Past studies on the issue of learning‐theory foundations in game‐based learning stressed the importance of establishing learning‐theory foundation and provided an exploratory examination of established learning theories. However, we found research seldom addressed the development of the use or failure to use learning‐theory foundations and categorized these learning theories into relative types and synthesized their development. We investigate this issue from the perspective of learning theories invoked to underpin educational computer game design and use based on the four types of learning theories: behaviourism, cognitivism, humanism and constructivism. Because the investigation needs to examine and analyse the results from a large number of independent previous studies, this study applied the meta‐analysis method to present a more comprehensive description and discussion of the influence and implications of the findings. This study shows the distribution of development trends for the use of learning theory as a theoretical foundation, as opposed to those that fail to use learning theory in game‐based learning, along with the distribution of types and principles of learning theories that used a learning‐theory foundation. These new findings can supplement the results of previous studies with regard to the issue of learning‐theory foundations in game‐based learning. The contributions of this study for the issue of learning‐theory foundations in game‐based learning are discussed.

Foreign bodies should not be allowed to remain in the esophagus beyond 24 hours after presentation. However, some patients with esophageal foreign body ingestion do not come to the hospital immediately and may delay medical intervention from the time of ingestion. The aim of this study was to investigate the outcomes of adults with suspected esophageal foreign body ingestion according to the time of ingestion and types of foreign bodies. A total of 326 adult patients (151 men and 175 women) were analyzed, and divided into two groups according to the time period: within or beyond 24 hours from ingestion to endoscopic intervention. A total of 172 patients (52.7%) were found to have ingested foreign bodies; 73.5% were removed smoothly, 10.3% were treated by push technique and 16.0% with failed retrieval received alternative treatments. A higher proportion of patients in the beyond-24 hours group suffered from odynophagia (25.9 vs. 12.9%, P < 0.05). Negative identification of esophageal foreign bodies was more frequent in the beyond-24 hours group (67 vs. 40.2%, P < 0.05), but these patients showed higher proportions of esophageal ulcers (21.1 vs. 7.2%, P < 0.05). The beyond-24 hours group also showed a significantly higher rate of foreign bodies in the lower esophagus (40.0 vs. 15.3%, P < 0.05). Patients with esophageal food bolus impaction had significant delayed endoscopic intervention, longer therapeutic endoscopic time, higher proportions of esophageal cancer, stricture and fewer complications. Endoscopic intervention within 24 hours from the time of ingestion should be considered early in adults, because delaying intervention may produce more symptomatic esophageal ulcerations with odynophagia.

This meta-analysis suggests that the -1082G/A polymorphism of the IL-10 gene could be a risk factor for TB in Europeans. Further studies with larger populations are required to assess the association between IL-10 polymorphisms and TB susceptibility.

Mutations of the bone morphogenetic protein type II receptor (BMPR2) gene predispose to pulmonary arterial hypertension (PAH). 290 idiopathic (I)PAH patients and 15 heritable (H)PAH were screened to determine the spectrum and rate of BMPR2 mutations in a large Chinese patient group.Gene sequencing and multiplex ligation-dependent probe amplification (MLPA1) were used to detect sequence mutations and large rearrangements (RGTs). Total mutation rate was 14.5% (n542 out of 290) in Chinese IPAH patients, and 53.3% (n58 out of 15) in HPAH patients. RGT mutation rate was 3.1% (n57 out of 229) and represented 14% (n57 out of 50) of all identified mutations. 25 BMPR2 mutations were newly identified.Patients in this study were younger than other reported PAH subjects. BMPR2 mutation carriers were ,6 yrs younger at diagnosis than noncarriers (p50.002), but this relationship was significant only in the female group, which was larger. The proportion of females carrying a BMPR2 mutation was half that of males (12.8% versus 25.3%; p50.008).Our results indicate that the overall genetics of Chinese PAH patients is similar to that of other populations, but the clinical picture differs by the precocity of the disease in the whole patient group, and the lower proportion of females found to carry a BMPR2 mutation.