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 me...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.展开更多
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...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.展开更多
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...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.展开更多
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 forecas...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.展开更多
The concentration difference in the near-surface region of lithium metal is the main cause of lithium dendrite growth.Resolving this issue will be key to achieving high-performance lithium metal batteries(LMBs).Herein...The concentration difference in the near-surface region of lithium metal is the main cause of lithium dendrite growth.Resolving this issue will be key to achieving high-performance lithium metal batteries(LMBs).Herein,we construct a lithium nitrate(LiNO_(3))-implanted electroactiveβphase polyvinylidene fluoride-co-hexafluoropropylene(PVDF-HFP)crystalline polymorph layer(PHL).The electronegatively charged polymer chains attain lithium ions on the surface to form lithium-ion charged channels.These channels act as reservoirs to sustainably release Li ions to recompense the ionic flux of electrolytes,decreasing the growth of lithium dendrites.The stretched molecular channels can also accelerate the transport of Li ions.The combined effects enable a high Coulombic efficiency of 97.0%for 250 cycles in lithium(Li)||copper(Cu)cell and a stable symmetric plating/stripping behavior over 2000 h at 3 mA cm^(-2)with ultrahigh Li utilization of 50%.Furthermore,the full cell coupled with PHL-Cu@Li anode and Li Fe PO_(4) cathode exhibits long-term cycle stability with high-capacity retention of 95.9%after 900 cycles.Impressively,the full cell paired with LiNi_(0.87)Co_(0.1)Mn_(0.03)O_(2)maintains a discharge capacity of 170.0 mAh g^(-1)with a capacity retention of 84.3%after 100 cycles even under harsh condition of ultralow N/P ratio of 0.83.This facile strategy will widen the potential application of LiNO_(3)in ester-based electrolyte for practical high-voltage LMBs.展开更多
基金supported in part by the Science and Technology Innovation 2030-“New Generation of Artificial Intelligence”Major Project(No.2021ZD0111000)Henan Provincial Science and Technology Research Project(No.232102211039).
文摘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.
文摘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.
文摘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.
基金Our work is supported by the National Key R&D Program of China(2021YFB2012400).
文摘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.
基金support from the National Science Foundation of China (No.51971249)the Natural Science Foundation of Shandong Province,China (No.ZR2020KE012)the Science and Technology Planning Project of Longkou City,China (No.2021KJJH025).
基金the financial support from the National Natural Science Foundation of China(Nos.22205191 and 52002346)the Science and Technology Innovation Program of Hunan Province(No.2021RC3109)+1 种基金the Natural Science Foundation of Hunan Province,China(No.2022JJ40446)Guangxi Key Laboratory of Low Carbon Energy Material(No.2020GXKLLCEM01)。
文摘The concentration difference in the near-surface region of lithium metal is the main cause of lithium dendrite growth.Resolving this issue will be key to achieving high-performance lithium metal batteries(LMBs).Herein,we construct a lithium nitrate(LiNO_(3))-implanted electroactiveβphase polyvinylidene fluoride-co-hexafluoropropylene(PVDF-HFP)crystalline polymorph layer(PHL).The electronegatively charged polymer chains attain lithium ions on the surface to form lithium-ion charged channels.These channels act as reservoirs to sustainably release Li ions to recompense the ionic flux of electrolytes,decreasing the growth of lithium dendrites.The stretched molecular channels can also accelerate the transport of Li ions.The combined effects enable a high Coulombic efficiency of 97.0%for 250 cycles in lithium(Li)||copper(Cu)cell and a stable symmetric plating/stripping behavior over 2000 h at 3 mA cm^(-2)with ultrahigh Li utilization of 50%.Furthermore,the full cell coupled with PHL-Cu@Li anode and Li Fe PO_(4) cathode exhibits long-term cycle stability with high-capacity retention of 95.9%after 900 cycles.Impressively,the full cell paired with LiNi_(0.87)Co_(0.1)Mn_(0.03)O_(2)maintains a discharge capacity of 170.0 mAh g^(-1)with a capacity retention of 84.3%after 100 cycles even under harsh condition of ultralow N/P ratio of 0.83.This facile strategy will widen the potential application of LiNO_(3)in ester-based electrolyte for practical high-voltage LMBs.
