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
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
Although air pollutant emissions have sharply reduced in recent years,the occurrence of PM_(2.5) pollution events remains an intractable environmental problem in Beijing,and regional transport is the key influence fac...Although air pollutant emissions have sharply reduced in recent years,the occurrence of PM_(2.5) pollution events remains an intractable environmental problem in Beijing,and regional transport is the key influence factor.However,it has been difficult to identify regional transport characteristics and the main contributors to pollution events in recent years.In this study,the relative contribution of regional transport was quantified(61.3%)in PM_(2.5) pollution events during 2018-2021 by the Community Multiscale Air Quality model embedded with the Integrated Source Apportionment Model(CMAQ-ISAM).The four regions with the largest fractional contributions to Beijing for all events were Shandong(7.7%),South Hebei(7.3%),Baoding(6.2%),and Langfang(5.8%).Pollution events were classified into the following types based on regional transport directions:local,southwest(SW),southeast(SE),south-mixed(SM),and others.Based on the transport distance,the SW,SE,and SM types can be subdivided into SW-short,SW-long,SE-short,SE-long,SM-short,SM-long distance from southwest,SM-long distance from southeast,and SM-long distance from southwest and southeast.SE-long was regarded as the most important type,with the highest relative frequency(20%).The transport directions were related to the southwest wind at 925 hPa and southeast wind at 1000 hPa in the south of the Beijing–Tianjin–Hebei(BTH)region,and the distance was mainly controlled by wind strength.The wind-field difference can be attributed to the low-pressure and high-pressure systems that control the BTH region.The results suggest that regional joint pollution control should be optimized based on the transport type.展开更多
BACKGROUND Minimally invasive esophagectomy(MIE)is a widely accepted treatment for esophageal cancer,yet it is associated with a significant risk of surgical adverse events(SAEs),which can compromise patient recovery ...BACKGROUND Minimally invasive esophagectomy(MIE)is a widely accepted treatment for esophageal cancer,yet it is associated with a significant risk of surgical adverse events(SAEs),which can compromise patient recovery and long-term survival.Accurate preoperative identification of high-risk patients is critical for improving outcomes.AIM To establish and validate a risk prediction and stratification model for the risk of SAEs in patients with MIE.METHODS This retrospective study included 747 patients who underwent MIE at two centers from January 2019 to February 2024.Patients were separated into a train set(n=549)and a validation set(n=198).After screening by least absolute shrinkage and selection operator regression,multivariate logistic regression analyzed clinical and intraoperative variables to identify independent risk factors for SAEs.A risk stratification model was constructed and validated to predict the probability of SAEs.RESULTS SAEs occurred in 10.2%of patients in train set and 13.6%in the validation set.Patients with SAE had significantly higher complication rate and a longer hospital stay after surgery.The key independent risk factors identified included chronic obstructive pulmonary disease,a history of alcohol consumption,low forced expiratory volume in the first second,and low albumin levels.The stratification model has excellent prediction accuracy,with an area under the curve of 0.889 for the training set and an area under the curve of 0.793 for the validation set.CONCLUSION The developed risk stratification model effectively predicts the risk of SAEs in patients undergoing MIE,facilitating targeted preoperative interventions and improving perioperative management.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
In the summer of 2024, following a strong El Ni?o event in the preceding winter, the tropical Indian Ocean and tropical North Atlantic recorded their highest SSTs since 1961, along with a significant westward shift an...In the summer of 2024, following a strong El Ni?o event in the preceding winter, the tropical Indian Ocean and tropical North Atlantic recorded their highest SSTs since 1961, along with a significant westward shift and intensification of the western Pacific subtropical high(WPSH). Under these conditions, China experienced its hottest summer since 1961,and was hit by a series of high-impact extreme weather and climate events. From 9 June to 2 July, southern China experienced an unprecedented extreme precipitation event that exceeded the well-known 1998 summer precipitation event in both duration and impact scope, resulting in devastating floods in the Yangtze River basin. Subsequently, in early to midJuly, the Huanghe-Huaihe Basin suffered from a severe drought–flood abrupt alternation event, heavily affecting Henan and Shandong. Meanwhile, southern China underwent a widespread heatwave event lasting 74 days, ranking as the second most intense since 1961. From late July to the end of August, northern China faced unusually frequent heavy precipitation events, with cumulative precipitation reaching the second highest for the same period since 1961, causing floods in many rivers of northern China. This study provides a timely summary and assessment of the characteristics and impacts of these extreme events. It serves as a reference for climate change research, including mechanism analysis, numerical simulation,and climate event attribution, and also offers valuable insights for improving meteorological disaster prevention and mitigation strategies.展开更多
BACKGROUND Patients with type 2 diabetes mellitus(T2DM)face a heightened risk of future cardiovascular events.It is therefore important to stratify these patients according to their future cardiovascular event risk to...BACKGROUND Patients with type 2 diabetes mellitus(T2DM)face a heightened risk of future cardiovascular events.It is therefore important to stratify these patients according to their future cardiovascular event risk to allow early intervention and improve prognosis.Recent proposals have indicated that nontraditional lipoprotein ratios may be superior predictors of cardiovascular events compared to traditional lipid parameters.However,further evidence is required for widespread clinical ap-plication.AIM To elucidate the associations of nontraditional lipoprotein ratios with future cardiovascular events in patients with T2DM.METHODS This study performed post-hoc analysis of data obtained during a clinical trial involving 10182 participants.To ascertain the correlations between nontraditional lipoprotein ratios and future cardiovascular events,including major adverse cardiovascular events(MACEs)and congestive heart failure(CHF).We employed univariable and multivariable-adjusted Cox proportional hazards regression models.Potential dose-response relationships and threshold values were explored by conducting restricted cubic spline analyses and two-piecewise linear regression models.Possible relevant interactions influencing independent relationships were tested using subgroup and interaction analyses.RESULTS After adjustment for confounding factors,all nontraditional lipoprotein ratios studied were strongly associated with MACE risk in patients with T2DM.In comparison with patients in the lowest quartile,the hazard ratios(95%confidence intervals)of those in the highest quartile were 1.50(1.29-1.73),1.51(1.30-1.74),1.50(1.29-1.73),and 1.30(1.12-1.50)for total cholesterol/high-density lipoprotein cholesterol(HDL-C),low-density lipoprotein cholesterol/HDL-C,non-HDL-C/HDL-C,and remnant cholesterol/HDL-C,respectively.Similar findings were noted for CHF.Dose-response relationships between nontraditional lipoprotein ratios and MACE were observed,with threshold values of 7.29,6.29,and 2.15 for total cholesterol/HDL-C,non-HDL-C/HDL-C,and remnant cholesterol/HDL-C,respectively.However,no notable dose-response relationships were detected between nontraditional lipoprotein ratios and CHF.CONCLUSION Elevated nontraditional lipoprotein ratios may independently predict the risk of MACE and CHF in patients with T2DM.展开更多
