The frequency and duration of observed concurrent hot and dry events(HDEs) over China during the growing season(April–September) exhibit significant decadal changes across the mid-1990s. These changes are characteriz...The frequency and duration of observed concurrent hot and dry events(HDEs) over China during the growing season(April–September) exhibit significant decadal changes across the mid-1990s. These changes are characterized by increases in HDE frequency and duration over most of China, with relatively large increases over southeastern China(SEC), northern China(NC), and northeastern China(NEC). The frequency of HDEs averaged over China in the present day(PD,1994–2011) is double that in the early period(EP, 1964–81);the duration of HDEs increases by 60%. Climate experiments with the Met Office Unified Model(MetUM-GOML2) are used to estimate the contributions of anthropogenic forcing to HDE decadal changes over China. Anthropogenic forcing changes can explain 60%–70% of the observed decadal changes,suggesting an important anthropogenic influence on HDE changes over China across the mid-1990s. Single-forcing experiments indicate that the increase in greenhouse gas(GHG) concentrations dominates the simulated decadal changes,increasing the frequency and duration of HDEs throughout China. The change in anthropogenic aerosol(AA) emissions significantly decreases the frequency and duration of HDEs over SEC and NC, but the magnitude of the decrease is much smaller than the increase induced by GHGs. The changes in HDEs in response to anthropogenic forcing are mainly due to the response of climatological mean surface air temperatures. The contributions from changes in variability and changes in climatological mean soil moisture and evapotranspiration are relatively small. The physical processes associated with the response of HDEs to GHG and AA changes are also revealed.展开更多
The SHRP2 Naturalistic Driving Study was used to evaluate the impact of various work zone and driver characteristics on back of queue safety critical events (crash, near-crash, or conflicts) The model included 43 SCE ...The SHRP2 Naturalistic Driving Study was used to evaluate the impact of various work zone and driver characteristics on back of queue safety critical events (crash, near-crash, or conflicts) The model included 43 SCE and 209 “normal” events which were used as controls. The traces included representing 209 unique drivers. A Mixed-Effects Logistic Regression model was developed with probability of a SCE as the response variable and driver and work zone characteristics as predictor variables. The final model indicated glances over 1 second away from the driving task and following closely increased risk of an SCE by 3.8 times and 2.9 times, respectively. Average speed was negatively correlated to crash risk. This is counterintuitive since in most cases, it is expected that higher speeds are related to back of queue crashes. However, most queues form under congested conditions. As a result, vehicles encountering a back of queue would be more likely to be traveling at lower speeds.展开更多
We conducted a comprehensive review of existing prediction models pertaining to the efficacy of immune-checkpoint inhibitor(ICI)and the occurrence of immune-related adverse events(irAEs).The predictive potential of ne...We conducted a comprehensive review of existing prediction models pertaining to the efficacy of immune-checkpoint inhibitor(ICI)and the occurrence of immune-related adverse events(irAEs).The predictive potential of neutrophil-to-lymphocyte ratio(NLR)and platelet-to-lymphocyte ratio(PLR)in determining ICI effectiveness has been extensively investigated,while limited research has been conducted on predicting irAEs.Furthermore,the combined model incor-porating NLR and PLR,either with each other or in conjunction with additional markers such as carcinoembryonic antigen,exhibits superior predictive capabilities compared to individual markers alone.NLR and PLR are promising markers for clinical applications.Forthcoming models ought to incorporate established efficacious models and newly identified ones,thereby constituting a multifactor composite model.Furthermore,efforts should be made to explore effective clinical application approaches that enhance the predictive accuracy and efficiency.展开更多
Microvasculature of the retina is considered an alternative marker of cerebral vascular risk in healthy populations.However,the ability of retinal vasculature changes,specifically focusing on retinal vessel diameter,t...Microvasculature of the retina is considered an alternative marker of cerebral vascular risk in healthy populations.However,the ability of retinal vasculature changes,specifically focusing on retinal vessel diameter,to predict the recurrence of cerebrovascular events in patients with ischemic stroke has not been determined comprehensively.While previous studies have shown a link between retinal vessel diameter and recurrent cerebrovascular events,they have not incorporated this information into a predictive model.Therefore,this study aimed to investigate the relationship between retinal vessel diameter and subsequent cerebrovascular events in patients with acute ischemic stroke.Additionally,we sought to establish a predictive model by combining retinal veessel diameter with traditional risk factors.We performed a prospective observational study of 141 patients with acute ischemic stroke who were admitted to the First Affiliated Hospital of Jinan University.All of these patients underwent digital retinal imaging within 72 hours of admission and were followed up for 3 years.We found that,after adjusting for related risk factors,patients with acute ischemic stroke with mean arteriolar diameter within 0.5-1.0 disc diameters of the disc margin(MAD_(0.5-1.0DD))of≥74.14μm and mean venular diameter within 0.5-1.0 disc diameters of the disc margin(MVD_(0.5-1.0DD))of≥83.91μm tended to experience recurrent cerebrovascular events.We established three multivariate Cox proportional hazard regression models:model 1 included traditional risk factors,model 2 added MAD_(0.5-1.0DD)to model 1,and model 3 added MVD0.5-1.0DD to model 1.Model 3 had the greatest potential to predict subsequent cerebrovascular events,followed by model 2,and finally model 1.These findings indicate that combining retinal venular or arteriolar diameter with traditional risk factors could improve the prediction of recurrent cerebrovascular events in patients with acute ischemic stroke,and that retinal imaging could be a useful and non-invasive method for identifying high-risk patients who require closer monitoring and more aggressive management.展开更多
BACKGROUND The incidence of chronic kidney disease among patients with diabetes mellitus(DM)remains a global concern.Long-term obesity is known to possibly influence the development of type 2 diabetes mellitus.However...BACKGROUND The incidence of chronic kidney disease among patients with diabetes mellitus(DM)remains a global concern.Long-term obesity is known to possibly influence the development of type 2 diabetes mellitus.However,no previous meta-analysis has assessed the effects of body mass index(BMI)on adverse kidney events in patients with DM.AIM To determine the impact of BMI on adverse kidney events in patients with DM.METHODS A systematic literature search was performed on the PubMed,ISI Web of Science,Scopus,Ovid,Google Scholar,EMBASE,and BMJ databases.We included trials with the following characteristics:(1)Type of study:Prospective,retrospective,randomized,and non-randomized in design;(2)participants:Restricted to patients with DM aged≥18 years;(3)intervention:No intervention;and(4)kidney adverse events:Onset of diabetic kidney disease[estimated glomerular filtration rate(eGFR)of<60 mL/min/1.73 m2 and/or microalbuminuria value of≥30 mg/g Cr],serum creatinine increase of more than double the baseline or end-stage renal disease(eGFR<15 mL/min/1.73 m2 or dialysis),or death.RESULTS Overall,11 studies involving 801 patients with DM were included.High BMI(≥25 kg/m2)was significantly associated with higher blood pressure(BP)[systolic BP by 0.20,95%confidence interval(CI):0.15–0.25,P<0.00001;diastolic BP by 0.21 mmHg,95%CI:0.04–0.37,P=0.010],serum albumin,triglycerides[standard mean difference(SMD)=0.35,95%CI:0.29–0.41,P<0.00001],low-density lipoprotein(SMD=0.12,95%CI:0.04–0.20,P=0.030),and lower high-density lipoprotein(SMD=–0.36,95%CI:–0.51 to–0.21,P<0.00001)in patients with DM compared with those with low BMIs(<25 kg/m2).Our analysis showed that high BMI was associated with a higher risk ratio of adverse kidney events than low BMI(RR:1.22,95%CI:1.01–1.43,P=0.036).CONCLUSION The present analysis suggested that high BMI was a risk factor for adverse kidney events in patients with DM.展开更多
