Search Results (12,393)

Background: Several markers have been shown to define subpopulations enriched for cancer stem cells (CSCs) and correlate with poor clinical outcomes in oral squamous cell carcinoma (OSCC). Objective: To investigate the pattern of expression and correlation with clinical parameters of two CSC markers, namely p75NTR and ALDH1A1, in both patient samples and cell lines. Methods: Archival formalin-fixed paraffin-embedded samples from normal human oral mucosa (NHOM, n = 31), oral dysplasia (OD, n = 10) and OSCC (n = 177) were subjected to multiple immunohistochemistry and some to qRT-PCR for expression of CSC and proliferation-related markers, BMI1 and Ki67. Correlations between CSC marker expression and clinical parameters were investigated. Primary cells and cell lines derived from NHOM, OD or OSCC were FACS-analyzed for the same markers. Results: A higher frequency of cells positive for CSC markers was detected in OD and OSCC compared to NHOM. Co-localization of the two markers was a rare finding in OSCC as compared to NHOM or OD and was more heterogeneous in OSCC cell lines than in OD and NHOM cells. Cells positive for p75NTR exhibited higher expression of proliferative and self-renewal markers in comparison to ALDH1A1+ or double ALDH1A1+/p75NTR+ cells. Cells positive for p75NTR were more frequent in small-size tumors and poorly to moderately differentiated tumors and correlated with poor survival of patients otherwise (clinically) deemed as of better prognosis. Higher frequency of ALDH1A1+ cells was found to be associated with lymph node metastasis. Both p75NTR+ cells and ALDH1A1+ cells could emerge de novo from the respective negative subpopulation after FACS and in vitro growth, but with different kinetics. Conclusions: Here, we show that several stem cell subpopulations with distinct phenotypes co-exist in a tumor, each having impact on different clinical parameters. The cell subpopulations identified by the use of different CSC markers were found to be dynamic populations, able to switch between phenotypes. In addition, our data suggest that the stem cell heterogeneity is acquired and evolves parallel with carcinoma progression. Full article

Background: Metabolic dysfunction-associated steatotic liver disease (MASLD) is common in T2DM, likely due to insulin resistance and obesity. Although screening is recommended in high-risk patients, its prevalence in outpatient cardiovascular clinical settings remains unclear. Methods: We analyzed data from 475 patients attending a cardiovascular outpatient clinic: 142 with T2DM, 78 with T1DM, and 255 non-diabetic individuals at elevated cardiovascular risk. Liver steatosis and fibrosis were assessed using vibration-controlled transient elastography (Fibroscan^®): steatosis by controlled attenuation parameter (CAP ≥ 275 dB/m), and fibrosis risk by liver stiffness measurement (LSM ≥ 8.1 kPa). Carotid intima-media thickness (cIMT) was also measured. Results: The cohort (47% women, mean age 53 years, BMI 29.8 kg/m²) showed MASLD in 39.2% and fibrosis risk in 18.3%. MASLD was most prevalent in T2DM (57.0%), followed by non-diabetics (35.3%) and T1DM (19.2%) (p < 0.001). Fibrosis risk was also highest in T2DM (22.5%) vs. T1DM (7.7%) and non-diabetics (19.2%) (p = 0.02). CAP values were higher in those with fibrosis risk. T2DM patients with MASLD had higher LSM (7.0 ± 3.0 kPa) compared to those without MASLD (5.1 ± 2.2 kPa; p < 0.001). cIMT was highest in T2DM (0.73 ± 0.12 mm; p = 0.04), but not associated with MASLD or fibrosis. BMI and triglycerides were the strongest predictors of both MASLD and fibrosis. Conclusions: MASLD and risk of significant fibrosis were highest among T2DM patients. Within T2DM, those with MASLD had higher LSM, indicating increased risk of fibrosis. The presence of MASLD and risk of significant fibrosis was not associated with cIMT in this cardiometabolic cohort. BMI and plasma TG were consistent predictors across groups urging for more strict control by body weight reduction and lifestyle interventions. Full article

