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Abstract Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) not only posed major health and economic burdens to international societies but also threatens patients with comorbidities and underlying autoimmune disorders, including Crohn’s disease (CD) patients. As the vaccinated population is gradually relieved from the stress of the latest omicron variant of SARS-CoV-2 due to competent immune responses, the anxiety of CD patients, especially those on immunosuppressive treatment, has not subsided. Whether the use of immunosuppressants for remission of CD outweighs the potential risk of severe coronavirus disease 2019 (COVID-19) has long been discussed. Thus, for the best benefit of CD patients, our primary goal in this study was to navigate the clinical management of CD during the COVID pandemic. Herein, we summarized COVID-19 outcomes of CD patients treated with immunosuppressive agents from multiple cohort studies and also investigated possible mechanisms of how SARS-CoV-2 impacts the host immunity with special consideration of CD patients. We first looked into the SARS-CoV-2-related immunopathology, including lymphocytopenia, T-cell exhaustion, cytokine storms, and their possible molecular interactions, and then focused on mechanistic actions of gastrointestinal systems, including interruption of tryptophan absorption, development of dysbiosis, and consequent local and systemic inflammation. Given challenges in managing CD, we summarized up-to-date clinical and molecular evidence to help physicians adjust therapeutic strategies to achieve the best clinical outcomes for CD patients.

Abstract Background It is critical to find optimal forms to identify perinatal depression (PND) and its vulnerable factors and make them more applicable to depression screening. This study aims to evaluate the reliability and validity of the Chinese version of the Leiden Index of Depression Sensitivity (LEIDS-RR-CV) among perinatal women in China and determine the cut-off values for screening for high-risk depression. Methods Women in their third trimester of pregnancy and six weeks postpartum completed the LEIDS-RR-CV and a diagnostic reference standard online. We assessed the LEIDS-RR-CV using classical test theory (CTT) and item response theory (IRT). We also assessed the test performance for cut-off scores using receiver operator characteristic analysis to further screen for high-risk depression at each time point. Results In total, 396 (third trimester) and 321 (six weeks postpartum) women participated. Cronbach’s alpha, two-week test–retest reliability, and marginal reliability for the scale were all greater than 0.8. It showed a five-factor model; the cut-off values were 58 (third trimester) and 60 (six weeks postpartum). The areas under the curve were acceptable (≥ 0.7), and the LEIDS-RR-CV was positively correlated with the total Edinburgh Postnatal Depression Scale (EPDS) score (r = 0.52 and 0.56, p = 0.00), indicating its predictive validity. An IRT analysis further confirmed its discriminative validity. Conclusions The LEIDS-RR-CV was found to be reliable, valid, and can be used to quantify cognitive reactivity among perinatal Chinese women and for screening for high-risk depression during this period.

Abstract Background Health belief is an important factor affecting lung cancer screening in high-risk population, but the research based on Chinese cultural background is still insufficient. Therefore, we adapted the English version of the Lung Cancer Screening Health Belief Scales (LCSHB) into the Chinese version (LCSHB-C) and examined its psychometric characteristics. Methods After obtaining authorization from the original author, the LCSHB-C was adapted based upon Brislin's translation model. Using a variety of community-based recruitment methods, a total of 353 participants were recruited in Fuzhou, Fujian province, China to complete the questionnaires. We combined the classical test theory and item response theory to examine the psychometric properties of the LCSHB-C. Results The Cronbach’s alpha for the four subscales ranged from 0.83 ~ 0.93. The content validity index for the four subscales was ranged from 0.87 ~ 1.0. Confirmatory factor analysis supported each subscale structure model fit well. Rasch analysis results further validated the reliability and validity of the four subscales. The person reliability and separation index of each subscale ranged from 0.77 to 0.87 and 1.83 to 2.63, respectively. Conclusions The LCSHB-C is a reliable and valid instrument used to measure health beliefs related to lung cancer screening among those high-risk for lung cancer in China, which facilitates the development of lung cancer screening programs and promotes the "three early prevention strategies" of lung cancer (i.e.,early detection, early diagnosis and early treatment).

