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961.
Periodic density functional theory (DFT) calculations were performed to investigate the adsorption of H2O on U(001) surface. The metallic nature of uranium atom and different adsorption sites of U(001) surface play key roles in the H2O molecular dissociate reaction. The long-bridge site is the most favorable site of H2O-U(001) adsorption configuration. The triangle-center site of the H atom is the most favorable site of HOH-U(001) adsorption configuration. The interaction between H2O and U surface is more evident on the first layer than that on any other two sub-layers. The dissociation energy of one hydrogen atom from H2O is ?1.994 to ?2.215 eV on U(001) surface, while the dissociating energy decreases to ?3.351 to ?3.394 eV with two hydrogen atoms dissociating from H2O. These phenomena also indicate that the Oads can promote the dehydrogenation of H2O. A significant charge transfer from the first layer of the uranium surface to the H and O atoms is also found to occur, making the bonding partly ionic.  相似文献   
962.
Efforts to integrate gender medicine into medical school curricula have focused largely on the work of individual champions. Online sex and gender materials for undergraduate courses have also been developed and disseminated. Success has been sporadic, with varying uptake across schools within and between countries. International trends in medical school accreditation processes and the growing force of the millennial student voice offer untapped opportunities to promote more systematic integration of gender medicine on a national and international level. In this commentary, the president and CEO of the Association of Faculties of Medicine of Canada and the Scientific Director of the Institute of Gender and Health of the Canadian Institutes of Health Research jointly reflect on top-down and bottom-up levers for sustainable innovation in gender medicine for undergraduate medical training.  相似文献   
963.

Background

Sex- and gender-based medicine (SGBM) aims to (1) delineate and investigate sex- and gender-based differences in health, disease, and response to treatment and (2) apply that knowledge to clinical care to improve the health of both women and men. However, the integration of SGBM into medical school curricula is often haphazard and poorly defined; schools often do not know the current status of SGBM content in their curricula, even if they are committed to addressing gaps and improving SGBM delivery. Therefore, complete auditing and accounting of SGBM content in the existing medical school curriculum is necessary to determine the baseline status and prepare for successful integration of SGBM content into that curriculum.

Methods

A review of course syllabi and lecture objectives as well as a targeted data analysis of the Curriculum Management and Information Tool (CurrMIT) were completed prior to a real-time curriculum audit. Subsequently, six “student scholars,” three first-year and three second-year medical students, were recruited and trained to audit the first 2 years of the medical school curriculum for SGBM content, thus completing an audit for both of the pre-clinical years simultaneously. A qualitative analysis and a post-audit comparative analysis were completed to assess the level of SGBM instruction at our institution.

Results

The review of syllabi and the CurrMIT data analysis did not generate a meaningful catalogue of SGBM content in the curriculum; most of the content identified specifically targeted women’s or men’s health topics and not sex- or gender-based differences. The real-time student audit of the existing curriculum at Texas Tech revealed that most of the SGBM material was focused on the physiological/anatomical sex differences or gender differences in disease prevalence, with minimal coverage of sex- or gender-based differences in diagnosis, prognosis, treatment, and outcomes.

Conclusions

The real-time student scholar audit was effective in identifying SGBM content in the existing medical school curriculum that was not possible with a retrospective review of course syllabi and lecture objectives or curriculum databases such as the CurrMIT. The audit results revealed the need for improved efforts to teach SGBM topics in our school’s pre-clinical curriculum.
  相似文献   
964.

Background

Sex and Gender Medicine is a novel discipline that provides equitable medical care for society and improves outcomes for both male and female patients. The integration of sex- and gender-specific knowledge into medical curricula is limited due to adequate learning material, systematic teacher training and an innovative communication strategy. We aimed at initiating an e-learning and knowledge-sharing platform for Sex and Gender Medicine, the eGender platform (http://egender.charite.de), to ensure that future doctors and health professionals will have adequate knowledge and communication skills on sex and gender differences in order to make informed decisions for their patients.

Methods

The web-based eGender knowledge-sharing platform was designed to support the blended learning pedagogical teaching concept and follows the didactic concept of constructivism. Learning materials developed by Sex and Gender Medicine experts of seven universities have been used as the basis for the new learning tools. The content of these tools is patient-centered and provides add-on information on gender-sensitive aspects of diseases. The structural part of eGender was designed and developed using the open source e-learning platform Moodle. The eGender platform comprises an English and a German version of e-learning modules: one focusing on basic knowledge and seven on specific medical disciplines. Each module consists of several courses corresponding to a disease or symptom complex. Self-organized learning has to be managed by using different learning tools, e.g., texts and audiovisual material, tools for online communication and collaborative work.

