Hemogram-derived ratios as prognostic markers for major adverse cardiovascular events in patients with non-ST-segment elevation myocardial infarction

BACKGROUND Non-ST segment elevation myocardial infarction(NSTEMI)poses significant challenges in clinical management due to its diverse outcomes.Understanding the prognostic role of hematological parameters and derived ratios in NSTEMI patients could aid in risk stratification and improve patient care.AIM To evaluate the predictive value of hemogram-derived ratios for major adverse cardiovascular events(MACE)in NSTEMI patients,potentially improving clinical outcomes.METHODS A prospective,observational cohort study was conducted in 2021 at the Internal Medicine Clinic of the University Hospital in Tuzla,Bosnia and Herzegovina.The study included 170 patients with NSTEMI,who were divided into a group with MACE and a control group without MACE.Furthermore,the MACE group was subdivided into lethal and non-lethal groups for prognostic analysis.Alongside hematological parameters,an additional 13 hematological-derived ratios(HDRs)were monitored,and their prognostic role was investigated.RESULTS Hematological parameters did not significantly differ between non-ST segment elevation myocardial infarction(NSTEMI)patients with MACE and a control group at T1 and T2.However,significant disparities emerged in HDRs among NSTEMI patients with lethal and non-lethal outcomes post-MACE.Notably,neutrophil-to-lymphocyte ratio(NLR)and platelet-to-lymphocyte ratio(PLR)were elevated in lethal outcomes.Furthermore,C-reactive protein-to-lymphocyte ratio(CRP/Ly)at T1(>4.737)demonstrated predictive value[odds ratio(OR):3.690,P=0.024].Both NLR at T1(>4.076)and T2(>4.667)emerged as significant predictors,with NLR at T2 exhibiting the highest diagnostic performance,as indicated by an area under the curve of 0.811(95%CI:0.727-0.859)and OR of 4.915(95%CI:1.917-12.602,P=0.001),emphasizing its important role as a prognostic marker.CONCLUSION This study highlights the significant prognostic value of hemogram-derived indexes in predicting MACE among NSTEMI patients.During follow-up,NLR,PLR,and CRP/Ly offer important insights into the inflammatory processes underlying cardiovascular events.

Trends of alkaline phosphatase to prealbumin ratio in patients with hepatitis B linked to hepatocellular carcinoma development

BACKGROUND Chronic hepatitis B often progresses silently toward hepatocellular carcinoma(HCC),a leading cause of mortality worldwide.Early detection of HCC is crucial,yet challenging.AIM To investigate the role of dynamic changes in alkaline phosphatase to prealbumin ratio(APR)in hepatitis B progression to HCC.METHODS Data from 4843 patients with hepatitis B(January 2015 to January 2024)were analyzed.HCC incidence rates in males and females were compared using the log-rank test.Data were evaluated using Kaplan–Meier analysis.The Linear Mixed-Effects Model was applied to track the fluctuation of APR levels over time.Furthermore,Joint Modeling of Longitudinal and Survival data was employed to investigate the temporal relationship between APR and HCC risk.RESULTS The incidence of HCC was higher in males.To ensure the model’s normality assumption,this study applied a logarithmic transformation to APR,yielding ratio.Ratio levels were higher in females(t=5.26,P<0.01).A 1-unit increase in ratio correlated with a 2.005-fold higher risk of HCC in males(95%CI:1.653-2.431)and a 2.273-fold higher risk in females(95%CI:1.620-3.190).CONCLUSION Males are more prone to HCC,while females have higher APR levels.Despite no baseline APR link,rising APR indicates a higher HCC risk.

Numerical analysis of crack generation within embankment built on expansive soil foundation

In order to analyze the initial cracking behavior of highway embankment in the regions of expansive soil, the changes in peaks of tensile stress and their location on top of the embankment for a typical highway embankment section were simulated by ABAQUS. The simulation results indicate that the matric suction was a concave distribution on top of the expansive soil foundation and that it induced differential deformation of foundation and embankment. The peaks of tensile stress on top of the embankment are not located at a fixed site, but gradually move towards the shoulder following the evaporation duration. When the evaporation intensity is larger, the peak of tensile stress on top of embankment increases at a faster rate following the evaporation duration,and its location is closer to the shoulder. The thicker expansive soil layer helps the peaks of tensile stress to reach the critical tensile stress quickly, but the embankment cannot crack when the expansive soil layer is no more than 1.5m after 30d soil surface evaporation; the higher the embankment, the smaller the peak of tensile stress occurring on top of the highway embankment, and its location will be further away from the shoulder. Therefore, a higher embankment constructed on a thinner expansive soil layer can reduce the crack generation within the highway embankment.

