Development and validation of a questionnaire to assess the implementation of physical education programs in Chinese junior high schools.

BACKGROUND: Students' physical fitness has always been the focus of attention of the Chinese government, and the school as an important way to improve students' physical fitness, there are many studies on the current status of the implementation of physical education in schools, and there are many studies that use self-made questionnaires to investigate the implementation of physical education in schools, but most of the studies do not adequately validate the self-made questionnaires, so the purpose of this study was to develop a questionnaire to assess the level of implementation of physical education programmes in Chinese junior secondary schools and to test its reliability and validity. METHOD: The content of the questionnaire was developed based on the content of Annex 1 of the Assessment Measures for Physical Education in Primary and Secondary Schools issued by the Ministry of Education of China in 2014 and was modified based on feedback from the expert panel and pre-test participants. The questionnaire was initially tested for validity by 5 expert reviewers, and then we collected data information from 350 participants and conducted exploratory factor analysis (EFA) to explore the factor structure of the initial version. One week later, 40 of the 350 participants were randomly selected to assess test-retest reliability. RESULTS: The I-CVI and KAPPA value analysis results of the expert review results show that the questionnaire has extremely high reliability and consistency among experts. EFA results indicate that the five dimensions of this questionnaire are highly reliable. In the test-retest reliability, the Pearson correlation coefficients of the initial test data and the retest data of each dimension are all greater than 0.7, and the significance probability values are all less than 0.05, reaching the significance level, the results show that the questionnaire has good stability. CONCLUSIONS: This study concluded that the 5 dimensions and 38 items of this questionnaire had high reliability and validity and could be used as a preliminary tool to measure the implementation level of physical education programs in junior high schools in China. However, future research should explore the potential need for adjustment to suit different regions and cultures.

Reprogramming macrophage metabolism following myocardial infarction: A neglected piece of a therapeutic opportunity.

Given the global prevalence of myocardial infarction (MI) as the leading cause of mortality, there is an urgent need to devise novel strategies that target reducing infarct size, accelerating cardiac tissue repair, and preventing detrimental left ventricular (LV) remodeling. Macrophages, as a predominant type of innate immune cells, undergo metabolic reprogramming following MI, resulting in alterations in function and phenotype that significantly impact the progression of MI size and LV remodeling. This article aimed to delineate the characteristics of macrophage metabolites during reprogramming in MI and elucidate their targets and functions in cardioprotection. Furthermore, we summarize the currently proposed regulatory mechanisms of macrophage metabolic reprogramming and identify the regulators derived from endogenous products and natural small molecules. Finally, we discussed the challenges of macrophage metabolic reprogramming in the treatment of MI, with the goal of inspiring further fundamental and clinical research into reprogramming macrophage metabolism and validating its potential therapeutic targets for MI.

GLObal Building heights for Urban Studies (UT-GLOBUS) for city- and street- scale urban simulations: Development and first applications.

We introduce University of Texas - GLObal Building heights for Urban Studies (UT-GLOBUS), a dataset providing building heights and urban canopy parameters (UCPs) for more than 1200 city or locales worldwide. UT-GLOBUS combines open-source spaceborne altimetry (ICESat-2 and GEDI) and coarse-resolution urban canopy elevation data with a machine-learning model to estimate building-level information. Validation using LiDAR data from six U.S. cities showed UT-GLOBUS-derived building heights had a root mean squared error (RMSE) of 9.1 meters. Validation of mean building heights within 1-km2 grid cells, including data from Hamburg and Sydney, resulted in an RMSE of 7.8 meters. Testing the UCPs in the urban Weather Research and Forecasting (WRF-Urban) model resulted in a significant improvement (55% in RMSE) in intra-urban air temperature representation compared to the existing table-based local climate zone approach in Houston, TX. Additionally, we demonstrated the dataset's utility for simulating heat mitigation strategies and building energy consumption using WRF-Urban, with test cases in Chicago, IL, and Austin, TX. Street-scale mean radiant temperature simulations using the SOlar and LongWave Environmental Irradiance Geometry (SOLWEIG) model, incorporating UT-GLOBUS and LiDAR-derived building heights, confirmed the dataset's effectiveness in modeling human thermal comfort in Baltimore, MD (daytime RMSE = 2.85°C). Thus, UT-GLOBUS can be used for modeling urban hazards with significant socioeconomic and biometeorological risks, enabling finer scale urban climate simulations and overcoming previous limitations due to the lack of building information.

