Serum Immunoglobulin A (IgA) Level Is a Potential Biomarker Indicating Cirrhosis during Chronic Hepatitis B Infection

Background. Serum immunoglobulins (Igs) are frequently elevated in patients with chronic liver disease, but currently there is a lack of sufficient data on serum Igs in patients with chronic hepatitis B virus (CHB) infection. This study aimed to evaluate serum IgA, IgG, and IgM levels in patients with HBV-related cirrhosis and to analyze, if altered, immunoglobulin levels that were associated with cirrhosis progress. Methods. A cohort of 174 CHB patients including 104 with cirrhosis (32 decompensated and 72 compensated) and 70 without cirrhosis and 55 healthy controls were enrolled. Serum immunoglobulin levels and biochemical and virological parameters were determined in the enrollment blood samples. Results. Serum IgA levels were significantly increased in cirrhosis group compared with noncirrhosis group and healthy controls (all P<0.001). Furthermore, serum IgA concentrations in decompensated cirrhosis patients were significantly higher than that of compensated patients (P=0.002). Multivariate analysis suggested that serum IgA, platelets, and albumin were independent predictors for cirrhosis (all P<0.001). Conclusions. Elevated IgA levels may function as an independent factor indicating cirrhosis, and there appears to be a strong association between increasing serum IgA level and disease progressing in patients with chronic HBV infection

Neutrophil-to-Lymphocyte Ratio Predicts Early Mortality in Patients with HBV-Related Decompensated Cirrhosis

Background. The neutrophil-to-lymphocyte ratio (NLR) is an inflammation index that has been shown to independently predict poor clinical outcomes. We aimed to evaluate the clinical value of NLR in the prediction of 30-day mortality in patients with HBV-related decompensated cirrhosis (HBV-DeCi). Methods. This was a retrospective cohort study that included 148 patients with HBV-DeCi. Results. An elevated NLR was associated with increased severity of liver disease and mortality within 30 days. Multivariate analysis suggested that NLR, similar to the model for end-stage liver disease (MELD) score, is an additional independent predictor of 30-day mortality (P<0.01). Conclusion. Our results suggest that a high NLR can be considered a new independent biomarker for predicting 30-day mortality in patients with HBV-DeCi

Clinical Usefulness of Measuring Red Blood Cell Distribution Width in Patients with Hepatitis B

BACKGROUND: Red blood cell distribution width (RDW), an automated measure of red blood cell size heterogeneity (e.g., anisocytosis) that is largely overlooked, is a newly recognized risk marker in patients with cardiovascular diseases, but its role in persistent viral infection has not been well-defined. The present study was designed to investigate the association between RDW values and different disease states in hepatitis B virus (HBV)-infected patients. In addition, we analyzed whether RDW is associated with mortality in the HBV-infected patients. METHODOLOGY/PRINCIPAL FINDINGS: One hundred and twenty-three patients, including 16 with acute hepatitis B (AHB), 61 with chronic hepatitis B (CHB), and 46 with chronic severe hepatitis B (CSHB), and 48 healthy controls were enrolled. In all subjects, a blood sample was collected at admission to examine liver function, renal function, international normalized ratio and routine hematological testing. All patients were followed up for at least 4 months. A total of 10 clinical chemistry, hematology, and biochemical variables were analyzed for possible association with outcomes by using Cox proportional hazards and multiple regression models. RDW values at admission in patients with CSHB (18.30±3.11%, P<0.001), CHB (16.37±2.43%, P<0.001) and AHB (14.38±1.72%, P<0.05) were significantly higher than those in healthy controls (13.03±1.33%). Increased RDW values were clinically associated with severe liver disease and increased 3-month mortality rate. Multivariate analysis demonstrated that RDW values and the model for end-stage liver disease score were independent predictors for mortality (both P<0.001). CONCLUSION: RDW values are significantly increased in patients with hepatitis B and associated with its severity. Moreover, RDW values are an independent predicting factor for the 3-month mortality rate in patients with hepatitis B

Review of Serum Biomarkers and Models Derived from Them in HBV-Related Liver Diseases

A series of predictive scoring systems is available for stratifying the severity of conditions and assessing the prognosis in patients with HBV-related liver diseases. We show nine of the most popular serum biomarkers and their models (i.e., serum cystatin C, homocysteine, C-reactive protein, C-reactive protein to albumin ratio, aspartate aminotransferase to platelet ratio index, fibrosis index based on four factors, gamma-glutamyl transpeptidase to platelet ratio, albumin-bilirubin score, and gamma-glutamyl transpeptidase to albumin ratio) that have gained great interest from clinicians. Compared with traditional scoring systems, these serum biomarkers and their models are easily acquired, simple, and relatively inexpensive. In the present review, we summarize the latest studies focused on these serum biomarkers and their models as diagnostic and prognostic indexes in HBV-related liver diseases

