Influence of statistical time range on estimating seismicity parameters

The influence of non-uniqueness in selecting statistical time ranges on seismicity parameters of b value and annual mean occurrence rate ν4 is widely analyzed and studied. The studied result states that the influence of statistical time range on the b value is generally smaller than on the annual mean rate. Owing to the exponentially functional relation between the annual mean rate and b value, the variation of b value by varying statistical time range brings about decrease or increase in the annual mean rates of each magnitude interval with power progression law. These results will exert a synthetic effect on seismic safety evaluation results in various regions in our country.

Time in range as a useful marker for evaluating retinal functional changes in diabetic retinopathy patients

·AIM:To elucidate the relationship between macular sensitivity and time in range(TIR)obtained from continuous glucose monitoring(CGM)measures in diabetic patients with or without diabetic retinopathy(DR).·METHODS:This was a cross-sectional study including 100 eyes of non-DR patients and 60 eyes of DR patients.An advanced microperimetry was used to quantitate the retinal mean sensitivity(MS)and fixation stability in central macula.TIR of 3.9-10.0 mmol/L was evaluated with CGM.Pearson coefficient analysis and multiple linear regression analysis were used to assess the correlation between TIR and retinal sensitivity.·RESULTS:In a comparison of non-DR patients,significant differences(P<0.05)were found in Hb A1c,TIR,coefficient of variation(CV),standard deviation of blood glucose(SDBG)and mean amplitude of glucose excursion(MAGE)values in DR patients.Besides,those DR patients had significantly poor best-corrected visual acuity(BCVA,log MAR,P=0.001).In terms of microperimetry parameters,retinal mean sensitivity(MS)and the percentages of fixation points located within 2°and 4°diameter circles were significantly decreased in the DR group(P<0.001,P<0.001,P=0.02,respectively).The bivariate contour ellipse area(BCEA)encompassing 68.2%,95.4%,99.6%of fixation points were all significantly increased in the DR group(P=0.01,P=0.006,P=0.01,respectively).Correlation analysis showed that MS were significantly correlated with Hb A1c(P=0.01).TIR was positively correlated with MS(r=0.23,P=0.01).SDBG was negatively correlated with MS(r=-0.24,P=0.01)but there was no correlation between CV and MAGE with MS(P>0.05).A multivariable linear regression analysis was performed to prove that TIR and SDBG were both independent risk factors for MS reduction in the DR group.·CONCLUSION:TIR is correlated with retinal MS reduction in DR patients,suggesting a useful option for evaluating DR progression.

Time range of Mesozoic tectonic regime inversion in eastern North China Block

An important tectonic inversion took place in eastern North China Block(NCB) during Mesozoic, which caused a great lithosphere thinning, reconstruction of basin-range series, powerful interaction between mantle and crust, a vast granitic intrusion and volcanism, and large-scale metallogenic explosion. The time range of the Mesozoic tectonic regime inversion in the eastern North China Block is one of the key issues to understand mechanism of tectonic regime inversion. Our updated results for recognizing the time range are mainly obtained from the following aspects: structural analyses along northern and southern margins of the NCB and within the NCB for revealing tectonic inversion from compression to extension and structural striking from ~EW to NNE; geothermic analyses of the eastern sedimental basins for a great change of thermal history and regime; basin analysis for basin inversion from compression to extension and basin migration from ~EW to NNE; petrological and geochemical studies of volcanic rocks and lowermost crust xenoliths for recognizing peak period of mantle upwelling and intense interaction between mantle and crust, and main metallogenic epoch. All the studies of the above give the same time range from~150-140 Ma to ~110-100Ma, peaking at ~120 Ma.

