bluuebunny/crossref_metadata_2025_split huggingface dataset:
Patients’ perception towards Doctor- Patient communication in medical clinics: a cross sectional study from a district hospital in northern, Sri Lanka
Authors: Shanjeeban Ponnudurai , Suganthan Navaneethakrishnan , Rajeshkannan Nadarajah , Consultant Acting 
Published: August 2023

Abstract
Background: A good medical practice involves good communication between the patient and the doctor. Patients' satisfaction is greatly based on the doctor’s skill of communication. Inadequate communication is a significant factor determining patients' dissatisfaction with distrust which leads to poor quality of health care. In this research, we aim to assess patients’ perception towards Doctor-Patient Communication in a medical clinic in Northern, Sri Lanka.
Method: This was an outpatient clinic-based cross-sectional study conducted among medical clinic patients where patients get their chronic disease care, in the district hospital Kilinochchi, Sri Lanka. Our study used a validated patient satisfaction questionnaire. Data were collected over a month in early 2023 among 407 systematically random sampled patients.
Results: Out of 407 patients (36.4%) were above the age of 60 years and 57.2% were females. One hundred and seven patients had secondary education (26.3%) and 33.9% of them completed tertiary education. The majority (37.6%) were unemployed and 20.9% were labourers.
Majority of respondents (97.8%) had reported that they had sufficient time with doctors and 97.2% of them revealed they were greeted. Also, 96.3% of patients were mentioned they were thoroughly examined by the doctor. Majority, 393 (96.6%CI: 94.4-98.0%) patients were satisfied with the doctor's communication. Gender showed a significant association with satisfaction level (P=0.028). Patients above the age of 60 years were more satisfied (99.3%) compared to the other ages (P>0.05). Similarly patients presented in their own to consultation showed more satisfaction level compared to patients presented with by standers (P<0.001).Longer waiting time negatively associated with satisfaction level (P-0.016) Patients trust level regarding doctors was high with mean score of 8.82 with SD-1.44 in 1-10 scale. Trust level score significantly varied with level of satisfaction regarding doctors’ communication (P<0.001).
Conclusion: According to the current study, patients’ satisfaction level was high regarding doctors’ communication skills. Also, the gender of the patient had a significant association with the level of satisfaction. Waiting time negatively associated with satisfaction level. Patient’s trust level significantly depends on the level of satisfaction regarding their communication which is corner stone for patient’s adherence to treatment
Comparison of structural variant callers for massive whole-genome sequence data
Authors: Joe Soobok , Park Jong-Lyul , Kim Jun , Kim Sangok , Park Ji-Hwan , Yeo Min-Kyung , Yang Jin Ok , Kim Seon-Young 
Published: August 2023

Abstract
Background
Detecting structural variations (SVs) at the population level using next-generation sequencing (NGS) requires substantial computational resources and processing time. Here, we compared the performances of 10 SV callers: Delly, Manta, GridSS, Wham, Sniffles, Lumpy, SvABA, Canvas, CNVnator, and MELT. These SV callers have been recently published and have been widely employed for processing massive whole-genome sequencing datasets. We evaluated the accuracy, sequence depth, running time, and memory usage of the SV callers.
Results
Notably, several callers exhibited better calling performance for deletions than for duplications, inversions, and insertions. Among the SV callers, Manta identified deletion SVs with better performance and efficient computing resources, and both Manta and MELT demonstrated relatively good precision regarding calling insertions. We confirmed that the copy number variation callers, Canvas and CNVnator, exhibited better performance in identifying long duplications as they employ the read-depth approach. Finally, we also verified the genotypes inferred from each SV caller using a phased long-read assembly dataset, and Manta showed the highest concordance in terms of the deletions and insertions.
Conclusions
Our findings provide a comprehensive understanding of the accuracy and computational efficiency of SV callers, thereby facilitating integrative analysis of SV profiles in diverse large-scale genomic datasets.
Effect of Non-Invasive Vagus Nerve Stimulation in Clinical and Molecular Biomarkers of Parkinson’s Disease
Authors: Mondal Banashree , Choudhury Supriyo , Banerjee Rebecca , Roy Akash , Chatterjee Koustav , Basu Purba , Singh Ravi , Halder Saptak , Shubham Shantanu , Baker Stuart N , Baker Mark R , Kumar Hrishikesh 
Published: August 2023

