Knowledge-based VisualQuestion Answering(VQA)requires the integration of visual information with external knowledge reasoning.Existing approaches typically retrieve information from external corpora and rely on pretra...Knowledge-based VisualQuestion Answering(VQA)requires the integration of visual information with external knowledge reasoning.Existing approaches typically retrieve information from external corpora and rely on pretrained language models for reasoning.However,their performance is often hindered by the limited capabilities of retrievers and the constrained size of knowledge bases.Moreover,relying on image captions to bridge the modal gap between visual and language modalities can lead to the omission of critical visual details.To address these limitations,we propose the Reflective Chain-of-Thought(ReCoT)method,a simple yet effective framework inspired by metacognition theory.ReCoT effectively activates the reasoning capabilities ofMultimodal Large LanguageModels(MLLMs),providing essential visual and knowledge cues required to solve complex visual questions.It simulates a metacognitive reasoning process that encompasses monitoring,reflection,and correction.Specifically,in the initial generation stage,an MLLM produces a preliminary answer that serves as the model’s initial cognitive output.During the reflective reasoning stage,this answer is critically examined to generate a reflective rationale that integrates key visual evidence and relevant knowledge.In the final refinement stage,a smaller language model leverages this rationale to revise the initial prediction,resulting in amore accurate final answer.By harnessing the strengths ofMLLMs in visual and knowledge grounding,ReCoT enables smaller language models to reason effectively without dependence on image captions or external knowledge bases.Experimental results demonstrate that ReCoT achieves substantial performance improvements,outperforming state-of-the-art methods by 2.26%on OK-VQA and 5.8%on A-OKVQA.展开更多
Objectives This review aimed to systematically synthesize the available research on the disclosure of diagnosis and related issues in childhood cancer from the perspectives of healthcare professionals,with the goal of...Objectives This review aimed to systematically synthesize the available research on the disclosure of diagnosis and related issues in childhood cancer from the perspectives of healthcare professionals,with the goal of informing the optimization of disclosure processes and meeting the communication needs of affected families.Methods In accordance with the Joanna Briggs Institute(JBI)methodology for mixed methods systematic reviews,the convergent segregated approach was used in this review.Articles were retrieved from 11 databases,including PubMed,Web of Science,CINAHL,CENTRAL,Embase,Ovid/Medline,PsycINFO,PsycArticles,Scopus,ERIC,and China National Knowledge Infrastructure(CNKI).The quality of the selected articles was assessed using the Mixed Method Appraisal Tool(MMAT).The review protocol was registered on PROSPERO(CRD42024542746).Results A total of 21 studies from 10 countries were included.Their methodological quality was generally medium to high,with MMAT scores ranging from 60%to 100%.The synthesis yielded three core themes:1)the spectrum of professional and societal attitudes toward disclosure;2)the dynamic practices of navigating disclosure amid uncertainty,including timing and environment,stakeholders,and content of disclosure;and 3)factors influencing disclosure,including children’s,parental,healthcare professionals’,and socio-cultural factors.Conclusions This review synthesized the perspectives and experiences of healthcare professionals regarding disclosure in childhood cancer,highlighting the complexity and multidimensional nature of this process in clinical practice.Future research should further investigate the experiences and needs of children and their parents,explore cultural variations in disclosure practices,develop context-appropriate assessment tools,and construct multidimensional intervention strategies to enhance the humanistic care and professional effectiveness of the disclosure process.展开更多
BACKGROUND Ischemic bowel disease(IBD)is a critical condition caused by reduced blood flow to the intestines,leading to tissue damage and potentially severe complications.Early recognition and timely management are es...BACKGROUND Ischemic bowel disease(IBD)is a critical condition caused by reduced blood flow to the intestines,leading to tissue damage and potentially severe complications.Early recognition and timely management are essential for improving patient outcomes and reducing morbidity and mortality associated with IBD.AIM To evaluate the knowledge,attitude and practice(KAP)of healthcare professionals regarding IBD.METHODS This cross-sectional study was conducted among healthcare professionals in China from November 2023 to December 2023 using a self-designed questionnaire.RESULTS A total of 315 valid questionnaires were analyzed,with 215 participants(68.25%)being female.The mean KAP scores were 17.55±5.35(range:0-24),27.65±2.77(range:8-40),and 18.88±4.23(range:6-30),respectively.Multivariate linear regression analysis revealed the following factors to be independently associated with knowledge:Age 26-35 years(β=2.80,95%CI:0.31-5.30,P=0.028),professional title(β=2.66,95%CI:0.91-4.41,P=0.003),position(β=-3.78,95%CI:-5.45 to-2.11,P<0.001),participation in IBD-related training(β=3.45,95%CI:2.39-4.51,P<0.001),and admission of more than five IBD cases in the past month(β=3.25,95%CI:1.58-4.92,P<0.001).Attitude was independently associated with knowledge(β=0.20,95%CI:0.15-0.26,P<0.001)and being a nurse or nursing supervisor(β=-1.30,95%CI:-2.16 to-0.40,P=0.003).Practice was independently associated with knowledge(β=0.20,95%CI:0.10-0.30,P<0.001)and attitude(β=0.24,95%CI:0.06-0.42,P=0.007).Structural equation modeling demonstrated direct effects of knowledge on attitude(β=0.24,P<0.001)and practice(β=0.26,P<0.001),as well as of attitude on practice(β=0.22,P=0.012).CONCLUSION Healthcare professionals demonstrated adequate knowledge but moderate attitude and inactive practice regarding IBD.Addressing the gaps in attitude and practice through targeted training programs and interventions is essential for improving patient care and outcomes.展开更多
The surrogate model serves as an efficient simulation tool during the slope parameter inversion process.However,the creep constitutive model integrated with dynamic damage evolution poses challenges in development of ...The surrogate model serves as an efficient simulation tool during the slope parameter inversion process.However,the creep constitutive model integrated with dynamic damage evolution poses challenges in development of the required surrogate model.In this study,a novel physics knowledge-based surrogate model framework is proposed.In this framework,a Transformer module is employed to capture straindriven softening-hardening physical mechanisms.Positional encoding and self-attention are utilized to transform the constitutive parameters associated with shear strain,which are not directly time-related,into intermediate latent features for physical loss calculation.Next,a multi-layer stacked GRU(gated recurrent unit)network is built to provide input interfaces for time-dependent intermediate latent features,hydraulic boundary conditions,and water-rock interaction degradation equations,with static parameters introduced via external fully-connected layers.Finally,a combined loss function is constructed to facilitate the collaborative training of physical and data loss,introducing time-dependent weight adjustments to focus the surrogate model on accurate deformation predictions during critical phases.Based on the deformation of a reservoir bank landslide triggered by impoundment and subsequent restabilization,an elasto-viscoplastic constitutive model that considers water effect and sliding state dependencies is developed to validate the proposed surrogate model framework.The results indicate that the framework exhibits good performance in capturing physical mechanisms and predicting creep behavior,reducing errors by about 30 times compared to baseline models such as GRU and LSTM(long short-term memory),meeting the precision requirements for parameter inversion.Ablation experiments also confirmed the effectiveness of the framework.This framework can also serve as a reference for constructing other creep surrogate models that involve non-time-related across dimensions.展开更多
