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2021-09-01 17:17:34 有 367 人按讚

急性心衰竭 (心衰竭指引 ESC guidelines, 2021)

Part 2~~

key words:
AHF: 急性心衰竭(Acute heart failure)
ADHF: 急性失償心衰竭(Acute decompensated heart failure)
Cardiogenic shock: 心因性休克
MCS：機械式循環輔助 (Mechanical circulation Support)
RRT：腎臟替代療法(Renal replacement therapy)
Natriuretic peptides (BNP, NT-proBNP, MR-proANP)
MR-proANP = mid-regional pro-atrial natriuretic peptide
NT-proBNP = N-terminal pro-B-type natriuretic peptide

AHF流行病學、診斷和預後

AHF 是指 HF 的症狀和/或癥兆迅速或逐漸發作，嚴重到足以使患者尋求緊急醫療照護，導致意外入院或急診就診。AHF患者需要緊急評估，隨後開始或積極治療，包括經由靜脈治療或裝置步驟。AHF在院內死亡率為4%-10% 。出院後一年死亡率: 25–30%，死亡或再入院率高達 45% 以上。

AHF 可能是 HF第一次發作，或者是由於慢性 HF 的急性失償。與急性失償心衰竭相比，新發HF患者的院內死亡率可能較高，但出院後死亡率和再住院率較低。

AHF的診斷檢查包括心電圖、心超、胸部X光、檢查和肺超檢查。尤其無法檢測Natriuretic peptides(NP)時。如果診斷無法確定是否心因性心衰竭時，則檢驗血漿 NP數值（BNP 或 NT-proBNP 或 MR-proANP）。

NPs正常：排除AHF 的診斷。
急性 HF 的臨界值是：
BNP <100 pg/mL、
NT-proBNP <300 pg/mL
MR-proANP <120 pg/mL。

但NP值升高與多種非心臟疾病相關，在一些患有晚期失償末期HF、肥胖、突發性肺水腫(flash pulmonary edema)或右側AHF的患者可測得低值NP。有AF和/或腎功能異常，其NP數值較高。

AHF診斷流程
• 初步驗血檢驗包括肌鈣蛋白(troponin)、血清肌酐、電解質、血尿素氮或尿素、TSH、肝功能檢查及D-dimer(疑似肺栓塞)；和procalcitonin (感染)，動脈血氧分析(呼吸窘迫)，以及lactate(低灌注的情況)。(註：procalcitonin降鈣素原可用於肺炎的診斷，數據 >0.2 μg/L 時，可能有使用抗生素治療的適應症。)
• 特定檢查包括冠狀動脈造影（疑似 ACS）和 CT（疑似肺栓塞）。
• 急性心衰診斷的NT-proBNP臨界值：
<55歲：> 450 pg/mL
55 -75 歲：> 900 pg/mL
> 75 歲> 1800 pg/mL

AHF臨床表現

AHF呈現四種主要的臨床表現，主要根據充血和/或外周血流灌注不足的原因所呈現出來不同的臨床表現。(參考表21)

四種臨床表現分別是：
1.急性失償心衰竭
2.急性肺水腫
3.孤立性右心室衰竭
4.心因性休克

各種急性心衰竭的臨床表現：

1.急性失償心衰竭(Acute decompensated heart failure, ADHF)
急性失償心衰竭 (ADHF) 是 AHF 最常見的形式，佔臨床表現的 50-70%。它發生在有HF病史和心臟功能異常，包括 RV 功能異常。與急性肺水腫表型不同，發作時程呈現漸進，主要變化是導致全身充血，液體滯留。
治療：
a. 使用環利尿劑，減少水份滯留。
b. 強心增壓劑(Norepinephrine)：於周邊低灌注時使用。
c. 短暫使用機械式循環輔助(MCS)：於周邊低灌注，器官受損時使用
c.腎臟替代療法(RRT: Renal replacement therapy)：如果利尿劑無效或腎病末期時，可考慮使用RRT (Class IIa)

2.急性肺水腫
急性肺水腫診斷的臨床標準包括:
呼吸困難合併端坐呼吸、
呼吸衰竭（低血氧症-高碳酸血症）、
呼吸急促、
>25 次/分鐘和呼吸功增加。

治療：
a. 給予氧氣，持續氣道正壓通氣、非侵入性正壓通氣和/或高流量鼻管。
b. 給予靜脈利尿劑。
c. 如果收縮壓 (SBP) 高，可以給予靜脈血管擴張劑，以減少 LV 後負荷。在少數晚期 HF 病例中，急性肺水腫可能與低心輸出量有關，在這種情況下，需要使用強心劑(Inotropics)、血管加壓藥(vasopressors)和/或MCS 來恢復器官灌注。

3. 孤立性右心衰竭 (Solitary RV Failure)
a. RV 衰竭是由於 RV 和心房壓力增加以及全身充血。RV 衰竭也可能損害 LV 填充功能，最後導致心輸出量減少。
b. 利尿劑通常是治療靜脈充血的首選藥物。
c. Norepinephrine，強心劑、血管加壓劑：適用於低心輸出量和血流動力學不穩定。可能優先選用能降低心臟充填壓的強心劑, 如，levosimendan, phosphodiesterase type III inhibitors。
d. 由於強心劑可能會使動脈低血壓更嚴重，必要時，可以與norepinephrine合用。

4.心因性休克
心因性休克是由於原發性心臟功能異常導致心輸出量不足的症候群，包括危及生命的組織低灌注狀態，可導致多器官衰竭和死亡。

心因性休克的診斷要件：

灌注不足的臨床症狀：例如四肢冷汗、少尿、精神錯亂、頭暈、脈壓變窄、低灌注。血清肌酐升高、代謝性酸中毒和血清乳酸升高，反映出組織缺氧和細胞代謝改變導致器官功能障礙。低灌注並不常合併低血壓，因為可以通過代償性血管收縮（使用/不使用升壓劑）來維持血壓。

應儘早開始治療心因性休克：早期識別和治療潛在原因。
尋找病因(口訣：CHAMPIT)：(see photo)
包括急性冠心症，高血壓急症，快速心律不整，嚴重心搏過慢，傳導阻滯，機械性原因(如，急性瓣膜返流，急性肺栓塞，感染，心肌炎，心包填塞)

