BACKGROUND Bradycardia,renal failure,atrioventricular nodal blockade,shock,and hyper-kalemia(BRASH)syndrome is an acronym used to describe a constellation of BRASH.It is an underrecognized phenomenon that can be deadl...BACKGROUND Bradycardia,renal failure,atrioventricular nodal blockade,shock,and hyper-kalemia(BRASH)syndrome is an acronym used to describe a constellation of BRASH.It is an underrecognized phenomenon that can be deadly if not appro-priately managed in a timely manner.This case highlights the importance of rapid diagnosis and reviews a multitude of treatment options in a uniquely severe case of BRASH syndrome.CASE SUMMARY We present a case of a 54-year-old male on a beta-blocker and angiotensin-con-verting enzyme inhibitor who presented with one day history of nausea,vomi-ting,and shortness of breath.Upon presentation,he was bradycardic and hypotensive,requiring transcutaneous pacing.Initial electrocardiogram showed atrial fibrillation with ventricular rate in 30’s.He was found to have acute kidney injury,hyperkalemia,and metabolic acidosis.He was successfully treated with multiple potassium lowering agents,continuous renal replacement therapy,four pressors,mechanical ventilation,and transvenous pacing with complete recovery prior to discharge.CONCLUSION Increased awareness of BRASH syndrome may improve outcomes through timely diagnosis and aggressive intervention.展开更多
The identification of fully spin-polarized topological phases in magnetic inorganic materials has attracted significant attention.In this study,through first-principles calculations,we characterize CrCl_(2)(pyz)_(2),a...The identification of fully spin-polarized topological phases in magnetic inorganic materials has attracted significant attention.In this study,through first-principles calculations,we characterize CrCl_(2)(pyz)_(2),a metal-organic framework(MOF),as a nodal chain semimetal.Our results reveal a ferromagnetic ground state in this material,presenting as a half-metal with a single spin channel near the Fermi level.Specifically,the spin-down states form a nodal chain close to the Fermi level,consisting of three nodal loops protected by glide mirror symmetry on distinct planes.Furthermore,fully spin-polarized drumhead surface states corresponding to these nodal loops are identified on the material’s surfaces.Remarkably,we observe the persistence of the fully spin-polarized nodal chain even when tuning the ligand rotation an-gle of the MOF.Furthermore,our investigation delves into the influence of spin-orbit coupling(SOC)on the system,revealing that it has minimal impact on the nodal chain.The robustness of the nodal chain in the presence of SOC underscores its intriguing and resilient nature,indicating its potential utility in various electronic applications.Ultimately,the robust realization of a fully spin-polarized nodal chain in this magnetic MOF system holds promise for applications in the realm of spintronics.展开更多
Nodal pricing is a critical mechanism in electricity markets,utilized to determine the cost of power transmission to various nodes within a distribution network.As power systems evolve to incorporate higher levels of ...Nodal pricing is a critical mechanism in electricity markets,utilized to determine the cost of power transmission to various nodes within a distribution network.As power systems evolve to incorporate higher levels of renewable energy and face increasing demand fluctuations,traditional nodal pricing models often fall short to meet these new challenges.This research introduces a novel enhanced nodal pricing mechanism for distribution networks,integrating advanced optimization techniques and hybrid models to overcome these limitations.The primary objective is to develop a model that not only improves pricing accuracy but also enhances operational efficiency and system reliability.This study leverages cutting-edge hybrid algorithms,combining elements of machine learning with conventional optimization