This paper puts forward a new conceptual idea on constructing an international central city in the Tumen River Economy Development Zone (TREDZ) on the basis of analysis of the superiorities and problems in developing...This paper puts forward a new conceptual idea on constructing an international central city in the Tumen River Economy Development Zone (TREDZ) on the basis of analysis of the superiorities and problems in developing city, and from the view point of present social, economic and natural conditions in this area and the background of Northeast Asia. The united international central city is the best distribution model not only in its polycentric spatial structure but also in organizing form. Its feasibility and practicability are thoroughly proved from various aspects including urban planning principles, comparison of port cities, special characteristics of cooperation in TREDZ, and natural, social, cultural factors etc.展开更多
On June 30,2019,on behalf of the Beijing Zhicheng Migrant Workers Legal Aid and Research Center(hereinafter referred to as the Center),I went to Geneva to attend the 41st Session of the UN Human Rights Council.This is...On June 30,2019,on behalf of the Beijing Zhicheng Migrant Workers Legal Aid and Research Center(hereinafter referred to as the Center),I went to Geneva to attend the 41st Session of the UN Human Rights Council.This is my third time to participate in the activities of the UN Human Rights System.展开更多
BACKGROUND The utility of hepatitis C virus(HCV)organs has increased after the Food and Drug Administration approval of direct acting anti-viral(DAA)medications for the HCV treatment.The efficacy of DAA in treating HC...BACKGROUND The utility of hepatitis C virus(HCV)organs has increased after the Food and Drug Administration approval of direct acting anti-viral(DAA)medications for the HCV treatment.The efficacy of DAA in treating HCV is nearly 100%.AIM To analyze the United Network for Organ Sharing(UNOS)database to compare the survival rates between the hepatitis C positive donors and negative recipients and hepatitis C negative donors and recipients.METHODS We analyzed the adult patients in UNOS database who underwent deceased donor liver transplant from January 2014 to December 2017.The primary endpoint was to compare the survival rates among the four groups with different hepatitis C donor and recipient status:(Group 1)Both donor and recipient negative for HCV(Group 2)Negative donor and positive recipient for HCV(Group 3)Positive donor and negative recipient for HCV(Group 4)Both positive donor and recipient for HCV.SAS 9.4 software was used for the data analysis.Kaplan Meier log rank test was used to analyze the estimated survival rates among the four groups.RESULTS A total of 24512 patients were included:Group 1:16436,Group 2:6174,Group 3:253 and Group 4:1649.The 1-year(Group 1:91.8%,Group 2:92.12%,Group 3:87%,Group 4:92.8%),2-year(Group 1:88.4%,Group 2:88.1%,Group 3:84.3%,Group 4:87.5%),3-year(Group 1:84.9%,Group 2:84.3%,Group 3:75.9%,Group 4:83.2%)survival rates showed no statistical significance among the four groups.Kaplan Meier log rank test did not show any statistical significance difference in the estimated survival rates between Group 3 vs all the other groups.CONCLUSION The survival rates in hepatitis C positive donors and negative recipients are similar as compared to both hepatitis C negative donors and recipients.This could be due to the use of DAA therapy with cure rates of nearly 100%.This study supports the use of hepatitis C positive organs in the selected group of recipients with and without HCV infection.Further long-term studies are needed to further validate these findings.展开更多
Taking its development in Baoding City as an example, we introduced service fields of rural cooperative economic organized united association. It mainly includes setting up service platform and providing scientific an...Taking its development in Baoding City as an example, we introduced service fields of rural cooperative economic organized united association. It mainly includes setting up service platform and providing scientific and technological services; organizing economic and trade negotiation and exchange, and promoting farmer-supermarket partnership; providing financial services and solving fund-raising problems. In line with these fields, we analyzed existing problems: (i) regional development is unbalanced and organization lacks internal connection; (ii) the development in some counties (cities) is to be improved, and the promotion effect is not significant; (iii) there is shortage of talent and the innovation strength is not enough; and (iv) it lacks system and management lacks restriction mechanism. Finally, we put forward countermeasures and recommendations: strengthen propaganda and cultivate farmers' cooperative awareness; incorporate rural cooperative economic organized united association into formal system arrangement, and absorb professional talents; innovate upon organization system of rural cooperative economic organized united association and improve service methods; improve internal operating mechanism and innovate upon working contents of rural cooperative economic organized united association at new development background.展开更多
One novel metal-organic framework [Cu2(L)(μ3-OH)]n(1, H3L = [1,1':3',1''-terphenyl]-4,4'',5'-tricarboxylic acid) has been synthesized and characterized by single-crystal powder X-ray diffraction, IR and...One novel metal-organic framework [Cu2(L)(μ3-OH)]n(1, H3L = [1,1':3',1''-terphenyl]-4,4'',5'-tricarboxylic acid) has been synthesized and characterized by single-crystal powder X-ray diffraction, IR and thermogravimetric analyses. Complex 1 crystallizes in orthorhombic crystal system, space group Pbca with a = 21.573(19), b = 5.404(5), c = 33.78(3) ?, C21H(12)O7Cu2, Mr = 503.39, V = 3938(6) A^3, Z = 8, Dc = 1.698 g·cm^-3, μ = 2.202 mm^-1, F(000) = 2016, 1.531〈θ〈25.009°, λ(Mo Kα) = 0.71073 A, T = 293(2) K, the final R = 0.0448 and wR = 0.1002. The structure of complex 1 is a three-dimensional(3D) framework based on infinite rod-shaped secondary building units and can be simplified as kgd topology. The gas adsorption measurements for N2, CO2, H2O, CH3OH and CH3CH2OH have been done. Fortunately, the selective sorption of CO2 over N2 was found at 195 K.展开更多
The cost-effective organic semiconductors are strongly needed in organic photovoltaics(OPVs). Herein,two medium bandgap(MBG) electron acceptors, TPT4F and TPT4Cl are developed via the new design of multi-noncovalent i...The cost-effective organic semiconductors are strongly needed in organic photovoltaics(OPVs). Herein,two medium bandgap(MBG) electron acceptors, TPT4F and TPT4Cl are developed via the new design of multi-noncovalent interaction assisted unfused core, flanked with two electron withdrawing end groups. These fullly non-fused MBG acceptors adapt the planar and rigid conformation in solid, therefore exhibiting the ordered face-on stacking and strong photoluminescence in films. As results, TPT4Cl^(-)based OPVs, upon blending with the PBDB-TF polymer donor, have achieved a power conversion efficiency of 10.16% with a low non-radiative loss of 0.27 e V, representing one of the best fullly non-fused medium bandgap acceptors with desirable cost-efficiency balance.展开更多
