Fixture is an important manufacturing activity. A fixture design system based on case-based reasoning (CBR) is proposed in this paper. A new method of case representation on the basis of fixture function is presented,...Fixture is an important manufacturing activity. A fixture design system based on case-based reasoning (CBR) is proposed in this paper. A new method of case representation on the basis of fixture function is presented, where the case representation is constituted of workpiece knowledge, processing feature knowledge, and fixture feature knowledge. Running the prototype system shows that the knowledge representation method, using cases, s a better way to transform and explain the design knowledge.展开更多
As the most critical part of post-graduate education,the Chinese government launched Standard Resident Training in 2013 to solve the regional inequality of medical quality and meet the increasing social requirement fo...As the most critical part of post-graduate education,the Chinese government launched Standard Resident Training in 2013 to solve the regional inequality of medical quality and meet the increasing social requirement for better medical service.We integrated problem-based learning(PBL)and case-based learning(CBL)in the Endodontics Standard Resident Training.By evaluating with objective parameters including theoretical knowledge and clinical practice skill,and subjective parameters including questionnaire,it was found that PBL+CBL played a positive role in endodontic resident training with a significant difference(P<0.05).This combined training model is instructive for China’s resident training,and this result can provide a rudimentary reference to current postgraduate teaching reform.展开更多
Objective:To explore the effect of implementing the case-based three-dimensional teaching method guided by evidence-based thinking in the teaching of trainee nurses in the rehabilitation department.Method:Eighty nursi...Objective:To explore the effect of implementing the case-based three-dimensional teaching method guided by evidence-based thinking in the teaching of trainee nurses in the rehabilitation department.Method:Eighty nursing practice nurses who were conducting clinical practice learning in the Rehabilitation Department of Deyang People’s Hospital from June 2024 to May 2025 were selected as the research subjects.By using the controlled grouping method,the practice nurses from June 2024 to November 2024 were taken as the control group(n=40).The period from December 2024 to May 2025 was taken as the experimental group(n=40 students),the control group was taught by traditional teaching methods,and the experimental group was taught by evidence-based nursing combined with case teaching method.The clinical thinking ability,autonomous learning ability,exit assessment scores and teaching satisfaction of the two groups of intern nurses at the time of leaving the department were compared.Results:At the time of leaving the department,the scores of each dimension and the total score of clinical thinking ability of the intern nurses in the experimental group were higher than those in the control group(t=9.268,6.354,6.199)9.694,all p<0.05).At the time of leaving the department the scores of each dimension and the total score of the autonomous learning ability of the intern nurses in the experimental group were higher than those in the control group(t=6.998,7.333,5.503,5.977,22.244)all p<0.05).At the time of leaving the department the theoretical assessment scores and operational assessment scores of the experimental group were both higher than those of the control group(t=14.546,11.676,all p<0.05).At the time of graduation,the teaching satisfaction of the experimental group was higher than that of the control group(χ^(2)=7.314,p<0.05.Conclusion:The adoption of the case-based three-dimensional teaching.Rehabilitation method guided by the evidence-based ideology during the teaching process can effectively improve the clinical thinking ability,autonomous learning ability,departmental assessment results and teaching satisfaction of the intern nurses in the rehabilitation department,which is worthy of reference.展开更多
Aiming at the characteristics of autonomy,confrontation,and uncertainty in unmanned aerial vehicle(UAV)swarm operations,case-based reasoning(CBR)technology with advantages such as weak dependence on domain knowledge a...Aiming at the characteristics of autonomy,confrontation,and uncertainty in unmanned aerial vehicle(UAV)swarm operations,case-based reasoning(CBR)technology with advantages such as weak dependence on domain knowledge and efficient problem-solving is introduced,and a recommendation method for UAV swarm operation strategies based on CBR is proposed.Firstly,we design a universal framework for UAV swarm operation strategies from three dimensions:operation effectiveness,time,and cost.Secondly,based on the representation of operation cases,certain,fuzzy,interval,and classification attribute similarity calculation methods,as well as entropybased attribute weight allocation methods,are suggested to support the calculation of global similarity of cases.This method is utilized to match the source case with the most similarity from the historical case library,to obtain the optimal recommendation strategy for the target case.Finally,in the form of red blue confrontation,a UAV swarm operation strategy recommendation case is constructed based on actual battle cases,and a system simulation analysis is conducted.The results show that the strategy given in the example performs the best in three evaluation indicators,including cost-effectiveness,and overall outperforms other operation strategies.Therefore,the proposed method has advantages such as high real-time performance and interpretability,and can address the issue of recommending UAV swarm operation strategies in complex battlefield environments across both online and offline modes.At the same time,this study could also provide new ideas for the selection of UAV swarm operation strategies.展开更多
Objective Observational studies have found associations between inflammatory bowel disease(IBD)and the risk of dementia,including Alzheimer’s dementia(AD)and vascular dementia(VD);however,these findings are inconsist...Objective Observational studies have found associations between inflammatory bowel disease(IBD)and the risk of dementia,including Alzheimer’s dementia(AD)and vascular dementia(VD);however,these findings are inconsistent.It remains unclear whether these associations are causal.Methods We conducted a meta-analysis by systematically searching for observational studies on the association between IBD and dementia.Mendelian randomization(MR)analysis based on summary genome-wide association studies(GWASs)was performed.Genetic correlation and Bayesian colocalization analyses were used to provide robust genetic evidence.Results Ten observational studies involving 80,565,688 participants were included in this metaanalysis.IBD was significantly associated with dementia(risk ratio[RR]=1.36,95%CI=1.04-1.78;I2=84.8%)and VD(RR=2.60,95%CI=1.18-5.70;only one study),but not with AD(RR=2.00,95%CI=0.96-4.13;I^(2)=99.8%).MR analyses did not supported significant causal associations of IBD with dementia(dementia:odds ratio[OR]=1.01,95%CI=0.98-1.03;AD:OR=0.98,95%CI=0.95-1.01;VD:OR=1.02,95%CI=0.97-1.07).In addition,genetic correlation and co-localization analyses did not reveal any genetic associations between IBD and dementia.Conclusion Our study did not provide genetic evidence for a causal association between IBD and dementia risk.The increased risk of dementia observed in observational studies may be attributed to unobserved confounding factors or detection bias.展开更多