methods,to achieve superior performance.Key findings demonstrate that the proposed hybrid nodal pricing model significantly reduces pricing errors and operational costs compared to conventional methods.Through extensive simulations and comparative analysis,the model exhibits enhanced performance under varying load conditions and increased levels of renewable energy integration.The results indicate a substantial improvement in pricing precision and network stability.This study contributes to the ongoing discourse on optimizing electricity market mechanisms and provides actionable insights for policymakers and utility operators.By addressing the complexities of modern power distribution systems,our research offers a robust solution that enhances the efficiency and reliability of power distribution networks,marking a significant advancement in the field.展开更多
The 13-node quadrilateral and 39-node hexahedral cubic serendipity elements produce nodally integrated positive-definite lumped heat capacity matrices in higher-order finite element analysis.However,these elements dis...The 13-node quadrilateral and 39-node hexahedral cubic serendipity elements produce nodally integrated positive-definite lumped heat capacity matrices in higher-order finite element analysis.However,these elements display severe convergence deterioration in explicit transient heat conduction analysis with lumped heat ca-pacity matrices.This convergence decay is due to the violation of variational integration consistency by the standard Galerkin formulation with lumped heat capacity matrices.This issue is resolved by introducing the boundary-enhanced Galerkin weak form that incorporates the elemental boundary contribution in the discrete finite element formulation.Subsequently,it is theoretically proven that a direct nodal integration identically fulfills the variational integration consistency in the context of the boundary-enhanced Galerkin weak form.The proposed variationally consistent nodal integration therefore enables optimal convergence for explicit transient heat conduction analysis with lumped heat capacity matrices.The efficacy of the proposed variationally con-sistent nodal integration formulation for the 13-node quadrilateral and 39-node hexahedral cubic elements is thoroughly demonstrated via numerical examples.展开更多
The doping evolution of the nodal electron dynamics in the trilayer cuprate superconductor Bi_(2)Sr_(2)Ca_(2)Cu_(3)O_(10+δ)(Bi2223)is investigated using high-resolution laser-based angle-resolved photoemission spectr...The doping evolution of the nodal electron dynamics in the trilayer cuprate superconductor Bi_(2)Sr_(2)Ca_(2)Cu_(3)O_(10+δ)(Bi2223)is investigated using high-resolution laser-based angle-resolved photoemission spectroscopy(ARPES).Bi2223single crystals with different doping levels are prepared by controlled annealing,which cover the underdoped,optimallydoped and overdoped regions.The electronic phase diagram of Bi2223 is established which describes the Tcdependence on the sample doping level.The doping dependence of the nodal Fermi momentum for the outer(OP)and inner(IP)CuO_(2)planes is determined.Charge distribution imbalance between the OP and IP CuO_(2)planes is quantified,showing enhanced disparity with increasing doping.Nodal band dispersions demonstrate a prominent kink at~94 meV in the IP band,attributed to the unique Cu coordination in the IP plane,while a weaker~60 meV kink is observed in the OP band.The nodal Fermi velocity of both OP and IP bands is nearly constant at~1.62 eV·A independent of doping.These results provide important information to understand the origin of high Tcand superconductivity mechanism in high temperature cuprate superconductors.展开更多
