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This work presents mechanical testing and numerical simulations on fatigue behavior, particularly the fatigue life and failure modes and the final fracture of metallic materials. First, the mechanical tests of the base alloys and their welded joint were conducted, and the stress-circulation curve with a survival rate was obtained. Second, the failure modes and fracture mechanisms of such metallic materials were analyzed. Third, the load spectrum of the key parts of a typical welding joint was converted into a stress spectrum. Finally, the fatigue life of the components was achieved based on the finite element analysis and corresponding numerical simulations. The results showed a very promising application of such composite materials to meet the safety requirements. Therefore, the present study also provides an efficient method, which can be applied in various industrial aspects such as materials and mechanical engineering, as well as structural control and safety monitoring. [ABSTRACT FROM AUTHOR]

Study design:This is a survey-based study.Objective:To investigate the practice of spinal cord injury (SCI) core data collection by Chinese physicians to measure the extent and accuracy of routine collection of elements contained in the International Spinal Cord Injury Core Data Set (ISCICDS).Setting:This study was conducted in a workshop in Peking University, China.Methods:During an SCI workshop, a survey questionnaire was administered to 48 physicians from 20 provinces of China. The questions were developed on the basis of the data elements within the ISCICDS including the following issues: date of birth, injury, acute admission and inpatient discharge, total hospitalized days, gender, injury etiology, vertebral injury, associated injury, spinal surgery, ventilatory assistance and place of discharge. In addition, data collection practice on neurologic examinations including date, neurological level, injury severity and frequency of examination were involved.Results:The self-reported practice of data collection regarding date of birth, acute admission and inpatient discharge, gender, vertebral injury, associated injury, spinal surgery and frequency of neurological examination are consistent with the information in the ISCICDS among the majority (⩾76%) of physicians. However, only gender, vertebral injury, associated injury and spinal surgery are completely consistent. The consistency percentages of other data elements ranged from 39.5 to 66.8%.Conclusion:Apart from four data elements, which were collected consistently with the intention in the ISCICDS, the collection of other core data elements need to be documented according to the guidelines included in the ISCICDS to ensure consistency of practice among Chinese physicians and to support worldwide comparison of SCI data.Suggestion:Only four data elements are collected in complete accordance with the ISCICDS by Chinese physicians. ISCICDS guidelines for the remaining elements need to be more rigorously adhered to in order to promote consistency and comparability of data. [ABSTRACT FROM AUTHOR]

Study design:This is an interventional training session.Objective:The objective of this study was to investigate the difference in response to self-assessment questions in the original and an adjusted version for a submodule of www.elearnSCI.org for student nurses.Setting:The study was conducted in a teaching hospital affiliated to Peking University, China.Methods:In all, 28 student nurses divided into two groups (groups A and B; 14 in each) received a print-out of a Chinese translation of the slides from the 'Maintaining skin integrity following spinal cord injury' submodule in www.elearnSCI.org for self-study. Both groups were then tested using the 10 self-assessment multiple-choice questions (MCQs) related to the same submodule. Group A used the original questions, whereas group B received an adjusted questionnaire.Results:The responses to four conventional single-answer MCQs were nearly all correct in both groups. However, in three questions, group A, with the option 'All of the above', had a higher number of correct answers than group B, with multiple-answer MCQs. In addition, in another three questions, group A, using the original multiple-answer MCQs, had fewer correct answers than group B, where it was only necessary to tick a single incorrect answer.Conclusion:Variations in design influence the response to questions. The use of conventional single-answer MCQs should be reconsidered, as they only examine the recall of isolated knowledge facts. The 'All of the above' option should be avoided because it would increase the number of correct answers arrived at by guessing. When using multiple-answer MCQs, it is recommended that the questions asked should be in accordance with the content within the www.elearnSCI.org. [ABSTRACT FROM AUTHOR]

Study design:Descriptive comparison analysis.Objective:To evaluate whether five training cases of International Spinal Cord Injury Core Data Set (ISCICDS) are appropriate for testing the facts within the International Standards for Neurological Classification of Spinal Cord Injury (ISNCSCI) and could thus be used for testing its training effectiveness.Methods:The authors reviewed the five training cases from the ISCICDS and determined the sensory level (SL), motor level (ML) and American Spinal Injury Association Impairment Scale (AIS) for the training cases. The key points from the training cases were compared with our interpretation of the key aspects of the ISNCSCI.Results:For determining SL, three principles of ML, sacral sparing, complete injury, classification of AIS A, B, C and D, determining motor incomplete status through sparing of motor function more than three levels below the ML, there are corresponding case scenarios in ISCICDS. However, no case scenario shows classification of AIS E and the use of voluntary anal sphincter contraction for determination of motor incomplete status. Neurological level of injury could be deduced from the SL and ML. Finally, none of the cases include information about zone of partial preservation, sensory score or motor score.Conclusion:Majority of the facts related to SL, ML and AIS are included in the five training cases of ISCICDS. Thus, using these training cases, it is feasible to test the above facts within the ISNCSCI. It is suggested that the missing fact should be included in an update of the training cases. [ABSTRACT FROM AUTHOR]

