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High Sensitivity CRP Predicts Long-Term Mortality in Patients with Atrial Fibrillation and Evident Acute Coronary Syndrome

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International Journal of Clinical Medicine 2013年第3期4卷 137-144页

作者： Christoph Liebetrau Luise Gaede Sebastian Szardien Johannes Rixe Oliver Doerr Matthias Willmer Michael Weber Andreas Rolf helge mollmann Albrecht Elsasser Christian Hamm Holger Nef Department of Cardiology Kerckhoff Heart and Thorax CenterBad NauheimGermany Department of Cardiology and Angiology Faculty of MedicineJustus-Liebig University of GiessenGiessenGermany

Background: Atrial fibrillation (AF) is a frequent arrhythmia associated with an adverse prognostic value in patients with ACS. Risk stratification as well as diagnosis of ACS is strongly supported by biomarkers. High sensitivity CRP (hs-CRP) is known to be elevated in patients presenting with ACS as well as with ***: In total, 2034 consecutive patients with an ACS were analysed. The incidence of AF in the setting of ACS, the prognostic value of hs-CRP and the clinical outcome within 6 months were subject of the study. Death after 6 months was considered as primary endpoint. Results: The frequency of AF among patients admitted with suspected ACS was 124 (6.1%). During 6-month follow-up the mortality rate among patients with AF was significantly higher (20 [16.1%] vs 133 [6.9%];log-rank 13.72;p 0.001) compared to patients without AF. Cox regression analysis revealed an increased risk for ACS patients with AF with an adjusted HR of 2.63 (95% CI 1.48 - 3.78;p 0.001). Patients with AF showed significant higher levels of hs-CRP than patients without AF (6.01mg/dl IQR [1.7 - 17.8] vs 3.3mg/dl IQR [1.37 - 9.83];p = 0.003). By the use of multivariate Cox regression analysis, risk of mortality was higher when AF patients had higher concentrations of hs-CRP (HR 1.076;95% CI 1.02 - 1.13;p = 0.002).Conclusions: AF is a strong and independent indicator for increased mortality in patients presenting with ACS. hs-CRP predicts mortality in AF patients and should be considered for risk stratification in clinical routine.

关键词： Acute Coronary Syndrome Atrial Fibrillation Risk Stratification High-Sensitivity CRP

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Detecting anomalies in blockchain transactions using machine learning classifiers and explainability analysis

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Blockchain(Research and Applications) 2024年第3期5卷 106-122页

作者： Mohammad Hasan Mohammad Shahriar Rahman helge Janicke Iqbal H.Sarker Department of Computer Science and Engineering Premier University4000 ChitagongBangladesh Department of Computer Science and Engineering United International University1212 DhakaBangladesh Cyber Security Cooperative Research Centre 6027 PerthAustralia Centre for Securing Digital Futures Edith Cowan University6027 PerthAustralia

As the use of blockchain for digital payments continues to rise,it becomes susceptible to various malicious *** detecting anomalies within blockchain transactions is essential for bolstering trust in digital ***,the task of anomaly detection in blockchain transaction data is challenging due to the infrequent occurrence of illicit *** several studies have been conducted in the field,a limitation persists:the lack of explanations for the model’s *** study seeks to overcome this limitation by integrating explainable artificial intelligence(XAI)techniques and anomaly rules into tree-based ensemble classifiers for detecting anomalous Bitcoin *** shapley additive explanation(SHAP)method is employed to measure the contribution of each feature,and it is compatible with ensemble ***,we present rules for interpreting whether a Bitcoin transaction is anomalous or ***,we introduce an under-sampling algorithm named XGBCLUS,designed to balance anomalous and non-anomalous transaction *** algorithm is compared against other commonly used under-sampling and over-sampling ***,the outcomes of various tree-based single classifiers are compared with those of stacking and voting ensemble *** experimental results demonstrate that:(i)XGBCLUS enhances true positive rate(TPR)and receiver operating characteristic-area under curve(ROC-AUC)scores compared to state-of-the-art under-sampling and over-sampling techniques,and(ii)our proposed ensemble classifiers outperform traditional single tree-based machine learning classifiers in terms of accuracy,TPR,and false positive rate(FPR)scores.