Takotsubo syndrome(TTS),also known as stress cardiomyopathy,occurs in approximately 2%of all patients presenting with suspected acute coronary syndrome.[1]The in-hospital mortality rate of pati-ents with TTS is report...Takotsubo syndrome(TTS),also known as stress cardiomyopathy,occurs in approximately 2%of all patients presenting with suspected acute coronary syndrome.[1]The in-hospital mortality rate of pati-ents with TTS is reported to be approximately 4%-5%.[2]This condition is commonly associated with various rhythm and conduction disturbances,such as atrial fibrillation(5%-15%),ventricular arrhythmias(4%-9%),and rarely sinus node dysfunction(1.3%).展开更多
Objective: To explore the clinicobiologic features and outcomes of diffuse large B-cell lymphoma(DLBCL)patients in China according to the primary site.Methods: A total of 1,085 patients diagnosed with DLBCL in Nationa...Objective: To explore the clinicobiologic features and outcomes of diffuse large B-cell lymphoma(DLBCL)patients in China according to the primary site.Methods: A total of 1,085 patients diagnosed with DLBCL in National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College during a 6-year period were enrolled. Their clinical characteristics and outcomes were analyzed according to the primary site.Results: In the 1,085 patients, 679(62.6%) cases were nodal DLBCL(N-DLBCL) and 406 cases(37.4%) were extranodal DLBCL(EN-DLBCL). The most common sites of N-DLBCL were lymphonodus(64.8%), Waldeyer's ring(19.7%), mediastinum(12.8%) and spleen(2.7%), while in EN-DLBCL, stomach(22.4%), intestine(16.0%),nose and sinuses(8.9%), testis(8.4%), skin(7.9%), thyroid(6.9%), central nervous system(CNS)(6.4%), breast(5.7%), bone(3.4%), and salivary gland(2.7%) were most common. N-DLBCL patients tend to present B symptoms, bulky disease, and elevated LDH more often, while age >60 years, extranodal sites >1, Ann Arbor stage I or II, bone marrow involvement, and Ki-67 index >90% were usually seen in EN-DLBCL. The 5-year overall survival(OS) rate and progression-free survival(PFS) rate for all patients were 62.5% and 54.2%. The 5-year OS rate for patients with N-DLBCL and EN-DLBCL were 65.5% and 56.9%(P=0.008), and the 5-year PFS were57.0% and 49.0%(P=0.020). Waldeyer's ring originated DLBCL possessed the highest 5-year OS rate(83.6%) and PFS rate(76.9%) in N-DLBCL. The top five EN-DLBCL subtypes with favorable prognosis were stomach,breast, nose and sinuses, lung, salivary gland, with 5-year OS rate: 70.3%, 69.6%, 69.4%, 66.7% and 63.6%,respectively. While CNS, testis, oral cavity and kidney originated EN-DLBCL faced miserable prognosis, with 5-year OS rate of 26.9%, 38.2%, and 42.9%.Conclusions: In our study, primary sites were associated with clinical characteristics and outcomes. Compared with EN-DLBCL, N-DLBCL had better prognosis.展开更多
文摘BACKGROUND Bradycardia,renal failure,atrioventricular nodal blockade,shock,and hyper-kalemia(BRASH)syndrome is an acronym used to describe a constellation of BRASH.It is an underrecognized phenomenon that can be deadly if not appro-priately managed in a timely manner.This case highlights the importance of rapid diagnosis and reviews a multitude of treatment options in a uniquely severe case of BRASH syndrome.CASE SUMMARY We present a case of a 54-year-old male on a beta-blocker and angiotensin-con-verting enzyme inhibitor who presented with one day history of nausea,vomi-ting,and shortness of breath.Upon presentation,he was bradycardic and hypotensive,requiring transcutaneous pacing.Initial electrocardiogram showed atrial fibrillation with ventricular rate in 30’s.He was found to have acute kidney injury,hyperkalemia,and metabolic acidosis.He was successfully treated with multiple potassium lowering agents,continuous renal replacement therapy,four pressors,mechanical ventilation,and transvenous pacing with complete recovery prior to discharge.CONCLUSION Increased awareness of BRASH syndrome may improve outcomes through timely diagnosis and aggressive intervention.
基金supported by the Intelligence of Electrical Equipment of the Hebei University of Technology(No.EERI_OY2021006)the Overseas Scientists Sponsorship Program of Hebei Province(No.C20230320)the S&T Program of Hebei(No.225676163GH).
