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Objective: The high hemoglobin, albumin, lymphocyte, and platelet (HALP) score has been reported to be a good prognostic indicator for several malignancies. However, more evidence is needed before it can be introduced into clinical practice. Here, we systematically evaluated the predictive value of HALP for survival outcomes in patients with solid tumors. Methods: This study was performed according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and Assessing the Methodological Quality of Systematic Reviews (AMSTAR) Guidelines. In March 2024, an electronic literature search was performed for articles regarding the prognostic role of HALP in solid tumors. Data from studies with reported risk ratios (HRs) and 95% confidence intervals (CIs) were pooled in a meta-analysis. Study bias was assessed using the QUIPS tool. Results: Of the 729 articles reviewed, 45 cohorts including data from 17,049 patients with cancer were included in the pooled analysis. The pooled results demonstrated that elevated HALP score was significantly associated with favorable overall survival (HR = 0.60, 95% CI 0.54-0.67, p < 0.01), cancer-specific survival (HR = 0.53, 95% CI 0.44- 0.64, p < 0.01), progression-free survival (HR = 0.62, 95% CI 0.54-0.72, p < 0.01), recurrence-free survival (HR = 0.48, 95% CI 0.30-0.77, p < 0.01), and disease-free survival (HR = 0.72, 95% CI 0.57-0.82, p < 0.01). Subgroup analyses based on various confounding factors further revealed the consistent prognostic impact of HALP on overall survival in patients with solid tumors. Conclusions: Our findings suggest that high HALP is associated with better survival outcomes in patients. The HALP score is a potential prognostic biomarker in solid tumors, but it needs to be further studied whether it can improve the established prognostic model. [ABSTRACT FROM AUTHOR]

Aim To develop and validate a dynamic nomogram to predict the risk of no-reflow phenomenon (NRP) after percutaneous coronary intervention (PCI) in patients with ST-segment elevation myocardial infarction (STEMI) by constructing HALP based on haemoglobin (Hb), albumin (Alb), lymphocytes (LYM), and platelets (PLT). Methods A retrospective analysis of 449 STEMI patients admitted to Nanyang Central Hospital from January 2022 to January 2024 was divided into 145 cases in the NRP group and 304 cases in the normal reflow group according to whether the patients developed NRP after surgery. HALP was calculated based on Hb, Alb, LYM and PLT observations. Independent influences on NRP risk were determined by multivariate Logistic regression analysis. Dynamic nomogram of NRP risk after PCI in STEMI patients were developed using the R language correlation software package. Results The incidence of NRP was 32. 3% (145/449) among 449 patients with NRP. The HALP of patients in the NRP group was lower than that of patients in the normal reflow group (P<0. 05). The area under the curve (AUC) of HALP for diagnosis of NRP was 0. 880 (0. 847 ~0. 909), and the Kappa coefficient of its optimal cutoff value ≤3. 04 versus patients with accurate diagnosis of NRP was 0. 612. The results of multivariate Logistic regression analysis showed that age, diabetes mellitus, and high sensitivity C-reactive protein (hs-CRP) were independent risk factors for NRP after PCI in STEMI pa-tients (P <0. 05), and left ventricular ejection fraction (LVEF) and HALP were independent protective factors (P < 0. 05). A dynamic nomogram (https://xz0311. shinyapps. io/DynNamicNRP/) based on HALP combined with age, diabetes, LVEF, and hs-CRP was effective in predicting the risk of post-PCI NRP in STEMI patients. Conclusion HALP is more effective than traditional risk factors in predicting NRP risk in STEMI patients after PCI, and the dynamic nomogram developed based on HALP will help develop personalized treatment strategies for patients with high NRP risk. [ABSTRACT FROM AUTHOR]

Abstract Background Achieving a pathological complete response (pCR) after neoadjuvant therapy (NAT) is considered to be a critical factor for a favourable prognosis in breast cancer. However, discordant pathological complete response (DpCR), characterised by isolated responses in the breast or axillary, represents an intermediate pathological response category between no response and complete response. This study aims to investigate predictive factors and develop models based on peripheral blood inflammatory indexes to more accurately predict NAT outcomes. Method A total of 789 eligible patients were enrolled in this retrospective study. The patients were randomized into training and validation cohort according to a 7:3 ratio. Lasso and uni/multivariable logistic regression analysis were applied to identify the predictor variables. Two Nomograms combining clinico-pathologic features and peripheral blood inflammatory indexes were developed. Result Molecular Subtype, HALP, P53, and FAR were used to construct the predictive models for traditional non pCR (T-NpCR) and total-pCR (TpCR). The T-NpCR group was divided into DpCR and non pCR (NpCR) subgroups to construct a new model to more accurately predict NAT outcomes. cN, HALP, FAR, Molecular Subtype, and RMC were used to construct the predictive models for NpCR and DpCR. The receiver operating characteristic (ROC) curves indicate that the model exhibits robust predictive capacity. Clinical Impact Curves (CIC) and Decision Curve Analysis (DCA) indicate that the models present a superior clinical utility. Conclusion HALP and FAR were identified as peripheral blood inflammatory index predictors for accurately predicting NAT outcomes.

Background: Achieving a pathological complete response (pCR) after neoadjuvant therapy (NAT) is considered to be a critical factor for a favourable prognosis in breast cancer. However, discordant pathological complete response (DpCR), characterised by isolated responses in the breast or axillary, represents an intermediate pathological response category between no response and complete response. This study aims to investigate predictive factors and develop models based on peripheral blood inflammatory indexes to more accurately predict NAT outcomes. Method: A total of 789 eligible patients were enrolled in this retrospective study. The patients were randomized into training and validation cohort according to a 7:3 ratio. Lasso and uni/multivariable logistic regression analysis were applied to identify the predictor variables. Two Nomograms combining clinico-pathologic features and peripheral blood inflammatory indexes were developed. Result: Molecular Subtype, HALP, P53, and FAR were used to construct the predictive models for traditional non pCR (T-NpCR) and total-pCR (TpCR). The T-NpCR group was divided into DpCR and non pCR (NpCR) subgroups to construct a new model to more accurately predict NAT outcomes. cN, HALP, FAR, Molecular Subtype, and RMC were used to construct the predictive models for NpCR and DpCR. The receiver operating characteristic (ROC) curves indicate that the model exhibits robust predictive capacity. Clinical Impact Curves (CIC) and Decision Curve Analysis (DCA) indicate that the models present a superior clinical utility. Conclusion: HALP and FAR were identified as peripheral blood inflammatory index predictors for accurately predicting NAT outcomes. [ABSTRACT FROM AUTHOR]

