Diverse Choices Research Articles

Tubeless ureteroenteric anastomosis in robot-assisted radical cystectomy with intracorporeal urinary diversion does not increase the risk of anastomotic stenosis or postoperative complications.

The objective is to demonstrate that omitting ureteral stent placement in robotic intracorporeal urinary diversion does not lead to increased risk of perioperative complications, namely ureteral strictures or anastomotic leaks. We retrospectively reviewed the records of 68 consecutive patients who underwent robotic radical cystectomy with ileal conduit creation or orthotopic neobladder by a single surgeon between January 2020 and September 2023. Chronologically, the first cohort of patients had ureteral stents placed to bridge the ureteroenteric anastomosis, and in the second cohort, stenting was omitted. Cohort 1 consisted of 28 patients with surgeries performed between January 2020 and April 2021, while cohort 2 had 40 patients who underwent surgery from April 2021 to September 2023. The cohorts were well matched with regard to patient age, gender, ASA score and rate of neoadjuvant chemotherapy. The choice of urinary diversion was left to surgeon and patient preference, and there was no significant difference in the proportion of ileal conduits versus orthotopic neobladders within each cohort. Estimated blood loss, total operative time, inpatient length of stay and pathologic T and N staging did not statistically differ between the cohorts. Overall, there was no difference in the rates of postoperative ileus, ureteral stricture, anastomotic leak, infectious complications, and 30-day readmission rates between the groups. Tubeless ureteroenteric anastomosis in patients undergoing robotic radical cystectomy with intracorporeal diversion does not appear to increase the risk of anastomotic strictures or postoperative complications. Further prospective evaluation is warranted.

Opportunities and Challenges in the Development of Antibody-Drug Conjugate for Triple-Negative Breast Cancer: The Diverse Choices and Changing Needs.

Triple-negative breast cancer (TNBC) is a highly heterogeneous breast cancer subtype, which is also characterized by the aggressive phenotype, high recurrence rate, and poor prognosis. Antibody-drug conjugate (ADC) is a monoclonal antibody with a cytotoxic payload connected by a linker. ADC is gaining more and more attention as a targeted anti-cancer agent. Clinical studies of emerging ADC drugs such as sacituzumab govitecan and trastuzumab deruxtecan in patients with metastatic breast cancer (including TNBC) are progressing rapidly. In view of its excellent clinical efficacy and good tolerability, Sacituzumab govitecan gained accelerated approval by the FDA for the treatment of advanced metastatic TNBC in 2020. This review discusses the treatment status and challenges in TNBC, with an emphasis on the current status of ADC development and clinical trials in TNBC and metastatic breast cancer. We also summarize the clinical experience and future exploration directions of ADC development for TNBC patients.

The Sustainability Journey of Chinese Ready-Meal Companies Going Global: Configurational Analysis Using the Technology-Organization-Environment Framework.

In the new wave of globalization, China's pre-cooked meal industry has rapidly emerged as a significant player in the food supply chain domain, owing to its convenience and diverse choices. Amidst intensifying market competition, crafting a sustainable supply chain for overseas expansion has become an indispensable core element for driving corporate internationalization. This study focuses on the sustainability generation mechanism of the overseas supply chain of Chinese pre-cooked meal A-share listed companies, employing the technology-organization-environment (TOE) framework and fuzzy-set qualitative comparative analysis (fsQCA) method. Herein, an in-depth analysis of 388 data points from 17 listed companies has been conducted. The study systematically reveals the key factors affecting the sustainability of overseas supply chains and identifies three critical sustainability generation paths: the technology-driven and norm compliance model (path 1), the market sensitivity and product innovation model (path 2), and the robust operation and risk control model (path 3). The present study not only introduces a novel perspective on the application of a TOE framework within the realms of sustainable supply chain management and environmental, social, and governance (ESG) criteria but also offers clear directions for companies to enhance sustainability in their overseas expansion process. This includes strengthening technological research and development, compliance construction, market adaptability, product diversity, infrastructure construction, and risk management. Moreover, the research findings provide valuable insights for policymakers in promoting the internationalization of the pre-cooked meal industry and enhancing industry competitiveness.

