bluuebunny/crossref_metadata_2025_split huggingface dataset:
Gamification of e-learning in higher education: a systematic literature review
Authors: Khaldi Amina , Bouzidi Rokia , Nader Fahima 
Published: January 2023

AbstractIn recent years, university teaching methods have evolved and almost all higher education institutions use e-learning platforms to deliver courses and learning activities. However, these digital learning environments present significant dropout and low completion rates. This is primarily due to the lack of student motivation and engagement. Gamification which can be defined as the application of game design elements in non-game activities has been used to address the issue of learner distraction and stimulate students’ involvement in the course. However, choosing the right combination of game elements remains a challenge for gamification designers and practitioners due to the lack of proven design approaches, and there is no one-size-fits-all approach that works regardless of the gamification context. Therefore, our study focused on providing a comprehensive overview of the current state of gamification in online learning in higher education that can serve as a resource for gamification practitioners when designing gamified systems. In this paper, we aimed to systematically explore the different game elements and gamification theory that have been used in empirical studies; establish different ways in which these game elements have been combined and provide a review of the state-of-the-art of approaches proposed in the literature for gamifying e-learning systems in higher education. A systematic search of databases was conducted to select articles related to gamification in digital higher education for this review, namely, Scopus and Google Scholar databases. We included studies that consider the definition of gamification as the application of game design elements in non-game activities, designed for online higher education. We excluded papers that use the term of gamification to refer to game-based learning, serious games, games, video games, and those that consider face-to-face learning environments. We found that PBL elements (points, badges, and leaderboards), levels, and feedback and are the most commonly used elements for gamifying e-learning systems in higher education. We also observed the increasing use of deeper elements like challenges and storytelling. Furthermore, we noticed that of 39 primary studies, only nine studies were underpinned by motivational theories, and only two other studies used theoretical gamification frameworks proposed in the literature to build their e-learning systems. Finally, our classification of gamification approaches reveals the trend towards customization and personalization in gamification and highlights the lack of studies on content gamification compared to structural gamification.
Early cessation of breastfeeding and the associated factors among mothers with children aged 2 to 3 years in rural Southern Ethiopia: a community-based cross-sectional study
Authors: Temesgen Kidus , Andarge Eshetu , Fikadu Teshale , Bekele Muluken , Chisha Yilma , Esubalew Habtamu , Toma Temesgen Mohammed 
Published: January 2023

Abstract
Background
Breast milk is the first natural food for babies. It has nutritional, immunological, developmental, psychological, societal and environmental advantages. Failing to feed children for twenty-four months has so many negative consequences to children. Though studies have well documented the duration of breast feeding in the first six months, the proportion of women completing the recommended duration and factors associated with it has not been well investigated in rural places of Ethiopia. Therefore, this study aims to fill this gap in evidence among mothers with children aged 2 to 3 years in Arba Minch Health and Demographic Surveillance Site in 2021 E.C.

Methods
A community-based cross-sectional study was conducted in all kebeles of the surveillance site by employing multi-stage sampling technique. Descriptive statistics was done to summarize findings and binary logistics regression model was used to identify factors significantly associated with early breast-feeding cessation respectively. OR with its 95% CI was obtained to quantify the degree of association between explanatory variables and early breastfeeding cessation.

Result
The proportion of early cessations of breast feeding was 29.30% (25.02, 33.64%). Being from a household with no fathers ‘education or primary education [AOR=0.22; 95%CI (0.07, 0.74)] and [AOR=0.30; 95%CI (0.12, 0.76)], farmer mothers [AOR=6.40; 95%CI: (1.38, 29.74)], birth interval of less than 2 years [AOR=2.07; 95%CI: (1.03, 4.16)], and with mothers’ one or two to three antenatal care visits [AOR = 2.73; 95%CI: (1.27,5.88)] were factors significantly associated with early cessations of breast feeding.

