《Leaning to do》的启示:把价值观教育与TVET结合起来

这几个模块相关联的核心价值是健康,与自然和谐,达到人的身体、智力、情感、社会和精神的全面发展,实现一种人与人、人与自然环境和谐的状态.要对自身健康负责,对所有形态的生命关爱,成为一个环境的看护者.

Update in lean metabolic dysfunction-associated steatotic liver disease

BACKGROUND A new nomenclature consensus has emerged for liver diseases that were previously known as non-alcoholic fatty liver disease(NAFLD)and metabolic dysfunction-associated fatty liver disease(MAFLD).They are now defined as metabolic dysfunction-associated steatotic liver disease(MASLD),which includes cardiometabolic criteria in adults.This condition,extensively studied in obese or overweight patients,constitutes around 30%of the population,with a steady increase worldwide.Lean patients account for approximately 10%-15%of the MASLD population.However,the pathogenesis is complex and is not well understood.AIM To systematically review the literature on the diagnosis,pathogenesis,characteristics,and prognosis in lean MASLD patients and provide an interpretation of these new criteria.METHODS We conducted a comprehensive database search on PubMed and Google Scholar between January 2012 and September 2023,specifically focusing on lean NAFLD,MAFLD,or MASLD patients.We include original articles with patients aged 18 years or older,with a lean body mass index categorized according to the World Health Organization criteria,using a cutoff of 25 kg/m2 for the general population and 23 kg/m2 for the Asian population.RESULTS We include 85 studies in our analysis.Our findings revealed that,for lean NAFLD patients,the prevalence rate varied widely,ranging from 3.8%to 34.1%.The precise pathogenesis mechanism remained elusive,with associations found in genetic variants,epigenetic modifications,and adaptative metabolic response.Common risk factors included metabolic syndrome,hypertension,and type 2 diabetes mellitus,but their prevalence varied based on the comparison group involving lean patients.Regarding non-invasive tools,Fibrosis-4 index outperformed the NAFLD fibrosis score in lean patients.Lifestyle modifications aided in reducing hepatic steatosis and improving cardiometabolic profiles,with some medications showing efficacy to a lesser extent.However,lean NAFLD patients exhibited a worse prognosis compared to the obese or overweight counterpart.CONCLUSION MASLD is a complex disease comprising epigenetic,genetic,and metabolic factors in its pathogenesis.Results vary across populations,gender,and age.Limited data exists on clinical practice guidelines for lean patients.Future studies employing this new nomenclature can contribute to standardizing and generalizing results among lean patients with steatotic liver disease.

Reproducibility of serial creatinine excretion measurements in peritoneal dialysis

AIMTo test whether muscle mass evaluated by creatinine excretion （EXCr） is maintained in patients with end-stage kidney disease （ESKD） treated by peritoneal dialysis （PD）, we evaluated repeated measurements of EXCr in a PD population.METHODSOne hundred and sixty-six PD patients （94 male, 72 female） receiving the same PD dose for the duration of the study （up to approximately 2.5 years） had repeated determinations of total （in urine plus spent dialysate） 24-h EXCr （EXCr T） to assess the adequacy of PD by creatinine clearance. All 166 patients had two EXCr T determinations, 84 of the 166 patients had three EXCr T determinations and 44 of the 166 patients had four EXCr T measurements. EXCr T values were compared using the paired t test in the patients who had two studies and by repeated measures ANOVA in those who were studied three or four times.RESULTSIn patients who were studied twice, with the first and second EXCr T measurements performed at 9.2 ± 15.2 mo and 17.4 ± 15.8 mo after onset of PD, respectively, EXCr T did not differ between the first and second study. In patients studied three times and whose fnal assessment occurred 24.7 ± 16.3 mo after initiating PD, EXCr T did not differ between the first and second study, but was significantly lower in the third study compared to the frst study. In patients who were studied four times and whose fourth measurement was taken 31.9 ± 16.8 mo after onset of PD, EXCr T did not differ between any of the studies. The average EXCr T value did not change signifcantly, with the exception of the third study in the patients studied thrice. However, repeated determinations of EXCr T in individuals showed substantial variability, with approximately 50% of the repeated determinations being higher or lower than the first determination by 15% or more.CONCLUSIONThe average value of EXCr T remains relatively constantfor up to 2.5 years of follow-up in PD patients who adhereto the same PD schedule. However, repeated individualEXCr T values vary considerably in a large proportion ofthe patients. Further studies are needed to evaluatethe clinical signifcance of varying EXCr T values and thestability of EXCr T beyond 2.5 years of PD follow-up.

