Traditional Bed Research Articles

CJEM Debate Series: #HallwayMedicine - Our responsibility to assess patients is not limited to those in beds; emergency physicians must assess patients in the hallway and the waiting room when traditional bed spaces are unavailable.

CJEM Debate Series: #HallwayMedicine - Our responsibility to assess patients is not limited to those in beds; emergency physicians must assess patients in the hallway and the waiting room when traditional bed spaces are unavailable.

Survival and Comparison of External Bleeding Methods in Artery-Only Distal Finger Replantations

If there are no veins available in a distal amputation, an artery-only replantation is performed, and an external bleeding method is commonly used. We conducted a survival analysis in a large series of artery-only replantations and compared 2 different external bleeding methods in artery-only distal replantations: nail matrix or hyponychial area bleeding and pulp skin area bleeding, which we have called the crater method. Two hundred twenty-eight artery-only distal finger replantations in 199 patients were included in the study. The replanted digits were divided into 2 groups according to the external bleeding methods. One group (n= 94; 41.2%) included the patients in whom the external bleeding was performed using a traditional nail bed incision and the second group (n= 134; 58.8%) included the patients in whom external bleeding was performed using the crater method. The finger survival rates and postoperative circulatory problems were examined. The impact of the injury mechanism, injury level, and external bleeding method on survival were evaluated. Clinical findings indicating venous insufficiency were observed in 198 (86.8%) replanted fingers. One hundred eighty-two (79.8%) survived, and complete necrosis developed in 46 (20.2%). Viability was maintained in 84% of patients treated with the nail bed bleeding method and 76.9% of patients treated using the crater method. Clean-cut cases had the best results and subzone 3 cases had the worst results. The artery-only replantation was associated with a 79.8% survival rate. The method of achieving venous outflow did not appear to have an impact on survival. Therapeutic IV.

CO2 adsorption in a confined fluidized bed of zeolite pellets: Influence of operating velocity

CO2 adsorption is performed across a fluidized bed comprising a commercial pelletized 13X zeolite confined to the interstitial void network of a coarse glass sphere packed bed. Compared with traditional fixed bed adsorption, the packed fluidized system allows operation across a wide-range of gas velocities without a substantial increase in pressure drop. Additionally, with respect to conventional fluidization regimes, the technique adopted herein prevents the formation of bubbles in favour of enhancing the bed expansion ability. Furthermore, for a given mass of sorbent, the CO2 uptake capacity is observed to increase as a result of improved thermal conditions and in eliminating any by-pass effect at the gas–particle interface, which is associated to the suppression of bubbling.

Full-scale model testing on the dynamic behaviour of weathered red mudstone subgrade under railway cyclic loading

Although weathered red mudstone (WRM) is widely distributed in the southwest of China, its suitability as a fill material for the subgrade bed of a high-speed railway (HSR) has not been comprehensively investigated. This paper presents the results of a field full-scale model testing of the cyclic loading and response of a railway track-subgrade system for the Dazhou-Chengdu Railway, where some WRM has been used in a newly designed subgrade structure. A control section of the HSR was also built using a traditional subgrade bed (Group A&B material) to compare the performances of the different sections. To better understand the dynamic characteristics and cumulative deformation of the two types of subgrade, the dynamic actions of different axle loads and different train speeds were simulated using specifically designed track-cyclic-loading equipment. The transverse and vertical distributions of the dynamic stress, dynamic displacement and acceleration of the track-subgrade system were measured and evaluated. The influence of the wheel axle load on the growth factor of the dynamic parameters, the vertical attenuation coefficient of the dynamic stress, and the effect of using WRM in the subgrade on the post-construction settlements were investigated. The tests enabled the development of cumulative settlement laws with railway loading for the two types of subgrade. Although the dynamic parameters and cumulative settlement of the WRM subgrade are always greater than those of better-quality material (Group A&B subgrade), they comply with HSR regulations. In conclusion, the results demonstrated that weathered red mudstone can be used as a filling material in the newly designed subgrade structure for HSRs.

