bluuebunny/crossref_metadata_2025_split huggingface dataset:
Implementing a school-based HIV intervention program during public health emergencies: Lessons learned in The Bahamas
Authors: Deveaux Lynette , Schieber Elizabeth , Cottrell Lesley , Firpo-Triplett Regina , Adderley Richard , MacDonell Karen , Forbes Nikkiah , Wang Bo 
Published: June 2022

Abstract
Background
Natural disasters and public health crises can disrupt communities’ capacities to implement important public health programs. A nationwide implementation of an evidence-based HIV prevention program, Focus on Youth in The Caribbean (FOYC) and Caribbean Informed Parents and Children Together (CImPACT), in The Bahamas suffered severe disruption from Hurricane Dorian and the COVID-19 pandemic, especially in its more remote islands. We explored the teacher- and school-level factors that affected implementation of the program in these islands during those disruptions.
Methods
Data were collected from 47 Grade 6 teachers and 984 students in 34 government elementary schools during the 2020–2021 school year. Teachers completed a pre-implementation questionnaire to record their characteristics and perceptions that might affect their implementation fidelity and an annual program training workshop. School coordinators and high-performing teachers acting as mentors received additional training to provide teachers with monitoring, feedback, and additional support. Teachers submitted data on their completion of the 9 sessions and 35 core activities of FOYC + CImPACT. The fidelity outcomes were the number of sessions and core activities taught by teachers each year.
Results
On average, teachers taught 60% of sessions and 53% of core activities. Teachers with “very good” school coordinators (34% of teachers) taught more activities than those with “satisfactory” (43%) or no (34%) school coordinator (27.5 vs. 16.8 vs. 14.8, F = 12.86, P < 0.001). Teachers who had attended online training or both online and in-person training taught more sessions (6.1 vs. 6.2 vs. 3.6, F = 4.76, P < 0.01) and more core activities (21.1 vs. 20.8 vs. 12.6, F = 3.35, P < 0.05) than those who received no training. Teachers’ implementation was associated with improved student outcomes (preventive reproductive health skills, self-efficacy, and intention).
Conclusions
Implementation fidelity in the Family Islands suffered from Hurricane Dorian and the COVID-19 pandemic that disrupted education in The Bahamas. However, we identified several strategies that supported teachers’ implementation in response to these events. Teacher training and implementation monitoring increased implementation fidelity despite external challenges, and students achieved the desired learning outcomes. These strategies can better support teachers’ implementation of school-based interventions during future crises.
The Peruvian COVID-19 Immunization Program: lessons learned from a policy evaluation
Authors: Quispe Antonio , Jimenez Gabriela , Vargas Lucía , Castro Julio , Cevallos Hernando 
Published: June 2022

Abstract
Peru started its COVID-19 Immunization Program after recording the highest mortality worldwide during the first wave of the pandemic and halfway through its second wave. However, it became one of the fastest developing countries to cover 80% of its adult population with two COVID-19 vaccine doses. Overall, from the beginning of the Program in February 2021 up to March 2022, Peru delivered 66.2 million vaccine doses in a country with 32.8 million inhabitants. To do so, Peru successfully implemented a COVID-19 Immunization Program using an intersectoral and multidisciplinary approach. In addition, and more importantly, the Program included the participation of traditional and nontraditional health leaders. Peru's experience from previous immunization campaigns played a crucial role in its success. This experience allowed Peru to tackle challenges such as having over 80 original languages, a segmented and fragmented health system, and a vast territory with remote communities across coastal, highland, and jungle regions. This manuscript reports the findings of the policy evaluation of the Peru COVID-19 Immunization Program and collects the critical lessons learned during the Program’s first year of implementation.
Association of CYP24A1 with survival and drug resistance in clinical cancer patients: a meta-analysis
Authors: Zeng Rui , Li Hua , Lee Sau Har , Jiang Rilei , Jia Lingyan , Zhang Yujia , Hu Xudong , Ye Tingjie , Wang Xiaoling , Yan Xiaofeng , Lu Yanlin , Sun Zhumei , Xu Jiatuo , Xu Wei 
Published: June 2022