基于改进Ratio统计量的重尾AR(p)时间序列均值变点检验

文章提出两个改进的Ratio统计量来研究重尾AR(p)时间序列均值变点检验问题,在原假设下推导了统计量的渐近分布,且在备择假设下证明了其一致性。由于重尾指数未知且难以估计,因此结合Wild Bootstrap重抽样方法来确定渐近分布的临界值;在均值变点存在的情形下,给出了变点位置的一致估计量。数值模拟结果表明:统计量的临界值均不受重尾指数和自回归系数的影响,其经验水平和经验势均取得满意的效果;尤其在原假设下,积分型Ratio统计量的经验水平表现出更好的稳健性,而在备择假设下,最值型Ratio统计量则具备更好的显著性。最后,基于一组股票数据,从实际应用角度进一步阐明所提方法的有效性和可行性。

Influence of MgO-type Expansive Agent Hydration Behaviors on Expansive Properties of Concrete

The hydration behaviors and expansive properties of MgO-type expansive agent curing at different temperatures and environment were investigated.When the curing temperatures changed from 25℃ to 50℃,the conductivities of MgO samples increased from 40 to 80 μs/cm,and the hydrations of MgO were quickened up obviously.Through SEM observation,the hydration product of MgO cured at 50℃ for 28 day was about 2-3μm in length.The expansion of pastes with 5% of the MgO-type expansive agent was from 0.36% to 1.01% when the curing temperature changed from 25oC to 50℃.When 8% of the MgO-type expansive agent was added,the early shrinkage of concrete was reduced.The expansion ratio increased with the curing temperature,and the expansive cracking of concrete with MgO-type expansive agent might be decreased by blending fly ash.

Factors influencing accuracy of free swelling ratio of expansive soil

Many geotechnical structures,such as the subgrade of high-speed railway,are extremely sensitive to micro deformations.As one of the most commonly used indexes in China to evaluate the potential swelling level of expansive soils,the effectiveness and accuracy of free swelling ratio should be highly required.However,due to the deficiency of geotechnical test regulations for the free swelling ratio test,non-negligible variation difference is often observed among the test results of the same type of soil samples.Thus,a series of laboratory tests are conducted to figure out the influences of soil particle size,initial soil temperature,and wet-dry circulation on the free swelling ratio of expansive soils.The results show that the initial soil temperature exerts an obvious influence on free swelling ratio and a relative weak influence on soil mass of expansive soil with the micro soil particle size(d<0.075 mm),and the correlation becomes unclear when soil particle size is within the range of 0.075 mm≤d<0.500 mm.A larger particle size of expansive soils induces a larger free swelling ratio and soil mass in the soil measuring cup regardless of initial soil temperature.However,the enlarging amplitude decreases as the particle size of expansive soils increases.There is a progressive enlargement of free swelling ratio at the first two wet-dry cycles and then it attenuates gradually when the number of wetdry cycles further increases.

Effect of Curing Temperature on the Morphology and Hydration of MgO Expansive Material in Paste

The morphologies and hydration properties of MgO expansive material at different curing temperatures were investigated.When the curing temperature varies from 25℃to 50℃,the conductivity of MgO rises from 40 to 80μs/cm,the hydration product of MgO expansive material curing in water for 28 days is from 1.5—2 mm to 2—2.5μm in length through SEM observation,and the expansion of pastes with 5%of the magnesium oxide is from 0.36%up to 1.01%,it is increased by 2.78 times.When the content of cement paste increases to 95%and cured in water for 90 days,the brucite forms as hexaflaggy?shaped crystal,which is less than 0.1μm and tends to aggregates.The effect of curing temperature on the hydration of MgO expansive material is obvious.

