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AbstractFeedback has long been considered a significant lever to enhance learning experience and success in higher education. However, students have shown much discontent with the current feedback practice. Feedback experienced as a relational process in which students feel recognized and valued is perceived as paramount for helping support the uptake of feedback and promote positive learning dispositions. However, little attention has been paid to suggesting how instructors in higher educational institutions can facilitate relational feedback. In response, we conducted a rapid literature review with a particular focus on the creation of feedback content. In total, 17 peer-reviewed publications on relational feedback are included. Based on a qualitative analysis of these papers, we developed a framework of 12 characteristics for offering relational feedback. These 12 characteristics were further categorised into four types of feedback conductive to a relational process, including (i) clarifying performance, (ii) suggesting improvement, (iii) inviting further communication, and (iv) evoking positive emotions. We examined how each of these characteristics supports the relational aspects of feedback. Based on the qualitative analysis results, we offered practical recommendations for instructors to apply relational feedback in their pedagogical practices. [ABSTRACT FROM AUTHOR]

Learning analytics (LA) has gained increasing attention for its potential to improve different educational aspects (e.g., students' performance and teaching practice). The existing literature identified some factors that are associated with the adoption of LA in higher education, such as stakeholder engagement and transparency in data use. The broad literature on information systems also emphasizes the importance of trust as a critical predictor of technology adoption. However, the extent to which trust plays a role in the adoption of LA in higher education has not been examined in detail in previous research. To fill this literature gap, we conducted a mixed method (survey and interviews) study aimed to explore how much teaching staff trust LA stakeholders (e.g., higher education institutions or third-parties) and LA technology, as well as the trust factors that could hinder or enable adoption of LA. The findings show that the teaching staff had a high level of trust in the competence of higher education institutions and the usefulness of LA; however, the teaching staff had a low level of trust in third parties that are involved in LA (e.g., external technology vendors) in terms of handling privacy and ethics-related issues. They also had a low level of trust in data accuracy due to issues such as outdated data and lack of data governance. The findings have strategic implications for institutional leaders and third parties in the adoption of LA by providing recommendations to increase trust, such as, improving data accuracy, developing policies for data sharing and ownership, enhancing the consent-seeking process, and establishing data governance guidelines. Therefore, this study contributes to the literature on the adoption of LA in HEIs by integrating trust factors. [ABSTRACT FROM AUTHOR]

To provide precision medicine for better cancer care, researchers must work on clinical patient data, such as electronic medical records, physiological measurements, biochemistry, computerized tomography scans, digital pathology, and the genetic landscape of cancer tissue. To interpret big biodata in cancer genomics, an operational flow based on artificial intelligence (AI) models and medical management platforms with high-performance computing must be set up for precision cancer genomics in clinical practice. To work in the fast-evolving fields of patient care, clinical diagnostics, and therapeutic services, clinicians must understand the fundamentals of the AI tool approach. Therefore, the present article covers the following four themes: (i) computational prediction of pathogenic variants of cancer susceptibility genes; (ii) AI model for mutational analysis; (iii) single-cell genomics and computational biology; (iv) text mining for identifying gene targets in cancer; and (v) the NVIDIA graphics processing units, DRAGEN field programmable gate arrays systems and AI medical cloud platforms in clinical next-generation sequencing laboratories. Based on AI medical platforms and visualization, large amounts of clinical biodata can be rapidly copied and understood using an AI pipeline. The use of innovative AI technologies can deliver more accurate and rapid cancer therapy targets. [ABSTRACT FROM AUTHOR]

Simple Summary: Cost-effective, Hepatocellular carcinoma (HCC) risk-based surveillance strategies should be established after achieving sustained virologic response (SVR). Circulating microRNAs are considered stable serum markers for early cancer diagnosis and prognosis and treatment response prediction. The aim of our longitudinal follow-up study was to assess whether Let-7 family members can predict HCC risk in CHC patients. We assessed the sera of 54 patients with CHC who developed HCC and 173 patients with CHC who did not develop HCC after antiviral therapy. Cox's regression model revealed the independent role of let-7i as an effective surrogate biomarker for predicting HCC development in patients with CHC. HCC, a leading cause of cancer-related mortality, is diagnosed at advanced stages. Although antiviral therapy has reduced the risk of HCC among chronic hepatitis C (CHC) patients, the risk of HCC remains, thus, highlighting the unmet need for continuous surveillance. Therefore, stable and cost-effective biomarkers, such as circulating microRNAs, must be identified. We aimed to clarify whether serum levels of the Let-7 family can predict HCC risk in patients with CHC using univariate and multivariate Cox's proportional hazards model. We analyzed the sera of 54 patients with CHC who developed HCC after antiviral therapy and compared the data with those of 173 patients without HCC development. The Let-7 family (except for let-7c) exhibited significant negative correlations with the fibrosis score (r = −0.2736 to −0.34, p = 0.0002 to <0.0001). After Cox's regression model was used to adjust for age, sex, HCV genotype, and FIB-4 ≥ 3.25, patients with CHC with let-7i median ≥ −1.696 (adjusted hazard ratio [aHR] = 0.31, 95% CI: 0.08–0.94, p = 0.0372) in the sustained virologic response (SVR) groups and ≥−1.696 (aHR = 0.09, 95% CI: 0.08–0.94, p = 0.0022) in the non-SVR group were less likely to develop HCC. Thus, circulating let-7i can be used for early CHC surveillance in patients with HCC risk after antiviral treatment. [ABSTRACT FROM AUTHOR]

Simple Summary: Using the covariate-adjusted tensor classification in the high-dimension (CATCH) model, we integrated adjusted radiomics-based CT images into RNA immune genomic expression data to achieve the accurate classification of recurrent CRC. The correlation between radiomic features and immune gene expression identifies potential therapeutic targets in CRC. We provide individualized cancer therapeutic strategies based on adjusted radiomic features in recurrent stage III CRC. To evaluate whether adjusted computed tomography (CT) scan image-based radiomics combined with immune genomic expression can achieve accurate stratification of cancer recurrence and identify potential therapeutic targets in stage III colorectal cancer (CRC), this cohort study enrolled 71 patients with postoperative stage III CRC. Based on preoperative CT scans, radiomic features were extracted and selected to build pixel image data using covariate-adjusted tensor classification in the high-dimension (CATCH) model. The differentially expressed RNA genes, as radiomic covariates, were identified by cancer recurrence. Predictive models were built using the pixel image and immune genomic expression factors, and the area under the curve (AUC) and F1 score were used to evaluate their performance. Significantly adjusted radiomic features were selected to predict recurrence. The association between the significantly adjusted radiomic features and immune gene expression was also investigated. Overall, 1037 radiomic features were converted into 33 × 32-pixel image data. Thirty differentially expressed genes were identified. We performed 100 iterations of 3-fold cross-validation to evaluate the performance of the CATCH model, which showed a high sensitivity of 0.66 and an F1 score of 0.69. The area under the curve (AUC) was 0.56. Overall, ten adjusted radiomic features were significantly associated with cancer recurrence in the CATCH model. All of these methods are texture-associated radiomics. Compared with non-adjusted radiomics, 7 out of 10 adjusted radiomic features influenced recurrence-free survival. The adjusted radiomic features were positively associated with PECAM1, PRDM1, AIF1, IL10, ISG20, and TLR8 expression. We provide individualized cancer therapeutic strategies based on adjusted radiomic features in recurrent stage III CRC. Adjusted CT scan image-based radiomics with immune genomic expression covariates using the CATCH model can efficiently predict cancer recurrence. The correlation between adjusted radiomic features and immune genomic expression can provide biological relevance and individualized therapeutic targets. [ABSTRACT FROM AUTHOR]