Reference values of erythrocyte sedimentation rate(ESR)are the key to interpret ESR blood test in clinic.The common local reference ESR values are more accuracy in blood test that are established with natural geograph...Reference values of erythrocyte sedimentation rate(ESR)are the key to interpret ESR blood test in clinic.The common local reference ESR values are more accuracy in blood test that are established with natural geographical factors by using the multiple linear regression(MLR)model and the artificial neural network(ANN).These knowledge-based methods have limitations since the knowledge domains of ESR and natural geographical factors are limited.This paper presents a new cases-depended model to establish reference ESR values with natural geographical factors and location using case-based reasoning(CBR)since knowledge domain of ESR and geographical factors is weak.Overall 224 local normal ESR values of China that calculated from 13623 samples were obtained,and the corresponding natural geographical factors and location that include altitude,sunshine hours,relative humidity,temperature,precipitation,annual temperature range and annual average wind speed were obtained from the National Geomatics Center of China.CBR was used to predict the unseen local reference ESR values with cases.The average absolute deviation(AAD),mean square error(MSE),prediction accuracy(PA),and Pearson correlation coefficient(r)between the observed and estimated data of proposed model is 33.07%,9.02,66.93% and 0.78,which are better than those of ANN and MLR model.The results show that the proposed model provides higher prediction accuracy than those of the artificial neural network and multiple linear regression models.The predicted values are very close to the observed values.Model results show significant agreement of cases data.Consequently,the model is used to predict the unseen local reference ESR with natural geographical factors and location.In spatial,the highest ESR reference areas are distributed in the southern-western district of China that includes Sichuan,Chongqing,Guangxi and Guizhou provinces,and the reference ESR values are greater than 23 mm/60 min.The higher ESR reference values are distributed in the middle part and northern-eastern of China which include Hubei,Henan,Shaanxi,Shanxi,Jilin and Heilongjiang provinces,and the reference ESR values are greater than 18 mm/60min.The lowest ESR reference values are distributed in the northern-western of China that includes Tibet and Xinjiang,and the reference ESR values are lower than 5 mm/60min.展开更多
This paper proposes an interdisciplinary talent training model that combines foreign language education with area studies.The model aims to cultivate international ocean affairs professionals with cross-cultural commu...This paper proposes an interdisciplinary talent training model that combines foreign language education with area studies.The model aims to cultivate international ocean affairs professionals with cross-cultural communication skills,in-depth regional and country knowledge,and practical expertise in ocean affairs.Additionally,the paper presents specific training pathways and policy recommendations for implementing this model.展开更多
In modern society,the globalization of literary works is evident,with exceptional literary pieces from various countries spreading worldwide.Among these,children’s literature,due to the specificity of its target audi...In modern society,the globalization of literary works is evident,with exceptional literary pieces from various countries spreading worldwide.Among these,children’s literature,due to the specificity of its target audience,imposes distinct requirements on children’s books,compelling translators to approach the text from a child’s perspective.“The Little Prince”has renowned both within and outside of China,and a careful reading of this work can provide us with much inspiration.To this end,the present study adopts the perspective of Gideon Toury’s Descriptive Translation Studies to conduct an in-depth analysis of the different English and Chinese translations in conjunction with the original French novel.This approach aims to better guide literary research and explores translation methods for children’s literature through the analysis of translation norms and rules.展开更多
Objective:To identify the root causes of typical adverse drug events through the lens of patient experiences proposing novel strategies to mitigate preventable harm.Methods:A qualitative case study leveraging in-depth...Objective:To identify the root causes of typical adverse drug events through the lens of patient experiences proposing novel strategies to mitigate preventable harm.Methods:A qualitative case study leveraging in-depth interviews with patients and families,anchored by Interactive Patient Par ticipation Theory,to analyze 4 high-severity adverse drug events(ADE)cases.Cases were purposively sampled from 8 communities in China's National Adverse Event Monitor Center(2018-2023).Semi-structured interviews explored patient perspectives,with data analyzed via thematic coding and triangulation against clinical records.Results:Five interconnected themes emerged:(1)erosion of trust,(2)communication breakdowns,(3)information asymmetry,(4)environmental inadequacies,and(5)technological alienation.Notably,75% of participants had≤high school education,and 50% used≥7 medications daily,compounding ADE risks.Conclusions:We considered elements mentioned by theory,exploring trust,communication,information,and suppor t as the root causes.In addition,we added“adaptability to new technology”as an impor tant and necessary component.It is impor tant and necessary to analyze typical adverse drug events from the perspectives of patients.展开更多
Mindfulness would enhance university students’emotional well-being and study engagement.However,the role of affect(positive and negative emotions)and psychological resources(psychological capital)linking mindfulness ...Mindfulness would enhance university students’emotional well-being and study engagement.However,the role of affect(positive and negative emotions)and psychological resources(psychological capital)linking mindfulness to study engagement remain underexplored.This cross-sectional study surveyed 688 Chinese university students(females=413,mean age=20.3,SD=0.83),using validated self-report measures of mindfulness,positive and negative emotions,psychological capital,and study engagement.Structural equation modeling and bias-corrected bootstrap analyses(5000 resamples)revealed that mindfulness directly enhanced positive emotions,psychological capital,and study engagement,while reducing negative emotions.Positive emotions partially mediated the positive effect of mindfulness on psychological capital and study engagement.Negative emotions partially and negatively mediated only the mindfulness-psychological capital link.Psychological capital independently mediated the mindfulness-engagement relationship,and two sequential mediation pathways emerged:(a)mindfulness→positive emotions→psychological capital→higher study engagement and(b)mindfulness→reduced negative emotions→psychological capital→higher study engagement.Consistent with broaden-and-build(B&B)theory and Conservation of Resources(COR)theory,these findings suggest that mindfulness fosters study engagement primarily by promoting positive emotional experiences and strengthening psychological capital.By implication,university student support programs should employ mindfulness-based interventions to cultivate emotional and psychological resources for higher students’engagement and overall well-being.展开更多