BACKGROUND Acute pancreatitis(AP)is a common surgical condition,with severe AP(SAP)potentially lethal.Many prognostic indices,including;acute physiology and chronic health evaluation II score(APACHE II),bedside index ...BACKGROUND Acute pancreatitis(AP)is a common surgical condition,with severe AP(SAP)potentially lethal.Many prognostic indices,including;acute physiology and chronic health evaluation II score(APACHE II),bedside index of severity in acute pancreatitis(BISAP),Glasgow score,harmless acute pancreatitis score(HAPS),Ranson’s score,and sequential organ failure assessment(SOFA)evaluate AP severity and predict mortality.AIM To evaluate these indices'utility in predicting severity,intensive care unit(ICU)admission,and mortality.METHODS A retrospective analysis of 653 patients with AP from July 2009 to September 2016 was performed.The demographic,clinical profile,and patient outcomes were collected.SAP was defined as per the revised Atlanta classification.Values for APACHE II score,BISAP,HAPS,and SOFA within 24 h of admission were retrospectively obtained based on laboratory results and patient evaluation recorded on a secure hospital-based online electronic platform.Data with<10%missing data was imputed via mean substitution.Other patient information such as demographics,disease etiology,and patient outcomes were also derived from electronic medical records.RESULTS The mean age was 58.7±17.5 years,with 58.7%males.Gallstones(n=404,61.9%),alcohol(n=38,5.8%),and hypertriglyceridemia(n=19,2.9%)were more common aetiologies.81(12.4%)patients developed SAP,20(3.1%)required ICU admission,and 12(1.8%)deaths were attributed to SAP.Ranson’s score and APACHE-II demonstrated the highest sensitivity in predicting SAP(92.6%,80.2%respectively),ICU admission(100%),and mortality(100%).While SOFA and BISAP demonstrated lowest sensitivity in predicting SAP(13.6%,24.7%respectively),ICU admission(40.0%,25.0%respectively)and mortality(50.0%,25.5%respectively).However,SOFA demonstrated the highest specificity in predicting SAP(99.7%),ICU admission(99.2%),and mortality(98.9%).SOFA demonstrated the highest positive predictive value,positive likelihood ratio,diagnostic odds ratio,and overall accuracy in predicting SAP,ICU admission,and mortality.SOFA and Ranson’s score demonstrated the highest area under receiver-operator curves at 48 h in predicting SAP(0.966,0.857 respectively),ICU admission(0.943,0.946 respectively),and mortality(0.968,0.917 respectively).CONCLUSION The SOFA and 48-h Ranson’s scores accurately predict severity,ICU admission,and mortality in AP,with more favorable statistics for the SOFA score.展开更多
The introduction of new treatments for cancer and advances in the intensive care of critically ill cancer patients has improved the prognosis and survival. In recent years, the classical intensive care unit(ICU) admis...The introduction of new treatments for cancer and advances in the intensive care of critically ill cancer patients has improved the prognosis and survival. In recent years, the classical intensive care unit(ICU) admission comorbidity criteria used for this group of patients have been discouraged since the risk factors for death that have been studied, mainly the number and severity of organic failures, allow us to understand the determinants of the prognosis inside the ICU. However, the availability of intensive care resources is dissimilar by country, and these differences are known to alter the indications for admission to critical care setting. Three to five days of ICU management is warranted before making a final decision(ICU trial) to consider keep down intensive management of critically ill cancer patients. Nowadays, taking into account only the diagnosis of cancer to consider ICU admission of patients who need full-supporting management is no longer justified.展开更多
Organic reefs, the targets of deep-water petro- leum exploration, developed widely in Xisha area. However, there are concealed igneous rocks undersea, to which organic rocks have nearly equal wave impedance. So the ig...Organic reefs, the targets of deep-water petro- leum exploration, developed widely in Xisha area. However, there are concealed igneous rocks undersea, to which organic rocks have nearly equal wave impedance. So the igneous rocks have become interference for future explo- ration by having similar seismic reflection characteristics. Yet, the density and magnetism of organic reefs are very different from igneous rocks. It has obvious advantages to identify organic reefs and igneous rocks by gravity and magnetic data. At first, frequency decomposition was applied to the free-air gravity anomaly in Xisha area to obtain the 2D subdivision of the gravity anomaly and magnetic anomaly in the vertical direction. Thus, the dis- tribution of igneous rocks in the horizontal direction can be acquired according to high-frequency field, low-frequency field, and its physical properties. Then, 3D forward model- ing of gravitational field was carried out to establish the density model of this area by reference to physical properties of rocks based on former researches. Furthermore, 3D inversion of gravity anomaly by genetic algorithm method of the graphic processing unit (GPU) parallel processing in Xisha target area was applied, and 3D density structure of this area was obtained. By this way, we can confine the igneous rocks to the certain depth according to the density of the igneous rocks. The frequency decomposition and 3D inversion of gravity anomaly by genetic algorithm method of the GPU parallel processing proved to be a useful method for recognizing igneous rocks to its 3D geological position. So organic reefs and igneous rocks can be identified, which provide a prescient information for further exploration.展开更多
BACKGROUND Sepsis is a severe medical condition that occurs when the body's immune system overreacts to an infection,leading to life-threatening organ dysfunction.The"Third international consensus definitions...BACKGROUND Sepsis is a severe medical condition that occurs when the body's immune system overreacts to an infection,leading to life-threatening organ dysfunction.The"Third international consensus definitions for sepsis and septic shock(Sepsis-3)"defines sepsis as an increase in sequential organ failure assessment score of 2 points or more,with a mortality rate above 10%.Sepsis is a leading cause of intensive care unit(ICU)admissions,and patients with underlying conditions such as cirrhosis have a higher risk of poor outcomes.Therefore,it is critical to recognize and manage sepsis promptly by administering fluids,vasopressors,steroids,and antibiotics,and identifying and treating the source of infection.AIM To conduct a systematic review and meta-analysis of existing literature on the management of sepsis in cirrhotic patients admitted to the ICU and compare the management of sepsis between cirrhotic and non-cirrhotic patients in the ICU.METHODS This study is a systematic literature review that followed the PRISMA statement's standardized search method.The search for relevant studies was conducted across multiple databases,including PubMed,Embase,Base,and Cochrane,using predefined search terms.One reviewer conducted the initial search,and the eligibility criteria were applied to the titles and abstracts of the retrieved articles.The selected articles were then evaluated based on the research objectives to ensure relevance to the study's aims.RESULTS The study findings indicate that cirrhotic patients are more susceptible to infections,resulting in higher mortality rates ranging from 18%to 60%.Early identification of the infection source followed by timely administration of antibiotics,vasopressors,and corticosteroids has been shown to improve patient outcomes.Procalcitonin is a useful biomarker for diagnosing infections in cirrhotic patients.Moreover,presepsin and resistin have been found to be reliable markers of bacterial infection in patients with decompensated liver cirrhosis,with similar diagnostic performance compared to procalcitonin.CONCLUSION This review highlights the importance of early detection and management of infections in cirrhosis patients to reduce mortality.Therefore,early detection of infection using procalcitonin test and other biomarker as presepsin and resistin,associated with early management with antibiotics,fluids,vasopressors and low dose corticosteroids might reduce the mortality associated with sepsis in cirrhotic patients.展开更多
The authors of this study note that in liver transplantation(LT),the survival rates of hepatitis C virus(HCV)-positive donors and HCV-negative receivers are compa-rable to those of HCV-negative donors and recipients.D...The authors of this study note that in liver transplantation(LT),the survival rates of hepatitis C virus(HCV)-positive donors and HCV-negative receivers are compa-rable to those of HCV-negative donors and recipients.Direct-acting antiviral(DAA)therapies have nearly 100%effectiveness in treating HCV.Between 2006 and 2016,the percentages of HCV-positive patients on the waiting list and HCVpositive LT recipients fell by 8.2 percent and 7.6 percent,respectively.Records from April 1,2014,in which the donor and receiver were both at least 18 years old and had a positive HCV status,were the only ones eligible for the study.The analysis for this study was restricted to the first transplant recorded for each patient using a data element that documented the number of prior transplants for each recipient,although some recipients appeared multiple times in the data set.HCV-positive recipients or people with fulminant hepatic failure were the main beneficiaries of primary biliary cirrhosis among HCV-positive donors.However,there is still a reticence to use HCV-positive donor organs in HCV recipients due to clinical and ethical considerations.Similar survival rates between HCV-positive donors and recipients and HCV-negative donors and receivers illustrate the efficacy of these DAA regimens.展开更多
