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Interprofessional Differences in Multidimensional Self-Efficacy Associated With Professional Performance in Nephrology During Case-Based Learning

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Kidney International Reports 2024年第4期9卷 877-887页

作者： Chao, Chia-Ter Wu, Mei-Yi Hung, Kuan-Yu Wu, Mai-Szu Liang, Jyh-Chong Division of Nephrology Department of Internal Medicine National Taiwan University Hospital Taipei Taiwan Division of Nephrology Department of Internal Medicine National Taiwan University College of Medicine Taipei Taiwan Division of Nephrology Department of Internal Medicine Min-Sheng General Hospital Taoyuan City Taiwan Center of faculty development National Taiwan University College of Medicine Taipei Taiwan Division of Nephrology Department of Internal Medicine Shuang Ho Hospital Taipei Medical University New Taipei City Taiwan Division of Nephrology Department of Internal Medicine School of Medicine College of Medicine Taipei Medical University Taipei Taiwan TMU-Research Center of Urology and Kidney (TMU-RCUK) Taipei Medical University Taipei Taiwan Institute of Epidemiology and Preventive Medicine College of Public Health National Taiwan University Taipei Taiwan Program of Learning Sciences and Institute for Research Excellence in Learning Sciences National Taiwan Normal University Taiwan

Introduction: Postgraduate medical education assumes rising importance in the rapidly advancing field of medicine. Case-based learning (CBL), a learner-centered pedagogy employing clinical cases to improve decision-making, is widely embraced in postgraduate medical education, including nephrology. Studies suggest that learning self-efficacy (SE) was closely associated with learning motivation and academic performance;however, very few studies examined this association in postgraduate nephrology education. None evaluated whether there were interprofessional differences concerning such association. Methods: In 2022, we prospectively enrolled physicians and nurses participating in chronic kidney disease (CKD) care from institutions around Taiwan. They completed the Professional Medical Learning Self-efficacy (PMLS) questionnaire after attending >1 CBL session involving CKD care. We undertook confirmatory factor analysis (CFA), followed by structural equation modeling (SEM) to evaluate associations between 5 dimensions of learning SE (conceptual understanding [CU], higher-order cognitive skills [HC], practical work [PW], everyday application [EA], and medical science communication [MSC]) and their professional SE in nephrology according to participants' medical professions. Results: A total of 513 healthcare providers were surveyed. The convergent and construct validity of our questionnaire were satisfied after analyses. We found that better perceived professional performance in the form of higher professional SE in nephrology was significantly associated with all 5 dimensions of learning SE among physicians and nurses. Only CU and PW were significantly associated with physicians' professional performance;whereas among nurses, only HC and MSC were significantly associated. Conclusion: We showed that learning SE was an important determinant of nephrology professional performance. Different medical professions posed influences on major SE dimensions. © 2024 International

关键词： chronic kidney disease interprofessional difference medical education nephrology professional self-efficacy self-efficacy

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Hepatitis B surface antigen loss in chronic hepatitis B patients with low-viral-load

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Journal of Gastroenterology and Hepatology (Australia) 2024年第11期39卷 2327-2331页

作者： Jang, Tyng-Yuan Batsaikhan, Batbold Chen, Yo-Chia Dai, Chia-Yen PhD Program of Environmental and Occupational Medicine and Graduate Institute of Clinical Medicine Kaohsiung Medical University Kaohsiung Taiwan Department of Internal Medicine Kaohsiung Medical University Hospital Kaohsiung Medical University Kaohsiung Taiwan Department of Internal Medicine Pingtung Hospital Ministry of Health and Welfare Ping-Tung Taiwan Department of Internal Medicine Institute of Medical Sciences Mongolian National University of Medical Sciences Ulaanbaatar Mongolia Department of Biological Science and Technology National Pingtung University of Science and Technology Pingtung Taiwan College of Professional Studies National Pingtung University of Science and Technology Pingtung Taiwan Drug Development and Value Creation Research Center Kaohsiung Medical University Kaohsiung Taiwan

Background and Aim: Among low viral load (DNA of hepatitis B virus (HBV) was 10 IU/mL vs 2.3 log10 IU/mL;P = 0.003), and higher proportion of prior NAs-treated history. Logistic regression analysis revealed ... 详细信息

