The atom-bond sum-connectivity(ABS)index,put forward by[J.Math.Chem.,2022,60(10):20812093],exhibits a strong link with the acentric factor of octane isomers.The experimental physico-chemical properties of octane isome...The atom-bond sum-connectivity(ABS)index,put forward by[J.Math.Chem.,2022,60(10):20812093],exhibits a strong link with the acentric factor of octane isomers.The experimental physico-chemical properties of octane isomers,such as boiling point,of formation are found to be better measured by the ABS index than by the Randi,atom-bond connectivity(ABC),and sum-connectivity(SC)indices.One important source of information for researching the molecular structure is the bounds for its topological indices.The extrema of the ABS index of the line,total,and Mycielski graphs are calculated in this work.Moreover,the pertinent extremal graphs were illustrated.展开更多
The Gabes aquifer system,located in southeastern Tunisia,is a crucial resource for supporting local socio-economic activities.Due to its dual porosity structure,is particularly vulnerable to pollution.This study aims ...The Gabes aquifer system,located in southeastern Tunisia,is a crucial resource for supporting local socio-economic activities.Due to its dual porosity structure,is particularly vulnerable to pollution.This study aims to develop a hybrid model that combines the Fracture Aquifer Index(FAI)with the conventional GOD(Groundwater occurrence,Overall lithology,Depth to water table)method,to assess groundwater vulnerability in fractured aquifer.To develop the hybrid model,the classical GOD method was integrated with FAI to produce a single composite index.Each parameter within both GOD and FAI was scored,and a final index was calculated to delineate vulnerable areas.The results show that the study area can be classified into four vulnerability levels:Very low,low,moderate,and high,indicating that approximately 8%of the area exhibits very low vulnerability,29%has low vulnerability,25%falls into the moderate category,and 38%is considered highly vulnerable.The FAI-GOD model further incorporates fracture network characteristics.This refinement reduces the classification to three vulnerability classes:Low,medium,and high.The outcomes demonstrate that 46%of the area is highly vulnerable due to a dense concentration of fractures,while 17%represents an intermediate zone characterized by either shallow or deeper fractures.In contrast,37%corresponds to areas with lightly fractured rock,where the impact on vulnerability is minimal.Multivariate statistical analysis was employed using Principal Components Analysis(PCA)and Hierarchical Cluster Analysis(HCA)on 24 samples across six variables.The first three components account for over 76%of the total variance,reinforcing the significance of fracture dynamics in classifying vulnerability levels.The FAI-GOD model removes the very-low-vulnerability class and expands the spatial extent of low-and high-vulnerability zones,reflecting the dominant influence of fracture networks on aquifer sensitivity.While both indices use a five-class system,FAI-GOD redistributes vulnerability by eliminating very-low-vulnerability areas and amplifying low/high categories,highlighting the critical role of fractures.A strong correlation(R2=0.94)between the GOD and FAI-GOD indices,demonstrated through second-order polynomial regression,confirms the robustness of the FAI-GOD model in accurately predicting vulnerability to pollution.This model provides a useful framework for assessing the vulnerability of complex aquifers and serves as a decision-making tool for groundwater managers in similar areas.展开更多
This commentary critically appraises the study by Li et al which pioneered the exploration of the triglyceride-glucose(TyG)index as a prognostic marker in hepatitis B virus-related advanced hepatocellular carcinoma pa...This commentary critically appraises the study by Li et al which pioneered the exploration of the triglyceride-glucose(TyG)index as a prognostic marker in hepatitis B virus-related advanced hepatocellular carcinoma patients undergoing combined camrelizumab and lenvatinib therapy.While we acknowledge the study’s clinical relevance in proposing an easily accessible metabolic biomarker,we delve into the mechanistic plausibility linking insulin resistance to immunotherapy response and angiogenic inhibition.We further critically examine the methodological limitations,including the retrospective design,the populationspecific TyG cut-off value,and unaddressed metabolic confounders.We highlight the imperative for future research to validate its utility across diverse etiologies and treatment settings,and to unravel the underlying immunometabolic pathways.展开更多
BACKGROUND Timely and accurate evaluation of mental disorders in adolescents using appropriate mental health literacy assessment tools is essential for improving their mental health literacy levels.AIM To develop an e...BACKGROUND Timely and accurate evaluation of mental disorders in adolescents using appropriate mental health literacy assessment tools is essential for improving their mental health literacy levels.AIM To develop an evaluation index system for the mental health literacy of adolescent patients with mental disorders,providing a scientific,comprehensive,and reliable tool for the monitoring and intervention of mental health literacy of such patients.METHODS From December 2022 to June 2023,the evaluation index system for mental health literacy of adolescents with mental disorders was developed through literature reviews,semi-structured interviews,expert letter consultations,and the analytic hierarchy process.Based on this index system,a self-assessment questionnaire was compiled and administered to 305 adolescents with mental disorders to test the reliability and validity of the index system.RESULTS The final evaluation index system for mental health literacy of adolescents with mental disorders included 4 first-level indicators,10 second-level indicators,and 52 third-level indicators.The overall Cronbach’sαcoefficient of the index system was 0.957,with a partial reliability of 0.826 and a content validity index of 0.975.The cumulative variance contribution rate of 10 common factors was 66.491%.The correlation coefficients between each dimension and the total questionnaire ranged from 0.672 to 0.724,while the correlation coefficients in each dimension ranged from 0.389 to 0.705.CONCLUSION The evaluation index system for mental health literacy of adolescents with mental disorders,developed in this study,demonstrated notable reliability and validity,making it a valuable tool for evaluating mental health literacy in this population.展开更多
AIM:To explore the repeatability,reproducibility,and agreement in the measurement of the choroidal vascularity index(CVI)for different swept-source optical coherence tomography(OCT)devices and between OCT and OCT angi...AIM:To explore the repeatability,reproducibility,and agreement in the measurement of the choroidal vascularity index(CVI)for different swept-source optical coherence tomography(OCT)devices and between OCT and OCT angiography(OCTA)images.METHODS:Two swept-source OCT imaging systems,VG200I and Topcon DRI OCT Triton,were used to capture OCT and OCTA images in triplicate.The first and third images were taken by one operator,and the second image was taken by another operator.The built-in software was used to calculate the CVI from the OCTA images(CVI-OCTA),and a custom-designed algorithm was used to calculate the CVI from the OCT images(CVI-OCT).Repeatability and reproducibility were assessed with the intraclass correlation coefficient(ICC),and agreement between devices and between OCT and OCTA were evaluated with Bland-Altman analysis.RESULTS:Sixty-eight eyes from 35 adults(17 females)were included in the analysis.The average age of the participants was 23.6±2.3y,with an average spherical equivalent refraction of-3.08±2.47 D and an average AL of 25.21±1.20 mm.Both OCT devices demonstrated high repeatability and reproducibility in measuring the CVI-OCTA(all ICCs>0.894 across five choroidal regions)and CVI-OCT(all ICCs>0.838).Furthermore,the between-device agreement in measuring the CVI-OCT was good[mean difference(MD)ranging from-2.32%to-3.07%],but that in measuring the CVI-OCTA was poor(MD,1.48%to-7.43%).Additionally,the between-imaging agreement(CVI-OCTA versus CVI-OCT)was poor for both devices(Triton,MD,6.05%to 12.68%;VG200I,MD,6.67%to 12.09%).CONCLUSION:Both OCT devices and the two analytical methods demonstrate good stability.The inter-device consistency of CVI-OCT is good,while the inter-device consistency of CVI-OCTA and the consistency between the two analytical methods in the same device are both poor.展开更多
Let G be a finite group and H a subgroup of G.The normal index of H in G is defined as the order of K/H_(G),where K is a normal supplement of H in G such that|K|is minimal and H_(G)≤K■G.Let p be a prime which divide...Let G be a finite group and H a subgroup of G.The normal index of H in G is defined as the order of K/H_(G),where K is a normal supplement of H in G such that|K|is minimal and H_(G)≤K■G.Let p be a prime which divides the order of a group G.In this paper,some characterizations of G being p-solvable or p-supersolvable were obtained by analyzing the normal index of certain subgroups of G.These results can be viewed as local version of recent results in the literature.展开更多