BACKGROUND Gastrointestinal endoscopy technology has significantly improved the diagnostic accuracy and the successful treatment of gastrointestinal diseases.However,a series of ethical issues have emerged,such as exp...BACKGROUND Gastrointestinal endoscopy technology has significantly improved the diagnostic accuracy and the successful treatment of gastrointestinal diseases.However,a series of ethical issues have emerged,such as expanding treatment indications,which affect the fair distribution of medical resources.There is limited research on ethical issues in the field of digestive endoscopy.AIM To investigate the level of ethical awareness among gastrointestinal endoscopy practitioners and analyze the ethical issues involved in gastrointestinal endoscopy technology.METHODS A questionnaire survey was performed to collect relevant data(gender,age,degree of education,professional title,personnel category,the level of understanding medical ethical principles,ethics training and its learning pathways)from gastrointestinal endoscopy practitioners at the Second Hospital of Dalian Medical University and Dalian Friendship Hospital,including licensed physicians and nurses(including trainees and graduate students).RESULTS The majority of gastrointestinal endoscopy practitioners have received training on ethics,but there is still considerable room for improvement in their ethical awareness.Different learning pathways may affect the mastery of ethical principles, and understanding of ethical principles is more easily achieved through hospital ethics institutions.CONCLUSIONTo address the ethical issues in gastrointestinal endoscopy technology, it is necessary to enhance the humanisticeducation of gastrointestinal endoscopy practitioners, incorporate ethical standards into the technology assessmentprocess, and establish a patient-centered diagnostic and treatment model to improve the ethical awareness of practitionersand achieve a balance between technology and ethics.展开更多
Escalating global energy demands and climate urgency necessitate advanced electrochemical energy conversion and storage technologies(EECSTs)like electrocatalysis and rechargeable batteries.Improving their performance ...Escalating global energy demands and climate urgency necessitate advanced electrochemical energy conversion and storage technologies(EECSTs)like electrocatalysis and rechargeable batteries.Improving their performance relies on elucidating reaction mechanisms and structure-performance relationships via in situ studies.This review summarizes recent in situ studies of EECSTs through a variety of advanced characterization techniques aiming at mapping reaction pathways for the rational design of overall high-performance reaction systems.We outline the principles,capabilities,advantages,and limitations of various in situ techniques.Their applications in in situ studies of fuel cells,water/CO_(2)electrolysis,and lithium batteries are highlighted with representative examples.These studies enable dynamic tracking of chemical and structural evolution of overall reaction systems,including materials,intermediates,products,and surroundings during operation,providing insights critical to rational system design.Future advancements will involve integrating multimodal in situ/operando approaches with artificial intelligence to enable real-time monitoring at practical scales.Such integration promises precise mechanistic insights and robust structure-performance correlations,ultimately accelerating the development of high-performance EECSTs aligned with sustainability and market requirements.展开更多
Objectives:In recent years,mental health has emerged as a pressing public health concern in China,driven by mounting societal pressures and fast-paced urban lifestyles.Physical activity,a well-established means of enh...Objectives:In recent years,mental health has emerged as a pressing public health concern in China,driven by mounting societal pressures and fast-paced urban lifestyles.Physical activity,a well-established means of enhancing psychological well-being,has received growing scholarly and policy attention.This study uses panel data from the 2020 and 2022 waves of the China Family Panel Studies(CFPS)to examine the impact of exercise frequency on mental health(with indicators such as CESD-8 depression scores)among college students and young employees,thereby providing empirical support for targeted mental health interventions.Methods:This study examines the relationship between individual exercise frequency and mental health among college students and young employees,using panel data from the 2020 and 2022 waves of the China Family Panel Studies(CFPS),with the Chinese version of the 8-item Center for Epidemiologic Studies Depression Scale(CESD-8)depression scores,self-rated health,and life satisfaction as outcome variables.Specifically,this study tests three hypotheses:(H1)increased exercise frequency significantly reduces depression symptoms and enhances well-being;(H2)the effects of exercise vary by social roles,with stronger mental health benefits among employed individuals and those with lower education;and(H3)lifestyle factors such as smoking amount,sleep duration,and Body Mass Index(BMI)partially mediate the relationship between exercise and mental health.Employing a two-way fixed effects model,baseline results indicate that a one-unit increase in exercise frequency significantly reduces the CESD-8 score by 0.183 points.To address potential endogeneity and spurious regression concerns,an instrumental variable(IV)approach is further applied.The heterogeneity analysis differentiates between students and employed individuals.Results:Among students,the effects of exercise on mental health are not statistically significant,regardless of education level.In contrast,for the employed,exercise demonstrates a significant positive impact on mental health,with particularly pronounced effects among those with lower educational attainment.These findings underscore the importance of promoting exercise as part of comprehensive mental health strategies.Mediation analysis indicates that the beneficial effect of exercise on mental health is partially transmitted through reductions in adverse health behaviors,especially smoking.Conclusions:Policymakers should integrate physical activity promotion into health interventions,prioritizing vulnerable groups to enhance psychological resilience and foster inclusive,health-oriented development.展开更多
