bluuebunny/crossref_metadata_2025_split huggingface dataset:
Heart Rate Variability-Derived Features Based on Deep Neural Networks for Monitoring Depth of Anaesthesia
Authors: Zhan Jian , Wu Zuo-xi , Duan Zhen-xin , Yang Gui-ying , Du Zhi-yong , Bao Xiao-hang , Li Hong 
Published: July 2020

Abstract
Background: Estimating the depth of anaesthesia (DoA) is critical in clinical anaesthesiology. Electroencephalograms (EEGs) have been widely used for monitoring the DoA; however, they may be inaccurate under certain conditions. Methods: In this study, we propose a novel method to evaluate the DoA based on multiple heart rate variability (HRV)-derived features combined with a discrete wavelet transform and deep neural networks (DNNs). Four features were extracted from an electrocardiogram, including the HRV high-frequency power, low-frequency power, high-to-low-frequency power ratio, and sample entropy. Next, these features were used as inputs for the DNN, which used the expert assessment of consciousness level as the reference output. Finally, the DNN was compared with the logistic regression (LR), support vector machine (SVM), and decision tree (DT) models. The data of 23 anaesthesia patients were used to assess the proposed method. Results: The results demonstrated that the accuracies of the four models, in distinguishing the anaesthesia states, were 86.2% (LR),87.5% (SVM),87.2% (DT), and 90.1%(DNN). Our method outperformed the LR, SVM, and DT methods.Conclusions: The proposed method could accurately distinguish between different anaesthesia states, thus, providing an alternative or supplementary method to EEG monitoring for the assessment of DoA.
Patient satisfaction and its socio-demographic correlates in a tertiary public hospital in Nepal: A cross-sectional study
Authors: Adhikari Mukesh , Poudel Narendra Raj , Mishra Shiva Raj , Shrestha Archana , Upadhyaya Dipak Prasad 
Published: July 2020

Abstract
Background
Patient satisfaction is one proxy indicator of the health care quality; however, enhancing patient satisfaction in low-income settings is very challenging due to the inadequacy of resources as well as low health literacy among patients. In this study, we assess patient satisfaction and its correlates in a tertiary public hospital in Nepal.
Methods
We conducted a cross sectional study at outpatient department of Bhaktapur Hospital of Nepal. To recruit participants for the study, we applied a systematic random sampling method. Our study used a validated Patient Satisfaction Questionnaire III (PSQ-III) developed by RAND Corporation including various contextual socio-demographic characteristics. We calculated mean score and percentages of satisfaction across seven dimensions of patient satisfaction. To determine the association between various dimensions of patient satisfaction and socio-demographic characteristics of the patient, we used a multi-ordinal logistic regression.
Results
Among 204 patients, we observed a wide variation in patient satisfaction across seven dimensions. About 39% of patients were satisfied in the dimension of general satisfaction, 92% in interpersonal manner, and 45% in accessibility and convenience. Sociodemographic factors such as age (AOR: 6.42; CI: 1.30-35.05), gender (AOR: 2.81; CI: 1.41–5.74), and ethnicity (AOR: 0.26; CI: 0.08–0.77) were associated with general satisfaction of the patients. Other sociodemographic variables such as education, occupation, and religion were associated with a majority of the dimensions of patient satisfaction (p < 0.05). Age was found to be the strongest predictor of patient satisfaction in five out of seven dimensions.
Conclusions
We concluded that patient satisfaction varies across different dimensions. Therefore, targeted interventions that direct to improve the dimensions of patient satisfaction where the proportion of satisfaction is low are needed. Similar studies should be conducted regularly at different levels of health facilities across the country to capture a wider picture of patient satisfaction at various levels.
Associations between Defense Mechanisms and Life Satisfaction among North Korean Refugees
Authors: Lee Chang Woo , Lee Jooyoung , Jun Jin Yong , Lee So Hee , Yu So Young , Park Juhyun , Kim Seog Ju 
Published: July 2020

