bluuebunny/crossref_metadata_2025_split huggingface dataset:
Can Driving-Restriction Policies Alleviate Traffic Congestion? A Case Study of Beijing, China
Authors: jia shuwei , Li Yao , Fang Tianhui 
Published: June 2021

Abstract
With ongoing urbanization, traffic congestion and the air pollution it induces are worsening. Using a system dynamics approach, this study constructed a driving-restriction policy model to explore the effects of different stages of policy implementation on variables such as traffic congestion, emissions, and parking demand. Medium- and long-term dynamic simulation showed that the effect of the policy was obvious in the initial stage but gradually weakened in the medium term, leading to a “fading” effect on emission reduction and traffic-congestion alleviation; a “rebound” effect was even observed at the end of the simulation. Thus, the policy will not effectively reduce traffic congestion in the long term and will induce a new demand for car purchases, resulting in paradoxical effects, which will aggravate parking demand, congestion, and pollution. Yet, it was also found that introducing penalty policies and an air pollution charging fee could weaken the paradoxical effects and compensate for some defects of the policy. Such strategies could help reduce emissions, traffic congestion, parking demand, the number of illegal trips, and the overall number of vehicle trips. These findings can provide not only a theoretical basis for further research but also practical guidance for policy improvement.
"Sharp Downward, Blunt Upward": District Maternal Death Audits' Challenges to Formulate Evidence-based Recommendations in Indonesia - a Qualitative Study
Authors: Cahyanti Ratnasari D , Widyawati Widyawati , Hakimi Mohammad 
Published: June 2021

Abstract
Background: Indonesia, the largest archipelago globally with decentralized health system, is faced with a stagnant high maternal mortality ratio (MMR). The disparity factors among regions and inequities in access have deterred the local assessments in preventing similar maternal deaths. This study explored the challenges of district maternal death audit (MDA) committees to provide evidence-based recommendations for local adaptive practices in reducing maternal mortality.Methods: A qualitative study was conducted with four focus-group discussions in Central Java, Indonesia, between July and October 2019. Purposive sampling was used to select 7-8 members of each district audit committee. Data were analyzed using the thematic analysis approach. Triangulation was done by peer debriefing and reviewing audit documentation.Results: The district audit committees had significant challenges to develop appropriate recommendations and action plans, involving: 1) lack of information to facilitate an accurate review; 2) no explicit clinical standard available; 3) poor support from key hospital decision-makers, and 4) insufficient skills of district health officers to organize standard MDA. The district audit committees tended to associate maternal death in lower and higher-level health facilities (hospitals) with mismanagement and unavoidable cause, respectively. These unfavorable cultures discourage transparency and prevent continuing improvement, leading to failure in addressing maternal death's local avoidable factors. Conclusion: A productive MDA is required to provide an evidence-based recommendation. A strong partnership between the key hospital decision-makers and district health officers is needed for quality evidence-based policymaking and practice to prevent maternal death.
The war of Brazilian Firefighters in the Fight Against Covid-19
Authors: de Oliveira Renan Augusto Bortolassi , Bail Rosângela de França , Michaloski Ariel Orlei , Kovaleski João Luiz , Chiroli Daiane Maria de Genaro 
Published: June 2021

Abstract
IntroductionThe years 2020 and 2021 were marked by the pandemic of SARS-CoV-2, a virus that infected 167 million more people, causing about 3.4 million deaths worldwide. And, because of this, the main global health agencies (WHO, governments, emergency services, hospitals and other health professionals), sought means of protection for workers on the front line to combat the pandemic. The Fire Brigades of Brazil, had the need to adopt new protocols of actions, which would mitigate the progress of the disease, justifying the importance of curbing the effects of the pandemic in their corporations and other victims of COVID-19.Case descriptionThe objective of this work is to propose the systematization of control and combating future pandemics, seeking to contribute with a model of assistance protocol that adapts to the needs of health institutions. The study is a literature review and is based on data collected through a questionnaire applied to the Brazilian Fire Departments in the 26 states and the Federal District.Discussion and evaluationWith the mapping of the actions carried out, it was possible to identify which actions were implemented, which involve the creation and development of new service protocols such as the use of specific PPE, care with the disposal of contaminated materials and behavioral changes, avoiding contamination. Within the mapping carried out in the corporations, it is possible to obtain relevant data in the fight against the coronavirus, such as (use of new PPE, exclusive vehicles, testing of personnel, infected firefighters, number of deaths, stress, change in work routines).ConclusionsWith the coronavirus pandemic, the Fire Brigade promoted an alignment between needs and decision making, through internal protocols of related actions, which were essential in the search to mitigate the impacts caused by the pandemic. Such actions serve as a model to be used in other work environments.
Effect Of Exhausted Olive Cake Contamination On Fly And Bottom Ash In Power Plants
Authors: Pazo Amparo , Lapuerta Magín , Acosta Anselmo , Hernández Juan J. , Monedero Esperanza 
Published: June 2021

