Northwest's Salmon Population May Be Running Out of Time

A Washington state report put it bluntly ( ): Because of the devastating ( ) effects of climate change and deteriorating ( ) habitats ( ), several species of salmon in the Pacific Northwest are “on the brink of ( ) extinction ( ).”

Of the 14 species of salmon and steelhead trout in Washington state that have been deemed ( ) endangered ( ) and are protected under the Endangered Species Act, 10 are lagging ( ) recovery goals, and five are considered “in crisis,” according to the 2020 State of Salmon in Watersheds report.

“Time is running out,” said the report, which is produced every other year ( ) by the Washington state Recreation and Conservation Office. “The climate is changing, rivers are warming, habitat is diminishing ( ), and the natural systems that support salmon in the Pacific Northwest need help now more than ever.”

Researchers say recovery efforts — involving state and federal agencies, Native American tribes, local conservation groups and others — have helped slow the decline of some salmon populations. The report found that two species — the Hood Canal summer chum and Snake River fall chinook — were approaching ( ) their recovery goals. It also noted that no new salmon species had been added to the endangered list since 2007.

“We are at least treading water,” said Kaleen Cottingham, director of the Washington state Recreation and Conservation Office. “We have not, however, seen the kind of progress ( ) that we had hoped for.”

With the effects of climate change expected to accelerate ( ), researchers said that more must be done to prevent further population decline and the possible extinction of some species.

Salmon play a vital ( ) role in the environment, economy and culture of the Pacific Northwest. At least 138 species depend on salmon for their food in some way. Salmon support an estimated ( ) 16,000 jobs in the fishing industry, and they are a draw ( ) for tourists.

Before the 20th century, an estimated 10 million to 16 million adult salmon and steelhead trout returned annually to the Columbia River system. The current return of wild fish is 2% of that.
One of the largest factors inhibiting salmon recovery is habitat loss. A growing human population has led to development along the shoreline and the addition of bulkheads, or sea walls, that encroach ( ) on beaches where salmon generally find insects and other food. More pavement ( ) and hard surfaces have contributed to an increase in toxic stormwater runoff ( ) that pollutes Puget Sound.

美國西北部鮭魚 陷瀕臨絕種危機

華盛頓州一篇報告直截了當指出，由於氣候變遷跟棲地劣化的毀滅性影響， 美國西北部有數種鮭魚「瀕臨滅絕」。

根據《2020年水域內鮭魚狀況報告》，華盛頓州有14種鮭魚和虹鱒被認定為瀕危物種，並受到《瀕危物種法》保護，其中10種復育進度未能達標，有5種更被認定「處於危機之中」。

這份由華盛頓州休閒與保育辦公室兩年發表一次的報告說：「時間不多了。氣候正在改變，河流水溫正在升高，棲地正在減少，供養美國西北部鮭魚生存的自然系統，如今比以往任何時候都更需要幫助。」

研究人員說，由州與聯邦機構、美國原住民部落、地方保育組織和其他機構共同參與的復育行動，緩和了一些鮭魚數量的減少。報告中發現胡德運河夏天的鉤吻鮭與蛇河秋天的帝王鮭兩種鮭魚，復育正接近目標。報告還指出，自2007年以來沒有新的鮭魚種列入瀕危名單。

華盛頓州休閒與保育辦公室主任Kaleen Cottingham說：「我們至少勉強穩住了情況，但我們沒有看到我們所期望的進展。」

研究人員表示，氣候變遷的影響料將加速，必須更加努力以防止鮭魚數量進一步減少和一些魚種的滅絕。

鮭魚在美國西北部環境、經濟與文化中扮演至關重要角色。在某種程度上，至少有138個物種以鮭魚為食。鮭魚為漁業提供約1萬6千個工作，並吸引大量遊客。

20世紀以前，估計每年有1000萬到1600萬成年鮭魚和虹鱒回到哥倫比亞河水系。目前返回的野生鮭魚數量只有這個數字的2％。
阻礙鮭魚復育的最大原因之一為棲地喪失，不斷成長的人口導致海岸沿線的開發，加上隔板或海堤的增加，這些侵占了鮭魚平常尋找昆蟲及其他食物的海灘。更多的鋪裝路面和堅硬的地面導致有毒雨水流量的增加，進而汙染了普吉特海灣。

#高雄人 #學習英文 請找 #多益達人林立英文
#高中英文 #成人英文
#多益家教班 #商用英文
#國立大學外國語文學系講師

心因性休克的診斷與治療 (2021)

