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Approach to the Patient: Management of Pituitary Hormone Replacement Through Transition. 对病人的态度:脑垂体激素替代的过渡管理。
IF 5 4区 工程技术 Q2 ENGINEERING, CIVIL Pub Date : 2022-06-16 DOI: 10.1210/clinem/dgac129
Manuela Cerbone, Harshini Katugampola, Helen L Simpson, Mehul T Dattani

Hypopituitarism in childhood is a rare, complex disorder that can present with highly variable phenotypes, which may continue into adult life. Pituitary deficits can evolve over time, with unpredictable patterns resulting in significant morbidity and mortality. Hypopituitarism and hypothalamic dysfunction may be associated with challenging comorbidities such as obesity, learning difficulties, behavioral issues, sleep disturbance, and visual impairment. Transition is the purposeful planned movement of adolescents and young adults with chronic conditions from child-centered to adult-oriented health care systems with a shift from parent- to patient-focused care. To achieve effective transition within a health care setting, the inherent challenges involved in the evolution from a dependent child to an independent adult must be recognized. Transition is a critical time medically for patients with hypopituitarism. Complex issues with respect to puberty, attainment of optimal stature, adherence to treatment, and acceptance of the need for life-sustaining medications need to be addressed. For health care professionals, transition is an opportunity for reassessment of the pituitary deficits and the need for lifelong replacement therapies, often against a background of complex psychological issues. We present 4 illustrative cases of hypopituitarism of differing etiologies with diverse clinical presentations. Diagnostic and management processes from clinical presentation to young adulthood are discussed, with a particular focus on needs and outcomes through transition.

儿童垂体功能减退症是一种罕见、复杂的疾病,其表型千变万化,可能会持续到成年。垂体功能障碍可随着时间的推移而演变,其模式难以预测,导致严重的发病率和死亡率。垂体功能减退症和下丘脑功能障碍可能与肥胖、学习困难、行为问题、睡眠障碍和视力障碍等具有挑战性的并发症有关。过渡是指有目的、有计划地将患有慢性疾病的青少年从以儿童为中心的医疗保健系统转移到以成人为中心的医疗保健系统,从以家长为中心的护理转变为以患者为中心的护理。要在医疗保健环境中实现有效的过渡,就必须认识到从依赖他人的儿童到独立的成年人这一演变过程中固有的挑战。对于垂体功能减退症患者来说,过渡时期在医学上是一个关键时期。需要解决青春期、达到最佳身材、坚持治疗以及接受维持生命药物治疗等方面的复杂问题。对于医护人员来说,过渡时期是重新评估垂体功能缺陷和终身替代疗法需求的一个机会,而这往往是在复杂的心理问题背景下进行的。我们介绍了 4 个病因不同、临床表现各异的垂体功能减退症病例。我们讨论了从临床表现到青年期的诊断和管理过程,并特别关注过渡时期的需求和结果。
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引用次数: 0
Seismic performance of exterior r/c beam-column joint under varying axial force 变轴力作用下外钢筋混凝土梁柱节点的抗震性能
IF 2.2 4区 工程技术 Q2 Engineering Pub Date : 2021-06-10 DOI: 10.12989/SEM.2021.78.5.623
Yanbing Hu, M. Maeda, Yusuke Suzuki, Kiwoong Jin
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引用次数: 2
A model for investigating vehicle-bridge interaction under high moving speed 高速行驶条件下车桥相互作用的研究模型
IF 2.2 4区 工程技术 Q2 Engineering Pub Date : 2021-03-01 DOI: 10.12989/SEM.2021.77.5.627
Li Hanyun, Yu Zhiwu, W. Guo, Yan Han
The speed of rail vehicles become higher and higher over two decades, and China has unveiled a prototype highspeed train in October 2020 that has been able to reach 400 km/h. At such high speeds, wheel-rail force items that had previously been ignored in common computational model should be reevaluated and reconsidered. Aiming at this problem, a new model for investigating the vehicle-bridge interaction at high moving speed is proposed. Comparing with the common model, the new model was more accurate and applicable, because it additionally considers the second-order pseudo-inertia forces effect and its modeling equilibrium position was based on the initial deformed curve of bridge, which could include the influences of temperature, pre-camber, shrinkage and creep deformation, and pier uneven settlement, etc. Taking 5 km/h as the speed interval, the dynamic responses of the classical vehicle-bridge system in the speed range of 5 km/h to 400 km/h are studied. The results show that ignoring the second-order pseudo-inertia force will underestimate the dynamic response of vehicle-bridge system and make the high-speed railway bridge structure design unsafe.
