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。

Application of a jigsaw puzzle flap based on free-style perforator to repair large scalp defects after tumor resection:A case series

Background:Reconstruction of large scalp defects after tumor resection is common and challenging.Free skin grafting or free flap transfer is always performed.However,these techniques can result in poor functional and cosmetic outcomes.Methods:In the Second Affiliated Hospital of Soochow University and the Second Affiliated Hospital of Chengdu Medical College,35 patients underwent jigsaw puzzle flap procedures based on a free-style perforator to repair large scalp defects after tumor resection from May 2013 to November 2022.The key to this procedure was to divide a large defect into several smaller parts that correspond to adjacent free-style perforators around the scalp defect.The free-style perforator flaps were designed in different ways,such as propeller flaps,rotation flaps,and V-Y advancement flaps,which were pedicled with free-style perforators.All of the small flaps were then mobilized to the defect and sutured to each other to create a new,large jigsaw puzzle-like flap to cover the large scalp defect.Finally,all the donor sites were closed directly.Results:Overall,35 patients were treated.The average defect size was 72 cm^(2)(range,25-91 cm^(2)).All flaps had a satisfactory appearance after follow-up periods of 6 months-10 years.Local tumor recurrence occurred in one case.Conclusion:The application of a jigsaw puzzle flap based on a free-style perforator is a suitable option for the reconstruction of large scalp defects after resection,yielding satisfactory functional and cosmetic results.

Resolving the“Matteo Ricci Puzzle”:Top-Level Design of the Grand Canal of China Based on the Ternary Leadership Theory

Guided by the ternary leadership theory from the perspective of social psychology,this paper explores the impacts of authoritarian,benevolent,and moral leadership on the top design of the Grand Canal of China in terms of its water management practice,while providing reference for resolving the“Matteo Ricci Puzzle”.The research findings are threefold:first,authoritarian as it is,the central government of China formulates relevant laws and regulations to provide legal system insurance for the construction of the Grand Canal Cultural Belt,thus providing the blueprint for constructing the“bright cultural belt,green ecological belt and colorful tourism belt of the Grand Canal”.Second,led by the Central Government,sticking to benevolent and moral leadership,China advocates scientific water management concepts and methods,and gives long-term and comprehensive care to the well-being of the people along the banks of the Grand Canal.Finally,the top-level design of the Grand Canal of China is based on the ternary leadership theory rooted in social psychology and has formulated a set of properly-scheduled,reasonably-coordinated,and flexibly-operated management system for the fundamental interests of the people and long-term goals of the country.

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.

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.

The Effect of the Menstrual Cycle on Cognitive Performance: Spatial Reasoning, Visual & Numerical Memory

The menstrual cycle has been a topic of interest in relation to behavior and cognition for many years, with historical beliefs associating it with cognitive impairment. However, recent research has challenged these beliefs and suggested potential positive effects of the menstrual cycle on cognitive performance. Despite these emerging findings, there is still a lack of consensus regarding the impact of the menstrual cycle on cognition, particularly in domains such as spatial reasoning, visual memory, and numerical memory. Hence, this study aimed to explore the relationship between the menstrual cycle and cognitive performance in these specific domains. Previous studies have reported mixed findings, with some suggesting no significant association and others indicating potential differences across the menstrual cycle. To contribute to this body of knowledge, we explored the research question of whether the menstrual cycles have a significant effect on cognition, particularly in the domains of spatial reasoning, visual and numerical memory in a regionally diverse sample of menstruating females. A total of 30 menstruating females from mixed geographical backgrounds participated in the study, and a repeated measures design was used to assess their cognitive performance in two phases of the menstrual cycle: follicular and luteal. The results of the study revealed that while spatial reasoning was not significantly related to the menstrual cycle (p = 0.256), both visual and numerical memory had significant positive associations (p < 0.001) with the luteal phase. However, since the effect sizes were very small, the importance of this relationship might be commonly overestimated. Future studies could thus entail designs with larger sample sizes, including neuro-biological measures of menstrual stages, and consequently inform competent interventions and support systems.

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。

Client Puzzle协议在防御资源耗尽型DoS攻击中的应用

文章在研究现有的被动式Client Puzzle协议(CPP)对防御资源耗尽型DoS攻击的基础上,结合分类服务的基本思想,在应用层提出了一个基于主动式CPP协议的HTTP请求分类服务系统模型(CPPWQ)。在对模型的分析和设计基础上,给出了它的一个实现原型,并在局域网条件下对原型系统的性能进行了测试和分析,验证了模型在防御资源耗尽型DoS攻击中的应用效果。

基于量子衍生算法的8-puzzle问题分析

阐述了量子编码形式的多样性,概述了8-puzzle启发式搜索问题的量子衍生算法与计算策略。通过设置扩展深度界限,运用量子计数器和酉变换操作进行8-puzzle问题的量子计算,比较了量子衍生算法与经典算法,对启发式智能搜索在量子计算机上的实现方式作了进一步的讨论。

3-puzzle量子计算的酉变换矩阵及逻辑线路

针对3-puzzle问题,运用量子计算方法分析了节点扩展的酉变换矩阵。对一个3-puzzle问题实例进行了元素编码和节点状态编码,描述了具体的节点扩展酉变换矩阵,并运用量子受控非门逻辑线路实现了酉变换矩阵。讨论了N-puzzle量子计算的线路模型,对量子位的基态和最佳基态的制备作了分析,阐述了N-puzzle启发式搜索量子计算框架。

基于AJAX的Client Puzzle协议框架的研究与实现

本文在研究了基于主动式Client Puzzle协议的HTTP请求分类服务系统模型(CPPWQ)的基础上,结合AJAX技术,实现了一个改进的ACPP模型。在对该模型的分析和设计基础上,本文给出了它的一个实现原型,并与原有模型做比较。

在AutoCAD中编程实现Sudoku puzzle的求解及生成

"数独"游戏目前颇为流行,日常见诸于各类报纸之端。其游戏规则较为简单,有利于计算机编程加以处理。本文利用AutoCAD附带的二次开发工具AutoLISP语言,编制了求解及生成数独谜题的程序,并用实例验证了程序的有效性。本文程序借助AutoCAD强大的界面功能,所编制的程序具有较好的用户交互性能。

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。

基于Puzzle的DHCP安全机制研究与实现

在深入研究DHCP协议的基础上,针对动态主机配置协议DHCP本身缺乏安全控制机制所导致的服务器端受Do S攻击时存在计算开销和存储开销过大等问题,提出了基于Puzzle的DHCP安全机制,通过Puzzle机制的谜题认证,利用资源平衡机制,对Puzzle难度系数动态调整,从而达到保护DHCP服务器的目的,并在Linux平台下实现和分析了改进的DHCP安全机制。

用计算机解决8 puzzle problem

本文介绍的是在计算机的发展过程中 ,利用不同的方法对同一个问题的解决。首先是在传统的图灵机模型下通过建立完整的求解模型后再通过程序运算完成问题的求解 ;

Client Puzzle协议综述

该文首先综述了现有的被动式 CPP 协议的理论和在防御资源耗尽型 Dos 攻击中的应用,在此基础上,结合分类服务的基本思想,在应用层提出了一个防御资源耗尽型 DoS 攻击的基于主动式 CPP 协议的 HTTP 请求分类服务系统模型(CPPWQ)。

等权Hanoi puzzle解的充分必要条件

提出等权 Hanoi Puzzle 的基本概念,并且推导出 Hanoi Puzzle 解的充分必要条件。