Progress in the Use of Echocardiography in Patients with Tumors.

Advances in cancer treatment have increased patient survival rates, shifting clinical focus towards minimizing treatment-related morbidity, including cardiovascular issues. Since echocardiography allows for a comprehensive non-invasive assessment at all cancer stages, it is well suited to monitor cardiovascular disease secondary to oncology treatment. This has earned it significant attention in the study of cardiac tumors and treatment-induced cardiac alterations. Ultrasound methods-ranging from transthoracic and transesophageal echocardiography to ultrasound diagnostic techniques including myocardial strain imaging, myocardial work indices, three-dimensional cardiac imaging-offer a holistic view of both the tumor and its treatment impact cardiac function. Stress echocardiography, myocardial contrast echocardiography, and myocardial acoustic angiography further augment this capability. Together, these echocardiographic techniques provide clinicians with early detection opportunities for cardiac damage, enabling timely interventions. As such, echocardiography continues to be instrumental in monitoring and managing the cardiovascular health of oncology patients, complementing efforts to optimize their overall treatment and survival outcomes.

Biomass-Derived Carbon Materials for Electrochemical Energy Storage.

The environmental impact from the waste disposal has been widely concerned around the world. The conversion of wastes to useful resources is important for the sustainable society. As a typical family of wastes, biomass materials basically composed of collagen, protein and lignin are considered as useful resources for recycle and reuse. In recent years, the development of carbon material derived from biomasses, such as plants, crops, animals and their application in electrochemical energy storage have attracted extensive attention. Through the selection of the appropriate biomass, the optimization of the activation method and the control of the pyrolysis temperatures, carbon materials with desired features, such as high-specific surface area, variable porous framework, and controllable heteroatom-doping have been fabricated. Herein, this review summarized the preparation methods, morphologies, heteroatoms doping in the plant/animal-derived carbonaceous materials, and their application as electrode materials for secondary batteries and supercapacitors, and as electrode support for lithium-sulfur batteries. The challenges and prospects for the controllable synthesis and large-scale application of biomass-derived carbonaceous materials have also been outlooked.

Letter to the Editor: clinical utility of urine DNA for noninvasive detection and minimal residual disease monitoring in urothelial carcinoma.

Current methods for the early detection and minimal residual disease (MRD) monitoring of urothelial carcinoma (UC) are invasive and/or possess suboptimal sensitivity. We developed an efficient workflow named urine tumor DNA multidimensional bioinformatic predictor (utLIFE). Using UC-specific mutations and large copy number variations, the utLIFE-UC model was developed on a bladder cancer cohort (n = 150) and validated in The Cancer Genome Atlas (TCGA) bladder cancer cohort (n = 674) and an upper tract urothelial carcinoma (UTUC) cohort (n = 22). The utLIFE-UC model could discriminate 92.8% of UCs with 96.0% specificity and was robustly validated in the BLCA_TCGA and UTUC cohorts. Furthermore, compared to cytology, utLIFE-UC improved the sensitivity of bladder cancer detection (p < 0.01). In the MRD cohort, utLIFE-UC could distinguish 100% of patients with residual disease, showing superior sensitivity compared to cytology (p < 0.01) and fluorescence in situ hybridization (FISH, p < 0.05). This study shows that utLIFE-UC can be used to detect UC with high sensitivity and specificity in patients with early-stage cancer or MRD. The utLIFE-UC is a cost-effective, rapid, high-throughput, noninvasive, and promising approach that may reduce the burden of cystoscopy and blind surgery.

Progress in the Metabolomics of Acute Coronary Syndrome.

Acute coronary syndrome (ACS) is a severe type of coronary heart disease (CHD) with increasing prevalence and significant challenges for prevention and treatment. Metabolomics is an emerging technology with intrinsic dynamics and flexibility to better delineate the phenotypic and metabolic alterations in organisms at the time of altered pathological states. It provides new insights into the complex pathological mechanisms of cardiovascular disease and contributes to the early detection, monitoring and evaluation of ACS. In this review, we analyze and summarize the literature related to ACS metabolomics which has contributed to the diagnosis and prevention of ACS.