Objective:To investigate the differences in childhood trauma and life events between adolescents with depression and healthy controls,and to analyze the correlations between these factors and depressive symptoms.As su...Objective:To investigate the differences in childhood trauma and life events between adolescents with depression and healthy controls,and to analyze the correlations between these factors and depressive symptoms.As such,we aim to provide theoretical foundations for early identification and intervention.Methods:This cross-sectional study enrolled 90 hospitalized adolescents with depression(case group)and 91 healthy adolescents(control group).Childhood Trauma Questionnaire(CTQ),Adolescent Self-Rating Life Events Checklist(ASLEC),and Children’s Depression Inventory(CDI)were administered to assess trauma history,life event stressors,and depressive symptoms.Statistical analyses included independent samples t-tests,chi-square tests,and Pearson correlation analysis.Results:The case group demonstrated a significantly higher proportion of only-child families(28.9%).ASLEC and CDI scores were significantly elevated in the case group compared to the control group(P<0.05).In comparison,CTQ scores were lower in the case group(P=0.025).Positive correlations were identified between CDI scores and both CTQ(r=0.261)and ASLEC(r=0.218)in the case group.Conclusion:Child-hood trauma and recent life event stressors demonstrate significant associations with adolescent depressive symp-toms,potentially mediated through emotional dysregulation and negative cognitive bias.Implementation of early trauma screening protocols combined with stress management interventions(e.g.,cognitive behavioral therapy)and family system optimization strategies may effectively mitigate depression risk in this population.展开更多
BACKGROUND Intra-arterial chemotherapy(IAC)has become a first-line standard treatment for retinoblastoma(RB).However,studies describing its adverse events are sparse,especially from the developing world.Our study desc...BACKGROUND Intra-arterial chemotherapy(IAC)has become a first-line standard treatment for retinoblastoma(RB).However,studies describing its adverse events are sparse,especially from the developing world.Our study described the outcomes and adverse events from a single center in South India.AIM To describe the challenges,treatment outcomes,and complications of selective IAC for RB in Indian eyes.METHODS This study was a single center,retrospective study that included 17 patients with RB who underwent IAC using melphalan(5/7.5 mg)and topotecan(1/2 mg)(n=12)or melphalan(5 mg)alone(n=3)or triple therapy that included carboplatin(30 mg)along with these drugs(n=2)between January 2018 and December 2023.In all,17 IAC procedures were performed using selective ophthalmic artery cannulation.Treatment outcomes were evaluated in terms of tumor control,vitreous and subretinal seed control,complications,and globe salvage rates.RESULTS Out of the 17 patients,11 were diagnosed with unilateral RB and 6 were diag-nosed with bilateral RB.The mean age at the time of diagnosis was 19.8 months.The mean interval between the first symptom and presentation was 6.5 months.IAC was employed as the primary(n=9)or secondary(n=8)modality of treatment.Each eye received a mean of 1.5 IAC sessions(median:1 session;range:1-3 sessions).Eyes were classified according to the international classification of RB as group B(n=5),group C(n=1),group D(n=4),and group E(n=7).Following IAC,complete regression of the main tumor was seen in 15 eyes(88%)and partial regression in 2 eyes(12%).Globe salvage was achieved in 15 eyes(88%).Adverse effects included vitreous hemorrhage(n=3),rhegmatogenous retinal de-tachment(n=2),choroidal ischemia(n=1),isolated subretinal hemorrhage(n=2),retinal pigment epithelium degeneration(n=2),forehead pigmentation(n=1),third nerve palsy with complete ptosis(n=1),and 30-degree exotropia(n=1).The mean follow-up period was 28.6 months(median:24 months,range:1–72 months).CONCLUSION IAC is an effective way to control RB and globe preservation.In the Indian context we encountered many cha-llenges highlighting the importance of case selection.Further studies in India are required to thoroughly un-derstand IAC as a treatment for RB.展开更多
This article centers on The Call of the Wild,an English novel by American author Jack London,alongside two Chinese translations by Dajie Liu and Menglin Zhang,and Rongyue Liu.Seventy sentences containing motion events...This article centers on The Call of the Wild,an English novel by American author Jack London,alongside two Chinese translations by Dajie Liu and Menglin Zhang,and Rongyue Liu.Seventy sentences containing motion events and their corresponding translations were randomly selected for analysis.The study focuses on the primary elements of motion events-manner,path,and ground-and examines their Chinese translations through the lens of Skopos theory.Skopos theory emphasizes whether translators can adopt appropriate translation strategies according to various contextual factors during the translation process.Compared to verb-framed languages,satellite-framed languages possess a richer vocabulary for manner verbs,express more detailed manner information,use more satellite words to indicate paths,and incorporate more background information.Verb-framed languages,by contrast,typically express manner information only when necessary and tend to include less background information.The analysis reveals that both Chinese translations embody the core principle of Skopos theory:translation strategies are determined by their purpose.To fulfill the novel’s translation objectives,the translators adeptly adjust their strategies for motion event components based on different contextual needs.It is noted that the Chinese translations do not fully retain the characteristics of English as a typical satellite-framed language.This observation aligns with Skopos theory’s purpose-oriented approach,which prioritizes translation goals over strict adherence to source text characteristics.展开更多
The southern part of East Siberia(SES)is highly vulnerable to flooding caused by the extreme precipitation events(EPEs)during summer.Building on previously detected EPEs in SES and Mongolia,we examined wave propagatio...The southern part of East Siberia(SES)is highly vulnerable to flooding caused by the extreme precipitation events(EPEs)during summer.Building on previously detected EPEs in SES and Mongolia,we examined wave propagation patterns for two periods:1982-98 and 1999-2019.Our analysis revealed distinct wave train configurations and geopotential anomalies preceding EPEs,with an increase in wave activity flux across the Northern Hemisphere,followed by a subsequent decrease during EPEs.Consequently,Eastern Siberia has experienced a significant rise in wave activity.Based on geopotential anomalies over Central Siberia accompanying EPEs,we identified two main types.The first,the ridge type,is predominant during the first period and features a meridional contrast with a positive geopotential(and temperature)anomaly over Central Siberia and a negative anomaly over the subtropical regions along the same longitude.The second type,termed the trough type,is more typical for the second period.It involves either a negative geopotential anomaly or the zonal proximity of positive and negative geopotential anomalies over Central Siberia.The trough type,marked by zonally oriented anomalies in geopotential and temperature,results in a more pronounced temperature decrease before EPEs and significant zonal temperature contrasts.Further,it is related to more stationary waves over Northern Eurasia,with persistent positive geopotential anomalies over Europe linked to quasi-stationary troughs over Central Siberia and positive anomalies east of Lake Baikal.Our findings align with shifts in boreal summer teleconnection patterns,reflecting significant changes in wave propagation patterns that have occurred since the late 1990s.展开更多
