A cross-sectional study on the nurses’attitude towards rapid response system activation for clinically deteriorated patients

Background:Hospitals have reported that implementing rapid response system activation(RRS)activation has increased patient safety.As a result,there has been growing interest in identifying factors that lead to successful RRS activation.While introducing an automated RRS activation system has prompted nurses to be more vigilant about monitoring vital signs,it has not necessarily encouraged them to conduct thorough patient assessments to identify early signs of deterioration.Purpose:The current study aimed to assess nurses’attitudes towards RRS activation for clinically deteriorated patients in the clinical units of King Abdul-Aziz Hospital.Methods:A descriptive cross-sectional research design was utilised in the study,and 144 nurses working in the medical and surgical units of King Abdul-Aziz Hospital were recruited to participate using a convenient non-probability sampling technique.Results:The study’s findings reported that nurses have a positive attitude towards RRS benefits(Mean=3.70;SD=0.70).Their overall attitude towards RRS activation among clinically deteriorated patients is still low positive(Mean=2.71;SD=0.61).The nurses’attitudes towards RRS benefits significantly differ among nationalities and the clinical area/unit where they were assigned,with a P-value of 0.0194 and 0.000,respectively.Attitudes towards RRS barriers significantly differ among nationality(P-value=0.0037),education level(P-value=0.0032),area of assignment(P-value=0.020),and whether they have a good understanding of abnormal observations(P-value=0.0122).Regarding the nurses’attitude towards management belief,the significant result is only with the clinical area/unit of assignment with a P-value of 0.000.Conclusion:The current study found a low positive attitude towards RRS activation among ward nurses,especially given that monitoring vital signs is critical to their job.Nurses may fear being perceived as clinically inept for redundant activations caused by poor quality,but their attitude towards activating the RRS in clinical deterioration is still largely negative.This is because most RRSs rely on ward nurses to recognise clinical deterioration and manually alert responders through phone calls,hospital communication systems,or face-to-face communication.

Synthesis of spinel ferrite and its role in the removal of free fatty acids from deteriorated vegetable oil

Deterioration and loss of quality of vegetable oil is a big challenge in the food industry.This study investigated the synthesis of nickel ferrite(Ni Fe_(2)_(O4))via co-precipitation method and its use for the removal of free fatty acids(FFAs)in deteriorated vegetable oil.Ni Fe2 O4 was characterized using Fourier transformed infrared spectroscopy(FTIR),X-ray diffraction(XRD),thermogravimetric(TG)analysis,Brunauer–Emm ett–Teller(BET)surface area,transmission electron microscopy(TEM),scanning electron microscopy(SEM)and energy-dispersive X-ray spectroscopy(EDX).Synthesis of Ni Fe_(2)_(O4)was confirmed by characterization,which revealed a BET surface area of 16.30 m^(2)·g^(-1)and crystallite size of 29 nm.Ni Fe_(2)_(O4)exhibited an adsorption capacity of 145.20 L·kg^(-1)towards FFAs with an 80.69%removal in a process,which obeys Langmuir isotherm and can be described by the pseudo-second-order kinetic model.The process has enthalpy(DH)of 11.251 k Jámolà1 and entropy(DS)of 0.038 k J·mol^(-1)K^(-1)with negative free energy change(DG),which suggests the process to be spontaneous and endothermic.The quantum chemical computation analysis via density functional theory further revealed the sorption mechanism of FFAs by Ni Fe_(2)_(O4)occurred via donor–acceptor interaction,which may be described by the lowest unoccupied molecular orbital(LUMO)and the highest occupied molecular orbital(HOMO).The study showed Ni Fe_(2)_(O4)to be a potential means that can remove FFAs from deteriorated vegetable oil.

