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Arctic landfast sea ice (LFSI) represents an important quasi-stationary coastal zone. Its evolution is determined by the regional climate and bathymetry. This study investigated the seasonal cycle and interannual variations of LFSI along the northwest coast of Kotelny Island. Initial freezing, rapid ice formation, stable and decay stages were identified in the seasonal cycle based on application of the visual inspection approach (VIA) to MODIS/Envisat imagery and results from a thermodynamic snow/ice model. The modeled annual maximum ice thickness in 1995–2014 was 2.02 ± 0.12 m showing a trend of −0.13 m decade−1. Shortened ice season length (−22 d decade−1) from model results associated with substantial spring (2.3°C decade−1) and fall (1.9°C decade−1) warming. LFSI break-up resulted from combined fracturing and melting, and the local spatiotemporal patterns of break-up were associated with the irregular bathymetry. Melting dominated the LFSI break-up in the nearshore sheltered area, and the ice thickness decreased to an average of 0.50 m before the LFSI disappeared. For the LFSI adjacent to drift ice, fracturing was the dominant process and the average ice thickness was 1.56 m at the occurrence of the fracturing. The LFSI stages detected by VIA were supported by the model results. [ABSTRACT FROM AUTHOR]

Aiming to address the challenge of inaccurately describing the curve boundary of the complex design domain in traditional finite element mesh, this paper proposes an improved polygon mesh generation and polygon scaled boundary finite element method (PSBFEM) using non-uniform rational B-spline (NURBS) boundary. In the improved mesh generation scheme, the domain boundary will be accurately described using NURBS curves. Within this framework, a NURBS updating strategy is proposed, allowing the NURBS curve information on the boundary to be updated as the mesh changes. By employing point inversion and knot insertion, additional control points are introduced to ensure that some coincide with the nodes of the elements, thereby guaranteeing the accuracy of subsequent analyses. The boundary elements can be discretized into NURBS elements and conventional elements using SBFEM, whose physical fields are respectively constructed using NURBS basis functions and Lagrange shape functions in the circumferential direction. In the radial direction, by transforming a system of partial differential equations into a system of ordinary differential equations, which can be analytically solved without fundamental solutions. Furthermore, the internal elements can be solved directly with the traditional polygon SBFEM. The numerical examples demonstrate that the proposed method can achieve a high-quality polygon mesh with NURBS updating. Moreover, it effectively solves the corresponding polygon elements and significantly improves the accuracy of the displacement and stress solutions compared to the traditional polygon SBFEM. [ABSTRACT FROM AUTHOR]

Objective: Research on generalized anxiety disorder (GAD) and its association with esophageal cancer (EC) is sparse. The study aimed to explore the association between GAD and EC. Methods: A multicenter, population‐based study in high‐risk regions for EC (ECHRRs) was conducted from 2017 to 2019. All participants received free endoscopy screening. If the esophageal endoscopy results were suspicious, the pathological biopsy was performed to confirm normal, esophagitis, low‐grade intraepithelial neoplasia (LGIN), high‐grade intraepithelial neoplasia (HGIN), and EC. Information on participants' exposure to risk factors was collected. GAD was assessed with Generalized Anxiety Disorder Scale‐7. Results: With esophageal endoscopy, 25,650 participants in ECHRRs were examined, 9586 of whom were suspicious and confirmed by esophageal pathology. The detection rate of EC and precancerous lesions was 6.83% (1751/25,650), with 1377 LGIN (5.37%), 272 HGIN (1.06%), and 102 EC (0.40%) cases. The overall mean GAD score (95% CI) and prevalence among 25,650 participants with endoscopy were 1.96 (1.93–1.99) and 16.90%, respectively. The mean GAD score and prevalence among 9586 participants with pathology were 1.96 (1.91–2.02) and 17.98%, respectively. The mean GAD scores of patients confirmed with normal, esophagitis, LGIN, HGIN, and EC were 1.73 (1.62–1.85), 1.91 (1.85–1.97), 1.94 (1.80–2.08), 3.98 (3.73–4.23). and 2.97 (2.49–3.45), respectively (p < 0.001). The corresponding prevalence of GAD were 5.21%, 18.72%, 17.72%, 43.75%, and 36.27%, respectively (p < 0.001). The age‐ and gender‐adjusted odds ratios (ORs) between GAD and each esophageal lesion type were 1.02 (0.99–1.04), 1.01 (0.98–1.04), 1.27 (1.21–1.33), and 1.16 (1.08‐1.24), respectively. The ORs (95% CIs) of the positive associations were 1.08 (1.05–1.12), 1.03 (0.99–1.07), 1.35 (1.29–1.42), and 1.19 (1.10–1.29) after further adjustment for potential confounders (all p < 0.001). Sensitivity analysis showed that the positive association persisted. Conclusions: GAD was significantly higher in patients with EC and precancerous lesions. Focusing on and alleviating anxiety in high‐risk groups (including patients with HGIN and EC) may be an effective strategy for EC prevention and control. Further prospective studies are warranted to validate the results. [ABSTRACT FROM AUTHOR]

