bluuebunny/crossref_metadata_2025_split huggingface dataset:
Challenges of Online Teaching During the COVID-19 Pandemic in an English as a Foreign Language Context: A Process Tracing Approach
Authors: Shahnama Mojdeh , Yazdanmehr Elham , Shirvan Majid Elahi 
Published: January 2021

Abstract
The prevalence of COVID-19 pandemic worldwide has affected educational systems around the world and has forced education systems to shift to online learning. The present study was motivated to explore the challenges (common technology-driven and content-specific challenges) facing an English as a foreign language teacher throughout an online English course in Iran. The main participant of this study was a female teacher, with 17 years of experience in teaching English to children, teenagers, and adults. To this aim, a process-tracing approach was employed in an online English class with 10 female students, all teenagers, to unravel the causal mechanisms involved in the beginning, middle and end of the English course. The results showed that the greatest challenges throughout the course especially in initial and mid sessions were caused by deficient technological resources. The two other causal categories, human and content resources, were at their peak early in the course and then reduced significantly by the end. The most troublesome challenges the teacher faced were platform limitations, internet connection and human resources’ unpreparedness for online education. Though the teacher’s as well as most students’ technological knowledge and media literacy showed an increase by the end of the course, some students’ slow adaptation challenged the teacher until the end. As for the content-based challenges, teaching vocabulary and speaking was considered the most challenging one due to lack of teacher’s physical contact with students.
Current Status of Genetically Modified Crops in Iran and the world: Overview of Production and Consumption Challenges
Authors: Baghbani-Arani Abolfazl , Poureisa Mona , Alekajbaf Hossein , Abad Rezvan Karami Borz- , Khodadadi-Dashtaki Khodadad 
Published: January 2021

Abstract
Transgenic technologies expanded in many countries regarding the nutritional needs of the increasing population. There are, however, some concerns about possible risks in growing genetically modified (GM) food such as threats of biodiversity and food allergies making it a challenge. This study aimed at examining the economic effects and political scopes of GM food in the production sector and policies made by different countries in the world and Iran. Moreover, essential (practical and legal) solutions and guidelines for GM food production and consumption are provided, which are useful for governmental entities and Iranian politicians and consumers' rights. transgenic technology has been accepted by high-rank farmers to produce genetically modified crops due to an increase in net profit caused by improved yield in spite of the high cost of transgenic seeds. Among 11 countries producing GM crops in the world in 2018, the USA is the first country followed by Brazil and Argentina at second and third ranks. In 2018, 78, 76, 30 and 29% of soybean, cotton, corn and canola production areas respectively were under cultivation of GM varieties. Although Iran has been one of the leading Asian countries not only in the field of transfer of technical knowledge of genetic engineering, but also in the development of specialized knowledge of biosafety, and despite the production of several transgenic plant lines by Iranian researchers, no GM crop has obtained release and cultivation license except for genetically modified rice that its growing process was banned after government change. This study implies that GM crops growing and production process does not follow the global trend owing to scientific and legal infrastructures.
Real Time Surveillance of COVID-19 Space and Time Clusters During the Summer 2020 in Spain
Authors: Rosillo Nicolás , del-Águila-Mejía Javier , Rojas-Benedicto Ayelén , Guerrero-Vadillo María , Peñuelas Marina , Mazagatos Clara , Segú-Tell Jordi , Ramis Rebeca , Gómez-Barroso Diana 
Published: January 2021

Abstract
Background:On June 21st de-escalation measures and state-of-alarm ended in Spain after the COVID-19 first wave. New surveillance and control strategy was set up to detect emerging outbreaks.Aim:To detect and describe the evolution of COVID-19 clusters and cases during the 2020 summer in Spain.Methods:A near-real time surveillance system to detect active clusters of COVID-19 was developed based on Kulldorf´s prospective space-time scan statistic (STSS) to detect daily emerging active clusters. Results:Analysis were performed daily during the summer 2020 (June 21st – August 31st) in Spain, showing an increase of active clusters and municipalities affected. Spread happened in the study period from a few, low-cases, regional-located clusters in June to a nationwide distribution of bigger clusters encompassing a higher average number of municipalities and total cases by end-August.Conclusion:STSS-based surveillance of COVID-19 can be of utility in a low-incidence scenario to help tackle emerging outbreaks that could potentially drive a widespread transmission. If that happens, spatial trends and disease distribution can be followed with this method. Finally, cluster aggregation in space and time, as observed in our results, could suggest the occurrence of community transmission.
Large-size intramuscular nodular fasciitis, a challenging histopathologic diagnosis confirmed by molecular detection of USP6 gene rearrangement: A case report and literature review
Authors: Wang Changrong , Wang Wei , Xu Rujun , Xiang Jingjing 
Published: January 2021

