Summer residential tourism is the future trend in China because of tourists’living quality improvement,heat crisis,rising market demand,and optimization of the destinations’residential environment,transport and acce...Summer residential tourism is the future trend in China because of tourists’living quality improvement,heat crisis,rising market demand,and optimization of the destinations’residential environment,transport and accessibility.Compared with summer tourism and vacation tourism,summer residential tourism had got less attention and lacks in prospective and preventive research.Hence,this study focused on potential assessment,pattern recognition and phase segmentation of 32 residential tourism destinations in China selected from 4 lists.An index system of 16 indicators from 5 dimensions was established as Summer Residence Index(SRI),and Range method,Entropy weight method and Composite index method were chosen as the core methods.Three main conclusions were as follows.(1)Only 2 typical districts’SRI value were near to 0.6,and 4 destinations were below 0.1,about 26 destinations were at medium-level,which indicated that China’s summer residential tourism was not so popular and only few destinations have stepped into a higher level.(2)Seven patterns could be recognized based on the contribution of the 5 dimensions to SRI value,including 3 single-factor driven patterns and 4 compound factors driven patterns.(3)Like tourist area life cycle(TALC),Unconscious stage,Initial stage,Developmental stage and Maturity stage could be segmented for summer residential destinations with the value of below 0.1,0.1-0.3,0.3-0.5,and above 0.5.Four destinations were under Unconscious stage.Twenty-two destinations were at initiate stage.Only 4 destinations have stepped into development stage and 2 at maturity stage.China’summer residential tourism has just started and has a better prospect.This study is just an attempt and needs further consideration,for example,a tracking study of SRI calculation for each year will be carried to justify the effectiveness of SRI and to check the rationality of the empirical results.As time goes on,policies in housing,residential estate and other aspects should be included as a factor in the SRI index.Data availability should be optimized because of better data sources and new technologies.Some other districts or cities in 2 batches of national Comprehensive Tourism Demonstration Zones(CTDZs)pilots and provincial CTDZs will be further selections of summer residential tourism destinations.展开更多
The Gabes aquifer system,located in southeastern Tunisia,is a crucial resource for supporting local socio-economic activities.Due to its dual porosity structure,is particularly vulnerable to pollution.This study aims ...The Gabes aquifer system,located in southeastern Tunisia,is a crucial resource for supporting local socio-economic activities.Due to its dual porosity structure,is particularly vulnerable to pollution.This study aims to develop a hybrid model that combines the Fracture Aquifer Index(FAI)with the conventional GOD(Groundwater occurrence,Overall lithology,Depth to water table)method,to assess groundwater vulnerability in fractured aquifer.To develop the hybrid model,the classical GOD method was integrated with FAI to produce a single composite index.Each parameter within both GOD and FAI was scored,and a final index was calculated to delineate vulnerable areas.The results show that the study area can be classified into four vulnerability levels:Very low,low,moderate,and high,indicating that approximately 8%of the area exhibits very low vulnerability,29%has low vulnerability,25%falls into the moderate category,and 38%is considered highly vulnerable.The FAI-GOD model further incorporates fracture network characteristics.This refinement reduces the classification to three vulnerability classes:Low,medium,and high.The outcomes demonstrate that 46%of the area is highly vulnerable due to a dense concentration of fractures,while 17%represents an intermediate zone characterized by either shallow or deeper fractures.In contrast,37%corresponds to areas with lightly fractured rock,where the impact on vulnerability is minimal.Multivariate statistical analysis was employed using Principal Components Analysis(PCA)and Hierarchical Cluster Analysis(HCA)on 24 samples across six variables.The first three components account for over 76%of the total variance,reinforcing the significance of fracture dynamics in classifying vulnerability levels.The FAI-GOD model removes the very-low-vulnerability class and expands the spatial extent of low-and high-vulnerability zones,reflecting the dominant influence of fracture networks on aquifer sensitivity.While both indices use a five-class system,FAI-GOD redistributes vulnerability by eliminating very-low-vulnerability areas and amplifying low/high categories,highlighting the critical role of fractures.A strong correlation(R2=0.94)between the GOD and FAI-GOD indices,demonstrated through second-order polynomial regression,confirms the robustness of the FAI-GOD model in accurately predicting vulnerability to pollution.This model provides a useful framework for assessing the vulnerability of complex aquifers and serves as a decision-making tool for groundwater managers in similar areas.展开更多