Rain-on-snow(ROS)events involve rainfall on snow surfaces,and the occurrence of ROS events can exacerbate water scarcity and ecosystem vulnerability in the arid region of Northwest China(ARNC).In this study,using dail...Rain-on-snow(ROS)events involve rainfall on snow surfaces,and the occurrence of ROS events can exacerbate water scarcity and ecosystem vulnerability in the arid region of Northwest China(ARNC).In this study,using daily snow depth data and daily meteorological data from 68 meteorological stations provided by the China Meteorological Administration National Meteorological Information Centre,we investigated the spatiotemporal variability of ROS events in the ARNC from 1978 to 2015 and examined the factors affecting these events and possible changes of future ROS events in the ARNC.The results showed that ROS events in the ARNC mainly occurred from October to May of the following year and were largely distributed in the Qilian Mountains,Tianshan Mountains,Ili River Valley,Tacheng Prefecture,and Altay Prefecture,with the Ili River Valley,Tacheng City,and Altay Mountains exhibiting the most occurrences.Based on the intensity of ROS events,the areas with the highest risk of flooding resulting from ROS events in the ARNC were the Tianshan Mountains,Ili River Valley,Tacheng City,and Altay Mountains.The number and intensity of ROS events in the ARNC largely increased from 1978 to 2015,mainly influenced by air temperature and the number of rainfall days.However,due to the snowpack abundance in areas experiencing frequent ROS events in the ARNC,snowpack changes exerted slight impact on ROS events,which is a temporary phenomenon.Furthermore,elevation imposed lesser impact on ROS events in the ARNC than other factors.In the ARNC,the start time of rainfall and the end time of snowpack gradually advanced from the spring of the current year to the winter of the previous year,while the end time of rainfall and the start time of snowpack gradually delayed from autumn to winter.This may lead to more ROS events in winter in the future.These results could provide a sound basis for managing water resources and mitigating related disasters caused by ROS events in the ARNC.展开更多
BACKGROUND Prediabetes is a well-established risk factor for major adverse cardiac and cerebrovascular events(MACCE).However,the relationship between prediabetes and MACCE in atrial fibrillation(AF)patients has not be...BACKGROUND Prediabetes is a well-established risk factor for major adverse cardiac and cerebrovascular events(MACCE).However,the relationship between prediabetes and MACCE in atrial fibrillation(AF)patients has not been extensively studied.Therefore,this study aimed to establish a link between prediabetes and MACCE in AF patients.AIM To investigate a link between prediabetes and MACCE in AF patients.METHODS We used the National Inpatient Sample(2019)and relevant ICD-10 CM codes to identify hospitalizations with AF and categorized them into groups with and without prediabetes,excluding diabetics.The primary outcome was MACCE(all-cause inpatient mortality,cardiac arrest including ventricular fibrillation,and stroke)in AF-related hospitalizations.RESULTS Of the 2965875 AF-related hospitalizations for MACCE,47505(1.6%)were among patients with prediabetes.The prediabetes cohort was relatively younger(median 75 vs 78 years),and often consisted of males(56.3%vs 51.4%),blacks(9.8%vs 7.9%),Hispanics(7.3%vs 4.3%),and Asians(4.7%vs 1.6%)than the non-prediabetic cohort(P<0.001).The prediabetes group had significantly higher rates of hypertension,hyperlipidemia,smoking,obesity,drug abuse,prior myocardial infarction,peripheral vascular disease,and hyperthyroidism(all P<0.05).The prediabetes cohort was often discharged routinely(51.1%vs 41.1%),but more frequently required home health care(23.6%vs 21.0%)and had higher costs.After adjusting for baseline characteristics or comorbidities,the prediabetes cohort with AF admissions showed a higher rate and significantly higher odds of MACCE compared to the non-prediabetic cohort[18.6%vs 14.7%,odds ratio(OR)1.34,95%confidence interval 1.26-1.42,P<0.001].On subgroup analyses,males had a stronger association(aOR 1.43)compared to females(aOR 1.22),whereas on the race-wise comparison,Hispanics(aOR 1.43)and Asians(aOR 1.36)had a stronger association with MACCE with prediabetes vs whites(aOR 1.33)and blacks(aOR 1.21).CONCLUSION This population-based study found a significant association between prediabetes and MACCE in AF patients.Therefore,there is a need for further research to actively screen and manage prediabetes in AF to prevent MACCE.展开更多
BACKGROUND Liver transplant(LT)patients have become older and sicker.The rate of post-LT major adverse cardiovascular events(MACE)has increased,and this in turn raises 30-d post-LT mortality.Noninvasive cardiac stress...BACKGROUND Liver transplant(LT)patients have become older and sicker.The rate of post-LT major adverse cardiovascular events(MACE)has increased,and this in turn raises 30-d post-LT mortality.Noninvasive cardiac stress testing loses accuracy when applied to pre-LT cirrhotic patients.AIM To assess the feasibility and accuracy of a machine learning model used to predict post-LT MACE in a regional cohort.METHODS This retrospective cohort study involved 575 LT patients from a Southern Brazilian academic center.We developed a predictive model for post-LT MACE(defined as a composite outcome of stroke,new-onset heart failure,severe arrhythmia,and myocardial infarction)using the extreme gradient boosting(XGBoost)machine learning model.We addressed missing data(below 20%)for relevant variables using the k-nearest neighbor imputation method,calculating the mean from the ten nearest neighbors for each case.The modeling dataset included 83 features,encompassing patient and laboratory data,cirrhosis complications,and pre-LT cardiac assessments.Model performance was assessed using the area under the receiver operating characteristic curve(AUROC).We also employed Shapley additive explanations(SHAP)to interpret feature impacts.The dataset was split into training(75%)and testing(25%)sets.Calibration was evaluated using the Brier score.We followed Transparent Reporting of a Multivariable Prediction Model for Individual Prognosis or Diagnosis guidelines for reporting.Scikit-learn and SHAP in Python 3 were used for all analyses.The supplementary material includes code for model development and a user-friendly online MACE prediction calculator.RESULTS Of the 537 included patients,23(4.46%)developed in-hospital MACE,with a mean age at transplantation of 52.9 years.The majority,66.1%,were male.The XGBoost model achieved an impressive AUROC of 0.89 during the training stage.This model exhibited accuracy,precision,recall,and F1-score values of 0.84,0.85,0.80,and 0.79,respectively.Calibration,as assessed by the Brier score,indicated excellent model calibration with a score of 0.07.Furthermore,SHAP values highlighted the significance of certain variables in predicting postoperative MACE,with negative noninvasive cardiac stress testing,use of nonselective beta-blockers,direct bilirubin levels,blood type O,and dynamic alterations on myocardial perfusion scintigraphy being the most influential factors at the cohort-wide level.These results highlight the predictive capability of our XGBoost model in assessing the risk of post-LT MACE,making it a valuable tool for clinical practice.CONCLUSION Our study successfully assessed the feasibility and accuracy of the XGBoost machine learning model in predicting post-LT MACE,using both cardiovascular and hepatic variables.The model demonstrated impressive performance,aligning with literature findings,and exhibited excellent calibration.Notably,our cautious approach to prevent overfitting and data leakage suggests the stability of results when applied to prospective data,reinforcing the model’s value as a reliable tool for predicting post-LT MACE in clinical practice.展开更多