Background: Hemoglobin, Albumin, Lymphocyte, and Platelet Score (HALP) is an accessible score that is easily reproducible from routine laboratory testing while also reflecting patients' immune-nutritional status. Along with other immuno-nutritional scores, such as the Prognostic Nutrition Index (PNI), HALP has been associated with a number of clinical and pathological features. The goal of our study was to evaluate the prognostic utility of HALP and PNI scores in testicular germ cell cancer (GCT) patients. Methods: This case-only study included 203 testicular GCT patients who were classified according to the disease stage and HALP and PNI cut-offs. Complete blood count and albumin concentration were routinely determined. Results: The values of HALP and PNI significantly differed among different clinical stages (p < 0.05). Moreover, they clearly exposed a significantly higher risk of advanced clinical stage development for those testicular GCT patients with lower values of HALP and PNI (p < 0.05). Finally, lower score levels were associated with larger tumor size (p < 0.05). Conclusion: Our investigation could provide evidence that specific immune-nutritional scores can help distinguish individuals diagnosed with testicular GCT who are more likely to be identified with advanced disease stages. [ABSTRACT FROM AUTHOR]

ObjectiveThe high hemoglobin, albumin, lymphocyte, and platelet (HALP) score has been reported to be a good prognostic indicator for several malignancies. However, more evidence is needed before it can be introduced into clinical practice. Here, we systematically evaluated the predictive value of HALP for survival outcomes in patients with solid tumors.MethodsThis study was performed according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and Assessing the Methodological Quality of Systematic Reviews (AMSTAR) Guidelines. In March 2024, an electronic literature search was performed for articles regarding the prognostic role of HALP in solid tumors. Data from studies with reported risk ratios (HRs) and 95% confidence intervals (CIs) were pooled in a meta-analysis. Study bias was assessed using the QUIPS tool.ResultsOf the 729 articles reviewed, 45 cohorts including data from 17,049 patients with cancer were included in the pooled analysis. The pooled results demonstrated that elevated HALP score was significantly associated with favorable overall survival (HR = 0.60, 95% CI 0.54-0.67, p < 0.01), cancer-specific survival (HR = 0.53, 95% CI 0.44- 0.64, p < 0.01), progression-free survival (HR = 0.62, 95% CI 0.54-0.72, p < 0.01), recurrence-free survival (HR = 0.48, 95% CI 0.30-0.77, p < 0.01), and disease-free survival (HR = 0.72, 95% CI 0.57-0.82, p < 0.01). Subgroup analyses based on various confounding factors further revealed the consistent prognostic impact of HALP on overall survival in patients with solid tumors.ConclusionsOur findings suggest that high HALP is associated with better survival outcomes in patients. The HALP score is a potential prognostic biomarker in solid tumors, but it needs to be further studied whether it can improve the established prognostic model.

Abstract Erectile dysfunction (ED) is related to nutritional and inflammatory factors. The hemoglobin, albumin, lymphocyte, and platelet score (HALP), a new index reflecting the nutritional and inflammatory status, has been associated with a higher risk of diabetic retinopathy, particularly at lower values (≤ 42.9). However, studies focusing on the relationship between HALP and ED risk are scarce. Hence, this study aimed to investigate the association between HALP and ED. Data were extracted from the National Health and Nutrition Examination Survey (NHANES) conducted between 2001 and 2004. Based on self-reported data, participants were classified into either the ED group or the non-ED group. Next, the HALP score was categorized into four quartiles (Q1–4). Weighted multivariate regression analysis was performed to assess the relationship between categorical HALP and ED risk. Additionally, restricted cubic spline (RCS) analysis was conducted to examine the association between continuous HALP scores and ED risk. Furthermore, subgroup analyses were conducted to examine the association between categorical HALP and the risk of ED based on age, as well as the status of hypertension, diabetes and cardiovascular disease. Finally, a mediation analysis was carried out to investigate the mediating effect of HALP and related parameters on the association between urinary cobalt levels and ED. Initially, the data of 21,161 participants were collected. After implementing the inclusion and exclusion criteria, 3406 participants were included in the final analyses. Weighted multivariate regression analysis demonstrated that the Q4 HALP group was associated with a lower risk of ED (OR 0.96, 95% confidence intervals 0.92–1.00, P = 0.037). Meanwhile, RCS analysis showed that HALP was nonlinearly associated with the risk of ED. In addition, subgroup analyses demonstrated that participants in the Q3/4 HALP group had a significantly lower ED risk than those in the Q1 group among patients aged ≥ 50 years, as well as those with hypertension and diabetes. Lastly, mediation analysis revealed that HALP and its associated parameters had a marginal average causal mediation effect on the relationship between urinary cobalt levels and ED risk (P > 0.05). In US adults, high HALP scores were correlated with a lower risk of ED. The relationship was more pronounced in participants aged ≥ 50 years with hypertension and diabetes. Furthermore, HALP and its parameters may not mediate the association between urinary cobalt levels and ED risk.

