In the present study, we aimed to analyze the irrational medical orders and evaluate the effect of pharmacy intervention on pharmacy intravenous admixture services of outpatient and emergency departments in our hospit...In the present study, we aimed to analyze the irrational medical orders and evaluate the effect of pharmacy intervention on pharmacy intravenous admixture services of outpatient and emergency departments in our hospital. The irrational medical orders of PIVAS at the outpatient and emergency departments were retrospectively analyzed in Jun. 2015. We strengthened the pharmacy intervention on irrational medical orders since July 2015. All the cases were selected by systematic sampling method. Cased studied in Jun. 2015 served as the control group, whereas those studied in Jan. 2016 served as the intervention group. The irrational rate and the irrational number of daily average were compared between the control group and intervention group. The common type of irrational outpatient and emergency intravenous orders mainly included irrational use of solvents, irrational dosing interval and inappropriate compatibility of drugs. The irrational rate was reduced from 17.4% to 3.3% （P〈0.01）, and the irrational number of daily average was decreased from 5.23 to 1.00 （P〈0.01）. Pharmacy intervention can reduce the irrational rate of medical orders in our hospital, which is of great significance to promote rational drug use and improve medical quality.展开更多
Aiming at dealing with the difficulty for traditional emergency rescue vehicle(ECV)to enter into limited rescue scenes,the electro-hydraulic steer-by-wire(SBW)system is introduced to achieve the multi-mode steering of...Aiming at dealing with the difficulty for traditional emergency rescue vehicle(ECV)to enter into limited rescue scenes,the electro-hydraulic steer-by-wire(SBW)system is introduced to achieve the multi-mode steering of the ECV.The overall structure and mathematical model of the SBW system are described at length.The fractional order proportional-integral-derivative(FOPID)controller based on fractional calculus theory is designed to control the steering cylinder’s movement in SBW system.The anti-windup problem is considered in the FOPID controller design to reduce the bad influence of saturation.Five parameters of the FOPID controller are optimized using the genetic algorithm by maximizing the fitness function which involves integral of time by absolute value error(ITAE),peak overshoot,as well as settling time.The time-domain simulations are implemented to identify the performance of the raised FOPID controller.The simulation results indicate the presented FOPID controller possesses more effective control properties than classical proportional-integral-derivative(PID)controller on the part of transient response,tracking capability and robustness.展开更多
BACKGROUND:Consenting to do-not-resuscitate(DNR)orders is an important and complex medical decision-making process in the treatment of patients at the end-of-life in emergency departments(EDs).The DNR decision in EDs ...BACKGROUND:Consenting to do-not-resuscitate(DNR)orders is an important and complex medical decision-making process in the treatment of patients at the end-of-life in emergency departments(EDs).The DNR decision in EDs has not been extensively studied,especially in the Chinese mainland.METHODS:This retrospective chart study of all deceased patients in the ED of a university hospital was conducted from January 2017 to December 2019.The patients with out-of-hospital cardiac arrest were excluded.RESULTS:There were 214 patients’deaths in the ED in the three years.Among them,132 patients were included in this study,whereas 82 with out-of-hospital cardiac arrest were excluded.There were 99(75.0%)patients’deaths after a DNR order medical decision,64(64.6%)patients signed the orders within 24 hours of the ED admission,68(68.7%)patients died within 24 hours after signing it,and 97(98.0%)patients had DNR signed by the family surrogates.Multivariate analysis showed that four independent factors infl uenced the family surrogates’decisions to sign the DNR orders:lack of referral(odds ratio[OR]0.157,95%confi dence interval[CI]0.047–0.529,P=0.003),ED length of stay(ED LOS)≥72 hours(OR 5.889,95%CI 1.290–26.885,P=0.022),acute myocardial infarction(AMI)(OR 0.017,95%CI 0.001–0.279,P=0.004),and tracheal intubation(OR 0.028,95%CI 0.007–0.120,P<0.001).CONCLUSIONS:In the Chinese mainland,the proportion of patients consenting for DNR order is lower than that of developed countries.The decision to sign DNR orders is mainly affected by referral,ED LOS,AMI,and trachea intubation.展开更多
BACKGROUND:Paramedic and emergency personnel may encounter directly many events that threat their own wellbeing during their daily work.This study was conducted to examine the prevalence rate of post-traumatic stress ...BACKGROUND:Paramedic and emergency personnel may encounter directly many events that threat their own wellbeing during their daily work.This study was conducted to examine the prevalence rate of post-traumatic stress disorder(PTSD) among two groups of paramedic and emergency personnel in south-east Iran.METHODS:The study employed a descriptive design and was conducted in four hospital emergency wards and a pre-hospital emergency base supervised by Kerman Medical University.Using Mississippi PTSD,we assessed the prevalence rate in paramedics(n=150) and emergency personnel(n=250).RESULTS:The two groups had different levels of education,marital status,experience of traumatic events,work hours per month,and gender.Most(94%) of paramedic and hospital emergency personnel reported moderate PTSD.The two groups had significant different levels of PTSD in all subscale.CONCLUSION:The study suggests that health care managers should organize systematic and dynamic policies and procedures in dealing with PTSD to assist both groups of personnel.展开更多
BACKGROUND: The purpose of the study was to explore the association between posttraumatic stress disorder(PTSD) and work performance of emergency medical services personnel in Karachi, Pakistan.METHODS: Emergency medi...BACKGROUND: The purpose of the study was to explore the association between posttraumatic stress disorder(PTSD) and work performance of emergency medical services personnel in Karachi, Pakistan.METHODS: Emergency medical service personnel were screened for potential PTSD using Impact of Event Scale-Revised(IES-R). Work performance was assessed on the basis of fi ve variables: number of late arrivals to work, number of days absent, number of days sick, adherence to protocol, and patient satisfaction over a period of 3 months. In order to model outcomes like the number of late arrivals to work, days absent and days late, negative binomial regression was applied, whereas logistic regression was applied for adherence to protocol and linear for patient satisfaction scores.RESULTS: Mean scores of PTSD were 24.0±12.2. No association was found between PTSD and work performance measures: number of late arrivals to work(RRadj 0.99; 0.98–1.00), days absent(RRadj 0.98; 0.96–0.99), days sick(RRadj 0.99; 0.98–1.00), adherence to protocol(ORadj 1.01; 0.99–1.04) and patient satisfaction(β 0.001%–0.03%) after adjusting for years of formal schooling, living status, coping mechanism, social support, working hours, years of experience and anxiety or depression.CONCLUSION: No statistically significant association was found between PTSD and work performance amongst EMS personnel in Karachi, Pakistan.展开更多
BACKGROUND:Postpartum posttraumatic stress disorder(PTSD)can occur in women who give birth after emergency admission.The identification of risk factors for this condition is crucial for developing effective preventive...BACKGROUND:Postpartum posttraumatic stress disorder(PTSD)can occur in women who give birth after emergency admission.The identification of risk factors for this condition is crucial for developing effective preventive measures.This retrospective study aimed to explore the incidence and risk factors for postpartum PTSD in women who give birth after emergency admission.METHODS:Medical records of women who gave birth after emergency admission were collected between March 2021 and April 2023.The patients’general conditions and perinatal clinical indicators were recorded.The puerperae were divided into PTSD group and control group based on symptom occurrence at six weeks postpartum.Multivariate logistic regression analysis was performed to identify risk factors.RESULTS:A total of 276 puerperae were included,with a PTSD incidence of 20.3% at six weeks postpartum.Multivariate logistic regression analysis identified emergency cesarean section(odds ratio[OR]=2.102;95%confidence interval[CI]:1.114-3.966,P=0.022),admission to the emergency department after midnight(12:00 AM)(OR=2.245;95%CI:1.170-4.305,P<0.001),and cervical dilation(OR=3.203;95%CI:1.670–6.141,P=0.039)as independent risk factors for postpartum PTSD.Analgesia pump use(OR=0.500;95%CI:0.259–0.966,P=0.015)was found to be a protective factor against postpartum PTSD.CONCLUSION:Emergency cesarean section,admission to the emergency department after midnight,and cervical dilation were identified as independent risk factors for postpartum PTSD,while analgesic pump use was a protective factor.These findings provide insights for developing more effective preventive measures for women who give birth after emergency admission.展开更多
