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。

Direct Regeneration of Spent Lithium-Ion Battery Cathodes:From Theoretical Study to Production Practice

Direct regeneration method has been widely concerned by researchers in the field of battery recycling because of its advantages of in situ regeneration,short process and less pollutant emission.In this review,we firstly analyze the primary causes for the failure of three representative battery cathodes(lithium iron phosphate,layered lithium transition metal oxide and lithium cobalt oxide),targeting at illustrating their underlying regeneration mecha-nism and applicability.Efficient stripping of material from the collector to obtain pure cathode material has become a first challenge in recycling,for which we report several pretreatment methods currently available for subsequent regeneration processes.We review and discuss emphatically the research progress of five direct regeneration methods,including solid-state sintering,hydrothermal,eutectic molten salt,electrochemical and chemical lithiation methods.Finally,the application of direct regeneration technology in production practice is introduced,the problems exposed at the early stage of the industrialization of direct regeneration technol-ogy are revealed,and the prospect of future large-scale commercial production is proposed.It is hoped that this review will give readers a comprehensive and basic understanding of direct regeneration methods for used lithium-ion batteries and promote the industrial application of direct regeneration technology.

AMachine Learning Approach to User Profiling for Data Annotation of Online Behavior

The user’s intent to seek online information has been an active area of research in user profiling.User profiling considers user characteristics,behaviors,activities,and preferences to sketch user intentions,interests,and motivations.Determining user characteristics can help capture implicit and explicit preferences and intentions for effective user-centric and customized content presentation.The user’s complete online experience in seeking information is a blend of activities such as searching,verifying,and sharing it on social platforms.However,a combination of multiple behaviors in profiling users has yet to be considered.This research takes a novel approach and explores user intent types based on multidimensional online behavior in information acquisition.This research explores information search,verification,and dissemination behavior and identifies diverse types of users based on their online engagement using machine learning.The research proposes a generic user profile template that explains the user characteristics based on the internet experience and uses it as ground truth for data annotation.User feedback is based on online behavior and practices collected by using a survey method.The participants include both males and females from different occupation sectors and different ages.The data collected is subject to feature engineering,and the significant features are presented to unsupervised machine learning methods to identify user intent classes or profiles and their characteristics.Different techniques are evaluated,and the K-Mean clustering method successfully generates five user groups observing different user characteristics with an average silhouette of 0.36 and a distortion score of 1136.Feature average is computed to identify user intent type characteristics.The user intent classes are then further generalized to create a user intent template with an Inter-Rater Reliability of 75%.This research successfully extracts different user types based on their preferences in online content,platforms,criteria,and frequency.The study also validates the proposed template on user feedback data through Inter-Rater Agreement process using an external human rater.

A comparative study on characteristics of retracted publications across different open access levels

Purpose:Recently,global science has shown an increasing open trend,however,the characteristics of research integrity of open access(OA)publications have rarely been studied.The aim of this study is to compare the characteristics of retracted articles across different OA levels and discover whether OA level influences the characteristics of retracted articles.Design/methodology/approach:The research conducted an analysis of 6,005 retracted publications between 2001 and 2020 from the Web of Science and Retraction Watch databases.These publications were categorized based on their OA levels,including Gold OA,Green OA,and non-OA.The study explored retraction rates,time lags and reasons within these categories.Findings:The findings of this research revealed distinct patterns in retraction rates among different OA levels.Publications with Gold OA demonstrated the highest retraction rate,followed by Green OA and non-OA.A comparison of retraction reasons between Gold OA and non-OA categories indicated similar proportions,while Green OA exhibited a higher proportion due to falsification and manipulation issues,along with a lower occurrence of plagiarism and authorship issues.The retraction time lag was shortest for Gold OA,followed by non-OA,and longest for Green OA.The prolonged retraction time for Green OA could be attributed to an atypical distribution of retraction reasons.A comparative study on characteristics of retracted publications across different open access levels Research limitations:There is no exploration of a wider range of OA levels,such as Hybrid OA and Bronze OA.Practical implications:The outcomes of this study suggest the need for increased attention to research integrity within the OA publications.The occurrences offalsification,manipulation,and ethical concerns within Green OA publications warrant attention from the scientific community.Originality/value:This study contributes to the understanding of research integrity in the realm of OA publications,shedding light on retraction patterns and reasons across different OA levels.

