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Background: Even though there have been improvements in antimicrobial and supportive therapies, sepsis and septic shock are still major causes of death in intensive care units. Early prognostic stratification is very important for helping doctors make decisions. Platelet-derived indices may provide useful, low-cost indicators that signify both inflammatory activation and coagulation irregularities. This study looked at how well different platelet-based ratios could predict death in the hospital from sepsis. Materials and Methods: We performed a prospective observational study spanning one year in a tertiary ICU, enrolling 114 adult patients diagnosed with sepsis or septic shock. Upon admission, four platelet-related biomarkers were measured: the C-reactive protein-to-platelet ratio (CPR), the platelet-to-lymphocyte ratio (PLR), the platelet-to-white blood cell ratio (PWR), and the platelet-to-creatinine ratio (PCR). Logistic regression models and receiver operating characteristic (ROC) analyses were employed to assess predictive accuracy. Results: Compared to survivors, non-survivors (n = 39) had much higher CRP levels and CPR values, alongside lower platelet and lymphocyte counts. The CPR index showed the best ability in differentiating between non-survivors and survivors (AUC 0.757), with a best cutoff of 0.886. In simplified multivariate models, CPR was still an independent predictor of death in the hospital (OR 1.98; 95% CI 1.22–3.21), whereas PLR and PWR were not. PCR showed a non-significant trend toward lower values in not survivors. Conclusions: CPR is a strong and clinically viable predictor of early mortality in sepsis, outperforming other platelet-based indices. Derived from routine laboratory parameters, CPR serves as a valuable adjunct for initial risk stratification in the ICU. To further confirm its prognostic role and incorporation into current scoring systems, large-scale multicenter studies with longitudinal measurements are warranted to validate its prognostic utility and integration into existing scoring systems. Full article

Despite the evidence from experimental studies that endogenous hormones have sex-related effects on action potential duration, the relationship between gonadal steroids and ventricular repolarization in acute myocardial infarction (AMI) is not clear. We tested the hypothesis that endogenous 17β-estradiol (E2) and 17β-estradiol-to-testosterone ratio (E2/T) are associated with inflammation, influencing the occurrence of early ventricular arrhythmia (VA) in AMI. Electrocardiographic (ECG) repolarization indices, including resting heart rate (HR), corrected QT (QTc) interval, QTc minimum (QTcmin), QTc maximum (QTcmax), and QTc dispersion (QTcd), along with E2, total T, and the ratio of E2 to T (E2/T), were measured and analyzed after percutaneous coronary intervention in 86 patients (36 women, 41.9%). In a non-specific sex analysis, the incidence of early VA in the course of AMI was determined by the ejection fraction of the left ventricle (OR 0.876, p = 0.054), and by the peak levels of plasma C-reactive protein (OR 1.026, p = 0.077). Endogenous plasma 17β-estradiol tended to be higher in cases with early ventricular arrhythmia (124.5 ± 79 vs. 181 ± 192.8, p = 0.089). 17β-estradiol levels were significantly predicted by C-reactive protein (OR 1.050, p = 0.042). This study found that reduced systolic function of the left ventricle and higher peak CRP levels are associated with endogenous plasma 17β-estradiol in the acute phase of MI, and predicted the risk of early in-hospital ventricular arrhythmia. Full article

