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Abstract Lysophosphoglycerides (LPLs) have been reported to accumulate in myocardium and serve as a cause of arrhythmias in acute myocardial ischemia. However, in this study we found that LPLs level in the ventricular myocardium was decreased by the onset of acute myocardial ischemia in vivo in rats. Decreasing of LPLs level in left ventricular myocardium, but not right, was observed within 26 min of left myocardial ischemia, regardless of whether arrhythmias were triggered. Lower LPLs level in the ventricular myocardium was also observed in aconitine-simulated ventricular fibrillation (P

Abstract Oil transport is greatly affected by heterogeneous pore–throat structures present in shale. It is therefore very important to accurately characterize pore–throat structures. Additionally, it remains unclear how pore–throat structures affect oil transport capacity. In this paper, using finite element (FE) simulation and mathematical modeling, we calculated the hydrodynamic resistance for four pore–throat structure. In addition, the influence of pore throat structure on shale oil permeability is analyzed. According to the results, the hydrodynamic resistance of different pore throat structures can vary by 300%. The contribution of additional resistance caused by streamline bending is also in excess of 40%, even without slip length. Furthermore, Pore–throat structures can affect apparent permeability by more than 60% on the REV scale, and this influence increases with heterogeneity of pore size distribution, organic matter content, and organic matter number. Clearly, modeling shale oil flow requires consideration of porous–throat structure and additional resistance, otherwise oil recovery and flow capacity may be overestimated.

The impact force of debris flow is the main cause of damage and destruction of check dam. In high altitude area, due to high mountains and deep valleys, serious physical weathering of surface materials, a wide range of source materials gradation, high frequency of debris flow occurence and high impact force, the damages induced by debris flow to the check dam are significant. To study the impact characteristics of the wide graded debris flow on check dam in high altitude area, the debris flow developed in Tibet is taking as a prototype. A physical test model of the impact check dam of wide graded debris flow is established. The unit weight of debris flow, the slope of flume and the maximum particle size of debris flow solid are selected as variable factors. 27 groups of flume tests were carried out to study the characteristics of impact force. The results show that: (1) Wide-graded debris flow mainly undergoes three contact evolution stages during the process of impact retaining dam, i.e. impact climbing-rolling return flow-accumulation and silting. The smaller of the debris flow volume weight could lead to a higher climbing distance, and more obvious stage performance of sourcing and sliting process. (2) The impact force in front of the dam decreases with the increase of the bulk weight of wide-graded debris flow. Under the same slope and gradation, a larger the bulk weight of debris flow materials lead to a lower velocity of the debris flow materials and less impact force, because it is more difficult to carry solid material sources. (3) The impact force in front of the dam increases with the increase of the groove gradient. The larger the groove gradient, the greater the flow velocity and flow depth of wide-graded debris flow, the greater the impact force of debris flow. The larger the particle size of solid phase of debris flow, the more significant the impact of slope on impact force. (4) The impact force in front of the sand bar increases with the increase of the maximum particle size of the solid phase of the wide graded debris flow, and the change trend is more significant than when the volume density of the debris flow and the slope conditions of the groove change. The maximum particle size has no obvious regular relationship with the velocity and depth of the debris flow. The research results will provide certain data reference for the prevention and research of wide graded debris flows.

The scale of Plectropomus leopardus breeding is continually expanding, and this has necessitated constant changes to ensure that breeding conditions are optimized. Background color is an important factor affecting fish feeding. In this study, fish (10.58 ± 0.03 g) were cultured on five background colors (red, blue, black, white, and transparent), and the growth status and intestinal microbes of these fish over 56 days were analyzed. Growth performance and the expression of growth-related genes were optimized when the background color was white. The white group had higher AMS and LPS enzyme activities and lower T-SOD and T-AOC enzyme activities, indicating that the white background could effectively promote feeding and reduce oxidative stress in P. leopardus. Additionally, changes in background color altered the composition and function of the intestinal microbiota. The diversity and abundance of intestinal microbiota, including the abundance of beneficial bacteria, were highest in fish on a white background. The abundances of Firmicutes and Actinobacteriota and the abundance of Bacillus were higher in the White group than in the other groups, indicating that a white background promotes the health of juvenile P. leopardus. In conclusion, a white background can promote the growth performance of P. leopardus and increase the abundance of beneficial intestinal microbes. Generally, the results of our study could be used to optimize the culture of P. leopardus.