This commentary critically appraises the study by Li et al which pioneered the exploration of the triglyceride-glucose(TyG)index as a prognostic marker in hepatitis B virus-related advanced hepatocellular carcinoma pa...This commentary critically appraises the study by Li et al which pioneered the exploration of the triglyceride-glucose(TyG)index as a prognostic marker in hepatitis B virus-related advanced hepatocellular carcinoma patients undergoing combined camrelizumab and lenvatinib therapy.While we acknowledge the study’s clinical relevance in proposing an easily accessible metabolic biomarker,we delve into the mechanistic plausibility linking insulin resistance to immunotherapy response and angiogenic inhibition.We further critically examine the methodological limitations,including the retrospective design,the populationspecific TyG cut-off value,and unaddressed metabolic confounders.We highlight the imperative for future research to validate its utility across diverse etiologies and treatment settings,and to unravel the underlying immunometabolic pathways.展开更多
BACKGROUND Timely and accurate evaluation of mental disorders in adolescents using appropriate mental health literacy assessment tools is essential for improving their mental health literacy levels.AIM To develop an e...BACKGROUND Timely and accurate evaluation of mental disorders in adolescents using appropriate mental health literacy assessment tools is essential for improving their mental health literacy levels.AIM To develop an evaluation index system for the mental health literacy of adolescent patients with mental disorders,providing a scientific,comprehensive,and reliable tool for the monitoring and intervention of mental health literacy of such patients.METHODS From December 2022 to June 2023,the evaluation index system for mental health literacy of adolescents with mental disorders was developed through literature reviews,semi-structured interviews,expert letter consultations,and the analytic hierarchy process.Based on this index system,a self-assessment questionnaire was compiled and administered to 305 adolescents with mental disorders to test the reliability and validity of the index system.RESULTS The final evaluation index system for mental health literacy of adolescents with mental disorders included 4 first-level indicators,10 second-level indicators,and 52 third-level indicators.The overall Cronbach’sαcoefficient of the index system was 0.957,with a partial reliability of 0.826 and a content validity index of 0.975.The cumulative variance contribution rate of 10 common factors was 66.491%.The correlation coefficients between each dimension and the total questionnaire ranged from 0.672 to 0.724,while the correlation coefficients in each dimension ranged from 0.389 to 0.705.CONCLUSION The evaluation index system for mental health literacy of adolescents with mental disorders,developed in this study,demonstrated notable reliability and validity,making it a valuable tool for evaluating mental health literacy in this population.展开更多
The “facial composite” is one of the major fields in the forensic science that helps the criminal investigators to carry out their investigation process. The survey conducted by United States Law Enforcement Agencie...The “facial composite” is one of the major fields in the forensic science that helps the criminal investigators to carry out their investigation process. The survey conducted by United States Law Enforcement Agencies confirms that 80% of the law enforcement agencies use computer automated composite systems whereas Sri Lanka is still far behind in the process of facial composite with lot of inefficiencies in the current manual process. Hence this research introduces a novel approach for the manual facial composite process, while eliminating the inefficiencies of the manual procedure in Sri Lanka. In order to overcome this situation, this study introduces an automated image processing based software solution with 2D facial feature templates targeting the Sri Lankan population. Thus, this was the first ever approach that creates the 2D facial feature templates by incorporating both medically defined indexes and relevant aesthetic aspects. Hence, this research study is comprised of two separate analyses on anthropometric indices and facial feature shapes which were carried out targeting the local population. Subsequently, several evaluation techniques were utilized to evaluate this methodology where we obtained an overall success rate as 70.19%. The ultimate goal of this research study is to provide a system to the law enforcement agencies in order to carry out an efficient and effective facial composite process which can lead to increase the success rate of suspect identification.展开更多
BACKGROUND Overweight children exhibit a higher prevalence of functional gastrointestinal disorders compared with their normal-weight peers,yet the underlying reasons remain unclear.Gastrointestinal motility,a key pat...BACKGROUND Overweight children exhibit a higher prevalence of functional gastrointestinal disorders compared with their normal-weight peers,yet the underlying reasons remain unclear.Gastrointestinal motility,a key pathophysiological factor in functional gastrointestinal disorders,may be influenced by body mass index(BMI).AIM To evaluate the impact of BMI on gastric motility parameters in children with functional abdominal pain disorders(FAPDs).METHODS We assessed gastric motility in 176 children with FAPDs(61.4%females,mean age 7.94 years,SD 1.96 years)and 63 healthy controls(57.1%females,mean age 9.17 years,SD 1.90 years)at the Gastroenterology Research Laboratory,University of Kelaniya,Sri Lanka.FAPDs were diagnosed and subtyped using the