真学习还是假参与?——Presentation在高校课堂教学应用中的问题与改进

Presentation是目前国内高校教学改革中常用的教学形式之一,在各类学科教学中均有不同程度的应用。这种以增强教学双主体互动为主要特征的教学形式,在实际教学中呈现出学生课堂参与深度不足、学习收获不系统、课堂汇报“一言堂”等问题。学生学习是为了完成任务而非获得知识、学生习惯于服从教师权威而非批判性思考、教师教学准备不足与指导环节缺失,以及教学评价的评价主体与形式单一是造成Presenta-tion应用效果不佳的重要因素。提高Presentation的应用效果,需要强化对教学过程的管理,保障Presentation规范实施;改革学业评价方式,促进学生主动思考与合作学习;拓展教学资源供给,为学生自主与合作学习提供更多支持;鼓励教师开展教学行动研究,不断提高教学专业化水平。

Chlorfenapyr poisoning:mechanisms,clinical presentations,and treatment strategies

BACKGROUND:Chlorfenapyr is used to kill insects that are resistant to organophosphorus insecticides.Chlorfenapyr poisoning has a high mortality rate and is difficult to treat.This article aims to review the mechanisms,clinical presentations,and treatment strategies for chlorfenapyr poisoning.DATA RESOURCES:We conducted a review of the literature using PubMed,Web of Science,and SpringerLink from their beginnings to the end of October 2023.The inclusion criteria were systematic reviews,clinical guidelines,retrospective studies,and case reports on chlorfenapyr poisoning that focused on its mechanisms,clinical presentations,and treatment strategies.The references in the included studies were also examined to identify additional sources.RESULTS:We included 57 studies in this review.Chlorfenapyr can be degraded into tralopyril,which is more toxic and reduces energy production by inhibiting the conversion of adenosine diphosphate to adenosine triphosphate.High fever and altered mental status are characteristic clinical presentations of chlorfenapyr poisoning.Once it occurs,respiratory failure occurs immediately,ultimately leading to cardiac arrest and death.Chlorfenapyr poisoning is diflcult to treat,and there is no specific antidote.CONCLUSION:Chlorfenapyr is a new pyrrole pesticide.Although it has been identified as a moderately toxic pesticide by the World Health Organization(WHO),the mortality rate of poisoned patients is extremely high.There is no specific antidote for chlorfenapyr poisoning.Therefore,based on the literature review,future efforts to explore rapid and effective detoxification methods,reconstitute intracellular oxidative phosphorylation couplings,identify early biomarkers of chlorfenapyr poisoning,and block the conversion of chlorfenapyr to tralopyril may be helpful for emergency physicians in the diagnosis and treatment of this disease.

Recent Advances for Global Perspectives on Etiology, Pathophysiology, Clinical Presentations, and Management of Moyamoya Disease

Moyamoya disease (MMD) is a condition characterized by the gradual narrowing and blockage of blood vessels in the brain, specifically those in the circle of Willis and the arteries that supply it. This results in reduced blood flow and oxygen to the brain, leading to progressive symptoms and potential complications. The underlying pathophysiological mechanism remains elucidated. However, recent studies have highlighted numerous etiologic factors: abnormal immune complex responses, susceptibility genes, branched-chain amino acids, antibodies, heritable diseases, and acquired diseases, which may be the great potential triggers for the development of moyamoya disease. Its clinical presentation has varying degrees from transient asymptomatic events to significant neurological deficits. Moyamoya disease (MMD) shows different patterns in children and adults. Children with MMD are more susceptible to ischemic events due to decreased blood flow to the brain. Conversely, adults with MMD are more prone to hemorrhagic events involving brain bleeding. Children with MMD may experience a range of symptoms including motor impairments, sensory issues, seizures, headaches, dizziness, cognitive delays, or ongoing neurological problems. Although adults may present with similar clinical symptoms as children, they are more prone to experiencing sudden onset intraventricular, subarachnoid, or intracerebral hemorrhages. One of the challenges in moyamoya disease is the potential for misdiagnosis or delayed diagnosis, particularly when physicians fail to consider MMD as a possible cause in stroke patients. This review aims to provide a comprehensive overview of recent global studies on the pathophysiology of MMD, along with advancements in its management. Additionally, the review will delve into various surgical treatment options for MMD, as well as its rare occurrence alongside atrioventricular malformations. Exciting prospects include the use of autologous bone marrow transplant and the potential role of Connexin 43 protein treatment in the development of moyamoya disease.

