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Challeng.s experienced by Nurse educators in Promoting.Acquisition of Clinical Reasoning.Skills by the Underg.aduate Nursing.Students: A Qualitative exploratory Study

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Open Journal of Nursing 2024年第8期14卷 459-476页

作者： omero. g. mwa.e Mukwato-Katowa Patricia Marjorie Kabing.-Makukula School of Nursing.Sciences University of Zambia Lusaka Zambia School of Nursing University of Zambia Lusaka Zambia Department of Basic and Clinical Nursing University of Zambia Lusaka Zambia

Backg.ound: Clinical reasoning.is an essential skill for nursing.students since it is required to solve difficulties that arise in complex clinical setting.. However, teaching.and learning.clinical reasoning.skills is difficult because of its complexity. This study, therefore aimed at exploring.the challeng.s experienced by nurse educators in promoting.acquisition of clinical reasoning.skills by underg.aduate nursing.students. Methods: A qualitative exploratory research desig. was used in this study. The participants were purposively sampled and recruited into the study. Data were collected using.semi-structured interview g.ides. Thematic analysis method was used to analyze the collected data The principles of beneficence, respect of human dig.ity and justice were observed. Results: The finding. have shown that clinical learning.environment, lacked material and human resources. The students had no interest to learn the skill. There was also knowledg. g.p 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 challeng.s in promoting.the acquisition of clinical reasoning.skills among.underg.aduate 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 knowledg. and skills throug. continuous professional development if they are to transfer the skill effectively.

关键词： Acquisition Clinical Reasoning.Skills Underg.aduate Nursing.Student Nurse educator

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Assessing.the Levels of Clinical Reasoning.Skills Using.Self-Assessment of Clinical Reflection and Reasoning.in Underg.aduate 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. mwa.e Patricia K. Mukwato Marjorie K. Makukula‡ The School of Nursing The University of Zambia Lusaka Zambia The Department of Basic and Clinical Nursing The University of Zambia Lusaka Zambia

Backg.ound: Clinical reasoning.is a critical cog.itive skill that enables underg.aduate 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 underg.aduate nursing.students. Methods: The study utilized a descriptive comparative research desig., based on the positivism paradig.. 410 underg.aduate 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 dig.ity. 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 underg.aduate nursing.students were knowledg./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 underg.aduate nursing.students was not sig.ificantly 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 sig.ificantno sig.ificant difference in clinical reasoning.between third year and fourth year underg.aduate nursing.students”, was accepted. Conclusion: This study has shown that the level of clinical reasoning.skills of the underg.aduate nursing.students was moderate to low. This meant that the teaching.method

关键词： Clinical Competences Clinical Reasoning.Skills Underg.aduate Nursing.Student

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First-principles calculation on the electronic structures, phonon dynamics, and electrical conductivities of Pb_(10)(PO_(4))_(6O) and Pb_(9)Cu(PO_(4))_(6O) compounds

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Journal of Materials Science & Technolog. 2024年第6期173卷 218-224页

作者： L.Y.Hao e.g.Fu State Key Laboratory of Nuclear Physics and Technolog. Department of Technical PhysicsSchool of PhysicsPeking UniversityBeijing 100871China

Superconducting.materials with hig. critical temperature have the potential to revolutionize many fields,including.military,electronic communications,and power ***,scientists around the world have been tirelessly working.with the ultimate g.al of achieving.hig.-temperature *** 2023,a preprint by Lee et *** South Korea claimed the discovery of ultra-hig.-temperature superconductivity with a critical temperature of up to 423 K in Cu-doped lead-apatite(LK-99)(arXiv:2307.12008,arXiv:2307.12037),which caused a worldwide sensation and ***,the electronic structures,phonon dynamics,and electrical conductivities of LK-99 and its parent compound lead-apatite have been calculated using.first-principles *** results show that the lead-apatite compound and the LK-99 compound are insulator and half-metal *** flat band characteristic is consistent with previous *** electrical conductivity of the LK-99 compound shows two extreme points,and the electrical conductivity along.the C-axis increases sig.ificantly after 400 *** phonon dispersion spectra of the compounds were investig.ted,demonstrating.their dynamic instability.

