In this research we are going to define two new concepts: a) “The Potential of Events” (EP) and b) “The Catholic Information” (CI). The term CI derives from the ancient Greek language and declares all the Catholic...In this research we are going to define two new concepts: a) “The Potential of Events” (EP) and b) “The Catholic Information” (CI). The term CI derives from the ancient Greek language and declares all the Catholic (general) Logical Propositions (<img src="Edit_5f13a4a5-abc6-4bc5-9e4c-4ff981627b2a.png" width="33" height="21" alt="" />) which will true for every element of a set A. We will study the Riemann Hypothesis in two stages: a) By using the EP we will prove that the distribution of events e (even) and o (odd) of Square Free Numbers (SFN) on the axis Ax(N) of naturals is Heads-Tails (H-T) type. b) By using the CI we will explain the way that the distribution of prime numbers can be correlated with the non-trivial zeros of the function ζ(s) of Riemann. The Introduction and the Chapter 2 are necessary for understanding the solution. In the Chapter 3 we will present a simple method of forecasting in many very useful applications (e.g. financial, technological, medical, social, etc) developing a generalization of this new, proven here, theory which we finally apply to the solution of RH. The following Introduction as well the Results with the Discussion at the end shed light about the possibility of the proof of all the above. The article consists of 9 chapters that are numbered by 1, 2, …, 9.展开更多
Clinical decision support(CDS) systems with automated alerts integrated into electronic medical records demonstrate efficacy for detecting medication errors(ME) and adverse drug events(ADEs). Critically ill patients a...Clinical decision support(CDS) systems with automated alerts integrated into electronic medical records demonstrate efficacy for detecting medication errors(ME) and adverse drug events(ADEs). Critically ill patients are at increased risk for ME, ADEs and serious negative outcomes related to these events. Capitalizing on CDS to detect ME and prevent adverse drug related events has the potential to improve patient outcomes. The key to an effective medication safety surveillance system incorporating CDS is advancing the signals for alerts by using trajectory analyses to predict clinical events, instead of waiting for these events to occur. Additionally, incorporating cutting-edge biomarkers into alert knowledge in an effort to identify the need to adjust medication therapy portending harm will advance the current state of CDS. CDS can be taken a step further to identify drug related physiological events, which are less commonly included in surveillance systems. Predictive models for adverse events that combine patient factors with laboratory values and biomarkers are being established and these models can be the foundation for individualized CDS alerts to prevent impending ADEs.展开更多
Objective:To identify the root causes of typical adverse drug events through the lens of patient experiences proposing novel strategies to mitigate preventable harm.Methods:A qualitative case study leveraging in-depth...Objective:To identify the root causes of typical adverse drug events through the lens of patient experiences proposing novel strategies to mitigate preventable harm.Methods:A qualitative case study leveraging in-depth interviews with patients and families,anchored by Interactive Patient Par ticipation Theory,to analyze 4 high-severity adverse drug events(ADE)cases.Cases were purposively sampled from 8 communities in China's National Adverse Event Monitor Center(2018-2023).Semi-structured interviews explored patient perspectives,with data analyzed via thematic coding and triangulation against clinical records.Results:Five interconnected themes emerged:(1)erosion of trust,(2)communication breakdowns,(3)information asymmetry,(4)environmental inadequacies,and(5)technological alienation.Notably,75% of participants had≤high school education,and 50% used≥7 medications daily,compounding ADE risks.Conclusions:We considered elements mentioned by theory,exploring trust,communication,information,and suppor t as the root causes.In addition,we added“adaptability to new technology”as an impor tant and necessary component.It is impor tant and necessary to analyze typical adverse drug events from the perspectives of patients.展开更多
BACKGROUND Hepatic cirrhosis is associated with greater adverse event rates following surgical procedures and is thought to have a higher risk of complications with interventional procedures in general.However,these s...BACKGROUND Hepatic cirrhosis is associated with greater adverse event rates following surgical procedures and is thought to have a higher risk of complications with interventional procedures in general.However,these same patients often require interventional gastrointestinal procedures such as endoscopic retrograde cholangiopancreatography(ERCP)and endoscopic ultrasound(EUS).While studies examining this scenario exist,the overall body of evidence for adverse event rates associated with ERCP/EUS procedures is more limited.We sought add to the literature by examining the incidence of adverse events after ERCP/EUS procedures in our safety-net hospital population with the hypothesis that severity of cirrhosis correlates with higher adverse event rates.AIM To examine whether increasing severity of cirrhosis is associated with greater incidence of adverse events after interventional ERCP/EUS procedures.METHODS We performed a retrospective study of patients diagnosed with hepatic cirrhosis who underwent ERCP and/or EUS-guided fine needle aspirations/fine needle biopsies from January 1,2016 to March 14,2019 at our safety net hospital.We recorded Child-Pugh and Model for End-stage Liver Disease(MELD-Na)scores at time of procedure,interventions completed,and 30-day post-procedural adverse events.Statistical analyses were done to assess whether Child-Pugh class and MELD-Na score were associated with greater adverse event rates and whether advanced techniques(single-operator cholangioscopy,electrohydraulic lithotripsy/laser lithotripsy,or needle-knife techniques)were associated with higher complication rates.RESULTS 77 procedures performed on 36 patients were included.The study population consisted primarily of middle-aged Hispanic males.30-d procedure-related adverse events included gastrointestinal bleeding(7.8%),infection(6.5%),and bile leak(2%).The effect of Child-Pugh class C vs class A and B significantly predicted adverse events(β=0.55,P<0.01).MELD-Na scores also significantly predicted adverse events(β=0.037,P<0.01).Presence of advanced techniques was not associated with higher adverse events(P>0.05).When MELD-Na scores were added as predictors with the effect of Child-Pugh class C,logistic regression showed MELD-Na scores were a significant predictor of adverse events(P<0.01).The findings held after controlling for age,gender,ethnicity and repeat cases.CONCLUSION Increasing cirrhosis severity predicted adverse events while the presence of advanced techniques did not.MELD-Na score may be more useful in predicting adverse events than Child-Pugh class.展开更多
On a summer morning in Boqiang Village,tucked beneath the emerald mountains of Fanshi County,Shanxi Province,the Ultra Trail Mount Wutai2025 commenced with the sound of the starting pistol-an event that was much more ...On a summer morning in Boqiang Village,tucked beneath the emerald mountains of Fanshi County,Shanxi Province,the Ultra Trail Mount Wutai2025 commenced with the sound of the starting pistol-an event that was much more than just a competition.As soon as the colorful smoke bombs lit up the sky,some2,000 runners from China and abroad set off to reach one of the country's most sacred Buddhist peaks.Over the past decade,this race has become a fixture on the global running calendar and a symbol of the growing popularity of endurance sports.展开更多