Rome IV criteria:Functional abdominal pain 97 patients;irritable bowel syndrome 39 patients,functional dyspepsia(FD)25 patients;and abdominal migraine 15 patients.Gastric motility was measured using a validated ultrasound method.Weight and height were measured using sensitive standard scales.RESULTS The BMIs of children with FAPDs and controls were 15.04 and 15.46 kg/m^(2),respectively(P=0.33).Fasting antral area(FAA)and antral area at 1 min(AA1)and 15 min(AA15)were significantly greater in patients with FAPD with a higher BMI(2.71 cm^(2),12.57 cm^(2),and 7.19 cm^(2),respectively)compared with those with a lower BMI(2.12 cm^(2),10.68 cm^(2),and 6.13 cm^(2),respectively)(P<0.01).BMI positively correlated with FAA and AA15(r=0.18 and r=0.19,respectively)(P<0.01)in those with FAPDs.In controls,only AA1 was greater in the higher BMI group(12.51 cm^(2)vs 9.93 cm^(2))and had a positive correlation(r=0.33)(P≤0.01).Subgroup analysis revealed that in patients with FD,BMI negatively correlated with gastric emptying rate(GER)(r=-0.59)and antral motility index(MI)(r=-0.49),while in functional abdominal pain,MI positively correlated(r=0.25)with BMI(P≤0.01).CONCLUSION In children with FAPDs,higher BMI was associated with increased gastric antral distention during fasting and postprandial periods(as indicated by FAA,AA1,and AA15)but not with contractility and transit(MI,GER).However,in the FD subgroup,high BMI correlated with reduced GER and MI.This indicates the possible role of BMI in gastric hypomotility and the pathophysiology of FD.These findings underscore the importance of lifestyle and dietary interventions aimed at optimizing BMI in the management of FAPDs,particularly FD.展开更多
The clinical study of solute removal index (SRI) was performed in 20 stable maintenance hemodialysis patients in order to find a proper hemodialydsis dosage and improve the life quality of the patients.Plasma BUN leve...The clinical study of solute removal index (SRI) was performed in 20 stable maintenance hemodialysis patients in order to find a proper hemodialydsis dosage and improve the life quality of the patients.Plasma BUN levels were tested pre-hemodialysis and 0, 1 hr post-hemodialysis. Urea generation rate (G)、protein catabolic rate(PCR)、solute removal amount(R)、SRI were calculated by double pools urea kinetic model . The result showed that urea rebound rate was 18.5±3.35 % 1 hr after hemodialysis,R was 13.82±5.48 g, G was 4.85±1.39 g, PCR was 0.94±0.29 g/kg.d, SRI was 71.33±6.8% respectively, which indicated that SRI was a better index to quantitate the adequacy of hemodialysis.展开更多
In the context of the digital transformation of vocational education,a quality evaluation index system has been constructed.Based on a questionnaire survey conducted among higher vocational colleges and enterprises in...In the context of the digital transformation of vocational education,a quality evaluation index system has been constructed.Based on a questionnaire survey conducted among higher vocational colleges and enterprises in Hainan Province,it has been found that the quality of vocational education generally depends on the talent training program and professional construction at the macro level.At the meso level,the teacher level and teaching environment are critical,while at the micro level,the evaluation of talent training quality cannot be underestimated.Strategies for quality improvement in vocational education are proposed from the perspectives of talent training programs,major construction,teacher development,teaching environment,and talent training quality,all under the lens of digital transformation.展开更多
BACKGROUND The diagnosis of gastric carcinoma(GC)is essential for improving clinical outcomes.However,the biomarkers currently used for GC screening are not ideal.AIM To explore the diagnostic implications of the neut...BACKGROUND The diagnosis of gastric carcinoma(GC)is essential for improving clinical outcomes.However,the biomarkers currently used for GC screening are not ideal.AIM To explore the diagnostic implications of the neutrophil-to-lymphocyte ratio(NLR),platelet-to-lymphocyte ratio(PLR),and systemic immune-inflammatory index(SII)for GC.METHODS The baseline data of 133 patients with GC and 134 patients with precancerous gastric conditions admitted between January 2022 and December 2023 were retrospectively analyzed.The information on peripheral blood platelet,neutrophil,and lymphocyte counts in each patient was collected,and the NLR,PLR,and SII levels of both groups were calculated.Additionally,multivariate logistic regression analysis was conducted,and the diagnostic implications of NLR,PLR,and SII in differentiating patients with precancerous gastric conditions,compared with those with GC,were analyzed through receiver operating characteristic(ROC)curves.RESULTS The data indicated that NLR,PLR,and SII had abnormally increased levels in the patients with GC.Gender and body mass index were risk factors for the occurrence of GC.ROC data revealed that the areas under the curve of three patients with precancerous gastric conditions,who were differentiated from those with GC,were 0.824,0.787,and 0.842,respectively.CONCLUSION NLR,PLR,and SII are all abnormally expressed in GC and have diagnostic implications,especially when used as joint indicators,in distinguishing patients with precancerous gastric conditions from those with GC.展开更多
