Accessibility is a factor affecting national park visitation.However,the effect of accessibility on national park visitation is not fully understood.This paper examines the relationship between U.S.national park visit...Accessibility is a factor affecting national park visitation.However,the effect of accessibility on national park visitation is not fully understood.This paper examines the relationship between U.S.national park visitation and accessibility.First,the global and local accessibility indexes of each park unit are computed based on an accessibility model that takes into account the surrounding population and its proximity to the park unit.Integrated in the model is a distance decay coefficient that is derived from U.S.national park visitor surveys and therefore pertinent to the case of study.Then correlation analysis is performed between park visitation and accessibility based on park types,regions,and visitation types.Results show that total visitation is positively related to accessibility in National Memorials,Military Parks and Battlefield Parks/Sites but negatively related to accessibility in national parks and national monuments.However,recreational overnight stay visits are commonly negatively correlated to accessibility for almost all park types.Moreover,local accessibility index displays enhanced correlation coefficients with improved significance levels in many categories of analysis.Results suggest that historical/cultural national parks which often show positive correlations tend to attract more local visitors,but nature-based parks which mainly show negative correlations tend to attract more distant visitors.展开更多
In the big forest countries, there is an actual challenge of accessing the forests for their resources, operational wildfire management, and economic estimations for various purposes. In Russia, there are two ways to ...In the big forest countries, there is an actual challenge of accessing the forests for their resources, operational wildfire management, and economic estimations for various purposes. In Russia, there are two ways to access the forests: by air and by ground means. The first way is quite expensive for any country. The second one is less expensive but has the spatial planning challenges to create access routes by existing public roads and forest glades. Regional authorities and firefighting departments are paying attention to the access by ground means, but there is a certain room to improve their management and cooperation methods on a limited budget. These tasks could be solved by GIS-technologies in a more operational manner to automate the routes’ construction especially during the fire season. We used combined geoinformation technology (developed previously) and satellite product, namely vegetation map from Moderate Resolution Imaging Spectroradiometer (MODIS) to estimate how accessible any forest area is when moving by public roads and forest glades from a fire station as a starting point. These stations are the main centers to fight the forest fires within the territory of ground protection zones in Russia and we have considered them as the logistic centers to manage the forest resources also. Transport model was created in two variants: no-barriers and barriers-based (forestries). By using these two models we have shown two different scenarios of action. The key area was Novosibirsk Region located in the Siberian Federal District, Russia. We have created a series of maps to show the transport accessibility of forest areas from the fire stations. Estimation of “located” pixels or forest areas accessible from the fire stations for the key area is about 66% - 83%;the most accessible forest type is mixed forests. The number of inaccessible pixels has been increased by more than two times in barriers scenario. Technology can be used for different thematic data sources and domains like ecology or economy.展开更多
With the explosive growth of highspeed wireless data demand and the number of mobile devices, fog radio access networks(F-RAN) with multi-layer network structure becomes a hot topic in recent research. Meanwhile, due ...With the explosive growth of highspeed wireless data demand and the number of mobile devices, fog radio access networks(F-RAN) with multi-layer network structure becomes a hot topic in recent research. Meanwhile, due to the rapid growth of mobile communication traffic, high cost and the scarcity of wireless resources, it is especially important to develop an efficient radio resource management mechanism. In this paper, we focus on the shortcomings of resource waste, and we consider the actual situation of base station dynamic coverage and user requirements. We propose a spectrum pricing and allocation scheme based on Stackelberg game model under F-RAN framework, realizing the allocation of resource on demand. This scheme studies the double game between the users and the operators, as well as between the traditional operators and the virtual operators, maximizing the profits of the operators. At the same time, spectrum reuse technology is adopted to improve the utilization of network resource. By analyzing the simulation results, it is verified that our proposed scheme can not only avoid resource waste, but also effectively improve the operator's revenue efficiency and overall network resource utilization.展开更多