Matching soil grid unit resolutions with polygon unit map scales is important to minimize the uncertainty of regional soil organic carbon(SOC) pool simulation due to their strong influences on the modeling.A series of...Matching soil grid unit resolutions with polygon unit map scales is important to minimize the uncertainty of regional soil organic carbon(SOC) pool simulation due to their strong influences on the modeling.A series of soil grid units at varying cell sizes was derived from soil polygon units at six map scales,namely,1:50 000(C5),1:200 000(D2),1:500 000(P5),1:1 000 000(N1),1:4 000 000(N4) and 1:14 000 000(N14),in the Taihu Region of China.Both soil unit formats were used for regional SOC pool simulation with a De Nitrification-DeC omposition(DNDC) process-based model,which spans the time period from 1982 to 2000 at the six map scales.Four indices,namely,soil type number(STN),area(AREA),average SOC density(ASOCD) and total SOC stocks(SOCS) of surface paddy soils that were simulated by the DNDC,were distinguished from all these soil polygon and grid units.Subjecting to the four index values(IV) from the parent polygon units,the variations in an index value(VIV,%) from the grid units were used to assess its dataset accuracy and redundancy,which reflects the uncertainty in the simulation of SOC pools.Optimal soil grid unit resolutions were generated and suggested for the DNDC simulation of regional SOC pools,matching their respective soil polygon unit map scales.With these optimal raster resolutions,the soil grid units datasets can have the same accuracy as their parent polygon units datasets without any redundancy,when VIV < 1% was assumed to be a criterion for all four indices.A quadratic curve regression model,namely,y = – 0.80 × 10^(–6)x^2 + 0.0228 x + 0.0211(R^2 = 0.9994,P < 0.05),and a power function model R? = 10.394?^(0.2153)(R^2 = 0.9759,P < 0.05) were revealed,which describe the relationship between the optimal soil grid unit resolution(y,km) and soil polygon unit map scale(1:10 000x),the ratio(R?,%) of the optimal soil grid size to average polygon patch size(?,km^2) and the ?,with the highest R^2 among different mathematical regressions,respectively.This knowledge may facilitate the grid partitioning of regions during the investigation and simulation of SOC pool dynamics at a certain map scale,and be referenced to other landscape polygon patches' mesh partition.展开更多
An unusual form of localized corrsion in copper tubes was detected early in service and in leakage tests after manufacturing.The morphology of this corrosion is similar to that of an ant's nest when viewed in cros...An unusual form of localized corrsion in copper tubes was detected early in service and in leakage tests after manufacturing.The morphology of this corrosion is similar to that of an ant's nest when viewed in cross section. The corrosion mechanisms, cases ofant's nest corrosion, and preventive measures are presented.展开更多
The development of new materials plays a critical role in improving the efficiency of organic solar cells(OSCs).At present,the relatively high-lying highest occupied molecular orbital(HOMO)level of the high-efficiency...The development of new materials plays a critical role in improving the efficiency of organic solar cells(OSCs).At present,the relatively high-lying highest occupied molecular orbital(HOMO)level of the high-efficiency polymer donor is regarded as one of the main reasons for the low open-circuit voltage(V_(OC)).In this work,we introduced the strong electron-withdrawing thiazole unit into the construction of a polymer donor.We designed and prepared an alternating donor-acceptor material,namely PSZ,by copolymerizing 4-methyl thiazole with an electron-donating benzodithiophene unit and studied its application in high-efficiency OSCs.The optical and electrical properties of the new material were characterized by UV-Vis absorption spectroscopy and electrochemical cyclic voltammetry.Results show that PSZ is a typical wide-bandgap material with a high optical bandgap of 2.0 eV and a deep HOMO level of-5.70 eV.When a non-fullerene BTP-eC9 was selected as the acceptor material,V_(OC) reached 0.88 V in the resulting device,and the corresponding power conversion efficiency(PCE)was8.15%.In addition,when PSZ was added as the third component to the binary photoactive combination with PBDB-TF as the donor and BTP-eC9 as the acceptor,V_(OC) of the cell device could be increased,thereby obtaining a high PCE of 17.4%.These results indicated that introducing thiazole units into polymer donors can remarkably reduce the HOMO levels and improve V_(OC) and PCE in OSCs.展开更多
This article will briefly outline the origins,structure and functions of United Nations Environment Program and the Commission on Sustainable Development in the context of the goals of ecologically sustainable develop...This article will briefly outline the origins,structure and functions of United Nations Environment Program and the Commission on Sustainable Development in the context of the goals of ecologically sustainable development(ESD).Economic development,social development and environmental protection form the three interconnected parts of ESD.The achievements of the key UN environmental institutions and programs in opening up the global system to civil society,the private sector and a diversity of actors and interests,promoting the role of poverty alleviation as part of ESD through the Millennium Development Goals,and facilitating important Multilateral Environmental Agreements should be recognized.However,with these notable exceptions,organizations such as United Nations Environment Program and the Commission on Sustainable Development have become weak in scientific and technical leadership,global policy,co-ordination(inside and outside the UN) and has few achievements in the international and national implementation of obligations and standards in Global Environmental Governance-including enforcement,compliance and effectiveness.This article will outline the key reasons for this inadequacy.Attention will also be focused on the way forward through of a new United Nations Environment Organization.This will require a clarification of purpose and function(within the UN system and as part of global governance structures) as well as consideration of whether it depends on system-wide UN reform.It is recommended that medium and long term strategies for reform are necessary.展开更多
BACKGROUND Early in the coronavirus disease 2019(COVID-19)pandemic,there was a significant impact on routine medical care in the United States,including in fields of transplantation and oncology.AIM To analyze the imp...BACKGROUND Early in the coronavirus disease 2019(COVID-19)pandemic,there was a significant impact on routine medical care in the United States,including in fields of transplantation and oncology.AIM To analyze the impact and outcomes of early COVID-19 pandemic on liver transplantation(LT)for hepatocellular carcinoma(HCC)in the United States.METHODS WHO declared COVID-19 as a pandemic on March 11,2020.We retrospectively analyzed data from the United Network for Organ Sharing(UNOS)database regarding adult LT with confirmed HCC on explant in 2019 and 2020.We defined pre-COVID period from March 11 to September 11,2019,and early-COVID period as from March 11 to September 11,2020.RESULTS Overall,23.5%fewer LT for HCC were performed during the COVID period(518 vs 675,P<0.05).This decrease was most pronounced in the months of March-April 2020 with a rebound in numbers seen from May-July 2020.Among LT recipients for HCC,concurrent diagnosis of non-alcoholic steatohepatitis significantly increased(23 vs 16%)and alcoholic liver disease(ALD)significantly decreased(18 vs 22%)during the COVID period.Recipient age,gender,BMI,and MELD score were statistically similar between two groups,while waiting list time decreased during the COVID period(279 days vs 300 days,P=0.041).Among pathological characteristics of HCC,vascular invasion was more prominent during COVID period(P<0.01),while other features were the same.While the donor age and other characteristics remained same,the distance between donor and recipient hospitals was significantly increased(P<0.01)and donor risk index was significantly higher(1.68 vs 1.59,P<0.01)during COVID period.Among outcomes,90-day overall and graft survival were the same,but 180-day overall and graft were significantly inferior during COVID period(94.7 vs 97.0%,P=0.048).On multivariable Coxhazard regression analysis,COVID period emerged as a significant risk factor of post-transplant mortality(Hazard ratio 1.85;95%CI:1.28-2.68,P=0.001).CONCLUSION During COVID period,there was a significant decrease in LTs performed for HCC.While early postoperative outcomes of LT for HCC were same,the overall and graft survival of LTs for HCC after 180 days were significantly inferior.展开更多