Abstract Background Humic acid affects plant growth. Its source and structure may play a central role to its functionality. The relationship between humic acid and plant bioactivity is still unclear. This study investigated the biostimulation effects of two natural humic acids derived from soil (SHA) and lignite (LHA) on Lepidium sativum in comparison to a synthetic humic acid model (HALP) with known structure. Results All humic acids positively affected cress seed germination and root elongation. Greater root hairs density and dry matter, compared to control, were observed using concentration of 5 mg L−1 for HALP, 50 mg L−1 for LHA, and 100 mg L−1 for SHA. The germination index was the largest (698% more effective than control) with 50 mg L−1 of SHA, while it was 528% for LHA, and 493% for HALP at 5 mg L−1. SHA contained the lowest aromatic and phenolic C content, the largest pK2 value of 9.0 (7.7 for LHA and 7.6 for HALP), the least ratio between the aromaticity index and lignin ratio (ARM/LigR) of 0.15 (0.66 for LHA and 129.92 for HALP), and at pH 6.3 the lowest amount of free radicals with a value of 0.567 × 1017 spin g−1 (1.670 × 1017 and 1.780 × 1017 spin g−1 for LHA and HALP, respectively), with the greatest g value of 2.0039 (2.0035 for LHA and 2.0037 for HALP). Conclusions The overall chemical structure of humic acids exerted a biostimulation of cress plantlets. The level of the intrinsic stable free radicals identified by EPR in the humic acids resulted well correlated to the ARM/LigR ratio calculated by NMR. Our results suggested that HA biostimulation effect is related to its applied concentration, which is limited by its free radical content. The modulation of the humic supramolecular structure by ROS and organic acids in root exudates can determine the release of bioactive humic molecules. When the content of the intrinsic humic free radicals is high, possible molecular coupling of the bioactive humic molecules may hinder their biostimulation activity. In such cases, a low humic acid concentration appears to be required to achieve the optimum biostimulation effects. Graphical Abstract

Abstract Background We aimed to investigate whether the HALP score was a predictor of survival in patients with Glioblastoma (GBM). Methods A total of 84 Glioblastoma (GBM) patients followed in our clinic were included in the study. HALP scores were calculated using the preoperative hemoglobin, albumin, lymphocyte and platelet results of the patients. For the HALP score, a cut-off value was found by examining the area below the receiver operating characteristic (ROC) curve. Patients were divided into two groups as low and high according to this cut-off value. The relationships among the clinical, dermographic and laboratory parameters of the patients were examined using these two groups. Results Median OS, PFS, HALP score, NLR, PLR were 15 months (1.0–78.0), 8 months (1.0–66.0), 37.39 ± 23.84 (min 6.00-max 132.31), 4.14, 145.07 respectively. A statistically significant correlation was found between HALP score and OS, PFS, NLR, PLR, ECOG-PS status using Spearman’s rho test (p = 0.001, p 37.39 was associated with prolonged survival in high-grade brain tumors.

Acute appendicitis (AA) is the predominant condition responsible for acute abdominal pain across all age demographics. The purpose of this research is to determine if the hemoglobin, albumin, lymphocyte, and platelet (HALP) and modified HALP (m-HALP) scores differ between complicated and uncomplicated appendicitis in patients diagnosed with AA who have applied to the emergency department (ED). Additionally, this study aims to investigate whether HALP and m-HALP scores are superior to other biomarkers.

Zhou Zhao,1,2,&ast; Menghua Yan,1,&ast; Huayang Pang,1,2 Lihui Chen,1 Xi Tang,1 Zhixiong Chen,1 Xiufeng Chen,1 Hao Sun1 1Gastrointestinal Cancer Center, Chongqing University Cancer Hospital, Chongqing, 400030, People’s Republic of China; 2Chongqing Key Laboratory of Translational Research for Cancer Metastasis and Individualized Treatment, Chongqing University Cancer Hospital, Chongqing, 400030, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Hao Sun; Xiufeng Chen, Gastrointestinal Cancer Center, Chongqing University Cancer Hospital, No. 181 of Hanyu Road, Chongqing, 400030, People’s Republic of China, Email sunhao_med@cqu.edu.cn; sunhao68@sina.com; 13028399392@163.comPurpose: To evaluate the predictive capacity of the nutritional-inflammatory index and clinicopathological characteristics in patients with locally advanced rectal cancer (LARC) receiving total neoadjuvant therapy (TNT).Methods: Data from 127 patients with LARC receiving TNT from January 2017 to January 2021 were retrospectively analyzed. Clinicopathological characteristics with different TNT-induced responses were compared. The Chi-square test and the Mann–Whitney test were used to analyze the association between pre-TNT factors and TNT-induced responses. Multivariable logistic regression analysis was used to construct a predictive model.Results: In the cohort of 127 patients with LARC who underwent total neoadjuvant therapy (TNT), the mean age was 54.1 ± 11.4 years; 88 (69.3%) were male. Seventy patients (55.1%) exhibited a favorable response to TNT, while 57 patients (44.9%) demonstrated a poor response. Tumor characteristics, including diameter, distance from the anal verge, pre-TNT lymphocyte, pre-TNT hemoglobin, CA199, PLR, and HALP, exhibit correlations with TNT-induced tumor regression. Multivariate logistic regression analysis identified large tumor diameters (> 5.0 cm; p = 0.005, HR 2.958; 95% CI 1.382– 6.335) and low HALP (≤ 40; p = 0.002, HR 0.261; 95% CI 0.111– 0.612) as predictors of TNT-induced poor responses. Additionally, low levels of HALP were associated with an increased risk of recurrence in patients with LARC with TNT, but this was not statistically significant (p = 0.087, HR 2.008, 95% CI 0.906– 4.447).Conclusion: A large tumor diameter and low HALP predict poor tumor regression induced by the CAPOX-based TNT regimen in patients with LARC.Plain Language Summary: Recent studies have shown that total neoadjuvant therapy (TNT) is becoming a key treatment for some people with advanced rectal cancer. However, there’s still a lot we do not know about what affects how well patients respond to this treatment. The aim of this study was to see if certain nutritional and inflammatory measures, along with other clinic characteristics, can predict how well patients with advanced rectal cancer will respond to TNT. We looked back at medical records from 127 patients who received TNT between 2017 and 2021. We examined how certain pre-treatment factors were linked to patients’ responses to the therapy. Certain tumor characteristics and blood test results were connected to how well the tumors responded to treatment. Specifically, patients with larger tumors (over 5 cm in diameter) and lower levels of a specific blood marker called HALP were more likely to have a poor response to treatment. Although low HALP was also linked to a higher chance of the cancer coming back, this result was not strong enough to be certain about.Keywords: Rectal cancer, Total neoadjuvant therapy, HALP, Tumor regression