Amend:An integrated platform of retracted papers and concerned papers

Purpose:The notable increase in retraction papers has attracted considerable attention from diverse stakeholders.Various sources are now offering information related to research integrity,including concerns voiced on social media,disclosed lists of paper mills,and retraction notices accessible through journal websites.However,despite the availability of such resources,there remains a lack of a unified platform to consolidate this information,thereby hindering efficient searching and cross-referencing.Thus,it is imperative to develop a comprehensive platform for retracted papers and related concerns.This article aims to introduce“Amend,”a platform designed to integrate information on research integrity from diverse sources.Design/methodology/approach:The Amend platform consolidates concerns and lists of problematic articles sourced from social media platforms(e.g.,PubPeer,For Better Science),retraction notices from journal websites,and citation databases(e.g.,Web of Science,CrossRef).Moreover,Amend includes investigation and punishment announcements released by administrative agencies(e.g.,NSFC,MOE,MOST,CAS).Each related paper is marked and can be traced back to its information source via a provided link.Furthermore,the Amend database incorporates various attributes of retracted articles,including citation topics,funding details,open access status,and more.The reasons for retraction are identified and classified as either academic misconduct or honest errors,with detailed subcategories provided for further clarity.Findings:Within the Amend platform,a total of 32,515 retracted papers indexed in SCI,SSCI,and ESCI between 1980 and 2023 were identified.Of these,26,620(81.87%)were associated with academic misconduct.The retraction rate stands at 6.64 per 10,000 articles.Notably,the retraction rate for non-gold open access articles significantly differs from that for gold open access articles,with this disparity progressively widening over the years.Furthermore,the reasons for retractions have shifted from traditional individual behaviors like falsification,fabrication,plagiarism,and duplication to more organized large-scale fraudulent practices,including Paper Mills,Fake Peer-review,and Artificial Intelligence Generated Content(AIGC).Research limitations:The Amend platform may not fully capture all retracted and concerning papers,thereby impacting its comprehensiveness.Additionally,inaccuracies in retraction notices may lead to errors in tagged reasons.Practical implications:Amend provides an integrated platform for stakeholders to enhance monitoring,analysis,and research on academic misconduct issues.Ultimately,the Amend database can contribute to upholding scientific integrity.Originality/value:This study introduces a globally integrated platform for retracted and concerning papers,along with a preliminary analysis of the evolutionary trends in retracted papers.

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.

A Formal Model for Analyzing Fair Exchange Protocols Based on Event Logic

Fair exchange protocols play a critical role in enabling two distrustful entities to conduct electronic data exchanges in a fair and secure manner.These protocols are widely used in electronic payment systems and electronic contract signing,ensuring the reliability and security of network transactions.In order to address the limitations of current research methods and enhance the analytical capabilities for fair exchange protocols,this paper proposes a formal model for analyzing such protocols.The proposed model begins with a thorough analysis of fair exchange protocols,followed by the formal definition of fairness.This definition accurately captures the inherent requirements of fair exchange protocols.Building upon event logic,the model incorporates the time factor into predicates and introduces knowledge set axioms.This enhancement empowers the improved logic to effectively describe the state and knowledge of protocol participants at different time points,facilitating reasoning about their acquired knowledge.To maximize the intruder’s capabilities,channel errors are translated into the behaviors of the intruder.The participants are further categorized into honest participants and malicious participants,enabling a comprehensive evaluation of the intruder’s potential impact.By employing a typical fair exchange protocol as an illustrative example,this paper demonstrates the detailed steps of utilizing the proposed model for protocol analysis.The entire process of protocol execution under attack scenarios is presented,shedding light on the underlying reasons for the attacks and proposing corresponding countermeasures.The developedmodel enhances the ability to reason about and evaluate the security properties of fair exchange protocols,thereby contributing to the advancement of secure network transactions.

