RORγt-specific transcriptional interactomic inhibition suppresses autoimmunity associated with TH17 cells.

The nuclear hormone receptor retinoic acid-related orphan receptor gamma t (RORγt) is a transcription factor (TF) specific to TH17 cells that produce interleukin (IL)-17 and have been implicated in a wide range of autoimmunity. Here, we developed a novel therapeutic strategy to modulate the functions of RORγt using cell-transducible form of transcription modulation domain of RORγt (tRORγt-TMD), which can be delivered effectively into the nucleus of cells and into the central nerve system (CNS). tRORγt-TMD specifically inhibited TH17-related cytokines induced by RORγt, thereby suppressing the differentiation of naïve T cells into TH17, but not into TH1, TH2, or Treg cells. tRORγt-TMD injected into experimental autoimmune encephalomyelitis (EAE) animal model can be delivered effectively in the splenic CD4(+) T cells and spinal cord-infiltrating CD4(+) T cells, and suppress the functions of TH17 cells. The clinical severity and incidence of EAE were ameliorated by tRORγt-TMD in preventive and therapeutic manner, and significant reduction of both infiltrating CD4(+) IL-17(+) T cells and inflammatory cells into the CNS was observed. As a result, the number of spinal cord demyelination was also reduced after tRORγt-TMD treatment. With the same proof of concept, tTbet-TMD specifically blocking TH1 differentiation improved the clinical incidence of rheumatoid arthritis (RA). Therefore, tRORγt-TMD and tTbet-TMD can be novel therapeutic reagents with the natural specificity for the treatment of inflammatory diseases associated with TH17 or TH1. This strategy can be applied to treat various diseases where a specific transcription factor has a key role in pathogenesis.ope

비가우시안 잡음 영상 복원을 위한 그룹 희소 표현

학위논문(박사)--서울대학교 대학원 :자연과학대학 수리과학부,2020. 2. 강명주.For the image restoration problem, recent variational approaches exploiting nonlocal information of an image have demonstrated significant improvements compared with traditional methods utilizing local features. Hence, we propose two variational models based on the sparse representation of image groups, to recover images with non-Gaussian noise. The proposed models are designed to restore image with Cauchy noise and speckle noise, respectively. To achieve efficient and stable performance, an alternating optimization scheme with a novel initialization technique is used. Experimental results suggest that the proposed methods outperform other methods in terms of both visual perception and numerical indexes.영상 복원 문제에서, 영상의 비국지적인 정보를 활용하는 최근의 다양한 접근 방식은 국지적인 특성을 활용하는 기존 방법과 비교하여 크게 개선되었다. 따라서, 우리는 비가우시안 잡음 영상을 복원하기 위해 영상 그룹 희소 표현에 기반한 두 가지 변분법적 모델을 제안한다. 제안된 모델은 각각 코시 잡음과 스펙클 잡음 영상을 복원하도록 설계되었다. 효율적이고 안정적인 성능을 달성하기 위해, 교대 방향 승수법과 새로운 초기화 기술이 사용된다. 실험 결과는 제안된 방법이 시각적인 인식과 수치적인 지표 모두에서 다른 방법보다 우수함을 나타낸다.1 Introduction 1 2 Preliminaries 5 2.1 Cauchy Noise 5 2.1.1 Introduction 6 2.1.2 Literature Review 7 2.2 Speckle Noise 9 2.2.1 Introduction 10 2.2.2 Literature Review 13 2.3 GSR 15 2.3.1 Group Construction 15 2.3.2 GSR Modeling 16 2.4 ADMM 17 3 Proposed Models 19 3.1 Proposed Model 1: GSRC 19 3.1.1 GSRC Modeling via MAP Estimator 20 3.1.2 Patch Distance for Cauchy Noise 22 3.1.3 The ADMM Algorithm for Solving (3.7) 22 3.1.4 Numerical Experiments 28 3.1.5 Discussion 45 3.2 Proposed Model 2: GSRS 48 3.2.1 GSRS Modeling via MAP Estimator 50 3.2.2 Patch Distance for Speckle Noise 52 3.2.3 The ADMM Algorithm for Solving (3.42) 53 3.2.4 Numerical Experiments 56 3.2.5 Discussion 69 4 Conclusion 74 Abstract (in Korean) 84Docto

