bluuebunny/crossref_metadata_2025_split huggingface dataset:
Student Learning Effects And Influencing Factors In Two Online Teaching Models: An Analysis
Authors: Wang Yan , An Na , Chen Xu , Hu Pei 
Published: May 2021

Abstract
Backgroud: Online teaching has become the main educational method in higher learning institutions during the Covid-19 pandemic. There is, however, no unified online teaching model in colleges and universities, and the pros and cons of different models and their teaching effects have not yet been reported. Methods: An anonymous online survey of students and teachers of Medical Laboratory Science at the Hubei University of Medicine, who participated in online teaching during the pandemic was conducted by the website Questionnaire Star.Results: The results found that 63.5 percent of students and 53.9 percent of teachers believed that the synchronous online teaching model in the form of live video streaming was more conducive to students’ understanding of the course content than Massive Open Online Course (MOOC). Additionally, 64.1 percent of teachers believed that online teaching generally had a substantial impact on students’ learning effects compared with face-to-face lectures, and that this was mainly because students were less able to focus their attention online. Although teachers and students agree that the methods of individual teachers are the most important factor in determining the effect of online teaching, their opinions on the influence of other factors vary. Interestingly, 41.4 percent of students interacted more online than they did in traditional offline classes, with only 25.5 percent recording fewer interactions. Conclusions: Both teachers and students are inclined to live video streaming than MOOC in online teaching, and teachers should take various influencing factors into consideration to improve their teaching effects.
Hepatocellular Carcinoma (HCC): Epidemiology, Risk Factors, and Survival
Authors: Soni Sweta , Pareek Puneet , Narayan Satya , Rakesh Amrita , Abhilasha Abhilasha 
Published: May 2021

Abstract
Background: HCC is an aggressive tumour with unpredictable outcome. It is fourth most common cause of cancers in India. However, information on HCC is inadequate in India.Therefore purpose of study is to determine overall survival for patients diagnosed with hepatocellular carcinoma (HCC) and association between various predictive factors and survival. Results: The median overall survival (OS) was 5 months ranging from 0-13 months. Majority of patients were in advance stage (III/IV). All patient died by 13 months. None of the possible predictive factors were found to be significantly associated with survival (P > 0.05) by univariate analysis. However age < 59 yrs, male gender, KPS ≤ 60, AFP ≥ 400, cirrhosis, multifocality, tumour size > 10 cm, advance stage (IIIB/IV), child pugh score B/C, CLIP score ≥ 4 and raised bilirubin level had poorer survival compared to other predictive factors. Median survival was better in patient treated with TACE followed by sorafenib + palliative care group (9 month) then sorafenib + palliative care and palliative care alone group (5 and 4 months respectively). Although results were not statistically significant (p: 0.133). Amongst all possible variables, highest hazard was found with multifocal lesion (2.0577) and results were statistically significantly (p 0.0451, 95 % confidence interval : 0.9225 to 4.5900 ) as compared to unifocal lesion with median survival period of 7 vs 9.5 months by Kaplan-Meier survival curve analysis using log rank test. Conclusion: Multifocality was independent predicator for poor survival in HCC. Further clinical studies are necessary to improve the outcomes of patients with high risk features.
Improving the Mechanical Properties of Ramie-Polylactic Acid Green Composites by Surface Modification using Single Bath Alkaline and Silane Treatment
Authors: Sharma Swati , Majumdar Abhijit , Butola Bhupendra Singh 
Published: May 2021

Abstract
This research work emphasises on improving the interfacial adhesion of ramie/ polylactic acid (PLA) composites. For this purpose, ramie fabric was modified using vinyl trimethoxy silane with two different hydrolysing agents, i.e. sodium hydroxide and ammonia. The surface modified ramie fabric was characterised by static water contact angle, elemental dispersive X-ray (EDX) and Fourier transform infrared spectroscopy (FTIR). FTIR and EDX analysis confirmed the presence of silica. The tensile strength of fabric showed a decrease after the silane treatment. The composites were prepared by compression moulding using untreated and treated ramie fabrics with PLA. The treatment improved tensile and impact performance of ramie/PLA composites due to enhanced interfacial adhesion between fibre and matrix. Dynamic mechanical analysis (DMA) results revealed that treated ramie/PLA composites have higher storage modulus and lower tangent delta than untreated composites.
Endovascular Recanalization of Chronic Total Occlusions of the Native Superficial Femoral Artery After Failed Femoropopliteal Bypass in Patients with Critical Limb Ischemia.
Authors: Minici Roberto , Ammendola Michele , Talarico Marisa , Luposella Maria , Minici Marco , Ciranni Salvatore , Guzzardi Giuseppe , Laganà Domenico 
Published: May 2021

