Objective:To evaluate the implementation effectiveness of standardized protective care procedures during hydrofluoric acid procedures in the dental department.Methods:This study was conducted from June 2023 to June 20...Objective:To evaluate the implementation effectiveness of standardized protective care procedures during hydrofluoric acid procedures in the dental department.Methods:This study was conducted from June 2023 to June 2025,selecting 90 patients who underwent hydrofluoric acid-related treatments in the outpatient dental department of this hospital during this period as subjects.Forty-five patients treated between June 2023 and June 2024 received conventional protective care(pre-intervention group),while 45 patients treated between June 2024 and June 2025 underwent the standardized protective care protocol(post-intervention group).Thirteen healthcare personnel participated in both pre-and post-intervention treatment phases.Based on the different nursing models,indicators such as the incidence of adverse events in patients and the exposure rate of healthcare personnel before and after implementation were compared to evaluate the effectiveness of the nursing intervention.Results:The incidence of oral mucosal irritation reactions in patients was lower after implementation,p<0.05.Compared with the pre-implementation period,the incidence of procedure-related adverse events decreased after implementation,p<0.05.There was a significant difference in the occupational exposure rate of healthcare personnel before and after implementation,with a higher rate observed before implementation(p<0.05).Post-implementation,healthcare personnel achieved higher compliance scores for pre-procedure preparation,intra-procedure protection,and post-procedure handling(p<0.05).Patient satisfaction with treatment was lower pre-implementation than post-implementation(p<0.05).Conclusion:Adherence to standardized protective care procedures during hydrofluoric acid operations by dental department staff in outpatient settings standardizes practitioner techniques,effectively prevents oral mucosal irritation in patients,reduces occupational exposure risks for staff,minimizes adverse procedural events,and consequently enhances patient treatment satisfaction.This demonstrates significant practical value.展开更多
Background:We aimed to study physician attitudes toward ultrasound-guided procedures and possible improvements.We hypothesized that the usage of ultrasound in procedures may be limited by a high barrier of entry and t...Background:We aimed to study physician attitudes toward ultrasound-guided procedures and possible improvements.We hypothesized that the usage of ultrasound in procedures may be limited by a high barrier of entry and that most physicians would choose to adopt software that provides real-time image guidance if accessible.Methods:A voluntary,cross-sectional survey of physicians at a single site was conducted using a five-point Likert scale.Data analysis included both descriptive and inferential statistical analyses and stratified by categorical descriptors,including variables of formal training,years of experience,and specialty of practice.Results:One hundred sixteen physicians responded to the survey.The majority disagreed that there was a steep learning curve(57.5%)and that they need more time to identify structures under ultrasound(85.0%).Overall attitudes were mixed about the use of additional software to improve ease of use,but most(55.4%)had positive opinions toward the addition of real-time 3D reconstruction.Respondents without formal training were significantly more likely to agree that additional software would improve ease of ultrasound-guided procedures(p=0.0389).Radiologists were significantly more likely to perceive a steeper learning curve and less likely to advocate for supplemental software compared to emergency medicine physicians,surgeons,or anesthesiologists.Conclusions:Surveyed physicians demonstrated comfort with ultrasound-guided procedures and a mixed stance toward the use of additional software to assist with procedures.Those without formal training had significantly more positive attitudes toward the use of additional technology to augment ultrasound-guided procedures,suggesting a knowledge gap that may benefit from such technology.展开更多
Performance-based warranties(PBWs)are widely used in industry and manufacturing.Given that PBW can impose financial burdens on manufacturers,rational maintenance decisions are essential for expanding profit margins.Th...Performance-based warranties(PBWs)are widely used in industry and manufacturing.Given that PBW can impose financial burdens on manufacturers,rational maintenance decisions are essential for expanding profit margins.This paper proposes an optimization model for PBW decisions for systems affected by Gamma degradation processes,incorporating periodic inspection.A system performance degradation model is established.Preventive maintenance probability and corrective renewal probability models are developed to calculate expected warranty costs and system availability.A benefits function,which includes incentives,is constructed to optimize the initial and subsequent inspection intervals and preventive maintenance thresholds,thereby maximizing warranty profit.An improved sparrow search algorithm is developed to optimize the model,with a case study on large steam turbine rotor shafts.The results suggest the optimal PBW strategy involves an initial inspection interval of approximately 20 months,with subsequent intervals of about four months,and a preventive maintenance threshold of approximately 37.39 mm wear.When compared to common cost-minimization-based condition maintenance strategies and PBW strategies that do not differentiate between initial and subsequent inspection intervals,the proposed PBW strategy increases the manufacturer’s profit by 1%and 18%,respectively.Sensitivity analyses provide managerial recommendations for PBW implementation.The PBW strategy proposed in this study significantly increases manufacturers’profits by optimizing inspection intervals and preventive maintenance thresholds,and manufacturers should focus on technological improvement in preventive maintenance and cost control to further enhance earnings.展开更多
To enhance the frequency stability and lower the regulation mileage payment of a multiarea integrated energy system(IES)that supports the power Internet of Things(IoT),this paper proposes a data-driven cooperative met...To enhance the frequency stability and lower the regulation mileage payment of a multiarea integrated energy system(IES)that supports the power Internet of Things(IoT),this paper proposes a data-driven cooperative method for automatic generation control(AGC).The method consists of adaptive fractional-order proportional-integral(FOPI)controllers and a novel efficient integration exploration multiagent twin delayed deep deterministic policy gradient(EIE-MATD3)algorithm.The FOPI controllers are designed for each area based on the performancebased frequency regulation market mechanism.The EIE-MATD3 algorithm is used to tune the coefficients of the FOPI controllers in real time using centralized training and decentralized execution.The algorithm incorporates imitation learning and efficient integration exploration to obtain a more robust coordinated control strategy.An experiment on the four-area China Southern Grid(CSG)real-time digital system shows that the proposed method can improve the control performance and reduce the regulation mileage payment of each area in the IES.展开更多
