Risk Index Research Articles

Synthesis, Characterization, Antimicrobial Activity, DFT, Molecular Docking, and ADMET of 4-Chlorophenyazolquniolin-8-ol and Its Metal Complexes

In this study, we prepared 4-chlorophenylazoquinoline, a derivative of 8-hydroxyquinoline, with Mn(II), Co(II), Ni(II), Cu(II), and Zn(II) ions to create metal complexes. We used various physical and spectroscopic methods to characterize the compound and its metal complexes, including molar conductivity measurements, melting point analysis, elemental analysis, electronic absorption spectroscopy, mass spectrometry, magnetic resonance spectroscopy, infrared spectroscopy, and thermogravimetric analysis. The octahedral geometry of all prepared complexes has been confirmed. To assess the antimicrobial activity, we examined two types of bacterial strains and two types of fungal strains. The antimicrobial activity of the prepared compounds was observed, and the higher increase was observed in the copper complex. The compounds were studied computationally after optimizing the angles, lengths, and bonds using the basic set 6-31G(d,p)/LANL2DZ. The molecular docking study of the compounds with the Alzheimer's disease protein 4BDT showed significant activity in binding to the amino acids of HL, C1, C2, C3, C4, and C5 compounds, with affinity energies of -6.4, -6.9, -6.9, -6.7, and -7.2 kcal.mol-1 for the compounds, respectively. To evaluate the safety of the prepared compounds in different drug designs, we employed the ADMET study, reducing the risk of failure in advanced drug design stages. The results of the ADMET showed a relative decrease in the toxicity and carcinogenicity factor. However, there are indications of metabolic risk and cellular uptake, requiring further study.

Assessment of risk intensity in the triffa plain aquifer: Integration of hazard quantification, land use analysis, dynamic vulnerability GCITF, and DRASTIC method

This study aims to assess the level of groundwater pollution risk in the Triffa Plain, stemming from various pollution sources, with a specific focus on agricultural intensification and excessive pesticide use. Data were collected from ABHM (the Moulouya Hydraulic Basin Agency) and ORMVAM (Regional Office of Moulouya Agricultural Development), and a field visit was conducted in July 2023. The study utilized two main methodologies for mapping risk intensity: the COST 620 action and overlaying vulnerability maps with the land use (LU) factor. Vulnerability maps were generated using the original DRASTIC method and the new dynamic vulnerability assessment method, GCITF.The research approach involved comparing the COST 620 risk index (Ri) and the land use risk index (LU) to identify the most suitable method for the study area. Due to challenges in inventorying various point sources of pollution, the study focused on mapping the primary sources of pollution (diffuse, point, and linear). The key findings indicate that the predominant pollution intensity in the region is high, covering 60.66% of the total surface area. These results closely align with those obtained using the European COST 620 approach and the spatial distribution of nitrates. The study demonstrates the reliability of integrating the GCITF method in assessing groundwater contamination risk, highlighting the significant negative impacts of agricultural activities on the Triffa Plain aquifer, primarily due to uncontrolled pesticide and fertilizer use and point sources of pollution.This study suggests that implementing targeted technical solutions for specific pollution sources is crucial for reducing contamination in the Triffa Plain. These pollution risk intensity maps can assist planners and decision-makers in understanding the origin of pollution and identifying necessary actions to minimize contamination risk, contributing to better groundwater management and protection in the region.

Plant litter as a heavy metal migration strategy following application of sewage sludge to subtropical forest soils

