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Clinical reasoning is the thought process that guides practice. Although a plethora of clinical reasoning studies in healthcare professionals exists, the majority appear to originate from Western cultures. A scoping review was undertaken to examine clinical reasoning related research across Asian cultures. PubMed, SciVerse Scopus, Web of Science and Airiti Library databases were searched. Inclusion criteria included full-text articles published in Asian countries (2007 to 2019). Search terms included clinical reasoning, thinking process, differential diagnosis, decision making, problem-based learning, critical thinking, healthcare profession, institution, medical students and nursing students. After applying exclusion criteria, n = 240 were included in the review. The number of publications increased in 2012 (from 5%, n = 13 in 2011 to 9%, n = 22) with a steady increase onwards to 12% (n = 29) in 2016. South Korea published the most articles (19%, n = 46) followed by Iran (17%, n = 41). Nurse Education Today published 11% of the articles (n = 26), followed by BMC Medical Education (5%, n = 13). Nursing and Medical students account for the largest population groups studied. Analysis of the articles resulted in seven themes: Evaluation of existing courses (30%, n = 73) being the most frequently identified theme. Only seven comparative articles showed cultural implications, but none provided direct evidence of the impact of culture on clinical reasoning. We illuminate the potential necessity of further research in clinical reasoning, specifically with a focus on how clinical reasoning is affected by national culture. A better understanding of current clinical reasoning research in Asian cultures may assist curricula developers in establishing a culturally appropriate learning environment.

The mechanical characteristics and mechanisms of rock failure involve complex rock mass mechanics problems involving parameters such as energy concentration, storage, dissipation, and release. Therefore, it is important to select appropriate monitoring technologies to carry out relevant research. Fortunately, infrared thermal imaging monitoring technology has obvious advantages in the experimental study of rock failure processes and energy dissipation and release characteristics under load damage. Therefore, it is necessary to establish the theoretical relationship between the strain energy and infrared radiation information of sandstone and to reveal its fracture energy dissipation and disaster mechanism. In this study, an MTS electro-hydraulic servo press was used to carry out uniaxial loading experiments on sandstone. The characteristics of dissipated energy, elastic energy, and infrared radiation during the damage process of sandstone were studied using infrared thermal imaging technology. The results show that (1) the transition of sandstone loading from one stable state to another occurs in the form of an abrupt change. This sudden change is characterized by the simultaneous occurrence of elastic energy release, dissipative energy surging, and infrared radiation count (IRC) surging, and it has the characteristics of a short duration and large amplitude variation. (2) With the increase in the elastic energy variation, the surge in the IRC of sandstone samples presents three different development stages, namely fluctuation (stage Ⅰ), steady rise (stage Ⅱ), and rapid rise (stage Ⅲ). (3) The more obvious the surge in the IRC, the greater the degree of local damage of the sandstone and the greater the range of the corresponding elastic energy change (or dissipation energy change). (4) A method of sandstone microcrack location and propagation pattern recognition based on infrared thermal imaging technology is proposed. This method can dynamically generate the distribution nephograph of tension-shear microcracks of the bearing rock and accurately evaluate the real-time process of rock damage evolution. Finally, this study can provide a theoretical basis for rock stability, safety monitoring, and early warning. [ABSTRACT FROM AUTHOR]

