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Abstract The path of tokamak fusion and International thermonuclear experimental reactor (ITER) is maintaining high-performance plasma to produce sufficient fusion power. This effort is hindered by the transient energy burst arising from the instabilities at the boundary of plasmas. Conventional 3D magnetic perturbations used to suppress these instabilities often degrade fusion performance and increase the risk of other instabilities. This study presents an innovative 3D field optimization approach that leverages machine learning and real-time adaptability to overcome these challenges. Implemented in the DIII-D and KSTAR tokamaks, this method has consistently achieved reactor-relevant core confinement and the highest fusion performance without triggering damaging bursts. This is enabled by advances in the physics understanding of self-organized transport in the plasma edge and machine learning techniques to optimize the 3D field spectrum. The success of automated, real-time adaptive control of such complex systems paves the way for maximizing fusion efficiency in ITER and beyond while minimizing damage to device components.

The DIII-D tokamak has elucidated crucial physics and developed projectable solutions for ITER and fusion power plants in the key areas of core performance, boundary heat and particle transport, and integrated scenario operation, with closing the core-edge integration knowledge gap being the overarching mission. New experimental validation of high-fidelity, multi-channel, non-linear gyrokinetic turbulent transport models for ITER provides strong confidence it will achieve Q ⩾ 10 operation. Experiments identify options for easing H-mode access in hydrogen, and give new insight into the isotopic dependence of transport and confinement. Analysis of 2,1 islands in unoptimized low-torque IBS demonstration discharges suggests their onset time occurs randomly in the constant β phase, most often triggered by non-linear 3-wave coupling, thus identifying an NTM seeding mechanism to avoid. Pure deuterium SPI for disruption mitigation is shown to provide favorable slow cooling, but poor core assimilation, suggesting paths for improved SPI on ITER. At the boundary, measured neutral density and ionization source fluxes are strongly poloidally asymmetric, implying a 2D treatment is needed to model pedestal fuelling. Detailed measurements of pedestal and SOL quantities and impurity charge state radiation in detached divertors has validated edge fluid modelling and new self-consistent ‘pedestal-to-divertor’ integrated modeling that can be used to optimize reactors. New feedback adaptive ELM control minimizes confinement reduction, and RMP ELM suppression with sustained high core performance was obtained for the first time with the outer strike point in a W-coated, compact and unpumped small-angle slot divertor. Advances have been made in integrated operational scenarios for ITER and power plants. Wide pedestal intrinsically ELM-free QH-modes are produced with more reactor-relevant conditions, Low torque IBS with W-equivalent radiators can exhibit predator-prey oscillations in T _e and radiation which need control. High- β _P scenarios with q _min > 2, q _95 –7.9, β _N > 4, β _T –3.3% and H _98y2 > 1.5 are sustained with high density ( $\bar n$ = 7E19 m ^−3 , f _G –1) for 6 τ _E , improving confidence in steady-state tokamak reactors. Diverted NT plasmas achieve high core performance with a non-ELMing edge, offering a possible highly attractive core-edge integration solution for reactors.

Sawteeth are one of the concerning instabilities in ITER and future burning plasma experiments. Sawtooth dynamics and its interaction with broadband plasma turbulence has been a challenge for predictive simulations of core transport in future fusion devices. This study provides new observations of core turbulence behavior during sawtooth oscillations in DIII-D hydrogen L-mode neutral beam injection heated plasmas in an inner wall limited configuration. A strong correlation of electron temperature and density turbulence levels with the sawtooth oscillation phase has been observed at locations inside the T _e inversion radius and/or safety factor q = 1 magnetic surface. The T _e turbulence amplitude in the core during the sawtooth ramp exhibits a critical T _e gradient behavior inside but not near the T _e inversion radius/ q = 1 magnetic surface. The most unstable mode calculated from the trapped gyro-landau fluid turbulence simulations reveal a change from low- k ion-type to low-k electron-type modes from pre- to post- sawtooth crash time periods.

Existing literature attests to the importance of assessing the learning enjoyment and learning interest of students toward socio-scientific issues (SSI). However, there are few existing studies that examine how ecological stimuli, which are crucial to young learners' perceptual development and the shaping of ethical judgment, predict their learning enjoyment and learning interest in SSI. This investigation addresses this gap in the available literature by investigating and assessing the effects of self-perceived influences of three ecological stimuli constructs--textbooks, family/classmates, and news media--on a learning interest in SSI construct and a learning enjoyment from SSI construct among Taiwanese high school students. A structural equation model consisting of these five constructs was fitted to data collected from 966 students. Results show that influence on students' ethical judgments from textbooks and news media directly predict learning interest in SSI, with effects partially mediated by learning enjoyment from SSI. The influence of family/classmates on students' learning interest was fully mediated by learning enjoyment. The role of enjoyment and learning interest as predictors of these outcomes is discussed within the context of genuine interest in learning SSI content. The value and implications of these results for science education specialists and interest researchers are forwarded and suggested directions of future investigation submitted.

The integration of a high-performance core and a dissipative divertor, or the so-called ‘core–edge integration,’ has been widely identified as a critical gap in the design of future fusion reactors. In this letter, we report, for the first time, direct experimental evidence of electron turbulence at the DIII-D H-mode pedestal that correlates with the broadening of the pedestal and thus facilitates core–edge integration. In agreement with gyrokinetic simulations, this electron turbulence is enhanced by high η _e ( η _e = L _n / L _T _e , where L _n is the density scale length and L _T _e is the electron temperature scale length), which is due to a strong shift between the density and temperature pedestal profiles associated with a closed divertor. The modeled turbulence drives significant heat transport with a lower pressure gradient that may broaden the pedestal to a greater degree than the empirical and theoretically predicted pedestal width scalings. Such a wide pedestal, coupled with a closed divertor, enables us to achieve a good core–edge scenario that integrates a high-temperature low-collisionality pedestal (pedestal top temperature T _e,ped > 0.8 keV and a pedestal top collisionality ν * _ped < 1) under detached divertor conditions. This paves a new path toward solving the core–edge integration issue in future fusion reactors.