Conclusion and recommendation
The proportion of early cessations of breast feeding was high. Father’s education, being farmer, birth interval and ante natal care visit were significant factors. Health education about proper breast feeding practice and improving ante natal care attendance might improve premature cessation of breast feeding among women.
Enzalutamide induced non-ischemic cardiomyopathy. A case report and review of literature on anti-androgen therapy-related cardiovascular events
Authors: Kumar Aswini , Reddy Aswanth , Sekar Arjun 
Published: January 2023

AbstractProstate cancer has a very high prevalence among elder men, and this could potentially increase as longevity in many parts of the world is increasing. Early stages of prostate cancer can have surgical options, but the more advanced stages require some form of anti-androgen therapy. There are novel anti-androgen agents that were recently approved. Cardiovascular toxicity has been reported with some of these drugs. This is a novel report of likely cardiovascular toxicity due to Enzalutamide, which typically has a safer cardiovascular profile than Abiraterone.We describe a 72-year-old male with repeated recurrence of prostate cancer with metastasis. The second time it recurred was within 2 years of the 1st recurrence and was treated with Enzalutamide.However, within 2 weeks he developed systolic congestive heart failure that improved with stopping the drug and medical optimization.Literature review shows that Abiraterone has more cardiovascular side effects than Enzalutamide which more commonly causes hypertension. The timeline in our case suggests Enzalutamide causing congestive heart failure which is a novel finding. This finding warrants further research regarding the safety profile of novel anti-androgen therapy. This includes risk stratification for potential cardiovascular adverse events and risk/benefit analysis prior to initiating therapy. Data on cumulative dose accumulation and risks can also be an area of future research.
Prevalence of autism spectrum disorder among children referred to special needs clinic in Giza
Authors: Meguid Nagwa A. , Nashaat Neveen Hassan , Ghannoum Heba , Hashem Heba Saher , Hussein Gina , El-Saied Amal 
Published: January 2023

Abstract
Background
Little is known about the prevalence of autism spectrum disorder (ASD) among the population with disability in Egypt. Furthermore, the increasing prevalence of ASD and the variability of the ASD manifestations and severity highlight the importance of investigating the ASD comorbidities.

Aim of work
This analysis was to compare the prevalence of autism with that of other disabilities among children visiting the clinic for special needs and to explore possible comorbid disorders in this sample of Egyptian ASD participants.

Methods
The study included individuals who visited the clinic for special needs in Giza, affiliated to the National Research Centre, for nearly 4 years (2019 to 2022). They were subjected to full clinical evaluation. Autistic children were further subjected to scales for confirming diagnosis and severity evaluation.

Results
The results revealed that a total of 3555 individuals were referred to the clinic. The percentage of children who were diagnosed as having ASD was 22.5% (N = 803; age: 4.5 ± 2.4 years). The most common associated comorbidities with ASD were language and intellectual deficits (80.25%, 58.7%). Hearing impairment was the least common (0.75%). The scores of the childhood autism rating scale were higher in the groups with the comorbid disorders (p = 0.03 or < 0.0001).

Conclusion
The prevalence of ASD among children with disability varied from other countries. Comorbid disorders have led to increasing the severity of ASD. We emphasize that accurate and early diagnosis of autism is the key for proper management of cases.
Follistatin Forms a Stable Complex With Inhibin A That Does Not Interfere With Activin A Antagonism
Authors: Kappes Emily C , Kattamuri Chandramohan , Czepnik Magdalena , Yarawsky Alexander E , Brûlé Emilie , Wang Ying , Ongaro Luisina , Herr Andrew B , Walton Kelly L , Bernard Daniel J , Thompson Thomas B 
Published: January 2023

