This paper presents a simplified elastic continuum method for calculating the restraint effect of isolation piles on tunneling-induced vertical ground displacement,which can consider not only the relative sliding of t...This paper presents a simplified elastic continuum method for calculating the restraint effect of isolation piles on tunneling-induced vertical ground displacement,which can consider not only the relative sliding of the pile‒soil interface but also the pile rowesoil interaction.The proposed method is verified by comparisons with existing theoretical methods,including the boundary element method and the elastic foundation method.The results reveal the restraining mechanism of the isolation piles on vertical ground displacements due to tunneling,i.e.the positive and negative restraint effects exerted by the isolation piles jointly drive the ground vertical displacement along the depth direction from the original tunneling-induced nonlinear variation situation to a relatively uniform situation.The results also indicate that the stiffness of the pile‒soil interface,including the pile shaft‒surrounding soil interface and pile tip-supporting soil interface,describes the strength of the pile‒soil interaction.The pile rows can confine the vertical ground displacement caused by the tunnel excavation to the inner side of the isolation piles and effectively prevent the vertical ground displacement from expanding further toward the outer side of the isolation piles.展开更多
BACKGROUND Despite numerous attempts to reduce the use of mechanical restraint(MR),this technique continues to be widely applied in many acute psychiatric care settings.In order to reduce MR,a better understanding of ...BACKGROUND Despite numerous attempts to reduce the use of mechanical restraint(MR),this technique continues to be widely applied in many acute psychiatric care settings.In order to reduce MR,a better understanding of the variables associated with its use and duration in different clinical environments is essential.AIM To determine the proportion of patients subjected to MR and the duration thereof in two acute care psychiatric units;and to identify the variables associated with the use and duration of MR.METHODS Descriptive study of all patients admitted to the acute psychiatric units at the Parc de Salut Mar(Barcelona,Spain)in the year 2018.The number and percentage of patients subjected to MR,as well as the duration of each episode were assessed.The following data were also registered:sociodemographic characteristics,psychiatric diagnosis,and presence of cultural and/or language barriers.Multivariate analyses were performed to assess determinants of MR and its duration.RESULTS Of the 464 patients,119(25.6%)required MR,with a median of 16.4 h per MR.Two factors-a diagnosis of psychotic disorder[Odds ratios(OR)=0.22;95%CI:0.06-0.62;P=0.005]and the presence of a language barrier(OR=2.13;95%CI:1.2-3.7;P=0.007)-were associated with a significantly higher risk of MR.Male sex was associated with a longer duration of MR(B=-19.03;95%CI:-38.06-0.008;P=0.05).CONCLUSION The presence of a language barrier and a psychotic disorder diagnosis are associated with a significantly higher risk of MR.Furthermore,male sex is associated with a longer duration of MR.Individualized restraint protocols that include the required tools are necessary to ultimately limit the use of mechanical restraint.展开更多
Throughout the vehicle crash event, the interactions between vehicle, occupant, restraint system (VOR) are complicated and highly non-linear. CAE and physical tests are the most widely used in vehicle passive safety d...Throughout the vehicle crash event, the interactions between vehicle, occupant, restraint system (VOR) are complicated and highly non-linear. CAE and physical tests are the most widely used in vehicle passive safety development, but they can only be done with the detailed 3D model or physical samples. Often some design errors and imperfections are difficult to correct at that time, and a large amount of time will be needed. A restraint system concept design approach which based on single-degree-of-freedom occupant-vehicle model (SDOF) is proposed in this paper. The interactions between the restraint system parameters and the occupant responses in a crash are studied from the view of mechanics and energy. The discrete input and the iterative algorithm method are applied to the SDOF model to get the occupant responses quickly for arbitrary excitations (impact pulse) by MATLAB. By studying the relationships between the ridedown efficiency, the restraint stiffness, and the occupant response, the design principle of the restraint stiffness aiming to reduce occupant injury level during conceptual design is represented. Higher ridedown efficiency means more occupant energy absorbed by the vehicle, but the research result shows that higher ridedown efficiency does not mean lower occupant injury level. A proper restraint system design principle depends on two aspects. On one hand,the restraint system should lead to as high ridedown efficiency as possible, and at the same time, the restraint system should maximize use of the survival space to reduce the occupant deceleration level. As an example, an optimization of a passenger vehicle restraint system is designed by the concept design method above, and the final results are validated by MADYMO, which is the most widely used software in restraint system design, and the sled test. Consequently, a guideline and method for the occupant restraint system concept design is established in this paper.展开更多
Objective: Physical restraint is frequently used in medical services,such as in mental health settings,intensive care units and nursing homes,but its nature varies in different institutions.By reviewing related litera...Objective: Physical restraint is frequently used in medical services,such as in mental health settings,intensive care units and nursing homes,but its nature varies in different institutions.By reviewing related literature,this study aims to clarify the concept of physical restraint in mental health nursing.Method: Three databases (PubMed,PsyclNFO and CINAHL) were retrieved,and Walker and Avant's concept analysis method was used to analyze the concept of physical restraint in mental health nursing.Results: Physical restraint is a coercive approach that enables the administration of necessary treatment by safely reducing the patient's physical movement.It should be the last option used by qualified personnel.Antecedents of physical restraint are improper behavior (violence and disturbance) of patients,medical assessment prior to implementation and legislation governing clinical usage.Consequences of physical restraint are alleviation of conflict,physical injury,mental trauma and invisible impact on the institution.Discussion: This study defined the characteristics of physical restraint in mental health nursing.The proposed concept analysis provided theoretical foundation for future studies.展开更多
