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Myocardial bridge contributes to chest pain, often accompanied by non-specific complaints.
Aims
Our study aims to determine somatic symptom disorder (SSD) prevalence in patients with myocardial bridge, investigating associated clinical and psychological features.
Method
In this prospective cross-sectional study, we enrolled 1357 participants (337 with and 1020 without myocardial bridge) from Shanghai Renji Hospital. The Somatic Symptom Scale-China questionnaire was used to assess SSD. Depressive and anxiety disorders were assessed by the Patient Health Questionnaire-9 (PHQ-9) and Generalised Anxiety Disorder-7 (GAD-7).
Results
The prevalence of SSD in the myocardial bridge group was 63.2%, higher than the group without myocardial bridge (53.8%). Patients with myocardial bridge were at an increased risk of SSD (odds ratio 1.362, 95% CI 1.026–1.809; P = 0.033). There were no differences in the mean PHQ-9 scores (3.2 ± 3.4 v. 3.2 ± 4.1; P = 0.751) or GAD-7 scores (2.5 ± 3.0 v. 2.3 ± 3.7; P = 0.143) between the two groups. Among patients with myocardial bridge, gender was the only independent risk factor for SSD. Women were 3.119 times more likely to experience SSD compared with men (95% CI 1.537–6.329; P = 0.002).
Conclusions
Our findings emphasise the high prevalence and severity of SSD among patients with myocardial bridge. The screening for SSD should be of particular concern, especially among female patients.
Process data refer to data recorded in computer-based assessments (CBAs) that reflect respondents’ problem-solving processes and provide greater insight into how respondents solve problems, in addition to how well they solve them. Using the rich information contained in process data, this study proposed an item expansion method to analyze action-level process data from the perspective of diagnostic classification in order to comprehensively understand respondents’ problem-solving competence. The proposed method cannot only estimate respondents’ problem-solving ability along a continuum, but also classify respondents according to their problem-solving skills. To illustrate the application and advantages of the proposed method, a Programme for International Student Assessment (PISA) problem-solving item was used. The results indicated that (a) the estimated latent classes provided more detailed diagnoses of respondents’ problem-solving skills than the observed score categories; (b) although only one item was used, the estimated higher-order latent ability reflected the respondents’ problem-solving ability more accurately than the unidimensional latent ability estimated from the outcome data; and (c) interactions among problem-solving skills followed the conjunctive condensation rule, which indicated that the specific action sequence appeared only when a respondent mastered all required problem solving skills. In conclusion, the proposed diagnostic classification approach is feasible and promising analyzing process data.
Linear instability analysis of a viscous swirling liquid jet surrounded by ambient gas is carried out by considering the significant influence of axial shear effect. The jet azimuthal flow is assumed as a Rankine vortex, and the non-uniform velocity distribution in the jet axial direction is approximated by parabolic and error functions. The enhancement of jet rotation is found to promote the predominant mode with larger azimuthal wavenumbers, and the mode transition is decided by the competition between centrifugal force and axial shear stress. Subsequently, the influence of the axial shear effect is examined through changing the degree of shear stress and the thickness of the gas velocity boundary layer. It is found that an increase of jet average velocity or surface velocity in the axial direction leads to the predominant mode transition to smaller azimuthal wavenumbers, due to the combined effects of shear stress and gas pressure perturbation. A larger velocity difference between ambient gas and liquid jet also promotes the predominant modes with smaller azimuthal wavenumbers, and the physical mechanism is attributed to gas pressure perturbation. Phase diagrams of different azimuthal modes are given and compared with the study of Kubitschek & Weidman (J. Fluid Mech., vol. 572, 2007, pp. 261–286), where a static swirling column without axial shear stress was considered. The strengthened axial shear effect is found to delay the transition of predominant modes with the increase of angular velocity. Experimental studies considering the swirling jets with different axial velocities are further carried out, which validate the theoretical findings. Different instability mechanisms and their transition rules are also identified through energy budget analysis. This study is expected to give scientific guidance on understanding the instability mechanisms of the swirling jets that widely exist in natural phenomena and engineering applications.
Language is one of the most celebrated hallmarks of human cognition. With the continuous improvement of medical technology, functional MRI (fMRI) has been used in aphasia. Although many related studies have been carried out, most studies have not extensively focused on brain regions with reduced activation in aphasic patients. The aim of this study was to identify brain regions normally activated in healthy controls but with reduced activation in aphasic patients during fMRI language tasks.
Methods:
We collected all previous task-state fMRI studies of secondary aphasia. The brain regions showed normal activation in healthy controls and reduced activation in aphasic patients were conducted activation likelihood estimation (ALE) meta-analysis to obtain the brain regions with consistently reduced activation in aphasic patients.