Background: The early detection of insulin resistance (IR) is critical for the prevention of type 2 diabetes and cardiometabolic diseases. The ECORE-BF index is a simple anthropometric tool for estimating body fat percentage and overweight. However, its potential utility as a predictor of IR risk has not been previously evaluated in large populations using validated IR indices. Methods: This cross-sectional study included 418,343 Spanish workers (172,282 women and 246,061 men) who underwent occupational health evaluations. The ECORE-BF index was calculated for all participants, and its association with four validated surrogate markers of IR was analyzed: the triglyceride–glucose index (TyG), TyG-BMI, METS-IR, and SPISE. Subjects were classified into normal or high-risk IR groups based on established cut-off values. We evaluated the mean ECORE-BF values across groups, the prevalence of ECORE-BF-defined obesity, and the diagnostic performance of ECORE-BF using receiver operating characteristic (ROC) curve analysis. Results: Participants with elevated IR index values had significantly higher mean ECORE-BF scores than those with normal values (p < 0.001). The prevalence of ECORE-BF-defined obesity was substantially higher in all high-risk IR groups, exceeding 99% for METS-IR and SPISE in both sexes. ROC analysis demonstrated the high diagnostic accuracy of ECORE-BF in predicting elevated IR risk, with area under the curve (AUC) values ranging from 0.698 (TyG in men) to 0.992 (METS-IR in women). Sensitivity and specificity were also high, particularly for TyG-BMI, SPISE, and METS-IR, with optimal Youden indices above 0.75. Conclusions: ECORE-BF demonstrated high accuracy as a non-invasive tool for identifying individuals at increased insulin resistance risk; however, due to the cross-sectional design, predictive value for incident disease cannot be inferred. Its simplicity, cost-effectiveness, and high diagnostic accuracy support its potential utility in large-scale screening programs for early detection of metabolic risk. Full article

Background: Oral semaglutide is the first oral GLP-1 receptor agonist approved for treating patients with type 2 diabetes mellitus (T2DM). This real-world retrospective study evaluated its effectiveness and tolerability in patients requiring a third-line antidiabetic agent due to poor glucoregulation. Methods: Adult patients with T2DM who were taking oral semaglutide and were monitored at tertiary diabetes centers in Croatia were identified through electronic medical records between October 2022 and December 2024. Patients’ data were included in the analysis if they had been on oral semaglutide for at least six months. Results: A total of 163 patients (72 females and 91 males) were recruited, with 96.9% classified as overweight or obese. Among them, 145 had a BMI greater than 30 (mean BMI: 34.18 ± 4.60). The addition of oral semaglutide to their treatment regimen resulted in significant reductions in BMI, HbA1c, and both postprandial and fasting blood glucose levels, as well as in AST and ALT levels (all p < 0.05). There was also an increase in HDL levels (p = 0.007). The side effects observed were consistent with those previously recognized. Conclusions: This study demonstrates that oral semaglutide is safe and effective for glycemic and extraglycemic management in a real-world setting when used as a third-line agent. The best outcomes in terms of weight and HbA1c reduction can be expected when it is introduced early, ideally within the first five years of diabetes duration, and particularly in patients who are insulin naive. Full article

Introduction: Breakfast skipping has been proposed as a determinant of childhood obesity and disorders of glucose metabolism. The present study aimed to examine the association between breakfast skipping and insulin resistance in children and adolescents with overweight or obesity. Methods: In total, 1291 children aged 2–18 years old (boys = 48.4%, boys with obesity = 69.8%; girls = 51.6%, girls with obesity = 60.8%) participated in the study, providing sociodemographic, anthropometric, lifestyle, biochemical, and clinical data. Breakfast consumption was assessed using a validated questionnaire. The IOTF criteria were used to categorize children’s body mass index (BMI) status, while the homeostasis model assessment (HOMA-IR) was used to assess insulin resistance. Results: According to the findings of this study, 37.3% of the children/adolescents were found to skip daily breakfast consumption. Girls tended to skip breakfast more than boys (40.5% vs. 33.9%, p = 0.016), with the percentage of girls skipping breakfast increasing in the older age groups (2–5 yrs: 27% vs. 6–12 yrs: 39.1% vs. 13–18 yrs: 53.5%, p = 0.001). Linear regression analyses showed that breakfast skipping is associated with HOMA-IR in the total sample and in children and adolescents with obesity, after adjusting for several confounding factors (age, gender, Tanner stage, residency, and sports participation). Conclusions: A large number of children and adolescents with overweight or obesity, especially adolescent girls, skip daily breakfast consumption, which was associated with insulin resistance. These findings underscore the importance of promoting regular breakfast consumption as a preventive strategy against metabolic complications in children and adolescents with overweight or obesity. Full article

