Myocardial injury and pericarditis after combined left atrial and coronary sinus ablation in Wolff-Parkinson-White syndrome: a case report.

BACKGROUND: Radiofrequency catheter ablation is an established procedure with a high success rate for treating Wolff-Parkinson-White (WPW) syndrome. Rare complications post-ablation may nonetheless occur particularly associated with coronary sinus. Identifying and avoiding these complications remains a challenge. CASE PRESENTATION: A 66-year-old woman with WPW syndrome was admitted to the hospital due to frequent attacks of paroxysmal tachycardia. During electrophysiological study, an accessory pathway was thought to connect the posterior wall of the left ventricle. The patient underwent Radiofrequency (RF) catheter ablation. The procedure was time-consuming because of combined left atrial and coronary sinus ablation. The total amount of radiofrequency application energy in the coronary sinus was 6800 J. After the operation, widespread concave ST-segment elevation, significantly increased value of serum troponin I and mild pericardial effusion were identified, but the patient did not show any symptoms. Therefore, the patient was suspected to have myocardial injury and pericarditis caused by ablation-related injury. The patient was uneventfully discharged five days after the procedure with a significantly decreased value of troponin I. The reexamined electrocardiogram was normal after three weeks. CONCLUSIONS: To the best of our knowledge, this is the first study to report on myocardial injury and pericarditis after combined left atrial and coronary sinus ablation in WPW syndrome. Our findings underscore the need for detailed mapping and careful ablation with low energy, as well as the merits of identifying myocardial infarction after coronary sinus ablation.

The preablation monocyte/ high density lipoprotein ratio predicts the late recurrence of paroxysmal atrial fibrillation after radiofrequency ablation.

BACKGROUND: The monocyte/high-density lipoprotein ratio (MHR) has emerged as a promising alternative biomarker in the fields of cardiovascular disease and atrial fibrillation (AF). This retrospective study was aimed to explore the predictive value of the MHR for the late recurrence of AF after radiofrequency ablation. METHODS: From April 2015 to October 2018, patients with paroxysmal AF who had undergone radiofrequency catheter ablation at Subei People's Hospital of Jiangsu Province were enrolled in our study. All the participants were observed until November 2019 after the procedure. During the postoperative follow up, the patients were categorized into the recurrence group and maintenance of sinus rhythm group based on who had experienced AF recurrence. RESULTS: One hundred twenty-five patients were diagnosed with paroxysmal AF, with an average age of 61.2 ± 9.3 years. Forty-seven patients had developed late recurrence during a mean follow up of 25.1 ± 12.0 months. The AF recurrence event rates were significantly increased in the highest MHR tertile compared with those in the lowest MHR tertile (22.0% vs. 57.1%; P < 0.05). On multivariate logistic regression analysis, the preablation MHR (OR = 1.34; 95% CI = 1.12 ~ 1.60; P = 0.001) and left atrial diameter (LAD) (OR = 1.21, 95% CI = 1.08 ~ 1.35; P = 0.001) were independent risk factors predicting the recurrence of AF after radiofrequency ablation. Furthermore, receiver operating characteristic (ROC) curve analysis revealed that the area under the curve (AUC) of the MHR was 0.712 (95% CI = 0.618 ~ 0.806; P = 0.000) and that of LAD was 0.739 (95% CI = 0.653 ~ 0.814; P = 0.000). Z-test found no significant difference between the MHR and LAD regarding the AUC (Z = 0.451; P = 0.652). CONCLUSION: An elevated preablation MHR was associated with an increased risk of the postoperative recurrence of AF. Additionally, the MHR independently predicted the late recurrence of paroxysmal AF after radiofrequency ablation, with the same predictive value as LAD.

Simultaneous Sensitive Determination of Selenium, Silver, Antimony, Lead, and Bismuth in Microsamples Based on Liquid Spray Dielectric Barrier Discharge Plasma-Induced Vapor Generation.

