bluuebunny/crossref_metadata_2025 huggingface dataset:
Uncovering Trend-based Research Insights on Teaching & Learning in Big Data
Authors: Park Young-Eun
Published: September 2020

Along with the occurrence of the big data era, digital transformation has had a transformative effect on modern education tremendously in higher education. It transforms an institutional core value of education to better meet students' needs by leveraging big data and digital technology. Based on this background, this study attempts to catch the principal trends, or new directions, paradigms as predictors with an association of each topic by discovering the up-to-date research trends on teaching and learning in higher education via text mining technique. For this, 285 research articles in the area of teaching and learning in higher education were collected from several big databases (distinguishable publishers' web platforms) through search engines for two years in 2018 ~ 2019. Then it was analyzed using a semantic network analysis that processes natural human language. In consequence, research results show a relatively high connection with 'student' or 'student-centered/led' rather than 'teacher-led.' Moreover, it exhibits that the practice and assessment in learning can be attained via diverse learning activities, containing community or outreach activities. Besides, research in academic contexts, experience-based classes, the effect of group activities, how students' feelings or perceptions, and relationships affect learning outcomes were addressed as the main topics through topic modeling of LDA, a machine learning algorithm. This study proposes that educators, researchers, and even academic leaders can exert the extraordinary power to reshape educational quality programs for future education and in a timely manner with recognizable trends or agendas in teaching and learning of higher education.
Investigation of the differences between the medical personnel’s and general population’s view on the doctor-patient relationship in China by a cross-sectional survey
Authors: Sang Tianqing , Zhou Hongli , Li Muhan , Li Wenting , Shi Haibo , Chen Haibin , Zhou Hongguang
Published: September 2020

Background: Due to economic development and an increase in the aging population, the demand for medical resources is increasing. A good doctor-patient relationship (DPR) can optimize patients’ medical experience and improve treatment efficiency. The DPR, however, is currently in crisis in China. To explore ways to improve DPR, this study assessed the views on the status of the DPR, medical services, and the general situation of medical work among medical personnel (MP) and the general population (GP). Methods: This cross-sectional study, conducted between December 2019 and March 2020, targeted the MP and the GP in Nanjing City, Jiangsu Province, and Zhengzhou City, Henan Province. A total of 154 MP and 329 GP answered a self-administered questionnaire through Questionnaire Star and WeChat apps. Wilcoxon's Sign Rank Test, Chi-square test, and frequency distributions and percentages were used to process the data. Results: Only 11.04% of the MP and 14.89% of the GP believed that the current DPR was harmonious. Moreover, 54.55% of the MP and 71.12% of the GP believed that the medical industry was a service industry. While 14.29% of the MP and 64.44% of the GP thought medical staff earned high salaries, 19.48% of the MP and 47.11% of the GP wanted their children to be in the medical industry. The recognition of the current status of the DPR did not affect the GP’s preference for their children's practice (p<0.05). Most MPs hoped to improve salaries (40.26%), followed by safety (17.53%) and social status (12.99%); only 8.44% of the MP wanted to improve the DPR. Conclusion: The MP’s and GP’s views on the current status of DPR, the importance of medical service attitudes, and the general sense of the medical industry were similar. However, there was a significant difference in the perception of the nature of medical services and the income of the people employed in the medical industry between the two groups. Balancing the expectations of patients in the medical industry and increasing public awareness of the actual situation in the medical industry may be a feasible way to improve the DPR.
The sniffing bead system, an olfactory dysfunction screening tool for geriatric subjects: A cross-sectional study
Authors: Min Hyun Jin , Kim Sun Mi , Han Doug Hyun , Kim Kyung Soo
Published: September 2020

Background: This study aimed to develop a simple and one-off olfactory screening test, the sniffing bead system, for general clinical use in older adults. Methods: In this cross-sectional study, geriatric subjects (aged > 50 years) who underwent neurocognitive and olfactory function tests were included. Overall, 137 subjects were enrolled, and the study was conducted at Chung-Ang University, Seoul, Korea. Olfactory function was measured by obtaining the scores of the sniffing bead system using 2-phenylethyl alcohol, n-butanol, and the YSK olfactory function test. Time taken for each olfactory function test was also measured.Results: The score of the 2-phenylethyl alcohol sniffing bead test was 2.58 ± 1.52, which was significantly associated with the YSK_threshold (2.41 ± 1.79) (p < 0.001, Pearson's correlation coefficient = 0.429), YSK_identification (8.93 ± 3.25) (p = 0.014, Pearson's correlation coefficient = 0.208) and YSK_threshold-discrimination-identification (17.46 ± 5.49) (p < 0.001, Pearson's correlation coefficient = 0.316) test scores. In the normal cognitive function group, YSK_threshold (p < 0.001, Pearson's correlation coefficient = 0.479), YSK_identification (p = 0.003, Pearson's correlation coefficient = 0.316), and YSK_threshold-discrimination-identification (p < 0.001, Pearson's correlation coefficient = 0.429) were significantly correlated with the scores of the 2-phenylethyl alcohol sniffing bead system. In the impaired cognitive function group, the YSK_threshold (p = 0.002, Pearson's correlation coefficient = 0.415) and YSK_ threshold-discrimination-identification (p = 0.004, Pearson's correlation coefficient = 0.385) were significantly correlated with the scores of the 2-phenylethyl alcohol sniffing bead system. Time taken for the 2-phenylethyl alcohol sniffing bead system was 5.00 ± 1.51 min, which was significantly lower than that for the YSK_threshold-discrimination-identification (20.43 ± 5.29 min) (p < 0.001). The scores of the 2-phenylethyl alcohol sniffing bead system were significantly correlated with those of the n-butanol sniffing bead system (3.50 ± 1.21) (p < 0.001, Pearson's correlation coefficient = 0.315). Conclusions: This sniffing bead system was specifically designed for screening olfactory function in older adults, and it may allow for the rapid and accurate assessment of olfactory dysfunction.
Polyethylenimine-Based Theranostic Nanoplatform for Glioma-Targeting Single-Photon Emission Computed Tomography Imaging and Anticancer Drug Delivery
Authors: Zhao Lingzhou , Zhu Jingyi , Gong Jiali , Song Ningning , Wu Shan , Qiao Wenli , Yang Jiqin , Zhu Meilin , Zhao Jinhua
Published: September 2020