BACKGROUND Postoperative pulmonary complications(PPCs)are the most common complications following major upper abdominal surgeries,particularly hepatobiliary procedures,and significantly compromise surgical outcomes an...BACKGROUND Postoperative pulmonary complications(PPCs)are the most common complications following major upper abdominal surgeries,particularly hepatobiliary procedures,and significantly compromise surgical outcomes and patients’quality of life.Although the adoption of laparoscopy has lowered their incidence,PPCs remain a frequent and serious concern after hepatobiliary surgery.Existing research on risk factors specific to hepatobiliary surgeries is limited,particularly regarding the epidemiology and risk factors of PPCs in liver and gallbladder surgeries in China.Therefore,this study aimed to investigate the risk factors for PPCs in a large hepatobiliary center.AIM To identify the incidence and risk factors for PPCs following hepatobiliary surgery based on perioperative variables.METHODS Retrospective data were collected from patients who underwent liver,gallbladder,or pancreatic surgery at a hepatobiliary center in China between May 2023 and December 2023.We retrospectively reviewed comprehensive medical records to extract demographic and hospital admission information for determining PPC incidence.Statistically significant variables were initially screened through univariate analysis,followed by binary logistic regression modeling to identify independent predictors of PPCs.Hospitalization expenditures and duration of stay were further contrasted across the study cohorts.RESULTS This study included 1941 patients who underwent liver,gallbladder,or pancreatic surgery,of whom 78 developed PPCs,resulting in an incidence rate of 4.02%.Logistic regression analysis revealed two independent predictors of PPCs in hepatobiliary surgery patients:Age≥75 year(odds ratio=8.350,95%CI:3.521-19.798,P<0.001)and prolonged anesthesia(odds ratio=1.052,95%CI:1.015-1.091,P=0.006).Patients with PPCs had significantly elevated healthcare resource utilization,including higher total hospitalization costs,increased medication expenses,longer hospital stays,and extended postoperative admissions(all P<0.001).CONCLUSION Age≥75 years and prolonged anesthesia emerged as independent predictors of PPCs following hepatobiliary surgery.These complications were correlated with protracted hospitalization and increased healthcare costs.展开更多
This paper presents a performance-based methodology for the assessment of seismic vulnerability and capacity of buildings.The vulnerability assessment methodology is based on the HAZUS methodology and the improved cap...This paper presents a performance-based methodology for the assessment of seismic vulnerability and capacity of buildings.The vulnerability assessment methodology is based on the HAZUS methodology and the improved capacity-demand-diagram method.The spectral displacement(Sd)of performance points on a capacity curve is used to estimate the damage level of a building.The relationship between Sd and peak ground acceleration(PGA)is established,and then a new vulnerability function is expressed in terms of PGA.Furthermore,the expected value of the seismic capacity index(SCev)is provided to estimate the seismic capacity of buildings based on the probability distribution of damage levels and the corresponding seismic capacity index.The results indicate that the proposed vulnerability methodology is able to assess seismic damage of a large number of building stock directly and quickly following an earthquake.The SCev provides an effective index to measure the seismic capacity of buildings and illustrate the relationship between the seismic capacity of buildings and seismic action.The estimated result is compared with damage surveys of the cities of Dujiangyan and Jiangyou in the M8.0 Wenchuan earthquake,revealing that the methodology is acceptable for seismic risk assessment and decision making.The primary reasons for discrepancies between the estimated results and the damage surveys are discussed.展开更多
With the development and implementation of performance-based earthquake engineering,harmonization of performance levels between structural and nonstructural components becomes vital. Even if the structural components ...With the development and implementation of performance-based earthquake engineering,harmonization of performance levels between structural and nonstructural components becomes vital. Even if the structural components of a building achieve a continuous or immediate occupancy performance level after a seismic event,failure of architectural,mechanical or electrical components can lower the performance level of the entire building system. This reduction in performance caused by the vulnerability of nonstructural components has been observed during recent earthquakes worldwide. Moreover,nonstructural damage has limited the functionality of critical facilities,such as hospitals,following major seismic events. The investment in nonstructural components and building contents is far greater than that of structural components and framing. Therefore,it is not surprising that in many past earthquakes,losses from damage to nonstructural components have exceeded losses from structural damage. Furthermore,the failure of nonstructural components can become a safety hazard or can hamper the safe movement of occupants evacuating buildings,or of rescue workers entering buildings. In comparison to structural components and systems,there is relatively limited information on the seismic design of nonstructural components. Basic research work in this area has been sparse,and the available codes and guidelines are usually,for the most part,based on past experiences,engineering judgment and intuition,rather than on objective experimental and analytical results. Often,design engineers are forced to start almost from square one after each earthquake event: to observe what went wrong and to try to prevent repetitions. This is a consequence of the empirical nature of current seismic regulations and guidelines for nonstructural components. This review paper summarizes current knowledge on the seismic design and analysis of nonstructural building components,identifying major knowledge gaps that will need to be filled by future research. Furthermore,considering recent trends in earthquake engineering,the paper explores how performance-based seismic design might be conceived for nonstructural components,drawing on recent developments made in the field of seismic design and hinting at the specific considerations required for nonstructural components.展开更多
Objective: To evaluate the procedures and timing of operation as well as long-term postoperative effect of congenital choledochal cysts (CCC) in adults. Methods: The procedures and timing of operation, effective rate,...Objective: To evaluate the procedures and timing of operation as well as long-term postoperative effect of congenital choledochal cysts (CCC) in adults. Methods: The procedures and timing of operation, effective rate, re-operation rate and incidence of car- cinoma after operation for 70 adult patients with CCC from January 1980 to June 1999 were analyzed retrospectively. Results: The re-operation rate of external drainage was 86% (6/7). The effective rate of internal drain- age was significantly lower than that of cyst resection (3/10 vs 45/49, X^2=20. 94, P<0.001). The re-op- eration rate and incidence of carcinoma of internal drainage were higher than those of cyst resection (5/ 10 vs 3/49, X^2=13. 64, P<0. 001 and 3/10 vs 3/49, X^2=5. 18, P<0. 025). The reoperation rate of e- mergency surgery was higher than that of selective operation (8/10 vs 6/56, X^2=24. 37, P<0.001). Conclusions: External drainage should be the first- aid measure and the therapy of choice on emergency basis. Internal drainage should never be attempted. Cyst resection with Roux-en-Y hepaticojejunostomy is recommended as the treatment of choice in selective operation.展开更多
