Exploring the role of mindfulness on obligatory exercise among young athletes: mediating roles of obsessive passion and cognitive state anxiety.

Introduction: In the current trend toward youthfulness and age reduction in competitive sports, the issue of obligatory exercise among young athletes is becoming more severe. This not only affects their physical and mental health but also hampers their future prospects in the sports world. While delving into the impact of mindfulness on the issue of obligatory exercise among young athletes, it reveals the mediating role of obsessive passion and cognitive state anxiety. Methods: This study is a cross-sectional research that employs convenience and snowball sampling methods. We selected 403 young athletes from several universities and high-level sports teams in the central-southern region of China as valid samples and used AMOS v.23 to construct a structural equation model to validate the hypotheses. Results: The research findings indicate a significant positive correlation between obsessive passion, cognitive state anxiety, and obligatory exercise. Furthermore, obsessive passion and cognitive state anxiety mediate the relationship between mindfulness and obligatory exercise. This implies that young athletes can better regulate their emotional state during training, manage training loads sensibly, and avoid issues with obligatory exercise through mindfulness training. Discussion: In conclusion, to enhance the cognitive levels of young athletes and reduce their obligatory exercise behaviors, national sports authorities and coaching teams should develop reasonable mindfulness training programs for athletes and encourage their participation in mindfulness training.

Extraction, purification, structural modification, activities and application of polysaccharides from different parts of mulberry.

The mulberry plant is a member of the Moraceae family and belongs to the Morus genus. Its entire body is a treasure, with mulberries, mulberry leaves, and mulberry branches all suitable for medicinal use. The main active ingredient in mulberries is mulberry polysaccharide. Studies have shown that polysaccharides from different parts of mulberry exhibit antioxidant, antidiabetic, antibacterial, anti-inflammatory, and blood pressure-lowering properties. There are more studies on the biological activities, extraction methods, and structural characterization of polysaccharides from different parts of mulberry. However, the structural characterization of mulberry polysaccharides is mostly confined to the types and proportions of monosaccharides and the molecular weights of polysaccharides, and there are fewer systematic studies on polysaccharides from different parts of mulberry. In order to better understand the bioactive structure of mulberry polysaccharides, this article discusses the recent research progress in the extraction, separation, purification, bioactivity, structural modification, and application of polysaccharides from different parts of mulberry (mulberry leaves, mulberry fruits, and mulberry branches). It also delves into the pharmacological mechanisms of action of mulberry polysaccharides to provide a theoretical basis for further research on mulberry polysaccharides with a view to their deeper application in the fields of feed and nutraceuticals.

Health Disparities Among Family Decision-Makers in China: An Ordered Probit Analysis of the China Family Panel Studies.

Purpose: The family decision-makers serve as the backbone of the family, and their health status warrants consideration. This study aims to explore how the health status of this group of people, namely the family decision-making group, is affected, and to delve into the mechanisms of influence based on this. The goal is to provide reliable evidence and strategies for the health management of the family decision-makers group, contributing to the achievement of the "Healthy China 2030" Planning Outline. Patients and Methods: Drawing on data from the China Family Panel Studies (CFPS), this study utilizes an Ordered Probit Model to analyze and compare the health status of family decision-makers and non-decision-makers. Results: The findings indicate that decision-makers tend to experience poorer health outcomes than other family members, with increased pressure related to decision-making identified as a significant contributor to their declining health. Heterogeneity analysis reveals that the negative effect is less pronounced in households with higher net worth but more pronounced in those with more significant housing, education, and medical spending pressures. Moreover, this study analysis highlights that enhancing individual or family socioeconomic status can alleviate the adverse health effects experienced by family decision-makers. Conclusion: The study reveals the presence of certain health adverse effects among family decision-makers. The implications drawn from this research hold significance for the health management of this demographic, underscoring the necessity for tailored interventions aimed at addressing the distinctive challenges confronted by this group.

Optimization of Thermal Control Design for Aerial Reflective Opto-Mechanical Structure.

