BACKGROUND Sarcoidosis is a rare multisystem disease characterized histologically by noncaseating granuloma formation in the affected organ.While cardiac sarcoidosis is found on autopsy in up to 25%of sarcoidosis case...BACKGROUND Sarcoidosis is a rare multisystem disease characterized histologically by noncaseating granuloma formation in the affected organ.While cardiac sarcoidosis is found on autopsy in up to 25%of sarcoidosis cases,it is still underdiagnosed and is associated with a poor prognosis.Although the etiology of sarcoidosis remains unclear,an antigen triggered exaggerated immune response has been hypothesized.Early detection and prompt management of cardiac sarcoidosis remains pivotal.CASE SUMMARY A 60-year-old female,with pulmonary sarcoidosis in remission,presented to the cardiology outpatient clinic for evaluation of weeks-long dyspnea on moderate exertion(New York Heart Association class II)that was relieved by rest.Submaximal exercise stress test showed multifocal ventricular extrasystoles,followed by a self-limiting torsades de pointes.Cardiac magnetic resonance imaging showed nondilated and normotrophic left ventricle with basoseptal and mid-septal dyskinesis.The magnetic resonance imaging-derived left ventricular ejection fraction was 45%.Delayed enhancement showed patchy transmural fibrosis of the septum and hyperenhancement of the papillary muscles,all in favor of extensive cardiac involvement of sarcoidosis.A double-chamber implantable cardiac defibrillator was implanted,and methylprednisolone(12 mg/d)and methotrexate(12.5 mg/wk)treatment was initiated.Follow-up and implantable cardiac defibrillator interrogation showed episodes of asymptomatic nonsustained ventricular tachycardia and an asymptomatic episode of nonsustained ventricular tachycardia ending by the first antitachycardia pacing run.CONCLUSION Along an extensive review of the literature,this unusual case report highlights the importance of early detection of cardiac involvement of sarcoidosis,in order to avoid potential complications and increase survival.展开更多
BACKGROUND QT interval prolongation can induce torsades de pointes(TdP),a potentially fatal ventricular arrhythmia.Recently,an increasing number of non-cardiac drugs have been found to cause QT prolongation and/or TdP...BACKGROUND QT interval prolongation can induce torsades de pointes(TdP),a potentially fatal ventricular arrhythmia.Recently,an increasing number of non-cardiac drugs have been found to cause QT prolongation and/or TdP onset.Moreover,recent findings have demonstrated the key roles of systemic inflammatory activation and fever in promoting long-QT syndrome(LQTS)and TdP development.CASE SUMMARY A 30-year-old woman was admitted with a moderate to high-grade episodic fever for two weeks.The patient was administered with multiple antibiotics after hospitalization but still had repeating fever and markedly elevated C-reactive protein.Once after a high fever,the patient suddenly lost consciousness,and electrocardiogram(ECG)showed transient TdP onset after frequent premature ventricular contraction.The patient recovered sinus rhythm and consciousness spontaneously,and post-TdP ECG revealed a prolonged QTc interval of 560 ms.The patient’s clinical manifestations and unresponsiveness to the antibiotics led to the final diagnosis of adult-onset Still’s disease(AOSD).There was no evidence of cardiac involvement.After the AOSD diagnosis,discontinuation of antibiotics and immediate initiation of intravenous dexamethasone administration resulted in the normal temperature and QTc interval.The genetic analysis identified that the patient and her father had heterozygous mutations in KCNH2(c.1370C>T)and AKAP9(c.7725A>C).During the 2-year follow-up period,the patient had no recurrence of any arrhythmia and maintained normal QTc interval.CONCLUSION This case study highlights the risk of systemic inflammatory activation and antibiotic-induced TdP/LQTS onset.Genetic analysis should be considered to identify individuals at high risk of developing TdP.展开更多
Abstract： Loperamide is a common, over-the-counter, antidiarrheal medication that has been implicated in cases of ventricular tachycardia. A 32 year-old female patient with a history of opioid abuse and no prior hist...Abstract： Loperamide is a common, over-the-counter, antidiarrheal medication that has been implicated in cases of ventricular tachycardia. A 32 year-old female patient with a history of opioid abuse and no prior history of cardiovascular disease experienced Torsades de pointes. An electrocardiogram at the time of hospital presentation revealed a prolonged QT interval at 636 msec. Diagnostic evaluation was unremarkable for any underlying cardiovascular pathology. Further investigation revealed the patient had been taking 30-40 loperamide 2 mg tablets oral daily for 2 weeks prior to the onset of Torsades de pointes. At high doses, loperamide may prolong the QT interval through antagonism of the human ether-a-go-go potassium current, thus increasing the risk of ventricular arrhythmias. Clinicians should be cautious with administration of high doses of loperamide to all patients, especially patients at high risk for QT interval prolongation.展开更多
Background Torsade de pointes (TdP) is a form of polymorphic ventricular tachycardia featuring prolonged QT intervals. Female gender is associated with an increased risk of TdP. However, the causes of the sex differe...Background Torsade de pointes (TdP) is a form of polymorphic ventricular tachycardia featuring prolonged QT intervals. Female gender is associated with an increased risk of TdP. However, the causes of the sex difference in risk are poorly understood. Recently, transmural dispersion of repolarization (TDR) has been implicated in the genesis of TdP. Consequently, we compared TdP incidence and TDR between male and female rabbit hearts in order to investigate the mechanism of sex difference in TdP risk in rabbits in vitro. Methods By means of monophasic action potential recording techniques, the monophasic action potential of the epicardium, midmyocardium, and endocardium were simultaneously recorded using specially designed plunge-needle electrodes placed across the left ventricular free wall of both female (n=8) and male (n=8) rabbit hearts purfused by the Langendorff method. TdP was induced by bradycardia, d-sotalol, and low-K +, Mg 2+ Tyrode solution. Results TDR measurements in all three myocardial layers of male and female rabbit hearts were (18±2) ms and (21±2) ms, respectively (n=8, P>0.05). After perfusion with d-sotalol, the 90% monophasic action potential duration was prolonged in both male and femlae rabbits. TDR in male and female rabbit hearts increased to (29±2) ms and (61±2) ms, respectively, a difference that is significant. Eight female rabbit hearts had early afterdepolarization and 7 of them developed TdP. Seven male rabbit hearts had early after depolarization, but only one of these hearts developed TdP.Conclusion Greater TDR may play an important role in the higher incidence of TdP in female rabbit hearts.展开更多
