INTRODUCTION

Cardiovascular diseases (CVDs) remain the main cause of death in the world with about 17.5 million deaths[1].Over the past few years, more and more people in the world develop CVDs; the American Heart Association(AHA) estimated that one in three Americans has a cardiac pathology[2]. As a matter of fact, in 2014, Nichols et al[3] observe that almost half of the deaths in Europe are attributable to CVDs, touching approximately 1.9 million men and 2.2 million women.

The development of different risk factors[4] (i.e.,abdominal obesity, depression, diabetes, dyslipidemia,hypertension, obesity, overweight, smoking) and physical inactivity promote CVDs. Physical inactivity,which is the fourth cardiovascular risk factor, has deleterious effects on general and cardiovascular health[5]. It is responsible for 5.3 million deaths[6]and it may be responsible for 12% of the risk factors of CVDs[7]. CVDs are usually associated with a high level of risk factors[8]. Thus, the practice of physical activities allows to decrease the risk of CVDs[9] and has a protective role against metabolic risk factors[10]. In point of fact, non limited to CVDs, physical activity can be considered a non-pharmacologic treatment both in human for other diseases such as musculoskeletal diseases[11,12] and immunology diseases[13,14].

Cardiac rehabilitation vs a conventional therapy[15]induces a reduction of 20% to 32% of all-cause mortality[16]. The goal of cardiac rehabilitation for CVDs is to improve their physical fitness[17] and to reduce CVDs in accordance with current guidelines[18]. We know that the level of physical fitness has an impact on mortality[19] and that the practice of physical activity has benefits on the risk factors after cardiovascular rehabilitation programs[16]. However, we do not know the preventive action of physical fitness on the risk factors in patients who have developed CVDs.

Consequently, the aims of this work are, on the one hand, to observe the distribution of risk factors according to physical fitness and, on the other hand, to study the impact of physical fitness on the preventive fraction of the risk factors in a population of cardiac subjects. We hypothesize that a normal physical fitness level in CVD patients is enough to induce a preventive action on cardiovascular risk factors.

MATERIALS AND METHODS

Study population

In this retrospective epidemiological study, all data were collected in May, 2008 from subjects with CVDs admitted in a cardiac rehabilitation center. Inclusion criteria were participants with coronary, infarct, heart failure or valvulopathy, and the exclusion criteria were participants under 18 years old and with lung disease as primary pathologies. Informed consent was obtained from all participants, and this investigation was conducted in accordance to the World Medical Association Declaration of Helsinki, and depended on country rules (law n°2004-806; August 9, 2004).

Assessment of the physical fitness

37 Lee DC, Sui X, Church TS, Lavie CJ, Jackson AS, Blair SN.Changes in fitness and fatness on the development of cardiovascular disease risk factors hypertension, metabolic syndrome, and hypercholesterolemia. J Am Coll Cardiol 2012; 59: 665-672 [PMID:22322083 DOI: 10.1016/j.jacc.2011.11.013]

Assessment of the risk factors

Cardiovascular risk factors were defined by the following standards[23,24] at the time of the study and were analysed from recent medical records (less than 2 mo) of patients or evaluated at the entrance on the program. Abdominal obesity was defined if the values of the abdominal circumference were ≥ 102 cm for the male and ≥ 88 cm for the female. Diabetes was defined if a subject had a high fasting glucose (＞ 126 mg/dL or ＞ 7.0 mmol/L), a high non-fasting glucose(＞ 198 mg/dL or ＞ 11.0 mmol/L), a high glycated hemoglobin (HbA1C ＞ 7%), a diagnosis of diabetes by a physician, a self-reported use of oral hypoglycemic treatment or insulin. Dyslipidemia was defined if a subject had a high total serum cholesterol level (＞ 250 mg/dL or ＞ 6.5 mmol/L), a high LDL-cholesterol (＞155 mg/dL or ＞ 4.0 mmol/L), a low HDL-cholesterol(for the male: ＜ 40 mg/dL or ＜ 1.0 mmol/L and for the female: ＜ 48 mg/dL or ＜ 1.2 mmol/L), a selfreported use of a treatment for abnormally high levels of cholesterol or a diagnosis of dyslipidemia by the physician. Hypertension was defined if a subject had a high blood pressure (≥ 140/90 mmHg at rest), a self-reported use of treatment for hypertension, or a diagnosis of hypertension by the physician. Overweight was defined if the subject had a body mass index(BMI) between 25 and 30 and obesity was defined if the subject had a BMI upper than 30. Depression was defined by a self-reported use of a treatment or diagnosis of depression by a physician. The risk factor associated with smoking was allocated into two categories. Participants classified as “smokers” had the characteristic of being active smokers, having an almost daily consumption or consuming a cigarette for the last time in the six months before the testing procedure. Participants “non-smokers” had the characteristic of never having smoked or the cessation of cigarette smoking more than six months before the testing procedure.