In order to promote efficient communication between nurses in Beijing hospitals and foreign patients, EOP (English for Occupational Purposes) courses specifically for nurses are demanded. This paper introduces the mai...In order to promote efficient communication between nurses in Beijing hospitals and foreign patients, EOP (English for Occupational Purposes) courses specifically for nurses are demanded. This paper introduces the main procedures for setting up an EOP course for nurses in Beijing.展开更多
Two procedures were compared for extraction and clean-up of 20organophosphorus and 19 pyrethroid pesticides in sediment to identify the more effective procedurefor groups of pesticides or individual compounds. In Proc...Two procedures were compared for extraction and clean-up of 20organophosphorus and 19 pyrethroid pesticides in sediment to identify the more effective procedurefor groups of pesticides or individual compounds. In Procedure I, methanol/water and n-hexane wereused for extraction, and 1:10 (v/v) dichloromethane in n-hexane and acetone were used as eluents foreluting the analyte through the cartridge, with one evaporating steps on a rotary evaporator andtwo eluting steps on the cartridge. n-hexane/acetone (2:1, v/v) was used for extraction and elutionin Procedure II with one evaporating step on a rotary evaporator and one eluting step on thecartridge. All extractions were performed under an ultrasonic bath and gas chromatography and massspectrometry were utilized for measurements. Procedure II was developed as a rapid, timesaving, lesscostly and safer substitute for Procedure I which was an old method. Procedure II was moreeffective for almost all the organophosphorus pesticides tested and 11of the 19 pyrethroidpesticides, while Procedure I was more appropriate for analysis of 5 pyrethroid pesticides. However,recoveries of most pyrethroid pesticides were fairly low. Thus, further studies should focus onadjustment and formulation of solvents for more efficient extraction and clean-up of pyrethroidpesticides from sediment samples.展开更多
Endoscopic retrograde cholangiopancreatography(ERCP) is one of the most frequently used image-guided procedures in gastrointestinal endoscopy. Post-ERCP pancreatitis is an important concern, and prophylaxis, cannulati...Endoscopic retrograde cholangiopancreatography(ERCP) is one of the most frequently used image-guided procedures in gastrointestinal endoscopy. Post-ERCP pancreatitis is an important concern, and prophylaxis, cannulation and other related technical procedures have been well documented by endoscopists. In addition, medical radiation exposure is of great concern in the general population because of its rapidly increasing frequency and its potential carcinogenic effects. International organizations and radiological societies have established diagnostic reference levels, which guide proper radiation use and serve as global standards for all procedures that use ionizing radiation. However, data on gastrointestinal fluoroscopic procedures are still lacking because the demand for these procedures has recently increased. In this review, we present the current status of quality indicators for ERCP and the methods for measuring radiation exposure in the clinical setting as the next quality indicator for ERCP. To reduce radiation exposure, knowledge of its adverse effects and the procedures for proper measurement and protection are essential. Additionally, further studies on the factors that affect radiation exposure, exposure management and diagnostic reference levels are necessary. Then, we can discuss how to manage medical radiation use inthese complex fluoroscopic procedures. This knowledge will help us to protect not only patients but also endoscopists and medical staff in the fluoroscopy unit.展开更多
Some research results are given in this paper about burnthrough and hydrogen cracking with a flowing chamber and a loop. Many factors including plate thickness, running rate, heat input and so forth have been studied....Some research results are given in this paper about burnthrough and hydrogen cracking with a flowing chamber and a loop. Many factors including plate thickness, running rate, heat input and so forth have been studied. By experiments it can be found that occurrence of hydrogen cracking can be effectively reduced by properly increasing heat input and using the tempering bead technique.展开更多
This paper presents the theory,method,and application of performance-based pavement needs assessment at a state level,using the Pennsylvania Interstate System as an example.First,a general framework is presented for t...This paper presents the theory,method,and application of performance-based pavement needs assessment at a state level,using the Pennsylvania Interstate System as an example.First,a general framework is presented for the pavement asset management and a general optimization model is established for the pavement maintenance and rehabilitation needs assessment.Also,the bundling of pavement segments for the project implementation is discussed.Using the examples of Statewide Transportation Improvement Plan and Long Range Transportation Plan for Pennsylvania Interstate System,the application of performance-based pavement needs assessment is demonstrated.It is shown that unconstrained analysis can help decision-makers investigate the real maintenance and rehabilitation needs;financially-constrained analysis can help decision-makers select projects for implementation and examine the corresponding future pavement conditions.Trade-off analysis can help decision-makers investigate the outcomes of different investment levels on pavement maintenance and rehabilitation and make the final decision on the investment level.The proposed case study provides a good example of performance-based pavement needs assessment for developing countries.展开更多
AIM： To determine factors affecting the outcome of patients with cirrhosis undergoing surgery and to compare the capacities of the Child-Turcotte-Pugh （CTP） and model for end-stage liver disease （MELD） score to p...AIM： To determine factors affecting the outcome of patients with cirrhosis undergoing surgery and to compare the capacities of the Child-Turcotte-Pugh （CTP） and model for end-stage liver disease （MELD） score to predict that outcome. METHODS： We reviewed the charts of 195 patients with cirrhosis who underwent surgery at two teaching hospitals over a five-year period. The combined endpoint of death or hepatic decompensation was considered to be the primary endpoint. RESULTS： Patients who reached the endpoint had a higher MELD score, a higher CTP score and were more likely to have undergone an urgent procedure. Among patients undergoing elective surgical procedures, no statistically significant difference was noted in the mean MELD （12.8 ＋ 3.9 vs 12.6 ＋ 4.7, P = 0.9） or in the mean CTP （7.6 ± 1.2 vs 7.7 ± 1.7, P = 0.8） between patients who reached the endpoint and those who did not. Both mean scores were higher in the patients reaching the endpoint in the case of urgent procedures （MELD： 22.4 ± 8.7 vs 15.2 ± 6.4, P = 0.0007; CTP： 9.9 ± 1.8 vs 8.5 ± 1.8, P = 0.008）. The performances of the MELD and CTP scores in predicting the outcome of urgent surgery were only fair, without a significant difference between them （AUC = 0.755 ± 0.066 for MELD vs AUC = 0.696 ± 0.070 for CTP, P = 0.3）. CONCLUSION： The CTP and MELD scores performed equally, but only fairly in predicting the outcome of urgent surgical procedures. Larger studies are needed to better define the factors capable of predicting the outcome of elective surgical procedures in patients with cirrhosis.equally, but only fairly in predicting the outcome of urgent surgical procedures. Larger studies are needed to better define the factors capable of predicting the outcome of elective surgical procedures in patients with cirrhosis.展开更多