Objectives: This study aimed to evaluate the feasibility of automatic Stanford classification of classic aortic dissection (AD) using a 2-step hierarchical neural network. Methods: Between 2015 and 2019, 130 arterial phase series (57 type A, 43 type B, and 30 negative cases) in aortic CTA were collected for the training and validation. A 2-step hierarchical model was built including the first step detecting AD and the second step predicting the probability (0–1) of Stanford types. The model's performance was evaluated with an off-line prospective test in 2020. The sensitivity and specificity for Stanford type A, type B, and no AD (Sens A, B, N and Spec A, B, N, respectively) and Cohen's kappa were reported. Results: Of 298 cases (22 with type A, 29 with type B, and 247 without AD) in the off-line prospective test, the Sens A, Sens B, and Sens N were 95.45% (95% confidence interval [CI], 77.16–99.88%), 79.31% (95% CI, 60.28–92.01%), and 93.52% (95% CI, 89.69–96.25%), respectively. The Spec A, Spec B, and Spec N were 98.55% (95% CI, 96.33–99.60%), 94.05% (95% CI, 90.52–96.56%), and 94.12% (95% CI, 83.76–98.77%), respectively. The classification rate achieved 92.28% (95% CI, 88.64–95.04%). The Cohen's kappa was 0.766 (95% CI, 0.68–0.85; p < 0.001). Conclusions: Stanford classification of classic AD can be determined by a 2-step hierarchical neural network with high sensitivity and specificity of type A and high specificity in type B and no AD. Key Points: • The Stanford classification for aortic dissection is widely adopted and divides it into Stanford type A and type B based on the ascending thoracic aorta dissected or not. • The 2-step hierarchical neural network for Stanford classification of classic aortic dissection achieved high sensitivity (95.45%) and specificity (98.55%) of type A and high specificity in type B and no aortic dissection (94.05% and 94.12%, respectively) in 298 test cases. • The 2-step hierarchical neural network demonstrated moderate agreement (Cohen's kappa: 0.766, p < 0.001) with cardiovascular radiologists in detection and Stanford classification of classic aortic dissection in 298 test cases. [ABSTRACT FROM AUTHOR]

Sarcopenia is defined as the loss of skeletal muscle mass and muscle function. It is common in patients with malignancies and often associated with adverse clinical outcomes. The presence of sarcopenia in patients with cancer is determined by body composition, and recently, radiologic technology for the accurate estimation of body composition is under development. Artificial intelligence- (AI-) assisted image measurement facilitates the detection of sarcopenia in clinical practice. Sarcopenia is a prognostic factor for patients with cancer, and confirming its presence helps to recognize those patients at the greatest risk, which provides a guide for designing individualized cancer treatments. In this review, we examine the recent literature (2017-2021) on AI-assisted image assessment of body composition and sarcopenia, seeking to synthesize current information on the mechanism and the importance of sarcopenia, its diagnostic image markers, and the interventions for sarcopenia in the medical care of patients with cancer. We concluded that AI-assisted image analysis is a reliable automatic technique for segmentation of abdominal adipose tissue. It has the potential to improve diagnosis of sarcopenia and facilitates identification of oncology patients at the greatest risk, supporting individualized prevention planning and treatment evaluation. The capability of AI approaches in analyzing series of big data and extracting features beyond manual skills would no doubt progressively provide impactful information and greatly refine the standard for assessing sarcopenia risk in patients with cancer. [ABSTRACT FROM AUTHOR]

Background: One-handed backhand (OB) and two-handed backhand (TB) styles are commonly used in tennis, but only TB generates loadings on the non-dominant arm and a greater extension torque on the rear leg, leading to a greater axial torque involving rotation of the hip and trunk. The current study investigated whether those effects can further affect bone area (BA), bone mineral content (BMC) and density (BMD) in postmenopausal recreational tennis players.Methods: BA, BMC and BMD of the lumbar spine, hip and distal radius were assessed using dual-energy X-ray absorptiometry in TB, OB, and swimmers' group as a control (SG) (all participants self-reported for at least 5 years of exercise history, n = 14 per group). Muscular strength was assessed with a hand dynamometer. Among these three groups, the BA, BMC and BMD of distal radius and muscle strength were assessed using one-way ANOVA, and those of the lumbar region and the hip joint were tested by one-way ANCOVA.Results: TB showed higher BMC and BMD for both lumbar spine and femoral neck than SG (all, p < 0.05). Both OB and TB showed greater BMD inter-trochanter than SG (both, p < 0.05). OB demonstrated greater inter-arm differences in the distal radius, which involved 1/3 distal for BMC and mid-distal radius for BMD compared to the TB and SG (all, p < 0.05). In addition, greater inter-arm asymmetry of grip strength was found in OB compared to TB and SG (both, p < 0.05).Conclusion: For postmenopausal women, performing two-handed backhand strokes, leads to higher BMC and BMD in the non-dominant arm, the lumbar region, and hips, indicating potential benefit to maintain bone health and strength. Whether this result leads to reducing the risk of osteoporosis needs to be investigated in further research. [ABSTRACT FROM AUTHOR]

The emergence of personalised data technologies such as learning analytics is framed as a solution to manage the needs of higher education student populations that are growing ever more diverse and larger in size. However, the current approach to learning analytics presents tensions between increasing student agency in making learning-related decisions and 'datafying' students in the process of collecting, analysing and interpreting data. This article presents a study that explores staff and student experience of agency, equity and transparency in existing data practices and expectations towards learning analytics in a UK university. The results show a number of intertwined factors that have contributed to the tensions between enhancing a learner's control of their studies and, at the same time, diminishing their autonomy as an active agent in the process of learning analytics. This article argues that learner empowerment should not be automatically assumed to have taken place as part of the adoption of learning analytics. Instead, the interwoven power relationships in a complex educational system and the interactions between humans and machines need to be taken into consideration when presenting learning analytics as an equitable process to enhance student agency and educational equity. [ABSTRACT FROM AUTHOR]

The emergence of personalised data technologies such as learning analytics is framed as a solution to manage the needs of higher education student populations that are growing ever more diverse and larger in size. However, the current approach to learning analytics presents tensions between increasing student agency in making learning-related decisions and 'datafying' students in the process of collecting, analysing and interpreting data. This article presents a study that explores staff and student experience of agency, equity and transparency in existing data practices and expectations towards learning analytics in a UK university. The results show a number of intertwined factors that have contributed to the tensions between enhancing a learner's control of their studies and, at the same time, diminishing their autonomy as an active agent in the process of learning analytics. This article argues that learner empowerment should not be automatically assumed to have taken place as part of the adoption of learning analytics. Instead, the interwoven power relationships in a complex educational system and the interactions between humans and machines need to be taken into consideration when presenting learning analytics as an equitable process to enhance student agency and educational equity. [ABSTRACT FROM AUTHOR]

Learning analytics (LA) has demonstrated great potential in improving teaching quality, learning experience and administrative efficiency. However, the adoption of LA in higher education is often beset by challenges in areas such as resources, stakeholder buy‐in, ethics and privacy. Addressing these challenges in a complex system requires agile leadership that is responsive to pressures in the environment and capable of managing conflicts. This paper examines LA adoption processes among 21 UK higher education institutions using complexity leadership theory as a framework. The data were collected from 23 interviews with institutional leaders and subsequently analysed using a thematic coding scheme. The results showed a number of prominent challenges associated with LA deployment, which lie in the inherent tensions between innovation and operation. These challenges require a new form of leadership to create and nurture an adaptive space in which innovations are supported and ultimately transformed into the mainstream operation of an institution. This paper argues that a complexity leadership model enables higher education to shift towards more fluid and dynamic approaches for LA adoption, thus ensuring its scalability and sustainability. [ABSTRACT FROM AUTHOR]

