基于Reason模型的SIF-Q260型电子小肠镜故障原因分析

根据武汉大学中南医院内窥镜中心SIF-Q260型小肠镜故障率高且维修成本高的情况,应用Reason模型,从环境影响、不安全监督、不安全行为前兆及不安全行为4个层面分析造成SIF-Q260小肠镜故障的原因,针对各个层面故障原因,从定期培训以规范内窥镜的洗消及使用、设置专人管理内窥镜并定期对内窥镜使用洗消的规范性进行监督及评价、完善内窥镜监管系统3方面拟定改进措施,堵住系统“漏洞”,为内窥镜质量控制措施的制定提供依据,可预防和减少内窥镜故障的发生。

Correlation between Reasons for Prescription and Karyotype Results in Patients Referred for Suspected Chromosomal Abnormalities

Karyotype prescription is based on clinical signs (or reasons for karyotype prescription) which are phenotypic manifestations associated with chromosomal abnormalities. The aim of this study was to establish a correspondence between karyotype indications and their results in patients. This was a retrospective study that was carried out in the Histology-Embryology-Cytogenetics laboratory of the University Hospital of Cocody-Abidjan from 2014 to 2019. 58 patient files were identified and included the indication or reason for prescribing a constitutional karyotype and the biological result obtained. An individual data sheet was used to collect the data. 17 reasons for prescription were identified and divided into 2 groups. Sexual ambiguity was the most frequent reason (29.3%). The first group (G1) represented the 10 reasons for which the karyotype results were normal. The second group (G2) corresponded of the 7 motives with normal or abnormal karyotype results. Several anomalies were listed according to these reasons: inversions, mosaics (anomalies of number and structure) and trisomy 21. The last was the most frequent chromosomal anomaly (69.24%). It was found in several reasons for karyotype prescription: malformations, neurological disorders, suspected trisomy and cardiac pathology. Several factors could explain these results, among which are the limits of the karyotype and the non-genetic causes that can induce these abnormal phenotypes. Complementary examinations to the karyotype are molecular cytogenetic techniques, notably fluorescence in situ hybridization (FISH) and array comparative genomic hybridization (Array-CGH).

The Reasons for Admission of Elderly Subjects in Intensive Care at the CHU Ignace Deen

Objective: To determine the reasons for admission of elderly subjects and the prognosis in general intensive care. Patients and Methods: Observational descriptive and analytical study with prospective collection of data over a period of one year from January 1 to December 31, 2021. Patients aged 65 or over were included. Abstract: During the study period, 223 cases were collected out of 587 patients admitted, giving a prevalence of 37.9%. The average age was 74.127.39 ± years with extremes of 65 and 96 years and a male predominance (58.7%). The comorbidities were dominated by arterial hypertension (71.3%). The patients were: transferred from medical and surgical emergencies (75.8%). The average admission time was 48.8 ± 29.8 hours. One hundred and eight patients had a Glasgow score between 3 and 7. The reasons for admission were dominated by vascular causes (51.6%). Strokes of any type accounted for 43.9% of these reasons for admission. The average time for carrying out the biological assessments and imaging was 41.8 ± 27.3 hours with the extremes of 3 and 89 hours, 37.2% had a complete assessment within 24 hours. The average duration of hospitalization was 7.10 ± 8.87 days with extremes of 1 and 72 days. The mortality rate was 71.7%. Conclusion: This study has made it possible to take stock of the reasons for the admission of elderly subjects to intensive care. It appears that vascular causes are the main reasons for admission with heavy comorbidities which results in high mortality.

Knowledge Reasoning Method Based on Deep Transfer Reinforcement Learning:DTRLpath

