Improvement of the nutritional support management system for patients in intensive care units

BACKGROUND Nutritional support for patients hospitalized in the intensive care unit(ICU)is an important part of clinical treatment and care,but there are significant implementation difficulties.AIM To introduce a modified nutritional support management system for ICU patients based on closed-loop information management and psychological counseling.METHODS The division of functions,personnel training,system construction,development of an intelligent decision-making software system,quality control,and improvement of the whole process were carried out to systematically manage nutritional support for ICU patients.RESULTS Following the implementation of the whole process management system,the scores of ICU medical staff’s knowledge,attitudes/beliefs,and practices regarding nutritional support were comprehensively enhanced.The proportion of hospital bed-days of total enteral nutrition(EN)in ICU patients increased from 5.58%to 11.46%,and the proportion of EN plus parenteral nutrition increased from 42.71%to 47.07%.The rate of EN initiation within 48 h of ICU admission increased from 37.50%to 48.28%,and the EN compliance rate within 72 h elevated from 20.59%to 31.72%.After the implementation of the project,the Self-rating Anxiety Scale score decreased from 61.07±9.91 points to 52.03±9.02 points,the Self-rating Depression Scale score reduced from 62.47±10.50 points to 56.34±9.83 points,and the ICU stay decreased from 5.76±2.77 d to 5.10±2.12 d.CONCLUSION The nutritional support management system based on closed-loop information management and psychological counseling achieved remarkable results in clinical applications in ICU patients.

Mechanically strong,flexible,and multi-responsive phase change films with a nacre-mimetic structure for wearable thermal management

Phase change materials(PCMs)are a highly promising candidate for thermal energy storage owing to their large latent heat and chemical stability.However,their intrinsic brittle induces poor flexibility and low mechanical strength,which limits them use for wearable thermal management.And,the electrical insulation and weak solar absorption make them lack multi-responsive capability.Herein,we report a facile strategy to synthesize mechanically strong and flexible multi-responsive phase change films by stirring an aqueous dispersion of cellulose nanofibrils(CNFs),MXene(Ti_(2)C_(3))nanosheets,and polyethylene glycol(PEG),followed by air-drying self-assembly and coating with hydrophobic fluorocarbon.The hydrogen bonds and nacre-mimetic synergistic toughening networks formed by ternary CNFs,Ti_(2)C_(3)nanosheets,and PEG endow films with high mechanical strength(16.7 MPa)and strain(10.4%),which are 18.6 and 8.7 times higher than those of pure PEG film,respectively.The films exhibit outstanding flexibility and do not crack or fracture even when bent,twisted,and folded into a complex small boat.Meanwhile,the laminar structure formed by the self-assembly Ti_(3)C_(2)nanosheets enhances electrical conductivity(3.95 S/m)and solar absorption,affording excellent electro-thermal(68.3%–81.0%)and solarthermal(85.6%–90.6%)conversion efficiency,thus achieving multi-response to external stimuli(electron/solar radiation).In addition,the as-prepared films also deliver large latent heat(136.1 J/g),outstanding cyclic and shape stability,leak-free encapsulation even under compressed at above 5000 times its weight,excellent hydrophobicity(131.4°),and self-cleaning function.This work paves the way for developing flexible,mechanically strong,and self-cleaning phase change film with multi-responsive function for wearable thermal management devices under high humidity condition.

Flexible Workflow Management in Agile Supply Chain System

With the vehement development of global competition , Agile Supply Chain (ASC) becomes an effective approach that supports dynamic ent erprise alliance and realizes agile manufacturing, as for the enterprises to cap ture market opportunities rapidly and strengthen their anti-risk ability. As Ag ile Supply Chain System (ASCS) is dynamic and distributed, the realization of it ’s processes needs to be much flexible. Often in Agile Supply Chain System (ASCS ), there are many dynamic tasks, many changes of the processes, and cooperative workflows, which need the workflows able to be adjusted agilely and smoothly, no t much affecting others. This paper will propose a flexible workflow management for achieving the agility and compatibility. At the first of the paper, we will discuss the situation in which Agile Supply C hain System is applied, and then we will elaborate the characteristics of Agile Supply Chain System. So with that, the shortcomings of the process managements t hat are, at present, used in Supply Chain Systems will be displayed clearly. The n, the proposal will be given in the paper, to resolve the problems in the prese nt process management in ASCS. We will see supply chain systems implemented mult i-agent-based technology to adapt to the dynamic environment, however in many systems, coordination of the workflows is executed by the explicit messages comm unicated between the agents. This will lead to a tightly coupled system. To over come it, the paper suggests the workflow management in agent-based ASCS using t he Events-Triggering mechanism, instead of the explicit messages. We create Eve nts-Triggering contents and rules, having push-pull mechanism, event-state se t and triggering-conditions, and store them in the distributed database subject ed to the corresponding agents. Adjusting the Events-Triggering data will be us ed to adapt to the dynamic tasks and the changes of processes. In sum, we will p resent the methods of process modeling, the system structure, and the executing -mechanism of the flexible workflow management we propose in the paper. Also, t he paper outlines several exception-handling policies for the flexible workflow management, in succession. And at the final of the paper, we discuss the realiz ation of the flexible workflow management in Agile Supply Chain System. The flex ible workflow management will be implemented using CORBA services and Java techn ology for the distributed systems. CORBA is chosen as the specification of distr ibuted electronic data exchange, and Java as the construction tool of the system . The framework of the flexible workflow management constructed on them is showe d in the paper.