Abstract
With the aim to prevent possible power plant malfunction due to the feedstock properties and suggest possible ash applications, feedstock samples and bottom and fly ash samples collected along more than a year in a 16 MW suspension-fired boiler power plant, fed mainly with pulverized exhausted olive cake (orujillo), were studied. A detailed characterization of fly and bottom ash has been done, as well as a seasonal evolution study. Altogether in order to find any trend on the ash composition changes and to study the relationship between ash (both fly and bottom fractions) and, on the one hand, the feedstock composition, and on the other hand, the troublesome deposit formation. A relationship between deposit growth and higher Cl and Na content in the feedstock has been noticed, showing the need for some control on these feedstock’s components. The high Cl and Na content is attributed to external contamination. Furthermore, the high Al content in the feedstock and the strong relationship between Al, Fe and Si (indicating a common origin) suggest some biomass soil contamination. However, no relationship was observed between troublesome deposit formation and the hypothesized biomass soil contamination.
Comparison of Six Decision Aid Rules For Diagnosis of Acute Myocardial Infarction In Elderly Patients Presenting To The Emergency Department With Acute Chest Pain
Authors: Hrečko Juraj , Dokoupil Jiří , Pudil Radek 
Published: June 2021

Abstract
Background: Using decision aid rules for diagnosis of acute myocardial infarction (AMI) is not common practice in our region. Elderly patients are often neglected in clinical trials, and the proper diagnostics of acute myocardial infarction in this group remains problematic. The objective of this study was to evaluate the accuracy and effectiveness of different strategies for the diagnosis of AMI in the elderly in real-life clinical practice. Methods: In a retrospective single-center study, we included patients older than 70 years presenting to the emergency department with chest pain as a dominant symptom. The performance of six decision aid rules (T-MACS, HEART, EDACS, TIMI, GRACE, and ADAPT) and solo troponin T strategy for diagnosing acute myocardial infarction was evaluated by calculating sensitivity, specificity, odds ratios, negative and positive predictive values.Results: A total of 250 patients, with a mean age of 78.5 years, were enrolled. Forty-eight patients (19.2%) had an acute myocardial infarction in a 30 day follow-up period. The sensitivity for ruling-out AMI was 100% for T-MACS, HEART, and ADAPT; 97.9% for EDACS, 93.8% for TIMI, and 81.3% for GRACE and solo TnT strategy. For ruling-in AMI, the specificity was 97.5% for T-MACS, 95% for TIMI, 83.2% for HEART, 81.7% for GRACE, and 46% for ADAPT. C-statistics were 0.52 for T-MACS, 0.51 for ADAPT, 0.47 for EDACS and GRACE, 0.46 for HEART and TIMI, and 0.33 for solo TnT strategy.Conclusion: T-MACS decision aid had the best performance with 100% sensitivity and 100% negative predictive value for rule-out AMI; 97.5% specificity and 64.3% positive predictive value for rule-in AMI. Other evaluated protocols were less accurate. Risk stratification of patients with suspected acute coronary syndrome based on decision aid rules can be used in real-life practice, even in the population of the elderly.
A novel Signature Constructed using Ferroptosis-Related lncRNA Pairs May Predict the Prognosis of Bladder Cancer Patients
Authors: Wu Hao , Zuo Li , Zhang Zi-Yi , Zhang Ze , Gao Sheng-Lin , Lu Chao , Zhang Li-Feng 
Published: June 2021

