The frequency and duration of observed concurrent hot and dry events(HDEs) over China during the growing season(April–September) exhibit significant decadal changes across the mid-1990s. These changes are characteriz...The frequency and duration of observed concurrent hot and dry events(HDEs) over China during the growing season(April–September) exhibit significant decadal changes across the mid-1990s. These changes are characterized by increases in HDE frequency and duration over most of China, with relatively large increases over southeastern China(SEC), northern China(NC), and northeastern China(NEC). The frequency of HDEs averaged over China in the present day(PD,1994–2011) is double that in the early period(EP, 1964–81);the duration of HDEs increases by 60%. Climate experiments with the Met Office Unified Model(MetUM-GOML2) are used to estimate the contributions of anthropogenic forcing to HDE decadal changes over China. Anthropogenic forcing changes can explain 60%–70% of the observed decadal changes,suggesting an important anthropogenic influence on HDE changes over China across the mid-1990s. Single-forcing experiments indicate that the increase in greenhouse gas(GHG) concentrations dominates the simulated decadal changes,increasing the frequency and duration of HDEs throughout China. The change in anthropogenic aerosol(AA) emissions significantly decreases the frequency and duration of HDEs over SEC and NC, but the magnitude of the decrease is much smaller than the increase induced by GHGs. The changes in HDEs in response to anthropogenic forcing are mainly due to the response of climatological mean surface air temperatures. The contributions from changes in variability and changes in climatological mean soil moisture and evapotranspiration are relatively small. The physical processes associated with the response of HDEs to GHG and AA changes are also revealed.展开更多
Ecological stability is a core issue in ecological research and holds significant implications forhumanity. The increased frequency and intensity of drought and wet climate events resulting from climatechange pose a m...Ecological stability is a core issue in ecological research and holds significant implications forhumanity. The increased frequency and intensity of drought and wet climate events resulting from climatechange pose a major threat to global ecological stability. Variations in stability among different ecosystemshave been confirmed, but it remains unclear whether there are differences in stability within the sameterrestrial vegetation ecosystem under the influence of climate events in different directions and intensities.China's grassland ecosystem includes most grassland types and is a good choice for studying this issue.This study used the Standardized Precipitation Evapotranspiration Index-12 (SPEI-12) to identify thedirections and intensities of different types of climate events, and based on Normalized DifferenceVegetation Index (NDVI), calculated the resistance and resilience of different grassland types for 30consecutive years from 1990 to 2019 (resistance and resilience are important indicators to measurestability). Based on a traditional regression model, standardized methods were integrated to analyze theimpacts of the intensity and duration of drought and wet events on vegetation stability. The resultsshowed that meadow steppe exhibited the highest stability, while alpine steppe and desert steppe had thelowest overall stability. The stability of typical steppe, alpine meadow, temperate meadow was at anintermediate level. Regarding the impact of the duration and intensity of climate events on vegetationecosystem stability for the same grassland type, the resilience of desert steppe during drought was mainlyaffected by the duration. In contrast, the impact of intensity was not significant. However, alpine steppewas mainly affected by intensity in wet environments, and duration had no significant impact. Ourconclusions can provide decision support for the future grassland ecosystem governance.展开更多
BACKGROUND Remimazolam is characterized by rapid action and inactive metabolites.It is used as the general anesthetic for many clinical surgeries.In this study,we performed a meta-analysis to evaluate whether remimazo...BACKGROUND Remimazolam is characterized by rapid action and inactive metabolites.It is used as the general anesthetic for many clinical surgeries.In this study,we performed a meta-analysis to evaluate whether remimazolam is superior to propofol for gastroenteroscopy in older patients.AIM To compare the adverse events and efficacy of remimazolam and propofol during gastroenteroscopy in older adults.METHODS The PubMed,Web of Science,the Cochrane Library databases were queried for the relevant key words"remimazolam,""and propofol,""and gastrointestinal endoscopy or gastroscopy."The search scope was"Title and Abstract,"and the search was limited to human studies and publications in English.Seven studies wherein remimazolam and propofol were compared were included for the metaanalysis.RESULTS We selected seven randomized controlled trials involving 1445 cases for the analysis.Remimazolam reduced the hypotension(relative risk,RR=0.44,95%CI:0.29-0.66,P=0.000),respiratory depression(RR=0.46,95%CI:0.30-0.70,P=0.000),injection pain(RR=0.12,95%CI:0.05-0.25,P=0.000),bradycardia(RR=0.37,95%CI:0.24-0.58,P=0.000),and time to discharge[weighted mean difference(WMD)=-0.58,95%CI:-0.97 to-0.18,P=0.005],compared to those after propofol administration.No obvious differences were observed for postoperative nausea and vomiting(RR=1.09,95%CI:0.97-1.24,P=0.151),dizziness(RR=0.77,95%CI:0.43-1.36,P=0.361),successful sedation rate(RR=0.96,95%CI:0.93-1.00,P=0.083),or the time to become fully alert(WMD=0.00,95%CI:-1.08-1.08,P=0.998).CONCLUSION Remimazolam appears to be safer than propofol for gastroenteroscopy in older adults.However,further studies are required to confirm these findings.展开更多
Fine particulate matter(PM_(2.5))and ozone(O_(3))double high pollution(DHP)events have occurred frequently over China in recent years,but their causes are not completely clear.In this study,the spatiotemporal distribu...Fine particulate matter(PM_(2.5))and ozone(O_(3))double high pollution(DHP)events have occurred frequently over China in recent years,but their causes are not completely clear.In this study,the spatiotemporal distribution of DHP events in China during 2013–20 is analyzed.The synoptic types affecting DHP events are identified with the Lamb–Jenkinson circulation classification method.The meteorological and chemical causes of DHP events controlled by the main synoptic types are further investigated.Results show that DHP events(1655 in total for China during 2013–20)mainly occur over the North China Plain,Yangtze River Delta,Pearl River Delta,Sichuan Basin,and Central China.The occurrence frequency increases by 5.1%during 2013–15,and then decreases by 56.1%during 2015–20.The main circulation types of DHP events are“cyclone”and“anticyclone”,accounting for over 40%of all DHP events over five main polluted regions in China,followed by southerly or easterly flat airflow types,like“southeast”,“southwest”,and“east”.Compared with non-DHP events,DHP events are characterized by static or weak wind,high temperature(20.9℃ versus 23.1℃)and low humidity(70.0%versus 64.9%).The diurnal cycles of meteorological conditions cause PM_(2.5)(0300–1200 LST,Local Standard Time=UTC+8 hours)and O_(3)(1500–2100 LST)to exceed the national standards at different periods of the DHP day.Three pollutant conversion indices further indicate the rapid secondary conversions during DHP events,and thus the concentrations of NO_(2),SO_(2) and volatile organic compounds decrease by 13.1%,4.7%and 4.4%,respectively.The results of this study can be informative for future decisions on the management of DHP events.展开更多