BACKGROUND Over the years,strides in colon cancer detection and treatment have boosted survival rates;yet,post-colon cancer survival entails cardiovascular disease(CVD)risks.Research on CVD risks and acute cardiovascu...BACKGROUND Over the years,strides in colon cancer detection and treatment have boosted survival rates;yet,post-colon cancer survival entails cardiovascular disease(CVD)risks.Research on CVD risks and acute cardiovascular events in colorectal cancer survivors has been limited.AIM To compare the CVD risk and adverse cardiovascular outcomes in current colon cancer survivors compared to a decade ago.METHODS We analyzed 2007 and 2017 hospitalization data from the National Inpatient Sample,studying two colon cancer survivor groups for CVD risk factors,mortality rates,and major adverse events like pulmonary embolism,arrhythmia,cardiac arrest,and stroke,adjusting for confounders via multivariable regression analysis.RESULTS Of total colon cancer survivors hospitalized in 2007(n=177542)and 2017(n=178325),the 2017 cohort often consisted of younger(76 vs 77 years),male,African-American,and Hispanic patients admitted non-electively vs the 2007 cohort.Furthermore,the 2017 cohort had higher rates of smoking,alcohol abuse,drug abuse,coagulopathy,liver disease,weight loss,and renal failure.Patients in the 2017 cohort also had higher rates of cardiovascular comorbidities,including hypertension,hyperlipidemia,diabetes,obesity,peripheral vascular disease,congestive heart failure,and at least one traditional CVD(P<0.001)vs the 2007 cohort.On adjusted multivariable analysis,the 2017 cohort had a significantly higher risk of pulmonary embolism(PE)(OR:1.47,95%CI:1.37-1.48),arrhythmia(OR:1.41,95%CI:1.38-1.43),atrial fibrillation/flutter(OR:1.61,95%CI:1.58-1.64),cardiac arrest including ventricular tachyarrhythmia(OR:1.63,95%CI:1.46-1.82),and stroke(OR:1.28,95%CI:1.22-1.34)with comparable all-cause mortality and fewer routine discharges(48.4%vs 55.0%)(P<0.001)vs the 2007 cohort.CONCLUSION Colon cancer survivors hospitalized 10 years apart in the United States showed an increased CVD risk with an increased risk of acute cardiovascular events(stroke 28%,PE 47%,arrhythmia 41%,and cardiac arrest 63%).It is vital to regularly screen colon cancer survivors with concomitant CVD risk factors to curtail long-term cardiovascular complications.展开更多
BACKGROUND Non-alcoholic fatty liver disease(NAFLD)increases cardiovascular disease(CVD)risk irrespective of other risk factors.However,large-scale cardiovascular sex and race differences are poorly understood.AIM To ...BACKGROUND Non-alcoholic fatty liver disease(NAFLD)increases cardiovascular disease(CVD)risk irrespective of other risk factors.However,large-scale cardiovascular sex and race differences are poorly understood.AIM To investigate the relationship between NAFLD and major cardiovascular and cerebrovascular events(MACCE)in subgroups using a nationally representative United States inpatient sample.METHODS We examined National Inpatient Sample(2019)to identify adult hospitalizations with NAFLD by age,sex,and race using ICD-10-CM codes.Clinical and demographic characteristics,comorbidities,and MACCE-related mortality,acute myocardial infarction(AMI),cardiac arrest,and stroke were compared in NAFLD cohorts by sex and race.Multivariable regression analyses were adjusted for sociodemographic characteristics,hospitalization features,and comorbidities.RESULTS We examined 409130 hospitalizations[median 55(IQR 43-66)years]with NFALD.NAFLD was more common in females(1.2%),Hispanics(2%),and Native Americans(1.9%)than whites.Females often reported non-elective admissions,Medicare enrolment,the median age of 55(IQR 42-67),and poor income.Females had higher obesity and uncomplicated diabetes but lower hypertension,hyperlipidemia,and complicated diabetes than males.Hispanics had a median age of 48(IQR 37-60),were Medicaid enrollees,and had non-elective admissions.Hispanics had greater diabetes and obesity rates than whites but lower hypertension and hyperlipidemia.MACCE,all-cause mortality,AMI,cardiac arrest,and stroke were all greater in elderly individuals(P<0.001).MACCE,AMI,and cardiac arrest were more common in men(P<0.001).Native Americans(aOR 1.64)and Asian Pacific Islanders(aOR 1.18)had higher all-cause death risks than whites.CONCLUSION Increasing age and male sex link NAFLD with adverse MACCE outcomes;Native Americans and Asian Pacific Islanders face higher mortality,highlighting a need for tailored interventions and care.展开更多
Mediatic sporting events are increasingly used in the geopolitical arena to gain consensus, at the same time emerging as platforms for the discussion of social issues, such as human rights and sustainability. This art...Mediatic sporting events are increasingly used in the geopolitical arena to gain consensus, at the same time emerging as platforms for the discussion of social issues, such as human rights and sustainability. This article presents an investigation into the role of mediatic sporting events and digital platforms in sparking political debate and social engagement to bring about change, including discussions on global and local interests and the performances of activist fans to promote debate on specific issues. The investigation employs a quantitative methodology. The initial inductive analysis uses a matrix of cultural key-frames of the empowerment and protest that accompany media sporting events, verifying their presence and effectiveness in different communication milieus. An analysis of the representation of protests on social media was performed through content analysis. The results of the investigation show that mediatic sporting events are to be understood as a diverse range of generators of multiple political effects: from the exercise of power to mass mobilization and media criticism.展开更多
Extreme weather events and their consequential impacts have been a key feature of the climate in recent years in many parts of the world,with many partly attributed to ongoing global-scale warming.The past year,2022,h...Extreme weather events and their consequential impacts have been a key feature of the climate in recent years in many parts of the world,with many partly attributed to ongoing global-scale warming.The past year,2022,has been no exception,with further records being broken.The year was marked by unprecedented heatwaves and droughts with highly unusual spatial extent,duration and intensity,with one measure indicating an aggregated and overall intensity of extreme heat events worldwide not seen since at least 1950.The extreme drought measured by surface soil moisture covered 47.3%of global land areas in 2022,which was the second most widespread year since 1980.Here,we examine notable events of the year in five major regions of the world:China’s Yangtze River region,western Europe,the western U.S.,the Horn of Africa and central South America.For each event,we review the potential roles of circulation,oceanic forcing(especially the“triple-dip”La Niña)and anthropogenic climate change,with an aim of understanding the extreme events in 2022 from a global perspective.This will serve as a reference for mechanism understanding,prediction and attribution of extreme events.展开更多
Arctic sea ice loss and the associated enhanced warming has been related to midlatitude weather and climate changes through modulate meridional temperature gradients linked to circulation. However, contrasting lines o...Arctic sea ice loss and the associated enhanced warming has been related to midlatitude weather and climate changes through modulate meridional temperature gradients linked to circulation. However, contrasting lines of evidence result in low confidence in the influence of Arctic warming on midlatitude climate. This study examines the additional perspectives that palaeoclimate evidence provides on the decadal relationship between autumn sea ice extent (SIE) in the Barents-Kara (B-K) Seas and extreme cold wave events (ECWEs) in southern China. Reconstruction of the winter Cold Index and SIE in the B-K Seas from 1289 to 2017 shows that a significant anti-phase relationship occurred during most periods of decreasing SIE, indicating that cold winters are more likely in low SIE years due to the “bridge” role of the North Atlantic Oscillation and Siberian High. It is confirmed that the recent increase in ECWEs in southern China is closely related to the sea ice decline in the B-K Seas. However, our results show that the linkage is unstable, especially in high SIE periods, and it is probably modulated by atmospheric internal variability.展开更多
Granular calcite is an authigenic mineral in fine-grained sedimentary rocks.Core observation,thin section observation,cathodoluminescence analysis,fluid inclusion analysis,scanning electron microscope(SEM),and isotopi...Granular calcite is an authigenic mineral in fine-grained sedimentary rocks.Core observation,thin section observation,cathodoluminescence analysis,fluid inclusion analysis,scanning electron microscope(SEM),and isotopic composition analysis were combined to clarify the genesis of granular calcite in the lacustrine fine-grained sedimentary rocks of the Permian Lucaogou Formation in the Jimusar Sag,Junggar Basin.It is found that the granular calcite is distributed with laminated characteristics in fine-grained sedimentary rocks in tuffite zones(or the transitional zone between tuffite and micritic dolomite).Granular calcite has obvious cathodoluminesence band,and it can be divided into three stages.Stage-Ⅰ calcite,with non-luminesence,high content of Sr element,inclusions containing Cos,and homogenization temperature higher than 170℃,was directly formed from the volcanic-hydrothermal deposition.Stage-Ⅱ calcite,with bright yellow luminescence,high contents of Fe,Mn and Mg,enrichment of light rare earth elements(LREEs),and high homogenization temperature,was formed by recrystallization of calcareous edges from exhalative hydrothermal deposition.Stage-IlI calcite,with dark orange luminescence band,high contents of Mg,P,V and other elements,no obvious fractionation among LREEs,and low homogenization temperature,was originated from diagenetic transformation during burial.The granular calcite appears regularly in the vertical direction and its formation temperature decreases from the center to the margin of particles,providing direct evidences for volcanic-hydrothermal events during the deposition of the Lucaogou Formation.The volcanic-hydrothermal event was conducive to the enrichment of organic matters in fine-grained sedimentary rocks of the Lucaogrou Formation,and positive to the development of high-quality source rocks.The volcanic-hydrothermal sediments might generate intergranular pores/fractures during the evolution,creating conditions for the self-generation and self-storage of shale oil.展开更多