Abstract
Background:Bladder cancer is one of the most common malignant tumors of the urinary system, and its incidence has been increasing in recent years. Ferroptosis is a recently discovered type of cell death, and some studies have suggested that it is closely associated with tumors. It can promote tumor apoptosis and also promote tumor development. Moreover, it has been reported that a correlation exists between long non-coding RNAs (lncRNAs) pairs and tumors. Herein, we developed an lncRNA pair signature associated with ferroptosis to predict the prognosis of bladder cancer. Methods: We combined the bladder cancer transcriptome data from the Cancer Genome Atlas (TCGA) database to identify ferroptosis-related lncRNA (FRlncRNA) pairs. Using univariate and multivariate Cox analyses and LASSO regression analysis, we identified a FRlncRNA pair signature. We subsequently assessed the predictive prognostic value of this signature and validated the results. Results: The signature included 18 lncRNA pairs and was highly accurate for clinical prediction in patients with bladder cancer. Univariate and multivariate Cox analyses and stratified analysis indicated that the model was an independent prognostic factor. Additionally, we detected a positive correlation between this signature and the tumor immune microenvironment. Conclusion: The FRlncRNA pair signature has good prognostic and clinical predictive value in patients with bladder cancer.
Validation and Clinical Application of the Chinese Version of the M. D. Anderson Symptom Inventory(MDASI-C) in Breast Cancer Patients
Authors: Chen Renwang , Wang Qiong , Hu Ting , Wang Jue , Xie Yu-xiu , Chang Hai-yan , Cheng Jing 
Published: June 2021

Abstract
Purpose To validate and use the Chinese Version of the M. D. Anderson Symptom Inventory (MDASI-C) to assess the symptom burden of breast cancer patients of China. And to reveal the features of the symptoms and provide a basis for improving their quality of life.Methods A total of 342 breast cancer patients participated in the study. All patients had pathological diagnosis. They were investigated and evaluated from November 2020 to February 2021 with MDASI-C. The reliability and validity were evaluated respectively. Cluster analysis and correlation analysis were carried out.Results The Cronbach’s alpha coefficient of the symptom and interference items was 0.827 and 0.880, respectively, which meant good reliability. Construct validity revealed a four-factor structure. The Kaiser- Meyer-Olkin (KMO) value was 0.760, which meant good construct validity. The patient's KPS, treatment phase and cancer stage were grouped, and the differences of scores within the groups were significant. The patient's employment status, education level and age had a significant correlation with symptoms. The top three symptoms were disturbed sleep (3.10 ± 2.52), diffificulty remembering (2.54 ± 2.30) and fatigue (2.24 ± 2.13). The higher the patient's education, the lower their symptoms. Patients' Body Mass Index (BMI), hemoglobin (Hb), alkaline phosphatase (ALP), neutral granulocyte lymphocyte ratio (N/L), and serum albumin globulin ratio (A/G) also had an effect on some of the symptoms of patients. Conclusions MDASI-C is a reliable and effective assessment tool when evaluating patients with breast cancer of China. The symptoms were related to many clinical, biochemical indicators.
The Association Between Overweight or Obesity and Prognosis of Kidney Cancer: A Study Protocol of An Updated Systematic Review and Meta-Analysis
Authors: Le SiYu , Fu XiaoYi , Jiang HuiNan , Liu Yi , Ruan BinYe , Liu YuPeng , Wang ShuRan 
Published: June 2021

Abstract
Introduction: Kidney cancer is among the 10 most common cancers in both men and women. As we know, obesity and overweight is one of the confirmed risk factors. However, several studies found that overweight or obese patients with kidney cancer had a better prognosis than normal weight patients, as known as the “obesity paradox”. Therefore, in this study, we aimed to conduct a systematic meta- analysis of peer- reviewed literature to investigate the association between obesity or overweight and kidney cancer outcomes.Methods and analysis: Our review will assess case-control or cohort studies on prognosis of kidney cancer patients who are classified as obese, overweight or normal weight before 1 August 2020. Databases to be searched include PubMed/MEDLINE, Scopus, Web of Science and Embase. Two authors will independently conduct eligible studies selection process, perform data extraction and appraise the quality of included studies. Original case-control or cohort studies published in English will be considered for inclusion. The outcomes of interest will be progression-free survival, cancer- specific survival and overall survival. Meta-analyses will be performed to calculate pooled estimates. Ethics and dissemination: Our study will be based on published data, and thus there is no requirement for ethics approval. The results will be shared through publication in a peer- reviewed journal and presentations at academic conferences. PROSPERO registration number: CRD42021223347
Exosomal miR-331 from Chemoresistant Osteosarcoma Cells Induced Chemoresistance Through Autophagy
Authors: Zhao Aiqing , Zhao Yan bin , Liu Wanlin , Feng Wei , Xing Wenhua , Zhao Zhenqun , Cui Shuxia , Bai Rui , Meng Chenyang 
Published: June 2021