The core module of China’s Space Station(CSS)is scheduled to be launched around the end of 2020,and the experimental module I and II will be launched in the next two years.After on-orbit constructions,CSS will be tra...The core module of China’s Space Station(CSS)is scheduled to be launched around the end of 2020,and the experimental module I and II will be launched in the next two years.After on-orbit constructions,CSS will be transferred into an operation period over 10 years(2022–2032 and beyond)to continuously implement space science missions.At present,based on the project selection and research work in the ground development period of CSS,China is systematically making a utilization mission planning for the operation period,which focuses on the fields of aerospace medicine and human research,space life science and biotechnology,microgravity fluid physics,combustion science,materials science,fundamental physics,space astronomy and astrophysics,Earth science,space physics and space environment,space application technology,etc.In combination with the latest development trend of space science and technology,China will continue to update planning for science research and technology development,carry out project cultivation,payload R&D,and upgrade onboard and ground experiment supporting systems to achieve greater comprehensive benefits in science,technology,economy,and society。展开更多
China scheduled to complete the assembly of the T-shaped Tiangong Space Station in 2022,and will enter a new stage of utilization.There are more than 20 experiment racks inside the modules,and more than 50 external on...China scheduled to complete the assembly of the T-shaped Tiangong Space Station in 2022,and will enter a new stage of utilization.There are more than 20 experiment racks inside the modules,and more than 50 external onboard payloads mounting spaces,which will support large-scale science and technology experiments during the operation.The development of internal experiment racks and external research accommodations approved during the construction has been completed,of which 4 racks in Tianhe core module,including High Microgravity Level research Rack(HMLR)and Container-less Materials Processing Rack(CMPR),have finished on-orbit tests;while other racks in Wentian and Mengtian experiment modules are under comprehensive ground tests.The Chinese Space Survey Telescope(CSST)has advanced much in the last two years with 24 pre-launch research projects funded and 4 joint science center built in preparation for CSST’s future scientific observations and operations.The systematic research planning for China’s Space Station(CSS)during 2022-2032 is updated with the researches classified into four important areas:space life sciences and human research,microgravity physical sciences,space astronomy and Earth science,and new space technologies and applications.According to the planning,more than 1000 experiments are expected to perform in CSS during the operating period.Overall,the CSS utilization missions are proceeding as planned,which will contribute to the major scientific or application output and have a positive impact on the quality of life on Earth.展开更多
The mode serials of the Earth’s free oscillation provide some important information on the Earth’s deep structure and superconducting gravimeters (SG) can investigate the phenomena of the Earth’s free oscillation...The mode serials of the Earth’s free oscillation provide some important information on the Earth’s deep structure and superconducting gravimeters (SG) can investigate the phenomena of the Earth’s free oscillations with high accuracy. The great Sumatra-Andaman earthquake fully excited the Earth’s free oscillations and these signals were perfectly recorded by five superconducting gravimeters in the globe. After the pre-treatment and spectral analysis on the SG observation data, we obtained the experimented mode serials of the Earth’s free oscillations consisting of 147 modes with GGP station data. These observed modes were themselves some new important data for the study of the Earth’s deep structure. On the basis of the discussions on some checked inner-core-sensitive modes, we distinguished three layers from the inner core, and the boundary of the upper layer was compatible with the formerly known transition zone in the inner core based on seismic body waves and supported that there were the hemispherical variation and very lower shear velocity zone in the lower inner core.展开更多
