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。

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.

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.

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.

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.

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.

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。

Local-to-Global Causal Reasoning for Cross-Document Relation Extraction

Cross-document relation extraction(RE),as an extension of information extraction,requires integrating information from multiple documents retrieved from open domains with a large number of irrelevant or confusing noisy texts.Previous studies focus on the attention mechanism to construct the connection between different text features through semantic similarity.However,similarity-based methods cannot distinguish valid information from highly similar retrieved documents well.How to design an effective algorithm to implement aggregated reasoning in confusing information with similar features still remains an open issue.To address this problem,we design a novel local-toglobal causal reasoning(LGCR)network for cross-document RE,which enables efficient distinguishing,filtering and global reasoning on complex information from a causal perspective.Specifically,we propose a local causal estimation algorithm to estimate the causal effect,which is the first trial to use the causal reasoning independent of feature similarity to distinguish between confusing and valid information in cross-document RE.Furthermore,based on the causal effect,we propose a causality guided global reasoning algorithm to filter the confusing information and achieve global reasoning.Experimental results under the closed and the open settings of the large-scale dataset Cod RED demonstrate our LGCR network significantly outperforms the state-ofthe-art methods and validate the effectiveness of causal reasoning in confusing information processing.

Critical Relation Path Aggregation-Based Industrial Control Component Exploitable Vulnerability Reasoning

With the growing discovery of exposed vulnerabilities in the Industrial Control Components(ICCs),identification of the exploitable ones is urgent for Industrial Control System(ICS)administrators to proactively forecast potential threats.However,it is not a trivial task due to the complexity of the multi-source heterogeneous data and the lack of automatic analysis methods.To address these challenges,we propose an exploitability reasoning method based on the ICC-Vulnerability Knowledge Graph(KG)in which relation paths contain abundant potential evidence to support the reasoning.The reasoning task in this work refers to determining whether a specific relation is valid between an attacker entity and a possible exploitable vulnerability entity with the help of a collective of the critical paths.The proposed method consists of three primary building blocks:KG construction,relation path representation,and query relation reasoning.A security-oriented ontology combines exploit modeling,which provides a guideline for the integration of the scattered knowledge while constructing the KG.We emphasize the role of the aggregation of the attention mechanism in representation learning and ultimate reasoning.In order to acquire a high-quality representation,the entity and relation embeddings take advantage of their local structure and related semantics.Some critical paths are assigned corresponding attentive weights and then they are aggregated for the determination of the query relation validity.In particular,similarity calculation is introduced into a critical path selection algorithm,which improves search and reasoning performance.Meanwhile,the proposed algorithm avoids redundant paths between the given pairs of entities.Experimental results show that the proposed method outperforms the state-of-the-art ones in the aspects of embedding quality and query relation reasoning accuracy.

基于SHEL+Reason模型的住院药房药品调剂差错安全风险综合评价指标体系的建立

目的建立基于SHEL+Reason模型的住院药房药品调剂差错安全风险综合评价指标体系。方法通过SHEL+Reason模型对我院住院药房2019年7—12月期间的441076条医嘱进行分析,结合文献复习法形成药品调剂差错安全风险的专家咨询表,采取德尔菲法(Delphi Method)进行咨询,通过统计学分析对指标体系进行完善,运用综合评分法构建综合评价方程,抽取2021年1—6月期间的897条调剂差错医嘱进行评价研究,采用信度分析验证指标体系的可靠性,对综合评价结果采用X-σ_(X)、X、X+σ_(X)确定区分不同等级的界限,进行单因素方差分析(完全随机设计),验证通过综合评价方法获得的各分类间的差异是否有统计学意义。结果本指标体系包含4个一级指标,10个二级指标,进行了两轮专家咨询后专家权威性和指标体系内部一致性良好,利用抽取的医嘱验证了构建的综合评价指标体系具有良好的区分度。结论建立的住院药房药品调剂安全风险评价指标体系适用于医院住院药房的药品调剂差错管理,可为医院相关管理工作的开展提供参考。

Intelligent Color Reasoning of IOT Based on P-laws

Aiming at the dynamics and uncertainties of natural colors affected by the natural environment,a color P-law generation model based on the natural environment is proposed to develop algorithms and to provide a theoretical basis for plant dynamic color simulation and color sensor data transmission.Based on the HSL(Hue,Saturation,Lightness)color solid,the proposed method uses the function P-set to provide a color P-law generation model and an algorithm of the Dynamic Colors System(DCS),establishing the DCS modeling theory of the natural environment and the color P-reasoning simulation based on the HSL color solid.The experimental results show that based on the color P-law,for the DCS of the natural environment,when the external factors change,the color of the plant changes,accordingly,verifying the effectiveness of the color P-law generation model and the algorithm of the DCS.In the dynamic color intel-ligent simulation system,when external factors change,the dynamic change of plant color generally conforms to the basic laws of the natural environment.This enables the effective extraction of color data from the Internet of Things(IoT)-based color sensors and provides an effective way to significantly reduce the data transmission bandwidth of the IoT network.

