Actuality and underlying mechanisms of systemic immuneinflammation index and geriatric nutritional risk index prognostic value in hepatocellular carcinoma

This editorial contains comments on the article“Correlation between preoperative systemic immune inflammation index,nutritional risk index,and prognosis of radical resection of liver cancer”in a recent issue of the World Journal of Gastrointestinal Surgery.It pointed out the actuality and importance of the article and focused primarily on the underlying mechanisms making the systemic immuneinflammation index(SII)and geriatric nutritional risk index(GNRI)prediction features valuable.There are few publications on both SII and GNRI together in hepatocellular carcinoma(HCC)and patient prognosis after radical surgery.Neutrophils release cytokines,chemokines,and enzymes,degrade extracellular matrix,reduce cell adhesion,and create conditions for tumor cell invasion.Neutrophils promote the adhesion of tumor cells to endothelial cells,through physical anchoring.That results in the migration of tumor cells.Pro-angiogenic factors from platelets enhance tumor angiogenesis to meet tumor cell supply needs.Platelets can form a protective film on the surface of tumor cells.This allows avoiding blood flow damage as well as immune system attack.It also induces the epithelial-mesenchymal transformation of tumor cells that is critical for invasiveness.High SII is also associated with macro-and microvascular invasion and increased numbers of circulating tumor cells.A high GNRI was associated with significantly better progression-free and overall survival.HCC patients are a very special population that requires increased attention.SII and GNRI have significant survival prediction value in both palliative treatment and radical surgery settings.The underlying mechanisms of their possible predictive properties lie in the field of essential cancer features.Those features provide tumor nutrition,growth,and distribution throughout the body,such as vascular invasion.On the other hand,they are tied to the possibility of patients to resist tumor progression and development of complications in both postoperative and cancer-related settings.The article is of considerable interest.It would be helpful to continue the study follow-up to 2 years and longer.External validation of the data is needed.

Associations between Geriatric Nutrition Risk Index,bone mineral density and body composition in type 2 diabetes patients

BACKGROUND Type 2 diabetes mellitus(T2DM),a fast-growing issue in public health,is one of the most common chronic metabolic disorders in older individuals.Osteoporosis and sarcopenia are highly prevalent in T2DM patients and may result in fractures and disabilities.In people with T2DM,the association between nutrition,sarcopenia,and osteoporosis has rarely been explored.AIM To evaluate the connections among nutrition,bone mineral density(BMD)and body composition in patients with T2DM.METHODS We enrolled 689 patients with T2DM for this cross-sectional study.All patients underwent dual energy X-ray absorptiometry(DXA)examination and were categorized according to baseline Geriatric Nutritional Risk Index(GNRI)values calculated from serum albumin levels and body weight.The GNRI was used to evaluate nutritional status,and DXA was used to investigate BMD and body composition.Multivariate forward linear regression analysis was used to identify the factors associated with BMD and skeletal muscle mass index.RESULTS Of the total patients,394 were men and 295 were women.Compared with patients in tertile 1,those in tertile 3 who had a high GNRI tended to be younger and had lower HbA1c,higher BMD at all bone sites,and higher appendicular skeletal muscle index(ASMI).These important trends persisted even when the patients were divided into younger and older subgroups.The GNRI was positively related to ASMI(men:r=0.644,P<0.001;women:r=0.649,P<0.001),total body fat(men:r=0.453,P<0.001;women:r=0.557,P<0.001),BMD at all bone sites,lumbar spine(L1-L4)BMD(men:r=0.110,P=0.029;women:r=0.256,P<0.001),FN-BMD(men:r=0.293,P<0.001;women:r=0.273,P<0.001),and hip BMD(men:r=0.358,P<0.001;women:r=0.377,P<0.001).After adjustment for other clinical parameters,the GNRI was still significantly associated with BMD at the lumbar spine and femoral neck.Additionally,a low lean mass index and higherβ-collagen special sequence were associated with low BMD at all bone sites.Age was negatively correlated with ASMI,whereas weight was positively correlated with ASMI.CONCLUSION Poor nutrition,as indicated by a low GNRI,was associated with low levels of ASMI and BMD at all bone sites in T2DM patients.Using the GNRI to evaluate nutritional status and using DXA to investigate body composition in patients with T2DM is of value in assessing bone health and physical performance.

