Right ventricle dysfunction does not predict mortality in patients with SARS-CoV-2-related acute respiratory distress syndrome on extracorporeal membrane oxygenation support

BACKGROUND The prognostic role of right ventricle dilatation and dysfunction(RVDD)has not been elucidated in patients with coronavirus disease(COVID)-related respiratory failure refractory to standard treatment needing extracorporeal membrane oxygenation(ECMO)support.AIM To assess whether pre veno-venous(VV)ECMO RVDD were related to inintensive care unit(ICU)mortality.METHODS We enrolled 61 patients with COVID-related acute respiratory distress syndrome refractory to conventional treatment submitted to VV ECMO and consecutively admitted to our ICU(an ECMO referral center)from 31th March 2020 to 31th August 2021.An echocardiographic exam was performed immediately before VV ECMO implantation.RESULTS Males were prevalent(73.8%)and patients with a body mass index>30 kg/m^(2) were the majority(46/61,75%).The overall in-ICU mortality rate was 54.1%(33/61).RVDD was detectable in more than half of the population(34/61,55.7%)and associated with higher simplified organ functional assessment(SOFA)values(P=0.029)and a longer mechanical ventilation duration prior to ECMO support(P=0.046).Renal replacement therapy was more frequently needed in RVDD patients(P=0.002).A higher in-ICU mortality(P=0.024)was observed in RVDD patients.No echo variables were independent predictors of in-ICU death.CONCLUSION In patients with COVID-related respiratory failure on ECMO support,RVDD(dilatation and dysfunction)is a common finding and identifies a subset of patients characterized by a more severe disease(as indicated by higher SOFA values and need of renal replacement therapy)and by a higher in-ICU mortality.RVDD(also when considered separately)did not result independently associated with in-ICU mortality in these patients.

An Evidence-Based CoCoSo Framework with Double Hierarchy Linguistic Data for Viable Selection of Hydrogen Storage Methods

Hydrogen is the new age alternative energy source to combat energy demand and climate change.Storage of hydrogen is vital for a nation’s growth.Works of literature provide different methods for storing the produced hydrogen,and the rational selection of a viable method is crucial for promoting sustainability and green practices.Typically,hydrogen storage is associated with diverse sustainable and circular economy(SCE)criteria.As a result,the authors consider the situation a multi-criteria decision-making(MCDM)problem.Studies infer that previous models for hydrogen storage method(HSM)selection(i)do not consider preferences in the natural language form;(ii)weights of experts are not methodically determined;(iii)hesitation of experts during criteria weight assessment is not effectively explored;and(iv)three-stage solution of a suitable selection of HSM is unexplored.Driven by these gaps,in this paper,authors put forward a new integrated framework,which considers double hierarchy linguistic information for rating,criteria importance through inter-criteria correlation(CRITIC)for expert weight calculation,evidence-based Bayesian method for criteria weight estimation,and combined compromise solution(CoCoSo)for ranking HSMs.The applicability of the developed framework is testified by using a case example of HSM selection in India.Sensitivity and comparative analysis reveal the merits and limitations of the developed framework.

The Historical Position and Value Dimensions of Human Rights Civilization

Human beings are the mainstay and the ultimate goal of civilization.The history of human civilization is a continuous struggle to realize the respect,liberation,protection,and development of humanity.Human rights are an achievement of humanity and a symbol of progress,and the human rights civilization is an important component of human civilization.Understanding and interpreting human rights from the perspective of human rights civilization means that human rights are not only a concept or an idea but also a grand historical and long-term social practice.Up to now,the development of human rights civilization has roughly experienced four awakening eras:initialization,revolution,popularization,and globalization.In terms of its value dimensions,it has the characteristics of progressiveness,diversity,commonality,inclusiveness,indivisibility,openness,and so on.The historical position of human rights civilization and the development of its value dimensions have shown to the world that human rights are the common wealth of humanity,and human rights belong to all mankind;human rights are historical,concrete,and developmental;the concept of human rights is constantly evolving,and its connotations and categories are constantly expanding;achieving the free and well-rounded development of every person is the highest value realm of human rights civilization.The Chinese modernization endows Chinese civilization with modern strength and opens up new horizons for human rights civilization.The new pattern of human rights civilization to be created by Chinese modernization not only possesses the common characteristics of human rights civilization but also enjoys Chinese characteristics based on its own national conditions,enriching and developing the diversity of human rights civilization for all mankind.

