Statistical Characteristics and Mechanistic Analysis of Suddenly Reversed Tropical Cyclones over the Western North Pacific Ocean

Based on best track data of tropical cyclones（TCs） from the Japan Meteorological Agency, the characteristics of suddenly reversed TCs（SRTCs）, which have turning angles usually approaching 180°, are statistically analyzed from 1949 to 2011 over the western North Pacific Ocean. The typical large-scale circulation patterns of SRTCs are investigated using reanalysis data and dynamical composite analysis. Results show that turnings mainly occur in low latitudes between 10°N and 20°N,and mainly west of 135°E. The majority of SRTCs reach their peak intensity at, or slightly before, the turning time and subsequently decrease at some variable rate. Specifically, SRTCs are divided into four types, each containing two groups（i.e.eight groups in total） in terms of the moving-direction changes. The moving speed of all SRTC types except the south–north type decreases to its lowest during the 24 h, corresponding to a significant reduction in the primary steering components.According to the analysis of the 13 typical flow patterns found in this study, we suggest that sudden track changes are caused by the reversal steering flow. The original balance of the background flow patterns are broken up by new systems, e.g. binary TCs or dispersion-induced anticyclones. Additionally, sudden track changes are often due to double ridge variations of the subtropical high or weakened/strengthened high pressure in the east and west, respectively.

NUMERICAL SIMULATION OF THREE DIMENSIONAL TURBULENT FLOW IN SUDDENLY EXPANDED RECTANGULAR DUCT

In this paper,to simulate the three dimensional turbulent flow in suddenly expanded rectangular duct numerically,the SIMPLEC algorithm is employed to solve the incompressible Navier-Stckes equation with k-εturbulence model.The numerical resulis show well the three dimensional turbulent flow field in the rectangular duct behind the sudden expansion cross-section. and agree.fairly well with the experimental result of the length of the main circumfluence.The numerical method of this paper can be applied to numerical analysis of this kind of turbulent flow.

Preface to the Special Issue on Causes, Impacts, and Predictability of Droughts for the Past, Present, and Future

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.

Controlled release of dexamethasone from fibrin sealant for intratympanic administration in inner ear therapy

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.

Challenging situation of coronary artery anomaly associated with ischemia and/or risk of sudden death

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.

Modified intratympanic steroid therapy for sudden sensorineural hearing loss via tympanic tube and gelfoam as a salvage treatment

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.

Analysis of gravity wave activity during stratospheric sudden warmings in the northern hemisphere

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.

Therapeutic efficacy of methylprednisolone sodium succinate via diverse administration routes for mid-to high-frequency sudden sensorineural hearing loss

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.

突发性聋患者中枢敏化因素分析及临床干预

目的探讨突发性聋的可能机制,以及中枢敏化因素临床干预在突发性聋患者中的应用分析。方法选取2020年1月~2023年1月在解放军总医院第三医学中心耳鼻咽喉头颈外科住院治疗且合并偏头痛或其他中枢敏化因素的37例突发性聋患者作为治疗组,随机选取同期无偏头痛及其他中枢敏化因素的30例突发性聋患者作为对照组。两组患者均参照突发性聋指南进行规范化分型治疗,对合并偏头痛或其他中枢敏化因素的患者进行抗偏头痛治疗,比较两组的治疗效果。结果治疗组总有效率为81.1%(30/37),其中痊愈13例、显效10例、有效7例、无效7例;对照组总有效率66.7%(20/30),其中痊愈6例、显效6例、有效8例、无效10例。治疗组痊愈及显效比例高于对照组,两组总有效率差异无统计学意义(χ^(2)=1.1364,P>0.05)。结论偏头痛是中枢敏化的一种表现形式,中枢敏化可能参与到一部分突发性聋患者的发病机制中,对突发性聋患者进行中枢敏化评估,合并偏头痛或其他中枢敏化因素的突发性聋患者可以考虑配合抗偏头痛药物进行治疗,有可能改善患者预后。

It's…Quadruplets!Couple Suddenly Becomes Family of Six

ON January 16, 1993, I received a letter from Shan Jiazhi, professor of gynecology and obstetrics at Shandong Provincial Hospital. In his letter, Shan informed me that a woman would soon give birth to quadruplets and asked me to quickly come to the hospital. In his office, Professor Shan produced two X-rays of the lying-in woman. "This woman, Su Lixin, is a worker with the Jinan No. 1 Machine Tool Factory. Since she was hospitalized, we’ve applied modern comprehensive measures to control the occurrence of complications and have striven for international standards for the gestational period reaching or surpassing 37 weeks." He then told me that in the United States,

全球金融公共品的武器化

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.

Keeping Pets

I am a cat lover and own a cat.But I didn’t always want to keep a pet.I bought the cat for the family and it has become an inseparable part of my life since.After my grandfather’s death,my grandmother was always down.Perhaps it was because he left suddenly without a proper goodbye.Grandma couldn’t overcome the grief,sitting quietly on the living room sofa every day.After being silent for one month,she told my mother one afternoon that she wanted to have a cat.

Population aging, medicalization of death and death education in China

Wuhan University,the development of death education in China has a history of more than 30 years.But it has lacked the clout it deserves in China.However,in recent years,death education has begun to attract more and more attention from the medical community.Various lectures and pieces of training related to death education held by the government and medical institutions,as well as related academic salons,seminars,workshops and“Death Cafes”held by the people have appeared and become popular.Death education has been developed in China for more than 30 years,why has it suddenly become popular and even popular in recent years?This has an important relationship with China’s aging population and the medicalization of death.

耳后注射神经节苷酯联合鼓室内注射甲泼尼龙治疗难治性突发性聋的临床研究

目的评价鼓室内注射甲泼尼龙联合耳后注射神经节苷酯治疗难治性突发性聋的临床疗效,为难治性突发性聋的治疗提供理论依据。方法以2019年9月~2022年1月于宜兴市人民医院和淮安市第二人民医院就诊的难治性突发性聋患者98例作为研究观察对象,随机分为观察组49例和对照组49例,观察组给予鼓室内注射甲泼尼龙联合耳后注射神经节苷脂治疗,对照组单纯行鼓室内注射甲泼尼龙治疗,通过随访调查,对两种不同治疗方法的临床效果进行对比分析。结果随访发现观察组患者治愈率明显高于对照组,差异具有显著性(P<0.05);两组患者不良反应发生率无明显差异,差异无统计学意义(P>0.05),对照组复发率明显高于观察组,差异显著(P<0.05)。结论鼓室内注射甲泼尼龙联合耳后注射神经节苷酯较单纯鼓室内注射甲泼尼龙治疗难治性突发性聋效果显著、复发率低,有一定的临床推广价值。

Super Typhoon Hinnamnor(2022)with a Record-Breaking Lifespan over the Western North Pacific

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.

Inherited arrhythmias and gene therapy: Are there any ethical considerations to take into account?

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.

Research on the MPPT of Photovoltaic Power Generation Based on the CSA-INC Algorithm

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.

Dynamic behaviors of rockslides subjected to brittle failure of locked segments

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.

Ventricular Arrhythmia in the Fontan Circulation:Prevalence,Risk Factors and Clinical Implications

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.