Founder events influence recessive diseases in highly endogamous populations.Several Indian populations have experienced significant founder events due to strict endogamy.However,the clinical implications of it remain...Founder events influence recessive diseases in highly endogamous populations.Several Indian populations have experienced significant founder events due to strict endogamy.However,the clinical implications of it remain underexplored.Therefore,we perform whole-exome sequencing of 281 individuals from four South Indian populations,characterized by high IBD scores.Our study reveals a high inbreeding rate of 59%across the populations.We identify∼29.2%of the variants that are exclusively present in a single population and uncover 1284 unreported exonic variants,underscoring the underrepresentation of Indian populations in global databases.Among these,23 are predicted to be deleterious,all of which are present in a heterozygous state;they may be pathogenic when homozygous,an expected phenomenon in endogamous populations.Approximately 16%-33%of the identified pathogenic variants showed significantly higher occurrence rates compared with the South Asian populations from 1000 Genomes dataset.Pharmacogenomic analysis revealed distinct allele frequencies of variants in CYP450 and non-CYP450 genes,highlighting heterogeneous drug responses and associated risks.We report a high prevalence of ankylosing spondylitis in Reddy population,linked to the HLA-B∗27:04 allele and strong founder effect.Our findings highlight the need for extensive genomic research in understudied Indian populations for a better understanding of disease risk and evolving strategies for precision and preventive medicine.展开更多
The March 11,2011,MW9.0 Tohoku-Oki earthquake,in Japan,caused rapid strain release near the epicenter,while the Boso Peninsula,located farther away,experienced stress redistribution,leading to changes in the recurrenc...The March 11,2011,MW9.0 Tohoku-Oki earthquake,in Japan,caused rapid strain release near the epicenter,while the Boso Peninsula,located farther away,experienced stress redistribution,leading to changes in the recurrence interval of slow slip events(SSEs)and regional strain.This study focuses on three detected post-2011 Boso SSEs,utilizing a segmented model displacement time series measured by Global Navigation Satellite System(GNSS)to calculate velocity and strain rate fields for eight periods before,during,and after the SSEs.Results show that the 2011 earthquake and the three SSEs significantly alter the velocity field in the Boso region,with SSE velocities predominantly oriented southeast,reaching maximum values of 26.9 cm/a,10.6 cm/a,and 38.5 cm/adnearly opposite to non-SSE periods.After the third SSE,the velocity field nearly returns to its pre-earthquake state,with a maximum of 1.8 cm/a.The maximum shear strain rates during the three SSEs are 25.88×10^(-7) a^(-1),11.38×10^(-7) a^(-1),and 29.02×10^(-7) a^(-1)(i.e.,per annum),significantly higher than those during non-slow slip periods,with principal strain rates following a similar pattern.The spatial distribution of strain rates during the SSEs indicates greater deformation compared to the non-slip periods,dominated by northwest-southeast extension and southwest-northeast compression.Spatiotemporal analysis reveals a strong correlation between seismic frequency and strain rate during the SSEs,with time correlation coefficients of 0.85,0.88,and 0.9.Although larger accumulated strain results in stronger strain release during the latter two SSEs,not all strain is fully released,suggesting that earthquake swarms accompanying the SSEs may contribute to the partial release of unreleased strain.This study,through the analysis of GNSS data,evaluates the spatiotemporal distribution of strain fields during periodic SSEs,contributing to further research on strain accumulation and release,and aiding in the analysis of this regional seismic activity.展开更多
This study sought to investigate adverse drug event(ADE)signals associated with eltrombopag use in pediatric patients aged 0–18 years,utilizing data from the U.S.Food and Drug Administration Adverse Event Reporting S...This study sought to investigate adverse drug event(ADE)signals associated with eltrombopag use in pediatric patients aged 0–18 years,utilizing data from the U.S.Food and Drug Administration Adverse Event Reporting System(FAERS).By analyzing this extensive pharmacovigilance database,the study aimed to offer meaningful insights for improving the clinical safety of eltrombopag in children.Data covering eltrombopag-related ADEs from Q12004 to Q42023 were extracted from FAERS,and signal detection was conducted using both the reporting odds ratio(ROR)and proportional reporting ratio(PRR)methods.ADEs were categorized based on the System Organ Class(SOC)classification in MedDRA version 25.0.A total of 582 reports involving pediatric patients receiving eltrombopag were identified,encompassing 21 SOC categories.The analysis revealed that,in addition to the known ADEs listed in the drug label,clinicians should remain vigilant for potential off-label ADE signals.These included abnormal platelet counts,thrombocytosis,antiphospholipid syndrome,myelofibrosis,reduced serum iron levels,myelodysplastic syndrome,hepatic infections,and other related conditions.Given these findings,it is strongly recommended that serum iron and ferritin levels should be routinely monitored in pediatric patients undergoing eltrombopag therapy,particularly during long-term treatment.Such proactive surveillance may help prevent the onset of iron deficiency anemia and enhance overall treatment safety.展开更多
Research on mass gathering events is critical for ensuring public security and maintaining social order.However,most of the existing works focus on crowd behavior analysis areas such as anomaly detection and crowd cou...Research on mass gathering events is critical for ensuring public security and maintaining social order.However,most of the existing works focus on crowd behavior analysis areas such as anomaly detection and crowd counting,and there is a relative lack of research on mass gathering behaviors.We believe real-time detection and monitoring of mass gathering behaviors are essential formigrating potential security risks and emergencies.Therefore,it is imperative to develop a method capable of accurately identifying and localizing mass gatherings before disasters occur,enabling prompt and effective responses.To address this problem,we propose an innovative Event-Driven Attention Network(EDAN),which achieves image-text matching in the scenario of mass gathering events with good results for the first time.Traditional image-text retrieval methods based on global alignment are difficult to capture the local details within complex scenes,limiting retrieval