基于TeamSTEPPS理论的案例情景教学法在急诊护理团队培训中的应用

急诊科具有危重患者多,突发状况多,医疗风险高等特点,目前国内大多数医院急诊科护士以团队形式开展工作,但临床工作中易出现职责分工不明确、配合不协调、组织抢救混乱等问题^([1])。团队培训是增强团队优质高效协作的重要途径^([2]),为进一步提升急诊护理团队协作,保障患者安全,本次研究将前期基于提高医疗质量和患者安全的团队策略与工具(team strategies and tools to enhance performance and patient safety,TeamSTEPPS)理论构建的急诊护理团队培训方案^([3])进行临床应用,取得了较好的效果。现报道如下。

Controllable step-flow growth of GaN on patterned freestanding substrate

A new kind of step-flow growth mode is proposed,which adopts sidewall as step source on patterned GaN substrate.The terrace width of steps originated from the sidewall was found to change with the growth temperature and ammonia flux.The growth mechanism is explained and simulated based on step motion model.This work helps better understand the behaviors of step advancement and puts forward a method of precisely modulating atomic steps.

Stability analysis of intermittently jointed rock slopes based on the stepped failure mode

In practical engineering,due to the noncontinuity characteristics of joints in rock slopes,in addition to plane failure,stepped sliding failure may occur for intermittently jointed rock slopes.Especially for intermittently bedding jointed rock slopes,the correlation and difference in strength parameters between joints and rock bridges,along with the various failure modes and intermittency of rock bridges,contribute to the complexity of stepped failure modes and the unpredictability of failure regions.Based on the upper-bound limit analysis method and multi-sliders step-path failure mode,considering the shear and tensile failure of rock bridges and the weakened relationship between the strength parameters of rock bridges and jointed surfaces,by introducing the modified M-C failure criterion and the formula for calculating the energy consumption of tensile failure of rock bridges,two failure mechanisms are constructed to obtain the safety factor(F_(s))of intermittently jointed rock slopes.The sequential quadratic programming method is used to obtain the optimal upper-bound solution for F_(s).The influence of multiple key parameters(slope height H,horizontal distance L,Slope angleβ,shear strength parameters of the rock bridgeφr and cr,Dimensionless parameter u,weakening coefficients of the internal friction angle and cohesion between the rock bridges and joint surfaces Kφand Kc)on the stability analysis of intermittently jointed rock slopes under the shear failure mode of rock bridges as well as under the tensile failure mode is also explored.The reliability of the failure mechanisms is verified by comparative analysis with theoretical results,numerical results,and landslide cases,and the variation rules of F_(s)with each key parameter are obtained.The results show that F_(s) varies linearly withφr and cr of the rock bridge and with K_(φ)and K_(c),whereas F_(s)changes nonlinearly with H and L.In particular,with the increase in Kφand Kc,Fs increases by approximately 52.78%and 171.02%on average,respectively.For rock bridge tensile failure,F_(s) shows a nonlinearly positive correlation withφr,cr,Kφand Kc.In particular,with the increase in Kφand Kc,Fs increases by approximately 13%and 61.69%on average,respectively.Fs decreases rapidly with increasing slope gradientβand decreasing dimensionless parameterμ.When Kφand Kc are both less than 1.0,the stepped sliding surface occurs more easily than the plane failure surface,especially in the case of tensile failure of the rock bridge.In addition,rock slopes with higher strength parameters,taller heights,and greater weakening coefficients are prone to rock bridge tension failure with lower Fs,and more attention should be given to the occurrence of such accidents in actual engineering.

Contribution to the Full 3D Finite Element Modelling of a Hybrid Stepping Motor with and without Current in the Coils

The paper presents our contribution to the full 3D finite element modelling of a hybrid stepping motor using COMSOL Multiphysics software. This type of four-phase motor has a permanent magnet interposed between the two identical and coaxial half stators. The calculation of the field with or without current in the windings (respectively with or without permanent magnet) is done using a mixed formulation with strong coupling. In addition, the local high saturation of the ferromagnetic material and the radial and axial components of the magnetic flux are taken into account. The results obtained make it possible to clearly observe, as a function of the intensity of the bus current or the remanent induction, the saturation zones, the lines, the orientations and the magnetic flux densities. 3D finite element modelling provide more accurate numerical data on the magnetic field through multiphysics analysis. This analysis considers the actual operating conditions and leads to the design of an optimized machine structure, with or without current in the windings and/or permanent magnet.

