• Steel and Composite Structures
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• 제45권3호
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• pp.349-367
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• 2022

In this research, an approach combining a semi-analytical method and an analytical method is presented to investigate the static and dynamic post-buckling behavior of the sandwich functionally graded (FG) porous cylindrical shells exposed to external pressure. The sandwich cylindrical shell considered is composed of a viscoelastic core and two FG porous (FGP) face layers. The viscoelastic core is made of Kelvin-Voigt-type material. The material properties of the FG porous face layer are considered continuous through each face thickness according to a porosity coefficient and a volume fraction index. Two types of sandwich FG porous viscoelastic cylindrical shells named Type A and Type B are considered in the research. Type A shell has the porosity evenly distributed across the thickness direction, and Type B has the porosity unevenly distributes across the thickness direction. The FG face layers are considered in two cases: outside metal surface, inside ceramic surface (OMS-ICS), and inside metal surface, outside ceramic surface (IMS-OCS). According to Donnell shell theory, von-Karman equation, and Galerkin's method, a discretized nonlinear governing equation is derived for analyzing the behavior of the shells. The explicit expressions for static and dynamic critical buckling loading are thus developed. To study the dynamic buckling of the shells, the governing equation is examined via a numerical approach implementing the fourth-order Runge-Kutta method. With a procedure presented by Budiansky-Roth, the critical load for dynamic post-buckling is obtained. The effects of various parameters, such as material and geometrical parameters, on the post-buckling behaviors are investigated.

• 한국간호교육학회지
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• 제23권4호
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• pp.463-473
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• 2017

Purpose: The purposes of study was to evaluate the effect of debriefing using reflection questions and writing on the critical thinking disposition, self-efficacy, and clinical judgement ability in simulation of post-operative care of abdominal surgery. Methods: The research method was a nonequivalent control group no-synchronized design. The study period was from August 22 to 30, 2016. The subjects were comprised of 34 people in the experimental group and 36 in the control group. In a simulation session for post-operative care of abdominal surgery, the treatment of the experimental group was to debrief for 30 minutes using Lasater's reflection questions and writing. For the control group, a typical debriefing was conducted in the same environment. Results: Critical thinking disposition, self-efficacy, and clinical judgement were significantly higher in the experimental group than the control group. Conclusion: To enhance the critical thinking disposition, self-efficacy, and clinical judgement of nursing students in simulation, it is recommended to debrief using reflection questions and writing.

• 중환자간호학회지
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• 제13권3호
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• pp.62-74
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• 2020

Purpose : This study aimed to investigate the prevalence and risk factors of mental health problems in patients discharged from the intensive care unit (ICU). Methods : This was a secondary analysis study using data from a multicenter prospective cohort of post-ICU patients. We analyzed data of 311 patients enrolled in the primary cohort study who responded to the mental health questionnaire three months after the discharge. Anxiety and depression were measured on the Hospital Anxiety-Depression Scale, and post-traumatic stress disorder (PTSD) was measured on the Posttraumatic Diagnostic Scale. Results : The prevalence of anxiety, depression, and PTSD in patients at three months after ICU discharge were 25.7%, 17.4%, and 18.0%, respectively, and 7.7% of them experienced all three problems. Unemployment (OR=1.99, p=.033) and unplanned ICU admission (OR=2.28, p=.017) were risk factors for depression, while women gender (OR=2.34, p=.009), comorbid diseases (OR=2.88, p=.004), non-surgical ICUs (trauma ICU: OR=7.31, p=.002, medical ICU: OR=3.72, p=.007, neurological ICU: OR=2.95, p=.019) and delirium (OR=2.89, p=.009) were risk factors for PTSD. Conclusion : ICU nurses should proactively monitor risk factors for post-ICU mental health problems. In particular, guidelines on the detection and management of delirium in critically ill patients should be observed.