关键词： Anomaly detection Blockchain Bitcoin transactions Data imbalance Data sampling Explainable AI Machine learning Decision tree Anomaly rules

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Pathologic Q Waves and Prolonged QTc Time in Preoperative ECG Are Predictive for Perioperative Cardiovascular Events

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World Journal of Cardiovascular Diseases 2014年第10期4卷 498-509页

作者： Thomas Wolters Michael Weber Thomas Neumann Hans-Georg Strauß Andreas Luchner Manfred Seeberger Christian Mueller Christoph Liebetrau Svetlana Apostolovic Radmilo Jankovic Dragic Bankovic Marina Jovic Vesselin Mitrovic Holger Nef helge mollmann Karl Werdan Christian W. Hamm Axel Schlitt Department of Medicine III University Clinic Halle (Saale) Halle Germany Department of Medicine Clinic Grabs Grabs Switzerland Department of Cardiology Kerckhoff Heart and Thorax Center Bad Nauheim Germany Department of Medicine II Clinic Gro&szlig -Umstadt Gro&szlig -Umstadt Germany Department of Medicine II University of Regensburg Regensburg Germany Department of Cardiology University of Basel Basel Switzerland University Cardiology Clinic Ni&scaron Serbia Department of Mathematical Sciences University of Kragujevac Kragujevac Serbia Department of Medicine I University Clinic of Gie&szlig en and Marburg Gie&szlig en Germany Department of Medicine I Paracelsus-Harz-Clinic Bad Suderode Quedlinburg Germany

Aims: The value of ECG in the perioperative risk stratification under modern treatment options is uncertain. The main objective of the present analysis was to determine the usefulness of a pre-operative ECG derivation for evaluating the risk of perioperative morbidity and mortality. Methods: We performed a secondary analysis of the prospective, international, multicenter, observational “No-Risk” Study (N-terminal B-type natriuretic peptide [NT-proBNP] for the assessment of the perioperative cardiac risk after major noncardiac surgery) to determine the prognostic value of 12-lead ECG. Inclusion criteria were age >55 years and at least one of the following cardiovascular risk factors: arterial hypertension, diabetes mellitus, dyslipidemia, active smoking, and family history positive for coronary heart disease. The combined primary endpoint included total mortality, acute myocardial infarction (NSTEMI and STEMI), cardiopulmonary resuscitation, heart failure, and asystole or ventricular fibrillation during hospitalization. ECGs from 616 patients enrolled from 2006 to 2009 prior to noncardiac surgery in the No-Risk Study were analyzed. Results: The mean age was 67.6 (±8.1) years;300 (48.7%) patients were male. Fourteen (2.3%) patients suffered from the combined primary endpoint while in the hospital. In Kaplan-Meier analyses, a pathologic Q wave and QTc > 500 ms were significantly related to the incidence of the primary endpoint (p p = 0.042, respectively), whereas other ECG parameters such as LBBB, RBBB, PQ interval, QRS interval, and others were not related to worse in-hospital outcome. Conclusion: The 12-lead ECG is still an important diagnostic tool for perioperative risk assessment of cardiovascular events in noncardiac surgery in patients at risk.

关键词： ECG Perioperative Risk Cardiovascular Risk

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Relative Impacts of Sea Ice Loss and Atmospheric Internal Variability on the Winter Arctic to East Asian Surface Air Temperature Based on Large-Ensemble Simulations with NorESM2

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Advances in Atmospheric Sciences 2024年第8期41卷 1511-1526页

作者： Shengping HE helge DRANGE Tore FUREVIK Huijun WANG Ke FAN Lise Seland GRAFF Yvan J.ORSOLINI Geophysical Institute University of Bergen and Bjerknes Centre for Climate ResearchBergen 5020Norway Nansen Environmental and Remote Sensing Center Bergen 5007Norway Key Laboratory of Meteorological Disaster Ministry of Education/Joint International Research Laboratory of Climate and Environment Change(ILCEC)/Collaborative Innovation Center on Forecast and Evaluation of Meteorological Disasters(CIC-FEMD)Nanjing University of Information Science&TechnologyNanjing 211544China Nansen-Zhu International Research Center Institute of Atmospheric PhysicsChinese Academy of SciencesBeijing 100029China Southern Marine Science and Engineering Guangdong Laboratory(Zhuhai) Zhuhai 511458China School of Atmospheric Science Sun Yat-Sen Universityand Southern Marine Science and Engineering Guangdong Laboratory(Zhuhai)Zhuhai 519082China Norwegian Meteorological Institute Oslo 0313Norway Norwegian Institute for Air Research Kjeller 2007Norway