The Hydration Characteristics and Expansion Machanism of Expansive Cement at Low W/B Ratio

The hydration characteristics and expansion impetus of three kinds of cement paste under free- and confined-curing conditions were investigated, which were respectively mixed with three different kinds of expansive agent at low W/B ratio.The results show that the hydration products of pure cement paste and paste mixed with expansive agent are same,but the amount of hydration products,un-hydrated C 3S and C 2S are obviously different at the same hydration age.At 3d age,the amount of CH in pure cement paste is less than that of paste mixed with expansive agent,but it is reverse when at 28d age.The amount of AFt at 3d and 28d age in pure cement paste is less than those of paste mixed with expansive agent.Regardless of under free- or confined-curing condition,the amount of ettringite produced varies little since 3d age.The joint effect of the tumefaction of gel-ettringite due to water absorption and the expansive pressure on the pore caused by the crystalloid ettringite is the cause of the volume expansion of cement paste,and the former effect is much greater than the latter.

Experimental research on the mixed sand ratio and initial dry density of weathered sand improved expansive soil free load swelling rate

In this paper, through the indoor free load swelling rate test, expansive soil in a section of a first- class highway reconstruction project in Yichang City was studied. It emphatically analyzed the interrelations among free load swelling rate, non-load time, the proportion of mixed sand and initial dry density. Experimen- tal studies have shown that： Free load swelling deformation is mainly divided into three stages of rapid expan- sion, slow expansion and final stability; when the initial dry density is constant, free load swelling rate of the weathered sand modified soil will reduce rapidly before they slow down with the increase of sand proportion, and weathered sand modified soil free load swelling rate is not sensitive to the large amount of sand mixed; in the same mixed sand ratio, weathered sand modified soil free load swelling rate increases rapidly with the in- crease of initial dry density, there is a good linear correlation between them. To take appropriate control of the initial dry density during the expansive soil subgrade construction helps to reduce its swelling deformation and ensures the stability of the embankment.

Evaluation of the Expansive Esna Shale and Its Role in the Deterioration of Heritage Buildings at West Bank of Luxor

The heritage buildings at the west bank of Luxor were affected by expansive Esna shale differentially from site to others. The role of expansive Esna shale was evaluated by using X-ray diffraction spectra (particle size, strain), X-ray fluorescence, basic soil properties test, swelling test, soil classification, and unconfined compression test. Three different samples were examined to determine the expansive role in the deterioration of heritage sites. The expansive is high, according to: (a) Soil classification based on plasticity index, (b) Classification chart based on the liquid limit and plastic index, (c) Classification chart based on clay content and activity, (d) Soil classification, and (e) Swelling pressure which determines the safety factor. In addition, expansive classification assesses that Esna shale Formation is one of environmental hazards characterized by damage role near Nile flood and irrigation area and characterized by deterioration role in heritage sites far from Nile flood and irrigation area. This paper refers to evaluation as a main process of integrated conservation approach.

Red cell distribution width-to-albumin ratio is a simple promising prognostic marker in acute cholangitis requiring biliary drainage

Background: It is crucial to assess the severity of acute cholangitis(AC). There are currently several prognostic markers. However, the accuracies of these markers are not satisfied. The present study aimed to investigate the predictive value of the red cell distribution width(RDW)-to-albumin ratio(RAR) for the prognosis of AC. Methods: We retrospectively evaluated consecutive patients diagnosed with AC between May 2019 and March 2022. RAR was calculated, and its predictive ability for in-hospital mortality, intensive care unit(ICU) admission, bacteremia, and the length of hospitalization were analyzed. Results: Out of 438 patients, 34(7.8%) died. Multivariate analysis showed that malignant etiology [odds ratio(OR) = 4.816, 95% confidence interval(CI): 1.936-11.980], creatinine(OR = 1.649, 95% CI: 1.095-2.484), and RAR(OR = 2.064, 95% CI: 1.494-2.851) were independent risk factors for mortality. When adjusted for relevant covariates, including age, sex, malignant etiology, Tokyo severity grading(TSG), Charlson comorbidity index, and creatinine, RAR significantly predicted mortality(adjusted OR = 1.833, 95% CI: 1.280-2.624). When the cut-off of RAR was set to 3.8, its sensitivity and specificity for mortality were 94.1% and 56.7%, respectively. Patients with an RAR of > 3.8 had a 20.9-fold(OR = 20.9, 95% CI: 4.9-88.6) greater risk of mortality than the remaining patients. The area under the curve value of RAR for mortality was 0.835(95% CI: 0.770-0.901), which was significantly higher than that of TSG and the other prognostic markers, such as C-reactive protein-to-albumin ratio, and procalcitonin-to-albumin ratio. Lastly, RAR was not inferior to TSG in predicting ICU admission, bacteremia, and the length of hospitalization. Conclusions: RAR successfully predicted the in-hospital mortality, ICU admission, bacteremia, and the length of hospitalization of patients with AC, especially in-hospital mortality. RAR is a promising marker that is more convenient than TSG and other prognostic markers for predicting the prognosis of patients with AC.