BACKGROUND Emergency situations in inflammatory bowel diseases(IBD)put significant burden on both the patient and the healthcare system.AIM To prospectively measure Quality-of-Care indicators and resource utilization ...BACKGROUND Emergency situations in inflammatory bowel diseases(IBD)put significant burden on both the patient and the healthcare system.AIM To prospectively measure Quality-of-Care indicators and resource utilization after the implementation of the new rapid access clinic service(RAC)at a tertiary IBD center.METHODS Patient access,resource utilization and outcome parameters were collected from consecutive patients contacting the RAC between July 2017 and March 2019 in this observational study.For comparing resource utilization and healthcare costs,emergency department(ED)visits of IBD patients with no access to RAC services were evaluated between January 2018 and January 2019.Time to appointment,diagnostic methods,change in medical therapy,unplanned ED visits,hospitalizations and surgical admissions were calculated and compared.RESULTS 488 patients(Crohn’s disease:68.4%/ulcerative colitis:31.6%)contacted the RAC with a valid medical reason.Median time to visit with an IBD specialist following the index contact was 2 d.Patients had objective clinical and laboratory assessment(C-reactive protein and fecal calprotectin in 91%and 73%).Fast-track colonoscopy/sigmoidoscopy was performed in 24.6%of the patients,while computed tomography/magnetic resonance imaging in only 8.1%.Medical therapy was changed in 54.4%.ED visits within 30 d following the RAC visit occurred in 8.8%(unplanned ED visit rate:5.9%).Diagnostic procedures and resource utilization at the ED(n=135 patients)were substantially different compared to RAC users:Abdominal computed tomography was more frequent(65.7%,P<0.001),coupled with multiple specialist consults,more frequent hospital admission(P<0.001),higher steroid initiation(P<0.001).Average medical cost estimates of diagnostic procedures and services per patient was$403 CAD vs$1885 CAD comparing all RAC and ED visits.CONCLUSION Implementation of a RAC improved patient care by facilitating easier access to IBD specific medical care,optimized resource utilization and helped avoiding ED visits and subsequent hospitalizations.展开更多
Understanding the composition and contents of carotenoids in various soybean seed accessions is important for their nutritional assessment.This study investigated the variability in the concentrations of carotenoids a...Understanding the composition and contents of carotenoids in various soybean seed accessions is important for their nutritional assessment.This study investigated the variability in the concentrations of carotenoids and chlorophylls and revealed their associations with other nutritional quality traits in a genetically diverse set of Chinese soybean accessions comprised of cultivars and landraces.Genotype,planting year,accession type,seed cotyledon color,and ecoregion of origin significantly influenced the accumulation of carotenoids and chlorophylls.The mean total carotenoid content was in the range of 8.15–14.72μg g–1 across the ecoregions.The total carotenoid content was 1.2-fold higher in the landraces than in the cultivars.Soybeans with green cotyledons had higher contents of carotenoids and chlorophylls than those with yellow cotyledons.Remarkably,lutein was the most abundant carotenoid in all the germplasms,ranging from 1.35–37.44μg g–1.Carotenoids and chlorophylls showed significant correlations with other quality traits,which will help to set breeding strategies for enhancing soybean carotenoids without affecting the other components.Collectively,our results demonstrate that carotenoids are adequately accumulated in soybean seeds,however,they are strongly influenced by genetic factors,accession type,and germplasm origin.We identified novel germplasms with the highest total carotenoid contents across the various ecoregions of China that could serve as the genetic materials for soybean carotenoid breeding programs,and thereby as the raw materials for food sectors,pharmaceuticals,and the cosmetic industry.展开更多
Alzheimer's disease(AD):AD,a neurodegenerative disorder and a significant cause of dementia throughout the world mostly affects the older adults but sometimes also seen in young age(early state AD)(Agrawal et a...Alzheimer's disease(AD):AD,a neurodegenerative disorder and a significant cause of dementia throughout the world mostly affects the older adults but sometimes also seen in young age(early state AD)(Agrawal et al.,2017).展开更多