Screening of low-friction two-dimensional materials from high-throughput calculations using lubricating figure of merit

Two-dimensional materials are excellent lubricants with inherent advantages. However, superlubricity has been reported for only a few of these materials. Unfortunately, other promising two-dimentional (2D) materials with different physical properties cannot be discovered or applied in production; thus, energy consumption can be greatly reduced. Here, we carry out high-throughput calculations for 1,475 2D materials and screen for low-friction materials. To set a standard, we propose, for the first time, a geometry-independent lubricating figure of merit based on the conditions for stick-slip transition and our theory of Moiré friction. For the efficient calculation of this figure of merit, an innovative approach was developed based on an improved registry index model. Through calculations, 340 materials were found to have a figure of merit lower than 10−3. Eventually, a small set of 21 materials with a figure of merit lower than 10−4 were screened out. These materials can provide diverse choices for various applications. In addition, the efficient computational approach demonstrated in this work can be used to study other stacking-dependent properties.

Penggunaan E-Commerce Di Kalangan Para Pedagang Di Pasar Baru Permai (Sudimampir) Banjarmasin

Based on DataIndonesia.id (28/02/2023) in 2022 in Indonesia there will be more and more online business actors. This research aims to (1) Find out the motives of traders at Baru Permai Market, Banjarmasin who use e-commerce. (2) Knowing the motives of traders at Baru Permai Market, Banjarmasin who do not use e-commerce. This research uses qualitative research methods. The data sources selected used purposive sampling and the informants in this study were 6 people. Data collection was carried out using observation, interviews and documentation techniques. The data analysis technique in this research uses data reduction techniques, data presentation, and drawing conclusions. The results of the research show that (1) The motives of traders who use e-commerce are because of cheaper prices, to fulfill stock of goods, and a more diverse choice of goods. The objective motive is for promotional activities, and is more flexible. (2) The motives of traders who do not use e-commerce are because they don't know how, it's difficult to access, and it's difficult. The goal motive is not having to buy a quota, and not creating content first. Based on the research results, it is recommended that future researchers use different theories and methods to those used by researchers, taking a different market from Pasar Baru Permai because Sudimampir Market itself is a combination of several markets and sells different goods.

Investigating Role of Supervised Machine Learning Approach in Classification of Diabetic Patient

Objectives: Healthcare analytics requires classifying diabetic patient datasets for quicker diagnosis and personalized treatment. This study used SVM, Decision Trees, KNN, ANN, and Logistic Regression to predict type 1 and 2 diabetes. Our detailed performance research shows these algorithms' utility in handling diabetic patient data's complexity. Methods: We compare SVM, Decision Trees, KNN, ANN, and Logistic Regression for diabetes patient dataset classification. While each approach has pros and cons, ANN and logistic regression are promising clinical possibilities. Diagnoses, proactive therapies, and diabetes patient outcomes increase with these breakthroughs. Results: SVM has 84.3% accuracy in type 1 and type 2 diabetics. SVM recognized complicated dataset patterns with great accuracy and recall. Decision trees were more interpretable and could record diverse choice limits, with accuracy rates of 86.15% for both types. With 90.6% accuracy, KNN predicted type 1 diabetes well. KNN was ideal for complex datasets because to its greater accuracy and recall using data point similarities. ANN and Logistic Regression had the highest accuracy for type 1 and type 2 diabetes patients at 96.1% and 97%, respectively. Novelty: Layered ANN and logistic regression identified complicated dataset relationships with accuracy, recall, and F1 scores exceeding 0.94. ANN with logistic regression may change diabetes patient classification with unequaled prediction power and accuracy.

Hot or Cold? Adaptive Temperature Sampling for Code Generation with Large Language Models

Recently, Large Language Models (LLMs) have shown impressive abilities in code generation. However, existing LLMs' decoding strategies are designed for Natural Language (NL) generation, overlooking the differences between NL and programming languages (PL). Due to this oversight, a better decoding strategy for code generation remains an open question. In this paper, we conduct the first systematic study to explore a decoding strategy specialized in code generation. With an analysis of loss distributions of code tokens, we find that code tokens can be divided into two categories: challenging tokens that are difficult to predict and confident tokens that can be easily inferred. Among them, the challenging tokens mainly appear at the beginning of a code block. Inspired by the above findings, we propose a simple yet effective method: Adaptive Temperature (AdapT) sampling, which dynamically adjusts the temperature coefficient when decoding different tokens. We apply a larger temperature when sampling for challenging tokens, allowing LLMs to explore diverse choices. We employ a smaller temperature for confident tokens avoiding the influence of tail randomness noises. We apply AdapT sampling to LLMs with different sizes and conduct evaluations on two popular datasets. Results show that AdapT sampling significantly outperforms state-of-the-art decoding strategy.

