Dreyfus scale-based feedback increased medical students’ satisfaction with the complex cluster part of a interviewing and physical examination course and improved skills readiness in Taiwan

Shiau-Shian Huang,Chia-Chang Huang,Ying-Ying Yang,Shuu-Jiun Wang,Boaz Shulruf,Chen-Huan Chen 한국보건의료인국가시험원 2019 보건의료교육평가 Vol.16 No.-

PurposeIn contrast to the core part of the clinical interviewing and physical examination (PE) skills course, corresponding to the basic, head-to-toe, and thoracic systems, learners need structured feedback in the cluster part of the course, which includes the gastrointestinal, neuromuscular, and musculoskeletal systems. This study evaluated the effects of using Dreyfus scale-based feedback, which has elements of continuous professional development, instead of Likert scale-based feedback in the cluster part of training in Taiwan. MethodsInstructors and final-year medical students in the 2015-2016 classes of National Yang-Ming University, Taiwan comprised the regular cohort, whereas those in the 2017-2018 classes formed the intervention cohort. In the intervention cohort, Dreyfus scale-based feedback, rather than Likert scale-based feedback, was used in the cluster part of the course. ResultsIn the cluster part of the course in the regular cohort, pre-trained standardized patients rated the class climate as poor, and students expressed low satisfaction with the instructors and course and low self-assessed readiness. In comparison with the regular cohort, improved end-of-course group objective structured clinical examination scores after the cluster part were noted in the intervention cohort. In other words, the implementation of Dreyfus scale-based feedback in the intervention cohort for the cluster part improved the deficit in this section of the course. ConclusionThe implementation of Dreyfus scale-based feedback helped instructors to create a good class climate in the cluster part of the clinical interviewing and PE skills course. Simultaneously, this new intervention achieved the goal of promoting medical students’ readiness for interviewing, PE, and self-directed learning.

Breviscapine Ameliorates Fear Extinction and Anxiety in BALB/cJ Mice

Wei Liang(Wei Liang),Jing Huang(Jing Huang),Shuya Yang(Shuya Yang),Peng Huang(Peng Huang),Jun Chen(Jun Chen),Chen Chen(Chen Chen),Qun Yang(Qun Yang),Fengzhan Li(Fengzhan Li) 대한신경정신의학회 2023 PSYCHIATRY INVESTIGATION Vol.20 No.3

Objective In this research, the influence of breviscapine on anxiety, fear elimination, and aggression and the potential mechanism was investigated. Methods Anxiety and locomotion were analyzed by elevated plus maze and open field test in mice. Bussey-Saksida Mouse Touch Screen Chambers were used to perform fear conditioning. Territorial aggression was assessed by resident intruder test. Protein levels were evaluated by Western blot. Breviscapine improved fear-extinction learning in BALB/cJ mice. Results Breviscapine at 20-100 mg/kg increased center cross number, total distance traveled, and velocity in a dose-dependent manner. On the other hand, breviscapine at 20-100 mg/kg decreased the immobility time in open field test. In addition, breviscapine at 20-100 mg/kg increased the ratio of time on the open arm, time on the distal parts of the open arm, and total distance traveled in elevated plus maze. Breviscapine at 100 mg/kg increased the average attack latency and decreased the number of attacks over the last 3 days of resident intruder test. In hippocampus, protein levels of postsynaptic density protein-95 and synaptophysin were elevated by breviscapine at these three doses. Conclusion The administration of breviscapine alleviates fear extinction, anxiety, and aggression, while increases locomotor in a dose-dependent manner, which might be associated with its influence on synaptic function.