accuracy.While local alignment-based methods aremore effective at extracting detailed features,they frequently process raw textual features directly,which often contain ambiguities and redundant information that can diminish retrieval efficiency and degrade model performance.To overcome these challenges,EDAN introduces an Event-Driven AttentionModule that adaptively focuses attention on image regions or textual words relevant to the event type.By calculating the semantic distance between event labels and textual content,this module effectively significantly reduces computational complexity and enhances retrieval efficiency.To validate the effectiveness of EDAN,we construct a dedicated multimodal dataset tailored for the analysis of mass gathering events,providing a reliable foundation for subsequent studies.We conduct comparative experiments with other methods on our dataset,the experimental results demonstrate the effectiveness of EDAN.In the image-to-text retrieval task,EDAN achieved the best performance on the R@5 metric,while in the text-to-image retrieval task,it showed superior results on both R@10 and R@5 metrics.Additionally,EDAN excelled in the overall Rsummetric,achieving the best performance.Finally,ablation studies further verified the effectiveness of event-driven attention module.展开更多
Subseasonal forecasting of extreme events is crucial for early warning systems.However,the forecast skills for extreme events are limited.Taking the extreme cold events in January 2018 as a specific example,and analyz...Subseasonal forecasting of extreme events is crucial for early warning systems.However,the forecast skills for extreme events are limited.Taking the extreme cold events in January 2018 as a specific example,and analyzing the 34 extreme cold events in East Asia from 1998 to 2020,the authors evaluated the forecast skills of the ECMWF model ensemble members on subseasonal time scales.The results show that while the ensemble mean has limited skills for forecasting extreme cold events at the 3-week lead time,some individual members demonstrate high forecast skills.For most extreme cold events,there are>10%of members among the total ensembles that can well predict the rapid temperature transitions at the 14-day lead time.This highlights the untapped potential of the ECMWF model to forecast extreme cold events on subseasonal time scales.High-skill ensemble members rely on accurate predictions of atmospheric circulation patterns(500-hPa geopotential height,mean sea level pressure)and key weather systems,including the Ural Blocking and Siberian High,that influence extreme cold events.展开更多
In a warming world,climate extremes tend to be more frequent and intense.The exceptional response of ecosystems triggered by extreme climate events under a warmer and wetter climate in northwest China(NWC)has aroused ...In a warming world,climate extremes tend to be more frequent and intense.The exceptional response of ecosystems triggered by extreme climate events under a warmer and wetter climate in northwest China(NWC)has aroused growing concern.However,understanding the responses of vegetation to climate extremes from the compound events perspective remains challenging.In this study,we identify the climate dynamics in NWC during 1971–2020 based on daily meteorological observations,focusing on the changes in compound hot-dry events(CHDEs)during the warmer and wetter period.We further explore the effects of CHDEs on vegetation by examining vegetation anomalies and recovery time using daily gross primary productivity(GPP)data.The results show a clear warmer and wetter period in NWC during 2000–2020.No signs of a hiatus in CHDEs increase are observed during this period,and even the duration of CHDEs in western NWC keeps showing an increasing tendency.Vegetation in eastern NWC,with a lower probability of GPP anomalies,exhibits stronger resistance of ecosystems to CHDEs than in western NWC.In NWC,vegetation typically returns to its normal state in 5.50 days on average,but exhibits greater resilience in the western region,where it takes less recovery time(4.82 days).Vegetation in the central region shows the lowest probability of GPP anomalies and relatively longer recovery time,likely due to its higher altitudes.Our research underscores the imperative to address the considerable impacts of CHDEs on vegetation growth even as the regional climate becomes increasingly warmer and wetter.展开更多
Background Coronary artery calcification(CAC),a hallmark of atherosclerosis,paradoxically associates with reduced cardiovascular risk under statin therapy despite accelerated calcification progression,prompting this s...Background Coronary artery calcification(CAC),a hallmark of atherosclerosis,paradoxically associates with reduced cardiovascular risk under statin therapy despite accelerated calcification progression,prompting this study to explore CAC metrics as potential mediators between statin use and major adverse cardiovascular events(MACE).Methods Clinical data of 246 hospitalized patients who underwent coronary computed tomography angiography(CCTA)at Guangdong Provincial People's Hospital from January 2023 to June 2023 were retrospectively analyzed.Linear regression was used to evaluate the relationship between statin use and CAC parameters.Multivariable Poisson regression models were applied to explore the associations of statin use and CAC parameters with MACE risk.A mediation analysis was performed to assess the role of CAC parameters in the statin-MACE relationship.Results Statin use was independently associated with increased calcification score(β=0.648,P<0.001),CAC volume(β=0.623,P<0.001),and calcified plaque proportion(β=0.606,P=0.002).Multivariable Poisson regression indicated that statin use significantly reduced MACE risk[incidence rate ratio(IRR):0.33,P=0.018],whereas calcification score(IRR:2.63,P=0.026)and CACvolume(IRR:2.66,P=0.044)were associated with elevated MACE risk;Calcified plaque proportion showed no significant association.Mediation analysis revealed that calcification score(β=0.035,P=0.021)and CAC volume(β=0.023,P=0.018)exerted masking effects,while calcified plaque proportion had no mediating role.Conclusions Calcification score and CACvolume demonstrated limited masking effects in the association between statin use and MACE.展开更多
Immune checkpoint inhibitors have markedly improved outcomes in patients with multiple advanced malignancies.However,their widespread use has markedly increased the incidence of immune-related adverse events(irAEs).ir...Immune checkpoint inhibitors have markedly improved outcomes in patients with multiple advanced malignancies.However,their widespread use has markedly increased the incidence of immune-related adverse events(irAEs).irAEs can affect a wide range of organ systems and are characterized by heterogeneous onset,broad toxicity spectra,and complex management requirements,thus ultimately impairing treatment continuation and patient quality of life.This review systematically summarizes the epidemiological features,clinical progression,and current management of irAEs.Existing guidelines largely focus on acute toxicities but have not provided structured strategies for chronic,delayed-onset,or multisystem irAEs.Moreover,clinical practice is hampered by incomplete multidisciplinary collaboration,insufficient training of oncologists,and fragmented treatment pathways,all of which limit the efficacy of irAE management.We propose incorporating irAE management into core oncology training and call for the establishment of comprehensive interdisciplinary frameworks to ensure the standardized long-term use of immunotherapy.展开更多
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.
