A combined treatment for patients with dry eye and associated laryngopharyngeal reflux:a real-life approach

AIM:To evaluate the efficacy and tolerability of administering a combined therapy in patients with dry eye syndrome(DES)and associated laryngopharyngeal reflux(LPR).METHODS:The study was retrospective,open,observational,and conducted in a real-life setting.Patients had pathological symptom assessment in dry eye(SANDE)and reflux symptom index(RSI)at baseline.Patients were re-assessed after 1mo and at the end of treatment.The treatment consisted of a three-month course based on the combined therapy:Gastroftal eye drops,one drop three times a day,and Gastroftal tablets,two tablets after lunch and two tablets after dinner.Tear break-up-time(TBUT)test,Schirmer test,RSI,and SANDE questionnaire were evaluated.RESULTS:The study included 253 patients.The mean age was 58±11.19y.TBUT test score and Schirmer’s test significantly increased(both P<0.001)after 1mo and at the end of treatment.The RSI score and SANDE scores significantly decreased(both P<0.001)after 1mo and at the end of treatment.CONCLUSION:The current,retrospective,and open study shows that combined therapy using Gastroftal eye drops and tablets could represent a valuable option in managing patients with DES associated with LPR.

Integrated Electrode-Electrolyte Optimization to Manufacture a Real-Life Applicable Aqueous Supercapacitor with Record-Breaking Lifespan

Aqueous supercapacitors(SCs)have been regarded as a promising candidate for commercial energy storage device due to their superior safety,low cost,and environmental benignity.Unfortunately,an age-old challenge of achieving both long electrode lifespan and qualified energy-storage property blocks their practical application.Herein,we develop an electrode-electrolyte integrated optimization strategy to fulfill the real-life device requirements.Electrode optimization simultaneously regulates the nanomorphology and surface chemistry of the tungsten oxide anode,resulting in superior electrochemical performance given by an ideal“bird-nest”structure with optimal oxygen vacancy status;the anodes interact with and are protected from dissolution and structural collapse by the rationally designed hybrid electrolyte with optimized pH and facilitated cation desorption behavior.Collaboratively,a record-breaking durability of no capacitive decay after 250000 cycles is achieved.On the basis of this integrated optimization,the first aqueous pouch SCs with real-life practicability were manufactured by a soft-package encapsulation technique,which can steadily power commercial 3 C products such as tablets and smartphones and maintain safely working against extreme conditions.This work demonstrates the possibility of using aqueous energy storage devices with enhanced safety and lower cost to replace the commercial organic counterparts for wide range of daily applications.

基于能力的高职英语Real-life Skills教学探析

Real-life Skills是一种具有较强实践意义的教学活动,给学生创设了听说读写综合能力实践的情境。从Real-life Skills的教学现状出发,探讨了在教学时应重点考虑解决真实生活的问题、教学过程中教师的角色适时转换、“教法”基于“学法”、注重学生的多元评价等事项。

Predictors of functional benefit of hepatitis C therapy in a‘real-life’cohort

AIM To define predictors of functional benefit of direct-acting antivirals(DAAs) in patients with chronic hepatitis C virus(HCV) infection and liver cirrhosis.METHODS We analysed a cohort of 199 patients with chronic HCV genotype 1, 2, 3 and 4 infection involving previously treated and untreated patients with compensated(76%) and decompensated(24%) liver cirrhosis at two tertiary centres in Germany. Patients were included withtreatment initiation between February 2014 and August 2016. All patients received a combination regimen of one or more DAAs for either 12 or 24 wk. Predictors of functional benefit were assessed in a univariable as well as multivariable model by binary logistic regression analysis.RESULTS Viral clearance was achieved in 88%(175/199) of patients. Sustained virological response(SVR) 12 rates were as follows: among 156 patients with genotype 1 infection the SVR 12 rate was 90%(n = 141); among 7 patients with genotype 2 infection the SVR 12 rate was 57%(n = 4); among 30 patients with genotype 3 infection the SVR 12 rate was 87%(n = 26); and among 6 patients with genotype 4 infection the SVR 12 rate was 67%(n = 4). Follow-up MELD scores were available for 179 patients. A MELD score improvement was observed in 37%(65/179) of patients, no change of MELD score in 41%(74/179) of patients, and an aggravation was observed in 22%(40/179) of patients. We analysed predictors of functional benefit from antiviral therapy in our patients beyond viral eradication. We identified the Child-Pugh score, the MELD score, the number of platelets and the levels of albumin and bilirubin as significant factors for functional benefit.CONCLUSION Our data may contribute to the discussion of potential risks and benefits of antiviral therapy with individual patients infected with HCV and with advanced liver disease.