Objective:To access the level of knowledge,perceptions,and practice towards adverse events following immunization(AEFI)surveillance among vaccination workers in Zhejiang province,China.Methods:This was a cross-section...Objective:To access the level of knowledge,perceptions,and practice towards adverse events following immunization(AEFI)surveillance among vaccination workers in Zhejiang province,China.Methods:This was a cross-sectional survey involving 768 vaccination workers.Data were collected using self-administered questionnaires and analyzed by using SAS 9.3 software.Knowledge,perceptions,and practice on AEFI surveillance were summarized using frequency tables.The mean±SD value was used as the cut-off for defining good(values≥mean)and poor(values<mean)knowledge,perceptions or practice.Binary logistic regression analysis was used to determine sociodemographic variables associated with knowledge,perceptions,and practice towards AEFI.Results:The proportions of good knowledge,perceptions and practice on AEFI surveillance were 78.13%,57.81%and 66.15%,respectively.Having a higher education background,longer years of experience,previous training on AEFI and≥30 years of age were factors associated with good knowledge,perceptions and practice on AEFI surveillance among vaccination workers.Conclusions:Over half of the respondents had good knowledge,perceptions and practice on AEFI surveillance work.Interventions on improving the vaccination workers’knowledge,perceptions and practice on AEFI surveillance should be considered in order to develop a more effective surveillance system.展开更多
Narrow bipolar events(NBEs)are intriguing intra-cloud discharge that have attracted enormous interest in the lightning community.They come with two polarities that dominate at different altitudes in thunderclouds.The ...Narrow bipolar events(NBEs)are intriguing intra-cloud discharge that have attracted enormous interest in the lightning community.They come with two polarities that dominate at different altitudes in thunderclouds.The sources of negative NBEs are usually located near the top of thunderclouds;those of positive NBEs are at the middle levels.NBEs may occur at the onset of lightning.The electrical properties of NBEs remain poorly understood.We present here the first comparative study of the electrical characteristics of negative and positive NBEs.To derive electrical parameters from the fast electric field change waveforms of 1673 positive NBEs and 364 negative NBEs recorded by the Jianghuai Area Sferic Array(JASA)in China,we use an improved method based on the transmission line model.This approach concludes that negative NBEs occurring at high altitudes tend to produce a narrower current pulse and take a shorter time to traverse the channel than their positive counterparts.Moreover,compared to positive NBEs,a larger portion of negative NBEs are associated with slightly greater peak current moments but smaller overall charge moments.The differences reported herein between electrical properties of negative and positive NBEs suggest that charge distribution in NBE-producing thunderstorms tends to vary systematically with altitude.展开更多
Various types of plasma events emerge in specific parameter ranges and exhibit similar characteristics in diagnostic signals,which can be applied to identify these events.A semisupervised machine learning algorithm,th...Various types of plasma events emerge in specific parameter ranges and exhibit similar characteristics in diagnostic signals,which can be applied to identify these events.A semisupervised machine learning algorithm,the k-means clustering algorithm,is utilized to investigate and identify plasma events in the J-TEXT plasma.This method can cluster diverse plasma events with homogeneous features,and then these events can be identified if given few manually labeled examples based on physical understanding.A survey of clustered events reveals that the k-means algorithm can make plasma events(rotating tearing mode,sawtooth oscillations,and locked mode)gathering in Euclidean space composed of multi-dimensional diagnostic data,like soft x-ray emission intensity,edge toroidal rotation velocity,the Mirnov signal amplitude and so on.Based on the cluster analysis results,an approximate analytical model is proposed to rapidly identify plasma events in the J-TEXT plasma.The cluster analysis method is conducive to data markers of massive diagnostic data.展开更多
Utilizing the Community Atmosphere Model,version 4,the influence of Arctic sea-ice concentration(SIC)on the extended-range prediction of three simulated cold events(CEs)in East Asia is investigated.Numerical results s...Utilizing the Community Atmosphere Model,version 4,the influence of Arctic sea-ice concentration(SIC)on the extended-range prediction of three simulated cold events(CEs)in East Asia is investigated.Numerical results show that the Arctic SIC is crucial for the extended-range prediction of CEs in East Asia.The conditional nonlinear optimal perturbation approach is adopted to identify the optimal Arctic SIC perturbations with the largest influence on CE prediction on the extended-range time scale.It shows that the optimal SIC perturbations are more inclined to weaken the CEs and cause large prediction errors in the fourth pentad,as compared with random SIC perturbations under the same constraint.Further diagnosis reveals that the optimal SIC perturbations first modulate the local temperature through the diabatic process,and then influence the remote temperature by horizontal advection and vertical convection terms.Consequently,the optimal SIC perturbations trigger a warming center in East Asia through the propagation of Rossby wave trains,leading to the largest prediction uncertainty of the CEs in the fourth pentad.These results may provide scientific support for targeted observation of Arctic SIC to improve the extended-range CE prediction skill.展开更多
Introduction: Despite the many efforts made to combat preventable maternal deaths, these still remain high in Benin. It was therefore important to revisit the causes but especially the adverse events associated with c...Introduction: Despite the many efforts made to combat preventable maternal deaths, these still remain high in Benin. It was therefore important to revisit the causes but especially the adverse events associated with care (EIS) in maternity. Objective: Determine the incidence, adverse events associated with care and causes of intra hospital maternal mortality in cotonou. Methods: This was a cross-sectional maternal mortality review study with retrospective data collection. It covered all cases of maternal death recorded between 2017 and 2021 in two (2) reference university maternities in Cotonou. Adverse events associated with care and the patient were analyzed using the maternal death audit grid validated for Benin. SPSS.26 software was used for data analysis. Results: The in-hospital maternal mortality ratio in Cotonou was 2028 maternal deaths per 100,000 live births in 2021. Only 7.2% (n = 36) of deaths were audited. The deceased mothers were 29.8 ± 7.4 years old, with no fixed monthly income in 82.7% (n = 420). Serious adverse events associated with care were: delay in decision to refer in 37% (n = 188), non-medical referral in 85.8% (n = 436) of cases, inadequate pre-referral treatment in 25.7% of cases. In receiving maternities, delay in diagnosis and inappropriate treatment at the receiving maternity were noted respectively in 22.9% and 28.6% of cases of maternal death. The direct causes of maternal death were dominated by serious obstetric hemorrhage in 43.9% (n = 223). As for the indirect causes, they were dominated by anemia excluding obstetric hemorrhages in 21.5% (n = 109). Conclusion: The in-hospital maternal mortality ratio was very high in Cotonou. The main cause was severe obstetric hemorrhage. There were several serious healthcare-associated adverse events whose correct management would significantly reduce the incidence of maternal deaths.展开更多
