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Teachers are increasingly encouraged to creatively integrate technology into their classroom instruction as designers of technology-enhanced learning (TEL). However, they are often not competent in designing TEL due to their lack of experience as participatory designers as well as the ill-structure nature of TEL design problem. Design thinking, as a methodology and a framework for the design process, can serve as a guideline for the development of pre-service teachers’ creativity. However, there is a lack of research investigating whether the strategies used in the empathizing stage of the design thinking process affect pre-service teachers’ creativity differently. This study explored the effects of two commonly used empathy strategies, interview and observation, on pre-service teachers’ creativity through a six-week learning design activity for pre-service teachers majoring in Science and Technology Education at a first-tier university in China. The results of this quasi-experimental research showed that the pre-service teachers using the interview empathy strategy performed better in creative problem-solving performance. While there was no significant difference in the pre-service teachers’ creative thinking disposition between the two empathy strategies, the pre-service teachers using the interview strategy reported more positive creative confidence in their creativity than those using the observation strategy. This study suggests future research directions for supporting design thinking–based instructional design.

Alumina-forming austenitic stainless steels (AFA-SSs) are candidates for high temperature applications to replace conventional stainless steels that form unstable chromium-oxide. In this work, a new AFA-SS composition was designed, through thermodynamic considerations, oxidation model calculations, and Genetic Algorithm-based optimization, which is expected to form alumina scale with only few number of alloying additions. The model incorporates thermodynamic stability of alumina with the kinetics of diffusion of aluminum and oxygen, and then considers the role of chromium as the third element, to predict alumina scale formability. In the present study, this model was utilized to design a new AFA-SS with minimum number of alloying additions. In addition, the oxidation behavior of the designed alloy was investigated at 800 °C to demonstrate its alumina forming capability and compared with a well-known alumina-forming steel. The cross-sections of the scales were studied using scanning electron microscopy and energy dispersive spectroscopy. The results confirmed the formation of the alumina layer in the designed alloy and validated the utility of the model and Genetic Algorithm-based optimization. Keywords: Alumina-forming austenitic stainless steels, Oxidation, Alloy design, Third element effect, Genetic algorithm based optimization

Background/purpose The treatment landscape of relapsed/refractory multiple myeloma (RRMM) is rapidly evolving in Taiwan. The present study aimed to assess the treatment patterns among RRMM patients in Taiwan.Methods This retrospective, chart review-based, non-interventional study collected data on RRMM patients (≥20 years old) receiving pomalidomide-based treatment between January 2017 and December 2020 across five sites in Taiwan.Results Median age of the study population was 65.6 years. Approximately 75% patients received a doublet regimen and 25% were on a triplet regimen. Disease progression was the most common cause for switching to pomalidomide-based treatments in doublet (71.2%) and triplet (58.3%) groups. Patients in doublet and triplet groups (>80%) received 4 mg pomalidomide as a starting dose. Overall response rate (ORR: 31.5% and 45.8%) and median progression-free survival (PFS: 4.7 and 6.8 months) were reported in the doublet and triplet regimen. Doublet regimen was discontinued mainly due to disease progression or death (78.1%); however, triplet regimen patients mainly terminated their treatment due to reimbursement limitations (29.2%). Healthcare resource utilization (HRU) was comparable between doublet and triplet groups.Conclusion In Taiwan, half of RRMM patients received pomalidomide-based triplet regimens. Triplet regimens showed a trend towards better outcomes with longer PFS and higher response rates compared to doublets. Notably, the duration of triplet use is influenced by reimbursement limitations. This study provides insight into RRMM treatment patterns in Taiwan and the findings suggest that triplet regimens may be a better alternative than doublet regimens.

Choosing between screw-retained and cement-retained restorations in the esthetic zone may significantly impact the restorative contour. This study analyzes the effect of facial-palatal implant positioning on the facial emergence angle of implant restorations in the anterior maxilla. A total of 133 maxillary anterior implant cases were captured with intraoral scans and used to create digital prosthetic designs. The restoration facial emergence angle and the implant depth were determined using images at the midfacial cross section. Simple logistic and linear regression models were used to analyze the interrelation between the emergence angle, depth, and retention methods. The average facial emergence angle for all restorations in this study was 34.4 degrees. A significant difference in emergence angle was found between screw-retained and cement-retained groups, with averages of 37.3 degrees and 27.9 degrees, respectively. There was no difference in the mean depth between the two groups. A strong negative linear relationship between depth and emergence angle was seen for the screw-retained group. Overall, implant positioning in the anterior maxilla has a significant influence on emergence angle. Facial emergence angle is significantly greater for implants in a screw-retained position. This may be partially alleviated by deeper implant placement. [ABSTRACT FROM AUTHOR]

Background and aim: Traumatic Brain Injury (TBI) and stroke are major sources of death and disability worldwide. Acupuncture has been used as a supplemental therapy for patients with TBI and stroke. This study was aimed to evaluate the effects of acupuncture therapy for patients with TBI and stroke by radial pulse spectrum. Experimental procedure: 22 patients (6 TBI and 16 stroke) were enrolled and underwent radial pressure wave measurement before and after acupuncture treatment at Dubi (ST-35), Zusanli (ST-36) and Jiexi (ST-41). The harmonic analysis of the radial pressure wave was calculated and transformed into Fourier series coefficients Cn, Pn and the variation coefficient CnCV. Results: After acupuncture, systolic blood pressure, heart rate, and Glasgow Coma Scale changed very slightly. The harmonic index C4, C7, C9, C10, C3CV and C5CV had significant increases. (P