嚴重休克病人則需要考慮將MCS(Class IIa)作為移植的過渡時期使用。

急性心衰竭的藥物治療：

利尿劑
靜脈利尿劑是AHF治療的基本。它們增加鈉和水份的排泄，適用於治療大多數AHF患者的體液過度負荷和充血。
a. Furosemide: 起始劑量為 20-40 mg，或靜脈推注 10-20 mg。Furosemide可以每天 2-3 次推注或連續輸注。由於給藥後，會有鈉滯留的可能性，因此不鼓勵每日單次推注給藥。連續輸注時，可使用負荷劑量以更早達到穩態。
b. 利尿劑治療開始後應立即評估利尿反應，並可通過在2或6小時後進行當時尿鈉含量(urine sport sodium) 和/或通過測量每小時尿量來評估。
c. 適當的利尿反應可以定義為2小時後，尿鈉(urine spot sodium) >50–70 mEq/L and/or
d. 前6小時尿量 >100–150 mL/h。
e. 如果利尿反應不足, 環利尿劑IV劑量可以加倍，並進一步評估利尿反應。
f. 如果利尿反應仍然不足，即使利尿劑劑量加倍，但每小時利尿量<100 mL，可以考慮同時使用其他作用於不同部位的利尿劑，即thiazides, metaolazone, acetazolamide。但需要仔細監測血清電解質和腎功能。

血管擴張劑
a. 靜脈血管擴張劑，如nitrate，可以擴張靜脈和動脈，因此減少靜脈返回心臟，充血減少，後負荷降低，增加心搏出量，因此緩解症狀。
b. Nitrate主要作用於靜脈，而nitroprusside則是動靜脈擴張。由於它們的作用機制，靜脈注射後，血管擴張劑可能比利尿劑更有效。急性肺水腫是由於後負荷增加和液體重新分配到肺部，而沒有周邊積液。
c. 當 SBP > 110 mmHg 時，可以考慮使用靜脈血管擴張劑來緩解AHF症狀。它們可以以低劑量開始並逐漸增加以達到臨床改善和血壓控制。應注意避免因前負荷和後負荷過度降低而導致的低血壓。因此，對於 LVH 和/或嚴重主動脈瓣狹窄的患者，應謹慎地使用。

強心升壓劑 (Inotropes)
a. 低心輸出量和低血壓患者的治療需要強心升壓劑（見表 22）。使用於左室收縮功能障礙、低心輸出量和低收縮壓（例如 <90 mmHg）導致重要器官灌注不良的情況。必須從低劑量開始謹慎使用，並在密切監測下逐漸增加。

b. Inotropes其是那些具有腎上腺素能機制的藥物，可引起竇性心動過速，增加 AF 患者的心室率，可能誘發心肌缺氧和心律異常，增加死亡率。

血管加壓藥(Vasopressors)
a. Norepinephrine具有顯著動脈收縮，適用於嚴重低血壓患者。主要目的是增加對重要器官的灌注。但會增加 LV 後負荷。因此，可以考慮同時併用Intropes + Norepisnephrine，特別是對於晚期 HF 和心因性休克的患者。

a. 休克患者第一線血管加壓藥的比較：Dopamine vs Norepinephrine，顯示在心因性休克患者Dopamine發生較多的心律不整，和死亡率。但低血容量或敗血性休克則沒有。

b. 在另一項前瞻性隨機試驗中，在急性 MI 引起的心因性休克患者中比較了Epinephrine vs Norepinephrine，由於頑固性心因性休克發生率較高，該研究提前終止。

c. Epinephrine會有較快的心率和乳酸中毒。儘管存在樣本量相對較小、追蹤時間短以及缺乏有關最大達到劑量的數據，但該研究表明Norepinephrine有較好的療效和安全性。這些數據與一項包括 2583 位心因性休克患者的綜合分析一致，顯示與Norepinephrine相比，心因性休克患者使用Epinephrine的死亡風險增加了三倍。因缺乏有關劑量、持續追蹤時間，和病因，使這些結果仍需進一步探討。

鴉片類製劑(Opoid)
a. Opoid類藥物可緩解呼吸困難和焦慮，在非侵入性正壓通氣期間用作為鎮靜劑，以改善患者的適應能力。副作用包括噁心、低血壓、心搏過緩和呼吸抑制。
b. Morphine給藥與會使機械通氣頻率更多、住院時間延長、重症監護病房入院次數增加和死亡率增加。因此，不推薦在AHF中常規使用opoid類藥物。嚴重頑固性疼痛或焦慮治療的情況下，亦可考慮使用opoid類藥物。
c. SBP <90 mmHg時，勿用Morphine.
d. Morphine會抑制呼吸，使用時特別注意呼吸狀況及保持呼吸道通暢。

Digoxin
a. AF患者使用了乙型阻斷劑，但仍有心室心率過快(AF with RVR) (>110 b.p.m.) ，可考慮使用Digoxin。
b. 如果未曾使用過Digoxin，可以靜脈推注 0.25–0.5 mg。
對於CKD或影響Digoxin代謝的其他因素（包括其他藥物）和/或老年人，維持劑量可能難以理論上估計，應檢查血清Digoxin level。