Neuromodulation techniques effectively intervene in cognitive function,holding considerable scientific and practical value in fields such as aerospace,medicine,life sciences,and brain research.These techniques utilize...Neuromodulation techniques effectively intervene in cognitive function,holding considerable scientific and practical value in fields such as aerospace,medicine,life sciences,and brain research.These techniques utilize electrical stimulation to directly or indirectly target specific brain regions,modulating neural activity and influencing broader brain networks,thereby regulating cognitive function.Regulating cognitive function involves an understanding of aspects such as perception,learning and memory,attention,spatial cognition,and physical function.To enhance the application of cognitive regulation in the general population,this paper reviews recent publications from the Web of Science to assess the advancements and challenges of invasive and non-invasive stimulation methods in modulating cognitive functions.This review covers various neuromodulation techniques for cognitive intervention,including deep brain stimulation,vagus nerve stimulation,and invasive methods using microelectrode arrays.The non-invasive techniques discussed include transcranial magnetic stimulation,transcranial direct current stimulation,transcranial alternating current stimulation,transcutaneous electrical acupoint stimulation,and time interference stimulation for activating deep targets.Invasive stimulation methods,which are ideal for studying the pathogenesis of neurological diseases,tend to cause greater trauma and have been less researched in the context of cognitive function regulation.Non-invasive methods,particularly newer transcranial stimulation techniques,are gentler and more appropriate for regulating cognitive functions in the general population.These include transcutaneous acupoint electrical stimulation using acupoints and time interference methods for activating deep targets.This paper also discusses current technical challenges and potential future breakthroughs in neuromodulation technology.It is recommended that neuromodulation techniques be combined with neural detection methods to better assess their effects and improve the accuracy of non-invasive neuromodulation.Additionally,researching closed-loop feedback neuromodulation methods is identified as a promising direction for future development.展开更多
History has never been driven by comfort,nor shaped solely by inheritance.Its most significant turning points have emerged from those with youth,conviction and courage ingrained in them.Progress starts when young peop...History has never been driven by comfort,nor shaped solely by inheritance.Its most significant turning points have emerged from those with youth,conviction and courage ingrained in them.Progress starts when young people not only dream but also take action.Sometimes,the boldest move is not to run towards the glow of cities,but to turn back-to one’s soil,roots and forgotten home-and help it to flourish.展开更多
Local residents,international artists and entrepreneurs are converging on Haikou’s historical Qilou Street,writing a new chapter of openness in Hainan More than 100 years ago,the area along Qilou(Sotto Portico)Street...Local residents,international artists and entrepreneurs are converging on Haikou’s historical Qilou Street,writing a new chapter of openness in Hainan More than 100 years ago,the area along Qilou(Sotto Portico)Street in Haikou,the capital of Hainan Province,served as the embarkation point for Hainanese setting out on their maritime voyages to seek greener pastures.展开更多
Background:The medicinal material known as Os Draconis(Longgu)originates from fossilized remains of ancient mammals and is widely used in treating emotional and mental conditions.However,fossil resources are nonrenewa...Background:The medicinal material known as Os Draconis(Longgu)originates from fossilized remains of ancient mammals and is widely used in treating emotional and mental conditions.However,fossil resources are nonrenewable,and clinical demand is increasingly difficult to meet,leading to a proliferation of counterfeit products.During prolonged geological burial,static pressure from the surrounding strata severely compromises the microstructural integrity of osteons in Os Draconis,but Os Draconis still largely retains the structural features of mammalian bone.Methods:Using verified authentic Os Draconis samples over 10,000 years old as a baseline,this study summarizes the ultrastructural characteristics of genuine Os Draconis.Employing electron probe microanalysis and optical polarized light microscopy,we examined 28 batches of authentic Os Draconis and 31 batches of counterfeits to identify their ultrastructural differences.Key points for ultrastructural identification of Os Draconis were compiled,and a new identification approach was proposed based on these differences.Results:Authentic Os Draconis exhibited distinct ultrastructural markers:irregularly shaped osteons with traversing fissures,deformed/displaced Haversian canals,and secondary mineral infill(predominantly calcium carbonate).Counterfeits showed regular osteon arrangements,absent traversal fissures,and homogeneous hydroxyapatite composition.Lab-simulated samples lacked structural degradation features.EPMA confirmed calcium carbonate infill in fossilized Haversian canals,while elemental profiles differentiated lacunae types(void vs.mineral-packed).Conclusion:The study established ultrastructural criteria for authentic Os Draconis identification:osteon deformation,geological fissures penetrating bone units,and heterogenous mineral deposition.These features,unattainable in counterfeits or modern processed bones,provide a cost-effective,accurate identification method.This approach bridges gaps in TCM material standardization and supports quality control for clinical applications.展开更多
The Three Gorges Reservoir area hosts numerous high-risk columnar rock masses,but predicting their full-process of collapse dynamics in narrow-deep terrains remains challenging.This study investigated the Changdongzi ...The Three Gorges Reservoir area hosts numerous high-risk columnar rock masses,but predicting their full-process of collapse dynamics in narrow-deep terrains remains challenging.This study investigated the Changdongzi columnar dangerous rock mass(CCDRM)through field surveys and simulated its collapse dynamics with Material Point Method(MPM),and analyzed the collapse-diffusionsurge generation mechanisms.Field investigations revealed a 0.8 m-thick lotus-like extrusion structure at the base,severely degraded by cyclic water fluctuations,predisposing the rock mass to base-crushing failure.Numerical simulations indicate collapse velocities up to 42 m/s,amplified spreading with a 318 m deposition range and 11 m maximum thickness,and two major collisions causing 50%-60%velocity reduction.Gully topography buffers kinetic energy,retaining 5%debris on slopes and channeling 7%into the river.High-speed river impact generates a 20 m-diameter cavity,producing an 11 m surge,identifying the Guandukou Town waterfront 1.2 km downstream as a high-risk zone.These results clarify the collapse mechanisms of columnar dangerous rock mass and inform its hazard mitigation strategies.展开更多