The Centre for China and Globalisation(CCG)hosted a side event on February 17 titled"China,Europe,and the United States:Climate Cooperation in an Era of Great Power Politics"at the Munich Security Conference...The Centre for China and Globalisation(CCG)hosted a side event on February 17 titled"China,Europe,and the United States:Climate Cooperation in an Era of Great Power Politics"at the Munich Security Conference(MSC)2024,which was convened from February 16 to 18,2024 in Munich,Germany.展开更多
BACKGROUND Intravenous infusion is a common method of drug administration in clinical practice.Errors in any aspect of the infusion process,from the verification of medical orders,preparation of the drug solution,to i...BACKGROUND Intravenous infusion is a common method of drug administration in clinical practice.Errors in any aspect of the infusion process,from the verification of medical orders,preparation of the drug solution,to infusion by nursing staff,may cause adverse infusion events.AIM To analyzed the value of improving nursing measures and enhancing nursing management to reduce the occurrence of adverse events in pediatric infusion.METHODS The clinical data of 130 children who received an infusion in the pediatric department of our hospital from May 2020 to May 2021 were analyzed and divided into two groups according to the differences in nursing measures and nursing management:65 patients in the control group received conventional nursing and nursing management interventions,while 65 patients in the observation group received improved nursing measure interventions and enhanced nursing management.The occurrence of adverse events,compliance of children,satisfaction of children’s families,and complaints regarding the transfusion treatment were recorded in both groups.RESULTS The incidence of fluid extravasation and infusion set dislodgement in the observation group were 3.08%and 1.54%,respectively,which were significantly lower than 12.31%and 13.85%in the control group(P<0.05),while repeated punctures and medication addition errors in the observation group were 3.08%and 0.00%,respectively,which were lower than 9.23%and 3.08%in the control group,but there was no significant difference(P>0.05).The compliance rate of children in the observation group was 98.46%(64/65),which was significantly higher than 87.69%(57/65)in the control group,and the satisfaction rate of children’s families was 96.92%(63/65),which was significantly higher than 86.15%(56/65)in the control group(P<0.05).The observation group did not receive any complaints from the child’s family,whereas the control group received four complaints,two of which were due to the crying of the child caused by repeated punctures,one due to the poor attitude of the nurse,and one due to medication addition errors,with a cumulative complaint rate of 6.15%.The cumulative complaint rate of the observation group was significantly lower than that of the control group(P<0.05).CONCLUSION Improving nursing measures and enhancing nursing management can reduce the incidence of fluid extravasation and infusion set dislodgement in pediatric patients,improve children’s compliance and satisfaction of their families,and reduce family complaints.展开更多
Objective: To investigate the impact of excellent event management in improving patient safety and nursing staff care satisfaction. Methods: The study was analyzed by retrospective comparison, and routine management f...Objective: To investigate the impact of excellent event management in improving patient safety and nursing staff care satisfaction. Methods: The study was analyzed by retrospective comparison, and routine management from January 2022 to December 2022 was set as the control group, and excellent event management from January 2023 to January 2024 was set as the study group. The differences in nursing outcomes between both groups were compared. Results: The rate of adverse events in the study group (0.61%) was lower than that in the control group (0.96%), and the rate of excellent events in the study group (2.57%) was higher than that in the control group (0.97%) (P < 0.05). Meanwhile, the satisfaction level of nursing safety in the study group reached 98.81%, which was much higher than in the control group (92.21%) (P < 0.05). Conclusion: Nursing excellent event management had a positive impact on improving patient care safety satisfaction, reducing the rate of adverse events, and increasing the rate of reporting excellent events.展开更多
Accurate forecasting of time series is crucial across various domains.Many prediction tasks rely on effectively segmenting,matching,and time series data alignment.For instance,regardless of time series with the same g...Accurate forecasting of time series is crucial across various domains.Many prediction tasks rely on effectively segmenting,matching,and time series data alignment.For instance,regardless of time series with the same granularity,segmenting them into different granularity events can effectively mitigate the impact of varying time scales on prediction accuracy.However,these events of varying granularity frequently intersect with each other,which may possess unequal durations.Even minor differences can result in significant errors when matching time series with future trends.Besides,directly using matched events but unaligned events as state vectors in machine learning-based prediction models can lead to insufficient prediction accuracy.Therefore,this paper proposes a short-term forecasting method for time series based on a multi-granularity event,MGE-SP(multi-granularity event-based short-termprediction).First,amethodological framework for MGE-SP established guides the implementation steps.The framework consists of three key steps,including multi-granularity event matching based on the LTF(latest time first)strategy,multi-granularity event alignment using a piecewise aggregate approximation based on the compression ratio,and a short-term prediction model based on XGBoost.The data from a nationwide online car-hailing service in China ensures the method’s reliability.The average RMSE(root mean square error)and MAE(mean absolute error)of the proposed method are 3.204 and 2.360,lower than the respective values of 4.056 and 3.101 obtained using theARIMA(autoregressive integratedmoving average)method,as well as the values of 4.278 and 2.994 obtained using k-means-SVR(support vector regression)method.The other experiment is conducted on stock data froma public data set.The proposed method achieved an average RMSE and MAE of 0.836 and 0.696,lower than the respective values of 1.019 and 0.844 obtained using the ARIMA method,as well as the values of 1.350 and 1.172 obtained using the k-means-SVR method.展开更多
The Tianshan range,a Paleozoic orogenic belt in Central Asia,has undergone multiple phases of tectonic activities characterized by the N-S compression after the early Mesozoic,including the far-field effects of the Ce...The Tianshan range,a Paleozoic orogenic belt in Central Asia,has undergone multiple phases of tectonic activities characterized by the N-S compression after the early Mesozoic,including the far-field effects of the Cenozoic Indian-Asian collision.However,there are limited reports on the tectonic deformation and initiation of Triassic intracontinental deformation in the Tianshan range.Understanding this structural context is crucial for interpreting the early intracontinental deformation history of the Eurasian continent during the early Mesozoic.Growth strata and syn-tectonic sediments provide a rich source of information on tectonic activities and have been extensively used in the studies of orogenic belts.Based on detail fieldwork conducted in this study,the middle-late Triassic Kelamayi Formation of the northern Kuqa Depression in the southern Tianshan fold-thrust belt has been identified as the typical syn-tectonic growth strata.The youngest detrital zircon component in two lithic sandstone samples from the bottom and top of the Kelamayi growth strata yielded U-Pb ages of 223.4±3.1 and 215.5±2.9 Ma,respectively,indicating that the maximum depositional age of the bottom and top of the Kelamayi growth strata is 226-220 and 218-212 Ma.The geochronological distribution of detrital samples from the Early-Middle Triassic and Late Triassic revealed abrupt changes,suggesting a new source supply resulting from tectonic activation in the Tianshan range.The coupling relationship between the syn-tectonic sedimentation of the Kelamayi Formation and the South Tianshan fold-thrust system provides robust evidence that the Triassic intracontinental deformation of the South Tianshan range began at approximately 226-220 Ma(during the Late Triassic)and ended at approximately 218-212 Ma.These findings provide crucial constraints for understanding the intraplate deformation in the Tianshan range during the Triassic.展开更多
