PLoS ONE最新文献

The primary aim of this study is to measure the competency gaps between industry expectations and current competencies of recent Chinese quantity surveying graduates from higher vocational colleges, using self-reported data. An innovative measure with a high-dimensional measurement error model was utilized to evaluate competency gaps. We used a quantitative technique with purposive sampling to collect data via a questionnaire survey of quantity surveying graduates with a higher vocational diploma who had worked in China for no more than three years. The findings indicate a competency gap in job matching between quantity surveying higher vocational college graduates' performance and industry expectations. The personality competency gap is medium, whereas the knowledge, skills, and ethical gaps are minimal. The top three gaps are in business administration, personal image, and innovative insight. The study's findings highlight the need for training programs focused on management and personality development for quantity surveying higher vocational college graduates. They also emphasize the importance of quantity surveying professionals acquiring interdisciplinary skills through educational programs that combine management with personality attributes such as personal image and innovative insight.

Background: Clinical management of tinnitus remains challenging due to unclear etiology and diverse phenotypic manifestations. To quantify its associated burden, a variety of patient-reported outcome measures (PROMs) are used. This study aims to comprehensively evaluate the content overlap of items between eight PROMs commonly used in tinnitus research.

Methods: A two-stage, blinded multi-rater process was used to analyze the content of all 199 items from the International Tinnitus Inventory (ITI), Subjective Tinnitus Severity Scale (STSS), Tinnitus Functional Index (TFI), Tinnitus Handicap Inventory (THI), Tinnitus Handicap Questionnaire (THQ), Tinnitus Primary Function Questionnaire (TPFQ), Tinnitus Questionnaire (TQ), and Tinnitus Reaction Questionnaire (TRQ). The Jaccard Index was used to measure pairwise content overlap between scales.

Results: The analysis revealed 83 distinct symptoms. "Concentration" was the most frequently captured symptom (in seven scales), whereas 41 symptoms (49.4%) were unique to one scale. The TQ exhibited the highest number of unique symptoms (52.5%), while the THI had the least (4%). The Jaccard Index identified very weak/weak scale overlap between the PROMs. The highest overlap was observed between TFI and THI (0.35). The TFI had the highest mean overlap (0.26), coming closest to the content measured by all other PROMs.

Conclusion: The results demonstrate high heterogeneity and limited content overlap among tinnitus burden PROMs, similar to other conditions. The findings suggest that tinnitus burden is not measured as a unified construct across questionnaires, thus, researchers and clinicians should carefully consider the specific symptoms measured when selecting instruments for treatment evaluation and comparison.

Background: Knee arthroplasty remains one of the most important treatment options in improving quality of life for patients with end-stage knee osteoarthritis. However, roughly 20% of patients remain dissatisfied with their outcome. Perceived implant instability and range of motion are factors that may contribute to dissatisfaction. The medial pivot (MP) total knee replacement (TKR) is postulated to provide increased stability due to greater implant conformity and replication of anatomical function compared to cruciate retaining (CR) implants. This systematic review and meta-analysis evaluates the impact of MP TKR on patient reported outcome measures (PROMs,) range of motion (ROM), pain scores and functional assessment measures in comparison to traditional CR implants.

Methods and findings: An extensive literature search of multiple databases was conducted to identify eligible high quality studies which compared PROMs data for MP and CR TKR, with a minimum of 12 months follow-up. Our primary outcome was the forgotten joint score (FJS-12). Secondary outcomes included additions PROMs, ROM data and functional assessments. Risk of bias and quality of research were assessed by GRADE rating and the AMQPP tool respectively. A total of 7 articles were included in the systematic review, encompassing 675 patients aged 59-86 years. Four studies assessed FJS-12, with mean difference of 7.46 (-2.44-17.37) in favour of MP TKRs, which was not statistically significant. Overall, 1415 PROM scores from 675 patients were included, giving a statistically significant difference 0.34 (0.16-0.52) and an effect size of 3.69 (p = 0.0002) in favour of MP designs utilising a standardised mean difference analysis. ROM data demonstrated an overall statistically significant mean difference of 4.63° (1.00-8.27) in favour of MP knees. Further functional outcomes, laxity, power measures demonstrated favourable outcomes for MP knees but were ineligible for inclusion in pooled analyses.