Purpose: The analysis of data collected from user interactions with educational and information technology has attracted much attention as a promising approach to advancing our understanding of the learning process. This promise motivated the emergence of the field of learning analytics and supported the education sector in moving toward data-informed strategic decision making. Yet, progress to date in embedding such data-informed processes has been limited. The purpose of this paper is to address a commonly posed question asked by educators, managers, administrators and researchers seeking to implement learning analytics – how do we start institutional adoption of learning analytics? Design/methodology/approach: A narrative review is performed to synthesize the existing literature on learning analytics adoption in higher education. The synthesis is based on the established models for the adoption of business analytics and finding two projects performed in Australia and Europe to develop and evaluate approaches to adoption of learning analytics in higher education. Findings: The paper first defines learning analytics and touches on lessons learned from some well-known case studies. The paper then reviews the current state of institutional adoption of learning analytics by examining evidence produced in several studies conducted worldwide. The paper next outlines an approach to learning analytics adoption that could aid system-wide institutional transformation. The approach also highlights critical challenges that require close attention in order for learning analytics to make a long-term impact on research and practice of learning and teaching. Originality/value: The paper proposed approach that can be used by senior leaders, practitioners and researchers interested in adoption of learning analytics in higher education. The proposed approach highlights the importance of the socio-technical nature of learning analytics and complexities pertinent to innovation adoption in higher education institutions. [ABSTRACT FROM AUTHOR]

Manga is typically recognised in the Western world by the distinct visual styles of its characters and the vast array of symbolic signs that indicate various emotions and physical reactions. However, research into the use of visual techniques in the development of emotional life in manga is far from sufficient. This paper aims to explore the adoption of the cinematic technique - close-ups in manga - as a narrative tool to communicate a character's emotions and build tension between panels. It draws examples from two manga and conversations with 16 young British readers to examine the impact of close shots on reader engagement. [ABSTRACT FROM AUTHOR]

Despite high-dose corticosteroids alone or with immunosuppressive agents as the standard therapy in lupus myocarditis (LM), an immune complex-mediated critical setting, such management is still associated with resistant disease and even mortality. A retrospective study was performed for the refractory LM patients treated with rituximab (RTX), a very limited experience in English literatures. A retrospective review of the myocarditis manifestation was carried out in hospitalized Han Chinese patients with SLE from February 2007 to January 2017. This study analyzed lupus patients who met the diagnosis of LM for their demographic, clinical, laboratory, and radiological data including cardiac magnetic resonance imaging and echocardiography as well as the medication profiles. Among 802 SLE patients, 13 female (1.6%) aged 19 to 52 years (31.9 ± 10.7), fulfilled the LM diagnostic criteria. Under the indications of LM or multi-organic flares with myocarditis refractory to the conventional therapy, three cases received the RTX therapy. All had improved myocardial function as demonstrated by clinical and imaging presentations as well as a decrease in lupus activity. In this 10-year retrospective monocentric cohort, improved myocardial function is demonstrated in refractory LM patients receiving the RTX therapy. [ABSTRACT FROM AUTHOR]

This article presents the results of a research project that explored young British readers’ engagement with manga in literary, aesthetic, social and cultural dimensions. Sixteen school pupils from two secondary schools participated in a number of interviews to provide feedback on selected manga and their own participation in manga fandom. The results show that four distinct features characterise this particular cultural group, including exclusivity, competitiveness, defensiveness and transculturalism. This article aims to discuss these features by exploring the political roots of popular culture, the constant negotiation of power both outwardly and inwardly in fandom, and the fan’s desire to engage with an exotic culture through the text. It is noteworthy that the declaration of one’s identity as a manga fan shows a deep level of passion with which fans demonstrate confidence in their expertise and a determination to defend a taste that is considered illegitimate and degraded by institutional authorities. [ABSTRACT FROM PUBLISHER]

Purpose This study aimed to validate standard deviations of lung densities obtained using high-pitch dual-source computed tomography (DSCT) densitometry as indices of bronchopulmonary dysplasia (BPD) severity in premature infants. Methods Data of preterm, late preterm group, and early term groups were evaluated. Mean and median standard deviations (SDmean, SDmedian) of CT lung density (CTLD) were calculated from CT images. Results SDmean of CTLD in infants with severe BPD was significantly higher than that of infants without BPD (198.1 vs. 140.9, respectively; P = .002). Conclusions Study results support using high-pitch DSCT for BPD diagnosis and quantitative evaluation in prematurity. [ABSTRACT FROM AUTHOR]

Cardiac involvement is a major mortality cause in eosinophilic granulomatosis with polyangiitis (EGPA), requiring novel therapeutics to spare the use of cyclophosphamide with known cardiotoxicity. Despite the observed efficacy of B-cell-depleting therapy in myocarditis of seropositive microscopic polyangiitis, it remains to be elucidated in seronegative EGPA. A retrospective study was performed in 21 hospitalized active patients aged 20 to 70 years with five-factor score 1 or 2, eosinophil counts 10,034 ± 6641/μL and vasculitis scores 27 ± 6. Overt myocarditis was identified in 10 cases, at disease onset in 6 and relapse in 4, with endomyocarditis in 4 and myopericarditis in 4. Five seronegative and one seropositive patient received rituximab with an induction regimen 375 mg/m2 weekly × 4 for refractory or relapse disease, and the same regimen for annual maintenance therapy. All cases had lower eosinophil counts, improved cardiac dysfunction and clinical remission with a relapse-free follow-up, 48 ± 15 months after the induction treatment. One seronegative endomyocarditis patient had eosinophilia and disease relapse with asthma attack and worsening cardiac insufficiency 24 months after induction, achieving clinical remission under anti-IL-5 therapy. Our findings suggest the suppression of IL-5-mediated eosinophilia as an action mechanism of B-cell-depleting therapy in seronegative EGPA myocarditis. [ABSTRACT FROM AUTHOR]

For service implementations to be widely adopted, it is necessary for the expectations of the key stakeholders to be considered. Failure to do so may lead to services reflecting ideological gaps, which will inadvertently create dissatisfaction among its users. Learning analytics research has begun to recognise the importance of understanding the student perspective towards the services that could be potentially offered; however, student engagement remains low. Furthermore, there has been no attempt to explore whether students can be segmented into different groups based on their expectations towards learning analytics services. In doing so, it allows for a greater understanding of what is and is not expected from learning analytics services within a sample of students. The current exploratory work addresses this limitation by using the three-step approach to latent class analysis to understand whether student expectations of learning analytics services can clearly be segmented, using self-report data obtained from a sample of students at an Open University in the Netherlands. The findings show that student expectations regarding ethical and privacy elements of a learning analytics service are consistent across all groups; however, those expectations of service features are quite variable. These results are discussed in relation to previous work on student stakeholder perspectives, policy development, and the European General Data Protection Regulation (GDPR). • Student expectations of learning analytics can be segmented based on service items. • Ethical and privacy expectations were relatively consistent across the sample. • Provides a discussion on how to integrate findings into institutional policies on learning analytics implementations. [ABSTRACT FROM AUTHOR]

