老年精神科患者潜在不适当用药评价及列线图预测模型的建立

目的探索影响老年精神科患者潜在不适当用药因素,并构建列线图预测模型。方法回顾性分析2022年3月至2024年2月在浙江省衢州市第三医院就诊的389例精神科老年患者的病历资料,评估患者潜在不恰当用药情况,经Logistic回归模型分析影响潜在性不恰当用药的独立因素,并使用列线图预测模型效能。结果389例精神科患者中,常用药为氯氮平片、舒必利片、利培酮片,而潜在风险因子最高的药物为氯氮平片。联合用药数>3种、共患疾病数≥3种、部分自费、住院时间>14 d是影响精神科患者药品潜在性不适当用药的独立因素(P<0.05)。构建列线图,C-index为0.99,经过1000次内部校准后,真实值和预测值吻合度绝对误差为0.016。经Bootstrap法内验证,预测模型曲线下面积(AUC)为0.870,95%CI(0.815,0.926),Hosmer-Lemeshow拟合优度检验为3.749(P>0.05)。结论住院时间、付费方式、共患疾病数、联合用药数是导致老年精神科患者潜在不适当用药的独立因素,临床上可针对高危因素适当调整患者用药情况,以降低潜在性不适当用药风险。

Reservoir-landslide Hazard Assessment Based on GIS: A Case Study in Wanzhou Section of the Three Gorges Reservoir

Reservoir-landslide is mainly caused by changes in hydrodynamic conditions of slope interior at the time of water storage or discharge. The current study mainly focuses on the typical reservoirlandslide, but the sudden occurrence of some unknown landslides brought a lot of difficulties for hazards prevention. Therefore, we proposed a method to evaluate the regional scale reservoir-landslide hazard. We took Wanzhou section of Three Gorges Reservoir(China) as the study area and systemically and synthetically carried out the reservoir-landslide hazard evaluation under the condition of water level regulation. Firstly, we made reservoir-landslide susceptibility assessment by using the methods of spatial analysis and statistics based on geological and geomorphological materials and field survey data, and then, analyzed the regional-scale slope stability based on the infinite slope model used to analyze the bank slope stability change under the condition of water fluctuation, finally, developed a reservoir-landslide hazard evaluation model based on the results of susceptibility and stability. The hazard evaluation model was used to predict and evaluate the hazard change under the role of water level regulation. The results showed that the landslide hazard of the whole region decreased during water storage, landslide hazards increased during water discharge. The faster the regulation speed, the greater the slope hazard. The results can provide the basis for hazard management and regional land-use planning.

Probabilistic Seismic Hazard Assessment for Bridgetown-Barbados, Employing Subduction Interface Characteristic Earthquakes

A new probabilistic seismic hazard analysis was performed for the city of Bridgetown, Barbados, West Indies. Hazard computations have been performed using the standard Cornell-McGuire approach based on the definition of appropriate seismogenic sources and expected maximum magnitudes, the authors take into consideration the possibility of large subduction interface earthquakes of magnitude 8.0-9.0 beneath the Barbados accretionary prism via application of a characteristic model and slip rates. The analysis has been conducted using a standard logic-tree approach. Uniform hazard spectra have been calculated for the 5% of critical damping and the horizontal component of ground motion for rock site conditions setting 5 return periods （95, 475, 975, 2,475 and 4,975 years） and spectral accelerations for 34 structural periods ranging from 0 to 3 s. The disaggregation results suggest that the magnitude-distance pair that dominates the hazard yields M 7.4 and 8.6 and a distance of 42.5 km in the Interface Subduction Zone beneath Barbados for the 475 and 975 years RP （return period）, respectively. An event with an M 8.0 at a distance of 107.5 km in the Intraplate Subduction Zone is the second scenario that dominates the hazard for both 475 and 975 years RP.

Probabilistic Seismic Hazard Assessment for Jamaica

A probabilistic seismic hazard analysis was performed to generate seismic hazard maps for Jamaica. The analysis was then conducted using a standard logic-tree approach that allowed systematically taking into account the model-based （i.e., epistemic） uncertainty and its influence on the computed ground motion parameters. Hazard computations have been performed using a grid of sites with a space of 0.05 degrees. Two different computation methodologies have been adopted： the standard approach based on the definition of appropriate seismogenic sources and the zone-free approach, which overcomes the ambiguities related with the definition of the seismic sources solely reflecting the characteristics of the earthquake catalogue. A comprehensive and updated earthquake catalogue for Jamaica has been compiled for the years 1551-2010 and new empirical relationships amongst magnitudes Mze-Ms and Mw-mb have been developed for the region. Uniform hazard spectra and their uncertainty have been calculated for the horizontal component of ground motion for rock site conditions and five return periods （95, 475, 975, 2,475 and 4,975 years） and spectral accelerations for 34 structural periods ranging from 0 to 3 s, and 5% of critical damping. The spectral accelerations have been calculated to allow the definition of seismic hazard in Jamaica according to the International Building Code 2012. The disaggregation analysis for Kingston Metropolitan Area suggests that the magnitude-distance pair that contributes most to the hazard corresponds to events with M 7.8 and M 7.0 in the Enriquillo Plantain Garden Fault and the Jamaican Faults at a distance of 28 km and 18 km for short and long period structures respectively corresponding to 2,475 years return period. However, for long period structures, a substantial contribution is found for a M 8.2 at a distance of 198 km in the Oriente Fault Zone.

