Prognostication of compensated advanced chronic liver disease(cACLD)is of paramount importance for the physician-and-patient communication and for rational clinical decisions.The paper published by Dallio et al report...Prognostication of compensated advanced chronic liver disease(cACLD)is of paramount importance for the physician-and-patient communication and for rational clinical decisions.The paper published by Dallio et al reports on red cell distribution width(RDW)/platelet ratio(RPR)as a non-invasive biomarker in predicting decompensation of metabolic dysfunction-associated steatotic liver disease(MASLD)-related cACLD.Differently from other biomarkers and algorithms,RPR is inexpensive and widely available,based on parameters which are included in a complete blood count.RPR is computed on the grounds of two different items,one of which,RDW,mirrors the host’s response to a variety of disease stimuli and is non-specific.The second parameter involved in RPR,platelet count,is more specific and has been used in the hepatological clinic to discriminate cirrhotic from non-cirrhotic chronic liver disease for decades.Cardiovascular disease is the primary cause of mortality among MASLD subjects,followed by extra-hepatic cancers and liver-related mortality.Therefore,MASLD biomarkers should be validated not only in terms of liver-related events but also in the prediction of major adverse cardiovascular events and cardiovascular mortality and extra-hepatic cancers.Adequately sized multi-ethnic confirmatory investigation is required to define the role and significance of RPR in the stratification of MASLD-cACLD.展开更多
BACKGROUND Rebleeding after recovery from esophagogastric variceal bleeding(EGVB)is a severe complication that is associated with high rates of both incidence and mortality.Despite its clinical importance,recognized p...BACKGROUND Rebleeding after recovery from esophagogastric variceal bleeding(EGVB)is a severe complication that is associated with high rates of both incidence and mortality.Despite its clinical importance,recognized prognostic models that can effectively predict esophagogastric variceal rebleeding in patients with liver cirrhosis are lacking.AIM To construct and externally validate a reliable prognostic model for predicting the occurrence of esophagogastric variceal rebleeding.METHODS This study included 477 EGVB patients across 2 cohorts:The derivation cohort(n=322)and the validation cohort(n=155).The primary outcome was rebleeding events within 1 year.The least absolute shrinkage and selection operator was applied for predictor selection,and multivariate Cox regression analysis was used to construct the prognostic model.Internal validation was performed with bootstrap resampling.We assessed the discrimination,calibration and accuracy of the model,and performed patient risk stratification.RESULTS Six predictors,including albumin and aspartate aminotransferase concentrations,white blood cell count,and the presence of ascites,portal vein thrombosis,and bleeding signs,were selected for the rebleeding event prediction following endoscopic treatment(REPET)model.In predicting rebleeding within 1 year,the REPET model ex-hibited a concordance index of 0.775 and a Brier score of 0.143 in the derivation cohort,alongside 0.862 and 0.127 in the validation cohort.Furthermore,the REPET model revealed a significant difference in rebleeding rates(P<0.01)between low-risk patients and intermediate-to high-risk patients in both cohorts.CONCLUSION We constructed and validated a new prognostic model for variceal rebleeding with excellent predictive per-formance,which will improve the clinical management of rebleeding in EGVB patients.展开更多
BACKGROUND Minimally invasive esophagectomy(MIE)is a widely accepted treatment for esophageal cancer,yet it is associated with a significant risk of surgical adverse events(SAEs),which can compromise patient recovery ...BACKGROUND Minimally invasive esophagectomy(MIE)is a widely accepted treatment for esophageal cancer,yet it is associated with a significant risk of surgical adverse events(SAEs),which can compromise patient recovery and long-term survival.Accurate preoperative identification of high-risk patients is critical for improving outcomes.AIM To establish and validate a risk prediction and stratification model for the risk of SAEs in patients with MIE.METHODS This retrospective study included 747 patients who underwent MIE at two centers from January 2019 to February 2024.Patients were separated into a train set(n=549)and a validation set(n=198).After screening by least absolute shrinkage and selection operator regression,multivariate logistic regression analyzed clinical and intraoperative variables to identify independent risk factors for SAEs.A risk stratification model was constructed and validated to predict the probability of SAEs.RESULTS SAEs occurred in 10.2%of patients in train set and 13.6%in the validation set.Patients with SAE had significantly higher complication rate and a longer hospital stay after surgery.The key independent risk factors identified included chronic obstructive pulmonary disease,a history of alcohol consumption,low forced expiratory volume in the first second,and low albumin levels.The stratification model has excellent prediction accuracy,with an area under the curve of 0.889 for the training set and an area under the curve of 0.793 for the validation set.CONCLUSION The developed risk stratification model effectively predicts the risk of SAEs in patients undergoing MIE,facilitating targeted preoperative interventions and improving perioperative management.展开更多
Patients admitted with prediabetes and atrial fibrillation are at high risk for major adverse cardiac or cerebrovascular events independent of confounding variables.The shared pathophysiology between these three serio...Patients admitted with prediabetes and atrial fibrillation are at high risk for major adverse cardiac or cerebrovascular events independent of confounding variables.The shared pathophysiology between these three serious but common diseases and their association with atherosclerotic cardiovascular risk factors establish a vicious circle culminating in high atherogenicity.Because of that,it is of paramount importance to perform risk stratification of patients with prediabetes to define phenotypes that benefit from various interventions.Furthermore,stress hyperglycemia assessment of hospitalized patients and consensus on the definition of prediabetes is vital.The roles lifestyle and metformin play in prediabetes are well established.However,the role of glucagon-like peptide agonists and metabolic surgery is less clear.Prediabetes is considered an intermediate between normoglycemia and diabetes along the blood glucose continuum.One billion people are expected to suffer from prediabetes by the year 2045.Therefore,realworld randomized controlled trials to assess major adverse cardiac or cerebrovascular event risk reduction and reversal/prevention of type 2 diabetes among patients are needed to determine the proper interventions.展开更多
Unmet needs exist in metabolic dysfunction-associated steatotic liver disease(MASLD)risk stratification.Our ability to identify patients with MASLD with advanced fibrosis and at higher risk for adverse outcomes is sti...Unmet needs exist in metabolic dysfunction-associated steatotic liver disease(MASLD)risk stratification.Our ability to identify patients with MASLD with advanced fibrosis and at higher risk for adverse outcomes is still limited.Incorporating novel biomarkers could represent a meaningful improvement to current risk predictors.With this aim,omics technologies have revolutionized the process of MASLD biomarker discovery over the past decades.While the research in this field is thriving,much of the publication has been haphazard,often using single-omics data and specimen sets of convenience,with many identified candidate biomarkers but lacking clinical validation and utility.If we incorporate these biomarkers to direct patients’management,it should be considered that the roadmap for translating a newly discovered omics-based signature to an actual,analytically valid test useful in MASLD clinical practice is rigorous and,therefore,not easily accomplished.This article presents an overview of this area’s current state,the conceivable opportunities and challenges of omics-based laboratory diagnostics,and a roadmap for improving MASLD biomarker research.展开更多
