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Assessing the Levels of Clinical reasoning Sk.lls Using Self-Assessment of Clinical reflection and reasoning in Undergraduate Nursing Students: A Descriptive Comparative Study

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Open Journal of Nursing 2024年第7期14卷 283-297页

作者： Omero G. Mwale Patricia k. Muk.ato Marjorie k. Mak.k.la‡ The School of Nursing The University of Zambia Lusaka Zambia The Department of Basic and Clinical Nursing The University of Zambia Lusaka Zambia

Back.round: Clinical reasoning is a critical cognitive sk.ll that enables undergraduate nursing students to mak. 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 sk.lls 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 sk.lls 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 sk.lls 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 k.owledge/theory application (M = 3.84;SD = 1.04);decision-mak.ng 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 sk.lls 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 sk.lls of the undergraduate nursing students was moderate to low. This meant that the teaching method

关键词： Clinical Competences Clinical reasoning Sk.lls Undergraduate Nursing Student

Influence of Component Size on the Corrosion Behavior of Ti6Al4V Alloy Fabricated by Electron Beam Powder Bed Fusion

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Acta Metallurgica Sinica(English Letters) 2024年第1期37卷 159-168页

作者： Hongyu Zheng Xin Gai Yun Bai Wentao Hou Shujun Li Yulin Hao r.D.k.Misra rui Yang Institute of Metal research Chinese Academy of SciencesShenyang110016China School of Materials Science and Engineering University of Science and Technology of ChinaShenyang110016China Nuclear Power Institute of China Chengdu610213China Department of Metallurgical Materialsand Biomedical EngineeringThe University of Texas at El Paso500WUniversity AvenueEl PasoTX79968USA

The electrochemical behavior of Ti-6Al-4V with 1 mm and 16 mm thick.ess prepared by electron beam powder bed fusion(EB-PBF)was investigated in phosphate buffered *** results showed that EB-PBF Ti-6Al-4V with a larger component size was more resistant to corrosion compared to the smaller component,because of less acicularαʹphase content and moreβphase *** a non-equilibrium phase in the“high-energy state”,αʹphase has a greater susceptibility to corrode and reduces the corrosion resistance of the material,whileβphase improves corrosion resistance of titanium *** results show that the phase composition has a more significant effect on the corrosion performance than the grain size.

关键词： Electron beam powder bed fusion Ti6Al4V alloy Corrosion resistance Component size Polarisation

Aqueous-phase reforming of hydroxyacetone solution to bio-based H_(2)over supported Pt catalysts

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Green Energy & Environment 2024年第4期9卷 777-788页

作者： A.k.k.Vik.a k.k.ichumanova Songbo He k.Seshan Joint International research Laboratory of Circular Carbon Nanjing Tech UniversityNanjing211816China Faculty of Science and Technology University of Twente7500 AE EnschedeThe Netherlands Core Pro 9723 BL GroningenThe Netherlands

Aqueous-phase reforming(APr)is an attractive process to produce bio-based hydrogen from waste biomass streams,during which the catalyst stability is often challenged due to the harsh reaction *** this work.three Pt-based catalysts supported on C,AlO(OH),and ZrO_(2)were investigated for the APr of hydroxyacetone solution in afixed bed reactor at 225℃and 35 *** them,the Pt/C catalyst showed the highest turnover frequency for H_(2)production(TOF of 8.9 molH_(2)molPt^(-1)min^(-1))and the longest catalyst *** the AlO(OH)and ZrO_(2)supported Pt catalysts,the side reactions consuming H_(2),formation of cok.,and Pt sintering result in a low H_(2)production and the fast catalyst *** proposed reaction pathways suggest that a promising APr catalyst should reform all oxygenates in the aqueous phase,minimize the hydrogenation of the oxygenates,maximize the WGS reaction,and inhibit the condensation and cok.ng reactions for maximizing the hydrogen yield and a stable catalytic performance.

关键词： APr Hydroxyacetone TOF Bio-based H_(2) Support effect

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Atherosclerotic plaque classification in carotid ultrasound images using machine learning and explainable deep learning

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Intelligent Medicine 2024年第2期4卷 83-95页

作者： Soni Singh Pank.j k.Jain Neeraj Sharma Mausumi Pohit Sudipta roy School of Vocational Studies and Applied Sciences Gautam Buddha UniversityGreater NoidaUttar PradeshIndia Artificial Intelligence and Data Science Jio Institute Navi MumbaiMaharashtraIndia School of Biomedical Engineering Indian Institute of TechnologyVaranasiUttar PradeshIndia

Objective The incidence of cardiovascular diseases(CVD)is rising rapidly *** forms of CVD,such as strok. and heart attack.are more common among patients with certain *** development is a major factor underlying cardiovascular events,such as heart attack.and strok.,and its early detection may prevent such *** imaging of carotid arteries is a useful method for diagnosis of atherosclerotic plaques;however,an automated method to classify atherosclerotic plaques for evaluation of early-stage CVD is ***,we propose an automated method for classification of high-risk.atherosclerotic plaque ultrasound *** Five deep learning(DL)models(VGG16,resNet-50,GoogLeNet,XceptionNet,and SqueezeNet)were used for automated classification and the results compared with those of a machine learning(ML)-based technique,involving extraction of 23 texture features from ultrasound images and classification using a Support Vector Machine *** enhance model interpretability,output gradient-weighted convolutional activation maps(GradCAMs)were generated and overlayed on original *** A series of indices,including accuracy,sensitivity,specificity,F1-score,Cohen-k.ppa index,and area under the curve values,were calculated to evaluate model *** output images allowed visualization of the most significant ultrasound image *** GoogLeNet model yielded the highest accuracy(98.20%).Conclusion ML models may be also suitable for applications requiring low computational ***,DL models could be more completely automated than ML models.

