Higher oxidative balance score is associated with lower kidney stone disease in US adults: a population-based cross-sectional study.

PURPOSE: Oxidative balance stress (OBS) was an important indicator for assessing exposure to oxidative stress related to diet and lifestyle. The purpose of this study was to explore the relationship between OBS and kidney stone disease (KSD). METHODS: Secondary dataset analysis was performed by the study from six survey cycles (2007-2018) in the National Health and Nutrition Examination Survey (NHANES). OBS was the exposure factor and ever had kidney stone (yes or no) was the outcome. Weighted univariate or multivariate logistic regression models were used to estimate the associations. RESULTS: The prevalence of KSD among participants was 8.6%. OBS showed a significant negative correlation with KSD (OR: 0.98, 95% CI 0.96-0.999), 35% reduction in KSD in the highest OBS quartile compared to the lowest OBS quartile. Dietary OBS was significantly negatively correlated with KSD (OR: 0.98, 95% CI 0.96-0.9998), but not with lifestyle OBS. In addition, OBS had a negative correlation with KSD in females (OR: 0.97, 95% CI 0.94-0.996), non-diabetic participants (OR: 0.98, 95% CI 0.96-0.99), and hypertensive participants (OR: 0.96, 95% CI 0.93-0.99), but OBS was not observed to be associated with KSD in gout participants. Interestingly, this relationship existed in participants aged 30-60 years and a ratio of family income to poverty (PIR) of 1.3-3.5 (all P value < 0.05). CONCLUSION: Our study revealed that OBS was negative associated with KSD, and high OBS might be a protective factor in KSD. Targeting one of the components of OBS might be beneficial.

Antioxidant diet/lifestyle could mitigate the adverse impacts of urinary polycyclic aromatic hydrocarbons on lung function.

BACKGROUND: Extant research has demonstrated a correlation between exposure to polycyclic aromatic hydrocarbons (PAHs) and impaired lung function. The maintenance of an antioxidant-rich diet/lifestyle positively benefits pulmonary health. However, the potential ameliorative impact of an antioxidant-based diet/lifestyle on PAH-induced detrimental effects remains unclear. METHODS: The study drew upon cross-sectional data encompassing 1615 participants derived from the National Health and Nutrition Examination Survey 2007 to 2012. To gauge the maintenance of an antioxidant-rich diet/lifestyle, we employed Oxidative Balance Score (OBS) that incorporates sixteen nutrients and four lifestyle factors. Lung function was evaluated using percent-predicted Forced Vital Capacity (FVC), Forced Expiratory Volume 1st Second (FEV1), FEV1/FVC, and fractional exhaled nitric oxide (FENO). Our analytical approach entailed the utilization of weighted linear models. RESULTS: Our analysis unveiled interaction effects between urinary monohydroxy polycyclic aromatic hydrocarbons (OH-PAHs) and OBS concerning lung function. A one-unit increase in ∑OH-PAH (sum of eight OH-PAHs) was linked to a -0.75% reduction (95% CI: -1.28, -0.22) in FEV1/FVC. Individuals exhibiting low OBS displayed a marked decrease in FEV1/FVC (mean difference = -1.10%; 95% CI: -1.82, -0.39) for each unit increase in ∑OH-PAH, whereas no significant associations were discerned for those with medium or high OBS. Further stratification by gender yielded consistent results. The correlation between ∑OH-PAH and FENO proved statistically significant among participants with low OBS (P = 0.002) and medium OBS (P = 0.001), but non-significant for those with high OBS. Parallel findings emerged when examining percent-predicted FEV1 and FVC. CONCLUSIONS: In conclusion, our study underscores the existence of statistically significant interactions between OH-PAHs and the maintenance of an antioxidant-rich diet and lifestyle concerning lung function. These findings underscore the pivotal role of maintaining an antioxidant-based diet and lifestyle in mitigating the adverse impacts of PAH exposure on lung function.

Single-Cell Study Unveils Lead Lifespan in Blood Cell Populations Follows a Universal Lognormal Distribution with Individual Skewness.