Yields,growth and water use under chemical topping in relations to row configuration and plant density in drip-irrigated cotton

Background Water deficit is an important problem in agricultural production in arid regions.With the advent of wholly mechanized technology for cotton planting in Xinjiang,it is important to determine which planting mode could achieve high yield,fiber quality and water use efficiency(WUE).This study aimed to explore if chemical topping affected cotton yield,quality and water use in relation to row configuration and plant densities.Results Experiments were carried out in Xinjiang China,in 2020 and 2021 with two topping method,manual topping and chemical topping,two plant densities,low and high,and two row configurations,i.e.,76 cm equal rows and 10+66 cm narrow-wide rows,which were commonly applied in matching harvest machine.Chemical topping increased seed cotton yield,but did not affect cotton fiber quality comparing to traditional manual topping.Under equal row spacing,the WUE in higher density was 62.4%higher than in the lower one.However,under narrow-wide row spacing,the WUE in lower density was 53.3%higher than in higher one(farmers’practice).For machine-harvest cotton in Xinjiang,the optimal row configuration and plant density for chemical topping was narrow-wide rows with 15 plants m-2 or equal rows with 18 plants m-2.Conclusion The plant density recommended in narrow-wide rows was less than farmers’practice and the density in equal rows was moderate with local practice.Our results provide new knowledge on optimizing agronomic managements of machine-harvested cotton for both high yield and water efficient.

Combining lymph node ratio to develop prognostic models for postoperative gastric neuroendocrine neoplasm patients

BACKGROUND Lymph node ratio(LNR)was demonstrated to play a crucial role in the prognosis of many tumors.However,research concerning the prognostic value of LNR in postoperative gastric neuroendocrine neoplasm(NEN)patients was limited.AIM To explore the prognostic value of LNR in postoperative gastric NEN patients and to combine LNR to develop prognostic models.METHODS A total of 286 patients from the Surveillance,Epidemiology,and End Results database were divided into the training set and validation set at a ratio of 8:2.92 patients from the First Affiliated Hospital of Soochow University in China were designated as a test set.Cox regression analysis was used to explore the relationship between LNR and disease-specific survival(DSS)of gastric NEN patients.Random survival forest(RSF)algorithm and Cox proportional hazards(CoxPH)analysis were applied to develop models to predict DSS respectively,and compared with the 8th edition American Joint Committee on Cancer(AJCC)tumornode-metastasis(TNM)staging.RESULTS Multivariate analyses indicated that LNR was an independent prognostic factor for postoperative gastric NEN patients and a higher LNR was accompanied by a higher risk of death.The RSF model exhibited the best performance in predicting DSS,with the C-index in the test set being 0.769[95%confidence interval(CI):0.691-0.846]outperforming the CoxPH model(0.744,95%CI:0.665-0.822)and the 8th edition AJCC TNM staging(0.723,95%CI:0.613-0.833).The calibration curves and decision curve analysis(DCA)demonstrated the RSF model had good calibration and clinical benefits.Furthermore,the RSF model could perform risk stratification and individual prognosis prediction effectively.CONCLUSION A higher LNR indicated a lower DSS in postoperative gastric NEN patients.The RSF model outperformed the CoxPH model and the 8th edition AJCC TNM staging in the test set,showing potential in clinical practice.