In recent years,with the continuous development of deep learning and knowledge graph reasoning methods,more and more researchers have shown great interest in improving knowledge graph reasoning methods by inferring missing facts through reasoning.By searching paths on the knowledge graph and making fact and link predictions based on these paths,deep learning-based Reinforcement Learning(RL)agents can demonstrate good performance and interpretability.Therefore,deep reinforcement learning-based knowledge reasoning methods have rapidly emerged in recent years and have become a hot research topic.However,even in a small and fixed knowledge graph reasoning action space,there are still a large number of invalid actions.It often leads to the interruption of RL agents’wandering due to the selection of invalid actions,resulting in a significant decrease in the success rate of path mining.In order to improve the success rate of RL agents in the early stages of path search,this article proposes a knowledge reasoning method based on Deep Transfer Reinforcement Learning path(DTRLpath).Before supervised pre-training and retraining,a pre-task of searching for effective actions in a single step is added.The RL agent is first trained in the pre-task to improve its ability to search for effective actions.Then,the trained agent is transferred to the target reasoning task for path search training,which improves its success rate in searching for target task paths.Finally,based on the comparative experimental results on the FB15K-237 and NELL-995 datasets,it can be concluded that the proposed method significantly improves the success rate of path search and outperforms similar methods in most reasoning tasks.

Deterioration Reason and Improvement Measure of the Retarding Effect of Protein Retarder on Phosphorus Building Gypsum

The retarding effect of protein retarder on phosphorus building gypsum(PBG)and desulfurization building gypsum(DBG)was investigated,and the results show that protein retarder for DBG can effectively prolong the setting time and displays a better retarding effect,but for PBG shows a poor retarding effect.Furthermore,the deterioration reason of the retarding effect of protein retarder on PBG was investigated by measuring the pH value and the retarder concentration of the liquid phase from vacuum filtration of PBG slurry at different hydration time,and the measure to improve the retarding effect of protein retarding on PBG was suggested.The pH value of PBG slurry(<5.0)is lower than that of DBG slurry(7.8-8.5).After hydration for 5 min,the concentration of retarder in liquid phase of DBG slurry gradually decreases,but in liquid phase of PBG slurry continually increases,which results in the worse retarding effect of protein retarder on PBG.The liquid phase pH value of PBG slurry can be adjusted higher by sodium silicate,which is beneficial to improvement in the retarding effect of the retarder.By adding 1.0%of sodium silicate,the initial setting time of PBG was efficiently prolonged from 17 to 210 min,but little effect on the absolute dry flexural strength was observed.

GATiT:An Intelligent Diagnosis Model Based on Graph Attention Network Incorporating Text Representation in Knowledge Reasoning

The growing prevalence of knowledge reasoning using knowledge graphs(KGs)has substantially improved the accuracy and efficiency of intelligent medical diagnosis.However,current models primarily integrate electronic medical records(EMRs)and KGs into the knowledge reasoning process,ignoring the differing significance of various types of knowledge in EMRs and the diverse data types present in the text.To better integrate EMR text information,we propose a novel intelligent diagnostic model named the Graph ATtention network incorporating Text representation in knowledge reasoning(GATiT),which comprises text representation,subgraph construction,knowledge reasoning,and diagnostic classification.In the text representation process,GATiT uses a pre-trained model to obtain text representations of the EMRs and additionally enhances embeddings by including chief complaint information and numerical information in the input.In the subgraph construction process,GATiT constructs text subgraphs and disease subgraphs from the KG,utilizing EMR text and the disease to be diagnosed.To differentiate the varying importance of nodes within the subgraphs features such as node categories,relevance scores,and other relevant factors are introduced into the text subgraph.Themessage-passing strategy and attention weight calculation of the graph attention network are adjusted to learn these features in the knowledge reasoning process.Finally,in the diagnostic classification process,the interactive attention-based fusion method integrates the results of knowledge reasoning with text representations to produce the final diagnosis results.Experimental results on multi-label and single-label EMR datasets demonstrate the model’s superiority over several state-of-theart methods.

Challenges Experienced by Nurse Educators in Promoting Acquisition of Clinical Reasoning Skills by the Undergraduate Nursing Students: A Qualitative Exploratory Study

