DSpace community: 高齡健康管理學研究所

Students’ learning experiences in a university physical education dance course within a blended learning environment

title: Students’ learning experiences in a university physical education dance course within a blended learning environment

智慧語音技術於社區高齡照護之可行性與挑戰-基於體驗課程的實證研究

title: 智慧語音技術於社區高齡照護之可行性與挑戰-基於體驗課程的實證研究

應用卷積神經網路於胸部X光片多標籤分類任務的性能提升研究

title: 應用卷積神經網路於胸部X光片多標籤分類任務的性能提升研究

以 MBTI 維度為基礎之高齡者人格與心理健康量表開發：宜蘭社區據點為例

title: 以 MBTI 維度為基礎之高齡者人格與心理健康量表開發：宜蘭社區據點為例

Navigating the technological landscape: a framework for understanding barriers to technology integration in physical education

title: Navigating the technological landscape: a framework for understanding barriers to technology integration in physical education abstract: This paper provides a comprehensive analysis of existing literature on the barriers hindering the effective integration of technology in physical education (PE). Utilizing a three-stage framework, this study examines the complex interplay of external and internal factors influencing PE teachers' adoption and implementation of technology. First-order barriers, encompassing resource limitations, inadequate funding, and insufficient access to technology devices, highlight the systemic constraints often faced by educators. Second-order barriers delve into the intrinsic challenges, including teachers' attitudes, beliefs, and self-efficacy in utilizing technology effectively within their pedagogical practices. Finally, third-order barriers address the complexities of design thinking, emphasizing the need for teachers to creatively and contextually incorporate technology to achieve desired learning outcomes. Through a multi-dimensional analysis of these three levels of barriers, this literature review aims to provide a comprehensive understanding of the challenges faced by in-service PE teachers in integrating technology into their teaching. The insights gained from this review can inform the development of targeted strategies and interventions to support PE teachers in effectively utilizing technology to enhance their teaching and students' learning experiences. This paper underscores the importance of addressing not only resource limitations but also the professional development needs of educators in fostering a technology-enhanced learning environment in PE.

Effects of implementation augmented reality in university dance courses on students' dance learning motivation and performance

title: Effects of implementation augmented reality in university dance courses on students' dance learning motivation and performance abstract: Introduction: In Taiwan, university physical education (PE) courses are expected to promote students' ability to explore and learn independently and develop their interests and habits in exercise and sports. Students have many different PE courses to choose from, including aerobic dancing. Common challenges in aerobic dancing include high heterogeneity and little time for independent thinking and movement learning. Students' lack of prior experience in the linkage of movement skills may also effect their learning process when creating aerobic movement programs during the course. This study combined an augmented reality (AR) movement device with elements of aerobic dance materials based on self-determination theory and social constructivism to design a teaching method to enhance students' performance and motivation. Methods: This study used a quasi-experimental design (i.e., a 12-hour course attended over six weeks with the same knowledge content for the experimental [EG] and control groups) was implemented. The EG class was taught with the additional help of AR technology. The aerobic dance routines were built using the three axes of aerobic dance (movement, rhythm, and style). The AR technology allowed students to compare movements and design the choreography independently. Experts measured learning outcomes before and after the learning module. Results: The EG showed significantly improved learning motivation and dance learning performance and greater courage in embracing challenges associated with movement changes, connections, and combinations. Using AR software and equipment and the overwhelming amount of information also impacted students' time spent on the AR technology and their willingness to use it. Conclusion: Using AR in the dance course enabled real-time visual learning and allowed students to reference and be inspired by choreography taught earlier. Overall, integrating AR into collegiate PE modules benefited students' dance learning outcomes and provided a better learning experience.

AI對大學體育舞蹈課的影響初探：應用與挑戰

title: AI對大學體育舞蹈課的影響初探：應用與挑戰

Enhancing Care Service Utilization and Reducing Burden: The Role of Needs Assessments for Dementia Caregivers in Long-Term Care

title: Enhancing Care Service Utilization and Reducing Burden: The Role of Needs Assessments for Dementia Caregivers in Long-Term Care abstract: Background Informal caregivers of people living with dementia often face significant physical and psychological burdens, which may limit their utilization of available support services. Needs assessments aim to identify these stressors and facilitate access to supportive resources. This study evaluates the effectiveness of needs assessments in enhancing service utilization and reducing the burden among informal caregivers of people living with dementia in central Taiwan. Methods A retrospective cohort study was conducted involving 464 informal caregivers of people living with dementia in central Taiwan, with data collected from January 2020 to December 2021. The primary outcome, caregiver burden, was assessed using the Zarit Burden Interview (ZBI) at the initial needs assessment (Time 1) and six months post-assessment (Time 2). Data on other variables, including service utilization, were collected at baseline, Time 1, and Time 2 through structured questionnaires. Linear regression analyses examined the relationships between caregiver burden, service utilization, and influencing factors. Results The implementation of needs assessments was associated with increased long-term care (LTC) service utilization. The proportion of caregivers using services rose from 37.3% at baseline to 45.5% after six months. The caregiver burden distribution shifted, with a reduction in moderate to severe burden (from 20.4 to 17.8%) and a slight increase in mild to moderate burden (from 43.7 to 47.2%). Linear regression analysis revealed several key factors influencing caregiver burden. Supportive resources were significantly associated with lower Zarit Burden Interview (ZBI) scores, an effect that often strengthened over time. Specifically, enhanced self-care abilities and the involvement of a foreign caregiver significantly reduced burden at both Time 1 (B = -4.79 and B = -5.44, respectively) and Time 2(B = -6.63 and B = -6.78, respectively). The positive impact of shared caregiving responsibilities became statistically significant at Time 2 mark (B = -5.86). Conversely, initial stressors were linked to higher burden. Caregiving for individuals with severe disabilities (B = 3.31) and the need to manage barrier-free environments (B = 5.06) were associated with greater burden at Time 1, though their influence diminished over time. Emotional strain was a strong predictor of increased burden at both time points (B = 3.51 at Time 1; B = 2.93 at Time 2), although its impact also lessened. Finally, older caregiver age was correlated with a lower burden at both time points. Conclusions The findings highlight the effectiveness of needs assessments in reducing caregiver burden and enhancing service utilization. Needs assessments play a critical role in identifying caregiver stressors and facilitating targeted interventions, essential for sustainable long-term care and caregiver well-being.