Given that physical restraints cause adverse effects to patients and nurses,their wide and frequent use has resulted in various clinical and ethical controversies in mental health services.The rate of physical restrai...Given that physical restraints cause adverse effects to patients and nurses,their wide and frequent use has resulted in various clinical and ethical controversies in mental health services.The rate of physical restraints is significantly higher in China than in other countries.Some western and domestic media blamed relevant institutions for compromising the basic rights of psychiatric patients.Therefore,this study aims to collect and synthesize the relevant ethical evidence and to provide corresponding guidance for the nursing practice based on the current situation of the mainland of China.This study synthesized the ethical issue according to the ethical principle of autonomy,justice,beneficence,and nonmaleficence.Given the current situation where the nursing workforce is limited and the mental health service is under-developed in China,applying physical restraints in the psychiatric inpatients to guarantee the safety of patients and nurses is crucial.In regard to respect the basic rights of psychiatric patients,it is recommended to protect the their autonomy,and eliminate the adverse effects of physical restraint.This goal would be achieved by ensuring the informed consent,providing humane care,and regulating the implementation of physical restraints.展开更多
Stress-induced gastric mucosal lesion(SGML)is one of the most common visceral complications after trauma.Exploring the nervous mechanisms of SGML has become a research hotspot.Restraint water-immersion stress(RWIS)can...Stress-induced gastric mucosal lesion(SGML)is one of the most common visceral complications after trauma.Exploring the nervous mechanisms of SGML has become a research hotspot.Restraint water-immersion stress(RWIS)can induce GML and has been widely used to elucidate the nervous mechanisms of SGML.It is believed that RWIS-induced GML is mainly caused by the enhanced activity of vagal parasympathetic nerves.Many central nuclei,such as the dorsal motor nucleus of the vagus,nucleus of the solitary tract,supraoptic nucleus and paraventricular nucleus of the hypothalamus,mediodorsal nucleus of the thalamus,central nucleus of the amygdala and medial prefrontal cortex,are involved in the formation of SGML in varying degrees.Neurotransmitters/neuromodulators,such as nitric oxide,hydrogen sulfide,vasoactive intestinal peptide,calcitonin gene-related peptide,substance P,enkephalin,5-hydroxytryptamine,acetylcholine,catecholamine,glutamate,γ-aminobutyric acid,oxytocin and arginine vasopressin,can participate in the regulation of stress.However,inconsistent and even contradictory results have been obtained regarding the actual roles of each nucleus in the nervous mechanism of RWIS-induced GML,such as the involvement of different nuclei with the time of RWIS,the different levels of involvement of the sub-regions of the same nucleus,and the diverse signalling molecules,remain to be further elucidated.展开更多
Integrated into the development process of a chinese independent brand class sedan,optimization about occupant restraint system associated with dummy chest deceleration is studied.Based on this simulated vehicle decel...Integrated into the development process of a chinese independent brand class sedan,optimization about occupant restraint system associated with dummy chest deceleration is studied.Based on this simulated vehicle deceleration and the target vehicle′s chest deceleration,tipped equivalent square wave(TESW)is calculated by combining the average stiffness kof occupant restraint system and the average free flight time t*from the existant CNCAP(China new car assessment program)tested cars.After proposing modeling regulations of occupant restraint system and establishing mathematical dynamic modelling(MADYMO)for occupant restraint system of the target vehicle,four optimization design parameters namely vent area A,load limit L,seat belt extension ratio Band pretension force Fare selected by weighted injury criteria(WIC)rule and the first-order response surface method.The four parameters have been optimized by using orthogonal test design of four factors with five levels and the optimum combination A5L1B1F5 has been chosen by range and variance analyses.The results show that occupant restraint system performance has been optimized and improved,while meeting the chest deceleration calculation peak based on TESW.展开更多
The purpose of this study is to prepare a nursing protocol for preventing discontinuation of treatments using a method other than physical restraint during acute exacerbation of chronic heart failure in patients with ...The purpose of this study is to prepare a nursing protocol for preventing discontinuation of treatments using a method other than physical restraint during acute exacerbation of chronic heart failure in patients with impaired cognitive function. For the first stage of the study, we prepared a draft of the nursing protocol based on a basic survey. For the second stage, semi-structured interviews were conducted with 5 nurses specialized in chronic heart failure and 10 nurses in dementia case to ensure content validity of the draft protocol. For the third stage, we examined the possibility of clinical application of the revised version of the protocol draft prepared in the second stage of the study. For assessment items, significant points of nursing care, and specific nursing care practice in this revised version, 154 subjects (93.9%) considered effective for patients, in terms of prevention of treatment discontinuation using a method other than physical restraint. All items and contents were considered useful by more than 60% of the nurses. Considering that the nurses working in the clinical setting reported 93.9% of usefulness, we concluded that this nursing protocol remained valid at a certain level. We also received a comment from the certified nurses that we should include the basic contents for newly graduated nurses. We consider that this nursing protocol will be also useful for newly graduated nurses to acquire knowledge. It helped to standardize nursing care in order to predict potential risks for patients with impaired cognitive function.展开更多
Physical restraint is a common nursing intervention in intensive care units and nurses often use it to ensure patients'safety and to prevent unexpected accidents.However,existing literature indicated that the use ...Physical restraint is a common nursing intervention in intensive care units and nurses often use it to ensure patients'safety and to prevent unexpected accidents.However,existing literature indicated that the use of physical restraint is a complex one because of inadequate rationales,the negative physical and emotional effects on patients,but the lack of perceived alternatives.This paper is aimed to interpret the clinical decision-making theories related to the use of physical restraint in intensive care units in order to facilitate our understanding on the use of physical restraint and to evaluate the quality of decisions made by nurses.By reviewing the literature,intuition and heuristics are the main decision-making strategies related to the use of physical restraint in intensive care units because the rapid and reflexive nature of intuition and heuristics allow nurses to have a rapid response to urgent and emergent cases.However,it is problematic if nurses simply count their decision-making on experience rather than incorporate research evidence into clinical practice because of inadequate evidence to support the use of physical restraint.Besides that,such a rapid response may lead nurses to make decisions without adequate assessment and thinking and therefore biases and errors may be generated.Therefore,despite the importance of intuition and heuristics in decision-making in acute settings on the use of physical restraint,it is recommended that nurses should incorporate research evidence with their experience to make decisions and adequate assessment before implementing physical restraint is also necessary.展开更多