Lead is a widespread environmental hazard that can adversely affect multiple biological functions. Blood cells are the initial targets that face lead exposure. However, a systematic assessment of lead dynamics in blood cells at single-cell resolution is still absent. Herein, C57BL/6 mice were fed with lead-contaminated food. Peripheral blood was harvested at different days. Extracted red blood cells and leukocytes were stained with 19 metal-conjugated antibodies and analyzed by mass cytometry. We quantified the time-lapse lead levels in 12 major blood cell subpopulations and established the distribution of lead heterogeneity. Our results show that the lead levels in all major blood cell subtypes follow lognormal distributions but with distinctively individual skewness. The lognormal distribution suggests a multiplicative accumulation of lead with stochastic turnover of cells, which allows us to estimate the lead lifespan of different blood cell populations by calculating the distribution skewness. These findings suggest that lead accumulation by single blood cells follows a stochastic multiplicative process.

Associations of blood cadmium and lead concentrations with all-cause mortality in US adults with chronic obstructive pulmonary disease.

BACKGROUND: Some literature indicates an association between exposure to cadmium and lead and the presence of emphysema and chronic bronchitis, which are the two primary components of COPD. Understanding whether there is a potential association between cadmium and lead exposure and higher mortality rates in individuals with COPD could provide profound insights into the long-term effects of these two metal exposures on human health. METHODS: This study included 2024 patients with COPD in the US from the NHANES from 1999 through 2016 who were followed up to 2019. Multivariable Cox regression models were used to calculate HRs and 95 % CIs for all-cause mortality in relation to blood cadmium and lead concentrations. Plotting Kaplan-Meier curves and Restricted cubic spline curves to visualize results. Furthermore, stratified and sensitivity analyses were conducted. RESULTS: After multivariate adjustment, blood cadmium and blood lead concentrations were independently associated with an increased risk of all-cause mortality. Compared with the first tertile, the HRs of all-cause mortality associated with the blood cadmium concentration were 1.74 (95 % CI, 1.22-2.49) in the second tertile and 1.89 (95 % CI, 1.31-2.72) in the third tertile. The HRs of all-cause mortality associated with the blood lead concentration were 1.13 (95 % CI, 0.84-1.51) in the second tertile and 1.43 (95 % CI, 1.05-1.93) in the third tertile. CONCLUSION: This study found that increased blood cadmium and blood lead concentrations were associated with increased all-cause mortality in COPD patients. Reducing cadmium and lead exposure could potentially mitigate mortality risk in these individuals. More prospective studies are needed in the future to demonstrate our findings.

Relationship between urinary tobacco-specific nitrosamine 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol (NNAL) and lung function: Evidence from NHANES 2007-2012.

INTRODUCTION: 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol (NNAL), a metabolite of tobacco-specific nitrosamine (TSNA) 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanone (NNK), is a tobacco-specific carcinogen. Spirometry values (FEV1%, PEF%, etc.) are commonly used as clinical indicators to assess the condition of lung function and the results can be used to diagnose respiratory diseases. However, the relationship between urinary NNAL levels and lung function is unclear. METHODS: We performed a secondary dataset analysis of the three cycles of the National Health and Nutrition Examination Survey (NHANES) from 2007 to 2012. The association of urinary NNAL with spirometry values was assessed using weighted linear models. In addition, subgroup analyses by gender were also tested. RESULTS: One unit increased in urinary NNAL could result in a 28% decrease of FEV1/FVC% (mean difference, MD= -0.28; 95% CI: -0.39 - -0.17), 44% decrease of FEV1% (MD= -0.44; 95% CI: -0.69 - -0.18), and FEV1/FEV6% and FEV3/FEV6% decreased by 20% and 8%, respectively. Increased urinary NNAL was associated with lower PEF% (MD= -0.85; 95% CI: -1.19 - -0.51), FEF25-75% (MD= -1.40; 95% CI: -1.94 - -0.87), and FENO (MD= -0.67; 95% CI: -0.92 - -0.42). But forced expiratory time (FET) showed an increment (MD=0.10; 95% CI: 0.03-0.16). The FEV1/FEV6% and FEV3/FEV6% showed decreasing trend from the lowest urinary NNAL quartiles to the highest urinary NNAL quartiles, while FET showed an increased trend. PEF%, FEF 25-75%, and FENO showed the same decreasing trend (all p<0.05). In addition, urinary NNAL seemed to affect spirometry values more in males. CONCLUSIONS: Urinary NNAL was negatively correlated with FEV1/FVC%, FEV1%, FEV1/FEV6%, FEV3/FEV6%, PEF%, FEF25-75%, and FENO, which was closely related to lung function.

