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简介：HeartfailureisthemostcommoncauseofhospitalizationintheUnitedStates.Justastheprevalenceofheartfailurehasincreased,thenumberofdiseasesidentifiedthatresultintheheartfailuresyndromehasescalated.Certaincardiomyopathiesthathavepreviouslybeenregardedasveryrarearebeingrecognizedwithincreasingfrequency,becauseofimprovedimagingtechniquesandanincreasedunderstandingofthepathophysiologicmechanismsthatresultinthesediseases.ImprovedechocardiographictechniquesandmethodssuchasspectralDopplerand3Dimagerendering,alongwiththeuseofadvanceddiagnostictoolssuchascardiacCTangiographyandcardiacmagneticresonanceimagingarenowcommon.Theseadvancedimagingmethodshaveledtoanincreasedappreciationofthefrequencyofdiseasessuchasisolatedleftventricularnoncompactionandcardiacamyloidosis.Leftventricularnoncompaction,oncethoughttooccurinroughlyoneinonemillionpatients,mayactuallybeseeninfewerthanonein1000patients.Cardiacamyloidosis,inthesenileform,mayexistin80%of80-year-oldpatients,althoughtheincidenceofclinicalsymptomsisless.Asthegeneticalterationsthatcontributetothesediseasesarefurtherelucidated,improveddiagnosisandabetterunderstandingoftheprognosisoftheseuncommoncardiomyopathieswillfollow.

简介：摘要：本文从EPC项目总包方视角，以施工分包结算常见的问题为切入点，对项目招标、施工、竣工结算等阶段提出了结算管理的意见和建议，为项目管理建立高效的结算体系，实现项目精细化管理提供了可行的控制方法。

简介：Objective:Therandomizedcontrolledtrial(ClinicalTrials.govidentifierNCT02990741)willinvestigatewhethermorefrequentelectrocardiographic(ECG)recordingsandanalyseswithanautomatedECGsystemwouldimprovedetectionofatrialfibrillationcomparedwithasingleannualECGscreeninelderlyChineseincommunityhealthcenters.Design:Menandwomen(≥65years)willberandomizedintointensive(n=3500)andusual(n=3500)screeninggroups,andwithintheintensivescreeninggroupintointensivescreening(n=2625)andmoreintensivescreening(n=875)subgroups.ECGrecordingswillbeperformedwithanautomatedECGanalysissystem(AliveCorheartmonitor)at1yearintheusualscreeninggroup,at3,6,9,and12monthsintheintensivescreeningsubgroup,andat1,2,3,and4weeksand3,6,9,and12monthsinthemoreintensivescreeningsubgroup.Theprimaryoutcomeisthedetectionrateofatrialfibrillationbetweentheusualscreeninggroupandtheintensivescreeninggroup.Samplesizeestimationwasbasedonaprojecteddetectionrateofatrialfibrillationof2.0%byasingleECGrecordingat12months,animprovementof50%withmorefrequentECGrecordings,α=0.05,powerof80%,andaone-sidedtest.Conclusions:ThetrialwillprovideevidenceontheclinicaleffectivenessofmorefrequentECGrecordingsbyahandheldautomatedanalysissysteminthedetectionofatrialfibrillation.