bluuebunny/crossref_metadata_2025_split huggingface dataset:
Integrating students’ perspectives about online learning: a hierarchy of factors
Authors: Van Wart Montgomery , Ni Anna , Medina Pamela , Canelon Jesus , Kordrostami Melika , Zhang Jing , Liu Yu 
Published: December 2020

AbstractThis article reports on a large-scale (n = 987), exploratory factor analysis study incorporating various concepts identified in the literature as critical success factors for online learning from the students’ perspective, and then determines their hierarchical significance. Seven factors--Basic Online Modality, Instructional Support, Teaching Presence, Cognitive Presence, Online Social Comfort, Online Interactive Modality, and Social Presence--were identified as significant and reliable. Regression analysis indicates the minimal factors for enrollment in future classes—when students consider convenience and scheduling—were Basic Online Modality, Cognitive Presence, and Online Social Comfort. Students who accepted or embraced online courses on their own merits wanted a minimum of Basic Online Modality, Teaching Presence, Cognitive Presence, Online Social Comfort, and Social Presence. Students, who preferred face-to-face classes and demanded a comparable experience, valued Online Interactive Modality and Instructional Support more highly. Recommendations for online course design, policy, and future research are provided.
Estimation of pollution indices and hazard evaluation from trace elements concentration in coastal sediments of Kerala, Southwest Coast of India
Authors: Vineethkumar V. , Sayooj V. V. , Shimod K. P. , Prakash V. 
Published: December 2020

AbstractBackgroundThe environment is always subjected to exposure from different natural and anthropogenic sources of trace elements. The excessive intake of these trace elements may become toxic and cause health disorders to the people when the concentration exceeds certain threshold limits. The measurement of trace elements concentration in general and toxic trace elements concentration in particular is important for the assessment and prediction of risk to the environment and public. Distribution of trace elements in various environmental matrices depends on the nature of the element itself and the site-specific characteristics such as type of the matrices and its physicochemical parameters. In view of these aspects, an attempt is made to assess the concentration of trace elements and pollution indices in the sediment samples collected from the coastal belt of Kerala and possible conclusions were drawn.ResultsThe results of pollution indices clearly indicate the moderate level of trace elements contamination in the coastal belts of Kerala. Significant correlations were observed between the concentration of trace elements and physicochemical parameters of the sediments.ConclusionMost of the trace elements enrichment in the coastal belt is due the crustal materials or natural weathering process and atmospheric deposition. The investigation revealed the sources of most of the elements present in the coastal belt of Kerala are lithogenic such as weathering and atmospheric deposition.
Outcomes of Indeterminate Thyroid Nodules Managed Nonoperatively after Molecular Testing
Authors: Zhu Catherine Y , Donangelo Ines , Gupta Deepashree , Nguyen Dalena T , Ochoa Joana E , Yeh Michael W , Livhits Masha J 
Published: December 2020

Abstract

Context
Molecular testing to refine the diagnosis of cytologically indeterminate thyroid nodules has become increasingly popular, but data on long-term durability of test results and the rate of delayed operation are limited.

Objective
Determine the delayed rate of surgical resection in indeterminate nodules with benign/negative molecular testing and the risk of false-negative molecular test results.

Design
Prospective follow-up of the Gene Expression Classifier vs Targeted Next-Generation Sequencing in the Management of Indeterminate Thyroid Nodules randomized controlled trial comparing the diagnostic test performance of Afirma Gene Expression Classifier and ThyroSeq v2.

Setting
University of California, Los Angeles.

Participants
Patients who underwent thyroid biopsy with indeterminate (Bethesda III/IV) cytology (April 2016 to July 2017).

Intervention
Ultrasound surveillance.

Main Outcome Measure
False-negative rate of molecular testing.

