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BackgroundUnder the conditions of regular containment of COVID-19 epidemic, the levels of core competencies in emergency management of community public health emergency responders are directly associated with the effectiveness of management of public health emergencies. However, there are few studies on core competencies in emergency management of public health emergencies and areas in demand for improvement in community public health emergency responders.ObjectiveTo examine the core competencies in emergency management of COVID-19 pandemic, and associated factors as well as areas in demand for improvement within community public health emergency responders from Zhejiang Province.MethodsUsing the Core Response Competence Index System for Infectious Disease Emergencies among Medical Staff as a reference, we developed a questionnaire consisting of three parts: demographic and COVID-19 containment status, Core Competencies for Emergency Management of Public Health Emergencies (CCEMPHE) , and areas in demand for improvement, and used it to conduct an online survey with 749 community public health emergency responders selected from six counties (districts) of Zhejiang using stratified cluster sampling in September 2020.ResultsThe survey achieved a response rate of 93.3% (699/749) . The average score of CCEMPHE for the respondents was (118.38±27.60) , with a scoring rate of 62.3%. The scoring rates of three dimensions of the CCEMPHE from high to low were prevention ability (66.4%) , preparedness ability (63.7%) and rescue ability (62.0%) . Multiple linear regression analysis showed that education background (b=4.55) , physical quality for emergency work (b=9.26) , experiences of participating in developing emergency plan/technical proposal (b=6.43) , attending emergency training (b=6.35) , field epidemiology training (b=4.62) , on-site emergency disposal experience (b=5.32) , the number of theoretical trainings related to COVID-19 (b=4.29) , and the number of COVID-19 containment projects involved in (b=1.16) , were associated with the core competencies in emergency management of COVID-19 pandemic in community public health emergency responders (P

Accurate and fast recognition of vehicle license plates from natural scene images is a crucial and challenging task. Existing methods can recognize license plates in simple scenarios, but their performance degrades significantly in complex environments. A novel license plate detection and recognition model YOLOv5-PDLPR is proposed, which employs YOLOv5 target detection algorithm in the license plate detection part and uses the PDLPR algorithm proposed in this paper in the license plate recognition part. The PDLPR algorithm is mainly designed as follows: (1) A Multi-Head Attention mechanism is used to accurately recognize individual characters. (2) A global feature extractor network is designed to improve the completeness of the network for feature extraction. (3) The latest parallel decoder architecture is adopted to improve the inference efficiency. The experimental results show that the proposed algorithm has better accuracy and speed than the comparison algorithms, can achieve real-time recognition, and has high efficiency and robustness in complex scenes. [ABSTRACT FROM AUTHOR]

To date, although radiation cooling technology has made some progress in numerous aspects, significant challenges remain in terms of efficient cooling and practical applications. Herein, we report the preparation of a polyvinylidene fluoride (PVDF) composite film with a multiscale micro-nano structure, in which zirconia (ZrO2) particles were bonded on the surface of the PVDF fibers via polydimethylsiloxane (PDMS). This PVDF composite film showed a relatively high solar reflectivity (>0.95) and excellent emissivity (>0.96) in the infrared atmospheric window, which resulted in a 21.8 °C and 10.4 °C temperature reduction compared to the simulated skin and ambient temperature under direct sunlight of about 1000 W m−2, respectively. Meanwhile, the combination of the multistage structure and hydrophobicity property of PDMS resulted in superhydrophobicity with a hydrophobic angle of 155° and sliding angle of about 5°, thereby conferring the film with exceptional self-cleaning ability. Notably, PDMS simultaneously facilitated the formation of a bonding structure between the fibers, leading to enhanced mechanical properties. Compared to those of the PVDF electrospun film (F-S), the tensile strength and tensile strain of the designed composite film increased by 9.5 times and 4.4 times, respectively. Thus, the excellent performances of the PVDF composite film provide a great development prospect for the practical application of electrospun films in smart textiles and energy-saving. [ABSTRACT FROM AUTHOR]

