Drought is a recurring dry condition with below-normal precipitation and is often associated with warm temperatures or heatwaves. A drought event can develop slowly over several weeks or suddenly within days, commonly...Drought is a recurring dry condition with below-normal precipitation and is often associated with warm temperatures or heatwaves. A drought event can develop slowly over several weeks or suddenly within days, commonly under abnormal atmospheric conditions(e.g., quasi-stationary high-pressure systems), and can persist for weeks, months, or even years.展开更多
The aim of the present work was to show the sustainability of fibrin sealant in releasing dexamethasone and adjust the protocol for clinical application of the novel method in the treatment of Meniere’s disease (MD) ...The aim of the present work was to show the sustainability of fibrin sealant in releasing dexamethasone and adjust the protocol for clinical application of the novel method in the treatment of Meniere’s disease (MD) and sudden sensorineural hearing loss (SSHL).Gelation occurred shortly after mixing dexamethasone-containing fibrinogen with thrombin.Dexamethasone was constantly released for at least 16 d at a stable level after 7d in protocol 1 (low-dose),while it was robustly released within 4 d and slowed afterward until 10 d in protocol 2(high-dose).There were significant differences among the time points in Protocol 2 (p<0.01,ANOVA),and the exponential model with the formula y=15.299*e~(-0.483*t) fits the association.The estimated concentration of dexamethasone released on 7 d in protocol 2 was slightly lower than that observed in protocol 1.The fibrin sealant is capable of constantly releasing dexamethasone with adjustable dynamics.Targeted and minimally invasive administration of the material can be achieved in the clinic by sequential injections of the fluids using a soft-tipped catheter.展开更多
Coronary artery anomaly is known as one of the causes of angina pectoris and sudden death and is an important clinical entity that cannot be overlooked.The incidence of coronary artery anomalies is as low as 1%-2%of t...Coronary artery anomaly is known as one of the causes of angina pectoris and sudden death and is an important clinical entity that cannot be overlooked.The incidence of coronary artery anomalies is as low as 1%-2%of the general population,even when the various types are combined.Coronary anomalies are practically challenging when the left and right coronary ostium are not found around their normal positions during coronary angiography with a catheter.If there is atherosclerotic stenosis of the coronary artery with an anomaly and percutaneous coronary intervention(PCI)is required,the suitability of the guiding catheter at the entrance and the adequate back up force of the guiding catheter are issues.The level of PCI risk itself should also be considered on a caseby-case basis.In this case,emission computed tomography in the R-1 subtype single coronary artery proved that ischemia occurred in an area where the coronary artery was not visible to the naked eye.Meticulous follow-up would be crucial,because sudden death may occur in single coronary arteries.To prevent atherosclerosis with full efforts is also important,as the authors indicated admirably.展开更多
Background: Sudden sensorineural hearing loss(SSNHL) is a prevalent emergency in ear, nose, and throat practice. Previous studies have demonstrated that intratympanic steroid therapy(IST) can serve as a salvage treatm...Background: Sudden sensorineural hearing loss(SSNHL) is a prevalent emergency in ear, nose, and throat practice. Previous studies have demonstrated that intratympanic steroid therapy(IST) can serve as a salvage treatment for SSNHL after the failure of systemic steroid therapy(SST).Objective: This study aimed to analyze the efficacy of modified IST involving the insertion of a tympanic tube and gelfoam as a salvage treatment for patients with SSNHL, and to explore its associated factors.Methods: Totally, 74 patients who were aged 22–81 years with SSNHL were enrolled and allocated to either the control group(n = 25) or the treatment group(n = 49) based on their treatment modalities. All patients received SST lasting for at least 7 days. Subsequently, patients in the treatment group, after SST failure, underwent IST twice a week for 2–6 weeks, while the control group did not. Efficacy was assessed by the improvement in pure tone average at the affected frequency at the beginning and end of IST.Results: Hearing improvement in all patients after IST in the treatment group was 9.71 ± 14.84 dB, with significant improvement at affected frequencies(250-8000 Hz) compared with the control group(P < 0.05). The findings indicated the duration from the onset of SSNHL to the beginning of IST as an independent factor for pure tone average improvement after treatment(P = 0.002), whereas age, duration of SST, and time of IST were not(P > 0.05).Conclusion: The modified IST was demonstrated to be a safe and effective method as a salvage treatment for SSNHL. This study explored the efficacy of a modified IST approach, incorporating the utilization of tympanic tubes and gelfoam as key components. The findings underscore the advantages of gelfoam as a strategic drug carrier placed in the round window niche. By minimizing drug loss, extending action time, and increasing perilymph concentration, gelfoam enhances the therapeutic impact of IST, contributing to improved hearing outcomes in patients with SSNHL.展开更多
Due to the significant changes they bring to high latitude stratospheric temperature and wind,stratospheric sudden warmings(SSWs)can have an impact on the propagation and energy distribution of gravity waves(GWs).The ...Due to the significant changes they bring to high latitude stratospheric temperature and wind,stratospheric sudden warmings(SSWs)can have an impact on the propagation and energy distribution of gravity waves(GWs).The variation characteristics of GWs during SSWs have always been an important issue.Using temperature data from January to March in 2014−2016,provided by the Constellation Observing System for Meteorology,Ionosphere and Climate(COSMIC)mission,we have analyzed global GW activity at 15−40 km in the Northern Hemisphere during SSW events.During the SSWs that we studied,the stratospheric temperature rose in one or two longitudinal regions in the Northern Hemisphere;the areas affected extended to the east of 90°W.During these SSWs,the potential energy density(E_(p)of GWs expanded and covered a larger range of longitude and altitude,exhibiting an eastward and downward extension.The E_(p)usually increased,while partially filtered by the eastward zonal winds.When zonal winds weakened or turned westward,E_(p)began to strengthen.After SSWs,the E_(p)usually decreased.These observations can serve as a reference for analyzing the interaction mechanism between SSWs and GWs in future work.展开更多