海洋教育融入水域運動對提升大學生海洋公民精神之研究

title: 海洋教育融入水域運動對提升大學生海洋公民精神之研究 abstract: 本研究旨在探討水域活動與海洋教育對大學生海洋公民精神的影響。海洋公民精神涵蓋個人對海洋環境保護的責任、義務及對海洋議題的關注。研究以淡水河獨木舟課程為核心，結合海洋教育議題，設計八週課程，對象為北部某私立大學50名學生，分為實驗組與對照組，進行前後測問卷調查，並採用共變數分析（analysis of covariance, ANCOVA）分析海洋公民精神量表中五項構面：海洋認知、海洋態度、地方依附、地方認同與行為改變。結果顯示，參與獨木舟課程的學生在海洋認知、地方認同與行為改變方面有顯著提升，但在海洋態度與地方依附上無顯著變化。另方面，將海洋教育融入課程雖對海洋態度、地方依附與行為改變有部分提升，卻未在海洋認知與地方認同上產生明顯差異。整體而言，水域活動與海洋教育對提升學生的海洋公民精神具正面效果。建議未來將此類課程納入正式教育體系，並擴大研究樣本與活動場域，以提供更多實證資料，深化海洋教育推廣與發展。

生成式人工智慧輔助適應體育課程提升學生自主學習

title: 生成式人工智慧輔助適應體育課程提升學生自主學習 abstract: 身心障礙學生在體育學習中常因認知困難、動作表現限制與自我效能不足而影響參與度，為改善此困境，本研究旨在結合生成式人工智慧（artificial intelligence, AI）鷹架與ARCS（attention, relevance, confidence, satisfaction）動機模式的教學策略，探討適應體育課程的應用成效，以及學生自主學習能力與學習動機之影響。以8名大學生為對象（男3人、女5人，年齡18～24歲），研究採用混合研究法，量化部分以兩種量表測驗，質性部分透過學生反思文本分析AI介入後的學習變化，檢驗學習構面與動機指標之相關性。研究結果顯示，學生在目標設定、自我規劃與滿足感構面上均有正向成長，並發現「專注力」與「自信心」呈現高度正相關，顯示AI能在學習動機歷程中提供潛在支持。本研究認為，若AI教學介入未搭配適切的教師引導與後設認知鷹架，學生可能出現對AI工具的依賴，導致學習動機下降與自我調節受限。建議未來研究應擴大樣本數、延長課程介入期，並設計更完善的AI人機協作架構與評估機制，以推動適應體育教學的永續發展與精緻化。

翻轉教室與傳統教學對瑜伽課程學生學習動機, 認知負荷與自我效能之影響

title: 翻轉教室與傳統教學對瑜伽課程學生學習動機, 認知負荷與自我效能之影響 abstract: 傳統教學中教師講授知識、學生被動接收訊息容易造成認知負荷過高，而翻轉教室強調學生課前自主學習、課堂互動和練習能有效降低外在認知負荷。本研究旨在探討不同教學模式（翻轉教室與傳統教學）及作業安排（有作業與無作業）對大學生瑜伽課程學習動機、認知負荷和自我效能的影響。研究對象為臺灣北部某綜合大學修習瑜伽課程的194位學生，大部分學生具備基本的瑜伽動作技能，少數為初學者。研究採用準實驗設計，將班級隨機抽籤分派為：翻轉教室有作業組（53人）、翻轉教室無作業組（56人）、傳統教學有作業組（52人）及傳統教學無作業組（33人），分析不同教學模式和作業安排對學生認知負荷、學習動機和自我效能的影響。研究結果顯示，翻轉教室能有效降低學生的認知負荷，然而對學習動機與自我效能並未帶來顯著提升，顯示可能需要更長期或更深入的教學介入；同時，作業安排雖在理論上可輔助課前學習並減少外在認知負荷，但其效果並不顯著。本研究結論為教師在實施翻轉教室前應充分評估教學能力與課程難度，適度調整作業量與難度，並在課堂中納入高層次思考與互動活動，協助學生在自主學習與同儕合作中深化理解與能力感。

海洋教育議題融入水域活動課程提升大學生水域安全素養

title: 海洋教育議題融入水域活動課程提升大學生水域安全素養 abstract: 游泳教學已在臺灣推動多年，但溺水事件仍頻繁發生，顯示除了游泳與自救能力的培養，水域安全素養的提升尤為重要。本研究目的在探討將海洋教育議題融入水域活動課程，對提升大學生水域安全素養的影響。研究對象為修習水上休閒活動實務課程的大學生，課程包括校內課程和淡水河獨木舟教學。研究採用問卷調查法，進行前後測比較，並透過教師觀察、學生心得、小組討論等方式進行多元評量。研究結果顯示，結合海洋教育及戶外教學的水域活動課程對學生的學習動機有正面影響，特別是在專注力和自信心方面有明顯進步。此外，學生的水域安全知識、行為能力和警戒知能也有顯著提升。本研究發現，將海洋教育融入水域活動課程能有效提升學生的水域安全素養。建議未來課程設計應持續結合實際操作與理論教學，並加強戶外教學的實施，以進一步提升學生的學習效果和安全意識。

是「守護」還是「手銬」:TAM 模型為中介探討健康監測科技對幸福感影響

title: 是「守護」還是「手銬」:TAM 模型為中介探討健康監測科技對幸福感影響

探討人工智慧在太極拳教學中的應用與影響

title: 探討人工智慧在太極拳教學中的應用與影響 abstract: 太極拳是一種源於中國的傳統武術，具有改善心臟健康、增強免疫系統等多種健康益處。然而，由於其動作流暢且節奏緩慢，學習太極拳對於初學者來說具有一定的挑戰。隨著人工智慧（artificial intelligence, AI）技術的發展，AI在運動和健康領域的應用越來越廣泛，特別是在運動訓練和傷害預防方面。AI動作辨識技術能夠實時、多人、準確地估計人體姿勢，並提供個性化的指導，這在太極拳教學中具有重要意義。本文介紹了建立AI太極拳動作辨識模型的過程，包括資料蒐集、特徵提取、模型構建和模型訓練。這些技術能夠協助學習者更有效地掌握太極拳的技巧和動作。此外，AI在太極拳教學中的應用實例顯示，AI可以提供實時反饋，改善學習質量，並結合虛擬現實和混合現實技術，提供更為互動的教學體驗。儘管AI在太極拳教學中帶來了許多優點，但也存在一些挑戰，如動作識別的準確性和動作生成的自然度。未來的研究方向包括改進動作識別的準確性、提高動作生成的自然度，以及利用AI進行太極拳教學輔助。總結來說，AI在太極拳教學中的應用為學習者提供了更好的訓練體驗和個性化的指導，但仍需找到AI教學與人類指導之間的平衡，以確保全面的學習體驗。

