Effects of the Water-Cement Ratio and the Molding Temperature on the Hydration Heat of Cement

The effects of the water-cement ratio and the molding temperature on the hydration heat of cement were investigated with semi-adiabatic calorimetry.The specimens were prepared with water-cement ratios of 0.31,0.38,and 0.45,and the molding temperature was specified at 10 and 20℃.The experimental results show that,as the water-binder ratio increases,the value of the second temperature peak on the temperature curve of the cement paste decreases,and the age at which the peak appears is delayed.The higher the water-cement ratio,the higher the hydration heat release in the early period of cement hydration,but this trend reverses in the late period.There are intersection points of the total hydration heat curve of the cement pastes under the influence of the water-cement ratio,and this law can be observed at both molding temperatures.With the increase in the molding temperature,the age of the second temperature peak on the temperature curve of the cement paste will advance,but the temperature peak will decrease.The higher the molding temperature,the earlier the acceleration period of the cement hydration began,and the larger the hydration heat of the cement in the early stage,but the smaller the total heat in the late period.A subsection function calculation model of the hydration heat,which was based on the existing models,was proposed in order to predict the heat of the hydration of the concrete.

Optimal scheduling of a township integrated-energy system using the adjustable heat-electricity ratio model

With the expansion and implementation of rural revitalization strategies,there is a constant need for new energy sources for the construction of new townships.Consequently,integrated energy systems with the interconnection and interaction of multiple energy sources are developing rapidly.Biomass energy,a renewable green energy source with low pollution and wide distribution,has significant application potential in integrated energy systems.Considering the application of biomass energy in townships,this study established an integrated biomass energy system and proposed a model to optimize its operation.Lowest economic cost and highest clean energy utilization rate were considered as the objective functions.In addition,a plan was suggested to adjust the heat-electricity ratio based on the characteristics of the combined heat and power of the biomass.Finally,a simulation analysis conducted for a town in China was discussed,demonstrating that the construction of a township integrated-energy system and the use of biomass can significantly reduce operating costs and improve the energy utilization rate.Moreover,by adjusting the heat-electricity ratio,the economic cost was further reduced by 6.70%,whereas the clean energy utilization rate was increased by 5.14%.

Isotopic dependence of the yield ratios of light fragments from different projectiles and their unified neutron skin thicknesses

The yield ratios of neutron-proton(R(n/p))and^(3)H-^(3)He(R(^(3)H∕^(3)He))with reduced rapidity from 0 to 0.5 were simulated at 50 MeV/u even-even ^(36−56)Ca+^(40)Ca,even-even ^(48−78)Ni+^(58)Ni,and ^(100−139)Sn(every third isotopes)+112 Sn for full reduced impact parameters using the isospin-dependent quantum molecular dynamics(IQMD)model.The neutron and proton density distributions and root-mean-square radii of the reaction systems were obtained using the Skyrme-Hartree-Fock model,which was used for the phase space initialization of the projectile and target in IQMD.We defined the unified neutron skin thickness asΔRnp=<r^(2)>^(1∕2) n−<r^(2)>^(1∕2)p,which was negative for neutron-deficient nuclei.The unifiedΔRnp values for nuclei with the same relative neutron excess from different isotopic chains were nearly equal,except for extreme neutron-rich isotopes,which is a type of scaling behavior.The yield ratios of the three isotopic chain-induced reactions,which depended on the reduced impact parameter and unified neutron skin thickness,were studied.The results showed that both R(n/p)and R(^(3)H∕^(3)He)decreased with a reduced impact parameter for extreme neutron-deficient isotopes;however,they increased with reduced impact parameters for extreme neutron-rich isotopes,and increased with theΔRnp of the projectiles for all reduced impact parameters.In addition,a scaling phenomenon was observed betweenΔR np and the yield ratios in peripheral colli-sions from different isotopic chain projectiles(except for extreme neutron-rich isotopes).Thus,R(n/p)and R(^(3)H∕^(3)He)from peripheral collisions were suggested as experimental probes for extracting the neutron or proton skin thicknesses of non-extreme neutron-rich nuclei from different isotopic chains.

