AIMTo compare predictive ability of Budd-Chiari syndrome (BCS) prognostic indices (PIs) for one-year survival and Transjugular intrahepatic portosystemic shunt (TIPS) patency.METHODSThis retrospective study enrolled 194 Egyptian patients with primary BCS who presented to the Budd-Chiari Study Group of Ain Shams University Hospital. Calculation of the available PIs was performed using Child-Pugh and model for end-stage liver disease scores, BCS-specific PIs (Clichy, New Clichy and Rotterdam) for all patients, and BCS-TIPS PI only for patients who underwent TIPS. The overall one-year survival rate and the one-year shunt patency rate for TIPS were reported.RESULTSThe overall one-year survival rate was 69.6%, and the New Clichy PI revealed the best validity for its prediction at a cut-off value of 3.75, with sensitivity and specificity of 78% and 73.3%, respectively [area under receiver operating characteristic curve (AUC) = 0.806]. The one-year survival rate post-TIPS was 89.7%, and the BCS-TIPS score demonstrated validity for its prediction at a cut-off value of 3.92 (sensitivity and specificity were 71.4% and 64.5%, respectively) (AUC = 0.715). Logistic regression analysis revealed that the New Clichy PI (P = 0.030), high serum total bilirubin (P = 0.047) and low albumin (P < 0.001) were independent factors for predicting mortality within one year. The one-year shunt patency rate in TIPS was 80.2%, and none of the PIs exhibited significant validity for its prediction.CONCLUSIONThe New Clichy score could independently predict the one-year survival in Egyptian BCS patients.
Smart cities are designed to deal with a variety of urban issues. With the spread of the concept of smart cities on a large scale, planners began to include the concept of resilience as one of the most important factors in their planning, especially when communication and information technology was integrated to provide a huge database that accelerates and develops interaction in times of crisis, and while mobility is concerned with meeting needs, transportation ( including vehicles, infrastructure and traffic rules) is the tool required to achieve tangible mobility . According to the literature review, there is a significant research gap as most studies focus on definitions, theory studies, and stochastic plans to respond to sudden crises, with little effort put into developing resilience indicators and measurement strategies. The research aims to access resilience in the urban mobility sector, and also to develop an indicator-based strategy for implementing and evaluating mobility resilience through smart solutions, while keeping in mind the expected climatic local threats Where the flash floods fall at the top of the list of risks affecting the local community. Working on the proposed strategy for the new administrative capital as an implementation area, since it is the most important new smart Egyptian city and its significance as a new smart capital.
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