Study design:Interventional training session.Objective:To investigate the effect and satisfaction with didactic training using printed text of a submodule of www.elearnSCI.org for nurse students and to assess the answers of each question.Setting:A Peking University teaching hospital.Methods:Twenty-eight nurse students in two groups (14 in each) were involved. Only group A received a translated print-out of the slides from the 'Nursing management' submodule in www.elearnSCI.org for 1-h self-study before the class. At the beginning of class, both groups were tested using the self assessment questions. Then, a lecture according to the content of this submodule was carried out and afterwards both groups answered the self assessment questions again. Finally, both groups filled in a training course satisfaction questionnaire.Results:At the beginning of the class, the mean score (max 9) of the self assessment in group A was 7.1±1.1, which was significantly higher than that in group B (4.9±1.7, P=0.001). After the lecture, the mean score of the self assessment in group A had insignificantly increased to 7.4±1.3, whereas in group B it increased significantly to 6.9±0.8 (P<0.001). The mean score (max 50) of the training course satisfaction questionnaire was 42.8±5.2. Sixty-four percentage of the students indicated that they were very satisfied (overall score ⩾42) with the training and no students were unsatisfied (overall score <30).Conclusion:Self-study and lecture presentation are effective methods for training the content of www.elearnSCI.org to nurse students. The training satisfaction of this submodule within the www.elearnSCI.org is favorable. [ABSTRACT FROM AUTHOR]

Study Design:Retrospective chart review.Objective:To compare autonomic dysreflexia (AD) severity during urodynamics and cystoscopy in individuals with spinal cord injury (SCI).Setting:Outpatient urological clinic.Methods:Demographic and clinical data were collected from charts of individuals with SCI who had blood pressure (BP) monitoring during urological procedures. Cardiovascular parameters were collected at baseline and during the various stages of two examinations.Results:A total of 21 SCI individuals (mean age 49.4 years) who underwent both procedures developed episodes of AD. The majority of individuals had cervical SCI (85.7%). The median duration of injury was 183 months (ranging from 3 to 530 months). There was statistically more of an increase (P=0.039) in systolic BP during cystoscopy (67.1±33.8 mm Hg) in comparison with urodynamics (51.8±21.8 mm Hg). The BP response during episodes of AD was more pronounced in individuals with more than 2 years post SCI than with less than 2 years post SCI during both urodynamics and cystoscopy (P=0.047 and P=0.010, respectively).Conclusion:Even though cystoscopy filled the bladder to lesser volumes than did urodynamics (150 ml vs 500 ml), during cystoscopy the individuals developed greater changes in systolic BP, indicating that stimulation of the urethra/prostate/internal sphincter region probably is a more potent stimulus of AD than just the filling of the bladder. The severity of AD also increased with time post SCI during both procedures. Considering the high incidence of silent episodes of AD during the urological procedures, it is recommended that monitoring of cardiovascular parameters during these procedures be routinely performed. [ABSTRACT FROM AUTHOR]

Study design:Interventional training sessions.Objectives:To examine the effectiveness of training medical students in the International Standards for Neurological Classification of Spinal Cord Injury (ISNCSCI).Setting:A Peking University teaching hospital.Methods:A total of 46 medical students were involved in the study. First, they had a 2-h self-study session with the ISNCSCI booklet, followed by a 10-item questionnaire. The booklet was allowed for use as a reference during this assessment. Two days later, the questionnaire was repeated without the use of reference. Students then had a session with case discussion, followed by a final questionnaire.Results:After the initial self-study session, the mean score (max. 10) on the questionnaire was 7.67±1.49. Two days later, the mean score of the second test was 7.96±1.15. All key points of the ISNCSCI were supplemented during the second session with case presentations. The mean score of the final test increased significantly to 9.61±0.88 (P<0.01) in comparison with the previous tests. The overall correct response rates by students in determining sensory level, motor level and American Spinal Injury Association Impairment Scale of the training case were 89.1%, 84.8% and 91.3%, respectively.Conclusion:The training effectiveness of ISNCSCI through self-study is reliable. The correct answers to key points could remain for at least 2 days without the need to use a reference. However, some specialized knowledge could not be transmitted without more detailed discussions and case presentations. Utilization of cases is a valuable method in training ISNCSCI and can improve the overall training effectiveness. [ABSTRACT FROM AUTHOR]