Association between nutritional inflammation index and diabetic foot ulcers: a population-based study

BackgroundDiabetic foot ulcers (DFU), a frequent complication of the worldwide disease (diabetes), are the primary causes of amputations and early mortality. The development of DFU is inseparably linked with inflammation and nutrition, necessitating a comprehensive evaluation of their impact on DFU risk. This study aimed to establish a new predictive metric that integrated immune inflammation and nutritional markers to holistically assess the risk of DFU development.MethodsData were sourced from NHANES, extracting participant from 1999 to 2004. Analysis of multivariate logistic regression and restricted cubic spline were employed to elucidate the connection and non-linear relationship between albumin/neutrophil to lymphocyte ratio (ANLR) and DFU. Stratified subgroup analysis identified advantageous populations, while interaction analysis evaluated variable interactions with ANLR. These approaches collectively contributed to a sensitivity analysis, improving the reliability of the outcomes.ResultsOut of 29,608 participants extracted, 1,531 qualified based on the study criteria. Employing the ANLR low group as a reference, the high group demonstrated a 54% reduction in DFU risk. Every increase of 0.1 unit in ANLR correlated with a 5% decrease in DFU risk. Moreover, an L-shaped non-linear link was observed. The turning point was at 3.09. Left of the inflection point, the relationship was negatively correlated. Beyond this point, further increased in ANLR no longer decrease DFU risk.ConclusionThe study not only proposed a new comprehensive indicator for predicting DFU for the first time but also specified the impact of ANLR on DFU risk. Broadly, a negative correlation existed between the two. Yet, a detailed analysis revealed that this negative correlation involved an inflection point effect. Furthermore, the study investigated how dynamic changes in ANLR affect DFU risk, aiding clinicians in more accurately assessing individual DFU risk and facilitating earlier identification and intervention of DFU. Therefore, for diabetic patients with low serum albumin, appropriate supplementation of albumin was crucial. Additionally, maintaining the NLR at an appropriate level should not be overlooked. Given the components of ANLR were widely used and readily available in clinical settings, their future clinical applications hold great potential

Evaluating the risk of phosphorus loss with a distributed watershed model featuring zero-order mobilization and first-order delivery

Many semi-distributed models that simulate pollutants' losses from watersheds do not handle well detailed spatially distributed and temporal data with which to identify accurate and cost-effective strategies for controlling pollutants issuing from non-point sources. Such models commonly overlook the flow pathways of pollutants across the landscape. This work aims at closing such knowledge gap by developing a Spatially and Temporally Distributed Empirical model for Phosphorus Management (STEM-P) that simulates the daily phosphorus loss from source areas to receiving waters on a spatially-distributed grid-cell basis. STEM-P bypasses the use of complex mechanistic algorithms by representing the phosphorus mobilization and delivery processes with zero-order mobilization and first-order delivery, respectively. STEM-P was applied to a 217km2 watershed with mixed forest and agricultural land uses situated in southwestern China. The STEM-P simulation of phosphorus concentration at the watershed outlet approximated the observed data closely: the percent bias (Pbias) was -7.1%, with a Nash-Sutcliffe coefficient (ENS) of 0.80 on a monthly scale for the calibration period. The Pbias was 18.1%, with a monthly ENS equal to 0.72 for validation. The simulation results showed that 76% of the phosphorus load was transported with surface runoff, 25.2% of which came from 3.4% of the watershed area (classified as standard A critical source areas), and 55.3% of which originated from 17.1% of the watershed area (classified as standard B critical source areas). The standard A critical source areas were composed of 51% residences, 27% orchards, 18% dry fields, and 4% paddy fields. The standard B critical source areas were mainly paddy fields (81%). The calculated spatial and temporal patterns of phosphorus loss and recorded flow pathways identified with the STEM-P simulations revealed the field-scale critical source areas and guides the design and placement of effective practices for non-point source pollution control and water quality conservation

Advanced lung cancer inflammation index is associated with prognosis in skin cancer patients: a retrospective cohort study

BackgroundSkin cancer ranks as one of the most prevalent malignant tumors affecting humans. This study was designed to explore the correlation between the advanced lung cancer inflammation index (ALI), a metric that gauged both nutrition and inflammation statuses, in skin cancer patients and their subsequent prognosis.MethodsData from the National Health and Nutrition Examination Survey (NHANES) spanning 1999-2018 were scrutinized, along with mortality tracking extending to December 31, 2019. Kaplan-Meier survival curves and COX regression analysis, utilizing NHANES-recommended weights, delineated the association between ALI levels and skin cancer prognosis. To decipher the potential non-linear relationship, a restricted cubic spline analysis was applied. Additionally, stratified analysis was conducted to affirm the robustness of our findings.ResultsThe 1,149 patients participating in NHANES 1999-2018 were enrolled. We observed a reverse J-shaped non-linear relationship between ALI and both skin cancer all-cause mortality and cancer mortality, with inflection points at 81.13 and 77.50, respectively.ConclusionsThe ALI served as a comprehensive indicator of a patient’s nutrition and inflammation status and was demonstrably linked to the prognosis in skin cancer cases. The meticulous evaluation and continuous monitoring of these parameters in skin cancer patients bear clinical importance

A lactate-related tSNE signature defines prognostic subtypes of bladder cancer and reveals LINC01094-mediated VIM stabilization in metastasis and drug resistance

