Topographic effects observed at Amatrice hill during the 2016-2017 Central Italy seismic sequence

The estimate of seismic site effects by experimental approaches is based on different assumptions aimed at simplifying the complex actual site conditions and related uncertainties.However,the reliability of the results can increase if the experimental data is focused on quite strong seismic sequences and the on-site acquisition of a large number of signals is deemed strategic for the assessment of the expected phenomena.Based on these considerations,the ground motion at the Red Zone sector of Amatrice hill,violently struck by the 2016-2017 Central Italy seismic sequence,was analyzed via an observational approach.A large set of weak motions(moment magnitude Mw 2.5-3.9)was analyzed in this study by means of standard(SSR)and horizontal to vertical(HVSR)spectral ratio techniques.The results from the experimental analysis of the site effects by using weak motion and noise signals show a significant amplification at the top of Amatrice hill with a remarkable polarization of the motion and changes in spectral shapes according to the topographic setting of the relief.

The five major autoimmune diseases increase the risk of cancer:epidemiological data froma large-scale cohort study in China

Background:Cancer incidence and mortality have received critical attention during the long-term management of morbidities in patients with autoimmune diseases(AIDs).This study aimed to investigate and compare the risk of cancer associated with five major AIDs in a large-scale Chinese cohort.Methods:A total of 8,120 AID patients consecutively admitted to a national tertiary referral center in China were included and followed-up for 38,726.55 patient-years,including those with systemic lupus erythematosus(SLE),rheumatoid arthritis(RA),Sjoren’s syndrome(SS),systemic scleroderma(SSc),and idiopathic inflammatory myositis(IIM).Demographic data,cancer incidence,predilecting sites and cancer onset time were recorded and compared among the five AIDs.Results:Four hundred and thirty(5.3%)patients developed cancer.Their median agewas 57.5 years and AID durationwas 79.8 months.The estimated total standardized incidence ratio(SIR)of cancer in AIDs patients was 3.37,with the highest SIR observed in IIM(4.31),followed by RA(3.99),SSc(3.77),SS(2.88)and SLE(2.58).The increased SIR of cancers in AID patients showed a female predominance(female vs.male:3.59 vs.2.77)and younger patient involvement(age<50 vs.≥50 years:4.88 vs.3.04).Patientswith SLE had increased SIRs for developing hematologic malignancies and solid tumors located in the urinary bladder,corpus uteri and cervix uteri.Patients with SS had a significantly high SIR for developing non-Hodgkin’s lymphoma.Within 3 years of IIM diagnosis,74.6%of the patients developed cancer and they had a high risk of ovarian cancer.RA was associated with a wide distribution of scancers,including non-Hodgkin’s lymphoma,gynecologic,urinary tract,thyroid gland and lung cancers.SSc patients had increased SIRs for developing cervical uterine,lung,and breast cancers.Conclusion:Patients with five major AIDs in China had an increased risk of developing cancer,with a predominance in women and younger patients,although cancer incidence,predilection sites and cancer onset time may vary greatly in each AID entity.

Performance of Simplified Acute Physiology Score 3 in Predicting Hospital Mortality in Emergency Intensive Care Unit

Background： Since the 1980s, severity of illness scoring systems has gained increasing popularity in Intensive Care Units （ICUs）. Physicians used them for predicting mortality and assessing illness severity in clinical trials. The objective of this study was to assess the performance of Simplified Acute Physiology Score 3 （SAPS 3） and its customized equation for Australasia （Australasia SAPS 3, SAPS 3 [AUS]） in predicting clinical prognosis and hospital mortality in emergency ICU （EICU）. Methods： A retrospective analysis of the EICU including 463 patients was conducted between January 2013 and December 2015 in the EICU of Peking University Third Hospital. The worst physiological data of enrolled patients were collected within 24 h after admission to calculate SAPS 3 score and predicted mortality by regression equation. Discrimination between survivals and deaths was assessed by the area under the receiver operator characteristic curve （AUC）. Calibration was evaluated by Hosmer-Lemeshow goodness-of fit test through calculating the ratio of observed-to-expected numbers of deaths which is known as the standardized mortality ratio （SMR）. Results： A total of 463 patients were enrolled in the study, and the observed hospital mortality was 26.1% （121/463）. The patients enrolled were divided into survivors and nonsurvivors. Age, SAPS 3 score, Acute Physiology and Chronic Health Evaluation Score 11 （APACHE 11）, and predicted mortality were significantly higher in nonsurvivors than survivors （P 〈 0.05 or P 〈 0.01 ）. The AUC （95% confidence intervals [C/s]） for SAPS 3 score was 0.836 （0.796-0.876）. The maximum of Youden＇s index, cutoff, sensitivity, and specificity of SAPS 3 score were 0.526%, 70.5 points, 66.9%, and 85.7%, respectively. The Hosmer-Lemeshow goodness-of-fit test for SAPS 3 demonstrated a Chi-square test score of 10.25, P = 0.33, SMR （95% CI） = 0.63 （0.52 0.76）. The Hosmer-Lemeshow goodness-of fit test tbr SAPS 3 （AUS） demonstrated a Chi-square test score of 9.55, P 0.38, SMR （95% CI） 0.68 （0.57-0.81）. Univariate and multivariate analyses were conducted for biochemical variables that were probably correlated to prognosis. Eventually, blood urea nitrogen （BUN）, albumin,lactate and free triiodothyronine （FT3） were selected as independent risk factors for predicting prognosis. Conclusions： The SAPS 3 score system exhibited satisfactory performance even superior to APACHE 11 in discrimination. In predicting hospital mortality, SAPS 3 did not exhibit good calibration and overestimated hospital mortality, which demonstrated that SAPS 3 needs improvement in the future.