The geographical mismatch between water availability and demand further exacerbates the challenge of the water-energy-food nexus in China. This study characterizes competing water uses for crops and energy to reveal their resulting impacts on regional inequality by integrating the modified Gini coefficient and unbalanced index with respect to water scarcity and water surplus. From 2000–2019, China's food production decreased by 2.3 % in the blue water footprint (ranging from −90.3 % to 71.7 % for specific provinces), while the energy sector increased by 111.9 % (varying from −69.9 % to 692.4 %). The energy sector showed greater inequality in blue water consumption verses available water, with the Gini coefficient ranged from 0.43 to 0.62, while the food-water nexus maintained a relatively stable value of approximately 0.35. Spatially, there was consistent water scarcity inequality in the north and water surplus inequality in the south for both the food-water and the energy-water nexus. Overall, the energy-water nexus exhibited larger variations in provincial inequalities. This divergent evolving inequality was primarily caused by a combination of factors that included resource endowments, regional economic disparities, and government interventions. These findings can inform policy makers towards optimizing the management of water-energy-food resources. • Water-energy-food nexus is assessed based on water scarcity-surplus. • Energy-water nexus shows greater inequality and spatio-temporal variations. • Inequalities of water scarcity and surplus occur in North and South, respectively. • The inequality is a result of resource endowments, economic disparities, and policies. [ABSTRACT FROM AUTHOR]

Introduction: The prognostic significance of red cell distribution width-SD (RDW-SD) as a promising inflammatory biomarker in individuals with non-ischemic dilated cardiomyopathy (DCM) and varying glycemic status remains unexplored., Research Design and Methods: Patients hospitalized for DCM in Fuwai Hospital from 2006 to 2021 were retrospectively included. The primary outcome encompassed all-cause mortality and heart transplantations. The multivariable Cox regression was used to evaluate the association between RDW-SD and outcomes in the overall DCM population, and among patients with normoglycemia (NG), pre-diabetes mellitus (pre-DM) and DM., Results: Among 1,102 patients with DCM, the median age was 48 years and 23.5% were women. In the overall DCM cohort, the RDW-SD was independently associated with the primary outcome (adjusted HR 1.29, 95% CI 1.15 to 1.45, p<0.001, per SD increase). When stratifying patients with glycemic status, the RDW-SD exhibited an independent association with outcome in patients with DCM with pre-DM and DM, the adjusted HRs were 1.48 (95% CI 1.21 to 1.79, p<0.001) and 1.30 (95% CI 1.06 to 1.60, p=0.011) per SD increase, respectively. However, in patients with DCM and NG, the prognostic value of RDW-SD was insignificant, with an adjusted HR of 1.20 per SD increase (95% CI: 0.97 to 1.48, p=0.101)., Conclusions: RDW-SD was independently associated with the outcome in patients with DCM with pre-DM and DM, suggesting potential individualized therapeutic targets for this subset of patients with DCM., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Aims: Acute myocarditis (AM) has been recognized as a rare complication of coronavirus disease 2019 (COVID-19) infection. This study was conducted to present the clinical characteristics, disease courses and short-term prognoses of Omicron variant of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) induced AM in China, which has been unavailable so far., Methods and Results: Data from 28 patients diagnosed with definite COVID-19-associated AM from 6 hospitals in China between 1 December 2022 and 30 June 2023 were collected and analysed. The diagnosis of AM was based on increased troponin level plus typical findings of AM on cardiac magnetic resonance (CMR) imaging and/or endomyocardial biopsy. Among 28 patients with definite COVID-19-related AM, median age was 37 years (Q1-Q3: 22-52) and 53.6% were men. Twenty-three patients occurred within 2 weeks of the onset of COVID-19 infection, 10 patients underwent endomyocardial biopsy and CMR was performed in all patients. Seven (25.0%) patients developed fulminant myocarditis that required inotropic agents or temporary mechanical circulatory support. Of the nine patients (32.1%) with left ventricular ejection fraction (LVEF) below 50% on admission, five had fully recovered LVEF and two demonstrated improvement but to levels below normal at discharge. The comparison of CMR parameters between the baseline and first follow-up showed that ECV was decreased at the first follow-up [28.95 (25.38, 32.55)% vs. 33.65 (31.58, 37.55)%, P = 0.028), while other CMR parameters had no significant changes. Eighteen patients (64.3%) were prescribed with corticosteroids, and seven patients (25.0%) underwent temporary mechanical circulatory support. Only two patients died during hospitalization., Conclusions: The majority of COVID-19-associated AM occurred within 2 weeks of Omicron variant infection. Fulminant myocarditis complicated by hemodynamic instability requiring temporary mechanical circulatory support was not uncommon. However, short-term outcome was generally good and most AM patients fully recovered., (© 2024 The Author(s). ESC Heart Failure published by John Wiley & Sons Ltd on behalf of European Society of Cardiology.)