Model Predictive Control Method of Simulated Moving Bed Chromatographic Separation Process Based on Subspace System Identification

Simulated moving bed (SMB) chromatographic separation is a new type of separation technology based on traditional fixed bed adsorption operation and true moving bed (TMB) chromatographic separation technology, which includes inlet‐outlet liquid, liquid circulation, and feed liquid separation. The input‐output data matrices were constructed based on SMB chromatographic separation process data. The SMB chromatographic separation process was modeled by utilizing two subspace system identification algorithms: multivariable output‐error state‐space (MOESP) identification algorithm and numerical algorithms for subspace state‐space system identification (N4SID), so as to obtain the 3rd‐order and 4th‐order state‐space yield models of the SMB chromatographic separation process, respectively. The model predictive control method based on the established state‐space models is used in the SMB chromatographic separation process. The influence of different control indicators on the predictive control system response performance is discussed. The output response curves of the yield models were obtained by changing the related parameters so that the yield model parameters are optimized set meanwhile. Finally, the simulation results showed that the yield models are successfully controlled based on the each control period and given yield range.

Mesoscale Electrochemical Performance Simulation of 3D Interpenetrating Lithium-Ion Battery Electrodes

Advancements in micro-scale additive manufacturing techniques have made it possible to fabricate intricate architectures including 3D interpenetrating electrode microstructures. A mesoscale electrochemical lithium-ion battery model is presented and implemented in the PETSc software framework using a finite volume scheme. The model is used to investigate interpenetrating 3D electrode architectures that offer potential energy density and power density improvements over traditional particle bed battery geometries. Using the computational model, a variety of battery electrode geometries are simulated and compared across various battery discharge rates and length scales to quantify performance trends and investigate geometrical factors that improve battery performance. The energy density vs. power density relationship of the electrode microstructures are compared in several ways, including a uniform surface area to volume ratio comparison as well as a comparison requiring a minimum manufacturable feature size. Significant performance improvements over traditional particle-bed electrode designs are predicted, and electrode microarchitectures derived from minimal surfaces are shown to be superior under a minimum feature size constraint, especially when subjected to high discharge currents. An average Thiele modulus formulation is presented as a back-of-the-envelope calculation to predict the performance trends of microbattery electrode geometries.

The Effects of an Advanced Movable Restraint Design on the Elderly Residents at Long-Term Care Facilities in Taiwan

Purpose: The purpose of this study was to evaluate the effects, both initially and after 6 months, of an “advanced movable restraint” with openended palm sleeve restraint bands for the elderly residents at long-term care facilities in northern Taiwan. Background. Elderly residents in long-term care facilities are often forced to remain bed-ridden by traditional bed restraint bands due to their irritable, confused conditions and the associated risks of self-extubating their nasogastric (NG) tubes, urinary catheters, etc. However, the traditional bed restraint bands can themselves lead to further physical and mental complications such as skin damage, depression, hostility, and even rhabdomyolysis, increasing the risk of death. Design. Quasiexperimental design. Methods: This parallel-design study was conducted with elderly residents at eight long-term care facilities. The newly designed advanced movable restraint featuring movable open-ended palm sleeve restraint bands was applied to the elderly residents in the experimental group, allowing them greater freedom of movement such that they were not required to remain bed-ridden. In contrast, the elderly residents in the control group were restrained with traditional bed restraints requiring that they remain bedridden. The following four instruments and indicators were then used to compare the effects of the two types of restraints: (1) an activities of daily living (ADL) survey based on the Barthel Index, (2) a muscle power test, (3) an exercise frequency and duration survey, and (4) self-extubation rates. The effects of the interventions were tested by using the t test or chi-square test to compare pre-test results for the ADL survey, muscle power test, exercise frequency and duration survey, and self-extubation rates to those at a 6-month follow-up. Results: A total of 80 elderly residents were included in the experimental group, while 80 elderly residents were included in the control group. At the 6-month follow-up, the residents restrained with the advanced movable restraint had a significantly increased mean muscle power score (χ2 =17.212, P < 0.001), significantly decreased self-extubation rate (χ2 =40.733, P < .001), and significantly increased exercise frequency and duration per week (χ2=27.095 P < 0.001; 26.241 P < 0.001). Conclusions: This study showed that the advanced movable restraint can improve muscle power scores, self-extubation rates, and exercise frequencies and durations by allowing residents greater freedom of movement without the need to remain bed-ridden. It is thus crucial to use such advanced movable restraints and develop standardized technology systems to support the elderly residents and nurses in long-term care facilities.

