Association between (ΔPaO2/FiO2)/PEEP and in-hospital mortality in patients with COVID-19 pneumonia: A secondary analysis.

BACKGROUND: The arterial pressure of oxygen (PaO2)/inspiratory fraction of oxygen (FiO2) is associated with in-hospital mortality in patients with Coronavirus Disease 2019 (COVID-19) pneumonia. ΔPaO2/FiO2 [the difference between PaO2/FiO2 after 24 h of invasive mechanical ventilation (IMV) and PaO2/FiO2 before IMV] is associated with in-hospital mortality. However, the value of PaO2 can be influenced by the end-expiratory pressure (PEEP). To the best of our knowledge, the relationship between the ratio of (ΔPaO2/FiO2)/PEEP and in-hospital mortality remains unclear. This study aimed to evaluate their association. METHODS: The study was conducted in southern Peru from April 2020 to April 2021. A total of 200 patients with COVID-19 pneumonia requiring IMV were included in the present study. We analyzed the association between (ΔPaO2/FiO2)/PEEP and in-hospital mortality by Cox proportional hazards regression models. RESULTS: The median (ΔPaO2/FiO2)/PEEP was 11.78 mmHg/cmH2O [interquartile range (IQR) 8.79-16.08 mmHg/cmH2O], with a range of 1 to 44.36 mmHg/cmH2O. Patients were divided equally into two groups [low group (< 11.80 mmHg/cmH2O), and high group (≥ 11.80 mmHg/cmH2O)] according to the (ΔPaO2/FiO2)/PEEP ratio. In-hospital mortality was lower in the high (ΔPaO2/FiO2)/PEEP group than in the low (ΔPaO2/FiO2)/PEEP group [18 (13%) vs. 38 (38%)]; hazard ratio (HR), 0.33 [95% confidence intervals (CI), 0.17-0.61, P < 0.001], adjusted HR, 0.32 (95% CI, 0.11-0.94, P = 0.038). The finding that the high (ΔPaO2/FiO2)/PEEP group exhibited a lower risk of in-hospital mortality compared to the low (ΔPaO2/FiO2)/PEEP group was consistent with the results from the sensitivity analysis. After adjusting for confounding variables, we found that each unit increase in (ΔPaO2/FiO2)/PEEP was associated with a 12% reduction in the risk of in-hospital mortality (HR, 0.88, 95%CI, 0.80-0.97, P = 0.013). CONCLUSIONS: The (ΔPaO2/FiO2)/PEEP ratio was associated with in-hospital mortality in patients with COVID-19 pneumonia. (ΔPaO2/FiO2)/PEEP might be a marker of disease severity in COVID-19 patients.

Identification and characterization of circular RNAs expression profiles in obstructive sleep apnea-induced liver injury.

Circular RNAs (circRNAs) have exhibited microRNA sponge activity, related to many important biological processes. Our study attempted to explore the comprehensive changes of circRNAs expression pattern in Obstructive sleep apnea (OSA)-induced liver injury and provide a global perspective of differentially expressed circRNAs (DECs). Then, RT-qPCR was used to confirm the microarray data. Further, gene ontology (GO) and KEGG pathway analysis were performed to annotate the DECs. Finally, the circRNA-miRNA-mRNA interaction network was established to predicted the target genes and target miRNAs of DECs for a stepwise bioinformatics analysis. We revealed a total of eighty DECs. In the meantime, six circRNAs were randomly validated by RT-qPCR. Among these circRNAs, mmu_circRNA_000469, 37851, 38959, 38983, 31665 were up-regulated in both microarray and qRT-PCR tissues, while mmu_circRNA_27565 was down-regulated. GO analysis revealed that circRNAs-target genes were largely related to liver function process such as carboxylic acid metabolic process and negative regulation of mitochondrial membrane potential. Meanwhile, KEGG analysis found that there were 13 pathways related to these circRNAs- target genes. And the most enriched pathway was Natural killer cell mediated cytotoxicity, which strongly suggests that immune responses may be important for the process of OSA-induced liver injury. In addition, four significant DECs (mmu_circRNA_000469, 38959, 38983, 27565) and their target mRNA and target miRNAs were further selected to establish the regulation network. Our study revealed that circRNAs may play a crucial role in OSA-induced liver injury and thus mmu_circRNA_000469, 38959, 38983, 27565 may serve as biomarkers of biological process of OSA-induced liver injury.

Identification and characteristic analysis of semi-natural habitats in China's economically developed areas: New insights to inform cultivated land system ecological conservation.