The environmental risks of migration of heavy metals (HMs) following applications of sewage sludge (SS) to forest soils are garnering increased attention. Plant litter at the forest floor may modify HM migration pathways through impacts on soil aggregates and water/soil erosion; however, HM migration responses to plant litter are poorly understood. The aim of this study was to determine the effects of plant litter cover on HMs migration, and water and soil erosion following the application of SS to subtropical forest soils. Effects of addition of SS along and SS plus plant litter at 0.75 or 1.5 kg m−2 on the migration of cadmium, chromium, copper, nickel, lead, and zinc in surface runoff, soil interflow, and sediments were quantified across nine simulated rainfall events in a laboratory experiment and following natural intense rain events in a field experiment. Addition of SS elevated HM concentrations in surface runoff by 38.7 to 98.5 %, in soil interflow by 48.3 to 312.5 %, and in sediment by 28.5 to 149.4 %, and increased the production of sediment aggregates <0.05 mm that led to greater cumulative migrations of HMs in surface runoff and sediment; sediment accounted for 89.5 % of HM migrations. Addition of plant litter reduced cumulative migration of HMs by 87.1–97.27 %; however, the higher rate of plant litter led to a decrease in surface runoff and sediment yield, and an increase in soil interflow. Addition of plant litter shifted the main pathway of HM migration from sediment to surface runoff and soil interflow. The potential ecological HM risk index was “low” for each treatment. We found consistency in HM concentrations and migrations via surface runoff between the field and laboratory experiments. Overall, the addition of plant litter with SS mitigated soil erosion and reduced total migration of HMs, resulting in a 88.7–97.3 % decrease in the ecological risk index of the six HMs. We conclude that the addition of plant litter may provide a management strategy for the mitigation of HM risks to environmental safety for the disposal of SS in subtropical forest systems.

Understanding typhoon-induced vegetation loss and potential ecosystem disservices from land use zonings perspective in high-density Hong Kong

While cities are embracing nature through urban greening and nature conservation, vegetation in typhoon-prone cities is facing stress from intense typhoon disturbances. Limited studies have investigated vegetation loss and its potential ecosystem disservices in the aftermath of typhoons from a land use zoning perspective. Therefore, we (1) compared vegetation losses from three 2023 category 3–4 typhoons in Hong Kong across all land uses in protected and non-protected areas, (2) identified hot spots and cold spots, and (3) weighed the annual average daily traffic and urban volumetric density with vegetation loss rates to generate a Disservice Risk Index for analysis. Results suggest that vegetation loss rate in non-protected areas was higher (7.23%) than in protected areas (1.57%). Within protected areas, country parks had the lowest loss rate (0.11%) and the highest percentage of cold spots (79.4%). In contrast, transportation land use has the highest loss rate of 18.04% and the highest percentage of hot spots (17.9%) within non-protected areas. Ecosystem disservices are potentially more adverse in the city center, which requires immediate preventive measures. This study provides timely urban greening and conservation implications for typhoon-prone cities to allocate vegetation that maximizes ecosystem services while minimizing disservices under frequent typhoon disturbances.

Residential natural hazard risk and mental health effects.

Mental health effects are frequently reported following natural disasters. However, little is known about effects of living in a hazard-prone region on mental health. We analyzed data from 9,312 Gulf Long-term Follow-up Study participants who completed standardized mental health questionnaires including the Patient Health Questionnaire-9 (depression=score≥10), Generalized Anxiety Disorder Questionnaire-7 (anxiety=score≥10), and Primary Care PTSD Screen (PTSD=score≥3). Geocoded residential addresses were linked to census-tract level natural hazard risk scores estimated using the National Risk Index (NRI). We considered an overall risk score representing 18 natural hazards, and individual scores for hurricanes, heatwaves, coastal flooding and riverine flooding. Log binomial regression estimated prevalence ratios (PR) and 95% confidence intervals (CI) for associations between risk scores (quartiles) and mental health outcomes. Increasing hurricane and coastal flooding scores were associated with all mental health outcomes in a suggestive exposure-response manner. Associations were strongest for PTSD, with PRs for the highest vs. lowest quartile of hurricane and coastal flooding risks of 2.29(1.74-3.01) and 1.59(1.23-2.05), respectively. High heatwave risk was associated with anxiety (PR=1.25(1.12-1.38)) and depression (PR=1.19(1.04-1.36)) and suggestively with PTSD (PR=1.20(0.94-1.52)). Results suggest that living in areas prone to natural disasters is one factor associated with poor mental health status.

Volatile organic compounds and cancer risk assessment in an intensive care unit.