A highly efficient liquid spray dielectric barrier discharge (LSDBD) plasma-induced vapor generation technique is developed for the simultaneous determination of selenium, silver, antimony, lead, and bismuth in liquid microsamples (20 µL) by inductively coupled plasma mass spectrometry (ICP-MS). It is demonstrated that the dissolved Se, Ag, Sb, Pb, and Bi ions in solution samples are readily and simultaneously converted to volatile species efficiently by LSDBD plasma-induced chemical processes under similar conditions. It eliminates the use of unstable and expensive reducing reagents, and only formic acid is required in the proposed LSDBD chemical vapor generation technique. It is also worth noting that this is the first report of using plasma-induced chemical processes for the vapor generation of Ag and Bi. The simultaneous sensitive determination of Se, Ag, Sb, Pb, and Bi is realized with a sample volume of only 20 µL and the sample throughput could be as high as 180 samples h-1. The limit of detection (LOD) for simultaneous determination of Se, Ag, Sb, Pb, and Bi is 10 ng L-1 (200 fg), 2 ng L-1 (40 fg), 5 ng L-1 (100 fg), 4 ng L-1 (80 fg), and 3 ng L-1 (60 fg), respectively. The precision of Se, Ag, Sb, Pb, and Bi in the present method is evaluated to be better than 4%. The utility of the proposed technique is demonstrated by the analysis of ultratrace Se, Ag, Sb, Pb, and Bi in archaea cells and single conodont samples.

Can men with atrial fibrillation really rest easy with a CHA2DS2-VASc score of 0?

BACKGROUND: Atrial fibrillation (AF) significantly increases the risk of ischemic stroke depending on various risk factors. The CHA2DS2-VASc score is used widely to improve stratification of AF-related stroke to identify for whom anticoagulation could be safely withheld. As upstream therapy, the management of lifestyle for AF and related stroke prevention has been ongoing for past decades. CASE PRESENTATION: A 56-year-old male was taken to our hospital because of acute ischemic stroke. Without intracranial vascular malformation and angiostenosis, two small emboli were successfully taken out from the left middle cerebral artery by mechanical thrombectomy. During the hospitalisation, no apparent abnormalities were found in various laboratory tests, echocardiogram or the coronary computed tomography angiography. However, asymptomatic paroxysmal AF was first diagnosed and was presumed to be responsible for his stroke. Noticeable, he was always in good fitness benefiting from the formed good habits of no smoking and drinking. With a CHA2DS2-VASc score of 0, he had no history of any known diseases or risk factors associated with AF and related stroke. Instead of lacking exercise, he persisted in playing table tennis faithfully 3-4 times a week and 2-3 h each time over the past 30 years, and, in fact, has won several amateur table tennis championships. CONCLUSION: In view of the possible pathophysiological mechanisms resulting from the long-term vigorous endurance exercise, it may be a potential risk factor for developing AF and even for subsequent stroke. Not merely should strengthen the screening for AF in specific individuals as sports enthusiasts, but the necessity of oral anticoagulant for those with a CHA2DS2-VASc score of 0 might deserve the further investigation.

Antifungal activity of star anise extract against Penicillium roqueforti and Aspergillus niger for bread shelf life.

Because star anise is underutilized in the baking sector and the antifungal targets are unclear, this study aimed to investigate the antifungal effect and mechanism of star anise extract (SAE) on spoilage fungi in bread. SAE was prepared by ethanol extraction and 31 substances were identified by GC-MS, among which trans-anethole (62.62%), estragole (7.82%) and linalool (4.66%) were the major components. The antifungal activity of SAE and the three main components against Penicillium roqueforti and Aspergillus niger were determined by using the Oxford cup method and the sesqui-dilution method. The inhibition zones were 9.88 mm and 15.09 mm, while the minimum inhibitory concentrations were 125.00 µL/mL and 31.25 µL/mL. Trans-anethole and estragole both showed antifungal activity against Penicillium roqueforti and Aspergillus niger, while linalool only showed antifungal activity against Aspergillus niger. Propidium iodide and fluorescein diacetate staining analysis, leakage of cellular components (nucleic acids and proteins) and rise in ergosterol content indicated that SAE disrupted the integrity and permeability of the cell membrane. Malondialdehyde was increased after SAE treatment, indicating that SAE caused lipid peroxidation in the cell membrane, further confirming that it disrupted the cell membrane. At the same time, SAE interacted with membrane proteins and altered their conformation, resulting in cell membrane dysfunction. Finally, the shelf life test showed that SAE extended the shelf life of the bread by up to 6 days. In general, this study highlights the antifungal effect of SAE against Penicillium roqueforti and Aspergillus niger, which indicated that SAE can be used as an antifungal agent to extend the shelf life of bread.