Dried blood spots,valid screening for viral hepatitis and human immunodeficiency virus in real-life

AIM To detect chronic hepatitis B(CHB),chronic hepatitis C(CHC) and human immunodeficiency virus(HIV) infections in dried blood spot(DBS) and compare these samples to venous blood sampling in real-life.METHODS We included prospective patients with known viral infections from drug treatment centers,a prison and outpatient clinics and included blood donors as negative controls. Five drops of finger capillary blood were spotted on filter paper,and a venous blood sample was obtained. The samples were analyzed for HBs Ag,antiHBc,anti-HBs,anti-HCV,and anti-HIV levels as well as subjected to a combined nucleic acid test(NAT) for HBV DNA,HCV RNA and HIV RNA.RESULTS Samples from 404 subjects were screened(85 CHB,116 CHC,114 HIV and 99 blood donors). DBS had a sensitivity of > 96% and a specificity of > 98% for the detection of all three infections. NAT testing did not improve sensitivity,but correctly classified 95% of the anti-HCV-positive patients with chronic and past infections. Anti-HBc and anti-HBS showed low sensitivity in DBS(68% and 42%).CONCLUSION DBS sampling,combined with an automated analysis system,is a feasible screening method to diagnose chronic viral hepatitis and HIV infections outside of the health care system.

Sorafenib for advanced renal cell carcinoma in real-life practice: a literature review

Sorafenib is a new treatment indicated for patients with advanced renal cell carcinoma who have failed prior cytokine-based therapy or are considered unsuitable for such therapy. Although treatment with sorafenib under ‘ideal trial conditions’ has been extensively studied, registration and reimbursement authorities are also interested in the behavior of sorafenib in real-life practice. This study aims to conduct a literature review of the dosage and treatment duration;safety, tolerability and effectiveness;costs and cost-effectiveness of sorafenib in routine clinical care. Studies were identified by searching PubMed, Embase, Centre for Reviews and Dissemination databases, Cochrane Database of Systematic Reviews, and EconLit up to November 2010. The literature search included articles published in peer-reviewed journals, congress abstracts, and internal studies of Bayer Schering Pharma. Eight studies were included. An open-label study observed stable disease for at least eight weeks in 80% of patients. The most common drug-related adverse events were hand-foot skin reaction, rash, hypertension, and fatigue. Although treatment with sorafenib led to fewer dose reductions, it was also associated with a shorter treatment duration, less time to pro-gression and a shorter survival time as compared to sunitinib. Monthly health care costs were lower with sorafenib as compared to sunitinib. A post-marketing surveillance study showed that patients rated the tolerability and effectiveness of sorafenib as very good, good or sufficient. In conclusion, the current evidence is too limited to derive conclusions and existing studies suffer from methodological shortcomings.

Real-life multi-center retrospective analysis on nivolumab in difficult-to-treat patients with advanced hepatocellular carcinoma

BACKGROUND Hepatocellular carcinoma(HCC)is one of the leading causes of cancer-related death worldwide.The landscape of the systemic treatment for advanced HCC is changing quickly,and recently,the standard of care became either atezolizumab plus bevacizumab or tremelimumab plus durvalumab in the single tremelimumab regular interval durvalumab regimen.Nivolumab monotherapy has proven to be effective sometimes for advanced HCC and could be a valuable treatment option for patients outside current treatment indications and reimbursement criteria for the standard of care.This is a particular population of interest.AIM To evaluate the real-world effectiveness of nivolumab monotherapy in patients with advanced HCC who are not eligible for other treatment.METHODS We conducted a retrospective,multicentric study including 29 patients with advanced HCC from 3 Belgian tertiary hospitals.All patients had had prior chemotherapy or were intolerant or ineligible for treatments.All study subjects received nivolumab 3 mg/kg in monotherapy,administered once every two weeks intravenously.Treatment continued until disease progression,severe adverse events or death.Data were retrieved from patients'medical records.The outcome parameters such as radiological response according to response evaluation criteria in solid tumors(RECIST)criteria,the biological response through the evolution of the alpha-fetoprotein(AFP)level,and clinical response considering both the Child–Pugh(CP)score and the World Health Organization(WHO)performance status(PS)were reported.A safety profile was also reported.Statistical analysis was performed using the SPSS Statistics 27 statistical software package.RESULTS The radiological overall response rate(defined as complete or partial response according to the immune RECIST and modified RECIST criteria)to nivolumab monotherapy was 24.1%.The biological overall response rate(defined as a decrease of≥25%in AFP blood level)was 20.7%.Radiological and biological responses were significantly associated both with each other(P<0.001)and with overall survival(P<0.005 for radiological response and P<0.001 for biological response).Overall survival was 14.5 mo(+/-2.1),and progression-free survival was 10.9 mo(+/-2.3).After 4 mo of treatment,78.3%of patients remained clinically stable or even showed improvement in WHO PS.Grade 3 adverse events occurred in 17.2%of patients,none had grade 4 adverse events,and no patients ceased nivolumab due to adverse events.CONCLUSION Nivolumab monotherapy is a good treatment choice in frail patients with HCC who are ineligible for the standard of care or other validated systemic treatments.

