Simple Indicator Research Articles

The Respiratory Adjusted Shock Index at Admission Is a Valuable Predictor of In-Hospital Outcomes for Elderly Emergency Patients with Medical Diseases at a Japanese Community General Hospital.

Background: The respiratory adjusted shock index (RASI) is a risk score whose usefulness in patients with sepsis and trauma has previously been reported. However, its relevance in elderly emergency patients with medical diseases is yet to be clarified. This study assessed the usefulness of the RASI, which can be evaluated without requiring special equipment, to provide objective and rapid emergency responses. Methods: In this retrospective study, we recruited patients with medical diseases, aged 65 years or older, who were transported to the emergency room from Tokushima Prefectural Kaifu Hospital and underwent arterial blood gas testing from 1 January 2022 to 31 December 2023. We investigated the association of the RASI with other indices, including the lactate level, National Early Warning Score 2 (NEWS2), Shock Index (SI), Sequential Organ Failure Assessment (SOFA) score, quick SOFA (qSOFA) score, and systemic inflammatory response syndrome (SIRS). Results: In this study, we included 260 patients (mean age, 86 years), of whom 234 were admitted to the hospital; 27 and 49 patients died within 7 and 30 days of admission, respectively. The RASI was positively correlated with the lactate level, NEWS2, SI, and increase in the SOFA score (p < 0.001). The RASI was higher in patients with a SIRS or qSOFA score ≥ 2 than in those without (p < 0.001). It predicted death within 7 and 30 days of admission with an area under the curve (AUC) of 0.80 (95% confidence interval [CI]: 0.73-0.87), sensitivity of 96.3%, and specificity of 53.6% when the cutoff value was set to 1.58 and with an AUC of 0.73 (95% CI: 0.66-0.81), sensitivity of 69.4%, and specificity of 70.6% when the cutoff value was set to 1.83, respectively. Conclusions: The RASI is a simple indicator that can be used for predicting in-hospital outcomes in elderly emergency patients with medical diseases. Larger prospective studies based on this study are needed.

Association between triglyceride-glucose index and hypertension: A systematic review and meta-analysis.

The triglyceride-glucose (TyG) index is a simple and reliable indicator of insulin resistance, which is an important contributor to the development of hypertension. The aim of this meta-analysis was to determine the dose-response association between the TyG index and the incidence of hypertension. An extensive search was conducted through several databases, including PubMed, EMBASE, ScienceDirect, and Scopus, until June 1, 2024. The TyG index was used as the exposure, and the incidence of hypertension was measured throughout the TyG index intervals. The effect estimates were presented as odds ratios (OR) in both the unadjusted and adjusted models. Adjusted OR were carried out from all included studies to eliminate the possibility of confounding factors being involved in the incidence of hypertension. A total of 108.936 participants (mean age: 48.2 years old, male: 47%, mean body mass index: 23.9 kg/m2) from 14 observational studies were included. The TyG index in the most eminent category was related to a higher risk of hypertension in both unadjusted (OR: 2.59, 95%CI: 2.03-3.31, p<0.001; I2: 97.1%, p<0.001) and adjusted model (OR: 1.74, 95%CI: 1.39-2.19, p<0.001; I2: 92.2%, p<0.001). The dose-response meta-analysis for the adjusted OR showed that the linear association analysis was not significant per 0.1 increase in the TyG index. The dose-response curve became increasingly steeper at the TyG index above 8.5. In conclusion, the TyG index was shown to be strongly linked with hypertension in a non-linear dose-response manner.

Prognostic value and therapeutic response of neutrophil-to-lymphocyte ratio in penile cancer.

