bluuebunny/crossref_metadata_2025_split huggingface dataset:
Alternative Vaccination Politics
Authors: Manca Davide , Benincasa Lorenzo 
Published: July 2021

Abstract
Background: The timely implementation of the vaccination campaign and sharp rules for vaccine administration can make a difference. The paper investigates the impact of alternative policies based on scientific vaccination priorities inspired by the extended statistics on Covid-19 fatalities.Methods: In the case of Covid-19 vaccination, a principal role is played by promptly adopting a reverse-order of age approach (to target first the elderly) coupled to covering the high priority categories but postponing the low priority ones. We implemented an in silico vaccination simulator capable of comparing what happened in reality with what might have happened if alternative vaccination policies had been adopted. The immunization profile and the death distribution curve allowed measuring the distance between reality and alternative policies and finally quantifying the expected number of saved lives.Results: The alternative approach to vaccination was applied to Italy and Lombardy that host 60 and 10 million residents respectively. In about 100 days of vaccination based on (a) a reverse-order of age policy (from 90+ to 80-89 to 70-79 year-olds, etc.), (b) vaccination of priority categories, (c) postponement of non-priority categories and reallocation of such doses to (a) and (b), the saved lives would have been 3969 in Italy (of which 799 in Lombardy). In the same period, Italy suffered 30,911 fatalities (of which 5,613 in Lombardy). Of those fatalities, about 12.8% in Italy and 14.2% in Lombardy might have been avoided if a different approach to vaccination had been applied. Even better results would have been achieved if the elderly vaccination had been anticipated a few days (which started only 53 days after the very beginning of the Italian vaccination campaign) or if the vaccination engine had performed better in terms of daily administered doses while respecting the available delivered doses.Conclusions: A different approach to the vaccination politics based on sharp and straight policies based on scientific quantitative data of Covid-19 mortality as a function of age and comorbidities would have accomplished a better quantitative effect on extinguishing the pandemic and containing the fatalities toll.
ISCA1 Deficiency Induces Iron Metabolism Disorder and Myocardial Oncosis in Rat
Authors: Ling Yahao , Yang Xinlan , Zhang Xu , Guan Feifei , Qi Xiaolong , Dong Wei , Liu Mengdi , Ma Jiaxin , Jiang Xiaoyu , Gao Kai , Li Jing , Chen Wei , Gao Shan , Gao Xiang , Pan Shuo , Ma Yuanwu , Wang Jizheng , Lu Dan , zhang lianfeng 
Published: July 2021

Abstract
The effects of multiple mitochondrial dysfunction (MMD) on heart, a highly mitochondria-dependent tissue, is still unclear. This study was the first to verify the effect of ISCA1 gene deficiency, which has been shown to cause multiple mitochondrial dysfunction syndromes type 5 (MMDS5), on cardiac development in vivo, that is cardiomyocytes suffer from energy shortage due to abnormal metabolism of iron ion, which leads to oncosis and eventually HF and body death. Subsequently, we determine a new interacting molecule for ISCA1, six-transmembrane epithelial antigen of prostate 3 (STEAP3), which acts as a reductase in the reduction of Fe3+ to Fe2+. Forward and reverse validation experiments demonstrated that STEAP3 plays an important role in iron metabolism and energy generation impairment induced by ISCA1 deficiency. This result provides theoretical basis for understanding of MMDS pathogenesis, especially on heart development and the pathological process of heart diseases, and finally provides new clues for searching of clinical therapeutic targets.
Experiences and Perception Towards Reproductive Health Education Among Secondary School Teachers in South India
Authors: Joseph Nitin , Mahato Vaibhav , Pandey Akhil , Mishra Shikha , Prakash Garima , Gandhi Rishika 
Published: July 2021

