Many magnetohydrodynamic stability analyses require generation of a set of equilibria with a fixed safety factor q-profile while varying other plasma parameters.A neural network(NN)-based approach is investigated that...Many magnetohydrodynamic stability analyses require generation of a set of equilibria with a fixed safety factor q-profile while varying other plasma parameters.A neural network(NN)-based approach is investigated that facilitates such a process.Both multilayer perceptron(MLP)-based NN and convolutional neural network(CNN)models are trained to map the q-profile to the plasma current density J-profile,and vice versa,while satisfying the Grad–Shafranov radial force balance constraint.When the initial target models are trained,using a database of semianalytically constructed numerical equilibria,an initial CNN with one convolutional layer is found to perform better than an initial MLP model.In particular,a trained initial CNN model can also predict the q-or J-profile for experimental tokamak equilibria.The performance of both initial target models is further improved by fine-tuning the training database,i.e.by adding realistic experimental equilibria with Gaussian noise.The fine-tuned target models,referred to as fine-tuned MLP and fine-tuned CNN,well reproduce the target q-or J-profile across multiple tokamak devices.As an important application,these NN-based equilibrium profile convertors can be utilized to provide a good initial guess for iterative equilibrium solvers,where the desired input quantity is the safety factor instead of the plasma current density.展开更多
Objective:To provide real-world evidence for the application of first-line dacomitinib treatment for epidermal growth factor receptor(EGFR)21L858R mutant non-small cell lung cancer(NSCLC)patients in China and to explo...Objective:To provide real-world evidence for the application of first-line dacomitinib treatment for epidermal growth factor receptor(EGFR)21L858R mutant non-small cell lung cancer(NSCLC)patients in China and to explore the factors influencing the efficacy and safety.Methods:A longitudinal,consecutive case-series,multicenter study with mixed prospective and retrospective data was conducted.The primary endpoint was progression-free survival(PFS),and the secondary endpoints included duration of treatment(DOT),overall survival(OS),objective response rate(ORR),disease control rate(DCR)and safety.Results:A total of 155 EGFR 21L858R mutant patients treated with first-line dacomitinib were included.The median follow-up time for these patients was 20.4 months.Among 134 patients with evaluable lesions,the ORR was 70.9%and the DCR was 96.3%.The median PFS was 16.3[95%confidence interval(95%CI),13.7−18.9]months.Multivariate Cox regression analysis suggested that the baseline brain metastasis(BM)status[with vs.without BM:hazard ratio(HR),1.331;95%CI,0.720−2.458;P=0.361]and initial doses(45 mg vs.30 mg:HR,0.837;95%CI,0.427−1.641;P=0.604)did not significantly affect the median PFS.The median DOT was 21.0(95%CI,17.5−24.6)months and the median OS was not reached.Genetic tests were performed in 64 patients after progression,among whom 29(45.3%)patients developed the EGFR 20T790M mutation.In addition,among the 46 patients who discontinued dacomitinib treatment after progression,31(67.4%)patients received subsequent third-generation EGFR-tyrosine kinase inhibitors.The most common grade 3−4 adverse events were rash(10.4%),diarrhea(9.1%),stomatitis(7.1%)and paronychia(4.5%).The incidence of grade 3−4 rash was significantly higher in the 45 mg group than that in the 30 mg group(21.9%vs.7.5%,P=0.042).Conclusions:First-line dacomitinib treatment demonstrated promising efficacy and tolerable adverse events among EGFR 21L858R mutant NSCLC patients in China.展开更多
The safety factor is a crucial quantitative index for evaluating slope stability.However,the traditional calculation methods suffer from unreasonable assumptions,complex soil composition,and inadequate consideration o...The safety factor is a crucial quantitative index for evaluating slope stability.However,the traditional calculation methods suffer from unreasonable assumptions,complex soil composition,and inadequate consideration of the influencing factors,leading to large errors in their calculations.Therefore,a stacking ensemble learning model(stacking-SSAOP)based on multi-layer regression algorithm fusion and optimized by the sparrow search algorithm is proposed for predicting the slope safety factor.In this method,the density,cohesion,friction angle,slope angle,slope height,and pore pressure ratio are selected as characteristic parameters from the 210 sets of established slope sample data.Random Forest,Extra Trees,AdaBoost,Bagging,and Support Vector regression are used as the base model(inner loop)to construct the first-level regression algorithm layer,and XGBoost is used as the meta-model(outer loop)to construct the second-level regression algorithm layer and complete the construction of the stacked learning model for improving the model prediction accuracy.The sparrow search algorithm is used to optimize the hyperparameters of the above six regression models and correct the over-and underfitting problems of the single regression model to further improve the prediction accuracy.The mean square error(MSE)of the predicted and true values and the fitting of the data are compared and analyzed.The MSE of the stacking-SSAOP model was found to be smaller than that of the single regression model(MSE=0.03917).Therefore,the former has a higher prediction accuracy and better data fitting.This study innovatively applies the sparrow search algorithm to predict the slope safety factor,showcasing its advantages over traditional methods.Additionally,our proposed stacking-SSAOP model integrates multiple regression algorithms to enhance prediction accuracy.This model not only refines the prediction accuracy of the slope safety factor but also offers a fresh approach to handling the intricate soil composition and other influencing factors,making it a precise and reliable method for slope stability evaluation.This research holds importance for the modernization and digitalization of slope safety assessments.展开更多
BACKGROUND Corneal neovascularization(CoNV)is the second major cause of blindness.Vascular endothelial growth factor(VEGF)inhibitors,e.g.,bevacizumab,have been used to prevent CoNV.AIM We conducted an updated systemat...BACKGROUND Corneal neovascularization(CoNV)is the second major cause of blindness.Vascular endothelial growth factor(VEGF)inhibitors,e.g.,bevacizumab,have been used to prevent CoNV.AIM We conducted an updated systematic review and meta-analysis of clinical trials to examine the efficacy and safety of anti-VEGF in CoNV.METHODS A literature search was conducted using three electronic databases.Mean difference(MD),standard mean difference(SMD),and relative risk(RR)are used to estimate the effect size.RESULTS Nine randomized controlled and three non-randomized trials were obtained.The pooled results demonstrated a significant reduction of CoNV area/Length(SMD=-1.17,95%CI:-1.58 to-0.75),best corrected visual acuity(MD=-0.54,95%CI:-0.91 to-0.17),and graft rejection(RR=0.44,95%CI:0.24 to 0.8)and failure(RR=0.39,95%CI:0.19 to 0.78)rates in the anti-VEGF group than the placebo group.A non-significant reduction of the epithelial defect was also observed in the bevacizumab group compared with the placebo(RR=0.56,95%CI:0.30 to 1.06).Compared with a placebo,the unsynthesizable trials also support that bevacizumab improves visual acuity,CoNV,graft rejection,and failure rates.Trials reporting other comparisons revealed the superiority of combined remedy with bevacizumab compared to other treatments in reducing CoNV.CONCLUSION Anti-VEGF agents,mainly bevacizumab,are an effective and safe treatment for CoNV of all causes and prevent corneal graft rejection and failure in corneal transplantation.展开更多