Correlation between preoperative systemic immune inflammation index, nutritional risk index, and prognosis of radical resection of liver cancer

BACKGROUND Radical surgery is the most commonly used treatment for hepatocellular carcinoma(HCC).However,the surgical effect remains not ideal,and prognostic evaluation is insufficient.Furthermore,clinical intervention is rife with uncertainty and not conducive to prolonging patient survival.AIM To explore correlations between the systemic immune inflammatory index(SII)and geriatric nutritional risk index(GNRI)and HCC operation prognosis.METHODS This retrospective study included and collected follow up data from 100 HCC.Kaplan–Meier survival curves were used to analyze the correlation between SII and GNRI scores and survival.SII and GNRI were calculated as follows:SII=neutrophil count×platelet count/lymphocyte count;GNRI=[1.489×albumin(g/L)+41.7×actual weight/ideal weight].We analyzed the predictive efficacy of the SII and GNRI in HCC patients using receiver operating characteristic(ROC)curves,and the relationships between the SII,GNRI,and survival rate using Kaplan–Meier survival curves.Cox regression analysis was utilized to analyze independent risk factors influencing prognosis.RESULTS After 1 year of follow-up,24 patients died and 76 survived.The area under the curve(AUC),sensitivity,specificity,and the optimal cutoff value of SII were 0.728(95%confidence interval:0.600-0.856),79.2%,63.2%,and 309.14,respectively.According to ROC curve analysis results for predicting postoperative death in HCC patients,the AUC of SII and GNRI combination was higher than that of SII or GNRI alone,and SII was higher than that of GNRI(P<0.05).The proportion of advanced differentiated tumors,tumor maximum diameter(5–10 cm,>10 cm),lymph node metastasis,and TNM stage III-IV in patients with SII>309.14 was higher than that in patients with SII≤309.14(P<0.05).The proportion of patients aged>70 years was higher in patients with GNRI≤98 than that in patients with GNRI>98(P<0.05).The 1-year survival rate of the SII>309.14 group(compared with the SII≤309.14 group)and GNRI≤98 group(compared with the GNRI>98 group)was lower(P<0.05).CONCLUSION The prognosis after radical resection of HCC is related to the SII and GNRI and poor in high SII or low GNRI patients.

Contamination assessment,source apportionment and associated health risks of PTEs in agricultural soil under five land-use patterns in Sanya,China

To understand the levels of potentially toxic elements(PTEs)contamination in soils and their effects on human health from different agricultural land use in Sanya,China.128 soil samples(64 topsoil samples and corresponding subsoil samples)were collected from the five representative land-use patterns.Inductively coupled plasma mass spectrometry(ICP-MS),Atomic fluorescence spectrometry(AFS),and Inductively coupled plasma optical emission spectrometry(ICP-OES)were used to determine the content of PTEs(As,Cd,Hg,Cu,Cr,Ni,Pb,Zn,Co,Mo,Sb,and V).Correlation analysis and factor analysis were used to determine the source of PTEs.Geo-accumulation index(I_(geo)),hazard quotient(HQ),and total carcinogenic risk index(TR)were used to measure the PTEs contamination and its relative health impacts.Results showed that the average values of 12 PTEs in topsoil were higher than the Hainan soil geochemical baseline,showing different degrees of PTEs accumulation effect.The concentration of PTEs in the topsoil was lower than those in the subsoil except for Cd and Hg.The I_(geo)revealed that the major accumulated element in soils was As followed by Mo.Source apportionment suggested that parent materials and agricultural practices were the dominant factors for PTEs accumulation in the topsoil.Noncarcinogenic risks of soil samples from five land-use patterns presented a trend of paddy field>dry field>woodland>orchard>garden plot.However,the HQ values of 12 PTEs were less than the recommended limit of HQ=1,representing that there are no non-carcinogenic risks of PTEs for children and adults in the study area.The TR values are within 6.95×10^(-6)-1.38×10^(-5),which corresponds to the low level.Therefore the PTEs in the agricultural soil of the study area show little influence on the health status of the local population.