Background: Humic acid affects plant growth. Its source and structure may play a central role to its functionality. The relationship between humic acid and plant bioactivity is still unclear. This study investigated the biostimulation effects of two natural humic acids derived from soil (SHA) and lignite (LHA) on Lepidium sativum in comparison to a synthetic humic acid model (HALP) with known structure. Results: All humic acids positively affected cress seed germination and root elongation. Greater root hairs density and dry matter, compared to control, were observed using concentration of 5 mg L−1 for HALP, 50 mg L−1 for LHA, and 100 mg L−1 for SHA. The germination index was the largest (698% more effective than control) with 50 mg L−1 of SHA, while it was 528% for LHA, and 493% for HALP at 5 mg L−1. SHA contained the lowest aromatic and phenolic C content, the largest pK2 value of 9.0 (7.7 for LHA and 7.6 for HALP), the least ratio between the aromaticity index and lignin ratio (ARM/LigR) of 0.15 (0.66 for LHA and 129.92 for HALP), and at pH 6.3 the lowest amount of free radicals with a value of 0.567 × 1017 spin g−1 (1.670 × 1017 and 1.780 × 1017 spin g−1 for LHA and HALP, respectively), with the greatest g value of 2.0039 (2.0035 for LHA and 2.0037 for HALP). Conclusions: The overall chemical structure of humic acids exerted a biostimulation of cress plantlets. The level of the intrinsic stable free radicals identified by EPR in the humic acids resulted well correlated to the ARM/LigR ratio calculated by NMR. Our results suggested that HA biostimulation effect is related to its applied concentration, which is limited by its free radical content. The modulation of the humic supramolecular structure by ROS and organic acids in root exudates can determine the release of bioactive humic molecules. When the content of the intrinsic humic free radicals is high, possible molecular coupling of the bioactive humic molecules may hinder their biostimulation activity. In such cases, a low humic acid concentration appears to be required to achieve the optimum biostimulation effects. [ABSTRACT FROM AUTHOR]

Background: We aimed to investigate whether the HALP score was a predictor of survival in patients with Glioblastoma (GBM). Methods: A total of 84 Glioblastoma (GBM) patients followed in our clinic were included in the study. HALP scores were calculated using the preoperative hemoglobin, albumin, lymphocyte and platelet results of the patients. For the HALP score, a cut-off value was found by examining the area below the receiver operating characteristic (ROC) curve. Patients were divided into two groups as low and high according to this cut-off value. The relationships among the clinical, dermographic and laboratory parameters of the patients were examined using these two groups. Results: Median OS, PFS, HALP score, NLR, PLR were 15 months (1.0–78.0), 8 months (1.0–66.0), 37.39 ± 23.84 (min 6.00-max 132.31), 4.14, 145.07 respectively. A statistically significant correlation was found between HALP score and OS, PFS, NLR, PLR, ECOG-PS status using Spearman's rho test (p = 0.001, p < 0.001, p < 0.001, p < 0.001, p = 0.026 respectively). For the HALP score, a cut-off value of = 37.39 (AUC = 0.698, 95% CI, p < 0.002) was found using ROC analysis. Median OS was 12 (6.99–17.01) months in the low HALP group and 21 (11.37–30.63) months in the high HALP group (p = 0.117). NLR and PLR were significantly lower in the HALP high group (p < 0.001, p < 0.001 respectively). The ratio of receiving treatment was significantly higher in the high HALP group (p < 0.05). In Multivariate analysis, significant results were found for treatment status and ECOG-PS status (p < 0.001, p = 0.038 respectively). Conclusions: The HALP score measured at the beginning of treatment seems to have predictive importance in the prognosis of GBM patients. A HALP score of > 37.39 was associated with prolonged survival in high-grade brain tumors. [ABSTRACT FROM AUTHOR]

Objective: The haemoglobin, albumin, lymphocyte, and platelet (HALP) score, a convenient and composite laboratory biomarker, can reflect inflammation and systemic nutritional status. This study was performed to investigate the effect of the HALP score on the prognosis of patients with IgA nephropathy (IgAN). Methods: This is a retrospective single centre study that enrolled 895 biopsyconfirmed IgAN patients from June 2019 to June 2022 who were followed for more than 1 year. Kaplan-Meier curves and Cox regression analyses were performed to determine the relationship between HALP and adverse outcomes. The restricted cubic splines was used to identify the possible associations. The optimal cut-off value of HALP for renal poor outcome was identified by the area under the receiver operating characteristic curve (AUC). Results: A total of 895 patients finally participated in the study and were divided into three groups (tertial 1-3) according to the baseline HALP score. More severe clinicopathologic features were observed in the lower HALP group, and Kaplan -Meier analysis showed patients in tertial 1 had a higher risk of kidney failure than the other groups (log-rank=11.02, P= 0.004). Multivariate Cox regression revealed that HALP score was an independent risk factor for renal prognosis in IgAN (adjusted HR: 0.967, 95% CI: 0.945-0.990, P = 0.006). The results of subgroup analysis suggested that HALP was more important in patients under the age of 50, BMI = 23.9 and eGFR = 90 mL/min/1.73 m². The best cut-off HALP for renal survival was 38.83, sensitivity 72.1%, and specificity 55.9% (AUC: 0.662). Patients were further grouped according to HALP cut-off values and propensity matched. Multivariate Cox regression analysis revealed that HALP remained an independent predictor of IgAN in the matched cohort (HR 0.222, CI: 0.084-0.588, P=0.002). Conclusion: HALP is a novel and potent composite parameter to predict kidney outcome in patients with IgAN. [ABSTRACT FROM AUTHOR]