Added value of ratio of cross diameters of the appendix in ultrasound diagnosis of acute appendicitis

BACKGROUND The maximum outer diameter(MOD)of the appendix is an essential parameter for diagnosing acute appendicitis,but there is space for improvement in ultrasound(US)diagnostic performance.AIM To investigate whether combining the ratio of the cross diameters(RATIO)of the appendix with MOD of the appendix can enhance the diagnostic performance of acute appendicitis.METHODS A retrospective study was conducted,and medical records of 233 patients with acute appendicitis and 112 patients with a normal appendix were reviewed.The MOD and RATIO of the appendix were calculated and tested for their diagnostic performance of acute appendicitis,both individually and in combination.RESULTS The RATIO for a normal appendix was 1.32±0.16,while for acute appendicitis it was 1.09±0.07.The cut-off value for RATIO was determined to be≤1.18.The area under the receiver operating characteristic curve(AUC)for diagnosing acute appendicitis using RATIO≤1.18 and MOD>6 mm was 0.870 and 0.652,respectively.There was a significant difference in AUC between RATIO≤1.18 and MOD>6 mm(P<0.0001).When comparing the combination of RATIO≤1.18 and MOD>6 mm with MOD>6 mm alone,the combination showed increased specificity,positive predictive value(PPV),and AUC.However,the sensitivity and negative predictive value decreased.CONCLUSION Combining RATIO of the appendix≤1.18 and MOD>6 mm can significantly improve the specificity,PPV,and AUC in the US diagnosis of acute appendicitis.

Influence of Trailing-Edge Wear on the Vibrational Behavior of Wind Turbine Blades

To study the impact of the trailing-edge wear on the vibrational behavior of wind-turbine blades,unworn blades and trailing-edge worn blades have been assessed through relevant modal tests.According to these experiments,the natural frequencies of trailing-edge worn blades-1,-2,and-3 increase the most in the second to fourth order,thefifth order increases in the middle,and thefirst order increases the least.The damping ratio data indi-cate that,in general,thefirstfive-order damping ratios of trailing-edge worn blades-1 and trailing-edge worn blades-2 are reduced,and thefirstfive-order damping ratios of trailing-edge worn blades-3 are slightly improved.The mode shape diagram shows that the trailing-edge worn blades-1 and-2 have a large swing in the tip and the blade,whereas the second-and third-order vibration shapes of the trailing edge-worn blade-3 tend to be improved.Overall,all these results reveal that the blade’s mass and the wear area are the main fac-tors affecting the vibration characteristics of wind turbine blades.

Changes in the adult sex ratio of six duck species breeding populations over two decades

Despite all efforts,long-term changes in the adult sex ratios of breeding duck populations are still unclear;this uncertainty is especially true for male-bias populations,which are often under the scrutiny of researchers lacking convenient results for the active protection of endangered species.Species with male-bias populations are usually strongly affected by a decline in population size that leads to a higher extinction risk.In this study,we examined our long-term data of the abundance of breeding populations in six duck species(Mallard Anas platyrhynchos,Gadwall Mareca strepera,Red-crested Pochard Netta rufina,Common Pochard Aythya ferina,Tufted Duck Aythya fuligula,and Common Goldeneye Bucephala clangula)from fishponds in South Bohemia,Czechia,between 2004 and 2022.This evidence was used to assess long-term changes in the adult sex ratio in these breeding populations and investigate the possible effects of the NAO index(North Atlantic Oscillation index)on them,indicating climate conditions in winter.We determined a long-term decrease of the proportion of females in the breeding season in two of the six examined species:Common Pochard and Red-crested Pochard,which is driven by the long-term increase in the number of males in contrast to the decreasing or stable number of females likely caused by different migration behaviours between females and males.In the case of Common Pochard,in breeding populations,we estimated 60-65%of males in the early 2000s rising to 75-80%in the early 2020s.However,we establish no significant effects linked to climate conditions of the previous winter in these species as a crucial cause of the changes of the proportion of females in the breeding population.

