Applying a Heuristic Approach for a Minimum-cost Operating Strategy for Tap Water

Source: ICHE Conference Archive - https://mdi-de.baw.de/icheArchive

Dual task measures in older adults with and without cognitive impairment: Response to simultaneous cognitive-exercise training and minimal clinically important difference estimates

BACKGROUND: Responsiveness and minimal clinically important difference (MCID) are critical indices to understand whether observed improvement represents a meaningful improvement after intervention. Although simultaneous cognitive-exercise training (SCET; e.g., performing memory tasks while cycling) has been suggested to enhance the cognitive function of older adults, responsiveness and MCID have not been established. Hence, we aimed to estimate responsiveness and MCIDs of two dual task performance involving cognition and hand function in older adults with and without cognitive impairment and to compare the differences in responsiveness and MCIDs of the two dual task performance between older adults with and without cognitive impairment. METHODS: A total of 106 older adults completed the Montreal Cognitive Assessment and two dual tasks before and after SCET. One dual task was a combination of Serial Sevens Test and Box and Block Test (BBT), and the other included frequency discrimination and BBT. We used effect size and standardized response mean to indicate responsiveness and used anchor- and distribution-based approaches to estimating MCID ranges. When conducting data analysis, all participants were classified into two cognitive groups, cognitively healthy (Montreal Cognitive Assessment ≥ 26) and cognitively impaired (Montreal Cognitive Assessment \u3c 26) groups, based on the scores of the Montreal Cognitive Assessment before SCET. RESULTS: In the cognitively healthy group, Serial Seven Test performance when tasked with BBT and BBT performance when tasked with Serial Seven Test were responsive to SCET (effect size = 0.18-0.29; standardized response mean = 0.25-0.37). MCIDs of Serial Seven Test performance when tasked with BBT ranged 2.09-2.36, and MCIDs of BBT performance when tasked with Serial Seven Test ranged 3.77-5.85. In the cognitively impaired group, only frequency discrimination performance when tasked with BBT was responsive to SCET (effect size = 0.37; standardized response mean = 0.47). MCIDs of frequency discrimination performance when tasked with BBT ranged 1.47-2.18, and MCIDs of BBT performance when tasked with frequency discrimination ranged 1.13-7.62. CONCLUSIONS: Current findings suggest that a change in Serial Seven Test performance when tasked with BBT between 2.09 and 2.36 corrected number (correct responses - incorrect responses) should be considered a meaningful change for older adults who are cognitively healthy, and a change in frequency discrimination performance when tasked with BBT between 1.47 and 2.18 corrected number (correct responses - incorrect responses) should be considered a meaningful change for older adults who are cognitively impaired. Clinical practitioners may use these established MCIDs of dual tasks involving cognition and hand function to interpret changes following SCET for older adults with and without cognitive impairment. TRIAL REGISTRATION: NCT04689776, 30/12/2020

Metastatic carcinoma of the urinary bladder in a 67-year-old female with underlying triple primary cancers

AbstractDue to progressive ageing of our population and increasing cancer incidence rates, more and more patients are presenting with multiple primary cancers. Here we describe a case of metastatic carcinoma involving the urinary bladder with underlying triple primary adenocarcinoma in a female adult.A 67-year-old Taiwanese female presented to our institution in November 1997 with gastric signet ring cell carcinoma, pT2N0M0, status post subtotal gastrectomy. In February 2003 she was diagnosed with left breast invasive lobular carcinoma status post modified radical mastectomy, pT2N2M0. Further examination in January 2005 revealed proximal transverse colon cancer, Dukes' C2, with status post right hemicolectomy. She achieved disease-free status from all three malignancies after surgical resection and adjuvant chemotherapy for breast and colon cancers sequentially. In November 2011, she complained about sudden onset of gross hematuria for several days. Diagnostic cystoscopy showed a mass lesion over her urinary bladder. Cystoscope-assisted biopsy showed metastatic poorly differentiated adenocarcinoma with signet ring appearance. Herein we have discussed the pathologic role in the diagnosis of metastatic tumor involving a patient with multiple primary cancers. We also explored the epidemiologic risk and potential causal mechanism of patients with multiple primary cancers

The Evaluation And Using Intention For Digital Teaching Materials Of Penghu Basalt

The Bureau of Culture of Penghu County produced the Penghu Basalt Digital Teaching Materials, which are supplementary teaching materials for local curriculums in elementary and middle schools in Penghu County. But just what are the teachers’ and students’ opinions of the said teaching materials? Are they willing to use them? Are they suitable? These questions are, indeed, worth further research. The questionnaire survey was conducted to gather the opinions of 142 teachers and 151 students of elementary and middle schools in Penghu County. In addition, using the quasi-experimental and experimental teaching methods, after comparing the pre-test and post-test results to the control group, the learning effectiveness was determined. The results indicate that teachers and students have the highest evaluation for the interface design aspect of this teaching material. The teachers’ evaluation for the teaching materials is significantly higher than the students’. Furthermore, the teaching materials are evaluated highly in terms of attracting attention, generating interest and willingness to use, indicating that the digital teaching materials have potential for promotion in Penghu. After the experimental teaching, only the vocational high school students’ scores before and after the experiment showed significantly improvement, while the scores of the students in the other levels of schools did not. &nbsp