Background and Aim: Among low viral load (DNA of hepatitis B virus (HBV) was < 2000 IU/mL), the factor of the loss of hepatitis B surface antigen (HBsAg) remained elusive. Methods: The retrospective study recruited patients with chronic hepatitis B (CHB) who were negative low for hepatitis B e-antigen (HBeAg), had a low viral load, and experienced HBsAg loss during follow-up. CHB patients with low-viral load but without consequent HBsAg loss were also enrolled at the ratio of 1:4. The factors contributing to HBsAg loss were analyzed. Results: A total of 80 patients were recruited for the current study, with a mean age of 63.9 years and 61.3% being male. Among them, 62.5% patients (50/80) were treated with potent nucleoside/nucleotide analogues (NAs) during the follow-up period. Additionally, 12.5% patients (10/80) had a prior history of NAs treatment before enrolment. During the follow-up, HBsAg loss occurred in 17 patients (21.3%). Compared with patients without HBsAg loss, those with HBsAg loss were younger (57.9 years vs 65.5 years;P = 0.01), had lower HBV DNA levels (1.3 log₁₀ IU/mL vs 2.3 log₁₀ IU/mL;P = 0.003), and higher proportion of prior NAs-treated history. Logistic regression analysis revealed that the factors associated with factors associated with HBsAg loss were age < 60 years (OR/CI: 3.95/1.15–13.60, P = 0.03), prior NAs-treated history (OR/CI: 7.59/1.42–40.51, P = 0.01) and current NAs-treated (OR/CI: 0.19/0.05–0.71, P = 0.01). Conclusions: In the study, older age and prior NAs were positively associated with HBsAg loss, and current NAs was negatively associated with HBsAg loss. Additionally, some patients experienced HBsAg loss during the NAs therapy. © 2024 Journal of Gastroenterology and Hepatology Foundation and John Wiley & Sons Australia, Ltd.

关键词： HBeAg HBsAg HBV NAs viral load

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A Graph-Based Modeling Framework for Tracing Hydrological Pollutant Transport in Surface Waters

arXiv

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arXiv 2023年

作者： Cole, David L. Ruiz-Mercado, Gerardo J. Zavala, Victor M. Department of Chemical and Biological Engineering University of Wisconsin-Madison MadisonWI53706 United States Office of Research and Development U.S. Environmental Protection Agency CincinnatiOH45268 United States Chemical Engineering Graduate Program Universidad del Atlántico Puerto Colombia080007 Colombia

Anthropogenic pollution of hydrological systems affects diverse communities and ecosystems around the world. Data analytics and modeling tools play a key role in fighting this challenge, as they can help identify key sources as well as trace transport and quantify impact within complex hydrological systems. Several tools exist for simulating and tracing pollutant transport throughout surface waters using detailed physical models;these tools are powerful, but can be computationally intensive, require significant amounts of data to be developed, and require expert knowledge for their use (ultimately limiting application scope). In this work, we present a graph modeling framework-which we call HydroGraphs-for understanding pollutant transport and fate across waterbodies, rivers, and watersheds. This framework uses a simplified representation of hydrological systems that can be constructed based purely on open-source data (National Hydrography Dataset and Watershed Boundary Dataset). The graph representation provides a flexible intuitive approach for capturing connectivity and for identifying upstream pollutant sources and for tracing downstream impacts within small and large hydrological systems. Moreover, the graph representation can facilitate the use of advanced algorithms and tools of graph theory, topology, optimization, and machine learning to aid data analytics and decision-making. We demonstrate the capabilities of our framework by using case studies in the State of Wisconsin;here, we aim to identify upstream nutrient pollutant sources that arise from agricultural practices and trace downstream impacts to waterbodies, rivers, and streams. Our tool ultimately seeks to help stakeholders design effective pollution prevention/mitigation practices and evaluate how surface waters respond to such practices. © 2023, CC BY.

关键词： Rivers

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Effect of cholesterol on plasma membrane and motility of Piau ( Leporinus obtusidens ) sperm

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Cryobiology 2022年 109卷 61-62页

作者： Elenice A. Moraes Illa Carla S. Carvalho Elizabeth Maria S. Moreira Virginia Renata T. Oliveir Karine V. Antunes Guilherme R. Moreira Rozzano Antonio C.R. Figueiredo Research Center for Pigs Native and Wild Species Federal University of Sao Francisco Valley Petrolina Brazil Biometrics and Applied Statistics Program Rural Federal University of Pernambuco Recife Brazil Regional Superintendence of the Sao Francisco and Parnaiba Valley Development Company Petrolina Brazil

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Learning history by practicing abduction: Does doing offline practice first help with online practice?

