Evaluation of drought propagations with multiple indices in the Yangtze River basin.

This paper explored the drought propagation phenomenon based on meteorological, hydrological, and agricultural aspects in the Yangtze River basin (YRB), China. To evaluate meteorological, hydrological, and agricultural droughts, this paper used three drought indices, standardized precipitation evapotranspiration index (SPEI), standardized runoff index (SRI), and standardized soil moisture index (SSMI), respectively. The community land model (CLM) in the YRB to generate the monthly evapotranspiration, soil moisture, runoff data, which are required for the estimation of drought index, were applied. Different mean durations (6-and 12-month) were used for drought estimation, and propagations of meteorological to hydrological and meteorological and agricultural droughts were investigated for different durations as SPEI6-SRI6, SPEI6-SSMI6, SPEI12-SRI12, SPEI12-SSMI12. The average drought propagation between 1950 and 2010 presented the highest autocorrelation and correlation with one-month lags in four combinations of drought indices in SPEI6-SRI6, SPEI6-SSMI6, SPEI12-SRI12, and SPEI12-SSMI12. Additionally, this paper estimated the optimal lags of SPEI-SRI and SPEI-SSMI drought propagations using mean 6-and 12-month lag times for six representative drought periods. Therefore, the propagation phenomenon of meteorological to hydrological and to agricultural droughts were confirmed in the YRB.

Outcomes in Patients with Pulmonary Arterial Hypertension Underwent Transcatheter Closure of an Atrial Septal Defect.

Pulmonary arterial hypertension (PAH) related to an atrial septal defect (ASD) poses a challenge to transcatheter closure of an ASD (tcASD). We aimed to determine the predictors for remaining PAH (rPAH) post-tcASD. This retrospective study was conducted at a single tertiary university hospital. Adult patients with an ASD and PAH were divided into three groups according to pulmonary vascular resistance (PVR). Normalization of pulmonary atrial systolic pressure (PASP) was defined as an estimated right ventricular systolic pressure < 40 mmHg and was determined using transthoracic echocardiography. Among 119 patients, 80% showed PAH normalization post-tcASD. Normalization of PAH post-tcASD was observed in 100%, 56.2%, and 28.6% of patients in mild, moderate, and severe PVR groups, respectively. The patients' New York Heart Association functional class improved. Multivariate logistic regression analysis showed that age and high PVR were significant risk factors for rPAH. A receiving operator curve analysis showed a PASP cutoff value > 67.5 mmHg to be predictive of rPAH post-tcASD, with an area under the curve value of 0.944 (sensitivity, 0.922; specificity 0.933). Most patients, including moderate-to-severe PAH patients, improved hemodynamically and clinically with tcASD. Since patients with severe PAH are at a risk of rPAH, tcASD should be performed by selecting the patient carefully based on pre-procedure medication, a vasoreactivity test, and a balloon occlusion test.