Modern 5G+grade low power wide area network (LPWAN) technologies such as Narrowband Internet-of-Things (NB-IoT) operate utilizing a multi-channel slotted ALOHA algorithm at the random access phase. As a result, the random access phase in such systems is characterized by relatively low throughput and is highly sensitive to traffic fluctuations that could lead the system outside of its stable operational regime. Although theoretical results specifying the optimal transmission probability that maximizes the successful preamble transmission probability are well known, the lack of knowledge about the current offered traffic load at the BS makes the problem of maintaining the optimal throughput a challenging task. In this paper, we propose and analyze a new reactive access-barring scheme for NB+IoT systems based on machine learning (ML) techniques. Specifically, we first demonstrate that knowing the number of user equipments (UE) experiencing a collision at the BS is sufficient to make conclusions about the current offered traffic load. Then, we show that through utilizing ML-based techniques, one can safely differentiate between events in the Physical Random Access Channel (PRACH) at the base station (BS) side based on only the signal-to-noise ratio (SNR). Finally, we mathematically characterize the delay experienced under the proposed reactive access-barring technique. In our numerical results, we show that by utilizing modern neural network approaches, such as the XGBoost classifier, one can precisely differentiate between events on the PRACH channel with accuracy reaching 0.98 and then associate it with the number of user equipment (UE) competing at the random access phase. Our simulation results show that the proposed approach can keep the successful preamble transmission probability constant at approximately 0.3 in overloaded conditions, when for conventional NB-IoT access, this value is less than 0.05. The proposed scheme achieves near-optimal throughput in multi-channel ALOHA by employing dynamic traffic awareness to adjust the non-unit transmission probability. This proactive congestion control ensures a controlled and bounded delay, preventing latency from exceeding the system’s maximum load capacity. Full article

Ischemic stroke is a major cause of long-term disability and death, with oxidative stress contributing substantially to post-ischemic injury. Reperfusion restores oxygen supply but simultaneously increases reactive oxygen species (ROS), amplifying secondary neuronal damage. This study examined time-dependent changes in systemic thiol redox status following transient middle cerebral artery occlusion (tMCAO) in rats. Plasma concentrations of cysteine (CySH), cystine (CySS), glutathione (GSH), and glutathione disulfide (GSSG), along with corresponding CySS/CySH and GSSG/GSH ratios and redox potentials (Eh), were evaluated 24 and 48 h after occlusion. At 24 h, thiol concentrations and redox ratios showed no significant differences between sham and tMCAO groups. By 48 h, a marked oxidative shift emerged, characterized by reduced CySH, elevated GSSG, and significant increases in both CySS/CySH and GSSG/GSH ratios. Redox potentials also demonstrated substantial oxidation at this time point. These findings indicate that prolonged ischemia–reperfusion induces systemic oxidative stress, with plasma redox status serving as a sensitive indicator of reperfusion-related injury. The results underscore the plasma redox status as a potentially sensitive biomarker of reperfusion-induced oxidative injury and support the therapeutic value of targeting redox imbalance to mitigate oxidative damage following stroke. Full article

This study investigated the effect of mechanical activation on the physicochemical properties of lepidolite and the leaching behavior of mechanically activated samples in sulfuric acid (H₂SO₄). Lepidolite was mechanically activated using a high-energy planetary ball mill (PBM) at 400 RPM with a 20:1 ball-to-feed weight ratio (BFR, g:g) and the samples activated for different durations were characterized for amorphous phase content, particle size, and morphology using various solid analyses. X-ray diffraction (XRD) revealed the progressive amorphization of lepidolite, with the amorphous fraction increased from 34.1% (unactivated) to 81.4% after 60 min of mechanical activation. Scanning electron microscopy (SEM) showed that mechanically activated particles became fluffy and rounded, whereas unactivated particles retained lamellar and angular shapes. The reactivity of minerals after mechanical activation was evaluated through a 2 M H₂SO₄ leaching test at different leaching temperatures (25–80 °C) and time periods (30–180 min). Although the leaching efficiencies of Li and Al slightly improved at higher leaching temperatures and longer leaching times, the leaching of these metals was primarily governed by the mechanical activation time. The highest Li and Al leaching efficiencies—87.0% for Li and 79.4% for Al—were obtained from lepidolite that was mechanically activated for 60 min under leaching conditions of 80 °C and a 10% (w/v) solid/liquid (S/L) ratio for 30 min. The elemental mapping images of leaching feed and residue produced via energy dispersive spectroscopy (EDS) indicated that unactivated particles in the leaching residue had much higher metal content than mechanically activated particles. Kinetic analysis further suggested that leaching predominantly occurs at mechanically activated sites and the apparent activation energies calculated in this study (<3.1 kJ·mol⁻¹) indicate diffusion-controlled behavior with weak temperature dependence. This result confirmed that mechanical activation significantly improves reactivity and that the residual unleached fraction can be attributed to unactivated particles. Full article