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Thinking Skills and Creativity 2023年 47卷

作者： Hong, Jon-Chao Hwang, Ming-Yueh Hsu, Yi-Hsin Tai, Kai-Hsin Institute for Research Excellence in Learning Sciences National Taiwan Normal University P. O. Box 7-513 Taipei 106308 Taiwan In-Service Master Program of Creativity Development National Taiwan Normal University Taipei 106308 Taiwan Global Program in Interdisciplinary Studies Soochow University No. 70 Linhsi Road Taipei 111002 Taiwan

To understand the effect of abduction practice, this study involved students in creating their own abductive items, which the teachers implemented in an application named Abduction-Genius for all other students to play. To understand the learning effect of abduction, this study explored the correlates between field-independent cognitive style (FI-CS), external cognitive load (ECL), the achievement of offline posing of abduction items (hereafter, posing achievement), attitude towards engaging in abduction (hereafter, attitude) and game performance of playing the abduction game (hereafter, game performance). The results revealed: participants’ FI-CS was negatively related to their ECL but positively related to their posing achievement;their posing achievement was negatively related to their ECL;their ECL was not significantly related to attitude, but their posing achievement was positively related to attitude;and attitude was positively related to game performance. © 2023

关键词： Abduction Cognitive load Cognitive style Game performance History learning Remote association

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Sustained human outbreak of a new MPXV clade I lineage in eastern Democratic Republic of the Congo

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Nature Medicine 2024年第10期30卷 2791-2795页

作者： Vakaniaki, Emmanuel Hasivirwe Kacita, Cris Kinganda-Lusamaki, Eddy O’Toole, Áine Wawina-Bokalanga, Tony Mukadi-Bamuleka, Daniel Amuri-Aziza, Adrienne Malyamungu-Bubala, Nadine Mweshi-Kumbana, Franklin Mutimbwa-Mambo, Léandre Belesi-Siangoli, Freddy Mujula, Yves Parker, Edyth Muswamba-Kayembe, Pauline-Chloé Nundu, Sabin S. Lushima, Robert S. Makangara-Cigolo, Jean-Claude Mulopo-Mukanya, Noella Pukuta-Simbu, Elisabeth Akil-Bandali, Prince Kavunga, Hugo Abdramane, Ombotimbe Brosius, Isabel Bangwen, Eugene Vercauteren, Koen Sam-Agudu, Nadia A. Mills, Edward J. Tshiani-Mbaya, Olivier Hoff, Nicole A. Rimoin, Anne W. Hensley, Lisa E. Kindrachuk, Jason Baxter, Cheryl de Oliveira, Tulio Ayouba, Ahidjo Peeters, Martine Delaporte, Eric Ahuka-Mundeke, Steve Mohr, Emma L. Sullivan, Nancy J. Muyembe-Tamfum, Jean-Jacques Nachega, Jean B. Rambaut, Andrew Liesenborghs, Laurens Mbala-Kingebeni, Placide Institut National de Recherche Biomédicale Department of Clinical Sciences Institute of Tropical Medicine Hemorrhagic Fever and Monkeypox Program Ministry of Health Service de Microbiologie Département de Biologie Médicale Cliniques Universitaires de Kinshasa Université de Kinshasa TransVIHMI (Recherches Translationnelles sur le VIH et les Maladies Infectieuses endémiques et émergentes) Université de Montpellier French National Research Institute for Sustainable Development (IRD) INSERM Institute of Ecology and Evolution University of Edinburgh Rodolphe Merieux INRB-Goma Laboratory Kamituga General Hospital Kamituga Health Zone Provincial Health Division African Center of Excellence for Genomics of Infectious Diseases Redeemer’s University Medical Department The Alliance for International Medical Action Department of Pediatrics and Child Health School of Medical Sciences University of Cape Coast International Research Center of Excellence Institute of Human Virology Nigeria Global Pediatrics Program and Division of Infectious Diseases Department of Pediatrics University of Minnesota Medical School Department of Health Research Methods Evidence and Impact Faculty of Health Sciences McMaster University Frederick National Laboratory Leidos Biomedical Research Clinical Monitoring Research Program Directorate Department of Epidemiology Jonathan and Karin Fielding School of Public Health University of California US Department of Agriculture University of Manitoba Centre for Epidemic Response and Innovation Stellenbosch University Department of Pediatrics Division of Infectious Diseases University of Wisconsin-Madison National Emerging Infectious Diseases Laboratory Boston University Department of Epidemiology Infectious Diseases and Microbiology University of Pittsburgh School of Public Health Department of Epidemiology and International Health Johns Hopkins Bloomberg School of Public Health Department of Medicine Division of Infectious Diseases Stellenbosch University Faculty of Medici