Background: Clinical reasoning is an essential skill for nursing students since it is required to solve difficulties that arise in complex clinical settings. However, teaching and learning clinical reasoning skills is difficult because of its complexity. This study, therefore aimed at exploring the challenges experienced by nurse educators in promoting acquisition of clinical reasoning skills by undergraduate nursing students. Methods: A qualitative exploratory research design was used in this study. The participants were purposively sampled and recruited into the study. Data were collected using semi-structured interview guides. Thematic analysis method was used to analyze the collected data The principles of beneficence, respect of human dignity and justice were observed. Results: The findings have shown that clinical learning environment, lacked material and human resources. The students had no interest to learn the skill. There was also knowledge gap between nurse educators and clinical nurses. Lack of role model was also an issue and limited time exposure. Conclusion: The study revealed that nurse educators encounter various challenges in promoting the acquisition of clinical reasoning skills among undergraduate nursing students. Training institutions and hospitals should periodically revise the curriculum and provide sufficient resources to facilitate effective teaching and learning of clinical reasoning. Nurse educators must also update their knowledge and skills through continuous professional development if they are to transfer the skill effectively.

Assessing the Levels of Clinical Reasoning Skills Using Self-Assessment of Clinical Reflection and Reasoning in Undergraduate Nursing Students: A Descriptive Comparative Study

Background: Clinical reasoning is a critical cognitive skill that enables undergraduate nursing students to make clinically sound decisions. A lapse in clinical reasoning can result in unintended harm to patients. The aim of the study was to assess and compare the levels of clinical reasoning skills between third year and fourth year undergraduate nursing students. Methods: The study utilized a descriptive comparative research design, based on the positivism paradigm. 410 undergraduate nursing students were systematically sampled and recruited into the study. The researchers used the Self-Assessment of Clinical Reflection and Reasoning questionnaire to collect data on clinical reasoning skills from third- and fourth-year nursing students while adhering to ethical principles of human dignity. Descriptive statistics were done to analyse the level of clinical reasoning and an independent sample t-test was performed to compare the clinical reasoning skills of the student. A p value of 0.05 was accepted. Results: The results of the study revealed that the mean clinical reasoning scores of the undergraduate nursing students were knowledge/theory application (M = 3.84;SD = 1.04);decision-making based on experience and evidence (M = 4.09;SD = 1.01);dealing with uncertainty (M = 3.93;SD = 0.87);reflection and reasoning (M = 3.77;SD = 3.88). The mean difference in clinical reasoning skills between third- and fourth-year undergraduate nursing students was not significantly different from an independent sample t-test scores (t = −1.08;p = 0.28);(t = −0.29;p = 0.73);(t = 1.19;p = 0.24);(t = −0.57;p = 0.57). Since the p-value is >0.05, the null hypothesis (H0) “there is no significantno significant difference in clinical reasoning between third year and fourth year undergraduate nursing students”, was accepted. Conclusion: This study has shown that the level of clinical reasoning skills of the undergraduate nursing students was moderate to low. This meant that the teaching methods have not been effective to improve the students clinical reasoning skills. Therefore, the training institutions should revise their curriculum by incorporating new teaching methods like simulation to enhance students’ clinical reasoning skills. In conclusion, evaluating clinical reasoning skills is crucial for addressing healthcare issues, validating teaching methods, and fostering continuous improvement in nursing education.

IndRT-GCNets: Knowledge Reasoning with Independent Recurrent Temporal Graph Convolutional Representations

Due to the structural dependencies among concurrent events in the knowledge graph and the substantial amount of sequential correlation information carried by temporally adjacent events,we propose an Independent Recurrent Temporal Graph Convolution Networks(IndRT-GCNets)framework to efficiently and accurately capture event attribute information.The framework models the knowledge graph sequences to learn the evolutionary represen-tations of entities and relations within each period.Firstly,by utilizing the temporal graph convolution module in the evolutionary representation unit,the framework captures the structural dependency relationships within the knowledge graph in each period.Meanwhile,to achieve better event representation and establish effective correlations,an independent recurrent neural network is employed to implement auto-regressive modeling.Furthermore,static attributes of entities in the entity-relation events are constrained andmerged using a static graph constraint to obtain optimal entity representations.Finally,the evolution of entity and relation representations is utilized to predict events in the next subsequent step.On multiple real-world datasets such as Freebase13(FB13),Freebase 15k(FB15K),WordNet11(WN11),WordNet18(WN18),FB15K-237,WN18RR,YAGO3-10,and Nell-995,the results of multiple evaluation indicators show that our proposed IndRT-GCNets framework outperforms most existing models on knowledge reasoning tasks,which validates the effectiveness and robustness.