Background: The aim of this study was to evaluate the diagnostic and prognostic performance of albumin-based inflammatory–nutritional indices in hyperemesis gravidarum (HG) and to determine their associations with disease severity and risk of re-hospitalization. Methods: This retrospective case–control study included 246 women with HG and 246 gestational-age-matched healthy pregnant controls at 6–16 weeks of gestation. Disease severity was classified as mild, moderate, or severe using the Pregnancy-Unique Quantification of Emesis (24 h scale) (PUQE-24) score. A comprehensive panel of albumin-based inflammatory indices—including C-reactive protein-to-albumin ratio (CAR), fibrinogen-to-albumin ratio (FAR), neutrophil-to-albumin ratio (NAR), leukocyte-to-albumin ratio (LAR), neutrophil percentage-to-albumin ratio (NPAR), monocyte-to-albumin ratio (MAR), hemoglobin–albumin–lymphocyte–platelet (HALP) score, modified HALP (m-HALP) score, prognostic nutritional index (PNI) score, systemic immune-inflammation index-to-albumin (SII/Alb), and systemic inflammatory response index-to-albumin (SIRI/Alb)—was calculated from routine complete blood count and serum biochemistry results obtained at diagnosis. Receiver operating characteristic analysis, along with univariate and multivariate logistic regression models, was performed to evaluate diagnostic performance and identify predictors of severe HG and re-hospitalization. Results: Albumin-based indices exhibited severity-associated alterations, with an overall trend toward worsening immuno-nutritional status across increasing HG severity. Among these, m-HALP score demonstrated the strongest inverse correlations with PUQE-24 score, ketonuria grade, length of hospital stay, and re-hospitalization risk (r = −0.74 to −0.52; all p < 0.001) and achieved the highest discriminative accuracy for both severe HG (AUC 0.864, 95% CI 0.836–0.892, p < 0.001) and re-hospitalization (AUC 0.722, 95% CI 0.675–0.766, p < 0.001). In multivariable analysis, higher HALP, m-HALP, and PNI were independently associated with a lower likelihood of severe HG. For re-hospitalization, higher m-HALP and HALP were independently associated with a lower risk, whereas higher NPAR, higher ketonuria grade, and higher PUQE-24 score were independently associated with an increased risk of re-hospitalization. Conclusions: Albumin-based indices, particularly m-HALP, demonstrated robust diagnostic and prognostic performance in HG compared with conventional biomarkers. These readily available, cost-neutral composite biomarkers enable objective severity stratification and accurate identification of patients at elevated risk of recurrent hospitalization, offering immediate potential to guide personalized, evidence-based clinical management. Full article