The out-of-plane deformation is a serious problem in thin-plate welded joint,and it is difficult to reduce or control the distortion during welding process. External restraint is regarded as an effective method to mit...The out-of-plane deformation is a serious problem in thin-plate welded joint,and it is difficult to reduce or control the distortion during welding process. External restraint is regarded as an effective method to mitigate the distortion,and it is widely used in the actual manufacturing process. In order to investigate the influence of external restraint on welding deformation in thin plate joints,a thermo-elastic-plastic finite element method based on ABAQUS software was developed to calculate welding-induced deformation. Meanwhile,welding deformation in the thin-plate joints was measured by experiments.Through comparing the numerical results with the measured data,the effectiveness of the developed computational approach was verified. Based on the simulated and experimental results,the generation mechanism of the out-of-plane deformation in thin plate bead-on joint was discussed,and the influence of external restraint on the final welding deformation was clarified.展开更多
Purpose: The aim of this study was to illuminate the connotation of “dilemma” regarding the use of physical restraint on elderly patients as represented by female nurses working in general wards at community hospita...Purpose: The aim of this study was to illuminate the connotation of “dilemma” regarding the use of physical restraint on elderly patients as represented by female nurses working in general wards at community hospitals who also live with elderly adults at home. Method: The study used the questionnaire method with an independently prepared questionnaire. Participants: The objective of the study was explained to the persons in charge of nursing in the selected 17 hospitals, and 1929. Finally, this study of participants were 524 female nurses working in general 54 wards (excluding the emergency wards of psychiatry, pediatrics, obstetrics, outpatients, operating rooms, and intensive care units) at community hospitals who also live with elderly adults at home. Results and conclusions: Cronbach’s overall coefficient for the 20 items of dilemma was high (0.78) and the factor analysis extracted four dilemma factors as having a characteristic value of 1 (Kaiser-Meyer-Olkin measure value = 0.81) with a cumulative contribution ratio of 64.5%. The high Cronbach’s for these items (0.86, 0.88, 0.87 and 0.81) confirmed the internal consistencies. With respect to the dilemma where nurses working in general wards at community hospitals who also live with elderly adults at home are faced with the physical restraint of elderly persons, four factors in the clarification of the dilemma were extracted: accomplishment of medical-treatment and accident prevention, characteristic features in nursing for elderly patients with dementia, healthcare professional relationship in nursing for elderly patients with dementia, and priorities on the accident prevention for elderly patients with dementia. Therefore, the construction of four systems to cope with these dilemmas is suggested. These systems would enable practising nurses to: (i) institution of policies to encourage discussion between nurses and other medical staff to reach consensus on treatment;(ii) allocating elderly care specialists to wards to promote alternatives to restraints;(iii) establishment of safety standards to define nurses’ responsibilities;and (iv) institution of continuous ethical education for nurses.展开更多
Objective:To explore the correlation between nurses’attitude and practice toward physical restraint(PR)in psychiatric settings and identify the factors that influence the use of PR.Methods:A cross-sectional survey wa...Objective:To explore the correlation between nurses’attitude and practice toward physical restraint(PR)in psychiatric settings and identify the factors that influence the use of PR.Methods:A cross-sectional survey was conducted.A self-designed questionnaire containing a PR scale was used to assess the attitude and practice of registered psychiatric nurses in Guangdong,China,from November 1,2018 to December 31,2018.Descriptive statistics,the Mann–Whitney U test,the Kruskal–Wallis test,and ordinal regression analysis were used to analyze the data.Results:The response rate was 74.6%.The nurses’responses showed neutral attitude and a moderate level of practice regarding the use of PR.Factors such as age,gender,marital status,professional position,nightshift,and the frequency of training programs on PR showed a significant association with nurses’attitude and practice concerning PR(P<0.05).In addition to these factors,this study found that the practice of PR was associated with nurses’attitude toward it(P<0.05).Our results showed that nurses with a largely negative attitude toward PR were more likely to use it(OR=1.91,P<0.001).Conclusions:Clinically,psychiatric nurses with negative attitude are more likely to practice PR.Training and education programs are highly recommended for nursing managers to change the nursing staff’s attitude,since their attitude may have an impact on the PR what they practice.展开更多
This study aimed to clarify the dilemma of nurses working in general wards who face the ethical dilemma of restraining older people with dementia in Midwestern Japan. The study used the questionnaire method with an in...This study aimed to clarify the dilemma of nurses working in general wards who face the ethical dilemma of restraining older people with dementia in Midwestern Japan. The study used the questionnaire method with an independently prepared questionnaire. The questionnaire was designed to ensure privacy and anonymity. The privacy and anonymity of study participants was assured. Of the 340 survey questionnaires distributed, 291 (85.6%) completed surveys were eligible number (12 additional surveys were returned without answers). An explanatory factor analysis revealed four dilemma factors among 15 items investigated (KMO value 0.84). These were: factor 1: “Execution of treatment and security,” α = 0.91;factor 2: “approach in the nursing of older people with dementia,” α = 0.93;factor 3: “A cooperative relationship in nursing of older people with dementia,” α = 0.87;and factor 4: “Priorities in nursing,” α = 0.81. The cumulative contribution ratio was 79.1%. We suggest that the program would enable nurses to cope with these dilemmas.展开更多
Objective:The objective of the study is to construct a training course for physical restraint(PR)evidence‑based practice project and apply it to verify its effect.Methods:A total of 162 nurses from five departments of...Objective:The objective of the study is to construct a training course for physical restraint(PR)evidence‑based practice project and apply it to verify its effect.Methods:A total of 162 nurses from five departments of a general hospital in Beijing were trained to compare the PR knowledge,attitudes,and behaviors of nurses before and after training.Results:The nurses were satisfied with the overall curriculum;the total scores of PR’knowledge,attitude and behavior of nurses after training were higher than before,and the difference was statistically significant(P<0.05);the total scores of nurses who received evidence‑related training before this training were higher than those of nurses who did not receive relevant training,and the difference was statistically significant(P<0.05).Conclusion:Continuing education can effectively improve nurses’knowledge,attitude,and behavior level of PR,ensure patient safety,and promote physical and psychological rehabilitation of patients.展开更多