Axial compressive behaviors of partial deteriorated strength concrete columns confined with CFRP

This paper aims to present an effective method to partial deteriorated strength columns,and to investigate the mechanical behavior of the defect part. Five groups of 150×150 mm×mm plain square columns are cast; each specimen has two different strengths,the lower strength in the middle segment and higher strength in both ends. The lower strength is to simulate the status of partial deteriorated region. Different layers of CFRP sheets have been wrapped just on the lower strength part to gain the reinforcement with CFRP sheets,and to verify the practicability of partial confinement. Specimens are subjected to monotonic axial compression until failure. Axial load,axial and transverse strains are measured to compare the different behaviors between the two parts. Experimental results show that partial confinement can significantly enhance the strength and the ductility of the deteriorated strength part,then,the load capacity of the whole column can be increased subsequently. Test data indicate that the ultimate load of the confined column is higher than that of the original column without deterioration; partial confinement on weakness is a feasible approach.

Optimal Policy and Simple Algorithm for a Deteriorated Multi-Item EOQ Problem

This paper considers a deteriorated multi-item economic order quantity (EOQ) problem, which has been studied in literature, but the algorithms used in the literature are limited. In this paper, we explore the optimal policy of this inventory problem by analyzing the structural properties of the model, and introduce a simple algorithm for generating the optimal solution to this problem. Numerical results are reported to show effi-cacy of the proposed method.

World Economic Survey World Economic Climate Deteriorates

The Ifo World Economic Climate Index fell in October 2008 to the historically lowest level since more than 20 years (60.0;1995=100). The decline is primarily the result of more unfavourable assessments of the current economic situation,but also the expectations for the coming six months have worsened further.

MAINTENANCE OF MULTI-STATE PRODUCTION SYSTEMS DETERIORATED BY RANDOM SHOCKS AND PRODUCTION

We consider the preventive maintenance of a production system that is deteriorated by random shocks and the production process itself. The degree of deterioration is modeled by discrete and finite states. Shocks arrive according to a Poisson process and deteriorate the system by random amounts. The system may deteriorate whenever it produces an item. The system is continuously monitored and repaired if the system state is at or above a predetermined level for maintenance. We analyze the lifetime, product quantity, average cost, and average profit considering revenue from the product and cost due to setup, operation, and repair. Assuming a structure of system parameters and costs, using numerical examples, we investigate the impact of production and shock arrivals on the average profit and the optimal maintenance level that maximizes the average profit. The proposed model is applicable to manufacturing tasks in which machines wear due to production, for example, press processes, milling, turning, punching, and drilling.

Mechanical Modeling and Analysis of Stability Deterioration of Production Well During Marine Hydrate Depressurization Production

Different from oil and gas production,hydrate reservoirs are shallow and unconsolidated,whose mechanical properties deteriorate with hydrate decomposition.Therefore,the formations will undergo significant subsidence during depressurization,which will destroy the original force state of the production well.However,existing research on the stability of oil and gas production wells assumes the formation to be stable,and lacks consideration of the force exerted on the hydrate production well by formation subsidence caused by hydrate decomposition during production.To fill this gap,this paper proposes an analytical method for the dynamic evolution of the stability of hydrate production well considering the effects of hydrate decomposition.Based on the mechanical model of the production well,the basis for stability analysis has been proposed.A multi-field coupling model of the force state of the production well considering the effect of hydrate decomposition and formation subsidence is established,and a solver is developed.The analytical approach is verified by its good agreement with the results from the numerical method.A case study found that the decomposition of hydrate will increase the pulling-down force and reduce the supporting force,which is the main reason for the stability deterioration.The higher the initial hydrate saturation,the larger the reservoir thickness,and the lower the production pressure,the worse the stability or even instability.This work can provide a theoretical reference for the stability maintaining of the production well.