An Ontology Based Cyclone Tracks Classification Using SWRL Reasoning and SVM

Tropical cyclones(TC)are often associated with severe weather conditions which cause great losses to lives and property.The precise classification of cyclone tracks is significantly important in thefield of weather forecasting.In this paper we propose a novel hybrid model that integrates ontology and Support Vector Machine(SVM)to classify the tropical cyclone tracks into four types of classes namely straight,quasi-straight,curving and sinuous based on the track shape.Tropical Cyclone TRacks Ontology(TCTRO)described in this paper is a knowledge base which comprises of classes,objects and data properties that represent the interaction among the TC characteristics.A set of SWRL(Semantic Web Rule Language)rules are directly inserted to the TCTRO ontology for reasoning and inferring new knowledge from ontology.Furthermore,we propose a learning algorithm which utilizes the inferred knowledge for optimizing the feature subset.According to experiments on the IBTrACS dataset,the proposed ontology based SVM classifier achieves an accuracy of 98.3%with reduced classification error rates.

A case-based reasoning method of recognizing liquefaction pits induced by 2021 M_(W) 7.3 Madoi earthquake

Earthquake-triggered liquefaction deformation could lead to severe infrastructure damage and associated casualties and property damage.At present,there are few studies on the rapid extraction of liquefaction pits based on high-resolution satellite images.Therefore,we provide a framework for extracting liquefaction pits based on a case-based reasoning method.Furthermore,five covariates selection methods were used to filter the 11 covariates that were generated from high-resolution satellite images and digital elevation models(DEM).The proposed method was trained with 450 typical samples which were collected based on visual interpretation,then used the trained case-based reasoning method to identify the liquefaction pits in the whole study area.The performance of the proposed methods was evaluated from three aspects,the prediction accuracies of liquefaction pits based on the validation samples by kappa index,the comparison between the pre-and post-earthquake images,the rationality of spatial distribution of liquefaction pits.The final result shows the importance of covariates ranked by different methods could be different.However,the most important of covariates is consistent.When selecting five most important covariates,the value of kappa index could be about 96%.There also exist clear differences between the pre-and post-earthquake areas that were identified as liquefaction pits.The predicted spatial distribution of liquefaction is also consistent with the formation principle of liquefaction.

Data-Driven Model for Risk Assessment of Cable Fire in Utility Tunnels Using Evidential Reasoning Approach

Cable fire is one of the most important events for operation and maintenance(O&M)safety in underground utility tunnels(UUTs).Since there are limited studies about cable fire risk assessment,a comprehensive assessment model is proposed to evaluate the cable fire risk in different UUT sections and improve O&M efficiency.Considering the uncertainties in the risk assessment,an evidential reasoning(ER)approach is used to combine quantitative sensor data and qualitative expert judgments.Meanwhile,a data transformation technique is contributed to transform continuous data into a five-grade distributed assessment.Then,a case study demonstrates how the model and the ER approach are established.The results show that in Shenzhen,China,the cable fire risk in District 8,B Road is the lowest,while more resources should be paid in District 3,C Road and District 25,C Road,which are selected as comparative roads.Based on the model,a data-driven O&M process is proposed to improve the O&M effectiveness,compared with traditional methods.This study contributes an effective ER-based cable fire evaluation model to improve the O&M efficiency of cable fire in UUTs.

A reasoning diagram based method for fault diagnosis of railway point system

Railway Point System(RPS)is an important infrastructure in railway industry and its faults may have significant impacts on the safety and efficiency of train operations.For the fault diagnosis of RPS,most existing methods assume that sufficient samples of each failure mode are available,which may be unrealistic,especially for those modes of low occurrence frequency but with high risk.To address this issue,this work proposes a novel fault diagnosis method that only requires the power signals generated under normal RPS operations in the training stage.Specifically,the failure modes of RPS are distinguished through constructing a reasoning diagram,whose nodes are either binary logic problems or those that can be decomposed into the problems of the binary logic.Then,an unsupervised method for the signal segmentation and a fault detection method are combined to make decisions for each binary logic problem.Based on the results of decisions,the diagnostic rules are established to identify the failure modes.Finally,the data collected from multiple real-world RPSs are used for validation and the results demonstrate that the proposed method outperforms the benchmark in identifying the faults of RPSs.

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.

基于Reason-AHP的有害气体中毒事故分析

为有效防范有害气体中毒事件的发生,首先,基于瑞士奶酪模型(Reason模型),构建包括5个一级指标、15个二级指标的有害气体中毒事故致因指标体系;然后,采用层次分析法(AHP)对事故致因因素指标进行权重分析,并对其重要度进行排序。结果表明:现场作业违章指挥(0.288)、习惯性行为(0.152)、人员培训不到位(0.130)及规章制度不落实或缺失(0.118)等致因指标对事故的影响较大。针对影响较大的致因指标提出改进措施。