Immune checkpoint inhibitors enhance the tumor-killing ability of T-cells in non-small cell lung cancer (NSCLC), thereby boosting overall survival (OS) and transforming treatment for advanced stages. However, challenges persist, including low response rates and the absence of effective markers for candidate selection. This study evaluated the impact of hemoglobin, albumin, and platelet (HALP), neutrophil-to-lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio (PLR) on immunotherapy efficacy and survival in advanced NSCLC. Furthermore, the study aimed to develop a nomogram based on these parameters. Clinical and hematological data from patients diagnosed with NSCLC who received immunotherapy were analyzed. Efficacy was assessed using the immune Response Evaluation Criteria in Solid Tumors (iRECIST), and progression-free survival (PFS) and OS were analyzed. Prediction models were based on baseline and post-treatment HALP, NLR, and PLR. The 203 included patients had a median follow-up of 16 months, a median PFS (mPFS) of 7 months (6.0 – 8.0), while the median OS (mOS) was not available (24.0 – not available). The PLR before treatment (PLR0) was linked to a higher disease control rate (DCR) (odds ratio [OR] = 0.258), while initial immunotherapy and NLR after four cycles of treatment (NLR4C) significantly boosted the objective response rate (ORR). Cox regression showed that HALP before treatment (HALP0), HALP after four cycles of treatment (HALP4C), and NLR before treatment (NLR0) significantly influenced PFS. Additionally, HALP0, NLR0, and PLR after four cycles of treatment (PLR4C) were associated with OS. The C-indices for PFS and OS were 0.823 and 0.878, respectively, indicating good prediction accuracy. HALP, NLR, and PLR at various time points effectively predicted immunotherapy response in advanced NSCLC patients. Low HALP with high NLR and PLR indicated a poor prognosis. The findings can provide the basis for stratified randomized controlled trials (RCTs) in the future.

Mingshuang Wu,&ast; Chenxi Pan,&ast; Yi He, Bo Yang Department of Urology, The Second Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Yi He; Bo Yang, The Second Affiliated Hospital of Dalian Medical University, 467, Zhongshan Road, Shahekou District, Dalian, 116044, People’s Republic of China, Tel/Fax +86 411 84671291, Email heyi_gzr@163.com; yangbo20160101@163.comPurpose: The goal of this study was to assess the prognostic impact of the lower urinary tract symptoms (LUTS) in advanced prostate cancer (PCa) patients before progression to castration-resistant prostate cancer (CRPC).Methods: A retrospective analysis of the follow-up data for 152 CRPC patients was performed. Severe LUTS symptom was defined as an International Prostate Symptoms Score (IPSS) ≥ 20 at baseline. Cox regression analysis was conducted to assess CRPC prognostic factors. Nomogram model was created and assessed using the concordance index (C-index), calibration curves, receiver operating characteristic (ROC) curves, and decision curve analyses (DCA).Results: The median CRPC free survival of patients with severe LUTS was 20.5 months, significantly longer than that (7.5 months) of less symptomatic patients. Furthermore, severe LUTS, the hemoglobin, albumin, lymphocyte, and platelet (HALP) score, and Gleason sum were determined to be independent prognostic markers and combined to establish a nomogram, which performed well in the customized prediction of CRPC progression at 6th, 12th, 18th and 24th month. The C-index (0.794 and 0.816 for the training and validation cohorts, respectively), calibration curve, and ROC curve all validated the prediction accuracy. DCA curve showed that it could be effective in helping doctors make judgments. The Nomogram-related risk score separated the patients into two groups with notable progression differences.Conclusion: Severe LUTS was significantly associated with decreased risk for rapid progression to CRPC. The developed nomogram could help identify patients who are at a high risk of rapid CRPC progression and provide tailored follow-up and therapeutic advice.Keywords: LUTS, HALP, castration-resistant prostate cancer, nomogram

Introduction: The immunoinflammatory indices IIS and HALP have been used to predict the prognosis of various neoplasms and acute inflammatory processes. Can they differentiate prostate cancer from an acute inflammatory process such as prostatitis? Objective: To evaluate the usefulness of IIS and HALP score in the detection of prostate cancer in patients with PSA ≤ 10 ng/dL. Method: Retrospective study including prostate biopsied patients in search of cancer from December 2022 to May 2023. ROC curves were performed to calculate the area under the curve (AUC), sensitivity and specificity. Results: 25 patients had prostatitis and 25 had prostate cancer. The age range was 55 to 81 years. The median IIS was 612.85, while HALP score had a median of 47.59. The AUC of IIS was 0.616, with sensitivity of 76% and specificity of 52%. The AUC of HALP score was 0.13 with a sensitivity of 88% and specificity of 28%. Conclusions: IIS and HALP score had no efficacy in differentiating prostatitis from prostate cancer. However, prospective studies with a larger number of patients are required to validate the results. [ABSTRACT FROM AUTHOR]

Sarcopenia and HALP (Hemoglobin, Albumin, Lymphocyte, and Platelet) scores are factors commonly associated with postoperative outcomes used in cancer patients. This study aims to evaluate the effect of these two prognostic factors on postoperative outcomes in operated pancreatic cancer patients and their correlation with each other. The study is a single-center, retrospective study conducted with 179 patients diagnosed with pancreatic adenocarcinoma after pancreatoduodenectomy (PD) between January 2012 and January 2022. The Psoas muscular index (PMI) and HALP scores of the patients were calculated. Cut-off values were determined in order to determine the nutritional status of the patients and to group them. The cut-off value of the HALP score was determined according to survival status. In addition, the clinical data and pathological findings of tumors were collected. These two parameters were evaluated in terms of length of hospital stay, postoperative complication rates, fistula development, and overall survival, and their correlations with each other were examined. Of the patients, 74 (41.3%) were female, and 105 (58.7%) were male. According to PMI cut-off values, 83 (46.4%) patients were in the sarcopenia group. According to the HALP score cut-off values, 77 (43.1%) patients were in the low HALP group. Sarcopenia and Low HALP group had a higher risk of death (respectively Hazard ratio:5.67, CI:3.58–8.98, Hazard ratio:5.95, CI: 3.72–9.52) (p < 0.001). There was a moderate correlation between PMI and HALP score (rs = 0.34, p = 0.01). The correlation in these values was higher in the female gender. In line with the data obtained from our study, HALP score and sarcopenia are among the important parameters used to evaluate postoperative complications and provide information about survival. Patients with a low HALP score and sarcopenic have an increased likelihood of developing postoperative complications and a lower survival. [ABSTRACT FROM AUTHOR]