In this paper we consider the stochastic systems with jumps (random impulses) generated by Erlang flow of events that lead to discontinuities in paths. These systems may be used in various applications such as a contr...In this paper we consider the stochastic systems with jumps (random impulses) generated by Erlang flow of events that lead to discontinuities in paths. These systems may be used in various applications such as a control of complex technical systems, financial mathematics, mathematical biology and medicine. We propose to use a spectral method formalism to the probabilistic analysis problem for the stochastic systems with jumps. This method allows to get a solution of the analysis problem in an explicit form.展开更多
Anxiety disorders are among the most common of all mental disorders and their pathogenesis is a major topic in psychiatry, both for prevention and treatment. Early stressful life events and alterations of hypothalamic...Anxiety disorders are among the most common of all mental disorders and their pathogenesis is a major topic in psychiatry, both for prevention and treatment. Early stressful life events and alterations of hypothalamic pituitary adrenal(HPA) axis function seem to have a significant role in the onset of anxiety. Existing data appear to support the mediating effect of the HPA axis between childhood traumata and posttraumatic stress disorder. Findings on the HPA axis activity at baseline and after stimuli in panic disordered patients are inconclusive, even if stressful life events may have a triggering function in the development of this disorder. Data on the relationship between stress, HPA axis functioning and obsessive-compulsive disorder(OCD) are scarce and discordant, but an increased activity of the HPA axis is reported in OCD patients. Moreover, normal basal cortisol levels and hyperresponsiveness of the adrenal cortex during a psychosocial stressor are observed in social phobics. Finally,abnormal HPA axis activity has also been observed in generalized anxiety disordered patients. While several hypothesis have attempted to explain these findings over time, currently the most widely accepted theory is that early stressful life events may provoke alterations of the stress response and thus of the HPA axis, that can endure during adulthood, predisposing individuals to develop psychopathology. All theories are reviewed and the authors conclude that childhood life events and HPA abnormalities may be specifically and transnosographically related to all anxiety disorders, as well as, more broadly, to all psychiatric disorders.展开更多
We describe the last glaciation climatic history Marine Isotope Stage(MIS, 2-4) from 66.7 ka to 14.5 ka in Hexigten, northeast Inner Mongolia, North China. The climate of the region experienced frequent and significan...We describe the last glaciation climatic history Marine Isotope Stage(MIS, 2-4) from 66.7 ka to 14.5 ka in Hexigten, northeast Inner Mongolia, North China. The climate of the region experienced frequent and significant fluctuations between dry-cold and less dry-cold during the late MIS4. The climate was generally warm and humid during early MIS3(MIS3 c) and late MIS3(MIS3 a), whereas it was cold and dry in middle MIS3(MIS3 b) and during MIS2. In this study, the cold and dry conditions were correlated with a stronger East Asian winter monsoon and strong dune activity; whereas, warm and humid conditions were related to a stronger East Asian summer monsoon(EASM) and weak dune activity. This study establishes six distinct dry and cold intervals during the last glacial period(66.7-14.5 ka) based on optically stimulated luminescence data, multi-proxies record(magnetic susceptibility, grain size analysis, Rb/Sr, SiO2/TiO2) and chemical index of alteration(CIA). The last glacial period may be correlated with Heinrich events 1 to 6 which were further confirmed by comparison with the Hulu cave stalagmites and Greenland ice core records. It is concluded that the study area was substantially affected by the EASM, as compared with the loess-desert transition zone of the Chinese Loess Plateau, especially in MIS3 c and suggested that the East Asian monsoon played a pivotal role in the last glacial period climate and dune activity.展开更多
This study examines a 1.32 m thick sediment sequence from the Cunge sag pond in the Litang Basin,eastern Tibetan Plateau,to assess the seismicity of the Litang fault during the Holocene.High-resolution geochemical,gra...This study examines a 1.32 m thick sediment sequence from the Cunge sag pond in the Litang Basin,eastern Tibetan Plateau,to assess the seismicity of the Litang fault during the Holocene.High-resolution geochemical,grain size,magnetic susceptibility,and total organic carbon indicators are employed to obtain a continuous record of changes in elemental,physical,and biological properties within the profile to identify seismic events.The seismic event layer generally comprises two sedimentary rhythms:a lower coarse sand layer and an upper fine silt-clay layer.These layers represent rapid deposition associated with fault activity(Earthquake A)and slower deposition during calm periods or earthquake recurrence intervals(Seismic interval A).Through six^(14)C dating,five seismic events have been identified in the Cunge sag pond section:E1(before 3955 a B.P.),E2(3713-3703 a B.P.),E3(3492-3392 a B.P.),E4(2031-1894 a B.P.),and E5(1384-1321 a B.P.).E1-E4 had shown a good consistency with the paleo-earthquake recorded by the trench,and whereas E5 is a newly identified seismic event,further improving the continuous earthquake sequence of the Litang fault.Based on existing trench data and the seismic event record from the Cunge sag pond,a total of 11 paleo-earthquakes are identified along the Litang fault since the Holocene.The paleo-earthquake activity of the Litang fault exhibits a clustered pattern,with recurrence intervals of both long periods(1000 a)and short periods(500 a).Since 5000 a,the interval between strong earthquake recurrences gradually decreases,indicating an increasing risk of strong earthquakes along the Litang fault.This study presents a continuous record of paleo-earthquakes along the Litang fault,eastern Tibetan Plateau,and can enhance the understanding of regional seismic activity.展开更多
Type 2 diabetes(T2D)is an insidious disease associated with neural and vascular complications,acceleration of cardiovascular disease,changes in heart function,and premature death.In the newly released article of the J...Type 2 diabetes(T2D)is an insidious disease associated with neural and vascular complications,acceleration of cardiovascular disease,changes in heart function,and premature death.In the newly released article of the Journal of Sport and Health Science,Liang et al.1 describe results from the UK Biobank data showing the benefits of moderate-to-vigorous intensity physical activity(MVPA)on reducing the risks for vascular events in 11,474 adults with T2D and prediabetes.展开更多
