基于TeamSTEPPS的出院准备联动干预在老年缺血性卒中患者中的应用

目的探讨基于Team STEPPS的出院准备联动干预在老年缺血性卒中患者中的应用。方法选取2022年10月—2023年9月在安徽医科大学附属巢湖医院神经内科住院的106例老年缺血性卒中患者为研究对象,按入院时间将2022年10月—2023年3月入院的51例患者作为对照组,予以常规出院护理及随访;2023年4月—2023年9月入院的55例患者为干预组,实施基于Team STEPPS的出院准备联动干预。比较两组患者的出院准备度、主要照顾者过渡期的准备情况以及出院90 d患者日常生活活动能力、不良事件发生及非计划再入院情况。结果干预组患者出院准备度评估量表总分及4个维度得分、主要照顾者过渡期准备情况评估量表总分及8个维度得分均高于对照组,差异有统计学意义(P均<0.01)。干预组患者出院90 d日常生活活动能力评分为55(40,65)分,高于对照组的40(20,55)分,差异有统计学意义(P<0.01)。干预组患者出院90 d发生跌倒/坠床2例、压力性损伤3例、非计划性拔管4例,均低于对照组的8、10、11例,差异有统计学意义(P均<0.05)。干预组患者出院90 d非计划再入院2例,少于对照组的8例,差异有统计学意义(P=0.046)。结论基于Team STEPPS的出院准备联动干预可提升老年缺血性卒中患者出院准备度,改善主要照顾者过渡期的准备情况,提高患者出院90 d后日常生活活动能力,降低不良事件发生及非计划再入院,为老年缺血性卒中患者出院准备提供一定的临床依据。

基于TeamSTEPPS风险防控模式的护理在气管切开患者感染防控中的应用

目的 探讨基于强化临床表现和医疗安全的团队策略与工具(Team STEPPS)?风险防控模式的护理在气管切开患者感染防控中的应用。方法 选取2021年1月~2022年12月在安庆市第一人民医院入住的82例气管切开患者。其中2021年41例为对照组,实施常规的气管切开术后护理;2022年41例为观察组,在常规的气管切开术后护理基础上,基于Team STEPPS风险防控模式的护理措施。比较两组患者感染高风险事件发生率、医护合作情况、患者满意度。结果 观察组患者感染高风险事件发生率低于对照组,医护合作得分、患者满意度明显高于对照组(P<0.05)。结论 基于Team STEPPS风险防控模式的护理在气管切开患者感染防控中应用,降低了感染风险发生的事件、医护合作程度明显增强,患者的满意度提高显著,值得在临床推广应用。

Debris flow runout behaviors considering the influences of densely populated buildings

Debris flows pose serious risks to communities in mountainous areas,often resulting in large losses of human life and property.The impeding presence of urban buildings often affects the runout behavior and deposition of debris flows.But the impact of different building densities and sizes on debris flow dynamics has yet to be quantified to guide urban planning in debris flow risk zones.This study focused on a debris flow that occurred in Zhouqu County,Gansu Province,China on August 7th,2010,which was catastrophic and destroyed many buildings.The FLO-2D software was used to simulate this debris flow in two scenarios,i.e.the presence and the absence of buildings,to obtain debris-flow intensity parameters.The developed model was then used to further analyze the influence of large buildings and narrow channels within the urban environment.The simulation results show that considering the presence of buildings in the simulation is essential for accurate assessment of debris flow intensity and deposition distribution.The layout of buildings in the upstream urban area,such as large buildings or parallel buildings which form narrow channels,can affect the flow velocity and depth of debris flow heading towards downstream buildings.To mitigate damage to downstream buildings,the relative spacing(d/a)between upstream and downstream buildings should not exceed a value of two and should ideally be even lower.These findings provide valuable insights for improving the resistance of mountainous cities to urban debris flows.

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.