Objective: Plant-based diets have multiple health benefits for cancers; however, little is known about the association between plant-based dietary patterns and esophageal cancer (EC).This study presents an investigation of the prospective associations among three predefined indices of plant-based dietary patterns and the risk of EC., Methods: We performed endoscopic screening for 15,709 participants aged 40-69 years from two high-risk areas of China from January 2005 to December 2009 and followed the cohort until December 31, 2022. The overall plant-based diet index (PDI), healthful plant-based diet index (hPDI), and unhealthful plant-based diet index (uPDI), were calculated using survey responses to assess dietary patterns. We applied Cox proportional hazard regression to estimate the multivariable hazard ratios (HRs) and 95% confidence intervals (95% CIs) of EC across 3 plant-based diet indices and further stratified the analysis by subgroups., Results: The final study sample included 15,184 participants in the cohort. During a follow-up of 219,365 person-years, 176 patients with EC were identified. When the highest quartile was compared with the lowest quartile, the pooled multivariable-adjusted HR of EC was 0.50 (95% CI, 0.32-0.77) for hPDI. In addition, the HR per 10-point increase in the hPDI score was 0.42 (95% CI, 0.27-0.66) for ECs. Conversely, uPDI was positively associated with the risk of EC, and the HR was 1.80 (95% CI, 1.16-2.82). The HR per 10-point increase in the uPDI score was 1.90 (95% CI, 1.26-2.88) for ECs. The associations between these scores and the risk of EC were consistent in most subgroups. These results remained robust in sensitivity analyses., Conclusions: A healthy plant-based dietary pattern was associated with a reduced risk of EC. Emphasizing the healthiness and quality of plant-based diets may be important for preventing the development of EC., (Copyright ©2024 Chinese Journal of Cancer Research. All rights reserved.)

Background: The prognostic significance of QRS duration (QRSd) in patients with dilated cardiomyopathy (DCM) and a left ventricular ejection fraction (LVEF) between 30% and 50% is unclear, resulting in questions regarding eligibility for cardiac resynchronisation therapy. This study aimed to explore the prognostic role of QRSd in patients with DCM and a LVEF 30-50% or LVEF < 30., Methods: Patients hospitalised at Fuwai hospital with DCM who had a LVEF ≤ 50% were prospectively included. The primary outcomes were a composite of death, heart transplantation, and rehospitalisation for worsening heart failure., Results: Among the 633 patients included, 302 (47.7%) had a LVEF of 30-50%. The multivariable hazard ratio (HR) for QRSd ≥ 120 ms was 1.65 (95% confidence interval [CI] 1.29-2.11, p < 0.001) for overall DCM patients, 2.8 (95% CI 1.82-4.30, p < 0.001) for patients with LVEF 30-50%, and 1.41 (95% CI 1.02-1.94, p = 0.036) for patients with LVEF < 30%. QRSd ≥ 120 ms tended to be more strongly associated with outcome in patients with LVEF 30-50% than in those with LVEF < 30% despite the non-significant interaction ( p = 0.067). DCM patients with QRSd ≥ 120 ms and LVEF 30-50% did not experience a significantly better outcome than those with LVEF < 30% and QRSd < 120 ms after propensity-score matching (HR 0.91, 95% CI 0.61-1.36, p = 0.645)., Conclusions: QRSd independently predicts prognosis in DCM patients irrespective of LVEF and identifies a group of high-risk patients who may benefit from device implantation despite the absence of severely reduced LVEF., Competing Interests: The authors declare no conflict of interest., (Copyright: © 2023 The Author(s). Published by IMR Press.)