Abstract Background Mature cystic teratomas of the ovary are the most common type of germ cell tumor, comprising 33% of ovarian tumors. Studying these tumors may result in a better understanding of their stepwise developmental processes and molecular bases and provide useful information for the development of tissue-engineering technologies. Methods In the present study, 9 mature cystic teratomas of the ovary were analyzed by whole-exome sequencing and the results were compared with the Catalogue of Somatic Mutations in Cancer and dbSNP databases. Results Mutations were validated in 15 genes with alterations in all 9 (100%) samples and changes in protein coding. The top 10 mutated genes were FLG, MUC17, MUC5B, RP1L1, NBPF1, GOLGA6L2, SLC29A3, SGK223, PTGFRN, and FAM186A. Moreover, 7 variants in exons with changes in protein coding are likely of importance in the development of mature cystic teratomas of the ovary, namely PTGFRN, DUSP5, MPP2, PHLDA1, PRR21, GOLGA6L2, and KRTAP4-2. Conclusions These genetic alterations may play an important etiological role in teratoma formation. Moreover, novel mutations in DUSP5 and PHLDA1 genes found on whole-exome sequencing may help to explain the characteristics of teratomas.

Objective: The prenatal course of a rare case with fetal anemia caused by maternal anti-c alloimmunization was reported. Case report: A 39-year-old female with anti-c and anti-E antibodies against red cells had previously experienced a stillbirth. At her present pregnancy, titers of maternal antibodies and fetal middle cerebral artery peak systolic velocity (MCA-PSV) were frequently monitored to investigate the severity of fetal hemolytic anemia. Rather than manifesting as an increase in MCA-PSV, the anemic fetus was delivered at 32 weeks and one day of gestation with a sole presentation: polyhydramnios. Neonatal hospitalization course were compatible with hemolytic anemia. The baby was discharged at 48 days of age. Conclusion: This case illustrated the complexities of dealing with maternal red cell alloimmunization during pregnancy and the limitations of noninvasive diagnostic modalities for detecting fetal anemia, and highlighted that obstetricians should refer all available clinical parameters in order to offer appropriate perinatal care.

Abstract Background Cecal ulcers are sometimes encountered in asymptomatic individuals. Their clinical outcomes and management recommendations remain uncertain. Methods Asymptomatic patients who underwent a colonoscopic exam for colon cancer screening were retrospectively reviewed from July 2009 to November 2016. Patients with cecal ulcers were included. Patients who had colorectal symptoms, such as abdominal pain, had nonsteroidal anti-inflammatory drugs or were lost to follow-up were excluded. Results A total of 34,036 patients underwent colon cancer screening. Cecal ulcers were found in 35 patients. After exclusion, 24 patients (mean duration, 52 months) received follow-up colonoscopy. In 20 patients, (83.3%), cecal ulcer resolved without intervention, but 4 patients (16.7%) developed clinical significant diseases, including intestinal tuberculosis (n = 2), Crohn’s disease (n = 1), and ulcerative colitis (n = 1). Patients who developed clinically significant diseases had a higher percentage of ulcers larger than 1 cm (75% vs. 15%, p = 0.035), terminal ileum involvement (100% vs. 15.4%, p = 0.006) and ulcers with irregular fold (75% vs. 5%, p = 0.008). Conclusions In patients with asymptomatic cecal ulcers, the endoscopic features included larger ulcer size, terminal ileum involvement and ulcers with irregular fold may predict development of clinically significant diseases. If the above-mentioned features are present, even asymptomatic patients should be closely monitored.

Objective: Pregnancy and menopause are significant life events associated with major changes in female hormone levels and changes in cardiovascular health. The role of estrogen in influencing cardiovascular risk is an ongoing research topic. Many studies have provided evidence that radial pressure wave characteristics are an important indicator to consistently and independently predict cardiovascular events. The aim of this study was to investigate if radial pressure wave analysis provided statistical insights into the physiological variations due to pregnancy and menopause. Furthermore, the study investigated how these variations could serve as an indicator for cardiovascular risks. As the radial pulse measurement is non-invasive and speedy, it may be helpful in evaluating cardiovascular changes and risk during these transitions. Materials and method: A total of 702 randomly selected female subjects (90 pregnant and 97 post-menopausal), aged 20–59, enrolled in the study. The visit measured the subject's hemodynamic parameters including heart rate, systolic blood pressure (SBP), diastolic blood pressure (DBP) and radial pressure waves. SBP and DBP were evaluated by an automatic blood pressure monitor. Radial pressure wave data were continuously recorded for 12-s using a TD01C pulse measuring instrument. Spectrum analysis of the radial pressure wave was performed to evaluate the first five harmonic components (C1–C5). Results: A comparison of pregnant women to non-pregnant women showed C3 and C5 were lower. Heart rate C2 and C4 were higher in pregnant women. A comparison of women pre-menopausal and post-menopausal showed no significant difference in SBP or DBP. Menopause significantly changed the C1 and C4 radial pressure wave harmonics. An increase in C1 and a decrease in C4 were observed. Conclusion and discussion: This study provided further clinical evidence to support the hemodynamic model that describes the cardiovascular changes and risks related to the harmonic components of the pulse spectrum. Beyond blood pressure, the effects of menopause on the radial pressure wave, especially on hemodynamic index C4, independent of age and BMI, may explain increased post-menopausal cardiovascular risk. This and past studies collectively suggest that radial pressure wave components may be an indicator of a female body's ability to supply oxygen and nutrients. Harmonic analysis of the radial pressure wave may provide additional insights into the underlying mechanism of the cardiovascular changes over the lifespan of a woman.