116 Background: Chronic inflammation mediated by poor genital hygiene is a well-recognized pathogenic trigger for penile squamous cell carcinoma (PSCC). The neutrophil-to-lymphocyte ratio (NLR) is a simple and reproducible factor reflecting the systemic inflammatory response and has been reported as an unfavorable indicator in PSCC. However, previous studies limited by small sample sizes, confounding prognostic features and without high-quality evidence to demonstrate the clinical significance of the NLR. Methods: A large cohort of 582 penile cancer patients who underwent radical inguinal lymphadenectomy with definitive pN stages were enrolled in this study. Univariate and multivariate Cox regression analyses were performed to investigate prognostic factors and inflammation-related markers in PSCC patients. More importantly, the propensity score matching (PSM) method was used to minimize the prognostic confounding clinicopathological features. Immunofluorescence was further used to investigate the correlation between tumor-infiltrating neutrophils, CD8+ T cells and the NLR. Results: According to the ROC curve, the optimal cutoff value for the NLR was 3.0, and 226 (38.8%) PSCC patients had a high NLR. Survival analyses indicated that advanced pT, pN, pathological grade, lymphovascular invasion, high NLR, C-reactive protein (≥ 2.2 mg/L) and serum amyloid A (≥ 11.3 mg/L) were associated with poor PFS and CSS. After PSM to eliminate interference from clinical factors, pN and the NLR were found to be independent prognostic indicators in PSCC patients (both p&lt;0.001). Cox multivariate regression analysis revealed that the HR for PFS was 1.64 (1.15–2.34) in the high NLR group and 1.56 (1.04–2.34) in the high NLR group (p=0.006 and 0.030, respectively). PSCC patients with high NLRs experienced shorter PFS after receiving cisplatin-based chemotherapy (p=0.037) and PD-1 immunotherapy (p=0.020). In addition, we found that the infiltration of tumor-associated neutrophils (CD66+) and the CD8+ T-cell ratio were positively correlated with the NLR. The development and formation of neutrophil extracellular traps (NETs) might contribute to chemoresistance and tumor progression in high-NLR PSCC patients. Conclusions: In this study, we demonstrated that the NLR is an effective, simple and independent prognostic indicator for PSCC. The NLR holds promise as a powerful tool to guide decision-making in clinical practice. [Table: see text]

Effects of 6-month administration of tofogliflozin on cardiac function in elderly patients with heart failure with preserved ejection fraction: A retrospective study of a patient cohort.

Patients with type 2 diabetes mellitus are frequently hospitalized for heart failure. The ratio of early diastolic mitral inflow velocity to early diastolic mitral annulus velocity (E/e'), measured by echocardiography, is a simple and convenient indicator of diastolic dysfunction. Various large clinical trials have reported that sodium glucose transporter-2 inhibitor therapy reduced cardiovascular events and hospitalizations in heart failure patients. We examined the effect of tofogliflozin on various physiological and cardiac function. A retrospective analysis was performed on elderly patients aged 65 years or older with type 2 diabetes mellitus attending Himi Municipal Hospital who were taking oral tofogliflozin 20 mg/day. Measurement of physiological and hormonal variables, blood sampling, and echocardiographic evaluations at 0, 1, 3, and 6 months were performed on those with ejection fraction (EF) of 40% or greater at the time of treatment. Statistical analysis was performed using t-tests and mixed-effects models, with brain natriuretic peptide less than or not less than 100 pg/mL, estimated glomerular filtration rate (eGFR) less than or not less than 50 mL/min/1.73 m2, and diuretics administered or not. Hypoglycemic effects were observed at 0, 1, 3, and 6 months. At each time point, EF was retained and E/e' was significantly reduced. On the other hand, most physiological parameters and laboratory results showed no clinical abnormalities. Mixed-effects models showed time-dependent reduction of E/e' in high/low brain natriuretic peptide, high/low eGFR, with or without diuretics between baseline and at 6 months. The interaction with time was significant in high/low eGFR. Tofogliflozin was shown to improve E/e', a measure of diastolic function, while maintaining EF, with hypoglycemic effects and no clinical side effects.

Development and validation of a predictive nomogram for the risk of MAFLD in postmenopausal women.

Metabolic-associated fatty liver disease (MAFLD) has gradually become one of the main health concerns regarding liver diseases. Postmenopausal women represent a high-risk group for MAFLD; therefore, it is of great importance to identify and intervene with patients at risk at an early stage. This study established a predictive nomogram model of MAFLD in postmenopausal women and to enhance the clinical utility of the new model, the researchers limited variables to simple clinical and laboratory indicators that are readily obtainable. Data of 942 postmenopausal women from January 2023 to October 2023 were retrospectively collected and divided into two groups according to the collection time: the training group (676 cases) and the validation group (226 cases). Significant indicators independently related to MAFLD were identified through univariate logistic regression and stepwise regression, and the MAFLD prediction nomogram was established. The C-index and calibration curve were used to quantify the nomogram performance, and the model was evaluated by measuring the area under the receiver operating characteristic curve (AUC), calibration curve, and decision curve analysis (DCA). Of 37 variables, 11 predictors were identified, including occupation (worker), body mass index, waist-to-hip ratio, number of abortions, anxiety, hypertension, hyperlipidemia, diabetes, hyperuricemia, and diet (meat and processed meat). The C-index of the training group predicting the related risk factors was 0.827 (95% confidence interval [CI] 0.794-0.860). The C-index of the validation group was 0.787 (95% CI 0.728-0.846). Calibration curves 1 and 2 (BS1000 times) were close to the diagonal, showing a good agreement between the predicted probability and the actual incidence in the two groups. The AUC of the training group was 0.827, the sensitivity was 0.784, and the specificity was 0.735. The AUC of the validation group was 0.787, the sensitivity was 0.674, and the specificity was 0.772. The DCA curve showed that the nomogram had a good net benefit in predicting MAFLD in postmenopausal women. A predictive nomogram for MAFLD in postmenopausal women was established and verified, which can assist clinicians in evaluating the risk of MAFLD at an early stage.

