Simple Index Research Articles

A Novel Inflammatory Indicator for Tuberculosis-Associated Obstructive Pulmonary Disease (TOPD): The Systemic Inflammatory Response Index (SIRI).

The development of chronic obstructive pulmonary disease (COPD) following tuberculosis (TB) is known as tuberculosis-associated obstructive pulmonary disease (TOPD). This study aimed to explore the predictive value of inflammatory indicators for TOPD in TB patients. Data for this cross-sectional study were collected between January 2014 and January 2022 at Wuhan Jinyintan Hospital. The ratio of inflammatory indicators, including Systemic Inflammatory Response Index (SIRI), C-reactive protein-to-lymphocyte ratio (CLR), eosinophil count-to-lymphocyte count ratio (ELR), were calculated. Univariate and multivariate logistic regression analyses were conducted to explore the association between the ratio of inflammatory indicators and TOPD. Furthermore, the relationship between the ratio of inflammatory indicators and TOPD was investigated using propensity score matching (PSM) and receiver operating characteristic (ROC) curve analysis was performed to evaluate their predictive value for TOPD. The present study included a total of 737 patients, of whom 83 participants (11.26%) had TOPD. Sixty-nine TOPD patients and 69 non-TOPD (NTOPD) patients were successfully matched. Univariate and multivariable logistics regression analysis, conducted before and after PSM, revealed that SIRI was independently significantly associated with an increased risk of TOPD. The area under curve (AUC) of SIRI were 0.702 and 0.668 before and after PSM, respectively. Additionally, patients were stratified into four different groups based on SIRI quartiles for further analysis. The prevalence of TOPD in TB patients showed an increase with higher SIRI values, both before and after PSM. Levels of inflammatory indicators were higher in TOPD patients when compared to NTOPD patients. SIRI may be a simple and useful inflammatory index for assessing TOPD, and TB patients with higher values of SIRI are more likely to be high-risk group for TOPD.

The association between systemic immune inflammation index and disease activity in patients with rheumatoid arthritis

Background. Novel blood-derived indices are a potential substitute for traditional inflammatory markers which have disputable correlations and clinical applications in different immunological diseases. Hereby, we aimed to reveal the association of neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and systemic immune-inflammation index (SII) with disease activity score (DAS28) and clinically active disease according to simple disease activity index (SDAI). Methods. We included 250 patients and they were grouped equally based on SDAI into two groups of patients in remission and with active disease. A blood sample was drawn from our patients to measure NLR, PLR, SII, rheumatoid factor, erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP). Independent samples t-tests, chi-square, and Mann-Whitney U test were used accordingly. Logistic regression evaluated the factors that affect active RA. Results. PLR, DAS28, rheumatoid factor, quantitative and qualitative ESR and CRP had a significant difference between patients with active RA and in remission. SII had significant correlation with DAS28 but PLR and NLR were not correlated with DAS28. Also, PLR was the only index to be correlated with clinically active disease based on SDAI. The logistic regression showed that NLR, SII, ESR, and CRP were independent factors predicting active RA. Conclusion. We demonstrated that SII was significantly correlated with DAS28 and PLR was correlated with active RA. NLR, SII, CRP, and ESR were independent risk factors for RA flare-ups.

Bioindicators for Assessing Soil Quality in Ecuador’s Jun Jun Micro-Watershed

The evaluation of soil quality in different altitudinal gradients, with vegetative and non-vegetative subareas, is crucial for proper soil functioning and optimal crop growth, thus contributing to the sustainability of agroecosystems. Although the altitudinal gradient significantly influences soil quality, the ability to predict this quality, expressed through an index, in soils with and without vegetative cover, is still insufficiently explored. This study employed the simple additive index (SQI) method to evaluate soil quality in Ecuador’s Jun Jun micro-watershed, Tungurahua region. Three altitude categories (<2800, 2800–2900, >2900 masl) were investigated, with 24 soil samples collected across both vegetated and non-vegetated areas. The indicators used included chemical and biological parameters such as soil organic carbon (OC), earthworm density (WD), earthworm biomass (WB), organic matter (OM), pH, and total nitrogen (TN). The results revealed that in areas with altitudinal gradients below 2800 masl, the soil quality index values were higher compared to other altitudes. In vegetated areas, a decrease in index values was observed as the altitudinal gradient increased, indicating a deterioration in soil quality with increasing altitude. These findings are significant in providing a quantitative assessment of the effects of altitudinal gradient and vegetative cover influence on soil quality.