Abstract
BackgroundAcquired chemo-drug resistance constantly led to the failure of chemotherapy for malignant cancers, consequently causing cancer relapse. Hence, identifying the biomarker of drug resistance in cancer is vital to improve the treatment efficacy. The clinical prognostic value of CYP24A1 remains conclusive, we aim to evaluate the association between CYP24A1 and the drug resistance in cancer patients through a meta-analysis approach. MethodRelevant studies detecting the expression or SNP of CYP24A1 in cancer patients up till May 2022 were systematically searched in four common scientific databases including PubMed, EMBASE, Cochrane library and ISI Web of Science. The pooled hazard ratios (HRs) indicating the ratio of hazard rate of survival time between CYP24A1high population vs CYP24A1low population were calculated. The pooled HRs and odds ratios (ORs) with 95% confidence intervals (CIs) were used to explore the association between CYP24A1’s expression or SNP with survival, metastasis, recurrence, and drug resistance in cancer patients. ResultFifteen studies were included in the meta-analysis after an initial screening according to the inclusion and exclusion criteria. There was a total of 3784 patients pooled from all the included studies. Results obtained indicated that high expression or SNP of CYP24A1 was significantly correlated with shorter survival time with pooled HRs (95% CI) of 1.21 (1.12, 1.31), metastasis with pooled ORs (95% CI) of 1.81 (1.11, 2.96), recurrence with pooled ORs (95% CI) of 2.14 (1.45, 3.18) and drug resistance with pooled HRs (95% CI) of 1.42 (1.17, 1.68). In the subgroup analysis, cancer type, treatment, and detection approach for CYP24A1 did not affect the significance of the association between CYP24A1 expression and poor prognosis. ConclusionFindings from our meta-analysis demonstrated that CYP24A1’s expression or SNP was correlated with cancer progression and drug resistance. Therefore, CYP24A1 could potentially be used as a molecular marker for cancer resistance.
The Role of Foreign Direct Investment in East and Southeast Asia: Evidence Before and After 2009 Global Financial Crisis
Authors: Wang Yi-Chia 
Published: June 2022

Abstract
This study quantifies the direct and spillover effects of foreign direct investment (FDI) on labor productivity in 17 East and Southeast Asian economies during the period 1980 to 2019. The growth accounting regressions used herein reveal the following findings in host economies over the period. First, the stocks of FDI and physical capital both have direct, significant, and positive contributions to labor productivity, and they are mutually substitutable in the production process. Second, human capital stock is not found to be productive, with and without its interactions with FDI stock. Third, the global financial crisis in 2009 has led to serious structural changes. Before the end of 2009, FDI stock had positive but minor significant effects on labor productivity, and physical capital stock is a dominant factor input in the production process. After 2009, although the contribution of physical capital stock to labor productivity increased three times, its dominance has been replaced by FDI stock since its output share becomes significant and greater than that of physical capital stock. In addition, the mutual substitutability between stocks of FDI and physical capital has grown by 16 times, showing an increasing level of competitiveness between FDI and domestic investment.
EAKT: Embedding Cognitive Framework with Attention for Interpretable Knowledge Tracing
Authors: Pu Yanjun , Wu Wenjun , Peng Tianhao , Liu Fang , Liang Yu , Yu Xin , Chen Ruibo , Feng Pu 
Published: June 2022

Abstract
Recently, deep neural network-based cognitive models such as deep knowledge tracing have been introduced into the field of learning analytics and educational data mining. Despite an accurate predictive performance of such models, it is challenging to interpret their behaviors and obtain an intuitive insight into latent student learning status. To address these challenges, this paper proposes a new learner modeling framework named the EAKT, which embeds a structured cognitive model into a transformer. In this way, the EKAT not only can achieve an excellent prediction result of learning outcome but also can depict students’ knowledge state on a multi-dimensional knowledge component(KC) level. By performing the fine-grained analysis of the student learning process, the proposed framework provides better explanatory learner models for designing and implementing intelligent tutoring systems. The proposed EAKT is verified by experiments. The experimental results show that the EAKT can accurately trace changes in the students’ knowledge state and predict the future performance of student learning.
Predicting overall survival in diffuse glioma from the presurgical connectome
Authors: Kesler Shelli R , Harrison Rebecca A , Rao Vikram , Dyson Hannah , Petersen Melissa , Prinsloo Sarah 
Published: June 2022