Objective To investigate the changes of perioperative serum levels of interleukin-6(IL-6), C-reactive protein (CRP), and cortisol, as well as gastric intramucosal pH (pHi) and plasma lactate, aiming to compare systemi...Objective To investigate the changes of perioperative serum levels of interleukin-6(IL-6), C-reactive protein (CRP), and cortisol, as well as gastric intramucosal pH (pHi) and plasma lactate, aiming to compare systemic changes and tissue perfusion during colorectal and orthopaedic surgical procedures. Methods Twenty patients were randomly assigned to two groups, 10 cases of operation on vertebral canal, 10 cases of colorectal radical operation.Venous blood was drawn at 1 day before operation, 2, 4, and 6 hours following skin incision, and 1 day after operation, in order to measure serum IL-6, CRP, and cortisol.pHi and plasma lactate were also measured at the same time points.Results Serum concentrations of IL-6 and cortisol increased gradually following operation, reaching the peak value at 6 hours from the beginning of operation.CRP was not detectable until the first day after operation.Peak concentration of IL-6 had positive relationship with CRP.These variables changed more significantly in colorectal group than that in orthopaedic group (P<0.05).pHi decreased gradually, reaching the lowest level at 4 hours from the beginning of operation, and to more extent in colorectal group than that in orthopaedic group (P<0.05).Conclusion IL-6 may reflect tissue damage more sensitively than CRP.Colorectal surgery might induce systemic disorder to more extent, in terms of immuno-endocrinal aspect as well as tissue perfusion, reflected with pHi.展开更多
Monitoring high-dimensional multistage processes becomes crucial to ensure the quality of the final product in modern industry environments. Few statistical process monitoring(SPC) approaches for monitoring and contro...Monitoring high-dimensional multistage processes becomes crucial to ensure the quality of the final product in modern industry environments. Few statistical process monitoring(SPC) approaches for monitoring and controlling quality in highdimensional multistage processes are studied. We propose a deviance residual-based multivariate exponentially weighted moving average(MEWMA) control chart with a variable selection procedure. We demonstrate that it outperforms the existing multivariate SPC charts in terms of out-of-control average run length(ARL) for the detection of process mean shift.展开更多
The BOF-key is the performance-based research funding system that is used in Flanders, Belgium. In this paper we describe the historical background of the system, its current design and organization, as well as its ef...The BOF-key is the performance-based research funding system that is used in Flanders, Belgium. In this paper we describe the historical background of the system, its current design and organization, as well as its effects on the Flemish higher education landscape. The BOFkey in its current form relies on three bibliometric parameters: publications in Web of Science, citations in Web of Science, and publications in a comprehensive regional database for SSH publications. Taken together, the BOF-key forms a unique variant of the Norwegian model: while the system to a large extent relies on a commercial database, it avoids the problem of inadequate coverage of the SSH. Because the bibliometric parameters of the BOF-key are reused in other funding allocation schemes, their overall importance to the Flemish universities is substantial.展开更多
When evaluating the seismic safety and reliability of complex engineering structures,it is a critical problem to reasonably consider the randomness and multi-dimensional nature of ground motions.To this end,a proposed...When evaluating the seismic safety and reliability of complex engineering structures,it is a critical problem to reasonably consider the randomness and multi-dimensional nature of ground motions.To this end,a proposed modeling strategy of multi-dimensional stochastic earthquakes is addressed in this study.This improved seismic model has several merits that enable it to better provide seismic analyses of structures.Specifically,at first,the ground motion model is compatible with the design response spectrum.Secondly,the evolutionary power spectrum involved in the model and the design response spectrum are constructed accordingly with sufficient consideration of the correlation between different seismic components.Thirdly,the random function-based dimension-reduction representation is applied,by which seismic modeling is established,with three elementary random variables.Numerical simulations of multi-dimensional stochastic ground motions in a specific design scenario indicate the effectiveness of the proposed modeling strategy.Moreover,the multi-dimensional seismic response and the global reliability of a high-rise frame-core tube structure is discussed in detail to further illustrate the engineering applicability of the proposed method.The analytical investigations demonstrate that the suggested stochastic model of multi-dimensional ground motion is available for accurate seismic response analysis and dynamic reliability assessment of complex engineering structures for performance-based seismic resistance design.展开更多
Performance-based design in earthquake engineering is a structural optimization problem that has, as the objective, the determination of design parameters for the minimization of total costs, while at the same time sa...Performance-based design in earthquake engineering is a structural optimization problem that has, as the objective, the determination of design parameters for the minimization of total costs, while at the same time satisfying minimum reliability levels for the specifi ed performance criteria. Total costs include those for construction and structural damage repairs, those associated with non-structural components and the social costs of economic losses, injuries and fatalities. This paper presents a general framework to approach this problem, using a numerical optimization strategy and incorporating the use of neural networks for the evaluation of dynamic responses and the reliability levels achieved for a given set of design parameters. The strategy is applied to an example of a three-story offi ce building. The results show the importance of considering the social costs, and the optimum failure probabilities when minimum reliability constraints are not taken into account.展开更多