基于Present算法的无线网络通信数据安全加密方法

为降低无线网络通信中数据传输节点的损失系数,引进Present算法,设计一种针对无线网络通信数据的安全加密方法。将贝叶斯定理作为参照,计算得到无线网络通信中数据处于安全状态的概率,推断得到数据通信的安全等级,实现对无线网络通信数据类别的划分;引进Present算法,生成无线网络通信数据轮密钥;根据窗口分割的结果,提取通信网络敏感数据,设定无线网络通信数据的时间序列,实现对无线网络通信数据中敏感数据的主动安全加密。实验结果表明:所提方法应用效果较好,可以将加密后节点损失系数控制在一个相对较低的水平,通过此种方式,降低节点在通信与传输信息时的损失。

PRESENT轻量级密码的中间相遇统计故障分析

PRESENT算法是于2007年在国际密码硬件与嵌入式系统会议提出的一种轻量级分组密码,2012年成为国际轻量级算法标准ISO/IEC-29192-2,适用于物联网中射频识别标签、网络传感器、智能卡等设备的数据保护.本文结合PRESENT密码的设计结构和实现特点,基于统计分析和中间相遇分析策略,提出了一种中间相遇统计故障分析方法,设计了皮尔逊相关系数-汉明重量、库尔贝克莱布勒散度-汉明重量区分器和杰卡德相似系数-汉明重量-极大似然估计等区分器,可以分别破译PRESENT密码全部版本的80比特和128比特原始密钥.该方法攻击轮数更深,故障数和耗时更少,有效地扩展了攻击范围,提升了攻击能力.结果表明,中间相遇统计故障分析对PRESENT密码构成了严重威胁.该研究为轻量级密码的实现安全研究提供了有价值的参考.

基于Present算法的通信网络自主防御数据安全加密方法

由于传统的通信网络数据加密方法受到攻击时节点损失系数较大,无法保证加密后的数据安全性,文章提出一种基于Present算法的通信网络自主防御数据安全加密方法。提取通信网络自主防御敏感数据,利用混沌条件量生成Present算法的轮密钥,实现敏感数据的加密。实验结果表明:经过此方法加密后的通信网络自主防御数据,受到攻击时节点损失系数仅有0.06,具有较好的加密性能。

A Flexible Architecture for Cryptographic Applications: ECC and PRESENT

This work presents a flexible/unified hardware architecture of Elliptic-curve Cryptography(ECC)and PRESENT for cryptographic applications.The features of the proposed work are(i)computation of only the point multiplication operation of ECC over GF(2163)for a 163-bit key generation,(ii)execution of only the variant of an 80-bit PRESENT block cipher for data encryption&decryption and(iii)execution of point multiplication operation(ECC algorithm)along with the data encryption and decryption(PRESENT algorithm).To establish an area overhead for the flexible design,dedicated hardware architectures of ECC and PRESENT are implemented in the first step,and a sum of their hardware area is computed.Then,the implementation of the proposed flexible architecture for ECC and PRESENT algorithms is presented.Implementation results regarding the area,clock cycles,latency,clock frequency,and power after the place-and-route level on Xilinx Virtex-5,Virtex-6,and Virtex-7 FPGA devices are presented.Hence,the implementation results and comparisons show that the proposed architecture suits applications demanding flexible implementation of cryptographic applications.

Clinical Presentation, Management and Materno-Fetal Outcome of Patients with HELLP Syndrome at the Yaoundé Gyneco-Obstetrics and Pediatric Hospital