Sofosbuvir/velpatasvir plus ribavirin for Child-Pugh B and Child-Pugh C hepatitis C virus-related cirrhosis

( Chen-hua Liu ),( Chi-yi Chen ),( Wei-wen Su ),( Chun-jen Liu ),( Ching-chu Lo ),( Ke-jhang Huang ),( Jyh-jou Chen ),( Kuo-chih Tseng ),( Chi-yang Chang ),( Cheng-yuan Peng ),( Yu-lueng Shih ),( Chia 대한간학회 2021 Clinical and Molecular Hepatology(대한간학회지) Vol.27 No.4

Background/Aims: Real-world studies assessing the effectiveness and safety of sofosbuvir/velpatasvir (SOF/VEL) plus ribavirin (RBV) for Child-Pugh B/C hepatitis C virus (HCV)-related cirrhosis are limited. Methods: We included 107 patients with Child-Pugh B/C HCV-related cirrhosis receiving SOF/VEL plus RBV for 12 weeks in Taiwan. The sustained virologic response rates at off-treatment week 12 (SVR₁₂) for the evaluable population (EP), modified EP, and per-protocol population (PP) were assessed. The safety profiles were reported. Results: The SVR₁₂ rates in the EP, modified EP and PP were 89.7% (95% confidence interval [CI], 82.5-94.2%), 94.1% (95% CI, 87.8-97.3%), and 100% (95% CI, 96.2-100%). Number of patients who failed to achieve SVR₁₂ were attributed to virologic failures. The SVR₁₂ rates were comparable regardless of patient characteristics. One patient discontinued treatment because of adverse events (AEs). Twenty-four patients had serious AEs and six died, but none were related to SOF/VEL or RBV. Among the 96 patients achieving SVR₁₂, 84.4% and 64.6% had improved Child-Pugh and model for endstage liver disease (MELD) scores. Multivariate analysis revealed that a baseline MELD score ≥15 was associated with an improved MELD score of ≥3 (odds ratio, 4.13; 95% CI, 1.16-14.71; P=0.02). Patients with chronic kidney disease (CKD) stage 1 had more significant estimated glomerular filtration rate declines than patients with CKD stage 2 (-0.42 mL/min/1.73 ㎡/month; P=0.01) or stage 3 (-0.56 mL/min/1.73 ㎡/month; P<0.001). Conclusions: SOF/VEL plus RBV for 12 weeks is efficacious and well-tolerated for Child-Pugh B/C HCV-related cirrhosis. (Clin Mol Hepatol 2021;27:575-588)

Internal filament modulation in low-dielectric gap design for built-in selector-less resistive switching memory application

Chen, Ying-Chen,Lin, Chih-Yang,Huang, Hui-Chun,Kim, Sungjun,Fowler, Burt,Chang, Yao-Feng,Wu, Xiaohan,Xu, Gaobo,Chang, Ting-Chang,Lee, Jack C IOP 2018 Journal of Physics. D, Applied Physics Vol.51 No.5

<P>Sneak path current is a severe hindrance for the application of high-density resistive random-access memory (RRAM) array designs. In this work, we demonstrate nonlinear (NL) resistive switching characteristics of a HfO<SUB> <I>x</I> </SUB>/SiO<SUB> <I>x</I> </SUB>-based stacking structure as a realization for selector-less RRAM devices. The NL characteristic was obtained and designed by optimizing the internal filament location with a low effective dielectric constant in the HfO<SUB> <I>x</I> </SUB>/SiO<SUB> <I>x</I> </SUB> structure. The stacking HfO<SUB> <I>x</I> </SUB>/SiO<SUB> <I>x</I> </SUB>-based RRAM device as the one-resistor-only memory cell is applicable without needing an additional selector device to solve the sneak path issue with a switching voltage of ~1 V, which is desirable for low-power operating in built-in nonlinearity crossbar array configurations.</P>

Graphite-based selectorless RRAM: improvable intrinsic nonlinearity for array applications

Chen, Ying-Chen,Hu, Szu-Tung,Lin, Chih-Yang,Fowler, Burt,Huang, Hui-Chun,Lin, Chao-Cheng,Kim, Sungjun,Chang, Yao-Feng,Lee, Jack C. The Royal Society of Chemistry 2018 Nanoscale Vol.10 No.33

