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中国急性冠状动脉综合征患者治疗和预后的地区差异:来自国家胸痛中心的证据

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Science Bulletin 2024年第9期69卷 1302-1312页

作者：周书铎张岩董雪洁马郡雄李娜史红 Sidney c.smith Jr 金音子许铭向定成郑志杰霍勇 Department of Global Health Peking University School of Public HealthBeijing 100191China Institute for Global Health and Development Peking UniversityBeijing100871China Department of cardiology Peking University First HospitalBeijing 100034China chinese Medical Association Beijing 100052China Division of cardiovascular Medicine School of MedicineUniversity of North Carolina at Chapel HillNorth Carolina 27599-3140USA Department of cardiology General Hospital of Southern Theater Command of PLAGuangzhou 510010China

Regional variations in acute coronary syndrome(AcS) management and outcomes have been an enormous public health issue. However, studies have yet to explore how to reduce the variations. The National chest Pain center Program(NcPcP) is the first nationwide, hospital-based, comprehensive, continuous quality improvement program for improving the quality of care in patients with AcS in china. We evaluated the association of NcPcP and regional variations in AcS healthcare using generalized linear mixed models and interaction analysis. Patients in the Western region had longer onset-to-first medical contact(FMc) time and time stay in non-percutaneous coronary intervention(PcI) hospitals, lower rates of PcI for ST-elevation myocardial infarction(STEMI) patients, and higher rates of medication *** in central regions had relatively lower in-hospital mortality and in-hospital heart failure *** in the door-to-balloon time(Dto B) and in-hospital mortality between Western and Eastern regions were less after accreditation(β =-8.82, 95% confidence interval(cI)-14.61 to-3.03;OR = 0.79, 95%cI 0.70 to 0.91). Similar results were found in differences in Dto B time, primary PcI rate for STEMI between central and Eastern regions. The differences in PcI for higher-risk non-ST-segment elevation acute coronary syndrome(NSTE-AcS) patients among different regions had been ***, the differences in medication use between Eastern and Western regions were higher after accreditation. Regional variations remained high in this large cohort of patients with AcS from hospitals participating in the NcPcP in china. More comprehensive interventions and hospital internal system optimizations are needed to further reduce regional variations in the management and outcomes of patients with AcS.

关键词： Acute coronary syndromes Quality improvement Regional variations Quality metrics

Oral anti-coagulants use in chinese hospitalized patients with atrial fibrillation

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chinese Medical Journal 2024年第2期137卷 172-180页

作者： Jing Lin Deyong Long chenxi Jiang caihua Sang Ribo Tang Songnan Li Wei Wang Xueyuan Guo Man Ning Zhaoqing Sun Na Yang Yongchen Hao Jun Liu Jing Liu Xin Du Louise Morgan Gregg c.Fonarow Sidney c.smith Jr Gregory Y.H.Lip Dong Zhao Jianzeng Dong changsheng Ma On behalf of ccc-AF investigators Department of cardiology Beijing Anzhen HospitalCapital Medical UniversityBeijing 100029China National clinical Research center for cardiovascular Diseases Beijing 100029 China Department of Epidemiology Beijing Anzhen HospitalCapital Medical UniversityBeijing Institute of HeartLung and Blood Vessel DiseasesBeijing 100029China International Quality Improvement Department American Heart AssociationDallasTX 07076USA Division of cardiology Geffen School of Medicine at University of CaliforniaLos Angeles CA 90024USA Division of cardiology University of North CarolinaChapel HillNC 27599USA Department of cardiology Liverpool Centre for Cardiovascular ScienceUniversity of Liverpool and Liverpool Heart&Chest HospitalLiverpool L143PEUK Department of clinical Medicine Aalborg UniversityAalborg 9000Denmark 不详