Multivariable index for assessing the activity and predicting all-cause mortality in antineutrophil cytoplasmic antibody-associated vasculitis

BACKGROUND: So far, there has been no tool to estimate activity at diagnosis and predict all-cause mortality in patients with ANCA-associated vasculitis (AAV). Hence, we determined the initial predictors of them in patients with AAV. METHODS: We retrospectively reviewed the medical records of 182 patients with AAV. Severe AAV was defined as Birmingham Vasculitis Activity Score (BVAS) ≥ 16. The cutoffs were extrapolated by the receiver operator characteristic (ROC) curve. The odds ratio (OR) and the relative risk (RR) were assessed using the multivariable logistic regression analysis and the chi-square test, respectively. RESULTS: In the comparison analysis, patients with severe AAV exhibited the higher neutrophil and platelet counts, creatinine, erythrocyte sedimentation rate and C-reactive protein, and the lower lymphocyte count, hemoglobin, and serum albumin than those without. In the multivariable logistic regression analysis, creatinine ≥ 0.9 mg/dL (OR 2.264), lymphocyte count ≤ 1430.0/mm3 (OR 1.856), and hemoglobin ≤ 10.8 g/dL (OR 2.085) were associated with severe AAV. We developed a new equation of a multivariable index for AAV (MVIA) = 0.6 × (Lymphocyte count ≤ 1430.0/mm3 ) + 0.7 × (Hemoglobin ≤ 10.8 g/dL) + 0.8 × (Creatinine ≥ 0.9 mg/dL). The optimal cutoff of MVIA for severe AAV was set as 1.35. Severe AAV was identified more frequently in patients with MVIA at diagnosis ≥1.35 than those without (RR 4.432). Patients with MVIA at diagnosis ≥1.35 exhibited the lower cumulative patient survival rate than those without. CONCLUSION: Multivariable index for AAV could assess the cross-sectional activity and predict all-cause mortality in patients with AAV.ope

A case of extranodal natural killer/T-cell lymphoma mimicking refractory Behçet's disease

ope

Antineutrophil Cytoplasmic Antibody-Associated Vasculitis in Korea: A Narrative Review

Antineutrophil cytoplasmic antibody-associated vasculitis (AAV) is a group of systemic necrotising vasculitides, which often involve small vessels, and which lead to few or no immune deposits in affected organs. According to clinical manifestations and pathological features, AAV is classified into three variants: microscopic polyangiitis, granulomatosis with polyangiitis (GPA), and eosinophilic GPA. The American College of Rheumatology 1990 criteria contributed to the classification of AAV, although currently the algorithm suggested by the European Medicines Agency in 2007 and the Chapel Hill Consensus Conference Nomenclature of Vasculitides proposed in 2012 have encouraged physicians to classify AAV patients properly. So far, there have been noticeable advancements in studies on the pathophysiology of AAV and the classification criteria for AAV in Western countries. However, studies analysing clinical features of Korean patients with AAV have only been conducted and reported since 2000. One year-, 5 year-, and 10 year-cumulative patient survival rates are reported as 96.1, 94.8, and 92.8%. Furthermore, initial vasculitis activity, prognostic factor score, age and specific organ-involvement have been found to be associated with either all-cause mortality or poor disease course. The rate of serious infection is 28.6%, and 1 year-, 5 year- and 10 year-cumulative hospitalised infection free survival rates range from 85.1% to 72.7%. The overall standardised incidence ratio of cancer in AAV patients was deemed 1.43 compared to the general Korean population.ope

Controlling Nutritional Status Score is Associated with All-Cause Mortality in Patients with Antineutrophil Cytoplasmic Antibody-Associated Vasculitis