The development of artificial intelligence has brought tremendous changes to enterprises and also pose higher demands on financial professionals.Through literature research,this paper explores the viewpoints of domest...The development of artificial intelligence has brought tremendous changes to enterprises and also pose higher demands on financial professionals.Through literature research,this paper explores the viewpoints of domestic and foreign scholars and industry experts on the impact of Artificial Intelligence(AI)on corporate financial management and the role transformation of financial professionals.It analyzes the current application status of AI technology in finance.The results indicate that AI will replace some repetitive and highly procedural tasks,such as simple data entry and bookkeeping.AI can improve the processing speed and accuracy of corporate financial data.With its learning capabilities,AI can assist financial professionals in addressing knowledge gaps.However,AI cannot completely replace human thinking,judgment,and decision-making,especially in areas like emotional communication and aesthetic experience.This requires financial professionals to continuously improve their overall qualities,leverage their strengths,and achieve complementary advantages with machines,jointly promoting innovative financial development in the era of artificial intelligence.展开更多
Within contemporary healthcare systems, professional identity among specialized nurses serves as a pivotal intrinsic factor influencing the development of their core competencies. This review synthesizes existing rese...Within contemporary healthcare systems, professional identity among specialized nurses serves as a pivotal intrinsic factor influencing the development of their core competencies. This review synthesizes existing research, revealing that professional identity positively impacts the development of core competencies through multiple pathways, including psychological drive, behavioral facilitation, teamwork, and career stability. Building on this analysis, this paper proposes systematic enhancement strategies from four dimensions: education and training, organizational environment, cultural development, and individual growth, aiming to provide a reference for nursing practice and professional development.展开更多
Professional learning communities(PLCs)offer essential contextual support for the development of foreign language teachers in higher education.The book Building Professional Learning Communities of Foreign Language Te...Professional learning communities(PLCs)offer essential contextual support for the development of foreign language teachers in higher education.The book Building Professional Learning Communities of Foreign Language Teachers in Higher Education,co-authored by Wen et al.(2021)systematically examines the necessity,practical measures,theoretical construction,and outcomes associated with building PLCs for university foreign language teachers.Notably,it introduces a research methodology rooted in local teacher education practices with Chinese characteristics—the dialectical research paradigm(DRP).This review introduces the content of the book,evaluates its contributions to teacher development,and explores its implications for future practice and research.展开更多
A machine-learning approach was developed for automated building of knowledgebases for soil resources mapping by using a classification tree to generate knowledge from trainingdata. With this method, building a knowle...A machine-learning approach was developed for automated building of knowledgebases for soil resources mapping by using a classification tree to generate knowledge from trainingdata. With this method, building a knowledge base for automated soil mapping was easier than usingthe conventional knowledge acquisition approach. The knowledge base built by classification tree wasused by the knowledge classifier to perform the soil type classification of Longyou County,Zhejiang Province, China using Landsat TM bi-temporal images and CIS data. To evaluate theperformance of the resultant knowledge bases, the classification results were compared to existingsoil map based on a field survey. The accuracy assessment and analysis of the resultant soil mapssuggested that the knowledge bases built by the machine-learning method was of good quality formapping distribution model of soil classes over the study area.展开更多
Automatic bridge detection is an important application of SAR images.Differed from the classical CFAR method,a new knowledge-based bridge detection approach is proposed.The method not only uses the backscattering inte...Automatic bridge detection is an important application of SAR images.Differed from the classical CFAR method,a new knowledge-based bridge detection approach is proposed.The method not only uses the backscattering intensity difference between targets and background but also applies the contextual information and spatial relationship between objects.According to bridges'special characteristics and scattering properties in SAR images,the new knowledge-based method includes three processes:river segmentation,potential bridge areas detection and bridge discrimination.The application to AIRSAR data shows that the new method is not sensitive to rivers'shape.Moreover,this method can detect bridges successfully when river segmentation is not very exact and is more robust than the radius projection method.展开更多
BACKGROUND:Competency in neonatal resuscitation is critical in the delivery rooms,neonatology units and pediatrics intensive care units to ensure the safety and health of neonates. Each year,millions of babies do not ...BACKGROUND:Competency in neonatal resuscitation is critical in the delivery rooms,neonatology units and pediatrics intensive care units to ensure the safety and health of neonates. Each year,millions of babies do not breathe immediately at birth,and among them the majority require basic neonatal resuscitation. Perinatal asphyxia is a major contributor to neonatal deaths worldwide in resource-limited settings. Neonatal resuscitation is effective only when health professionals have sufficient knowledge and skills. But malpractices by health professionals are frequent in the resuscitation of neonates. The present study was to assess the knowledge and skills of health professionals about neonatal resuscitation.METHODS:An institution based cross-sectional study was conducted in our hospital from February15 to April 30,2014. All nurses,midwives and residents from obstetrics-gynecology(obsgyn),midwifery and pediatric departments were included. The mean scores of knowledge and skills were compared for sex,age,type of profession,qualification,year of service and previous place of work of the participants by using Student's t test and ANOVA with Scheffe's test. A P value <0.05 was considered statistically significant.RESULTS:One hundred and thirty-five of 150 participants were included in this study with a response rate of 90.0%. The overall mean scores of knowledge and skills of midwives,nurses and residents were 19.9(SD=3.1) and 6.8(SD=3.9) respectively. The mean knowledge scores of midwives,nurses,pediatric residents and obs-gyn residents were 19.7(SD=3.03),20.2(SD=2.94),19.7(SD=4.4) and 19.6(SD=3.3) respectively. Whereas the mean scores of skills of midwives,nurses,pediatric residents and obs-gyn residents were 7.1(SD=4.17),6.7(SD=3.75),5.7(SD=4.17) and 6.6(SD=3.97) respectively.CONCLUSIONS:The knowledge and skills of midwives,nurses and residents about neonatal resuscitation were substandardized. Training of neonatal resuscitation for midwives,nurses and residents should be emphasized.展开更多
