Protocol of Investigation on Sudden Death at Autopsy, Including Molecular, Genetic and Toxicology Testing

The role of the autopsy: 1) Whether the death is ascribable to a natural or unnatural cause and when natural, if cardiac or extra-cardiac;2) The nosology of the cardiac diseases and the mechanism of cardiac death, whether arrhythmic or mechanical;3) If the cardiac disease is inherited, screening and counselling of the next of kin is required. About 30% of sudden deaths is ascribable to genetically determined morbid entities, mostly transmissible with the autosomal dominant pattern of inheritance, so that 50% of the first degree relatives are genetically affected (“carriers”) and exposed at risk;4) If toxic or illicit drug abuse was involved.

Sudden Strike

本年度最受关注的即时战略游戏，除了《红色警报2》，就数它了。目前Sudden Strike(闪击战)只出了德文版本，英文的正式版要在10月底才会面世。这个游戏模仿二战场面的逼真度绝对不会让军事爱好者们失望。仅仅是看到栩栩如生的德军虎王式坦克、豹式坦克歼击车．自行火炮、半履带装甲车、吉普车，弹药补给车等等构成的装甲部队，与盟军的装甲部队、

Neurocysticercosis causing sudden death:a case report

We report an acute case of a native man from Bolivia suffered from cephalalgia which rapidly worsened and ended in his sudden and unexpected death.Magnetic resonance imaging(MRI) of the brain was obtained.Features demonstrated on brain MRI scan were consistent with a diagnosis of neurocysticercosis(NCC).An autopsy showed the presence of intraventricular Taenia solium(T.solium) cysts which caused blockage of cerebrospinal fluid and secondary hydrocephalus.Due to the increasing travel movements of people neurocysticercosis must be considered as a cause of unexplained sudden death.

Early repolarization syndrome: A cause of sudden cardiac death

Early repolarization syndrome(ERS), demonstrated as J-point elevation on an electrocardiograph, was formerly thought to be a benign entity, but the recent studies have demonstrated that it can be linked to a considerable risk of life- threatening arrhythmias and sudden cardiac death(SCD). Early repolarization characteristics associated with SCD include high-amplitude J-point elevation, horizontal and/or downslopping ST segments, and inferior and/or lateral leads location. The prevalence of ERS varies between 3% and 24%, depending on age, sex and J-point elevation(0.05 m V vs 0.1 m V) being the main determinants.ERS patients are sporadic and they are at a higher risk of having recurrent cardiac events. Implantable cardioverter-defibrillator implantation and isoproterenol are the suggested therapies in this set of patients. On the other hand, asymptomatic patients with ERS are common and have a better prognosis. The risk stratification in asymptomatic patients with ERS still remains a grey area. This review provides an outline of the up-to-date evidence associated with ERS and the risk of life- threatening arrhythmias. Further prospective studies are required to elucidate the mechanisms of ventricular arrhythmogenesis in patients with ERS.

The Possible Influence of Stratospheric Sudden Warming on East Asian Weather

By analyzing the linkage of the Northern Annular Mode （NAM） anomaly to the East Asian jet and the East Asian trough during Stratospheric Sudden Warming （SSW）, the influence of SSW on East Asian weather is studied. The results show that the East Asian jet is strengthened and the East Asian trough is deepened during SSW. With the downward propagation of SSW, the strengthened East Asian jet and the East Asian trough would move southward, expand westward and gradually influence the area of north and northeastern China. This implies that the winter monsoon tends to be enhanced over East Asia during SSW.

Sudden sensorineural hearing loss(SSHL) following a local anesthetic dental procedure

Acute sensorineural hearing loss is an uncommon phenomenon in dentistry.We describe the case of a 79-year-old male who presented with acute sensorineural hearing loss occurring 2 days after a tooth extraction procedure under local anesthesia.Possible mechanisms are discussed.He was treated with vasodilators(Ginaton and Alprostadil Injection)and Mecobalamin injection with benefit.High dose oral steroids(1 mg/kg)and low molecular weight dextran were used.