Biodegradable Pea Protein Fibril Hydrogel-Based Quasi-Solid-State Zn-Ion Battery.

Zinc-ion batteries show great potential as the next-generation power source due to their nontoxic, low-cost, and safe properties. However, issues with zinc anodes, such as dendrite growth and parasitic hydrogen evolution reactions (HERs), must be addressed to commercialize them. Solutions, such as quasi-solid-state electrolytes made from synthetic polymer hydrogels, have been proposed to improve battery flexibility and energy density. However, most polymers used are nonbiodegradable, posing a challenge to sustainability. In this study, hydrogels made from biodegradable poly(vinyl alcohol) and protein nanofibrils from pea protein, a renewable plant-based source, are used as an electrolyte in aqueous zinc-ion batteries. Results show that the flexible and biodegradable hydrogel can enhance the zinc anode stability and effectively restrict HER. This phenomenon is because of the hydrogen-bond network between nanofibril functional groups and water molecules. In addition, the interaction between functional groups on nanofibrils and Zn2+ constructs ion channels for the even migration of Zn2+, avoiding dendrite growth. The Zn||Zn symmetric cell using the hydrogel electrolyte exhibits a long lifespan of over 3000 h and improved capacity retention in the Zn||AC-I2 hybrid ion batteries by suppressing cathode material dissolution. This study suggests the potential of biodegradable hydrogels as a sustainable and effective solution for biodegradable soft powering sources.

Association of oxidative balance score with sleep quality: NHANES 2007-2014.

BACKGROUND: Oxidative stress is correlated with sleep quality. A common tool for evaluating dietary and lifestyle exposures to oxidative stress is the Oxidative Balance Score (OBS), with higher OBS suggesting more substantial antioxidant exposures. The relationship between OBS and sleep quality is unclear. Investigating the association between OBS and sleep quality was the purpose of this study. METHODS: To figure out the relationship between OBS and sleep quality, we utilized weighted linear models and weighted logistic regression. Adjusted models were also examined. RESULTS: 6300 participants who took part in the National Health and Nutrition Examination Survey (NHANES) from 2007 to 2014 were recruited. OBS was negatively associated with sleep disorder (OR: 0.97; 95 % CI: 0.94-0.99), and positively associated with sleep duration (MD: 0.02; 95%CI: 0.01-0.03). Within the range of OBS > 24, each unit increase in OBS will result in a 40 % reduction in sleep disorder, and a 26 % increasement in sleep duration after adjustment (all P for trend <0.05). Dietary and lifestyle components were closely related to sleep quality independently. The relationship between OBS and sleep quality was prominent in the female population under 50 years of age. After stratification by education level, this relationship persisted. LIMITATION: This research was cross-sectional design, and it was not possible to deduce causality. CONCLUSION: Diet and lifestyle might influence sleep quality by modulating oxidative balance. Antioxidant diets and lifestyles were important in reducing sleep problems and our study also provided new ideas for improving sleep quality.

Fibroblast growth factor 10 alleviates acute lung injury by inhibiting excessive autophagy via Nrf2.