Effects of grazing and precipitation addition induced by functional groups on the relationship between aboveground biomass and species richness of a typical steppe.

Several studies have explored the influence of grazing or precipitation addition (PA), two important components of human activities and global climate change on the structure and function of communities. However, the response of communities to a combination of grazing and PA remains largely unexplored. We investigated the impact of grazing and PA on the relationship between aboveground biomass (AGB) and species richness (SR) of communities in three-year field experiments conducted in a typical steppe in the Loess Plateau, using a split-plot design with grazing as the main-plot factor and PA as the split-plot factor. AGB and SR have response threshold value to PA, which was decreased by grazing for AGB, but increased for SR. This indicates that implementing grazing management strategies is conducive to strengthening the protection of biodiversity in arid and semi-arid grasslands. Grazing promoted the AGB-SR coupling of the community by increasing the SR of medium drought tolerance (MD), low drought tolerance, and grazing tolerant functional groups. Grazing also accelerated the AGB-SR decoupling of the community by changing the AGB of high drought tolerance, MD, high grazing tolerance, and medium grazing tolerance functional groups. PA mediated changes in MD and SR of both drought and grazing tolerant functional groups and AGB of low grazing tolerance promoted the coupling of AGB-SR of the community. The Two-dimension functional groups classification method reflects the changes of AGB and SR in communities more reasonable than the division of single-factor functional groups.

Development of a performance measurement system for general practitioners' office in China's primary healthcare.

BACKGROUND: General practitioners are the main providers of primary care services. To better strengthen the important role of general practitioners in primary healthcare services, China is promoting the general practitioners' office system. There is a lack of well-accepted methods to measure the performance of general practitioner offices in China. We thus aim to develop a systematic and operable performance measurement system for evaluating the general practitioner's office. METHODS: We establish an index pool of the performance measurement system of general practitioners' offices by a cross-sectional study and the literature research method and adopt the focus group method to establish the preliminary system. The Delphi method is then used to conduct three rounds of consultation to modify indices, which aims to form the final indicator system. We determine the weight of each index by the analytic hierarchy process method, which together with the final indicator system constitutes the final performance measurement system. Finally, we select three offices from three different cities in Sichuan Province, China, as case offices to conduct the case study, aiming to assess its credibility. RESULTS: Our results show that the first office scored 958.5 points, the second scored 768.1 points, and the third scored 947.7 points, which corresponds to the reality of these three offices, meaning that the performance measurement system is effective and manoeuvrable. CONCLUSIONS: Our study provides support for standardizing the functions of China's general practitioner's office, improving the health service quality of generalists, and providing a theoretical basis for the standardization of the general practitioner's office.

Identification and Functional Analysis of Key Autophosphorylation Residues of Arabidopsis Senescence Associated Receptor-like Kinase.

Reversible protein phosphorylation mediated by protein kinases and phosphatases plays important roles in the regulation of leaf senescence. We previously reported that the senescence-associated leucine-rich repeat receptor-like kinase AtSARK autophosphorylates on both serine/threonine and tyrosine residues and functions as a positive regulator of Arabidopsis leaf senescence; the senescence-suppressed protein phosphatase SSPP interacts with and dephosphorylates the cytoplasmic domain of AtSARK, thereby negatively regulating leaf senescence. Here, 27 autophosphorylation residues of AtSARK were revealed by mass spectrometry analysis, and six of them, including two Ser, two Thr, and two Tyr residues, were further found to be important for the biological functions of AtSARK. All site-directed mutations of these six residues that resulted in decreased autophosphorylation level of AtSARK could significantly inhibit AtSARK-induced leaf senescence. In addition, mutations mimicking the dephosphorylation form of Ser384 (S384A) or the phosphorylation form of Tyr413 (Y413E) substantially reduced the interaction between AtSARK and SSPP. All results suggest that autophosphorylation of AtSARK is essential for its functions in promoting leaf senescence. The possible roles of S384 and Y413 residues in fine-tuning the interaction between AtSARK and SSPP are discussed herein.

Recent Advances in Self-Assembly and Application of Para-Aramids.

