早期肺康复联合ESCAPE集束化护理对ICU有创机械通气患者呼吸机相关膈肌功能障碍的影响

目的:探讨早期肺康复联合ESCAPE集束化护理对ICU有创机械通气患者呼吸机相关膈肌功能障碍(VIDD)的影响。方法:将2023年2月1日~12月31日综合ICU收治的41例成人有创机械通气患者随机分为实验组20例和对照组21例,其中实验组3例、对照组4例因转出ICU而脱落,最终纳入实验组和对照组各17例。实验组给予早期肺康复训练联合ESCAPE集束化护理,对照组给予ESCAPE集束化护理。比较两组膈肌移动度及增厚率、临床肺部感染评分(CPIS)、急性生理学与慢性健康状况评分(APACHEⅡ)。结果:实验组治疗后膈肌移动度高于治疗前(P<0.05),膈肌增厚率比较差异无统计学意义(P>0.05);实验组治疗后CPIS、APACHEⅡ评分均低于治疗前(P<0.05)。结论:早期肺康复联合ESCAPE集束化护理可改善ICU有创机械通气患者的膈肌移动度,降低肺部感染发生风险、改善健康状况,减轻膈肌萎缩,控制ICU呼吸机相关性肺炎。

Escape room游戏宣教对阴道分娩初产妇分娩恐惧及产程进展的影响

目的探究Escape room游戏宣教对阴道分娩初产妇分娩恐惧及产程进展的影响。方法采用便利抽样法,选取本院2021年1月—2022年6月收治的140例阴道分娩初产妇为研究对象,按随机数字表法将其分为对照组和观察组,每组各70例。对照组采取常规教育模式,观察组在常规护理基础上应用Escape room游戏宣教,比较两组初产妇分娩恐惧水平、产程进展。结果观察组分娩恐惧中高水平初产妇占比为57.14%小于对照组的80.00%,差异有统计学意义(P<0.05);观察组初产妇第一产程时间、第二产程时间均短于对照组,差异有统计学意义(P<0.05),两组第三产程时间比较差异无统计学意义(P>0.05)。结论Escape room游戏宣教在阴道分娩初产妇中的应用,能缓解产妇分娩恐惧情绪,可一定程度上加快产程进展。

优化ESCAPE集束化策略对ICU亚临床谵妄患者的效果评价

目的 分析优化ESCAPE集束化策略对ICU亚临床谵妄患者的效果。方法 选取本院入住ICU超过24h的亚临床谵妄患者,对照组予常规护理,观察组在常规护理上给优化ESCAPE集束化策略。比较2组睡眠质量、认知水平、谵妄发生率及48h内亚临床谵妄持续时间。结果 观察组睡眠质量、认知水平、谵妄发生率、亚临床谵妄持续时间低于对照组,差异有统计学意义(P<0.05)。结论 优化ESCAPE集束化策略可提高患者睡眠质量,改善亚临床谵妄患者认知水平,缩短亚临床谵妄持续时间,降低谵妄发生率。

Correction:The escape mechanisms of the proto-atmosphere on terrestrial planets:“boil-off”escape,hydrodynamic escape and impact erosion

In the original publication of the article,the affiliation“College of Earth and Planetary Sciences,University of Chinese Academy of Sciences,Beijing,People’s Republic of China”for author Ziqi Wang was missing and included in this correction article.

When Fleeing Matters:Differences in Escape Behaviours of Three Northeast Asian Anurans

Prey species may have their own optimal escape strategy to balance predation risks and the energetic cost of fleeing.Some species have an advantage when maintaining a short fleeing distance,while others may favour an earlier escape based on microhabitat,size,or body condition.Here,we examined the escape behaviour of the three syntopic Northeast Asian anuran species:Mongolian toads(Strauchbufo raddei),Amur brown frogs(Rana amurensis),and Japanese treefrogs(Dryophytes japonicus)in Mongolia,Russia,China and DPR Korea.We examined flight initiation distance(FID;the distance from a potential predator to the point when the individual starts to flee)and distance fled(DF;distance between flight initiation and flight termination points)of each species and the effects of microhabitat,sex,and body size.Strauchbufo raddei and R.amurensis had a longer FID than D.japonicus,and S.raddei also had a longer DF than D.japonicus.These trends remained similar when dividing FID and DF by a size proxy(snout-vent length)for all individuals.This suggests that the treefrog D.japonicus used a strategy to stay immobile even when they were detected,and the toad S.raddei reacted quicker and more sensitively to predators despite the presence of toxin.Female S.raddei had a significantly longer FID than males suggesting that females are more sensitive to predation risk in this species,but body size was not significant for any of the three species.Our results indicate that the three sympatric species have different escaping strategies,likely related to differences in physiology and crypticity.