Results
Of 95 indeterminate nodules with negative/benign molecular test results, 12 nodules underwent immediate resection (11 benign nodules, 1 noninvasive follicular thyroid neoplasm nodule with papillary-like nuclear features). Nonoperative management was pursued for 83 (87.4%) nodules. The median surveillance was 26.7 months. Ten nodules were resected during surveillance and malignancy was identified in 4 nodules (overall false-negative rate of 5.8%). In the 4 malignant nodules that underwent delayed operation, surgery was prompted by sonographic changes during surveillance.

Conclusions
The majority of indeterminate nodules with negative molecular testing have a stable clinical course over 3 years of follow-up, but our finding of a 6% false-negative rate highlights the importance of continuing sonographic surveillance. Long-term studies are needed to determine the optimal length of follow-up.
Induction of Functional Hypothalamus and Pituitary Tissues From Pluripotent Stem Cells for Regenerative Medicine
Authors: Kano Mayuko , Suga Hidetaka , Arima Hiroshi 
Published: December 2020

Abstract
The hypothalamus and pituitary have been identified to play essential roles in maintaining homeostasis. Various diseases can disrupt the functions of these systems, which can often result in serious lifelong symptoms. The current treatment for hypopituitarism involves hormone replacement therapy. However, exogenous drug administration cannot mimic the physiological changes that are a result of hormone requirements. Therefore, patients are at a high risk of severe hormone deficiency, including adrenal crisis.
Pluripotent stem cells (PSCs) self-proliferate and differentiate into all types of cells. The generation of endocrine tissues from PSCs has been considered as another new treatment for hypopituitarism. Our colleagues established a 3-dimensional (3D) culture method for embryonic stem cells (ESCs). In this culture, the ESC-derived aggregates exhibit self-organization and spontaneous formation of highly ordered patterning. Recent results have shown that strict removal of exogenous patterning factors during early differentiation efficiently induces rostral hypothalamic progenitors from mouse ESCs. These hypothalamic progenitors generate vasopressinergic neurons, which release neuropeptides upon exogenous stimulation.
Subsequently, we reported adenohypophysis tissue self-formation in 3D cultures of mouse ESCs. The ESCs were found to differentiate into both nonneural oral ectoderm and hypothalamic neuroectoderm in adjacent layers. Interactions between the 2 tissues appear to be critically important for in vitro induction of a Rathke’s pouch-like developing embryo. Various endocrine cells were differentiated from nonneural ectoderm. The induced corticotrophs efficiently secreted adrenocorticotropic hormone when engrafted in vivo, which rescued hypopituitary hosts.
For future regenerative medicine, generation of hypothalamic and pituitary tissues from human PSCs is necessary. We and other groups succeeded in establishing a differentiation method with the use of human PSCs. Researchers could use these methods for models of human diseases to elucidate disease pathology or screen potential therapeutics.
COVID‐19 and Independent Abortion Providers: Findings from a Rapid‐Response Survey
Authors: Roberts Sarah C.M. , Schroeder Rosalyn , Joffe Carole 
Published: December 2020

CONTEXTThe ways in which the COVID‐19 pandemic has affected abortion providers and abortion care, and the strategies clinics are adopting to navigate the pandemic, have not been well documented.METHODSIn April–May 2020, representatives from 103 independent abortion clinics (i.e., those not affiliated with Planned Parenthood) completed a survey that included close‐ended questions about how the pandemic, the public health response, and designations of abortion as a nonessential service had affected their clinic, as well as open‐ended questions about the pandemic's impact. Analyses were primarily descriptive but included an exploration of regional variation.RESULTSAll U.S. regions were represented in the sample. At 51% of clinics, clinicians or staff had been unable to work because of the pandemic or public health responses. Temporary closures were more common among clinics in the South (35%) and Midwest (21%) than in the Northeast and West (5% each). More than half of clinics had canceled or postponed nonabortion services (e.g., general gynecologic care); cancelation or postponement of abortion services was less common (25–38%, depending on type) and again especially prevalent in the South and Midwest. Respondents reported the pandemic had had numerous effects on their clinics, including disrupting their workforce, clinic flow and work practices; increasing expenses; and reducing revenues. State laws (including designations of abortion as nonessential) had exacerbated these difficulties.CONCLUSIONSAlthough independent abortion clinics have faced considerable challenges from the pandemic, most continued to provide abortion care. Despite this resiliency, additional support may be needed to ensure sustainability of these clinics.
Maternal exposure to sulfonamides and adverse pregnancy outcomes: A systematic review and meta-analysis
Authors: Li Peixuan , Qin Xiaoyun , Tao Fangbiao , Huang Kun 
Published: December 2020