The Ministerial Conference Decision of 10 NOV.2001 Having regard to paragraph 2 of Article Ⅻ and paragraph 1 of Article Ⅸ of the Marrakesh Agreement Establishing the World Trade Organization, and the Decision—Makin...The Ministerial Conference Decision of 10 NOV.2001 Having regard to paragraph 2 of Article Ⅻ and paragraph 1 of Article Ⅸ of the Marrakesh Agreement Establishing the World Trade Organization, and the Decision—Making Procedures under Articles Ⅸ and Ⅻ of the Marrakesh Agreement Establishing the World Trade Organization agreed by the General Council (WT/L/93). Taking note of the application 0f the People's Republic of China for accession to the Marrakesh Agreement Establishing the World Trade Organiza-展开更多
BACKGROUND Atrial fibrillation(AF)is one of the most common arrhythmias,and radiofrequency catheter ablation is the most effective treatment strategy.The inferior vena cava(IVC)is a common approach for radiofrequency ...BACKGROUND Atrial fibrillation(AF)is one of the most common arrhythmias,and radiofrequency catheter ablation is the most effective treatment strategy.The inferior vena cava(IVC)is a common approach for radiofrequency ablation of AF.However,this approach may not be applied to some cases such as chronic venous occlusions,surgical ligation of the IVC,and heterotaxy syndrome(HS).CASE SUMMARY A 68-year-old man with HS suffered from severely symptomatic persistent AF for 9 years,and we successfully ablated by percutaneous transhepatic access.CONCLUSION In patients without femoral vein access,the use of the hepatic vein for pulmonary vein isolation is a viable alternative for invasive electrophysiology procedures.展开更多
Objective: Nationwide dissemination of public-access defibrillation (PAD) contributed to an increase of survival rate in Japan. We analysed cardiac arrests (CAs) that occurred in railroad stations in Tokyo to evaluate...Objective: Nationwide dissemination of public-access defibrillation (PAD) contributed to an increase of survival rate in Japan. We analysed cardiac arrests (CAs) that occurred in railroad stations in Tokyo to evaluate PAD in the metropolis. Methods: We collected Utstein data from the Tokyo Fire Department (TFD) and analysed CA cases that occurred in stations. In total, 245 non-traumatic CAs from January 1, 2007 to March 31, 2008 were analysed;CAs in children under 8 years were excluded. Results: The rates of pre-hospital return of spontaneous circulation (ROSC) were 41 out of 145 witnessed CA patients (28.3%) and 12 ROSC out of 100 unwitnessed CA patients (12%). Of 245 CA cases, bystander cardiopulmonary resuscitation (CPR) performed in 156 (63.7%), automated external defibrillator (AED) used in 117 (47.8%) and shock delivered in 65 (26.5%). Rates of ROSC were 31.6% (37/117) with AED use significantly higher than those of 12.5% (16/128) without AED use (P < 0.001). Most CAs occurred on platforms;the use of AEDs on platforms increased from 18/31 (58.1%) in 2007 to 32/43 (74.4%) in 2008 and ROSC rates increased from 8 (25.8%) to 14 (32.6%), respectively. On train CAs: ROSC cases were very few, 1 case each year (8.3%;7.7%) while the use of AED increased from 8/12 (66.7%) in 2007 to 10/13 (76.9%) in 2008. Conclusion: Bystander CPR and the use of AED at railroad stations improved ROSC for out-of-hospital cardiac arrest (OHCA) patients. AED location and strategies for dealing with CAs on trains should be re-evaluated.展开更多
基金supported by the National Nature Science Foundation of China (Grant No. 41401604)the Central Universities Fund Project of Southwest Minzu University (Grant No. 2019SYB07)
文摘Accessibility is a factor affecting national park visitation.However,the effect of accessibility on national park visitation is not fully understood.This paper examines the relationship between U.S.national park visitation and accessibility.First,the global and local accessibility indexes of each park unit are computed based on an accessibility model that takes into account the surrounding population and its proximity to the park unit.Integrated in the model is a distance decay coefficient that is derived from U.S.national park visitor surveys and therefore pertinent to the case of study.Then correlation analysis is performed between park visitation and accessibility based on park types,regions,and visitation types.Results show that total visitation is positively related to accessibility in National Memorials,Military Parks and Battlefield Parks/Sites but negatively related to accessibility in national parks and national monuments.However,recreational overnight stay visits are commonly negatively correlated to accessibility for almost all park types.Moreover,local accessibility index displays enhanced correlation coefficients with improved significance levels in many categories of analysis.Results suggest that historical/cultural national parks which often show positive correlations tend to attract more local visitors,but nature-based parks which mainly show negative correlations tend to attract more distant visitors.
