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Distinct but correct: generating diversified and entity-revised medical response

Science China(Information Sciences) 2024年第3期67卷 94-113页

作者： Bin LI Bin SUN Shutao LI Encheng CHEN Hongru LIU Yixuan WENG Yongping BAI Meiling HU College of Electrical and Information Engineering Hunan University School of Mathematics Sun Yat-sen University JD Technology National Laboratory of Pattern Recognition Institute of AutomationChinese Academy of Sciences Xiangya Hospital of Central South University Teaching and Research section of Clinical nursing Xiangya Hospital of Central South University

Medical dialogue generation(MDG) is applied for building medical dialogue systems for intelligent consultation. Such systems can communicate with patients in real time, thereby improving the efficiency of clinical diagnosis. However, predicting correct entities and correctly generating distinct responses remain a great challenge. Inspired by actual doctors’ responses to patients, we consider MDG a two-stage task: entity prediction and dialogue generation. For entity prediction, we design an ent-mac post pre-training strategy by leveraging external medical entity knowledge to enhance the pre-trained model. For dialogue generation, we propose an entity-aware fusion MDG method in which predicted entities are integrated into the dialogue generation model through different encoding fusion mechanisms, using information from different sources. Because the diverse beam search algorithm can produce responses with entities that deviate from the predicted entities, an entity-revised diverse beam search is proposed to correct the entities entailed in the generated responses and make the generated responses more distinct. The experimental results on the China Conference on Knowledge Graph and Semantic Computing 2021(A/B tests) and the International Conference on Learning Representations 2021(online test) datasets show that the proposed method outperforms several state-of-the-art methods, which demonstrates its practicability and effectiveness.

关键词： medical entity prediction ent-mac post pre-training strategy entity-aware fusion medical dialogue generation encoding fusion mechanism entity-revised diverse beam search

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护士参与抗菌药物管理现状及影响因素研究

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International Journal of nursing Sciences 2024年第1期11卷 91-98,I0002,I0003页

作者：聂慧宇岳丽青彭欢周金平李冰玉曹紫薇 Teaching and Research section of Clinical nursing Xiangya Hospital of Central South UniversityChangshaHunanChina Xiangya School of nursing Central South UniversityChangshaHunanChina

目的基于能力、机会、动机和行为(capability, opportunity, motivation, and behavior, COM-B )理论,调查我国护士抗菌药物管理(antimicrobial stewardship, AMS)参与水平及其影响因素,为制订有效策略提高AMS护理质量提供参考依据。... 详细信息

目的基于能力、机会、动机和行为(capability, opportunity, motivation, and behavior, COM-B )理论,调查我国护士抗菌药物管理(antimicrobial stewardship, AMS)参与水平及其影响因素,为制订有效策略提高AMS护理质量提供参考依据。方法采用横断面调查法。于2021年11月至2022年1月,选取湖南省的17所三级医院的4514名护士进行调查。在COM-B理论指导下,自行编制护士参与抗菌药物管理问卷(the NurseAMS Engagement Que stionnaire ,NAEQ)。该问卷包括能力(14个条目)、机会(7个条目)、动机(6个条目)和行为(12个条目)4个维度,共39个条目。结果护士NAEQ总分为( 155.08±±27.12)分,得分率为79.5% ,表明护士参与AMS处于中等水平。其中,能力维度得分为(52.33±13.48 )分,机会维度得分为(28.64±5.76)分,动机维度得分为(24.57±4.57)分,行为维度得分为(4953±8.83)分。不同职称、是否兼职感染控制护士、是否知晓AMS团队、是否知晓抗菌药物限定日剂量、科室类型、科室是否配备临床药师、参与抗菌药物培训和医师-护士联合查房的频率等特征不同的护士NAEQ得分比较,差异有统计学意义(P<0.05)。其中初级职称护士的NAEQ得分高于中级职称护士(P<0.05);担任兼职感染控制护士、知晓AMS团队、知晓抗菌药物限定日剂量的护士NAEQ得分高于其他护士(P<0.01);重症监护室和传染病科护士NAEQ得分低于五官科等其他科室的护士(P<0.01);科室配备临床药师的护士NAEQ得分高于未配备或不清楚是否配备临床药师的护士(P<0.01);参与抗菌药物培训和医师-护士联合查房次数较多的护士NAEQ得分高于其他护士(P<0.01)。结论加强教育和培训及改善多学科沟通与协作等多种策略有望提高护士参与AMS的水平。此外,应更多关注中级职称、感染控制经验较少以及特定科室工作的护士。