Background Transradial coronary procedure （TRP） traumatizes the radial artery （RA）, especially resulting in changes to arterial wall morphology. This study explored the significance of the early onset of traumatic...Background Transradial coronary procedure （TRP） traumatizes the radial artery （RA）, especially resulting in changes to arterial wall morphology. This study explored the significance of the early onset of traumatic effects to wall layers of the RA following the first TRP （FTRP） and repeat TRP （RTRP） using very-high-frequency ultrabiomicroscopy （VHFUBM）. Methods A total of 1431 patients that re- ceived TRP were divided into the FTRP group that comprised 781 patients and the RTRP group that comprised 650 patients depending on the number of procedures. Two-dimensional RA images were acquired by 30-55 MHz ultrasound one day before and one day after the pro- cedure. Results After TRP, the incidence of intimal tears, medial dissections and external elastic lamina fracture were greater in the RTRP （P 〈 0.001）. The RTRP group showed significantly thicker intimal thickness （IT）, media thickness （MT）, adventitia thickness and all complex layer thicknesses as compared with the FTRP group （P 〈 0.001）. Conclusions Multivariate linear regression analysis discovered that repeated TRP and other observations were independent predictors of increased IT in post-operative RA. VHFUBM provides an approach to study structural and histopathological injury in the wall layers of RA which showed increased trauma to the RA following RTRP.展开更多
基金Construction of Standardized Protective Nursing Plan for Hydrofluoric Acid Operation in Stomatology and Re search on Injury Prevention Effect(Project No.:FZ2025101)。
文摘Objective:To evaluate the implementation effectiveness of standardized protective care procedures during hydrofluoric acid procedures in the dental department.Methods:This study was conducted from June 2023 to June 2025,selecting 90 patients who underwent hydrofluoric acid-related treatments in the outpatient dental department of this hospital during this period as subjects.Forty-five patients treated between June 2023 and June 2024 received conventional protective care(pre-intervention group),while 45 patients treated between June 2024 and June 2025 underwent the standardized protective care protocol(post-intervention group).Thirteen healthcare personnel participated in both pre-and post-intervention treatment phases.Based on the different nursing models,indicators such as the incidence of adverse events in patients and the exposure rate of healthcare personnel before and after implementation were compared to evaluate the effectiveness of the nursing intervention.Results:The incidence of oral mucosal irritation reactions in patients was lower after implementation,p<0.05.Compared with the pre-implementation period,the incidence of procedure-related adverse events decreased after implementation,p<0.05.There was a significant difference in the occupational exposure rate of healthcare personnel before and after implementation,with a higher rate observed before implementation(p<0.05).Post-implementation,healthcare personnel achieved higher compliance scores for pre-procedure preparation,intra-procedure protection,and post-procedure handling(p<0.05).Patient satisfaction with treatment was lower pre-implementation than post-implementation(p<0.05).Conclusion:Adherence to standardized protective care procedures during hydrofluoric acid operations by dental department staff in outpatient settings standardizes practitioner techniques,effectively prevents oral mucosal irritation in patients,reduces occupational exposure risks for staff,minimizes adverse procedural events,and consequently enhances patient treatment satisfaction.This demonstrates significant practical value.
文摘Background:We aimed to study physician attitudes toward ultrasound-guided procedures and possible improvements.We hypothesized that the usage of ultrasound in procedures may be limited by a high barrier of entry and that most physicians would choose to adopt software that provides real-time image guidance if accessible.Methods:A voluntary,cross-sectional survey of physicians at a single site was conducted using a five-point Likert scale.Data analysis included both descriptive and inferential statistical analyses and stratified by categorical descriptors,including variables of formal training,years of experience,and specialty of practice.Results:One hundred sixteen physicians responded to the survey.The majority disagreed that there was a steep learning curve(57.5%)and that they need more time to identify structures under ultrasound(85.0%).Overall attitudes were mixed about the use of additional software to improve ease of use,but most(55.4%)had positive opinions toward the addition of real-time 3D reconstruction.Respondents without formal training were significantly more likely to agree that additional software would improve ease of ultrasound-guided procedures(p=0.0389).Radiologists were significantly more likely to perceive a steeper learning curve and less likely to advocate for supplemental software compared to emergency medicine physicians,surgeons,or anesthesiologists.Conclusions:Surveyed physicians demonstrated comfort with ultrasound-guided procedures and a mixed stance toward the use of additional software to assist with procedures.Those without formal training had significantly more positive attitudes toward the use of additional technology to augment ultrasound-guided procedures,suggesting a knowledge gap that may benefit from such technology.
基金supported by the National Natural Science Foundation of China(71871219).
文摘Performance-based warranties(PBWs)are widely used in industry and manufacturing.Given that PBW can impose financial burdens on manufacturers,rational maintenance decisions are essential for expanding profit margins.This paper proposes an optimization model for PBW decisions for systems affected by Gamma degradation processes,incorporating periodic inspection.A system performance degradation model is established.Preventive maintenance probability and corrective renewal probability models are developed to calculate expected warranty costs and system availability.A benefits function,which includes incentives,is constructed to optimize the initial and subsequent inspection intervals and preventive maintenance thresholds,thereby maximizing warranty profit.An improved sparrow search algorithm is developed to optimize the model,with a case study on large steam turbine rotor shafts.The results suggest the optimal PBW strategy involves an initial inspection interval of approximately 20 months,with subsequent intervals of about four months,and a preventive maintenance threshold of approximately 37.39 mm wear.When compared to common cost-minimization-based condition maintenance strategies and PBW strategies that do not differentiate between initial and subsequent inspection intervals,the proposed PBW strategy increases the manufacturer’s profit by 1%and 18%,respectively.Sensitivity analyses provide managerial recommendations for PBW implementation.The PBW strategy proposed in this study significantly increases manufacturers’profits by optimizing inspection intervals and preventive maintenance thresholds,and manufacturers should focus on technological improvement in preventive maintenance and cost control to further enhance earnings.
基金upported by National Natural Science Foundation of China(52307118).