We analyze a continuous review lost sales inventory system with two types of orders—regular and emergency. The regular order has a stochastic lead time and is placed with the cheapest acceptable supplier. The emergen...We analyze a continuous review lost sales inventory system with two types of orders—regular and emergency. The regular order has a stochastic lead time and is placed with the cheapest acceptable supplier. The emergency order has a deterministic lead time is placed with a local supplier who has a higher price. The emergency order is not always filled since the supplier may not have the ability to provide the order on an emergency basis at all times. This emergency order has a higher cost per item and has a known probability of being filled. The total costs for this system are compared to a system without emergency placement of orders. This paper provides managers with a tool to assess when dual sourcing is cost optimal by comparing the single sourcing and dual sourcing models.展开更多
The purpose of our Quality Improvement (QI) project was to evaluate the effectiveness of radiology-led didactics on efficiency and ordering practices in the emergency department. Residents of the emergency medicine (E...The purpose of our Quality Improvement (QI) project was to evaluate the effectiveness of radiology-led didactics on efficiency and ordering practices in the emergency department. Residents of the emergency medicine (EM) program at Downstate Medical Center/Kings County Hospital (postgraduate years 1 - 4) participated in a didactic lecture series during the first two months of the 2013 academic year. Two fifteen-minute lectures with a question and answer session were designed to focus on radiation risk, American College of Radiology (ACR) appropriateness criteria and the department of radiology’s policies. A short survey questionnaire that included questions on ACR appropriateness criteria, radiology experiences and opinions/attitudes regarding radiology was distributed and analyzed before and after the didactic series. The average score for the knowledge-based technical questions on ACR appropriateness criteria was 60.5% initially and 76.4% post-lecture with an overall improvement of 25%, which was statistically significant (p < 0.0001). Following a short didactic lecture series, EM residents showed significant improvement of their knowledge of appropriate image utilization on the post-lecture survey. This highlights the need for dedicated radiology-led lecture series for EM residents. This type of program could be implemented yearly and expanded to other departments to promote interdepartmental commuication, increases radiology awareness, improves ordering practices and encourages appropriate imaging utilization.展开更多
BACKGROUND In the past years,only a few studies with a limited number of adult patients analyzed clinical features of allied disorders of Hirschsprung’s disease(ADHD),most of which were individual case reports or lac...BACKGROUND In the past years,only a few studies with a limited number of adult patients analyzed clinical features of allied disorders of Hirschsprung’s disease(ADHD),most of which were individual case reports or lacked detailed clinical information.Although many studies have reported patients presenting to the emergency department(ED)with recurrent abdominal symptoms for a number of disorders,there are few data involving ADHD.However,owing to a lack of awareness of the disease,misdiagnoses and mistreatments are common.Severe complications such as perforation,bleeding,malabsorption,and even death in ADHD had been reported by many studies.AIM To assist ED clinicians in having a more comprehensive understanding of this disease and making an early suspected diagnosis of ADHD more effectively.METHODS We enrolled 53 patients who visited the ED and were eventually diagnosed with ADHD over the past 11 years in our hospital.Their basic information,clinical manifestations,and imaging findings were analyzed.Blood indices were compared between the ADHD and irritable bowel syndrome(IBS)groups.RESULTS Adult patients with ADHD had a mean age of 48.8±14.3 years,and 77.4%had been treated before admission.The transverse colon was the most common dilated part(73.6%),and constipation(67.9%)was the most common symptom.ADHD patients can present with uncommon symptoms and false-negative imaging findings.Logistic regression analysis indicated that body mass index(BMI)[odds ratio(OR)=0.786,P=0.013],cholinesterase(per 1000 units;OR=0.693,P=0.008),and blood chlorine(OR=0.816,P=0.022)were determined to be independent related factors between the ADHD and IBS groups.The area under the receiver operating characteristics curve of these three indices combined was 0.812(P<0.001).CONCLUSION Emergency physicians should be vigilant regarding patients with chronic constipation,abdominal pain,or abdominal distension,and consider the possibility of ADHD despite its rarity.Abdominal computed tomography examination is recommended as a useful tool in the suspected diagnosis of ADHD.BMI,cholinesterase,and blood chlorine have good discriminative abilities between ADHD and IBS.The nutritional status of adult patients with ADHD is worthy of further attention.Surgical treatment for adult patients with ADHD is important and inevitable.展开更多
This study investigated the application and the application value of intelligent emergency in emergency management in the big data environment.It addresses the neglect of the application value(performance)measurement ...This study investigated the application and the application value of intelligent emergency in emergency management in the big data environment.It addresses the neglect of the application value(performance)measurement of intelligent emergency,further improving the effectiveness of intelligent emergency management.First,approximately 3,900 documents from the intelligent emergency field are analyzed to determine the future research trend in intelligent emergency management.The socio-technical theory concerning technical and social systems is introduced.The emergency management system concepts of“technology enabling”and“enabling value creation”are defined according to bibliometric analysis and socio-technical theory.Second,a research framework that includes technology enabling and enabling value creation for the decision-making paradigm in emergency management according to the big data environment is constructed.A detailed analysis approach from intelligent emergency technology enabling to enabling value creation in emergency management is proposed.Finally,earthquake disasters are taken as examples,and specific analyses of the intelligent emergency enabling and enabling value creation are explored;enabling value creation is discussed based on measurable indicators.The clear concept of emergency management system technology enabling and enabling value creation,as well as the detailed analysis approach from intelligent emergency technology enabling to enabling value creation,provide a theoretical bases for scholars and practitioners to evaluate the value(performance)of intelligent emergency for the first time.展开更多