Abstract
Diffuse gliomas are incurable brain tumors, yet there is significant heterogeneity in patient survival. Advanced computational techniques such as radiomics show potential for presurgical prediction of survival and other outcomes from neuroimaging. However, these techniques ignore non-lesioned brain features that could be essential for improving prediction accuracy. Whole-brain network (connectome) features were retrospectively identified from 305 adult patients diagnosed with diffuse glioma. These features were entered into a Cox proportional hazards model to predict overall survival with 10-folds cross-validation. The mean time-dependent area under the curve (AUC) of the connectome model was compared with the mean AUCs of clinical and radiomic models using a pairwise t-test with Bonferroni correction. One clinical model included only features that are known presurgery (clinical) and another included an advantaged set of features that are not typically known presurgery (clinical+). The median survival time for all patients was 134.2 months. The connectome model (AUC 0.88 +/- 0.01) demonstrated superior performance (P < 0.001, corrected) compared to the clinical (AUC 0.61 +/- 0.02), clinical+ (AUC 0.79 +/- 0.01) and radiomic models (AUC 0.75 +/- 0.02). These findings indicate that the connectome is a feasible and reliable early biomarker for predicting survival in patients with diffuse glioma. Connectome models could be valuable tools for precision medicine by informing patient risk stratification and treatment decision-making.
Visual Concept of Game Heroic Education Based on Player-Centered Design
Authors: Mu'minin Amirul , Mutiaz Intan Rizky 
Published: June 2022

Abstract
A national hero represents a nation as a role model with heroic values that need to be introduced to Z-generation as students. The case study of this research is Himayatuddin Muhammad Saidi as, the 185th national hero from Indonesia, November 2019. The design process is carried out using the Player-Centered Design method, which is explained in terms of Mission Understanding Human Motivation, Implementing Game Mechanics, Manage, and Measure in usability testing. The visual concept of the game is sourced from Gen-Z responses by 73 respondents by assessing four-game designs, which ANOVA analyzed. The dominant preference is the strategy game genre with an average score (71.25), Action (69.94), RPG (67.09), and Adventure (63.87). Through research and experimentation, it was found that ten components make up a heroic game. Then usability testing was carried out with measurement results using a Likert scale and Nielsen's model by 25 students. The heroic game design has an average response of 4.45, i.e., 89% success, ready to be used by Gen-Z in Indonesia and on the International scale.
Ethnic variation in the onset age of menopause and its consequences on women’s health
Authors: Benyo Sarah , Brown Michelle , Singh Rama 
Published: June 2022

Abstract
Background: Reproduction is a major determinant of health in women. To investigate whether female reproductive physiology is still evolving in different ethnic populations, the relationship between ethnicity and onset age of menopause was examined. The relationship between menopause and women’s health was additionally investigated to reflect on the increased risk of serious health conditions following the hormonal fluctuations associated with menopause. Methods: All data used to complete the study’s statistical analyses were obtained from the Study of Women’s Health Across the Nation (SWAN). Women from five ethnicities were included: African American, Chinese, Japanese, Caucasian, and Hispanic. The onset ages of early perimenopause, late perimenopause, and post-menopause were considered, as well as race and diagnoses of stroke, heart attack, osteoporosis, and diabetes. Both ANOVA and Tukey’s honestly significant difference (HSD) tests were performed. Results: We found that the population of Chinese women reached late perimenopause and the population of Japanese women reached both late perimenopause and post-menopause significantly later than African American women. The cohort of Hispanic women reached late perimenopause significantly earlier than most ethnicities, excluding African American women, and reached post-menopause significantly later than all ethnicities. Various associations between the onset of menopause and diagnoses of serious health conditions, including osteoporosis, heart attack, and stroke, were found, individually and in combination with other variables. Conclusions: The ethnicity-related variation found within the onset age of late perimenopause and post-menopause in the SWAN populations suggests that female reproductive changes are still evolving in different ethnicities. The associations found between menopause and women’s health suggest that menopause plays a substantial role in the diagnosis of serious health conditions such as heart attacks, stroke, and osteoporosis. Future studies should consider the impact of both biological (menopause) and non-biological factors on the variation seen in middle-aged women’s health and focus on practical applications in women’s healthcare.
Overexpression of ClRAP2.4 in Chrysanthemum enhances tolerance to cold stress
Authors: Ren Manrong , Yang Wenting , Zhang Jianing , Zhao Li , Quan Yingjie , He Zihan , Xu Yanan , Zhang Fageng , Yin Ming , Wang Yaoying , gao ri 
Published: June 2022

