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Prevention of peripherally inserted central catheter-related infections in very low-birthweight infants by using a central line bundle guideline with a standard checklist 被引量:1
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作者 Chen Yuan Qing Zhao +1 位作者 Xiaoyan Song Fei Meng 《International Journal of Nursing Sciences》 2016年第1期50-53,共4页
Objective:To investigate the effectiveness and feasibility of using a central line bundle(CLB)guideline with a standard checklist in the prevention of peripherally inserted central catheter(PICC)-related infections(CR... Objective:To investigate the effectiveness and feasibility of using a central line bundle(CLB)guideline with a standard checklist in the prevention of peripherally inserted central catheter(PICC)-related infections(CRIs)in very low-birth-weight infants(VLBWIs).Methods:Fifty-seven VLBWIs who underwent PICC insertion at a hospital in Qingdao,China,between November 2012 and June 2013,were monitored with the CLB guideline and a standard checklist.Fifty-three VLBWIs who underwent PICC insertion were monitored by standard hospital procedures.The incidence of CRIs was compared between the two groups.Results:The incidence of infection significantly decreased from 10.0%catheter days in the control group to 2.2%catheter days in the study group(p<0.05).The indwelling catheter time significantly increased in the study group compared to the control group(31.9±15.0days vs.24.8±7.4 days,respectively,p<0.05).Colonization infections also decreased from 6.9% catheter days in the control group to 2.2%catheter days in the study group(p<0.05).The incidence of catheter-related bloodstream infections decreased from 3.1%catheter days in the control group to 0%catheter days in the study group.Conclusion:The use of a CLB guideline with a standard checklist could be an effective and feasible protocol for preventing CRIs and prolonging indwelling catheter timein VLBWIs. 展开更多
关键词 central line bundle CHECKLIST Very low birth weight infant PICC Catheter related infection
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Trends of central line-associated bloodstream infections in the intensive care unit in the Kingdom of Bahrain:Four years’experience
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作者 Safaa Al-Khawaja Nermin Kamal Saeed +2 位作者 Sanaa Al-khawaja Nashwa Azzam Mohammed Al-Biltagi 《World Journal of Critical Care Medicine》 2021年第5期220-231,共12页
BACKGROUND The central venous line is an essential component in monitoring and managing critically ill patients.However,it poses patients with increased risks of severe infections with a higher probability of morbidit... BACKGROUND The central venous line is an essential component in monitoring and managing critically ill patients.However,it poses patients with increased risks of severe infections with a higher probability of morbidity and mortality.AIM To define the trends of the rates of central line-associated bloodstream infections(CLABSI)over four years,its predicted risk factors,aetiology,and the antimicrobial susceptibility of the isolated pathogens.METHODS The study was a prospective case-control study,performed according to the guidelines of the Center for Disease Control surveillance methodology for CLABSI in patients admitted to the adult intensive care unit(ICU)and