Results:
The ALE meta-analysis revealed that the left inferior frontal gyrus, left middle temporal gyrus, left superior temporal gyrus, left fusiform gyrus, left lentiform nucleus and the culmen of the cerebellum were the brain regions with reduced activation in aphasic patients.
Discussion:
These findings from the ALE meta-analysis have significant implications for understanding the language network and the potential for recovery of language functions in individuals with aphasia.
The Chinese Loess Plateau (CLP), recognized as the world's largest loess plateau, has been a subject of ongoing debate regarding the continuity of its sedimentary loess sequence due to its intricate depositional environment. In this study, we conducted dating on a 9.8-m-long Malan loess core obtained from the Sanmen Gorge in the southern CLP using optically stimulated luminescence (OSL). The OSL dates indicate loess deposition between 52.4 and 11.3 ka, with no apparent hiatus on a millennial scale, and a sedimentation rate (SR) exhibiting six distinct episodes. Additionally, a comprehensive review of 613 OSL ages from 18 sections at 14 sites across the CLP was conducted. The results reveal loess deposition at most sites shows no apparent hiatus on a millennial scale over the past 60 ka, except for two specific locations. High SR episodes during Marine Isotope Stage (MIS) 3 across the CLP were attributed to heightened dust emissions from the source region and an enhanced dust deposition efficiency, while MIS 2 deposits were influenced by an intensified East Asian winter monsoon. Low SR episodes during MIS 1 at most sites were likely associated with reduced atmospheric transportation and pedogenesis. Spatially heterogeneous SR variations across the CLP might be influenced by local depositional environments.
Caused by multiple risk factors, heavy burden of major depressive disorder (MDD) poses serious challenges to public health worldwide over the past 30 years. Yet the burden and attributable risk factors of MDD were not systematically known. We aimed to reveal the long-term spatio-temporal trends in the burden and attributable risk factors of MDD at global, regional and national levels during 1990–2019.
Methods
We obtained MDD and attributable risk factors data from Global Burden of Disease Study 2019. We used joinpoint regression model to assess the temporal trend in MDD burden, and age–period–cohort model to measure the effects of age, period and birth cohort on MDD incidence rate. We utilized population attributable fractions (PAFs) to estimate the specific proportions of MDD burden attributed to given risk factors.
Results
During 1990–2019, the global number of MDD incident cases, prevalent cases and disability-adjusted life years (DALYs) increased by 59.10%, 59.57% and 58.57%, respectively. Whereas the global age-standardized incidence rate (ASIR), age-standardized prevalence rate (ASPR) and age-standardized DALYs rate (ASDR) of MDD decreased during 1990–2019. The ASIR, ASPR and ASDR in women were 1.62, 1.62 and 1.60 times as that in men in 2019, respectively. The highest age-specific incidence, prevalence and DALYs rate occurred at the age of 60–64 in women, and at the age of 75–84 in men, but the maximum increasing trends in these age-specific rates occurred at the age of 5–9. Population living during 2000–2004 had higher risk of MDD. MDD burden varied by socio-demographic index (SDI), regions and nations. In 2019, low-SDI region, Central sub-Saharan Africa and Uganda had the highest ASIR, ASPR and ASDR. The global PAFs of intimate partner violence (IPV), childhood sexual abuse (CSA) and bullying victimization (BV) were 8.43%, 5.46% and 4.86% in 2019, respectively.
Conclusions
Over the past 30 years, the global ASIR, ASPR and ASDR of MDD had decreased trends, while the burden of MDD was still serious, and multiple disparities in MDD burden remarkably existed. Women, elderly and populations living during 2000–2004 and in low-SDI regions, had more severe burden of MDD. Children were more susceptible to MDD. Up to 18.75% of global MDD burden would be eliminated through early preventing against IPV, CSA and BV. Tailored strategies-and-measures in different regions and demographic groups based on findings in this studywould be urgently needed to eliminate the impacts of modifiable risk factors on MDD, and then mitigate the burden of MDD.
