Over the past two decades, there have been calls to integrate Education for Sustainable Development (ESD) across all subjects in the primary and secondary curricula. However, researchers have argued ...that sustainability and mathematics education remain largely unconnected in actual classrooms. The question of what sustainable mathematics education could look like in the twenty-first century remains unanswered. There is a pressing need to rethink, re-envision mathematics teaching and learning for the twenty-first-century learning priorities.
In this note, we first present a theoretical synthesis of the specialized literature on the learning and teaching of mathematics. We then attempt to contribute to this particular area by challenging the traditional boundaries of the philosophy of mathematics, followed by some thoughts on ESD in mathematics teacher education. In doing so, we seek to call attention to the need for integrating ESD into mathematics education. We hope, through our call in this note, that more researchers will be stimulated to revisit the integration of ESD into mathematics education, and, consequently, to conceptualize how, and where, efforts should be focused to integrate the aspects of ESD with mathematics teaching and learning in schools.
To evaluate the kinetic patterns of benign and malignant breast lesions using contrast-enhanced digital mammogram (CEDM). Women with suspicious breast lesions on mammography or ultrasound were ...enrolled. Single-view mediolateral oblique (MLO) CEDM of an affected breast was acquired at 2, 3, 4, 7, and 10 min after injection of contrast agent. Three readers visually and semi-quantitatively analyzed the enhancement of suspicious lesions. The kinetic pattern of each lesion was classified as persistent, plateau, or washout over two time intervals, 2-4 min and 2-10 min, by comparing the signal intensity at the first time interval with that at the second. There were 73 malignant and 75 benign lesions in 148 patients (mean age: 52 years). Benign and malignant breast lesions showed the highest signal intensity at 3 min and 2 min, respectively. Average areas under receiver operating characteristic (ROC) curve for diagnostic accuracy based on lesion enhancement at different time points were 0.73 at 2 min, 0.72 at 3 min, 0.69 at 4 min, 0.67 at 7 min, and 0.64 at 10 min. Diagnostic performance was significantly better at 2, 3, and 4 min than at 7 and 10 min (all p < 0.05). A washout kinetic pattern was significantly associated with malignant lesions at 2-4 min and 2-10 min frames according to two of the three readers' interpretations (all p less than or equal to 0.001). Applications of optimal time intervals and kinetic patterns show promise in differentiation of benign and malignant breast lesions on CEDM.
Viral- and host-targeted traditional Chinese medicine (TCM) formulae NRICM101 and NRICM102 were administered to hospitalized patients with COVID-19 during the mid-2021 outbreak in Taiwan. We report ...the outcomes by measuring the risks of intubation or admission to intensive care unit (ICU) for patients requiring no oxygen support, and death for those requiring oxygen therapy.
This multicenter retrospective study retrieved data of 840 patients admitted to 9 hospitals between May 1 and July 26, 2021. After propensity score matching, 302 patients (151 received NRICM101 and 151 did not) and 246 patients (123 received NRICM102 and 123 did not) were included in the analysis to assess relative risks.
During the 30-day observation period, no endpoint occurred in the patients receiving NRICM101 plus usual care while 14 (9.27%) in the group receiving only usual care were intubated or admitted to ICU. The numbers of deceased patients were 7 (5.69%) in the group receiving NRICM102 plus usual care and 27 (21.95%) in the usual care group. No patients receiving NRICM101 transitioned to a more severe status; NRICM102 users were 74.07% less likely to die than non-users (relative risk= 25.93%, 95% confidence interval 11.73%-57.29%).
NRICM101 and NRICM102 were significantly associated with a lower risk of intubation/ICU admission or death among patients with mild-to-severe COVID-19. This study provides real-world evidence of adopting broad-spectrum oral therapeutics and shortening the gap between outbreak and effective response. It offers a new vision in our preparation for future pandemics.
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Over the recent decades, much empirical evidence has shown the benefits of problem-based learning (PBL) over traditional teacher-centred pedagogy. However, research on problem-based learning (PBL) ...has focused more on students’ learning outcomes and less on what it might take for teachers to implement it, especially in primary school and in education systems such as Taiwan, where its principles deviate from customary practice. Issues concerning how PBL, which initially derived from the adult medical education field, can be applied to primary education, remain poorly understood. This study examines what was involved for a teacher while she implemented a 1-year PBL intervention in a year 5 (ages 10–11) mathematics classroom in Taiwan. On the basis of the evidence in this paper, we provide a realistic account of the teacher’s pedagogical practice and how she changed, or further developed her pedagogies in order to adapt to PBL. The findings from our study brought important messages for teachers and educators when implementing PBL at primary education level. With a focus on the teacher’s pedagogical changes, implications for primary teachers when implementing PBL are discussed.