血栓栓塞預防
a. 推薦使用肝素（例如低分子量肝素）或其他抗凝劑預防血栓栓塞。
c. 若正服用服抗凝劑或禁忌，則不需使用肝素。

短期機械式循環輔助(MCS)
a. 心因性休克可能需要短期 MCS 以增加心輸出量和維持器官灌注。
b. 短期 MCS 可用作恢復前(BTR, bridge to recover)，治療策略決定前(是否繼續積極治療或視為無效醫療, BTD, Bridge to decision) 暫時過渡期的使用。臨床研究證據仍然很少。因此，不支持在心因性休克患者中未經選擇地使用 MCS。
c. 心因性休克 II (IABP-SHOCK-II) 研究中的IABP-SHOCK-II顯示，主動脈內球泵浦 (IABP) 和合適藥物治療之比較，於心因性休克患者接受早期血管再灌注的急性 MI 後之休克中，30天和長期死亡率沒有差異。根據這些結果，不推薦 IABP常規用於 MI後的心因性休克(Class III)。然而，其他非ACS引起的心因性休克，對藥物治療無效，IABP作為BTD、BTR ，仍有幫助(Class IIb)。
d. 在小型隨機試驗和傾向匹配分析中將其他短期 MCS 與 IABP 進行了比較，但結果不確定。ECMO與 IABP或 MT進行比較的RCT亦無確定結果。
e. 一項僅包括觀察性研究的綜合分析顯示，與對照組相比，接受靜脈-動脈 (VA-ECMO) 治療的心因性休克或心臟驟停患者的預後良好。 VA-ECMO 也可用於治療暴發性心肌炎和其他導致嚴重心因性的疾病。
f. 根據心肌功能異常和/或合併二尖瓣或主動脈瓣閉鎖不全的嚴重程度，VA-ECMO 可能會增加 LV 後負荷，同時增加 LV 舒張末期壓力和肺充血。在這些情況下，可以通過經中隔/心室心尖通氣口或使用解除LV 負荷（例如 Impella 裝置）。

本文出處：
https://reurl.cc/VEy9Gn

Ref:
European Heart Journal (2021) 00, 1-128
https://academic.oup.com/eurheartj/advance-article/doi/10.1093/eurheartj/ehab368/6358045#292214341

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solitary 在 Sharmaine Kwan - Artist Facebook 的最佳貼文

By Sharmaine Kwan - Artist

2021-08-08 22:45:28 有 6 人按讚

Alice R50 testing in progress~ 🔊 Come visit and feed her words! As an interactive installation she will generate and recite original poems from your input~

'Poems from the eternal hoop'
In her heydays, Alice R50 eased people’s loneliness. Today, she is stripped down to a court jester’s head, saying poems from user input as if they were religious chants. She does so by means of The Hoop Sayer, an algorithm written by Johan F. Hoorn and implemented in Ruby by Giovanni Lion.

The generative loop that creates ‘variations on a theme’ is like a banquet of liberal arts in which poets work together on a solitary sequence. The rule of poetry the algorithm uses is the rhetorical and writing technique of Anadiplosis, repeating the last word of the preceding line. In Chinese, this stylistic device is known as 頂真 (dingzhen). As an algorithm that dynamically interacts with the visitors, the robot and the people work together to create never-before-heard verses, which then form new and original poems within the constraints of the designed rules. The process itself is a beautiful open and collaborative art in itself.

Tags: solitary

Sharmaine Kwan - Artist

About author

Sharmaine Kwan - Artist Hong Kong & UK Website: www.sharmainekwan.wixsite.com/kwan Instagram: sharmainekwan_art

solitary 在 CH Music Channel Youtube 的最讚貼文

By CH Music Channel

2021-09-18 19:08:59 有 81,468 人看過有 3,318 人喜歡

《Walpurgis》
wonderland / 僅屬兩人的仙境
作詞 / Lyricist：梶浦由記
作曲 / Composer：梶浦由記
編曲 / Arranger：梶浦由記
歌 / Singer：Aimer
翻譯：CH（CH Music Channel）
意譯：CH（CH Music Channel）
English Translation: thisisars

背景 / Background - ひとば - 標本:
https://www.pixiv.net/artworks/82963977

上傳你的字幕吧！/ Submit your subtitles here!
https://forms.gle/MSsAM2WHpT31UuUh8

版權聲明:
本頻道不握有任何音樂所有權，亦無任何營利，一切僅為推廣用途。音樂所有權歸原始創作者所有。請支持正版。

Copyright Info:
Be aware this channel is for promotion purposes only without any illegal profit. All music's ownership belongs to the original creators.
Please support the original creator.

すべての権利は正当な所有者/作成者に帰属します。あなたがこの音楽（または画像）の作成者で、この動画に使用されたくない場合はメッセージまたはこのYoutubeチャンネルの概要のメールアドレスにご連絡ください。私はすぐに削除します。

如果你喜歡我的影片，不妨按下喜歡和訂閱，你的支持就是我創作的最大原動力！
If you like my videos, please click like and subscribe! Thx :)

粉絲團隨時獲得最新訊息！
Check my Facebook page for more information!
https://www.facebook.com/chschannel/

中文翻譯 / Chinese Translation :
https://home.gamer.com.tw/creationDetail.php?sn=5269021

英文翻譯 / English Translation :
https://genius.com/Genius-english-translations-aimer-wonderland-english-translation-lyrics

日文歌詞 / Japanese Lyrics :
迷いの森にあるほんとう　探しに行く月のひかり
羊歯を踏んで足を濡らして　ひたりほとり夏の小道

よく笑って泣いて見つめあって　おそるおそる恋に堕ちた
ふたり歩き出した違う方へ　呼び合う声だけもどかしく
find me in the wonderland

そろそろ手を汚して　自分の欲しいものを　追いかけてみる
みつあみをほどいて　同じ星を齧る　ふたりになる

寂しがって夜になって　まだ明るい夢のほとり
食べかけで残した心だって　ここから始まるうたになる

世界は君のものさ、どこへ行こうか、貴方は笑う
踏み外してみようか、後ろめたさが私を誘う
find me in the wonderland

どうしたって　生まれ変わるほどの　強い意志が必要だわ
慎重ないのちだった　私だけじゃ道は見つからない

星を数え繋ぎ合わせ　まだ知らない夏の星座
見つめあって泣いて朝になって　ここから始まる物語

もう一人じゃないのよ、夢のようでしょ、私は歌う
寂しさはひるがえり旗の元へと二人は集う
何も思い通りにならないことが始まったから
踏み外してみようか、目隠し鬼の手の鳴る方へ
in your wonderland

あなたが迷う場所に　あかりを灯すために
花束一つ抱いて　りりしく笑いましょう

もう一人じゃないのよ、とても怖いね、幸せなんて
寂しさはひるがえり旗の元へと二人は集う
世界は君のものさ、手が届いてあなたがいて
踏み外してみようか、愛するひとが私を誘う
find me in the wonderland
in your wonderland