Objective: To explore the natural history of severe dysplasia/carcinoma in situ (SD/CIS) patients and to evaluate the efficacy of endoscopic treatment to SD/CIS patients., Methods: Between January 2005 and December 2009, a population-based prospective screening program on esophageal squamous cell carcinoma (ESCC) was performed in Linzhou, China, with endoscopic screening plus iodine staining. All the eligible histologically confirmed SD/CIS patients were followed up through the door-to-door follow-up and local cancer registry. The endpoint was diagnosed as ESCC or the December 31st, 2016. Kaplan-Meier survival analysis and Log-rank test were used to compare the survival rates among treated and untreated patients., Results: A total of 175 SD/CIS patients were enrolled and grouped by whether they received endoscopic treatment. Eleven-year cumulative incidence rates for untreated and treated SD/CIS patients were 10.7% [95% confidence interval (95% CI): 6.9-16.1] and 3.2% (95% CI: 1.4-7.0), respectively. The ESCC incidence free survival rate, and all-cause incidence and mortality free survival rates were all significantly higher in the treated patients vs. untreated patients (P=0.043, P=0.008 and P=0.015, respectively). The ESCC mortality free survival rate showed no significant differences between the two groups (P=0.847)., Conclusions: The cumulative incidence rate of SD/CIS patients to ESCC was much lower than previously reported. The Kaplan-Meier survival analysis showed that endoscopic treatment could increase the ESCC and all-cause disease-free survival rates of SD/CIS patients significantly.

Objective: To evaluate the feasibility of DNA image cytometry (DNA-ICM) as a primary screening method for esophageal squamous cell cancer (ESCC)., Methods: A total of 5,382 local residents aged 40-69 years from three high-risk areas in China (Linzhou in Henan province, Feicheng in Shandong province and Cixian in Hebei province) from 2008 to 2011 were recruited in this population-based screening study. And 2,526 subjects declined to receive endoscopic biopsy examination with Lugol's iodine staining, while 9 and 815 subjects were excluded from liquid-based cytology and DNA-ICM test respectively due to slide quality. Finally, 2,856, 5,373 and 4,567 subjects were enrolled in the analysis for endoscopic biopsy examination, liquid-based cytology and DNA-ICM test, respectively. Sensitivity (SE), specificity (SP), negative predictive values (NPV) and positive predictive values (PPV) as well as their 95% confidence intervals (95% CI) for DNA-ICM, liquid-based cytology and the combination of the two methods were calculated. Receiver operating characteristic (ROC) curves were applied to determine the cutoff point of DNA-ICM for esophageal cancer., Results: DNA-ICM results were significantly correlative with esophageal cancer and precancer lesions (χ(2)=18.016, P<0.001). The cutoff points were 5,802, 5,803 and 8,002 based on dissimilar pathological types of low grade intraepithelial neoplasia (LGIN), high grade intraepithelial neoplasia (HGIN), and ESCC, respectively, and 5,803 was chosen in this study considering the SE and SP. The SE, SP, PPV, NPV of DNA-ICM test (cutoff point 5,803) combined with liquid-based cytology [threshold atypical squamous cells of undetermined significance (ASCUS)] were separately 72.1% (95% CI: 70.3%-73.9%), 43.3% (95% CI: 41.3%-45.3%), 22.8% (95% CI: 21.1%-24.5%) and 87.0% (95% CI: 85.7%-88.3%) for LGIN, 85.7% (95% CI: 84.3%-87.1%), 41.3% (95% CI: 39.3%-43.3%), 4.6% (95% CI: 3.8%-5.4%) and 98.9% (95% CI: 98.5%-99.3%) for HGIN, and 96.0% (95% CI: 95.2%-96.8%), 40.8% (95% CI: 38.8%-42.8%), 1.7% (95% CI: 1.2%-2.2%) and 99.9% (95% CI: 99.8%-100.0%) for ESCC., Conclusions: It is possible to use DNA-ICM test as a primary screening method before endoscopic screening for esophageal cancer., Competing Interests: The authors have no conflicts of interest to declare.