Freedom comes at a cost?: An exploratory study on affordances' impact on users' perception of a social robot.

Along with the development of speech and language technologies, the market for speech-enabled human-robot interactions (HRI) has grown in recent years. However, it is found that people feel their conversational interactions with such robots are far from satisfactory. One of the reasons is the habitability gap, where the usability of a speech-enabled agent drops when its flexibility increases. For social robots, such flexibility is reflected in the diverse choice of robots' appearances, sounds and behaviours, which shape a robot's 'affordance'. Whilst designers or users have enjoyed the freedom of constructing a social robot by integrating off-the-shelf technologies, such freedom comes at a potential cost: the users' perceptions and satisfaction. Designing appropriate affordances is essential for the quality of HRI. It is hypothesised that a social robot with aligned affordances could create an appropriate perception of the robot and increase users' satisfaction when speaking with it. Given that previous studies of affordance alignment mainly focus on one interface's characteristics and face-voice match, we aim to deepen our understanding of affordance alignment with a robot's behaviours and use cases. In particular, we investigate how a robot's affordances affect users' perceptions in different types of use cases. For this purpose, we conducted an exploratory experiment that included three different affordance settings (adult-like, child-like, and robot-like) and three use cases (informative, emotional, and hybrid). Participants were invited to talk to social robots in person. A mixed-methods approach was employed for quantitative and qualitative analysis of 156 interaction samples. The results show that static affordance (face and voice) has a statistically significant effect on the perceived warmth of the first impression; use cases affect people's perceptions more on perceived competence and warmth before and after interactions. In addition, it shows the importance of aligning static affordance with behavioural affordance. General design principles of behavioural affordances are proposed. We anticipate that our empirical evidence will provide a clearer guideline for speech-enabled social robots' affordance design. It will be a starting point for more sophisticated design guidelines. For example, personalised affordance design for individual or group users in different contexts.

Improvement the Bunch and Oil Yields of Oil Palm (Elaeis guineensis Jacq.) by Introducing Material of Yocoboué Origin into the Selection Scheme in Côte d'Ivoire

The introduction of Yocoboué-origin material into Group B of the reciprocal recurrent selection (RRS) scheme in Côte d'Ivoire aimed to enhance extraction rates of La Mé material and augment genetic diversity within the group. In this study, 1120 trees from 13 progenies and 3 controls, from the first and second selection cycles, were evaluated for bunch and oil yields in a balanced square lattice design (BSLD) with 4 x 4 and 5 replications. Results indicated that twelve progenies exhibited significantly higher bunch yields, ranging from 23 to 25 t/ha/year, compared to the three controls. Remarkably, industrial oil extraction rates reached up to 27%, resulting in an impressive oil yield capacity of 6.90 t/ha/year. Noteworthy progenitors, including LM13878P, LM13015T, and LM13832T, played a key role in achieving these performances and displayed favorable crossing values with Deli testers. These findings underscore the potential for creating high-performance hybrid seeds and advancing genetic improvement in oil palm. The diverse choices presented by these performances hold promise for the continued enhancement of oil palm cultivation.