Abstract
Background The present study investigated associations between defense mechanisms and life satisfaction among North Korean refugees living in South Korea.Methods A total of 178 North Korean refugees completed the Korean version of the Defense Style Questionnaire, a revised version of the Ways of Thinking of North Korean Defectors scale, the Center for Epidemiologic Studies Depression Scale, and the State–Trait Anxiety Inventory. Multiple stepwise regression analysis was performed to investigate the defense mechanisms associated with North Korean refugees’ life satisfaction in South Korea. Results Among defense mechanisms, denial most strongly predicted higher overall and economic satisfaction among North Korean refugees living in South Korea (β = 0.145, p < 0.01; β = 0.137, p = 0.03, respectively) after controlling for age, gender, anxiety, depression, and number of traumatic events experienced. Furthermore, resignation predicted lower overall (β = –0.206, p < 0.001) and economic satisfaction (β = –0.134, p = 0.02). However, the association between resignation and life satisfaction was not significant after controlling for depression, anxiety, and number of traumatic events experienced. Conclusions Specific defense mechanisms such as high denial and low resignation were associated with life satisfaction in South Korea among North Korean refugees. Our findings suggest that refugees’ psychological defense mechanisms may affect their satisfactory resettlement.
HIV/AIDS-care and Support Competence of Secondary Schools in Western Uganda: A Qualitative Inquiry With School Stakeholders
Authors: Kimera Emmanuel , Vindevogel Sofie , Reynaert Didier , Engelen Anne-Mie , Justice Kintu Mugenyi , Rubaihayo John , Maeyer Jessica De , Bilsen Johan 
Published: July 2020

Abstract
Background

Although schools have been identified as significant settings in the response to the HIV/AIDS pandemic, limited research is available on how they can accommodate Youth Living with HIV/AIDS (YLWHA) especially in resource limited countries. In this study we explored how school stakeholders in western Uganda perceived of good practices to include and support YLWHA in their schools. We conceptualized an HIV/AIDS-care and support competent school community.
Methods

This qualitative inquiry involved school stakeholders (parents/caretakers, school staff and students) purposively selected from 3 secondary schools in western Uganda. A total of 88 participants were involved in focus group discussions and individual interviews. Data analysis followed an inductive and deductive thematic strategy.
Results

We identified 7 overarching interrelated themes in which participants reported practices to include and support YLWHA: counselling and guidance; social support networks and linkages; knowledge and skills; anti-stigma and anti-discrimination measures; disclosure of HIV status; treatment and management of HIV/AIDS; and affirmative actions for YLWHA. Stakeholders’ perceptions of good practices often differed regarding what was considered appropriate, the approach and who to take lead in supporting YLWHA.
Conclusion

Despite the meager support for YLWHA currently available in schools, our study points to optimism and high potential. We posit that building competent HIV/AIDS-care and support school communities is a gradual process requiring each school to develop a strong knowledge base about HIV/AIDS and support needs of YLWHA, develop a coherent and school-wide approach, and collaborate extensively with external stakeholders who are significant in supporting YLWHA.
The Pattern of Liver Dysfunction in Patients with COVID-19: A Retrospective Study
Authors: wang Chunyan , Rong Yihui , Wei Lei , Zheng Huanwei , Xu Jing , Niu Xiaoxia , Ji Dong 
Published: July 2020

Abstract
Background. Information about liver dysfunction in patients with COVID-19 is scarce. We aimed to explored the pattern and risk factors of liver dysfunction in patients with COVID-19.Methods. In this retrospective study, we included all consecutive confirmed patients with COVID-19 in Fuyang Second People’s Hospital between January 20 and February 25, 2020 and collected clinical characteristics until discharge. The pattern and risk factors of liver dysfunction, viral shedding and outcome were analyzed.Results. Totally, 146 patients were analyzed. The median age was 44.9 years and 54.1% were men, 43.8% patients presented liver dysfunction (22.6% on admission, 21.2% during hospitalization). The percentage of elevated ALT (15.1% on admission and 24.7% during hospitalization) were significantly higher than ALP (2.1% on admission and 3.4% during hospitalization) (P < 0.001). Four clinical types were identified, type 1 (persistent normal liver function, 56.2%), type 2 (normal liver function on admission developed to liver dysfunction during hospitalization, 21.2%), type 3 (liver dysfunction on admission restored to normal on discharge, 13.0%) and type 4 (persistent liver dysfunction, 9.6%). The median duration of viral shedding was 12.0 (type 1), 15.0 (type 2), 14.0 (type 3) and 18.0 (type 4) days (P < 0.001). Prolonged viral shedding and severity were potential risk factors associated with liver dysfunction. Conclusions. The incidence of liver dysfunction in patients with COVID-19 is common but not severe, which mainly due to SARS-CoV-2-mediated immune injury on hepatocyte rather than cholangiocyte, DILI and underlying chronic liver disease should not be neglect.
Evaluation of Variances in VEGF-A-D and VEGFR-1-3 Expression in the Ishikawa Endometrial Cancer Cell Line Treated with Salinomycin and Anti-Angiogenic/Lymphangiogenic Effect
Authors: Kras Piotr , Talkowski Karol , Grabarek Beniamin O. , Skalska-Dziobek Nina , Boroń Dariusz , Oplawski Marcin 
Published: July 2020