BACKGROUND:Healthcare professionals are expected to have knowledge of current basic and advanced cardiac life support(BLS/ACLS) guidelines to revive unresponsive patients.METHODS:Across-sectional study was conducted t...BACKGROUND:Healthcare professionals are expected to have knowledge of current basic and advanced cardiac life support(BLS/ACLS) guidelines to revive unresponsive patients.METHODS:Across-sectional study was conducted to evaluate the current practices and knowledge of BLS/ACLS principles among healthcare professionals of North-Kerala using pretested self-administered structured questionnaire.Answers were validated in accordance with American Heart Association's BLS/ACLS teaching manual and the results were analysed.RESULTS:Among 461 healthcare professionals,141(30.6%) were practicing physicians,268(58.1%) were nurses and 52(11.3%) supporting staff.The maximum achievable score was 20(BLS15/ACLS 5).The mean score amongst all healthcare professionals was 8.9±4.7.The mean score among physicians,nurses and support staff were 8.6±3.4,9±3.6 and 9±3.3 respectively.The majority of healthcare professionals scored <50%(237,51.4%);204(44.3%) scored 51%-80%and 20(4.34%)scored >80%.Mean scores decreased with age,male sex and across occupation.Nurses who underwent BLS/ACLS training previously had significantly higher mean scores(10.2±3.4) than untrained(8.2±3.6,P=0.001).Physicians with <5 years experience(P=0.002) and nurses in the private sector(P=0.003)had significantly higher scores.One hundred and sixty three(35.3%) healthcare professionals knew the correct airway opening manoeuvres like head tilt,chin lift and jaw thrust.Only 54(11.7%) respondents were aware that atropine is not used in ACLS for cardiac arrest resuscitation and 79(17.1%) correctly opted ventricular fibrillation and pulseless ventricular tachycardia as shockable rhythms.The majority of healthcare professionals(356,77.2%) suggested that BLS/ACLS be included in academic curriculum.CONCLUSION:Inadequate knowledge of BLS/ACLS principles amongst healthcare professionals,especially physicians,illuminate lacunae in existing training systems and merit urgent redressal.展开更多
Due to the insufficiency of utilizing knowledge to guide the complex optimal searching, existing genetic algorithms fail to effectively solve excavator boom structural optimization problem. To improve the optimization...Due to the insufficiency of utilizing knowledge to guide the complex optimal searching, existing genetic algorithms fail to effectively solve excavator boom structural optimization problem. To improve the optimization efficiency and quality, a new knowledge-based real-coded genetic algorithm is proposed. A dual evolution mechanism combining knowledge evolution with genetic algorithm is established to extract, handle and utilize the shallow and deep implicit constraint knowledge to guide the optimal searching of genetic algorithm circularly. Based on this dual evolution mechanism, knowledge evolution and population evolution can be connected by knowledge influence operators to improve the conflgurability of knowledge and genetic operators. Then, the new knowledge-based selection operator, crossover operator and mutation operator are proposed to integrate the optimal process knowledge and domain culture to guide the excavator boom structural optimization. Eight kinds of testing algorithms, which include different genetic operators, arc taken as examples to solve the structural optimization of a medium-sized excavator boom. By comparing the results of optimization, it is shown that the algorithm including all the new knowledge-based genetic operators can more remarkably improve the evolutionary rate and searching ability than other testing algorithms, which demonstrates the effectiveness of knowledge for guiding optimal searching. The proposed knowledge-based genetic algorithm by combining multi-level knowledge evolution with numerical optimization provides a new effective method for solving the complex engineering optimization problem.展开更多
Knowledge-Based Engineering （KBE） is introduced into the ship structural design in this paper. From the implementation of KBE, the design solutions for both Rules Design Method （RDM） and Interpolation Design Meth...Knowledge-Based Engineering （KBE） is introduced into the ship structural design in this paper. From the implementation of KBE, the design solutions for both Rules Design Method （RDM） and Interpolation Design Method （IDM） are generated. The corresponding Finite Element （FE） models are generated. Topological design of the longitudinal structures is studied where the Gaussian Process （GP） is employed to build the surrogate model for FE analysis. Multi-objective optimization methods inspired by Pareto Front are used to reduce the design tank weight and outer surface area simultaneously. Additionally, an enhanced Level Set Method （LSM） which employs implicit algorithm is applied to the topological design of typical bracket plate which is used extensively in ship structures. Two different sets of boundary conditions are considered. The proposed methods show satisfactory efficiency and accuracy.展开更多
Job crafting (JC) is a form of proactive behavior and refers to the initiatives employees that could take to change their tasks or other job characteristics to achieve the best person-job fit. JC consists of six dimen...Job crafting (JC) is a form of proactive behavior and refers to the initiatives employees that could take to change their tasks or other job characteristics to achieve the best person-job fit. JC consists of six dimensions: seeking structural and social job resources, as well as challenges, hindering job demands, optimizing job demands, and delegating tasks. The aim of the present study was to explore the impact of self-efficacy and work engagement on healthcare professionals’ (HP) proactive behavior. A convenience sample of 295 HP working in Primary and Secondary healthcare structures of Northern Greece completed a questionnaire that included: 1) demographic/occupational characteristics, 2) the Job Crafting Scale, 3) the Generalized Self-Efficacy Scale (GSE) and 4) the Utrecht Work Engagement Scale (UWES). Increased age was found to be associated with decreased levels of seeking social job resources (p < 0.01). Education level was positively associated with increased levels of seeking structural job resources (p < 0.01), seeking challenges (p < 0.05), and optimizing job demands (p < 0.05), while job position was found to be negatively related to delegating tasks (p < 0.01). Self-efficacy was positively associated with increased levels of seeking structural resources (p < 0.001), challenges (p < 0.001), and increased levels of optimizing job demands (p < 0.001), while it was positively associated with decreased levels of delegating tasks (p < 0.05). In addition, increased work engagement was found to be associated with increased levels of seeking social job resources (p < 0.05), challenges (p < 0.01), and optimizing job demands (p < 0.01). Findings highlight the importance of self-efficacy, work engagement and individual characteristics in the realization of a resourceful work environment and HP’ adjustment in the organization. Thus, interventions that promote HP’ JC proactive behaviors should be encouraged.展开更多