Changes caused by air-cleaning devices in the amounts of volatile organic compounds in an intensive care unit were monitored in the study. The cancer risk and hazard index were calculated. The measurements were made for one month at isolated room and two different points and times in the intensive care unit. According to the sampling program, the air-cleaning devices were turned off in weeks 1 and 4 and turned on in weeks 2 and 3. Volatile organic compounds were collected by active sampling. Samples were analyzed by a thermal desorber coupled to a gas chromatography-mass spectrometry instrument with selective ion monitoring. The results showed that the concentrations of benzene, toluene, and o-xylene decreased by about 70% after the air-cleaning devices were installed. The cancer risk assessment for naphthalene was recorded at the highest level of cancer risk (Class A). The hazard index value of naphthalene was recorded at the harmful level when air-cleaning devices were not installed. The concentrations of benzene (p = 0.01), toluene (p = 0.02), ethylbenzene (p = 0.02), styrene (p = 0.01), and m, p-xylene (p = 0.04) before the air-cleaning devices were installed were significantly different from those recorded when the air-cleaning devices were turned on.

Modeling risk potential fields for mandatory lane changes in intelligent connected vehicle environment

In the environment of Intelligent Connected Vehicles (ICVs), the ICV system is capable of gathering, processing, and transmitting the majority of traffic information to each vehicle, thereby empowering drivers to make more informed and secure decisions. Nevertheless, ICVs are still incapable of completely avoiding traffic conflicts and accidents. Consequently, developing a risk assessment model for ICVs is crucial for their deployment. To investigate the dynamic patterns of lane-changing vehicle risks within ICV environments, this study developed a quantitative relationship model based on the Artificial Potential Field (APF) theory. The model correlates the Total Potential Field (TPF) of mandatory lane-changing (MLC) vehicle with the longitudinal/transverse gravitational potential field (LGPF/TGPF) and the longitudinal/transverse repulsion potential field (LRPF/TRPF). Subsequently, three sets of Human Machine Interface (HMI) systems were developed to delineate distinct ICV environments: baseline, warning group, and guidance group. The baseline furnishes fundamental data, the warning group supplements preceding vehicle icons and real-time headway information, whereas the guidance group additionally augments speed and voice guidance functionalities. Following this, a simulated driving experiment involving 43 participants was carried out to simulate MLC scenarios in highway merging sections. Using enumeration and gradient descent methods, the quantitative relationship between different types of risk fields was determined. The findings indicated that the ICV environment significantly impacts the mean values of LGPF, TGPF, LRPF (Leading Vehicle, LV), and TRPF, while insignificantly affecting the mean value of LRPF (Following Vehicle, FV). Nevertheless, a notable discrepancy in the mean value of LRPF (FV) was observed between the warning and guidance groups. Comparative results with lane positions demonstrate that the proposed TPF accurately depicts vehicle lane-changing behaviors. Comparative results with classical risk indicators indicate that TPF more accurately depicts the actual driving risks and variation trends faced by vehicles in different MLC processes. The research findings will be pivotal in improving real-time control and guidance strategies for vehicles in highway merging sections under ICV environments.

Neck Circumference and Its Relation with Body Fat Percentage in Children 5-10 Years Old.

Neck circumference (NC) has been proposed as an indicator of upper trunk adiposity and a potential indicator of metabolic risk. The objective was to evaluate NC and its correlation with body fat percentage (BF%) and other indicators of adiposity in children with normal weight, overweight, and obesity. In a cross-sectional study, 112 children 5 to 10 years of age were included in the outpatient clinic from a public hospital. Measures of weight and height to calculate BMI (kg/m2), NC, mid-upper arm circumference, waist circumference, and tricipital skinfold thickness. Body composition measurements were performed using an electrical bioimpedance device (BIA). The relationship between anthropometric variables and BF% obtained by BIA was determined using Spearman correlation tests. Multivariate models were constructed with BF% as the dependent variable and anthropometric parameters as independent. In the entire group, there was a direct correlation between NC and BF% (r = 0.50, p < 0.001), but lost statistical significance in the case of normal weight. The relationship maintained its significance in subjects from the overweight and obesity groups. In multivariate models, BMI exhibited the highest correlation with BF%, followed by waist circumference and mid-upper arm circumference; for NC, the R2 value was 0.30 (p < 0.001). Neck circumference is useful in the screening of population groups with the advantage of not requiring any specialized instruments for its measurement other than a tape measure. BMI and waist circumference were the best indicators of general and central adiposity, respectively.