Background
Sulfonamides are widely used to treat infectious diseases during pregnancy. However, the safety of maternal exposure to sulfonamides is controversial. This study aims to systematically review the available studies and examine the effect of maternal sulfonamides use on adverse pregnancy outcomes.

Methods
We searched PubMed, Science Direct, Web of Science, ClinicalTrials.gov, CNKI and Wanfang Database (in Chinese). The meta-analysis used random effects model or fixed effects model to obtain the total odds ratio (OR) for each outcome through Stata11.0 software. Study on the relationship between sulfonamide exposure during pregnancy and adverse pregnancy outcomes. The study design covered randomized controlled trials, cohort studies and case-control studies. The study protocol was registered in PROSPERO with protocol number CRD42020178687.

Results
A total of 10 studies, and 1096350 participants were included for systematic review. Maternal exposure to sulfonamides was found to be possibly associated with increased risk of congenital malformations (OR = 1.21, 95% CI 1.07–1.37). The use of sulfonamides in the first trimester of pregnancy and during the entire pregnancy might be associated with congenital malformations.

Conclusions
Maternal exposure to sulfonamides may be associated with offspring’ s congenital malformations. Prescription of sulfonamides for pregnant women is suggested to be carefully censored.
A multicenter, randomized, open-label, controlled trial to evaluate the efficacy and tolerability of hydroxychloroquine and a retrospective study in adult patients with mild to moderate coronavirus disease 2019 (COVID-19)
Authors: Chen Cheng-Pin , Lin Yi-Chun , Chen Tsung-Chia , Tseng Ting-Yu , Wong Hon-Lai , Kuo Cheng-Yu , Lin Wu-Pu , Huang Sz-Rung , Wang Wei-Yao , Liao Jia-Hung , Liao Chung-Shin , Hung Yuan-Pin , Lin Tse-Hung , Chang Tz-Yan , Hsiao Chin-Fu , Huang Yi-Wen , Chung Wei-Sheng , Cheng Chien-Yu , Cheng Shu-Hsing ,   on behalf of the Taiwan HCQ Study Group
Published: December 2020

Objective
In this study, we evaluated the efficacy of hydroxychloroquine (HCQ) against coronavirus disease 2019 (COVID-19) via a randomized controlled trial (RCT) and a retrospective study.

Methods
Subjects admitted to 11 designated public hospitals in Taiwan between April 1 and May 31, 2020, with COVID-19 diagnosis confirmed by pharyngeal real-time RT-PCR for SARS-CoV-2, were randomized at a 2:1 ratio and stratified by mild or moderate illness. HCQ (400 mg twice for 1 d or HCQ 200 mg twice daily for 6 days) was administered. Both the study and control group received standard of care (SOC). Pharyngeal swabs and sputum were collected every other day. The proportion and time to negative viral PCR were assessed on day 14. In the retrospective study, medical records were reviewed for patients admitted before March 31, 2020.

Results
There were 33 and 37 cases in the RCT and retrospective study, respectively. In the RCT, the median times to negative rRT-PCR from randomization to hospital day 14 were 5 days (95% CI; 1, 9 days) and 10 days (95% CI; 2, 12 days) for the HCQ and SOC groups, respectively (p = 0.40). On day 14, 81.0% (17/21) and 75.0% (9/12) of the subjects in the HCQ and SOC groups, respectively, had undetected virus (p = 0.36). In the retrospective study, 12 (42.9%) in the HCQ group and 5 (55.6%) in the control group had negative rRT-PCR results on hospital day 14 (p = 0.70).