The Claimed Revolution to Understand Consciousness:Information Plays the Driving/Essential Role for the Structuration and Behavior of the Living Organisms

A prestigious conference claimed recently a revolution in neuroscience to understand consciousness.In this paper it is shown that this revolution already came,revealing the determinant role of information for human and living structures,both for their structuration and behavior,explaining consciousness at human as the result of the activity of the Informational System of Human and Living Structures.For this,it is emphasized and discussed the informational structure of the eukaryotic cell,the basic/representative composing unit of the multicellular body of human,animals,and plants,showing that the composition and functions of the informational system are basically similar with that of human.To reveal the driving role of informational mechanisms in human and subhuman organisms,it is introduced the concept of matter-related information,showing that information can be hidden/“embodied”or released/“disembodied”in or from the elemental micro/macro components of the body,during the multiple chain/cascade interactions including transduction processes.It is shown that such interactions are initiated from two main categories of informational sources:implicit(genetic)and explicit(external/internal)sources,the first category leading to structuration of the body and the second the reactive behavior.Consciousness in human and subhuman organisms,expressed by two corresponding informational relations,is the result of the release of information by the mind,acting as an informational operator/device,the development degree of mind and consciousness depending on the complexity degree and adaptation.An analogy of this Informational Model of Human and Living Structures(IMHLS)with the ancient model of chakras is highlighted,showing that these models support each other,applied with beneficial effects in Reiki technique and music-based cognitive multi-task therapy for neuro-rehabilitation.

The Axiology of Consciousness in Mocombeian Consciousness Field Theory

This work explores the axiology of consciousness in Mocombe’s consciousness field in the material world.The paper critically assesses Mocombe’s consciousness field theory(CFT)within the larger body of contemporary ontological debates regarding the nature,origin,and constitution of consciousness in the universe.The work goes on to highlight the manifestation of Mocombe’s consciousness field in the material resource framework that is the earth,and the nature and origins of ethics and values.

Analysis of Commuting Modal Shift in Consideration of Social Interaction of Consciousness for Environment

It is the matter for achievement of the low carbon transport system that the excessive use of private vehicles can be controlled appropriately.Not only improvement of service level of modes except private vehicle,but also consciousness for environmental problem of individual trip maker is important for eco-commuting promotion.On the other hand,consciousness for environment would be changed by influence of other person.Accordingly,it is aimed in the study that the structure of decision-making process for modal shift to the eco-commuting mode in the local city is described considering environmental consciousness and social interaction.For the purpose,the consciousness for the environment problem and the travel behavior of the commuter at the suburban area in the local city are investigated by the questionnaire survey.The covariance structure about the eco-consciousness is analyzed with the database of the questionnaire survey by structural equation modeling.As the result,it can be confirmed with the structural equation model that the individual environmental consciousness is strongly related with the intention of self-sacrifice and is influenced with the local interaction of the individual connections.On the other hand,the intention of modal shift for the commuting mode is analyzed with the database of the questionnaire survey.It can be found out that the environmental consciousness is not statistically significant for commuting mode choice with the present poor level of service of public transport.However,the intention of self-sacrifice for the prevention of the global warming is statistically confirmed as the factor of modal shift with the operation of eco-commuting bus service with the RP/SP integrated estimation method.As the result,the multi-agent simulation system with social interaction model for eco consciousness is developed to measure the effect of the eco-commuting promotion.For the purpose,the carbon dioxide emission is estimated based on traffic demand and road network condition in the traffic environment model.On the other hand,the relation between agents is defined based on the small world network.The proposed multi-agent simulation is applied to measure the effect of the eco-commuting promotion such as improvement of level of service on the public transport or education of eco-consciousness.The effect of the promotion plan can be observed with the proposed multi-agent system.Finally,it can be concluded that the proposed multi-agent simulation with social interaction for eco-consciousness is useful for planning of eco-commuting promotion.