Chinese unit residential buildings can be understood as a flexible urban element, and theintroduction of its concept changed the urban structure of China. In this study, starting from the constraintsof contemporary pl...Chinese unit residential buildings can be understood as a flexible urban element, and theintroduction of its concept changed the urban structure of China. In this study, starting from the constraintsof contemporary planning contexts by Chinese historical units, the categories of historical Chinese unitresidential buildings were analyzed, and how spatial order and social ties has made Chinese units becomea common framework within which collective living takes place, how does the political strategy of theChinese government creates and constructs a particular form of spatial order in each example of Chineseunit residential buildings, and the impact on the daily life of the urban population were studied. Finally,how social relations, politics, and economic strategies confront and interact within Chinese unit residentialbuildings was explored.展开更多
Currently, 86% of the energy originates from fossil fuelsforelectricity. These are expected to run out, causing severe environmental damage threatening future generations. The total impact of Small and Medium Enterpri...Currently, 86% of the energy originates from fossil fuelsforelectricity. These are expected to run out, causing severe environmental damage threatening future generations. The total impact of Small and Medium Enterprises (SMEs) on the economy is significant. Solar cells harness the sun's energy to generate electricity in an environmentally friendly manner. This study compares silicon solar cells to flexible Organic Photovoltaic solar cells (OPV) for electricity energy for a micro-business in the UK and Iraq. It shows that it is feasible to replace existing fossil fuel sources with solar cells in Iraq due to a greater amount of solar radiation striking the earth's surface. Flexible solar cells can replace a proportion of the energy requirements in the UK and a larger proportion in Iraq. Using existing 20% efficient solar cells, 28% and 83% of the energy requirements of the microbusiness can be replaced in UK and Iraq respectively. Assuming 20% efficiency for solar cells placed on windows, 74% and 220% of the energy requirements of UK and Kurdistan can be replaced respectively and the surplus stored.展开更多
Rationale: Recent studies have reported the effectiveness of the early introduction of rehabilitation for preventing muscle weakness in patients in the intensive care unit (ICU). The early introduction of full-scale r...Rationale: Recent studies have reported the effectiveness of the early introduction of rehabilitation for preventing muscle weakness in patients in the intensive care unit (ICU). The early introduction of full-scale rehabilitation by a physical therapist is difficult in some cases because of disease severity and/or patient conditions. However, mild mobilization by a nurse (MMN), as a part of standard care performed, may have a positive effect on patient recovery. We examined the effect of the early introduction of MMN on the recovery of patients in the ICU. Methods: We retrospectively examined patients admitted to Niigata University Hospital’s ICU during between April 2014 and March 2015 who were receiving mechanical ventilation for 7 days or more. Patients were divided into two groups according to the date of initiation of MMN: group L comprised patients for whom MMN was started after 72 hours and group E comprised patients for whom MMN was started within 72 hours after ICU admission. The data were analyzed using the Fisher test, Mann-Whitney U test, and Wilcoxon test. Statistical significance was defined as P Results: Sixty-three patients were included: 42 patients in group L and 21 in group E. There was no significant difference between the two groups in patients’ background, including the type of illness, steroid use, presence of sepsis or diabetes, and sequential organ failure assessment (SOFA) score on ICU admission;however, the SOFA score at ICU discharge was significantly decreased in group E compared to that in group L (6.21 versus 4.30;P = 0.034). Conclusion: Our results indicate that MMN may reduce disease severity if started within 72 hours after ICU admission.展开更多
Ever since Lawrence Goodwyn published The Populist Moment, social historians have been keenly aware of the power culture represents when it comes to resistance. Historically, "movement culture" has been used to crea...Ever since Lawrence Goodwyn published The Populist Moment, social historians have been keenly aware of the power culture represents when it comes to resistance. Historically, "movement culture" has been used to create a collective climate and offered political activists a springboard to discuss with the masses the benefits of joining a social movement. "Beyond the Dreams of Loveliness" uses the cultural outlet of film and the labor movement in the city of Detroit as analytical tools to examine working class community resistance throughout the 1930s. In the midst of the "golden age of film" community activists and union organizers--some of whom were well-known radicals and some of whom were mainstream unionists--used the institution of cinema to instill a level of class consciousness in the masses and mobilize the working class community against exploitation of employers, reactionary politicians, and white supremacist organizations. Movie-going had been a very popular form of recreation in Detroit since the 1920s and downtown theatres increasingly became the destination of an eclectic array of workers. Movie theaters themselves were bastions of community activity around the thirties and many were located in the heart of the city's working class district. Yet it was the films themselves that offered community activists and unionists a chance to converse with workers regarding the socio-economic matters of the day. Hollywood released a good number of films that dealt with working class issues and provided activists with ample opportunities to "instruct" the audience and carry on the discussion into the factory or union halls. "Beyond the Dreams of Loveliness" relies on a combination of oral histories, movie reviews, film clips, and union and/or working class organizational records to illuminate how activists in Detroit's working class community used film as an outlet to inspire working class resistance. In sum, film provided an accessible form of entertainment that proved to be effective on two fronts: It promoted increased group cooperation, friendship, and alliances while it also fostered a shared culture, making it easier for activists to organize workers in the coming struggles for unionism.展开更多
文摘This paper puts forward a new conceptual idea on constructing an international central city in the Tumen River Economy Development Zone (TREDZ) on the basis of analysis of the superiorities and problems in developing city, and from the view point of present social, economic and natural conditions in this area and the background of Northeast Asia. The united international central city is the best distribution model not only in its polycentric spatial structure but also in organizing form. Its feasibility and practicability are thoroughly proved from various aspects including urban planning principles, comparison of port cities, special characteristics of cooperation in TREDZ, and natural, social, cultural factors etc.