We report on the observation of spatially asymmetric turbulent structures with a long radial correlation length in the core of high-collisionality H -mode plasmas on DIII-D tokamak. These turbulent structures develop from shorter wavelength turbulence and have a radially elongated structure. The envelope of turbulence spans a broad radial range in the mid-radius region, leading to streamer-like transport events. The underlying turbulence is featured by intermittency, long-term memory effect, and the characteristic spectrum of self-organized criticality. The amplitude and the radial scale increase substantially when the shearing rate of the mean flow is reduced below the turbulent scattering rate. The enhanced long-radial-range-correlated (LRRC) transport events are accompanied by apparent degradation of normalized energy confinement time. The emergence of such LRRC transport events may serve as a candidate explanation for the degrading nature of H-mode core plasma confinement at high collisionality on DIII-D tokamak.

Measurements of the turbulent density wavenumber spectrum, $\delta \hat{n}_e(k_\perp)$ , using the Doppler Back-Scattering (DBS) diagnostic are reported from DIII-D H-mode plasmas with electron cyclotron heating as the only auxiliary heating method. These electron-heated plasmas have low collisionality, $\nu^*_e \lt 1$ , $T_e/T_i \gt 1$ , and zero injected torque—a regime expected to be relevant for future fusion devices. We probe density fluctuations in the core ( ρ ≈ 0.7) over a broad wavenumber range, $0.5 \unicode{x2A7D} k_\perp \unicode{x2A7D} 16$ cm ^−1 ( $0.1 \unicode{x2A7D} k_\perp\rho_s \unicode{x2A7D} 5$ ), to characterize plasma instabilities and compare with theoretical predictions. We present a novel synthetic DBS diagnostic to relate the back-scattered power spectrum, $P_s(k_\perp)$ —which is directly measured by DBS—to the underlying electron density fluctuation spectrum, $\delta \hat{n}_e(k_\perp)$ . The synthetic DBS $P_s(k_\perp)$ spectrum is calculated by combining the SCOTTY beam-tracing code with a model $\delta \hat{n}_e(k_\perp)$ predicted either analytically or numerically. In this work we use the quasi-linear code Trapped Gyro-Landau Fluid (TGLF) to approximate the $\delta \hat{n}_e(k_\perp)$ spectrum. We find that TGLF, using the experimental profiles, is capable of closely reproducing the DBS measurements. Both the DBS measurements and the TGLF-DBS synthetic diagnostic show a wavenumber spectrum with variable decay. The measurements show weak decay ( k ^−0.6 ) for k 8.5 cm ^−1 . Scans of physics parameters using TGLF suggest that the normalized $\nabla T_e$ scale-length, $R/L_{T_e}$ , is an important factor for distinguishing microturbulence regimes in these plasmas. A combination of DBS observations and TGLF simulations indicate that fluctuations remain peaked at ITG-scales (low k ) while $R/L_{T_e}$ -driven TEM/ETG-type modes (intermediate/high k ) are marginally sub-dominant.

Understanding the extent engagement and math attitudes predict performance in statistics courses could inform educational interventions in this subject area, which has growing demand. We examined direct and indirect associations between course engagement-related constructs, math attitudes, and learning outcomes. Confirmatory factor analysis was used to validate scores from measures of these constructs with a sample of high school students enrolled in Advanced Placement (AP) statistics (N = 720, mean age = 16.8 years, SD = 0.82). Structural equation models were fitted to the data to examine relations between these constructs on a subsample (N = 220). A greater proportion of variation was explained in a high-stakes learning outcome (R2 = 0.54) than a low-stakes learning outcome (R2 = 0.24). We found some evidence of indirect effects of academic procrastination and course engagement on the learning outcome by way of math attitudes. The findings shed light on opportunities for intervention on academic maladaptive behaviors, such as procrastination, which could lessen negative effects on math attitudes and learning. These findings highlight the importance of testing stakes when examining associations between engagement, math attitudes, and learning, particularly in the context of high school statistics, a growing and yet understudied STEM learning context.

Purpose: To report a case of high-risk human papillomavirus (HPV)-associated corneal/conjunctival intraepithelial neoplasia (CIN) in a 17-year-old fair-skinned male with no other risk factors. Observations: A 17-year-old Caucasian male presented with an 18-month history of left eye pain, redness, itchiness, and decreased vision. Examination revealed a leukoplakic nasal limbal/peripheral corneal lesion resistant to topical antibiotic and anti-inflammatory treatments. Excisional biopsy confirmed the diagnosis of CIN, and RNA in situ hybridization testing for high-risk HPV types 16/18 was positive. Subsequent testing of the patient for human immunodeficiency virus (HIV) returned negative. Conclusions and Importance: The median age of CIN diagnosis in the United States is in the sixth decade of life and is usually associated with a history of ultraviolet (UV) light exposure. There are reports of CIN in young patients with systemic immunodeficiency, immunosuppression, xeroderma pigmentosum, atopic dermatitis, asthma, and vaping. Here we present a case of high-risk HPV-associated CIN in a young, fair-skinned patient with no other identifiable risk factors.

Purpose: To enhance the characterization of primary bulbar conjunctival basal cell carcinoma (BCC) clinically and histologically, via report of a case and review of the relevant medical literature. Observations: We report the case of a 73-year-old man with no history of skin cancer who presented with a bulbar conjunctival nodule without connection to the eyelid or caruncle, originally thought to represent a pyogenic granuloma. After one month without improvement on topical prednisolone, excisional biopsy was performed, with routine histopathology and immunohistochemistry. The tumor was found histologically to be primary conjunctival BCC. Immunostaining exhibited negative Ber-EP4 and S100, mostly negative CK7 and EMA, and positive p63. Margins were negative, and the patient had no recurrence six months after excision. Conclusions and Importance: Primary conjunctival BCC must be considered in the differential diagnosis of a conjunctival lesion which may initially appear benign but does not behave as expected clinically. The location of the tumor in the case presented here refutes a prior postulate that primary conjunctival BCC arises from basal adnexal epithelium in the caruncle. Of the immunohistochemical findings, only the Ber-EP4 result differed from the typical immunostaining profile of cutaneous BCC. Further study is needed to determine the frequency of Ber-EP4 positivity in primary conjunctival BCC.