Abstract
The apetala/ethylene responsive factor (AP2/ERF) family is one of the largest plant-specific transcription factors and plays a vital role in plant development and response to stress. The apetala 2.4 (RAP2.4) gene is a member of the AP2/ERF family. Whether RAP2.4 is involved in low-temperature stress in chrysanthemum is unknown. Here, we cloned the ClRAP2.4 cDNA fragment containing an open reading frame of 768 bp. Phylogenetic analysis showed that ClRAP2.4 was most closely related to AT1G22190 and belonged to the DREB subfamily. The ClRAP2.4 protein is localized in the cell nucleus and promotes transcriptional activation in yeast. We obtained four overexpression lines (OX-1, OX-2, OX-7, and OX-8) using the Agrobacterium-mediated leaf disc method. The overexpression of ClRAP2.4 in chrysanthemum increased tolerance to cold stress. The activities of superoxide dismutase (SOD) and peroxidase (POD) and the proline content in the transgenic chrysanthemum leaf were higher than those in the wild type (WT) under cold stress, but electrical conductivity and malondialdehyde (MDA) content in transgenic plants increased rapidly with decreasing temperature.We have identified 390 differentially expressed genes (DEGs) between the transgenic plants and wild type using RNA-Seq, among which, 229 were upregulated and 161 were downregulated. The number of ABRE, LTR, and DRE cis-elements in the DEGs promoter were 175, 106, and 46, respectively. The relative expression levels of ClCOR, ClAPX, ClAP, ClNCL, ClPLK, ClFAD, ClMYB in transgenic plants were higher than those in WT plants at low temperatures. Collectively, these data suggest that ClRAP2.4 may increase chrysanthemum tolerance to cold stress.
Enhanced fear limits behavioral flexibility in a mouse model of autism spectrum disorder
Authors: Yun Miru , Kim Eunjoon , Jung Min Whan 
Published: June 2022

Abstract
Background: A core symptom of autism spectrum disorder (ASD) is repetitive and restrictive patterns of behavior. Cognitive inflexibility has been proposed as a potential basis for these symptoms of ASD. More generally, behavioral inflexibility has been proposed to underlie repetitive and restrictive behavior in ASD. Here, we investigated whether and how behavioral flexibility is compromised in a widely used animal model of ASD.Methods: We compared the behavioral performance of Shank2-knockout mice and wild-type littermates in reversal learning employing a probabilistic classical trace conditioning paradigm. A conditioned stimulus (odor) was paired with an unconditioned appetitive (water, 6 µl) or aversive (air puff) stimulus in a probabilistic manner. We also compared air puff-induced eye closure responses of Shank2-knockout and wild-type mice.Results: Male, but not female, Shank2-knockout mice showed impaired reversal learning when the expected outcomes consisted of a water reward and a strong air puff. Moreover, male, but not female, Shank2-knockout mice showed stronger anticipatory eye closure responses to the air puff compared to wild-type littermates, raising the possibility that the impairment might reflect enhanced fear. In support of this contention, male Shank2-knockout mice showed intact reversal learning when the strong air puff was replaced with a mild air puff and when the expected outcomes consisted of only rewards. Limitations: We examined behavioral flexibility in one behavioral task (reversal learning in a probabilistic classical trace conditioning paradigm) using one ASD mouse model (Shank2-knockout mice). Thus, future work is needed to clarify the extent to which our findings (that enhanced fear limits behavioral flexibility in ASD) can explain the behavioral inflexibility associated with ASD. Also, we examined only the relationship between fear and behavioral flexibility, leaving open the question of whether abnormalities in processes other than fear contribute to the behavioral inflexibility in ASD. Finally, the neurobiological mechanisms linking Shank2-knockout and enhanced fear remain to be elucidated. Conclusions: Our results indicate that enhanced fear suppresses reversal learning in the presence of an intact capability to learn cue-outcome contingency changes in Shank2-knockout mice. Our findings suggest that behavioral flexibility might be seriously limited by abnormal emotional responses in ASD.
An unusual sternalis with variation of the contralateral sternocleidomastoid muscle: A Case Report
Authors: Duan Jingjing , Xu Dazheng , Guo Kaihua , Zou Huijin , Chen Jihang , Wang Xing , Zhang Haoting , Fu Yilin , Wang Yanheng , Chen Zihang , Zhang Ruikai , Zhang Linhan 
Published: June 2022