auditing the implementation of its prevention bundle.RESULTS Thirty-four CLABSI identified over the study period,giving an average CLABSI rate of 3.2/1000 central line days.The infection's time trend displayed significant reductions over time concomitantly with the CLABSI prevention bundle's reinforcement from 4.7/1000 central line days at the beginning of 2016 to 1.4/1000 central line days by 2018.The most frequently identified pathogens causing CLABSI in our ICU were gram-negative organisms(59%).The most common offending organisms were Acinetobacter,Enterococcus,and Staphylococcus epidermidis,each of them accounted for 5 cases(15%).Multidrug-resistant organisms contributed to 56%of CLABSI.Its rate was higher when using femoral access and longer hospitalisation duration,especially in the ICU.Insertion of the central line in the non-ICU setting was another identified risk factor.CONCLUSION Implementing the prevention bundles reduced CLABSI significantly in our ICU.Implementing the CLABSI prevention bundle is crucial to maintain a substantial reduction in the CLABSI rate in the ICU setting. 展开更多
关键词 Bloodstream infection central line Intensive Care Unit MICROBIOLOGY Prevention bundle Kingdom of Bahrain
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Central line-associated bloodstream infection among children with biliary atresia listed for liver transplantation 被引量:2
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作者 Nicole D Triggs Stacey Beer +5 位作者 Sonam Mokha Kat Hosek Danielle Guffey Charles G Minard Flor M Munoz Ryan W Himes 《World Journal of Hepatology》 CAS 2019年第2期208-216,共9页
BACKGROUND Pre-transplant nutrition is a key driver of outcomes following liver transplantation in children.Patients with biliary atresia(BA) may have difficulty achieving satisfactory weight gain with enteral nutriti... BACKGROUND Pre-transplant nutrition is a key driver of outcomes following liver transplantation in children.Patients with biliary atresia(BA) may have difficulty achieving satisfactory weight gain with enteral nutrition alone,and parenteral nutrition(PN) may be indicated.While PN has been shown to improve anthropometric parameters of children with BA listed for liver transplantation,less is known about the risks,particularly infectious,associated with this therapy among this specific group of patients.AIM To describe the incidence,microbiology,and risk factors of central line-associated bloodstream infection(CLABSI) among children with BA listed for liver transplantation.METHODS Retrospective review of children aged ≤ 2-years of age with BA who were listed for primary liver transplantation at Texas Children's Hospital from 2008 through2015(n = 96).Patients with a central line for administration of PN(n = 63) were identified and details of each CLABSI event were abstracted.We compared the group of patients who experienced CLABSI to the group who did not,to determine whether demographic,clinical,or laboratory factors correlated with development of CLABSI.RESULTS Nineteen of 63 patients(30%,95%CI:19,43) experienced 29 episodes of CLABSI during 4800 line days(6.04 CLABSI per 1000 line days).CLABSI was predominantly associated with Gram-negative organisms(14/29 episodes,48%)including Klebsiella spp.,Enterobacter spp.,and Escherichia coli.The sole polymicrobial infection grew Enterobacter cloacae and Klebsiella