Objective Fluid management in patients with septic shock and coexisting heart failure is a critical challenge,as it requires balancing resuscitation and the risk of fluid overload.This study investigated the potential...Objective Fluid management in patients with septic shock and coexisting heart failure is a critical challenge,as it requires balancing resuscitation and the risk of fluid overload.This study investigated the potential of the fluid accumulation index(FAI),which is measured serially during the initial 72 h of intensive care unit(ICU)care,to provide dynamic prognostic information to guide fluid management in this high-risk population.Methods Restricted cubic spline(RCS)analysis was used to explore the relationships between FAI levels at different time points within 72 h of ICU admission and ICU mortality.Associations were quantified via multivariate Cox proportional hazards models.Subgroup analyses and Kaplan-Meier survival curves were used to evaluate the consistency of associations and differences in survival between groups.Results A total of 643 patients with septic shock and concurrent heart failure were included,among whom 127 died.The RCS revealed a significant nonlinear relationship between FAI levels at various time points and ICU mortality.The optimal FAI cutoff values decreased over time:the cumulative values were 0.87 at 24 h,0.59 at 48 h,and 0.56 at 72 h.The cutoff values for specific intervals were 0.27 for the 24-48 h period(2-24 h-FAI)and 0.12 for the 48-72 h period(3-24 h-FAI).In the fully adjusted model,FAI values exceeding these time-specific thresholds were significantly associated with increased ICU mortality(24 h-FAI>0.87,HR=1.96,P=0.0251;2-24 h-FAI>0.27,HR=2.07,P=0.0051;48 h-FAI>0.59,HR=2.50,P=0.0005;3-24 h-FAI>0.12,HR=2.05,P=0.0091;72 h-FAI>0.56,HR=2.97,P<0.0001).These associations remained consistent across most predefined subgroups.Conclusion FAI serves as a dynamic and independent prognostic marker for critically ill patients with septic shock and heart failure during the first 72 h of ICU admission.A key finding was the time-dependent decline in the optimal FAI cutoff values(0.87 at 24 h vs.0.12 for the 3-24 h period).This temporal decline supports a shift in fluid management strategy from an initial liberal approach toward a conservative strategy after the first 24 h,which may mitigate mortality risk.展开更多
The concentrations of Fe, Mn, Al, Zn, Pb, Ni, Cr, and As were measured in soils and leaves from 21 plant species growing on hills near the Beijing Steel Factory(BSF) and 17 plant species in the Beijing Botanical Garde...The concentrations of Fe, Mn, Al, Zn, Pb, Ni, Cr, and As were measured in soils and leaves from 21 plant species growing on hills near the Beijing Steel Factory(BSF) and 17 plant species in the Beijing Botanical Garden(BBG). The results showed that soils from BSF were Zn contaminated according to the threshold of natural background of China. There was a metal contamination of the soils by Ni, and Cr in BSF comparing with those in BBG. The comparison between concentrations of metals in leaves from both sites indicated that, in general, accumulation of metals in the leaves of the same species was significantly different between the two sites. Even within the same locality each species accumulation of metals was significantly variable. The study aimed to screen landscape plants for the capacity to clean-up toxic metals in soils, and developed an overall metal accumulation index(MAI) for leaves and then categorized the MAI that can be applied broadly in the selection of species in polluted areas. To do this, the spectrum of MAI values were divided into four classes: strongly accumulated(SA or grade I), moderately accumulated(MA or grade II), intermediately accumulated(IA or grade III), and weakly accumulated(WA or grade IV). The results showed that elemental association between Fe, Al, Ni, and As was generally highly correlated with each other in the sampling sites. This may suggest their common biochemical characteristics. Generally, those species containing strong and moderate accumulation in both sites are considered including Vitex negundo, Broussonetia papyrifera, Ulmus pumila, and Rubia cordifolia. At BSF and other industrial sites with a similar ecosystem, strong and moderate accumulation species include Sophora japonica, Ampelopsis aconitifolia var. glabra, Platycladus orientalis, Wikstroemia chamaedaphne, Cleistogenes squarrosa, Grewia biloba, and in BBG, in addition Setaria viridis, Cotinus coggygria, Lespedeza floribunda, Rhamnus parvifolia, Lespedeza tomentosa.展开更多