A Phanerozoic gridded dataset for palaeogeographic reconstructions

Global Plate Models are widely used in the Earth Sciences to reconstruct the past geographic position of geological and palaeontological samples. However, the application of Global Plate Models to retrieve ‘palaeocoordinates’ is not trivial. Different Global Plate Models exist which vary in their complexity, spatiotemporal coverage, reference frame, and intended use. Consequently, careful consideration of which models are appropriate for any given research question is required. Here, we document and provide access to reconstruction datasets for five Global Plate Models in the palaeomagnetic reference frame. These datasets provide ‘true’ palaeolatitudes for three discrete global grids reconstructed at one-million-year intervals throughout the Phanerozoic (540–0 Ma), offering three key benefits for the Earth Science community: (1) allow users to look up palaeocoordinates for their samples (e.g. fossil occurrences) through simple indexing without having to learn additional software packages; (2) provide palaeocoordinates which have been generated consistently with thorough documentation; (3) provide static files which preserve model output and which can be used to evaluate palaeogeographic differences between Global Plate Models.

Hyperspectral Reflectance-Based High Throughput Phenotyping to Assess Water-Use Efficiency in Cotton

Cotton is a pivotal global commodity underscored by its economic value and widespread use. In the face of climate change, breeding resilient cultivars for variable environmental conditions becomes increasingly essential. However, the process of phenotyping, crucial to breeding programs, is often viewed as a bottleneck due to the inefficiency of traditional, low-throughput methods. To address this limitation, this study utilizes hyperspectral remote sensing, a promising tool for assessing crucial crop traits across forty cotton varieties. The results from this study demonstrated the effectiveness of four vegetation indices (VIs) in evaluating these varieties for water-use efficiency (WUE). The prediction accuracy for WUE through VIs such as the simple ratio water index (SRWI) and normalized difference water index (NDWI) was higher (up to R2 = 0.66), enabling better detection of phenotypic variations (P < 0.05) among the varieties compared to physiological-related traits (from R2 = 0.21 to R2= 0.42), with high repeatability and a low RMSE. These VIs also showed high Pearson correlations with WUE (up to r = 0.81) and yield-related traits (up to r = 0.63). We also selected high-performing varieties based on the VIs, WUE, and fiber quality traits. This study demonstrated that the hyperspectral-based proximal sensing approach helps rapidly assess the in-season performance of varieties for imperative traits and aids in precise breeding decisions.

IMHB-Mediated Chameleonicity in Drug Design: A Focus on Structurally Related PROTACs.

Molecular chameleonicity may enable compounds to compensate for the unfavorable ADME properties typically associated with complex molecules, such as PROTACs. Here we present a few in silico strategies to implement chameleonicity considerations in drug design. Initially, we identified six structurally related CRBN-based PROTACs targeting BET proteins and experimentally verified whether chameleonicity is needed to obtain an acceptable physicochemical profile. Then, we utilized experimental data to validate our novel computational strategies based on tools crafted to encompass a spectrum of complexities and innovative features. After confirming that the formation of IMHBs is the primary driving factor behind chameleonicity, we initially utilized conformational sampling data to define cChameCS, an IMHB-mediated, simple, and rapid chameleonicity predictor index suitable for early drug discovery. Subsequently, we identified dynamic IMHB patterns relevant to chameleonicity through molecular dynamics simulations. Finally, we proposed a workflow for designing structurally related chameleonic PROTACs of potential application in the lead optimization process.

Oral Hygiene Profile of Schoolchildren from Bucharest, Romania-How It Can Be Used and Improved for Better Prevention of Oral Diseases.

Oral hygiene is essential for low caries or gingivitis prevalence in children. This study aimed to determine the oral hygiene profile of children from secondary schools (10-17 years) in Bucharest, Romania, and to explore options for preventing their future oral diseases. The study was cross-sectional, with a sample of n = 1595 pupils. The sample was stratified by clusters in city areas, grades, and the criterion of the presence/absence of in-school dental service. Dental check-ups were performed by using a commune dental examination kit. The oral hygiene simplified index (OHI; Silness and Löe) was used to assess the children's oral hygiene status. Five questions were used to determine oral hygiene habits. The mean value of the OHI was 1.04. Some differences in oral hygiene scores were found for different socioeconomic variables, such as parents' education (p < 0.05): parents with vs. without a university degree-0.95/0.94 (male/female) vs. 1.06. Most of the children used manual toothbrushes (88%). The analysis of objective data (OHI) revealed a good level of oral hygiene, with many socioeconomic disparities.