Clinical Value of the Quantitative Flow Ratio to Predict Long-term Target Vessel Failure in Patients with In-stent Restenosis after Drug-coated Balloon Angioplasty

Objective The study sought to investigate the clinical predictive value of quantitative flow ratio(QFR)for the long-term target vessel failure(TVF)outcome in patients with in-stent restenosis(ISR)by using drug-coated balloon(DCB)treatment after a long-term follow-up.Methods This was a retrospective study.A total of 186 patients who underwent DCB angioplasty for ISR in two hospitals from March 2014 to September 2019 were enrolled.The QFR of the entire target vessel was measured offline.The primary endpoint was TVF,including target vessel-cardiac death(TV-CD),target vessel-myocardial infarction(TV-MI),and clinically driven-target vessel revascularization(CD-TVR).Results The follow-up time was 3.09±1.53 years,and 50 patients had TVF.The QFR immediately after percutaneous coronary intervention(PCI)was significantly lower in the TVF group than in the no-TVF group.Multivariable Cox regression analysis indicated that the QFR immediately after PCI was an excellent predictor for TVF after the long-term follow-up[hazard ratio(HR):5.15×10−5(6.13×10−8−0.043);P<0.01].Receiver-operating characteristic(ROC)curve analysis demonstrated that the optimal cut-off value of the QFR immediately after PCI for predicting the long-term TVF was 0.925(area under the curve:0.886,95%confidence interval:0.834–0.938;sensitivity:83.40%,specificity:88.00;P<0.01).In addition,QFR≤0.925 post-PCI was strongly correlated with the TVF,including TV-MI and CD-TVR(P<0.01).Conclusion The QFR immediately after PCI showed a high predictive value of TVF after a long-term follow-up in ISR patients who underwent DCB angioplasty.A lower QFR immediately after PCI was associated with a worse TVF outcome.

Using Pearson’s System of Curves to Approximate the Distributions of the Difference between Two Correlated Estimates of Signal-to-Noise Ratios: The Cases of Bivariate Normal and Bivariate Lognormal Distributions

Background: The signal-to-noise ratio (SNR) is recognized as an index of measurements reproducibility. We derive the maximum likelihood estimators of SNR and discuss confidence interval construction on the difference between two correlated SNRs when the readings are from bivariate normal and bivariate lognormal distribution. We use the Pearsons system of curves to approximate the difference between the two estimates and use the bootstrap methods to validate the approximate distributions of the statistic of interest. Methods: The paper uses the delta method to find the first four central moments, and hence the skewness and kurtosis which are important in the determination of the parameters of the Pearsons distribution. Results: The approach is illustrated in two examples;one from veterinary microbiology and food safety data and the other on data from clinical medicine. We derived the four central moments of the target statistics, together with the bootstrap method to evaluate the parameters of Pearsons distribution. The fitted Pearsons curves of Types I and II were recommended based on the available data. The R-codes are also provided to be readily used by the readers.

Predictive Value of the Neutrophil to Lymphocyte Ratio (NLR) to Predict the Development of Preeclampsia and Pregnancy Induced Hypertension at 1st Trimester

Introduction: Hypertensive disorder in pregnancy affects 4 to 6 percent of all pregnancies and carries risks for the both baby and the mother. Only a few groups of women who are at high-risk pregnancies are received prophylaxis Aspirin, more than 15 percent of women develop pre-eclampsia with a single minor risk factor. Methods: This descriptive cross-sectional study was conducted to compare the 1st trimester NLR value of normotensive, pregnancy induced hypertensive and pre-eclamptic pregnant women. The study was conducted with a sample of 416, antenatal patients who were admitted to ward 25, at Colombo North Teaching Hospital Ragama. Data was collected as separated three groups. NLR value was calculated separately and ANOVA test was used to analyze the 3 categorical data. Post HOC test was done to assess the multiple comparison. Results: The prevalence rates of pregnancy induced hypertension and pre-eclampsia among the pregnant women were 8.6% and 5.7%. The mean NLR values of normotensive group was 2.708, pregnancy induced hypertensive group was 2.650 and pre eclamptic group was 3.789. There was a significant difference in NLR value between pre eclamptic group and other two groups with P value of Conclusion: The 1st trimester NLR value of pre eclamptic patients significantly increased compared to normotensive women.