綺麗な吐息になって
あなたの歌をうたって

中文歌詞 / Chinese Lyrics :
皎潔的月光為我照亮此行、於迷幻之森捕獵真心
踩踏著草蕨、潤濕了雙足，行於令人陶醉的夏日小徑岸邊

曾互相歡笑、哭泣、注視彼此，才使得我們惶恐地墜入愛戀
卻漸漸步入相異路途，竟連呼喊之聲都令人無比焦躁
請步入仙境尋覓迷失的我吧

雙手漸漸開始沾染污穢，試著放縱自身索求慾望
解開扎起的髮辮，成為共食星斗的戀人，相濡以沫

寂寞的心、鋪張的夜色，仍遊走於璀璨的夢的畔邊
早已被啃咬殘缺的心，將自此幻化為歌謠

「你已擁有了全世界，我們要去哪呢？」你莞爾而笑
「要不試著背離正道呢？」罪惡感正如此略誘著我
請步入仙境尋覓孤單的我吧

尚須一份不論如何都欲潰爛重生的強烈意志
曾嚴謹拘束的生命，卻僅自身無法尋見方向

細數繁星、相相連繫，嘗試探尋尚不知悉的夏季星座
彼此相視而泣直至天明，兩人的故事自此展開

「我已不再孤身一人，就彷彿夢一般對吧？」我唱著
寂寥的心隨風飄揚，使彼此相遇於同面旗下
乃因不如己意才使得兩人的生命交織展開
不妨背離正道、作個矇眼鬼循向掌鳴之處
步向有你所處的仙境

僅為了在你迷失之地，綻亮一絲光芒
我將為此獻上花束，兩人一同凜然而笑吧

「我已不再孤身一人，但這份幸福仍會讓人感到恐懼吧？」
寂寥的心隨風飄揚，使彼此相遇於同面旗下
「你已擁有了全世界。」向著觸手可及的你說著
「要不試著背離正道呢？」心愛之人如此略誘著我
請步入仙境尋覓重生的我吧
在那僅有兩人的仙境

化作絢麗的吐息
唱著屬於你的歌謠

英文歌詞 / English Lyrics :
Within a forest of delusion, I search for truth
The light of the moon illuminating my hunt
I step over ferns, my feet becoming wet
The water puddling on the edge of a summer path

Having shared laughter, tears, and gazes between us
Warily, cautiously, I fell in love
Along the separate paths the two of us walked
Is vexingly, only the sound of our voices calling to each other
Find me in the wonderland

Before long, my hands grow dirty
As I chase after that which my self desirеs
My braid becoming undone
We bitе down into the same star, and become a pair

A lonesome, solitary night arrives
The shore of dreams still brightly lit
A heart is left half-eaten and tossed aside
From here forth begins a transformation into song

This world is your plaything, and wherever I go
You are there, laughing
Should I try and step off the path, the unease shall beckon to me
Find me in the wonderland

Even if I must be reborn anew
I cannot go on without a strong, unshakeable will
My life has been a cautious, prudent one
And thus, only I am unable to find a path

Counting the stars, connecting them together
Into an as-yet-unknown summer constellation
Gazing at each other, I cry, and morning comes
From here forth begins a story

I'm no longer on my own, aren't I? Isn't this like a dream? I sing
Desolation flutters in the wind, and we meet at the base of its flag
Since nothing is beginning to go as I had expected
I shall try and step off the path, to the source of the hunter's clap
In your wonderland

For the sake of kindling a light in the place you wander, lost
You held a bouquet in your arms, chivalrously, let's have a laugh

I'm no longer on my own
It is incredibly frightening, about happiness
Desolation flutters in the wind, and we meet at the base of its flag
This world belongs to you, I reach out my hand and you are there
As I step off of the path, my beloved beckons to me
Find me in the wonderland
In your wonderland

Becoming a beautiful breath
Singing a song about you

CH Music Channel

About author

This channel provides lots of music videos not only with high quality but also high definition. Be aware that this channel is for promotional purpose only without any "ILLEGAL" profit. Most of the Chinese translations are translated by this channel, and that's the main purpose of this channel, that is, sharing comprehensible lyrics for people. That means I will not use other's hard works as a way to make money, I think that's way too disrespectful also pathetic. Oh, by the way, I HATE nightcore music :) If you like my videos, you can click the like button and subscribe me! Don't forget to turn on the notifications :)) 嗨，大家好，我是CH 這個音樂頻道的創立宗旨便是透過翻譯讓大家理解歌詞、以便宣傳各種大家所喜歡的音樂！我會提供不僅僅是高音質更有高品質享受的影片～！頻道內的歌曲部分是來自他人翻譯，其餘則是本頻道親自翻譯，比較偏向意境翻就是了，就還請別過度追究詞句囧小弟也想強調一點就是：「本頻道不具有任何營利意圖。」所以我創立並經營本頻道只不過是興趣導向，我不會賺錢，我只打算讓大家聽到更多的歌曲與聲音。倘若你喜歡我的影片的話，還請在影片按下喜歡，並訂閱本頻道！別忘了開啟頻道提醒喔喔喔！！！

solitary 在 translation Youtube 的最讚貼文

By translation

2021-04-10 14:00:16 有 4,497 人看過有 44 人喜歡

#アイレムが稼働させた、AC用横スクロールSTG作「R-TYPE II」('89年)からのSFC移植版。アイレムが開発、発売を行った。

主な変更点としては、全体的な処理落ち、4ステージボスのライオスの大幅弱体化、サーチレーザーがスプリットレーザーへ変更、ショットガンレーザーの拡散パターンが変更、開始時のデモの変更、復活ポイントが削除されミスるとステージ最初に変更、ステージの半分程がSFCオリジナルに変更(AC版と共通面でもアレンジ化)、オート連射の追加などが挙げられる。

システムは操作は前作を踏襲、BEAMゲージフル状態を更にボタンを押下し続ける事で拡散波動砲を放てる様になった。
AC版から難易度の調整をされ遊びやすくはなったが、パターン構築は必須。