Access to Financial Services——An Analysis from the Human Rights Perspective

There is a broad connection between finance and human rights,with finance having both positive and negative impacts on human rights.Everyone has a need for access to financial services.Documents in both the international human rights and international finance fields address the relationship between financial services and human rights.Among financial services,microcredit and inclusive finance have the closest connection to human rights and potentially the greatest impact on human rights.Access to financial services promotes economic,social,and cultural rights as well as the rights of specific groups.The conditions for access to financial services to promote human rights require the state to assume obligations to recognize,respect,protect,and fulfill the need for individuals to access financial services,and to ensure the availability,accessibility,acceptability,and adaptability of basic financial services.Access to financial services has played a significant role in China’s comprehensive victory in the battle of poverty alleviation,providing valuable experience for the international community in poverty eradication,achieving sustainable development goals,and protecting and promoting human rights.

The Historic Achievements of the Communist Party of China in Respecting and Protecting Human Rights in the New Era

In the new era,the Communist Party of China(CPC)has made historic achievements in respecting and protecting human rights.Building upon the principle of the“two integrations”(integrating the basic tenets of Marxism with China’s specific realities and fine traditional culture),it has nurtured new theories on respecting and protecting human rights in the new era,which can address the fundamental questions of whom and what the human rights protection efforts in the new era are for.Guided by the principle of“taking our own path,”it has charted a distinct course for the development of human rights,diverging from the Western approach.The CPC has maintained the unity between Party leadership and the respect for and protection of human rights,promoting progress in human rights through the pursuit of“high-quality development,”and ensuring various fundamental rights of the people through the rule of law.Building upon the past experience,the CPC has established the“source”of the institutional framework for respecting and protecting human rights in the new era,crafted the“body”of this institutional framework,and introduced its practical“application.”In promoting the comprehensive advancement of human rights protection,the CPC has facilitated the connotative development of human rights protection in China,empowering China in international human rights discourse,and contributing Chinese strength and wisdom to global human rights governance.

Donor ductal anomaly is not a contraindication to right liver lobe donation

Background:Data of living-donor liver transplantation(LDLT)suggested that donor ductal anomaly may contribute to postoperative biliary complications in recipients and in donors.This retrospective study aimed to determine if the occurrence of postoperative biliary stricture in donors or recipients in rightlobe LDLT(RLDLT)is related to donor biliary anatomy type.Methods:We analyzed our RLDLT recipients’clinical data and those of their graft donors.The recipients were divided into 2 groups:with and without postoperative biliary stricture.The 2 groups were compared.The primary endpoints were donor biliary anatomy type and postoperative biliary complication incidence;the secondary endpoints were 1-,3-and 5-year graft and patient survival rates.Results:Totally 127 patients were included in the study;25(19.7%)of them developed biliary anastomotic stricture.In these 25 patients,16 had type A biliary anatomy,3 had type B,2 had type C,3 had type D,and 1 had type E.In the 127 donors,96(75.6%)had type A biliary anatomy,13(10.2%)had type B,6(4.7%)had type C,10(7.9%)had type D,and 2(1.6%)had type E.Biliary stricture was seen in 2 donors,who had type A biliary anatomy.None of the recipients or donors developed bile leakage.No association between the occurrence of postoperative biliary stricture and donor biliary anatomy type was found(P=0.527).Conclusions:The incidence of biliary stricture in donors or recipients after RLDLT was not related to donor biliary anatomy type.As postoperative complications were similar in whatever type of donor bile duct anatomy,donor ductal anomaly should not be considered a contraindication to donation of right liver lobe.