A gated recurrent unit model to predict Poisson’s ratio using deep learning

Static Poisson’s ratio(vs)is crucial for determining geomechanical properties in petroleum applications,namely sand production.Some models have been used to predict vs;however,the published models were limited to specific data ranges with an average absolute percentage relative error(AAPRE)of more than 10%.The published gated recurrent unit(GRU)models do not consider trend analysis to show physical behaviors.In this study,we aim to develop a GRU model using trend analysis and three inputs for predicting n s based on a broad range of data,n s(value of 0.1627-0.4492),bulk formation density(RHOB)(0.315-2.994 g/mL),compressional time(DTc)(44.43-186.9 μs/ft),and shear time(DTs)(72.9-341.2μ s/ft).The GRU model was evaluated using different approaches,including statistical error an-alyses.The GRU model showed the proper trends,and the model data ranges were wider than previous ones.The GRU model has the largest correlation coefficient(R)of 0.967 and the lowest AAPRE,average percent relative error(APRE),root mean square error(RMSE),and standard deviation(SD)of 3.228%,1.054%,4.389,and 0.013,respectively,compared to other models.The GRU model has a high accuracy for the different datasets:training,validation,testing,and the whole datasets with R and AAPRE values were 0.981 and 2.601%,0.966 and 3.274%,0.967 and 3.228%,and 0.977 and 2.861%,respectively.The group error analyses of all inputs show that the GRU model has less than 5% AAPRE for all input ranges,which is superior to other models that have different AAPRE values of more than 10% at various ranges of inputs.

Serum cystatin C,monocyte/high-density lipoprotein-C ratio,and uric acid for the diagnosis of coronary heart disease and heart failure

BACKGROUND Coronary heart disease(CHD)and heart failure(HF)are the major causes of morbidity and mortality worldwide.Early and accurate diagnoses of CHD and HF are essential for optimal management and prognosis.However,conventional diagnostic methods such as electrocardiography,echocardiography,and cardiac biomarkers have certain limitations,such as low sensitivity,specificity,availability,and cost-effectiveness.Therefore,there is a need for simple,noninvasive,and reliable biomarkers to diagnose CHD and HF.AIM To investigate serum cystatin C(Cys-C),monocyte/high-density lipoprotein cholesterol ratio(MHR),and uric acid(UA)diagnostic values for CHD and HF.METHODS We enrolled 80 patients with suspected CHD or HF who were admitted to our hospital between July 2022 and July 2023.The patients were divided into CHD(n=20),HF(n=20),CHD+HF(n=20),and control groups(n=20).The serum levels of Cys-C,MHR,and UA were measured using immunonephelometry and an enzymatic method,respectively,and the diagnostic values for CHD and HF were evaluated using receiver operating characteristic(ROC)curve analysis.RESULTS Serum levels of Cys-C,MHR,and UA were significantly higher in the CHD,HF,and CHD+HF groups than those in the control group.The serum levels of Cys-C,MHR,and UA were significantly higher in the CHD+HF group than those in the CHD or HF group.The ROC curve analysis showed that serum Cys-C,MHR,and UA had good diagnostic performance for CHD and HF,with areas under the curve ranging from 0.78 to 0.93.The optimal cutoff values of serum Cys-C,MHR,and UA for diagnosing CHD,HF,and CHD+HF were 1.2 mg/L,0.9×10^(9),and 389μmol/L;1.4 mg/L,1.0×10^(9),and 449μmol/L;and 1.6 mg/L,1.1×10^(9),and 508μmol/L,respectively.CONCLUSION Serum Cys-C,MHR,and UA are useful biomarkers for diagnosing CHD and HF,and CHD+HF.These can provide information for decision-making and risk stratification in patients with CHD and HF.