Abstract
Background: Reproductive health education (RHE) is an important component of school curricula. It helps students in the decision-making process regarding several issues concerning reproductive health. However delivering RHE at schools is a difficult task for the teachers. Methods: This study was conducted to assess the experiences and perceptions towards reproductive health education (RHE) among 236 secondary school teachers in January 2019. Data were collected using a self-administered questionnaire. Results: Only 21(8.9%) were trained in RHE. Majority [179(75.8%)] identified cultural barriers as the major challenge involved in its implementation. 95(40.3%) teachers felt that the provision of sexual education as a part of RHE will promote pre-marital sexual activity among the students. Of the total, 185 (78.4%) had average while 51 (21.6%) participants had a good perception towards RHE. It was taught in only 3(16.7%) out of the 18 schools surveyed. Only 11(4.7%) participants felt that the availability of teaching aids to conduct RHE classes at their schools was adequate. Hardly 14(5.9%) teachers had taken RHE classes for students. Among the rest, 135(60.8%) expressed their willingness to take RHE classes with appropriate training. In multi variable analysis, participants aged ≤40 years (p=0.031), those belonging to nuclear families (p=0.013), and those who had taken classes in RHE (p=0.037) had significantly good perception level towards RHE.Conclusions: Teachers therefore need to be trained and given more opportunities to take RHE sessions which will help improve their perception towards RHE. Schools need to be better equipped with resources and various perceived barriers need to be overcome before RHE can be successfully implemented.
Identifying Autism Spectrum Disorder Symptoms Using Response and Gaze Behavior during the Go/NoGo Game CatChicken
Authors: Putra Prasetia Utama , Shima Keisuke , Shimatani Koji , Alvarez Sergio A. 
Published: July 2021

Abstract
Previous studies have found that Autism Spectrum Disorder (ASD) children scored lower during a Go/No-Go task and faced difficulty focusing their gaze on the speaker's face during a conversation. To date, however, there has not been an adequate study examining children's response and gaze during the Go/No-Go task to distinguish ASD from typical children. We investigated typical and ASD children's gaze modulation when they played a version of the Go/No-Go game. The proposed system represents the Go and the No-Go stimuli as chicken and cat characters, respectively. It tracks children's gaze using an eye tracker mounted on the monitor. Statistically significant between-group differences in spatial and auto-regressive temporal gaze-related features for 21 ASD and 31 typical children suggest that ASD children had more unstable gaze modulation during the test. Using the features that differ significantly as inputs, the AdaBoost meta-learning algorithm attained an accuracy rate of 88.6% in differentiating the ASD subjects from the typical ones.
Fine-Scale Genetic Diversity of the Brazilian Pantaneiro Horse Breed Adapted To Flooded Regions
Authors: Nogueira Marcelo Bchara , Pimentel Concepta M , de Faria Danielle Assis , Santos Sandra Aparecida Oliveria , Ianella Patrícia , Paiva Samuel Rezende 
Published: July 2021

Abstract
Among the animal species first introduced in Brazil during the country's discovery, horses (Equus caballus) stand out because of their evolutionary history and relationship with humans. Among the Brazilian horse breeds, the Pantaneiro draws attention due to its adaptative traits. Blood samples of 116 Pantaneiro horses were divided into six populations based on their sampling location, aiming to identify the existence of genetic structure and quantify genetic diversity within and between them. Populations were compared to elucidate genetic variability and differentiation better and assess the impact of Pantanal's natural geographic barriers on gene flow between populations. Data from the GGP Equine BeadChip (Geneseek-Neogen, 65.157 SNPs) was used to assess basic diversity parameters, genetic distance (FST), Principal Component Analysis (PCA) and population structure (ADMIXTURE) for the sampled animals. Mantel Test was also performed to investigate the correlation between the populations' genetic and geographic distances. Results showed high genetic variability in all populations, with elevated levels of admixture in their structure. High levels of admixture make it challenging to establish a racial pattern and, consequently, populations within the breed, being that only one of the populations differentiated itself from the others. No significant correlations between genetic and geographic distances were observed, indicating that environmental barriers did not hinder gene flow between populations. and neither farmers selection practices might have change breed genetic composition signficantly Low genetic distance and similar heterozygosity values were observed among populations, suggesting strong genetic proximity and low differentiation. Thereby, the Pantaneiro breed does not exhibit genetic subpopulations and could be considered, for conservation purposes, a single big population in the Panatnal region. This study will support sampling strategies for National genebank.
Simulation of Actual Evapotranspiration and Evaluation of Three Complementary Relationships in the Upper Regions of the Mekong River and the Salween River
Authors: Jiang Yongshan , Liu Zhaofei , Wang Rui , Gele Pingcuo 
Published: July 2021

