LiverRisk score: An accurate, cost-effective tool to predict fibrosis, liver-related, and diabetes-related mortality in the general population.

BACKGROUND: Noninvasive and early assessment of liver fibrosis is of great significance and is challenging. We aimed to evaluate the predictive performance and cost-effectiveness of the LiverRisk score for liver fibrosis and liver-related and diabetes-related mortality in the general population. METHODS: The general population from the NHANES 2017-March 2020, NHANES 1999-2018, and UK Biobank 2006-2010 were included in the cross-sectional cohort (n = 3,770), along with the NHANES follow-up cohort (n = 25,317) and the UK Biobank follow-up cohort (n = 17,259). The cost-effectiveness analysis was performed using TreeAge Pro software. Liver stiffness measurements ≥10 kPa were defined as compensated advanced chronic liver disease (cACLD). FINDINGS: Compared to conventional scores, the LiverRisk score had significantly better accuracy and calibration in predicting liver fibrosis, with an area under the receiver operating characteristic curve (AUC) of 0.76 (0.72-0.79) for cACLD. According to the updated thresholds of LiverRisk score (6 and 10), we reclassified the population into three groups: low, medium, and high risk. The AUCs of LiverRisk score for predicting liver-related and diabetes-related mortality at 5, 10, and 15 years were all above 0.8, with better performance than the Fibrosis-4 score. Furthermore, compared to the low-risk group, the medium-risk and high-risk groups in the two follow-up cohorts had a significantly higher risk of liver-related and diabetes-related mortality. Finally, the cost-effectiveness analysis showed that the incremental cost-effectiveness ratio for LiverRisk score compared to FIB-4 was USD $18,170 per additional quality-adjusted life-year (QALY) gained, below the willingness-to-pay threshold of $50,000/QALY. CONCLUSIONS: The LiverRisk score is an accurate, cost-effective tool to predict liver fibrosis and liver-related and diabetes-related mortality in the general population. FUNDING: The National Natural Science Foundation of China (nos. 82330060, 92059202, and 92359304); the Key Research and Development Program of Jiangsu Province (BE2023767a); the Fundamental Research Fund of Southeast University (3290002303A2); Changjiang Scholars Talent Cultivation Project of Zhongda Hospital of Southeast University (2023YJXYYRCPY03); and the Research Personnel Cultivation Program of Zhongda Hospital Southeast University (CZXM-GSP-RC125).

A Study on Circular Economy Material Using Fish Scales as a Natural Flame Retardant and the Properties of Its Composite Materials.

Fish scales (FSs) are fishery wastes that can cause environmental pollution. This study aimed to solve this environmental problem. FSs were used as a flame retardant for polymer materials, making them valuable. Fish scales were combined with a commercial flame retardant, ammonium polyphosphate (APP), through synergistic effects to reduce the amount of commercial flame retardant. The use of FSs conforms to the concept of a circular economy and lowers costs by reducing the consumption of APP. Thermogravimetric analysis (TGA), integral procedural decomposition temperature (IPDT), pyrolysis kinetics, limiting oxygen index (LOI), the Underwriters Laboratories 94 (UL94) flammability test, scanning election microscopy, Raman spectroscopy, and energy-dispersive X-ray spectroscopy were used to determine the thermal properties, flame retardant properties, flame retardant mechanism, char morphology, and composition of the composites. The TGA results indicated that the addition of 40% flame retardant raised the char residue from 16.45 wt.% (pure EP) to 36.07 wt.%; IPDT from 685.6 °C (pure EP) to 1143.1°C; LOI from 21% (pure EP) to 30%; and UL94 classification from fail (pure EP) to V-0. These results suggest an increase in char residue, which indicates better protection of the polymer matrix material. The improvements in IPDT, LOI, and UL94 classification, which indicate greater thermal stability, lower flammability (from flammable to fireproof), and higher flammability rating (from fail to V-0), respectively, suggest that the composite material has favorable thermal properties and is less inflammable.

Thermal hazards of benzoyl peroxide and its derived process products through theoretical thermodynamics assessment and different calorimetric technologies.

Benzoyl peroxide (BPO) is one of the primary OPs used as an initiator, curing agent, or medicine. Some of the plastic processes use BPO without air for maintaining the efficiency of the entire reaction. However, there have been numerous accidents involving BPO in petrochemical plants, especially those related to fire and explosion, that are due to its unstable thermal properties and peroxy bond (OO). BPO can be identified as a typical substance with autocatalytic reaction characteristics. Therefore, the related processes and their products are critical to prevent these kinds of chemical contingencies. This research was based on two types of instruments (nonisothermal and isothermal calorimetry), and theoretical methods to further determine the thermal hazard level. From the experimental results for BPO and BPO mixed with its by-products, the heat of decomposition was much higher (from 800 to 1235 J/g), the time to maximum rate under isothermal conditions was much shorter (from 99.1 to 17.4 h at 75.0 °C), and the apparent activation energy was much lower (from 118 to 91 kJ/mol) after BPO was mixed with its by-products. Therefore, the hazard level of BPO mixed with its by-products from the reaction process was much higher than that of pure BPO.