The SHRP2 Naturalistic Driving Study was used to evaluate the impact of various work zone and driver characteristics on back of queue safety critical events (crash, near-crash, or conflicts) The model included 43 SCE ...The SHRP2 Naturalistic Driving Study was used to evaluate the impact of various work zone and driver characteristics on back of queue safety critical events (crash, near-crash, or conflicts) The model included 43 SCE and 209 “normal” events which were used as controls. The traces included representing 209 unique drivers. A Mixed-Effects Logistic Regression model was developed with probability of a SCE as the response variable and driver and work zone characteristics as predictor variables. The final model indicated glances over 1 second away from the driving task and following closely increased risk of an SCE by 3.8 times and 2.9 times, respectively. Average speed was negatively correlated to crash risk. This is counterintuitive since in most cases, it is expected that higher speeds are related to back of queue crashes. However, most queues form under congested conditions. As a result, vehicles encountering a back of queue would be more likely to be traveling at lower speeds.展开更多
The Newton’s theory of universal gravitation is generalized. Significantly strong at short distances central interaction of bodies and particles is established in comparison with Newtonian. A connection is found with...The Newton’s theory of universal gravitation is generalized. Significantly strong at short distances central interaction of bodies and particles is established in comparison with Newtonian. A connection is found with Black Holes, with the horizon of events. Possibility of systematization of all Black Holes is shown. An illustration is given on the example of Black Hole S<sub>gr</sub>A*.展开更多
We investigate the characteristics and mechanisms of persistent wet–cold events(PWCEs)with different types of coldair paths.Results show that the cumulative single-station frequency of the PWCEs in the western part o...We investigate the characteristics and mechanisms of persistent wet–cold events(PWCEs)with different types of coldair paths.Results show that the cumulative single-station frequency of the PWCEs in the western part of South China is higher than that in the eastern part.The pattern of single-station frequency of the PWCEs are“Yangtze River(YR)uniform”and“east–west inverse”.The YR uniform pattern is the dominant mode,so we focus on this pattern.The cold-air paths for PWCEs of the YR uniform pattern are divided into three types—namely,the west,northwest and north types—among which the west type accounts for the largest proportion.The differences in atmospheric circulation of the PWCEs under the three types of paths are obvious.The thermal inversion layer in the lower troposphere is favorable for precipitation during the PWCEs.The positive water vapor budget for the three types of PWCEs mainly appears at the southern boundary.展开更多
BACKGROUND:The accelerated diagnostic protocol(ADP)using the Emergency Department Assessment of Chest pain Score(EDACS-ADP),a tool to identify patients at low risk of a major adverse cardiac event(MACE)among patients ...BACKGROUND:The accelerated diagnostic protocol(ADP)using the Emergency Department Assessment of Chest pain Score(EDACS-ADP),a tool to identify patients at low risk of a major adverse cardiac event(MACE)among patients presenting with chest pain to the emergency department,was developed using a contemporary troponin assay.This study was performed to validate and compare the performance of the EDACS-ADP incorporating high-sensitivity cardiac troponin I between patients who had a 30-day MACE with and without unstable angina(MACE I and II,respectively).METHODS:A single-center prospective observational study of adult patients presenting with chest pain suggestive of acute coronary syndrome was performed.The performance of EDACS-ADP in predicting MACE was assessed by calculating the sensitivity and negative predictive value.RESULTS:Of the 1,304 patients prospectively enrolled,399(30.6%;95%confidence interval[95%CI]:27.7%–33.8%)were considered low-risk using the EDACS-ADP.Among them,the rates of MACE I and II were 1.3%(5/399)and 1.0%(4/399),respectively.The EDACS-ADP showed sensitivities and negative predictive values of 98.8%(95%CI:97.2%–99.6%)and 98.7%(95%CI:97.0%–99.5%)for MACE I and 98.7%(95%CI:96.8%–99.7%)and 99.0%(95%CI:97.4%–99.6%)for MACE II,respectively.CONCLUSION:EDACS-ADP could help identify patients as safe for early discharge.However,when unstable angina was added to the outcome,the 30-day MACE rate among the designated lowrisk patients remained above the level acceptable for early discharge without further evaluation.展开更多
BACKGROUND The advent of cutting-edge systemic therapies has driven advances in the treatment of hepatocellular carcinoma(HCC),and therapeutic strategies with multiple modes of delivery have been shown to be more effi...BACKGROUND The advent of cutting-edge systemic therapies has driven advances in the treatment of hepatocellular carcinoma(HCC),and therapeutic strategies with multiple modes of delivery have been shown to be more efficacious than mono-therapy.However,the mechanisms underlying this innovative treatment modality have not been elucidated.AIM To evaluate the clinical efficacy of targeted therapy plus immunotherapy combined with hepatic arterial infusion chemotherapy(HAIC)of FOLFOX in patients with unresectable HCC.METHODS We enrolled 53 patients with unresectable HCC who received a combination of targeted therapy,immunotherapy,and HAIC of FOLFOX between December 2020 and June 2021 and assessed the efficacy and safety of the treatment regimen.RESULTS The objective response rate was 60.4%(32/53),complete response was 24.5%(13/53),partial response was 35.9%(19/53),and stable disease was 39.6%(21/53).The median duration of response and median progression-free survival were 9.1 and 13.9 months,respectively.The surgical conversion rate was 34.0%(18/53),and 1-year overall survival was 83.0%without critical complicating diseases or adverse events(AEs).CONCLUSION The regimen of HAIC of FOLFOX,targeted therapy,and immunotherapy was curative for patients with unresectable HCC,with no serious AEs and a high rate of surgical conversion.展开更多
We conducted a comprehensive review of existing prediction models pertaining to the efficacy of immune-checkpoint inhibitor(ICI)and the occurrence of immune-related adverse events(irAEs).The predictive potential of ne...We conducted a comprehensive review of existing prediction models pertaining to the efficacy of immune-checkpoint inhibitor(ICI)and the occurrence of immune-related adverse events(irAEs).The predictive potential of neutrophil-to-lymphocyte ratio(NLR)and platelet-to-lymphocyte ratio(PLR)in determining ICI effectiveness has been extensively investigated,while limited research has been conducted on predicting irAEs.Furthermore,the combined model incor-porating NLR and PLR,either with each other or in conjunction with additional markers such as carcinoembryonic antigen,exhibits superior predictive capabilities compared to individual markers alone.NLR and PLR are promising markers for clinical applications.Forthcoming models ought to incorporate established efficacious models and newly identified ones,thereby constituting a multifactor composite model.Furthermore,efforts should be made to explore effective clinical application approaches that enhance the predictive accuracy and efficiency.展开更多