During the rapid spread of COVID-19,first responders are at risk of being exposed to COVID-19 due to their role in providing first aid and responding to an unspecified number of people.This uncertainty can have advers...During the rapid spread of COVID-19,first responders are at risk of being exposed to COVID-19 due to their role in providing first aid and responding to an unspecified number of people.This uncertainty can have adverse mental health effects,such as increased anxiety and fear.This study aimed to investigate the degree of association between fear of COVID-19,obsession with COVID-19,and post-traumatic stress disorder(PTSD)in emergency rescue firefighters.The participants were 150 emergency rescue firefighters working in Region S,Korea.They filled out self-report questionnaires:The data obtained through the Fear of COVID-19 Scale,Obsession with COVID-19 Scale,and Impact of Event Scale-Revised Korean version were subjected to nonparametric statistical analysis using SPSS WIN 25.0.The study found a significant correlation between emergency rescue firefighters’fear of COVID-19,obsession with COVID-19,and PTSD.Fear and obsession with COVID-19 were higher among first responder firefighters who were directly involved in COVID-19-related tasks.Furthermore,a one-point increase in obsession was associated with a 2.837-point increase in PTSD.Based on the results,we found that there is a need for effective control of obsessions and fears among first responder firefighters during COVID-19,and we suggest that there is a need for mental health care for first responder firefighters during the pandemic through the development and support of programs to prevent and mitigate obsessions.展开更多
BACKGROUND Managing critical care emergencies in children with autism spectrum disorder(ASD)presents unique challenges due to their distinct sensory sensitivities,communication difficulties,and behavioral issues.Effec...BACKGROUND Managing critical care emergencies in children with autism spectrum disorder(ASD)presents unique challenges due to their distinct sensory sensitivities,communication difficulties,and behavioral issues.Effective strategies and protocols are essential for optimal care in these high-stress situations.AIM To systematically evaluate and synthesize current evidence on best practices for managing critical care emergencies in children with ASD.The review focuses on key areas,including sensory-friendly environments,communication strategies,behavioral management,and the role of multidisciplinary approaches.METHODS A comprehensive search was conducted across major medical databases,including PubMed,Embase,and Cochrane Library,for studies published between 2000 and 2023.Studies were selected based on their relevance to critical care management in children with ASD,encompassing randomized controlled trials,observational studies,qualitative research,and case studies.Data were extracted and analyzed to identify common themes,successful strategies,and areas for improvement.RESULTS The review identified 50 studies that met the inclusion criteria.Findings highlighted the importance of creating sensory-friendly environments,utilizing effective communication strategies,and implementing individualized behavioral management plans.These findings,derived from a comprehensive review of current evidence,provide valuable insights into the best practices for managing critical care emergencies in children with ASD.Sensory modifications,such as reduced lighting and noise,visual aids,and augmentative and alternative communication tools,enhanced patient comfort and cooperation.The involvement of multidisciplinary teams was crucial in delivering holistic care.Case studies provided practical insights and underscored the need for continuous refi-nement of protocols.CONCLUSION The review emphasizes the need for a tailored approach to managing critical care emergencies for children with ASD.Sensory-friendly adjustments,effective communication,and behavioral strategies supported by a mul-tidisciplinary team are integral to improving outcomes.Despite progress,ongoing refinement of care practices and protocols is necessary.This ongoing process addresses remaining challenges and engages healthcare professionals in continuous improvement of care for children with ASD in critical settings.展开更多
The synchrotron radiation beamline BL17B of the National Facility for Protein Science(NFPS)in Shanghai,situated at the Shanghai Synchrotron Radiation Facility(SSRF),was originally designed for diffraction experiments ...The synchrotron radiation beamline BL17B of the National Facility for Protein Science(NFPS)in Shanghai,situated at the Shanghai Synchrotron Radiation Facility(SSRF),was originally designed for diffraction experiments and accommodates techniques including single-crystal diffraction,powder diffraction,and grazing-incidence wide-angle X-ray scattering(GIWAXS)to enable the characterization of long-range ordered atomic structures.The academic community associated with BL17B engages in research domains encompassing biology,environment,energy,and materials,and a pronounced demand for characterizing short-range ordered structures exists.To address these requirements,BL17B established an advanced X-ray absorption fine structure(XAFS)experimental platform that enabled it to address a wide range of systems,from crystalline to amorphous and from long-range order to short-range order.The XAFS platform allows simultaneous XAFS data acquisition for both the transmission and fluorescence modes within an energy range of 5-23 keV,encompassing the K-edges of titanium to ruthenium and the L3-edges of cesium to bismuth.The platform exemplifies high levels of automation achieved through automated sample assessment and data collection based on large-capacity sample wheels that facilitate remote sample loading.When integrated with a highly integrated control system that simplifies experimental preparation and data collection,the XAFS platform significantly bolsters experimental efficiency and enhances user experience.Notably,the platform boasts an impressively low extended X-ray absorption fine structure(EXAFS)detection limit of 0.04 wt%for dilute copper phthalocyanine(CuPc)samples and an even more remarkable X-ray absorption near edge structure(XANES)detection threshold of 0.01 wt%.These results demonstrate the methodology?s reliability in low-concentration sample analysis,confirming its capability to generate high-quality XAFS data.展开更多
BACKGROUND:Tracheal intubation(TI)is a fundamental procedure for securing the airway or assisting ventilation in emergency medicine.Tracheal intubation in the lateral position(TILP)has been utilized in clinical practi...BACKGROUND:Tracheal intubation(TI)is a fundamental procedure for securing the airway or assisting ventilation in emergency medicine.Tracheal intubation in the lateral position(TILP)has been utilized in clinical practice,demonstrating potential advantages in specific scenarios,including emergency settings.However,there is a lack of comprehensive reviews and practical protocols on TILP application.To address this gap,we performed a narrative review,and provided evidence-based recommendations to formulate a practice protocol,to assist clinicians to effectively apply TILP.METHODS:We conducted a narrative review of TILP applications and developed recommendations based on clinical research evidence and clinical experience.Delphi method was used among the TILP consortium to grade the strength of the recommendations and to help reach consensus.The practice protocols were formulated as warranted by advancements in medical knowledge,technology,and practice.RESULTS:This narrative review summarized the current evidence on TILP application,highlighting its safety,efficacy,challenges,and potential complications.In total,24 recommendations and a clinical protocol for TILP application in emergency patients were established.CONCLUSION:TILP is a valuable technique in emergency medicine.We reviewed its application in emergency settings and formulated recommendations along with a clinical practice protocol.Future studies are needed to evaluate the safety and efficacy of TILP,broaden its scope of application,and explore effective training protocols.展开更多
The stable nanobubbles adhered to mineral surfaces may facilitate their efficient separation via flotation in the mining industry.However,the state of nanobubbles on mineral solid surfaces is still elusive.In this stu...The stable nanobubbles adhered to mineral surfaces may facilitate their efficient separation via flotation in the mining industry.However,the state of nanobubbles on mineral solid surfaces is still elusive.In this study,molecular dynamics(MD)simulations are employed to examine mineral-like model surfaces with varying degrees of hydrophobicity,modulated by surface charges,to elucidate the adsorption behavior of nanobubbles at the interface.Our findings not only contribute to the fundamental understanding of nanobubbles but also have potential applications in the mining industry.We observed that as the surface charge increases,the contact angle of the nanobubbles increases accordingly with shape transformation from a pancake-like gas film to a cap-like shape,and ultimately forming a stable nanobubble upon an ordered water monolayer.When the solid–water interactions are weak with a small partial charge,the hydrophobic gas(N_(2))molecules accumulate near the solid surfaces.However,we have found,for the first time,that gas molecules assemble a nanobubble on the water monolayer adjacent to the solid surfaces with large partial charges.Such phenomena are attributed to the formation of a hydrophobic water monolayer with a hydrogen bond network structure near the surface.展开更多