Muscle strength deficits are associated with low bone mineral density in young pediatric cancer survivors:The iBoneFIT project

Background Pediatric cancer survivors are at increased risk of muscle weakness and low areal bone mineral density(aBMD).However,the prevalence of muscle strength deficits is not well documented,and the associations of muscle strength with aBMD are unknown in this population.Therefore,this study aimed to investigate the prevalence of upper-and lower-body muscle strength deficits and to examine the associations of upper-and lower-body muscle strength with age-,sex,and race-specific aBMD Z-scores at the total body,total hip,femoral neck,and lumbar spine.Methods This cross-sectional study included 116 pediatric cancer survivors(12.1±3.3 years old,mean±SD;42.2%female).Upper-and lower-body muscle strength were assessed by handgrip and standing long jump test,respectively.Dual‑energy X‑ray absorptiometry was used to measure aBMD(g/cm2).Associations between muscle strength and aBMD were evaluated in multivariable linear regression models.Logistic regression was used to evaluate the contribution of muscle strength(1-decile lower)to the odds of having low aBMD(Z-score≤1.0).All analyses were adjusted for time from treatment completion,radiotherapy exposure,and body mass index.Results More than one-half of survivors were within the 2 lowest deciles for upper-(56.9%)and lower-body muscle strength(60.0%)in comparison to age-and sex-specific reference values.Muscle strength deficits were associated with lower aBMD Z-scores at all sites(B=0.133–0.258,p=0.001–0.032).Each 1-decile lower in upper-body muscle strength was associated with 30%–95%higher odds of having low aBMD Z-scores at all sites.Each 1-decile lower in lower-body muscle strength was associated with 35%–70%higher odds of having low aBMD Z-scores at total body,total hip,and femoral neck.Conclusion Muscle strength deficits are prevalent in young pediatric cancer survivors,and such deficits are associated with lower aBMD Z-scores at all sites.These results suggest that interventions designed to improve muscle strength in this vulnerable population may have the added benefit of improving aBMD.

Heterostructured nickel-cobalt metal alloy and metal oxide nanoparticles as a polysulfide mediator for stable lithium-sulfur full batteries with lean electrolyte

Batteries that utilize low-cost elemental sulfur and light metallic lithium as electrodes have great potential in achieving high energy density.However,building a lithium-sulfur(Li-S)full battery by controlling the electrolyte volume generally produces low practical energy because of the limited electrochemical Li-S redox.Herein,the high energy/high performance of a Li-S full battery with practical sulfur loading and minimum electrolyte volume is reported.A unique hybrid architecture configured with Ni-Co metal alloy(NiCo)and metal oxide(NiCoO_(2))nanoparticles heterogeneously anchored in carbon nanotube-embedded selfstanding carbon matrix is fabricated as a host for sulfur.This work demonstrates the considerable improvement that the hybrid structure's high conductivity and satisfactory porosity promote the transport of electrons and lithium ions in Li-S batteries.Through experimental and theoretical validations,the function of NiCo and NiCoO_(2) nanoparticles as an efficient polysulfide mediator is established.These particles afford polysulfide anchoring and catalytic sites for Li-S redox reaction,thus improving the redox conversion reversibility.Even at high sulfur loading,the nanostructured Ni-Co metal alloy and metal oxide enable to have stable cycling performance under lean electrolyte conditions both in half-cell and full-cell batteries using a graphite anode.

