Heart failure with preserved ejection fraction (HFpEF) is associated with an increased risk of stroke.This study sought to determine whether the Essen Stroke Risk Score (ESRS) could predict the risks of adjudicated clinical outcomes in patients with Heart failure with preserved ejection fraction (HFpEF) from the TOPCAT trial. Of 3,441 HFpEF patients with a mean follow-up of 3.3 years, the risk of stroke ranged from 0.32% per year at an ESRS of 1-2 points to 1.71% per year at a score of ≥6 points. Each point increase in ESRS was associated with increased risks of stroke (HR=1.33 [95% CI 1.16-1.53]) with a C-index of 0.68, as well as myocardial infarction (HR=1.60 [95% CI 1.40-1.83]; C-index, 0.75), HF hospitalization (HR=1.30 [95% CI 1.20-1.41]; C-index, 0.71), any hospitalization (HR=1.20, 95% CI 1.15-1.26; C-index, 0.68), cardiovascular death (HR=1.32 [95% CI 1.20-1.44]; C-index, 0.68), and all-cause death (HR=1.37, [95% CI 1.28-1.48]; C-index, 0.68). The calibration curve showed that the ESRS had an adequate agreement between predicted and observed stroke risk. The ESRS had similar predictive abilities compared to the R2CHADS2, CHADS2, or CHA2DS2-VASC stroke scores as assessed by non-significant Z-statistics, NRI and IDI values.The ESRS had modest discriminatory abilities for predicting stroke as well as other adverse outcomes including myocardial infarction, hospitalization, and death in HFpEF patients. Furthermore, ESRS might have improvement in clinical usefulness compared with other scores in patients at high risk for stroke.

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Background Knee dislocation is a serious injury, representing less than 0.2% of all orthopedic injuries, and 16% to 40% of these patients suffer an associated injury to the common peroneal nerve (CPN). However, it is still unclear which structures are most intently associated with CPN injury. This study attempts to analyze the potential risk factors for CPN injury and provide clues for a comprehensive diagnosis of knee dislocation. Methods We retrospectively reviewed 153 cases of knee dislocation related to lateral and/or posterior ligament injury between 2015 and 2018. All 153 patients were divided into the CPN injury group or the no-CPN injury group. The baseline characteristics included age, gender, cause of injury, posterior cruciate ligament (PCL) disruption, anterior cruciate ligament (ACL) disruption, popliteofibular ligament and/or tendon of popliteus injury, biceps femoris tendon injury and fibular head fracture. We identified potential variables for a multivariable logistic regression model to identify the major risk factors for CPN injury. Results Multivariate regression analysis revealed the biceps femoris tendon injury and fibular head fracture to be predictive of CPN injury in knee dislocation. Gender, age, cause of injury, ligamentous classification, popliteofibular ligament and/or tendon of popliteus injury, PCL disruption or ACL disruption do not predict CPN injury. Conclusions Biceps femoris tendon injury and fibular head fracture are risk factors of CPN injury in knee dislocation. A better understanding of the risk factors for CPN injury allows surgeons to achieve more accurate diagnoses.

With the continuous changes in China's investment environment, new changes in power grid investment patterns have emerged, requiring the transformation and upgrading of traditional businesses and the continuous development of new businesses. This paper analyses the coupling relationship between traditional business and new business based on coupling degree theory, and analyses the factors influencing the investment demand of traditional business and new business of power grid enterprises. With the goal of maximizing the investment value of traditional and new business, we consider the impact of investment projects on the economy, reliability and security of power grid, and add the capital constraint to the objective function in the form of penalty function, so as to build an optimization model of power grid investment based on the integration of traditional and new business. The practicality and accuracy of the model are verified through case analysis based on genetic algorithm.

The overuse of smart phone may cause addiction, however, the deaf or hard-of-hearing addicts haven’t gained enough attention. The purpose of this study is to address the characteristics of mobile phone addiction of students who are deaf or hard-of-hearing( hereafter DHH), and to explore the possible formation mechanism of mobile phone addiction of Chinese DHH students through a mediating model. The data were collected by recruiting 570 Chinese DHH students in junior high schools, senior high schools and universities to finish questionnaires of Mobile Phone Addiction Index, Perceived Discrimination Questionnaire and Sense of Security Questionnaire. The results show that: (1) 47.4% of DHH students have mobile phone addiction tendency; (2) the degree of mobile phone addiction of girls is significantly higher than that of boys; (3) the degree of mobile phone addiction of DHH students who can successfully communicate with ordinary people is significantly lower than that of those who can communicate at an acceptable dis-fluency and those who suffer apraxia; (4) there is a significant positive correlation between the discrimination perception of DHH students and their mobile phone addiction; (5) the sense of security plays a complete mediating role between the perception of discrimination and mobile phone addiction of DHH students. It shows that some deaf or hard-of-hearing people may have obvious problems of smart phone addiction. The perception of discrimination is the possible cause of smart phone addiction of the DHH people, and plays an indirect role through the sense of security. In conclusion, this study proposes a possible explanatory model of mobile phone addiction in DHH people, which can provide reference for early intervention in the prevention and intervention of mobile phone addiction in DHH people. Public Significance Statement: The research has put forward an explaining model for Chinese DHH students’ smart phone addiction,which may offer suggestions towards this phenomenon’s early intervention.