Abstract
Background: The femoropopliteal bypass occlusion in patients with critical limb ischemia and chronic total occlusion of the native superficial femoral artery remains a significant problem, that hardly challenges vascular surgeons and interventional radiologists. Performing a secondary femoropopliteal bypass is still considered the standard of care, although it is associated with a higher complication rate and lower patency rate in comparison with primary bypass. Advanced age, lack of a good great saphenous vein, anastomosis’ pseudoaneurysms and high surgical risks make surgical approach not always suitable. Over the past few years, angioplasty has been commonly used, with the development in endovascular technologies, to treat chronic total occlusions of the native SFA, with a good technical success rate and clinical prognosis. Hence, the idea to recanalize the native SFA chronic total occlusions, in patients with critical limb ischemia (CLI) and femoro-popliteal bypass failure, has been born, limited to those patients unfit for surgery or refusing surgical reconstruction. Data regarding long-term outcomes of this approach in femoro-popliteal bypass failure are limited to few case-series studies.Results: Technical success was achieved in 51 (94.4%) of 54 limbs. Angiographically, 77.8% of the lesions were TASC II category D, while 22.2% TASC II category C. The average length of the native SFA lesions was 26.8 cm. Clinical success, with improved Rutherford classification staging, followed each case of technical success. The median follow-up value was 5.75 years (IQR, 1.5 – 7). By Kaplan-Meier survival analysis, primary patency rates were 61% (±0.07 SE) at 1 year and 46% (±0.07 SE) at 5 years. Secondary patency rates were 93% (±0.04 SE) at 1 year and 61% (±0.07 SE) at 5 years. Limb salvage rates were 94% (±0.03 SE) at 1 year and 88% (±0.05 SE) at 5 years.Conclusions: The endovascular recanalization of chronic total occlusions (CTO) of the native superficial femoral artery (SFA) after failed femoropopliteal bypass is a safe and effective therapeutic option in patients unfit for surgery with critical limb ischemia.
A Clinical Study of AWT Measurement and Polynomial Regression Model Analysis in Critically Ill Patients
Authors: Tang Hao , Zhao Dongchu , Zhang Chuan , Huang Xiaoying , Liu Dong , Li Yang , Wang Yaoli , Jiang Dongpo , Wang Zhengguo , Liang Huaping , zhang lianyang 
Published: May 2021

Abstract
Objective: In this study, a new measurement device was used to measure the AWT in critically ill patients and a polynomial regression model was applied to analyze the correlation between intra-abdominal hypertension (IAH) and AWT in critically ill patients.Methods: A retrospective analysis was conducted in critically ill patients who were admitted to the Department of Critical Care Medicine of Daping Hospital of Army Medical University from August 30, 2018, to June 30, 2020. According to the intravesical pressure (IVP) on the first day of ICU admission and death within 28 days, the patients were divided into the IAH group (IVP ≥12 mmHg), the non-IAH group, the survival group and the nonsurvival group. The demographic and clinical data, prognostic indicators, AWT and IVP on days 1-7 after entering the ICU, IAH risk factors, and 28-day death risk factors were collected.Results: The AWT on the 1st and mean 7th day of the IAH group was (2.89±0.32)N/mm and (2.82±0.46) N/mm, respectively, which was higher than that of the non-IAH group [ (2.45±0.29) N/mm, (2.43±0.39) N/mm], p＜0.001. The average IVP on the 1st and mean 7th day of all patients were 12.78 (6.14, 18.99) and 11.49 (6.66, 19.43) mmHg, and the AWT on the 1st and mean 7th days were (2.75±0.38) and (2.75±0.47) N/mm, respectively, with significant differences (p< 0.0001). The polynomial regression models showed that the average AWT and IVP on the 1st and mean 7th were AWTday1=-2.450×10-3, IVP2+9.695×10-2 IVP+2.046，r=0.667（p＜0.0001），and AWTmean=-2.293×10-3, IVP2+9.273×10-2 IVP+2.081, respectively. The logistic regression analysis showed that AWTday1 2.73-2.97N/mm increased the patient's 28-day mortality risk (OR: 6.834; 95%: 1.105-42.266, p=0.010).Conclusion: There is a nonlinear correlation between AWT and IVP in critically ill patients, and a high AWT may indicate poor prognosis.
Prognostic Factors in Conventional Chondrosarcoma Patients: a SEER Database Analysis
Authors: Fu Peng , Gao zhenzhen , Sun Ting , Bao Yi , Chen Gang 
Published: May 2021