Linking Real-Life Situations with Classroom Assessment: Development of Real-Life Performance-Based Tasks in Business Mathematics

This study aimed to develop real-life performance-based tasks in Business Mathematics (RLPBTs) following the ADDIE’s model of instructional development. Using the descriptive-developmental research design, the study developed RLPBTS with mathematics experts, mathematics department head, bank manager, mathematics teachers, and students as respondents. The RLPBTs consist of instructional plans. Each instructional plan has these components: Introduction, Learning Competency, Learning Outcome, Task Execution, Scoring Guide, and Generalization. The design and content of the instructional plans were assessed as very good. On the other hand, the design and execution of the Tasks were assessed as favorable. Grade 11 students also agreed that real-life performance-based tasks helped them understand better concepts in business mathematics. They claimed that they enjoyed the tasks because of the inclusion of real-life situations that they simulated. The use of the RLPBTs provides another innovation in the teaching and learning concepts in Business Mathematics.

Patient education improves adherence to peg-interferon and ribavirin in chronic genotype 2 or 3 hepatitis C virus infection:A prospective,real-life,observational study

AIM: To evaluate the impact of therapeutic education on adherence to antiviral treatment and sustained virological response (SVR) in a real-life setting in genotype 2/3 hepatitis C,as there are few adherence data in genotype 2/3 infection,even from randomized trials.METHODS: This prospective survey included genotype 2/3 patients who received peg-interferon alfa-2b and ribavirin.There was no intervention.Adherence was self-reported over the past 4 wk (peg-interferon) or 7 d (ribavirin).Adherence to bitherapy was defined as adherence to the two drugs for ≥ 20 wk.SVR was defined as undetectable RNA ≥ 12 wk after the end of treatment.RESULTS: 370/674 patients received education during the first 3 mo of treatment.After 6 mo,adherence to bitherapy was higher in educated patients (61% vs 47%,P = 0.01).Adherence to peg-interferon was 78% vs 69% (P = 0.06).Adherence to ribavirin was 70% vs 56% (P = 0.006).The SVR (77% vs 70%,P = 0.05) and relapse (10% vs 16%,P = 0.09) rates tended to be improved.After adjustment for baseline differences,education improved adherence [Odds ratio (OR) 1.58,P = 0.04] but not the SVR (OR 1.54,P = 0.06).CONCLUSION: In genotype 2/3 patients,therapeutic education helped maintain real-life adherence to bitherapy.

On the classification of listening situations and the significance of real-life situations on planning listening exercises

Understanding foreign speeches is a complex process involving many different skills and abilities,as Ur(1998)cited. In the real world people use different listening skills for different purposes in different listening situations. When teaching listening the teacher should provide various listening materials and design various listening exercises to give the student practice of these skills. This article will firstly talk about the different purposes of real life listening; then,go on to classify the different listening situations whith reference to Ur's (1998) taxonomy. At last the pedagogic implication for the classification is given.

Insulin Glargine 300 Units/mL Effectiveness in Patients with T2DM Uncontrolled by Basal Insulin in Real-Life Settings in the Czech Republic