文摘On June 30,2019,on behalf of the Beijing Zhicheng Migrant Workers Legal Aid and Research Center(hereinafter referred to as the Center),I went to Geneva to attend the 41st Session of the UN Human Rights Council.This is my third time to participate in the activities of the UN Human Rights System.
文摘BACKGROUND The utility of hepatitis C virus(HCV)organs has increased after the Food and Drug Administration approval of direct acting anti-viral(DAA)medications for the HCV treatment.The efficacy of DAA in treating HCV is nearly 100%.AIM To analyze the United Network for Organ Sharing(UNOS)database to compare the survival rates between the hepatitis C positive donors and negative recipients and hepatitis C negative donors and recipients.METHODS We analyzed the adult patients in UNOS database who underwent deceased donor liver transplant from January 2014 to December 2017.The primary endpoint was to compare the survival rates among the four groups with different hepatitis C donor and recipient status:(Group 1)Both donor and recipient negative for HCV(Group 2)Negative donor and positive recipient for HCV(Group 3)Positive donor and negative recipient for HCV(Group 4)Both positive donor and recipient for HCV.SAS 9.4 software was used for the data analysis.Kaplan Meier log rank test was used to analyze the estimated survival rates among the four groups.RESULTS A total of 24512 patients were included:Group 1:16436,Group 2:6174,Group 3:253 and Group 4:1649.The 1-year(Group 1:91.8%,Group 2:92.12%,Group 3:87%,Group 4:92.8%),2-year(Group 1:88.4%,Group 2:88.1%,Group 3:84.3%,Group 4:87.5%),3-year(Group 1:84.9%,Group 2:84.3%,Group 3:75.9%,Group 4:83.2%)survival rates showed no statistical significance among the four groups.Kaplan Meier log rank test did not show any statistical significance difference in the estimated survival rates between Group 3 vs all the other groups.CONCLUSION The survival rates in hepatitis C positive donors and negative recipients are similar as compared to both hepatitis C negative donors and recipients.This could be due to the use of DAA therapy with cure rates of nearly 100%.This study supports the use of hepatitis C positive organs in the selected group of recipients with and without HCV infection.Further long-term studies are needed to further validate these findings.
基金Supported by social science project of Hebei province(HB12YJ092)Development Funds of Agricultural University of Hebei(SK201111)
文摘Taking its development in Baoding City as an example, we introduced service fields of rural cooperative economic organized united association. It mainly includes setting up service platform and providing scientific and technological services; organizing economic and trade negotiation and exchange, and promoting farmer-supermarket partnership; providing financial services and solving fund-raising problems. In line with these fields, we analyzed existing problems: (i) regional development is unbalanced and organization lacks internal connection; (ii) the development in some counties (cities) is to be improved, and the promotion effect is not significant; (iii) there is shortage of talent and the innovation strength is not enough; and (iv) it lacks system and management lacks restriction mechanism. Finally, we put forward countermeasures and recommendations: strengthen propaganda and cultivate farmers' cooperative awareness; incorporate rural cooperative economic organized united association into formal system arrangement, and absorb professional talents; innovate upon organization system of rural cooperative economic organized united association and improve service methods; improve internal operating mechanism and innovate upon working contents of rural cooperative economic organized united association at new development background.
基金Supported by the Natural Science Foundation of Shandong Province(No.ZR2016BL01)the Talent Introduction Project of Dezhou University(No.320116)
文摘One novel metal-organic framework [Cu2(L)(μ3-OH)]n(1, H3L = [1,1':3',1''-terphenyl]-4,4'',5'-tricarboxylic acid) has been synthesized and characterized by single-crystal powder X-ray diffraction, IR and thermogravimetric analyses. Complex 1 crystallizes in orthorhombic crystal system, space group Pbca with a = 21.573(19), b = 5.404(5), c = 33.78(3) ?, C21H(12)O7Cu2, Mr = 503.39, V = 3938(6) A^3, Z = 8, Dc = 1.698 g·cm^-3, μ = 2.202 mm^-1, F(000) = 2016, 1.531〈θ〈25.009°, λ(Mo Kα) = 0.71073 A, T = 293(2) K, the final R = 0.0448 and wR = 0.1002. The structure of complex 1 is a three-dimensional(3D) framework based on infinite rod-shaped secondary building units and can be simplified as kgd topology. The gas adsorption measurements for N2, CO2, H2O, CH3OH and CH3CH2OH have been done. Fortunately, the selective sorption of CO2 over N2 was found at 195 K.