20年来,轨道车辆的速度越来越高,中国于2020年10月推出了一款时速可达400公里的高速列车原型。在如此高的速度下,以前在通用计算模型中被忽略的轮轨力项目应该重新评估和考虑。针对这一问题,提出了一种研究高速行驶时车桥相互作用的新模型。与普通模型相比,新模型更加准确和适用,因为它额外考虑了二阶拟惯性力效应,其建模平衡位置基于桥梁的初始变形曲线,其中可以包括温度、预拱、收缩和蠕变变形以及桥墩不均匀沉降等的影响。以5km/h为速度区间,研究了经典车桥系统在5km/h至400km/h速度范围内的动力响应。结果表明,忽略二阶拟惯性力会低估车桥系统的动力响应,使高速铁路桥梁结构设计变得不安全。
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引用次数: 3
Damage detection using both energy and displacement damage index on the ASCE benchmark problem 基于能量和位移损伤指标的ASCE基准问题损伤检测
IF 2.2 4区 工程技术 Q2 Engineering Pub Date : 2021-01-01 DOI: 10.12989/SEM.2021.77.2.151
M. J. Khosraviani, O. Bahar, S. Ghasemi
This paper aims to present a novelty damage detection method to identify damage locations by the simultaneous use of both the energy and displacement damage indices. Using this novelty method, the damaged location and even the damaged floor are accurately detected. As a first method, a combination of the instantaneous frequency energy index (EDI) and the structural acceleration responses are used. To evaluate the first method and also present a rapid assessment method, the Displacement Damage Index (DDI), which consists of the error reliability (β) and Normal Probability Density Function (NPDF) indices, are introduced. The innovation of this method is the simultaneous use of displacement-acceleration responses during one process, which is more effective in the rapid evaluation of damage patterns with velocity vectors. In order to evaluate the effectiveness of the proposed method, various damage scenarios of the ASCE benchmark problem, and the effects of measurement noise were studied numerically. Extensive analyses show that the rapid proposed method is capable of accurately detecting the location of sparse damages through the building. Finally, the proposed method was validated by experimental studies of a six‐story steel building structure with single and multiple damage cases.
提出了一种同时利用能量损伤指标和位移损伤指标识别损伤位置的新型损伤检测方法。利用这种新颖的方法,可以准确地检测出损坏的位置,甚至是损坏的地板。作为第一种方法,将瞬时频率能量指数(EDI)与结构加速度响应相结合。为了对第一种方法进行评价并提出一种快速评估方法,引入了由误差可靠度(β)和正态概率密度函数(NPDF)指标组成的位移损伤指数(DDI)。该方法的创新之处在于在一个过程中同时使用位移-加速度响应,可以更有效地利用速度矢量快速评估损伤模式。为了评价该方法的有效性,对ASCE基准问题的各种损伤场景以及测量噪声的影响进行了数值研究。广泛的分析表明,该方法能够准确地检测出建筑物中稀疏损伤的位置。最后,对某六层钢结构进行了单损伤和多损伤的试验研究,验证了该方法的有效性。
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引用次数: 1
Effect of rebar spacing on the behavior of concrete slabs under projectile impact 钢筋间距对抛物冲击下混凝土板性能的影响
IF 2.2 4区 工程技术 Q2 Engineering Pub Date : 2021-01-01 DOI: 10.12989/SEM.2021.77.3.329
H. Abbas, N. Siddiqui, T. Almusallam, A. Abadel, H. Elsanadedy, Y. Al-Salloum
In this paper, the effect of different steel bar configurations on the quasi-static punching and impact response of concrete slabs was studied. A total of forty RC square slab specimens were cast in two groups of concrete strengths of 40 and 63 MPa. In each group of twenty specimens, ten specimens were reinforced at the back face (singly reinforced), and the remaining specimens were reinforced on both faces of the slab (doubly reinforced). Two rebar spacing of 25 and 100 mm, with constant reinforcement ratio and effective depth, were used in both singly and doubly reinforced slab specimens. The specimens were tested against the normal impact of cylindrical projectiles of hemispherical nose shape. Slabs were also quasi-statically tested in punching using the same projectile, which was employed for the impact testing. The experimental response illustrates that 25 mm spaced rebars are effective in (I) decreasing the local damage and overall penetration depth, (II) increasing the absorption of impact energy, and (III) enhancing the ballistic limit of RC slabs. The ballistic limit was predicted using the quasi-static punching test results of slab specimens showing a strong correlation between the dynamic perforation energy and the energy required for quasi-static perforation of slabs.