Psychiatry Is Bereft-It Lacks a Workable Philosophy for Consciousness-Herewith a Three Pronged Escape Plan

PHILOSOPHY and PSYCHIATRY are unusual bedfellows.Medical students,already hard pressed for time,are generally thrust into the melee of mental disorders,having spent years focussing on first dissecting and then prodding human bodies,which too often leaves little room for evaluating theories about human nature,especially with respect to“Intent”or Free Will.The present writer was unusual in that having spent two years in pre-clinical medical training,he devoted a full university year to pursuing philosophical studies in up to 20 different university departments.Thus he entered his teaching hospital with a working knowledge of Hume,Kant,Sartre,Wittgenstein,Buber and others.This is not a clinical paper-it focuses on the reasoning behind psychiatric precepts-so it is perhaps inevitable that today’s prevailing ideology is shown to be grievously wanting-a case of decidedly unphilosophical,even anti-philosophical,medical practice.The notion of there ever being a“scientific”theory of psychiatry has already been discounted in a series of earlier papers-which leaves us with the responsibility for choosing the best possible option,from an infinite number of theoretical models available.The paper provides a whistle-stop tour of how mental disease looks if you start with a confident and consistent look at that pinnacle of human attributes-consciousness.It doesn’t presume to say what consciousness is,but it does assume that it has a function,like every other human asset.Indeed by cutting corners,evaluating what has worked over 60 years in psychiatry,the result is as straightforward a picture of sanity as one can reasonably expect.As such,it leaves the reader with little wriggle room-there is enough clarity here,for you to accept or reject the main proposition.However,since the flaws described tend to be lethal,acceptance entails action.Now read on.

改良ESCAPE集束化策略在急性呼吸衰竭有创机械通气脱机患者中的应用价值

目的:探讨改良ESCAPE集束化策略在急性呼吸衰竭有创机械通气脱机患者中的应用价值。方法:接受有创机械通气治疗的急性呼吸衰竭患者116例,随机分为观察组60例和对照组56例。对照组由主管医师制定整体治疗方案,采用常规治疗护理。观察组在常规治疗护理基础上,实施改良ESCAPE集束化策略。结果:观察组脱机后1 h、12 h、24 h时SaO_(2)分别为(96.7±3.7)%、(97.3±3.8)%和(97.4±3.3)%,高于对照组的(92.1±4.3)%、(92.5±2.1)%和(93.3±3.9)%,观察组脱机后1 h、12 h、24 h时PaO_(2)/FiO_(2)分别为255.5±33.5 mmHg、257.5±28.7 mmHg和271.3±32.6 mmHg,高于对照组的213.4±30.7 mmHg、218.1±30.4 mmHg和225.5±30.3 mmHg,差异均有统计学意义(P<0.05);观察组患者脱机后1 h RR 20.5±3.7次/min,低于对照组的25.6±4.1次/min,差异有统计学意义(P<0.05)。观察组机械通时间5.9±2.7 d,短于对照组的8.6±3.1 d,差异有统计学意义(P<0.05);观察组48 h内再插管5例(8.3%),对照组48 h内再插管6例(10.7%),两组再插管率的差异无统计学意义(P>0.05)。观察组谵妄发生率18.3%,低于对照组的35.7%,观察组ICU-AW发生率16.7%,低于对照组的25.0%,差异均有统计学意义(P<0.05);观察组ICU住院时间8.3±3.7 d,短于对照组的11.2±4.1 d,差异有统计学意义(P<0.05)。结论:改良ESCAPE策略可改善急性呼吸衰竭患者呼吸机撤机后的氧合指标,降低谵妄及ICU获得性衰弱的发生率,缩短机械通气时间和ICU住院时间。