Poly(p-phenylene terephthalamide) (PPTA) is one kind of lyotropic liquid crystal polymer. Kevlar fibers performed from PPTA are widely used in many fields due to their superior mechanical properties resulting from their highly oriented macromolecular structure. However, the "infusible and insoluble" characteristic of PPTA gives rise to its poor processability, which limits its scope of application. The strong interactions and orientation characteristic of aromatic amide segments make PPTA attractive in the field of self-assembly. Chemical derivation has proved an effective way to modify the molecular structure of PPTA to improve its solubility and amphiphilicity, which resulted in different liquid crystal behaviors or supramolecular aggregates, but the modification of PPTA is usually complex and difficult. Alternatively, higher-order all-PPTA structures have also been realized through the controllable hierarchical self-assembly of PPTA from the polymerization process to the formation of macroscopic products. This review briefly summarizes the self-assembly methods of PPTA-based materials in recent years, and focuses on the polymerization-induced PPTA nanofibers which can be further fabricated into different macroscopic architectures when other self-assembly methods are combined. This monomer-started hierarchical self-assembly strategy evokes the feasible processing of PPTA, and enriches the diversity of product, which is expected to be expanded to other liquid crystal polymers.

Multiscale research on spatial supply-demand mismatches and synergic strategies of multifunctional cultivated land.

Multifunctional cultivated land has both sides of supply and demand, and their matches are very important to boost the high-quality development of agriculture and rural areas. The supply-demand match index and GIS spatial analysis were employed to explore the supply-demand mismatches and synergic strategies of multifunctional cultivated land. Taking the Wuhan Metropolitan Area (WMA), China as an example, we obtained the following results: (1) There were obvious supply-demand mismatches of multifunctional cultivated land in the production function, ecological function, and landscape culture function. The spatial distribution of supply-demand mismatches of the three different functions of cultivated land is different. The supply of cultivated land production function is less than the demand, while the supply of landscape culture function is greater than the demand. The supply matches the demand of cultivated land in the ecological function. (2) The supply-demand mismatches of multifunctional cultivated land have scale effects. From the 1 km × 1 km grid scale to the township, county (district), and prefecture-level city scales, the proportion of deficit regions of production function and ecological function decreases with increasing scale. In contrast, the deficit regions of landscape culture function are always concentrated in the center of the WMA. It is considered that we should improve the supply of cultivated land in the production function, protect ecological function and enhance the demand of landscape culture function. Moreover, the management of multifunctional cultivated land needs to strengthen the multiscale spatial linkage and differential strategies of the supply side and demand side.

The protective effect of kaempferol on heart via the regulation of Nrf2, NF-κß, and PI3K/Akt/GSK-3ß signaling pathways in isoproterenol-induced heart failure in diabetic rats.

This study was designed to delineate the effect of kaempferol (KF) on heart failure (HF) in diabetic rats. Streptozotocin-induced male diabetic rats received KF orally at 10 and 20 mg/kg for 42 consecutive days. In last 2 days of the experimental period, isoproterenol was subcutaneously injected at 85 mg/kg to induce HF. The hearts were processed for hemodynamic, biochemical, molecular, and histological investigations. Systolic blood pressure, diastolic blood pressure, and mean arterial blood pressure were elevated in KF-treated HF-induced diabetic rats. Moreover, KF treatment resulted in decreased fasting blood glucose and glycosylated hemoglobin levels with increased serum insulin levels. Besides, serum cardiac injury markers like troponin-I, creatine kinase-muscle/brain, lactate dehydrogenase, and brain natriuretic peptide levels were significantly reduced in KF treatment. KF treatment has shown decrease in cardiac heme oxygenase-1, nuclear factor erythroid 2-related factor 2 (Nrf-2), and γ-glutamylcysteine synthetase with increased Keap1 mRNA levels. The cardioprotection of KF was improved by inhibition of apoptosis via blocking phosphorylation of Akt/glycogen synthase kinase (GSK)-3ß and p38 mitogen-activated protein-kinase/extracellular signal-regulated kinases signaling pathways in HF-induced diabetic rats. Moreover, reduced cardiac apoptosis in KF treatment was confirmed by decreased terminal deoxynucleotidyl transferase dUTP nick-end labeling (TUNEL) positive cells, histopathological changes in HF-induced diabetic rats. Therefore, the cardioprotective effect of KF is attributed to the regulation of Nrf2, nuclear factor kappa-light-chain-enhancer of activated B cells, and Akt/GSK-3ß signaling pathways in HF-induced diabetic rats.