Conclusion: No statistical difference was observed for the majority of PROMs. PROMs including FJS-12, range of motion and functional outcome scores trended towards favouring MP TKRs; with a statistically significance advantage seen for pooled PROMs scores and ROM. However, there remains limited data relating to functional outcome measures within the literature. Further high-powered, multicentre studies are required to analyse whether MP TKRs are superior to CR TKRs regarding functional outcomes.

Background: Dementia poses an increasingly serious public health challenge worldwide, particularly in China, where home-based care remains the primary form of management. Family caregivers of older adults with moderate-to-severe dementia often experience a substantial caregiving burden, which can adversely affect both their own well-being and that of the patients.

Objective: This study aimed to examine the level of caregiver burden among family caregivers of older adults with moderate-to-severe dementia and to explore the relationships between patient activities of daily living (ADL), quality of life (QoL), depression severity, caregiver QoL, depression severity, and caregiver burden.

Methods: A cross-sectional study in 22 tertiary general hospitals in Shanxi Province, China, involved 529 dyads of older adults with moderate-to-severe dementia and their family caregivers. Caregivers completed the Zarit Burden Interview, the Patient Health Questionnaire-9, and the World Health Organization Quality of Life-Brief Version. Older adults completed the Patient Health Questionnaire-9, the Activity of Daily Living Scale, and the Quality of Life in Alzheimer's Disease scale. Structural equation modeling evaluated relationships among patient ADL, QoL, depression severity, caregiver QoL, depression severity, and caregiver burden.

Results: Patient QoL, ADL, and caregiver QoL had direct negative effects on caregiver burden, whereas patient and caregiver depression severity had direct positive effects on caregiver burden. Meanwhile, caregiver QoL partially mediated the relationships between patient QoL, depression severity, ADL, caregiver depression severity, and caregiver burden.

Conclusion: The results indicate that higher patient QoL, better patient ability in ADL, higher caregiver QoL, and lower levels of depressive severity in both patients and caregivers are associated with reduced caregiver burden. Healthcare professionals should implement family-centered, comprehensive interventions to alleviate caregiver burden.

Athletic training is characterized by physiological systems responding to repeated exercise-induced stress, resulting in gradual alterations in the functional properties of these systems. The adaptive response leading to improved performance follows a remarkably predictable pattern that may be described by a systems model provided that training load can be accurately quantified and that the constants defining the training-performance relationship are known. While various impulse-response models have been proposed, they are inherently limited in reducing training stress (the impulse) into a single metric, assuming that the adaptive responses are independent of the type of training performed. This is despite ample evidence of markedly diverse acute and chronic responses to exercise of different intensities and durations. Herein, we propose an alternative, three-dimensional impulse-response model that uses three training load metrics as inputs and three performance metrics as outputs. These metrics, represented by a three-parameter critical power model, reflect the stress imposed on each of the three energy systems: the alactic (phosphocreatine/immediate) system; the lactic (glycolytic) system; and the aerobic (oxidative) system. The purpose of this article is to outline the scientific rationale and the practical implementation of the three-dimensional impulse-response model.

Identifying drivers of deforestation is crucial for developing targeted conservation and land management strategies, and satellite data provide a long time series of data to understand deforestation dynamics. However, the timing of imagery after forest loss may affect classification accuracy, and optimal timing may be different for different drivers. Studies of broad-scale drivers across large and pan-tropical regions have shown that using time series can improve driver classification from satellite imagery, but requiring multi-year information means waiting longer after forest loss to classify what drives it. Our previously introduced model, Cam-ForestNet, was developed to use single-date imagery to classify fifteen direct detailed deforestation and degradation drivers for Cameroon. Here, we test whether the overall and per-class classification performance of Cam-ForestNet can be improved by either using imagery taken longer after a forest loss event or by incorporating a greater number of images, with performance evaluated using macro-average and per-class F1 scores to enable broad comparability across different contexts. Combining data up to four years after forest loss leads to improved model performance overall (macro-average F1 score) and for nearly all individual classes (per-class F1 scores). The classification of degradation drivers and slow-growing plantation benefitted most by incorporating time series data. However, when comparing approaches using only a single image from different years after a forest loss event, images from the first year following an event performed best, both overall (macro-average F1 score) and for most classes (per-class F1 scores), offering a promising strategy for relatively fast analysis of deforestation and degradation drivers following forest loss. We conclude that whilst multi-year imagery is beneficial, relying on a single image from the first year after forest loss still provides valuable and timely insights into the nature of drivers of forest loss.