Continuous glucose monitoring defined time-in-range is associated with sudomotor dysfunction in type 2 diabetes

BACKGROUND Time in range(TIR),as a novel metric for glycemic control,has robust relevance with diabetic complications.Diabetic peripheral neuropathy(DPN)is characterized by sudomotor dysfunction.AIM To explore the relationship between TIR obtained from continuous glucose monitoring(CGM)and sudomotor function detected by SUDOSCAN in subjects with type 2 diabetes.METHODS The research enrolled 466 inpatients with type 2 diabetes.All subjects underwent 3-d CGM and SUDOSCAN.SUDOSCAN was assessed with electrochemical skin conductance in hands(HESC)and feet(FESC).Average feet ESC<60μS was defined as sudomotor dysfunction(+),otherwise it was sudomotor dysfunction(-).TIR refers to the percentage of time when blood glucose is between 3.9-10 mmol/L during 1 d period.RESULTS Among the enrolled subjects,135(28.97%)presented with sudomotor dysfunction.Patients with sudomotor dysfunction(+)showed a decreased level of TIR(P<0.001).Compared to the lowest tertile of TIR,the middle and the highest tertiles of TIR was associated with an obviously lower prevalence of sudomotor dysfunction(20.51%and 21.94%vs 44.52%)(P<0.001).In addition,with the increase of TIR,HESC and FESC increased(P<0.001).Regression analysis demonstrated that TIR was inversely and independently linked with the prevalence of sudomotor dysfunction after adjusting for confounding values(odds ratio=0.979,95%CI:0.971-0.987,P<0.001).CONCLUSION The tight glycemic control assessed by TIR is of vitally protective value for sudomotor dysfunction in type 2 diabetes mellitus.

Patients’time in therapeutic range on warfarin among atrial fibrillation patients in Warfarin Medication Therapy Adherence Clinic

BACKGROUND The quality of warfarin therapy can be determined by the time in the therapeutic range(TTR)of international normalized ratio(INR).The estimated minimum TTR needed to achieve a benefit from warfarin therapy is≥60%.AIM To determine TTR and the predictors of poor TTR among atrial fibrillation patients who receive warfarin therapy.METHODS A retrospective observational study was conducted at a cardiology referral center in Selangor,Malaysia.A total of 420 patients with atrial fibrillation and under follow-up at the pharmacist led Warfarin Medication Therapeutic Adherence Clinic between January 2014 and December 2018 were included.Patients’clinical data,information related to warfarin therapy,and INR readings were traced through electronic Hospital Information system.A data collection form was used for data collection.The percentage of days when INR was within range was calculated using the Rosendaal method.The poor INR control category was defined as a TTR<60%.Predictors for poor TTR were further determined by using logistic regression.RESULTS A total of 420 patients[54.0%male;mean age 65.7(10.9)years]were included.The calculated mean and median TTR were 60.6%±20.6%and 64%(interquartile range 48%-75%),respectively.Of the included patients,57.6%(n=242)were in the good control category and 42.4%(n=178)were in the poor control category.The annual calculated mean TTR between the year 2014 and 2018 ranged from 59.7%and 67.3%.A high HAS-BLED score of≥3 was associated with poor TTR(adjusted odds ratio,2.525;95%confidence interval:1.6-3.9,P<0.001).CONCLUSION In our population,a high HAS-BLED score was associated with poor TTR.This could provide an important insight when initiating an oral anticoagulant for these patients.Patients with a high HAS-BLED score may obtain less benefit from warfarin therapy and should be considered for other available oral anticoagulants for maximum benefit.

The Use of Standardized Reporting and Time-in-Range in the Management of Diabetes: A Consensus Report