BACKGROUND Patients with human epidermal growth factor receptor 2(HER2)-positive advanced gastric cancer have poor outcomes.Trastuzumab combined with chemotherapy is the first-line standard treatment for HER2-positive...BACKGROUND Patients with human epidermal growth factor receptor 2(HER2)-positive advanced gastric cancer have poor outcomes.Trastuzumab combined with chemotherapy is the first-line standard treatment for HER2-positive advanced gastric cancer.Inetetamab is a novel anti-HER2 drug,and its efficacy and safety in gastric cancer have not yet been reported.AIM To evaluate the efficacy and safety of the S-1 plus oxaliplatin(SOX)regimen combined with inetetamab as a first-line treatment for HER2-positive advanced gastric cancer.METHODS Thirty-eight patients with HER2-positive advanced gastric cancer or gastroeso-phageal junction adenocarcinoma were randomly divided into two groups:One group received inetetamab combined with the SOX regimen,and the other group received trastuzumab combined with the SOX regimen.After 4-6 cycles,patients with stable disease received maintenance therapy.The primary endpoints were progression-free survival(PFS)and overall survival(OS),and the secondary endpoints were the objective response rate,disease control rate,and adverse events(AEs).RESULTS Thirty-seven patients completed the trial,with 18 patients in the inetetamab group and 19 patients in the trastuzumab group.In the inetetamab group,the median PFS was 8.5 months,whereas it was 7.3 months in the trastuzumab group(P=0.046);this difference was significant.The median OS in the inetetamab group vs the trastuzumab group was 15.4 months vs 14.3 months(P=0.33),and the objective response rate was 50%vs 42%(P=0.63),respectively;these differences were not significant.Common AEs included leukopenia,thrombocytopenia,nausea,and vomiting.The incidence rates of grade≥3 AEs were 56%in the inetetamab group and 47%in the trastuzumab group(P=0.63),with no significant difference.CONCLUSION In the first-line treatment of HER2-positive advanced gastric cancer,inetetamab and trastuzumab showed comparable efficacy.The inetetamab group showed superior PFS,and both groups had good safety.展开更多
When a patient falls within a hospital setting,there is a significant increase in the risk of severe injury or health complications.Recognizing factors associated with such falls is crucial to mitigate their impact on...When a patient falls within a hospital setting,there is a significant increase in the risk of severe injury or health complications.Recognizing factors associated with such falls is crucial to mitigate their impact on patient safety.This review seeks to analyze the factors contributing to patient falls in hospitals.The main goal is to enhance our understanding of the reasons behind these falls,enabling hospitals to devise more effective prevention strategies.This study reviewed literature published from 2013 to 2022,using the Arksey and O’Malley methodology for a scoping review.The research literature was searched from seven databases,namely,PubMed,ScienceDirect,Wiley Library,Garuda,Global Index Medicus,Emerald Insight,and Google Scholar.The inclusion criteria comprised both qualitative and quantitative primary and secondary data studies centered on hospitalized patients.Out of the 893 studies analyzed,23 met the criteria and were included in this review.Although there is not an abundance of relevant literature,this review identified several factors associated with falls in hospitals.These encompass environmental,patient,staff,and medical factors.This study offers valuable insights for hospitals and medical personnel aiming to enhance fall prevention practices.Effective prevention efforts should prioritize early identification of patient risk factors,enhancement of the care environment,thorough training for care staff,and vigilant supervision of high-risk patients.By comprehending the factors that contribute to patient falls,hospitals can bolster patient safety and mitigate the adverse effects of falls within the health-care setting.展开更多
Fire incidents in commercial vehicles pose significant risks to passengers, drivers, and cargo. Traditional fire extinguishing systems, while effective, may have limitations in terms of response time, coverage, and hu...Fire incidents in commercial vehicles pose significant risks to passengers, drivers, and cargo. Traditional fire extinguishing systems, while effective, may have limitations in terms of response time, coverage, and human intervention [1]. This study investigates the efficacy of a novel fire suppression technology—the Exploding Fire Extinguishing Ball (EFEB) —as an alternative and complementary fire safety solution for commercial vehicles. The research employs a multidisciplinary approach, encompassing engineering, materials science, fire safety, and human factors analysis. A systematic literature review establishes a comprehensive understanding of existing fire suppression technologies, including EFEBs. Subsequently, this study analyzes the unique features of EFEBs, such as automatic activation, as well as manual activation upon exposure to fire, and their potential to provide rapid, localized, and autonomous fire suppression. The study presents original experimental investigations to assess the performance and effectiveness of EFEBs in various fire scenarios representative of commercial vehicles. Experiments include controlled fires in confined spaces and dynamic simulations to emulate real-world fire incidents. Data on activation times, extinguishing capability, and coverage area are collected and analyzed to compare the efficacy of EFEBs with traditional fire extinguishing methods. Furthermore, this research shows the practical aspects of implementing EFEBs in commercial vehicles. A feasibility study examines the integration challenges, cost-benefit analysis, and potential regulatory implications. The study also addresses the impact of EFEBs on vehicle weight, stability, and overall safety. Human factors and user acceptance are crucial elements in adopting new safety technologies. Therefore, this research utilizes an experimental design to assess the performance and effectiveness of EFEBs in various fire scenarios representative of commercial vehicles. This dissertation presents original controlled experiments to emulate real-world fire incidents, including controlled fires in confined spaces and dynamic simulations. The experimental approach ensures rigorous evaluation and objective insights into EFEBs’ potential as an autonomous fire suppression system for commercial vehicles. This includes the perspectives of drivers, passengers, fleet operators, insurance agencies, and regulatory bodies. Factors influencing trust, perceived safety, and willingness to adopt EFEBs are analyzed to provide insights into the successful integration of this technology. The findings of this research will contribute to the knowledge of fire safety technology and expand the understanding of the applicability of EFEBs in commercial vehicles.展开更多
This study aims to thoroughly investigate the axial power peaking factors (PPF) within the low-enriched uranium (LEU) core of the Ghana Research Reactor-1 (GHARR-1). This study uses advanced simulation tools, like the...This study aims to thoroughly investigate the axial power peaking factors (PPF) within the low-enriched uranium (LEU) core of the Ghana Research Reactor-1 (GHARR-1). This study uses advanced simulation tools, like the MCNPX code for analysing neutron behavior and the PARET/ANL code for understanding power variations, to get a clearer picture of the reactor’s performance. The analysis covers the initial six years of GHARR-1’s operation and includes projections for its whole 60-year lifespan. We closely observed the patterns of both the highest and average PPFs at 21 axial nodes, with measurements taken every ten years. The findings of this study reveal important patterns in power distribution within the core, which are essential for improving the safety regulations and fuel management techniques of the reactor. We provide a meticulous approach, extensive data, and an analysis of the findings, highlighting the significance of continuous monitoring and analysis for proactive management of nuclear reactors. The findings of this study not only enhance our comprehension of nuclear reactor safety but also carry significant ramifications for sustainable energy progress in Ghana and the wider global context. Nuclear engineering is essential in tackling global concerns, such as the demand for clean and dependable energy sources. Research on optimising nuclear reactors, particularly in terms of safety and efficiency, is crucial for the ongoing advancement and acceptance of nuclear energy.展开更多
