Efficacy and Safety of Different Aerobic Exercise Intensities in Patients With Heart Failure With Reduced Ejection Fraction: Design of a Multicenter Randomized Controlled Trial (HF-EI Trial).

Background: Heart failure (HF) is one of the major causes of mortality worldwide, representing the terminal stage of several cardiovascular diseases. Exercise-based rehabilitation is a beneficial therapy for patients with chronic heart failure (CHF). However, there is a lack of specific guidance on clinical decision-making regarding optimal exercise intensity. It is necessary to optimize the clinical recommendations for HF exercises. We will evaluate the efficacy and safety of different aerobic exercise intensities in patients with heart failure with reduced ejection fraction (HFrEF): the HF-EI trial. This trial aims to assess the appropriate exercise intensity for patients with HFrEF. Methods: After a baseline assessment to determine the safety of exercise, 180 patients will be randomly assigned to supervised high-intensity exercise training (ET) group, supervised moderate intensity training (MIT) group, and control group at a ratio of 1:1:1. Patients randomly receiving high intensity training (HIT) undergo supervised ET (3 times/week, 30 min) for aerobic endurance at 70% peak oxygen consumption (peak VO2) intensity for 12 weeks. The MIT patients will perform supervised aerobic ET (3 times/week, 35-42 min) at the anaerobic threshold (AT) intensity for 12 weeks. The control group will continue to maintain their daily activities and will not receive ET. During the baseline and follow-up period, physical examination, laboratory tests, cardiology diagnostic tests, cardiopulmonary exercise tests (CPET), 6-min walk distance (6MWD), scale scores, exercise steps, medications, and clinical events will be monitored. Throughout the research, sport bracelets and patient diaries will be used to monitor and record overall physical activity, training courses, and compliance. Discussion: The HF-EI trial will evaluate the effects of different aerobic exercise intensities on peak VO2, quality of life (QoL), and clinical events among patients with HFrEF. The findings of this trial will provide a basis for formulating exercise prescriptions for patients with HFrEF. Clinical Trial Registration:http://www.chictr.org.cn/, identifier: ChiCTR2000036381.

Used disposable face masks are significant sources of microplastics to environment.

The consumption of disposable face masks increases greatly because of the outbreak of the COVID-19 pandemic. Inappropriate disposal of wasted face masks has already caused the pollution of the environment. As made from plastic nonwoven fabrics, disposable face masks could be a potential source of microplastics for the environment. In this study, we evaluated the ability of new and used disposable face masks of different types to release microplastics into the water. The microplastic release capacity of the used masks increased significantly from 183.00 ± 78.42 particles/piece for the new masks to 1246.62 ± 403.50 particles/piece. Most microplastics released from the face masks were medium size transparent polypropylene fibers originated from the nonwoven fabrics. The abrasion and aging during the using of face masks enhanced the releasing of microplastics since the increasing of medium size and blue microplastics. The face masks could also accumulate airborne microplastics during use. Our results indicated that used disposable masks without effective disposal could be a critical source of microplastics in the environment. The efficient allocation of mask resources and the proper disposal of wasted masks are not only beneficial to pandemic control but also to environmental safety.

Occurrence of microplastic in the water of different types of aquaculture ponds in an important lakeside freshwater aquaculture area of China.

Aquaculture ponds are exposed to numerous potential microplastic sources, but studies on their microplastic pollution are still limited. Various culture species may influence the occurrence of microplastic in ponds. In the present study, the occurrence of microplastics was studied in aquaculture ponds for fish, crayfish, and crab, as well as in the natural lake near the aquaculture area around the Honghu Lake, which is the principal freshwater aquaculture area of China. The microplastic abundances ranged from 87 items/m3 to 750 items/m3 in the aquaculture ponds, and 117 items/m3 to 533 items/m3 in the lake. The crab ponds contained higher abundances of microplastics than fish ponds and the nearby natural lakes. Microplastics that were between 100 and 500 µm and larger than 1000 µm in size were predominant in the ponds and nearby lakes, whereas the proportion of microplastics that were smaller than 100 µm was higher in crab ponds than those in other ponds. Fragments and fibers were the predominant shapes of microplastics in the ponds. The proportion of smaller microplastics in the ponds had a positive correlation with the proportion of fragment microplastics. The results of this study implied that differences in the use of plastics in various types of aquaculture ponds might affect their microplastic pollution characteristics. Microplastics discharged from ponds to nearby lakes through drainage processes require attention in further studies.