Carbothermic Reduction of Ore-Coal Composite Pellets in a Tall Pellets Bed

Recently, increasing attention has been paid to alternative ironmaking processes due to the desire for sustainable development. Aiming to develop a new direct reduction technology, the paired straight hearth (PSH) furnace process, the carbothermic reduction of ore-coal composite pellets in a tall pellets bed was investigated at the lab-scale in the present work. The experimental results show that, under the present experimental conditions, when the height of the pellets bed is 80 mm (16–18 mm each layer, and 5 layers), the optimal amount of carbon to add is C/O = 0.95. Addition of either more or less carbon does not benefit the production of high quality direct reduced iron (DRI). The longer reduction time (60 min) may result in more molten slag in the top layer of DRI, which does not benefit the actual operation. At 50 min, the metallization degree could be up to 85.24%. When the experiment was performed using 5 layers of pellets (about 80 mm in height) and at 50 min duration, the productivity of metallic iron could reach 55.41 kg-MFe/m2·h (or 75.26 kg-DRI/m2·h). Therefore, compared with a traditional shallow bed (one or two layers), the metallization degree and productivity of DRI can be effectively increased in a tall pellets bed. It should be pointed out that the pellets bed and the temperature should be increased simultaneously. The present investigation may give some guidance for the commercial development of the PSH process in the future.

Dynamic behavior of a polyurethane foam solidified ballasted track in a heavy haul railway tunnel

Dynamic behavior of a new type of track using the polyurethane foam solidified ballast in heavy haul railway tunnels is comprehensively investigated in this study. First, a dynamic model of the vehicle–track–tunnel interaction system was developed based on the multi-body system dynamics theory and finite element method. Then, the dynamic effects of the polyurethane foam solidified ballast track on the train and the surrounding infrastructures were calculated and compared to those of the traditional ballasted track. Moreover, the effects of the elastic modulus and the solidified area size of polyurethane foam solidified ballast on the dynamic behavior were analyzed. Results show that, compared to the traditional ballast bed, polyurethane foam solidified ballast decreases the track stiffness and the vibration acceleration of the tunnel, while does not affect the vehicle safety (derailment coefficient and the rate of wheel load reduction). A larger elastic modulus of polyurethane foam solidified ballast has little effects on the wheel–rail interaction and the vibration acceleration of the tunnel, while a smaller modulus results in amplification of the displacements of rails and sleepers. Considering the vehicle–track interaction and tunnel vibration, the optimal elastic modulus of polyurethane foam solidified ballast is suggested to be 60–80 MPa. In addition, smaller solidified area of polyurethane foam solidified ballast presents lower effects on the vibration reduction and rate of wheel load reduction, while larger area leads to a higher derailment coefficient and cost. Therefore, an optimal solidified area size of polyurethane foam solidified ballast with the top width of 0.85 m is recommended.

Experimental Investigation on Rice Straw Gasification in a Cyclone Gasifier

A cyclone gasifier is an effective technology for the gasification of low-density biomass containing a high ash content. The ash removal performance was improved in the gasifier due to being similar to a cyclone dust collector. The cyclone reactor is relatively simple, easy to use, and has low construction costs compared with a traditional fluidized bed gasifier. In this study, the air gasification characteristics of rice straw were investigated in a cyclone gasifier. The results showed that by increasing the equivalence ratio (ER), the gasifier temperature also increased. This, in turn, led to a higher gas quality (higher heating value (HHV) and lower tar content) and enhanced the gasification performance (gas yield, carbon conversion efficiency, cold gas efficiency, and hot gas efficiency). A high ER reduced the amount of the combustible gas component (CO and H2) and caused the HHV of the producer gas to decrease. The optimum value range of ER was observed to be about 0.29 to 0.34. A smaller feedstock size was more favorable for higher producer gas quality and gasification performance. Biomass moisture content parameters played an important role in the cyclone gasification process. Higher moisture content decreased the gasifier temperature, leading to low gas quality (lower HHV and higher tar content), and resulted in lower gasification performance.

