Blood eosinophils and mortality in patients with acute respiratory distress syndrome: A propensity score matching analysis

BACKGROUND: The effect of blood eosinophils(EOSs) on mortality in acute respiratory distress syndrome(ARDS) patients and whether corticosteroids affect this effect are unclear.METHODS: The Medical Information Mart for Intensive Care III database(version 1.4) was used to extract data. Patients with ARDS were selected for inclusion. Cox regression models using the backward stepwise method and propensity score matching(PSM) were used to assess the relationship between blood EOS counts and 28-day mortality. RESULTS: A total of 2,567 patients with ARDS were included, and the 28-day mortality rate was 24.19%. The crude 28-day mortality was significantly lower in patients with EOS counts ≥2%(18.60% [85/457] vs. 25.40% [536/2,110], P=0.002) than in those with EOS counts <2%. In the Cox regression model, the EOS counts ≥2% showed a significant association with the decreased 28-day mortality(hazard ratio [HR] 0.731;95% confidence interval [95% CI] 0.581–0.921, P=0.008). In the corticosteroid non-use subgroup, EOS counts ≥2% was significantly related to decreased 28-day mortality(HR 0.697, 95% CI 0.535–0.909, P=0.008), but the result was not significant in the corticosteroid non-use subgroup model(P=0.860). A total of 457 well-matched pairs were obtained by a 1:1 matching algorithm after PSM. The 28-day mortality remained significantly lower in the EOS counts ≥2% group(18.60% [85/457] vs. 26.70% [122/457], P=0.003).CONCLUSIONS Higher EOS counts are related to lower 28-day mortality in ARDS patients, and this relationship can be counteracted by using corticosteroids.

Effects of MgSiO3 on the crystal growth and characteristics of type-Ib gem quality diamond in Fe-Ni-C system

We report the effects of MgSiO3 addition on the crystal growth and characteristics of type-Ib diamonds synthesized in Fe–Ni–C system. The experiments were carried out with pressure at 5.5 GPa, temperature at 1385℃–1405℃, and duration of 23.1 h. As MgSiO3 increases from 0.0 wt% to 3.0 wt%, the diamond growth temperature increases from1385℃ to 1405℃, the addition of MgSiO3 and the movement of P–T diagram toward the higher temperature direction result in a series of effects to the Fe–Ni–C system and crystal growth. Firstly, it increases the content of metastable recrystallized graphite and accelerates the competition with the carbon source needed for diamond growth, thus causing the decreased crystal growth rate. Diamond crystals exhibit the combination form of {111}, {100}, {113}, and {110}sectors, the decreased {100} and {113} sectors, dominated {111} sector are all attributed to the higher growth rate in [100]direction caused by the synergy of MgSiO3 and the movement of P–T diagram. The higher growth rate in [100] direction also increases the metal catalyst and graphite inclusions and leads to the increase of residual tensile stress on the crystal surface. Accompanying with the high growth rate, a higher dissolution rate along [100] and [113] directions than [111]direction occurs at the microstructure and forms the significantly developed(111) stepped growth layer. In addition to the movement of P–T diagram, the addition of MgSiO3 poisons the catalyst and increases the nitrogen content of diamond from 120 ppm to 227 ppm.