A CHARACTERISTIC OF RIEMANNIAN SPACES ADMITTING QUASI-CONCIRCULAR TRANSFORMATION

In this paper, we have considered some properties of quasi-umbilical hypersurfaces of a Riemannian space and obtained a characteristic of Riemannian spaces admitting quasi-concircular transformation.

Admitting Flaws

In the mid-1980’s researchers at Cleveland State University made a startling discovery. They conducted an experiment by creating two fictitious job candidates—David and John.Thecandidates had identical resumes and letters of reference.The only difference was that John’s letterincluded the sentence“Sometimes,John can be difficult to get along with.”They showed the re-

Association of acute glycemic parameters at admission with cardiovascular mortality in the oldest old with acute myocardial infarction

OBJECTIVES Stress-related glycemic indicators,including admission blood glucose(ABG),stress-hyperglycemia ratio(SHR),and glycemic gap(GG),have been associated with worse outcomes after acute myocardial infarction(AMI).However,data regarding their prognostic value in the oldest old with AMI are unavailable.Therefore,this study aimed to investigate the association of stress-related glycemic indicators with short-and long-term cardiovascular mortality(CVM)in the oldest old(≥80 years)with AMI.METHODS In this prospective study,a total of 933 consecutive old patients with AMI admitted to FuWai hospital(Beijing,China)were enrolled.On admission,ABG,SHR,and GG were assessed and all participants were classified according to their quartiles.Kaplan-Meier,restricted cubic splines(RCS),and multivariate Cox regression analyses were performed to evaluate the association between these glycemic indicators and CVM within 30 days and long-term follow-up.RESULTS During an average of 1954 patient-years of follow-up,a total of 250 cardiovascular deaths were recorded.Kaplan-Meier analyses showed the lowest CVM in quartile 1 of ABG and in quartile 2 of SHR and GG.After adjusting for potential covariates,patients in quartile 4 of ABG,SHR,and GG had a respective 1.67-fold(95%CI:1.03-2.69;P=0.036),1.80-fold(95%CI:1.16-2.79;P=0.009),and 1.78-fold(95%CI:1.14-2.79;P=0.011)higher risk of long-term CVM risk compared to those in the reference groups(quartile 1 of ABG and quartile 2 of SHR and GG).Furthermore,RCS suggested a J-shaped relationship of ABG and a Ushaped association of SHR and GG with long-term CVM.Additionally,we observed similar associations of these acute glycemic parameters with 30-day CVM.CONCLUSIONS Our data first indicated that SHR and GG consistently had a U-shaped association with both 30-day and longterm CVM among the oldest old with AMI,suggesting that they may be useful for risk stratification in this special population.

Aggressive fluid management may be associated with disease progression in suspected sepsis patients admitted to the intensive care unit: a retrospective cohort study

Sepsis is a lethal condition characterized by multiple organ dysfunction due to disrupted host responses to severe infections.[1]Aff ected patients often have a Sequential Organ Failure Assessment(SOFA)score≥2.[2]Patients with a SOFA score<2 and at least one of the following were considered as“suspected sepsis”:(1)quick SOFA(qSOFA)score≥2;(2)SOFA score=1;or(3)National Early Warning Score(NEWS)4-6.[3]Compared with studies on fluid resuscitation in sepsis patients,there are few studies on fluid management in patients with suspected sepsis.Therefore,we conducted a retrospective cohort study to evaluate the relationship between fluid management and disease progression in suspected sepsis patients.

A contradictory phenomenon of thicken pericardium and cardiac compression without inferior vena cava dilation:sign of IVC escape

A 77-year-old female presented with shortness of breath and tightness of chest was admitted.Her past medical history included hypertension and she has been taking nifedipine regularly.Two years before,she was diagnosed with pericardial effusion(Figure 1)and had pericardiocentesis drainage.On physical examination,her blood pressure was 151/100 mm-Hg and her pulse rate was 91 beats/min.

Subdiaphragmatic abscess caused by the recently identifi ed pathogen Cutibacterium modestum: a case report

Subdiaphragmatic abscess is uncommon in patients who undergo resection for hepatocellular carcinoma.The identifi cation of pathogens and appropriate treatment can be challenging.[1]Herein,we present a case of subdiaphragmatic abscess caused by Cutibacterium modestum.A 66-year-old man was admitted to our hospital with fever,cough,and persistent,dull pain in the right upper quadrant for two days.The patient’s medical history included liver cirrhosis,radical resection of hepatocellular carcinoma three months prior to admission,and type 2 diabetes mellitus.Physical examination revealed tachycardia with small moist rales in the right lower chest.Abdominal examination revealed an L-shaped,well-healed surgical incision in the right upper quadrant without intra-abdominal mass or tenderness.