Shotcrete is one of the common solutions for shallow sliding.It works by forming a protective layer with high strength and cementing the loose soil particles on the slope surface to prevent shallow sliding.However,the...Shotcrete is one of the common solutions for shallow sliding.It works by forming a protective layer with high strength and cementing the loose soil particles on the slope surface to prevent shallow sliding.However,the solidification time of conventional cement paste is long when shotcrete is used to treat cohesionless soil landslide.The idea of reinforcing slope with polyurethane solidified soil(i.e.,mixture of polyurethane and sand)was proposed.Model tests and finite element analysis were carried out to study the effectiveness of the proposed new method on the emergency treatment of cohesionless soil landslide.Surcharge loading on the crest of the slope was applied step by step until landslide was triggered so as to test and compare the stability and bearing capacity of slope models with different conditions.The simulated slope displacements were relatively close to the measured results,and the simulated slope deformation characteristics were in good agreement with the observed phenomena,which verifies the accuracy of the numerical method.Under the condition of surcharge loading on the crest of the slope,the unreinforced slope slid when the surcharge loading exceeded 30 k Pa,which presented a failure mode of local instability and collapse at the shallow layer of slope top.The reinforced slope remained stable even when the surcharge loading reached 48 k Pa.The displacement of the reinforced slope was reduced by more than 95%.Overall,this study verifies the effectiveness of polyurethane in the emergency treatment of cohesionless soil landslide and should have broad application prospects in the field of geological disasters concerning the safety of people's live.展开更多
Typhoons can cause large-area blackouts or partial outages of distribution networks.We define a partial outage state in the distribution network as a gray state and propose a gray-start strategy and two-stage distribu...Typhoons can cause large-area blackouts or partial outages of distribution networks.We define a partial outage state in the distribution network as a gray state and propose a gray-start strategy and two-stage distribution network emergency recovery framework.A phase-space reconstruction and stacked integrated model for predicting wind and photovoltaic generation during typhoon disasters is proposed in the first stage.This provides guidance for second-stage post-disaster emergency recovery scheduling.The emergency recovery scheduling model is established in the second stage,and this model is supported by a thermal power-generating unit,mobile emergency generators,and distributed generators.Distributed generation includes wind power generation,photovoltaics,fuel cells,etc.Simultaneously,we con-sider the gray-start based on the pumped storage unit to be an important first step in the emergency recovery strategy.This model is val-idated on the improved IEEE 33 node system,which utilizes data from the 2022 super typhoon“Muifa”in Zhoushan,Zhejiang,China.Simulations indicate the superiority of a gray start with a pumped storage unit and the proposed emergency recovery strategy.展开更多
Emergency department nurses face severe occupational stress leading to anxiety,depression,and burnout,which significantly impair their well-being and patientcare quality.This narrative review examined the role of mind...Emergency department nurses face severe occupational stress leading to anxiety,depression,and burnout,which significantly impair their well-being and patientcare quality.This narrative review examined the role of mindfulness-based stress reduction(MBSR)in addressing these challenges.Rooted in nonjudgmental present-moment awareness,MBSR enhances emotional regulation and reduces psychological distress by fostering adaptive coping strategies.Studies have demonstrated its efficacy in lowering anxiety,depressive symptoms,and emotional exhaustion,while improving workplace well-being,empathy,and job satisfaction.Mechanistically,MBSR improves interoceptive awareness and autonomic balance,as evidenced by physiological markers such as heart rate variability.However,gaps remain in long-term efficacy assessments,personalized interventions,and integration with multidisciplinary approaches.Future research should prioritize tailored biomarker-driven programs,longitudinal studies,and scalable implementation strategies in high-stress clinical settings.This review underscores MBSR’s potential as a sustainable,evidence-based tool to enhance emergency department nurses’mental health and professional performance,advocating for broader adoption and further refinement of its practical applications.展开更多
In this manuscript,we propose an analytical equivalent linear viscoelastic constitutive model for fiber-reinforced composites,bypassing general computational homogenization.The method is based on the reduced-order hom...In this manuscript,we propose an analytical equivalent linear viscoelastic constitutive model for fiber-reinforced composites,bypassing general computational homogenization.The method is based on the reduced-order homogenization(ROH)approach.The ROH method typically involves solving multiple finite element problems under periodic conditions to evaluate elastic strain and eigenstrain influence functions in an‘off-line’stage,which offers substantial cost savings compared to direct computational homogenization methods.Due to the unique structure of the fibrous unit cell,“off-line”stage calculation can be eliminated by influence functions obtained analytically.Introducing the standard solid model to the ROH method enables the creation of a comprehensive analytical homogeneous viscoelastic constitutive model.This method treats fibrous composite materials as homogeneous,anisotropic viscoelastic materials,significantly reducing computational time due to its analytical nature.This approach also enables precise determination of a homogenized anisotropic relaxation modulus and accurate capture of various viscoelastic responses under different loading conditions.Three sets of numerical examples,including unit cell tests,three-point beam bending tests,and torsion tests,are given to demonstrate the predictive performance of the homogenized viscoelastic model.Furthermore,the model is validated against experimental measurements,confirming its accuracy and reliability.展开更多
In this paper,we delve into a generalized higher order Camassa-Holm type equation,(or,an ghmCH equation for short).We establish local well-posedness for this equation under the condition that the initial data uo belon...In this paper,we delve into a generalized higher order Camassa-Holm type equation,(or,an ghmCH equation for short).We establish local well-posedness for this equation under the condition that the initial data uo belongs to the Sobolev space H'(R)for some s>2.In addition,we obtain the weak formulation of this equation and prove the existence of both single peakon solution and a multi-peakon dynamic system.展开更多
文摘In the present study, we aimed to analyze the irrational medical orders and evaluate the effect of pharmacy intervention on pharmacy intravenous admixture services of outpatient and emergency departments in our hospital. The irrational medical orders of PIVAS at the outpatient and emergency departments were retrospectively analyzed in Jun. 2015. We strengthened the pharmacy intervention on irrational medical orders since July 2015. All the cases were selected by systematic sampling method. Cased studied in Jun. 2015 served as the control group, whereas those studied in Jan. 2016 served as the intervention group. The irrational rate and the irrational number of daily average were compared between the control group and intervention group. The common type of irrational outpatient and emergency intravenous orders mainly included irrational use of solvents, irrational dosing interval and inappropriate compatibility of drugs. The irrational rate was reduced from 17.4% to 3.3% （P〈0.01）, and the irrational number of daily average was decreased from 5.23 to 1.00 （P〈0.01）. Pharmacy intervention can reduce the irrational rate of medical orders in our hospital, which is of great significance to promote rational drug use and improve medical quality.