Abstract Background: When patients return to the emergency department (ED) shortly after being seen, it is generally assumed that their initial evaluation or treatment was inadequate. Objectives: The ...purpose of this study was to determine the rates and causes of revisits to the ED of a 710-bed secondary teaching referral hospital (Kuang Tien General Hospital), to identify areas for improvement, and to define the initial ED presentations that are associated with such revisits. Methods: The study period was from January 1, 2006 to December 31, 2006. There were 34,714 patients seen and discharged in the ED; 1899 patients returned within 72 h. Monthly revisit rates were calculated. The patients who revisited the ED within 72 h were retrospectively identified by the authors, and their charts were examined to determine the causes of the revisits. Results: There were 1899 patients (5.47% of total) found to have revisited the ED within 72 h after their initial visit. The monthly revisit rates ranged from 2.85% to 6.25% (average, 5.47%). The rates of revisits that were related to factors of illness, patients, and doctors were 80.9%, 10.9%, and 8.2%, respectively. Among the factors related to doctors, 3.7% (70 cases) were misdiagnosis, and abdominal pain was the most common presentation (55.7%, 39/70). The most common initial ED presentations were for abdominal pain (12.9%), fever (12.6%), vertigo (4.5%), headache (2.1), and upper respiratory infection (2.1%). Conclusions: Unplanned ED revisits are associated with medical errors in prognosis, treatment, follow-up care, and information. Differentiation between the natural course of a disease, suboptimal therapy, over-anxious reaction of the patient, and medical errors is difficult. Although this study indicates that most revisits are illness-related, further prospective studies are needed to evaluate the most common and the most serious causes of revisits to see if improvements can be made.
In clinical practice, the Ishak Score system would be adopted to perform the evaluation of the grading and staging of hepatitis according to whether portal areas have fibrous expansion, bridging with ...other portal areas, or bridging with central veins. Based on these staging criteria, it is necessary to identify portal areas and central veins when performing the Ishak Score staging. The bile ducts have variant types and are very difficult to be detected under a single magnification, hence pathologists must observe bile ducts at different magnifications to obtain sufficient information. This pathologic examinations in routine clinical practice, however, would result in the labor intensive and expensive examination process. Therefore, the automatic quantitative analysis for pathologic examinations has had an increased demand and attracted significant attention recently. A multi-scale inputs of attention convolutional network is proposed in this study to simulate pathologists' examination procedure for observing bile ducts under different magnifications in liver biopsy. The proposed multi-scale attention network integrates cell-level information and adjacent structural feature information for bile duct segmentation. In addition, the attention mechanism of proposed model enables the network to focus the segmentation task on the input of high magnification, reducing the influence from low magnification input, but still helps to provide wider field of surrounding information. In comparison with existing models, including FCN, U-Net, SegNet, DeepLabv3 and DeepLabv3-plus, the experimental results demonstrated that the proposed model improved the segmentation performance on Masson bile duct segmentation task with 72.5% IOU and 84.1% F1-score.
The detection of the most common type of liver tumor, that is, hepatocellular carcinoma (HCC), is one essential step to liver pathology image analysis. In liver tissue, common cell change phenomena ...such as apoptosis, necrosis, and steatosis are similar in tumor and benign tissue. Hence, the detection of HCC may fail when the patches covered only limited tissue region without enough neighboring cell structure information. To address this problem, a Feature Aligned Multi-Scale Convolutional Network (FA-MSCN) architecture is proposed in this paper for automatic liver tumor detection based on whole slide images (WSI). The proposed network integrates the features obtained at different magnification levels to improve the detection performance by referencing more neighboring information. The FA-MSCN consists of two parallel convolutional networks in which one would extract high-resolution features and the other would extract low-resolution features by atrous convolution. The low-resolution features then go through central cropping, upsampling, and concatenation with high-resolution features for final classification. The experimental results demonstrated that Multi-Scale Convolutional Network (MSCN) improves the detection performance compared to Single-Scale Convolutional Network (SSCN), and that the FA-MSCN is superior to both SSCN and MSCN, demonstrating on HCC detection.
•A Feature Aligned Multi-Scale Convolutional Network (FA-MSCN) for liver tumor detection on whole slide images is proposed.•Two parallel convolutional networks in FA-MSCN would extract high-resolution and low-resolution features, respectively.•Experiments demonstrated that the proposed FA-MSCN improves the HCC detection performance compared to both SSCN and MSCN.