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基于卡尔加里-剑桥指南的沙龙培训模式提升全科规培医师医患沟通技能的对照研究

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中国全科医学 2025年第1期28卷 71-76页

作者：彭涛邹川曾欣张焱沈静四川省成都市第五人民医院全科医学科 611130

背景医患沟通技能是全科医生的核心岗位胜任力之一,高水平的医患沟通能力是创建和谐医患关系的基石,有助于提高患者就医获得感和满意度。而我国全科医生沟通能力普遍偏低,有待探索出一种适应我国国情、满足我国全科医生沟通需求的医患... 详细信息

背景医患沟通技能是全科医生的核心岗位胜任力之一,高水平的医患沟通能力是创建和谐医患关系的基石,有助于提高患者就医获得感和满意度。而我国全科医生沟通能力普遍偏低,有待探索出一种适应我国国情、满足我国全科医生沟通需求的医患沟通培训模式来提高其医患沟通能力。目的探索基于卡尔加里-剑桥指南的沙龙培训模式在全科规培医师医患沟通技能培训中的应用效果,为构建适合我国国情的医患沟通培训体系提供参考依据。方法选取成都市第五人民医院2019—2020年度全科规培医师40名作为研究对象,按照随机数字表法分为沙龙组和对照组,每组20名,其中沙龙组使用基于卡尔加里-剑桥指南的沙龙培训模式进行医患沟通培训,对照组设置为空白对照,培训前、培训后1周分别对两组学员采用标准化病人(SP)模式进行接诊,使用医患沟通评价量表(SEGUE量表)进行现场观察评分,比较两组学员的医患沟通培训效果。结果最终纳入28名,其中沙龙组15名,对照组13名,培训后沙龙组规培医师SEGUE量表评分从(11.80±4.36)分提高至(18.07±4.11)分,对照组规培医师SEGUE量表评分从(12.15±4.63)分提高至(14.46±3.71)分。沙龙组培训后的SEGUE量表评分与培训前的比较,差异有统计学意义(t=3.250,P<0.001);对照组培训后的SEGUE量表评分与培训前比较,差异无统计学意义(t=2.582,P=0.624);培训后对SEGUE量表中的25个项目进行分析,沙龙组与对照组SEGUE量表评分比较,差异有统计学意义(P<0.05)。沙龙组以下5个项目结果优于对照组,准备阶段中的“建立个人信任关系”(93.3%比7.7%)、“保护患者的隐私/尊重患者选择权”(53.3%比15.4%);理解患者阶段中的“认同患者为疾病所付出的努力、改变及其遇到的困难”(33.3%比23.1%)、“表达关心,使患者感到温暖/树立信心”(100.0%比69.2%);结束问诊阶段中的“询问患者是否还有其他的问题需要探讨”(66.7%比23.1%)。结论基于卡尔加里-剑桥指南的沙龙培训模式对全科规培医师进行医患沟通技能培训可增强学员主动参加培训的兴趣和积极性,对于医患沟通能力的提升具有较好的培训效果,值得借鉴和推广。

关键词：全科医学全科医师规范化培训医患沟通沟通培训卡尔加里-剑桥指南

Comprehensive bibliometric analysis of pharmacotherapy for bipolar disorders:Present trends and future directions

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World Journal of Psychiatry 2025年第1期15卷 153-167页

作者： Bo-Fan Chen Li Liu Fang-Zhen Lin Hai-Min zeng Hai-Qiang Huang Chun-Fang Zhang Cong-Cong Liu Xiang Chen Jie Peng Yun-Fa Wang Zhi-Lin Wang Bin Chen De-Le Liu Yun Liu Zheng-Zheng Li xin-xing zeng The Second Affiliated Hospital Jiangxi Medical CollegeNanchang UniversityNanchang 330006Jiangxi ProvinceChina The Second Clinical Medical College Jiangxi Medical CollegeNanchang UniversityNanchang 330006Jiangxi ProvinceChina Department of Rehabilitation Medicine The Second Affiliated HospitalJiangxi Medical CollegeNanchang UniversityNanchang 330006Jiangxi ProvinceChina Jiangxi Provincial People’s Hospital The First Affiliated Hospital of Nanchang Medical CollegeNanchang 330006Jiangxi ProvinceChina Department of Psychiatry Jiangxi Mental HospitalHospital of Nanchang UniversityNanchang UniversityNanchang 330029Jiangxi ProvinceChina