文摘The identification of fully spin-polarized topological phases in magnetic inorganic materials has attracted significant attention.In this study,through first-principles calculations,we characterize CrCl_(2)(pyz)_(2),a metal-organic framework(MOF),as a nodal chain semimetal.Our results reveal a ferromagnetic ground state in this material,presenting as a half-metal with a single spin channel near the Fermi level.Specifically,the spin-down states form a nodal chain close to the Fermi level,consisting of three nodal loops protected by glide mirror symmetry on distinct planes.Furthermore,fully spin-polarized drumhead surface states corresponding to these nodal loops are identified on the material’s surfaces.Remarkably,we observe the persistence of the fully spin-polarized nodal chain even when tuning the ligand rotation an-gle of the MOF.Furthermore,our investigation delves into the influence of spin-orbit coupling(SOC)on the system,revealing that it has minimal impact on the nodal chain.The robustness of the nodal chain in the presence of SOC underscores its intriguing and resilient nature,indicating its potential utility in various electronic applications.Ultimately,the robust realization of a fully spin-polarized nodal chain in this magnetic MOF system holds promise for applications in the realm of spintronics.
文摘Nodal pricing is a critical mechanism in electricity markets,utilized to determine the cost of power transmission to various nodes within a distribution network.As power systems evolve to incorporate higher levels of renewable energy and face increasing demand fluctuations,traditional nodal pricing models often fall short to meet these new challenges.This research introduces a novel enhanced nodal pricing mechanism for distribution networks,integrating advanced optimization techniques and hybrid models to overcome these limitations.The primary objective is to develop a model that not only improves pricing accuracy but also enhances operational efficiency and system reliability.This study leverages cutting-edge hybrid algorithms,combining elements of machine learning with conventional optimization methods,to achieve superior performance.Key findings demonstrate that the proposed hybrid nodal pricing model significantly reduces pricing errors and operational costs compared to conventional methods.Through extensive simulations and comparative analysis,the model exhibits enhanced performance under varying load conditions and increased levels of renewable energy integration.The results indicate a substantial improvement in pricing precision and network stability.This study contributes to the ongoing discourse on optimizing electricity market mechanisms and provides actionable insights for policymakers and utility operators.By addressing the complexities of modern power distribution systems,our research offers a robust solution that enhances the efficiency and reliability of power distribution networks,marking a significant advancement in the field.
基金supported by the National Natural Science Foundation of China(Grant Nos.12372201 and 12072302).
文摘The 13-node quadrilateral and 39-node hexahedral cubic serendipity elements produce nodally integrated positive-definite lumped heat capacity matrices in higher-order finite element analysis.However,these elements display severe convergence deterioration in explicit transient heat conduction analysis with lumped heat ca-pacity matrices.This convergence decay is due to the violation of variational integration consistency by the standard Galerkin formulation with lumped heat capacity matrices.This issue is resolved by introducing the boundary-enhanced Galerkin weak form that incorporates the elemental boundary contribution in the discrete finite element formulation.Subsequently,it is theoretically proven that a direct nodal integration identically fulfills the variational integration consistency in the context of the boundary-enhanced Galerkin weak form.The proposed variationally consistent nodal integration therefore enables optimal convergence for explicit transient heat conduction analysis with lumped heat capacity matrices.The efficacy of the proposed variationally con-sistent nodal integration formulation for the 13-node quadrilateral and 39-node hexahedral cubic elements is thoroughly demonstrated via numerical examples.