The High-energy Fragment Separator(HFRS),which is currently under construction,is a leading international radioactive beam device.Multiple sets of position-sensitive twin time projection chamber(TPC)detectors are dist...The High-energy Fragment Separator(HFRS),which is currently under construction,is a leading international radioactive beam device.Multiple sets of position-sensitive twin time projection chamber(TPC)detectors are distributed on HFRS for particle identification and beam monitoring.The twin TPCs'readout electronics system operates in a trigger-less mode due to its high counting rate,leading to a challenge of handling large amounts of data.To address this problem,we introduced an event-building algorithm.This algorithm employs a hierarchical processing strategy to compress data during transmission and aggregation.In addition,it reconstructs twin TPCs'events online and stores only the reconstructed particle information,which significantly reduces the burden on data transmission and storage resources.Simulation studies demonstrated that the algorithm accurately matches twin TPCs'events and reduces more than 98%of the data volume at a counting rate of 500 kHz/channel.展开更多
BACKGROUND The incidence of chronic kidney disease among patients with diabetes mellitus(DM)remains a global concern.Long-term obesity is known to possibly influence the development of type 2 diabetes mellitus.However...BACKGROUND The incidence of chronic kidney disease among patients with diabetes mellitus(DM)remains a global concern.Long-term obesity is known to possibly influence the development of type 2 diabetes mellitus.However,no previous meta-analysis has assessed the effects of body mass index(BMI)on adverse kidney events in patients with DM.AIM To determine the impact of BMI on adverse kidney events in patients with DM.METHODS A systematic literature search was performed on the PubMed,ISI Web of Science,Scopus,Ovid,Google Scholar,EMBASE,and BMJ databases.We included trials with the following characteristics:(1)Type of study:Prospective,retrospective,randomized,and non-randomized in design;(2)participants:Restricted to patients with DM aged≥18 years;(3)intervention:No intervention;and(4)kidney adverse events:Onset of diabetic kidney disease[estimated glomerular filtration rate(eGFR)of<60 mL/min/1.73 m2 and/or microalbuminuria value of≥30 mg/g Cr],serum creatinine increase of more than double the baseline or end-stage renal disease(eGFR<15 mL/min/1.73 m2 or dialysis),or death.RESULTS Overall,11 studies involving 801 patients with DM were included.High BMI(≥25 kg/m2)was significantly associated with higher blood pressure(BP)[systolic BP by 0.20,95%confidence interval(CI):0.15–0.25,P<0.00001;diastolic BP by 0.21 mmHg,95%CI:0.04–0.37,P=0.010],serum albumin,triglycerides[standard mean difference(SMD)=0.35,95%CI:0.29–0.41,P<0.00001],low-density lipoprotein(SMD=0.12,95%CI:0.04–0.20,P=0.030),and lower high-density lipoprotein(SMD=–0.36,95%CI:–0.51 to–0.21,P<0.00001)in patients with DM compared with those with low BMIs(<25 kg/m2).Our analysis showed that high BMI was associated with a higher risk ratio of adverse kidney events than low BMI(RR:1.22,95%CI:1.01–1.43,P=0.036).CONCLUSION The present analysis suggested that high BMI was a risk factor for adverse kidney events in patients with DM.展开更多
Rain-on-snow(ROS)events involve rainfall on snow surfaces,and the occurrence of ROS events can exacerbate water scarcity and ecosystem vulnerability in the arid region of Northwest China(ARNC).In this study,using dail...Rain-on-snow(ROS)events involve rainfall on snow surfaces,and the occurrence of ROS events can exacerbate water scarcity and ecosystem vulnerability in the arid region of Northwest China(ARNC).In this study,using daily snow depth data and daily meteorological data from 68 meteorological stations provided by the China Meteorological Administration National Meteorological Information Centre,we investigated the spatiotemporal variability of ROS events in the ARNC from 1978 to 2015 and examined the factors affecting these events and possible changes of future ROS events in the ARNC.The results showed that ROS events in the ARNC mainly occurred from October to May of the following year and were largely distributed in the Qilian Mountains,Tianshan Mountains,Ili River Valley,Tacheng Prefecture,and Altay Prefecture,with the Ili River Valley,Tacheng City,and Altay Mountains exhibiting the most occurrences.Based on the intensity of ROS events,the areas with the highest risk of flooding resulting from ROS events in the ARNC were the Tianshan Mountains,Ili River Valley,Tacheng City,and Altay Mountains.The number and intensity of ROS events in the ARNC largely increased from 1978 to 2015,mainly influenced by air temperature and the number of rainfall days.However,due to the snowpack abundance in areas experiencing frequent ROS events in the ARNC,snowpack changes exerted slight impact on ROS events,which is a temporary phenomenon.Furthermore,elevation imposed lesser impact on ROS events in the ARNC than other factors.In the ARNC,the start time of rainfall and the end time of snowpack gradually advanced from the spring of the current year to the winter of the previous year,while the end time of rainfall and the start time of snowpack gradually delayed from autumn to winter.This may lead to more ROS events in winter in the future.These results could provide a sound basis for managing water resources and mitigating related disasters caused by ROS events in the ARNC.展开更多
BACKGROUND Acute nonvariceal upper gastrointestinal bleeding(ANVUGIB)is a frequent lifethreatening acute condition in gastroenterology associated with high morbidity and mortality.Over-the-scope-clip(OTSC)is a new end...BACKGROUND Acute nonvariceal upper gastrointestinal bleeding(ANVUGIB)is a frequent lifethreatening acute condition in gastroenterology associated with high morbidity and mortality.Over-the-scope-clip(OTSC)is a new endoscopic hemostasis technique,which is being used in ANVUGIB and is more effective.AIM To summarize and analyze the effects of the OTSC in prevention of recurrent bleeding,clinical success rate,procedure time,hospital stay,and adverse events in the treatment of ANVUGIB,to evaluate whether OTSC can replace standard endoscopic therapy as a new generation of treatment for ANVUGIB.METHODS The literature related to OTSC and standard therapy for ANVUGIB published before January 2023 was searched in PubMed,Web of Science,EMBASE,Cochrane,Google,and CNKI databases.Changes in recurrent bleeding(7 or 30 days),clinical results(clinical success rate,conversion rate to surgery,mortality),therapy time(procedure time,hospital stay),and adverse events in the OTSC intervention group were summarized and analyzed,and the MD or OR of 95%CI is calculated by Review Manager 5.3.RESULTS This meta-analysis involved 11 studies with 1266 patients.Total risk of bias was moderate-to-high.For patients in the OTSC group,7-and 30-days recurrent bleeding rates,as well as procedure time,hospital stay,and intensive care unit stay,were greatly inhibited.OTSC could significantly improve the clinical success rate of ANVUGIB.OTSC therapy did not cause serious adverse and was effective in reducing patient mortality.CONCLUSION OTSC may provide more rapid and sustained hemostasis,and thus,promote recovery and reduce mortality in patients with ANVUGIB.In addition,the safety of OTSC is assured.展开更多