Previous investigations have shown that areca nut extracts (ANE) or arecoline (ARE) causes DNA damage, which in turn contributes to oral cell carcinogenesis. To understand the role of microRNA (miRNA) in ANE-associated carcinogenesis, miRNA expression profile was examined in ANE-treated normal human oral fibroblasts. Among the miRNAs changed by ANE exposure, we found that ANE-induced miR-23a overexpression was correlated with an increase of γ-H2AX, a DNA damage marker. In addition, DNA double-strand breaks (DSB) repair that was determined by an in vivo plasmid-based assay was reduced in ANE-treated or miR-23a–overexpressed cells, suggesting the role of miR-23a in DSB repair. FANCG is one of Fanconi anemia susceptibility genes that participate in DSB repair pathway to prevent chromosomal aberrations. FANCG was predicted as a candidate target of miR-23a by TargetScan algorithm. This was confirmed by ectopic overexpression or knockdown of miR-23a. The correlation between miR-23a overexpression and areca nut–chewing habit could also be found in oral cancer patients. Finally, we showed that ANE-induced/ARE-induced miRNAs were significantly associated with the functional categories of “genetic disorders” and “cancer” using network-based analyses. In conclusion, our data showed for the first time that ANE-induced miR-23a was correlated with a reduced FANCG expression and DSB repair, which might contribute to ANE-associated human malignancies. [ABSTRACT FROM AUTHOR]

Summary: One apparent feature of cancerous cells is genomic instability, which may include various types of chromosomal aberrations, such as translocation, aneuploidy, and the presence of micronuclei inside the cells. Mutagenic factors that promote the emergence of genomic instability are recognized as risk factors for the development of human malignancies. In Asia, betel quid (BQ) chewing is one of such risk factors for oral cancer. Areca nut is an essential constitute of BQ and is declared as a group I carcinogen by the International Agency for Research on Cancer. However, the molecular and cellular mechanisms regarding the carcinogenicity of areca nut are not fully explored. Here we reported that arecoline, a major alkaloid of areca nut, could arrest cells at prometaphase with large amounts of misaligned chromosomes. This prometaphase arrest was evidenced by condensed chromosome pattern, increased histone H3 phosphorylation, and accumulation of mitotic proteins, including aurora A and cyclin B1. To investigate the molecular mechanisms accounting for arecoline-induced prometaphase arrest, we found that arecoline could stabilize mitotic spindle assembly, which led to distorted organization of mitotic spindles, misalignment of chromosomes, and up-regulation of spindle assembly checkpoint (SAC) genes. The SAC proteins BubR1 and Mps1 were differentially modified between the cells treated with arecoline and nocodazole. This together with aurora A overexpression suggested that SAC might be partly suppressed by arecoline. As a result, the arecoline-exposed cells might produce progeny that contained various chromosomal aberrations and exhibited genomic instability. [Copyright &y& Elsevier]

Abstract: The International Agency for Research on Cancer declared that areca nut was carcinogenic to human. Areca nut is the main component of betel quid (BQ), which is commonly consumed in Asia. Epidemiological studies have shown that BQ chewing is a predominant risk factor for oral and pharyngeal cancers. It has been known that areca nut is genotoxic to human epithelial cells. However, the molecular and cellular mechanisms underlying areca nut-associated genotoxicity are not fully understood. Here we showed that arecoline, a major alkaloid of areca nut, might contribute to oral carcinogenesis through inhibiting p53 and DNA repair. We found, on the biological aspect, that arecoline could induce γ-H2AX phosphorylation, a sensitive DNA damage marker, in KB, HEp-2, and 293 cells, suggesting that DNA damages were elicited by arecoline. This phenomenon was supported by the observations of arecoline-induced hyperphosphorylation of ATM, Nbs1, Chk1/2, p53, and Cdc25C, as well as G2/M cell cycle arrest, indicating that a cellular DNA damage response was activated. To explore the possible mechanism accounting for arecoline-elicited DNA damages, we found that arecoline could inhibit p53 by its expression and transactivation function. As a result, the expression of p53-regulated p21WAF1 and the p53-activated DNA repair were repressed by arecoline. Finally, we showed that p53 mRNA transcripts were frequently down-regulated in BQ-associated oral cancer, suggesting that arecoline-mediated p53 inhibition might play a role in BQ-associated tumorigenesis. [Copyright &y& Elsevier]

Cdc kinase subunit 1 (Cks1) has been shown to involve in the regulation of cell cycle progression and p27 Kip1 degradation. To define the role of Cks1 in lung tumorigenesis, we examined the expression of Cks1 in human lung cancer cell lines and tested the effect of Cks1-specific small interfering RNA (siRNA) on these cells. Reverse transcriptase-polymerase chain reaction (RT-PCR) and western blot analysis showed that Cks1 was highly expressed in human lung cancer cells. Transfection of Cks1 siRNA down-regulated Cdc2 kinase activity and induced G2/M arrest in Cks1- overexpressing H358 lung cancer cells. Long-term treatment of Cks1 siRNA induced caspase activation and apoptosis in H358 cells . On the contrary, Cks1 siRNA did not affect viability of normal human lung fibroblasts under the same experimental condition. Collectively, our results suggest that Cks1 participates in the steps of lung tumorigenesis and this gene may be a target for the treatment of lung cancer. IUBMB Life, 57: 583–589, 2005 [ABSTRACT FROM AUTHOR]

Existing studies have shed light on policies and strategies for learning analytics (LA) adoption, yet there is limited understanding of associations among factors that influence adoption processes or the change in priorities when institutional experience with LA increases. This paper addresses this gap by presenting a study based on interviews with institutional leaders from 27 European higher education institutions. Results showed that experienced institutions demonstrated more interest in exploring learning behaviour and pedagogical reformation than simply measuring a phenomenon. Experienced institutions also paid more attention to methodological approaches to LA than data constraints, and demonstrated a broader involvement of teachers and students. This paper also identifies inter-related connections between prevailing challenges that impede the scaling of LA. Based on the results, we suggest regular evaluations of LA adoption to ensure the alignment of strategy and desired changes. We also identify three areas that require particular attention when forming short-term goals for LA at different phases of adoption • Connections of key adoption factors vary among institutions with different LA experience. • Experienced institutions prioritised exploring over measuring a learning phenomenon. • Experienced institutions were more concerned with methods than constraints of data. • Experienced institutions engaged primary stakeholders more equally. • Special attention is need for institutional context, people issues, and ethics and privacy. [ABSTRACT FROM AUTHOR]

Learning analytics (LA) as a research field has grown rapidly over the last decade. However, adoption of LA is mostly found to be small in scale and isolated at the instructor level. This paper presents an exploratory study on institutional approaches to LA in European higher education and discusses prominent challenges that impede LA from reaching its potential. Based on a series of consultations with senior managers from 83 different higher education institutions in 24 European countries, we observe that LA is primarily perceived as a tool to enhance teaching and institutional management. As a result, teaching and support staff are found to be the main users of LA and the target audience of training support. In contrast, there is little evidence of active engagement with students or using LA to develop self-regulated learning skills. We highlight the importance of grounding LA in learning sciences and including students as a key stakeholder in the design and implementation of LA. This paper contributes to our understanding of the development of LA in European higher education and highlights areas to address in both practice and research. • Teaching and support staff are the main users of learning analytics (LA). • Managers prioritise using LA to influence institutional and teaching decisions. • There is little evidence of active engagement with students. • LA is primarily implemented at small scales in European higher education. • Few institutions have a dedicated strategy, policy, or evaluation framework for LA. [ABSTRACT FROM AUTHOR]