BACKGROUND Sudden sensorineural hearing loss(SSNHL),characterized by a rapid and unexplained loss of hearing,particularly at moderate to high frequencies,presents a significant clinical challenge.The therapeutic use o...BACKGROUND Sudden sensorineural hearing loss(SSNHL),characterized by a rapid and unexplained loss of hearing,particularly at moderate to high frequencies,presents a significant clinical challenge.The therapeutic use of methylprednisolone sodium succinate(MPSS)via different administration routes,in combination with conventional medications,remains a topic of interest.AIM To compare the therapeutic efficacy of MPSS administered via different routes in combination with conventional drugs for the treatment of mid-to high-frequency SSNHL.METHODS The medical records of 109 patients with mid-to high-frequency SSNHL were analyzed.The patients were divided into three groups based on the route of administration:Group A[intratympanic(IT)injection of MPSS combined with mecobalamin and Ginkgo biloba leaf extract injection],Group B(intravenous injection of MPSS combined with mecobalamin and Ginkgo biloba leaf extract injection),and Group C(single IT injection of MPSS).The intervention effects were compared and analyzed.RESULTS The posttreatment auditory thresholds in Group A(21.23±3.34)were significantly lower than those in Groups B(28.52±3.36)and C(30.23±4.21;P<0.05).Group A also exhibited a significantly greater speech recognition rate(92.23±5.34)than Groups B and C.The disappearance time of tinnitus,time to hearing recovery,and disappearance time of vertigo in Group A were significantly shorter than those in Groups B and C(P<0.05).The total effective rate in Group A(97.56%)was significantly greater than that in Groups B and C(77.14%and 78.79%,χ^(2)=7.898,P=0.019).Moreover,the incidence of adverse reactions in Groups A and C was significantly lower than that in Group B(4.88%,3.03%vs 2.57%,χ^(2)=11.443,P=0.003),and the recurrence rate in Group A was significantly lower than that in Groups B and C(2.44%vs 20.00%vs 21.21%,χ^(2)=7.120,P=0.028).CONCLUSION IT injection of MPSS combined with conventional treatment demonstrates superior efficacy and safety compared to systemic administration via intravenous infusion and a single IT injection of MPSS.This approach effectively improves patients'hearing and reduces the risk of disease recurrence.展开更多
Super Typhoon Hinnamnor(2022)was a rare and unique western North Pacific typhoon,and throughout its lifespan,it exhibited all of the major features that pose current challenges in typhoon research.Specifically,during ...Super Typhoon Hinnamnor(2022)was a rare and unique western North Pacific typhoon,and throughout its lifespan,it exhibited all of the major features that pose current challenges in typhoon research.Specifically,during different stages of its lifespan,it experienced a sudden change of track,underwent rapid intensification,interacted and merged with another vortex,expanded in size,underwent rapid weakening,produced a strong cold wake,exhibited eyewall replacement,and underwent extratropical transition.Therefore,a timely identification and review of these features of Hinnamnor(2022),as reported in this article,will help update and enrich the case sets for each of these scientific issues and provide a background for more in-depth mechanistic studies of typhoon track,intensity,and structural changes in the future.We also believe that Hinnamnor(2022)can serve as an excellent benchmark to quickly evaluate the overall performance of different numerical models in predicting typhoon’s track,intensity,and structural changes.展开更多
Interventional electrophysiology represents a relatively recent subspecialty within the field of cardiology.In the past half-century,there has been significant advan-cement in the development and implementation of inn...Interventional electrophysiology represents a relatively recent subspecialty within the field of cardiology.In the past half-century,there has been significant advan-cement in the development and implementation of innovative ablation treatments and approaches.However,the treatment of arrhythmias continues to be inade-quate.Several arrhythmias,such as ventricular tachycardia and atrial fibrillation,pose significant challenges in terms of therapeutic efficacy,whether through interventional procedures or the administration of antiarrhythmic drugs.Cardio-logists are engaged in ongoing research to explore innovative methodologies,such as genome editing,with the purpose of effectively managing arrhythmias and meeting the growing needs of patients afflicted with rhythm disturbances.The field of genome editing has significant promise and has the potential to serve as a highly effective personalized therapy for rhythm disorders in patients.However,several ethical issues must be considered.展开更多
The existing Maximum Power Point Tracking(MPPT)method has low tracking efficiency and poor stability.It is easy to fall into the Local Maximum Power Point(LMPP)in Partial Shading Condition(PSC),resulting in the degrad...The existing Maximum Power Point Tracking(MPPT)method has low tracking efficiency and poor stability.It is easy to fall into the Local Maximum Power Point(LMPP)in Partial Shading Condition(PSC),resulting in the degradation of output power quality and efficiency.It was found that various bio-inspired MPPT based optimization algorithms employ different mechanisms,and their performance in tracking the Global Maximum Power Point(GMPP)varies.Thus,a Cuckoo search algorithm(CSA)combined with the Incremental conductance Algorithm(INC)is proposed(CSA-INC)is put forward for the MPPT method of photovoltaic power generation.The method can improve the tracking speed by more than 52%compared with the traditional Cuckoo Search Algorithm(CSA),and the results of the study using this algorithm are compared with the popular Particle Swarm Optimization(PSO)and the Gravitational Search Algorithm(GSA).CSA-INC has an average tracking efficiency of 99.99%and an average tracking time of 0.19 s when tracking the GMPP,which improves PV power generation’s efficiency and power quality.展开更多