Severe trauma often involves complex injuries,leading to high disability and fatality rates.Effective treatment requires prompt and coordinated efforts across multiple disciplines to enhance success rates.Time-based c...Severe trauma often involves complex injuries,leading to high disability and fatality rates.Effective treatment requires prompt and coordinated efforts across multiple disciplines to enhance success rates.Time-based chain rescue is crucial in managing severe trauma.A patient with chest and abdominal injuries and hemorrhagic shock was transferred from an ambulance to our hospital.Our trauma team-initiated pre-hospital first aid,utilized an emergency green channel,and conducted rapid ultrasound,collaborating across disciplines.The patient eventually recovered and was discharged.展开更多
In reliability analyses,the absence of a priori information on the most probable point of failure(MPP)may result in overlooking critical points,thereby leading to biased assessment outcomes.Moreover,second-order relia...In reliability analyses,the absence of a priori information on the most probable point of failure(MPP)may result in overlooking critical points,thereby leading to biased assessment outcomes.Moreover,second-order reliability methods exhibit limited accuracy in highly nonlinear scenarios.To overcome these challenges,a novel reliability analysis strategy based on a multimodal differential evolution algorithm and a hypersphere integration method is proposed.Initially,the penalty function method is employed to reformulate the MPP search problem as a conditionally constrained optimization task.Subsequently,a differential evolution algorithm incorporating a population delineation strategy is utilized to identify all MPPs.Finally,a paraboloid equation is constructed based on the curvature of the limit-state function at the MPPs,and the failure probability of the structure is calculated by using the hypersphere integration method.The localization effectiveness of the MPPs is compared through multiple numerical cases and two engineering examples,with accuracy comparisons of failure probabilities against the first-order reliability method(FORM)and the secondorder reliability method(SORM).The results indicate that the method effectively identifies existing MPPs and achieves higher solution precision.展开更多
Discontinuities in rock masses critically impact the stability and safety of underground engineering.Mainstream discontinuities identificationmethods,which rely on normal vector estimation and clustering algorithms,su...Discontinuities in rock masses critically impact the stability and safety of underground engineering.Mainstream discontinuities identificationmethods,which rely on normal vector estimation and clustering algorithms,suffer from accuracy degradation,omission of critical discontinuities when orientation density is unevenly distributed,and need manual intervention.To overcome these limitations,this paper introduces a novel discontinuities identificationmethod based on geometric feature analysis of rock mass.By analyzing spatial distribution variability of point cloud and integrating an adaptive region growing algorithm,the method accurately detects independent discontinuities under complex geological conditions.Given that rock mass orientations typically follow a Fisher distribution,an adaptive hierarchical clustering algorithm based on statistical analysis is employed to automatically determine the optimal number of structural sets,eliminating the need for preset clusters or thresholds inherent in traditional methods.The proposed approach effectively handles diverse rock mass shapes and sizes,leveraging both local and global geometric features to minimize noise interference.Experimental validation on three real-world rock mass models,alongside comparisons with three conventional directional clustering algorithms,demonstrates superior accuracy and robustness in identifying optimal discontinuity sets.The proposed method offers a reliable and efficienttool for discontinuities detection and grouping in underground engineering,significantlyenhancing design and construction outcomes.展开更多
With the maturation of coalbed methane(CBM)exploitation and the transition into the late stages of dewatering and gas production,liquid loading in gathering pipelines has emerged as a major constraint on productivity ...With the maturation of coalbed methane(CBM)exploitation and the transition into the late stages of dewatering and gas production,liquid loading in gathering pipelines has emerged as a major constraint on productivity and operational stability.Based on real-time field data and gas-liquid physicochemical analyses,this study elucidates the mechanisms governing liquid loading formation under varying temperature,pressure,and water saturation conditions.An HYSYS model is employed to determine the water dew point,while the Turner model is used to evaluate the critical conditions for liquid holdup.The results indicate that gas water saturation exerts the dominant influence on liquid loading risk,followed by pressure,whereas temperature plays a comparatively minor role.When water saturation exceeds 2%and the operating temperature falls below the dew point,condensation-driven liquid loading increases sharply.To further characterize the spatial distribution of liquid accumulation,a steady-state OLGA model of a DN100 gathering pipeline network is developed to examine the effects of pipe diameter,water saturation,and soil temperature.The simulations show that larger pipe diameters and higher water saturation significantly aggravate liquid holdup,while elevated soil temperature mitigates liquid accumulation.Moreover,the liquid holdup ratio is found to correlate closely with flow regime transitions,confirming its suitability as a key indicator of liquid loading risk.Based on these findings,optimization strategies for pipeline design and operation are proposed.To mitigate liquid loading,the gathering pipeline velocity should be maintained above the critical value of 1.63 m/s,and the gas water content should be strictly controlled below 2%.Under operating conditions representative of the Hancheng block,it is recommended to reduce the pipeline diameter from DN130 to DN100 to enhance self-cleaning capacity.In addition,thermal insulation should be applied during winter operation to maintain the pipe wall temperature above 10◦C,thereby suppressing condensation-induced liquid accumulation.展开更多
