 43.3% patients reported current smoking, 36.7% patients had significant proteinuria and 26.7% patients had diabetes mellitus. Variables with higher odds for uncontrolled hypertension were; age ≥ 50 years (OR = 5.17, 95% CI 2.37–13.33, P = 0.001), alcohol use (OR = 11.21, 95% CI 3.83–32.84, P = 0.001), Overweight/obesity (OR = 6.28, 95% CI 2.54–15.53, P = 0.001), non-adherence to antihypertensives (OR = 10.19, 95% CI 4.22–24.61, P = 0.001) and CKD stage 3 (OR = 3.52, 95% CI 1.32–9.42, P = 0.012).
Conclusion
Uncontrolled hypertension is highly prevalent among patients with early-stage CKD in our settings and it’s associated with age, current alcohol use, overweight/obesity and non-adherence to antihypertensives.