pneumoniae.Grampositive organisms(all Staphylococcus spp.) and fungus(all Candida spp.)comprised 9/29(31%) and 6/29(21%) episodes,respectively.No demographic,clinical,or laboratory factors were significantly associated with an increased risk for the first CLABSI event in Cox proportional hazards regression analysis CONCLUSION There is substantial risk for CLABSI among children with BA listed for liver transplantation.No clinical,demographic,or laboratory factor we tested emerged as an independent predictor of CLABSI.While our data did not show an impact of CLABSI on the short-term clinical outcome,it would seem prudent to implement CLABSI reduction strategies in this population to the extent that each CLABSI event represents potentially preventable hospitalization,unnecessary healthcare dollar expenditures,and may exact an opportunity cost,in terms of missed allograft offers. 展开更多
关键词 PARENTERAL nutrition central line-associated BLOODSTREAM infection Pediatric Microbiology central VENOUS CATHETER
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Central venous catheterization-related complications in a cohort of 100 hospitalized patients:An observational study
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作者 Reena Singh Naimish Patel +2 位作者 Nidhi Mehta Gaurav Singh Nirav Patel 《Journal of Acute Disease》 2023年第4期169-172,共4页
Objective:To evaluate the complications of central venous catheterization(CVC).Methods:A prospective,observational study was conducted at a tertiary care center in India from December 2018 to September 2020.Critically... Objective:To evaluate the complications of central venous catheterization(CVC).Methods:A prospective,observational study was conducted at a tertiary care center in India from December 2018 to September 2020.Critically ill patients(aged≥18 years)in the intensive care unit undergoing CVC procedures were included in the study.Baseline demographics and detailed medical history were recorded.Chest X-rays and electrocardiography were performed on all the patients.Complications associated with CVC were recorded.Results:A total of 100 patients with the indication for central venous catheter insertion were included.The majority(81%)of the patients were inserted with CVC at the right internal jugular vein.Complications such as arterial puncture(2%),hematoma(4%),blood clot formation(4%),catheter kinking(3%),thoracic injury(1%),thrombophlebitis(6%),sepsis(9%)and nerve injury(1%)were reported.Conclusions:Though central venous access is preferred in management of critically ill patients,it has its risks.However,early recognition and prompt management of complications may reduce mortality and morbidity.Physicians and intensive care unit intensivists should be vigilant for central venous catheter-related complications.Suitable site selection,operator experience,and proper catheter maintenance are associated with optimal outcomes. 展开更多
关键词 central venous catheter COMPLICATIONS central line central venous access Critical care Internal jugular vein
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三级甲等医院ICU中心静脉导管相关血流感染防控护理实践现况
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作者 彭飞 李阳洋 +2 位作者 王芳 荆瑶 蔡虻 《中国护理管理》 CSCD 北大核心 2024年第1期24-29,共6页