Abstract Targeting the interaction between leukemic cells and the microenvironment is an appealing approach to enhance the therapeutic efficacy in acute myeloid leukemia (AML). AML infiltration induces a significant release of inflammatory cytokines in the human bone marrow niche which accelerates leukemogenesis. As the transmembrane glycoprotein CD38 has been shown to regulate cytokine release, we assessed the anti-leukemic potential of CD38 inhibition in AML. CD38 expression in AML cells proved to depend on microenvironmental cues and could be significantly enforced through addition of tretinoin. In fact, the anti-CD38 antibody daratumumab showed significant cytostatic efficacy in a 3D in vitro triple-culture model of AML, but with modest cell-autonomous cytotoxic activity and independent of CD38 expression level. In line with a predominantly microenvironment-mediated activity of daratumumab in AML, CD38 inhibition significantly induced antibody-dependent phagocytosis and showed interference with AML cell trafficking in vivo in a xenograft transplantation model, but overall lacked robust anti-leukemic effects.

Microbial fuel cells (MFCs) are recognized as an efficient method to utilize biomass to generate power while simultaneously treats wastewater. Micro-electro-mechanical system (MEMS) technology enables miniaturization of the MFCs system. Miniaturized MFCs through MEMS strengthen the system’s reaction capacity that makes it suitable for environmental sense field applications such as sensors or biomedical actuators. In this work, MEMS technology is employed to deposit metal layers on the surface of the anode/cathode electrode to enhance the power density of the MFC. Hence, micromixers and micro-pillars in the anode tank along with the influence of the electron transport media on MFC performance were evaluated. The introduction of the micro-mixers promotes the full mixing of the anolyte. The inclusion of the micro-pillars increases the surface area of the electrode, thereby enhancing the electrical energy output of the MFC. Results revealed that the introduction of the microstructure and the electron transfer media to the anolyte in the MFC have yielded a maximum current of 66.55 μA cm−2, a maximum power density of 3.28 μW cm−2, and an internal resistance value of 2.57kΩ. Moreover, the inclusion of several micro-mixers and micro-pillar structures to the anode tank has shown the performance enhancement of MFC. Relevant research results will provide a reference for future research on the combination of MFCs and sensors.

Mirror therapy (MT) has been proposed as an essential component of upper limb neurorehabilitation, using mirror illusion of the unaffected hand movement and superimposing it on the affected hand to improve neuroplasticity for improving motor recovery in stroke patients. In this paper, we developed a virtual reality mirror therapy (VRMT) system, and examined the performance of the proposed VRMT system. The VRMT system consists of a motion-tracking device, a VR goggle, and a VRMT software. Young, healthy participants, and stroke patients with mild-to-severe hemiparesis were recruited in this study, to validate the effectiveness of the proposed VRMT system. Experimental results based on the pinch-holding-up activity (PHUA) test revealed a significant effect on the precision pinch performance of young-healthy participants receiving VRMT, whereas traditional MT could not improve the precision pinch performance in young-healthy participants (Wilcoxon signed-rank test, Z = -2.693, p = 0.007). For patients having suffered a stroke and being treated with VRMT, significant beneficial effects examined by mixed effect model were found on the total score of FMA (p = 0.033) and hand part of FMA (p = 0.008). The findings in this study indicate that the VRMT system has a potentially positive effects on the sensorimotor performance of hands in healthy participants. In addition, add-on effect of VR to MT provides beneficial effects on motor function of the upper extremity in chronic stroke patients.