Efficacy of acupuncture to regain consciousness in patients with traumatic brain injury: a systematic review and meta-analysis

Background:Traumatic brain injury(TBI)is a leading cause of death and disability worldwide,and consciousness disorder is a common problem in TBI patients.Acupuncture has been used to improve neurological deficits in patients with TBI.This meta-analysis aims to evaluate the effects and safety of acupuncture in improving consciousness in patients with TBI when compared with other therapies.Methods:A systematic search was conducted in electronic databases PubMed,EMBASE,Web of Science,the Cochrane Central Register of Controlled Trials,Allied and Complementary Medicine Database,WHO International Clinical Trials Registry Platform,ClinicalTrials.gov,and Google Scholar for randomized controlled trials that investigated the effect of acupuncture on patients with TBI.From the inception of databases to March 2023.Results:A total of 653 participants were included in nine trials.We found that acupuncture adjunct to routine treatment significantly improved the wakeup rate of patients in TBI when compared with routine treatment alone(relative risk=1.36,95%confidence interval:1.16 to 1.59,I2=4.78%,P=0).Additionally,we found that acupuncture is significantly associated with reduced impaired consciousness after TBI when adjunct to medicine therapy.As a safe intervention,acupuncture can also improve the activities of daily living for people with TBI(mean difference=15.71,95%confidence interval:9.19 to 22.22,I2=0%,P=0).Conclusion:Acupuncture can improve consciousness and braise wakeup of patients with TBI when adjunct to conventional treatment compared with routine treatment alone.Further high-quality studies are needed to confirm these findings and to determine the optimal acupuncture treatment parameter for TBI.

Possible mechanisms associated with immune escape and apoptosis on anti-hepatocellular carcinoma effect of Mu Ji Fang granules

BACKGROUND Hepatocellular carcinoma(HCC)is one of the most common digestive system cancers with high mortality rates worldwide.The main ingredients in Mu Ji Fang Granules(MJF)are alkaloids,flavonoids,and polysaccharides.MJF has been used in the clinical treatment of hepatitis,cirrhosis and HCC for more than 30 years.Few previous studies have focused on the mechanism of MJF on tumor immunology in the treatment of HCC.AIM To explore the mechanism of action of MJF on tumor immunology in the treatment of HCC.METHODS The absorbable ingredients of MJF were identified using Molecule Network related to High Performance Liquid Chromatography-Electron Spray Ionization-Time of Flight-Mass Spectrometry,and hub potential anti-HCC targets were screened using network pharmacology and pathway enrichment analysis.Forty male mice were randomly divided into the Blank,Model,and MJF groups(1.8,5.4,and 10.8 g/kg/d)following 7 d of oral administration.Average body weight gain,spleen and thymus indices were calculated,tumor tissues were stained with hematoxylin and eosin,and Interferon gamma(IFN-γ),Tumor necrosis factorα(TNF-α),Interleukin-2,aspartate aminotransferase,alanine aminotransferase,alpha-fetoprotein(AFP),Fas,and FasL were measured by Enzyme-linked Immunosorbent Assay.Relevant mRNA expression of Bax and Bcl2 was evaluated by Real Time Quantitative PCR(RTqPCR)and protein expression of Transforming growth factorβ1(TGF-β1)and Mothers against decapentaplegic homolog(SMAD)4 was assessed by Western blotting.The HepG2 cell line was treated with 10 mg/mL,20 mg/mL,30 mg/mL,40 mg/mL of MJF,and another 3 groups were treated with TGF-β1 inhibitor(LY364947)and different doses of MJF.Relevant mRNA expression of TNF-α,IFN-γ,Bax and Bcl2 was evaluated by RT-qPCR and protein expression of TGF-β1,SMAD2,p-SMAD2,SMAD4,and SMAD7 was assessed by Western blotting.RESULTS It was shown that MJF improved body weight gain and tumor inhibition rate in H22 tumorbearing mice,protected immune organs and liver function,reduced the HCC indicator AFP,affected immunity and apoptosis,and up-regulated the TGF-β1/SMAD signaling pathway,by increasing the relative expression of TGF-β1,SMAD2,p-SMAD2 and SMAD4 and decreasing SMAD7,reducing immune factors TNF-αand IFN-γ,decreasing apoptosis cytokines Fas,FasL and Bcl2/Bax,and inhibiting the effect of LY364947 in HepG2 cells.CONCLUSION MJF inhibits HCC by activating the TGF-β1/SMAD signaling pathway,and affecting immune and apoptotic cytokines,which may be due to MJF adjusting immune escape and apoptosis.