Background: Glioma is the deadliest brain cancer in adults because the blood-brain-barrier (BBB) prevents the vast majority of therapeutic drugs from entering into the central nervous system. The development of BBB-penetrating drug delivery systems for glioma therapy still remains a great challenge. In this study, we aimed to design and develop a theranostic nanocomplex with enhanced BBB penetrability and tumor-targeting efficiency for glioma single-photon emission computed tomography (SPECT) imaging and anticancer drug delivery.Results: This multifunctional nanocomplex was manufactured using branched polyethylenimine (PEI) as a template to sequentially conjugate with methoxypolyethylene glycol (mPEG), glioma-targeting peptide chlorotoxin (CTX), and diethylenetriaminepentaacetic acid (DTPA) for 99mTc radiolabeling on the surface of PEI. After the acetylation of the remaining PEI surface amines using acetic anhydride (Ac2O), the CTX-modified PEI (mPEI-CTX) was utilized as a carrier to load chemotherapeutic drug doxorubicin (DOX) in its interior cavity. The formed mPEI-CTX/DOX complex had excellent water dispersibility and released DOX in a sustainable and pH-dependent manner; furthermore, it showed targeting specificity and therapeutic effect of DOX toward glioma cells in vitro and in vivo (a subcutaneous tumor mouse model). Owing to the unique biological properties of CTX, the mPEI-CTX/DOX complex was able to cross the BBB and accumulate at the tumor site in an orthotopic rat glioma model. In addition, after efficient radiolabeling of PEI with 99mTc via DTPA, the 99mTc-labeled complex could help to visualize the drug accumulation in tumors of glioma-bearing mice and the drug delivery into the brains of rats through SPECT imaging.Conclusions: These results indicate the potential of the developed PEI-based nanocomplex in facilitating glioma-targeting SPECT imaging and chemotherapy.
Uncomplicated falciparum malaria among schoolchildren in Bajil district of Hodeidah governorate, west of Yemen: association with anaemia and underweight
Authors: Alwajeeh Talal S , Abdul-Ghani Rashad , Allam Amal F. , Farag Hoda F. , Khalil Safia S.M. , Shehab Amel Y. , El-Sayad Mona H. , Alharbi R.A. , Al Shaia S.R. , Azazy Ahmed A.
Published: September 2020

BackgroundMalaria, malnutrition and anaemia are major public health problems in Yemen, with Hodeidah being the most malaria-afflicted governorate. To address the lack of relevant studies, this study was conducted to determine the prevalence of Plasmodium falciparum and its relation to nutritional status and haematological indices among schoolchildren in Bajil district of Hodeidah governorate, west of Yemen. Methods A cross-sectional study was conducted among 400 schoolchildren selected randomly from four schools in Bajil district. Data about demographic characteristics, risk factors and anthropometric measurements of age, height and weight were collected. Duplicate thick and thin blood films were prepared, stained with Giemsa and examined microscopically for malaria parasites. The density of P. falciparum asexual stages was estimated on thick films. EDTA-blood samples were examined for the haematological indices of haemoglobin (Hb) and blood cell counts. Results Plasmodium falciparum was prevalent among 8.0% (32/400) of schoolchildren with a mean parasite density of 244.3 299.3/µl of blood and most infections showing low-level parasitaemia, whereas Plasmodium vivax was detected in one child (0.25%). Residing near water collections was a significant independent predictor of falciparum malaria (adjusted odds ratio (AOR) = 2.6, 95.0% CI: 1.20-5.72; p = 0.016) in schoolchildren. Mild anaemia was prevalent among more than half of P. falciparum-infected schoolchildren and significantly associated with falciparum malaria (AOR = 5.8, 95.0% CI: 2.39-14.17; p <0.001), with a mean Hb concentration of 10.7 1.0 g/dL. Although the mean values of the total white blood cells, monocytes and platelets were significantly lower in infected than non-infected schoolchildren, they were within normal ranges. More than half of the children were malnourished, with stunting (39.3%) and underweight (36.0%) being the most prevalent forms of malnutrition; 6.3% of children were wasted. Underweight (AOR = 5.3, 95.0% CI: 2.09-13.62; p <0.001) but not stunting or wasting, was a significant predictor of falciparum malaria among schoolchildren. ConclusionAsymptomatic falciparum malaria is prevalent among schoolchildren in Bajil district of Hodeidah Governorate, with predominance of low parasitaemic infections and significant association with mild anaemia and underweight. Residence near water collection is a significant predictor of infection with falciparum malaria among schoolchildren. Further studies among children with severe malaria and those with high parasite densities are recommended.
Clinical Characteristics of Pediatric Inflammatory Multisystem Syndrome Associated with COVID-19
Authors: Shahbaznejad Leila , Navaifar Mohammad Reza , Abbaskhanian Ali , Hosseinzadeh Fatemeh , Rahimzadeh Golnar , Rezai Mohammad Sadegh
Published: September 2020