Abstract
Non-invasive vagus nerve stimulation (nVNS) is an established neurostimulation therapy used in the treatment of epilepsy, migraine and cluster headache. In this randomized, double-blind, sham-controlled trial we explored the role of nVNS in the treatment of gait and other motor symptoms in Parkinson’s disease (PD) patients. In a subgroup of patients, we measured selected neurotrophins, inflammatory markers and oxidative stress in serum. Thirty-three PD patients with freezing of gait (FOG) were randomised to either nVNS or sham. After baseline assessments, patients were instructed to deliver six 2 minute stimulations (12 minutes/day) of the nVNS/sham device for one month at home. Patients were then re-assessed. After a one-month washout period, they were allocated to the alternate treatment arm and the same process was followed. Significant improvements in key gait parameters (speed, stance time and step length) were observed with nVNS. While serum tumor necrosis factor- α decreased, glutathione and brain-derived neurotrophic factor levels increased significantly (p < 0.05) after nVNS treatment. Here we present the first evidence of the efficacy and safety of nVNS in the treatment of gait in PD patients, and propose that nVNS can be used as an adjunctive therapy in the management of PD patients, especially those suffering from FOG. Clinical trial registration number: ISRCTN14797144 Date of Registration: 11 May, 2020
Effects of nitrogen fertilization strategies on yield-related traits of rice cultivars with different yield types at panicle development stage
Authors: Zou Yue , Zhang Yuchen , Cui Jiehao , Gao Jiacong , Guo Liying , Zhang Qiang 
Published: August 2023

Abstract
Rice is one of the most important food crops in the world. About half of the world's people use rice as their staple food. Rice panicle morphogenesis plays an important role in rice yield formation. However, under different nitrogen ( N ) fertilization strategies, it is not clear whether the morphological and physiological state of panicles affects the formation of yield by changing the differentiation and development of panicle. To understand how the panicle differentiation and development, and grain yield are affected by the N fertilization strategies, and clarify the relationship between related traits and yield in the process of panicle development in different varieties. In this study consisted of five N treatments, a panicle weight type (PWT) and a panicle number type (PNT) rice cultivar were grown in the field. The results showed that N fertilization strategies could improve the nitrogen use efficiency and yield of rice, but the response of different rice varieties to N fertilizer strategies was different. The further increase of panicle N fertilizer ratio could not further improve the yield of PNT rice varieties. Correlation analysis showed that SDN and SSR were the main factors affecting yield of DF114. PCA results showed that ZR content in panicle of DF114 was significantly correlated with N concentration in panicle, and was significantly negatively correlated with SRN and RP in floret differentiation stage. ABA content in panicle was significantly positively correlated with SSR in grain filling stage. The floret differentiation of LD11 was the main factor affecting the yield. PCA results showed that IAA in the panicle of LD11 was significantly positively correlated with SDN in the floret differentiation stage. These results suggest that N fertilizer strategies can affect the content of phytohormones in rice at the panicle differentiation stage, and then regulate the differentiation and development of rice panicles to affect yield. It is of great significance to optimize the application mode of N fertilizer according to the characteristics of varieties to improve rice yield and ensure food security.
A single-institutional retrospective analysis of related factors for vaginal intraepithelial neoplasia
Authors: Hongmin Zeng , Qianling Dai , Dan Jiang 
Published: August 2023