[Objective] This study was conducted to discuss influence factors for safety full heading of machine-transplanted rice seedlings in cool-warm rice area. [Method] Effects of variety, seedling age and nitrogen fertilize...[Objective] This study was conducted to discuss influence factors for safety full heading of machine-transplanted rice seedlings in cool-warm rice area. [Method] Effects of variety, seedling age and nitrogen fertilizer dosage and strategy of machine-transplanted seedlings on safety full heading of machine-transplanted seedlings were investigated. [Result] During mechanized rice production in coolwarm rice area, mid-early-maturing cold-resistant varieties with growth periods no longer than 180 d could selected, and seedling age could controlled within 30-35 d; and the total amount of pure nitrogen should be less than 300 kg/hm^2, and the proportion of nitrogen fertilizer applied in later stages should be properly reduced. [Conclusion] Under this condition, safety full heading of rice is ensured, and the target yield is realized.展开更多
Given the extensive utilization of cantilever retaining walls in construction and development projects,their optimal design and analysis with proper attention to seismic loads is a typical engineering problem.This res...Given the extensive utilization of cantilever retaining walls in construction and development projects,their optimal design and analysis with proper attention to seismic loads is a typical engineering problem.This research presents a new algorithm for pseudo-static analysis of retaining walls employing upper bound method.The algorithm can be utilized to design and check the external and internal stability of the wall based on the proposed mechanism.One of the main features of this algorithm is its ability to determine the critical condition of failure wedges,the minimum safety factor and maximum force acting on the wall,as well as the minimum weight of the wall,simultaneously,by effectively using the multi-objective optimization.The results obtained by the proposed failure mechanisms show that,while using the upper bound limit analysis approach,the active force should be maximized concurrent with optimizing the direction of the plane passing through the back of the heel.The present study also applies the proposed algorithm to determine the critical direction of the earthquake acceleration coefficient.The critical direction of earthquake acceleration coefficient is defined as the direction that maximizes the active force exerted on the wall and minimizes the safety factor for wall stability.The results obtained in this study are in good agreement with those of similar studies carried out based on the limit equilibrium method and finite element analysis.The critical failure mechanisms were determined via optimization with genetic algorithm.展开更多
Many years experience of the operation of high stress (>72% specified minimum yield strength, SMYS) gas pipelines and statistical analysis results of pipeline incidents showed that the operating pipelines at stress...Many years experience of the operation of high stress (>72% specified minimum yield strength, SMYS) gas pipelines and statistical analysis results of pipeline incidents showed that the operating pipelines at stress levels over 72% SMYS have not presented problems in USA and Canada, and design factor does not control incidents or the safety of pipelines. Enhancing pipeline safety management level is most important for decreasing incident rate. The application history of higher design factors in the U.S and Canada was reviewed. And the effect of higher factors to the critical flaw size, puncture resistance, change of reliability with time, risk level and the arrest toughness requirements of pipeline were analyzed here. The comparison of pipeline failure rates and risk levels between two design factors (0.72 and 0.8) has shown that a change in design factor from 0.72 to 0.8 would bring little effect on failure rates and risk levels. On the basis of the analysis result, the application feasibility of design factor of 0.8 in China was discussed and the related suggestions were proposed. When an operator wishes to apply design factor 0.8 to gas pipeline, the following process is recommended: stress level of line pipe hydro test should be up to 100% SMYS, reliability and risk assessment at the design feasibility or conceptual stage should be conducted, Charpy impact energy should meet the need of pipeline crack arrest; and establish and execute risk based integrity management plan. The technology of pipeline steel metallurgy, line pipe fabrication and pipeline construction, and line pipe quality control level in China achieved tremendous progresses, and line pipe product standards and property indexes have come up to international advanced level. Furthermore, pipeline safety management has improved greatly in China. Consequently, the research for the feasibility of application of design factor of 0.8 in China has fundamental basis.展开更多
The safety factor of roof under deep high stress is a quantitative index for evaluating roof stability.Based on the failure mode of surrounding rock of stope roof,the mechanics model of goaf roof is constructed,and th...The safety factor of roof under deep high stress is a quantitative index for evaluating roof stability.Based on the failure mode of surrounding rock of stope roof,the mechanics model of goaf roof is constructed,and the internal force of roof is deduced by the theory of hingeless arch.The calculation method of roof safety factor(K)under the environment of deep mining is proposed in view of compression failure and shear failure of roof.The calculation formulas of shear safety factor(K1),compression safety factor(K2)and comprehensive safety factor(K)of roof are given.The influence of stope span and roof thickness on roof stability is considered in this paper.The results show that when the roof thickness remains constant,the roof safety factor decreases with the increasing of the stope span;when the stope span remains constant,the roof safety factor increases with the increasing of the roof thickness.The deep mining example shows that when the stope span is 30 m and the roof thickness is 10 m,the roof comprehensive safety factor is 1.12,which indicates the roof is in a stable state.展开更多
Human factors in the delivery of service are considered in many occupations of high impact on others such as airline industry and nuclear power industry, but not sufficiently in healthcare delivery. A common administr...Human factors in the delivery of service are considered in many occupations of high impact on others such as airline industry and nuclear power industry, but not sufficiently in healthcare delivery. A common administrative framework of healthcare involves focus upon costs, quality and patient satisfaction (The Triple Aim). Many industries which support healthcare and healthcare administrators do not have firsthand knowledge of the complexities in delivering care. As a result, the experience and human factors of providing care are often overlooked at high level decision-making unless incorporated into the healthcare delivery framework, proposed as the fourth aim of The Quadruple Aim framework. Research is pointing to consequent negative effects on quality, safety, joy, meaning and sustainability of healthcare practice. High acute occupational stress and chronic occupational stress can cause direct and indirect effects on safety and quality of care. The biological, psychological and social consequences of burnout from excessive acute and chronic occupational stress are more of a threat to healthcare than commonly acknowledged. Patient safety, quality of care and clinician well-being are inextricably linked. This report will describe the process of transition from The Triple Aim to The Quadruple Aim administrative framework of healthcare delivery at the University of Rochester Medical Center. Developing the fourth aim of improving the experience of providing care, had high acceptability and aligned with other health system goals of optimization of safety, quality, and performance by applying a human factors/ergonomic (HFE) framework that considers human capabilities and human limitations. The goal of HFE is to fit the healthcare system to the human instead of the human to the healthcare system. Concepts include removal of extraneous cognitive load, using clinician neural resource (brain power) optimally for highest order decision making in patient care. An integrative model of patient safety and clinician wellbeing is a product of this effort.展开更多