Preventive fraction

The preventive fraction is a ratio used in epidemiological studies to assess the impact of an exposure factor (physical activity) on a disease (risk factors)[25,26].Assuming that the exposure factor (physical activity) is represented by its consequence (physical fitness)[27]. It is an important evaluation tool, which allows knowing the preventive action of the physical fitness levels on the risk factors studied. The PF is derived from odds ratio (OR), indeed, the OR is a measure of association between the physical fitness level and the risk factors.Thus, the preventive fraction can be calculated when OR is under one, as PF = (1-OR). It can then be expressed in percentage with the following equation:PF (%) = (1-OR) × 100. This provides a percentage of risk factors reduction in the exposed group that can be attributed to the beneficial exposure of physical fitness level of the subjects[25].

Statistical analysis

The final data analysis has allowed to obtaining, for each subject, a physical fitness levels in the aim to normalize the data and to obtain a classification by physical fitness levels (i.e., high, normal, low and poor). The higher the percentage was, the higher the physical fitness level was, and inversely. We considered the subjects with a normal physical fitness as being physically active before their CVDs and conversely for the subjects with a poor physical fitness[28].

Statistical analysis was performed using R (R Foundation for Statistical Computing, Vienna, Austria).Quantitative variables were represented by their mean and median and their dispersion was evaluated by the standard deviation. Qualitative variables were represented by their frequency. To compare two means, a two-tailed Student t-test was performed with a significance level of 5%. Comparisons of two percentages were performed through a χ2 test with a threshold at 5%. The Fisher exact test (performed using univariate analysis) was used when the conditions for applying the χ2 test were not met. We carried an analysis of variance (ANOVA) at one factor,for the multiple comparisons of the means. The χ2 tests were applied to contingency tables, comparing multiple categorical variables. The α risk was controlled by Holm method in the analysis of variance and by the Tukey’s HSD for the χ2 tests. The OR, related to the risk factors, were obtained using the logistic regression. The selection of logistic regression models was made by minimizing the Akaike criterion. The PF was obtained from the OR when OR ＜ 1.

RESULTS

Characteristics of all participants (n = 249) are shown in Table 1. In each model, the subjects were divided into two groups (Table 2) according to their physical fitness level. This distribution allowed to assigning the subjects in the modela, from group 1 with a normal physical fitness level (≥ 80% predicted V·O2peak) to group 2 with a poor physical fitness level (＜ 80% predicted V·O2peak). In the modelb, the subjects were assigned to a group 1 with the high physical fitness level (≥100% predicted V·O2peak) to group 2 with the low physical fitness level (＜ 100% predicted V·O2peak). We observed in Figure 1 that subjects with a high physical fitness level were less exposed to different risk factors,compared to those with a low physical fitness level.According to our study design we observed (Table 2)that the V·O2peak during exercise stress test of the subjects, in the modela and modelb, was higher for subjects in group 1 than in group 2. The V·O2peak in the group 1b was higher than the one in the group 1a during exercise stress test because, only the subjects which had the highest physical fitness were assigned to the group 1b. In Group 1a, the subjects had a V·O2peak during exercise stress test (23.6 ± 5.1 mL·kg-1·min-1)similar to the V·O2peak predicted (23.4 ± 4.7 mL·kg-1·min-1), whereas in group 1b, the V·O2peak during exercise stress test (25.5 ± 5.5 mL·kg-1·min-1) is much higher than the V·O2peak predicted (22.4 ± 4.6 mL·kg-1·min-1). In group 2a and group 2b, V·O2peak during exercise stress test (20.0 ± 3.5 mL·kg-1·min-1 and 20.9 ± 4.0mL·kg-1·min-1, respectively) were lower than V·O2peak predicted (27.8 ± 4.6 mL·kg-1·min-1 and 26.2 ± 4.9 mL·kg-1·min-1, respectively).