关键词：抗菌药物管理行为中国医院知识动机护士

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Stress and coping styles among nursing students during the initial period of the clinical practicum:A cross-section study

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International Journal of nursing Sciences 2022年第2期9卷 222-229,I0008页

作者： Jing Liu Yeqin Yang Junya Chen Yi Zhang Yawei Zeng Jufang Li School of nursing Wenzhou Medical UniversityWenzhouZhejiangChina

Objectives:This study aimed to explore the level of stress,types of stressors,type of coping styles,and factors influencing stress levels and coping styles among nursing students during the initial period of the clinical ***:A cross-sectional survey design was *** September 2017,participants were recruited from a tertiary hospital in Zhejiang Province,China,using a convenience sampling method.A demographic characteristics questionnaire,the Intern nursing Student Stressor Scale,and the Simple Coping Style Questionnaire were used to collect *** were analyzed using descriptive analysis,independent sample t-tests,one-way analysis of variance,Pearson’s correlation analysis,and multiple linear regres-sion ***:A total of 158 nursing students were recruited,most of whom were female,undergraduates,and from rural *** nursing students perceived a moderate level of stress during the initial period of the clinical *** need for knowledge and skills was the most common source of *** coping styles were most commonly *** students who were undergraduates,only children,and chose nursing major involuntarily experienced higher stress levels than those who were junior college students,not only children,and chose nursing major *** undergraduates were more likely to use positive coping styles than junior college *** nursing students and those experiencing higher stress levels related to the“environment and equipment of the wards”and the“nature and content of the work”were more likely to use negative coping ***:nursing educators should offer targeted guidance based on the stress reported during the clinical practicum and the demographic characteristics of the nursing *** should be provided to encourage nursing students to adopt effective coping strategies and reduce stress.

关键词： Clinical practicum Coping styles Stress nursing students Psychological adaptation

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6DOF pose estimation of a 3D rigid object based on edge-enhanced point pair features

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Computational Visual Media 2024年第1期10卷 61-77页

作者： Chenyi Liu Fei Chen Lu Deng Renjiao Yi Lintao Zheng Chenyang Zhu Jia Wang Kai Xu College of Computing National University of Defense TechnologyChangsha410073China Department of Spine Surgery the Second Xiangya HospitalCentral South UniversityChangsha410011China Clinical nursing Teaching and Research section the Second Xiangya HospitalChangsha410011China College of Meteorology and Oceanography National University of Defense TechnologyChangsha410073China Beijing Institute of Tracking and Communication Technology Beijing100094China

The point pair feature(PPF)is widely used for 6D pose *** this paper,we propose an efficient 6D pose estimation method based on the PPF *** introduce a well-targeted down-sampling strategy that focuses on edge areas for efficient feature extraction for complex geometry.A pose hypothesis validation approach is proposed to resolve ambiguity due to symmetry by calculating the edge matching *** perform evaluations on two challenging datasets and one real-world collected dataset,demonstrating the superiority of our method for pose estimation for geometrically complex,occluded,symmetrical *** further validate our method by applying it to simulated punctures.

关键词： point pair feature(PPF) pose estimation object recognition 3D point cloud

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重症监护室智慧化管理措施减少临床虚假警报效果的整合性综述

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International Journal of nursing Sciences 2024年第1期11卷 133-142页

作者：李冰玉岳丽青聂慧宇曹紫薇柴小桠彭彬张恬鸽黄伟红 Teaching and Research section of Clinical nursing Xiangya Hospital of Central South UniversityChangshaHunanChina Xiangya School of nursing Central South UniversityChangshaHunanChina “Mobile Health”Ministry of Education-China Mobile Joint Laboratory Xiangya Hospital of Central South UniversityChangshaHunanChina

目的医疗设备的频繁虚假警报可能导致护土警报疲劳,这可能导致反应行动延迟或错过警报,增加患者不良事件的风险。本综述旨在探讨重症监护室临床警报智慧化管理措施对减少临床虚假警报的应用效果。方法根据Whitmore 和Knaf的方法学框架,... 详细信息