基金funded by the National Natural Science Foundation of China(22125901 and 21722404)the Research Grants Council(RGC)of Hong Kong(General Research Fund(14303519)+3 种基金the Joint Laboratory Funding Scheme Project(JLFS/P-102/18)the NSFC/RGC Joint Research Scheme Grant(NCUHK418/17))the CUHK direct grant(4442384)the beam time and technical support provided by Chun-Jen Su and U-Ser Jeng form Synchrotron Radiation Research Center,Hsinchu Science Park,Taiwan,China。
文摘The cost-effective organic semiconductors are strongly needed in organic photovoltaics(OPVs). Herein,two medium bandgap(MBG) electron acceptors, TPT4F and TPT4Cl are developed via the new design of multi-noncovalent interaction assisted unfused core, flanked with two electron withdrawing end groups. These fullly non-fused MBG acceptors adapt the planar and rigid conformation in solid, therefore exhibiting the ordered face-on stacking and strong photoluminescence in films. As results, TPT4Cl^(-)based OPVs, upon blending with the PBDB-TF polymer donor, have achieved a power conversion efficiency of 10.16% with a low non-radiative loss of 0.27 e V, representing one of the best fullly non-fused medium bandgap acceptors with desirable cost-efficiency balance.
文摘BACKGROUND Acute pancreatitis(AP)is a common surgical condition,with severe AP(SAP)potentially lethal.Many prognostic indices,including;acute physiology and chronic health evaluation II score(APACHE II),bedside index of severity in acute pancreatitis(BISAP),Glasgow score,harmless acute pancreatitis score(HAPS),Ranson’s score,and sequential organ failure assessment(SOFA)evaluate AP severity and predict mortality.AIM To evaluate these indices'utility in predicting severity,intensive care unit(ICU)admission,and mortality.METHODS A retrospective analysis of 653 patients with AP from July 2009 to September 2016 was performed.The demographic,clinical profile,and patient outcomes were collected.SAP was defined as per the revised Atlanta classification.Values for APACHE II score,BISAP,HAPS,and SOFA within 24 h of admission were retrospectively obtained based on laboratory results and patient evaluation recorded on a secure hospital-based online electronic platform.Data with<10%missing data was imputed via mean substitution.Other patient information such as demographics,disease etiology,and patient outcomes were also derived from electronic medical records.RESULTS The mean age was 58.7±17.5 years,with 58.7%males.Gallstones(n=404,61.9%),alcohol(n=38,5.8%),and hypertriglyceridemia(n=19,2.9%)were more common aetiologies.81(12.4%)patients developed SAP,20(3.1%)required ICU admission,and 12(1.8%)deaths were attributed to SAP.Ranson’s score and APACHE-II demonstrated the highest sensitivity in predicting SAP(92.6%,80.2%respectively),ICU admission(100%),and mortality(100%).While SOFA and BISAP demonstrated lowest sensitivity in predicting SAP(13.6%,24.7%respectively),ICU admission(40.0%,25.0%respectively)and mortality(50.0%,25.5%respectively).However,SOFA demonstrated the highest specificity in predicting SAP(99.7%),ICU admission(99.2%),and mortality(98.9%).SOFA demonstrated the highest positive predictive value,positive likelihood ratio,diagnostic odds ratio,and overall accuracy in predicting SAP,ICU admission,and mortality.SOFA and Ranson’s score demonstrated the highest area under receiver-operator curves at 48 h in predicting SAP(0.966,0.857 respectively),ICU admission(0.943,0.946 respectively),and mortality(0.968,0.917 respectively).CONCLUSION The SOFA and 48-h Ranson’s scores accurately predict severity,ICU admission,and mortality in AP,with more favorable statistics for the SOFA score.
文摘The introduction of new treatments for cancer and advances in the intensive care of critically ill cancer patients has improved the prognosis and survival. In recent years, the classical intensive care unit(ICU) admission comorbidity criteria used for this group of patients have been discouraged since the risk factors for death that have been studied, mainly the number and severity of organic failures, allow us to understand the determinants of the prognosis inside the ICU. However, the availability of intensive care resources is dissimilar by country, and these differences are known to alter the indications for admission to critical care setting. Three to five days of ICU management is warranted before making a final decision(ICU trial) to consider keep down intensive management of critically ill cancer patients. Nowadays, taking into account only the diagnosis of cancer to consider ICU admission of patients who need full-supporting management is no longer justified.
基金financially supported by the National Natural Science Foundation of China (No.41174085)
文摘Organic reefs, the targets of deep-water petro- leum exploration, developed widely in Xisha area. However, there are concealed igneous rocks undersea, to which organic rocks have nearly equal wave impedance. So the igneous rocks have become interference for future explo- ration by having similar seismic reflection characteristics. Yet, the density and magnetism of organic reefs are very different from igneous rocks. It has obvious advantages to identify organic reefs and igneous rocks by gravity and magnetic data. At first, frequency decomposition was applied to the free-air gravity anomaly in Xisha area to obtain the 2D subdivision of the gravity anomaly and magnetic anomaly in the vertical direction. Thus, the dis- tribution of igneous rocks in the horizontal direction can be acquired according to high-frequency field, low-frequency field, and its physical properties. Then, 3D forward model- ing of gravitational field was carried out to establish the density model of this area by reference to physical properties of rocks based on former researches. Furthermore, 3D inversion of gravity anomaly by genetic algorithm method of the graphic processing unit (GPU) parallel processing in Xisha target area was applied, and 3D density structure of this area was obtained. By this way, we can confine the igneous rocks to the certain depth according to the density of the igneous rocks. The frequency decomposition and 3D inversion of gravity anomaly by genetic algorithm method of the GPU parallel processing proved to be a useful method for recognizing igneous rocks to its 3D geological position. So organic reefs and igneous rocks can be identified, which provide a prescient information for further exploration.
文摘BACKGROUND Sepsis is a severe medical condition that occurs when the body's immune system overreacts to an infection,leading to life-threatening organ dysfunction.The"Third international consensus definitions for sepsis and septic shock(Sepsis-3)"defines sepsis as an increase in sequential organ failure assessment score of 2 points or more,with a mortality rate above 10%.Sepsis is a leading cause of intensive care unit(ICU)admissions,and patients with underlying conditions such as cirrhosis have a higher risk of poor outcomes.Therefore,it is critical to recognize and manage sepsis promptly by administering fluids,vasopressors,steroids,and antibiotics,and identifying and treating the source of infection.AIM To conduct a systematic review and meta-analysis of existing literature on the management of sepsis in cirrhotic patients admitted to the ICU and compare the management of sepsis between cirrhotic and non-cirrhotic patients in the ICU.METHODS This study is a systematic literature review that followed the PRISMA statement's standardized search method.The search for relevant studies was conducted across multiple databases,including PubMed,Embase,Base,and Cochrane,using predefined search terms.One reviewer conducted the initial search,and the eligibility criteria were applied to the titles and abstracts of the retrieved articles.The selected articles were then evaluated based on the research objectives to ensure relevance to the study's aims.RESULTS The study findings indicate that cirrhotic patients are more susceptible to infections,resulting in higher mortality rates ranging from 18%to 60%.Early identification of the infection source followed by timely administration of antibiotics,vasopressors,and corticosteroids has been shown to improve patient outcomes.Procalcitonin is a useful biomarker for diagnosing infections in cirrhotic patients.Moreover,presepsin and resistin have been found to be reliable markers of bacterial infection in patients with decompensated liver cirrhosis,with similar diagnostic performance compared to procalcitonin.CONCLUSION This review highlights the importance of early detection and management of infections in cirrhosis patients to reduce mortality.Therefore,early detection of infection using procalcitonin test and other biomarker as presepsin and resistin,associated with early management with antibiotics,fluids,vasopressors and low dose corticosteroids might reduce the mortality associated with sepsis in cirrhotic patients.