Triceps skinfold thickness trajectories and the risk of all-cause mortality:A prospective cohort study

BACKGROUND The measurement of triceps skinfold(TSF)thickness serves as a noninvasive metric for evaluating subcutaneous fat distribution.Despite its clinical utility,the TSF thickness trajectories and their correlation with overall mortality have not been thoroughly investigated.AIM To explore TSF thickness trajectories of Chinese adults and to examine their associations with all-cause mortality.METHODS This study encompassed a cohort of 14747 adults sourced from the China Health and Nutrition Survey.Latent class trajectory modeling was employed to identify distinct trajectories of TSF thickness.Subjects were classified into subgroups reflective of their respective TSF thickness trajectory.We utilized multivariate Cox regression analyses and mediation examinations to explore the link between TSF thickness trajectory and overall mortality,including contributory factors.RESULTS Upon adjustment for multiple confounding factors,we discerned that males in the‘Class 2:Thin-stable’and‘Class 3:Thin-moderate’TSF thickness trajectories exhibited a markedly reduced risk of mortality from all causes in comparison to the‘Class 1:Extremely thin’subgroup.In the mediation analyses,the Geriatric Nutritional Risk Index was found to be a partial intermediary in the relationship between TSF thickness trajectories and mortality.For females,a lower TSF thickness pattern was significantly predictive of elevated all-cause mortality risk exclusively within the non-elderly cohort.CONCLUSION In males and non-elderly females,lower TSF thickness trajectories are significantly predictive of heightened mortality risk,independent of single-point TSF thickness,body mass index,and waist circumference.

Spatial distribution and potential ecological and health risks associated with heavy metals in the Ijero-Ekiti mining site,Nigeria

Artisanal gold mining,a labor-intensive and antiquated technique,is a growing industry and the source of income for rural communities all over the world.However,artisanal gold mining has potential negative and long-term effects on economy,environment,and society.This study collected soil samples from 16 sample points including a control point to examine the pollution degrees and spatial distribution of heavy metals,as well as ecological and health risks associated with heavy metal pollution in the Ijero-Ekiti mining site,Nigeria.Geographical Information System(GIS)and remote sensing technologies were used to identify regions with high concentrations of heavy metals and assess the environmental impact of gold mining activities.The results show that the mean heavy metal concentrations of 16 soil pointa are 8.94(±5.97)mg/kg for As,0.18(±0.54)mg/kg for Cd,0.11(±1.06)mg/kg for Co,14.32(±3.43)mg/kg for Cr,6.89(±0.64)mg/kg for Cu,48.92(±11.77)mg/kg for Fe,135.81(±30.75)mg/kg for Mn,5.92(±0.96)mg/kg for Ni,5.72(±1.66)mg/kg for Pb,and 13.94(±1.38)mg/kg for Zn.The study reveals that heavy metal concentration in soils follows the order of Mn>Fe>Cr>Zn>As>Cu>Ni>Pb>Co>Cd.An analysis of soil samples indicates that 3 principal components(PCs)account for 70.008%of the total variance and there are strong positive correlations between various pairs of heavy metals.The total potential ecological risk index(309.599)in the study area is high.Non-carcinogenic risk suggests that there may be long-term health impacts on people who work in the mining areas due to chronic exposure to the environment.Based on the study,the hazard index of carcinogenic health risks associated with heavy metals through ingestion is 520.00×10^(–4).Dermal contact from As and Cr also increases the risk of cancer,with the highest hazard index value of 18.40×10^(–4).The lowest exposure pathway,with the hazard index value of 0.68×10^(–4),indicates that the inhalation of heavy metals has a comparatively low risk of cancer.This study recommends the formulation of policies to monitor the Ijero-Ekiti mining site and other regions in Nigeria where indiscriminate artisanal gold mining activities exist.

Heavy Metal Levels and Ecological Risk in Crude Oil-Contaminated Soils from Okpare-Olomu, Niger Delta, Nigeria