基金supported by the National Key R&D program of China(No.2022YFC3703404)the National Natural Science Foundation of China(No.22188102)the Samsung Advanced Institute of Technology.
文摘Although air pollutant emissions have sharply reduced in recent years,the occurrence of PM_(2.5) pollution events remains an intractable environmental problem in Beijing,and regional transport is the key influence factor.However,it has been difficult to identify regional transport characteristics and the main contributors to pollution events in recent years.In this study,the relative contribution of regional transport was quantified(61.3%)in PM_(2.5) pollution events during 2018-2021 by the Community Multiscale Air Quality model embedded with the Integrated Source Apportionment Model(CMAQ-ISAM).The four regions with the largest fractional contributions to Beijing for all events were Shandong(7.7%),South Hebei(7.3%),Baoding(6.2%),and Langfang(5.8%).Pollution events were classified into the following types based on regional transport directions:local,southwest(SW),southeast(SE),south-mixed(SM),and others.Based on the transport distance,the SW,SE,and SM types can be subdivided into SW-short,SW-long,SE-short,SE-long,SM-short,SM-long distance from southwest,SM-long distance from southeast,and SM-long distance from southwest and southeast.SE-long was regarded as the most important type,with the highest relative frequency(20%).The transport directions were related to the southwest wind at 925 hPa and southeast wind at 1000 hPa in the south of the Beijing–Tianjin–Hebei(BTH)region,and the distance was mainly controlled by wind strength.The wind-field difference can be attributed to the low-pressure and high-pressure systems that control the BTH region.The results suggest that regional joint pollution control should be optimized based on the transport type.
基金Supported by Joint Funds for the Innovation of Science and Technology,Fujian Province,No.2023Y9187 and No.2021Y9057.
文摘BACKGROUND Minimally invasive esophagectomy(MIE)is a widely accepted treatment for esophageal cancer,yet it is associated with a significant risk of surgical adverse events(SAEs),which can compromise patient recovery and long-term survival.Accurate preoperative identification of high-risk patients is critical for improving outcomes.AIM To establish and validate a risk prediction and stratification model for the risk of SAEs in patients with MIE.METHODS This retrospective study included 747 patients who underwent MIE at two centers from January 2019 to February 2024.Patients were separated into a train set(n=549)and a validation set(n=198).After screening by least absolute shrinkage and selection operator regression,multivariate logistic regression analyzed clinical and intraoperative variables to identify independent risk factors for SAEs.A risk stratification model was constructed and validated to predict the probability of SAEs.RESULTS SAEs occurred in 10.2%of patients in train set and 13.6%in the validation set.Patients with SAE had significantly higher complication rate and a longer hospital stay after surgery.The key independent risk factors identified included chronic obstructive pulmonary disease,a history of alcohol consumption,low forced expiratory volume in the first second,and low albumin levels.The stratification model has excellent prediction accuracy,with an area under the curve of 0.889 for the training set and an area under the curve of 0.793 for the validation set.CONCLUSION The developed risk stratification model effectively predicts the risk of SAEs in patients undergoing MIE,facilitating targeted preoperative interventions and improving perioperative management.
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 National Natural Science Foundation of China (Grant Nos.42005029 and 41701103)the China Meteorological Administration Special Foundation for Innovation and Development (Grant No.CXFZ2024Q007)。
文摘In the summer of 2024, following a strong El Ni?o event in the preceding winter, the tropical Indian Ocean and tropical North Atlantic recorded their highest SSTs since 1961, along with a significant westward shift and intensification of the western Pacific subtropical high(WPSH). Under these conditions, China experienced its hottest summer since 1961,and was hit by a series of high-impact extreme weather and climate events. From 9 June to 2 July, southern China experienced an unprecedented extreme precipitation event that exceeded the well-known 1998 summer precipitation event in both duration and impact scope, resulting in devastating floods in the Yangtze River basin. Subsequently, in early to midJuly, the Huanghe-Huaihe Basin suffered from a severe drought–flood abrupt alternation event, heavily affecting Henan and Shandong. Meanwhile, southern China underwent a widespread heatwave event lasting 74 days, ranking as the second most intense since 1961. From late July to the end of August, northern China faced unusually frequent heavy precipitation events, with cumulative precipitation reaching the second highest for the same period since 1961, causing floods in many rivers of northern China. This study provides a timely summary and assessment of the characteristics and impacts of these extreme events. It serves as a reference for climate change research, including mechanism analysis, numerical simulation,and climate event attribution, and also offers valuable insights for improving meteorological disaster prevention and mitigation strategies.
文摘BACKGROUND Patients with type 2 diabetes mellitus(T2DM)face a heightened risk of future cardiovascular events.It is therefore important to stratify these patients according to their future cardiovascular event risk to allow early intervention and improve prognosis.Recent proposals have indicated that nontraditional lipoprotein ratios may be superior predictors of cardiovascular events compared to traditional lipid parameters.However,further evidence is required for widespread clinical ap-plication.AIM To elucidate the associations of nontraditional lipoprotein ratios with future cardiovascular events in patients with T2DM.METHODS This study performed post-hoc analysis of data obtained during a clinical trial involving 10182 participants.To ascertain the correlations between nontraditional lipoprotein ratios and future cardiovascular events,including major adverse cardiovascular events(MACEs)and congestive heart failure(CHF).We employed univariable and multivariable-adjusted Cox proportional hazards regression models.Potential dose-response relationships and threshold values were explored by conducting restricted cubic spline analyses and two-piecewise linear regression models.Possible relevant interactions influencing independent relationships were tested using subgroup and interaction analyses.RESULTS After adjustment for confounding factors,all nontraditional lipoprotein ratios studied were strongly associated with MACE risk in patients with T2DM.In comparison with patients in the lowest quartile,the hazard ratios(95%confidence intervals)of those in the highest quartile were 1.50(1.29-1.73),1.51(1.30-1.74),1.50(1.29-1.73),and 1.30(1.12-1.50)for total cholesterol/high-density lipoprotein cholesterol(HDL-C),low-density lipoprotein cholesterol/HDL-C,non-HDL-C/HDL-C,and remnant cholesterol/HDL-C,respectively.Similar findings were noted for CHF.Dose-response relationships between nontraditional lipoprotein ratios and MACE were observed,with threshold values of 7.29,6.29,and 2.15 for total cholesterol/HDL-C,non-HDL-C/HDL-C,and remnant cholesterol/HDL-C,respectively.However,no notable dose-response relationships were detected between nontraditional lipoprotein ratios and CHF.CONCLUSION Elevated nontraditional lipoprotein ratios may independently predict the risk of MACE and CHF in patients with T2DM.
