Application of the “Three Threes” Method in Clinical Teaching of Internal Jugular Vein Puncture

Objective: To clarify the role of the “Three Threes” method in clinical teaching of internal jugular vein puncture and explore improvements in teaching methods. Methods: A doctor was assigned to the induction room of the Second Affiliated Hospital of Naval Medical University (Shanghai Changzheng Hospital) for two months. The time required for catheterization, the first puncture success rate, and occurrence of puncture-related complications were compared before and after learning the “Three Threes” method. Results: Using the “Three Threes” method reduced the catheterization time by 43%, increased the first puncture success rate by 17%, and led to fewer puncture-related complications. Conclusion: The application of the “Three Threes” method not only improves the success rate of internal jugular vein puncture but also reduces complications, making it easier for students to master the technique.

Research and Application of Bedside Rhetorical Teaching Method in Teaching Nursing Interns

Objective:To observe and analyze the application of the bedside rhetorical teaching method in teaching nursing interns.Methods:A total of 64 nursing interns in the gastroenterology department of our hospital from July 2022 to May 2023 were randomly divided into two groups,32 cases in the control group and 32 cases in the intervention group.The control group was given conventional teaching methods,and the intervention group was given the bedside rhetorical teaching method on the basis of the conventional teaching.The differences in the methods of teaching between the two groups were compared after the end of the internship,and there was a statistically significant difference with P<0.05.Results:The scores of the interns in the intervention group were significantly better than those of the control group in theoretical knowledge,communication skills,and case analysis items(P<0.05).Conclusion:The bedside rhetorical teaching method transforms classroom education into bedside teaching,which enables the interns to apply the theoretical knowledge to clinical practice,and has a higher improvement in the three aspects of disease knowledge,communication skills,and case analysis,cultivates the interns’comprehensive clinical skills,and lays a good foundation for the future entry into the nursing field.

Application of Heuristic Method to the Clinical Teaching of Internal Medicine

There is an old saying,“Give a man a fish,and he will eat for a day.Teach a man to fish,and he will eat for the rest of his life.”In clinical teaching,students should not only be taught about diseases,but their intelligence should also be cultivated,along with their analytical,comprehension,and independent learning skills.The ability to solve problems enables students to think independently and acquire knowledge.This is known as the heuristic method of teaching.In this study,we mainly analyze the application value of the heuristic method in the clinical teaching of internal medicine.

An evaluation method for internal erosion potential of gravelly soil based on particle size distribution

Internal erosion occurs when fine particles escape from the soil driven by seepage flow,which is considered to be the crucial factor causing the failure of earth structures filled with gravelly soil.The objective of this paper is to suggest an appropriate method to assess internal erosion potential of gravelly soil.By analyzing the sensitivity of soil material to internal erosion,the variable(Dc15/df85)max and the content of coarse particles(Pc)are selected as the evaluation indexes(Dc15 and df85 are the diameters of 15%mass passing in the coarse component and 85%mass passing in the fine component,respectively).A series of gravelly soils with different particle size distributions are tested for internal erosion by the self-made permeameter.Based on the test results,an evaluation method for the internal erosion of gravelly soil is proposed.Gravelly soil is prone to internal erosion when 60%≤Pc<95%and(Dc15/df85)max≥9.5.The proposed method shows good accuracy in evaluating the internal erosion of 36 soil samples from other studies,which confirms the reliability of the method.The proposed method makes it possible to accurately assess internal erosion of gravelly soil,and an alternative method is provided for engineers to determine whether there is a risk of internal erosion in earth structures consisting of gravelly soil.

Application of the “Six-Step Teaching Method” in the Nursing Teaching of Obstetric Interns

Objective: The “six-step teaching method” is a teaching method, which is summarized based on practical experience. This study aimed to explore the effect of “six-step teaching method” in clinical teaching of obstetrics. Methods: A quasi-experimental study design was used, 30 nursing students who entered obstetrics practice from March 2022 to July 2022 were selected as the control group according to the order of time, and traditional teaching methods were adopted. From August to December 2022, 30 interns were selected as the experimental group, and the “six-step teaching method” was adopted. After 8 weeks of clinical practice, the assessment results and teaching effect satisfaction of the two groups were compared. Results: The scores of obstetrical specialty in the experimental group were higher than those in the control group, and the difference was statistically significant (P < 0.05);The evaluation of teaching methods, teaching quality, classroom atmosphere and individual observation ability, clinical thinking ability and nurse-patient communication ability of the experimental group were higher than those of the control group, and the differences were statistically significant (P Conclusion: “six-step teaching method” can effectively master the professional knowledge of obstetrics, stimulate the clinical thinking ability of interns, and improve the teaching effect and satisfaction. .