Obituary:Prof.Yun Zhang(1963-2023)-A scientist focused on toxins and their underlying mechanisms to decipher human diseases

Prof.Yun Zhang was born on 9 July 1963 in Kunming,Yunnan,China,during a tumultuous period which he often referenced.Throughout his life,he harbored a steadfast belief in using knowledge to unravel the mysteries of human diseases.His educational journey was marked by frequent changes in schools due to his parents’occupational relocations.However,despite these challenges,he consistently displayed diligence and was admitted to the East China University of Science and Technology,Shanghai,after completing high school in 1980.He remained an active and loyal member of the School of Biotechnology at the university.

Association of prealbumin with short-term and long-term outcomes in patients with acute ST-segment elevation myocardial infarction

BACKGROUND Prealbumin is considered to be a useful indicator of nutritional status. Furthermore, it has been found to be associated with severities and prognosis of a range of diseases. However, limited data on the association of baseline prealbumin level with outcomes of patients with acute ST-segment elevation myocardial infarction(STEMI) are available.METHODS We analyzed 2313 patients admitted for acute STEMI between October 2013 and December 2020. In-hospital outcomes and mortality during the 49 months(interquartile range: 26–73 months) follow-up period were compared between patients with the low prealbumin level(< 170 mg/L) and those with the high prealbumin level(≥ 170 mg/L).RESULTS A total of 114 patients(4.9%) died during hospitalization. After propensity score matching, patients with the low prealbumin level than those with the high prealbumin level experienced higher incidences of heart failure with Killip class Ⅲ(9.9%vs. 4.4%, P = 0.034), cardiovascular death(8.4% vs. 3.4%, P = 0.035) and the composite of major adverse cardiovascular events(19.2%vs. 10.3%, P = 0.012). Multivariate logistic regression analysis identified that the low prealbumin level(< 170 mg/L) was an independent predictor of in-hospital major adverse cardiovascular events(odds ratio = 1.918, 95% CI: 1.250–2.942, P = 0.003). The cutoff value of prealbumin level for predicting in-hospital death was 170 mg/L(area under the curve = 0.703, 95% CI: 0.651–0.754, P< 0.001;sensitivity = 0.544, specificity = 0.794). However, after multivariate adjustment of possible confounders, baseline prealbumin level(170 mg/L) was no longer independently associated with 49-month cardiovascular death. After propensity score matching, Kaplan-Meier survival curves revealed consistent results.CONCLUSIONS Decreased prealbumin level closely related to unfavorable short-term outcomes. However, after multivariate adjustment and controlling for baseline differences, baseline prealbumin level was not independently associated with an increased risk of long-term cardiovascular mortality in STEMI patients.

Management of ruptured renal angiomyolipoma with bilateral staghorn calculi

Dear Editor,We present a case of ruptured renal angiomyolipoma(AML)and bilateral renal staghorn calculi.We discuss about the management of this patient by angioembolization,partial nephrectomy,and pyelolithotomy,followed by contralateral interval percutaneous nephrolithotomy(PCNL).Our case is a 40-year-old male who presented with history of dull aching and dragging sensation in bilateral flanks of 6-month duration.He was admitted and evaluated at other hospital for dizziness,sweating,and loss of consciousness.He was found to have bilateral staghorn calculi and left AML and was referred to our institute for further management after initial stabilization.The proper written and informed consent was taken from the patient for management as well as publication of the report and images,maintaining the patient’s anonymity.

Virtual reality-based cognitive-behavioural therapy for the treatment of anxiety in patients with acute myocardial infarction:a randomised clinical trial

Background The presence of mental health conditions is pervasive in patients who experienced acute myocardial infarction(AMI),significantly disrupting their recovery.Providing timely and easily accessible psychological interventions using virtual reality-based cognitive-behavioural therapy(VR-CBT)could potentially improve both acute and long-term symptoms affecting their mental health.Aims We aim to examine the effectiveness of VR-CBT on anxiety symptoms in patients with AMI who were admitted to the intensive care unit(ICU)during the acute stage of their illness.Methods In this single-blind randomised clinical trial,participants with anxiety symptoms who were admitted to the ICU due to AMI were continuously recruited from December 2022 to February 2023.Patients who were Han Chinese aged 18-75 years were randomly assigned(1:1)via block randomisation to either the VR-CBT group to receive VR-CBT in addition to standard mental health support,or the control group to receive standard mental health support only.VR-CBT consisted of four modules and was delivered at the bedside over a 1-week period.Assessments were done at baseline,immediately after treatment and at 3-month follow-up.The intention-to-treat analysis began in June 2023.The primary outcome measure was the changes in anxiety symptoms as assessed by the Hamilton Anxiety Rating Scale(HAM-A).Results Among 148 randomised participants,70 were assigned to the VR-CBT group and 78 to the control group.The 1-week VR-CBT intervention plus standard mental health support significantly reduced the anxiety symptoms compared with standard mental health support alone in terms of HAM-A scores at both post intervention(Cohen’s d=−1.27(95%confidence interval(CI):−1.64 to−0.90,p<0.001)and 3-month follow-up(Cohen’s d=−0.37(95%CI:−0.72 to−0.01,p=0.024).Of the 70 participants who received VR-CBT,62(88.6%)completed the entire intervention.Cybersickness was the main reported adverse event(n=5).Conclusions Our results indicate that VR-CBT can significantly reduce post-AMI anxiety at the acute stage of the illness;the improvement was maintained at the 3-month follow-up.Trial registration number The trial was registered at www.chictr.org.cn with the identifier:ChiCTR2200066435.