Crude oil spills have inflicted extensive disruption upon the Niger Delta ecosystem, resulting in crop loss and severe environmental damage. Such spills exacerbate heavy metal concentration within soil due to the presence of metallic ions. The Okpare-Olomu community has borne the brunt of crude oil pollution from illicit bunkering, sabotage, and equipment malfunction. This study targets an evaluation of ecological hazards linked to heavy metals (HMs) in crude oil impacted agriculturally soils within Okpare-Olomu in Ughelli South LGA of Delta State. In this study, 24 topsoil samples were obtained from areas affected by crude oil pollution;the heavy metal content was evaluated through atomic absorption spectrometry. The concentration ranges for HMs (mg/kg) in soil were: 24.1 - 23,174 (Cu);0.54 - 37.1 (Cd);9.05 - 54 (Cr);12 - 174 (Ni);18.5 - 8611 (Pb);and 148 - 9078 (Zn) at a soil depth of 0 - 15 cm. Notably, metal concentrations were recorded to be above permissible World Health Organization limits. Predominantly, Zn and Pb recorded higher heavy metal concentration when compared to other heavy metals analysed, notably at sampling points PT7 through PT24. Zinc and Pb contamination exhibited highly significant contamination factors, and contamination severity was evidenced across all sample points, signifying a grave risk level. Pollution load indices indicated pervasive extreme pollution levels. Geoaccumulation indices signaled moderate to strong pollution, mainly by Pb and Zn. Ecological risk assessments revealed variable levels of heavy metal contamination, from low to very high, with potential ecological risk reflecting markedly elevated levels. This study underscores the imperative for soil remediation to rectify ecological imbalances in agriculturally affected soil constituents.

Spatio-temporal Evolution and Optimization of Landscape Ecological Risk in Karst Mountainous Areas

[Objective]The ecological vulnerability and landscape ecological risk of karst mountainous areas have increased as a result of enhanced disturbance of natural resources by human activities.This paper aimed to explore the characteristics of ecological risk evolution under different landscape patterns in the region,with a view to providing reference for land classification protection,sustainable use of resources and regional ecological risk optimization in karst mountainous areas.[Method]Taking Huangping County,a typical karst mountainous area,as an example,eight evaluation factors of natural and landscape patterns were selected to construct a landscape ecological risk evaluation model,to quantitatively explore the spatio-temporal evolution of landscape ecological risk and the trend of risk level transfer in the study area from^(2)010-2018,and to reveal the complex relationship between ecological risk and topography in karst mountainous areas.[Result]①From 2010 to 2018,land use types changed to different degrees,with the most amount of woodland transferred out(1627.37 hm^(2))and the most amount of construction land transferred in(1303.93 hm^(2));a total of 3552.31 hm^(2) of land was transferred,with a change ratio of 2.13%,and there was a significant conversion between construction land,arable land,and woodland.②From 2010 to 2018,the landscape ecological risk in the study area changed significantly,and the landscape ecological risk index decreased from 0.3441 to 0.1733,showing an upward and then downward trend;the landscape ecological risk of the whole region was dominated by low-risk and lower-risk zones,and the ecological risk level generally shifted from a high level to a low level,and the ecological environment was improved.③There was a negative correlation between ecological risk and topographic position,and high-risk zones were mainly distributed among low topographic zones;with the change of time,the advantage of risk level for the selection of topography was gradually weakened,and the influence of anthropogenic factors on the ecological risk of the landscape was becoming more and more prominent.[Conclusion]This paper can provide theoretical basis for land use optimization and ecological protection in karst mountainous areas.

Validation of nutritional risk index method against patientgenerated subjective global assessment in screening malnutrition in colorectal cancer patients

Objective：To validate malnutrition screening tool of nutrition risk index （NRI） against patent-generated subjective global assessment （PG-SGA） as a gold standard tool in colorectal cancer patients before radiotherapy.Methods：Nutritional status of 52 volunteer colorectal cancer patients with a mean age of 54.1±16.8 years who referred to radiotherapy center were assessed by PG-SGA （gold standard method） and NRI.Serum albumin levels of patients were determined by colorimetric method.A contingency table was used to determine the sensitivity,specificity,and predictive value of the NRI in screening patients at risk of malnutrition,in comparison with the PG-SGA in patients before radiotherapy.Results：The findings of PG-SGA and NRI showed that 52％ and 45％ of patients in our study were moderately or severely malnourished respectively.The NRI had a sensitivity of 66％ and a specificity of 60％ against PG-SGA.The positive predictive value was 64％ and the negative predicative value was 62％.The agreement between NRI and PG-SGA was statistically insignificant （kappa =0.267; P＞0.05）.Conclusions：The findings of present study showed that the prevalence of malnutrition was high in patients with colorectal cancer.Moreover,NRI method had low sensitivity and specificity in assessing nutritional status of patients with cancer.It seems that the combination of anthropometric,laboratory parameters and a subjective scoring system may be helpful tools in screening of malnutrition in cancer patients.