To quantify the relative contributions of Arctic sea ice and unforced atmospheric internal variability to the “warm Arctic, cold East Asia”(WACE) teleconnection, this study analyses three sets of large-ensemble simulations carried out by the Norwegian Earth System Model with a coupled atmosphere–land surface model, forced by seasonal sea ice conditions from preindustrial, present-day, and future periods. Each ensemble member within the same set uses the same forcing but with small perturbations to the atmospheric initial state. Hence, the difference between the present-day(or future) ensemble mean and the preindustrial ensemble mean provides the ice-loss-induced response, while the difference of the individual members within the present-day(or future) set is the effect of atmospheric internal variability. Results indicate that both present-day and future sea ice loss can force a negative phase of the Arctic Oscillation with a WACE pattern in winter. The magnitude of ice-induced Arctic warming is over four(ten) times larger than the ice-induced East Asian cooling in the present-day(future) experiment;the latter having a magnitude that is about 30% of the observed cooling. Sea ice loss contributes about 60%(80%) to the Arctic winter warming in the present-day(future) experiment. Atmospheric internal variability can also induce a WACE pattern with comparable magnitudes between the Arctic and East Asia. Ice-lossinduced East Asian cooling can easily be masked by atmospheric internal variability effects because random atmospheric internal variability may induce a larger magnitude warming. The observed WACE pattern occurs as a result of both Arctic sea ice loss and atmospheric internal variability, with the former dominating Arctic warming and the latter dominating East Asian cooling.

关键词： Arctic sea ice loss warm Arctic–cold East Asia atmospheric internal variability large-ensemble simulation NorESM2 PAMIP

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Functional dissimilarity in mixed forests promotes stem radial growth by mitigating tree water deficit

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National Science Review 2024年第3期11卷 55-57页

作者：张宏图艾尤尔.亥热提白云旻郭焱培李珊 Bernhard Schmid helge Bruelheide 马克平唐志尧 Institute of Ecology College of Urban and Environmental Sciences and Key Laboratory for Earth Surface Processes of Ministry of EducationPeking University College of Geography and Tourism Xinjiang Normal University State Key Laboratory of Vegetation and Environmental Change Institute of BotanyChinese Academy of Sciences Department of Geography Remote Sensing LaboratoriesUniversity of Zurich Institute of Biology/Geobotany and Botanical Garden Martin Luther University Halle-Wittenberg German Centre for Integrative Biodiversity Research(iDiv)Halle-Jena-Leipzig

Tree growth is a key component of forest ecosystem functioning and is wellknown to be limited by water availability[1]. It is acknowledged that composition and diversity of co-occurring tree species can mitigate the influence of drought on tree growth through the resource complementarity for water use via niche partitioning and facilitation between different species [2,3].

关键词： RESILIENCE

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Haemorrhage after thrombectomy with adjuvant thrombolysis in unknown onset stroke depends on high early lesion water uptake

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Stroke & Vascular Neurology 2024年第4期9卷 390-398页

作者： Gabriel Broocks Lukas Meyer Uta Hanning Tobias Djamsched Faizy Matthias Bechstein helge Kniep Noel Van Horn Gerhard Schön Ewgenia Barow Götz Thomalla Jens Fiehler Andre Kemmling Department of Diagnostic and Interventional Neuroradiology University Medical Center Hamburg-EppendorfHamburgGermany Department of Medical Biometry and Epidemiology University Medical Center Hamburg EppendorfHamburgGermany Department of Neurology University Medical Center Hamburg-EppendorfHamburgGermany Department of Neuroradiology University MarburgMarburgGermany

Background and purpose In wake-up stroke,CT-based quantitative net water uptake(NWU)might serve as an alternative tool to MRI to guide intravenous thrombolysis with alteplase(IVT).An important complication after IVT is symptomatic intracerebral haemorrhage(sICH).As NWU directly implies ischaemic lesion progression,reflecting blood-brain barrier injury,we hypothesised that NWU predicts sICH in patients who had a ischaemic stroke undergoing thrombectomy with unknown *** Consecutive analysis of all patients who had unknown onset anterior circulation ischaemic stroke who underwent CT at baseline and endovascular treatment between December 2016 and October *** NWU was assessed on baseline *** primary endpoint was *** association of NWU and other baseline parameters to sICH was investigated using inverse-probability weighting(IPW)*** A total of 88 patients were included,of which 46 patients(52.3%)received *** median NWU was 10.7%(IQR:5.1–17.7).The proportion of patients with any haemorrhage and sICH were 35.2%and 13.6%.NWU at baseline was significantly higher in patients with sICH(19.1%vs 9.6%,p<0.0001)and the median Alberta Stroke Program Early CT Score(ASPECTS)was lower(5 vs 8,p<0.0001).Following IPW,there was no association between IVT and sICH in unadjusted ***,after adjusting for ASPECTS and NWU,there was a significant association between IVT administration and sICH(14.6%,95%CI:3.3%to 25.6%,p<0.01).Conclusion In patients with ischaemic stroke with unknown onset,the combination of high NWU with IVT is directly linked to higher rates of *** ASPECTS for evaluating the extent of the early infarct lesion,quantitative NWU could be used as an imaging biomarker to assess the degree of blood-brain barrier damage in order to predict the risk of sICH in patients with wake up stroke.