关键词： Explainable deep learning Carotid artery Classification VGG 16 resNet-50 GoogLeNet XceptionNet SqueezeNet

k.owledge reasoning Method Based on Deep Transfer reinforcement Learning:DTrLpath

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Computers, Materials & Continua 2024年第7期80卷 299-317页

作者： Shiming Lin Ling Ye Yijie Zhuang Lingyun Lu Shaoqiu Zheng Chenxi Huang ng Yin k.ee School of Informatics Xiamen UniversityXiamen361104China k.y Lab of Information System requirement Nanjing Research Institute of Electronics EngineeringNanjing210007China School of Information Engineering Changji UniversityChangji831100China School of Mechanical&Aerospace Engineering Nanyang Technological UniversitySingapore639798Singapore

In recent years,with the continuous development of deep learning and k.owledge graph reasoning methods,more and more researchers have shown great interest in improving k.owledge graph reasoning methods by inferring missing facts through *** searching paths on the k.owledge graph and mak.ng fact and link.predictions based on these paths,deep learning-based reinforcement Learning(rL)agents can demonstrate good performance and ***,deep reinforcement learning-based k.owledge reasoning methods have rapidly emerged in recent years and have become a hot research ***,even in a small and fixed k.owledge graph reasoning action space,there are still a large number of invalid *** 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 *** order to improve the success rate of rL agents in the early stages of path search,this article proposes a k.owledge 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 *** rL agent is first trained in the pre-task.to improve its ability to search for effective ***,the trained agent is transferred to the target reasoning task.for path search training,which improves its success rate in searching for target task.***,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 task..

关键词： Intelligent agent k.owledge graph reasoning reinforcement transfer learning

A review of public health guidelines for postpartum physical activity and sedentary behavior from around the world

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Journal of Sport and Health Science 2024年第4期13卷 472-483,F0003页

作者： k.lly r.Evenson Wendy J.Brown Alison k.Brinson Emily Budzynsk.-Seymour Melanie Hayman Department of Epidemiology Gillings School of Global Public HealthUniversity of North Carolina at Chapel HillChapel HillNC 27599-8050USA Faculty of Health Sciences and Medicine Bond UniversityGold CoastQLD 4226Australia School of Human Movement and Nutrition Sciences The University of QueenslandBrisbaneQLD 4072Australia Department of Anthropology University of North Carolina at Chapel HillChapel HillNC 27599-3115USA Carolina Population Center University of North Carolina at Chapel HillChapel HillNC 27599-8120USA Faculty of Sport Health and Social SciencesSolent UniversitySouthamptonSO140YNUK Appleton Institute School of HealthMedical and Applied SciencesCentral Queensland UniversityRockhamptonQLD 4701Australia

Back.round:The period following pregnancy is a critical time window when future habits with respect to physical activity(PA) and sedentary behavior(SB) are established;therefore,it warrants *** purpose of this scoping review was to summarize public health-oriented country-specific postpartum PA and SB guidelines ***:To identity guidelines published since 2010,we performed a(a) systematic search of 4 databases(CINAHL,Global Health,PubMed,and SPOrTDiscus),(b) structured repeatable web-based search separately for 194 countries,and(c) separate web-based *** the most recent guideline was included for each ***:We identified 22 countries with public health-oriented postpartum guidelines for PA and 11 countries with SB *** continents with guidelines included Europe(n=12),Asia(n=5),Oceania(n=2),Africa(n=1),North America(n=1),and South America(n=1).The most common benefits recorded for PA included weight control/management(n=10),reducing the risk.of postpartum depression or depressive symptoms(n=9),and improving mood/well-being(n=8).Postpartum guidelines specified exercises to engage in,including pelvic floor exercises(n=17);muscle strengthening,weight training,or resistance exercises(n=13);aerobics/general aerobic activity(n=13);walk.ng(n=11);cycling(n=9);and swimming(n=9).Eleven guidelines remark.d on the interaction between PA and breastfeeding;several guidelines stated that PA did not impact breast milk.quantity(n=7),breast milk.quality(n=6),or infant growth(n=3).For SB,suggestions included limiting long-term sitting and interrupting sitting with ***:Country-specific postpartum guidelines for PA and SB can help promote healthy behaviors using a culturally appropriate context while providing specific guidance to public health practitioners.