Locked segments are recognized as a critical role that controls the stability of rock slopes but remain an unclear and challenging problem with respect to their role incorporated into the failure mechanism.In order to...Locked segments are recognized as a critical role that controls the stability of rock slopes but remain an unclear and challenging problem with respect to their role incorporated into the failure mechanism.In order to study the effect of the locked segments on the initial failure process of rockslides,thirty-six groups of locked segment specimens with three different lithologies were prepared,direct shear tests were carried out to obtain the accelerations caused by brittle failure of the locked segment specimens.Experiment results showed that the maximum accelerations caused by the brittle failure of locked segment specimens was 2.91 g in the horizontal direction,and 3.18 g in the vertical direction.We took the Wangjiayan rockslide in 2008 Wenchuan earthquake as an example,the critical balance condition of the sliding mass under combined effect of gravity and accelerations induced by brittle failure of locked segment was analyzed,which indicated that the initial failure process of the Wangjiayan rockslides was notably influenced by the existence of the locked segment.The departure acceleration and direction of the Wangjiayan rockslide were proposed.The study results can provide a new insight into the understanding of the initial failure mechanism of rockslides with locked segments.展开更多
Objective:Sudden cardiac death(SCD)and malignant ventricular arrhythmia(VA)are increasingly recognized as important issues for people living with a Fontan circulation,but data are lacking.We sought to characterize the...Objective:Sudden cardiac death(SCD)and malignant ventricular arrhythmia(VA)are increasingly recognized as important issues for people living with a Fontan circulation,but data are lacking.We sought to characterize the cohort who had sudden cardiac death,most likely related to VA and/or documented VA in the Australia and New Zealand Fontan Registry including risk factors and clinical outcomes.Methods:A retrospective cohort study was performed.Inclusion criteria were documented non-sustained ventricular tachycardia,sustained ventricular tachycardia,ventricular fibrillation,resuscitated cardiac arrest or SCD>30 days post-Fontan completion.Results:Of 1611 patients,20(1.2%)had VA;14(1.0%)had VA without SCD and 6(<1%)had SCD(6%of all deaths recorded in Registry;5 of those had documented VA at the time of arrest and 1 was presumed to be VA-associated).The median age at first VA was 20.5(14–32)years,10(50%)were females,and the median age at Fontan operation was 8(4–17)years.On univariable analysis,hypoplastic left heart syndrome(p=0.03)and older age Fontan operation(p<0.001)were associated with VA.Earlier Fontan era(p<0.003),atriopulmonary Fontan(p<0.001),pre-Fontan atrioventricular valve repair(p=0.013)pre-or post-Fontan atrial arrhythmia(p=0.010)were associated with SCD.Patients with VA had a 3 times higher risk of death or heart transplant(HR 3.27(1.19,8.98),p=0.02).Conclusions:A proportion of people living with a Fontan circulation have malignant VA.Routine VA screening in this cohort is essential.More data are needed to aid risk stratification.展开更多
Objective:To investigate the potential influence of anatomical variation in the anterior inferior cerebellar artery(AICA)on the occurrence and severity of idiopathic sudden sensorineural hearing loss(ISSNHL).Methods:N...Objective:To investigate the potential influence of anatomical variation in the anterior inferior cerebellar artery(AICA)on the occurrence and severity of idiopathic sudden sensorineural hearing loss(ISSNHL).Methods:Ninety ISSNHL patients were enrolled.The anatomical location of the AICA was exhibited using high-resolution magnetic resonance imaging(MRI),and the various AICA types classified by previously reported Chavda and Gorrie methods were analyzed.The severity of hearing loss in the ipsilateral ear among different AICA types was compared.Results:Approximately 85.6%of subjects had unilateral ISSNHL(uISSNHL),and the others had bilateral ISSNHL(bISSNHL).In the uISSNHL group,the ratios of different AICA types were similar between the ipsilateral and contralateral ears.The ratios of the different AICA types in the bISSNHL group were similar to those in the uISSNHL group.In the uISSNHL group,pure tone audiometry(PTA)thresholds at 2 kHz,4 kHz and 8 kHz of patients with Chavda type II AICA were higher than those of patients with Chavda type I and type III,with a significant difference at 4 kHz between type I and type II.There was a tendency of the PTA threshold in patients with Chavda type II or Gorrie type C to gradually increase from low to high frequency zones.Conclusion:When the AICA enters the IAC(Chavda type II)or crosses between the 7th and 8th cranial nerves(Gorrie type C),the severity and frequency of hearing impairment in ISSNHL but not the occurrence of ISSNHL will be affected.展开更多
Background:Despite its widespread therapeutic use and effectiveness,the underlying pharmacologic mechanisms of Wendan decoction(WDD)and how it works to treat sudden deafness(SD)remain unclear.In this study,the pharmac...Background:Despite its widespread therapeutic use and effectiveness,the underlying pharmacologic mechanisms of Wendan decoction(WDD)and how it works to treat sudden deafness(SD)remain unclear.In this study,the pharmacological mechanisms of WDD underlying SD were analyzed using network pharmacology and molecular docking.Methods:The Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform(TCMSP)was employed to identify the active compounds and target genes of WDD,and genes associated with SD were screened on five databases.RGUI conducted Gene Ontology(GO)functional and the Kyoto Encyclopedia of Genes and Genomes(KEGG)enrichment analyses.A compound-target network was established using Cytoscape,and the STRING database created a protein-protein interaction(PPI)network to identify the key compounds and targets.Subsequently,a network of crucial compound-target was generated for further molecular docking analysis.For molecular docking simulations of the macromolecular target proteins and their matching ligand molecules,AutoDock Vina and AutoDockTool were utilized.Results:TCMSP identified 162 active target genes and 36 active compounds for WDD.The active target genes were compared with the 2271 genes associated with SD to identify 70 intersecting active target genes linked to 34 active compounds.The GO functional enrichment and KEGG pathway enrichment analyses were undertaken,and compound–target,and PPI networks were built.The key compounds and protein targets were identified and integrated to form a key compound–target network.Eventually,molecular docking was performed to investigate the interactions of the protein targets with their respective compounds.Conclusion:This study highlights the mechanisms of multi-compounds,targets,and pathways of WDD acting on SD and provides further evidence of crucial compounds and their matching target proteins of WDD acting on SD.展开更多