AIM:To investigate the potential causal associations between 41 inflammatory cytokines and myopia using a two-sample Mendelian randomization(MR)approach.METHODS:Publicly available genome-wide association study(GWAS)da...AIM:To investigate the potential causal associations between 41 inflammatory cytokines and myopia using a two-sample Mendelian randomization(MR)approach.METHODS:Publicly available genome-wide association study(GWAS)datasets were utilized for this two-sample MR analysis.Inflammatory cytokine-related GWAS data were extracted from The University of Bristol’s Research Data Repository,and myopia-related GWAS data were obtained from the FinnGen project.Single nucleotide polymorphisms(SNPs)associated with inflammatory cytokines were systematically selected as instrumental variables(IVs)based on three rigorous criteria:relevance,independence,and exclusion of pleiotropy.Five MR methods were employed for causal inference:the inverse-variance weighted(IVW)method as the primary analysis,supplemented by MREgger regression,weighted median estimator,simple mode,and weighted mode approaches.Sensitivity analyses were performed to evaluate the robustness of the causal estimates.RESULTS:A total of 773 myopia-associated SNPs were identified.MR analysis revealed that higher levels of macrophage inflammatory protein 1-α(MIP-1α)were associated with a 17%reduced risk of myopia[odds ratio(OR)=0.83;95%confidence interval(CI):0.69-0.99;P<0.05].In contrast,elevated levels of eotaxin(OR=1.26;95%CI:1.07-1.47;P<0.01),stromal cell-derived factor-1α(SDF-1α;OR=1.68;95%CI:1.08-2.62;P<0.05),and interleukin-2 receptor subunit alpha(IL-2Rα;OR=1.25;95%CI:1.01-1.53;P<0.05)were significantly associated with an increased risk of myopia.Sensitivity analyses confirmed the reliability of these results.CONCLUSION:This study provides evidence supporting a causal relationship between specific inflammatory cytokines and myopia.MIP-1αmay act as a protective factor against myopia,while eotaxin,SDF-1α,and IL-2Rαare potential risk factors for myopia.These findings emphasize the critical role of inflammatory pathways in the pathogenesis of myopia,offering novel insights for the development of preventive and therapeutic strategies for myopia.展开更多
Background:Despite highly effective vaccines against SARS-CoV-2,COVID-19 vaccine hesitancy persisted in some populations in England during the pandemic,with rates and motivations for hesitancy varying by demographic g...Background:Despite highly effective vaccines against SARS-CoV-2,COVID-19 vaccine hesitancy persisted in some populations in England during the pandemic,with rates and motivations for hesitancy varying by demographic group.Addressing the drivers of vaccine hesitancy through targeted interventions in hesitant groups is a public health priority for better and more rapid control of disease spread.We aimed to characterise the determinants and subtypes of vaccine hesitancy and identify more persistent forms of hesitancy via analysis of vaccine uptake in a large cross-sectional cohort with linked National Health Service(NHS)data.展开更多
Background:To determine whether initiating a glucagon-like peptide-1 receptor agonist(GLP-1 RA)within 3 months of type 2 diabetes(T2DM)diagnosis alters the subsequent risk of overall and site-specific cancer and wheth...Background:To determine whether initiating a glucagon-like peptide-1 receptor agonist(GLP-1 RA)within 3 months of type 2 diabetes(T2DM)diagnosis alters the subsequent risk of overall and site-specific cancer and whether this association differs by baseline body-mass index(BMI).Methods:This retrospective cohort study used electronic health records from the TriNetX U.S.research network.Adults aged 20 years or older diagnosed with T2DM between 2016 and 2024 were included if they received any hypoglycemic agents within 3 months before and after diagnosis.Following 1:1 propensity score matching,both the GLP-1 RA user and non-user groups included 183,264 patients.The study outcome was defined as a diagnosis of malignant neoplasms.Hazard ratios(HRs)for overall and site-specific cancer risk were estimated using Cox proportional hazards models.Kaplan–Meier analysis and stratified analysis by BMI were performed.Results:Early GLP-1 RA use demonstrated a modest but significant association with reduced overall cancer risk(HR 0.93;95%CI:0.90–0.96).Reduced risks were noted for cancers of the digestive(HR 0.81),respiratory(HR 0.66),and female genital(HR 0.87)systems.In stratified analysis,benefits were more pronounced in patients with BMI≥30,particularly for pancreatic and colorectal cancers.Conclusion:Early initiation of GLP-1 receptor agonists in patients with diagnosed T2DM was associated with a modest reduction in overall cancer risk,particularly among individuals with obesity.These findings highlight the dual metabolic and oncologic value of prompt GLP-1 RA therapy.展开更多
To increase the efficiency of the multidisciplinary optimization of aircraft, an aerodynamic approximation model is improved. Based on the study of aerodynamic approximation model constructed by the scaling correction...To increase the efficiency of the multidisciplinary optimization of aircraft, an aerodynamic approximation model is improved. Based on the study of aerodynamic approximation model constructed by the scaling correction model, case-based reasoning technique is introduced to improve the approximation model for optimization. The aircraft case model is constructed by utilizing the plane parameters related to aerodynamic characteristics as attributes of cases, and the formula of case retrieving is improved. Finally, the aerodynamic approximation model for optimization is improved by reusing the correction factors of the most similar aircraft to the current one. The multidisciplinary optimization of a civil aircraft concept is carried out with the improved aerodynamic approximation model. The results demonstrate that the precision and the efficiency of the optimization can be improved by utilizing the improved aerodynamic approximation model with ease-based reasoning technique.展开更多
Through the questionnaire survey and comparative studies on tourist satisfaction of tourism services among three world heritage sites,i.e.Huangshan Mountain,Lushan Mountain and Wuyi Mountain,this study pointed out the...Through the questionnaire survey and comparative studies on tourist satisfaction of tourism services among three world heritage sites,i.e.Huangshan Mountain,Lushan Mountain and Wuyi Mountain,this study pointed out the problems in tourism services of three scenic areas and then put forward relevant countermeasures for the management of scenic areas.展开更多
The increasing complexity and size of configuration knowledge bases requres the provisionof advanced methods supporting the development of the actual configuration process and design reuse.A new framework to find a fe...The increasing complexity and size of configuration knowledge bases requres the provisionof advanced methods supporting the development of the actual configuration process and design reuse.A new framework to find a feasible and practical product configuration method is presented in masscustomization. The basic idea of the appoach is to integrate case-based reasoning (CBR) with a con-straint satisfaction problem(CSP). The similarity measure between a crisp and range is also given,which is common in case retrieves. Based on the configuration model, a product platform and customerneeds, case adaptation is carried out with the repair-based algorithm. Lastly, the methodology in theelevator configuration design domain is tested.展开更多
文摘Fixture is an important manufacturing activity. A fixture design system based on case-based reasoning (CBR) is proposed in this paper. A new method of case representation on the basis of fixture function is presented, where the case representation is constituted of workpiece knowledge, processing feature knowledge, and fixture feature knowledge. Running the prototype system shows that the knowledge representation method, using cases, s a better way to transform and explain the design knowledge.