Reservoir impoundment imposes a significant triggering effect on bank landslides. Studying the early identification of landslides and their stability concerning reservoir water levels and rainfall is vital for guaranteeing the safety of residents and infrastructure in reservoir regions. This study proposed a method for establishing a dynamic inventory of active landslides at large hydropower stations using integrated remote sensing techniques, demonstrated at Lianghekou Reservoir. We employed interferometric stacking synthetic aperture radar (stacking-InSAR) technology, small baseline subset interferometric synthetic aperture radar (SBAS-InSAR) technology, and optical satellite images to identify and catalogue active landslides. Moreover, we conducted field investigations to examine the deformation characteristics of landslides. Finally, Pearson’s correlation analysis was employed to evaluate the response between deformation values, reservoir water levels, and rainfall. The results revealed 75 active landslides, including 12 long-term active landslides before impoundment and 63 new landslides after impoundment, which were primarily concentrated in the Waduo and Yazho–Zatou regions. The correlation coefficient between landslide deformation values and the reservoir level was high (0.93), while the correlation coefficient with rainfall was low (0.57). The results of this research offer a crucial foundation for preventing and mitigating landslides in reservoir areas.

The deterioration mechanism of red-bed soft rock is attributed to microstructural changes induced by water–rock interactions, where the damage to pores and the development of fractures significantly impact its macroscopic mechanical performance. The microstructural deterioration pattern of red-bed rock with different water saturation times was obtained by scanning electron microscopy (SEM), which showed that the microdamage effect of mudstone is an evolutionary process comprising the dissolution and detachment of its internal soluble bond structure. Three-dimensional (3D) images of the water-saturated damage of the rock mass were extracted by computed tomography (CT) scanning and calculated based on the box-counting algorithm to obtain the fractal dimension of the fracture development, leading to the theory that a soft rock fracture has multiple fractal characteristics. With the continuous increase in the water saturation time, the pores inside the rock mass began to reorganize and connect, and the mudstone specimens showed accelerated damage and some self-similarity. Furthermore, chemical element testing was conducted on the solutions used for water saturation, leading to the establishment of a microscopic interfacial evolution model describing water–rock damage, with theoretical equations derived based on diffusion theory.

Hypoxic-ischemic encephalopathy (HIE) is a prominent cause of neonatal mortality and neurodevelopmental disorders; however, effective therapeutic interventions remain limited. During neonatal hypoxic-ischemic injury events, increased reactive oxygen species (ROS) production and decreased antioxidant levels lead to the induction of oxidative stress, which plays a pivotal role in the pathological process of neonatal HIE. Nuclear factor erythroid 2-related factor 2 (Nrf2) is a key endogenous antioxidant transcription factor that protects against oxidative stress by promoting the transcription of various antioxidant genes. It has been demonstrated that Nrf2 signaling pathway activation by different compounds may protect against neonatal HIE. This review outlines the role of oxidative stress in neonatal HIE and summarizes the impact of antioxidants on neonatal HIE via activation of the Nrf2 signaling pathway. In conclusion, Nrf2 signaling pathway potentially exerts antioxidant, anti-inflammatory, antiapoptotic and antiferroptotic effects, thereby emerging as a focal point for future neonatal HIE treatment strategies.

Advanced water injection has become an effective method for developing low-permeability reservoirs. However, after a period of high yield from fracturing, the injected water flows rapidly along high-capacity channels, which greatly reduces the sweep efficiency of reservoirs. In this work, the plugging process by microspheres and nanospheres from the fracture to the matrix was simulated through core experiments. The plugging performance of multi-scale microspheres (microspheres and nanospheres) on the core matrix was evaluated by measuring the plugging rate and other parameters. Enhanced oil recovery after synergistic plugging with multi-scale microspheres was used as the evaluation index, a sensitivity analysis of injection parameters was performed, and the best combination of injection parameters was optimized by orthogonal experiments. The experimental results showed that the plugging performance of nanospheres is mainly reflected in the filling of the core matrix, while the plugging performance of microspheres is mainly reflected by retention at the injection end of the core (as opposed to the fractured end face). The plugging rate of nanospheres reached 78.83%, which is much higher than the 30.28% rate achieved with microspheres. The maximum oil recovery after plugging was 19.12%, which corresponds to the following combination of injection parameters: total injection of 0.6 pore volume (PV), injection ratio between nanospheres and microspheres of 2:1, injection rate of 1.5 mL·min−1, and aging time of 6 days. Among the injection parameters, the injection ratio between nanospheres and microspheres had the greatest influence on the recovery of waterflooding after plugging, followed by the total injection of multi-scale microspheres. The injection rate and aging time had little effect.