Objective: Patients with radioactive iodine-refractory differentiated thyroid cancer(RAIR-DTC) are often diagnosed with delay and constrained to limited treatment options. The correlation between RAI refractoriness an...Objective: Patients with radioactive iodine-refractory differentiated thyroid cancer(RAIR-DTC) are often diagnosed with delay and constrained to limited treatment options. The correlation between RAI refractoriness and the underlying genetic characteristics has not been extensively studied.Methods: Adult patients with distant metastatic DTC were enrolled and assigned to undergo next-generation sequencing of a customized 26-gene panel(Thyro Lead). Patients were classified into RAIR-DTC or non-RAIR groups to determine the differences in clinicopathological and molecular characteristics. Molecular risk stratification(MRS) was constructed based on the association between molecular alterations identified and RAI refractoriness, and the results were classified as high, intermediate or low MRS.Results: A total of 220 patients with distant metastases were included, 63.2% of whom were identified as RAIRDTC. Genetic alterations were identified in 90% of all the patients, with BRAF(59.7% vs. 17.3%), TERT promoter(43.9% vs. 7.4%), and TP53 mutations(11.5% vs. 3.7%) being more prevalent in the RAIR-DTC group than in the non-RAIR group, except for RET fusions(15.8% vs. 39.5%), which had the opposite pattern. BRAF and TERT promoter are independent predictors of RAIR-DTC, accounting for 67.6% of patients with RAIR-DTC. MRS was strongly associated with RAI refractoriness(P<0.001), with an odds ratio(OR) of high to low MRS of 7.52 [95%confidence interval(95% CI), 3.96-14.28;P<0.001] and an OR of intermediate to low MRS of 3.20(95% CI,1.01-10.14;P=0.041).Conclusions: Molecular alterations were associated with RAI refractoriness, with BRAF and TERT promoter mutations being the predominant contributors, followed by TP53 and DICER1 mutations. MRS might serve as a valuable tool for both prognosticating clinical outcomes and directing precision-based therapeutic interventions.展开更多
The global physical and biogeochemical environment has been substantially altered in response to increased atmospheric greenhouse gases from human activities.In 2023,the sea surface temperature(SST)and upper 2000 m oc...The global physical and biogeochemical environment has been substantially altered in response to increased atmospheric greenhouse gases from human activities.In 2023,the sea surface temperature(SST)and upper 2000 m ocean heat content(OHC)reached record highs.The 0–2000 m OHC in 2023 exceeded that of 2022 by 15±10 ZJ(1 Zetta Joules=1021 Joules)(updated IAP/CAS data);9±5 ZJ(NCEI/NOAA data).The Tropical Atlantic Ocean,the Mediterranean Sea,and southern oceans recorded their highest OHC observed since the 1950s.Associated with the onset of a strong El Niño,the global SST reached its record high in 2023 with an annual mean of~0.23℃ higher than 2022 and an astounding>0.3℃ above 2022 values for the second half of 2023.The density stratification and spatial temperature inhomogeneity indexes reached their highest values in 2023.展开更多
The deformation in sedimentary rock induced by train loads has potential threat to the safe operation of tunnels. This study investigated the influence of stratification structure on the infrared radiation and tempora...The deformation in sedimentary rock induced by train loads has potential threat to the safe operation of tunnels. This study investigated the influence of stratification structure on the infrared radiation and temporal damage mechanism of hard siltstone. The uniaxial compression tests, coupled with acoustic emission(AE) and infrared radiation temperature(IRT) were conducted on siltstones with different stratification effects. The results revealed that the stratigraphic structure significantly affects the stress-strain response and strength degradation characteristics. The mechanical parameters exhibit anisotropy characteristics, and the stratification effect exhibits a negative correlation with the cracking stress and peak stress. The failure modes caused by the stratification effect show remarkable anisotropic features, including splitting failure(Ⅰ: 0°-22.50°, Ⅱ: 90°), composite failure(45°), and shearing failure(67.50°). The AE temporal sequences demonstrate a stepwise response characteristic to the loading stress level. The AE intensity indicates that the stress sensitivity of shearing failure and composite failure is generally greater than that of splitting failure. The IRT field has spatiotemporal migration and progressive dissimilation with stress loading and its dissimilation degree increases under higher stress levels. The stronger the stratification effect, the greater the dissimilation degree of the IRT field. The abnormal characteristic points of average infrared radiation temperature(AIRT) variance at local stress drop and peak stress can be used as early and late precursors to identify fracture instability. Theoretical analysis shows that the competitive relationship between compaction strengthening and fracturing damage intensifies the dissimilation of the infrared thermal field for an increasing stress level. The present study provides a theoretical reference for disaster warnings in hard sedimentary rock mass.展开更多
BACKGROUND Cirrhotic patients with acute-on-chronic liver failure(ACLF)in the intensive care unit(ICU)have a poor but variable prognoses.Accurate prognosis evaluation can guide the rational management of patients with...BACKGROUND Cirrhotic patients with acute-on-chronic liver failure(ACLF)in the intensive care unit(ICU)have a poor but variable prognoses.Accurate prognosis evaluation can guide the rational management of patients with ACLF.However,existing prognostic scores for ACLF in the ICU environment lack sufficient accuracy.AIM To develop a new prognostic model for patients with ACLF in ICU.METHODS Data from 938 ACLF patients in the Medical Information Mart for Intensive Care(MIMIC)database were used to develop a new prognostic model(MIMIC ACLF)for ACLF.Discrimination,calibration and clinical utility of MIMIC ACLF were assessed by area under receiver operating characteristic curve(AUROC),calibration curve and decision curve analysis(DCA),respectively.MIMIC ACLF was then externally validated in a multiple-center cohort,the Electronic Intensive Care Collaborative Research Database and a single-center cohort from the Second Hospital of Hebei Medical University in China.RESULTS The MIMIC ACLF score was determined using nine variables:ln(age)×2.2+ln(white blood cell count)×0.22-ln(mean arterial pressure)×2.7+respiratory failure×0.6+renal failure×0.51+cerebral failure×0.31+ln(total bilirubin)×0.44+ln(internationalized normal ratio)×0.59+ln(serum potassium)×0.59.In MIMIC cohort,the AUROC(0.81/0.79)for MIMIC ACLF for 28/90-day ACLF mortality were significantly greater than those of Chronic Liver Failure Consortium ACLF(0.76/0.74),Model for End-stage Liver Disease(MELD;0.73/0.71)and MELD-Na(0.72/0.70)(all P<0.001).The consistency between actual and predicted 28/90-day survival rates of patients according to MIMIC ACLF score was excellent and superior to that of existing scores.The net benefit of MIMIC ACLF was greater than that achieved using existing scores within the 50%threshold probability.The superior predictive accuracy and clinical utility of MIMIC ACLF were validated in the external cohorts.CONCLUSION We developed and validated a new prognostic model with satisfactory accuracy for cirrhotic patients with ACLF hospitalized in the ICU.The model-based risk stratification and online calculator might facilitate the rational management of patients with ACLF.展开更多
To study the stratified stability of a water column in the North Passage of the Yangtze River Estuary,a numerical model of the hydrodynamics of this estuary is established using the EFDC model.On the basis of EFDC res...To study the stratified stability of a water column in the North Passage of the Yangtze River Estuary,a numerical model of the hydrodynamics of this estuary is established using the EFDC model.On the basis of EFDC results,this paper derives and pro-vides the discriminative index of water body stability caused by salinity and analyzes the along-range variation in water body strati-fication stability in the North Passage of the Yangtze River Estuary and the periodic variation at a key location(bend area)based on the simulation results of the numerical model.This work shows that the water body in the bend area varies between mixed and strati-fied types,and the vertical average flow velocity has a good negative correlation with the differential velocity between the surface and bottom layers of the water body.The model simulation results validate the formulae for the stratified stability discriminant during spring tides.展开更多
Acute non-variceal upper gastrointestinal bleeding(ANVUGIB)is a common medical emergency in clinical practice.While the incidence has significantly reduced,the mortality rates have not undergone a similar reduction in...Acute non-variceal upper gastrointestinal bleeding(ANVUGIB)is a common medical emergency in clinical practice.While the incidence has significantly reduced,the mortality rates have not undergone a similar reduction in the last few decades,thus presenting a significant challenge.This editorial outlines the key causes and risk factors of ANVUGIB and explores the current standards and recent updates in risk assessment scoring systems for predicting mortality and endoscopic treatments for achieving hemostasis.Since ANUVGIB predominantly affects the elderly population,the impact of comorbidities may be responsible for the poor outcomes.A thorough drug history is important due to the increasing use of antiplatelet agents and anticoagulants in the elderly.Early risk stratification plays a crucial role in deciding the line of management and predicting mortality.Emerging scoring systems such as the ABC(age,blood tests,co-morbidities)score show promise in predicting mortality and guiding clinical decisions.While conventional endoscopic therapies remain cornerstone approaches,novel techniques like hemostatic powders and over-the-scope clips offer promising alternatives,particularly in cases refractory to traditional modalities.By integrating validated scoring systems and leveraging novel therapeutic modalities,clinicians can enhance patient care and mitigate the substantial morbidity and mortality associated with ANVUGIB.展开更多