目的 :调查三级甲等医院ICU中心静脉导管相关血流感染(Central Line-AssociatedBloodStreamInfections,CLABSI)三级质量控制中的共性问题,为进一步制订干预措施、促进护理质量持续改进提供依据。方法 :基于Donabedian三维质量结构模型,... 目的 :调查三级甲等医院ICU中心静脉导管相关血流感染(Central Line-AssociatedBloodStreamInfections,CLABSI)三级质量控制中的共性问题,为进一步制订干预措施、促进护理质量持续改进提供依据。方法 :基于Donabedian三维质量结构模型,借鉴《预防血管内导管相关血流感染过程质控工具包(推荐版)》中四大指引量表,自行编制ICU中心静脉导管相关血流感染防控护理实践调查问卷,采用便利抽样法于2023年9月—10月对中华护理学会医院感染管理专业委员会委员所在三级甲等医院ICU进行问卷调查分析。结果 :共129家医院的215个ICU完成调查,护理实践结构维度中,156个(72.56%)ICU定期进行CLABSI培训;过程维度中,护士执行率低于80%的项目有10项(31.25%),其中52个(24.19%)ICU在CVC穿刺时使用超声引导,59个(27.44%)ICU采用指南推荐的思乐扣固定导管,55个(25.58%)ICU使用葡萄糖氯己定抗菌敷料。结果维度中,193个(89.77%)ICU填写了CLABSI发生率。结论 :目前CLABSI防控聚焦导管置管和维护过程中的结构、过程及结果环节,但调研发现临床仍未形成同质化的防控措施。建议进一步加强过程质控管理,以期更好地改进护理质量。 展开更多
关键词 中心静脉导管相关血流感染 调查研究 护理 三级质控 医院感染与控制
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SHEA/IDSA/APIC实践建议:预防医院感染策略纲要(2022年更新版)
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作者 肖园园 谭彩霞(译) +3 位作者 吴安华(审校) Yokoe DA Advani SD Anderson DJ 《中国感染控制杂志》 CAS CSCD 北大核心 2024年第5期652-660,共9页
美国医疗保健流行病学学会/美国感染病协会/感染控制和流行病学专业人员协会(SHEA/IDSA/APIC)2022年更新了“急诊医院医疗保健相关感染的预防策略纲要”,内容包括“导尿管相关尿路感染(CAUTI)的预防策略”“中央导管相关血流感染(CLABSI... 美国医疗保健流行病学学会/美国感染病协会/感染控制和流行病学专业人员协会(SHEA/IDSA/APIC)2022年更新了“急诊医院医疗保健相关感染的预防策略纲要”,内容包括“导尿管相关尿路感染(CAUTI)的预防策略”“中央导管相关血流感染(CLABSI)的预防策略”“艰难梭菌感染(CDI)的预防策略”“预防耐甲氧西林金黄色葡萄球菌(MRSA)传播和感染的策略”“手术部位感染(SSI)的预防策略”“呼吸机相关肺炎(VAP)和呼吸机相关事件(VAE)的预防策略”“预防非呼吸机医院获得性肺炎(NV-HAP)的策略”“通过手卫生预防医疗保健相关感染的策略”“实施预防医疗保健相关感染的策略”九部分。 展开更多
关键词 医院感染 导尿管相关尿路感染 中央导管相关血流感染 艰难梭菌感染 耐甲氧西林金黄色葡萄球菌 手术部位感染 呼吸机相关肺炎 呼吸机相关事件 非呼吸机医院获得性肺炎 手卫生 医疗保健相关感染 预防策略
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周向六线起爆下杀伤战斗部的破片飞散特性
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作者 刘恒言 姬聪生 +1 位作者 何勇 梁争峰 《火炸药学报》 EI CAS CSCD 北大核心 2024年第1期72-80,共9页
为简化起爆结构,提高引战系统可靠性,采用定向战斗部已有的周向六线起爆方式替代中心起爆,基于流体动力学理论对周向六线起爆下爆轰波的碰撞进行了理论分析,采用LS-DYNA进行了数值计算,并开展了战斗部样弹静爆试验。结果表明,相较于中... 为简化起爆结构,提高引战系统可靠性,采用定向战斗部已有的周向六线起爆方式替代中心起爆,基于流体动力学理论对周向六线起爆下爆轰波的碰撞进行了理论分析,采用LS-DYNA进行了数值计算,并开展了战斗部样弹静爆试验。结果表明,相较于中心起爆,周向六线起爆条件下破片加速历程与其所在周向位置存在关联,并出现二次加速现象;在相邻起爆点对称面附近产生马赫爆轰波,局部压力可达44.2GPa,并在战斗部中心汇聚,中心处压力可达100GPa以上;轴向多点起爆改善了端面稀疏波的影响,破片速度得到提升,轴向破片速度一致性明显提高;破片飞散初速数值计算与试验结果误差在8.1%以内,不同区域破片初速增益可达4.6%~9.9%。表明周向六线起爆模式是替代定向杀伤战斗部中心起爆模式的有效途径。 展开更多
关键词 爆炸力学 定向杀伤战斗部 周向六线起爆 中心起爆 破片飞散特性 破片速度增益
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榆树坡矿长距离巷道贯通测量误差控制及分析
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作者 赵敏 《煤炭与化工》 CAS 2024年第1期78-80,87,共4页
巷道对掘可以提高掘进效率,但对测量提出了更高的要求。为了尽快形成工作面系统,榆树坡矿在5201工作面进风顺槽采用双向对掘的施工方式。结合工作面的实际情况,确定了巷道贯通的测量方案。为保证顺利贯通,提出了测角精度控制以及中线控... 巷道对掘可以提高掘进效率,但对测量提出了更高的要求。为了尽快形成工作面系统,榆树坡矿在5201工作面进风顺槽采用双向对掘的施工方式。结合工作面的实际情况,确定了巷道贯通的测量方案。为保证顺利贯通,提出了测角精度控制以及中线控制等措施。结果表明,贯通点水平误差和高程误差分别为88.6 mm和47.1 mm,满足精度要求,工作面提前投产,可为长距离顺槽巷道的掘进提供参考。 展开更多
关键词 长距离巷道 贯通测量 误差分析 中线控制
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肿瘤病人PICC导管相关血流感染评估工具研究进展
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作者 于倩倩 赵素琴 赵丽婷 《循证护理》 2024年第7期1197-1201,共5页
总结经外周静脉置入中心静脉导管(PICC)肿瘤病人发生中央静脉导管相关血流感染(CLABSI)的研究现状,提出有效的风险预测模型或可成为临床早期评估肿瘤病人发生PICC导管相关血流感染(PICC-CLABSI)的有效客观工具,建议临床进一步加强对肿... 总结经外周静脉置入中心静脉导管(PICC)肿瘤病人发生中央静脉导管相关血流感染(CLABSI)的研究现状,提出有效的风险预测模型或可成为临床早期评估肿瘤病人发生PICC导管相关血流感染(PICC-CLABSI)的有效客观工具,建议临床进一步加强对肿瘤病人发生PICC-CLABSI的危险因素评估探索,通过预测模型补充肿瘤病人发生PICC-CLABSI客观评估手段的不足。 展开更多
关键词 经外周静脉置入中心静脉导管 中央导管相关血流感染 肿瘤病人 风险预测模型 综述
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无缝钢管智能制造探索与实践
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作者 周亮 《钢管》 CAS 2024年第2期46-52,共7页