Changes in perceived distress among patients receiving inpatient palliative care

title: Changes in perceived distress among patients receiving inpatient palliative care abstract: Context Understanding the impact of palliative care on patient outcomes is crucial for enhancing end-of-life care. Objectives This study aimed to examine changes in perceived distress among patients receiving inpatient palliative care. Methods In this retrospective cohort study, data were collected from a palliative care unit in central Taiwan between January and December 2021. Patients were categorized into “survived to discharge” and “non-survivor” groups based on discharge status. The Symptom Assessment Scale (SAS) was used to measure subjective distress daily during hospitalization. SAS scores on the admission day were compared to days 3 and 7, with changes analyzed using the chi-square test. Results A total of 191 patients were included in the study. Significant differences in symptom intensity changes were observed for sleep disturbance, appetite problems, bowel issues, breathing difficulties, fatigue, and pain during the first week of hospitalization. In the “non-survivor” group, improvements in pain were noted over time; however, distress related to appetite, bowel function, and fatigue worsened. Conversely, the “survived to discharge” group showed continuous improvement in sleep disturbance and breathing distress throughout the hospitalization period. Conclusion This study offers insights into how inpatient palliative care differentially influences perceived distress based on patients’ end-of-life stage. Enhancements in palliative care approaches are needed to more comprehensively support patients, particularly those nearing the end of life.

智慧照護導入科技與高齡者幸福感關聯之初探：從應用現況與研究論述落差之文獻分析

title: 智慧照護導入科技與高齡者幸福感關聯之初探：從應用現況與研究論述落差之文獻分析

GPT與大學生科專計畫申請

title: GPT與大學生科專計畫申請

International climate policy dilemmas: Examining effective carbon tariff rate and cap-and-trade scheme regulation from a financing perspective

title: International climate policy dilemmas: Examining effective carbon tariff rate and cap-and-trade scheme regulation from a financing perspective abstract: This paper introduces a contingent claim model, offering a financial perspective on the global climate policy challenge. The model prioritizes the use of carbon tariffs to prevent carbon leakage and cap-and-trade initiatives to incentivize carbon emission reductions. In this model, manufacturers in an exporting country's supply chain collaborate with a life insurance company to acquire carbon allowances through the cap-and-trade mechanism. The importing country enforces carbon tariffs to protect its import-substitution industries and to prevent carbon leakage, assessed by the effective carbon tariff rate. Our findings show that increasing carbon tariffs on final products and intermediate goods reduces equity for both the life insurance company and the importer but strengthens carbon tariff protection. Conversely, a stricter regulatory cap within the exporting country's cap-and-trade system bolsters equity for the life insurance company and the importer but weakens carbon tariff effectiveness in the importing country. This dilemma underscores the urgent need for global collaboration in managing carbon emissions. Our research highlights the complex challenges of global climate policies. It is suggested to foster efficient and sustainable international cooperation in shaping climate policies to address these challenges.

Changes in perceived distress among patients receiving inpatient palliative care

由臺灣中老年長期追蹤調查結果探討行動能力下降趨勢與危險因子

title: 由臺灣中老年長期追蹤調查結果探討行動能力下降趨勢與危險因子 abstract: 目的：本研究藉由全國的中老年人問卷調查研究，探討臺灣地區老年人在4年期間行動能力演變趨勢。主要結果評估疾病對行動能力下降的影響，次要結果評估行動能力下降對於醫療資源應用的增加程度。方法：本研究為回溯性研究，利用衛生福利部衛生福利資料科學中心提供之2011年及2015年中老年調查資料，探討臺灣地區中老年人行動能力變化。研究資料包括受訪者的基本資料、一年內住院及急診就醫情形及日常活動量表，量表分數愈高代表行動能力愈差。利用多元羅吉斯回歸進行分析，找出影響活動能力下降的主要危險因子。結果：本研究於2011年納入3,727名受訪者，2015年再度對其中2,865人（76.9%）進行追蹤調查。受訪者中，女性1,470人（51.3%），男性1,395人（48.7%）。2011年的日常活動量表平均分數為4.4±6.7，2015年上升至6.14±8.4。1221人（46.6%）出現活動能力下降。多元邏輯斯迴歸分析結果顯示，影響活動能力下降的主要危險因子包括女性（Odds Ratio [OR] = 1.26, 95% Confidence Interval [CI]: 1.08-1.48）、高血壓（OR = 1.58, 95%CI: 1.34-1.86）、髖骨骨折（OR = 1.61, 95%CI: 1.05-2.46）以及白內障（OR = 1.88, 95%CI: 1.60-2.21）。結論：近五成老年人的行動能力會隨著年齡呈現下降趨勢。當老年人行動能力下降，其醫療資源的使用是有顯著的增加，不論是住院人數、人次或天數，還是急診就醫人數與人次。

Impulse oscillometry in patients with persistent post-COVID-19 symptoms: A retrospective study

title: Impulse oscillometry in patients with persistent post-COVID-19 symptoms: A retrospective study abstract: Introduction Impaired lung function has been observed in patients following COVID-19 infection, with studies reporting persistent lung volume and diffusing capacity impairments. Some studies have demonstrated significantly higher small airway resistance in COVID-19 positive cases. This retrospective study aims to examine impulse oscillometry (IOS) data of patients with persistent symptoms after COVID-19 infection, focusing on the relationship between time and symptoms. Material and Method The study analyzed data from adult patients with persistent symptoms who underwent IOS testing within and after 84 days from the diagnosis date. Result The results showed that patients within 84 days and those between 31 and 84 days had higher small airway resistance values, indicating peripheral airway disease. Patients with dyspnea exhibited higher IOS values compared to those with cough symptoms, suggesting more significant impairment in the peripheral airways. Conclusion The study highlights the importance of using comprehensive diagnostic tools like IOS to assess respiratory impairments in post-COVID-19 patients, particularly in the small airways. Understanding the relationship between time and symptoms can provide valuable insights for the treatment of peripheral airway dysfunction in post-COVID-19 patients.