Background: Research has shown that high-sensitivity C-reactive protein (hs-CRP) is a major inflammatory marker for prediction of acute coronary syndrome (ACS). Myeloperoxidase (MPO) also plays an important role in at...Background: Research has shown that high-sensitivity C-reactive protein (hs-CRP) is a major inflammatory marker for prediction of acute coronary syndrome (ACS). Myeloperoxidase (MPO) also plays an important role in atherosclerosis initiation and development. In present study, the major adverse cardiovascular events (MACEs) of patients with coronary heart disease (CHD) were investigated. Methods: MPO, hs-CRP and ACS-related risk factors from 201 ACS (78 AMI and 123 UAP) and 210 non-ACS (84 SAP and 126 non-CHD) patients confirmed by coronary angiography were detected, and the data were analyzed with receiver operating characteristic (ROC) curve and Spearman’s correlation coefficients. MACEs of 285 CHD patients were investigated during the 4-year period follow-up from March 2010 to May 2014. Results: The areas under ROC curve for diagnosing ACS were 0.888 (95% CI 0.843 - 0.933) for MPO, and 0.862 (95% CI 0.815-0.910) for hs-CRP, respectively. There were significantly correlations between MPO and hs-CRP in both ACS and non-ACS groups. Regarding to ACS patients, both MPO and hs-CRP were positively correlated with BMI, TC, TG, LDL-C and Hcy. Prospective study demonstrated that the incidences of MACEs associated significantly with elevated MPO baseline level (yes vs no, OR 7.383, 95% CI 4.095 - 13.309) and high hs-CRP baseline level (yes vs no, OR 4.186, 95% CI 2.469 - 7.097) in CHD patients. Conclusions: The present study provides the epidemiological evidence that elevated baseline MPO and hs-CRP levels are both valuable predictors of MACEs in CHD patients. MPO and hs-CRP would prompt the progression of atherosclerosis and development from SAP to ACS.展开更多
In this study, based on the data on the frequency of waterlogging events and the number of waterlogging days of 1,638 stations from 1961 to 2016, a variety of mathematical statistics methods were used to analyze the s...In this study, based on the data on the frequency of waterlogging events and the number of waterlogging days of 1,638 stations from 1961 to 2016, a variety of mathematical statistics methods were used to analyze the spatiotemporal evolution of waterlogging events in eastern China. The results showed that:① In terms of time, the annual frequency of waterlogging events and the number of waterlogging days in eastern China in 1961–2016 showed an increasing trend despite of fluctuations. In the interdecadal changes, the highest frequency of waterlogging events and the greatest number of waterlogging days occurred in the 1990s, and from the 1960s to the 1980s, the frequency of waterlogging events and the number of waterlogging days in eastern China showed a decreasing trend. There were 6-year and 30-year periodic variations in the frequency of waterlogging events and the number of waterlogging days in eastern China, and mutations occurred in 1991.② In terms of space, from 1961 to 2016, the areas with high frequency of waterlogging events in various years in eastern China were mainly South China, western and southern Yunnan, northern Jiangsu, southern Zhejiang, northern Fujian, junction areas between Hunan and Chongqing, northern Sichuan, and eastern Liaoning.③ In the spatial distribution of change trends and fluctuation characteristics, the frequency of waterlogging events and the number of waterlogging days in eastern China increased significantly in the southeastern coastal areas from 1961 to 2016, and the fluctuations of the frequency of waterlogging events and the number of waterlogging days in eastern China from 1961 to 2016 presented a spatial variation pattern of low in the southwest and high in the northwest.展开更多
The Tarim River Basin(TRB)is a vast area with plenty of light and heat and is an important base for grain and cotton production in Northwest China.In the context of climate change,however,the increased frequency of ex...The Tarim River Basin(TRB)is a vast area with plenty of light and heat and is an important base for grain and cotton production in Northwest China.In the context of climate change,however,the increased frequency of extreme weather and climate events is having numerous negative impacts on the region's agricultural production.To better understand how unfavorable climatic conditions affect crop production,we explored the relationship of extreme weather and climate events with crop yields and phenology.In this research,ten indicators of extreme weather and climate events(consecutive dry days(CDD),min Tmax(TXn),max Tmin(TNx),tropical nights(TR),warm days(Tx90p),warm nights(Tn90p),summer days(SU),frost days(FD),very wet days(R95p),and windy days(WD))were selected to analyze the impact of spatial and temporal variations on the yields of major crops(wheat,maize,and cotton)in the TRB from 1990 to 2020.The three key findings of this research were as follows:extreme temperatures in southwestern TRB showed an increasing trend,with higher extreme temperatures at night,while the occurrence of extreme weather and climate events in northeastern TRB was relatively low.The number of FD was on the rise,while WD also increased in recent years.Crop yields were higher in the northeast compared with the southwest,and wheat,maize,and cotton yields generally showed an increasing trend despite an earlier decline.The correlation of extreme weather and climate events on crop yields can be categorized as extreme nighttime temperature indices(TNx,Tn90p,TR,and FD),extreme daytime temperature indices(TXn,Tx90p,and SU),extreme precipitation indices(CDD and R95p),and extreme wind(WD).By using Random Forest(RF)approach to determine the effects of different extreme weather and climate events on the yields of different crops,we found that the importance of extreme precipitation indices(CDD and R95p)to crop yield decreased significantly over time.As well,we found that the importance of the extreme nighttime temperature(TR and TNx)for the yields of the three crops increased during 2005-2020 compared with 1990-2005.The impact of extreme temperature events on wheat,maize,and cotton yields in the TRB is becoming increasingly significant,and this finding can inform policy decisions and agronomic innovations to better cope with current and future climate warming.展开更多
This letter addressed the impactful study by Zhong et al,which introduced a risk prediction and stratification model for surgical adverse events following minimally invasive esophagectomy.By identifying key risk facto...This letter addressed the impactful study by Zhong et al,which introduced a risk prediction and stratification model for surgical adverse events following minimally invasive esophagectomy.By identifying key risk factors such as chronic obstructive pulmonary disease and hypoalbuminemia,the model demonstrated strong predictive accuracy and offered a pathway to personalized perioperative care.This correspondence highlighted the clinical significance,emphasizing its potential to optimize patient outcomes through tailored inter-ventions.Further prospective validation and application across diverse settings are essential to realize its full potential in advancing esophageal surgery practices.展开更多