Abstract
Background: Conventional chondrosarcoma, a rare type of bone tumor, was resistant to chemotherapy and radiation therapy, so more characteristics were needed. In clinic, the use of small series and single-institution studies have limited the investigation of chondrosarcoma. The Surveillance, Epidemiologic, and End Results is the most complete and comprehensive database worldwide. Based on this database, the study aimed to collect clinicopathological features and detect the prognosis of patients with conventional chondrosarcoma. Methods: Clinicopathologic and survival data of 782 patients from 2010 to 2016 and 353 patients from 2007 to 2009 were downloaded and analyzed. Overall survival was analyzed using the Kaplan-Meier method and verified by univariable Cox regression, and independent prognostic factors were assessed using the multi-variable Cox regression hazards model. Then, nomogram was established and the one-, three-, and five-year survival rates could be calculated with the nomogram. Competitive risk models were conducted to identify prognostic risk factors related to competitive endpoint events in patients with conventional chondrosarcoma. Results: In total, 361 extremities, 360 axial bones, and 61 cranial samples were collected from the 2010 to 2016 cohort. The median survival time of patients with conventional chondrosarcoma was 35 months, and the independent prognostic factors were sex, grade, surgery, AJCC_M age, and tumor size. Thereafter, a nomogram was established based on those independent prognostic factors. The competitive risk model revealed no competitive risk for the cancer specific endpoint event. Those data from 2007 to 2009 were used to validate the results from 2010 to 2016 with general consistency. This retrospective study determined the prognostic factors in patients with conventional chondrosarcoma using the Cox regression hazards model. A nomogram was established to help oncologists assess this rare malignant tumor with low heterogeneity.Conclusions: In the study, independent prognostic risk factors for conventional chondrosarcoma were identified, and a nomogram predicting three- and five- year overall survival rates were established, which may help physicians to predict the prognosis of patients with chondrosarcoma.
Intimate Partner Violence as a Predictor of Antenatal Care Services Utilization in Rwanda
Authors: Bahati Claire , Izabayo Josias , Niyonsenga Japhet , Sezibera Vincent , Mutesa Léon 
Published: May 2021

Abstract
Background: Although compelling evidence shows that the experience of intimate partner violence (IPV) during pregnancy is detrimental to both physical and mental health of the victims and their offspring, studies on negative impact of IPV on antenatal care (ANC) services utilization are scarce. Methods: The aim of the current study was to determine the impact of IPV exposure on ANC services utilization indicators such as (i) initiation of care within the first three months of pregnancy, (ii) receipt of at least four ANC visits and (iii) receipt of care from skilled providers among reproductive age women in Rwanda. This study used the data from the 2014-15 Rwanda Demographic and Health Survey. Multiple logistic regression was used to estimate the effects of physical and sexual IPV on the antenatal care (ANC) services utilization indicators. Results: Among married women living with their partners with at least one child aged 5years or under (N=5116), 17% of them reported physical violence, 22.8% reported psychological violence and 9.2% reported sexual violence. We found that there was a significant negative relationship between physical IPV and both early ANC and sufficient ANC. Women who had experienced physical violence by their partners during the preced­ing 12 months were less likely to receive more than four ANC visits, (O.R) = 0.6151 confidence interval (CI) [0.417-0.908] and they were less likely to attend the first ANC visits within the first three months (O.R) =0.656 confidence interval (CI) = [0.445-0.967].Conclusion: In this study, the prevalence of IPV is still high and there is evidence that it does have significant impact on ANC. Therefore, the results provide support for continued efforts to reduce intimate partner violence, through the improvement of screening for IVP during ANC visits.
Prospective Study of Epigenetic Alterations Responsible for Isolated Hemihyperplasia/Hemihypoplasia and Their Association With Leg Length Discrepancy
Authors: Shin Chang Ho , Lim Chaemoon , Kim Hwa Young , Yoo Won Joon , Cho Tae-Joon , Choi In Ho , Ko Jung Min 
Published: May 2021