Abstract
Background: The intramuscular subtype of nodular fasciitis (NF) is rare with lesions normally not more than 2 cm in size and characterized by pseudosarcomatous morphology. Case presentation: Here, we report a case of a 27-year-old man presenting with a chief complaint of an increasingly enlarged mass of the left upper arm for 4 months. Magnetic resonance imaging confirmed the presence of a well-defined tumor measuring 5 cm within the outer edge of the middle humerus. Microscopically, the neoplasm was highly cellular with focally discohesive and myxoid features. In more cellular areas, cells grew in bundles with an interlaced pattern. The mitotic index was high and multinuclear giant cells were evident. The stroma contained collagen with erythrocyte extravasation. The tumor border was infiltrative. Immunohistochemically, the tumor cells were positive for SMA and negative for CK, desmin, CD34, S100, ALK, and β-catenin. Molecular detection demonstrated evidence of USP6 gene rearrangement in this tumor. Based on the findings, we diagnose this case as intramuscular NF. At 48 months after the initial surgery, the patient had recovered well with no evidence of recurrence or metastasis. Conclusions: In this study, the diagnosis of intramuscular NF with a relatively large tumor was confirmed by molecular detection of USP6 gene rearrangement.
Primary High-grade Serous Carcinoma of Fallopian Tube, an Incidental Intraoperative Finding: A Case Report&nbsp;
Authors: Shokouhi Nasim , Saeedi Sara , Sarmadi Soheila , Moradi Behnaz , Feizabad Elham 
Published: January 2021

Abstract
Background: Primary carcinoma of fallopian tube is a rare but deadly gynecologic cancer, In addition, its preoperative diagnosis is strict due to the lack of specific symptoms and signs and in most patients, it is an intraoperative finding.Case presentation: A 55-year-old patient, G3Ab1P2 referred to urogynecology clinic of our hospital with chief complaint about heavy, prolonged menstrual bleeding and a permanently abnormal yellow discharge that could not be distinguished from its urinary or vaginal source.After complete diagnostic work-up, the patient became a candidate for hysterectomy due to the drug (Megestrol Acetate) -resistant abnormal vaginal bleeding, her abnormal vaginal bleeding, positive family history of malignancy, and abnormal vaginal discharge.Laparotomy revealed unusual left fallopian tube feature (Large, bulky, and vegetative feature), suspected to malignancy. Intraoperative frozen-section analysis of the left fallopian tube and ovary specimens detected the mass as a high-grade serous carcinoma of fallopian tube. Total abdominal hysterectomy, bilateral salpingo-oophorectomy, and partial omentectomy were performed. The definitive histopathological diagnosis was high-grade serous carcinoma of the left fallopian tube stage 2b with omental involvement without any evidence of lymph-vascular invasion.Conclusions: High-grade serous carcinoma of fallopian tube is likely to present nonspecific symptoms, which may cause considerable delay in diagnosis and treatment. This consequently, affects the prognosis and survival of the patient.
NDRG1&nbsp;Inhibition of Tumor Progression in Caco2&nbsp;Cells
Authors: He Yixiao , Ji Yuzhu , Hua Hairong , Zhu Yu , Yu Peng , Zeng Xiangfei , Wang Kaixin , Wang Fang 
Published: January 2021