文摘To enhance the frequency stability and lower the regulation mileage payment of a multiarea integrated energy system(IES)that supports the power Internet of Things(IoT),this paper proposes a data-driven cooperative method for automatic generation control(AGC).The method consists of adaptive fractional-order proportional-integral(FOPI)controllers and a novel efficient integration exploration multiagent twin delayed deep deterministic policy gradient(EIE-MATD3)algorithm.The FOPI controllers are designed for each area based on the performancebased frequency regulation market mechanism.The EIE-MATD3 algorithm is used to tune the coefficients of the FOPI controllers in real time using centralized training and decentralized execution.The algorithm incorporates imitation learning and efficient integration exploration to obtain a more robust coordinated control strategy.An experiment on the four-area China Southern Grid(CSG)real-time digital system shows that the proposed method can improve the control performance and reduce the regulation mileage payment of each area in the IES.
基金Supported by the Beijing Tsinghua Changgung Hospital Fund,China,No.12023C01005.
文摘BACKGROUND Postoperative pulmonary complications(PPCs)are the most common complications following major upper abdominal surgeries,particularly hepatobiliary procedures,and significantly compromise surgical outcomes and patients’quality of life.Although the adoption of laparoscopy has lowered their incidence,PPCs remain a frequent and serious concern after hepatobiliary surgery.Existing research on risk factors specific to hepatobiliary surgeries is limited,particularly regarding the epidemiology and risk factors of PPCs in liver and gallbladder surgeries in China.Therefore,this study aimed to investigate the risk factors for PPCs in a large hepatobiliary center.AIM To identify the incidence and risk factors for PPCs following hepatobiliary surgery based on perioperative variables.METHODS Retrospective data were collected from patients who underwent liver,gallbladder,or pancreatic surgery at a hepatobiliary center in China between May 2023 and December 2023.We retrospectively reviewed comprehensive medical records to extract demographic and hospital admission information for determining PPC incidence.Statistically significant variables were initially screened through univariate analysis,followed by binary logistic regression modeling to identify independent predictors of PPCs.Hospitalization expenditures and duration of stay were further contrasted across the study cohorts.RESULTS This study included 1941 patients who underwent liver,gallbladder,or pancreatic surgery,of whom 78 developed PPCs,resulting in an incidence rate of 4.02%.Logistic regression analysis revealed two independent predictors of PPCs in hepatobiliary surgery patients:Age≥75 year(odds ratio=8.350,95%CI:3.521-19.798,P<0.001)and prolonged anesthesia(odds ratio=1.052,95%CI:1.015-1.091,P=0.006).Patients with PPCs had significantly elevated healthcare resource utilization,including higher total hospitalization costs,increased medication expenses,longer hospital stays,and extended postoperative admissions(all P<0.001).CONCLUSION Age≥75 years and prolonged anesthesia emerged as independent predictors of PPCs following hepatobiliary surgery.These complications were correlated with protracted hospitalization and increased healthcare costs.
基金National Natural Science Foundation of China Under Grant No.50908216Postdoctoral Science Foundation of China Under Grant No.20070420878
文摘This paper presents a performance-based methodology for the assessment of seismic vulnerability and capacity of buildings.The vulnerability assessment methodology is based on the HAZUS methodology and the improved capacity-demand-diagram method.The spectral displacement(Sd)of performance points on a capacity curve is used to estimate the damage level of a building.The relationship between Sd and peak ground acceleration(PGA)is established,and then a new vulnerability function is expressed in terms of PGA.Furthermore,the expected value of the seismic capacity index(SCev)is provided to estimate the seismic capacity of buildings based on the probability distribution of damage levels and the corresponding seismic capacity index.The results indicate that the proposed vulnerability methodology is able to assess seismic damage of a large number of building stock directly and quickly following an earthquake.The SCev provides an effective index to measure the seismic capacity of buildings and illustrate the relationship between the seismic capacity of buildings and seismic action.The estimated result is compared with damage surveys of the cities of Dujiangyan and Jiangyou in the M8.0 Wenchuan earthquake,revealing that the methodology is acceptable for seismic risk assessment and decision making.The primary reasons for discrepancies between the estimated results and the damage surveys are discussed.
文摘With the development and implementation of performance-based earthquake engineering,harmonization of performance levels between structural and nonstructural components becomes vital. Even if the structural components of a building achieve a continuous or immediate occupancy performance level after a seismic event,failure of architectural,mechanical or electrical components can lower the performance level of the entire building system. This reduction in performance caused by the vulnerability of nonstructural components has been observed during recent earthquakes worldwide. Moreover,nonstructural damage has limited the functionality of critical facilities,such as hospitals,following major seismic events. The investment in nonstructural components and building contents is far greater than that of structural components and framing. Therefore,it is not surprising that in many past earthquakes,losses from damage to nonstructural components have exceeded losses from structural damage. Furthermore,the failure of nonstructural components can become a safety hazard or can hamper the safe movement of occupants evacuating buildings,or of rescue workers entering buildings. In comparison to structural components and systems,there is relatively limited information on the seismic design of nonstructural components. Basic research work in this area has been sparse,and the available codes and guidelines are usually,for the most part,based on past experiences,engineering judgment and intuition,rather than on objective experimental and analytical results. Often,design engineers are forced to start almost from square one after each earthquake event: to observe what went wrong and to try to prevent repetitions. This is a consequence of the empirical nature of current seismic regulations and guidelines for nonstructural components. This review paper summarizes current knowledge on the seismic design and analysis of nonstructural building components,identifying major knowledge gaps that will need to be filled by future research. Furthermore,considering recent trends in earthquake engineering,the paper explores how performance-based seismic design might be conceived for nonstructural components,drawing on recent developments made in the field of seismic design and hinting at the specific considerations required for nonstructural components.
文摘Objective: To evaluate the procedures and timing of operation as well as long-term postoperative effect of congenital choledochal cysts (CCC) in adults. Methods: The procedures and timing of operation, effective rate, re-operation rate and incidence of car- cinoma after operation for 70 adult patients with CCC from January 1980 to June 1999 were analyzed retrospectively. Results: The re-operation rate of external drainage was 86% (6/7). The effective rate of internal drain- age was significantly lower than that of cyst resection (3/10 vs 45/49, X^2=20. 94, P<0.001). The re-op- eration rate and incidence of carcinoma of internal drainage were higher than those of cyst resection (5/ 10 vs 3/49, X^2=13. 64, P<0. 001 and 3/10 vs 3/49, X^2=5. 18, P<0. 025). The reoperation rate of e- mergency surgery was higher than that of selective operation (8/10 vs 6/56, X^2=24. 37, P<0.001). Conclusions: External drainage should be the first- aid measure and the therapy of choice on emergency basis. Internal drainage should never be attempted. Cyst resection with Roux-en-Y hepaticojejunostomy is recommended as the treatment of choice in selective operation.