Data-driven Methods to Predict the Burst Strength of Corroded Line Pipelines Subjected to Internal Pressure

A corrosion defect is recognized as one of the most severe phenomena for high-pressure pipelines,especially those served for a long time.Finite-element method and empirical formulas are thereby used for the strength prediction of such pipes with corrosion.However,it is time-consuming for finite-element method and there is a limited application range by using empirical formulas.In order to improve the prediction of strength,this paper investigates the burst pressure of line pipelines with a single corrosion defect subjected to internal pressure based on data-driven methods.Three supervised ML(machine learning)algorithms,including the ANN(artificial neural network),the SVM(support vector machine)and the LR(linear regression),are deployed to train models based on experimental data.Data analysis is first conducted to determine proper pipe features for training.Hyperparameter tuning to control the learning process is then performed to fit the best strength models for corroded pipelines.Among all the proposed data-driven models,the ANN model with three neural layers has the highest training accuracy,but also presents the largest variance.The SVM model provides both high training accuracy and high validation accuracy.The LR model has the best performance in terms of generalization ability.These models can be served as surrogate models by transfer learning with new coming data in future research,facilitating a sustainable and intelligent decision-making of corroded pipelines.

Effect of Wafer Size on the Film Internal Stress Measurement by Wafer Curvature Method

Wafer curvature method has been applied to determine the internal stress in the films using Stoney＇s equation.During the film deposition,the wafer fixation on the sample holder will restrict the deformation of the rectangle-shaped wafer,which may result in the stress datum difference along length and width direction.In this paper,the effect of wafer size and the wafer fixation on the TiN film internal stress measured by wafer curvature method was discussed.The rectangle-shaped wafers with different length/width ratios（L/W=1：1,2：1,3：1 and 4：1） were fixed as a cantilever beam.After the TiN films deposition,the profiles of the film/wafer were measured using a stylus profilometer and then the internal stress was calculated using the Stoney equation in the film.The results showed that the fixed end of the wafers limited to some degree the curvature of the wafers along the width direction.For film internal stress measured by wafer curvature method,the wafer profile should be scanned along the length direction and the scan distance should be greater than or equal to half of wafer length.When the length/width ratio of the wafer reached 3：1,the wafer curvature and the calculated stress were basically the same at different positions along the length direction.For film internal stress measured by wafer curvature method,it was recommended that the length/width ratio of wafer should be considered to be greater than or equal to 3：1,and the deformed profile was scanned along the length direction.

LA-ICP-MS Calibrations for Intact Rock Samples with Internal Standard and Modified Constant-Sum Methods

Laser ablation coupled with inductively coupled plasma-mass spectrometry (LA-ICP-MS) calibration was conducted with multiple spot analyses on eleven intact rock samples using both an internal standard (IS) method and a modified constant-sum (MCS) method. Methods were then compared for reported bulk elemental composition of the rocks. The MCS method was based on the sum of eight major elements, which is spatially more stable than one single major ele-ment as used in the IS method, and is quite constant among different rock samples. Calibrations were performed with standard reference materials NIST SRM 610, 612, 614, and 616. Little difference was found between using a single standard and a set of standards, because of the good linearity shown by the reference materials. Comparison of the two calibration methods shows that the MCS method produced better and more stable results than the IS method for heterogeneous samples. With the MCS method, approximately 94% to 95% of the total measurements are within the range of ±100% relative deviation, compared with 82% to 86% with the IS method. The IS method resulted insubstantial overestimations for some rock samples (e.g., 648% for Basalt BCR-2 using NIST SRM 610 as the calibration standard), while the largest deviation with the MCS method was 216% for U in Eagle Ford shale #80 sample. For Quartz latite QLO-1, a relative homogeneous sample, the IS method generated slightly better results than the MCS method. Regardless of method, spatially heterogeneous distribution of elements in the intact rock at the scale of the laser spot is considered to be the main reason for the large relative deviations seen in our work compared to published results.