Gender difference on the mediation effects of filial piety on the association between chronic obstructive pulmonary disease and depressive symptoms in older adults: A community-based study

title: Gender difference on the mediation effects of filial piety on the association between chronic obstructive pulmonary disease and depressive symptoms in older adults: A community-based study abstract: Filial piety is viewed as strong family support for older Chinese people, and strongly associated with depressive symptoms. It is unknown if there exists gender difference in the mediation effects of filial piety on the relationship between chronic obstructive pulmonary disease (manifested as lung function) and depression. We investigated whether filial piety mediates the association between lung function and depression in community-dwelling older men and women using the Healthy Aging Longitudinal Study in Taiwan (HALST). Community dwelling adults aged 65 and above were analyzed. Pulmonary function, depressive symptoms, and filial piety expectation (FPE) and receipt of filial piety (RFP) were collected. The interaction and mediation of filial piety between lung function and depression was analyzed. We found that in older men, forced expiratory volume in the first second (FEV1) was inversely correlated with depression (β = -0.1281, p = 0.004) with no mediation effect of FPE. In older women, FEV1 was negatively associated with FPE, but FPE did not increase the risk of depression (β = 0.0605, p = 0.12). In both older men and women, FEV1 was negatively associated with RFP, while RFP reduced the risk of depression (p< 0.001). In older women, the correlation between FEV1 was complete mediation of RFP. Results indicate that feelings of insufficient filial piety may increase the likelihood of depression, especially in elderly women with worse lung function. Although modest, the main mediation effect of filial piety was improvement of lung function in older subjects, which might decrease depression.

A Study on the Integration of Marine Education Into Water Sports to Enhance the Local Identity of University Students A Case Study of Canoeing in the Tamsui River

title: A Study on the Integration of Marine Education Into Water Sports to Enhance the Local Identity of University Students A Case Study of Canoeing in the Tamsui River abstract: 研究背景與動機：本研究探討將海洋教育融入水上運動，以提升大學生的地方認同感。以淡水河的獨木舟活動為例，旨在通過實地體驗，增進學生對當地環境的連結，推動海洋保育及環境責任感。研究方法及工具：採用單組前後測準實驗設計，對象為20名修讀水上休閒實務課程的學生。課程包括游泳池內的自救及獨木舟技術訓練，並在淡水河進行戶外獨木舟活動。使用學習動機量表及地方認同量表進行前後測評估。研究結果：學生在參與海洋教育課程後，地方認同感顯著提升，尤其是地方依附感。此外，海洋教育認知測驗分數也顯著提高，顯示課程有效增進學生的海洋知識。建議：建議進一步發展和推廣以淡水河為背景的水上運動及海洋教育課程，以增強學生的地方認同感和學習動機。同時，探索其他教學方法或工具，以進一步提升學生的海洋教育認知。

A Study on the Integration of Marine Education Into Water Sports to Enhance the Local Identity of University Students A Case Study of Canoeing in the Tamsui River

Return to school practices after hematopoietic cell transplantation: a survey of transplant centers in the United States

title: Return to school practices after hematopoietic cell transplantation: a survey of transplant centers in the United States abstract: To understand transplant center recommendations on return-to-school timing and related support for hematopoietic cell transplant (HCT) survivors, we conducted a two-phase, cross-sectional, web-based survey: In Phase I, medical directors of pediatric HCT centers from the National Marrow Donor Program/ Be The Match Registry were asked regarding the availability of a return to school standardized operating procedure (SOP). In Phase II, HCT physician members of the Pediatric Transplantation and Cellular Therapy Consortium were approached to study inter-physician practice variability regarding return to school post-HCT, factors affecting their decision-making, and support provided by HCT centers for return to school. Out of 46 respondents in Phase I (55% response rate), 28 (61%) reported having a SOP. Wide variations in recommendations were noted in 12 received SOPs. In Phase II, 122 physicians (60 centers) responded (30.6% response rate). The majority (60%) recommended autologous HCT recipients return to school within 6 months post-HCT but 65% recommended allogeneic HCT recipients return to school after 6 months or once off immunosuppression. Our findings indicate a lack of consensus within and across HCT centers regarding recommended return to school timing and underscore need for a guideline to standardize this process to ensure patient safety and re-integration into school.

What do patients think about palliative care? A national survey of hematopoietic stem cell transplant recipients

title: What do patients think about palliative care? A national survey of hematopoietic stem cell transplant recipients abstract: Palliative care (PC) benefits patients undergoing hematopoietic stem cell transplantation (HSCT), but it remains underutilized. Although transplant physicians report concerns regarding how patients perceive PC, HSCT recipients’ perceptions about PC remain unaddressed. We conducted a multisite, cross-sectional survey of autologous and allogeneic HSCT recipients 3 to 12 months after transplant to assess their familiarity, knowledge, and perception of PC, as well as their unmet PC needs. We computed a composite score of patients’ perceptions of PC and used a generalized linear regression model to examine factors associated with these perceptions. We enrolled 69.6% (250/359) of potential participants (median age = 58.1; 63.1% autologous HSCT). Overall, 44.3.8% (109/249) reported limited knowledge about PC and 52% (127/245) endorsed familiarity with PC. Most patients felt hopeful (54%) and reassured (50%) when they heard the term PC; 83% saw referral as a sign their doctor cared about what was happening to them. In multivariate analyses, patients who were more knowledgeable about PC were more likely to have positive perceptions of PC (B = 7.54, standard error = 1.61, P < .001). Patients’ demographics, HSCT features, quality of life, and symptom burden were not significantly associated with perceptions of PC. HSCT recipients have positive perceptions of PC, though many have limited knowledge about its role. Patients who were more knowledgeable about PC were more likely to have positive perceptions of PC. These data do not support transplant physicians’ negative concerns about how patients perceive PC and underscore the need to further educate patients and transplant physicians about PC.