Iron plaque effects on selenium and cadmium stabilization in Cd-contaminated seleniferous rice seedlings.

Dietary intake of selenium (Se)-enriched rice has benefit for avoiding Se-deficient disease, but there is a risk of excessive cadmium (Cd) intake. Through hydroponic culture and adsorption-desorption experiments, this paper focused on Se and Cd uptake in rice seedlings associated with the interactive effects of Se (Se4+ or Se6+), Cd, and iron (Fe) plaque. The formation of Fe plaque was promoted by Fe2+ and inhibited by Cd but not related with Se species. Shoot Se (Se4+ or Se6+) uptake was not affected by Fe plaque in most treatments, except that shoot Se concentrations were decreased by Fe plaque when Se4+ and Cd co-exposure. Shoot Cd concentrations were always inhibited by Fe plaque, regardless of Se species. Inhibiting Cd adsorption onto root surface (Se4+  + Cd) or increased Cd retention in Fe plaque (Se6+  + Cd) is an important mechanism for Fe plaque to reduce Cd uptake by rice. However, we found that DCB Cd concentrations (Cd adsorbed by Fe plaque) were not always positively correlated with Fe plaque amounts and always negatively correlated with the distribution ratios of Cd mass in root to that in Fe plaque (abbreviated as DRCMRF; r = - 0.942**); meanwhile, with the increase of DCB Fe concentration, the directions of variations of DCB Cd concentration and DRCMRF were affected by Se species. It indicated that the root system is also an important factor to affect DCB Cd concentration and inhibit Cd uptake, which is mediated by Se species. This paper provides a new understanding of Fe plaque-mediated interactive effect of Se and Cd uptakes in rice, which is beneficial for the remediation of Cd-contaminated and Cd-contaminated seleniferous areas.

Selenium Species and Fractions in the Rock-Soil-Plant Interface of Maize (Zea mays L.) Grown in a Natural Ultra-Rich Se Environment.

Selenium (Se) enrichments or deficiency in maize (Zea mays L.), one of the world's most important staple foods and livestock feeds, can significantly affect many people's diets, as Se is essential though harmful in excess. In particular, Se-rich maize seems to have been one of the factors that led to an outbreak of selenosis in the 1980s in Naore Valley in Ziyang County, China. Thus, this region's geological and pedological enrichment offers some insight into the behavior of Se in naturally Se-rich crops. This study examined total Se and Se species in the grains, leaves, stalks, and roots of 11 maize plant samples, Se fractions of soils around the rhizosphere, and representative parent rock materials from Naore Valley. The results showed that total Se concentrations in the collected samples were observed in descending order of soil > leaf > root > grain > stalk. The predominant Se species detected in maize plants was SeMet. Inorganic Se forms, mainly Se(VI), decreased from root to grain, and were possibly assimilated into organic forms. Se(IV) was barely present. The natural increases of Se concentration in soils mainly affected leaf and root dry-weight biomasses of maize. In addition, Se distribution in soils markedly correlated with the weathered Se-rich bedrocks. The analyzed soils had lower Se bioavailability than rocks, with Se accumulated predominantly as recalcitrant residual Se. Thus, the maize plants grown in these natural Se-rich soils may uptake Se mainly from the oxidation and leaching of the remaining organic-sulfide-bound Se fractions. A viewpoint shift from natural Se-rich soils as menaces to possibilities for growing Se-rich agricultural products is also discussed in this study.

Enhanced Adsorption of Cd on Iron-Organic Associations Formed by Laccase-Mediated Modification: Implications for the Immobilization of Cadmium in Paddy Soil.