Acute lung injury (ALI) is associated with an increased incidence of respiratory diseases, which are devastating clinical disorders with high global mortality and morbidity. Evidence confirms that fibroblast growth factors (FGFs) play key roles in mediating ALI. Mice were treated with LPS (lipopolysaccharide: 5 mg/kg, intratracheally) to establish an in vivo ALI model. Human lung epithelial BEAS-2B cells cultured in a corresponding medium with LPS were used to mimic the ALI model in vitro. In this study, we characterized FGF10 pretreatment (5 mg/kg, intratracheally) which improved LPS-induced ALI, including histopathological changes, and reduced pulmonary edema. At the cellular level, FGF10 pretreatment (10 ng/mL) alleviated LPS-induced ALI accompanied by reduced reactive oxygen species (ROS) accumulation and inflammatory responses, such as IL-1ß, IL-6, and IL-10, as well as suppressed excessive autophagy. Additionally, immunoblotting and co-immunoprecipitation showed that FGF10 activated nuclear factor erythroid-2-related factor 2 (Nrf2) signaling pathway via Nrf2 nuclear translocation by promoting the interaction between p62 and keap1, thereby preventing LPS-induced ALI. Nrf2 knockout significantly reversed these protective effects of FGF10. Together, FGF10 protects against LPS-induced ALI by restraining autophagy via p62-Kelch-like ECH-associated protein 1 (Keap1)-Nrf2 signaling pathway, implying that FGF10 could be a novel therapy for ALI.

Associations between the muscle quality index and adult lung functions from NHANES 2011-2012.

Background: The muscle quality index (MQI), as an important component of sarcopenia, is defined as the ratio of muscle strength to muscle mass. Lung function, is a clinical indicator to assess ventilation and air exchange function. This study investigated the relationship between lung function indices and MQI in the NHANES database from 2011 to 2012. Methods: This study included 1,558 adults from the National Health and Nutrition Examination Survey from 2011 to 2012. Muscle mass and muscle strength were assessed using DXA and handgrip strength, and all participants underwent pulmonary function measurements. Multiple linear regression and multivariable logistic regression were used to assess the correlation between the MQI and lung function indices. Results: In the adjusted model, MQI was significantly correlated with FVC% and PEF%. And, after quartiles of MQI in Q3, where FEV1%, FVC%, and PEF% were all associated with MQI, in Q4, a lower relative risk of a restrictive spirometry pattern was linked to increased MQI. Compared to the lower age group, the relationship between the MQI and lung function indices was more significant in the higher age group. Conclusion: There was an association between the MQI and lung function indices. Furthermore, in the middle-aged and older adult populations, lung function indicators and restrictive ventilation impairment were significantly associated with MQI. This implies that improving lung function through muscle training may be beneficial to this group.

Synergistic Tuning of CoO/CoP Heterojunction Nanowire Arrays as Efficient Bifunctional Catalysts for Alkaline Overall Water Splitting.

Bifunctional electrocatalysts with superior activity and durability are of great importance for electrocatalytic water splitting. Herein, hierarchical structured CoO/CoP heterojunctions are successfully designed as highly efficient and freestanding bifunctional electrocatalysts toward overall water splitting. The unique microstructure combining two-dimensional nanosheets with one-dimensional nanowires enables numerous exposed active sites, shortened ion-diffusion pathways, and enhanced conductivity, significantly improving performance. Such freestanding electrodes achieve high current density over 400 mA cm-2 at low overpotentials and have exceptional electrocatalytic activity as well as long-term durability for both hydrogen and oxygen evolution reactions under alkaline conditions. Remarkably, a high current density of 20 mA cm-2 is generated at a low cell voltage of 1.56 V in an alkaline water electrolyzer, originating from synergistic interactions between CoO and CoP exposing active sites and facilitating charge transfer and enhancing kinetics. This work provides new insight into designing low-cost but high-performance bifunctional electrocatalysts for practical water splitting.

Self-Transformation Strategy Toward Vanadium Dioxide Cathode For Advanced Aqueous Zinc Batteries.

In the lithium-dominated era, rechargeable Zn batteries are emerging as a competitive alternative. However, the sluggish kinetics of ion diffusion and structural destruction of cathode materials have thus far hampered the realization of future large-scale energy storage. Herein, an in situ self-transformation approach is reported to electrochemically boost the activity of a high-temperature, argon-treated VO2 (AVO) microsphere for effective Zn ion storage. The presynthesized AVO with hierarchical structure and high crystallinity allows efficient electrochemical oxidation and water insertion to induce self-phase transformation into V2 O5 ·nH2 O within the first charging process, which leads to rich active sites and fast electrochemical kinetics. Using AVO cathode, an outstanding discharge capacity of 446 mAh g-1 at 0.1 A g-1 , high rate capability of 323 mAh g-1 at 10 A g-1 and excellent cycling stability for 4000 cycles at 20 A g-1 with high capacity retention are demonstrated. Importantly, such zinc-ion batteries with phase self-transition can also perform well at high-loading, sub-zero temperature, or pouch cell conditions for practical application. This work not only paves a new route to design in situ self-transformation in energy storage devices, but also broadens the horizons of aqueous zinc-supplied cathodes.