BGMは冷牟田氏, 木村氏, 川上氏による共同作・編曲。
ほぼ全てが新曲に変えられ、全編に渡ってブラスセクションやオケヒを多用した大胆な構成で、本編以上に力が入っている。
ボス曲はAC版Iからのアレンジで、副旋律にAC版IIのボス曲が流れてくるなど巧みなコードで書かれている。
また、コンティニューBGMは1ループ16分以上の長さがあり、余程本作のファンでなければそれに気づかないだろう。
曲自体はサウンドモードで聴く事が可能だが、CD化はスーパーファミコンマガジンの付録CDのみとなっている。

ドライバ作成：吉岡幹之氏
作・編曲：冷牟田卓志氏, 木村浩氏, 川上泰広氏

Year: 1991.07.13(J),1991.09.01(U),1992.06.04(EU)
Manufacture: IREM
Hardware: spc700
computer: super famicom / snes
Music driver programmer: Motoyuki Yoshioka (Moto), Keisuke
composer & Arranger: Yasuhiro Kawakami,Takushi Hiyamuta,Hiroshi Kimura
-----------------------------------------------------------------------------------------
00:00 01.R9 TO THE FRONT (REMIX) / スタート
00:17 02.SOLITARY FLIGHT / ステージ 1
06:11 03.COUNTER ATTACK '91 / ステージ 2
08:33 04.WE WET YOU (SEXY BASS MIX) / ステージ 3
11:30 05.GIGANTIC SIDE DOWN (BRASS IMPRESSION) / ステージ 4
14::05 06.FUNKY JUNCTION / ステージ 5
16:47 07."R"-DANCE (DEEP OSAKA MIX) / ステージ6
20:12 08.THE NATIONAL ANTHEM OF BYDO EMPIRE / ステージ 7
22:35 09.THE RETURN OF THE ATROCITY (LONG FORM OF BASS MIX) / ボスステージ
25:07 10.ESCAPE FROM THE BYDO (PART1) / エンディング 1
26:56 11.ESCAPE FROM THE BYDO (PART2) / エンディング 2
28:55 12.BAD END (NO!NO!NO!) / NOVICE MODE エンディング
29:32 13.TIDE OVER / STAGE CLEARANCE
29:43 14.BE ALL GONE / ゲームオーバー
29:51 15.70'S BLAST ROCK OF ALL NIGHT SHAKING HEADS RADIO CONDITION 16 45 / コンティニュー
46:41 16.R-TYPE MEDLEY / スタッフ & MUSIC LIST
-----------------------------------------------------------------------------------------
履歴

2021-04-10 stage2のloop見直しをした.Titleの修正をした.
2020-08-19 initial upload

アイレムが稼働させた

translation

About author

It is a central game music channel in the generation for 'from 80s to '90 such as an arcade, household use, the PC As for the music here, the basics become the recording from a reproduction sound source

solitary 在メンタリスト DaiGo Youtube 的最佳解答

By メンタリスト DaiGo

2021-03-10 19:30:17 有 76,824 人看過有 1,648 人喜歡

⬇️今ならDラボが20日間無料⬇️
続きは
ASDの持つ8つの特殊能力〜ASD(アスペルガー症、自閉症スペクトラム)という進化の秘密

動画はこちら▶︎https://daigovideolab.jp/?utm_source=youtube&utm_medium=social&utm_campaign=official&utm_content=6wQ2cNaHi9c

🎧本日の無料オーディオブック
【無料】自分を操り、不安をなくす究極のマインドフルネスを Amazon でチェック！ https://amzn.to/2WY2jHN

そのほかのメンタリストDaiGoの【無料】オーディオブックはこちら→https://amzn.to/2UBuD1j ※Audible無料体験

📚本日の参考📚
▶︎ASD・アスペルガー症候群に関するオススメ認知行動療法の本

成人アスペルガー症候群の認知行動療法を Amazon でチェック！ https://amzn.to/3bc9gge

▶︎子供とADHD
自閉スペクトラム症の子どものための認知行動療法ワークブック―愛情をしっかり理解し上手に表現しよう! を Amazon でチェック！ https://amzn.to/3kH9Gyt

高機能自閉症・アスペルガー障害・ADHD・LDの子のSSTの進め方―特別支援教育のためのソーシャルスキルトレーニング(SST) を Amazon でチェック！ https://amzn.to/3kFE3oY

▶︎恋愛・結婚とADHD
夫がアスペルガーと思ったとき妻が読む本を Amazon でチェック！ https://amzn.to/3bj5rWV

アスペルガーの男性が女性について知っておきたいことを Amazon でチェック！ https://amzn.to/3kI0qKp

Jared Edward Reser. Conceptualizing the autism spectrum in terms of natural selection and behavioral ecology: The solitary forager hypothesis. Evolutionary Psychology, 2011; 9 (2): 207-238

Researched by http://ch.nicovideo.jp/paleo #今なら
#Dラボとオーディオブックが概要欄から無料

今なら Dラボとオーディオブックが概要欄から無料

メンタリスト DaiGo

About author

⭕️今なら20日間無料⭕️ メンタリストDaiGoの心理学動画が見放題の【Dラボ】はこのページの下にあるDラボ?‍⬛のアイコンから20日間無料【免責事項】このチャンネルは、科学の面白さを伝えることを目的としたエンタメです。なるべく多くの方に、科学的思考に興味を持ってもらうために、参考資料や過去の動画を元に、大胆な独自の考察したもので、事実を確定するものではなく、あくまで一説です。動画の結論は実際の研究とは異なる場合があります。僕は文献を読むのが好きなタダの理系であり、専門家ではありません。また、多くの科学者とも同じように人間ですから、間違うことも多々あります。実際に知識を利用する際には自己責任、または然るべき専門家に相談してください。また、Amazonリンクはアソシエイトリンクを使用しております。メンタリストDaiGoの心理学動画が見放題の【Dラボ】は ⬇️ここから20日間無料

社群媒體上有些相關的討論：

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#1. solitary中文(繁體)翻譯：劍橋詞典

solitary 的例句. solitary. The atrium receiving the systemic veins appeared to be a solitary chamber, connected with the large morphologically right ventricle ...

#2. solitary - Yahoo奇摩字典搜尋結果

solitary · adj. 單獨的，獨自的[Z][B]；單個的，唯一的[Z][B] · n. 獨居者；隱士[C]；單獨監禁[U] ...