Background:
In cancer, an excessive and uncontrolled process of creating new blood and
lymphatic vessels that play a key role in the metastasis process can be observed. The Vascular Endothelial
Growth Factor (VEGF-A,-B,-C,-D) family together with their specific receptors (VEGFR-1,-2,-
3) plays a key role in these processes, therefore, it would be reasonable to determine the correct pattern
of their expression.

Objective:
The study aimed to assess the use of salinomycin as an anti-angiogenic and anti-lymphangiogenic
drug during endometrial cancer by examining changes in the expression pattern of VEGF-A,
VEGF-B, VEGF-C, VEGF-D, VEGFR-1, VEGFR-2 and VEGFR-3 depending on the treatment period of
the Ishikawa endometrial cancer cells with salinomycin in comparison to the control culture.

Materials and Methods:
To determine how influential salinomycin was on the expression of both
mRNAs, 1 μM of the drug was added to the cell culture and then it was cultured all together for 12, 24
and 48 hour periods. The cells that made up the control culture were not treated with salinomycin. To
determine the changes in the expression profile of the selected genes, we used the microarray, techniques:
RTqPCR and ELISA (p<0.05).

Results:
For all isoforms of VEGF-A-D as well as receptors of VEGFR-1-3, a decrease in expression
under the influence of salinomycin was noted. For VEGF-A and VEGFR-1, the difference in the expression
between the culture treated with salinomycin in comparison to the control was statistically
significant (p=0.0004). In turn, for VEGF-B, the difference between the culture exposed for 24 hours in
comparison to the control (p=0.00000) as well as the comparison between H48 vs. C (p=0.00000) was
statistically significant. In reference to VEGF-C, VEGFR-2 and VEGFR-3, the statistical analysis
showed the significant difference in expression between the culture incubated with the drug for 12, 24
and 48 hours in comparison to the control as well as between the selected times. For all of these comparisons,
p=0.00000 was utilized.

Conclusions:
Salinomycin changes the expression pattern of VEGF-A, VEGF-B, VEGF-C, VEGF-D,
VEGFR-1, VEGFR-2, and VEGFR-3 in endometrial cancer cells. The obtained results suggest that salinomycin
might exert the effect via VEGF signaling pathways.
Activation of Caspase-3 by Terpenoids and Flavonoids in Different Types of Cancer Cells
Authors: Masood Nusrat , Dubey Vijaya , Luqman Suaib 
Published: July 2020

Background:
Caspase-3 is accountable for the execution of apoptosis. Recently, it has gained
attention as a promising target for the discovery of natural products as anticancer agents.

Methods:
We examined the efficacy of two different sets of natural products (terpenoids and flavonoids)
towards caspase-3 activity adopting in silico, cell-free and cell-based activity and real-time gene expression
analysis.

Results:
It was observed that terpenes activate caspase-3 activity in both the cell-free and cell-based systems,
which was supported by the gene expression analysis, binding energy and activation constant. Flavonoids’
action, however, was limited to the cell-based system and transcriptional regulation suggesting
their indirect association, which enhanced the enzyme activity and up-regulated the expression of
mRNA levels in the cells. Among the tested natural products, (+) carvone was observed to be the best
activator of caspase-3 in K562 (34.4 μM), WRL-68 (22.3 μM), HeLa (18.7 μM), MCF-7 (39.4 μM) and
MDA-MB-231 cell lines (45.1 μM).

