Clinical practice guidelines drive clinical practice and clinicians rely to them when trying to answer their most common questions.One of the most important position papers in the field of gastro-esophageal reflux dis...Clinical practice guidelines drive clinical practice and clinicians rely to them when trying to answer their most common questions.One of the most important position papers in the field of gastro-esophageal reflux disease(GERD)is the one produced by the Lyon Consensus.Recently an updated second version has been released.Mean nocturnal baseline impedance(MNBI)was proposed by the first Consensus to act as supportive evidence for GERD diagnosis.Originally a cut-off of 2292 Ohms was proposed,a value revised in the second edition.The updated Consensus recommended that an MNBI<1500 Ohms strongly suggests GERD while a value>2500 Ohms can be used to refute GERD.The proposed cut-offs move in the correct direction by diminishing the original cut-off,nevertheless they arise from a study of normal subjects where cut-offs were provided by measuring the mean value±2SD and not in symptomatic patients.However,data exist that even symptomatic patients with inconclusive disease or reflux hypersensitivity(RH)show lower MNBI values in comparison to normal subjects or patients with functional heartburn(FH).Moreover,according to the data,MNBI,even among symptomatic patients,is affected by age and body mass index.Also,various studies have proposed different cut-offs by using receiver operating characteristic curve analysis even lower than the one proposed.Finally,no information is given for patients submitted to on-proton pump inhibitors pH-impedance studies even if new and extremely important data now exist.Therefore,even if MNBI is an extremely important tool when trying to approach patients with reflux symptoms and could distinguish conclusive GERD from RH or FH,its values should be interpreted with caution.展开更多
Lexical meaning mainly includes rational meaning,grammatical meaning,and coloring meaning.Mastering the coloring meaning of vocabulary is of great significance for foreign students to use Chinese vocabulary correctly....Lexical meaning mainly includes rational meaning,grammatical meaning,and coloring meaning.Mastering the coloring meaning of vocabulary is of great significance for foreign students to use Chinese vocabulary correctly.This study mainly examines the psychological mechanism of Chinese second language learners mastering the coloring meaning of words,examines the psychological characteristics of students mastering the color meaning of words from the perspectives of second language learning theory and cognitive theory,establishes a cognitive schema for coloring meaning learning,and proposes corresponding learning models and teaching strategies.展开更多
BACKGROUND Neonatal sepsis,a formidable threat to newborns,is a leading cause of neonatal mortality,with late-onset sepsis manifesting after 72 hours post-birth being particularly concerning.Pneumonia,a prevalent seps...BACKGROUND Neonatal sepsis,a formidable threat to newborns,is a leading cause of neonatal mortality,with late-onset sepsis manifesting after 72 hours post-birth being particularly concerning.Pneumonia,a prevalent sepsis presentation,poses a significant risk,especially during the neonatal phase when lung defenses are compromised.Accurate diagnosis of pneumonia is imperative for timely and effective interventions.Saliva,a minimally invasive diagnostic medium,holds great promise for evaluating infections,especially in infants.AIM To investigate the potential of serum C-reactive protein(CRP),salivary CRP(sCRP),and mean platelet volume(MPV)as diagnostic markers for late-onset neonatal pneumonia(LONP).METHODS Eighty full-term neonates were systematically examined,considering anthropometric measurements,clinical manifestations,radiology findings,and essential biomarkers,including serum CRP,sCRP,and MPV.RESULTS The study reveals noteworthy distinctions in serum CRP levels,MPV,and the serum CRP/MPV ratio between neonates with LONP and healthy controls.MPV exhibited a robust discriminatory ability[area under the curve(AUC)=0.87]with high sensitivity and specificity at a cutoff value of>8.8.Correlations between serum CRP,sCRP,and MPV were also identified.Notably,sCRP demonstrated excellent predictive value for serum CRP levels(AUC=0.89),underscoring its potential as a diagnostic tool.CONCLUSION This study underscores the diagnostic promise of salivary and serum biomarkers,specifically MPV and CRP,in identifying and predicting LONP among neonates.These findings advocate for further research to validate their clinical utility in larger neonatal cohorts.展开更多