Objective: This research aims to analyze the HALP. (hemoglobin, albumin, lymphocyte. platelet) score of.survivor-deceased Covid-19 patients. Material and methods: 590 patients with. Covid-19 were. included. in. this. study. Patients. were. divided. into two groups as survivor (n:296) and deceased (n:294). Patient information was collected from the hospital online system. The Study was conducted retrospectively, and it aims to.investigate.the association.between HALP score and.mortality.in Covid-19.patients. Results: In.the deceased group.the.mean.age was 71.32±10.9 (n:294) while in the survivor.group, it.was 59.97±16.2 (n:296) (p:0.000). 65,6% of the deceased group were.male, while 55% of survivor group were male (p Conclusion: There is a meaningful correlation established between low HALP score and.mortality. in.Covid-19.patients. We.have reached the.conclusion that using HALP score.to. predict.mortality.in.Covid-19.patients might be useful.

Simple Summary: Systemic inflammation and changes in the inflammatory status are frequent features of lung cancer. There is a close interconnection between cancer development and the clinical, general, and inflammatory status of patients. In this paper, we evaluate a large panel of inflammatory indexes in patients who underwent lung resection for NSCLC lung cancer; we show that pre-operative inflammatory status strongly influences long-term prognosis in patients affected by NSCLC and undergoing surgery. Background (1): Our goal was to investigate if and how pre-operative inflammatory status can influence the long-term prognosis of patients undergoing lung surgery for cancer. Materials and Methods (2): This prospective observational study includes the agreement of all operable patients to the study, who were referred to our department between 1 January 2017 and 30 December 2018. The inflammatory pre-operative status of the patients was investigated by calculating albumin, CPR (c-protein reactive), complete blood count (neutrophils, lymphocytes, platelets, hemoglobin), and some other indexes referring to inflammatory status, namely the HALP amalgamated index, platelet-to-lymphocyte ratio (PLR), neutrophil-to-lymphocytes ratio (NLR), systemic immune-inflammation index (SII), and advanced lung cancer inflammation Index (ALI). The follow-up ended in November 2021. Patient overall survival was assessed using the Kaplan–Meier method. The log-rank test was used to compare survival rates. Variables significantly associated with survival at univariate analysis were entered int Cox multivariate analysis (stepwise mode) to assess their independent character. Hazard ratios and their 95% confidence intervals were calculated. Variables associated with p < 0.05 were considered significative. Results (3): We enrolled 257 patients in our study. The overall survival of the cohort was as follows: 1 year, 96.1%; 3 year, 81.3%; and 4 year, 74.2%. Univariate analysis showed risk factors for overall survival as follows: Thoracoscore ≥ 2 (p = 0.002); histology (p = 0.002); HALP < 32.2 (p = 0.0002); SII ≥ 808.9 (p = 0.0004); ALI < 34.86 (p = 0.0005); NLr ≥ 2.29 (p = 0.01); hemoglobin < 13 g/dl (p = 0.01); PLR ≥ 196.1 (p = 0.005); pN+ (p < 0.0001); pleural invasion (p = 0.0002); and presence of vascular or lymphatic tumor emboli (p = 0.0002). Multivariate Cox analysis (stepwise model) identified Thoracoscore ≥ 2 (p = 0.02); histology, HALP < 32.2 (p = 0.004), and pN (p < 0.0001) as independent predictors of death. Conclusion (4): Pre-operative inflammatory status strongly influences long-term prognosis in patients affected by NSCLC and undergoing surgery. [ABSTRACT FROM AUTHOR]

Background: It has already been established that the consumption of alcoholic beverages increases high-density lipoprotein cholesterol (HDL-C) levels in dose–response. Methods and Results:A cross-sectional analysis was carried out with 6132 participants of both sexes aged between 35 and 74 years, who were active and retired workers from six Brazilian states. Heavy drinkers were categorized by sex: men > 210 g/week and women > 140 g/week; moderate drinkers: men ≤ 209 g/week and women ≤ 139 g/week. The HDL-C level was dichotomized into normal (40 mg/dL–82.9 mg/dL) and extremely high (≥83 mg/dL). We used binary logistic regression to assess associations between baseline alcohol intake and HDL-C, which were adjusted for sex, age, income, physical activity, kilocalories and body mass index (BMI), and we found an positive association between extremely high HDL-C and the excessive consumption of alcoholic beverages. These participants were mostly women with a high income, lower waist circumference, kilocalorie consumption and also a higher consumption in all categories of alcoholic beverages. Conclusion: Excessive alcohol consumption was associated with a higher probability of extremely high HDL-C. [ABSTRACT FROM AUTHOR]

The combination of hemoglobin, albumin, lymphocyte, and platelet (HALP) score has been confirmed as an important risk biomarker in several cancers. Hence, we aimed at evaluating the prognostic value of the HALP score in patients with non-metastatic upper tract urothelial carcinoma (UTUC). We retrospectively enrolled 533 of the 640 patients from two centers (315 and 325 patients, respectively) who underwent radical nephroureterectomy (RNU) for UTUC in this study. The cutoff value of HALP was determined using the Youden index by performing receiver operating characteristic (ROC) curve analysis. The relationship between postoperative survival outcomes and preoperative HALP level was assessed using Kaplan-Meier analysis and Cox regression analysis. As a result, the cutoff value of HALP was 28.67 and patients were then divided into HALP

