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The purpose of this study is to investigate the use of both formative and summative assessment in Taiwan and the United States. The focus is on the comparisons between undergraduate and graduate students and between U.S. and Taiwanese students in their attitudes toward the use of assessment in higher education. Responses from 349 undergraduate and graduate students from Taiwan and 97 undergraduate and graduate students from a large city in the United States were used for chi-square test, multivariate analysis of variance, and independent samples t-test. The two groups of students were comparable with respect to the distribution of gender and grade level. Results suggest no statistically significant difference with respect to the forms of assessment: self-assessment, peer assessment, and teacher assessment. As for the tools of assessment, attendance, class participation, homework, reading report, quizzes and exams were used more often in the classrooms in Taiwan whereas learning diary, essays, display, and projects were used more often in the United States. Students in Taiwan also agreed more to use a combination of all forms of assessments in comparison to their American counterparts. As for the contents of assessment, students in Taiwan endorsed more on the perception that assessments should include aspects of cognition, skill, and attitude. Results from this study provided information about the use of formative and summative assessment in Taiwan and the United States and student perspectives of its use. Findings from this study might be helpful for the U.S. and Taiwanese instructors to learn from each other and to meet their students' expectations in the use of assessment.

Teacher educators drive preservice teachers' learning about teaching particularly through feedback. The learning materials produced by preservice teachers also play a crucial role in English language teacher training but may not be receiving the necessary attention in teacher education programs. Preservice teachers lack formal teaching experiences, which may result in their overemphasizing material delivery while underemphasizing material suitability. Providing teacher educators with criteria for evaluating learning materials developed by preservice teachers could aid in their providing quality formative feedback. Therefore, this study was designed to construct a research-based contextualized evaluation checklist for learning materials. Adopting a systematic yet flexible design-based method allowed for the integration of design and intervention to develop a solution for this targeted educational problem. The researchers adopted a three-phase process for this study: analysis and exploration of a teacher educator's needs and extant literature on learning materials; design and construction; and evaluation and reflection. Learning materials designed by a preservice teacher were used to pilot the checklist. The results showed a need for refinement to form the final evaluation checklist. The checklist can be used by teacher educators for preservice teacher evaluation purposes or by preservice teachers as a quality check.

Instructional settings (English as a second language (ESL) and English as a foreign language (EFL)) may provide different opportunities for learners' meaningful language use. This qualitative study was designed to shed light on this issue. The data included multiple sources collected from a sustained content gastronomy language course taught in an American ESL and a Taiwanese EFL context. Findings revealed that various factors (e.g., themes, environment, and learners) contributed to learners from both contexts meeting course goals. The findings further indicate that it is not the ESL/EFL context but instead using a sustained content language teaching approach that incorporates theme-based instruction and dynamic units that ensures learners are provided opportunities for meaningful and purposeful language use.

Student engagement research in university students has been scarce, despite its major positive role on performance, degree completion and mental health. Social and emotional competencies, which are currently called twenty-first-century skills, exert some impact on student engagement in youth. Since engagement is cultural-sensitive, individual (social and emotional competencies) and cross-cultural (human developmental index and unemployment rate) characteristics were examined in association with student engagement in youth. This study included 2,092 participants from nine countries/regions, aged between 17 and 27 years (M = 21.52, SD = 2.27), mostly cisgender woman (n = 1,035, 68.7%) and undergraduate (n = 1,401, 96.2%). Data were collected using a cross-sectional online survey that included the Student Engagement Scale, the Emotional Skills and Competence Questionnaire, and the prosocial behaviour/resources subscale of the Strengths and Difficulties Questionnaire. Multilevel-models showed that social and emotional competencies were relevant predictors of student engagement independently of the country-level variables. Moreover, student engagement varied with country/region human development and unemployment rate, with students from higher developed countries/regions and lowered unemployment reporting lower engagement. This study reinforces the need to implement evidence-based social and emotional learning programmes in universities worldwide, as well as public policies that can influence engagement and protect youth.