基金the University of Reading, funded by the UK–China Research and Innovation Partnership Fund through the Met Office Climate Science for Service Partnership (CSSP) China as part of the Newton Fundsupported by the National Natural Science Foundation of China (Grant Nos. 42030603 and 42175044)+1 种基金supported by CSSP-China. NPK was supported by an Independent Research Fellowship from the Natural Environment Research Council (Grant No. NE/L010976/1)supported by the National Centre for Atmospheric Science via the NERC/GCRF programme “Atmospheric hazards in developing countries: risk assessment and early warnings ” (ACREW)。
文摘The frequency and duration of observed concurrent hot and dry events(HDEs) over China during the growing season(April–September) exhibit significant decadal changes across the mid-1990s. These changes are characterized by increases in HDE frequency and duration over most of China, with relatively large increases over southeastern China(SEC), northern China(NC), and northeastern China(NEC). The frequency of HDEs averaged over China in the present day(PD,1994–2011) is double that in the early period(EP, 1964–81);the duration of HDEs increases by 60%. Climate experiments with the Met Office Unified Model(MetUM-GOML2) are used to estimate the contributions of anthropogenic forcing to HDE decadal changes over China. Anthropogenic forcing changes can explain 60%–70% of the observed decadal changes,suggesting an important anthropogenic influence on HDE changes over China across the mid-1990s. Single-forcing experiments indicate that the increase in greenhouse gas(GHG) concentrations dominates the simulated decadal changes,increasing the frequency and duration of HDEs throughout China. The change in anthropogenic aerosol(AA) emissions significantly decreases the frequency and duration of HDEs over SEC and NC, but the magnitude of the decrease is much smaller than the increase induced by GHGs. The changes in HDEs in response to anthropogenic forcing are mainly due to the response of climatological mean surface air temperatures. The contributions from changes in variability and changes in climatological mean soil moisture and evapotranspiration are relatively small. The physical processes associated with the response of HDEs to GHG and AA changes are also revealed.
文摘The SHRP2 Naturalistic Driving Study was used to evaluate the impact of various work zone and driver characteristics on back of queue safety critical events (crash, near-crash, or conflicts) The model included 43 SCE and 209 “normal” events which were used as controls. The traces included representing 209 unique drivers. A Mixed-Effects Logistic Regression model was developed with probability of a SCE as the response variable and driver and work zone characteristics as predictor variables. The final model indicated glances over 1 second away from the driving task and following closely increased risk of an SCE by 3.8 times and 2.9 times, respectively. Average speed was negatively correlated to crash risk. This is counterintuitive since in most cases, it is expected that higher speeds are related to back of queue crashes. However, most queues form under congested conditions. As a result, vehicles encountering a back of queue would be more likely to be traveling at lower speeds.
文摘We conducted a comprehensive review of existing prediction models pertaining to the efficacy of immune-checkpoint inhibitor(ICI)and the occurrence of immune-related adverse events(irAEs).The predictive potential of neutrophil-to-lymphocyte ratio(NLR)and platelet-to-lymphocyte ratio(PLR)in determining ICI effectiveness has been extensively investigated,while limited research has been conducted on predicting irAEs.Furthermore,the combined model incor-porating NLR and PLR,either with each other or in conjunction with additional markers such as carcinoembryonic antigen,exhibits superior predictive capabilities compared to individual markers alone.NLR and PLR are promising markers for clinical applications.Forthcoming models ought to incorporate established efficacious models and newly identified ones,thereby constituting a multifactor composite model.Furthermore,efforts should be made to explore effective clinical application approaches that enhance the predictive accuracy and efficiency.
基金supported by the Youth Fund of Fundamental Research Fund for the Central Universities of Jinan University,No.11622303(to YZ).
文摘Microvasculature of the retina is considered an alternative marker of cerebral vascular risk in healthy populations.However,the ability of retinal vasculature changes,specifically focusing on retinal vessel diameter,to predict the recurrence of cerebrovascular events in patients with ischemic stroke has not been determined comprehensively.While previous studies have shown a link between retinal vessel diameter and recurrent cerebrovascular events,they have not incorporated this information into a predictive model.Therefore,this study aimed to investigate the relationship between retinal vessel diameter and subsequent cerebrovascular events in patients with acute ischemic stroke.Additionally,we sought to establish a predictive model by combining retinal veessel diameter with traditional risk factors.We performed a prospective observational study of 141 patients with acute ischemic stroke who were admitted to the First Affiliated Hospital of Jinan University.All of these patients underwent digital retinal imaging within 72 hours of admission and were followed up for 3 years.We found that,after adjusting for related risk factors,patients with acute ischemic stroke with mean arteriolar diameter within 0.5-1.0 disc diameters of the disc margin(MAD_(0.5-1.0DD))of≥74.14μm and mean venular diameter within 0.5-1.0 disc diameters of the disc margin(MVD_(0.5-1.0DD))of≥83.91μm tended to experience recurrent cerebrovascular events.We established three multivariate Cox proportional hazard regression models:model 1 included traditional risk factors,model 2 added MAD_(0.5-1.0DD)to model 1,and model 3 added MVD0.5-1.0DD to model 1.Model 3 had the greatest potential to predict subsequent cerebrovascular events,followed by model 2,and finally model 1.These findings indicate that combining retinal venular or arteriolar diameter with traditional risk factors could improve the prediction of recurrent cerebrovascular events in patients with acute ischemic stroke,and that retinal imaging could be a useful and non-invasive method for identifying high-risk patients who require closer monitoring and more aggressive management.
基金Supported by Special Project for Improving Science and Technology Innovation Ability of Army Medical University,No.2022XLC09.
文摘BACKGROUND The incidence of chronic kidney disease among patients with diabetes mellitus(DM)remains a global concern.Long-term obesity is known to possibly influence the development of type 2 diabetes mellitus.However,no previous meta-analysis has assessed the effects of body mass index(BMI)on adverse kidney events in patients with DM.AIM To determine the impact of BMI on adverse kidney events in patients with DM.METHODS A systematic literature search was performed on the PubMed,ISI Web of Science,Scopus,Ovid,Google Scholar,EMBASE,and BMJ databases.We included trials with the following characteristics:(1)Type of study:Prospective,retrospective,randomized,and non-randomized in design;(2)participants:Restricted to patients with DM aged≥18 years;(3)intervention:No intervention;and(4)kidney adverse events:Onset of diabetic kidney disease[estimated glomerular filtration rate(eGFR)of<60 mL/min/1.73 m2 and/or microalbuminuria value of≥30 mg/g Cr],serum creatinine increase of more than double the baseline or end-stage renal disease(eGFR<15 mL/min/1.73 m2 or dialysis),or death.RESULTS Overall,11 studies involving 801 patients with DM were included.High BMI(≥25 kg/m2)was significantly associated with higher blood pressure(BP)[systolic BP by 0.20,95%confidence interval(CI):0.15–0.25,P<0.00001;diastolic BP by 0.21 mmHg,95%CI:0.04–0.37,P=0.010],serum albumin,triglycerides[standard mean difference(SMD)=0.35,95%CI:0.29–0.41,P<0.00001],low-density lipoprotein(SMD=0.12,95%CI:0.04–0.20,P=0.030),and lower high-density lipoprotein(SMD=–0.36,95%CI:–0.51 to–0.21,P<0.00001)in patients with DM compared with those with low BMIs(<25 kg/m2).Our analysis showed that high BMI was associated with a higher risk ratio of adverse kidney events than low BMI(RR:1.22,95%CI:1.01–1.43,P=0.036).CONCLUSION The present analysis suggested that high BMI was a risk factor for adverse kidney events in patients with DM.