Two-year growth of Deep Underground Science and Engineering: A perspective

Deep Underground Science and Engineering(DUSE)launched its first issue in September 2022 as a quarterly journal.So far,it has published 106 articles with nine issues and online early view.The volume of received manuscripts increases by 50%each year and over 200 manuscripts were received by 28th of November 2024.In the early period,DUSE authorship came from five countries and now reaches 29 countries.DUSE articles have been downloaded over 97000 times by readers from 170 countries/regions.It is indeed encouraging to note that DUSE has been admitted to different indices,including ESCI(August 2024),EI(March 2024),Scopus(July 2023),and DOAJ(May 2023).Its CiteScore in Scopus was 2.2 in 2023 and increased to 5.1 at the mid-November 2024.Its first impact factor from the Web of Science will be available in 2025.DUSE is growing to be a rapidly recognized international journal by readers in deep underground research and practice.

Hong-Yang Wang:devoted to discovery—a female scientist who is willing to lead

1.Introducing Professor Wang ProfessorHong-YangWangwas admitted to the MedicalDepartment,Second Military Medical University,in 1973.After graduation,she worked as a physician for the Department of Gastroenterology,Changzheng Hospital,Shanghai,while earning herMaster's inGastrointestinal Immunology(awarded in 1984).As a chief physician,ProfessorWang was encouraged by academician Mengchao Wu to pursue a Ph.D.in clinical biochemistry at theMedical School of theUniversity of Ulm,Germany,in 1989.

How Can Foreign Trade Be Stabilized?

At an economy-themed press conference held on the day of the Second Session of the 14th National People's Congress,Minister of Commerce Wang Wentao admitted that the situation of foreign trade situation is still"very severe"this year.When it comes to the future policies for stabilizing foreign trade,Wang Wentao said that the government will provide better financial services forforeign trade enterprises.

Instruments of Change

Lucy Wahome stumbles and struggles to maintain her balance and walk as a nurse rushes to lend her support,soon after she got admitted at the clinic.Wahome,30,initially sought medical treatment at her home clinic in Kiambu County,Kenya,which seemed well organised;but she later realised that constant power outages at the facility seriously compromised the quality of care at the clinic.

I’ve Grown alongside the Growth in the Field of Animal Welfare in China

In December 2007,I was invited by the Chinese Academy of Sciences in Beijing to deliver a lecture on the results of my PhD,which I completed in 2006,regarding the welfare of dolphins under human care.The professor introduced me and admitted he did not know how to translate“animal welfare”(动物福利,dongwu fuli)into Chinese.

Two surgical pathways for isolated hip fractures:A comparative study

BACKGROUND Hip fractures(HF)are common among the aging population,and surgery within 48 h is recommended.Patients can be hospitalized for surgery through different pathways,either trauma or medicine admitting services.AIM To compare management and outcomes among patients admitted through the trauma pathway(TP)vs medical pathway(MP).METHODS This Institutional Review Board-approved retrospective study included 2094 patients with proximal femur fractures(AO/Orthopedic Trauma Association Type 31)who underwent surgery at a level 1 trauma center between 2016-2021.There were 69 patients admitted through the TP and 2025 admitted through the MP.To ensure comparability between groups,66 of the 2025 MP patients were propensity matched to 66 TP patients by age,sex,HF type,HF surgery,and American Society of Anesthesiology score.The statistical analyses included multivariable analysis,group characteristics,and bivariate correlation comparisons with theχ^(2)test and t-test.RESULTS After propensity matching,the mean age in both groups was 75-years-old,62%of both groups were females,the main HF type was intertrochanteric(TP 52%vs MP 62%),open reduction internal fixation was the most common surgery(TP 68%vs MP 71%),and the mean American Society of Anesthesiology score was 2.8 for TP and 2.7 for MP.The majority of patients in TP and MP(71%vs 74%)were geriatric(≥65-years-old).Falls were the main mechanism of injury in both groups(77%vs 97%,P=0.001).There were no significant differences in pre-surgery anticoagulation use(49%vs 41%),admission day of the week,or insurance status.The incidence of comorbidities was equal(94%for both)with cardiac comorbidities being dominant in both groups(71%vs 73%).The number of preoperative consultations was similar for TP and MP,with the most common consultation being cardiology in both(44%and 36%).HF displacement occurred more among TP patients(76%vs 39%,P=0.000).Time to surgery was not statistically different(23 h in both),but length of surgery was significantly longer for TP(59 min vs 41 min,P=0.000).Intensive care unit and hospital length of stay were not statistically different(5 d vs 8 d and 6 d for both).There were no statistical differences in discharge disposition and mortality(3%vs 0%).CONCLUSION There were no differences in outcomes of surgeries between admission through TP vs MP.The focus should be on the patient’s health condition and on prompt surgical intervention.

