Copper Clusters Containing Hydrides in Trigonal Pyramidal Geometry

International audienceStructurally precise copper hydrides [CuH{SP(OPr)}(C≡CR)], R = Ph (1), CHF (2), and CHOMe (3), were first synthesized from the polyhydrido copper cluster [CuH{SP(OPr)}] with nine equivalents of terminal alkynes. Later, their isolated yields were significantly improved by direct synthesis from [Cu(CHCN)](PF), [NH][SP(OPr)], NaBH, and alkynes along with NEt in THF. 1, 2, and 3 were fully characterized by single-crystal X-ray diffraction, ESI-MS, and multinuclear NMR spectroscopy. All three clustershave 11 copper atoms, adopting 3,3,4,4,4-pentacapped trigonal prismatic geometry, with two hydrides inside the Cu cage, the position of which was ascertained by a single-crystal neutron diffraction structure of cluster 1 co-crystallized with a [Cu(H){SP(OPr)}] (4) cluster. Six dithiophosphate and three alkynyl ligands stabilize the CuH core in which the two hydrides adopt a trigonal pyramidal coordination mode. This coordination mode is so far unprecedented for hydride. The H NMR resonance frequency of the two hydrides appears at 4.8 ppm, a value further confirmed by H NMR spectroscopy for their deuteride derivatives [Cu(D){SP(OPr)}(C≡CR)]. A DFT investigation allows understanding the bonding within this new type of copper(I) hydrides

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London

Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study

Background: Surgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world. Methods: This international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the GlobalSurg 1 study and other studies that have been found to affect the likelihood of SSI were entered into risk adjustment models. The primary outcome measure was the 30-day SSI incidence (defined by US Centers for Disease Control and Prevention criteria for superficial and deep incisional SSI). Relationships with explanatory variables were examined using Bayesian multilevel logistic regression models. This trial is registered with ClinicalTrials.gov, number NCT02662231. Findings: Between Jan 4, 2016, and July 31, 2016, 13 265 records were submitted for analysis. 12 539 patients from 343 hospitals in 66 countries were included. 7339 (58·5%) patient were from high-HDI countries (193 hospitals in 30 countries), 3918 (31·2%) patients were from middle-HDI countries (82 hospitals in 18 countries), and 1282 (10·2%) patients were from low-HDI countries (68 hospitals in 18 countries). In total, 1538 (12·3%) patients had SSI within 30 days of surgery. The incidence of SSI varied between countries with high (691 [9·4%] of 7339 patients), middle (549 [14·0%] of 3918 patients), and low (298 [23·2%] of 1282) HDI (p < 0·001). The highest SSI incidence in each HDI group was after dirty surgery (102 [17·8%] of 574 patients in high-HDI countries; 74 [31·4%] of 236 patients in middle-HDI countries; 72 [39·8%] of 181 patients in low-HDI countries). Following risk factor adjustment, patients in low-HDI countries were at greatest risk of SSI (adjusted odds ratio 1·60, 95% credible interval 1·05–2·37; p=0·030). 132 (21·6%) of 610 patients with an SSI and a microbiology culture result had an infection that was resistant to the prophylactic antibiotic used. Resistant infections were detected in 49 (16·6%) of 295 patients in high-HDI countries, in 37 (19·8%) of 187 patients in middle-HDI countries, and in 46 (35·9%) of 128 patients in low-HDI countries (p < 0·001). Interpretation: Countries with a low HDI carry a disproportionately greater burden of SSI than countries with a middle or high HDI and might have higher rates of antibiotic resistance. In view of WHO recommendations on SSI prevention that highlight the absence of high-quality interventional research, urgent, pragmatic, randomised trials based in LMICs are needed to assess measures aiming to reduce this preventable complication

The Research on the Acquaintance and Executability of Green Wedding Reception in Terms of Wedding Potential Consumers and Suppliers.