The objectives of this study were to evaluate the cadmium adsorption capacity of iron-organic associations (Fe-OM) formed by laccase-mediated modification and assess the effect of Fe-OM on the immobilization of cadmium in paddy soil. Leaf organic matter (OM) was extracted from Changshan grapefruit leaves, and then dissolved organic matter (Lac-OM) and precipitated organic matter (Lac-P) were obtained by laccase catalytic modification. Different Fe-OM associations were obtained by co-precipitation of Fe with OM, Lac-OM, and Lac-P, respectively, and the adsorption kinetics, adsorption edge, and isothermal adsorption experiments of Cd on Fe-OM were carried out. Based on the in situ generation of Fe-OM, passivation experiments on Cd-contaminated soils with a high geological background were carried out. All types of Fe-OM have a better Cd adsorption capacity than ferrihydrite (FH). The theoretical maximum adsorption capacity of the OM-FH, Lac-OM-FH, and Lac-P-FH were 2.2, 2.53, and 2.98 times higher than that of FH, respectively. The adsorption of Cd on Fe-OM is mainly chemisorption, and the -OH moieties on the Fe-OM surface form an inner-sphere complex with the Cd ions. Lac-OM-FH showed a higher Cd adsorption capacity than OM-FH, which is related to the formation of more oxygen-containing groups in the organic matter modified by laccase. The immobilization effect of Lac-OM-FH on active Cd in soil was also higher than that of OM-FH. The Lac-OM-FH formed by laccase-mediated modification has better Cd adsorption performance, which can effectively inactivate the activity of Cd in paddy soil.

Phosphorus sorption capacity of various iron-organic matter associations in peat soils.

This study was carried out to evaluate the contribution of different types of iron-organic matter associations (Fe-OM) to the phosphorus sorption capacity of peatland. Humic substance (HS) and particulate organic matter (POM) were isolated from peat soils, and different types of iron-organic matter associations (Fe-HS and Fe-POM) were prepared. Then, isothermal adsorption experiments were carried out on the synthesized Fe-OM and iron-contained peat soils. The morphology structure of Fe-HS associations is amorphous like that of ferrihydrite. The theoretical maximum adsorption capacity (Qmax) of Fe-HS associations can reach 36.90 mg/g, which is approximately two times higher than that of ferrihydrite (19.23 mg/g) and ten times higher than that of hematite (3.26 mg/g) and goethite (2.08 mg/g). Both peat soils and POM can strongly complex ferric ions, resulting in improved phosphorus sorption capacity. The Qmax of original peat soil and POM is 2.83 mg/g and 4.31 mg/g, which increased to 7.36 mg/g and 5.89 mg/g, respectively, after complexing ferric ions. Compared to inorganic Fe minerals, the associations of iron and organic matter (HS and POM) contribute more to the phosphorus retention ability of peat soils. However, the formation of Fe-OM associations could not fully explain why the addition of iron increases the phosphorus sorption capacity of peat soil by so much. Iron should also participate in other phosphorus retention processes, which need further exploration and research.

Bioaccumulation and risk assessment of heavy metals in soil-crop systems in Liujiang karst area, Southwestern China.

Evaluating the bioaccumulation and health risk of heavy metals in soil-crop systems is essential in Liujiang karst regions. In the current study, the single and comprehensive uptake effects of heavy metals (i.e., Cu, Cr, Cd, As, and Zn) between rice and sugarcane and their rhizosphere soils were investigated. The estimated daily ingestion (EDI), target hazard quotient (THQ), and hazard index (HI) were estimated for health risk assessments. The results showed that the mean contents of Cu, Cr, Cd, As, and Zn in rice soils were 25.8, 168, 1.91, 20.0, and 160 mg/kg, respectively, and those in sugarcane soils were 28.8, 186, 0.44, 31.0, and 108 mg/kg. Rice soils were mainly contaminated by Cd, and Cd and Cr were the main pollutants in sugarcane soils. The average concentrations of Cu, Cr, Cd, As, and Zn in rice grains were 1.79, 0.15, 0.16, 0.11, and 12.7 mg/kg, respectively, and in sugarcanes were 0.10, 0.036, 0.022, 0.006, and 0.38 mg/kg. Both crops tended to take up Cd more effectively, and rice grains exhibited higher accumulation capacities of heavy metals in edible part than sugarcanes. Prediction models of Cd and comprehensive accumulation factors were established for rice and sugarcane, and different soil factors affect metal accumulation in crops cultivated in different types. Due to the exposure to As and Cd through rice consumption, non-carcinogenic risks are likely to occur in Liujiang residents.