基金Research Project of Yunnan Provincial Psychiatric Hospital(SJKY-2023-10).
文摘Objective:To investigate the differences in childhood trauma and life events between adolescents with depression and healthy controls,and to analyze the correlations between these factors and depressive symptoms.As such,we aim to provide theoretical foundations for early identification and intervention.Methods:This cross-sectional study enrolled 90 hospitalized adolescents with depression(case group)and 91 healthy adolescents(control group).Childhood Trauma Questionnaire(CTQ),Adolescent Self-Rating Life Events Checklist(ASLEC),and Children’s Depression Inventory(CDI)were administered to assess trauma history,life event stressors,and depressive symptoms.Statistical analyses included independent samples t-tests,chi-square tests,and Pearson correlation analysis.Results:The case group demonstrated a significantly higher proportion of only-child families(28.9%).ASLEC and CDI scores were significantly elevated in the case group compared to the control group(P<0.05).In comparison,CTQ scores were lower in the case group(P=0.025).Positive correlations were identified between CDI scores and both CTQ(r=0.261)and ASLEC(r=0.218)in the case group.Conclusion:Child-hood trauma and recent life event stressors demonstrate significant associations with adolescent depressive symp-toms,potentially mediated through emotional dysregulation and negative cognitive bias.Implementation of early trauma screening protocols combined with stress management interventions(e.g.,cognitive behavioral therapy)and family system optimization strategies may effectively mitigate depression risk in this population.
文摘BACKGROUND Intra-arterial chemotherapy(IAC)has become a first-line standard treatment for retinoblastoma(RB).However,studies describing its adverse events are sparse,especially from the developing world.Our study described the outcomes and adverse events from a single center in South India.AIM To describe the challenges,treatment outcomes,and complications of selective IAC for RB in Indian eyes.METHODS This study was a single center,retrospective study that included 17 patients with RB who underwent IAC using melphalan(5/7.5 mg)and topotecan(1/2 mg)(n=12)or melphalan(5 mg)alone(n=3)or triple therapy that included carboplatin(30 mg)along with these drugs(n=2)between January 2018 and December 2023.In all,17 IAC procedures were performed using selective ophthalmic artery cannulation.Treatment outcomes were evaluated in terms of tumor control,vitreous and subretinal seed control,complications,and globe salvage rates.RESULTS Out of the 17 patients,11 were diagnosed with unilateral RB and 6 were diag-nosed with bilateral RB.The mean age at the time of diagnosis was 19.8 months.The mean interval between the first symptom and presentation was 6.5 months.IAC was employed as the primary(n=9)or secondary(n=8)modality of treatment.Each eye received a mean of 1.5 IAC sessions(median:1 session;range:1-3 sessions).Eyes were classified according to the international classification of RB as group B(n=5),group C(n=1),group D(n=4),and group E(n=7).Following IAC,complete regression of the main tumor was seen in 15 eyes(88%)and partial regression in 2 eyes(12%).Globe salvage was achieved in 15 eyes(88%).Adverse effects included vitreous hemorrhage(n=3),rhegmatogenous retinal de-tachment(n=2),choroidal ischemia(n=1),isolated subretinal hemorrhage(n=2),retinal pigment epithelium degeneration(n=2),forehead pigmentation(n=1),third nerve palsy with complete ptosis(n=1),and 30-degree exotropia(n=1).The mean follow-up period was 28.6 months(median:24 months,range:1–72 months).CONCLUSION IAC is an effective way to control RB and globe preservation.In the Indian context we encountered many cha-llenges highlighting the importance of case selection.Further studies in India are required to thoroughly un-derstand IAC as a treatment for RB.
基金Humanities and Social Sciences Research Project of China’s Ministry of Education(23YJCZH242)Major Humanities and Social Sciences Research Projects in Zhejiang Higher Education Institutions(2024QN069)Hangzhou Collaborative Innovation Institute of Language Services,Hangzhou City University,China。
文摘This article centers on The Call of the Wild,an English novel by American author Jack London,alongside two Chinese translations by Dajie Liu and Menglin Zhang,and Rongyue Liu.Seventy sentences containing motion events and their corresponding translations were randomly selected for analysis.The study focuses on the primary elements of motion events-manner,path,and ground-and examines their Chinese translations through the lens of Skopos theory.Skopos theory emphasizes whether translators can adopt appropriate translation strategies according to various contextual factors during the translation process.Compared to verb-framed languages,satellite-framed languages possess a richer vocabulary for manner verbs,express more detailed manner information,use more satellite words to indicate paths,and incorporate more background information.Verb-framed languages,by contrast,typically express manner information only when necessary and tend to include less background information.The analysis reveals that both Chinese translations embody the core principle of Skopos theory:translation strategies are determined by their purpose.To fulfill the novel’s translation objectives,the translators adeptly adjust their strategies for motion event components based on different contextual needs.It is noted that the Chinese translations do not fully retain the characteristics of English as a typical satellite-framed language.This observation aligns with Skopos theory’s purpose-oriented approach,which prioritizes translation goals over strict adherence to source text characteristics.
文摘The southern part of East Siberia(SES)is highly vulnerable to flooding caused by the extreme precipitation events(EPEs)during summer.Building on previously detected EPEs in SES and Mongolia,we examined wave propagation patterns for two periods:1982-98 and 1999-2019.Our analysis revealed distinct wave train configurations and geopotential anomalies preceding EPEs,with an increase in wave activity flux across the Northern Hemisphere,followed by a subsequent decrease during EPEs.Consequently,Eastern Siberia has experienced a significant rise in wave activity.Based on geopotential anomalies over Central Siberia accompanying EPEs,we identified two main types.The first,the ridge type,is predominant during the first period and features a meridional contrast with a positive geopotential(and temperature)anomaly over Central Siberia and a negative anomaly over the subtropical regions along the same longitude.The second type,termed the trough type,is more typical for the second period.It involves either a negative geopotential anomaly or the zonal proximity of positive and negative geopotential anomalies over Central Siberia.The trough type,marked by zonally oriented anomalies in geopotential and temperature,results in a more pronounced temperature decrease before EPEs and significant zonal temperature contrasts.Further,it is related to more stationary waves over Northern Eurasia,with persistent positive geopotential anomalies over Europe linked to quasi-stationary troughs over Central Siberia and positive anomalies east of Lake Baikal.Our findings align with shifts in boreal summer teleconnection patterns,reflecting significant changes in wave propagation patterns that have occurred since the late 1990s.