Introduction: The exhaustion of healthcare resources due to the rising prevalence in Saudi Arabia mandates the search for each method that can help in better control of diabetes. Methods: The gathered task force gath-ered to develop an explicit, evidence-based consensus for the use of time-in-range targets as guidance for better glycemic control while using continuous glucose monitoring (CGM). This article has the recommenda-tions of this expert panel. Results: HbA1c and self-monitoring blood glu-cose (SMBG) are not enough to detect blood glucose (BG) fluctuations on a daily basis. The incorporation of technology like FreeStyle Libre with its applications like Libre View is now used in many institutes in Saudi Ara-bia. This system is comprehensive and has all the standardized metrics needed. However, training and support are always needed. Barriers and challenges include the awareness & experience of the technology, the time barrier, the patients’ barriers, the technical barriers, and of course, the availability barrier. All the barriers and challenges should be dealt with by designing new training programs. Conclusion: The expert panel recom-mended using CGMs technology in people with type 1 diabetes (T1DM) children and adults, type 2 diabetes (T2DM) on multiple insulin injections, gestational diabetes (GDM) who need further glycemic control, and those at high risk for hypoglycemia. In addition, we recommend using them for a short period for those who require intensive BG control or during acute illness or stress. In addition, Ambulatory Glucose Profile (AGP) could be used as an educational tool for any individuals with DM to study the im-pact of certain elements of lifestyle modifications on their immediate BG level.

Elderly Disabled Patients in Oral Anticoagulation Treatment: An Evaluation of a Bioanalyst-Led Management Program Reaching an Average of 72% of Time in Therapeutic Range

Introduction: The need for anticoagulation therapy increases with age, mainly due to the increased prevalence of atrial fibrillation. Time in therapeutic range (TTR) is a marker of the quality of the therapy as TTR is inversely correlated with adverse reactions. We developed a bioanalyst-led management program for control of warfarin treatment in elderly disabled patients in their own home and maintain a high TTR. Material and Methods: Residents in nursing home settings were included. Visiting nurses measured INR with a point of care testing device. If INR was within Therapeutic Range (TR), the nurse dosed warfarin unaltered. If INR was out of TR, the visiting nurse contacted a specially trained bioanalyst by phone. An explanation was sought, and a new dosage plan was made. Results: A total of 579 patients were included;356 females (61%). Mean age was 79.6 years. Approximately 10% were residents in nursing home settings and the rest in domiciliary care. TTR was 72%. The subtherapeutic values were 15% and supratherapeutic values 13%. In total, 139 patients died during the study period. Ten deaths could be related to possible side effects of warfarin treatment. Conclusions: Our results indicate that a bioanalyst-led program is able to simplify anticoagulation monitoring, while maintaining INR control similar to a specialized clinic. Furthermore, we avoided hospitalizations when INR was unacceptably high by treating the patient with oral vitamin-K at home. Our findings could be helpful when planning warfarin treatment in elderly, fragile patients.

Association of point in range withβ-cell function and insulin sensitivity of type 2 diabetes mellitus in cold areas

Background and Objective:Self-monitoring of blood glucose(SMBG)is crucial for achieving a glycemic target and upholding blood glucose stability,both of which are the primary purpose of anti-diabetic treatments.However,the association between time in range(TIR),as assessed by SMBG,andβ-cell insulin secretion as well as insulin sensitivity remains unexplored.Therefore,this study aims to investigate the connections between TIR,derived from SMBG,and indices representingβ-cell functionality and insulin sensitivity.The primary objective of this study was to elucidate the relationship between short-term glycemic control(measured as points in range[PIR])and bothβ-cell function and insulin sensitivity.Methods:This cross-sectional study enrolled 472 hospitalized patients with type 2 diabetes mellitus(T2DM).To assessβ-cell secretion capacity,we employed the insulin secretion-sensitivity index-2(ISSI-2)and(ΔC-peptide_(0-120)/Δglucose_(0-120))×Matsuda index,while insulin sensitivity was evaluated using the Matsuda index and HOMA-IR.Since SMBG offers glucose data at specific point-in-time,we substituted TIR with PIR.According to clinical guidelines,values falling within the range of 3.9-10 mmol were considered"in range,"and the corresponding percentage was calculated as PIR.Results:We observed significant associations between higher PIR quartiles and increased ISSI-2,(ΔC-peptide_(0-120)/Δglucose_(0-120))×Matsuda index,Matsuda index(increased)and HOMA-IR(decreased)(all P<0.001).PIR exhibited positive correlations with log ISSI-2(r=0.361,P<0.001),log(ΔC-peptide_(0-120)/Δglucose_(0-120))×Matsuda index(r=0.482,P<0.001),and log Matsuda index(r=0.178,P<0.001)and negative correlations with log HOMA-IR(r=-0.288,P<0.001).Furthermore,PIR emerged as an independent risk factor for log ISSI-2,log(ΔC-peptide_(0-120)/Δglucose_(0-120))×Matsuda index,log Matsuda index,and log HOMA-IR.Conclusion:PIR can serve as a valuable tool for assessingβ-cell function and insulin sensitivity.