The research is motivated by the strategic integration of moral and value education into China's college English curriculum and the critical role of textbooks as value carriers in EFL education. Despite growing attention to value integration in EFL materials, empirical studies on moral and value representation in oral English textbooks remain sparse, and learners' perspectives on value acquisition through oral instruction are underexplored-this study aims to address these gaps. The study employed a mixed-methods approach: the researcher systematically analyzed 318 pages of New Inside Out Book 1 and Book 2 (first-year college EFL oral English textbooks), screening all module types including vocabulary, grammar, dialogue, listening, reading, writing, and exercise for value-related content, which was then coded and recorded in Excel. Frequency statistics show the sample textbooks include 273 value-laden verbal text samples, with a Chi-Square Test revealing statistically significant differences in dimension emphasis between the two volumes. Within Martin and White's (2005) Language Appraisal Theory, qualitative textual analysis identifies the value significance of linguistic resources as a prominent feature across module types. Additionally, to gather learner feedback on the effectiveness of value education in the oral English course, an online questionnaire survey (via Wen Juan Xing platform) was administered to learners who used the selected EFL oral English textbooks for a whole academic year. The survey showed that values-based EFL instruction positively impacted morality and personal growth.

Reliability evaluation of park-level integrated energy systems (PIES) requires capturing the complex interactions among electricity, gas, thermal, and building subsystems, which exhibit typical multiscale dynamic behaviors. Although existing studies have partially considered the dynamic characteristics of PIES, the critical transient responses and the long-term impacts of heat supply interruptions on human health are overlooked. To address these gaps, this paper proposes a reliability evaluation method based on quasi-steady-state simulation. The dynamic behaviors of the electricity, gas, and heating systems, as well as buildings, are analyzed to develop simplified quasi-steady-state models for both energy demand under normal conditions and indoor temperature evolution under extreme scenarios. A new reliability index is then formulated by incorporating the thermal inertia of district heating networks and the temperature tolerance of occupants, forming a comprehensive framework for PIES reliability assessment. Case studies verify that the proposed method enhances the accuracy and interpretability of reliability evaluations, bridging the gap in user health considerations under extreme conditions. The results further reveal that building thermal dynamics play a dominant role in determining the overall reliability performance of PIES.

Background: Systemic lupus erythematosus (SLE) is a heterogeneous autoimmune rheumatic disease whose epidemiology and clinical prognosis vary by race and sex. Observed disparities in SLE may be partly attributable to cognitive processes in clinical decision-making, which can influence diagnostic accuracy and clinical management. We aimed to examine variation in primary care physicians' (PCP) diagnosis and management of SLE when all content of a clinical case is identical, apart from race and sex.

Methods: We distributed an online randomized factorial survey from 04/11/2024-06/10/2024 to PCPs across the US. Participants were presented with one of four possible SLE vignettes - Black female, White female, Black male, White male - for which all other clinical content was identical. Block randomization was used to randomly modify the race (Black/White) and sex (female/male) of the SLE "case". Primary outcomes were correct text-based responses for SLE diagnosis at initial case presentation and after reviewing additional lab results. Secondary outcomes were participants' review time and planned next steps (treatment, referral, tests) as a proxy for cognitive bias and certainty, respectively. We calculated descriptive statistics for all outcomes stratified by assigned randomized factor and used chi-square tests to evaluate between-group differences.

Results: 1031 PCPs (42.7% women, mean age 52.1 ± 12.1 years) completed the case. At initial presentation, 63.9% of participants correctly identified SLE as a differential diagnosis. An initial diagnosis of SLE significantly differed by the race and sex of the case (p < 0.001), with the highest proportion of correct diagnoses occurring for Black female cases (72.2%) and lowest for White male cases (55.3%). Median review time for correct initial diagnoses was longest for White male cases (175 s). After participants reviewed lab results, the overall proportion assigning a final diagnosis of SLE (63.9%) remained unchanged from the initial diagnosis.

Conclusion: A patient's race and sex may influence diagnostic accuracy and clinical decision-making for SLE in primary care. The observed variation in diagnostic accuracy, which aligns with the descriptive epidemiology of SLE, highlights the need for targeted interventions to ensure equitable diagnostic processes.