Patient profiles and endoscopic findings according to the gastroesophageal flap valve grades.

<p>Fisher exact test or chi-square test was used for categorical data. Continuous non-parametric variables were compared by Mann-Whitney u test.</p>†<p>Los Angeles classification grade.</p>‡<p>The values of pH monitor and Impedance findings were expressed as median (25%–75% range).</p><p>Patient profiles and endoscopic findings according to the gastroesophageal flap valve grades.</p

Logistic regression analysis of the association between GEFV and erosive esophagitis, pathological gatroesophageal reflux.

<p>Logistic regression analysis of the association between GEFV and erosive esophagitis, pathological gatroesophageal reflux.</p

Retroflex view of the gastroesophageal flap valve.

<p>(a) Grade I. The prominent fold of tissue along the lesser curvature apposed closely to the endoscope. (b) Grade II. The fold was present but less well defined than in grade I, and some periods of opening and rapid closing around the endoscope were found. (c) Grade III. The fold was not prominent and often failed to close around the endoscope, gripping it tightly. (d) Grade IV. There was no fold and the lumen of the esophagus was open. The squamous epithelium of the esophagus could be seen below.</p

Data_Sheet_1_Highly Engaged Video-Watching Pattern in Asynchronous Online Pharmacology Course in Pre-clinical 4th-Year Medical Students Was Associated With a Good Self-Expectation, Understanding, and Performance.DOCX

BackgroundOnline video-based learning is more common in higher education. Investigating students' viewing behaviors while watching online video lectures is essential for instructors to understand their learning status so that the course content, structure, and media selection can be improved continuously. The current study identified the engagement level of the learners based on their online video-watching behaviors, and tested the correlation between the engagement level and learning outcome.MethodsThe action logs of watching online video lectures in 2020 Spring Pharmacology of the 4th-year medical students of the 6-year course and their feedbacks by questionnaires after each exam during the semester were provided anonymously. The data were analyzed and visualized for an efficient way to comprehend and interpret. To define the student's engagement level in his or her video-based learning journey, three viewing criteria, “Completion,” “Pausing,” and “Repeated watching” were identified. We evaluated the association between the engagement level and the students' learning outcomes, including their learning satisfaction, knowledge acquisition progresses based on assessment results, and the grades measured by the instructors.ResultsThe graphs and the charts demonstrate whether the students allocated enough time to finish the video lectures (completion), paused for a while, then resumed the video (pausing), or replayed the specific sections of video content (repeated watching). The engagement level with video lectures, evaluated by pre-defined thresholds for “Completion,” “Pausing,” and “Repeated watching” had a positive correlation with the learning outcomes.ConclusionsWe suggested that an engagement dashboard containing real-time visualized information on students' online video-watching behaviors can be developed to help instructors to monitor students' learning progress and improve teaching in a timely fashion. It can also help each student to re-feel the stimulation of peers, prompt self-monitoring, improve their learning attitudes and disciplines for better learning outcomes. This innovative way of assessing student's engagement during online video-based learning can also be used for quality assurance purposes.</p

Infantile Hepatitis B in Immunized Children: Risk for Fulminant Hepatitis and Long-Term Outcomes

<div><p>Background</p><p>Infantile hepatitis B after neonatal immunoprophylaxis is a rare yet distinct disease. This study aimed to analyze the long-term outcomes and risk factors in immunized infants with hepatitis B.</p><p>Methods</p><p>The clinical parameters and outcomes of 41 infants born after universal immunization, and admitted for HBV-positive hepatitis were studied. All patients were followed for at least 6 months (median  = 4.4 years, range 0.6–18.1 years). Patient survival, changes of HBsAg and HBeAg status, and complications were analyzed.</p><p>Results</p><p>Among the 41 cases (32 males, 9 females), 21 presented with fulminant hepatitis (FH), and 20 with non-fulminant hepatitis (NFH). Ninety-five percent (36/38) of the mothers were positive for hepatitis B surface antigen (HBsAg). Multivariate analyses revealed younger age of onset (age <7 months) and negative maternal hepatitis B e antigen (HBeAg) were associated with FH (p = 0.03 and p = 0.01, respectively). An infantile fulminant hepatitis B risk score using maternal/infant HBeAg positivity and onset age was proposed. Among the FH cases, the rate of mortality, HBsAg clearance, and chronic HBV infection were 47.6%, 38.1%, and 14.3%, respectively. Among the NFH cases, 35% developed chronic infection. Of the 9 chronically infected children received long-term follow-up, 8 had HBeAg seroconversion before 4 years of age. One case of FH developed hepatocellular carcinoma 14 years later.</p><p>Conclusions</p><p>Maternal HBsAg + /HBeAg- and early onset age were risk factors for FH in immunized infants. A significant portion of patients with FH or NFH evolve to chronic HBV infection, with HBeAg seroconversion in young childhood. Close surveillance for hepatocellular carcinoma is warranted in patients surviving infantile hepatitis B.</p></div

Clinical course and outcomes of infants with hepatitis B; FH, fulminant hepatitis; NFH, non-fulminant hepatitis.

<p>Recovery is defined as HBsAg seroclearance. Chronic infection is defined as persistence of HBsAg for more than 6 months.</p

Clinical characteristics of 41 infants with acute or fulminant hepatitis B.

<p>FH: fulminant hepatitis, NFH: non-fulminant hepatitis, HBsAg, hepatitis B surface antigen; HBeAg, hepatitis B e antigen, HBV, hepatitis B virus; HBIG, hepatitis B immunoglobulin; ALT, alanine aminotransferase; INR, international normalized ratio.</p><p>Clinical characteristics of 41 infants with acute or fulminant hepatitis B.</p

Cumulative HBeAg seroconversion rates in survivors of infantile fulminant/non-fulminant hepatitis B (N = 9).

<p>Cumulative HBeAg seroconversion rates in survivors of infantile fulminant/non-fulminant hepatitis B (N = 9).</p

Clinical characteristics and outcome of 21 infants with fulminant hepatitis B.

<p>HBsAg, hepatitis B surface antigen; HBeAg, hepatitis B e antigen, HBV, hepatitis B virus;</p><p>HBIG, hepatitis B immunoglobulin; ALT, alanine aminotransferase; INR, international normalized ratio.</p><p>Clinical characteristics and outcome of 21 infants with fulminant hepatitis B.</p

The IFHB Risk Scores in the infantile cases of hepatitis B.

<p>FH, fulminant hepatitis; NFH, non-fulminant hepatitis.</p><p>The IFHB Risk Scores in the infantile cases of hepatitis B.</p