以上三种两线划定模式均需要进行生态适宜性分析，结合不同城市的发展特征进行建设用地适宜性评价，进而确定城市开发边界。生态控制是针对生态用地的特点促进生态用地功能化，由山体、水体、林地、成片的基本农田和各类保护区等组成的城市生态用地不仅是确保区域生态安全的支撑，同时还具有农业生产、基础设施承载、旅游休闲和文化景观等多种价值，体现在生态、经济和社会服务等多个方面。城市基本生态控制区绝大部分为乡村地区，在保护性利用功能选择上，既要适合其在生态系统中的角色和地位，又要与城市的功能互补。

DISCUSSION

Our main results validate the hypothesis whereby a normal physical fitness level provides a preventive action on cardiovascular risk factors despite people having already developed a CVD. The findings add new insights with previously published reports[29] and allow the identification of a prophylactic effect of the physical fitness on cardiovascular risk factors studied despite presenting the diagnosis of heart disease.

The presence of risk factors for the patient does not necessarily imply a direct relationship between cause and effect because some people could have a CVD inheritance. Moreover, it is not necessary to have risk factors to develop a CVD, the genetic heritage of the person might be the cause[30]. The overall percentage of the risk factors prevalence seems to be higher in our population compared to previous studies, nevertheless,it follows the trend according to the exposure of patients to differents cardiovascular risk factors[31,32].Several epidemiological studies demonstrated that low physical activity levels are associated with a higherprevalence of most CVDs risk factors[29]. Our group 2b,composed of patients with the lowest physical fitness level, confirms this observation. It is shown that a low physical fitness level is associated with an important risk factor and with increased mortality for both men and women[33]. The physical fitness level declines with the age, even more, if a regular physical activity is not preserved. Contrary to what is observed in the literature[34], our study show that the subjects in the group 1a with a normal physical fitness level (20%below the predicted) and in the group 1b with a high physical fitness level were the oldest (64.7 ± 11.0 years old and 66.2 ± 11.7 years old, respectively).

The subjects physically or professionally active before their cardiac events, no matter their age,will be able to have a better physical fitness level than those who were physically inactive. Within this context, our study observed positive results for the patients admitted into a cardiac rehabilitation center.Indeed, getting a physical fitness level close to the baseline level (even 20% below the predicted fitness)induces a preventive action on the cardiovascular risk factors. In the group 1a, we observed a positive action of the physical fitness level on five of our eight risk factors studied (i.e., abdominal obesity, diabetes,hypertension, obesity and overweight). A correlation between physical activity and physical fitness level demonstrates that it is the practice of physical activity that could reduce many risk factors[33]. Kodama et al[35] have confirmed that the physical fitness level is associated with a weakening in CVDs. The subjects who are exposed to a high physical fitness level (group 1b)are susceptible to get a higher preventive action on hypertension than group 1a (PF = 36% and PF = 33%,respectively). It is argued that improving physical fitness, through the physical activity, has an effect on hypertension by reducing blood pressure[36]. Physical activity is also important in the fight against the weight gain and the development of fat and abdominal obesity which are favorable to the appearance of hypertension[37]. Thus, our results show a preventive action of the normal and high physical fitness level groups on the abdominal obesity. This preventive action is in favor of the group 1a (PF = 38%), comparatively to the group 1b (PF = 37%). In a recent study, it has been shown that the excess of abdominal fat would be associated with a higher risk of cardiovascular mortality than overweight or obesity[38]. Physical activity is known to decrease the risk of cardiovascular mortality in patients with obesity[39]. In our study, it is clearly identified that a normal physical fitness level induces a preventive action on the obesity (PF = 12%)since the group 1b has not observed a benefit action of the exposure factor on this risk factor. We observe the same result for diabetes risk factor. Indeed, the group with a normal physical fitness level induces a preventive action for diabetes (PF = 12%), which was not observed for the subjects with a high physical fitness level. Reaching moderate or high physical activity levels reduce the risk of CVDs mortality in type 2 diabetics patients[40] by improving glucose metabolism and insulin sensitivity[37]. A moderate exercise program can also reduce the diabetes risk and percentage of body fat[41]. It is especially important in the prevention of cardiovascular risk factors because the subjects who suffer overweight have a high risk of developing diabetes[42]. Our results demonstrate that the subjects who have a normal physical fitness level induce a preventive action of 11% on the overweight risk factor. A 5% difference, in favor of group 1b with a high physical fitness level (PF = 16%), was observed for overweight. The logistic regression models in the multivariate analysis have shown that the group 1a,composed of subjects with a normal physical fitness level, induced a preventive action of 36% on the overweight. These findings strengthen our hypothesis and highlight the importance of having a normal physical fitness level, without necessarily being a patient with a high physical fitness level.