Risk Assessment Index System of Natural Gas Industrial Chain in China

This paper establishes a risk assessment index system for the natural gas industrial chain. China＇s natural gas industrial chain is entering a stage of rapid growth. In order to guarantee healthy development of the natural gas industrial chain, it is urgent to establish a risk alert system, which is based on a risk assessment index system. First of all, the risks of the natural gas industrial chain are defined in the paper; then the risk factors are analyzed according to the present status of the natural gas industrial chain, and five categories of risk factors are summarized： resource risk, transport risk, marketing risk, risk of unbalanced chain links, and environment risk. The paper presents the principles of the risk assessment index system. The natural gas industrial chain risk assessment index system is established with four levels and forty-six risk indices.

Cigarette smoking,body mass index associated with the risks of age-related cataract in male patients in northeast China

AIM: To determine the association between cigarettes smoking, body mass index (BMI) and the risk of age-related cataract (ARC) in middle-aged and elderly men in Northeast China. METHODS: A hospital-based case control study was conducted. Cases (n =362) were men who had surgically treated ARC, 45-85 years old; controls frequency-matched (n=362) were men who had been admitted to the same hospital as cases for other diseases not related with eye diseases. Cases and controls were matched with 1:1. The cases and controls were interviewed during their hospital stay, using a structured interviewer-administrated questionnaire that included information on sociodemographic characteristics, socioeconomic, lifestyle habits (tobacco smoking and alcohol consumption, etc.), anthropometric measures, personal medical history, and family history of ARC in first-degree relatives, and simultaneously BMI was calculated. The odds ratios (OR) and 95% confidence intervals (CI) of ARC were estimated using multiple logistic regression models. RESULTS: After adjusting for age and multiple potential confounders, higher BMI was associated with an increased risk of ARC. Cigarette smoking, years smoking or moderate cigarette smoking (1-29 cigarettes per day) had no relation with the risk of ARC (P>0.05), although patients smoking >= 30 cigarettes per day had an elevated risk of ARC as compared with the non-smokers (OR=1.55, 95% CI; 1.16-2.85, P=0.026). Higher BMI was associated with an increased risk of ARC. Both overweight and obesity was associated with an obviously increased risk for surgically ARC (OR=1.55, 95% CI:1.02-1.98, P=0.015 and OR=1.71, 95% CI:1.32-2.39, P=0.013 respectively) compared to normal BMI. Then participants were grouped into quartiles of BMI (Q1 to Q4), compared to controls in the lowest quartile, the ORfor cases in the highest quartile of BMI was 1.54 (OR=1.54, 95% CI: 1.08-2.46, P=0.022). The results of univariate analysis showed cigarette smoking was not associated with ARC formation for men with lower or normal BMI (P >0.05). Compared to the non-smokers, for men of overweight or obesity, cigarette smoking was associated with a significantly increased risk for surgically ARC (OR=2.00, 95% CI: 1.49-6.65, P=0.003 and OR=1.66, 95% CI: 1.63-13.21, P=0.002 respectively). Similarly, smokers in the highest quartile of BMI had approximately 1.5 times the risk of ARC as non-smokers in the lowest quartile (OR =1.46, 95% CI: 1.06-5.29, P<0.001). Followed multivariate models revealed that the association had never changed. CONCLUSION: Current cigarette smoking is positively related to ARC only among those who smoking 30 or more cigarettes per day. For men who are both overweight and obesity, cigarette smoking is associated with a significantly increased risk for ARC.