Introduction: Biliary tract cancer (BTC) comprises infrequently occurring neoplasms with poor prognoses. Red blood cell-related parameters are commonly reported prognostic factors. We aimed to compare and evaluate the clinical value of red blood cell-related parameters and develop a prognostic nomogram. Methods: The analysis involved 418 patients with BTC who underwent surgery from December 2003 to April 2017. Patients were divided into training and validation cohorts. Red blood cell-related parameters were compared using Kaplan-Meier analysis, the area under receiver-operating characteristic curve (AUC), and C-index. Predictive abilities were evaluated using Cox regression. We developed a nomogram incorporating superior parameters verified using calibration curves, internal validation, and subgroup analysis. The nomogram was compared with the tumour-node-metastasis staging system through ROC, C-index, and Kaplan-Meier analysis. Results: A combined parameter comprising haemoglobin, albumin, lymphocytes, and platelets (HALP), which was superior to other red blood cell-related parameters, indicated a high risk of worse overall survival when low. Univariate analysis revealed that HALP together with other clinical characteristics was associated with overall survival. Multivariate analysis revealed that HALP, tumour-node-metastasis staging, and operative outcome were independent predictors of poor overall survival. Internal validation proved the predictive value of the nomogram. Additional statistical analyses established the advantages of the nomogram vs. tumour-node-metastasis staging. Conclusion: HALP was a superior red blood cell-related parameter and an independent predictor of prognosis. Our nomogram based on HALP, tumour-node-metastasis staging, and operative outcome is a promising model for predicting overall survival. [ABSTRACT FROM AUTHOR]

Abstract Background To evaluate the prognostic significance of the novel index combining preoperative hemoglobin and albumin levels and lymphocyte and platelet counts (HALP) in renal cell carcinoma (RCC) patients. Methods We enrolled 1360 patients who underwent nephrectomy in our institution from 2001 to 2010. The cutoff values for HALP, neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio were defined by using X-tile software. Survival was analyzed by the Kaplan–Meier method, with differences analyzed by the log-rank test. Multivariate Cox proportional-hazards model was used to evaluate the prognostic significance of HALP for RCC. Results Low HALP was significantly associated with worse clinicopathologic features. Kaplan-Meier and log-rank tests revealed that HALP was strongly correlated with cancer specific survival (P

Background Hyperalphalipoproteinemia (HALP) is inversely correlated with coronary heart disease (CHD) although genetic variants associated with high serum levels of high-density lipoprotein cholesterol (HDL-C) have not been shown to be cardioprotective. Objective The objective of the study was to uncover novel genetic variants associated with HALP and possibly with reduced risk of CHD. Methods Exome sequencing data, HDL-C, and triglyceride levels were analyzed in 1645 subjects. They included the University of Maryland outpatients with high HDL-C ( n = 12), Cardiovascular Health Study ( n = 210), Jackson Heart Study ( n = 402), Multi-Ethnic Study of Atherosclerosis ( n = 404), Framingham Heart Study ( n = 463), and Old Order Amish ( n = 154). Results Novel nonsynonymous single-nucleotide polymorphisms (nsSNPs) were identified in men and women with primary HALP (mean HDL-C, 145 ± 30 mg/dL). Using PolyPhen-2 and Combined Annotation Dependent Depletion to estimate the predictive effect of each nsSNP on the gene product, rare, deleterious polymorphisms in UGT1A3, PLLP, PLEKHH1, ANK2, DIS3L, ACACB , and LRP4 were identified in 16 subjects with HALP but not in any tested subject with low HDL-C (<40 mg/dL). In addition, a single novel polymorphism, rs376849274, was found in OSBPL1A . The majority of these candidate genes have been implicated in fat and lipid metabolism, and none of these subjects has a history of CHD despite 75% of subjects having risk factors for CHD. Overall, the probability of finding these nsSNPs in a non-high HDL-C population ranges from 1 × 10 −17 to 1 × 10 −25 . Conclusion Novel functional polymorphisms in 8 candidate genes are associated with HALP in the absence of CHD. Future study is required to examine the extent to which these genes may affect HDL function and serve as potential therapeutic targets for CHD risk reduction. [ABSTRACT FROM AUTHOR]

Background: Sarcopenia and HALP (Hemoglobin, Albumin, Lymphocyte, and Platelet) scores are factors commonly associated with postoperative outcomes used in cancer patients. This study aims to evaluate the effect of these two prognostic factors on postoperative outcomes in operated pancreatic cancer patients and their correlation with each other., Methods: The study is a single-center, retrospective study conducted with 179 patients diagnosed with pancreatic adenocarcinoma after pancreatoduodenectomy (PD) between January 2012 and January 2022. The Psoas muscular index (PMI) and HALP scores of the patients were calculated. Cut-off values were determined in order to determine the nutritional status of the patients and to group them. The cut-off value of the HALP score was determined according to survival status. In addition, the clinical data and pathological findings of tumors were collected. These two parameters were evaluated in terms of length of hospital stay, postoperative complication rates, fistula development, and overall survival, and their correlations with each other were examined., Results: Of the patients, 74 (41.3%) were female, and 105 (58.7%) were male. According to PMI cut-off values, 83 (46.4%) patients were in the sarcopenia group. According to the HALP score cut-off values, 77 (43.1%) patients were in the low HALP group. Sarcopenia and Low HALP group had a higher risk of death (respectively Hazard ratio:5.67, CI:3.58-8.98, Hazard ratio:5.95, CI: 3.72-9.52) (p < 0.001). There was a moderate correlation between PMI and HALP score (rs = 0.34, p = 0.01). The correlation in these values was higher in the female gender., Conclusions: In line with the data obtained from our study, HALP score and sarcopenia are among the important parameters used to evaluate postoperative complications and provide information about survival. Patients with a low HALP score and sarcopenic have an increased likelihood of developing postoperative complications and a lower survival., Competing Interests: Declaration of competing interest The authors declare no conflict of interest., (Copyright © 2023 IAP and EPC. Published by Elsevier B.V. All rights reserved.)

