استكشف المجموعة الواسعة من العناوين المتاحة.

When doctors are fatigued, they often make diagnostic errors. Similarly, pharmacists may also make mistakes in dispensing medication. Therefore, object segmentation plays a vital role in many healthcare-related areas, such as symptom analysis in biomedical imaging and drug classification. However, many traditional deep-learning algorithms use a single view of an image for segmentation or classification. When the image is blurry or incomplete, these algorithms fail to segment the pathological area or the shape of the drugs accurately, which can then affect subsequent treatment plans. Consequently, we propose the Fuzzy DBNet, which combines the dual butterfly network and the fuzzy ASPP in a deep-learning network and processes images from both sides of an object simultaneously. Our experiments used multi-category pill and lung X-ray datasets for training. The average Dice coefficient of our proposed model reached 95.05% in multi-pill segmentation and 97.05% in lung segmentation. The results showed that our proposed model outperformed other state-of-the-art networks in both applications, demonstrating that our model can use multiple views of an image to obtain image segmentation or identification.

Pain assessment and treatment are key factors affecting the quality and safety of care for patients and capabilities related to them are crucial for new nursing staff. Consequently, we developed a multimedia-assisted teaching program for nursing newcomers' pain assessment learning to facilitate their practical pain assessment ability. The goal of this study was to evaluate a multimedia instructional program to boost new nurses' ability to conduct pain assessment and treatment, through simulated scenario instruction. A quasi-experimental, pretest-posttest design with purposive sampling was used in this study. Eighty-six nurses were enrolled (control group, n = 39; experimental group, n = 47). Both groups underwent traditional pain assessment training in the classroom. The control group received lectures using PowerPoint files; while the experimental group undertook pain assessment training with the same content but delivered via multimedia-assisted instruction based on the ADDIE model. Pre- and post-instruction questionnaires relating to pain knowledge were completed. Participants' competence in performing pain assessment was subsequently evaluated one-month post instruction. The experimental group had significantly higher satisfaction scores (27.67 ± 3.76 vs. 31.36 ± 3.42, p < .01, respectively), and demonstrated greater knowledge of pain assessment (7.73 ± 0.67 vs. 7.08 ± 0.90, p < .05, respectively) than did the control group. Additionally, when evaluated at the one month follow-up, newcomers in the experimental group had better communication ability to perform pain assessment (26.58 ± 3.01 vs. 25.08 ± 3.32, p < .05, respectively). The program can improve nurses' pain assessment knowledge and competence. Newcomers were able to better respond to patients in pain, which is essential for pain assessment. This pilot study thus suggests a new, multimedia program for training nursing newcomers in pain assessment.

Spinal cord injury (SCI) is a devastating disorder. Alcohol abuse has been recognized as hindering SCI patients from rehabilitation, thus leading to longer length of days and poorer prognosis. This article aimed to investigate the association between spinal cord injury (SCI) and alcohol dependence. Data were derived from the National Health Insurance Research Database (NHIRD). The incidence of alcohol dependence between SCI and non-SCI groups was compared. Other possible risk factors were also analyzed. Patients (N = 5670) with SCI from 2000 to 2009 were initially assessed for eligibility. After propensity score matching, 5639 first-time SCI survivors were included. The Cox proportional hazard regression model was used to assess differences in the incidence of alcohol dependence syndrome. Based on the adjusted hazard ratios (HR), the SCI group had a higher hazard for alcohol dependence syndrome compared to the non-SCI group (adjusted HR: 1.39, 95% CI: 1.03~1.86, = 0.0305). The injury level did not have an impact on the incidence of alcohol dependence syndrome. A higher incidence of alcohol dependence syndrome was related to male patients, lower insurance levels, higher Deyo's CCI, and psychiatric OPD times. A lower incidence of alcohol dependence syndrome was related to elder age. The incidence of alcohol dependence increased after the occurrence of SCI and was also related to age, sex, monthly income, comorbidities, and psychiatric problems. The injury level did not affect the incidence of alcohol dependence after SCI.

Purpose – The purpose of this paper is to propose a game-based learning (GBL) content design model that replicates the two-dimensional Bloom cognitive process in GBL units. The proposed model, called the knowledge and cognitive-process representation (KCR) model, enables a game player to access three types of Bloom knowledge by allowing the learner to experience-related cognitive processes that can be replicated in the GBL units via appropriate representation approaches. Design/methodology/approach – To validate the feasibility of the proposed KCR model, 14 GBL units for a Cisco-certified network associate (CCNA) certification training program were designed and installed on several servers. Players played the GBL units via internet browsers. According to the problem-solving theory, three game components, including a tool, feedback, and goal, are necessary for game playing and should be adopted to implement three sub-cognitive processes. A three-phase experiment was performed for one year. Subjects were university sophomores and a randomized block experiment design was implemented. Findings – The experimental results show that, compared with a traditional web-based learning platform, the GBL platform is more efficient and it enables learners to achieve improved learning performance. In addition, most hypotheses support the fact that particular cognizance processes should be implemented by a specific representation approach in GBL. Finally, a KCR model for GBL content design is inferred to represent a cognitive process appropriately that can be referenced for both the digital content instructor and the game developer. Research limitations/implications – Because the CCNA training material does not include meta-knowledge of Bloom knowledge type and the creation of the Bloom cognitive process, the KCR model should be further extended. In addition, others certification training materials (such as Oracle DBA, Java programmer) can be implemented on the basis of the KCR model for general validation as further research. Practical implications – Players can acquire specific types of knowledge, such as factual knowledge, by experiencing a particular cognitive process, such as the “remembering & understanding” processes, which can be represented with a computer tool. The KCR model can provide both the instructor and the game developer with design recommendations and accelerate GBL content implementation. Originality/value – GBL is a learning platform that can stimulate a learner by improving the motivation to learn and the learning experience. To ensure high-learning performance, the learner should perform specific cognitive processes and acquire knowledge. This research proposes a content design model for GBL units that appropriately replicate the Bloom framework in a computer game.