BACKGROUND:Rapid identification of patients at risk of clinical deterioration(in-hospital mortality) in emergency settings is essential for timely and appropriate care.Existing prognostic scores,such as the Acute Phys...BACKGROUND:Rapid identification of patients at risk of clinical deterioration(in-hospital mortality) in emergency settings is essential for timely and appropriate care.Existing prognostic scores,such as the Acute Physiology and Chronic Health Evaluation IV(APACHE IV),Simplified Acute Physiology Score 3(SAPS 3),Sequential Organ Failure Assessment(SOFA),and National Early Warning Score 2(NEWS 2),have limitations in emergency scenarios,particularly in resource-limited settings.We aimed to develop a simple and efficient tool tailored to the Brazilian healthcare system.METHODS:This retrospective,multicenter,cohort study analyzed data from 50,709 adult patients admitted to 12 hospitals in southern and southeastern Brazil between 2019 and 2020.The BRASIL score(Brazilian Risk Assessment Severity Index and Length of stay) was constructed using demographic and clinical variables available at admission.Logistic regression was used to determine the weight of each variable,and each variable was assigned a point value based on its β-coefficient and clinical relevance,with thresholds defined according to established medical cutoffs and statistical performance.The score's predictive accuracy was validated using the area under the receiver operating characteristic curve(AUC) with comparative analysis against NEWS 2.RESULTS:The BRASIL score,including age,sex,respiratory rate,heart rate,oxygen saturation,blood pressure,and body temperature,was derived through variables independently associated with in-hospital mortality in a multicenter cohort.The total score was stratified into three risk categories — low(0–3 points),moderate(4–7 points),and high(>7 points) — using observed inflection points in mortality distribution to optimize discrimination.This stratification demonstrated a stepwise increase in mortality rates across categories and the discriminatory performance,with an overall AUC of 0.743(95% CI:0.726–0.761).Compared to NEWS 2(AUC 0.697,95% CI:0.683–0.711),the BRASIL score offered superior early risk identification,supporting timely clinical decisionmaking and resource allocation in the emergency setting.CONCLUSION:The BRASIL score is a novel tool for predicting in-hospital mortality in emergency departments.Its predictive performance and ease of use suggest that it has the potential to improve patient outcomes.展开更多
Gradient refractive index(GRIN)metalenses are increasingly valued in high-frequency communication due to their exceptional radiation performance.Ceramics with high dielectric constants and low dielectric losses are id...Gradient refractive index(GRIN)metalenses are increasingly valued in high-frequency communication due to their exceptional radiation performance.Ceramics with high dielectric constants and low dielectric losses are ideal candidates for GRIN metalenses.Digital light processing(DLP)3D printing provides a feasible and efficient approach for manufacturing ceramic GRIN metalenses.However,the scattering of ultraviolet(UV)light by ceramic particles in the slurry reduces the printing accuracy of DLP technology,making it difficult to achieve the intricate structural features required for GRIN metalenses in high-frequency communication.In this work,we propose an approach to improve printing accuracy by optimizing the ceramic slurry composition and implementing a dimensional compensation design strategy.Utilizing geometric optics and the S-parameter inversion method,we design a GRIN metalens consisting of two distinct types of subwavelength unit cells(Y-shaped and circular hole geometries)with a minimum feature size of 160μm.Through a refined slurry formulation and precise design parameter compensation,high-fidelity ceramic GRIN metalenses are successfully fabricated.The fabricated metalens exhibits a maximum gain enhancement of 18.4 dBi and a deflection angle of±30°over a bandwidth of 37.84% in the W-band(75-110 GHz).The highly directional far-field beam radiation and efficient beam steering capabilities highlight the potential of ceramic GRIN metalenses for applications in satellite communications,radar systems,and other high-frequency technologies.展开更多
Surface polaritons,as surface electromagnetic waves propagating along the surface of a medium,have played a crucial role in enhancing photonic spin Hall effect(PSHE)and developing highly sensitive refractive index(RI)...Surface polaritons,as surface electromagnetic waves propagating along the surface of a medium,have played a crucial role in enhancing photonic spin Hall effect(PSHE)and developing highly sensitive refractive index(RI)sensors.Among them,the traditional surface plasmon polariton(SPP)based on noble metals limits its application beyond the near-infrared(IR)regime due to the large negative permittivity and optical losses.In this contribution,we theoretically proposed a highly sensitive PSHE sensor with the structure of Ge prism-SiC-Si:InAs-sensing medium,by taking advantage of the hybrid surface plasmon phonon polariton(SPPhP)in mid-IR regime.Here,heavily Si-doped InAs(Si:InAs)and SiC excite the SPP and surface phonon polariton(SPhP),and the hybrid SPPhP is realized in this system.More importantly,the designed PSHE sensor based on this SPPhP mechanism achieves the multi-stage RI measurements from 1.00025-1.00225 to 1.70025-1.70225,and the maximal intensity sensitivity and angle sensitivity can be up to 9.4×10^(4)μm/RIU and245°/RIU,respectively.These findings provide a new pathway for the enhancement of PSHE in mid-IR regime,and offer new opportunities to develop highly sensitive RI sensors in multi-scenario applications,such as harmful gas monitoring and biosensing.展开更多
This study presents a hybrid methodology for predicting building collapses within the Intelligent Circular Resilience(ICR)framework.This uses a supervised Machine Learning(ML)approach,earthquake damage re-ports,and th...This study presents a hybrid methodology for predicting building collapses within the Intelligent Circular Resilience(ICR)framework.This uses a supervised Machine Learning(ML)approach,earthquake damage re-ports,and the Simplified Resilience Index(SRI),derived from existing earthquake damage models(EDM)-based on fragility and vulnerability functions-used in the probabilistic seismic risk assessment(PSRA).A curated building damage database comprising 89 structures(71 collapsed and 18 non-collapsed)from ten countries affected by major earthquakes(Mw 6.1-8.1,epicentral distances of 3-125 km,and PGA values ranging from 0.14 g to 0.82 g)was developed,including attributes related to exposure:occupancy,main structural material,number of stories,construction year,and hazard:magnitude,epicentral distance,intensity measures(Peak-ground acceleration,PGA,and elastic spectral acceleration).The dataset includes events such as the 2017 Puebla-Morelos earthquake(Mw 7.1,Mexico),the 1999 Kocaeli earthquake(Mw 7.6,Turkey),and the 2011 Christchurch earthquake(Mw 6.1,New Zealand),among others.Likewise,dependent attributes such as time elapsed and SRI(under 120-,180-,and 365-day recovery scenarios)were calculated using 2-EDMs.Eight Random Forest models were trained and tested for collapse and non-collapse classification using combinations of independent and dependent attributes.The results indicate that models incorporating exposure-related varia-bles-such as structural material,number of stories,construction year,and occupancy-alongside the SRI significantly improve collapse classification performance,achieving recall and F1 scores above 95%.Notably,many collapsed buildings exhibited low intensities(PGA≤0.25 g),emphasizing the influence of local site effects-particularly in Mexico City.The findings demonstrate that incorporating SRI enhances the reliability of collapse prediction and supports its use as an interpretable resilience proxy during early ICR stages.This hybrid methodology bridges empirical data,traditional PSRA models,and ML techniques,contributing to more accurate and scalable post-earthquake resilience assessments.展开更多