Yet, only the group 1b with a high physical fitness level induce a preventive action on the depression risk factor (PF = 22%). We have not observed a preventive action on the depression in the patients with a normal physical fitness level. The subjects with a low selfreported physical activity levels are associated with an increased prevalence of depressive symptoms[43].The patients with CVDs and with depression are likely to have recurrent heart problems[44,45]. According to Gary et al[46] the patients who are facing a cardiac complication recognize a depressive episode afterward.Furthermore, our results demonstrate the importance of having a high physical fitness level, before and after a cardiac event, to induce a preventive action on the depression. Finally, our findings have not observed a preventive action for smoking, this is consistent with the statement of Marín Armero et al[47] who suggest that the best way to stop smoking is to combine smoking cessation with a psychological program.Smoking may induce changes in the serum lipoprotein profiles causing an increase in total cholesterol[48],which might explain that no positive effect of the physical fitness levels were observed for dyslipidemia.

This study is based in retrospective data, which may represent some limitations. Retrospective studies have disadvantages because peoples who were responsible for the data collections might have made classification errors or information bias. This is why we have worked closely with the cardiologist of the cardiac rehabilitation center whose data were from. Also, as pharmacological treatments could have been optimized since the data collection it could be argued that results would have been different and that the positive impact of physical training would be attenuated. Over a long period (from 1988 until now), since the firsts metaanalysis by Oldridge et al[49] and O’Connors et al[50] and despite the increasing development of new medication,the result of exercise on mortality reduction in CVDs is quite constant[16]. The works of Bouchard et Shepard shows that a part of physical fitness can be genetically determined and not related to environment(by physical activity practice)[51]. Finally, treatments were not introduced in the study as recruitment were made from University hospital with patients arriving with optimized treatment so inducing a low deviation between subject, furthermore due to the small number of the subjects for such a study we did not separate the different pathologies in the analysis and consider CVD’s as a whole group.

It is established that the exercise capacity is an important prognostic factor in patients with CVD[28].There is evidence of an inverse relationship between the physical activity and CVDs; our study reinforces these statements. Regular physical activity is a practice accessible to all patients with CVDs, but it may be difficult to adhere to an aerobic-based exercise program, due to external constraints. Our study suggests that even if the recommendations of ACSM[52] (allowing to reach 100% of the theoretical physical fitness) are not met, a normal physical fitness level, even 20% below the predicted fitness, is enough to reduce some of the risk factors studied. This is in concordance with the recommendations of European Society of Cardiology[53] which supports that the subjects with a physical fitness level, even 25% below the predicted fitness, will face long-term health issues.The practice of physical activity should be maintained throughout life to preserve these training effects[19].

In summary, this study demonstrated that a normal physical fitness level induces a preventive action for most risk factors studied and that a high level of physical fitness does not necessarily lead to a better preventive fraction. Our work provides new insights on the aggregate role of physical fitness in the development of cardiovasculars risk factors.