The influences of dipole-dipole interaction and detuning on the sudden death of entanglement between two atoms in the Tavis-Cummings model

The influences of dipole-dipole interaction and detuning on the entanglement between two atoms with different initial tripartite entangled W-like states in the Tavis Cummings model have been investigated by means of Wootters＇ concurrence, respectively. The results show that the entanglement between the two atoms can be enhanced via appropriately tuning the strength of dipole-dipole interaction of two atoms or the detunings between atom and cavity, and the so-called sudden death effect can he weakened simultaneously.

A novel PIK3CD C896T mutation detected in bilateral sudden sensorineural hearing loss using next generation sequencing:An indication of primary immunodeficiency

Objective:To investigate immune-related genetic background in bilateral sudden sensorineural hearing loss (SSNHL). Case report and methods: The case is a 45-year-old man presenting with a 7-year history of bilateral profound SSNHL. Blood biochemical testing demonstrated increased levels of total cholesterol (5.88 mmol/L). Tests for hepatitis B showed a positive antibody against the hepatitis B core antigen. Complement C3 was below the normal value, and complement C4 and IgG were in the lower range of normal values. CT images showed a normal inner ear and vestibular aqueduct but round window membranous ossification on both sides. A total number of 232 immune-associated genes were sequenced using the next generation sequencing technique. Results: Mutations were detected in 5 genes, including the phosphoinositide 3-kinase catalytic subunit delta (PIK3CD), caspase recruitment domain-containing protein 9 (CARD9), complement factor H-related (CFHR2), immunoglobulin lambda-like polypeptide 1 Protein (IGLL1), and transmembrane channel-like gene family 8 (TMC8). In the PIK3CD gene, a C896T substitute in exon 7 was detected. This mutation causes primary immunodeficiency and is an autosomal dominant disease. Conclusion: The PIK3CD C896T mutation responsible for primary immunodeficiency may contribute to the onset of bilateral SSNHL with subsequent rapid progression.

Sub-seasonal to Seasonal Hindcasts of Stratospheric Sudden Warming by BCC_CSM1.1(m):A Comparison with ECMWF

This study focuses on model predictive skill with respect to stratospheric sudden warming(SSW) events by comparing the hindcast results of BCC_CSM1.1(m) with those of the ECMWF's model under the sub-seasonal to seasonal prediction project of the World Weather Research Program and World Climate Research Program. When the hindcasts are initiated less than two weeks before SSW onset, BCC_CSM and ECMWF show comparable predictive skill in terms of the temporal evolution of the stratospheric circumpolar westerlies and polar temperature up to 30 days after SSW onset. However, with earlier hindcast initialization, the predictive skill of BCC_CSM gradually decreases, and the reproduced maximum circulation anomalies in the hindcasts initiated four weeks before SSW onset replicate only 10% of the circulation anomaly intensities in observations. The earliest successful prediction of the breakdown of the stratospheric polar vortex accompanying SSW onset for BCC_CSM(ECMWF) is the hindcast initiated two(three) weeks earlier. The predictive skills of both models during SSW winters are always higher than that during non-SSW winters, in relation to the successfully captured tropospheric precursors and the associated upward propagation of planetary waves by the model initializations. To narrow the gap in SSW predictive skill between BCC_CSM and ECMWF, ensemble forecasts and error corrections are performed with BCC_CSM. The SSW predictive skill in the ensemble hindcasts and the error corrections are improved compared with the previous control forecasts.

Relation Between Sudden Sedimentation and Wind Energy in Outer Channel of Huanghua Port and Its Application in Binzhou Port

Based on the analysis of ocean dynamic condition and sediment environment, conclusions can be drawn that strong wind is an essential factor influencing sudden sedimentation in outer channel. Through theoretical analysis, it changes the complex process that wind raises wave, wave tilts sediment and current transports sediment into a comprehensive factor, and obtains mathematical formula between effective wind energy and the thickness of sudden sedimentation. The parametees in this formula are determined with field data of Huanghua Port. It may be used to predict siltation thickness and volume along the channel. By analyzing and comparing the difference in ocean hydrodynamic conditions and seabed material between Huanghua Port and Binzhou Port, the proposed formula can be used to predict sudden sedimentation in Binzhou Port and the calculated results is rehable. By predicting it on different combination plans among different recurrence in- tervals, entrance locations and channel classes, it provides references for the plane design of Binzhou Port.

