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Dyskalemia are associated with an increased risk of mortality in patients undergoing maintenance hemodialysis (MHD). However, studies evaluating the impact of serum potassium variability on mortality in MHD patients are scarce. To investigate serum potassium variability and its association with prognosis in MHD patients, we conducted a retrospective study on maintenance hemodialysis patients from three campus of Renji Hospital between June 2018 and December 2022. The exposure of interest was serum potassium variability defined as the coefficient of variation of serum potassium levels (CVSP). Cox regression models and Kaplan-Meier survival analysis were used to assess the prognostic significance of serum potassium variability. In a subgroup analysis, the association between serum potassium variability and prognosis was investigated in patients within normal serum potassium concentration range. Total of 588 maintenance hemodialysis patients were included. During a median follow-up of 45 months (24, 54), 121 patients (20.6%) died. The survival analysis suggested significantly higher survival rates for both all-cause ( p  < 0.01) and cardiovascular ( p  < 0.01) death in patients in the highest group of CVSP (H-CVSP) compared with those in the the lowest group (L-CVSP). After adjustment, the all-cause mortality hazard ratio compared to L-CVSP was 2.17 [95% confidence interval (CI) 1.18, 3.97] for H-CVSP ( p  < 0.05) and was 2.53 [95%CI 1.03, 6.22] for cardiovascular mortality ( p  < 0.05). In the subgroup analysis, 493 patients (83.8%) presented normokalemia (the mean of serum potassium levels ≥ 3.5mmol/L and ≤ 5.0mmol/L) were included. Similar association was found between serum potassium variability and accumulated survival rates, and higher serum potassium variablity was remained an independent risk factor for cardiovascular mortality (2.69, 95% CI 1.07–6.78, p  < 0.05) in patients within normal serum potassium concentration range. In conclusion, a higher serum potassium variability was associated with all-cause and cardiovascular mortality in maintenance haemodialysis patients, even in the normal range.

Background After coronary artery bypass grafting (CABG), maintaining serum potassium at the upper normal limit lacks clear evidence for its impact on clinical outcomes. Also, potassium variability might signal poor prognosis. This retrospective study aimed to assess how postoperative serum potassium levels and variability affect 1-year mortality rate in CABG patients. Methods This retrospective study was based on data from the Medical Information Mart for Intensive Care IV (MIMIC-IV) database. We analyzed the relationships between the average value, coefficient of variation (CV), and change trajectory of postoperative serum potassium levels and 1-year mortality rate, using logistic regression as the primary analytical method. Results A total of 50,903 potassium measurements, all collected during the postoperative ICU stay, from 4,606 patients were analyzed in this study. The patients whose average serum potassium level was maintained at 3.5-4 mmol/L had the lowest mortality rate of 1.33% ( p  = 0.004) and pointed a significant inflection point at 3.85mmo/L. The CV in deceased patients was greater than that in surviving patients ( p  < 0.001). Patients with CV < 5% exhibited a mortality rate of 1.36%. After adjustment for age, sex and comorbidities, those with CV > 20% had significantly higher mortality (11.63%; adjusted OR = 4.72, 95% CI: 1.32–15.17, p  = 0.011). In addition, the patients with highly fluctuating potassium change trajectories had the highest 1-year mortality rate of 19.72%. Moreover, the shorter the time to the stability of the serum potassium level, the lower the mortality rate. Conclusions In this retrospective cohort of patients who underwent CABG, those with a mean potassium level between 3.5 and 4.0 mmol/l or minimal potassium variability correlated with the lowest observed 1-year mortality risk. Higher levels above 3.85 mmol/L correlated with increased mortality; mild hypokalemia risk remained inconclusive.