Novel nanohybrid materials were prepared by covalent grafting of a polyphenolic polymer [Humic Acid Like Polycondensate (HALP)] on SiO 2 nanoparticles. Four nanohybrids were so-produced, using four different types of SiO 2 i.e. three Aerosil flame-made nanoparticles with nominal specific surface area of 50, 90 and 300 m 2 /g, herein codenamed OX50, A90, A300 respectively, plus a colloidal SiO 2 [S300] with SSA = 300 m 2 /g. The antioxidant activity of the SiO 2 –HALP nanohybrids was evaluated by assessing their kinetics for Hydrogen Atom Transfer [HAT] to DPPH radicals. When normalized per same HALP concentration, bigger NPs SiO 2 [OX50]-HALP NPs can scavenge 280 μmoles of DPPH radicals per gram of HALP, while [A90]-HALP and [A300]-HALP NPs can scavenge 514 and 832 μmoles of DPPH radicals per gram of HALP, respectively. The colloidal SiO 2 [S300]-HALP can scavenge fewer DPPH radicals (252 μmoles) per gram of HALP. Based on detailed kinetic data it is shown that (i) surface grafted HALPs perform 300% better HAT than non-grafted HALP in solution. (ii) By controlling the particle type and grafting-loading, we can control/optimize the HAT performance: when grafted on the appropriate SiO 2 surface the HALP macromolecules are able to quench up to 0.8 mmoles of DPPH-radical per gram of HALP. [ABSTRACT FROM AUTHOR]

Abstract: The HAlP and HPAl radicals have been studied using CASSCF, CASPT2, and CCSD(T) methods. The geometries of the stationary points were optimized at the CASPT2/ANO and CCSD(T)/aug-cc-pVTZ levels. For the double states, the potential energy curves of isomerization reactions between HAlP and HPAl were calculated as functions of HAlP bond angle. The calculated results showed that the ground-state HAlP is linear, while the ground-state HPAl is bent, which is in contradiction to Walsh’s rules predicting linear structures for the HXY systems containing 10 or less valence electrons. Some quartet states of HAlP and HPAl were also calculated. [Copyright &y& Elsevier]

Abstract: The synthesis and physicochemical characterization of a water soluble humic-acid-like polycondensate (HALP), which mimics fundamental physicochemical and spectroscopic properties of natural humic acids is presented. The polymer can be synthesized under ambient O2 by oxidative co-polymerization of gallic (GA) and protocatechuic (PA) acid at pH >9, with no need for a catalyst. Solid state 13C NMR spectra for GA-PA-HALP show that ring-opening reactions of GA, PA monomers are involved in GA-PA-HALP formation. EPR spectroscopy shows that GA-PA-HALP contains stable phenol-based radicals, with pH-dependent concentration. The H-binding profile of GA-PA-HALP follows the NICA-Donnan model, with two sets of distributed pK a values in the range 4–6 corresponding to carboxyl groups, and 7–9 corresponding to phenolic groups, as in natural HA. GA-PA-HALP bears a permanent negative charge Q 0 =−2.3equivkg−1 which is higher than the literature Q 0 values of −1 to −2equivkg−1 observed for natural HAs. A critical comparison of the present data with literature data is provided. [Copyright &y& Elsevier]

Background: Systemic inflammation and nutrition status play an important role in cancer metastasis. The combined index of hemoglobin, albumin, lymphocyte, and platelet (HALP), consisting of haemoglobin, albumin, lymphocytes, and platelets, is considered as a novel marker to reflect both systemic inflammation and nutrition status. However, no studies have investigated the relationship between HALP and survival of patients with pancreatic cancer following radical resection., Aim: To evaluate the prognostic value of preoperative HALP in pancreatic cancer patients., Methods: The preoperative serum levels of hemoglobin, albumin, lymphocyte counts, and platelet counts were routinely detected in 582 pancreatic adenocarcinoma patients who underwent radical resection. The relationship between postoperative survival and the preoperative level of HALP was investigated., Results: Low levels of HALP were significantly associated with lymph node metastasis ( P = 0.002), poor tumor differentiation ( P = 0.032), high TNM stage ( P = 0.008), female patients ( P = 0.005) and tumor location in the head of the pancreas ( P < 0.001). Low levels of HALP were associated with early recurrence [7.3 mo vs 16.3 mo, P < 0.001 for recurrence-free survival (RFS)] and short survival [11.5 mo vs 23.6 mo, P < 0.001 for overall survival (OS)] in patients with resected pancreatic adenocarcinoma. A low level of HALP was an independent risk factor for early recurrence and short survival irrespective of sex and tumor location., Conclusion: Low levels of HALP may be a significant risk factor for RFS and OS in patients with resected pancreatic cancer., Competing Interests: Conflict-of-interest statement: All authors declare no conflicts-of-interest related to this article., (©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.)

Background: To evaluate the prognostic significance of the novel index combining preoperative hemoglobin and albumin levels and lymphocyte and platelet counts (HALP) in renal cell carcinoma (RCC) patients.Methods: We enrolled 1360 patients who underwent nephrectomy in our institution from 2001 to 2010. The cutoff values for HALP, neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio were defined by using X-tile software. Survival was analyzed by the Kaplan-Meier method, with differences analyzed by the log-rank test. Multivariate Cox proportional-hazards model was used to evaluate the prognostic significance of HALP for RCC.Results: Low HALP was significantly associated with worse clinicopathologic features. Kaplan-Meier and log-rank tests revealed that HALP was strongly correlated with cancer specific survival (P < 0.001) and Cox multivariate analysis demonstrated that preoperative HALP was independent prognostic factor for cancer specific survival (HR = 1.838, 95%CI:1.260-2.681, P = 0.002). On predicting prognosis by nomogram, the risk model including TNM stage, Fuhrman grade and HALP score was more accurate than only use of TNM staging.Conclusions: HALP was closely associated with clinicopathologic features and was an independent prognostic factor of cancer-specific survival for RCC patients undergoing nephrectomy. A nomogram based on HALP could accurately predict prognosis of RCC. [ABSTRACT FROM AUTHOR]

More than 50% of patients with colorectal cancer (CRC) are initially diagnosed with locally advanced CRC (LACRC), and half of those patients develop recurrence or metastasis after resection. Here, we investigated whether the novel index HALP, which is a combination of preoperative hemoglobin, albumin, lymphocyte and platelet levels, correlates with survival in LACRC patients. A total of 820 patients with LACRC from two independent hospitals were included in our study. The correlations between HALP and overall and cancer-specific survival were calculated using training and validation sets. Lower HALP values correlated with an increased risk of death and cancer-related death in both sets. Moreover, the risk score based on HALP allowed stratification of patients into distinct prognostic groups with greater accuracy than previously proposed indexes. These results suggest that HALP may be useful as a clinical prognostic factor for patients with LACRC.