Respiratory system compliance during anesthesia induction and postoperative mechanical ventilation needs: An observational study.

Respiratory system compliance (Crs) is a simple indicator of lung flexibility. However, it remains unclear whether a low Crs during anesthesia induction (iCrs) is associated with an increased risk of postoperative mechanical ventilation. This retrospective observational study was conducted using a local database. All mechanically ventilated postoperative ICU patients were included in this study. The duration of postoperative mechanical ventilation, length of hospital stay, and in-hospital mortality were compared between the low iCrs group (<25% of distribution) and the normal iCrs group. A total of 315 patients were classified into the low iCrs (<39 mL/cmH2O) group (n = 78) or the normal iCrs group (n = 237). Low iCrs was associated with a higher chance of mechanical ventilation in 28 days (log-rank test, p < 0.001). The duration of hospital stay was similar. Multivariate analysis showed that in-hospital mortality was higher in the low iCrs group than in the normal iCrs group (adjusted odds ratio, 6.04 [1.13, 32.26]; p = 0.04). Low iCrs was associated with an increased risk of requiring postoperative mechanical ventilation. An additional result of poor survival related to low iCrs may require further study.

Building a system of diagnostics of problem areas in the management of business processes of the organization

Aim. To develop and formulate an algorithm that allows timely diagnosing and eliminating problems in business processes.Objectives. To consider and systematize the main signs of problems in business processes; to determine the main sources, causes of losses and inefficiency; to formulate an algorithm that allows to assess the effectiveness of the process; to test the proposed algorithm for assessing the effectiveness of business processes on the example of a specific organization.Methods. The authors used the methods of descriptive literature review and statistical data analysis. The research includes the study and analysis of scientific articles, reports of scientific conferences and other publications related to the subject of the article. The analysis of statistical data is based on the performance of the organization, in particular the operator of urban mobility services. All data used for calculations are of a conditional nature.Results. In the process of research the works of modern authors related to the analysis of efficiency and diagnostics of problems in business processes are considered and generalized. In the mentioned works some theoretical aspects of the topic are widely and in detail studied, which are then systematized by the authors of the present study. As a result, an algorithm has been formed that allows in practice to monitor the efficiency of business processes of the organization, as well as to diagnose possible problems in a timely manner. When testing this approach in practice, in the context of the analysis of business processes in the organization, the following results were obtained: a number of critical problems in business processes that have a negative impact on the result of activity were identified; a plan to improve their efficiency was developed and implemented.Conclusions. The process approach is one of the most successful tools to improve the efficiency of the organization. Optimal operation of all key and essential business processes ultimately affects the company’s result. The operating conditions of an organization are constantly changing under the influence of a dynamic business environment. One of the most important elements of the efficiency management system for business processes, and consequently for the business as a whole, is a properly formed set of indicative indicators reflecting the progress of each process. The choice of indicators should be based primarily on the strategic goals of the organization, cascaded down to the level of individual processes. The study confirmed the hypothesis that the risks of efficiency reduction can be identified in advance and in a timely manner with the help of a correctly constructed system of simple control indicators. For these purposes, taking into account the concept of lean production and continuous improvement, as well as on the basis of the classification of losses set out in it, a questionnaire for express analysis of business process efficiency has been developed.