Assessment of Oral Anticoagulation with Vitamin K Antagonists in Patients Living in a Low-Income Country of West Africa

Introduction: Despite the rise of direct oral anticoagulants (DOACs), vitamin K antagonists (VKA) remain the most widely used oral anticoagulants in developing countries. The aim of this study was to estimate the prevalence of good anticoagulation in patients treated with VKA in Lomé and describe associated factors. Methods: This was a cross-sectional study conducted from November 2019 to October 2020 in the cardiology departments of two University teaching hospitals in Lomé (CHU Sylvanus Olympio and CHU Campus), involving patients on VKA for ≥3 months, with a target international normalized ratio (INR) of 2.5 and a therapeutic margin between 2 and 3. The quality of anticoagulation was assessed by the time in therapeutic range (TTR) which was assessed by the Rosendaal method. Good anticoagulation was defined by a TTR > 70%. Results: A total of 344 patients were included (mean age = 58 ± 13.8 years, women = 56.1%). Indications for VKA treatment were represented by venous thromboembolic disease (43.3%), supraventricular arrhythmia (28.2%), severe left ventricular systolic dysfunction (19.8%) and pulmonary hypertension (8.7%). The average TTR was 47.6 ± 20.8%. The rate of good anticoagulation was 17.7%. Factors associated with good anticoagulation were the use of fluindione vs acenocoumarol (OR = 11.17;95% CI: 3.2 - 39.6;p = 0.0002), concomitant low-dose aspirin (OR 4.44;95% CI: 1.4 - 13.9;p = 0.01) and INR monitoring exclusively by the patient himself (OR = 4.92;95% CI: 1.5 - 16.3;p = 0.008). The rate of thromboembolic and hemorrhagic complications was each 2.6% and was not correlated with the quality of anticoagulation. Quality of anticoagulation by VKAs was poor in our practice. Factors associated with good anticoagulation were the use of fluindione vs acenocoumarol, concomitant low-dose aspirin and monitoring of INR exclusively by the patient himself. Conclusion: The quality of oral anticoagulation by VKAs could be improved in our practice by the creation of anticoagulation clinics for better therapeutic education of patients and efficient management of VKA dose, and the use of prescription assistance software.

Research progress in the application of time in range: more than a percentage

Glucose monitoring is an important part of medical care in diabetes mellitus,which not only helps assess glycemic control and treatment safety,but also assists with treatment adjustment.With the development of continuous glucose monitoring(CGM),the use of CGM has increased rapidly.With the wealth of glucose data produced by CGM,new metrics are greatly needed to optimally evaluate glucose status and guide the treatment.One of the parameters that CGM provides,time in range(TIR),has been recognized as a key metric by the international consensus.Before the adoption of TIR in clinical practice,several issues including the minimum length of CGM use,the setting of the target range,and individualized TIR goals are summarized.Additionally,we discussed the mounting evidence supporting the association between TIR and diabetes-related outcomes.As a novel glucose metric,it is of interest to compare TIR with other conventional glucose markers such as glycated hemoglobin A1c.It is anticipated that the use of TIR may provide further information on the quality of glucose control and lead to improved diabetes management.

