Extracorporeal organ support for critically ill patients:Overcoming the past,achieving the maximum at present,and redefining the future

Extracorporeal organ support(ECOS)has made remarkable progress over the last few years.Renal replacement therapy,introduced a few decades ago,was the first available application of ECOS.The subsequent evolution of ECOS enabled the enhanced support to many other organs,including the heart[veno-arterial extracorporeal membrane oxygenation(ECMO),slow continuous ultrafiltration],the lungs(veno-venous ECMO,extracorporeal carbon dioxide removal),and the liver(blood purification techniques for the detoxification of liver toxins).Moreover,additional indications of these methods,including the suppression of excessive inflammatory response occurring in severe disorders such as sepsis,coronavirus disease 2019,pancreatitis,and trauma(blood purification techniques for the removal of exotoxins,endotoxins,or cytokines),have arisen.Multiple organ support therapy is crucial since a vast majority of critically ill patients present not with a single but with multiple organ failure(MOF),whereas,traditional therapeutic approaches(mechanical ventilation for acute respiratory failure,antibiotics for sepsis,and inotropes for cardiac dysfunction)have reached the maximum efficacy and cannot be improved further.However,several issues remain to be clarified,such as the complexity and cost of ECOS systems,standardization of indications,therapeutic protocols and initiation time,choice of the patients who will benefit most from these interventions,while evidence from randomized controlled trials supporting their use is still limited.Nevertheless,these methods are currently a part of routine clinical practice in intensive care units.This editorial presents the past,present,and future considerations,as well as perspectives regarding these therapies.Our better understanding of these methods,the pathophysiology of MOF,the crosstalk between native organs resulting in MOF,and the crosstalk between native organs and artificial organ support systems when applied sequentially or simultaneously,will lead to the multiplication of their effects and the minimization of complications arising from their use.

The intensity of organ support: Restrictive or aggressive therapy for critically ill patients

The intensity of organ support has received attention in recent years. To make better clinical decisions, we should understand the mechanisms and benefits, and disadvantages of the different intensities of organ support in critically ill patients. Therapeutic strategies such as supplemental oxygen therapy, mechanical ventilation, respiratory stimulant, vasoactive agents, transfusion, albumin infusion, fluid management, renal placement, and nutrition support, if they are implemented in accordance with an aggressive strategy, could result in side effects and/or complications, resulting in iatrogenic harm in critically ill patients. It is found that the intensity of organ support is not a determining factor in prognosis. A normal rather than supernormal physiological target is recommended for support therapy.

Method for designing organization decision support system framework

The concept of organization decision support system （ODSS） is defined according to practical applications and novel understanding. And a framework for ODSS is designed. The framework has three components： infrastructure, decision-making process and decision execution process. Infrastructure is responsible to transfer data and information. Decision-making process is the ODSS＇s soul to support decision-making. Decision execution process is to evaluate and execute decision results derived from decision-making process. The framework presents a kind of logic architecture. An example is given to verify and analyze the framework. The analysis shows that the framework has practical values, and has also reference values for understanding ODSS and for theoretical studies.

Financial Support for Farmers' Cooperative Organizations——A Case of Yunan Province,China

In the paper,the status quo of the development of farmers' cooperative organizations in Yunnan Province is introduced.And then a series of problems exist in the financial support of farmers' cooperatives in Yunnan is analyzed,covering the unitary mainstay of credit and loan supply;inadequate credit and loan supply caused by famers' lack of security and mortgage;farmers' difficulties in loaning from banks or other financial institutions;single financial service,which can not satisfy the demands of farmers;the private loans are active while lacks right direction and guide;the outflow of capital in rural areas has limited the development of rural economy.In view of the above mentioned problems,countermeasures and relevant suggestions are put forward,namely increasing the subjects of the loan and credit supply and expanding the financing channels.Therefore,the spheres of business of the Agricultural Development Bank of China should be expanded.Besides,the support from Agricultural Bank of China for rural construction should be strengthened and the major role played by rural credit cooperatives in rural finance should be enforced.In addition,the innovation of financial products should be highlighted;the appearance of private financing should be allowed;financial support from the government should be increased and the preferential policies for taxes and fees should be implemented.