Improved electrical conductivity of TPU/carbon black composites by addition of COPA and selective localization of carbon black at the interface of sea-island structured polymer blends.

The electrical percolation threshold of carbon black (CB) in thermoplastic polyurethane (TPU) decreases by 46% with the incorporation of 20 wt% polyamide copolymer (COPA) through selective localization of CB particles at the interface of sea-island structured TPU/COPA blends. Composites with a composition of TPU/20 wt% COPA/9 wt% CB were prepared by four different mixing sequences and their morphologies were investigated by FESEM and TEM. The majority of CB particles were observed at the interface of sea-island structured blends irrespective of the compounding sequence used, although the percentage of CB particles at the interface is considerably less in the composite prepared by adding COPA to premixed TPU/CB. The driving force for the interfacial localization of most CB particles is the hydrogen bonding of CB with both TPU and COPA, which is confirmed by FTIR and DMA investigations. CB particles act like Janus particle-type compatibilizers with bonded TPU molecules toward the TPU phase and bonded COPA chains toward the COPA phase. Highly efficient conductive paths are formed through the CB-covered domains and a short inter-domain distance.

SENESCENCE-SUPPRESSED PROTEIN PHOSPHATASE Directly Interacts with the Cytoplasmic Domain of SENESCENCE-ASSOCIATED RECEPTOR-LIKE KINASE and Negatively Regulates Leaf Senescence in Arabidopsis.

Reversible protein phosphorylation mediated by protein kinases and phosphatases plays an important role in the regulation of leaf senescence. We previously reported that the leucine-rich repeat receptor-like kinase SENESCENCE-ASSOCIATED RECEPTOR-LIKE KINASE (AtSARK) positively regulates leaf senescence in Arabidopsis (Arabidopsis thaliana). Here, we report the involvement of a protein serine/threonine phosphatase 2C-type protein phosphatase, SENESCENCE-SUPPRESSED PROTEIN PHOSPHATASE (SSPP), in the negative regulation of Arabidopsis leaf senescence. SSPP transcript levels decreased greatly during both natural senescence and SARK-induced precocious senescence. Overexpression of SSPP significantly delayed leaf senescence in Arabidopsis. Protein pull-down and bimolecular fluorescence complementation assays demonstrated that the cytosol-localized SSPP could interact with the cytoplasmic domain of the plasma membrane-localized AtSARK. In vitro assays showed that SSPP has protein phosphatase function and can dephosphorylate the cytosolic domain of AtSARK. Consistent with these observations, overexpression of SSPP effectively rescued AtSARK-induced precocious leaf senescence and changes in hormonal responses. All our results suggested that SSPP functions in sustaining proper leaf longevity and preventing early senescence by suppressing or perturbing SARK-mediated senescence signal transduction.

The non-catalytic N-terminal domain of ACS7 is involved in the post-translational regulation of this gene in Arabidopsis.