基金funded by the National Natural Science Foundation of China(42171145,42171147)the Gansu Provincial Science and Technology Program(22ZD6FA005)the Key Talent Program of Gansu Province.
文摘Rain-on-snow(ROS)events involve rainfall on snow surfaces,and the occurrence of ROS events can exacerbate water scarcity and ecosystem vulnerability in the arid region of Northwest China(ARNC).In this study,using daily snow depth data and daily meteorological data from 68 meteorological stations provided by the China Meteorological Administration National Meteorological Information Centre,we investigated the spatiotemporal variability of ROS events in the ARNC from 1978 to 2015 and examined the factors affecting these events and possible changes of future ROS events in the ARNC.The results showed that ROS events in the ARNC mainly occurred from October to May of the following year and were largely distributed in the Qilian Mountains,Tianshan Mountains,Ili River Valley,Tacheng Prefecture,and Altay Prefecture,with the Ili River Valley,Tacheng City,and Altay Mountains exhibiting the most occurrences.Based on the intensity of ROS events,the areas with the highest risk of flooding resulting from ROS events in the ARNC were the Tianshan Mountains,Ili River Valley,Tacheng City,and Altay Mountains.The number and intensity of ROS events in the ARNC largely increased from 1978 to 2015,mainly influenced by air temperature and the number of rainfall days.However,due to the snowpack abundance in areas experiencing frequent ROS events in the ARNC,snowpack changes exerted slight impact on ROS events,which is a temporary phenomenon.Furthermore,elevation imposed lesser impact on ROS events in the ARNC than other factors.In the ARNC,the start time of rainfall and the end time of snowpack gradually advanced from the spring of the current year to the winter of the previous year,while the end time of rainfall and the start time of snowpack gradually delayed from autumn to winter.This may lead to more ROS events in winter in the future.These results could provide a sound basis for managing water resources and mitigating related disasters caused by ROS events in the ARNC.
文摘BACKGROUND Prediabetes is a well-established risk factor for major adverse cardiac and cerebrovascular events(MACCE).However,the relationship between prediabetes and MACCE in atrial fibrillation(AF)patients has not been extensively studied.Therefore,this study aimed to establish a link between prediabetes and MACCE in AF patients.AIM To investigate a link between prediabetes and MACCE in AF patients.METHODS We used the National Inpatient Sample(2019)and relevant ICD-10 CM codes to identify hospitalizations with AF and categorized them into groups with and without prediabetes,excluding diabetics.The primary outcome was MACCE(all-cause inpatient mortality,cardiac arrest including ventricular fibrillation,and stroke)in AF-related hospitalizations.RESULTS Of the 2965875 AF-related hospitalizations for MACCE,47505(1.6%)were among patients with prediabetes.The prediabetes cohort was relatively younger(median 75 vs 78 years),and often consisted of males(56.3%vs 51.4%),blacks(9.8%vs 7.9%),Hispanics(7.3%vs 4.3%),and Asians(4.7%vs 1.6%)than the non-prediabetic cohort(P<0.001).The prediabetes group had significantly higher rates of hypertension,hyperlipidemia,smoking,obesity,drug abuse,prior myocardial infarction,peripheral vascular disease,and hyperthyroidism(all P<0.05).The prediabetes cohort was often discharged routinely(51.1%vs 41.1%),but more frequently required home health care(23.6%vs 21.0%)and had higher costs.After adjusting for baseline characteristics or comorbidities,the prediabetes cohort with AF admissions showed a higher rate and significantly higher odds of MACCE compared to the non-prediabetic cohort[18.6%vs 14.7%,odds ratio(OR)1.34,95%confidence interval 1.26-1.42,P<0.001].On subgroup analyses,males had a stronger association(aOR 1.43)compared to females(aOR 1.22),whereas on the race-wise comparison,Hispanics(aOR 1.43)and Asians(aOR 1.36)had a stronger association with MACCE with prediabetes vs whites(aOR 1.33)and blacks(aOR 1.21).CONCLUSION This population-based study found a significant association between prediabetes and MACCE in AF patients.Therefore,there is a need for further research to actively screen and manage prediabetes in AF to prevent MACCE.
文摘BACKGROUND Liver transplant(LT)patients have become older and sicker.The rate of post-LT major adverse cardiovascular events(MACE)has increased,and this in turn raises 30-d post-LT mortality.Noninvasive cardiac stress testing loses accuracy when applied to pre-LT cirrhotic patients.AIM To assess the feasibility and accuracy of a machine learning model used to predict post-LT MACE in a regional cohort.METHODS This retrospective cohort study involved 575 LT patients from a Southern Brazilian academic center.We developed a predictive model for post-LT MACE(defined as a composite outcome of stroke,new-onset heart failure,severe arrhythmia,and myocardial infarction)using the extreme gradient boosting(XGBoost)machine learning model.We addressed missing data(below 20%)for relevant variables using the k-nearest neighbor imputation method,calculating the mean from the ten nearest neighbors for each case.The modeling dataset included 83 features,encompassing patient and laboratory data,cirrhosis complications,and pre-LT cardiac assessments.Model performance was assessed using the area under the receiver operating characteristic curve(AUROC).We also employed Shapley additive explanations(SHAP)to interpret feature impacts.The dataset was split into training(75%)and testing(25%)sets.Calibration was evaluated using the Brier score.We followed Transparent Reporting of a Multivariable Prediction Model for Individual Prognosis or Diagnosis guidelines for reporting.Scikit-learn and SHAP in Python 3 were used for all analyses.The supplementary material includes code for model development and a user-friendly online MACE prediction calculator.RESULTS Of the 537 included patients,23(4.46%)developed in-hospital MACE,with a mean age at transplantation of 52.9 years.The majority,66.1%,were male.The XGBoost model achieved an impressive AUROC of 0.89 during the training stage.This model exhibited accuracy,precision,recall,and F1-score values of 0.84,0.85,0.80,and 0.79,respectively.Calibration,as assessed by the Brier score,indicated excellent model calibration with a score of 0.07.Furthermore,SHAP values highlighted the significance of certain variables in predicting postoperative MACE,with negative noninvasive cardiac stress testing,use of nonselective beta-blockers,direct bilirubin levels,blood type O,and dynamic alterations on myocardial perfusion scintigraphy being the most influential factors at the cohort-wide level.These results highlight the predictive capability of our XGBoost model in assessing the risk of post-LT MACE,making it a valuable tool for clinical practice.CONCLUSION Our study successfully assessed the feasibility and accuracy of the XGBoost machine learning model in predicting post-LT MACE,using both cardiovascular and hepatic variables.The model demonstrated impressive performance,aligning with literature findings,and exhibited excellent calibration.Notably,our cautious approach to prevent overfitting and data leakage suggests the stability of results when applied to prospective data,reinforcing the model’s value as a reliable tool for predicting post-LT MACE in clinical practice.
