56 research outputs found

    Hyperoxemia and excess oxygen use in early acute respiratory distress syndrome : Insights from the LUNG SAFE study

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    Publisher Copyright: © 2020 The Author(s). Copyright: Copyright 2020 Elsevier B.V., All rights reserved.Background: Concerns exist regarding the prevalence and impact of unnecessary oxygen use in patients with acute respiratory distress syndrome (ARDS). We examined this issue in patients with ARDS enrolled in the Large observational study to UNderstand the Global impact of Severe Acute respiratory FailurE (LUNG SAFE) study. Methods: In this secondary analysis of the LUNG SAFE study, we wished to determine the prevalence and the outcomes associated with hyperoxemia on day 1, sustained hyperoxemia, and excessive oxygen use in patients with early ARDS. Patients who fulfilled criteria of ARDS on day 1 and day 2 of acute hypoxemic respiratory failure were categorized based on the presence of hyperoxemia (PaO2 > 100 mmHg) on day 1, sustained (i.e., present on day 1 and day 2) hyperoxemia, or excessive oxygen use (FIO2 ≥ 0.60 during hyperoxemia). Results: Of 2005 patients that met the inclusion criteria, 131 (6.5%) were hypoxemic (PaO2 < 55 mmHg), 607 (30%) had hyperoxemia on day 1, and 250 (12%) had sustained hyperoxemia. Excess FIO2 use occurred in 400 (66%) out of 607 patients with hyperoxemia. Excess FIO2 use decreased from day 1 to day 2 of ARDS, with most hyperoxemic patients on day 2 receiving relatively low FIO2. Multivariate analyses found no independent relationship between day 1 hyperoxemia, sustained hyperoxemia, or excess FIO2 use and adverse clinical outcomes. Mortality was 42% in patients with excess FIO2 use, compared to 39% in a propensity-matched sample of normoxemic (PaO2 55-100 mmHg) patients (P = 0.47). Conclusions: Hyperoxemia and excess oxygen use are both prevalent in early ARDS but are most often non-sustained. No relationship was found between hyperoxemia or excessive oxygen use and patient outcome in this cohort. Trial registration: LUNG-SAFE is registered with ClinicalTrials.gov, NCT02010073publishersversionPeer reviewe

    Cabbage and fermented vegetables : From death rate heterogeneity in countries to candidates for mitigation strategies of severe COVID-19

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    Large differences in COVID-19 death rates exist between countries and between regions of the same country. Some very low death rate countries such as Eastern Asia, Central Europe, or the Balkans have a common feature of eating large quantities of fermented foods. Although biases exist when examining ecological studies, fermented vegetables or cabbage have been associated with low death rates in European countries. SARS-CoV-2 binds to its receptor, the angiotensin-converting enzyme 2 (ACE2). As a result of SARS-CoV-2 binding, ACE2 downregulation enhances the angiotensin II receptor type 1 (AT(1)R) axis associated with oxidative stress. This leads to insulin resistance as well as lung and endothelial damage, two severe outcomes of COVID-19. The nuclear factor (erythroid-derived 2)-like 2 (Nrf2) is the most potent antioxidant in humans and can block in particular the AT(1)R axis. Cabbage contains precursors of sulforaphane, the most active natural activator of Nrf2. Fermented vegetables contain many lactobacilli, which are also potent Nrf2 activators. Three examples are: kimchi in Korea, westernized foods, and the slum paradox. It is proposed that fermented cabbage is a proof-of-concept of dietary manipulations that may enhance Nrf2-associated antioxidant effects, helpful in mitigating COVID-19 severity.Peer reviewe

    Nrf2-interacting nutrients and COVID-19 : time for research to develop adaptation strategies

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    There are large between- and within-country variations in COVID-19 death rates. Some very low death rate settings such as Eastern Asia, Central Europe, the Balkans and Africa have a common feature of eating large quantities of fermented foods whose intake is associated with the activation of the Nrf2 (Nuclear factor (erythroid-derived 2)-like 2) anti-oxidant transcription factor. There are many Nrf2-interacting nutrients (berberine, curcumin, epigallocatechin gallate, genistein, quercetin, resveratrol, sulforaphane) that all act similarly to reduce insulin resistance, endothelial damage, lung injury and cytokine storm. They also act on the same mechanisms (mTOR: Mammalian target of rapamycin, PPAR gamma:Peroxisome proliferator-activated receptor, NF kappa B: Nuclear factor kappa B, ERK: Extracellular signal-regulated kinases and eIF2 alpha:Elongation initiation factor 2 alpha). They may as a result be important in mitigating the severity of COVID-19, acting through the endoplasmic reticulum stress or ACE-Angiotensin-II-AT(1)R axis (AT(1)R) pathway. Many Nrf2-interacting nutrients are also interacting with TRPA1 and/or TRPV1. Interestingly, geographical areas with very low COVID-19 mortality are those with the lowest prevalence of obesity (Sub-Saharan Africa and Asia). It is tempting to propose that Nrf2-interacting foods and nutrients can re-balance insulin resistance and have a significant effect on COVID-19 severity. It is therefore possible that the intake of these foods may restore an optimal natural balance for the Nrf2 pathway and may be of interest in the mitigation of COVID-19 severity

    Phytoplankton-zooplankton inter-relationships in tropical waters—Grazing and gut pigment dynamics