基金supported by the DBT JRF-SRF research fellowship.KT was supported the J C Bose Fellowship from Science and Engineering Research Board(SERB),Department of Science and Technology,Government of India(JCB/2019/000027)CSIR Bhatnagar Fellowship,from Council of Scientific and Industrial Research(CSiR),Ministry of Science and Technology,Government of India.
文摘Founder events influence recessive diseases in highly endogamous populations.Several Indian populations have experienced significant founder events due to strict endogamy.However,the clinical implications of it remain underexplored.Therefore,we perform whole-exome sequencing of 281 individuals from four South Indian populations,characterized by high IBD scores.Our study reveals a high inbreeding rate of 59%across the populations.We identify∼29.2%of the variants that are exclusively present in a single population and uncover 1284 unreported exonic variants,underscoring the underrepresentation of Indian populations in global databases.Among these,23 are predicted to be deleterious,all of which are present in a heterozygous state;they may be pathogenic when homozygous,an expected phenomenon in endogamous populations.Approximately 16%-33%of the identified pathogenic variants showed significantly higher occurrence rates compared with the South Asian populations from 1000 Genomes dataset.Pharmacogenomic analysis revealed distinct allele frequencies of variants in CYP450 and non-CYP450 genes,highlighting heterogeneous drug responses and associated risks.We report a high prevalence of ankylosing spondylitis in Reddy population,linked to the HLA-B∗27:04 allele and strong founder effect.Our findings highlight the need for extensive genomic research in understudied Indian populations for a better understanding of disease risk and evolving strategies for precision and preventive medicine.
基金funded by the National Natural Science Foundation of China(41704031,42374040)the Natural Science Foundation of Jiangxi Science and Technology Department(20232BAB203073)the Key Laboratory of Mine Environmental Monitoring and Improving around Poyang Lake,Ministry of Natural Resources(MEMI-2021-2022-29).
文摘The March 11,2011,MW9.0 Tohoku-Oki earthquake,in Japan,caused rapid strain release near the epicenter,while the Boso Peninsula,located farther away,experienced stress redistribution,leading to changes in the recurrence interval of slow slip events(SSEs)and regional strain.This study focuses on three detected post-2011 Boso SSEs,utilizing a segmented model displacement time series measured by Global Navigation Satellite System(GNSS)to calculate velocity and strain rate fields for eight periods before,during,and after the SSEs.Results show that the 2011 earthquake and the three SSEs significantly alter the velocity field in the Boso region,with SSE velocities predominantly oriented southeast,reaching maximum values of 26.9 cm/a,10.6 cm/a,and 38.5 cm/adnearly opposite to non-SSE periods.After the third SSE,the velocity field nearly returns to its pre-earthquake state,with a maximum of 1.8 cm/a.The maximum shear strain rates during the three SSEs are 25.88×10^(-7) a^(-1),11.38×10^(-7) a^(-1),and 29.02×10^(-7) a^(-1)(i.e.,per annum),significantly higher than those during non-slow slip periods,with principal strain rates following a similar pattern.The spatial distribution of strain rates during the SSEs indicates greater deformation compared to the non-slip periods,dominated by northwest-southeast extension and southwest-northeast compression.Spatiotemporal analysis reveals a strong correlation between seismic frequency and strain rate during the SSEs,with time correlation coefficients of 0.85,0.88,and 0.9.Although larger accumulated strain results in stronger strain release during the latter two SSEs,not all strain is fully released,suggesting that earthquake swarms accompanying the SSEs may contribute to the partial release of unreleased strain.This study,through the analysis of GNSS data,evaluates the spatiotemporal distribution of strain fields during periodic SSEs,contributing to further research on strain accumulation and release,and aiding in the analysis of this regional seismic activity.
文摘This study sought to investigate adverse drug event(ADE)signals associated with eltrombopag use in pediatric patients aged 0–18 years,utilizing data from the U.S.Food and Drug Administration Adverse Event Reporting System(FAERS).By analyzing this extensive pharmacovigilance database,the study aimed to offer meaningful insights for improving the clinical safety of eltrombopag in children.Data covering eltrombopag-related ADEs from Q12004 to Q42023 were extracted from FAERS,and signal detection was conducted using both the reporting odds ratio(ROR)and proportional reporting ratio(PRR)methods.ADEs were categorized based on the System Organ Class(SOC)classification in MedDRA version 25.0.A total of 582 reports involving pediatric patients receiving eltrombopag were identified,encompassing 21 SOC categories.The analysis revealed that,in addition to the known ADEs listed in the drug label,clinicians should remain vigilant for potential off-label ADE signals.These included abnormal platelet counts,thrombocytosis,antiphospholipid syndrome,myelofibrosis,reduced serum iron levels,myelodysplastic syndrome,hepatic infections,and other related conditions.Given these findings,it is strongly recommended that serum iron and ferritin levels should be routinely monitored in pediatric patients undergoing eltrombopag therapy,particularly during long-term treatment.Such proactive surveillance may help prevent the onset of iron deficiency anemia and enhance overall treatment safety.
基金sponsored by Natural Science Foundation of Xinjiang Uygur Autonomous Region(2024D01A19).