Purpose: Age-related macular degeneration is a leading cause of blindness in the elderly. At a later stage, neovascular or exudative age-related macular degeneration can lead to severe central vision loss that is related to aging-associated cumulative oxidative stress of the human retinal pigment epithelium (hRPE) cells. Early prevention with antioxidants is mandatory. The aim of this study was to determine whether and how baicalein can act as an antioxidant. Methods: The methods used included lactate dehydrogenase, 2′,7′-dichloro-fluorescein diacetate, or enzyme-linked immunosorbent assay to measure cell viability, oxygen free radical levels, or the levels of vascular endothelial growth factor (VEGF)/matrix metalloproteinase-9 (MMP-9), respectively. Results: H2O2 dose-dependently reduced the cell viability of hRPE cells. This negative effect was dose-dependently (with a lower effect at 20 μM) and significantly counteracted by pretreatment with baicalein (50 μM). Treatment with H2O2 significantly stimulated the formation of oxygen free radicals. This increase was dose-dependently and significantly blunted by baicalein. Further, treatment with a sublethal dose of H2O2 was associated with an upregulation in the levels of VEGF and MMP-9. The increases in these proteins were also dose-dependently (with a lower effect at 20 μM) and significantly (50 μM) blunted by pretreatment with baicalein. Conclusion: This study supports an antioxidative role for baicalein whereby it protects hRPE cells against H2O2-induced oxidative stress by downregulating the levels of VEGF and MMP-9, which are increased by H2O2. [ABSTRACT FROM AUTHOR]

Abstract: The structures of sandwich-like and chain-like superatom compounds Li3–N4–M3 (M=Li, Na and K) are obtained at the MP2/6-311+G(2d) level. These structures are stable own to large interaction energy ranging from −184.4 to −236.9kcal/mol. Maximum nucleus-independent chemical shift (NICSmax) values of M3 + are located at the outside of the M3 + ring plane about 0.6–1.5Å for the sandwich-like structures, which exhibit unusual out-of-plane σ-aromaticity. The NICSmax values of N4 2− in the sandwich-like structures are obviously larger than that of corresponding chain-like structures, which show that the two adjacent rings (Li3 + and M3 +) enhance the aromaticity of N4 2− ring in the sandwich-like structures. In addition, the N4 in the superatom compound is proposed as a new “supersulfur” atom. [Copyright &y& Elsevier]

Abstract: The structures and nonlinear optical (NLO) properties of the charge transfer anion-radical salts without excess electron, M+TCNQ− (M=Li, Na, K) are studied for the first time. These anion-radical salts exhibit large first (β 0) and second (γ 0) hyperpolarizabilities, which are related to the ligand-to-metal charge transfer (LMCT) transitions. The largest β 0 and γ 0 values for K+TCNQ− are 2.8×104 and 2.0×106 a.u., respectively. In addition, the effect of alkali-metal doping and monotonous dependence on the alkali atomic number of both β 0 and γ 0 are observed. These results may be beneficial to design high-performance NLO materials. [Copyright &y& Elsevier]

A new class of metal-nonmetal-metal sandwich structures M3-CO3-M3' (M, M' = Li, Na, K) with all real frequencies is obtained at the second-order Möller-Plesset theory (MP2) method with the 6-311+G (2d) basis set. Because the sandwich molecule M3-CO3-M3' is composed of superatoms (M3, CO3, and M3'), it is a sandwich "superomolecule". The superatoms M3 and M3' are electron donors and CO3 is the acceptor, and then there is a strong charge transfer between M3 (or M3') and CO3 superatom, so M3-CO3-M3' can be denoted as M3(+)CO3(2-)M3'(+). Owing to the CO3(2-) anion in the middle repulsing the valence electrons of two metal rings (M3 and M3') forming a pair of excess electrons, the compound with excess electrons is also a novel electride. In metal-nonmetal-metal sandwich compound M3(+)CO3(2-)M3'(+), superatom units M3(+) and M3'(+) exhibit unusual sigma-aromaticity: the maximum negative nucleus-independent chemical shift (NICSmax) value of each aromatic ring (M3(+) and M3'(+)) does not locate at the center of the ring plane but locates outside the ring plane. The distance value from the center of the M3(+) or M3'(+) ring plane to the point with NICSmax ranges from 0.8 to 1.9 A. This shows a notable out-of-plane sigma-aromaticity for these sandwich compounds. What is the reason? We find that the out-of-plane sigma-aromaticity of M3(+) (or M3'(+)) results from the action of CO3(2-)M3'(+) (or M3(+)CO3(2-)). For electric property, on account of excess electrons, the sandwich electride M3-CO3-M3' without the central symmetry can exhibit large static first hyperpolarizability (beta0). For Na3-CO3-K3, the beta0 value is close to 56,000 au.