Background: Although symptoms and signs of COVID-19 (Coronavirus disease 2019) in children are milder than adults, there are reports of more severe cases which were defined as pediatric inflammatory multisystem syndrome (PIMS). The purpose of this report was to describe the possible association between COVID-19 and PIMS in children. Methods: From 28 March to 24 June 2020, 10 febrile children were admitted with COVID-19 infection showing characteristics of PIMS in Buali tertiary hospital of Sari, in Mazandaran province, northern Iran. Demographic and clinical characteristics, laboratory and imaging findings, and therapeutic modalities were recorded and analyzed. Results: The mean age of the patients was 5.37±3.9 years (13 months to 12 years). Six of them were boys. Kawasaki disease, myocarditis, toxic shock syndrome, appendicitis, sepsis, urosepsis, prolonged febrile seizure, acute hemorrhagic edema of infancy, and COVID-19-related pneumonia were their first presentation. All of them had increased C-reactive protein levels, and most of them had elevated erythrocyte sedimentation rate, lymphopenia, anemia, and hypoalbuminemia. Some of them had thrombocytopenia. Six of them were serologically or polymerase chain reaction positive for COVID-19, and 4 of them were diagnosed as COVID-19 just by chest computed tomography scan. Most of the patients improved without a residual sequel, except one who died with multiorgan failure and another case was discharged with a giant coronary aneurysm. Conclusion: Children with COVID-19 may present symptoms similar to Kawasaki disease and inflammatory syndromes. PIMS should be considered in children with fever, rash, seizure, cough, tachypnea, and gastrointestinal symptoms such as vomiting, diarrhea, and abdominal pain.
Bone marrow mesenchymal stem cell-derived exosomes promote rotator cuff tendon-bone healing by promoting angiogenesis and regulating M1 macrophages in rats
Authors: Huang Yao , He Bing , Wang Lei , Yuan Bin , Shu Hao , Zhang Fucheng , Sun Luning
Published: September 2020

Background: Rotator cuff tears (RCTs) often require reconstructive surgery. Tendon-bone healing is critical for the outcome of rotator cuff reconstruction, but the process of tendon-bone healing is complex and difficult. Mesenchymal stem cells (MSCs) are considered to be an effective method to promote tendon-bone healing. MSCs have strong paracrine, anti-inflammatory, immunoregulatory, and angiogenic potential. Recent studies have shown that MSCs achieve many regulatory functions through exosomes. The purpose of this study was to explore the role of bone marrow mesenchymal stem cell-derived exosomes (BMSC-Exos) in tendon-bone healing. Methods: Our study found that BMSC-Exos promote the proliferation, migration, and angiogenic tube formation of Human Umbilical Vein Endothelial Cells (HUVECs). The mechanism by which BMSC-Exos achieve this may be through the regulation of the angiogenic signaling pathway. In addition, BMSC-Exos can inhibit the polarization of M1 macrophages and inhibit the secretion of proinflammatory factors by M1 macrophages. After rotator cuff reconstruction in rats, BMSC-Exos were injected into the tail vein to analyze their effect on the rotator cuff tendon-bone interface healing. Results: It was confirmed that BMSC-Exos increased the breaking load and stiffness of the rotator cuff after reconstruction in rats, induced angiogenesis around the rotator cuff endpoint, and promoted growth of the tendon-bone interface. Conclusion: BMSC-Exos promote tendon-bone healing after rotator cuff reconstruction in rats by promoting angiogenesis and inhibiting inflammation.
Regulation of Connective Tissue Growth Factor Expression by miR-133b for the Treatment of Renal Interstitial Fibrosis in Aged Mice with Unilateral Ureteral Obstruction
Authors: Cao Dan , Wang Yuan , Zhang Yingjie , Zhang Yinping , Huang Qi , Yin Zhong , Cai Guangyan , Chen Xiangmei , Sun Xuefeng
Published: September 2020