Triglyceride-glucose index and combined indicators: effective indicators for screening NAFLD in snoring patients

AimsNonalcoholic fatty liver disease (NAFLD) is a common complication in snoring patients, especially in patients with obstructive sleep apnea syndrome (OSA). Triglyceride-glucose (TyG) index was a simple indicator of metabolic status and a surrogate marker of insulin resistance. This study aimed to explore the relationship between NAFLD and TyG index in snoring patients.MethodsA retrospective study was conducted. The successive snoring patients enrolled in the Sleep Center of the First Affiliated Hospital of Fujian Medical University and had abdominal ultrasonography were included. The clinical characteristics of patients in different quartile TyG groups were compared. The relationship of the TyG index and NAFLD were valued via logistic regression models and restricted cubic spline analysis. The value of TyG index in predicting NAFLD was determined by receiver operating characteristic curve (ROC curve).ResultsA total of 463 NAFLD cases were found among the 654 snoring patients. TyG index was a risk factor of NAFLD in snoring patients (OR = 2.38, 95% CI = 1.71–3.36). The risk of NAFLD was much higher in patients with the highest quartile of TyG index (OR = 5.12, 95% CI = 2.85–9.22), compared with the lowest quartile group. Restricted cubic spline (RCS) analysis showed a significant dose-response relationship between TyG index and risk of NAFLD (p for non-linearity < 0.001). A combination of TyG, neck circumference and ESS score presented the acceptable AUC for the detection of NAFLD in snoring patients (0.746, 95% CI 0.701–0.790, p < 0.001).ConclusionThe TyG index was a risk factor of NAFLD in snoring patients. A combination of TyG, neck circumferences and ESS score could act as a convenient and effective indicator for screening NAFLD in snoring patients.

Job Satisfaction and Change Readiness: Moderating Role of Gender

Failing to assess employees' readiness for change can lead managers to waste significant time and effort managing resistance. This time could otherwise be spent productively. This study attempts to make a rigorous empirical examination of the effects of job satisfaction on change readiness along with assessing the moderating role of gender. The primary collection of data is done through likert scale and were analyzed by using IBM SPSS statistics version 23. On the other hand, the secondary data were taken from the articles, journals and website. Through a simple and dummy indicator regression analysis of the variables, it talks about the analysis's findings, which show that job satisfaction had a positive and significant impact on change readiness. This study implies that the value of coefficient of multiple determination is 0.299 which implies that the variation in CR can be explained by JS was 9.9%. Similarly, gender was no moderating the effects of job satisfaction on change readiness shown by the dummy indicator regression analysis. While acknowledging that there is no established theory describing the relationship between these two major constructs in organizational behavior, this study attempts to provide some of the empirical support that there was positive significant association between job satisfaction and change readiness. This study determined the value of R is to be .547a. This paper includes with the number of implications and research direction for both academic and organizational managers, Job satisfaction plays a critical role in determining employees' readiness for change, with higher satisfaction leading to increased acceptance and enthusiasm for change efforts.

Gait Assessment Using Smartphone Applications in Older Adults: A Scoping Review.

Spatiotemporal parameters such as gait velocity and stride length are simple indicators of functional status and can be used to predict major adverse outcomes in older adults. A smartphone can be used for gait analysis by providing spatiotemporal parameters useful for improving the diagnosis and rehabilitation processes in frail people. The aim of this study was to review articles published in the last 20 years (from 2004 to 2024) concerning the application of smartphones to assess the spatiotemporal parameters of gait in older adults. This systematic review was performed in line with Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA), and original articles were identified by searching seven electronic databases: SciVerse (ScienceDirect), Excerpta Medica Database (EMBASE), Medline, Scopus, PubMed, Web of Science and the Cochrane Library. Studies were rigorously screened using the inclusion criteria of smartphones and mobile apps, older adults and spatiotemporal gait parameters, and results were narratively synthesized. Seventy-three articles were initially identified while searching the scientific literature regarding this topic. Eleven articles were selected and included in this review. Analysis of these studies covered information about gait assessment using mobile apps recorded in 723 older adults and 164 control cases. Analysis of data related to the application of smartphones to assess spatiotemporal parameters of gait in older adults showed moderate-to-excellent test-retest reliability and validity (ICCs around 0.9) of gait speed, the most common parameter reported. Additionally, gait speeds recorded with mobile apps showed excellent agreement when compared to gold standard systems. Smartphones and mobile apps are useful, non-invasive, low-cost and objective tools that are being extensively used to perform gait analysis in older adults. Smartphones and mobile apps can reliably identify spatiotemporal parameters related to adverse outcomes, such as a slow gait speed, as predictors and outcomes in clinical practice and research involving older adults.