To improve the adaptability of aerial reflective opto-mechanical structures (mainly including the primary mirror and secondary mirror) to low-temperature environments, typically below -40 °C, an optimized thermal control design, which includes passive insulation and temperature-negative feedback-variable power zone active heating, is proposed. Firstly, the relationship between conventional heating methods and the axial/radial temperature differences of mirrors with different shapes is analyzed. Based on the heat transfer analyses, it is pointed out that optimized thermal control design is necessary to ensure the temperature uniformity of the fused silica mirror, taking into account the temperature level when the aerial electro-optics system is working in low-temperature environments. By adjusting the input voltage based on the measured temperature, the heating power of the subregion is changed accordingly, so as to locally increase or decrease the temperature of the mirrors. The thermal control scheme ensures that the average temperature of the mirror fluctuates slowly and slightly around 20 °C. At the same time, the temperature differences within a mirror and between the primary mirror and the secondary mirror can be controlled within 5 °C. Thereby, the resolution of EO decreases by no more than 11.4%.

Mindfulness and impulsive behavior: exploring the mediating roles of self-reflection and coping effectiveness among high-level athletes in Central China.

Introduction: In the highly competitive field of sports, impulsive behavior by athletes not only threatens personal and team harmony but also poses significant risks to their careers and public image. Despite these behaviors often becoming the focus of public attention, their underlying causes and prevention strategies remain relatively unknown. This study delves deep into the impact of mindfulness on athletes' impulsive behavior, revealing the mediating roles of self-reflection and coping effectiveness. Methods: Using a combination of snowball and convenience sampling, a sample of 403 athletes from high-level sports teams in the Central China region participated in a questionnaire survey. The data were analyzed using Amos v.23 software. Results: The findings indicate a positive correlation between mindfulness and coping effectiveness (standardized coefficient = 0.336, p < 0.001), as well as between self-reflection and coping effectiveness (standardized coefficient = 0.406, p < 0.001). There is a negative correlation between coping effectiveness and impulsive behavior (standardized coefficient = -0.476, p < 0.001). The positive impact of mindfulness on impulsive behavior (standardized coefficient = -0.371, p < 0.01) is mediated by self-reflection and coping effectiveness. The explanatory power of this study is R2 = 0.35. Discussion: Mindfulness reduces impulsive behavior by enhancing self-reflection capabilities and improving coping effectiveness. Based on these substantive research results, to mitigate impulsive behavior in athletes, it is recommended that the National Sports Administration and coaches actively implement mindfulness training. Additionally, targeted psychological intervention strategies should be developed to enhance athletes' mental health levels and optimize their sports performance.

Activation of toll-like receptor 4/nuclear factor-kappa B signaling by triggering a receptor expressed on myeloid cells 1 promotes alveolar macrophage M1 polarization and exacerbates septic acute lung injury.

BACKGROUND: Septic acute lung injury (ALI) is a life-threatening condition commonly occurring in the intensive care unit. Inflammation is considered as the basic pathological response of septic ALI. Triggering receptor expressed on myeloid cells 1 (TREM1) is a member of the immunoglobulin superfamily receptors that regulates the inflammatory response. However, the role of TREM1 in septic ALI has not yet been reported. METHODS: Cell viability was tested using the MTT assay. TdT-mediated dUTP nick end labeling assay and flow cytometry were used for apoptosis. The level of protein was detected using western blot analysis. The levels of tumor necrosis factor-α and interleukin-1ß were assessed using enzyme-linked immunosorbent assay. The lactate dehydrogenase content was assessed using the assay kit. Myeloperoxidase activity was determined using an assay. Histology of lung tissue was further analyzed through hematoxylin-eosin staining. RESULTS: We found that TREM1 knockdown by transfection with si-TREM1 inhibited lipopolysaccharide (LPS)-induced cell apoptosis of alveolar macrophage cell line MH-S. The LPS stimulation caused M1 polarization of MH-S cells, which could be reversed by TREM1 knockdown. In vivo assays proved that si-TREM1 injection improved lung injury and inflammation of cecal ligation and puncture-induced ALI in mice. In addition, TREM1 knockdown suppressed the activation of toll-like receptor 4/nuclear factor-kappa B signaling, implying the involvement of TLR4 in the effects of TREM1 in response to LPS stimulation. CONCLUSIONS: This study examined the proinflammatory role of TREM1 in septic ALI and its regulatory effect on alveolar macrophage polarization. These results suggest that TREM1 could potentially serve as a therapeutic target in the prevention and treatment of ALI.