BackgroundHyperkalemia and hypokalemia are associated with mortality in patients undergoing hemodialysis. However, there are few reports on the association between potassium level fluctuations and mortality. We retrospectively investigated the association between serum potassium level variability and mortality in patients undergoing hemodialysis.MethodsThis study was conducted at a single center. Variability in serum potassium levels was evaluated using the standard deviation of potassium level from July 2011 to June 2012, and its association with prognosis was examined by following up the patients for 5 years. Serum potassium variability was assessed as the coefficient of variation, and the statistical analysis was performed after log transformation.ResultsAmong 302 patients (mean age 64.9 ± 13.3; 57.9% male; and median dialysis vintage 70.5 months [interquartile range, IQR 34–138.3]), 135 died during the observation period (median observation period 5.0 years [2.3–5.0]). Although the mean potassium level was not associated with prognosis, serum potassium level variability was associated with prognosis, even after adjustments for confounding factors such as age and dialysis time (hazard ratio: 6.93, 95% confidence interval [Cl] 1.98–25.00, p = 0.001). After the adjustments, the coefficient of variation of potassium level in the highest tertile (T3) showed a higher relative risk for prognosis than that in T1 (relative risk: 1.98, 95% CI 1.19–3.29, p = 0.01).ConclusionsVariability in serum potassium levels was associated with mortality in patients undergoing hemodialysis. Careful monitoring of potassium levels and their fluctuations is necessary for this patient population.

Serum potassium (K+) levels between 3.5 and 5.0 mmol/L are considered safe for patients. The optimal serum K+ level for critically ill patients with acute kidney injury undergoing continuous renal replacement therapy (CRRT) remains unclear. This retrospective study investigated the association between ICU mortality and K+ levels and their variability. Patients aged >20 years with a minimum of two serum K+ levels recorded during CRRT who were admitted to the ICU in a tertiary hospital in central Taiwan between January 01, 2010, and April 30, 2021 were eligible for inclusion. Patients were categorized into different groups based on their mean K+ levels: <3.0, 3.0 to <3.5, 3.5 to <4.0, 4.0 to <4.5, 4.5 to <5.0, and ≥5.0 mmol/L; K+ variability was divided by the quartiles of the average real variation. We analyzed the association between the particular groups and in-hospital mortality by using Cox proportional hazard models. We studied 1991 CRRT patients with 9891 serum K+ values recorded within 24 h after the initiation of CRRT. A J-shaped association was observed between serum K+ levels and mortality, and the lowest mortality was observed in the patients with mean K+ levels between 3.0 and 4.0 mmol/L. The risk of in-hospital death was significantly increased in those with the highest variability (HR and 95% CI = 1.61 [1.13–2.29] for 72 h mortality; 1.39 [1.06–1.82] for 28-day mortality; 1.43 [1.11–1.83] for 90-day mortality, and 1.31 [1.03–1.65] for in-hospital mortality, respectively). Patients receiving CRRT may benefit from a lower serum K+ level and its tighter control. During CRRT, progressively increased mortality was noted in the patients with increasing K+ variability. Thus, the careful and timely correction of dyskalemia among these patients is crucial.

Potassium (K) deficiency has emerged as a critical constraint for sustainable apple production in highland regions, yet spatial variability of soil K status and site-specific fertilization responses remain poorly characterized. A survey-based study was initiated where soil samples (0–15 and 15–30 cm) were collected from 60 representative apple orchards to analyze various K fractions. Additionally, Geostatistical analysis using semi-variogram modeling in GIS was also used to map the spatial distribution of K, and then a field trial was conducted in orchards with low, medium, and adequate initial K status to assess the impact of variable doses of K 2 SO 4 on apple fruit quality and yield attributes. Spatial analysis of the experimental site revealed that surface soil contained higher plant-available K fractions, while substantial reserves of non-exchangeable K (1500–3800 mg kg⁻¹) remained locked in mineral forms. Spatial analysis also showed that orchards of the central Swat valley had 20% lower extractable K compared to peripheral areas. Based on extractable K status, orchards were classified into deficient, medium, and adequate categories for targeted fertilization trials. Application of 300 g K 2 SO 4 plant − 1 enhanced fruit yield, firmness, total sugars, and vitamin C content up to 45, 39, 37.98, and 23.57%, respectively, under K-deficient conditions, compared to the unamended control group. Strong positive correlations ( p  < 0.05) were observed between K application rates and apple fruit quality attributes. Overall, these findings provide evidence-based K status of Swat orchards and also highlight the significance of precision K management in enhancing apple productivity and quality attributes in the temperate highland apple-grown areas of Pakistan.