本研究目的在探討高中職學生參與科學探究文創工作坊後，科學探究自我效能之差異性與中介效果表現。科學探究文創工作坊於臺灣北、中、南三區辦理，藉以培養高中職學生對於自然科學具備好奇心與想像力，並能用文字、影像、漫畫表達出科學探究的創作能力。科學探究文創工作坊包含兩階段課程，第一階段為2小時「科學探究能力培養課程」，第二階段為3小時「科學探究文創實作課程」。共計有480位高中職學生參與本次工作坊，並於課程結束後填寫信、效度良好的「科學探究自我效能問卷」線上版。本研究發現：一、南區高中職 學生的科學探究自我效能顯著高於中區學生；二、男學生科學探究自我效能顯著高於女學生；三、主動參與工作坊之高中職學生的科學探究自我效能顯著高於其他被動參與的學生；四、高中職學生的科學探究自我效能總分與「探究力」以及「科學表現」分向度有高度顯著正關聯；五、高中職學生之「參與度」與「興趣好奇」對於「探究力」及「科學表現」具有顯著的預測力。本研究為辦理科學探究文創工作坊之初探，未來將根據研究結果作為規劃非制式科學探究課程及相關研究之參考。 Background and Purpose The Ministry of Education in Taiwan officially launched the 12-year National Basic Education Curriculum Guidelines in 2019. The core purpose of the 12-year national education curriculum is to cultivate people-oriented lifelong learners. Specifically, learning is no longer limited by subject knowledge and skills; instead, it should cultivate student competency to solve problems, conduct inquiries, analyze data, and critically examine findings to solve problems and achieve self-growth (Ministry of Education, 2021). To cultivate student scientific inquiry literacy, this study hosted a 1-day scientific inquiry creative workshop (SICW) in northern, central, and southern Taiwan on October 17 and 18, 2020. The main purposes of this study were to improve student scientific inquiry self-efficacy through the SICW, to determine the differential performance of students with different backgrounds, and to explore the key factors related to student scientific inquiry self-efficacy. Literature Review The PISA 2015 results revealed no significant differences in the scientific self-efficacy of 15-year-old male and female students in Taiwan (Organization for Economic Co-operation and Development, 2015). However, clear gender differences were noted in the choice of higher education academic fields between male and female students (Lin & Tsai, 2018). Accordingly, gender influences student scientific inquiry self-efficacy. In addition, Chang (2013) reported that the uneven distribution of educational resources between the north and the south of Taiwan also exerts a considerable effect on student learning motivation and learning self-efficacy. Therefore, to understand the scientific inquiry self-efficacy of students with different background variables after participating in the SICW, we proposed the following research hypothesis (H1): Significant regional, gender, and motivation differences exist in student scientific inquiry self-efficacy after participating in the SICW. Studies on scientific self-efficacy (Bandura, 1997; Trujillo & Tanner, 2014) have reported that students’ beliefs about their ability to succeed in science activities significantly affect their willingness to engage in science-related activities. In addition, Kupermintz (2002) observed that students’ scientific inquiry self-efficacy was significantly correlated with their interest in science learning and academic performance in middle school, high school, and university. Accordingly, to understand the factors affecting student scientific inquiry self-efficacy after participating in the SICW, we proposed the following research hypothesis (H2): Significant correlations exist between gender, learning motivation, and scientific inquiry self-efficacy variables. In Taiwan, Hong et al. (2020) found that students’ high learning motivation exerted a significant mediating effect on the relationships between learning interest and scientific inquiry self-efficacy. Furthermore, Hong and Lin (2013) indicated that the scientific self-efficacy scores of senior and vocational high school male students were significantly higher than those of female students, especially for male students with a high level of interest in scientific activities. This thus implies that gender would have a mediating effect on student scientific inquiry self-efficacy. Accordingly, we proposed the following hypothesis (H3): Learning motivations and gender have a significant mediating effect on the relationship between science participation and curiosity as a predictor of scientific inquiry ability and scientific performance. Methods The SICW was a 1-day workshop divided into two parts. The first part involved a Scientific Inquiry Ability Training course, and the second part involved a Scientific Inquiry Creative Practice course, consisting of science writing, science video production, and science comics drawing. The SICW was held in northern, central, and southern Taiwan, with a total of 480 senior and vocational high school students participating in it. All participating students completed a structured scientific inquiry self-efficacy questionnaire after the 1-day SICW. Regarding the data analysis process, this study first used multivariate analysis of variance to analyze the effects of region, gender, and learning motivation differences on student scientific inquiry self-efficacy. Subsequently, the Pearson product–moment correlation coefficient and structural equation modeling were used to explore the relationships between the variables related to student scientific inquiry self-efficacy. Results 1. Students with different backgrounds exhibited significant differences in scientific inquiry self-efficacy after participating in the SICW. (1) Students from southern Taiwan presented significantly higher scores on scientific inquiry self-efficacy than did those from central Taiwan. (2) Male students exhibited significantly higher scientific inquiry self-efficacy than did female students. (3) Actively engaged students had higher scientific inquiry self-efficacy than did their passively engaged counterparts. 2. The students’ total scientific inquiry self-efficacy score had a significant and positive correlation with their inquiry ability and scientific performance. 3. The students’ scientific engagement, scientific interest, and curiosity scores had significant predictive power on their inquiry ability and scientific performance. 4. The student gender and learning motivation exerted a mediating effect on their scientific inquiry self-efficacy. Discussion and Suggestions According to the theory proposed by Clark and Mayer (2016), when meaningful learning images are used in the learning process, students’ positive emotions toward learning and learning motivation are improved. The present study observed that combining the Scientific Inquiry Ability Training course with the Scientific Inquiry Creative Practice course in the SICW exerted a significant effect on secondary school students. The SICW also combined multiple strategies, such as cross-disciplinary scientific innovation themes, professional innovative teaching, and multimedia teaching, which could effectively improve learning motivation and scientific inquiry self-efficacy (Park et al., 2014). This study has two essential findings: First, students’ scientific engagement and scientific interest and curiosity can significantly predict their inquiry ability and scientific performance. This study combined scientific inquiry theory with three different creative practice courses (science writing, science video production, and science comics drawing) to cultivate student scientific inquiry self-efficacy in a 1-day workshop (Falk & Dierking, 2010). The study findings demonstrate the educational value of the SICW and reveal the differences and relationships among participants’ scientific inquiry self-efficacy variables. Second, this study verified the mediating effect of gender and learning motivation on students’ inquiry ability and scientific performance. Accordingly, teachers should consider how to integrate the cross-domain STEAM curriculum design with effective teaching methods to eliminate gender differences and help those who have low learning motivation to improve their learning interest; this may influence their inquiry ability and scientific performance. In conclusion, the present study explored the effectiveness of an SICW in promoting senior and vocational high school students’ scientific inquiry self-efficacy. The study findings are expected to stimulate further discussion on informal science education and provide more beneficial empirical evidence to strengthen the development of student scientific inquiry self-efficacy.