Somatostatin receptor2 (SSTR2) expression, prognostic implications, modifications and potential therapeutic strategies associates with head and neck squamous cell carcinomas.

Head and neck squamous cell carcinomas (HNSCC) constitute a heterogeneous cluster of tumors celebrated for their predisposition to metastasize and exhibit local recurrence. Recent explorations have illuminated the intricate involvement of Somatostatin Receptor 2 (SSTR2), a growth-regulatory receptor traditionally classified as a tumor suppressor, yet concurrently implicated in bolstering specific tumor phenotypes. Advances in the realm of SSTR2 investigation within HNSCC, with a specific spotlight on laryngeal squamous cell carcinomas (LSCC), tongue squamous cell carcinomas (TSCC), and nasopharyngeal carcinomas (NPC), have been established. This study aims to provide a comprehensive overview of SSTR2 expression patterns, prognostic implications, distinctive signaling pathways, epigenetic modifications, and potential therapeutic strategies associated with SSTR2 in HNSCC.

Transcriptome and miRNAs Profiles Reveal Regulatory Network and Key Regulators of Secondary Xylem Formation in "84K" Poplar.

Secondary xylem produced by stem secondary growth is the main source of tree biomass and possesses great economic and ecological value in papermaking, construction, biofuels, and the global carbon cycle. The secondary xylem formation is a complex developmental process, and the underlying regulatory networks and potential mechanisms are still under exploration. In this study, using hybrid poplar (Populus alba × Populus glandulosa clone 84K) as a model system, we first ascertained three representative stages of stem secondary growth and then investigated the regulatory network of secondary xylem formation by joint analysis of transcriptome and miRNAs. Notably, 7507 differentially expressed genes (DEGs) and 55 differentially expressed miRNAs (DEMs) were identified from stage 1 without initiating secondary growth to stage 2 with just initiating secondary growth, which was much more than those identified from stage 2 to stage 3 with obvious secondary growth. DEGs encoding transcription factors and lignin biosynthetic enzymes and those associated with plant hormones were found to participate in the secondary xylem formation. MiRNA-target analysis revealed that a total of 85 DEMs were predicted to have 2948 putative targets. Among them, PagmiR396d-PagGRFs, PagmiR395c-PagGA2ox1/PagLHW/PagSULTR2/PagPolyubiquitin 1, PagmiR482d-PagLAC4, PagmiR167e-PagbHLH62, and PagmiR167f/g/h-PagbHLH110 modules were involved in the regulating cambial activity and its differentiation into secondary xylem, cell expansion, secondary cell wall deposition, and programmed cell death. Our results give new insights into the regulatory network and mechanism of secondary xylem formation.

Association of Mindfulness with Perfectionism, Exercise Self-Efficacy, and Competitive State Anxiety in Injured Athletes Returning to Sports.

Injured athletes often face performance challenges upon returning to the field, influenced by external factors and negative emotions. This study investigates how mindfulness is associated with perfectionism, exercise self-efficacy, and competitive state anxiety in athletes recovering from injuries. Using snowball sampling and convenience sampling methods with a cross-sectional dataset of 359 participants from southern China (collected between October and November 2022), we employed structural equation modelling to analyse the relationship between mindfulness and competitive state anxiety in returning athletes. The results reveal that mindfulness interventions enhance exercise self-efficacy, boost task-related confidence, reshape perfectionism towards a positive outlook, and decrease competitive state anxiety. This study establishes positive correlations between perfectionism and competitive state anxiety, and a negative correlation between exercise self-efficacy and competitive state anxiety. Moreover, exercise self-efficacy and perfectionism partially mediate mindfulness's positive impact on competitive state anxiety. In conclusion, this research highlights mindfulness's potential to alleviate perfectionism and competitive state anxiety while enhancing exercise self-efficacy among athletes on the road to recovery.

Study on Potato Bud Cultivation Techniques in a Greenhouse in Spring.