BACKGROUND Sudden death is unanticipated,non-violent death taking place within the first 24 h after the onset of symptoms.It is a major public health problem worldwide.Moreover,the effects of living at moderate altitu...BACKGROUND Sudden death is unanticipated,non-violent death taking place within the first 24 h after the onset of symptoms.It is a major public health problem worldwide.Moreover,the effects of living at moderate altitude on mortality are poorly understood.AIM To retrospectively report the frequency and the main causes of sudden deaths in relation to total deaths at Asir Central Hospital,2255 m above sea level,in the southern region of Saudi Arabia over a period of 4 years from 2013 to 2016.METHODS The medical records of 1821 deaths were examined and showed 353 cases(19.4%)of sudden death.RESULTS The highest incidence of sudden death was among the elderly(51%),whereas,the lowest was among children and adolescents(6.5%).With regard to gender,the incidence of sudden death was higher in males(54.4%)compared to 45.6% in females.In this study,we found that the most common direct causes of sudden death were cardiovascular diseases(29.2%),respiratory disease(22.7%),infectious disease(12.2%),cancer(9.4%)and hematological diseases(6.2%).With respect to seasonal variation,the highest incidence was during winter(31.32%)followed by summer(25.8%).CONCLUSION The results of this study will help emergency physicians and health care providers to exercise due care to reduce the incidence of sudden death and raise public awareness about the impact of sudden death.展开更多
BACKGROUND Edaravone is a widely used treatment for patients with cerebral infarction and,in most cases,edaravone-induced side effects are mild.However,edaravone-related adverse reactions have been receiving increasin...BACKGROUND Edaravone is a widely used treatment for patients with cerebral infarction and,in most cases,edaravone-induced side effects are mild.However,edaravone-related adverse reactions have been receiving increasing attention.CASE SUMMARY We treated three patients with acute cerebral infarction who died following treatment with edaravone.Edaravone is a widely used treatment for patients with cerebral infarction and,in most cases,edaravone-induced side effects are mild.However,edaravone-related adverse reactions have been receiving increasing attention.CONCLUSION Our cases highlight the importance of educating clinicians regarding the new edaravone-induced clinical syndromes of cerebral infarction as potentially fatal adverse drug reactions.Considering that no laboratory or confirmatory test exists to diagnose edaravone-induced death from cerebral infarction,clinicians’knowledge is the key element in recognizing this phenomenon.展开更多
The US-led Western countries have imposed financial sanctions against Russia after the Russia-Ukraine crisis broke out in 2022.Since last year,the“weaponization of global public goods”suddenly appeared regularly in ...The US-led Western countries have imposed financial sanctions against Russia after the Russia-Ukraine crisis broke out in 2022.Since last year,the“weaponization of global public goods”suddenly appeared regularly in academic studies and media reports worldwide.The financial sanctions led by the US had a long history before the Ukraine crisis.For example,the United States has imposed various sanctions against Iraq,the Democratic People’s Republic of Korea(DPRK),Iran and Russia for some time.Scant academic studies and media reports discussed the weaponization of global public goods before,and the reasons were that the scale of earlier financial sanctions was limited,and the influence of the sanctioned countries was also limited.Those sanctions did not directly threaten global public goods,so researchers have not lifted these issues to the level of weaponization of global public goods.展开更多
Background: Cardiopulmonary resuscitation (CPR) is a life-saving skill that is often overlooked until a tragic event occurs. A popular NFL player, Damar Hamlin, safety for the Buffalo Bills, suffered a cardiac arrest ...Background: Cardiopulmonary resuscitation (CPR) is a life-saving skill that is often overlooked until a tragic event occurs. A popular NFL player, Damar Hamlin, safety for the Buffalo Bills, suffered a cardiac arrest on January 2, 2023. Due to prompt intervention and CPR, Hamlin survived the arrest and is playing again. This research sought to understand how people respond to this event on the internet. It also seeks to understand how this response can be used to raise CPR awareness. Design and Methods: Using Google Trends and Twitter data, we searched, downloaded, and retrospectively analyzed search interests relative to Hamlin’s cardiac arrest for a one-year duration. We searched for related keywords in the United States from March 2022 to March 2023, including “Damar Hamlin”, “sudden cardiac death”, “heart attack”, and “CPR”. Results: There was a significant rise in post-event Google searches that combined the terms “Damar Hamlin” and “SCD” (M = -28898.88, SE = 1537.66;t = 1.62, p Conclusion: Based on the analytics of these platforms, it can be concluded that there were active discussions and an awareness of life-saving skills such as CPR along with Hamlin’s cardiac event by his fans, as demonstrated by the data gathered from these platforms. This can provide us with valuable insight into human behavior and help us leverage this knowledge to promote health.展开更多
Introduction: Hypertrophic cardiomyopathy (HCM) belongs to the very heterogeneous group of cardiomyopathies. This study aimed to study myocardial perfusion abnormalities on scintigraphy and assess the risk of sudden d...Introduction: Hypertrophic cardiomyopathy (HCM) belongs to the very heterogeneous group of cardiomyopathies. This study aimed to study myocardial perfusion abnormalities on scintigraphy and assess the risk of sudden death from ventricular arrhythmia in hereditary sarcomeric HCM. Patients and Methods: This is a retrospective and prospective descriptive study over 18 months (January 01, 2021, to July 31, 2022) on the records of patients over 18 with the diagnosis of hypertrophic sarcomeric cardiomyopathy with or without ventricular rhythm disorders and who have undergone myocardial scintigraphy. Results: Three patients were included. The average age of our patients was 66 years old. Dyspnea is the primary symptomatology found in our patients. One patient presented with syncope and unsustained ventricular tachycardia. His risk score for sudden death from ESC at five years is estimated at 6.45%, and the patient received an ICD in primary prevention. The average sudden death risk score of our patients was 3.78%. The mean LV wall thickness was 20 mm. The mean maximum left intraventricular gradient was 39 mmHg. Myocardial fibrosis was present in all our patients. Myocardial scintigraphy was normal in all cases. Conclusion: Hypertrophic cardiomyopathy is a very heterogeneous group of cardiomyopathies. The rhythmic risk is multifactorial and constitutes a significant prognostic factor.展开更多
文摘Drought is a recurring dry condition with below-normal precipitation and is often associated with warm temperatures or heatwaves. A drought event can develop slowly over several weeks or suddenly within days, commonly under abnormal atmospheric conditions(e.g., quasi-stationary high-pressure systems), and can persist for weeks, months, or even years.
