关键词： myocardial infarction   non-ST elevated myocardial infarction   percutaneous coronary intervention   treatment outcomes   troponin  

摘要： BACKGROUND:Periprocedural myocardial injury (PMI) with or without type 4a myocardial infarction (MI) might occur in patients with non-ST-segment-elevation MI (NSTEMI) after percutaneous coronary intervention (PCI). This study investigated the incidence and prognostic relevance of these events, according to current definitions, in patients with NSTEMI undergoing PCI. The best cardiac troponin I (cTnI) threshold of PMI for prognostic stratification is also suggested. METHODS:Consecutive patients with NSTEMI from January 2017 to April 2022 undergoing PCI with stable or falling pre-PCI cTnI levels were enrolled. According to the Fourth Universal Definition of Myocardial Infarction, the study population was stratified into those experiencing (1) PMI with type 4a MI, (2) PMI without type 4a MI, or (3) no PMI. Post-PCI cTnI increase >20% with an absolute postprocedural value of >= 5 times the 99th percentile upper reference limit within 48 hours after PCI was used to define PMI. The primary end point was 1-year all-cause mortality, and the secondary end point consisted of major adverse cardiovascular events at 1 year, including all-cause mortality, nonfatal reinfarction, urgent revascularization, nonfatal ischemic stroke, and hospitalization for heart failure. Internal validation was performed in patients enrolled between May 2022 and April 2023. RESULTS:Among 1412 patients with NSTEMI undergoing PCI with stable or falling cTnI levels at baseline, 240 (17%) experienced PMI with type 4a MI, 288 (20.4%) experienced PMI without type 4a MI, and 884 (62.6%) experienced no PMI. PMI was associated with an increased risk of adverse clinical outcomes, with patients with type 4a MI demonstrating the highest rates of 1-year all-cause mortality and major adverse cardiovascular events. A post-PCI Delta cTnI >20% but <= 40% showed similar outcomes to patients without PMI, whereas >40% was identified as the optimal threshold for prognostically relevant PMI, confirmed in an internal valid

关键词： diffusion   thermal properties   sT hydrogen hydrate   mechanical properties   molecular dynamic simulation   machine learning potential  

摘要： Newly-synthesized structure T (sT) hydrate show promising practical applications in hydrogen storage and transport, yet the properties remain poorly understood. Here, we develop a machine learning potential (MLP) of sT hydrogen hydrate derived from quantum-mechanical molecular dynamics simulations. Using this MLP forcefield, the structural, hydrogen diffusion, mechanical and thermal properties of sT hydrogen hydrate are extensively explored. It is revealed that the translational and rotational mobilities of hydrogen molecule in sT hydrate are limited due to unique shape and finite dimensional cavities, and tiny windows of neighboring cavities. sT hydrogen hydrate exhibits unique uniaxial tension stress-strain response, with first nonlinear increase to GPa-level but followed by deep drop in the stretching stress, indicating brittle failure, similar to that by Density Functional Theory and empirical forcefields. Moreover, temperature-dependent thermal conductivity in sT hydrogen hydrate is mainly contributed by hydrogen-bonded network formed by host water molecules, while hydrogen guest molecules play an insignificant role in the thermal transport.

摘要： 数字经济快速发展的背景下,企业财务管理面临新的挑战与机遇.传统的财务管理模式难以满足现代企业的高效运作和精准决策需求.数字化技术的广泛应用,为企业财务管理带来了变革契机,成为企业实现可持续发展的重要推动力.