The effect of meditative movement on the quality of life in patients recovering from COVID-19: A protocol for systematic review and meta-analysis.

BACKGROUND: The outbreak of a novel coronavirus (2019-nCoV)-infected pneumonia is currently ongoing all over the world. The treatment scheme is generally isolation treatment and symptomatic support treatment. While the majority of patients recover from this disease through methods above, COVID-19 Infection severely affect the physical and mental health of rehabilitation patients, as well as their living quality. Thus, meditative movement is needed to improve outcome of COVID-19 patients in recovery period. METHODS: We will conduct systematic searches to identify all relevant studies without any language limitation from the following electronic databases from inception to October 2020: Medline, Ovid, PubMed, Embase, Cochrane Library, Google Scholar, China National Knowledge Infrastructure (CNKI), Chinese Scientific Journals Database (VIP), Chinese Biomedical Database, Chinese Biomedical Literature Service System and Wan fang Database. At the same time, we will search the following Clinical trial registries to identify records of on-going or completed but not yet published trials, including WHO International Clinical Trials Registry Platform (ICTRP), Trials Register of Promoting Health Interventions (TRoPHI) and Chinese Clinical Trial Registry (ChiCTR). No limits will be placed on language. The article will study the effect of meditative movement on the quality of life of convalescent patients. The main outcome will be the effect of meditative movement on the quality of life of patients in recovery period. The secondary results will select accompanying symptoms (including myalgia, cough, sputum, runny nose, pharyngalgia, anhelation, chest distress, nausea, vomiting, anorexia, diarrhea), disappearance rate, negative COVID-19 results rate on 2 consecutive occasions (not on the same day), the quality of life improved, CT image improvement, average hospitalization time, occurrence rate of common type to severe form, clinical cure rate, and mortality. Data collection and management 3 authors will independently carry out data from eligible studies in a pretested and standardized Microsoft Excel sheet, with reciprocal validation of data extraction results. Data analysis and quantitative data synthesis will be performed using RevMan software (V.5.3). RESULTS: The findings of the study will provide new and relatively high-quality evidence in meditative movement treatment for COVID-19. CONCLUSION: The conclusion of systematic review will provide evidence to judge whether meditative movement is an effective intervention for patient with COVID-19 in recovery period. PROSPERO REGISTRATION NUMBER: CRD42020210256.

Effects of microplastic biofilms on nutrient cycling in simulated freshwater systems.

Microplastic surfaces could be colonized by microorganisms and form biofilms in aquatic ecosystem, which can participate in the nitrogen (N) and phosphorus (P) cycles. In this work, polypropylene squares were deployed in a pond for 30 days for microplastic biofilms colonization and then were transported to indoor microcosms at an environmental relevant level to study their effects on N and P cycling. Results showed that microplastic biofilms could accelerate ammonia and nitrite oxidation as well as denitrification. Presence of microplastic biofilms accumulated P temporarily and increased alkaline phosphatase activities (APA) in the system. Later in the experiment, disintegration of matured biofilms released N and P into the water. Mass balance calculation suggested possible N input caused by biological nitrogen fixation. Our results demonstrated that microplastics associated biofilms have the ability to alter the N and P cycling processes in aquatic system. However, additional works are required to further quantify the extent of such impact.

Sinking of floating plastic debris caused by biofilm development in a freshwater lake.

Plastic pollution has been increasingly reported in both marine environment and inland waters, but their fate is not well understood. Several studies have showed that the surface of plastic debris can be colonized by microbes, leading to the sinking of floating plastic debris in marine environment. In this work, development of biofilm on polypropylene sheet (squares with a side length of 5 and 10 mm) and their buoyancy changes were studied in a freshwater lake in four seasons. Results showed that biofilm development have different growth rate and distinct algae composition in different seasons, which are mainly related to the difference in temperature, nutrient levels, and suspend solids in lake water. Biofilm development was much quicker on small plastics in all seasons. At the end of the experiment, all plastics lost buoyancy in summer while only a small portion lost buoyance in other seasons. Sinking of the floating plastics can be attributed to the development of biofilm and the trapped minerals. Our results demonstrated that biofilm development can cause the sinking of floating plastics in fresh lakes but the time required to lose buoyance can differ seasonally. Floating plastics will remain in water for a longer time in cold season but sink in a short time in warm season. Future research is required to determine the influence of plastic types and shapes, and quantitative relation between environmental variables and the sinking behavior of the fouled plastics should be established for a better prediction of their fate in the freshwater environment.

