The Indices of Instantaneous Pulse Rate Variability Are Indicators for Daily Life Quality Assessment in Patients with COPD.

Chronic obstructive pulmonary disease (COPD) is a progressive respiratory illness. Questionnaires such as modified Medical Research Council (mMRC) dyspnea scale and COPD assessment test (CAT) are useful for COPD condition and life quality assessment. These questionnaires reflect how respiratory disorder affects daily life. Breathing and autonomic nervous system (ANS) usually regulate each other. Few studies discussed the ANS activity and daily life quality in patients with COPD. Therefore, this study aimed to find the relationship between daily life quality assessed by mMRC or CAT and ANS assessed by a novel method, instantaneous pulse rate variability (iPRV), a method indicating not only the ANS activity but also the peripheral response. The result showed that the change in mMRC and the change in low frequency power to high frequency power ratio, which usually represents the sympathetic activity in conventional heart rate variability analysis, had significant correlation (r = 0.63; p < 0.05). The change in CAT and the change in high frequency power (regulated by vagal nervous and respiratory system) or very high frequency power (new frequency band can be indicated in iPRV spectrum) had significant negative correlation (r = -0.64 and -0.55, respectively; p < 0.05 for both). This study showed the change in iPRV indices when the condition of COPD was improvement or exacerbation. This study presents a possible way to show how cardiovascular activity affects daily life quality in patients with COPD. Increase in LF or decrease in HF and VHF would cause poorer quality of daily life in patients with COPD. The result can also be a reference for patients with COPD to choose the breathing type to adjust rehabilitation and therapy program for ANS regulation to indicate or improve their daily life quality.

[Characteristics and Evaluation of Soil Rare Earth Element Pollution in the Bayan Obo Mining Region of Inner Mongolia].

The Bayan Obo deposit is the largest light rare earth ore deposit in the world, which releases rare earth elements (REEs) to the surrounding environment through long-term mining processes. To inform restoration plans, it is necessary to investigate the concentration, spatial distribution, pollution level, and ecological risk of REEs. Sample analyses showed that the average total concentration of REEs in this area is 6064.95 mg·kg-1, which was higher than the background levels of control soils (207.44 mg·kg-1), Inner Mongolia (150.95 mg·kg-1), and China (184.72 mg·kg-1). Light REEs (LREEs) accounted for 83%-99% of the detected REE, and Ce was the dominant element. Areas with high REE concentrations were mainly located near the source bed, and the distribution was extremely inhomogeneous, being greatly affected by external interference. Chondrite normalized REE patterns of different functional areas were similar and normalized curves inclined to the right, indicating district fractionation between the LREE and heavy REEs (HREEs). Significant negative Eu anomalies and positive Ce anomalies were observed in the soils based on δCe and δEu values. La/Yb, La/Sm, and Gd/Yb ratios all indicated that the soils were LREE-enriched, whereas the LREEs were more fractionated than the HREE. Four methods were employed to evaluate the pollution and ecological risk of the detected soil REEs. The average values of Ce, Nd, Pr, and La reached heavily contaminated levels based the geo-accumulation index (Igeo). The modified degree of contamination method showed that the average mCd values of REEs in different functional areas ranged from 7.14 to 31.38. The tailings pond had a high level of pollution, residential and industrial areas had a very high pollution level, and the mining area and waste dump showed extremely high levels of pollution. Based on the pollution load index, the tailings pond is moderately polluted while all other functional areas are severely polluted. The potential ecological risk index values ranged from 120.99 to 6376.46, with REEs in soils posing high strong risk, very strong risk, strong risk, moderate risk, and low risk in 33%, 16%, 12%, 30%, and 9% of the sampling sites, respectively. Based on these findings, measures for controlling current pollution and potential ecological risks from REE in the soils of the Bayan Obo mining region are urgently needed.

Excessive umbilical cord coiling confers risk of elevated nocturnal blood pressure and severe/early-onset preeclampsia.

BACKGROUND: The associations between umbilical cord coiling, feto-placental vascular resistance and maternal blood pressure (BP) are not well understood. METHOD: We retrospectively analyzed 502 pregnant women suspected of hypertensive disorders in the third trimester from a hospital-based cohort, who underwent ambulatory BP monitoring and umbilical artery Doppler velocimetry examinations within 14 days before delivery. By applying quantile regression, a significant quantile-dependent positive association between umbilical cord coiling index and umbilical artery pulsatility index (UAPIMOM; converted to multiples of median) was observed from above 0.75th quantiles for each parameter. RESULTS: Using the cutoffs both at the 0.75th quantile to define high umbilical cord coiling (≥0.28 coils/cm) and high UAPIMOM (≥1.30), respectively, a graded increase in BP level was observed from patients with both low, either high and both high categories. Multivariate linear and quantile regression revealed that the high umbilical cord coiling/high UAPIMOM interaction was significantly correlated with night-time mean DBP level. Moreover, umbilical cord hypercoiling (≥0.3 coils/cm) was significantly correlated with night-time DBP with an average increase of ∼5 mmHg from the 0.05th to 0.70th quantiles and independently predicted the occurrence of severe (odds ratio 2.32, 95% confidence interval: 1.22-4.41) and early-onset (odds ratio 2.43, 95% confidence interval: 1.18-4.97) preeclampsia after adjusting for covariates. Further mediation analysis showed that elevated high UAPIMOM (≥1.30) could explain 11.4% of the umbilical cord hypercoiling → high night-time DBP association. CONCLUSION: Therefore, this retrospective study identifies excessive umbilical cord coiling, and its interaction with increased feto-placental vascular resistance, as novel risk factors for nocturnal BP elevation and preeclampsia.