bluuebunny/crossref_metadata_2025_split huggingface dataset:
Burn-out and mental health of minority medical students in Hungarian medical education.
Authors: Szél Zsuzsanna , Győrffy Zsuzsa 
Published: May 2020

Abstract
Background Previous researches suggested that minority students are more exposed to discrimination and mistreatment at university, therefore may have higher risk of mental and physical health problems. Methods An online questionnaire was conducted among medical students of the 4 Hungarian medical universities (N=530). The survey contained questions about general demographic data, health behavior, burnout, mental and physical health issues and discrimination. Results 29.6% of students self-identified as minority. High level burnout was indicated by 48.1% of respondents, while another 27.0% showed moderate level. High level burn-out was associated with minority status (84.6% vs. 71.0%; p<0.001), discrimination (83.0% vs. 68.5%, p< 0.001), lower level of social support (89.0% vs 69.0%, p<0.001) and higher levels of perceived stress (57.1% vs. 95.4%) in the chi-squared test. Higher scores on trait (B = 0.123; p<0.001) and state anxiety (B = 0.082; p<0.001) subscales of STAI and lower score of resilience (B= -0.168; p<0.001) were significantly associated with higher level of burnout in the univariate model. In our final analysis, perceived stress, resilience, minority identity and experienced discrimination remained significant. Conclusions Belonging to a minority community might need to be considered an essential factor leading to burnout in Hungarian medical students. Our research suggests that minority medical students have poorer mental health and higher risk for burnout.
The net present value of human lives lost due to coronavirus disease (COVID-19) in the Islamic Republic of Iran
Authors: Kirigia Joses M. , Muthuri Rose Nabi Deborah Karimi , Muthuri Newton Gitonga 
Published: May 2020

Abstract
Objective As of 11 April 2020, there were 68,192 confirmed cases, including 4,232 deaths. This study aimed to estimate the net present value of human lives lost due to COVID-19 in Iran as of 11 April 2020.Results The 4,232 human lives lost had a total net present value of Int$ 436,275,007. The average net present value per human life was Int$103,090. Re-estimation of the economic model with 5% and 10% discount rates resulted in a reduction in the expected total net present value by Int$ 64,881,144 (14.9%) and Int$ 168,066,782 (38.5%), respectively. Additional re-calculation of the economic model using the highest life expectancy in the world (i.e., that of the Japanese Females) increased the total net present value of human lives lost by 114%.
Test–retest reliability and convergent validity of the Test of Nonverbal Intelligence-Fourth Edition in patients with schizophrenia.
Authors: Chen Kuan-Wei , Lee Ya-Chen , Yu Tzu-Ying , Cheng Li-Jung , Chao Chien-Yu , Hsieh Ching-Lin 
Published: May 2020

Abstract
Background Fluid intelligence deficits affect executive functioning and social behaviors in patients with schizophrenia. To help clinicians manage fluid intelligence deficits, a psychometric sound measure is needed. The purposes of this study were to examine the test–retest reliability and convergent validity of the Test of Nonverbal Intelligence-Fourth Edition (TONI-4) assessing fluid intelligence in patients with schizophrenia.Methods A total of 103 patients with stable condition were assessed with the TONI-4 twice with a 4-week interval to examine the test–retest reliability. We further used the Montreal Cognitive Assessment (MoCA) and the Tablet-Based Symbol Digit Modalities Test (T-SDMT) to examine the convergent validity of the TONI-4.Results The intra-class correlation coefficient was 0.73 for the TONI-4. The percentages of standard error of measurement and minimal detectable change for the TONI-4 were 5.1% and 14.2%, respectively. The practice effect of the TONI-4 was small (Cohen’s d = -0.03). Convergent validity showed small to moderate significant correlations between the TONI-4 and the MoCA as well as the T-SDMT (r = 0.35, p = .011 with the T-SDMT and r = 0.61, p < .001 with the MoCA). The results demonstrated that the TONI-4 had good test–retest reliability, limited random measurement error, and a trivial practice effect. The convergent validity of the TONI-4 was good.Conclusions These findings indicate that the TONI-4 has potential to be a reliable and valid assessment of fluid intelligence in patient with schizophrenia.
Subtype classification and prognosis of diffuse large B-cell lymphoma based on variable importance analysis
Authors: Gao Qian , Zhang Huifang , Que Ximei , Xi Yanfeng , Wang Tong 
Published: May 2020