Oral health status and oral habits: A study on 33 rare diseases

Objectives: To analyze the patient profile and characterize the oral health status, oral habits, and daily oral hygiene difficulties of individuals with rare diseases. Methods: Data were collected from records of the clinic for people with disabilities at the Faculdade de Medicina Dentária da Universidade de Lisboa, using the Decayed, Missing, and Filled Teeth index, the simplified debris index, and the bleeding index. Results: The sample comprised 64 individuals with 33 different rare diseases, with a mean age of 31.5(±10.29) years, predominantly male (54.7%). Most could move without difficulty (51.6%), required assistance in activities of daily living (60.9%), and were cooperative in oral hygiene (54.7%). Also, 40.6% could not communicate. Half of the sample brushed their teeth twice a day, with 18.8% being independent in this activity, and the most common toothbrushing difficulty was not being able to rinse (53.1%). The Decayed, Missing, and Filled Teeth index was 8.81 (±7.54), with a higher number of filled teeth (4.47; ±5.35). The bleeding index had a mean of 1.23 (±0.56), and the simplified debris index had a mean value of 1.62 (±0.78). Conclusions: The population studied expresses care for oral health and treatment.

Extreme climate events and future population exposure under climate change in the Huaihe River basin of China based on CMIP6 multimodel ensembles projections

AbstractThe Huaihe River basin (HRB) of China located in the climate transition zone between warm temperate and subtropical areas is highly sensitive to climatic change. However, the changes in future climate extreme events under anthropogenic warming and the population exposure to these climate extremes in HRB remain unexplored. Here, using the eight commonly used extreme climate indices and based on the bias‐corrections of 16 global climate models (GCMs) in CMIP6, we present a projection and uncertainty analysis of extreme events and investigate the corresponding population exposure risk in HRB under three shared socioeconomic pathways (SSP1‐2.6, SSP2‐4.5, SSP5‐8.5). The 16‐GCM ensemble mean projects an evident warming trend under all three scenarios with a total increase of 25.6–68.0 days in summer days (&gt;25°C) by the end of the century in HRB. Larger increases (decreases) in maximum and minimum temperatures (frost days) are projected in the western HRB. Very heavy rain days (R20mm), maximum 5‐day precipitation (RX5day) and simple daily intensity index (SDII) will experience intensification across most of HRB (especially in southern and western HRB). The consecutive dry days is projected to decrease in northwestern HRB and increase in southern HRB. However, there is a large spatial variability in GCM uncertainty with a higher SSP scenario generally having higher uncertainty. Increases in summer days and R20mm exacerbate population exposure in HRB in near future (2030–2059), but in far future (2070–2099) although summer days (R20mm) continues to rise, population exposure is expected to decrease due to the rapid decline in population density.

The difference in the uncertainty sources between future projections of mean and extreme precipitation over East Asia

As the incidence of extreme precipitation events attributable to global climate change increases, providing policymakers with accurate model predictions is of the utmost importance. However, model projections have inherent uncertainties. The present study attempted to distinguish the sources of the uncertainty of the mean and extreme precipitation projections in the East Asia region using the mean boreal summer precipitation, simple precipitation intensity index (SDII), maximum cumulative 5 day precipitation, and annual maximum daily precipitation (Rx1d). The results show that while the mean precipitation was projected to change very little regardless of the scenario, more extreme indices were projected to increase considerably by the end of the century, particularly in the high-emissions scenarios. On average, model uncertainty accounted for the largest part of the uncertainty. However, for Rx1d in the 2030s, as well as mean and SDII in some regions until the 2060s, the internal variability was the largest contributor. In addition, whilst scenario uncertainty accounted for a negligible proportion of average precipitation variability, for the more extreme the precipitation indices, scenario uncertainty contribution to total variability by the end of the century was significant; namely, the scenario uncertainty contribution was overall highest for the maximum one-day precipitation. Additionally, comparatively wetter regions had greater overall projection uncertainties, especially uncertainty arising from internal variability, likely due to the influence of interannual variability from the EA summer monsoon.