Nonideality in Arrayed Carbon Nanotube Field Effect Transistors Revealed by High-Resolution Transmission Electron Microscopy.

High density and high semiconducting-purity single-walled carbon nanotube array (A-CNT) have recently been demonstrated as promising candidates for high-performance nanoelectronics. Knowledge of the structures and arrangement of CNTs within the arrays and their interfaces to neighboring CNTs, metal contacts, and dielectrics, as the key components of an A-CNT field effect transistor (FET), is essential for device mechanistic understanding and further optimization, particularly considering that the current technologies for the fabrication of A-CNT wafers are mainly laboratory-level solution-based processes. Here, we conduct a systematic investigation into the microstructures of A-CNT FETs mainly via cross-sectional high-resolution transmission electron microscopy and tentatively establish a framework consisting of up to 11 parameters which can be used for structure-side quality evaluation of the A-CNT FETs. The parameter ensemble includes the diameter, length (or terminal), and density distribution of CNTs, radial deformation of CNTs, array alignment defects, surface crystallography facets of contact metal, thickness distribution of high-k dielectrics (HfO2), and the contact ratios for the CNT-CNT, CNT-metal, CNT-dielectric, and CNT-substrate interfaces. Enriched array alignment defects, i.e., bundle, stacking, misorientation, and voids, are observed with a total ratio sometimes up to ∼90% in pristine A-CNTs and even up to ∼95% after the device fabrication process. Thus, they are suggested as the prevalent performance-limiting factors for A-CNT FETs. Complex interfacial structures are observed at the CNT-CNT, CNT-metal contact, and CNT-high-k dielectric interfaces, making the local environment and the property of each component CNT involved in an A-CNT FET distinct from others in terms of the diameters, radial deformation, and interactions with the local surroundings (mainly through van der Waals interactions). The present study suggests further improvements on the fabrication technology of A-CNT wafers and devices and mechanistic investigations into the impacts of complex array alignment defects and interface structures on the electrical performance of A-CNT FETs as well.

Protocol for a randomized controlled trial of intensive blood pressure control on cardiovascular risk reduction in patients with atrial fibrillation: rationale and design of the CRAFT trial.

BACKGROUND: Co-morbid hypertension is strong predictor of adverse cardiovascular (CV) outcomes in patients with atrial fibrillation (AF) but the optimal target for blood pressure (BP) control in this patient population has not been clearly defined. METHOD: The Cardiovascular Risk reduction in patients with Atrial Fibrillation Trial (CRAFT) is an investigator-initiated and conducted, international, multicenter, open-label, parallel-group, blinded outcome assessed, randomized controlled trial of intensive BP control in patients with AF. The aim is to determine whether intensive BP control (target home systolic blood pressure [SBP] <120 mmHg) is superior to standard BP control (home SBP <135 mmHg) on the hierarchical composite outcome of time to CV death, number of stroke events, time to the first stroke, number of myocardial infarction (MI) events, time to the first MI, number of heart failure hospitalization (HFH) events, and time to the first HFH. A sample size of 1675 patients is estimated to provide 80% power to detect a win-ratio of 1.50 for intensive versus standard BP control on the primary composite outcome. Study visits are conducted at 1, 2, 3, and 6 months post-randomization, and every 6 months thereafter during the study. CONCLUSION: This clinical trial aims to provide reliable evidence of the effects of intensive BP control in patients with AF.

STRIP2 is regulated by the transcription factor Sp1 and promotes lung adenocarcinoma progression via activating the PI3K/AKT/mTOR/MYC signaling pathway.

