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designing a medical ethics curriculum in ophthalmology

Annals of Eye Science 2024年第1期9卷 4-9页

作者： Matthew d.Gearinger Flaum Eye Institute University of Rochester Medical CenterRochesterNYUSA

Ethical principles form a bedrock to medical practice in any specialty,guiding physicians to appropriate attitudes and behaviors.A formal ethics curriculum can be difficult to generate de novo in an ophthalmology training program.A number of barriers exist in most ophthalmology departments:trainees may think ethics is of secondary importance compared to core basic and clinical science topics;most ophthalmology faculty have no formal degree in medical ethics;there is limited didactic time with competing academic,clinical,and surgical priorities;work-hours regulations may limit the time available to deliver“para-professional”lectures;and there is a belief that the medical ethics lectures during medical school is a sufficient amount of coursework to last through a physician’s career with no need for continuing professional *** four pillars of medical ethics are beneficence,non-maleficence,autonomy,and *** addition,morals,ethics,and professionalism are important aspects of sound medical practice.A curriculum specific to medical ethics in ophthalmology can be developed in any of our sub-specialties and include lectures,curated readings,case rounds,and clinic wrap-up *** considerations are part of everyday clinical practice,and a structured ethics curriculum can be incorporated into ophthalmology training *** concept of backward design can be used to structure the curriculum,starting with the expected outcome,then designing authentic assessments,and finally putting together a learning plan that has students actively involved in ethical *** paper will provide a guide to developing an ethics curriculum for an ophthalmology training program utilizing the concept of backwards design and guide the reader through the process of developing expected learning outcomes,authentic assessments,and a unified learning plan.

关键词： Medical ethics curriculum design medical education

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Performance analysis of deep borehole heat exchangers for decarbonization of heating systems

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deep Underground Science and Engineering 2024年第3期3卷 349-357页

作者： Andreas E.d.Lund department of Electrical Engineering and Automation Aalto UniversityEspooFinland

Meeting the climate change mitigation targets will require a substantial shift from fossil to clean fuels in the heating *** pumps with deep borehole exchangers are a promising solution to reduce *** the thermal behavior of deep borehole exchangers(dBHEs)ranging from 1 to 2 km was analyzed for various heat flow profiles.A strong correlation between thermal energy extraction and power output from dBHEs was found,also influenced by the heating profile *** operating time over the year typically resulted in higher energy production,while shorter one yielded higher average thermal power output,highlighting the importance of the choice of heating strategy and system design for optimal performance of *** breaks in operation for regenerating the borehole,for example,with waste heat,proved to be favorable for the performance yielding an overall heat output close to the same as with continuous extraction of *** results demonstrate the usefulness of deep boreholes for dense urban areas with less available *** the heat production from a single dBHE in Finnish conditions ranges from half up to even a few GWh a year,the technology is best suitable for larger heat loads.

关键词： clean energy deep borehole exchangers energy transition geothermal heat ground-coupled heat pump

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Autonomous Vehicle Platoons In Urban Road Networks:A Joint distributed Reinforcement Learning and Model Predictive Control Approach

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IEEE/CAA Journal of Automatica Sinica 2024年第1期11卷 141-156页

作者： Luigi d’Alfonso Francesco Giannini Giuseppe Franzè Giuseppe Fedele Francesco Pupo Giancarlo Fortino IEEE the department of Computer Engineering ModelingElectronics and SystemsUniversitàdella CalabriaVia Pietro BucciCubo 42-CRende(CS)87036Italy the department of Mechanical Engineering Energy Engineering and ManagementUniversitàdella CalabriaVia Pietro BucciCubo 42-CRende(CS)87036Italy