A prediction model for prehospital clinical deterioration: The use of early warning scores.

Various prognosticative approaches to assist in recognizing clinical deterioration have been proposed. To date, early warning scores (EWSs) have been evaluated in hospital with limited research investigating their suitability in the prehospital setting. This study evaluated the predictive ability of established EWSs and other clinical factors for prehospital clinical deterioration. A retrospective cohort study investigating adult patients of all etiologies attended by Queensland Ambulance Service paramedics between January 1, 2018, and December 31, 2020, was conducted. With logistic regression, several models were developed to predict adverse event outcomes. The National Early Warning Score (NEWS), Modified Early Warning Score (MEWS), Queensland Adult Deterioration Detection System (Q-ADDS), and shock index were calculated from vital signs taken by paramedics. A total of 1,422,046 incidents met the inclusion criteria. NEWS, MEWS, and Q-ADDS were found to have comparably high predictive ability with area under the receiver operating characteristic curve (AUC-ROC) between 70% and 90%, whereas shock index had relatively low AUC-ROC. Sensitivity was lower than specificity for all models. Although established EWSs performed well when predicting adverse events, these scores require complex calculations requiring multiple vital signs that may not be suitable for the prehospital setting. This study found NEWS, MEWS, and Q-ADDS all performed well in the prehospital setting. Although a simple shock index is easier for paramedics to use in the prehospital environment, it did not perform comparably to established EWSs. Further research is required to develop suitably performing parsimonious solutions until established EWSs are integrated into technological solutions to be used by prehospital clinicians in real time.

Decreased Hepatic Functional Reserve Increases the Risk of Piperacillin/Tazobactam-Induced Abnormal Liver Enzyme Levels: A Retrospective Case-Control Study.

Piperacillin/tazobactam (PIPC/TAZ), which is a combination of a beta-lactam/beta-lactamase inhibitor, often causes liver enzyme abnormalities. The albumin-bilirubin (ALBI) score is a simple index that uses the serum albumin and total bilirubin levels for estimating hepatic functional reserve. Although patients with low hepatic reserve may be at high risk for drug-induced liver enzyme abnormalities, the relationship between PIPC/TAZ-induced abnormal liver enzymes levels and the ALBI score remains unknown. This study aimed to elucidate the relationship between PIPC/TAZ-induced abnormal liver enzyme levels and the ALBI score. This single-center retrospective case-control study included 335 patients. The primary outcome was PIPC/TAZ-induced abnormal liver enzyme levels. We performed COX regression analysis with male gender, age (≥75 years), alanine aminotransferase level (≥20 IU/L), and ALBI score (≥-2.00) as explanatory factors. To investigate the influence of the ALBI score on the development of abnormal liver enzyme levels, 1:1 propensity score matching between the ≤-2.00 and ≥-2.00 ALBI score groups was performed using the risk factors for drug-induced abnormal liver enzyme levels. The incidence of abnormal liver enzyme levels was 14.0% (47/335). COX regression analysis revealed that an ALBI score ≥-2.00 was an independent risk factor for PIPC/TAZ-induced abnormal liver enzyme levels (adjusted hazard ratio: 3.08, 95% coefficient interval: 1.207-7.835, P = 0.019). After 1:1 propensity score matching, the Kaplan-Meier curve revealed that the cumulative risk for PIPC/TAZ-induced abnormal liver enzyme levels was significantly higher in the ALBI score ≥-2.00 group (n = 76) than in the <-2.00 group (n = 76) (P = 0.033). An ALBI score ≥-2.00 may predict the development of PIPC/TAZ-induced abnormal liver enzyme levels. Therefore, frequent monitoring of liver enzymes should be conducted to minimize the risk of severe PIPC/TAZ-induced abnormal liver enzyme levels in patients with low hepatic functional reserve.

A New Formula Based on Simple Blood Indices to Differentiate Beta Thalassemia Trait from Iron Deficiency Anemia.