基于犹豫模糊集的TOPSIS多属性决策方法及其应用

针对不确定语言环境下的决策问题,考虑决策者偏好不同,提出基于犹豫模糊集的TOPSIS多属性决策方法。首先采用犹豫模糊语言集群决策者的评价信息,更准确地表达决策者在决策过程中的犹豫性。其次基于犹豫模糊相关理论,提出改进的犹豫模糊熵权法确定属性客观权重,运用改进结构熵权法确定属性主观权重。然后利用级差最大化组合优化客观权重后,确定属性最终权重,并利用逼近理想解(TOPSIS)综合评价方法对评价对象进行排序。最后通过某临地铁项目优选桩基方案,验证该方法的有效性和可行性。

“A Prospective Randomized Case-Control Study To Evaluate Mini Right Thoracotomy versus Conventional Sternotomy For Mitral Valve Repair In Rheumatic Heart Disease.”

Purpose: Right mini thoracotomy has been evaluated in many studies for mitral valve repair mainly in degenerative valvular disease but not in rheumatic heart disease. Mitral valve repair is more challenging in rheumatic etiology due to complexity of lesions. This prospective randomized case control study was designed to evaluate repair through mini right thoracotomy and to compare the clinical and echocardiographic outcomes with sternotomy in rheumatic patients. Methods: 25 patients of rheumatic heart disease underwent mitral valve repair through mini right thoracotomy (group I). Various clinical and functional parameters were compared with 25 patients of mitral valve repair through sternotomy (group II). On follow up the results were compared in both groups for clinical and echocardiographic parameters. Results: The various pre-operative demographic parameters were comparable in two groups. Equal rate of mitral valve repair (group I-21/25, 84% and group II-21/25, 84%) was achieved in both groups. The various intra-operative and post-operative clinical parameters were better in group I .There were equivalent functional and valve related outcomes in both groups in term of NYHA class (1.28 ± 0.613 vs 1.08 ± 0.276, P = 0.144), post-operative mitral valve area (2.43 ± 0.891 vs 2.82 ± 0.662, P = 0.090), incidence of more than mild mitral regurgitation (0) and mean pressure gradient across mitral valve (4.98 ± 3.33 vs 4.23 ± 1.5, P = 0.309). Conclusion: Mitral valve repair through mini right thoracotomy approach in rheumatic etiology is feasible and safe with equivalent rate of successful repair as compared to median sternotomy. It is associated with lesser morbidity, cosmetic advantage and lesser resource utilization.

Addressing Japan’s disposal of nuclear-contaminated water from the perspective of international human rights law

The discharge of nuclear-contaminated water containing radionuclides into the ocean by Japan will lead to its integration into the entire ecosystem through processes of circulation and biomagnification,eventually entering the human body via the food chain.This poses a substantial risk of irreversible damage to both the ecosystem and human health,a situation that will worsen with the ongoing discharge of such water.The respect and protection of human rights represent an international consensus,and safeguarding fundamental human rights is a substantial obligation that states must undertake in accordance with both international and domestic law.Since the Fukushima nuclear disaster,Japan has continuously violated its international legal obligations to protect human rights in several areas,including the resettlement of disaster victims,the reduction of nuclear radiation levels,and the handling of contaminated water.Such actions have compromised and will continue to compromise the basic human rights of not only its citizens but also those of people worldwide,including environmental rights,the right to life,development rights,and food rights.In the aftermath of the Fukushima meltdown,the public and workers involved in handling nuclear contaminants have been continually exposed to high radiation levels,endangering their rights to life,development,and health.Japan’s inadequate efforts in victim resettlement and environmental restoration have jeopardized the environmental and food rights of its citizens to live healthily and access food in an environment unaffected by nuclear radiation.The release of nuclear-contaminated water poses a risk of Japan’s nuclear pollution to the people of neighboring countries and the global population at large.The principle of human rights underpins the theory of a community with a shared future for humanity,and human rights are a crucial area of China’s active participation in United Nations affairs and global governance.By voicing concerns over Japan’s potential human rights violations globally,China demonstrates its role as a responsible major country.In response to Japan’s breach of legal obligations and human rights violations,China can adopt a reasoned and beneficial approach,including calling on the international community to hold Japan criminally accountable for crimes against humanity under the Rome Statute and advancing scholarly discussions on ecocide and crimes against the marine environment.Furthermore,China should persist in seeking advisory opinions from the International Court of Justice and strive for substantive accountability,utilizing the mechanisms of international human rights organizations to make its voice heard.

