bluuebunny/crossref_metadata_2025_split huggingface dataset:
Predicting Hospital Mortality and Length of Stay: The Delirium Screening Checklist versus Confusion Assessment Method for Intensive Care Units
Authors: Li Hsiu Ching , Chen Cheryl Chia-Hui , Yeh Tony Yu-Chang , Liao Shih-Cheng , Hsu Adrian-Shengchun , Wei Yu-Chung , Shun Shiow-Ching , Ku Shih-Chi , Inouye Sharon K 
Published: August 2021

Abstract
Background: Both the intensive care delirium screening checklist (ICDSC) and confusion assessment method for ICU (CAM-ICU) are valid tools for identification of delirium, however their relative predictive validity for important delirium outcomes, such as hospital mortality and LOS have not been well-established. We aim to compare the two tools for their predictive validity for outcomes related to delirium, hospital mortality and length of stay (LOS).Methods: The prospective cohort study conducted in six medical ICUs at a tertiary care hospital in Taiwan. The study enrolled consecutive adult patients (≥20 years) who were delirium free at ICU admission. Delirium was screened daily by trained research nurses using the ICDSC and CAM-ICU in random order. Arousal was assessed by the Richmond Agitation-Sedation Scale (RASS). Participants with any one positive result were classified as ICDSC- or CAM-ICU-delirium groups, respectively.Results: Delirium incidence evaluated by the ICDSC and CAM-ICU were 69.1% (67/97) and 50.5% (49/97), respectively. Although the ICDSC identified 18 more cases as delirious, substantial concordance (κ =0.63; p < 0.001) was found between tools. Independent of age, APACHE II score, and Charlson comorbidity index, both ICDSC- and CAM-ICU-rated delirium significantly predicted hospital mortality (adjusted odds ratio [aOR] 4.93; 95% confidence interval [CI]:1.56 to 15.63 vs. 2.79; 95% CI, 1.12 to 6.97, respectively), and only the ICDSC significantly predicted hospital LOS with a mean of 17.59 additional days compared to the no-delirium group. Irrespective of delirium status, a sensitivity analysis of normal-to-increased arousal (RASS≥0) test results did not alter the predictive ability of ICDSC- or CAM-ICU-delirium for hospital mortality (aOR 2.97; 95% CI, 1.06 to 8.37 vs. 3.82; 95% CI, 1.35 to 10.82, respectively). With reduced arousal (RASS<0), neither tool significantly predicted mortality or LOS.Conclusions: The ICDSC identified more delirium cases and may have higher predictive validity for mortality and LOS than the CAM-ICU. However, arousal substantially affected performance. Future studies may want to consider patients’ arousal when deciding which tool to use to maximize the effects of delirium identification on patient mortality.Trial registration: NCT 04206306
Molecular and microscopic detection of Babesia caballi and Theileria equi among working horses and donkeys in Cairo and Giza provinces of Egypt
Authors: Soliman Ahmed M. , Elhawary Nagwa M. , Helmy Nashwa M. , Gadelhaq Sahar M. 
Published: August 2021

Abstract
Equine piroplasmosis (EP) is an ixodid tick-borne disease caused by Theileria equi and/or Babesia caballi that can lead to severe health issues and economic losses among equine population. This study aimed to determine the prevalence of T. equi and B. caballi among Egyptian equines based on microscopy and conventional PCR. Also, to determine the effect of season, age, and sex of on their prevalence and determining the difference in sensitivity between microscopy and conventional PCR in the diagnosis of EP. This study was carried out on 432 blood samples randomly collected from 146 horses and 286 donkeys during a period from April 2016 to March 2018. Microscopic examination revealed that among horses, 13 (8.9%) and 4 (2.7%) were infected by T. equi and B. caballi respectively. While among donkeys, 22 (7.7%), 16 (5.6%) respectively. While mixed infections were detected in 4 (1.4%) donkeys. There was a statistically nonsignificant relation between prevalence of infection and season and sex of equines but the highest prevalence was recorded in age group less than 5 years old. By conventional PCR, among 64 horses, 15 (23.4%) and 8 (12.5%) were infected by T. equi and B. caballi, respectively. While among 76 donkeys, 36 (47.4%), 16 (21.1%), and 5 (6.6%) were infected by T. equi, B. caballi, and mixed infection, respectively. Our finding proved the existence of T. equi and B. caballi among equines.
Decision-Making Models Based on Satisfaction Degree with Incomplete Hesitant Fuzzy Preference Relation
Authors: Li Jian , Niu Li-li , Chen Qiongxia , Wang Zhong-xing 
Published: August 2021