BACKGROUND Gastric cancer(GC)is the fifth most common cancer and the third leading cause of cancer-related deaths in China.Many patients with GC frequently experience symptoms related to the disease,including anorexia...BACKGROUND Gastric cancer(GC)is the fifth most common cancer and the third leading cause of cancer-related deaths in China.Many patients with GC frequently experience symptoms related to the disease,including anorexia,nausea,vomiting,and other discomforts,and often suffer from malnutrition,which in turn negatively affects perioperative safety,prognosis,and the effectiveness of adjuvant therapeutic measures.Consequently,some nutritional indicators such as nutritional risk index(NRI),prognostic nutritional index(PNI),and systemic immune-inflammatorynutritional index(SIINI)can be used as predictors of the prognosis of GC patients.AIM To examine the prognostic significance of PNI,NRI,and SIINI in postoperative patients with GC.METHODS A retrospective analysis was conducted on the clinical data of patients with GC who underwent surgical treatment at the Guangxi Medical University Cancer Hospital between January 2010 and December 2018.The area under the receiver operating characteristic(ROC)curve was assessed using ROC curve analysis,and the optimal cutoff values for NRI,PNI,and SIINI were identified using the You-Review-HTMLden index.Survival analysis was performed using the Kaplan-Meier method.In addition,univariate and multivariate analyses were conducted using the Cox proportional hazards regression model.RESULTS This study included a total of 803 patients.ROC curves were used to evaluate the prognostic ability of NRI,PNI,and SIINI.The results revealed that SIINI had superior predictive accuracy.Survival analysis indicated that patients with GC in the low SIINI group had a significantly better survival rate than those in the high SIINI group(P<0.05).Univariate analysis identified NRI[hazard ratio(HR)=0.68,95%confidence interval(CI):0.52-0.89,P=0.05],PNI(HR=0.60,95%CI:0.46-0.79,P<0.001),and SIINI(HR=2.10,95%CI:1.64-2.69,P<0.001)as prognostic risk factors for patients with GC.However,multifactorial analysis indicated that SIINI was an independent risk factor for the prognosis of patients with GC(HR=1.65,95%CI:1.26-2.16,P<0.001).CONCLUSION Analysis of clinical retrospective data revealed that SIINI is a valuable indicator for predicting the prognosis of patients with GC.Compared with NRI and PNI,SIINI may offer greater application for prognostic assessment.展开更多
In the context of the digital transformation of vocational education,a quality evaluation index system has been constructed.Based on a questionnaire survey conducted among higher vocational colleges and enterprises in...In the context of the digital transformation of vocational education,a quality evaluation index system has been constructed.Based on a questionnaire survey conducted among higher vocational colleges and enterprises in Hainan Province,it has been found that the quality of vocational education generally depends on the talent training program and professional construction at the macro level.At the meso level,the teacher level and teaching environment are critical,while at the micro level,the evaluation of talent training quality cannot be underestimated.Strategies for quality improvement in vocational education are proposed from the perspectives of talent training programs,major construction,teacher development,teaching environment,and talent training quality,all under the lens of digital transformation.展开更多
BACKGROUND The atherogenic index of plasma(AIP)has been shown to be positively correlated with cardiovascular disease in previous studies.However,it is unclear whether elderly people with long-term high AIP levels are...BACKGROUND The atherogenic index of plasma(AIP)has been shown to be positively correlated with cardiovascular disease in previous studies.However,it is unclear whether elderly people with long-term high AIP levels are more likely to develop coronary heart disease(CHD).Therefore,the aim of this study was to investigate the relationship between AIP trajectory and CHD incidence in elderly people.METHODS 19,194 participants aged≥60 years who had three AIP measurements between 2018 and 2020 were included in this study.AIP was defined as log10(triglyceride/high-density lipoprotein cholesterol).The group-based trajectory model was used to identify different trajectory patterns of AIP from 2018 to 2020.Cox proportional hazards models were used to estimate the hazard ratio(HR)with 95%CI of CHD events between different trajectory groups from 2020 to 2023.RESULTS Three different trajectory patterns were identified through group-based trajectory model:the low-level group(n=7410,mean AIP:-0.25 to-0.17),the medium-level group(n=9981,mean AIP:0.02-0.08),and the high-level group(n=1803,mean AIP:0.38-0.42).During a mean follow-up of 2.65 years,a total of 1391 participants developed CHD.After adjusting for potential confounders,compared with the participants in the low-level group,the HR with 95%CI of the medium-level group and the high-level group were estimated to be 1.24(1.10-1.40)and 1.43(1.19-1.73),respectively.These findings remained consistent in subgroup analyses and sensitivity analyses.CONCLUSIONS There was a significant correlation between persistent high AIP level and increased CHD risk in the elderly.This suggests that monitoring the long-term changes in AIP is helpful to identify individuals at high CHD risk in elderly people.展开更多
BACKGROUND The diagnosis of gastric carcinoma(GC)is essential for improving clinical outcomes.However,the biomarkers currently used for GC screening are not ideal.AIM To explore the diagnostic implications of the neut...BACKGROUND The diagnosis of gastric carcinoma(GC)is essential for improving clinical outcomes.However,the biomarkers currently used for GC screening are not ideal.AIM To explore the diagnostic implications of the neutrophil-to-lymphocyte ratio(NLR),platelet-to-lymphocyte ratio(PLR),and systemic immune-inflammatory index(SII)for GC.METHODS The baseline data of 133 patients with GC and 134 patients with precancerous gastric conditions admitted between January 2022 and December 2023 were retrospectively analyzed.The information on peripheral blood platelet,neutrophil,and lymphocyte counts in each patient was collected,and the NLR,PLR,and SII levels of both groups were calculated.Additionally,multivariate logistic regression analysis was conducted,and the diagnostic implications of NLR,PLR,and SII in differentiating patients with precancerous gastric conditions,compared with those with GC,were analyzed through receiver operating characteristic(ROC)curves.RESULTS The data indicated that NLR,PLR,and SII had abnormally increased levels in the patients with GC.Gender and body mass index were risk factors for the occurrence of GC.ROC data revealed that the areas under the curve of three patients with precancerous gastric conditions,who were differentiated from those with GC,were 0.824,0.787,and 0.842,respectively.CONCLUSION NLR,PLR,and SII are all abnormally expressed in GC and have diagnostic implications,especially when used as joint indicators,in distinguishing patients with precancerous gastric conditions from those with GC.展开更多
BACKGROUND Glycated hemoglobin(HbA1c),the gold standard for assessing glycemic control,has limited ability to reflect the risks of hypoglycemia and glycemic variability,raising great concerns,especially in patients wi...BACKGROUND Glycated hemoglobin(HbA1c),the gold standard for assessing glycemic control,has limited ability to reflect the risks of hypoglycemia and glycemic variability,raising great concerns,especially in patients with type 1 diabetes(T1D).The glycemia risk index(GRI),a composite metric derived from continuous glucose monitoring(CGM),has emerged as a potential solution by systematically in-tegrating both hypoglycemia and hyperglycemia risks into a single interpretable score.The GRI exhibited linear correlations with HbA1c(r=0.53),time in range(r=-0.90),time above range(r=0.63),time below range(TBR)(r=0.37),and co-efficient of variation(CV)(r=0.71).It correlated strongly with TBR and CV than HbA1c.The association between HbA1c levels and GRI was influenced by TBR and CV.At a given HbA1c,each 1%increase in TBR or CV raised GRI by 1.87[95%confidence interval(CI):1.72-2.01]and 1.94(95%CI:1.80-2.10),respectively(P<0.001).Clustering of the CGM data identified four subgroups:Moderate-risk glycemic fluctuations,high-risk hypoglycemia,optimal glycemic control,and high-risk hyperglycemia.The GRI and its components for hypoglycemia and hyperglycemia could distinguish between these subgroups.CONCLUSION The GRI offers a comprehensive view of glycemic control in T1D.Combining HbA1c with the GRI enables accurate assessment for managing glycemic control in patients with T1D.展开更多