Potassium ion disorders are prevalent among patients in Intensive Care Units (ICUs), yet there is a notable deficiency in established protocols and supplemental plans for potassium management. This retrospective study conducted at a single center aims to explore the relationship between potassium levels, their variability, and the 28-day mortality rate in ICU patients. This study analyzed data from patients admitted to the ICU of the First Affiliated Hospital of Guangxi Medical University between October 2022 and October 2023. We assessed serum potassium variability using the coefficient of variation and categorized it into four quartile groups (Q1, Q2, Q3, Q4). Additionally, patients were classified into six groups based on serum potassium concentrations. The associations between these categories and the 28-day mortality rate were evaluated using binary logistic regression, adjusting for potential confounders. A total of 506 patients and 12,099 potassium measurements were analyzed. The group with the lowest potassium variability (Q1) exhibited the lowest mortality rate at 21% (P<0.01). It is noteworthy that within 28 days in the intensive care unit (ICU), the coefficient of variation (CV) of potassium levels significantly increased among deceased patients compared to surviving patients (P < 0.01). Significant variability in potassium levels is associated with an increased risk of 28-day mortality among ICU patients, underscoring the need for stringent monitoring and management of potassium levels in this population.

Improper use of water resources in irrigation that contain a significant amount of salts, faulty agronomic practices such as improper fertilization, climate change etc. are gradually increasing soil salinity of arable lands across the globe. It is one of the major abiotic factors that inhibits overall plant growth through ionic imbalance, osmotic stress, oxidative stress, and reduced nutrient uptake. Plants have evolved with several adaptation strategies at morphological and molecular levels to withstand salinity stress. Among various approaches, harnessing the crop genetic variability across different genepools and developing salinity tolerant crop plants offer the most sustainable way of salt stress mitigation. Some important major genetic determinants controlling salinity tolerance have been uncovered using classical genetic approaches. However, its complex inheritance pattern makes breeding for salinity tolerance challenging. Subsequently, advances in sequence based breeding approaches and functional genomics have greatly assisted in underpinning novel genetic variants controlling salinity tolerance in plants at the whole genome level. This current review aims to shed light on physiological, biochemical, and molecular responses under salt stress, defense mechanisms of plants, underlying genetics of salt tolerance through bi-parental QTL mapping and Genome Wide Association Studies, and implication of Genomic Selection to breed salt tolerant lines.

Potassium (K) is essential for winter wheat growth, yield formation, and grain quality; however, it is commonly applied as a single basal dose in the Huang-Huai-Hai region despite large spatial variability in soil K availability, leading to inefficient utilization. This study aimed to evaluate K application strategies across contrasting regions and identify an optimal, site-specific K management approach. Field experiments were conducted during 2021-2022 and 2022-2023 at three sites with contrasting soil K levels. A two-factor randomized block design with three replicates was used, including two K rates (K1: 120 and K2: 60kg K O ha ) and five application methods: no K (T1), single basal (T2), two-split (T3: 50% basal + 50% jointing), three-split (T4: 20% basal + 30% jointing + 50% anthesis), and single controlled-release basal (T5). The strong-gluten winter wheat cultivar 'Weilong 169' was used. Basal and controlled-release treatments (T2 and T5) increased the available K in the 0-60-cm soil layer during early growth, while split application (T3 and T4) improved the K availability in the surface layer (0-30 cm) during later stages. The three-split application (T4) consistently improved K accumulation, 1, 000-grain weight, and grain yield across all sites. In high-K soils, single basal application showed no significant yield advantage, underscoring the importance of application timing. Split K application, particularly T4, also improved the grain quality traits, including protein content, wet gluten content, sedimentation value, and dough rheological properties. These improvements were associated with enhanced post-anthesis K uptake and KUE. Optimizing K application timing through split fertilization improves K utilization, yield, and grain quality. A site-specific strategy is recommended: 120kg K O ha applied in a 2:3:5 ratio (sowing/jointing/anthesis) for K-deficient eastern regions and K O ha with the same split ratio for high-K western regions. This approach provides a sustainable and efficient fertilization strategy for winter wheat production in the Huang-Huai-Hai region.