BACKGROUND: Patients with lung adenocarcinoma (LUAD) generally have poor prognosis. The role of striatin-interacting protein 2 (STRIP2) in LUAD remain unclear. METHODS: Liquid chromatography-mass spectrometry analyses were used to screen the STRIP2-binding proteins and co-immunoprecipitation verified these interactions. A dual luciferase reporter assay explored the transcription factor activating STRIP2 transcription. Xenograft and lung metastasis models assessed STRIP2's role in tumor growth and metastasis in vivo. RESULTS: STRIP2 is highly expressed in LUAD tissues and is linked to poor prognosis. STRIP2 expression in LUAD cells significantly promoted cell proliferation, invasion, and migration in vitro and in vivo. Mechanistically, STRIP2 boosted the PI3K/AKT/mTOR/MYC cascades by binding AKT. In addition, specificity protein 1, potently activated STRIP2 transcription by binding to the STRIP2 promoter. Blocking STRIP2 reduces tumor growth and lung metastasis in xenograft models. CONCLUSIONS: Our study identifies STRIP2 is a key driver of LUAD progression and a potential therapeutic target.

Impact of Sodium-glucose Cotransporter 2 Inhibitor on Recurrence and Cardiovascular Outcomes after Catheter Ablation for Atrial Fibrillation in Patients with Heart Failure.

BACKGROUND: The impact of sodium-glucose cotransporter 2 inhibitors (SGLT2i) on atrial fibrillation (AF) recurrence outcomes and adverse cardiovascular outcomes in heart failure (HF) patients after AF ablation is unknown. OBJECTIVE: To investigate whether SGLT2i reduces the risk of AF recurrence and adverse cardiovascular outcomes in HF patients after AF ablation. METHOD: HF patients with AF undergoing catheter ablation between January 2017 and December 2022 from the China-AF Registry were included. Patients were stratified into 2 groups based on the use of SGLT2i at discharge and were 1:1 matched by propensity score, with SGLT2i using (n=368) and non-SGLT2i using (n=368) in each group. The primary outcome was AF recurrence after a 3-month blanking period. RESULTS: During a total of 1315 person-year follow-ups, AF recurrence occurred in 83 patients (22.6%) in the SGLT2i group and 132 patients (35.8%) in the non-SGLT2i group. SGLT2i was associated with a lower risk of AF recurrence (adjusted HR = 0.56, 95% CI: 0.43-0.74, P<0.001). The composite risk of cardiovascular death, thrombotic events, or cardiovascular hospitalization was significantly lower in the SGLT2i group compared with those without SGLT2i (adjusted HR = 0.58, 95%CI: 0.41-0.80, p = 0.001). Although there was a trend toward benefits, the differences in all-cause mortality, cardiovascular death, or thrombotic events were insignificant between the 2 groups. CONCLUSION: The use of SGLT2i was associated with a lower risk of AF recurrence and the composite outcome of cardiovascular death, thrombotic events, or cardiovascular hospitalization after catheter ablation for AF in patients with HF.

Repurposing Proximity-Dependent Protein Labeling (BioID2) for Protein Interaction Mapping in E. coli.

Methods that identify protein-protein interactions are essential for understanding molecular mechanisms controlling biological systems. Proximity-dependent labeling has proven to be a valuable method for revealing protein-protein interaction networks in living cells. A mutant form of the biotin protein ligase enzyme from Aquifex aeolicus (BioID2) underpins this methodology by producing biotin that is attached to proteins that enter proximity to it. This labels proteins for capture, extraction, and identification. In this chapter, we present a toolkit for BioID2 specifically adapted for use in E. coli, exemplified by the chemotaxis protein CheA. We have created plasmids containing BioID2 as expression cassettes for proteins (e.g., CheA) fused to BioID2 at either the N or C terminus, optimized with an 8 × GGS linker. We provide a methodology for expression and verification of CheA-BioID2 fusion proteins in E. coli cells, the in vivo biotinylation of interactors by protein-BioID2 fusions, and extraction and analysis of interacting proteins that have been biotinylated.