基于AHP-熵权-TOPSIS改进风险矩阵的连续刚构桥施工风险评价研究

针对传统风险矩阵法(LS法)的不足,提出将ALARP准则引入风险矩阵,并建立了关于连续刚构桥的桥梁施工风险评价指标体系,运用层次分析法从横向角度对准则层风险指标赋予权重,再使用熵权法从纵向角度对指标层风险指标的风险发生概率和风险损失分别赋予权重,最后结合TOPSIS法(逼近理想排序法)对给出的风险值进行精确排序,得出基于AHP-熵权-TOPSIS改进风险矩阵,解决了传统风险矩阵无法针对同一级别的风险因素继续细分排序的问题,便于项目管理人员合理分配人力、物力、财力等安全资源的投入。

Fate of Right Coronary Artery Occlusion after a Surgically Repaired Aorto- Ventricular Tunnel in a Neonate

The aorto-ventricular tunnel is a rare congenital cardiac anomaly.We present a case of aorto-ventricular tunnel diagnosed via fetal echocardiography.Emergency surgery was performed on the 2nd day of life to close the tun-nel,located just in front of the right coronary ostium,due to the patient’s unstable health condition.The post-operative period revealed complete occlusion of the right coronary artery.Due to the patient’s stability,we opted not to reintervene on the right coronary artery.The patient fully recovered without the need for further coronary intervention.In cases of patients with an aorto-ventricular tunnel(AVT)and associated coronary lesions,it is crucial to exercise caution when intervening in the coronary arteries.

Prospects for the transformation and development of carbon storage in abandoned mines of coal enterprises from the perspective ofcarbon neutrality

Under the carbon neutrality goal,coal enterprises must seek breakthroughs from abandoned mines,develop new resources in the new era,turn problems into countermeasures,and participate in the carbon emissions market,for contributing to the accomplishment of the national strategic goal of carbon neutrality.To this end,we investigated the relevant national policies and regulations to clarify the boundaries disclosed by the carbon information of enterprises,understood the development direction of carbon storage in abandoned mines,and clarified the transformation and development of carbon storage in aban-doned mines.We made a few suggestions:(1)China should learn from its past experience and other countries to develop the energy industry with Chinese characteristics and reform the economic system.(2)Coal enterprises must actively respond to the national carbon information disclosure policy,clarify their own responsibilities and carbon emission boundaries.(3)It is necessary to proactively obtain advanced knowledge and plan carbon storage pathways for abandoned mines.(4)Devel-opment problems of coal enterprises should be deduced using cases.The'dual carbon'goals should be achieved steadily step-by-step.(5)Three measures,i.e.improving the existing resource structure,coordinating the information of abandoned mines,and promoting the cultivation of scientific and technological talents.

Venopulmonary ECMO Improved Hypoxemia and Supported the Right Ventricle in a Patient with Decompensated Eisenmenger Syndrome

Mechanical circulatory and/or respiratory assistance with extracorporeal membrane oxygenation (ECMO) has become a standard of care for patients with circulatory (venoarterial) and/or respiratory (venovenous) failure refractory to standard therapies. Adult patients with congenital heart disease are an increasingly recognized and growing population and include various groups, such as undiagnosed cases in childhood and palliated and/or corrected cases, which require subsequent care because of residual lesions, cardiac arrest/insufficiency, and arrhythmias, among other conditions. In addition, these patients are prone to developing pathologies that are typical of adulthood with a generally increased risk of morbidity and mortality because of their low reserves and organic damage associated with the underlying heart disease, which makes them candidates for ECMO. These patients represent an additional challenge in this therapy because malformations and the presence of a shunt can generally affect the usual cannulation methods and hemodynamic and oximetry monitoring. Thus, the configuration decision must be made on a case-by-case basis. Here, we present a cannulation method, venopulmonary artery ECMO, which provides hemodynamic and respiratory support, and may be ideal for patients with shunts and/or right ventricular dysfunction. To our knowledge, this is the first report of this configuration in patients with congenital heart diseases.