An Implementation of Virtualized System for Energy Saving Concept

title: An Implementation of Virtualized System for Energy Saving Concept abstract: The study is mainly to explore information service of school affairs system, how virtualization establishes effective service policy for energy saving. No matter all walks of life are also closely associated with information service in today’s society. In recent years, in addition to steady and effective supply of information service, an attention on energy saving issue is paid with each passing day. Energy saving could not only minimize level of damage on natural environment, but also enable saving of electricity funds, and hence is highly emphasized by everybody. Server service provides optimal energy saving plan is via virtualization structure, in which how to plan for a more effective energy saving policy is a topic worth discussing. After establishment of complete virtualization and high availability structure by information service of school affairs system proposed in the study, long-term monitoring of electric power and performance difference by different system service time slots is conducted, to judge and analyze results, and to establish a set of energy saving policies, to expect to lower electricity used by system without affecting information backup and service supply. Combined with virtualization structure of school affairs system, energy saving policy for information service is proposed by the study, which could be applied to structure of virtual environment owned by academy or enterprises, to enable effective saving of electricity funds.

The Application of Remote Control Home Appliances Based on Bluetooth Phone App. the International Journal of Cognitive Performance Support

title: The Application of Remote Control Home Appliances Based on Bluetooth Phone App. the International Journal of Cognitive Performance Support abstract: Entering the era of science and technology, there are many inventions and researches developed in the modern society. Technologies have been gradually integrated as parts of modern life, especially on the mobile phone and computer. They are closely related to our life and generate far-reaching influence among people communication and convenience. A smart phone contains all functions launched to the era of market and goes far beyond the traditional role of a phone: communication. However, how to achieve convenience and simple manipulation is still an emerging issue. Therefore, we design a multi-function menu in an app program that allows you to select your required electrical remote control function in cell phone. A user delivers an instruction to the Bluetooth receiver through Bluetooth technology. Receiving the command, the Bluetooth receiver will further control home appliances and then controls home appliances. After that, we use TV remote control as the subject and design the required fundamental functions. Finally, we then extend this method to design Bluetooth receiver module or Bluetooth receiver of USB interface and apply to other home appliances. That is so-called smart appliances.

Recommendation system based on rule-space model of two-phase blue-red tree and optimized learning path with multimedia learning and cognitive assessment evaluation

title: Recommendation system based on rule-space model of two-phase blue-red tree and optimized learning path with multimedia learning and cognitive assessment evaluation abstract: Among the various indicators used by the Ministry of Education to assess the learning performance and competencies in Taiwan, a highly emphasized one for students in the vocational education system is the numbers of professional certification they have, which is also an important factor for vocational students to gain suitable job opportunities and to enhance their working competitiveness. As a result, the importance of obtaining professional certifications can never be over emphasized. Specifically, the numbers of certifications they obtained is highly related with the numbers of job opportunities they can expect. In this research, we propose a RS (Recommendation System) based solution. The proposed solution combines two-phase Blue-Red trees of Rule-Space Model and the optimized learning path, and is focused on remedying and analyzing the learning status of MTA courses with the goal of enhancing students’ pass rate of MTA certifications. In phase one, we then identify three SGs (Skill Groups) based on course information from the Certiport of Microsoft certification center, and the three SGs can be utilized for producing both concept maps and Blue-Red trees. In phase two, we classified ten chapters of MTA course into three SGs identified in phase one based on the similarities observed in the ten chapters and the three SGs. The three SGs will then be used for generating the needed concept maps and groups of Blue-Red trees. In this research, we generated three of each. The analysis is based on Rule-Space Mode for all learning objects in each skill group of phase two. For each pair of learning objects, we define the RW (Relation Weight) of them. From all learning paths, we calculate the Confidence Level values of each adjacent pairs of learning objects. Finally, we obtain the optimized learning path through the adoption of the inferred optimized learning path derivation algorithm from the combination of RW (Relation Weight) and CL (Confidence Level). It can be used in OCMLS (Online Course Multimedia Learning System) that recommended the optimized learning path of learning objects for learners to online self-learning, or to RS (Recommendation System) that provides the basis of self-learning remedies for RFRC (Recommended Form of Remedial Course). By adopting this recommendation system for giving guidance for students in preparing for the MTA (Microsoft Technology Associate) certification, we have observed good results in learning performance and pass rate.

Application of Deep Learning Techniques for Detection of Pneumothorax in Chest Radiographs

title: Application of Deep Learning Techniques for Detection of Pneumothorax in Chest Radiographs abstract: With the advent of Artificial Intelligence (AI) and even more so recently in the field of Machine Learning (ML), there has been rapid progress across the field. One of the prominent examples is image recognition in the medical category, such as X-ray imaging, Computed Tomography (CT), and Magnetic Resonance Imaging (MRI). It has the potential to alleviate a doctor’s heavy workload of sifting through large quantities of images. Due to the rising attention to lung-related diseases, such as pneumothorax and nodules, ML is being incorporated into the field in the hope of alleviating the already strained medical resources. In this study, we proposed a system that can detect pneumothorax diseases reliably. By comparing multiple models and hyperparameter configurations, we recommend a model for hospitals, as its focus on minimizing false positives aligns with the precision required by medical professionals. Through our cooperation with Poh-Ai Hospital, we acquired a total of over 8000 X-ray images, with more than 1000 of them from pneumothorax patients. We hope that by integrating AI systems into the automated process of scanning chest X-ray images with various diseases, more resources will be available in the already strained medical systems. Our proposed system showed that the best model that is used for transfer learning from our dataset performed with an AP of 51.57 and an AP75 of 61.40, with accuracy at 93.89%, a false positive of 1.12%, and a false negative of 4.99%. Based on the feedback from practicing doctors, they are more wary of false positives. For their use case, we recommend another model due to the lower false positive rate and higher accuracy compared with other models, which in our test shows a rate of only 0.88% and 95.68%, demonstrating the feasibility of the research. This promising result showed that it could be utilized in other types of diseases and expand to more hospitals and medical organizations, potentially benefitting more people.