Deterioration Reason and Improvement Measure of the Retarding Effect of Protein Retarder on Phosphorus Building Gypsum

The retarding effect of protein retarder on phosphorus building gypsum(PBG)and desulfurization building gypsum(DBG)was investigated,and the results show that protein retarder for DBG can effectively prolong the setting time and displays a better retarding effect,but for PBG shows a poor retarding effect.Furthermore,the deterioration reason of the retarding effect of protein retarder on PBG was investigated by measuring the pH value and the retarder concentration of the liquid phase from vacuum filtration of PBG slurry at different hydration time,and the measure to improve the retarding effect of protein retarding on PBG was suggested.The pH value of PBG slurry(<5.0)is lower than that of DBG slurry(7.8-8.5).After hydration for 5 min,the concentration of retarder in liquid phase of DBG slurry gradually decreases,but in liquid phase of PBG slurry continually increases,which results in the worse retarding effect of protein retarder on PBG.The liquid phase pH value of PBG slurry can be adjusted higher by sodium silicate,which is beneficial to improvement in the retarding effect of the retarder.By adding 1.0%of sodium silicate,the initial setting time of PBG was efficiently prolonged from 17 to 210 min,but little effect on the absolute dry flexural strength was observed.

Research on the quality deterioration of UHT milk products during shelf life:core microorganisms and related characteristics

Commercial sterility does not guarantee the sustained stability of ultrahigh temperature(UHT)milk over 6 months shelf life.We explore the microbiota presented in normal(SZ)and quality deteriorated UHT milk(QY and WY)products from the same brand.Based on high-throughput sequencing research results,11 phyla and 54 genera were identified as dominant microbiota.Pseudomonas,Streptococcus,and Acinetobacter as core functional microbiota significantly influenced the UHT milk quality properties.Moreover,principal component analysis(PCA)and multivariate analyses were used to examine the quality characteristics,including 11 physicochemical parameters,10 fatty acids,and 2 enzyme activities,in normal and quality deteriorated UHT milk.We found that the abundance of Pseudomonas increased in quality deteriorated milk(WY)and showed a significant positive correlation with heat-resistant protease content.Acinetobacter in quality deteriorated milk(QY)also considerably contributed to the content of heat-resistant lipase,which resulted in spoilage deterioration of UHT milk.

Damage degradation mechanism and macro-meso structural response of mudstone after water wetting

The predominant presence of weak interlayers primarily composed of mudstone renders them highly susceptible to a reduction in bearing capacity due to the water-rock weakening effect,significantly impacting the safety of open-pit mining operations.This study focuses on the weak mudstone layers within open-pit mine slopes.The mineral composition of mudstone and the microstructure evolution characteristics before and after water wetting were analyzed by X-ray diffraction(XRD)and scanning electron microscope(SEM).The meso-structure and parameter variation characteristics of mudstone interior space after water-rock interaction were quantified by computed tomography scanning test,and the damage variable characterization method was proposed.Additionally,according to the uniaxial compression test,the degradation characteristics of the macroscopic mechanical behavior of mudstone under different water wetting time were explored,and the elastic modulus and strength attenuation model of mudstone based on mesoscopic damage were established.Finally,building upon the macro-meso structural response characteristics of mudstone,an exploration of the failure characteristics and deterioration mechanism under the influence of water-rock interactions was undertaken.The results show that the water-rock interaction makes the internal defects of mudstone gradually develop and form a fracture network structure,which eventually leads to the deterioration of its macroscopic mechanical properties.The porosity,fractal dimension and damage characteristics of mudstone show an exponential trend with the increase of water wetting time.Moreover,the deterioration mechanism of mudstone after water wetting are postulated to encompass factors such as the hydrophilicity of mineral molecular structures,hydration stress and expansion effects on clay particles,as well as the spatial distribution of microcracks and the phenomenon of fracture adsorption.The outcomes of this research endeavor aim to provide certain reference value for further understanding the water-rock interaction and stability control of mudstone slope.