The species degeneration caused by traditional potato cultivation methods is becoming increasingly evident, and it is particularly important to study new potato cultivation methods. Sprout planting technology has the advantages of large reproductive capacity, fast growth speed, and simplified maintenance of cultivated crops. In this study, four disease-free potato varieties ('Fujin', 'Youjin', 'Zhongshu 4', and 'Feiwuruita') were treated with different parts (top bud, middle bud, and tail bud) and different bud lengths (10 cm, 15 cm, and 20 cm), and then potato sprout planting was carried out. A nutrient pot experiment was performed following a randomized complete block design (RCBD) with various replicates and a natural control (CK) treatment. By comprehensively measuring the emergence, chlorophyll content, net photosynthetic rate, dry matter distribution during the bulking period of blocks, and effect of growth and quality with bud direct seeding under both treatments, it was found that potato block top bud direct seeding cultivation is significantly superior to other parts. In terms of early maturity and yield statistics, the advantage of top bud cultivation in 'zhongshu 4' is most obvious; it reaches maturity an average of 14 days earlier, and the yield can be increased by 38.05%. Therefore, top bud direct seeding is more suitable for potato sprout planting technology. On this basis, the 20 cm and 15 cm bud length treatments of top buds were used for direct cultivation, and all the above indicators performed well. Among them, in the zhongshu 4 variety, the yields of 15 cm and 20 cm bud length treatments increased by 41.78% and 38.05%, the growth rates of commercial potatoes increased by 6% and 6.9%, respectively, and the effects were the most obvious. In conclusion, the deep research and application of potato sprouting technology has high utilization value for improving potato yield and quality and has guiding significance for greenhouse potato cultivation in early spring.

Exploring configurations of social determinants for enhancing older adult health in China: an fuzzy-set qualitative comparative analysis based on 31 provinces in China.

With China's aging population on the rise, addressing population aging has become a national priority, particularly focusing on improving older adult health. This study employs the social determinants of health framework, considering China's unique macro-social, economic, policy, healthcare, and family cultural factors, to develop a framework for understanding the social determinants of health for older adult in China. Using the fsQCA method and a configurational perspective, the complex relationship between social determinants of health and older adult health status is examined. The findings indicate that individual social determinants alone are insufficient for achieving high levels of older adult health. Instead, three configurations of social determinants have been identified as conducive to high older adult health: Economic Development-Environment - Cultural Dominant Type, Socio-Economic Development - Older Adult Security - Environment - Cultural Dominant Type, and Economic Development Dominant Type. These configurations offer diverse pathways for enhancing older adult health. Conversely, the study identifies two configurations associated with low older adult health levels, exhibiting an asymmetric relationship with the configurations resulting in high older adult health levels. Moreover, economic development consistently emerges as a core condition across all three configurations associated with high older adult health levels, while two configurations associated with low older adult health lack this core condition. These findings underscore the universal contribution of enhancing economic development to improving older adult health.

Differential effects of climatic and non-climatic factors on the distribution of vegetation phenology trends on the Tibetan plateau.

The study of vegetation phenology changes is important because it is a sensitive indicator of climate change, affecting the exchange of carbon, energy and water fluxes between the land and the atmosphere. Previous studies have focused on the effects of climatic factors among environmental factors on vegetation phenology, thus the effects of non-climatic factors among environmental factors have not been well quantified. This study endeavors to scrutinize the spatiotemporal inconsistency in the start-of-season (SOS) and the end-of-season (EOS) on the Tibetan Plateau (TP) and to quantify the effects of environmental factors on phenology. To this end, the Moderate-resolution Imaging Spectroradiomater (MODIS) Normalized Difference Vegetation Index (NDVI) data from 2001 to 2018 and four common used methods were employed to extract SOS and EOS, and the site data was used to select the most appropriate phenology results. The Geodetector model was used to assess and measure the explanatory power of different environmental factors. The research results indicate that temperature exerts a more substantial impact on phenology than precipitation on TP. non-climatic factors such as longitude, latitude, and elevation are more influential in determining the distribution of phenological trends than climatic factors. Among these non-climatic factors, latitude has the most prominent effect on the trends of SOS. Furthermore, non-climatic factors exhibit a stronger effect on SOS, whereas EOS is more susceptible to climatic factors and less influenced by non-climatic factors. These discoveries bear great significance in comprehending the intricate outcomes of regional changes on vegetation phenology and enhancing phenology models.