Introduction: To evaluate the clinical effectiveness of Gla-300 units/mL (Gla-300) in the treatment of patients with type 2 diabetes (T2DM) uncontrolled by basal insulin in real-life clinical settings in the Czech Republic (TOPAZ study). Methods: TOPAZ was a prospective, multi-center, non-interventional, 6-month study. Of the 312 patients screened, 289 were evaluated at month 6. The primary objective was the change of HbA1c after 6 months. The proportion of patients with HbA1c < 7.0% DCCT (< 53 mmol/mol), and those with a decrease of at least 0.5% of HbA1c at month 6, change in FPG, body weight and insulin dose at month 3 and 6 were analysed as secondary objectives. Incidence of hypoglycemia, adverse events and patient treatment satisfaction were also assessed. Results: HbA1c decreased significantly after 6 months (mean change 0.9% ± 1.1% DCCT [−9.9 ± 11.6 mmol/mol], p < 0.0001). HbA1c target < 7.0% DCCT was achieved in 17.6% of patients, 66.1% of patients showed mean HbA1c decrease of 0.5% ± 0.8%. At month 6, FPG decreased (mean change from baseline −1.8 ± 3.1 mmol/L) as well as the incidence of hypoglycemia decreased by 49% (p < 0.0001) while no weight gain was observed. No significant safety signals were identified. Conclusion: In a real-life setting, switching to Gla-300 in T2DM patients uncontrolled with other basal insulin was associated with improved glycemic control and reduced risk of hypoglycemia without weight gain, while patients’ satisfaction with treatment increased.

Efficacy and safety of secukinumab in Chinese patients with moderate-to-severe plaque psoriasis: a real-life cohort study

Background:There have been few real-life dose-comparing studies on the efficacy and safety of secukinumab in Chinese patients with plaque psoriasis.We conducted a real-life cohort study to investigate the efficacy and safety of secukinumab 150 and 300 mg in Chinese patients with moderate-to-severe plaque psoriasis.Methods:A total of 106 patients with moderate-to-severe plaque psoriasis were included in this study.Patients received either secukinumab 150 mg or secukinumab 300 mg according to patients’weights and severity of psoriasis.The treatment continued for at least 24 weeks.The efficacy was evaluated by improvement in the psoriasis area and severity index(PASI)scores.The safety was also analyzed.Results:Fifty-nine patients(55.7%)were treated with secukinumab 300 mg and 47 patients(44.3%)were treated with secukinumab 150 mg.After 12-week treatment,PASI75/90/100 responses were achieved in 100%,97.8%,and 95.7%of patients,respectively,in secukinumab 150 mg group,and the efficacy was maintained to week 24.In secukinumab 300 mg group,PASI75/90/100 responses were achieved in 93.2%,81.4%,and 76.3%of patients,respectively,at week 12.In this group,PASI75/90/100 responses reached 91.5%,86.4%,and 79.9%,respectively,at week 24.Biologic-experienced patients had lower responses than biologic-naïve patients.Secukinumab 150 and 300 mg were well tolerated.Five patients discontinued treatment due to poor response,adverse event,or economic reasons.Conclusions:This real-life study demonstrated that high PASI 90 and PASI 100 responses were achieved in Chinese psoriasis patients receiving secukinumab 150 or 300 mg.Biologic-naïve was associated with better clinical efficacy.

Effect of Aspergillus niger prolyl endopeptidase in patients with celiac disease on a long-term gluten-free diet

BACKGROUND The gluten-free diet(GFD)has limitations,and there is intense research in the development of adjuvant therapies.AIM To examine the effects of orally administered Aspergillus niger prolyl endopeptidase protease(AN-PEP)on inadvertent gluten exposure and symptom prevention in adult celiac disease(CeD)patients following their usual GFD.METHODS This was an exploratory,double-blind,randomized,placebo-controlled trial that enrolled CeD patients on a long-term GFD.After a 4-wk run-in period,patients were randomized to 4 wk of two AN-PEP capsules(GliadinX;AVI Research,LLC,United States)at each of three meals per day or placebo.Outcome endpoints were:(1)Average weekly stool gluten immunogenic peptides(GIP)between the run-in and end of treatments and between AN-PEP and placebo;(2)celiac symptom index(CSI);(3)CeD-specific serology;and(4)quality of life.Stool samples were collected for GIP testing by ELISA every Tuesday and Friday during run-ins and treatments.RESULTS Forty patients were randomized for the intention-to-treat analysis,and three were excluded from the per-protocol assessment.Overall,628/640(98.1%)stool samples were collected.GIP was undetectable(<0.08μg/g)in 65.6%of samples,and no differences between treatment arms were detected.Only 0.5%of samples had GIP concentrations sufficiently high(>0.32μg/g)to potentially cause mucosal damage.Median GIP concentration in the AN-PEP arm was 44.7%lower than in the run-in period.One-third of patients exhibiting GIP>0.08μg/g during run-in had lower or undetectable GIP after AN-PEP treatment.Compared with the run-in period,the proportion of symptomatic patients(CSI>38)in the AN-PEP arm was significantly lower(P<0.03).AN-PEP did not result in changes in specific serologies.CONCLUSION This exploratory study conducted in a real-life setting revealed high adherence to the GFD.The AN-PEP treatment did not significantly reduce the overall GIP stool concentration.However,given the observation of a significantly lower prevalence of patients with severe symptoms in the AN-PEP arm,further clinical research is warranted.