Semaglutide, a GLP-1 (glucagon-like peptide-1) receptor agonist, is widely prescribed for weight loss in non-diabetic populations. Given the link between obesity and overactive bladder (OAB), we explored whether GLP-1 use would improve adverse urinary events beyond its weight loss benefit for non-diabetic adults undergoing onabotulinumtoxin A (BTX-A) treatment for OAB. Using the TriNetX database, we conducted a retrospective cohort study of non-diabetic OAB patients treated with BTX-A alone or with concurrent GLP-1 therapy. Propensity score matching (1:1) was adjusted for age, race, ethnicity, hypertension, and BMI/obesity. After matching, 992 patients were included in each group. GLP-1 use was associated with a lower incidence of urinary retention (8.6% vs. 4.9%, risk difference 3.66%, p = 0.0044) and urinary tract infection (13.3% vs. 8.8%, risk difference 4.54%, p = 0.00224), with corresponding improved one-year retention-free and UTI-free survival on Kaplan–Meier (KM) analysis. Antispasmodic initiation rates were similar (11.8% vs. 10.3%, risk difference 1.55%, p = 0.6921), and KM analysis showed no significant difference. These findings suggest that GLP-1 receptor agonist use may improve select urinary adverse events in non-diabetic adults undergoing BTX-A treatment for OAB and support further investigation into its potential adjunctive role in OAB management with longer follow-up. Full article

Introduction: The prevalence of cardiorenal syndrome (CRS) and its management might be challenging, so an interdisciplinary approach is advocated. The aim of this study was to identify and describe the population which might profit from such an interdisciplinary clinic at the University Hospital of Zürich. Methods: We screened 551 patients who were seen at least once in the nephrology and cardiology outpatient clinics from 2015 to 2022. Patients with kidney (87) or heart (47) transplantation, on dialysis (179), without concomitant chronic kidney disease (CKD) and heart failure (HF) (179), and those who died before the end of follow-up (94), were excluded, resulting in a cohort of 150 patients. Characteristics related to the type and cause of renal and cardiac disease, cardiovascular risk factors, adequacy of therapy, and incidence of hospitalization for HF were recorded. Results: The median age of the population was 71 years, with one-third having diabetes and two-thirds being male. The median BMI was 28 kg/m². The predominant cause of chronic kidney disease (CKD) was cardiorenal syndrome type 2, affecting 44% (66 out of 150 patients). At the start of the follow-up, the distribution of CKD stages was as follows: 52 patients (34.7%) had CKD stage 2, 30 (20%) had CKD stage 3a, 21 (14%) had CKD stage 3b, 11 (7.3%) had CKD stage 4, and 1 (0.6%) had CKD stage 5. Notably, 81 patients (54%) had moderate or severe albuminuria. Ischemic cardiomyopathy was the leading cause of heart failure, affecting 36.4% (47 patients). Among the heart failure classifications, 73 patients (48.7%) had HFrEF, 32 (21.3%) had HFmrEF, and 45 (30%) had HFpEF. A total of 54 patients (36%) were treated with SGLT2 inhibitors, while 116 (77.3%) received RAAS inhibitors, including 32 patients (21.3%) on an ARNI. Those using both RAAS inhibitors and SGLT2 inhibitors were younger (average age 66 vs. 73 years, p = 0.005) and had a higher prevalence of diabetes (44% vs. 30%) and HFrEF compared to HFpEF (70% vs. 7%, p = 0.002). The hospitalization rate was notably high at 2.2 admissions per patient per year, with an incidence of acute kidney injury (AKI) at 0.23 events per patient per year. Conclusions: We identified a high-risk patient population with cardiorenal disease that might particularly benefit from evidence-based and patient-centered interdisciplinary care. Full article