Expression of cyclin-dependent kinase 9 is positively correlated with the autophagy level in colon cancer

BACKGROUND Cyclin-dependent kinase 9(CDK9)expression and autophagy in colorectal cancer(CRC)tissues has not been widely studied.CDK9,a key regulator of transcription,may influence the occurrence and progression of CRC.The expression of auto-phagy-related genes BECN1 and drug resistance factor ABCG2 may also play a role in CRC.Under normal physiological conditions,autophagy can inhibit tumorigenesis,but once a tumor forms,autophagy may promote tumor growth.Therefore,understanding the relationship between autophagy and cancer,partic-ularly how autophagy promotes tumor growth after its formation,is a key motivation for this research.AIM To investigate the relationship between CDK9 expression and autophagy in CRC,assess differences in autophagy between left and right colon cancer,and analyze the associations of autophagy-related genes with clinical features and prognosis.METHODS We collected tumor tissues and paracarcinoma tissues from colon cancer patients with liver metastasis to observe the level of autophagy in tissues with high levels of CDK9 and low levels of CDK9.We also collected primary tissue from left and right colon cancer patients with liver metastasis to compare the autophagy levels and the expression of BECN1 and ABCG2 in the tumor and paracarcinoma tissues.RESULTS The incidence of autophagy and the expression of BECN1 and ABCG2 were different in left and right colon cancer,and autophagy might be involved in the occurrence of chemotherapy resistance.Further analysis of the rela-tionship between the expression of autophagy-related genes CDK9,ABCG2,and BECN1 and the clinical features and prognosis of colorectal cancer showed that the high expression of CDK9 indicated a poor prognosis in colorectal cancer.CONCLUSION This study laid the foundation for further research on the combination of CDK9 inhibitors and autophagy inhibitors in the treatment of patients with CRC.

Understanding the Human Rights of Modern Individuals—Revisiting Habermas’s Dual Critique and the Reconstruction of Intersubjectivity

Human rights are not only pivotal in depicting the relationship between individuals and communities but also a focal point of political philosophical concerns oriented towards reality. The inseparability of human rights from individual self-identity reveals a contradiction between practicality and historicity in understanding individuals, as highlighted in the debate between liberalism and communitarianism. In order to reconcile this contradiction, Habermas,drawing from German classical philosophy, examines practicality and historicity separately: while Fichte intertwines objectivity in self-identity, revealing the practicality of individuals but neglecting their real elements, Hegel interprets self-identity under the concept of unity,examining individuals from a historical dimension but letting rational rules dominate reality. Ultimately, Habermas reconstructs the process of modern individual self-identity from the theory of communicative action by critiquing the shackles of subjective philosophy. He not only reconciles the divergence between practicality and historicity in self-identity, but also elucidates the intersubjective core inherent in human rights.

Comparative Analysis and Legal Reflection on the Boundaries of Human Rights Due Diligence in the Supply Chain

As global supply chains become increasingly lengthy and complex, human rights due diligence in the supply chain is becoming a controversial focal point in the accountability of multinational corporations. In recent years, legislative practices in the field of human rights due diligence have shown a trend from voluntary soft law toward mandatory hard law, and from corporate due diligence for their own operations towards extended due diligence for the entire supply chain. However, there is a divergence in national practices regarding the extent to which human rights due diligence should extend along the supply chain and the manner in which it should be incorporated into domestic legal policies. International soft law interpretations surrounding the boundaries of human rights due diligence in the supply chain are decentralized, posing risks of interpretation diversification, boundary blurring, and procedural formalization, as well as risks of misinterpretation and misuse. Meanwhile, some countries and regions are vigorously promoting mandatory legislation on human rights due diligence in the supply chain, which has profound implications for the stability of global supply chains and the international economic and trade order. Against this backdrop, it is crucial to explore the reasonable boundaries of human rights due diligence in the supply chain. Instead of applying a one-size-fits-all approach,the rationality of legal factors and the complexity of practical factors should be considered, applying context-specific measures based on the varying degrees of linkage between companies and negative human rights impacts in the supply chain. China should be particularly wary of the “chilling effect” of mandatory legislation on human rights due diligence in the supply chain, attaching great importance to national supply chain security and international supply chain competitiveness.Additionally,China should actively promote the implementation of voluntary human rights due diligence under the United Nations framework, and accelerate the enhancement of China's discourse power in the international rule-making process in the fields of industry and commerce as well as human rights.