基金supported by the Teaching Reform Project of Stomatology College of Chongqing Medical University(KQJ202215,KQJ202204)the Teaching Reform Project of Chongqing Medical University(JY20220317).
文摘As the most critical part of post-graduate education,the Chinese government launched Standard Resident Training in 2013 to solve the regional inequality of medical quality and meet the increasing social requirement for better medical service.We integrated problem-based learning(PBL)and case-based learning(CBL)in the Endodontics Standard Resident Training.By evaluating with objective parameters including theoretical knowledge and clinical practice skill,and subjective parameters including questionnaire,it was found that PBL+CBL played a positive role in endodontic resident training with a significant difference(P<0.05).This combined training model is instructive for China’s resident training,and this result can provide a rudimentary reference to current postgraduate teaching reform.
基金2023 Higher Education Teaching Research and Reform Project of Southwest Medical University(Project No.:JG2023jdyb033)。
文摘Objective:To explore the effect of implementing the case-based three-dimensional teaching method guided by evidence-based thinking in the teaching of trainee nurses in the rehabilitation department.Method:Eighty nursing practice nurses who were conducting clinical practice learning in the Rehabilitation Department of Deyang People’s Hospital from June 2024 to May 2025 were selected as the research subjects.By using the controlled grouping method,the practice nurses from June 2024 to November 2024 were taken as the control group(n=40).The period from December 2024 to May 2025 was taken as the experimental group(n=40 students),the control group was taught by traditional teaching methods,and the experimental group was taught by evidence-based nursing combined with case teaching method.The clinical thinking ability,autonomous learning ability,exit assessment scores and teaching satisfaction of the two groups of intern nurses at the time of leaving the department were compared.Results:At the time of leaving the department,the scores of each dimension and the total score of clinical thinking ability of the intern nurses in the experimental group were higher than those in the control group(t=9.268,6.354,6.199)9.694,all p<0.05).At the time of leaving the department the scores of each dimension and the total score of the autonomous learning ability of the intern nurses in the experimental group were higher than those in the control group(t=6.998,7.333,5.503,5.977,22.244)all p<0.05).At the time of leaving the department the theoretical assessment scores and operational assessment scores of the experimental group were both higher than those of the control group(t=14.546,11.676,all p<0.05).At the time of graduation,the teaching satisfaction of the experimental group was higher than that of the control group(χ^(2)=7.314,p<0.05.Conclusion:The adoption of the case-based three-dimensional teaching.Rehabilitation method guided by the evidence-based ideology during the teaching process can effectively improve the clinical thinking ability,autonomous learning ability,departmental assessment results and teaching satisfaction of the intern nurses in the rehabilitation department,which is worthy of reference.
基金supported by the National Natural Science Foundation of China(72101263)the Natural Science Foundation of Hunan Province(2023JJ40677).
文摘Aiming at the characteristics of autonomy,confrontation,and uncertainty in unmanned aerial vehicle(UAV)swarm operations,case-based reasoning(CBR)technology with advantages such as weak dependence on domain knowledge and efficient problem-solving is introduced,and a recommendation method for UAV swarm operation strategies based on CBR is proposed.Firstly,we design a universal framework for UAV swarm operation strategies from three dimensions:operation effectiveness,time,and cost.Secondly,based on the representation of operation cases,certain,fuzzy,interval,and classification attribute similarity calculation methods,as well as entropybased attribute weight allocation methods,are suggested to support the calculation of global similarity of cases.This method is utilized to match the source case with the most similarity from the historical case library,to obtain the optimal recommendation strategy for the target case.Finally,in the form of red blue confrontation,a UAV swarm operation strategy recommendation case is constructed based on actual battle cases,and a system simulation analysis is conducted.The results show that the strategy given in the example performs the best in three evaluation indicators,including cost-effectiveness,and overall outperforms other operation strategies.Therefore,the proposed method has advantages such as high real-time performance and interpretability,and can address the issue of recommending UAV swarm operation strategies in complex battlefield environments across both online and offline modes.At the same time,this study could also provide new ideas for the selection of UAV swarm operation strategies.
基金supported by the China Postdoctoral Science Foundation(Grant No.2021M703366)Shenzhen Science and Technology Program(Grant No.KQTD20190929172835662).