"Five steps four quadrants" modularized en bloc dissection technique for accessing hepatic hilum lymph nodes in laparoscopic pancreaticoduodenectomy

BACKGROUND Although en bloc dissection of hepatic hilum lymph nodes has many advantages in radical tumor treatment,the feasibility and safety of this approach for laparo-scopic pancreaticoduodenectomy(LPD)require further clinical evaluation and investigation.AIM To explore the application value of the"five steps four quadrants"modularized en bloc dissection technique for accessing hepatic hilum lymph nodes in LPD patients.METHODS A total of 52 patients who underwent LPD via the"five steps four quadrants"modularized en bloc dissection technique for hepatic hilum lymph nodes from April 2021 to July 2023 in our department were analyzed retrospectively.The patients'body mass index(BMI),preoperative laboratory indices,intraoperative variables and postoperative complications were recorded.The relationships between preoperative data and intraoperative lymph node dissection time and blood loss were also analyzed.RESULTS Among the 52 patients,36 were males and 16 were females,and the average age was 62.2±11.0 years.There were 26 patients with pancreatic head cancer,16 patients with periampullary cancer,and 10 patients with distal bile duct cancer.The BMI was 22.3±3.3 kg/m²,and the median total bilirubin(TBIL)concentration was 57.7(16.0-155.7)µmol/L.All patients successfully underwent the"five steps four quadrants"modularized en bloc dissection technique without lymph node clearance-related complications such as postoperative bleeding or lymphatic leakage.Correlation analysis revealed significant associations between preoperative BMI(r=0.3581,P=0.0091),TBIL level(r=0.2988,P=0.0341),prothrombin time(r=0.3018,P=0.0297)and lymph node dissection time.Moreover,dissection time was significantly correlated with intraoperative blood loss(r=0.7744,P<0.0001).Further stratified analysis demonstrated that patients with a preoperative BMI≥21.9 kg/m²and a TIBL concentration≥57.7μmol/L had significantly longer lymph node dissection times(both P<0.05).CONCLUSION The"five steps four quadrants"modularized en bloc dissection technique for accessing the hepatic hilum lymph node is safe and feasible for LPD.This technique is expected to improve the efficiency of hepatic hilum lymph node dissection and shorten the learning curve;thus,it is worthy of further clinical promotion and application.

谐波驱动系统Back-stepping滑模控制研究

针对谐波传动系统动力学模型中存在的柔性变形、摩擦和运动误差等非线性因素。为了提高系统的传动精度,针对系统非线性刚度和静态误差因素进行了建模,并提出了一种Back-stepping滑模控制方法。利用Lyapunov稳定性理论,证明了闭环系统的误差是一致有界的。仿真结果表明,与PID控制相比,采用Back-stepping滑模控制,系统传动误差曲线峰峰值减小66.63%;负载端角速率误差曲线峰峰值减小77.35%。Back-stepping滑模控制能有效地补偿系统传动误差,抑制其负载端的速度波动,提高了系统的传动精度。

A Clean Switch Inner Mongolian town takes giant steps in transitioning to clean energy production

Staff at the Ruichen Wanniu Livestock Farm in Jungar Zhao Town,Jungar Banner,Inner Mongolia,are consistently busy,even during important festivals.

基于STEP模式下的计算机专业课堂实践教学效果提升策略

本研究的目的在于探讨基于STEP模式的计算机专业课堂实践教学效果提升策略。本研究采用了文献研究和理论分析的方法,探讨了STEP模式在计算机专业课堂中的优势,并提出了提升教学效果的策略。研究结果表明,STEP模式在计算机专业课堂实践教学中有利于跨学科整合、解决实际问题、促进团队协作。为了提高教学效果,本研究提出了多元化教学手段、师资队伍培训、及时更新理论教材等策略。本研究的结论是,采用STEP模式并实施相应策略可以有效提升计算机专业课堂实践教学的效果,帮助学生更好地适应现实问题解决和职业需求。

Emissions of SO_2, NO and N_2O in a circulating fluidized bed combustor during co-firing coal and biomass