Ultrafine grain size is often achieved by severe plastic deformation. A few techniques have been devel- oped to achieve severe plastic deformation,such as equal channel angular (ECA ) processing, torsion, and accumula...Ultrafine grain size is often achieved by severe plastic deformation. A few techniques have been devel- oped to achieve severe plastic deformation,such as equal channel angular (ECA ) processing, torsion, and accumulative roll bonding (ARB) techmpues. This paper will introduce a moftiaxis deformation technique which can achieve essentially unlimited strain with constant deformation volume. The mul- tiaxis deformation can be fully restrained or unrestrained.The bulk volume of a multiaxis restraint compression specimen can be easily machined into mechanical testing specimens for mechanical property measurement and other studies.展开更多
Exposure to maternal stress during prenatal life is associated with an increased risk of neuropsychiatric disorders, such as depression and anxiety, in offspring. It has also been increasingly observed that prenatal s...Exposure to maternal stress during prenatal life is associated with an increased risk of neuropsychiatric disorders, such as depression and anxiety, in offspring. It has also been increasingly observed that prenatal stress alters the phenotype of offspring via immunological mechanisms and that immunological dysfunction, such as elevated interleukin-18 levels, has been reported in cultures of microglia. Prenatal restraint stress(PRS) in rats permits direct experimental investigation of the link between prenatal stress and adverse outcomes. However, the majority of studies have focused on the consequences of PRS delivered in the second half of pregnancy, while the effects of early prenatal stress have rarely been examined. Therefore, pregnant rats were subjected to PRS during early/middle and late gestation(days 8–14 and 15–21, respectively). PRS comprised restraint in a round plastic transparent cylinder under bright light(6500 lx) three times per day for 45 minutes. Differences in interleukin-18 expression in the hippocampus and in behavior were compared between offspring rats and control rats on postnatal day 75. We found that adult male offspring exposed to PRS during their late prenatal periods had higher levels of anxiety-related behavior and depression than control rats, and both male and female offspring exhibited higher levels of depression-related behavior, impaired recognition memory and diminished exploration of novel objects. Moreover, an elevated level of interleukin-18 was observed in the dorsal and ventral hippocampus of male and female early-and late-PRS offspring rats. The results indicate that PRS can cause anxiety and depression-related behaviors in adult offspring and affect the expression of interleukin-18 in the hippocampus. Thus, behavior and the molecular biology of the brain are affected by the timing of PRS exposure and the sex of the offspring. All experiments were approved by the Animal Experimentation Ethics Committee at Kunming Medical University, China(approval No. KMMU2019074) in January 2019.展开更多
Aim To investigate whether Kv7 channels opener retigabine could alleviate memory impairment induced by chronic restraint stress （CRS） and the underlying neuroprotective mechanisms. Methods Adult male Kunming （KM） ...Aim To investigate whether Kv7 channels opener retigabine could alleviate memory impairment induced by chronic restraint stress （CRS） and the underlying neuroprotective mechanisms. Methods Adult male Kunming （KM） mice, weighing 20 - 25 g, were restrained in well-ventilated Plexiglass tubes for 6 h daily beginning from 10 ： 00 to 16 ： 00 for 21 consecutive days. Mice were injected with retigabine （ 10 mg · kg^-1） or vehicle （ 10% DM- SO） 30 rain before restraint stress for 21 days. After stressor cessation, the spatial learning and memory was deter- mined by Morris water maze test, the levels of p-Akt, p-GSK-3β and p-Erkl/2 of hippocampal tissues were exam- ined by western blot. Results Compared with control group, CRS mice exhibited significantly longer escape laten- cies on day 2, 3 and 4 （P 〈 0.05, P 〈 0. 01, P 〈 0.01 ） respectively, but retigabine （ 10 mg · kg^-1） treatment had no influences on escape latencies compared with CRS group. During the probe test, CRS mice spent significant less time in target quadrant than control group （P 〈 0.01 ）. Compared with CRS group, retigabine （ 10 mg · kg^-1 ） treatment increased the time spent in target quadrant （P 〈 0.01 ）. Additionally, the swimming speed showed no significant differences among groups. Western blot results showed that the levels of p-Akt, p-GSK-3β and p-Erkl/ 2 in the hippocampus of CRS mice were significantly decreased compared with control group. Compared with CRS group, retigabine （ 10 mg· kg^-1） treatment strongly prevented the reduction of p-Akt and p-GSK-3 β （P 〈 0.01 ）, but had no effect on the reduction of p-Erkl/2. Conclusion Retigabine protected against CRS-induced spatial memory retrieval impairment partly via activation of Akt/GSK-3β signaling pathway.展开更多
The restraint intensity(RI) of the pipeline girth welding joint was investigated using finite element method and experimental method to predict the cold cracking susceptibility of pipeline steel.The distribution of RI...The restraint intensity(RI) of the pipeline girth welding joint was investigated using finite element method and experimental method to predict the cold cracking susceptibility of pipeline steel.The distribution of RI along the girth weld was investigated to study the influence of welding position on the RI.Subsequently,the effects of outer diameter(OD) and wall thickness of pipeline on the RI were studied with ABAQUS software.The results show that the RI is almost independent of welding position.The RI increased with the increasing wall thickness but decreased with the increasing OD.A prediction model of RI was developed based on the effects of the OD and the wall thickness.It has been found that the predicted RIs were in good agreement with the experimental values.The maximum fractional error between the predicted RI and the experimental values was just about 10%.It was indicated that the errors were mainly caused by the heterogeneous of the weld bead.展开更多
The prediction of protein–protein complex structures is crucial for fundamental understanding of celluar processes and drug design. Despite significant progresses in the field, the accuracy of ab initio docking witho...The prediction of protein–protein complex structures is crucial for fundamental understanding of celluar processes and drug design. Despite significant progresses in the field, the accuracy of ab initio docking without using any experimental restraints remains relatively low. With the rapid advancement of structural biology, more and more information about binding can be derived from experimental data such as NMR experiments or chemical cross-linking. In addition, information about the residue contacts between proteins may also be derived from their sequences by using evolutionary analysis or deep learning. Here, we propose an efficient approach to incorporate interface residue restraints into protein–protein docking, which is named as HDOCKsite. Extensive evaluations on the protein–protein docking benchmark 4.0 showed that HDOCKsite significantly improved the docking performance and obtained a much higher success rate in binding mode predictions than original ab initio docking.展开更多
基金support by the National Natural Science Foundation of China(Grant Nos.52108376 and 51908371)China Postdoctoral Science Foundation(Grant No.2022T150436).