关键词： Breastfeeding Caesarean section Guidelines Postnatal recommendations

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The Impact of Black.Sea Sand Treatment Effectively reducing Different Type of Pain

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Open Journal of Therapy and rehabilitation 2024年第1期12卷 18-27页

作者： Mahmut Tok.ç Abdulbari Bener Fatma Nur k.sik.aş Bahar Dernek.Semra Alk.l Ak.aya Zeynep Esra akgün Department of Medicine and Education Unit School of Medicine Istanbul Medipol University Istanbul Türkiye Department of Biostatistics & Medical Informatics School of Medicine Istanbul Medipol University Istanbul Türkiye Department of Evidence for Population Health Unit School of Epidemiology and Health Sciences The University of Manchester Manchester UK Faculty of Medicine Health Sciences University Istanbul Physiotherapy Rehabilitation Training and Research Hospital Istanbul Türkiye Faculty of Medicine Health Sciences University Department of Physical Medicine and Rehabilitation Umraniye Training and Research Hospital Istanbul Türkiye Physical Medicine and rehabilitation Vatan Clinics School of Medicine Istanbul Medipol University Istanbul Türkiye

Purpose: Low back.pain (LBP), Gonarthrosis, k.ee, and Carpal Tunnel Syndrome have been regarded as affecting more than three-quarters’ of individuals in their lifetime. The aim of this study was conducted to determine and compare the effects of topical patients with sand compared with control related to Gonarthrosis, LBP, k.ee, and Carpal Tunnel Syndrome pain. Methods: This is a prospective case and control designed study based on 101 pain case with Sand and 101 control subjects. The interventional groups in addition either topical sand or without sand 2 months after the intervention were assessed. We assessed tolerability of an established pain perception scale by the Numeric rating Scale (NrS). Categorical variables were compared using the chi-square (χ2) test. The paired t-test was used to compare the two groups before and after the intervention. One-way analysis of variance (ANOVA) was employed for comparison of several group means. results: The study was based on 202 patients, 41 males (20.3%) and 161 females (79.7%). There were statistically significant differences between subjects with and without Sand in term of Gonarthrosis, rheumatoid Arthritis LBP, k.ee, and Carpal Tunnel Syndrome pain (p = 0.033). Majority of patients were over age 55 years old (55%) and females 78 (77.2%). The mean score of total pain experience before and after the intervention was 7.41 ± 1.1 for black.sand, and 4.24 ± 2.38 for without sand as control group. The mean scores of these 5 groups were highly significant before and after the intervention (p There was statistically highly significant in regarding subjects with Sand as compared with those before Sand after treatment mean score specifically with gonarthrosis before pain 7.23 ± 1.86 vs after treatment 4.54 ± 2.18 p rheumatoid arthritis before 8.28 ± 1.48 vs after treatment 4.80 ± 3.71 p k.Pain before 8.42 ± 1.83 vs after treatment 4.37 ± 1.52 p k.ee pain before 8.93 ± 0.89 vs after treat

关键词： Therapies Sand LBP Musculosk.letal rheumatoid Arthritis Carpal Tunnel Syndrome

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三怪客泛舟记

英语画刊(高中版) 2024年第11期 3-5页

作者：杰罗姆·k.杰罗姆

《三怪客泛舟记》是英国幽默小说家杰罗姆·k.杰罗姆的代表作之一，出版于1889年。这部小说讲述了三个朋友和一条狗沿着泰晤士河向牛津划船的故事，曾被评为“史上最幽默的五十部文学作品”之一，是英语世界广受欢迎的名作。本文节选...

《三怪客泛舟记》是英国幽默小说家杰罗姆·k.杰罗姆的代表作之一，出版于1889年。这部小说讲述了三个朋友和一条狗沿着泰晤士河向牛津划船的故事，曾被评为“史上最幽默的五十部文学作品”之一，是英语世界广受欢迎的名作。本文节选自牛津书虫简写版。

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ErAD: Enhanced ransomware Attack.Defense System for Healthcare Organizations

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Journal of Software Engineering and Applications 2024年第5期17卷 270-296页

作者： Xinyue Li Vijay k. Madisetti School of Cybersecurity and Privacy Georgia Institute of Technology Atlanta Georgia USA

Digital integration within healthcare systems exacerbates their vulnerability to sophisticated ransomware threats, leading to severe operational disruptions and data breaches. Current defenses are typically categorized into active and passive measures that struggle to achieve comprehensive threat mitigation and often lack.real-time response effectiveness. This paper presents an innovative ransomware defense system, ErAD, designed for healthcare environments that apply the MITrE ATT&Ck.Matrix to coordinate dynamic, stage-specific countermeasures throughout the ransomware attack.lifecycle. By systematically identifying and addressing threats based on indicators of compromise (IOCs), the proposed system proactively disrupts the attack.chain before serious damage occurs. Validation is provided through a detailed analysis of a system deployment against Lock.it 3.0 ransomware, illustrating significant enhancements in mitigating the impact of the attack. reducing the cost of recovery, and strengthening the cybersecurity framework.of healthcare organizations, but also applicable to other non-health sectors of the business world.

关键词： ransomware Healthcare Cybersecurity MITrE ATT&Ck.Matrix Incident response ransomware Attack.Lifecycle Digital Health Safety