This paper presents the experimental investigations of the emissions of SO2, NO and N20 in a bench scale circulating fluidized bed combustor for coal combustion and co-firing coal and biomass. The thermal capacity of the combustor is 30 kW. The setup is electrically heated during startup. The infuence of the excess air, the degree of the air staging, the biomass share and the feeding position of the fuels on the emissions of SO2, NO and N2O were studied. The results showed that an increase in the biomass shares resulted in an increase of the CO concentration in the flue gas, probably due to the high volatile content of the biomass. In co-firing, the emission of SO2 increased with increasing biomass share slightly, however, non-linear increase relationship between SO2 emission and fuel sulfur content was observed. Air staging significantly decreased the NO emission without raising the SO2 level. Although the change of the fuel feeding position from riser to downer resulted in a decrease in the NO emission level, no obvious change was observed for the SO2 level. Taking the coal feeding position R as a reference, the relative NO emission could significantly decrease during co-firing coal and biomass when feeding fuel at position D and keeping the first stage stoichiometry greater than 0.95. The possible mechanisms of the sulfur and nitrogen chemistry at these conditions were discussed and the ways of simultaneous reduction of SO2, NO and N2O were proposed.

CMT Cycle Step工艺参数对焊缝表面特征纹路及成形尺寸的影响

采用CMT Cycle Step焊接工艺进行平板堆焊正交试验,研究了送丝速度、焊接速度、熔滴数量和间隔时间四个参数对焊缝表面特征纹路及成形尺寸的影响,建立了各参数与焊缝表面鱼鳞纹步长S、焊缝熔宽B、堆焊层厚度h之间的回归模型.结果表明,随着焊接速度、熔滴数量和间隔时间的增大,焊缝表面鱼鳞纹步长S呈逐渐增大的趋势.适当减小焊接速度和间隔时间,可有效减小焊缝表面高度差Δh,提高焊缝表面成形质量.随着送丝速度和熔滴数量的增大,焊缝熔宽B和堆焊层厚度h均逐渐增大;随着焊接速度的增大,焊缝熔宽B和堆焊层厚度h逐渐减小.根据理论分析和回归分析得到准确性较高的回归方程,为预测焊接焊缝成形以及优化焊接工艺参数提供理论依据.创新点:(1)系统研究了CMT Cycle Step焊接工艺参数对焊缝成形的影响规律,有助于采用该方法解决点焊、热敏感材料焊接、电弧增材制造等领域的相关技术难题.(2)建立了CMT Cycle Step焊接工艺的送丝速度、焊接速度、熔滴数量和间隔时间四个参数对焊缝表面特征纹路及成形尺寸回归模型,为预测焊缝成形以及优化焊接工艺参数提供理论依据.(3)对CMT Cycle Step焊缝表面特征纹路—鱼鳞纹进行量化评价,探究工艺参数对焊缝表面鱼鳞纹步长S和表面高度差Δh的影响规律,有利于获得高表面平整度的焊缝.

Co-firing of coal and biomass in oxy-fuel fluidized bed for CO2 capture: A review of recent advances

The co-firing of coal and biomass in oxy-fuel fluidized beds is one of the most promising technologies for capturing CO2.This technology has attracted wide attention from academia and industry in recent years as a negative emission method to capture CO2 produced by carbon contained in biomass.In the past decades,many studies have been carried out regarding experiments and numerical simulations under oxy-fuel combustion conditions.This paper firstly briefly discusses the techno-economic viability of the biomass and coal co-firing with oxycombustion and then presents a review of recent advancements involving experimental research and computational fluid dynamics(CFD)simulations in this field.Experimental studies on mechanism research,such as thermogravimetric analysis and tube furnace experiments,and fluidized bed experiments based on oxy-fuel fluidized beds with different sizes as well as the main findings,are summarized as a part of this review.It has been recognized that CFD is a useful approach for understanding the behaviors of the co-firing of coal and biomass in oxyfuel fluidized beds.We summarize a recent survey of published CFD research on oxy-fuel fluidized bed combustion,which categorized into Eulerian and Lagrangian methods.Finally,we discuss the challenges and interests for future research.

Waste biomass from production process co-firing with coal in a steam boiler to reduce fossil fuel consumption:A case study

Waste biomass is always generated during the production process in industries. The ordinary way to get rid of the waste biomass is to send them to landfill or burn it in the open field. The waste may potentially be used for co-firing with coal to save fossil fuel consumption and also reduce net carbon emissions. In this case study, the bio-waste from a Nicotiana Tahacum （NT） pre-treatment plant is used as the biomass to co-fire with coal. The samples of NT wastes were analysed. It was found that the wastes were of the relatively high energy content which were suitable for co-firing with coal. To investigate the potential and benefits for adding NT wastes to a Fluidised Bed Combustion （FBC） boiler in the plant, detailed modelling and simulation are carried out using the European Coal Liquefaction Process Simulation and Evaluation （ECLIPSE） process simulation package. The feedstock blending ratios of NT waste to coal studied in this work are varied from 0% to 30%. The results show that the addition of NT wastes may decrease the emissions of CO2 and SOx without reducing the boiler performance.