Mean Platelet Volume/Lymphocyte Ratio as a Prognostic Indicator for HBV-Related Decompensated Cirrhosis

Aim. To evaluate the prognostic role of the mean platelet volume/lymphocyte ratio (MPVLR) for mortality in patients with hepatitis B virus-related decompensated cirrhosis (HBV-DeCi). Methods. The medical records of 101 patients with HBV-DeCi were retrospectively reviewed, and their baseline clinical and laboratory characteristics were extracted. The predictive value of the MPVLR for death was estimated using receiver operating characteristic curve analysis and a multivariate logistic regression model. Results. Patients with HBV-DeCi in the high-MPVLR group exhibited significantly increased 90-day mortality compared with that of the patients within the low-MPVLR group, and MPVLR was an independent predictor of 90-day mortality in patients with HBV-DeCi. Conclusions. Increased MPVLR is associated with poor outcomes in patients with HBV-DeCi and might be a useful component of future prognostic scores

A Novel Recursive Model Based on a Convolutional Long Short-Term Memory Neural Network for Air Pollution Prediction

Deep learning provides a promising approach for air pollution prediction. The existing deep learning-based predicted models generally consider either the temporal correlations of air quality monitoring stations or the nonlinear relationship between the PM2.5 (particulate matter with an aerodynamic diameter of less than 2.5 μm) concentrations and explanatory variables. Spatial correlation has not been effectively incorporated into prediction models, therefore exhibiting poor performance in PM2.5 prediction tasks. Additionally, determining the manner by which to expand longer-term prediction tasks is still challenging. In this paper, to allow for spatiotemporal correlations, a spatiotemporal convolutional recursive long short-term memory (CR-LSTM) neural network model is proposed for predicting the PM2.5 concentrations in long-term prediction tasks by combining a convolutional long short-term memory (ConvLSTM) neural network and a recursive strategy. Herein, the ConvLSTM network was used to capture the complex spatiotemporal correlations and to predict the future PM2.5 concentrations; the recursive strategy was used for expanding the long-term prediction tasks. The CR-LSTM model was used to realize the prediction of the future 24 h of PM2.5 concentrations for 12 air quality monitoring stations in Beijing by configuring both the appropriate time lag derived from the temporal correlations and the spatial neighborhood, including the hourly historical PM2.5 concentrations, the daily mean meteorological data, and the annual nighttime light and normalized difference vegetation index (NDVI). The results showed that the proposed CR-LSTM model achieved better performance (coefficient of determination (R2) = 0.74; root mean square error (RMSE) = 18.96 μg/m3) than other common models, such as multiple linear regression (MLR), support vector regression (SVR), the conventional LSTM model, the LSTM extended (LSTME) model, and the temporal sliding LSTM extended (TS-LSTME) model. The proposed CR-LSTM model, implementing a combination of geographical rules, recursive strategy, and deep learning, shows improved performance in longer-term prediction tasks

Throughput maximization for irregular reconfigurable intelligent surface assisted NOMA systems

Abstract Reconfigurable intelligent surface (RIS) is an emerging technology to improve the spectral efficiency of wireless communication systems. However, the high complexity of beam design and the non-negligible overhead associated with RIS limit the number of elements that can be deployed in practice. In this paper, we investigate the downlink communications of irregularly deployed intelligent reflecting surfaces that assist non-orthogonal multiple access (NOMA) systems. To address this challenge, we propose a novel four-step resource allocation algorithm. Specifically, we first obtain a sub-optimal solution for the sparse deployment of RIS elements using a Simulated Annealing Algorithm. We then solve the power allocation problem by employing an integer optimization algorithm that continuously iterates the immobile point. To simplify and optimize the reflection coefficient matrix, we propose a construction inequality algorithm. Finally, we optimize the channel assignment using a genetic algorithm. The simulation results demonstrate that the proposed irregular RIS-assisted NOMA system outperforms the traditional RIS-assisted orthogonal multiple access system, with a maximum throughput increase of approximately 30%

Clinical and laboratory characteristics among patients with different red blood cell distribution width (RDW) values at admission.

*<p>Data are expressed as mean±standard deviation.</p><p>MCV, mean corpuscular volume; MELD score, model for end-stage liver disease score; RDW, red cell distribution width.</p