Oxidative balance score was negatively associated with the risk of metabolic syndrome, metabolic syndrome severity, and all-cause mortality of patients with metabolic syndrome.

Background: The oxidative balance score (OBS), an encompassing scoring mechanism for assessing oxidative stress, is formulated based on nutritional and lifestyle components. The emergence of metabolic syndrome (MetS) is intricately linked to oxidative stress. Nonetheless, the correlation between OBS and MetS displays variability within distinct cohorts. Objective: We worked on the relationships between OBS and the risk of MetS, MetS severity, and all-cause mortality of MetS patients. Methods: A total of 11,171 adult participants were collected from the U.S. National Health Examination Survey (NHANES) 2007-2018. Employing survey-weighted logistic models, we evaluated the relationship between OBS and MetS risk. Furthermore, survey-weighted linear models were utilized to investigate the connection between OBS and MetS severity. Among the participants, 3,621 individuals had their survival status recorded, allowing us to employ Cox proportional hazards regression models in order to ascertain the association between OBS and the all-cause mortality within the subset of individuals with MetS. The OBS (where a higher OBS signified an increased prevalence of anti- or pro-oxidant exposures) weighed the 20 factors, while the MetS severity score weighed the five factors. Results: After multivariable adjustment, individuals with elevated OBS were found to exhibit a decreased susceptibility to MetS [odds ratio (OR) 0.95; 95% CI 0.94-0.96]. The adjusted OR was 0.42 (95% CI 0.33-0.53) for MetS risk in the fourth OBS quartile compared with those in the first OBS quartile (P for trend < 0.001). A one-unit increase in OBS was linked to a 3% reduction in MetS severity score by 3% (mean difference, -0.03; 95% CI, -0.04 to -0.03). Moreover, increased OBS correlated with decreased hazard of all-cause mortality risk among MetS subjects (adjusted hazard ratio, 0.95; 95% CI, 0.93-0.98). These associations retained their strength even subsequent to the introduction of sensitivity analyses. There existed a statistically significant negative correlation between diet/lifestyle OBS and both MetS risk as well as MetS severity. Conclusions: An inverse correlation was observed between OBS and the susceptibility to MetS, MetS severity, and all-cause mortality of MetS patients. Health outcomes for MetS patients were positively related to antioxidant diets and lifestyles.

Performance of Machine Learning Algorithms for Predicting Adverse Outcomes in Community-Acquired Pneumonia.

Background: The ability to assess adverse outcomes in patients with community-acquired pneumonia (CAP) could improve clinical decision-making to enhance clinical practice, but the studies remain insufficient, and similarly, few machine learning (ML) models have been developed. Objective: We aimed to explore the effectiveness of predicting adverse outcomes in CAP through ML models. Methods: A total of 2,302 adults with CAP who were prospectively recruited between January 2012 and March 2015 across three cities in South America were extracted from DryadData. After a 70:30 training set: test set split of the data, nine ML algorithms were executed and their diagnostic accuracy was measured mainly by the area under the curve (AUC). The nine ML algorithms included decision trees, random forests, extreme gradient boosting (XGBoost), support vector machines, Naïve Bayes, K-nearest neighbors, ridge regression, logistic regression without regularization, and neural networks. The adverse outcomes included hospital admission, mortality, ICU admission, and one-year post-enrollment status. Results: The XGBoost algorithm had the best performance in predicting hospital admission. Its AUC reached 0.921, and accuracy, precision, recall, and F1-score were better than those of other models. In the prediction of ICU admission, a model trained with the XGBoost algorithm showed the best performance with AUC 0.801. XGBoost algorithm also did a good job at predicting one-year post-enrollment status. The results of AUC, accuracy, precision, recall, and F1-score indicated the algorithm had high accuracy and precision. In addition, the best performance was seen by the neural network algorithm when predicting death (AUC 0.831). Conclusions: ML algorithms, particularly the XGBoost algorithm, were feasible and effective in predicting adverse outcomes of CAP patients. The ML models based on available common clinical features had great potential to guide individual treatment and subsequent clinical decisions.