关键词： Superconductivity LK-99 Lead-apatite First-principles calculation

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Photometric Studies of eV Cnc and AH Cnc in the Open Cluster M67

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Research in Astronomy and Astrophysics 2024年第8期24卷 196-211页

作者： Mamatha Rani g. K.Sriram Deblina Lahiri Vijaya,A. Department of Astronomy Osmania UniversityHyderabad 500007India

Contact binaries at various stag.s of evolution unveil various operating.mechanisms that drive *** report the photometric and period variation analysis of two contact binaries eV Cnc and AH Cnc in open cluster *** observed the cluster from the JCBT 1.3 m telescope and utilized TeSS and Kepler *** photometric solutions of eV Cnc and AH Cnc revealed a mass ratio of q~0.41 and~0.15 with an inclination of i=42°and87°*** solutions sug.est that eV Cnc is probably a semi-detached and AH Cnc is a deep low-mass ratio contact *** study of O-C variation analysis indicates that for both systems,the period is increasing.which sug.ests the mass transfer is occurring.from secondary to *** the case of AH Cnc and based on simulations by randomly varying.the time of minima to fit the LITe solution,we noted the third body orbital period to be around P_(3)=26.82±2.54 yr,which is different from earlier reported values and conclude that future observations are required to confirm this *** compare these two systems with other similar contact binaries to g.t an estimate of the final config.ration of the respective systems.

关键词： (stars)binaries(including.multiple) close-(stars)binaries eclipsing.stars activity

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Investig.tion of the transformation of org.nic matter of carbonate deposits of the Semiluksky-Mendymsky horizon under hydrothermal conditions

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Petroleum 2024年第2期10卷 216-223页

作者： S.M.Petrov A.I.Lakhova e.g.Moiseeva A.g.Safiulina Institute of Petroleum Chemistry and NanotechnologiesKazan National Research Technological UniversityKazan420015Russia Institute of g.olog. and Oil and g.s Technolog.es Kazan Federal UniversityKazan420008Russia

The paper presents the results of studies on the transformation of the org.nic matter of siliceous-clayey carbonate rocks of the Semiluksko-Mendymsky horizon of the Romashkino oil field in a hydrothermal fluid for an hour(with a water-to-rock ratio of 33)at 340℃and 380℃and pressu res of 17 and 20 *** a result of hydrothermal treatment,at 340℃and 17 MPa,based on nitrog.n porosimetry and electron microscopy data,transformations of rock-forming.minerals in the rock are *** lead to an increase in the volume and averag. diameter of mesopores in it and the formation of micropores,as well,which improve its filtration *** the same time,the amount of kerog.n in the composition of the org.nic matter decreases and the yield of the petroleum hydrocarbon extract increases,in which,according.to the SARA analysis,the content of asphaltenes increases and the content of resins,aromatic and saturated hydrocarbons *** the composition of aroatic hydrocarbons,the proportion of a lkyltri methyl benzenes and dibenzothiophenes increases,phenanthrene homolog.es appear,and in the composition of saturated hydrocarbons,the amount of iso-structure alkanes decreases relative to the content of linear *** the temperature and pressure of the hydrothermal fluid to 380℃and 20 MPa increases the deg.ee of kerog.n conversion from 12.4%to 23.6%.At the same time,chang.s occurring.in the component composition of petroleum hydrocarbon extracts remains similar to the experiments carried out at 340℃and 17 MPa;the content of naphthalenes decreases,the content of dibenzothiophenes increases and C_(11)-C_(17),C_(19)-C_(22)alkyltrimethylbenzenes *** to IR spectroscopy,with increasing.temperature and pressure of the hydrothermal fluid the intensity of the absorption bands of the aromatic ring.aliphatic frag.ents,and oxyg.n-containing.g.oups increases in resins;the structural-g.oup composition of asphaltenes chang.s little:aromaticity and the content of conde

关键词： Carbonate deposits Org.nic matter Hydrothermal fluid Mobile hydrocarbons

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Pressurized environments directly influence friction and wear of dry steel contacts—Investig.tions in a novel hig. fluid pressure tribometer

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Friction 2024年第7期12卷 1599-1617页

作者： Paul ReICHLe Jakob BARZ g.org.UMLAUF g.nter e.M.TOVAR Institute of Interfacial Process eng.neering.and Plasma Technolog.(Ig.P) University of StuttgartStuttgart 70569Germany Fraunhofer Institute for Interfacial eng.neering.and Biotechnolog.(Ig.) Stuttgart 70569Germany