Red cell distribution width/platelet ratio estimates the 3-year risk of decompensation in Metabolic Dysfunction-Associated Steatotic Liver Disease-induced cirrhosis

BACKGROUND For compensated advanced chronic liver disease(cACLD)patients,the first decompensation represents a dramatically worsening prognostic event.Based on the first decompensation event(DE),the transition to decompensated advanced chronic liver disease(dACLD)can occur through two modalities referred to as acute decompensation(AD)and non-AD(NAD),respectively.Clinically Significant Portal Hypertension(CSPH)is considered the strongest predictor of decompensation in these patients.However,due to its invasiveness and costs,CSPH is almost never evaluated in clinical practice.Therefore,recognizing noninvasively predicting tools still have more appeal across healthcare systems.The red cell distribution width to platelet ratio(RPR)has been reported to be an indicator of hepatic fibrosis in Metabolic Dysfunction-Associated Steatotic Liver Disease(MASLD).However,its predictive role for the decompensation has never been explored.AIM In this observational study,we investigated the clinical usage of RPR in predicting DEs in MASLD-related cACLD patients.METHODS Fourty controls and 150 MASLD-cACLD patients were consecutively enrolled and followed up(FUP)semiannually for 3 years.At baseline,biochemical,clinical,and Liver Stiffness Measurement(LSM),Child-Pugh(CP),Model for End-Stage Liver Disease(MELD),aspartate aminotransferase/platelet count ratio index(APRI),Fibrosis-4(FIB-4),Albumin-Bilirubin(ALBI),ALBI-FIB-4,and RPR were collected.During FUP,DEs(timing and modaities)were recorded.CSPH was assessed at the baseline and on DE occurrence according to the available Clinical Practice Guidelines.RESULTS Of 150 MASLD-related cACLD patients,43(28.6%)progressed to dACLD at a median time of 28.9 months(29 NAD and 14 AD).Baseline RPR values were significantly higher in cACLD in comparison to controls,as well as MELD,CP,APRI,FIB-4,ALBI,ALBI-FIB-4,and LSM in dACLD-progressing compared to cACLD individuals[all P<0.0001,except for FIB-4(P:0.007)and ALBI(P:0.011)].Receiving operator curve analysis revealed RPR>0.472 and>0.894 as the best cut-offs in the prediction respectively of 3-year first DE,as well as its superiority compared to the other non-invasive tools examined.RPR(P:0.02)and the presence of baseline-CSPH(P:0.04)were significantly and independently associated with the DE.Patients presenting baseline-CSPH and RPR>0.472 showed higher risk of decompensation(P:0.0023).CONCLUSION Altogether these findings suggest the RPR as a valid and potentially applicable non-invasive tool in the prediction of timing and modalities of decompensation in MASLD-related cACLD patients.

Swelling pressure evolution characterization of strong expansive soil considering the influence of reserved expansion deformation

Numerous engineering cases have demonstrated that the expansive soil channel slope remains susceptible to damage with the implementation of a rigid or closed protective structure. It is common for the protective structure to experience bulging failure due to excessive swelling pressure. To investigate the swelling pressure properties of expansive soil, the constant volume test was employed to study the influence of water content and reserved expansion deformation on the characteristics of swelling pressure in strong expansive soils, and also to explore the evolution mechanism of the swelling pressure. The findings demonstrate that the swelling pressure-time curve can be classified into swelling pressure-time softening and swelling pressure-time stability type. The swelling pressuretime curve of the specimen with low water content is the swelling pressure-time softening type, and the softening level will be weakened with increasing reserved expansion deformation. Besides, the maximum swelling pressure Psmax decreases with increasing water content and reserved expansion deformation, especially for expansion ratio η from 24% to 37%. The reserved deformation has little effect on reducing Psmax when it is beyond 7% of the expansion rate. The specimen with low water content has a more homogeneous structure due to the significant expansion-filling effect, and the fracture and reorganization of the aggregates in the specimens with low water content cause the swelling pressure-time softening behavior. In addition, the proposed swelling pressure-time curve prediction model has a good prediction on the test results. If necessary, a deformation space of about 7% expansion rate is recommended to be reserved in the engineering to reduce the swelling pressure except for keeping a stable water content.