Abstract
To address the situation where the incomplete hesitant fuzzy preference relation (IHFPR) is necessary, this paper develops decision-making models based on decision makers’ satisfaction degree with IHFPR. First, the consistency measures from the perspectives of additive and multiplicative consistent IHFPR are defined based on the relationships between the IHPFRs and their corresponding priority weight vector, respectively. Second, two decision-making models are developed in view of the proposed additive and multiplicative consistency measures. The main characteristic of the constructed model sarethey taking into account the decision makers’ satisfaction degree. The objective functions of the models are developed by maximizing the parameter of satisfaction degree. Third, a square programming model is developed to obtain the decision makers’ weights byutilizing the optimal priority weight vectors information, the solution of the model is obtained by solving the partial derivatives ofLagrange function.Finally, a procedure for multi-criteria decision-making (MCDM) problems with IHFPRs is given, and an illustrative example in conjunction with comparative analysis is used to demonstrate the proposed models are feasible and efficiency for practical MCDM problems.
Collaboration Challenges of Non-Governmental Organizations in Healthcare system in Iran: a qualitative study
Authors: hooshmand elahe , Pardasi Esmat , Jamali Jamshid , Javan-Noughabi Javad , najar Ali Vafaee 
Published: August 2021

Abstract
Objective

Despite the strong emphasize of government on collaboration and application of non-governmental organizations in healthcare, there can be seen a research gap in this area in developing countries. The present study aims to investigate collaboration challenges of non-governmental organizations in healthcare from the viewpoint of healthcare managers and active managers of non-governmental organizations of Iran as an example of low-middle income country.
Results

The content analysis of qualitative data led to the emergence of five main themes of collaboration challenges of non-governmental organizations in healthcare: political issues, operational issues, cultural issues, management issues, and communication issues. This study presents a clear framework for identification of collaboration challenges of non-governmental organizations in healthcare Especially for developing countries. This framework should be taken into consideration by authorities of Ministry of health in their policy makings.
Extracellular vesicles from Gram-positive and Gram-negative probiotics remediate stress-induced depressive behavior in mice
Authors: Choi Juli , Kwon Hyejin , Kim Yoon-Keun , Han Pyung-Lim 
Published: August 2021

Abstract
Chronic stress causes maladaptive changes in the brain that lead to depressive behavior. In the present study, we investigate whether chronic stress alters gut microbiota and whether specific mediators of probiotics remedies stress-induced maladaptive changes in the brain. Mice treated with daily 2-h restraint for 14 days (CRST) exhibit depressive-like behavior. Sequence readings of 16S rRNA genes prepared from fecal samples taken from CRST-treated mice suggest that chronic stress induces gut microbiota changes that are pronounced 14 days after the last restraint, relative to those that occur in the 14-day stress phase. The genus Lactobacillus is one such microbiota substantially changed following chronic stress. In contrast, post-stress treatment with extracellular vesicles (EVs) derived from the Gram-positive probiotic Lactobacillus plantarum are sufficient to ameliorate stress-induced depressive-like behavior. Interestingly, EVs from the Gram-positive probiotic Bacillus subtilis and EVs from the Gram-negative probiotic Akkermansia muciniphila also produce anti-depressive-like effects. While chronic stress decreases expression of MeCP2, Sirt1, and/or neurotrophic factors in the hippocampus, EVs from the selected probiotics differentially restore stress-induced changes of these factors. These results suggest that chronic stress produces persistent changes in gut microbiota composition, whereas EVs of certain probiotics can be used for treatment of stress-induced maladaptive changes.
Investigation of the effects of six medicinal plants with antiviral effects against COVID-19
Authors: ALP Harun , ASİL Hasan , Duman Demet 
Published: August 2021

