Multidrug-resistant organisms in intensive care units and logistic analysis of risk factors

BACKGROUND Intensive care unit(ICU)patients are critically ill and have low immunity.They will undergo various trauma medical procedures during diagnosis and treatment.The use of high-dose hormones and broad-spectrum antibiotics will increase the incidence of nosocomial infection in ICU patients.Therefore,it is necessary to explore the causes of nosocomial infection in ICU and provide basis for the prevention and control of nosocomial infection in ICU.AIM To explore major pathogens of nosocomial infection in ICUs,methods of detection and drug resistance trends.METHODS Risk factors of multidrug-resistant infection were analyzed to provide a basis for clinical rational use of antimicrobial drugs in the ICU.These findings were used to standardize rational use of antimicrobial agents.BD PhoenixTM100 automatic bacterial identification analyzer was used to for cell identification in specimens collected from the ICU between January 2016 and December 2019.Drug sensitivity tests were carried out and drug resistance trends were analyzed using the optical disc diffusion method.Odds ratios and corresponding 95%CI of independent variables were calculated using a logistic regression model.Backward elimination(trend=0.1)was used as an inclusion criterion for multivariate analysis.All data were analyzed using SPSS version 22.0,and P<0.05 was considered statistically significant.RESULTS We collected 2070 samples from ICU patients between January 2016 and December 2019.Sample types comprised sputum(1139 strains,55.02%),blood(521 strains,25.17%),and drainage fluid(117 strains,5.65%).A total of 1051 strains of major pathogens,including Acinetobacter baumannii,Escherichia coli(E.coli),Pseudomonas aeruginosa(P.aeruginosa),Klebsiella pneumoniae(K.pneumoniae)and Staphylococcus aureus,were detected,with a detection rate of 35.97%(378/1051).Most of these strains were resistant to antibiotics.Detection rate of E.coli was 21.79%(229/1051),and it was generally sensitive to many antimicrobial drugs.Detection rate of P.aeruginosa was 24.74%(260/1051),and showed low sensitivity to most antibiotics.Detection rate of K.pneumoniae was 9.42%(99/1051),which was generally resistant to multiple antimicrobial drugs and resistant forms.K.pneumoniae was resistant to imipenem for approximate 4 years,and showed a 19.9%(19/99)and 20.20%(20/99)rate of meropenem resistance.Logistic analysis showed that mechanical ventilation and ureteral intubation were risk factors for multidrug-resistant bacterial infections.CONCLUSION This study showed a high incidence of ICU infections.Mechanical ventilation and urine tube intubation were risk factors for infection with multidrug-resistant bacteria.

Risk factors for infection with multidrug-resistant organisms in diabetic foot ulcer patients:A systematic review and meta-analysis

Objective:To systematically evaluate the risk factors for multidrug-resistant organisms(MDROs)infection in patients with diabetic foot ulcer(DFU).Methods:The quality assessment of outcome measures was performed by searching the Web of Science,Embase library,PubMed,Cochrane Library databases and screening the literature on the risk factors of MDROs infection in DFU patients according to the inclusion and exclusion criteria,and meta-analysis was performed using revman5.3 analysis software.Results:13 literature was retrieved,involving in 1715 patients.A total of 15 risk factors were included in the analysis and the meta-analysis showed that Previous hospitalization(OR=2.61,95%CI[1.51,4.52],P=0.0006),Previous antibiotic use(OR=2.17,95%CI[1.24-3.78],P<0.01),Type of diabetes(OR=2.44,95%CI[1.29-4.63],P<0.01),Nature of ulcer(OR=2.16,95%CI[1.06-4.40],P=0.03),Size of ulcer(OR=2.56,95%CI[1.53-4.28],P<0.01),Osteomyelitis(OR=3.50,95%CI[2.37-5.17],P<0.01),Peripheral vascular disease(OR=2.37,95%CI[1.41-3.99],P<0.01),and Surgical treatment(OR=4.81,95%CI[2.95-7.84],P<0.01)were closely associated with MDROs infection in DFU patients.Conclusions:The risk factors of MDROs infection in patients with DFU were previous hospitalization,previous antibiotic use,type of diabetes,nature of ulcer,size of ulcer,osteomyelitis,peripheral vascular disease,and surgical treatment.This study is conducive to early detection of MDROs infection in high-risk groups and timely comprehensive treatment to delay the development of the disease.