目的医疗设备的频繁虚假警报可能导致护土警报疲劳,这可能导致反应行动延迟或错过警报,增加患者不良事件的风险。本综述旨在探讨重症监护室临床警报智慧化管理措施对减少临床虚假警报的应用效果。方法根据Whitmore 和Knaf的方法学框架,对6个数据库进行系统检索: PubMed, EMBASE,CINAHL,OVID,CochraneLibrary,Scopus,检索从每个数据库建库到2022年12月以英文或中文发表的临床警报的智慧化管理相关文章。采用乔安娜布里格斯研究所的评价工具(JBI-MAStARI)评估研究的质量,并对文献进行数据提取和分析。该研究已在PROSPERO完成注册(CRD42023411552)。结果共纳入7项研究。不同的警报智慧化管理措施有利于减少虚假警报数量和警报的持续时间,缩短护士对重要警报的应答时间,减轻护士的警报疲劳程度。在实践中,应用新的警报管理方式后取得了积极的效果。结论智慧化管理措施可能是警报减少的有效途径,医院迫切需要进行临床警报的智慧化管理。为确保更有效的患者监测、减少警报给护士带来的困扰,未来需要更多与人工智能相结合的警报管理手段,以实现关键警报的准确识别,确保护士对警报准确响应,并真正改善警报频繁的临床医疗环境。

关键词：人工智能临床警报重症监护室护士生理监测安全管理

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护士参与抗菌药物管理现状及影响因素研究（英文）

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International Journal of nursing Sciences 2024年第1期 91-98+159-160页

作者：聂慧宇岳丽青彭欢周金平李冰玉曹紫薇 Teaching and Research section of Clinical nursing Xiangya Hospital of Central South University Xiangya School of nursing Central South University

目的基于能力、机会、动机和行为(capability,opportunity,motivation,and behavior,COM-B)理论,调查我国护十抗菌药物管理(antmicroD1al stewardship,AMS)参与水平及其影响因素,为制订有效策略提高AMS护理质量提供参考依据。方法采... 详细信息

目的基于能力、机会、动机和行为(capability,opportunity,motivation,and behavior,COM-B)理论,调查我国护十抗菌药物管理(antmicroD1al stewardship,AMS)参与水平及其影响因素,为制订有效策略提高AMS护理质量提供参考依据。方法采用横断面调查法。于2021年11月至2022年1月,选取湖南省的17所三级医院的4 514名护士进行调查。在COM-B理论指导下,自行编制护士参与抗菌药物管理问卷(the Nurse AMS Engagement Questionnaire,NAEQ)。该问卷包括能力(14个条目)、机会(7个条目)、动机(6个条目)和行为(12个条目)4个维度,共39个条目。结果护十NAEQ总分为(155.08±27.12)分,得分率为79.5%,表明护士参与AMS处于中等水平。其中,能力维度得分为(52.33±13.48)分,机会维度得分为(28.64±5.76)分,动机维度得分为(24.57±4.57)分,行为维度得分为(49.53±8.83)分。不同职称、是否兼职感染控制护士、是否知晓AMS团队、是否知晓抗菌药物限定口剂量、科室类型、科室是否配备临床药师、参与抗菌药物培训和医师-护士联合查房的频率等特征不同的护士NAEQ得分比较,差异有统计学意义(P<0.05)。其中初级职称护士的NAEQ得分高于中级职称护士(P<0.05);担任兼职感染控制护士、知晓AMS团队、知晓抗菌药物限定日剂量的护士NAEQ得分高于其他护上(P<0.01);重症监护室和传染病科护士NAEQ得分低于五官科等其他科室的护士(P<0.01);科室配备临床药师的护士NAEQ得分高于未配备或不清楚是否配备临床药师的护士(P<0.01);参与抗菌药物培训和医师-护十联合查房次数较多的护士NAEQ得分高于其他护十(P<0.01)。结论加强教育和培训及改善多学科沟通与协作等多种策略有望提高护士参与AMS的水平。此外,应更多关注中级职称、感染控制经验较少以及特定科室工作的护士。

关键词：抗菌药物管理行为中国医院知识动机护士

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Evaluation of a complex couplet care intervention in a neonatal intensive care unit:A mixed methods study protocol