Humanistic Value Development Through Extracurricular Activities in Anatomical Education

SUMMARY: Human Anatomy is the first medical specialization course for students of clinical medicine and cultivates the virtues of medical students, helping them to establish the humanitarian values. Therefore, integrating humanistic values education into the course of human anatomy is crucial. In anatomy courses for clinical students, online previews, group-based clinical problem- based learning, and theoretical lectures are used in anatomical education which is integrated with extracurricular activities for the education of human values, such as classical medical stories, group-based humanistic value cultivation, a memorial ceremony for "silent mentors", the morphological drawing and basic experimental skills competitions, and public welfare activities. After a year of implementation and investigation analysis, it was shown that students had a higher willingness to participate in the curriculum activities in this blended learning system, and these activities could stimulate students' interest in learning, which is beneficial to the cultivation of professional and humanistic values.

Anatomía Humana es el primer curso de especialización médica para estudiantes de medicina clínica y cultiva las virtudes de los estudiantes de medicina, ayudándolos a establecer los valores humanitarios. Por lo tanto, es crucial integrar la educación en valores humanísticos en el curso de anatomía humana. En los cursos de anatomía para estudiantes clínicos se utilizan avances en línea, aprendizaje grupal basado en problemas clínicos y conferencias teóricas en la educación anatómica que se integra con actividades extracurriculares para la educación de los valores humanos, como historias médicas clásicas, humanísticas grupales, cultivo de valores, una ceremonia en memoria de los "mentores silenciosos", concursos de dibujo morfológico y habilidades experimentales básicas, y actividades de bienestar público. Después de un año de implementación y análisis de investigación, se demostró que los estudiantes tenían una mayor disposición a participar en las actividades curriculares en este sistema de aprendizaje combinado, y estas actividades podrían estimular el interés de los estudiantes en el aprendizaje, lo que es beneficioso para el cultivo de habilidades profesionales y valores humanistas.

Sensory intelligence for extraction of abstract auditory rules from a speech sound stream in children with cochlear implants.

OBJECTIVE: Sensory intelligence in the brain helps listeners automatically extract abstract auditory rules formed by invariant acoustic features from complex speech sound streams, presumably serving as the neural basis for speech comprehension. However, whether this intelligence is deficient in children with cochlear implants (CIs) remains unclear. METHODS: Mandarin Chinese monosyllables shared a flat lexical tone contour to form an abstract auditory rule but differed in other acoustic features to construct a complex speech sound stream. The abstract rule was occasionally violated by monosyllables with a rising or falling lexical tone. RESULTS: In normal hearing (NH) children, the abstract auditory rule could be extracted, as revealed by a mismatch negativity (MMN) and a late discriminative negativity (LDN). However, the MMN and LDN were only evoked in CI children with good hearing and speech performance. NH children with a higher speech perception or spatial hearing score had a greater MMN. The LDN was attenuated with increasing age in NH children. CONCLUSIONS: The sensory intelligence for extraction of auditory abstract rules, associated with speech perception, is deficient in CI children. This intelligence may gradually develop during childhood and adolescence. SIGNIFICANCE: Deficient sensory intelligence in CI children may aid in understanding poor speech comprehension in complex environments.

Achievement splitting for topological states with pseudospin in phase modulation by using gyromagnetic photonic crystals.

As we know, valley-Hall kink states or pseudospin helical edge states are excited by polarized-momentum-locking [left-handed circular polarization (LCP) and right-handed circular polarization (RCP)] because the valley-Hall kink modes or pseudospin polarized modes have intrinsic and local chirality, which is difficult for these states to achieve phase modulation. Here we theoretically design and study a compatible topological photonic system with coexistence of photonic quantum Hall phase and pseudospin Hall phase, which is composed of gyromagnetic photonic crystals with a deformed honeycomb lattice containing six cylinders. A typical kind of hybrid topological waveguide states with pseudospin-characteristic, magnetic field-dependent, and strong robustness against backscattering and perfect electric conductor (PEC) is realized in the present system. Furthermore, we re-design a structure with intersection-liked, achieve splitting for one-way pseudospin quantum Hall edge states by using phase modulation. Robustness of the one-way pseudospin-quantum Hall edge states in splitting has been demonstrated as well. Additionally, PEC inserted in transport channel brings optical path difference in waveguide transmission, which would influence splitting for hybrid topological waveguide states in phase difference modulation. This work not only provides a new way for manipulation (i.e., phase modulation) of hybrid topological waveguide states in compatible topological photonic system from distinct topological classes but also has potential in various applications, such as sensing, signal processing, and on-chip communications.