Review of Resilience Evaluation Methods in Operational Highway Tunnel

The research on tunnel resilience has garnered increasing attention in recent years. Owing to prolonged exposure to natural or anthropogenic factors, the resilience level of many highway tunnels is continuously declining, rendering them susceptible to sudden accidents and challenging to restore postincident. Currently, although several scholars have employed diverse evaluation methods in their research on tunnel resilience, there is a lack of summarization and integration of these methods. In addition, there is also a dearth of a unified evaluation index system and framework for different types of natural or man‐made disasters, which are crucial for advancing the development of tunnel resilience evaluation. This study commences with an introduction to the origin of resilience and the definition of tunnel resilience, and comprehensively summarizes commonly employed evaluation methods. Subsequently, this study centers on the resilience evaluation methods in tunnel engineering and analyzes their strengths and weaknesses. Besides, the distribution of resilience metrics in current researches is analyzed and the detailed explanations for the diverse choices are provided. According to the results and deficiencies of existing research, combined with the author’s perspectives, the index systems, evaluation frameworks, and resilience improvement strategies are proposed, which can be applied to the resilience evaluation of various operational highway tunnels under diverse disaster scenarios. Furthermore, this study also presents a case study on the evaluation of tunnel fire resilience to validate the applicability of the research findings. These findings aim to provide a guide for the operation and maintenance management of the operating tunnels and improve the scientific decision‐making level of tunnel maintenance.

Understanding the effect of the condensation temperature on solar-driven reverse distillation for enhanced water production

Reverse distillation driven by solar energy decouples light-incoming and evaporation–condensation regions that are integrated together in conventional solar distillation, thereby providing diverse choices in materials and structures for enhancing vapor condensation. However, detailed experiments and discussion are scarce in exploring how condensation temperature influences the solar-to-water energy conversion efficiency in the reverse-distillation process and may thus constrict the further understanding and application in water production processes. A common impression is that a low temperature is good for vapor condensation and performance improvement but that may not be the case. An interesting conclusion from both experimental and theoretical exploration in this research is that the efficiency of the reverse-distillation device first increases and then decreases with the condensation temperature, indicating an optimal condensation temperature for obtaining the best water production performance. In indoor experiments with one-sun illumination, the reverse-distillation device with natural air cooling shows a distillate yield of 1.04 kg⋅m−2⋅h−1 and a solar-to-water energy conversion efficiency of 68.8 %, which is 9.4 % and 6.3 % more than that of a device with enhanced cooling by water flow and inhibited cooling by thermal insulation, respectively. In the outdoor experiments, the increase in efficiency using natural air cooling is 4.9 % and 7.1 % compared with the enhanced and inhibited cooling measures, respectively. The conclusion is further explained from the perspective of heat-and-mass transfer, which may provide meaningful guidance for designing a high-efficiency reverse-distillation system. In future water production, cooling measures should be cautiously considered according to the device structure and the actual working conditions to achieve better performance.

Reconfigurable MIMO antenna: previous advancements and the potential for future wireless communication

Abstract Future smart reconfigurable antennas (RAs) (Haupt R-L and Lanagan M (2013) Reconfigurable antennas. IEEE Antennas and Propagation Magazine 55, 49–61) will likely be fully multipurpose and controlled by software and equipped with machine learning skills that can discern and respond to alterations in the radio frequency environment. Cognitive radio utilizations will be accomplished using a new generation of antenna technology and communication protocols. The effective use of frequencies and the use of polarization diversity and radiation pattern reconfigurability to send data over existing congested frequencies will be major advantages for such applications. The usage of antennas that can be reconfigured in multiple-input multiple-output (MIMO) channels will enhance channel capacity while simultaneously improving channel efficiency and lowering costs (Christodoulou C-G, Tawk Y, Lane S-A and Erwin S-R (2012) Reconfigurable antennas for wireless and space applications. Proceedings of the IEEE 100, 2250–2261). There are a lot of antennas used both at the transmitter and at the receiver front end in a MIMO system. The benefit of employing such arrangements is that different types of information can be conveyed at a similar time, boosting the spectral efficiency of communication in a multipath situation. The coding rate, modulation level, and transmission signaling method of a MIMO system can all be changed in response to changing channel circumstances and user needs. In a MIMO context, polarization reconfigurable/frequency-reconfigurable/radiation pattern RA increase the degree of freedom and enhancing the system’s performance. The usage of such antennas greatly enhances capacity by enabling a choice of various polarization configurations and pattern diversity. Antenna arrays that can be reconfigured are also an appealing MIMO system solution that needs to retain robust communication channels, particularly in portable gadgets where the area is limited.