Abstract
Background
To date, there are only a few studies on the related factors of vaginal intraepithelial neoplasia (VaIN). This study analyzes the features of VaIN and identify underlying risk factors.
Methods
Patients with histologically confirmed VaIN at the Industrial Street Branch of Chengdu Women’s and Children’s Central Hospital from July 2020 to December 2021 were objectively identified. We used the baseline clinical characteristics, human papillomavirus (HPV), cytology, and pathology of the cases enrolled for statistical analysis.
Results
A total of 62 patients with VaIN (mean age: 39.06 ± 11.66 years; range: 19–69 years) were included, with 16 patients having cervical intraepithelial neoplasia (CIN) complications. Synchronous CIN was identified in 46 (74.2%) patients. Except for one patient with vulvar itching, almost all patients were asymptomatic. The most common cytological abnormalities among women were atypical squamous cells of undetermined significance (ASC-US) (59.5%) and low-grade squamous intraepithelial lesions (LSIL) (21.6%). Abnormalities occurred in six (37.5%) out of 16 patients with VaIN only and in 31 (67.4%) out of 46 patients with concurrent CIN (P = 0.0358). Additionally, 60 (96.8%) patients developed HPV infection. The most prevalent HPV genotypes were HPV16 in patients with VaIN alone and both HPV58 and HPV16 in patients with concurrent CIN.
Conclusions
Attention should be paid to HPV16- and HPV58-positive patients with cytological abnormalities such as ASC-US and LSIL (especially concurrent CIN) to avoid misdiagnosis or underdiagnosis and to facilitate early interventions for VaIN.
Integrated Analysis of Cancer Risk from Metabolic Dysfunction: Biological Mechanisms and Tipping Points
Authors: Pepper John W 
Published: August 2023

Abstract
Obesity and metabolic syndrome are associated with the incidence of cancer, and they are rising epidemics. Therefore, clarification of the biological mechanisms of metabolic cancer risk is needed to guide strategies to intercept any elevated cancer risk resulting from metabolic syndrome. This study addressed whether interactions among known biological mechanisms elevate cancer risk, and which mechanisms offer the best leverage points for preventing any resulting cancer risk. It used a systems approach to examine the network of biological mechanisms, with special attention to clinically important feedbacks and tipping points. The results show that while no single mechanism leads from metabolic dysfunction to cancer risk, the integrated network of known mechanisms does. Metabolic syndrome collectively, and most of its components individually, induce documented oncogenic pathways. A network of such pathways leads from metabolic dysfunction to oncogenesis. This network includes self-reinforcing feedback loops, mostly centered on systemic metabolic inflammation, that can create tipping points into chronically dysfunctional metabolism with elevated cancer risk. Optimal interventions to reduce cancer risk should preempt these tipping points by targeting elements of metabolic dysfunction upstream of known feedback loops.
Bone mineral density in lower thoracic vertebral for osteoporosis diagnosis in older adults during CT lung cancer screening
Authors: Hu Nandong , Wang Miaomiao , Yang Meng , Chen Xin , Wang Jiangchuan , Xie Chao , Zhang Bin , Wang Zhongqiu , Chen Xiao 
Published: August 2023