本文研究了不同钢筋配置对混凝土板准静态冲孔和冲击响应的影响。混凝土强度分别为40和63 MPa,共40个RC方板试件进行浇筑。每组20个试件,背面加筋10个试件(单加筋),两侧加筋(双加筋)。单加筋和双加筋板均采用间距为25和100 mm的两根钢筋,配筋率和有效深度不变。对试样进行了半球形柱面弹丸的正常冲击试验。用相同的弹丸对板料进行了准静力冲击试验,该弹丸用于冲击试验。试验结果表明,25mm间距钢筋对降低混凝土板的局部损伤和整体侵彻深度、增加冲击能吸收、提高混凝土板的弹道极限具有显著的作用。利用板坯的准静态冲孔试验结果预测了板坯的弹道极限,结果表明,板坯的动态穿孔能量与板坯准静态穿孔所需能量之间存在很强的相关性。
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引用次数: 8
Study on mechanical behaviors of loose mortise-tenon joint with neighbouring gap 具有相邻间隙的松动榫卯连接力学行为研究
IF 2.2 4区 工程技术 Q2 Engineering Pub Date : 2021-01-01 DOI: 10.12989/SEM.2021.77.4.509
Jun-xiao He, Juan Wang, Qin Yang, Miao Han, Y. Deng
The neighbouring gaps at the mortise-tenon joint in traditional timber structure, which leads to the complexity of the joint, are considered to impair the mechanical performance of the joint. In this paper, numerical simulation of loose joint was conducted to examine the deformation states, stress distributions, and bearing capacities, which was verified by full-scale test. On the basis of the experimental and numerical results, a simplified mechanics model with gaps has been proposed to present the bending capacity of the loose joint. Besides, the gap effects and parameter studies on the influences of tenon height, friction coefficient, elastic modulus and axial load were also investigated. As a result, the estimated relationship between moment and rotation angle of loose joint showed the agreement with the numerical results, demonstrating validity of the proposed model; The bending bearing capacity and rotational stiffness of loose joint had a certain drop with the increasing of gaps; and the tenon height may be the most important factor affecting the mechanical behaviors of the joint when it is subjected to repeated load; Research results can provide important references on the condition assessments of the existing mortise-tenon joint.
传统木结构的榫卯节点存在相邻缝隙,导致节点结构的复杂性,影响了节点的力学性能。本文通过数值模拟研究了松动接头的变形状态、应力分布和承载能力,并通过全尺寸试验对其进行了验证。在试验和数值结果的基础上,提出了一个带间隙的简化力学模型来表示松动接头的弯曲能力。此外,还研究了榫头高度、摩擦系数、弹性模量和轴向载荷对榫头间隙效应和参数的影响。结果表明,计算得到的松动节点弯矩与转角之间的关系与数值结果吻合较好,验证了模型的有效性;随着间隙的增大,松动节点的弯曲承载力和转动刚度有一定的下降;在重复荷载作用下,榫头高度可能是影响节点力学行为的最重要因素;研究结果可为现有榫卯节点的状态评估提供重要参考。
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引用次数: 1
In-situ dynamic loading test of a hybrid continuous arch bridge 某混合式连续拱桥原位动载试验研究
IF 2.2 4区 工程技术 Q2 Engineering Pub Date : 2021-01-01 DOI: 10.12989/SEM.2021.77.6.809
Hongye Gou, L. Liang, Yu Hong, Y. Bao, Q. Pu
In this study, the dynamic behavior of a three-span hybrid continuous arch bridge under vehicle loading is investigated. The natural vibration characteristics of the bridge were analyzed through pulsation test. In the dynamic loading test, the vibrations of the bridge under different truck speeds and different pavement conditions were tested, and time histories of deflection and acceleration of the bridge were measured. Based on the dynamic loading test, the impact coefficient was analyzed. The results indicate that the pavement smoothness had more impacts on the vibration of the bridge than the truck's speed. The vertical damping of the bridge under the excitation of the trucks is larger than the transverse damping. Resonance occurs at the side span of the bridge under a truck at 10 km/h.
研究了三跨混合连续拱桥在车辆荷载作用下的动力特性。通过脉动试验,分析了桥梁的自振特性。在动载试验中,测试了桥梁在不同车速和不同路面条件下的振动,并测量了桥梁的挠度和加速度时程。在动加载试验的基础上,分析了冲击系数。结果表明,路面平整度对桥梁振动的影响大于货车车速对桥梁振动的影响。在货车的激励下,桥梁的竖向阻尼大于横向阻尼。共振发生在桥的侧跨下的卡车在10公里/小时。
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引用次数: 0
Electromagnetic field and initial stress on a porothermoelastic medium 孔隙热弹性介质上的电磁场和初始应力
IF 2.2 4区 工程技术 Q2 Engineering Pub Date : 2021-01-01 DOI: 10.12989/SEM.2021.78.1.001
Elsayed M. Abd‐Elaziz
In this study, the porothermoelastic problem with the effect of the magnetic field and initial stress was investigated. We applied normal mode analysis to solve the resulting non-dimensional coupled equations. Numerical results for the displacements, temperature distribution, pore pressure, stresses, induced electric field and induced magnetic field distributions are presented graphically and discussed. The medium deformed because of thermal shock and due to the application of the magnetic field, there result an induced magnetic and an induced electric field in the medium. Numerical analyses are given graphically on the square (2D) and cubic (3D) domains to illustrate the effects of the porosity parameter, magnetic field and initial stress parameter on the physical variables.