文摘Objective Observational studies have found associations between inflammatory bowel disease(IBD)and the risk of dementia,including Alzheimer’s dementia(AD)and vascular dementia(VD);however,these findings are inconsistent.It remains unclear whether these associations are causal.Methods We conducted a meta-analysis by systematically searching for observational studies on the association between IBD and dementia.Mendelian randomization(MR)analysis based on summary genome-wide association studies(GWASs)was performed.Genetic correlation and Bayesian colocalization analyses were used to provide robust genetic evidence.Results Ten observational studies involving 80,565,688 participants were included in this metaanalysis.IBD was significantly associated with dementia(risk ratio[RR]=1.36,95%CI=1.04-1.78;I2=84.8%)and VD(RR=2.60,95%CI=1.18-5.70;only one study),but not with AD(RR=2.00,95%CI=0.96-4.13;I^(2)=99.8%).MR analyses did not supported significant causal associations of IBD with dementia(dementia:odds ratio[OR]=1.01,95%CI=0.98-1.03;AD:OR=0.98,95%CI=0.95-1.01;VD:OR=1.02,95%CI=0.97-1.07).In addition,genetic correlation and co-localization analyses did not reveal any genetic associations between IBD and dementia.Conclusion Our study did not provide genetic evidence for a causal association between IBD and dementia risk.The increased risk of dementia observed in observational studies may be attributed to unobserved confounding factors or detection bias.
基金Under the auspices of National Natural Science Foundation of China(No.40971060)
文摘Reference values of erythrocyte sedimentation rate(ESR)are the key to interpret ESR blood test in clinic.The common local reference ESR values are more accuracy in blood test that are established with natural geographical factors by using the multiple linear regression(MLR)model and the artificial neural network(ANN).These knowledge-based methods have limitations since the knowledge domains of ESR and natural geographical factors are limited.This paper presents a new cases-depended model to establish reference ESR values with natural geographical factors and location using case-based reasoning(CBR)since knowledge domain of ESR and geographical factors is weak.Overall 224 local normal ESR values of China that calculated from 13623 samples were obtained,and the corresponding natural geographical factors and location that include altitude,sunshine hours,relative humidity,temperature,precipitation,annual temperature range and annual average wind speed were obtained from the National Geomatics Center of China.CBR was used to predict the unseen local reference ESR values with cases.The average absolute deviation(AAD),mean square error(MSE),prediction accuracy(PA),and Pearson correlation coefficient(r)between the observed and estimated data of proposed model is 33.07%,9.02,66.93% and 0.78,which are better than those of ANN and MLR model.The results show that the proposed model provides higher prediction accuracy than those of the artificial neural network and multiple linear regression models.The predicted values are very close to the observed values.Model results show significant agreement of cases data.Consequently,the model is used to predict the unseen local reference ESR with natural geographical factors and location.In spatial,the highest ESR reference areas are distributed in the southern-western district of China that includes Sichuan,Chongqing,Guangxi and Guizhou provinces,and the reference ESR values are greater than 23 mm/60 min.The higher ESR reference values are distributed in the middle part and northern-eastern of China which include Hubei,Henan,Shaanxi,Shanxi,Jilin and Heilongjiang provinces,and the reference ESR values are greater than 18 mm/60min.The lowest ESR reference values are distributed in the northern-western of China that includes Tibet and Xinjiang,and the reference ESR values are lower than 5 mm/60min.
基金supported by“Dalian Maritime University Teaching Reform Research Fund 2022 Annual Project”(Fund No.XJG2022-96).
文摘This paper proposes an interdisciplinary talent training model that combines foreign language education with area studies.The model aims to cultivate international ocean affairs professionals with cross-cultural communication skills,in-depth regional and country knowledge,and practical expertise in ocean affairs.Additionally,the paper presents specific training pathways and policy recommendations for implementing this model.
文摘In modern society,the globalization of literary works is evident,with exceptional literary pieces from various countries spreading worldwide.Among these,children’s literature,due to the specificity of its target audience,imposes distinct requirements on children’s books,compelling translators to approach the text from a child’s perspective.“The Little Prince”has renowned both within and outside of China,and a careful reading of this work can provide us with much inspiration.To this end,the present study adopts the perspective of Gideon Toury’s Descriptive Translation Studies to conduct an in-depth analysis of the different English and Chinese translations in conjunction with the original French novel.This approach aims to better guide literary research and explores translation methods for children’s literature through the analysis of translation norms and rules.
基金supported by the Science and Technology Fund Project of Guizhou Health Commission(gzwkj2025-163)。
文摘Objective:To identify the root causes of typical adverse drug events through the lens of patient experiences proposing novel strategies to mitigate preventable harm.Methods:A qualitative case study leveraging in-depth interviews with patients and families,anchored by Interactive Patient Par ticipation Theory,to analyze 4 high-severity adverse drug events(ADE)cases.Cases were purposively sampled from 8 communities in China's National Adverse Event Monitor Center(2018-2023).Semi-structured interviews explored patient perspectives,with data analyzed via thematic coding and triangulation against clinical records.Results:Five interconnected themes emerged:(1)erosion of trust,(2)communication breakdowns,(3)information asymmetry,(4)environmental inadequacies,and(5)technological alienation.Notably,75% of participants had≤high school education,and 50% used≥7 medications daily,compounding ADE risks.Conclusions:We considered elements mentioned by theory,exploring trust,communication,information,and suppor t as the root causes.In addition,we added“adaptability to new technology”as an impor tant and necessary component.It is impor tant and necessary to analyze typical adverse drug events from the perspectives of patients.
文摘Mindfulness would enhance university students’emotional well-being and study engagement.However,the role of affect(positive and negative emotions)and psychological resources(psychological capital)linking mindfulness to study engagement remain underexplored.This cross-sectional study surveyed 688 Chinese university students(females=413,mean age=20.3,SD=0.83),using validated self-report measures of mindfulness,positive and negative emotions,psychological capital,and study engagement.Structural equation modeling and bias-corrected bootstrap analyses(5000 resamples)revealed that mindfulness directly enhanced positive emotions,psychological capital,and study engagement,while reducing negative emotions.Positive emotions partially mediated the positive effect of mindfulness on psychological capital and study engagement.Negative emotions partially and negatively mediated only the mindfulness-psychological capital link.Psychological capital independently mediated the mindfulness-engagement relationship,and two sequential mediation pathways emerged:(a)mindfulness→positive emotions→psychological capital→higher study engagement and(b)mindfulness→reduced negative emotions→psychological capital→higher study engagement.Consistent with broaden-and-build(B&B)theory and Conservation of Resources(COR)theory,these findings suggest that mindfulness fosters study engagement primarily by promoting positive emotional experiences and strengthening psychological capital.By implication,university student support programs should employ mindfulness-based interventions to cultivate emotional and psychological resources for higher students’engagement and overall well-being.