EFFECTS OF AMINO GROUPS AND MICROSTRUCTURE OF ORGANIC MESOPOROUS SILICA SUPPORTED METALLOCENE CATALYSTS ON ETHYLENE POLYMERIZATION

Mesoporous silica （MS）, 3-aminopropyltriethoxysilane （APTES） modified mesoporous silica （AMS）, bis（3- trimethoxysilylpropyl）amine modified mesoporous silica （BAMS） and APTES modified solid spherical silica （AS） were prepared and used to immobilize metallocene catalysts for ethylene polymerization. Gel permeation chromatography results showed that polyethylenes （PEs） catalyzed by AMS （or BAMS） supported metallocene catalysts at the molar ratios of Al/Zr = 100, 300 and 500 were of bimodal molecular weight distribution （BMWD）; while PEs catalyzed by the above catalysts at the molar ratios of Al/Zr 〉 800 were of monomodal molecular weight distribution （MMWD）. However, MS （or AS） supported metallocene catalysts could only produce PEs with MMWD in spite of the molar ratio of Al/Zr. It was because that AMS （or BAMS） supported catalysts possessed two active sites for ethylene polymerization at low molar ratios of Al/Zr due to the combination effects of mesopore geometrical constraint and amino groups of the supports, which was confirmed by X-ray photoelectron spectroscopy. This brings forward a novel and easy method for the synthesis of polyolefin with BMWD.

Prediction of Henry Constants and Adsorption Mechanism of Volatile Organic Compounds on Multi-Walled Carbon Nanotubes by Using Support Vector Regression

Support vector regression （SVR） combined with particle swarm optimization for its parameter optimization is employed to establish a model for predicting the Henry constants of multi-walled carbon nanotubes （MWNTs） for adsorption of volatile organic compounds （VOCs）. The prediction performance of SVR is compared with those of the model of theoretical linear salvation energy relationship （TLSER）. By using leave-one-out cross validation of SVR test Henry constants for adsorption of 35 VOCs on MWNTs, the root mean square error is 0.080, the mean absolute percentage error is only 1.19~, and the correlation coefficient （R2） is as high as 0.997. Compared with the results of the TLSER model, it is shown that the estimated errors by SVR are ali smaller than those achieved by TLSER. It reveals that the generalization ability of SVR is superior to that of the TLSER model Meanwhile, multifactor analysis is adopted for investigation of the influences of each molecular structure descriptor on the Henry constants. According to the TLSER model, the adsorption mechanism of adsorption of carbon nanotubes of VOCs is mainly a result of van der Waals and interactions of hydrogen bonds. These can provide the theoretical support for the application of carbon nanotube adsorption of VOCs and can make up for the lack of experimental data.

The Function,Future and Support Elements of Farmer Cooperative Economy Organization

The nature of farmer cooperative economy organization( known as FCEO) determines the fact that the economic effects of farmer cooperative economy organization are as important as its social effects. Many experts,however,now would only focus on its economic function, and either neglect or weaken its social influence. Therefore,this paper introduces the theoretical foundation of the farmer cooperative economy organization,and studies the nature of cooperative economics. Based on those typical cases,the future of cooperative organization and four supporting elements were put forward in this paper.

Construction of the Government Support and Evaluation Index System of Farmers' Cooperative Economic Organizations

On the basis of expounding the necessity of evaluation index system of farmers' cooperative economic organization,the three first level indexes including organization development index,member development index and social development index and 13 second level indexes including aggregate capital of cooperative organization,annual profit share of cooperative organization,annual total income of cooperative organization,etc.,are established according to the principles of Systematics and the methods of Statistics and Quantitative economics.By using the analytical hierarchy process,the weight of each index is tested and the operation result and evaluation mode is established,as well as the index standard value and comprehensive value.As for the result of the evaluation,it is suggested that the government should support the farmers' cooperative organizations in hierarchy and targeted way according to local conditions.Though the construction of index system and comprehensive score,the government should establish the entry and exit mechanism of farmers' cooperative organizations to reasonably guild the rapid development of cooperators.

A Childhood lost? A case of Gulu Support Children Organization in Northern Uganda

The number of children affected in conflicts is on the rise in Africa.All childhood experiences of such children are nightmares by war.The conflict in Northern Uganda continues to attract local,national and international attention.Once a vibrant area,Gulu has been shuttered by the Lord Resistance Army (LRA)atrocities,a region where several vehicles were burnt and people were butchered.The purpose of

Applying the Technology Acceptance Model (TAM) in Information Technology System to Evaluate the Adoption of Decision Support System