文摘This paper presents a simplified elastic continuum method for calculating the restraint effect of isolation piles on tunneling-induced vertical ground displacement,which can consider not only the relative sliding of the pile‒soil interface but also the pile rowesoil interaction.The proposed method is verified by comparisons with existing theoretical methods,including the boundary element method and the elastic foundation method.The results reveal the restraining mechanism of the isolation piles on vertical ground displacements due to tunneling,i.e.the positive and negative restraint effects exerted by the isolation piles jointly drive the ground vertical displacement along the depth direction from the original tunneling-induced nonlinear variation situation to a relatively uniform situation.The results also indicate that the stiffness of the pile‒soil interface,including the pile shaft‒surrounding soil interface and pile tip-supporting soil interface,describes the strength of the pile‒soil interaction.The pile rows can confine the vertical ground displacement caused by the tunnel excavation to the inner side of the isolation piles and effectively prevent the vertical ground displacement from expanding further toward the outer side of the isolation piles.
文摘BACKGROUND Despite numerous attempts to reduce the use of mechanical restraint(MR),this technique continues to be widely applied in many acute psychiatric care settings.In order to reduce MR,a better understanding of the variables associated with its use and duration in different clinical environments is essential.AIM To determine the proportion of patients subjected to MR and the duration thereof in two acute care psychiatric units;and to identify the variables associated with the use and duration of MR.METHODS Descriptive study of all patients admitted to the acute psychiatric units at the Parc de Salut Mar(Barcelona,Spain)in the year 2018.The number and percentage of patients subjected to MR,as well as the duration of each episode were assessed.The following data were also registered:sociodemographic characteristics,psychiatric diagnosis,and presence of cultural and/or language barriers.Multivariate analyses were performed to assess determinants of MR and its duration.RESULTS Of the 464 patients,119(25.6%)required MR,with a median of 16.4 h per MR.Two factors-a diagnosis of psychotic disorder[Odds ratios(OR)=0.22;95%CI:0.06-0.62;P=0.005]and the presence of a language barrier(OR=2.13;95%CI:1.2-3.7;P=0.007)-were associated with a significantly higher risk of MR.Male sex was associated with a longer duration of MR(B=-19.03;95%CI:-38.06-0.008;P=0.05).CONCLUSION The presence of a language barrier and a psychotic disorder diagnosis are associated with a significantly higher risk of MR.Furthermore,male sex is associated with a longer duration of MR.Individualized restraint protocols that include the required tools are necessary to ultimately limit the use of mechanical restraint.
基金supported by National Natural Science Foundation of China (Grant No. 51075180)Open Foundation of State Key Laboratory of Vehicle NVH and Safety Technology of China (Grant No.NVHSKL-201013)
文摘Throughout the vehicle crash event, the interactions between vehicle, occupant, restraint system (VOR) are complicated and highly non-linear. CAE and physical tests are the most widely used in vehicle passive safety development, but they can only be done with the detailed 3D model or physical samples. Often some design errors and imperfections are difficult to correct at that time, and a large amount of time will be needed. A restraint system concept design approach which based on single-degree-of-freedom occupant-vehicle model (SDOF) is proposed in this paper. The interactions between the restraint system parameters and the occupant responses in a crash are studied from the view of mechanics and energy. The discrete input and the iterative algorithm method are applied to the SDOF model to get the occupant responses quickly for arbitrary excitations (impact pulse) by MATLAB. By studying the relationships between the ridedown efficiency, the restraint stiffness, and the occupant response, the design principle of the restraint stiffness aiming to reduce occupant injury level during conceptual design is represented. Higher ridedown efficiency means more occupant energy absorbed by the vehicle, but the research result shows that higher ridedown efficiency does not mean lower occupant injury level. A proper restraint system design principle depends on two aspects. On one hand,the restraint system should lead to as high ridedown efficiency as possible, and at the same time, the restraint system should maximize use of the survival space to reduce the occupant deceleration level. As an example, an optimization of a passenger vehicle restraint system is designed by the concept design method above, and the final results are validated by MADYMO, which is the most widely used software in restraint system design, and the sled test. Consequently, a guideline and method for the occupant restraint system concept design is established in this paper.
基金We acknowledge this paper was supported by the program of Key Specialty of TCM Nursing of Guangzhou City,which aims to enrich theoretical content of mental health nursing
文摘Objective: Physical restraint is frequently used in medical services,such as in mental health settings,intensive care units and nursing homes,but its nature varies in different institutions.By reviewing related literature,this study aims to clarify the concept of physical restraint in mental health nursing.Method: Three databases (PubMed,PsyclNFO and CINAHL) were retrieved,and Walker and Avant's concept analysis method was used to analyze the concept of physical restraint in mental health nursing.Results: Physical restraint is a coercive approach that enables the administration of necessary treatment by safely reducing the patient's physical movement.It should be the last option used by qualified personnel.Antecedents of physical restraint are improper behavior (violence and disturbance) of patients,medical assessment prior to implementation and legislation governing clinical usage.Consequences of physical restraint are alleviation of conflict,physical injury,mental trauma and invisible impact on the institution.Discussion: This study defined the characteristics of physical restraint in mental health nursing.The proposed concept analysis provided theoretical foundation for future studies.