BACKGROUND Bipolar disorder(BD)is a severe mental illness characterized by significant mood *** drug treatment modalities are crucial for managing *** To analyze the current status and future trends of global research on BD drug treatment over the last *** The Web of Science Core Collection database spanning from 2015 to 2024 was utilized to retrieve literature related to BD drug treatment.A total of 2624 articles were *** visualization and analysis were conducted using CiteSpace,VOSviewer,Pajek,Scimago Graphica,and R-studio bibliometrix to identify RESULTS The United States,China,and the United Kingdom have made the most significant contributions to research on BD drug treatment and formed notable research collaboration *** University of Pittsburgh,Massachusetts General Hospital,and the University of Michigan have been identified as the major research institutions in this *** Journal of Affective Disorders is the most influential journal.A keyword analysis revealed research hotspots related to clinical symptoms,drug efficacy,and genetic mechanisms.A citation analysis identified the management guidelines published by Yatham et al in 2018 as the most cited *** This study provides a detailed overview of the field of BD drug treatment,highlighting key contributors,research hotspots,and future *** study findings can be employed as a reference for future research and policymaking,which may enable further development and optimization of BD pharmacotherapy.

关键词： Bipolar disorder Drug treatment Bibliometric analysis Visualization Mental disorder

An Arbitrary Polygonal Stress Hybrid Element for Structural Dynamic Response Analysis

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Acta Mechanica Solida Sinica 2023年第5期36卷 692-701页

作者： xin zeng Ran Guo Lihui Wang Faculty of Civil Engineering and Mechanics Kunming University of Science and TechnologyKunming 650000China

This paper constructs a new two-dimensional arbitrary polygonal stress hybrid dynamic(APSHD)element for structural dynamic response ***,the energy function is established based on Hamilton's ***,the finite element time-space discrete format is constructed using the generalized variational principle and the direct integration ***,an explicit polynomial form of the combined stress solution is give,and its derivation process is shown in *** completing the theoretical construction,the numerical calculation program of the APSHD element is written in Fortran,and samples are *** show that the APSHD element performs well in accuracy and ***,it is insensitive to mesh distortion and has low dependence on selecting time steps.

关键词： Stress hybrid element method Arbitrary polygonal element Dynamic response analysis Polynomial stress function solution

Integrable Properties Associated with a Discrete Three-by-Three Matrix Spectral Problem

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Communications in Theoretical Physics 2009年第12期52卷 981-986页

作者： LI xin-Yue WANG xin-zeng College of Science Shandong University of Science and Technology Qingdao 266510 China Information School Shandong University of Science and Technology Qingdao 266510 China

Based on a new discrete three-by-three matrix spectral problem, a hierarchy of integrable lattice equations with three potentials is proposed through discrete zero-curvature representation, and the resulting integrable lattice equation reduces to the classical Toda lattice equation. It is shown that the hierarchy possesses a HamiItonian structure and a hereditary recursion operator. Finally, infinitely many conservation laws of corresponding lattice systems are obtained by a direct way.

关键词： discrete Hamiltonian structure discrete zero-curvature representation conservation laws

Comparative Experimental and Numerical Study of Wave Loads on A Monopile Structure Using Different Turbulence Models

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China Ocean Engineering 2021年第4期35卷 554-565页

作者： zeng xin-meng SHI Wei Constantine MICHAILIDES WANG Kai LI xin DeepWater Engineering Research Centre Dalian University of TechnologyDalian 116024China State Key Laboratory of Coastal and Offshore Engineering Dalian University of TechnologyDalian 116024China Civil Engineering and Geomatics Cyprus University of TechnologyLimassol 2026Cyprus School of Marine Engineering and Technology Sun Yat-Sen UniversityZhuhai 51900China

This study numerically and experimentally investigates the effects of wave loads on a monopile-type offshore wind turbine placed on a 1:25 slope at different water depths as well as the effect of choosing different turbulence models on the efficiency of the numerical *** numerical model adopts a two-phase flow by solving Unsteady Reynolds-Averaged Navier−Stokes(URANS)equations using the Volume Of Fluid(VOF)method and three differentk-􀀀ωturbulence *** environmental conditions from the East China Sea are *** wave run-up and the wave loads applied on the monopile are investigated and compared with relevant experimental data as well as with mathematical predictions based on relevant *** numerical model is well validated against the experimental data at model *** use of different turbulence models results in different predictions on the wave height but less differences on the wave *** baseline k-􀀀ωturbulence model and Shear-Stress Transport(SST)k-􀀀ωturbulence model exhibit better performance on the prediction of hydrodynamic load,at a model-scale water depth of 0.42 m,while the laminar model provides better results for large water *** SST turbulence model performs better in predicting wave run-up for water depth 0.42 m,while the laminar model and standard k-􀀀ωmodel perform better at water depth 0.52 m and 0.62 m,respectively.