Taste and odor compounds(T&Os),which is often associated with plankton in water sources,pose significant challenges to water quality in the world.Identifying the potential producers and understanding the driving f...Taste and odor compounds(T&Os),which is often associated with plankton in water sources,pose significant challenges to water quality in the world.Identifying the potential producers and understanding the driving factors are critical for effective treatment.While most studies focused on outbreak of T&Os linked with summer cyanobacterial blooms,questions remain about the mechanisms and environmental factors driving spring outbreaks when cyanobacteria are typically in low abundance.Therefore,changes in the concentrations of T&Os,i.e.,2-methylisoborneol(2-MIB)and three others,in relation to the phytoplankton community,the physico-chemical and hydrological conditions in a mesotrophic reservoir surrounded by hills in East China were investigated from March to June 2023.Results show that 2-MIB was the main T&O during the spring outbreak of phytoplankton,and peaked at 96.10 ng/L,which is nearly 10 times of its odor threshold concentration(OTC)of 10 ng/L.The filamentous cyanobacterium Pseudanabaena sp.was identified as the primary producer of 2-MIB,and the cell concentration of 4000 cells/mL of Pseudanabaena sp.could potentially result in 10 ng/L of 2-MIB in this reservoir.The abundance of Pseudanabaena sp.and 2-MIB were correlated significantly with turbidity,suggesting that a lower light environment might be critical to promote the dominance of Pseudanabaena sp.and the subsequent production of 2-MIB.Moreover,the combination of consistently decreased water level,moderate water stratification,optimal water temperature ranging~14-23℃,the increase of the chemical oxygen demand using permanganate as an oxidant(CODMn)and total nitrogen(TN)concentration were likely to drive the accumulation and outbreak of 2-MIB.The hydrodynamic disturbance(i.e.,a sudden rapid flow of water)triggered the abrupt disappearance of both Pseudanabaena sp.and 2-MIB.This study suggests that proliferation of Pseudanabaena sp.in spring is important in contributing to 2-MIB outbreak,and flushing may be an effective approach to mitigate T&O issues in water sources.展开更多
BACKGROUND Coronary heart disease(CHD)and heart failure(HF)are the major causes of morbidity and mortality worldwide.Early and accurate diagnoses of CHD and HF are essential for optimal management and prognosis.Howeve...BACKGROUND Coronary heart disease(CHD)and heart failure(HF)are the major causes of morbidity and mortality worldwide.Early and accurate diagnoses of CHD and HF are essential for optimal management and prognosis.However,conventional diagnostic methods such as electrocardiography,echocardiography,and cardiac biomarkers have certain limitations,such as low sensitivity,specificity,availability,and cost-effectiveness.Therefore,there is a need for simple,noninvasive,and reliable biomarkers to diagnose CHD and HF.AIM To investigate serum cystatin C(Cys-C),monocyte/high-density lipoprotein cholesterol ratio(MHR),and uric acid(UA)diagnostic values for CHD and HF.METHODS We enrolled 80 patients with suspected CHD or HF who were admitted to our hospital between July 2022 and July 2023.The patients were divided into CHD(n=20),HF(n=20),CHD+HF(n=20),and control groups(n=20).The serum levels of Cys-C,MHR,and UA were measured using immunonephelometry and an enzymatic method,respectively,and the diagnostic values for CHD and HF were evaluated using receiver operating characteristic(ROC)curve analysis.RESULTS Serum levels of Cys-C,MHR,and UA were significantly higher in the CHD,HF,and CHD+HF groups than those in the control group.The serum levels of Cys-C,MHR,and UA were significantly higher in the CHD+HF group than those in the CHD or HF group.The ROC curve analysis showed that serum Cys-C,MHR,and UA had good diagnostic performance for CHD and HF,with areas under the curve ranging from 0.78 to 0.93.The optimal cutoff values of serum Cys-C,MHR,and UA for diagnosing CHD,HF,and CHD+HF were 1.2 mg/L,0.9×10^(9),and 389μmol/L;1.4 mg/L,1.0×10^(9),and 449μmol/L;and 1.6 mg/L,1.1×10^(9),and 508μmol/L,respectively.CONCLUSION Serum Cys-C,MHR,and UA are useful biomarkers for diagnosing CHD and HF,and CHD+HF.These can provide information for decision-making and risk stratification in patients with CHD and HF.展开更多
BACKGROUND Acute non-variceal upper gastrointestinal bleeding(ANVUGIB)represents a sig-nificant clinical challenge due to its unpredictability and potentially severe out-comes.The Rockall risk score has emerged as a c...BACKGROUND Acute non-variceal upper gastrointestinal bleeding(ANVUGIB)represents a sig-nificant clinical challenge due to its unpredictability and potentially severe out-comes.The Rockall risk score has emerged as a critical tool for prognostic asse-ssment in patients with ANVUGIB,aiding in the prediction of rebleeding and mo-rtality.However,its applicability and accuracy in the Chinese population remain understudied.AIM To assess the prognostic value of the Rockall risk score in a Chinese cohort of patients with ANVUGIB.METHODS A retrospective analysis of 168 ANVUGIB patients’medical records was condu-cted.The study employed statistical tests,including the t-test,χ^(2) test,spearman correlation,and receiver operating characteristic(ROC)analysis,to assess the re-lationship between the Rockall score and clinical outcomes,specifically focusing on rebleeding events within 3 months post-assessment.RESULTS Significant associations were found between the Rockall score and various clinical outcomes.High Rockall scores were significantly associated with rebleeding events(r=0.735,R2=0.541,P<0.001)and strongly positively correlated with adverse outcomes.Low hemoglobin levels(t=2.843,P=0.005),high international normalized ratio(t=3.710,P<0.001),active bleeding during endoscopy(χ^(2)=7.950,P=0.005),large ulcer size(t=6.348,P<0.001),and requiring blood transfusion(χ^(2)=6.381,P=0.012)were all significantly associated with rebleeding events.Furthermore,differences in treatment and management strategies were identified between patients with and without rebleeding events.ROC analysis indicated the excellent discriminative power(sensitivity:0.914;specificity:0.816;area under the curve:0.933;Youden index:0.730)of the Rockall score in predicting rebleeding events within 3 months.CONCLUSION This study provides valuable insights into the prognostic value of the Rockall risk score for ANVUGIB in the Chinese population.The results underscore the potential of the Rockall score as an effective tool for risk strati-fication and prognostication,with implications for guiding risk-appropriate management strategies and optimizing care for patients with ANVUGIB.展开更多
Forest tree species reproduction is a key factor in maintaining the genetic diversity of future generations and the stability of forest ecosystems.The ongoing ash dieback disease could affect the reproductive ecology ...Forest tree species reproduction is a key factor in maintaining the genetic diversity of future generations and the stability of forest ecosystems.The ongoing ash dieback disease could affect the reproductive ecology of Fraxinus excelsior L.and have a major impact on the quantity and quality of pollen and seeds.In this study,we investigated pollen production and viability of pollen and seeds of ash trees with different health status from 2018 to 2022.Inflorescences were collected from 105 trees(pollen production),pollen from 125 trees(pollen viability),and seeds from 53 trees(seed quality)in two seed orchards and in one floodplain forest in southern Germany.Not all parameters were examined at every site every year.The average pollen production per tree was estimated at 471.2±647.9 billion pollen grains.In addition,we found that a high number of inflorescences did not equate to high pollen production per inflorescence.Pollen production of healthy and diseased trees did not differ significantly,although only 47%of severely diseased male trees(vs.72%for healthy trees)produced flowers.With regards to pollen viability,the TTC test showed an average viability of 73%±17%.Overall,there was a slight tendency for diseased trees to have less viable pollen.However,a significant difference could only be calculated for trees in the floodplain forest.The percentage of germinable seeds in 2018 was 38%in the floodplain forest and 57%in one of the seed orchards.The percentage of viable seeds(TTC test)ranged from 17 to 22%in the orchards in 2020.Non-viable seeds were usually heavily infested by insects.In general,seed quality was not significantly different between healthy and diseased trees.Our results indicate that ash dieback affects flower formation and pollen viability but not pollen production or seed quality.Nevertheless,the fact that hardly any flowering was observed,especially for trees that were seriously affected,suggests a negative effect of ash dieback on reproductive performance.Thus,severely diseased trees will transfer their genes to a smaller extent to the next generation.展开更多