针对无缝钢管传统生产中面临的痛点问题,本着“高效率、高质量、低成本、绿色环保”的基本原则,提出了无缝钢管智能制造的探索方案,即建设以工业互联网平台为基础的数字化产线,打造智能作业系统、产线智能操控和管控系统以及全厂智能管... 针对无缝钢管传统生产中面临的痛点问题,本着“高效率、高质量、低成本、绿色环保”的基本原则,提出了无缝钢管智能制造的探索方案,即建设以工业互联网平台为基础的数字化产线,打造智能作业系统、产线智能操控和管控系统以及全厂智能管控体系,实行产线集中控制,并通过对数据的深度挖掘和运用,最终实现无缝钢管产线高效率、高品质及低成本平稳运行。结合工程实践进一步对无缝钢管企业智能化转型中需注意的问题和所面临的难点做了阐述和分析。 展开更多
关键词 无缝钢管 智能制造 产线智能操控和管控 全厂智能管控 集中控制
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高寒膨胀土地区单线铁路隧道深埋中心水沟的施工方法
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作者 张琦 宋佳 +1 位作者 赵宝毓 隋雨佳 《黑龙江交通科技》 2024年第4期139-142,共4页
高寒、膨胀土地区单线铁路隧道深埋中心水沟施工空间小、基坑深、坑壁渗水严重时坑壁易失稳滑塌,施工难度极大。北黑铁路升级改造工程卧牛隧道在深埋中心水沟开挖过程中发生严重渗水,采用传统喷锚网施工方法不能保证坑壁的稳定性且严重... 高寒、膨胀土地区单线铁路隧道深埋中心水沟施工空间小、基坑深、坑壁渗水严重时坑壁易失稳滑塌,施工难度极大。北黑铁路升级改造工程卧牛隧道在深埋中心水沟开挖过程中发生严重渗水,采用传统喷锚网施工方法不能保证坑壁的稳定性且严重威胁作业人员安全。为顺利开展施工,研究探索出一种在洞外预制支护构件的方法,将支护刚度提前形成,在基坑开挖后直接吊装就位。通过对传统工艺进行革新,成功解决了施工难题,降低了人员在深埋中心水沟施工时的作业时间,降低了安全风险。 展开更多
关键词 高寒地区 单线铁路隧道 膨胀土 深埋中心水沟 预制支护构件
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Investigation and Analysis of the Status Quo of Prevention and Control Practices of Catheter-Line Associated Bloodstream Infections (CLABSI) in Guangxi, China 被引量:1
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作者 Caijiao Wu Huihan Zhao +3 位作者 Galal A. Al-Samhari Qingjuan Jiang Ying Ling Yanping Ying 《Advances in Infectious Diseases》 2021年第4期333-343,共11页
The prevention and control of catheter line-associated bloodstream infections (CLABSI) have become the key content of medical care and have become the core improvement goal of nursing quality control. However, the pre... The prevention and control of catheter line-associated bloodstream infections (CLABSI) have become the key content of medical care and have become the core improvement goal of nursing quality control. However, the prevention and control status of CLABSI in hospitals of different grades in Guangxi is not clear. In this study, we aim to investigate central venous catheter (CVC) placement and disinfectant use in second and third-level hospitals in Guangxi. This survey was conducted on the second and third-level hospitals in Guangxi, China from 13th April 2021 to 19th April 2021. The results show that a total of 283 questionnaires were collected, including 206 secondary hospitals and 77 tertiary hospitals. In terms of the CVC, tertiary hospitals were able to place CVC entirely under the guidance of B-ultrasound, which was 24 (31.6%) and secondary hospitals were 26 (20.6%). In secondary hospitals, Most CVC placements were performed in operating rooms 94 (74.6%) and 65 (85.5%) on the third level hospital, but 32.5% of secondary hospitals and 48.7% of tertiary hospitals were selected at the bedside of patients in general wards, and 27.8% of the second-level hospital, 43.4% of third-level hospitals was done in general ward treatment rooms, only 61.9% of secondary hospitals and 64.5% of tertiary hospitals could fully achieve the maximum sterile barrier. In terms of skin disinfectants, only 36.0% of tertiary hospitals and 16.4% of second-level CVC-operators chose > 0.5% chlorhexidine alcohol. In conclusion, the prevention and control of catheter line-associated bloodstream infections (CLABSI) in Guangxi are not ideal. The prevention and control department should increase training, implement guidelines and standardize management to reduce the incidence of CLABSI. 展开更多
关键词 central Venous Catheter Catheter-line Associated Bloodstream Infections PREVENTION Quality Control Survey