Generation of Indicators to Assess Quality of Health Care in Hospital at Home Through e-Delphi.

The quality of health care in hospital at home (HaH) has been measured in different countries using simple indicators and clinical results that only contribute to some dimensions of the quality of health care. We sought to generate indicators to comprehensively evaluate the quality of health care provided to HaH users through the e-Delphi technique. The e-Delphi technique was performed with the participation of 17 HaH experts. The methodological strategy applied in this study was divided into the following 3 phases: a preparatory phase; consultation phase; and consensus phase. Three rounds of consultations were conducted with experts. In round 1, they were asked to identify which aspects of HaH they believed should be evaluated using an indicator for each of the following 6 dimensions of health care quality: effectiveness; efficiency; timeliness; patient-centered care; equity; and safety. In round 2, they were asked to rate each indicator using a 5-point Likert-type scale with the following values: (1) Totally disagree; (2) Disagree; (3) Moderately agree; (4) Agree; and (5) Totally agree. The criteria for evaluating each indicator were as follows: (1) The indicator is a useful measure for assessing the quality of health care provided to HaH users. (2) The indicator is clearly and specifically written and does not require modification. (3) The indicator is essential and incorporates information that can be extracted from HaH program records. An indicator was considered approved if it received at least 65% approval from the expert panel for each evaluation criterion. In round 3, experts were asked to reassess their ratings, taking into account the opinions of the other experts. The reliability of this technique was ensured through credibility, reliability, and confirmability. We obtained ethical approval of the corresponding institutions and informed consent from the participating experts. Nine unpublished and reliable indicators were generated. In addition, 13 indicators were incorporated that evaluate aspects previously analyzed by other authors and/or national and international institutions, which were adapted to be used in HaH. The total indicators generated (n = 22) represented all dimensions of the quality of health care: safety; opportunity; effectiveness; efficiency; equity; and patient-centered care. The 22 indicators generated through the e-Delphi technique permit a comprehensive evaluation of the quality of health care provided to HaH users.

The density of the inner cell mass is a new indicator of the quality of a human blastocyst: a valid supplement to the Gardner scoring system.

Can the density of the inner cell mass (ICM) be a new indicator of the quality of the human blastocyst? The densification index (DI) developed in this study can quantify ICM density and provide positive guidance for ploidy, pregnancy, and live birth. In evaluating the quality of ICM, reproductive care clinics still use size indicators without further evaluation. The main disadvantage of this current method is that the evaluation of blastocyst ICM is relatively rough and cannot meet the needs of clinical embryologists, especially when multiple blastocysts have the same ICM score, which makes them difficult to evaluate further. This observational study included data from 2272 blastocysts in 1991 frozen-thawed embryo transfer (FET) cycles between January 2018 to November 2021 and 1105 blastocysts in 430 preimplantation genetic testing cycles between January 2019 and February 2023. FET, ICSI, blastocyst culture, trophectoderm biopsy, time-lapse (TL) monitoring, and next-generation sequencing were performed. After preliminary sample size selection, the 11 focal plane images captured by the TL system were normalized and the spatial frequency was used to construct the DI of the ICM. This study successfully constructed a quantitative indicator DI that can reflect the degree of ICM density in terms of fusion and texture features. The higher the DI value, the better the density of the blastocyst ICM, and the higher the chances that the blastocyst was euploid (P < 0.001) and that pregnancy (P < 0.001) and live birth (P = 0.005) were reached. In blastocysts with ICM graded B and blastocysts graded 4BB, DI was also positively associated with ploidy, pregnancy, and live birth (P < 0.05). ROC analysis showed that combining the Gardner scoring system with DI can more effectively predict pregnancy and live births, when compared to using the Gardner scoring system alone. Accurate calculation of the DI value places high demands on image quality, requiring manual selection of the clearest focal plane and exposure control. Images with the ICM not completely within the field of view cannot be used. The association between the density of ICM and chromosomal mosaicism was not evaluated. The associations between the density of ICM and different assisted reproductive technologies and different culture conditions in embryo laboratories were also not evaluated. Prospective studies are needed to further investigate the impact of ICM density on clinical outcomes. ICM density assessment is a new direction in blastocyst assessment. This study explores new ways of assessing blastocyst ICM density and develops quantitative indicators and a corresponding qualitative evaluation scheme for ICM density. The DI of the blastocyst ICM developed in this study is easy to calculate and requires only TL equipment and image processing, providing positive guidance for clinical outcomes. The qualitative evaluation scheme of ICM density can assist embryologists without TL equipment to manually evaluate ICM density. ICM density is a simple indicator that can be used in practice and is a good complement to the blastocyst scoring systems currently used in most centers. This work was supported by the National Key Research & Development Program of China (2021YFC2700603). The authors report no financial or commercial conflicts of interest. N/A.