• 한국도로학회논문집
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• 제15권4호
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• pp.127-133
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• 2013

PURPOSES : The impact performance of flexible barrier system such as structural response, vehicular motion and occupant safety vary depending on the impact point. Thus, to properly evaluate the performance of a flexible barrier system, impact should be made to a point which will lead to the worst possible results. This point is called the Critical Impact Point (CIP). This paper presents the way to determine the CIP for a SB2 class flexible barrier system which is consisted of Thrie-Beam rail and circular hollow tube post of 2m span. METHODS: Barrier VII simulations were made for impact points; Case 1 at a post, Case 2 at 1/3 span downstream from a post, Case 3 at middle of the span, Case 4 at 2/3 span downstream from a post. For the structural performance (deflections), impact simulation of 8000kg-65km/h-15degree was used, and for vehicle motion and occupant safety, simulation of 1300kg-80km/h-20degree impact was made and analysed. RESULTS: Case 1 gave the largest dynamic deflection of 75.72cm and also gave the largest snag value of 44.3cm. Occupant safety and exit angle of the vehicle after the impact were not sensitive to the impact point and were all below the allowable limit. CONCLUSIONS : For the SB2 class flexible barrier system's CIP can be regarded as a post which is sufficiently away from the end of Length of Need in order to avoid the end-effect of the barrier system. It can be more economic in the long run because the normal concrete pavement material is likely to cost more due to higher probability of maintenance and repair and higher social cost due to traffic accident, etc.

• 중환자간호학회지
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• 제17권1호
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• pp.30-43
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• 2024

Purpose : Post-intensive care syndrome (PICS) is characterized by a constellation of mental health, physical, and cognitive impairments, and is recognized as a long-term sequela among survivors of intensive care units (ICUs). The objective of this study was to explore the impact of intensive care experience (ICE) on the development of PICS in individuals surviving critical care. Methods : This secondary analysis utilized data derived from a prospective, multicenter cohort study of ICU survivors. The cohort comprised 143 survivors who were enrolled between July and August 2019. The original study's participants completed the Korean version of the ICE questionnaire (K-ICEQ) within one week following discharge from the ICU. Of these, 82 individuals completed the PICS questionnaire (PICSQ) three months subsequent to discharge from hospital. The influence of ICE on the manifestation of PICS was examined through Partial Least Squares-Structural Equation Modeling (PLS-SEM). Result : The R² values of the final model ranged from 0.35 to 0.51, while the Q² values were all greater than 0, indicating adequacy for prediction of PICS. Notable pathways in the relationship between the four ICE dimensions and the three PICS domains included significant associations from 'ICE-awareness of surroundings' to 'PICS-cognitive', from 'ICE-recall of experience' to 'PICS-cognitive', and from 'ICE-frightening experiences' to 'PICS-mental health'. Analysis found no significant moderating effects of age or disease severity on these relationships. Additionally, gender differences were identified in the significant pathways within the model. Conclusion : Adverse ICU experiences may detrimentally impact the cognitive and mental health domains of PICS following discharge. In order to improve long-term outcomes of individuals who survive critical care, it is imperative to develop nursing interventions aimed at enhancing the ICU experience for patients.

• Tuberculosis and Respiratory Diseases
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• 제85권4호
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• pp.332-340
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• 2022

Background: Cardiac dysfunction patients have long been considered at high risk of reintubation. However, it is based on past studies in which only conventional oxygen therapy was applied after extubation. We investigated association between cardiac dysfunction and reintubation rate in situation where high-flow nasal cannula (HFNC) was widely used during post-extubation period. Methods: We conducted a retrospective observational cohort study of patients treated with HFNC after planned extubation in medical intensive care unit of single tertiary center. Patients were divided into normal function group (ejection fraction [EF] ≥45%) and cardiac dysfunction group (EF <45%). The primary outcome was reintubation rate within 72 hours following extubation. Results: Of 270 patients, 35 (13%) had cardiac dysfunction. Baseline characteristics were similar in both groups. There were no differences in the changes in vital signs between the two groups during the first 12 hours after extubation except diastolic blood pressure. The reintubation rates were 20% and 17% for cardiac dysfunction group and normal function group, respectively (p=0.637). In a multivariate Cox regression analysis, cardiac dysfunction was not associated with an increased risk of reintubation within 72 hours following extubation (hazard ratio, 1.56; p=0.292). Conclusion: Cardiac dysfunction was not associated with increased reintubation rate within 72 hours when HFNC is immediately applied after planned extubation.

