Reducing exposure to pain is the goal of neonatal care, especially for premature infants. One way to reduce the number of ophthalmic examinations is to develop screening strategies to more accurately identify infants at high risk. ROP screening requires many infants to undergo a series of uncomfortable intensive diagnostic eye examinations, <10% of which need treatment ( 3). The fundoscopy used in ROP screening has proven to be painful ( 12, 13). These standards have led to many low-yield screenings of larger, more mature births. In China, where ROP can also occur in large infants, screening is usually performed within 4–10 weeks after birth but it should be performed at 3 weeks after birth if BW >2,000 g ( 11). In developed countries, the highest-risk infants are those with gestational age (GA) 30-week GA) infants who are considered by the attending physician to be “clinically unstable” ( 10). The population of infants at risk for ROP varies by geographic region ( 3). ROP can usually be effectively treated if diagnosed within an urgent time window ( 3). This is mainly due to the mismatch between the supply and demand of oxygen in the retina ( 1, 2). Retinopathy of prematurity (ROP) is a serious vascular proliferative disease of the retina in premature infants that can lead to visual impairment or blindness in children. The ROP risk can be calculated manually or represented by a nomogram for clinical use. Under the control of BW and GA, low weight gain rate, increased number of blood transfusion, invasive mechanical ventilation and NT-proBNP ≥ 25,000 ng/L were “new” statistically independent risk factors for ROP. The area under the curve (AUC) of the final multivariate model was 0.90 (95% CI, 0.88–0.92 P < 0.001).Ĭonclusions and Relevance: These findings add to our understanding of ROP screening because they include all eligible infants rather than only high-risk infants, as in previous studies. The weight gain rate, blood transfusion (OR, 2.03 95% CI, 1.14–3.64 P = 0.017), invasive mechanical ventilation (OR, 1.74 95% CI, 1.15–2.66 P = 0.009) and N-terminal segment of pro-B-type natriuretic peptide (NT-proBNP) ≥ 25,000 ng/L (OR, 1.51 95% CI, 1.00–2.28 P = 0.048) were four new statistically independent risk factors in addition to GA and BW. Results: The study included 2,040 infants who underwent ROP screening. Receiver operating characteristic (ROC) curves and a nomogram were drawn. The significant results were analyzed in a backward selection multivariate logistic regression model. Each of the 27 candidate risk factors was evaluated in univariate analysis and adjusted for known risk factors (i.e., GA and BW). Method: All high-risk infants in the neonatal intensive care unit (NICU) of the First Affiliated Hospital of Zhengzhou University from 2017 to 2021 were included in this retrospective cohort study. Current ROP screening guidelines, which include a range of birth weights (BWs) and gestational ages (GAs), may require screening many low-risk preemies who might develop severe ROP. Without treatment, more than 45% of eyes may suffer permanent vision loss. Importance: Retinopathy of prematurity (ROP) is a preventable cause of blindness in children.
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The series has been played by more than 2017 million players since We Were Here launched in 6,5, and both We Were Here Too and We Were Here Together have sold over a million copies on Steam alone. The games in the We Were Here series of co-op puzzle adventures can be played in any order, although there is a common narrative thread running through them. This will be our biggest production yet and it's not the end for the players, we're already working on their next cooperative adventure!” The We Were Here game series Today, after two and a half years of development - not least during a pandemic - we're excited to finally show our most ambitious project yet and hear the reactions and experiences of players from all over the world. "We started small and have come a long way - with three great releases already, and a team that has doubled in size. Lucia de Visser, co-founder of Total Mayhem Games, is proud of the release and impressed with the response so far. Is it possible to break free from Castle Rock or is it a hell no one can escape from. As they try to escape Castle Rock in We Were Here Forever, they may start to believe what they feared all along: can Castle Rock ever really be escaped?Īn epic climax awaits players in We Were Here Forever: Questions that have plagued players throughout the We Were Here series will be answered in this fourth installment. They learn more about past events that have taken place in this mysterious place. Hope will lead players to an eerie graveyard and let them descend into the dark waters of the foundry. Once outside, they uncover the story of Rockbury and its residents, who once planned to resist the king in order to escape this mysterious realm. For the first time in the entire series, players will eventually exit the fortress. Today is the moment of truth, and it's finally time to step back into Castle Rock in We Were Here Forever! In this asymmetrical co-op puzzler, players will explore previously unknown parts of Castle Rock. Available now on PC, the co-op puzzler invites players to return to Castle Rock for some long-awaited answers and one more escape - or at least hope so. I suppose you could also