Groundwater health risk assessment and its temporal and spatial evolution based on trapezoidal fuzzy number-Monte Carlo stochastic simulation: A case study in western Jilin province

The United States Environmental Protection Agency (USEPA) Four-step-Method (FSM) is a straightforward and extensively utilized tool for evaluating regional health risks, However, the complex and heterogeneous groundwater environment system causes great uncertainty in the assessment process. Triangular stochastic simulation (TSS) possesses certain advantages in solving uncertainty problems, but its inadequacy with discrete data reveals limitations in this aspect. To solve the above problems, this study proposes to construct trapezoidal fuzzy number-Monte Carlo stochastic simulation (TFN-MCSS) to compensate for the shortcomings of the first two methods. This method adopted trapezoidal fuzzy number (TFN) analysis to comprehensively consider the characteristics of a large dispersion of water quality monitoring data and the uncertainty of the human health risk assessment (HHRA) process. Concurrently, to overcome the subjectivity and uncertainty of artificially determining the interval of TFN in traditional methods, the slope was used to select the most probable interval value (TMPIV) of TFN combined with the α-truncated set technique (α-TST) and MCSS. Based on these, a TFN-MCSS was constructed and applied to groundwater HHRA in western Jilin Province. First, the groundwater chemical characteristic determination and water quality evaluation in western Jilin were performed to identify the main pollution indicators, and the health risk effects of pollutants in groundwater of different aquifers at different time periods on adults and children were evaluated using the TFN-MCSS. The uncertainty and sensitivity were analyzed, and the primary risk control indicators were identified and compared to FSM and TSS. The results reveal that TFN-MCSS was more sensitive to data and could reduce the uncertainty of assessment process. It indicated that over a 10-year period, the health risks associated with unconfined groundwater (UW) and confined water (CW) decreased by greater than 52 %. However, the highest total non-carcinogenic risk index (THI) was 1.3-fold higher than the safety threshold, and this posed a health risk.

A combined nutritional risk index and carcinoembryonic antigen score predicts the outcome in radically resected colorectal cancer.

Nutritional risk index (NRI) and carcinoembryonic antigen (CEA) are useful prognostic markers in colorectal cancer (CRC); however, the prognostic value of a combination of the NRI and CEA, namely, the NRI and CEA score (NCS), needs further investigation. Stage I-III CRC patients were collected and then divided into three subgroups by counting the NCS: NCS 1: high NRI with normal CEA; NCS 2: high NRI with elevated CEA or low NRI with normal CEA; and NCS 3: low NRI with elevated CEA. The differences in outcome, counted as disease-free survival (DFS) and overall survival (OS), were tested among the subgroups. A total of 285 patients were enrolled, with 108 in NCS 1, 118 in NCS 2 and 59 in NCS 3. Patient features, including age, tumour deposit, T stage, N stage and TNM stage, were significantly different in the NCS subgroups. Both the DFS (log-rank = 26.06, P<0.001) and OS (log-rank = 39.10, P<0.001) were significant in different NCS subgroups, even in maximum tumour diameter ≤4 cm cases (DFS: log-rank = 21.42, P<0.001; OS: log-rank = 30.95, P<0.001), and NCS 1 patients displayed the best outcome compared with the rest of the subgroups. NCS was also found to be an independent risk factor for both DFS and OS. NCS was a useful prognostic indicator in stages I-III CRC patients.