文摘BACKGROUND Over the years,strides in colon cancer detection and treatment have boosted survival rates;yet,post-colon cancer survival entails cardiovascular disease(CVD)risks.Research on CVD risks and acute cardiovascular events in colorectal cancer survivors has been limited.AIM To compare the CVD risk and adverse cardiovascular outcomes in current colon cancer survivors compared to a decade ago.METHODS We analyzed 2007 and 2017 hospitalization data from the National Inpatient Sample,studying two colon cancer survivor groups for CVD risk factors,mortality rates,and major adverse events like pulmonary embolism,arrhythmia,cardiac arrest,and stroke,adjusting for confounders via multivariable regression analysis.RESULTS Of total colon cancer survivors hospitalized in 2007(n=177542)and 2017(n=178325),the 2017 cohort often consisted of younger(76 vs 77 years),male,African-American,and Hispanic patients admitted non-electively vs the 2007 cohort.Furthermore,the 2017 cohort had higher rates of smoking,alcohol abuse,drug abuse,coagulopathy,liver disease,weight loss,and renal failure.Patients in the 2017 cohort also had higher rates of cardiovascular comorbidities,including hypertension,hyperlipidemia,diabetes,obesity,peripheral vascular disease,congestive heart failure,and at least one traditional CVD(P<0.001)vs the 2007 cohort.On adjusted multivariable analysis,the 2017 cohort had a significantly higher risk of pulmonary embolism(PE)(OR:1.47,95%CI:1.37-1.48),arrhythmia(OR:1.41,95%CI:1.38-1.43),atrial fibrillation/flutter(OR:1.61,95%CI:1.58-1.64),cardiac arrest including ventricular tachyarrhythmia(OR:1.63,95%CI:1.46-1.82),and stroke(OR:1.28,95%CI:1.22-1.34)with comparable all-cause mortality and fewer routine discharges(48.4%vs 55.0%)(P<0.001)vs the 2007 cohort.CONCLUSION Colon cancer survivors hospitalized 10 years apart in the United States showed an increased CVD risk with an increased risk of acute cardiovascular events(stroke 28%,PE 47%,arrhythmia 41%,and cardiac arrest 63%).It is vital to regularly screen colon cancer survivors with concomitant CVD risk factors to curtail long-term cardiovascular complications.
文摘BACKGROUND Non-alcoholic fatty liver disease(NAFLD)increases cardiovascular disease(CVD)risk irrespective of other risk factors.However,large-scale cardiovascular sex and race differences are poorly understood.AIM To investigate the relationship between NAFLD and major cardiovascular and cerebrovascular events(MACCE)in subgroups using a nationally representative United States inpatient sample.METHODS We examined National Inpatient Sample(2019)to identify adult hospitalizations with NAFLD by age,sex,and race using ICD-10-CM codes.Clinical and demographic characteristics,comorbidities,and MACCE-related mortality,acute myocardial infarction(AMI),cardiac arrest,and stroke were compared in NAFLD cohorts by sex and race.Multivariable regression analyses were adjusted for sociodemographic characteristics,hospitalization features,and comorbidities.RESULTS We examined 409130 hospitalizations[median 55(IQR 43-66)years]with NFALD.NAFLD was more common in females(1.2%),Hispanics(2%),and Native Americans(1.9%)than whites.Females often reported non-elective admissions,Medicare enrolment,the median age of 55(IQR 42-67),and poor income.Females had higher obesity and uncomplicated diabetes but lower hypertension,hyperlipidemia,and complicated diabetes than males.Hispanics had a median age of 48(IQR 37-60),were Medicaid enrollees,and had non-elective admissions.Hispanics had greater diabetes and obesity rates than whites but lower hypertension and hyperlipidemia.MACCE,all-cause mortality,AMI,cardiac arrest,and stroke were all greater in elderly individuals(P<0.001).MACCE,AMI,and cardiac arrest were more common in men(P<0.001).Native Americans(aOR 1.64)and Asian Pacific Islanders(aOR 1.18)had higher all-cause death risks than whites.CONCLUSION Increasing age and male sex link NAFLD with adverse MACCE outcomes;Native Americans and Asian Pacific Islanders face higher mortality,highlighting a need for tailored interventions and care.
文摘Mediatic sporting events are increasingly used in the geopolitical arena to gain consensus, at the same time emerging as platforms for the discussion of social issues, such as human rights and sustainability. This article presents an investigation into the role of mediatic sporting events and digital platforms in sparking political debate and social engagement to bring about change, including discussions on global and local interests and the performances of activist fans to promote debate on specific issues. The investigation employs a quantitative methodology. The initial inductive analysis uses a matrix of cultural key-frames of the empowerment and protest that accompany media sporting events, verifying their presence and effectiveness in different communication milieus. An analysis of the representation of protests on social media was performed through content analysis. The results of the investigation show that mediatic sporting events are to be understood as a diverse range of generators of multiple political effects: from the exercise of power to mass mobilization and media criticism.
基金supported by the National Key Technologies R&D Program of China[grant number 2022YFC3002803]the National Science Fund for Distinguished Young Scholars[grant number 41925021].
基金supported by the National Natural Science Foundation of China(Grant No.42075037 and 42275033)the UK–China Research and Innovation Partnership Fund through the Met Office Climate Science for Service Partnership(CSSP)-China programme as part of the Newton Fund.
文摘Extreme weather events and their consequential impacts have been a key feature of the climate in recent years in many parts of the world,with many partly attributed to ongoing global-scale warming.The past year,2022,has been no exception,with further records being broken.The year was marked by unprecedented heatwaves and droughts with highly unusual spatial extent,duration and intensity,with one measure indicating an aggregated and overall intensity of extreme heat events worldwide not seen since at least 1950.The extreme drought measured by surface soil moisture covered 47.3%of global land areas in 2022,which was the second most widespread year since 1980.Here,we examine notable events of the year in five major regions of the world:China’s Yangtze River region,western Europe,the western U.S.,the Horn of Africa and central South America.For each event,we review the potential roles of circulation,oceanic forcing(especially the“triple-dip”La Niña)and anthropogenic climate change,with an aim of understanding the extreme events in 2022 from a global perspective.This will serve as a reference for mechanism understanding,prediction and attribution of extreme events.
基金the National Natural Science Foundation of China(Grant No.42101142)the Strategic Priority Research Program of the Chinese Academy of Sciences(Grant No.XDA19070103)the Young Elite Scientists Sponsorship Program by CAST(Grant No.2022QNRC001).
文摘Arctic sea ice loss and the associated enhanced warming has been related to midlatitude weather and climate changes through modulate meridional temperature gradients linked to circulation. However, contrasting lines of evidence result in low confidence in the influence of Arctic warming on midlatitude climate. This study examines the additional perspectives that palaeoclimate evidence provides on the decadal relationship between autumn sea ice extent (SIE) in the Barents-Kara (B-K) Seas and extreme cold wave events (ECWEs) in southern China. Reconstruction of the winter Cold Index and SIE in the B-K Seas from 1289 to 2017 shows that a significant anti-phase relationship occurred during most periods of decreasing SIE, indicating that cold winters are more likely in low SIE years due to the “bridge” role of the North Atlantic Oscillation and Siberian High. It is confirmed that the recent increase in ECWEs in southern China is closely related to the sea ice decline in the B-K Seas. However, our results show that the linkage is unstable, especially in high SIE periods, and it is probably modulated by atmospheric internal variability.
基金Supported by the National Natural Science Foundation Project of China(42072161)College Basic Research Funding Project(22CX07008A).