Abstract
Inhibins are transforming growth factor-β family heterodimers that suppress follicle-stimulating hormone (FSH) secretion by antagonizing activin class ligands. Inhibins share a common β chain with activin ligands. Follistatin is another activin antagonist, known to bind the common β chain of both activins and inhibins. In this study, we characterized the antagonist-antagonist complex of inhibin A and follistatin to determine if their interaction impacted activin A antagonism. We isolated the inhibin A:follistatin 288 complex, showing that it forms in a 1:1 stoichiometric ratio, different from previously reported homodimeric ligand:follistatin complexes, which bind in a 1:2 ratio. Small angle X-ray scattering coupled with modeling provided a low-resolution structure of inhibin A in complex with follistatin 288. Inhibin binds follistatin via the shared activin β chain, leaving the α chain free and flexible. The inhibin A:follistatin 288 complex was also shown to bind heparin with lower affinity than follistatin 288 alone or in complex with activin A. Characterizing the inhibin A:follistatin 288 complex in an activin-responsive luciferase assay and by surface plasmon resonance indicated that the inhibitor complex readily dissociated upon binding type II receptor activin receptor type IIb, allowing both antagonists to inhibit activin signaling. Additionally, injection of the complex in ovariectomized female mice did not alter inhibin A suppression of FSH. Taken together, this study shows that while follistatin binds to inhibin A with a substochiometric ratio relative to the activin homodimer, the complex can dissociate readily, allowing both proteins to effectively antagonize activin signaling.
Beyond Expression: Role of Phosphorylated Residues of EZH2 in Lineage Plasticity in Prostate Cancer
Authors: Nouruzi Shaghayegh , Tabrizian Nakisa , Zoubeidi Amina 
Published: January 2023

AbstractDespite the development of effective targeted therapies and a significant understanding of carcinogenesis and cancer progression, treatment resistance is a major obstacle in achieving durable long-term control in many types of cancers. Emerging evidence supports that nongenetic mechanisms could play an underappreciated role in therapy resistance. These mechanisms include phenotypic plasticity, which is recognized as a hallmark of cancer and translates to epigenetic and transcriptional control of gene expression. Alterations in the expression and activity of the epigenetic modifier enhancer of zeste homolog 2 (EZH2) support prostate cancer lineage plasticity and progression. EZH2 expression and activity is elevated in castration-resistant prostate cancer treated with androgen receptor pathway inhibitors and in treatment-resistant prostate cancer. Moreover, 17 known residues of EZH2 are phosphorylated on by multiple kinases that modulate its activity, localization, stability, and polycomb repressive complex (PRC2) assembly. In this review, we explore the contribution of EZH2 phosphorylation in regulating canonical PRC2 in a methylation-dependent manner as an epigenetic repressor and in a noncanonical manner independent of PRC2 as a transcription activator. Apart from the contribution of EZH2 phosphorylation at serine 21, threonine 350, and threonine 311 in prostate cancer progression and treatment resistance, we discuss how other EZH2 phosphorylated residues with unknown functions could contribute to prostate cancer based on their upstream regulators and potential therapeutic utility.
Embracing the diversity of model systems to deconstruct the basis of regeneration and tissue repair
Authors: Amiel Aldine R. , Tsai Stephanie L. , Wehner Daniel 
Published: January 2023

ABSTRACT
The eighth EMBO conference in the series ‘The Molecular and Cellular Basis of Regeneration and Tissue Repair’ took place in Barcelona (Spain) in September 2022. A total of 173 researchers from across the globe shared their latest advances in deciphering the molecular and cellular basis of wound healing, tissue repair and regeneration, as well as their implications for future clinical applications. The conference showcased an ever-expanding diversity of model organisms used to identify mechanisms that promote regeneration. Over 25 species were discussed, ranging from invertebrates to humans. Here, we provide an overview of the exciting topics presented at the conference, highlighting novel discoveries in regeneration and perspectives for regenerative medicine.
Single-chromosome dynamics reveals locus-dependent dynamics and chromosome territory orientation
Authors: Chung Yu-Chieh , Bisht Madhoolika , Thuma Jenna , Tu Li-Chun 
Published: January 2023