<P>Selectorless graphite-based resistive random-access memory (RRAM) has been demonstrated by utilizing the intrinsic nonlinear resistive switching (RS) characteristics, without an additional selector or transistor for low-power RRAM array application. The low effective dielectric constant value (<I>k</I>) layer of graphite or graphite oxide is utilized, which is beneficial in suppressing sneak-path currents in the crossbar RRAM array. The tail-bits with low nonlinearity can be manipulated by the positive voltage pulse, which in turn can alleviate variability and reliability issues. Our results provide additional insights for built-in nonlinearity in 1<I>R</I>-only selectorless RRAMs, which are applicable to the low-power memory array, ultrahigh density storage, and in-memory neuromorphic computational configurations.</P>

Male Infertility Increases the Risk of Cardiovascular Diseases: A Nationwide Population-Based Cohort Study in Taiwan

Chen Peng-Ciao,Chen Yu-Ju,Yang Chia-Chen,Lin Ting-Ti,Huang Chien-Chu,Chung Chi-Hsiang,Sun Chien-An,Chien Wu-Chien 대한남성과학회 2022 The World Journal of Men's Health Vol.40 No.3

Purpose: Some evidence suggests that male infertility increases the risk of cardiovascular diseases (CVDs). However, the evidence in Asian populations is relatively scarce. The aim of this study is to determine whether male infertility increases the risk of CVDs. Materials and Methods: We used inpatient and outpatient data for the years 2000 to 2015 from the Taiwanese Longitudinal Health Insurance Database. We enrolled 7,016 males over 18 years old and diagnosed with male infertility. Of these, 2,326 matched our inclusion criteria and were assigned to the study group. For each infertility patient, four comparison patients were frequency-matched by age and index date to form a control cohort comprising 9,304 patients. Cox proportional hazards analysis was used to estimate the association between male infertility and CVDs. Results: After a 15-year follow-up, the incidence rate of CVDs was higher in the infertility group than the control group (1,460.23 and 1,073.70 per 100,000 person-years, respectively). The Cox proportional hazards regression analysis revealed that the adjusted HR for CVDs was 1.472 for the infertility group (95% CI, 1.288–1.683; p<0.001) relative to the control group. The Kaplan–Meier analysis of the cumulative incidence of CVDs in the two groups showed that the cumulative risk curve for CVDs was significantly higher for the infertility group than the control group. Conclusions: This study shows that men with infertility have a higher risk of developing incident CVDs. In the future, healthcare providers should pay attention to these patients because of their higher health risks.

Design Trade Off on Noise Figure and Chip Area in Multi-Stage Low-Noise Amplifier for Ultra-Wideband Wireless Receiver

Zhe-Yang Huang,Che-Cheng Huang,Yeh-Tai Hung,Meng-Ping Chen 대한전자공학회 2008 ITC-CSCC :International Technical Conference on Ci Vol.2008 No.7

A multi-stage low-noise amplifier (LNA) with LC-tank load to extend the bandwidth is designed for ultrawideband (UWB) wireless receiver. The design consists of three LC-tank cascode amplifier and one output buffer and is implemented in 0.18um RF CMOS process. The trade off on noise figure and chip area in low-noise amplifier design is discussed. The two LNA (LC and Res) gives 14.5㏈ gain; 7.2㎓ and 7.0㎓ 3㏈ bandwidth (3.1-10.3㎓ and 3.1-10.1㎓) while consuming 22.8㎽ and 23.8㎽ through a 1.5V supply. Over the 3.1㎓ - 10.3㎓ and 3.1㎓-10.1㎓ frequency band, a minimum noise figure of 2.6㏈ and 6.3㏈ and input return loss lower than -8.8㏈ and - 6.8㏈ have been achieved.

