Background:Most sepsis patients develop sepsis-associated acute kidney injury(SA-AKI),which poses a significant threat to survival and lacks specific treatment.To date,there are no published randomized controlled tria...Background:Most sepsis patients develop sepsis-associated acute kidney injury(SA-AKI),which poses a significant threat to survival and lacks specific treatment.To date,there are no published randomized controlled trials that have established a link between albumin use and SA-AKI development in sepsis.Therefore,it is unclear whether albumin use may influence the risk of SA-AKI.Methods:The present study employed a target trial emulation using observational data to track adult sepsis patients initially admitted to the intensive care unit at Beth Israel Deaconess Medical Center,Boston,Massachusetts,for a period of 7 d from 2008 to 2022.Immortal time bias was controlled using the clone-censor-weight(CCW)method,along with a new-user design to address current user bias.The exposure variable was the early administration of albumin following the onset of sepsis.Based on albumin use,patients were classified into two groups:the albumin group(n=27,088)and the no albumin group(n=27,088).The primary outcome was the development of SA-AKI,and the secondary outcome was 7-day all-cause mortality.The primary outcome was analyzed using competing risk analyses.Furthermore,sensitivity and subgroup analyses were also performed.Results:Among the 27,088 patients analyzed,albumin administration was associated with a significantly higher SA-AKI risk(relative difference=3.47%,95%CI 1.76-5.23)compared to non-administration.There was no clinically meaningful difference in 7-day survival(relative difference=0.05%,95%CI-2.30 to 2.45).Sensitivity analyses consistently supported these results.All these analyses were conducted on data that were collected after CCW.Conclusions:Early albumin administration may increase the risk of SA-AKI in sepsis patients without conferring a short-term survival benefit.These results underscore the need for a rigorous risk-benefit assessment when incorporating albumin into sepsis resuscitation protocols and highlight the need for further clinical validation.However,it is important to exercise caution when interpreting the conclusions of this study,given its exploratory and preliminary nature.展开更多
Objective： To understand the effect of humanistic nursing care model wards in Children Caring Ward School （CCWS） on the nurses＇ caring ability. Methods： Questionnaire 25 nurses of humanistic nursing care model wa...Objective： To understand the effect of humanistic nursing care model wards in Children Caring Ward School （CCWS） on the nurses＇ caring ability. Methods： Questionnaire 25 nurses of humanistic nursing care model wards in CCWS using the Nkongho Caring Ability Inventory （CAI） before and after implement the humanistic nursing care model, including reform the systems of nursing care, introduce humanistic care model, implement the humanistic care, to measure the nurses＇ caring ability. Results： The nurses＇ caring ability had significantly developed on total, cognition dimension, courage dimension and patience dimension after all measures considered （p 〈 0.05）. Conclusions： The humanistic nursing care model wards in CCWS has a positive effect on the nurses＇ caring ability, not only to help build great relationships between nurses and patients but also to enhance the patients＇ satisfaction.展开更多
Yanshanian igneous rocks in the East China, on an orogenic belt scale, are characterized by the continental marginal arc in petrology and geochemistry as Andes and West USA, except for the Hercyn type biotite two mi...Yanshanian igneous rocks in the East China, on an orogenic belt scale, are characterized by the continental marginal arc in petrology and geochemistry as Andes and West USA, except for the Hercyn type biotite two mica muscovite granite belt in the Nanling region. Three segments of the Yanshanian igneous rocks along the belt are recognized. In terms of magma tectonic event sequence, the north, middle and south segments have counter clockwise (ccw), clockwise (cw) and ccw+cw pTt paths of the orogenic process, respectively. A genetic model of the lithospheric delamination (loss of the lithospheric root in about 120 km) in combination with the oceanic subduction for the Yanshanian Andes like orogenic belt and both the crust and lithosphere thickening for the Yanshanian Hercyn type Nanling orogenic belt in the East China is suggested.展开更多
IBM4341处理机,为了使其能与IBM 370系列机向上兼容,并在性能上有所改进和提高,采用了二套控制微码对机器硬件的操作进行控制。一套是S/370微码,它使 IBM 4341处理机保留了S/370处理机的操作性能;另一套是ECPS/VSE微码,在它的控制下,IBM...IBM4341处理机,为了使其能与IBM 370系列机向上兼容,并在性能上有所改进和提高,采用了二套控制微码对机器硬件的操作进行控制。一套是S/370微码,它使 IBM 4341处理机保留了S/370处理机的操作性能;另一套是ECPS/VSE微码,在它的控制下,IBM 4341处理机的性能得到了大大改善。在二套微码控制下,处理机操作的区别,在于对指令和通道所进行地址翻译方式的不同。展开更多
One of the big problems of the urban centres of the cities in Brazil is the growth of the generation of the Civil Construction Waste （CCW）. A disturbing concern for the public and private sectors is to find proper d...One of the big problems of the urban centres of the cities in Brazil is the growth of the generation of the Civil Construction Waste （CCW）. A disturbing concern for the public and private sectors is to find proper disposal of Urban Solid Waste （USW） in large cities, since suitable dumping sites for this waste are increasingly scarce due to the spread and development of large urban centres. In general, recycling is currently one of the procedures most studied by researchers for disposal of such waste. In this context and aiming a new application for recycled CCW aggregates, the research characterized the physical properties of the material to use in fill compaction piles in soil improvement. The analysis shows results from laboratorial tests executed in CCW recycled samples, which came from works in different construction stages from Recife-PE, and natural aggregate, adopted as a reference. Characterization tests were performed with samples CCW recycled CLue aggregates and samples of natural fine aggregate （stone powder）. The results of characterization tests showed similarities between the CCW samples tested and the reference samples, indicating that the civil construction wastes has potcntial use as material for consolidation piles in foundation works.展开更多
基金supported by grants from the National Institute of Biomedical Imaging and Bioengineering(NIBIB)of the National Institutes of Health(NIH)under award numbers R01-EB001659(2003-2013)and R01-EB017205(2014-2018)approved by the Institutional Review Boards of Beth Israel Deaconess Medical Center(Boston,MA)and the Massachusetts Institute of Technology(Cambridge,MA).