The impact of virtual reality exposure on anxiety and pain levels in pediatric patients: A systematic review and meta-analysis.

PROBLEM: Virtual reality (VR) is used as a novel intervention technique to alleviate uncomfortable experiences such as anxiety and pain in children. Recently, VR distraction has gained prominence in pediatric medical procedures. However, no studies have yet conducted a further quantitative analysis of the intervention effects of virtual reality exposure (VRE). This systematic review aims to analyse the effect of VRE on anxiety and pain levels in paediatric patients undergoing medical procedures. ELIGIBILITY CRITERIA: Relevant studies were searched from four databases, including PubMed, Cochrane Library, Embase, and Web of Science. This systematic review has been registered in the International Prospective Register of Systematic Reviews (PROSPERO). RESULTS: The meta-analysis incorporated a total of 11 articles, encompassing 1,099 pediatric patients. The results showed that VRE relieved children's anxiety [SMD = -0.61, 95% CI (-0.93, -0.28), p < 0.001], but there was no significant difference in alleviating pain in children [SMD = -1.48, 95% CI (-3.40, 0.44), p = 0.131]. CONCLUSIONS: The results suggest that VRE is effective in reducing children's anxiety during medical procedures. However, 7 of the 11 original studies included in this review were from the same research project, which may increase the risk of reporting bias. Also, more high-quality studies are needed in the future to verify its effectiveness for pain levels. IMPLICATIONS: VRE can help children become familiar with the medical environment, overcome anxiety and fear, and learn about medical procedures in advance. This can enhance their cooperation during medical process, leading to a more positive medical experience.

Morphology and location of thrombus and sludge in patients with non-valvular atrial fibrillation.

BACKGROUND: Stroke and thromboembolism in nonvalvular atrial fibrillation (NVAF) primarily arise from thrombi or sludge in the left atrial appendage (LAA). Comprehensive insight into the characteristics of these formations is essential for effective risk assessment and management. METHODS: We conducted a single-center retrospective observational of 176 consecutive NVAF patients with confirmed atrial/appendage thrombus or sludge determined by a pre-ablation transesophageal echocardiogram (TEE) from December 2017 to April 2019. We obtained clinical and echocardiographic characteristics, including left atrial appendage emptying velocity (LAAeV) and filling velocity (LAAfV). Data analysis focused on identifying the morphology and location of thrombus or sludge. Patients were divided into the solid thrombus and sludge groups, and the correlation between clinical and echocardiographic variables and thrombotic status was analyzed. RESULTS: Morphological classification: In total, thrombi were identified in 78 patients, including 71 (40.3%) mass and 7 (4.0%) lamellar, while sludge was noted in 98 (55.7%). Location classification: 92.3% (72/78) of patients had thrombus confined to the LAA; 3.8% (3/78) had both LA and LAA involvement; 2.7% (2/78) had LA, LAA and RAA extended into the RA, the remained 1.2%(1/78) was isolated to RAA. 98.0% (96/98) of patients had sludge confined to the LAA; the remaining 2.0% (2/98) were present in the atrial septal aneurysm, which protrusion of interatrial septum into the RA. The thrombus and sludge groups showed low LAAeV (19.43 ± 9.59 cm/s) or LAAfV (17.40 ± 10.09 cm/s). Only LA dimension ≥ 40 mm was independently associated with the thrombus state in the multivariable model. CONCLUSION: This cohort study identified rare thrombus morphology and systematically summarized the classification of thrombus morphology. The distribution of thrombus and sludge outside limited to LAA was updated, including bilateral atrial and appendage involvement and rare atrial septal aneurysm sludge. LAAeV and LAAfV were of limited value in distinguishing solid thrombus from sludge. CLINICAL TRIAL NUMBER: ChiCTR-OCH-13,003,729.

Combining single-cell profiling and functional analysis explores the role of pseudogenes in human early embryonic development.