An Ultrafast, Durable, and High-Loading Polymer Anode for Aqueous Zinc-Ion Batteries and Supercapacitors.

Zn metal has shown promise as an anode material for grid-level energy storage, yet is challenged by dendritic growth and low Coulombic efficiency. Herein, an ultrafast, stable, and high-loading polymer anode for aqueous Zn-ion batteries and capacitors (ZIBs and ZICs) is developed by engineering both the electrode and electrolyte. The anode polymer is rationally prepared to have a suitable electronic structure and a large π-conjugated structure, whereas the electrolyte is manufactured based on the superiority of triflate anions over sulfate anions, as analyzed and confirmed via experiments and simulations. This dual engineering results in an optimal polymer anode with a low discharge potential, near-theoretical capacity, ultrahigh-loading capability (≈50 mg cm-2 ), ultrafast rate (100 A g-1 ), and ultralong lifespan (one million cycles). Its mechanism involves reversible Zn2+ /proton co-storage at the carbonyl site. When the polymer anode is coupled with cathodes for both ZIB and ZIC applications, the devices demonstrate ultrahigh power densities and ultralong lifespans, far surpassing those of corresponding Zn-metal-based devices.

Efficient Zn Metal Anode Enabled by O,N-Codoped Carbon Microflowers.

Zinc metal anodes show great promise for cheap and safe energy storage devices. However, it remains challenging to regulate highly efficient Zn plating/stripping under a high depth of discharge (DOD). Guided by density functional theory calculation, we here synthesized an oxygen- and nitrogen-codoped carbon superstructure as an efficient host for high-DOD Zn metal anodes through rational monomer selection, polymer self-assembly, and structure-preserved carbonization. With microscale 3D hierarchical structures, microcrystalline graphitic layers, and zincophilic heteroatom dopants, a flower-shaped carbon (Cflower) host could guide Zn nucleation and growth in a heteroepitaxial mode, affording horizontal plating with a high Coulombic efficiency (CE) and long life. As a demonstration, the Cflower-hosted Zn anode was paired with both battery and supercapacitor cathodes and delivered large capacity/capacitance, fast rates, long life, and ca. 100% CE even under a high DOD, outclassing hostless Zn-based devices. As they possess cheap, scalable, and efficient features, Cflower hosts hold the potential for practical zinc-metal-based energy devices.

Association of oxidative balance score and lung health from the National Health and Nutrition Examination Survey 2007-2012.

Background: Oxidative stress is associated with outcomes of chronic lung disease. The oxidative stress-related exposures of diet and lifestyle can be evaluated by the oxidative balance score (OBS), and higher OBS scores indicate more significant antioxidant exposures. But the relationship between OBS and lung health is unknown. Purpose: The aim of this study was to explore the association between OBS and lung health (respiratory symptoms, chronic lung disease, and lung function). Methods: A series of models, including weighted linear models, weighted logistic regression, and weighted multinomial logistic regression, were performed to assess the associations of OBS with respiratory symptoms, chronic lung disease, and lung function. The models adjusted by age, race/ethnicity, gender, educational background, poverty-to-income ratio, and dietary energy were also performed. Results: Cross-sectional data of 5,214 participants from the National Health and Nutrition Examination Survey for the years 2007-2012 were analyzed. For every one-unit increase in OBS, the odds of wheezing/chronic bronchitis decreased by 6%. Increased OBS was associated with higher percent-predicted forced expiratory volume in one second (FEV1) (adjusted mean difference (MD), 0.21%; 95% CI: 0.10-0.32) and percent-predicted forced vital capacity (FVC) (adjusted MD, 0.15%; 95% CI: 0.07-0.24). A significantly lower risk of wheezing/chronic bronchitis was found in participants in the second/third/fourth OBS quartile compared to those in the first OBS quartile (all P for trend < 0.05). Moreover, higher percent-predicted FEV1 and FVC were also found in the third quartile and fourth quartile (all P for trend < 0.05). Furthermore, both dietary and lifestyle components were tightly related to pulmonary outcomes. Many associations were maintained after stratified by sex or after sensitivity analyses. Conclusion: Oxidative balance score was negatively correlated with the diagnosis of chronic bronchitis/wheezing/restrictive spirometry pattern and positively correlated with percent-predicted FVC and FEV1. It seems that the higher the OBS score, the better the pulmonary outcomes. The findings highlight the importance of adherence to an antioxidant diet and lifestyle and that it contributes to lung health.