Study on Evacuation Strategy of Commercial High-Rise Building under Fire Based on FDS and Pathfinder

With the development of economy and society and the growth of population,the high-rise and multi-function of commercial buildings have become an international trend.But it also poses huge fire hazards.Most of the existing studies’research objects are predominantly high-rise residential buildings,without considering the impact of different functional zones(Standard floor,entertainment zone,office zone,equipment room and so on)and personnel distribution of commercial buildings evacuation.And the influence of using elevators to carry evacuees on the refuge floor on personnel evacuation is rarely studied.In this work,the fire scenario of the Yangtze River InternationalConferenceCenter,a high-rise commercial building,is simulated with the Pyrosim programto get the necessary parameters under various fire scenarios and to calculate the available evacuation time TASET.At the same time,according to the complex functional zone of the commercial high-rise building and the distribution of people in different time periods,a reasonable evacuation strategy is developed and simulated by Pathfinder software.The results indicate that unorganized evacuation will lead individuals to take the erroneous evacuation route,resulting in a vast region of congestion;comprehensive consideration of the time staggering and the reasonable distribution of evacuation routes can significantly improve evacuation efficiency,and the TRSET of night and working hours is 36.6%–55.3%and 49.9%–79.6%of unorganized evacuation,respectively.For the night fire,60%of the people use elevator-refuge floor to evacuate is the optimal strategy;for the fire during working hours,half of the people on standard floors use the elevator to evacuate and people on multifunctional floors evacuate in four batches is the best plan.The results of this study can provide viable solutions and a foundation for analyzing the fire evacuation and safety of big commercial high-rise buildings.

Farm buildings and agri-food transitions in Southern France:Mapping dynamics using a stakeholder-based diagnosis

This study's goal is to present a dynamic portrait of the farm-buildings environment in Occitania,in Southern France,in order to better identify the transitions underway in agri-food chains.To this end,we undertook a ter-ritorial diagnosis based on actor statements,using 28 semi-structured interviews across Occitania.This diagnosis was enriched by graphic modelling,which enabled the spatialization of the dynamics described.We show that the process of standardisation of farm buildings prevails in the majority of the territories studied.This phenomenon has intensified in recent years with the development of vast photovoltaic-roofed sheds,accentuating the farm-land conversion and soil sealing.At the same time,in areas with strong environmental,landscape and heritage contexts,a'new adventure in farm buildings'(2022 survey)is taking shape.It is primarily driven by local short food chains,which rely on self-construction,repurposing and refurbishment,the sharing of tools and equipment,and which favour the use and reuse of local resources.This study shows that farm-buildings dynamics crystallise many challenges confronting the reterritorialisation of agriculture and food production.

Controllable thermal rectification design for buildings based on phase change composites

Phase-change material(PCM)is widely used in thermal management due to their unique thermal behavior.However,related research in thermal rectifier is mainly focused on exploring the principles at the fundamental device level,which results in a gap to real applications.Here,we propose a controllable thermal rectification design towards building applications through the direct adhesion of composite thermal rectification material(TRM)based on PCM and reduced graphene oxide(rGO)aerogel to ordinary concrete walls(CWs).The design is evaluated in detail by combining experiments and finite element analysis.It is found that,TRM can regulate the temperature difference on both sides of the TRM/CWs system by thermal rectification.The difference in two directions reaches to 13.8 K at the heat flow of 80 W/m^(2).In addition,the larger the change of thermal conductivity before and after phase change of TRM is,the more effective it is for regulating temperature difference in two directions.The stated technology has a wide range of applications for the thermal energy control in buildings with specific temperature requirements.

A Stroke-Limitation AMD Control System with Variable Gain and Limited Area for High-Rise Buildings

Collisions between a moving mass and an anti-collision device increase structural responses and threaten structural safety.An active mass damper(AMD)with stroke limitations is often used to avoid collisions.However,a strokelimited AMD control system with a fixed limited area shortens the available AMD stroke and leads to significant control power.To solve this problem,the design approach with variable gain and limited area(VGLA)is proposed in this study.First,the boundary of variable-limited areas is calculated based on the real-time status of the moving mass.The variable gain(VG)expression at the variable limited area is deduced by considering the saturation of AMD stroke.Then,numerical simulations of a stroke-limited AMD control system with VGLA are conducted on a high-rise building structure.These numerical simulations show that the proposed approach has superior strokelimitation performance compared with a stroke-limited AMD control system with a fixed limited area.Finally,the proposed approach is validated through experiments on a four-story steel frame.