Application of the Stress Evolutionary Model in Hebei Province,North China

Coulomb stress changes associated with strong earthquakes occurring since 1484 in Hebei Province,China are investigated. The North China block has had many large historical earthquakes and some damaging earthquakes in the past century,including the 1976 Tangshan earthquake (M =7.8) . The study area and the adjacent areas of the province comprise the most active seismic fault zones and suffer from both strong and frequent events. The North China Block,which includes the Ordos plateau and the North China plain,is part of the Archean Sino-Lorean craton and one of the most active seismic regions in the world. Its movement is accommodated on major strike-slip intraplate fault zones that strike in the E-W direction. The faults in the study area contribute to the complexity of the stress field. Seismic hazard assessment in this region is attempted by calculating the change of the Coulomb failure function ( ΔCFF) arising from both the coseismic slip of strong events (MS≥6.5) and the stress built up by continuous tectonic loading on major regional faults. At every step of the stress evolutionary model an examination of possible triggering of each next strong event is made and the model finally puts in evidence that the fault segments that are apt to fail in an impending strong event,thus providing future seismic hazard evaluation. In this paper,the results of ΔCFF for Zhangjiakou fault, Xiadian fault and Langfang fault have been shown as examples to express the possiblity of generating future seismic hazard.

Tsunami Hazard Assessment in the Alboran Sea for the Western Coast of Algeria

In October 1790, a destructive earthquake occurred near Oran city in the western part of Algeria （MSK, Medvdev-Sponheuer-Kamik macroseismic intensity： X）. It generated a tsunami that inundated the Spanish and North Africa coasts. The regional tectonic includes NW-SE compressional stress in Algeria and NE-SW strike-slip structures in the Alboran basin. In this work, we identified tsunami sources for the Alboran from numerical modeling. The sea bottom displacement is calculated from the Okada equations. The tsunami＇s propagation is simulated with the SWAN code. The identified tsunami source for the 1790 event is a 7.5 magnitude earthquake at the entrance of the Oran harbor, with a pure reverse faulting, probably associated with the Murdjajo fold The tsunami wave height profile that is obtained for the city of Oran showed an initial withdrawal of the sea that was followed by tsunami waves reaching 2 meters in height. The results obtained in Spain agree with the observations reported in the literature. Finally, the simulations led to a better understanding of the interdisciplinary approach to be considered as for tsunami sources in the Alboran. Sedimentary mass-movements should be now included as an additional component in the tsunami hazard assessment for the West Mediterranean. The contribution of sedimentary disturbance due to the series of canyons offshore the western margin could induce water waves higher than 2 meters in Western Algeria.

Characteristic Period Value of the Seismic Design Response Spectrum of UHV Electrical Equipment

Characteristic period is an important parameter of the seismic design response spectrum. There is important theoretical significance and engineering application value to the study of the characteristic period of seismic design response spectrum of ultra high voltage （UHV） electrical equipment. In this paper, 1448 horizontal earthquake records within the world scope including the United States and Japan for Site Class m were analyzed. Results show that both magnitude and epicentral distance have great influence on the characteristic period. About 80 % of characteristic periods of strong earthquake records are about 0. 9s. Statistical analysis was conducted on the seismic hazard assessment results of 312 projects of China in recent years, and it is found that about 70 % of characteristic periods are about 0. 9s. Combined with the related code comparison and analysis, it is suggested that the characteristic period of the seismic design response spectrmn of UHV electrical equipment should select 0. 9s in order to effectively guarantee the seismic safety of UHV electrical equipment.

Seismic Hazard Assessment for Selected Real Locality in Central Europe-Critical Points of Assessment

The seismic hazard value is a fundamental quantity for the seismic risk assessment and for the determination of terms of references of seismic design of important facilities as dams, chemical plants, nuclear power plants, etc.. In real sites, the seismic hazard value is influenced by both, the earthquake sizes, the impacts of which in a given site may be expected, and the properties of geological structure through which seismic waves spread from earthquake loci to a given site. The seismic risk is predetermined by hazard value, distribution of assets in the given site and asset numbers and vulnerabilities. The paper describes the used procedure of hazard assessment of important sites. The attention is especially paid to the basic steps as the data collection （homogeneity level, uncertainty and vagueness）, the focal region boundaries （their uncertainties and vagueness）, and the maximum expected earthquake size in each focal region that must be taken into account （its uncertainty and vagueness）, because they substantially influence the hazard value. Discussion is also concentrated to the attenuation that Central Europe substantially depends on the azimuth between earthquake focus and the given site. The attenuation differences are shown in seismic scenarios for individual focal regions. They are caused by focal mechanisms in near focal zone and differences in structure properties in distant zone; the boundary between near and distant zone in Central Europe is ca 2.5 h, where h is the focal depth in km. The real results are given for a real locality in Central Europe. It is shown than that great influence on hazard value is caused by great differences in azimuth attenuation curves. It is the reality that the Bohemian Massif is characterised with very low seismic attenuation in comparison with its vicinity. The following real results are presented： geological structure of near site vicinity, earthquake catalogue for Central Europe, focal regions in Central Europe, attenuation curves in Central Europe, typical earthquake isoseismals for individual focal regions, frequency graph, recurrence probability curve, etc.. The approaches used for nuclear facilities were recommended by the IAEA （International Atomic Energy Agency）.