Solution of idle LBO problem for high FAR aero combustor

The paper sheds light on the idle lean blow off(LBO)problem for high fuel air ratio(FAR)com⁃bustor,which is impossible to be addressed with traditional aero combustor design.A significant improvement in aero combustor design is required to resolve the idle LBO issue.The authors detailed a practical and efficient solu⁃tion,which not only solved the idle LBO issue but also defined the aero-thermal design for high-FAR combustor.The design will usher in a new era of aero combustor.

基于E-leaning的体育课程网络化教学改革

E-leaning可以优化教育资源、提高学习效率、降低学习成本,对于体育课程教学而言,其灵活便捷的教学方式能够解决"学训矛盾",方便学生自主学习。学习过程记录方便、教学管理和课程资源及时有效的更新,既方便了教学管理,也为体育远程教育创造了条件。E-leaning借助网络跨越了校园空间的限制,给学习者提供了一个全新的学习环境,促使了学校与学习者之间距离的缩短,让学校教育向更广泛的地区辐射。借助E-leaning进行体育精品课程和网络课程整合,开展体育远程教育有助于现有体育精品课程和网络课程的可持续发展,有利于体育教育资源共享,是未来学校体育教育和终身体育教育的重要途径。

Empirical study on cooperative learning approach to College oral English teaching

As a creative and effective teaching method adopted by many countries, cooperative learning is one of the most widespread and fruitful areas in modern education theory. With the introduction of the concept of cooperative learning among College oral English teaching, students could undergo all-round training in English proficiency, cooperative ability, self-learning ability and sense of competition. This paper mainly focuses on how to make full use of cooperative leaning in College oral English teaching, and tries to verify that cooperative leaning is a practical and effective teaching mode which could enhance the College oral English classroom teaching quality.

Prevalence,clinical characteristics,risk factors,and indicators for lean Chinese adults with nonalcoholic fatty liver disease

BACKGROUND Nonalcoholic fatty liver disease(NAFLD)is one of the most common chronic diseases in the world.Nowadays,the percentage of non-obese or lean patients with NAFLD is increasing.NAFLD in non-obese populations,especially the lean subgroup with a normal waist circumference(WC),might lead to more problems than obese individuals,as these individuals may not visit clinics for NAFLD diagnosis or ignore the diagnosis of NAFLD.If the precise characteristics of these populations,especially the lean subgroup,are identified,the clinicians would be able to provide more appropriate advice and treatment to these populations.AIM To investigate the prevalence,clinical characteristics,risk factors,and possible indicators for NAFLD in lean Chinese adults with a normal WC.METHODS People without diabetes mellitus or significant alcohol consumption who underwent routine health examinations were included.Their fatty liver index(FLI),abdominal ultrasonography results,and controlled attenuation parameter were all assessed.Genotyping for single-nucleotide polymorphisms associated with NAFLD was performed in another small group consisting of biopsy-proven NAFLD subjects and healthy controls.RESULTS A total of 2715 subjects who underwent routine health examinations were included in the study.Among 810 lean participants with a normal WC,142(17.5%)fulfilled the diagnostic criteria for NAFLD.Waist-height ratio,hemoglobin,platelets,and triglycerides were significant factors associated with the presence of NAFLD in these participants.The appropriate cut-off value of the FLI score in screening for NAFLD in the lean subjects with a normal WC was 25.15,which had a 77.8%sensitivity and 75.9%specificity.There was no significant difference in the single-nucleotide polymorphisms in the SIRT1,APOC3,PNPLA3,AGTR1,and PPARGC1A genes between lean subjects with and without NAFLD(P<0.05).CONCLUSION NAFLD is not uncommon in lean Chinese adults even with a normal WC.Metabolic factors,rather than genetic factors,may play important roles in the development of NAFLD in this population.A lower cut-off value of the FLI score in screening for NAFLD should be used for lean Chinese adults with a normal WC.