Post-transcriptional control of the expression of the 1-aminocyclopropane-1-carboxylate synthase (ACS) gene family is important for maintaining appropriate levels of ethylene production. However, the molecular mechanism underlying the post-transcriptional regulation of type 3 ACS proteins remains unclear. Multiple sequence alignment revealed that the N-terminus of type 3 ACSs was longer than that of other ACSs. Fusing the N-terminal 54 residues of ACS7, the sole type 3 ACS in Arabidopsis, to the ß-glucuronidase (GUS) reporter significantly decreased the stability of N(7(1-54))-GUS fusion protein. Among these 54 residues, residues 1-14 conferred this negative effect on the GUS fusion gene. Consistently, a truncated form of ACS7 lacking residues 1-14 was more stable than full-length ACS7 when transgenically expressed in Arabidopsis and led to a more severe ethylene response phenotype in the light-grown transgenic seedlings. Interestingly, the ACS7 N-terminus had no effect on the stability of N(7)-GUS and ACS7 proteins at the etiolated seedling stage. Both exogenous 1-aminocyclopropane-1-carboxylic acid (ACC) treatment and salt stress could rescue the levels of accumulation of N(7)-GUS fusion protein in light-grown seedlings. These results suggest that the non-catalytic N-terminus of ACS7 is involved in its own post-translational regulation. The proteasome inhibitor MG132 suppressed degradation of full-length ACS7 in vivo, but had little effect on the N-terminal truncated form of ACS7, indicating that the N-terminus mediates the regulation of ACS7 stability through the ubiquitin-26S proteasome pathway.

Exclusion of livestock decouples the relationship between plant production and diversity, species richness on complex topography in typical steppe in the Loess Plateau, China.

Grazing is widely used in more than one-forth of global terrestrial ecosystems, with three quarters are distributed on complex topography. Grazing and topography have both resulted in degradation of approximately 49 % of natural grasslands. However, research on the interaction between topography and livestock exclusion on grassland characteristics is scarce. This study was carried out on a typical steppe to explore the effect of topography and enclosure year on vegetation characteristics. Aboveground biomass, and species richness were examined for three different enclosure years (0, 3, and 6 years), on four slopes (0°, 15°, 30°, and 45° slope), and three aspects (flat, shady and sunny). The results indicated that: The aboveground biomass on the 0° slope had a greater value after 6 years of the enclosure. Aboveground biomass increased with the increasing enclosure year, while it decreased with increasing slope except enclosure for 0 year on shady slope. Aboveground biomass on the shady slopes was greater than on the sunny slopes. Species richness of community and perennial plants increased with increasing slope and enclosure year. The annual plants richness inversely correlated with slope and enclosure year. All plant diversity indexes increased with increasing enclosure year. Margalef and Shannon-wiener indexes decreased with increasing slope, while Simpson and Pielou indexes increased. This paper demonstrates that aspect, slope and enclosure affect aboveground biomass by affecting other vegetation characteristics. In conclusion, grassland production can be improved with moderate livestock exclusion under different topography.

Incidence and predictors of in-stent restenosis following intervention for pulmonary vein stenosis due to fibrosing mediastinitis.

BACKGROUND: Fibrosing mediastinitis (FM) is a rare yet fatal condition, caused by different triggers and frequently culminating in the obstruction of the pulmonary vasculature and airways, often leading to pulmonary hypertension and right heart failure. Percutaneous transluminal pulmonary venoplasty (PTPV) is an emerging treatment for pulmonary vein stenosis (PVS) caused by FM. Our previous study showed as high as 24% of in-stent restenosis (ISR) in FM. However, the predictors of ISR are elusive. OBJECTIVES: We sought to identify the predictors of ISR in patients with PVS caused by extraluminal compression due to FM. METHODS: We retrospectively enrolled patients with PVS-FM who underwent PTPV between July 1, 2018, and December 31, 2022. According to ISR status, patients were divided into two groups: the ISR group and the non-ISR group. Baseline characteristics (demographics and lesions) and procedure-related information were abstracted from patient records and analyzed. Univariate and multivariate analyses were performed to determine the predictors of ISR. RESULTS: A total of 142 stents were implanted in 134 PVs of 65 patients with PVS-FM. Over a median follow-up of 6.6 (3.4-15.7) months, 61 of 134 PVs suffered from ISR. Multivariate analysis demonstrated a significantly lower risk of ISR in PVs with a larger reference vessel diameter (RVD) (odds ratio (OR): 0.79; 95% confidence interval [CI]: 0.64 to 0.98; P = 0.032), and stenosis of the corresponding pulmonary artery (Cor-PA) independently increased the risk of restenosis (OR: 3.41; 95% CI: 1.31 to 8.86; P = 0.012). The cumulative ISR was 6.3%, 21.4%, and 39.2% at the 3-, 6-, and 12-month follow-up, respectively. CONCLUSION: ISR is very high in PVS-FM, which is independently associated with RVD and Cor-PA stenosis. TRAIL REGISTRATION: Chinese Clinical Trials Register; No.: ChiCTR2000033153. URL: http://www.chictr.org.cn .