Introduction The global uptake rates of lung cancer screening (LCS) with low-dose CT remain low. Since numerous factors contribute to the underuse of LCS, a theory-informed approach to identify and address the uptake of LCS barriers and facilitators is required. This study aims to document the methods which were used to identify, appraise, and synthesise the available qualitative, quantitative, and mixed methods evidence, addressing the barriers and facilitators at the individual and healthcare provider level, according to the social–ecological model, before identifying gaps to aid future practices and policies.Methods and analysis The following databases will be searched: PubMed, Ovid (Journals @ Ovid Full Text and Ovid MEDLINE), EMBASE, CINAHL, PsycINFO, Cochrane Library, Chinese Biomedical Database, Chinese National Knowledge Infrastructure, and Wanfang database, from their creation up to 31 December 2020. Two reviewers will be involved in independently screening, reviewing, and synthesising the data; and calibration exercises will be conducted at each stage. Disagreements between the two reviewers will be resolved by arbitration by a third reviewer. The Critical Appraisal Checklist for Studies Reporting Prevalence Data from the Joanna Briggs Institute, the Critical Appraisal Skills Programme criteria adapted for qualitative studies, and the 16-item Quality Assessment Tool (QATSDD) will be used in the quality assessment of primary studies. We will perform data synthesis using the Review Manager software, V.5.3.Ethics and dissemination This study is a review of published data and therefore needs no ethical approval. The findings of this systematic review will be published in a peer-reviewed journal.Trial registration number CRD42020162802.

This study examined the effects of students' argumentation standpoints on their argumentation learning in the context of socio-scientific issues (SSIs). To that end, four kinds of argumentation standpoints were defined: affirmative standpoints, oppositional standpoints, multiple standpoints, and non-standpoints. These four kinds of standpoints allow for six possible combinations of any two of the different kinds of standpoints, which enabled us to conduct six kinds of 2-team format debates. The resulting differences of students' four types of arguments (i.e., claims, warrants, rebuttals, and qualifiers) generated in six types of debates were examined. This study invited 208 10th-grade students to participate in a quasi-experimental research design. The results showed the affirmative group students demonstrated superior performance in terms of claims and warrants, and the oppositional group students had the largest number of rebuttals. The students in the debate with combinations of affirmative and oppositional groups exhibited the best performance regarding the generation of claims, warrants, and rebuttals. Based on the results, the present study concluded the standpoint had significant effects on the students' argumentation learning, which suggests that teachers can investigate students' standpoint on the learning topic of SSI and their prior knowledge about the standpoint before teaching.

PurposeThis study aimed to determine the composition and diversity of bacterial communities on the ocular surface before and after the intervention with sodium hyaluronate eye drops (with or without preservatives) using 16S rRNA gene amplicon sequencing.MethodsSixteen healthy adults were randomly divided into two groups and treated with sodium hyaluronate eye drops with or without preservatives for 2 weeks. The individuals used the same artificial tears in both eyes. The microbial samples from the conjunctival sac of each participant were collected at baseline and 2 weeks after intervention. The diversity and taxonomic differences among different groups before and after intervention were compared by sequencing the V3–V4 region of the 16S rRNA gene.ResultsThe similarity in the binocular microbial community was high in 1 of the 16 volunteers (Bray-Curtis dissimilarity score < 0.3). At the genus level, 11 bacteria were detected in all samples with an average relative abundance of more than 1%. The bacterial community changed significantly after the use of sodium hyaluronate eye drops (with or without preservatives), whether within individuals or between individuals in different groups (P < 0.05, PERMANOVA). Different dosage forms of sodium hyaluronate eye drops significantly decreased the relative abundance of Flavobacterium caeni and Deinococcus antarcticus, respectively (P < 0.05).ConclusionsHealthy people had a rich diversity of the bacterial microbiota on the ocular surface, but the bacterial communities between the eyes were not completely similar. Irrespective of containing benzalkonium chloride (BAC), sodium hyaluronate eye drops can change the bacterial community on the ocular surface.

This study investigated the effectiveness of applying a smartphone to reduce the hyperactive/impulsive behaviors of 3 students with attention deficit hyperactivity disorder (ADHD) in class. A smartphone that can simultaneously provide vibration and visual text prompts was adopted in this study to remind the participants when they exhibited hyperactive/impulsive behaviors. This study adopted the multiple baseline design across subjects under the broader rubric of the single-subject research design, including 2 baseline phases and 2 intervention phases. The results show that the time spent engaged in target behaviors decreased for participants during the intervention phases, compared to the baseline phases. The findings show that applying the vibration and visual text prompts of a smartphone is a feasible prompting strategy to assist students with ADHD to reduce their hyperactive/impulsive behaviors in class.