Revisiting the Spirit of the UDHR and Discussing Human Rights Development——Summary of Views from the Seminar Commemorating the 75th Anniversary of the Universal Declaration of Human Rights

On December 4,2023,the China Society for Human Rights Studies hosted a seminar in Beijing commemorating the 75^(th) Anniversary of the Universal Declaration of Human Rights.Participants discussed topics such as the significance of the Universal Declaration of Human Rights,China’s theories and practices in respecting and safeguarding human rights,the three global initiatives and global human rights governance,human rights protection in the digital age,and telling Chinese stories of human rights in the new era.The discussions led to a broad consensus and achieved positive results.

Point-of-care ultrasonography in cirrhosis-related acute kidney injury:How I do it

Discerning the etiology of acute kidney injury(AKI)in cirrhotic patients remains a formidable challenge due to diverse and overlapping causes.The conventional approach of empiric albumin administration for suspected volume depletion may inadvertently lead to fluid overload.In the recent past,point-of-care ultrasonography(POCUS)has emerged as a valuable adjunct to clinical assessment,offering advantages in terms of diagnostic accuracy,rapidity,cost-effectiveness,and patient satisfaction.This review provides insights into the strategic use of POCUS in evaluating cirrhotic patients with AKI.The review distinguishes basic and advanced POCUS,emphasizing a 5-point basic POCUS protocol for efficient assessment.This protocol includes evaluations of the kidneys and urinary bladder for obstructive nephropathy,lung ultrasound for detecting extravascular lung water,inferior vena cava(IVC)ultrasound for estimating right atrial pressure,internal jugular vein ultrasound as an alternative to IVC assessment,and focused cardiac ultrasound for assessing left ventricular(LV)systolic function and identifying potential causes of a plethoric IVC.Advanced POCUS delves into additional Doppler parameters,including stroke volume and cardiac output,LV filling pressures and venous congestion assessment to diagnose or prevent iatrogenic fluid overload.POCUS,when employed judiciously,enhances the diagnostic precision in evaluating AKI in cirrhotic patients,guiding appropriate therapeutic interventions,and minimizing the risk of fluid-related complications.

Research on the Reform of"Separation of Three Rights"for Rural Homesteads in Juancheng County,Shandong Province

In order to realize rural revitalization in an all-round way and promote the sustainable and healthy development of the economy and society,China is committed to deepening the pace of building a new countryside with Chinese characteristics.The reform of the"Separation of Three Rights"of rural homesteads is a key measure,which aims to activate rural resources,enhance the vitality of rural economic development,and then promote the overall process of rural revitalization.This study selects Juancheng County,Heze City,Shandong Province as a typical case.Through an in-depth analysis of the relevant policy orientation of the national homestead reform and the specific practice of local promotion work,it systematically sorts out the registration of homestead rights,transfer of use rights and relevant policy measures adopted in paid use,qualification conversion,policy publicity and system establishment.After in-depth research on the system reform practice of the"Separation of Three Rights"of homesteads in Juancheng County,this paper reveals the main problems existing in the current reform,including the lack of clear policy support for the mechanism of paid use of homesteads,difficulties in the process of identifying qualification rights and challenges,the imperfection of the transfer mechanism of use rights,and the lack or lag of relevant policies.A series of problem-oriented policy suggestions are put forward,including establishing and improving the system of paid use of rural homesteads,improving the income distribution mechanism,promoting the innovation of the mortgage guarantee system for the right to use homesteads,and optimizing the homestead qualification certification procedures.These suggestions aim to provide a useful reference for the Juancheng County Government in promoting the reform of"Separation of Three Rights"of homesteads,and then promote the rational allocation and efficient utilization of rural homestead resources.

Pioneering a New Realm of Human Rights Civilization in the Chinese Path to Modernization——An Overview of the Symposium on“The Chinese Path to Modernization and the Promotion of Free and Comprehensive Human Development”

On October 14,2023,a symposium themed“The Chinese Path to Modernization and the Promotion of Free and Comprehensive Human Development”was held in Changchun,Jilin Province,China.More than fifty experts,scholars,and researchers from national institutions and universities engaged in discussions and exchanges on human rights on the Chinese path to modernization,including the path,practice,knowledge systems,and civilization forms of human rights.This symposium played a significant role in advancing the construction of the disciplinary system,academic system,and discourse system of human rights in China.