BACKGROUND Anastomotic leakage(AL)is a serious complication following rectal cancer surgery and is associated with increased recurrence,mortality,extended hospital stays,and delayed chemotherapy.The Onodera prognostic...BACKGROUND Anastomotic leakage(AL)is a serious complication following rectal cancer surgery and is associated with increased recurrence,mortality,extended hospital stays,and delayed chemotherapy.The Onodera prognostic nutritional index(OPNI)and inflammation-related biomarkers,such as the neutrophil-lymphocyte ratio(NLR)and platelet-to-lymphocyte ratio(PLR),have been studied in the context of cancer prognosis,but their combined efficacy in predicting AL remains unclear.AIM To investigate the relationships between AL and these markers and developed a predictive model for AL.METHODS A retrospective cohort study analyzed the outcomes of 434 patients who had undergone surgery for rectal cancer at a tertiary cancer center from 2016 to 2023.The patients were divided into two groups on the basis of the occurrence of AL:One group consisted of patients who experienced AL(n=49),and the other group did not(n=385).The investigation applied logistic regression to develop a risk prediction model utilizing clinical,pathological,and laboratory data.The efficacy of this model was then evaluated through receiver operating characteristic curve analysis.RESULTS In the present study,11.28%of the participants(49 out of 434 participants)suffered from AL.Multivariate analysis revealed that preoperative levels of the OPNI,NLR,and PLR emerged as independent risk factors for AL,with odds ratios of 0.705(95%CI:0.641-0.775,P=0.012),1.628(95%CI:1.221-2.172,P=0.024),and 0.994(95%CI:0.989-0.999,P=0.031),respectively.These findings suggest that these biomarkers could effectively predict AL risk.Furthermore,the proposed predictive model has superior discriminative ability,as demonstrated by an area under the curve of 0.910,a sensitivity of 0.898,and a specificity of 0.826,reflecting its high level of accuracy.CONCLUSION The risk of AL in rectal cancer surgery patients can be effectively predicted by assessing the preoperative levels of serum nutritional biomarkers and inflammatory indicators,emphasizing their importance in the preoperative evaluation process.展开更多
BACKGROUND Acute liver failure(ALF)is a life-threatening multisystemic condition with high short-term mortality.With the growing prevalence of obesity and metabolic syndrome,it is important to investigate the clinical...BACKGROUND Acute liver failure(ALF)is a life-threatening multisystemic condition with high short-term mortality.With the growing prevalence of obesity and metabolic syndrome,it is important to investigate the clinical implications of high body mass index(BMI)on survival outcomes in ALF.AIM To explore the impact of overweight and obesity on the clinical outcomes of patients with ALF.METHODS A retrospective observational cohort study was conducted involving patients with ALF admitted to the Johns Hopkins Health System between January 1,2000 and May 1,2020.We performed Cox proportional hazards regression to identify outcomes,including the need for liver transplantation(LT)or all-cause mortality.RESULTS A total of 196 patients were included,the median age was 43.5 years,63.3%were female,and 59.7%were of Caucasian ethnicity.Acetaminophen-induced ALF was the most common etiology(45%).The mean BMI was significantly greater among patients who underwent LT or died(29.64 kg/m^(2)vs 26.59 kg/m^(2),P=0.008)than among survivors.Patients with overweight and obesity had a higher risk of all-cause mortality or need for LT by 2.22-fold(95%CI:1.30-3.78)and 2.04-fold(95%CI:1.29-3.39),respectively.Elevated BMI was associated with renal failure and higher grades of hepatic encephalopathy.Derangements in serologic markers,including alanine transaminase,lactate,and ammonia,were associated with a mortality risk or need for LT.CONCLUSION In this large,retrospective study,with a diverse cohort of United States patients,Overweight and obese were independently associated with an increased risk of all-cause mortality or need for LT.This work highlights the importance of closely monitoring ALF patients who are overweight or obese for adverse complications and measures to improve outcomes in this vulnerable patient population.展开更多
BACKGROUND Gastric motility is an essential gastrointestinal function.It can be influenced by age,gender,body composition,and metabolic status.However,published data on these associations remains limited.AIM To assess...BACKGROUND Gastric motility is an essential gastrointestinal function.It can be influenced by age,gender,body composition,and metabolic status.However,published data on these associations remains limited.AIM To assess the relationship between gastric motility and adiposity,and metabolic indicators in a cohort of Sri Lankan office workers.METHODS A cross-sectional study was conducted among 130 office workers(58.5%females)aged 20-50 years(mean 36.81,SD 8.85 years)of the University of Kelaniya,Sri Lanka.Gastric motility was assessed by real-time ultrasonography,using a previously validated method.Fasting antral area(FAA),postprandial antral areas at 1 minutes and 15 minutes(AA1,AA15),and antral contraction frequency(FAC)were measured,and gastric emptying rate(GER)and antral motility index were calculated.Anthropometric parameters were obtained using sensitive scales.Glycated hemoglobin,lipid profile,and liver enzyme levels were measured at an accredited laboratory.RESULTS The mean body mass index(BMI)was 24.36(SD 4.09)kg/m^(2),and 39.2%were overweight or obese.Increased abdominal adiposity was