基金funded by the grant of the Scientific Research Project of the Twelfth Five-year Plan Internal Medicine of the Affiliated Brain Hospital of Guangzhou Medical University (Grant Number:GBH2014-HL07).
文摘Given that physical restraints cause adverse effects to patients and nurses,their wide and frequent use has resulted in various clinical and ethical controversies in mental health services.The rate of physical restraints is significantly higher in China than in other countries.Some western and domestic media blamed relevant institutions for compromising the basic rights of psychiatric patients.Therefore,this study aims to collect and synthesize the relevant ethical evidence and to provide corresponding guidance for the nursing practice based on the current situation of the mainland of China.This study synthesized the ethical issue according to the ethical principle of autonomy,justice,beneficence,and nonmaleficence.Given the current situation where the nursing workforce is limited and the mental health service is under-developed in China,applying physical restraints in the psychiatric inpatients to guarantee the safety of patients and nurses is crucial.In regard to respect the basic rights of psychiatric patients,it is recommended to protect the their autonomy,and eliminate the adverse effects of physical restraint.This goal would be achieved by ensuring the informed consent,providing humane care,and regulating the implementation of physical restraints.
基金Supported by National Natural Science Foundation of China,No.31501861 and No.31672286Natural Science Foundation of Shandong Province,China,No.ZR2015CM013。
文摘Stress-induced gastric mucosal lesion(SGML)is one of the most common visceral complications after trauma.Exploring the nervous mechanisms of SGML has become a research hotspot.Restraint water-immersion stress(RWIS)can induce GML and has been widely used to elucidate the nervous mechanisms of SGML.It is believed that RWIS-induced GML is mainly caused by the enhanced activity of vagal parasympathetic nerves.Many central nuclei,such as the dorsal motor nucleus of the vagus,nucleus of the solitary tract,supraoptic nucleus and paraventricular nucleus of the hypothalamus,mediodorsal nucleus of the thalamus,central nucleus of the amygdala and medial prefrontal cortex,are involved in the formation of SGML in varying degrees.Neurotransmitters/neuromodulators,such as nitric oxide,hydrogen sulfide,vasoactive intestinal peptide,calcitonin gene-related peptide,substance P,enkephalin,5-hydroxytryptamine,acetylcholine,catecholamine,glutamate,γ-aminobutyric acid,oxytocin and arginine vasopressin,can participate in the regulation of stress.However,inconsistent and even contradictory results have been obtained regarding the actual roles of each nucleus in the nervous mechanism of RWIS-induced GML,such as the involvement of different nuclei with the time of RWIS,the different levels of involvement of the sub-regions of the same nucleus,and the diverse signalling molecules,remain to be further elucidated.
基金supported by the National Science and Technology Support Program of China(2011BAG02B02)
文摘Integrated into the development process of a chinese independent brand class sedan,optimization about occupant restraint system associated with dummy chest deceleration is studied.Based on this simulated vehicle deceleration and the target vehicle′s chest deceleration,tipped equivalent square wave(TESW)is calculated by combining the average stiffness kof occupant restraint system and the average free flight time t*from the existant CNCAP(China new car assessment program)tested cars.After proposing modeling regulations of occupant restraint system and establishing mathematical dynamic modelling(MADYMO)for occupant restraint system of the target vehicle,four optimization design parameters namely vent area A,load limit L,seat belt extension ratio Band pretension force Fare selected by weighted injury criteria(WIC)rule and the first-order response surface method.The four parameters have been optimized by using orthogonal test design of four factors with five levels and the optimum combination A5L1B1F5 has been chosen by range and variance analyses.The results show that occupant restraint system performance has been optimized and improved,while meeting the chest deceleration calculation peak based on TESW.
文摘The purpose of this study is to prepare a nursing protocol for preventing discontinuation of treatments using a method other than physical restraint during acute exacerbation of chronic heart failure in patients with impaired cognitive function. For the first stage of the study, we prepared a draft of the nursing protocol based on a basic survey. For the second stage, semi-structured interviews were conducted with 5 nurses specialized in chronic heart failure and 10 nurses in dementia case to ensure content validity of the draft protocol. For the third stage, we examined the possibility of clinical application of the revised version of the protocol draft prepared in the second stage of the study. For assessment items, significant points of nursing care, and specific nursing care practice in this revised version, 154 subjects (93.9%) considered effective for patients, in terms of prevention of treatment discontinuation using a method other than physical restraint. All items and contents were considered useful by more than 60% of the nurses. Considering that the nurses working in the clinical setting reported 93.9% of usefulness, we concluded that this nursing protocol remained valid at a certain level. We also received a comment from the certified nurses that we should include the basic contents for newly graduated nurses. We consider that this nursing protocol will be also useful for newly graduated nurses to acquire knowledge. It helped to standardize nursing care in order to predict potential risks for patients with impaired cognitive function.
文摘Physical restraint is a common nursing intervention in intensive care units and nurses often use it to ensure patients'safety and to prevent unexpected accidents.However,existing literature indicated that the use of physical restraint is a complex one because of inadequate rationales,the negative physical and emotional effects on patients,but the lack of perceived alternatives.This paper is aimed to interpret the clinical decision-making theories related to the use of physical restraint in intensive care units in order to facilitate our understanding on the use of physical restraint and to evaluate the quality of decisions made by nurses.By reviewing the literature,intuition and heuristics are the main decision-making strategies related to the use of physical restraint in intensive care units because the rapid and reflexive nature of intuition and heuristics allow nurses to have a rapid response to urgent and emergent cases.However,it is problematic if nurses simply count their decision-making on experience rather than incorporate research evidence into clinical practice because of inadequate evidence to support the use of physical restraint.Besides that,such a rapid response may lead nurses to make decisions without adequate assessment and thinking and therefore biases and errors may be generated.Therefore,despite the importance of intuition and heuristics in decision-making in acute settings on the use of physical restraint,it is recommended that nurses should incorporate research evidence with their experience to make decisions and adequate assessment before implementing physical restraint is also necessary.