Abstract
Background: Colorectal cancer (CRC) is a leading cause of cancer death worldwide. Invasiveness and migration are the main cause of death, and so there is a need to find a sensitive, reliable molecular marker that can predict the migration of colorectal cancer at an early stage. NDRG1 (N-myc Downstream Regulated Gene 1) has been reported to be a multifunctional gene that has a strong relationship with tumor invasion and migration, but theories about the current role of NDRG1 in colorectal cancer remains to be conclusively determined. Methods and Results: Through lentivirus infection and CRISPR/Cas9 methods, respectively, we established that NDRG1 stably overexpressed and knocked out Caco2 cell lines. CCK8(Cell Counting kit 8) data showed that NDRG1 inhibited Caco2 proliferation. Flow cytometry further confirmed that the cell cycle can be arrested at the G1/S phase when NDRG1 overexpresses, while the number of G2 phase cells significantly increased after NDRG1 was knocked out. This means that NDRG1 inhibited the proliferation of Caco2 cells by arresting the cell cycle in the G1/S phase. Our data also demonstrated that NDRG1 promotes early cell apoptosis. The strength of invasion and migration was decreased when NDRG1 overexpressed. Conclusions: Our results underline that NDRG1 inhibits tumor progression in Caco2 cells. These findings may provide a new potential therapeutic strategy for the treatment of CRC.
Rhinocerebral Mucormycosis Secondary to Severe Acute Pancreatitis and Diabetic Ketoacidosis: A Case Report
Authors: Wang Jinjing , Li Yao , Luo Shuai , Zheng Hong 
Published: January 2021

Abstract
Introduction: Rhinocerebral mucormycosis is a rare and severe form of opportunistic fungal infection that can develop rapidly and cause significant mortality, particularly among diabetic patients suffering from ketoacidosis. Diagnosing rhinocerebral mucormycosis during the early stages of infection is challenging. Case presentation：We describe a case of rhinocerebral mucormycosis secondary to severe acute pancreatitis in a patient suffering from diabetic ketoacidosis. In this case, the condition was not diagnosed during the optimal treatment window. we therefore provide a thorough overview of related clinical findings and histopathological characteristics, and we discuss potential differential diagnoses.Conclusions: In summary, we described a case of rhinocerebral mucormycosis secondary to severe acute pancreatitis in a patient suffering from diabetic ketoacidosis, with the optimal treatment window for this condition having been missed. This report suggests that a definitive mucormycosis diagnosis can be made based upon tissue biopsy that reveals the presence of characteristic hyphae. Early diagnosis and treatment are essential in order to improve patient prognosis.
Hot Spot Mapping and Size Estimation of Illicit Drug Users in Iran: A Pilot Study
Authors: Khodadost Mahmoud , Ghalehkhani Nima , Hajebi Ahmad , Gouya Mohammad Mahdi , Kazerooni Parvin Afsar , Ghodusi Ebrahim , Fathi Hamid R , Bojnordi Toktam Khojasteh , Sarvi Fatemeh , Vashani Jamshid , Kokie Fatima Zare Banad , Hashemvarzi Mahmoud Reza , Davasazirani Reza , Sharifi Hamid , Motevalian Seyed Abbas 
Published: January 2021

Abstract
Background: Mapping and size estimation of people who use (PWUD) or inject drugs (PWID) are important issues for control of drug use. The aim of this pilot study is to mapping and estimate the number of PWUD and PWID in Iran.Methods: We used the hotspot mapping and size estimation method to estimate the number of illicit drug users in four cities of Iran from December 2017 to January 2019. We identified hotspots by local knowledge of key informants. For size estimation in each hotspot, three estimates were made during hotspot visit: a) KAP-KI (Key Affected Population Key Informant) estimate (drug users met in the hotspot), b) Non-KAP KI estimate (e.g. taxi drivers, shopkeepers nearby the hotspot); c) estimation made by field observers. Locations of hotspots were recorded by the field team and ArcGIS software was used for mapping. Results: A total number of 335 hot spots were identified in four cities of them, 70 (20.9%) were in Ahvaz, 90 (26.9%) in Sari, 67 (20%) in Yazd and 108(32.2%) in district 2 of Tehran metropolitan. We identified nine high-density areas for PWUDs of them three were in Ahvaz, one in the south of Sari, two in district 2 of Tehran and three in Yazd. The total numbers of 1524 key informants were interviewed by the field team in 335 identified hot spots. Based on the median estimated number of PWUD, Ahvaz had the highest estimated number of PWUD (1242, range, 606-1285), followed by Sari (788, range, 373-1044), district 2 of Tehran (684, range, 642-728) and Yazd (123, range, 76-316). The median estimated number of PWID indicated that Ahvaz had the highest estimated number of PWID (843, range, 703-887), followed by Sari (346, range, 307-666), Yazd (228, range, 221-471) and Tehran (18, range, 18-34). Conclusions: Findings highlight the importance of geographical targeting of illicit drug users to provide harm reduction programs with a broader reach in Iran.
Pitfalls and Remedial Technique of Intramedullary Nail for Subtrochanteric Femur Fractures: A Case Series
Authors: Chen Botao , Fan Xiaohong 
Published: January 2021