Abstract
Based on observed precipitation and runoff data, monthly actual evapotranspiration (ETa) was calculated by the hydrological budget balance method in the Nu River Basin (NRB) and Lancang River Basin (LCRB). The performance of three developed complementary relationship methods, the nonlinear advection-aridity (nonlinear AA) method, generalized complementary relationship method (B2015), and sigmoid generalized complementary function (H2018), on simulating (ETa) were evaluated. The evaluation results showed that three methods were able to accurately simulate monthly (ETa) series. The NSE between the monthly (ETa) simulated by the nonlinear AA, B2015, and H2018 methods and the water-balance-derived (ETa) were 0.89, 0.83, and 0.91, respectively. The R-square were 0.90, 0.84, and 0.93, respectively. Overall, the H2018 method showed the best performance. The parameter α had a negative correlation with regional aridity index. Annual (ETa) and precipitation showed significant increasing trends during 1956–2018 in the basins at all temporal scales (dry and wet seasons and annual series). Runoff also exhibited an increasing trend in each sub-basin, except for the downstream region of the LCRB. The increasing magnitudes of wet reason precipitation and runoff in the mid-stream region was the highest, with the value of 73.7 mm/10a and 44.9 mm/10a, respectively. The (ETa) increased dramatically in the downstream region, the magnitude reached 25.9 mm/10a. Precipitation was the main factor leasing to (ETa) change. The increasing magnitude of (ETa) accounted for 42.4% of the precipitation increment. Research on the influence mechanism between meteorological factors and (ETa) showed that the contribution rate of air temperature to (ETa) was the highest, reaching 23.5%, which showed a significant positive correlation. The second was wind speed, whose contribution rate was − 10.2% on average, and even reached − 14.1% in the upstream region of the NRB. The correlation coefficient between (ETa) and wind speed was highest in mid-stream region of the NRB, which was greater than 0.80. The contribution rates of increasing humidity to (ETa) were − 12.5% and − 9.2% in the NRB and LCRB, respectively. (ETa) was negatively correlated with humidity. The negative correlation was especially strong in the mid-stream region, with coefficients were greater than − 0.65. The sunshine hours had the least effect on (ETa), and the contribution rates were − 6.5% and − 4.1%, respectively.
Is there a Trade-off between Economy and Task Goal Variability in Transfemoral Amputee Gait?
Authors: Lee I-Chieh , Fylstra Bretta , Liu Ming , Lenzi Tommaso , Huang He 
Published: July 2021

Abstract
Background: Energy cost minimization has been widely accepted to regulate gait. Optimization principles have been frequently used to explain how individuals adapt their gait pattern. However, there have been rare attempts to account for the role of variability in this optimization process. Motor redundancy can enable individuals to perform tasks reliably while achieving energy optimization. However, we do not know how the goal-irrelevant and goal-relevant variability is regulated.. In this study, we investigated how unilateral transfemoral amputees regulate step and stride variability based on the task to achieve energy economy. Methods: Nine individuals with unilateral transfemoral amputation walked on a treadmill at speeds of 0.6,0.8,1.0,1.2 and 1.4 m/s using their prescribed passive prostheses. We calculated the step-to-step and stride-to-stride variability and applied goal equivalent manifold (GEM) based control to decompose goal-relevant and goal-irrelevant manifold. To quantify the energy economy, the energy recovery rate (R) was calculated based on potential energy and kinetic energy. Comparisons were made between GEM variabilities and commonly used standard deviation measurements. A linear regression model was used to investigate the trade-off between R and GEM variabilities. Results: Our analysis shows greater variability along the goal-relevant manifold compared to the goal-irrelevant manifold (p<.001). Moreover, our analysis shows lower energy recovery rate for amputee gait compared to nonamputee gait (at least 20% less at faster walking speed). We found a negative relationship between energy recovery rate and goal-irrelevant variability. Compared to the standard deviation measurements, the variability decomposed using GEM reflected the preferred walking speed and the limitation of the passive prosthetic device.Conclusion: Individuals with amputation cleverly leverage task redundancy, regulating step and stride variability to the goal equivalent manifold (GEM). This result suggests that task redundancy enables unilateral amputees to benefit from motor variability in terms of energy economy. The differences observed between prosthetic step and intact step support the development of prosthetic leg capable of enhancing positive work during the double support phase and of powered prosthesis controllers that allow for variability along the task space while minimizing variability that interferes with the task goal. This study provides a different perspective on amputee gait analysis and challenge the field to think differently about the role of variability.
The Prognosis of Refractory Hypotension and Severe Intraventricular Hemorrhage in Very Low Birth Weight Infants
Authors: Hwang-Bo Seok , Seo Yu-Mi , Oh Moon-Yeon , Im Soo-Ah , Youn YoungAh 
Published: July 2021