There is a lack of information about the factors responsible for the effectiveness of environmental policies in Brazilian agriculture.This study aimed at identifying the perception and practices of agrarian profession...There is a lack of information about the factors responsible for the effectiveness of environmental policies in Brazilian agriculture.This study aimed at identifying the perception and practices of agrarian professionals.The data analysis was carried out using a survey and methodological approaches focusing on environmental complexity and categorization of environmental actions.Quantitative analysis was based on descriptive statistics.Atmospheric problems were perceived as the main problems for the current and next two generations,while hydrological problems were indicated as those deserving most urgent solutions.On the other hand,the main developed actions and those planned to be carried out were classified within the responsibility category.Because of the reductionist perceptions,introduction of the concept of a socio-ecological system is indicated by means of methodological interventions during the development of agrarian professionals;also,in order to stimulate actions related to the competence and citizenship category,a methodological intervention focusing on resilience thinking is proposed.Typical actions of individuals with either reductionist or complex conceptions of the environment can be captured and,therefore,educational strategies can be traced based on the profiles obtained.展开更多
A novel knowledge-based fuzzy neural network （KBFNN） for fault diagnosis is presented. Crude rules were extracted and the corresponding dependent factors and antecedent coverage factors were calculated firstly from ...A novel knowledge-based fuzzy neural network （KBFNN） for fault diagnosis is presented. Crude rules were extracted and the corresponding dependent factors and antecedent coverage factors were calculated firstly from the diagnostic sample based on rough sets theory. Then the number of rules was used to construct partially the structure of a fuzzy neural network and those factors were implemented as initial weights, with fuzzy output parameters being optimized by genetic algorithm. Such fuzzy neural network was called KBFNN. This KBFNN was utilized to identify typical faults of rotating machinery. Diagnostic results show that it has those merits of shorter training time and higher right diagnostic level compared to general fuzzy neural networks.展开更多
The aim of this study was to examine the possible relationship between physical and psychological aggression suffered in the workplace and professional burnout, depression and anxiety suffered by healthcare profession...The aim of this study was to examine the possible relationship between physical and psychological aggression suffered in the workplace and professional burnout, depression and anxiety suffered by healthcare professionals of the emergency services. Methods: 315 physicians, nurses, orderlies and ambulance drivers of Critical Care and Emergency Devices (CCED) in the Andalusian Public Health System, in the province of Granada (Spain) participated. They were interviewed about the exposure to violence at work and answered a battery of questions that measured burnout, depression and anxiety. Results: Physical aggression was significantly related to emotional exhaustion, personal accomplishment at work, depression and anxiety. Psychological aggression was associated with personal accomplishment. Logistic regression showed that the CCED professionals who have suffered physical aggression were 4.2 and 2.6 times more likely to have suffered anxiety and reduced personal accomplishment, respectively, than those who did not suffer physical aggression. On the other hand, feelings of anxiety and reduced personal accomplishment increase the professionals’ risk (3.4 and 2.1 times more likely, respectively) of suffering from physical aggression. Conclusion: The results suggest that exposure to violence is related to the other psychological problems tested: emotional exhaustion and personal accomplishment (two components of burnout), depression and anxiety. In addition, physical violence is a risk factor for anxiety and diminished personal accomplishment of the CCED professionals.展开更多
Biological raw data are growing exponentially, providing a large amount of information on what life is. It is believed that potential functions and the rules governing protein behaviors can be revealed from analysis o...Biological raw data are growing exponentially, providing a large amount of information on what life is. It is believed that potential functions and the rules governing protein behaviors can be revealed from analysis on known native structures of proteins. Many knowledge-based potentials for proteins have been proposed. Contrary to most existing review articles which mainly describe technical details and applications of various potential models, the main foci for the discussion here are ideas and concepts involving the construction of potentials, including the relation between free energy and energy, the additivity of potentials of mean force and some key issues in potential construction. Sequence analysis is briefly viewed from an energetic viewpoint.展开更多
This paper describes the development of a knowledgebased system (KBS) for determining whether or not, and under what conditions, a bank Ioan officer should grant a business loan to a company. The prototype system deve...This paper describes the development of a knowledgebased system (KBS) for determining whether or not, and under what conditions, a bank Ioan officer should grant a business loan to a company. The prototype system developed focuses on what is bank loans risks management, how to prevent risk by the analysis of the ability of paying back loans. The paper makes the structural analysis involved in the system's decision situation, the structured situation diagram or model, dependency diagram and the document needed by the KBS prototype system thus are developed. Through testing the samples from loan business, the quality for the analysis of the ability of paying back loans can be effectively evaluated by the KBS prototype system.展开更多
The limitations of traditional approaches to selection problems are examined. A problemsolving strategy is presented in which decision-support and knowledge-based techniques play complementary roles. An approach to th...The limitations of traditional approaches to selection problems are examined. A problemsolving strategy is presented in which decision-support and knowledge-based techniques play complementary roles. An approach to the representation of knowledge to support the problem-solving strategy is presented which avoids commitment to a specific programming language or implementation environment. The problem of choosing a home is used to illustrate the representation of knowledge in a specific problem domain. Techniques for implementation of the problem-solving strategy are described. Knowledge elicitation techniques and their implementation in a development shell for application of the problem-solving strategy to any selection problem are also described.展开更多
基金supported by the National Natural Science Foundation of China(Nos.62572017,62441232,62206007)R&D Program of Beijing Municipal Education Commission(KZ202210005008).