Contamination and Ecological Risk Assessment of Heavy Metal in the Sediment of Turag River, Bangladesh: An Index Analysis Approach

Encroachment, disposal of untreated domestic and industrial wastewater and dumping of solid wastes have degraded the overall quality of the river Turag, which is located in Dhaka—the Capital City of Bangladesh. The present study investigated the extent of pollution of sediments of this river and analyzed the regional variability for the concentrations of Cr, Pb, Zn, Cu and Cd—all of concern because of their potential toxicity, using atomic absorption spectrophotometer. As per US EPA sediment quality guideline, metal concentrations ranged between Cd: 0.00 - 0.80, Cr: 32.00 - 75.50, Cu: 46.30 - 60.00, Pb: 28.30 - 36.40, and Zn: 94.60 - 190.10 mg/kg in the Turag river sediments. Cr, Cu, Zn belongs to moderately to highly polluted, Pb and Cd belongs to not polluted for Turag river. The heavy metals contamination in the sediments were also evaluated by applying Index of geo-accumulation (Igeo), contamination factor (Cf), pollution load index (PLI) etc. Toxicity characteristics leaching procedure (TCLP) test (US EPA 1311) for sediment samples have been performed also for metals (Pb, Cd, Cr, Cu and Zn) to determine the readily toxicity level of heavy metals. Sieve analysis of sediment performed in this study to determine the physical characteristic of sediment samples. The metal concentrations are well below the regulated level as per US EPA. This index can be complemented with the contamination index, which allows more site-specific and accurate information on contaminant levels. If the aim of work on contamination evaluation is to assess the overall contamination of a study area, the indices are highly appropriate.

Risk Index Prediction of Civil Aviation Based on Deep Neural Network

Safety is the foundation of sustainable development in civil aviation.Although catastrophic accidents are rare,indicators of potential incidents and unsafe events frequently materialize.Therefore,a history of unsafe data are considered in predicting safety risks.A deep learning method is adopted for extracting reactions in safety risks.The deep neural network(DNN)model for safety risk prediction is shown to extract complex data characteristics better than a shallow network model.Using extended unsafe data and monthly risk indices,hidden layers and iterations are determined.The effectiveness of DNN is also revealed in comparison with the traditional neural network.Through early risk detection using the method in the paper,airlines and the government can mitigate potential risk and take proactive measures to improve civil aviation safety.

Geriatric Nutritional Risk Index as a Simple Predictor of Mortality in Maintenance Hemodialysis Patients: A Single Center Study

Background: Malnutrition is associated with higher risk of mortality in maintenance hemodialysis (MHD) patients. The geriatric nutritional risk index (GNRI) has been developed as a tool to assess the nutritional risk. Objectives: The purpose of the present study was to examine the significance of the GNRI as a mortality predictor in MHD patients. Methods: We retrospectively examined the GNRI of 259 MHD patients aged 59.2 ± 12.8 years, and followed up for 36 months. The patients were divided into two groups according to GNRI values of 91.0. Predictors for all-cause mortality were examined using Kaplan-Meier and Cox proportional-hazards analyses. Results: During the follow-up period of 36 months, a total of 76 patients died. Kaplan-Meier survival analysis showed that the subjects with a GNRI 91 (n = 230) (Log-rank test,

The Establishment of a New Air Health Index Integrating the Mortality Risks Due to Ambient Air Pollution and Non-Optimum Temperature

A composite Air Health Index(AHI)is helpful for separately emphasizing the health risks of multiple stimuli and communicating the overall risks of an adverse atmospheric environment to the public.We aimed to establish a new AHI by integrating daily mortality risks due to air pollution with those due to non-optimum temperature in China.Based on the exposure-response(E-R)coefficients obtained from time-series models,the new AHI was constructed as the sum of excess mortality risk associated with air pollutants and non-optimum temperature in 272 Chinese cities from 2013 to 2015.We examined the association between the“total AHI”(based on total mortality)and total mortality,and further compared the ability of the“total AHI”to predict specific cardiopulmonary mortality with that of“specific AHIs”(based on specific mortalities).On average,air pollution and non-optimum temperature were associated with 28.23%of daily excess mortality,of which 23.47%was associated with non-optimum temperature while the remainder was associated with fine particulate matter(PM2.5)(1.12%),NO2(2.29%,),and O3(2.29%).The new AHI uses a 10-point scale and shows an average across all 272 cities of 6 points.The E-R curve for AHI and mortality is approximately linear,without any thresholds.Each one unit increase in“total AHI”is associated with a 0.84%increase in all-cause mortality and 1.01%,0.98%,1.02%,1.66%,and 1.71%increases in cardiovascular disease,coronary heart disease,stroke,respiratory diseases,and chronic obstructive pulmonary disease mortality,respectively.Cause-specific mortality risk estimates using the“total AHI”are similar to those predicted by“specific AHIs.”In conclusion,the“total AHI”proposed herein could be a promising tool for communicating health risks related to exposure to the ambient environment to the public.