3D laser scanning technology is widely used in underground openings for high-precision,rapid,and nondestructive structural evaluations.Segmenting large 3D point cloud datasets,particularly in coal mine roadways with m...3D laser scanning technology is widely used in underground openings for high-precision,rapid,and nondestructive structural evaluations.Segmenting large 3D point cloud datasets,particularly in coal mine roadways with multi-scale targets,remains challenging.This paper proposes an enhanced segmentation method integrating improved PointNet++with a coverage-voted strategy.The coverage-voted strategy reduces data while preserving multi-scale target topology.The segmentation is achieved using an enhanced PointNet++algorithm with a normalization preprocessing head,resulting in a 94%accuracy for common supporting components.Ablation experiments show that the preprocessing head and coverage strategies increase segmentation accuracy by 20%and 2%,respectively,and improve Intersection over Union(IoU)for bearing plate segmentation by 58%and 20%.The accuracy of the current pretraining segmentation model may be affected by variations in surface support components,but it can be readily enhanced through re-optimization with additional labeled point cloud data.This proposed method,combined with a previously developed machine learning model that links rock bolt load and the deformation field of its bearing plate,provides a robust technique for simultaneously measuring the load of multiple rock bolts in a single laser scan.展开更多
AIM:To evaluate the differences in near point of convergence(NPC),fusional vergence,saccadic eye movements,versional eye movements,and heterophoria between patients diagnosed with Parkinson’s disease(PD)and healthy s...AIM:To evaluate the differences in near point of convergence(NPC),fusional vergence,saccadic eye movements,versional eye movements,and heterophoria between patients diagnosed with Parkinson’s disease(PD)and healthy subjects.METHODS:A cross-sectional comparative study was conducted,enrolling two cohorts:a PD group and a healthy control group.The PD group was recruited via non-random convenience sampling,while the control group was selected randomly from individuals without PD.All participants were screened according to predefined inclusion and exclusion criteria before undergoing a comprehensive optometric assessment,which included measurements of uncorrected visual acuity,corrected visual acuity,and objective and subjective refraction.Subsequently,binocular vision function evaluations were performed,covering NPC measurement,fusional vergence reserve assessment at both distance and near,saccadic eye movement testing,and versional eye movement and heterophoria assessment.RESULTS:A total of 42 PD patients and 41 healthy controls were included in the final analysis.The two groups were well-matched in terms of sex distribution[29 males(69.0%)in the PD group vs 29 males(70.7%)in the control group,P=0.867]and mean age(55.3±9.6y in the PD group vs 54.9±9.8y in the control group,P=0.866).The prevalence of abnormal versional eye movements was significantly higher in the PD group than in the control group(23.81%,95%CI:12.05%-39.45%vs 7.32%,95%CI:1.54%-19.92%;P=0.025).Near exophoria was more prevalent in PD patients(61.90%,95%CI:45.64%-76.43%)than in controls(17.07%,95%CI:7.15%-32.06%),with a significant difference[odds ratio(OR)=7.99;95%CI:2.83-21.99;P<0.001].The mean NPC was significantly greater(more receded)in the PD group than in the control group(9.01±3.74 cm vs 7.20±2.15 cm;P=0.007).A statistically significant positive correlation was observed between PD severity and NPC values(Pearson’s correlation coefficient=0.309;P=0.046).Except for distance baseout break and distance base-out recovery values,all other fusional vergence parameters were significantly lower in the PD group than in the control group(P<0.05).The mean saccadic test score was significantly lower in PD patients than in controls(3.29±0.57 vs 3.78±0.42;P<0.001).Among all fusional vergence indices,near base-in blur yielded the highest area under the curve(AUC=0.877),with a sensitivity of 69%and specificity of 90%,followed by distance base-out blur(AUC=0.824,sensitivity=97.6%,specificity=66.7%),near base-out blur(AUC=0.814,sensitivity=76.2%,specificity=72.7%),near base-out break(AUC=0.749,sensitivity=78.6%,specificity=67.6%),and near base-out recovery(AUC=0.749,sensitivity=95.2%,specificity=50%).CONCLUSION:PD is associated with significant binocular vision function impairment,with receded NPC and reduced near fusional vergence reserves being the most prominent disorders.These findings highlight the potential value of binocular vision assessment as a non-invasive biomarker for the early detection and clinical monitoring of PD.展开更多
Human object detection and recognition is essential for elderly monitoring and assisted living however,models relying solely on pose or scene context often struggle in cluttered or visually ambiguous settings.To addre...Human object detection and recognition is essential for elderly monitoring and assisted living however,models relying solely on pose or scene context often struggle in cluttered or visually ambiguous settings.To address this,we present SCENET-3D,a transformer-drivenmultimodal framework that unifies human-centric skeleton features with scene-object semantics for intelligent robotic vision through a three-stage pipeline.In the first stage,scene analysis,rich geometric and texture descriptors are extracted from RGB frames,including surface-normal histograms,angles between neighboring normals,Zernike moments,directional standard deviation,and Gabor-filter responses.In the second stage,scene-object analysis,non-human objects are segmented and represented using local feature descriptors and complementary surface-normal information.In the third stage,human-pose estimation,silhouettes are processed through an enhanced MoveNet to obtain 2D anatomical keypoints,which are fused with depth information and converted into RGB-based point clouds to construct pseudo-3D skeletons.Features from all three stages are fused and fed in a transformer encoder with multi-head attention to resolve visually similar activities.Experiments on UCLA(95.8%),ETRI-Activity3D(89.4%),andCAD-120(91.2%)demonstrate that combining pseudo-3D skeletonswith rich scene-object fusion significantly improves generalizable activity recognition,enabling safer elderly care,natural human–robot interaction,and robust context-aware robotic perception in real-world environments.展开更多
Highlights By conjugating the same anti-N monoclonal antibody(mAb4-mAb1)with colloidal gold or fluorescent microspheres,this study developed two rapid point-of-care antigen immunochromatographic strips for the detecti...Highlights By conjugating the same anti-N monoclonal antibody(mAb4-mAb1)with colloidal gold or fluorescent microspheres,this study developed two rapid point-of-care antigen immunochromatographic strips for the detection of porcine deltacoronavirus.The fluorescent microsphere-based lateral flow test strip demonstrated a sensitivity of 10^(1.7)TCID_(50)/0.1 mL,which is fourfold higher than that of the colloidal gold-based assay.Porcine deltacoronavirus(PDCoV)is a recently identified enteric coronavirus that causes an acute infectious disease in piglets,leading to diarrhea,vomiting,dehydration,and mortality(Hu et al.2015).展开更多