Conclusion:
Overall, terpenoids have a persistent activation of caspase-3 in all the investigated systems,
while flavonoids circuitously affect the enzyme activity.
Isothymusin, a Potential Inhibitor of Cancer Cell Proliferation: An In Silico and In Vitro Investigation
Authors: Singh Shilpi , Kumari Priyanka , Hussain Yusuf , Luqman Suaib , Meena Abha , Kanaojia Deepika 
Published: July 2020

Background:Since centuries plant-based compounds are known for the treatment of cancer in both traditional and contemporary medicine. The problems like target non-specificity and toxicity are well-known regarding anticancer drugs. Therefore, target specific search of novel entities is constant. Isothymusin is a dimethoxy, trihydroxy flavone present in plants like Ocimum sanctum, and Limnophilla geoffrayi. There are limited reports available on the anticancer potential of isothymusin.Objectives:The effects of isothymusin on redox status, cell cytotoxicity, and targets involved in the promotion and progression of the cancer cells have been investigated.Methods:Antiproliferative efficacy was evaluated by MTT, Neutral Red Uptake, and Sulforhodamine-B assays. The spectrophotometric methods were adopted to study the effect against selected targets. Redox activity was assessed by in vitro antioxidant assays and the interaction study, ADMET profiling, and toxicity assessments were done in silico.Results:Isothymusin scavenges the radicals, i.e., DPPH and nitric oxide with moderate ferric reducing potential. It affected the proliferation of leukemia, colon, skin, and breast cancer cell lines by more than 50% but moderately affected prostate, kidney, lung, hepatic, and breast adenocarcinoma (up to 48%). Isothymusin inhibited the enzymes associated with the promotion stage of cancer, including cycloxygenase- 2 and lipoxygenase-5. Additionally, it also inhibited the activity of proliferation markers like cathepsin- D, dihydrofolate reductase, hyaluronidase, and ornithine-decarboxylase. Besides, in silico studies supported the in vitro enzyme inhibition assays outcome. Toxicity studies showed promising results of chemical descriptors and non-skin-irritant, moderate ocular-irritancy, and in vitro Ames test confirmed non-mutagenic nature.Conclusion:Isothymusin showed radical scavenging and anti-proliferative activities, which may be taken up as a phytochemical lead for the synthesis of analogues possessing enhanced anticancer potential.
Delineating Characteristic Sequence and Structural Features of Precursor and Mature Piwi-interacting RNAs of Epithelial Ovarian Cancer
Authors: Singh Garima , Swain Arpit Chandan , Mallick Bibekanand 
Published: July 2020

Background:
Piwi-interacting RNAs (piRNAs) are an amazing class of small noncoding
RNAs (sncRNAs) known for its promising role in germline and somatic cells. Myriad
functional studies have been performed to unveil the true potential of this class of ncRNAs;
however, global features encoded in their sequence and structure have not been explored.

Objectives:
We aim to identify the sequence and structural level characteristic features of piRNAs of normal ovary (NO),
and two subtypes of epithelial ovarian cancer (EOCa)- endometrioid (ENOCa), and serous ovarian cancer (SOCa) that we
had reported earlier and their precursors.

Methods:
We have performed sequence analysis of mature piRNAs and their upstream/downstream regions as well as
structural analysis of precursor piRNAs (pre-piRNAs) by examining their minimal folding energy (MFE), adjusted
minimal folding energy (AMFE) and minimal folding energy index (MFEI) etc using in silico approaches.

Results:
We observed enrichment of U at first position and G at several other positions of mature
piRNAs, which might be associated with the processing of mature piRNAs similar to what is seen
in the case of miRNAs and strong target binding, respectively. In addition, we found the richness
of AU in and around 20 nts upstream and downstream of precursor piRNAs (pre-piRNAs). This
characteristic feature of pre-piRNAs possibly contributes to lower MFE compared to random
sequences and make its secondary structure less stable which decides biogenesis of piRNAs. We
also noticed that MFE, AMFE and MFEI of pre-piRNAs are comparatively less than pre-miRNAs
of metazoans, plants and viruses reported in other studies, which clearly discriminate pre-piRNAs
from other RNA sequences including pre-miRNAs of other organisms.

Conclusion:
In summary, the present study reveals key characteristic features encoded within and around mature piRNAs
as well as pre-piRNAs of NO and EOCa samples that distinguish piRNAs from miRNAs and other random RNA
sequences. These findings might act as a cornerstone for better understanding of biogenesis and function of piRNAs as
well as will aid in easier identification of new piRNAs from unknown stretch of sequences using the characteristic
features.
Comparison of the Detection of Toxocara Spp. in the Soils of Public Parks of Ahvaz (Southwest of Iran) by PCR and Loop-Mediated Isothermal Amplification (LAMP)
Authors: Kazemi Forough , Arjmand Reza , Fallahizadeh Somayeh , Tavalla Mehdi 
Published: July 2020