Rational construction of noble-metal-free fuel cell-supercapacitor hybrid power source using polyaniline electrode as both anode and cathode

The integration of fuel cell device and supercapacitor device into a singular hybrid power source at the electrode level can make the best use of the advantages of each individual device and more importantly, eliminate the energy loss by virtue of the conversion of chemical energy to electric energy on electrocatalyst material and the storage of electric energy on energy storage material simultaneously. To avoid the use of noble metal electrocatalyst and exploit the dual electrocatalytic and capacitive function of polyaniline, a noble-metal-free fuel cell-supercapacitor hybrid power source employing polyaniline electrode as both anode and cathode is rationally constructed. Based on electrochemical in-situ Raman spectroscopy, this work proposes that the open circuit potential (OCP) of polyaniline electrode is a simple and quick indicator of the redox state of polyaniline. After carefully selecting the fuel and carbon-based support, it is found that the ascorbic acid fuel and the carbon fiber cloth supported polyaniline contributes to the lowest OCP threshold in the anode, and thus the fastest self-charge and largest stabilized open circuit voltage of hybrid power source. The hybrid power source can be self-charged to 0.32 V and yield a peak power density of 0.21 mW cm−2.

Visual tracking of real-time freshness of fish using an agar hydrogel colorimetric indicator containing CuNPs/NCQDs

A simple, selective, and affordable dual fluorescence-colorimetric indicator for hydrogen sulfide was developed based on a complex of copper nanoparticles and N-doped carbon quantum dots (CuNPs/NCQDs). Real-time and visual freshness tracking of fish was done using a colorimetric indicator by incorporating CuNPs/NCQDs into agar hydrogel (AH-CuNPs/NCQDs). The fluorescence response of the CuNPs/NCQDs solution is quenched upon exposure to H2S. The field-emission scanning electron microscopy image of the AH-CuNPs/NCQDs film revealed a unified structure. The prepared indicator exhibited a good and irreversible response to H2S, with a LOD of 91.36 and a LOQ of 276.86 μM, based on the localized surface plasmon resonance (LSPR) mechanism. The X-ray photoelectron spectrometer and Fourier transform infrared spectrometer results confirmed the formation of a CuS bond in the colorimetric indicator exposed to fish spoilage. The prepared indicator demonstrated good stability and remained unaffected by pH or other volatile compounds. Notably, there was a strong correlation between ΔΕ and fish freshness parameters (pH, TV-BN, and TVC). Light green, pale yellow, and dark yellow colors, respectively, indicated freshness, semi-freshness, and spoilage of fish during storage in the refrigerator. Overall, the prepared indicator can be effectively used for detecting spoilage in meat products as a highly sensitive freshness indicator.

Soil footprint: A simple indicator to communicate and quantify soil security

Soil erosion is a major threat to soil security, and therefore to agriculture. To address this challenge, effective strategies are needed to protect soil resources without compromising crop yields. Currently, there are three main players involved: scientists, policymakers, and land managers. However, the technical knowledge required to understand how soil erosion affects food production hinders the communication of the potential benefits of soil sustainability strategies to nontechnical stakeholders, such as farmers and food producers. Moreover, a major player in this fight is still missing, consumers. If there is no connection between soil and society then the soil itself may not be valued and it is less likely to be managed sustainably. In this study, we propose the concept of soil footprint, defined as the ratio of soil loss to crop yield, to communicate, quantify, and compare soil security for different crops. It is a versatile concept that can be applied for a multitude of potential practical uses. To showcase some of these potential uses, we used national data to calculate the soil footprint of the ten main crops in Spain. We demonstrate the utility of this metric to compare and rank crops, identify problematic regions, and assess the effect of land management on the soil footprint. The soil footprint indicator offers advantages in terms of simplicity, facilitating easy calculation, comparison, and interpretation by non-technical users. This can engage society in soil conservation, empower land managers to define sustainable soil management strategies, and promote policies to enhance soil security.