Introduction: Renal interstitial fibrosis, an important pathological feature of kidney aging and chronic renal failure, is regulated by mesenchymal stem cells (MSCs). We have previously demonstrated low expression of miR-133b in MSC-derived extracellular vesicles (MSC-EVs) in aged rats. However, miR-133b can mediate the inhibition of epithelial-mesenchymal transition (EMT) of renal tubules induced by transforming growth factor-β1 (TGF-β1). We investigated the effect of miR-133b for the treatment of geriatric renal interstitial fibrosis and evaluated its target genes.Methods: We performed real-time polymerase chain reaction to detect miR-133b expression induced during EMT of HK2 cells by TGF-β1 at different concentrations (0, 6, 8, and 10 ng/mL) and at different time points (0, 24, 48, and 72 h). The target genes of miR-133b were validated using the dual-luciferase reporter assay. In vitro experiments were performed to evaluate mRNA and protein expression of miR-133b targets, E-cadherin, α-smooth muscle actin (SMA), fibronectin, and collagen 3A1 (Col3A1), in HK2 cells transfected with miR-133b under TGF-β1 stimulation. A 24-month-old unilateral ureteral obstruction (UUO) mouse model was established and injected with transfection reagent and miR-133b into the caudal vein. The target gene of miR-133b and other parameters mentioned above such as mRNA and protein expression levels and renal interstitial fibrosis were detected at 7 and 14 days.Results: miR-133b expression gradually decreased with an increase in TGF-β1 concentration and treatment time, and the miR-133b mimic downregulated connective tissue growth factor (CTGF) expression. The dual-luciferase reporter assay confirmed CTGF as a direct target of miR-133b. Transfection of the miR-133b mimic inhibited TGF-β1-induced EMT of HK2 cells; this effect was reversed by CTGF overexpression. miRNA-133b expression significantly increased (approximately 70-100 times) in mice kidney tissues after injection of the miRNA-133b overexpression complex, which significantly alleviated renal interstitial fibrosis in mice with UUO.Conclusion: miR-133b exerted targeted inhibitory effects on CTGF expression, which consequently reduced TGF-β1-induced EMT of HK2 cells and renal interstitial fibrosis in aged mice with UUO.
Multidimensional Analysis of the Learning Curve of Laparoscopic Colorectal Surgery in a Regional Hospital. The Implementation of a Standardised Surgical Procedure Counterbalances the Lack of Experience.
Authors: Gkionis Ioannis G. , Flamourakis Mathaios E. , Tsagkataki Eleni S. , Kaloeidi Eleni I. , Spiridakis Konstantinos G. , Kostakis Georgios E. , Alegkakis Athanasios K. , Christodoulakis Manousos S.
Published: September 2020

Background: Although in the last few years a larger proportion of colorectal surgeries have been performed laparoscopically, a steep learning curve prevents us from considering laparoscopic colorectal surgery as the gold standard technique for treating disease entities in the colon and rectum. The purpose of this single center study is to determine, using various parameters and following a well structured and standardised surgical procedure, the adequate number of cases after which a single surgeon qualified in open surgery but with no previous experience of laparoscopic colorectal surgery and without supervision, can acquire proficiency in this technique.Methods: From 2012 to 2019, 112 patients with pathology in the rectum and colon underwent a laparoscopic colorectal resection by a team led by the same surgeon. The patients were divided into two groups (Group A:50 – Group B:62) and their case records and histopathology reports were examined for predefined parameters, statistically analyzed and compared between groups.Results: There was no significant difference between groups in the distribution of conversions (p=0.635) and complications (p=0.637). Patients in both groups were operated for the same median number of lymph nodes (p=0.145) and stayed the same number of days in hospital (p=0.109). A statistically important difference was found in operation duration both in total (p=0.006) and for each different type of colectomy (sigmoidectomy: p=0.026, right colectomy: p=0.013, Extralevator abdominoperineal resection: p=0.050, low anterior resection: p=0.083).Conclusions: Taking into consideration all the parameters, it is our belief that a surgeon acquires proficiency in laparoscopic colorectal surgery after performing at least 50 diverse cases with a well structured and standardised surgical procedure.
Influence of MIF polymorphisms on CpG island hyper-methylation of CDKN2A in the patients with ulcerative colitis
Authors: Sakurai Naoko , Shibata Tomoyuki , Nakamura Masakatsu , Takano Hikaru , Hayashi Tasuku , Ota Masafumi , Nomura-Horita Tomoe , Hayashi Ranji , Shimasaki Takeo , Otsuka Toshimi , Tahara Tomomitsu , Arisawa Tomiyasu
Published: September 2020

Background: CDKN2A hypermethylation is among the major events associated with carcinogenesis and is also observed in non-neoplastic colonic mucosa in patients with ulcerative colitis (UC). Macrophage migration inhibitory factor (MIF) plays a crucial role in promoting gastrointestinal inflammation characteristic of UC. The aim of this study is to explore associations between CDKN2A methylation status and MIF polymorphisms (rs755622 and rs5844572).Methods: One hundred and fifty-nine patients diagnosed with UC were enrolled in this study. The methylation status of p14ARF and p16INK4a was determined by MSP; MIF genotypes were identified by PCR-SSCP.Results: We found no differences with respect to mean age, gender, clinical type (chronic continuous or relapse/remitting), or extent of disease among the patients with methylated and unmethylated p14ARF or p16INK4a. Carrying the rs755622 C allele indicated a significantly higher risk for p14ARF methylation (odds ratio (OR), 2.16; 95% confidence interval (CI), 1.08-4.32; p=0.030); similarly, carrying the rs5844572 7-repeat allele indicated a significantly higher risk for p16INK4a methylation (OR, 2.57; 95% CI, 1.26–5.24; p=0.0094) after an adjusted regression analysis. The carriers of the rs755662 C allele or the rs5844572 7-repeat allele were both at a significantly higher risk for methylation of both p14ARF and p16INK4a when compared to the cohort in which neither of the genes were methylated (OR, 2.70; 95% CI, 1.22–6.01; p=0.015 and OR, 2.87; 95% CI, 1.25–6.62; p=0.013, respectively). Additionally, carrying rs755622 C allele was significantly associated with CIHM in chronic continuous of clinical type and total colitis (OR, 25.9; 95% CI, 2.55-262.6; p=0.0059 and OR, 4.38; 95% CI, 1.12-17.2; p=0.034, respectively), and carrying 7-repeat allele of rs5844572 was significantly associated in chronic continuous type (OR, 14.5; 95%CI, 1.46-144.3; p=0.022).Conclusions: Taken together, our findings suggest that MIF genotypes associated with inflammation may also be involved in promoting carcinogenesis via CDKN2A hypermethylation in patients diagnosed with UC.
De novo assembly and analysis of the transcriptome of the Dermacentor marginatus genes differentially expressed after blood feeding and long-term starvation
Authors: Hu Ercha , Meng Yuan , Ma Ying , Song Ruiqi , Hu Zhengxiang , Li Min , Hao Yunwei , Fan Xinli , Wei Liting Wei , Fan Shilong , Chen Songqin , Zhai Xuejie , Li Yongchang , Wei Zhang , Zhang Yang , Guo Qingyong , Bayin Chahan
Published: September 2020