The fully nonlinear equations of gas dynamics are solved in the framework of a numerical approach in order to study the stability of the steady mode of Rayleigh-Bénard convection in compressible,viscous and heat-...The fully nonlinear equations of gas dynamics are solved in the framework of a numerical approach in order to study the stability of the steady mode of Rayleigh-Bénard convection in compressible,viscous and heat-conducting gases encapsulated in containers with no-slip boundaries and isothermal top and bottom walls.An initial linear temperature profile is assumed.A map of the possible convective modes is presented assuming the height of the region and the value of the temperature gradient as influential parameters.For a relatively small height,isobaric convection is found to take place,which is taken over by an adiabatic mode when the height exceeds the critical value,or by a super-adiabatic mode in case of a relatively high temperature gradient.In the adiabatic mode,convective flow develops due to adiabatic processes given a stable initial stratification.An analytic formula for the critical height of the region is derived taking into account and neglecting the dependence of the gas viscosity on the temperature.Moreover,an analytic formula is obtained for the upper boundary of the region of applicability of the Boussinesq approximation for incompressible gases.These models for compressible gases are relevant to practical situations such as the study of convective flows in spatially extended gas mixtures when dealing with safety issues related to hydrocarbons stored in gas stations.A dangerous situation arises when the tank is almost empty but some hydrocarbon is left at the bottom of the tank.In the presence of convective flows,the vaporized fuel is mixed with the oxidizer(air)forming a gas-vapor medium.However,if the volumetric concentration of fuel vapor(hydrocarbon)is in the interval between the lower and upper concentration limits of ignition,then the gas-vapor mixture becomes explosive and any accidental spark is sufficient to cause an emergency.展开更多
In the last 10 years(2012-2021),five hypoxic events have been observed in summer in the central Bohai Sea(CBS).Frequent and persistent hypoxia will have an impact on the ecosystem of the CBS.In this paper,historical s...In the last 10 years(2012-2021),five hypoxic events have been observed in summer in the central Bohai Sea(CBS).Frequent and persistent hypoxia will have an impact on the ecosystem of the CBS.In this paper,historical sea temperature(ST),salinity(SAL),density(Den),and dissolved oxygen(DO)concentration data from three stations in the CBS are analyzed via the linear regression method,and the correlations between the stratification factors(ST,SAL,and Den)and DO concentration are determined.The thresholds of the stratification factors at the three stations in June in the year in which hypoxia occurred were determined and applied to survey data from 29 stations in late May to early June in 2022 in the CBS;this assessment found that the data from 19 stations indicated that hypoxia was about to occur.In August,the survey data showed that 14 out of the 29 stations indicated hypoxic conditions,of which 12 were from the predicted 19 stations,meaning that the estimation accuracy reached 63%.The same approach was applied to data from June 2023.The data for August from a bottom-type online monitoring system in the CBS verified the occurrence of hypoxic events around Sta.M2.The results show that the strength of the seawater stratification plays a leading role in hypoxic events in the summer in the CBS,and the thresholds of the stratification factors can be used to predict the occurrence of hypoxic events.展开更多
Estimation of velocity profile within mud depth is a long-standing and essential problem in debris flow dynamics.Until now,various velocity profiles have been proposed based on the fitting analysis of experimental mea...Estimation of velocity profile within mud depth is a long-standing and essential problem in debris flow dynamics.Until now,various velocity profiles have been proposed based on the fitting analysis of experimental measurements,but these are often limited by the observation conditions,such as the number of configured sensors.Therefore,the resulting linear velocity profiles usually exhibit limitations in reproducing the temporal-varied and nonlinear behavior during the debris flow process.In this study,we present a novel approach to explore the debris flow velocity profile in detail upon our previous 3D-HBPSPH numerical model,i.e.,the three-dimensional Smoothed Particle Hydrodynamic model incorporating the Herschel-Bulkley-Papanastasiou rheology.Specifically,we propose a stratification aggregation algorithm for interpreting the details of SPH particles,which enables the recording of temporal velocities of debris flow at different mud depths.To analyze the velocity profile,we introduce a logarithmic-based nonlinear model with two key parameters,that a controlling the shape of velocity profile and b concerning its temporal evolution.We verify the proposed velocity profile and explore its sensitivity using 34 sets of velocity data from three individual flume experiments in previous literature.Our results demonstrate that the proposed temporalvaried nonlinear velocity profile outperforms the previous linear profiles.展开更多
This study is devoted to an analysis of natural convection and the emergence of delamination in an incompressible fluid encapsulated in a closed region heated from the side.Weak,medium and intensive modes of stationar...This study is devoted to an analysis of natural convection and the emergence of delamination in an incompressible fluid encapsulated in a closed region heated from the side.Weak,medium and intensive modes of stationary laminar thermal and thermo-concentration convection are considered.It is shown that nonlinear flow features can radically change the flow structure and characteristics of heat and mass transfer.Moreover,the temperature and concentration segregation in the center of the square region display a non-monotonic dependence on the Grashof number(flow intensity).The formation of a nonstationary periodic structure of thermal convection in boundary layers and in the core of a convective flow in the closed region is also examined.Details of the formation of countercurrents inside the region with the direction opposite to the main convective flow are given.Finally,the influence of vertical and horizontal vibrations on oscillatory convection is analyzed in detail.展开更多
Oxygen facilitates the breakdown of the organic material to provide energy for life.The concentration of dissolved oxygen(DO) in the water must exceed a certain threshold to support the normal metabolism of marine org...Oxygen facilitates the breakdown of the organic material to provide energy for life.The concentration of dissolved oxygen(DO) in the water must exceed a certain threshold to support the normal metabolism of marine organisms.Located in the northern B eibu Gulf,Qinzhou B ay receives abundant freshwater and nutrients from several rivers which significantly influence the level of the dissolved oxygen.However,the spatial-temporal variations of DO as well as the associated driving mechanisms have been rarely studied through field observations.In this study,a three-dimension al coupled physical-biogeochemical model is used to investigate the spatial and seasonal variations of the DO and the associated driving mechanisms in Qinzhou B ay.The validation against observations indicates that the model can capture the seasonal and inter-annual variability of the DO concentration with the range of 5-10 mg/L.Sensitivity experiments show that the river discharges,winds and tides play crucial roles in the seasonal variability of the DO by changing the vertical mixing and stratification of the water column and the circulation pattern.In winter,the tide and wind forces have strong effects on the DO distribution by enhancing the vertical mixing,especially near the bay mouth.In summer,the river discharges play a dominant role in the DO distribution by inhibiting the vertical water exchange and delivering more nutrients to the Bay,which increases the DO depletion and results in lower DO on the bottom of the estuary salt wedge.These findings can contribute to the preservation and management of the coastal environment in the northern Beibu Gulf.展开更多
文摘Prognostication of compensated advanced chronic liver disease(cACLD)is of paramount importance for the physician-and-patient communication and for rational clinical decisions.The paper published by Dallio et al reports on red cell distribution width(RDW)/platelet ratio(RPR)as a non-invasive biomarker in predicting decompensation of metabolic dysfunction-associated steatotic liver disease(MASLD)-related cACLD.Differently from other biomarkers and algorithms,RPR is inexpensive and widely available,based on parameters which are included in a complete blood count.RPR is computed on the grounds of two different items,one of which,RDW,mirrors the host’s response to a variety of disease stimuli and is non-specific.The second parameter involved in RPR,platelet count,is more specific and has been used in the hepatological clinic to discriminate cirrhotic from non-cirrhotic chronic liver disease for decades.Cardiovascular disease is the primary cause of mortality among MASLD subjects,followed by extra-hepatic cancers and liver-related mortality.Therefore,MASLD biomarkers should be validated not only in terms of liver-related events but also in the prediction of major adverse cardiovascular events and cardiovascular mortality and extra-hepatic cancers.Adequately sized multi-ethnic confirmatory investigation is required to define the role and significance of RPR in the stratification of MASLD-cACLD.