A stony track towards innovation in remote highland regions: agricultural intensification in the apricot sector of Northern Pakistan

BackgroundTraditional farming practices of remote highland regions are usually well adapted to the local agro-ecological and social conditions. There, introduced agricultural innovation geared towards sustainable intensification as a response to changing environments often faces multiple barriers. These may comprise limited market incentives for enhanced production, narrow pathways of knowledge transmission, and infrastructural hurdles. To quantify effects of innovation and sustainable intensification in enhancing smallholders’ livelihoods in the Karakoram Mountains of Northern Pakistan, the present study was conducted with 86 small-holder farmers. We chose interviewees who are involved in the cultivation, processing and/or trading of apricot (Prunus armeniaca L.), a traditionally important currently eroding fruit crop of the Central Asian highlands. By investigating the status quo of apricot production and producers’ innovative farming practices, we generated an intensification index based on simple agronomic indicators. Explanatory farm and framers’ characteristics, production characteristics, knowledge, and apricot management were tested for their predictive power.ResultsAlthough the data show low average profits of 3.8 US$ tree−1, we found that intensified apricot production can contribute to the provision of nutritious food and increased household income. Age and training of farmers were key factors fostering innovation, while lacking awareness of innovative practices was attributed to slow communication. Rejection of intensification was either due to low-value attribution towards apricot farming or risk aversion. Commonly adopted innovations, particularly sulfur drying, were either well integrated with traditional practices or characterized by low up-front costs and high returns on investment.ConclusionsManagement intensification may increase farmers’ incomes and retard abandonment of apricot farming and the consecutive loss of associated benefits, such as diversified farm output and improved ecosystem services.Graphical

Molecular-level insights into dissolved organic matter and its variations of the full-scale processes in a typical petrochemical wastewater treatment plant

Petrochemical wastewater (PCWW) treatment poses challenges due to its unique and complex dissolved organic matter (DOM) composition, originating from various industrial processes. Despite the addition of advanced treatment units in PCWW treatment plants to meet discharge standards, the mechanisms of molecular-level sights into DOM reactivity of the upgraded full-scale processes including multiple biological treatments and advanced treatment remain unclear. Herein, we employ water quality indexes, spectra, molecular weight (MW) distribution, and Fourier transform ion cyclotron resonance mass spectrometry to systematically characterize DOM in a typical PCWW treatment plant including influent, micro-oxygen hydrolysis acidification (MOHA), anaerobic/oxic (AO), and micro-flocculation sand filtration–catalytic ozonation (MFSF–CO). Influent DOM is dominated by tryptophan-like and soluble microbial products with MW fractions 〈 1 kDa and 〉 100 kDa, and CHO with lignin and aliphatic/protein structures. MOHA effectively degrades macromolecular CHO (10.86 %) and CHON (5.24 %) compounds via deamination and nitrogen reduction, while AO removes CHOS compounds with MW < 10 kDa by desulfurization, revealing distinct DOM conversion mechanisms. MFSF–CO transforms unsaturated components to less aromatic and more saturated DOM through oxygen addition reactions and shows high CHOS and CHONS reactivity via desulfurization and deamination reactions, respectively. Moreover, the correlation among multiple parameters suggests UV254 combined with AImod as a simple monitoring indicator of DOM to access the chemical composition. The study provides molecular-level insights into DOM for the contribution to the improvement and optimization of the upgraded processes in PCWW.

Indicator displacement-based colorimetric assay for dibutyl phthalate in pharmaceutical products with titanium(IV)-pyridylazo resorcinol (PAR)