Abstract
Background Gene expression profiling (GEP) is considered as gold standard for cell-of-origin classification of diffuse large B-cell lymphoma (DLBCL). The high dimensionality of GEP limits its application in clinical practice. Penalized regression was commonly used to determine the optimal gene subset for classification in high dimensional gene data. However, the results of penalized regression methods were affected by the tuning parameters.Results To solve the instability of penalized regression methods, we proposed a strategy to measure the importance of variables with an aggregated index. This strategy was applied to six penalized methods to identify a small gene subset for DLBCL classification. Using a training dataset of 350 DLBCL patients, we identified six genes (MYBL1, TNFRSF13B, MAML3, CYB5R2, BATF, and S1PR2) as the optimal gene subset for DLBCL classification. The AUC was 0.9986 (95%CI 0.9967–1) and discrimination slope (DS) was 0.9442 (95%CI 0.9203–0.9661) in the training dataset. The discriminative performances were further validated in the external dataset with an AUC of 0.9455 (95%CI 0.9298–0.9612) and DS of 0.6211 (95%CI 0.5824–0.6591). Additionally, the calibration and clinical usefulness were apt in both datasets. Subgroups of patients characterized by these six genes showed significantly different prognosis. Furthermore, model comparisons demonstrated that the six-gene model outperformed models constructed by typical penalized regression methods.Conclusions The six genes had considerable clinical usefulness in DLBCL classification and prognosis. Penalized variable importance analysis is an efficient strategy to identify an optimal gene subset with good predictive performance.
Early warning signs for severe patients with Coronavirus Disease 2019 and its epidemical significance
Authors: Ji Hong , Dai Qigang , Jin Hui , Xu Ke , Ai Jing , Fang Xinyu , Shi Naiyang , Huang Haodi , Wu Ying , Peng Zhihang , Hu Jianli , Zhu Liguo , Wu Ming , Bao Changjun 
Published: May 2020

Abstract
The authors have requested that this preprint be removed from Research Square.
HIV-1 Vpr activates host CRL4-DCAF1 E3 ligase to degrade histone deacetylase SIRT7
Authors: Zhou Xiaohong , Monnie Christina , Delucia maria , ahn jinwoo 
Published: May 2020

Abstract
Background: Vpr is a virion-associated protein that is encoded by lentiviruses and serves to counteract intrinsic immunity factors that restrict infection. HIV-1 Vpr mediates proteasome-dependent degradation of several DNA repair/modification proteins. Mechanistically, Vpr directly recruits cellular targets onto DCAF1, a substrate receptor of Cullin 4 RING E3 ubiquitin ligase (CRL4) for poly-ubiquitination. Further, Vpr can mediate poly-ubiquitination of DCAF1-interacting proteins by the CRL4. Because Vpr-mediated degradation of its known targets can not explain the primary cell-cycle arrest phenotype that Vpr expression induces, we surveyed the literature for DNA-repair-associated proteins that interact with the CRL4-DCAF1. One such protein is SIRT7, a deacetylase of histone 3 that belongs to the Sirtuin family and regulates a wide range of cellular processes. We wondered whether Vpr can mediate degradation of SIRT7 via the CRL4-DCAF1. Methods: HEK293T cells were transfected with cocktails of plasmids expressing DCAF1, DDB1, SIRT7 and Vpr. Ectopic and endogeneous levels of SIRT7 were monitered by immunoblotting and protein-protein interactions were assessed by immunoprecipitation. For in vitro reconstitution assays, recombinant CRL4-DCAF1-Vpr complexes and SIRT7 were prepared and poly-ubiqutination of SIRT7 was monitored with immunoblotting. Results: We demonstrate SIRT7 polyubiquitination and degradation upon Vpr expression. Specifically, SIRT7 is shown to interact with the CRL4-DCAF1 complex, and expression of Vpr in HEK293T cells results in SIRT7 degradation, which is partially rescued by CRL inhibitor MNL4924 and proteasome inhibitor MG132. Further, in vitro reconstitution assays show that Vpr induces poly-ubiquitination of SIRT7 by the CRL4-DCAF1. Importantly, we find that Vpr from several different HIV-1 strains, but not HIV-2 strains, mediates SIRT7 poly-ubiquitination in the reconstitution assay and degradation in cells. Finally, we show that SIRT7 degradation by Vpr is independent of the known, distinctive phenotype of Vpr-induced cell cycle arrest at the G2 phase, Conclusions: Targeting histone deacetylase SIRT7 for degradation is a conserved feature of HIV-1 Vpr. Altogether , our findings reveal that HIV-1 Vpr mediates down-regulation of SIRT7 by a mechanism that does not involve novel target recruitment to the CRL4-DCAF1 but instead involves regulation of the E3 ligase activity.
Protective CD8+ T-cell response against Hantaan virus infection induced by immunization with designed linear multi-epitope peptides in HLA-A2.1/Kb transgenic mice
Authors: Ma Ying , Tang Kang , Zhang Yusi , Zhang Chunmei , Cheng Linfeng , Zhang Fanglin , Zhuang Ran , Jin Boquan , Zhang Yun 
Published: May 2020