Unlike the limit equilibrium method(LEM), with which only the global safety factor of the landslide can be calculated, a local safety factor(LSF) method is proposed to evaluate the stability of different sections of a...Unlike the limit equilibrium method(LEM), with which only the global safety factor of the landslide can be calculated, a local safety factor(LSF) method is proposed to evaluate the stability of different sections of a landslide in this paper. Based on three-dimensional(3D) numerical simulation results, the local safety factor is defined as the ratio of the shear strength of the soil at an element on the slip zone to the shear stress parallel to the sliding direction at that element. The global safety factor of the landslide is defined as the weighted average of all local safety factors based on the area of the slip surface. Some example analyses show that the results computed by the LSF method agree well with those calculated by the General Limit Equilibrium(GLE) method in two-dimensional(2D) models and the distribution of the LSF in the 3D slip zone is consistent with that indicated by the observed deformation pattern of an actual landslide in China.展开更多
Stability analysis of strain-softening slopes is carried out using the shear strength reduction method and Mohr-Coulomb model with degrading cohesion and friction angle.The e ffect of strain-softening behavior on the ...Stability analysis of strain-softening slopes is carried out using the shear strength reduction method and Mohr-Coulomb model with degrading cohesion and friction angle.The e ffect of strain-softening behavior on the slope factor of safety is investigated by performing a series of analyses for various slope geometries and strength properties.Stability charts and equations are developed to estimate the factor of safety of strain-softe ning slopes from the results of traditional stability analysis based on perfectly-plastic behavior.Two example applications including an open pit mine in weak rock and clay shale slope with daylighting bedding planes are presented.The results of limit equilibrium analysis and shear strength reduction method with perfectly-plastic models were in close agreement.Using perfectly-plastic models with peak strength properties led to overly optimistic results while adopting residual strength properties gave excessively conservative outcomes.The shear strength reduction method with a strain-softening model gave realistic factors of safety while accounting for the process of strength degradation.展开更多
In recent years,marine pilotage accidents occurring on a worldwide basis as a result of human error have not been ceased to transpire,despite advances in technology and a significant set of international conventions,r...In recent years,marine pilotage accidents occurring on a worldwide basis as a result of human error have not been ceased to transpire,despite advances in technology and a significant set of international conventions,regulations,and recommendations to reduce them.This paper aims to investigate the effect of human factors on the safety of maritime pilotage operations.The human factors that affect the operators who are performing ships’berthing operations have also been examined in detail.In this study,in order to determine the causes of human-related errors occurred in maritime pilotage accidents,a comprehensive literature review is carried out,and a considerable number of real past case examples and an analysis of the maritime accident investigation reports regarding pilotage operations events that occurred between 1995 and 2015 have been reviewed.To validate the identified humanrelated risk factors(HCFs)and explore other contributory factors,survey questionnaires and semi-structured interviews with domain experts have been conducted.A structural hierarchy diagram for the identified risk factors(HCFs)has been developed and validated through experienced experts belonging to the maritime sector.A questionnaire for pair-wise comparison is carried out and analysed using the analytic hierarchy process(AHP)approach to evaluate the weight and rank the importance of the identified human causal factors.The findings of this study will benefit the maritime industry,by identifying a new database on causal factors that are contributing to the occurrence of maritime pilotage disasters.The database can be used as a stand-alone reference or help implement effective risk reduction strategies to reduce the human error,that might occur during pilotage operations.展开更多
When the bridge structure stability safety factor of the first type is 4, the research that whether the structure reliability index will reach target reliability index under the more-likely-to-happen collapse situatio...When the bridge structure stability safety factor of the first type is 4, the research that whether the structure reliability index will reach target reliability index under the more-likely-to-happen collapse situation of the second type is necessary. The stability calculations of the first and the second type are made respectively for single layer and single span rigid frame bridge. Based on the critical load obtained from the stability calculation of the first type, the stability safety factor of the first type is taken as 4, and the first order reliability method is used to program and calculate the reliability index. Then, the load effect under the stability reliability index cal- culation of the first type and the critical load of the second type are employed to calculate the reliability index of the second type. The evaluation of structure stability safety factor is discussed according to reliability index. Based on the discussion above, parameter analysis of the stable critical loads of two types is made, and the in- fluence of critical load change on reliability index is researched. The result shows that stability analysis should identify collapse state; when the stability safety factor of the first type is 4, but the structure has the collapse of the second type, the reliability index cannot be ensured to reach the target reliability index under certain condi- tions.展开更多
Our healthcare delivery system has accumulated complexity of payment, regulation systems, expectations and requirements. Often these are not designed to align with clinical thinking process flow of patient care. As a ...Our healthcare delivery system has accumulated complexity of payment, regulation systems, expectations and requirements. Often these are not designed to align with clinical thinking process flow of patient care. As a result, clinicians are utilizing enormous mental (cognitive) resource to comply with these complexities, over and above the baseline mental effort required to give good care to the patient. Recent studies suggest a significant number of physicians, advanced practice providers and nurses no longer want to stay in healthcare due to difficult work expectations and conditions that have become unreasonable. Technology has benefitted healthcare delivery, but also is a conduit of many expectations that have been grafted upon clinician workloads, exceeding the resources provided to accomplish them. Cognitive load is a measure of mental effort and is divided into Intrinsic, Germane and Extraneous Cognitive Load. Extraneous Cognitive Load (ECL) is what is not necessary and can be removed by better design. High cognitive load is associated with increased risk of both medical error and clinician burnout. Chronic high level occupational stress occurs from dealing with this job/resource imbalance and is showing serious personal health impact upon clinicians and the quality of the work they can provide for patients. Since organizational systems have become more complex, leadership methods, clinician wellbeing and patient safety efforts need to adjust to adapt and succeed. Safety efforts have tended to predominantly follow methods of a few decades ago with predominant focus upon how things go wrong (Safety I) but are now being encouraged to include more of the study of how things go right (Safety II). Human Factors/Ergonomics (HFE) science has been used in many industries to preserve worker wellbeing and improve system performance. Patient safety is a product of good system performance. HFE science helps inform mechanisms behind Safety I and II approach. HFE concepts augment existing burnout and safety interventions by providing a conceptual roadmap to follow that can inform how to improve the multiple human/technology, human/system, and human/work environment interfaces that comprise healthcare delivery. Healthcare leaders, by their influence over culture, resource allocation, and implementation of requirements and workflows are uniquely poised to be effective mitigators of the conditions leading to clinician burnout and latent medical error. Basic knowledge of HFE science is a strategic advantage to leaders and individuals tasked with achieving quality of care, controlling costs, and improving the experiences of receiving and providing care.展开更多