In this paper, platoons of autonomous vehicles operating in urban road networks are considered. From a methodological point of view, the problem of interest consists of formally characterizing vehicle state trajectory tubes by means of routing decisions complying with traffic congestion criteria. To this end, a novel distributed control architecture is conceived by taking advantage of two methodologies: deep reinforcement learning and model predictive control. On one hand, the routing decisions are obtained by using a distributed reinforcement learning algorithm that exploits available traffic data at each road junction. On the other hand, a bank of model predictive controllers is in charge of computing the more adequate control action for each involved vehicle. Such tasks are here combined into a single framework:the deep reinforcement learning output(action) is translated into a set-point to be tracked by the model predictive controller;conversely, the current vehicle position, resulting from the application of the control move, is exploited by the deep reinforcement learning unit for improving its reliability. The main novelty of the proposed solution lies in its hybrid nature: on one hand it fully exploits deep reinforcement learning capabilities for decisionmaking purposes;on the other hand, time-varying hard constraints are always satisfied during the dynamical platoon evolution imposed by the computed routing decisions. To efficiently evaluate the performance of the proposed control architecture, a co-design procedure, involving the SUMO and MATLAB platforms, is implemented so that complex operating environments can be used, and the information coming from road maps(links,junctions, obstacles, semaphores, etc.) and vehicle state trajectories can be shared and exchanged. Finally by considering as operating scenario a real entire city block and a platoon of eleven vehicles described by double-integrator models, several simulations have been performed with the a

关键词： distributed model predictive control distributed reinforcement learning routing decisions urban road networks

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Small molecules to target tau amyloid aggregation

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Neural Regeneration Research 2024年第3期19卷 509-511页

作者： Zoe Manglano-Artuñedo Samuel Peña-díaz Salvador Ventura Institut de Biotecnologia i Biomedicina Universitat Autònoma de BarcelonaBellaterraSpain

Protein aggregation has been linked with many neurodegenerative diseases,such as Alzheimer’s disease(Ad)or Parkinson’s *** belongs to a group of heterogeneous and incurable neurodegenerative disorders collectively known as *** comprise frontotemporal dementia,Pick’s disease,or corticobasal degeneration,among *** symptomatology varies with the specific tau protein variant involved and the affected brain region or cell ***,they share a common neuropathological hallmark-the formation of proteinaceous deposits named neurofibrillary *** tangles,primarily composed of aggregated tau(Zhang et al.,2022),disrupt normal neuronal functions,leading to cell death and cognitive decline.

关键词： tau degeneration aggregation

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A Review of State-of-the-art Flexible Power Point Tracking Algorithms in Photovoltaic Systems for Grid Support:Classification and Application

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Journal of Modern Power Systems and Clean Energy 2024年第1期12卷 1-21页

作者： Mina Haghighat Mehdi Niroomand Hossein dehghani Tafti Christopher d.Townsend Tyrone Fernando the department of Electrical Engineering University of IsfahanIsfahanIran the department of Electrical Electronic and Computer EngineeringUniversity of Western AustraliaCrawley WA 6009Australia

To maximize conversion efficiency,photovoltaic(PV)systems generally operate in the maximum power point tracking(MPPT)***,due to the increasing penetra tion level of PV systems,there is a need for more developed control functions in terms of frequency support services and voltage control to maintain the reliability and stability of the power ***,flexible active power control is a manda tory task for grid-connected PV systems to meet part of the grid ***,a significant number of flexible pow er point tracking(FPPT)algorithms have been introduced in the existing *** purpose of such algorithms is to real ize a cost-effective method to provide grid support functional ities while minimizing the reliance on energy storage *** paper provides a comprehensive overview of grid support functionalities that can be obtained with the FPPT control of PV systems such as frequency support and volt-var *** of these grid support functionalities necessitates PV sys tems to operate under one of the three control strategies,which can be provided with FPPT *** three control strate gies are classified as:①constant power generation control(CP GC),②power reserve control(PRC),and③power ramp rate control(PRRC).A detailed discussion on available FPPT algo rithms for each control strategy is also *** paper can serve as a comprehensive review of the state-of-the-art FPPT algorithms that can equip PV systems with various grid support functionalities.