ABSTRACT
Dynamic chromatin organization instantly influences DNA accessibility through modulating local macromolecular density and interactions, driving changes in transcription activities. Chromatin dynamics have been reported to be locally confined but contribute to coherent chromatin motion across the entire nucleus. However, the regulation of dynamics, nuclear orientation and compaction of subregions along a single chromosome are not well-understood. We used CRISPR-based real-time single-particle tracking and polymer models to characterize the dynamics of specific genomic loci and determine compaction levels of large human chromosomal domains. Our studies showed that chromosome compaction changed during interphase and that compactions of two arms on chromosome 19 were different. The dynamics of genomic loci were subdiffusive and dependent on chromosome regions and transcription states. Surprisingly, the correlation between locus-dependent nuclear localization and mobility was negligible. Strong tethering interactions detected at the pericentromeric region implies local condensation or associations with organelles within local nuclear microenvironments, such as chromatin–nuclear body association. Based on our findings, we propose a ‘guided radial model’ for the nuclear orientation of the long arm of chromosome 19.
The Minimal Difference as an Individual Threshold to Examine the Utility of a Verification Bout in Determining V̇O2max
Authors: SUCCI PASQUALE J. , BENITEZ BRIAN , KWAK MINYOUNG , BERGSTROM HALEY C. 
Published: January 2023

ABSTRACT

Purpose
A square-wave verification bout to confirm maximal oxygen uptake (V̇O2max) from a graded exercise test (GXT) has been recommended based on mean responses. This study used the test–retest reliability, mean, and individual differences between the highest V̇O2 from the GXT (V̇O2GXT) and verification bout (V̇O2verification) to examine the efficacy of a verification bout in the determination of

O2max in healthy, recreationally trained, well-motivated men.

Methods
Ten men (24 ± 4 yr) completed a GXT on a cycle ergometer followed by a submaximal verification bout to determine V̇O2GXT and V̇O2verification. After completion of the initial GXT, subjects rested for 5 min then performed the verification bout at 90% of the peak power output from the initial GXT. Analyses included a two-way repeated-measures ANOVA, intraclass correlation coefficients (ICC2,1), standard errors of the measurement (SEM), minimal differences (MD), and coefficients of variation (COV).

Results
There was no test (test 1 vs test 2)–method (GXT vs verification) interaction (P = 0.300) and no main effect for test (P = 0.690), but there was a main effect for method (P = 0.003). The V̇O2GXT (46.0 mL⋅kg−1⋅min−1) was significantly greater than V̇O2verification (43.9 mL⋅kg−1⋅min−1), collapsed across test. The V̇O2GXT (ICC = 0.970, SEM = 1.63 mL⋅kg−1⋅min−1, MD = 4.51 mL⋅kg−1⋅min−1, COV = 3.54%) and the V̇O2verification (ICC = 0.953, SEM = 1.87 mL⋅kg−1⋅min−1, MD = 5.17 mL⋅kg−1⋅min−1, COV = 4.25%) demonstrated “excellent” reliability. No subject exceeded the MD test–retest for V̇O2GXT or V̇O2verification. No subject had a V̇O2verification that exceeded V̇O2GXT by more than the MD, but two subjects had a V̇O2GXT, which exceeded V̇O2verification by more than the MD.

Conclusions
The excellent reliability of V̇O2GXT in addition to the examination of the individual differences between V̇O2GXT and V̇O2verification using the MD indicated that a standalone GXT was sufficient to determine V̇O2max.
Exploring faculty perception of simulation-based education: Benefits and challenges of using simulation for improving patient safety in cardiovascular diploma program
Authors: Ajlan A Alshehri  , Fahaad S Alenazi  , Hamad Alturki  , Farida Habib Khan  
Published: January 2023