Optimal entropy squeezing sudden generation and its control for an effective two-level moving atom entanglement with the two-mode coherent fields

From the viewpoint of quantum information, this paper proposes a concept and a definition of the atomic optimal entropy squeezing sudden generation （AOESSG） for the system of an effective two-level moving atom which entangles with the two-mode coherent fields. It also researches the relationship between the AOESSG and entanglement sudden death of the atom-fields, and discusses the influences of atomic initial state on the AOESSG and obtains the system parameter which controls the AOESSG.

Sudden death of entanglement of a quantum model

In this paper the so-called sudden death effect of entanglement is investigated in a quantum model. The results show that one can expect the resurrection of the original entanglement to occur in a periodic way following each sudden death event. The length of the time interval for the zero entanglement depends not only on the degree of entanglement of the initial state but also on the initial state.

Transient Characteristics of Residual Meridional Circulation during Stratospheric Sudden Warming

The residual meridional circulation derived from the transformed Eulerian-mean thermodynamic equation and continuity equation can be separated into two parts,the slowly varying diabatic circulation and the transient circulation,as demonstrated by others.We calculated and composite-analyzed the transient and diabatic circulation for 14 stratospheric sudden warming(SSW) events from 1979-2002 by using the daily ECMWF reanalysis data.Specifically,the transient residual meridional circulation was calculated both with and without inclusion of the eddy heat transport term in the transformed Eulerian-mean thermodynamic equation to investigate the importance of the eddy heat transport term.The results showed that calculations of transient residual meridional circulation present rapid variations during SSWs,with or without inclusion of the eddy heat transport term.Although the patterns of transient residual meridional circulation with the eddy heat transport term were similar to that without the eddy heat transport term during SSW,the magnitudes in the upper stratosphere and high-latitude regions differed.As for the diabatic circulation,its daily variations were small during SSW events,and its patterns were in agreement with its monthly average.

Assessment of a Sudden Death Case due to Coronary Artery Disease Based on the PMCT and Forensic Autopsy

It is never an easy thing to diagnose heart vascular disease only depending on the unenhanced postmortem computed tomography(PMCT).This article reported a case of sudden natural death after the complaint of anterior chest pain in which coronary artery calcification(CAC) was clearly displayed using PMCT scan.The entire coronary artery system was almost reconstructed via multiplanar reformation(MPR) and volume-rendering reconstruction(VR),and the total calcium score of the coronary arteries was obtained with CaScoring automatic analysis software.The results showed that CAC was conspicuous;the total calcium score was 640.3,considerably higher than 400.The pulmonary ground-glass opacity(GGO) and small amount of fluid both in the subglottic trachea and main bronchi were also found.The imaging results confirmed those of autopsy.In addition,the results concluded that PMCT might serve as an invaluable adjunct to the classic autopsy procedure.

Risk factors for sudden cardiac death to determine high risk patients in specific patient populations that may benefit from a wearable defibrillator

BACKGROUND There is a high risk for sudden cardiac death(SCD) in certain patient groups that would not meet criteria for implantable cardioverter defibrillator(ICD) therapy.In conditions such as hypertrophic cardiomyopathy(HCM) there are clear risk scores that help define patients who are high risk for SCD and would benefit from ICD therapy. There are however many areas of uncertainty such as certain patients post myocardial infarction(MI). These patients are high risk for SCD but there is no clear tool for risk stratifying such patients.AIM To assess risk factors for sudden cardiac death in major cardiac disorders and to help select patients who might benefit from Wearable cardiac defibrillators(WCD).METHODS A literature search was performed looking for risk factors for SCD in patients post-MI, patients with left ventricular systolic dysfunction(LVSD), HCM, long QT syndrome(LQTS). There were 41 studies included and risk factors and the relative risks for SCD were compiled in table form.RESULTS We extracted data on relative risk for SCD of specific variables such as age,gender, ejection fraction. The greatest risk factors for SCD in post MI patients was the presence of diabetes [Hazard ratio(HR) 1.90-3.80], in patient with LVSD was ventricular tachycardia(Relative risk 3.50), in LQTS was a prolonged QTc(HR36.53) and in patients with HCM was LVH greater than 20 mm(HR 3.10). A proportion of patients currently not suitable for ICD might benefit from a WCDCONCLUSION There is a very high risk of SCD post MI, in patients with LVSD, HCM and LQTS even in those who do not meet criteria for ICD implantation. These patients may be candidates for a WCD. The development of more sensitive risk calculators to predict SCD is necessary in these patients to help guide treatment.