Triboelectric nanogenerators (TENGs) are gaining tremendous attention as an environmentally friendly technology that converts low-frequency mechanical energy into electrical energy. However, the output of TENGs is limited by the tribolayer material used. In this study, a unique lamellar crystal triboelectric nanogenerator (LC-TENG) that uses polyamide-66 (PA66) lamellar crystal spin-coated films as positive triboelectric layers and FEP films as negative triboelectric layers is presented. The large vertical interlocking nanosheet structure on the PA66 spin-coating film, incubated in solution, improves surface roughness and promotes charge storage capacity. Under a constant force of 10 N and a frequency of 2 Hz, the LC-TENG with dimensions of 3 cm × 3 cm can achieve a peak voltage and current of 153 V and 7.35 μA, respectively. With an external load resistance of ∼11 MΩ, the TENG's maximum power density is 0.67 W m−2. The LC-TENG can easily harvest energy from human motions and light up a 36-LED array driven by a linear motor. Compared to TENGs using the initial smooth spin-coated film as the triboelectric electrode, the voltage and current from the lamellar structure film are 2.38 times and 2.17 times higher, respectively. This is the first time that a lamellar crystal structure has been introduced into friction material optimization, providing an efficient and feasible way to explore active sensor or electrode materials for self-powered electronic devices. [ABSTRACT FROM AUTHOR]

Large‐area gold‐coated polyamide 66 (PA66) nanopillar (PA66NP@Au) arrays consisting of secondary lamellar structures and sub‐10–nm gaps are fabricated for surface‐enhanced Raman spectroscopy (SERS) using ultrathin anodized aluminum oxide (AAO) template, solution‐phase growth of PA66 lamellae, and Au sputtering. Such closely packed PA66NP@Au arrays with high density of electromagnetic field enhancement ("hot spots") on large area exhibit high SERS sensitivity for detection of rhodamine 6g (R6G) molecules with concentration down to 10−14m and a large Raman analytical enhancement factor (AEF) of ≈1010. Furthermore, the as‐fabricated PA66NP@Au arrays provide highly sensitive Raman signals in detection of a commonly pesticide residue, carbendazim with a limit of detection (LOD) of 0.05 mg L−1 (0.05 ppm), which is lower than that of maximum residue limit of 0.2 ppm allowed in Europe Union. The as‐fabricated PA66NP@Au arrays are promising for highly sensitive and uniform SERS detection. [ABSTRACT FROM AUTHOR]

Background: COVID‐19 has challenged critical care nursing through increased critical care service utilization. This may have a profound impact on intensive care unit (ICU) nurses' ability to maintain patient safety. However, the experiences of ICU nurses in managing patient safety during an infectious disease outbreak remains unexplored. Aims and objectives: To explore ICU nurses' narratives in managing patient safety in the outbreak ICUs during the COVID‐19 pandemic. Design: A narrative inquiry design. Methods: A purposive sample of 18 registered nurses who practiced in the outbreak ICUs during the COVID‐19 pandemic were recruited between June and August 2020. Individual semi‐structured interviews were conducted, transcribed verbatim, and narratively analysed. Results: Findings reviewed an overarching anatomy‐specific storyline of a 'hand‐brain‐heart' connection that describes nurses' experience with managing patient safety during the COVID‐19 pandemic. Firstly, stories on 'the hands of clinical practice' revealed how critical care nursing is practiced and adapted by ICU nurses during the pandemic. In particular, ICU nurses banded together to safeguard patient safety by practicing critical care nursing with mastery. Secondly, stories on 'the brain of psychosocial wellness' highlights the tumultuous impact of COVID‐19 on the nurses' psychosocial well‐being and how nurses demonstrated resilience to continually uphold patient safety during the pandemic. Lastly, stories on 'the heart of nursing' drew upon the nurses' intrinsic professional nursing identity and values to safeguard patient safety. Specific patient tales further boosted the nurses' commitment to render safe nursing care during the pandemic. Conclusions: Through their stories, ICU nurses reported how they continually seek to uphold patient safety through clinical competence, resilience, and heightened nursing identity. Relevance to clinical practice: ICU nurses require sustainable clinical resources and references such as clinical instructors, as well as visible psychosocial support channels, for ICU nurses to continue to uphold patient safety during COVID‐19. [ABSTRACT FROM AUTHOR]