Abstract
Today, the coronavirus epidemic, which caused the death of 79 million cases and 1743 thousand people in 218 countries around the world, continues to increase its impact all over the world. Researchers are still trying to develop an effective solution against covid-19, including vaccines and drugs. However, there are few studies that determine the effect of natural products obtained from plants on covid-19. Medicinal and aromatic plants have been used for therapeutic purposes since the existence of humanity. In this study, the effects of some important medicinal plants including Licorice (Glycyrrhiza glabra), Saffron (Crocus sativus L.), Nigella (Nigella sativa L.), Laurel (Lauris nobilis), Karabaş (Lavandula stoechas), and Zahter (Thymbra spicata L. var. Spicata) against Covid-19 were investigated in vitro conditions. The six plants were evaluated for cytotoxic effect on Vero cells and determining inhibition of viral replication in Vero-E6 cells at concentrations of broad-spectrum antiviral non-cytotoxic against Covid-19 in cell culture and an additional antiviral effect against Covid-19. According to the results, the five examined plants (Saffron, Nigella, Laurel, Karabaş, Zahter) were ineffective against Covid-19 in vitro conditions. Interisingly, the water extract obtained from the root of the licorice plant (Glycyrrhiza glabra) inhibited Covid-19 in vitro conditions in the 2nd dilution (1: 4) following the initial concentration in Vero-E6 cells.
Nexus between integrating technology readiness 2.0 index and students’ e-library services adoption amid the COVID-19 challenges: Implications based on the theory of planned behavior
Authors: Rahmat Taufik Edi , Raza Saqlain , Zahid Hasan , Abbas Jaffar , Sobri Fatimah Azzahraa Mohd , Sidiki Shehla Najib 
Published: August 2021

Abstract
Background

The advent of the pandemic COVID-19 has resulted in a global crisis that resulted in the closure of universities and educational institutions worldwide. This study aims to explore the determinants of students’ intention towards e-library services usage amid the challenging time of the COVID-19 pandemic. This paper reviews the technology-oriented individual attitude based on four dimensions of the technology readiness 2.0 index factors, which affect medical students’ perspectives.
Materials and methods

The authors provided a self-administered questionnaire to medical students to investigate their e-library adoption attitude during the COVID-19 crisis. The authors distributed 542 questionnaires, received 361 complete responses and analyzed the data through path modeling/partial least squares structural equations modeling technique (PLS-SEM) with the smart PLS software version 3.3.3. The structural equation-modelling tool permits the estimation of results.
Results

The main finding revealed that medical students have a positive and explicit approach to use the services available at the e-library. Technology use and online services helped students continue their educational needs in the advent of the current pandemic COVID-19. Attitude and subjective norms have significant influence and are strong predictors of intention. However, due to inadequate support for the government side, the perceived behavioural control has an insignificant impact on intention. This paper indicated one of the pioneers investigating the determinants of e-library adoption among medical students based on technology-oriented personality traits, employing the four dimensions of the technology readiness 2.0 index during the challenges of the COVID-19 outbreak.
Conclusion

The study’s findings provide useful insight that offers valuable insights to implement specific strategies from the government officials to address medical students’ uncertainties and increase the technology adoption amid the COVID-19 pandemic in medical education for developing nations.
Meta-analysis of genome-wide association studies for litter size in sheep
Authors: Gholizade Mohsen , Esmaeili-Fard Seyed Mehdi 
Published: August 2021

Abstract
Background
Litter size and ovulation rate are important reproduction traits in sheep and have important impacts on the profitability of farm animals. To investigate the genetic architecture of litter size, we report the first meta-analysis of genome-wide association studies (GWAS) using 522 ewes and 564,377 SNPs from six sheep breeds.
Results
We identified 29 significant associations for litter size which 27 of which have been not reported in GWASs for each population. However, we could confirm the role of BMPR1B in prolificacy. Our gene set analysis discovered biological pathways related to cell signaling, communication, and adhesion. Functional clustering and enrichment using protein databases identified epidermal growth factor-like domain affecting litter size. Through analyzing protein-protein interaction data, we could identify hub genes like CASK, PLCB4, RPTOR, GRIA2, and PLCB1 that were enriched in most of the significant pathways. These genes have a role in cell proliferation, cell adhesion, cell growth and survival, and autophagy.
Conclusions
Notably, identified SNPs were scattered on several different chromosomes implying different genetic mechanisms underlying variation of prolificacy in each breed. Given the different layers that make up the follicles and the need for communication and transfer of hormones and nutrients through these layers to the oocyte, the significance of pathways related to cell signaling and communication seems logical. Our results provide genetic insights into the litter size variation in different sheep breeds.
Estimating SARS-CoV-2 prevalence from large-scale wastewater surveillance: insights from combined analysis of 44 sites in England
Authors: Morvan Mario , Jacomo Anna Lo , Souque Celia , Wade Matthew , Hoffmann Till , Pouwels Koen , Singer Andrew , Bunce Joshua , Engeli Andrew , Grimsley Jasmine , O'Reilly Kathleen , Danon Leon 
Published: August 2021