Geriatric nutritional risk index and quality of life among elderly hemodialysis patients: a cross-sectional study

Background: Nutritional problems are considered one of the main complications of hemodialysis, and the geriatric nutritional risk index (GNRI) is a new instrument for assessing geriatric nutritional status. The present study sought to evaluate the relationship between the GNRI and quality of life (QOL) among elderly hemodialysis patients. Methods: In the present analytical cross-sectional study, 110 hemodialysis individuals were selected by applying a simple random sampling method, among whom 57 and 53 were males and females, respectively (mean: 70.3±6.93 years). Demographic characteristics, GNRI, and QOL status were determined. The data were analyzed using SPSS 20 software and descriptive statistics, Pearson’s correlation, ANOVA, independent sample t-tests, and multiple linear regression analysis. Results: The mean GNRI and mean total QOL were respectively obtained 93.903±11.067 and 20.95 ± 4.89. Among females, a significant direct relationship was observed between GNRI and total QOL (P = 0.010, r = 0.352), autonomy (P = 0.004, r = 0.389), and pleasure (P = 0.015, r = 0.333), while GNRI was not directly and significantly related to QOL in males (P = 0.161, r = 0.188). Conclusion: Due to the presence of a significant association between Geriatric GNRI and QOL among elderly hemodialysis patients, particularly among females, highlighting the importance of addressing nutritional status in optimizing well-being.

Tranexamic acid efficacy in geriatric hip fractures: impact of nutritional status on blood loss, transfusion rates, and safety

BackgroundTranexamic acid (TXA) is a widely employed intervention in orthopedic surgeries to minimize blood loss and the need for postoperative transfusions. This study focuses on assessing the efficacy and safety of TXA specifically in undernourished older adults undergoing hip fracture procedures.MethodsA total of 216 patients were classified into two groups based on the Geriatric Nutritional Risk Index: undernourished and normal. In total, 82 patients received intravenous TXA at a dosage of 15 mg/kg before incision, with an additional 1 g administered intravenously over a 3-hour period postoperatively. Postoperative hemoglobin (Hb) drop, blood transfusion rate, and the incidence of deep venous thrombosis (DVT) were assessed in each group according to the presence or absence of TXA. Additionally, demographic factors including age, sex, body mass index, and serum albumin were investigated.Results51.9% patients were identified as undernourished, experiencing progressive anemia (Hb: 10.9 ± 1.5 g/dL) and hypoalbuminemia (serum albumin: 31.9 ± 8 g/L). In comparison with the normal group, undernourished individuals were more likely to sustain femoral neck fractures (undernutrition vs. normal: 56.2 vs. 42.3%) and less likely to incur trochanteric fractures (undernutrition vs. normal: 43.8 vs. 57.7%) (P = 0.043). TXA administration significantly reduced the transfusion rate (P = 0.014) and Hb drop (P = 0.001) in the normal nutritional group, while its impact on the undernourished group remained less pronounced. There was no significant association between TXA administration and the rate of DVT complications, irrespective of the nutritional status.ConclusionsUndernutrition not only diminishes muscle strength and gait function, leading to various types of hip fractures, but it may also hinder the efficacy of TXA in reducing blood transfusion rates and blood loss.

Factors associated with skeletal muscle mass in middle-aged men living with HIV.

Despite extensive research on muscle loss in people living with HIV (PLWH), the prevalence and contributing factors specifically among middle-aged men remain unclear. This study aimed to determine the prevalence of low muscle mass within this demographic and to identify associated factors. A total of 378 men living with HIV were enrolled in the study. They were classified into low muscle mass group if they displayed a skeletal muscle index (SMI) <7.00kg/m2 or fell within the lowest quintile of SMI based on the criteria established by the Asian Working Group for Sarcopenia 2019. Out of the 378 men living with HIV enrolled, 351 had normal muscle mass, while 27 (7.1%) had low muscle mass. Antiretroviral drugs Zidovudine (AZT) (OR=0.246, P=0.022) and higher serum albumin levels (OR=0.899, P=0.026) were found to be protective factors against low muscle mass according to quintile grouping. Strong positive associations between SMI and body mass index (BMI), nutritional risk index (NRI), oedema index and fat-free mass index (FFMI) (R>0.5, P<0.001) were observed. In addition, both BMI (sensitivity=0.741, specificity=0.906) and NRI (sensitivity=0.963, specificity=0.601) had high sensitivity and specificity in diagnosing low muscle mass, with critical values of 19.85 and 114.177 for BMI and NRI, respectively. The oedema index was the most effective measure of body composition in detecting abnormal fluid retention with high sensitivity (92.6%) and moderate specificity (71.8%) in identifying individuals with low muscle mass. Notably, PLWH with low muscle mass participants had a significantly higher prevalence (92.6%) of a high oedema index compared with those with normal muscle mass (28.2%). This observation indicates that individuals with HIV who experience reduced muscle mass is commonly accompanied with abnormal fluid retention within the body. Antiretroviral medication types, specifically Zidovudine, BMI and NRI can be independent risk factors for low muscle mass in men with HIV. These factors, along with BMI, could be used conveniently to predict low muscle mass. Furthermore, the association between the oedema index and muscle mass suggests that observing signs of oedema may indicate a risk of low muscle mass in PLWH.