基于改进Reason模型的航空事故人为维修差错解析与预防

当今航空工业发展迅猛,航空器制造管理技术日趋成熟,重大航空事故发生率逐年下降,但维修差错相关事故占比却不降反升。本文首先利用数组数据,证明了因维修差错造成的事故在航空事故中的占比在逐渐提高。其次利用Reason模型提出了一种归纳方法,利用历史航空事故数据进行分析,通过讨论各类维修差错致因在航空事故Reason模型中的占比,给出减少维修差错的建议。

Reason模型在肝癌介入术病人围术期护理安全管理中的应用分析

目的:探讨Reason模型在肝癌介入术病人围术期护理安全管理中的应用效果。方法:应用Reason模型对2020年6月-2021年6月22例次肝癌介入术病人围术期护理安全不良事件进行回顾性分析,从不安全行为、不安全性前提、不安全监督、组织管理4个方面分析原因并制定解决方案,比较方案实施前后护理安全不良事件发生率。结果:实施Reason模型后肝癌介入术病人围术期护理安全不良事件发生率为0.135%,显著低于实施前的0.586%(P<0.05)。结论:基于Reason模型的管理有利于深度挖掘护理管理问题,降低护理安全不良事件发生率,有助于改变医护人员对不良事件上报的态度,保障病人安全。

A Brief Analysis Reasons of English Shortening Words

Shortening is one of important word formations which demands attentions of both teachers and students. The paper first briefly introduces shortening words in English into clipped words, initialisms, acronyms and blends,and then it mainly explores the reasons why shortening words appear and become popular.

Characteristics and Reasons for Catchwords' Emergence

All social phenomena are,to some extent,determined by economy,and language is also under the leverage of economic factor.With the development of society,economy,science and economy,human interpretation and consciousness of their language have been greatly enhanced.The exploration of catchword can be developed from its definition,its characteristics and reasons for its emergence.

Reasons of Taoism in Robert Bly's Poetry

Bly's preference of Taoist thoughts to Western philosophy and ideology in his poetry has its deeper reasons. It is his secluded life attitude and his poetics construction that promote him to learn from the ancient Chinese poetry which contains adequate Taoist ideas.

STUDY ON WETLAND LOSS AND ITS REASONS IN CHINA

Wetlands are ecosystems with many f unctions.But the general public and government lack a comprehen-sive understanding of the importance of wetland benefits,thus making bl indly exploitation,wetland resour ces decreasing and losing biodiversity.So wetlands in China,as in most countries,have suffered heavily from the pressure o f develop-ment and have confronted with the thr eats of loss.The paper takes Sanjian g Plain marshes,lakes in the middle r eaches of the Changjiang(Yangtze)River,coastal wetlands and mangroves as cases to study wetland loss in China,and puts forward main existing reasons of wetland loss,such as blindly reclamati on and exploitation of wetland resou rces,over-exploitation of bio-resource s in wetland,etc.More recently,there has been a growing recognition of t he benefits of wetlands and a wide range of legal and regulatory initiatives have been undertaken which are designed to impro ve wetland management and conservation.On the basis of the above analysis,the paper brings forward some suggestions on wetland conservation.

Prevalence Reasons and Monitoring Countermeasures of Scab in Eastern Wheat Area of Jiangsu Province

With the increasing prevalence frequency and aggravating harm degree in the 21st century, wheat scab had become a recurrent disease in eastern wheat area of Jiangsu Province. This paper reviewed general occurrence situation of wheat scab in eastern Jiangsu, and summarized its occurrence characteristics in last decade. The disease prevalence was elaborated from the aspects of fungal source quantity, chmatic conditions, cultivation modes, variety resistance and pesticide resistance. The author put forward a series of measures and countermeasures, including strengthening resistance monitoring and early warning, promoting and cultivating disease-resistant varieties, compressing planting area of direct seeding rice, canting out chemical control scientifically, and realizing unified prevention and control, in order to provide a scientific basis for the control of wheat scab.