Adding Centralized Electronic Patient-Reported Outcome Data Collection to an Established International Clinical Outcomes Registry

title: Adding Centralized Electronic Patient-Reported Outcome Data Collection to an Established International Clinical Outcomes Registry abstract: The importance of patient-reported outcomes (PROs) in cellular therapies, including hematopoietic cell transplantation (HCT) is highlighted in this study. Longitudinal collection of PROs in a registry is recommended for several reasons, yet to date, PROs are not routinely collected from HCT patients to augment clinical registry data. The aim of this study was to determine the feasibility of electronic PRO data collection by a national clinical outcomes registry, by assessing differences between who does and does not report PROs. We conducted a cross-sectional pilot collection of PROs from HCT recipients after treatment using computer-adapted tests from the Patient-Reported Outcome Measurement Information System (PROMIS). We implemented centralized data collection through the Center for International Blood and Marrow Transplant Research (CIBMTR) among patients who underwent HCT for myelodysplastic syndromes (MDS), were at least 6 months post-HCT, and spoke English or Spanish. The main objective was identifying patient, disease, and transplant-related differences associated with completion of electronic PROs. Patients were excluded from analysis if they were determined to be ineligible (deceased, did not speak English or Spanish, refused to be contacted by the CIBMTR). A total of 163 patients were contacted and potentially eligible to participate; of these, 92 (56%) enrolled and 89 (55%) completed the PRO assessment. The most frequent reason for incomplete surveys was inability to contact patients (n = 88), followed by declining to participate in the study (n = 37). There were no sociodemographic or age differences between those who completed the PRO survey (n = 89) and eligible nonresponders (n = 155). Patient scores were within 3 points of the US average of 50 for all symptoms and functioning except physical functioning. Responders and nonresponders did not exhibit meaningfully different sociodemographic characteristics. Difficulty contacting patients posed the greatest barrier and also provided the greatest opportunity for improvement. Once enrolled, survey completion was high. These results support standardizing centralized PRO data collection through the CIBMTR registry.

Trends in Allogeneic Hematopoietic Cell Transplantation Utilization and Estimated Unmet Need Among Medicare Beneficiaries with Acute Myelogenous Leukemia

title: Trends in Allogeneic Hematopoietic Cell Transplantation Utilization and Estimated Unmet Need Among Medicare Beneficiaries with Acute Myelogenous Leukemia abstract: Allogeneic hematopoietic cell transplantation (alloHCT) is a resource-intensive procedure and the sole potentially curative treatment available for patients with acute myelogenous leukemia (AML). Although Medicare coverage may help address a major financial barrier to accessing alloHCT, there remains an unmet need for alloHCT owing to sociodemographic disparities. This study examined trends and factors associated with the utilization of alloHCT and the estimated unmet need for alloHCT among Medicare beneficiaries with AML. This retrospective cohort study included patients (age 65 to 74 years) with a diagnosis of AML identified in Medicare claims data from 2010 through 2016. To study trends in utilization, transplantation rates were calculated as the number of patients who underwent alloHCT within 180 days and 1 year of diagnosis (numerator) divided by the total number of patients with AML within each diagnosis year (denominator). A multivariable logistic regression was used to identify factors associated with the likelihood of undergoing alloHCT within 1 year of diagnosis. Two approaches were applied to estimate the unmet need for alloHCT. The first approach used claims data to identify the potential need for alloHCT among patients who achieved complete remission for at least 90 days. The second approach used established National Marrow Donor Program (NMDP) methodology, which considers estimates of risk level, response to treatment, comorbidity, and early mortality, to identify the potential and unmet need for alloHCT. The overall estimated need and unmet need from 2010 to 2015 and over different time periods were evaluated for both approaches. The alloHCT rate within 180 days of diagnosis increased from 8% in 2010 to 15.8% in 2016 (P < .001), and the 1-year alloHCT rate also increased over time, from 11.9% in 2010 to 20.0% in 2015 (P < .001). The likelihood of undergoing alloHCT within 1 year of diagnosis was associated with diagnosis year, age, race, geographic region, Elixhauser Comorbidity Index, and population-level median household income. Between 2010 and 2015, the claims data approach estimated a lower potential need for alloHCT compared with the NMDP methodology estimate (27% versus 36%); both approaches estimated that 43% to 44% of patients with a potential need for alloHCT had an unmet treatment need. Despite the differences in estimated potential need between the 2 approaches, both showed a sustained unmet need but with a downward trend over time. Our data show that utilization of alloHCT has increased over time among Medicare beneficiaries with AML. Two approaches of need analysis were conducted for validation of estimated need and unmet need for alloHCT using claim-identified remission status, given the lack of cytogenetics and molecular information in claims data. Both approaches to estimating the unmet need for alloHCT found a downward trend over time; however, there are differences in utilization of alloHCT by age, race, geographic region, comorbidity, and socioeconomic status, indicating disparities in access to alloHCT among Medicare beneficiaries with AML. This suggests the need for policy efforts, research, and continued education to improve access to alloHCT and to close the gap between the actual utilization of alloHCT and the unmet need.

Return to school practices after hematopoietic cell transplantation: a survey of transplant centers in the United States

Enhancing Administrative Claims Data: Feasibility, Validation and Application of Linking Medicare Claims Data and National Marrow Donor Program Search Data

title: Enhancing Administrative Claims Data: Feasibility, Validation and Application of Linking Medicare Claims Data and National Marrow Donor Program Search Data abstract: Purpose Administrative claims data provide real-world service utilization of acute myeloid leukemia (AML) treatment, but lacks insight into treatment delays or barriers. The National Marrow Donor Program (NMDP)/Be The Match Search (Search) data contains information on donor search, but lacks information on treatment received if allogeneic hematopoietic cell transplant (HCT) is not performed. We hypothesized that linking these two data sets would create a rich resource to define factors associated with receiving HCT that could not be evaluated with either data set alone. Methods A subset of 2010-2016 Medicare administrative claims data was linked with Search data. A total of 5,351 patients with AML age 65-74 years (HCT = 607, no HCT = 4,744) were identified using Medicare. These patients were then linked to 93,800 records with a donor search between 2009 and 2016. Patient date of birth, sex, disease, ZIP code, transplant center/hospital, and diagnosis date were used for matching. Exploratory analysis was conducted to identify predictors associated with receiving HCT for patients with AML who received a search. Results The data sets were successfully linked, showing high sensitivity and specificity. The final cohort included 5,085 patients with AML (HCT = 533, no HCT = 4,552). Of 97 patients who received HCT without a matched search, more than 85% received a related donor HCT. Of those not receiving HCT, 609 had a matched NMDP search and 3,943 did not have a matched NMDP search. Multivariate analysis showed time to search, age, diagnosis year, race/ethnicity, and neighborhood education status associated with receiving HCT. Conclusion Methods herein demonstrate the feasibility of linking Search and Medicare data. Similar methods may be applied to answer critical questions regarding barriers to HCT, thereby identifying areas to improve access to care.