A cost-effective climate mitigation pathway for China with co-benefits for sustainability.

Climate mitigation policies have broad environmental and socioeconomic impacts and thus underpin progress towards the United Nations Sustainable Development Goals (SDGs). Through national-scale integrated modeling, we explore the spillover effects of China's long-term climate mitigation pathways (CMPs) on achieving all 17 SDGs, and then identify a cost-effective CMP for China with co-benefits for sustainability. Our analysis indicates that the 9 original CMPs and 180 bundled CMPs can both substantially boost the SDGs, resulting in an increase of 6.33-8.86 and 5.90-9.33 points in overall SDG score (0=no progress, 100=full achievement) by 2060, compared to the Reference pathway of 70.75 points, respectively. The identified cost-effective CMP deals with the trade-offs among sustainability, CO2 emissions and mitigation cost, and maximizes the synergies between them. This CMP can inform future directions for China's policy-makers to maximize the potential synergies between carbon neutrality and long-term sustainable development.

Safeguarding China's long-term sustainability against systemic disruptors.

China's long-term sustainability faces socioeconomic and environmental uncertainties. We identify five key systemic risk drivers, called disruptors, which could push China into a polycrisis: pandemic disease, ageing and shrinking population, deglobalization, climate change, and biodiversity loss. Using an integrated simulation model, we quantify the effects of these disruptors on the country's long-term sustainability framed by 17 Sustainable Development Goals (SDGs). Here we show that ageing and shrinking population, and climate change would be the two most influential disruptors on China's long-term sustainability. The compound effects of all disruptors could result in up to 2.1 and 7.0 points decline in the China's SDG score by 2030 and 2050, compared to the baseline with no disruptors and no additional sustainability policies. However, an integrated policy portfolio involving investment in education, healthcare, energy transition, water-use efficiency, ecological conservation and restoration could promote resilience against the compound effects and significantly improve China's long-term sustainability.

Exogenous fibrolytic enzymes promoted energy and nitrogen utilization and decreased CH4 emission per unit dry matter intake of tan sheep grazed a typical steppe by enhancing nutrient digestibility on China loess plateau.

Exogenous fibrolytic enzyme (EFE) products in ruminant nutrition may be an important alternative to meet the increased demands for animal products in the future with reduced environmental impacts. This study aimed to evaluate the dose-response of EFE supplementation on the nutrient digestibility, nitrogen and energy utilization, and methane (CH4) emissions of Tan sheep grazed in summer and winter. A total of 20 Tan wether sheep with an initial body weight of 23.17 ±â€…0.24 kg were used in a randomized complete block design and categorized into two groups. Animals fed orally with 1 g of EFE (10,000 U/g) mixed with 30 mL of water using a drencher constituted the EFE group. For experimental accuracy, the control (CON) group was orally administered with 30 mL of normal saline daily before grazing. The following results were obtained: EFE in the diet increased dry matter intake (DMI) (P < 0.05), average daily gain (ADG) (P < 0.05), and digestibility (P < 0.05) compared with CON in summer and winter. DMI increased but ADG and digestibility decreased in winter compared with those in summer. Sheep fed with the EFE diet increased the concentrations of rumen ammonia nitrogen (P < 0.05) and total volatile fatty acids (P > 0.05), but reduced pH (P > 0.05), compared with CON in summer and winter. EFE increased nitrogen (N) intake, digestible N, retained N, and retained N/digestible N (P < 0.05) but reduced fecal N/N intake, urinary N/N intake, and excretion N/N intake in summer and winter (P < 0.05), compared with CON. Retained N/N intake was reduced and excretion N/N intake increased in winter relative to those in summer. In winter, gross energy (GE), manure E/GE, CH4 emissions, CH4/DMI, and CH4/GE increased but digestion energy and metabolic energy decreased compared with those in summer. Sheep fed with the EFE diet had a greater GE intake than those fed with the CON diet (P < 0.05) but had lesser CH4/DMI and CH4E/GE (P < 0.05) than those fed with the CON diet in both summer and winter. In conclusion, EFE supplementation increased DMI, apparent digestibility, and N deposition rate. These effects were beneficial for animal production. The CH4 emission per unit DMI of grazing Tan sheep was lesser and conducive for augmenting the environmental benefits.