Primary productivity in the nutrient-poor subtropical ocean gyres depends on new nitrogen inputs from nitrogen fixers that convert inert dinitrogen gas into bioavailable forms. Temperature and iron (Fe) availability constrain marine nitrogen fixation, and both are changing due to anthropogenic ocean warming. We examined the physiological responses of the globally important marine nitrogen fixer, Crocosphaera watsonii across its full thermal range as a function of iron availability. At the lower end of its thermal range, from 22 to 27°C, Crocosphaera growth, nitrogen fixation, and Nitrogen-specific Iron Use Efficiencies (N-IUEs, mol N fixed hour–1 mol Fe–1) increased with temperature. At an optimal growth temperature of 27°C, N-IUEs were 66% higher under iron-limited conditions than iron-replete conditions, indicating that low-iron availability increases metabolic efficiency. However, Crocosphaera growth and function decrease from 27 to 32°C, temperatures that are predicted for an increasing fraction of tropical oceans in the future. Altogether, this suggests that Crocosphaera are well adapted to iron-limited, warm waters, within prescribed limits. A model incorporating these results under the IPCC RCP 8.5 warming scenario predicts that Crocosphaera N-IUEs could increase by a net 47% by 2100, particularly in higher-latitude waters. These results contrast with published responses of another dominant nitrogen fixer (Trichodesmium), with predicted N-IUEs that increase most in low-latitude, tropical waters. These models project that differing responses of Crocosphaera and Trichodesmium N-IUEs to future warming of iron-limited oceans could enhance their current contributions to global marine nitrogen fixation with rates increasing by ∼91 and ∼22%, respectively, thereby shifting their relative importance to marine new production and also intensifying their regional divergence. Thus, interactive temperature and iron effects may profoundly transform existing paradigms of nitrogen biogeochemistry and primary productivity in open ocean regimes.

This paper presents the design and analysis of microwave and millimeter-wave (MMW) high-linear track-and-hold amplifiers (THAs) for high-speed data conversion systems. The silicon germanium (SiGe) process utilized in the proposed circuits is analyzed in detail and its several merits are demonstrated, including operating speed, linearity, and resolution. Bandwidth extension techniques, such as peaking, Darlington, and distributed topologies, are adopted to further enhance the operating speed of the proposed THAs up to a 0.5-unity current gain frequency (fT) of the transistor. The switched emitter-follower (SEF) as well as the switched capacitor (SC) track-and-hold (T/H) stages are modified using pedestal error reduction techniques, including a cascode stage and differential cancellation, to further enhance the overall resolution of the THAs. The proposed cascoded SEF-based T/H circuit with a modified Darlington-based input buffer has a track-mode bandwidth of up to 0.5-fT, a maximum spurious-free dynamic range (SFDR) of 45.1 dBc, and dc power consumption of 94.3 mW. Moreover, the proposed differential cancellation SC-based T/H circuit with an input buffer based on the distributed bandwidth extension technique exhibits an operating speed of up to 0.32-fT, an SFDR of 47.9 dBc, and dc power consumption of 180.1 mW. Both proposed THAs are suitable for low-power, high-speed MMW conversion systems without incurring a high cost. Moreover, by using the proposed design methodology, a sampling rate up to tens of gigahertz can be easily achieved with time-interleaved architecture.

Ankle sprains are generally the most common injuries that are frequently experienced by competitive athletes. Ankle sprains, which are the main cause of ankle instability, can impair long-term sports performance and cause chronic ankle instability (CAI). Thus, a comprehensive understanding of the key factors involved in repeated ankle strains is necessary. During jumping and landing, adaptation to the landing force and control of neuromuscular activation is crucial in maintaining ankle stability. Ankle mobility provides a buffer during landing, and peroneus longus activation inhibits ankle inversion; together, they can effectively minimize the risk of ankle inversion injuries. Accordingly, this study recommends that ankle mobility should be enhanced through active and passive stretching and muscle recruitment training of the peroneus longus muscles for landing strategies should be performed to improve proprioception, which would in turn prevent ankle sprain and injury to neighboring joints.