Results

More than 90 users from Europe registered for the eGender Medicine learning modules. The most frequently accessed module was “Gender Medicine—Basics” and the users favored discussion forums. These e-learning modules fulfill the quality criteria for higher education and are used within the elective Master Module “Gender Medicine—Basics” implemented into the accredited Master of Public Health at Charité—Berlin.

Conclusions

The eGender platform is a flexible and user-friendly electronical knowledge-sharing platform providing evidence-based high-quality learning material used by a growing number of registered users. The eGender Medicine learning modules could be key in the reform of medical curricula to integrate Sex and Gender Medicine into the education of health professionals.
  相似文献   
965.
966.
967.
This study was conducted to analyze the habitat preference of six major mammals for various environmental factors based on 100 random points within a mountain area in South Korea. In-situ presence and absence data for the mammals were surveyed and collected, and twelve explanatory variables related to topography, water, greenness, and anthropogenic influence were applied to create a habitat distribution model. The best combination of variables was determined using Moran’s I coefficients and Akaike criteria information, and applied to estimate the habitat preference for each species using GRASP v.3.0. The predictive map showed that wildlife animals in this study were mainly categorized into two groups: Group I (Korean squirrel, Sciurus vulgaris, mole, Talpa micrura and water deer, Hydropotes inermis), showed equal preference for all mountainous areas; Group II (weasel, Mustela sibirica, leopard cat, Felis bengalensis and raccoon dog, Nyctereutes procyonoides) showed different preferences in a mountain.  相似文献   
968.
969.

Background and Objective

Recently, there are few studies reporting on depressive status and obstructive sleep apnoea (OSA) in China. A large-sample survey was to be performed to explore the prevalence of depressive status and related factors in Chinese patients with OSA.

Methods

From among a randomly-selected group of OSA patients, 1,327 met inclusion criteria. After screening with the Symptom Checklist 90 (SCL-90) and Self-Rating Depression Scale (SDS), patients were assigned to OSA without depressive status (control group, n = 698) and OSA with depressive status (n = 629) groups. Using chi-squared testing, the correlation analyses between the depressive status and OSA patient demographic and clinical variables were tested. Then depression-related risk factors in OSA patients were analysed using stepwise linear regression analysis. The effects of family and social factors on depressive status in OSA patients were investigated using Mann-Whitney U (one of nonparametric test).

Results

The prevalence of depressive status was 47.4% in OSA patients. Depressive status was significantly associated with female gender, single status, Family Burden Scale of Disease (FBS), Family APGAR Index (APGAR), apnoea-hypopnea index (AHI), and Perceived Social Support Scale (PSSS). Stepwise linear regression analysis further indicated that single status, hypoxemia, APGAR, AHI, PSSS, AHI, and FBS were all risk factors for depressive status in OSA patients. The total of the FBS score and three of its sub-factors scores (family daily activities, family relationships and mental health of family members) were higher, and the total of the APGAR score and two of its sub-factors scores (adaptability and affection) were lower in OSA with depressive status compared with the control group. Besides, the total score for the PSSS and scores for its two sub-factors (family support and social support) were all lower in OSA patients with depressive status than those of the control group.

Conclusions

Depressive status has high comorbid rate in Chinese OSA patients and is significantly associated with single status, apnoea-hypopnea index, hypoxemia, family and social supports.  相似文献   
970.
The objective of this study was to identify possible hygiene behaviors associated with the incidence of ILI among adults in Beijing. In January 2011, we conducted a multi-stage sampling, cross-sectional survey of adults living in Beijing using self-administered anonymous questionnaires. The main outcome variable was self-reported ILI within the past year. Multivariate logistic regression was used to identify factors associated with self-reported ILI. A total of 13003 participants completed the questionnaires. 6068 (46.7%) of all participants reported ILI during the past year. After adjusting for demographic characteristics, the variables significantly associated with a lower likelihood of reporting ILI were regular physical exercise (OR 0.80; 95% CI 0.74–0.87), optimal hand hygiene (OR 0.87; 95% CI 0.80–0.94), face mask use when going to hospitals (OR 0.87; 95% CI 0.80–0.95), and not sharing of towels and handkerchiefs (OR 0.68; 95% CI 0.63–0.73). These results highlight that personal hygiene behaviors were potential preventive factors against the incidence of ILI among adults in Beijing, and future interventions to improve personal hygiene behaviors are needed in Beijing.  相似文献   
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