A Survey of Knowledge Graph Construction Using Machine Learning

Knowledge graph(KG)serves as a specialized semantic network that encapsulates intricate relationships among real-world entities within a structured framework.This framework facilitates a transformation in information retrieval,transitioning it from mere string matching to far more sophisticated entity matching.In this transformative process,the advancement of artificial intelligence and intelligent information services is invigorated.Meanwhile,the role ofmachine learningmethod in the construction of KG is important,and these techniques have already achieved initial success.This article embarks on a comprehensive journey through the last strides in the field of KG via machine learning.With a profound amalgamation of cutting-edge research in machine learning,this article undertakes a systematical exploration of KG construction methods in three distinct phases:entity learning,ontology learning,and knowledge reasoning.Especially,a meticulous dissection of machine learningdriven algorithms is conducted,spotlighting their contributions to critical facets such as entity extraction,relation extraction,entity linking,and link prediction.Moreover,this article also provides an analysis of the unresolved challenges and emerging trajectories that beckon within the expansive application of machine learning-fueled,large-scale KG construction.

Upper and Lower Bounds of the α-Universal Triple I Method for Unified Interval Implications

Theα-universal triple I(α-UTI)method is a recognized scheme in the field of fuzzy reasoning,whichwas proposed by our research group previously.The robustness of fuzzy reasoning determines the quality of reasoning algorithms to a large extent,which is quantified by calculating the disparity between the output of fuzzy reasoning with interference and the output without interference.Therefore,in this study,the interval robustness(embodied as the interval stability)of theα-UTI method is explored in the interval-valued fuzzy environment.To begin with,the stability of theα-UTI method is explored for the case of an individual rule,and the upper and lower bounds of its results are estimated,using four kinds of unified interval implications(including the R-interval implication,the S-interval implication,the QL-interval implication and the interval t-norm implication).Through analysis,it is found that theα-UTI method exhibits good interval stability for an individual rule.Moreover,the stability of theα-UTI method is revealed in the case of multiple rules,and the upper and lower bounds of its outcomes are estimated.The results show that theα-UTI method is stable for multiple rules when four kinds of unified interval implications are used,respectively.Lastly,theα-UTI reasoning chain method is presented,which contains a chain structure with multiple layers.The corresponding solutions and their interval perturbations are investigated.It is found that theα-UTI reasoning chain method is stable in the case of chain reasoning.Two application examples in affective computing are given to verify the stability of theα-UTImethod.In summary,through theoretical proof and example verification,it is found that theα-UTImethod has good interval robustness with four kinds of unified interval implications aiming at the situations of an individual rule,multi-rule and reasoning chain.

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.

An Exploration of How Practitioners Make Meaning in a Chinese Medicine Consultation and Treatment

In Chinese medicine, practitioners assess patients’ complaints, analyze their underlying problems, identify causes and come to a diagnosis, which then directs treatment. What is not obvious and not recorded in a consultation is the clinical reasoning process that practitioners use. The research filmed three practitioners in the UK while they conducted a consultation and treatment on new patients. The practitioners and researchers viewed the films and used them as aide-memoirs while the reasoning process throughout was discussed. In order to determine the pattern, practitioners used the four examinations to gather information from the patient in an iterative process;their aesthetic reasoning was highly developed. Through triangulation they checked the information they received against a detailed understanding of the qi-dynamic. They used highly analytical strategies of forward(inductive) and backward(deductive) reasoning against the prototypes of the signs and symptoms that indicate a specific Zheng. This was achieved through an abductive process that linked description with explanation and causal factors with pathological mechanisms. The feedback loop with the patient continued through the consultation and into the treatment. A process of translation and interpretation was needed to turn the patient’s story into the practitioner’s story of qi-dynamics that then directed the treatment. Awareness of our clinical reasoning process will mitigate against biases, improve our diagnoses and treatment choices and support the training of students.

International law obligations for the disposal of Fukushima nuclear-contaminated water under the principles of nuclear safety