本研究目的首先探討實驗組與對照組參與者在食安素養、食安態度與食安自陳行為和使用保健產品行為的現況及差異，並進而分析國中生食安素養現況及藉由實證知情實務（Evidence-Informed Practice, EIP）教學介入提升國中生食安素養之成效。在預試階段選取高雄市某所公立國中九年級467位學生填寫「食安素養情境測驗」、「食安態度量表」與「食安自陳行為量表」，經過信度、效度及鑑別度檢驗修正後成為正式研究工具。接著進行準實驗教學 法，本研究以便利取樣選取第一位作者班級53位學生在健康教育課實施六週EIP教學是為實驗組；對照組選取另一位健康教育老師51位九年級學生實施六週傳統講述教學是為對照組。所有參與學生在EIP教學前、教學後及三個月後填寫三份研究工具，以瞭解國中學生的食安素養、食安態度與食安自陳行為的差異。經由相關性檢驗、獨立樣本t考驗及單因子共變數分析發現多數國中生相信均衡飲食、規律運動與良好的衛生習慣能增加身體的抵抗力；當國中生使用保健食品行為愈高，則食安素養愈差。本研究結果顯示EIP教學能有效提升國中生的食安素養。本研究建議將EIP教學推廣至其他教學現場，並作為國中各校發展食安素養課程、教學與評量及相關研究之參考。 With the continual growth in global trade and the emergence of new food products, food hygiene and safety issues are becoming increasingly complex, with food safety receiving enormous international attention (Ministry of Health and Welfare, 2016). The World Health Organization (WHO) reported that eating unsafe substances can cause more than 200 diseases, including diarrhea and serious illnesses, such as cancer. Therefore, acquiring the necessary food safety literacy to distinguish between food safety and nutrition is a crucial competency to improve personal health. The Literacy Information and Communication System conducted a health literacy workshop in 2011, involving approximately 1,600 national and international public health and medical experts; it recommended establishing a hypothetical relationship between knowledge, attitudes, and behavior to create a new set of measurement methods for food safety literacy (Pleasant et al., 2011). Thus, integrating knowledge, attitude, and behavior is crucial in order to assess “food security literacy” in the 21st century (Frewer et al., 2013; Jevšnik et al., 2008; Rollin et al., 2011; Yeung & Morris, 2001). In recent years, there has been an international emphasis on literacy assessment, such as the Programme International Student Assessment, which was supported by the Organisation for Economic Co-operation and Development in 2013, using contextual-based tests to assess whether students can apply knowledge and analyze and solve problems in everyday life. First, this study aimed to develop effective food safety literacy tests, food security attitude scales, and food safety behavior scales. Second, we explored the effect of Evidence-Informed Practice (EIP) in teaching interventions on junior high school students’ food safety literacy. During our pilot study, we randomly selected 467 ninth-graders from southern Taiwan to respond to research instruments regarding food safety literacy, food security attitudes, and food safety behaviors. We used the content validity index (Lawshe, 1975), item analysis, and KR 20 to examine the tests’ validity, discrimination, reliability, respectively, and applied item response theory to determine a suitable model of the relationship between the tests and participants. We found that all the tests met the index of validity and reliability. Then, we conducted a quasi-experimental study design and selected 104 ninth-graders from a public junior high school in Kaohsiung City through convenience sampling; the school is known for its moral education, encouraging teachers to develop innovative teaching. This study lasted six weeks and included two teachers with similar teaching experiences who implemented different teaching styles. Both teachers had majored in health education and had 17 years of teaching experience. Teacher A was the first author of this article, graduated from the Department of Science and Education of Southern Normal University, taught two classes of students in the experimental group. The teacher B, who graduated from the Department of Health Promotion and Health Education of the Northern Normal University, was familiar with health education theory, and taught two classes of students in the comparison group. To ensure a high response rate, the first investigator informed the students of this study’s purpose and research tools, mentioning that the contents of the questionnaire would be properly preserved and not be used for individual comparison. Students agreed to participate in the study and responded to two scales and a food safety literacy test that took approximately 15-20 minutes, after which they were given a small gift. Four classes participated in this study, two of which comprised the comparison group that received traditional narrative teaching; the teaching content and time were the same for this group. The other two classes in the experimental group received an EIP teaching intervention. The experimental group students (n = 53) participated in a 6-week one period of EIP teaching model; with the same teaching intervention time, the comparison group students (n = 51) received a teacher-centered intervention concerning new trends in dietary consumption; the intervention convened 45 minutes per week for 6 consecutive weeks. The EIP intervention involved students asking questions, thinking, gathering evidence, and making judgments. The teacher in this group questioned students to promote their thinking, enabling them to search for empirical information to support the discussion and interpretation of food security issues, such as false advertising, supplementing them with new scientific findings. Meanwhile, the comparison group was taught about food security issues in a traditional manner, with the teacher presenting and students listening. We conducted descriptive statistics, independent t-tests, and paired sample t-tests to compare the students’ similarities and differences on their food safety literacy tests, food security attitude scales, and food safety behavior scales after the interventions. In addition, we used a one-way analysis of covariance to examine the effects of the EIP intervention. The results revealed that junior high school students’ beliefs concerning maintaining healthy behaviors involved medium and high scores. They believed that a balanced diet, regular exercise, and good hygiene could increase the body’s resistance to disease. More than 80% of the students consumed healthy food, and nearly 40% of these students consumed more than two types of healthy food. Students with a higher belief in the value of maintaining health had a significantly higher score in food safety literacy. However, those students with a frequent intake of healthy food tended to have lower scores on their food safety literacy. This study developed and validated well-structured food safety literacy scales and an effective EIP teaching model that enhanced the experimental group students’ food safety literacy. This empirical evidence provides fresh insight into how to promote junior high school students’ food safety literacy. Our findings have implications for implementing the EIP teaching model and administering effective food safety literacy scales with context-based items in more educational settings.