Dilated cardiomyopathy is characterized by progressive left ventricular dilation and impaired systolic function, with inflammation recognized as a key contributor to disease onset and adverse outcomes. C-reactive protein reflects systemic biochemical inflammation, whereas Delta Neutrophil Index represents the circulating immature neutrophil fraction and provides a cellular dimension of inflammatory burden. The combined diagnostic and prognostic value of these two biomarkers in dilated cardiomyopathy has not been adequately explored. This retrospective study included one hundred and fifty patients with dilated cardiomyopathy and one hundred and fifty age-, diabetes-, and hypertension-matched controls. Demographic, laboratory, and echocardiographic measurements were analyzed. The diagnostic and prognostic performances of C-reactive protein, Delta Neutrophil Index, and their combined model were assessed using logistic regression, receiver operating characteristic curve analysis, reclassification metrics, calibration testing, and decision curve analysis. Additional analyses were performed for patients with left ventricular ejection fraction below twenty percent, and mortality predictors were examined within the dilated cardiomyopathy cohort. Both C-reactive protein and Delta Neutrophil Index levels were significantly higher in patients with dilated cardiomyopathy than in controls and were further elevated in those with severely reduced ejection fraction. Delta Neutrophil Index remained independently associated with severe left ventricular dysfunction (ejection fraction ≤ 20%) in multivariable analysis (odds ratio 2.51). Each biomarker showed an independent association with the presence of dilated cardiomyopathy, and their combined model achieved the highest diagnostic accuracy. In receiver operating characteristic analysis, the area under the curve was 0.895 for Delta Neutrophil Index, 0.691 for C-reactive protein, and increased to 0.920 for the combined model, with a sensitivity of 81.3% and specificity of 92.0%. Delta Neutrophil Index was independently associated with severe left ventricular dysfunction and mortality, while C-reactive protein, age, ejection fraction, urea, and sodium also contributed to mortality risk. Delta Neutrophil Index was independently associated with mortality (odds ratio 2.51), while C-reactive protein, age, ejection fraction, urea, and sodium also contributed to mortality risk. The combined model provided significant improvement in risk reclassification and demonstrated superior calibration and greater net clinical benefit across a wide range of decision thresholds. C-reactive protein and Delta Neutrophil Index offer complementary diagnostic and prognostic information in dilated cardiomyopathy. Their combined use enhances diagnostic discrimination, strengthens risk stratification, and improves identification of patients at high risk for severe ventricular dysfunction and mortality. Incorporation of these accessible biomarkers into clinical evaluation may support earlier recognition and more tailored management of high-risk individuals. Full article

Background: Systemic inflammation plays a central role in the pathogenesis and progression of type 2 diabetes mellitus (T2DM). Hematologic inflammatory indices-such as the Systemic Immune-Inflammation Index (SII), Neutrophil-to-Lymphocyte Ratio (NLR), Platelet-to-Lymphocyte Ratio (PLR), and Monocyte-to-Lymphocyte Ratio (MLR)-have emerged as accessible markers of chronic inflammation, yet longitudinal comparisons across oral antidiabetic therapies remain limited. This study uniquely integrates longitudinal correlation and network analyses in a large real-world T2DM cohort, allowing assessment of the temporal stability and class-specific inflammatory patterns across four oral antidiabetic therapies. Methods: This retrospective, longitudinal study analyzed 13,425 patients with T2DM treated with Biguanidines, Dipeptidyl Peptidase-4 (DPP-4) inhibitors, Sodium–Glucose Cotransporter-2 (SGLT-2) inhibitors or Thiazolidinediones (TZDs) between 2020 and 2024. Data were retrieved from the Probel^® Hospital Information System and included baseline, early (30–180 days), and late (180–360 days) follow-up laboratory results. Systemic inflammatory indices were computed from hematologic parameters, and correlations among inflammatory and biochemical markers were assessed using Spearman’s coefficients. Results: At baseline, all hematologic indices were strongly intercorrelated (SII–NLR r = 0.83, p < 0.001; SII–PLR r = 0.73, p < 0.001), with moderate associations to C-reactive protein (CRP; r ≈ 0.3–0.4) and weak or no correlations with Ferritin (r ≈ −0.1). These relationships remained stable throughout follow-up, confirming reproducibility of systemic inflammatory coupling. Longitudinally, SII and NLR showed modest early increases followed by significant declines at one year (p < 0.05), while PLR and MLR remained stable. Class-specific differences were observed: SGLT-2 inhibitors and TZDs demonstrated stronger and more integrated anti-inflammatory networks, whereas Biguanidines and DPP-4 inhibitors exhibited moderate coherence. Principal Component Analysis (PCA) explained 62.4% of total variance and revealed distinct clustering for TZD and SGLT-2 groups, reflecting class-specific inflammatory modulation. Conclusions: Systemic inflammatory indices (SII, NLR, PLR) provide reproducible and accessible measures of low-grade inflammation in T2DM. Despite overall inflammation reduction with treatment, drug-specific patterns emerged-SGLT-2 inhibitors and TZDs showed greater anti-inflammatory coherence, while Biguanidines and DPP-4 inhibitors maintained moderate effects. Full article

