Early Fluid Balance Is Associated with 90-Day Mortality in Patients Receiving Continuous Renal Replacement Therapy

Continuous renal replacement therapy (CRRT) is widely used to control fluid balance, but the optimal fluid balance to improve the prognosis of patients remains debated. Appropriate fluid management may depend on hemodynamic status. We investigated the association between 90-day mortality and fluid balance/mean arterial pressure (MAP) in patients receiving CRRT. This single-center retrospective study was conducted between May 2018 and March 2021. Based on the cumulative fluid balance at 72 h after initiation of CRRT, the cases were divided into negative ( 0 mL) fluid balance groups. Ninety-day mortality was higher in the positive fluid balance group (p=0.009). At 4 h before and after CRRT initiation, the mean MAP was lower in the positive fluid balance group (p<0.05). After multivariate cox adjustment, 72-h positive fluid balance was independently associated with 90-day mortality (p=0.004). In addition, the cumulative fluid balance was associated with 90-day mortality (p<0.05) in cases without shock, high APACHE II score, sepsis, dialysis dependence, or vasopressor use. A 72-h positive fluid balance was associated with 90-day mortality in patients receiving CRRT

Impact of Different KDIGO Criteria on Clinical Outcomes for Early Identification of Acute Kidney Injury after Non-Cardiac Surgery

The Kidney Disease Improving Global Outcomes (KDIGO) guidelines are currently used in acute kidney injury (AKI) diagnosis and include both serum creatinine (SCR) and urine output (UO) criteria. Currently, many AKI-related studies have inconsistently defined AKI, which possibly affects the comparison of their results. Therefore, we hypothesized that the different criteria in the KDIGO guidelines vary in measuring the incidence of AKI and its association with clinical outcomes. We retrospectively analyzed that data of patients admitted to the intensive care unit after non-cardiac surgery in 2019. Three different criteria used to define AKI were included: UOmean, mean UO < 0.5 mL/kg/h over time; UOcont, hourly UO < 0.5 mL/kg/h over time; or SCR, KDIGO guidelines SCR criteria. A total of 777 patients were included, and the incidence of UOmean-AKI was 33.1%, the incidence of UOcont-AKI was 7.9%, and the incidence of SCR-AKI was 2.0%. There were differences in the length of ICU stay and hospital stay between AKI and non-AKI patients under different criteria. We found differences in the incidence and clinical outcomes of AKI after non-cardiac surgery when using different KDIGO criteria

Coherent transfer of light polarization to electron spins in a semiconductor

We demonstrate that the superposition of light polarization states is coherently transferred to electron spins in a semiconductor quantum well. By using time-resolved Kerr rotation we observe the initial phase of Larmor precession of electron spins whose coherence is transferred from light. To break the electron-hole spin entanglement, we utilized the big discrepancy between the transverse g-factors of electrons and light holes. The result encourages us to make a quantum media converter between flying photon qubits and stationary electron spin qubits in semiconductors.Comment: 4 pages. Submitted to Physical Review Letter

福祉的<関係性>と援助の実践 : 社会福祉の実践基盤のための一試論として

本稿では援助の実践場面で経験される、どちらが「援助者」でどちらが「被援助者」かが、当事者自身さえ認め難いような関係が成り立ち、福祉的な行為と感情との享受が同時的・相互的になされている状態としての「福祉的」について考察することを目的とした。そこでまず心理的経験、とくに「同一化」と「同一性」の関係との比較、次いで知覚的経験における「イマージュ」概念あるいは「相貌」の知覚と「客観的世界」の関係との比較を行った。その結果「福祉的化」は、両経験とは転倒した方向性をもっていることがわかり、これには近代市民社会における集合表象としての「個人主義」の関わりがあることを述べた。最後に、「福祉的」の経験は、人と人との支え合いの始点へ実感を伴うかたちで経験させ、客体化された援助関係のあり方から援助当事者を解放させ、主体性を回復させる瞬間でもあること、その結果としてクライエントとの関係の再構成を促す基盤ともなりうるものと考察された。さらに、援助する側の専門性、援助される側の対象論的規定という、従来の制度的な捉え方を超える可能性を見出す契機になりうることを指摘した