New development of powder metallurgy in automotive industry

The driving force for using powder metallurgy(PM)mostly relies on its near net-shape ability and cost-performance ratio.The automotive application is a main market of PM industry,requiring parts with competitive mechanical or functional performance in a mass production scale.As the automobile technology transforms from traditional internal combustion engine vehicles to new energy vehicles,PM technology is undergoing significant changes in manufacturing and materials development.This review outlines the challenges and opportunities generated by the changes in the automotive technology for PM.Low-cost,high-performance and light-weight are critical aspects for future PM materials development.Therefore,the studies on PM lean-alloyed steel,aluminum alloys,and titanium alloy materials were reviewed.In addition,PM soft magnetic composite applied to new energy vehicles was discussed.Then new opportunities for advanced processing,such as metal injection molding(MIM)and additive manufacturing(AM),in automotive industry were stated.In general,the change in automotive industry raises sufficient development space for PM.While,emerging technologies require more preeminent PM materials.Iron-based parts are still the main PM products due to their mechanical performance and low cost.MIM will occupy the growing market of highly flexible and complex parts.AM opens a door for fast prototyping,great flexibility and customizing at low cost,driving weight and assembling reduction.

Thoughts and Exploration on Transformation and Upgrading of Tobacco Production Promoted by Lean Management

Tobacco-producing field should carry out research oriented by fined technology,fluent work procedure and satisfied effect,reinforce lean management promotion,optimize allocation of tobacco production technologies,employees and resources,and improve science and technology research and development in a premise of improving tobacco quality,stable tobacco texture,and increasing tobacco production profit,in order to highlight service function of cooperatives and advance sustainable development.

An integrated approach to improve the performance of lean–electrolyte lithium–sulfur batteries

While the sulfur conversion reaction kinetics in Li–S batteries is nowadays improved by the use of appropriate electrocatalysts,it remains a challenge for the batteries to perform well under the lean electrolyte condition where polysulfide shuttle,electrode passivation and the loss of electrolyte due to side reactions,are aggravated.These challenges are addressed in this study by the tandem use of a polysulfide conversion catalyst and a redox–targeting mediator in a gel sulfur cathode.Specifically,the gel cathode reduces the polysulfide mobility and hence the polysulfide shuttle and the passivation of the lithium anode by the crossover polysulfides.The redox mediator restrains the deposition of inactive sulfur species in the cathode thereby enabling the Fe–N and Co–N co–doped carbon catalyst to prolong its catalytic activity.Consequently,the integrated catalytic system is able to increase the discharge capacity of high–loading (6.8 mg cm^(-2)) lean–electrolyte (4.0μL mg^(-1)) Li–S batteries from~630 to~1316 m Ah g^(-1),concurrently with an improvement of the cycle life (600 cycles with 46%capacity retention at 1.0 m A cm^(-2)).Redox mediator assisted catalysis in a gel cathode is therefore an effective strategy to extend the application of the sulfur conversion catalyst in lean electrolyte Li–S batteries.

DSNNs:learning transfer from deep neural networks to spiking neural networks

Deep neural networks(DNNs)have drawn great attention as they perform the state-of-the-art results on many tasks.Compared to DNNs,spiking neural networks(SNNs),which are considered as the new generation of neural networks,fail to achieve comparable performance especially on tasks with large problem sizes.Many previous work tried to close the gap between DNNs and SNNs but used small networks on simple tasks.This work proposes a simple but effective way to construct deep spiking neural networks(DSNNs)by transferring the learned ability of DNNs to SNNs.DSNNs achieve comparable accuracy on large networks and complex datasets.

Dendrite-free lithium anode achieved under lean-electrolyte condition through the modification of separators with F-functionalized Ti_(3)C_(2)nanosheets

An unstable solid electrolyte interphase(SEI)and chaotic lithium ion fux are key impediments to commercial high-energy-density lithium batteries because of the uncontrolled growth of rigid lithium dendrites,which would pierce through the conventional polypropylene(PP)separator,causing short circuit and safety issues.Herein,the homogenization of lithium ion fux and the generation of stable SEI layers on lithium anodes were achieved via coating a fuorine-functionalized Ti_(3)C_(2)(F-Ti_(3)C_(2))nanosheets on PP separator(F-Ti_(3)C_(2)@PP).F-Ti_(3)C_(2)nanosheets provide abundant ions pathways to homogeneously manipulate lithium ion fux and increase the Young’s modulus and electrolyte wettability of the separators.In addition,F species derived from the F-Ti_(3)C_(2)nanosheets would promote the formation of Li F-rich SEI film.The synergistic effect contribute to the uniform lithium deposition.Symmetric Li|Li,asymmetric Li|Cu and full Li|Li Fe PO4cells incorporated with the modified separators exhibit improved electrochemical performance even under lean electrolyte conditions.This work provides a feasible strategy to improve the performance of lithium batteries through both fuoridized SEI formation and lithium ion fux manipulation.