What do patients think about palliative care? A national survey of hematopoietic stem cell transplant recipients

title: What do patients think about palliative care? A national survey of hematopoietic stem cell transplant recipients abstract: Background: Palliative care (PC) benefits patients with cancer and those undergoing hematopoietic stem cell transplantation (HSCT), but remains under-utilized in HSCT. While transplant physicians have substantial concerns regarding how patients perceive PC, studies examining HSCT recipients' perceptions of PC are lacking. Methods: Between 11/2020-4/2021, the CIBMTR Survey Research Group conducted a multi-site cross-sectional survey of adult autologous and allogeneic HSCT recipients at 11 transplant centers in the United States who were 3-12 months post-transplant to assess their experience, knowledge, and perceptions of PC. Using validated questionnaires, we assessed patients' familiarity with PC, knowledge and perception of PC, unmet PC needs, quality of life, and symptom burden. We computed a composite score of patients' perceptions of PC (mean = 48.8, SD = 12.2). We used a generalized linear regression model to examine factors associated with patients' perceptions of PC. Results: Of 359 potentially eligible patients, 250 (69.6%) enrolled in the study and 249 were eligible for analysis. Median participant age was 58.1 years (IQR 16.6). Most were white (85.9%), non-Hispanic or Latino (95.2%), and male (53.0%). Overall, 63.1% underwent autologous HSCT. The most common diagnoses were multiple myeloma (42.2%), lymphoma (22.1%), leukemia (16.9%), and MDS/MPN (12.4%). Overall, 44.2% (110/249) of patients reported limited knowledge about PC and 51.0% (127/249) endorsed being familiar with PC. Most patients stated that when they hear the term PC, they feel hopeful (54%), and reassured (50%) while a minority reported feeling scared (21%), stressed (22%), or depressed (15%) [Figure 1]. Most endorsed that when a PC referral is suggested for them, they think their doctor really cares about what is happening to them (83%), and only 7% of patients stated that when a PC referral is suggested, they think their doctor has given up on them [Figure 2]. In multivariate analyses, patients who were more knowledgeable about PC were more likely to have a positive perception of PC (B = 7.54, SE=1.61, P < 0.001) compared to those who had less knowledge about PC. Patients with postgraduate education were more likely to have a negative perception of PC (B = -5.55, SE=2.60, P = 0.034) compared to those with high school education or less. Patients' demographics, HSCT type, diagnosis, unmet PC needs, quality of life, and symptom burden were not statistically significantly associated with their perceptions of PC. Conclusions: A substantial proportion of HSCT recipients report limited knowledge and familiarity with PC. Most patients reported positive perceptions of PC, and those who were more knowledgeable about PC were more likely to have positive perceptions of PC. These data do not support transplant physicians' concerns about how patients perceive PC and underscore the need for future interventions to further educate patients about PC to overcome barriers to PC utilization in HSCT.

Efficacy, safety, and cost of mobilization strategies in multiple myeloma: a prospective, observational study

title: Efficacy, safety, and cost of mobilization strategies in multiple myeloma: a prospective, observational study

Combining HAIC and Sorafenib as a Salvage Treatment for Patients with Treatment-Failed or Advanced Hepatocellular Carcinoma: A Single-Center Experience

title: Combining HAIC and Sorafenib as a Salvage Treatment for Patients with Treatment-Failed or Advanced Hepatocellular Carcinoma: A Single-Center Experience abstract: Background: Hepatic arterial infusion chemotherapy (HAIC) has been proven to be an effective treatment for advanced HCC. In this study, we present our single-center experience of implementing combined sorafenib and HAIC treatment for these patients and compare the treatment benefit with that of sorafenib alone. Methods: This was a retrospective single-center study. Our study included 71 patients who started taking sorafenib between 2019 and 2020 at Changhua Christian Hospital in order to treat advanced HCC or as a salvage treatment after the failure of a previous treatment for HCC. Of these patients, 40 received combined HAIC and sorafenib treatment. The efficacy of sorafenib alone or in combination with HAIC was measured in regard to overall survival and progression-free survival. Multivariate regression analysis was performed to identify factors associated with overall survival and progression-free survival. Results: HAIC combined with sorafenib treatment and sorafenib alone resulted in different outcomes. The combination treatment resulted in a better image response and objective response rate. Moreover, among the patients aged under 65 years old and male patients, the combination therapy resulted in a better progression-free survival than sorafenib alone. A tumor size ≥ 3 cm, AFP > 400, and ascites were associated with a poor progression-free survival among young patients. However, the overall survival of these two groups showed no significant difference. Conclusions: Combined HAIC and sorafenib treatment showed a treatment effect equivalent to that of sorafenib alone as a salvage treatment modality used to treat patients with advanced HCC or with experience of a previously failed treatment.

Meridian energy analysis may predict the prognosis of patients with advanced cancers receiving palliative care.

title: Meridian energy analysis may predict the prognosis of patients with advanced cancers receiving palliative care. abstract: Background and aim A better understanding of irreversible prognoses in palliative care is crucial for improving patients’ quality of life and their sense of dignity. We examined whether measurements of meridian electrical conductance can noninvasively and objectively predict survival time in a hospice patient population. Experimental procedure This was a single-center cohort study. Between 2019 and 2020, we measured skin conductance from 24 representative acupoints of 12 meridians on both sides of the body in 181 advanced cancer patients within 48 h of hospitalization and monitored their survival time. The Palliative Prognostic Score (PaP Score) was calculated for each patient, classifying them into one of three prognosis groups: Group A, B, or C. Factors associated with short-term and long-term survival were identified using multivariate regression analysis. Statistical differences in survival times were analyzed between the meridian electrical conductance measurements and PaP Scores. Results and conclusion Analyses of the clinicopathological data from terminal cancer patients revealed that male sex, mean meridian electrical conductance measurements of ≤8.8 μA, and PaP Scores in Group C were independent predictors of short-term survival. Mean meridian electrical conductance measurements of ≤8.8 μA demonstrated good sensitivity (85.1%) and adequate specificity (60.6%) for short-term survival. A survival curve analysis revealed a mortality rate of 90.6% at 30 days among patients with meridian electrical conductance measurements of ≤8.8 μA. A mean meridian electrical conductance measurement of ≤8.8 μA can objectively assess short-term survival with advanced cancer and reduce nonbeneficial medical treatment.