BACKGROUND Anastomotic leakage(AL)is a serious complication following rectal cancer surgery and is associated with increased recurrence,mortality,extended hospital stays,and delayed chemotherapy.The Onodera prognostic...BACKGROUND Anastomotic leakage(AL)is a serious complication following rectal cancer surgery and is associated with increased recurrence,mortality,extended hospital stays,and delayed chemotherapy.The Onodera prognostic nutritional index(OPNI)and inflammation-related biomarkers,such as the neutrophil-lymphocyte ratio(NLR)and platelet-to-lymphocyte ratio(PLR),have been studied in the context of cancer prognosis,but their combined efficacy in predicting AL remains unclear.AIM To investigate the relationships between AL and these markers and developed a predictive model for AL.METHODS A retrospective cohort study analyzed the outcomes of 434 patients who had undergone surgery for rectal cancer at a tertiary cancer center from 2016 to 2023.The patients were divided into two groups on the basis of the occurrence of AL:One group consisted of patients who experienced AL(n=49),and the other group did not(n=385).The investigation applied logistic regression to develop a risk prediction model utilizing clinical,pathological,and laboratory data.The efficacy of this model was then evaluated through receiver operating characteristic curve analysis.RESULTS In the present study,11.28%of the participants(49 out of 434 participants)suffered from AL.Multivariate analysis revealed that preoperative levels of the OPNI,NLR,and PLR emerged as independent risk factors for AL,with odds ratios of 0.705(95%CI:0.641-0.775,P=0.012),1.628(95%CI:1.221-2.172,P=0.024),and 0.994(95%CI:0.989-0.999,P=0.031),respectively.These findings suggest that these biomarkers could effectively predict AL risk.Furthermore,the proposed predictive model has superior discriminative ability,as demonstrated by an area under the curve of 0.910,a sensitivity of 0.898,and a specificity of 0.826,reflecting its high level of accuracy.CONCLUSION The risk of AL in rectal cancer surgery patients can be effectively predicted by assessing the preoperative levels of serum nutritional biomarkers and inflammatory indicators,emphasizing their importance in the preoperative evaluation process.展开更多
BACKGROUND Acute liver failure(ALF)is a life-threatening multisystemic condition with high short-term mortality.With the growing prevalence of obesity and metabolic syndrome,it is important to investigate the clinical...BACKGROUND Acute liver failure(ALF)is a life-threatening multisystemic condition with high short-term mortality.With the growing prevalence of obesity and metabolic syndrome,it is important to investigate the clinical implications of high body mass index(BMI)on survival outcomes in ALF.AIM To explore the impact of overweight and obesity on the clinical outcomes of patients with ALF.METHODS A retrospective observational cohort study was conducted involving patients with ALF admitted to the Johns Hopkins Health System between January 1,2000 and May 1,2020.We performed Cox proportional hazards regression to identify outcomes,including the need for liver transplantation(LT)or all-cause mortality.RESULTS A total of 196 patients were included,the median age was 43.5 years,63.3%were female,and 59.7%were of Caucasian ethnicity.Acetaminophen-induced ALF was the most common etiology(45%).The mean BMI was significantly greater among patients who underwent LT or died(29.64 kg/m^(2)vs 26.59 kg/m^(2),P=0.008)than among survivors.Patients with overweight and obesity had a higher risk of all-cause mortality or need for LT by 2.22-fold(95%CI:1.30-3.78)and 2.04-fold(95%CI:1.29-3.39),respectively.Elevated BMI was associated with renal failure and higher grades of hepatic encephalopathy.Derangements in serologic markers,including alanine transaminase,lactate,and ammonia,were associated with a mortality risk or need for LT.CONCLUSION In this large,retrospective study,with a diverse cohort of United States patients,Overweight and obese were independently associated with an increased risk of all-cause mortality or need for LT.This work highlights the importance of closely monitoring ALF patients who are overweight or obese for adverse complications and measures to improve outcomes in this vulnerable patient population.展开更多
BACKGROUND Overweight children exhibit a higher prevalence of functional gastrointestinal disorders compared with their normal-weight peers,yet the underlying reasons remain unclear.Gastrointestinal motility,a key pat...BACKGROUND Overweight children exhibit a higher prevalence of functional gastrointestinal disorders compared with their normal-weight peers,yet the underlying reasons remain unclear.Gastrointestinal motility,a key pathophysiological factor in functional gastrointestinal disorders,may be influenced by body mass index(BMI).AIM To evaluate the impact of BMI on gastric motility parameters in children with functional abdominal pain disorders(FAPDs).METHODS We assessed gastric motility in 176 children with FAPDs(61.4%females,mean age 7.94 years,SD 1.96 years)and 63 healthy controls(57.1%females,mean age 9.17 years,SD 1.90 years)at the Gastroenterology Research Laboratory,University of Kelaniya,Sri Lanka.FAPDs were diagnosed and subtyped using the Rome IV criteria:Functional abdominal pain 97 patients;irritable bowel syndrome 39 patients,functional dyspepsia(FD)25 patients;and abdominal migraine 15 patients.Gastric motility was measured using a validated ultrasound method.Weight and height were measured using sensitive standard scales.RESULTS The BMIs of children with FAPDs and controls were 15.04 and 15.46 kg/m^(2),respectively(P=0.33).Fasting antral area(FAA)and antral area at 1 min(AA1)and 15 min(AA15)were significantly greater in patients with FAPD with a higher BMI(2.71 cm^(2),12.57 cm^(2),and 7.19 cm^(2),respectively)compared with those with a lower BMI(2.12 cm^(2),10.68 cm^(2),and 6.13 cm^(2),respectively)(P<0.01).BMI positively correlated with FAA and AA15(r=0.18 and r=0.19,respectively)(P<0.01)in those with FAPDs.In controls,only AA1 was greater in the higher BMI group(12.51 cm^(2)vs 9.93 cm^(2))and had a positive correlation(r=0.33)(P≤0.01).Subgroup analysis revealed that in patients with FD,BMI negatively correlated with gastric emptying rate(GER)(r=-0.59)and antral motility index(MI)(r=-0.49),while in functional abdominal pain,MI positively correlated(r=0.25)with BMI(P≤0.01).CONCLUSION In children with FAPDs,higher BMI was associated with increased gastric antral distention during fasting and postprandial periods(as indicated by FAA,AA1,and AA15)but not with contractility and transit(MI,GER).However,in the FD subgroup,high BMI correlated with reduced GER and MI.This indicates the possible role of BMI in gastric hypomotility and the pathophysiology of FD.These findings underscore the importance of lifestyle and dietary interventions aimed at optimizing BMI in the management of FAPDs,particularly FD.展开更多
ACKGROUND The hemoglobin glycation index(HGI)represents the discrepancy between the glucose management indicator(GMI)based on mean blood glucose levels and laboratory values of glycated hemoglobin(HbA1c).The HGI is a ...ACKGROUND The hemoglobin glycation index(HGI)represents the discrepancy between the glucose management indicator(GMI)based on mean blood glucose levels and laboratory values of glycated hemoglobin(HbA1c).The HGI is a promising indicator for identifying individuals with excessive glycosylation,facilitating personalized evaluation and prediction of diabetic complications.However,the factors influencing the HGI in patients with type 1 diabetes(T1D)remain unclear.Autoimmune destruction of pancreaticβcells is central in T1D pathogenesis,yet insulin resistance can also be a feature of patients with T1D and their coexistence is called“double diabetes”(DD).However,knowledge regarding the relationship between DD features and the HGI in T1D is limited.AIM To assess the association between the HGI and DD features in adults with T1D.METHODS A total of 83 patients with T1D were recruited for this cross-sectional study.Laboratory HbA1c and GMI from continuous glucose monitoring data were collected to calculate the HGI.DD features included a family history of type 2 diabetes,overweight/obesity/central adiposity,hypertension,atherogenic dyslipidemia,an abnormal percentage of body fat(PBF)and/or visceral fat area(VFA)and decreased estimated insulin sensitivity.Skin autofluorescence of advanced glycation end products(SAF-AGEs),diabetic complications,and DD features were assessed,and their association with the HGI was analyzed.RESULTS A discrepancy was observed between HbA1c and GMI among patients with T1D and DD.A higher HGI was associated with an increased number of SAF-AGEs and a higher prevalence of diabetic microangiopathy(P=0.030),particularly retinopathy(P=0.031).Patients with three or more DD features exhibited an eight-fold increased risk of having a high HGI,compared with those without DD features(adjusted odds ratio=8.12;95%confidence interval:1.52-43.47).Specifically,an elevated PBF and/or VFA and decreased estimated insulin sensitivity were associated with high HGI.Regression analysis identified estimated insulin sensitivity and VFA as factors independently associated with HGI.CONCLUSION In patients with T1D,DD features are associated with a higher HGI,which represents a trend toward excessive glycosylation and is associated with a higher prevalence of chronic diabetic complications.展开更多
基金Supported by Ningbo NSF(No.2021J234)Zhejiang Provincial Philosophy and Social Sciences Planning Project(No.24NDJC057YB)。
文摘The atom-bond sum-connectivity(ABS)index,put forward by[J.Math.Chem.,2022,60(10):20812093],exhibits a strong link with the acentric factor of octane isomers.The experimental physico-chemical properties of octane isomers,such as boiling point,of formation are found to be better measured by the ABS index than by the Randi,atom-bond connectivity(ABC),and sum-connectivity(SC)indices.One important source of information for researching the molecular structure is the bounds for its topological indices.The extrema of the ABS index of the line,total,and Mycielski graphs are calculated in this work.Moreover,the pertinent extremal graphs were illustrated.