More than 32,000 motorists are killed on U.S. roads and streets annually, and approximately 54% of the accidents occur on rural roads. In an attempt to address and reduce these fatalities, the current transportation a...More than 32,000 motorists are killed on U.S. roads and streets annually, and approximately 54% of the accidents occur on rural roads. In an attempt to address and reduce these fatalities, the current transportation act, the Safe, Accountable, Flexible, Efficient Transportation Equality Act: A Legacy for Users (SAFETY-LU), elevated the Highway Safety Improvement Program (HSIP) to a core program and included a $90,000,000 High-Risk Rural Road Program (HRRRP) to address and significantly reduce traffic fatalities and incapacitating injuries on rural major or minor collectors, and/or rural local roads. While there were many challenges to properly implement the HRRRP in counties, this study provided important information that was needed to identify the predominant crash types on HRRRP-eligible roads and compiled a list of countermeasures for the predominant crash types that were identified on Kansas’ high-risk rural roads. For the gathered countermeasures, crash reduction factors (CRFs) were also provided from the literature review, and their values were validated by conducting interviews with Kansas county engineers/officials. This study provided valuable information for the county engineers and local government officials while they worked on improving the safety of high-risk rural roads using HRRRP funds.展开更多
Residual fatigue strength of 48MnV crankshaft was studied and analyzed based on safety factor. Three different status crankshafts were used to the hop-up tests, which maintain new after 500h hop-up tests and after 1...Residual fatigue strength of 48MnV crankshaft was studied and analyzed based on safety factor. Three different status crankshafts were used to the hop-up tests, which maintain new after 500h hop-up tests and after 1000h hop-up tests. Then, crankshafts were cut into unit cranks. The unit cranks were used to do endurance bending tests to get the residual fatigue strength. Finally, the results were analyzed based on safety factor. The results show that safety factor of crankshaft descends a little with the increase of the running time, and the residual safety factor is still much bigger than the endurable safety factor. Furthermore, after the crankshaft accomplishes a full life cycle, the residual fatigue strength of the crankshaft is enough to remanufacture and fulfill the next life cycle.展开更多
基金supported by National Natural Science Foundation of China (Nos. 12205033, 12105317, 11905022 and 11975062)Dalian Youth Science and Technology Project (No. 2022RQ039)+1 种基金the Fundamental Research Funds for the Central Universities (No. 3132023192)the Young Scientists Fund of the Natural Science Foundation of Sichuan Province (No. 2023NSFSC1291)
文摘Many magnetohydrodynamic stability analyses require generation of a set of equilibria with a fixed safety factor q-profile while varying other plasma parameters.A neural network(NN)-based approach is investigated that facilitates such a process.Both multilayer perceptron(MLP)-based NN and convolutional neural network(CNN)models are trained to map the q-profile to the plasma current density J-profile,and vice versa,while satisfying the Grad–Shafranov radial force balance constraint.When the initial target models are trained,using a database of semianalytically constructed numerical equilibria,an initial CNN with one convolutional layer is found to perform better than an initial MLP model.In particular,a trained initial CNN model can also predict the q-or J-profile for experimental tokamak equilibria.The performance of both initial target models is further improved by fine-tuning the training database,i.e.by adding realistic experimental equilibria with Gaussian noise.The fine-tuned target models,referred to as fine-tuned MLP and fine-tuned CNN,well reproduce the target q-or J-profile across multiple tokamak devices.As an important application,these NN-based equilibrium profile convertors can be utilized to provide a good initial guess for iterative equilibrium solvers,where the desired input quantity is the safety factor instead of the plasma current density.
文摘Objective:To provide real-world evidence for the application of first-line dacomitinib treatment for epidermal growth factor receptor(EGFR)21L858R mutant non-small cell lung cancer(NSCLC)patients in China and to explore the factors influencing the efficacy and safety.Methods:A longitudinal,consecutive case-series,multicenter study with mixed prospective and retrospective data was conducted.The primary endpoint was progression-free survival(PFS),and the secondary endpoints included duration of treatment(DOT),overall survival(OS),objective response rate(ORR),disease control rate(DCR)and safety.Results:A total of 155 EGFR 21L858R mutant patients treated with first-line dacomitinib were included.The median follow-up time for these patients was 20.4 months.Among 134 patients with evaluable lesions,the ORR was 70.9%and the DCR was 96.3%.The median PFS was 16.3[95%confidence interval(95%CI),13.7−18.9]months.Multivariate Cox regression analysis suggested that the baseline brain metastasis(BM)status[with vs.without BM:hazard ratio(HR),1.331;95%CI,0.720−2.458;P=0.361]and initial doses(45 mg vs.30 mg:HR,0.837;95%CI,0.427−1.641;P=0.604)did not significantly affect the median PFS.The median DOT was 21.0(95%CI,17.5−24.6)months and the median OS was not reached.Genetic tests were performed in 64 patients after progression,among whom 29(45.3%)patients developed the EGFR 20T790M mutation.In addition,among the 46 patients who discontinued dacomitinib treatment after progression,31(67.4%)patients received subsequent third-generation EGFR-tyrosine kinase inhibitors.The most common grade 3−4 adverse events were rash(10.4%),diarrhea(9.1%),stomatitis(7.1%)and paronychia(4.5%).The incidence of grade 3−4 rash was significantly higher in the 45 mg group than that in the 30 mg group(21.9%vs.7.5%,P=0.042).Conclusions:First-line dacomitinib treatment demonstrated promising efficacy and tolerable adverse events among EGFR 21L858R mutant NSCLC patients in China.
基金supported by the Basic Research Special Plan of Yunnan Provincial Department of Science and Technology-General Project(Grant No.202101AT070094)。
文摘The safety factor is a crucial quantitative index for evaluating slope stability.However,the traditional calculation methods suffer from unreasonable assumptions,complex soil composition,and inadequate consideration of the influencing factors,leading to large errors in their calculations.Therefore,a stacking ensemble learning model(stacking-SSAOP)based on multi-layer regression algorithm fusion and optimized by the sparrow search algorithm is proposed for predicting the slope safety factor.In this method,the density,cohesion,friction angle,slope angle,slope height,and pore pressure ratio are selected as characteristic parameters from the 210 sets of established slope sample data.Random Forest,Extra Trees,AdaBoost,Bagging,and Support Vector regression are used as the base model(inner loop)to construct the first-level regression algorithm layer,and XGBoost is used as the meta-model(outer loop)to construct the second-level regression algorithm layer and complete the construction of the stacked learning model for improving the model prediction accuracy.The sparrow search algorithm is used to optimize the hyperparameters of the above six regression models and correct the over-and underfitting problems of the single regression model to further improve the prediction accuracy.The mean square error(MSE)of the predicted and true values and the fitting of the data are compared and analyzed.The MSE of the stacking-SSAOP model was found to be smaller than that of the single regression model(MSE=0.03917).Therefore,the former has a higher prediction accuracy and better data fitting.This study innovatively applies the sparrow search algorithm to predict the slope safety factor,showcasing its advantages over traditional methods.Additionally,our proposed stacking-SSAOP model integrates multiple regression algorithms to enhance prediction accuracy.This model not only refines the prediction accuracy of the slope safety factor but also offers a fresh approach to handling the intricate soil composition and other influencing factors,making it a precise and reliable method for slope stability evaluation.This research holds importance for the modernization and digitalization of slope safety assessments.