文摘In the big forest countries, there is an actual challenge of accessing the forests for their resources, operational wildfire management, and economic estimations for various purposes. In Russia, there are two ways to access the forests: by air and by ground means. The first way is quite expensive for any country. The second one is less expensive but has the spatial planning challenges to create access routes by existing public roads and forest glades. Regional authorities and firefighting departments are paying attention to the access by ground means, but there is a certain room to improve their management and cooperation methods on a limited budget. These tasks could be solved by GIS-technologies in a more operational manner to automate the routes’ construction especially during the fire season. We used combined geoinformation technology (developed previously) and satellite product, namely vegetation map from Moderate Resolution Imaging Spectroradiometer (MODIS) to estimate how accessible any forest area is when moving by public roads and forest glades from a fire station as a starting point. These stations are the main centers to fight the forest fires within the territory of ground protection zones in Russia and we have considered them as the logistic centers to manage the forest resources also. Transport model was created in two variants: no-barriers and barriers-based (forestries). By using these two models we have shown two different scenarios of action. The key area was Novosibirsk Region located in the Siberian Federal District, Russia. We have created a series of maps to show the transport accessibility of forest areas from the fire stations. Estimation of “located” pixels or forest areas accessible from the fire stations for the key area is about 66% - 83%;the most accessible forest type is mixed forests. The number of inaccessible pixels has been increased by more than two times in barriers scenario. Technology can be used for different thematic data sources and domains like ecology or economy.
基金supported in part by the National Natural Science Foundation of China (61771120)the Fundamental Research Funds for the Central Universities (N171602002)
文摘With the explosive growth of highspeed wireless data demand and the number of mobile devices, fog radio access networks(F-RAN) with multi-layer network structure becomes a hot topic in recent research. Meanwhile, due to the rapid growth of mobile communication traffic, high cost and the scarcity of wireless resources, it is especially important to develop an efficient radio resource management mechanism. In this paper, we focus on the shortcomings of resource waste, and we consider the actual situation of base station dynamic coverage and user requirements. We propose a spectrum pricing and allocation scheme based on Stackelberg game model under F-RAN framework, realizing the allocation of resource on demand. This scheme studies the double game between the users and the operators, as well as between the traditional operators and the virtual operators, maximizing the profits of the operators. At the same time, spectrum reuse technology is adopted to improve the utilization of network resource. By analyzing the simulation results, it is verified that our proposed scheme can not only avoid resource waste, but also effectively improve the operator's revenue efficiency and overall network resource utilization.
文摘The core module of China’s Space Station(CSS)is scheduled to be launched around the end of 2020,and the experimental module I and II will be launched in the next two years.After on-orbit constructions,CSS will be transferred into an operation period over 10 years(2022–2032 and beyond)to continuously implement space science missions.At present,based on the project selection and research work in the ground development period of CSS,China is systematically making a utilization mission planning for the operation period,which focuses on the fields of aerospace medicine and human research,space life science and biotechnology,microgravity fluid physics,combustion science,materials science,fundamental physics,space astronomy and astrophysics,Earth science,space physics and space environment,space application technology,etc.In combination with the latest development trend of space science and technology,China will continue to update planning for science research and technology development,carry out project cultivation,payload R&D,and upgrade onboard and ground experiment supporting systems to achieve greater comprehensive benefits in science,technology,economy,and society。
文摘China scheduled to complete the assembly of the T-shaped Tiangong Space Station in 2022,and will enter a new stage of utilization.There are more than 20 experiment racks inside the modules,and more than 50 external onboard payloads mounting spaces,which will support large-scale science and technology experiments during the operation.The development of internal experiment racks and external research accommodations approved during the construction has been completed,of which 4 racks in Tianhe core module,including High Microgravity Level research Rack(HMLR)and Container-less Materials Processing Rack(CMPR),have finished on-orbit tests;while other racks in Wentian and Mengtian experiment modules are under comprehensive ground tests.The Chinese Space Survey Telescope(CSST)has advanced much in the last two years with 24 pre-launch research projects funded and 4 joint science center built in preparation for CSST’s future scientific observations and operations.The systematic research planning for China’s Space Station(CSS)during 2022-2032 is updated with the researches classified into four important areas:space life sciences and human research,microgravity physical sciences,space astronomy and Earth science,and new space technologies and applications.According to the planning,more than 1000 experiments are expected to perform in CSS during the operating period.Overall,the CSS utilization missions are proceeding as planned,which will contribute to the major scientific or application output and have a positive impact on the quality of life on Earth.