THE SPILLOVER MANAGEMENT IN THE DYNAMIC OUTPUT FEEDBACK CONTROL OF FLEXIBLE SPACECRAFT

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A review of closed-loop reservoir management

The closed-loop reservoir management technique enables a dynamic and real-time optimal production schedule under the existing reservoir conditions to be achieved by adjusting the injection and production strategies. This is one of the most effective ways to exploit limited oil reserves more economically and efficiently. There are two steps in closed-loop reservoir management： automatic history matching and reservoir production opti- mization. Both of the steps are large-scale complicated optimization problems. This paper gives a general review of the two basic techniques in closed-loop reservoir man- agement; summarizes the applications of gradient-based algorithms, gradient-free algorithms, and artificial intelligence algorithms; analyzes the characteristics and application conditions of these optimization methods; and finally discusses the emphases and directions of future research on both automatic history matching and reservoir production optimization.

Exploiting demand-side heterogeneous flexible resources in risk management of power system frequency

More demand-side flexible resources(DFRs)are participating in the frequency regulation of renewable power systems,whose heterogeneous characteristics have a significant impact on the system frequency response.Consequently,selecting suitable DFRs poses a formidable challenge for independent system operators(ISO).In this paper,a reserve allocation methodology for heterogeneous DFRs is proposed to manage the risk of power system frequency.Firstly,a performance curve is developed to describe the cost,capacity,and response speed of DFRs.Moreover,a clustering method for multiple distributed DFRs is conducted to calculate the aggregated performance curves and uncertainty coefficients.Then,the frequency security criterion considering DFRs’performance is constructed,whose linearity makes it can be easily coupled into the system scheduling model and solved.Furthermore,a risk management model for DFRs considering frequency-chance-constraint is proposed to make a trade-off between cost and frequency security.Finally,the model is transformed into mixed integer second-order cone programming(MISOCP)and solved by the commercial solver.The proposed model is validated by the IEEE 30 and IEEE 118 bus systems.

Closed-loop prevention and control research of coal mine safety management

According to the current problems of safety management processes in coalmine enterprises,we introduced barrel theory to coal mine safety management,constructedthe closed-loop structure of a coal mine safety management system,andpointed out that efficient safety management lies in three factors:safety quality of all ofthe staff in coal mine enterprises,weak links in security management systems,and cooperationamong departments.After conducting detailed analysis of these three factors,we proposed concrete ways of preventing and controlling potential safety hazards duringthe process of coal mine production.

Improving the Performance of Urban Waste Management Systems in the Context of a Closed-Loop Supply Chain

The saving of non-renewable energies, as well as the reduction of emissions into the environment, are two crucial objectives of industrial production. The recovery of post-consumer products associated with the use of end-of-life products is part of a context of optimization of these objectives. This recovery maximizes the use of resources from end-of-life products in a circular logic while recording the environmental footprint. This study considers a recycling strategy adapted to the need and urgency to reduce greenhouse gas emissions caused by global warming. The proposed model aims to optimize the profits of the circular manufacturing strategies while minimizing operational costs (collection, sorting, recycling), transport, GHG emissions and recycling. In this paper, a compromise between the gains of CM and the costs associated with it was studied. The robustness of the designed model was tested using a case study based on real-world scenarios. A sensitivity analysis was carried out to study the impact of the emission cost on the overall objective, considering the two options currently offered to industries. The obtained results support companies to take the ecological aspect into account and integrate sustainable development into their strategic axes for their logistics supply chains.

Emerging Flexible Thermally Conductive Films:Mechanism,Fabrication,Application

Effective thermal management is quite urgent for electronics owing to their ever-growing integration degree,operation frequency and power density,and the main strategy of thermal management is to remove excess energy from electronics to outside by thermal conductive materials.Compared to the conventional thermal management materials,flexible thermally conductive films with high in-plane thermal conductivity,as emerging candidates,have aroused greater interest in the last decade,which show great potential in thermal management applications of next-generation devices.However,a comprehensive review of flexible thermally conductive films is rarely reported.Thus,we review recent advances of both intrinsic polymer films and polymer-based composite films with ultrahigh in-plane thermal conductivity,with deep understandings of heat transfer mechanism,processing methods to enhance thermal conductivity,optimization strategies to reduce interface thermal resistance and their potential applications.Lastly,challenges and opportunities for the future development of flexible thermally conductive films are also discussed.