Background:Oral anti-coagulants(OAc)are the intervention for the prevention of stroke,which consistently improve clinical outcomes and survival among patients with atrial fibrillation(AF).The main purpose of this study is to identify problems in OAc utilization among hospitalized patients with AF in ***:Using data from the Improving care for cardiovascular Disease in china-Atrial Fibrillation(ccc-AF)registry,guideline-recommended OAc use in eligible patients was ***:A total of 52,530 patients with non-valvular AF were enrolled from February 2015 to December 2019,of whom 38,203 were at a high risk of stroke,9717 were at a moderate risk,and 4610 were at a low *** admission,only 20.0%(6075/30,420)of patients with a diagnosed AF and a high risk of stroke were taking *** use of pre-hospital OAc on admission was associated with a lower risk of new-onset ischemic stroke/transient ischemic attack among the diagnosed AF population(adjusted odds ratio:0.54,95%confidence interval:0.43-0.68;Pcharge,the prescription rate of OAc was 45.2%(16,757/37,087)in eligible patients with high stroke risk and 60.7%(2778/4578)in eligible patients with low stroke *** utilization in patients with high stroke risk on admission or at discharge both increased largely over time(all Pc utilization at discharge was positively associated with in-hospital rhythm control strategies,including catheter ablation(adjusted odds ratio[OR]11.63,95%confidence interval[cI]10.04-13.47;Pctronic cardioversion(adjusted OR 2.41,95%cI 1.65-3.51;Pc drug use(adjusted OR 1.45,95%cI 1.38-1.53;Pconclusions:In hospitals participated in the ccc-AF project,>70%of AF patients were at a high risk of *** poor performance on guideline-recommended OAc use was found in this study,over time the ccc-AF project has made progress in stroke prevention in the chinese AF ***

关键词： Atrial fibrillation Oral anti-coagulants OAc Stroke prevention contraindication

Open land-use map:a regional land-use mapping strategy for incorporating OpenStreetMap with earth observations

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Geo-Spatial Information Science 2017年第3期20卷 269-281页

作者： Di Yang chiung-Shiuan Fu Audrey c.smith Qiang Yu Department of Geography University of FloridaGainesvilleFLUSA Land Use and Environmental change Institute University of FloridaGainesvilleFLUSA Beijing Key Laboratory of Precision Forestry Beijing Forestry UniversityBeijingChina

A land-use map at the regional scale is a heavy computation task yet is critical to most landowners,researchers,and decision-makers,enabling them to make informed decisions for varying *** are two major difficulties in generating land classification maps at the regional scale:the necessity of large data-sets of training points and the expensive computation cost in terms of both money and *** Geographic Information opens a new era in mapping and visualizing the physical world by providing an open-access database valuable georeferenced information collected by volunteer *** one of the most well-known VGI initiatives,OpenStreetMap(OSM),contributes not only to road network distribution information but also to the potential for using these data to justify and delineate land ***,most large-scale mapping approaches-including regional and national scales–confuse“land cover”and“land-use”,or build up the land-use database based on modeled land cover data-sets,in this study,we clearly distinguished and differentiated land-use from land *** focusing on our prime objective of mapping land-use and management practices,a robust regional land-use mapping approach was developed by integrating OSM data with the earth observation remote sensing *** novel approach incorporates a vital temporal component to large-scale land-use mapping while effectively eliminating the typically burdensome computation and time/money demands of such ***,our novel approach in regional scale land-use mapping produced robust results in our study area:the overall internal accuracy of the classifier was 95.2%and the external accuracy of the classifier was measured at 74.8%.

关键词： OpenStreetMap(OSM) Volunteered Geographic Information(VGI) crowdsourced data Random Forest Google Earth Engine(GEE)

Lower Paleozoic oil relationships within Williston Basin, canada

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成都理工大学学报（自然科学版） 2004年第6期31卷 601-605页

作者： Stephen L.Bend Mauri c.smith Department of Geology University of Regina Saskatchewan Canada Presently with Shell Canada

The Williston Basin is a significant petroleum province, containing oil production zones that include the Middle cambrian to Lower Ordovician, Upper Ordovician, Middle Devonian, Upper Devonian and Mississippian and within the Jurassic and cretaceous. The oils of the Williston Basin exhibit a wide range of geochemical characteristics defined as “oil families”, although the geochemical signature of the cambrian Deadwood Formation and Lower Ordovician Winnipeg reservoired oils does not match any “oil family”. Despite their close stratigraphic proximity, it is evident that the oils of the Lower Palaeozoic within the Williston Basin are distinct. This suggests the presence of a new “oil family” within the Williston Basin. Diagnostic geochemical signatures occur in the gasoline range chromatograms, within saturate fraction gas chromatograms and biomarker fingerprints. However, some of the established criteria and cross-plots that are currently used to segregate oils into distinct genetic families within the basin do not always meet with success, particularly when applied to the Lower Palaeozoic oils of the Deadwood and Winnipeg Formation.