关键词： throm thrombolysis high

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A Possible Feedback Mechanism Involving the Arctic Freshwater,the Arctic Sea Ice,and the North Atlantic Drift

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Advances in Atmospheric Sciences 2004年第5期21卷 784-801页

作者： Odd helge OTTER helge DRANGE Nansen Environmental and Remote Sensing Center Edv. Griegsvei 3A5059 Bergen Bjerknes Centre for Climate Research Allégt. 55 5007 BergenNansen Environmental and Remote Sensing Center Edv. Griegsvei 3A5059 Bergen Bjerknes Centre for Climate Research Allégt. 55 5007 BergenGeophysical Institute University of Bergen Allégt. 70 5007 Bergen Nansen-Zhu International Research Centre Beijing 100029

Model studies point to enhanced warming and to increased freshwater ?uxes to high northern latitudes in response to global warming. In order to address possible feedbacks in the ice-ocean system in response to such changes, the combined e?ect of increased freshwater input to the Arctic Ocean and Arctic warming—the latter manifested as a gradual melting of the Arctic sea ice—is examined using a 3-D isopycnic coordinate ocean general circulation model. A suite of three idealized experiments is carried out: one control integration, one integration with a doubling of the modern Arctic river runo?, and a third more extreme case, where the river runo? is ?ve times the modern value. In the two freshwater cases, the sea ice thickness is reduced by 1.5–2 m in the central Arctic Ocean over a 50-year period. The modelled ocean response is qualitatively the same for both perturbation experiments: freshwater propagates into the Atlantic Ocean and the Nordic Seas, leading to an initial weakening of the North Atlantic Drift. Furthermore, changes in the geostrophic currents in the central Arctic and melting of the Arctic sea ice lead to an intensi?ed Beaufort Gyre, which in turn increases the southward volume transport through the Canadian Archipelago. To compensate for this southward transport of mass, more warm and saline Atlantic water is carried northward with the North Atlantic Drift. It is found that the increased transport of salt into the northern North Atlantic and the Nordic Seas tends to counteract the impact of the increased freshwater originating from the Arctic, leading to a stabilization of the North Atlantic Drift.

关键词： Arctic Ocean freshwater seaice North Atlantic Drift

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The Effect of Diapycnal Mixing on the Ventilation and CFC-11 Uptake in the Southern Ocean

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Advances in Atmospheric Sciences 2004年第5期21卷 755-766页

作者： helge DRANGE Nansen Environmental and Remote Sensing Center Bergen Norway Nansen-Zhu International Research Centre Institute of Atmospheric Physics Chinese Academy of Sciences Beijing 100029Bjerknes Centre for Climate Research Bergen Norway Geophysical Institute University of Bergen Bergen Norway

The Miami Isopycnic Coordinate Ocean Model (MICOM) is used to investigate the effect of diapycnal mixing on the oceanic uptake of CFC-11 and the ventilation of the surface waters in the Southern Ocean (south of 45°S). Three model experiments are performed: one with a diapycnal mixing coefficientK d (m2 s?1) of 2 × 10?7/N (Expt. 1), one withK d = 0 (Expt. 2), and one withK d = 5 × 10?8/N (Expt. 3),N (s?1) is the Brunt-V?is?l? frequency. The model simulations indicate that the observed vertical distribution of CFC-11 along 88°W (prime meridian at 0°E) in the Southern Ocean is caused by local ventilation of the surface waters and westward-directed (eastward-directed) isopycnic transport and mixing from deeply ventilated waters in the Weddell Sea region. It is found that at the end of 1997, the simulated net ocean uptake of CFC-11 in Expt. 2 is 25% below that of Expt. 1. The decreased uptake of CFC-11 in the Southern Ocean accounts for 80% of this difference. Furthermore, Expts. 2 and 3 yield far more realistic vertical distributions of the ventilated CFC-waters than Expt. 1. The experiments clearly highlight the sensitivity of the Southern Ocean surface water ventilation to the distribution and thickness of the simulated mixed layer. It is argued that inclusion of CFCs in coupled climate models could be used as a test-bed for evaluating the decadal-scale ocean uptake of heat and CO2.