Identifying and characterizing semi-natural habitats (SNHs) are important to the ecological conservation of cultivated land systems and implementing China's ecological civilization strategy. This study revealed the concept and characteristics of SNHs in Chinese cultivated land systems regarding human activities, resource types, and spatial landscape patterns. The resource quantity, landscape quality, and spatial distribution of SNHs in Southern Jiangsu's cultivated land system were analyzed by constructing the identification model of "land use/land cover type-cultivated land use intensity-spatial landscape pattern". The results showed that the area of SNHs in Southern Jiangsu's cultivated land system was 25.35%, significantly influenced by cultivated land intensification and expansion. The higher the cultivated land use intensity, the lower the quantity of SNHs, and the proportion of SNHs in the intensive-use pattern was only 2.97%. 68.18% of the SNHs in Southern Jiangsu were water, and habitats for important species, such as woodland, grassland, wetlands, and bare land, were scarce. A small patch area, high landscape fragmentation, poor landscape richness and diversity, and low connectivity accompanied increased cultivated land use intensity. From the extensive to intensive utilization, the spatial spread of SNHs from low-value aggregation to high-value scatter areas, with hotspot areas of cultivated land use intensity and SNHs existing only in a small part of Nanjing and Changzhou. This study provides a scientific reference for the rehabilitation and restoration of SNHs in the context of the ecological transformation of land use. It promotes the sustainable intensification of cultivated land systems. It also provides new ideas for linking ecological and urban spaces to form a stable and systematic national ecological safety network.

The role of harmonized Landsat Sentinel-2 (HLS) products to reveal multiple trajectories and determinants of cropland abandonment in subtropical mountainous areas.

Cropland abandonment is a widespread land-change process globally, which can stem from the accelerated outmigration of the population from rural to urban areas, socio-economic and political changes, catastrophes, and other trigger events. Clouds limit the utility of optical satellite data to monitor cropland abandonment in highly fragmented mountain agricultural landscapes of tropical and subtropical regions, including the south of China. Taking Nanjing County of China as an example, we developed a novel approach by utilizing multisource satellite (Landsat and Sentinel-2) imagery to map multiple trajectories of cropland abandonment (transitioning from cropland to grassland, shrubs and forest) in subtropical mountainous landscapes. Then, we employed a redundancy analysis (RDA) to identify the spatial association of cropland abandonment considering agricultural productivity, physiography, locational characteristics and economic factors. Results indicate the great suitability of harmonized Landsat 8 and Sentinel-2 images to distinguish multiple trajectories of cropland abandonment in subtropical mountainous areas. Our framework of mapping cropland abandonment resulted in good producer's (78.2%) and user's (81.3%) accuracies. The statistical analysis showed 31.85% of croplands cultivated in 2000 were abandoned by 2018, and more than a quarter of townships experienced cropland abandonment with high abandoned rates (>38%). Cropland abandonment mainly occurred in relatively unfavorable areas for agricultural production, for instance with a slope above 6°. Slope and the proximity to the nearest settlement explained 65.4% and 8.1% of the variation of cropland abandonment at the township level, respectively. The developed approaches on both mapping cropland abandonment and modeling determinants can be highly relevant to monitor multiple trajectories of cropland abandonment and ascribe their determinants not only in mountainous China but also elsewhere and thus promote the formulation of land-use policies that aim to steer cropland abandonment.

Overexpression of MicroRNA-133a Inhibits Apoptosis and Autophagy in a Cell Model of Parkinson's Disease by Downregulating Ras-Related C3 Botulinum Toxin Substrate 1 (RAC1).

The manuscript is being retracted due to non-original and duplicated content in the figure images, which raise concerns regarding the credibility of the study. Reference: Wusheng Lu, Jinhuang Lin, Dequan Zheng, Chunyong Hong, Laishun Ke, Xinyu Wu, Peineng Chen. Overexpression of MicroRNA-133a Inhibits Apoptosis and Autophagy in a Cell Model of Parkinson's Disease by Downregulating Ras-Related C3 Botulinum Toxin Substrate 1 (RAC1). Med Sci Monit, 2020; 26: e922032. DOI: 10.12659/MSM.922032.

Driving forces of UHI changes in China's major cities from the perspective of land surface energy balance.