detected in 29.2%and 40.8%had high waist-to-hip ratios.Prediabetes/diabetes were observed in 20.0%,hypercholesterolemia in 47.7%,hypertriglyceridemia in 14.7%,high low-density lipoproteins in 39.2%,and elevated aspartate transaminase and alanine transaminase in 5.4%and 21.5%respectively.FAA had a weak negative correlation with high-density lipoprotein level(r=-0.227,P=0.009),and a positive correlation with waist circumference(r=0.235,P=0.007),and waist-to-hip ratio(r=0.244,P=0.005).GER and AA1 correlated weakly with triglyceride(GER:r=0.174,P=0.048;AA1:r=0.194,P=0.027)and VLDL levels(GER:r=0.183,P=0.038;AA1:r=0.195,P=0.026).In females,AA1 positively correlated with triglycerides(r=0.333,P=0.003),and VLDL levels(r=0.337,P=0.003),and AA15 with BMI(r=0.284,P=0.013)and hip circumference(r=0.229,P=0.047).FAC negatively correlated with BMI(r=-0.234,P=0.042)and hip circumference(r=-0.247,P=0.032).CONCLUSION Gastric motility parameters showed weak associations with metabolic indicators,particularly lipid profiles,and to a lesser extent,with adiposity indicators.The greater number of correlations observed in females suggests the possibility of sex-specific differences in these associations.These findings highlight potential relationships that require confirmation through longitudinal studies.展开更多
ACKGROUND The hemoglobin glycation index(HGI)represents the discrepancy between the glucose management indicator(GMI)based on mean blood glucose levels and laboratory values of glycated hemoglobin(HbA1c).The HGI is a ...ACKGROUND The hemoglobin glycation index(HGI)represents the discrepancy between the glucose management indicator(GMI)based on mean blood glucose levels and laboratory values of glycated hemoglobin(HbA1c).The HGI is a promising indicator for identifying individuals with excessive glycosylation,facilitating personalized evaluation and prediction of diabetic complications.However,the factors influencing the HGI in patients with type 1 diabetes(T1D)remain unclear.Autoimmune destruction of pancreaticβcells is central in T1D pathogenesis,yet insulin resistance can also be a feature of patients with T1D and their coexistence is called“double diabetes”(DD).However,knowledge regarding the relationship between DD features and the HGI in T1D is limited.AIM To assess the association between the HGI and DD features in adults with T1D.METHODS A total of 83 patients with T1D were recruited for this cross-sectional study.Laboratory HbA1c and GMI from continuous glucose monitoring data were collected to calculate the HGI.DD features included a family history of type 2 diabetes,overweight/obesity/central adiposity,hypertension,atherogenic dyslipidemia,an abnormal percentage of body fat(PBF)and/or visceral fat area(VFA)and decreased estimated insulin sensitivity.Skin autofluorescence of advanced glycation end products(SAF-AGEs),diabetic complications,and DD features were assessed,and their association with the HGI was analyzed.RESULTS A discrepancy was observed between HbA1c and GMI among patients with T1D and DD.A higher HGI was associated with an increased number of SAF-AGEs and a higher prevalence of diabetic microangiopathy(P=0.030),particularly retinopathy(P=0.031).Patients with three or more DD features exhibited an eight-fold increased risk of having a high HGI,compared with those without DD features(adjusted odds ratio=8.12;95%confidence interval:1.52-43.47).Specifically,an elevated PBF and/or VFA and decreased estimated insulin sensitivity were associated with high HGI.Regression analysis identified estimated insulin sensitivity and VFA as factors independently associated with HGI.CONCLUSION In patients with T1D,DD features are associated with a higher HGI,which represents a trend toward excessive glycosylation and is associated with a higher prevalence of chronic diabetic complications.展开更多
This study investigates the psychological and cultural motivations that underpin charitable giving in Sri Lanka,with particular attention to whether such behaviour can be considered genuinely altruistic.While charitab...This study investigates the psychological and cultural motivations that underpin charitable giving in Sri Lanka,with particular attention to whether such behaviour can be considered genuinely altruistic.While charitable acts are commonly perceived as selfless,this research highlights the complex and often contradictory nature of the motivations involved.Using a qualitative approach,semi-structured interviews were conducted with individuals who regularly engage in charitable activities.Thematic analysis revealed three overarching categories of motivation.The first,obliged motives stem from social expectations and religious duty.The second,independent motives reflect personal values and intrinsic satisfaction.The third,ambivalent motives are a novel category that captures the simultaneous interplay between self-serving and other-oriented intentions.The emergence of ambivalent motives is especially significant,as it challenges binary distinctions between altruism and egoism,suggesting that charitable giving frequently serves psychological,social,and existential needs alongside prosocial goals.The findings support established psychological frameworks such as Self-Determination Theory and the Theory of Planned Behavior,while also highlighting the unique cultural dynamics of Sri Lankan society,particularly the influence of Buddhist ethics and collectivist values.These cultural factors shape both the meaning and practice of giving,embedding it within broader narratives of moral obligation,social harmony,and spiritual merit.Ultimately,the study concludes that while charitable giving in Sri Lanka may outwardly appear altruistic,it is often driven by a complex mixture of internal and external motives,suggesting that authenticity in giving is rarely absolute but rather contextually and psychologically mediated.展开更多