An immune cell atlas reveals the dynamics of human macrophage specification during prenatal development.

Macrophages are heterogeneous and play critical roles in development and disease, but their diversity, function, and specification remain inadequately understood during human development. We generated a single-cell RNA sequencing map of the dynamics of human macrophage specification from PCW 4-26 across 19 tissues. We identified a microglia-like population and a proangiogenic population in 15 macrophage subtypes. Microglia-like cells, molecularly and morphologically similar to microglia in the CNS, are present in the fetal epidermis, testicle, and heart. They are the major immune population in the early epidermis, exhibit a polarized distribution along the dorsal-lateral-ventral axis, and interact with neural crest cells, modulating their differentiation along the melanocyte lineage. Through spatial and differentiation trajectory analysis, we also showed that proangiogenic macrophages are perivascular across fetal organs and likely yolk-sac-derived as microglia. Our study provides a comprehensive map of the heterogeneity and developmental dynamics of human macrophages and unravels their diverse functions during development.

Association of mindfulness on state-trait anxiety in choking-susceptible athletes: mediating roles of resilience and perceived stress.

Introduction: It is a well-documented psychological phenomenon for athletes to experience abnormal performance on the field, often called choking. Negative emotions such as perceived stress and state-trait anxiety have been linked to this phenomenon. In an effort to delve into the intricate relationship between mindfulness and state-trait anxiety among athletes susceptible to choking, this study was conducted in Central China during the period from October to November 2022. Methods: The sample selection process employed a combination of cluster sampling and random sampling, resulting in a total of 377 viable samples encompassing choking-susceptible athletes who frequently grapple with state-trait anxiety and demonstrate performance deviations. The data analysis was executed utilizing AMOS v.26. Results: The results indicate a negative association between mindfulness and perceived stress (standardized coefficient = -0.224, p < 0.001), resilience and perceived stress (standardized coefficient = -0.237, p < 0.001), as well as perceived stress and state-trait anxiety (standardized coefficient = 0.510, p < 0.001). The positive impact of mindfulness on state-trait anxiety is mediated by resilience and perceived stress (standardized indirect effect = 0.237, p < 0.001). The explanatory power of this study is R2 = 0.35. Discussion: Drawing from these substantial findings, a key recommendation is to implement mindfulness training programs for athletes prone to choking. This proactive measure, facilitated by sports departments, clubs, and coaches, could potentially alleviate state-trait anxiety, enhancing athletes' mental well-being and optimizing their performance outcomes during competitions.

Investigating Links between Moderate-to-Vigorous Physical Activity and Self-Rated Health Status in Adolescents: The Mediating Roles of Emotional Intelligence and Psychosocial Stress.

Adolescence represents a crucial phase, characterized by rapid physical and mental development and numerous challenges. Physical activity plays a vital role in the mental well-being of adolescents; however, due to the prevailing educational philosophy prioritizing academic performance, adolescent participation in physical activities has yet to reach its full potential. Thus, this study aims to investigate the effects of moderate-to-vigorous physical activity on adolescents' emotional intelligence, psychosocial stress, and self-rated health status. To achieve this objective, a cluster sampling method was employed to collect data from 600 adolescents in 10 schools across five municipal districts of Changsha, China. A total of 426 valid questionnaires were returned and analyzed. Utilizing AMOS v.23, a structural equation model was constructed to validate the hypotheses. The findings reveal that moderate-to-vigorous physical activity significantly impacts adolescents' emotional intelligence and self-rated health status. Conversely, it exerts a significant negative influence on their psychosocial stress. Moreover, emotional intelligence and psychosocial stress mediate the relationship between moderate-to-vigorous physical activity and self-rated health status. In light of these results, education departments, schools, and families must embrace a paradigm shift in educational philosophies and provide robust support for adolescents to engage in moderate-to-vigorous physical activities.