Skeletal muscle depletion predicts death in severe community-acquired pneumonia patients entering ICU.

BACKGROUND: Sarcopenia, or skeletal muscle depletion, was common in the elderly and often led to a poor prognosis of diseases. The area of the psoas muscle in abdominal computed tomography (CT) is the most common used for diagnosing sarcopenia. However, patients with pneumonia routinely only undergo chest CT. OBJECTIVES: This study aimed to determine whether paraspinal muscle area (PMA) obtained by chest CT can predict death for community-acquired pneumonia (SCAP) patients entering intensive care unit (ICU). METHODS: This study enrolled 208 SCAP patients admitted to ICU after undergoing chest CT. PMA, paraspinal muscle radiodensity (PMD), and lean paraspinal muscle area (LPMA) were calculated on chest CT images. The main outcome was mortality during hospitalization. Logistic regression, receiver operating characteristic (ROC) curve, and Kaplan-Meier curves were used to evaluate forecasting effectiveness. RESULTS: The primary outcome occurred in 76 (36.53%) patients. In multivariate logistic regression, PMA, lactic dehydrogenase (LDH), invasive mechanical ventilation (IMV), red blood cell (RBC) and age≥ 65 years were independent risk factors predicting death during hospitalization (adjusted Odds Ratio [OR]: 0.886, 1.002, 3.178, 0.612 and 2.003, respectively). The area under curve (AUC) of PMA to predict death was 0.720 (P< 0.001). During hospitalization, the median survival time of high-PMA (51.00 days) and low-PMA groups (20.00 days) was statistically significant (P< 0.001). CONCLUSION: Lower PMA was associated with an increased risk of death for SCAP patients admitted to the ICU. In other words, PMA may help early identify adverse prognosis of SCAP patients admitted to ICU.

Abnormal Expression and Prognostic Significance of Bone Morphogenetic Proteins and Their Receptors in Lung Adenocarcinoma.

BACKGROUND: Lung adenocarcinoma (LUAD) is one of the most life-threatening malignancies. The crucial role of bone morphogenetic protein (BMP)/BMP receptors reveals the significance of exploring BMP protein-related prognostic predictors in LUAD. METHODS: The mRNA expression of BMPs/BMP receptors was investigated in LUAD and normal lung tissues. Gene Ontology and the Kyoto Encyclopedia of Genes and Genomes pathway analyses were performed, and the prognostic values were assessed by Kaplan-Meier Plotter. Univariate and multivariate Cox regression analyses were executed to ascertain the correlation between overall survival (OS) and the mRNA expression of BMPs/BMP receptors. The receiver operating characteristic (ROC) curves were implemented to evaluate the predictive power of the prognostic model. Then, the prognostic model was validated in the GEO cohort. Furthermore, a nomogram comprising the prognostic model was established. RESULTS: The mRNA expression of BMP2/5/6/R2, ACVRL1, and TGFBR2/3 was lower in LUAD tissues than in normal lung tissues. High expression of BMP2/4/5/R1A/R2, ACVR1/2A/L1, and TGFBR1/3 was associated with better OS, while BMP7 and ACVR1C/2B were associated with poorer OS. Three genes (BMP5, BMP7, and ACVR2A) were screened by univariate and multivariate Cox regression analyses to develop the prognostic model in TCGA. Significantly better survival was observed in LUAD patients with a low-risk score than those with a high-risk score. The ROC curves confirmed the good performance of the prognostic model, then, the prognostic model was validated in the GSE31210 dataset. A nomogram was constructed (AUCs>0.7). And hub genes were further evaluated, including gene set enrichment analysis and immune cell infiltration. CONCLUSIONS: BMP5, BMP7, and ACVR2A are potential therapeutic targets in LUAD. The three-gene prognostic model and the nomogram are reliable tools for predicting the OS of LUAD patients.