Abstract
Quantitative computed tomography (QCT) has been used to diagnose osteoporosis. Whether the thresholds of lumbar bone mineral density (LBMD) are applicable to the thoracic spine should be validated. This study explored the value of lower thoracic BMD (TBMD) in diagnosing osteoporosis in older adults during CT lung cancer screening. This study included 610 subjects who underwent QCT scans with both LBMD and TBMD. Osteoporosis was diagnosed based on LBMD using the ACR criteria (gold standard). Receiver operating characteristic (ROC) curve was used to define the TBMD thresholds. TBMD was translated into LBMD (TTBMD) and osteoporosis was defined based on TTBMD using ACR criteria. The performance of TBMD thresholds and TTBMD in identifying osteoporosis was determined using the Kappa test. In addition, 227 subjects with baseline TBMD data and followed up spine fracture were included to show the association between TBMD- and TTBMD-based osteoporosis and fracture. The performance of TBMD in identifying osteoporosis was low (kappa = 0.66) if using the ACR criteria. Two thresholds of TBMD for identifying osteopenia (128 mg/cm3) and in identifying osteoporosis (91 mg/cm3) were obtained with areas under the curve of 0.97 and 0.99, respectively. The performance of the identification of osteoporosis/osteopenia using the two thresholds or TTBMD both had good agreement with the gold standard (kappa = 0.78, 0.86). Osteopenia and osteoporosis identified using the thresholds (adjusted hazard ratio (HR) = 4.43, 95% confidence interval (CI): 1.31–15.06; adjusted HR = 18.72, 95% CI: 5.13–68.36) or TTBMD (adjusted HR = 2.78, 95% CI: 1.16–6.72; adjusted HR = 10.28, 95% CI: 4.22–25.08) were also associated with fractures. Calculating the threshold of TBMD or normalizing TBMD to LBMD both showed good performance in identifying osteoporosis in older adults during CT lung cancer screening.
Assessments of Food Waste Practices for the Reductions of Greenhouse Gas Emissions in Selected Cities of Ethiopia
Authors: Ahmed Abdulshekur , Caucci Serena , Lohmann Dietmar , Sitotaw Yohannis 
Published: August 2023

Abstract
By the year 2050, the global food system must feed nine billion people, out of which around 8 billion would be in developing countries. And also the global community should change the food system to achieve Sustainable Development Goal #2 which is to end hunger, achieve food security and improved nutrition, and promote sustainable agriculture by 2030. Most importantly, in the year 2017, the tragic landslide at the waste collection site at the place known as koshe in the capital of Ethiopia killed 116 people. This landfill was 30% arise from food waste. Nevertheless, it is estimated that at least 21% of all food produced in Sub-Saharan African countries is wasted. Food systems account for 24% of global greenhouse gas emissions. As a result, the study of Assessments of Food Waste Practices for the Reduction of Greenhouse Gas Emissions in the selected cities of Ethiopia was undertaken with the main focus on food waste prevention, As is seen from the data (n = 50), 48% of our respondents were holders of MSc degree, 24% Ph.D. degree, 22% Primary education level respondents and the remaining 6% BSc degree holders. On the other hand, 78% of our respondents were fully employed, 50% were in the age range of 30 to 40, and 28%. Moreover, 58% have an income of ≥ 10,000 local currency and pay for food 40% of their income per month. For the correlation between the city of living and the money spend on food, P-value was 0.15 indicating there was no correlation between respondents’ area of living and the amount of money spent on food purchases. The amount of money they usually pay for food per their family members per week is ≥ 1000 which means they spend approximately 40% of their income per month which is a significant amount. Moreover, correlation analysis between income range and the money spent on food purchases per week shows that the P-value of 0.2 indicates there was no correlation between income and food expenditures. Incredibly 84% said they don’t consume all that they purchased indicating they are no plan for food purchasing, producing avoidable food waste, and 92% replied that they never record their meal and snack including when, why, and how much they usually consume, which is another indicator of bad food habits which also leads to eating disorders.
Barriers and Facilitators to Accessing Adolescents’ Mental Health Services in Karachi: Users and Providers Perspectives
Authors: Mubeen Zainab , Fatmi Zafar , Hameed Waqas , Asim Muhammad 
Published: August 2023