This research attempted to explore, based on the broaden--and--build theory of positive emotions, the relationships among high school teachers' savoring and instructional design imagination, and to verify the mediating effects of resilience and inspiration through action on the aforementioned relationships. Data were collected from 497 high school teachers in Taiwan. PLS-SEM was used to validate the research hypotheses. The results show that: (a) Savoring positively influences instructional design imagination; (b) Resilience has a complementary mediation effect on the relationship between savoring and instructional design imagination; (c) Inspiration through action has a complementary mediation effect on the relationship between savoring and instructional design imagination. Accordingly, this study bears important theoretical and practical implications for the professional development of teachers' instructional design imagination.

Strategic planning is a key competency for business management education. This study designed a dual scaffold-oriented strategy planning board game based on cognitive scaffolding and peer scaffolding and combined it with a real-time checking mechanism using mobile technology. The 68 university students were divided into an experimental group for scaffold game-based learning and a control group for case-based discussion learning to investigate the differences in learning effectiveness, flow and learning anxiety, and to explore the technology acceptance, scaffold usefulness, and activity anxiety of the game-based learning group. The results revealed that the learning effectiveness of the experimental group was significantly improved, while there was no significant difference in the control group; the overall flow and technology acceptance of the experimental group were both relatively high; learning anxiety was significantly reduced in both groups, and the experimental group did not have excessive activity anxiety. There were no significant differences in learning anxiety of the two groups. As for scaffolding usefulness evaluation, the proportion of using peer scaffolding was the highest, and the learners thought that using peer scaffolding was helpful for developing their strategic planning skills. It is suggested that the design of the game mechanism in the future can encourage learners to use the cognitive scaffolding and the mobile-based metacognitive scaffolding more often, and the quality of peer discussions may be improved through the real-time evaluation of the metacognitive scaffolding.

Contemporary educational reform discourses in Taiwan call for the modernization of education to meet the needs of society of the 21st century. The principles and rules of 'reason' that historically order educational discourses can't be taken for granted. This article uses Popkewitz's notion of alchemy to think about the principles. The notions of democracy and globalization provide the analytic 'tools' to consider the processes of translation from political programs to educational reform discourses. It is argued that ironically the translation models of educational reform require a particular epistemological structuring of agency, but while recognizing how it does not produce harmony of what is being told in political programs. Three ways of thinking about the alchemy of political in educational reform discourses are offered. It then turns to the delineation of the changing role of teachers, students, and the textbooks that mapped the 'modern' child in educational reform discourses. The apparent paradox that evidences the limits of current discourses about democracy and globalization, then, has a critical reflection.

Computer programming is essential nowadays but still challenging to learn due to its invisible thinking. Current programming environments are mostly designed for operating on computers directly to learn concrete programming, but this approach lacks the support for clarifying learners' thinking processes. On the other hand, using paper and pens shows usability in developing creative thinking, but it cannot help verify learners' thinking results due to its nature. To benefit from both paper and computers, we developed an interactive programming learning environment consisting of a paper board game, a computer system, and a digitalization mechanism. Learners can use the learning environment to draw down their thinking results and verify them by comparing them with the evaluation on the computer system immediately. Two experiments were conducted to compare this learning environment with paper board games and computer programming environments, respectively. The experimental results show that the subjects who learn in our environment can learn to program better than those who learn with the other two. The proposed environment is easy to prepare for learners in a classroom as their first step to programming learning. It can help learners cross over from paper board games for computational thinking to computer programming environments.