文摘In order to promote efficient communication between nurses in Beijing hospitals and foreign patients, EOP (English for Occupational Purposes) courses specifically for nurses are demanded. This paper introduces the main procedures for setting up an EOP course for nurses in Beijing.
基金Project supported by the Outstanding Youth Fund of National Natural Science Foundation of China, the National Key Basic Research Support Foundation (NKBRSF) of China (No. 2002CB410805) and the Federal Ministry of Education and Research, Germany.
文摘Two procedures were compared for extraction and clean-up of 20organophosphorus and 19 pyrethroid pesticides in sediment to identify the more effective procedurefor groups of pesticides or individual compounds. In Procedure I, methanol/water and n-hexane wereused for extraction, and 1:10 (v/v) dichloromethane in n-hexane and acetone were used as eluents foreluting the analyte through the cartridge, with one evaporating steps on a rotary evaporator andtwo eluting steps on the cartridge. n-hexane/acetone (2:1, v/v) was used for extraction and elutionin Procedure II with one evaporating step on a rotary evaporator and one eluting step on thecartridge. All extractions were performed under an ultrasonic bath and gas chromatography and massspectrometry were utilized for measurements. Procedure II was developed as a rapid, timesaving, lesscostly and safer substitute for Procedure I which was an old method. Procedure II was moreeffective for almost all the organophosphorus pesticides tested and 11of the 19 pyrethroidpesticides, while Procedure I was more appropriate for analysis of 5 pyrethroid pesticides. However,recoveries of most pyrethroid pesticides were fairly low. Thus, further studies should focus onadjustment and formulation of solvents for more efficient extraction and clean-up of pyrethroidpesticides from sediment samples.
文摘Endoscopic retrograde cholangiopancreatography(ERCP) is one of the most frequently used image-guided procedures in gastrointestinal endoscopy. Post-ERCP pancreatitis is an important concern, and prophylaxis, cannulation and other related technical procedures have been well documented by endoscopists. In addition, medical radiation exposure is of great concern in the general population because of its rapidly increasing frequency and its potential carcinogenic effects. International organizations and radiological societies have established diagnostic reference levels, which guide proper radiation use and serve as global standards for all procedures that use ionizing radiation. However, data on gastrointestinal fluoroscopic procedures are still lacking because the demand for these procedures has recently increased. In this review, we present the current status of quality indicators for ERCP and the methods for measuring radiation exposure in the clinical setting as the next quality indicator for ERCP. To reduce radiation exposure, knowledge of its adverse effects and the procedures for proper measurement and protection are essential. Additionally, further studies on the factors that affect radiation exposure, exposure management and diagnostic reference levels are necessary. Then, we can discuss how to manage medical radiation use inthese complex fluoroscopic procedures. This knowledge will help us to protect not only patients but also endoscopists and medical staff in the fluoroscopy unit.
文摘Some research results are given in this paper about burnthrough and hydrogen cracking with a flowing chamber and a loop. Many factors including plate thickness, running rate, heat input and so forth have been studied. By experiments it can be found that occurrence of hydrogen cracking can be effectively reduced by properly increasing heat input and using the tempering bead technique.
基金The National Key Research and Development Program of China(No.2018YFB1601202)the Natural Science Foundation of Shaanxi Province(No.2019JM-228)+1 种基金the National Natural Science Foundation of China(No.51308335)the Fundamental Research Funds for the Central Universities of Chang’an University(No.300102218401)
文摘This paper presents the theory,method,and application of performance-based pavement needs assessment at a state level,using the Pennsylvania Interstate System as an example.First,a general framework is presented for the pavement asset management and a general optimization model is established for the pavement maintenance and rehabilitation needs assessment.Also,the bundling of pavement segments for the project implementation is discussed.Using the examples of Statewide Transportation Improvement Plan and Long Range Transportation Plan for Pennsylvania Interstate System,the application of performance-based pavement needs assessment is demonstrated.It is shown that unconstrained analysis can help decision-makers investigate the real maintenance and rehabilitation needs;financially-constrained analysis can help decision-makers select projects for implementation and examine the corresponding future pavement conditions.Trade-off analysis can help decision-makers investigate the outcomes of different investment levels on pavement maintenance and rehabilitation and make the final decision on the investment level.The proposed case study provides a good example of performance-based pavement needs assessment for developing countries.
文摘AIM： To determine factors affecting the outcome of patients with cirrhosis undergoing surgery and to compare the capacities of the Child-Turcotte-Pugh （CTP） and model for end-stage liver disease （MELD） score to predict that outcome. METHODS： We reviewed the charts of 195 patients with cirrhosis who underwent surgery at two teaching hospitals over a five-year period. The combined endpoint of death or hepatic decompensation was considered to be the primary endpoint. RESULTS： Patients who reached the endpoint had a higher MELD score, a higher CTP score and were more likely to have undergone an urgent procedure. Among patients undergoing elective surgical procedures, no statistically significant difference was noted in the mean MELD （12.8 ＋ 3.9 vs 12.6 ＋ 4.7, P = 0.9） or in the mean CTP （7.6 ± 1.2 vs 7.7 ± 1.7, P = 0.8） between patients who reached the endpoint and those who did not. Both mean scores were higher in the patients reaching the endpoint in the case of urgent procedures （MELD： 22.4 ± 8.7 vs 15.2 ± 6.4, P = 0.0007; CTP： 9.9 ± 1.8 vs 8.5 ± 1.8, P = 0.008）. The performances of the MELD and CTP scores in predicting the outcome of urgent surgery were only fair, without a significant difference between them （AUC = 0.755 ± 0.066 for MELD vs AUC = 0.696 ± 0.070 for CTP, P = 0.3）. CONCLUSION： The CTP and MELD scores performed equally, but only fairly in predicting the outcome of urgent surgical procedures. Larger studies are needed to better define the factors capable of predicting the outcome of elective surgical procedures in patients with cirrhosis.equally, but only fairly in predicting the outcome of urgent surgical procedures. Larger studies are needed to better define the factors capable of predicting the outcome of elective surgical procedures in patients with cirrhosis.