Precipitation events,which follow a life cycle of initiation,development,and decay,represent the fundamental form of precipitation.Comprehensive and accurate detection of these events is crucial for effective water re...Precipitation events,which follow a life cycle of initiation,development,and decay,represent the fundamental form of precipitation.Comprehensive and accurate detection of these events is crucial for effective water resource management and flood control.However,current investigations on their spatio-temporal patterns remain limited,largely because of the lack of systematic detection indices that are specifically designed for precipitation events,which constrains event-scale research.In this study,we defined a set of precipitation event detection indices(PEDI)that consists of five conventional and fourteen extreme indices to characterize precipitation events from the perspectives of intensity,duration,and frequency.Applications of the PEDI revealed the spatial patterns of hourly precipitation events in China and its first-and second-order river basins from 2008 to 2017.Both conventional and extreme precipitation events displayed spatial distribution patterns that gradually decreased in intensity,duration,and frequency from southeast to northwest China.Compared with those in northwest China,the average values of most PEDIs in southeast China were usually 2-10 times greater for first-order river basins and 3-15 times greater for second-order basins.The PEDI could serve as a reference method for investigating precipitation events at global,regional,and basin scales.展开更多
Extreme rainfall events(EREs)frequently hit the middle and lower reaches of the Yellow River basin(YRB)during boreal summer.Recent observations have indicated that EREs exhibit teleconnection patterns across long spat...Extreme rainfall events(EREs)frequently hit the middle and lower reaches of the Yellow River basin(YRB)during boreal summer.Recent observations have indicated that EREs exhibit teleconnection patterns across long spatial distances.This study investigated ERE teleconnections in the YRB using the Event Synchronization(ES)method in combination with Complex Network(CN)theory.EREs in the YRB are significantly synchronized with other regions from regional to global scales.Additionally,high-resolution CMIP6 models in general show better skill in capturing these characteristics compared to low-resolution models.A further examination shows that the spatial synchronization patterns exhibit pronounced timescale dependence.Significant ERE synchronizations between the YRB and Europe were uncovered,where the YRB lags Eastern Europe by 3-5 days and Western Europe by 5-7 days,with Rossby wave propagation playing a key role.Wave trains from Europe propagate downstream along the Eurasian jet,inducing anomalous circulations over the YRB that enhance vertical upward motion and moisture transport,ultimately triggering EREs.Two distinct wave trains are observed:one is associated with Eastern Europe-YRB synchronization,occurring in the midlatitude region;the other is linked to Western Europe-YRB synchronization,positioned at higher latitudes.Notably,17.5%of Eastern Europe-YRB synchronization cases and 17.0%of Western Europe-YRB cases overlap.Quantitative analysis indicates that the synchronized events between Eastern(Western)Europe and the YRB account for roughly 28%(30%)of EREs in the YRB.These findings are critical for better understanding ERE mechanisms,offering guidance for forecasting and early warning capabilities for EREs in the YRB.展开更多
Recent studies have suggested that rapid warming over the Mongolian Plateau(MP) may intensify extreme heat events(EHEs). However, the characteristics and mechanisms driving summer EHEs over the MP(MP-EHEs) remain uncl...Recent studies have suggested that rapid warming over the Mongolian Plateau(MP) may intensify extreme heat events(EHEs). However, the characteristics and mechanisms driving summer EHEs over the MP(MP-EHEs) remain unclear. This study explores the interannual variations in summer MP-EHEs and their relationship with the summer soil moisture over the Inner Tibetan Plateau(TP-SM). The results reveal that changes in the MP-EHEs are linked to descending atmospheric motion induced by a local high-pressure system over the MP region. Descending motion further results in decreased mid-tolow-level cloud cover and increased shortwave radiation, thereby warming the surface and triggering summer MP-EHEs.Further analysis indicates that increased TP-SM results in a greater latent heat flux, triggering a local secondary circulation that reinforces the local high-pressure system over the MP region, thus serving to promote the occurrence of summer MPEHEs. Additionally, model results from the linear baroclinic model(LBM) and CMIP6 further confirm that variations in summer TP-SM contribute to the occurrence of the MP-EHEs.展开更多
In this study, the daily observational precipitation data and NCEP reanalysis data during 1951e2014, Euler and Lagrangian method were used to investigate the moisture sources of summer extreme precipitation events in ...In this study, the daily observational precipitation data and NCEP reanalysis data during 1951e2014, Euler and Lagrangian method were used to investigate the moisture sources of summer extreme precipitation events in North Xinjiang. The results show that water vapor at low and upper levels of most summer heavy rain (more than 50 mm d1 and less than 100 mm d1) in North Xinjiang are mainly transported by westerly circulation from the North Atlantic Ocean and the Eurasian continent. However, rainstorms of more than 100 mm d1, which are rarely observed, are dominated by vertically integrated moisture from the North Atlantic, Arctic Oceans, and the Eurasian continent, in addition to lowlevel moisture from the Indian Ocean. Among these sources, the anomalous low-level moisture from the Indian Ocean, which is closely associated with stronger meridional circulation, is considered to be more important with respect to rainstorms. On the days prior to rainstorm days, stronger meridional circulation leads to an anomalous pressure gradient force, which can transport low-level moisture from the Indian Ocean along the eastern periphery of the Tibetan Plateau to North Xinjiang. Furthermore, moisture from the North Atlantic, Arctic Oceans, the Eurasian continent, and the Indian Ocean converge together to influence rainstorm development in this region.展开更多
BACKGROUND Left ventricular noncompaction(LVNC)is a genetic cardiomyopathy.It is characterized by intensely developed trabeculae in the ventricles with deep intertrabecular lacunae.LVNC manifests as arrhythmias and he...BACKGROUND Left ventricular noncompaction(LVNC)is a genetic cardiomyopathy.It is characterized by intensely developed trabeculae in the ventricles with deep intertrabecular lacunae.LVNC manifests as arrhythmias and heart failure with a predisposition for thrombus formation.AIM To study predictors of arrhythmic,thromboembolic events and adverse outcomes(death/transplantation)in adult patients with LVNC.METHODS Adult patients with LVNC were included(n=125;mean follow-up:14 months).Electrocardiography,echocardiography,and 24-hour electrocardiography monitoring were performed.Other procedures were conducted for some patients including:Coronary angiography;cardiac magnetic resonance imaging;cardiac computed tomography;genetic testing;myocardial pathological examination;and anti-cardiac antibody level estimation.Primary endpoints were death,heart transplantation,combined endpoint(death+transplantation),and sudden cardiac death.Secondary endpoints were intracardiac thrombosis,embolic events,myocardial infarction,sustained ventricular tachycardia(VT),and implantable cardioverter-defibrillator intervention.RESULTS LVNC manifestations included non-sustained VT,thrombosis/embolism,sustained VT, and sudden cardiac death. Non-sustained VT was associated with the New York Heart Association(NYHA) chronic heart failure (CHF) class, poor R-wave progression, superimposed myocarditis, and highermortality. Thrombosis/embolism was associated with NYHA CHF class ≥ 3, right ventricular end-diastolicdiameter ≥ 3 cm, right atrium volume ≥ 67 mL, left ventricle end-diastolic diameter ≥ 6.3 cm, and velocity timeintegral ≤ 11.2 cm. Sustained VT was associated with premature ventricular contractions (PVCs), low QRS voltage,and atrioventricular block. PVCs > 500/day were predictive of defibrillator intervention. Fatal outcomes wereassociated with E wave/A wave ratio > 1.9, left ventricle ejection fraction < 35%, NYHA CHF class ≥ 3, VT, andmyocarditis.CONCLUSIONFrequent PVCs, non-sustained VT, low QRS voltage, and signs of systolic dysfunction on echocardiogram arepredictors of life-threatening events in patients with LVNC.展开更多