Decarbonization of compression-ignition engines requires evaluation of carbon-free and low-carbon fuel alternatives. Ammonia (${NH}_3$) offers zero direct carbon emissions but faces combustion challenges including low flame speed (7 $\mathrm{c}\mathrm{m}/\mathrm{s}$) and high auto-ignition temperature (657 °$\mathrm{C}$). Methanol provides improved reactivity and bound oxygen content that can enhance ignition characteristics. This computational study investigates diesel–ammonia–methanol ternary fuel blends using validated three-dimensional CFD simulations (ANSYS Forte 2023 R2; ANSYS, Inc., Canonsburg, PA, USA) with merged chemical kinetic mechanisms (247 species, 2431 reactions). The model was validated against experimental in-cylinder pressure data with deviations below 5% on a single-cylinder diesel engine (510 cm³, 17.5:1 compression ratio, 1500 rpm). Ammonia energy ratios were systematically varied (10–50%) with methanol substitution levels (0–90%). Fuel preheating at 530 K was employed for high-alcohol compositions exhibiting ignition failure at standard temperature. Results demonstrate that peak cylinder pressures of 130–145 bar are achievable at 10–30% ammonia with M30K–M60K configurations, comparable to baseline diesel (140 bar). Indicated thermal efficiency reaches 38–42% at 30% ammonia-representing 5–8 percentage point improvements over diesel baseline (31%)-but declines to 30–32% at 50% ammonia due to fundamental combustion limitations. ${CO}_2$ reductions scale approximately linearly with ammonia content: 35–55% at 30% ammonia and 75–78% at 50% ammonia. ${NO}_X$ emissions demonstrate 30–60% reductions at efficiency-optimal configurations. Multi-objective optimization analysis identifies the A30M60K configuration (30% ammonia, 60% methanol, 530 K preheating) as optimal, achieving 42% thermal efficiency, 58% ${CO}_2$ reduction, 51% ${NO}_X$ reduction, and 11% power enhancement versus diesel. This configuration occupies the Pareto frontier “knee point” with cross-scenario robustness. Full article

Postoperative delirium (POD) is a neurocognitive complication that commonly occurs after cardiac surgery. Despite the association of POD with increased morbidity and mortality, reliable perioperative biomarkers for predicting POD remain scarce. This retrospective observational study investigated whether temporal changes in perioperative redox balance are associated with POD development. Fifty adult patients who underwent elective cardiac surgery at Osaka University Hospital were included. Serum levels of derivatives of reactive oxygen metabolites (d-ROMs) and biological antioxidant potential (BAP) were measured preoperatively, immediately after intensive care unit admission, and on postoperative days 1–4. POD was assessed twice daily using the Intensive Care Delirium Screening Checklist (ICDSC), with an ICDSC score of ≥3 indicating delirium. POD occurred in 18 (36%) out of 50 patients. Compared with non-POD patients, those with POD exhibited higher preoperative d-ROMs levels, a lower BAP/d-ROMs ratio, a transient postoperative increase in BAP, and a relatively higher BAP/d-ROMs ratio during the early postoperative period. Preoperative d-ROMs levels showed a positive correlation with the maximum ICDSC score. In conclusion, perioperative redox dynamics are associated with POD risk and severity. Redox-related markers, particularly d-ROMs, may have potential as biomarkers for identifying patients at higher risk of POD after cardiac surgery, and their clinical utility warrants further prospective validation. Full article