基金supported by the National Natural Science Foundation of China(Grant Nos.12488201 by X.J.Z.,12374066 by L.Z.,and 12374154 by X.T.L.)the National Key Research and Development Program of China(Grant Nos.2021YFA1401800 by X.J.Z.,2022YFA1604200 by L.Z.,2022YFA1403900 by G.D.L.and 2023YFA1406000by X.T.L.)+3 种基金the Strategic Priority Research Program(B)of the Chinese Academy of Sciences(Grant No.XDB25000000by X.J.Z.)Innovation Program for Quantum Science and Technology(Grant No.2021ZD0301800 by X.J.Z.)the Youth Innovation Promotion Association of CAS(Grant No.Y2021006 by L.Z.)the Synergetic Extreme Condition User Facility(SECUF)。
文摘The doping evolution of the nodal electron dynamics in the trilayer cuprate superconductor Bi_(2)Sr_(2)Ca_(2)Cu_(3)O_(10+δ)(Bi2223)is investigated using high-resolution laser-based angle-resolved photoemission spectroscopy(ARPES).Bi2223single crystals with different doping levels are prepared by controlled annealing,which cover the underdoped,optimallydoped and overdoped regions.The electronic phase diagram of Bi2223 is established which describes the Tcdependence on the sample doping level.The doping dependence of the nodal Fermi momentum for the outer(OP)and inner(IP)CuO_(2)planes is determined.Charge distribution imbalance between the OP and IP CuO_(2)planes is quantified,showing enhanced disparity with increasing doping.Nodal band dispersions demonstrate a prominent kink at~94 meV in the IP band,attributed to the unique Cu coordination in the IP plane,while a weaker~60 meV kink is observed in the OP band.The nodal Fermi velocity of both OP and IP bands is nearly constant at~1.62 eV·A independent of doping.These results provide important information to understand the origin of high Tcand superconductivity mechanism in high temperature cuprate superconductors.
文摘Takotsubo syndrome(TTS),also known as stress cardiomyopathy,occurs in approximately 2%of all patients presenting with suspected acute coronary syndrome.[1]The in-hospital mortality rate of pati-ents with TTS is reported to be approximately 4%-5%.[2]This condition is commonly associated with various rhythm and conduction disturbances,such as atrial fibrillation(5%-15%),ventricular arrhythmias(4%-9%),and rarely sinus node dysfunction(1.3%).
基金funded by grants from the National Science and Technology Support Program (No. 2014BAI09B12)Chinese Academy of Medical Sciences (CAMS) Innovation Fund for Medical Sciences (CIFMS) (No. 2016-I2M-1-001)
文摘Objective: To explore the clinicobiologic features and outcomes of diffuse large B-cell lymphoma(DLBCL)patients in China according to the primary site.Methods: A total of 1,085 patients diagnosed with DLBCL in National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College during a 6-year period were enrolled. Their clinical characteristics and outcomes were analyzed according to the primary site.Results: In the 1,085 patients, 679(62.6%) cases were nodal DLBCL(N-DLBCL) and 406 cases(37.4%) were extranodal DLBCL(EN-DLBCL). The most common sites of N-DLBCL were lymphonodus(64.8%), Waldeyer's ring(19.7%), mediastinum(12.8%) and spleen(2.7%), while in EN-DLBCL, stomach(22.4%), intestine(16.0%),nose and sinuses(8.9%), testis(8.4%), skin(7.9%), thyroid(6.9%), central nervous system(CNS)(6.4%), breast(5.7%), bone(3.4%), and salivary gland(2.7%) were most common. N-DLBCL patients tend to present B symptoms, bulky disease, and elevated LDH more often, while age >60 years, extranodal sites >1, Ann Arbor stage I or II, bone marrow involvement, and Ki-67 index >90% were usually seen in EN-DLBCL. The 5-year overall survival(OS) rate and progression-free survival(PFS) rate for all patients were 62.5% and 54.2%. The 5-year OS rate for patients with N-DLBCL and EN-DLBCL were 65.5% and 56.9%(P=0.008), and the 5-year PFS were57.0% and 49.0%(P=0.020). Waldeyer's ring originated DLBCL possessed the highest 5-year OS rate(83.6%) and PFS rate(76.9%) in N-DLBCL. The top five EN-DLBCL subtypes with favorable prognosis were stomach,breast, nose and sinuses, lung, salivary gland, with 5-year OS rate: 70.3%, 69.6%, 69.4%, 66.7% and 63.6%,respectively. While CNS, testis, oral cavity and kidney originated EN-DLBCL faced miserable prognosis, with 5-year OS rate of 26.9%, 38.2%, and 42.9%.Conclusions: In our study, primary sites were associated with clinical characteristics and outcomes. Compared with EN-DLBCL, N-DLBCL had better prognosis.