基金Project(2016YFC0802904)supported by the National Key Research and Development Program of China
文摘Aiming at dealing with the difficulty for traditional emergency rescue vehicle(ECV)to enter into limited rescue scenes,the electro-hydraulic steer-by-wire(SBW)system is introduced to achieve the multi-mode steering of the ECV.The overall structure and mathematical model of the SBW system are described at length.The fractional order proportional-integral-derivative(FOPID)controller based on fractional calculus theory is designed to control the steering cylinder’s movement in SBW system.The anti-windup problem is considered in the FOPID controller design to reduce the bad influence of saturation.Five parameters of the FOPID controller are optimized using the genetic algorithm by maximizing the fitness function which involves integral of time by absolute value error(ITAE),peak overshoot,as well as settling time.The time-domain simulations are implemented to identify the performance of the raised FOPID controller.The simulation results indicate the presented FOPID controller possesses more effective control properties than classical proportional-integral-derivative(PID)controller on the part of transient response,tracking capability and robustness.
基金The study protocol was reviewed and approved by the Institutional Review Board of the Second Affiliated Hospital of Zhejiang University School of Medicine(IRB number:IR2020001036).
文摘BACKGROUND:Consenting to do-not-resuscitate(DNR)orders is an important and complex medical decision-making process in the treatment of patients at the end-of-life in emergency departments(EDs).The DNR decision in EDs has not been extensively studied,especially in the Chinese mainland.METHODS:This retrospective chart study of all deceased patients in the ED of a university hospital was conducted from January 2017 to December 2019.The patients with out-of-hospital cardiac arrest were excluded.RESULTS:There were 214 patients’deaths in the ED in the three years.Among them,132 patients were included in this study,whereas 82 with out-of-hospital cardiac arrest were excluded.There were 99(75.0%)patients’deaths after a DNR order medical decision,64(64.6%)patients signed the orders within 24 hours of the ED admission,68(68.7%)patients died within 24 hours after signing it,and 97(98.0%)patients had DNR signed by the family surrogates.Multivariate analysis showed that four independent factors infl uenced the family surrogates’decisions to sign the DNR orders:lack of referral(odds ratio[OR]0.157,95%confi dence interval[CI]0.047–0.529,P=0.003),ED length of stay(ED LOS)≥72 hours(OR 5.889,95%CI 1.290–26.885,P=0.022),acute myocardial infarction(AMI)(OR 0.017,95%CI 0.001–0.279,P=0.004),and tracheal intubation(OR 0.028,95%CI 0.007–0.120,P<0.001).CONCLUSIONS:In the Chinese mainland,the proportion of patients consenting for DNR order is lower than that of developed countries.The decision to sign DNR orders is mainly affected by referral,ED LOS,AMI,and trachea intubation.
文摘BACKGROUND:Paramedic and emergency personnel may encounter directly many events that threat their own wellbeing during their daily work.This study was conducted to examine the prevalence rate of post-traumatic stress disorder(PTSD) among two groups of paramedic and emergency personnel in south-east Iran.METHODS:The study employed a descriptive design and was conducted in four hospital emergency wards and a pre-hospital emergency base supervised by Kerman Medical University.Using Mississippi PTSD,we assessed the prevalence rate in paramedics(n=150) and emergency personnel(n=250).RESULTS:The two groups had different levels of education,marital status,experience of traumatic events,work hours per month,and gender.Most(94%) of paramedic and hospital emergency personnel reported moderate PTSD.The two groups had significant different levels of PTSD in all subscale.CONCLUSION:The study suggests that health care managers should organize systematic and dynamic policies and procedures in dealing with PTSD to assist both groups of personnel.
基金partially supported through the Johns Hopkins-Pakistan International Collaborative Trauma and Injury Research Training program(grant number 2D43-TW007-292)from the Fogarty International Center of the United States,National Institutes of Healthpartially supported from department of Community Health Sciences,Aga Khan University,Karachi,Pakistan
文摘BACKGROUND: The purpose of the study was to explore the association between posttraumatic stress disorder(PTSD) and work performance of emergency medical services personnel in Karachi, Pakistan.METHODS: Emergency medical service personnel were screened for potential PTSD using Impact of Event Scale-Revised(IES-R). Work performance was assessed on the basis of fi ve variables: number of late arrivals to work, number of days absent, number of days sick, adherence to protocol, and patient satisfaction over a period of 3 months. In order to model outcomes like the number of late arrivals to work, days absent and days late, negative binomial regression was applied, whereas logistic regression was applied for adherence to protocol and linear for patient satisfaction scores.RESULTS: Mean scores of PTSD were 24.0±12.2. No association was found between PTSD and work performance measures: number of late arrivals to work(RRadj 0.99; 0.98–1.00), days absent(RRadj 0.98; 0.96–0.99), days sick(RRadj 0.99; 0.98–1.00), adherence to protocol(ORadj 1.01; 0.99–1.04) and patient satisfaction(β 0.001%–0.03%) after adjusting for years of formal schooling, living status, coping mechanism, social support, working hours, years of experience and anxiety or depression.CONCLUSION: No statistically significant association was found between PTSD and work performance amongst EMS personnel in Karachi, Pakistan.