Dynamic response of buildings under debris flow impact

This study employs the smoothed particle hydrodynamics–finite element method(SPH–FEM) coupling numerical method to investigate the impact of debris flow on reinforced concrete(RC)-frame buildings. The methodology considers the variables of debris flow depth and velocity and introduces the intensity index IDV(IDV = DV) to evaluate three different levels of debris flow impact intensity. The primary focus of this study is to investigate the dynamic response and failure mechanism of RC-frame buildings under debris flow impact, including structural failure patterns, impact force and column displacement. The results show that under a highintensity impact, a gradual collapse process of the RCframe building can be observed, and the damage mode of the frame column reflects shear failure or plastic hinge failure mechanism. First, the longitudinal infill walls are damaged owing to their low out-of-plane flexural capacity;the critical failure intensity index IDV value is approximately 7.5 m2/s. The structure cannot withstand debris flows with an intensity index IDV greater than 16 m2/s, and it is recommended that the peak impact force should not exceed 2100 k N. The impact damage ability of debris flow on buildings mostly originates from the impact force of the frontal debris flow, with the impact force of the debris flow body being approximately 42% lower than that of the debris flow head. Finally, a five-level classification system for evaluating the damage status of buildings is proposed based on the numerical simulation and investigation results of the disaster site.

Studies of an event-building algorithm of the readout system for the twin TPCs in HFRS

The High-energy Fragment Separator(HFRS),which is currently under construction,is a leading international radioactive beam device.Multiple sets of position-sensitive twin time projection chamber(TPC)detectors are distributed on HFRS for particle identification and beam monitoring.The twin TPCs'readout electronics system operates in a trigger-less mode due to its high counting rate,leading to a challenge of handling large amounts of data.To address this problem,we introduced an event-building algorithm.This algorithm employs a hierarchical processing strategy to compress data during transmission and aggregation.In addition,it reconstructs twin TPCs'events online and stores only the reconstructed particle information,which significantly reduces the burden on data transmission and storage resources.Simulation studies demonstrated that the algorithm accurately matches twin TPCs'events and reduces more than 98%of the data volume at a counting rate of 500 kHz/channel.

Progress in Resource Utilization of River Sediment in the Field of Building Materials

At present,there is a great demand for building materials in the market,and the market prospect of building materials is relatively considerable.Through studying the composition of river sediment and its resource utilization in the field of building materials,this paper expounds the current domestic scholars research on river sediment in building materials,and summarizes the current problems and challenges,so as to provide a reference for the sustainable development of river sediment in the field of building materials.

Progress of semitransparent emerging photovoltaics for building integrated applications

With the rapid development of emerging photovoltaics technology in recent years,the application of building-integrated photovoltaics(BIPVs)has attracted the research interest of photovoltaic communities.To meet the practical application requirements of BIPVs,in addition to the evaluation indicator of power conversion efficiency(PCE),other key performance indicators such as heat-insulating ability,average visible light transmittance(AVT),color properties,and integrability are equally important.The traditional Si-based photovoltaic technology is typically limited by its opaque properties for application scenarios where transparency is required.The emerging PV technologies,such as organic and perovskite photovoltaics are promising candidates for BIPV applications,owing to their advantages such as high PCE,high AVT,and tunable properties.At present,the PCE of semitransparent perovskite solar cells(ST-PSCs)has attained 14%with AVT of 22–25%;for semitransparent organic solar cells(ST-OSCs),the PCE reached 13%with AVT of almost 40%.In this review article,we summarize recent advances in material selection,optical engineering,and device architecture design for high-performance semitransparent emerging PV devices,and discuss the application of optical modeling,as well as the challenges of commercializing these semitransparent solar cells for building-integrated applications.

Application of multidisciplinary team-based integrated traditional Chinese medicine and Western medicine in rotator cuff injury patients undergoing arthroscopic surgery

BACKGROUND Arthroscopic rotator cuff repair is a common surgical treatment for rotator cuff injuries(RCIs).Although this procedure has certain clinical advantages,it requires rehabilitation management interventions to ensure therapeutic efficacy.AIM To investigate the effect of integrated traditional Chinese medicine and Western medicine(TCM-WM)under the multidisciplinary team(MDT)model on the postoperative recovery of patients undergoing arthroscopic surgery for RCIs.METHODS This study enrolled 100 patients who underwent arthroscopic rotator cuff repair for RCIs at the Seventh People’s Hospital of Shanghai University of Traditional Chinese Medicine between June 2021 and May 2024.They were divided into a control group(n=48)that received routine rehabilitation treatment and an experimental group(n=52)that received TCM-WM under the MDT model(e.g.,acupuncture,TCM traumatology and orthopedics,and rehabilitation).The results of the Constant–Murley Shoulder Score(CMS),Visual Analogue Scale(VAS),Shoulder Pain and Disability Index(SPADI),muscular strength evaluation,and shoulder range of motion(ROM)assessments were analyzed.RESULTS After treatment,the experimental group showed significantly higher CMS scores in terms of pain,functional activity,shoulder joint mobility,and muscular strength than the baseline and those of the control group.The experimental group also exhibited significantly lower VAS and SPADI scores than the baseline and those of the control group.In addition,the experimental group showed significantly enhanced muscular strength(forward flexor and external and internal rotator muscles)and shoulder ROM(forward flexion,abduction,and lateral abduction)after treatment compared with the control group.CONCLUSION TCM-WM under the MDT model improved shoulder joint function,relieved postoperative pain,promoted postoperative functional recovery,and facilitated the recovery of muscular strength and shoulder ROM in patients with RCIs who underwent arthroscopic rotator cuff repair.