基金Supported by National Natural Science Foundation of China,No.81874390 and No.81573948Shanghai Natural Science Foundation,No.21ZR1464100+1 种基金Science and Technology Innovation Action Plan of Shanghai Science and Technology Commission,No.22S11901700the Shanghai Key Specialty of Traditional Chinese Clinical Medicine,No.shslczdzk01201.
文摘BACKGROUND Rebleeding after recovery from esophagogastric variceal bleeding(EGVB)is a severe complication that is associated with high rates of both incidence and mortality.Despite its clinical importance,recognized prognostic models that can effectively predict esophagogastric variceal rebleeding in patients with liver cirrhosis are lacking.AIM To construct and externally validate a reliable prognostic model for predicting the occurrence of esophagogastric variceal rebleeding.METHODS This study included 477 EGVB patients across 2 cohorts:The derivation cohort(n=322)and the validation cohort(n=155).The primary outcome was rebleeding events within 1 year.The least absolute shrinkage and selection operator was applied for predictor selection,and multivariate Cox regression analysis was used to construct the prognostic model.Internal validation was performed with bootstrap resampling.We assessed the discrimination,calibration and accuracy of the model,and performed patient risk stratification.RESULTS Six predictors,including albumin and aspartate aminotransferase concentrations,white blood cell count,and the presence of ascites,portal vein thrombosis,and bleeding signs,were selected for the rebleeding event prediction following endoscopic treatment(REPET)model.In predicting rebleeding within 1 year,the REPET model ex-hibited a concordance index of 0.775 and a Brier score of 0.143 in the derivation cohort,alongside 0.862 and 0.127 in the validation cohort.Furthermore,the REPET model revealed a significant difference in rebleeding rates(P<0.01)between low-risk patients and intermediate-to high-risk patients in both cohorts.CONCLUSION We constructed and validated a new prognostic model for variceal rebleeding with excellent predictive per-formance,which will improve the clinical management of rebleeding in EGVB patients.
基金Supported by Joint Funds for the Innovation of Science and Technology,Fujian Province,No.2023Y9187 and No.2021Y9057.
文摘BACKGROUND Minimally invasive esophagectomy(MIE)is a widely accepted treatment for esophageal cancer,yet it is associated with a significant risk of surgical adverse events(SAEs),which can compromise patient recovery and long-term survival.Accurate preoperative identification of high-risk patients is critical for improving outcomes.AIM To establish and validate a risk prediction and stratification model for the risk of SAEs in patients with MIE.METHODS This retrospective study included 747 patients who underwent MIE at two centers from January 2019 to February 2024.Patients were separated into a train set(n=549)and a validation set(n=198).After screening by least absolute shrinkage and selection operator regression,multivariate logistic regression analyzed clinical and intraoperative variables to identify independent risk factors for SAEs.A risk stratification model was constructed and validated to predict the probability of SAEs.RESULTS SAEs occurred in 10.2%of patients in train set and 13.6%in the validation set.Patients with SAE had significantly higher complication rate and a longer hospital stay after surgery.The key independent risk factors identified included chronic obstructive pulmonary disease,a history of alcohol consumption,low forced expiratory volume in the first second,and low albumin levels.The stratification model has excellent prediction accuracy,with an area under the curve of 0.889 for the training set and an area under the curve of 0.793 for the validation set.CONCLUSION The developed risk stratification model effectively predicts the risk of SAEs in patients undergoing MIE,facilitating targeted preoperative interventions and improving perioperative management.
文摘Patients admitted with prediabetes and atrial fibrillation are at high risk for major adverse cardiac or cerebrovascular events independent of confounding variables.The shared pathophysiology between these three serious but common diseases and their association with atherosclerotic cardiovascular risk factors establish a vicious circle culminating in high atherogenicity.Because of that,it is of paramount importance to perform risk stratification of patients with prediabetes to define phenotypes that benefit from various interventions.Furthermore,stress hyperglycemia assessment of hospitalized patients and consensus on the definition of prediabetes is vital.The roles lifestyle and metformin play in prediabetes are well established.However,the role of glucagon-like peptide agonists and metabolic surgery is less clear.Prediabetes is considered an intermediate between normoglycemia and diabetes along the blood glucose continuum.One billion people are expected to suffer from prediabetes by the year 2045.Therefore,realworld randomized controlled trials to assess major adverse cardiac or cerebrovascular event risk reduction and reversal/prevention of type 2 diabetes among patients are needed to determine the proper interventions.
基金Supported by PIP-CONICET 2021-2023 grant,No.11220200100875COPICT-2020-Serie,No.A-00788and“Florencio Fiorini Foundation”grants.
文摘Unmet needs exist in metabolic dysfunction-associated steatotic liver disease(MASLD)risk stratification.Our ability to identify patients with MASLD with advanced fibrosis and at higher risk for adverse outcomes is still limited.Incorporating novel biomarkers could represent a meaningful improvement to current risk predictors.With this aim,omics technologies have revolutionized the process of MASLD biomarker discovery over the past decades.While the research in this field is thriving,much of the publication has been haphazard,often using single-omics data and specimen sets of convenience,with many identified candidate biomarkers but lacking clinical validation and utility.If we incorporate these biomarkers to direct patients’management,it should be considered that the roadmap for translating a newly discovered omics-based signature to an actual,analytically valid test useful in MASLD clinical practice is rigorous and,therefore,not easily accomplished.This article presents an overview of this area’s current state,the conceivable opportunities and challenges of omics-based laboratory diagnostics,and a roadmap for improving MASLD biomarker research.
基金supported by the Project on InterGovernmental International Scientific and Technological Innovation Cooperation in National Key Projects of Research and Development Plan (No. 2019YFE0106400)the National Natural Science Foundation of China (No. 81771875)。
文摘Objective: Patients with radioactive iodine-refractory differentiated thyroid cancer(RAIR-DTC) are often diagnosed with delay and constrained to limited treatment options. The correlation between RAI refractoriness and the underlying genetic characteristics has not been extensively studied.Methods: Adult patients with distant metastatic DTC were enrolled and assigned to undergo next-generation sequencing of a customized 26-gene panel(Thyro Lead). Patients were classified into RAIR-DTC or non-RAIR groups to determine the differences in clinicopathological and molecular characteristics. Molecular risk stratification(MRS) was constructed based on the association between molecular alterations identified and RAI refractoriness, and the results were classified as high, intermediate or low MRS.Results: A total of 220 patients with distant metastases were included, 63.2% of whom were identified as RAIRDTC. Genetic alterations were identified in 90% of all the patients, with BRAF(59.7% vs. 17.3%), TERT promoter(43.9% vs. 7.4%), and TP53 mutations(11.5% vs. 3.7%) being more prevalent in the RAIR-DTC group than in the non-RAIR group, except for RET fusions(15.8% vs. 39.5%), which had the opposite pattern. BRAF and TERT promoter are independent predictors of RAIR-DTC, accounting for 67.6% of patients with RAIR-DTC. MRS was strongly associated with RAI refractoriness(P<0.001), with an odds ratio(OR) of high to low MRS of 7.52 [95%confidence interval(95% CI), 3.96-14.28;P<0.001] and an OR of intermediate to low MRS of 3.20(95% CI,1.01-10.14;P=0.041).Conclusions: Molecular alterations were associated with RAI refractoriness, with BRAF and TERT promoter mutations being the predominant contributors, followed by TP53 and DICER1 mutations. MRS might serve as a valuable tool for both prognosticating clinical outcomes and directing precision-based therapeutic interventions.