Conclusions
Neither study demonstrated that HCQ shortened viral shedding in mild to moderate COVID-19 subjects.
Social and child care provision in kinship networks: An agent-based model
Authors: Gostoli Umberto , Silverman Eric 
Published: December 2020

Providing for the needs of the vulnerable is a critical component of social and health policy-making. In particular, caring for children and for vulnerable older people is vital to the wellbeing of millions of families throughout the world. In most developed countries, this care is provided through both formal and informal means, and is therefore governed by complex policies that interact in non-obvious ways with other areas of policy-making. In this paper we present an agent-based model of social and child care provision in the UK, in which agents can provide informal care or pay for private care for their relatives. Agents make care decisions based on numerous factors including their health status, employment, financial situation, and social and physical distance to those in need. Simulation results show that the model can produce plausible patterns of care need and availability, and therefore can provide an important aid to this complex area of policy-making. We conclude that the model’s use of kinship networks for distributing care and the explicit modelling of interactions between social care and child care will enable policy-makers to develop more informed policy interventions in these critical areas.“The moral test of government is how it treats those who are in the dawn of life,the children;those who are in the twilight of life,the aged;and those in the shadows of life, the sick,the needy and the handicapped.”— Hubert Humphrey Jr.
In silico immune infiltration profiling combined with functional enrichment analysis reveals a potential role for naïve B cells as a trigger for severe immune responses in the lungs of COVID-19 patients
Authors: Wu Yi-Ying , Wang Sheng-Huei , Wu Chih-Hsien , Yen Li-Chen , Lai Hsing-Fan , Ho Ching-Liang , Chiu Yi-Lin 
Published: December 2020

COVID-19, caused by SARS-CoV-2, has rapidly spread to more than 160 countries worldwide since 2020. Despite tremendous efforts and resources spent worldwide trying to explore antiviral drugs, there is still no effective clinical treatment for COVID-19 to date. Approximately 15% of COVID-19 cases progress to pneumonia, and patients with severe pneumonia may die from acute respiratory distress syndrome (ARDS). It is believed that pulmonary fibrosis from SARS-CoV-2 infection further leads to ARDS, often resulting in irreversible impairment of lung function. If the mechanisms by which SARS-CoV-2 infection primarily causes an immune response or immune cell infiltration can be identified, it may be possible to mitigate excessive immune responses by modulating the infiltration and activation of specific targets, thereby reducing or preventing severe lung damage. However, the extent to which immune cell subsets are significantly altered in the lung tissues of COVID-19 patients remains to be elucidated.This study applied the CIBERSORT-X method to comprehensively evaluate the transcriptional estimated immune infiltration landscape in the lung tissues of COVID-19 patients and further compare it with the lung tissues of patients with idiopathic pulmonary fibrosis (IPF). We found a variety of immune cell subtypes in the COVID-19 group, especially naïve B cells were highly infiltrated. Comparison of functional transcriptomic analyses revealed that non-differentiated naïve B cells may be the main cause of the over-active humoral immune response. Using several publicly available single-cell RNA sequencing data to validate the genetic differences in B-cell populations, it was found that the B-cells collected from COVID-19 patients were inclined towards naïve B-cells, whereas those collected from IPF patients were inclined towards memory B-cells. Further differentiation of B cells between COVID-19 mild and severe patients showed that B cells from severe patients tended to be antibody-secreting cells, and gene expression showed that B cells from severe patients were similar to DN2 B cells that trigger extrafollicular response. Moreover, a higher percentage of B-cell infiltration seems associated with poorer clinical outcome. Finally, a comparison of several specific COVID-19 cases treated with targeted B-cell therapy suggests that appropriate suppression of naïve B cells might potentially be a novel strategy to alleviate the severe symptoms of COVID-19.
Impact of disease stage and age at Parkinson’s onset on patients’ primary concerns: Insights for targeted management
Authors: Bhidayasiri Roongroj , Boonmongkol Thanatat , Thongchuam Yuwadee , Phumphid Saisamorn , Kantachadvanich Nitinan , Panyakaew Pattamon , Jagota Priya , Plengsri Rachaneewan , Chokpatcharavate Marisa , Phokaewvarangkul Onanong 
Published: December 2020