This qualitative case study explores a language teacher educator's beliefs and practices regarding pre-primary English teacher education in Macau. The focal participant was an experienced English language teacher (20 years) and teacher educator who is a native speaker of American English. The data were collected over five years, and include written reflections, classroom observations, course syllabi, and interviews. The findings reveal that the teacher educator held six main beliefs regarding various aspects of language teacher education for the preprimary level, namely, beliefs about (1) the purpose of pre-primary English teacher education, (2) being a teacher educator, (3) the nature of the teaching methodology course, (4) the students, (5) pre-school learners and learning, and (6) the development of the teaching methodology course. The educator's beliefs were largely reflected in practice, as revealed in the course design, material selection, teaching, and the design of student assignments and other forms of assessment. The educator adjusted his/her practice over time in response to students' needs, self-awareness, and the university policies. The teacher educator's beliefs and practices were shown to be mutually informing.

Teachers in institutions of higher education have a very high degree of freedom when designing curricula. They make decisions on learning objectives, content, content organization, teaching arrangement, and assessment. Teachers' beliefs regarding curriculum design affect decision-making and planning processes, teaching approaches, and their relationships with students. This study aimed to examine the role beliefs played in influencing an English as a Second Language (ESL) teacher's curriculum design. The teacher's beliefs, their origins, and their impact on curriculum design were investigated through the analysis of in-depth interview transcripts, course outlines, teaching and learning materials, and teaching reflection notes. The results of the analysis revealed that the ESL teacher believed that an ESL curriculum should be balanced, authentic, and enjoyable. While teaching experiences, article reading, and personal interests were shown to have shaped the ESL teacher's beliefs, the most significant influencer was his personal experiences in a postgraduate Teaching English to Speakers of Other Languages teacher education programme. This finding underscores that quality curricula will bring about positive learning experiences, which, in turn, will lead to better curriculum design.

We report data from the Small World of Singlish Words (SWOSW) Project, where word associations are obtained for a list of common Singlish words. Singapore English, colloquially known as Singlish, is a dialect of English spoken in Singapore. Free association data on these words were collected from a young adult population of university undergraduates using an online survey platform. This data enables the construction of semantic networks, allowing one to examine the semantic structure of individual words in the Singlish lexicon, as well as to compare differences in semantic structure across groups of participants.

Background: Depression is a significant health problem in undergraduate students, exacerbated by factors that include the transition into adulthood and the changes in social environment. Research has shown depressive tendency and alexithymia as positively correlated. Greater attention to the issue of depression in undergraduate students is needed in order to facilitate appropriate strategies to promote mental health. Objectives: This study was designed to identify the association between depressive tendencies and the identification and expression of emotional obstacles in undergraduate students. Methods: A cross-sectional and descriptive research design was conducted. A stratified cluster approach randomly selected a total of 600 undergraduate subjects from a university in southern Taiwan. The response rate for the self-administrated questionnaire was 76%. Measurement tools used included Zung's Self-Rating Depression Scale and the Toronto Alexithymia Scale-20. The odds ratio of depressive tendency and the identification and expression of emotional obstacles among undergraduate students was calculated, and then the association between the two variables was examined using logistic regression, with confounding variables taken into account. Results: In total, 48.8% and 38.1% of participants suffered from depressive tendencies and the identification and expression of emotional obstacles, respectively. Findings showed that slightly over half (56.5%) of those with depressive tendencies identified and expressed emotional obstacles. This percentage was only one-fifth (20.9%) among those without depressive tendencies. The odds ratio for identification and expression of emotional obstacles among those with depressive tendencies was 4.9 times (p < .001) that of their peers without depressive tendency as calculated using logistic regression adjusted for gender, age, and academic department. Conclusions: Undergraduate students with depressive tendencies face a significantly higher risk of identifying and expressing emotional obstacles. School mental-health professionals may use the results of this study to promote mental health and improve the accurate identification and expression of emotions. [ABSTRACT FROM AUTHOR]