Flexible Bronchoscopy as a Diagnostic and Therapeutic Method in Patients with Tracheobronchial Foreign Body

Objective: To analyze bronchoscopy as a diagnostic and therapeutic method in patients with tracheobronchial foreign body. Methods: We analyzed reports of flexible bronchoscopy with diagnose of tracheobronchial foreign body performed from 2003 to 2013 in S&#227o Salvador Hospital, in Goiania, capital of Goiás. The analysis was based on: sex and age of the patients, airways and foreign body characteristics, foreign body localization, success rate and rate of bleeding. We calculated the frequencies after analyzing the data. Results: We analyzed 26 reports of the studied period and found that 57.7% of the patients were male with median age of 58.83 years old (+—13.79). The airways characteristics were normal in most of the cases. Sputum wasn’t found in 57.69% of the cases. Foreign bodies were located in right bronchus in 88.46% of the cases, and the extraction of them was successful in 80.76% of the cases. The absence of bleeding was reported in 96.15% of the cases. Conclusions: Flexible bronchoscopy is a notably successful method in management of tracheobronchial foreign bodies. Airways characteristics aren’t good indicatives of FB’s presence, once they are normal in most of the times.

西门子WinCC flexible的SQL数据库操作

通过微软数据源管理器ODBC建立WinCC flexible与SQL数据库的连接,并借助WinCC flexible脚本系统,来完成实际工程中比较复杂的过程值以及报警记录的归档。

The application of feedforward control in the nursing emergency management of COVID-19

Objective:To explore the application of feedforward control in the nursing emergency management of COVID-19.Methods:The feedforward control theory was applied to the emergency management of COVID-19 nursing,including grasping the latest epidemic information,preparing for the early stage,formulating nursing workflow,implementing flexible management,standardizing isolation and protection measures,unifying nursing document record format,and implementing humanistic care.Results:During the period of support to Wuhan,the nursing work in the isolated area was orderly,the nursing staff's job satisfaction was high,no nursing errors and hospital infections occurred.Conclusion:Efficient feedforward control in the nursing emergency management that could avoid work blindness to a certain extent and play a guiding role in maintaining the normal operation of treatment and nursing work and protecting the safety of patients and medical staff in the ward during the epidemic period of COVID-19.

Management Agility Depends on Well-Renovated IT Infrastructure

Today management agility as an inter-corporate competitive advantage cannot be realized unless given all of the following quickness： （a） quick recognition of changes in the management environment, （b） quick decision-making on countermeasures against these changes, and （c） quick implementation of the countermeasures chosen. With a focus on （c） and assuming flexibility as a core property that an MIS （Management Information System） should have to make management agile, this study aims to clarify how MIS flexibility could be enhanced. With this aim in mind, the authors will first survey the sources and types of change demands on an MIS and consider in a structured way the flexibility characteristics of an MIS, enhancement of which will conduce to its efficiency in dealing with these change demands. With this groundwork laid, the authors will go on to discuss practical methods to enhance MIS flexibility, and wind up their discussion by presenting the evaluation procedure for this property.

Optimal Operation of Flexible Distribution Networks for Security Improvement Considering Active Management

This paper presents a stochastic optimal operation problem of gas turbine integrated distribution networks in the presence of active management schemes,which is formulated as a multi-objective chance-constrained mixed integer nonlinear programming problem.The control variables are the on-load tap-changer tap position,the power provided by the distributed generation(DG),the DG power factor angle,the load participating in demand side management and the switch status.The objectives defined in this paper are to simultaneously minimize the expectation cost and variation coefficient of security distance.Uncertainties related to DG output and load fluctuation and fault power restoration under contingencies are also considered in the optimization problem.The collaboration of normal boundary intersection and the dynamic niche differential evolution algorithm is proposed to handle the optimal operation mode.Simulation results are presented and demonstrate the effectiveness of the proposed model.Compared with the operation result without the consideration of security,the security-constrained operation can reduce the expectation cost.Therefore,the proposed optimization is reasonable and valuable.