Synergistic inhibitory effect of selenium, iron, and humic acid on cadmium uptake in rice (Oryza sativa L.) seedlings in hydroponic culture.

Selenium (Se), iron (Fe), and humic acid (HA) are beneficial fertilizers that inhibit cadmium (Cd) uptake in crops and are crucial for agricultural yields as well as human health. However, the joined effect of Se, Fe, and HA on Cd uptake in rice are still poorly understood. Therefore, a hydroponic culture experiment was established to evaluate the combined effect of Se (Se4+ or Se6+), Fe, and HA on the biomass, Cd uptake, and Cd translocation of/in rice seedlings. Compared to Se6+ application, Se4+ application in most treatments resulted in lower Cd translocations from roots to shoots, leading to a significant decrease in shoot Cd concentrations. Compared to the treatments with Se4+ or Fe2+ application, joined application of Se4+ and Fe2+ inhibited Cd uptake in shoots by decreasing Cd adsorption onto (iron plaque) and uptake by roots, and alleviating Cd translocation from root to shoot. Compared to the treatments with Se6+ or Fe2+ application, joined application of Se6+ and Fe2+ inhibited Cd uptake in shoots by sequestering (retaining) Cd onto root surface (iron plaque). HA inhibited Cd uptake in all treatments by decreasing the bioavailability of Cd in the nutrient solution through complexation. The simultaneous application of Se, Fe, and HA decreased the shoot Cd concentrations the most, followed by the combined application of two fertilizers and their individual application; the mean shoot Cd concentration in the Fe-SeIV-HA2 treatment was the lowest among all the treatments, at only 11.39 % of those in the control treatments. The 3-way ANOVA results indicated that the Cd concentrations in shoots were significantly affected by Se, Fe, HA, and certain of their interactions (Fe×Se and Se×HA) (p< 0.05). The above findings suggest that the joined application of Se, Fe, and HA ameliorated Cd uptake mainly by inhibiting Cd adsorption onto (iron plaque) and uptake by roots and the translocation from roots to shoots (Fe×Se4+), retaining (sequestering) Cd in iron plaque (Fe×Se6+), and decreasing Cd availability in nutrient solution (HA).

Germanium fractions in typical paddy soil and its interaction with humic substances.

Ge and Si differ strongly in their biogeochemical behavior due to the differences in binding capacity to organic matter. The mechanisms of soil organic matter affecting the mobility and bioavailability of Ge in soil-plant system remain unclear. This work aimed to investigate the soil Ge fractions and Ge binding to humic substances in paddy soil. Paddy soil samples taken from Changxing County, Zhejiang Province, China, were investigated by the sequential extraction method. Humic acid (HA) and fulvic acid (FA) isolated from paddy soils were characterized by Fourier transform infrared spectrometry (FT-IR) and 3-dimensional excitation-emission matrix (3D-EEM). The effect of humic substances on the binding of Ge was studied by fluorescence-quenching titration. Results showed that residual Ge was the dominant fraction in soil (up to 85%). The mobile Ge, organic matter bound Ge and easily reduceable compounds bound Ge accounted for approximately 10% of soil TGe and may represented critical labile pools of soil Ge. Organic matter bound Ge significantly correlated (r = 0.56, p < 0.01) with rice Ge concentrations. The fluorescence of HA and FA was markedly quenched by the addition of Ge. The conditional stability constant of HA-Ge complexes was larger than that of FA-Ge complexes, and the complexation capacity of HA-Ge complexes was lower than that of FA-Ge complexes. Humic substances played a dual role in affecting the behavior of dissolved Ge in paddy soil. HA formed stable complexes with Ge and tended to sequester Ge, while FA formed soluble and unstable complexes with Ge and tended to act as a Ge carrier in soil-plant system.