Relationship between duration of heart failure and nutritional status in hospitalised patients - preliminary cross-sectional study

Abstract Introduction Heart failure (HF) is a chronic disease which is one of the most common causes of hospitalisation of elderly patients. Nutritional status has a crucial impact on the course of disease and survival. HF frequently occurs with nutritional deficits, which may lead to malnutrition and loss of skeletal mass, which makes the prognosis worse. Nutritional status depends also on the patient's economic status, ability to prepare meals, and availability of fresh vegetables and fruits. Knowledge of the connection between the duration of heart failure and nutritional status will enable selection of patients with a higher risk of malnutrition, for which nutritional support should be considered. Purpose The study aims to assess the variability of nutritional status in heart failure patients over the duration of the disease, using the Mini Nutritional Assessment (MNA) and Geriatric Nutritional Risk Index (GNRI). Methods The nutritional status of 134 patients with HF admitted to the cardiology department was assessed with the MNA questionnaire. Additionally, GNRI has counted from serum albumin concentration, weight and height of patients. Patients were divided according to the duration of HF into two groups, one with patients with equal or less than five years of history of disease and the second with patients with HF lasting more than five years. Results The mean age was 52.4±16.9 years, 20.2% of patients were women, and the mean LVEF was 30.3±13.8%. The group of patients with HF lasting equal or less than five years was younger than patients with more than five years of the disease (49.5±16.9 years vs. 57.3 ±16.2 years, p=0.002). There were no significant differences in sex, LVEF and NYHA class between the two groups. According to MNA and GNRI scores, the nutritional status had no differences between the group of patients suffering from HF for more than five years compared with those with HF lasting 5 years or less (p=0.50; p=0.63, respectively). Moreover, the time of HF lasting was not correlated with scores of MNA and GNRI (p=0.33; p=0.22). Conclusions The study found no significant association between the nutritional status of patients and duration of heart failure. Therefore, monitoring nutritional status is crucial, irrespective of the duration of HF. It is necessary to analyse this issue in a larger group of patients with heart failure to identify specifically which patients are at risk of malnutrition and how nutritional status changes with the duration of the disease.

Enhancing transparency in public procurement: A data-driven analytics approach

Open data is a strategy used by governments to promote transparency and accountability in public procurement processes. To reap the benefits of open data, exploring and analyzing the data is necessary to gain meaningful insights into procurement practices. However, accessing, processing, and analyzing open data can be challenging for non-data-savvy users with domain expertise, creating a barrier to leveraging open procurement data. To address this issue, we present the design, development, and implementation of a visual analytics tool. This tool automates data extraction from multiple sources, performs data cleansing, standardization, and database processing, and generates meaningful visualizations to streamline public procurement analysis. In addition, the tool estimates and visualizes corruption risk indicators at different levels (e.g., regions or public entities), providing valuable insights into the integrity of the procurement process. Key contributions of this work include: (1) providing a comprehensive guide to the development of an open procurement data visualization tool; (2) proposing a data pipeline to support processing, corruption risk estimator and data visualization; (3) demonstrating through a case study how visual analytics can effectively use open data to generate insights that promote and enhance transparency.

Assessment of disease severity with magnetic resonance cholangiography in pediatric-onset primary sclerosing cholangitis.