基金Science and Technology Development Plan Project of Suzhou(SKJYD2021035)Science and Technology Development Plan Project of Suzhou(SKJYD2022078)The Key Project Research Fund of the Second Affiliated Hospital of Wannan Medical College(YK2023Z04)。
文摘BACKGROUND:Postpartum posttraumatic stress disorder(PTSD)can occur in women who give birth after emergency admission.The identification of risk factors for this condition is crucial for developing effective preventive measures.This retrospective study aimed to explore the incidence and risk factors for postpartum PTSD in women who give birth after emergency admission.METHODS:Medical records of women who gave birth after emergency admission were collected between March 2021 and April 2023.The patients’general conditions and perinatal clinical indicators were recorded.The puerperae were divided into PTSD group and control group based on symptom occurrence at six weeks postpartum.Multivariate logistic regression analysis was performed to identify risk factors.RESULTS:A total of 276 puerperae were included,with a PTSD incidence of 20.3% at six weeks postpartum.Multivariate logistic regression analysis identified emergency cesarean section(odds ratio[OR]=2.102;95%confidence interval[CI]:1.114-3.966,P=0.022),admission to the emergency department after midnight(12:00 AM)(OR=2.245;95%CI:1.170-4.305,P<0.001),and cervical dilation(OR=3.203;95%CI:1.670–6.141,P=0.039)as independent risk factors for postpartum PTSD.Analgesia pump use(OR=0.500;95%CI:0.259–0.966,P=0.015)was found to be a protective factor against postpartum PTSD.CONCLUSION:Emergency cesarean section,admission to the emergency department after midnight,and cervical dilation were identified as independent risk factors for postpartum PTSD,while analgesic pump use was a protective factor.These findings provide insights for developing more effective preventive measures for women who give birth after emergency admission.
文摘We analyze a continuous review lost sales inventory system with two types of orders—regular and emergency. The regular order has a stochastic lead time and is placed with the cheapest acceptable supplier. The emergency order has a deterministic lead time is placed with a local supplier who has a higher price. The emergency order is not always filled since the supplier may not have the ability to provide the order on an emergency basis at all times. This emergency order has a higher cost per item and has a known probability of being filled. The total costs for this system are compared to a system without emergency placement of orders. This paper provides managers with a tool to assess when dual sourcing is cost optimal by comparing the single sourcing and dual sourcing models.
文摘The purpose of our Quality Improvement (QI) project was to evaluate the effectiveness of radiology-led didactics on efficiency and ordering practices in the emergency department. Residents of the emergency medicine (EM) program at Downstate Medical Center/Kings County Hospital (postgraduate years 1 - 4) participated in a didactic lecture series during the first two months of the 2013 academic year. Two fifteen-minute lectures with a question and answer session were designed to focus on radiation risk, American College of Radiology (ACR) appropriateness criteria and the department of radiology’s policies. A short survey questionnaire that included questions on ACR appropriateness criteria, radiology experiences and opinions/attitudes regarding radiology was distributed and analyzed before and after the didactic series. The average score for the knowledge-based technical questions on ACR appropriateness criteria was 60.5% initially and 76.4% post-lecture with an overall improvement of 25%, which was statistically significant (p < 0.0001). Following a short didactic lecture series, EM residents showed significant improvement of their knowledge of appropriate image utilization on the post-lecture survey. This highlights the need for dedicated radiology-led lecture series for EM residents. This type of program could be implemented yearly and expanded to other departments to promote interdepartmental commuication, increases radiology awareness, improves ordering practices and encourages appropriate imaging utilization.
基金the Foundation of Key Discipline Construction of Zhejiang Province for Traditional Chinese Medicine,No. 2017-XK-A36
文摘BACKGROUND In the past years,only a few studies with a limited number of adult patients analyzed clinical features of allied disorders of Hirschsprung’s disease(ADHD),most of which were individual case reports or lacked detailed clinical information.Although many studies have reported patients presenting to the emergency department(ED)with recurrent abdominal symptoms for a number of disorders,there are few data involving ADHD.However,owing to a lack of awareness of the disease,misdiagnoses and mistreatments are common.Severe complications such as perforation,bleeding,malabsorption,and even death in ADHD had been reported by many studies.AIM To assist ED clinicians in having a more comprehensive understanding of this disease and making an early suspected diagnosis of ADHD more effectively.METHODS We enrolled 53 patients who visited the ED and were eventually diagnosed with ADHD over the past 11 years in our hospital.Their basic information,clinical manifestations,and imaging findings were analyzed.Blood indices were compared between the ADHD and irritable bowel syndrome(IBS)groups.RESULTS Adult patients with ADHD had a mean age of 48.8±14.3 years,and 77.4%had been treated before admission.The transverse colon was the most common dilated part(73.6%),and constipation(67.9%)was the most common symptom.ADHD patients can present with uncommon symptoms and false-negative imaging findings.Logistic regression analysis indicated that body mass index(BMI)[odds ratio(OR)=0.786,P=0.013],cholinesterase(per 1000 units;OR=0.693,P=0.008),and blood chlorine(OR=0.816,P=0.022)were determined to be independent related factors between the ADHD and IBS groups.The area under the receiver operating characteristics curve of these three indices combined was 0.812(P<0.001).CONCLUSION Emergency physicians should be vigilant regarding patients with chronic constipation,abdominal pain,or abdominal distension,and consider the possibility of ADHD despite its rarity.Abdominal computed tomography examination is recommended as a useful tool in the suspected diagnosis of ADHD.BMI,cholinesterase,and blood chlorine have good discriminative abilities between ADHD and IBS.The nutritional status of adult patients with ADHD is worthy of further attention.Surgical treatment for adult patients with ADHD is important and inevitable.
基金the National Natural Science Foundation of China(Grant No.:71771061).
文摘This study investigated the application and the application value of intelligent emergency in emergency management in the big data environment.It addresses the neglect of the application value(performance)measurement of intelligent emergency,further improving the effectiveness of intelligent emergency management.First,approximately 3,900 documents from the intelligent emergency field are analyzed to determine the future research trend in intelligent emergency management.The socio-technical theory concerning technical and social systems is introduced.The emergency management system concepts of“technology enabling”and“enabling value creation”are defined according to bibliometric analysis and socio-technical theory.Second,a research framework that includes technology enabling and enabling value creation for the decision-making paradigm in emergency management according to the big data environment is constructed.A detailed analysis approach from intelligent emergency technology enabling to enabling value creation in emergency management is proposed.Finally,earthquake disasters are taken as examples,and specific analyses of the intelligent emergency enabling and enabling value creation are explored;enabling value creation is discussed based on measurable indicators.The clear concept of emergency management system technology enabling and enabling value creation,as well as the detailed analysis approach from intelligent emergency technology enabling to enabling value creation,provide a theoretical bases for scholars and practitioners to evaluate the value(performance)of intelligent emergency for the first time.