BACKGROUND Gastric cancer(GC)is the fifth most common cancer and the third leading cause of cancer-related deaths in China.Many patients with GC frequently experience symptoms related to the disease,including anorexia...BACKGROUND Gastric cancer(GC)is the fifth most common cancer and the third leading cause of cancer-related deaths in China.Many patients with GC frequently experience symptoms related to the disease,including anorexia,nausea,vomiting,and other discomforts,and often suffer from malnutrition,which in turn negatively affects perioperative safety,prognosis,and the effectiveness of adjuvant therapeutic measures.Consequently,some nutritional indicators such as nutritional risk index(NRI),prognostic nutritional index(PNI),and systemic immune-inflammatorynutritional index(SIINI)can be used as predictors of the prognosis of GC patients.AIM To examine the prognostic significance of PNI,NRI,and SIINI in postoperative patients with GC.METHODS A retrospective analysis was conducted on the clinical data of patients with GC who underwent surgical treatment at the Guangxi Medical University Cancer Hospital between January 2010 and December 2018.The area under the receiver operating characteristic(ROC)curve was assessed using ROC curve analysis,and the optimal cutoff values for NRI,PNI,and SIINI were identified using the You-Review-HTMLden index.Survival analysis was performed using the Kaplan-Meier method.In addition,univariate and multivariate analyses were conducted using the Cox proportional hazards regression model.RESULTS This study included a total of 803 patients.ROC curves were used to evaluate the prognostic ability of NRI,PNI,and SIINI.The results revealed that SIINI had superior predictive accuracy.Survival analysis indicated that patients with GC in the low SIINI group had a significantly better survival rate than those in the high SIINI group(P<0.05).Univariate analysis identified NRI[hazard ratio(HR)=0.68,95%confidence interval(CI):0.52-0.89,P=0.05],PNI(HR=0.60,95%CI:0.46-0.79,P<0.001),and SIINI(HR=2.10,95%CI:1.64-2.69,P<0.001)as prognostic risk factors for patients with GC.However,multifactorial analysis indicated that SIINI was an independent risk factor for the prognosis of patients with GC(HR=1.65,95%CI:1.26-2.16,P<0.001).CONCLUSION Analysis of clinical retrospective data revealed that SIINI is a valuable indicator for predicting the prognosis of patients with GC.Compared with NRI and PNI,SIINI may offer greater application for prognostic assessment.展开更多
This study assesses the portfolio concentration of socially responsible investment(SRI)pension funds,which may be subject to a potentially limited asset universe and have a higher concentration and lower performance t...This study assesses the portfolio concentration of socially responsible investment(SRI)pension funds,which may be subject to a potentially limited asset universe and have a higher concentration and lower performance than conventional funds.Nonetheless,in contrast to previous studies on SRI funds,this study considers the informationadvantage theory,positing that skilled managers should increase their concentration in assets in which they possess valuable information,departing from optimization models to achieve outperformance.This study first compares actual fund concentration with concentration obtained from several traditional and modern portfolio optimization techniques(minimum variance,global minimum variance,optimal portfolio,naïve diversification,risk parity,and reward-to-risk timing)to understand whether SRI pension funds concentrate portfolios and deviate from optimization model solutions.Unlike previous studies,the actual fund assets are considered in the optimization models to take into account the real investment profiles of SRI funds.The results indicate that SRI pension funds are less concentrated than conventional funds,and SRI and conventional pension funds largely diversify their portfolios,presenting lower concentration than portfolios formed with the optimization models.Furthermore,concentration strategies positively influence performance in SRI and conventional funds,revealing the use of information advantage.However,SRI and conventional fund managers present poor skills(picking,timing,and trading)to exploit information advantages due to overconfidence issues,which affect performance with concentration strategies.This situation may be modified if SRI funds follow modern optimization models and conventional funds follow traditional optimization models,improving managers’performance and skills.展开更多