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Pediatric Investigation 2024年第2期8卷 139-148页

作者： Michella Bjerregaard Anna Axelin Emma Louise Malchau Carlsen Hans Okkels Birk Ingrid Poulsen Patrick Palisz Thomas Kallemose Anne Brødsgaard Department of Paediatric and Adolescent Medicine Copenhagen University Hospital Amager HvidovreHvidovreDenmark Department of Public Health Faculty of HealthResearch Unit for Nursing and HealthcareUniversity of AarhusAarhusDenmark Department of nursing Science University of TurkuTurkuFinland Department of Clinical Medicine Faculty of Health and Medical ScienceUniversity of CopenhagenCopenhagenDenmark Department of Public Health Section of Health Service ResearchUniversity of CopenhagenCopenhagenDenmark Department of People and Technology Roskilde UniversityRoskildeDenmark Department of Clinical Research Copenhagen University Hospital Amager HvidovreHvidovreDenmark Department of Gynaecology and Obstetrics Copenhagen University Hospital Amager HvidovreHvidovreDenmark

Background:Families with an infant in need of intensive care most often experience a harmful separation after *** is due to a division of medical specialties into neonatal care and maternal ***,a couplet care intervention is implemented for mother-infant dyads in a neonatal intensive care *** study protocol provides a comprehensive evaluation of the *** aim is to evaluate the effect and implementation of a complex couplet care intervention to promote zero separation between mother and ***:The couplet care intervention is a family-centered model of care,where treatment-requiring mother-infant dyads will be admitted together and receive couplet care by neonatal *** study adheres to the framework of the Medical Research Council and will use a mixed methods embedded design comprising a quasi-experimental trial and a qualitative process ***,a health economic evaluation will be conducted to assess the cost-effectiveness of this complex couplet care ***:Separation of mother-infant dyads after birth has an adverse impact on family health and *** study protocol evaluates a complex couplet care *** this study,a first step is taken to help bridge the gap between current practices and a new care model to prevent the separation of mothers and their infants.

关键词： Complex interventions Couplet care Family-centered care Neonatology Zero separation

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Acceptability of Caesarean section among Pregnant Women Seeking Antenatal Care at Women and Newborn Hospital-University Teaching Hospitals, Lusaka Zambia

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Open Journal of Obstetrics and Gynecology 2024年第5期14卷 721-743页

作者： Huhenya Sharon Chongo Maureen Masumo Namayipo Nankamba Lusaka College of nursing and Midwifery University Teaching Hospital Lusaka Zambia Department of Midwifery Women and Child Health School of Nursing Sciences University of Zambia Lusaka Zambia

Caesarean section remains one of the most common obstetric and major operations performed on women during pregnancy and has contributed to improving maternal and foetal health. Consequently, significant mortality and morbidity from pregnancy and labour-related causes can be eliminated by a timely caesarean section. The acceptance of the life-saving procedure remains unsatisfactory in most sub-Saharan nations. The study aimed to assess the acceptability of caesarean section and associated factors among pregnant women seeking antenatal care at Women and Newborn Hospital-University Teaching Hospitals in Lusaka Zambia. The study utilised a quantitative cross-sectional analytical study design involving 420 pregnant women selected using systematic random sampling at Women and Newborn Hospital-University Teaching Hospitals Lusaka Zambia. Data was obtained using an Interview schedule and analysed using R software version 4.3.2. Chi-square, Fisher’s exact test, Wilcoxon rank sum test and binary logistic regression for statistical analysis at a 5% level of significance. The study found that the acceptability of Caesarean section as a mode of delivery was low (29%) among respondents at Women and Newborn Hospital-University Teaching Hospitals. This was influenced by marital status (P = 0.002), socioeconomic status (P = 0.050), parity (P = 0.004), gestation age (P = 0.008), previous history of caesarean section (P = 0.003), knowledge (P section delivery is common among women at Women and Newborn Hospital-University Teaching Hospitals, despite its potential benefits for maternal and neonatal health. Socio-demographic and maternal characteristics, knowledge, attitude, perception, and socio-cultural beliefs play a major role in determining acceptability. Therefore, efforts to enhance acceptability should focus on improving knowledge, enhancing positive perceptions and attitudes, an