　　Environmental Protection Administration (EPA) in 2012 promoted “a hundred- year couples of low-carbon wedding activity” to raise the citizen’s, wedding suppliers’, catering traders’, and wedding adviser companies’ cognitions toward the low-carbon wedding started in the wedding waves of Centennial. To encourage the newly weds to elaborate creations, the government prepares a low-carbon wedding guidebook for the healthy and environmental low-carbon wedding. Recently, some newly weds also incorporated environmental protection, social care and green consumption into the wedding. 　　According to some researches, the largest amount of spending money in operating wedding process is the wedding reception (Zhou, 2008). The wedding reception has a great significance for Chinese on the traditional concepts. It become especially important for the newly wed’s parents to compare the wealth and magnificence (Liu, 2000). Nontheless, many creative thoughts have been gradually influenced by the time changes and environmental consciousness. Thus, the purpose of this study is to discuss the wedding consumers and wedding suppliers toward the conceptual cognitions and performing recognitions of “green wedding receptions”. 　　This study develops the questions from the low-carbon wedding guidebook published by EPA, and then chooses nine wedding suppliers to have a deep interview, at the same time produces a questionnaire to survey the latent wedding consumers. The study shows that only part of wedding reception suppliers have cognitions about the green wedding reception. However, if the government can promote the concept powerfully, provide the performing plan and the consumers are willing to support the green wedding reception, the suppliers will have a highly performing recognition. Also, through our survey shows that the actual and most important descision makers of the wedding consuming place are newly weds’ parents, and the newly couples come in second. Therefore, the concept of green wedding reception should be greatly promulgated to the newly weds’ parents. The latent consumers feel highly cognitions and recognitions to the partial content of implementing the guided green wedding receptions, but they cannot be fully carry out in the implementation. It is said the reason may be the civil wedding reception suppliers cannot provide the supporting green wedding reception for consumers to choose. 　　Although vegetable food can lower the carbon emission, through the research studies, we can know that green wedding reception is not a vegetarian diet but a focus on the productions of food origin, the growing quality, and cooking ways to lower the impact toward the environment. To strength the call for the healthy diet for the modern people and attain the supply and demand balancing protection for the earth and eco-environment, the green wedding reception will be accepted and carried out by the public.　　2012年行政院環境保護署，為提升國人、婚紗業者、餐飲業者及婚禮顧問公司對低碳婚禮的認知度，於建國百年結婚熱潮湧現開始，推動「百年琴瑟低碳婚禮活動」，鼓勵新人發揮創意舉行健康且環保的低碳婚禮，特此製作低碳婚禮指引手冊。近年來的確有新人於婚禮與婚宴中融入了環境保護、社會關懷與綠色消費等概念。 　　執行婚禮運作流程中所消費金額以婚宴占最大宗(卓怡君，2008)，婚宴在中國人的傳統概念中深具意義，通常亦是長輩們間接比較財富與氣派程度的場合(劉鳳媛，2000)，但隨著時代變遷新人們已漸融入現代西方婚禮運作概念，有許多創新的思維，因應時代變遷與環保意識抬頭，本研究嚐試探討潛在婚宴消費者與婚宴供給者對「綠色婚宴」概念認知與執行認同度。 　　本研究以行政院環境保護署所發行之低碳婚禮指引手冊(2012)中發展出研究問卷，選擇九家婚宴供給者進行深入訪談，及對五百位潛在婚宴消費者實施問卷調查。研究發現，對婚宴供給者而言，唯有部分業者對綠色婚宴有所認知，但若政府可大力推廣觀念與提出執行方案加上消費者願意支持綠色婚宴，業者則對綠色婚宴有高度執行認同。對潛在婚宴消費者而言，決定婚宴消費模式與地點其決策者以新人的父母親居多，其次才是準新人，所以綠色婚宴應對正確的消費族群加以推廣，潛在婚宴消費者對綠色婚宴實施指引中部分內容感到認知與認同，但在執行上卻無法完全落實，其原因推測為坊間婚宴供給者無法完全提供綠色婚宴配套供消費者選擇外，其綠色婚宴之執行理念亦須突破許多傳統婚宴上的思維。 　　雖然素食可減少碳排放量，但透過研究資料整理可知，綠色婚宴並不完全等同素食婚宴，而是在葷、素食材中著重產地來源、生長環境品質、葷素食材使用的比例與烹調料理的方式以降低對環境的衝擊，強化現代人對健康飲食的訴求，對地球與生態環境加以維護取得供需平衡而設計的綠色婚宴，才可被大眾所接受執行與推廣。誌謝辭　i 中文摘要　іі 英文摘要　ііі 內容目錄　v 表目次　vii 圖目次　ix 第一章 緒論 第一節 研究背景與動機　1 第二節 研究目的與問題　3 第三節 名詞釋義　4 第四節 研究流程　4 第二章 文獻探討 第一節 綠色消費的定義　6 第二節 婚禮與婚宴的演變與婚禮市場經濟規模　8 第三節 低碳綠色婚禮執行現況　12 第三章 研究方法 第一節 質性研究設計　16 第二節 量化研究設計　21 第四章 研究結果與分析 第一節 回收樣本特性分析　33 第二節 傳統婚宴、婚宴前置作業、婚宴餐食供應問項之分析　35 第三節 綠色婚宴、場地佈置決策、場地設備決策、購買決策問項分析　38 第四節 質性訪談資料分析　42 第五章 研究結論與建議 第一節 研究結論　57 第二節 研究限制　60 第三節 後續研究建議　61 參考文獻　62 附錄 附錄一　潛在婚宴消費者正式問卷　65 附錄二 W1業者訪談內容逐字稿　70 附錄三 W2業者訪談內容逐字稿　75 附錄四 W3業者訪談內容逐字稿　80 附錄五 W4業者訪談內容逐字稿　83 附錄六 H1業者訪談內容逐字稿　86 附錄七 H2業者訪談內容逐字稿　88 附錄八 H3業者訪談內容逐字稿　93 附錄九 R1業者訪談內容逐字稿　96 附錄十 R2業者訪談內容逐字稿　10