Effects of Different Land Use Types on Soil Organic Carbon and Carbon Management Index in Karst Area

[Objective] The aim was to reveal changes of soil organic matter fraction and their corresponding carbon management indexes as affected by different land use types.[Method]Soil organic carbon,active soil organic carbon and soil carbon management index（CMI）of different land use types in Guilin Maocun karst area were studied.Sampling with field investigation and laboratory testing was carried out.Heavy potassium chromate method was adopted to determine soil organic matter.333 mmol/L KMnO4 oxidation method was used to determine active organic carbon.[Result]With active soil organic matter increasing,the differences of CMI between different land use types were bigger.The CMI value of different land uses was shrubforest paddy fielddry farmland.The statistical analysis showed that labile organic matter was related with major soil properties at a significant level.[Conclusion]Labile organic matter could be used to reveal the influence of different land use types on soil organic matter and carbon management index in karst area.

Effect of Management Practices on Seasonal Dynamics of Organic Carbon in Soils Under Bamboo Plantations

Soil samples for conventional management (CM) and intensive management (IM) practices were taken over a year at 2-month intervals to determine the effect of management practices on soil organic carbon (SOC) and to quantify seasonal dynamics in SOC for bamboo (Phyllostachys pubescens Mazel ex H. de Lehaie) stands. The results with IM compared to CM showed large decreases in total organic carbon (TOC), microbial biomass carbon (MBC), water-soluble organic carbon (WSOC), and the MBC/TOC ratio in the soils. With all IM plots in the 0-20 cm depth across sampling periods, average decreases compared with CM were: TOC, 12.1%; MBC, 26.1%; WSOC, 29.3%; the MBC/TOC ratio, 16.1%; and the WSOC/TOC ratio, 20.0%. Due to seasonal changes of climate, seasonal variations were observed in MBC and WSOC. Soil MBC in the 0-20 cm depth in September compared to May were 122.9% greater for CM and 57.6% greater for IM. However, due primarily to soil temperature, soil MBC was higher during the July to November period, whereas because of soil moisture, WSOC was lower in July and January. This study revealed that intensive management in bamboo plantations depleted the soil C pool; therefore, soil quality with IM should be improved through application of organic manures.

Global pattern and change of cropland soil organic carbon during 1901-2010: Roles of climate, atmospheric chemistry, land use and management

Soil organic carbon(SOC)in croplands is a key property of soil quality for ensuring food security and agricultural sustainability,and also plays a central role in the global carbon(C)budget.When managed sustainably,soils may play a critical role in mitigating climate change by sequestering C and decreasing greenhouse gas emissions into the atmosphere.However,the magnitude and spatio-temporal patterns of global cropland SOC are far from well constrained due to high land surface heterogeneity,complicated mechanisms,and multiple influencing factors.Here,we use a process-based agroecosystem model(DLEM-Ag)in combination with diverse spatially-explicit gridded environmental data to quantify the long-term trend of SOC storage in global cropland area during 1901-2010 and identify the relative impacts of climate change,elevated CO2,nitrogen deposition,land cover change,and land management practices such as nitrogen fertilizer use and irrigation.Model results show that the total SOC and SOC density in the 2000s increased by 125%and 48.8%,respectively,compared to the early 20th century.This SOC increase was primarily attributed to cropland expansion and nitrogen fertilizer use.Factorial analysis suggests that climate change reduced approximately 3.2%(or 2,166 Tg C)of the total SOC over the past 110 years.Our results indicate that croplands have a large potential to sequester C through implementing better land use management practices,which may partially offset SOC loss caused by climate change.

Forest management causes soil carbon loss by reducing particulate organic carbon in Guangxi, Southern China

Background: The loss of soil organic carbon(SOC) following conversion of natural forests to managed plantations has been widely reported. However, how different SOC fractions and microbial necromass C(MNC) respond to forest management practices remains unclear.Methods: We sampled 0–10 cm mineral soil from three different management plantations and one protected forest in Guangxi, Southern China, to explore how forest management practices affect SOC through changing mineralassociated C(MAOC) and particulate organic C(POC), as well as fungal and bacterial necromass C.Results: Compared with the protected forest, SOC and POC in the abandoned, mixed and Eucalyptus plantations significantly decreased, but MAOC showed no significant change, indicating that the loss of SOC was mainly from decreased POC under forest management. Forest management also significantly reduced root biomass, soil extractable organic C, MNC, and total microbial biomass(measured by phospholipid fatty acid), but increased fungi-to-bacteria ratio(F:B) and soil peroxidase activity. Moreover, POC was positively correlated with root biomass, total microbial biomass and MNC, and negatively with F:B and peroxidase activity. These results suggested that root input and microbial properties together regulated soil POC dynamics during forest management.Conclusion: Overall, this study indicates that forest management intervention significantly decreases SOC by reducing POC in Guangxi, Southern China, and suggests that forest protection can help to sequester more soil C in forest ecosystems.