IVUS引导下Step-Crush术治疗左主干分叉病变对支架贴壁情况及患者预后的影响

目的:分析血管内超声(IVUS)引导下Step-Crush术治疗左主干分叉病变对支架贴壁情况及患者预后的影响。方法:回顾分析2021年3月—2022年12月于九江市第一人民医院总院心血管内科就诊的左主干分叉病变患者60例,根据手术方式将患者分为IVUS组(n=34,采用IVUS引导下StepCrush术)和常规组(n=26,采用常规Step-Crush术)。对比两组支架情况(最大支架直径、左主干支架长度、支架贴壁不良发生率、支架边缘夹层发生率)、球囊参数(球囊最大直径、球囊最大压力)、心功能指标[左室射血分数(LVEF)、左室舒张末内径(LVEDD)]及心血管不良事件发生率。结果:相较于常规组,IVUS组最大支架直径、左主干支架长度、球囊最大直径均更长,球囊最大压力更大(P<0.05);术后2个月,IVUS组LVEF较常规组更高,LVEDD较常规组更低,差异均有统计学意义(P<0.05);IVUS组支架贴壁不良发生率、心血管不良事件发生率均更低,差异均有统计学意义(P<0.05)。两组支架边缘夹层发生率对比,差异无统计学意义(P>0.05)。结论:IVUS应用于Step-Crush术中可改善左主干分叉病变患者支架置入情况,降低支架贴壁发生率,有效预防心血管不良事件发生。

Low SO_2 emission from CFB co-firing MSW and bituminous

Influence of co-firing rate on SO 2 emission from co-firing municipal solid waste(MSW) and bituminous containing high amount of sulfur(1.79%) was studied in a 0.15 MWt circulating fluidized bed(CFB). The temperature selected is 1123 K, typical for MSW incineration using CFB. The particle concentration in the dilution zone of the furnace, the alkali metal concentration and sulfate concentration in the recirculating ash and fly ash, and flue gas composition were determined. The results showed that the addition of MSW leads to a significant decrease in SO 2 emission. Concentration of SO 2 in flue gas decreased to 0 with the co-firing rate greater than 51%. This reduction in SO 2 emission is attributed both to the high particle concentration in the dilution zone of the furnace, the high content of alkali metals in the bed material, and to the comparatively high concentration of HCl in flue gas during co-firing of MSW and bituminous.

基于STEP工程教育理念的卓越工程师培养模式

为了适应新形势下卓越工程师人才培养的需求,在工程教育改革和工程认证大环境下,对标国际一流高校,借鉴CDIO等国内外先进的教育理念,并结合北京航空航天大学工程教育实际,提出了对支撑工程教育、培养卓越工程师具有普适性的STEP(即软件、理论、实验、项目)教育模式。STEP教育模式构建了项目驱动、理论教学与实验教学协同、软件工具支撑的课程体系,科教融合、虚实结合、竞赛聚合的教学模式,以及提升教学能力、完善实践环境、改进质量评价体系的保障机制。STEP教育模式已在北京航空航天大学相关学院部分课程建设中进行了推广和实践,并取得了良好的教学实践效果。

Effects of Flue Gas Internal Recirculation on NOx and SOx Emissions in a Co-Firing Boiler

Volumetric combustion has been developed to realize a high substitution ratio of biomass in co-firing boilers, which features an intensive flue gas internal recirculation inside furnace. However, the characteristics of NOx and SOx emissions in large-scale boilers with volumetric combustion were not fully clear. In this paper, an Aspen Plus model of volumetric combustion system was built up based on a co-firing boiler. In order to characterize the reductions of NOx and SOx, three biomass substitution ratios were involved, namely, 100% biomass, 45% biomass with 55% coal, and 100% coal. The effects of flue gas recirculation ratio, air preheating temperature, oxygen concentration, and fuel types on pollutants emission in the volumetric combustion system were investigated. According to the results, it was concluded the higher substitution ratio of biomass in a co-firing boiler, the lower emissions of NOx and SOx. Moreover, flue gas internal recirculation is an effective pathway for NOx reduction and an increased recirculation ratio resulted in a significant decreasing of NOx emission;however, the SOx increased slightly. The influences of air preheating temperature and O2 concentration on NOx emission were getting weak with increasing of recirculation ratio. When 10% or even higher of flue gas was recycled, it was observed that almost no NOx formed thermodynamically under all studied conditions. Finally, to reach a low emission level of NOx, less energy would be consumed during biomass combustion than coal combustion process for internal recirculation of flue gas.