Rechallenge with EGFR-TKI after failure of immunotherapy is considered an effective treatment for advanced lung adenocarcinoma patients with EGFR exon 19 deletion: a case report.

In advanced lung adenocarcinoma patients with epidermal growth factor receptor (EGFR) mutation, epidermal growth factor receptor-tyrosine kinase inhibitors (EGFR-TKIs) have an excellent and long-lasting therapeutic response; however, virtually all patients eventually develop drug resistance and experience disease progression. The use of immunotherapy after EGFR-TKIs may be a successful therapeutic option for individuals who are resistant to them. It is still unclear if EGFR-TKIs can be administered again after immunotherapy has failed. We describe a case of a 37-year-old woman who was found to have T4N3M1a stage IVa lung adenocarcinoma. Amplification refractory mutation system PCR (ARMS-PCR) genetic testing suggested EGFR exon 19 deletion. The patient was initially treated with a regimen of icotinib (125 mg tid) combined with anlotinib (8 mg qd d1-d14) with an optimal efficacy rating of partial response (PR) and was granted a PFS of 7 months. In second-line treatment, the patient received three cycles of a KN046 (KN046 is a bispecific antibody inhibitor of PD-L1 and CTLA-4) 295 mg d1, pemetrexed 800 mg d1, plus carboplatin 750 mg d1 regimen, with an optimal efficacy rating of stable disease (SD) on CT. The third-line therapy was chosen to be afatinib with docetaxel, and the patient was evaluated for PR on CT. Up to 15 August 2022, the patient had a progression free survival (PFS) of 14 months. The successful treatment of this patient is a reminder that EGFR-TKI rechallenge in EGFR exon 19 deletion patients with EGFR-TKI resistance, in which immunotherapy has failed, may be effective.

The geographical pension gap: Understanding the causes of inequality in China's pension funds.

The sustainability of social pension insurance is of great significance in guaranteeing the essential life of the elderly and promoting social stability. Based on the provincial panel data from 2012 to 2020, this study uses non-spatial measurement methods, ArcGIS visualization research methods, and geographic detectors to study the regional differences in China's pension fund balances and the underlying influencing factors. Compared with the traditional way of establishing regression equations to explore the correlation of influencing factors, geographic detectors can quantify the strength of each influencing factor and detect the interaction of different influencing factors. This study found that: First, the growth rate of China's overall pension fund balances has been declining yearly, with the fastest decline in northeast China, the middle in the Western and Central regions of China, and the slowest decline in Eastern China. Second, the spatial distribution of pension fund balances shows agglomeration characteristics, with high-value areas mainly distributed in Eastern China and low-value regions distributed primarily in Western and Northeastern China. Third, the overall Theil index for pension fund balances is trending down, but the Theil index for the Eastern region is on the rise. Fourth, seven factors, including the working-age population, the population aged 65 and above, and regional GDP, are the main factors that lead to regional differences in the balance of urban and rural residential insurance funds. Finally, the superimposed effects of each element are reflected in double-factor enhancement or non-linear enhancement relation.

Association between greenspace and cancer: evidence from a systematic review and meta-analysis of multiple large cohort studies.

Cancer is a chronic disease that seriously endangers human health, and studies on its association with greenspace have been published. We aimed to systematically review the epidemiological evidence and obtain the best available evidence. PubMed, Web of Science, Embase, and Cochrane Library were used as search databases, the time limit was September 12, 2022, and the cited articles were manually supplemented. Two researchers independently performed literature screening and data extraction. We performed a meta-analysis of data using a normalized difference vegetation index (NDVI) as the greenspace measure, providing hazard ratio (HR) and corresponding 95% CI. After standardization of the data, we used a random effects model for pooling. We also assessed the risk of bias for each study and the quality of each evidence body. We identified 10,108 items and included 14 studies from 11 institutions in eight countries. All studies had a low risk of bias. Quantitative analysis of 13 studies found a beneficial association of greenspace with the mortality of lung cancer (pooled HR [95% CI]=0.965 [0.947, 0.983]) and prostate cancer (HR [95% CI]=0.939 [0.898, 0.980]) based on 0.1-unit NDVI increment and a potential beneficial association with the incidence of prostate, lung, and breast cancer. Greenspace had opposite associations with cancer mortality for urban and rural populations. Indirect comparisons did not find statistically significant differences in the effects of greenspace on different cancer outcomes. The evidence body assessment was considered to be "very low." This review indicated potential beneficial associations between greenspace for lung, prostate, and breast cancer outcomes. However, there was a lack of mediation analysis to explore the underlying mechanism of a causal association. Meanwhile, the interstudy heterogeneity was large. Therefore, future studies should consider more accurate exposure assessment and more comprehensive covariate coverage, while focusing on mediating analysis. PROSPERO: CRD42022361068.