Background: The ixodid tick Dermacentor marginatus is a vector of many pathogens wide spread in Eurasia. Studies of gene sequence on many tick species have greatly increased the information on tick protective antigen which might have the potential to function as effective vaccine candidates or drug targets for eco-friendly acaricide development. In the current study, RNA-seq was applied to identify D. marginatus sequences and analyze differentially expressed unigenes.Methods: To obtain a broader picture of gene sequences and changes in expression level, RNA-seq was performed to obtain the whole-body transcriptome data of D. marginatus adult female ticks after engorgement and long-term starvation. Subsequently, the real-time quantitative PCR (RT-qPCR) was applied to validate the RNA-seq data.Results: RNA-seq produced 30,251 unigenes, of which 32% were annotated. Gene expression was compared among groups that differed by status as newly molted, starved and engorged female adult ticks. Nearly 1/3 of the unigenes in each group were differentially expressed compared to the other two groups, and the most numerous were genes encoding proteins involved in catalytic and binding activities and apoptosis. Selected up-regulated differentially expressed genes in each group were associated to protein, lipids, carbohydrate and chitin metabolism. Blood-feeding and long-term starvation also caused genes differentially expressed in the defense response and antioxidant response. RT-qPCR results indicated 6 differentially expressed transcripts showed similar trends in expression changes with RNA-seq results confirming that the gene expression profiles in transcriptome data is in consistent with RT-qPCR validation.Conclusions: Obtaining the sequence information of D. marginatus and characterizing the expression pattern of the genes involved in blood feeding and during starvation would be helpful in understanding molecular physiology of D. marginatus and provides data for anti-tick vaccine and drug development for controlling the tick.
Is the perceived neighborhood built environment associated with domain-specific physical activity in Latin American adults? An eight-country observational study
Authors: Ferrari Gerson , Werneck André O. , Silva Danilo Rodrigues , Kovalskys Irina , Gómez Georgina , Rigotti Attilio , Sanabria Lilia Yadira Cortés , García Martha Cecilia Yépez , Pareja Rossina G. , Herrera-Cuenca Marianella , Zimberg Ioná Zalcman , Guajardo Viviana , Pratt Michael , Cristi-Montero Carlos , Rodríguez-Rodríguez Fernando , Marques Adilson , Cerin Ester , Dyck Delfien Van , Pires Carlos André Miranda , Fisberg Mauro
Published: September 2020

Background: Characteristics of the neighborhood built environment are associated with physical activity (PA). However, few studies with representative samples have examined environmental correlates of domain-specific PA in Latin America. We examined the associations of the perceived neighborhood built environment with domain-specific PA in a large sample of adults from eight Latin American countries.Methods: This study examined data from 8185 adults (aged 18–65 years) from eight Latin American countries. The Neighbourhood Environment Walkability Survey - Abbreviated (NEWS-A) scale was used to assess perceptions of land use mix–diversity, land use mix-access, street connectivity, walking/cycling facilities, aesthetics, safety from traffic, and safety from crime. Perceived proximity from home to public open spaces (metropolitan parks, playgrounds, public squares) and to shopping centers was also measured. Transport-related and leisure-time PA were assessed using the long form of the International Physical Activity Questionnaire. Both logistic and linear regression models were estimated on pooled data.Results: Perceptions of higher land use mix-access (OR: 1.40; 95% CI: 1.22,1.61), the existence of many alternative routes in the neighbourhood (1.12; 1.04,1.20), slow speed of traffic (1.19; 1.03,1.35) and few drivers exceeding the speed limits (1.09; 1.03,1.15) were associated with greater odds of reporting at least 10 min/week of transport-related PA. Perceptions of higher levels of land use mix-diversity, better aesthetics and greater safety from crime, the presence of crosswalks and pedestrian signals, and greater proximity of shopping centers were associated with more min/week of transport-related PA. Perceptions of higher land use mix-diversity (1.12; 1.05,1.20), higher land use mix-access (1.27; 1.13,1.43), more walking/cycling facilities (1.18; 1.09,1.28), and better aesthetics (1.10; 1.02,1.18) were associated with greater odds of engaging in at least 10 min/week of leisure-time PA versus none. Perceptions of higher land use mix-diversity were associated with more min/week of leisure PA.Conclusions: Different perceived neighborhood built environment characteristics were associated with domain-specific PA among adults from Latin America countries. Interventions designed to modify perceptions of the neighbourhood built environment might influence initiation or maintenance of domain-specific PA.Trial registration: ClinicalTrials.Gov NCT02226627. Retrospectively registered on August 27, 2014.
Unilateral synchronous papillary renal neoplasm with reverse polarity and clear cell renal cell carcinoma: a case report with KRAS and PIK3CA mutations
Authors: Lee Hyun Jung , Shin Dong Hoon , Park Joon Young , Kim So Young , Hwang Chung Su , Lee Jung Hee , Kim Jee Yeon , Sol Mee Young , Nam Jong Kil
Published: September 2020