The Kibble-Zurek (KZ) effect offers an overarching description of dynamical scaling behavior near a critical point.[1,2] Originally proposed in a classical setup,the KZ effect has been generalized to quantum phase tra...The Kibble-Zurek (KZ) effect offers an overarching description of dynamical scaling behavior near a critical point.[1,2] Originally proposed in a classical setup,the KZ effect has been generalized to quantum phase transitions[3-5] and is actively explored on quantum simulation platforms.[6-9] Exploring how the KZ effect fares across different criticalities has proven to be a rewarding pursuit,significantly enriching our understanding of nonequilibrium quantum dynamics.[3-5,10-23]展开更多
文摘BACKGROUND Sarcoidosis is a rare multisystem disease characterized histologically by noncaseating granuloma formation in the affected organ.While cardiac sarcoidosis is found on autopsy in up to 25%of sarcoidosis cases,it is still underdiagnosed and is associated with a poor prognosis.Although the etiology of sarcoidosis remains unclear,an antigen triggered exaggerated immune response has been hypothesized.Early detection and prompt management of cardiac sarcoidosis remains pivotal.CASE SUMMARY A 60-year-old female,with pulmonary sarcoidosis in remission,presented to the cardiology outpatient clinic for evaluation of weeks-long dyspnea on moderate exertion(New York Heart Association class II)that was relieved by rest.Submaximal exercise stress test showed multifocal ventricular extrasystoles,followed by a self-limiting torsades de pointes.Cardiac magnetic resonance imaging showed nondilated and normotrophic left ventricle with basoseptal and mid-septal dyskinesis.The magnetic resonance imaging-derived left ventricular ejection fraction was 45%.Delayed enhancement showed patchy transmural fibrosis of the septum and hyperenhancement of the papillary muscles,all in favor of extensive cardiac involvement of sarcoidosis.A double-chamber implantable cardiac defibrillator was implanted,and methylprednisolone(12 mg/d)and methotrexate(12.5 mg/wk)treatment was initiated.Follow-up and implantable cardiac defibrillator interrogation showed episodes of asymptomatic nonsustained ventricular tachycardia and an asymptomatic episode of nonsustained ventricular tachycardia ending by the first antitachycardia pacing run.CONCLUSION Along an extensive review of the literature,this unusual case report highlights the importance of early detection of cardiac involvement of sarcoidosis,in order to avoid potential complications and increase survival.
基金the Beijing Key Clinical Subject Program and Beijing Municipal Administration of Hospitals Incubating Program,No.PX2018002.
文摘BACKGROUND QT interval prolongation can induce torsades de pointes(TdP),a potentially fatal ventricular arrhythmia.Recently,an increasing number of non-cardiac drugs have been found to cause QT prolongation and/or TdP onset.Moreover,recent findings have demonstrated the key roles of systemic inflammatory activation and fever in promoting long-QT syndrome(LQTS)and TdP development.CASE SUMMARY A 30-year-old woman was admitted with a moderate to high-grade episodic fever for two weeks.The patient was administered with multiple antibiotics after hospitalization but still had repeating fever and markedly elevated C-reactive protein.Once after a high fever,the patient suddenly lost consciousness,and electrocardiogram(ECG)showed transient TdP onset after frequent premature ventricular contraction.The patient recovered sinus rhythm and consciousness spontaneously,and post-TdP ECG revealed a prolonged QTc interval of 560 ms.The patient’s clinical manifestations and unresponsiveness to the antibiotics led to the final diagnosis of adult-onset Still’s disease(AOSD).There was no evidence of cardiac involvement.After the AOSD diagnosis,discontinuation of antibiotics and immediate initiation of intravenous dexamethasone administration resulted in the normal temperature and QTc interval.The genetic analysis identified that the patient and her father had heterozygous mutations in KCNH2(c.1370C>T)and AKAP9(c.7725A>C).During the 2-year follow-up period,the patient had no recurrence of any arrhythmia and maintained normal QTc interval.CONCLUSION This case study highlights the risk of systemic inflammatory activation and antibiotic-induced TdP/LQTS onset.Genetic analysis should be considered to identify individuals at high risk of developing TdP.
文摘Abstract： Loperamide is a common, over-the-counter, antidiarrheal medication that has been implicated in cases of ventricular tachycardia. A 32 year-old female patient with a history of opioid abuse and no prior history of cardiovascular disease experienced Torsades de pointes. An electrocardiogram at the time of hospital presentation revealed a prolonged QT interval at 636 msec. Diagnostic evaluation was unremarkable for any underlying cardiovascular pathology. Further investigation revealed the patient had been taking 30-40 loperamide 2 mg tablets oral daily for 2 weeks prior to the onset of Torsades de pointes. At high doses, loperamide may prolong the QT interval through antagonism of the human ether-a-go-go potassium current, thus increasing the risk of ventricular arrhythmias. Clinicians should be cautious with administration of high doses of loperamide to all patients, especially patients at high risk for QT interval prolongation.
文摘Background Torsade de pointes (TdP) is a form of polymorphic ventricular tachycardia featuring prolonged QT intervals. Female gender is associated with an increased risk of TdP. However, the causes of the sex difference in risk are poorly understood. Recently, transmural dispersion of repolarization (TDR) has been implicated in the genesis of TdP. Consequently, we compared TdP incidence and TDR between male and female rabbit hearts in order to investigate the mechanism of sex difference in TdP risk in rabbits in vitro. Methods By means of monophasic action potential recording techniques, the monophasic action potential of the epicardium, midmyocardium, and endocardium were simultaneously recorded using specially designed plunge-needle electrodes placed across the left ventricular free wall of both female (n=8) and male (n=8) rabbit hearts purfused by the Langendorff method. TdP was induced by bradycardia, d-sotalol, and low-K +, Mg 2+ Tyrode solution. Results TDR measurements in all three myocardial layers of male and female rabbit hearts were (18±2) ms and (21±2) ms, respectively (n=8, P>0.05). After perfusion with d-sotalol, the 90% monophasic action potential duration was prolonged in both male and femlae rabbits. TDR in male and female rabbit hearts increased to (29±2) ms and (61±2) ms, respectively, a difference that is significant. Eight female rabbit hearts had early afterdepolarization and 7 of them developed TdP. Seven male rabbit hearts had early after depolarization, but only one of these hearts developed TdP.Conclusion Greater TDR may play an important role in the higher incidence of TdP in female rabbit hearts.