Background: HELLP (Hemolysis, Elevated Liver enzymes and Low Platelets) syndrome is a common complication of severe preeclampsia, with a high maternal and perinatal mortality rate. Data on HELLP syndrome is scanty in our setting. We sought to study the clinical presentation, management, and materno-fetal outcome of patients with HELLP syndrome at the Yaoundé Gyneco-Obstetrics and Pediatric Hospital (YGOPH). Methods: This was a cross-sectional, analytical study with a retrospective data collection of patients, diagnosed with HELLP syndrome at the YGOPH between 1st January 2020 and 31st July 2021. Data were analyzed using the software R version 4.0.2. Results are presented as mean ± standard deviation, frequencies and percentages. P values < 0.05 were considered statistically significant. Results: Of 254 cases of severe preeclampsia, 17 developed HELLP syndrome, giving us a frequency of 6.7%. One patient who presented with hepatitis B was excluded. The mean age was 27.19 ± 6.44 years. Most patients (56.3%) had poor follow up during antenatal contacts. The most common symptom was headache (93.8%). Most cases (56.3%) were diagnosed during post-partum, prepartum (25.0%), and per partum (18.8%). Obstetrical management was done by cesarean section (62.5%) and vaginal delivery (37.5%). Post-partum management of HELLP syndrome consisted of antihypertensive medication, anticonvulsants, sedatives, transfusion of blood and blood products, and fluid resuscitation. Of the 50% of patients who presented with acute kidney injury, only 12.5% (1) were referred for dialysis. Over 50% of our study participants presented severe complications after delivery, but 43.8% recovered, while 56.2% finally died. The fetal outcome was: still birth (31.2%), intra-uterine growth restriction/low birth weight (12.5%), term delivery (≥37 weeks) (31.3%), and preterm deliveries (<37 weeks) (68.7%). Three (18.8%) of the neonates delivered alive presented with a poor Apgar score at the 5th minute. Conclusion: Although rare, HELLP syndrome exists in our setting. Proper management in appropriate centers is key to improving maternal and fetal outcomes.

Unusual Presentation of a Large Multi-Septated Cystic Hygroma: A Case Report and Comprehensive Literature Review

Background: Cystic hygromas are primarily found in the cervicofacial, thoracic, and abdominal regions, with limited occurrences in other areas. Despite existing literature on this condition, comprehensive descriptions and MRI findings of cystic hygromas in the extremities are rare. Aim: This case report aims to present a unique instance of a cystic hygroma in the left thigh. The objective is to provide detailed insights into the characteristics of this atypical presentation. Case Presentation: The case involves a 2-year-10 month-old girl with a cystic hygroma in her left thigh. The report includes a comprehensive description of the lesion’s clinical features and diagnostic evaluation, emphasizing the MRI findings to enhance understanding of this rare occurrence. Conclusion: This case report highlights the rarity of cystic hygromas outside the cervicofacial, thoracic, and abdominal regions, explicitly focusing on the occurrence in the left thigh. By presenting detailed insights into the clinical features, MRI findings, histopathological findings, and the surgical approach employed, this report contributes to the existing knowledge on this condition in atypical locations and informs future treatment strategies.

What to do when it is breech? A state-of-the-art review on management of breech presentation

Any non-cephalic presentation in a fetus is regarded as malpresentation.The most common malpresentation,breech,contributes to 3%-5%of term pregnancies and is a leading indication for cesarean delivery.Identification of risk factors and a proper physical examination are beneficial;however,ultrasound is the gold standard for the diagnosis of malpresentations.External cephalic version(ECV)refers to a procedure aimed to convert a non-cephalic presenting fetus to cephalic presentation.This procedure is performed manually through the mother’s abdomen by a trained health care provider,to reduce the likelihood of a cesarean section.Studies have reported a version success rate of above 50%by ECV.The main objective of this review is to present a broad perspective on fetal malpresentation,ECV,and delivery of a breech fetus.The focus is to elaborate all clinical scenarios of breech and to provide an evidence-based clinical approach for them.After discussing breech prevalence,risk factors,diagnosis,and management,an updated review of ECV is presented.Moreover,ECV indications/contraindications,alternatives,clinical techniques on how to perform ECV and breech vaginal delivery,and obstetrical considerations for the delivery of malpresentations are thoroughly discussed.

Late presentation of dural tears:Two case reports and review of literature

BACKGROUND The late presentation of dural tears(LPDT)has a low incidence rate and hidden symptoms and is easily ignored in clinical practice.If the disease is not treated in time,a series of complications may occur,including low intracranial pressure headache,infection,pseudodural cyst formation,and sinus formation.Here,we describe two cases of LPDT.CASE SUMMARY Two patients had sudden fever 1 wk after lumbar surgery.Physical examination showed obvious tenderness in the operation area.The patients were confirmed as having LPDT by lumbar magnetic resonance imaging and surgical exploration.One case was caused by continuous negative pressure suction and malnutrition,and the other was caused by decreased dural ductility and low postoperative nutritional status.The first symptom of both patients was fever,with occasional headache.Both patients underwent secondary surgery to treat the LPDT.Dural defects were observed and dural sealants were used to seal the dural defects,then drainage tubes were retained for drainage.After the operation,the patients were treated with antibiotics and the patients’surgical incisions healed well,without fever or incision tenderness.Both recovered and were discharged 1 wk after the operation.CONCLUSION LPDT is a rare complication of spinal surgery or neurosurgery that has hidden symptoms and can easily be overlooked.Since it may cause a series of complic-ations,LPDT needs to be actively addressed in clinical practice.