Uranium(VI) removal by nanoscale zerovalent iron in anoxic batch systems.

This study investigated the influences of pH, bicarbonate, and calcium on U(VI) removal and reduction by synthetic nanoscale zerovalent iron (nanoFe(0)) particles under anoxic conditions. The results showed that the rates of U(VI) removal and reduction by nanoFe(0) varied significantly with pH and concentrations of bicarbonate and/or calcium. For instance, at pH 6.92 the pseudo-first-order rate constants of U(VI) removal decreased by 78.5% and 81.3%, and U(VI) reduction decreased by 90.3% and 89.3%, when bicarbonate and calcium concentrations were increased from 0 to 1 mM, respectively. X-ray photoelectron spectroscopy (XPS) analysis confirmed the formation of UO(2) and iron (hydr)oxides as a result of the redox interactions between U(VI) and nanoFe(0). The study demonstrated the potential of using nanoFe(0) for U(VI)-contaminated site remediation and highlighted the impacts of pH, bicarbonate, and calcium on the U(VI) removal and reduction processes.

Assessing heavy-metal contamination and sources by GIS-based approach and multivariate analysis of urban-rural topsoils in Wuhan, central China.

Nine potentially harmful heavy metals (Cd, Co, Cr, Cu, Hg, Mn, Pb, Ni, and Zn) were measured in 477 topsoil samples collected from urban-rural areas in the city of Wuhan in order to identify their concentrations and possible sources, and characterize their spatial variability for risk assessment. Results showed that in most rural areas heavy-metal concentrations in soil were similar to their natural background values, but Cd, Cu, Hg, Pb, and Zn concentrations were relatively higher in densely populated districts and around industrial facilities. Multivariate analyses (correlation matrix, principal component analysis, and cluster analysis) indicated that Cd, Cu, Hg, Pb, and Zn were mainly derived from anthropogenic inputs, and Co, Cr, and Mn were controlled by natural source, whereas Ni appeared to be affected by both anthropogenic and natural sources. The result of risk assessment indicated that nearly 48% of the study area suffered from moderate to severe contamination.

Lead concentration distribution and source tracing of urban/suburban aquatic sediments in two typical famous tourist cities: Haikou and Sanya, China.

The content and spatial distribution of lead in the aquatic systems in two Chinese tropical cities in Hainan province (Haikou and Sanyan) show an unequal distribution of lead between the urban and the suburban areas. The lead content is significantly higher (72.3 mg/kg) in the urban area than the suburbs (15.0 mg/kg) in Haikou, but quite equal in Sanya (41.6 and 43.9 mg/kg). The frequency distribution histograms suggest that the lead in Haikou and in Sanya derives from different natural and/or anthropogenic sources. The isotopic compositions indicate that urban sediment lead in Haikou originates mainly from anthropogenic sources (automobile exhaust, atmospheric deposition, etc.) which contribute much more than the natural sources, while natural lead (basalt and sea sands) is still dominant in the suburban areas in Haikou. In Sanya, the primary source is natural (soils and sea sands).

Comprehensive Analysis of Codon Usage on Porcine Astrovirus.

Porcine astrovirus (PAstV), associated with mild diarrhea and neurological disease, is transmitted in pig farms worldwide. The purpose of this study is to elucidate the main factors affecting codon usage to PAstVs. Phylogenetic analysis showed that the subtype PAstV-5 sat at the bottom of phylogenetic tree, followed by PAstV-3, PAstV-1, PAstV-2, and PAstV-4, indicating that the five existing subtypes (PAstV1-PAstV5) may be formed by multiple differentiations of PAstV ancestors. A codon usage bias was found in the PAstVs-2,3,4,5 from the analyses of effective number of codons (ENC) and relative synonymous codon usage (RSCU). Nucleotides A/U are more frequently used than nucleotides C/G in the genome CDSs of the PAstVs-3,4,5. Codon usage patterns of PAstV-5 are dominated by mutation pressure and natural selection, while natural selection is the main evolutionary force that affects the codon usage pattern of PAstVs-2,3,4. The analyses of codon adaptation index (CAI), relative codon deoptimization index (RCDI), and similarity index (SiD) showed the codon usage similarities between the PAstV and animals might contribute to the broad host range and the cross-species transmission of astrovirus. Our results provide insight into understanding the PAstV evolution and codon usage patterns.