文摘Knowledge-based VisualQuestion Answering(VQA)requires the integration of visual information with external knowledge reasoning.Existing approaches typically retrieve information from external corpora and rely on pretrained language models for reasoning.However,their performance is often hindered by the limited capabilities of retrievers and the constrained size of knowledge bases.Moreover,relying on image captions to bridge the modal gap between visual and language modalities can lead to the omission of critical visual details.To address these limitations,we propose the Reflective Chain-of-Thought(ReCoT)method,a simple yet effective framework inspired by metacognition theory.ReCoT effectively activates the reasoning capabilities ofMultimodal Large LanguageModels(MLLMs),providing essential visual and knowledge cues required to solve complex visual questions.It simulates a metacognitive reasoning process that encompasses monitoring,reflection,and correction.Specifically,in the initial generation stage,an MLLM produces a preliminary answer that serves as the model’s initial cognitive output.During the reflective reasoning stage,this answer is critically examined to generate a reflective rationale that integrates key visual evidence and relevant knowledge.In the final refinement stage,a smaller language model leverages this rationale to revise the initial prediction,resulting in amore accurate final answer.By harnessing the strengths ofMLLMs in visual and knowledge grounding,ReCoT enables smaller language models to reason effectively without dependence on image captions or external knowledge bases.Experimental results demonstrate that ReCoT achieves substantial performance improvements,outperforming state-of-the-art methods by 2.26%on OK-VQA and 5.8%on A-OKVQA.
基金supported by the Fuxing Nursing Research Foundation of Fudan University[FNF202352].
文摘Objectives This review aimed to systematically synthesize the available research on the disclosure of diagnosis and related issues in childhood cancer from the perspectives of healthcare professionals,with the goal of informing the optimization of disclosure processes and meeting the communication needs of affected families.Methods In accordance with the Joanna Briggs Institute(JBI)methodology for mixed methods systematic reviews,the convergent segregated approach was used in this review.Articles were retrieved from 11 databases,including PubMed,Web of Science,CINAHL,CENTRAL,Embase,Ovid/Medline,PsycINFO,PsycArticles,Scopus,ERIC,and China National Knowledge Infrastructure(CNKI).The quality of the selected articles was assessed using the Mixed Method Appraisal Tool(MMAT).The review protocol was registered on PROSPERO(CRD42024542746).Results A total of 21 studies from 10 countries were included.Their methodological quality was generally medium to high,with MMAT scores ranging from 60%to 100%.The synthesis yielded three core themes:1)the spectrum of professional and societal attitudes toward disclosure;2)the dynamic practices of navigating disclosure amid uncertainty,including timing and environment,stakeholders,and content of disclosure;and 3)factors influencing disclosure,including children’s,parental,healthcare professionals’,and socio-cultural factors.Conclusions This review synthesized the perspectives and experiences of healthcare professionals regarding disclosure in childhood cancer,highlighting the complexity and multidimensional nature of this process in clinical practice.Future research should further investigate the experiences and needs of children and their parents,explore cultural variations in disclosure practices,develop context-appropriate assessment tools,and construct multidimensional intervention strategies to enhance the humanistic care and professional effectiveness of the disclosure process.
文摘BACKGROUND Ischemic bowel disease(IBD)is a critical condition caused by reduced blood flow to the intestines,leading to tissue damage and potentially severe complications.Early recognition and timely management are essential for improving patient outcomes and reducing morbidity and mortality associated with IBD.AIM To evaluate the knowledge,attitude and practice(KAP)of healthcare professionals regarding IBD.METHODS This cross-sectional study was conducted among healthcare professionals in China from November 2023 to December 2023 using a self-designed questionnaire.RESULTS A total of 315 valid questionnaires were analyzed,with 215 participants(68.25%)being female.The mean KAP scores were 17.55±5.35(range:0-24),27.65±2.77(range:8-40),and 18.88±4.23(range:6-30),respectively.Multivariate linear regression analysis revealed the following factors to be independently associated with knowledge:Age 26-35 years(β=2.80,95%CI:0.31-5.30,P=0.028),professional title(β=2.66,95%CI:0.91-4.41,P=0.003),position(β=-3.78,95%CI:-5.45 to-2.11,P<0.001),participation in IBD-related training(β=3.45,95%CI:2.39-4.51,P<0.001),and admission of more than five IBD cases in the past month(β=3.25,95%CI:1.58-4.92,P<0.001).Attitude was independently associated with knowledge(β=0.20,95%CI:0.15-0.26,P<0.001)and being a nurse or nursing supervisor(β=-1.30,95%CI:-2.16 to-0.40,P=0.003).Practice was independently associated with knowledge(β=0.20,95%CI:0.10-0.30,P<0.001)and attitude(β=0.24,95%CI:0.06-0.42,P=0.007).Structural equation modeling demonstrated direct effects of knowledge on attitude(β=0.24,P<0.001)and practice(β=0.26,P<0.001),as well as of attitude on practice(β=0.22,P=0.012).CONCLUSION Healthcare professionals demonstrated adequate knowledge but moderate attitude and inactive practice regarding IBD.Addressing the gaps in attitude and practice through targeted training programs and interventions is essential for improving patient care and outcomes.