基金supported by the National Natural Science Foundation of China (Grant Nos. 42076202, 42122046, 42206208 and 42261134536)the Open Research Cruise NORC2022-10+NORC2022-303 supported by NSFC shiptime Sharing Projects 42149910+7 种基金the new Cornerstone Science Foundation through the XPLORER PRIZE, DAMO Academy Young Fellow, Youth Innovation Promotion Association, Chinese Academy of SciencesNational Key Scientific and Technological Infrastructure project “Earth System Science Numerical Simulator Facility” (EarthLab)sponsored by the US National Science Foundationsupported by NASA Awards 80NSSC17K0565, 80NSSC21K1191, and 80NSSC22K0046by the Regional and Global Model Analysis (RGMA) component of the Earth and Environmental System Modeling Program of the U.S. Department of Energy’s Office of Biological & Environmental Research (BER) via National Science Foundation IA 1947282supported by NOAA (Grant No. NA19NES4320002 to CISESS-MD at the University of Maryland)supported by the Young Talent Support Project of Guangzhou Association for Science and Technologyfunded by the Istituto Nazionale di Geofisica e Vulcanologia (INGV) in agreement between INGV, ENEA, and GNV SpA shipping company that provides hospitality on its commercial vessels
文摘The global physical and biogeochemical environment has been substantially altered in response to increased atmospheric greenhouse gases from human activities.In 2023,the sea surface temperature(SST)and upper 2000 m ocean heat content(OHC)reached record highs.The 0–2000 m OHC in 2023 exceeded that of 2022 by 15±10 ZJ(1 Zetta Joules=1021 Joules)(updated IAP/CAS data);9±5 ZJ(NCEI/NOAA data).The Tropical Atlantic Ocean,the Mediterranean Sea,and southern oceans recorded their highest OHC observed since the 1950s.Associated with the onset of a strong El Niño,the global SST reached its record high in 2023 with an annual mean of~0.23℃ higher than 2022 and an astounding>0.3℃ above 2022 values for the second half of 2023.The density stratification and spatial temperature inhomogeneity indexes reached their highest values in 2023.
基金National Natural Science Foundation of China(No.52178393)2023 High-level Talent Research Project from Yancheng Institute of Technology(No.xjr2023019)+1 种基金Open Fund Project of Shaanxi Key Laboratory of Geotechnical and Underground Space Engineering(Grant No.YT202302)Science and Technology Innovation Team of Shaanxi Innovation Capability Support Plan(No.2020TD005).
文摘The deformation in sedimentary rock induced by train loads has potential threat to the safe operation of tunnels. This study investigated the influence of stratification structure on the infrared radiation and temporal damage mechanism of hard siltstone. The uniaxial compression tests, coupled with acoustic emission(AE) and infrared radiation temperature(IRT) were conducted on siltstones with different stratification effects. The results revealed that the stratigraphic structure significantly affects the stress-strain response and strength degradation characteristics. The mechanical parameters exhibit anisotropy characteristics, and the stratification effect exhibits a negative correlation with the cracking stress and peak stress. The failure modes caused by the stratification effect show remarkable anisotropic features, including splitting failure(Ⅰ: 0°-22.50°, Ⅱ: 90°), composite failure(45°), and shearing failure(67.50°). The AE temporal sequences demonstrate a stepwise response characteristic to the loading stress level. The AE intensity indicates that the stress sensitivity of shearing failure and composite failure is generally greater than that of splitting failure. The IRT field has spatiotemporal migration and progressive dissimilation with stress loading and its dissimilation degree increases under higher stress levels. The stronger the stratification effect, the greater the dissimilation degree of the IRT field. The abnormal characteristic points of average infrared radiation temperature(AIRT) variance at local stress drop and peak stress can be used as early and late precursors to identify fracture instability. Theoretical analysis shows that the competitive relationship between compaction strengthening and fracturing damage intensifies the dissimilation of the infrared thermal field for an increasing stress level. The present study provides a theoretical reference for disaster warnings in hard sedimentary rock mass.
文摘BACKGROUND Cirrhotic patients with acute-on-chronic liver failure(ACLF)in the intensive care unit(ICU)have a poor but variable prognoses.Accurate prognosis evaluation can guide the rational management of patients with ACLF.However,existing prognostic scores for ACLF in the ICU environment lack sufficient accuracy.AIM To develop a new prognostic model for patients with ACLF in ICU.METHODS Data from 938 ACLF patients in the Medical Information Mart for Intensive Care(MIMIC)database were used to develop a new prognostic model(MIMIC ACLF)for ACLF.Discrimination,calibration and clinical utility of MIMIC ACLF were assessed by area under receiver operating characteristic curve(AUROC),calibration curve and decision curve analysis(DCA),respectively.MIMIC ACLF was then externally validated in a multiple-center cohort,the Electronic Intensive Care Collaborative Research Database and a single-center cohort from the Second Hospital of Hebei Medical University in China.RESULTS The MIMIC ACLF score was determined using nine variables:ln(age)×2.2+ln(white blood cell count)×0.22-ln(mean arterial pressure)×2.7+respiratory failure×0.6+renal failure×0.51+cerebral failure×0.31+ln(total bilirubin)×0.44+ln(internationalized normal ratio)×0.59+ln(serum potassium)×0.59.In MIMIC cohort,the AUROC(0.81/0.79)for MIMIC ACLF for 28/90-day ACLF mortality were significantly greater than those of Chronic Liver Failure Consortium ACLF(0.76/0.74),Model for End-stage Liver Disease(MELD;0.73/0.71)and MELD-Na(0.72/0.70)(all P<0.001).The consistency between actual and predicted 28/90-day survival rates of patients according to MIMIC ACLF score was excellent and superior to that of existing scores.The net benefit of MIMIC ACLF was greater than that achieved using existing scores within the 50%threshold probability.The superior predictive accuracy and clinical utility of MIMIC ACLF were validated in the external cohorts.CONCLUSION We developed and validated a new prognostic model with satisfactory accuracy for cirrhotic patients with ACLF hospitalized in the ICU.The model-based risk stratification and online calculator might facilitate the rational management of patients with ACLF.
基金supported by the National Natural Science Foundation of China(Nos.42176166,41776024).
文摘To study the stratified stability of a water column in the North Passage of the Yangtze River Estuary,a numerical model of the hydrodynamics of this estuary is established using the EFDC model.On the basis of EFDC results,this paper derives and pro-vides the discriminative index of water body stability caused by salinity and analyzes the along-range variation in water body strati-fication stability in the North Passage of the Yangtze River Estuary and the periodic variation at a key location(bend area)based on the simulation results of the numerical model.This work shows that the water body in the bend area varies between mixed and strati-fied types,and the vertical average flow velocity has a good negative correlation with the differential velocity between the surface and bottom layers of the water body.The model simulation results validate the formulae for the stratified stability discriminant during spring tides.