Objective: To understand the distribution of esophageal squamous cell cancer and precursor lesions in high-risk areas of China, and to provide evidence for determining the reference ranges of detection rates in high-risk areas., Methods: Endoscopy with Lugol's iodine staining was performed on 15 709 local residents aged 40 to 69 years old in Linzhou of Henan province and Feicheng of Shandong province from 2005-2009. 35 cases without accurate pathology diagnosis and 11 cases with vital disease before screening were excluded. 15 663 subjects were enrolled in this study. Compliance was calculated by the percentage of the people who had endoscopic screening among the target population. Chi-square test and trend chi-square test were used to compare the distribution differences in age, gender and areas of esophageal squamous cell cancer and precancer. 95% CI of the detection rates was then employed to represent the reference ranges of esophageal squamous cell cancer and precursor lesions., Results: The compliance rate of screening endoscopy of this study was 49.36% (15 709/31 826) of all, and female's compliance (54.05%, 8 447/15 628) was much higher than that of male (44.83%, 7 262/16 198) (χ(2) = 88.14, P < 0.001). The detection rates of basal cell hyperplasia, low grade intraepithelial neoplasia, high grade intraepithelial neoplasia and esophageal squamous cell cancer of males were 4.17% (302/7 246), 17.22% (1 248/7 246), 1.67% (121/7 246), 0.83% (60/7 246), and were higher than that of females (3.45% (290/8 417), 14.82% (1 247/8 417), 1.41% (119/8 417), 0.48% (40/8 417), respectively). Except for high-grade intraepithelial neoplasia, the detection rates of male were higher than that of female (P values were 0.018, < 0.001, 0.960, 0.006). The detection rates of all grades of precursor lesions increased with age rising (all P values < 0.001), among which the detection rates of the mentioned four lesions for 40-44 years old were 2.69% (94/3 500), 8.11% (284/3 500), 0.40% (14/3 500), 0.14% (5/3 500), and that of 65-69 years old were 5.46% (46/843), 23.25% (196/843), 3.68% (31/843), 2.14% (18/843). The proportion of esophageal precursor lesion of Linzhou were higher than that of Feicheng observably except for esophageal squamous cell cancer (P values were < 0.001, < 0.001, < 0.001, 0.437). The detection rates of the four lesions of Linzhou and Feicheng were 4.90% (504/10 287), 17.37% (1 787/10 287), 1.79% (184/1 0287), 0.60% (62/10 287) and 1.64% (88/5 376), 13.17% (708/5 376), 1.04% (56/5 376), 0.71% (38/5 376). The 95% CI of detection rates of various lesions were, 3.78% (3.48%-4.08%) for basal cell hyperplasia, 15.93% (15.37%-16.50%) for low-grade intraepithelial neoplasia, 12.31% (11.79%-12.82%) for mild dysplasia and 3.62% (3.33%-3.91%) for moderate hyperplasia, 1.53% (1.34%-1.72%) for high-grade intraepithelial neoplasia and 0.64% (0.51%-0.76%) for esophageal squamous cell cancer, respectively., Conclusion: Up to 21.88% residents that were asymptomatic were suffered from esophageal squamous cancer or precursor lesions in high-risk areas in China. The distribution of esophageal squamous cell cancer and precursor lesions was closely related to the gender and the age, which suggested that males were supposed to be paid more attention to.

Objective: To improve the efficiency of skin soft tissue expansion with the overlapping tissue expansion techniques., Methods: From June 2003 to March 2005, 5 cases of skin soft tissue defects were treated with the overlapping tissue expansion technique-two overlapped expanders in one soft tissue pocket, which was different from the traditional technique--one expander in one soft tissue pocket. Five patients included 3 males and 2 females, aging from 11 to 28 years. The defect was caused by scar of forearm in 2 cases, by melanotic nevus in 1 case and by cicatricial baldness in 2 cases. The disease course was 1.5 to 24 years. The defect size ranged from 12 cm X 5 cm to 13 cm X 12 cm., Results: Skin expansion process was satisfactory and skin defect was completely repaired with the expanded skin tissue in one operation in 5 cases. After operation, the wound of donor-recipient site healed by first intention. All patients were followed up from 3 to 15 months, no contracture, pigmentation and scar occurred at the expanded skin area. The long-term appearances were satisfactory., Conclusion: Compare with the traditional tissue expansion techniques, the new overlapping tissue expansion techniques can apparently improve the efficiency of skin soft tissue expansion. It is suitable for the patients whose expandable skin is limited or no more skin tissue can be dissected near the skin defect and who need more expandable skin to repair skin defect.