⭕️ 心因性休克 (CS, Cardiogenic Shock) 的診斷要件：

臨床表徵：血流灌注不足在臨床上出現的表徵，例如四肢冷汗、少尿、意識混亂、頭暈、脈壓變窄。

生化數據：血流灌注不足反映在組織缺氧和細胞代謝改變，例如Creatinine 升高、代謝性酸中毒和血清乳酸升高。

CS 是一種臨床診斷，因此血液動力學參數，例如降低的心臟指數 (CI) 和升高的肺微血管楔壓 (PCWP)，並不是必要強制性的診斷要件。

以前CS的定義包括，低血壓定義為收縮壓（SBP）<90毫米汞柱30分鐘以上，或者使用Catecholamine維持SBP需要> 90 mmHg。但2020 ESC就不再將血壓列入診斷條件之ㄧ。休克發生時，組織灌注和氧合會顯著降低，但經由代償機制可以通過血管收縮來保持血壓。因此，血流灌注不足並不表示存在着低血壓。

如果出現低血壓，卻沒有血流灌注不足的現象，可能預示著較好的預後。

在 SHOCK Registry研究中，即使在血壓正常的患者中，血流灌注不足的臨床表徵與院內死亡有顯著風險關連。這說明了，不論低血壓如何，早期辨識血流灌注不足表徵可辨識高危險患者。

歐洲重症醫學學會將休克定義為：組織灌注不足，且無法提供足夠的氧氣以維持細胞的基礎代謝，導致危及生命的全身性急性循環衰竭。(其中低血壓的存在不是定義CS的先決條件。)

基於這些考慮，ESC將CS定義為：

由原發性心血管疾病引起的症候群，其中CO不足，導致組織血流灌注不足而危及生命，並與組織氧代謝受損和產生高乳酸血症。根據其嚴重程度，可能導致多器官功能異常和死亡。

⭕️ 心因性休克的分期

根據臨床嚴重程度和對治療的反應，CS型態可分為前CS前期、CS 和難治型CS。

CS前期
早期辨識CS可以快速啟動適當的措施與治療。即使在正常的SBP情況下，周邊血流灌注不足，出現的臨床症狀被稱為CS前期，並且出現在明顯的CS之前。休克前期可能發生在嚴重的急性心衰竭，可能與組織灌注不足的臨床症狀有關，但不會影響細胞基礎代謝和正常的乳酸。這種狀態應與血壓正常的CS區分開來，後者代表CS的實體，具有血流灌注不足和細胞改變（包括細胞缺氧和乳酸升高）的所有特徵，但沒有低血壓。血壓正常的CS患者全身血管阻力較大，但左心室(LV)射出分率、CO和PCWP與典型的CS患者相似，因此突顯血流灌注不足的風險。

難治型CS
被定義為：儘管給予足夠劑量的兩種血管升壓收縮劑，治療潛在病因，但仍存在組織灌注不足的CS。

⭕️ SCAI分類
SCAI分類描述了CS的五個進展階段，從A（有CS風險）到 E極度），這種分類可以在臨床環境中迅速方便應用。SCAI分類利用低灌注的臨床評估、乳酸值和侵入性血流動力學評估。最近，SCAI分類已在一大群未經選擇的重症心臟加護病房 (CCU)患者中得到驗證，無論CS病因如何，都提供了穩健的死亡風險分類。

A: At risk, 風險期。有CS風險；SBP=N, CI>2.5; 乳酸: 正常，沒有血流灌注不足。
B: Beginning, 開始期。相對低血壓，或心跳加速而沒有血流灌注不足，CI <2.2, PA sat ≧65%,乳酸< 2.2 mmol/L。
C: Classic, 典型期。血流灌注不足，除了輸液急救，還需要血管增壓劑，MCS或ECMO來恢復血流灌注。
D: Deteriorating 惡化期。緊急加護治療後，無法穩定。超過30分鐘後，病人的低血壓，血流灌注不足仍無改善。需要更多的輸液，或額外的MCS。乳酸 > 5 mmol/L。
E: Extremis, 極度期。難治之心跳停止，進行中的CPR，需要緊急使用介入治療，包括ECMO。

⭕️ 流行病學和預後

CS的患病率因CS的定義、臨床狀況和數據收集時代而異。CS佔急性心衰竭的2-5％，ICU的14-16％。院內死亡率在30%和 60%之間變化，近一半的院內死亡發生在就診的前24小時內。1年死亡率約為50％-60％；70-80 %CS發病後出現在第30〜60天死亡。

心因性休克的病生理、藥物治療、MCS……

⭕️ 完整全文閱讀：

⭕️ 心因性休克的診斷與治療
https://reurl.cc/6D2b6M

資料下載：
表 1. 非急性冠心症病因之心因性休克特徵與治療
https://reurl.cc/35Dbq9

表 2. 短期機械循環輔助的特徵
https://reurl.cc/gz7rW4

表3 強心及血管升壓劑之特性
https://reurl.cc/r1x0g1

Ref:
■Cardiogenic shock. ESC. European Journal of Heart Failure (2020) 22, P. 1315-1341
■SCAI分類：Catheter Cardiovasc Interv 2019;94:29–37

The passing of Singer Arwah Siti Sarah left a big void in the industry. I recall her being very down to earth and bubbly when I interviewed her during my stint as a TV Journalist and Presenter, and as I attended her virtual tahlil, it seems others peers felt the same thing as she was very joyful and lovely to be around.