1.总体上，地价和房价之间存在正向的双向因果关系，且房价对地价的影响程度要高于地价对房价的影响。土地市场与房地产市场息息相关，房屋的建成离不开土地这块基石。由此可想而知，房价和地价之间势必会有所关联。当土地价格上涨时，房屋的建设成本会上升，从而导致房地产厂商们的投资热情下降，房屋供给量减少，进而引起房屋价格上涨。反之，当房屋价格上涨时，房地产厂商们会普遍认为投资房地产业将有利可图，其对土地的需求量会增加，从而引起土地价格进一步上涨。但需要指出的是，房价每增加1%，地价将上涨约0.1079%，而地价每增加1%时，房价仅上涨约0.0573%，其约占房价对地价影响的1/2。

The OR was calculated to obtain the PF of the cardiovascular risk factors in order to assess the effect of the exposure factor. Upon univariate analysis(Table 3), in the modela, PF was calculated for age(6%), abdominal obesity (38%), diabetes (12%),hypertension (33%), obesity (12%) and overweight(11%). In the modelb, PF was calculated for the age(5%), abdominal obesity (37%), depression (22%),hypertension (36%) and overweight (16%). In both models, PF was not calculated for dyslipidemia and smoking because OR ＞ 1.

ARTICLE HIGHLIGHTS

Research background

Cardiovascular diseases (CVDs) remain the main cause of death in the world with about 17.5 million deaths. CVDs are usually associated with a high level of risk factors. The practice of physical activity has benefits on the risk factors,however, we do not know the preventive action of physical fitness on the risk factors in patients who have developed CVDs. Thus, this study aims to quantify the preventive fraction of physical fitness on the risk factors in patients with CVDs.

深层搅拌支护技术在实际应用中也较为广泛的，在应用过程中，首先将混凝土作为固化剂，并将其与软土剂按照一定的比例进行混合、搅拌，在搅拌过程中使其硬化，从而形成一个整体，这个整体具有相当强度的稳定性与整体性，因此，将其用于深基坑的支护，效果非常显著。运用该支护技术时，对于由混凝土充当的固化剂与软土剂进行混合时，要严格的按照实际的要求进行配比，这样能够有效地保证施工的稳定性。

Research motivation

The effect of physical fitness on the risk factors in patients who have developed a cardiovascular disease remains an open question. Regular physical activity is a practice accessible to all patients with CVDs, but it may be difficult to adhere to an aerobic-based exercise program, due to external constraints.

Research objectives

Quantifying the preventive fraction of physical fitness on the risk factors in patients with CVDs is very important. The aggregate role of physical fitness in the development of cardiovascular risk factors needs to be better documented.Our work provides new insights on this research field.

Research methods

A total of 249 subjects (205 men and 44 women) suffering from a CVD were categorized into four groups, according to their percentage of physical fitness.The physical fitness of subjects was evaluated from an exercise stress test on an ergocycle. We calculated the odds ratio to obtain the preventive fraction in order to evaluate the impact of the physical fitness level on the risk factors(i.e., abdominal obesity, depression, diabetes, dyslipidemia, hypertension,obesity, overweight and smoking). The preventive fraction is a ratio used in epidemiological studies to assess the impact of an exposure factor (physical fitness) on a disease (risk factors). It is an important evaluation tool that allows knowing the preventive action of the physical fitness levels on the risk factors studied.

Research results

It is observed that a normal physical fitness level is sufficient to induce a preventive action on abdominal obesity (38%), diabetes (12%), hypertension(33%), obesity (12%) and overweight (11%). Also, the preventive fraction increases with the level of physical fitness, in particular for hypertension (36%)and overweight (16%). A high physical fitness level does not necessarily induce a preventive action in most risk factors, excluding depression. Our study suggests that even if the recommendations of ACSM (allowing to reach 100%of the theoretical physical fitness) are not met, a normal physical fitness level,even 20% below the predicted fitness, is enough to reduce some of the risk factors studied.

27 Blair SN, Cheng Y, Holder JS. Is physical activity or physical fitness more important in defining health benefits? Med Sci Sports Exerc 2001; 33: S379-99; discussion S419-20 [PMID: 11427763]

Research conclusions

This study demonstrates that a normal physical fitness level induces a preventive action for most risk factors studied. A high level of physical fitness does not necessarily lead to a better preventive fraction. CVDs remain the main cause of death in the world with about 17.5 million deaths. It is observed that almost half of the deaths in Europe are attributable to CVDs, touching approximately 1.9 million men and 2.2 million women. The development of different risk factors (i.e., abdominal obesity, depression, diabetes, dyslipidemia,hypertension, obesity, overweight, smoking) and physical inactivity promote CVDs. The practice of physical activities allows to decrease the risk of CVDs and has a protective role against metabolic risk factors.