As remarkable human-induced temperature anomalies on the land surface, variations of urban heat island (UHI) and its driving factors have been investigated in numerous studies. However, few studies discussed the spatiotemporal heterogeneity of the driving forces exerted by land surface energy fluxes, i.e., net radiation, sensible heat, latent heat and heat storage, on UHI behaviors at large scale and long term. In this study, a comprehensive application of multisource datasets and statistical methods have been implemented based on land surface energy balance theory, the spatiotemporal variations of surface UHI intensity (urban-rural temperature difference) and changes of their driving forces have been quantified. The results demonstrate the dynamics of UHI intensity in 32 major cities of China from 2003 to 2017 are generally coherent with the common perception, the overall surface UHI intensity is 4.57 K higher in summer than in winter. The spatial variations of the fluxes that alter UHI intensity can be largely attributed to the varied energy interactions between vegetated/paved surface and atmosphere and the differences of background temperature and precipitation, the contribution of latent heat to UHI changes declines nearly 40% from semiarid/arid climate at the north to subtropical humid climate at the south, while the contributions of other fluxes are stable. The temporal changes of the effect of these fluxes, however, imply more complex mechanisms. The contributions of sensible heat and latent heat to UHI intensity variations are three times and eight times larger in the warm season than in the cold season respectively, indicating the influence of seasonality of background temperature, precipitation and vegetation. The low contributions of these fluxes in the cold season also suggest the significant effect of other driving forces such as anthropogenic heat, especially in semiarid/semihumid climate zones. This study highlights the temporal shifts of major driving forces of UHI intensity, the mitigation tactics for UHI in different cities and seasons should be customized for better validity.

Spatial-Temporal Distribution Variation of Ground-Level Ozone in China's Pearl River Delta Metropolitan Region.

Long-term exposure to ozone pollution will cause severe threats to residents' physical and mental health. Ground-level ozone is the most severe air pollutant in China's Pearl River Delta Metropolitan Region (PRD). It is of great significance to accurately reveal the spatial-temporal distribution characteristics of ozone pollution exposure patterns. We used the daily maximum 8-h ozone concentration data from PRD's 55 air quality monitoring stations in 2015 as input data. We used six models of STK and ordinary kriging (OK) for the simulation of ozone concentration. Then we chose a better ozone pollution prediction model to reveal the ozone exposure characteristics of the PRD in 2015. The results show that the Bilonick model (BM) model had the highest simulation precision for ozone in the six models for spatial-temporal kriging (STK) interpolation, and the STK model's simulation prediction results are significantly better than the OK model. The annual average ozone concentrations in the PRD during 2015 showed a high spatial variation in the north and east and low in the south and west. Ozone concentrations were relatively high in summer and autumn and low in winter and spring. The center of gravity of ozone concentrations tended to migrate to the north and west before moving to the south and then finally migrating to the east. The ozone's spatial autocorrelation was significant and showed a significant positive correlation, mainly showing high-high clustering and low-low clustering. The type of clustering undergoes temporal migration and conversion over the four seasons, with spatial autocorrelation during winter the most significant.

Clinical characteristics of chronic liver disease with coronavirus disease 2019 (COVID-19): a cohort study in Wuhan, China.

BACKGROUND: Previous work has described acute liver injury (ALI) in coronavirus disease 2019 (COVID-19) pneumonia patients, However, there is limited analyses available investigating chronic liver disease (CLD) in COVID-19 patients. This study aimed to investigate clinical characteristics and outcomes of CLD confirmed in COVID-19 patients. RESULTS: A total of 104 cases (each group containing 52 patients) were analyzed in this study. The CLD group showed an average of 14 (10.0~21.2) length of stay (LOS) days, compared to the group without CLD that only showed an average of 12.5 (10~16) LOS days (Relative Risk [RR] = 1.34, 95% CI (1.22~1.48), P<0.001; Adjusted Relative Risk was 1.24 (95% CI: 1.12~1.39)). The CLD group contained a higher mortality rate and slight liver injury. Furthermore, COX regression model analyses suggested that the neutrophil-to-lymphocyte ratio (NLR) was an independent predictor of mortality risk (P < 0.001) in the CLD group. Additionally, a high NLR significantly correlated with a shorter overall survival (P <0.001). CONCLUSIONS: COVID-19 patients also diagnosed with CLD suffered longer LOS, slight liver injuries and a higher mortality when compared to COVID-19 patients without CLD. The NLR was an independent risk factor for in-hospital deaths. Increased expression of NLR was an indicator of poor prognosis in COVID-19 patients with CLD. Thus, COVID-19 patients diagnosed with CLD and who show a higher NLR need additional care. METHODS: A retrospective cohort study was performed at the Wuhan Jin Yin-tan Hospital from February 2, 2020 to April 2, 2020. COVID-19 patients diagnosed with CLD or not diagnosed with CLD were enrolled in this study. The clinical characteristics and outcomes of these patients were compared.

Overexpression of MicroRNA-133a Inhibits Apoptosis and Autophagy in a Cell Model of Parkinson's Disease by Downregulating Ras-Related C3 Botulinum Toxin Substrate 1 (RAC1).