关键词： hydrodynamic loads turbulence models Morison equation wave run-up numerical wave tank monopile structure

A guidance method for coplanar orbital interception based on reinforcement learning

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Journal of Systems Engineering and Electronics 2021年第4期32卷 927-938页

作者： zeng xin ZHU Yanwei YANG Leping ZHANG Chengming College of Aeronautics and Astronautics National University of Defense TechnologyChangsha 410073China

This paper investigates the guidance method based on reinforcement learning(RL)for the coplanar orbital interception in a continuous low-thrust *** problem is formulated into a Markov decision process(MDP)model,then a welldesigned RL algorithm,experience based deep deterministic policy gradient(EBDDPG),is proposed to solve *** taking the advantage of prior information generated through the optimal control model,the proposed algorithm not only resolves the convergence problem of the common RL algorithm,but also successfully trains an efficient deep neural network(DNN)controller for the chaser spacecraft to generate the control *** simulation results show that the proposed algorithm is feasible and the trained DNN controller significantly improves the efficiency over traditional optimization methods by roughly two orders of magnitude.

关键词： orbital interception reinforcement learning(RL) Markov decision process(MDP) deep neural network(DNN)

An optimal guidance method for free-time orbital pursuit-evasion game

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Journal of Systems Engineering and Electronics 2022年第6期33卷 1294-1308页

作者： ZHANG Chengming ZHU Yanwei YANG Leping zeng xin College of Aerospace Science and Engineering National University of Defense TechnologyChangsha 410000China

With the development of space rendezvous and proximity operations(RPO)in recent years,the scenarios with noncooperative spacecraft are attracting the attention of more and more researchers.A method based on the costate normalization technique and deep neural networks is presented to generate the optimal guidance law for free-time orbital pursuit-evasion ***,the 24-dimensional problem given by differential game theory is transformed into a three-parameter optimization problem through the dimension-reduction method which guarantees the uniqueness of solution for the specific ***,a close-loop interactive mechanism involving feedback is introduced to deep neural networks for generating precise initial *** the optimal guidance law is obtained efficiently and stably with the application of optimization algorithm initialed by the deep neural ***,the results of the comparison with another two methods and Monte Carlo simulation demonstrate the efficiency and robustness of the proposed optimal guidance method.

关键词： orbital pursuit-evasion differential game dimension-reduction deep neural networks

A DNN based trajectory optimization method for intercepting non-cooperative maneuvering spacecraft

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Journal of Systems Engineering and Electronics 2022年第2期33卷 438-446页

作者： YANG Fuyunxiang YANG Leping ZHU Yanwei zeng xin College of Aerospace Science and Engineering National University of Defense TechnologyChangsha 410073China

Current successes in artificial intelligence domain have revitalized interest in neural networks and demonstrated their potential in solving spacecraft trajectory optimization problems. This paper presents a data-free deep neural network(DNN) based trajectory optimization method for intercepting noncooperative maneuvering spacecraft, in a continuous low-thrust scenario. Firstly, the problem is formulated as a standard constrained optimization problem through differential game theory and minimax principle. Secondly, a new DNN is designed to integrate interception dynamic model into the network and involve it in the process of gradient descent, which makes the network endowed with the knowledge of physical constraints and reduces the learning burden of the network. Thus, a DNN based method is proposed, which completely eliminates the demand of training datasets and improves the generalization capacity. Finally, numerical results demonstrate the feasibility and efficiency of our proposed method.

关键词： non-cooperative maneuvering spacecraft neural network differential game trajectory optimization

Robust trajectory planning for UAV communication systems in the presence of jammers

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Chinese Journal of Aeronautics 2022年第10期35卷 265-274页

作者： Lingyun ZHOU Xiaotong ZHAO xin GUAN Enbin SONG xin zeng Qingjiang SHI School of Software Engineering Tongji UniversityShanghai 200092China College of Mathematics and School of Aeronautics and Astronautics Sichuan UniversityChengdu 610064China Department of Information and Communication Engineering Tongji UniversityShanghai 200092China

Unmanned Aerial Vehicle(UAV)has emerged as a promising novel application for the Sixth-Generation(6G)wireless communication by leveraging more favorable Line-of-Sight(Lo S)***,the jamming resistance by exploiting UAV’s mobility is a new challenge in the UAV-ground *** paper investigates the trajectory planning problem in an UAV communication system,where the UAV is operated by a Ground Control Unit(GCU)to perform certain tasks in the presence of multiple jammers with imperfect power and location *** ensure the reliability of the GCU-to-UAV link,we formulate the problem as a non-convex semi-infinite optimization,aiming to maximize the average worst-case Signal-toInterference-plus-Noise Ratio(SINR)over a given flight duration by designing the robust trajectory of the UAV under stringent energy availability *** handle this problem efficiently,we develop an iterative algorithm for the solution with the aid of S-procedure and Successive Convex Approximation(SCA)*** results demonstrate the efficacy of our proposed algorithm and offer some useful design insights to practical system.

关键词： 6G UAV communications Jamming resistance Trajectory optimization Robust design Non-convex optimization