Abstract
Background: Adolescent mental healthcare (MHC) is driven by numerous factors, and adolescents occasionally seek professional help for mental health issues due to several reasons. The reasons become more complex within low- and middle-income countries; therefore, this study aims to enhance the understanding of perceived barriers and facilitators to accessing mental health services among adolescents aged 10 to 19 years old from the perspective of users and providers.
Method: Semi-structured interview guide was developed using Andersen’s health service utilization model. In-depth interviews were conducted with healthcare providers (n=21) and parents of adolescents (n=19) in psychiatry departments of public and private tertiary care hospitals in Karachi. Inductive thematic analysis technique was used to identify themes from the data and further themes were developed.
Result: The findings revealed a consensus of mental health providers (MHPs) and users in all three categories of the Andersen model and consider the MHC access and utilization for adolescents because of compulsion rather than personal health choices. Within pre-disposing, need, and enabling factors; the study participants highlighted a unique perspective; users regarded frequent migration, daily wage loss, and women's societal status as barriers while the need for marriage and patient willingness were stated as facilitators. Likewise, MHPs indicated societal tolerance, the burden on the health system, and the absence of CAMH services as major gaps in service delivery.
Conclusion: Service utilization is mostly facilitated by the severity of illness instead of individual personal choices, health beliefs, accessibility, and affordability. It is therefore imperative to prioritize adolescent MH through mental health promotion and prevention approaches. and address service delivery gaps to prevent treatment delays via task shifting and capacity building of the health workforce.
A Strategy for co-expression of multiple proteins in Komagataella phaffii without introducing selectable markers via the Cre/loxP system
Authors: Wang Weixian , Han Minghai , Zhu Guofei , Liu Xiaohui , Zhao Tianming , Ma Xiaoyan , Gong Xun , Xu Cunbin 
Published: August 2023

Abstract
Objective The objective was to develop a convenient strategy for co-expressing multiple proteins in Komagataella phaffii via the Cre/loxP system without introducing any markers.Results A plasmid in this strategy was generated from pPICZαA with integration of lox71-Sh ble-lox66. Firstly, the plasmid was inserted with one target protein gene and then transformed into K. phaffii KM71. Secondly, the auxiliary plasmid pPICZαA/cre/his4 containing CRE recombinase gene was further chromosomally inserted to Sh ble gene therein. Finally, methanol induction was conducted to produce CRE for Cre/loxP-mediated recombination, and consequently, the sequence between lox71 and lox66 was deleted, leading to recovery of ZeoR and His− markers. Then the resulted strain expressing the one target protein was used as the host to which another target protein gene could be inserted by the same procedures.Conclusions With easy manipulation, the method was effective in co-expressing multiple proteins with rescue of markers in this yeast.
Diagnosis of Multiple Sclerosis using Optical Coherence Tomography Supported by Explainable Artificial Intelligence
Authors: Garcia-Martin Elena , Dongil-Moreno Francisco , Ortiz Miguel , Ciubotaru Olga , Boquete Luciano , Sánchez-Morla Eva , Jimeno-Huete Daniel , Miguel Juan , Barea Rafael , Vilades Elisa 
Published: August 2023

Abstract
Background/Objectives:
Study of retinal structure based on optical coherence tomography (OCT) data can facilitate early diagnosis of relapsing-remitting multiple sclerosis (RRMS). Although artificial intelligence can provide highly reliable diagnoses, the results obtained must be explainable.
Subjects/Methods:
The study included 79 recently diagnosed RRMS patients and 69 age matched healthy control subjects. Thickness (Avg) and inter-eye difference (Diff) features are obtained in 4 retinal layers using the posterior pole protocol. Each layer is divided into 6 analysis zones. The Support Vector Machine plus Recursive Feature Elimination with Leave-One-Out Cross Validation (SVM-RFE-LOOCV) approach is used to find the subset of features that reduces dimensionality and optimizes the performance of the classifier.
Results
SVM-RFE-LOOCV was used to identify OCT features with greatest capacity for early diagnosis, determining the area of the papillomacular bundle to be the most influential. A correlation was observed between loss of layer thickness and increase in functional disability. There was also greater functional deterioration in patients with greater asymmetry between left and right eyes. The classifier based on the top-ranked features obtained sensitivity = 0.86 and specificity = 0.90.
Conclusions
There was consistency between the features identified as relevant by the SVM-RFE-LOOCV approach and the retinotopic distribution of the retinal nerve fibers and the optic nerve head. This simple method contributes to implementation of an assisted diagnosis system and its accuracy exceeds that achieved with magnetic resonance imaging of the central nervous system, the current gold standard. This paper provides novel insights into RRMS affectation of the neuroretina.