基金supported by STI 2030-Major Projects,No.2021ZD0201603(to JL)the Joint Foundation Program of the Chinese Academy of Sciences,No.8091A170201(to JL)+1 种基金the National Natural Science Foundation of China,Nos.T2293730(to XC),T2293731(to XC),T2293734(to XC),62471291(to YW),62121003(to XC),61960206012(to XC),62333020(to XC),and 62171434(to XC)the National Key Research and Development Program of China,Nos.2022YFC2402501(to XC),2022YFB3205602(to XC).
文摘Neuromodulation techniques effectively intervene in cognitive function,holding considerable scientific and practical value in fields such as aerospace,medicine,life sciences,and brain research.These techniques utilize electrical stimulation to directly or indirectly target specific brain regions,modulating neural activity and influencing broader brain networks,thereby regulating cognitive function.Regulating cognitive function involves an understanding of aspects such as perception,learning and memory,attention,spatial cognition,and physical function.To enhance the application of cognitive regulation in the general population,this paper reviews recent publications from the Web of Science to assess the advancements and challenges of invasive and non-invasive stimulation methods in modulating cognitive functions.This review covers various neuromodulation techniques for cognitive intervention,including deep brain stimulation,vagus nerve stimulation,and invasive methods using microelectrode arrays.The non-invasive techniques discussed include transcranial magnetic stimulation,transcranial direct current stimulation,transcranial alternating current stimulation,transcutaneous electrical acupoint stimulation,and time interference stimulation for activating deep targets.Invasive stimulation methods,which are ideal for studying the pathogenesis of neurological diseases,tend to cause greater trauma and have been less researched in the context of cognitive function regulation.Non-invasive methods,particularly newer transcranial stimulation techniques,are gentler and more appropriate for regulating cognitive functions in the general population.These include transcutaneous acupoint electrical stimulation using acupoints and time interference methods for activating deep targets.This paper also discusses current technical challenges and potential future breakthroughs in neuromodulation technology.It is recommended that neuromodulation techniques be combined with neural detection methods to better assess their effects and improve the accuracy of non-invasive neuromodulation.Additionally,researching closed-loop feedback neuromodulation methods is identified as a promising direction for future development.
文摘History has never been driven by comfort,nor shaped solely by inheritance.Its most significant turning points have emerged from those with youth,conviction and courage ingrained in them.Progress starts when young people not only dream but also take action.Sometimes,the boldest move is not to run towards the glow of cities,but to turn back-to one’s soil,roots and forgotten home-and help it to flourish.
文摘Local residents,international artists and entrepreneurs are converging on Haikou’s historical Qilou Street,writing a new chapter of openness in Hainan More than 100 years ago,the area along Qilou(Sotto Portico)Street in Haikou,the capital of Hainan Province,served as the embarkation point for Hainanese setting out on their maritime voyages to seek greener pastures.
基金supported by the Scientific and Technological Innovation Project of the China Academy of Chinese Medical Sciences(CI2021A04013)the National Natural Science Foundation of China(82204610)+1 种基金the Qihang Talent Program(L2022046)the Fundamental Research Funds for the Central Public Welfare Research Institutes(ZZ15-YQ-041 and L2021029).
文摘Background:The medicinal material known as Os Draconis(Longgu)originates from fossilized remains of ancient mammals and is widely used in treating emotional and mental conditions.However,fossil resources are nonrenewable,and clinical demand is increasingly difficult to meet,leading to a proliferation of counterfeit products.During prolonged geological burial,static pressure from the surrounding strata severely compromises the microstructural integrity of osteons in Os Draconis,but Os Draconis still largely retains the structural features of mammalian bone.Methods:Using verified authentic Os Draconis samples over 10,000 years old as a baseline,this study summarizes the ultrastructural characteristics of genuine Os Draconis.Employing electron probe microanalysis and optical polarized light microscopy,we examined 28 batches of authentic Os Draconis and 31 batches of counterfeits to identify their ultrastructural differences.Key points for ultrastructural identification of Os Draconis were compiled,and a new identification approach was proposed based on these differences.Results:Authentic Os Draconis exhibited distinct ultrastructural markers:irregularly shaped osteons with traversing fissures,deformed/displaced Haversian canals,and secondary mineral infill(predominantly calcium carbonate).Counterfeits showed regular osteon arrangements,absent traversal fissures,and homogeneous hydroxyapatite composition.Lab-simulated samples lacked structural degradation features.EPMA confirmed calcium carbonate infill in fossilized Haversian canals,while elemental profiles differentiated lacunae types(void vs.mineral-packed).Conclusion:The study established ultrastructural criteria for authentic Os Draconis identification:osteon deformation,geological fissures penetrating bone units,and heterogenous mineral deposition.These features,unattainable in counterfeits or modern processed bones,provide a cost-effective,accurate identification method.This approach bridges gaps in TCM material standardization and supports quality control for clinical applications.
基金supported by the Regional Innovation Development Joint Fund of the National Natural Science Foundation of China(U23A2045)the scientific research project of the Chongqing Municipal Bureau of Planning and Natural Resources(KJ-2023046)the scientific and technological project of the Hubei Provincial Bureau of Geological Survey(KJ2024-34)。
文摘The Three Gorges Reservoir area hosts numerous high-risk columnar rock masses,but predicting their full-process of collapse dynamics in narrow-deep terrains remains challenging.This study investigated the Changdongzi columnar dangerous rock mass(CCDRM)through field surveys and simulated its collapse dynamics with Material Point Method(MPM),and analyzed the collapse-diffusionsurge generation mechanisms.Field investigations revealed a 0.8 m-thick lotus-like extrusion structure at the base,severely degraded by cyclic water fluctuations,predisposing the rock mass to base-crushing failure.Numerical simulations indicate collapse velocities up to 42 m/s,amplified spreading with a 318 m deposition range and 11 m maximum thickness,and two major collisions causing 50%-60%velocity reduction.Gully topography buffers kinetic energy,retaining 5%debris on slopes and channeling 7%into the river.High-speed river impact generates a 20 m-diameter cavity,producing an 11 m surge,identifying the Guandukou Town waterfront 1.2 km downstream as a high-risk zone.These results clarify the collapse mechanisms of columnar dangerous rock mass and inform its hazard mitigation strategies.