#3. solitary 的中文翻釋｜影音字典- VoiceTube 看影片學英語

solitary. 分享單字. US /ˈsɑlɪˌtɛri/. ・. UK /'sɒlətrɪ/. B2 中高級. 定義影片字幕. adj. 孤單的；獨居的；寂寞的；偏僻的；唯；一的；獨居者；隱居者； ...

#4. Definition of solitary - Merriam-Webster

English Language Learners Definition of solitary · without anyone or anything else : not involving or including anyone or anything else · done by a person who is ...

#5. solitary - 唯一的，單個的，弧獨的 - 國家教育研究院雙語詞彙

以solitary 進行詞彙精確檢索結果. 出處/學術領域, 英文詞彙, 中文詞彙. 學術名詞動物學名詞, solitary, 孤立的；單獨的. 學術名詞醫學名詞

#6. solitary中文, solitary是什麼意思:孤獨的… - 查查在線詞典

solitary 中文::孤獨的…，點擊查查權威綫上辭典詳細解釋solitary的中文翻譯，solitary的發音，音標，用法和例句等。

#7. Solitary definition and meaning | Collins English Dictionary

solitary in American English · 1. alone; without companions; unattended · 2. living alone; avoiding the society of others · 3. by itself; alone · 4. characterized ...

#8. Solitary Definition & Meaning | Dictionary.com

Solitary definition, alone; without companions; unattended: a solitary passer-by. See more.

#9. meaning of solitary in Longman Dictionary of Contemporary ...

2 ALONEdoing something without anyone else with you a long, solitary walk3 ALONEspending a lot of time alone, usually because you like being alone OPP sociable ...

#10. solitary - 維基詞典，自由的多語言詞典

名詞編輯 · 隱士 · 單獨監禁. 形容詞編輯. 1.獨居的: 2.單獨的: 3.荒涼的，偏僻的: 4.寂寞的: 5.(動物)非群居的: 6.(植物)單生的.

#11. NYC Board of Correction Votes to end Solitary Confinement in ...

"New York City is going further than any jail system in America to ban solitary confinement once and for all,” said Mayor Bill de Blasio. “ ...

#12. Solitary Confinement - Vera Institute of Justice

Solitary confinement—also known as segregation, isolation and restrictive housing—is a growing safety and human rights concern across the country.…

#13. solitary (【形容詞】) 意思、用法及發音| Engoo Words

"solitary" 相關課程教材. Solitary bees don't make honey, but pollinate far more than honey bees. 獨居蜂不會生產蜂蜜，但是授粉的數量遠比一般蜜蜂來得多。

#14. solitary - Dreye權威釋義

solitary. 添加到生字筆記. KK:[ˈsɑlǝˌtɛrɪ] DJ:[ˈsɒlitǝri]. 形變: 比較級:more solitary 最高級:most solitary. 名複: solitaries. 權威釋義.

#15. Stop Solitary for Kids: Homepage

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#16. We Can Stop Solitary | American Civil Liberties Union

Across the country, states are waking up to the fact that we must address our overreliance on solitary confinement. Long-term isolation costs too much, ...

#17. Superficial Solitary Fibrous Tumor: A Series of 26 Cases

While superficial (cutaneous/subcutaneous) solitary fibrous tumor (SFT) have been described, definitive diagnosis is difficult due to overlapping features ...

#18. Solitary: A Biography (National Book Award Finalist - Amazon ...

Solitary : A Biography (National Book Award Finalist; Pulitzer Prize Finalist) [Woodfox, Albert] on Amazon.com. *FREE* shipping on qualifying offers.

#19. solitary - Chinese translation – Linguee

Many translated example sentences containing "solitary" – Chinese-English dictionary and search engine for Chinese translations.

#20. COVID precautions put more prisoners in isolation. It ... - NPR

An estimated 300000 people were held in solitary confinement in the U.S. at the height of the pandemic. Advocates are pushing to limit the ...

#21. Solitary confinement of prisoners - Council of Europe

Solitary confinement of prisoners. Date: 10/11/2011. Reference: CPT/Inf(2011)28-part2. English · French. Available translations:.

#22. solitary - 必应词典

必应词典为您提供solitary的释义，美[ˈsɑləˌteri]，英[ˈsɒlət(ə)ri]，adj. 独自的；单独的；喜欢（或惯于）独处的；单个的； n. 独居者；网络释义：孤独的；唯一的； ...

#23. Solitary - Wikipedia

Solitary is the state of being alone or in solitude. The term may refer to: shortened form of solitary confinement · Solitary animal, an animal that does ...

#24. 48 Synonyms & Antonyms for SOLITARY | Thesaurus.com

Find 48 ways to say SOLITARY, along with antonyms, related words, and example sentences at Thesaurus.com, the world's most trusted free thesaurus.

#25. I Survived 18 Years in Solitary Confinement - The New York ...

When he was 14 years old, he was sentenced to life in prison with no parole and spent 18 years in solitary confinement.

#26. Solitary Confinement and Mental Illness in US Prisons

In recent years, prison officials have increasingly turned to solitary confinement as a way to manage difficult or dangerous prisoners. Many of the prisoners ...

#27. SolitaryConfinement.org - Sourcebook on Solitary Confinement

A comprehensive single point of reference on solitary confinement, its documented health effects, and professional, ethical and human rights guidelines and ...

#28. Solitary by Terry Allen Kupers - Hardcover - University of ...

When I testify in court, I am often asked: 'What is the damage of long-term solitary confinement?' . . . Many prisoners emerge from prison after years in ...

#29. Solitary confinement facts | American Friends Service Committee

A: Solitary confinement of prisoners goes by a number of names—isolation, SHU (special housing units), administrative segregation, supermax prisons, ...

#30. Solitary (2020) - IMDb

'Solitary' is a contained sci-fi film about a man who wakes up inside a room to discover he's a prisoner sent into space to form Earth's first colony, and worse ...

#31. Abolish all forms of solitary confinement in Washington state

Solitary confinement goes by many names, including restricted housing, maximum custody, special housing and isolation.

#32. Solitary - Facebook

Solitary. 9385 likes · 88 talking about this. The new album "The Truth Behind The Lies" is out now Management - Imperative PR -...