The Effects of the Geometry of a Current Collector with an Equal Open Ratio on Output Power of a Direct Methanol Fuel Cell

The open ratio of a current collector has a great impact on direct methanol fuel cell(DMFC)performance.Although a number of studies have investigated the influence of the open ratio of DMFC current collectors,far too little attention has been given to how geometry(including the shape and feature size of the flow field)affects a current collector with an equal open ratio.In this paper,perforated and parallel current collectors with an equal open ratio of 50%and different feature sizes are designed,and the corresponding experimental results are shown to explain the geometry effects on the output power of the DMFC.The results indicate that the optimal feature sizes are between 2 and 2.5 mm for both perforated and parallel flow field in the current collectors with an equal open ratio of 50%.This means that for passive methanol fuel cells,to achieve the highest output power,the optimal feature size of the flow field in both anode and cathode current collectors is between 2 and 2.5 mm under the operating mode of this experiment.The effects of rib and channel position are also investigated,and the results indicate that the optimum pattern depends on the feature sizes of the flow field.

Effect of NaCl Concentration on the Cumulative Strain and Pore Distribution of Clay under Cyclic Loading

Clay,as the most common soil used for foundationfill,is widely used in various infrastructure projects.The phy-sical and mechanical properties of clay are influenced by the pore solution environment.This study uses a GDS static/dynamic triaxial apparatus and nuclear magnetic resonance experiments to investigate the effects of cyclic loading on clay foundations.Moreover,the development of cumulative strain in clay is analyzed,and afitting model for cumulative plastic strain is introduced by considering factors such as NaCl solution concentration,con-solidation stress ratio,and cycle number.In particular,the effects of the NaCl solution concentration and con-solidation stress ratio on the pore distribution of the test samples before and after cyclic loading are examined,and the relationship between microscopic pore size and macroscopic cumulative strain is obtained accordingly.Our results show that as the consolidation stress ratio grows,an increasing number of large pores in the soil samples are transformed into small pores.As the NaCl solution concentration becomes higher,the number of small pores gradually decreases,while the number of large pores remains unchanged.Cyclic loading causes the disappearance of the large pores in the samples,and the average pore size before cyclic loading is posi-tively correlated with the axial cumulative strain after cyclic loading.The cumulative strain produced by the soil under cyclic loading is inversely proportional to the NaCl solution concentration and consolidation stress ratio.

Enhanced entropy generation and heat transfer characteristics of magnetic nano-encapsulated phase change materials in latent heat thermal energy storage systems

The objective of the current study is to investigate the importance of entropy generation and thermal radiation on the patterns of velocity,isentropic lines,and temperature contours within a thermal energy storage device filled with magnetic nanoencapsulated phase change materials(NEPCMs).The versatile finite element method(FEM)is implemented to numerically solve the governing equations.The effects of various parameters,including the viscosity parameter,ranging from 1 to 3,the thermal conductivity parameter,ranging from 1 to 3,the Rayleigh parameter,ranging from 102 to 3×10^(2),the radiation number,ranging from 0.1 to 0.5,the fusion temperature,ranging from 1.0 to 1.2,the volume fraction of NEPCMs,ranging from 2%to 6%,the Stefan number,ranging from 1 to 5,the magnetic number,ranging from 0.1 to 0.5,and the irreversibility parameter,ranging from 0.1 to 0.5,are examined in detail on the temperature contours,isentropic lines,heat capacity ratio,and velocity fields.Furthermore,the heat transfer rates at both the cold and hot walls are analyzed,and the findings are presented graphically.The results indicate that the time taken by the NEPCMs to transition from solid to liquid is prolonged inside the chamber region as the fusion temperatureθf increases.Additionally,the contours of the heat capacity ratio Cr decrease with the increase in the Stefan number Ste.