Thalassemia is an inherited blood disorder with a defect in the sufficient production of a protein called hemoglobin. We aimed to investigate the simple blood indices of patients with Beta Thalassemia Trait (BTT) and Iron Deficiency Anemia (IDA) to propose a new formula using logistic regression for differentiate two characteristics from each other. Among the 702 records of the BTT Counseling Center (Khoy, Iran-2022), 292 cases (219 iron deficiency anemia (IDA) and 73 BTT) were eligible for the study. Blood indices such as RBC, HGB, HbA2 described and used to diagnose two types of participants. Blood indices had high multicollinearity that was modified. Logistic regression for blood indices fitted and goodness of fit indices with Area Under ROC curve (AUC) estimated. The average age of the participants was 24.56 yr. The status of Multicollinearity between independent variables was modified. The HGB, MCV, HbA2, and HbA variables were used in the model and only HbA2 status was significant (P<0.001). According to the output of the model, for each unit increase in HbA2, the chance of having BTT was about 8.5 times higher than IDA. The sensitivity, specificity, AUC curve, and accuracy of the final model were estimated to be 97, 72, 84, and 93%, respectively. A regression formula to differentiate BTT from IDA proposed. In studies related to the differentiation of the BTT from IDA, the presence of the HbA2 index in the model and prediction is very necessary.

Relationship of immature granulocytes with disease activity in rheumatoid arthritis.

To determine whether the IG count (#) and IG percentage (%) are associated with disease activity in rheumatoid arthritis (RA). This retrospective study included 65 RA patients and 65 healthy controls. Clinical and demographic characteristics of controls and RA patients (at active period and when the patients achieved remission) were obtained from medical records. Disease activity was defined by disease activity score 28 (DAS28). Furthermore, the clinical disease activity index (CDAI), and simple disease activity index (SDAI) were calculated. For the differential diagnosis of RA patients from healthy controls, the cut-off value was estimated by making receiver-operator curves (ROC). In active RA patients, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), IG#, and IG% levels were significantly higher compared to the healthy controls (p < .001, for all). When the patients achieved remission, DAS28, CDAI, SDAI, ESR, CRP, IG#, and IG% values were significantly decreased (p < .001, for all). IG# and IG% were significantly positively correlated with DAS28, CDAI, SDAI, ESR, and CRP (p = .024, p = .008, p = .003, p < .001, p < .001, respectively). According to ROC curve analysis, IG% and IG# were the biomarkers to have a significant diagnostic value for RA with the area under the curve of 0.853 and 0.865 (p < .001, for all). The present study demonstrated that two novel inflammatory markers, IG# and IG%, can be useful for monitoring RA patients' disease activity. Furthermore, IG# and IG% can also be used as fast, inexpensive, and easily available complementary diagnostic markers to diagnose RA patients.

CLINICAL AND MORPHOLOGICAL ASSESSMENT OF THE EFFECTIVENESS OF THE APPLICATION INNOVATIVE THERAPEUTIC AND PROPHYLACTIC TOOTHPASTE IN THE COMPLEX TREATMENT OF PATIENTS WITH MAJOR DENTAL DISEASES

The social and economic development of a society is largely determined by the level of health of its young population. The objective of this study was to increase the effectiveness of preventive and comprehensive treatment of young patients with major dental diseases using an innovative therapeutic and preventive toothpaste based on organic gel. A group of 32 volunteers participated in the study. All patients underwent a complex dental examination that included basic and additional methods (determination of indices of caries intensity, indicators of oral hygiene (simple hygiene index OHI-S, Silnes-Low index), evaluation of periodontal tissue status (papillary-limbal alveolar abscess index PMA, gingival bleeding in inflammatory periodontal disease index BI Müllmann), evaluation of pain (hypersensitivity) to stimuli using a visual analog scale (VAS), measurement of the electrical conductivity of tooth enamel using the Dentest electrodiagnostic device (ZAO Geosoftident), clinical evaluation of enamel remineralization rate, spectrophotometer "VITA (Easy Shade) (VITA) to evaluate tooth discoloration, oral fluid immunoassay, and cytomorphometric studies of the buccal epithelium. The results of the clinical trials showed that the therapeutic and prophylactic toothpaste has excellent consumer characteristics, has no allergic or local irritant effects on the oral mucosa, improves the natural protection of the oral cavity, effectively cleans up to 100% of the oral cavity, provides anti-inflammatory effects, eliminates gum swelling and bleeding from the first use, reduces tooth sensitivity, reduces tooth enamel structure, and was shown to have no toxic effect on the cells of the buccal epithelium. The results of the clinical trial suggest that the innovative therapeutic and prophylactic dentifrice can be recommended for daily use in a wide range of individuals, as well as in patients with low tooth enamel resistance, various periodontal diseases, and oral mucosa.