Background: The presence of histologically different neoplasms in the same organ is rare in pathologic practice. We report the first case of synchronous clear cell renal cell carcinoma (clear cell RCC) and papillary renal neoplasm with reverse polarity (PRNRP) with comprehensive immunohistochemical and molecular characterization using next-generation sequencing (NGS). Case presentation: A 61-year-old man was incidentally found to have a left renal mass on imaging studies performed for workup of left back pain and urine color change for one week. A laparoscopic left radical nephrectomy was performed. Gross examination showed lobulated masses measuring 5.6 × 4.0 × 3.3 cm in the upper to mid pole and 1.1 × 1.0 × 1.0 cm in the lower pole. Microscopic findings revealed these to be two different separate masses of clear cell renal cell carcinoma and papillary renal neoplasm with reverse polarity. NGS analyses revealed KRAS gene mutation (c.35G>T/p.G12V in exon 2) in the papillary renal neoplasm with reverse polarity, with PIK3CA gene mutation restricted to the clear cell renal cell carcinoma (c.1624G>A/p.E542K in exon 10).Conclusions: We report here an extraordinarily rare case of synchronous renal tumors of papillary renal neoplasm with reverse polarity and clear cell renal cell carcinoma. We identified simultaneous KRAS and PIK3CA mutations in two different renal masses in the same kidney for the first time. New pathologic assessment with comparative molecular analysis of mutational profiles may be helpful for tumor studies.
Baseline Thrombopoietin Level is Associated with Platelet Count Improvement in Thrombocytopenic Chronic Hepatitis C Patients After Direct-Acting Antiviral Agent Therapy
Authors: Chen Yen-Chun , Ko Ping-Hung , Lee Chi-Che , Tseng Chih-Wei , Tseng Kuo-Chih
Published: September 2020

Background
Thrombocytopenia can rapidly improve in chronic hepatitis C (CHC) patients receiving direct-acting antiviral agents (DAA). The role of baseline (BL) thrombopoietin (TPO) in this phenomenon is unclear.
Methods
From June 2016 to February 2019, a total of 104 CHC patients receiving DAA, with a sustained virologic response and BL thrombocytopenia, at Dalin Tzu Chi Hospital, were enrolled in this retrospective study. Significant platelet count improvement and platelet count improvement ratio were analyzed for correlation with BL TPO.
Results
This cohort included 40 men (38.5%). Seventy-two (69.2%) patients had advanced fibrosis. The platelet count [median (range)] increased from 110.5 (32–149) × 103/µL at BL to 116.5 (40–196) and 118.0 (35–275) × 103/µL at end of treatment (EOT) and 12 weeks after EOT (P12), respectively, (EOT vs. BL, P < 0.001; P12 vs. BL, P < 0.001).BL TPO was positively correlated with significant platelet count improvement (P < 0.001), platelet count improvement ratio at EOT (P = 0.004), and P12 (P < 0.001). The area under the receiver operating characteristic curve and optimal cutoffs (pg/ml) were 0.77 (95% confidence interval, 0.67–0.86) and 120, respectively, for significant platelet count improvement prediction. The sensitivity, specificity, and accuracy were 88.6%, 71.7%, and 78.8%, respectively.
Conclusions
BL TPO level might be a useful marker for predicting significant platelet count improvement in thrombocytopenic patients after successful DAA therapy.
Deep Active Learning for Classifying Cancer Pathology Reports
Authors: De Angeli Kevin , Gao Shang , Alawad Mohammed , Yoon Hong-Jun , Schaefferkoetter Noah , Wu Xiao-Cheng , Durbin Eric B , Doherty Jennifer , Stroup Antoinette , Coyle Linda , Penberthy Lynne , Tourassi Georgia
Published: September 2020

Background: Automated text classiﬁcation has many important applications in the clinical setting; however, obtaining labelled data for training machine learning and deep learning models is often diﬃcult and expensive. Active learning techniques may mitigate this challenge by reducing the amount of labelled data required to eﬀectively train a model. In this study, we analyze the eﬀectiveness of eleven active learning algorithms on classifying subsite and histology from cancer pathology reports using a Convolutional Neural Network (CNN) as the text classiﬁcation model. Results: We compare the performance of each active learning strategy using two diﬀerently sized datasets and two diﬀerent classiﬁcation tasks. Our results show that on all tasks and dataset sizes, all active learning strategies except diversity-sampling strategies outperformed random sampling, i.e., no active learning. On our large dataset (15K initial labelled samples, adding 15K additional labelled samples each iteration of active learning), there was no clear winner between the diﬀerent active learning strategies. On our small dataset (1K initial labelled samples, adding 1K additional labelled samples each iteration of active learning), marginal and ratio uncertainty sampling performed better than all other active learning techniques. We found that compared to random sampling, active learning strongly helps performance on rare classes by focusing on underrepresented classes. Conclusions: Active learning can save annotation cost by helping human annotators eﬃciently and intelligently select which samples to label. Our results show that a dataset constructed using eﬀective active learning techniques requires less than half the amount of labelled data to achieve the same performance as a dataset that constructed using random sampling.
The Perception and Disposal Practices of Unused And Expired Medicines By Households In an Urban Municipality, Southwest Nigeria: A Comparative Cross-Sectional Study.
Authors: Aluko Olufemi O. , Imbianozor G. T , Jideama C. O. , Ogundele O. V. , Fapetu T. E , Afolabi Olusegun T.
Published: September 2020