Noise color influence on escape times in nonlinear oscillators-experimental and numerical results

The interplay between noise and nonlinearites can lead to escape dynamics.Associated nonlinear phe-nomena have been observed in various applications ranging from climatology to biology and engineering.For reasons of computational ease,in most studies,Gaussian white noise is used.However,this noise model is not physical due to the associated infinite energy content.Here,the authors present extensive experimental investigations and numerical simulations conducted to examine the impact of noise color on escape times in nonlinear oscillators.With a careful parameterization of the numerical simulations,the authors are able to make quantitative comparisons with experimental results.Through the experi-ments and simulations,it is illustrated that the noise color can drastically influence escape times and escape probability.

Correlations between the Global Earth Healing and Global Consciousness Projects—Brain-Mind-Matter-Interactions through Physical Noise Generators

Inspired by Roger Nelson’s Global Consciousness Project (GCP), the Global Earth Healing Project (GEHP) uses a network of several hundred physical noise generators to amplify the combined intentions of their users in order to infuse positive affirmations into the global consciousness. As mentioned in the original study design, it was intended to use the GCP as a reference for the effectiveness of its activities. The data of the GEHP consisting of 21 events from 2013 to 2020 is analyzed and statistically compared to the data of the GCP. An astonishing synchronicity was observed, which suggests an interaction between the brain states of the observers and the physical noise generators of the GCP.

The Great Cholesterol Quandary and Global Consciousness Awakening

Ancestors of human species have been living on the planet earth for about six million years while the modern form of humans only evolved about 200,000 years ago. Civilization is only about 6000 years old, and industrialization started in the 1800s. World population interconnectedness is enhanced with love and mercy but disrupted with dishonest, lies and wars. Human species has been feeding on animal fat as the finest and prime source of energy for all human history. In 1953 Ancel Keys and collaborates illusionized human kind that their historical source of energy is toxic. Massive health, behavioral as well as economic consequences followed. Human hearts known historically to be the seat of spirit, soul and emotions is proven by our group to orchestrate with global energetic fields. Global consciousness as represented by the planetary electromagnetic fields is in critical need to be feed with awakening merciful information. Documents refuting Ancek Keys dogma and reverting humanity to the truth in their energy source is presented in this review. The harmony we expect is not only physiological but will affect our global planetary environment for the wellbeing of human species in earth.

Survey study of the etiology of non-traumatic altered consciousness in the Emergency Department at Suez Canal University Hospital in Egypt

BACKGROUND Disorders of consciousness including coma in non-trauma patients can be caused by a wide variety of pathologies affecting the central nervous system.They represent a frequent challenge in emergency medicine and are combined with a very high in-hospital mortality.Hence,early treatment of these patients is vital and increases the likelihood of a good outcome.AIM To identify the causes of altered consciousness presentation to the Emergency Department at Suez Canal University Hospital.METHODS This was a descriptive cross-sectional study conducted on 87 patients with acute non-traumatic disturbed level of consciousness(DLOC)at the Emergency Department.RESULTS The mean age of the studied patients was 60.5±13.6 years.Among them,60%were males and 40%were females.The most common cause of acute non-traumatic DLOC was systemic infection,such as sepsis and septic shock(25.3%),followed by respiratory causes(24.1%)and neurological causes(18.4%).CONCLUSION The most common cause of acute non-traumatic DLOC was systemic infections followed by respiratory and neurological causes.