Research perspectives

There is evidence of an inverse relationship between the physical activity and CVDs; our study reinforces these statements. However, it may be difficult to adhere to an aerobic-based exercise program, due to external constraints.Our study suggests that a normal physical fitness level, even 20% below the predicted fitness, is enough to reduce some of the risk factors studied. The practice of physical activity should be maintained throughout life to preserve these training effects. The future research should include the pharmacological treatments.

马铃薯收获可采用机械与人工配合的形式，既可保证收获效率及质量，又可减少对马铃薯块茎的损伤。收获前植株较高或未彻底枯死的，在收获前2～3天全部人工或机械割除薯秧，可用粉碎机粉碎后还田或运出田外。马铃薯收获后要按照不同的质量等级进行分级，晾晒至表皮干燥后无光贮藏，避免发芽，并能减少龙葵素的产生与积累。

ACKNOWLEDGMENTS

We would like to thank the cardiac rehabilitation center, all the staff of service of rehabilitation, all participants of this study and we are also grateful to the students who participated in the data collection(Elodie Couderc et Caroline Munoz). We appreciate the invaluable assistance of Aliciane Julien for her review of the article in English language and the assistance of Vincent Guyader (SASU ThinkR) for his help in the statistical analysis. The contents of this article are solely the responsibility of the authors and none has received funding to carry out this work.

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认证机构通过帮助企业提升ISO14001实施绩效，实现了企业价值的增长，也提升了自身价值（Wang Y等，2018）。为了能够实现这个目标，客观上要求认证公司审核员接受过高等教育，具有较高的专业水平和实践经验，不仅掌握一般性的知识系统，而且具有应用并进一步发展知识的能力，能满足客户新需求、解决各类复杂问题（Zuo Z.2017）。同时要求企业能接受并认真落实ISO14001的规范，提高企业绩效，最终实现企业价值（肖定生，初志春；2007）。具体来说，认证机构对企业绩效影响的运行过程有知识的共享、转移、获取、整合、应用以及创新等实现方式，是从无序到有序、从差别到统一的过程。

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24 Smith SC Jr, Blair SN, Bonow RO, Brass LM, Cerqueira MD,Dracup K, Fuster V, Gotto A, Grundy SM, Miller NH, Jacobs A,Jones D, Krauss RM, Mosca L, Ockene I, Pasternak RC, Pearson T, Pfeffer MA, Starke RD, Taubert KA. AHA/ACC Scientific Statement: AHA/ACC guidelines for preventing heart attack and death in patients with atherosclerotic cardiovascular disease: 2001 update: A statement for healthcare professionals from the American Heart Association and the American College of Cardiology.Circulation 2001; 104: 1577-1579 [PMID: 11571256]

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新接班不久就遇到了一个很特殊的学生—小睿。说他特殊一点也不过分：用板凳打同学；拿尖尖的铅笔扎同学的脑袋；咬人；往别人脖子领子里塞沙子；解小便常常排在别人身上……“斑斑劣迹”使小睿在班里没有一个朋友，更得不到同学们的喜欢。而最让人头疼的是小睿偷偷拿别人的东西，他这种行为已经引起了公愤。

28 Myers J, Prakash M, Froelicher V, Do D, Partington S, Atwood JE.Exercise capacity and mortality among men referred for exercise testing. N Engl J Med 2002; 346: 793-801 [PMID: 11893790 DOI:10.1056/NEJMoa011858]

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31 Bernardo AFB, Rossi RC, Souza NMd, Pastre CM, Vanderlei LCM. Association between physical activity and cardiovascular risk factors in individuals undergoing cardiac rehabilitation program.Revista Brasileira de Medicina do Esporte. 2013: 231

党中央、国务院高度重视，国家防总全力组织，三省（自治区）党委、政府把抗洪抢险救灾工作作为中心工作来抓，主要领导亲自安排部署、亲赴一线组织指挥，动员有关部门和广大军民奋力抗灾，保障了各项工作有力有序有效开展。

32 Kołtuniuk A, Rosińczuk J. The prevalence of risk factors for cardiovascular diseases among Polish surgical patients over 65 years. Clin Interv Aging 2016; 11: 631-639 [PMID: 27257376 DOI:10.2147/CIA.S105201]