BackgroundOnchocerciasis ("river blindness") has been targeted for elimination. New treatments that kill or permanently sterilize female worms could accelerate this process. Prior studies have shown that triple drug treatment with ivermectin plus diethylcarbamazine and albendazole (IDA) leads to prolonged clearance of microfilaremia in persons with lymphatic filariasis. We now report results from a randomized clinical trial that compared the tolerability and efficacy of IDA vs. a comparator treatment (ivermectin plus albendazole, IA) in persons with onchocerciasis.Methods and findingsThe study was performed in the Volta region of Ghana. Persons with microfiladermia and palpable subcutaneous nodules were pre-treated with two oral doses of ivermectin (150 μg/kg) separated by at least 6 months prior to treatment with either a single oral dose of ivermectin 150 μg/kg plus albendazole 400 mg (IA), a single oral dose of IDA (IDA1, IA plus diethylcarbamazine (DEC. 6 mg/kg) or three consecutive daily doses of IDA (IDA3). These treatments were tolerated equally well. While adverse events were common (approximately 30% overall), no severe or serious treatment-emergent adverse events were observed. Skin microfilariae were absent or present with very low densities after all three treatments through 18 months, at which time nodules were excised for histological assessment. Nodule histology was evaluated by two independent assessors who were masked regarding participant infection status or treatment assignment. Significantly lower percentages of female worms were alive and fertile in nodules recovered from study participants after IDA1 (40/261, 15.3%) and IDA3 (34/281, 12.1%) than after IA (41/180, 22.8%). This corresponds to a 40% reduction in the percentage of female worms that were alive and fertile after IDA treatments relative to results observed after the IA comparator treatment (P = 0.004). Percentages of female worms that were alive (a secondary outcome of the study) were also lower after IDA treatments (301/574, 52.4%) than after IA (127/198, 64.1%) (P = 0.004). Importantly, some comparisons (including the reduced % of fertile female worms after IDA1 vs IA treatment, which was the primary endpoint for the study) were not statistically significant when results were adjusted for intraclass correlation of worm fertility and viability for worms recovered from individual study participants.ConclusionsResults from this pilot study suggest that IDA was well tolerated after ivermectin pretreatment. They also suggest that IDA was more effective than the comparator treatment IA for killing or sterilizing female O. volvulus worms. No other short-course oral treatment for onchocerciasis has been demonstrated to have macrofilaricidal activity. However, this first study was too small to provide conclusive results. Therefore, additional studies will be needed to confirm these promising findings.Trial registrationThe study is registered at Cinicaltrials.gov under the number NCT04188301.

Abstract Background The recommendation from national documents and reports to promote inquiry-related science activities has not been supported by recent studies, which have found the overall frequency of inquiry activities to be negatively associated with student learning outcomes. This study was inspired by such conflicting reports and aimed to clarify the associations of science-specific, inquiry-related activities and epistemological beliefs with students’ mathematical and scientific literacies. Results A secondary analysis of the database from the Programme for International Student Assessment 2015 of Australia (N 1 = 14,530) and Taiwan (N 2 = 7708) utilizing structural equation modelling revealed that these two countries exhibited similar data patterns. Results suggested that open-inquiry activities (such as debating and planning experiments) had a negative relationship with secondary students’ mathematical and scientific literacies. Structured inquiry learning (such as students explaining their ideas and teacher explaining how an idea can be applied to different phenomena) and epistemological beliefs about science were significant and positive predictors of student mathematical and scientific literacy performance. Conclusions The current study further highlights and provides empirical evidence that the teacher’s role in structured inquiry (especially pertaining to the relevance and applicability of these ideas) appears to be essential to the development of student literacy. Educational implications and recommendations are discussed.

The role of hypoxic tumour cells in resistance to radiotherapy, and in suppression of immune response, continues to endorse tumour hypoxia as a bona fide, yet largely untapped, drug target. Radiotherapy innovations such as stereotactic body radiotherapy herald new opportunities for classical oxygen-mimetic radiosensitisers. Only nimorazole is used clinically as a radiosensitiser, and there is a dearth of new radiosensitisers in development. In this report, we augment previous work to present new nitroimidazole alkylsulfonamides and we document their cytotoxicity and ability to radiosensitise anoxic tumour cells in vitro. We compare radiosensitisation with etanidazole and earlier nitroimidazole sulfonamide analogues and we identify 2-nitroimidazole and 5-nitroimidazole analogues with marked tumour radiosensitisation in ex vivo assays of surviving clonogens and with in vivo tumour growth inhibition.

本研究目的在探討大學運動績優排球選手自我統合之類型，不同背景大學運動績優排球選手的自我統合與幸福感的差異和其關聯。本研究以立意取樣選取136位大學運動績優排球選手為研究對象，填寫「大學運動績優排球選手問卷」，最後再選取兩位幸福感最高分及兩位幸福感最低分的大學運動績優排球選手進行個別訪談。本研究以偏最小平方法中的測量模式分析檢驗研究工具之信度與效度，再以獨立樣本t考驗、卡方考驗、偏最小平方法及內容主題分析進行資料分析。本研究量化資料分析結果顯示，32.3%大學運動績優排球選手歸類為迷失型統合；而大學運動績優男排球選手多歸屬於定向型統合，最多數女選手歸屬於迷失型統合；就讀體育相關學系與一般學系之大學運動績優排球選手自我統合類型並未呈現顯著性差異；定向型統合類型大學運動績優排球選手的人際關係、生活滿意、學業成就及個人成長皆呈現顯著正相關。質性個別訪談結果發現大學運動績優排球選手的「自我滿足」與「人際關係與 互動」能提升其幸福感和形成定向型統合，而課業壓力和挫折感則會降低幸福感和形成迷失型統合。建議招收運動績優選手的大學在規劃課程、教學與活動時，需考慮大學運動績優選手的身心狀況及學習需求，以提升大學運動績優女排球選手及就讀一般學系排球選手的定向 型統合。 This study investigated outstanding college volleyball players’ ego identity and well-being. This study purposively selected 136 outstanding volleyball players as the sample. All participants were asked to respond to the well-structured “Outstanding College Volleyball Players’ Questionnaire” to assess their ego identity and well-being. In addition, two target students with the highest scores in well-being and another two target students with the lowest scores were selected purposively for individual interviews. Exploratory factor analysis, internal consistency reliability test, t test, Chi-squared test, Partial Least Squares (PLS), and theme content analysis were performed. Initial results revealed that 32.3% of outstanding volleyball players were in the “identity diffusion” stage. More male players than female players were identified as being in the “identity achievement” stage. The players in the “identity achievement” stage had positive interpersonal relationships, high life satisfaction and academic achievement, and successful personal growth. The qualitative results indicated that the male players’ high levels of life satisfaction and positive interpersonal relationships improved their well-being and identity achievement. By contrast, the pressure and frustration from academic study might have decreased some players’ well-being and increased their identity diffusion. The current results suggest that college educators should consider the physical and mental health of players who are female or non-physical education majors. We recommend that more attention be given to providing players with approaches of improving their identity achievement.