基金supported by the National Natural Science Foundation of China(81771006)。
文摘The aim of the present work was to show the sustainability of fibrin sealant in releasing dexamethasone and adjust the protocol for clinical application of the novel method in the treatment of Meniere’s disease (MD) and sudden sensorineural hearing loss (SSHL).Gelation occurred shortly after mixing dexamethasone-containing fibrinogen with thrombin.Dexamethasone was constantly released for at least 16 d at a stable level after 7d in protocol 1 (low-dose),while it was robustly released within 4 d and slowed afterward until 10 d in protocol 2(high-dose).There were significant differences among the time points in Protocol 2 (p<0.01,ANOVA),and the exponential model with the formula y=15.299*e~(-0.483*t) fits the association.The estimated concentration of dexamethasone released on 7 d in protocol 2 was slightly lower than that observed in protocol 1.The fibrin sealant is capable of constantly releasing dexamethasone with adjustable dynamics.Targeted and minimally invasive administration of the material can be achieved in the clinic by sequential injections of the fluids using a soft-tipped catheter.
文摘Coronary artery anomaly is known as one of the causes of angina pectoris and sudden death and is an important clinical entity that cannot be overlooked.The incidence of coronary artery anomalies is as low as 1%-2%of the general population,even when the various types are combined.Coronary anomalies are practically challenging when the left and right coronary ostium are not found around their normal positions during coronary angiography with a catheter.If there is atherosclerotic stenosis of the coronary artery with an anomaly and percutaneous coronary intervention(PCI)is required,the suitability of the guiding catheter at the entrance and the adequate back up force of the guiding catheter are issues.The level of PCI risk itself should also be considered on a caseby-case basis.In this case,emission computed tomography in the R-1 subtype single coronary artery proved that ischemia occurred in an area where the coronary artery was not visible to the naked eye.Meticulous follow-up would be crucial,because sudden death may occur in single coronary arteries.To prevent atherosclerosis with full efforts is also important,as the authors indicated admirably.
文摘Background: Sudden sensorineural hearing loss(SSNHL) is a prevalent emergency in ear, nose, and throat practice. Previous studies have demonstrated that intratympanic steroid therapy(IST) can serve as a salvage treatment for SSNHL after the failure of systemic steroid therapy(SST).Objective: This study aimed to analyze the efficacy of modified IST involving the insertion of a tympanic tube and gelfoam as a salvage treatment for patients with SSNHL, and to explore its associated factors.Methods: Totally, 74 patients who were aged 22–81 years with SSNHL were enrolled and allocated to either the control group(n = 25) or the treatment group(n = 49) based on their treatment modalities. All patients received SST lasting for at least 7 days. Subsequently, patients in the treatment group, after SST failure, underwent IST twice a week for 2–6 weeks, while the control group did not. Efficacy was assessed by the improvement in pure tone average at the affected frequency at the beginning and end of IST.Results: Hearing improvement in all patients after IST in the treatment group was 9.71 ± 14.84 dB, with significant improvement at affected frequencies(250-8000 Hz) compared with the control group(P < 0.05). The findings indicated the duration from the onset of SSNHL to the beginning of IST as an independent factor for pure tone average improvement after treatment(P = 0.002), whereas age, duration of SST, and time of IST were not(P > 0.05).Conclusion: The modified IST was demonstrated to be a safe and effective method as a salvage treatment for SSNHL. This study explored the efficacy of a modified IST approach, incorporating the utilization of tympanic tubes and gelfoam as key components. The findings underscore the advantages of gelfoam as a strategic drug carrier placed in the round window niche. By minimizing drug loss, extending action time, and increasing perilymph concentration, gelfoam enhances the therapeutic impact of IST, contributing to improved hearing outcomes in patients with SSNHL.
基金the National Science Foundation of Hunan Province,China(Grant No.2022JJ40471)the Research Foundation of the Education Bureau of Hunan Province,China(Grant No.22B0345)the Key Laboratory of Geospace Envi-ronment,Chinese Academy of Sciences,University of Science&Technology of China(Grant No.GE2023-01).
