Thyroid dysfunction in the wake of Omicron: understanding its role in COVID-19 severity and mortality.

Purpose: SARS-CoV-2 can invade the thyroid gland. This study was to delineate the risk of thyroid dysfunction amidst the prevalence of the Omicron variant, and to investigate the correlation between thyroid function and Coronavirus disease 2019 (COVID-19) outcomes. The study also aimed to ascertain whether thyroid dysfunction persisted during COVID-19 recovery phase. Methods: This was a retrospective cohort study. COVID-19 patients from the Renmin Hospital of Wuhan University, China during the epidemic of Omicron variants were included, and their thyroid function were analyzed in groups. Results: A history of thyroid disease was not associated with COVID-19 outcomes. COVID-19 can lead to a bimodal distribution of thyroid dysfunction. The severity of COVID-19 was inversely proportional to the levels of thyroid- stimulating hormone (TSH), free triiodothyronine (FT3) and free thyroxine (FT4), leading to a higher prevalence of thyroid dysfunction. Severe COVID-19 was a risk factor for euthyroid sick syndrome (ESS) (OR=22.5, 95% CI, 12.1 - 45.6). Neutrophil to lymphocyte ratio mediated the association between severe COVID-19 and ESS (mediation effect ratio = 41.3%, p < 0.001). ESS and decreased indicators of thyroid function were associated with COVID-19 mortality, while high levels of FT3 and FT4 exhibited a protective effect against death. This effect was more significant in women (p < 0.05). During the recovery period, hyperthyroidism was quite uncommon, while a small percentage of individuals (7.7%) continued to exhibit hypothyroidism. Conclusion: COVID-19 severity was linked to thyroid dysfunction. Severe COVID-19 increased the risk of ESS, which was associated with COVID-19 mortality. Post-recovery, hyperthyroidism was rare, but some individuals continued to have hypothyroidism.

The nitrogen and carbon footprints of ammonia synthesis in China based on life cycle assessment.

The global nitrogen (N) cycle has emerged as an earth system process with more serious artificial disruption than climate change. Artificially synthesized reactive nitrogen (Nr) already accounts for nearly 50% of the total Nr in the earth system. The massive anthropogenic conversion of inert nitrogen (N2) to Nr is a major driver of imbalance and disruption of the earth's N cycle, where the artificial ammonia (NH3) synthesis process is the main trigger. Existing studies on life cycle environmental impacts of ammonia synthesis mainly focused on the greenhouse effect but lacked or underestimated the interference with the nitrogen cycle due to currently incomplete nitrogen footprint frameworks. In addition, the comprehensive evaluation of the nexus between nitrogen and carbon footprint of NH3 synthesis systems is also insufficient. Attempting to solve the above-mentioned problems, life cycle assessment models of seven ammonia synthesis systems were established considering different raw material pathways and production technologies under China's context, assisted by the Brightway2 platform. The general framework of nitrogen footprint accounting (GFNFA) that was established by the authors previously was employed to assess the ammonia synthesis on nitrogen footprint covered all ecosphere. The performance and hotspots of the system nitrogen footprint, carbon footprint (CF) and nitrogen-carbon nexus were then systematically quantified and analyzed. Results indicated that electrolysis-based ammonia powered by renewable and nuclear energy had the lowest Nr emission (0.499-1.148 kg Nr/t NH3) and carbon emission (592.822-1045.494 kg CO2-eq/t NH3). Among the seven ammonia synthesis systems investigated, biomass-based ammonia had the largest Nr emission and system nitrogen accumulation, and it converts the most N2 to Nr per ton ammonia produced, due to the extensive resources consumption and emissions during straw growth and direct Nr emission in gasification process. Thus, it caused the most significant disturbance to the earth's nitrogen cycle. The nexus between nitrogen and carbon footprints was revealed that the system's energy consumption was found to be a common driver through hotspots and contribution analysis. NH3 synthesis efficiency was the most determining factor in the system's Nr and carbon emissions. With a 15% increase in synthesis efficiency, nitrogen and carbon footprints can be reduced by more than 12.5%. This study can help researchers better understand the life cycle impacts of ammonia synthesis systems on earth's nitrogen and carbon cycle from multidisciplinary ecological origins.

Effect of obstructive sleep apnea on semen quality.

BACKGROUND: Obstructive sleep apnea (OSA) has several notable complications such as hypertension and diabetes. Studies have also shown that OSA is associated with erectile dysfunction and reduced androgen levels. However, the effect of OSA on semen quality remains poorly studied. METHODS: Men attending a tertiary reproductive center for semen analysis were tested with a portable sleep breathing monitor. Patients were divided into four groups based on their apnea hypopnea index: none, mild, moderate, and severe obstructive sleep apnea. Differences between groups were assessed using χ2, and associations were tested with multiple regression analysis. RESULTS: We included a total of 175 male subjects with a mean age of 32.2 ± 3.6 years. There were significant differences between groups in progressive sperm motility (%) (43 ± 16, 42 ± 17, 36 ± 18, 29 ± 18, respectively; p = 0.002), total motility (%) (59 ± 19, 59 ± 20, 49 ± 21, 42 ± 20, respectively; p = 0.010), and vitality (%) (80 ± 10, 81 ± 11, 79 ± 8, 72 ± 19, respectively; p = 0.039). Asthenospermia (progressive motility < 35%) was significantly more common in subjects with OSA (χ2 = 5.195, p = 0.023). In multiple regression models, after adjusting for age and body mass index, apnea hypopnea index remained negatively and significantly associated with progressive motility, total motility, and vitality. CONCLUSIONS: OSA is an independent risk factor for sperm motility and vitality, and further investigation is now needed to determine if continuous positive pressure ventilation or other therapies can improve semen quality in these patients.