Bully victimization is known to cause adverse psychological outcomes; however, resilience may mitigate the more adverse effects. Little is known regarding the role played by BDNF Val66Met polymorphism in youth resilience against psychological harm caused by bully victimization. In this cross-sectional study, a community sample of 598 participants (M[subscript age] = 20.1 ± 1.4 years, 48.8% males) completed the questionnaire on bully victimization, resilience, and psychological symptoms. Salivary genomic DNA was genotyped for the BDNF Val66Met polymorphism. A path analysis was used to test the mediating role of resilience in the association between bully victimization and psychological symptoms. Furthermore, the BDNF genotype was added to the model to explore its moderating effects on the mediating role of resilience in the path with 5000 bootstrapped samplings using SPSS PROCESS Macro. Results revealed a significant indirect effect via resilience that accounted for 17.2% of the association between bully victimization and psychological symptoms. While the Val66Met polymorphism interacted with bully victimization to predict resilience scores, bully victimization was more strongly associated with poor resilience (F = 4.59, p = 0.03) in subjects with the Met/Met genotype ([beta] = -3.22, p < 0.001), as compared to participants with other genotypes ([beta] = -1.33, p = 0.051). Findings suggest a gene-environment interaction effect on psychological resilience in bully-victimized youth.

The integration of augmented reality (AR) and game-based learning could increase interaction in educational games and provide more learning guidance in higher education courses. This study developed an AR educational board game that featured cognitive scaffolding, immediate feedback, and collaborative interaction. The study also analyzed and compared the competition- and collaboration-oriented mechanisms in the game. Participants of the study were 60 university students, who were divided into a competitive group and a collaborative group. We analyzed learners' psychological and cognitive differences in their learning effectiveness, motivation, flow, technology acceptance, learning anxiety, and gaming anxiety in the game. The results showed that both groups significantly improved in learning, and the competitive group had better learning effectiveness than the collaborative group. As for learning motivation, the competitive group improved in certain sub-dimensions, whereas the collaborative group improved in all sub-dimensions. Moreover, the collaborative group had higher scores in flow antecedent and perceived ease of use than the competitive group. The students had more smooth gaming experiences and perceived more clear feedback. Both groups showed lower gaming anxiety. These findings may have important implications for AR educational board game design.

Dyslexia and developmental language disorders are important learning difficulties. However, their genetic basis remains poorly understood, and most genetic studies were performed on Europeans. There is a lack of genome-wide association studies (GWAS) on literacy phenotypes of Chinese as a native language and English as a second language (ESL) in a Chinese population. In this study, we conducted GWAS on 34 reading/language-related phenotypes in Hong Kong Chinese bilingual children (including both twins and singletons; total N = 1046). We performed association tests at the single-variant, gene, and pathway levels. In addition, we tested genetic overlap of these phenotypes with other neuropsychiatric disorders, as well as cognitive performance (CP) and educational attainment (EA) using polygenic risk score (PRS) analysis. Totally 5 independent loci (LD-clumped at r[superscript 2] = 0.01; MAF > 0.05) reached genome-wide significance (p < 5e-08; filtered by imputation quality metric Rsq>0.3 and having at least 2 correlated SNPs (r[superscript 2] > 0.5) with p < 1e-3). The loci were associated with a range of language/literacy traits such as Chinese vocabulary, character and word reading, and rapid digit naming, as well as English lexical decision. Several SNPs from these loci mapped to genes that were reported to be associated with EA and other neuropsychiatric phenotypes, such as "MANEA" and "PLXNC1." In PRS analysis, EA and CP showed the most consistent and significant polygenic overlap with a variety of language traits, especially English literacy skills. To summarize, this study revealed the genetic basis of Chinese and English abilities in a group of Chinese bilingual children. Further studies are warranted to replicate the findings.

The existing literature on reading motivation primarily focuses on monolingual children and adolescents using quantitative approaches. To date, there is an absence of qualitative studies exploring bilingual college students' reading motivation that can provide details of participants' views, beliefs, and experiences related to reading motivation. To meet this need, this qualitative study used the bioecological model of human development to explore sociocultural impacts on multidimensions of reading motivation in Latinx college students. Twenty-eight Latinx bilingual college students participated in individual and semi-structured interviews and generated written literacy journeys that focused on understanding factors affecting the multidimensionality of their reading motivation and ways to motivate them. Our data suggest Latinx college students' reading motivation was influenced by the three systems of the bioecological model of human development: "microsystem, exosystem," and "macrosystem." Furthermore, we found that reflective, autonomous, and interactive learning environments were effective for enhancing their reading motivation.