基金the University of Reading, funded by the UK–China Research and Innovation Partnership Fund through the Met Office Climate Science for Service Partnership (CSSP) China as part of the Newton Fundsupported by the National Natural Science Foundation of China (Grant Nos. 42030603 and 42175044)+1 种基金supported by CSSP-China. NPK was supported by an Independent Research Fellowship from the Natural Environment Research Council (Grant No. NE/L010976/1)supported by the National Centre for Atmospheric Science via the NERC/GCRF programme “Atmospheric hazards in developing countries: risk assessment and early warnings ” (ACREW)。
文摘The frequency and duration of observed concurrent hot and dry events(HDEs) over China during the growing season(April–September) exhibit significant decadal changes across the mid-1990s. These changes are characterized by increases in HDE frequency and duration over most of China, with relatively large increases over southeastern China(SEC), northern China(NC), and northeastern China(NEC). The frequency of HDEs averaged over China in the present day(PD,1994–2011) is double that in the early period(EP, 1964–81);the duration of HDEs increases by 60%. Climate experiments with the Met Office Unified Model(MetUM-GOML2) are used to estimate the contributions of anthropogenic forcing to HDE decadal changes over China. Anthropogenic forcing changes can explain 60%–70% of the observed decadal changes,suggesting an important anthropogenic influence on HDE changes over China across the mid-1990s. Single-forcing experiments indicate that the increase in greenhouse gas(GHG) concentrations dominates the simulated decadal changes,increasing the frequency and duration of HDEs throughout China. The change in anthropogenic aerosol(AA) emissions significantly decreases the frequency and duration of HDEs over SEC and NC, but the magnitude of the decrease is much smaller than the increase induced by GHGs. The changes in HDEs in response to anthropogenic forcing are mainly due to the response of climatological mean surface air temperatures. The contributions from changes in variability and changes in climatological mean soil moisture and evapotranspiration are relatively small. The physical processes associated with the response of HDEs to GHG and AA changes are also revealed.
基金the National Natural Science Foundation of China(42271289).
文摘Ecological stability is a core issue in ecological research and holds significant implications forhumanity. The increased frequency and intensity of drought and wet climate events resulting from climatechange pose a major threat to global ecological stability. Variations in stability among different ecosystemshave been confirmed, but it remains unclear whether there are differences in stability within the sameterrestrial vegetation ecosystem under the influence of climate events in different directions and intensities.China's grassland ecosystem includes most grassland types and is a good choice for studying this issue.This study used the Standardized Precipitation Evapotranspiration Index-12 (SPEI-12) to identify thedirections and intensities of different types of climate events, and based on Normalized DifferenceVegetation Index (NDVI), calculated the resistance and resilience of different grassland types for 30consecutive years from 1990 to 2019 (resistance and resilience are important indicators to measurestability). Based on a traditional regression model, standardized methods were integrated to analyze theimpacts of the intensity and duration of drought and wet events on vegetation stability. The resultsshowed that meadow steppe exhibited the highest stability, while alpine steppe and desert steppe had thelowest overall stability. The stability of typical steppe, alpine meadow, temperate meadow was at anintermediate level. Regarding the impact of the duration and intensity of climate events on vegetationecosystem stability for the same grassland type, the resilience of desert steppe during drought was mainlyaffected by the duration. In contrast, the impact of intensity was not significant. However, alpine steppewas mainly affected by intensity in wet environments, and duration had no significant impact. Ourconclusions can provide decision support for the future grassland ecosystem governance.
文摘BACKGROUND Remimazolam is characterized by rapid action and inactive metabolites.It is used as the general anesthetic for many clinical surgeries.In this study,we performed a meta-analysis to evaluate whether remimazolam is superior to propofol for gastroenteroscopy in older patients.AIM To compare the adverse events and efficacy of remimazolam and propofol during gastroenteroscopy in older adults.METHODS The PubMed,Web of Science,the Cochrane Library databases were queried for the relevant key words"remimazolam,""and propofol,""and gastrointestinal endoscopy or gastroscopy."The search scope was"Title and Abstract,"and the search was limited to human studies and publications in English.Seven studies wherein remimazolam and propofol were compared were included for the metaanalysis.RESULTS We selected seven randomized controlled trials involving 1445 cases for the analysis.Remimazolam reduced the hypotension(relative risk,RR=0.44,95%CI:0.29-0.66,P=0.000),respiratory depression(RR=0.46,95%CI:0.30-0.70,P=0.000),injection pain(RR=0.12,95%CI:0.05-0.25,P=0.000),bradycardia(RR=0.37,95%CI:0.24-0.58,P=0.000),and time to discharge[weighted mean difference(WMD)=-0.58,95%CI:-0.97 to-0.18,P=0.005],compared to those after propofol administration.No obvious differences were observed for postoperative nausea and vomiting(RR=1.09,95%CI:0.97-1.24,P=0.151),dizziness(RR=0.77,95%CI:0.43-1.36,P=0.361),successful sedation rate(RR=0.96,95%CI:0.93-1.00,P=0.083),or the time to become fully alert(WMD=0.00,95%CI:-1.08-1.08,P=0.998).CONCLUSION Remimazolam appears to be safer than propofol for gastroenteroscopy in older adults.However,further studies are required to confirm these findings.
基金supported by the National Natural Science Foundation of China(Grant Nos.41830965 and 41905112)the Key Program of the Ministry of Science and Technology of the People’s Republic of China(Grant No.2019YFC0214703)+2 种基金the Hubei Natural Science Foundation(Grant No.2022CFB027)supported by the State Key Laboratory of Atmospheric Boundary Layer Physics and Atmospheric Chemistry(Grant No.LAPC-KF-2023-07)the Key Laboratory of Atmospheric Chemistry,China Meteorological Administration(Grant No.2023B08).
文摘Fine particulate matter(PM_(2.5))and ozone(O_(3))double high pollution(DHP)events have occurred frequently over China in recent years,but their causes are not completely clear.In this study,the spatiotemporal distribution of DHP events in China during 2013–20 is analyzed.The synoptic types affecting DHP events are identified with the Lamb–Jenkinson circulation classification method.The meteorological and chemical causes of DHP events controlled by the main synoptic types are further investigated.Results show that DHP events(1655 in total for China during 2013–20)mainly occur over the North China Plain,Yangtze River Delta,Pearl River Delta,Sichuan Basin,and Central China.The occurrence frequency increases by 5.1%during 2013–15,and then decreases by 56.1%during 2015–20.The main circulation types of DHP events are“cyclone”and“anticyclone”,accounting for over 40%of all DHP events over five main polluted regions in China,followed by southerly or easterly flat airflow types,like“southeast”,“southwest”,and“east”.Compared with non-DHP events,DHP events are characterized by static or weak wind,high temperature(20.9℃ versus 23.1℃)and low humidity(70.0%versus 64.9%).The diurnal cycles of meteorological conditions cause PM_(2.5)(0300–1200 LST,Local Standard Time=UTC+8 hours)and O_(3)(1500–2100 LST)to exceed the national standards at different periods of the DHP day.Three pollutant conversion indices further indicate the rapid secondary conversions during DHP events,and thus the concentrations of NO_(2),SO_(2) and volatile organic compounds decrease by 13.1%,4.7%and 4.4%,respectively.The results of this study can be informative for future decisions on the management of DHP events.
