Relationship between PaO2/FiO2 and delirium in intensive care: A cross-sectional study

Background: To investigate the relationship between partial pressure of oxygen (PaO2)/fraction of inspired oxygen (FiO2) and the probability of delirium in intensive care units (ICUs). Methods: The investigation was a cross-sectional study that involved the collection of data from patients admitted to the Xiang Ya Hospital Cardiothoracic Surgical Care Unit and Comprehensive Intensive Care Unit from 01 September 2016 to 10 December 2016. Delirium was diagnosed using the simplified version of the Chinese Confusion Assessment Method (CAM) for the ICU. Demographic and medical data were obtained within 24 h of each patient admitted in the ICU. The PaO2/FiO2 of each patient was recorded 24 h after admission in the ICU. The patients were divided into three groups according to PaO2/FiO2 data : normal (PaO2/FiO2 ≥300 mmHg), slightly low (200 ≥PaO2/FiO2 <300 mmHg), and severely low (PaO2/FiO2 <200 mmHg). Baseline characteristics were compared in the three groups. Results of the unadjusted model, minimally adjusted model, and fully adjusted model are presented. Results: A total of 403 participants were included in the study, of which 184 (45.7%) developed delirium. Age (P <0.001), Sequential Organ Failure Assessment (SOFA) score (P <0.001), Acute Physiology and Chronic Health Evaluation (APACHE) II score (P <0.001), mechanical ventilation time (P <0.001), history of hypertension (P=0.040), heart disease (P=0.040), sedation (P=0.001), and PaO2/FiO2 (P=0.006) were significantly associated with delirium in univariate analysis. Multivariate regression analysis models were used to further analyze the associations between PaO2/FiO2 and delirium. In the crude model, for 1 standard deviation (SD) increase in PaO2/FiO2, the odds ratio (OR) of delirium was 0.8 (95% confidence interval [CI]: 0.6–0.9), but there was no significant correlation in the fully adjusted model. There was a non-linear relationship between the PaO2/FiO2 and delirium in a generalized additive model. A two-piecewise linear regression model was used to calculate a PaO2/FiO2 threshold of 243 mmHg. On the left side of the threshold, the OR was 0.9 and the 95% CI was 0.9–1.0 (P=0.013) when PaO2/FiO2 increased by 1 SD. Conclusions: PaO2/FiO2 was negatively associated with delirium when PaO2/FiO2 was below the identified threshold. As a readily available laboratory indicator, PaO2/FiO2 has potential value in the clinical evaluation of risk of delirium in ICU patients

A Method for Autonomous Generation of High-Precision Time Scales for Navigation Constellations

The time maintenance accuracy of the navigation constellation determines the user positioning and timing performance. Especially in autonomous operation scenarios, the performance of navigation constellation maintenance time directly affects the duration of constellation autonomous navigation. Among them, the frequency stability of the atomic clock onboard the navigation satellite is a key factor. In order to further improve the stability of the navigation constellation time-frequency system, combined with the development of high-precision inter-satellite link measurement technology, the idea of constructing constellation-level synthetic atomic time has gradually become the development trend of major GNSS systems. This paper gives a navigation constellation time scale generation framework, and designs an improved Kalman plus weights (KPW) time scale algorithm and time-frequency steer algorithm that integrates genetic algorithms. Finally, a 30-day autonomous timekeeping simulation was carried out using the GPS precision clock data provided by CODE, when the sampling interval is 300 s, the Allan deviation of the output time scale is 5.73 × 10−14, a 71% improvement compared with the traditional KPW time scale algorithm; when the sampling interval is 1 day, the Allan deviation is 9.17 × 10−15; when the sampling interval is 1 × 106 s, the Allan deviation is 8.87 × 10−16, a 94% improvement compared with the traditional KPW time scale algorithm. The constellation-level high-precision time scale generation technology proposed in this paper can significantly improve the stability performance of navigation constellation autonomous timekeeping

Stable Iso-osmabenzenes from a Formal [3+3] Cycloaddition Reaction of Metal Vinylidene with Alkynols

National Science Foundation of China[20872123, 20925208

The association between anterior cruciate ligament degeneration and incident knee osteoarthritis: Data from the osteoarthritis initiative

Background: Though anterior cruciate ligament (ACL) tear has been widely accepted as an important accelerator for knee osteoarthritis (KOA), the role of intrinsic ACL degeneration in developing KOA has not been fully investigated. Purpose: To determine whether ACL degeneration, in the absence of ACL tear, is associated with incident KOA over 4 years. Study design: Cohort study; Level of evidence, 2. Methods: Participants’ knees in this nested case–control study were selected from the Osteoarthritis Initiative (OAI) study, with Kellgren–Lawrence grading (KLG) of 0 or 1 ​at baseline (BL). Case knees which had incident KOA (KLG ≥2) over 4 years, were matched 1:1 with control knees by gender, age and radiographic status. ACL signal intensity alteration (0–3 scale) and volume were assessed as compositional feature and morphology of ACL degeneration, using knee MRI at P0 (time of onset of incident KOA), P-1 (1 year prior to P0) and baseline. Conditional logistic regression was applied to analyze the association between measures of ACL degeneration and incident KOA. Results: 337 case knees with incident KOA were matched to 337 control knees. Participants were mostly female (68.5%), with an average age of 59.9 years old. ACL signal intensity alterations at BL, P-1 and P0 were significantly associated with an increased odds of incident KOA respectively (all P for trend ≤0.001). In contrast, ACL volumes were not significantly associated with incident KOA at any time points. Conclusions: ACL signal intensity alteration is associated with increased incident KOA over 4 years, whereas ACL volume is not.The translational potential of this article: This paper focused on ACL signal intensity alteration which could better reflect ACL degeneration rather than ACL tear during the progression of KOA and explored this topic in a nested case–control study. Utilizing MR images from KOA participants, we extracted the imaging features of ACL. In addition, we established a semi-quantitative score for ACL signal intensity alteration and found a significant correlation between it and KOA incidence. Our findings confirmed that the more severe the ACL signal intensity alteration, the stronger relationship with the occurrence of KOA. This suggests that more emphasis should be placed on ACL degeneration rather than ACL integrity in the future

Anticancer effect of Polyphyllin Ι in colorectal cancer cells through ROS-dependent autophagy and G2/M arrest mechanisms

<p>Polyphyllin Ι is a steroidal saponin isolated from the rhizoma of <i>Paris polyphylla</i>. In the present study, we aimed to investigate the anticancer effects of polyphyllin Ι in colorectal cancer and to elucidate the potential underlying molecular mechanisms. Using, CCK8 assay, flow cytometry, laser confocal microscope analysis and western blot, the anticancer effects of the polyphyllin Ι were analysed in colorectal cells. Our results indicate that polyphyllin Ι significantly decreased cell viability of HCT 116 cells and induced autophagy. Furthermore, we found that polyphyllin Ι induced autophagy in an ROS-dependent cell death and not related with PI3 K/AKT/mTOR pathway. We also provide evidence that excessive ROS triggered by polyphyllin Ι could induce G2/M phase arrest via regulating cycle proteins expression of cell cycle regulators, such as p21 and cyclinB1. In conclusion, polyphyllin Ι exhibit anticancer effect through ROS-dependent autophagy and induces G2/M arrest in colorectal cancer.</p