Globally, the supply­demand relationship between grassland and livestock is mainly mediated by the optimization of pasture management. The interaction between grassland and livestock is one of the fundamental drivers of grassland occurrence and development. Natural grassland yields and quality are affected by precipitation, heat, and grazing, and their dynamics vary seasonally with distinct peaks and troughs. The use of exogenous fibrolytic enzymes during troughs can improve the growth performance, digestion, and metabolism of grazing sheep. The exogenous fibrolytic enzyme supplement used in this research may aid in improving the health and overall productivity of grazing sheep.

Factors affecting wearable ECG device adoption by general practitioners for atrial fibrillation screening: cross-sectional study.

Introduction: Atrial fibrillation (AF) is a challenging cardiovascular disease worldwide. Wearable electrocardiograph devices (WEDs) have great potential to improve the detection rate of AF in primary care. However, the factors that influence general practitioners' (GPs) perception and acceptance of WEDs are not well understood. To identify factors that influence the intention of GPs to utilize WEDs in a clinical setting to screen patients for AF. Method: The research hypotheses and questionnaire items were designed and developed based on the unified theory of acceptance and technology (UTAUT) framework. We used stratified sampling and obtained the data through an online survey. Structural equation modeling was used to analyze the collected data.Results: A total of 1,004 valid questionnaires from GPs across Sichuan province in China were collected. Three factors increased GPs' intention to utilize WEDs to screen patients for AF, including performance expectancy (ß = 0.121, p = 0.004), social influence (ß = 0.356, p < 0.001), and price perception (ß = 0.587, p < 0.001). Perception risk (ß = -0.059, p < 0.001) decreased usage intention, while effort expectancy (ß = -0.079, p = 0.155) and facilitating conditions (ß = -0.014, p = 0.868) did not affect usage intention. Gender (ß = -0.022, p = 0.179), age (ß = 0.006, p = 0.699), education level (ß = -0.22, p = 0.184) and training (ß = 0.007, p = 0.69) were not significantly correlated with usage intention, and these four factors had no moderating effect on the path coefficients. Discussion: GPs' intention to utilize WEDs is affected by performance expectancy, price perception, perception risk and social influence. Researcher should improve the usability and perception of WEDs for screening and carry out studies to provide high-quality evidence for the security and efficacy of wearable devices.

Construction of Aramid Engineering Materials via Polymerization-Induced para-Aramid Nanofiber Hydrogel.

The processing of poly(p-phenylene terephthalamide) (PPTA) has long been a great challenge. This work reports a simple "monomers-nanofibers-macroscopic product" (MNM) hierarchical self-assembly approach to build 3D all-PPTA engineering materials. This approach mainly includes the preparation of polymerization-induced aramid nanofibers (PANFs) from monomers and the fabrication of all-PPTA materials from PANF hydrogel. Various 3D architectures, including simple solid bulks and sophisticated honeycombs (HCs), are obtained after the dehydration and shrinking of the PANF hydrogel. The tensile strength and compressive yield strength of PANF bulk are more than 62 and 90 MPa, respectively, which are comparable to typical engineering plastics. The compressive strength of PANF HC with a density of 360 kg m-3 is more than 24 MPa. The thermal stability of PANF bulk and PANF HC are as good as that of Kevlar fiber and almost no decomposition occurred before 500 °C in a nitrogen atmosphere. Furthermore, the MNM process is performed under mild conditions, without high temperature, high pressure, or corrosive solvent. The MNM process is a novel strategy for the processing of all aromatic polyamide materials with complex structures and high performances and would be another development since the breakthrough of liquid crystal spinning technology of PPTA.