文摘The authors of this study note that in liver transplantation(LT),the survival rates of hepatitis C virus(HCV)-positive donors and HCV-negative receivers are compa-rable to those of HCV-negative donors and recipients.Direct-acting antiviral(DAA)therapies have nearly 100%effectiveness in treating HCV.Between 2006 and 2016,the percentages of HCV-positive patients on the waiting list and HCVpositive LT recipients fell by 8.2 percent and 7.6 percent,respectively.Records from April 1,2014,in which the donor and receiver were both at least 18 years old and had a positive HCV status,were the only ones eligible for the study.The analysis for this study was restricted to the first transplant recorded for each patient using a data element that documented the number of prior transplants for each recipient,although some recipients appeared multiple times in the data set.HCV-positive recipients or people with fulminant hepatic failure were the main beneficiaries of primary biliary cirrhosis among HCV-positive donors.However,there is still a reticence to use HCV-positive donor organs in HCV recipients due to clinical and ethical considerations.Similar survival rates between HCV-positive donors and recipients and HCV-negative donors and receivers illustrate the efficacy of these DAA regimens.
基金Under the auspices of Special Project of National Key Research and Development Program(No.2016YFD0200301)National Natural Science Foundation of China(No.41571206)Special Project of National Science and Technology Basic Work(No.2015FY110700-S2)
文摘Matching soil grid unit resolutions with polygon unit map scales is important to minimize the uncertainty of regional soil organic carbon(SOC) pool simulation due to their strong influences on the modeling.A series of soil grid units at varying cell sizes was derived from soil polygon units at six map scales,namely,1:50 000(C5),1:200 000(D2),1:500 000(P5),1:1 000 000(N1),1:4 000 000(N4) and 1:14 000 000(N14),in the Taihu Region of China.Both soil unit formats were used for regional SOC pool simulation with a De Nitrification-DeC omposition(DNDC) process-based model,which spans the time period from 1982 to 2000 at the six map scales.Four indices,namely,soil type number(STN),area(AREA),average SOC density(ASOCD) and total SOC stocks(SOCS) of surface paddy soils that were simulated by the DNDC,were distinguished from all these soil polygon and grid units.Subjecting to the four index values(IV) from the parent polygon units,the variations in an index value(VIV,%) from the grid units were used to assess its dataset accuracy and redundancy,which reflects the uncertainty in the simulation of SOC pools.Optimal soil grid unit resolutions were generated and suggested for the DNDC simulation of regional SOC pools,matching their respective soil polygon unit map scales.With these optimal raster resolutions,the soil grid units datasets can have the same accuracy as their parent polygon units datasets without any redundancy,when VIV < 1% was assumed to be a criterion for all four indices.A quadratic curve regression model,namely,y = – 0.80 × 10^(–6)x^2 + 0.0228 x + 0.0211(R^2 = 0.9994,P < 0.05),and a power function model R? = 10.394?^(0.2153)(R^2 = 0.9759,P < 0.05) were revealed,which describe the relationship between the optimal soil grid unit resolution(y,km) and soil polygon unit map scale(1:10 000x),the ratio(R?,%) of the optimal soil grid size to average polygon patch size(?,km^2) and the ?,with the highest R^2 among different mathematical regressions,respectively.This knowledge may facilitate the grid partitioning of regions during the investigation and simulation of SOC pool dynamics at a certain map scale,and be referenced to other landscape polygon patches' mesh partition.
文摘An unusual form of localized corrsion in copper tubes was detected early in service and in leakage tests after manufacturing.The morphology of this corrosion is similar to that of an ant's nest when viewed in cross section. The corrosion mechanisms, cases ofant's nest corrosion, and preventive measures are presented.
基金supported by the National Natural Science Foundation of China(Nos.22122905 and 22075301)。
文摘The development of new materials plays a critical role in improving the efficiency of organic solar cells(OSCs).At present,the relatively high-lying highest occupied molecular orbital(HOMO)level of the high-efficiency polymer donor is regarded as one of the main reasons for the low open-circuit voltage(V_(OC)).In this work,we introduced the strong electron-withdrawing thiazole unit into the construction of a polymer donor.We designed and prepared an alternating donor-acceptor material,namely PSZ,by copolymerizing 4-methyl thiazole with an electron-donating benzodithiophene unit and studied its application in high-efficiency OSCs.The optical and electrical properties of the new material were characterized by UV-Vis absorption spectroscopy and electrochemical cyclic voltammetry.Results show that PSZ is a typical wide-bandgap material with a high optical bandgap of 2.0 eV and a deep HOMO level of-5.70 eV.When a non-fullerene BTP-eC9 was selected as the acceptor material,V_(OC) reached 0.88 V in the resulting device,and the corresponding power conversion efficiency(PCE)was8.15%.In addition,when PSZ was added as the third component to the binary photoactive combination with PBDB-TF as the donor and BTP-eC9 as the acceptor,V_(OC) of the cell device could be increased,thereby obtaining a high PCE of 17.4%.These results indicated that introducing thiazole units into polymer donors can remarkably reduce the HOMO levels and improve V_(OC) and PCE in OSCs.
文摘This article will briefly outline the origins,structure and functions of United Nations Environment Program and the Commission on Sustainable Development in the context of the goals of ecologically sustainable development(ESD).Economic development,social development and environmental protection form the three interconnected parts of ESD.The achievements of the key UN environmental institutions and programs in opening up the global system to civil society,the private sector and a diversity of actors and interests,promoting the role of poverty alleviation as part of ESD through the Millennium Development Goals,and facilitating important Multilateral Environmental Agreements should be recognized.However,with these notable exceptions,organizations such as United Nations Environment Program and the Commission on Sustainable Development have become weak in scientific and technical leadership,global policy,co-ordination(inside and outside the UN) and has few achievements in the international and national implementation of obligations and standards in Global Environmental Governance-including enforcement,compliance and effectiveness.This article will outline the key reasons for this inadequacy.Attention will also be focused on the way forward through of a new United Nations Environment Organization.This will require a clarification of purpose and function(within the UN system and as part of global governance structures) as well as consideration of whether it depends on system-wide UN reform.It is recommended that medium and long term strategies for reform are necessary.