Despite extensive research, the stabilization mechanism of mesomorphic isotactic polypropylene (iPP) at room temperature has not been elucidated completely. To address this issue, nanoscale structural information is indispensable. In this study, mesomorphic‐α phase transition is studied with synchrotron wide‐angle diffraction and small‐angle X‐ray scattering. It is found that during phase transition, the mobile amorphous content remained unchanged, while rigid amorphous fraction (RAF) decreased constantly, accompanied by an increase in long period. Assuming that the increase in long period is induced by the extension of the rigid amorphous coil (RAC), the thickness of RAF (RRAF) is estimated, which is found to be 2.2 nm. This value is greater than the length of b axis in α crystal cell, which can be the reason that folded‐chain iPP clusters in mesomorphic iPP cannot approach closer to form α crystal at room temperature. Besides, with RRAF, the thickness of smectic layer is estimated, which is found to be 0.9 nm. At this thickness, bulk‐free energy cannot compensate for the folded‐surface free energy, which can be the other reason that mesomorphic iPP chains cannot transit into α crystal at room temperature. The information obtained in this study is favorable for understanding the stabilization mechanism of mesomorphic iPP. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study was to explore the lived experiences of interprofessional collaboration among nurses, doctors, and respiratory therapists during medical emergencies in the intensive care unit. Design: Descriptive phenomenological study. Method: Participants will be recruited through purposive sampling with maximum variation across the ICUs in a tertiary hospital in Singapore. Guided by data saturation, data collection will include individual semi‐structured interviews with ICU nurses, physicians, and respiratory therapist who have attended to medical emergencies such as cardiopulmonary arrest or difficult airway management in the ICUs. Interviews will be audio recorded, transcribed verbatim, and analysed via Colaizzi's descriptive phenomenology method. Research Ethics Committee approval was sought from the National Healthcare Group, Domain Specific Review Board (April 2019). The study is funded by the National Healthcare Group ‐ Health Outcomes and Medical Education Research Grant (April 2019). The study is expected to be concluded by April 2020. Discussion: Whilst interprofessional collaboration remains a major interest among nursing research, there is a paucity of evidence surrounding interprofessional collaboration in the specific context of medical emergencies in the ICUs. This is especially crucial as the failure of interprofessional collaboration during medical emergencies can be catastrophic to patient safety. Hence, this study will adopt a qualitative approach to contribute to the evidence base surrounding this lesser known phenomenon. The findings generated from this study will inform future team training initiatives, advance nursing leadership initiatives, and identify barriers and facilitators towards fostering greater interprofessional collaboration during medical emergencies. Impact: The evidence gained from this study contributes to the limited knowledge base of interprofessional collaboration during medical emergencies. Findings will have vast impact on nursing and interprofessional programs such as crisis leadership and management. The findings could also inform practice frameworks during medical emergencies to support interprofessional collaboration and optimize patient care. [ABSTRACT FROM AUTHOR]

Background: Self-extubation is an adverse patient event that can lead to severe complications. Gaps in clinical practice from the lack of nursing awareness and decision making capacity have often resulted in cases of preventable self-extubation. Review of current evidence suggests that initiatives to support nursing clinical decision making can help prevent adverse patient events such as self-extubation. Aims: The aim of this study was to reduce the incidence of self-extubation by 50% in a cardiology intensive care unit over 1 year. Methods: A quality improvement project was undertaken with a PEST model of nursing care introduced from January 2017 to December 2017 in the cardiology intensive care unit to guide nursing staff to assess and render appropriate interventions along patient domains such as pain, endotracheal tube securement, sedation, and tie to prevent incidences of self-extubation. Results: Incidences of self-extubation have reduced to 5 cases in 2017, reflecting a 50% improvement from 10 cases in 2016. Conclusions: Formalizing practice standards into an easy-to-remember mnemonics or framework can improve patient outcomes. Policy makers must be aware that initiatives to facilitate decision making can improve patient safety. [ABSTRACT FROM AUTHOR]