A novel control strategy for reproducing the floor motions of high-rise buildings by earthquake-simulating shake tables

To enable the experimental assessment of the seismic performance of full-scale nonstructural elements with multiple engineering parameters(EDPs),a three-layer testbed named Nonstructural Element Simulator on Shake Table(NEST)has been developed.The testbed consists of three consecutive floors of steel structure.The bottom two floors provide a space to accommodate a full-scale room.To fully explore the flexibility of NEST,we propose a novel control strategy to generate the required shake table input time histories for the testbed to track the target floor motions of the buildings of interest with high accuracy.The control strategy contains two parts:an inverse dynamic compensation via simulation of feedback control systems(IDCS)algorithm and an offline iteration procedure based on a refined nonlinear numerical model of the testbed.The key aspects of the control strategy were introduced in this paper.Experimental tests were conducted to simulate the seismic responses of a full-scale office room on the 21^(st)floor of a 42-story high-rise building.The test results show that the proposed control strategy can reproduce the target floor motions of the building of interest with less than 20%errors within the specified frequency range.

Exploring the Path of Party Building Leading League Construction in Colleges and Universities under the Pattern of Great Ideological and Political Education

In accordance with the pattern of"great ideology and politics",the Party and youth League organizations assume the role of vanguard in the organization of colleges and universities.Simultaneously,they serve as a pivotal force in ideological and political education.In order to construct a comprehensive ideological and political framework encompassing the entire educational process,it is of paramount importance to identify an efficacious methodology for Party building leading League construction.This paper employs a comprehensive analysis to elucidate the pivotal role of Party building leading League construction in facilitating ideological and political education.It also illuminates the practical challenges encountered in the implementation of Party building leading League construction initiatives within colleges and universities.The article proposes a specific path for Party building leading League construction in colleges and universities based on three key aspects:cohesion of the consensus of Party building leading League building,establishment of the institutional system of Party building leading League construction,and creation of the model brand of Party building leading League construction.The aim is to promote in-depth development of Party building in colleges and universities and enhance the quality and effect of ideological and political education.

Parameters Optimization and Performance Evaluation of the Tuned Inerter Damper for the Seismic Protection of Adjacent Building Structures

In order to improve the seismic performance of adjacent buildings,two types of tuned inerter damper(TID)damping systems for adjacent buildings are proposed,which are composed of springs,inerter devices and dampers in serial or in parallel.The dynamic equations of TID adjacent building damping systems were derived,and the H2 norm criterion was used to optimize and adjust them,so that the system had the optimum damping performance under white noise random excitation.Taking TID frequency ratio and damping ratio as optimization parameters,the optimum analytical solutions of the displacement frequency response of the undamped structure under white noise excitation were obtained.The results showed that compared with the classic TMD,TID could obtain a better damping effect in the adjacent buildings.Comparing the TIDs composed of serial or parallel,it was found that the parallel TIDs had more significant advantages in controlling the peak displacement frequency response,while the H2 norm of the displacement frequency response of the damping system under the coupling of serial TID was smaller.Taking the adjacent building composed of two ten-story frame structures as an example,the displacement and energy collection time history analysis of the adjacent building coupled with the optimum design parameter TIDs were carried out.It was found that TID had a better damping effect in the full-time range compared with the classic TMD.This paper also studied the potential power of TID in adjacent buildings,which can be converted into available power resources during earthquakes.