Empirical Study on the Impact of Intensive Extracurricular Education Experiences on the Future Development of Adolescents: A Case Study of the 'Jiwa Phenomenon' in Beijing

In the context of the Double Reduction policy, this paper takes the group of Tiger Parenting in Beijing, who have had intensive extracurricular education experiences, as the research subjects, and explores how extracurricular education influences the formation of self-awareness in adolescents. The research findings indicate that extracurricular education not only provides adolescents with more educational choices but also, due to its particularly concentrated distribution in specific areas, serves as a platform for adolescents to engage in social activities with more diverse peers and to gather and disseminate information. At the same time, the extracurricular class becomes another space for adolescents, beyond the family and school, where they can encounter different groups and various life scenarios, contributing to the development of their spatiotemporal perspectives. The study concludes that although overly intensive extracurricular education can occasionally lead to psychological stress among adolescents in rare cases, overall, the diverse choices offered by extracurricular education aid adolescents in better exploring their interests. Furthermore, it positively influences their self-confidence and social skills through various means.

Subverting Trauma: Evidencing a need for trauma-informed principles in editing practice

Trauma-informed practice is a strengths-based framework that guides the service provisions of the Australian healthcare and education sectors. Based on Mental Health Australia’s (Kezelman, 2014) definition of trauma-informed care, the principles underpinning a trauma-informed approach to practice include safety, trustworthiness, opportunity for choice, collaboration, empowerment and respect for diversity. While there is significant research on trauma-informed care and trauma-informed pedagogy in both national and international contexts, there is a dearth of literature on trauma-informed editing practice. Given that writing itself is a vehicle for processing and sharing traumatic experience, the lack of directives around editing potentially traumatic content and working with authors who have histories of trauma is concerning, with risks of harm to both the author and editor if adequate provisions are not in place. This qualitative study reviews existing trauma-informed frameworks and conducts a field survey of practising editors who self-identify as working, or having worked, with traumatic material or trauma survivors. The use of trauma-informed tools in a creative industry necessitates a cultural and philosophical shift and the findings from this research corroborate the need for both formalised guidelines, and for future editors to be explicitly educated in these practices.

The age-based digital divide in an increasingly digital world: A focus group investigation during the COVID-19 pandemic

Background and objectivesPrevious research has identified numerous benefits of information and communication technology (ICT) on the well-being of older adults. However, it has been increasingly recognized that older adults do not necessarily catch up with the rapidly digitalized society, known as the ‘age-based digital divide’. The progress of digitalization has been accelerated during the COVID-19 pandemic, which may have widened the digital divide. This study aimed to gain a better understanding of their living experience and concerns about digital exclusion during the pandemic. The perceptions of older adults in Hong Kong, a highly digitalized, metropolitan city, towards the digital age and its impact on their daily living during the COVID-19 pandemic were explored. Research design and methodsWe conducted 12 focus group interviews with 77 community-dwelling older adults during the COVID-19 pandemic. Data were analyzed using thematic analysis, applying both organization, reduction, and refinement. ResultsFour themes were identified: 1) Diversified means to access community information; 2) Facilitated daily living through the usage of ICTs; 3) Concerns about age-related decline in function; and 4) Fear of digital exclusion and accelerated digitalization during the pandemic. The results indicate that ICT provided numerous benefits to the daily life of older adults, but our participants also expressed concerns about age-related losses and the fear of digital exclusion due to the ongoing digitalization of society. Discussion and implicationsOur findings indicated that older adults do not necessarily benefit from technological innovations, which are becoming more pervasive during the pandemic. To create age-friendly environments that cater to the needs of all members of society in the digital age, policymakers and service providers should provide diverse choices for older adults, rather than relying solely on one-size-fits-all technological solutions.

Isonicotinic acid-based copper-MOF: An exotic redox propertied electrode material for high energy asymmetric supercapacitor