Cost-Effective Monitoring of the Fuel Air Equivalence-Ratio with a Lambda Sensor and a Microcontroller in a Downdraft Biomass Gasifier

The operation of biomass treatment devices such as gasifiers is based on the control of key parameters that play an important role in product formation. These include: temperature, excess oxygen, relative humidity and biomass composition. This work focuses on excess oxygen and temperature. Unfortunately, flue gas oxygen analyzers are expensive and not accessible to small industries. However, the equivalence ratio is linked to excess oxygen and has the advantage of not depending on biomass composition. This study therefore focuses on the design and development of a device for controlling this equivalence ratio by measuring oxygen concentration using a self-propelled Lambda probe, and a system for monitoring this equivalence ratio using an Arduino Uno 3 microcontroller. The temperature is recorded with an accuracy of ±1.5°C. For a heating time of 10 minutes, the response time to temperature change is around 3 seconds, which is sufficient for the device to function properly. This simple device is an efficient and cost-effective means of checking the equivalence ratio.

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.

Calcium-Magnesium Ca/Mg Ratios and Their Agronomic Implications for the Optimization of Phosphate Fertilization in Rainfed Rice Farming on Acidic Ferralsol in the Forest Zone of Ivory Coast

This study is a contribution to improving rice productivity on acidic plateau soils of the tropical rainforest zone. It is based on taking into account the cationic balances of the soil in order to optimize the phosphorus (P) nutrition of rice on these acidic soils, where this nutrient constitutes a limiting factor for agricultural production. Three (3) pot trials were conducted in Adiopodoumé in the forested south of Côte d’Ivoire. The interactive effects of calcium carbonate (0, 25, 50 and 75 kg Ca ha−1) and magnesium sulfate (0, 25, 50 and 75 kg Mg ha−1) were evaluated on the response of NERICA 5 rice at doses 0, 25, 50 and 75 kg P ha−1 of natural phosphate from Togo, applied only once at the start of the experiment. Additional fertilizers of nitrogen (N) (100 kg N ha−1) and potassium (K) (50 kg KCl ha−1) were added to each of the tests in a split-plot device. The test results revealed a paddy production potential of approximately 3 to 5 t⋅ha−1 for NERICA 5 on an acidic soil, under the effect of the interaction of P, Ca and Mg. The quadratic response of rice yield to the doses of these fertilizers would be more dependent on their balance, itself influenced by Ca nutrition. For the sustainability and maintenance of rice production in agro-ecology studied, it was recommended doses of 38 kg Ca ha−1, 34 kg Mg ha−1 in a Ca/Mg ratio (1/1) with intakes of 41 kg P ha−1, overall in a ratio 1/1/1 (P/Ca/Mg) more favorable to the availability of free iron considered a guiding element of mineral nutrition. Thus, these promising results should be confirmed in a real environment for better management of the fertilization of rice cultivated on acidic plateau soils in Côte d’Ivoire.

Ratio of Gravitational Force to Electric Force from Empirical Equations in Terms of the Cosmic Microwave Background Temperature

Previously, we presented several empirical equations using the cosmic microwave background (CMB) temperature. Next, we propose an empirical equation for the fine-structure constant. Considering the compatibility among these empirical equations, the CMB temperature (Tc) and gravitational constant (G) were calculated to be 2.726312 K and 6.673778 × 10−11 m3∙kg−1∙s−2, respectively. Every equation could be explained in terms of the Compton length of an electron (λe), the Compton length of a proton (λp) and a. Furthermore, every equation could also be explained in terms of Avogadro’s number and the number of electrons in 1 C. However, the ratio of the gravitational force to the electric force cannot be uniquely determined when the unit of the Planck constant (Js) is changed. In this study, we showed that every equation can be described in terms of Planck constant. From the assumption of minimum mass, the ratio of gravitational force to electric force could be elucidated.