Analysis of quality-related proteins in golden pompano(Trachinotus ovatus)fillets with modified atmosphere packaging under superchilling storage

Here,we aimed to study the changes in proteome of golden pompano fillets during post-mortem storage.Tandem mass tags(TMT)-labeled quantitative proteomic strategy was applied to investigate the relationships between protein changes and quality characteristics of modified atmosphere packaging(MAP)fillets during superchilling(-3°C)storage.Scanning electron microscopy was used to show that the muscle histology microstructure of fillets was damaged to varying degrees,and low-field nuclear magnetic resonance was used to find that the immobilized water and free water in the muscle of fillets changed significantly.Total sulfhydryl content,TCA-soluble peptides and Ca2+-ATPase activity also showed that the fillet protein had a deterioration by oxidation and denaturation.The Fresh(FS),MAP,and air packaging(AP)groups were set.Total of 150 proteins were identified as differential abundant proteins(DAPs)in MAP/FS,while 209 DAPs were in AP/FS group.The KEGG pathway analysis indicated that most DAPs were involved in binding proteins and protein turnover.Correlation analysis found that 52 DAPs were correlated with quality traits.Among them,8 highly correlated DAPs are expected to be used as potential quality markers for protein oxidation and water-holding capacity.These results provide a further understanding of the muscle deterioration mechanism of packaging golden pompano fillets during superchilling.

Experimental investigation on shear strength deterioration at the interface between different rock types under cyclic loading

The shear strength deterioration of bedding planes between different rock types induced by cyclic loading is vital to reasonably evaluate the stability of soft and hard interbedded bedding rock slopes under earthquake;however,rare work has been devoted to this subject due to lack of attention.In this study,experimental investigations on shear strength weakening of discontinuities with different joint wall material(DDJM)under cyclic loading were conducted by taking the interface between siltstone and mudstone in the Shaba slope of Yunnan Province,China as research objects.A total of 99 pairs of similar material samples of DDJM(81 pairs)and discontinuities with identical joint wall material(DIJM)(18 pairs)were fabricated by inserting plates,engraved with typical surface morphology obtained by performing three-dimensional laser scanning on natural DDJMs sampled from field,into mold boxes.Cyclic shear tests were conducted on these samples to study their shear strength changes with the cyclic number considering the effects of normal stress,joint surface morphology,shear displacement amplitude and shear rate.The results indicate that the shear stress vs.shear displacement curves under each shear cycle and the peak shear strength vs.cyclic number curves of the studied DDJMs are between those of DIJMs with siltstone and mudstone,while closer to those of DIJMs with mudstone.The peak shear strengths of DDJMs exhibit an initial rapid decline followed by a gradual decrease with the cyclic number and the decrease rate varies from 6%to 55.9%for samples with varied surface morphology under different testing conditions.The normal stress,joint surface morphology,shear displacement amplitude and shear rate collectively influence the shear strength deterioration of DDJM under cyclic shear loading,with the degree of influence being greater for larger normal stress,rougher surface morphology,larger shear displacement amplitude and faster shear rate.

Transcatheter aortic valve replacement in low-risk young population:A double edge sword?

Since the advent of transcatheter aortic valve replacement(TAVR)in 2002,it has now become the default interventional strategy for symptomatic patients presenting with severe aortic stenosis,particularly in intermediate to highsurgical risk patients.In 2019,the United States Food and Drug Administration approved TAVR in low-risk patients based on two randomized trials.However,these breakthrough trials excluded patients with certain unfavorable anatomies and odd profiles.While currently there is no randomized study of TAVR in young patients,it may be preferred by the young population given the benefits of early discharge,shorter hospital stay,and expedite recovery.Nonetheless,it is important to ruminate various factors including lifetime expectancy,risk of pacemaker implantation,and the need for future valve or coronary interventions in young cohorts before considering TAVR in these patients.Furthermore,the data on long-term durability(>10 years)of TAVR is still unknown given most of the procedures were initially performed in the high or prohibitive surgical risk population.Thus,this editorial aims to highlight the importance of considering an individualized approach in young patients with consideration of various factors including lifetime expectancy while choosing TAVR against surgical aortic valve replacement.