文摘Objective To investigate the changes of perioperative serum levels of interleukin-6(IL-6), C-reactive protein (CRP), and cortisol, as well as gastric intramucosal pH (pHi) and plasma lactate, aiming to compare systemic changes and tissue perfusion during colorectal and orthopaedic surgical procedures. Methods Twenty patients were randomly assigned to two groups, 10 cases of operation on vertebral canal, 10 cases of colorectal radical operation.Venous blood was drawn at 1 day before operation, 2, 4, and 6 hours following skin incision, and 1 day after operation, in order to measure serum IL-6, CRP, and cortisol.pHi and plasma lactate were also measured at the same time points.Results Serum concentrations of IL-6 and cortisol increased gradually following operation, reaching the peak value at 6 hours from the beginning of operation.CRP was not detectable until the first day after operation.Peak concentration of IL-6 had positive relationship with CRP.These variables changed more significantly in colorectal group than that in orthopaedic group (P<0.05).pHi decreased gradually, reaching the lowest level at 4 hours from the beginning of operation, and to more extent in colorectal group than that in orthopaedic group (P<0.05).Conclusion IL-6 may reflect tissue damage more sensitively than CRP.Colorectal surgery might induce systemic disorder to more extent, in terms of immuno-endocrinal aspect as well as tissue perfusion, reflected with pHi.
基金supported by the Qatar National Research Fund(NPRP5-364-2-142NPRP7-1040-2-293)
文摘Monitoring high-dimensional multistage processes becomes crucial to ensure the quality of the final product in modern industry environments. Few statistical process monitoring(SPC) approaches for monitoring and controlling quality in highdimensional multistage processes are studied. We propose a deviance residual-based multivariate exponentially weighted moving average(MEWMA) control chart with a variable selection procedure. We demonstrate that it outperforms the existing multivariate SPC charts in terms of out-of-control average run length(ARL) for the detection of process mean shift.
文摘The BOF-key is the performance-based research funding system that is used in Flanders, Belgium. In this paper we describe the historical background of the system, its current design and organization, as well as its effects on the Flemish higher education landscape. The BOFkey in its current form relies on three bibliometric parameters: publications in Web of Science, citations in Web of Science, and publications in a comprehensive regional database for SSH publications. Taken together, the BOF-key forms a unique variant of the Norwegian model: while the system to a large extent relies on a commercial database, it avoids the problem of inadequate coverage of the SSH. Because the bibliometric parameters of the BOF-key are reused in other funding allocation schemes, their overall importance to the Flemish universities is substantial.
基金National Natural Science Foundation of China under Grant Nos.51978543,52108444,and 51778343Plan of Outstanding Young and Middle-aged Scientific and Technological Innovation Team in the Universities of Hubei Province with Project No.T2020010Natural Science Foundation of Hebei Province under Grant No.E2021512001。
文摘When evaluating the seismic safety and reliability of complex engineering structures,it is a critical problem to reasonably consider the randomness and multi-dimensional nature of ground motions.To this end,a proposed modeling strategy of multi-dimensional stochastic earthquakes is addressed in this study.This improved seismic model has several merits that enable it to better provide seismic analyses of structures.Specifically,at first,the ground motion model is compatible with the design response spectrum.Secondly,the evolutionary power spectrum involved in the model and the design response spectrum are constructed accordingly with sufficient consideration of the correlation between different seismic components.Thirdly,the random function-based dimension-reduction representation is applied,by which seismic modeling is established,with three elementary random variables.Numerical simulations of multi-dimensional stochastic ground motions in a specific design scenario indicate the effectiveness of the proposed modeling strategy.Moreover,the multi-dimensional seismic response and the global reliability of a high-rise frame-core tube structure is discussed in detail to further illustrate the engineering applicability of the proposed method.The analytical investigations demonstrate that the suggested stochastic model of multi-dimensional ground motion is available for accurate seismic response analysis and dynamic reliability assessment of complex engineering structures for performance-based seismic resistance design.
文摘Performance-based design in earthquake engineering is a structural optimization problem that has, as the objective, the determination of design parameters for the minimization of total costs, while at the same time satisfying minimum reliability levels for the specifi ed performance criteria. Total costs include those for construction and structural damage repairs, those associated with non-structural components and the social costs of economic losses, injuries and fatalities. This paper presents a general framework to approach this problem, using a numerical optimization strategy and incorporating the use of neural networks for the evaluation of dynamic responses and the reliability levels achieved for a given set of design parameters. The strategy is applied to an example of a three-story offi ce building. The results show the importance of considering the social costs, and the optimum failure probabilities when minimum reliability constraints are not taken into account.
文摘Background Transradial coronary procedure （TRP） traumatizes the radial artery （RA）, especially resulting in changes to arterial wall morphology. This study explored the significance of the early onset of traumatic effects to wall layers of the RA following the first TRP （FTRP） and repeat TRP （RTRP） using very-high-frequency ultrabiomicroscopy （VHFUBM）. Methods A total of 1431 patients that re- ceived TRP were divided into the FTRP group that comprised 781 patients and the RTRP group that comprised 650 patients depending on the number of procedures. Two-dimensional RA images were acquired by 30-55 MHz ultrasound one day before and one day after the pro- cedure. Results After TRP, the incidence of intimal tears, medial dissections and external elastic lamina fracture were greater in the RTRP （P 〈 0.001）. The RTRP group showed significantly thicker intimal thickness （IT）, media thickness （MT）, adventitia thickness and all complex layer thicknesses as compared with the FTRP group （P 〈 0.001）. Conclusions Multivariate linear regression analysis discovered that repeated TRP and other observations were independent predictors of increased IT in post-operative RA. VHFUBM provides an approach to study structural and histopathological injury in the wall layers of RA which showed increased trauma to the RA following RTRP.