基于多线程加速的STEP标准并行解析算法

当前CAD软件加载大型STEP中性文件时速度慢,其效率瓶颈关键在于其解析算法.针对基于单线程的中性标准解析算法已经远远不能满足当前CAD应用需求的问题,提出了一种基于多线程的分层并行数据解析算法,利用当前主流CPU都采用的多核并行架构,大幅提升了STEP文件解析效率.根据模型体中数据的分层特性,算法利用线程池对各层数据解析进行并行加速.文中算法已经在开源几何引擎OpenGE中实现.与OpenCASCADE的对比实验验证了文中算法的有效性.实验结果表明,算法的并行解析程序运行速度相比串行解析程序运行速度提升至原算法的2倍,比OpenCASCADE解析算法快50%.

Air Quality Impact of Biomass Co-Firing with Coal at a Power Plant in the Greater Houston Area

The Houston-Galveston-Brazoria (HGB) area of Texas is a moderate nonattainment region for ozone, and has a history of severe summer ozone episodes. W. A. Parish power plant (WAP) located in the greater Houston area is the largest coal and natural gas based electricity generating unit (EGU) in Texas. Forest residue is an abundant renewable resource, and can be used to offset coal usage at EGUs. This study evaluates the impact of co-firing 5%, 10%, and 15% (energy-basis) of forest residue at WAP on the air quality of the HGB area. Photochemical modeling with Comprehensive Air Quality Model with Extensions (CAMx) was conducted to investigate the air quality at three air quality monitoring sites (C696, C53, C556) in the HGB area, under two source scenarios (all-sources, point + biogenic sources). Significant reduction of SO2 and O3 was observed for 10% and 15% co-firing ratios at monitoring station (C696) close to WAP. The maximum reduction of ozone observed for 15% co-firing is 4.7% and 6.3% for all-sources and point + biogenic sources scenarios respectively. The reduction in other criteria air pollutants is not significant at all locations. The overall results from this study indicate that biomass co-firing at WAP would not lead to a significant reduction in ozone concentrations in the region during periods of peak ozone.

Wood Pellet Co-Firing for Electric Generation Source of Income for Forest Based Low Income Communities in Alabama

Alabama imports coal from other states to generate electricity. This paper assessed the direct and indirect economic impacts of wood pellet production to be co-fired with coal for power generation in Alabama. Four sizes of wood pellet plants and regional input-output models were used for the analysis. The results showed that the economic impact increases with the size of the plant. Wood pellet production will have a multiplier effect on the economy especially, forest-related services, retail stores, the health service industry, and tax revenue for the government. Domestic wood pellet production can reduce the use of imported coal, allow the use of local woody biomass, and create economic activities in Alabama’s rural communities. Policies that support the production of wood pellet will serve to encourage the use of wood for power generation and support the rural economies.

Aging effect and test-retest reliability of the sinusoidal harmonic acceleration test and velocity step test using nanotorque rotatory chair

Introduction:Rotatory chair testing has been used to evaluate horizontal canal function.Frequently used tests include sinusoidal harmonic acceleration test(SHAT)and velocity step test(VST).Objectives:Assessment of age effect on the SHAT and VST and assessment of test-retest reliability of the parameters of those two tests.Methods:A prospective study was performed on 100 subjects with no ear or vestibular complaints and normal vestibular evaluation.They were divided into two groups;Group A:below 50 years of age and Group B:50 years of age or above.SHAT was presented at frequencies 0.02,0.04,0.08,0.16,0.32,0.64 Hz with a peak velocity of 60°/s.VST was performed using a maximum velocity of 100°/s with acceleration and deceleration of 200°/s2.Thirty subjects were tested twice to assess reliability.Results:Study participants ranged in age from 20 to 67 years.Regarding group A,the mean age was30.92±7.31 and 55.36±4.61 for group B.No significant differences were found in SHAT parameters between the two groups.As well,there was no significant difference in VST per-rotatory time constant,however,post-rotatory time constant was significantly longer for Group B(P value<0.05).Intraclass correlation coefficient(ICC)values showed moderate to good reliability(ICC 0.5800.818)for SHAT parameters for the lower frequencies and indicated moderate reliability for VST time constant(ICC 0.5090.652).Conclusions:Age has no significant effect on the parameters of SHAT and VST.Test-retest reliability is generally good for both tests.