1.Objective The Songpan-Ganze terrane is a key region for understanding the tectonic evolution of the Tibetan Plateau and the Yangtze Craton.The Songpan-Ganzi complex comprises a thick succession of deformed Ladinian-...1.Objective The Songpan-Ganze terrane is a key region for understanding the tectonic evolution of the Tibetan Plateau and the Yangtze Craton.The Songpan-Ganzi complex comprises a thick succession of deformed Ladinian-Norian turbidites(ca.230-203 Ma),covering about 200000 km^(2)of the eastern Tibet Plateau with a volume of approximately 2.0×10^(6)km^(3)(Fig.1a).Furthermore,this complex has over 100 Permian-Cenozoic felsic plutons.展开更多
文摘In this research we are going to define two new concepts: a) “The Potential of Events” (EP) and b) “The Catholic Information” (CI). The term CI derives from the ancient Greek language and declares all the Catholic (general) Logical Propositions (<img src="Edit_5f13a4a5-abc6-4bc5-9e4c-4ff981627b2a.png" width="33" height="21" alt="" />) which will true for every element of a set A. We will study the Riemann Hypothesis in two stages: a) By using the EP we will prove that the distribution of events e (even) and o (odd) of Square Free Numbers (SFN) on the axis Ax(N) of naturals is Heads-Tails (H-T) type. b) By using the CI we will explain the way that the distribution of prime numbers can be correlated with the non-trivial zeros of the function ζ(s) of Riemann. The Introduction and the Chapter 2 are necessary for understanding the solution. In the Chapter 3 we will present a simple method of forecasting in many very useful applications (e.g. financial, technological, medical, social, etc) developing a generalization of this new, proven here, theory which we finally apply to the solution of RH. The following Introduction as well the Results with the Discussion at the end shed light about the possibility of the proof of all the above. The article consists of 9 chapters that are numbered by 1, 2, …, 9.
基金Supported by The Agency for Healthcare Research and Quality,No.R18HS02420-01
文摘Clinical decision support(CDS) systems with automated alerts integrated into electronic medical records demonstrate efficacy for detecting medication errors(ME) and adverse drug events(ADEs). Critically ill patients are at increased risk for ME, ADEs and serious negative outcomes related to these events. Capitalizing on CDS to detect ME and prevent adverse drug related events has the potential to improve patient outcomes. The key to an effective medication safety surveillance system incorporating CDS is advancing the signals for alerts by using trajectory analyses to predict clinical events, instead of waiting for these events to occur. Additionally, incorporating cutting-edge biomarkers into alert knowledge in an effort to identify the need to adjust medication therapy portending harm will advance the current state of CDS. CDS can be taken a step further to identify drug related physiological events, which are less commonly included in surveillance systems. Predictive models for adverse events that combine patient factors with laboratory values and biomarkers are being established and these models can be the foundation for individualized CDS alerts to prevent impending ADEs.
基金supported by the Science and Technology Fund Project of Guizhou Health Commission(gzwkj2025-163)。
文摘Objective:To identify the root causes of typical adverse drug events through the lens of patient experiences proposing novel strategies to mitigate preventable harm.Methods:A qualitative case study leveraging in-depth interviews with patients and families,anchored by Interactive Patient Par ticipation Theory,to analyze 4 high-severity adverse drug events(ADE)cases.Cases were purposively sampled from 8 communities in China's National Adverse Event Monitor Center(2018-2023).Semi-structured interviews explored patient perspectives,with data analyzed via thematic coding and triangulation against clinical records.Results:Five interconnected themes emerged:(1)erosion of trust,(2)communication breakdowns,(3)information asymmetry,(4)environmental inadequacies,and(5)technological alienation.Notably,75% of participants had≤high school education,and 50% used≥7 medications daily,compounding ADE risks.Conclusions:We considered elements mentioned by theory,exploring trust,communication,information,and suppor t as the root causes.In addition,we added“adaptability to new technology”as an impor tant and necessary component.It is impor tant and necessary to analyze typical adverse drug events from the perspectives of patients.
文摘BACKGROUND Hepatic cirrhosis is associated with greater adverse event rates following surgical procedures and is thought to have a higher risk of complications with interventional procedures in general.However,these same patients often require interventional gastrointestinal procedures such as endoscopic retrograde cholangiopancreatography(ERCP)and endoscopic ultrasound(EUS).While studies examining this scenario exist,the overall body of evidence for adverse event rates associated with ERCP/EUS procedures is more limited.We sought add to the literature by examining the incidence of adverse events after ERCP/EUS procedures in our safety-net hospital population with the hypothesis that severity of cirrhosis correlates with higher adverse event rates.AIM To examine whether increasing severity of cirrhosis is associated with greater incidence of adverse events after interventional ERCP/EUS procedures.METHODS We performed a retrospective study of patients diagnosed with hepatic cirrhosis who underwent ERCP and/or EUS-guided fine needle aspirations/fine needle biopsies from January 1,2016 to March 14,2019 at our safety net hospital.We recorded Child-Pugh and Model for End-stage Liver Disease(MELD-Na)scores at time of procedure,interventions completed,and 30-day post-procedural adverse events.Statistical analyses were done to assess whether Child-Pugh class and MELD-Na score were associated with greater adverse event rates and whether advanced techniques(single-operator cholangioscopy,electrohydraulic lithotripsy/laser lithotripsy,or needle-knife techniques)were associated with higher complication rates.RESULTS 77 procedures performed on 36 patients were included.The study population consisted primarily of middle-aged Hispanic males.30-d procedure-related adverse events included gastrointestinal bleeding(7.8%),infection(6.5%),and bile leak(2%).The effect of Child-Pugh class C vs class A and B significantly predicted adverse events(β=0.55,P<0.01).MELD-Na scores also significantly predicted adverse events(β=0.037,P<0.01).Presence of advanced techniques was not associated with higher adverse events(P>0.05).When MELD-Na scores were added as predictors with the effect of Child-Pugh class C,logistic regression showed MELD-Na scores were a significant predictor of adverse events(P<0.01).The findings held after controlling for age,gender,ethnicity and repeat cases.CONCLUSION Increasing cirrhosis severity predicted adverse events while the presence of advanced techniques did not.MELD-Na score may be more useful in predicting adverse events than Child-Pugh class.