文摘The Centre for China and Globalisation(CCG)hosted a side event on February 17 titled"China,Europe,and the United States:Climate Cooperation in an Era of Great Power Politics"at the Munich Security Conference(MSC)2024,which was convened from February 16 to 18,2024 in Munich,Germany.
文摘BACKGROUND Intravenous infusion is a common method of drug administration in clinical practice.Errors in any aspect of the infusion process,from the verification of medical orders,preparation of the drug solution,to infusion by nursing staff,may cause adverse infusion events.AIM To analyzed the value of improving nursing measures and enhancing nursing management to reduce the occurrence of adverse events in pediatric infusion.METHODS The clinical data of 130 children who received an infusion in the pediatric department of our hospital from May 2020 to May 2021 were analyzed and divided into two groups according to the differences in nursing measures and nursing management:65 patients in the control group received conventional nursing and nursing management interventions,while 65 patients in the observation group received improved nursing measure interventions and enhanced nursing management.The occurrence of adverse events,compliance of children,satisfaction of children’s families,and complaints regarding the transfusion treatment were recorded in both groups.RESULTS The incidence of fluid extravasation and infusion set dislodgement in the observation group were 3.08%and 1.54%,respectively,which were significantly lower than 12.31%and 13.85%in the control group(P<0.05),while repeated punctures and medication addition errors in the observation group were 3.08%and 0.00%,respectively,which were lower than 9.23%and 3.08%in the control group,but there was no significant difference(P>0.05).The compliance rate of children in the observation group was 98.46%(64/65),which was significantly higher than 87.69%(57/65)in the control group,and the satisfaction rate of children’s families was 96.92%(63/65),which was significantly higher than 86.15%(56/65)in the control group(P<0.05).The observation group did not receive any complaints from the child’s family,whereas the control group received four complaints,two of which were due to the crying of the child caused by repeated punctures,one due to the poor attitude of the nurse,and one due to medication addition errors,with a cumulative complaint rate of 6.15%.The cumulative complaint rate of the observation group was significantly lower than that of the control group(P<0.05).CONCLUSION Improving nursing measures and enhancing nursing management can reduce the incidence of fluid extravasation and infusion set dislodgement in pediatric patients,improve children’s compliance and satisfaction of their families,and reduce family complaints.
文摘Objective: To investigate the impact of excellent event management in improving patient safety and nursing staff care satisfaction. Methods: The study was analyzed by retrospective comparison, and routine management from January 2022 to December 2022 was set as the control group, and excellent event management from January 2023 to January 2024 was set as the study group. The differences in nursing outcomes between both groups were compared. Results: The rate of adverse events in the study group (0.61%) was lower than that in the control group (0.96%), and the rate of excellent events in the study group (2.57%) was higher than that in the control group (0.97%) (P < 0.05). Meanwhile, the satisfaction level of nursing safety in the study group reached 98.81%, which was much higher than in the control group (92.21%) (P < 0.05). Conclusion: Nursing excellent event management had a positive impact on improving patient care safety satisfaction, reducing the rate of adverse events, and increasing the rate of reporting excellent events.
基金supported by the National Natural Science Foundation of China [grant number 41991281]the National Key R&D Program of China [grant number 2018YFA0606403]the National Natural Science Foundation of China [grant number 41790472]。
基金funded by the Fujian Province Science and Technology Plan,China(Grant Number 2019H0017).
文摘Accurate forecasting of time series is crucial across various domains.Many prediction tasks rely on effectively segmenting,matching,and time series data alignment.For instance,regardless of time series with the same granularity,segmenting them into different granularity events can effectively mitigate the impact of varying time scales on prediction accuracy.However,these events of varying granularity frequently intersect with each other,which may possess unequal durations.Even minor differences can result in significant errors when matching time series with future trends.Besides,directly using matched events but unaligned events as state vectors in machine learning-based prediction models can lead to insufficient prediction accuracy.Therefore,this paper proposes a short-term forecasting method for time series based on a multi-granularity event,MGE-SP(multi-granularity event-based short-termprediction).First,amethodological framework for MGE-SP established guides the implementation steps.The framework consists of three key steps,including multi-granularity event matching based on the LTF(latest time first)strategy,multi-granularity event alignment using a piecewise aggregate approximation based on the compression ratio,and a short-term prediction model based on XGBoost.The data from a nationwide online car-hailing service in China ensures the method’s reliability.The average RMSE(root mean square error)and MAE(mean absolute error)of the proposed method are 3.204 and 2.360,lower than the respective values of 4.056 and 3.101 obtained using theARIMA(autoregressive integratedmoving average)method,as well as the values of 4.278 and 2.994 obtained using k-means-SVR(support vector regression)method.The other experiment is conducted on stock data froma public data set.The proposed method achieved an average RMSE and MAE of 0.836 and 0.696,lower than the respective values of 1.019 and 0.844 obtained using the ARIMA method,as well as the values of 1.350 and 1.172 obtained using the k-means-SVR method.
基金supported by the National Key Research and Development Project(Grant No.2018YFC0603700)research grants from the China Geological Survey(Grant Nos.DD20230408,DD20190011,DD20191011 and DD20221824)+1 种基金the Fundamental Research Funds from the Chinese Academy of Geological Sciences(Grant No.JKY202011)the Key Laboratory of Airborne Geophysics and Remote Sensing Geology Ministry of Natural Resources(Grant No.2023YFL23)。
文摘The Tianshan range,a Paleozoic orogenic belt in Central Asia,has undergone multiple phases of tectonic activities characterized by the N-S compression after the early Mesozoic,including the far-field effects of the Cenozoic Indian-Asian collision.However,there are limited reports on the tectonic deformation and initiation of Triassic intracontinental deformation in the Tianshan range.Understanding this structural context is crucial for interpreting the early intracontinental deformation history of the Eurasian continent during the early Mesozoic.Growth strata and syn-tectonic sediments provide a rich source of information on tectonic activities and have been extensively used in the studies of orogenic belts.Based on detail fieldwork conducted in this study,the middle-late Triassic Kelamayi Formation of the northern Kuqa Depression in the southern Tianshan fold-thrust belt has been identified as the typical syn-tectonic growth strata.The youngest detrital zircon component in two lithic sandstone samples from the bottom and top of the Kelamayi growth strata yielded U-Pb ages of 223.4±3.1 and 215.5±2.9 Ma,respectively,indicating that the maximum depositional age of the bottom and top of the Kelamayi growth strata is 226-220 and 218-212 Ma.The geochronological distribution of detrital samples from the Early-Middle Triassic and Late Triassic revealed abrupt changes,suggesting a new source supply resulting from tectonic activation in the Tianshan range.The coupling relationship between the syn-tectonic sedimentation of the Kelamayi Formation and the South Tianshan fold-thrust system provides robust evidence that the Triassic intracontinental deformation of the South Tianshan range began at approximately 226-220 Ma(during the Late Triassic)and ended at approximately 218-212 Ma.These findings provide crucial constraints for understanding the intraplate deformation in the Tianshan range during the Triassic.