Background: Medicines are formulations for the prevention and treatment of diseases and symptoms. Pharmaceutical wastes are products of unused, damaged, and expired medicines (UEMs) which pose a disposal challenge globally. Previous studies have shown that environmental disposal of medicines has health and environmental consequences. Hence, this study aims to determine and compare the management of household UEMs in a heterogeneous municipality in southwest Nigeria.Methods: The study was comparative, cross-sectional in design. Multi-stage sampling identified respondents, who are females, experienced in the handling and safekeeping of medicines. The study sample was 404 and recorded a 93% response rate. Data were analysed by IBM-SPSS, version 20. Continuous and categorical variables were presented in tables as mean(±SD), proportions (%) while bar charts highlight salient findings. Differences between LDS and HDS values were determined by 𝝌2(Pα>0.05).Results: 53.4% and 71.2% of respondents respectively had good knowledge and positive attitudes to safe disposal of UEMs. At least 31.5% households do not stock medicines in homes while 1-2 sachets of antimalarial (57.3%), analgesics (52.7%) and antibiotics (49.7%) medicines were inventoried in households and significantly different between low-density (LD) and high-density (HD) settlements. 72.9% and 67.8%; 47.9% and 55.6% respondents in LD and HD settlements respectively disposed of household solid and liquid UEMs in thrash-bins, though 34.9% (LDS) and 16.7% (HDS) disposed of liquid UEMs in the toilet/sink. There were significant differences in medicines abundance and disposal practices between LD and HD settlements for solid and liquid medications. 37.1% of respondents perceived consequences for the current methods of disposing of UEMs, which include accidental ingestion (76.6% vs 26.7%) and land pollution (69.6% vs 36.7%) and water pollution (72.4% vs 32.8%) and drugs toxicity (58.3% vs 32.8%), respectively in LD and HD settlements.Conclusions: Respondents good knowledge and positive attitudes contrasted the poor UEMs disposal practice. Most of the households’ medicines were antimalaria and analgesics and there were disparities in the disposal of solid and liquid medicines, between LD and HD settlements, respectively. Appropriate legislation, compliance monitoring and enforcement are drivers to incentive-driven, sound recovery systems for UEMs to alleviate the consequences of current disposal practices in Nigeria.
Resources-based Strategies for Health Promotion of Students With Different General Conditions and Different Origins
Authors: Böckelmann Irina , Darius Sabine , Thielmann Beatrice
Published: September 2020

Background: The aim of this study is to investigate the study-/work-related behavior and experience patterns of students, taking into account their origins as well as the stressful general conditions. Methods: A total of 194 students (41.8% women, 58.2% men, 58.7% German and 41.3% foreign students) were evaluated to their strains during the study and study-/work-related Behavior and Experience Patterns (AVEM). Four potentially stressful conditions were taken into account.Results: For only 14% of foreign students, but 45% of German students risk patterns for work-related behavior and experience were found. Study-/work-related behaviour and experience patterns depend on the origin of the students. Resources during study were significantly higher among students of German origin. Conclusions: A study-related strengthening of resources is necessary, which can be viewed as a competitive advantage when choosing a study location.
Perspectives of Infant Active Play: A Qualitative Comparison of Working Versus Stay-at-home Parents
Authors: Snyder Kailey , Rech John P , Masuda Kim , Dinkel Danae
Published: September 2020

Background: Parents play a key role in infants’ development through their interactions and the type of environment they provide for their child to promote active play. The amount of time parents are able to spend with their infant is dependent on their working status, yet few studies have explored parents’ perceptions of their infants’ active play by parental working status. The purpose of this study was to explore parents’ perceptions of active play and compare responses between working and stay at home parents. Methods: Twenty-nine parents participated in this qualitative study by completing a one-time, in-person semi-structured interview based on the Theory of Planned Behavior. Themes were developed and the proportion of working and stay at home parents who responded within each theme were used to compare for differences between working status using a directed content analysis approach. Results: All parents believed active play could have a positive effect on their child’s development through physical, social and emotional, cognitive, and/or language and communication development. However, stay at home parents reported a broader impact of active play across these domains; whereas working parents most often referenced active play as impacting infant’s physical development. Social and emotional interactions were the highest reported form of active play among all parents. Additionally, all parents described similar barriers to increasing the time for active play. The most commonly reported barrier for all parents was time or schedule followed by care needs of the infant, environmental concerns, and need for restrictive devices (e.g., car seats). More stay at home parents than working parents reported the care needs of the infant as being a barrier. Recommendations for active play were not widely known amongst all parents, with a higher percentage of working parents reporting they would listen to a healthcare provider.Conclusions: Working status of parents seems to have implications on certain aspects and perceptions of active play which in turn may influence infants’ physical development. Future studies should objectively assess the impact of parents’ working status on infant development and explore how gender of the parent may serve as a confounding variable.
The germline/somatic DNA damage repair gene mutations modulate the therapeutic response in Chinese patients with advanced pancreatic ductal adenocarcinoma
Authors: Shui Lin , Li Xiaofen , Peng Yang , Tian Jiangfang , Li Shuangshuang , He Du , Li Ang , Tian Bole , Li Mao , Yi Cheng , Cao Dan
Published: September 2020