Abstract
Background: The increased survival rate among very low birth weight infants has resulted in a higher risk for developing neurocomplications such as intraventricular hemorrhage (IVH), periventricular leukomalacia (PVL) and adverse neurodevelopmental outcomes.Purpose: We examined refractory hypotension experienced within a week of life in association with severe IVH (grades 3-4) among very low birth weight infants (VLBWIs).Method: Between Jan 2014 and Dec 2017, the clinical data of 191 VLBWIs admitted were retrospectively reviewed. Of a total of 191 VLBWIs, 71.2% (136/191) had IVH, and 28.7% (55/191) had severe IVH.Results: The VLBWI with severe IVH group (grade 3-4) presented with a significantly lower gestational age along with higher use of postnatal hydrocortisone for refractory hypotension. Resuscitation at delivery, pulmonary hemorrhage, neonatal seizure, and periventricular leukomalacia (PVL) were significantly more frequent in the severe IVH group (p<0.05). Higher mortality occurred in the VLBWI with severe IVH group (p<0.001). The multivariable logistic regression analysis consistently showed that refractory hypotension within a week of life and neonatal seizures were significantly associated with severe IVH. Those in the severe IVH and refractory hypotension groups had significantly lower composite cognitive, language, motor, and Bayley Scales of Infant and Toddler Development III scores at corrected 18 months.Those in the severe IVH and refractory hypotension groups showed significant developmental delay.Conclusion: Refractory hypotension within a week of life and seizures were consistently associated with severe IVH. VLBWI who experienced refractory hypotension within a week of life may indicate a more vulnerable perinatal settings with a higher risk for developmental delay.
Fluid Management for Critically Unwell Children with Diabetic Ketoacidosis: A Multi-centre Study
Authors: Mustafa Khurram , Cromie Kirsten , Foster Aimee , Barrow Anna , Winter Michelle , Cox Kathryn , Hosheh Osama , Henderson Amy , Lumsden Jo 
Published: July 2021

Abstract
Background:Cerebral oedema in paediatric diabetic ketoacidosis (DKA) can be associated with significant mortality and morbidity. These concerns have led to restrictive fluid management in children presenting with DKA and also led to the revision of guidance by the British Society of Paediatric Endocrinology and Diabetes (BSPED) in 2015. Methods:We conducted a multi-centre study of compliance with two BSPED guidelines with liberal (2009) and restrictive fluid management (2015) protocols for children admitted to paediatric critical care units (PCCU) in the UK. We also used univariate and multivariate logistic regressions to study associations with clinical outcomes such as diagnosis of cerebral oedema.Results:96 patients with DKA were admitted to eight PCCUs between January 2013 and December 2017. The median age at presentation was 9 years and weight was 32.4kg. Of all admissions, 25% were invasively ventilated, 4% received vasoactive support, 10% received renal replacement therapy and 98% survived to discharge. 42% were suspected to have cerebral oedema with older children being more likely to be diagnosed with cerebral oedema. There was no significant difference in receiving renal replacement therapy, mechanical ventilation, vasoactive support or a clinical diagnosis of cerebral oedema between the two treatment protocols.Conclusion:Compliance was lower for the guideline with a more restrictive fluid protocol. The study found no evidence to suggest that differing fluid management across BSPED guidance had any significant impact on clinical outcomes. A larger prospective study is needed to study the impact of the revised 2020 guidance.
Meteorological Drought Analysis with Different Indices for the Betwa River Basin, India
Authors: Singh Uttam , Agarwal Pooja , Sharma Pramod Kumar 
Published: July 2021