关键词： Maximum power point tracking(MPPT) flexi ble power point tracking(FPPT) power reserve control(PRC) power ramp rate control(PRRC) low voltage ride-through(LVRT) constant power generation(CPG)

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Prescribed-Time Nash Equilibrium Seeking for Pursuit-Evasion Game

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IEEE/CAA Journal of Automatica Sinica 2024年第6期11卷 1518-1520页

作者： Lei Xue Jianfeng Ye Yongbao Wu Jian Liu d.C.Wunsch Key Laboratory of Measurement and Control of Complex Systems of Engineering Ministry of EducationNanjing 210096 School of Automation Southeast UniversityNanjing 210096China department of Electrical and Computer Engineering Missouri University of Science and TechnologyRollaMO 65409 USA IEEE

dear Editor,This letter is concerned with prescribed-time Nash equilibrium(PTNE)seeking problem in a pursuit-evasion game(PEG)involving agents with second-order *** order to achieve the prior-given and user-defined convergence time for the PEG,a PTNE seeking algorithm has been developed to facilitate collaboration among multiple pursuers for capturing the evader without the need for any global ***,it is theoretically proved that the prescribedtime convergence of the designed algorithm for achieving Nash equilibrium of ***,the effectiveness of the PTNE method was validated by numerical simulation results.A PEG consists of two groups of agents:evaders and *** pursuers aim to capture the evaders through cooperative efforts,while the evaders strive to evade *** is a classic noncooperative *** has attracted plenty of attention due to its wide application scenarios,such as smart grids[1],formation control[2],[3],and spacecraft rendezvous[4].It is noteworthy that most previous research on seeking the Nash equilibrium of the game,where no agent has an incentive to change its actions,has focused on asymptotic and exponential convergence[5]-[7].

关键词： seeking prescribed convergence

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Refractive outcomes after V4c Toric collamer lens implantation over 1y of follow-up

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International Journal of Ophthalmology(English edition) 2024年第7期17卷 1322-1330页

作者： Humberto Carreras-díaz Josefina Reñones de Abajo María del Rosario Carreras-díaz Amalia Lorente-Velázquez Vithas Eurocanarias Las Palmas de Gran Canaria 35004Spain University Hospital of Girona doctor Josep Trueta Gerona 17007Spain departament of Optometry and Vision Faculty of Optics and OptometryComplutense University of MadridMadrid 28040Spain

AIM:To evaluate refractive outcomes and corneal astigmatism changes after Toric implantable collamer lens with a central port(V4c T-ICL)implantation over 1y of ***:A retrospective study was performed including 50 eyes of 50 patients that underwent V4c T-ICL ***(UdVA)and corrected(CdVA)distance visual acuities,refraction,refractive and corneal astigmatism changes and corneal coupling correction were evaluated preoperatively,1 and 12mo *** analysis was used for astigmatism *** of adjustment(CAdj)was calculated for corneal coupling ***:The mean UdVA achieved was 0.03 logMAR at 1mo and remained unchanged throughout the whole follow-up(P=0.193).At the last visit,84%of the eyes achieved a CdVA of 0.00 logMAR or *** spherical equivalent refraction(SEQ),96%of eyes were ranges of±1.00 d and 84%of them within±0.50 ***,94%of eyes had a remaining refractive cylinder within±1.00 d and 78%of them within±0.50 ***,SEQ and refractive cylinder,remain stable over the postoperative follow-up(P=1.000 and P=0.660,respectively).In terms of surgically induced astigmatism(SIA),no statistically significant differences were found over the follow-up(P=0.102)and under correction was found with a correction index lower than the unit at each visit.A keratometric astigmatism induced of 0.59±0.53(vector mean:0.26×73º)d was reached at the last *** significant changes in terms of corneal astigmatism orientation were reported over post-surgery visits(P=0.129 and P=0.097 at 1 and 12mo respectively).No clinical significance was found for CAdj on with-the-rule *** postoperative complications resulting from the surgery were ***:Refractive outcomes suggest that the V4c T-ICL implantation for correction of myopic astigmatism was satisfactory in terms of effectiveness,safety,and stability during 1y of *** astigmatism induced by the incision around 0.5 d is achieved