关键词： Caesareans section Acceptability Knowledge Attitude Perception

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The Value of Modern Information Technology in nursing Emergencies

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Health 2024年第9期16卷 849-855页

作者： Xushan Zhou Ying Li Henglong Xu Chenyan Li Hongling Sun Department of Information Technology section The First Rehabilitation Hospital of Shandong Linyi China Department of nursing The First Rehabilitation Hospital of Shandong Linyi China Department of Health Management Center The First Rehabilitation Hospital of Shandong Linyi China Department of Laboratory The Second Affiliated Hospital of Guangxi Medical University Liuzhou Cancer Hospital of Guangxi Liuzhou China

In first aid, traditional information interchange has numerous shortcomings. For example, delayed information and disorganized departmental communication cause patients to miss out on critical rescue time. Information technology is becoming more and more mature, and as a result, its use across numerous industries is now standard. China is still in the early stages of developing its integration of emergency medical services with modern information technology; despite our progress, there are still numerous obstacles and constraints to overcome. Our goal is to integrate information technology into every aspect of emergency patient care, offering robust assistance for both patient rescue and the efforts of medical personnel. Information may be communicated in a fast, multiple, and effective manner by utilizing modern information technology. This study aims to examine the current state of this field’s development, current issues, and the field’s future course of development.

关键词： Modern Information Technology nursing First Aid Critical Care

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Recovery rates of persistent post-COVID-19 olfactory dysfunction using psychophysical assessment:A longitudinal cohort study

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World Journal of Otorhinolaryngology-Head and Neck Surgery 2024年第2期10卷 79-87页

作者： Jeremy P.Tervo Patricia T.Jacobson Brandon J.Vilarello Tiana M.Saak Francesco F.Caruana Liam W.Gallagher Joseph B.Gary David A.Gudis Paule V.Joseph D.P.Devanand Terry E.Goldberg Jonathan B.Overdevest Columbia University Vagelos College of Physicians and Surgeons New YorkNew YorkUSA Department of Otolaryngology-Head and Neck Surgery New York-Presbyterian/Columbia University Irving Medical CenterNew YorkNew YorkUSA Department of Otolaryngology-Head and Neck Surgery University of PittsburghPittsburghPennsylvaniaUSA Department of Otolaryngology-Head and Neck Surgery University of MinnesotaMinneapolisMinnesotaUSA National Institute of Alcohol Abuse and Alcoholism Section of Sensory Science and Metabolism&National Institute of Nursing ResearchBethesdaMarylandUSA New York-Presbyterian/Columbia University Irving Medical Center New YorkNew YorkUSA

Objectives:Persistent olfactory dysfunction(OD)following loss of smell associated with SARS-CoV-2 infection is a major feature of long *** on the prevalence of persistent OD predominantly rely on self-reported olfactory *** studies have tracked longitudinal rates of recovery using psychophysical assessment among patients presenting for evaluation of persistent OD beyond a window of acute *** anchored in standardized testing methods are needed to counsel patients who fail to acutely regain their sense of *** study aims to quantify the degree of persistent OD in post-COVID-19 patients who experience subjective and psychophysical ***:We grouped participants presenting for OD evaluation into cohorts based on both subjective and psychophysical olfactory status at a baseline assessment and assessed their olfactory abilities with a visual analogue scale and the Sniffin'Sticks extended test at baseline and 1-year time *** had confirmed a history of COVID-19 by lab evaluation or clinical diagnosis if lab evaluation was not ***:Baseline olfactory evaluation was completed by 122 participants,53 of whom completed the 1-year follow-up *** participants presenting with perceived OD,74.5%had confirmed psychophysical OD at baseline,with 55.1%at 1-year *** had reliable trends in self-rated versus psychophysically tested olfactory function at both time *** total threshold,discrimination,and identification(TDI)score improved by+3.25 points in the cohort with psychophysical OD(p=0.0005),with this improvement largely attributable to an increase in median threshold scores(+2.75 points;p=0.0004).Conclusions:OD persists in a significant number of patients who fail to acutely recovery their sense of smell after COVID-19,with many demonstrating lingering deficits at *** in threshold,but not discrimination or identification,most significantly mediate improvement

关键词： long COVID olfaction post-COVID condition smell dysfunction

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