Abstract
Accurate surveillance of the COVID-19 pandemic can be weakened by under-reporting of cases, particularly due to asymptomatic or pre-symptomatic infections, resulting in bias. Quantification of SARS-CoV-2 RNA in wastewater (WW) can be used to infer infection prevalence, but uncertainty in sensitivity and considerable variability has meant that accurate measurement remains elusive. Data from 44 sewage sites in England, covering 31% of the population, shows that SARS-CoV-2 prevalence is estimated to within 1.1% of estimates from representative prevalence surveys (with 95% confidence). Using machine learning and phenomenological models, differences between sampled sites, particularly the WW flow rate, influence prevalence estimation and require careful interpretation. SARS-CoV-2 signals in WW appear 4–5 days earlier in comparison to clinical testing data but are coincident with prevalence surveys suggesting that WW surveillance can be a leading indicator for asymptomatic viral infections. Wastewater-based epidemiology complements and strengthens traditional surveillance, with significant implications for public health.
Influence of the placental cord insertion site on the placental mass and the birth weight in dichorionic diamniotic twins
Authors: Tepla Iryna 
Published: August 2021

The aim of the study was to determine the effect of the displacement of the umbilical cord insertion site from the centre of the placenta on the placental mass and the birth weight of dichorionic diamniotic twins and to consider the importance of the direction of the displacement, as well as to assess the influence of the umbilical cord displacement on the placental mass and the birth weight of dichorionic diamniotic twins taking into account the direction of displacement.
Material and methods. The study was performed on 135 dichorionic diamniotic pairs: 68 opposite-sex, 35 same-sex males, and 32 same-sex females. The impact of an absolute cord displacement from the centroid of the placental disc and the direction of its shifting were compared with the birth weight and the placental mass.
Results. In the investigated group, a central insertion was revealed in 6 (2.2 %), eccentric – in 224 (83.0 %), marginal – in 31 (11.5 %), and velamentous – in 9 (3.3 %) cases. The first two types of cord insertion are considered to be normal, the third and the fourth are seen as abnormal. The placental mass was in a strong positive correlation with the birth weight (r=0.71, p<0.0001). The placentas with an eccentric cord insertion had a smaller surface area. A negative correlation was established between the displacement of the cord insertion site and the placental mass (r=-0.4284, p<0.0001) as well as the birth weight (r=-0.6115, p<0.0001). The shift along the long axis was of greater importance than in relation to the shorter one. The placental mass and the birth weight were higher in the new-borns with a normal cord insertion site. In the abnormal cord insertion group, 32.5 % of the infants were under the 10th birth weight percentile, in the normal cord insertion group – only 8.3 %.
Conclusions. The birth weight of dichorionic diamniotic twins and their placental mass are negatively correlated with the distance of the umbilical cord insertion site from the placental centre. The insertion site displacement along the long axis has a stronger negative effect on the birth weight and the placental mass in comparison with the shifting along the short axis. The placentas with an eccentric cord insertion have a smaller surface area.
Features of laboratory markers in pregnant women with antiphospholipid syndrome and retrochorial hematoma
Authors: Tomniuk Oleh 
Published: August 2021