Synthesis of an IS and Steviol Glycoside Analysis by a Validated Internal Standard Method

The internal standard (IS) method is the best method for the analysis of samples, as it is independent of errors in injection volume, changes in sample volumes, and changes in sensitivity of the detector, etc. Use of an internal standard allows for the correction of losses due to sample clean-up of complex samples. An ideal IS is a compound that has properties very similar to, and that behaves as the compounds to be analysed. Ideally, only in the last step of analysis (HPLC), the IS should be well separated from the compounds of the mixture to be analysed. After testing several existing compounds with negative results, we decided to synthesise the 19-O-β-D-galactopyranosyl-13-O-β-D-glucopyranosyl-steviol as IS. This is the 19-galactosyl ester of steviolmonoside (13-O-β-D-glucopyranosyl-steviol). The IS was made according to published methods. Steviolmonoside (SM) was made from purified commercial rubusoside (Rub) by refluxing it in 10% KOH for 2 h. SM was precipitated and crystallized from MeOH. The hydroxyls of the glucose unit of SM were protected by acetylation. The acetylated SM was crystallized from acetone and dissolved in 1,2-dichloroethane. Then Ag2CO3 on Celite and tetra-acetylated galactopyranosyl bromide were added and the mixture was refluxed for 2 h. After cooling, BaO in MeOH was added to remove the acetyl groups. The 1,2-dichloroethane fraction was then extracted three times with equal volumes of water and the water fraction containing the IS was further purified on a C18 flash chromatography column. Traces of unreacted SM were removed by preparative HPLC on an Alltima C18 column (250 mm × 22 mm, particle size 10 μm) with AcCN:water (35:65, 20 ml/min). Detection was at 210 nm (KNAUER, “Smartline” UV detector 2500). The collected IS fraction from the HPLC was completely dried. Mixtures of steviol glycosides (SVglys) containing IS could be purified over SPE cartridges without change of the SVgly over IS ratio. The calibration curves for rebaudioside A (RebA) and stevioside (ST) were linear between 0.012 and 0.95 and between 0.013 and 1.13 mM for RebA and ST, respectively. The accuracy was checked by the standard addition method. It was concluded that the IS method gives an excellent precision and accuracy.

Quantitative Determination of Tetrachlorantraniliprole by(1)^H NMR Spectroscopy with Internal Standard Method

[Objective]This study was to establish a rapid,specific and simple method for quantitative determination of tetrachlorantraniliprole by 1H NMR.[Method]1H NMR spectroscopy was acquired with deuterium DMSO as the solvent and maleic acid as internal standard under the conditions of temperature 25℃,pulses width 8.0μs,delay time 5 s,and scanning times 8.[Result]The hydrogen proton peaks of tetrachlorantraniliprole(δ=10.55)and maleic acid(δ=6.27)were taken as quantitative peaks.The peak area ratio y(As/Ar)and mass ratio x(ms/mr)were linearly regressed,and the correlation coefficient was 0.9999.The RSD value of repeatability test was 0.38%,and the RSD value of stability test was 0.77%.The content of tetrachlorantraniliprole was determined as 99.6%.[Conclusion]1H NMR spectroscopy can be used for quantitative determination of tetrachlorantraniliprole without standard reference,which is rapid,accurate and simple.

2-21 Key Step of Dispersing Carbide in the Preparation of Uranium Carbide Microspheres with Internal Gelation Method

Uranium carbide kernels is one special fuel materials for the High-Temperature Gas-cooled Reactor[1], which can improve nuclear fuel’s efficiency, longevity, and safety. In the fabrication process, there are many factors affect the quality of the kernels, such as subsequent ageing, HMTA/uranium mole ratio, gelation forming temperature, washing step, heating rate of the calcine and sinter step, one important step is the dispersing carbon into the solution stock of HMTA and urea[2;3].

AN ANALYTICAL METHOD FOR SOLVING INTERNAL FORCES AND DEFORMATIONS OF BAR-SYSTEM STRUCTURE IN SPACE

In this paper, based on the idea of finite element method, the initial parametric method in bending, problem of a beam is extended to analyse the bar-system structure by employing Dirac function and llcavisidc step function.Then a new method for analysing the internal forces and deformations of bar-system structure in space is suggested by improving the mixed method in statically indeterminate structure.The inferred process and obtained answer will be more succinct and accurate when the problem of internal forces and deformations of bar-system structure is analysed by using the new method provided in this paper.