文摘The Gabes aquifer system,located in southeastern Tunisia,is a crucial resource for supporting local socio-economic activities.Due to its dual porosity structure,is particularly vulnerable to pollution.This study aims to develop a hybrid model that combines the Fracture Aquifer Index(FAI)with the conventional GOD(Groundwater occurrence,Overall lithology,Depth to water table)method,to assess groundwater vulnerability in fractured aquifer.To develop the hybrid model,the classical GOD method was integrated with FAI to produce a single composite index.Each parameter within both GOD and FAI was scored,and a final index was calculated to delineate vulnerable areas.The results show that the study area can be classified into four vulnerability levels:Very low,low,moderate,and high,indicating that approximately 8%of the area exhibits very low vulnerability,29%has low vulnerability,25%falls into the moderate category,and 38%is considered highly vulnerable.The FAI-GOD model further incorporates fracture network characteristics.This refinement reduces the classification to three vulnerability classes:Low,medium,and high.The outcomes demonstrate that 46%of the area is highly vulnerable due to a dense concentration of fractures,while 17%represents an intermediate zone characterized by either shallow or deeper fractures.In contrast,37%corresponds to areas with lightly fractured rock,where the impact on vulnerability is minimal.Multivariate statistical analysis was employed using Principal Components Analysis(PCA)and Hierarchical Cluster Analysis(HCA)on 24 samples across six variables.The first three components account for over 76%of the total variance,reinforcing the significance of fracture dynamics in classifying vulnerability levels.The FAI-GOD model removes the very-low-vulnerability class and expands the spatial extent of low-and high-vulnerability zones,reflecting the dominant influence of fracture networks on aquifer sensitivity.While both indices use a five-class system,FAI-GOD redistributes vulnerability by eliminating very-low-vulnerability areas and amplifying low/high categories,highlighting the critical role of fractures.A strong correlation(R2=0.94)between the GOD and FAI-GOD indices,demonstrated through second-order polynomial regression,confirms the robustness of the FAI-GOD model in accurately predicting vulnerability to pollution.This model provides a useful framework for assessing the vulnerability of complex aquifers and serves as a decision-making tool for groundwater managers in similar areas.
文摘This commentary critically appraises the study by Li et al which pioneered the exploration of the triglyceride-glucose(TyG)index as a prognostic marker in hepatitis B virus-related advanced hepatocellular carcinoma patients undergoing combined camrelizumab and lenvatinib therapy.While we acknowledge the study’s clinical relevance in proposing an easily accessible metabolic biomarker,we delve into the mechanistic plausibility linking insulin resistance to immunotherapy response and angiogenic inhibition.We further critically examine the methodological limitations,including the retrospective design,the populationspecific TyG cut-off value,and unaddressed metabolic confounders.We highlight the imperative for future research to validate its utility across diverse etiologies and treatment settings,and to unravel the underlying immunometabolic pathways.
基金Supported by Inter Disciplinary Direction Cultivation Project of Hunan University of Chinese Medicine,No.2025JC01032025 Hunan Province Science and Technology Innovation Plan Project,No.2025RC9012+2 种基金2022"Unveiling and Leading"Project of Discipline Construction at Hunan University of Chinese Medicine,No.22JBZ044Changsha Municipal Natural Science Foundation,No.kq2402174Hunan Provincial Science Popularization Fund Project,No.2025ZK4223.
文摘BACKGROUND Timely and accurate evaluation of mental disorders in adolescents using appropriate mental health literacy assessment tools is essential for improving their mental health literacy levels.AIM To develop an evaluation index system for the mental health literacy of adolescent patients with mental disorders,providing a scientific,comprehensive,and reliable tool for the monitoring and intervention of mental health literacy of such patients.METHODS From December 2022 to June 2023,the evaluation index system for mental health literacy of adolescents with mental disorders was developed through literature reviews,semi-structured interviews,expert letter consultations,and the analytic hierarchy process.Based on this index system,a self-assessment questionnaire was compiled and administered to 305 adolescents with mental disorders to test the reliability and validity of the index system.RESULTS The final evaluation index system for mental health literacy of adolescents with mental disorders included 4 first-level indicators,10 second-level indicators,and 52 third-level indicators.The overall Cronbach’sαcoefficient of the index system was 0.957,with a partial reliability of 0.826 and a content validity index of 0.975.The cumulative variance contribution rate of 10 common factors was 66.491%.The correlation coefficients between each dimension and the total questionnaire ranged from 0.672 to 0.724,while the correlation coefficients in each dimension ranged from 0.389 to 0.705.CONCLUSION The evaluation index system for mental health literacy of adolescents with mental disorders,developed in this study,demonstrated notable reliability and validity,making it a valuable tool for evaluating mental health literacy in this population.
基金Supported by the National Key Research and Development Program of China(No.2022YFC3502503)the Medical and Health Science and Technology Project of the Zhejiang Provincial Health Commission of China(No.2022PY072).
文摘AIM:To explore the repeatability,reproducibility,and agreement in the measurement of the choroidal vascularity index(CVI)for different swept-source optical coherence tomography(OCT)devices and between OCT and OCT angiography(OCTA)images.METHODS:Two swept-source OCT imaging systems,VG200I and Topcon DRI OCT Triton,were used to capture OCT and OCTA images in triplicate.The first and third images were taken by one operator,and the second image was taken by another operator.The built-in software was used to calculate the CVI from the OCTA images(CVI-OCTA),and a custom-designed algorithm was used to calculate the CVI from the OCT images(CVI-OCT).Repeatability and reproducibility were assessed with the intraclass correlation coefficient(ICC),and agreement between devices and between OCT and OCTA were evaluated with Bland-Altman analysis.RESULTS:Sixty-eight eyes from 35 adults(17 females)were included in the analysis.The average age of the participants was 23.6±2.3y,with an average spherical equivalent refraction of-3.08±2.47 D and an average AL of 25.21±1.20 mm.Both OCT devices demonstrated high repeatability and reproducibility in measuring the CVI-OCTA(all ICCs>0.894 across five choroidal regions)and CVI-OCT(all ICCs>0.838).Furthermore,the between-device agreement in measuring the CVI-OCT was good[mean difference(MD)ranging from-2.32%to-3.07%],but that in measuring the CVI-OCTA was poor(MD,1.48%to-7.43%).Additionally,the between-imaging agreement(CVI-OCTA versus CVI-OCT)was poor for both devices(Triton,MD,6.05%to 12.68%;VG200I,MD,6.67%to 12.09%).CONCLUSION:Both OCT devices and the two analytical methods demonstrate good stability.The inter-device consistency of CVI-OCT is good,while the inter-device consistency of CVI-OCTA and the consistency between the two analytical methods in the same device are both poor.
基金Supported by the National Natural Science Foundation of China(Grant No.12071092)Guangdong Basic and Applied Basic Research Foundation(Grant No.2025A1515012072)+1 种基金the Natural Science Research Project of Anhui Educational Committee(Grant No.2024AH051298)the Scientific Research Foundation of Bozhou University(Grant No.BYKQ202419).