The hydro-fluctuation belt of the Three Gorges Reservoir: Source or sink of microplastics in the water?

Reservoirs can be an important environmental compartment for microplastic pollution. Previous investigations have found that surface waters and sediments in the Three Gorges Reservoir (TGR) have had high microplastic abundance, and the Xiangxi River, which is one of the largest primary tributaries of the TGR, has had much higher microplastic abundance than several marine and freshwater systems in China. A strip of land on the bank of the reservoir area, which is called the hydro-fluctuation belt (HFB), is periodically exposed due to the special hydrodynamic conditions in the TGR. The HFB may be an important source and/or sink of microplastics in TGR. In this study, microplastic occurrence in sediments from the Xiangxi River HFB was investigated to reflect the local microplastic pollution status and to evaluate its potential to serve as a source/sink of microplastics in the TGR. Seven sampling sites were selected, and sediments within the HFB and above the belt were collected in summer when the water level was low. The results showed that the microplastic abundance ranged from 0.55 ±â€¯0.12 × 103 to 14.58 ±â€¯5.67 × 103 particles m-2, which was one to two orders of magnitude higher than that in sediments from the Xiangxi River in our previous study (80-846 particles m-2). Statistical analysis revealed that the microplastic abundance within the HFB was significantly higher than that of the area above the HFB. The results indicate that the HFB can be an important microplastic sink when the water level is low, and the belt can turn into a potential source when the water level is high. Cluster analysis was applied to reveal the characteristics of the microplastics collected at different sites, and the results suggest that the cluster analysis may be a useful tool in elucidating the source and fate of microplastics.

Ingestion and egestion of polyethylene microplastics by goldfish (Carassius auratus): influence of color and morphological features.

It is vital to understand processes of microplastic ingestion and egestion by aquatic organisms in order to evaluate the potential effects and impacts of microplastics in aquatic ecosystems. In this study, goldfish (Carassius auratus) was used to investigate ingestion and egestion of polyethylene (PE) microplastics and how these processes were affected by size, color, and shape of microplastics. Results showed that goldfish ingested white PE microplastics only in the presence of fish feed and that microplastics larger than 2 mm were rejected even after being ingested. However, in the presence of food, more green and black microplastics were ingested compared with red, blue, and white microplastics while significantly higher amounts of microplastic films were ingested compared with fragments and filaments. Microplastics ingested by goldfish were egested within 72 h. However, the egestion rate of filaments was the lowest among all tested microplastic shapes. The presence of food appeared to reduce film and filament residues in fish after 72 h. Results of this study imply that different features of microplastics result in different exposure risks for fish. Thus, the specific features of microplastics (e.g. their shape, color, and size) should be considered in future ecotoxicological studies.

Microplastics in the intestinal tracts of East Asian finless porpoises (Neophocaena asiaeorientalis sunameri) from Yellow Sea and Bohai Sea of China.

The direct evidences for the ingestion of microplastics by cetaceans, especially the cetaceans in Asian marine areas are limited. In this study, residue of microplastics in the intestinal tracts of East Asian finless porpoises (Neophocaena asiaeorientalis sunameri) was investigated. Microplastics were detected in all specimens, with mean abundance of 19.1 ±â€¯7.2 items/individual. With respect to microplastics properties, fibers, blue items, and polypropylene were predominant in shapes, colors, and plastic materials, respectively. Trophic transfer and unintentional ingestion might be the potential pathways for microplastics ingested by finless porpoise. The specific intestinal structure might account for the predominance of fibers and the accumulation of microplastics at the beginning portion of intestines. This study indicates that cetaceans in Chinese marine areas also suffer from microplastics pollution. Further studies on the fate and ecological effects of microplastics should be conducted to reveal their potential risks to cetaceans.

Sources and distribution of microplastics in China's largest inland lake - Qinghai Lake.