The Hospital-Community-Family-Based Telemedicine (HCFT-AF) Program for Integrative Management of Patients With Atrial Fibrillation: Pilot Feasibility Study.

BACKGROUND: The potential effectiveness of integrated management in further improving the prognosis of patients with atrial fibrillation has been demonstrated; however, the best strategy for implementation remains to be discovered. OBJECTIVE: The aim of this study was to ascertain the feasibility of implementing integrated atrial fibrillation care via the Hospital-Community-Family-Based Telemedicine (HCFT-AF) program. METHODS: In this single-arm, pre-post design pilot study, a multidisciplinary teamwork, supported by efficient infrastructures, provided patients with integrated atrial fibrillation care following the Atrial fibrillation Better Care (ABC) pathway. Eligible patients were continuously recruited and followed up for at least 4 months. The patients' drug adherence, and atrial fibrillation-relevant lifestyles and behaviors were assessed at baseline and at 4 months. The acceptability, feasibility, and usability of the HCFT-AF technology devices and engagement with the HCFT-AF program were assessed at 4 months. RESULTS: A total of 73 patients (mean age, 68.42 years; 52% male) were enrolled in November 2019 with a median follow up of 132 days (IQR 125-138 days). The patients' drug adherence significantly improved after the 4-month intervention (P<.001). The vast majority (94%, 64/68) of indicated patients received anticoagulant therapy at 4 months, and none of them received antiplatelet therapy unless there was an additional indication. The atrial fibrillation-relevant lifestyles and behaviors ameliorated to varying degrees at the end of the study. In general, the majority of patients provided good feedback on the HCFT-AF intervention. More than three-quarters (76%, 54/71) of patients used the software or website more than once a week and accomplished clinic visits as scheduled. CONCLUSIONS: The atrial fibrillation-integrated care model described in this study is associated with improved drug adherence, standardized therapy rate, and lifestyles of patients, which highlights the possibility to better deliver integrated atrial fibrillation management. TRIAL REGISTRATION: Clinicaltrials.gov NCT04127799; https://clinicaltrials.gov/ct2/show/NCT04127799.

A Hospital-Community-Family-Based Telehealth Program for Patients With Chronic Heart Failure: Single-Arm, Prospective Feasibility Study.

BACKGROUND: An increasing number of patients with chronic heart failure (CHF) are demanding more convenient and efficient modern health care systems, especially in remote areas away from central cities. Telehealth is receiving increasing attention, which may be useful to patients with CHF. OBJECTIVE: This study aimed to evaluate the feasibility of a hospital-community-family (HCF)-based telehealth program, which was designed to implement remote hierarchical management in patients with CHF. METHODS: This was a single-arm prospective study in which 70 patients with CHF participated in the HCF-based telehealth program for remote intervention for at least 4 months. The participants were recruited from the clinic and educated on the use of smart health tracking devices and mobile apps to collect and manually upload comprehensive data elements related to the risk of CHF self-care management. They were also instructed on how to use the remote platform and mobile app to send text messages, check notifications, and open video channels. The general practitioners viewed the index of each participant on the mobile app and provided primary care periodically, and cardiologists in the regional central hospital offered remote guidance, if necessary. The assessed outcomes included accomplishments of the program, usability and satisfaction, engagement with the intervention, and changes of heart failure-related health behaviors. RESULTS: As of February 2018, a total of 66 individuals, aged 40-79 years, completed the 4-month study. Throughout the study period, 294 electronic medical records were formed on the remote monitoring service platform. In addition, a total of 89 remote consultations and 196 remote ward rounds were conducted. Participants indicated that they were generally satisfied with the intervention for its ease of use and usefulness. More than 91% (21/23) of physicians believed the program was effective, and 87% (20/23) of physicians stated that their professional knowledge could always be refreshed and enhanced through a library hosted on the platform and remote consultation. More than 60% (40/66) of participants showed good adherence to the care plan in the study period, and 79% (52/66) of patients maintained a consistent pattern of reporting and viewing their data over the course of the 4-month follow-up period. The program showed a positive effect on self-management for patients (healthy diet: P=.046, more fruit and vegetable intake: P=.02, weight monitoring: P=.002, blood pressure: P<.001, correct time: P=.049, and daily dosages of medicine taken: P=.006). CONCLUSIONS: The HCF-based telehealth program is feasible and provided researchers with evidence of remote hierarchical management for patients with CHF, which can enhance participants' and their families' access and motivation to engage in self-management. Further prospective studies with a larger sample size are necessary to confirm the program's effectiveness.