Association between pre-pregnancy body mass index and gestational weight gain and the risk of preeclampsia:A systematic review and meta-analysis

Objective:To analyze the relationship between body mass index(BMI)before pregnancy and gestational weight gain throughout pregnancy with the incidence of preeclampsia.Methods:This was a systematic review-meta analysis of literature collected from three e-databases:Scopus,PubMed,and Science Direct.Quality assessment was measured with the Effective Public Health Practice Project methods.Meta-analysis was done by calculating the fixed and random-effects of odds ratio(OR)for each BMI category and gestational weight gain as compared with the incidence of preeclampsia.Results:Overweight was associated with a significantly increased risk of preeclampsia(OR=2.152,95%CI 1.363-3.400;P=0.001).Obesity was also associated with a noticeably increased risk of preeclampsia(OR=2.856,95%CI 1.755-4.649;P<0.001).Meanwhile,underweight was associated with a significantly reduced risk of preeclampsia(OR=0.639,95%CI 0.500-0.817;P<0.001)when compared with normal BMI.Pregnant women who gained weight below the standard throughout pregnancy was a protective factor from preeclampsia(OR=0.813,95%CI 0.610-1.083;P=0.157)whereas pregnant women who gained weight above the standard had almost doubled risk of preeclampsia(OR=1.850,95%CI 1.377-2.485;P<0.001).Conclusions:The result of this study affirms the role of overweight-obesity pre-pregnancy,and gestational weight gain above the standard during pregnancy as significant risk factors for developing preeclampsia.

Disease Risk Comorbidity Index for Patients Receiving Haploidentical Allogeneic Hematopoietic Transplantation

We aimed to develop a disease risk comorbidity index(DRCI)based on disease risk index(DRI)and Hematopoietic Cell Transplantation-Specific Comorbidity Index(HCT-CI)in patients receiving haploidentical hematopoietic stem cell transplantation(haplo-HSCT).We identified the prognostic factors of disease-free survival(DFS)in a training subset(n=593),then assigned a weighted score using these factors to the remaining patients(validation subset;n=296).The multivariable model identified two independent predictors of DFS:DRI and HCT-CI before transplantation.In this scoring system,we assigned a weighted score of 2 to very high-risk DRI,and assigned a weighted score of 1 to high-risk DRI and intermediate-and high-risk HCT-CI(i.e.,haplo-DRCI).In the validation cohort,the three-year DFS rate was 65.2%(95%confidence interval(CI),58.2%–72.2%),55.8%(95%CI,44.9%–66.7%),and 32.0%(95%CI,5.8%–58.2%)for the low-,intermediate-,and high-risk group,respectively(P=0.005).Haplo-DRCI can also predict DFS in disease-specific subgroups,particularly in acute leukemia patients.Increasing score was also significantly predictive of increased relapse,increased non-relapse mortality(NRM),decreased DFS,and decreased overall survival(OS)in an independent historical cohort(n=526).These data confirmed that haplo-DRCI could effectively risk stratify haplo-HSCT recipients and provide a tool to better predict who will best benefit from haplo-HSCT.

Nutritional risk index as a predictor of postoperative wound complications after gastrectomy

AIM:To investigate the correlation between the nutritional risk index (NRI) and postoperative wound complications.METHODS:From January 2008 through June 2008,669 patients who underwent curative gastrectomy for gastric cancer were included in a retrospective study.Medical records of consecutive patients were collected and analyzed to determine postoperative wound complication rates.The NRI was assessed on the fifth postoperative day and other possible risk factors for the incidence of wound complications were analyzed to identify the factors affecting postoperative wound complications.Patients with other postoperative complications were excluded from the study.RESULTS:On the 5th postoperative day,the NRI showed a malnutrition rate of 84.6% among postoperative patients.However,postoperative wound complications occurred in only 66/669 (9.86%) patients.Of the patients with wound complications,62/66 (94%) belonged to the malnourished group (NRI < 97.5),and 4/66 (6%) patients to the non-malnourished group (NRI ≥ 97.5).The only factor correlated with wound complications was the NRI on the 5th postoperative day (odds ratio of NRI ≥ 97.5 vs NRI < 97.5:0.653;95% confidence interval:0.326-0.974;P=0.014) according to univariate analysis as well as multivariate analysis.CONCLUSION:This study suggests that malnutrition immediately after surgery may play a significant role in the development of wound complications.