Abstract
Background: Hemihyperplasia and hemihypoplasia result in leg length discrepancy (LLD) by causing skeletal asymmetry. Beckwith-Wiedemann syndrome (BWS) and Silver-Russell syndrome (SRS) are opposite growth-affecting disorders caused by opposite epigenetic alterations at the same chromosomal locus, 11p15, to induce hemihyperplasia and hemihypoplasia, respectively. Because of their somatic mosaicism, BWS and SRS show a wide spectrum of clinical phenotypes. We evaluated the underlying epigenetic alterations and potential epigenotype-phenotype correlations, focusing on LLD, in a group of individuals with pure isolated hemihyperplasia/hemihypoplasia.Results: We prospectively collected paired blood-tissue samples from 30 patients with pure isolated hemihyperplasia/hemihypoplasia who underwent surgery for LLD. Methylation-specific multiplex-ligation-dependent probe amplification assay (MS-MLPA) and bisulfite pyrosequencing for differentially methylated regions 1 and 2 (DMR1 and DMR2) on chromosome 11p15 were performed using the patient samples. Samples from patients showing no abnormalities in MS-MLPA or bisulfite pyrosequencing were analyzed by single nucleotide polymorphism (SNP) microarray and CDKN1C Sanger sequencing. We introduced a metric named as the methylation difference, defined as the difference in DNA methylation levels between DMR1 and DMR2. The correlation between the methylation difference and the predicted LLD at skeletal maturity, calculated using a multiplier method, was evaluated. Predicted LLD was standardized for stature. Ten patients (33%) showed epigenetic alterations in MS-MLPA and bisulfite pyrosequencing. Of these, six and four patients had epigenetic alterations related to BWS and SRS, respectively. The clinical diagnosis of hemihyperplasia/hemihypoplasia was not compatible with the epigenetic alterations in four of these ten patients. No patients showed abnormalities in SNP array or their CDKN1C sequences. The methylation difference was strongly correlated with the standardized predicted LLD in patients with epigenetic alterations (r = 0.76; p = 0.01).Conclusions: Pure isolated hemihyperplasia and hemihypoplasia can occur as a spectrum of BWS and SRS. Although the accurate differentiation between isolated hemihyperplasia and isolated hemihypoplasia is important in tumor surveillance planning, it is often difficult to clinically differentiate these two diseases without epigenetic tests. Epigenetic tests may play a role in the prediction of leg length discrepancy, which would aid in treatment planning.
IL-2 Increases Tams-Derived Exosomal Mir-375 to Ameliorate Hepatocellular Carcinoma Development and Progression
Authors: Chen Hao , Tang Chao , Wu Fei , Lu Linming , Li Shu , Li Zhenhan , Lu Wei , Wu Zhihao , huang yanqiang 
Published: May 2021

Abstract
Background: Interleukin-2 (IL-2) is proved to play an irreplaceable role in anti-tumor regulation in numerous experimental and clinical trials. Tumor-associated macrophages (TAMs) is able to release exosomes to promote the development and progression of hepatocellular carcinoma (HCC) as part of microenvironment.Methods: In this study, our intention is to explore the effects of the exosomes from TAMs with IL-2 treatment on HCC development.TAMs were collected and cultured from liver cancer tissues. The exosomes from the TAMs treated with IL-2 (ExoIL2-TAM) or not (ExoTAM) were identified and used to treat HCC cells. The HCC cells proliferation, apoptosis and metastasis were measured in vivo and in vitro. The changes of miR-375 in exosomes was explored to clarify whether it is reponsible to the anti-apoptotic effects of IL-2. Results: Both decrease of cell proliferation and metastasis and increase of apoptosis were observed with ExoIL2-TAM treatment compared with ExoTAM in vivo and in vitro. miR-375 was obviously abundant in ExoIL2-TAM. Enriched miR-375 could be transmitted between TAMs and HCC cells via exosomes and was responbible for the increased apoptosis of HCC cells. Conclusions: Taken together, IL-2 increases exosomal miR-375 from TAMs to attenuate hepatocellular carcinoma development. This study provides a new perspective to explain the mechanism how IL-2 inhibits hepatocellular carcinoma and implys the potential clinical value of exosomal miR-375 released by TAMs.
Acute Dyspnea After Use of Non-Invasive Ventilation in COPD Patients: The Deventilation Syndrome
Authors: Schellenberg Mavi , Imach Sandra , Iberl Gabriele , Kirchner Marietta , Herth Felix , Trudzinski Franziska 
Published: May 2021