This study explored IgG N-glycosylation pattern differences in maternal and infant serum in the context of gestational diabetes mellitus (GDM). Serum samples from 15 mother–infant pairs were collected at 12 weeks postpartum and categorized according to maternal body mass index (BMI) and GDM status. The N-glycosylation patterns of the isolated IgG pools were analyzed by capillary electrophoresis with laser-induced fluorescence detection (CE-LIF). Descriptive comparison of the relative area percentage of IgG N-glycan structures revealed differences between the groups. Comparison of the maternal and infant sialo-form/neutral-form ratio (SF/NF) of the N-glycans suggested differences between control mothers and their children, as well as between obese mothers and their children. The maternal SF/NF ratio of IgG varied between the obese and normal-weight GDM mothers. The SF/NF ratios of IgG from the infants showed variation between infants of control mothers and infants of obese mothers, between infants of obese and infants of obese GDM mothers, and between infants of GDM with normal-weight and GDM with obese mothers. The observed differences in maternal and infant IgG N-glycosylation profiles suggest potentially selective placental transfer mechanisms. Full article

Background and Objectives: The selection of the optimal distal level of fusion in long-level fusion surgery remains controversial. Fusion ending at L5 preserves motion but increases the risk of L5–S1 disc degeneration. The L5 laminar hook has been introduced to enhance distal fixation, but its indications and clinical effects remain unclear. This study aimed to investigate the indication of the L5 laminar hook and its effect on adjacent segment degeneration when performing long-level fusion terminating at L5 in patients with degenerative sagittal imbalance (DSI). Materials and Methods: 112 patients with DSI who had undergone corrective surgery and ended at L5 were analyzed retrospectively. Finally, 64 were treated with an L5 laminar hook (Group I), while 48 were not (Group II). We compared radiographic spinopelvic parameters between the two groups and followed up disc degeneration at the L5–S1 level. Additional analysis was conducted within Group I to determine the indications for L5 laminar hook. Results: Preoperative C7 sagittal vertical axis (C7SVA), lumbar lordosis (LL), and pelvic incidence (PI)-LL mismatch were significantly greater in Group I than in Group II (p < 0.05). At 2 years of follow-up, advanced L5–S1 disc degeneration had developed in 14 patients (21.9%) in Group I and 36 patients (75%) in Group II. Patients in Group B (exacerbated L5–S1) had a significantly higher body mass index (BMI), larger preoperative C7SVA, and PI-LL mismatch than patients in Group A (preserved L5–S1). The C7SVA and PI-LL mismatch cut-off values for Group A were 15.8 cm and 40.8°, respectively. Conclusions: L5 laminar hook helps to reduce disc degeneration at the L5–S1 level and can be used to maintain the deformity correction ending at L5 in patients with DSI. We propose a series of indicators for the use of L5 laminar hooks in patients with DSI: a low BMI, a PI-LL mismatch < 40.8°, and a C7SVA < 15.8 cm. Full article

Background: Identifying latent tuberculosis infection (LTBI) is critical for pediatric TB control in China, especially among students from high-burden areas. With no gold-standard test, we compared the tuberculin skin test (TST) and interferon-gamma release assay (IGRA), focusing on factors related to test discordance. Materials and Methods: TST was administered to 1047 local and 900 migrant students; all migrants also received IGRA. TST cutoffs of 5 mm and 10 mm were applied. Agreement was measured using Cohen’s Kappa, and determinants of discordance were analyzed with binary logistic regression. Results: Migrant students had higher TST positivity than locals (28.89% vs. 19.67%, p < 0.001). The agreement between IGRA and TST-12 mm (k = 0.491) was higher than that observed for TST-10 mm (k = 0.466) and TST-5 mm (k = 0.356). Subgroup analyses across sex, residence, ethnicity, BMI, TB contact, and BCG history confirmed superior consistency for TST-12 mm. Individuals without BCG vaccination were less likely to show discordance between IGRA and TST-12 mm (OR = 0.32, 95% CI: 0.10–0.81). Conclusions: Using a 12 mm cutoff improves TST accuracy for students from high-burden areas. IGRA should be preferred for individuals with BCG vaccination history. Full article