Truth be told? I thought she was going to make it. Prior to her complications, Myslondongallery had another friend, Ika who suffered stage 5 Covid-19 complications. She was 33 weeks pregnant and the doctors pulled her son out at a mere 1.8kgs. We extended donations and food for her whole family who also were tested positive.

Ika pulled thru and woke up.

Alhamdulillah.

Before Arwah's passing, there have been other pregnant mothers who suffered the same fate but Arwah's death highlighted again, the need to be more cautious about SOP and managing the pandemic. Most importantly? The need for herd immunity and for focus on priority vaccination for the vulnerable - the elders, pregnant and nursing mothers and those who require immediate jabs.

It is sad that there are still anti-vaxxers out there. It seems Arwah's widow felt the way about the vaccination. Could she have survived the fate had she agreed to the vaccination? Only God knows.

We are living in scary times but we can't afford to be confined for too long as businesses and mental health is deteriorating. But at the same time, the cases are on the rise and the rakyat is not coming together to be SOP compliant and careful.

This article popped on my feed.

"70 kes kematian ibu hamil disebabkan komplikasi COVID-19 - Dr Noor Hisham"

Let's fight this virus folks. It can only be done collectively.

The first nature documentary series on global endangered species in Taiwan, 《Orphans of the Earth》presents three new episodes in 2021 《Elves of Taiwan》，that reach out to the sky, the sea and the grasslands only to reveal precocious footages of the endangered endemic species that are known for extreme rarity, minimal sighting rate and videotaping challenges—Taiwan Grass Owls, the Taiwanese Humpback Dolphins, and the Formosan pangolins.

The production crew of “Elves of Taiwan” partakes in perhaps the most difficult animal rescue operations in line with conservation efforts and the most dignified science-based survey projects. The program unveils diversified local landscapes and endemic species completed by various angles and perspectives—from aerial rescues, ocean investigations, to underground bone excavations; it is indeed a brutally honest series that documents the conservation and restoration of the terrestrial, oceanic, and airborne endemic species in Taiwan.

The film crew participates in Taiwan humpback dolphin surveys by Ocean Conservation Administration on the sea, captures a rare humpback dolphin group, and explores root causes behind their dwindling populations. Also, we document the largest pygmy killer whale rescue effort by 2,000 people over 56 days. We follow researchers to Orchid Island, an outer islet of Taiwan, to uncover the bones of a baby sperm whale, and record the tragic deaths of stranded melon-headed whales and blue whales. Their survivals and deaths are symptomatic of a deteriorating marine environment.


■台灣1001個故事　說不完的故事
每周日晚間9點，請鎖定東森新聞【台灣1001個故事】唷！

更多精彩內容鎖定《台灣1001個故事》
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#台灣的精靈 #地球的孤兒 #台灣白海豚 #白心儀 #台灣1001個故事 #海洋保育署 #成大鯨豚研究中心 #四草鯨豚搶救站 #台大獸醫系 #蘭嶼 #小虎鯨救援 #自然科學紀實節目

This clip is from: Joseph Prince—Live Bold Without Guild And Fear (8 April 2018)

Are there certain things that you’re just not sure whether you can ask God for? We’re talking about the seemingly frivolous things like a parking lot in a crowded mall, or how about the “bigger” more impossible-sounding things, like a miracle for your deteriorating relationship or healing for a terminal disease?

God doesn’t pick and choose which of our prayers He hears—He hears them all.

But being able to ask of God and to ask big of Him, comes from a place of knowing who He is to you. Hear all about it in our latest video.

The God you have is “able to [carry out His purpose and] do superabundantly more than all that we dare ask or think [infinitely beyond our greatest prayers, hopes, or dreams], according to His power that is at work within us” (Eph. 3:20 AMP). And He is also a good Father who desires to give good things to His children (see Matt. 7:7–12).

Would you ask big of your God today? :)

–

Decibel.one: A digital magazine and online channel by Joseph Prince Ministries. Check out at https://decibel.one/ for more grace-centered content.