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Confirming longline position in neonates-Survey of practice in England and Wales 被引量:1
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作者 Arunoday Arunoday Christos Zipitis 《World Journal of Clinical Pediatrics》 2017年第3期149-153,共5页
AIM To establish how neonatal units in England and Wales currently confirm longline tip position, immediately after insertion of a longline.METHODS We conducted a telephone survey of 170 neonatal units(37 special care... AIM To establish how neonatal units in England and Wales currently confirm longline tip position, immediately after insertion of a longline.METHODS We conducted a telephone survey of 170 neonatal units(37 special care baby units, 81 local neonatal units and 52 neonatal intensive care units) across England and Wales over the period from January to May 2016. Data was collected on specifically designed proformas. We gathered information on the following: Unit Level designation; whether the unit used longlines and specific type used? Modality used to confirm longline tip position? Whether guide wires were routinely removed and contrast injected to determine longline position? The responders were primarily senior nurses.RESULTS We had 100% response rate. Out of the total neonatal units surveyed(170) in England and Wales, 141 units(83%) used longlines. Fifty-five out of 81 local neonatal units(68%) using longlines, used ones that came with guide wires; a similar percentage of neonatal intensive care units, i.e., 31 out of 52 units(60%) did the same. All of those units used radiography, plain X-rays, to establish longline tip position. Out of 55 local neonatal units usinglonglines with guide wires, 42(76%) were not removing wire to use contrast while this figure was 58%(18 out of 31 units) for neonatal intensive care units. Overall, only 49 out of 141 units(35%) of the units using longlines were using contrast. However it was interesting to note that use of contrast increased as one moved from special care baby units(25%, 2 out of 8 units) to local neonatal units(28%, 23 out of 81 units) and neonatal intensive care units level(46%, 24 out of 52 units) designation. CONCLUSION Neonatal units in England and Wales are overwhelmingly relying on plain radiographs to assess longline tip position immediately after insertion. Despite evidence of its usefulness, and in the absence of perhaps more accurate methods of assessing longline tip position in a reliable and consistent way, i.e., ultrasonography, contrast is only used in a third of units. 展开更多
关键词 central VENOUS CATHETERS NEWBORN Contrast media line placement PREMATURE INFANTS
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交流转辙机在线监测技术研究与应用
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作者 邓新江 秦汉泽 +3 位作者 康宏玲 杜瑜 王友香 杨云国 《铁道通信信号》 2024年第5期104-111,共8页
针对既有信号集中监测系统存在三相交流转辙机的模拟量和开关量监测不完善,监测信息间缺少交叉关联,不能支撑监测数据深度挖掘分析,以及升级改造时存在设备投资大、运营成本高等问题,提出一种融合传感器、计算机在线监测、信号处理等技... 针对既有信号集中监测系统存在三相交流转辙机的模拟量和开关量监测不完善,监测信息间缺少交叉关联,不能支撑监测数据深度挖掘分析,以及升级改造时存在设备投资大、运营成本高等问题,提出一种融合传感器、计算机在线监测、信号处理等技术的改进方案,实现三相交流转辙机在状态表示时,提前对室外动作电路完整性、道岔动作转换过程中关键继电器状态、转辙机自动开闭器动接点动作时序及位置状态等的在线监测。通过信号集中监测系统的升级改造,验证了该方案的应用效果。该方案不仅设备投资少、运营维护成本低,而且适用于各版本监测系统升级,可为同类型工程改造提供参考,同时也可推广应用于地铁、轻轨、铁路等轨道交通领域。 展开更多
关键词 交流转辙机 信号集中监测系统 道岔电路 提速道岔 在线监测 信号继电器