Abstract
Background

Osteosarcoma (OS) is a highly malignant tumor. Improving chemotherapeutic resistance is very important to improve the survival rate of OS. Exosomes and microRNAs (MiRNA) play important roles in the mechanism of chemotherapeutic resistance transmission. More and more researches focus the mechanism of miRNAs carried by exosomes in the transmission of chemotherapeutic resistance of OS. This study focused on exploring the mechanism of exosomal miR-331 in the transmission of chemoresistance in OS.
Methods

We cultured OS drug-resistant cells and extracted exosomes of these cells. The secretion and uptake of exosomes in OS drug-resistant cells and OS cells (OSCs) were confirmed by fluorescence tracking assay and transwell experiments. The differential expression of microRNA-331 (miR-331) in exosomes of OS resistant and OS cells was investigated by RT-PCR. The effects of drug-resistant exosomes on proliferation and migration of OS cells were determined by MTT assay and scratches assay. MDC staining, RT-PCR, and Western blot were used to detect the role of autophagy which regulated by drug-resistant cell-derived exosom-miR-331.
Results

We found that the expression difference of miR-331 between drug-resistant cells of MG63 and HOS cell lines and tumor cells was the most significant. Drug resistant OSCs secreted exosomes and were ingested by OSCs, which then promoted OSCs to acquire drug resistance. In addition, exosomes secreted by drug-resistant OSCs promote drug resistance by carrying miRNAs. Interestingly, inhibition of miRNA resulted in reduced drug resistance transmission of exosomes. Finally, we found that the exosomes secreted by drug-resistant OSCs could induce autophagy of OSCs by carrying miR-331, thus making OSCs acquire drug resistance. Inhibition of miR-331 can effectively improve drug resistance of OSCs.
Conclusions

Chemoresistant OSCs-derived exosomes promote the transmission of drug resistance by carrying miR-331 and inducing autophagy. Inhibition of miR-331 could effectively alleviate drug resistance of OSCs.
The Sea Urchin Centrostephanus Tenuispinus (Clark, 1914) is an Important Bio-Eroder on a High Latitude (32o S) Coral Reef.
Authors: Thilakarathna RMGN , Keulen Mike van , Keesing John K. 
Published: June 2021

Abstract
Sea urchins are keystone herbivores in many marine benthic habitats. They can significantly influence coral-algae phase shifts and impact on reef carbonate budgets through grazing. Hall Bank reef in Western Australia is unique among other reefs in the region being high latitude with a high hermatypic coral cover but lacking macroalgae and soft corals. Since the reef status is thought to result from high densities of the urchin Centrostephanus tenuispinus limiting the growth of macroalgae, the present study was focused on evaluating their role as bio-eroders. Monthly samples of 26 urchins were collected from 2014–2016 and gut composition was analyzed. Gut evacuation rates were calculated using 50 urchins dissected at time intervals (0, 4, 8, 16, 24, 36, 48, 60, 72 and 96 h). Reworked calcium carbonate was calculated using 30 urchins maintained in five cages in a seagrass bed adjacent to the reef site. Mean percentages for organic component, calcium carbonate and other siliceous components were 86.29 ± 3.23%, 10.32 ± 2.76% and 3.39 ± 1.52% respectively. Gut evacuation rates for autumn, winter, spring and summer were 0.70, 0.24, 0.48 and 0.72 (day− 1). Bio-erosion rates were significantly higher in Summer-16 (3.52 g CaCO3 m− 2 day− 1) and lower in winter (1.32 g CaCO3 m− 2 day− 1) (F = 101.580, p < 0.000). High erosion rates were recorded for large urchins (F = 37.789, P < 0.001. Annual urchin bio-erosion was 1017.69 g CaCO3 m− 2 a− 1. Differences in food ingestion rates in response to seawater temperature changes are thought to be the main cause for the significant differences in seasonal bio-erosion rates.
Antibiotic Prescription Rationality And Associated In-Patient Treatment Outcomes In Children Under-Five With Severe Pneumonia At Bwizibwera Health Center IV, Mbarara District, South-Western Uganda
Authors: Abeja Christine Joy , Niozima Valence , Byagamy John Paul , Obua Celestino 
Published: June 2021