With the beginning of the information systems’ spreading, people started thinking about using them for making business decisions. Computer technology solutions, such as the Decision Support System, make the decision-making process less complex and simpler for problem-solving. In order to make a high-quality business decision, managers need to have a great deal of appropriate information. Nonetheless, this complicates the process of making appropriate decisions. In a situation like that, the possibility of using DSS is quite logical. The aim of this paper is to find out the intended use of DSS for medium and large business organizations in USA by applying the Technology Acceptance Model (TAM). Different models were developed in order to understand and predict the use of information systems, but the information systems community mostly used TAM to ensure this issue. The purpose of the research model is to determine the elements of analysis that contribute to these results. The sample for the research consisted of the target group that was supposed to have completed an online questionnaire about the manager’s use of DSS in medium and large American companies. The information obtained from the questionnaires was analyzed through the SPSS statistical software. The research has indicated that, this is primarily used due to a significant level of Perceived usefulness and For the Perceived ease of use.

Research on Benefit Distribution Mechanism of Farmers’ Specialized Cooperative Economic Organization

On the basis of conducting survey in Jiaonan City,the thesis analyzes benefit distribution mechanism of farmers’ specialized cooperative economic organizations:firstly,the benefit correlation is mainly the contract correlation;secondly,the profit distribution is mainly the dividend;thirdly,patronage refund has many connotations;fourthly,the public accumulation has not yet been quantified to individual;fifthly,the government support capital is ill-defined.Based on these,the measures are put forward in order to improve benefit distribution pattern of farmers’ specialized cooperative economic organizations:firstly,reform structure of property rights and realize farmers’ ownership;secondly,change mode of decision-making,and realize farmers’ control;thirdly,increase turnover rebate and realize farmers’ benefiting;fourthly,quantify public accumulation and government support fund.

Traceless solid-phase synthesis of 3-substituted isoxazoles from polystyrene-supported vinyl selenide

A novel facile procedure for traceless solid-phase synthesis of 3-substituted isoxazoles in good yields and with excellent purities using polymer-supported vinyl selenide has been developed.

Synthesis, Characterization, and Properties of Supported Tungstozincate Bridged by Co(Ⅱ) Complex Fragment

[Co^11（phen）3]2[{（ZnW12O40）Co^11（phen）2（H2O）}2Co^11（trien）2（NaH2O）2]·3H2O was synthesized via hydrothermal technique and characterized with elemental analyses, IR spectroscopy, TGA-DTA, and variable temperature magnetic susceptibility. The compound crystallized in the monoclinic system with the space group P21/n, a=1.8210 nm, b=2.3592 nm, c=2.2932 nm, β=110.31°, V=9.239 nm^3, Z=2, R1=0.0827. The compound consists of two coordination cations, three lattice water molecules, and a macroanion [{（ZnW12O40）Co（phen）2（H2O）}2Co（C6H18N4）2·（NaH2O）2]^4- in which each supported Keggin anion [（ZnW12O40Co^11（phen）2（H2O）]^4- acts as a ligand to coordinate to central bridging Co^2＋ ion via a terminal oxygen atom. Hydrogen bonds are responsible for the construction of 3D architecture of the compound. The compound is paramagnetic with a weak antiferromagnetic interaction（0=-46.796 K）.

Solid-phase synthesis of (Z)-allyl iodides from 3-acetoxy-2-methylene-alkanoates with recyclable polymer-supported selenium bromide

Reaction of polystyrene-supported lithium selenide with 3-acetoxy-2-methylene-alkanoates afforded the corresponding allyl selenide resins and subsequent cleavage from the polymer by treating with methyl iodide to furnish （Z）-allyl iodides in good yields and high purities. The polymeric selenium reagent can be regenerated and reused. So it is a environmentally benign reagent.

Solid-phase Synthesis of Vinyl Sulfones Using Polystyrene-supported Selenomethyl Phenyl Sulfone

The solid-phase preparation of vinyl sulfones via a novel polystyrene-supported selenomethyl phenyl sulfone reagent has been reported.