文摘On a summer morning in Boqiang Village,tucked beneath the emerald mountains of Fanshi County,Shanxi Province,the Ultra Trail Mount Wutai2025 commenced with the sound of the starting pistol-an event that was much more than just a competition.As soon as the colorful smoke bombs lit up the sky,some2,000 runners from China and abroad set off to reach one of the country's most sacred Buddhist peaks.Over the past decade,this race has become a fixture on the global running calendar and a symbol of the growing popularity of endurance sports.
文摘In this paper we consider the stochastic systems with jumps (random impulses) generated by Erlang flow of events that lead to discontinuities in paths. These systems may be used in various applications such as a control of complex technical systems, financial mathematics, mathematical biology and medicine. We propose to use a spectral method formalism to the probabilistic analysis problem for the stochastic systems with jumps. This method allows to get a solution of the analysis problem in an explicit form.
文摘Anxiety disorders are among the most common of all mental disorders and their pathogenesis is a major topic in psychiatry, both for prevention and treatment. Early stressful life events and alterations of hypothalamic pituitary adrenal(HPA) axis function seem to have a significant role in the onset of anxiety. Existing data appear to support the mediating effect of the HPA axis between childhood traumata and posttraumatic stress disorder. Findings on the HPA axis activity at baseline and after stimuli in panic disordered patients are inconclusive, even if stressful life events may have a triggering function in the development of this disorder. Data on the relationship between stress, HPA axis functioning and obsessive-compulsive disorder(OCD) are scarce and discordant, but an increased activity of the HPA axis is reported in OCD patients. Moreover, normal basal cortisol levels and hyperresponsiveness of the adrenal cortex during a psychosocial stressor are observed in social phobics. Finally,abnormal HPA axis activity has also been observed in generalized anxiety disordered patients. While several hypothesis have attempted to explain these findings over time, currently the most widely accepted theory is that early stressful life events may provoke alterations of the stress response and thus of the HPA axis, that can endure during adulthood, predisposing individuals to develop psychopathology. All theories are reviewed and the authors conclude that childhood life events and HPA abnormalities may be specifically and transnosographically related to all anxiety disorders, as well as, more broadly, to all psychiatric disorders.
基金supported by the Research Fund for Hexigten Global Geopark(Grant No.62932014004)Specialized Fund for Fundamental Research Program of China University of Geosciences,Beijing(Grant No.2011YYL016)+1 种基金the Specialized Fund for Public Welfare Industry,Ministry of Land and Resources of China(Grant No.201211077-3)the Specialized Research Fund for the Doctoral Program of Higher Education of China(for PhD supervisors,Grant No.20110022110005)
文摘We describe the last glaciation climatic history Marine Isotope Stage(MIS, 2-4) from 66.7 ka to 14.5 ka in Hexigten, northeast Inner Mongolia, North China. The climate of the region experienced frequent and significant fluctuations between dry-cold and less dry-cold during the late MIS4. The climate was generally warm and humid during early MIS3(MIS3 c) and late MIS3(MIS3 a), whereas it was cold and dry in middle MIS3(MIS3 b) and during MIS2. In this study, the cold and dry conditions were correlated with a stronger East Asian winter monsoon and strong dune activity; whereas, warm and humid conditions were related to a stronger East Asian summer monsoon(EASM) and weak dune activity. This study establishes six distinct dry and cold intervals during the last glacial period(66.7-14.5 ka) based on optically stimulated luminescence data, multi-proxies record(magnetic susceptibility, grain size analysis, Rb/Sr, SiO2/TiO2) and chemical index of alteration(CIA). The last glacial period may be correlated with Heinrich events 1 to 6 which were further confirmed by comparison with the Hulu cave stalagmites and Greenland ice core records. It is concluded that the study area was substantially affected by the EASM, as compared with the loess-desert transition zone of the Chinese Loess Plateau, especially in MIS3 c and suggested that the East Asian monsoon played a pivotal role in the last glacial period climate and dune activity.
基金supported by the National Natural Science Foundation of China(42202131 and 42177184).
文摘This study examines a 1.32 m thick sediment sequence from the Cunge sag pond in the Litang Basin,eastern Tibetan Plateau,to assess the seismicity of the Litang fault during the Holocene.High-resolution geochemical,grain size,magnetic susceptibility,and total organic carbon indicators are employed to obtain a continuous record of changes in elemental,physical,and biological properties within the profile to identify seismic events.The seismic event layer generally comprises two sedimentary rhythms:a lower coarse sand layer and an upper fine silt-clay layer.These layers represent rapid deposition associated with fault activity(Earthquake A)and slower deposition during calm periods or earthquake recurrence intervals(Seismic interval A).Through six^(14)C dating,five seismic events have been identified in the Cunge sag pond section:E1(before 3955 a B.P.),E2(3713-3703 a B.P.),E3(3492-3392 a B.P.),E4(2031-1894 a B.P.),and E5(1384-1321 a B.P.).E1-E4 had shown a good consistency with the paleo-earthquake recorded by the trench,and whereas E5 is a newly identified seismic event,further improving the continuous earthquake sequence of the Litang fault.Based on existing trench data and the seismic event record from the Cunge sag pond,a total of 11 paleo-earthquakes are identified along the Litang fault since the Holocene.The paleo-earthquake activity of the Litang fault exhibits a clustered pattern,with recurrence intervals of both long periods(1000 a)and short periods(500 a).Since 5000 a,the interval between strong earthquake recurrences gradually decreases,indicating an increasing risk of strong earthquakes along the Litang fault.This study presents a continuous record of paleo-earthquakes along the Litang fault,eastern Tibetan Plateau,and can enhance the understanding of regional seismic activity.
文摘Type 2 diabetes(T2D)is an insidious disease associated with neural and vascular complications,acceleration of cardiovascular disease,changes in heart function,and premature death.In the newly released article of the Journal of Sport and Health Science,Liang et al.1 describe results from the UK Biobank data showing the benefits of moderate-to-vigorous intensity physical activity(MVPA)on reducing the risks for vascular events in 11,474 adults with T2D and prediabetes.