文摘Acute non-variceal upper gastrointestinal bleeding(ANVUGIB)is a common medical emergency in clinical practice.While the incidence has significantly reduced,the mortality rates have not undergone a similar reduction in the last few decades,thus presenting a significant challenge.This editorial outlines the key causes and risk factors of ANVUGIB and explores the current standards and recent updates in risk assessment scoring systems for predicting mortality and endoscopic treatments for achieving hemostasis.Since ANUVGIB predominantly affects the elderly population,the impact of comorbidities may be responsible for the poor outcomes.A thorough drug history is important due to the increasing use of antiplatelet agents and anticoagulants in the elderly.Early risk stratification plays a crucial role in deciding the line of management and predicting mortality.Emerging scoring systems such as the ABC(age,blood tests,co-morbidities)score show promise in predicting mortality and guiding clinical decisions.While conventional endoscopic therapies remain cornerstone approaches,novel techniques like hemostatic powders and over-the-scope clips offer promising alternatives,particularly in cases refractory to traditional modalities.By integrating validated scoring systems and leveraging novel therapeutic modalities,clinicians can enhance patient care and mitigate the substantial morbidity and mortality associated with ANVUGIB.
基金Supported by the National Natural Science Foundation of China(Nos.42271080,U2340209)the Science and Technology Planning Project of NIGLAS(Nos.NIGLAS2022GS03,NIGLAS2022TJ08)。
文摘Taste and odor compounds(T&Os),which is often associated with plankton in water sources,pose significant challenges to water quality in the world.Identifying the potential producers and understanding the driving factors are critical for effective treatment.While most studies focused on outbreak of T&Os linked with summer cyanobacterial blooms,questions remain about the mechanisms and environmental factors driving spring outbreaks when cyanobacteria are typically in low abundance.Therefore,changes in the concentrations of T&Os,i.e.,2-methylisoborneol(2-MIB)and three others,in relation to the phytoplankton community,the physico-chemical and hydrological conditions in a mesotrophic reservoir surrounded by hills in East China were investigated from March to June 2023.Results show that 2-MIB was the main T&O during the spring outbreak of phytoplankton,and peaked at 96.10 ng/L,which is nearly 10 times of its odor threshold concentration(OTC)of 10 ng/L.The filamentous cyanobacterium Pseudanabaena sp.was identified as the primary producer of 2-MIB,and the cell concentration of 4000 cells/mL of Pseudanabaena sp.could potentially result in 10 ng/L of 2-MIB in this reservoir.The abundance of Pseudanabaena sp.and 2-MIB were correlated significantly with turbidity,suggesting that a lower light environment might be critical to promote the dominance of Pseudanabaena sp.and the subsequent production of 2-MIB.Moreover,the combination of consistently decreased water level,moderate water stratification,optimal water temperature ranging~14-23℃,the increase of the chemical oxygen demand using permanganate as an oxidant(CODMn)and total nitrogen(TN)concentration were likely to drive the accumulation and outbreak of 2-MIB.The hydrodynamic disturbance(i.e.,a sudden rapid flow of water)triggered the abrupt disappearance of both Pseudanabaena sp.and 2-MIB.This study suggests that proliferation of Pseudanabaena sp.in spring is important in contributing to 2-MIB outbreak,and flushing may be an effective approach to mitigate T&O issues in water sources.
文摘BACKGROUND Coronary heart disease(CHD)and heart failure(HF)are the major causes of morbidity and mortality worldwide.Early and accurate diagnoses of CHD and HF are essential for optimal management and prognosis.However,conventional diagnostic methods such as electrocardiography,echocardiography,and cardiac biomarkers have certain limitations,such as low sensitivity,specificity,availability,and cost-effectiveness.Therefore,there is a need for simple,noninvasive,and reliable biomarkers to diagnose CHD and HF.AIM To investigate serum cystatin C(Cys-C),monocyte/high-density lipoprotein cholesterol ratio(MHR),and uric acid(UA)diagnostic values for CHD and HF.METHODS We enrolled 80 patients with suspected CHD or HF who were admitted to our hospital between July 2022 and July 2023.The patients were divided into CHD(n=20),HF(n=20),CHD+HF(n=20),and control groups(n=20).The serum levels of Cys-C,MHR,and UA were measured using immunonephelometry and an enzymatic method,respectively,and the diagnostic values for CHD and HF were evaluated using receiver operating characteristic(ROC)curve analysis.RESULTS Serum levels of Cys-C,MHR,and UA were significantly higher in the CHD,HF,and CHD+HF groups than those in the control group.The serum levels of Cys-C,MHR,and UA were significantly higher in the CHD+HF group than those in the CHD or HF group.The ROC curve analysis showed that serum Cys-C,MHR,and UA had good diagnostic performance for CHD and HF,with areas under the curve ranging from 0.78 to 0.93.The optimal cutoff values of serum Cys-C,MHR,and UA for diagnosing CHD,HF,and CHD+HF were 1.2 mg/L,0.9×10^(9),and 389μmol/L;1.4 mg/L,1.0×10^(9),and 449μmol/L;and 1.6 mg/L,1.1×10^(9),and 508μmol/L,respectively.CONCLUSION Serum Cys-C,MHR,and UA are useful biomarkers for diagnosing CHD and HF,and CHD+HF.These can provide information for decision-making and risk stratification in patients with CHD and HF.
文摘BACKGROUND Acute non-variceal upper gastrointestinal bleeding(ANVUGIB)represents a sig-nificant clinical challenge due to its unpredictability and potentially severe out-comes.The Rockall risk score has emerged as a critical tool for prognostic asse-ssment in patients with ANVUGIB,aiding in the prediction of rebleeding and mo-rtality.However,its applicability and accuracy in the Chinese population remain understudied.AIM To assess the prognostic value of the Rockall risk score in a Chinese cohort of patients with ANVUGIB.METHODS A retrospective analysis of 168 ANVUGIB patients’medical records was condu-cted.The study employed statistical tests,including the t-test,χ^(2) test,spearman correlation,and receiver operating characteristic(ROC)analysis,to assess the re-lationship between the Rockall score and clinical outcomes,specifically focusing on rebleeding events within 3 months post-assessment.RESULTS Significant associations were found between the Rockall score and various clinical outcomes.High Rockall scores were significantly associated with rebleeding events(r=0.735,R2=0.541,P<0.001)and strongly positively correlated with adverse outcomes.Low hemoglobin levels(t=2.843,P=0.005),high international normalized ratio(t=3.710,P<0.001),active bleeding during endoscopy(χ^(2)=7.950,P=0.005),large ulcer size(t=6.348,P<0.001),and requiring blood transfusion(χ^(2)=6.381,P=0.012)were all significantly associated with rebleeding events.Furthermore,differences in treatment and management strategies were identified between patients with and without rebleeding events.ROC analysis indicated the excellent discriminative power(sensitivity:0.914;specificity:0.816;area under the curve:0.933;Youden index:0.730)of the Rockall score in predicting rebleeding events within 3 months.CONCLUSION This study provides valuable insights into the prognostic value of the Rockall risk score for ANVUGIB in the Chinese population.The results underscore the potential of the Rockall score as an effective tool for risk strati-fication and prognostication,with implications for guiding risk-appropriate management strategies and optimizing care for patients with ANVUGIB.
文摘Forest tree species reproduction is a key factor in maintaining the genetic diversity of future generations and the stability of forest ecosystems.The ongoing ash dieback disease could affect the reproductive ecology of Fraxinus excelsior L.and have a major impact on the quantity and quality of pollen and seeds.In this study,we investigated pollen production and viability of pollen and seeds of ash trees with different health status from 2018 to 2022.Inflorescences were collected from 105 trees(pollen production),pollen from 125 trees(pollen viability),and seeds from 53 trees(seed quality)in two seed orchards and in one floodplain forest in southern Germany.Not all parameters were examined at every site every year.The average pollen production per tree was estimated at 471.2±647.9 billion pollen grains.In addition,we found that a high number of inflorescences did not equate to high pollen production per inflorescence.Pollen production of healthy and diseased trees did not differ significantly,although only 47%of severely diseased male trees(vs.72%for healthy trees)produced flowers.With regards to pollen viability,the TTC test showed an average viability of 73%±17%.Overall,there was a slight tendency for diseased trees to have less viable pollen.However,a significant difference could only be calculated for trees in the floodplain forest.The percentage of germinable seeds in 2018 was 38%in the floodplain forest and 57%in one of the seed orchards.The percentage of viable seeds(TTC test)ranged from 17 to 22%in the orchards in 2020.Non-viable seeds were usually heavily infested by insects.In general,seed quality was not significantly different between healthy and diseased trees.Our results indicate that ash dieback affects flower formation and pollen viability but not pollen production or seed quality.Nevertheless,the fact that hardly any flowering was observed,especially for trees that were seriously affected,suggests a negative effect of ash dieback on reproductive performance.Thus,severely diseased trees will transfer their genes to a smaller extent to the next generation.