文摘Let G be a finite group and H a subgroup of G.The normal index of H in G is defined as the order of K/H_(G),where K is a normal supplement of H in G such that|K|is minimal and H_(G)≤K■G.Let p be a prime which divides the order of a group G.In this paper,some characterizations of G being p-solvable or p-supersolvable were obtained by analyzing the normal index of certain subgroups of G.These results can be viewed as local version of recent results in the literature.
文摘BACKGROUND:Rapid identification of patients at risk of clinical deterioration(in-hospital mortality) in emergency settings is essential for timely and appropriate care.Existing prognostic scores,such as the Acute Physiology and Chronic Health Evaluation IV(APACHE IV),Simplified Acute Physiology Score 3(SAPS 3),Sequential Organ Failure Assessment(SOFA),and National Early Warning Score 2(NEWS 2),have limitations in emergency scenarios,particularly in resource-limited settings.We aimed to develop a simple and efficient tool tailored to the Brazilian healthcare system.METHODS:This retrospective,multicenter,cohort study analyzed data from 50,709 adult patients admitted to 12 hospitals in southern and southeastern Brazil between 2019 and 2020.The BRASIL score(Brazilian Risk Assessment Severity Index and Length of stay) was constructed using demographic and clinical variables available at admission.Logistic regression was used to determine the weight of each variable,and each variable was assigned a point value based on its β-coefficient and clinical relevance,with thresholds defined according to established medical cutoffs and statistical performance.The score's predictive accuracy was validated using the area under the receiver operating characteristic curve(AUC) with comparative analysis against NEWS 2.RESULTS:The BRASIL score,including age,sex,respiratory rate,heart rate,oxygen saturation,blood pressure,and body temperature,was derived through variables independently associated with in-hospital mortality in a multicenter cohort.The total score was stratified into three risk categories — low(0–3 points),moderate(4–7 points),and high(>7 points) — using observed inflection points in mortality distribution to optimize discrimination.This stratification demonstrated a stepwise increase in mortality rates across categories and the discriminatory performance,with an overall AUC of 0.743(95% CI:0.726–0.761).Compared to NEWS 2(AUC 0.697,95% CI:0.683–0.711),the BRASIL score offered superior early risk identification,supporting timely clinical decisionmaking and resource allocation in the emergency setting.CONCLUSION:The BRASIL score is a novel tool for predicting in-hospital mortality in emergency departments.Its predictive performance and ease of use suggest that it has the potential to improve patient outcomes.
基金financial support by the National Key Research and Development Program of China(No.2023YFB4605400)the National Natural Science Foundation of China(No.12472152)the Department of Science and Technology of Guangdong Province(No.2019QN01Z438)。
文摘Gradient refractive index(GRIN)metalenses are increasingly valued in high-frequency communication due to their exceptional radiation performance.Ceramics with high dielectric constants and low dielectric losses are ideal candidates for GRIN metalenses.Digital light processing(DLP)3D printing provides a feasible and efficient approach for manufacturing ceramic GRIN metalenses.However,the scattering of ultraviolet(UV)light by ceramic particles in the slurry reduces the printing accuracy of DLP technology,making it difficult to achieve the intricate structural features required for GRIN metalenses in high-frequency communication.In this work,we propose an approach to improve printing accuracy by optimizing the ceramic slurry composition and implementing a dimensional compensation design strategy.Utilizing geometric optics and the S-parameter inversion method,we design a GRIN metalens consisting of two distinct types of subwavelength unit cells(Y-shaped and circular hole geometries)with a minimum feature size of 160μm.Through a refined slurry formulation and precise design parameter compensation,high-fidelity ceramic GRIN metalenses are successfully fabricated.The fabricated metalens exhibits a maximum gain enhancement of 18.4 dBi and a deflection angle of±30°over a bandwidth of 37.84% in the W-band(75-110 GHz).The highly directional far-field beam radiation and efficient beam steering capabilities highlight the potential of ceramic GRIN metalenses for applications in satellite communications,radar systems,and other high-frequency technologies.
基金Project supported by the National Natural Science Foundation of China(Grant No.12175107)the Qing Lan Project of Jiangsu Province+2 种基金the Hua Li Talents Program of Nanjing University of PostsTelecommunications,Natural Science Foundation of Nanjing Vocational University of Industry Technology(Grant No.YK22-02-08)the Fund from the Research Center of Industrial Perception and Intelligent Manufacturing Equipment Engineering of Jiangsu Province,China(Grant No.ZK21-05-09)。
文摘Surface polaritons,as surface electromagnetic waves propagating along the surface of a medium,have played a crucial role in enhancing photonic spin Hall effect(PSHE)and developing highly sensitive refractive index(RI)sensors.Among them,the traditional surface plasmon polariton(SPP)based on noble metals limits its application beyond the near-infrared(IR)regime due to the large negative permittivity and optical losses.In this contribution,we theoretically proposed a highly sensitive PSHE sensor with the structure of Ge prism-SiC-Si:InAs-sensing medium,by taking advantage of the hybrid surface plasmon phonon polariton(SPPhP)in mid-IR regime.Here,heavily Si-doped InAs(Si:InAs)and SiC excite the SPP and surface phonon polariton(SPhP),and the hybrid SPPhP is realized in this system.More importantly,the designed PSHE sensor based on this SPPhP mechanism achieves the multi-stage RI measurements from 1.00025-1.00225 to 1.70025-1.70225,and the maximal intensity sensitivity and angle sensitivity can be up to 9.4×10^(4)μm/RIU and245°/RIU,respectively.These findings provide a new pathway for the enhancement of PSHE in mid-IR regime,and offer new opportunities to develop highly sensitive RI sensors in multi-scenario applications,such as harmful gas monitoring and biosensing.
基金Vicerrectoría de Inves-tigaciones of the UMNG for the financial support of the IMP-ING-3743 Project.
文摘This study presents a hybrid methodology for predicting building collapses within the Intelligent Circular Resilience(ICR)framework.This uses a supervised Machine Learning(ML)approach,earthquake damage re-ports,and the Simplified Resilience Index(SRI),derived from existing earthquake damage models(EDM)-based on fragility and vulnerability functions-used in the probabilistic seismic risk assessment(PSRA).A curated building damage database comprising 89 structures(71 collapsed and 18 non-collapsed)from ten countries affected by major earthquakes(Mw 6.1-8.1,epicentral distances of 3-125 km,and PGA values ranging from 0.14 g to 0.82 g)was developed,including attributes related to exposure:occupancy,main structural material,number of stories,construction year,and hazard:magnitude,epicentral distance,intensity measures(Peak-ground acceleration,PGA,and elastic spectral acceleration).The dataset includes events such as the 2017 Puebla-Morelos earthquake(Mw 7.1,Mexico),the 1999 Kocaeli earthquake(Mw 7.6,Turkey),and the 2011 Christchurch earthquake(Mw 6.1,New Zealand),among others.Likewise,dependent attributes such as time elapsed and SRI(under 120-,180-,and 365-day recovery scenarios)were calculated using 2-EDMs.Eight Random Forest models were trained and tested for collapse and non-collapse classification using combinations of independent and dependent attributes.The results indicate that models incorporating exposure-related varia-bles-such as structural material,number of stories,construction year,and occupancy-alongside the SRI significantly improve collapse classification performance,achieving recall and F1 scores above 95%.Notably,many collapsed buildings exhibited low intensities(PGA≤0.25 g),emphasizing the influence of local site effects-particularly in Mexico City.The findings demonstrate that incorporating SRI enhances the reliability of collapse prediction and supports its use as an interpretable resilience proxy during early ICR stages.This hybrid methodology bridges empirical data,traditional PSRA models,and ML techniques,contributing to more accurate and scalable post-earthquake resilience assessments.
基金Supported by the Scientific Research Project of Hospital Pharmacy of Guangxi Pharmaceutical Association in 2022,No.GXYXH1-202202.