Candidate Genes Identified in Systemic Sclerosis-Related Pulmonary Arterial Hypertension Were Associated with Immunity, Inflammation, and Cytokines.

BACKGROUND: Pulmonary complications of systemic sclerosis (SSc), including pulmonary arterial hypertension (PAH), are the leading causes of patient death. However, the precise molecular mechanisms of its etiology are unclear. This study's objective was to identify the candidate genes involved in the progression of SSc-PAH and investigate the genes' function. METHODS: The gene expression profiles of GSE33463 were obtained from the Gene Expression Omnibus (GEO) database. A free-scale gene coexpression network was constructed using the weighted gene coexpression network analysis (WGCNA) to explore the association between gene sets and clinical features and identify candidate biomarkers. Then, gene ontology analysis was performed. A second dataset was used, GSE19617, to validate the hub genes. The verified hub genes' potential function was further explored using gene set enrichment analysis (GSEA). RESULTS: Through average link-level clustering, a total of seven modules were classified. A total of 938 hub genes were identified in the key module, and the key module's function mainly enriched was related to chemokine activities. Subsequently, four candidate genes, BTG3, CCR2, RAB10, and TMEM60, were filtered. The expression levels of these four hub genes were consistent in the GSE19617 and GSE33463 datasets. We plotted the ROC curve of the hub genes (all AUC > 0.70). Furthermore, the results of the GSEA for hub genes were correlated with complement and inflammatory responses. CONCLUSIONS: The hub genes (BTG3, CCR2, RAB10, and TMEM60) performed well in distinguishing the SSc-PAH patients from controls, and some biological functions, related to immunity, inflammation, and cytokines, might pave the way for follow-up studies on the diagnosis and treatment of SSc-PAH.

Neutrophil-to-Lymphocyte Ratio and Platelet-to-Lymphocyte Ratio Predict Mortality in Patients with Diabetic Foot Ulcers Undergoing Amputations.

PURPOSE: Elevated platelet-to-lymphocyte ratio (PLR) and neutrophil-to-lymphocyte ratio (NLR) are associated with poor outcomes in various diseases. The objectives of this study were to explore the utility of PLR and NLR in predicting all-cause mortality in patients with diabetic foot ulcers (DFU) undergoing amputations. PATIENTS AND METHODS: A retrospective observational study was performed that included a total of 348 DFU patients undergoing amputations. The primary end-point was all-cause death. According to the PLR and NLR cut-off values, patients were divided into two groups and Kaplan-Meier survival curves were constructed. Multivariable Cox regression was conducted to test the independent predictors of mortality in the study cohort. RESULTS: All-cause mortality was significantly higher in patients with a high PLR/NLR compared to those with a low PLR/NLR. In the low NLR group, the overall survival (OS) rates at 1, 3, and 5 years after amputation were 96.8%, 84% and 80.1%, respectively (p=0.001). In the high NLR group the corresponding OS rates at 1, 3, and 5 years were 85.2%, 58.6% and 23.9% (p<0.001). According to the multivariate analysis, age (HR 1.074, 95% CI 1.045-1.104, p<0.001), Wagner classification (HR 2.274, 95% CI 1.351-3.828, p=0.002), PLR (HR 1.794, 95% CI 1.014-3.174, p=0.045), NLR (HR 2.029, 95% CI 1.177-3.499, p=0.011), creatinine (HR 1.003, 95% CI 1.001-1.004, p<0.001) and direct bilirubin (HR 1.154, 95% CI 1.081-1.232, p<0.001) were independent predictors of mortality following amputation. CONCLUSION: Postoperative PLR and NLR values may be reliable predictive biomarkers of mortality in patients following amputation for DFU. Considering the high mortality in those patients, the patients with elevated PLR/NLR should be given more intensive in clinical practice.