关键词：加拿大古生代寒武纪石油地质油气生成

Genetic interactions between polycystin-1 and Wwtr1 in osteoblasts define a novel mechanosensing mechanism regulating bone formation in mice

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Bone Research 2023年第4期11卷 772-783页

作者： Zhousheng Xiao Li cao Micholas Dean smith Hanxuan Li Wei Li Jeremy c.smith Leigh Darryl Quarles Department of Medicine University of Tennessee Health Science CenterMemphisTN 38163USA UT/ORNL center for Molecular Biophysics Oak Ridge National LaboratoryOak RidgeTN 37830USA Department of Biochemistry and cellular and Molecular Biology The University of Tennessee-KnoxvilleKnoxvilleTN 37996-1939USA Department of Pharmaceutical Sciences University of Tennessee Health Science CenterMemphisTN 38163USA

Molecular mechanisms transducing physical forces in the bone microenvironment to regulate bone mass are poorly ***,we used mouse genetics,mechanical loading,and pharmacological approaches to test the possibility that polycystin-1 and Wwtr1 have interdependent mechanosensing functions in *** created and compared the skeletal phenotypes of control Pkd1^(flox/)+;Wwtr1^(flox/)+,Pkd1^(Oc-cKO),Wwtr1^(Oc-cKO),and Pkd1/Wwtr1^(Oc-cKO)mice to investigate genetic *** with an interaction between polycystins and Wwtr1 in bone in vivo,Pkd1/Wwtr1^(Oc-cKO)mice exhibited greater reductions of BMD and periosteal MAR than either Wwtr1Oc-cKOor Pkd1^(Oc-cKO)***-cT 3D image analysis indicated that the reduction in bone mass was due to greater loss in both trabecular bone volume and cortical bone thickness in Pkd1/Wwtr1Oc-cKO mice compared to either Pkd1Oc-cKOor Wwtr1^(Oc-cKO)***1/Wwtr1^(Oc-cKO)mice also displayed additive reductions in mechanosensing and osteogenic gene expression profiles in bone compared to Pkd1Oc-cKOor Wwtr1^(Oc-cKO)***,we found that Pkd1/Wwtr1^(Oc-cKO)mice exhibited impaired responses to tibia mechanical loading in vivo and attenuation of loadinduced mechanosensing gene expression compared to control ***,control mice treated with a small molecule mechanomimetic,MS2 that activates the polycystin complex resulted in marked increases in femoral BMD and periosteal MAR compared to vehicle *** contrast,Pkd1/Wwtr1^(Oc-cKO)mice were resistant to the anabolic effects of *** findings suggest that Pc1 and Wwtr1 form an anabolic mechanotransduction signaling complex that mediates mechanical loading responses and serves as a potential novel therapeutic target for treating osteoporosis.

关键词： mec impaired additive

Theory-guided construction of electron-deficient sites via removal of lattice oxygen for the boosted electrocatalytic synthesis of ammonia

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Nano Research 2021年第5期14卷 1457-1464页

作者： Li Zhang Shilong Jiao Xin Tan Yuliang Yuan Yu Xiang Yu-Jia Zeng Jingyi Qiu Ping Peng Sean c.smith Hongwen Huang college of Materials Science and Engineering Hunan UniversityChangsha410082China college of Physics and Optoelectronic Engineering Shenzhen UniversityShenzhen518061China Integrated Materials Design Laboratory Department of Applied MathematicsResearch School of PhysicsThe Australian National UniversityCanberraACT2601Australia Research Institute of chemical Defense Beijing100191China

Rational design of catalytic sites to activate the inert N≡N bond is of paramount importance to advance N2 electroreduction. Here, guided by the theoretical predictions, we construct a NiFe layered double hydroxide (NiFe-LDH) nanosheet catalyst with a high density of electron-deficient sites, which were achieved by introducing oxygen vacancies in NiFe-LDH. Density functional theory calculations indicate that the electron-deficient sites show a much lower energy barrier (0.76 eV) for the potential determining step compared with that of the pristine NiFe-LDH (2.02 eV). Benefiting from this, the NiFe-LDH with oxygen vacancies exhibits the greatly improved electrocatalytic activity, presenting a high NH3 yield rate of 19.44 µg·h−1·mgcat−1, Faradaic efficiency of 19.41% at −0.20 V vs. reversible hydrogen electrode (RHE) in 0.1 M KOH electrolyte, as well as the outstanding stability. The present work not only provides an active electrocatalyst toward N2 reduction but also offers a facile strategy to boost the N2 reduction.