Objectives: The study was conducted in a tertiary educational hospital based in Riyadh to explore faculty’s perception of using simulation-based teaching as part of the Cardiovascular Diploma Program (CDP) to improve patients’ safety. The study, also aimed to identify the benefits and challenges of utilizing simulation.
Methods: Researchers used a qualitative approach. Semi-structured interviews were conducted online with ten faculty-members. The interviews were performed between July and September in the year 2019. Authors used convenient sampling techniques for recruitment. Data were transcribed and analyzed using a framework analysis approach.
Results: Data analysis showed four emergent themes, i.e., the concept of simulation (it is a risk-free environment for training), simulation for patients’ safety (students first learn on the simulators and deal with patients), simulation as a safe learning environment (gives idea basic things about the working environment, knowing the symptoms of the patients, catheterizing the patient, knowing preparations for the procedure and post care), and the challenges of utilizing simulation (identify gaps between the theoretical and practical parts).
Conclusion: Faculty has appreciated the role of simulation in improving patients’ safety. Simulation was underutilized due to the limited time allotted for simulation and lack of adequate experienced faculty. It is recommended that simulation should be integrated into the CDP curriculum.
doi: https://doi.org/10.12669/pjms.39.2.6693
How to cite this: Alshehri AA, Alenazi FS, Alturki H, Khan FH. Exploring faculty perception of simulation-based education: Benefits and challenges of using simulation for improving patient safety in cardiovascular diploma program. Pak J Med Sci. 2023;39(2):---------. doi: https://doi.org/10.12669/pjms.39.2.6693
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
SOME ASPECTS OF EATING AND DRUG ADDICTION BEHAVIOR OF ADOLESCENTS
Authors: Maleeva Nina P. , Dmitrieva Marina K. , Moskovtseva Nellya I. , Popova Lyudmila V. 
Published: January 2023

The problems of eating and drug-addicted behavior of adolescents are one of the most urgent both in Russia and around the world.
The purpose of the study: to analyze the behavioral factors of adolescents’ adaptation to the environment, such as smoking, alcohol and drug use, as well as the eating behavior of adolescents, indicating a deviation in healthy eating.
Novelty: a comprehensive approach to the social portrait of adolescents was used with an assessment of eating and drug-addicted behavior in the gender aspect in the Orenburg region of the Russian Federation. In the literature known to us, the eating and drug-dependent behavior of adolescents was assessed in isolation.
The results obtained from a survey of 200 teenagers studying at a college in the Orenburg region revealed that all teenagers attend Fast-Food and prefer sweet drinks to eating fresh fruits and vegetables. The identified gender differences in eating behavior indicate that boys have breakfast and snacks more often than girls, while girls are more attentive to the principles of healthy eating and more often have theoretical knowledge on this issue. Drug-directed behavior in terms of alcohol consumption was registered in 22% of adolescents, smoking in 19% of adolescents, and the use of narcotic psychoactive substances in 1% of the adolescents surveyed. The status of families with children with early drug-directed behavior was characterized by low social responsibility.
Practical significance: the results of the study will be used to determine the main areas of work with adolescents on the formation of a healthy lifestyle, as well as to purposefully prevent early deviations in their eating and addictive behavior
Mechanism of adhesion of glass monomeric cements of Meron and Total-cem to dentin
Authors: Nebogatov S. S. , Chulak L. D. 
Published: January 2023

Recently, researchers note an increase in the prevalence of non-carious lesions of solid dental tissues. The forms of non-carious lesions of teeth are described: erosion and abrasion, wedge-shaped defects and erosion, which were previously practically not met.
Increasing the life expectancy and maintaining natural teeth also led to the fact that clinicians often began to meet with patients with increased erosion of teeth.
Study of the mechanism of adherence of glass-like cements to dentin is very important. In our case, the adhesion of our cements to dentin and enamelabs of acid protrusion, in our opinion, is provided by two mechanisms. The first of these is based on the fact that carboxylate groups of the macromolecules of polyacrylic acid are capable of forming chelating compounds with calcium, in particular calcium hydroxyapatite dentin and enamel.
The second possible mechanism of communication is based on the affinity of polycarboxylic acids to nitrogen of protein molecules, in particular, collagen, which is manifested by the absorption of polyacrylic acid on collagen dentin.