Abstract
Background An effective vaccine that prevents disease caused by hantaviruses is a global public health priority, but up to now, no vaccine has been approved for worldwide use. Therefore, novel vaccines with high prophylaxis efficacy are urgently needed.Methods Herein, we designed and synthesized Hantaan virus (HTNV) linear multi-epitope peptide consisting of HLA-A*02-restricted HTNV cytotoxic T cell (CTL) epitope and pan HLA-DR-binding epitope (PADRE), and evaluated the immunogenicity, as well as effectiveness, of multi-epitope peptides in HLA-A2.1/Kb transgenic mice with interferon (IFN)-γ enzyme-linked immunospot assay, cytotoxic mediator detection, proliferation assay and HTNV-challenge test.Results The results showed that a much higher frequency of specific IFN-γ-secreting CTLs, high levels of granzyme B production, and a strong proliferation capacity of specific CTLs were observed in splenocytes of mice immunized with multi-epitope peptide than in those of a single CTL epitope. Moreover, pre-immunization of multi-epitope peptide could reduce the levels of HTNV RNA loads in the liver, spleen and kidneys of mice, indicating that specific CTL responses induced by multi-epitope peptide could inhibit HTNV replication in vivo.Conclusions This study may provide an important foundation for the development of novel peptide vaccines for HTNV prophylaxis.
Selection and implementation of SNP markers for parentage analysis in a Chinese crossbred cattle population
Authors: Hu Lirong , Li Dong , Chu Qin , Wang Yachun , Zhou Lei , Yu Ying , Zhang Yuan , Zhang Shengli , Usman Tahir , Xie Zhenquan , Hou Shiyu , Liu Lin , Shi Wanhai 
Published: May 2020

Abstract
Background: In China, the widespread crossbreeding between Simmental and Holstein is a universal way so as to better improve the comprehensive benefits, as well as decline the inbreeding coefficient. However, the wrong parentage appeared frequently in this population than others due to not only the reasons in pure breeds, but more importantly, the lack of enough attention, which caused the lower accuracy of genetic parameter estimation and genetic evaluation in breeding systems. Single nucleotide polymorphism (SNP) panel in a certain population as a powerful tool for parentage assignment has been reported in numerous studies, especially in cattle. Therefore, the aim of this study was to build an SNP panel with sufficient power for parentage testing in the crossbred population of Simmental and Holstein in China. Results: In the present study, combining direct sequencing method in polymerase chain reaction (PCR) products of deoxyribonucleic acid (DNA) pooling and matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) genotyping method in individuals, a panel comprising 50 highly informative single nucleotide polymorphisms (SNPs) for parentage analysis was developed in a crossbred Chinese cattle population. The average minor allele frequency (MAF) was 0.43 and the cumulative exclusion probability for single-parent and both-parent inference met 0.99797 and 0.999999, respectively. The maker-set was then used for parentage verification in a group of 81 trios with the likelihood-based parentage-assignment program of Cervus software. Compared with on-farm records, the results showed that this 50-SNP system could provide sufficient and reliable information for parentage testing with the parental mistakes for mother-offspring and sire-offspring being 8.6% and 18.5%, respectively.Conclusion: Knowledge of these results, we provided one set of low-cost and efficient SNPs for running paternity testing in the crossbred cattle population of Simmental and Holstein in China. Keywords: Parentage analysis, Single nucleotide polymorphism (SNP), Chinese crossbred cattle
Role of Circulating Tumor DNA in Evaluating Clinical Tumor Burden and Predicting Survival in Chinese Metastatic Colorectal Cancer Patients
Authors: xu xiaojing , yu yiyi , shen minna , liu menglin , wu shengchao , liang li , huang fei , zhang chenlu , guo wei , liu tianshu 
Published: May 2020