Advance care planning (ACP) has the potential to improve the outcomes of end-of-life care for residents in nursing homes. The aim of this study was to determine whether an ACP program was beneficial for nursing home residents by assessing end-of-life indicators. An experimental study with a retrospective chart review was conducted. In total, 37 residents in the intervention group participated in an institutional advance care planning program for 1 year, and their chart data over 1 year were collected following the completion of the program; 33 residents in the control group had died within 1 year before the start date of program, and their chart data were reviewed retrospectively. Chi-square and t tests were used to examine four indicators of the quality of end-of-life care. Compared with the control group, the intervention group had a higher proportion of do-not-resuscitate directives, hospice care before death, and deaths in the nursing home, and fewer hospitalizations and deaths in an emergency department. ACP programs may improve the quality of end-of-life care for nursing home residents in Taiwan. Further research across different long-term care facilities is warranted.

Introduction: Geriatric disaster nursing simulation curriculum use scenarios with trauma-based topics that may contribute to lack of psychological safety in learners. This learning condition lowers students' self-efficacy, so supportive debriefing is needed to provide psychological safety for learners. The aims of this study are to develop and apply a geriatric disaster nursing simulation and to evaluate the effectiveness of a supportive debriefing model on psychological safety, learning self-efficacy, and counseling self-efficacy., Methods: A geriatric nursing simulation scenario, checklists, and a standardized patient were developed based on the Analysis-Design-Development-Implementation-Evaluation model. Nursing students were recruited as participants and randomly assigned to either the experimental group, conventional group, or control group. All 3 groups participated in the same geriatric disaster nursing simulation scenario, after which the experimental group used a supportive debriefing model-the SENSE (share-explore-notice-support-extend) model. The conventional group used a common debriefing model, the GAS (gathering-analyzing-summarizing) model, and the control group received simple comments with no debriefing model. The effects of the debriefing models on psychological safety, learning self-efficacy, and counseling self-efficacy were measured by self-report questionnaires. The aggregate scores of the measures were 222 for counseling self-efficacy, 70 for learning self-efficacy, and 50 for psychological safety. Higher scores within these measures corresponded to heightened capabilities., Results: The mean score of counseling self-efficacy in the SENSE model group was significantly increased after the simulation with the supportive debriefing from 142.80 ± 11.43 to 164.53 ± 15.48 ( Z = -3.411, P = 0.001). In addition, the SENSE model group and the GAS model group had significantly higher scores in counseling self-efficacy, learning self-efficacy, and psychological safety than those of the control group. However, the SENSE model group had a significantly higher score in psychological safety than that of the GAS model group., Conclusions: The SENSE debriefing model is recommended as a supportive debriefing model to foster students' psychological safety in disaster nursing simulations., Competing Interests: The authors declare no conflict of interest., (Copyright © 2024 Society for Simulation in Healthcare.)