The “Static” and “Dynamic” Design Verification Stages of the Lean Development Process: Automotive Industry

he design verification steps that take place in today’s automotive industry, which constitute the values of each successive or simultaneous phase in the new product development process, create a complex structure with the inclusion of each new technology and discipline. Therefore, step by step, each design verification phase definition in the flow contains important phase transition measurements or approval tolerances that ensure the simplicity and continuity of vehicle development processes. In addition, classification of design verification stages within the framework of this study or evaluation in two classes (static and dynamic) is a new approach, but it is a synthesis with the analysis of the new product development process. The vehicle’s basic structure, which constitutes the ergonomic and functional requirements of the vehicle in a static environment, takes into account the dynamic environment variables with crash or accident tests. Increasing new technology adaptations in the automotive industry have changed the new product development process that performs this function structurally and created the concept of design verification under consecutive or simultaneous process simplicity. From the autonomous driving to the use of alternative energy, possible accident scenarios and design verification phase transitions in the integration of parts and systems of the newly developed vehicle create a new structure that models and directs the lean product development process especially in the automotive industry in the coming days. In the lean product development process that takes place in the automotive industry, the design verification transition steps or the approval-control analysis of the development stages, which form a new and effective approach, are re-modeling the entire flow. Therefore, successful execution of design verification steps used in the control of new interdisciplinary product development phase transitions provides value creation.?Within the scope of this study, the effectiveness of the static and dynamic design verification steps, which are carried out in 5 global automotive companies included in the research, which constitute the stage transitions of the new product development process, has been measured. Apart from the design verification transition stages, the process variables that differ among the automotive companies involved in the research are excluded from the scope of this study. In other words, in field researches in the automotive industry, new vehicle design steps or basic engineering steps in the new product development process steps, while creating independent fixed variables, interdisciplinary collaborations, static and dynamic design verification transition stages they perform, or their sequence in the basic flow, is accepted as a dependent variable. Therefore, in the study, the positive effect of the automotive companies that included the static and dynamic design verification phase transition approvals in the lean product development process was investigated. Under the comparative analysis structure of the research, the effect of automotive companies, which accept international vehicle specifications as static design verification input, on market performance has been examined in depth. The detailed depth in the comparison analysis conducted under the second field studies of the study is due to the prediction of dynamic design verification stages to provide a high impact on the market performance, according to the static verification analysis. The new product development stages of the dependent variables were fixed and the flow-oriented?“effect”?of the independent variables in the basic process influenced by the design verification activities was analyzed under the new automotive industry company comparisons. In addition, the impact of the automotive design activities that make up the comparison analysis of the research on the scope of the lean product development stage and its effect on the basic process flow has been demonstrated competition-oriented. Therefore, sub-variables, options, criteria, results, which form a defined comparison problem, create basic test values that affect the problem.

Lean Product Development Process with Design Verification Stages in the Value Stream of Automotive Industry

