A Shared Container Transportation Mode in the Yangtze River

Sharing economy is an emerging concept that has been implemented in several industries and has achieved huge success. Novel solutions, built on the emerging concept of sharing economy, such as Uber, Didi, Mobike, and Cargostream, offer unprecedented opportunities for maritime organizations to reform traditional water transportation. This paper presents an analysis framework of a shared container transportation mode to show the restrictions and benefit of the implementation of the concept of sharing economy in maritime transportation. As a typical inland water area in China, the Yangtze River is selected as the study area. A general shared container transportation framework is designed, including a new waiting mode, business process, and software platform system design. The new business process is developed to overcome the contradiction between the new shared container transportation mode and the traditional shipping process. The potential of the new mode is also discussed. It would contribute to the sustainability of maritime transportation with respect to energy saving

Coupling Coordination Degree of Ecological-Economic and Its Influencing Factors in the Counties of Yangtze River Economic Belt

The rapid economic development (ED) of the Yangtze River Economic Belt (YREB) has had a significant negative impact on regional ecosystem services (ES). Accurately understanding and properly handling the relationship between ES and ED is critical to achieving coordinated regional development of the YREB. Restricted by a minimal number of research units, traditional studies have not fully considered the spatial heterogeneity of the influencing factors, leading to results with poor accuracy and applicability. To address these problems, this paper introduces a spatial econometric model to explore the impact of influencing factors on the level of coordinated development in the YREB. For the 1013 counties in the YREB, we used the value equivalent method, the entropy weight method, and the coupling coordination model to quantify the coupling coordination relationship between the ecosystem services value (ESV) and ED from 2010 to 2020. The multi-scale geographically weighted regression model (MGWR) was adopted to analyze the role of influencing factors. The results showed the following: (1) The coupling coordination degree (CCD) of ESV and ED along the YREB demonstrated significant spatial heterogeneity, with Sichuan and Anhui provinces forming a low-value lag. The average CCD from high to low were found in the Triangle of Central China (TOCC), the Yangtze River Delta urban agglomeration (YRDUA), and the Chengdu–Chongqing urban agglomeration (CCUA). (2) There was spatial autocorrelation in the distribution of CCD, with high–high clustering mainly distributed in Hunan, Jiangxi, and Zhejiang provinces. The counties with high–high clustering were expanding, mainly centering on Kunming City in Yunnan Province and expanding outward. (3) There was significant spatial heterogeneity in the impact of each influencing factor on CCD. Per capita fiscal expenditure was sensitive to low–low clustering areas of CCD; per capita, food production was a negative influence, and the rate of urbanization transitioned from negative to positive values from west to east.Forestry, Faculty ofNon UBCForest and Conservation Sciences, Department ofReviewedFacultyGraduateUndergraduat

Evolutionary Game Model of Strategic Maritime Transport Passages: A Case of the Strait of Hormuz

Given the in-depth advancement of the “Belt and Road” initiative, cooperation among countries along the initiative is increasing. The strategic maritime transport passage is closely related to the interests of relevant countries. The games between countries along important transport passages in terms of the pursuit of geopolitical rights and interests occur frequently. This paper establishes an evolutionary game model of the strategic maritime transport passages taking the Strait of Hormuz as an example and explores the game of the countries on both sides of the strait. By analysing their behaviour and possible strategies, the evolutionary stable strategy for each country is obtained. Recommendations are made to aid with the relevant rights and interests of related countries

Research on the Current Situation of Mental Health in Rural Community and Urban Community

There are few studies on the treatment orientation of psychological counseling and psychotherapy practitioners in China. Additionally, integrative therapy as the first choice is much commoner in less developed areas and among unsupervised practitioners, which reflects the risk of technical confusion relating to the use of integrative therapy in China. The counseling and psychotherapy practitioners are treated as "variables", and researchers are concerned because these "variables" can have a significant impact on the course of treatment and outcomes. Therefore, we analyze the effects of socioeconomic development level on practitioners' treatment orientation. Based on the results, in addition to areas of employment, urban stratification and practitioners’ system factors, gender, age, education, professional background, work hours, and other factors affect psychological counseling and psychological treatment practitioners