Evaluation of the Effect of New Multimodal Analgesia Regimen for Cardiac Surgery: A Prospective, Randomized Controlled, Single-Center Clinical Study.

Objective: To investigate the feasibility of multimodal regimen by paracetamol, gabapentin, ketamine, lidocaine, dexmedetomidine and sufentanil among cardiac surgery patients, and compare the analgesia efficacy with conventional sufentanil-based regimen. Design: A single-center, prospective, randomized, controlled clinical trial. Setting: One participating center, the cardiovascular center of the major integrated teaching hospital. Participants: A total of 115 patients were assessed for eligibility: 108 patients were randomized, 7 cases were excluded. Interventions: The control group (group T) received conventional anesthesia management. Interventions in the multimodal group (group M) were as follows in addition to the standard of care: gabapentin and acetaminophen 1 hour before surgery; ketamine for induction and to maintain anesthesia with lidocaine and dexmedetomide. Ketamine, lidocaine, and dexmedetomidine were added to routine sedatives postoperatively in group M. Measurements and Main Results: The incidence of moderate-to-severe pain on coughing made no significant difference (68.5% vs 64.8%, P=0.683). Group M had significantly less sufentanil use (135.72µg vs 94.85µg, P=0.000) and lower rescue analgesia rate (31.5% vs 57.4%, P=0.007). There was no significant difference in the incidence of chronic pain, PONV, dizziness, inflammation index, mechanical ventilation time, length of stay, and complications between the two groups. Conclusion: Our multimodal regimen in cardiac surgery is feasible, but was not superior to traditional sufentanil-based regimen in the aspects of analgesia effects; however, it did reduce perioperative opioid consumption along with rescue analgesia rate. Moreover, it showed the same length of stay and the incidences of postoperative complications.

Effects of Mindfulness on Obligatory Exercise During the Return of Injured Athletes to Sports: The Mediating Roles of Self-Criticism and Competitive State Anxiety.

Purpose: Despite the Advances in sports training methods and medicine, they have not reduced the recurrence rate of athletes' injuries significantly, and obligatory exercise may be an important reason for their re-injury. The purpose of this study was to investigate the effects of mindfulness on obligatory exercise behavior, self-criticism, and competitive state anxiety in athletes recovering from injury, and explain their interactions. Patients and Methods: The study adopted the snowball and convenience sampling methods. From November to December 2022, a total of 265 high-level sports players in South China were selected, and ultimately, 208 valid data samples were obtained. Maximum likelihood estimation was used to analyze the data and test the hypotheses proposed using 5000 bootstrap samples to test the mediating effects of the structural equation model. Results: The results demonstrated that there were positive correlations between self-criticism and obligatory exercise (standardized coefficients = 0.38, p < 0.001), as well as competitive state anxiety and self-criticism (standardized coefficients = 0.45, p < 0.001). Mindfulness and obligatory exercise were correlated negatively (standardized coefficients = -0.31, p < 0.001), but there was no significant relation between competitive state anxiety and obligatory exercise (standardized coefficients = 0.05, p > 0.01). Self-criticism and competitive state anxiety mediated mindfulness's positive effects on obligatory exercise in part (standardized indirect effect = -0.16, p < 0.01), and this explanatory power was higher than in any previous study (R2 = 0.37). Conclusion: The irrational beliefs in Activating events-Beliefs-Consequence (ABC) theory play an important role in explaining athletes' obligatory exercise, and mindfulness has a positive effect on reducing obligatory exercise behavior.