Micro/nanoplastics are widespread in the environment and may cause severe damage to creatures and human beings. Micro/nanoplastic pollution has become a global focus issue; hence, the rapid and accurate detection of micro/nanoplastics is an essential step to ensure health. Herein, we report a surface-enhanced Raman scattering (SERS) technique to sensitively and quantitatively identify micro/nanoplastics in environmental water samples. A three-dimensional hierarchical Au@Ag nanostar (NSs) was synthesized and employed as an efficient SERS substrate. The “lightning rod effect” generated by tip branches of the nanostars and the coupling effect of the neighboring branches of the nanostar array enabled the ultra-trace detection of crystal violet (CV) down to 10−9 M, even with a portable Raman device. Moreover, the hydrophobic property of the SERS substrate endowed it with a desirable enrichment effect, which meant an increase in the concentration or quantity of the micro/nanoplastic particles. And thereafter, the SERS sensor achieved a highly sensitive detection of polystyrene (PS) particle standard solution at a low concentration of 25 μg/mL or 2.5 μg/mL. Importantly, the detected concentration and the SERS intensity followed a nearly linear relationship, indicating the capability of quantitative analysis of micro/nanoplastics. In addition, the SERS sensor was successfully extended to detect PS particles in environmental water samples, including tap water, sea water, and soil water, and the detection concentration was determined to be 25 μg/mL, 2.5 μg/mL, and 25 μg/mL, respectively. The present Au@AgNSs array substrate with a two-order magnitude signal amplification further exhibited significant advantages in the label-free analysis of micro/nanoplastics in real water samples.

Neonatal hypoxic-ischemic encephalopathy (HIE) is considered a major cause of death and long-term neurological injury in newborns. Studies have demonstrated that oxidative stress and apoptosis play a major role in the progression of neonatal HIE. Echinocystic acid (EA), a natural plant extract, shows great antioxidant and antiapoptotic activities in various diseases. However, it has not yet been reported whether EA exerts a neuroprotective effect against neonatal HIE. Therefore, this study was undertaken to explore the neuroprotective effects and potential mechanisms of EA in neonatal HIE using in vivo and in vitro experiments. In the in vivo study, a hypoxic-ischemic brain damage (HIBD) model was established in neonatal mice, and EA was administered immediately after HIBD. Cerebral infarction, brain atrophy and long-term neurobehavioral deficits were measured. Hematoxylin and eosin (H&E), terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL) and dihydroethidium (DHE) staining were performed, and the contents of malondialdehyde (MDA) and glutathione (GSH) were detected. In the in vitro study, an oxygen-glucose deprivation/reperfusion (OGD/R) model was employed in primary cortical neurons, and EA was introduced during OGD/R. Cell death and cellular ROS levels were determined. To illustrate the mechanism, the PI3K inhibitor LY294002 and Nrf2 inhibitor ML385 were used. The protein expression levels of p-PI3K, PI3K, p-Akt, Akt, Nrf2, NQO1, and HO-1 were measured by western blotting. The results showed that EA treatment significantly reduced cerebral infarction, attenuated neuronal injury, and improved brain atrophy and long-term neurobehavioral deficits in neonatal mice subjected to HIBD. Meanwhile, EA effectively increased the survival rate in neurons exposed to OGD/R and inhibited oxidative stress and apoptosis in both in vivo and in vitro studies. Moreover, EA activated the PI3K/Akt/Nrf2 pathway in neonatal mice following HIBD and in neurons after OGD/R. In conclusion, these results suggested that EA alleviated HIBD by ameliorating oxidative stress and apoptosis via activation of the PI3K/Akt/Nrf2 signaling pathway.

Characteristics of pore structure are crucial to oil exploration and development in shale reservoirs, but practical evaluation of shale pore structure remains a longstanding challenge. In this study, based on nuclear magnetic resonance transverse relaxation time (T2) spectra under water-saturated and irreducible conditions, total pore space and moveable fluid space were skillfully determined. Meanwhile, multifractal spectra were used to characterize T2 distributions of total pore space and movable fluid space. The results show characteristic parameters of high probability measure areas of multifractal spectra (multifractal parameters) have strong negative correlations with T2 geometric mean value, and average radii of pore and throat increase with a decrease in the multifractal parameters, indicating the shale reservoirs with low values of the multifractal parameters may have good pore structure. Moreover, clay mineral content has strong positive effects on the multifractal parameters. In contrast, (quartz+feldspar) mineral content negatively influences on the multifractal parameters. Finally, new accurate models for permeability estimation in core scale and well-logging scale of shales are both proposed based on the multifractal parameters, which are also applicable for the other reservoirs. Overall, this study is important and timely for evaluating pore structure and predicting permeability in shale reservoirs.