文摘Background:Most sepsis patients develop sepsis-associated acute kidney injury(SA-AKI),which poses a significant threat to survival and lacks specific treatment.To date,there are no published randomized controlled trials that have established a link between albumin use and SA-AKI development in sepsis.Therefore,it is unclear whether albumin use may influence the risk of SA-AKI.Methods:The present study employed a target trial emulation using observational data to track adult sepsis patients initially admitted to the intensive care unit at Beth Israel Deaconess Medical Center,Boston,Massachusetts,for a period of 7 d from 2008 to 2022.Immortal time bias was controlled using the clone-censor-weight(CCW)method,along with a new-user design to address current user bias.The exposure variable was the early administration of albumin following the onset of sepsis.Based on albumin use,patients were classified into two groups:the albumin group(n=27,088)and the no albumin group(n=27,088).The primary outcome was the development of SA-AKI,and the secondary outcome was 7-day all-cause mortality.The primary outcome was analyzed using competing risk analyses.Furthermore,sensitivity and subgroup analyses were also performed.Results:Among the 27,088 patients analyzed,albumin administration was associated with a significantly higher SA-AKI risk(relative difference=3.47%,95%CI 1.76-5.23)compared to non-administration.There was no clinically meaningful difference in 7-day survival(relative difference=0.05%,95%CI-2.30 to 2.45).Sensitivity analyses consistently supported these results.All these analyses were conducted on data that were collected after CCW.Conclusions:Early albumin administration may increase the risk of SA-AKI in sepsis patients without conferring a short-term survival benefit.These results underscore the need for a rigorous risk-benefit assessment when incorporating albumin into sepsis resuscitation protocols and highlight the need for further clinical validation.However,it is important to exercise caution when interpreting the conclusions of this study,given its exploratory and preliminary nature.
基金supported by the Fundamental Research Funds for the Central Universities,Huazhong University of Science and Technology(No.2014LC028)
文摘Objective： To understand the effect of humanistic nursing care model wards in Children Caring Ward School （CCWS） on the nurses＇ caring ability. Methods： Questionnaire 25 nurses of humanistic nursing care model wards in CCWS using the Nkongho Caring Ability Inventory （CAI） before and after implement the humanistic nursing care model, including reform the systems of nursing care, introduce humanistic care model, implement the humanistic care, to measure the nurses＇ caring ability. Results： The nurses＇ caring ability had significantly developed on total, cognition dimension, courage dimension and patience dimension after all measures considered （p 〈 0.05）. Conclusions： The humanistic nursing care model wards in CCWS has a positive effect on the nurses＇ caring ability, not only to help build great relationships between nurses and patients but also to enhance the patients＇ satisfaction.
文摘Yanshanian igneous rocks in the East China, on an orogenic belt scale, are characterized by the continental marginal arc in petrology and geochemistry as Andes and West USA, except for the Hercyn type biotite two mica muscovite granite belt in the Nanling region. Three segments of the Yanshanian igneous rocks along the belt are recognized. In terms of magma tectonic event sequence, the north, middle and south segments have counter clockwise (ccw), clockwise (cw) and ccw+cw pTt paths of the orogenic process, respectively. A genetic model of the lithospheric delamination (loss of the lithospheric root in about 120 km) in combination with the oceanic subduction for the Yanshanian Andes like orogenic belt and both the crust and lithosphere thickening for the Yanshanian Hercyn type Nanling orogenic belt in the East China is suggested.
文摘IBM4341处理机,为了使其能与IBM 370系列机向上兼容,并在性能上有所改进和提高,采用了二套控制微码对机器硬件的操作进行控制。一套是S/370微码,它使 IBM 4341处理机保留了S/370处理机的操作性能;另一套是ECPS/VSE微码,在它的控制下,IBM 4341处理机的性能得到了大大改善。在二套微码控制下,处理机操作的区别,在于对指令和通道所进行地址翻译方式的不同。
文摘One of the big problems of the urban centres of the cities in Brazil is the growth of the generation of the Civil Construction Waste （CCW）. A disturbing concern for the public and private sectors is to find proper disposal of Urban Solid Waste （USW） in large cities, since suitable dumping sites for this waste are increasingly scarce due to the spread and development of large urban centres. In general, recycling is currently one of the procedures most studied by researchers for disposal of such waste. In this context and aiming a new application for recycled CCW aggregates, the research characterized the physical properties of the material to use in fill compaction piles in soil improvement. The analysis shows results from laboratorial tests executed in CCW recycled samples, which came from works in different construction stages from Recife-PE, and natural aggregate, adopted as a reference. Characterization tests were performed with samples CCW recycled CLue aggregates and samples of natural fine aggregate （stone powder）. The results of characterization tests showed similarities between the CCW samples tested and the reference samples, indicating that the civil construction wastes has potcntial use as material for consolidation piles in foundation works.