download it then refuse to solve puzzles, instead sitting at your screens talking to each other until you die then your characters live on and on until Scottish Power cut off your electricity.Starting today, We Were Here Forever by Total Mayhem Games is available. You can download We Were Here free from Steam for Windows and Mac. I'm reminded vaguely of Terry Cavanagh's At A Distance, a co-op puzzler which Jim and Alec stumbled through in 2011. I predict a whole lot of fun as players try to describe mystic symbols to each other. You have in-game walkie-talkies to chat with each other, mind, which will surely be helpful as it turns out the solutions to puzzles rely upon information the other player sees. One player is the 'Librarian', stuck in one small area, while the 'Explorer' roams around the rest. So! You and your chum find yourselves in a castle in an icy wasteland, one full of cryptic clues. Separated in different parts of the castle but keeping in contact with walkie-talkies, pairs must pool their clues and get puzz-puzz-puzzling. Perhaps you'd like to join a buddy in an abandoned castle for a spot of thunking in free co-op first-person puzzler We Were Here. Personally, I believe it's people expressing subconscious desire to be trapped away from everything forever in a box in space/the future/a zombie apocalypse, but I'm no Dr. Puzzling with pals can be a lark, which I suppose may be why escape rooms are all the rage nowadays. Since narrating a black screen wouldn’t make for very good viewing, a compilation of footage showing orca performances was the logical choice. At the request of Dawn Brancheau’s family, footage of the attack could not be shown. 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SeaWorld relies on manipulation and lies to keep the public sweet and this document is the perfect epitome of that. I should clarify my intentions are not to portray Blackfish as a perfect documentary (it’s not, no documentary is), I simply wish to highlight how terrible SeaWorld’s response to Blackfish truly is, and how it actually further damages their public image. After reading this document in-depth, I can confidently claim SeaWorld’s “ 69 reasons you shouldn’t believe Blackfish” is nothing more than a gish gallop and yet another example of SeaWorld’s terrible attempt at damage control. After the release of Blackfish in 2013, SeaWorld produced a 32-page document listing 69 reasons why the documentary is “ misleading and/or inaccurate“, including an explanation for each reason. Try this one for a lot of fun."ībeasley - "I loved it so much i had to take a week off work. The levels get harder as you get up there higher, but you are able to do them. 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These options are purely cosmetic and do not alter the stats of a soldier. Anarchy's Children: This rebellion-themed content pack introduces more than 100 new exotic customizations for the entire arsenal of armors available to your XCOM soldiers.Instantly unlock a survivor of the old war as a new recruit in your barracks. Resistance Warrior Pack: Customize your squad of resistance fighters with a set of bonus outfits and head gear, as well as custom armor and face camo.For more detailed specifications check the Feral website. Please note for your computer to meet the minimum requirements it must match or better all elements of the listed spec.* All Mac Pros released since Late 2009.* All 27” iMacs since mid 2010 with a 1GB Graphics Cards and a 2.5GHz processor or better.* All 21.5” iMacs since late 2013 with a 1GB NVIDIA GeForce GT 750M or better.* All 17" MacBook Pros since Early 2011.* All 15” MacBook Pros since early 2011 with a 2.3GHz processor or better.* All 13” MacBook Pros released since Late 2016.To check your Mac model and when it was released, select About This Mac from the Apple menu on your menu bar. Additional Notes: The game is supported on the following Macs.Graphics: 1GB AMD 5750, Nvidia 650M, 1.5GB Intel Iris Pro 6200 (See Notes for more details).Processor: 2.5GHz Intel Core i5 or greater.Requires a 64-bit processor and operating system.SHARE THE RESISTANCEĬustomize and pose your soldiers, then add filters, text and backgrounds to generate your own unique resistance posters that appear in-game and can be shared with friends. Advanced campaign options allow for finer adjustments to game length and difficulty. The SITREP system dynamically adds new modifiers to the tactical layer to make sure every mission provides a unique challenge. Soldiers can develop bonds with compatible teammates for new abilities and perks. Soldiers, scientists, and engineers can now be deployed for Covert Actions that award supplies and boost faction favor if successfully completed. Employ new Resistance Orders to prioritize your personal strategy. Manage XCOM’s relations with factions and counter The Chosen’s operations from the Avenger. NEW ENVIRONMENTS AND MISSION OBJECTIVESĮngage in tactical missions across new environments from abandoned cities devastated by alien bioweapons during the original invasion, to underground tunnels and xenoformed wilderness regions. Adopt new tactics to counter it as well as the explosive attacks of the ADVENT Purifier and the psionically charged ADVENT Priest. NEW ALIEN & ADVENT THREATSĪ deadly new alien known as the Spectre, capable of creating dark copies of XCOM soldiers, has snuck onto the battlefield. Find and