基金the National Research Foundation of Korea(NRF)grant funded by the Korea government(MSIP)(No.NRF-2020R1A2B5B0100208).
文摘During the rapid spread of COVID-19,first responders are at risk of being exposed to COVID-19 due to their role in providing first aid and responding to an unspecified number of people.This uncertainty can have adverse mental health effects,such as increased anxiety and fear.This study aimed to investigate the degree of association between fear of COVID-19,obsession with COVID-19,and post-traumatic stress disorder(PTSD)in emergency rescue firefighters.The participants were 150 emergency rescue firefighters working in Region S,Korea.They filled out self-report questionnaires:The data obtained through the Fear of COVID-19 Scale,Obsession with COVID-19 Scale,and Impact of Event Scale-Revised Korean version were subjected to nonparametric statistical analysis using SPSS WIN 25.0.The study found a significant correlation between emergency rescue firefighters’fear of COVID-19,obsession with COVID-19,and PTSD.Fear and obsession with COVID-19 were higher among first responder firefighters who were directly involved in COVID-19-related tasks.Furthermore,a one-point increase in obsession was associated with a 2.837-point increase in PTSD.Based on the results,we found that there is a need for effective control of obsessions and fears among first responder firefighters during COVID-19,and we suggest that there is a need for mental health care for first responder firefighters during the pandemic through the development and support of programs to prevent and mitigate obsessions.
文摘BACKGROUND Managing critical care emergencies in children with autism spectrum disorder(ASD)presents unique challenges due to their distinct sensory sensitivities,communication difficulties,and behavioral issues.Effective strategies and protocols are essential for optimal care in these high-stress situations.AIM To systematically evaluate and synthesize current evidence on best practices for managing critical care emergencies in children with ASD.The review focuses on key areas,including sensory-friendly environments,communication strategies,behavioral management,and the role of multidisciplinary approaches.METHODS A comprehensive search was conducted across major medical databases,including PubMed,Embase,and Cochrane Library,for studies published between 2000 and 2023.Studies were selected based on their relevance to critical care management in children with ASD,encompassing randomized controlled trials,observational studies,qualitative research,and case studies.Data were extracted and analyzed to identify common themes,successful strategies,and areas for improvement.RESULTS The review identified 50 studies that met the inclusion criteria.Findings highlighted the importance of creating sensory-friendly environments,utilizing effective communication strategies,and implementing individualized behavioral management plans.These findings,derived from a comprehensive review of current evidence,provide valuable insights into the best practices for managing critical care emergencies in children with ASD.Sensory modifications,such as reduced lighting and noise,visual aids,and augmentative and alternative communication tools,enhanced patient comfort and cooperation.The involvement of multidisciplinary teams was crucial in delivering holistic care.Case studies provided practical insights and underscored the need for continuous refi-nement of protocols.CONCLUSION The review emphasizes the need for a tailored approach to managing critical care emergencies for children with ASD.Sensory-friendly adjustments,effective communication,and behavioral strategies supported by a mul-tidisciplinary team are integral to improving outcomes.Despite progress,ongoing refinement of care practices and protocols is necessary.This ongoing process addresses remaining challenges and engages healthcare professionals in continuous improvement of care for children with ASD in critical settings.
基金supported by the Chinese Academy of Science(CAS)Key Technology Talent Program(No.2021000022)。
文摘The synchrotron radiation beamline BL17B of the National Facility for Protein Science(NFPS)in Shanghai,situated at the Shanghai Synchrotron Radiation Facility(SSRF),was originally designed for diffraction experiments and accommodates techniques including single-crystal diffraction,powder diffraction,and grazing-incidence wide-angle X-ray scattering(GIWAXS)to enable the characterization of long-range ordered atomic structures.The academic community associated with BL17B engages in research domains encompassing biology,environment,energy,and materials,and a pronounced demand for characterizing short-range ordered structures exists.To address these requirements,BL17B established an advanced X-ray absorption fine structure(XAFS)experimental platform that enabled it to address a wide range of systems,from crystalline to amorphous and from long-range order to short-range order.The XAFS platform allows simultaneous XAFS data acquisition for both the transmission and fluorescence modes within an energy range of 5-23 keV,encompassing the K-edges of titanium to ruthenium and the L3-edges of cesium to bismuth.The platform exemplifies high levels of automation achieved through automated sample assessment and data collection based on large-capacity sample wheels that facilitate remote sample loading.When integrated with a highly integrated control system that simplifies experimental preparation and data collection,the XAFS platform significantly bolsters experimental efficiency and enhances user experience.Notably,the platform boasts an impressively low extended X-ray absorption fine structure(EXAFS)detection limit of 0.04 wt%for dilute copper phthalocyanine(CuPc)samples and an even more remarkable X-ray absorption near edge structure(XANES)detection threshold of 0.01 wt%.These results demonstrate the methodology?s reliability in low-concentration sample analysis,confirming its capability to generate high-quality XAFS data.
基金National Natural Science Foundation of China(U24A20714 to XMF and 82102238 to PC)。
文摘BACKGROUND:Tracheal intubation(TI)is a fundamental procedure for securing the airway or assisting ventilation in emergency medicine.Tracheal intubation in the lateral position(TILP)has been utilized in clinical practice,demonstrating potential advantages in specific scenarios,including emergency settings.However,there is a lack of comprehensive reviews and practical protocols on TILP application.To address this gap,we performed a narrative review,and provided evidence-based recommendations to formulate a practice protocol,to assist clinicians to effectively apply TILP.METHODS:We conducted a narrative review of TILP applications and developed recommendations based on clinical research evidence and clinical experience.Delphi method was used among the TILP consortium to grade the strength of the recommendations and to help reach consensus.The practice protocols were formulated as warranted by advancements in medical knowledge,technology,and practice.RESULTS:This narrative review summarized the current evidence on TILP application,highlighting its safety,efficacy,challenges,and potential complications.In total,24 recommendations and a clinical protocol for TILP application in emergency patients were established.CONCLUSION:TILP is a valuable technique in emergency medicine.We reviewed its application in emergency settings and formulated recommendations along with a clinical practice protocol.Future studies are needed to evaluate the safety and efficacy of TILP,broaden its scope of application,and explore effective training protocols.
基金supported by the National Natural Science Foundation of China(Grant Nos.12022508,12074394,and 22125604)Shanghai Supercomputer Center of ChinaShanghai Snowlake Technology Co.Ltd.