Changes in metal concentrations in the litter of Potamogeton crispus were monitored during a consecutive 40-day in situ decomposition experiment using the litterbag method.The accumulation index was calculated and use...Changes in metal concentrations in the litter of Potamogeton crispus were monitored during a consecutive 40-day in situ decomposition experiment using the litterbag method.The accumulation index was calculated and used to indicate the changes in the metals in litter.The results showed that the concentrations of Al,Cd,Cr,Fe,Mn,and Pb in litter increased significantly during the decomposition,while Cu and Zn concentrations decreased dramatically.Significant positive correlations were found between the concentrations of Al,Cr,Fe,and Mn and between Cu and Zn.Moreover,Cu and Zn both negatively correlated with Al and Fe.The remaining dry mass was negatively correlated with Al and Fe concentrations but positively correlated with Cu and Zn concentrations.Generally the accumulation index values of metals other than Al were less than one,indicating that the litter of P.crispus acted as a source of metals to the surrounding water body.Al was the only metal that showed continuous net accumulation in litter.The net accumulation of Fe and Mn in litter during the last 10 days of the experiment may indicate the precipitation of Feand Mn-oxides.It was estimated that 160 g/m^2（dry weight）P.crispus was decomposed in40 days.This was equivalent to releasing the following amounts of metals：0.01 mg Cd,0.03 mg Cr,0.71 mg Cu,0.55 mg Mn,0.02 mg Pb and 13.8 mg Zn into surrounding water,and accumulating 149 mg Al and 11 mg Fe,in a 1 m^2 area.展开更多
Soil and plant samples were collected from roadside sites (along with primary, secondary and tertiary roads) and reference site to investigate the contamination of soils and old common plant species with lead (Pb) and...Soil and plant samples were collected from roadside sites (along with primary, secondary and tertiary roads) and reference site to investigate the contamination of soils and old common plant species with lead (Pb) and cadmium (Cd) in Peshawar City, Pakistan. All the data were analyzed using ANOVA analysis that showed a significant (P ≤ 0.01) variation in Pb and Cd concentrations in the roadside soils and plants as compared to the reference site. The mean concentrations of Pb and Cd were 53.9 and 6.0 mg kg-1 in soils and 49.1 and 10.9 mg kg-1 in plants, respectively. Significant variation (P ≤ 0.01) in concentrations of Pb and Cd in soil and plant samples along with primary, secondary and tertiary roads might be due to different traffic densities. The highest value (9.4) of metal accumulation index (MAI) was observed for Eucalyptus camaldulensis. In selected plant species, the Pb and Cd accumulation was found in the order of E. camaldulensis > Ficus elastica > Dalbergia sissoo > Alstonia scholaris. The roadside soils and plants were highly contaminated with Pb and Cd as compared to the reference site.展开更多
The present work is to evaluate and investigate the distribution of heavy metals (As, Cr and Cd) and to assess the road side samples contamination using an Index (SEPI), (CPI), (GAI), (CF) and (PLI). From right and le...The present work is to evaluate and investigate the distribution of heavy metals (As, Cr and Cd) and to assess the road side samples contamination using an Index (SEPI), (CPI), (GAI), (CF) and (PLI). From right and left Khasa in Kirkuk city, road soil samples were collected in order to estimate the probable contamination level of heavy metals (Cd), (As) and (Cr) in the study area. The heavy metal concentrations were determined in the way side samples by using (ICP-MS) technique. The 22 samples have collected in August, 2013. The results of average levels of heavy metals revealed Cr, As and Cd recorded the highest concentration of (178.6 ppm, 10.4 ppm and 0.599 ppm) in right Khasa respectively. These heavy metals are recorded the lowest value (165.8, 8.29 and 0.4 ppm) in left Khasa respectively. However, the concentration of Cr and As was higher than the studied worldwide permissible of contaminated soil. The highest (SEPI) for As in right Khasa and Cr in left in Khasa seems therefore to be that this road side soil is the most polluted in the city of Kirkuk classified moderately contamination. The accounted of (CPI) for As, Cd and Cr ranged from 0.82 to 1.30 with average 1.01 and 0.6 to 1.12 with an average 0.78 in right and left Khasa respectively. The highest values in the right Khasa which suggest multi-elements contamination and suggested this area of study area received more heavy metals comes from manmade and industrial activities. The GAI showed a moderate contaminated with Cd in right Khasa of study area, while the other metals are in their uncontaminated level. The CF results has been showed by a considerable contamination metals (As, Cr and Cd) in of right Khasa, but low to moderate contamination in left Khasa. The results of (PLI) revealed a deterioration of site quality in all samples of Kirkuk city. Thus the evaluation methods revealed that the studied areas especially right Khasa impacted with heavy industrial activity, phosphate fertilizer, emission of gasses from automobile manufacture tire abrasion and workshop causing an increasing in metal concentrations towards the right Khasa.展开更多
基金supported by a grant from the Natural Science Foundation of Hubei Province,China(No.2023AFD074).