PURPOSE: The controlling nutritional status (CONUT) score was developed to detect undernutrition in patients. Here, we investigated whether the CONUT score estimated at diagnosis could help predict poor outcomes [all-cause mortality, relapse, and end-stage renal disease (ESRD)] of antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV). MATERIALS AND METHODS: We retrospectively reviewed and collated data, including baseline characteristics, clinical manifestations (to calculate AAV-specific indices), and laboratory results, from 196 newly diagnosed AAV patients. Serum albumin, peripheral lymphocyte, and total cholesterol levels (at diagnosis) were used to calculate CONUT scores. RESULTS: In total, 111 patients had high CONUT scores (≥3), which showed higher frequency of myeloperoxidase-ANCA and ANCA positivity, and demonstrated higher AAV-specific indices. The optimal cut-offs of CONUT score (at diagnosis) for predicting all-cause mortality and ESRD were ≥3.5 and ≥2.5, respectively. Patients with CONUT scores higher than the cut-off at diagnosis exhibited lower cumulative and ESRD-free survival rates compared to those with lower scores than the cut-off. In multivariable analyses, diabetes mellitus [hazard ratio (HR): 4.394], five-factor score (HR: 3.051), and CONUT score ≥3.5 (HR: 4.307) at diagnosis were independent predictors of all-cause mortality, while only serum creatinine (HR: 1.714) was an independent predictor of ESRD occurrence.ope

Rituximab Biosimilar Prevents Poor Outcomes of Microscopic Polyangiitis and Granulomatosis with Polyangiitis as Effectively as Rituximab Originator

Purpose: There has been no extensive study to compare the efficacy between rituximab originator (Mabthera®) and its biosimilar (Truxima®) for microscopic polyangiitis (MPA) and granulomatosis with polyangiitis (GPA). Here, we investigated the clinical effects of rituximab on poor outcomes of MPA and GPA in Korean patients, and compared those between Mabthera® and Truxima®. Materials and methods: We retrospectively reviewed the medical records of a total of 139 patients, including 97 MPA patients and 42 GPA patients. At diagnosis, antineutrophil cytoplasmic antibody positivity and comorbidities were assessed. During follow-up, all-cause mortality, relapse, end-stage renal disease, cerebrovascular accident and acute coronary syndrome were evaluated as poor outcomes. In this study, rituximab was used as either Mabthera® or Truxima®. Results: The median age at diagnosis was 60.1 years and 46 patients were men (97 MPA and 42 GPA patients). Among poor outcomes, patients receiving rituximab exhibited a significantly lower cumulative relapse-free survival rate compared to those not receiving rituximab (p=0.002). Nevertheless, rituximab use did not make any difference in other poor outcomes of MPA and GPA except for relapse, which might be a rebuttal to the fact that rituximab use after relapse eventually led to better prognosis. There were no significant differences in variables at diagnosis and during follow-up between patients receiving Mabthera® and those receiving Truxima®. Patients receiving Truxima® exhibited a similar pattern of the cumulative survival rates of each poor outcome to those receiving Mabthera®. Conclusion: Truxima® prevents poor outcomes of MPA and GPA as effectively as does Mabthera®.ope

Total Haemolytic Complement Activity at Diagnosis as an Indicator of the Baseline Activity of Antineutrophil Cytoplasmic Antibody-associated Vasculitis

Objective. The total haemolytic complement activity (CH50) assay evaluates the functioning of the complement system. Accumulating evidence indicates that the activation of the complement system plays a critical role in the pathogenesis of antineutrophil cytoplasmic antibody-associated vasculitis (AAV). Therefore, this study aimed to investigate whether CH50 levels at diagnosis could reflect the baseline activity of AAV. Methods. This retrospective study included 101 immunosuppressive drug-naïve patients with AAV. At diagnosis, all patients underwent clinical assessments for disease activity, including measurement of the Birmingham Vasculitis Activity Score (BVAS) and Five Factor Score (FFS), and laboratory evaluations, such as tests for CH50, C3, and C4 levels. The association between CH50 levels and disease activity was determined. Results. The median BVAS and FFS at diagnosis were 12.0 and 1.0, respectively, whereas the median CH50 level was 60.4 U/mL. There was a negative correlation between the CH50 level and BVAS (r=−0.241; p=0.015). A CH50 cut-off value of 62.1 U/mL was used to classify the patients into two groups: patients with CH50 levels ＜62.1 U/mL (low-CH50 group) and those with CH50 levels ≥ 62.1 U/mL (high-CH50 group). The low-CH50 group had a higher proportion of patients with high disease activity, based on the BVAS, than the high-CH50 group (52.5% vs. 23.8%, p=0.004). Additionally, the low-CH50 group exhibited a lower relapse- free survival rate than the high-CH50 group; however, this difference was not statistically significant (p=0.082). Conclusion. Low CH50 levels at diagnosis may reflect high baseline activity of AAV.ope