Objective:To explore the meaning of care experienced by people with blindness in hospitals.Methods:Interpretive phenomenology along with the 6-step method of van Manen was used to conduct the study.Using purposeful sa...Objective:To explore the meaning of care experienced by people with blindness in hospitals.Methods:Interpretive phenomenology along with the 6-step method of van Manen was used to conduct the study.Using purposeful sampling,15 people with legal blindness were interviewed.Thematic analysis was used to isolate the meaning of care.Results:Five themes emerged:(a)nurses in the eyes of patients with blindness;(b)negligence in the caring moments;(c)being cared for in ambiguity;(d)Uncoordinated care;and(e)Psychological discomfor t.These sub-themes were condensed into an overarching theme titled as“marginalized patients inside the stereotypical healthcare system.”Conclusions:Lived experiences of patients with blindness revealed that hospitals provide stereotypic or inappropriate care for this minority group in society.Health professionals par ticularly nurses should be skilled to provide person-centered and coordinated care for patients with blindness.展开更多
The k-means algorithm is a popular data clustering technique due to its speed and simplicity. However, it is susceptible to issues such as sensitivity to the chosen seeds, and inaccurate clusters due to poor initial s...The k-means algorithm is a popular data clustering technique due to its speed and simplicity. However, it is susceptible to issues such as sensitivity to the chosen seeds, and inaccurate clusters due to poor initial seeds, particularly in complex datasets or datasets with non-spherical clusters. In this paper, a Comprehensive K-Means Clustering algorithm is presented, in which multiple trials of k-means are performed on a given dataset. The clustering results from each trial are transformed into a five-dimensional data point, containing the scope values of the x and y coordinates of the clusters along with the number of points within that cluster. A graph is then generated displaying the configuration of these points using Principal Component Analysis (PCA), from which we can observe and determine the common clustering patterns in the dataset. The robustness and strength of these patterns are then examined by observing the variance of the results of each trial, wherein a different subset of the data keeping a certain percentage of original data points is clustered. By aggregating information from multiple trials, we can distinguish clusters that consistently emerge across different runs from those that are more sensitive or unlikely, hence deriving more reliable conclusions about the underlying structure of complex datasets. Our experiments show that our algorithm is able to find the most common associations between different dimensions of data over multiple trials, often more accurately than other algorithms, as well as measure stability of these clusters, an ability that other k-means algorithms lack.展开更多
针对电池储能系统(battery energy storage system,BESS)进行光伏波动平抑时寿命损耗高及荷电状态(state of charge,SOC)一致性差的问题,提出了光伏波动平抑下改进K-means的BESS动态分组控制策略。首先,采用最小最大调度方法获取光伏并...针对电池储能系统(battery energy storage system,BESS)进行光伏波动平抑时寿命损耗高及荷电状态(state of charge,SOC)一致性差的问题,提出了光伏波动平抑下改进K-means的BESS动态分组控制策略。首先,采用最小最大调度方法获取光伏并网指令。其次,设计了改进侏儒猫鼬优化算法(improved dwarf mongoose optimizer,IDMO),并利用它对传统K-means聚类算法进行改进,加快了聚类速度。接着,制定了电池单元动态分组原则,并根据电池单元SOC利用改进K-means将其分为3个电池组。然后,设计了基于充放电函数的电池单元SOC一致性功率分配方法,并据此提出BESS双层功率分配策略,上层确定电池组充放电顺序及指令,下层计算电池单元充放电指令。对所提策略进行仿真验证,结果表明,所设计的IDMO具有更高的寻优精度及更快的寻优速度。所提BESS平抑光伏波动策略在有效平抑波动的同时,降低了BESS运行寿命损耗并提高了电池单元SOC的均衡性。展开更多
离群点检测任务是指检测与正常数据在特征属性上存在显著差异的异常数据。大多数基于聚类的离群点检测方法主要从全局角度对数据集中的离群点进行检测,而对局部离群点的检测性能较弱。基于此,本文通过引入快速搜索和发现密度峰值方法改...离群点检测任务是指检测与正常数据在特征属性上存在显著差异的异常数据。大多数基于聚类的离群点检测方法主要从全局角度对数据集中的离群点进行检测,而对局部离群点的检测性能较弱。基于此,本文通过引入快速搜索和发现密度峰值方法改进K-means聚类算法,提出了一种名为KLOD(local outlier detection based on improved K-means and least-squares methods)的局部离群点检测方法,以实现对局部离群点的精确检测。首先,利用快速搜索和发现密度峰值方法计算数据点的局部密度和相对距离,并将二者相乘得到γ值。其次,将γ值降序排序,利用肘部法则选择γ值最大的k个数据点作为K-means聚类算法的初始聚类中心。然后,通过K-means聚类算法将数据集聚类成k个簇,计算数据点在每个维度上的目标函数值并进行升序排列。接着,确定数据点的每个维度的离散程度并选择适当的拟合函数和拟合点,通过最小二乘法对升序排列的每个簇的每1维目标函数值进行函数拟合并求导,以获取变化率。最后,结合信息熵,将每个数据点的每个维度目标函数值乘以相应的变化率进行加权,得到最终的异常得分,并将异常值得分较高的top-n个数据点视为离群点。通过人工数据集和UCI数据集,对KLOD、LOF和KNN方法在准确度上进行仿真实验对比。结果表明KLOD方法相较于KNN和LOF方法具有更高的准确度。本文提出的KLOD方法能够有效改善K-means聚类算法的聚类效果,并且在局部离群点检测方面具有较好的精度和性能。展开更多