Flexible thermoregulatory microcapsule/polyurethane-MXene composite films with multiple thermal management functionalities and excellent EMI shielding performance

The development of miniaturized,flexible,and portable electronic devices has led to an increasing demand for multifunctional flexible films that can provide temperature regulation,electromagnetic interference(EMI)shielding,and thermal management.In this study,a novel hierarchical multifunctional flexible composite film is presented.The first step involves the synthesis of phase change microcapsule(PCMC)latex through in-situ polymerization.Next,PCMC and waterborne polyurethane(WPU)latex were mixed and dried using a binary colloidal approach to produce a flexible composite phase change film(WPU/PCMC)with complete anti-leakage and satisfying melting enthalpy(147.86 J g^(-1)).To enhance the EMI performance and mechanical strength,a thin layer of antioxidant MXene@poly tannin acid(PTA)was directly sprayed onto the surface of WPU/PCMC,resulting in the WPU/PCMC/MXene@PTA film(WPM).Consequently,the WPM displays exceptional thermal management performance for multiple drives and outstanding EMI performance(56.86 dB),making it an ideal candidate for future multifunctional products.

Impact of Capacity Parameters on Flexible Inventory Control Decision Model

From the mathematical point of view,the flexible inventory control model is proved in the practical problem application and the rationality of the capacity parameter selection and calculation.The purpose is to actively respond to demand fluctuations when there is a demand forecast error or a missing part of the demand information,and to avoid the risk of passive variable demand forecasting to set the immutable inventory capacity.At the same time,the game is controlled by the flexible and variable inventory control strategy and the customer’s willingness to demand.The paper mainly studies the influence of the setting of capacity parameters on the booking-limit decision and its benefits under the control of flexible space with variable total capacity.Through the two trends of capacity increase flexibility and capacity reduction flexibility in the flexible inventory control model,the mathematical performance and marginal utility methods are introduced to change the performance of the booking-limit control decision model under different scenarios.The correlation analysis between the capacity limit level and the return under the optimal Bookinglimit decision,and the above two flexibility parameters are obtained.

Analysis of an SME using Silicon and Flexible Organic Solar Cells as Replacements for Fossil Fuel Sources of Electricity in UK and Iraq

Currently, 86% of the energy originates from fossil fuelsforelectricity. These are expected to run out, causing severe environmental damage threatening future generations. The total impact of Small and Medium Enterprises （SMEs） on the economy is significant. Solar cells harness the sun＇s energy to generate electricity in an environmentally friendly manner. This study compares silicon solar cells to flexible Organic Photovoltaic solar cells （OPV） for electricity energy for a micro-business in the UK and Iraq. It shows that it is feasible to replace existing fossil fuel sources with solar cells in Iraq due to a greater amount of solar radiation striking the earth＇s surface. Flexible solar cells can replace a proportion of the energy requirements in the UK and a larger proportion in Iraq. Using existing 20% efficient solar cells, 28% and 83% of the energy requirements of the microbusiness can be replaced in UK and Iraq respectively. Assuming 20% efficiency for solar cells placed on windows, 74% and 220% of the energy requirements of UK and Kurdistan can be replaced respectively and the surplus stored.

Proposed Flexibility to USA Nuclear Waste Management Strategy

USA nuclear waste management program has stalled due to its continued insistence upon using Yucca Mountain for its disposal of DOE （Department of Energy） and commercial power plants NSF （nuclear spent fuel）. Increased flexibility and significant changes in DOE program are proposed. They include a private waste company to manage it; the construction and operation of ICS （interim centralized storage） facilities for NSF; the search for an AGR （alternate geological repository）; the use of a different methodology involving key local and state participants; a new ＂as safe as practical＂ strategy with defined benefits to the involved locations and states. Assured removal of NSF from ICS and providing limited Price Anderson indemnity for the program will enhance its acceptance. Minimum politics, regular information meetings, compromises, good cost projections and meeting schedules will be necessary to increase the chances of the proposed nuclear waste management program.

Strategic Management of Large Projects

The strategic management of large projects is both theoretically and practically important. Some scholars have advanced flexible strategy theory in China. The difference of strategic flexibility and flexible strategy is pointed out. The supporting system and characteristics of flexible strategy are analyzed. The changes of flexible strategy and integration of strategic management are discussed.

柔性人力资源管理对高科技企业技术创新的影响研究

为更有效地推进高科技企业技术创新,基于自我决定理论,以员工的基本心理需要、内部动机为中介变量,构建柔性人力资源管理影响高科技企业技术创新的理论分析框架,并运用层次回归分析和Bootstrap方法,对360位高科技企业员工的样本数据进行实证检验,研究柔性人力资源管理对高科技企业技术创新的影响及作用机制。结果表明,柔性人力资源管理对高科技企业技术创新具有显著的正向影响;基本心理需要和内部动机不仅在两者之间分别独立地起到中介作用,而且还共同地发挥了链式中介作用。结合分析结果,高科技企业应发挥柔性人力资源管理的战略作用;高科技企业管理者和人力资源从业者应重视研发人员的基本心理需要;高科技企业人力资源管理活动应注重对员工内部动机的培养。