#33. Barack Obama: Why we must rethink solitary confinement

Prisoners in solitary are more likely to commit suicide, especially juveniles and people with mental illnesses. The United States is a nation of ...

#34. Alone, in 'the hole' - American Psychological Association

Psychologists probe the mental health effects of solitary confinement. ... For most of the 20th century, prisoners' stays in solitary confinement were ...

#35. Solitary confinement | Association for the Prevention of Torture

Under certain circumstances, solitary confinement can amount to cruel, inhuman or degrading treatment, or even torture. Children, persons suffering from mental ...

#36. Historic Settlement Overhauls Solitary Confinement in New York

The New York Civil Liberties Union and New York State today announced a settlement agreement that will comprehensively overhaul solitary ...

#37. The Science of Solitary: Expanding the Harmfulness Narrative

The harmful effects of solitary confinement have been established in a variety of direct observations and empirical studies that date back to the nineteenth ...

#38. Solitary - Rotten Tomatoes

When Issac wakes up inside a room with no memory of how he got there, he discovers he's a prisoner sent into space to form Earth's first colony on another ...

#39. Solitary confinement: New York bans prison isolation over 15 ...

New York has adopted a law banning more than 15 days in solitary confinement, and is set to become one of the first US states to fall in ...

#40. What is solitary confinement? | Prisons and probation - The ...

Few prison systems use the term “solitary confinement”, instead referring to prison “segregation” or placement in “restrictive housing”. As this ...

#41. Last Days of Solitary | Watch S2017 E19 | FRONTLINE | PBS

Watch FRONTLINE's documentary on the long-term effects of solitary confinement and one state's ambitious attempt to decrease its use of solitary.

#42. Solitary•, 線上商店 - 蝦皮購物

solitary _ 全館以現貨為主12hr 快速出貨保證正品官方授權代理強烈招代理/批發/零售闆娘會代理各式商品目前以⭐️ishine愛閃耀⭐ ️ 日喬恩為主下單前如有任何 ...

#43. After 16 months in solitary, Ghislaine Maxwell prepares for her ...

Maxwell, 59, has spent 500 days in solitary confinement, the family declared on Twitter at the weekend, saying this contravened the “Nelson ...

#44. Explainer: Solitary Confinement of people in prison - Human ...

The practice of solitary confinement exists in all Australian states and territories by many different names: isolation, separation, seclusion, ...

#45. solitary - 用法_例句 - 海词词典

海詞詞典,最權威的學習詞典,為您提供solitary的在線翻譯,solitary是什麼意思,solitary的真人發音,權威用法和精選例句等。

#46. Solitary Islands Marine Park - NSW Department of Primary ...

Solitary Islands Marine Park on the NSW North Coast extends north from Coffs Harbour to Sandon River along about 75 km of coastline.

#47. solitary-翻译为中文-例句英语

使用Reverso Context: solitary confinement, solitary life，在英语-中文情境中翻译"solitary"

#48. Effects of solitary confinement on mental and physical health

Solitary confinement is associated with significant increases in anxiety, suicidal thoughts, and physical health conditions, such as vision ...

#49. SOLITARY CONFINEMENT - Southern Poverty Law Center

Solitary confinement in Florida takes four different forms: maximum management, close management, disciplinary confine- ment, and administrative confinement.

#50. Solitary Confinement: Effects, Practices, and Pathways toward ...

The use of solitary confinement in prisons became common with the rise of the modern penitentiary during the first half of the nineteenth century and his ...

#51. Solitary | Grove Atlantic

His book Solitary was a finalist for the Pulitzer Prize and the National Book Award for Nonfiction, and winner of the Stowe Prize and the Louisiana Endowment ...

#52. New data: Solitary confinement increases risk of premature ...

Any amount of time spent in solitary confinement increases the risk of death after release from prison, including deaths by suicide, ...

#53. Guidance on the risk assessment of plant protection products ...

and solitary bees) (EFSA Panel on Plant Protection Products and their Residues (PPR), 2012a) provided the scientific basis for the development ...

#54. Stop Solitary CT

Screen Shot 2021-03-11 at 1.35.59 PM.png. unlock humanity. Stop Solitary CT. about us · solitary in ct · In the News · The PROTECT Act · Petition.

#55. Generation of internal solitary waves by frontally forced ...

Internal solitary waves are hump-shaped, large-amplitude waves that are physically analogous to surface waves except that they propagate ...

#56. Solitary Islands Marine Park

Solitary Islands Marine Park is a place where the warm waters of the East Australian Current meet cooler waters from the south. They bring together tropical ...

#57. Iran: Ahmadreza Djalali nearing death in solitary confinement ...

He has been held in prolonged solitary confinement for over 100 days with the constant risk of his imminent execution laying over his head,” ...

#58. Solitary confinement should be banned in most cases, UN ...

A United Nations expert on torture today called on all countries to ban the solitary confinement of prisoners except in very exceptional ...

#59. Neuroscientists Make a Case against Solitary Confinement

Most prisoners sentenced to solitary confinement remain there for one to three months (pdf), although nearly a quarter spend over a year ...

#60. Solitary Confinement (Isolation) - National Commission on ...

Definition. Solitary confinement is the housing of an adult or juvenile with minimal to rare meaningful contact with other individuals. Those in ...

#61. Solitary Islands Aquarium

The Solitary Islands Aquarium, located at Southern Cross University's National Marine Science Centre, serves as an important community asset helping to ...

#62. Solitary confinement - The Howard League

What is solitary confinement and who is affected? The Supreme Court has described the “segregation” and “removal from association” of prisoners as “solitary ...

#63. Fighting Solitary Confinement - CCLA - Canadian Civil ...

Solitary confinement is the practice of confining someone in conditions of extreme isolation. · Getting the practice ruled unconstitutional has been a major goal ...

#64. solitary - Dictionary Definition : Vocabulary.com

If you're a lone wolf, a one-man band, a rugged individualist, or an island unto yourself, you prefer to be solitary — in other words, alone or single.

#65. Buried Alive: Stories From Inside Solitary Confinement | GQ

Any imposition of solitary confinement beyond 15 days constitutes torture. —Juan E. Méndez, United Nations special rapporteur, August 5, 2011 ...