基金supported by Chongqing Municipal Science and Technology funded projects(Projected No.CSTC 2010BB4060)
文摘The out-of-plane deformation is a serious problem in thin-plate welded joint,and it is difficult to reduce or control the distortion during welding process. External restraint is regarded as an effective method to mitigate the distortion,and it is widely used in the actual manufacturing process. In order to investigate the influence of external restraint on welding deformation in thin plate joints,a thermo-elastic-plastic finite element method based on ABAQUS software was developed to calculate welding-induced deformation. Meanwhile,welding deformation in the thin-plate joints was measured by experiments.Through comparing the numerical results with the measured data,the effectiveness of the developed computational approach was verified. Based on the simulated and experimental results,the generation mechanism of the out-of-plane deformation in thin plate bead-on joint was discussed,and the influence of external restraint on the final welding deformation was clarified.
文摘Purpose: The aim of this study was to illuminate the connotation of “dilemma” regarding the use of physical restraint on elderly patients as represented by female nurses working in general wards at community hospitals who also live with elderly adults at home. Method: The study used the questionnaire method with an independently prepared questionnaire. Participants: The objective of the study was explained to the persons in charge of nursing in the selected 17 hospitals, and 1929. Finally, this study of participants were 524 female nurses working in general 54 wards (excluding the emergency wards of psychiatry, pediatrics, obstetrics, outpatients, operating rooms, and intensive care units) at community hospitals who also live with elderly adults at home. Results and conclusions: Cronbach’s overall coefficient for the 20 items of dilemma was high (0.78) and the factor analysis extracted four dilemma factors as having a characteristic value of 1 (Kaiser-Meyer-Olkin measure value = 0.81) with a cumulative contribution ratio of 64.5%. The high Cronbach’s for these items (0.86, 0.88, 0.87 and 0.81) confirmed the internal consistencies. With respect to the dilemma where nurses working in general wards at community hospitals who also live with elderly adults at home are faced with the physical restraint of elderly persons, four factors in the clarification of the dilemma were extracted: accomplishment of medical-treatment and accident prevention, characteristic features in nursing for elderly patients with dementia, healthcare professional relationship in nursing for elderly patients with dementia, and priorities on the accident prevention for elderly patients with dementia. Therefore, the construction of four systems to cope with these dilemmas is suggested. These systems would enable practising nurses to: (i) institution of policies to encourage discussion between nurses and other medical staff to reach consensus on treatment;(ii) allocating elderly care specialists to wards to promote alternatives to restraints;(iii) establishment of safety standards to define nurses’ responsibilities;and (iv) institution of continuous ethical education for nurses.
基金supported by Guangdong Science of Medical Technique Program(No.A2018440)。
文摘Objective:To explore the correlation between nurses’attitude and practice toward physical restraint(PR)in psychiatric settings and identify the factors that influence the use of PR.Methods:A cross-sectional survey was conducted.A self-designed questionnaire containing a PR scale was used to assess the attitude and practice of registered psychiatric nurses in Guangdong,China,from November 1,2018 to December 31,2018.Descriptive statistics,the Mann–Whitney U test,the Kruskal–Wallis test,and ordinal regression analysis were used to analyze the data.Results:The response rate was 74.6%.The nurses’responses showed neutral attitude and a moderate level of practice regarding the use of PR.Factors such as age,gender,marital status,professional position,nightshift,and the frequency of training programs on PR showed a significant association with nurses’attitude and practice concerning PR(P<0.05).In addition to these factors,this study found that the practice of PR was associated with nurses’attitude toward it(P<0.05).Our results showed that nurses with a largely negative attitude toward PR were more likely to use it(OR=1.91,P<0.001).Conclusions:Clinically,psychiatric nurses with negative attitude are more likely to practice PR.Training and education programs are highly recommended for nursing managers to change the nursing staff’s attitude,since their attitude may have an impact on the PR what they practice.
文摘This study aimed to clarify the dilemma of nurses working in general wards who face the ethical dilemma of restraining older people with dementia in Midwestern Japan. The study used the questionnaire method with an independently prepared questionnaire. The questionnaire was designed to ensure privacy and anonymity. The privacy and anonymity of study participants was assured. Of the 340 survey questionnaires distributed, 291 (85.6%) completed surveys were eligible number (12 additional surveys were returned without answers). An explanatory factor analysis revealed four dilemma factors among 15 items investigated (KMO value 0.84). These were: factor 1: “Execution of treatment and security,” α = 0.91;factor 2: “approach in the nursing of older people with dementia,” α = 0.93;factor 3: “A cooperative relationship in nursing of older people with dementia,” α = 0.87;and factor 4: “Priorities in nursing,” α = 0.81. The cumulative contribution ratio was 79.1%. We suggest that the program would enable nurses to cope with these dilemmas.
文摘Objective:The objective of the study is to construct a training course for physical restraint(PR)evidence‑based practice project and apply it to verify its effect.Methods:A total of 162 nurses from five departments of a general hospital in Beijing were trained to compare the PR knowledge,attitudes,and behaviors of nurses before and after training.Results:The nurses were satisfied with the overall curriculum;the total scores of PR’knowledge,attitude and behavior of nurses after training were higher than before,and the difference was statistically significant(P<0.05);the total scores of nurses who received evidence‑related training before this training were higher than those of nurses who did not receive relevant training,and the difference was statistically significant(P<0.05).Conclusion:Continuing education can effectively improve nurses’knowledge,attitude,and behavior level of PR,ensure patient safety,and promote physical and psychological rehabilitation of patients.