The aim. Study of hemostasis, antiphospholipid antibody levels and immunological parameters in pregnant women with antiphospholipid syndrome (APS), in particular with retrochorial hematoma (RCH).
Materials and methods. 90 women were selected and divided into two groups: the control group – 30 pregnant women with a normal pregnancy (without APS) and the main group – 60 pregnant women with APS. Women in the main group were diagnosed with APS before pregnancy. In turn, the main group was divided into two subgroups: 1 subgroup – 41 pregnant women without RCH and 2 subgroup – 19 pregnant women with RCH.
The main indicators of hemostasis were determined in all pregnant women, namely: the degree and rate of platelet aggregation, Willebrand factor, D-dimers. In addition, the level of antiphospholipid antibodies (APLA), antibodies to β2-glycoprotein, to annexin V, to prothrombin was examined, and the level of annexin V was also determined. The absolute and relative content of Treg, CD3+, T-lymphocytes, CD4+ (T-helpers), CD8+ (cytotoxic T-lymphocytes), CD19+ (B-lymphocytes), CD16+CD56+ (NK cells), CD16+CD56+CD107a+ (activated NK cells).
Results. The obtained results showed that in pregnant women with APS compared to pregnant women without APS there are statistically significantly higher values of the degree and rate of platelet aggregation (90.6±6.3% and 106.3±6.7% vs. 65.3±5.3 % and 73.4±5.6%, respectively). There were also higher values ​​of Willebrand factor and D-dimers (2.5±0.3 IU/ml and 378.1±34.3 ng/ml against 1.7±0.2 IU/ml and 268.1±27, 3 ng/ml, respectively).
APLAs were significantly higher in pregnant women with APS compared with pregnant women in the control group, namely: 16.1±1.5 vs. 3.8±0.4 U/ml. With regard to antibodies to β2-glycoprotein, to annexin V, to prothrombin and to the level of annexin V, their values were also statistically significantly higher in the group of pregnant women with APS.
In addition, the results of the study showed that pregnant women with APS showed changes in subpopulations of immunocompetent cells.
However, examining the difference in hemostasis, antibody content, and level of lymphocyte subpopulations between pregnant women with APS with and without RCH, it was found that their shifts in pregnant women with RCH were more pronounced than in women without RCH.
Conclusions. Pregnant women with APS are characterized by significantly more significant changes in hemostasis, manifested by activation of intravascular thrombosis. In addition, such pregnant women had a significantly higher concentration of autoantibodies. There are also changes in the immune system, in particular, a decrease in Treg-cells, which have the ability to reduce the specific proliferation and effector functions of lymphocytes, thereby participating in the pathogenesis of APS.
Free radical damage: role in varicella zoster virus infection
Authors: Volobuieva Olga , Liadova Tetiana , Popov Mykola , Sorokina Olga , Ognivenko Olena , Dorosh Diana 
Published: August 2021

Study of the role of lipid peroxidation and antioxidant system in patients with infectious diseases is of great interest to researchers. Numerous studies have led to a common understanding of their contribution to the pathogenesis of infectious diseases, as well as to the complications development. However, the state of lipid peroxidation and antioxidant protection in patients with chickenpox (varicella) has not been sufficiently studied which is important for the development of new targeted treatments.
The aim of the research - to assess the state of lipid peroxidation (LPO) and the antioxidant system (AOS) in the dynamics in patients with chickenpox, depending on the severity of the disease.
Materials and methods. We selected for participating in the study 240 chickenpox patients (142 women and 98 men) aged 18-40 years. Chickenpox was diagnosed using clinical, serological, and molecular genetic methods. The state assessment of LPO in chickenpox patients was based on the determination of serum diene conjugates (DC), malondialdehyde (MDA) levels and the total oxidative activity (TOA) of blood plasma.
Results. Study showed that the process of lipid peroxidation increases and the activity of the antioxidant system decreases in patients with chickenpox during the acute period of the disease. The extent of these processes becomes greater as the severity of chickenpox increases. A decrease in the activity of antioxidant enzymes and a disruption in the functioning of the glutathione system in patients with moderate to severe hypertension leads to disruption of protective mechanisms and, as a result, to an increase in the free radical chain reactions, the uncontrolled growth of which causes irreversible damage to the membranes of various cells, which underlies visceropathy in chickenpox patients.
Conclusions. Antioxidant system is activated in the acute period in patients with mild chickenpox. It is evidenced by an increase in the overall antioxidant activity of blood plasma (p=0.045) and red blood cells (p=0.00087), in the activity of catalase (p=0.001), superoxide dismutase (p=0.0093), glutathione peroxidase (p=0.036), glutathione reductase of plasma and red blood cells, and an increase in the concentration of oxidized and reduced glutathione in blood. Lipid peroxidation is hyperactivated in the acute period in patients with a moderate and severe course of the disease and an excess amount of primary and secondary hydroperoxides of fatty acids accumulates in the blood. This is accompanied by indicates a developing imbalance between the oxidative and antioxidant systems in group of patients with moderate and severe chickenpox. Our findings confirm the usefulness of antioxidants in the treatment of chickenpox.