文摘BACKGROUND Gastric cancer(GC)is the fifth most common cancer and the third leading cause of cancer-related deaths in China.Many patients with GC frequently experience symptoms related to the disease,including anorexia,nausea,vomiting,and other discomforts,and often suffer from malnutrition,which in turn negatively affects perioperative safety,prognosis,and the effectiveness of adjuvant therapeutic measures.Consequently,some nutritional indicators such as nutritional risk index(NRI),prognostic nutritional index(PNI),and systemic immune-inflammatorynutritional index(SIINI)can be used as predictors of the prognosis of GC patients.AIM To examine the prognostic significance of PNI,NRI,and SIINI in postoperative patients with GC.METHODS A retrospective analysis was conducted on the clinical data of patients with GC who underwent surgical treatment at the Guangxi Medical University Cancer Hospital between January 2010 and December 2018.The area under the receiver operating characteristic(ROC)curve was assessed using ROC curve analysis,and the optimal cutoff values for NRI,PNI,and SIINI were identified using the You-Review-HTMLden index.Survival analysis was performed using the Kaplan-Meier method.In addition,univariate and multivariate analyses were conducted using the Cox proportional hazards regression model.RESULTS This study included a total of 803 patients.ROC curves were used to evaluate the prognostic ability of NRI,PNI,and SIINI.The results revealed that SIINI had superior predictive accuracy.Survival analysis indicated that patients with GC in the low SIINI group had a significantly better survival rate than those in the high SIINI group(P<0.05).Univariate analysis identified NRI[hazard ratio(HR)=0.68,95%confidence interval(CI):0.52-0.89,P=0.05],PNI(HR=0.60,95%CI:0.46-0.79,P<0.001),and SIINI(HR=2.10,95%CI:1.64-2.69,P<0.001)as prognostic risk factors for patients with GC.However,multifactorial analysis indicated that SIINI was an independent risk factor for the prognosis of patients with GC(HR=1.65,95%CI:1.26-2.16,P<0.001).CONCLUSION Analysis of clinical retrospective data revealed that SIINI is a valuable indicator for predicting the prognosis of patients with GC.Compared with NRI and PNI,SIINI may offer greater application for prognostic assessment.
文摘In the context of the digital transformation of vocational education,a quality evaluation index system has been constructed.Based on a questionnaire survey conducted among higher vocational colleges and enterprises in Hainan Province,it has been found that the quality of vocational education generally depends on the talent training program and professional construction at the macro level.At the meso level,the teacher level and teaching environment are critical,while at the micro level,the evaluation of talent training quality cannot be underestimated.Strategies for quality improvement in vocational education are proposed from the perspectives of talent training programs,major construction,teacher development,teaching environment,and talent training quality,all under the lens of digital transformation.
基金supported by the National Key Research and Development Program of China(2017YFC1307705).
文摘BACKGROUND The atherogenic index of plasma(AIP)has been shown to be positively correlated with cardiovascular disease in previous studies.However,it is unclear whether elderly people with long-term high AIP levels are more likely to develop coronary heart disease(CHD).Therefore,the aim of this study was to investigate the relationship between AIP trajectory and CHD incidence in elderly people.METHODS 19,194 participants aged≥60 years who had three AIP measurements between 2018 and 2020 were included in this study.AIP was defined as log10(triglyceride/high-density lipoprotein cholesterol).The group-based trajectory model was used to identify different trajectory patterns of AIP from 2018 to 2020.Cox proportional hazards models were used to estimate the hazard ratio(HR)with 95%CI of CHD events between different trajectory groups from 2020 to 2023.RESULTS Three different trajectory patterns were identified through group-based trajectory model:the low-level group(n=7410,mean AIP:-0.25 to-0.17),the medium-level group(n=9981,mean AIP:0.02-0.08),and the high-level group(n=1803,mean AIP:0.38-0.42).During a mean follow-up of 2.65 years,a total of 1391 participants developed CHD.After adjusting for potential confounders,compared with the participants in the low-level group,the HR with 95%CI of the medium-level group and the high-level group were estimated to be 1.24(1.10-1.40)and 1.43(1.19-1.73),respectively.These findings remained consistent in subgroup analyses and sensitivity analyses.CONCLUSIONS There was a significant correlation between persistent high AIP level and increased CHD risk in the elderly.This suggests that monitoring the long-term changes in AIP is helpful to identify individuals at high CHD risk in elderly people.
文摘BACKGROUND The diagnosis of gastric carcinoma(GC)is essential for improving clinical outcomes.However,the biomarkers currently used for GC screening are not ideal.AIM To explore the diagnostic implications of the neutrophil-to-lymphocyte ratio(NLR),platelet-to-lymphocyte ratio(PLR),and systemic immune-inflammatory index(SII)for GC.METHODS The baseline data of 133 patients with GC and 134 patients with precancerous gastric conditions admitted between January 2022 and December 2023 were retrospectively analyzed.The information on peripheral blood platelet,neutrophil,and lymphocyte counts in each patient was collected,and the NLR,PLR,and SII levels of both groups were calculated.Additionally,multivariate logistic regression analysis was conducted,and the diagnostic implications of NLR,PLR,and SII in differentiating patients with precancerous gastric conditions,compared with those with GC,were analyzed through receiver operating characteristic(ROC)curves.RESULTS The data indicated that NLR,PLR,and SII had abnormally increased levels in the patients with GC.Gender and body mass index were risk factors for the occurrence of GC.ROC data revealed that the areas under the curve of three patients with precancerous gastric conditions,who were differentiated from those with GC,were 0.824,0.787,and 0.842,respectively.CONCLUSION NLR,PLR,and SII are all abnormally expressed in GC and have diagnostic implications,especially when used as joint indicators,in distinguishing patients with precancerous gastric conditions from those with GC.
基金Supported by the Noncommunicable Chronic Diseases-National Science and Technology Major Project,No.2023ZD0508201the National Key R and D Program of China,No.2022YFC2010100+3 种基金the National Natural Science Foundation of China,No.82070812the Natural Science Foundation of Hunan Province,No.2024JJ9049,No.2023JJ30762 and No.2021JC0003Sinocare Diabetes Foundation,No.2020SD08the National Clinical Research Center for Metabolic Diseases Clinical Diagnosis and Treatment Capacity Enhancement Program,No.2023ZLNL003.
文摘BACKGROUND Glycated hemoglobin(HbA1c),the gold standard for assessing glycemic control,has limited ability to reflect the risks of hypoglycemia and glycemic variability,raising great concerns,especially in patients with type 1 diabetes(T1D).The glycemia risk index(GRI),a composite metric derived from continuous glucose monitoring(CGM),has emerged as a potential solution by systematically in-tegrating both hypoglycemia and hyperglycemia risks into a single interpretable score.The GRI exhibited linear correlations with HbA1c(r=0.53),time in range(r=-0.90),time above range(r=0.63),time below range(TBR)(r=0.37),and co-efficient of variation(CV)(r=0.71).It correlated strongly with TBR and CV than HbA1c.The association between HbA1c levels and GRI was influenced by TBR and CV.At a given HbA1c,each 1%increase in TBR or CV raised GRI by 1.87[95%confidence interval(CI):1.72-2.01]and 1.94(95%CI:1.80-2.10),respectively(P<0.001).Clustering of the CGM data identified four subgroups:Moderate-risk glycemic fluctuations,high-risk hypoglycemia,optimal glycemic control,and high-risk hyperglycemia.The GRI and its components for hypoglycemia and hyperglycemia could distinguish between these subgroups.CONCLUSION The GRI offers a comprehensive view of glycemic control in T1D.Combining HbA1c with the GRI enables accurate assessment for managing glycemic control in patients with T1D.
基金Supported by Natural Science Foundation of Xinjiang Uygur Autonomous Region,No.2022D01C297.