Background: PDAC is a fatal disease with molecular heterogeneity, inducing differences in biological behavior and therapeutic strategy. NGS profiles of pathogenic alterations in Chinese PDAC population are limited. We conducted a retrospective study to investigate the predictive role of DNA damage repair (DDR) mutations in precise medicine. Methods: NGS were performed on resected tissues or peripheral blood from 195 Chinese PDAC patients. Baseline clinical or genetic characteristics, and survival status were collected. The Kaplan–Meier survival analyses were performed by the R version 3.6.1.Results: The main driver genes were KRAS, TP53, CDKN2A, and SMAD4. Advanced patients with KRAS mutation showed worse OS than those without (p=0.048). DDR deficiency was identified in 30 (15.38%) of overall patients, mainly involving BRCA2 (n=9, 4.62%), ATM (n=8, 4.10%) and RAD50 genes (n=3, 1.54%). There was no significant improvement of OS between patients with or without DDR mutations (p=0.88). Treatment with platinum-based chemotherapy (p=0.0096) or olaparib (p=0.018) respectively improved the overall survival of patients with DDR mutation. No statistical correlation between tumor mutation burden (TMB) and DDR mutations was identified. Treatment of PD-1 blockades did not bring significiantly improved OS to DDR-mutated patients than intact DDR group (p=0.14). Conclusions: In this multi-center retrospective study, we showed the role of germline and somatic DDR mutation in predicting the efficacy of olaparib and platinum-based chemotherapy. However, DDR alteration has shown limited value in prediction of hypermutational status and the sensitivity to PD-1 blockade.
A Noninvasive Model to Predict Liver Histology for Antiviral Therapy Decision in Chronic Hepatitis B with Alanine Aminotransferase＜2 Upper Limit of Normal
Authors: Chen Shanshan , Huang Haijun
Published: September 2020

Background and Aim: Although liver biopsy is currently the gold standard to evaluate liver histology, it has many limitations, such as sampling error, cost and risk of complications. This study aims to construct a noninvasive model to predict liver histology for antiviral therapy in chronic hepatitis B (CHB) with alanine aminotransferase (ALT)＜2 times upper limit of normal(ULN).Methods: We retrospectively analyzed 577 patients with CHB who received liver biopsy and whose ALT was less than 2 ULN. Then they were randomly divided into a training group and a validation group. Through logistic regression analysis, a novel predictive model was constructed in the training group to predict significant changes in liver histology [necro-inflammatory activity grade (G) ≥2 or fibrosis stage (S) ≥2] and then validated in the validation group.Results: If liver biopsy showed moderate or severe inflammation or significant fibrosis, antiviral treatment was recommended. Aspartate aminotransferase (AST), anti-hepatitis B virus core antibody (anti-HBC) and glutamine transpeptidase (GGT) were identified as independent predictors for antiviral therapy, with area under the ROC curve (AUROC) of 0.649, 0.647 and 0.616, respectively. Our novel model index, which combined AST, anti- HBC and GGT with AUROC of 0.700 and 0.742 in estimation set and validation set.Conclusions: This study established a noninvasive model to predict liver histology for antiviral treatment decision in patients with CHB with ALT < 2 ULN, which can reduce the clinical needs of liver biopsy.
Appraisal of Long-time Outcomes After Curative Surgery in Elderly Patients with Gastric Cancer: A Propensity Score Matching Analysis
Authors: Matunaga Tomoyuki , Ishiguro Ryo , Miyauchi Wataru , Shishido Yuji , Miyatani Kozo , Yamamoto Manabu , Tokuyasu Naruo , Takano Shuichi , Sakamoto Teruhisa , Honjo Soichiro , Saito Hiroaki , Fujiwara Yoshiyuki
Published: September 2020

Background: This study was conducted to assess the long-term outcomes of elderly patients among propensity-score-matched gastric cancer patients after curative gastrectomy and to propose the proper management of elderly gastric cancer patients.Methods: We enrolled 626 patients with gastric cancer who underwent curative gastrectomy at our institution between January 2004 and December 2015. To minimize selection bias among 2 groups, propensity score matching was performed.Results: Patients were divided into an elderly group over 75 years old (EP group; n=186) and a non-elderly group (NEP group; n=440). After propensity score matching, patients were divided into EP group (n=186) and NEP group (n=186). Five-year overall survival was significantly lower in the EP group than in the NEP group, consistent with a subgroup analysis of each stage. However, the 5-year disease-specific survival among all enrolled patients and those with stage I and II disease did not differ significantly. Moreover, in the subgroup of stage III patients, 5-year disease-specific survival was significantly lower in the EP group (23.0%) than in the NEP group (59.4%; P=0.004). Because elderly patients with stage III disease had an extremely poor prognosis, we decided to compare the two groups with stage III. The EP group contained significantly fewer patients with D2 lymphadectomy (P=0.002) and adjuvant chemotherapy (P<0.001) than the NEP group. Multivariate analysis revealed that older age and lymphatic invasion were independent prognostic factors. C-reactive protein to albumin ratio was significantly higher in patients in the EP group than in the NEP group (P=0.046), and the prognostic nutritional index was significantly lower in EP group patients than NEP group patients (P=0.045). Conclusions: Elderly gastric cancer patients with stage III disease showed poorer disease-specific survival compared with non-elderly patients, which may be due to fewer D2 lymphadenectomies, a lack of adjuvant chemotherapy, and a poorer nutritional and inflammatory background. The safe induction of standard lymphadenectomy and adjuvant chemotherapy with perioperative aggressive nutritional support may improve the prognosis of elderly gastric cancer patients with stage III disease.