基金supported jointly by the National Natural Science Foundation of China (Nos. 40974046,90814009 and 40730316)the Natural Science Foundation of Hubei Province (No. 2008CDB389)the Knowledge Innovation Project of Chinese Academy of Sciences (No. KZCX2-YW-133)
文摘The mode serials of the Earth’s free oscillation provide some important information on the Earth’s deep structure and superconducting gravimeters (SG) can investigate the phenomena of the Earth’s free oscillations with high accuracy. The great Sumatra-Andaman earthquake fully excited the Earth’s free oscillations and these signals were perfectly recorded by five superconducting gravimeters in the globe. After the pre-treatment and spectral analysis on the SG observation data, we obtained the experimented mode serials of the Earth’s free oscillations consisting of 147 modes with GGP station data. These observed modes were themselves some new important data for the study of the Earth’s deep structure. On the basis of the discussions on some checked inner-core-sensitive modes, we distinguished three layers from the inner core, and the boundary of the upper layer was compatible with the formerly known transition zone in the inner core based on seismic body waves and supported that there were the hemispherical variation and very lower shear velocity zone in the lower inner core.
文摘BACKGROUND Emergency situations in inflammatory bowel diseases(IBD)put significant burden on both the patient and the healthcare system.AIM To prospectively measure Quality-of-Care indicators and resource utilization after the implementation of the new rapid access clinic service(RAC)at a tertiary IBD center.METHODS Patient access,resource utilization and outcome parameters were collected from consecutive patients contacting the RAC between July 2017 and March 2019 in this observational study.For comparing resource utilization and healthcare costs,emergency department(ED)visits of IBD patients with no access to RAC services were evaluated between January 2018 and January 2019.Time to appointment,diagnostic methods,change in medical therapy,unplanned ED visits,hospitalizations and surgical admissions were calculated and compared.RESULTS 488 patients(Crohn’s disease:68.4%/ulcerative colitis:31.6%)contacted the RAC with a valid medical reason.Median time to visit with an IBD specialist following the index contact was 2 d.Patients had objective clinical and laboratory assessment(C-reactive protein and fecal calprotectin in 91%and 73%).Fast-track colonoscopy/sigmoidoscopy was performed in 24.6%of the patients,while computed tomography/magnetic resonance imaging in only 8.1%.Medical therapy was changed in 54.4%.ED visits within 30 d following the RAC visit occurred in 8.8%(unplanned ED visit rate:5.9%).Diagnostic procedures and resource utilization at the ED(n=135 patients)were substantially different compared to RAC users:Abdominal computed tomography was more frequent(65.7%,P<0.001),coupled with multiple specialist consults,more frequent hospital admission(P<0.001),higher steroid initiation(P<0.001).Average medical cost estimates of diagnostic procedures and services per patient was$403 CAD vs$1885 CAD comparing all RAC and ED visits.CONCLUSION Implementation of a RAC improved patient care by facilitating easier access to IBD specific medical care,optimized resource utilization and helped avoiding ED visits and subsequent hospitalizations.
基金financially supported by the National Natural Science Foundation of China(32161143033 and 32001574)the Agricultural Science and Technology Innovation Program of CAAS(2060203-2).
文摘Understanding the composition and contents of carotenoids in various soybean seed accessions is important for their nutritional assessment.This study investigated the variability in the concentrations of carotenoids and chlorophylls and revealed their associations with other nutritional quality traits in a genetically diverse set of Chinese soybean accessions comprised of cultivars and landraces.Genotype,planting year,accession type,seed cotyledon color,and ecoregion of origin significantly influenced the accumulation of carotenoids and chlorophylls.The mean total carotenoid content was in the range of 8.15–14.72μg g–1 across the ecoregions.The total carotenoid content was 1.2-fold higher in the landraces than in the cultivars.Soybeans with green cotyledons had higher contents of carotenoids and chlorophylls than those with yellow cotyledons.Remarkably,lutein was the most abundant carotenoid in all the germplasms,ranging from 1.35–37.44μg g–1.Carotenoids and chlorophylls showed significant correlations with other quality traits,which will help to set breeding strategies for enhancing soybean carotenoids without affecting the other components.Collectively,our results demonstrate that carotenoids are adequately accumulated in soybean seeds,however,they are strongly influenced by genetic factors,accession type,and germplasm origin.We identified novel germplasms with the highest total carotenoid contents across the various ecoregions of China that could serve as the genetic materials for soybean carotenoid breeding programs,and thereby as the raw materials for food sectors,pharmaceuticals,and the cosmetic industry.