文摘Objective Fluid management in patients with septic shock and coexisting heart failure is a critical challenge,as it requires balancing resuscitation and the risk of fluid overload.This study investigated the potential of the fluid accumulation index(FAI),which is measured serially during the initial 72 h of intensive care unit(ICU)care,to provide dynamic prognostic information to guide fluid management in this high-risk population.Methods Restricted cubic spline(RCS)analysis was used to explore the relationships between FAI levels at different time points within 72 h of ICU admission and ICU mortality.Associations were quantified via multivariate Cox proportional hazards models.Subgroup analyses and Kaplan-Meier survival curves were used to evaluate the consistency of associations and differences in survival between groups.Results A total of 643 patients with septic shock and concurrent heart failure were included,among whom 127 died.The RCS revealed a significant nonlinear relationship between FAI levels at various time points and ICU mortality.The optimal FAI cutoff values decreased over time:the cumulative values were 0.87 at 24 h,0.59 at 48 h,and 0.56 at 72 h.The cutoff values for specific intervals were 0.27 for the 24-48 h period(2-24 h-FAI)and 0.12 for the 48-72 h period(3-24 h-FAI).In the fully adjusted model,FAI values exceeding these time-specific thresholds were significantly associated with increased ICU mortality(24 h-FAI>0.87,HR=1.96,P=0.0251;2-24 h-FAI>0.27,HR=2.07,P=0.0051;48 h-FAI>0.59,HR=2.50,P=0.0005;3-24 h-FAI>0.12,HR=2.05,P=0.0091;72 h-FAI>0.56,HR=2.97,P<0.0001).These associations remained consistent across most predefined subgroups.Conclusion FAI serves as a dynamic and independent prognostic marker for critically ill patients with septic shock and heart failure during the first 72 h of ICU admission.A key finding was the time-dependent decline in the optimal FAI cutoff values(0.87 at 24 h vs.0.12 for the 3-24 h period).This temporal decline supports a shift in fluid management strategy from an initial liberal approach toward a conservative strategy after the first 24 h,which may mitigate mortality risk.
文摘The concentrations of Fe, Mn, Al, Zn, Pb, Ni, Cr, and As were measured in soils and leaves from 21 plant species growing on hills near the Beijing Steel Factory(BSF) and 17 plant species in the Beijing Botanical Garden(BBG). The results showed that soils from BSF were Zn contaminated according to the threshold of natural background of China. There was a metal contamination of the soils by Ni, and Cr in BSF comparing with those in BBG. The comparison between concentrations of metals in leaves from both sites indicated that, in general, accumulation of metals in the leaves of the same species was significantly different between the two sites. Even within the same locality each species accumulation of metals was significantly variable. The study aimed to screen landscape plants for the capacity to clean-up toxic metals in soils, and developed an overall metal accumulation index(MAI) for leaves and then categorized the MAI that can be applied broadly in the selection of species in polluted areas. To do this, the spectrum of MAI values were divided into four classes: strongly accumulated(SA or grade I), moderately accumulated(MA or grade II), intermediately accumulated(IA or grade III), and weakly accumulated(WA or grade IV). The results showed that elemental association between Fe, Al, Ni, and As was generally highly correlated with each other in the sampling sites. This may suggest their common biochemical characteristics. Generally, those species containing strong and moderate accumulation in both sites are considered including Vitex negundo, Broussonetia papyrifera, Ulmus pumila, and Rubia cordifolia. At BSF and other industrial sites with a similar ecosystem, strong and moderate accumulation species include Sophora japonica, Ampelopsis aconitifolia var. glabra, Platycladus orientalis, Wikstroemia chamaedaphne, Cleistogenes squarrosa, Grewia biloba, and in BBG, in addition Setaria viridis, Cotinus coggygria, Lespedeza floribunda, Rhamnus parvifolia, Lespedeza tomentosa.