文摘The SHRP2 Naturalistic Driving Study was used to evaluate the impact of various work zone and driver characteristics on back of queue safety critical events (crash, near-crash, or conflicts) The model included 43 SCE and 209 “normal” events which were used as controls. The traces included representing 209 unique drivers. A Mixed-Effects Logistic Regression model was developed with probability of a SCE as the response variable and driver and work zone characteristics as predictor variables. The final model indicated glances over 1 second away from the driving task and following closely increased risk of an SCE by 3.8 times and 2.9 times, respectively. Average speed was negatively correlated to crash risk. This is counterintuitive since in most cases, it is expected that higher speeds are related to back of queue crashes. However, most queues form under congested conditions. As a result, vehicles encountering a back of queue would be more likely to be traveling at lower speeds.
文摘The Newton’s theory of universal gravitation is generalized. Significantly strong at short distances central interaction of bodies and particles is established in comparison with Newtonian. A connection is found with Black Holes, with the horizon of events. Possibility of systematization of all Black Holes is shown. An illustration is given on the example of Black Hole S<sub>gr</sub>A*.
基金supported by the National Key Research and Development Program of China (Grant No. 2018YFC1505602)the National Natural Science Foundation of China (Grant No. 41705055)+2 种基金the Graduate Innovation Project of Jiangsu Province (Grant No. CXZZ11_0485)the Creative Teams of Jiangsu Qinglan Projectthe Priority Academic Program Development of Jiangsu Higher Education Institutions (PAPD)
文摘We investigate the characteristics and mechanisms of persistent wet–cold events(PWCEs)with different types of coldair paths.Results show that the cumulative single-station frequency of the PWCEs in the western part of South China is higher than that in the eastern part.The pattern of single-station frequency of the PWCEs are“Yangtze River(YR)uniform”and“east–west inverse”.The YR uniform pattern is the dominant mode,so we focus on this pattern.The cold-air paths for PWCEs of the YR uniform pattern are divided into three types—namely,the west,northwest and north types—among which the west type accounts for the largest proportion.The differences in atmospheric circulation of the PWCEs under the three types of paths are obvious.The thermal inversion layer in the lower troposphere is favorable for precipitation during the PWCEs.The positive water vapor budget for the three types of PWCEs mainly appears at the southern boundary.
基金supported by the National Research Foundation of Korea(NRF)grant funded by the Korean government Ministry of Science and ICT(NRF-2021R1G1A101056711)。
文摘BACKGROUND:The accelerated diagnostic protocol(ADP)using the Emergency Department Assessment of Chest pain Score(EDACS-ADP),a tool to identify patients at low risk of a major adverse cardiac event(MACE)among patients presenting with chest pain to the emergency department,was developed using a contemporary troponin assay.This study was performed to validate and compare the performance of the EDACS-ADP incorporating high-sensitivity cardiac troponin I between patients who had a 30-day MACE with and without unstable angina(MACE I and II,respectively).METHODS:A single-center prospective observational study of adult patients presenting with chest pain suggestive of acute coronary syndrome was performed.The performance of EDACS-ADP in predicting MACE was assessed by calculating the sensitivity and negative predictive value.RESULTS:Of the 1,304 patients prospectively enrolled,399(30.6%;95%confidence interval[95%CI]:27.7%–33.8%)were considered low-risk using the EDACS-ADP.Among them,the rates of MACE I and II were 1.3%(5/399)and 1.0%(4/399),respectively.The EDACS-ADP showed sensitivities and negative predictive values of 98.8%(95%CI:97.2%–99.6%)and 98.7%(95%CI:97.0%–99.5%)for MACE I and 98.7%(95%CI:96.8%–99.7%)and 99.0%(95%CI:97.4%–99.6%)for MACE II,respectively.CONCLUSION:EDACS-ADP could help identify patients as safe for early discharge.However,when unstable angina was added to the outcome,the 30-day MACE rate among the designated lowrisk patients remained above the level acceptable for early discharge without further evaluation.
基金This study was reviewed and approved by the Ethics Committee of Zhongshan People’s Hospital(Approval No.2022-029).
文摘BACKGROUND The advent of cutting-edge systemic therapies has driven advances in the treatment of hepatocellular carcinoma(HCC),and therapeutic strategies with multiple modes of delivery have been shown to be more efficacious than mono-therapy.However,the mechanisms underlying this innovative treatment modality have not been elucidated.AIM To evaluate the clinical efficacy of targeted therapy plus immunotherapy combined with hepatic arterial infusion chemotherapy(HAIC)of FOLFOX in patients with unresectable HCC.METHODS We enrolled 53 patients with unresectable HCC who received a combination of targeted therapy,immunotherapy,and HAIC of FOLFOX between December 2020 and June 2021 and assessed the efficacy and safety of the treatment regimen.RESULTS The objective response rate was 60.4%(32/53),complete response was 24.5%(13/53),partial response was 35.9%(19/53),and stable disease was 39.6%(21/53).The median duration of response and median progression-free survival were 9.1 and 13.9 months,respectively.The surgical conversion rate was 34.0%(18/53),and 1-year overall survival was 83.0%without critical complicating diseases or adverse events(AEs).CONCLUSION The regimen of HAIC of FOLFOX,targeted therapy,and immunotherapy was curative for patients with unresectable HCC,with no serious AEs and a high rate of surgical conversion.
文摘We conducted a comprehensive review of existing prediction models pertaining to the efficacy of immune-checkpoint inhibitor(ICI)and the occurrence of immune-related adverse events(irAEs).The predictive potential of neutrophil-to-lymphocyte ratio(NLR)and platelet-to-lymphocyte ratio(PLR)in determining ICI effectiveness has been extensively investigated,while limited research has been conducted on predicting irAEs.Furthermore,the combined model incor-porating NLR and PLR,either with each other or in conjunction with additional markers such as carcinoembryonic antigen,exhibits superior predictive capabilities compared to individual markers alone.NLR and PLR are promising markers for clinical applications.Forthcoming models ought to incorporate established efficacious models and newly identified ones,thereby constituting a multifactor composite model.Furthermore,efforts should be made to explore effective clinical application approaches that enhance the predictive accuracy and efficiency.