Outbreaks of monkeypox (mpox) have historically resulted from zoonotic spillover of clade I monkeypox virus (MPXV) in Central Africa and clade II MPXV in West Africa. In 2022, subclade IIb caused a global epidemic linked to transmission through sexual contact. Here we describe the epidemiological and genomic features of an mpox outbreak in a mining region in eastern Democratic Republic of the Congo, caused by clade I MPXV. Surveillance data collected between September 2023 and January 2024 identified 241 suspected cases. Genomic analysis demonstrates a distinct clade I lineage divergent from previously circulating strains in the Democratic Republic of the Congo. Of the 108 polymerase chain reaction-confirmed mpox cases, the median age of individuals was 22 years, 51.9% were female and 29% were sex workers, suggesting a potential role for sexual transmission. The predominance of APOBEC3-type mutations and the estimated emergence time around mid-September 2023 imply recent sustained human-to-human transmission. © The Author(s) 2024.

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Dealing with the COVID-19 pandemic: an opportunity to reflect on sustainability research

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Sustainability Management Forum | NachhaltigkeitsManagementForum 2022年第1期30卷 11-27页

作者： Nölting, Benjamin König, Bettina Zimmermann, Anne B. Di Giulio, Antonietta Schäfer, Martina Schneider, Flurina Eberswalde University for Sustainable Development Eberswalde Germany Integrative Research Institute on Transformations of Human-Environment Systems (IRI THESys) Humboldt Universität zu Berlin Berlin Germany Centre for Development and Environment University of Bern Bern Switzerland Program Man-Society-Environment (MGU) University of Basel Basel Switzerland Center for Technology and Society (ZTG) Technische Universität Berlin Berlin Germany Institute for Social-Ecological Research (ISOE) and Faculty of Biological Sciences Goethe University of Frankfurt Frankfurt Germany

The COVID-19 pandemic has jolted societies out of normality, possibly creating new conditions for sustainability transformations. What does this mean for sustainability research? Because of the scope of the crisis, researchers have been heavily involved: not only have they had to speed up the pace of scientific production to provide urgently needed COVID-19 knowledge, but they have also been affected citizens. For sustainability science, this calls for an experience-based reflection on the positionality and orientation of research aiming to support sustainability transformations. Twenty sustainability researchers discussed their sustainability research on COVID-19 in three workshops based on the following questions: How does the pandemic—and the measures taken to deal with it—affect sustainable development? What can we learn from the pandemic from the perspective of societal transformation? The present discussion paper emerged from this multidisciplinary exchange among sustainability researchers, considering five topics: impacts of the COVID-19 crisis on sustainability transformations; learning for sustainability transformations; the role of solidarity; governance and political steering; and the role of science in society. Our discussions led to a meta-level reflection on what sustainability research can learn from research on COVID-19 regarding topics and disciplinary angles, time dimensions, the role of researchers, and how adequate preparation for both crises and long-term transformations requires interdisciplinary interaction.

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Control and Mitigation of Aquatic Invasive Species in Pacific Island Streams: Guidance for Control of Aquatic Invasive Species in Hawaiian Island Streams

Control and Mitigation of Aquatic Invasive Species in Pacifi...

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作者： Blum, M. J Hogan, J. D McIntyre, P. B Tulane University New Orleans LA STRATEGIC ENVIRONMENTAL RESEARCH AND DEVELOPMENT PROGRAM ALEXANDRIA VA Strategic Environmental Research Development Program Alexandria VA