재무성과와 비재무성과를 중심으로

학위논문(석사) -- 서울대학교대학원 : 행정대학원 공기업정책학과, 2023. 8. 박상인.With the increasing crisis of low birth rates, aging population, and youth unemployment, there is growing social interest in the overall life of young people. In an effort to strengthen the function of overseeing youth policies and to solve youth problems, the government has established a Youth Policy Coordination Office within the Prime Minister's Office and enacted the "Youth Basic Act" to expand and substantiate the foundation for promoting youth policies. While support for young people has increased quantitatively as a result of these efforts, analysis of the results and effectiveness of such support is still lacking. This study aims to empirically analyze the growth and employment effects of promising young startup companies supported by guarantees from the Credit Guarantee Fund. To examine the impact on financial and non-financial performance, we analyzed the relationship between growth, profitability, stability, and employment indicators and the support provided by the Promising Youth Startup Guarantee compared to general guarantees, and derived policy implications. The study analyzed the impact of each guarantee support on the business performance of young (under 39 years old) and startup companies (less than 7 years of experience) receiving guarantee support from the Credit Guarantee Fund between 2016 and 2018, distinguishing between Promising Youth Startup Guarantee and General Guarantee support, from T+1 to T+3. In this study, we aimed to empirically analyze the growth and job creation effects of start-up companies supported by the Credit Guarantee Fund through the Young Entrepreneur Start-up Guarantee. To determine the impact on financial and non-financial performance indicators, we compared the growth, profitability, stability, and employment metrics of start-ups that received the Young Entrepreneur Start-up Guarantee with those of start-ups that received the General Guarantee from 2016 to 2018. We analyzed the effects of each guarantee on the companies' business performance from T+1 to T+3. Regarding the effects of credit guarantee support, we selected sales revenue, sales growth rate, and total asset growth rate as indicators of growth and compared them. Both the Young Entrepreneur Start-up Guarantee and the General Guarantee showed a tendency for sales revenue to increase from T+1 to T+3, but start-ups that received the Young Entrepreneur Start-up Guarantee showed a greater increase. Negative effects were observed in the sales growth rate and total asset growth rate, with ratios decreasing from T+1 to T+3, and the negative impact was greater for start-ups that received the Young Entrepreneur Start-up Guarantee. In terms of profitability indicators, the sales operating profit margin did not produce significant results, and the total asset net profit margin showed a negative impact for the General Guarantee in all periods. In terms of stability indicators, the debt ratio had a negative impact on the General Guarantee, with the supported companies' ratios increasing at T+1. The interest coverage ratio did not produce significant results. Regarding non-financial indicators, we found that the Young Entrepreneur Start-up Guarantee showed an increase in employment from T+2 to T+3. However, as a policy financial instrument, guarantee support should achieve not only simple financial growth but also various non-financial achievements such as enhancing economic vitality, driving innovation growth, creating jobs, and activating investment. Therefore, it is necessary to consider intangible effects such as creating a favorable atmosphere for youth entrepreneurship, increasing employment, and accumulating youth experience. From this perspective, considering that the policy focus from 2016 to 2018 was job creation, it appears that certain policy goals were achieved through the guarantee support examined in this study. Despite this, in order to enhance the financial impact of guarantee support, it appears necessary to expand the screening capabilities to identify promising youth startups with excellent future growth potential. It is necessary to strengthen human and physical capacities, including organization and infrastructure, to enable the