Various psychosocial and psychological interventions have been developed to reduce schizophrenia relapse prevention. A better understanding of these active interventions is important for clinical practice and for meaningful allocation of resources. However, no bibliometric analysis of this area has been conducted. Studies were retrieved from the Web of Science Core Collection database. The publication outputs and cooperation of institutions were visualized with Origin 2021. Global cooperation was visualized using ArcGIS Pro3.0. VOSviewer was used to generate visualizations of network of authors and keywords. The number of annual publications generally showed a fluctuating upward trend over the past 20 years. Germany published the most relevant articles (361, 26.76%). The Technical University of Munich was the most productive institution (70, 9.86%). Leucht Stefan published the most articles (46, 6.48%) and had the highest number of citations (4,375 citations). Schizophrenia Research published the most studies (39, 5.49%). Keywords were roughly classified into three clusters: cognitive behavioral therapy (CBT), family interventions and family psychoeducation and other factors related to interventions. The findings provided the current status of research on psychosocial and psychological interventions for schizophrenia relapse prevention from a bibliometric perspective. Recent research has mainly focused on CBT, family interventions and family psychoeducation.
People with neuropsychiatric symptoms often experience delay in accurate diagnosis. Although cerebrospinal fluid neurofilament light (CSF NfL) shows promise in distinguishing neurodegenerative disorders (ND) from psychiatric disorders (PSY), its accuracy in a diagnostically challenging cohort longitudinally is unknown.
Methods:
We collected longitudinal diagnostic information (mean = 36 months) from patients assessed at a neuropsychiatry service, categorising diagnoses as ND/mild cognitive impairment/other neurological disorders (ND/MCI/other) and PSY. We pre-specified NfL > 582 pg/mL as indicative of ND/MCI/other.
Results:
Diagnostic category changed from initial to final diagnosis for 23% (49/212) of patients. NfL predicted the final diagnostic category for 92% (22/24) of these and predicted final diagnostic category overall (ND/MCI/other vs. PSY) in 88% (187/212), compared to 77% (163/212) with clinical assessment alone.
Conclusions:
CSF NfL improved diagnostic accuracy, with potential to have led to earlier, accurate diagnosis in a real-world setting using a pre-specified cut-off, adding weight to translation of NfL into clinical practice.
Many protected areas worldwide have been established to protect the last natural refuges of flagship animal species. However, long-established protected areas do not always match the current distributions of target species under changing environmental conditions. Here we present a case study of the Asian elephant Elephas maximus in Xishuangbanna, south-west China, to evaluate whether the established protected areas match the species’ current distribution and to identify key habitat patches for Asian elephant conservation. Our results show that currently only 24.5% of the predicted Asian elephant distribution in Xishuangbanna is located within Xishuangbanna National Nature Reserve, which was established for elephant conservation. Based on the predicted Asian elephant distribution, we identified the most important habitat patches for elephant conservation in Xishuangbanna. The three most important patches were outside Xishuangbanna National Nature Reserve and together they contained 43.3% of the estimated food resources for Asian elephants in all patches in Xishuangbanna. Thus, we identified a spatial mismatch between immobile protected areas and mobile animals. We recommend the inclusion of the three identified key habitat patches in a new national park currently being planned by the Chinese authorities for the conservation of the Asian elephant.
The association between blood transfusion and ventilator-associated events (VAEs) has not been fully understood. We sought to determine whether blood transfusion increases the risk of a VAE.
Design:
Nested case-control study.
Setting:
This study was based on a registry of healthcare-associated infections in intensive care units at West China Hospital system.
Patients:
1,657 VAE cases and 3,293 matched controls were identified.
Methods:
For each case, 2 controls were randomly selected using incidence density sampling. We defined blood transfusion as a time-dependent variable, and we used weighted Cox models to calculate hazard ratios (HRs) for all 3 tiers of VAEs.
Results:
Blood transfusion was associated with increased risk of ventilator-associated complication-plus (VAC-plus; HR, 1.47; 95% CI, 1.22–1.77; P <.001), VAC-only (HR, 1.29; 95% CI, 1.01–1.65; P = .038), infection-related VAC-plus (IVAC-plus; HR, 1.78; 95% CI, 1.33–2.39; P < .001), and possible ventilator-associated pneumonia (PVAP; HR, 2.10; 95% CI, 1.10–3.99; P = .024). Red blood cell (RBC) transfusion was also associated with increased risk of VAC-plus (HR, 1.34; 95% CI, 1.08–1.65; P = .007), IVAC-plus (HR, 1.70; 95% CI, 1.22–2.36; P = .002), and PVAP (HR, 2.49; 95% CI, 1.17–5.28; P = .018). Compared to patients without transfusion, the risk of VAE was significantly higher in patients with RBC transfusions of >3 units (HR, 1.73; 95% CI, 1.25–2.40; P = .001) but not in those with RBC transfusions of 0–3 units.
Conclusion:
Blood transfusions were associated with increased risk of all tiers of VAE. The risk was significantly higher among patients who were transfused with >3 units of RBCs.