BackgroundBladder cancer (BLCA) is prone to metastasis and often shows poor responses to chemotherapy and immunotherapy. Investigating the underlying mechanisms of metastasis and drug resistance may therefore offer new therapeutic strategies for BLCA.MethodsPublicly available datasets were analyzed using consensus clustering and t-distributed stochastic neighbor embedding (tSNE) to characterize a lactate-related gene signature in BLCA. Gene set variation analysis (GSVA) was employed to assess signaling pathway activity, while immune cell infiltration in the tumor microenvironment (TME) was evaluated using single-sample gene set enrichment analysis (ssGSEA), the Estimation of Stromal and Immune cells in Malignant Tumors using Expression data (ESTIMATE), and CIBERSORT. RNA pull-down and RNA-binding protein immunoprecipitation (RIP) assays were then performed to confirm molecular interactions.ResultsTwo distinct BLCA subtypes were identified based on lactate-related gene expression, and a lactate-based tSNE score was constructed. This score demonstrated prognostic value and was integrated into a nomogram confirmed by a calibration curve. Functionally, higher tSNE scores correlated with immune- and inflammation-related pathways, as well as with immunotherapy efficacy in BLCA. Among candidate regulators identified, LINC01094 emerged as a key factor in BLCA metastasis and drug resistance. LINC01094 was predominantly localized in the cytoplasm and was upregulated in tumor tissues compared with adjacent normal tissues, acting as an unfavorable prognostic factor. In vitro, LINC01094 promoted metastasis and chemotherapy resistance, potentially by stabilizing VIM protein levels and inhibiting its ubiquitination.ConclusionsThis comprehensive analysis of lactate-related genes reveals how this gene signature may shape the tumor microenvironment and affect BLCA patient prognosis. Additionally, our data suggest that targeting LINC01094 with antisense oligonucleotides (ASOs) could reduce BLCA cell metastasis and enhance their sensitivity to chemotherapy

Cadre Information Management System Design and Implementation of People's Bank

AbstractThis paper proposed the architecture design and implementation plan for the Cadre Information Management System Design and Implementation of People's Bank based on B/S structure. In addition this paper introduced the implementation method for this system using ASP.NET and SQL Server

Off-label medicine use in children and adolescents: results of a population-based study in Germany

Background: Population-based self-reported data on off-label medicine use independent from health care provisions are lacking. The purpose of this study is to investigate off-label medicine use in children and adolescents in Germany in a non-clinical setting and to identify prevalence, determinants and spectrum of off-label medicine use. Methods: Data were obtained from the German Health Interview and Examination Survey for Children and Adolescents (KiGGS) conducted by the Robert Koch Institute (2003–2006). 17,450 randomly selected children aged 0–17 years took part in the drug interviews. Of those, 8,899 took at least one medicine during the 7 days preceding the interview. Off-label medicine use was defined as the discrepancy between actual use and the intended use described in the summary of product characteristics. Off-label medicine use was stratified into off-label indication, off-label age, off-label over-dosing, and off-label under-dosing. Results: The prevalence rate of off-label medicine use among those who used medicines amount of is 40.2%. The prevalence rate is significantly higher in boys (41.4%), in children aged 3 to 6 years (48.7%), without migration background (40.9%), with high social status (42.5%), living in small (42.0%) and medium sized cities (41.6%), and with a poor parents rated health status (41.7%). 12,667 preparations (attributable in respect to off-label use) were taken by 8,899 children. 30% of the medicines have been used off-label. Off-label medicine use was highest in preparations of the ATC-class “C00 Cardiovascular System”. In all origins of medicine, all age groups and all ATC-classes under-dosing was the most frequent reason for off-label medicine use. Conclusions: There is a considerable level of self-reported off-label medicines use in the general paediatric population. Further investigations are needed to examine in how far off-label medicine use is based on lack of knowledge or on empiricism in paediatric pharmacotherapy. Attention also needs to be paid to under-dosing which potentially exposes drug users to risks of side effects without the benefit of a therapeutic effect. Clinical trials for licensing of paediatric medicines, education of health care professionals, but also of parents and carers are needed to ensure the rational use of medicines

Use of herbal medicinal products among children and adolescents in Germany

Background: Germany is a country with a high use of herbal medicinal products. Population-based data on the use of herbal medicinal products among children are lacking. The aim of this study is to investigate the prevalence, patterns and determinants of herbal medicine use among children and adolescents in Germany. Methods: As data base served the German Health Interview and Examination Survey for Children and Adolescents (KiGGS), a representative population based survey conducted 2003–2006 by the Robert Koch Institute. 17,450 boys and girls aged 0–17 years provided information on drug use in the preceding seven days. Herbal medicinal products were defined according to the European and German drug laws. SPSS Complex Sample method was used to estimate prevalence rates and factors associated with herbal medicine use. Results: The prevalence rate of herbal medicinal product use amounts to 5.8% (95% confidence interval 5.3-6.3%). Use of herbal medicine declines along with increasing age and shows no difference between boys and girls in younger age groups. Teenage girls are more likely to use herbal medicines than teenage boys. Two thirds of herbal medicines are used for the treatment of coughs and colds; nearly half of herbal medicines are prescribed by medical doctors. Determinants of herbal medicinal product use are younger age, residing in South Germany, having a poor health status, having no immigration background and coming from a higher social class family. Children’s and parents-related health behavior is not found to be associated with herbal medicine use after adjusting for social class. Conclusions: Use of herbal medicinal products among children and adolescents between the ages of 0 and 17 years in Germany is widely spread and shows relatively higher rates compared to international data. This study provides a reference on the use of herbal medicinal products for policy-makers, health professionals and parents. Further studies are needed to investigate the effectiveness and safety of specific herbal medicinal products, potential effects of long term use as well as possible interactions of herbal medicinal products with concomitantly used conventional medicines