More and more studies have demonstrated that pseudogenes possess coding ability, and the functions of their transcripts in the development of diseases have been partially revealed. However, the role of pseudogenes in maintenance of normal physiological states and life activities has long been neglected. Here, we identify pseudogenes that are dynamically expressed during human early embryogenesis, showing different expression pattern from that of adult tissues. We explore the expression correlation between pseudogenes and the parent genes, part due to their shared gene regulatory elements or the potential regulation network between them. The essential role of three pseudogenes, PI4KAP1, TMED10P1, and FBXW4P1, in maintaining self-renewal of human embryonic stem cells is demonstrated. We further find that the three pseudogenes might perform their regulatory functions by binding to proteins or microRNAs. The pseudogene-related single-nucleotide polymorphisms are significantly associated with human congenital disease, further illustrating their importance during early embryonic development. Overall, this study is an excavation and exploration of functional pseudogenes during early human embryonic development, suggesting that pseudogenes are not only capable of being specifically activated in pathological states, but also play crucial roles in the maintenance of normal physiological states.

maxPIE: An innovative high throughput approach to enhance pathogen inactivation practices.

Effective pathogen inactivation is highly desired in public health but limited by existing methods each capable of assessing pathogen inactivation effectiveness (PIE) only in a specific condition. We therefore developed a novel method maxPIE designed to identify maximal PIEs across inactivation conditions by leveraging the power of massive array technologies. maxPIE implements a three-step algorithm to quickly identify maximal PIEs of inactivation treatments: (1) dilute pathogens into different initial titers each stored in an array well, (2) submit one sorted array to one treatment, (3) scan the treated array to find the maximum. maxPIE outperformed the conventional methods in (a) inactivating S. aureus using ultraviolet light of different wavelengths with different durations; (b) antibiotic treatment of S. aureus, E. coli, and multidrug-resistant E. coli; (c) inactivating S. aureus in plasma using ultraviolet light in different wavelengths with and without riboflavin. maxPIE was easy to understand and interpret and was robust in situations where conventional PIE methods would suffer. Hence, maxPIE can serve as an innovative and high throughput approach that can be widely used to enhance pathogen inactivation practices.

Impact of fast-track surgery-oriented care pathways on perioperative rehabilitation indices in patients undergoing radical prostatectomy for prostate cancer.

OBJECTIVE: This study was conducted to evaluate the effects of Fast-Track Surgery (FTS)-oriented care pathways on perioperative rehabilitation indicators in patients undergoing radical prostatectomy for prostate cancer. METHODS: The clinical data of 120 patients admitted to Sichuan Cancer Hospital & Institute who underwent radical prostatectomy for prostate cancer from September 2020 to October 2022 were collected and retrospectively analyzed. The patients were divided into a control group (n=60, receiving standard care) and an FTS group (n=60 patients receiving FTS-oriented care) according to different nursing methods. The perioperative rehabilitation indices were compared between the groups. RESULTS: The FTS group exhibited shorter hospitalization duration (P=0.001), postoperative anal exhaust time (P=0.012), drain removal time (P=0.007), gastrointestinal recovery time (P=0.008), and a lower total complication rate (P=0.016) compared to the control group. The scores of Visual Analog Scale (VAS) (P=0.001, P=0.003, P=0.015) and Activities of Daily Living (ADL) (P=0.011, P=0.005, P=0.007) at 24, 48, and 72 hours postoperatively were significantly lower in the FTS group than in the control group. Hospitalization cost (P=0.002) and medication expenses (P=0.016) were notably lower in the FTS group. During a 12-month follow-up, the FTS group showed a significantly lower complication rates (3.33%) compared to the control group (18.33%) (P=0.009). CONCLUSION: The application of FTS-oriented nursing pathway in patients undergoing radical prostatectomy for prostate cancer significantly enhances postoperative rehabilitation, reduces pain, lowers hospitalization and medication costs, and improves postoperative quality of life, which contributes positively to the nurse-patient relationship and patient outcome.

[Trade-off and Synergy of Ecosystem Services in the Yangtze River Economic Belt and Its Driving Factors].