21st century critical care medicine:An overview

Critical care medicine in the 21st century has witnessed remarkable advancements that have significantly improved patient outcomes in intensive care units(ICUs).This abstract provides a concise summary of the latest developments in critical care,highlighting key areas of innovation.Recent advancements in critical care include Precision Medicine:Tailoring treatments based on individual patient characteristics,genomics,and biomarkers to enhance the effectiveness of therapies.The objective is to describe the recent advancements in Critical Care Medicine.Telemedicine:The integration of telehealth technologies for remote patient monitoring and consultation,facilitating timely interventions.Artificial intelligence(AI):AI-driven tools for early disease detection,predictive analytics,and treatment optimization,enhancing clinical decision-making.Organ Support:Advanced life support systems,such as Extracorporeal Membrane Oxygenation and Continuous Renal Replacement Therapy provide better organ support.Infection Control:Innovative infection control measures to combat emerging pathogens and reduce healthcare-associated infections.Ventilation Strategies:Precision ventilation modes and lung-protective strategies to minimize ventilatorinduced lung injury.Sepsis Management:Early recognition and aggressive management of sepsis with tailored interventions.Patient-Centered Care:A shift towards patient-centered care focusing on psychological and emotional wellbeing in addition to medical needs.We conducted a thorough literature search on PubMed,EMBASE,and Scopus using our tailored strategy,incorporating keywords such as critical care,telemedicine,and sepsis management.A total of 125 articles meeting our criteria were included for qualitative synthesis.To ensure reliability,we focused only on articles published in the English language within the last two decades,excluding animal studies,in vitro/molecular studies,and non-original data like editorials,letters,protocols,and conference abstracts.These advancements reflect a dynamic landscape in critical care medicine,where technology,research,and patient-centered approaches converge to improve the quality of care and save lives in ICUs.The future of critical care promises even more innovative solutions to meet the evolving challenges of modern medicine.

THE ASYMMETRIC SYNTHESIS OF AMINO ACIDS UNDER POLYMER-SUPPORTED PHASE TRANSFER CATALYTIC CONDITION

The optical alpha-amino acids were synthesized under room temperature by alkylation of N-(diphenyl methylene) glycine t-butyl ester under polymer-supported phase transfer conditions using polymer-supported cinchonine (or quinine) alkaloids as chiral phase transfer catalysts and dichloromethane as solvent, followed by hydrolysis of the above intermediates introduced to the final products-optical alpha-amino acids. This is a new method for the asymmetric synthesis of alpha-amino acids. The influences of catalyst, temperature, substrates, and organic solvents on the chemical yield and optical purities of products were studied.

End Organ Recovery and Survival with the QuadroxD Oxygenator in Adults on Extracorporeal Membran Oxygenation

Introduction: Extracorporeal Membrane Oxygenation (ECMO) is used in selected patient with cardiogenic and/or re- spiratory shock. We report our experience with standardized management protocols and the application of the Qua- droxD oxygenator with a centrifugal pump to maximize end-organ recovery and improve survival. Methods: This is an Internal Review Board (IRB) approved, single institution retrospective study of end-organ recovery and survival in pa- tients who required ECMO for cardiogenic and/or respiratory shock between July 2010 and June 2011. Results: Sixteen patients (median age: 46 years) were initiated on either Veno-Arterial (VA) or Veno-Venous (VV) ECMO. Cardiogenic shock, acute respiratory distress syndrome (ARDS) and a combined respiratory and cardiogenic compromise were the primary indications for ECMO in 8 (50%), 5 (31%) and 3 (19%) patients respectively. The median time on ECMO was 8 days (range: 4 - 26 days). Twelve patients (75%) were successfully weaned off ECMO, of which four (25%) were bridged to a ventricular assist device (VAD) and eight (50%) were weaned to recovery. All eight patients (100%) that were weaned to recovery and two patients (50%) that were bridged to a VAD were successfully discharged from the hospital, resulting in a discharge rate of 63%. There was an improvement in pre- vs. post-ECMO AST (449 IU/L vs. 63 IU/L, p Conclusion: ECMO using the QuadroxD oxygenator and a centrifugal pump, coupled with standardized management protocols is beneficial in carefully selected patients. Improvement or main- tenance of end-organ function is associated with successful bridge to device therapy and/or increased survival.

组织支持对专利密集型企业研发人员创新绩效的影响——以知识贡献为中介

基于社会交换理论,以46家专利密集型企业的150名专利研发人员为调研对象,并采用研发人员参与研发的专利数量作为创新绩效的衡量指标,探讨组织支持与研发人员创新绩效之间的关系以及知识贡献(显性知识贡献和隐性知识贡献)的中介作用和成长需求强度的调节作用。结果表明:组织支持与研发人员绩效呈正相关,研发人员的创新绩效可以从更高水平的隐性知识贡献中受益,组织支持对隐性知识贡献的积极效应部分由成长需求强度来调节。由此提出企业应该通过制定相关民主政策等方法来塑造高水平的组织支持、注重组织内部评估体系以增强员工贡献的意识等相关建议。