Purpose: Among cases of breast cancer, estrogen receptor-positive (ER +), PIK3CA-mutant, HER2- advanced breast cancer stands as a particularly complex clinical indication where approximately 40% of ER + /HER2- breast carcinomas present mutations in the PIK3CA gene. A significant hurdle in treating ER + breast cancer lies in surmounting the challenges of endocrine resistance. In the clinical setting, a multifaceted approach is essential for this indication, one that not only explores the effectiveness of individual treatments but also delves into the potential gains in therapeutic outcome from combination therapies., Methods: In the current study, longitudinal tumor growth inhibition (TGI) models were developed to characterize tumor response over time in postmenopausal women with ER + /HER2- advanced or metastatic breast cancer undergoing treatment with fulvestrant alone or in combination with the PI3K inhibitor, taselisib. Impact of clinically relevant covariates on TGI metrics was assessed to identify patient subsets most likely to benefit from treatment with fulvestrant monotherapy or combination with taselisib., Results: Tumor growth rate constant (K g ) was found to increase with increasing baseline tumor size and in the absence of baseline endocrine sensitivity. Further, K g decreased in the absence of baseline liver metastases both in fulvestrant monotherapy and combination therapy with taselisib. Overall, additive/potentially synergistic anti-tumor effects were observed in patients treated with the taselisib-fulvestrant combination., Conclusion: These results have important implications for understanding the therapeutic impact of combination treatment approaches and individualized responses to these treatments. Finally, this work, emphasizes the importance of model informed drug development for targeted cancer therapy., Clinical Trial Registration: NCT02340221 Registered January 16, 2015, NCT01296555 Registered February 14, 2011., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Cancer remains a significant global health challenge, and despite remarkable advancements in therapeutic strategies, poor tolerability of drugs (causing dose reduction/interruptions) and/or the emergence of drug resistance are major obstacles to successful treatment outcomes. Metastatic renal cell carcinoma (mRCC) accounts for 2% of global cancer diagnoses and deaths. Despite the initial success of targeted therapies in mRCC, challenges remain to overcome drug resistance that limits the long-term efficacy of these treatments. Our analysis aim was to develop a semi-mechanistic longitudinal exposure-tumor growth inhibition model for patients with mRCC to characterize and compare everolimus (mTORC1) and apitolisib's (dual PI3K/mTORC1/2) ability to inhibit tumor growth, and quantitate each drug's efficacy decay caused by emergence of tumor resistance over time. Model-estimated on-treatment tumor growth rate constant was 1.7-fold higher for apitolisib compared to everolimus. Estimated half-life for loss of treatment effect over time for everolimus was 16.1 weeks compared to 7.72 weeks for apitolisib, suggesting a faster rate of tumor re-growth for apitolisib patients likely due to the emergence of resistance. Goodness-of-fit plots including visual predictive check indicated a good model fit and the model was able to capture individual tumor size-time profiles. Based on our knowledge, this is the first clinical report to quantitatively assess everolimus (mTORC1) and apitolisib (PI3K/mTORC1/2) efficacy decay in patients with mRCC. These results highlight the difference in overall efficacy of 2 drugs due to the quantified efficacy decay caused by emergence of resistance, and emphasize the importance of model-informed drug development for targeted cancer therapy., (© 2024 The Authors. The Journal of Clinical Pharmacology published by Wiley Periodicals LLC on behalf of American College of Clinical Pharmacology.)

Background: Lymphopenia is known for its significance on poor survivals in breast cancer patients. Considering full dosimetric data, this study aimed to develop and validate predictive models for lymphopenia after radiotherapy (RT) in breast cancer., Material and Methods: Patients with breast cancer treated with adjuvant RT were eligible in this multicenter study. The study endpoint was lympopenia, defined as the reduction in absolute lymphocytes and graded lymphopenia after RT. The dose-volume histogram (DVH) data of related critical structures and clinical factors were taken into account for the development of dense neural network (DNN) predictive models. The developed DNN models were validated using external patient cohorts., Results: A total of 918 consecutive patients with invasive breast cancer enrolled. The training, testing, and external validating datasets consisted of 589, 203, and 126 patients, respectively. Treatment volumes at nearly all dose levels of the DVH were significant predictors for lymphopenia following RT, including volumes at very low-dose 1 Gy (V1) of organs at risk (OARs) including lung, heart and body, especially ipsilateral-lung V1. A final DNN model, combining full DVH dosimetric parameters of OARs and three key clinical factors, achieved a predictive accuracy of 75 % or higher., Conclusion: This study demonstrated and externally validated the significance of full dosimetric data, particularly the volume of low dose at as low as 1 Gy of critical structures on lymphopenia after radiation in patients with breast cancer. The significance of V1 deserves special attention, as modern VMAT RT technology often has a relatively high value of this parameter. Further study is warranted for RT plan optimization., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024. Published by Elsevier B.V.)

Background: Polydactyly is a prevalent congenital anomaly with an incidence of 2.14 per 1000 live births in China. GLI family zinc finger 3 (GLI3) is a classical causative gene of polydactyly, and serves as a pivotal transcription factor in the hedgehog signaling pathway, regulating the development of the anterior-posterior axis in limbs., Methods: Three pedigrees of polydactyly patients were enrolled from Hunan Province, China. Pathogenic variants were identified by whole-exome sequencing (WES) and Sanger sequencing., Results: Three variants in GLI3 were identified in three unrelated families, including a novel deletion variant (c.1372del, p.Thr458GlnfsTer44), a novel insertion-deletion (indel) variant (c.1967&#95;1968delinsAA, p.Ser656Ter), and a nonsense variant (c.2374 C > T, p.Arg792Ter). These variants were present exclusively in patients but not in healthy individuals., Conclusions: We identified three pathogenic GLI3 variants in polydactyly patients, broadening the genetic spectrum of GLI3 and contributing significantly to genetic counseling and diagnosis for polydactyly., (© 2024. The Author(s).)