关键词： chlorofluorocarbons CFC-11 diapycnal mixing ocean modelling ocean ventilation Southern Ocean transient tracers

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Simulating the Effects of the 1991 Mount Pinatubo Volcanic Eruption Using the ARPEGE Atmosphere General Circulation Model

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Advances in Atmospheric Sciences 2008年第2期25卷 213-226页

作者： Odd helge OTTER Nansen Environmental and Remote Sensing Center Thorm0hlensgt. 47 5006 Bergen Norway Bjerknes Centre for Climate Research Allegt. 55 5007 Bergen Norway

The climate changes that occured following the volcanic eruption of Mount Pinatubo in the Phillippines on 15 June 1991 have been simulated using the ARPEGE atmosphere general circulation model （AGCM）. The model was forced by a reconstructed spatial-time distribution of stratospheric aerosols intended for use in long climate simulations. Four statistical ensembles of the AGCM simulations with and without volcanic aerosols over a period of 5 years following the eruption have been made, and the calculated fields have been compared to available observations. The model is able to reproduce some of the observed features after the eruption, such as the winter warming pattern that was observed over the Northern Hemisphere （NH） during the following winters. This pattern was caused by an enhanced Equator-to-pole temperature gradient in the stratosphere that developed due to aerosol heating of the tropics. This in turn led to a strengthening of the polar vortex, which tends to modulate the planetary wave field in such a way that an anomalously positive Arctic Oscillation pattern is produced in the troposphere and at the surface, favouring warm conditions over the NH. During the summer, the model produced a more uniform cooling over the NH.

关键词： volcanic aerosol climate Mount Pinatubo Arctic Oscillation

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A Preliminary Study on the Relationship Between Arctic Oscillation and Daily SLP Variance in the Northern Hemisphere During Wintertime

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Advances in Atmospheric Sciences 2005年第3期22卷 313-327页

作者：龚道溢 helge DRANGE Key Laboratory of Environmental Change and Natural DisasterCollege of Resources Science and Technology Beijing Normal University Beijing 100875 Bjerknes Centre for Climate Research/Nansen Environmental and Remote Sensing CenterUniversity of Bergen Norway

In the present study, the authors investigated the relationship between the Arctic Oscillation (AO) and the high-frequency variability of daily sea level pressures in the Northern Hemisphere in winter (November through March), using NCEP/NCAR reanalysis datasets for the time period of 1948/49-2000/01. High-frequency signals are defined as those with timescales shorter than three weeks and measured in terms of variance, for each winter for each grid. The correlations between monthly mean AO index and high-frequency variance are conducted. A predominant feature is that several regional centers with high correlation show up in the middle to high latitudes. Significant areas include mid- to high-latitude Asia centered at Siberia, northern Europe and the middle-latitude North Atlantic east of northern Africa. Their strong correlations can also be confirmed by the singular value decomposition analysis of covariance between mean SLP and high-frequency variance. This indicates that the relationship of AO with daily Sea Level Pressure (SLP) is confined to some specific regions in association with the inherent atmospheric dynamics. In middle-latitude Asia, there is a significant (at the 95% level) trend of variance of-2.26% (10 yr)-1. Another region that displays a strong trend is the northwestern Pacific with a significant rate of change of 0.80% (10 yr)-1. If the winter of 1948/49, an apparent outlier, is excluded, a steady linear trend of +1.51% (10 yr)-1 shows up in northern Europe. The variance probability density functions (PDFs) are found to change in association with different AO phases. The changes corresponding to high and low AO phases, however, are asymmetric in these regions. Some regions such as northern Europe display much stronger changes in high AO years, whereas some other regions such as Siberia show a stronger connection to low AO conditions. These features are supported by ECMWF reanalysis data. However, the dynamical mechanisms involved in the AO-high fr

关键词： Arctic Oscillation sea level pressure (SLP) Northern Hemisphere synoptic variance

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