Magnetic resonance cholangiopancreaticography (MRCP) has supplanted endoscopic retrograde cholangiopancreaticography (ERCP) as the preferred imaging modality for primary sclerosing cholangitis (PSC). However, data about the accuracy of MRCP in assessing disease severity are limited, particularly in children. We assessed the accuracy of MRCP in disease severity evaluation and investigated the correlation between imaging findings and biochemical parameters (including the multivariate risk index SCOPE) in patients with pediatric-onset PSC. We included 36 patients with PSC (median age: 16) who had MRCP and ERCP performed within 4-month intervals. Two experts, blinded to ERCP findings, evaluated the bile duct changes in consensus using the Modified Amsterdam PSC Score. The agreement between MRCP and ERCP evaluations was tested with weighted kappa statistics and the correlation between disease severity and biochemical parameters with Spearman's rank correlation. The agreement between MRCP and ERCP was good for extrahepatic (weighted kappa 0.69; 95% CI 0.53-0.84) but fair for intrahepatic (weighted kappa 0.35; 95% CI 0.14-0.56) bile ducts. Intrahepatic and extrahepatic MRCP scores correlated with APRI (ρ = 0.42, p = 0.020 and ρ = 0.39, p = 0.033, respectively), while extrahepatic MRCP score also correlated with biliary neutrophils (ρ = 0.36, p = 0.035). We found a good correlation between the SCOPE index and intrahepatic MRCP score (ρ = 0.53, p = 0.004), and extrahepatic MRCP score (ρ = 0.57, p = 0.001). MRCP is accurate at evaluating the severity of extrahepatic bile duct changes in pediatric-onset PSC but tends to underestimate intrahepatic changes. The SCOPE index's robust correlation with imaging scores supports its role as a comprehensive diagnostic tool, outperforming individual laboratory metrics.

Association between nutrition-related indicators with the risk of chronic obstructive pulmonary disease and all-cause mortality in the elderly population: evidence from NHANES.

This study aims to use six nutrition-related indicators to assess the relationship between nutritional status and the risk of COPD as well as the all-cause mortality rate, and to determine the most reliable predictive indicators. Data from the National Health and Nutrition Examination Survey (NHANES) spanning the years 2013 to 2018 were extracted. Nutritional status was evaluated using Controlling nutritional status (CONUT) score, Geriatric Nutritional Risk Index (GNRI), Advanced Lung Cancer Inflammation Index (ALI), Prognostic Nutritional Index (PNI), Triglycerides (TG) × Total Cholesterol (TC) × Body Weight (BW) Index (TCBI), and Albumin-to-Globulin Ratio (AGR) nutritional-related indicators. Multivariate weighted logistic and Cox regression models were employed to assess the correlation between the six nutritional-related indicators and the risk of COPD and as all-cause mortality. The restricted cubic spline tests were applied to explore potential nonlinear relationships, and ROC curves and C-index analyses were conducted to compare the predictive capabilities of different indicators. Stratified analysis and propensity score matching (PSM) to assess the robustness of the results. In this study, Lower ALI, lower GNRI, and higher CONUT scores were positively correlated with an increased risk of COPD (OR: 1.77, 95% CI: 1.10-2.84) (OR: 8.66, 95% CI: 2.95-25.5), and (OR: 5.11, 95% CI: 1.72-15.2), respectively. It was found that ALI and GNRI had a non-linear relationship with the risk of COPD. After propensity score matching (PSM), the associations between ALI, GNRI, CONUT scores, and COPD remained consistent. Lower ALI, PNI, and GNRI scores were positively associated with all-cause mortality in COPD patients (HR: 2.41, 95% CI: 1.10-5.27), (HR: 3.76, 95% CI: 1.89-7.48), and (HR: 4.55, 95% CI: 1.30-15.9), respectively, with GNRI displaying a non-linear relationship with all-cause mortality. ROC curve and C-index analyses indicated that ALI had the best predictive ability for both COPD risk and all-cause mortality. ALI, GNRI, and CONUT scores are correlated with the risk of COPD, while ALI, PNI, and GNRI scores are associated with all-cause mortality in COPD patients. Compared to other nutritional scores, ALI may provide more effective predictive value for both risk and all-cause mortality.