Model-based tumor growth inhibition (TGI) metrics are increasingly used to predict overall survival (OS) data in Phase III immunotherapy clinical trials. However, there is still a lack of understanding regarding the differences between two-stage or joint modeling methods to leverage Phase I/II trial data and help early decision-making. A recent study showed that TGI metrics such as the tumor growth rate constant K G may have good operating characteristics as early endpoints. This previous study used a two-stage approach that is easy to implement and intuitive but prone to bias as it does not account for the relationship between the longitudinal and time-to-event processes. A relevant alternative is to use a joint modeling approach. In the present article, we evaluated the operating characteristics of TGI metrics using joint modeling, assuming an OS model previously developed using historical data. To that end, we used TGI and OS data from IMpower150-a study investigating atezolizumab in over 750 patients suffering from non-small cell lung cancer-to mimic randomized Phase Ib/II trials varying in terms of number of patients included (40 to 15 patients per arm) and follow-up duration (24 to 6 weeks after the last patient included). In this context, joint modeling did not outperform the two-stage approach and provided similar operating characteristics in all the investigated scenarios. Our results suggest that K G geometric mean ratio could be used to support early decision-making provided that 30 or more patients per arm are included and followed for at least 12 weeks., (© 2024 Genentech, Inc. Institut Roche and F. Hoffmann‐La Roche AG. CPT: Pharmacometrics & Systems Pharmacology published by Wiley Periodicals LLC on behalf of American Society for Clinical Pharmacology and Therapeutics.)

Background and Objectives: Despite significant progress in biomedical research, the rate of success in oncology drug development remains inferior to that of other therapeutic fields. Mechanistic models provide comprehensive understanding of the therapeutic effects of drugs, which is crucial for designing effective clinical trials. This study was performed to acquire a better understanding of PI3K-AKT-TOR pathway modulation and preclinical to clinical translational bridging for a specific compound, apitolisib (PI3K/mTOR inhibitor), by developing integrated mechanistic models., Methods: Integrated pharmacokinetic (PK)-pharmacodynamic (PD)-efficacy models were developed for xenografts bearing human renal cell adenocarcinoma and for patients with solid tumors (phase 1 studies) to characterize relationships between exposure of apitolisib, modulation of the phosphorylated Akt (pAkt) biomarker triggered by inhibition of the PI3K-AKT-mTOR pathway, and tumor response., Results: Both clinical and preclinical integrated models show a steep sigmoid curve linking pAkt inhibition to tumor growth inhibition and quantified that a minimum of 35-45% pAkt modulation is required for tumor shrinkage in patients, based on platelet-rich plasma surrogate matrix and in xenografts based on tumor tissue matrix. Based on this relationship between targeted pAkt modulation and tumor shrinkage rate, it appeared that a constant pAkt inhibition of 61% and 65%, respectively, would be necessary to achieve tumor stasis in xenografts and patients., Conclusions: These results help when it comes to evaluating the translatability of the preclinical analysis to the clinical target, and provide information that will enhance the value of future preclinical translational dose-finding and dose-optimization studies to accelerate clinical drug development., Trial Registry: ClinicalTrials.gov NCT00854152 and NCT00854126., (© 2024. The Author(s).)