Hepatitis C virus (HCV) infections can cause permanent liver-related diseases, including hepatocellular carcinoma (HCC). Low mortality and incidence of HCC have been observed in patients with chronic hepatitis C undergoing direct-acting antiviral therapy. Tumor suppressive let-7 family members are down-regulated in HCC. The present study, therefore, aimed to investigate whether expression levels for the full spectrum of let-7 family members (let-7a, 7b, 7c, 7d, 7e, 7f, 7g, 7i, and miR-98) in the circulatory system are useful as surveillance biomarkers for liver-related diseases to monitor treatment efficacy during HCV infection. To this end, we measured the levels of mature circulating let-7 family members using quantitative reverse transcription-PCR in 236 patients with HCV infection, and 147 age- and sex-matched controls. Using hierarchical cluster analysis and principal component analysis, three clusters were obtained after measuring expression levels of let-7 family members in the patients and controls. Cluster 1 included let-7a/d/e/g, Cluster 2 comprised let-7b and let-7i, and Cluster 3 comprised let-7c/f/miR-98. Let-7b/c/g represented the three clusters and showed the best survival response to liver cancer when analyzed with respect to patient data. Therefore, considering the circulating levels of let7 b/c/g as representatives of the let-7 family may facilitate effective monitoring of liver-related disease. [ABSTRACT FROM AUTHOR]

Background: Radiotherapy (RT) might lead to atherosclerotic plaque buildup and coronary artery stenosis of breast cancer (BC) survivors, and coronary artery calcium (CAC) might be a sign of preclinical atherosclerosis. This study explores possible determinants affecting the acceleration of CAC burden in BC patients after adjuvant RT.Methods: Female BC patients receiving adjuvant RT from 2002 to 2010 were included. All patients received noncontrast computed tomography (NCCT) of thorax before and after adjuvant RT. Their CAC burden was compared with healthy controls from the Multi-Ethnic Study of Atherosclerosis (MESA) cohort. The progression of the CAC burden was manifested by the increment of CAC percentiles (%CACinc).Results: Ninety-four patients, including both left- and right-side BC, were enrolled in this study. From undergoing the first to second NCCT, the %CACinc in BC patients significantly increased rather than non-BC women. In addition, the %CACinc was significantly higher in left-side than right-side BC patients (p < 0.05), and significant differences in most heart outcomes were found between the two groups. Besides, the lower the mean right coronary artery (RCA) dose, the lower the risks of CAC percentiles increase ≥ 50% after adjusting the disease's laterality.Conclusions: A significantly higher accelerated CAC burden in BC patients than non-BC women represents that BC could affect accelerated CAC. A higher risk of accelerated CAC burden was found in left-side than right-side BC patients after adjuvant RT. A decrease of the mean RCA dose could reduce more than 50% of the risk of accelerated CAC burden in BC patients. [ABSTRACT FROM AUTHOR]

To assist higher education institutions in meeting the challenge of limited student engagement in the implementation of Learning Analytics services, the Questionnaire for Student Expectations of Learning Analytics (SELAQ) was developed. This instrument contains 12 items, which are explained by a purported two‐factor structure of "Ethical and Privacy Expectations" and "Service Feature Expectations." As it stands, however, the SELAQ has only been validated with students from UK university, which is problematic on account of the interest in Learning Analytics extending beyond this context. Thus, the aim of the current work was to assess whether the translated SELAQ can be validated in three contexts (an Estonian, a Spanish, and a Dutch University). The findings show that the model provided acceptable fits in both the Spanish and Dutch samples, but was not supported in the Estonian student sample. In addition, an assessment of local fit is undertaken for each sample, which provides important points that need to be considered in future work. Finally, a general comparison of expectations across contexts is undertaken, which are discussed in relation to the General Data Protection Regulation (2018). Lay Description: What is currently known about the subject matter: Accounting for student expectations allows for a service that is meaningful.SELAQ measures student expectations towards Learning Analytics services.The 12 items of the SELAQ can be explained by a two‐factor structure (Ethical and Privacy Expectations and Service Feature Expectations). What their paper adds to this: Validation of the SELAQ in three contextsA discussion of localized sources of strainAn assessment of measurement quality in each contextA general comparison of student expectations across contexts The implications of study findings for practitioners: SELAQ can be used with Spanish and Dutch students.SELAQ responses provide a much needed input from end‐users in Learning Analytics implementations. [ABSTRACT FROM AUTHOR]

Background: Learning Analytics (LA) is an emerging field concerned with measuring, collecting, and analysing data about learners and their contexts to gain insights into learning processes. As the technology of Learning Analytics is evolving, many systems are being implemented. In this context, it is essential to understand stakeholders' expectations of LA across Higher Education Institutions (HEIs) for large‐scale implementations that take their needs into account. Objectives: This study aims to contribute to knowledge about individual LA expectations of European higher education students. It may facilitate the strategy of stakeholder buy‐in, the transfer of LA insights across HEIs, and the development of international best practices and guidelines. Methods: To this end, the study employs a 'Student Expectations of Learning Analytics Questionnaire' (SELAQ) survey of 417 students at the Goethe University Frankfurt (Germany) Based on this data, Multiple Linear Regressions are applied to determine how these students position themselves compared to students from Madrid (Spain), Edinburgh (United Kingdom) and the Netherlands, where SELAQ had already been implemented at HEIs. Results and Conclusions: The results show that students' expectations at Goethe University Frankfurt are rather homogeneous regarding 'LA Ethics and Privacy' and 'LA Service Features'. Furthermore, we found that European students generally show a consistent pattern of expectations of LA with a high degree of similarity across the HEIs examined. European HEIs face challenges more similar than anticipated. The HEI experience with implementing LA can be more easily transferred to other HEIs, suggesting standardized LA rather than tailor‐made solutions designed from scratch. Lay Description: What is currently known about this topic: Implementing Learning Analytics is a promising but challenging task.SELAQ is a questionnaire that can be used to determine students' expectations of Learning Analytics.Several institutions in Europe applied SELAQ to implement Learning Analytics that meet the needs of their students. What this paper adds to this: This study applies SELAQ for the first time at a German university and compares the results to studies from the UK, Spain, and the Netherlands.The participating students at the German university show relatively homogeneous expectations of Learning Analytics.The expectations towards Learning Analytics of students across Europe are comparable. The implications of study findings for practitioners: Learning Analytics systems should be shared across institutions rather than being implemented separately as tailored solutions.More standardized or modular Learning Analytics systems are reasonable. [ABSTRACT FROM AUTHOR]

Background: Cancer-specific adoptive T cell therapy has achieved successful milestones in multiple clinical treatments. However, the commercial production of cancer-specific T cells is often hampered by laborious cell culture procedures, the concern of retrovirus-based gene transfection, or insufficient T cell purity. Methods: In this study, we developed a non-genetic engineering technology for rapidly manufacturing a large amount of cancer-specific T cells by utilizing a unique anti-cancer/anti-CD3 bispecific antibody (BsAb) to directly culture human peripheral blood mononuclear cells (PBMCs). The anti-CD3 moiety of the BsAb bound to the T cell surface and stimulated the differentiation and proliferation of T cells in PBMCs. The anti-cancer moiety of the BsAb provided these BsAb-armed T cells with the cancer-targeting ability, which transformed the naïve T cells into cancer-specific BsAb-armed T cells. Results: With this technology, a large amount of cancer-specific BsAb-armed T cells can be rapidly generated with a purity of over 90% in 7 days. These BsAb-armed T cells efficiently accumulated at the tumor site both in vitro and in vivo. Cytotoxins (perforin and granzyme) and cytokines (TNF-α and IFN-γ) were dramatically released from the BsAb-armed T cells after engaging cancer cells, resulting in a remarkable anti-cancer efficacy. Notably, the BsAb-armed T cells did not cause obvious cytokine release syndrome or tissue toxicity in SCID mice bearing human tumors. Conclusions: Collectively, the BsAb-armed T cell technology represents a simple, time-saving, and highly safe method to generate highly pure cancer-specific effector T cells, thereby providing an affordable T cell immunotherapy to patients. [ABSTRACT FROM AUTHOR]