Abstract
Background: In daily routine, many COPD patients lament early onset augmented dyspnea following use of NIV (Deventilation Syndrome, DVS) as a negative side-effect. This is the first study to this date to quantify and characterize DVS. MethodsThis monocenter prospective observational study collected demographic, physiologic and symptomatic data from 67 in-patients with severe COPD Gold III-IV and chronic hypercapnic failure before, during and after use of an established NIV.During their inpatient follow-up, we examined patients during the first hour after termination of nocturnal NIV. DVS was defined by the authors as an increase of ≥ 2 points on the Borg scale during the first 30 minutes. We monitored cardiovascular and respiratory data and measured diaphragm excursion. Subjective dyspnea was documented by use of the Borg scale and questionnaires. In addition, respirator and demographic data were collected.ResultsDVS occurred in 58% of our COPD patients. Patients with DVS were more severely ill than non-DVS concerning bronchial obstruction (FEV1 0.6 vs 0.8l, p<0.05) and hypercapnia during spontaneous breathing (pre NIV pCO2: 54.5 vs 49.3mmHg, p<0.02). DVS patients showed significantly higher respiratory rates (RR) (20.1 vs 18.1/min p<0.05) after termination of NIV.ConclusionsThis is the first trial quantifying and characterizing early onset augmented dyspnea after the use of NIV, referred to as DVS. It is now brought to attention as a frequent side effect of long-term home ventilation and possible pathophysiologic mechanisms are elucidated.
Digitalized Long-Lasting Insecticidal Nets Mass Distribution Campaign in the Context of Covid-19 Pandemic in Kongo Central, Democratic Republic of Congo: Challenges and Lessons Learned.
Authors: LIKWELA Joris LOSIMBA , NGWALA Phillipe LUKANU , Austin Julian , Ntale Deogratias Cibinda , SOMPWE Eric MUKOMENA , MPIANA Godé KANYEBA , TSHULA Joseph KALONJI , LIKWELA Tathy KALONDA , KANKU-KA-MUNABE Patrick , KUMBI Adrien N’SIALA , NDAHAMBARA Gilbert KULIMUSHI , NTALE Helen CIBINDA , KIAMENGA Michele LUNTADILA , NJILA Jules KABONGO , YAV Ghislain MAKHAN , BANETI Didier GASIGWA , NTUMBA Albert KALONJI 
Published: May 2021

Abstract
Background: The DRC organized a first mass distribution campaign of LLINs with digitalized data management with coordinated support from the Ministry of Health (MOH) and SANRU Asbl, in the context of the Covid-19 pandemic in Kongo Central province. This article describes the planning and implementation process of this campaign as well as the challenges and lessons learned.Methods: The planning and implementation process was performed in line with the standard guidance issued by the National Malaria Control Program (NMCP) following the start of Covid-19. The changes and adaptations put in place as well as the challenges encountered are described.Results: A total of 5,629,211 people were registered (7.7% above projection) in 1,065,537 households (6.2% below projection) giving an average of 5.3 people per household. Of a total of 3,062,850 LLINs ordered, 2,886,096 were distributed to households (94%). Out of 11,070 villages and 3,947 teams planned, 91.7% of villages were reached and 93% of teams were established.Conclusion: The revision of standards of campaign implementation during Covid-19, as well as effective coordination supported by real-time decision-making through digital data management, have been factors in the success of this campaign. Maintaining this momentum is essential to ensure the continuity of malaria prevention services for the population.