The outcomes of thoracoscopic decortication between fungal empyema and bacterial empyema

title: The outcomes of thoracoscopic decortication between fungal empyema and bacterial empyema abstract: Background Fungal empyema is an uncommon disease and is associated with a high mortality rate. Surgical intervention is suggested in stage II and III empyema. However, there were no studies that reported the outcomes of surgery for fungal empyema. Methods This study is a retrospective analysis in a single institute. Patients with empyema thoracis who underwent thoracoscopic decortication between January 2012 and December 2021 were included in the study. We separated the patients into a fungal empyema group and a bacterial empyema group according to culture results. We used 1:3 propensity score matching to reduce selection bias. Results There were 1197 empyema patients who received surgery. Of these, 575 patients showed positive culture results and were enrolled. Twenty-eight patients were allocated to the fungal empyema group, and the other 547 patients were placed in the bacterial empyema group. Fungal empyema showed significantly longer intensive care unit stay (16 days vs. 3 days, p = 0.002), longer median ventilator usage duration (20.5 days vs. 3 days, p = 0.002), longer hospital stay duration (40 days vs. 17.5 days, p < 0.001) and a higher 30-day mortality rate (21.4% vs. 5.9%, p < 0.001). Fungal empyema revealed significantly poorer 1-year survival rate than bacterial empyema before matching (p < 0.001) but without significant difference after matching. Conclusions The fungal empyema patients had much worse surgical outcomes than the bacterial empyema patients. Advanced age and high Charlson Comorbidity Index score are independent predictors for poor prognosis. Prompt surgical intervention combined with the use of antifungal agents was the treatment choice for fungal empyema.

Application of Deep Learning Techniques for Detection of Pneumothorax in Chest Radiographs

DSpace community: 高齡健康管理學研究所

Students’ learning experiences in a university physical education dance course within a blended learning environment

智慧語音技術於社區高齡照護之可行性與挑戰-基於體驗課程的實證研究

應用卷積神經網路於胸部X光片多標籤分類任務的性能提升研究

以 MBTI 維度為基礎之高齡者人格與心理健康量表開發：宜蘭社區據點為例

Navigating the technological landscape: a framework for understanding barriers to technology integration in physical education

Effects of implementation augmented reality in university dance courses on students' dance learning motivation and performance

AI對大學體育舞蹈課的影響初探：應用與挑戰

Enhancing Care Service Utilization and Reducing Burden: The Role of Needs Assessments for Dementia Caregivers in Long-Term Care

海洋教育融入水域運動對提升大學生海洋公民精神之研究

生成式人工智慧輔助適應體育課程提升學生自主學習

翻轉教室與傳統教學對瑜伽課程學生學習動機, 認知負荷與自我效能之影響

海洋教育議題融入水域活動課程提升大學生水域安全素養

是「守護」還是「手銬」:TAM 模型為中介探討健康監測科技 對幸福感影響

探討人工智慧在太極拳教學中的應用與影響

Changes in perceived distress among patients receiving inpatient palliative care

智慧照護導入科技與高齡者幸福感關聯之初探：從應用現況與研究論述落差之文獻分析

GPT與大學生科專計畫申請

International climate policy dilemmas: Examining effective carbon tariff rate and cap-and-trade scheme regulation from a financing perspective

Changes in perceived distress among patients receiving inpatient palliative care

由臺灣中老年長期追蹤調查結果探討行動能力下降趨勢與危險因子

Impulse oscillometry in patients with persistent post-COVID-19 symptoms: A retrospective study

Gender difference on the mediation effects of filial piety on the association between chronic obstructive pulmonary disease and depressive symptoms in older adults: A community-based study

A Study on the Integration of Marine Education Into Water Sports to Enhance the Local Identity of University Students A Case Study of Canoeing in the Tamsui River

A Study on the Integration of Marine Education Into Water Sports to Enhance the Local Identity of University Students A Case Study of Canoeing in the Tamsui River

Return to school practices after hematopoietic cell transplantation: a survey of transplant centers in the United States

What do patients think about palliative care? A national survey of hematopoietic stem cell transplant recipients

An Implementation of Virtualized System for Energy Saving Concept

The Application of Remote Control Home Appliances Based on Bluetooth Phone App. the International Journal of Cognitive Performance Support

Recommendation system based on rule-space model of two-phase blue-red tree and optimized learning path with multimedia learning and cognitive assessment evaluation

Application of Deep Learning Techniques for Detection of Pneumothorax in Chest Radiographs

Adding Centralized Electronic Patient-Reported Outcome Data Collection to an Established International Clinical Outcomes Registry

Trends in Allogeneic Hematopoietic Cell Transplantation Utilization and Estimated Unmet Need Among Medicare Beneficiaries with Acute Myelogenous Leukemia

Return to school practices after hematopoietic cell transplantation: a survey of transplant centers in the United States

Enhancing Administrative Claims Data: Feasibility, Validation and Application of Linking Medicare Claims Data and National Marrow Donor Program Search Data

What do patients think about palliative care? A national survey of hematopoietic stem cell transplant recipients

Efficacy, safety, and cost of mobilization strategies in multiple myeloma: a prospective, observational study

Combining HAIC and Sorafenib as a Salvage Treatment for Patients with Treatment-Failed or Advanced Hepatocellular Carcinoma: A Single-Center Experience

Meridian energy analysis may predict the prognosis of patients with advanced cancers receiving palliative care.

The outcomes of thoracoscopic decortication between fungal empyema and bacterial empyema

Application of Deep Learning Techniques for Detection of Pneumothorax in Chest Radiographs

是「守護」還是「手銬」:TAM 模型為中介探討健康監測科技對幸福感影響