Background
The concerns of people with Parkinson’s disease (PD) about their disease are often different from the objective clinical picture and subject to various influencing factors, including disease progression. Currently our understanding of these concerns is limited, particularly in Asian countries.

Methods
A 50-item survey on Parkinson’s Disease Patients’ Concerns (PDPC Survey) was developed by a multidisciplinary care team. The subjective greatest concerns (most commonly concerning symptoms) of patients at a specialist centre in Bangkok, Thailand, were explored and categorised according to disease stage and age at onset of PD.

Results
Data for 222 patients showed concerns varied widely. Motor symptoms giving the greatest concern were problems with walking and/or balance (40.5% of patients), while the most commonly concerning non-motor symptom (NMS) was constipation (41.0%). Patterns were observed amongst different patient subgroups. Early PD patients (H&Y stage 1) were more concerned about NMS than motor symptoms, while the reverse was true for advanced PD patients. Young-onset PD patients showed significantly greater concerns than typical-onset patients about motor symptoms relating to social functioning, working and stigmatisation, such as speech (p = 0.003).

Conclusions
This study, in an Asian patient cohort, provides an assessment of a wide range of PD patients’ concerns, encompassing not only motor symptoms and NMS, but also treatment-related adverse events, care in the advanced stage, and the need for assistive devices. Identifying the concerns of individual PD patients and implementing a patient-centred approach to care is critical to their wellbeing and optimal outcomes. The PDPC survey can help healthcare teams build a more accurate picture of patients’ experiences to inform clinical management.
CT texture analysis of mediastinal lymphadenopathy: Combining with US-based elastographic parameter and discrimination between sarcoidosis and lymph node metastasis from small cell lung cancer
Authors: Koda Eriko , Yamashiro Tsuneo , Onoe Rintaro , Handa Hiroshi , Azagami Shinya , Matsushita Shoichiro , Tomita Hayato , Inoue Takeo , Mineshita Masamichi 
Published: December 2020

Objectives
To investigate the potential of computed tomography (CT)-based texture analysis and elastographic data provided by endobronchial ultrasonography (EBUS) for differentiating the mediastinal lymphadenopathy by sarcoidosis and small cell lung cancer (SCLC) metastasis.

Methods
Sixteen patients with sarcoidosis and 14 with SCLC were enrolled. On CT images showing the largest mediastinal lymph node, a fixed region of interest was drawn on the node, and texture features were automatically measured. Among the 30 patients, 19 (12 sarcoidosis and 7 SCLC) underwent endobronchial ultrasound transbronchial needle aspiration, and the fat-to-lesion strain ratio (FLR) was recorded. Texture features and FLRs were compared between the 2 patient groups. Logistic regression analysis was performed to evaluate the diagnostic accuracy of these measurements.

Results
Of the 31 texture features, the differences between 11 texture features of CT ROIs in the patients with sarcoidosis versus patients with SCLC were significant. Among them, the grey-level run length matrix with high gray-level run emphasis (GLRLM-HGRE) showed the greatest difference (P<0.01). Differences between FLRs were significant (P<0.05). Logistic regression analysis together with receiver operating characteristic curve analysis demonstrated that the FLR combined with the GLRLM-HGRE showed a high diagnostic accuracy (100% sensitivity, 92% specificity, 0.988 area under the curve) for discriminating between sarcoidosis and SCLC.

Conclusion
Texture analysis, particularly combined with the FLR, is useful for discriminating between mediastinal lymphadenopathy caused by sarcoidosis from that caused by metastasis from SCLC.