文摘Research on mass gathering events is critical for ensuring public security and maintaining social order.However,most of the existing works focus on crowd behavior analysis areas such as anomaly detection and crowd counting,and there is a relative lack of research on mass gathering behaviors.We believe real-time detection and monitoring of mass gathering behaviors are essential formigrating potential security risks and emergencies.Therefore,it is imperative to develop a method capable of accurately identifying and localizing mass gatherings before disasters occur,enabling prompt and effective responses.To address this problem,we propose an innovative Event-Driven Attention Network(EDAN),which achieves image-text matching in the scenario of mass gathering events with good results for the first time.Traditional image-text retrieval methods based on global alignment are difficult to capture the local details within complex scenes,limiting retrieval accuracy.While local alignment-based methods aremore effective at extracting detailed features,they frequently process raw textual features directly,which often contain ambiguities and redundant information that can diminish retrieval efficiency and degrade model performance.To overcome these challenges,EDAN introduces an Event-Driven AttentionModule that adaptively focuses attention on image regions or textual words relevant to the event type.By calculating the semantic distance between event labels and textual content,this module effectively significantly reduces computational complexity and enhances retrieval efficiency.To validate the effectiveness of EDAN,we construct a dedicated multimodal dataset tailored for the analysis of mass gathering events,providing a reliable foundation for subsequent studies.We conduct comparative experiments with other methods on our dataset,the experimental results demonstrate the effectiveness of EDAN.In the image-to-text retrieval task,EDAN achieved the best performance on the R@5 metric,while in the text-to-image retrieval task,it showed superior results on both R@10 and R@5 metrics.Additionally,EDAN excelled in the overall Rsummetric,achieving the best performance.Finally,ablation studies further verified the effectiveness of event-driven attention module.
基金supported by the National Key Research and Development Program[grant number 2022YFC3004203]the S&T Development Fund of CAMS(Chinese Academy of Meteorological Sciences)[grant numbers 2023KJ040 and 2024KJ013].
文摘Subseasonal forecasting of extreme events is crucial for early warning systems.However,the forecast skills for extreme events are limited.Taking the extreme cold events in January 2018 as a specific example,and analyzing the 34 extreme cold events in East Asia from 1998 to 2020,the authors evaluated the forecast skills of the ECMWF model ensemble members on subseasonal time scales.The results show that while the ensemble mean has limited skills for forecasting extreme cold events at the 3-week lead time,some individual members demonstrate high forecast skills.For most extreme cold events,there are>10%of members among the total ensembles that can well predict the rapid temperature transitions at the 14-day lead time.This highlights the untapped potential of the ECMWF model to forecast extreme cold events on subseasonal time scales.High-skill ensemble members rely on accurate predictions of atmospheric circulation patterns(500-hPa geopotential height,mean sea level pressure)and key weather systems,including the Ural Blocking and Siberian High,that influence extreme cold events.
基金supported by the National Natural Science Foundation of China(Grant No.42371423)the Fundamental Research Funds for the Central Universities(Grant No.2042023kfyq04)+1 种基金the China Postdoctoral Science Foundation(Grant No.2023M742682)the Postdoctoral Fellowship Program of CPSF(Grant No.GZB20230539).
文摘In a warming world,climate extremes tend to be more frequent and intense.The exceptional response of ecosystems triggered by extreme climate events under a warmer and wetter climate in northwest China(NWC)has aroused growing concern.However,understanding the responses of vegetation to climate extremes from the compound events perspective remains challenging.In this study,we identify the climate dynamics in NWC during 1971–2020 based on daily meteorological observations,focusing on the changes in compound hot-dry events(CHDEs)during the warmer and wetter period.We further explore the effects of CHDEs on vegetation by examining vegetation anomalies and recovery time using daily gross primary productivity(GPP)data.The results show a clear warmer and wetter period in NWC during 2000–2020.No signs of a hiatus in CHDEs increase are observed during this period,and even the duration of CHDEs in western NWC keeps showing an increasing tendency.Vegetation in eastern NWC,with a lower probability of GPP anomalies,exhibits stronger resistance of ecosystems to CHDEs than in western NWC.In NWC,vegetation typically returns to its normal state in 5.50 days on average,but exhibits greater resilience in the western region,where it takes less recovery time(4.82 days).Vegetation in the central region shows the lowest probability of GPP anomalies and relatively longer recovery time,likely due to its higher altitudes.Our research underscores the imperative to address the considerable impacts of CHDEs on vegetation growth even as the regional climate becomes increasingly warmer and wetter.
文摘Background Coronary artery calcification(CAC),a hallmark of atherosclerosis,paradoxically associates with reduced cardiovascular risk under statin therapy despite accelerated calcification progression,prompting this study to explore CAC metrics as potential mediators between statin use and major adverse cardiovascular events(MACE).Methods Clinical data of 246 hospitalized patients who underwent coronary computed tomography angiography(CCTA)at Guangdong Provincial People's Hospital from January 2023 to June 2023 were retrospectively analyzed.Linear regression was used to evaluate the relationship between statin use and CAC parameters.Multivariable Poisson regression models were applied to explore the associations of statin use and CAC parameters with MACE risk.A mediation analysis was performed to assess the role of CAC parameters in the statin-MACE relationship.Results Statin use was independently associated with increased calcification score(β=0.648,P<0.001),CAC volume(β=0.623,P<0.001),and calcified plaque proportion(β=0.606,P=0.002).Multivariable Poisson regression indicated that statin use significantly reduced MACE risk[incidence rate ratio(IRR):0.33,P=0.018],whereas calcification score(IRR:2.63,P=0.026)and CACvolume(IRR:2.66,P=0.044)were associated with elevated MACE risk;Calcified plaque proportion showed no significant association.Mediation analysis revealed that calcification score(β=0.035,P=0.021)and CAC volume(β=0.023,P=0.018)exerted masking effects,while calcified plaque proportion had no mediating role.Conclusions Calcification score and CACvolume demonstrated limited masking effects in the association between statin use and MACE.
基金supported by grants from the Beijing Natural Science Foundation,Beijing Economic and Technological Development Zone Innovation Joint Fund(Grant no.L248072).
文摘Immune checkpoint inhibitors have markedly improved outcomes in patients with multiple advanced malignancies.However,their widespread use has markedly increased the incidence of immune-related adverse events(irAEs).irAEs can affect a wide range of organ systems and are characterized by heterogeneous onset,broad toxicity spectra,and complex management requirements,thus ultimately impairing treatment continuation and patient quality of life.This review systematically summarizes the epidemiological features,clinical progression,and current management of irAEs.Existing guidelines largely focus on acute toxicities but have not provided structured strategies for chronic,delayed-onset,or multisystem irAEs.Moreover,clinical practice is hampered by incomplete multidisciplinary collaboration,insufficient training of oncologists,and fragmented treatment pathways,all of which limit the efficacy of irAE management.We propose incorporating irAE management into core oncology training and call for the establishment of comprehensive interdisciplinary frameworks to ensure the standardized long-term use of immunotherapy.