Abstract
Background: Intraoperative technical complications are occasionally encountered while implanting intramedullary nails for subtrochanteric fractures. Surgeons must pay attention to the pitfalls and remedial technique of this operation.Methods: We report on three cases in which intraoperative difficulties occurred during the implantation of an intramedullary nail among Han Chinese patients from mainland China. In Case 1, during an operation on a 57-year-old man, a seinsheimer type V in a right subtrochanteric fracture was not fully realized, and the dislocation of intertrochanteric fracture was aggravated after reduction of the subtrochanteric fracture. The intramedullary nail fixation was completed with the aid of an additional anterolateral plate. Case 2 involved a transverse subtrochanteric fracture. The surgeon neglected the coronal dislocation when considering good sagittal reduction. Although an auxiliary reduction device was used during the operation, there was unacceptable coronal dislocation after the intramedullary nail was inserted. A temporary anterolateral locking plate fixation was used to complete the intramedullary nail fixation. Case 3 involved an old trochanteric fracture combined with a new subtrochanteric fracture in an 81-year-old woman. After reducing the subtrochanteric fractures, the intramedullary nail fixation was successfully completed by releasing the poorly healed intertrochanteric fractures and fixing the anterior lateral plate.Results: With the development of techniques, reliable results can be obtained with fewer complications. Of the various internal fixation methods, we favor using a trochanteric start intramedullary nail.Conclusions: The treatment of subtrochanteric fractures presents challenges. Good reduction and reliable temporary fixation are key to completing the intramedullary nailing. If percutaneous joysticks, finger reduction tools, blocking screws, clamps, and Schanz pins cannot be used for effective auxiliary reduction or temporary reliable fixation, reduction after intramedullary nailing will not be satisfactory. The temporary addition of a reconstruction locking plate can achieve good reduction and temporary stability, and an extra reconstruction locking plate should be retained when the temporary fixation device is removed to reduce the risk of internal fixation failure during fracture healing.
Impact of Diabetes Mellitus on Early Postoperative Outcomes After Hip Fracture Surgery in Geriatric Patients: A Retrospective, Propensity Score Matching Study
Authors: Li Ruibo , Yuan Xingyue , Liu Yuehong , Liu Shuping , Zhou Yu , Chen Xi , Zhou Qing , Wang Zhicong 
Published: January 2021

Abstract
Background：The impact of diabetes mellitus (DM) on hip fracture (HF) is still controversial. The primary aim of this study was to examine the influence of DM on perioperative transfusion， the secondary aims were to evaluate 1-year mortality, length of stay，and total charges in individuals with hip fracture.Methods: All patients with initial HF aged 60 years or older admitted to our hospital from January 2014 to January 2018 were eligible for this study. After excluding some patients who did not meet the experimental requirements, 326 HF patients aged 60 years and above were admitted to the study institution, and were divided into DM group (n=71) and non-diabetes mellitus (non-DM) group (n=255). Sex, age, American Society of Anesthesiologists (ASA) classification, anesthesia type and surgery type were matched in the two groups (DM group vs. non-DM group) using propensity score matching (PSM) without any statistical differences. Then，perioperative transfusion，length of stay，direct total charges and 1-year mortality in individuals with HF were compared between two groups.Results: Following PSM, 62 patients in the DM group and 62 patients in the non-DM group were included in the study. Twenty-eight patients had received blood transfusion during the perioperative period, the difference in blood transfusion rate between two groups was statistically significant (p=0.032). There were no statistical differences in 1-year mortality, length of stay and direct hospital costs between two groups.Conclusions: This study showed that DM patients with hip fractures have a higher probability of receiving transfusions compared to patients without DM. Higher blood transfusion rates may be associated with lower hemoglobin and hematocrit levels at admission. However, there was no significant increase in 1-year mortality, length of hospital stay, and direct hospital costs after hip fracture surgery due to diabetes.
Expression of The Factors Associated With Wnt/β-Catenin, BMP-2/Runx2/Osterix, OPG/RANKL&nbsp;and&nbsp;LGR4/RANKL Pathways&nbsp;in Postmenopausal Osteoporosis Fracture
Authors: Mai Caiyuan , Luo Xiping , Cao Yanming , Wang Zhizhong , Li Xinxu , Wang Bin 
Published: January 2021