In natural micro-nanoscale porous media, the movable fluid porosity can effectively represent storage and permeable properties, but various mineral compositions have complicated effects on it. Taking saline lacustrine shale as an example, this study researched the effects of mineral composition on movable fluid porosity, based on nuclear magnetic resonance (NMR), focused ion beam (FIB), and x-ray diffraction (XRD) experiments. The results show that movable fluid porosity exhibits a stronger dependence on porosity than movable fluid saturation does. Micropores (1000 nm) are mostly developed in silicate and gypsum minerals, and have a highly heterogeneous distribution. In contrast, carbonate intercrystalline pores are dominated by mesopores (100−1000 nm), and behave strongly heterogeneously. Many mesopores play a positive role in generating highly movable fluid porosity, but the development of micropores and macropores is not conducive to an increase in movable fluid porosity. Overall, a significant negative effect is observed between silicate mineral content and movable fluid porosity, and carbonate mineral content has a strong positive effect on movable fluid porosity, whereas movable fluid porosity exhibits a relatively small reduction with an increase in the gypsum.

Thoracic aortic dissection (TAD) is the most common cause of sudden cardiac death associated with aortic diseases. The age of TAD victims in forensic studies is significantly younger than hospitalized patients with TAD, while only a few studies have been conducted on autopsy-diagnosed TAD deceased. A retrospective study was conducted at the Medicolegal Center of Sun Yat-sen University from 1999 to 2019 to address the characteristics of TAD victims. A total of 200 deceased from spontaneous rupture of TAD were assessed, with 165 (82.5%) males and 175 (87.5%) Stanford type A deceased. Our main results showed that compared with patients with TAD diagnosed during their lifetime, individuals diagnosed with TAD until an autopsy showed an earlier onset (43.80 years old) and less accompanied hypertension (

Ductile flexural toppling failure is a common form of toppling failure, and it is the product of long-term geological history and shows the characteristics of long-term deformation and progressive failure. The creep characteristics of rock mass have been seldom considered in the current research on toppling, especially interlayer creep of rock layers in the process of toppling. Based on the thought of deformation stability analysis, the flexural toppling failure was divided into the following four stages: start-up, rapid deformation, transient stability, and long-term creep stages. Combined with mechanical analysis, the developmental conditions of the start-up, transient stability, and long-term creep development stages are discussed respectively. Finally, several cases were selected to analyze the stage and the stability of the toppling deformation body, as well as to verify the rationality of the mechanical analysis condition. Study results show that the start-up conditions meet Equation 2, the rock layer inclination and slope angle is 0.5π−φ in the transient stability stage, and that angle is the infinite 0.5π in the long-term creep stage. Other external forces (such as water pressure) will intensify the development of ductile flexural toppling failure, so that the angle between the toppled bedding surface and the slope surface increases. It is of great significance to analyze the development stage of the ductile flexural toppling, comprehensively analyze and evaluate the stability of the ductile flexural toppling, reasonably develop and utilize its self-stability ability, and set up support measures.

Circular RNAs (circRNAs) are a distinctive type of endogenous non-coding RNAs, and their regulatory roles in neurological disorders have received immense attention. CircRNAs significantly contribute to the regulation of gene expression and progression of neurodegenerative disorders including Alzheimer’s disease (AD). The current study aimed to identify circRNAs as prognostic and potential biomarkers in AD. The differentially expressed circRNAs among subjective cognitive decline, amnestic mild cognitive impairment, and age-matched normal donors were determined through Arraystar Human circRNA Array V2 analysis. The annotations of circRNAs-microRNA interactions were predicted by employing Arraystar’s homemade microRNAs (miRNA) target prediction tool. Bioinformatics analyses comprising gene ontology enrichment, KEGG pathway, and network analysis were conducted. Microarray analysis revealed the 33 upregulated and 11 downregulated differentially expressed circRNAs (FC ≥ 1.5 and p-values ≤ 0.05). The top 10 differentially expressed upregulated and downregulated circRNAs have been chosen for further expression validation through quantitative real-time PCR and subsequently, hsa-circRNA_001481 and hsa_circRNA_000479 were confirmed experimentally. Bioinformatics analyses determined the circRNA-miRNA-mRNA interactions and microRNA response elements to inhibit the expression of miRNAs and mRNA targets. Gene ontology enrichment and KEGG pathways analysis revealed the functional clustering of target mRNAs suggesting the functional verification of these two promising circRNAs. It is concluded that human circRNA_001481 and circRNA_000479 could be utilized as potential biomarkers for the early onset detection of AD and the development of effective therapeutics.