Contagious corporate reputation risk: Uncovering the pandemic's impact

Firms' Reputation Risk Index (RRI) co-move with their industry and local peers in the US market, suggesting that managers follow their industry and local peers to conduct ESG-related irresponsible activities. Moreover, the RRI co-movement with local peers is attenuated during the COVID-19 pandemic period, and the reduction is more significant in democratic states with stringent social distancing policies and in states with higher pandemic mortality rates. In contrast, the industry-level RRI co-movement is not significantly affected during the pandemic period. Our findings suggest that social interactions among local managers may be an essential driver for the regional RRI co-movement before the pandemic.

Impact on Glycemia Risk Index and other metrics in type 1 adult patients switching to Advanced Hybrid Closed-Loop systems: a one-year real-life experience

BackgroundAdvanced Hybrid Closed-Loop system (AHCL) has profoundly changed type 1 diabetes therapy. This study primarily aimed to assess the impact on Glycemia Risk Index (GRI) and other continuous glucose monitoring (CGM) metrics when switching from one of four insulin strategies to AHCL in type 1 adult patients.MethodsA single-center, retrospective pre/post observational study; 198 patients (age 44.4 ± 12.7 years, 115 females/83 males, diabetes duration 24.7 ± 11.6 years, HbA1c 7.4 ± 1%), treated with different insulin therapies (MDI, CSII, SAP with PLGS, HCL) were assessed before and after switching to an AHCL (MiniMed 780G, Diabeloop Roche, Tandem Control-IQ) at 1, 3, 6, and 12 months. Mixed-effects multivariable regression models were used to estimate the mean pre/post variations at different time points, adjusted for potential confounders.ResultsA month after the switch, there was an improvement in CGM metrics and HbA1c for all patients: GRI −10.7, GMI −0.27%, CV −2.1%, TAR>250 −3.7%, TAR180-250 −5.6%, TIR + 9.7%, HbA1c −0.54% (all p < 0.001). This improvement was maintained throughout the observational period (at 3, 6, and 12 months, with all p-values < 0.001). When improvements across the 780, Diabeloop, and Tandem CIQ devices were compared: Diabeloop demonstrated significantly better performance in terms of GRI, GMI, CV, TAR>250 at T1 (for all p < 0.01); 780 recorded highest average decrease in TAR180-250 (p = 0.020), while Tandem achieved the most significant reduction in TBR54-69 (p = 0.004).ConclusionsAdopting an AHCL leads to a rapid and sustained improvement in GRI and other parameters of metabolic control for up to a year, regardless of prior insulin therapies, baseline conditions or brands.

Evaluation of time in tight range and the glycaemia risk index in adults with type 1 diabetes using an advanced hybrid closed loop system: A 1-year real-world assessment.

To assess the long-term glycaemic outcomes, with additional metrics, in adults with type 1 diabetes (T1D) using the Tandem t:slim X2 with Control-IQ technology advanced hybrid closed-loop (AHCL) system. This was a single-centre, retrospective study involving 56 T1D patients who transitioned to the Tandem t:slim X2 with Control-IQ system. The primary and secondary endpoints consisted of variations in time in tight range (TiTR; 70-140 mg/dL) and the glycaemia risk index (GRI), respectively. Additional standardized continuous glucose monitoring (CGM) metrics, mean sensor glucose, coefficient of variation, the glucose management indicator (GMI), HbA1c and insulin daily dose, were also evaluated. Variables were measured at baseline and at 15 days, 3 months, 6 months and 1 year after Tandem t:slim X2 Control-IQ initiation. Glucose outcomes are expressed as mean (standard deviation). Use of Tandem t:slim X2 with Control-IQ over 1 year was associated with an increase in mean TiTR, from 38.11% (17.05%) to 43.10% (13.20%) (P = .059), and with a decline in the GRI, from 41.03 (25.48) to 28.55 (16.27) (P = .008). CGM metrics, including time in range and time above range, showed consistent improvements. Mean sensor glucose, the GMI and HbA1c decreased significantly over time. After an initial increase, insulin daily dose remained stable throughout the 12 months. The results highlight the sustained effectiveness of Tandem t:slim X2 with Control-IQ in improving glycaemic outcomes over 1 year and support the use of this technology for the management of T1D.