文摘BACKGROUND Corneal neovascularization(CoNV)is the second major cause of blindness.Vascular endothelial growth factor(VEGF)inhibitors,e.g.,bevacizumab,have been used to prevent CoNV.AIM We conducted an updated systematic review and meta-analysis of clinical trials to examine the efficacy and safety of anti-VEGF in CoNV.METHODS A literature search was conducted using three electronic databases.Mean difference(MD),standard mean difference(SMD),and relative risk(RR)are used to estimate the effect size.RESULTS Nine randomized controlled and three non-randomized trials were obtained.The pooled results demonstrated a significant reduction of CoNV area/Length(SMD=-1.17,95%CI:-1.58 to-0.75),best corrected visual acuity(MD=-0.54,95%CI:-0.91 to-0.17),and graft rejection(RR=0.44,95%CI:0.24 to 0.8)and failure(RR=0.39,95%CI:0.19 to 0.78)rates in the anti-VEGF group than the placebo group.A non-significant reduction of the epithelial defect was also observed in the bevacizumab group compared with the placebo(RR=0.56,95%CI:0.30 to 1.06).Compared with a placebo,the unsynthesizable trials also support that bevacizumab improves visual acuity,CoNV,graft rejection,and failure rates.Trials reporting other comparisons revealed the superiority of combined remedy with bevacizumab compared to other treatments in reducing CoNV.CONCLUSION Anti-VEGF agents,mainly bevacizumab,are an effective and safe treatment for CoNV of all causes and prevent corneal graft rejection and failure in corneal transplantation.
基金Supported by China Scientific Research Fund for HER2 Target from China Anti-Cancer Association,No.CORP-239-M9.
文摘BACKGROUND Patients with human epidermal growth factor receptor 2(HER2)-positive advanced gastric cancer have poor outcomes.Trastuzumab combined with chemotherapy is the first-line standard treatment for HER2-positive advanced gastric cancer.Inetetamab is a novel anti-HER2 drug,and its efficacy and safety in gastric cancer have not yet been reported.AIM To evaluate the efficacy and safety of the S-1 plus oxaliplatin(SOX)regimen combined with inetetamab as a first-line treatment for HER2-positive advanced gastric cancer.METHODS Thirty-eight patients with HER2-positive advanced gastric cancer or gastroeso-phageal junction adenocarcinoma were randomly divided into two groups:One group received inetetamab combined with the SOX regimen,and the other group received trastuzumab combined with the SOX regimen.After 4-6 cycles,patients with stable disease received maintenance therapy.The primary endpoints were progression-free survival(PFS)and overall survival(OS),and the secondary endpoints were the objective response rate,disease control rate,and adverse events(AEs).RESULTS Thirty-seven patients completed the trial,with 18 patients in the inetetamab group and 19 patients in the trastuzumab group.In the inetetamab group,the median PFS was 8.5 months,whereas it was 7.3 months in the trastuzumab group(P=0.046);this difference was significant.The median OS in the inetetamab group vs the trastuzumab group was 15.4 months vs 14.3 months(P=0.33),and the objective response rate was 50%vs 42%(P=0.63),respectively;these differences were not significant.Common AEs included leukopenia,thrombocytopenia,nausea,and vomiting.The incidence rates of grade≥3 AEs were 56%in the inetetamab group and 47%in the trastuzumab group(P=0.63),with no significant difference.CONCLUSION In the first-line treatment of HER2-positive advanced gastric cancer,inetetamab and trastuzumab showed comparable efficacy.The inetetamab group showed superior PFS,and both groups had good safety.
文摘When a patient falls within a hospital setting,there is a significant increase in the risk of severe injury or health complications.Recognizing factors associated with such falls is crucial to mitigate their impact on patient safety.This review seeks to analyze the factors contributing to patient falls in hospitals.The main goal is to enhance our understanding of the reasons behind these falls,enabling hospitals to devise more effective prevention strategies.This study reviewed literature published from 2013 to 2022,using the Arksey and O’Malley methodology for a scoping review.The research literature was searched from seven databases,namely,PubMed,ScienceDirect,Wiley Library,Garuda,Global Index Medicus,Emerald Insight,and Google Scholar.The inclusion criteria comprised both qualitative and quantitative primary and secondary data studies centered on hospitalized patients.Out of the 893 studies analyzed,23 met the criteria and were included in this review.Although there is not an abundance of relevant literature,this review identified several factors associated with falls in hospitals.These encompass environmental,patient,staff,and medical factors.This study offers valuable insights for hospitals and medical personnel aiming to enhance fall prevention practices.Effective prevention efforts should prioritize early identification of patient risk factors,enhancement of the care environment,thorough training for care staff,and vigilant supervision of high-risk patients.By comprehending the factors that contribute to patient falls,hospitals can bolster patient safety and mitigate the adverse effects of falls within the health-care setting.
文摘Fire incidents in commercial vehicles pose significant risks to passengers, drivers, and cargo. Traditional fire extinguishing systems, while effective, may have limitations in terms of response time, coverage, and human intervention [1]. This study investigates the efficacy of a novel fire suppression technology—the Exploding Fire Extinguishing Ball (EFEB) —as an alternative and complementary fire safety solution for commercial vehicles. The research employs a multidisciplinary approach, encompassing engineering, materials science, fire safety, and human factors analysis. A systematic literature review establishes a comprehensive understanding of existing fire suppression technologies, including EFEBs. Subsequently, this study analyzes the unique features of EFEBs, such as automatic activation, as well as manual activation upon exposure to fire, and their potential to provide rapid, localized, and autonomous fire suppression. The study presents original experimental investigations to assess the performance and effectiveness of EFEBs in various fire scenarios representative of commercial vehicles. Experiments include controlled fires in confined spaces and dynamic simulations to emulate real-world fire incidents. Data on activation times, extinguishing capability, and coverage area are collected and analyzed to compare the efficacy of EFEBs with traditional fire extinguishing methods. Furthermore, this research shows the practical aspects of implementing EFEBs in commercial vehicles. A feasibility study examines the integration challenges, cost-benefit analysis, and potential regulatory implications. The study also addresses the impact of EFEBs on vehicle weight, stability, and overall safety. Human factors and user acceptance are crucial elements in adopting new safety technologies. Therefore, this research utilizes an experimental design to assess the performance and effectiveness of EFEBs in various fire scenarios representative of commercial vehicles. This dissertation presents original controlled experiments to emulate real-world fire incidents, including controlled fires in confined spaces and dynamic simulations. The experimental approach ensures rigorous evaluation and objective insights into EFEBs’ potential as an autonomous fire suppression system for commercial vehicles. This includes the perspectives of drivers, passengers, fleet operators, insurance agencies, and regulatory bodies. Factors influencing trust, perceived safety, and willingness to adopt EFEBs are analyzed to provide insights into the successful integration of this technology. The findings of this research will contribute to the knowledge of fire safety technology and expand the understanding of the applicability of EFEBs in commercial vehicles.
文摘This study aims to thoroughly investigate the axial power peaking factors (PPF) within the low-enriched uranium (LEU) core of the Ghana Research Reactor-1 (GHARR-1). This study uses advanced simulation tools, like the MCNPX code for analysing neutron behavior and the PARET/ANL code for understanding power variations, to get a clearer picture of the reactor’s performance. The analysis covers the initial six years of GHARR-1’s operation and includes projections for its whole 60-year lifespan. We closely observed the patterns of both the highest and average PPFs at 21 axial nodes, with measurements taken every ten years. The findings of this study reveal important patterns in power distribution within the core, which are essential for improving the safety regulations and fuel management techniques of the reactor. We provide a meticulous approach, extensive data, and an analysis of the findings, highlighting the significance of continuous monitoring and analysis for proactive management of nuclear reactors. The findings of this study not only enhance our comprehension of nuclear reactor safety but also carry significant ramifications for sustainable energy progress in Ghana and the wider global context. Nuclear engineering is essential in tackling global concerns, such as the demand for clean and dependable energy sources. Research on optimising nuclear reactors, particularly in terms of safety and efficiency, is crucial for the ongoing advancement and acceptance of nuclear energy.