Biomedical measurements usually generate high-dimensional data where individual samples are classified in several categories. Vogelstein et al. propose a supervised dimensionality reduction method which estimates the low-dimensional data projection for classification and prediction in big datasets.

Studies regarding sport-related sudden cardiac death (SCD) mainly focus on competitive athletes; similar data are rare in the general population, especially in China. We conducted a retrospective study (from September 1998 to August 2013) to investigate the aetiological distribution and epidemiological features of sport-related SCD in Southern China. Selections of cases are based on details, and two subgroups were established: one was the sport-related SCD group, and the other was the disease-free accident victims group which was matched with the sport-related SCD group in gender, age and year of death. Among the 3770 sudden-death cases, 1656 cases were SCD cases. A total of 65 cases (57 males) out of 1 656 SCD cases were sport-related. The age range of the 65 sport-related SCD cases was from 12 to 68 years old with a mean (35.92 ± 14.23) years old. Only two of these cases were competitive athletes. The most common circumstances of the 65 sport-related SCD cases were heavy physical labour (46.15%) and running (30.77%). The three leading forensic diagnoses were the coronary atherosclerotic disease (CAD, 28 cases), cardiomyopathy (CM, 14 cases) and sudden unexplained death (7 cases). CM was the most common forensic diagnosis in those ≤35 years old, while CAD was the most common one in those >35 years old. Left anterior descending in which atherosclerotic plaques was most commonly found was the principal artery branch associated with sport-related SCD. There was a statistically significant difference in the weight of hearts between the 65 sport-related SCD cases and 65 diseases-free accidental cases. This study highlights the need to attract public attention to sport-related SCD and to issue a prevention strategy to the public, and to make the SCD-related genetic sequencing a routine tool in both forensic pathological examination and clinic screening.

Autopsy is of great significance for elucidating the pathological changes, pathogenesis and cause of death of Coronavirus Disease 2019 (COVID-19) and can provide a theoretical basis for scientific and accurate prevention and control of its outbreak. Based on related laws and regulations, such as the Law of the People’s Republic of China on Prevention and Control of Infectious Diseases, clinical manifestations and epidemiological characteristics of COVID-19 and guidelines on the prevention and control of this epidemic, combined with the practical work of forensic pathology examinations, we developed the Guide to Forensic Pathology Practice for Death Cases Related to Coronavirus Disease 2019 (COVID-19) (Trial Draft). This guide describes the background investigation of the death cases, autopsy room requirements, personal prevention and protections, external examinations, autopsy practices and auxiliary examinations, and thus offers a reference for forensic and pathological examination institutions and staff.

Fish skin color is usually strongly affected by the background color of their environment. The study investigated the effects of five different background colors on the skin color of leopard coral groupers (Plectropomus leopardus). More than 450 juveniles were reared in Blue, Red, Black, White, and Transparent background tanks for 56 days. The paraffin section showed that the skin melanin zone of fish in the White group was smaller, whereas the Black and Red groups (especially Black) were nearly the largest. The apparent skin color of P. leopardus was red on the white background, which darkened in response to the other color backgrounds. The Black group revealed the blackest skin color, followed by the transparent group. Moreover, the White group had the highest L*, a*, and b* values. The melanin content and tyrosinase activity in the dorsal and ventral skin of the Black group were significantly higher than those in the other groups (p < 0.05), and the serum α-MSH level was higher in the Black group as well. The carotenoid and lutein contents showed completely different trends among the experimental groups, as carotenoid content was higher in the Red and White groups, while lutein content was higher in the Transparent group. The expression level of scarb1 was highest in the Blue and White groups, followed by the Transparent group, and lowest in the Black group (p < 0.05). The expression trend of scarb1 was similar to the skin color in different backgrounds, indicating that the background color regulated scarb1 expression level through visual center, then influenced the uptake and transport of carotenoids, then influenced the skin color formation of P. leopardus. Moreover, lighter colors inhibited the formation of melanocytes and had a significant effect on carotenoid and lutein contents. Pigment-related genes were involved in the regulation of fish skin color, and they were affected by background color in P. leopardus. These results indicate that a white background is more conducive to maintaining red skin color in juvenile P. leopardus.