Here we describe the feasibility and effectiveness of an AIS removal protocol designed for Hawaiian Island streams that involved use of modified electrofishing techniques, including two tiers of precautionary steps to protect native species from exposure to electrofishing activity. First, all native species were exhaustively captured by hand-netting, sequestered streamside for the duration of electrofishing, and subsequently returned to their location of capture. As a further precaution, amperage and waveform combinations were set during electrofishing to reduce the likelihood of injuries and mortality of any native species potentially remaining in the removal reach. Given that effects of AIS removal on native species and habitats might manifest in a number of ways, we examined a suite of organismal and demographic variables to understand sensitivity and response capacity of at-risk native species in the study watersheds. Native species densities did not decrease following AIS removal events, suggesting negative effects of electrofishing on native species can be mitigated with the modified methodology. However, the efficacy of AIS removal varied according to key stream characteristics and targeted taxon. These results suggest that modifiedelectrofishing can be a valuable tool for AIS management in Hawaiian Island streams and streams on other oceanicislands in the Pacific, with the understanding that users must carefully consider conditions within streams that caninfluence the efficacy of electrofishing as well as the importance of preventing (re)introductions of AIS to sustainlong-term benefits of removal.

关键词： Fish Department of defense Universities Water chemistry Contracts Conductivity Direct current Alternating current Chemistry Information operations

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Investigating the Sensitivity of Emerging Geophysical Technologies to Immobile Porosity and Isolated DNAPL and Dissolved/Sorbed VOC Mass in Fractured Media

Investigating the Sensitivity of Emerging Geophysical Techno...

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作者： Slater, L. D Day-Lewis, F Keating, K Parker, B Rutgers University Newark NJ STRATEGIC ENVIRONMENTAL RESEARCH AND DEVELOPMENT PROGRAM ALEXANDRIA VA Strategic Environmental Research Development Program Alexandria VA SERDP

The primary objectives of this research were to [1] determine the sensitivity of two emerging borehole geophysical technologies (nuclear magnetic resonance [NMR] and complex resistivity[CR]) to key pore geometric properties (primarily pore size distribution and permeability)controlling contaminant transport, [2] investigate the potential sensitivity of emerging geophysical methods to contaminant mass (as DNAPL and/or aqueous phase) isolated within the immobile porosity of fractured rock inaccessible to aqueous sampling techniques, and [3] to evaluate the predictive capabilities of these geophysical technologies with respect to quantifying immobile porosity and/or contaminant mass concentration. Laboratory and field datasets were acquired on three contaminated sedimentary fractured rock aquifers. Pore geometric parameters (e.g. pore size, permeability) controlling contaminant transport were predicted from the geophysical datasets. Contaminant mass distributions were inferred from analysis of multiple geophysical logs and a procedure for estimating a mass transfer rate coefficient from an electrical geophysical tracer test was demonstrated.

关键词： Chemistry Chemical synthesis Groundwater Ecology Geology Mass transfer Water resources Electrical conductivity Mineralogy Chemical analysis Earth sciences Liquid chromatography Magnetic resonance Test methods Chemical properties Alcohols Core sampling

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Integrating Noise Classification and Speech Enhancement Model for Hearing Aids

Integrating Noise Classification and Speech Enhancement Mode...

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International SoC Design Conference, ISOCC

作者： Ying-Hsiu Hung Yen-Ching Chang Shin-Chi Lai Wen-Ho Juang Ming-Hwa Sheu Jeng-Dao Lee Dept. Electronics Engineering National Yunlin University of Science and Technology Douliu Taiwan Doctoral Degree Program in Smart Industry Technology Research and Development National Formosa University Huwei Taiwan Dept. Automation Engineering & Smart Machinery and Intelligent Manufacturing Research Center National Formosa University Huwei Taiwan Dept. Computer Science and Information Engineering National Formosa University Huwei Taiwan Dept. Automation Engineering National Formosa University Huwei Taiwan

ISBN: (数字)9798350377088

ISBN: (纸本)9798350377095

As the global population ages, the number of elderly people needing hearing aids is increasing. This paper proposed an architecture designed to enhance speech based on noise conditions. After noise types are identified by a Convolutional Neural Network (CNN) noise classification model, these noise conditions are combined with the noisy speech and input into a conditional Generative Adversarial Network (cGAN) for speech enhancement. The CNN noise classification model achieves an average recognition accuracy of nearly 92%, with a Kappa value as high as 0.88. The cGAN speech enhancement achieves lower error values in the Mel-Cepstral Distortion (MCD) measure. Although some parts of the human voice may be filtered out, the results demonstrate the potential development of the proposed algorithm.

关键词： Accuracy Noise Noise reduction Speech recognition Speech enhancement Hearing aids Classification algorithms Convolutional neural networks Human voice Older adults

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