To investigate the clinical impact of ventilator-associated events (VAEs) on adverse prognoses and risk factors for mortality among intensive care unit (ICU) patients receiving invasive mechanical ventilation (IMV) based on an ICU healthcare-associated infection (ICU-HAI) registry.
Design:
A cohort study was conducted based on an ICU-HAI registry including 30,830 patients between 2015 and 2018.
Setting:
The study was conducted using data from 5 adult ICUs of a referral hospital.
Patients:
Adult patients in the ICU-HAI registry who received ≥4 consecutive IMV days.
Methods:
Clinical outcomes and mortality risk factors for VAEs were analyzed using propensity score matching (PSM), multivariate regression models, and sensitivity analyses.
Results:
Of 6,426 included patients, 1,803 developed 1,899 VAEs. After PSM, patients with VAEs did have prolonged length of stay in the ICU and in the hospital, increased hospitalization costs, longer days on mechanical ventilation, higher proportion of ≥9 days on mechanical ventilation, higher rate of failure in extubating mechanical ventilation, and excess all-cause mortality in the ICU. Older age (adjusted OR [aOR], 1.02), higher APACHE II score on ICU admission (aOR, 1.06), pneumonia (aOR, 1.49), blood transfusion (aOR 1.43), immunosuppressive drugs (aOR, 1.69), central-line catheter (aOR, 2.06), and ≥2 VAEs in the ICU (aOR, 1.99) were associated with higher risks for all-cause mortality in an ICU.
Conclusions:
Patients with VAEs indeed had poorer clinical outcomes. Older age, higher APACHE II score on ICU admission, pneumonia, blood transfusion, immunosuppressive drugs, central-line catheter, and ≥2 VAEs in the ICU were risk factors for all-cause mortality of VAE patients in the ICU.
The timing of the Holocene summer monsoon maximum (HSMM) in northeastern China has been much debated and more quantitative precipitation records are needed to resolve the issue. In the present study, Holocene precipitation and temperature changes were quantitatively reconstructed from a pollen record from the sediments of Tianchi Crater Lake in northeastern China using a plant functional type-modern analogue technique (PFT-MAT). The reconstructed precipitation record indicates a gradual increase during the early to mid-Holocene and a HSMM at ~5500–3100 cal yr BP, while the temperature record exhibits a divergent pattern with a marked rise in the early Holocene and a decline thereafter. The trend of reconstructed precipitation is consistent with that from other pollen records in northeastern China, confirming the relatively late occurrence of the HSMM in the region. However, differences in the onset of the HSMM within northeastern China are also evident. No single factor appears to be responsible for the late occurrence of the HSMM in northeastern China, pointing to a potentially complex forcing mechanism of regional rainfall in the East Asian monsoon region. We suggest that further studies are needed to understand the spatiotemporal pattern of the HSMM in the region.
X-ray powder diffraction data, unit-cell parameters and space group for azilsartan, C25H20N4O5, are reported [a = 9.641(3) Å, b = 11.301(9) Å, c = 20.010(8) Å, α = 90°, β = 90.351(5)°, γ = 90°, unit-cell volume V = 2196.735(4) Å3, Z = 4, ρcal = 1.379 g·cm−3, and space group P21/c]. All measured lines were indexed and are consistent with the P21/c space group. No detectable impurities were observed.
A glacier system is regarded as the ensemble of many glaciers sharing the same region, influenced by a similar climate and organized by certain intrinsic laws. It can be either ‘sensitive’ or ‘steady’. On the basis of the structure of the glacier system and the nature of the equilibrium-line altitudes at the steady state, functional models of a glacier system responding to climate warming were established, using the Kotlyakov–Krenke equation relating annual glacier ablation and mean summer temperature and the glacier system’s median size. The modeling results under the climatic scenarios with a rate of temperature increase of 0.01, 0.03 and 0.05 K a-1 indicate that by the end of this century the glacial area of China will be reduced by –14%, –40%and –60% respectively. However, model results show distinct differences between the sensitive glacier system and the steady glacier system.
Temperate glaciers are more sensitive to climate changes than polar or continental glaciers, and can drive remarkable runoff variation in local water catchments. Here we present recent glacier shrinkage and runoff change for Hailuogou glacier, a typical monsoon temperate glacier on the east slope of Mount Gongga (Minya Konga), China. The surface area of Hailuogou glacier has decreased by 3.5% (0.92 km2) between 1966 (aerial photographs) and 2007 (ASTER images). Flow measurements at a stream gauge about 500 m down-glacier commencing in 1994 display a remarkable increase in annual runoff (mostly during July–September) since 1999. Annual runoff over the same period in a nonglacierized but forested subcatchment (9.17 km2) did not experience significant change. By separating the daily rainfall component from the daily total discharge, monthly catchment water-balance series were calculated for the period 1994–2005, which shows an increasing trend of glacier storage loss. We concluded that air-temperature rise (with a trend of +0.2°C (10 a)−1 between 1988 and 2005, recorded at nearby weather stations) has had an increased effect on glacier mass loss and river runoff change during the past 20 years.