Microplastic pollution was studied in China's largest inland lake - Qinghai Lake in this work. Microplastics were detected with abundance varies from 0.05 × 105 to 7.58 × 105 items km-2 in the lake surface water, 0.03 × 105 to 0.31 × 105 items km-2 in the inflowing rivers, 50 to 1292 items m-2 in the lakeshore sediment, and 2 to 15 items per individual in the fish samples, respectively. Small microplastics (0.1-0.5 mm) dominated in the lake surface water while large microplastics (1-5 mm) are more abundant in the river samples. Microplastics were predominantly in sheet and fiber shapes in the lake and river water samples but were more diverse in the lakeshore sediment samples. Polymer types of microplastics were mainly polyethylene (PE) and polypropylene (PP) as identified using Raman Spectroscopy. Spatially, microplastic abundance was the highest in the central part of the lake, likely due to the transport of lake current. Based on the higher abundance of microplastics near the tourist access points, plastic wastes from tourism are considered as an important source of microplastics in Qinghai Lake. As an important area for wildlife conservation, better waste management practice should be implemented, and waste disposal and recycling infrastructures should be improved for the protection of Qinghai Lake.

Dual Function Behavior of Carbon Fiber-Reinforced Polymer in Simulated Pore Solution.

The mechanical and electrochemical performance of carbon fiber-reinforced polymer (CFRP) were investigated regarding a novel improvement in the load-carrying capacity and durability of reinforced concrete structures by adopting CFRP as both a structural strengthener and an anode of the impressed current cathodic protection (ICCP) system. The mechanical and anode performance of CFRP were investigated in an aqueous pore solution in which the electrolytes were available to the anode in a cured concrete structure. Accelerated polarization tests were designed with different test durations and various levels of applied currents in accordance with the international standard. The CFRP specimens were mechanically characterized after polarization. The measured feeding voltage and potential during the test period indicates CFRP have stable anode performance in a simulated pore solution. Two failure modes were observed through tensile testing. The tensile properties of the post-polarization CFRP specimens declined with an increased charge density. The CFRP demonstrated success as a structural strengthener and ICCP anode. We propose a mathematic model predicting the tensile strengths of CFRP with varied impressed charge densities.

[Prevention of hospital-acquired pneumonia with Yupingfeng Powder in patients with acute cerebral vascular diseases: a randomized controlled trial].

BACKGROUND: An increase in the incidence rate of hospital-acquired pneumonia (HAP) has a direct influence on prognosis and survival of patients with acute cerebral vascular diseases (ACVD), and how to prevent HAP is a growing concern to clinicians. OBJECTIVE: To study the efficacy of Yupingfeng Powder, a compound traditional Chinese herbal medicine, in preventing HAP in patients with ACVD. DESIGN, SETTING, PARTICIPANTS AND INTERVENTIONS: Sixty ACVD patients with lung qi deficiency syndrome without concurrent infections were randomly divided into prevention group (28 cases) and control group (32 cases). The 60 cases were all from Shanghai Yueyang Hospital of Integrated Traditional Chinese and Western Medicine. Tough measures were taken to prevent cross-infection based on treatment of the primary diseases, well nutrition and support therapy. Yupingfeng Powder was used in the prevention group to prevent HAP. The patients were treated for 10 days. MAIN OUTCOME MEASURES: The clinical symptoms, physical signs, body temperature, and chest X-ray were observed. The changes of blood immunoglobulin A (IgA), immunoglobulin G (IgG), immunoglobulin M (IgM) and interleukin-6 (IL-6) were detected before and after treatment. RESULTS: The total response rate in the prevention group was higher than that in the control group (P<0.05), and the total response rates were 78.57% (22/28) and 31.25% (10/32) respectively. The incidence rate of HAP in the prevention group was lower than that in the control group. There were no significant differences in white blood cell count, neutrophilic granulocyte count, and the levels of IgA, IgG, IgM and IL-6 between the two groups before treatment. The white blood cell count and neutrophilic granulocyte count in the control group increased after treatment, and there was a significant difference between the two groups (P<0.05). There was no significant difference in IgA level in the two groups after treatment, and the IgM levels in the two groups were higher than those before treatment (P<0.05), however there was no significant difference in IgM level between the two groups. In the prevention group, there were significant differences in values of IgG and IL-6 between before and after treatment (P<0.01), and after treatment there were differences in values of IgG and IL-6 between the two groups (P<0.05). CONCLUSION: Yupingfeng Powder has a good clinical effect in prevention of HAP in patients with ACVD, and it can improve the immunological function and relieve the lung qi deficiency symptoms. So the prevention effect of Yupingfeng Powder on HAP is worth being further investigated.

