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How to identify the optimum switch point of sequential invasive and noninvasive ventilation is the focus of clinical attention on the patients suffering from acute exacerbation of chronic obstructive pulmonary disease (AECOPD) complicated by acute respiratory failure (ARF). This study aims to explore the clinical significance of taking the change rate of procalcitonin (PCT) as identifying the timing of weaning on the mechanical ventilation for the patients of AECOPD followed by ARF as a complication. There were altogether 140 patients of AECOPD complicated with ARF, who were randomly selected and divided into a study group and a control group respectively. A change rate of serum PCT level exceeding 50% was taken as the switch point selection of tracheal intubation removal for the patients of the study group, while the 'pulmonary infection control (PIC) window' was done for those in the control group. With CRP, IL-6, TNF-a, PaCO2, PaO2, and Lac having been detected before and after treatment to them all, clinical indexes were obtained and compared between these two groups. The CRP, TNF-a, and IL-6 levels of the patients in the study group after treatment (p < 0.05) were lower than those in the control group. There was no significant difference in PaCO2, PaO2, and Lac between these two groups before and after treatment (p > 0.05). Even so, some other indexes available for the study group of patients were found to be lower than those for the control group (p < 0.05) in the following aspects: duration of invasive ventilation support, total time of mechanical ventilation support, incidence rate of ventilator-associated pneumonia, 48-hour reintubation rate, incidence rate of upper gastrointestinal bleeding, hospitalization time of critical respiratory illness, total hospitalization time, RICU treatment cost, total treatment cost, and mortality. It is preferable to take the change rate of PCT level exceeding 50% as the switch point of weaning time in sequential mechanical ventilation rather than the PIC window. Abbreviations AECOPD: acute exacerbation of chronic obstructive pulmonary disease; ARF: acute respiratory failure; PCT: procalcitonin; PaO2: the oxygen partial pressure; PaCO2: the partial pressure of carbon dioxide; TNF-a: serum tumor necrosis factor-a; IL-6: interleukin-6; CRP: serum C-reactive protein; PIC window: pulmonary infection control window; RICU: respiration and intensive care unit [ABSTRACT FROM AUTHOR]

Functional traits offer generalizability to the prediction of ecosystem processes such as production, and community-weighted mean trait values are increasingly used for such predictions. However, the underlying causal direction between traits and ecosystem processes are often indirect and sometimes even tenuous. In this study, we aimed to uncover underlying causal mechanisms between traits, habitat adaptation and canopy productivity. We used canopy production data estimated from leaf litter traps, and trait and habitat association data obtained from 40 permanent vegetation plots in the Nee Soon catchment in Singapore, which contains a heterogeneous mix of freshwater swamp and dry-land tropical forests. Mean canopy production across the catchment was estimated to be 768 g m−2 year−1, which is similar to other tropical dry-land forests in the region. Biweekly per-basal-area canopy production was found to be consistently lower in swamp than non-swamp plots, and positively correlated with monthly mean temperature. Structural equation models fitted to data of canopy production, leaf traits, plot type (swamp versus non-swamp), basal areas and habitat adaptations of 69 tree species–plot combinations suggested that tree species possessing leaf traits associated with more conservative resource acquisition strategies, viz. low specific leaf area, high leaf C:N ratio, and thicker leaves, are better adapted to stressful, waterlogged swamp conditions, but that this adaptation also reduces canopy—and likely total—net primary productivity. These observations suggest that the stressful conditions of waterlogged, anoxic swamp habitats significantly reduce the rate at which nutrients are cycled by communities found in such environments. [ABSTRACT FROM AUTHOR]