基金supported by the National Natural Science Foundation of China(Nos.41401563,41301544,41201094)the Natural Science Foundation of Shandong Province(Nos.ZR2014JL028+2 种基金ZR2012DQ003)the China Postdoctoral Science Foundation(No.2015M571830)the Taishan Scholar Program of Shandong Province for supporting his research
文摘Changes in metal concentrations in the litter of Potamogeton crispus were monitored during a consecutive 40-day in situ decomposition experiment using the litterbag method.The accumulation index was calculated and used to indicate the changes in the metals in litter.The results showed that the concentrations of Al,Cd,Cr,Fe,Mn,and Pb in litter increased significantly during the decomposition,while Cu and Zn concentrations decreased dramatically.Significant positive correlations were found between the concentrations of Al,Cr,Fe,and Mn and between Cu and Zn.Moreover,Cu and Zn both negatively correlated with Al and Fe.The remaining dry mass was negatively correlated with Al and Fe concentrations but positively correlated with Cu and Zn concentrations.Generally the accumulation index values of metals other than Al were less than one,indicating that the litter of P.crispus acted as a source of metals to the surrounding water body.Al was the only metal that showed continuous net accumulation in litter.The net accumulation of Fe and Mn in litter during the last 10 days of the experiment may indicate the precipitation of Feand Mn-oxides.It was estimated that 160 g/m^2（dry weight）P.crispus was decomposed in40 days.This was equivalent to releasing the following amounts of metals：0.01 mg Cd,0.03 mg Cr,0.71 mg Cu,0.55 mg Mn,0.02 mg Pb and 13.8 mg Zn into surrounding water,and accumulating 149 mg Al and 11 mg Fe,in a 1 m^2 area.
基金Supported by the University of Peshawar, Pakistan
文摘Soil and plant samples were collected from roadside sites (along with primary, secondary and tertiary roads) and reference site to investigate the contamination of soils and old common plant species with lead (Pb) and cadmium (Cd) in Peshawar City, Pakistan. All the data were analyzed using ANOVA analysis that showed a significant (P ≤ 0.01) variation in Pb and Cd concentrations in the roadside soils and plants as compared to the reference site. The mean concentrations of Pb and Cd were 53.9 and 6.0 mg kg-1 in soils and 49.1 and 10.9 mg kg-1 in plants, respectively. Significant variation (P ≤ 0.01) in concentrations of Pb and Cd in soil and plant samples along with primary, secondary and tertiary roads might be due to different traffic densities. The highest value (9.4) of metal accumulation index (MAI) was observed for Eucalyptus camaldulensis. In selected plant species, the Pb and Cd accumulation was found in the order of E. camaldulensis > Ficus elastica > Dalbergia sissoo > Alstonia scholaris. The roadside soils and plants were highly contaminated with Pb and Cd as compared to the reference site.
文摘The present work is to evaluate and investigate the distribution of heavy metals (As, Cr and Cd) and to assess the road side samples contamination using an Index (SEPI), (CPI), (GAI), (CF) and (PLI). From right and left Khasa in Kirkuk city, road soil samples were collected in order to estimate the probable contamination level of heavy metals (Cd), (As) and (Cr) in the study area. The heavy metal concentrations were determined in the way side samples by using (ICP-MS) technique. The 22 samples have collected in August, 2013. The results of average levels of heavy metals revealed Cr, As and Cd recorded the highest concentration of (178.6 ppm, 10.4 ppm and 0.599 ppm) in right Khasa respectively. These heavy metals are recorded the lowest value (165.8, 8.29 and 0.4 ppm) in left Khasa respectively. However, the concentration of Cr and As was higher than the studied worldwide permissible of contaminated soil. The highest (SEPI) for As in right Khasa and Cr in left in Khasa seems therefore to be that this road side soil is the most polluted in the city of Kirkuk classified moderately contamination. The accounted of (CPI) for As, Cd and Cr ranged from 0.82 to 1.30 with average 1.01 and 0.6 to 1.12 with an average 0.78 in right and left Khasa respectively. The highest values in the right Khasa which suggest multi-elements contamination and suggested this area of study area received more heavy metals comes from manmade and industrial activities. The GAI showed a moderate contaminated with Cd in right Khasa of study area, while the other metals are in their uncontaminated level. The CF results has been showed by a considerable contamination metals (As, Cr and Cd) in of right Khasa, but low to moderate contamination in left Khasa. The results of (PLI) revealed a deterioration of site quality in all samples of Kirkuk city. Thus the evaluation methods revealed that the studied areas especially right Khasa impacted with heavy industrial activity, phosphate fertilizer, emission of gasses from automobile manufacture tire abrasion and workshop causing an increasing in metal concentrations towards the right Khasa.