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The Sinking City พากย์ไทย แปลไทย

Charles W. Reed อดีตทหารเรือของกองทัพเรือสหรัฐฯและทหารผ่านศึกผู้ผันตัวเองมาเป็นนักสืบเอกชนเดินทางจาก Boston ไปยัง Oakmont ตามคำเชิญของ Johannes van der Berg เพื่อค้นหาสาเหตุของภาพฝันร้ายที่รบกวนเขามาหลายปี โดยภาพฝันร้ายนี้ได้กับหลายคนใน Oakmont Reedได้รับการว่าจ้างจาก Robert Throgmorton หัวหน้าผู้มีอิทธิพลและแข็งแรงของหนึ่งในครอบครัวชั้นนำของ Oakmont ผู้ซึ่งได้ศึกษาเกี่ยวกับปรากฎการภาพหลอนนี้อยู่เพื่อที่จะหาสาเหตุของน้ำท่วมที่ทำให้เกิดภัยพิบัติในเมือง ในขณะที่ Reed ทำการสืบสวนเรื่องนี้และเขาได้ใช้พลังนักสืบที่ดูเหมือนจะมอบให้โดยนิมิตของเขาในการเปิดเผยเรื่องราวลึกลับที่อยู่ใน Oakmont

ณ เมือง Oakmont ที่ประกอบไปด้วย 7 ย่าน (Advent, Coverside, Grimhaven Bay, Oldgrove, Reed Heights, Salvation Harbor, and The Shells) ทั้งหมดได้รับผลกระทบจากน้ำท่วม ผู้เล่นจะต้องใช้เรือเพื่อความปลอดภัยในการออกสำรวจเพื่อไปยังพื้นที่ที่น้ำไม่ท่วมโดยที่ผู้เล่นสามารถว่ายน้ำได้ถ้าจำเป็น แต่น้ำนั้นสามารถสร้างความเสียหายให้กับตัวละครเราได้ ในการเล่นนั้นจะมีระบบประกอบอาวุธและเครื่องมือต่าง ๆ และบางครั้งต้องใช้พวกมันสู้กับสัตว์ร้ายและทำลายภาพหลอน เนื่องจาก Oakmont เป็นสถานที่โดดเดี่ยวที่มีทรัพยากรลดน้อยลง กระสุนได้เปลี่ยนเงินเป็นสกุลเงิน หากใช้กระสุนที่มากเกินไปก็อาจจะทำให้ผู้เล่นไม่สามารถแลกเปลี่ยนสิ่งของที่ต้องการได้ ทรัพยากรสำคัญอีกอย่างคือพลังในการสืบสวนซึ่งใช้ในการสร้างฉากอาชญากรรมขึ้นใหม่และระบุเบาะแส มันสามารถ regenerates ด้วยตัวเอง แต่สามารถเติมได้เร็วขึ้นด้วยยารักษาโรคจิต เพื่อใช้ในยามฉุกเฉิน

The Sinking City is an open-world detective game with a third-person camera perspective. It features an open investigation system in which the outcome of the player's quests will often be defined by how observant the players are when investigating different clues and pieces of evidence.

Charles W. Reed, a U.S. Navy sailor and Great War veteran turned private investigator, travels from Boston to Oakmont at the invitation of intellectual Johannes van der Berg to discover the cause of the nightmarish visions that have been plaguing him for years, visions which are shared by numerous other people and most commonly occur in Oakmont. Reed is hired by Robert Throgmorton, the influential and physically striking head of one of Oakmont's leading families who has also been studying the visions, to help uncover the cause of the Flood plaguing the town. While Reed pursues this investigation and others using extrasensory powers of observation seemingly bestowed by his visions, uncovering the shadowy history and seedy underbelly of Oakmont along the way, he must guard his sanity as it is eroded by the town's darkness, otherworldly creatures attracted to death called Wylebeasts, and the use of his own powers.

The town of Oakmont is made up of seven districts (Advent, Coverside, Grimhaven Bay, Oldgrove, Reed Heights, Salvation Harbor, and The Shells) which have all been affected by flooding to various degrees, and the player must use a boat to safely traverse the flooded streets to reach drier areas. The player can swim if necessary, but the water is infested and can fatally damage the player's health and sanity. The player also assembles an arsenal of tools and weapons, and at times must use them to kill otherworldly creatures and dispel hallucinations. However, as Oakmont is an isolated place with dwindling resources and deteriorating social order, bullets have replaced money as the preferred currency; expending too many bullets can leave the player unable to barter for desired items. Another major resource is sanity, which is spent on investigative powers used to reconstruct crime scenes and identify clues. Sanity slowly regenerates on its own, but can be replenished faster with antipsychotic drugs. Disturbing scenes and encounters can cause sudden, sharp drops in sanity, affecting the player's perception of the surrounding environment, and complete loss of sanity is fatal.