文摘[Objective] This study was conducted to discuss influence factors for safety full heading of machine-transplanted rice seedlings in cool-warm rice area. [Method] Effects of variety, seedling age and nitrogen fertilizer dosage and strategy of machine-transplanted seedlings on safety full heading of machine-transplanted seedlings were investigated. [Result] During mechanized rice production in coolwarm rice area, mid-early-maturing cold-resistant varieties with growth periods no longer than 180 d could selected, and seedling age could controlled within 30-35 d; and the total amount of pure nitrogen should be less than 300 kg/hm^2, and the proportion of nitrogen fertilizer applied in later stages should be properly reduced. [Conclusion] Under this condition, safety full heading of rice is ensured, and the target yield is realized.
文摘Given the extensive utilization of cantilever retaining walls in construction and development projects,their optimal design and analysis with proper attention to seismic loads is a typical engineering problem.This research presents a new algorithm for pseudo-static analysis of retaining walls employing upper bound method.The algorithm can be utilized to design and check the external and internal stability of the wall based on the proposed mechanism.One of the main features of this algorithm is its ability to determine the critical condition of failure wedges,the minimum safety factor and maximum force acting on the wall,as well as the minimum weight of the wall,simultaneously,by effectively using the multi-objective optimization.The results obtained by the proposed failure mechanisms show that,while using the upper bound limit analysis approach,the active force should be maximized concurrent with optimizing the direction of the plane passing through the back of the heel.The present study also applies the proposed algorithm to determine the critical direction of the earthquake acceleration coefficient.The critical direction of earthquake acceleration coefficient is defined as the direction that maximizes the active force exerted on the wall and minimizes the safety factor for wall stability.The results obtained in this study are in good agreement with those of similar studies carried out based on the limit equilibrium method and finite element analysis.The critical failure mechanisms were determined via optimization with genetic algorithm.
基金supported by China National Petroleum Corporation Application Fundamental Research Foundation (Grant No. 07A40401)
文摘Many years experience of the operation of high stress (>72% specified minimum yield strength, SMYS) gas pipelines and statistical analysis results of pipeline incidents showed that the operating pipelines at stress levels over 72% SMYS have not presented problems in USA and Canada, and design factor does not control incidents or the safety of pipelines. Enhancing pipeline safety management level is most important for decreasing incident rate. The application history of higher design factors in the U.S and Canada was reviewed. And the effect of higher factors to the critical flaw size, puncture resistance, change of reliability with time, risk level and the arrest toughness requirements of pipeline were analyzed here. The comparison of pipeline failure rates and risk levels between two design factors (0.72 and 0.8) has shown that a change in design factor from 0.72 to 0.8 would bring little effect on failure rates and risk levels. On the basis of the analysis result, the application feasibility of design factor of 0.8 in China was discussed and the related suggestions were proposed. When an operator wishes to apply design factor 0.8 to gas pipeline, the following process is recommended: stress level of line pipe hydro test should be up to 100% SMYS, reliability and risk assessment at the design feasibility or conceptual stage should be conducted, Charpy impact energy should meet the need of pipeline crack arrest; and establish and execute risk based integrity management plan. The technology of pipeline steel metallurgy, line pipe fabrication and pipeline construction, and line pipe quality control level in China achieved tremendous progresses, and line pipe product standards and property indexes have come up to international advanced level. Furthermore, pipeline safety management has improved greatly in China. Consequently, the research for the feasibility of application of design factor of 0.8 in China has fundamental basis.
基金Projects(51974135,51704094)supported by the National Natural Science Foundation of ChinaProject(2016YFC0600802)supported by the National Key Research and Development Program of ChinaProject(2020M672226)supported by the China Postdoctoral Science Foundation。
文摘The safety factor of roof under deep high stress is a quantitative index for evaluating roof stability.Based on the failure mode of surrounding rock of stope roof,the mechanics model of goaf roof is constructed,and the internal force of roof is deduced by the theory of hingeless arch.The calculation method of roof safety factor(K)under the environment of deep mining is proposed in view of compression failure and shear failure of roof.The calculation formulas of shear safety factor(K1),compression safety factor(K2)and comprehensive safety factor(K)of roof are given.The influence of stope span and roof thickness on roof stability is considered in this paper.The results show that when the roof thickness remains constant,the roof safety factor decreases with the increasing of the stope span;when the stope span remains constant,the roof safety factor increases with the increasing of the roof thickness.The deep mining example shows that when the stope span is 30 m and the roof thickness is 10 m,the roof comprehensive safety factor is 1.12,which indicates the roof is in a stable state.
文摘Human factors in the delivery of service are considered in many occupations of high impact on others such as airline industry and nuclear power industry, but not sufficiently in healthcare delivery. A common administrative framework of healthcare involves focus upon costs, quality and patient satisfaction (The Triple Aim). Many industries which support healthcare and healthcare administrators do not have firsthand knowledge of the complexities in delivering care. As a result, the experience and human factors of providing care are often overlooked at high level decision-making unless incorporated into the healthcare delivery framework, proposed as the fourth aim of The Quadruple Aim framework. Research is pointing to consequent negative effects on quality, safety, joy, meaning and sustainability of healthcare practice. High acute occupational stress and chronic occupational stress can cause direct and indirect effects on safety and quality of care. The biological, psychological and social consequences of burnout from excessive acute and chronic occupational stress are more of a threat to healthcare than commonly acknowledged. Patient safety, quality of care and clinician well-being are inextricably linked. This report will describe the process of transition from The Triple Aim to The Quadruple Aim administrative framework of healthcare delivery at the University of Rochester Medical Center. Developing the fourth aim of improving the experience of providing care, had high acceptability and aligned with other health system goals of optimization of safety, quality, and performance by applying a human factors/ergonomic (HFE) framework that considers human capabilities and human limitations. The goal of HFE is to fit the healthcare system to the human instead of the human to the healthcare system. Concepts include removal of extraneous cognitive load, using clinician neural resource (brain power) optimally for highest order decision making in patient care. An integrative model of patient safety and clinician wellbeing is a product of this effort.
基金financially supported by the National Natural Science Foundation of China(Grant No.51178402,10902112)Department of Transportation Technology Projects(Grant No.2011318740240)the Fundamental Research Funds for the Central Universities(Grant No.2682014CX074)
文摘Unlike the limit equilibrium method(LEM), with which only the global safety factor of the landslide can be calculated, a local safety factor(LSF) method is proposed to evaluate the stability of different sections of a landslide in this paper. Based on three-dimensional(3D) numerical simulation results, the local safety factor is defined as the ratio of the shear strength of the soil at an element on the slip zone to the shear stress parallel to the sliding direction at that element. The global safety factor of the landslide is defined as the weighted average of all local safety factors based on the area of the slip surface. Some example analyses show that the results computed by the LSF method agree well with those calculated by the General Limit Equilibrium(GLE) method in two-dimensional(2D) models and the distribution of the LSF in the 3D slip zone is consistent with that indicated by the observed deformation pattern of an actual landslide in China.