Comparison of the effects of a sulfuric acid environment on traditionally manufactured and additive manufactured stainless steel 316L alloy

The effects on the surface and mechanical properties of stainless steel AISI316L dogbones created using either traditional manufacturing (TM) or laser powder bed fusion (LPBF) exposed to 0.75 M sulfuric acid solution over 2184 h were studied. General corrosion was not a major form of corrosion, based on surface feature changes, surface roughness, and mass loss for either method. No change to the mechanical properties occurred for the TM samples. Both tensile stress and strain decreased for the LPBF samples. The decrease was caused by hydrogen embrittlement, due to the formation of large brittle particles, as demonstrated by scanning electron microscopy.

Functional sit-to-stands evoke greater neuromuscular activation than orthopaedic bed exercises in healthy older adults

OBJECTIVE: To compare EMG activity of the hip and thigh muscles during traditional static bed exercises and the sit-to-stand exercise in healthy older adults. METHODS: Twenty-four healthy, older adults (8 male; age 65±7 yrs) performed four static rehabilitation exercises: isometric contractions of the gluteal, abductor, inner quadriceps and quadriceps (ten, ~5 s submaximal contractions, with 60 rests), and the sit-to-stand test. Electromyographic (EMG) activity was recorded from the rectus femoris, vastus medialis, gluteus medius, biceps femoris and gluteus maximus, and root mean square-processed (RMS) in this observational preliminary study. Handgrip strength, 10 m walking speed and hamstring-quadriceps ratio represented participant characteristics. RESULTS: Hip and thigh muscles were activated differently between the isometric bed and sit-to-stand exercises. Greatest RMS activity was shown in the chair rising phase of the sit-to-stand exercise. No bed exercise exceeded the muscle RMS activity required to perform a sit-to-stand, and only for sit-to-stands were all muscles activated over 40% of maximal; the level required to stimulate muscle strength adaptation. CONCLUSIONS: Functional daily activities, such as sit-to-standing, produce greater muscle activity than static bed exercises in healthy older adults. Sit-to-stands should be included in exercise and rehabilitation programs for older adults, to evoke sufficient levels of neuromuscular activation for muscle strength adaptation.

Investigation of hydrodynamic and heat transfer performances in grille-sphere composite pebble beds with DEM-CFD-Taguchi method

In the present paper, grille-sphere composite pebble bed (GSCPB) is developed to improve the hydrodynamic and heat transfer performances for high temperature gas cooled reactor with 10 MW (HTR-10). The fluid flow and heat transfer characteristics in typical GSCPB channels are numerically investigated, and the effects of typical parameters on the pressure drop and maximum pebble temperature inside are carefully analyzed with Taguchi method. Firstly, in the GSCPB bed, the grille can not only support the pebbles to achieve a structured packing quickly, but can also enhance convective heat transfer from pebbles to the fluid. With proper design of grille inside, the heat transfer rate would be improved and the pressure drop would be reduced in GSCPB channel when compared with traditional random pebble bed. Secondly, the effect of sub-channel width to pebble diameter ratio (N) on both the hydrodynamic and heat transfer performances in GSCPB channel is quite significant. The contribution ratios of N on the pressure drop and maximum pebble temperature in GSCPB channel are of 86.3% and 81.0%, respectively. Finally, with Taguchi method, the optimum design parameter combinations are obtained for the lowest pressure drop and lowest maximum pebble temperature in GSCPB channels, respectively.

Characterization and Processing Behavior of Heated Aluminum-Polycarbonate Composite Build Plates for the FDM Additive Manufacturing Process

One of the most essential components of the fused deposition modeling (FDM) additive manufacturing (AM) process is the build plate, the surface upon which the part is constructed. These are typically made from aluminum or glass, but there are clear disadvantages to both and restrictions on which materials can be processed on them successfully. This study examined the suitability of heated aluminum-polycarbonate (AL-PC) composite print beds for FDM, looking particularly at the mechanical properties, thermal behavior, deformation behavior, bonding strength with deposited material, printing quality, and range of material usability. Theoretical examination and physical experiments were performed for each of these areas; the results were compared to similar experiments done using heated aluminum and aluminum-glass print beds. Ten distinct materials (ABS, PLA, PET, HIPS, PC, TPU, PVA, nylon, metal PLA, and carbon-fiber PLA) were tested for printing performance. The use of a heated AL-PC print bed was found to be a practical option for most of the materials, particularly ABS and TPU, which are often challenging to process using traditional print bed types. Generally, the results were found to be equivalent to or superior to tempered glass and superior to standard aluminum build plates in terms of printing capability.