Research into polymer injection timing for Bohai heavy oil reservoirs

Polymer flooding has been proven to effectively improve oil recovery in the Bohai Oil Field. However, due to high oil viscosity and significant formation heterogeneity, it is necessary to further improve the displacement effectiveness of polymer flooding in heavy oil reservoirs in the service life of offshore platforms. In this paper, the effects of the water/oil mobility ratio in heavy oil reservoirs and the dimensionless oil productivity index on polymer flooding effectiveness were studied utilizing rel- ative permeability curves. The results showed that when the water saturation was less than the value, where the water/oil mobility ratio was equal to 1, polymer flooding could effectively control the increase of fractional water flow, which meant that the upper limit of water/oil ratio suitable for polymer flooding should be the value when the water/oil mobility ratio was equal to 1. Mean while, by injecting a certain volume of water to create water channels in the reservoir, the polymer flooding would be the most effective in improving sweep efficiency, and lower the fractional flow of water to the value corresponding to △Jmax. Considering the service life of the platform and the polymer mobility control capacity, the best polymer injection timing for heavy oil reservoirs was optimized. It has been tested for reservoirs with crude oil viscosity of 123 and 70 mPa s, the optimum polymer flooding effec- tiveness could be obtained when the polymer floods were initiated at the time when the fractional flow of water were 10 % and 25 %, respectively. The injection timing range for polymer flooding was also theoretically analyzed for the Bohai Oil Field utilizing which provided methods for effectiveness. relative permeability curves, improving polymer flooding

Negative association of time in range and urinary albumin excretion rate in patients with type 2 diabetes mellitus:a retrospective study of inpatients

Background:Time in range(TIR)refers to the time an individual spends within their target glucose range,which now has been popularized as an important metric to classify glycemic management and also recognized as an important outcome of current diabetes therapies.This study aimed to investigate the association between TIR and the severity of the urinary albumin excretion rate(UAER)in patients with type 2 diabetes mellitus(T2DM).Methods:We retrospectively analyzed the data of 1014 inpatients with T2DM at the Department of Endocrinology and Metabolism of Peking University International Hospital,China.TIR was defined as the percentage of blood glucose within the target range of 3.90-10.00 mmol/L.Urine samples for assessment of UAER were collected for 3 consecutive days from the start of hospitalization.Results:The TIR values for patients with normal urine levels of albumin,microalbuminuria,and macroalbuminuria were 70%±20%,50%±20%,and 30%±20%,respectively(allP<0.001).The patients were stratified according to quartiles of TIR as follows:quartile(Q)1,<55%;Q2,55%-72%;Q3,73%-83%;and Q4,>83%.The incidences of microalbuminuria in Q1,Q2,Q3,and Q4 were 41.1%,21.6%,7.1%,and 5.5%(allP<0.001),respectively.The respective incidences of macroalbuminuria were 24.2%,1.1%,1.4%,and 0%(allP<0.001).In multinomial logistic regression analyses,TIR was significantly correlated with microalbuminuria(odds ratio[OR]0.58,95%confidence interval[CI]:0.52-0.65,P<0.001)and macroalbuminuria(OR 0.26,95%CI:0.18-0.38,P<0.001)after adjusting for age,sex,body mass index,diabetes duration,systolic blood pressure,and levels of triglycerides,glycosylated hemoglobin A1c,and creatinine.Conclusion:The proportion of blood glucose in TIR is closely related to the severity of UAER in patients with T2DM.

Relationship between time in range and corneal nerve fiber loss in asymptomatic patients with type 2 diabetes