Evaluation of groundwater quality using pollution index of groundwater(PIG) and non-carcinogenic health risk assessment in part of the Gangetic Basin

The aim of this study was to evaluate groundwater fitness for domestic and irrigational use in Unnao district of Uttar Pradesh,India.For this study,block wise(n=16)groundwater samples were collected,and measured parameters were analyzed using the pollution index of groundwater(PIG),various irrigational indices,and graphical techniques.The results of this study suggested that most of the parameters were within the prescribed limits of WHO and BIS,excluding F-(0.4 to 2.6 mg L^(-1))and Fe^(2+)(0.1 to 1.7 mg L^(-1)).Concentrations of total dissolved solids(TDS)were exceeded the desirable limit(>500 mg L^(-1))in 43.75%of samples at some sites.The Gibbs plot revealed that groundwater chemistry was governed by rock-water interaction in the region,especially silicate weathering.The Piper plot suggested that Ca^(2+)-HCO3-is dominant hydrochemical facies in the area followed by mixed Ca^(2+)-Na^(+)-HCO_(3)^(-)type,Na^(+)-Cl^(-)type,and Na^(+)-HCO_(3)^(-)type.PIG evaluation revealed that the contribution of F-and Fe2+in groundwater degradation is high in comparison to other elements in the region,about 18.75%samples showed low pollution,while about 6.25%samples shows moderate pollution,and 6.25%samples reflected high pollution.The human health risk(HHR)assessment finding suggested that children(mean:1.36)are more vulnerable than adults(mean:1.01).Sodium absorption ration(SAR),Residual sodium carbonate(RSC),and Permeability index(PI)indicated that most of the groundwater was suitable for irrigation,whereas,Magnesium hazard ration(MHR)and Potential salinity(PS)indices suggested that only 37.5%and 56.25%of the samples were suitable for irrigational use,respectively.This regional study would help in decision making for stakeholders and relevant authorities in the execution of groundwater management and remediation plans in the area.

Health risk assessment of heavy metals in soils and crops in a mining area(Au-Ag-Cutrona-oil et al.) of the Nanyang Basin, Henan Province, China

Heavy metal distribution in mining areas has always been a hot research topic due to the special environment of these areas. This study aims to explore the impact of heavy metal pollution on soils and crops in the study area, ensure the safety of local crops and the health of local residents, and provide a basis for the subsequent environmental restoration and the prevention and control of environmental pollution. Based on the analysis of the heavy metal concentrations in local soils and crops, the study investigated the spatial distribution, pollution degrees, and potential ecological risks of heavy metals in the farmland of a mining area in the southeastern Nanyang Basin, Henan province, China explored the sources of heavy metals and assessed the health risks caused by crop intake. The results of this study are as follows. The root soils of crops in the study area suffered heavy metal pollution to varying degrees. The degree of heavy metal pollution in maize fields is higher than that in wheat fields, and both types of fields suffer the most severe Cd pollution. Moreover, the root soils of different crops suffer compound pollution.The root soils in the maize fields suffer severe compound pollution at some sampling positions, whose distribution is similar to that of the mining area. Cd poses the highest potential ecological risks among all heavy metals, and the study area mainly suffers low and moderate comprehensive potential ecological risks. The principal component analysis(PCA) shows that the distribution of Zn, Cd, Pb, and As in soils of the study area is mainly affected by anthropogenic factors such as local mining activities;the distribution of Cr and Ni is primarily controlled by the local geological background;the distribution of Hg is mainly affected by local vehicle exhaust emissions, and the distribution of Cu is influenced by both human activities and the geological background. Different cereal crops in the study area are polluted with heavy metals dominated by Cd and Ni to varying degrees, especially wheat. As indicated by the health risk assessment results, the intake of maize in the study area does not pose significant human health risks;however, Cu has high risks to human health, and the compound heavy metal pollution caused by the intake of wheat in the study area poses risks to the health of both adults and children. Overall, the soils and crops in the study area suffer a high degree of heavy metal pollution, for which mining activities may be the main reason.