In the automotive industry, lean projects and innovation creation come to life by being updated under the control of systematic interdisciplinary process flows. The lean product development process that changes the shell, defined under the light of the variables created by the competitive conditions, is today measured by the value flow efficiency and the global market spread of the final product. Consequently, the lean product development approach, which aims to identify and purify all the wastes that do none value or create value to the system or cause burdens in the new product development process, is shaped by step-by-step approvals in the flow. In the main automotive industry company practices within the scope of the research (3 national, 3 international), the beginning of the concept of lean in design is to define and optimize the steps in the product development process under the value stream map. Therefore, the product function for which the customer has paid for, the function of the new product or the physical structure used to meet the needs in question, the comfort, life, experience, innovations of the scope that constitute the new product concept are planned and verified and implemented in the simplified automotive design stages at the beginning of the lean product development process. In this research, initial automotive design objectives and stages are at the focal point of the innovation and added value creation brought by the concept of “lean” approach. The research is modelled on the determination of steps that do not create added value together with the points where the flow circuits’ or stems, the process is devalued, the interdisciplinary holistic studies intensify, the information and delay begin and end in the sequential and simultaneous design validation step transition stages, which are examined under the lean approach. As a visual and virtual tool that enables the elaboration of nominal values such as the total duration of the design verification stages and the influence of interdisciplinary stakeholders or the test level of the product design with the new product added, it reveals the value flow or losses. Hence research;from innovation creation and new product design steps, which constitute the initial stages of the lean product development process, to design verification analysis, the efficiency of the automotive company processes within the scope of the research has been measured by comparing using lean automotive design techniques, methods and concepts.

Update on nutritional status,body composition and growth in paediatric inflammatory bowel disease

Growth and nutritional status are important issues in paediatric inflammatory bowel disease(IBD).While linear growth is easy to assess,nutritional status is more complicated,with reports often compromised by the use of simple measures,such as weight and the body mass index,to assess nutritional status rather than more appropriate and sophisticated techniques to measure body composition.This review is an update on what is currently known about nutritional status as determined by body composition in paediatric IBD.Further,this review will focus on the impact of biologics on growth in paediatric IBD.Significant lean mass deficits have been reported in children with IBD compared with controls,and there is evidence these deficits persist over time.Furthermore,data imply that gender differences exist in body composition,both at diagnosis and in response to treatment.With respect to growth improvements following treatment with biologics,there are conflicting data.While some studies report enhancement of growth,others do not.The relationship between disease severity,impaired growth and the requirement for biologics needs to be considered when interpreting these data.However,key features associated with improvements in growth appear to be successful clinical response to treatment,patients in early stages of puberty,and the presence of growth failure at the onset of treatment.

How Can Lean Manufacturing Lead the Manufacturing Sector during Health Pandemics Such as COVID 19: A Multi Response Optimization Framework

Lean manufacturing has been used for the last few decades as a process and performance improvement tool.Initially known as Toyota production system(TPS),lean is now used in almost all service and manufacturing sectors to deliver favorable results such as decreased operational cost,increased customer satisfaction,decreased cycle time,and enhanced profits.During the coronavirus disease(COVID 19)pandemic,the manufacturing sector struggled immensely and could not function well even after lockdown was eased in many countries.Many companies found out there are not ready to conform with new regulations made by authorities in many countries.This paper proposes the use of simulation and multi response optimization in addition to other typical lean tools in order to arrive at optimum performance at the end of each project through an established optimization framework.The framework is used in a real case study performed at an aluminum extrusion factory.Lean manufacturing helps organizations to operate with smaller number of resources.It standardizes all processes so that most of the jobs can be done by most of the workers,but this is not enough to create a healthy,sanitized work place.Our framework utilizes the strengths of lean tools and adds pandemic readiness factor to them to ensure improvement in performance and health pandemic readiness.Implementation of the framework in the case company resulted in 50%reduction in labor,$730000 in expected annual cost savings,reduction in inventory levels,improved employee morale and the achievement of pandemic ready status.

Cell Layout Application in Product Recovery： A Lean Proposal to Increase Efficiency in Remanufacturing

The growing demand of organizations for alternative technologies to reduce environmental damage and meet new legislative issues brought greater focus to the activities of product recovery. One way to recover and revalue a product is by remanufacturing, which is defined as the process of recovering a product to its original specifications, promoting the reuse of materials and improving its quality and functionality. However, the context of the remanufacturing industry faces difficulties and is considered unstable and inefficient if compared to manufacturing. In this sense, this paper aims to propose a cell layout based on lean concepts and adapted to the context of remanufacturing, aiming to minimize waste, reduce variability and thereby increase efficiency. The cell layout proposal was based on a literature review and researchers＇ practical experience in the area. This layout can provide the flexibility to handle the variations inherent in the context of remanufacturing, boosting product recovery and related environmental issues.