[Color Doppler ultrasound evaluation of a Chinese herbal formula in treating lower limb arteriosclerosis: a randomized controlled trial].

OBJECTIVE: To observe the effects of a Chinese compound herbal medicine for reinforcing qi, activating blood circulation, expelling phlegm and dredging collaterals in treatment of lower limb arteriosclerosis. METHODS: The outpatients and inpatients with lower limb arteriosclerosis from Shanghai Yueyang Hospital of Integrated Traditional Chinese and Western Medicine were randomly divided into control group and treatment group after color Doppler ultrasound inspection, and there were 30 cases in each group. The patients in the treatment group were treated with simvastatin and a Chinese compound herbal medicine for reinforcing qi, activating blood circulation, expelling phlegm and dredging collaterals, and the patients in the control group were treated only with simvastatin. The color Doppler ultrasound imaging of lower limb arteries including inside diameter, intima-media thickness, and plaque area in all the patients were examined after 6-month treatment. The levels of serum total cholesterol (TC) and low-density lipoprotein (LDL) were detected too. RESULTS: After the treatment, the lower limb artery intima-media thickness and artery plaque area in the treatment group decreased obviously as compared with those in the control group (P < 0.05). Color Doppler flow imaging showed that the percentage of patients with uniphase wave decreased from 26.67% (8/30) to 6.67% (2/30) in the treatment group (P < 0.05), and from 26.67% (8/30) to 16.67% (5/30) in the control group (P < 0.05) as compared with those before the treatment, and there was also a significant difference between the two groups (P < 0.05). The concentrations of serum TC and LDL in the treatment group were lower than those in the control group (P < 0.05). CONCLUSION: Color Doppler ultrasound showed that the Chinese compound medicine for reinforcing qi, activating blood circulation, expelling phlegm and dredging collaterals has positive effects on lower limb arteriosclerosis.

Efficacy and safety of benidipine therapy of essential hypertension in elderly Chinese patients.

BACKGROUND: Benidipine (CAS 105979-17-7) is a dihydropyridine calcium channel blocker used in the treatment of hypertension and angina pectoris. OBJECTIVE: To examine the efficacy and safety of therapy with benidipine in elderly hypertensive patients. METHODS: Chinese patients >60 years of age with mild to moderate essential hypertension were enrolled. The patients were prescribed benidipine at the dose of 8 mg once daily for 12 weeks. Detailed laboratory examinations and 24-h ambulatory blood pressure monitoring were performed before and after the treatment. RESULTS: One hundred and sixty-four of the 180 patients enrolled completed the 12-week active treatment phase. Sitting systolic blood pressure (SBP) and diastolic blood pressure (DBP) reductions at the end of treatment were 21.50 +/- 12.83 and 10.60 +/- 8.04 mmHg, respectively; the proportion of patients showing a good treatment response was 95.1% for SBP and 96.9% for DBP. Benidipine significantly reduced the mean 24-h ambulatory blood pressure (p < 0.001 vs. baseline) exhibiting smooth, sustained effects and high trough-to-peak ratios (T/P ratio) (0.87 for SBP and 0.72 for DBP). Moreover, benidIpine significantly reduced the systolic morning blood pressure surge and urinary albumin, and it was well tolerated. No serious adverse events were noted. CONCLUSION: Benidipine was welltolerated and effective in elderly Chinese patients with essential hypertension.

Ring-like pore structures of SecA: implication for bacterial protein-conducting channels.

SecA, an essential component of the general protein secretion pathway of bacteria, is present in Escherichia coli as soluble and membrane-integral forms. Here we show by electron microscopy that SecA assumes two characteristic forms in the presence of phospholipid monolayers: dumbbell-shaped elongated structures and ring-like pore structures. The ring-like pore structures with diameters of 8 nm and holes of 2 nm are found only in the presence of anionic phospholipids. These ring-like pore structures with larger 3- to 6-nm holes (without staining) were also observed by atomic force microscopic examination. They do not form in solution or in the presence of uncharged phosphatidylcholine. These ring-like phospholipid-induced pore-structures may form the core of bacterial protein-conducting channels through bacterial membranes.