文摘Ultrafine grain size is often achieved by severe plastic deformation. A few techniques have been devel- oped to achieve severe plastic deformation,such as equal channel angular (ECA ) processing, torsion, and accumulative roll bonding (ARB) techmpues. This paper will introduce a moftiaxis deformation technique which can achieve essentially unlimited strain with constant deformation volume. The mul- tiaxis deformation can be fully restrained or unrestrained.The bulk volume of a multiaxis restraint compression specimen can be easily machined into mechanical testing specimens for mechanical property measurement and other studies.
基金supported by the National Natural Science Foundation of China,No.81260296(to LJA)and 81300987(to QLi)
文摘Exposure to maternal stress during prenatal life is associated with an increased risk of neuropsychiatric disorders, such as depression and anxiety, in offspring. It has also been increasingly observed that prenatal stress alters the phenotype of offspring via immunological mechanisms and that immunological dysfunction, such as elevated interleukin-18 levels, has been reported in cultures of microglia. Prenatal restraint stress(PRS) in rats permits direct experimental investigation of the link between prenatal stress and adverse outcomes. However, the majority of studies have focused on the consequences of PRS delivered in the second half of pregnancy, while the effects of early prenatal stress have rarely been examined. Therefore, pregnant rats were subjected to PRS during early/middle and late gestation(days 8–14 and 15–21, respectively). PRS comprised restraint in a round plastic transparent cylinder under bright light(6500 lx) three times per day for 45 minutes. Differences in interleukin-18 expression in the hippocampus and in behavior were compared between offspring rats and control rats on postnatal day 75. We found that adult male offspring exposed to PRS during their late prenatal periods had higher levels of anxiety-related behavior and depression than control rats, and both male and female offspring exhibited higher levels of depression-related behavior, impaired recognition memory and diminished exploration of novel objects. Moreover, an elevated level of interleukin-18 was observed in the dorsal and ventral hippocampus of male and female early-and late-PRS offspring rats. The results indicate that PRS can cause anxiety and depression-related behaviors in adult offspring and affect the expression of interleukin-18 in the hippocampus. Thus, behavior and the molecular biology of the brain are affected by the timing of PRS exposure and the sex of the offspring. All experiments were approved by the Animal Experimentation Ethics Committee at Kunming Medical University, China(approval No. KMMU2019074) in January 2019.
文摘Aim To investigate whether Kv7 channels opener retigabine could alleviate memory impairment induced by chronic restraint stress （CRS） and the underlying neuroprotective mechanisms. Methods Adult male Kunming （KM） mice, weighing 20 - 25 g, were restrained in well-ventilated Plexiglass tubes for 6 h daily beginning from 10 ： 00 to 16 ： 00 for 21 consecutive days. Mice were injected with retigabine （ 10 mg · kg^-1） or vehicle （ 10% DM- SO） 30 rain before restraint stress for 21 days. After stressor cessation, the spatial learning and memory was deter- mined by Morris water maze test, the levels of p-Akt, p-GSK-3β and p-Erkl/2 of hippocampal tissues were exam- ined by western blot. Results Compared with control group, CRS mice exhibited significantly longer escape laten- cies on day 2, 3 and 4 （P 〈 0.05, P 〈 0. 01, P 〈 0.01 ） respectively, but retigabine （ 10 mg · kg^-1） treatment had no influences on escape latencies compared with CRS group. During the probe test, CRS mice spent significant less time in target quadrant than control group （P 〈 0.01 ）. Compared with CRS group, retigabine （ 10 mg · kg^-1 ） treatment increased the time spent in target quadrant （P 〈 0.01 ）. Additionally, the swimming speed showed no significant differences among groups. Western blot results showed that the levels of p-Akt, p-GSK-3β and p-Erkl/ 2 in the hippocampus of CRS mice were significantly decreased compared with control group. Compared with CRS group, retigabine （ 10 mg· kg^-1） treatment strongly prevented the reduction of p-Akt and p-GSK-3 β （P 〈 0.01 ）, but had no effect on the reduction of p-Erkl/2. Conclusion Retigabine protected against CRS-induced spatial memory retrieval impairment partly via activation of Akt/GSK-3β signaling pathway.
基金financially supported by the Tianjin Natural Science Foundation(No.11JCYBJC06000)the Key Project of Tianjin Municipal Science and Technology Support Program(No.11ZCGYSF00100)the Gansu Province Science and Technology Support Program(No.1204GKCA007)
文摘The restraint intensity(RI) of the pipeline girth welding joint was investigated using finite element method and experimental method to predict the cold cracking susceptibility of pipeline steel.The distribution of RI along the girth weld was investigated to study the influence of welding position on the RI.Subsequently,the effects of outer diameter(OD) and wall thickness of pipeline on the RI were studied with ABAQUS software.The results show that the RI is almost independent of welding position.The RI increased with the increasing wall thickness but decreased with the increasing OD.A prediction model of RI was developed based on the effects of the OD and the wall thickness.It has been found that the predicted RIs were in good agreement with the experimental values.The maximum fractional error between the predicted RI and the experimental values was just about 10%.It was indicated that the errors were mainly caused by the heterogeneous of the weld bead.
基金Project supported by the National Natural Science Foundation of China(Grant No.31670724)the Startup Grant of Huazhong University of Science and Technology。
文摘The prediction of protein–protein complex structures is crucial for fundamental understanding of celluar processes and drug design. Despite significant progresses in the field, the accuracy of ab initio docking without using any experimental restraints remains relatively low. With the rapid advancement of structural biology, more and more information about binding can be derived from experimental data such as NMR experiments or chemical cross-linking. In addition, information about the residue contacts between proteins may also be derived from their sequences by using evolutionary analysis or deep learning. Here, we propose an efficient approach to incorporate interface residue restraints into protein–protein docking, which is named as HDOCKsite. Extensive evaluations on the protein–protein docking benchmark 4.0 showed that HDOCKsite significantly improved the docking performance and obtained a much higher success rate in binding mode predictions than original ab initio docking.