文摘BACKGROUND Gastrointestinal endoscopy technology has significantly improved the diagnostic accuracy and the successful treatment of gastrointestinal diseases.However,a series of ethical issues have emerged,such as expanding treatment indications,which affect the fair distribution of medical resources.There is limited research on ethical issues in the field of digestive endoscopy.AIM To investigate the level of ethical awareness among gastrointestinal endoscopy practitioners and analyze the ethical issues involved in gastrointestinal endoscopy technology.METHODS A questionnaire survey was performed to collect relevant data(gender,age,degree of education,professional title,personnel category,the level of understanding medical ethical principles,ethics training and its learning pathways)from gastrointestinal endoscopy practitioners at the Second Hospital of Dalian Medical University and Dalian Friendship Hospital,including licensed physicians and nurses(including trainees and graduate students).RESULTS The majority of gastrointestinal endoscopy practitioners have received training on ethics,but there is still considerable room for improvement in their ethical awareness.Different learning pathways may affect the mastery of ethical principles, and understanding of ethical principles is more easily achieved through hospital ethics institutions.CONCLUSIONTo address the ethical issues in gastrointestinal endoscopy technology, it is necessary to enhance the humanisticeducation of gastrointestinal endoscopy practitioners, incorporate ethical standards into the technology assessmentprocess, and establish a patient-centered diagnostic and treatment model to improve the ethical awareness of practitionersand achieve a balance between technology and ethics.
基金supported by the National Key Research and Development Program of China(2023YFA1508004)the National Natural Science Foundation of China(T2293692,22502164,92472203,22222903,52271229,22472074,22272069,22361132532,and 22021001)+6 种基金the Industry-University-Research Joint Innovation Project of Fujian Province(2023H6029)the Beijing National Laboratory for Molecular Sciences(BNLMS202305)the Scientific and Technological Project of Yunnan Precious Metals Laboratory(YPML-20240502063)the Liaoning Binhai Laboratory(Grant No.2024-05)the State Key Laboratory of Fine Chemicals,Dalian University of Technology(KF 2401)the Postdoctoral Fellowship Program of CPSF under Grant Number GZC20240897the China Postdoctoral Science Foundation(No.2025M770016).
文摘Escalating global energy demands and climate urgency necessitate advanced electrochemical energy conversion and storage technologies(EECSTs)like electrocatalysis and rechargeable batteries.Improving their performance relies on elucidating reaction mechanisms and structure-performance relationships via in situ studies.This review summarizes recent in situ studies of EECSTs through a variety of advanced characterization techniques aiming at mapping reaction pathways for the rational design of overall high-performance reaction systems.We outline the principles,capabilities,advantages,and limitations of various in situ techniques.Their applications in in situ studies of fuel cells,water/CO_(2)electrolysis,and lithium batteries are highlighted with representative examples.These studies enable dynamic tracking of chemical and structural evolution of overall reaction systems,including materials,intermediates,products,and surroundings during operation,providing insights critical to rational system design.Future advancements will involve integrating multimodal in situ/operando approaches with artificial intelligence to enable real-time monitoring at practical scales.Such integration promises precise mechanistic insights and robust structure-performance correlations,ultimately accelerating the development of high-performance EECSTs aligned with sustainability and market requirements.
文摘Objectives:In recent years,mental health has emerged as a pressing public health concern in China,driven by mounting societal pressures and fast-paced urban lifestyles.Physical activity,a well-established means of enhancing psychological well-being,has received growing scholarly and policy attention.This study uses panel data from the 2020 and 2022 waves of the China Family Panel Studies(CFPS)to examine the impact of exercise frequency on mental health(with indicators such as CESD-8 depression scores)among college students and young employees,thereby providing empirical support for targeted mental health interventions.Methods:This study examines the relationship between individual exercise frequency and mental health among college students and young employees,using panel data from the 2020 and 2022 waves of the China Family Panel Studies(CFPS),with the Chinese version of the 8-item Center for Epidemiologic Studies Depression Scale(CESD-8)depression scores,self-rated health,and life satisfaction as outcome variables.Specifically,this study tests three hypotheses:(H1)increased exercise frequency significantly reduces depression symptoms and enhances well-being;(H2)the effects of exercise vary by social roles,with stronger mental health benefits among employed individuals and those with lower education;and(H3)lifestyle factors such as smoking amount,sleep duration,and Body Mass Index(BMI)partially mediate the relationship between exercise and mental health.Employing a two-way fixed effects model,baseline results indicate that a one-unit increase in exercise frequency significantly reduces the CESD-8 score by 0.183 points.To address potential endogeneity and spurious regression concerns,an instrumental variable(IV)approach is further applied.The heterogeneity analysis differentiates between students and employed individuals.Results:Among students,the effects of exercise on mental health are not statistically significant,regardless of education level.In contrast,for the employed,exercise demonstrates a significant positive impact on mental health,with particularly pronounced effects among those with lower educational attainment.These findings underscore the importance of promoting exercise as part of comprehensive mental health strategies.Mediation analysis indicates that the beneficial effect of exercise on mental health is partially transmitted through reductions in adverse health behaviors,especially smoking.Conclusions:Policymakers should integrate physical activity promotion into health interventions,prioritizing vulnerable groups to enhance psychological resilience and foster inclusive,health-oriented development.