基金supported by the National Natural Science Foundation of China(Grant No.41961134032).
文摘The surrogate model serves as an efficient simulation tool during the slope parameter inversion process.However,the creep constitutive model integrated with dynamic damage evolution poses challenges in development of the required surrogate model.In this study,a novel physics knowledge-based surrogate model framework is proposed.In this framework,a Transformer module is employed to capture straindriven softening-hardening physical mechanisms.Positional encoding and self-attention are utilized to transform the constitutive parameters associated with shear strain,which are not directly time-related,into intermediate latent features for physical loss calculation.Next,a multi-layer stacked GRU(gated recurrent unit)network is built to provide input interfaces for time-dependent intermediate latent features,hydraulic boundary conditions,and water-rock interaction degradation equations,with static parameters introduced via external fully-connected layers.Finally,a combined loss function is constructed to facilitate the collaborative training of physical and data loss,introducing time-dependent weight adjustments to focus the surrogate model on accurate deformation predictions during critical phases.Based on the deformation of a reservoir bank landslide triggered by impoundment and subsequent restabilization,an elasto-viscoplastic constitutive model that considers water effect and sliding state dependencies is developed to validate the proposed surrogate model framework.The results indicate that the framework exhibits good performance in capturing physical mechanisms and predicting creep behavior,reducing errors by about 30 times compared to baseline models such as GRU and LSTM(long short-term memory),meeting the precision requirements for parameter inversion.Ablation experiments also confirmed the effectiveness of the framework.This framework can also serve as a reference for constructing other creep surrogate models that involve non-time-related across dimensions.
文摘The development of artificial intelligence has brought tremendous changes to enterprises and also pose higher demands on financial professionals.Through literature research,this paper explores the viewpoints of domestic and foreign scholars and industry experts on the impact of Artificial Intelligence(AI)on corporate financial management and the role transformation of financial professionals.It analyzes the current application status of AI technology in finance.The results indicate that AI will replace some repetitive and highly procedural tasks,such as simple data entry and bookkeeping.AI can improve the processing speed and accuracy of corporate financial data.With its learning capabilities,AI can assist financial professionals in addressing knowledge gaps.However,AI cannot completely replace human thinking,judgment,and decision-making,especially in areas like emotional communication and aesthetic experience.This requires financial professionals to continuously improve their overall qualities,leverage their strengths,and achieve complementary advantages with machines,jointly promoting innovative financial development in the era of artificial intelligence.
文摘Within contemporary healthcare systems, professional identity among specialized nurses serves as a pivotal intrinsic factor influencing the development of their core competencies. This review synthesizes existing research, revealing that professional identity positively impacts the development of core competencies through multiple pathways, including psychological drive, behavioral facilitation, teamwork, and career stability. Building on this analysis, this paper proposes systematic enhancement strategies from four dimensions: education and training, organizational environment, cultural development, and individual growth, aiming to provide a reference for nursing practice and professional development.
文摘Professional learning communities(PLCs)offer essential contextual support for the development of foreign language teachers in higher education.The book Building Professional Learning Communities of Foreign Language Teachers in Higher Education,co-authored by Wen et al.(2021)systematically examines the necessity,practical measures,theoretical construction,and outcomes associated with building PLCs for university foreign language teachers.Notably,it introduces a research methodology rooted in local teacher education practices with Chinese characteristics—the dialectical research paradigm(DRP).This review introduces the content of the book,evaluates its contributions to teacher development,and explores its implications for future practice and research.
基金Project supported by the National Natural Science Foundation of China(Nos.40101014 and 40001008).
文摘A machine-learning approach was developed for automated building of knowledgebases for soil resources mapping by using a classification tree to generate knowledge from trainingdata. With this method, building a knowledge base for automated soil mapping was easier than usingthe conventional knowledge acquisition approach. The knowledge base built by classification tree wasused by the knowledge classifier to perform the soil type classification of Longyou County,Zhejiang Province, China using Landsat TM bi-temporal images and CIS data. To evaluate theperformance of the resultant knowledge bases, the classification results were compared to existingsoil map based on a field survey. The accuracy assessment and analysis of the resultant soil mapssuggested that the knowledge bases built by the machine-learning method was of good quality formapping distribution model of soil classes over the study area.
基金supported by the National Key Laboratory of ATR(9140C8002010706).
文摘Automatic bridge detection is an important application of SAR images.Differed from the classical CFAR method,a new knowledge-based bridge detection approach is proposed.The method not only uses the backscattering intensity difference between targets and background but also applies the contextual information and spatial relationship between objects.According to bridges'special characteristics and scattering properties in SAR images,the new knowledge-based method includes three processes:river segmentation,potential bridge areas detection and bridge discrimination.The application to AIRSAR data shows that the new method is not sensitive to rivers'shape.Moreover,this method can detect bridges successfully when river segmentation is not very exact and is more robust than the radius projection method.