Learning analytics (LA) employs educational data to improve the timeliness of support for learners. Apart from technical aspects, there is a need to understand social complexities brought about by different stakeholders, so as to systematise the adoption of LA in Higher Education (HE). We present an analysis of the situation, needs and challenges of LA in the context of Spanish HE, considering managers', teachers' and students' perspectives. Qualitative research is employed using recursive abstraction. Results reveal that the level of institutional adoption is low and none of the analysed institutions had an LA policy. Furthermore, only two of these institutions had an initial LA strategy. While the institutions shared some commonalities in their objectives for LA, chosen tools and adoption challenges, the distinct differences in the political contexts and institutional practices among the institutions reaffirmed that LA solutions and services cannot be implemented in the same manner. Moreover, different needs for LA and concerns are identified about its adoption among managers, students and teachers. These observations lead to our conclusion that the main challenges to implement LA in Spain are not related to technological issues but to the social and cultural issues rooted in institutions and those associated with different stakeholders. [ABSTRACT FROM AUTHOR]

The high accessibility to healthcare and increasing awareness of hepatocellular carcinoma (HCC) surveillance after sustained virologic response (SVR) to HCV treatment allow early detection of operable HCC in Taiwan. However, the effects of achieving SVR on patient characteristics and surgical outcomes after curative resection remain elusive. We aimed to compare the clinical presentation and postoperative prognosis among patients with early-stage HCV-related HCC and different viral status. We retrospectively analyzed 208 patients with BCLC stage 0 or A-HCC, including 44 patients who remained HCV viremic, 90 patients who developed HCC after achieving SVR (post-SVR HCC), and 74 patients who subsequently achieved SVR after resection. Patients with post-SVR HCC had a lower degree of hepatitis and better liver function than those who achieved SVR or remained viremic after resection. Notably, 75.6% of patients with post-SVR HCC did not have cirrhosis. Patients with post-SVR HCC and those achieving SVR after resection exhibited comparable recurrence rates and recurrence-free survival, while patients with persistent viremia had the worst surgical outcomes. We concluded that patients with post-SVR HCC had a better liver function but similar surgical outcomes compared with patients who achieved SVR after resection. The low prevalence of cirrhosis in patients with post-SVR HCC highlights the importance of regular surveillance after SVR. [ABSTRACT FROM AUTHOR]

Background: The aim of this study was to evaluate the impact of adverse lifestyle factors on outcomes in patients with human papillomavirus (HPV)-related oropharyngeal squamous cell carcinoma (OPSCC). Methods: From 2010 to 2019, 150 consecutive non-metastatic OPSCC patients receiving curative treatment in our institution were retrospectively enrolled. HPV positivity was defined as p16 expression ≥75%. The effects of adverse lifestyle factors on overall survival (OS) and disease-free survival (DFS) on OPSCC patients were determined. Results: The median follow-up duration was 3.6 years. Of the 150 OPSCCs, 51 (34%) patients were HPV-positive and 99 (66%) were HPV-negative. The adverse lifestyle exposure rates were 74.7% (n = 112) alcohol use, 57.3% (n = 86) betel grid chewing, and 78% (n = 117) cigarette smoking. Alcohol use strongly interacted with HPV positivity (HR, 6.00; 95% CI, 1.03–35.01), leading to an average 26.1% increased risk of disease relapse in patients with HPV-positive OPSCC. Heavy smoking age ≥30 pack-years was associated with increased risk of death (HR, 2.05; 95% CI, 1.05–4.00) and disease relapse (HR, 1.99; 95% CI, 1.06–3.75) in OPSCC patients. In stratified analyses, the 3-year absolute risk of disease relapse in HPV-positive OPSCC patients reached up to 50% when alcohol use and heavy smoking for ≥30 pack-years were combined. Conclusions: Alcohol acted as a significant treatment-effect modifier for DFS in HPV-positive OPSCC patients, diluting the favorable prognostic effect of HPV positivity. Heavy smoking age ≥30 pack-years was an independent adverse prognostic factor of OS and DFS in OPSCC patients. De-intensification treatment for HPV-related OPSCC may be avoided when these adverse lifestyle factors are present. [ABSTRACT FROM AUTHOR]

The article describes about dacryocystoceles which develops due to neonatal nasal obstruction. Extirpation of the nasal passage can take place when dacryocystoceles extend intranasally and they cause airway obstruction in neonates who breathe through their nose. While some cases can be cured on the spot with conservative management, most often treatment is justified when there is respiratory distress.

Purpose: This meta-analysis examined roles of several metabolites in differentiating recurrent tumor from necrosis in patients with brain tumors using MR perfusion and spectroscopy. Methods: Medline, Cochrane, EMBASE, and Google Scholar were searched for studies using perfusion MRI and/or MR spectroscopy published up to March 4, 2015 which differentiated between recurrent tumor vs. necrosis in patients with primary brain tumors or brain metastasis. Only two-armed, prospective or retrospective studies were included. A meta-analysis was performed on the difference in relative cerebral blood volume (rCBV), ratios of choline/creatine (Cho/Cr) and/or choline/N-acetyl aspartate (Cho/NAA) between participants undergoing MRI evaluation. A χ2-based test of homogeneity was performed using Cochran’s Q statistic and I2. Results: Of 397 patients in 13 studies who were analyzed, the majority had tumor recurrence. As there was evidence of heterogeneity among 10 of the studies which used rCBV for evaluation (Q statistic = 31.634, I2 = 97.11%, P < 0.0001) a random-effects analysis was applied. The pooled difference in means (2.18, 95%CI = 0.85 to 3.50) indicated that the average rCBV in a contrast-enhancing lesion was significantly higher in tumor recurrence compared with radiation injury (P = 0.001). Based on a fixed-effect model of analysis encompassing the six studies which used Cho/Cr ratios for evaluation (Q statistic = 8.388, I2 = 40.39%, P = 0.137), the pooled difference in means (0.77, 95%CI = 0.57 to 0.98) of the average Cho/Cr ratio was significantly higher in tumor recurrence than in tumor necrosis (P = 0.001). There was significant difference in ratios of Cho to NAA between recurrent tumor and necrosis (1.02, 95%CI = 0.03 to 2.00, P = 0.044). Conclusions: MR spectroscopy and MR perfusion using Cho/NAA and Cho/Cr ratios and rCBV may increase the accuracy of differentiating necrosis from recurrent tumor in patients with primary brain tumors or metastases. [ABSTRACT FROM AUTHOR]