Quantum Theory of Consciousness

Both consciousness and quantum phenomenon are subjective and indeterministic. In this paper, we propose consciousness is a quantum phenomenon. A quantum theory of consciousness (QTOC) is presented based on a new interpretation of quantum physics. We show that this QTOC can address the mind and body problem, the hard problem of consciousness. It also provides a physics foundation and mathematical formulation to study consciousness and neural network. We demonstrate how to apply it to develop and extend various models of consciousness. We show the predictions from this theory about the existence of a universal quantum vibrational field and the large-scale, nearly instantaneous synchrony of brainwaves among different parts of brain, body, people, and objects. The correlation between Schumann Resonances and some brainwaves is explained. Recent progress in quantum information theory, especially regarding quantum entanglement and quantum error correction code, is applied to study memory and shed new light in neuroscience.

Students' sustainability consciousness with the three dimensions of sustainability:Does the locus of control play a role?

The persistent environmental problems and the growing difficulty to achieve sustainable development require a re-evaluation of person’ sustainable knowledge, attitude, and behaviour. To go to where we want to go, we must first assess where we are now. The study investigated the level of sustainability consciousness of students in India, and sustainability consciousness was expressed in sustainability knowledge, attitude, and behaviour. Sustainability consciousness was further examined using the three dimensions, such as environment, society, and economy. By drawing the perception map of students and studying the role of the locus of control, the reasons why sustainability knowledge does not appear in sustainability behaviour were analyzed. Quantitative analysis was conducted for a sample of 205 students from higher educational institutions across central India(Madhya Pradesh) from January to March in 2022. The data were analyzed using the SPSS 26 and Smart Partial Least Square(PLS) 3.0. The research revealed that sustainability attitude impacts sustainability behaviour more than sustainability knowledge. The results showed that respondents’ sustainability knowledge is higher than their sustainability attitude and behaviour. Moreover, it was discovered that economic concerns can lead to sustainability behaviour. In order to study respondents’ behaviour regarding sustainability consciousness, the study divided respondents into two groups according to the locus of control: the internal and external locus of control. It was found that most respondents thought whatever happened around them was beyond their control. Further, the locus of control influenced sustainability behaviour in groups with the internal locus of control. The study helps to explain why sustainability knowledge and attitude cannot translate into sustainability behaviour and provides a basis for achieving sustainable development. The conclusions of this study are crucial for governments, educational institutions, and organizations that empower youth to change their behaviour.

Creative Activity and the Development of Consciousness:A Discussion With Piaget and Rudolf Steiner

This study aims to discuss the possibility of becoming conscious of certain aspects of one’s own existence through creative activity.The discussion involves Piagetian constructivism and Steiner’s ideas about human development and is justified by the contribution of creative activity to the development of autonomy,according to Piaget,and to the development of an ethical individuality,according to Steiner.The participation of adults in sessions of creative process,as well as the questions posed after this activity,asking for the relationships between what they created and their life,is evidence of practices favourable to increasing the grasping of consciousness of self and of the process of developing an ethical individuality.

Secondary electron emission and photoemission from a negative electron affinity semiconductor with large mean escape depth of excited electrons

The formulae for parameters of a negative electron affinity semiconductor(NEAS)with large mean escape depth of secondary electrons A(NEASLD)are deduced.The methods for obtaining parameters such asλ,B,E_(pom)and the maximumδandδat 100.0 keV≥E_(po)≥1.0 keV of a NEASLD with the deduced formulae are presented(B is the probability that an internal secondary electron escapes into the vacuum upon reaching the emission surface of the emitter,δis the secondary electron yield,E_(po)is the incident energy of primary electrons and E_(pom)is the E_(po)corresponding to the maximumδ).The parameters obtained here are analyzed,and it can be concluded that several parameters of NEASLDs obtained by the methods presented here agree with those obtained by other authors.The relation between the secondary electron emission and photoemission from a NEAS with large mean escape depth of excited electrons is investigated,and it is concluded that the presented method of obtaining A is more accurate than that of obtaining the corresponding parameter for a NEAS with largeλ_(ph)(λ_(ph)being the mean escape depth of photoelectrons),and that the presented method of calculating B at E_(po)>10.0 keV is more widely applicable for obtaining the corresponding parameters for a NEAS with largeλ_(ph).