Research on the origin and evolution of technical management regulations for railway

Purpose–To facilitate technical managers and field workers to master and understand the provisions of Technical Management Regulations for Railway more accurately,so as to better serve the comprehensive revision of the Regulations,this paper carries out the research on the traceability and evolution of the provisions of the Regulations.Design/methodology/approach–This paper studies and analyzes the evolution of the 11th edition of the Regulations by analyzing the relevance of clauses and summarizes the historical background of the development of calendar editions of the Regulations.The basic research on the traceability and evolution of the Regulations is carried out from four aspects:the continuity of the development of the Regulations,the authority of contents,the relevance of clauses and the richness of historical materials.Findings–From the first edition of the Regulations issued by the former Ministry of Railways in 1950 to the 11th edition,there have been ten comprehensive revisions.There is a strong correlation and continuity between the calendar editions of the Regulations in terms of chapter structure and clauses.Studying the context of the terms of the Regulations is an important way to understand and master the current clauses of the Regulations.Originality/value–Through the research on the traceability and evolution of the clauses of the Regulations,one is to explore the context of the development of railway technical equipment in China,the other is to clarify the historical background when the provisions were formulated and the third is to trace the development and evolution of the provisions.The revision of the Regulations is based on an accurate grasp of the context of the provisions,which can effectively judge the possible security risks caused by the revision of the provisions and avoid the possible risks in field implementation from the source.

The Planning, Organization and Management of Post-disaster Reconstruction of the Lushan Earthquake Based on the Local as the Main Body

A new organization and management mechanism with the local government as the main body was created during the post-disaster reconstruction of the "4. 20 " Lushan earthquake,in which the experiences and lessons were drawn from the "5. 12"Wenchuan earthquake. Correspondingly, the local government conducted an exploration of the organization and management mode in the field of planning and construction. The effective experiences have been accumulated, including working out a full coverage planning,taking the leading part in the urban-rural planning,and exercising whole space control over the disaster area. An innovation management mode named as "Five Generals Pattern"was implemented in the construction projects. In view that the rural housing reconstruction was a weak link, a new approach to improving the construction management was investigated,by means of strengthening on-site supervision,establishing a technical platform,and bolstering public participation.

Self-Organized Public-Key Management for Mobile Ad Hoc Networks Based on a Bidirectional Trust Model

In traditional networks , the authentication is performed by certificate authoritys（CA）,which can＇t be built in distributed mobile Ad Hoc Networks however. In this pa per, we propose a fully self-organized public key management based on bidirectional trust model without any centralized authority that allows users to generate their public-private key pairs, to issue certificates, and the trust relation spreads rationally according to the truly human relations. In contrast with the traditional self-organized public-key management, the average certificates paths get more short, the authentication passing rate gets more high and the most important is that the bidirectional trust based model satisfys the trust re quirement of hosts better.

Assessment of System of Rice Intensification(SRI) and Conventional Practices under Organic and Inorganic Management in Japan

The system of rice intensification(SRI) is a production system that involves the adoption of certain changes in management practices for rice cultivation that create a better growing environment for the crop.This system was compared with conventional practices and assessed under organic and inorganic management.SRI practices showed significant response in root number,number of effective tillers per hill,days to flowering and harvest index.In addition,SRI was found effective in minimizing pest and disease incidence,shortening the crop cycle,and improving plant stand.Grain yield was not different from conventional method.Except for harvest index and plant lodging percentage,there were no significant effects from management treatments.Synergistic responses were noted when SRI practices were combined with organic management for plant height,number of effective tillers per hill,days to flowering and to maturity.The improved panicle characteristics,lower plant lodging percentage and higher harvest index that ultimately led to comparable grain yields.Net returns increased approximately 1.5 times for SRI-organic management regardless of the added labor requirements for weed control.However,comparatively higher grain yield from conventional-inorganic methods underscore the need for further investigations in defining what constitutes an optimum set of practices for an SRI-organic system specifically addressing grain yield and weed management.