Background and Aims: Regorafenib has demonstrated its survival benefit for unresectable hepatocellular carcinoma (uHCC) patients in a phase III clinical trial. We aimed to assess the efficacy and tolerability of regorafenib and the predictors of treatment outcomes in Taiwanese patients. Methods: We analyzed the survival, best overall response, predictors of treatment outcomes, and safety for uHCC patients who had tumor progression on sorafenib therapy and received regorafenib as salvage therapy between March 2018 and November 2020. Results: Eighty‐six patients with uHCC were enrolled (median age, 66.5 years; 76.7% male). The median regorafenib treatment duration was 4.0 months (95% confidence interval [CI], 3.6–4.6). The most frequently reported adverse events were hand‐foot skin reaction (44.2%), diarrhea (36.0%), and fatigue (29.1%). No unpredictable toxicity was observed during treatment. The median overall survival (OS) with regorafenib was 12.4 months (95% CI, 7.8–17.0) and the median progression‐free survival (PFS) was 4.2 months (95% CI, 3.7–4.7). Of 82 patients with regorafenib responses assessable, 4 patients (4.9%) achieved a partial response, and 33 (40.2%) had stable disease, leading to a disease control rate (DCR) of 45.1% (n = 37). Patients possessing baseline AFP < 400 ng/ml exhibited a markedly longer median OS, median PFS, and higher DCR compared with their counterparts (15.7 vs. 8.1 months, 4.6 vs. 3.7 months, 60.9% vs. 27.5%, respectively). Despite possessing high baseline AFP levels, patients with early AFP response (>10% reduction at 4 weeks or >20% reduction at 8 weeks after regorafenib administration) exhibited comparable treatment outcomes to those with baseline AFP < 400 ng/ml. Conclusions: The results of this real‐world study verified the tolerability and efficacy of regorafenib treatment for uHCC patients who failed prior sorafenib therapy, especially for those with lower baseline AFP levels or with early AFP response. [ABSTRACT FROM AUTHOR]

Microdrills are fundamental cutting tools used in mechanical microdrilling. The web thickness of a microdrill is an important design parameter in balancing drill rigidity and chip removal ability. Conventional destructive method for measuring the web thickness is currently adopted by some microdrill manufactures. The conventional method must be carried out manually by experienced inspectors and thus lacks sufficient efficiency and accuracy. To improve the drawbacks of the conventional method, a vision-aided automation system for performing the destructive web thickness measurement is introduced in this paper. Based on the integration of motion and logic control, machine vision, and image processing techniques, an automated measuring process is then established. Experiments to measure the web thickness of microdrill samples were conducted to test the feasibility and effectiveness of the presented automation system and automated measuring process. The experimental results showed that the presented vision-aided automation system, in combination with the automated measuring process, could be an efficient and precise manner for replacing the conventional manual procedure in performing the destructive web thickness measurement of certain microdrills. [ABSTRACT FROM AUTHOR]

Background. Radiation using conventional X-ray is associated with exposure of radiosensitive organs and typically requires the use of protection. This study is aimed at evaluating the use of bismuth shielding for radiation protection in pediatric pelvic radiography. The effects of the anteroposterior and lateral bismuth shielding were verified by direct measurements at the anatomical position of the gonads. Methods. Radiation doses were measured using optically stimulated luminescence dosimeters (OSLD) and CIRS ATOM Dosimetry Verification Phantoms. Gonad radiographs were acquired using different shields of varying material (lead, bismuth) and thickness and were compared with radiographs obtained without shielding to examine the effects on image quality and optimal reduction of radiation dose. All images were evaluated separately by three pediatric orthopedic practitioners. Results. Results showed that conventional lead gonadal shielding reduces radiation doses by 67.45%, whereas dose reduction using one layer of bismuth shielding is 76.38%. The use of two layers of bismuth shielding reduces the dose by 84.01%. Using three and four layers of bismuth shielding reduces dose by 97.33% and 99.34%, respectively. Progressively lower radiation doses can be achieved by increasing the number of bismuth layers. Images obtained using both one and two layers of bismuth shielding provided adequate diagnostic information, but those obtained using three or four layers of bismuth shielding were inadequate for diagnosis. Conclusions. Bismuth shielding reduces radiation dose exposure providing appropriate protection for children undergoing pelvic radiography. The bismuth shielding material is lighter than lead, making pediatric patients more comfortable and less apt to move, thereby avoiding repeat radiography. [ABSTRACT FROM AUTHOR]

A 56‐year‐old woman was misdiagnosed, based on a coronary computed tomography, with a left main coronary artery aneurysm the referring hospital. Detailed diagnostic modalities—conventional angiography, transesophageal echocar‐diography, and electrocardiography‐gated cardiac computed tomography—showed the accurate anatomical structure and supported a final diagnosis of a rare case of hypoplastic sinus of Valsalva with a small localized aneurysm. [ABSTRACT FROM AUTHOR]

ATM and BRCA1 are DNA repair genes that play a central role in homologous recombination repair. Alterations of ATM and BRCA1 gene expression are found in cancers, some of which are correlated with treatment response and patient outcome. However, the role of ATM and BRCA1 gene expression in head and neck cancer (HNC) is not well characterized. Here, we examined the prognostic role of ATM and BRCA1 expression in two HNC cohorts with and without betel quid (BQ) exposure. The results showed that the expression of ATM and BRCA1 was downregulated in BQ-associated HNC, as the BQ ingredient arecoline could suppress the expression of both genes. Low expression of either ATM or BRCA1 was correlated with poor overall survival (OS) and was an independent prognostic factor in multivariate analysis (ATM HR: 1.895, p = 0.041; BRCA1 HR: 2.163, p = 0.040). The combination of ATM and BRCA1 expression states further improved on the prediction of OS (HR: 4.195, p = 0.001, both low vs. both high expression). Transcriptomic analysis showed that inhibition of ATM kinase by KU55933 induced apoptosis signaling and potentiated cisplatin-induced cytotoxicity. These data unveil poor prognosis in the HNC patient subgroup with low expression of ATM and BRCA1 and support the notion of ATM-targeted therapy. [ABSTRACT FROM AUTHOR]

The spreading of viral hepatitis among injecting drug users (IDU) is an emerging public health concern. This study explored the prevalence and the risks of hepatitis B virus (HBV), hepatitis C virus (HCV) and hepatitis D virus (HDV) among IDU-dominant prisoners in Taiwan. HBV surface antigen (HBsAg), antibodies to HCV (anti-HCV) and HDV (anti-HDV), viral load and HCV genotypes were measured in 1137(67.0%) of 1697 prisoners. 89.2% of participants were IDUs and none had HIV infection. The prevalence of HBsAg, anti-HCV, dual HBsAg/anti-HCV, HBsAg/anti-HDV, and triple HBsAg/anti-HCV/anti-HDV was 13.6%, 34.8%, 4.9%, 3.4%, and 2.8%, respectively. HBV viremia rate was significantly lower in HBV/HCV-coinfected than HBV mono-infected subjects (66.1% versus 89.9%, adjusted odds ratio/95% confidence intervals [aOR/CI] = 0.27/0.10–0.73). 47.5% anti-HCV-seropositive subjects (n = 396) were non-viremic, including 23.2% subjects were antivirals-induced. The predominant HCV genotypes were genotype 6(40.9%), 1a(24.0%) and 3(11.1%). HBsAg seropositivity was negatively correlated with HCV viremia among the treatment naïve HCV subjects (44.7% versus 72.4%, aOR/CI = 0.27/0.13–0.58). Anti-HCV seropositivity significantly increased the risk of anti-HDV-seropositivity among HBsAg carriers (57.1% versus 7.1%, aOR/CI = 15.73/6.04–40.96). In conclusion, IUDs remain as reservoirs for multiple hepatitis viruses infection among HIV-uninfected prisoners in Taiwan. HCV infection increased the risk of HDV infection but suppressed HBV replication in HBsAg carriers. An effective strategy is mandatory to control the epidemic in this high-risk group. [ABSTRACT FROM AUTHOR]