Reasons for Permanent Tooth Extraction in the West of Kabul

Background: There has been no study in Kabul on reasons for permanent tooth extraction. This study aimed to determine the prevalence and reasons for tooth loss in a sample from two dental clinics in the west of Kabul. Methods: During a 6-month period (April-September 2019), the reasons for every extraction of a permanent tooth were recorded. Different reasons for tooth extraction were assigned, such as, dental caries, periodontal disease, eruption problems, trauma, orthodontics and others. The data requested for each extraction were: patient age, gender, previous treatment, educational level, type of tooth removed and the reason for its extraction. Results: young people aged between 20 - 29 years old had the highest percentage of extraction. Periodontal disease (39%) followed by caries (20%) was the most common reason for tooth extraction. Maxillary and mandibular first molars were removed most frequently (31%). 29% of patients have treated their teeth before extraction and RCT (Root Canal Treatment) (19%) is the most common previous treatment. Tooth loss has an opposite relationship with education level. People with high education level, loose their tooth less (14%). Conclusion: periodontal disease was the most common reason for tooth loss in Kabul, Afghanistan and a high percentage of tooth loss is seen among young people. Educating and preventive programs need to be implemented in order to reduce tooth loss.

Reasons for Delayed Breastfeeding Initiation among Newly Delivered Women in Two First-Category Hospitals in Yaoundé, Cameroon

Introduction: Exclusive breastfeeding is fundamental for the good health and development of the mother and the child. According to the World Health Organization (WHO), breastfeeding after childbirth should be initiated within 30 minutes. For a number of reasons, WHO recommendations on guiding principles for infants and young children feeding are often not followed. Objective: To determine the reasons for the delayed initiation of breastfeeding in newly delivered women. Means and Method: We carried out a mixed cross-sectional study over a period of six months from December 1st 2018 to May 31st 2019, at the Yaoundé Gynaeco-Obstetric and Pediatric Hospital. We included all mothers with full-term or premature babies weighing ≥ 2000 grams and those whom initiated breastfeeding more than one hour after delivery. The mother’s reasons for delaying breastfeeding initiation were recorded using a dictaphone and data were accurately extracted for analysis. Results: We interviewed 153 mothers. Their mean age was 27.9 ± 6.2 years. The main reasons for delaying breastfeeding initiation were caesarean delivery (22%), the belief in “spoiled milk” (21%), lack of knowledge about the time to initiate breastfeeding (21%), baby asleep (18%), and lack of instruction given to the mother by the health staff (2%). Conclusion: Delayed breastfeeding was common in our context. Improving the quality of breastfeeding involves communication, to break beliefs about spoiled milk, and strengthening mothers’ knowledge for optimal breastfeeding processes in accordance with WHO’s guidelines. The medical staff should anticipate and undertake the early initiation of breastfeeding in babies from mothers who deliver through caesarean section.

Reasons and Solutions of the Time-consuming College English Teaching with Low Efficiency

College English teaching has been regarded as time- consuming with low efficiency for a long time. This thesis proceeds with the entity of English education in China, deals with the main problems lying in the current college English teaching from 3 perspectives, including the nation and society, teachers, and students, and provides 5 suggestions accordingly.

Psychometric characteristics of the Reasons for Death Fear Scale among Iranian nurses

Objectives:Death fear is the main subject in thanatology.Several researchers have defined different reasons for fear of death.This study aimed to explore the performance of the Farsi version of the Reasons for Death Fear Scale(RDFS)among a convenience sample of Iranian nurses(n=106).Methods:The nurses were selected by the convenience sampling method and were asked to complete the RDFS,Death Concern Scale,Collett-Lester Fear of Death Scale,Death Anxiety Scale,Death Depression Scale,and Death Obsession Scale.Results:For the RDFS,the Cronbach's a coefficient was 0.90,and the 2-week test-retest reliability was 0.64.The RDFS was correlated at 0.34,0.39,0.50,0.35,and 0.39 to the above-mentioned five scales,indicating its good construct and criterion-related validity.Based on the exploratory factor analysis,the RDFS-identified four factors accounted for 66.20%of the variance and were labeled as"Fear of Pain and Punishment,""Fear of Losing Worldly Involvements,""Religious Transgressions and Failures,"and"Parting from Loved Ones."Conclusions:The RDFS presents good validity and reliability and can be used in clinical and research settings in Iran.