The present study examined the 2015 Trends in International Mathematics and Science Study “Advanced” data to examine how the educational credentials of maths teachers and other teacher characteristics were related to attitude towards advanced mathematics and perceptions of engaged teaching among 12th-grade students enrolled in advanced mathematics courses in the U.S. As attitudinal outcomes in this study, two measures of attitude towards mathematics were employed – the Students Like Learning Advanced Mathematics scale and the Students Value Advanced Mathematics scale, and one measure of student perception of engaged teaching – the Students’ Views on Engaging Teaching in Advanced Mathematics Lessons. A set of multilevel regression analyses were conducted predicting each of these aforementioned outcomes. No statistically significant effects on the attitudinal outcomes were observed for teacher variables. Positive effects were noted for parental education on students’ valuing of advanced mathematics. A prominent finding was that higher levels of parental education were associated with higher student levels of valuing mathematics, which likely reflects a family/home culture that implicitly or explicitly places high value on science and mathematics. Identifying factors that might facilitate positive attitude is important to increase the likelihood that students will choose, and be retained in, mathematics and STEM education and careers.

本研究旨在發展青少年健康素養量表，再以此量表探討量表之健康知識、健康態度與健康行為的相關及預測因素。首先進行青少年健康素養量表之編製，由 206 位學生的預試及1,005位學生的正式施測，三個分量表之內部一致性信度係數 Cronbach’s α 分別為 .85、.73及 .91，總量表信度為 .90。接著以探索式因素分析及驗證性因素分析研究工具之效度，再以卡方檢定、獨立樣本 t 檢定、單因子變異數分析比較不同背景青少年的健康素養之差異，最後使 用階層迴歸分析釐清青少年健康素養三個層面「健康知識」、「健康態度」及「健康行為」的相關性，並以「健康知識」為調節變項區辨對「健康態度」與「健康行為」的關係。本研究發現青少年隨著年齡及年級增加而健康態度逐漸低落，大學生健康態度分數顯著低於國中學生，而女學生的健康行動分數顯著高於男學生；健康知識與健康態度對於健康行動具有顯著預測力。本研究提供青少年的健康素養現況及其預測因素作為各級學校及相關研究之參考，建議各級學校重視學生的健康素養並研發符合青少年生活情境的課程、教學及相關活動，以提升學生的健康素養，而如何提升女學生的健康知識及男學生的健康行為有待進一步探究與討論。 This study validated instruments for assessing the health awareness and health literacy of adolescents and explored the related and protective factors of adolescents’ health literacy in Taiwan. A total of 1,005 representative adolescents were stratified randomly selected from Kaohsiung City, and they completed two well-structured instruments for measuring their health awareness and health literacy. First, exploratory and confirmatory factor analyses and internal consistency were used to examine the instruments’ validities and reliabilities. Second, chi-square test, independent t-test, and one-way analysis of variance were conducted to compare the health awareness and health literacy levels of adolescents from different backgrounds. Finally, hierarchical regression analysis was employed to identify the relations between health knowledge, attitudes toward health, and healthy behaviors and their predictors. The initial results indicated that adolescents’ means of health attitude decreased with increasing age and improvement in grades. University students’ means of attitude toward health and health literacy were significantly lower than those of junior high school students. Male adolescents’ scores for health awareness and health knowledge were significantly higher than those of their female counterparts. On the other hand, female adolescents’ means of health actions were significantly higher than those of their male counterparts’. Additionally, adolescents’ means of health knowledge and attitudes toward health had significant and adjusted predictive power on their health behaviors. This study demonstrated the importance of developing and implementing situational tests and curricula and activities related to students’ everyday lives to improve their health literacy. Finally, further discussion on methods to improve adolescents’ health actions and female adolescents’ health knowledge is warranted.

本研究目的在探討臺灣公民科技素養、科學興趣和科學參與之交互作用，並以分層隨機抽樣選取年滿18～70 歲公民共計1,831 人為研究樣本，填答信度與效度良好之公民科技素養試題。為瞭解臺灣民眾科技素養及科學興趣狀況，首先以極端組群法將公民的科技素養及科學興趣依據分數高低區分為四類組：「高科技素養、高科學興趣組」、「高科技素養、低科學興趣組」、「低科技素養、高科學興趣組」及「低科技素養、低科學興趣組」。再以百分比同質性檢定比較不同性別、年齡層及學歷在這四組的分布差異，發現「高科技素養、高科學興趣組」男性公民比例顯著高於女性公民、年齡層較輕、具大學畢業以上學歷；而「低科技素養、低科學興趣組」則是女性公民比例顯著高於男性公民、年齡層較高、具中學以下學 歷。接著以單因子變異數分析比較四類組公民在科學參與之差異，發現「高科技素養、高科學興趣組」公民的整體科學參與頻率最高；而「低科技素養、高科學興趣組」公民為「科技議題活動參與」涉入程度最高。這些結果顯示高科學興趣的公民對科學及科技議題的參與較為積極。因此本研究建議，提升未來公民科技素養當務之急宜先培養公民科學興趣，進一步鼓勵其科學參與，養成終身學習的習慣。 This study explored Taiwan citizens’ scientific literacy, interest in, and engagement in learning science. By using the stratified random sampling strategy, 1,831 citizens in the age group of 18-70 years were selected to respond to a questionnaire survey along with a paper-pencil test. For exploring the relationship between Taiwan citizens’ scientific literacy and their interest in science, the participants were divided into four groups on the basis of their scores for scientific literacy and interest in science. According to the essential results, the high scientific literacy and high science interest (HH) group was mainly represented by males, young citizens, and citizens with higher educational degrees. Conversely, the low scientific literacy and low science interest (LL) group was dominated by females, elderly citizens, and citizens with only a secondary school diploma. Among the four groups, citizens in the HH and LH groups exhibited higher frequency of engagement in science activities. Finally, citizens with high science interest tended to be enthusiastic in learning science and technology. This study contributed a novel insight that the interest in learning science plays a critical role in promoting adults’ engagement in learning science. Future studies are recommended for focusing on the citizens in the LH group to investigate how high engagement in learning science influences their scientific literacy.