本文研究了磁场和初始应力作用下的孔隙热弹性问题。我们应用正态分析来求解得到的无量纲耦合方程。给出了位移、温度分布、孔隙压力、应力、感应电场和感应磁场分布的数值结果,并进行了讨论。介质由于热冲击和磁场作用而发生变形,在介质中产生感应磁场和感应电场。通过二维和三维的数值分析,说明了孔隙度参数、磁场和初始应力参数对物理变量的影响。
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引用次数: 0
Concrete filled double skin square tubular stub columns subjected to compression load 混凝土填充双蒙皮方管短柱承受压缩荷载
IF 2.2 4区 工程技术 Q2 Engineering Pub Date : 2021-01-01 DOI: 10.12989/SEM.2021.77.6.745
Kojiro Uenaka
Concrete filled double skin tubular members (CFDST) consist of double concentric circular or square steel tubes with concrete filled between the two steel tubes. The CFDST members, having a hollow section inside the internal tube, are generally lighter than ordinary concrete filled steel tubular members (CFT) which have a solid cross-section. Therefore, when the CFDST members are applied to bridge piers, reduction of seismic action can be expected. The present study aims to investigate, experimentally, the behavior of CFDST stub columns with double concentric square steel tubes filled with concrete (SS-CFDST) when working under centric compression. Two test parameters, namely, inner-to-outer width ratio and outer square steel tube's width-to-thickness were selected and outer steel tube's width-to-thickness ratio ranging from 70 to 160 were considered. In the results, shear failure of the concrete fill and local buckling of the double skin tubes having largest inner-toouter width ratio were observed. A method to predict axial loading capacity of SS-CFDST is also proposed. In addition, the load capacity in the axial direction of stub column test on SS-CFDST is compared with that of double circular CFDST. Finally, the biaxial stress behavior of both steel tubes under plane stress is discussed.
混凝土填充双皮管构件(CFDST)由两根同心圆形或方形钢管组成,两根钢管之间填充混凝土。CFDST构件在内管内部具有空心截面,通常比具有实心截面的普通钢管混凝土构件(CFT)轻。因此,当CFDST构件应用于桥墩时,可以预期减少地震作用。本研究旨在对双同心方钢管混凝土短柱(SS-CFDST)在中心受压作用下的受力性能进行试验研究。选取内外宽比和外方钢管宽厚两个试验参数,考虑外方钢管宽厚比为70 ~ 160。结果表明,混凝土充填体出现剪切破坏,内外宽比最大的双皮管出现局部屈曲。提出了一种预测SS-CFDST轴向承载力的方法。此外,还对SS-CFDST短柱试验的轴向承载能力与双圆CFDST进行了比较。最后,讨论了两种钢管在平面应力作用下的双轴应力行为。
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引用次数: 2
Concerning the tensor-based flexural formulation: Applications 关于基于张量的弯曲公式:应用
IF 2.2 4区 工程技术 Q2 Engineering Pub Date : 2021-01-01 DOI: 10.12989/SEM.2021.77.6.765
Mohammed A. Alhassan, R. Al-Rousan, Moheldeen A. Hejazi
Recently, the plate bending analysis has been interpreted in terms of the tensor's components of curvatures and bending moments by presenting the conceptual perspectives of the Hydrostatic Method of Analysis (HM) and theoretical formulations that combine the continuum mechanics with the graphical statics analysis, the theory of thin orthotropic and isotropic plates, and the elasticity theory. In pursuance of uncovering a genuine formulation of the plate's flexural differential equations, that possess the general-covariance and coordinates-independency. This study had then, tackled various natural and structural problems in both solid and fluid branches of the continuum mechanics in a description of such theoretical and conceptual attainment in uncovering the dimensional independent diffeomorphism covariant partial differential laws.
最近,通过提出流体静力分析方法(HM)的概念视角和结合连续介质力学与图形静力学分析、薄正交各向异性和各向同性板理论以及弹性理论的理论表述,从曲率和弯矩的张量分量的角度解释了板的弯曲分析。为了揭示具有一般协方差和坐标无关性的板挠曲微分方程的真正公式。该研究在揭示维度无关的微分同态协变偏微分定律的理论和概念上的成就中,解决了连续介质力学中固体和流体分支中的各种自然和结构问题。
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引用次数: 0
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Structural Engineering and Mechanics
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