An Incidental Finding and Unusual Presentation of Atypical Coccidioidomycosis in a 72-Year-Old Man: A Case Report

This case report presents an unusual and challenging diagnostic scenario involving a 72-year-old man who recently returned from a trip to Maui, Hawaii. While in Maui, the patient presented with a fever and fatigue that resolved spontaneously. However, he had an observable rash on his head and was given a steroid injection to resolve the rash. Later on his trip, the patient experienced a dry, nonproductive cough which resolved with a five-day course of prednisone. While visiting Michigan, the patient began to experience neck pain and visited Troy Beaumont Hospital for further treatment. Meningitis tests were negative. Vancomycin was given due to the detection of gram positive coccidioidomycosis in the culture, but this was later proven to be a contaminant. Coccidiomycosis does not initially have specific symptoms. Despite negative coccidioidomycosis antigen tests, the patient exhibited features more consistent with blastomycosis and cryptococcus, highlighting the complexities of diagnosing fungal infections with atypical presentations. The case emphasizes the importance of considering alternative fungal pathogens native to endemic regions and pursuing comprehensive diagnostic measures to establish an accurate diagnosis. Lastly, the discussion about recommendations for antifungal therapy and preventative measures for individuals at risk of respiratory fungal infections is critically important for the advancement of early detection of fungal infections.

言语刺激强度对健听者听配能的影响——瞳孔测量研究

目的探究言语刺激强度对健听者听配能的影响。方法选取38例健听成人,采用语速x刺激强度的言语理解测试范式,将瞳孔扩张听配能测量和听觉任务完成准确度及反应速度相结合,观察阈上范围内20 dB SPL的强度变化对听配能和任务表现的影响。结果语速对平均瞳孔扩张有显著影响(P<0.001,η_(p)^(2)=0.618),但刺激强度对平均瞳孔扩张无显著影响(P=0.213,η_(p)^(2)=0.040)。增加言语刺激强度能够显著提升任务反应速度(P=0.043,η_(p)^(2)=0.099),在正常语速下,还能够显著提升言语理解准确度(P<0.001,η_(p)^(2)=0.374)。结论健听人群听觉舒适阈范围内将言语声刺激强度增加20 dB SPL能够提高聆听效率,但该效应可能并不是通过改变可听度或唤醒度,从而影响听配能结果,可能是改变听觉处理速度。

我国铁水联运标准化建设现状研究分析及对策建议

铁水联运标准化是助推铁水联运高质量发展的重要技术支撑。为明晰制约铁水联运高质量发展的标准化问题,准确把握铁水联运标准化工作任务,本文在文献调研、实地调研、专家座谈和问卷调研的基础上,全面梳理了我国铁水联运标准化取得的成绩,深入研究了基础设施标准不健全、服务规则不统一、危险货物界定标准不一致、信息交换标准有待完善、标准实施效果不佳等制约铁水联运高质量发展的标准化问题,并从重点标准制修订、标准实施评估、标准宣贯和推广应用等方面提出了对策建议,为加强铁水联运标准化工作提供决策支持。

对分课堂在本科护理专业解剖学教学中的应用效果

目的 探索在解剖学课程中应用对分课堂教学对护理专业本科生临床思维能力的影响。方法 将2020级护理本科生按照班级随机分为试验组(n=60)和对照组(n=60)。试验组采用对分课堂,对照组采用传统讲授法。比较教学后两组的考核成绩和临床思维能力得分。结果 教学后,试验组平时成绩(t=5.150)和期末理论考试成绩(t=7.060)均高于对照组(P<0.05)。教学实施前两组临床思维能力总分和各维度得分差异无统计学意义(P>0.05);教学后,试验组评判思维能力得分(t=4.557)、系统思维能力得分(t=3.667)、循证思维能力得分(t=5.975)及总分(t=6.809)均高于对照组(P<0.05)。结论 护理专业解剖学课程中应用对分课堂教学效果良好,有利于护理专业学生早期临床思维的培养。