BACKGROUND Parkinson's disease (PD) is a movement disorder. microRNA (miR)-133 expression is reduced in PD patients and in mice with a dopamine neuron deficiency. We aimed to identify the mechanism of miR-133a in apoptosis and autophagy in PD. MATERIAL AND METHODS The optimal concentration of MPP⁺ (1-methyl-4-phenylpyridinium ion) was initially determined to construct a PD cell model. Gain-of function experiments were carried out to evaluate the role of miR-133a in PD. The levels of miR-133a, RAC1 (Ras-related C3 botulinum toxin substrate 1), apoptosis-related factors, and autophagy-related factors were detected after detection of cell proliferation, cell cycle, and apoptosis. Transmission electron microscopy was applied to observe autophagosomes, and immunofluorescence staining was performed to detect LC3 and further analyze the effect of miR-133a on autophagy in a PD cell model. RESULTS Low miR-133a expression was detected in a cell model of MPP⁺-induced PD. After overexpressing miR-133a, cell proliferation increased, and apoptosis (cleaved caspase-3 and Bax levels decreased, while Bcl2 levels increased) and autophagy was inhibited (LC3II/I and Beclin-1 levels decreased, while p62 levels increased). MiR-133a targeted RAC1. RACY upregulation attenuated the inhibitory effects of miR-133a on PC12 cell apoptosis and autophagy. CONCLUSIONS Our data highlighted that miR-133a overexpression prevented apoptosis and autophagy in a cell model of MPP⁺-induced PD by inhibiting RAC1 expression.

Changes in oxidative stress biomarkers in Sinonovacula constricta in response to toxic metal accumulation during growth in an aquaculture farm.

Clam farming comprises an important part of China's economy. However, increasing pollution in the ocean caused by toxic metals has led to the bioaccumulation of toxic metals in marine animals, especially the bivalves such as clams, and the consequence of heavy metal-associated toxicity in these animals. Such toxicity can enhance the production of reactive oxygen species (ROS) within the tissues of the animals. In aquatic species, oxidative stress mechanisms have been studied by measuring the antioxidant and oxidative damage index in the tissues. The objectives of this study were to investigate the levels of different toxic metals and the extent of oxidative stress responses in the clam Sinonovacula constricta at different growth periods (from May to October) in an aquaculture farm in Wengyang, an important economic shellfish culture zone in Zhejiang Province, China. Water and sediment samples taken from the farm were subjected to Pb, Hg, Cd, Cr assays. Overall, the levels of these metals in the water and sediment could be considered as light pollution, though the levels of Hg in the water (0.266) and Cd in the sediment (0.813) could be considered as reaching moderate pollution. In addition, the levels of these metals, H2O2, MDA and GSH content, antioxidant enzyme (CAT, SOD, GPx) activities as well as the level of metallothioneins (MT) mRNA in the tissues of S. constricta were also analyzed. The levels of Pb, Hg, Cd, Cr increased with increasing culturing time, and a higher level of these metals was accumulated in the visceral mass than in the foot. The levels of MDA and GSH, as well as the level of SOD activity in the viscera and foot of S. constricta increased with increasing metal accumulation. However, CAT and GPX activities, H2O2 level and the expression of MT initially increased and then decreased. This suggested that S. constricta might have the ability to control oxidative damage by triggering antioxidant defense in coordination with the metal sequestering response. The results also implied that toxic metal pollution should be taken into account when selecting the site to be used as an aquaculture farm. In addition, the visceral mass should be considered to be a good tissue for measuring the level of metal pollutants.

Neuroprotective effects of vagus nerve stimulation on traumatic brain injury.

Previous studies have shown that vagus nerve stimulation can improve the prognosis of traumatic brain injury. The aim of this study was to elucidate the mechanism of the neuroprotective effects of vagus nerve stimulation in rabbits with brain explosive injury. Rabbits with brain explosive injury received continuous stimulation (10 V, 5 Hz, 5 ms, 20 minutes) of the right cervical vagus nerve. Tumor necrosis factor-α, interleukin-1ß and interleukin-10 concentrations were detected in serum and brain tissues, and water content in brain tissues was measured. Results showed that vagus nerve stimulation could reduce the degree of brain edema, decrease tumor necrosis factor-α and interleukin-1ß concentrations, and increase interleukin-10 concentration after brain explosive injury in rabbits. These data suggest that vagus nerve stimulation may exert neuroprotective effects against explosive injury via regulating the expression of tumor necrosis factor-α, interleukin-1ß and interleukin-10 in the serum and brain tissue.