基金financially supported by the Natural Sciences and Engineering Research Council of Canada(NSERC:RES0014117).
文摘Stability analysis of strain-softening slopes is carried out using the shear strength reduction method and Mohr-Coulomb model with degrading cohesion and friction angle.The e ffect of strain-softening behavior on the slope factor of safety is investigated by performing a series of analyses for various slope geometries and strength properties.Stability charts and equations are developed to estimate the factor of safety of strain-softe ning slopes from the results of traditional stability analysis based on perfectly-plastic behavior.Two example applications including an open pit mine in weak rock and clay shale slope with daylighting bedding planes are presented.The results of limit equilibrium analysis and shear strength reduction method with perfectly-plastic models were in close agreement.Using perfectly-plastic models with peak strength properties led to overly optimistic results while adopting residual strength properties gave excessively conservative outcomes.The shear strength reduction method with a strain-softening model gave realistic factors of safety while accounting for the process of strength degradation.
文摘In recent years,marine pilotage accidents occurring on a worldwide basis as a result of human error have not been ceased to transpire,despite advances in technology and a significant set of international conventions,regulations,and recommendations to reduce them.This paper aims to investigate the effect of human factors on the safety of maritime pilotage operations.The human factors that affect the operators who are performing ships’berthing operations have also been examined in detail.In this study,in order to determine the causes of human-related errors occurred in maritime pilotage accidents,a comprehensive literature review is carried out,and a considerable number of real past case examples and an analysis of the maritime accident investigation reports regarding pilotage operations events that occurred between 1995 and 2015 have been reviewed.To validate the identified humanrelated risk factors(HCFs)and explore other contributory factors,survey questionnaires and semi-structured interviews with domain experts have been conducted.A structural hierarchy diagram for the identified risk factors(HCFs)has been developed and validated through experienced experts belonging to the maritime sector.A questionnaire for pair-wise comparison is carried out and analysed using the analytic hierarchy process(AHP)approach to evaluate the weight and rank the importance of the identified human causal factors.The findings of this study will benefit the maritime industry,by identifying a new database on causal factors that are contributing to the occurrence of maritime pilotage disasters.The database can be used as a stand-alone reference or help implement effective risk reduction strategies to reduce the human error,that might occur during pilotage operations.
基金National Natural Science Foundation of China (No.51278182)
文摘When the bridge structure stability safety factor of the first type is 4, the research that whether the structure reliability index will reach target reliability index under the more-likely-to-happen collapse situation of the second type is necessary. The stability calculations of the first and the second type are made respectively for single layer and single span rigid frame bridge. Based on the critical load obtained from the stability calculation of the first type, the stability safety factor of the first type is taken as 4, and the first order reliability method is used to program and calculate the reliability index. Then, the load effect under the stability reliability index cal- culation of the first type and the critical load of the second type are employed to calculate the reliability index of the second type. The evaluation of structure stability safety factor is discussed according to reliability index. Based on the discussion above, parameter analysis of the stable critical loads of two types is made, and the in- fluence of critical load change on reliability index is researched. The result shows that stability analysis should identify collapse state; when the stability safety factor of the first type is 4, but the structure has the collapse of the second type, the reliability index cannot be ensured to reach the target reliability index under certain condi- tions.
文摘Our healthcare delivery system has accumulated complexity of payment, regulation systems, expectations and requirements. Often these are not designed to align with clinical thinking process flow of patient care. As a result, clinicians are utilizing enormous mental (cognitive) resource to comply with these complexities, over and above the baseline mental effort required to give good care to the patient. Recent studies suggest a significant number of physicians, advanced practice providers and nurses no longer want to stay in healthcare due to difficult work expectations and conditions that have become unreasonable. Technology has benefitted healthcare delivery, but also is a conduit of many expectations that have been grafted upon clinician workloads, exceeding the resources provided to accomplish them. Cognitive load is a measure of mental effort and is divided into Intrinsic, Germane and Extraneous Cognitive Load. Extraneous Cognitive Load (ECL) is what is not necessary and can be removed by better design. High cognitive load is associated with increased risk of both medical error and clinician burnout. Chronic high level occupational stress occurs from dealing with this job/resource imbalance and is showing serious personal health impact upon clinicians and the quality of the work they can provide for patients. Since organizational systems have become more complex, leadership methods, clinician wellbeing and patient safety efforts need to adjust to adapt and succeed. Safety efforts have tended to predominantly follow methods of a few decades ago with predominant focus upon how things go wrong (Safety I) but are now being encouraged to include more of the study of how things go right (Safety II). Human Factors/Ergonomics (HFE) science has been used in many industries to preserve worker wellbeing and improve system performance. Patient safety is a product of good system performance. HFE science helps inform mechanisms behind Safety I and II approach. HFE concepts augment existing burnout and safety interventions by providing a conceptual roadmap to follow that can inform how to improve the multiple human/technology, human/system, and human/work environment interfaces that comprise healthcare delivery. Healthcare leaders, by their influence over culture, resource allocation, and implementation of requirements and workflows are uniquely poised to be effective mitigators of the conditions leading to clinician burnout and latent medical error. Basic knowledge of HFE science is a strategic advantage to leaders and individuals tasked with achieving quality of care, controlling costs, and improving the experiences of receiving and providing care.
文摘More than 32,000 motorists are killed on U.S. roads and streets annually, and approximately 54% of the accidents occur on rural roads. In an attempt to address and reduce these fatalities, the current transportation act, the Safe, Accountable, Flexible, Efficient Transportation Equality Act: A Legacy for Users (SAFETY-LU), elevated the Highway Safety Improvement Program (HSIP) to a core program and included a $90,000,000 High-Risk Rural Road Program (HRRRP) to address and significantly reduce traffic fatalities and incapacitating injuries on rural major or minor collectors, and/or rural local roads. While there were many challenges to properly implement the HRRRP in counties, this study provided important information that was needed to identify the predominant crash types on HRRRP-eligible roads and compiled a list of countermeasures for the predominant crash types that were identified on Kansas’ high-risk rural roads. For the gathered countermeasures, crash reduction factors (CRFs) were also provided from the literature review, and their values were validated by conducting interviews with Kansas county engineers/officials. This study provided valuable information for the county engineers and local government officials while they worked on improving the safety of high-risk rural roads using HRRRP funds.
文摘Residual fatigue strength of 48MnV crankshaft was studied and analyzed based on safety factor. Three different status crankshafts were used to the hop-up tests, which maintain new after 500h hop-up tests and after 1000h hop-up tests. Then, crankshafts were cut into unit cranks. The unit cranks were used to do endurance bending tests to get the residual fatigue strength. Finally, the results were analyzed based on safety factor. The results show that safety factor of crankshaft descends a little with the increase of the running time, and the residual safety factor is still much bigger than the endurable safety factor. Furthermore, after the crankshaft accomplishes a full life cycle, the residual fatigue strength of the crankshaft is enough to remanufacture and fulfill the next life cycle.