Fish skin color is often strongly affected by background color. We hypothesized that the regulatory mechanism of variations in skin color in P. leopardus is linked to the background color. In this study, we conducted transcriptome analysis of Plectropomus leopardus cultured under different background colors to compare gene expression levels and the important signaling pathways. The RNA-seq analysis yielded 26,675 known mRNAs, 3278 novel mRNAs, and 3179 differentially expressed genes (DEGs). The DEGs related to melanin synthesis were screened out. Some key melanin-related genes were identified, specifically tyr, slc7a11, mc1r, ednrb, dct, tat, and wnt1. These DEGs were mainly involved in melanogenesis, including tyrosine metabolism, the Wnt signaling pathway, and the cAMP signaling pathway. The expression levels of some key genes were upregulated when background color deepened, such as α-msh, wnt, and gf. The α-MSH/cAMP-dependent, Wnt/β-catenin, and PI3K/Akt signaling pathways were activated, resulting in the accumulation of intracellular mitf. mitf promoted melanin production by binding to the tyr/tyrp1/dct promoter region. In the present study, we explored the molecular mechanism underlying the darkened skin color pattern of P. leopardus, providing a theoretical basis for the molecular mechanism underlying pigmentation in P. leopardus.

To reveal the impact of slope angle change on toppling deformation, this paper takes the dam toppling deformation of Gushui Hydropower Station based at Lancang River as an example, based on which three groups of models with different slope angles are conceptualized and designed. Through the centrifuge test, the evolution of toppling deformation of a counter-tilt layered slope under different slope angles was simulated. The research results show that: (1) The steeper the slope angle, the shorter the cumulative time required for such deformation is, the larger the toppling deformation will be, and it is more likely that multi-stage fracture zones will occur during the toppling process. (2) The toppling deformation process can be summarized as four stages. (3) The toppling deformation mainly occurs above the datum surface of the toppling fracture; the angle between the datum surface and the normal of the layer is between 12° to 16°. This value shall not change as the slope angle changes. (4) The lesser the slope angle is, the more likely the toppling deformed slope will be experience overall slipping instability. while the steeper the slope angle is, the greater the possibility of collapse after the rock mass falls.

Controversies have been raised regarding the prevalence and potential clinical significance of mitral annular disjunction (MAD). We aim to address the anatomic characteristics of MAD and their association, if any, on survival. We retrospectively reviewed 1373 consecutive dissected hearts (1017 men, mean age at death 44.9 ± 0.4 y) and frequently detected MAD (median disjunctional length: 2.0 mm, range: 1.5 mm~8.5 mm), with the prevalence of 92.1% over the entire mitral annulus and 74.9% within the posterior annulus (pMAD). The presence of pMAD was associated with increased all-cause mortality (45 y vs. 49 y, hazard ratio [HR]: 1.28, 95% confidence interval [CI]: 1.11~1.47, p < 0.001), which persisted in the context of cardiovascular diseases (CVDs; 46 y vs. 51 y, HR: 1.33, 95% CI: 1.14~1.56, p < 0.001) but was insignificant in those without CVDs. Compared to those without pMAD, individuals with pMAD affecting the entire posterior annulus or having a mean standardized length of ≥1.78 showed other clinically significant cardiovascular phenotypes, including the enlargement of aortic annular circumferences and a higher occurrence of thoracic aortic aneurysm/dissection. This largest series of autopsies show that MAD is a common phenotype that may exert additive influence on the survival of individuals. It is necessary to establish a precise classification and stratification of MAD.

Lady Precious Stream by Shih-I Hsiung was the first successful West End play by a Chinese playwright. Based on a traditional Chinese opera but with many changes, the play had an enormous appeal to the modern audience in the West. This paper argues that the play is essentially an ingenious re-creation in which Hsiung has undertaken a combination of three roles: translating the original into English; adapting it to the English theatrical practice while maintaining the Chinese convention; and re-writing some of the details. Hsiung is thus able to keep the original cultural elements with sensitivity to the taste, convention, and ethical values of the targeted audience, transforming the ancient Chinese opera into a modern English-language play. Lady Precious Stream reveals the evolution and mutation of literary products that cross cultural and geographical boundaries as well as the significant role a writer may play in transcultural exchanges.