文摘AIM:To investigate the potential causal associations between 41 inflammatory cytokines and myopia using a two-sample Mendelian randomization(MR)approach.METHODS:Publicly available genome-wide association study(GWAS)datasets were utilized for this two-sample MR analysis.Inflammatory cytokine-related GWAS data were extracted from The University of Bristol’s Research Data Repository,and myopia-related GWAS data were obtained from the FinnGen project.Single nucleotide polymorphisms(SNPs)associated with inflammatory cytokines were systematically selected as instrumental variables(IVs)based on three rigorous criteria:relevance,independence,and exclusion of pleiotropy.Five MR methods were employed for causal inference:the inverse-variance weighted(IVW)method as the primary analysis,supplemented by MREgger regression,weighted median estimator,simple mode,and weighted mode approaches.Sensitivity analyses were performed to evaluate the robustness of the causal estimates.RESULTS:A total of 773 myopia-associated SNPs were identified.MR analysis revealed that higher levels of macrophage inflammatory protein 1-α(MIP-1α)were associated with a 17%reduced risk of myopia[odds ratio(OR)=0.83;95%confidence interval(CI):0.69-0.99;P<0.05].In contrast,elevated levels of eotaxin(OR=1.26;95%CI:1.07-1.47;P<0.01),stromal cell-derived factor-1α(SDF-1α;OR=1.68;95%CI:1.08-2.62;P<0.05),and interleukin-2 receptor subunit alpha(IL-2Rα;OR=1.25;95%CI:1.01-1.53;P<0.05)were significantly associated with an increased risk of myopia.Sensitivity analyses confirmed the reliability of these results.CONCLUSION:This study provides evidence supporting a causal relationship between specific inflammatory cytokines and myopia.MIP-1αmay act as a protective factor against myopia,while eotaxin,SDF-1α,and IL-2Rαare potential risk factors for myopia.These findings emphasize the critical role of inflammatory pathways in the pathogenesis of myopia,offering novel insights for the development of preventive and therapeutic strategies for myopia.
文摘Background:Despite highly effective vaccines against SARS-CoV-2,COVID-19 vaccine hesitancy persisted in some populations in England during the pandemic,with rates and motivations for hesitancy varying by demographic group.Addressing the drivers of vaccine hesitancy through targeted interventions in hesitant groups is a public health priority for better and more rapid control of disease spread.We aimed to characterise the determinants and subtypes of vaccine hesitancy and identify more persistent forms of hesitancy via analysis of vaccine uptake in a large cross-sectional cohort with linked National Health Service(NHS)data.
基金financial support fromthe Chung Shan Medical University Hospital,Taiwan(CSH-2022-A-009).
文摘Background:To determine whether initiating a glucagon-like peptide-1 receptor agonist(GLP-1 RA)within 3 months of type 2 diabetes(T2DM)diagnosis alters the subsequent risk of overall and site-specific cancer and whether this association differs by baseline body-mass index(BMI).Methods:This retrospective cohort study used electronic health records from the TriNetX U.S.research network.Adults aged 20 years or older diagnosed with T2DM between 2016 and 2024 were included if they received any hypoglycemic agents within 3 months before and after diagnosis.Following 1:1 propensity score matching,both the GLP-1 RA user and non-user groups included 183,264 patients.The study outcome was defined as a diagnosis of malignant neoplasms.Hazard ratios(HRs)for overall and site-specific cancer risk were estimated using Cox proportional hazards models.Kaplan–Meier analysis and stratified analysis by BMI were performed.Results:Early GLP-1 RA use demonstrated a modest but significant association with reduced overall cancer risk(HR 0.93;95%CI:0.90–0.96).Reduced risks were noted for cancers of the digestive(HR 0.81),respiratory(HR 0.66),and female genital(HR 0.87)systems.In stratified analysis,benefits were more pronounced in patients with BMI≥30,particularly for pancreatic and colorectal cancers.Conclusion:Early initiation of GLP-1 receptor agonists in patients with diagnosed T2DM was associated with a modest reduction in overall cancer risk,particularly among individuals with obesity.These findings highlight the dual metabolic and oncologic value of prompt GLP-1 RA therapy.
文摘To increase the efficiency of the multidisciplinary optimization of aircraft, an aerodynamic approximation model is improved. Based on the study of aerodynamic approximation model constructed by the scaling correction model, case-based reasoning technique is introduced to improve the approximation model for optimization. The aircraft case model is constructed by utilizing the plane parameters related to aerodynamic characteristics as attributes of cases, and the formula of case retrieving is improved. Finally, the aerodynamic approximation model for optimization is improved by reusing the correction factors of the most similar aircraft to the current one. The multidisciplinary optimization of a civil aircraft concept is carried out with the improved aerodynamic approximation model. The results demonstrate that the precision and the efficiency of the optimization can be improved by utilizing the improved aerodynamic approximation model with ease-based reasoning technique.
文摘Through the questionnaire survey and comparative studies on tourist satisfaction of tourism services among three world heritage sites,i.e.Huangshan Mountain,Lushan Mountain and Wuyi Mountain,this study pointed out the problems in tourism services of three scenic areas and then put forward relevant countermeasures for the management of scenic areas.
基金This project is supported by National Natural Science Foundation of China(No.50275133) and China Hi-tech Program CIMS Topic (No.2003-China(No.50275133) and China Hi-tech Program CIMS Topic (No.2003-AA411320). Received July 22, 2003
文摘The increasing complexity and size of configuration knowledge bases requres the provisionof advanced methods supporting the development of the actual configuration process and design reuse.A new framework to find a feasible and practical product configuration method is presented in masscustomization. The basic idea of the appoach is to integrate case-based reasoning (CBR) with a con-straint satisfaction problem(CSP). The similarity measure between a crisp and range is also given,which is common in case retrieves. Based on the configuration model, a product platform and customerneeds, case adaptation is carried out with the repair-based algorithm. Lastly, the methodology in theelevator configuration design domain is tested.