Introduction:The infections caused by Toxocara spp. are considered as one of the most important zoonotic diseases in the world, especially in developing countries. Human toxocariasis, particularly in children, is acquired by playing in public parks. Hence, the aim of the current study was to detect Toxocara spp. in the soils of public parks of the city of Ahvaz, southwest of Iran, using the PCR and loop-mediated isothermal amplification (LAMP) methods.Methods:In this descriptive cross-sectional study, 260 soil samples were randomly collected from the different public parks of the city of Ahvaz. After performing zinc sulfate (ZnSO4) flotation technique, the DNA samples were extracted from the isolated Toxocara spp. eggs. Lastly, the extracted DNA was used for PCR and LAMP-based molecular detection.Results:Out of 260 specimens, 57 (21.9%) samples were found positive for Toxocara spp., using the PCR method, out of that 38 (14.6%) samples were positive for T. canis and 19 (7.3%) samples were positive for T. cati. Also, out of 260 specimens, 81 (31.1%) cases were positive for Toxocara species, using the LAMP method, among them 51 (19.6%) samples were found positive for T. canis and 30 (11.5%) samples were positive for T. cati. Kappa (κ) coefficient between PCR and LAMP showed a strong agreement (0.766, P-value=0.002).Conclusion:The obtained data showed a relatively high outbreak of Toxocara spp. in the public parks’ soils of the city, using the PCR and LAMP methods. Since the parasite can cause human toxocariasis, particularly in children; thus, the health authorities of the city of Ahvaz and other similar cities, especially in developing countries, must pay more attention to the hygiene of the public parks’ soils.
An Iterative Process for Identifying Pediatric Patients With Type 1 Diabetes: Retrospective Observational Study
Authors: Morris Heather Lynne , Donahoo William Troy , Bruggeman Brittany , Zimmerman Chelsea , Hiers Paul , Zhong Victor W , Schatz Desmond 
Published: July 2020

Background
The incidence of both type 1 diabetes (T1DM) and type 2 diabetes (T2DM) in children and youth is increasing. However, the current approach for identifying pediatric diabetes and separating by type is costly, because it requires substantial manual efforts.

Objective
The purpose of this study was to develop a computable phenotype for accurately and efficiently identifying diabetes and separating T1DM from T2DM in pediatric patients.

Methods
This retrospective study utilized a data set from the University of Florida Health Integrated Data Repository to identify 300 patients aged 18 or younger with T1DM, T2DM, or that were healthy based on a developed computable phenotype. Three endocrinology residents/fellows manually reviewed medical records of all probable cases to validate diabetes status and type. This refined computable phenotype was then used to identify all cases of T1DM and T2DM in the OneFlorida Clinical Research Consortium.

Results
A total of 295 electronic health records were manually reviewed; of these, 128 cases were found to have T1DM, 35 T2DM, and 132 no diagnosis. The positive predictive value was 94.7%, the sensitivity was 96.9%, specificity was 95.8%, and the negative predictive value was 97.6%. Overall, the computable phenotype was found to be an accurate and sensitive method to pinpoint pediatric patients with T1DM.

Conclusions
We developed a computable phenotype for identifying T1DM correctly and efficiently. The computable phenotype that was developed will enable researchers to identify a population accurately and cost-effectively. As such, this will vastly improve the ease of identifying patients for future intervention studies.
Partial Characterization of Chitosanase from Bacillus cereus Strain BFE5400 Isolated from Snakehead Fish Intestine
Authors: Lestari Shanti Dwita , Baehaki Ace , Guttifera Guttifera 
Published: July 2020

Feeding pattern of wild snakehead fish (Channa striata) which includes shrimp and small crustaceans makes it is intestine a good source of chitinase and chitosanase enzymes. This study aimed to isolate chitosanase producing bacteria from snakehead fish intestine, to select isolate with highest chitosanolytic activity, to produce chitosanase using the selected isolate and partially characterize the resulting enzyme. I2 isolate exhibited the highest chitosanolytic index with the value of 1.5 and produced enzyme with an activity of 0.00331 U/mL after 72 hours incubation. The ultimate bacterial density was at the 24th hour with a turbidity value of 0.5315. The enzyme activity was optimum at pH 6, with a value of 0.00816 U/mL, while the optimum temperature was 70°C with the enzyme activity of 0.00785 U/mL. Genetic identification of I2 isolate using 16S rRNA showed that the isolate has a high similarity to Bacillus cereus strain BFE 5400.