A Study on the Effects of Internal Heat Generation on the Thermal Performance of Solid and Porous Fins using Differential Transformation Method

In this study,the impacts of internal heat generation on heat transfer enhancement of porous fin is theoretical investigated using differential transform method.The parametric studies reveal that porosity enhances the fin heat dissipating capacity but the internal heat generation decreases the heat enhancement capacity of extended surface.Also,it is established that when the internal heat parameter increases to some certain values,some negative effects are recorded where the fin stores heat rather than dissipating it.This scenario defeats the prime purpose of the cooling fin.Additionally,it is established in the present study that the limiting value of porosity parameter for thermal stability for the passive device increases as internal heat parameter increases.This shows that although the internal heat parameter can help assist higher range and value of thermal stability of the fin,it produces negative effect which greatly defeats the ultimate purpose of the fin.The results in the work will help in fin design for industrial applications where internal heat generation is involved.

Weight Function Method for Stress Intensity Factor of Internal Surface Semi-elliptical Crack in Elliptical Holes

The hatches for inspecting are usually designed with elliptical holes in airplane structures, so computation of the stress intensity factor of three dimensional crack at elliptical holes is pivotal for damage tolerance analysis of these structures. In this paper, weight function is derived for a two dimensional through cracks at elliptical holes by applying a compounding method. Stress intensity factor formulas for an internal surface semi-elliptical crack in elliptical holes are obtained wing the three dimensional weight function method. Stress intensity factors for an internal surface semi-elliptical crack in elliptical holes under remote tension are computed. At the same time, research on how radius of curvature for elliptical holes affect stress intensity factors was conducted. Stress intensity factors decrease when radius of curvature increases. Some results and conclusions which are of practical value are given.

Physics-Informed Neural Networks with Two Weighted Loss Function Methods for Interactions of Two-Dimensional Oceanic Internal Solitary Waves

The multiple patterns of internal solitary wave interactions(ISWI)are a complex oceanic phenomenon.Satellite remote sensing techniques indirectly detect these ISWI,but do not provide information on their detailed structure and dynamics.Recently,the authors considered a three-layer fluid with shear flow and developed a(2+1)Kadomtsev-Petviashvili(KP)model that is capable of describing five types of oceanic ISWI,including O-type,P-type,TO-type,TP-type,and Y-shaped.Deep learning models,particularly physics-informed neural networks(PINN),are widely used in the field of fluids and internal solitary waves.However,the authors find that the amplitude of internal solitary waves is much smaller than the wavelength and the ISWI occur at relatively large spatial scales,and these characteristics lead to an imbalance in the loss function of the PINN model.To solve this problem,the authors introduce two weighted loss function methods,the fixed weighing and the adaptive weighting methods,to improve the PINN model.This successfully simulated the detailed structure and dynamics of ISWI,with simulation results corresponding to the satellite images.In particular,the adaptive weighting method can automatically update the weights of different terms in the loss function and outperforms the fixed weighting method in terms of generalization ability.

3D simulation of image-defined complex internal features using the numerical manifold method

The numerical simulation of internal features,such as inclusions and voids,is important to analyze their impact on the performance of composite materials.However,the complex geometries of internal features and the induced continuous-discontinuous(C-D)deformation fields are challenges to their numerical simulation.In this study,a 3D approach using a simple mesh to simulate irregular internal geometries is developed for the first time.With the help of a developed voxel crack model,image models that are efficient when recording complex geometries are directly imported into the simulation.Surface reconstructions,which are usually labor-intensive,are excluded from this approach.Moreover,using image models as the geometric input,image processing techniques are applied to detect material interfaces and develop contact pairs.Then,the C-D deformations of the complex internal features are directly calculated based on the numerical manifold method.The accuracy and convergence of the developed3D approach are examined based on multiple benchmarks.Successful 3D C-D simulation of sandstones with naturally formed complex microfeatures demonstrates the capability of the developed approach.