关键词： nitrogen reduction density functional theory oxygen vacancies electron-deficient sites

The 2013 Acc/AHA Guidelines on Treatment of Blood cholesterol to Improve cardiovascular Outcomes:Implications for Statin Use and Dose ***^a

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cardiovascular Innovations and Applications 2016年第B9期1卷 465-467页

作者： Sidney c.smith Department of Medicine Division of CardiologyUniversity of North Carolina at Chapel HillChapel HillNCUSA

Take-home *** recently published Acc/AHA cholesterol guidelines recommend fi xed-dose statin therapy for those at risk,and although not recommended as fi rst line therapy,nonstatin therapies are recommended when less than anticipated therapeutic response to statin therapy occurs or when patients are not able to tolerate statin *** cholesterol-lowering drugs shown to reduce atherosclerotic cardiovascular disease(AScVD)events in randomized controlled trials(RcTs)are *** evidence was found to support the use of specifi c low-density lipoprotein(LDL)-cholesterol target levels.

关键词： Acc/AHA Blood cholesterol cardiovascular

Damage mechanism identification in composites via machine learning and acoustic emission

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npj computational Materials 2021年第1期7卷 852-866页

作者： c.Muir B.Swaminathan A.S.Almansour K.Sevener c.smith M.Presby J.D.Kiser T.M.Pollock S.Daly Materials Department University of California-Santa BarbaraSanta BarbaraCAUSA NASA Glenn Research center ClevelandOHUSA Materials Scienceand Engineering Department University of Michigan-Ann ArborAnn ArborMIUSA Mechanical Engineering Department University of California-Santa BarbaraSanta BarbaraCAUSA

Damage mechanism identification has scientific and practical ramifications for the structural health monitoring,design,and application of composite *** advances in machine learning uncover pathways to identify the waveform-damage mechanism relationship in higher-dimensional spaces for a comprehensive understanding of damage *** review evaluates the state of the field,beginning with a physics-based understanding of acoustic emission waveform feature extraction,followed by a detailed overview of waveform clustering,labeling,and error analysis *** requirements for damage mechanism identification in any machine learning framework,including those currently in use,under development,and yet to be explored,are discussed.

关键词： composites composite mechanism

A machine learning framework for damage mechanism identification from acoustic emissions in unidirectional Sic/Sic composites

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npj computational Materials 2021年第1期7卷 1326-1335页

作者： c.Muir B.Swaminathan K.Fields A.S.Almansour K.Sevener c.smith M.Presby J.D.Kiser T.M.Pollock S.Daly Materials University of California-Santa BarbaraSanta BarbaraCAUSA Mechanical Engineering University of California-Santa BarbaraSanta BarbaraCAUSA NASA Glenn Research center ClevelandOHUSA Materials Science and Engineering University of Michigan-Ann ArborAnn ArborMIUSA

In this work,we demonstrate that damage mechanism identification from acoustic emission(AE)signals generated in minicomposites with elastically similar constituents is *** waveforms were generated by Sic/Sic ceramic matrix minicomposites(cMcs)loaded under uniaxial tension and recorded by four sensors(two models with each model placed at two ends).Signals were encoded with a modified partial power scheme and subsequently partitioned through spectral *** cracking and fiber failure were identified based on the frequency information contained in the AE event they produced,despite the similar constituent elastic properties of the matrix and ***,the resultant identification of AE events closely followed cMc damage chronology,wherein early matrix cracking is later followed by fiber breaks,even though the approach is fully domain-knowledge ***,the partitions were highly precise across both the model and location of the sensors,and the partitioning was *** presented approach is promising for cMcs and other composite systems with elastically similar constituents.

关键词： composites damage mechanism