Metal-organic frameworks (MOFs) have been explored as potential electrode materials with significant electrochemical outcomes, but still crave for higher energy density, and electrical conductivity. Among diverse choices of metal nodes and linkers, optimization as well as a thorough understanding of charge storage mechanisms is still to accomplish. This research article investigates the electrochemical performance and charge storage chemistry of isonicotinic acid-based copper Copper-Metal Organic Framework (Cu-MOF) synthesized via hydrothermal approach. SEM, XRD, and FTIR were employed to depict the structural and surface analysis. Investigation in three cell configurations revealed prominent redox active behavior of Cu-MOF with a sound maximum specific capacity of 469.12C/g (781.87 F/g) at 0.6 A/g. Further, the depiction of storage insight via simulation approach reveals dominant faradic characters (6.30 % non-Faradic contributions at 3 mV/s) and sound conductivity of electrode material. The employment of Cu-MOF as positive electrode material in a hybrid supercapacitor configuration delivered a splendid specific energy of 48.50 Wh/kg at 1.3 A/g. A remarkable specific power of 8667 W/kg was achieved via the fabricated device while sustaining specific energy of 33.32 Wh/kg (68.70 % preservation) at a high current density of 10 A/g. After 5000 GCD cycles, the prototype stood out with an excellent 93.47 % retention and improved conductivity. Scrutinization of device charge storage insights discloses substantial hybrid behavior with 89.69 % diffusive contents at 3 mV/s and 53.11 % capacitive benefaction at 100 mV/s. To the best of our knowledge, this is the first approach toward scrutinizing the electrochemical behavior of Isonicotinic acid based Cu-MOF and finding present it as a potential electrode material for high energy and rate capability electrochemical systems.

Migration choices of China's older adults and spatial patterns emerging therefrom (1995-2015).

The steady increase in China's ageing population and an upswing in migration among the country's population, on the whole, has caused a continuous expansion of the scale of older migrants. The migration of older adults not only directly affects the well-being of individual families but also significantly impacts the population structure and economic development of the places of origin and destination. Despite this, in China, the various relevant aspects concerning this age group and, in particular, its migration choices and the patterns thereof have only rarely been the subject of sound research. The study presented in this paper seeks to fill this gap; the present study makes use of the microdata obtained from the national population censuses of 2000 and 2010 and the 1% population sample surveys conducted nationally in 2005 and 2015. The findings of the present study were the following: ① During 1995-2015, the efficiency of older adults' migration was significantly higher in the eastern region than in the central and western regions. ② Older individuals migrating to urban areas are increasingly choosing, for their relocation, economically developed, urban areas such as the Yangtze River Delta, Pearl River Delta and Beijing-Tianjin-Hebei region. ③ Relocation of older adults to urban areas was much more than to rural areas. The latter group has a more diverse choice of destination, and the larger migration flow is primarily from developed provinces to relatively underdeveloped provinces. ④ The results of binary logit regression indicated that the factors that significantly and consistently influence the migration decisions of older adults were found to be the following: age, education level, health status, the primary financial resource, children aged ≤ 6 years being members of the household that would receive the migrants, and the average wage of employees. As for the geographical characteristics of the province to which the older adults migrate, a substantial difference was observed between the preferences of older adults migrating to urban regions and those of older adults relocating to rural areas. The findings of the present study provide further insight into the decision-making of older adults regarding migration. Further, these findings constitute an empirical basis for the local governments concerned to devise and implement policies to better cope with an ageing population.

Understanding youth drinking decline: Similarity and change in the function and social meaning of alcohol use (and non-use) in adolescent cohorts 20 years apart.

Qualitative research aimed at understanding the decline in youth drinking has so far been hampered by a lack of baseline data for comparison. This New Zealand study overcomes this limitation by comparing archival qualitative data collected at the height of youth drinking (1999-2001) with contemporary data collected for this study (June-October 2022). The aim is to explore changes in the function and social meaning of alcohol use (and non-use) for two cohorts about 20 years apart. Both archival and contemporary data were collected from 14 to 17 year old secondary school students (years 10-12) through individual and small-group/pair interviews in matched suburban co-ed schools. Interviews explored friendships, lifestyles, romantic relationships and experiences and perceptions of substance use and non-use. Comparative analysis highlighted changes that may help to explain the decline in youth drinking, including an increased value placed on personal choice and acceptance of diversity; decreased face-to-face socialising and the emergence of social media as a central feature of adolescent social life, perhaps displacing key functions of drinking and partying; increased pervasiveness of risk discourses and increased awareness of health and social risks of alcohol; and increased framing of alcohol use as a coping mechanism by both drinkers and non-drinkers. Collectively, these changes appear to have shifted the social position of drinking from an almost compulsory component of adolescent social life in 1999-2001, to an optional activity that many contemporary adolescents perceive to have high risks and few benefits.