Taking advantage of the competitive binding affinity towards Ti(IV) between 4-(2-pyridylazo) resorcinol (PAR) and phthalate, a simple indicator displacement (ID)–based colorimetric assay was designed for indirect determination of a well-known phthalic acid ester, dibutyl phthalate (DBP). The indicator PAR and Ti(IV) formed a purplish-red-colored Ti(IV)-PAR complex (λmax = 540 nm) at a 1:1 ratio. In the presence of pre-hydrolyzed DBP, colorless complex formation of phthalate ion (emerging from alkaline hydrolysis of DBP) with Ti(IV) resulted in a hypsochromic shift in absorbance maximum, accompanying a color change from purplish-red to yellowish-orange (λmax = 390 nm) by the release of PAR from Ti(IV)-PAR system. Based on this mechanism, the linear response range of the system for DBP was found to lie between 0.16 and 0.37 mmol L–1 with an experimental detection limit of 11.6 µmol L–1. The recommended Ti(IV)-PAR system was successfully applied to DBP-containing pharmaceutical products (as real sample) after a simple clean-up process for removing possible water-soluble interferents. The analytical results obtained from the recommended method (by applying the standard addition approach) and the reference liquid chromatography-tandem mass spectrometric (LC–MS/MS) method were statistically compared using DBP-extract of the drug samples. Consequently, a simple and selective colorimetric ID strategy was proposed for the analysis of DBP in pharmaceuticals for the first time.

PH-indicator based on delignified jute fiber and red cabbage anthocyanins for monitoring fish spoilage using a smartphone application

Halochromic materials that show visible color changes in response to changes in pH are suitable for the real-time monitoring of fish spoilage. In this study, an easy-to-use, simple, inexpensive, and non-toxic fish freshness indicator was fabricated by combining delignified jute (Corchorus olitorius) fibers and anthocyanins (halochromic materials) from red cabbage (DFA: Delignified jute fibers incorporated with anthocyanins). A single-step decolorization/delignification using solar irradiation along with NaOH and H2O2 treatment was used for modifying the jute fibers. This method helps to overcome the self-color, mitigates the lack of affinity of jute fibers towards anthocyanins and preserves the lignin so that the strength of the fiber is not impacted. A smartphone-based color analysis was used for real-time fish quality monitoring using DFA. To the best of our knowledge, there are no reports on the use of jute fibers as substrates to incorporate anthocyanins for food spoilage monitoring. The indicator displayed an observable color response to the pH and varying concentrations of amine compounds. During the storage of fish (mackerel), the colorimetric indicator showed a visible color change from pink (for fresh fish) to blue (for spoiling fish) and then to green (for spoiled fish), corresponding to changes in pH and total volatile basic nitrogen. To offer a straightforward quantitative assessment of color changes, we utilized the freely available Android application Color Grab to measure the color using RGB and L*, a*, and b* indices. The DFA indicator providing naked-eye analysis has the potential to be an effective tool for real-time monitoring of on-site food spoilage by non-specialized personnel in resource-limited areas.

Triglyceride Glucose Index for the Detection of Diabetic Kidney Disease and Diabetic Peripheral Neuropathy in Hospitalized Patients with Type 2 Diabetes.

The triglyceride-glucose index (TyG) has been identified as a dependable and simple indicator marker of insulin resistance (IR). Research has demonstrated a correlation between macrovascular complications and TyG. However, limited research exists regarding the relationship between TyG and diabetic microvascular complications. Consequently, the objective of this study is to investigate the association between TyG and diabetic kidney disease (DKD) and diabetic peripheral neuropathy (DPN). This is a cross-sectional, observational study. A total of 2048 patients from Tongren Hospital, Shanghai Jiao Tong University School of Medicine were enrolled. The primary outcomes are DKD and DPN. Quantile regression analysis was employed to investigate the implicit factors of TyG quartiles. Subsequently, based on implicit factors, logistic regression models were constructed to further examine the relationship between TyG and DKD and DPN. In the baseline, TyG exhibited higher values across patients with DKD, DPN, and co-existence of DKD and DPN (DKD + DPN) in type 2 diabetes (T2D). Univariate logistic regressions demonstrated a significant association between an elevated TyG and an increased risk of DKD (OR = 1.842, [95% CI] 1.317-2.578, P for trend < 0.01), DPN (OR = 1.516, [95% CI] 1.114-2.288, P for trend < 0.05), DKD + DPN (OR = 2.088, [95% CI] 1.429-3.052, P for trend < 0.05). Multivariable logistic regression models suggested a statistically significant increase in the risk of DKD (OR = 1.581, [95% CI] 1.031-2.424, p < 0.05),DKD + DPN (OR = 1.779, [95% CI] 1.091-2.903, p < 0.05) after adjusting the implicit factors of TyG quartiles. However, no significant relationship was observed between TyG and DPN in the multivariable regression analysis. Elevated TyG was significantly associated with an increased risk of DKD in T2D, but no significant relationship was shown with DPN. This finding provided further evidence for the clinical significance of integrating TyG into the initial assessment of diabetic microvascular complications.