Abstract
Background:The aim of this study was to further explore the utility of ctDNA in the evaluation of clinical tumor burden and survival in Chinese metastatic CRC (mCRC) patients and to preliminarily summarize some metastatic characteristics associated with mutations in ctDNA. Patients and Methods:A four-gene mutation testing panel covering a total 197 mutation hotspots of KRAS, NRAS, BRAF and PIK3CA was used to evaluate the gene mutation status via next-generation sequencing of plasma from patients with mCRC. Clinical markers including CEA, CA199, CA125,NSE and LDH in serum and the sum of all tumor diameters on CT or PET/CT were collected to indicate clinical tumor burden. The correlations between cfDNA levels and clinical tumor burden were analyzed using Pearson correlation and linear regression models. The median PFS and 1-year OS rates were calculated by Kaplan–Meier (K–M) survival analysis. Results：The study enrolled 126 mCRC patients for ctDNA testing. Wild-type patients accounted for 54.8% (69/126) of the total patients, and mutant-type patients accounted for 45.2% (57/126) of the total patients. Mutations in KRAS, NRAS, BRAF and PIK3CA were detected in 37.3% (47/126), 1.6% (2/126), 3.2% (4/126) and 13.5% (17/126) of patients, respectively. The overall concordance rate of gene status between ctDNA and matched tissues was 78.6% (99/126). The concentration of cfDNA was significantly correlated with the levels of clinical markers, especially CEA (P<0.0001, Pearson r = 0.81), LDH (P<0.0001, Pearson r = 0.84) and the sum of tumor diameters (P<0.0001, Pearson r = 0.80). The median PFS (11.7 versus 6.6 months, P<0.0001) and 1-year OS rates (94% versus 56%, P<0.0001) were significantly different between patients with a low cfDNA concentration (≤17.91 ng/ml) and those with a high cfDNA concentration (>17.91 ng/ml). The most common metastatic site was liver (77.8%), followed by lymph nodes (62.7%), lung (40.5%), peritoneum (14.3%) and bone (10.3%), in all patients. There was no significant difference in metastasis regardless of gene status. Conclusion:These results suggested that the level of cfDNA could be a quantitative biomarker of tumor burden and could predict survival in Chinese patients with mCRC. Patients with gene mutations had a similar metastatic pattern to those with wild-type genes.
The application of the joint stimulus control model in teaching complex receptive language to children with autism spectrum disorder
Authors: Raudeliūnaitė Rita , Steponėnienė Eglė 
Published: May 2020

Lithuanian educators are still not adequately well prepared to teach children with autism spectrum disorder (further in text ASD). There is a lack of research, the access to evidence-based methods is limited, and traditional educational methodological approaches are usually ineffective (Diržytė, Mikulėnaitė, & Kalvaitis, 2016; Buivydaitė, Newman, & Prasauskienė, 2017).One of the earliest signs of ASD is failure to develop language and social communication (Mody & Belliveau, 2013; Arunachalam & Luyster 2016; etc.). Meta-analyses conducted by foreign researchers show that B.F. Skinner’s (1957) verbal behaviour analysis is one of the evidence-based effective methods used for developing language in children with ASD (McPherson et al., 1984; Dymond et al. 2006; Sautter & LeBlanc, 2006; Devine & Petursdottir, 2017). A rapid increase in the prevalence of ASD brings the researchers’ attention to the possibilities of applying this method, however, there are still some areas in verbal behaviour approach remaining, which lack research. Scientific studies in these areas would likely open effective ways for developing language in children with ASD (Devine & Petursdottir, 2017). The researchers (Buivydaitė, Newman, & Prasauskienė, 2017) have conducted a review of scientific articles on ASD in the Baltic states (including Lithuania), and the findings of it confirm the lack of such research.In this study, a single-subject educational experiment was used, during which a joint stimulus control model was applied for developing language in children with ASD, with the main focus being on receptive language acquisition. The object of joint stimulus control is the development of a symmetrical (bi-directional) word-object relation and independent, verbally maintained generalisation with unlearned stimuli. The results of the experiment show that a joint stimulus control model can be applied as an effective mechanism to develop language in children with ASD. In the presence of non-verbal stimuli and rehearsing the names of the stimuli overtly or covertly, the joint stimulus control emerges and, in this way, the complex receptive language perception in children with ASD is developed within the context of social interaction. The participants of this experiment were able to emit correct responses with the novel sets of stimuli and were able to apply this mechanism without prompts not only in teaching sessions, but also in other social situations.
Critical Review: “Discipline survival guide for the secondary teacher”
Authors: St-Amand Jerome 
Published: May 2020

<p>Critical review of Thompson, J. (2012). <em>La gestion de classe au secondaire: Guide pratique </em>[<em>Discipline survival guide for the secondary teacher</em>].<em> </em>Montréal: éditions Chenelière.</p><p> </p>
ATENDIMENTO EM SAÚDE SUPLEMENTAR: PROPOSIÇÃO E VALIDAÇÃO DE UM MODELO ESTRUTURAL PARA AVALIAÇÃO, COM BASE NA ACOLHIDA E CHEGADA DO PACIENTE
Authors: SOARES FILHO AFRANIO DE AMORIM FRANCISCO , Breval Santiago Sandro 
Published: May 2020

