重症监护室智慧化管理措施减少临床虚假警报效果的整合性综述

目的医疗设备的频繁虚假警报可能导致护土警报疲劳,这可能导致反应行动延迟或错过警报,增加患者不良事件的风险。本综述旨在探讨重症监护室临床警报智慧化管理措施对减少临床虚假警报的应用效果。方法根据Whitmore 和Knaf的方法学框架,对6个数据库进行系统检索: PubMed, EMBASE,CINAHL,OVID,CochraneLibrary,Scopus,检索从每个数据库建库到2022年12月以英文或中文发表的临床警报的智慧化管理相关文章。采用乔安娜布里格斯研究所的评价工具(JBI-MAStARI)评估研究的质量,并对文献进行数据提取和分析。该研究已在PROSPERO完成注册(CRD42023411552)。结果共纳入7项研究。不同的警报智慧化管理措施有利于减少虚假警报数量和警报的持续时间,缩短护士对重要警报的应答时间,减轻护士的警报疲劳程度。在实践中,应用新的警报管理方式后取得了积极的效果。结论智慧化管理措施可能是警报减少的有效途径,医院迫切需要进行临床警报的智慧化管理。为确保更有效的患者监测、减少警报给护士带来的困扰,未来需要更多与人工智能相结合的警报管理手段,以实现关键警报的准确识别,确保护士对警报准确响应,并真正改善警报频繁的临床医疗环境。

Simulation of roof snow loads based on a multi-layer snowmelt model:Impact of building heat transfer

To investigate the impact of building heat transfer on roof snow loads,roof snow loads and snow load thermal coefficients from 61 Chinese sites over a period of 50 years are simulated based on basic meteorological data such as temperature,humidity,wind speed,and precipitation,and a multi-layer snowmelt model considering the building heat transfer.Firstly,the accuracy of the multi-layer snowmelt model is validated using the data of observed ground snow load and roof snow melting tests.The relationship between meteorological conditions,snow cover characteristics,and thermal coefficients of snow loads in three representative sites is then studied.Furthermore,the characteristics of thermal coefficients in each zone are analyzed by combining them with the statistical results of meteorological data from 1960 to 2010,and the equations of thermal coefficients in different zones on indoor temperatures and roof heat transfer coefficients are fitted separately.Finally,the equations in this paper are compared with the thermal coefficients in the main snow load codes.The results indicate that the snowmelt model using basic meteorological data can effectively provide samples of roof snow loads.In the cold zone where the snow cover lasts for a long time and does not melt easily,the thermal coefficients of the snow loads on the heating buildings are lower than those in the warm zone due to the long-term influence of the heat from inside the buildings.Thermal coefficients are negatively correlated with indoor temperatures and roof heat transfer coefficients.When the indoor temperature is too low or the roof insulation is good,the roof snow load may exceed the ground snow load.The thermal coefficients for heated buildings in the main snow load codes are more conservative than those calculated in this paper,and the thermal coefficients for buildings with lower indoor temperatures tend to be smaller.

基于CiteSpace的我国高校网球研究知识图谱分析

本研究通过分析2000至2024年中国知网数据库中250篇网球主题论文,使用CiteSpace软件进行可视化分析,探讨了中国网球研究的现状和发展趋势。研究发现,高产作者多来自体育院校,关注网球教学与训练。研究机构以体育院校为主导,但需加强合作以促进创新。研究热点包括竞技网球、教学和产业,显示向多学科交叉发展的趋势。研究为网球事业的发展和国际竞争力提升提供了指导。

Numerical simulation of rime ice accretion on a threedimensional wind turbine blade using a Lagrangian approach

The accreted ice on wind turbine blades significantly deteriorates the blade aerodynamic performance and consequently the power production.The existing numerical simulations of blade icing have mostly been performed with the Eulerian approach for two-dimensional(2D)blade profiles,neglecting the possible three-dimensional(3D)rotating effect.This paper conducts a numerical simulation of rime ice accretion on a 3D wind turbine blade using the Lagrangian approach.The simulation results are validated through previously published experimental data.The icing characteristics along the blade radial direction are then investigated in detail.Significant radial airflow along the blade is observed,which demonstrates the necessity of 3D simulation.In addition,more droplets are found to impinge on the blade surface near the tip region,thereby producing severer ice accretion there.The accreted ice increases almost linearly along the blade radial direction in terms of both ice mass and maximum ice thickness.