selection of companies with promising growth potential through the advanced future growth evaluation system and to support tailored financial solutions for each company. It is also necessary to strengthen continuous post-management after guarantee support. Continuous management, including various management guidance activities such as tax and management consulting, is needed to help young people overcome obstacles more wisely and cleverly. In addition to simple guarantee and loan support, it is also necessary to diversify support measures through the introduction of innovative financial products such as factoring and new forms of investment. This study is significant in that it attempts to analyze the effectiveness of supporting promising youth start-ups with the guarantee system compared to general guarantees, which has recently received a lot of social attention, in a reasonable way. However, the study has limitations in that it had to exclude start-up companies in their early stages from the analysis due to difficulties in calculating ratio indicators, and it could only analyze short-term performance for up to 3 years after support due to limitations in data collection, and it was unable to conduct an analysis of non-quantitative and intangible aspects, as well as considering various external factors such as follow-up investments and private financing. Through this study, we hope for more substantial support and systematic management of promising youth start-ups.저출산·고령화에 따른 부양비 증가, 청년실업 등의 위기속에서 청년의 삶 전반에 대한 사회적인 관심이 증가하고 있다. 정부 또한 청년문제 해결 및 청년정책 총괄 기능 강화를 위해 국무조정실 내 청년정책조정실을 마련하고 「청년기본법」을 제정하는 등 청년정책 추진에 대한 기반확대 및 내실화를 위해 노력을 지속하고 있는 중이다. 이러한 노력에 힘입어 청년에 대한 지원은 양적으로 급증하였으나, 아직 그에 대한 성과 및 실효성에 대한 분석은 미비한 상황이다. 이에 본 연구에서는 신용보증기금으로부터 유망청년창업기업 보증을 지원받은 기업의 성장 및 고용창출 효과를 실증 분석하고자 하였다. 재무적 성과, 비재무적 성과에 미치는 영향을 확인하기 위해, 성장성, 수익성, 안정성, 고용인원 지표가 유망청년창업보증지원과 어떠한 상관관계를 보이는지를 일반보증과 비교하여 분석하고 정책적 시사점을 도출하고자 하였다. 2016년부터 2018년까지 신용보증기금으로부터 보증지원을 받은 청년(만39세이하)·창업(업력7년미만)기업을 대상으로 유망청년창업기업 보증, 일반보증 지원 기업으로 구분하여 각 보증지원이 기업의 경영성과에 어떠한 영향을 미쳤는지를 T+1기부터 T+3기까지 분석하였다. 신용보증 지원효과 중 성장성 지표는 매출액, 매출액증가율 및 총자산증가율을 선정하여 비교분석 하였다. 유망청년창업기업 보증과 일반보증 지원기업 모두 매출액이 T+1기부터 T+3기까지 모두 증가하는 경향을 보이나, 유망청년창업기업 보증 지원기업은 매출액 증가 폭이 더 큰 것으로 분석되었다. 매출액증가율, 총자산증가율에서는 T+1기부터 T+3기까지 모두 비율이 감소하는 부정적 효과가 발생하는 것으로 분석되었으며, 그 폭은 유망청년창업기업 보증에서 더 큰 것으로 나타났다. 수익성 지표에서는 매출액영업이익률 지표는 유의미한 결과를 도출하지 못하였고, 총자산순이익률은 일반보증은 모든 기간에서 부정적인 영향을 미친 것으로 나타났다. 안정성 지표에서 부채비율은 T+1기에 일반보증 지원기업의 비율이 상승하는 부정적인 영향을 미치고, 이자보상배율에서는 유의미한 분석결과를 도출하지 못했다. 비재무지표에서는 유망청년창업보증의 경우 T+2기와 T+3기에 고용인원이 증가한 것을 확인할 수 있었다. 다만, 정책금융 수단의 하나인 보증 지원은 단순 재무적 성장뿐 아니라 추가적으로 경제활력 제고, 혁신성장 견인, 일자리 창출, 투자 활성화 등 다양한 비재무적 성과를 달성해야 하며, 이에 따라 청년 창업 분위기 조성 및 고용 증대 및 청년경험 축적과 같은 무형적 효과 또한 고려할 필요가 있다. 이러한 관점에서 본 연구의 대상되는 2016년에서 2018년까지의 정책 화두가 일자리 창출이었다는 점을 감안할 때, 해당 보증을 통해 일정부분의 정책목표는 달성한 것으로 보여진다. 그럼에도 보증지원의 재무적 효과를 제고하기 위해 미래성장성이 우수한 유망청년창업기업을 발굴해 낼 수 있는 심사역량을 보다 확충할 필요가 있을 것으로 보인다. 미래성장성 평가체계를 고도화하여 성장성이 양호한 기업을 선별하고, 기업에 맞는 맞춤형 금융을 지원할 수 있도록 조직과 인프라 등을 포함한 인적·물적역량을 확충할 필요가 있다. 보증지원 이후 지속적 사후관리도 강화할 필요가 있다. 청년들이 겪게 될 난관을 보다 지혜롭고 슬기롭게 헤쳐나갈수 있도록 세무·경영 컨설팅 등 다양한 경영지도 활동을 포함한 지속적 관리가 필요할 것으로 보이고, 단순 보증지원 및 대출지원의 형태뿐 아니라 팩토링, 새로운 방식의 투자 등 혁신금융상품 도입을 통해 지원방안을 다각화할 필요도 있다. 본 연구는 최근 사회적 관심이 높은 청년층을 대상으로 한 유망청년창업기업보증의 지원성과를 일반보증과 비교하여 합리적으로 접근을 시도하여 분석한 점에 의미가 있다고 할 수 있다. 다만, 비율지표 산정 곤란으로 인해 창업초기기업들을 분석대상에서 제외할 수 밖에 없었던 점과, 자료수집 한계로 인해 지원 후 3년까지의 단기적 성과만을 대상으로 분석하여 장기적인 측면에서의 분석이 이루어지지 못한 점, 그리고 비계량적·무형적 측면의 분석을 실시하지 못한 점 및 후속투자, 민간금융 등 다양한 외적요인들을 고려하지 못한 점 등을 한계로 제시하였다. 본 연구를 통해 유망청년창업기업에 대한 보다 내실있는 지원과 체계적 관리가 이루어지길 기대한다.제 1 장 서론 1 제 1 절 연구의 배경 및 목적 1 제 2 절 연구의 범위 및 방법 3 제 2 장 이론적 논의와 선행연구 검토 4 제 1 절 이론적 논의 4 1. 청년의 정의 4 2. 청년정책에 대한 논의 5 3. 정책금융 7 4. 신용보증 10 5. 유망청년창업기업 보증 13 제 2 절 선행연구 검토 15 1. 신용보증 지원에 따른 재무 성과분석 15 2. 신용보증 지원에 따른 고용창출 효과 18 3. 선행연구와의 차별성 19 제 3 장 연구설계 21 제 1 절 연구절차 21 제 2 절 연구문제 및 가설설정 22 1. 연구문제 22 2. 가설설정 22 제 3 절 연구의 분석틀과 변수의 정의 24 1. 연구의 분석틀 24 2. 변수의 조작적 정의 25 제 4 절 자료수집 및 분석방법 29 1. 자료수집 29 2. 분석방법 29 제 4 장 실증 분석결과 31 제 1 절 분석대상 및 기술통계량 분석 31 1. 분석대상 자료 및 표본 추출 31 2. 기술통계량 33 제 2 절 상관분석 결과 39 제 3 절 다중회귀분석결과 40 1. 성장성에 미치는 효과 분석 40 2. 수익성에 미치는 효과 분석 44 3. 안정성에 미치는 효과 분석 46 4. 고용창출효과에 미치는 효과 분석 49 제 5 장 결론 50 제 1 절 연구결과 요약 50 제 2 절 연구의 시사점 52 제 3 절 연구의 한계 및 향후과제 53 참고문헌 55 부 록 58 Abstract 64석