关键词： V4c Toric collamer lens corneal astigmatism surgically induced astigmatism corneal coupling

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The effect of Common Cuckoo parasitism on the annual productivity of a host population

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Avian Research 2024年第2期15卷 287-291页

作者： Alfred Trnka department of Biology University of TrnavaPriemyselna 491843TrnavaSlovakia

Avian interspecific brood parasitism is an excellent system for studying coevolutionary processes in nature because brood parasites directly affect host reproductive *** research on avian brood parasitism has,therefore,focused primarily on specific host anti-parasite behaviours and parasite ***,the population-level consequences of brood parasitism for host species are poorly *** study investigated the effect of Common Cuckoo(Cuculus canorus)parasitism on the productivity of a local population of the Great Reed Warbler(Acrocephalus arundinaceus)host in south-western Slovakia.A total of 495 females nesting at the studied site successfully fledged 1321 of their own young and 63 young of the Common Cuckoo over the course of 15 years(2008-2022),and the annual rate of successful parasitism ranged from 18% to 44% over this *** predicted,higher rates of successful cuckoo parasitism significantly reduced the annual productivity of the local Great Reed Warbler population,and its contribution to decreased host reproductive success was at about the same rate as overall nest failure caused by predation and other environmental *** a heavily parasitized population was probably maintained by immigrants from other populations and density-dependent selection,which is also consistent with source-sink ***,further long-term studies monitoring parasitized populations are required to confirm these findings.

关键词： Acrocephalus arundinaceus Cuculus canorus Great Reed Warbler Population growth Reproductive success

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The Effect of External Magnetic Field on Electron Scale Kelvin–Helmholtz Instability

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Research in Astronomy and Astrophysics 2024年第9期 238-249页

作者： d.Tsiklauri Joule Physics Laboratory School of ScienceEngineering and EnvironmentUniversity of Salford

We use particle-in-cell,fully electromagnetic,plasma kinetic simulation to study the effect of external magnetic field on electron scale Kelvin–Helmholtz instability （ESKHI）.The results are applicable to collisionless plasmas when,e.g.,solar wind interacts with planetary magnetospheres or a magnetic field is generated in AGN *** find that as in the case of magnetohydrodynamic （MHd） KHI,in the kinetic regime,the presence of an external magnetic field reduces the growth rate of the *** the MHd case,there is a known threshold magnetic field for KHI stabilization,while for ESKHI this is to be analytically *** a kinetic analytical expression,we use several numerical simulation runs to establish an empirical dependence of ESKHI growth rate,Γ（B0）ωpe,on the strength of the applied external magnetic *** find the best fit is hyperbolic,■,whereΓ0is the ESKHI growth rate without an external magnetic field and ■is the ratio of external and two-fluid MHd stability threshold magnetic field,derived *** analytical theory to back up this growth rate dependence on the external magnetic field is *** results suggest that in astrophysical settings where a strong magnetic field pre-exists,the generation of an additional magnetic field by the ESKHI is suppressed,which implies that nature provides a“safety valve”—natural protection not to“over-generate”magnetic field by the ESKHI ***,we find that our two-fluid MHd threshold magnetic field is the same （up to a factor■） as the dC saturation magnetic field,previously predicted by fully kinetic theory.

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Insm1:orchestrating cellular mimicry in the thymus medulla

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Cellular & Molecular Immunology 2024年第4期21卷 414-416页

作者： K.d.James J.E.Cowan UCL Institute of Immunity and Transplantation The Pears BuildingRowland Hill StreetLondonNW32PPUK

The thymus is the primary production site for a functional and self-tolerant T-cell *** establishment of immune tolerance is mediated by the generation and presentation of tissue-restricted self-antigens(TRAs)by medullary thymic epithelial cells(mTECs),which screen T-cell receptors for self-reactivity to eliminate autoreactive T *** studies have extended our understanding of mTEC heterogeneity by examining the mechanisms by which mTECs mimic the peripheral self[1].

关键词： medullary eliminate restricted

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