Clinical effectiveness of cognitive behavioural therapy on alcoholdependent patients:an observation with the WeChat platform

Background With the continuous improvement of people's material living standards,the consumption of alcoholic beverages is increasing.Alcohol dependence caused by alcohol addiction has become a widespread concern in society.As the brand-new medical and health model created by the modern biomedical technology revolution and the information technology revolution,mobile health has been used more and more widely in the field of medical health with the characteristics of convenience,rapidity and generalisability.With the general use of the social software WeChat,it is feasible to implement mobile health on the WeChat platform.Aim We aimed to explore the clinical effect of WeChat platform used in the cognitive behavioural therapy(CBT)on the maintenance period of alcohol dependence and addiction.Methods Seventy alcohol-dependent patients in the withdrawal maintenance stage admitted into our hospital were randomly divided into the CBT on WeChat platform group(the experiment group,n=35)and the general clinical treatment using sertraline group(the control group,n=35)with block randomisation grouping.They were evaluated with the Severity of Alcohol Dependence Questionnaire(SADQ-C)before the treatment,at the end of the fourth week,at the end of the eighth week and at the end of the twelfth week of treatment.In addition,Zung's Self-Rating Anxiety Scale(SAS)and Self-Rating Depression Scale(SDS)were employed to evaluate the degree of anxiety and depression of the two groups.Results The SADQ-C,SAS and SDS scores of the two groups after treatment decreased markedly compared with those before treatments,and the differences were statistically significant.Between-group comparison:the SADQ-C scores of the experiment group at the end of the fourth,eighth and twelfth weeks were lower than those of the control group,and the difference was statistically significant,which indicated that the score reduction in the experiment group was larger than that in the control group.The SAS and SDS scores of the experiment group at these time points were not significantly different from those of the control group,which indicated that these two treatment methods were comparable in treating patients1 anxiety and depression.Conclusion The CBT in tervention using WeChat may improve the subjectively reported severity of alcohol dependence of patients who had completed detoxification.It is conducive to prevention of relapse,and is convenient for patients.It is worthy of clinical application and further study.

Establishment of a diagnostic model of coronary heart disease in elderly patients with diabetes mellitus based on machine learning algorithms

OBJECTIVE To establish a prediction model of coronary heart disease(CHD)in elderly patients with diabetes mellitus(DM)based on machine learning(ML)algorithms.METHODS Based on the Medical Big Data Research Centre of Chinese PLA General Hospital in Beijing,China,we identified a cohort of elderly inpatients(≥60 years),including 10,533 patients with DM complicated with CHD and 12,634 patients with DM without CHD,from January 2008 to December 2017.We collected demographic characteristics and clinical data.After selecting the important features,we established five ML models,including extreme gradient boosting(XGBoost),random forest(RF),decision tree(DT),adaptive boosting(Adaboost)and logistic regression(LR).We compared the receiver operating characteristic curves,area under the curve(AUC)and other relevant parameters of different models and determined the optimal classification model.The model was then applied to 7447 elderly patients with DM admitted from January 2018 to December 2019 to further validate the performance of the model.RESULTS Fifteen features were selected and included in the ML model.The classification precision in the test set of the XGBoost,RF,DT,Adaboost and LR models was 0.778,0.789,0.753,0.750 and 0.689,respectively;and the AUCs of the subjects were 0.851,0.845,0.823,0.833 and 0.731,respectively.Applying the XGBoost model with optimal performance to a newly recruited dataset for validation,the diagnostic sensitivity,specificity,precision,and AUC were 0.792,0.808,0.748 and 0.880,respectively.CONCLUSIONS The XGBoost model established in the present study had certain predictive value for elderly patients with DM complicated with CHD.

Melanoma of the gallbladder misdiagnosed as gallbladder cancer

To the Editor:Metastatic melanoma of the gallbladder is extremely rare,and despite appropriate therapy its prognosis is poor withfew patients surviving more than 2 years. We present acase of gallbladder involvement by malignant melanomain a