Este artigo apresenta o desenvolvimento e validação de escala e modelo explicativo, por meio de modelagem em equações estruturais, para avaliar o ATENDIMENTO a pacientes de um plano de saúde em suas próprias instalações. Foi um estudo de caso único e holístico, quantitativo, com dados obtidos junto aos pacientes atendidos em um período de 90 dias nas clínicas médicas, hospital, maternidade, pronto-socorro ou laboratório de exames clínicos. Ocorreu de modo transversal, sendo os dados coletados uma vez ao ano entre 2015 e 2018. Os levantamentos foram por meio de survey, com rigorosos critérios para qualificação dos dados, escala e índices de mensuração e ajuste do modelo. A amostra foi dividida em duas subamostras, sendo uma para a fase exploratória e a outra para a etapa confirmatória. O modelo estrutural, resultante destes dois procedimentos, culminou com três construtos, que pela natureza de seus componentes foram nomeados como CHEGADA, ACOLHIDA e ATENDIMENTO. Os índices, apurados por meio de modelagem em equações estruturais, mostraram bom ajuste e forte correlação entre os construtos. O GFI no modelo estrutural foi 0,946 e outros testes, como o AIC, indicaram melhores índices no modelo estrutural do que no de mensuração. As conclusões permitiram vislumbrar, de modo prático, que quanto mais favorável for a impressão do paciente em sua CHEGADA, mais propenso ele estará para bem avaliar o ACOLHIMENTO. Confirmando-se a boa avaliação do acolhimento, aumentam as possibilidades de o ATENDIMENTO vir a ser bem avaliado.
A IMPORTÂNCIA DA GESTÃO POR RESULTADOS NA MELHORIA DE DESEMPENHO INSTITUCIONAL: UM ESTUDO SOBRE O HOSPITAL DAS CLÍNICAS DA UFMG
Authors: Kellen Rodrigues de Oliveira Nyhara , De Carvalho Bandeira Mendes André 
Published: May 2020

O estudo tem por objetivo descrever e avaliar o aprimoramento de metodologia de gestão por resultados no Hospital das Clínicas (HC) da Universidade Federal de Minas Gerais (UFMG) apresentando os primeiros resultados, análises e o monitoramento de indicadores como medida de qualidade e de melhoria. Trata-se de relato de experiência com descrição e avaliação dos dados referentes aos indicadores monitorados durante os anos de 2016 e 2017 com base na metodologia de Gestão por Resultados adotada no hospital em 2013. Para tal, foi realizada consultas em documentos do sistema interno da instituição, intranet, sites e Geplanes, além do acompanhamento nas etapas do monitoramento de indicadores junto às unidades do hospital. Como resultado, o hospital obteve uma melhoria nos índices de desempenho de indicadores de 59,04 em 2016 para 75,05 em 2017. O estudo identificou que, a prática de monitoramento promove a consolidação e maturidade da gestão por resultados.
ATRIBUTOS DE PREFERÊNCIA PARA COMPRAS EM DROGARIAS: UM ESTUDO NA PERSPECTIVA DE CLIENTES E PROFISSIONAIS DA ÁREA
Authors: Jeunon Ester Eliane , LARA JOSE , Pires Edna Maria 
Published: May 2020

Fundamento do estudo: O tema da preferência de compras tem demonstrado grande importância, tanto na literatura acadêmica, quanto na executiva.
Objetivo: Analisar os atributos para a preferência de compras em drogarias, na perspectiva de clientes e profissionais da área.
Metodologia: Realizou-se pesquisa descritiva na Região Metropolitana de Belo Horizonte, em 2019. Na qualitativa foram entrevistadas 16 profissionais e na quantitativa fez-se um levantamento com 468 compradores.
Resultados: Os resultados identificaram a hierarquia de importância dos atributos, sendo o principal, o Preço. Mostraram ainda como as variáveis: gênero, idade, renda, ocupação e residência em zona urbana ou rural influenciam os clientes. As mulheres relevaram o Atendimento, Televendas e Entrega domiciliar, Variedade de Produtos de higiene e beleza e Proximidade de casa. Os participantes de baixa renda avaliaram quase todos os atributos como abaixo da média, inclusive Preço e Atendimento. Consideraram importantes os atributos Formas de pagamento, Televendas e Entrega em domicílio. Os respondentes com alta renda valorizam mais os atributos de conveniência.
Contribuições teóricas/metodológicas: O artigo revisita e contrasta teorias clássicas de atitude e preferências dos consumidores no varejo farmacêutico.
Contribuições organizacionais: Conteúdos relevantes para a tomada de decisões.