Study on the impact of industrial structure upgrading on soil conservation in the Yellow River basin counties

The problem of soil and water loss in the Yellow River Basin has been impacting the local high-quality development. The upgrading of industrial structure is a method to alleviate the issue of soil and water loss. In order to address the soil and water loss problem in the Yellow River Basin, this study investigates the internal mechanisms of how the upgrading of industrial structure impacts soil conservation, promoting coordinated development in the region. This research utilizes the entropy weight method, the InVEST model, and the fixed spatial Durbin model to explore how the greening, upgrading, and rationalization of industries affect the average soil conservation. The main conclusions of this study are: (1) For every 0.1 increase in the greening index, it effectively increases the local average soil conservation by 17.25 (t/hm2) and 49.61 (t/hm2). It is necessary to reduce the emission of pollutants in the upstream region in order to effectively improve the average soil conservation; (2) For every 0.1 decrease in the industry upgrading index, it will lead to a decrease in the average soil conservation in surrounding areas by 2.82 (t/hm2). Only by continuously increasing the financial investment in the upgrading of industries in the downstream region can the average soil conservation be increased. (3) An increase in the rationalization of industries in the upstream and midstream regions will lead to a decrease in the average soil conservation in surrounding areas, while in the downstream region, it will increase the local average soil conservation

Changes of cardiac output and velocity time integral in blood return at the end of renal replacement therapy predict fluid responsiveness in critically Ill patients with acute circulatory failure

Abstract Objectives To observe if blood return, also defined as the blood infusion test (BIT) could predict fluid responsiveness in critically ill patients with acute circulatory failure and renal replacement therapy (RRT). Methods This was a single-center, prospective, diagnostic accuracy study. Before BIT, the passive leg raise test (PLRT) was performed to record the change of cardiac output (ΔCO) by pulse contour analysis, and ΔCO >  = 10% was defined as the fluid responder. Meanwhile, the change in velocity time integral (ΔVTI) was recorded by ultrasound. Later, the ΔCO and ΔVTI during BIT were recorded 5–10 min after PLRT. The receiver-operating characteristic curves of ΔCO and ΔVTI of BIT were performed in predicting the fluid responder defined by PLRT. Results A total of 43 patients with acute circulatory failure undergoing RRT were enrolled in the present study, and 25 patients (58.1%) were recognized as responders during PLRT. According to the receiver-operating characteristic curves, the cutoff value of ΔCO was 10% and ΔVTI was 9% during BIT with the area under curve of 0.96 and 0.94, respectively. Conclusions BIT in RRT could identify fluid responsiveness in critically ill patients with shock. Trial registration ChiCTR-DDD-17010534. Registered on 30/01/2017 (retrospective registration)

Using automatic speckle tracking imaging to measure diaphragm excursion and predict the outcome of mechanical ventilation weaning