Novel mortality-predicting index at diagnosis can effectively predict all-cause mortality in patients with antineutrophil cytoplasmic antibody-associated vasculitis

Background: This study investigated whether the inflammation prognostic index (IPI) and the mortality predicting index (MPI) at diagnosis could predict all-cause mortality in patients with antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV). Methods: We included 223 AAV patients and reviewed their medical records. Clinical and laboratory data and AAV-specific indices at diagnosis were assessed. The IPI was calculated as neutrophil-to-lymphocyte ratio (NLR) × C-reactive protein to albumin ratio (CAR). Here, we newly developed an MPI (NLR × CAR × monocyte counts). Results: The mean age of 223 patients (122 MPA, 57 GPA and 44 EGPA patients) was 59 years. The rate of mortality was 11.2%. Using the receiver operator characteristic curve for all-cause mortality, the cut-offs were calculated as NLR: 3.22, CAR: 3.25, IPI: 18.53 and MPI: 8367.82. In the univariable Cox hazard analysis, age, gender, smoking history, BVAS, FFS and over the cut-off of each index showed statistical significance. As the indices share at least two mutual variables, the multivariable analysis was conducted four times based on each index. An IPI ≥18.53 (HR 3.162) and MPI ≥8367.82 (HR 3.356) were significantly associated with all-cause mortality. Conclusions: This study developed a novel indicator, MPI, that uses the existing NLR and CAR indices and proved that it could predict all-cause mortality in AAV patients.ope