基金partially supported by the Strategic Priority Research Program of Chinese Academy of Science(No.XDB 34030000)the National Natural Science Foundation of China(Nos.11975293 and 12205348)。
文摘The High-energy Fragment Separator(HFRS),which is currently under construction,is a leading international radioactive beam device.Multiple sets of position-sensitive twin time projection chamber(TPC)detectors are distributed on HFRS for particle identification and beam monitoring.The twin TPCs'readout electronics system operates in a trigger-less mode due to its high counting rate,leading to a challenge of handling large amounts of data.To address this problem,we introduced an event-building algorithm.This algorithm employs a hierarchical processing strategy to compress data during transmission and aggregation.In addition,it reconstructs twin TPCs'events online and stores only the reconstructed particle information,which significantly reduces the burden on data transmission and storage resources.Simulation studies demonstrated that the algorithm accurately matches twin TPCs'events and reduces more than 98%of the data volume at a counting rate of 500 kHz/channel.
基金Supported by Special Project for Improving Science and Technology Innovation Ability of Army Medical University,No.2022XLC09.
文摘BACKGROUND The incidence of chronic kidney disease among patients with diabetes mellitus(DM)remains a global concern.Long-term obesity is known to possibly influence the development of type 2 diabetes mellitus.However,no previous meta-analysis has assessed the effects of body mass index(BMI)on adverse kidney events in patients with DM.AIM To determine the impact of BMI on adverse kidney events in patients with DM.METHODS A systematic literature search was performed on the PubMed,ISI Web of Science,Scopus,Ovid,Google Scholar,EMBASE,and BMJ databases.We included trials with the following characteristics:(1)Type of study:Prospective,retrospective,randomized,and non-randomized in design;(2)participants:Restricted to patients with DM aged≥18 years;(3)intervention:No intervention;and(4)kidney adverse events:Onset of diabetic kidney disease[estimated glomerular filtration rate(eGFR)of<60 mL/min/1.73 m2 and/or microalbuminuria value of≥30 mg/g Cr],serum creatinine increase of more than double the baseline or end-stage renal disease(eGFR<15 mL/min/1.73 m2 or dialysis),or death.RESULTS Overall,11 studies involving 801 patients with DM were included.High BMI(≥25 kg/m2)was significantly associated with higher blood pressure(BP)[systolic BP by 0.20,95%confidence interval(CI):0.15–0.25,P<0.00001;diastolic BP by 0.21 mmHg,95%CI:0.04–0.37,P=0.010],serum albumin,triglycerides[standard mean difference(SMD)=0.35,95%CI:0.29–0.41,P<0.00001],low-density lipoprotein(SMD=0.12,95%CI:0.04–0.20,P=0.030),and lower high-density lipoprotein(SMD=–0.36,95%CI:–0.51 to–0.21,P<0.00001)in patients with DM compared with those with low BMIs(<25 kg/m2).Our analysis showed that high BMI was associated with a higher risk ratio of adverse kidney events than low BMI(RR:1.22,95%CI:1.01–1.43,P=0.036).CONCLUSION The present analysis suggested that high BMI was a risk factor for adverse kidney events in patients with DM.
基金funded by the National Natural Science Foundation of China(42171145,42171147)the Gansu Provincial Science and Technology Program(22ZD6FA005)the Key Talent Program of Gansu Province.
文摘Rain-on-snow(ROS)events involve rainfall on snow surfaces,and the occurrence of ROS events can exacerbate water scarcity and ecosystem vulnerability in the arid region of Northwest China(ARNC).In this study,using daily snow depth data and daily meteorological data from 68 meteorological stations provided by the China Meteorological Administration National Meteorological Information Centre,we investigated the spatiotemporal variability of ROS events in the ARNC from 1978 to 2015 and examined the factors affecting these events and possible changes of future ROS events in the ARNC.The results showed that ROS events in the ARNC mainly occurred from October to May of the following year and were largely distributed in the Qilian Mountains,Tianshan Mountains,Ili River Valley,Tacheng Prefecture,and Altay Prefecture,with the Ili River Valley,Tacheng City,and Altay Mountains exhibiting the most occurrences.Based on the intensity of ROS events,the areas with the highest risk of flooding resulting from ROS events in the ARNC were the Tianshan Mountains,Ili River Valley,Tacheng City,and Altay Mountains.The number and intensity of ROS events in the ARNC largely increased from 1978 to 2015,mainly influenced by air temperature and the number of rainfall days.However,due to the snowpack abundance in areas experiencing frequent ROS events in the ARNC,snowpack changes exerted slight impact on ROS events,which is a temporary phenomenon.Furthermore,elevation imposed lesser impact on ROS events in the ARNC than other factors.In the ARNC,the start time of rainfall and the end time of snowpack gradually advanced from the spring of the current year to the winter of the previous year,while the end time of rainfall and the start time of snowpack gradually delayed from autumn to winter.This may lead to more ROS events in winter in the future.These results could provide a sound basis for managing water resources and mitigating related disasters caused by ROS events in the ARNC.
文摘BACKGROUND Acute nonvariceal upper gastrointestinal bleeding(ANVUGIB)is a frequent lifethreatening acute condition in gastroenterology associated with high morbidity and mortality.Over-the-scope-clip(OTSC)is a new endoscopic hemostasis technique,which is being used in ANVUGIB and is more effective.AIM To summarize and analyze the effects of the OTSC in prevention of recurrent bleeding,clinical success rate,procedure time,hospital stay,and adverse events in the treatment of ANVUGIB,to evaluate whether OTSC can replace standard endoscopic therapy as a new generation of treatment for ANVUGIB.METHODS The literature related to OTSC and standard therapy for ANVUGIB published before January 2023 was searched in PubMed,Web of Science,EMBASE,Cochrane,Google,and CNKI databases.Changes in recurrent bleeding(7 or 30 days),clinical results(clinical success rate,conversion rate to surgery,mortality),therapy time(procedure time,hospital stay),and adverse events in the OTSC intervention group were summarized and analyzed,and the MD or OR of 95%CI is calculated by Review Manager 5.3.RESULTS This meta-analysis involved 11 studies with 1266 patients.Total risk of bias was moderate-to-high.For patients in the OTSC group,7-and 30-days recurrent bleeding rates,as well as procedure time,hospital stay,and intensive care unit stay,were greatly inhibited.OTSC could significantly improve the clinical success rate of ANVUGIB.OTSC therapy did not cause serious adverse and was effective in reducing patient mortality.CONCLUSION OTSC may provide more rapid and sustained hemostasis,and thus,promote recovery and reduce mortality in patients with ANVUGIB.In addition,the safety of OTSC is assured.