STEAM教育理念下数学拓展课教学设计研究

为了达成培育真实情境问题解决能力的目标,围绕以跨学科为核心特征的STEAM教育,寻求数学拓展课的优化路径.从确定以真实情境问题解决能力为目标、设计体现多维化特征的教学内容、实施彰显数学化脉络的教学活动、设定关注学习过程的评价侧重点4个维度切入,剖析STEAM教育理念对数学拓展课教学的指导价值,提炼教学基本理念,并构建了STEAM教育理念下的数学拓展课教学基本流程.最后归纳总结出教学设计与实施过程中应注意的关键点:防止过度数学生活化,妥善处理情境虚实;关注协作创新过程,培育工程设计思维;合理融入人文艺术,凸显数学学科本质.

基于生活情境的“探究抗生素对细菌的选择作用”实验设计

基于生活化真实情境,从实验菌、抗生素、滤纸片、培养基、实验过程五个方面对高中生物学“探究抗生素对细菌的选择作用”实验方案做了新的设计和实践,取得了良好的实验效果。

精准思维视域下高校辅导员师德建设的现实困囿及疏解路径

高校辅导员的师德建设不仅对辅导员自身的职业发展有着重要意义,对培育新时代社会主义需要的时代新人,落实思想政治教育立德树人的根本任务也有着重要的促进作用。利用精准思维和辅导员师德建设的内在价值耦合,通过对辅导员自身道德认知不足、辅导员职责冗杂、辅导员师德评价体系不合理的探析,精准分析辅导员师德建设的现实困囿;通过精准定位辅导员职业道德内涵、精准区分辅导员“应为”范畴、精准建构“发展性”评价体系,以精准思维为引领,探求辅导员师德建设的疏解路径,切实推进辅导员师德建设的实效性和可持续性,促进辅导员的全面发展。

“血流的管道——血管”一节概念建构教学设计

在“血流的管道——血管”一节的教学中,以真实情境贯穿课堂,通过观察小鱼尾鳍的实验培养实践能力,并获取事实和证据,借助问题串引导学生在探究和讨论中自主构建知识体系,帮助学生逐步建构“血管”的概念,培养学生的生物学学科核心素养。

项目沉浸式教学模式在高校设计类专业课程思政教学中的应用——以乡土建筑空间设计课程为例

为了更好地促进高校设计类专业学生不断提升专业高阶能力,增强家国情怀和主人翁精神,实现专业教育促进高校学生思想价值塑造的目标,以项目沉浸式教学模式贯穿乡土建筑空间设计课程教学全流程,通过明确教学目标、构建学习情境、重组学习共同体、搭建教学内容、拓展教学组织和建构正向评价的六项教学措施,帮助学生以“设计服务乡村振兴”为核心,在多元化专业教师团队的帮助下,在专业项目实践中沉浸式融入乡村学习环境,真正理解乡村振兴发展的内涵,提升设计专业促进乡村发展的动力和学生的社会责任感,真正实现知识内化与情感共鸣的专业价值塑造。

城市可持续性的影响机制研究——王澍基于现实生活的设计启发

在王澍看来,现代城市和建筑设计与真实的生活世界缺乏基本联系,这成为影响城市可持续性的一个主要因素。文章基于王澍在获得普利茨克奖期间对城市和建筑设计的现实问题的深入思考,探讨了他的理想设计原型。通过分析王澍学生时代的调研报告和学位论文,文章揭示了他对城市可持续性的独特见解。王澍强调,具有可持续性的设计必须深入理解并服务于现实世界中的日常生活,创造出既实用又与日常生活紧密结合的空间。他主张,为了真正深入日常生活,建筑师需要采取与现实环境中的人本视角相融合的方法,这不仅能展现真实生活的丰富性,也为城市的可持续发展奠定了基础。

高中历史教学开展家国情怀教育探赜

作为一门重要的人文学科,历史学科在塑造学生的思想品质、民族意识和爱国情感方面起着不可忽视的作用。家国情怀是中华民族的精神支柱,教师应重视在高中历史教学中培养学生的家国情怀。在高中历史教学中开展家国情怀教育,教师应深入挖掘教材中的家国情怀元素,注重结合现实生活,以典型案例弘扬中华文化,发挥课外活动作用,让学生深入了解家国情怀的丰富内涵和重要性,提高学生的思想品质和人文素质,完成立德树人根本任务。