文摘Clinical practice guidelines drive clinical practice and clinicians rely to them when trying to answer their most common questions.One of the most important position papers in the field of gastro-esophageal reflux disease(GERD)is the one produced by the Lyon Consensus.Recently an updated second version has been released.Mean nocturnal baseline impedance(MNBI)was proposed by the first Consensus to act as supportive evidence for GERD diagnosis.Originally a cut-off of 2292 Ohms was proposed,a value revised in the second edition.The updated Consensus recommended that an MNBI<1500 Ohms strongly suggests GERD while a value>2500 Ohms can be used to refute GERD.The proposed cut-offs move in the correct direction by diminishing the original cut-off,nevertheless they arise from a study of normal subjects where cut-offs were provided by measuring the mean value±2SD and not in symptomatic patients.However,data exist that even symptomatic patients with inconclusive disease or reflux hypersensitivity(RH)show lower MNBI values in comparison to normal subjects or patients with functional heartburn(FH).Moreover,according to the data,MNBI,even among symptomatic patients,is affected by age and body mass index.Also,various studies have proposed different cut-offs by using receiver operating characteristic curve analysis even lower than the one proposed.Finally,no information is given for patients submitted to on-proton pump inhibitors pH-impedance studies even if new and extremely important data now exist.Therefore,even if MNBI is an extremely important tool when trying to approach patients with reflux symptoms and could distinguish conclusive GERD from RH or FH,its values should be interpreted with caution.
文摘Lexical meaning mainly includes rational meaning,grammatical meaning,and coloring meaning.Mastering the coloring meaning of vocabulary is of great significance for foreign students to use Chinese vocabulary correctly.This study mainly examines the psychological mechanism of Chinese second language learners mastering the coloring meaning of words,examines the psychological characteristics of students mastering the color meaning of words from the perspectives of second language learning theory and cognitive theory,establishes a cognitive schema for coloring meaning learning,and proposes corresponding learning models and teaching strategies.
文摘BACKGROUND Neonatal sepsis,a formidable threat to newborns,is a leading cause of neonatal mortality,with late-onset sepsis manifesting after 72 hours post-birth being particularly concerning.Pneumonia,a prevalent sepsis presentation,poses a significant risk,especially during the neonatal phase when lung defenses are compromised.Accurate diagnosis of pneumonia is imperative for timely and effective interventions.Saliva,a minimally invasive diagnostic medium,holds great promise for evaluating infections,especially in infants.AIM To investigate the potential of serum C-reactive protein(CRP),salivary CRP(sCRP),and mean platelet volume(MPV)as diagnostic markers for late-onset neonatal pneumonia(LONP).METHODS Eighty full-term neonates were systematically examined,considering anthropometric measurements,clinical manifestations,radiology findings,and essential biomarkers,including serum CRP,sCRP,and MPV.RESULTS The study reveals noteworthy distinctions in serum CRP levels,MPV,and the serum CRP/MPV ratio between neonates with LONP and healthy controls.MPV exhibited a robust discriminatory ability[area under the curve(AUC)=0.87]with high sensitivity and specificity at a cutoff value of>8.8.Correlations between serum CRP,sCRP,and MPV were also identified.Notably,sCRP demonstrated excellent predictive value for serum CRP levels(AUC=0.89),underscoring its potential as a diagnostic tool.CONCLUSION This study underscores the diagnostic promise of salivary and serum biomarkers,specifically MPV and CRP,in identifying and predicting LONP among neonates.These findings advocate for further research to validate their clinical utility in larger neonatal cohorts.