文摘Background: Research has shown that high-sensitivity C-reactive protein (hs-CRP) is a major inflammatory marker for prediction of acute coronary syndrome (ACS). Myeloperoxidase (MPO) also plays an important role in atherosclerosis initiation and development. In present study, the major adverse cardiovascular events (MACEs) of patients with coronary heart disease (CHD) were investigated. Methods: MPO, hs-CRP and ACS-related risk factors from 201 ACS (78 AMI and 123 UAP) and 210 non-ACS (84 SAP and 126 non-CHD) patients confirmed by coronary angiography were detected, and the data were analyzed with receiver operating characteristic (ROC) curve and Spearman’s correlation coefficients. MACEs of 285 CHD patients were investigated during the 4-year period follow-up from March 2010 to May 2014. Results: The areas under ROC curve for diagnosing ACS were 0.888 (95% CI 0.843 - 0.933) for MPO, and 0.862 (95% CI 0.815-0.910) for hs-CRP, respectively. There were significantly correlations between MPO and hs-CRP in both ACS and non-ACS groups. Regarding to ACS patients, both MPO and hs-CRP were positively correlated with BMI, TC, TG, LDL-C and Hcy. Prospective study demonstrated that the incidences of MACEs associated significantly with elevated MPO baseline level (yes vs no, OR 7.383, 95% CI 4.095 - 13.309) and high hs-CRP baseline level (yes vs no, OR 4.186, 95% CI 2.469 - 7.097) in CHD patients. Conclusions: The present study provides the epidemiological evidence that elevated baseline MPO and hs-CRP levels are both valuable predictors of MACEs in CHD patients. MPO and hs-CRP would prompt the progression of atherosclerosis and development from SAP to ACS.
基金Sponsored by the National Natural Science Fund(41801064,71790611)China Postdoctoral Science Foundation(2019 T120114,2019M650756)the Central Asian Atmospheric Science Research Fund(CAAS201804)
文摘In this study, based on the data on the frequency of waterlogging events and the number of waterlogging days of 1,638 stations from 1961 to 2016, a variety of mathematical statistics methods were used to analyze the spatiotemporal evolution of waterlogging events in eastern China. The results showed that:① In terms of time, the annual frequency of waterlogging events and the number of waterlogging days in eastern China in 1961–2016 showed an increasing trend despite of fluctuations. In the interdecadal changes, the highest frequency of waterlogging events and the greatest number of waterlogging days occurred in the 1990s, and from the 1960s to the 1980s, the frequency of waterlogging events and the number of waterlogging days in eastern China showed a decreasing trend. There were 6-year and 30-year periodic variations in the frequency of waterlogging events and the number of waterlogging days in eastern China, and mutations occurred in 1991.② In terms of space, from 1961 to 2016, the areas with high frequency of waterlogging events in various years in eastern China were mainly South China, western and southern Yunnan, northern Jiangsu, southern Zhejiang, northern Fujian, junction areas between Hunan and Chongqing, northern Sichuan, and eastern Liaoning.③ In the spatial distribution of change trends and fluctuation characteristics, the frequency of waterlogging events and the number of waterlogging days in eastern China increased significantly in the southeastern coastal areas from 1961 to 2016, and the fluctuations of the frequency of waterlogging events and the number of waterlogging days in eastern China from 1961 to 2016 presented a spatial variation pattern of low in the southwest and high in the northwest.
基金funded by the Tianshan Yingcai Program of the Xinjiang Uygur Autonomous Region(2022TSYCCX0038)the Youth Innovation Promotion Association of the Chinese Academy of Sciences(Y2022108)the Postdoctoral Fellowship Program of Chinese Postdoctoral Science Foundation(CPSF)(GZC20232962).
文摘The Tarim River Basin(TRB)is a vast area with plenty of light and heat and is an important base for grain and cotton production in Northwest China.In the context of climate change,however,the increased frequency of extreme weather and climate events is having numerous negative impacts on the region's agricultural production.To better understand how unfavorable climatic conditions affect crop production,we explored the relationship of extreme weather and climate events with crop yields and phenology.In this research,ten indicators of extreme weather and climate events(consecutive dry days(CDD),min Tmax(TXn),max Tmin(TNx),tropical nights(TR),warm days(Tx90p),warm nights(Tn90p),summer days(SU),frost days(FD),very wet days(R95p),and windy days(WD))were selected to analyze the impact of spatial and temporal variations on the yields of major crops(wheat,maize,and cotton)in the TRB from 1990 to 2020.The three key findings of this research were as follows:extreme temperatures in southwestern TRB showed an increasing trend,with higher extreme temperatures at night,while the occurrence of extreme weather and climate events in northeastern TRB was relatively low.The number of FD was on the rise,while WD also increased in recent years.Crop yields were higher in the northeast compared with the southwest,and wheat,maize,and cotton yields generally showed an increasing trend despite an earlier decline.The correlation of extreme weather and climate events on crop yields can be categorized as extreme nighttime temperature indices(TNx,Tn90p,TR,and FD),extreme daytime temperature indices(TXn,Tx90p,and SU),extreme precipitation indices(CDD and R95p),and extreme wind(WD).By using Random Forest(RF)approach to determine the effects of different extreme weather and climate events on the yields of different crops,we found that the importance of extreme precipitation indices(CDD and R95p)to crop yield decreased significantly over time.As well,we found that the importance of the extreme nighttime temperature(TR and TNx)for the yields of the three crops increased during 2005-2020 compared with 1990-2005.The impact of extreme temperature events on wheat,maize,and cotton yields in the TRB is becoming increasingly significant,and this finding can inform policy decisions and agronomic innovations to better cope with current and future climate warming.
文摘This letter addressed the impactful study by Zhong et al,which introduced a risk prediction and stratification model for surgical adverse events following minimally invasive esophagectomy.By identifying key risk factors such as chronic obstructive pulmonary disease and hypoalbuminemia,the model demonstrated strong predictive accuracy and offered a pathway to personalized perioperative care.This correspondence highlighted the clinical significance,emphasizing its potential to optimize patient outcomes through tailored inter-ventions.Further prospective validation and application across diverse settings are essential to realize its full potential in advancing esophageal surgery practices.
基金National Key Research and Development Program of China,No.2023YFC3206605,No.2021YFC3201102National Natural Science Foundation of China,No.41971035。
文摘Precipitation events,which follow a life cycle of initiation,development,and decay,represent the fundamental form of precipitation.Comprehensive and accurate detection of these events is crucial for effective water resource management and flood control.However,current investigations on their spatio-temporal patterns remain limited,largely because of the lack of systematic detection indices that are specifically designed for precipitation events,which constrains event-scale research.In this study,we defined a set of precipitation event detection indices(PEDI)that consists of five conventional and fourteen extreme indices to characterize precipitation events from the perspectives of intensity,duration,and frequency.Applications of the PEDI revealed the spatial patterns of hourly precipitation events in China and its first-and second-order river basins from 2008 to 2017.Both conventional and extreme precipitation events displayed spatial distribution patterns that gradually decreased in intensity,duration,and frequency from southeast to northwest China.Compared with those in northwest China,the average values of most PEDIs in southeast China were usually 2-10 times greater for first-order river basins and 3-15 times greater for second-order basins.The PEDI could serve as a reference method for investigating precipitation events at global,regional,and basin scales.