基金Jiangsu Provincial Hospital Association Hospital Management Innovation Research Fund(Project Ni.:JSYGY-3-2025-267)。
文摘Severe trauma often involves complex injuries,leading to high disability and fatality rates.Effective treatment requires prompt and coordinated efforts across multiple disciplines to enhance success rates.Time-based chain rescue is crucial in managing severe trauma.A patient with chest and abdominal injuries and hemorrhagic shock was transferred from an ambulance to our hospital.Our trauma team-initiated pre-hospital first aid,utilized an emergency green channel,and conducted rapid ultrasound,collaborating across disciplines.The patient eventually recovered and was discharged.
基金National Natural Science Foundation of China(No.52375236)Fundamental Research Funds for the Central Universities of China(No.23D110316)。
文摘In reliability analyses,the absence of a priori information on the most probable point of failure(MPP)may result in overlooking critical points,thereby leading to biased assessment outcomes.Moreover,second-order reliability methods exhibit limited accuracy in highly nonlinear scenarios.To overcome these challenges,a novel reliability analysis strategy based on a multimodal differential evolution algorithm and a hypersphere integration method is proposed.Initially,the penalty function method is employed to reformulate the MPP search problem as a conditionally constrained optimization task.Subsequently,a differential evolution algorithm incorporating a population delineation strategy is utilized to identify all MPPs.Finally,a paraboloid equation is constructed based on the curvature of the limit-state function at the MPPs,and the failure probability of the structure is calculated by using the hypersphere integration method.The localization effectiveness of the MPPs is compared through multiple numerical cases and two engineering examples,with accuracy comparisons of failure probabilities against the first-order reliability method(FORM)and the secondorder reliability method(SORM).The results indicate that the method effectively identifies existing MPPs and achieves higher solution precision.
基金the National Key Research and Development Program of China(Grant No.2023YFC3009400).
文摘Discontinuities in rock masses critically impact the stability and safety of underground engineering.Mainstream discontinuities identificationmethods,which rely on normal vector estimation and clustering algorithms,suffer from accuracy degradation,omission of critical discontinuities when orientation density is unevenly distributed,and need manual intervention.To overcome these limitations,this paper introduces a novel discontinuities identificationmethod based on geometric feature analysis of rock mass.By analyzing spatial distribution variability of point cloud and integrating an adaptive region growing algorithm,the method accurately detects independent discontinuities under complex geological conditions.Given that rock mass orientations typically follow a Fisher distribution,an adaptive hierarchical clustering algorithm based on statistical analysis is employed to automatically determine the optimal number of structural sets,eliminating the need for preset clusters or thresholds inherent in traditional methods.The proposed approach effectively handles diverse rock mass shapes and sizes,leveraging both local and global geometric features to minimize noise interference.Experimental validation on three real-world rock mass models,alongside comparisons with three conventional directional clustering algorithms,demonstrates superior accuracy and robustness in identifying optimal discontinuity sets.The proposed method offers a reliable and efficienttool for discontinuities detection and grouping in underground engineering,significantlyenhancing design and construction outcomes.
基金supported by PetroChina Coalbed Methane Co.,Ltd.
文摘With the maturation of coalbed methane(CBM)exploitation and the transition into the late stages of dewatering and gas production,liquid loading in gathering pipelines has emerged as a major constraint on productivity and operational stability.Based on real-time field data and gas-liquid physicochemical analyses,this study elucidates the mechanisms governing liquid loading formation under varying temperature,pressure,and water saturation conditions.An HYSYS model is employed to determine the water dew point,while the Turner model is used to evaluate the critical conditions for liquid holdup.The results indicate that gas water saturation exerts the dominant influence on liquid loading risk,followed by pressure,whereas temperature plays a comparatively minor role.When water saturation exceeds 2%and the operating temperature falls below the dew point,condensation-driven liquid loading increases sharply.To further characterize the spatial distribution of liquid accumulation,a steady-state OLGA model of a DN100 gathering pipeline network is developed to examine the effects of pipe diameter,water saturation,and soil temperature.The simulations show that larger pipe diameters and higher water saturation significantly aggravate liquid holdup,while elevated soil temperature mitigates liquid accumulation.Moreover,the liquid holdup ratio is found to correlate closely with flow regime transitions,confirming its suitability as a key indicator of liquid loading risk.Based on these findings,optimization strategies for pipeline design and operation are proposed.To mitigate liquid loading,the gathering pipeline velocity should be maintained above the critical value of 1.63 m/s,and the gas water content should be strictly controlled below 2%.Under operating conditions representative of the Hancheng block,it is recommended to reduce the pipeline diameter from DN130 to DN100 to enhance self-cleaning capacity.In addition,thermal insulation should be applied during winter operation to maintain the pipe wall temperature above 10◦C,thereby suppressing condensation-induced liquid accumulation.
基金supported by the National Natural Science Foundation of China(Grant Nos.52304139,52325403)the CCTEG Coal Mining Research Institute funding(Grant No.KCYJY-2024-MS-10).
文摘3D laser scanning technology is widely used in underground openings for high-precision,rapid,and nondestructive structural evaluations.Segmenting large 3D point cloud datasets,particularly in coal mine roadways with multi-scale targets,remains challenging.This paper proposes an enhanced segmentation method integrating improved PointNet++with a coverage-voted strategy.The coverage-voted strategy reduces data while preserving multi-scale target topology.The segmentation is achieved using an enhanced PointNet++algorithm with a normalization preprocessing head,resulting in a 94%accuracy for common supporting components.Ablation experiments show that the preprocessing head and coverage strategies increase segmentation accuracy by 20%and 2%,respectively,and improve Intersection over Union(IoU)for bearing plate segmentation by 58%and 20%.The accuracy of the current pretraining segmentation model may be affected by variations in surface support components,but it can be readily enhanced through re-optimization with additional labeled point cloud data.This proposed method,combined with a previously developed machine learning model that links rock bolt load and the deformation field of its bearing plate,provides a robust technique for simultaneously measuring the load of multiple rock bolts in a single laser scan.