文摘Due to the significant changes they bring to high latitude stratospheric temperature and wind,stratospheric sudden warmings(SSWs)can have an impact on the propagation and energy distribution of gravity waves(GWs).The variation characteristics of GWs during SSWs have always been an important issue.Using temperature data from January to March in 2014−2016,provided by the Constellation Observing System for Meteorology,Ionosphere and Climate(COSMIC)mission,we have analyzed global GW activity at 15−40 km in the Northern Hemisphere during SSW events.During the SSWs that we studied,the stratospheric temperature rose in one or two longitudinal regions in the Northern Hemisphere;the areas affected extended to the east of 90°W.During these SSWs,the potential energy density(E_(p)of GWs expanded and covered a larger range of longitude and altitude,exhibiting an eastward and downward extension.The E_(p)usually increased,while partially filtered by the eastward zonal winds.When zonal winds weakened or turned westward,E_(p)began to strengthen.After SSWs,the E_(p)usually decreased.These observations can serve as a reference for analyzing the interaction mechanism between SSWs and GWs in future work.
文摘BACKGROUND Sudden sensorineural hearing loss(SSNHL),characterized by a rapid and unexplained loss of hearing,particularly at moderate to high frequencies,presents a significant clinical challenge.The therapeutic use of methylprednisolone sodium succinate(MPSS)via different administration routes,in combination with conventional medications,remains a topic of interest.AIM To compare the therapeutic efficacy of MPSS administered via different routes in combination with conventional drugs for the treatment of mid-to high-frequency SSNHL.METHODS The medical records of 109 patients with mid-to high-frequency SSNHL were analyzed.The patients were divided into three groups based on the route of administration:Group A[intratympanic(IT)injection of MPSS combined with mecobalamin and Ginkgo biloba leaf extract injection],Group B(intravenous injection of MPSS combined with mecobalamin and Ginkgo biloba leaf extract injection),and Group C(single IT injection of MPSS).The intervention effects were compared and analyzed.RESULTS The posttreatment auditory thresholds in Group A(21.23±3.34)were significantly lower than those in Groups B(28.52±3.36)and C(30.23±4.21;P<0.05).Group A also exhibited a significantly greater speech recognition rate(92.23±5.34)than Groups B and C.The disappearance time of tinnitus,time to hearing recovery,and disappearance time of vertigo in Group A were significantly shorter than those in Groups B and C(P<0.05).The total effective rate in Group A(97.56%)was significantly greater than that in Groups B and C(77.14%and 78.79%,χ^(2)=7.898,P=0.019).Moreover,the incidence of adverse reactions in Groups A and C was significantly lower than that in Group B(4.88%,3.03%vs 2.57%,χ^(2)=11.443,P=0.003),and the recurrence rate in Group A was significantly lower than that in Groups B and C(2.44%vs 20.00%vs 21.21%,χ^(2)=7.120,P=0.028).CONCLUSION IT injection of MPSS combined with conventional treatment demonstrates superior efficacy and safety compared to systemic administration via intravenous infusion and a single IT injection of MPSS.This approach effectively improves patients'hearing and reduces the risk of disease recurrence.
基金supported in part by the National Science Foundation of China (Grant Nos. 42192554, 41876011, 61827901, and 41775065)the National Key Research and Development Program of China (Grant Nos. 2020YFE0201900 and 2022YFC3004200)+2 种基金Shanghai Typhoon Research Foundation (TFJJ202201)S&T Development Fund of CAMS 2022KJ012Basic Research Fund of CAMS 2022Y006
文摘Super Typhoon Hinnamnor(2022)was a rare and unique western North Pacific typhoon,and throughout its lifespan,it exhibited all of the major features that pose current challenges in typhoon research.Specifically,during different stages of its lifespan,it experienced a sudden change of track,underwent rapid intensification,interacted and merged with another vortex,expanded in size,underwent rapid weakening,produced a strong cold wake,exhibited eyewall replacement,and underwent extratropical transition.Therefore,a timely identification and review of these features of Hinnamnor(2022),as reported in this article,will help update and enrich the case sets for each of these scientific issues and provide a background for more in-depth mechanistic studies of typhoon track,intensity,and structural changes in the future.We also believe that Hinnamnor(2022)can serve as an excellent benchmark to quickly evaluate the overall performance of different numerical models in predicting typhoon’s track,intensity,and structural changes.
文摘Interventional electrophysiology represents a relatively recent subspecialty within the field of cardiology.In the past half-century,there has been significant advan-cement in the development and implementation of innovative ablation treatments and approaches.However,the treatment of arrhythmias continues to be inade-quate.Several arrhythmias,such as ventricular tachycardia and atrial fibrillation,pose significant challenges in terms of therapeutic efficacy,whether through interventional procedures or the administration of antiarrhythmic drugs.Cardio-logists are engaged in ongoing research to explore innovative methodologies,such as genome editing,with the purpose of effectively managing arrhythmias and meeting the growing needs of patients afflicted with rhythm disturbances.The field of genome editing has significant promise and has the potential to serve as a highly effective personalized therapy for rhythm disorders in patients.However,several ethical issues must be considered.
基金supported by the Natural Science Foundation of Gansu Province(Grant No.21JR7RA321)。
文摘The existing Maximum Power Point Tracking(MPPT)method has low tracking efficiency and poor stability.It is easy to fall into the Local Maximum Power Point(LMPP)in Partial Shading Condition(PSC),resulting in the degradation of output power quality and efficiency.It was found that various bio-inspired MPPT based optimization algorithms employ different mechanisms,and their performance in tracking the Global Maximum Power Point(GMPP)varies.Thus,a Cuckoo search algorithm(CSA)combined with the Incremental conductance Algorithm(INC)is proposed(CSA-INC)is put forward for the MPPT method of photovoltaic power generation.The method can improve the tracking speed by more than 52%compared with the traditional Cuckoo Search Algorithm(CSA),and the results of the study using this algorithm are compared with the popular Particle Swarm Optimization(PSO)and the Gravitational Search Algorithm(GSA).CSA-INC has an average tracking efficiency of 99.99%and an average tracking time of 0.19 s when tracking the GMPP,which improves PV power generation’s efficiency and power quality.