The Dst index has been commonly used to measure the geomagnetic effectiveness of magnetic storm events for several decades.Based on Burton’s empirical Dst model and the global magneto-hydrodynamic(MHD)simulation of E...The Dst index has been commonly used to measure the geomagnetic effectiveness of magnetic storm events for several decades.Based on Burton’s empirical Dst model and the global magneto-hydrodynamic(MHD)simulation of Earth’s magnetosphere,here we proposed a semi-empirical model to forecast the Dst index during geomagnetic storms.In this model,the ring current contribution to the Dst index is derived from Burton’s model,while the contributions from other current systems are obtained from the global MHD simulation.In order to verify the model accuracy,a number of recent magnetic storm events are tested and the simulated Dst index is compared with the observation through the correlation coefficient(CC),prediction efficiency(PE),root mean square error(RMSE)and central root mean square error(CRMSE).The results indicate that,in the context of moderate and intense geomagnetic storm events,the semi-empirical model performs well in global MHD simulations,showing relatively higher CC and PE,and lower RMSE and CRMSE compared to those from the empirical model.Compared with the physics-based ring current models,this model inherits the advantage of fast processing from the empirical model,and easy implementation in a global MHD model of Earth’s magnetosphere.Therefore,it is suitable for the Dst estimation under a context of a global MHD simulation.展开更多
Extreme weather events,such as floods and droughts,are expected to rise significantly worldwide as a result of climate change.Investigating future drought patterns is therefore a key approach for elaborating anticipat...Extreme weather events,such as floods and droughts,are expected to rise significantly worldwide as a result of climate change.Investigating future drought patterns is therefore a key approach for elaborating anticipatory water resources management responses to climate change.In this paper,future meteorological drought conditions are investigated based on the SPEI(Standardised Precipitation Evapotranspiration Index).This study makes use of observed and projected data.The simulated data were retrieved from the CMIP6(Coupled Model Intercomparison Project Phase 6)over the period 2025-2050,and the Delta change method was adopted to remove the bias in the dataset.Then SPEI at various scales has been estimated under four future scenarios(SSP1-2.6,SSP2-4.5,SSP3-7.0 and SSP5-8.5).The trend analysis of the projected SPEI was performed at p<0.05 using the MMK(Modified Mann-Kendall)test in order to detect the statistically significant trend of the drought against the null hypothesis of no trend.Results show large variability in the magnitude of drought in the past and future.Based on SPEI at 24 months accumulation,the result shows that under SSP1-2.6,the basin will experience a wet period during the first decade(SPEI=0.60),the second decade will be dry(SPEI24=-0.43).The remaining years will be also dry(SPEI=-0.34).Under SSP2-4.5,SSP3-7.0 and SSP5-8.5 scenarios,the district will experience a wet period during the first two decades with SPEI ranging from 0.38 to 0.59.This wet period will be followed by a dry period under these scenarios ranging from-0.14 to-0.06.Overall,under SSPs scenarios,two main periods characterized by a rainfall recovery spanning from followed by a moderately prolonged drought are identified within the study area.The findings of this study may provide valuable information for developing proactive measures to reduce water insecurity in Fada N’Gourma through effective drought mitigation.展开更多
基金Supported by Ningxia Natural Science Foundation(2024AAC03100).
文摘Summer residential tourism is the future trend in China because of tourists’living quality improvement,heat crisis,rising market demand,and optimization of the destinations’residential environment,transport and accessibility.Compared with summer tourism and vacation tourism,summer residential tourism had got less attention and lacks in prospective and preventive research.Hence,this study focused on potential assessment,pattern recognition and phase segmentation of 32 residential tourism destinations in China selected from 4 lists.An index system of 16 indicators from 5 dimensions was established as Summer Residence Index(SRI),and Range method,Entropy weight method and Composite index method were chosen as the core methods.Three main conclusions were as follows.(1)Only 2 typical districts’SRI value were near to 0.6,and 4 destinations were below 0.1,about 26 destinations were at medium-level,which indicated that China’s summer residential tourism was not so popular and only few destinations have stepped into a higher level.(2)Seven patterns could be recognized based on the contribution of the 5 dimensions to SRI value,including 3 single-factor driven patterns and 4 compound factors driven patterns.(3)Like tourist area life cycle(TALC),Unconscious stage,Initial stage,Developmental stage and Maturity stage could be segmented for summer residential destinations with the value of below 0.1,0.1-0.3,0.3-0.5,and above 0.5.Four destinations were under Unconscious stage.Twenty-two destinations were at initiate stage.Only 4 destinations have stepped into development stage and 2 at maturity stage.China’summer residential tourism has just started and has a better prospect.This study is just an attempt and needs further consideration,for example,a tracking study of SRI calculation for each year will be carried to justify the effectiveness of SRI and to check the rationality of the empirical results.As time goes on,policies in housing,residential estate and other aspects should be included as a factor in the SRI index.Data availability should be optimized because of better data sources and new technologies.Some other districts or cities in 2 batches of national Comprehensive Tourism Demonstration Zones(CTDZs)pilots and provincial CTDZs will be further selections of summer residential tourism destinations.