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Glacier reconstruction of La Covacha Massif in Sierra de Gredos(central Spain) during the Last Glacial Maximum
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作者 Néstor CAMPOS David PALACIOS Luis M.TANARRO 《Journal of Mountain Science》 SCIE CSCD 2019年第6期1336-1352,共17页
A paleoglacier reconstruction during the Last Glacial Maximum(LGM) is presented for a high mountain area of La Covacha massif in Sierra de Gredos(Iberian Central System) in central Spain. The moraines that, according ... A paleoglacier reconstruction during the Last Glacial Maximum(LGM) is presented for a high mountain area of La Covacha massif in Sierra de Gredos(Iberian Central System) in central Spain. The moraines that, according with the previous literature, had formed during the global LGM, were mapped through photo interpretation of digital aerial photographs and 3D images and detailed field surveys. The topography of the paleoglaciers was estimated using a simple steady-state model that assumed a perfectly plastic ice rheology, reconstructing the theoretical ice profiles and obtaining the ice thickness of the glaciers during the LGM. The reconstruction of the glaciers was carried out using automated and semi-automated physically-based models, obtaining more realistic results with semi-automated models. According to our study, the paleoglaciers in the study area covered an area of 34.79 km^2 during the global LGM, with a maximum ice thickness of 366 meters in La Vega gorge, a total volume of 34.25 × 108 m^3 and a mean paleoELA of 1932 meters. Most of the ice(~82%) was in paleoglaciers facing north, and the rest was in paleoglaciers with other orientations. This emphasizes the importance of orientation in relation to glacier dynamics and ice accumulation. The results obtained in the calculation of paleoELAs during the global LGM in Gredos are average compared to the Iberian mountains of the Northwest where the values were much lower, and with respect to those of the Southwest, much higher. This demonstrates the importance of the exposure of Mediterranean mountains to the humidity sources coming from the NW during the global LGM, as is the case at present. 展开更多
关键词 GLACIER reconstruction Paleoglacier ICE thickness EQUILIBRIUM line ALTITUDE Iberian central System
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“四体系一平台”护理管理模式在预防ICU中心导管相关血流感染中的应用研究
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作者 高明榕 薛卫华 +2 位作者 唐宇君 申贵江 成守珍 《现代临床护理》 2023年第9期25-30,共6页
目的探讨“四体系一平台”护理管理模式预防重症监护病房(intensive care unit,ICU)中心导管相关血流感染(central line associated blood stream infection,CLABSI)的效果,降低CLABSI发生率。方法采用不同病例前-后对照研究,选取2019年... 目的探讨“四体系一平台”护理管理模式预防重症监护病房(intensive care unit,ICU)中心导管相关血流感染(central line associated blood stream infection,CLABSI)的效果,降低CLABSI发生率。方法采用不同病例前-后对照研究,选取2019年9月至2021年8月本院4个外科ICU病区收治的5968例患者作为研究对象,其中2019年9月至2020年8月收治的2852例患者设为实施前组,2020年9月至2021年8月收治的3116例患者设为实施后组。实施前组应用常规护理管理方法,实施后组应用“四体系一平台”护理管理模式。比较两组患者CLABSI发生率,实施前后护士输液附加装置更换合格率、手卫生依从性;两组患者置管最大无菌屏障合格率、皮肤消毒合格率。结果应用“四体系一平台”护理管理模式后,患者CLABSI率由1.96‰(29/14765)降至0.97‰(17/17458),两组比较,差异具有统计学意义(χ^(2)=5.504,P=0.019);护士输液附加装置更换合格率(92.86%v 99.73%,χ^(2)=264.498,P<0.001)、手卫生方法正确率(99.02%v 99.73%,χ^(2)=32.342,P<0.001)、手卫生依从性(99.18%v 99.49%,χ^(2)=5.664,P=0.019)、最大无菌屏障合格率(95.93%v 99.69%,χ^(2)=10.399,P=0.002)、皮肤消毒合格率(93.61%v 98.80%,χ^(2)=67.630,P<0.001)均较实施前组提高,两组比较,差异有统计学意义。结论“四体系一平台”护理管理模式有利于促进ICU护士在导管维护时的规范性、有效性和依从性,降低ICU患者CLABSI率。 展开更多
