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。

如何理解菲尼斯的“practical reasonableness”?

“practical reasonableness”是菲尼斯自然法理论中的一个核心概念,也是晚近有关菲尼斯的讨论中最困扰学界的理解及翻译的概念。在汉语学界有关“practical reasonableness”的多种理解中,有着诸多混淆,把“practial reasonableness”与“practical reason”“practical reasoning”“practical intelligibility”区分开来对于恰切理解这个概念尤为必要。另外,菲尼斯所使用的“practical reasonableness”概念在很大程度上可追溯至阿奎那的“prudentia”概念,尽管其在一定程度上对阿奎那的理论进行了改造。通过区分及渊源上的考察,我们大体上可以界定菲尼斯的“practical reasonableness”概念所包含的基本含义:其一,它是一种整合性的和统合性的力量;其二,它的这种力量在根本意义上来源于理性,所以,它是实践理性活动的一种产物;其三,它是实践理性活动成功而达致的状态,因此它会对人的倾向、态度和行动提出要求。

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.

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.

On the “Reasonable” Handling of Personal Information Disclosed According to the Law

The model for protection of personal information dis-closed according to the law has changed from indirect protection to direct protection.The indirect protection model for traditional repu-tation rights and privacy rights was not enough to meet the practical needs of governance.However;due to the ambiguity in the application of the“reasonable”processing requirements,the direct protection model centered on Article 27 of the Personal Information Protection Law also is not enough to effectively respond to practical disputes.The essence of the problem is to resolve the tension between informa-tion circulation and risk control and reshape the legal order for the protection of personal information disclosed according to the law.The determination of“reasonable”should be centered on the scenario theory and holism interpretation and carried out by using the interpre-tation technique of the dynamic system under Article 998 of the Civil Code.With the support of scenario-based discussions and comparative propositions,the crawling and tag extraction of personal information.disclosed according to the law should be considered as reasonable processing;profiling and automated decision-making should not be covered in the scope of reasonable processing,in principle;for behav-iors such as correlation analysis,elements like information subject,identifiability and sensitivity should be comprehensively considered to draw open and inclusive conclusions in individual cases.

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。

Analysis of the Impact of Inductive Reasoning on the Mathematical Thinking Style of Deaf and Hard-of-Hearing Students

In this paper,we combine the teaching and learning situation of deaf and hard-of-hearing students in the Linear Algebra course of the Computer Science and Technology major at the Nanjing Normal University of Special Education.Based on the cognitive style of deaf and hard-of-hearing students,we apply example induction,exhaustive induction,and mathematical induction to the teaching of Linear Algebra by utilizing specific course content.The aim is to design comprehensive teaching that caters to the cognitive style characteristics of deaf and hard-of-hearing students,strengthen their mathematical thinking styles such as quantitative thinking,algorithmic thinking,symbolic thinking,visual thinking,logical thinking,and creative thinking,and enhance the effectiveness of classroom teaching and learning outcomes in Linear Algebra for deaf and hard-of-hearing students.

论罗尔斯对the reasonable与the rational的区分

在《政治自由主义》中罗尔斯明确区分了the rational(合理)和the reasonable(讲理),这个区分是理解罗尔斯整个正义理论尤其是其思想转变缘由的枢纽。而在其《学士论文》中,罗尔斯区分了the natural(自然)和the personal(人格),进而恰当而清晰地定位了伦理学。在这种定位中,伦理学的研究对象是人格关系,而且与神学、宗教不可分离。合理与讲理这对区分的内涵在《政治自由主义》中得以展开,而对自然和人格的区分则进一步推进了对合理与讲理这对区分的理解,罗尔斯做出此种区分的原因也将得到呈现。

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。

Reasonable,rational与当代政治哲学的变化

理性是政治哲学的论题,理性的分裂与整合直接影响到政治哲学的研究方法和研究动向。当代政治哲学对于reasonable和rational的理解存在明显的冲突,这种冲突也是自理性被概念化以来本身就具有的。理性的分裂影响着当代政治哲学研究的动向:使政治学实现了从传统向现代及其科学化的转向,完成了政治和行政及事实与价值的分离,促使政治智慧转向政治知识,引发了政治统治合法性的现代转译。理性的整合也使当代政治哲学出现了新的研究趋势:政治事实与政治价值的整合,经验方法与规范方法的互补和政治与行政的联袂。

A DELTA INFERENCE OPERATOR FOR REASONABLE CONSEQUENCE RELATION

This paper determines a delta inference operator C based on the notion of reasonable consequence of Adams′ system and studies its properties. It shows another approach to study inductive and probabilistic reasoning.

Determination of reasonable finished state of self-anchored suspension bridges

A systematic and generic procedure for the determination of the reasonable finished state of self-anchored suspension bridges is proposed, the realization of which is mainly through adjustment of the hanger tensions. The initial hanger tensions are first obtained through an iterative analysis by combining the girder-tower-only finite element(FE) model with the analytical program for shape finding of the spatial cable system. These initial hanger tensions, together with the corresponding cable coordinates and internal forces, are then included into the FE model of the total bridge system, the nonlinear analysis of which involves the optimization technique. Calculations are repeated until the optimization algorithm converges to the most optimal hanger tensions(i.e. the desired reasonable finished bridge state). The "temperature rigid arm" is introduced to offset the unavoidable initial deformations of the girder and tower, which are due to the huge axial forces originated from the main cable. Moreover, by changing the stiffness coefficient K in the girder-tower-only FE model, the stiffness proportion of the main girder, the tower or the cable subsystem in the whole structural system could be adjusted according to the design intentions. The effectiveness of the proposed method is examined and demonstrated by one simple tutorial example and one self-anchored suspension bridge.

Model for Bidding and Tendering with Bill of Quantities Based on Bid-Winning Estimate at Reasonable Low Price

The possibility and rationality of introducing an bid-winning estimate based on a reasonable low price into construction bidding mode with bill of quantities were analyzed by setting up a model for bidding and tendering, and the functions of the estimate of reasonable low price in the bidding were revealed. On this basis, a new bidding mode of the project with bill of quantities was pro- posed. The application of the new mode will be advantageous to the promotion of the bill of quantities in China.

A REASONABLE METHOD FOR CONSTRACTING GENERAL ELEMENT DM4 OF THICK AND THIN PLATE WITH EFFECTUAL AND REALIABLE NUMERICAL SOLUTIONS

In this thesis, the interal relations between about shear looking, zero energy mode and patch test are studied, and a reasonable method provided for building general element of thick and thin plate with effectual and realiable numerical solution.

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。