Objective: To identify major sugar-sweetened beverage (SSB) consumption patterns among Chinese children and adolescents and examine their associations with childhood overweight/obesity. Methods: Data were drawn from the Chinese Food Consumption Survey (2017–2020), including 7979 children and adolescents. SSB intake was assessed using a non-consecutive 3-day 24 h dietary recall and classified into nine types. Principal component analysis identified SSB consumption patterns. Nutritional status was defined using BMI Z-scores, following the World Health Organization growth standards. Multivariable logistic regression was used to assess the associations between SSB patterns and overweight/obesity, with subgroup analyses by sex, age, and residence area. Results: Three major SSB patterns were identified: (1) Carbonated Beverage and Milk Tea Pattern (dominated by carbonated beverages and milk tea); (2) Functional Beverages Pattern (dominated by coffee beverages and sports beverages); and (3) Plant Hybrid Pattern (dominated by plant protein beverages and plant-based beverages). Preschool-aged children exhibited lower scores across all three patterns. Higher pattern scores were observed among school-aged children and adolescents and those with lower parental education levels, parents working as unskilled labor or homemakers, lower family annual income per capita, and residence in rural areas. All three identified SSB consumption patterns demonstrated significant positive associations with overweight/obesity in children, where higher consumption levels corresponded to greater odds of overweight/obesity. Children exhibiting higher scores in two or more patterns had higher odds of being overweight/obese (Medium-high: OR = 1.249, 95% CI = 1.053, 1.482; High: OR = 1.256, 95% CI = 1.081, 1.459). Subgroup analysis further indicated that the association between the Plant Hybrid Pattern score and overweight/obesity varied significantly by sex. Conclusions: Three SSB consumption patterns were associated with a higher likelihood of overweight/obesity among Chinese children, particularly among those with preferences for multiple SSB types. Interventions should be tailored to SSB consumption habits and socioeconomic contexts, with special attention to rural populations. Full article

Urban blue spaces (UBSs) play a pivotal role in supporting ecological integrity and public health, yet the causal mechanisms connecting the magnitude of water quality improvements to specific health outcomes remain insufficiently explored. The objective of the study is to investigate the effects of two large-scale surface water quality initiatives on the health and physical activity patterns of residents in Qingdao, China: a river pollution clean-up program and a shoreline and estuary monitoring program. Employing a quasi-experimental difference-in-differences (DID) framework with repeated cross-sectional survey data (2017 and 2018; n = 735), we evaluate effects on self-rated health (SRH), happiness, physical activity levels, and body mass index (BMI). Results reveal that both programs significantly enhanced exercise frequency. River pollution clean-up could promote SRH by 0.319 points on the 5-point scale (β = 0.319, p < 0.05), while shoreline quality monitoring program boosted happiness by 0.233 points on the 5-point scale (β = 0.233, p < 0.05). In contrast, both interventions had no significant effect on BMI (p > 0.1). Subgroup analysis revealed that the health and well-being benefits of water quality improvements varied by gender, age, education, and income level. These findings emphasize the importance of prioritizing high-impact UBS interventions in degraded urban areas and integrating them with accessible infrastructure to optimize health gains in a more effective and equitable way. Full article

Background/Objectives: The gluten-free diet (GFD) may be anti-inflammatory in treating Hashimoto’s thyroiditis (HT), but the studies are inconsistent. Methods: To determine the effects of the GFD in non-celiac HT, we included randomized controlled trials from the following databases: Cochrane Central, Embase, Lilacs, Medline, Scopus, and Web of Science. The study was registered at Prospero (no. CRD42024566034). The outcomes assessed included free triiodothyronine (fT3), free tetraiodothyronine (fT4), thyroid stimulating hormone (TSH), Anti-thyroid Peroxidase (TPO), anti-thyroglobulin (Tg), C-reactive protein (CRP), body weight (BW), body mass index (BMI) and adverse effects. Sensitivity, subgroup, meta-regression, bias risk, and evidence analyses’ certainty were also assessed. Results: Only three studies were meta-analyzed, comprising 110 participants. The pooled data revealed the evidence was very uncertain about the effect of GFD compared to the control group on mean differences (MD) of TSH (MD −0.63 uIU/mL; 95% CI −1.63 to 0.36; p = 0.21), fT3 (MD −0.18 pg/mL; 95% CI −0.50 to 0.14; p = 0.28), fT4 (MD −0.33 ng/dL; 95% CI −0.89 to 0.23; p = 0.24), anti-Tg (MD −10.07 IU/mL; 95% CI −17.73 to −2.42; p = 0.010), anti-TPO (MD 76.19 IU/mL; 95% CI 46.86 to 108.51; p < 0.00001), CRP (MD −0.12 IU/mL; 95% CI −0.30 to 0.07), BW (MD −1.46 kg; 95% CI −6.70 to 3.77), and BMI (MD −1.80 kg/m2; 95% CI −3.30 to −0.31). The quality of evidence was rated as having serious methodological concerns to extremely serious imprecision. Conclusions: The GFD decreased anti-Tg and increased the anti-TPO levels, both significantly. There were no significant results on fT3, fT4, and TSH. Full article