Hepatitis D virus (HDV) infection increases the risk of hepatocellular carcinoma (HCC) in the natural course of chronic hepatitis B (CHB) patients. Its role in patients treated with nucleotide/nucleoside analogues (NAs) is unclear. We aimed to study the role of hepatitis D in the development of HCC in CHB patients treated with NAs. Altogether, 1349 CHB patients treated with NAs were tested for anti-HDV antibody and RNA. The incidence and risk factors of HCC development were analyzed. Rates of anti-HDV and HDV RNA positivity were 2.3% and 1.0%, respectively. The annual incidence of HCC was 1.4 per 100 person-years after a follow-up period of over 5409.5 person-years. The strongest factor association with HCC development was liver cirrhosis (hazard ratio [HR]/95% confidence interval [CI] 9.98/5.11–19.46, P < 0.001), followed by HDV RNA positivity (HR/ CI 5.73/1.35–24.29, P = 0.02), age > 50 years old (HR/CI 3.64/2.03–6.54, P < 0.001), male gender (HR/CI 2.69/1.29–5.60, P: 0.01), and body mass index (BMI, HR/CI 1.11/1.03–1.18, P = 0.004). The 5-year cumulative incidence of HCC was 7.3% for patients with HDV RNA negativity compared to that of 22.2% for patients with HDV RNA positivity (P = 0.01). In the subgroup of cirrhotic patients, the factors associated with HCC development were HDV RNA positivity (HR/CI 4.45/1.04–19.09, P = 0.04) and BMI (HR/CI 1.11/1.03–1.19, P = 0.01). HDV viremia played a crucial role in HCC development in CHB patients who underwent NA therapy. [ABSTRACT FROM AUTHOR]

Prospective electrocardiography (ECG)-gated cardiac computed tomography angiography (CTA) is widely used for pediatric patients with congenital heart disease (CHD) due to the lower radiation dose compared with the ECG-gated technique. However, functional parameters acquired using ECG-gated cardiac CT to predict pulmonary hypertension (PH) in children with CHD have not yet been reported. This study aimed to investigate the potential of diastolic and systolic right ventricular diameters (RVD) on prospective ECG-gated cardiac CTA to predict PH in children with CHD. A total of 44 children with CHD were divided into two groups: CHD with PH (n = 22) and CHD without PH (n = 22). The association between ECG-gated CTA parameters and PH was evaluated by logistic regression. The receiver operating characteristic curve (ROC) was used to find the best cut-off point for the parameters measured by Youden's index. Patients with higher RVD-BSA [aOR (95% CI) diastolic: 2.76 (1.23–6.23); systolic: 6.15 (1.72–22.06)] had higher risk of PH after adjusting for age and patent ductus arteriosus. The area under the curve (AUC) of D-RVD-BSA was 0.907 and the AUC of S-RVD-BSA was 0.917. Logistic regression showed that patients with D-RVD-BSA over 6.86 or S-RVD-BSA over 5.87 had significantly higher risk of PH after adjustments (aOR = 23.52, 95% CI = 2.89–191.03; aOR = 31.14, 95% CI = 2.75–352.85). In conclusion, in children with CHD, measurements of diastolic or systolic BSA-modified RVDs on prospective ECG-gated CTA are non-invasive markers of PH. BSA-modified D-RVD of 6.86 or BSA-modified S-RVD of 5.87 may be used to identify PH in children with CHD. • In children with PH, an association is found between ECG-CTA-gated image parameters and PH. • Diastolic-RVD & systolic-RVD are associated with pulmonary arterial systolic pressure. • Patients with D-RVD-BSA over 6.86 had significantly higher risk of PH. • Patients with S-RVD-BSA over 5.87 had significantly higher risk of PH. • The AUCs of diastolic-RVD and systolic-RVD were 0.907 and 0.917, respectively. [ABSTRACT FROM AUTHOR]

Background and Aim: The serial serologic changes of hepatitis D virus (HDV) infection among chronic hepatitis B virus (HBV) infected patients who received oral nucleotide/nucleoside analogues are elusive. Methods: Serum anti‐HDV and HDV RNA among chronic hepatitis B (CHB) patients were tested at the time of initiating anti‐HBV therapy and subsequently during the follow‐up period. Results: The seropositive rate of anti‐HDV and HDV RNA among 2850 CHB patients, was 2.7% and 0.9%, respectively. Factors associated with anti‐HDV seropositivity were platelet counts (odds ratio [OR]/95% confidence intervals [CI]: 0.995/0.992–0.999; P = 0.006), HBV DNA levels (OR/CI: 0.81/0.70–0.94; P = 0.005), and hepatitis B e‐antigen (HBeAg) seropositivity (OR/CI: 0.22/0.05–0.95; P = 0.04). The only factor associated with HDV RNA positivity among anti‐HDV seropositive patients was age (OR/CI: 0.95/0.90–1.00; P = 0.03). The spontaneous clearance rate of serum anti‐HDV antibody was 3.0 per 100 person‐years with a median follow‐up period of 3.5 years (range 2–12 years), whereas the seroclearance rate of HDV RNA was 4.3 per 100 person‐years among anti‐HDV seropositive patients after a median follow‐up period of 6.0 years (range 2–11 years). A baseline anti‐HDV titer < 0.5 cut‐off index was the only factor predictive of anti‐HDV seroclearance (hazard ratio [HR]/CI: 30.11/3.73–242.85; P = 0.001). Conclusions: HDV infection was not common among patients treated for HBV in Taiwan. Seroclearance of anti‐HDV and HDV RNA did occur over time, albeit the chance is rare. [ABSTRACT FROM AUTHOR]

It has been identified that bisphenol A (BPA) exposure causes developmental toxicity in breast cells. However, the exact molecular mechanisms underlying the association between exposure to BPA and breast cancer remain unclear. The aim of the present study was to investigate the BPA-regulated signaling pathways associated with the aggressiveness and the development of breast cancer. Microarray technology and functional gene set analyses were used to evaluate BPA and breast cancer-associated biomarkers and pathways in a discovery-driven manner. Using individual dataset analyses, it was indicated that two BPA-associated gene sets, the visceral obesity pathway, involved in visceral fat deposits and the metabolic syndrome, and the cell cycle pathway, involved in cyclins and cell cycle regulation, were significantly associated with a high grade of aggressiveness and the development of estrogen receptor (ER)-positive breast cancer (between P<0.05 and 0.0001). The pooled analysis indicated that the most significant pathway was G1/S checkpoint regulation, and the cyclin and cell cycle regulation pathway for BPA-associated ER-positive cancer. Cancer cell signaling pathways were associated with healthy breast cells developing into breast cancer. The visceral obesity and the cell cycle pathways were indicated to link BPA exposure to breast cancer. The results of the present study demonstrate a significant association between breast cancer and BPA-regulated gene pathways. [ABSTRACT FROM AUTHOR]

In Latin American universities, Learning Analytics (LA) has been perceived as a promising opportunity to leverage data to meet the needs of a diverse student cohort. Although universities have been collecting educational data for years, the adoption of LA in this region is still limited due to the lack of expertise and policies for processing and using educational data. In order to get a better picture of how existing data‐related practices and policies might affect the incorporation of LA in Latin American institutions, we conducted a mixed methods study in four Latin American universities (two Chilean and two Ecuadorian). In this paper, the qualitative data were based on 37 interviews with managers and 16 focus groups with 51 teaching staff and 45 students; the quantitative data were collected through two surveys answered by 1884 students and 368 teachers, respectively. The findings reveal opportunities to incorporate LA services into existing data practices in the four case studies. However, the lack of reliable information systems and policies to regulate the use of data imposes challenges that need to be overcome for future LA adoption. [ABSTRACT FROM AUTHOR]