Ambulatory emergency care – improvement by design

Ambulatory emergency care (AEC) has been developed by clinicians as a means of providing emergency care without the traditional bed base of a hospital. Given that AEC is provided in a clinic-style setting, it can continue to operate during periods of high bed occupancy, alleviating bed pressures and continuing to provide timely care for selected patients. Although different models of AEC have developed according to local context, there are common principles that apply to AEC services, including early access to senior decision-makers, opening hours matching demand, access to diagnostics, close collaboration with other clinical services, a mixed workforce and patient selection processes. Some of the key AEC developments have been related to technology, including high-sensitivity troponin, low-molecular-weight heparins and computer tomography (CT) pulmonary angiography. Risk stratification tools are useful for assessing the appropriateness of using AEC as a care model for patients.

Assessment of Bed Bathing Methods in the Faroe Islands

There are two types of bed baths: the traditional basin used with soap and water, and the disposable bath, which is pre-packed in single-use units and heated before use. From earlier studies it was recommended with further studies witch would strengthen the evidence. To compare the traditional basin bed bath to a disposable bed bath, there are three factors that need to bed considered: (1) duration and quality of the bath, (2) patient satisfaction and (3) nurse satisfaction.31 patients received bed baths on two consecutive days. The patients were bathed by the same nurse on both days. The bed baths were observed in relation to duration and quality. Nurses and patients were interviewed about their preferences. The study was performed in both surgical and medical floors. Both types of bed baths scored very highly in the area of quality. Significantly less time was used with the disposable bed baths (p< 0.001). The registered nurses prefer the disposable bath (78%). The patients were satisfied with both types of bed baths. There was no significant difference in the results. Even when we adapt the results in relation to the patients’ gender and age, there is still no significant difference. Patients rated the bed baths equally in most cases. By this study we applied further research in the area of personal hygiene. When all aspects of bed baths are considered (time, cost, quality, and patient and nurse preferences), both types of bed baths are secure and well received. Due to the times savings achieved and the importance of this for patients (who are weak and need nursing assistance to perform personal hygiene), we recommend the use of disposable bed baths.

Opinions of Intensive Care Nurses: Traditional or Disposable Wipes Bed Bath? A Quasi-Qualitative and Cost Analysis Study

Background: This study is to compare the traditional basin with the disposable washcloths bed bath in terms of two outcomes: ICU nurses’ satisfaction/preference and cost analysis. Methods: This is a quasi-qualitative and descriptive study was performed in three ICUs (orthopaedic, neurosurgery, and general surgical) at a university hospital. The sample consisted of 41 ICU nurses agreed to participate in the study. The ICU nurses used a visual analogue scale to respond to the questions about the two types of bed-baths. The researchers conducted interviews with ICU nurses about the two bedbath practices based on open-ended questions. The interview, lasting for 20-30 minutes, was administered during a rest period. A cost analysis was calculated by researchers based on equipment and workload. Results: The application time, workload of nurses, and cost analysis scores favoured the disposable bedbath method (p≤0.05). The traditional bed-bath application scored higher than the disposable washcloth application in parameters (performing, providing communication to the patient, patient feedback, cleanliness, integrity, and softness of skin) (p≤0.01). ICU nurses reported that the three most important parameters that affect the preference for the traditional bed-bath application are communication with patients, patient satisfaction feedback, and the cleanness and integrity of skin. Conclusion: Disposable bed-bath method was performed less time, less workload of nurses, and cost effective than traditional method. Furthermore the ICU nurses preferred the traditional bed bath application. Researchers determined that a bridge between cultural habits and nursing science should be established.