Exosomal MicroRNAs: Biomarkers of moyamoya disease and involvement in vascular cytoskeleton reconstruction

Moyamoya disease currently lacks a suitable method for early clinical screening.This study aimed to identify a simple and feasible clinical screening index by investigating microRNAs carried by peripheral blood exosomes. Experimental subjects participated in venous blood collection, and exosomes were isolated using Exquick-related technology. Sequencing was performed on the extracted exosomal ribonucleic acids (RNAs) to identify differential microRNAs. Verification of the results involved selecting relevant samples from the genetic database. The study successfully pinpointed a potential marker for early screening, hsa-miR-328-3p + hsa-miR-200c-3p carried by peripheral blood exosomes. Enrichment analysis of target genes revealed associations with intercellular junctions, impaired cytoskeletal regulation, and increased fibroblast proliferation, leading to bilateral internal carotid artery neointimal expansion and progressive stenosis. These findings establish the diagnostic value of hsa-miR-328-3p+hsa-miR-200c-3p in screening moyamoya disease, while also contributing to a deeper understanding of its underlying pathophysiology. Significant differences in microRNA expressions derived from peripheral blood exosomes were observed between moyamoya disease patients and control subjects. Consequently, the utilization of peripheral blood exosomes, specifically hsa-miR-328-3p + hsa-miR-200c-3p, holds potential for diagnostic screening purposes.

The relationship between body roundness index and depression: A cross-sectional study using data from the National Health and Nutrition Examination Survey (NHANES) 2011–2018

BackgroundDepression is linked to obesity. The body roundness index (BRI) provides a more accurate assessment of body and visceral fat levels than the body mass index or waist circumference. However, the association between BRI and depression is unclear. Therefore, we investigated this relationship using the National Health and Nutrition Examination Survey (NHANES) database. MethodsIn this population-based cross-sectional study, data from 18,654 adults aged ≥20 years from the NHANES 2011–2018 were analyzed. Covariates, including age, gender, race/ethnicity, education level, marital status, poverty-income ratio, alcohol status, smoking status, hypertension, diabetes mellitus, cardiovascular disease, energy intake, physical activity, total cholesterol, and triglycerides were adjusted in multivariable logistic regression models. In addition, smooth curve fitting, subgroup analysis, and interaction testing were conducted. ResultsAfter adjusting for covariates, BRI was positively correlated with depression. For each one-unit increase in BRI, the prevalence of depression increased by 8 % (odds ratio = 1.08, 95 % confidence interval = 1.05–1.10, P < 0.001). LimitationsAs this was a cross-sectional study, we could not determine a causal relationship between BRI and depression. Patients with depression in this study were not clinically diagnosed with major depressive disorder. ConclusionBRI levels were positively related to an increased prevalence of depression in American adults. BRI may serve as a simple anthropometric index to predict depression.

The use of an anterior-posterior atrophy index to distinguish Alzheimer's disease from frontotemporal disorders: an automated volumetric MRI Study.

Alzheimer's disease (AD) and frontotemporal dementia (FTD) require different treatments. Since clinical presentation can be nuanced, imaging biomarkers aid in diagnosis. Automated software such as Neuroreader (NR) provides volumetric imaging data, and indices between anterior and posterior brain areas have proven useful in distinguishing dementia subtypes in research cohorts. Existing indices are complex and require further validation in clinical settings. To provide initial validation for a simplified anterior-posterior index (API) from NR in distinguishing FTD and AD in a clinical cohort. A retrospective chart review was completed. We derived a simplified API: API = (logVA/VP-μ)/σ where is weighted volume of frontal and temporal lobes and of parietal and occipital lobes. and are the mean and standard deviation of logVA/VP computed for AD participants. Receiver operating characteristic (ROC) curves and regression analyses assessed the efficacy of the API versus brain areas in predicting diagnosis of AD versus FTD. A total of 39 participants with FTD and 78 participants with AD were included. The API had an excellent performance in distinguishing AD from FTD with an area under the ROC curve of 0.82 and a positive association with diagnostic classification on logistic regression analysis (B = 1.491, P < 0.001). The API successfully distinguished AD and FTD with excellent performance. The results provide preliminary validation of the API in a clinical setting.