Hypoxia in tumors results in resistance to both chemotherapy and radiotherapy treatments but affords an environment in which hypoxia-activated prodrugs (HAP) are activated upon bioreduction to release targeted cytotoxins. The benzotriazine 1,4-di-N-oxide (BTO) HAP, tirapazamine (TPZ, 1), has undergone extensive clinical evaluation in combination with radiotherapy to assist in the killing of hypoxic tumor cells. Although compound 1 did not gain approval for clinical use, it has spurred on the development of other BTOs, such as the 3-alkyl analogue, SN30000, 2. There is general agreement that the cytotoxin(s) from BTOs arise from the one-electron reduced form of the compounds. Identifying the cytotoxic radicals, and whether they play a role in the selective killing of hypoxic tumor cells, is important for continued development of the BTO class of anticancer prodrugs. In this study, nitrone spin-traps, combined with electron spin resonance, give evidence for the formation of aryl radicals from compounds 1, 2 and 3-phenyl analogues, compounds 3 and 4, which form carbon C-centered radicals. In addition, high concentrations of DEPMPO (5-(diethoxyphosphoryl)-5-methyl-1-pyrroline N-oxide) spin-trap the •OH radical. The combination of spin-traps with high concentrations of DMSO and methanol also give evidence for the involvement of strongly oxidizing radicals. The failure to spin-trap methyl radicals with PBN (N-tert-butylphenylnitrone) on the bioreduction of compound 2, in the presence of DMSO, implies that free •OH radicals are not released from the protonated radical anions of compound 2. The spin-trapping of •OH radicals by high concentrations of DEPMPO, and the radical species arising from DMSO and methanol give both direct and indirect evidence for the scavenging of •OH radicals that are involved in an intramolecular process. Hypoxia-selective cytotoxicity is not related to the formation of aryl radicals from the BTO compounds as they are associated with high aerobic cytotoxicity.

本研究目的在發展與效化「性別偏見態度量表」和「性騷擾防治概念量表」兩種評估工具，並探討「性騷擾防治旁觀者介入課程」對於降低學生性別偏見及提高性騷擾防治概念的成效。本研究先以立意取樣選取125 位高中生填答預試量表，經信度與效度考驗及項目分析後，發展出29題「性別偏見態度量表」和16 題「性騷擾防治概念量表」，皆具良好的信度與效度。再以便利取樣選取同所高中75位學生，分為實驗組和對照組，兩組學生在教學介入之前後分別填答兩份量表。實驗組進行合計18 小時的性騷擾防治旁觀者介入課程，對照組進行一般性別平等教育課程。在課程實施結束後徵募研究對象同意，個別訪談8 位實驗組學生，以進一步蒐集質性資料。本研究以共變數分析、獨立樣本t 檢驗進行量化分析，以內容主題歸納方法進行質性分析，結果顯示性騷擾防治旁觀者介入課程對於降低高中生性別偏見及提高性騷擾防治概念具有顯著成效，而訪談分析內容顯示本課程能引發研究對象有旁觀者介入五步驟之反應。本研究提出課程設計、教學實施、未來應用於性霸凌或約會暴力防治等建議，期能更深入探討旁觀者介入教育之實施，並建議未來可針對不同變項、研究工具、成功經驗、網路應用等進行研究。 Reports of sexual harassment continue to grow worldwide; therefore, the social and educational reasons for such incidents must be explored. This study proposed a sexual harassment prevention bystander intervention (SHBPI) course, the effects of which were determined using two research instruments: a gender prejudice scale (GPS) and a sexual harassment prevention perception scale (SHPPS). A total of 125 students were purposively recruited from a representative senior high school in Kaohsiung City, Taiwan to determine the reliability and validity of the two instruments. Then, 41 senior high school students from the same school were randomly selected as an experimental group (EG) to join a 6-unit 18-hour SHPBI program, while another 34 students were randomly selected as a comparison group (CG). All participants completed the 29-item GPS and 16-item SHPPS at the beginning and end of the intervention to assess their gender bias and perceptions regarding sexual harassment prevention. In addition, 8 students were selected from the EG to be interviewed following the posttest. The findings indicated that the SHPBI program effectively reduced students’ gender biases and improved their perceptions regarding sexual harassment prevention. The EG students’ total scores on the GPS were significantly lower than their CG counterparts. In addition, EG students’ total means on the SHPPS were significantly higher than their CG counterparts. Interview analysis revealed that the course taught participants about the 5 steps of bystander reaction. Suggestions regarding curriculum design, teaching implementation, and bullying or dating violence prevention are provided, and the implementation of bystander intervention education is discussed. Future research should examine different variables, research tools, experiences, and internet interactions.