文摘Alzheimer's disease(AD):AD,a neurodegenerative disorder and a significant cause of dementia throughout the world mostly affects the older adults but sometimes also seen in young age(early state AD)(Agrawal et al.,2017).
文摘The Ministerial Conference Decision of 10 NOV.2001 Having regard to paragraph 2 of Article Ⅻ and paragraph 1 of Article Ⅸ of the Marrakesh Agreement Establishing the World Trade Organization, and the Decision—Making Procedures under Articles Ⅸ and Ⅻ of the Marrakesh Agreement Establishing the World Trade Organization agreed by the General Council (WT/L/93). Taking note of the application 0f the People's Republic of China for accession to the Marrakesh Agreement Establishing the World Trade Organiza-
基金Supported by Shanxi Provincial Health Commission “Four batch” Science and Technology Innovation Project of Medical Development,No. 2021XM45 (to Dr. Wang HX)Academic promotion plan of Shanxi Cardiovascular Hospital,No. XYS20180102 (to Dr. Wang HX)+1 种基金Natural Science Foundation of Shanxi Province,No. 20210302123346 (to Dr. Wang HX)and Scientific Research Incentive Fund of Shanxi Cardiovascular Hospital,No. XYS20190206 (to Dr. Li N)
文摘BACKGROUND Atrial fibrillation(AF)is one of the most common arrhythmias,and radiofrequency catheter ablation is the most effective treatment strategy.The inferior vena cava(IVC)is a common approach for radiofrequency ablation of AF.However,this approach may not be applied to some cases such as chronic venous occlusions,surgical ligation of the IVC,and heterotaxy syndrome(HS).CASE SUMMARY A 68-year-old man with HS suffered from severely symptomatic persistent AF for 9 years,and we successfully ablated by percutaneous transhepatic access.CONCLUSION In patients without femoral vein access,the use of the hepatic vein for pulmonary vein isolation is a viable alternative for invasive electrophysiology procedures.
文摘Objective: Nationwide dissemination of public-access defibrillation (PAD) contributed to an increase of survival rate in Japan. We analysed cardiac arrests (CAs) that occurred in railroad stations in Tokyo to evaluate PAD in the metropolis. Methods: We collected Utstein data from the Tokyo Fire Department (TFD) and analysed CA cases that occurred in stations. In total, 245 non-traumatic CAs from January 1, 2007 to March 31, 2008 were analysed;CAs in children under 8 years were excluded. Results: The rates of pre-hospital return of spontaneous circulation (ROSC) were 41 out of 145 witnessed CA patients (28.3%) and 12 ROSC out of 100 unwitnessed CA patients (12%). Of 245 CA cases, bystander cardiopulmonary resuscitation (CPR) performed in 156 (63.7%), automated external defibrillator (AED) used in 117 (47.8%) and shock delivered in 65 (26.5%). Rates of ROSC were 31.6% (37/117) with AED use significantly higher than those of 12.5% (16/128) without AED use (P < 0.001). Most CAs occurred on platforms;the use of AEDs on platforms increased from 18/31 (58.1%) in 2007 to 32/43 (74.4%) in 2008 and ROSC rates increased from 8 (25.8%) to 14 (32.6%), respectively. On train CAs: ROSC cases were very few, 1 case each year (8.3%;7.7%) while the use of AED increased from 8/12 (66.7%) in 2007 to 10/13 (76.9%) in 2008. Conclusion: Bystander CPR and the use of AED at railroad stations improved ROSC for out-of-hospital cardiac arrest (OHCA) patients. AED location and strategies for dealing with CAs on trains should be re-evaluated.