文摘The fully nonlinear equations of gas dynamics are solved in the framework of a numerical approach in order to study the stability of the steady mode of Rayleigh-Bénard convection in compressible,viscous and heat-conducting gases encapsulated in containers with no-slip boundaries and isothermal top and bottom walls.An initial linear temperature profile is assumed.A map of the possible convective modes is presented assuming the height of the region and the value of the temperature gradient as influential parameters.For a relatively small height,isobaric convection is found to take place,which is taken over by an adiabatic mode when the height exceeds the critical value,or by a super-adiabatic mode in case of a relatively high temperature gradient.In the adiabatic mode,convective flow develops due to adiabatic processes given a stable initial stratification.An analytic formula for the critical height of the region is derived taking into account and neglecting the dependence of the gas viscosity on the temperature.Moreover,an analytic formula is obtained for the upper boundary of the region of applicability of the Boussinesq approximation for incompressible gases.These models for compressible gases are relevant to practical situations such as the study of convective flows in spatially extended gas mixtures when dealing with safety issues related to hydrocarbons stored in gas stations.A dangerous situation arises when the tank is almost empty but some hydrocarbon is left at the bottom of the tank.In the presence of convective flows,the vaporized fuel is mixed with the oxidizer(air)forming a gas-vapor medium.However,if the volumetric concentration of fuel vapor(hydrocarbon)is in the interval between the lower and upper concentration limits of ignition,then the gas-vapor mixture becomes explosive and any accidental spark is sufficient to cause an emergency.
基金The National Natural Science Foundation of China under contract Nos U2106211 and 42076197supported by the Data Center of Yantai Insti-tute of Coastal Zone Research,Chinese Academy of Sciences,China.Some of the data and samples were collected utilizing R/V Lanhai101 during open research cruise NORC2023-01supported by the NSFC Shiptime Sharing Project under contrac No.42249901.
文摘In the last 10 years(2012-2021),five hypoxic events have been observed in summer in the central Bohai Sea(CBS).Frequent and persistent hypoxia will have an impact on the ecosystem of the CBS.In this paper,historical sea temperature(ST),salinity(SAL),density(Den),and dissolved oxygen(DO)concentration data from three stations in the CBS are analyzed via the linear regression method,and the correlations between the stratification factors(ST,SAL,and Den)and DO concentration are determined.The thresholds of the stratification factors at the three stations in June in the year in which hypoxia occurred were determined and applied to survey data from 29 stations in late May to early June in 2022 in the CBS;this assessment found that the data from 19 stations indicated that hypoxia was about to occur.In August,the survey data showed that 14 out of the 29 stations indicated hypoxic conditions,of which 12 were from the predicted 19 stations,meaning that the estimation accuracy reached 63%.The same approach was applied to data from June 2023.The data for August from a bottom-type online monitoring system in the CBS verified the occurrence of hypoxic events around Sta.M2.The results show that the strength of the seawater stratification plays a leading role in hypoxic events in the summer in the CBS,and the thresholds of the stratification factors can be used to predict the occurrence of hypoxic events.
基金supported by the National Natural Science Foundation of China(Grant No.52078493)the Natural Science Foundation of Hunan Province(Grant No.2022JJ30700)+2 种基金the Natural Science Foundation for Excellent Young Scholars of Hunan(Grant No.2021JJ20057)the Science and Technology Plan Project of Changsha(Grant No.kq2305006)the Innovation Driven Program of Central South University(Grant No.2023CXQD033).
文摘Estimation of velocity profile within mud depth is a long-standing and essential problem in debris flow dynamics.Until now,various velocity profiles have been proposed based on the fitting analysis of experimental measurements,but these are often limited by the observation conditions,such as the number of configured sensors.Therefore,the resulting linear velocity profiles usually exhibit limitations in reproducing the temporal-varied and nonlinear behavior during the debris flow process.In this study,we present a novel approach to explore the debris flow velocity profile in detail upon our previous 3D-HBPSPH numerical model,i.e.,the three-dimensional Smoothed Particle Hydrodynamic model incorporating the Herschel-Bulkley-Papanastasiou rheology.Specifically,we propose a stratification aggregation algorithm for interpreting the details of SPH particles,which enables the recording of temporal velocities of debris flow at different mud depths.To analyze the velocity profile,we introduce a logarithmic-based nonlinear model with two key parameters,that a controlling the shape of velocity profile and b concerning its temporal evolution.We verify the proposed velocity profile and explore its sensitivity using 34 sets of velocity data from three individual flume experiments in previous literature.Our results demonstrate that the proposed temporalvaried nonlinear velocity profile outperforms the previous linear profiles.
基金the Russian Science Foundation Grant 24-29-00101.
文摘This study is devoted to an analysis of natural convection and the emergence of delamination in an incompressible fluid encapsulated in a closed region heated from the side.Weak,medium and intensive modes of stationary laminar thermal and thermo-concentration convection are considered.It is shown that nonlinear flow features can radically change the flow structure and characteristics of heat and mass transfer.Moreover,the temperature and concentration segregation in the center of the square region display a non-monotonic dependence on the Grashof number(flow intensity).The formation of a nonstationary periodic structure of thermal convection in boundary layers and in the core of a convective flow in the closed region is also examined.Details of the formation of countercurrents inside the region with the direction opposite to the main convective flow are given.Finally,the influence of vertical and horizontal vibrations on oscillatory convection is analyzed in detail.
基金The Major Projects of the National Natural Science Foundation of China under contract No.U20A20105the Guangdong Key Project under contract No.2019BT2H594+2 种基金the National Key Research and Development Program of China under contract No.2022YFC3105000the State Key Laboratory of Tropical Oceanography Independent Research Fund under contract No.LTOZZ2103the Guangxi Key Laboratory of Marine Environmental Change and Disaster in Beibu Gulf,Beibu Gulf University under contract No.2023KF01。
文摘Oxygen facilitates the breakdown of the organic material to provide energy for life.The concentration of dissolved oxygen(DO) in the water must exceed a certain threshold to support the normal metabolism of marine organisms.Located in the northern B eibu Gulf,Qinzhou B ay receives abundant freshwater and nutrients from several rivers which significantly influence the level of the dissolved oxygen.However,the spatial-temporal variations of DO as well as the associated driving mechanisms have been rarely studied through field observations.In this study,a three-dimension al coupled physical-biogeochemical model is used to investigate the spatial and seasonal variations of the DO and the associated driving mechanisms in Qinzhou B ay.The validation against observations indicates that the model can capture the seasonal and inter-annual variability of the DO concentration with the range of 5-10 mg/L.Sensitivity experiments show that the river discharges,winds and tides play crucial roles in the seasonal variability of the DO by changing the vertical mixing and stratification of the water column and the circulation pattern.In winter,the tide and wind forces have strong effects on the DO distribution by enhancing the vertical mixing,especially near the bay mouth.In summer,the river discharges play a dominant role in the DO distribution by inhibiting the vertical water exchange and delivering more nutrients to the Bay,which increases the DO depletion and results in lower DO on the bottom of the estuary salt wedge.These findings can contribute to the preservation and management of the coastal environment in the northern Beibu Gulf.