本橫斷調查研究目的在探討青少年於自覺健康、身體意象與幸福感的差異性及中介效果。本研究以分層叢集抽樣方式選取高雄市國中、高中及大學一年級共計1,129位學生為研究對象，以三種自編量表蒐集青少年自覺健康、身體意象與幸福感的現況。首先，以探索性及驗證性因素分析及內部一致性信度檢驗量表之信度與效度，再以描述性統計、獨立性t檢定、單因子變異數分析，比較不同背景的青少年在自覺健康、身體意象及幸福感的差異情形，最後，使 用結構方程模式檢驗青少年自覺健康、身體意象、幸福感間相關性與預測力。本研究發現，七年級學生的自覺健康與身體意象總分顯著高於高一及大一學生，男學生自覺健康與身體意象總分顯著高於女學生，而女學生的幸福感顯著高於男學生，青少年的身體意象對於自覺健康及幸福感具有顯著完全中介效果。本研究建議融入健康教育理論與實務於各級學校和各學科領域課程與教學及各類型活動中，以引導青少年樹立正確身體意象觀念及提升幸福感。 This survey investigated the relationships between the health awareness, body image, and well-being of Taiwanese adolescents. The mediation effects of students’ health awareness on the relationship between their body image and well-being were explored. A total of 1,129 adolescents were selected through stratified random sampling from seven junior high schools (seventh-grade students), six senior high schools (tenth-grade students), and five universities in Kaohsiung (freshmen). Three well-structured scales—health awareness, body image, and well-being scales—were conducted to measure adolescents’ health awareness, body image, and well-being. Subsequently, data from the measurements were compared by conducting individual t-tests, one-way analyses of variance, and structural equation modeling. The results revealed that the seventh-grade students possessed significantly higher scores on the health awareness and body image parameters compared with the tenth-grade students and freshmen. The adolescent boys possessed significantly higher total scores on the health awareness and body image parameters compared with the adolescent girls. The well-being total score of the adolescent girls was significantly higher than that of the adolescent boys. In addition, this study provides evidence to support the fact that adolescents’ body image is a mediating factor between health awareness and well-being. This study adds empirical evidence and provides insights into how grade and gender differences can be integrated in planning and implementing effective pedagogical strategies for increasing adolescent’ health awareness, body image, and well-being in Taiwan.

This study applied the Deming Cycle perspective on evaluating pre-service training mechanism for novice school counselors. First, a pilot study and field observations were conducted. Then, seven experts were purposively interviewed (Average relevant working = 20.3 years, SD = 11.1 years), adding up to 715 minutes of interview time. The result found that the current programs rarely conducted assessment and goal-setting, mixed different background participants, lack inspection for training results and curriculum planning, and need to strengthen system cooperation and learning gap. We suggested: (1)”Plan”- emphasize overall thinking and expert team, assess the needs of organizations and individuals, and set training objectives from learners and practitioners; (2)”Do” - establish a dedicated and single contact window, design two-track and blended-learning modules, flexible adjustment of curriculum structure and use case teaching methods; (3) "Check" - Strengthen training program and effectiveness; (4) "Act" - develop a standardized mechanism and create a progressive cycle.

本研究旨在探討大學生畫地圖能力、空間自我效能（方向判斷力、距離估算力、位置記憶力）、地圖素養（使用地圖、估算地圖、畫記地圖）的相關性，以及畫地圖能力對於空間自我效能、地圖素養是否具有中介效果？本研究以便利取樣選取南部某大學182 位學生參與本研究，利用信度與效度良好的「回憶式速寫校園地圖」、「空間自我效能量表」及「地圖素養量表」為研究工具，蒐集大學生畫地圖能力、空間自我效能及地圖素養。本研究以t考驗、相 關分析及階層迴歸分析進行資料分析，主要發現如下：一、男大學生的地圖素養顯著優於女大學生；二、大學生空間自我效能、畫地圖能力與地圖素養具有顯著正相關；三、大學生畫地圖能力在方向判斷力影響使用地圖上具有部分的中介效果。最後，針對上述評量結果提出對於提升大學生的畫地圖能力、空間自我效能及地圖素養相關議題，進行討論與建議。 This study investigated the relationships among Taiwanese college students’ map-drawing ability, spatial self-efficacy (direction judgment, distance estimation, and location memory), and map literacy (using maps, estimating maps, drawing maps). The mediated effects of students’ map-drawing ability on the relationship between their spatial self-efficacy and map literacy were explored. A total of 182 undergraduates were selected from a university in Kaohsiung City through convenient sampling. Campus sketch maps as well as the spatial self-efficacy scale (SSES) and map literacy scale (MLS) were employed to measure college students’ map-drawing ability, spatial self-efficacy, and map literacy. These skills were then compared and contrasted through factor analyses, t tests, correlation analyses, hierarchical regression, and theme content analyses. The results revealed that male college students possessed significantly higher map literacy than their female counterparts did. The students’ spatial self-efficacy, map-drawing ability, and map literacy were significantly and positively related. In addition, this study provides evidence to support that map-drawing ability partially mediates between direction judgment and map use. The implications of the findings and recommendations for future research are discussed.

Intra-tumor heterogeneity represents a major barrier to anti-cancer therapies. One strategy to minimize this limitation relies on bystander effects via diffusion of cytotoxins from targeted cells. Hypoxia-activated prodrugs (HAPs) have the potential to exploit hypoxia in this way, but robust methods for measuring bystander effects are lacking. The objective of this study is to develop experimental models (monolayer, multilayer, and multicellular spheroid co-cultures) comprising ‘activator’ cells with high expression of prodrug-activating reductases and reductase-deficient ‘target’ cells, and to couple these with agent-based models (ABMs) that describe diffusion and reaction of prodrugs and their active metabolites, and killing probability for each cell. HCT116 cells were engineered as activators by overexpressing P450 oxidoreductase (POR) and as targets by knockout of POR, with fluorescent protein and antibiotic resistance markers to enable their quantitation in co-cultures. We investigated two HAPs with very different pharmacology: SN30000 is metabolized to DNA-breaking free radicals under hypoxia, while the dinitrobenzamide PR104A generates DNA-crosslinking nitrogen mustard metabolites. In anoxic spheroid co-cultures, increasing the proportion of activator cells decreased killing of both activators and targets by SN30000. An ABM parameterized by measuring SN30000 cytotoxicity in monolayers and diffusion-reaction in multilayers accurately predicted SN30000 activity in spheroids, demonstrating the lack of bystander effects and that rapid metabolic consumption of SN30000 inhibited prodrug penetration. In contrast, killing of targets by PR104A in anoxic spheroids was markedly increased by activators, demonstrating that a bystander effect more than compensates any penetration limitation. However, the ABM based on the well-studied hydroxylamine and amine metabolites of PR104A did not fit the cell survival data, indicating a need to reassess its cellular pharmacology. Characterization of extracellular metabolites of PR104A in anoxic cultures identified more stable, lipophilic, activated dichloro mustards with greater tissue diffusion distances. Including these metabolites explicitly in the ABM provided a good description of activator and target cell killing by PR104A in spheroids. This study represents the most direct demonstration of a hypoxic bystander effect for PR104A to date, and demonstrates the power of combining mathematical modeling of pharmacokinetics/pharmacodynamics with multicellular culture models to dissect bystander effects of targeted drug carriers.