The Spatial and Temporal Variability of Global Stratospheric GravityWaves and Their Activity during Sudden StratosphericWarming Revealed by COSMIC Measurements

This study investigates the spatial and temporal variability of global stratospheric gravity waves(GWs) and the characteristics of GW activity during sudden stratospheric warming(SSW) using the GPS radio occultation measurements from the COSMIC mission during September 2006 to May 2013. Corresponding to the COSMIC RO observational window and analysis method,GW potential energy(Ep) with vertical scales no shorter than ～2 km is resolved. It is found that the distributions of GW Ep over 20-30 km and 30-38 km show similar spatial and seasonal variations. The variations of GW Ep with altitude and latitude along the westerly wind are identified in different seasons over 60°-80°W. In the middle and high latitudes,seasonal cycles are distinct in the time-latitude and time-altitude distributions of GW activities,which show larger Ep in winters when westerly wind dominates and smaller Ep in summers when easterly wind dominates. The influence of quasi-biennial oscillation on GW activity is recognized in the tropics. GW Ep enhances closely following the occurrence of minor SSW events; while during major events, GW Ep may not enhance, and sometimes may even weaken,in the regions where reversals of zonal wind occur, probably caused by the filtering impact of the 0 ms^(-1) wind level on the GWs.

Hypertrophic cardiomyopathy and sudden cardiac death

Hypertrophic cardiomyopathy (HCM) is a common genetic cardiovascular disease that affects the left ventricle. HCM can appear at any age, with the majority of the patients remaining clinically stable. When patients complain of symptoms, these include: dyspnea, dizziness, syncope and angina. HCM can lead to sudden cardiac death (SCD), mainly due to ventricular tachyarrhythmia or ventricular tachycardia. High-risk patients benefit from implantable cardioverter-defibrillators. Left ventricular outflow tract obstruction is not a rare feature in HCM, especially in symptomatic patients, and procedures that abolish that obstruction provide positive and consistent results that can improve longterm survival. HCM is the most common cause of sudden death in young competitive athletes and preparticipation screening programs have to be implemented to avoid these tragic fatalities. The structure of these programs is a matter of large debate. Worldwide registries are necessary to identify the full extent of HCMrelated SCD.

Distillability sudden death in a two qutrit systems under a thermal reservoir

The dynamics of distillability entanglement between qutrit-qutrit systems interacting with a thermal reservoir is investigated in this paper. We discovered an interesting phenomenon that under a thermal reservoir certain initially prepared free=entangled states become bound-entangled states in a finite time, which is called distillability sudden death （DSD）. We use a realignment criterion to measure the nine-dimensional density matrix of the entanglement. Moreover, we analyze some other parameters to investigate the effects to the systems. Explanations are then given.

Outcomes of treatment of sudden deafness using different Protocols:a retrospective analysis of 104 cases

Objective To compare different treatment protocols for sudden deafness(SD), for the purpose of identifying an appropriate approach to SD. Methods A total of 104 patients with diagnosis of sudden hearing loss treated from Jan 2006 to December 2008 were included in this study, of which 31 received the typical pharmaceutical treatment (groupⅠ), 40 received the typical pharmaceutical treatment plus polarized liquid (GroupⅡ) and 33 received the hyperbaric oxygen in addition to the treatment included in Group Ⅱ(Group Ⅲ). Results The total improvement rate (67.74%, 62.50% and 75.76% for Groups Ⅰ, Ⅱ and Ⅲ respectively) was not statistically different between the three groups (P > 0.05). Conclusion The three treatment protocols are similar when judged by the treatment outcomes in SD, neither being superior to the others. The two important factors that appear to influence treatment outcomes are the audiogram pattern and duration of hearing loss before seeking treatment. Patients with upsloping or peak-type audiograms and treated within 7 days from the onset have better prognosis than others.