Background and Objectives: Acute mesenteric ischemia (AMI) lacks reliable prognostic biomarkers, and the prognostic performance of the C-reactive protein–albumin–lymphocyte (CALLY) index in this population has not been previously evaluated. This study aimed to assess the predictive value of the CALLY index for 30-day mortality in patients presenting to the emergency department (ED) with AMI. Materials and Methods: This retrospective cohort study included patients aged ≥18 years who presented to the ED with AMI over a 4-year period. Demographic and clinical data were collected. The CALLY index, neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and CRP-to-lactate ratio were calculated. The primary outcome was 30-day mortality. Univariate and multivariate logistic regression analyses were performed to identify predictors of mortality. A receiver operating characteristic (ROC) curve analysis was used to assess predictive performance. A p-value < 0.05 was considered statistically significant. Results: A total of 111 patients were included (mean age, 69.2 ± 11.8 years; 52.3% male). The most common comorbidities were hypertension and coronary artery disease (45% each). The 30-day mortality rate was 55.9%. In a univariate analysis, lower CALLY index values were associated with higher mortality (p = 0.011). However, the CALLY index did not remain independently associated with mortality in multivariate logistic regression analysis (p = 0.773). The ROC analysis indicated that the CALLY index had a modest but statistically significant ability to predict 30-day mortality (AUC = 0.64, 95% CI: 0.54–0.74, p = 0.011). At a cut-off value of 0.0015, the CALLY index showed a sensitivity of 55% and a specificity of 77%. Conclusions: The CALLY index had modest predictive value for 30-day mortality in patients with AMI. Full article

Background: Pre-eclampsia causes endothelial dysfunction and altered vascular reactivity, which may increase perioperative risk, particularly under the physiologic stress of general anesthesia (GA). However, the evidence regarding its independent effects under uniform GA conditions is limited. This study assessed the association between pre-eclampsia and intraoperative hemodynamic stability as well as postoperative complications in women undergoing cesarean section under GA. Methods: This retrospective cohort study screened 1242 women who underwent GA for cesarean delivery between January 2017 and July 2024. After applying exclusion criteria, 959 patients were included: 169 with and 790 without pre-eclampsia. The intraoperative blood-pressure and heart-rate trends, vasopressor use, operative variables, and postoperative complications were analyzed. Predictors of postoperative respiratory complications were identified using logistic regression with Firth correction. Results: Patients with pre-eclampsia showed consistently higher mean arterial pressures throughout induction and emergence, whereas trends in heart rate were similar. Postoperative morbidity was higher in the pre-eclampsia group (11.8% vs. 5.3%), with increased respiratory complications (3.6% vs. 1.1%) and longer hospital stays. Pre-eclampsia independently predicted postoperative respiratory complications in univariable (odds ratio [OR] 3.27, 95% confidence interval [CI] 1.13–8.90, p = 0.03), multivariable (OR 3.13, 95% CI 1.09–8.98, p = 0.03), and Firth’s analyses (OR 3.21, 95% CI 1.11–8.77, p = 0.03). Conclusions: Pre-eclampsia was associated with persistent intraoperative hypertension and higher risks of postoperative respiratory morbidity under GA. These findings support the need for individualized hemodynamic control, cautious fluid management, and increased postoperative respiratory surveillance in patients with pre-eclampsia. Full article

Objectives: This study aimed to evaluate the diagnostic value of presepsin in differentiating benign and malignant causes of cervical lymphadenopathy and to compare its performance with conventional inflammatory markers, including C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), and neutrophil-to-lymphocyte ratio (NLR). Methods: A total of 76 individuals were enrolled, including 52 patients who underwent excisional biopsy for cervical lymphadenopathy and 24 healthy controls. Serum presepsin, CRP, ESR, and complete blood count parameters were measured preoperatively. Patients were classified according to histopathological diagnosis as reactive, granulomatous, or malignant lymphadenopathy. Correlation and receiver operating characteristic (ROC) analyses were performed to assess the diagnostic performance of biomarkers. Results: Median presepsin, CRP, ESR, NLR, and monocyte-to-lymphocyte ratio (MLR) levels were significantly higher in the patient group compared with controls (all p < 0.001). Presepsin levels correlated positively with CRP (r = 0.42), ESR (r = 0.38), and NLR (r = 0.36). Although subgroup analysis revealed no statistically significant differences in presepsin levels among reactive, granulomatous, and malignant cases (p = 0.50), ROC analysis demonstrated the highest diagnostic accuracy for presepsin (AUC = 0.85), followed by CRP (AUC = 0.78), ESR (AUC = 0.74), and NLR (AUC = 0.72). A presepsin threshold of >210 pg/mL predicted malignancy with 82.4% sensitivity and 78.6% specificity. Conclusions: Presepsin provides an objective and noninvasive tool that complements traditional inflammatory markers in the diagnostic evaluation of cervical lymphadenopathy. Its superior diagnostic performance for malignancy prediction suggests potential utility in guiding biopsy decisions and avoiding unnecessary surgical procedures in benign cases. Full article