Century galaxy group: The price of compassion

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Empty nose syndrome treated by autologous auricular cartilage turbinate augmentation: a case report

Empty nose syndrome (ENS), once viewed as a psychological issue, is now a recognized complication of turbinate surgery. It is most frequently associated with total turbinate excision. Its symptoms include chronic dryness of the nose and pharynx, paradoxical obstruction of the nose, feeling of suffocation, lack of airflow sensation, and even neuropathic pain. It may cause severe stress upon the patient resulting in mood instability issues. Surgical treatment to augment turbinate volume has been reported to be an effective treatment method. We would like to report a case of ENS treated by autologous auricular cartilage turbinate augmentation

How do East and Southeast Asian Cities Differ from Western Cities? A Systematic Review of the Urban Form Characteristics

The Fifth Assessment Report released by the Intergovernmental Panel on Climate Change (IPCC AR5) revealed that the scale of greenhouse gas (GHG) emissions in Asian cities is similar to those from developed economies, which are driven predominantly by economic growth. Due to variations in geographic and climatic contexts, culture and religion, living style and travel behavior, governance and institutions, and a wide range of density and land use mixes, there are significant variations in urban form patterns across Western and Asian cities. This paper uses a systematic review, which is a critical interpretive synthesis methodology, to review keywords of studies related to urban form among East and Southeast Asian cities. From 3725 records identified through database searching, 213 studies were included in qualitative analysis. The results show that, although the population density in built-up areas is higher, annual population density is declining significantly in East and Southeast Asia. In addition, there are various kinds of land use mixes including horizontal, vertical, and temporal forms. As a whole, the inconsistencies of urban form characteristics exist not only between Western and Asian cities, but also among Asian cities. Serious population density decreases in Asian cities might indicate that they are undergoing similar urban development processes to those of Western cities. We should be aware of the potential lock-in trends of urban development patterns in Chinese and Southeast Asian cities