关键词 中心静脉导管相关血流感染 重症监护病房 四体系一平台 护理管理 不同病例前-后对照研究
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新冠疫情期间住院患儿院内感染及多重耐药菌变化趋势分析
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作者 苏春妹 张志勤 +1 位作者 虞景 王雪 《江苏卫生事业管理》 2023年第12期1670-1674,1678,共6页
目的:回顾性分析新冠疫情对住院患儿院内感染产生的影响以及多重耐药菌的变化。方法:收集2017年至2022年的医院感染监测数据,包括重点关注部位和科室、器械相关性感染和多重耐药菌数据。对新冠疫情前和疫情期间的数据进行比较和分析。结... 目的:回顾性分析新冠疫情对住院患儿院内感染产生的影响以及多重耐药菌的变化。方法:收集2017年至2022年的医院感染监测数据,包括重点关注部位和科室、器械相关性感染和多重耐药菌数据。对新冠疫情前和疫情期间的数据进行比较和分析。结果:共收集疫情前185116名和疫情期间218681名住院患儿的数据。与疫情前相比,疫情期间患儿平均住院天数从6.5天下降至6.1天,NICU、ICU和SICU的平均住院天数增加。住院患儿的感染率从2.7%降至1.79%,呼吸机的使用率从0.9%增加至1.3%,VAP感染率从6.08‰降至2.55‰,中央血管导管使用率从3.42‰增加至13.97‰,均差异显著(P<0.001),CLABSI、住院患儿导尿管的使用率、CAUTI无统计学差异。除ICU多重耐药菌检出率从30%增加至42%,全院多重耐药菌检出率无统计学差异。检出MRSA与CRE占比下降,CRAB与CRPA占比增加。结论:疫情期间各种阻断病毒传播的防控措施使全院住院患儿感染率下降,设备相关的VAP感染率显著降低。医院应继续加强院内感染控制措施,预防可能增加的多重耐药菌的发生。 展开更多
关键词 COVID-19 医院感染 呼吸机相关性肺炎 导尿管相关尿路感染 中央导管相关血流感染 多重耐药菌
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A new optimal approach to segmentation of 2D range scans to line sections 被引量:1
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作者 张亮 蒋荣欣 陈耀武 《Journal of Central South University》 SCIE EI CAS 2009年第5期807-814,共8页
In order to obtain a compact and exact representation of 2D range scans,UKF(unscented Kalman filter) and CDKF(central difference Kalman filter) were proposed for extracting the breakpoint of the laser data. Line extra... In order to obtain a compact and exact representation of 2D range scans,UKF(unscented Kalman filter) and CDKF(central difference Kalman filter) were proposed for extracting the breakpoint of the laser data. Line extraction was performed in every continuous breakpoint region by detecting the optimal angle and the optimal distance in polar coordinates,and every breakpoint area was constructed with two points. As a proof to the method,an experiment was performed by a mobile robot equipped with one SICK laser rangefinder,and the results of UKF/CDKF in breakpoint detection and line extraction were compared with those of the EKF(extended Kalman filter) . The results show that the exact geometry of the raw laser data of the environments can be obtained by segmented raw measurements(combining the proposed breakpoint detection approach with the line extraction method) ,and method UKF is the best one compared with CDKF and EKF. 展开更多
关键词 二维扫描 扩展卡尔曼滤波 分割 扫描线 激光测距 提取方法 中断点 移动机器人
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两段三产品旋流器应用于尾矿分级试验研究 被引量:1
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作者 刘小平 卢涛 +6 位作者 吴启明 周炳 龙学君 冯模伦 王磊 李永峰 宋坤 《有色金属(选矿部分)》 CAS 北大核心 2023年第4期113-118,共6页
根据实验室FX250/200型两段三产品水力旋流器的结构参数放大并制作了一台工业用两段连体三产品旋流器。通过实验室试验、工业试验,优化新型两段连体三产品旋流器的一段溢流管直径、二段溢流管直径、一段底流锥开度、二段沉砂口直径、二... 根据实验室FX250/200型两段三产品水力旋流器的结构参数放大并制作了一台工业用两段连体三产品旋流器。通过实验室试验、工业试验,优化新型两段连体三产品旋流器的一段溢流管直径、二段溢流管直径、一段底流锥开度、二段沉砂口直径、二段补水量,获得了沉砂—0.074 mm粒级含量13.85%,总溢流中—0.074 mm粒级含量87.21%,沉砂产率为35.72%的理想筑坝粗砂。同时也优化了中线法筑坝工艺,降低了投资及生产成本。 展开更多
关键词 新型 三产品旋流器 尾砂分级 筑坝 中线法 优化 成本
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某“三甲”医院中央导管相关血流感染因素分析及临床分布 被引量:1
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作者 王新晴 于丰源 +1 位作者 袁桂敏 马学英 《卫生职业教育》 2023年第12期133-136,共4页
研究2015年1月至2019年12月某“三甲”医院发生中央导管相关血流感染(CLABSI)的相关因素及全院临床分布,提升医务人员对CLABSI的认识,为医院防治措施提供依据,减少CLABSI的发生。
关键词 中央导管 血流感染 临床分布
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