Formation of internal cracks during soft reduction in rectangular bloom continuous casting

To investigate the formation of internal cracks in GCrl 5 bearing steels during the soft reduction process in rectangular bloom con- tinuous casting, fully coupled thermomechanieal finite element models were developed using the commercial software MSC.MARC, and microstructures and fractographs were also observed. With the finite element models, the contours of temperature, equivalent plastic strain, and equivalent vun Mises stress were simulated. It is observed that the fracture surfaces of internal cracks are covered by cleavage or quasi-cleavage facets. The region of internal cracks in the intergranular brittle fracture mode is in the mushy zone between the zero ductility temperature （ZDT） and the zero strength temperature （ZST）. The simulated equivalent plastic strain in the crack region is 2.34%-2.45%, which is larger than the critical strain （0.4%-1.5%）, and the equivalent von Mises stress is 1.84-5.05 MPa, which is within the range of criti- cal stress （3.9-7.2 MPa）, thus resulting in the occurrence of internal cracks. Reducing the soft reduction amount from 3 to 2 mm can lower the stress under the critical value.

Evolution and breaking of a propagating internal wave in stratified ocean

The evolution and breaking of a propagating internal wave are directly numerically simulated using a pseudo-spectral method. The mechanism of PSI （ parametric subharmonic instability） involved in the evolution is testified clearly. It dominates gradually in nonlinear resonant interactions. As a consequence, the energy cascades to a second plant wave packet which has lower frequencies and higher wavenumbers than that of the primary wave. With the growth of this wave packet, wave breaking occurs and causes strongly nonlinear regime, i.e. stratified turbulence. The strong mixing and intermittent of the turbulence can be learned from the evolution of the total energy and kurtosis of vorticity vs. time. Some statistic properties of the stratified turbulence are also analyzed, including the spectra of KE （kinetic energy） and PE （potential energy）. The results show that the PE spectra display a wavenumber range scaling as 0. 2 N^4ky^-3 （N is the Brunt - Vaisala frequency, k, is the vertical wavenumber）, which is called buoyancy sub-range. However, the KE spectra cannot satisfy the negative cubic law of vertical wavenumber, which have a much larger downtrend than that of the PE spectra, for the potential energy is transferred more efficiently toward small scales than the kinetic energy. The Cox number of diapycnal diffusivity is also calculated, and it shows a good consistency with the observations and deductions in the ocean interior, during the stage of the stratified turbulence maintaining a fairly active level.

Three-to-one internal resonance in multiple stepped beam systems

In this study, the vibrations of multiple stepped beams with cubic nonlinearities are considered. A three-to-one internal resonance case is investigated for the system. A general approximate solution to the problem is found using the method of multiple scales （a perturbation technique）. The modulation equations of the amplitudes and the phases are derived for two modes. These equations are utilized to determine steady state solutions and their stabilities. It is assumed that the external forcing frequency is close to the lower frequency. For the numeric part of the study, the three-to-one ratio in natural frequencies is investigated. These values are observed to be between the first and second natural frequencies in the cases of the clamped-clamped and clamped-pinned supports, and between the second and third natural frequencies in the case of the pinned-pinned support. Finally, a numeric algorithm is used to solve the three-to-one internal resonance. The first mode is externally excited for the clamped-clamped and clamped-pinned supports, and the second mode is externally excited for the pinned-pinned support. Then, the amplitudes of the first and second modes are investigated when the first mode is externally excited. The amplitudes of the second and third modes are investigated when the second mode is externally excited. The force-response, damping-response, and .frequency- response curves are plotted for the internal resonance modes of vibrations. The stability analysis is carried out for these plots.

Finite Element Analysis of Internal Gear in High-Speed Planetary Gear Units

The stress and the elastic deflection of internal ring gear in high-speed spur planetary gear units are investigated. A rim thickness parameter is defined as the flexibility of internal ring gear. Six evenly spaced linear springs are used to describe the fitting status between internal ring gear and the gearcase. The finite element model of the whole internal ring gear is established by means of Pro/E and ANSYS. The loads on meshing teeth of internal ring gear are applied according to the contact ratio and the load-sharing coefficient. With the finite element analysis (FEA), the influences of flexibility and fitting status on the stress and elastic deflection of internal ring gear are predicted. The simulation reveals that the principal stress and deflection increase with the decrease of rim thickness of internal ring gear. Moreover, larger spring stiffness helps to reduce the stress and deflection of internal ring gear. Therefore, the flexibility of internal ring gear must be considered during the design of high-speed planetary gear transmissions.