Abstract
Climate change is adversely affecting the development, management, and planning of surface and groundwater resources. The meteorological drought becomes a severe natural problem, and it can occur in any climatic region of the world. So, monitoring and minimizing drought is a crucial stage for analyzing and predicting drought impacts. A single drought index can't assess each aspect of the meteorological drought. In this study, we considered seven drought indices such as the Standardized Precipitation Index (SPI), China Z Index (CZI), Modified China Z Index (MCZI), Percent Normal drought index (PNI), Deciles Index (DI), Rainfall Anomaly Index (RAI), and Z-score index (ZSI). The drought was analyzed for 3, 6, 9, and 12 months’ time-step, and drought classification and threshold values were estimated. SPI showed maximum correlation values 0.389, 0.412, 0.560,and 0.996 for 3, 6, 9,and 12-month time steps compared to the other drought indices. The value of correlation is increased with the increase in time step for all drought indices; therefore, the accuracy of drought assessment also increases with an increase in time step. The Mann-Kendall's trend test was analyzed at a 5% level of significance for drought assessments. The drought magnitude and severity of the Betwa river basin were estimated based on the meteorological data (Rainfall) for the year between 1970 to 2014.
Evolution of the Prevalence, Clinical Features and Risk Factors for Acute Mountain Sickness in the Qinghai-Tibet Plateau
Authors: Zhang Chen , Liu Chuan , Chen Renzheng , Yang Jie , Ke Jingbin , Bian Shizhu , Yu Shiyong , Zhang Jihang , Yu Jie , Zeng Ying , Gao Xubin , Ding Xiaohan , Yang Yuanqi , Yuan Fangzhengyuan , He Chunyan , Shen Yang , Tan Hu , Zhao Xiaohui , Jin Jun , Huang Lan 
Published: July 2021

Abstract
Background Ascending to high altitude (HA) contribute to the development of acute mountain sickness (AMS). The prevalence, clinical features and relative risks for AMS may dynamically evolve but has not been described. Methods A total of 1,629 healthy men aged from 16 to 45 years were enrolled. A fast ascent cohort (n=1283) ascended to 3700 m by airplane and further ascended to 4400 m by bus; a slow ascent cohort (n=346) ascended to 3450 m by bus and further ascended to 4100 m by bus. AMS was diagnosed by the Lake Louise Scoring (LLS) system. Results As diagnosed by the old LLS and new LLS, the prevalence of AMS was 68.4% and 56.1% at 3700 m, respectively, which decreased to 21.4% and 14.3% after further ascending to 4400 m in the fast ascent cohort; the prevalence of AMS was 30.3% and 25.7% at 3450 m, which increased to 36.6% and 32.2% after further ascending to 4100 m in the slow ascent cohort. Moreover, AMS-related symptoms, such as headache, dizziness and fatigue, were the leading symptoms except at 4400 m in the fast ascent cohort. Fast ascent protocol was a risk factor during the initial ascent but became a protective factor after a further ascent to a higher altitude. Conclusions Ascent protocol was the primary factor that affected the incidence of AMS and related symptoms. These findings imply a novel strategy for high altitude travels or work with a plan to ascend to a higher altitude.
Can a Multitiered Copayment System Affect People’s Healthcare-seeking Behavior? A Case Study of Wenzhou, China
Authors: Ge Lizheng , Huang Yunyun , Xu Tingke , Zhao Qianru , Chen Chun , Zhang Xiangyang 
Published: July 2021

Abstract
Background. Facilitating the primary health care (PHC) system and maintaining people’s reasonable health-seeking behavior are key to establishing a sustainable healthcare system. China has employed a multitiered copayment system to incentivize the public to utilize PHC services through its hierarchical medical care system; however, most people still prefer visiting tertiary care hospitals. Methods. This preliminary study was conducted in 2016 on 1831 individuals from four regions of Wenzhou in Zhejiang Province to explore the effect and influencing factors of the multitiered copayment system that drives their primary healthcare-seeking behavior. We question whether a quality gap in healthcare services influences the minimal effect of the multitiered copayment system, which existing literature has considered as an important factor in the lack of reform in the Chinese healthcare system. We discuss the effect of the policy following the current situation in which there exists a large gap and further consider the hypothetical situation of a reduced gap in the future. Result. The results indicate that the initial effects of the multitiered copayment system was limited. However, they become more pronounced after the equalization of the quality of healthcare services. Moreover, the main determinants in people’s selection of PHC institutions changed from age and needs variables (self-rated health status) to age and enabling variables (distance to a medical care facility). Conclusion. This study confirms that changes in the quality gap in healthcare services influence the multitiered copayment system. Hence, reducing this gap can help to achieve the intended outcome of the tiered healthcare insurance schedule.