This paper presents a review on the rock associations, geochemistry, and spatial distribution of Mesozoic-Paleogene igneous rocks in Northeast Asia. The record of magmatism is used to evaluate the spatial-temporal extent and influence of multiple tectonic regimes during the Mesozoic, as well as the onset and history of Paleo-Pacific slab subduction beneath Eurasian continent. Mesozoic-Paleogene magmatism at the continental margin of Northeast Asia can be subdivided into nine stages that took place in the Early-Middle Triassic, Late Triassic, Early Jurassic, Middle Jurassic, Late Jurassic, early Early Cretaceous, late Early Cretaceous, Late Cretaceous, and Paleogene, respectively. The Triassic magmatism is mainly composed of adakitic rocks, bimodal rocks, alkaline igneous rocks, and A-type granites and rhyolites that formed in syn-collisional to post-collisional extensional settings related to the final closure of the Paleo-Asian Ocean. However, Triassic calc-alkaline igneous rocks in the Erguna-Xing’an massifs were associated with the southward subduction of the Mongol-Okhotsk oceanic slab. A passive continental margin setting existed in Northeast Asia during the Triassic. Early Jurassic calc-alkaline igneous rocks have a geochemical affinity to arc-like magmatism, whereas coeval intracontinental magmatism is composed of bimodal igneous rocks and A-type granites. Spatial variations in the potassium contents of Early Jurassic igneous rocks from the continental margin to intracontinental region, together with the presence of an Early Jurassic accretionary complex, reveal that the onset of the Paleo- Pacific slab subduction beneath Eurasian continent occurred in the Early Jurassic. Middle Jurassic to early Early Cretaceous magmatism did not take place at the continental margin of Northeast Asia. This observation, combined with the occurrence of low-altitude biological assemblages and the age population of detrital zircons in an Early Cretaceous accretionary complex, indicates that a strike-slip tectonic regime existed between the continental margin and Paleo-Pacific slab during the Middle Jurassic to early Early Cretaceous. The widespread occurrence of late Early Cretaceous calc-alkaline igneous rocks, I-type granites, and adakitic rocks suggests low-angle subduction of the Paleo-Pacific slab beneath Eurasian continent at this time. The eastward narrowing of the distribution of igneous rocks from the Late Cretaceous to Paleogene, and the change from an intracontinental to continental margin setting, suggest the eastward movement of Eurasian continent and rollback of the Paleo- Pacific slab at this time.

Sepsis has emerged as a global health burden associated with multiple organ dysfunction and 20% mortality rate in patients. Numerous clinical studies over the past two decades have correlated the disease severity and mortality in septic patients with impaired heart rate variability (HRV), as a consequence of impaired chronotropic response of sinoatrial node (SAN) pacemaker activity to vagal/parasympathetic stimulation. However, the molecular mechanism(s) downstream to parasympathetic inputs have not been investigated yet in sepsis, particularly in the SAN. Based on electrocardiography, fluorescence Ca2+ imaging, electrophysiology, and protein assays from organ to subcellular level, we report that impaired muscarinic receptor subtype 2-G protein-activated inwardly-rectifying potassium channel (M2R-GIRK) signaling in a lipopolysaccharide-induced proxy septic mouse model plays a critical role in SAN pacemaking and HRV. The parasympathetic responses to a muscarinic agonist, namely I KACh activation in SAN cells, reduction in Ca2+ mobilization of SAN tissues, lowering of heart rate and increase in HRV, were profoundly attenuated upon lipopolysaccharide-induced sepsis. These functional alterations manifested as a direct consequence of reduced expression of key ion-channel components (GIRK1, GIRK4, and M2R) in the mouse SAN tissues and cells, which was further evident in the human right atrial appendages of septic patients and likely not mediated by the common proinflammatory cytokines elevated in sepsis.