#2528 Comparing patient-reported and performance-based physical function assessments in hemodialysis: insights from the CONVINCE trial

Abstract Background and Aims Physical function is a crucial outcome in nephrology. In alignment with the Patient-Reported Outcomes Measurement Information System (PROMIS) Initiative, physical function is characterized as the ability to execute activities involving physical actions, ranging from self-care to more complex activities, such as social activities. This definition of physical function spans various domains of the International Classification of Functioning, Health, and Disability (ICF). The assessment of physical function commonly employs two distinct approaches, patient-reported outcomes (PRO) and observed performance outcomes (PerfO). PRO and PerfO assessments have distinct advantages and limitations and were found to correlate only moderately, adding complexity to cross-instrument outcome comparisons and interpretation. Despite this, there is limited understanding of the factors contributing to the discordance between PRO and PerfO assessments in patients with kidney disease. In this study, we applied a previously established common T-score metric for patient-reported and performance-based physical function to compare patterns of associations with potential laboratory-based, psychosocial, sociodemographic, and health-related determinants in hemodialysis patients. Method Cross-sectional data from the baseline assessment of the CONVINCE trial (N = 1,132), a multinational randomized controlled trial comparing high-dose hemodiafiltration with high-flux hemodialysis, were analysed. To investigate the relationships between potential determinants and performance-based versus patient-reported physical function, we performed multiple linear regression analysis. Dependent variables were standardized T-scores derived from the PROMIS physical function short-form 4a (PRO) and the Physical Performance Test (PerfO). Both measures assess a generic concept of physical function. We compared the effect sizes of each potential determinant in the multiple regression model using partial f2 values, with thresholds of 0.02, 0.15, and 0.35 denoting small, medium, and large effects. Results Both, PerfO and PRO exhibited significant associations with a laboratory marker-based indicator of muscle mass (simplified creatinine index), albeit with relatively small effects (partial f² of 0.04 and 0.05, respectively). None of the other laboratory measures investigated in this study showed any relevant associations with physical functioning. Age demonstrated a negative association with physical function, with a larger effect size observed for performance-based (partial f² = 0.11) compared to patient-reported physical function (partial f² = 0.04). In contrast to performance-based physical function, patient-reported physical function displayed a stronger association with self-reported health domains, particularly pain interference and fatigue. Exploring the differences between patient-reported and performance-based T-scores at the individual level, we found that younger age and more cognitive/emotional fatigue were associated with lower patient-reported compared to performance-based physical function (small effect sizes). Conclusion PRO and PerfO assessments of physical function in hemodialysis patients had similar associations with the simplified creatinine index, suggesting comparable links to objective physical impairment. However, PRO-based physical function exhibited a notably stronger association with other patient-reported variables, suggesting that patient-reported constructs of physical function might represent more than just capability, but ‘capability free from symptomatic constraints’. This distinction should be taken into account when directly comparing or aggregating PRO and PerfO scores. A noteworthy aspect of our study is the utilization of a common T-score metric for both PRO and PerfO measures. This method enhances interpretability of results and facilitates comparisons across diverse assessment types, thereby offering valuable insights into the determinants of physical function in patients undergoing hemodialysis.

The prognostic value of immune-nutritional status in metastatic colorectal cancer: Prognostic Nutritional Index (PNI)

Backround and purposeA low Prognostic Nutritional Index (PNI) value, which reflects immune nutrition and inflammation around the tumor, is associated with an unfavorable prognosis, and it was aimed to reveal its prognostic value in metastatic colorectal cancer (CRC).MethodsIn our retrospective cross-sectional study, patients with a diagnosis of metastatic colorectal disease without active infection, between January 2010 and December 2016 were included. The PNI values at the time of diagnosis were calculated according to the formula (10 × serum albumin (g/dL)) + (0.005 × total lymphocyte value).ResultsThe mean PNI value of 253 patients included in the study was 46.6. While 53.75% (n = 136) of the patients had a PNI value of 46.6 and above, 46.25% (n = 117) had a PNI value below 46.6. The overall survival (OS) of the group with a PNI of 46.6 and above was statistically significantly longer (53.06 months vs 38.80 months, p = 0.039). The PFS duration of the group with PNI below 46.6 was 25.66 months, while the PFS duration of the group with PNI above 46.6 was not reached (p = 0.265).ConclusionPNI is a simple and inexpensive index that evaluates the immunonutritional status, and it is a prognostic marker that can be easily used in patients with metastatic colorectal cancer as in other cancer types.