#66. "solitary" 和"lonely" 的差別在哪裡？

solitary 的同義字I am feeling lonely. He is in solitary confinement. lonely is more of a feeling word - more emotive, a resultant state.

#67. Solitary confinement - Penal Reform International

The impact of solitary confinement on mental and physical health has been well documented, and new research published […]

#68. Solitary Pulmonary Nodules: Part I. Morphologic Evaluation for ...

This is important because a solitary pulmonary nodule is the initial radiographic finding in 20%–30% of patients with lung cancer, and prognosis depends in part ...

#69. Reforming solitary confinement - Health & Justice

Over the past decade there have been numerous and impassioned calls to reform the practice of solitary confinement in U.S. prisons.

#70. SOLITARY CONFINEMENT - John Howard Society

Prolonged solitary confinement has been called a form of torture. In Ontario, segregation (the term used by the government for solitary confinement) is ...

#71. How Albert Woodfox Survived Solitary | The New Yorker

Instead, he founded a chapter of the Party at the Louisiana State Penitentiary, in Angola, where he was held in solitary confinement for ...

#72. Guide to Solitary Bees in Britain | The Wildlife Trusts

Most of these bees are known as solitary bees with only 250 bumblebee species, 9 honey bee species and a number of social stingless bees ...

#73. Solitary Confinement - University of Minnesota Press

Why the living death of solitary confinement is both a form of political and racial violence and an attack on the structure of being itself.

#74. Report and Recommendations Concerning the Use of ...

Not all segregation is truly “solitary,” and many prison systems, ... that an inmate is in “restrictive housing” (or “solitary confinement,” ...

#75. Liman Center Releases Updated Report on Solitary ...

... 2019: A Snapshot of Restrictive Housing," the only comprehensive, current national data on the number of prisoners in solitary confinement.

#76. 名詞-[ solitary ]英文詞性

solitary. ['sɔlitəri]. adj.孤獨的, 獨立的, 單個的, 唯一的, 荒涼的 n.隱士,單獨禁閉. 例句與用法：. He lived in a solitary woodland. 他住在一個人跡罕至的林區裡 ...

#77. Solitary Idiopathic Choroiditis: The Richard B. Weaver Lecture

Conditions known to manifest as a solitary choroidal granuloma include sarcoidosis, tuberculosis, toxocariasis, or several other diseases. In many instances, ...

#78. Solitary Gardens

Solitary Gardens · About · Gardeners · Gardens · Garrison · Moms · Revolutionary Mortar · Grow Together · Us · About · Gardeners · Gardens · Garrison · Moms ...

#79. Solitary or Extramedullary Plasmacytoma - Memorial Sloan ...

People with solitary plasmacytoma do not have myeloma cells in the bone marrow or throughout the body. Instead, they have a tumor composed of plasma cells that ...

#80. Solitary rectal ulcer syndrome - Diagnosis and treatment

Solitary rectal ulcer syndrome is a rare condition that's often linked to chronic constipation. Learn more about symptoms and treatment.

#81. Senate Passes the 'HALT' Solitary Confinement Act | NY State ...

(Albany, NY) Today, the Senate passed the Humane Alternatives to Long-Term Solitary Confinement Act (HALT). Sponsored by Senator Julia ...

#82. Evaluation of the Solitary Pulmonary Nodule - American ...

Solitary pulmonary nodules are common radiologic findings, typically discovered incidentally through chest radiography or computed ...

#83. Solitary Confinement at Guantanamo Bay

There are three camps at Guantánamo where conditions qualify as solitary confinement or isolation: Camps 5, 6 and Echo. The military maintains ...

#84. Ian Manuel Speaks About Solitary Confinement - Equal ...

Ian Manuel spent 18 consecutive years in solitary confinement after he was sentenced to die in a Florida prison for a crime that happened ...

#85. Solitary Confinement | National Immigrant Justice Center

DHS must end the misuse of solitary confinement, particularly for individuals with mental health and chronic medical conditions, LGBT individuals, ...

#86. What Is Solitary Play? Definition, Age, Games, Examples, and ...

Solitary play, sometimes called independent play, is a stage of infant development where your child plays alone. While that may seem sad at ...

#87. De Blasio Delays Solitary Confinement Reforms Over Rikers ...

Mayor Bill de Blasio postponed planned limits on solitary confinement amid Rikers Island chaos — drawing a rebuke Tuesday from the sister of ...

#88. Solitary Sandpiper - eBird

Solitary Sandpiper. Tringa solitaria. © Garrett MacDonald. 18 Jul 2015. US-AK-Copper Center-Wrangell-Saint Elias National Park and Preserve ...

#89. Last Days of Solitary (full documentary) | FRONTLINE - YouTube

In this 2017 documentary, FRONTLINE goes inside one state's ambitious attempt to decrease its use of ...

#90. On View: Solitary Garden with jackie sumell - Institute of the ...

Solitary Garden, the participatory public sculpture and garden project by jackie sumell, is on view at UC Santa Cruz Baskin Art Studios.

#91. The Science of Solitary Confinement - Smithsonian Magazine

The Science of Solitary Confinement. Research tells us that isolation is an ineffective rehabilitation strategy and leaves lasting psychological ...

#92. Solitary Sandpiper Identification - All About Birds

The natty Solitary Sandpiper, with its olive-gray wings, black-and-white tail, and bold eyering, is a distinctive exception among the many lookalike ...

#93. Solitary confinement placement and post-release mortality risk ...

Our findings suggest that incarcerated individuals ever placed in solitary confinement are a vulnerable population in need of interventions.

#94. A Solitary Greenhouse - Department of Art, Art History, and ...

“(ADX is) The Worst Prison In America”. — Mother Jones Magazine. The same size and blueprint as an ADX isolation cell, A Solitary Greenhouse ...

#95. Solitary Confinement and Risk of Self-harm Among Jail Inmates

This analysis examines self-harm and diversion from a punitive setting to a therapeutic setting outside solitary confinement.

#96. Spotlight On Solitary - The John Howard Society of Canada

Join us and many other Correctional law based entities from November 16-30, 2020 as we examine how solitary confinement still exists in Canada.

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