Benefits of Aronia melanocarpa Elliot in Eye Protection

This paper reviews the main benefits of Aronia melanocarpa Elliot for eye health,focusing on its antioxidant protection,prevention of visual deterioration,reduction of inflammation,improvement of blood circulation,protection of the retina,and immunity enhancement.Based on the existing studies,the application of A.melanocarpa Elliot in the field of eye health is promising and deserves further research and promotion.

Flow and Heat Transfer Features of Supercritical Pressure CO_(2) in Horizontal Flows under Whole-Wall Heating Conditions

Based on the first and second laws of thermodynamics,the heat transfer and flow(thermohydraulic)characteristics of horizontal supercritical pressure CO_(2)(S-CO_(2))in a circular pipe under heating conditions were investigated numerically.Heating flows in two different diameters(d)of 4 and 6 mm were simulated in pipes with pressures of 8 MPa,mass fluxes(G)of 300 and 400 kg/(m^(2)·s),and heat fluxes(q)of 50,75 and 100 kW/m^(2).In the d=4 mm pipe,the peak heat transfer coefficient(hb)was about 3 times higher than in the d=6 mm pipe,while the entropy production due to fluid friction in the 4 mm pipe was on average 1.1 times higher,and the entropy production due to heat transfer was on average about 67%lower.A 4 mm tube was employed to further evaluate the influence of the applied wall heat flux,the results demonstrated that the irreversibility due to heat transfer was on average more than 4 times higher when heat flux density was 100 kW/m^(2)than when the heat flux density was 50 kW/m^(2),while the peak of heat transfer coefficient increased by 1.4 times as q was decreased from 100 to 50 kW/m^(2).The effect of thermal acceleration was ignored,while the buoyancy effect resulted in secondary flow and significantly affected the flow and heat transfer features.The jet flows were found in the vicinity of the lower wall of the pipe,which made the two fields of velocity and temperature gradient more synergistic,leading to an enhancement in heat transfer in the vicinity of the upper wall.The aggravation of heat transfer resulted in high irreversibility of heat transfer in the cross-sectional area near the wall,while the local friction irreversibility was less affected by the buoyancy effect,and the distribution was uniform.The uneven distribution of thermophysical properties also confirmed that the enhanced heat transfer occurred near the wall area at the bottom of the pipe.

A Note on an Order Level Inventory Model with Varying Two-Phased Demand and Time-Proportional Deterioration

The main purpose of this paper is to generalize the effect of two-phased demand and variable deterioration within the EOQ (Economic Order Quantity) framework. The rate of deterioration is a linear function of time. The two-phased demand function states the constant function for a certain period and the quadratic function of time for the rest part of the cycle time. No shortages as well as partial backlogging are allowed to occur. The mathematical expressions are derived for determining the optimal cycle time, order quantity and total cost function. An easy-to-use working procedure is provided to calculate the above quantities. A couple of numerical examples are cited to explain the theoretical results and sensitivity analysis of some selected examples is carried out.

Effectiveness of Chromated Copper Arsenate against Deteriorating Agents of Eucalyptus Poles and Posts in Four Eco-Regions in Kenya