Gossip-Based Topology Management Protocol for Self-Organizing Overlays

Gossip-based protocols have attracted more and more attention because of their simplicity and reliability.They can be applied to large-scale overlays for solving problems such as topology management,information dissemination,and aggregation.However,previous works sample nodes by their indegrees,without considering the differences in capability among nodes,and result in losing global load balancing.This paper proposes a load balancing gossip protocol for self-organizing overlays-LBTMP(Load-Balancing Topology Management Protocol),which takes into account the differences in capability among nodes and real loads.The novel protocol takes remainder service ability as the determinant for node selection metric,making light loading nodes from local neighbor view as returned samples preferentially.In the meantime,LBTMP selects light loading nodes preferentially for topology information exchange,which can diffuse light loading nodes over the whole overlay more quickly.Simulations show that returned sample node selection is biased to light loading nodes in a global view,and the overlay tends to load balancing.

NonOperative Management of Blunt Solid Abdominal Organ Injury in Calabar, Nigeria

Background: Over the past several years, nonoperative management has been increasingly recommended for the care of selected blunt abdominal trauma patients with solid organ injuries. Objective: To evaluate the pattern and outcome of blunt abdominal trauma using haemodynamic stability and ultrasonography in the selection of patients for nonoperative management in a facility without computed tomogram. Methods: Patients admitted with blunt abdominal trauma between February 2005 and January 2010 were prospectively studied. Haemodynamic stability and sonography formed the basis for selecting patients for nonoperative management. Results: In total, 58 patients suffered blunt abdominal trauma and 19(33%) patients were successfully managed nonoperatively suffered blunt solid abdominal organ injuries. Road traffic accidents inflicted 17(89%) patients while 2(11%) patients sustained sports injury (football). The spleen was the commonest solid organ injured 12(60%), while the liver and kidney were injured in 6(30%) and 2(10%) respectively. Associated injuries were fractured left femur recorded in 3(16%) patients and fractured rib in a patient (5%). Conclusion: Nonoperative treatment is a safe and effective method in the management of haemodynamically stable patient with blunt solid abdominal organ injury. This translated to a reduction in hospital stay, absence of the risk of blood transfusion as well as attendant morbidity and mortality associated with laparotomy. Establishment of trauma system, provision of diagnostic and monitoring facilities, good roads, and education on road safety is recommended for improved outcome.

Cassava Groundnut Intercropping: A Sustainable Land Management Practice for Increasing Crop Productivity and Organic Carbon Stock on Smallholder Farms

Cassava-groundnut intercropping is not a common practice among smallholder farmers in Sierra Leone even though both crops are well suited for intercropping. On-farm trials were conducted in three locations (Bai Largor, Bassah, and Njala Kanima) in the Moyamba district during the 2021 cropping season to investigate the efficacy of cassava-groundnut intercropping for increasing crop productivity and soil organic carbon stock on smallholder farms in the Moyamba district, Southern Sierra Leone. The experimental design was a randomized complete block design in three replications with treatments of sole groundnut, sole cassava and cassava-groundnut intercropping. Data on the yield and yield components of cassava and groundnut were analysed using the PROC MIXED procedure of SAS 9.4 and means were compared using the standard error of difference (SED). The above-ground biomass, number of roots per plant, and fresh root yield of cassava were not significantly (p > 0.05) affected by the cassava-based cropping system. Averaged across locations, intercropping cassava with groundnut decreased the above-ground biomass, the number of roots per plant, and fresh root yield of cassava by 17%, 11%, and 17%, respectively. The above-ground biomass, number of pods per plant and fresh pod yield of groundnut were significantly (p 1), the highest net revenue and benefit-cost ratio. The benefit-cost ratio was also favourable for the sole cassava (BCR > 1) but not favourable for the sole groundnut (BCR < 1). Averaged across locations, intercropping cassava with groundnut increased the benefit-cost ratio by 121% and 13% when compared to the sole groundnut and sole cassava. In the event of a 40% yield loss for the cassava and groundnut, the benefit-cost ratio was favourable (1.12) only for the cassava groundnut intercropping system. The net soil organic carbon stock was favourable only for the cassava-groundnut intercrop. Averaged across locations, the net soil organic carbon for the cassava-groundnut intercropping increased by 3.4% when compared to the baseline within one cropping cycle of the cassava (12 months). The results confirm that cassava-groundnut intercropping is a sustainable land management practice that could enhance crop productivity and soil organic carbon stock on smallholder farms.

Rethinking Project Organization and Management

How projects should be organized and managed are two important aspects of the role that Project Managers perform and the processes involved can be linked to the measurement of the project management outcome. Recent studies indicate that these processes are not implemented and concerns have been raised. The authors present an investigation into the current practices of the three soft project management subject matters of selecting project team members, structuring the teams and the management style followed in the construction industry in UK and their reflection upon the project management outcome. The results confirm the concerns raised and indicate that the current levels of implementation by practitioners delivers only acceptable as opposed to successful level of project management outcome. The findings call for a reconsideration of the approach taken when deciding how to organize and manage project teams and a redress towards improving project management outcome.