Analysis of the Peripheral Blood Helper T-Cell 17- Cell Level and Monocyte/Lymphocyte Ratio for Colorectal Cancer Prognosis Prediction

Objective: To investigate the value of peripheral blood helper T cell 17 cell level and monocyte/lymphocyte ratio to predict the prognosis of colorectal cancer patients. Methods: 74 colorectal cancer patients who attended Hospital 960 from January 2021 to January 2022 were retrospectively analyzed. Clinical data of the patients were collected, including gender, age, and histologic type. Immunohistochemical indexes such as Th17 cell level and monocyte/ lymphocyte ratio in the peripheral blood of patients were also collected. The prognosis of patients after treatment, as well as peripheral blood Th17 and MLR levels, were observed and analyzed. Results: After follow-up after treatment, in the final 74 patients, the prognosis was good in 32 patients, accounting for 43.24%, and the prognosis was bad in 42 patients, accounting for 56.76%. There were no significant differences between the average age and tumor diameters of the good prognosis and poor prognosis groups (P > 0.05). However, the TNM staging, intervention taken, differentiation degree, presence of distant metastasis, presence of lymph node metastasis, Th17 level, and MLR level are significantly different between the two groups (P < 0.05). Conclusion: Peripheral blood Th17 and MLR have predictive value for the prognosis of colorectal cancer patients, and high levels of peripheral blood Th17 and MLR imply poor prognosis. The detection of peripheral blood Th17 and MLR levels is simple and convenient and can be used as indicators to provide a reference for the prognostic assessment of colorectal cancer patients.

Comparative efficacy of sodium glucose cotransporter-2 inhibitors in the management of type 2 diabetes mellitus:A real-world experience

BACKGROUND Sodium glucose cotransporter-2 inhibitors(SGLT-2i)are a class of drugs with modest antidiabetic efficacy,weight loss effect,and cardiovascular benefits as proven by multiple randomised controlled trials(RCTs).However,real-world data on the comparative efficacy and safety of individual SGLT-2i medications is sparse.AIM To study the comparative efficacy and safety of SGLT-2i using real-world clinical data.METHODS We evaluated the comparative efficacy data of 3 SGLT-2i drugs(dapagliflozin,canagliflozin,and empagliflozin)used for treating patients with type 2 diabetes mellitus.Data on the reduction of glycated hemoglobin(HbA1c),body weight,blood pressure(BP),urine albumin creatinine ratio(ACR),and adverse effects were recorded retrospectively.RESULTS Data from 467 patients with a median age of 64(14.8)years,294(62.96%)males and 375(80.5%)Caucasians were analysed.Median diabetes duration was 16.0(9.0)years,and the duration of SGLT-2i use was 3.6(2.1)years.SGLT-2i molecules used were dapagliflozin 10 mg(n=227;48.6%),canagliflozin 300 mg(n=160;34.3%),and empagliflozin 25 mg(n=80;17.1).Baseline median(interquartile range)HbA1c in mmol/mol were:dapagliflozin-78.0(25.3),canagliflozin-80.0(25.5),and empagliflozin-75.0(23.5)respectively.The respective median HbA1c reduction at 12 months and the latest review(just prior to the study)were:66.5(22.8)&69.0(24.0),67.0(16.3)&66.0(28.0),and 67.0(22.5)&66.5(25.8)respectively(P<0.001 for all comparisons from baseline).Significant improvements in body weight(in kilograms)from baseline to study end were noticed with dapagliflozin-101(29.5)to 92.2(25.6),and canagliflozin 100(28.3)to 95.3(27.5)only.Significant reductions in median systolic and diastolic BP,from 144(21)mmHg to 139(23)mmHg;(P=0.015),and from 82(16)mmHg to 78(19)mmHg;(P<0.001)respectively were also observed.A significant reduction of microalbuminuria was observed with canagliflozin only[ACR 14.6(42.6)at baseline to 8.9(23.7)at the study end;P=0.043].Adverse effects of SGLT-2i were as follows:genital thrush and urinary infection-20(8.8%)&17(7.5%)with dapagliflozin;9(5.6%)&5(3.13%)with canagliflozin;and 4(5%)&4(5%)with empagliflozin.Diabetic ketoacidosis was observed in 4(1.8%)with dapagliflozin and 1(0.63%)with canagliflozin.CONCLUSION Treatment of patients with SGLT-2i is associated with statistically significant reductions in HbA1c,body weight,and better than those reported in RCTs,with low side effect profiles.A review of large-scale real-world data is needed to inform better clinical practice decision making.

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.