Previous studies done elsewhere have shown that Eucalyptus poles treated with chromated copper arsenate (CCA) can last over 30 years. Kenya is exceptional because in some eco-regions, the Eucalyptus poles’ life span has greatly reduced to 5 years. The current study was designed to evaluate wood deteriorating agents of CCA-treated Eucalyptus poles and variability in four eco-regions of Kenya, namely, dryland, coastal, highland and humid lake. A total of 360 Eucalyptus pole samples were used for this experiment. Three CCA treatments were used to treat transmission poles at 20 kg/cm3 fencing posts samples at 6 kg/cm3, and a control group. Results indicated that termites and wood-decay fungi attacks caused wood deterioration in the four eco-regions. The proportion of power transmission pole degradation by wood deteriorating agents varied across eco-regions, between treatments and control and between time after treatments. Dryland eco-regions had the highest termite-related degradation (41.82%) while wood-decay fungi attack was highest in the highland eco-regions (9.20%). Samples treated with 6 kg/cm3 recorded the lowest level of wood deterioration, manifested by minimal superficial termite and wood-decay fungi attack. Samples treated with 20 kg/cm3 were characterized by moderate termite and wood-decay fungi attacks observed around the heartwood region, unlike sapwood. This study concluded that the deterioration of Eucalyptus CCA-treated poles is a question of climatic variability and hence, to increase the poles’ lifespan, CCA treatment should be tailored according to the characteristics of the ecoregion of use. Further investigations will inform the diversity of termites and decay-fungi across different eco-regions.

Risk Factors of the Progression of Renal Function Deterioration Among Patients with Diabetic Nephropathy

Objective:To explore the risk factors for the progression of renal function deterioration in patients with diabetic nephropathy(DN).Methods:The clinical data and biochemical indexes of 100 diabetic patients admitted to our hospital from October 2021 to October 2022 were retrospectively analyzed.The patients were divided into a DN group,which consisted of 55 cases,and a nondiabetic nephropathy group(NDN),which consisted of 45 cases.The urinary microalbumin to creatinine ratio,the clinical data(gender,age,duration of the disease,and BMI),and the biochemical indexes(triglycerides[TG],low-density lipoprotein cholesterol[LDL-C],high-density lipoprotein cholesterol[HDL-C],total cholesterol[TC],glycated hemoglobin A1c[HbA1c],systolic blood pressure[SBP],diastolic blood pressure[DBP])of the two groups were compared.Subsequently,the risk factors related to the progression of renal function deterioration in DN were analyzed through multifactorial logistic regression analysis.Results:No statistically significant difference was observed in the comparison of gender,age,BMI,LDL-C,and DBP between the two groups(P>0.05).The DN group demonstrated a longer disease duration and higher SBP,TC,HDL-C,HbA1c,and TG compared to the NDN group(P<0.05).Through multifactorial logistic regression analysis,it was found that the duration of the disease,the TC,the HDL-C,the HbA1c,the TG,and the SBP were independent risk factors of the deterioration of renal function in DN patients.Conclusion:Other than conventional indicators,TC,HDL-C,HbA1c,TG,and SBP are also crucial indicators in determining the progression of renal function deterioration in DN patients.

Fuzzy Inventory Model under Selling Price Dependent Demand and Variable Deterioration with Fully Backlogged Shortages

The objective is to develop a model considering demand dependent on selling price and deterioration occurs after a certain period of time, which follows two-parameter Weibull distribution. Shortages are allowed and fully backlogged. Fuzzy optimal solution is obtained by considering hexagonal fuzzy numbers and for defuzzification Graded Mean Integration Representation Method. A numerical example is provided for the illustration of crisp and fuzzy, both models. To observe the effect of changes in parameters, sensitivity analysis is carried out.

A Note on a One-Parameter Weibull Distributed Deteriorating Item EOQ Inventory Model with Varying Quadratic Demand and Delay in Payments

In this paper, an EOQ inventory model is developed for deteriorating items with variable rates of deterioration and conditions of grace periods when demand is a quadratic function of time. The deterioration rate considered here is a special type of Weibull distribution deterioration rate, i.e., a one-parameter Weibull distribution deterioration rate and it increases with respect to time. The quadratic demand precisely depicts of the demand of seasonal items, fashion apparels, cosmetics, and newly launched essential commodities like android mobiles, laptops, automobiles etc., coming to the market. The model is divided into three policies according to the occurrence of the grace periods. Shortages, backlogging and complete backlogging cases are not allowed to occur in the model. The proposed model is well-explained with the help of a simple solution procedure. The three numerical examples are taken to illustrate the effectiveness of the EOQ inventory model along with sensitivity analysis.