基金granted by the Offi ce of Vice President for Research and Community Services of the University of Gondar
文摘BACKGROUND:Competency in neonatal resuscitation is critical in the delivery rooms,neonatology units and pediatrics intensive care units to ensure the safety and health of neonates. Each year,millions of babies do not breathe immediately at birth,and among them the majority require basic neonatal resuscitation. Perinatal asphyxia is a major contributor to neonatal deaths worldwide in resource-limited settings. Neonatal resuscitation is effective only when health professionals have sufficient knowledge and skills. But malpractices by health professionals are frequent in the resuscitation of neonates. The present study was to assess the knowledge and skills of health professionals about neonatal resuscitation.METHODS:An institution based cross-sectional study was conducted in our hospital from February15 to April 30,2014. All nurses,midwives and residents from obstetrics-gynecology(obsgyn),midwifery and pediatric departments were included. The mean scores of knowledge and skills were compared for sex,age,type of profession,qualification,year of service and previous place of work of the participants by using Student's t test and ANOVA with Scheffe's test. A P value <0.05 was considered statistically significant.RESULTS:One hundred and thirty-five of 150 participants were included in this study with a response rate of 90.0%. The overall mean scores of knowledge and skills of midwives,nurses and residents were 19.9(SD=3.1) and 6.8(SD=3.9) respectively. The mean knowledge scores of midwives,nurses,pediatric residents and obs-gyn residents were 19.7(SD=3.03),20.2(SD=2.94),19.7(SD=4.4) and 19.6(SD=3.3) respectively. Whereas the mean scores of skills of midwives,nurses,pediatric residents and obs-gyn residents were 7.1(SD=4.17),6.7(SD=3.75),5.7(SD=4.17) and 6.6(SD=3.97) respectively.CONCLUSIONS:The knowledge and skills of midwives,nurses and residents about neonatal resuscitation were substandardized. Training of neonatal resuscitation for midwives,nurses and residents should be emphasized.
文摘BACKGROUND:Healthcare professionals are expected to have knowledge of current basic and advanced cardiac life support(BLS/ACLS) guidelines to revive unresponsive patients.METHODS:Across-sectional study was conducted to evaluate the current practices and knowledge of BLS/ACLS principles among healthcare professionals of North-Kerala using pretested self-administered structured questionnaire.Answers were validated in accordance with American Heart Association's BLS/ACLS teaching manual and the results were analysed.RESULTS:Among 461 healthcare professionals,141(30.6%) were practicing physicians,268(58.1%) were nurses and 52(11.3%) supporting staff.The maximum achievable score was 20(BLS15/ACLS 5).The mean score amongst all healthcare professionals was 8.9±4.7.The mean score among physicians,nurses and support staff were 8.6±3.4,9±3.6 and 9±3.3 respectively.The majority of healthcare professionals scored <50%(237,51.4%);204(44.3%) scored 51%-80%and 20(4.34%)scored >80%.Mean scores decreased with age,male sex and across occupation.Nurses who underwent BLS/ACLS training previously had significantly higher mean scores(10.2±3.4) than untrained(8.2±3.6,P=0.001).Physicians with <5 years experience(P=0.002) and nurses in the private sector(P=0.003)had significantly higher scores.One hundred and sixty three(35.3%) healthcare professionals knew the correct airway opening manoeuvres like head tilt,chin lift and jaw thrust.Only 54(11.7%) respondents were aware that atropine is not used in ACLS for cardiac arrest resuscitation and 79(17.1%) correctly opted ventricular fibrillation and pulseless ventricular tachycardia as shockable rhythms.The majority of healthcare professionals(356,77.2%) suggested that BLS/ACLS be included in academic curriculum.CONCLUSION:Inadequate knowledge of BLS/ACLS principles amongst healthcare professionals,especially physicians,illuminate lacunae in existing training systems and merit urgent redressal.
基金supported by National Natural Science Foundation of China(Grant No.51175086)
文摘Due to the insufficiency of utilizing knowledge to guide the complex optimal searching, existing genetic algorithms fail to effectively solve excavator boom structural optimization problem. To improve the optimization efficiency and quality, a new knowledge-based real-coded genetic algorithm is proposed. A dual evolution mechanism combining knowledge evolution with genetic algorithm is established to extract, handle and utilize the shallow and deep implicit constraint knowledge to guide the optimal searching of genetic algorithm circularly. Based on this dual evolution mechanism, knowledge evolution and population evolution can be connected by knowledge influence operators to improve the conflgurability of knowledge and genetic operators. Then, the new knowledge-based selection operator, crossover operator and mutation operator are proposed to integrate the optimal process knowledge and domain culture to guide the excavator boom structural optimization. Eight kinds of testing algorithms, which include different genetic operators, arc taken as examples to solve the structural optimization of a medium-sized excavator boom. By comparing the results of optimization, it is shown that the algorithm including all the new knowledge-based genetic operators can more remarkably improve the evolutionary rate and searching ability than other testing algorithms, which demonstrates the effectiveness of knowledge for guiding optimal searching. The proposed knowledge-based genetic algorithm by combining multi-level knowledge evolution with numerical optimization provides a new effective method for solving the complex engineering optimization problem.
基金financially supported by the Project of Ministry of Education and Finance of China(Grant Nos.200512 and 201335)the Project of the State Key Laboratory of Ocean Engineering,Shanghai Jiao Tong University(Grant No.GKZD010053-10)
文摘Knowledge-Based Engineering （KBE） is introduced into the ship structural design in this paper. From the implementation of KBE, the design solutions for both Rules Design Method （RDM） and Interpolation Design Method （IDM） are generated. The corresponding Finite Element （FE） models are generated. Topological design of the longitudinal structures is studied where the Gaussian Process （GP） is employed to build the surrogate model for FE analysis. Multi-objective optimization methods inspired by Pareto Front are used to reduce the design tank weight and outer surface area simultaneously. Additionally, an enhanced Level Set Method （LSM） which employs implicit algorithm is applied to the topological design of typical bracket plate which is used extensively in ship structures. Two different sets of boundary conditions are considered. The proposed methods show satisfactory efficiency and accuracy.