数字化赋能学校高质量发展——基于北京市中小学教师的调查

数字化转型已成为学校高质量发展的新动能,然而学界对数字化赋能学校发展的实践进展及存在问题尚缺乏深入研究。为了解当前中小学校数字化赋能的总体水平、主要特征和关键问题,本研究通过文献研究、政策分析、专家咨询和实践调研,从学校管理、教学应用、环境建设、教育评价、教师发展、协同育人六个维度构建数字化赋能学校发展的指标体系并编制量表,对北京市5400余名教师开展调查。研究发现,数字化赋能中小学校发展总体程度较高,但不同维度的赋能程度存在显著差异;不同区域和不同主体的数字化实践存在显著差异。为此,数字化赋能学校发展实践应激发各主体的数字化应用意识、采取差异化区域推进策略、推进新老教师群体分类培训等,以更好地赋能基础教育学校高质量发展。

单木造材优化嵌入传统林分经营优化中的红松人工林精准经营模式

以黑龙江省红松(Pinus koraiensis Siebold et Zuccarini)人工林主要分布区域的标准幼龄林(初植密度2500、3300株/hm~2,地位指数12、14、16 m)为研究对象,利用韦布尔(Weibull)函数预测株数保存率为85%时不同立地指数的红松人工林在10 a时的直径分布;依据红松人工林幼龄标准林分数据,利用人工红松单木-林分基础模型和球果模型构建的林分模拟器对标准林分进行生长模拟,在传统经营优化模式中嵌套单木造材优化,构建单木造材优化嵌入传统林分经营优化中的红松人工林精准经营模式(简称“精准林分经营优化模式”);以木材和球果总净现值最大为目标,对比精准林分经营优化模式、传统林分经营优化模式的差异,分析造材优化对林分经营优化结果、林分经营措施的影响。结果表明:在约束间伐强度和固定下层伐的条件时,与传统经营优化模式相比,精准林分经营优化模式使总经济效益提升6.5%~9.1%。立地条件越好,精准林分经营优化模式对木材净现值增长率、年均木材产量、主伐时林分平均胸径的增量影响越显著,而对年均球果产量、球果净现值增长率的增量影响较小。在同一立地条件时,与传统林分经营优化模式相比,精准林分经营优化模式提升木材净现值增长率对林分初植密度更敏感。

康县香菇产业现状及发展建议

香菇生产是康县农业农村经济重要的优势产业和支柱性产业之一。基于实地调研,分析了康县香菇的产业基础、品牌建设、产业模式、技术特色等方面的优势。针对康县香菇产业发展中存在的主要问题,提出了扶持龙头企业、研发推广新技术新产品、开展地理标志认证、扩大林地规模等发展建议。

喜马拉雅造山带聂拉木地区渐新世深熔作用的厘定

喜马拉雅新生代淡色花岗岩记录了地壳深熔作用和花岗岩侵位的地球化学和构造物理效应。与形成于增厚地壳条件下和伸展背景下的始新世和中新世花岗岩相比,渐新世花岗岩分布比较局限,且源区和形成机制还存在着较大的争议。位于喜马拉雅造山带中部的聂拉木地区,可见32.1Ma的含电气石黑云母的花岗岩、29.8Ma的含黑云母的花岗岩、26.6Ma的含电气石黑云母的伟晶花岗岩侵入到高喜马拉雅岩系上部。这三组渐新世花岗岩具有以下特征:(1)较高的SiO_(2)、Al_(2)O_(3)、K_(2)O和Na_(2)O,A/CNK>1.0;(2)Ba、Nb、Ta、Sr和Ti的负异常;(3)略微富集轻稀土,亏损中稀土和重稀土,高度变化的Eu异常和微弱的负Nd异常;(4)均一的初始Sr-Nd同位素比值,^(87)Sr/^(86)Sr(t)=0.7463~0.7471,ε_(Nd)(t)=-15.0~-14.6。此外,含电气石黑云母的花岗岩和含电气石黑云母的伟晶花岗岩具有较高的Sr和Ba,较低的Rb/Sr比值,其Rb/Sr比值与Ba和Sr含量都无相关性,表明其为富B流体参与高喜马拉雅变沉积岩含水部分熔融作用的产物。而含黑云母的花岗岩具有较低的Sr和Ba,较高的Rb/Sr比值,且其Rb/Sr比值与Ba和Sr含量显示明显的负相关关系,表明其为变沉积岩发生脱水熔融作用的产物。综合喜马拉雅造山带已有的研究成果,得出以下认识:渐新世花岗岩的源区从下地壳基性物质转变为中地壳变泥质岩,展示了源区向上迁移的过程,并经历了一期重要的岩浆热液交代作用;渐新世深熔作用记录了造山带从缩短增厚向伸展垮塌转换阶段深部地壳的响应,从而促使了高喜马拉雅岩系的折返。

基于脑电的快速序列视觉呈现脑-机接口系统研究进展综述

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