在第二学段，（1）概念引入，北师版由对8个四边形分类引入，而其它版本均是由生活素材引入．6个版本均是在探究出平行四边形的元素关系特征，尤其是对边平行之后，得出平行四边形概念．（2）概念描述，北京版和人教版呈现了概念的文字定义，即两组对边分别平行的四边形叫做平行四边形．其它4个版本不仅有概念的文字定义，还辅以平行四边形的几何图形进行直观支撑．（3）概念应用，北京版、北师版、冀教版和人教版都编写了长方形、正方形和平行四边形的关系，北京版和人教版呈现了平行四边形的不稳定性．苏教版和青岛版没有明显地呈现概念应用．

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At their admission to the cardiac rehabilitation program, all the subject were evaluated for risk factors and physical fitness. Physical fitness of subjects was evaluated from an exercise stress test on ergocycle,conducted by physicians, physiotherapists and exercise physiologist, in accordance with the current recommendations of AHA[20]. In order to evaluate the physical fitness of subjects, the maximum oxygen consumption (V·O2peak) was calculated using equations published by Wasserman and Hansen normalizing V·O2peak depending age, gender, weight and height[21,22]. The percentage of physical fitness is the ratio between V·O2peak measured and V·O2peak predicted. It has been calculated using the following equation: % predicted V·O2peak = measured V·O2peak (mL·kg-1·min-1)/predicted V·O2peak (mL·kg-1·min-1) × 100

师：我们从各种各样的长方体物体中抽象出来的长方体、长方形、线和点，都称为几何图形，刚刚大家举出的各种各样物体中抽象出来的图形，也都是几何图形．

10 Glazer NL, Lyass A, Esliger DW, Blease SJ, Freedson PS,Massaro JM, Murabito JM, Vasan RS. Sustained and shorter bouts of physical activity are related to cardiovascular health. Med Sci Sports Exerc 2013; 45: 109-115 [PMID: 22895372 DOI: 10.1249/MSS.0b013e31826beae5]

基层警务工作要提高自身的智能化治理水平。智能化为社会治理提供了一个专业性方案。[3]在城乡基层社会治理中将所属行政区域按照一定的原则和标准划分成若干个网格状的单元，各网格责任主体及其成员在实地走访、调查或借助社会治理电子网络平台了解、采集网格内所有居民住户基本情况及其意见和要求的基础上，向其所在辖区内的居民和住户提供更为专业和日常化的服务。

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46 Gary RA, Dunbar SB, Higgins MK, Musselman DL, Smith AL.Combined exercise and cognitive behavioral therapy improves outcomes in patients with heart failure. J Psychosom Res 2010; 69:119-131 [PMID: 20624510 DOI: 10.1016/j.jpsychores.2010.01.013]

47 Marín Armero A, Calleja Hernandez MA, Perez-Vicente S,Martinez-Martinez F. Pharmaceutical care in smoking cessation.Patient Prefer Adherence 2015; 9: 209-215 [PMID: 25678779 DOI:10.2147/ppa.s67707]

48 Mouhamed DH, Ezzaher A, Neffati F, Gaha L, Douki W, Najjar M.Association between cigarette smoking and dyslipidemia. Immunoanalyse Biologie Spécialisée. 2013: 195

2012年，曼老江咖啡成为第一个进入WBC决赛的中国咖啡。2012-2014年间，曼老江咖啡作为首家云南精品咖啡自主品牌出口美国，与美国著名咖啡生豆商Sweet Maria`s 以及Ground Work成为优质合作伙伴。2018年，曼老江咖啡以ManLao River Specity Coffee名称进入北美咖啡市场，并通过了国际SGS-509项无农残检测。8月荣登美国纽约时报/The New York Times。这也成功刷新了北美区饮品消费者对于中国云南仅有普洱茶的认知，曼老江咖啡让云南精品咖啡进一步走向世界。

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53 Guazzi M, Arena R, Halle M, Piepoli MF, Myers J, Lavie CJ. 2016 Focused Update: Clinical Recommendations for Cardiopulmonary Exercise Testing Data Assessment in Specific Patient Populations.Circulation 2016; 133: e694-e711 [PMID: 27143685 DOI: 10.1161/cir.0000000000000406]