文摘Job crafting (JC) is a form of proactive behavior and refers to the initiatives employees that could take to change their tasks or other job characteristics to achieve the best person-job fit. JC consists of six dimensions: seeking structural and social job resources, as well as challenges, hindering job demands, optimizing job demands, and delegating tasks. The aim of the present study was to explore the impact of self-efficacy and work engagement on healthcare professionals’ (HP) proactive behavior. A convenience sample of 295 HP working in Primary and Secondary healthcare structures of Northern Greece completed a questionnaire that included: 1) demographic/occupational characteristics, 2) the Job Crafting Scale, 3) the Generalized Self-Efficacy Scale (GSE) and 4) the Utrecht Work Engagement Scale (UWES). Increased age was found to be associated with decreased levels of seeking social job resources (p < 0.01). Education level was positively associated with increased levels of seeking structural job resources (p < 0.01), seeking challenges (p < 0.05), and optimizing job demands (p < 0.05), while job position was found to be negatively related to delegating tasks (p < 0.01). Self-efficacy was positively associated with increased levels of seeking structural resources (p < 0.001), challenges (p < 0.001), and increased levels of optimizing job demands (p < 0.001), while it was positively associated with decreased levels of delegating tasks (p < 0.05). In addition, increased work engagement was found to be associated with increased levels of seeking social job resources (p < 0.05), challenges (p < 0.01), and optimizing job demands (p < 0.01). Findings highlight the importance of self-efficacy, work engagement and individual characteristics in the realization of a resourceful work environment and HP’ adjustment in the organization. Thus, interventions that promote HP’ JC proactive behaviors should be encouraged.
基金FAPEMIG and CNPq for financial support,studentships(to M.R.F.and S.V.B.G.M.),and fellowships(to R.L.G.M.and N.V.)
文摘There is a lack of information about the factors responsible for the effectiveness of environmental policies in Brazilian agriculture.This study aimed at identifying the perception and practices of agrarian professionals.The data analysis was carried out using a survey and methodological approaches focusing on environmental complexity and categorization of environmental actions.Quantitative analysis was based on descriptive statistics.Atmospheric problems were perceived as the main problems for the current and next two generations,while hydrological problems were indicated as those deserving most urgent solutions.On the other hand,the main developed actions and those planned to be carried out were classified within the responsibility category.Because of the reductionist perceptions,introduction of the concept of a socio-ecological system is indicated by means of methodological interventions during the development of agrarian professionals;also,in order to stimulate actions related to the competence and citizenship category,a methodological intervention focusing on resilience thinking is proposed.Typical actions of individuals with either reductionist or complex conceptions of the environment can be captured and,therefore,educational strategies can be traced based on the profiles obtained.
基金Project supported by the National Major Science and Technology Foundation of China during the 10th Five-Year Plan Period(No.2001BA204B05-KHK Z0009)
文摘A novel knowledge-based fuzzy neural network （KBFNN） for fault diagnosis is presented. Crude rules were extracted and the corresponding dependent factors and antecedent coverage factors were calculated firstly from the diagnostic sample based on rough sets theory. Then the number of rules was used to construct partially the structure of a fuzzy neural network and those factors were implemented as initial weights, with fuzzy output parameters being optimized by genetic algorithm. Such fuzzy neural network was called KBFNN. This KBFNN was utilized to identify typical faults of rotating machinery. Diagnostic results show that it has those merits of shorter training time and higher right diagnostic level compared to general fuzzy neural networks.
文摘The aim of this study was to examine the possible relationship between physical and psychological aggression suffered in the workplace and professional burnout, depression and anxiety suffered by healthcare professionals of the emergency services. Methods: 315 physicians, nurses, orderlies and ambulance drivers of Critical Care and Emergency Devices (CCED) in the Andalusian Public Health System, in the province of Granada (Spain) participated. They were interviewed about the exposure to violence at work and answered a battery of questions that measured burnout, depression and anxiety. Results: Physical aggression was significantly related to emotional exhaustion, personal accomplishment at work, depression and anxiety. Psychological aggression was associated with personal accomplishment. Logistic regression showed that the CCED professionals who have suffered physical aggression were 4.2 and 2.6 times more likely to have suffered anxiety and reduced personal accomplishment, respectively, than those who did not suffer physical aggression. On the other hand, feelings of anxiety and reduced personal accomplishment increase the professionals’ risk (3.4 and 2.1 times more likely, respectively) of suffering from physical aggression. Conclusion: The results suggest that exposure to violence is related to the other psychological problems tested: emotional exhaustion and personal accomplishment (two components of burnout), depression and anxiety. In addition, physical violence is a risk factor for anxiety and diminished personal accomplishment of the CCED professionals.
基金Project supported in part by the National Natural Science Foundation of China(Grant Nos.11175224 and 11121403)
文摘Biological raw data are growing exponentially, providing a large amount of information on what life is. It is believed that potential functions and the rules governing protein behaviors can be revealed from analysis on known native structures of proteins. Many knowledge-based potentials for proteins have been proposed. Contrary to most existing review articles which mainly describe technical details and applications of various potential models, the main foci for the discussion here are ideas and concepts involving the construction of potentials, including the relation between free energy and energy, the additivity of potentials of mean force and some key issues in potential construction. Sequence analysis is briefly viewed from an energetic viewpoint.
基金Supported by the National Science Foundation of China(No.7977086)
文摘This paper describes the development of a knowledgebased system (KBS) for determining whether or not, and under what conditions, a bank Ioan officer should grant a business loan to a company. The prototype system developed focuses on what is bank loans risks management, how to prevent risk by the analysis of the ability of paying back loans. The paper makes the structural analysis involved in the system's decision situation, the structured situation diagram or model, dependency diagram and the document needed by the KBS prototype system thus are developed. Through testing the samples from loan business, the quality for the analysis of the ability of paying back loans can be effectively evaluated by the KBS prototype system.
文摘The limitations of traditional approaches to selection problems are examined. A problemsolving strategy is presented in which decision-support and knowledge-based techniques play complementary roles. An approach to the representation of knowledge to support the problem-solving strategy is presented which avoids commitment to a specific programming language or implementation environment. The problem of choosing a home is used to illustrate the representation of knowledge in a specific problem domain. Techniques for implementation of the problem-solving strategy are described. Knowledge elicitation techniques and their implementation in a development shell for application of the problem-solving strategy to any selection problem are also described.