Effect of Carbide Dissolution on Chlorine Induced High Temperature Corrosion of HVOF and HVAF Sprayed Cr3C2-NiCrMoNb Coatings

Highly corrosion- and wear-resistant thermally sprayed chromium carbide (Cr3C2)-based cermet coatings are nowadays a potential highly durable solution to allow traditional fluidized bed combustors (FBC) to be operated with ecological waste and biomass fuels. However, the heat input of thermal spray causes carbide dissolution in the metal binder. This results in the formation of carbon saturated metastable phases, which can affect the behavior of the materials during exposure. This study analyses the effect of carbide dissolution in the metal matrix of Cr3C2-50NiCrMoNb coatings and its effect on chlorine-induced high-temperature corrosion. Four coatings were thermally sprayed with HVAF and HVOF techniques in order to obtain microstructures with increasing amount of carbide dissolution in the metal matrix. The coatings were heat-treated in an inert argon atmosphere to induce secondary carbide precipitation. As-sprayed and heat-treated self-standing coatings were covered with KCl, and their corrosion resistance was investigated with thermogravimetric analysis (TGA) and ordinary high-temperature corrosion test at 550 °C for 4 and 72 h, respectively. High carbon dissolution in the metal matrix appeared to be detrimental against chlorine-induced high-temperature corrosion. The microstructural changes induced by the heat treatment hindered the corrosion onset in the coatings.

An in-depth exploration of residents’ perceived impacts of transient vacation rentals

ABSTRACTThe recent explosion of transient vacation rental (TVR) accommodations has been aided by websites like AirBnB, Vacation Rentals By Owner (VRBO), and HomeAway and this segment continues to grow in popularity. Many communities have enacted bans on TVRs with little empirical data to support decisions. This study explores TVR-related impacts as perceived by residents, and why those particular impacts are perceived. A series of 12 semi-structured, in-depth interviews of key resident stakeholders on Oahu, Hawai’i, United States (US) were conducted. Thematic analysis revealed residents perceived both positive and negative impacts in the economic, environmental, and sociocultural realms. Extended quotes from interviewees reveal the connection of perceived impacts to the presence of TVRs in residential zoned areas and the lack of a proprietor to manage the property and tourists like a traditional bed and breakfast (B&B). Findings provide a baseline for future research examining the unique impacts of this area of rapid tourism growth. Marketing implications are discussed.

How does washing without water perform compared to the traditional bed bath: a systematic review

BackgroundFor immobile patients, a body wash in bed is sometimes the only bathing option. Traditionally, the bed bath is performed with water and soap. However, alternatives are increasingly used in health care. Washing without water is one such alternative that has been claimed to offer several advantages, such as improved hygiene and skin condition. This systematic review aims to provide a comprehensive overview of the evidence on outcomes of the washing without water concept compared to the traditional bed bath.MethodsControlled trials about washing without water outcomes published after 1994 were collected by means of a systematic literature search in CINAHL, Embase, MEDLINE, and PUBMED at the 25th of February, 2016. Additionally, references and citations were searched and experts contacted. Studies were eligible if (1) the study designs included outcomes of washing without water products developed for the full body wash compared to the traditional bed bath, and (2) they were controlled trials. Two researchers independently used a standardized quality checklist to assess the methodological quality of the eligible studies. Finally, outcomes were categorized in (1) physiological outcomes related to hygiene and skin condition, (2) stakeholder-related outcomes, and (3) organizational outcomes in the data synthesis.ResultsOut of 33 potentially relevant articles subjected to full text screening, six studies met the eligibility criteria. Only two studies (of the same research group) were considered of high quality. The results of these high quality studies show that washing without water performed better than the traditional bed bath regarding skin abnormalities and bathing completeness. No differences between washing without water and the traditional bed bath were found for outcomes related to significant skin lesions, resistance during bathing and costs in the studies of high quality.ConclusionsThere is limited moderate to high quality evidence that washing without water is not inferior to the traditional bed bath. Future research on washing without water is needed and should pay special attention to costs, hygiene, and to stakeholder-related outcomes, such as experiences and value perceptions of patients, nursing staff and family.