Background: Chronic urticaria (CU) is characterized by recurrent wheals and/or angioedema persisting for more than six weeks. While disease triggers are often unidentified, seasonal and environmental factors may modulate disease activity; however, evidence regarding their clinical impact remains limited. Objective: This study aimed to evaluate the effects of seasonal, meteorological, and pollutant-specific environmental factors on urticaria control using the Urticaria Control Test (UCT), and to compare these effects between chronic spontaneous urticaria (CSU) and chronic inducible urticaria (CIU) in relation to inflammatory serum biomarkers. Materials and Methods: This prospective observational study was conducted at the Allergy and Clinical Immunology outpatient clinic of Kirikkale University Faculty of Medicine between 1 June 2023 and 1 April 2024. Patients with CU were classified as CSU or CIU according to international guidelines. Each participant was evaluated during summer and winter seasons. Area-level air pollution data and meteorological parameters were obtained from national monitoring systems. Disease control was assessed using the UCT, and inflammatory biomarkers were analyzed. Results: Urticaria control showed significant seasonal variation, with lower UCT scores during summer and higher scores during winter in both CSU and CIU patients. Among environmental factors, ozone (O₃) was the only pollutant consistently associated with poorer urticaria control, whereas particulate matter and traffic-related pollutants, despite being higher in winter, showed no clinically relevant association. Summer months were characterized by increased inflammatory activity, including elevated leukocyte counts, neutrophil-to-lymphocyte ratio (NLR), C-reactive protein (CRP), and D-dimer levels, particularly in CSU patients. D-dimer emerged as an independent marker associated with poor disease control during summer. Conclusions: CU demonstrates marked seasonal variation, with disease worsening during summer months. Pollutant-specific effects, particularly O₃ exposure, rather than overall air pollution burden, appear to be clinically relevant in urticaria control. Inflammatory and coagulation-related biomarkers may provide additional insight into disease activity. These findings support a season-aware and individualized management approach and highlight the need for future studies incorporating individual-level exposure assessment and biomarker-guided strategies. Full article

Background/Objectives: Non-small-cell lung cancer (NSCLC) is a common disease with a high mortality rate and is often treated with immunotherapies; however, prognostic markers are required to identify patients who are most likely to benefit from these treatments. Therefore, we designed this study to assess the prognostic significance of the C-PLAN index, which includes performance status (PS) and C-reactive protein (CRP). Methods: A total of 560 patients were included in this multicenter study. Patients had been diagnosed with NSCLC and had received nivolumab therapy. The C-PLAN index, defined in 2022, is a score derived from the combination of PS, CRP, lactate dehydrogenase (LDH), albumin, and neutrophil–lymphocyte ratio (NLR). Patients were classified into good-, moderate-, and poor-prognosis groups according to the C-PLAN score. Results: The median metastatic overall survival was 25 months in the group with a C-PLAN score < 2 and 6 months in the group with a C-PLAN score ≥ 2 (p < 0.001). The median metastatic progression-free survival was 11 months in the group with a C-PLAN score < 2 and 3 months in the group with a C-PLAN score ≥ 2. Conclusion: This is the first comprehensive study demonstrating that the C-PLAN index can be used for prognostic purposes in immunotherapy. This score, which can be easily, economically, and practically calculated in outpatient clinics, can predict patient prognosis and determine who should receive longer durations of immunotherapy. Full article