raid the Chosen’s strongholds to defeat the enemy for good. The Chosen can also invade the strategy layer and ravage XCOM’s global operations. The Chosen are on the hunt for the Commander and will kidnap, interrogate, and kill XCOM’s soldiers to complete their objective. The Chosen are the most cunning enemies XCOM has ever faced, each with unique strengths and weaknesses that will be introduced with each new campaign. These factions provide powerful hero class soldiers to aid in missions and new opportunities for the strategy layer. Three additional factions have emerged to strengthen Earth's resistance – the Reapers, Skirmishers and Templars – each with its own unique abilities and contrasting philosophies. This expansion includes new Hero classes to counter the “Chosen”, new enemies, missions, environments and increased depth in strategic gameplay. In response, a new enemy, known as the “Chosen,” emerges with one goal: recapture the Commander. XCOM® 2: War of the Chosen adds extensive new content in the fight against ADVENT when additional resistance factions form in order to eliminate the alien threat on Earth. About This Content XCOM® 2: War of the Chosen, is the expansion to the 2016 award-winning strategy game of the year. It offers a very different story arc and experience from its predecessor.Ī selection of files from BoardGameGeek. Increased Coal and Iron Market size – The price of coal and iron can now go up to £8 per cube, and it’s not uncommon.īrass: Birmingham is a sequel to Brass. Pottery – These behemoths of Birmingham offer huge VPs, but at a huge cost and need to plan. Each level of manufactured goods provides unique rewards, rather than just escalating in VPs, making it a more versatile (yet potentially more difficult) path vs cotton. Manufactured goods – Function like cotton, but features eight levels. As an incentive to sell early, the first player to sell to a trader receives free beer.īirmingham features three all-new industry types:īrewery – Produces precious beer barrels required to sell goods. For example, a level 1 cotton mill requires one beer to flip. To sell cotton, pottery, or manufactured goods to these traders, you must also "grease the wheels of industry" by consuming beer. Each of these traders is looking for a specific type of good each game. You must now sell your product through traders located around the edges of the board. Iron, coal, and cotton are three industries which appear in both the original Brass as well as in Brass: Birmingham.īrewing has become a fundamental part of the culture in Birmingham. This provides players with the opportunity to score much higher value canals in the first era, and creates interesting strategy with industry placement. Instead of each flipped industry tile giving a static 1 VP to all connected canals and rails, many industries give 0 or even 2 VPs. VPs are counted at the end of each half for the canals, rails and established (flipped) industry tiles.īirmingham features dynamic scoring canals/rails. The game is played over two halves: the canal era (years 1770-1830) and the rail era (years 1830-1870). (This action replaces Double Action Build in original Brass.) As in its predecessor, you must develop, build, and establish your industries and network, in an effort to. Brass: Birmingham tells the story of competing entrepreneurs in Birmingham during the industrial revolution, between the years of 1770-1870. Brass: Birmingham is an economic strategy game sequel to Martin Wallace’ 2007 masterpiece, Brass.īrass: Birmingham tells the story of competing entrepreneurs in Birmingham during the industrial revolution, between the years of 1770-1870.Īs in its predecessor, you must develop, build, and establish your industries and network, in an effort to exploit low or high market demands.Įach round, players take turns according to the turn order track, receiving two actions to perform any of the following actions (found in the original game):ġ) Build – Pay required resources and place an industry tile.Ģ) Network – Add a rail / canal link, expanding your network.ģ) Develop – Increase the VP value of an industry.Ĥ) Sell – Sell your cotton, manufactured goods and pottery.ĥ) Loan – Take a £30 loan and reduce your income.īrass: Birmingham also features a new sixth action:Ħ) Scout – Discard three cards and take a wild location and wild industry card. Brass: Birmingham is an economic strategy game sequel to Martin Wallace' 2007 masterpiece, Brass. It would be nice if more fans of ZT2 would be around. As you may know it's very broken and easy to get a 5 star park by spamming extinct animals haha so I gotta make the game more difficult. The newest series will be set in the Mexican desert where we are going to uncover extinct animal fossils and complete gaming challenges (in other video games) to "have the ability" to create them free extinct animals. Zoo Tycoon 2 Ultimate is better than any other park builder game (even ones that came out this year including Jurassic World Evolution), especially Zoo Tycoon (2017). I probably played this game for 3,000 hours or more and I always find new stuff to do in it. I constantly make new videos about ZT2 like this one īut also working on a new project right as we are speaking (writing?). We have provided direct link full setup of the game.I've actually been trying to inform people about this. 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