文摘Granular calcite is an authigenic mineral in fine-grained sedimentary rocks.Core observation,thin section observation,cathodoluminescence analysis,fluid inclusion analysis,scanning electron microscope(SEM),and isotopic composition analysis were combined to clarify the genesis of granular calcite in the lacustrine fine-grained sedimentary rocks of the Permian Lucaogou Formation in the Jimusar Sag,Junggar Basin.It is found that the granular calcite is distributed with laminated characteristics in fine-grained sedimentary rocks in tuffite zones(or the transitional zone between tuffite and micritic dolomite).Granular calcite has obvious cathodoluminesence band,and it can be divided into three stages.Stage-Ⅰ calcite,with non-luminesence,high content of Sr element,inclusions containing Cos,and homogenization temperature higher than 170℃,was directly formed from the volcanic-hydrothermal deposition.Stage-Ⅱ calcite,with bright yellow luminescence,high contents of Fe,Mn and Mg,enrichment of light rare earth elements(LREEs),and high homogenization temperature,was formed by recrystallization of calcareous edges from exhalative hydrothermal deposition.Stage-IlI calcite,with dark orange luminescence band,high contents of Mg,P,V and other elements,no obvious fractionation among LREEs,and low homogenization temperature,was originated from diagenetic transformation during burial.The granular calcite appears regularly in the vertical direction and its formation temperature decreases from the center to the margin of particles,providing direct evidences for volcanic-hydrothermal events during the deposition of the Lucaogou Formation.The volcanic-hydrothermal event was conducive to the enrichment of organic matters in fine-grained sedimentary rocks of the Lucaogrou Formation,and positive to the development of high-quality source rocks.The volcanic-hydrothermal sediments might generate intergranular pores/fractures during the evolution,creating conditions for the self-generation and self-storage of shale oil.
基金funded by medical and health science and technology project of Zhejiang province (Grant number:2023KY633)
文摘Objective:To access the level of knowledge,perceptions,and practice towards adverse events following immunization(AEFI)surveillance among vaccination workers in Zhejiang province,China.Methods:This was a cross-sectional survey involving 768 vaccination workers.Data were collected using self-administered questionnaires and analyzed by using SAS 9.3 software.Knowledge,perceptions,and practice on AEFI surveillance were summarized using frequency tables.The mean±SD value was used as the cut-off for defining good(values≥mean)and poor(values<mean)knowledge,perceptions or practice.Binary logistic regression analysis was used to determine sociodemographic variables associated with knowledge,perceptions,and practice towards AEFI.Results:The proportions of good knowledge,perceptions and practice on AEFI surveillance were 78.13%,57.81%and 66.15%,respectively.Having a higher education background,longer years of experience,previous training on AEFI and≥30 years of age were factors associated with good knowledge,perceptions and practice on AEFI surveillance among vaccination workers.Conclusions:Over half of the respondents had good knowledge,perceptions and practice on AEFI surveillance work.Interventions on improving the vaccination workers’knowledge,perceptions and practice on AEFI surveillance should be considered in order to develop a more effective surveillance system.
基金The authors would acknowledge financial support from the National Key Laboratory on Electromagnetic Environmental Effects and Electro-optical Engineering(NO.JCKYS2022LD6)the National Natural Science Foundation of China(42005068 and 42375074)+1 种基金the Project of Stable Support for Youth Team in Basic Research Field CAS(YSBR-018)the Joint Open Fund of Mengcheng National Geophysical Observatory(MENGO-202208).
文摘Narrow bipolar events(NBEs)are intriguing intra-cloud discharge that have attracted enormous interest in the lightning community.They come with two polarities that dominate at different altitudes in thunderclouds.The sources of negative NBEs are usually located near the top of thunderclouds;those of positive NBEs are at the middle levels.NBEs may occur at the onset of lightning.The electrical properties of NBEs remain poorly understood.We present here the first comparative study of the electrical characteristics of negative and positive NBEs.To derive electrical parameters from the fast electric field change waveforms of 1673 positive NBEs and 364 negative NBEs recorded by the Jianghuai Area Sferic Array(JASA)in China,we use an improved method based on the transmission line model.This approach concludes that negative NBEs occurring at high altitudes tend to produce a narrower current pulse and take a shorter time to traverse the channel than their positive counterparts.Moreover,compared to positive NBEs,a larger portion of negative NBEs are associated with slightly greater peak current moments but smaller overall charge moments.The differences reported herein between electrical properties of negative and positive NBEs suggest that charge distribution in NBE-producing thunderstorms tends to vary systematically with altitude.
基金supported by the National Magnetic Confinement Fusion Science Program of China(Nos.2018YFE0301104 and 2018YFE0301100)National Natural Science Foundation of China(Nos.12075096 and 51821005)。
文摘Various types of plasma events emerge in specific parameter ranges and exhibit similar characteristics in diagnostic signals,which can be applied to identify these events.A semisupervised machine learning algorithm,the k-means clustering algorithm,is utilized to investigate and identify plasma events in the J-TEXT plasma.This method can cluster diverse plasma events with homogeneous features,and then these events can be identified if given few manually labeled examples based on physical understanding.A survey of clustered events reveals that the k-means algorithm can make plasma events(rotating tearing mode,sawtooth oscillations,and locked mode)gathering in Euclidean space composed of multi-dimensional diagnostic data,like soft x-ray emission intensity,edge toroidal rotation velocity,the Mirnov signal amplitude and so on.Based on the cluster analysis results,an approximate analytical model is proposed to rapidly identify plasma events in the J-TEXT plasma.The cluster analysis method is conducive to data markers of massive diagnostic data.
基金the National Natural Science Foundation of China(Grant Nos.42288101,41790475,42175051,and 42005046)the State Key Laboratory of Tropical Oceanography(South China Sea Institute of Oceanology,Chinese Academy of Sciences+1 种基金Grant No.LTO2109)the Guangdong Basic and Applied Basic Research Foundation(Grant No.2021A1515011868).
文摘Utilizing the Community Atmosphere Model,version 4,the influence of Arctic sea-ice concentration(SIC)on the extended-range prediction of three simulated cold events(CEs)in East Asia is investigated.Numerical results show that the Arctic SIC is crucial for the extended-range prediction of CEs in East Asia.The conditional nonlinear optimal perturbation approach is adopted to identify the optimal Arctic SIC perturbations with the largest influence on CE prediction on the extended-range time scale.It shows that the optimal SIC perturbations are more inclined to weaken the CEs and cause large prediction errors in the fourth pentad,as compared with random SIC perturbations under the same constraint.Further diagnosis reveals that the optimal SIC perturbations first modulate the local temperature through the diabatic process,and then influence the remote temperature by horizontal advection and vertical convection terms.Consequently,the optimal SIC perturbations trigger a warming center in East Asia through the propagation of Rossby wave trains,leading to the largest prediction uncertainty of the CEs in the fourth pentad.These results may provide scientific support for targeted observation of Arctic SIC to improve the extended-range CE prediction skill.
文摘Introduction: Despite the many efforts made to combat preventable maternal deaths, these still remain high in Benin. It was therefore important to revisit the causes but especially the adverse events associated with care (EIS) in maternity. Objective: Determine the incidence, adverse events associated with care and causes of intra hospital maternal mortality in cotonou. Methods: This was a cross-sectional maternal mortality review study with retrospective data collection. It covered all cases of maternal death recorded between 2017 and 2021 in two (2) reference university maternities in Cotonou. Adverse events associated with care and the patient were analyzed using the maternal death audit grid validated for Benin. SPSS.26 software was used for data analysis. Results: The in-hospital maternal mortality ratio in Cotonou was 2028 maternal deaths per 100,000 live births in 2021. Only 7.2% (n = 36) of deaths were audited. The deceased mothers were 29.8 ± 7.4 years old, with no fixed monthly income in 82.7% (n = 420). Serious adverse events associated with care were: delay in decision to refer in 37% (n = 188), non-medical referral in 85.8% (n = 436) of cases, inadequate pre-referral treatment in 25.7% of cases. In receiving maternities, delay in diagnosis and inappropriate treatment at the receiving maternity were noted respectively in 22.9% and 28.6% of cases of maternal death. The direct causes of maternal death were dominated by serious obstetric hemorrhage in 43.9% (n = 223). As for the indirect causes, they were dominated by anemia excluding obstetric hemorrhages in 21.5% (n = 109). Conclusion: The in-hospital maternal mortality ratio was very high in Cotonou. The main cause was severe obstetric hemorrhage. There were several serious healthcare-associated adverse events whose correct management would significantly reduce the incidence of maternal deaths.