Abstract
Purpose
To report a previously undocumented variant of sternalis.
Methods
An unusual muscle was observed during routine dissection.
Results
The sternalis muscle located in the right thoracic region originated from the superior portion of the rectus abdominis sheath and 5-6th costal cartilages, crossed the midline and attached at the sternum. The muscle fibers then ascended with the left sternocleidomastoid muscle as an additional fasciculus, of which the superior ends were finally terminated at the left mastoid process. The sternalis muscle of the thoracic region was innervated by the anterior cutaneous branches of right intercostal nerve, while the additional fasciculus ascended with the left sternocleidomastoid muscle was innervated by the branches of left accessory nerve.
Conclusions
This study presents a unilateral sternalis muscle with the contralateral sternocleidomastoid variation. It will enhance the exhaustive classification of sternalis, and provide significant information to radiologists, angiologists and surgeons for better interpretation of images and safer interventions.
Effects of abnormal expression of CD73 on malignant phenotype in nasopharyngeal carcinoma
Authors: Jiang Bin , Tang Mingming , Shi Si , Xie Haijing , Pan Si , Zhang Lin , Sheng Juping 
Published: June 2022

Abstract
Background Cluster of differentiation (CD) 73, encoded by the NT5E gene, plays important enzymatic and non-enzymatic roles in cells. There is growing evidence show that CD73 is a key regulator in the development of tumor. Nasopharyngeal carcinoma (NPC) is one of the most common cancers in east and southeast Asia. It is urgent to know more about the mechanism of NPC development and find diagnose markers for the patients.Methods and Results Western blot, IHC and qRT-PCR were used to investigate the expression level of CD73 in NPC and we found NPC tissues had higher expression of CD73 than normal tissues. We also detected the relationship between its expression level with the clinicopathology and prognosis of NPC patients. The results showed CD73 expression was related to the clinical stages, lymph node metastasis and survival state of NPC patients. More importantly, patients with higher expression of CD73 had poorer prognosis. Then, CD73 was knocked down in NPC cells (CNE2 and CNE1), and the effects of CD73 on cell proliferation and migration were investigated by CCK8, colony formation, Transwell and wound-healing assays. We found knocking down the expression of CD73 in NPC cells could inhibit cells malignant phenotype.Conclusion CD73 plays important roles in NPC malignant behavior and might be used as a novel target for the diagnose and treatment of NPC.
The relation between infertility factor and sexual functioning, perceived social support and adherence to treatment in infertile women
Authors: Sheikhian Marzie , Loripoor Marzeyeh , Ghorashi Zohreh , Safdari Faranak 
Published: June 2022

Abstract
Background
In some societies, childbearing is a part of women’s identity and infertile women are under a great amount of pressure from others. The present study was conducted to evaluate the relation between infertility factor and sexual functioning, perceived social support and adherence to treatment in infertile women.
Methods
In the present descriptive analytical cross-sectional stud, 230 infertile women who referred to the infertility center of Shahrekord during 2022 were enrolled using convenient sampling method. Data were collected using demographic characteristics checklist, Female Sexual Function Index (FSFI), Multidimensional Scale of Perceived Social Support (MSPSS), and General Adherence Scale (GAS) and were analyzed using SPSS software and chi square test, independent t test, one-way variance analysis, Tukey post hoc test and Pearson correlation coefficient.
Results
There was no significant relation between infertility factor and the mean score of sexual functioning. Among the aspects of sexual functioning, only the mean score of lubrication in the group of male factors was significantly higher than the common factors for men and women (p = 0.07). There was also no significant relation between infertility factor and the mean score of perceived social support and the mean score of adherence to treatment (p > 0.05). There was a linear positive relation between sexual functioning (r = 0.189), perceived social support (r = 0.200) and adherence to treatment (r = 0.146) in infertile women.
Conclusions
Results showed no significant relation between sexual functioning, perceived social support and adherence to treatment with infertility factor in infertile women.