基金supported by the National Natural Science Foundation of China (Grant No. 41672295)
文摘Locked segments are recognized as a critical role that controls the stability of rock slopes but remain an unclear and challenging problem with respect to their role incorporated into the failure mechanism.In order to study the effect of the locked segments on the initial failure process of rockslides,thirty-six groups of locked segment specimens with three different lithologies were prepared,direct shear tests were carried out to obtain the accelerations caused by brittle failure of the locked segment specimens.Experiment results showed that the maximum accelerations caused by the brittle failure of locked segment specimens was 2.91 g in the horizontal direction,and 3.18 g in the vertical direction.We took the Wangjiayan rockslide in 2008 Wenchuan earthquake as an example,the critical balance condition of the sliding mass under combined effect of gravity and accelerations induced by brittle failure of locked segment was analyzed,which indicated that the initial failure process of the Wangjiayan rockslides was notably influenced by the existence of the locked segment.The departure acceleration and direction of the Wangjiayan rockslide were proposed.The study results can provide a new insight into the understanding of the initial failure mechanism of rockslides with locked segments.
文摘Objective:Sudden cardiac death(SCD)and malignant ventricular arrhythmia(VA)are increasingly recognized as important issues for people living with a Fontan circulation,but data are lacking.We sought to characterize the cohort who had sudden cardiac death,most likely related to VA and/or documented VA in the Australia and New Zealand Fontan Registry including risk factors and clinical outcomes.Methods:A retrospective cohort study was performed.Inclusion criteria were documented non-sustained ventricular tachycardia,sustained ventricular tachycardia,ventricular fibrillation,resuscitated cardiac arrest or SCD>30 days post-Fontan completion.Results:Of 1611 patients,20(1.2%)had VA;14(1.0%)had VA without SCD and 6(<1%)had SCD(6%of all deaths recorded in Registry;5 of those had documented VA at the time of arrest and 1 was presumed to be VA-associated).The median age at first VA was 20.5(14–32)years,10(50%)were females,and the median age at Fontan operation was 8(4–17)years.On univariable analysis,hypoplastic left heart syndrome(p=0.03)and older age Fontan operation(p<0.001)were associated with VA.Earlier Fontan era(p<0.003),atriopulmonary Fontan(p<0.001),pre-Fontan atrioventricular valve repair(p=0.013)pre-or post-Fontan atrial arrhythmia(p=0.010)were associated with SCD.Patients with VA had a 3 times higher risk of death or heart transplant(HR 3.27(1.19,8.98),p=0.02).Conclusions:A proportion of people living with a Fontan circulation have malignant VA.Routine VA screening in this cohort is essential.More data are needed to aid risk stratification.
基金supported by the National Natural Science Foundation of China[81771006].
文摘Objective:To investigate the potential influence of anatomical variation in the anterior inferior cerebellar artery(AICA)on the occurrence and severity of idiopathic sudden sensorineural hearing loss(ISSNHL).Methods:Ninety ISSNHL patients were enrolled.The anatomical location of the AICA was exhibited using high-resolution magnetic resonance imaging(MRI),and the various AICA types classified by previously reported Chavda and Gorrie methods were analyzed.The severity of hearing loss in the ipsilateral ear among different AICA types was compared.Results:Approximately 85.6%of subjects had unilateral ISSNHL(uISSNHL),and the others had bilateral ISSNHL(bISSNHL).In the uISSNHL group,the ratios of different AICA types were similar between the ipsilateral and contralateral ears.The ratios of the different AICA types in the bISSNHL group were similar to those in the uISSNHL group.In the uISSNHL group,pure tone audiometry(PTA)thresholds at 2 kHz,4 kHz and 8 kHz of patients with Chavda type II AICA were higher than those of patients with Chavda type I and type III,with a significant difference at 4 kHz between type I and type II.There was a tendency of the PTA threshold in patients with Chavda type II or Gorrie type C to gradually increase from low to high frequency zones.Conclusion:When the AICA enters the IAC(Chavda type II)or crosses between the 7th and 8th cranial nerves(Gorrie type C),the severity and frequency of hearing impairment in ISSNHL but not the occurrence of ISSNHL will be affected.
基金funded by the Traditional Chinese Medicine Science and Technology Development Plan Project of Jiangsu Province(ZT202113 to Haibing Hua)the 510 Talent Training Project of Yizheng City(2022 to Shiming Ye)+1 种基金the Scientific Research Project of Jiangyin Association of Chinese Medicine(Y202205 to Yufeng Zhang)the ChengXing Talent Training Plan of Jiangyin Hospital of Traditional Chinese Medicine(2022 to Yufeng Zhang).
文摘Background:Despite its widespread therapeutic use and effectiveness,the underlying pharmacologic mechanisms of Wendan decoction(WDD)and how it works to treat sudden deafness(SD)remain unclear.In this study,the pharmacological mechanisms of WDD underlying SD were analyzed using network pharmacology and molecular docking.Methods:The Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform(TCMSP)was employed to identify the active compounds and target genes of WDD,and genes associated with SD were screened on five databases.RGUI conducted Gene Ontology(GO)functional and the Kyoto Encyclopedia of Genes and Genomes(KEGG)enrichment analyses.A compound-target network was established using Cytoscape,and the STRING database created a protein-protein interaction(PPI)network to identify the key compounds and targets.Subsequently,a network of crucial compound-target was generated for further molecular docking analysis.For molecular docking simulations of the macromolecular target proteins and their matching ligand molecules,AutoDock Vina and AutoDockTool were utilized.Results:TCMSP identified 162 active target genes and 36 active compounds for WDD.The active target genes were compared with the 2271 genes associated with SD to identify 70 intersecting active target genes linked to 34 active compounds.The GO functional enrichment and KEGG pathway enrichment analyses were undertaken,and compound–target,and PPI networks were built.The key compounds and protein targets were identified and integrated to form a key compound–target network.Eventually,molecular docking was performed to investigate the interactions of the protein targets with their respective compounds.Conclusion:This study highlights the mechanisms of multi-compounds,targets,and pathways of WDD acting on SD and provides further evidence of crucial compounds and their matching target proteins of WDD acting on SD.