基金Supported by Mashhad University of Medical Sciences.
文摘AIM:To evaluate the differences in near point of convergence(NPC),fusional vergence,saccadic eye movements,versional eye movements,and heterophoria between patients diagnosed with Parkinson’s disease(PD)and healthy subjects.METHODS:A cross-sectional comparative study was conducted,enrolling two cohorts:a PD group and a healthy control group.The PD group was recruited via non-random convenience sampling,while the control group was selected randomly from individuals without PD.All participants were screened according to predefined inclusion and exclusion criteria before undergoing a comprehensive optometric assessment,which included measurements of uncorrected visual acuity,corrected visual acuity,and objective and subjective refraction.Subsequently,binocular vision function evaluations were performed,covering NPC measurement,fusional vergence reserve assessment at both distance and near,saccadic eye movement testing,and versional eye movement and heterophoria assessment.RESULTS:A total of 42 PD patients and 41 healthy controls were included in the final analysis.The two groups were well-matched in terms of sex distribution[29 males(69.0%)in the PD group vs 29 males(70.7%)in the control group,P=0.867]and mean age(55.3±9.6y in the PD group vs 54.9±9.8y in the control group,P=0.866).The prevalence of abnormal versional eye movements was significantly higher in the PD group than in the control group(23.81%,95%CI:12.05%-39.45%vs 7.32%,95%CI:1.54%-19.92%;P=0.025).Near exophoria was more prevalent in PD patients(61.90%,95%CI:45.64%-76.43%)than in controls(17.07%,95%CI:7.15%-32.06%),with a significant difference[odds ratio(OR)=7.99;95%CI:2.83-21.99;P<0.001].The mean NPC was significantly greater(more receded)in the PD group than in the control group(9.01±3.74 cm vs 7.20±2.15 cm;P=0.007).A statistically significant positive correlation was observed between PD severity and NPC values(Pearson’s correlation coefficient=0.309;P=0.046).Except for distance baseout break and distance base-out recovery values,all other fusional vergence parameters were significantly lower in the PD group than in the control group(P<0.05).The mean saccadic test score was significantly lower in PD patients than in controls(3.29±0.57 vs 3.78±0.42;P<0.001).Among all fusional vergence indices,near base-in blur yielded the highest area under the curve(AUC=0.877),with a sensitivity of 69%and specificity of 90%,followed by distance base-out blur(AUC=0.824,sensitivity=97.6%,specificity=66.7%),near base-out blur(AUC=0.814,sensitivity=76.2%,specificity=72.7%),near base-out break(AUC=0.749,sensitivity=78.6%,specificity=67.6%),and near base-out recovery(AUC=0.749,sensitivity=95.2%,specificity=50%).CONCLUSION:PD is associated with significant binocular vision function impairment,with receded NPC and reduced near fusional vergence reserves being the most prominent disorders.These findings highlight the potential value of binocular vision assessment as a non-invasive biomarker for the early detection and clinical monitoring of PD.
基金funded by Princess Nourah bint Abdulrahman University Researchers Supporting Project number(PNURSP2025R410),Princess Nourah bint Abdulrahman University,Riyadh,Saudi Arabia.
文摘Human object detection and recognition is essential for elderly monitoring and assisted living however,models relying solely on pose or scene context often struggle in cluttered or visually ambiguous settings.To address this,we present SCENET-3D,a transformer-drivenmultimodal framework that unifies human-centric skeleton features with scene-object semantics for intelligent robotic vision through a three-stage pipeline.In the first stage,scene analysis,rich geometric and texture descriptors are extracted from RGB frames,including surface-normal histograms,angles between neighboring normals,Zernike moments,directional standard deviation,and Gabor-filter responses.In the second stage,scene-object analysis,non-human objects are segmented and represented using local feature descriptors and complementary surface-normal information.In the third stage,human-pose estimation,silhouettes are processed through an enhanced MoveNet to obtain 2D anatomical keypoints,which are fused with depth information and converted into RGB-based point clouds to construct pseudo-3D skeletons.Features from all three stages are fused and fed in a transformer encoder with multi-head attention to resolve visually similar activities.Experiments on UCLA(95.8%),ETRI-Activity3D(89.4%),andCAD-120(91.2%)demonstrate that combining pseudo-3D skeletonswith rich scene-object fusion significantly improves generalizable activity recognition,enabling safer elderly care,natural human–robot interaction,and robust context-aware robotic perception in real-world environments.
基金financially supported by the National Key Research and Development Program of China(2021YFF0703600)。
文摘Highlights By conjugating the same anti-N monoclonal antibody(mAb4-mAb1)with colloidal gold or fluorescent microspheres,this study developed two rapid point-of-care antigen immunochromatographic strips for the detection of porcine deltacoronavirus.The fluorescent microsphere-based lateral flow test strip demonstrated a sensitivity of 10^(1.7)TCID_(50)/0.1 mL,which is fourfold higher than that of the colloidal gold-based assay.Porcine deltacoronavirus(PDCoV)is a recently identified enteric coronavirus that causes an acute infectious disease in piglets,leading to diarrhea,vomiting,dehydration,and mortality(Hu et al.2015).
文摘The Kibble-Zurek (KZ) effect offers an overarching description of dynamical scaling behavior near a critical point.[1,2] Originally proposed in a classical setup,the KZ effect has been generalized to quantum phase transitions[3-5] and is actively explored on quantum simulation platforms.[6-9] Exploring how the KZ effect fares across different criticalities has proven to be a rewarding pursuit,significantly enriching our understanding of nonequilibrium quantum dynamics.[3-5,10-23]