• Structural Engineering and Mechanics
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• 제43권4호
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• pp.459-473
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• 2012

Post-tensioned concrete voided slab girders are widely used in highway bridge constructions. To obtain greater section hollow rate and reduce the self-weight, the plate thickness of slab girders are designed to be small with the adoption of flat anchorage system. Since large prestress is applied to the anchor end section, it was found that longitudinal shear cracks are easy to occur along the voided slab girder. The reason is the existence of great shearing effect at the junction area between web and bottom (top) plate in the anchor end section. This paper focuses on the longitudinal anti-cracking problem at the anchor end of post-tensioned concrete voided slab girders. Two possible models for longitudinal anticracking analysis are proposed. Differential element analysis method is adopted to derive the solving formula of the critical cracking state, and then the practical analysis method for longitudinal anti-cracking is established. The influence of some factors on the longitudinal anti-cracking ability is studied. Results show that the section dimensions (thickness of bottom, web and top plate) and prestress eccentricity on web plate are the main factors that influence the anti-cracking ability. Moreover, the proposed method is applied into three engineering examples to make longitudinal anti-cracking verification for the girders. According to the verification results, the design improvements for these girders are determined.

• Steel and Composite Structures
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• 제27권5호
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• pp.555-566
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• 2018

A 1/3 composite cylindrical shell with a central rectangular opening was axially compressed experimentally, and its critical buckling load and displacement, and strains were measured. A finite element model (FEM) of the shell with Hashin failure criteria was established to analyze its buckling and post-buckling behaviors by nonlinear Newton-Raphson method. The geometric imperfection sensitivity and the effect of side supported conditions of the shell were investigated. It was found that the Newton-Raphson method can be used to analyze the buckling and post-buckling behaviors of the shell. The shell is not sensitive to initial geometric imperfection. And the support design of the shell by side stiffeners is a good way to obtain the critical buckling load and simplify the experimental fixture.

• 대한간호학회지
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• 제50권6호
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• pp.787-798
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• 2020

Purpose: This study aimed to assign weights for subscales and items of the Post-Intensive Care Syndrome questionnaire and suggest optimal cut-off values for screening unplanned hospital readmissions of critical care survivors. Methods: Seventeen experts participated in an analytic hierarchy process for weight assignment. Participants for cut-off analysis were 240 survivors who had been admitted to intensive care units for more than 48 hours in three cities in Korea. We assessed participants using the 18-item Post-Intensive Care Syndrome questionnaire, generated receiver operating characteristic curves, and analysed cut-off values for unplanned readmission based on sensitivity, specificity, and positive likelihood ratios. Results: Cognitive, physical, and mental subscale weights were 1.13, 0.95, and 0.92, respectively. Incidence of unplanned readmission was 25.4%. Optimal cut-off values were 23.00 for raw scores and 23.73 for weighted scores (total score 54.00), with an area of under the curve (AUC) of .933 and .929, respectively. There was no significant difference in accuracy for original and weighted scores. Conclusion: The optimal cut-off value accuracy is excellent for screening of unplanned readmissions. We recommend that nurses use the Post-Intensive Care Syndrome Questionnaire to screen for readmission risk or evaluating relevant interventions for critical care survivors.

• Structural Engineering and Mechanics
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• 제51권6호
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• pp.955-971
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• 2014

Large post-buckling behavior of Timoshenko beams subjected to non-follower axial compression loads are studied in this paper by using the total Lagrangian Timoshenko beam element approximation. Two types of support conditions for the beams are considered. In the case of beams subjected to compression loads, load rise causes compressible forces end therefore buckling and post-buckling phenomena occurs. It is known that post-buckling problems are geometrically nonlinear problems. The considered highly non-linear problem is solved considering full geometric non-linearity by using incremental displacement-based finite element method in conjunction with Newton-Raphson iteration method. There is no restriction on the magnitudes of deflections and rotations in contradistinction to von-Karman strain displacement relations of the beam. The beams considered in numerical examples are made of lower-Carbon Steel. In the study, the relationships between deflections, rotational angles, critical buckling loads, post-buckling configuration, Cauchy stress of the beams and load rising are illustrated in detail in post-buckling case.