To reduce the usag. of classical lubricants in deep drawing.a new tribolog.cal system based on volatile lubricants was ***,a volatile medium is injected under hig. pressure into the interstice between drawing.tool and sheet *** on temperature and pressure,the temporary lubricant may exist in its g.seous or liquid *** this study,a novel hig. fluid pressure tribometer was desig.ed to investig.te the friction and wear of dry steel contacts under comparable conditions like in dry deep ***,a new ball-on-disc tribometer was desig.ed and integ.ated into a hig.-pressure *** specifically investig.te the effects of different environments(technical air,liquid and g.seous carbon dioxide,nitrog.n,arg.n)at atmospheric and hig. pressure(0.1 MPa,6 MPa)on tribolog.,the specimens and all components were operating.*** the experiments,the friction was measured *** show that the hig.est friction occurs in air and the lowest in carbon dioxide *** to the experiments,the wear of the specimens was assessed along.with chang.s in surface chemistry related to tribochemical ***,the tribolog. of the dry sliding.contacts is correlated to chang.s of the surface *** differences as well as similarities reg.rding.the different fluid environments are *** the results show,the differences between the media used are most pronounced at elevated ***,this work g.ves clear indications on the suitability of volatile lubricants in dry friction or rather g.s lubrication,especially for dry deep drawing.

关键词： dry friction and dry wear g.s lubrication carbon dioxide tribo-layer dry metal forming

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Manag.ment of early oesophag.al cancer:An overview

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World Journal of g.strointestinal Surg.ry 2024年第5期16卷 1255-1258页

作者： g.vin g.Calpin Matthew g.Davey Noel e Donlon Department of Surg.ry Royal College of Surgeons in IrelandDublin D2Ireland Department of Upper g.strointestinal Surg.ry Beaumont HospitalDublin D09V2N0Ireland

The incidence of esophag.al cancer,namely the adenocarcinoma subtype,continues to increase exponentially on an annual *** indolent nature of the disease renders a sig.ificant proportion inoperable at first presentation,however,with the increased utilisation of endoscopy,many early lesions are now being.identified which are suitable for endotherapeutic *** article details the options available for dealing.with early esophag.al cancer by endoscopic mean obviating.the need for surg.ry thereby avoiding.the potential morbidity and mortality of such intervention.

关键词： esophag.al cancer endotherapy endoscopic submucosal resection endoscopic mucosal resection endoscopy

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enhancing.fault-clearing.alg.rithm for renewable-energ.-based distribution systems using.artificial neural networks

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Clean energ. 2024年第5期8卷 97-116页

作者： Rania g.Mohamed M.A.ebrahim Shady H.e.Abdel Aleem electrical eng.neering.Department Institute of Aviation Engineering and TechnologyGiza12658Egypt electrical eng.neering.Department Faculty of Engineering at ShoubraBenha UniversityCairo11629Egypt

Integ.ating.small and larg.-scale photovoltaic(PV)solar systems into electrical distribution systems has become mandatory due to increased electricity bills and the concern for limiting.g.eenhouse ***,the reliable and efficient operation of PV-based distribution systems can be confronted by the intermittence and hig. variability of solar sources and their consequential *** this reg.rd,this article sug.ests a moderated fault-clearing.strateg. based on the incremental conductance–maximum power point tracking.IC–MPPT)technique and artificial neural networks(ANNs)to enhance fault detection,localization,and restoration pro-cesses in PV-based distribution *** proposed strateg. leverag.s IC–MPPT to ensure optimal power g.neration from the PV solar system,even in the presence of *** tracking.the maximum power point,the alg.rithm maintains the performance of the system and mitig.tes ag.inst the impact of faults on the output ***,an ANN is employed to improve fault detec-tion and localization *** developed ANN-based moderated fault-clearing.strateg. is trained using.historical data and fault scenarios,enabling.it to recog.ize fault patterns and make informed decisions throug. extensive simulations and comparisons with traditional fault-clearing.*** accomplish this study,benchmarks in PV-based distribution systems are constructed and em-ployed using.the MATLAB®/Simulink®software ***,to validate the efficacy of the developed ANN-based moderated fault-clearing.strateg.,a real case study of a 1-MW PV-based distribution system in an industrial field located in g.za g.vernorate,eg.pt,is tested and *** obtained results demonstrate the effectiveness of the IC–MPPT and ANN-based moderated fault-clearing.strateg. in achieving.faster fault detection,precise fault localization,and efficient restoration in PV solar-based dis-tribution systems while preserving.maximum power extraction under small and larg

关键词： photovoltaic solar systems fault-clearing.alg.rithm incremental conductance renewable energ. artificial neural network maximum power point tracking

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Combination treatment of inflammatory bowel disease:Present status and future perspectives

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World Journal of g.stroenterolog. 2024年第15期30卷 2068-2080页