文摘Extreme rainfall events(EREs)frequently hit the middle and lower reaches of the Yellow River basin(YRB)during boreal summer.Recent observations have indicated that EREs exhibit teleconnection patterns across long spatial distances.This study investigated ERE teleconnections in the YRB using the Event Synchronization(ES)method in combination with Complex Network(CN)theory.EREs in the YRB are significantly synchronized with other regions from regional to global scales.Additionally,high-resolution CMIP6 models in general show better skill in capturing these characteristics compared to low-resolution models.A further examination shows that the spatial synchronization patterns exhibit pronounced timescale dependence.Significant ERE synchronizations between the YRB and Europe were uncovered,where the YRB lags Eastern Europe by 3-5 days and Western Europe by 5-7 days,with Rossby wave propagation playing a key role.Wave trains from Europe propagate downstream along the Eurasian jet,inducing anomalous circulations over the YRB that enhance vertical upward motion and moisture transport,ultimately triggering EREs.Two distinct wave trains are observed:one is associated with Eastern Europe-YRB synchronization,occurring in the midlatitude region;the other is linked to Western Europe-YRB synchronization,positioned at higher latitudes.Notably,17.5%of Eastern Europe-YRB synchronization cases and 17.0%of Western Europe-YRB cases overlap.Quantitative analysis indicates that the synchronized events between Eastern(Western)Europe and the YRB account for roughly 28%(30%)of EREs in the YRB.These findings are critical for better understanding ERE mechanisms,offering guidance for forecasting and early warning capabilities for EREs in the YRB.
基金supported by the National Natural Science Foundation of China (Grant No.42288101)the Young Scientists Fund of the National Natural Science Foundation of China (Grand No.42505018)the Shanghai “Science and Technology Innovation Action Plan” Venus Project (Grant No.23YF1437300)。
文摘Recent studies have suggested that rapid warming over the Mongolian Plateau(MP) may intensify extreme heat events(EHEs). However, the characteristics and mechanisms driving summer EHEs over the MP(MP-EHEs) remain unclear. This study explores the interannual variations in summer MP-EHEs and their relationship with the summer soil moisture over the Inner Tibetan Plateau(TP-SM). The results reveal that changes in the MP-EHEs are linked to descending atmospheric motion induced by a local high-pressure system over the MP region. Descending motion further results in decreased mid-tolow-level cloud cover and increased shortwave radiation, thereby warming the surface and triggering summer MP-EHEs.Further analysis indicates that increased TP-SM results in a greater latent heat flux, triggering a local secondary circulation that reinforces the local high-pressure system over the MP region, thus serving to promote the occurrence of summer MPEHEs. Additionally, model results from the linear baroclinic model(LBM) and CMIP6 further confirm that variations in summer TP-SM contribute to the occurrence of the MP-EHEs.
文摘In this study, the daily observational precipitation data and NCEP reanalysis data during 1951e2014, Euler and Lagrangian method were used to investigate the moisture sources of summer extreme precipitation events in North Xinjiang. The results show that water vapor at low and upper levels of most summer heavy rain (more than 50 mm d1 and less than 100 mm d1) in North Xinjiang are mainly transported by westerly circulation from the North Atlantic Ocean and the Eurasian continent. However, rainstorms of more than 100 mm d1, which are rarely observed, are dominated by vertically integrated moisture from the North Atlantic, Arctic Oceans, and the Eurasian continent, in addition to lowlevel moisture from the Indian Ocean. Among these sources, the anomalous low-level moisture from the Indian Ocean, which is closely associated with stronger meridional circulation, is considered to be more important with respect to rainstorms. On the days prior to rainstorm days, stronger meridional circulation leads to an anomalous pressure gradient force, which can transport low-level moisture from the Indian Ocean along the eastern periphery of the Tibetan Plateau to North Xinjiang. Furthermore, moisture from the North Atlantic, Arctic Oceans, the Eurasian continent, and the Indian Ocean converge together to influence rainstorm development in this region.
文摘BACKGROUND Left ventricular noncompaction(LVNC)is a genetic cardiomyopathy.It is characterized by intensely developed trabeculae in the ventricles with deep intertrabecular lacunae.LVNC manifests as arrhythmias and heart failure with a predisposition for thrombus formation.AIM To study predictors of arrhythmic,thromboembolic events and adverse outcomes(death/transplantation)in adult patients with LVNC.METHODS Adult patients with LVNC were included(n=125;mean follow-up:14 months).Electrocardiography,echocardiography,and 24-hour electrocardiography monitoring were performed.Other procedures were conducted for some patients including:Coronary angiography;cardiac magnetic resonance imaging;cardiac computed tomography;genetic testing;myocardial pathological examination;and anti-cardiac antibody level estimation.Primary endpoints were death,heart transplantation,combined endpoint(death+transplantation),and sudden cardiac death.Secondary endpoints were intracardiac thrombosis,embolic events,myocardial infarction,sustained ventricular tachycardia(VT),and implantable cardioverter-defibrillator intervention.RESULTS LVNC manifestations included non-sustained VT,thrombosis/embolism,sustained VT, and sudden cardiac death. Non-sustained VT was associated with the New York Heart Association(NYHA) chronic heart failure (CHF) class, poor R-wave progression, superimposed myocarditis, and highermortality. Thrombosis/embolism was associated with NYHA CHF class ≥ 3, right ventricular end-diastolicdiameter ≥ 3 cm, right atrium volume ≥ 67 mL, left ventricle end-diastolic diameter ≥ 6.3 cm, and velocity timeintegral ≤ 11.2 cm. Sustained VT was associated with premature ventricular contractions (PVCs), low QRS voltage,and atrioventricular block. PVCs > 500/day were predictive of defibrillator intervention. Fatal outcomes wereassociated with E wave/A wave ratio > 1.9, left ventricle ejection fraction < 35%, NYHA CHF class ≥ 3, VT, andmyocarditis.CONCLUSIONFrequent PVCs, non-sustained VT, low QRS voltage, and signs of systolic dysfunction on echocardiogram arepredictors of life-threatening events in patients with LVNC.
基金supported by the Science and Technology Major Project of the Sichuan Institute of Geological Survey(SCIGS-CZDXM-2023003)the National Natural Science Foundation of China(41603034).
文摘1.Objective The Songpan-Ganze terrane is a key region for understanding the tectonic evolution of the Tibetan Plateau and the Yangtze Craton.The Songpan-Ganzi complex comprises a thick succession of deformed Ladinian-Norian turbidites(ca.230-203 Ma),covering about 200000 km^(2)of the eastern Tibet Plateau with a volume of approximately 2.0×10^(6)km^(3)(Fig.1a).Furthermore,this complex has over 100 Permian-Cenozoic felsic plutons.