Databases of 2D material-substrate interfaces and 2D charged building blocks

Discovery of materials using“bottom-up”or“top-down”approach is of great interest in materials science.Layered materials consisting of two-dimensional(2D)building blocks provide a good platform to explore new materials in this respect.In van der Waals(vdW)layered materials,these building blocks are charge neutral and can be isolated from their bulk phase(top-down),but usually grow on substrate.In ionic layered materials,they are charged and usually cannot exist independently but can serve as motifs to construct new materials(bottom-up).In this paper,we introduce our recently constructed databases for 2D material-substrate interface(2DMSI),and 2D charged building blocks.For 2DMSI database,we systematically build a workflow to predict appropriate substrates and their geometries at substrates,and construct the 2DMSI database.For the 2D charged building block database,1208 entries from bulk material database are identified.Information of crystal structure,valence state,source,dimension and so on is provided for each entry with a json format.We also show its application in designing and searching for new functional layered materials.The 2DMSI database,building block database,and designed layered materials are available in Science Data Bank at https://doi.org/10.57760/sciencedb.j00113.00188.

Effects of nursing team communication and collaboration on treatment outcomes in intensive care unit patients with severe pneumonia

BACKGROUND Severe pneumonia is a common severe respiratory infection worldwide,and its treatment is challenging,especially for patients in the intensive care unit(ICU).AIM To explore the effect of communication and collaboration between nursing teams on the treatment outcomes of patients with severe pneumonia in ICU.METHODS We retrospectively analyzed 60 patients with severe pneumonia who were treated at the ICU of the hospital between January 1,2021 and December 31,2023.We compared and analyzed the respiratory mechanical indexes[airway resistance(Raw),mean airway pressure(mPaw),peak pressure(PIP)],blood gas analysis indexes(arterial oxygen saturation,arterial oxygen partial pressure,and oxygenation index),and serum inflammatory factor levels[C-reactive protein(CRP),procalcitonin(PCT),cortisol(COR),and high mobility group protein B1(HMGB1)]of all patients before and after treatment.RESULTS Before treatment,there was no significant difference in respiratory mechanics index and blood gas analysis index between 2 groups(P>0.05).However,after treatment,the respiratory mechanical indexes of patients in both groups were significantly improved,and the improvement of Raw,mPaw,plateau pressure,PIP and other indexes in the combined group after communication and collaboration with the nursing team was significantly better than that in the single care group(P<0.05).The serum CRP and PCT levels of patients were significantly decreased,and the difference was statistically significant compared with that of nursing group alone(P<0.05).The levels of serum COR and HMGB1 before and after treatment were also significantly decreased between the two groups.CONCLUSION The communication and collaboration of the nursing team have a significant positive impact on respiratory mechanics indicators,blood gas analysis indicators and serum inflammatory factor levels in the treatment of severe pneumonia patients in ICU.

Low-Cost Insulation for Energy Efficient Buildings in Terai Region of Nepal

There is a huge amount of energy savings potential in public building sector that has yet to be realized.By prioritizing energy efficiency in its own buildings and thus promoting the development of required knowledge in terms of new technology and construction methods,the public sector will lead the way in efforts to increase the rate of renovations.The low-cost insulation strategies and a comparison of cost with existing insulation materials has been described in this study.We have repeatedly faced energy crises and will continue to do so in the future if appropriate action is not taken in a timely manner.Properly implementing energy-saving initiatives in for achieving thermal comfort in buildings as well as reducing the energy costs would undoubtedly inspire the residential sector,resulting in significant reductions in energy usage.Simulations were carried out to study insulation layers on various building components like exterior walls,floor and roofs,generating different scenarios for a building as a base model,which were then compared and analysed to verify the literature used to develop the cases.The proposed recommendations,which have been validated,are certain to increase building energy efficiency,achieve thermal comfort in low cost than what is currently being used.

Visual Analysis of Domestic and Foreign Building Brick Skin Research Based on Citespace

With the progress of the times and the leap of science and technology,the application of brick materials and the research on the brick skin in modern architectural design have shown a dual-track development trend of returning to tradition and innovation.Based on the core collection database resources of Web of Science and the CiteSpace visual analysis tool,this paper constructed and analyzed the spatio-temporal map of keyword co-occurrence network,cluster structure,mutation phenomenon,time course and regional distribution map of building brick skin research.The study revealed that in recent years,the research on brick materials has spanned the study of single material properties and extensively involved in the broad world of construction,especially in the integration of green energy-saving technology,the innovation of fine construction technology of brick skin,and the frontier exploration of digital technology in brick masonry,which has shown particularly significant research vitality and development potential.