Participatory and integrated watershed management and community based organgzanon

In Iran, and in order to encourage local watershed management, community based organizations （CBO） like ＂cooperatives of watershed＂, ＂construction groups＂ and ＂watershed management groups＂ have been established to obtain resident＇s cooperation in activities eormeeted with protection, reclamation and exploitation of natural resources in the basins that lead to sustainability within watershed management. This study was done as a ease study to explore the role of Remeleh Group （RG） as a CBO in the management of the ＂Kharkheh＂ sub-basin. Participatory action and learning method was used. Participatory tools including natural resources mapping, flow diagram, transect walk, semi-structured interview and brainstorming were applied. Making the conclusion, it was found that the CBO of Remeleh Group cause： （1） Enhancement of social capital through encouraging cooperation and participatory practices, creating new communication among local residents and outsiders, reducing conflicts and promoting the solidarity among communities in the sub basin of Karldaeh; （2） Sustain livelihood and economic situation through agricultural intensification and livelihood diversification （gardening and agriculture together and reducing migration）; （3） Conservation of environmental and natural recourses via the implementation of watershed activities like vine, terracing, bunding and destocking, seedling, and check dams; （4） Empower local people through carrying out training on the watershed practices.

Can adequate hemodynamic management of brain-dead donors improve donor organ procurement?

There is increasing evidence that adequate donor management with a goal of optimization of organ function is essential to maximize the number of organs that can be procured.Therefore,identification of the cause of hemodynamic instability is crucial in order to direct the right therapy.Several donor management goals for better hemodynamic management including serial echocardiography can guide hemodynamic management in potential donors to increase both number and quality of donor hearts.

Intellectual Capital in Knowledge Management Organizations

This paper templet is copyright by Global Conference on Business and Social Science organized by Global Academy of Training&Research(GATR)Enterprise.Intellectual capital and knowledge are the most important assets of most organizations to ensure that determined or intended strategies can be implemented.The resource-based view of the firm considers the firm as a bundle of tangible resources,intangible resources,and organisational capabilities.An effective IC refers to the critical issues of organisational adaptation,survival and competence in the face of discontinuous environmental change.KM is essential for retaining employees’knowledge within a firm by using appropriate technology and tools to capture and store the knowledge residing in the minds of its employees,so it can be easily shared and reused.There is a growing realisation of the importance of the development and understanding of theory for both Intellectual Capital and Knowledge Management in relation to guide the successful development of Knowledge Management Organisations.This study is fundamental because it will provide the whole picture about the different levels of knowledge;individual,group and organizational,which express internal knowledge(formal and informal knowledge)and external knowledge such as customers and suppliers.The aim of this study is addressed some of the gaps in Intellectual Capital literature.It is necessary to investigate the interactions between IC components in Knowledge management organizations,which include human capital(HC),Organizational capital(OC),and Relational capital(RC).This is important in order to discover the extent to which these factors work together to achieve a network’s knowledge management in organization.

Impacts of Rice Field Winter Planting on Soil Organic Carbon and Carbon Management Index

To tackle with the problem of prevailing farmland abandonment in winter,5 treatments includes Chinese milk vetch-double cropping rice(CRR),rape-double cropping rice(RRR),garlic-double cropping rice(GRR),winter crop multiple cropping rotation(ROT),winter fallow control(WRR)were set up.By measuring soil total organic carbon,active organic carbon and its components and calculating the soil carbon pool management index in 0~15 cm and 15~30 cm soil layers in the early and late rice ripening stage.The effects of different winter planting patterns on the changes of soil organic carbon and carbon pool management index were discussed.In order to provide theoretical basis for the optimization and adjustment of winter planting pattern of double cropping rice field in the middle reaches of Yangtze River.The results showed that soil total organic carbon,active organic carbon and its components in different winter cropping patterns were increased,and ROT and CRR treatments were more beneficial to the accumulation of soil total organic carbon,active organic carbon and its components as well as the improvement of soil carbon pool management index,which should be preferred in the adjustment of cropping patterns.

Study on the Issue with Optimization of Enterprise Organization Management and the Solutions

After the introduction of"corporate governance"in China,the organization and management of enterprises have been comprehensively updated,and the multiple functions and values of enterprise organization and management have been recognized.This paper,with the enterprise organization and management optimization problems and solutions as the research topic,analyzes the connotation of organization management as well as the problems existing in the optimization of enterprise organization management,and puts forward some solutions.