文摘BACKGROUND Anastomotic leakage(AL)is a serious complication following rectal cancer surgery and is associated with increased recurrence,mortality,extended hospital stays,and delayed chemotherapy.The Onodera prognostic nutritional index(OPNI)and inflammation-related biomarkers,such as the neutrophil-lymphocyte ratio(NLR)and platelet-to-lymphocyte ratio(PLR),have been studied in the context of cancer prognosis,but their combined efficacy in predicting AL remains unclear.AIM To investigate the relationships between AL and these markers and developed a predictive model for AL.METHODS A retrospective cohort study analyzed the outcomes of 434 patients who had undergone surgery for rectal cancer at a tertiary cancer center from 2016 to 2023.The patients were divided into two groups on the basis of the occurrence of AL:One group consisted of patients who experienced AL(n=49),and the other group did not(n=385).The investigation applied logistic regression to develop a risk prediction model utilizing clinical,pathological,and laboratory data.The efficacy of this model was then evaluated through receiver operating characteristic curve analysis.RESULTS In the present study,11.28%of the participants(49 out of 434 participants)suffered from AL.Multivariate analysis revealed that preoperative levels of the OPNI,NLR,and PLR emerged as independent risk factors for AL,with odds ratios of 0.705(95%CI:0.641-0.775,P=0.012),1.628(95%CI:1.221-2.172,P=0.024),and 0.994(95%CI:0.989-0.999,P=0.031),respectively.These findings suggest that these biomarkers could effectively predict AL risk.Furthermore,the proposed predictive model has superior discriminative ability,as demonstrated by an area under the curve of 0.910,a sensitivity of 0.898,and a specificity of 0.826,reflecting its high level of accuracy.CONCLUSION The risk of AL in rectal cancer surgery patients can be effectively predicted by assessing the preoperative levels of serum nutritional biomarkers and inflammatory indicators,emphasizing their importance in the preoperative evaluation process.
文摘BACKGROUND Acute liver failure(ALF)is a life-threatening multisystemic condition with high short-term mortality.With the growing prevalence of obesity and metabolic syndrome,it is important to investigate the clinical implications of high body mass index(BMI)on survival outcomes in ALF.AIM To explore the impact of overweight and obesity on the clinical outcomes of patients with ALF.METHODS A retrospective observational cohort study was conducted involving patients with ALF admitted to the Johns Hopkins Health System between January 1,2000 and May 1,2020.We performed Cox proportional hazards regression to identify outcomes,including the need for liver transplantation(LT)or all-cause mortality.RESULTS A total of 196 patients were included,the median age was 43.5 years,63.3%were female,and 59.7%were of Caucasian ethnicity.Acetaminophen-induced ALF was the most common etiology(45%).The mean BMI was significantly greater among patients who underwent LT or died(29.64 kg/m^(2)vs 26.59 kg/m^(2),P=0.008)than among survivors.Patients with overweight and obesity had a higher risk of all-cause mortality or need for LT by 2.22-fold(95%CI:1.30-3.78)and 2.04-fold(95%CI:1.29-3.39),respectively.Elevated BMI was associated with renal failure and higher grades of hepatic encephalopathy.Derangements in serologic markers,including alanine transaminase,lactate,and ammonia,were associated with a mortality risk or need for LT.CONCLUSION In this large,retrospective study,with a diverse cohort of United States patients,Overweight and obese were independently associated with an increased risk of all-cause mortality or need for LT.This work highlights the importance of closely monitoring ALF patients who are overweight or obese for adverse complications and measures to improve outcomes in this vulnerable patient population.
基金Supported by The University of Kelaniya,Sri Lanka,Research Council Grant No.G23.
文摘BACKGROUND Overweight children exhibit a higher prevalence of functional gastrointestinal disorders compared with their normal-weight peers,yet the underlying reasons remain unclear.Gastrointestinal motility,a key pathophysiological factor in functional gastrointestinal disorders,may be influenced by body mass index(BMI).AIM To evaluate the impact of BMI on gastric motility parameters in children with functional abdominal pain disorders(FAPDs).METHODS We assessed gastric motility in 176 children with FAPDs(61.4%females,mean age 7.94 years,SD 1.96 years)and 63 healthy controls(57.1%females,mean age 9.17 years,SD 1.90 years)at the Gastroenterology Research Laboratory,University of Kelaniya,Sri Lanka.FAPDs were diagnosed and subtyped using the Rome IV criteria:Functional abdominal pain 97 patients;irritable bowel syndrome 39 patients,functional dyspepsia(FD)25 patients;and abdominal migraine 15 patients.Gastric motility was measured using a validated ultrasound method.Weight and height were measured using sensitive standard scales.RESULTS The BMIs of children with FAPDs and controls were 15.04 and 15.46 kg/m^(2),respectively(P=0.33).Fasting antral area(FAA)and antral area at 1 min(AA1)and 15 min(AA15)were significantly greater in patients with FAPD with a higher BMI(2.71 cm^(2),12.57 cm^(2),and 7.19 cm^(2),respectively)compared with those with a lower BMI(2.12 cm^(2),10.68 cm^(2),and 6.13 cm^(2),respectively)(P<0.01).BMI positively correlated with FAA and AA15(r=0.18 and r=0.19,respectively)(P<0.01)in those with FAPDs.In controls,only AA1 was greater in the higher BMI group(12.51 cm^(2)vs 9.93 cm^(2))and had a positive correlation(r=0.33)(P≤0.01).Subgroup analysis revealed that in patients with FD,BMI negatively correlated with gastric emptying rate(GER)(r=-0.59)and antral motility index(MI)(r=-0.49),while in functional abdominal pain,MI positively correlated(r=0.25)with BMI(P≤0.01).CONCLUSION In children with FAPDs,higher BMI was associated with increased gastric antral distention during fasting and postprandial periods(as indicated by FAA,AA1,and AA15)but not with contractility and transit(MI,GER).However,in the FD subgroup,high BMI correlated with reduced GER and MI.This indicates the possible role of BMI in gastric hypomotility and the pathophysiology of FD.These findings underscore the importance of lifestyle and dietary interventions aimed at optimizing BMI in the management of FAPDs,particularly FD.
基金Supported by the National Key R D Program of China,No.2022YFC2010102Natural Science Foundation of Hunan Province,No.2021JC0003+1 种基金National Natural Science Foundation of China,No.82070812the Sinocare Diabetes Foundation,No.LYF2022039.
文摘ACKGROUND The hemoglobin glycation index(HGI)represents the discrepancy between the glucose management indicator(GMI)based on mean blood glucose levels and laboratory values of glycated hemoglobin(HbA1c).The HGI is a promising indicator for identifying individuals with excessive glycosylation,facilitating personalized evaluation and prediction of diabetic complications.However,the factors influencing the HGI in patients with type 1 diabetes(T1D)remain unclear.Autoimmune destruction of pancreaticβcells is central in T1D pathogenesis,yet insulin resistance can also be a feature of patients with T1D and their coexistence is called“double diabetes”(DD).However,knowledge regarding the relationship between DD features and the HGI in T1D is limited.AIM To assess the association between the HGI and DD features in adults with T1D.METHODS A total of 83 patients with T1D were recruited for this cross-sectional study.Laboratory HbA1c and GMI from continuous glucose monitoring data were collected to calculate the HGI.DD features included a family history of type 2 diabetes,overweight/obesity/central adiposity,hypertension,atherogenic dyslipidemia,an abnormal percentage of body fat(PBF)and/or visceral fat area(VFA)and decreased estimated insulin sensitivity.Skin autofluorescence of advanced glycation end products(SAF-AGEs),diabetic complications,and DD features were assessed,and their association with the HGI was analyzed.RESULTS A discrepancy was observed between HbA1c and GMI among patients with T1D and DD.A higher HGI was associated with an increased number of SAF-AGEs and a higher prevalence of diabetic microangiopathy(P=0.030),particularly retinopathy(P=0.031).Patients with three or more DD features exhibited an eight-fold increased risk of having a high HGI,compared with those without DD features(adjusted odds ratio=8.12;95%confidence interval:1.52-43.47).Specifically,an elevated PBF and/or VFA and decreased estimated insulin sensitivity were associated with high HGI.Regression analysis identified estimated insulin sensitivity and VFA as factors independently associated with HGI.CONCLUSION In patients with T1D,DD features are associated with a higher HGI,which represents a trend toward excessive glycosylation and is associated with a higher prevalence of chronic diabetic complications.