Digital elevation models (DEMs) of the ablation area of Hailuogou glacier, China, produced from Advanced Spaceborne Thermal Emission and Reflection Radiometer (ASTER) data obtained in 2009, differential GPS (DGPS) data surveyed in 2008 and aerial photographs acquired in 1966 and 1989 are differenced to estimate long- and short-term glacier surface elevation change (dh/dt). The mean dh/dt of the ablation area over 43 years (1966–2009) is −1.1 ± 0.4 m a−1. Since 1989 the thinning has accelerated significantly. Ice velocities measured by DGPS at 28 fixed stakes implanted in the ablation area increase with distance from the glacier terminus, ranging from 41.0 m a−1 approaching the glacier terminus to a maximum of 205.0 m a−1 at the base of an icefall. Our results reveal that the overall average ice velocity in the ablation area has undergone significant temporal variability over the past several decades. Changes in glacier surface elevation in the ablation area result from the combined effects of climate change and glacier dynamics, which are driven by different factors for different regions and periods.
X-ray powder diffraction data, unit-cell parameters, and space group for alogliptin benzoate, C18H21N5O2·C7H6O2, are reported [a = 28.8260(8) Å, b = 9.9654(4) Å, c = 8.1477(8) Å, α = 90, β = 90, γ = 90°, unit-cell volume V = 2340.57 Å3, Z = 4, ρcal = 1.3097 g cm−3, and space group P212121]. All measured lines were indexed and are consistent with the P212121 space group, No detectable impurities were observed.
Late Ordovician rocks of the Qilang and Yingan formations from the Kalpin area in the Tarim region of western Xinjiang, China (Tarim palaeoplate) contain a moderately diverse graptolite fauna. The fauna from the Qilang Formation contains Corynoides calicularis Nicholson, 1867; Dicranograptus clingani resicis Williams and Bruton, 1983; Lasiograptus costatus Lapworth, 1873; Pseudoclimacograptus scharenbergi (Lapworth, 1876); and Glossograptus sp. among other species. This assemblage most likely corresponds to the upper Climacograptus (Climacograptus) bicornis Zone? to lower C. (Diplacanthograptus) lanceolatus Zone of Australia. The Qilang Formation also yields the new taxon, Amplexograptus maxwelli spinousus new subspecies. The overlying Yingan Formation yields a more diverse assemblage that includes Climacograptus (Diplacanthograptus) spiniferus Ruedemann, 1912; C. (D.) lanceolatus VandenBerg, 1990; Orthograptus quadrimucronatus (Hall, 1865); Amplexograptus praetypicalis Riva, 1987; Dicellograptus pumilus Lapworth, 1876; and D. morrisi Hopkinson, 1871. This assemblage most likely corresponds to the Corynoides americanus Zone through the C. (D.) spiniferus Zone of eastern Laurentia, or to the D. clingani Zone of Scotland and central Newfoundland. The presence of a C. (D.) lanceolatus and C. (D.) spiniferus succession in the Yingan Formation also suggests correlation with the Eastonian 1 and 2 of Australasia. The Yingan Formation faunas represent an offshore Pacific Province assemblage dominated by cosmopolitan epipelagic species. The fauna is most similar, both in terms of species composition and relative abundance patterns, to those of the Appalachian Basin. The Yingan faunas differ from the latter in the absence of Laurentian endemic species (except for Amplexograptus praetypicalis), and in the common occurrence of dicellograptids.
The Sun drives most events of space weather in the vicinity of the Earth. Because the activities of the Sun are complicated, a visualized chart with key objects of solar activities is needed for space weather forecast. This work investigates the key objects in research during the past forty years and surveys a variety of solar observational data. We design the solar synoptic chart (SSC) that covers the key objects of solar activities, i.e., active regions, coronal holes, filaments/prominences, flares and coronal mass ejections, and synthesizes images from different heights and temperatures of solar atmosphere. The SSC is used to analyze the condition of the Sun in March 2012 and October 2014 as examples. The result shows that the SSC is timely, comprehensive, concise and easy to understand. It has the potentiality for space weather forecast and can help in improving the public education.