A 0.18um CMOS Current Reused Low-Noise Amplifier with Gain Compensated for Ultra-Wideband Wireless Receiver

Zhe-Yang Huang,Yeh-Tai Hung,Che-Cheng Huang,Meng-Ping Chen 대한전자공학회 2008 ITC-CSCC :International Technical Conference on Ci Vol.2008 No.7

A current reused low-noise amplifier (LNA) with gain compensated to extend the bandwidth and is designed for ultra-wideband (UWB) wireless receiver. The design consists of two cascode common-source amplifier and an output buffer which is implemented in 0.18um RF CMOS process. The LNA gives 13.1㏈ gain; 9.1㎓ 3㏈ bandwidth (3.1-12.2㎓) while consuming 13.9㎽ through a 1.8V supply. Over the 3.1㎓ - 10.6㎓ frequency band, a minimum noise figure of 2.7㏈ and input return loss lower than -8.7㏈ have been achieved.

A Retrospective Study of the Effect of Spinopelvic Parameters on Fatty Infiltration in Paraspinal Muscles in Patients With Lumbar Spondylolisthesis

Jia-Chen Yang,Jia-Yu Chen,Yin Ding,Yong-Jie Yin,Zhi-Ping Huang,Xiu-Hua Wu,Zu-Cheng Huang,Yi-Kai Li,Qing-An Zhu 대한척추신경외과학회 2024 Neurospine Vol.21 No.1

Objective: The effect on fat infiltration (FI) of paraspinal muscles in degenerative lumbar spinal diseases has been demonstrated except for spinopelvic parameters. The present study is to identify the effect of spinopelvic parameters on FI of paraspinal muscle (PSM) and psoas major muscle (PMM) in patients with degenerative lumbar spondylolisthesis. Methods: A single-center, retrospective cross-sectional study of 160 patients with degenerative lumbar spondylolisthesis (DLS) and lumbar stenosis (LSS) who had lateral full-spine x-ray and lumbar spine magnetic resonance imaging was conducted. PSM and PMM FIs were defined as the ratio of fat to its muscle cross-sectional area. The FIs were compared among patients with different pelvic tilt (PT) and pelvic incidence (PI), respectively. Results: The PSM FI correlated significantly with pelvic parameters in DLS patients, but not in LSS patients. The PSM FI in pelvic retroversion (PT > 25°) was 0.54 ± 0.13, which was significantly higher in DLS patients than in normal pelvis (0.41 ± 0.14) and pelvic anteversion (PT < 5°) (0.34 ± 0.12). The PSM FI of DLS patients with large PI ( > 60°) was 0.50 ± 0.13, which was higher than those with small ( < 45°) and normal PI (0.37 ± 0.11 and 0.36 ± 0.13). However, the PSM FI of LSS patients didn’t change significantly with PT or PI. Moreover, the PMM FI was about 0.10–0.15, which was significantly lower than the PSM FI, and changed with PT and PI in a similar way of PSM FI with much less in magnitude. Conclusion: FI of the PSMs increased with greater pelvic retroversion or larger pelvic incidence in DLS patients, but not in LSS patients.

Experimental study on timing and pattern of gas injection in low permeability reservoir

Wei Huang,Shenglai Yang,Meng Chen,Zhipeng Qiu,Can Chen,Hao Chen 한국자원공학회 2014 Geosystem engineering Vol.17 No.3

Experiments were conducted to study the selection of development methods for low permeability reservoir exploitation after water drive, including the effects of different gas injection cycle times and different injection modes on oil displacement efficiency. Results showed that both gas injection cycle time and injection mode have significant effects on oil displacement efficiency. Based on the results of gas injection cycle time of the displacement with mode shifting to gas drive when water cut reaches 50% and 100%, it can be concluded that in the low permeability reservoir, which is exploited by water drive in the early time, the sooner the gas injection, the higher the oil displacement efficiency is. Because high water saturation can cause serious water-blocking effect, leading to a large amount of trapped oil and low displacement efficiency. Further, in view of the results of water drive, gas injection, and water alternating gas (WAG) flooding, it is obvious that WAG flooding is one of the best methods in enhanced oil recovery. Under the effect of gravity differentiation, WAG flooding can spread to the upper reservoir, which cannot be swept by water drive. Thus, the oil recovery factor can be improved effectively. However, it should be noted that gas injectivity should be considered in the field test.