EFL TEACHERS’ PERCEPTIONS OF DIGITAL TRANSFORMATION READINESS: A CASE IN A VIETNAMESE EDUCATIONAL INSTITUTION

The development of digital technology has significantly affected Vietnamese education in recent years, presenting both challenges and opportunities. In many educational institutions, digital transformation has helped to improve the learning experience for both students and teachers through interactive and customizable learning. Various uses of digital teaching and learning may include providing diverse choices of online learning such as participating in classes through mobile apps or web applications, enhancing self-directed learning, and using technology to track students' progress. Although digital transformation has become a worldwide topic recently, particularly in the new normal, limited research has explored this subject in the context of EFL teaching and learning in Vietnam. This empirical study aims to explore teachers’ perceptions of their readiness for the digital transformation at a center of foreign languages. The results revealed that teachers were relatively ready for this important change, although a number of typical challenges can have a negative influence on the effective implementation of the process. Many suggestions for improving teaching quality thanks to digital transformation were also presented.<p> </p><p><strong> Article visualizations:</strong></p><p><img src="/-counters-/soc/0001/a.php" alt="Hit counter" /></p>

MP12-08 EVALUATING THE IMPACT OF EXCLUDING THE RACE FACTOR FROM THE eGFR EQUATION ON BLADDER CANCER TREATMENT OPTIONS

You have accessJournal of UrologyCME1 Apr 2023MP12-08 EVALUATING THE IMPACT OF EXCLUDING THE RACE FACTOR FROM THE eGFR EQUATION ON BLADDER CANCER TREATMENT OPTIONS Amir Khan, Shu Wang, Rehan Choudhary, Michael Phelan, Eberechukwu Onukwugha, and M. Minhaj Siddiqui Amir KhanAmir Khan More articles by this author , Shu WangShu Wang More articles by this author , Rehan ChoudharyRehan Choudhary More articles by this author , Michael PhelanMichael Phelan More articles by this author , Eberechukwu OnukwughaEberechukwu Onukwugha More articles by this author , and M. Minhaj SiddiquiM. Minhaj Siddiqui More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003227.08AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: The estimated glomerular filtration rate (eGFR) equation is based on several factors among which the race factor has been broadly criticized. In September 2021, the National Kidney Foundation and American Society of Nephrology Task Force announced a new race-free calculation for eGFR. Aspects of treatment decisions for muscle-invasive bladder cancer (MIBC) are dependent on eGFR, specifically neoadjuvant cisplatin eligibility and choice of diversion with cystectomy. Herein, we evaluate the impact of removal of race-based eGFR calculation on the management of patients with MIBC. METHODS: Using the National Surgical Quality Improvement Program database, adult patients diagnosed with MIBC and who received radical cystectomy from 2015 to 2020 were included in this study. eGFR was calculated using the Modification of Diet in Renal Disease (MDRD) equation. We calculated the proportion of African American patients who were candidates for neobladder urinary diversions and cisplatin-based chemotherapy using >30 and >60 ml/min/1.73m2 as the cutoff for eGFR, respectively, as calculated with and without the race factor. RESULTS: African Americans constituted 4.5% (579) of the total sample population (12,192) among which 39.7% (230) were female and 60.3% (349) were male. There was no association of eGFR with gender. Using the MDRD equation, the mean eGFR decreased from 70.0 to 57.8 ml/min/1.73m2 after removing the race factor. With the adjusted eGFR without race, 4.1% fewer patients (94.6% vs 90.5%) were eligible for neobladder urinary diversion with a >30 ml/min/1.73m2 eGFR cutoff. Furthermore, among patients who were previously eligible to receive cisplatin chemotherapy, 18.0% fewer patients (63.0% vs 45.0%) would remain eligible with a >60 ml/min/1.73m2 eGFR. (Figure 1) CONCLUSIONS: Excluding race from the eGFR equation will preclude some previously eligible African American patients for certain treatment in bladder cancer management. Further studies are needed to understand the relative risks and benefits of decisions that are based on the adjusted eGFR. Source of Funding: No source of funding © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e136 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Amir Khan More articles by this author Shu Wang More articles by this author Rehan Choudhary More articles by this author Michael Phelan More articles by this author Eberechukwu Onukwugha More articles by this author M. Minhaj Siddiqui More articles by this author Expand All Advertisement PDF downloadLoading ...