Ecosystem services (ESs) and their changes are complex processes driven by multiple factors. Understanding the trade-off and synergy between ESs and their driving factors is essential for achieving effective management of ESs and human well-being. Taking the Yangtze River Economic Belt as the research area, this study analyzed the temporal and spatial variation characteristics of four ESs including water yield, soil conservation, carbon sequestration, and food supply from 2000 to 2020. Correlation analysis and geographically weighted regression were used to identify and quantify the trade-off and synergy between ESs. On this basis, the partial least squares structural equation model was used to explore the impact of natural and human activities on ESs, and then the driving mechanism of ESs relationship change was analyzed via GeoDetector. The results showed that:① During the 20 years, the average annual carbon sequestration increased from 946.14 t·km-2 to 1 202.73 t·km-2, and the average food supply increased from 32.73×104 Yuan·km-2 to 127.22×104 Yuan·km-2. Water yield and soil conservation increased to a lesser degree. ② On the whole, carbon sequestration and soil conservation and food supply and water yield showed synergy, and other ESs were trade-offs. The relationship between ESs varied in different regions. ③ Terrain and climate were important driving factors for ESs and the trade-off and synergy of multiple ESs. Among them, structural equation model results showed that climate had a positive impact on water yield (S=0.73), and terrain had a negative impact on food supply (S=-0.57). GeoDetector results revealed that the main driving factors affecting the spatial relationship between carbon sequestration and water yield were elevation (q=0.38) and precipitation (q=0.19). The results of this study can provide a scientific reference for the sustainable management of ESs in the Yangtze River Economic Belt and the realization of the coordinated development of ecological environment protection and social economy in the region.

Association between the preprocedural serum potassium level and atrial fibrillation recurrence after catheter ablation.

BACKGROUND: The association between serum potassium and atrial fibrillation (AF) recurrence after catheter ablation remains unclear. OBJECTIVE: The purpose of this study was to investigate whether preprocedural serum potassium influences AF recurrence in patients who underwent catheter ablation. METHODS: We used data of patients with AF who underwent de novo catheter ablation from the prospective Chinese Atrial Fibrillation Registry Study. Patients with prior ablation and without baseline serum potassium were excluded. The primary outcome was 1-year AF recurrence after a 3-month blanking period from the ablation procedure. Restricted cubic spline and Cox proportional models were used to compare outcomes across serum potassium categories. RESULTS: A total of 4838 patients with AF who underwent de novo catheter ablation was enrolled. At 1 year, AF recurrence occurred in 1347 patients (27.8%). The relationship between preprocedural serum potassium and 1-year AF recurrence after ablation presented as U shape (P for nonlinear = .048). Compared with the group of serum potassium within 4.41-4.60 mmol/L, the risk of AF recurrence increased significantly in the lowest serum potassium group (≤4.00 mmol/L) after multivariate analysis (hazard ratio [HR] 1.26; 95% confidence interval 1.06-1.51; P = .010). Other categories with lower or higher serum potassium levels including 4.01-4.20 mmol/L (HR 1.18), 4.21-4.40 mmol/L (HR 1.16), 4.61-4.80 mmol/L (HR 1.07), and ≥4.81 mmol/L (HR 1.11) showed nonsignificant higher recurrence risk. CONCLUSION: The relationship between preprocedural potassium and AF recurrence was U shaped, with an optimal potassium range (4.41-4.60 mmol/L). Lower potassium level is associated with increased AF recurrence risk after catheter ablation.

Electrically weldable conductive elastomers.

Flexible and stretchable electronic devices are subject to failure because of vulnerable circuit interconnections. We develop a low-voltage (1.5 to 4.5 V) and rapid (as low as 5 s) electric welding strategy to integrate both rigid electronic components and soft sensors in flexible circuits under ambient conditions. This is achieved through the design of conductive elastomers composed of borate ester polymers and conductive fillers, which can be self-welded and generate welding effects to various materials including metals, hydrogels, and other conductive elastomers. The welding effect is generated through the electrochemical reaction-triggered exposure of interfacial adhesive promotors or the cleavage/reformation of dynamic bonds. Our strategy can ensure both mechanical compliance and conductivity at the circuit interfaces and easily produce welding strengths in the kilopascal to megapascal range. The as-designed conductive elastomers in combination with the electric welding technique provide a robust platform for constructing standalone flexible and stretchable electronic devices that are detachable and assemblable on demand.