文摘BACKGROUND Early in the coronavirus disease 2019(COVID-19)pandemic,there was a significant impact on routine medical care in the United States,including in fields of transplantation and oncology.AIM To analyze the impact and outcomes of early COVID-19 pandemic on liver transplantation(LT)for hepatocellular carcinoma(HCC)in the United States.METHODS WHO declared COVID-19 as a pandemic on March 11,2020.We retrospectively analyzed data from the United Network for Organ Sharing(UNOS)database regarding adult LT with confirmed HCC on explant in 2019 and 2020.We defined pre-COVID period from March 11 to September 11,2019,and early-COVID period as from March 11 to September 11,2020.RESULTS Overall,23.5%fewer LT for HCC were performed during the COVID period(518 vs 675,P<0.05).This decrease was most pronounced in the months of March-April 2020 with a rebound in numbers seen from May-July 2020.Among LT recipients for HCC,concurrent diagnosis of non-alcoholic steatohepatitis significantly increased(23 vs 16%)and alcoholic liver disease(ALD)significantly decreased(18 vs 22%)during the COVID period.Recipient age,gender,BMI,and MELD score were statistically similar between two groups,while waiting list time decreased during the COVID period(279 days vs 300 days,P=0.041).Among pathological characteristics of HCC,vascular invasion was more prominent during COVID period(P<0.01),while other features were the same.While the donor age and other characteristics remained same,the distance between donor and recipient hospitals was significantly increased(P<0.01)and donor risk index was significantly higher(1.68 vs 1.59,P<0.01)during COVID period.Among outcomes,90-day overall and graft survival were the same,but 180-day overall and graft were significantly inferior during COVID period(94.7 vs 97.0%,P=0.048).On multivariable Coxhazard regression analysis,COVID period emerged as a significant risk factor of post-transplant mortality(Hazard ratio 1.85;95%CI:1.28-2.68,P=0.001).CONCLUSION During COVID period,there was a significant decrease in LTs performed for HCC.While early postoperative outcomes of LT for HCC were same,the overall and graft survival of LTs for HCC after 180 days were significantly inferior.
文摘Chinese unit residential buildings can be understood as a flexible urban element, and theintroduction of its concept changed the urban structure of China. In this study, starting from the constraintsof contemporary planning contexts by Chinese historical units, the categories of historical Chinese unitresidential buildings were analyzed, and how spatial order and social ties has made Chinese units becomea common framework within which collective living takes place, how does the political strategy of theChinese government creates and constructs a particular form of spatial order in each example of Chineseunit residential buildings, and the impact on the daily life of the urban population were studied. Finally,how social relations, politics, and economic strategies confront and interact within Chinese unit residentialbuildings was explored.
文摘Currently, 86% of the energy originates from fossil fuelsforelectricity. These are expected to run out, causing severe environmental damage threatening future generations. The total impact of Small and Medium Enterprises (SMEs) on the economy is significant. Solar cells harness the sun's energy to generate electricity in an environmentally friendly manner. This study compares silicon solar cells to flexible Organic Photovoltaic solar cells (OPV) for electricity energy for a micro-business in the UK and Iraq. It shows that it is feasible to replace existing fossil fuel sources with solar cells in Iraq due to a greater amount of solar radiation striking the earth's surface. Flexible solar cells can replace a proportion of the energy requirements in the UK and a larger proportion in Iraq. Using existing 20% efficient solar cells, 28% and 83% of the energy requirements of the microbusiness can be replaced in UK and Iraq respectively. Assuming 20% efficiency for solar cells placed on windows, 74% and 220% of the energy requirements of UK and Kurdistan can be replaced respectively and the surplus stored.
文摘Rationale: Recent studies have reported the effectiveness of the early introduction of rehabilitation for preventing muscle weakness in patients in the intensive care unit (ICU). The early introduction of full-scale rehabilitation by a physical therapist is difficult in some cases because of disease severity and/or patient conditions. However, mild mobilization by a nurse (MMN), as a part of standard care performed, may have a positive effect on patient recovery. We examined the effect of the early introduction of MMN on the recovery of patients in the ICU. Methods: We retrospectively examined patients admitted to Niigata University Hospital’s ICU during between April 2014 and March 2015 who were receiving mechanical ventilation for 7 days or more. Patients were divided into two groups according to the date of initiation of MMN: group L comprised patients for whom MMN was started after 72 hours and group E comprised patients for whom MMN was started within 72 hours after ICU admission. The data were analyzed using the Fisher test, Mann-Whitney U test, and Wilcoxon test. Statistical significance was defined as P Results: Sixty-three patients were included: 42 patients in group L and 21 in group E. There was no significant difference between the two groups in patients’ background, including the type of illness, steroid use, presence of sepsis or diabetes, and sequential organ failure assessment (SOFA) score on ICU admission;however, the SOFA score at ICU discharge was significantly decreased in group E compared to that in group L (6.21 versus 4.30;P = 0.034). Conclusion: Our results indicate that MMN may reduce disease severity if started within 72 hours after ICU admission.
文摘Ever since Lawrence Goodwyn published The Populist Moment, social historians have been keenly aware of the power culture represents when it comes to resistance. Historically, "movement culture" has been used to create a collective climate and offered political activists a springboard to discuss with the masses the benefits of joining a social movement. "Beyond the Dreams of Loveliness" uses the cultural outlet of film and the labor movement in the city of Detroit as analytical tools to examine working class community resistance throughout the 1930s. In the midst of the "golden age of film" community activists and union organizers--some of whom were well-known radicals and some of whom were mainstream unionists--used the institution of cinema to instill a level of class consciousness in the masses and mobilize the working class community against exploitation of employers, reactionary politicians, and white supremacist organizations. Movie-going had been a very popular form of recreation in Detroit since the 1920s and downtown theatres increasingly became the destination of an eclectic array of workers. Movie theaters themselves were bastions of community activity around the thirties and many were located in the heart of the city's working class district. Yet it was the films themselves that offered community activists and unionists a chance to converse with workers regarding the socio-economic matters of the day. Hollywood released a good number of films that dealt with working class issues and provided activists with ample opportunities to "instruct" the audience and carry on the discussion into the factory or union halls. "Beyond the Dreams of Loveliness" relies on a combination of oral histories, movie reviews, film clips, and union and/or working class organizational records to illuminate how activists in Detroit's working class community used film as an outlet to inspire working class resistance. In sum, film provided an accessible form of entertainment that proved to be effective on two fronts: It promoted increased group cooperation, friendship, and alliances while it also fostered a shared culture, making it easier for activists to organize workers in the coming struggles for unionism.