The disposal of contaminated water from Japan’s Fukushima nuclear power plant is a significant international nuclear safety issue with considerable cross-border implications.This matter requires compliance not only with the law of the sea but also with the principles of nuclear safety under international law.These principles serve as the overarching tenet of international and China’s domestic nuclear laws,applicable to nuclear facilities and activities.The principle of safety in nuclear activities is fully recognized in international and domestic laws,carrying broad legal binding force.Japan’s discharge of nuclear-contaminated water into the sea violates its obligations under the principle of safety in nuclear activities,including commitments to optimum protection,as low as reasonably practicable,and prevention.The Japanese government and the International Atomic Energy Agency(IAEA)have breached the obligation of optimum protection by restricting the scope of assessments,substituting core concepts,and shielding dissenting views.In the absence of clear radiation standards,they have acted unilaterally without fulfilling the obligation as low as reasonably practicable principle.The discharge of Fukushima nuclear-contaminated water poses an imminent and unpredictable risk to all countries worldwide,including Japanese residents.Japan and the IAEA should fulfill their obligations under international law regarding disposal,adhering to the principles of nuclear safety,including optimum protection,the obligation as low as reasonably practicable,and prevention through multilateral cooperation.Specifically,the obligation to provide optimum protection should be implemented by re-evaluating the most reliable disposal technologies and methods currently available and comprehensively assessing various options.The standard of the obligation as low as reasonably practicable requires that the minimization of negative impacts on human health,livelihoods,and the environment should not be subordinated to considerations of cutting costs and expenses.Multilateral cooperation should be promoted through the establishment of sound multilateral long-term monitoring mechanisms for the discharge of nuclear-contaminated water,notification and consultation obligations,and periodic assessments.These obligations under international law were fulfilled after the accidents at the Three Mile Island and Chernobyl nuclear power plants.The implications of the principles of nuclear safety align with the concept of building a community of shared future for nuclear safety advocated by China.In cases of violations of international law regarding the disposal of nuclear-contaminated water that jeopardize the concept of a community of a shared future for nuclear safety,China can also rely on its own strength to promote the implementation of due obligations through self-help.

Ten misconceptions regarding decision-making in critical care

Diagnostic errors are prevalent in critical care practice and are associated with patient harm and costs for providers and the healthcare system.Patient complexity,illness severity,and the urgency in initiating proper treatment all contribute to decision-making errors.Clinician-related factors such as fatigue,cognitive overload,and inexperience further interfere with effective decision-making.Cognitive science has provided insight into the clinical decision-making process that can be used to reduce error.This evidence-based review discusses ten common misconceptions regarding critical care decision-making.By understanding how practitioners make clinical decisions and examining how errors occur,strategies may be developed and implemented to decrease errors in Decision-making and improve patient outcomes.

长春市高校足球后备人才培养风险管理研究

采用访谈法、逻辑分析法等,研究长春市高等教育阶段足球后备人才培养过程中的风险因素,建立长春市高等教育阶段足球后备人才培养Reason模型。研究表明:需要采取成立高等教育阶段足球后备人才培养专项工作组、减轻运动员学习负担、优化高校足球赛事建设、改进足球教练员培训与考核、健全“一条龙”足球人才培养体系等措施,以突破长春市高等教育阶段足球后备人才培养困境。

Using AI and Precision Nutrition to Support Brain Health during Aging

Artificial intelligence, often referred to as AI, is a branch of computer science focused on developing systems that exhibit intelligent behavior. Broadly speaking, AI researchers aim to develop technologies that can think and act in a way that mimics human cognition and decision-making [1]. The foundations of AI can be traced back to early philosophical inquiries into the nature of intelligence and thinking. However, AI is generally considered to have emerged as a formal field of study in the 1940s and 1950s. Pioneering computer scientists at the time theorized that it might be possible to extend basic computer programming concepts using logic and reasoning to develop machines capable of “thinking” like humans. Over time, the definition and goals of AI have evolved. Some theorists argued for a narrower focus on developing computing systems able to efficiently solve problems, while others aimed for a closer replication of human intelligence. Today, AI encompasses a diverse set of techniques used to enable intelligent behavior in machines. Core disciplines that contribute to modern AI research include computer science, mathematics, statistics, linguistics, psychology and cognitive science, and neuroscience. Significant AI approaches used today involve statistical classification models, machine learning, and natural language processing. Classification methods are widely applicable to problems in various domains like healthcare, such as informing diagnostic or treatment decisions based on patterns in data. Dean and Goldreich, 1998, define ML as an approach through which a computer has to learn a model by itself from the data provided but no specification on the sort of model is provided to the computer. They can then predict values for things that are different from the values used in training the models. NLP looks at two interrelated concerns, the task of training computers to understand human languages and the fact that since natural languages are so complex, they lend themselves very well to serving a number of very useful goals when used by computers.

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.

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.