Abstract Introduction The speckle tracking ultrasound is an innovative technology enabling distinct assessment of diaphragmatic movement, yet the relative data are scarce. In this pilot study, we sought to evaluate the predictive value of the weaning outcome of automatic speckle tracking in assessing diaphragm excursion. Methods This is a prospective, multicenter, observational study. A total of 160 critically ill subjects underwent speckle-tracking ultrasonography of the right/left hemidiaphragm before the spontaneous breathing trial. Meanwhile, the diaphragm excursion and velocity values were measured manually by M-mode ultrasound. Patients were divided into weaning-failure and weaning-success groups. The correlation was assessed between automatic and manual measurement, and the diagnostic efficacy of automatic measured excursion and velocity for predicting weaning outcome was analyzed. Results A total of 88 patients completed the follow-up of the weaning outcome. The overall incidence of weaning failure was 43.18%. There was a significant correlation between the automatic measurement of mean excursion and velocity assessed by speckle tracking imaging and manual measurement (R 0.69 and 0.65, respectively). Receiver operating characteristic (ROC) curve analysis showed that the mean excursion and diaphragmatic velocity exhibited high diagnostic values for prolonged weaning [area under the ROC curve (AUROC) 0.824 and 0.786, respectively]. The diaphragmatic excursion showed moderate diagnostic value for predicting both weaning failure and in-hospital death/withdrawal of treatment (AUROC 0.659 and 0.653, respectively). Conclusion Automatic speckle tracking analysis of the diaphragm showed high consistency with conventional manual ultrasound measures. Diaphragmatic excursion and its excursion velocity helped predict mechanical ventilation weaning failure, prolonged weaning, as well as in-hospital adverse outcomes, which served as a reliable tool in guiding clinical weaning strategy. Key message Automatic speckle tracking analysis of the diaphragm showed high consistency with conventional manual ultrasound measures. Diaphragmatic excursion and its excursion velocity helped predict mechanical ventilation weaning failure, prolonged weaning, as well as in-hospital adverse outcomes

Diagnostic value of cardiopulmonary ultrasound in elderly patients with acute respiratory distress syndrome

Abstract Background Lung ultrasound and echocardiography are mainly applied in critical care and emergency medicine. However, the diagnostic value of cardiopulmonary ultrasound in elderly patients with acute respiratory distress syndrome (ARDS) is still unclear. Methods Consecutive patients admitted to ICU with the diagnosis of suspected ARDS based on clinical grounds were enrolled. Cardiopulmonary ultrasound was performed as part of monitoring on day 1, day 2 and day 3. On each day a bedside ultrasound was performed to examine the lungs and calculate the Left Ventricular Ejection Fraction (LVEF). On day 3, a thoracic CT was performed on each patient as gold standard for ARDS imaging diagnosis. According to the results from CT scan, patients were grouped into ARDS group or Non-ARDS group. The relation between the cardiopulmonary ultrasound results on each day and the results of CT scan was analyzed. Results Fifty one consecutive patients aged from 73 to 97 years old were enrolled. Based on CT criteria, 33 patients were classified into the ARDS group, while 18 patients were included in non-ARDS group. There was no significant difference between the two groups in baseline characteristics, including gender, age, underlying disease, comorbidities, APACHE II score, SOFA score, and PaO2/FiO2 ratio (P > 0.05). Lung ultrasound (LUS) examination results were consistent with the CT scan results in diagnosis of pulmonary lesions. The Kappa values were 0.55, 0.74 and 0.82 on day 1, day 2 and day 3, respectively. The ROC analysis showed that the sensitivity, specificity and area under curve of ROC (AUROC) for lung ultrasound in diagnose ARDS were 0.788,0.778,0.783;0.909,0.833,0.871;0.970,0.833,0.902 on day 1, day 2 and day 3, respectively. However, cardiopulmonary ultrasound performed better in diagnosing ARDS in elderly patients. The sensitivity, specificity and AUROC were 0.879,0.889,0.924;0.939,0.889,0.961;and 0.970,0.833,0.956 on day 1, day 2 and day 3, respectively. The combined performances of cardiopulmonary ultrasound, N-terminal pro-brain natriuretic peptide (NT-proBNP), and PaO2/FiO2 ratio improved the specificity of the diagnosis of ARDS in elderly patients. Conclusions LUS examination results were consistent with the CT scan results in diagnosis of pulmonary lesions. Cardiopulmonary ultrasound has a greater diagnostic accuracy in elderly patients with ARDS, compared with LUS alone. The combined performances of cardiopulmonary ultrasound, NT-proBNP, and PaO2/FiO2 increased the specificity of the diagnosis of ARDS in elderly patients