Background: The oral microbiota is the largest and most diverse microbial community in the human body, shaped by numerous factors such as body composition, dietary habits, and oral health status. However, relationships between these parameters and the salivary microbiota in adolescents are not yet well understood. Objectives: This study aimed to characterize the salivary microbiota of healthy Turkish adolescents and to examine its associations with body mass index (BMI), diet quality, decayed-missing filled teeth (DMFT) index, and community periodontal index of treatment needs (CPITN). Methods: A descriptive, cross-sectional study was conducted among 40 adolescents aged 14–18 years, classified into four BMI z-score categories (underweight, normal weight, overweight, and obese). Anthropometric measurements, nutritional information, and oral health parameters (DMFT, CPITN) were assessed. Unstimulated saliva samples were collected, and the V3–V4 region of the 16S rRNA gene was sequenced using Illumina MiSeq. Alpha and beta diversity, differential abundance (LEfSe), and correlations with HEI components were analyzed. Results: Underweight adolescents exhibited significantly higher alpha diversity than obese participants (p = 0.024), while beta diversity did not differ across BMI, HEI, DMFT, or CPITN categories. LEfSe analysis revealed BMI-specific taxa: Leptotrichia sp., Haemophilus sp., and Treponema socranskii were enriched in the underweight group; Prevotella denticola in the obese group; and Selenomonas sputigena in the normal-weight group. HEI components, including whole fruits, whole grains, and plant-based proteins, showed positive correlations with Desulfobacterota and Proteobacteria. Poor oral hygiene was associated with higher species richness but not with large shifts in community structure. Conclusions: Salivary microbiota diversity and composition in adolescents vary with BMI, diet quality, and oral hygiene. These patterns are consistent with the idea that targeted nutritional and oral health interventions could influence the salivary microbiome during adolescence. Full article

Background: The aim of this study is to identify people with cystic fibrosis (pwCF) at risk for future pulmonary exacerbations (PEx) based on established and unestablished markers of chronic inflammation. There is currently no universal definition of PEx in cystic fibrosis (CF), but it is commonly characterized by clinical deterioration and a drop in FEV1 ≥10% with or without elevations in systemic inflammatory markers. PEx negatively affect clinical outcomes in pwCF; therefore, predicting and preventing PEx is a crucial goal in the treatment of pwCF. Methods: We retrospectively examined pwCF ≥18 years who had ≥2 pulmonary function tests per year for a 3-year period. The first year was marked as the baseline. The follow-up period (FU) was defined as the following two-year period after baseline. PEx were defined as a need for intravenous antibiotic treatment due to clinical deterioration. Various scoring systems and ratios (neutrophil/lymphocyte (NLR), lymphocyte/monocyte (LMR), CRP, CRP/albumin, Glasgow Prognostic Score (GPS), high-sensitivity modified Glasgow Prognostic Score (hs-GPS)) were compared in pwCF with and without PEx during the FU. Logistic regression models were used to determine the best marker for predicting PEx, considering factors such as age, sex, PEx at baseline, BMI, homozygote F508del mutation, diabetes mellitus, chronic bacterial infection, and CFTR (cystic fibrosis transmembrane conductance regulator)-modulator therapy. The results are reported as odds ratios (ORs) with p-values. Results: Out of 283 pwCF, 131 were included in the study. In total, 43.5% were female, and the mean age was 34.0 years. A total of 75 pwCF (57.3%) had PEx during FU. In the multivariate analysis, the following markers at baseline were significantly associated with having a PEx during FU: CRP(log) (OR = 7.29, p = 0.01), CRP/albumin (OR = 1.08, p = 0.006), decreased LMR (OR = 0.51, p = 0.02), increased NLR (OR = 1.52, p = 0.02), and GPS of 1 vs. 0 (OR = 2.75, p = 0.04). The results indicate that the CRP/albumin ratio was the best model for predicting PEx in pwCF during the FU, outperforming other models. Conclusions: While several inflammation-based scoring systems can predict PEx in pwCF, the easily calculated CRP/albumin proved to reliably identify pwCF with an increased risk for PEx, making it a promising tool in clinical practice. Full article