基金supported by Ardabil University of Medical Sciences(No.9319.1393-11-21)。
文摘Objective:To explore the meaning of care experienced by people with blindness in hospitals.Methods:Interpretive phenomenology along with the 6-step method of van Manen was used to conduct the study.Using purposeful sampling,15 people with legal blindness were interviewed.Thematic analysis was used to isolate the meaning of care.Results:Five themes emerged:(a)nurses in the eyes of patients with blindness;(b)negligence in the caring moments;(c)being cared for in ambiguity;(d)Uncoordinated care;and(e)Psychological discomfor t.These sub-themes were condensed into an overarching theme titled as“marginalized patients inside the stereotypical healthcare system.”Conclusions:Lived experiences of patients with blindness revealed that hospitals provide stereotypic or inappropriate care for this minority group in society.Health professionals par ticularly nurses should be skilled to provide person-centered and coordinated care for patients with blindness.
文摘The k-means algorithm is a popular data clustering technique due to its speed and simplicity. However, it is susceptible to issues such as sensitivity to the chosen seeds, and inaccurate clusters due to poor initial seeds, particularly in complex datasets or datasets with non-spherical clusters. In this paper, a Comprehensive K-Means Clustering algorithm is presented, in which multiple trials of k-means are performed on a given dataset. The clustering results from each trial are transformed into a five-dimensional data point, containing the scope values of the x and y coordinates of the clusters along with the number of points within that cluster. A graph is then generated displaying the configuration of these points using Principal Component Analysis (PCA), from which we can observe and determine the common clustering patterns in the dataset. The robustness and strength of these patterns are then examined by observing the variance of the results of each trial, wherein a different subset of the data keeping a certain percentage of original data points is clustered. By aggregating information from multiple trials, we can distinguish clusters that consistently emerge across different runs from those that are more sensitive or unlikely, hence deriving more reliable conclusions about the underlying structure of complex datasets. Our experiments show that our algorithm is able to find the most common associations between different dimensions of data over multiple trials, often more accurately than other algorithms, as well as measure stability of these clusters, an ability that other k-means algorithms lack.
文摘针对电池储能系统(battery energy storage system,BESS)进行光伏波动平抑时寿命损耗高及荷电状态(state of charge,SOC)一致性差的问题,提出了光伏波动平抑下改进K-means的BESS动态分组控制策略。首先,采用最小最大调度方法获取光伏并网指令。其次,设计了改进侏儒猫鼬优化算法(improved dwarf mongoose optimizer,IDMO),并利用它对传统K-means聚类算法进行改进,加快了聚类速度。接着,制定了电池单元动态分组原则,并根据电池单元SOC利用改进K-means将其分为3个电池组。然后,设计了基于充放电函数的电池单元SOC一致性功率分配方法,并据此提出BESS双层功率分配策略,上层确定电池组充放电顺序及指令,下层计算电池单元充放电指令。对所提策略进行仿真验证,结果表明,所设计的IDMO具有更高的寻优精度及更快的寻优速度。所提BESS平抑光伏波动策略在有效平抑波动的同时,降低了BESS运行寿命损耗并提高了电池单元SOC的均衡性。
文摘离群点检测任务是指检测与正常数据在特征属性上存在显著差异的异常数据。大多数基于聚类的离群点检测方法主要从全局角度对数据集中的离群点进行检测,而对局部离群点的检测性能较弱。基于此,本文通过引入快速搜索和发现密度峰值方法改进K-means聚类算法,提出了一种名为KLOD(local outlier detection based on improved K-means and least-squares methods)的局部离群点检测方法,以实现对局部离群点的精确检测。首先,利用快速搜索和发现密度峰值方法计算数据点的局部密度和相对距离,并将二者相乘得到γ值。其次,将γ值降序排序,利用肘部法则选择γ值最大的k个数据点作为K-means聚类算法的初始聚类中心。然后,通过K-means聚类算法将数据集聚类成k个簇,计算数据点在每个维度上的目标函数值并进行升序排列。接着,确定数据点的每个维度的离散程度并选择适当的拟合函数和拟合点,通过最小二乘法对升序排列的每个簇的每1维目标函数值进行函数拟合并求导,以获取变化率。最后,结合信息熵,将每个数据点的每个维度目标函数值乘以相应的变化率进行加权,得到最终的异常得分,并将异常值得分较高的top-n个数据点视为离群点。通过人工数据集和UCI数据集,对KLOD、LOF和KNN方法在准确度上进行仿真实验对比。结果表明KLOD方法相较于KNN和LOF方法具有更高的准确度。本文提出的KLOD方法能够有效改善K-means聚类算法的聚类效果,并且在局部离群点检测方面具有较好的精度和性能。