Abstract
Objective Detect and analyse the correlation between factors of related pathways (Wnt/β-catenin, BMP-2/Runx2/Osterix, OPG/RANKL and LGR4/RANKL) and postmenopausal osteoporotic fracture (PMOPF). Methods The postmenopausal patients with tibial fracture were divided into control group (36 cases) and PMOPF group (36 cases). Using RNAiso Plus method to extract total RNA of bone tissue, RT-qPCR method was used to detect the expression of each factor. Detected the levels of serum of factors by ELISA method in control group. PMOPF group was divided into group A-F according to the blood collection time interval (at different time period), use ELISA method to detect each factor’s level. Compared the changes between control group and PMOPF group, and the subdivided groups of PMOPF group. Results (1) RT-qPCR detected the expressions of LRP5, β-catenin, Runx2, C-myc, Osterix, OPG and LGR4 in PMOPF group were lower than control group (P<0.05), but the expression of RANKL was increased (P<0.05). (2) ELISA detected the serum levels of LRP5, β-catenin, Runx2, C-myc, Osterix, OPG and LGR4 decreased significantly (P<0.05), and RANKL increased significantly (P<0.05). LRP5 and Runx2 appeared the lowest in Group B (2-3 days after fracture); β-catenin and C-myc appeared the lowest in Group C (4-7 days after fracture); RANKL appeared the highest in Group C; Osterix appeared the lowest in Group D (8-14 days after fracture); OPG and LGR4 appeared the lowest in Group E (15-28 days after fracture). Conclusion The related factors of Wnt/β-catenin, BMP-2/Runx2/Osterix, OPG/RANKL and LGR4/RANKL pathway are closely related to the occurrence of PMOPF. LRP5 and Runx2 decreased to the lowest level within 3 days after fracture, β-catenin and C-myc decreased to the lowest level within 7 days after fracture, the results showed that these changes in Wnt/β-catenin osteogenesis pathway were consistent; Osterix decreased to the lowest level within 14 days after fracture, OPG and LGR4 decreased to the lowest level within 28 days after fracture, which may be related to the difficulty of short-term healing of PMOPF; RANKL increased to the highest level within 7 days after fracture, which may be associated with the increase in bone formation after PMOPF. According to the changes and characteristics of these factors in above pathways, we can regulate or intervene the occurrence and progression of PMOPF.
Response Rate of Patient Reported Outcomes: the Delivery Method Matters
Authors: Neve Olaf , Benthem Peter Paul G. Van , Stiggelbout Anne M. , Hensen Erik F. 
Published: January 2021

Abstract
Background: Patient Reported Outcomes (PROs) are subjective outcomes of disease and/or treatment in clinical research. For effective evaluations of PROs, high response rates are crucial. This study assessed the impact of the delivery method on the patients’ response rate.Methods: A cohort of patients with a unilateral vestibular schwannoma (a condition with substantial impact on quality of life, requiring prolonged follow-up) was assigned to three delivery methods: email, regular mail, and hybrid. Patients were matched for age and time since the last visit to the outpatient clinic. The primary outcome was the response rate, determinants other than delivery mode were age, education and time since the last consultation. In addition, the effect of a second reminder by phone was evaluated. Results: In total 602 patients participated in this study. The response rates for delivery by email, hybrid, and mail were 45%, 58% and 60%, respectively. The response rates increased after a reminder by phone to 62%, 67% and 64%, respectively. A lower response rate was seen in association with a low level of education and longer time interval since last outpatient clinic visit.Conclusion: The response rate for PRO surveys is influenced by the delivery method. PRO surveys by regular mail yield the highest response rate, followed by hybrid and email delivery methods. Hybrid delivery combines good response rates with the ease of digitally returned questionnaires.