文摘BACKGROUND Sudden death is unanticipated,non-violent death taking place within the first 24 h after the onset of symptoms.It is a major public health problem worldwide.Moreover,the effects of living at moderate altitude on mortality are poorly understood.AIM To retrospectively report the frequency and the main causes of sudden deaths in relation to total deaths at Asir Central Hospital,2255 m above sea level,in the southern region of Saudi Arabia over a period of 4 years from 2013 to 2016.METHODS The medical records of 1821 deaths were examined and showed 353 cases(19.4%)of sudden death.RESULTS The highest incidence of sudden death was among the elderly(51%),whereas,the lowest was among children and adolescents(6.5%).With regard to gender,the incidence of sudden death was higher in males(54.4%)compared to 45.6% in females.In this study,we found that the most common direct causes of sudden death were cardiovascular diseases(29.2%),respiratory disease(22.7%),infectious disease(12.2%),cancer(9.4%)and hematological diseases(6.2%).With respect to seasonal variation,the highest incidence was during winter(31.32%)followed by summer(25.8%).CONCLUSION The results of this study will help emergency physicians and health care providers to exercise due care to reduce the incidence of sudden death and raise public awareness about the impact of sudden death.
文摘BACKGROUND Edaravone is a widely used treatment for patients with cerebral infarction and,in most cases,edaravone-induced side effects are mild.However,edaravone-related adverse reactions have been receiving increasing attention.CASE SUMMARY We treated three patients with acute cerebral infarction who died following treatment with edaravone.Edaravone is a widely used treatment for patients with cerebral infarction and,in most cases,edaravone-induced side effects are mild.However,edaravone-related adverse reactions have been receiving increasing attention.CONCLUSION Our cases highlight the importance of educating clinicians regarding the new edaravone-induced clinical syndromes of cerebral infarction as potentially fatal adverse drug reactions.Considering that no laboratory or confirmatory test exists to diagnose edaravone-induced death from cerebral infarction,clinicians’knowledge is the key element in recognizing this phenomenon.
文摘The US-led Western countries have imposed financial sanctions against Russia after the Russia-Ukraine crisis broke out in 2022.Since last year,the“weaponization of global public goods”suddenly appeared regularly in academic studies and media reports worldwide.The financial sanctions led by the US had a long history before the Ukraine crisis.For example,the United States has imposed various sanctions against Iraq,the Democratic People’s Republic of Korea(DPRK),Iran and Russia for some time.Scant academic studies and media reports discussed the weaponization of global public goods before,and the reasons were that the scale of earlier financial sanctions was limited,and the influence of the sanctioned countries was also limited.Those sanctions did not directly threaten global public goods,so researchers have not lifted these issues to the level of weaponization of global public goods.
文摘Background: Cardiopulmonary resuscitation (CPR) is a life-saving skill that is often overlooked until a tragic event occurs. A popular NFL player, Damar Hamlin, safety for the Buffalo Bills, suffered a cardiac arrest on January 2, 2023. Due to prompt intervention and CPR, Hamlin survived the arrest and is playing again. This research sought to understand how people respond to this event on the internet. It also seeks to understand how this response can be used to raise CPR awareness. Design and Methods: Using Google Trends and Twitter data, we searched, downloaded, and retrospectively analyzed search interests relative to Hamlin’s cardiac arrest for a one-year duration. We searched for related keywords in the United States from March 2022 to March 2023, including “Damar Hamlin”, “sudden cardiac death”, “heart attack”, and “CPR”. Results: There was a significant rise in post-event Google searches that combined the terms “Damar Hamlin” and “SCD” (M = -28898.88, SE = 1537.66;t = 1.62, p Conclusion: Based on the analytics of these platforms, it can be concluded that there were active discussions and an awareness of life-saving skills such as CPR along with Hamlin’s cardiac event by his fans, as demonstrated by the data gathered from these platforms. This can provide us with valuable insight into human behavior and help us leverage this knowledge to promote health.
文摘Introduction: Hypertrophic cardiomyopathy (HCM) belongs to the very heterogeneous group of cardiomyopathies. This study aimed to study myocardial perfusion abnormalities on scintigraphy and assess the risk of sudden death from ventricular arrhythmia in hereditary sarcomeric HCM. Patients and Methods: This is a retrospective and prospective descriptive study over 18 months (January 01, 2021, to July 31, 2022) on the records of patients over 18 with the diagnosis of hypertrophic sarcomeric cardiomyopathy with or without ventricular rhythm disorders and who have undergone myocardial scintigraphy. Results: Three patients were included. The average age of our patients was 66 years old. Dyspnea is the primary symptomatology found in our patients. One patient presented with syncope and unsustained ventricular tachycardia. His risk score for sudden death from ESC at five years is estimated at 6.45%, and the patient received an ICD in primary prevention. The average sudden death risk score of our patients was 3.78%. The mean LV wall thickness was 20 mm. The mean maximum left intraventricular gradient was 39 mmHg. Myocardial fibrosis was present in all our patients. Myocardial scintigraphy was normal in all cases. Conclusion: Hypertrophic cardiomyopathy is a very heterogeneous group of cardiomyopathies. The rhythmic risk is multifactorial and constitutes a significant prognostic factor.