Responding to the Tiananmen Square protests in 1989, anti-government slogans appeared on the campus walls at He's school in Yunnan, which were first enclosed in concrete by the officials, and then revealed days following heavy rain. The precariousness of the democratic system as an authority is addressed in the alias of the work, 'asking the tiger for its skin' - a Chinese proverb that refers to putting oneself in danger, and which seems to describe the plight of not being able to balance institutional rules and humanity. According to He, the use of sandpaper on the skin illustrates how historical memories are erased in the media and official histories.5 He's decision to use photographic and painting materials as mediums to disseminate his extreme acts challenges the conventional view that liveness is at the centre of performance art. The artist has described the act of making an incision on his body as being 'in the name of democracy' which 'seems to have fulfilled democracy on the surface', and this staging of cruelty is 'as objective as real history'.9 He may sound critical of all democratic systems, but an extreme work such as One Meter of Democracy seems to prove that artistic freedom is possible even in a society without neoliberalist democracy.

He Yunchang's performance works, with their scenes of self-torture or long durational meditative acts, are driven by an urge to respond to social issues that cannot be openly addressed. They are often staged with a vivid painterly image in mind. He applies paint and concrete, incisions, textures, sculptures and piercings to his body, and has even extracted one of his ribs and turned it into a work. Many such actions leave him in a critical condition or even imprint permanent traces on him. He has been able to execute physically demanding works in Belgium, England, the United States and his home country of China, where performance works, particularly with nudity, are still censored. To avoid official intervention, he usually performs with only a small audience from the arts community present.

He Yunchang's performance works, with their scenes of self-torture or long durational meditative acts, are driven by an urge to respond to social issues that cannot be openly addressed. They are often staged with a vivid painterly image in mind. He applies paint and concrete, incisions, textures, sculptures and piercings to his body, and has even extracted one of his ribs and turned it into a work. Many such actions leave him in a critical condition or even imprint permanent traces on him. He has been able to execute physically demanding works in Belgium, England, the United States and his home country of China, where performance works, particularly with nudity, are still censored. To avoid official intervention, he usually performs with only a small audience from the arts community present.

Advanced glycation end products (AGEs) are generated by nonenzymatic modifications of macromolecules (proteins, lipids, and nucleic acids) by saccharides (glucose, fructose, and pentose) via Maillard reaction. The formed AGE molecules can be catabolized and cleared by glyoxalase I and II in renal proximal tubular cells. AGE-related diseases include physiological aging, neurodegenerative/neuroinflammatory diseases, diabetes mellitus (DM) and its complications, autoimmune/rheumatic inflammatory diseases, bone-degenerative diseases, and chronic renal diseases. AGEs, by binding to receptors for AGE (RAGEs), alter innate and adaptive immune responses to induce inflammation and immunosuppression via the generation of proinflammatory cytokines, reactive oxygen species (ROS), and reactive nitrogen intermediates (RNI). These pathological molecules cause vascular endothelial/smooth muscular/connective tissue-cell and renal mesangial/endothelial/podocytic-cell damage in AGE-related diseases. In the present review, we first focus on the cellular and molecular bases of AGE-RAGE axis signaling pathways in AGE-related diseases. Then, we discuss in detail the modes of action of newly discovered novel biomolecules and phytochemical compounds, such as Maillard reaction and AGE-RAGE signaling inhibitors. These molecules are expected to become the new therapeutic strategies for patients with AGE-related diseases in addition to the traditional hypoglycemic and anti-hypertensive agents. We particularly emphasize the importance of \"metabolic memory\", the \"French paradox\", and the pharmacokinetics and therapeutic dosing of the effective natural compounds associated with pharmacogenetics in the treatment of AGE-related diseases. Lastly, we propose prospective investigations for solving the enigmas in AGE-mediated pathological effects.

Genome-wide transcriptome analyses are routinely used to monitor tissue-, disease- and cell type–specific gene expression, but it has been technically challenging to generate expression profiles from single cells. Here we describe a robust mRNA-Seq protocol (Smart-Seq) that is applicable down to single cell levels. Compared with existing methods, Smart-Seq has improved read coverage across transcripts, which enhances detailed analyses of alternative transcript isoforms and identification of single-nucleotide polymorphisms. We determined the sensitivity and quantitative accuracy of Smart-Seq for single-cell transcriptomics by evaluating it on total RNA dilution series. We found that although gene expression estimates from single cells have increased noise, hundreds of differentially expressed genes could be identified using few cells per cell type. Applying Smart-Seq to circulating tumor cells from melanomas, we identified distinct gene expression patterns, including candidate biomarkers for melanoma circulating tumor cells. Our protocol will be useful for addressing fundamental biological problems requiring genome-wide transcriptome profiling in rare cells.

Clustered regularly interspaced short palindromic repeats (CRISPR) guide RNA scaffolds have been adapted to carry multiple binding sites for fluorescent proteins to enhance brightness for live cell imaging of genomic loci. However, many of these modifications result in guide RNA instability and thus produce lower genome-labeling efficiency than anticipated. Here we introduce CRISPR-Sirius, based on octet arrays of aptamers conferring both enhanced guide RNA stability and brightness, and provide initial biological applications of this platform.