Background: Corneal confocal microscopy (CCM) is a noninvasive technique to detect early nerve damage of diabetic sensorimotor polyneuropathy (DSPN). Time in range (TIR) is an emerging metric of glycemic control which was reported to be associated with diabetic complications. We sought to explore the relationship between TIR and corneal nerve parameters in asymptomatic patients with type 2 diabetes (T2DM).Methods: In this cross-sectional study, 206 asymptomatic inpatients with T2DM were recruited. After 7 days of continuous glucose monitoring, the TIR was calculated as the percentage of time in the glucose range of 3.9 to 10.0 mmol/L. CCM was performed to determine corneal nerve fiber density, corneal nerve branch density, and corneal nerve fiber length (CNFL). Abnormal CNFL was defined as ≤15.30 mm/mm2.Results: Abnormal CNFL was found in 30.6% (63/206) of asymptomatic subjects. Linear regression analyses revealed that TIR was positively correlated with CCM parameters both in the crude and adjusted models (all P< 0.05). Each 10% increase in TIR was associated with a 28.2% (95% CI: 0.595–0.866,P = 0.001) decreased risk of abnormal CNFL after adjusting for covariates. With the increase of TIR quartiles, corneal nerve fiber parameters increased significantly (allP for trend <0.01). The receiver operating characteristic curve indicated that the optimal cutoff point of TIR was 77.5% for predicting abnormal CNFL in asymptomatic patients.Conclusions: There is a significant independent correlation between TIR and corneal nerve fiber loss in asymptomatic T2DM patients. TIR may be a useful surrogate marker for early diagnosis of DSPN.

Association between time in range and cancer mortality among patients with type 2 diabetes:a prospective cohort study

Background:Little was known about the association among time in range(TIR),time above range(TAR),time below range(TBR),and cancer mortality among patients with type 2 diabetes.We aimed to investigate the association among TIR,TAR,TBR,and the risk of cancer mortality among patients with type 2 diabetes.Methods:A total of 6225 patients with type 2 diabetes were prospectively recruited in Shanghai,China.TIR was measured with continuous glucose monitoring at baseline and was defined as the average percentage of time in the target glucose range during a 24 h period.Cox proportion hazard regression analysis was used to determine the association between TIR and the risk of cancer mortality.Results:During a mean follow-up of 7.10 years,we confirmed 237 death events related to cancer.The multivariable-adjusted hazard ratio(HR)for cancer mortality was 1.32(95%confidence interval[CI]:1.01-1.75)in patients with TIR≤70%compared with those with TIR>70%.When TIR was considered as a continuous variable,the multivariable-adjusted HR for cancer mortality associated with each 10%decrease in TIR was 1.07(95%CI:1.02-1.14).In the site-specific analysis,a significant association between TIR as a continuous variable and the risk of hepatocellular cancer was found(HR:1.24;95%CI:1.09-1.41).However,no relationship between hemoglobin A1c and cancer mortality was observed(HR:1.04;95%CI:0.97-1.10).Conclusions:The present study found an inverse association of TIR with the risk of cancer mortality among patients with type 2 diabetes.New evidence of TIR was added into the clinical practice that TIR may be an optimal target of glycemic control among patients with type 2 diabetes.

A New Independent GPS-Free System for Geo-Referencing from Space

A new system’s geo-referencing from space is entirely free from any GNSS (GPS or equivalent) systems. The system addresses to various strategic and economic applications such as in remote clock synchronism, aircraft and balloon navigation, missile and smart bombs tracking, satellite orbital determination and remote target geo-positioning. The new geometry concept corresponds to an “inverted GPS” configuration, utilizing four ground-based reference stations, synchronized in time, installed at well known geodesic coordinates and a repeater in space, carried by an aircraft, balloon, satellite, etc. Signal transmitted by one of the reference bases is retransmitted by the transponder, received back by the four bases, producing four ranging measurements which are corrected for the time delays undergone in every retransmission. A minimization function was derived to compare the repeater’s positions referred to at least two groups of three reference bases, to correct for the signal transit time at the repeater and propagation delays, and consequently to provide the accurate repeater position for each time interaction. Once the repeater’s coordinates are known, the other determinations and applications become straightforward. The system solving algorithm and process performance has been demonstrated by simulations adopting a practical example with the transponder carried by an aircraft moving over bases and a target on the ground. Effects produced by reference clock synchronism uncertainties at the four bases on the measurements are reviewed.