文摘The stable nanobubbles adhered to mineral surfaces may facilitate their efficient separation via flotation in the mining industry.However,the state of nanobubbles on mineral solid surfaces is still elusive.In this study,molecular dynamics(MD)simulations are employed to examine mineral-like model surfaces with varying degrees of hydrophobicity,modulated by surface charges,to elucidate the adsorption behavior of nanobubbles at the interface.Our findings not only contribute to the fundamental understanding of nanobubbles but also have potential applications in the mining industry.We observed that as the surface charge increases,the contact angle of the nanobubbles increases accordingly with shape transformation from a pancake-like gas film to a cap-like shape,and ultimately forming a stable nanobubble upon an ordered water monolayer.When the solid–water interactions are weak with a small partial charge,the hydrophobic gas(N_(2))molecules accumulate near the solid surfaces.However,we have found,for the first time,that gas molecules assemble a nanobubble on the water monolayer adjacent to the solid surfaces with large partial charges.Such phenomena are attributed to the formation of a hydrophobic water monolayer with a hydrogen bond network structure near the surface.
基金the financial support from the Fujian Science Foundation for Outstanding Youth(2023J06039)the National Natural Science Foundation of China(Grant No.41977259,U2005205,41972268)the Independent Research Project of Technology Innovation Center for Monitoring and Restoration Engineering of Ecological Fragile Zone in Southeast China(KY-090000-04-2022-019)。
文摘Shotcrete is one of the common solutions for shallow sliding.It works by forming a protective layer with high strength and cementing the loose soil particles on the slope surface to prevent shallow sliding.However,the solidification time of conventional cement paste is long when shotcrete is used to treat cohesionless soil landslide.The idea of reinforcing slope with polyurethane solidified soil(i.e.,mixture of polyurethane and sand)was proposed.Model tests and finite element analysis were carried out to study the effectiveness of the proposed new method on the emergency treatment of cohesionless soil landslide.Surcharge loading on the crest of the slope was applied step by step until landslide was triggered so as to test and compare the stability and bearing capacity of slope models with different conditions.The simulated slope displacements were relatively close to the measured results,and the simulated slope deformation characteristics were in good agreement with the observed phenomena,which verifies the accuracy of the numerical method.Under the condition of surcharge loading on the crest of the slope,the unreinforced slope slid when the surcharge loading exceeded 30 k Pa,which presented a failure mode of local instability and collapse at the shallow layer of slope top.The reinforced slope remained stable even when the surcharge loading reached 48 k Pa.The displacement of the reinforced slope was reduced by more than 95%.Overall,this study verifies the effectiveness of polyurethane in the emergency treatment of cohesionless soil landslide and should have broad application prospects in the field of geological disasters concerning the safety of people's live.
基金supported in part by the National Nat-ural Science Foundation of China(52177110)Key Pro-gram of the National Natural Science Foundation of China(U22B20106,U2142206)+2 种基金Shenzhen Science and Technology Program(JCYJ20210324131409026)the Science and Technology Project of the State Grid Corpo-ration of China(5200-202319382A-2-3-XG)State Grid Zhejiang Elctric Power Co.,Ltd.Science and Tech-nology Project(B311DS24001A).
文摘Typhoons can cause large-area blackouts or partial outages of distribution networks.We define a partial outage state in the distribution network as a gray state and propose a gray-start strategy and two-stage distribution network emergency recovery framework.A phase-space reconstruction and stacked integrated model for predicting wind and photovoltaic generation during typhoon disasters is proposed in the first stage.This provides guidance for second-stage post-disaster emergency recovery scheduling.The emergency recovery scheduling model is established in the second stage,and this model is supported by a thermal power-generating unit,mobile emergency generators,and distributed generators.Distributed generation includes wind power generation,photovoltaics,fuel cells,etc.Simultaneously,we con-sider the gray-start based on the pumped storage unit to be an important first step in the emergency recovery strategy.This model is val-idated on the improved IEEE 33 node system,which utilizes data from the 2022 super typhoon“Muifa”in Zhoushan,Zhejiang,China.Simulations indicate the superiority of a gray start with a pumped storage unit and the proposed emergency recovery strategy.
文摘Emergency department nurses face severe occupational stress leading to anxiety,depression,and burnout,which significantly impair their well-being and patientcare quality.This narrative review examined the role of mindfulness-based stress reduction(MBSR)in addressing these challenges.Rooted in nonjudgmental present-moment awareness,MBSR enhances emotional regulation and reduces psychological distress by fostering adaptive coping strategies.Studies have demonstrated its efficacy in lowering anxiety,depressive symptoms,and emotional exhaustion,while improving workplace well-being,empathy,and job satisfaction.Mechanistically,MBSR improves interoceptive awareness and autonomic balance,as evidenced by physiological markers such as heart rate variability.However,gaps remain in long-term efficacy assessments,personalized interventions,and integration with multidisciplinary approaches.Future research should prioritize tailored biomarker-driven programs,longitudinal studies,and scalable implementation strategies in high-stress clinical settings.This review underscores MBSR’s potential as a sustainable,evidence-based tool to enhance emergency department nurses’mental health and professional performance,advocating for broader adoption and further refinement of its practical applications.
基金support by the National Key R&D Program of China(Grant No.2023YFA1008901)the National Natural Science Foundation of China(Grant Nos.11988102,12172009)is gratefully acknowledged.
文摘In this manuscript,we propose an analytical equivalent linear viscoelastic constitutive model for fiber-reinforced composites,bypassing general computational homogenization.The method is based on the reduced-order homogenization(ROH)approach.The ROH method typically involves solving multiple finite element problems under periodic conditions to evaluate elastic strain and eigenstrain influence functions in an‘off-line’stage,which offers substantial cost savings compared to direct computational homogenization methods.Due to the unique structure of the fibrous unit cell,“off-line”stage calculation can be eliminated by influence functions obtained analytically.Introducing the standard solid model to the ROH method enables the creation of a comprehensive analytical homogeneous viscoelastic constitutive model.This method treats fibrous composite materials as homogeneous,anisotropic viscoelastic materials,significantly reducing computational time due to its analytical nature.This approach also enables precise determination of a homogenized anisotropic relaxation modulus and accurate capture of various viscoelastic responses under different loading conditions.Three sets of numerical examples,including unit cell tests,three-point beam bending tests,and torsion tests,are given to demonstrate the predictive performance of the homogenized viscoelastic model.Furthermore,the model is validated against experimental measurements,confirming its accuracy and reliability.
文摘In this paper,we delve into a generalized higher order Camassa-Holm type equation,(or,an ghmCH equation for short).We establish local well-posedness for this equation under the condition that the initial data uo belongs to the Sobolev space H'(R)for some s>2.In addition,we obtain the weak formulation of this equation and prove the existence of both single peakon solution and a multi-peakon dynamic system.