Systemic immune-inflammation index,neutrophilto-lymphocyte ratio,and platelet-to-lymphocyte ratio in patients with type 2 diabetes at different stages of diabetic retinopathy

AIM:To investigate systemic immune-inflammation index(SII),neutrophil-to-lymphocyte ratio(NLR),and plateletto-lymphocyte ratio(PLR)levels in patients with type 2 diabetes at different stages of diabetic retinopathy(DR).METHODS:This retrospective study included 141 patients with type 2 diabetes mellitus(DM):45 without diabetic retinopathy(NDR),47 with non-proliferative diabetic retinopathy(NPDR),and 49 with proliferative diabetic retinopathy(PDR).Complete blood counts were obtained,and NLR,PLR,and SII were calculated.The study analysed the ability of inflammatory markers to predict DR using receiver operating characteristic(ROC)curves.The relationships between DR stages and SII,PLR,and NLP were assessed using multivariate logistic regression.RESULTS:The average NLR,PLR,and SII were higher in the PDR group than in the NPDR group(P=0.011,0.043,0.009,respectively);higher in the NPDR group than in the NDR group(P<0.001 for all);and higher in the PDR group than in the NDR group(P<0.001 for all).In the ROC curve analysis,the NLR,PLR,and SII were significant predictors of DR(P<0.001 for all).The highest area under the curve(AUC)was for the PLR(0.929 for PLR,0.925 for SII,and 0.821 for NLR).Multivariate regression analysis indicated that NLR,PLR,and SII were statistically significantly positive and independent predictors for the DR stages in patients with DM[odds ratio(OR)=1.122,95%confidence interval(CI):0.200–2.043,P<0.05;OR=0.038,95%CI:0.018–0.058,P<0.05;OR=0.007,95%CI:0.001–0.01,P<0.05,respectively).CONCLUSION:The NLR,PLR,and SII may be used as predictors of DR.

Predictive Ability of Hypertriglyceridemic Waist,Hypertriglyceridemic Waist-to-Height Ratio,and Waist-to-Hip Ratio for Cardiometabolic Risk Factors Clustering Screening among Chinese Children and Adolescents

Objective Hypertriglyceridemic waist(HW),hypertriglyceridemic waist-to-height ratio(HWHtR),and waist-to-hip ratio(WHR)have been shown to be indicators of cardiometabolic risk factors.However,it is not clear which indicator is more suitable for children and adolescents.We aimed to investigate the relationship between HW,HWHtR,WHR,and cardiovascular risk factors clustering to determine the best screening tools for cardiometabolic risk in children and adolescents.Methods This was a national cross-sectional study.Anthropometric and biochemical variables were assessed in approximately 70,000 participants aged 6–18 years from seven provinces in China.Demographics,physical activity,dietary intake,and family history of chronic diseases were obtained through questionnaires.ANOVA,χ2 and logistic regression analysis was conducted.Results A significant sex difference was observed for HWHtR and WHR,but not for HW phenotype.The risk of cardiometabolic health risk factor clustering with HW phenotype or the HWHtR phenotype was significantly higher than that with the non-HW or non-HWHtR phenotypes among children and adolescents(HW:OR=12.22,95%CI:9.54-15.67;HWHtR:OR=9.70,95%CI:6.93-13.58).Compared with the HW and HWHtR phenotypes,the association between risk of cardiometabolic health risk factors(CHRF)clustering and high WHR was much weaker and not significant(WHR:OR=1.14,95%CI:0.97-1.34).Conclusion Compared with HWHtR and WHR,the HW phenotype is a more convenient indicator with higher applicability to screen children and adolescents for cardiovascular risk factors.

Neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio:Markers predicting immune-checkpoint inhibitor efficacy and immune-related adverse events

We conducted a comprehensive review of existing prediction models pertaining to the efficacy of immune-checkpoint inhibitor(ICI)and the occurrence of immune-related adverse events(irAEs).The predictive potential of neutrophil-to-lymphocyte ratio(NLR)and platelet-to-lymphocyte ratio(PLR)in determining ICI effectiveness has been extensively investigated,while limited research has been conducted on predicting irAEs.Furthermore,the combined model incor-porating NLR and PLR,either with each other or in conjunction with additional markers such as carcinoembryonic antigen,exhibits superior predictive capabilities compared to individual markers alone.NLR and PLR are promising markers for clinical applications.Forthcoming models ought to incorporate established efficacious models and newly identified ones,thereby constituting a multifactor composite model.Furthermore,efforts should be made to explore effective clinical application approaches that enhance the predictive accuracy and efficiency.