Abstract
Background: Pneumonia is a major cause of morbidity and mortality in children under five. Antibiotic treatment must be started immediately in children with pneumonia. The irrational use of antibiotics may increase morbidity and mortality in children with pneumonia. Pneumonia accounted for approximately 16 % of the 5.6 million under-five deaths word wide in 2016. In Uganda, it kills approximately 2,400 children per year. Early diagnosis and appropriate case management with rational use of antibiotics remain the most effective intervention to reduce pneumonia-related mortality. This study aimed at determining antibiotic prescription rationality and associated in-patient treatment outcomes in children aged 2-59 months with severe community-acquired pneumonia at Bwizibwera Health Centre IV from 1st May 2018 to 30th April 2019. Methods: We conducted a retrospective cohort design; data were collected from in-patient records of all children aged 2-59 months with severe community-acquired pneumonia who met the eligibility criteria for a period of one year. Data abstraction template was used for data collection. Health care records of children aged 2-59 months who had other co-morbidities and were on medication that could influence or impact on in-patient treatment outcomes from 1st May 2018 to 30th April 2019 were excluded. Data was entered and analyzed using Epi-info v 7.2 and STATA v 13.0 respectively, Descriptive statistics were reported and Chi-square test was used to compare the proportions.Results: Of the total records of children retrieved and screened (N = 847), 229 prescription records of children fulfilled inclusion criteria, 57 (24.9 %) had rational prescriptions with good outcomes and 172 (75.1 %) had irrational prescriptions with 10 (4.4 %) having unfavorable outcomes. The majority (73.7 %) of those who received rational prescription were on treatment with a combination of benzyl penicillin plus gentamycin while (26.3 %) were on ampicillin plus gentamycin. The majority (32.4 %) of patients with good treatment outcomes were aged 6 – 11 months. This age category also doubled as the group that experienced the highest percentage (40.0 %) of unfavorable outcomes.Conclusion: The majority of children 172 (75.1%) had received irrational antibiotic prescriptions. There were no statistically significant associations between patient characteristics and treatment outcomes.
Spatial Correction Improves Accuracy of Catheter Positioning During Ablation of Premature Ventricular Contractions: Differences Between Ventricular Outflow Tracts And Other Localizations.
Authors: Nies Moritz , Schleberger Ruben , Dinshaw Leon , Klatt Niklas , Muenkler Paula , Jungen Christiane , Rottner Laura , Lemoine Marc D , Reißmann Bruno , Rillig Andreas , Metzner Andreas , Kirchhof Paulus , Meyer Christian 
Published: June 2021

Abstract
1.1. PurposeHybrid activation mapping is a novel tool to correct for spatial displacement of the mapping catheter due to asymmetrical contraction of myocardium during premature ventricular contractions (PVC). The aim of this study is to describe the extent and cause of spatial displacement during PVC mapping and options for correction using hybrid activation mapping. 1.2. Methods and ResultsWe analyzed 5798 hybrid mapping points in 40 acquired hybrid maps of 22 consecutive patients (age 63±16 years, 45% female) treated for premature ventricular contractions (PVCs). Median PVC-coupling interval was 552 ms (IQR 83 ms). Spatial displacement was determined by measuring the dislocation of the catheter tip during PVC compared to the preceding sinus beat. Mean spatial displacement was 3.8±1.5 mm for all maps. The displacement was 1.3±0.4 mm larger for PVCs with non-outflow-tract origin compared to PVCs originating from the ventricular outflow tracts (RVOT/LVOT; p=0.028). Demographic parameters, PVC-coupling-interval and chamber of origin had no significant influence on the extent of spatial displacement. 1.3. ConclusionEctopic activation of the ventricular myocardium during PVCs results in spatial displacement of mapping points that is significantly larger for PVCs with non-outflow-tract origin. The correction for spatial displacement may improve accuracy of radiofrequency current (RFC)-application in catheter ablation of PVCs.