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    116-124<span style="font-size:14.0pt;line-height: 115%;font-family:" times="" new="" roman";mso-fareast-font-family:"times="" roman";="" color:black;mso-ansi-language:en-in;mso-fareast-language:en-in;mso-bidi-language:="" hi"="" lang="EN-IN">An examinaion of the feeding mechanisms in two taxonomically dissimilar classes of tropical planktonic herbivores Evadne tergestina (Cladocera) and Acrocalanus spp. (Copepoda) revealed a distinct rhythmicity of food intake. Brief bouts of phytoplankton intake were interspersed with breaks during which grazing activity ceased probably due to the onset of digestive enzyme activity. Over 90% of the chl a ingested was rapidly degraded during its passage through the digestive tract of the animals suggesting a high assimilatory and metabolic capacity within tropical planktonic herbivores as compared to temperate and polar forms. When subject to prolonged periods of starvation, both animals exhibited a clear tendency to reingest their own fecal pellets. In tropical oligotrophic waters where an invariably limiting size of phytoplankton food stock imposes constraints on zooplankton growth, the ability of tropical planktonic herbivores to resort to coprophagic feeding assumes particular importance as existing models make no allowances for reingestion of fecal pellets when quantifying and computing energy transfer in·the food chain.</span

    Atmospheric Correction of Airborne Hyperspectral CASI Data Using Polymer, 6S and FLAASH

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    Airborne hyperspectral data play an important role in remote sensing of coastal waters. However, before their application, atmospheric correction is required to remove or reduce the atmospheric effects caused by molecular and aerosol scattering and absorption. In this study, we first processed airborne hyperspectral CASI-1500 data acquired on 4 May 2019 over the Uljin coast of Korea with Polymer and then compared the performance with the other two widely used atmospheric correction approaches, i.e., 6S and FLAASH, to determine the most appropriate correction technique for CASI-1500 data in coastal waters. Our results show the superiority of Polymer over 6S and FLAASH in deriving the Rrs spectral shape and magnitude. The performance of Polymer was further evaluated by comparing CASI-1500 Rrs data with those obtained from the MODIS-Aqua sensor on 3 May 2019 and processed using Polymer. The spectral shapes of the derived Rrs from CASI-1500 and MODIS-Aqua matched well, but the magnitude of CASI-1500 Rrs was approximately 0.8 times lower than MODIS Rrs. The possible reasons for this difference were time difference (1 day) between CASI-1500 and MODIS data, higher land adjacency effect for MODIS-Aqua than for CASI-1500, and possible errors in MODIS Rrs from Polymer

    Atmospheric Correction of Airborne Hyperspectral CASI Data Using Polymer, 6S and FLAASH

    No full text
    Airborne hyperspectral data play an important role in remote sensing of coastal waters. However, before their application, atmospheric correction is required to remove or reduce the atmospheric effects caused by molecular and aerosol scattering and absorption. In this study, we first processed airborne hyperspectral CASI-1500 data acquired on 4 May 2019 over the Uljin coast of Korea with Polymer and then compared the performance with the other two widely used atmospheric correction approaches, i.e., 6S and FLAASH, to determine the most appropriate correction technique for CASI-1500 data in coastal waters. Our results show the superiority of Polymer over 6S and FLAASH in deriving the Rrs spectral shape and magnitude. The performance of Polymer was further evaluated by comparing CASI-1500 Rrs data with those obtained from the MODIS-Aqua sensor on 3 May 2019 and processed using Polymer. The spectral shapes of the derived Rrs from CASI-1500 and MODIS-Aqua matched well, but the magnitude of CASI-1500 Rrs was approximately 0.8 times lower than MODIS Rrs. The possible reasons for this difference were time difference (1 day) between CASI-1500 and MODIS data, higher land adjacency effect for MODIS-Aqua than for CASI-1500, and possible errors in MODIS Rrs from Polymer

    Reviews and syntheses: Present, past, and future of the oxygen minimum zone in the northern Indian Ocean

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    Decreasing concentrations of dissolved oxygen in the ocean are considered one of the main threats to marine ecosystems as they jeopardize the growth of higher organisms. They also alter the marine nitrogen cycle, which is strongly bound to the carbon cycle and climate. While higher organisms in general start to suffer from oxygen concentrations  0 and ∼ 0.05 µM is highly extraordinary considering that the monsoon reverses the surface ocean circulation twice a year and turns vast areas of the Arabian Sea from an oligotrophic oceanic desert into one of the most productive regions of the oceans within a few weeks. Thus, the comparably low variability of oxygen concentration in the OMZ implies stable balances between the physical oxygen supply and the biological oxygen consumption, which includes negative feedback mechanisms such as reducing oxygen consumption at decreasing oxygen concentrations (e.g., reduced respiration). Lower biological oxygen consumption is also assumed to be responsible for a less intense OMZ in the Bay of Bengal. According to numerical model results, a decreasing physical oxygen supply via the inflow of water masses from the south intensified the Arabian Sea OMZ during the last 6000 years, whereas a reduced oxygen supply via the inflow of Persian Gulf Water from the north intensifies the OMZ today in response to global warming. The first is supported by data derived from the sedimentary records, and the latter concurs with observations of decreasing oxygen concentrations and a spreading of functional anoxia during the last decades in the Arabian Sea. In the Arabian Sea decreasing oxygen concentrations seem to have initiated a regime shift within the pelagic ecosystem structure, and this trend is also seen in benthic ecosystems. Consequences for biogeochemical cycles are as yet unknown, which, in addition to the poor representation of mesoscale features in global Earth system models, reduces the reliability of estimates of the future OMZ development in the northern Indian Ocean
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