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To explore a new technique of planting wheat with high yield and efficiency by mulching technology in rain-fed semiarid regions in Northwest China, a two-year fixed-site trail was conducted during 2013-2015. There were five mulching modes: (1) three sowing rows by bundled straw mul-ching with alternating 30-cm-wide mulching belt and planting belt (SM1), (2) four sowing rows by bundled straw mulching with alternating 40-cm-wide mulching belt and planting belt with (SM2), (3) five sowing rows by bundled straw mulching with alternating 50-cm-wide mulching belt and planting belt (SM3), (4) whole plastic film mulching with dibbling (PMF), (5) bare field planting without any mulching (CK). We examined the effects of different mulching modes on water consumption, water use efficiency (WUE), and yield of winter wheat in rain-fed region in Northwest China. The results showed that bundled straw mulching significantly increased soil water storage. Soil water storage with bundled straw mulching was remarkably higher than that with the whole plastic mul-ching with SM1＞SM2＞SM3. Soil water storage at 0-200 cm soil layer in flowering period was increased by 15.4%-20.8%,11.2%-14.7%and 10.1%-14.5% respectively over that in the bare field. Bundled straw mulching significantly increased water consumption during the whole growing period while reduced water consumption from sowing and flowering periods. Further, it increased water consumption from flowering to maturity periods and the ratio of water consumption during this period to the total water consumption during the whole growing periods. The results showed that mulching could increase the consumption ratio of deep water storage from the soil layer below 120 cm. Compared with CK, PMF and SM significantly increased grain yield and water use efficiency by 11.9%-19.5%, 26.9%-27.1%, respectively, and increased water use efficiency by 9.8%-13.9%, 18.4%-22.0% respectively. In all, bundled straw mulching could reduce water consumption ratio in the early growing periods, improve moisture condition, increase grain yield and water use efficiency of winter wheat. Therefore, we concluded that bundled straw mulching is an environment-friendly cultivation technology suitable for the winter wheat in semi-arid region of the Loess Plateau in Northwest China.

Geological emission of methane from the Yakela condensed oil/gas field in Talimu Basin, Xinjiang, China.

A static flux chamber method was applied to study natural emissions of methane into the atmosphere in the Yakela condensed oil/gas field in Talimu Basin, Xinjiang, China. Using an online method, which couples a gas chromatography/high-temperature conversion/isotope ratio mass spectrometry (GC/C/MS) together, the 13C/12C ratios of methane in the flux chambers were measured. The results demonstrated that methane gases were liable to migrate from deep oil/gas reservoir to the surface through microseepage and pervasion, and that a part of the migrated methane that remained unoxidized could emit into the atmosphere. Methane emission rates varied less in the oil/gas field because the whole region was homogeneous in geology and geography, with a standard deviation of less than 0.02 mg/(m2 x h). These were the differences in methane emission flux in the day and at night in the oil/gas field. The maximum methane emission flux reached 0.15 mg/(m2 x h) at 5:00-6:00 early in the morning, and then decreased gradually. The minimum was shown 0.10 mg/(m2 x h) at 17:00-18:00 in the afternoon, and then increased gradually. The daily methane released flux of the study area was 2.89 mg/(m2 x d), with a standard deviation of 0.43 mg/(m2 x d), using the average methane flux of every hour in a day for all chambers. delta13C of methane increased with the increase of methane concentration in the flux chambers, further indicating that the pyrogenetic origin of methane was come from deep oil/gas reservoirs.