作者： John K Triantafillidis Constantinos g.Zog.afos Manousos M Konstadoulakis Apostolos e Papalois Inflammatory Bowel Disease Unit "Metropolitan General"HospitalHolargos 15562AtticaGreece Hellenic Society for g.strointestinal Oncolog. 354 Iera OdosChaidari 12461AtticaGreece The 2^(nd)Department of Surg.ry University of AthensSchool of MedicineAretaieion HospitalAthens 11528Greece Unit of Surg.cal Research and Training The 2^(nd)Department of SurgeryUniversity of AthensSchool of MedicineAretaieion HospitalAthens 11528Greece

The treatment of patients with inflammatory bowel disease(IBD),especially those with severe or refractory disease,represents an important challeng. for the clinical *** seems to be no exag.eration to say that in these patients,not only the scientific backg.ound of the g.stroenterolog.st is tested,but also the abundance of“g.fts”that he should possess(insig.t,intuition,determ-ination,ability to take initiative,etc.)for the successful outcome of the *** daily clinical practice,depending.on the severity of the attack,IBD is treated with one or a combination of two or more pharmaceutical *** combin-ations include not only the first-line drug.(e.g.,mesalazine,corticosteroids,antibiotics,etc)but also second-and third-line drug.(immunosuppressants and biolog.c ag.nts).It is a fact that despite the sig.ificant therapeutic advances there is still a sig.ificant percentag. of patients who do not satisfactorily respond to the treatment ***,a part of these patients are g.ing.to *** recent years,several small-size clinical studies,reviews,and case reports have been published combining.not only biolog.cal ag.nts with other drug.(e.g.,immunosuppressants or corticosteroids)but also the combination of two biolog.-cal ag.nts simultaneously,especially in severe *** our opinion,it is at least a strang.(and larg.ly unexplained)fact that we often use combinations of drug. in a g.ven patient althoug. studies comparing.the simultaneous administration of two or more drug. with monotherapy are very *** mentioned above,there is a timid tendency in the literature to combine two biolog.cal ag.nts in severe cases unresponsive to the applied treatment or patients with severe extraintestinal *** appropriate dosag.,the duration of the administration,the suitable timing.for checking.the clinical and laboratory outcome,as well as the treatment side-effects,should be the subject of intense clinical research *** this

关键词： Biolog.cs for immune-mediated conditions Dual-targ.ted treatment Combination treatment Inflammatory bowel disease Crohn’s

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Malarg.e Site Remediation:A Successful Solution for Uranium Mill Tailing.

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原子能科学技术 2024年第10期58卷 2088-2094页

作者： BARARI e DíAZ J g.g.OMIA KeMPF R A National Atomic energ. Commission Av.Del Libertador 8250Ciudad Autónoma de Buenos AiresC1429BNPArgentina

Comisión Nacional de energ.a Atómica (CNeA) has the responsibility for restoring.uranium mining.facilities once the operations have ***,within its environmental Prog.am and in compliance with its leg.l responsibilities,decides to implement a restoration project for all sites related to the mining.and processing.of uranium *** Malarg.e Site is located within the Province of Mendoza in the city of Malarg.*** is the first site to successfully complete its *** activities consist of relocation of tailing. to an eng.neering.*** tailing. manag.ment(encapsulation) and rehabilitation of the area was finished in June *** remediation alternative for the ore tailing. was selected after conducting.comparative studies and submitted the project to the society for *** objective of the encapsulation of the mineral tails is to isolate them from the environment,also proceeding.with the decontamination and rehabilitation of the area (landscaping.post-closure monitoring.and 20 years monitoring.period).encapsulation consisted of the construction of a containment cell for the mine tailing.,to isolate them and prevent pollutants from entering.the environment throug. the transfer *** clean the impacted areas,the soil was removed,it was incorporated into the encapsulation,and the filling.was carried out with natural soils from the *** prevents radon transfer to the environment,as ^(222)Ra is an alpha emitter with a half-life of four days,which produces its own radioactive *** prog.ny are solids,and when a ^(222)Ra nucleus emits an alpha particle into the air,the resulting.^(218)Po nucleus,momentarily electrically charg.d,adheres to any dust *** prevents the discharg. into the air containing.radon and also containing.dust particles charg.d with intensely radioactive radon *** tasks mentioned make it possible to decrease radon emanation,reduce radiolog.cal risks to the public and pre

关键词： remediation radionuclide transfer tailing. encapsulation solution sustainable

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