Background: Atherosclerosis (AS), a chronic inflammatory disease of blood vessels, is a major contributor to cardiovascular disease. Dental pulp stem cells (DPSCs) are capable of exerting immunomodulatory and anti-inflammatory effects by secreting cytokines and exosomes and are widely used to treat autoimmune and inflammation-related diseases. Hepatocyte growth factor (HGF) is a pleiotropic cytokine that plays a key role in many inflammatory and autoimmune diseases., Aim: To modify DPSCs with HGF (DPSC-HGF) and evaluate the therapeutic effect of DPSC-HGF on AS using an apolipoprotein E-knockout (ApoE -/- ) mouse model and an in vitro cellular model., Methods: ApoE -/- mice were fed with a high-fat diet (HFD) for 12 wk and injected with DPSC-HGF or Ad-Null modified DPSCs (DPSC-Null) through tail vein at weeks 4, 7, and 11, respectively, and the therapeutic efficacy and mechanisms were analyzed by histopathology, flow cytometry, lipid and glucose measurements, real-time reverse transcription polymerase chain reaction (RT-PCR), and enzyme-linked immunosorbent assay at the different time points of the experiment. An in vitro inflammatory cell model was established by using RAW264.7 cells and human aortic endothelial cells (HAOECs), and indirect co-cultured with supernatant of DPSC-Null (DPSC-Null-CM) or DPSC-HGF-CM, and the effect and mechanisms were analyzed by flow cytometry, RT-PCR and western blot. Nuclear factor-κB (NF-κB) activators and inhibitors were also used to validate the related signaling pathways., Results: DPSC-Null and DPSC-HGF treatments decreased the area of atherosclerotic plaques and reduced the expression of inflammatory factors, and the percentage of macrophages in the aorta, and DPSC-HGF treatment had more pronounced effects. DPSCs treatment had no effect on serum lipoprotein levels. The FACS results showed that DPSCs treatment reduced the percentages of monocytes, neutrophils, and M1 macrophages in the peripheral blood and spleen. DPSC-Null-CM and DPSC-HGF-CM reduced adhesion molecule expression in tumor necrosis factor-α stimulated HAOECs and regulated M1 polarization and inflammatory factor expression in lipopolysaccharide-induced RAW264.7 cells by inhibiting the NF-κB signaling pathway., Conclusion: This study suggested that DPSC-HGF could more effectively ameliorate AS in ApoE -/- mice on a HFD, and could be of greater value in stem cell-based treatments for AS., Competing Interests: Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article., (©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.)

Noncompartmental analysis (NCA) is a model-independent approach for assessing pharmacokinetics (PKs). Although the existing NCA algorithms are very well-established and widely utilized, they suffer from low accuracies in the setting of sparse PK samples. In response, we developed Deep-NCA, a deep learning (DL) model to improve the prediction of key noncompartmental PK parameters. Our methodology utilizes synthetic PK data for model training and uses an innovative patient-specific normalization method for data preprocessing. Deep-NCA demonstrated adequate performance across six previously unseen simulated drugs under multiple dosing, showcasing effective generalization. Compared to traditional NCA, Deep-NCA exhibited superior performance for sparse PK data. This study advances the application of DL to PK studies and introduces an effective method for handling sparse PK data. With further validation and refinement, Deep-NCA could significantly enhance the efficiency of drug development by providing more accurate NCA estimates while requiring fewer PK samples., (© 2024 Genentech, Inc. CPT: Pharmacometrics & Systems Pharmacology published by Wiley Periodicals LLC on behalf of American Society for Clinical Pharmacology and Therapeutics.)

MORF4-related gene on chromosome 15 (MRG15), a chromatin remodeller, is evolutionally conserved and ubiquitously expressed in mammalian tissues and cells. MRG15 plays vital regulatory roles in DNA damage repair, cell proliferation and division, cellular senescence and apoptosis by regulating both gene activation and gene repression via associations with specific histone acetyltransferase and histone deacetylase complexes. Recently, MRG15 has also been shown to rhythmically regulate hepatic lipid metabolism and suppress carcinoma progression. The unique N-terminal chromodomain and C-terminal MRG domain in MRG15 synergistically regulate its interaction with different cofactors, affecting its functions in various cell types. Thus, how MRG15 elaborately regulates target gene expression and performs diverse functions in different cellular contexts is worth investigating. In this review, we provide an in-depth discussion of how MRG15 controls multiple physiological and pathological processes., (© 2023. The Author(s), under exclusive licence to Shanghai Institute of Materia Medica, Chinese Academy of Sciences and Chinese Pharmacological Society.)