文摘The Gabes aquifer system,located in southeastern Tunisia,is a crucial resource for supporting local socio-economic activities.Due to its dual porosity structure,is particularly vulnerable to pollution.This study aims to develop a hybrid model that combines the Fracture Aquifer Index(FAI)with the conventional GOD(Groundwater occurrence,Overall lithology,Depth to water table)method,to assess groundwater vulnerability in fractured aquifer.To develop the hybrid model,the classical GOD method was integrated with FAI to produce a single composite index.Each parameter within both GOD and FAI was scored,and a final index was calculated to delineate vulnerable areas.The results show that the study area can be classified into four vulnerability levels:Very low,low,moderate,and high,indicating that approximately 8%of the area exhibits very low vulnerability,29%has low vulnerability,25%falls into the moderate category,and 38%is considered highly vulnerable.The FAI-GOD model further incorporates fracture network characteristics.This refinement reduces the classification to three vulnerability classes:Low,medium,and high.The outcomes demonstrate that 46%of the area is highly vulnerable due to a dense concentration of fractures,while 17%represents an intermediate zone characterized by either shallow or deeper fractures.In contrast,37%corresponds to areas with lightly fractured rock,where the impact on vulnerability is minimal.Multivariate statistical analysis was employed using Principal Components Analysis(PCA)and Hierarchical Cluster Analysis(HCA)on 24 samples across six variables.The first three components account for over 76%of the total variance,reinforcing the significance of fracture dynamics in classifying vulnerability levels.The FAI-GOD model removes the very-low-vulnerability class and expands the spatial extent of low-and high-vulnerability zones,reflecting the dominant influence of fracture networks on aquifer sensitivity.While both indices use a five-class system,FAI-GOD redistributes vulnerability by eliminating very-low-vulnerability areas and amplifying low/high categories,highlighting the critical role of fractures.A strong correlation(R2=0.94)between the GOD and FAI-GOD indices,demonstrated through second-order polynomial regression,confirms the robustness of the FAI-GOD model in accurately predicting vulnerability to pollution.This model provides a useful framework for assessing the vulnerability of complex aquifers and serves as a decision-making tool for groundwater managers in similar areas.
文摘This commentary critically appraises the study by Li et al which pioneered the exploration of the triglyceride-glucose(TyG)index as a prognostic marker in hepatitis B virus-related advanced hepatocellular carcinoma patients undergoing combined camrelizumab and lenvatinib therapy.While we acknowledge the study’s clinical relevance in proposing an easily accessible metabolic biomarker,we delve into the mechanistic plausibility linking insulin resistance to immunotherapy response and angiogenic inhibition.We further critically examine the methodological limitations,including the retrospective design,the populationspecific TyG cut-off value,and unaddressed metabolic confounders.We highlight the imperative for future research to validate its utility across diverse etiologies and treatment settings,and to unravel the underlying immunometabolic pathways.
基金Supported by Inter Disciplinary Direction Cultivation Project of Hunan University of Chinese Medicine,No.2025JC01032025 Hunan Province Science and Technology Innovation Plan Project,No.2025RC9012+2 种基金2022"Unveiling and Leading"Project of Discipline Construction at Hunan University of Chinese Medicine,No.22JBZ044Changsha Municipal Natural Science Foundation,No.kq2402174Hunan Provincial Science Popularization Fund Project,No.2025ZK4223.
文摘BACKGROUND Timely and accurate evaluation of mental disorders in adolescents using appropriate mental health literacy assessment tools is essential for improving their mental health literacy levels.AIM To develop an evaluation index system for the mental health literacy of adolescent patients with mental disorders,providing a scientific,comprehensive,and reliable tool for the monitoring and intervention of mental health literacy of such patients.METHODS From December 2022 to June 2023,the evaluation index system for mental health literacy of adolescents with mental disorders was developed through literature reviews,semi-structured interviews,expert letter consultations,and the analytic hierarchy process.Based on this index system,a self-assessment questionnaire was compiled and administered to 305 adolescents with mental disorders to test the reliability and validity of the index system.RESULTS The final evaluation index system for mental health literacy of adolescents with mental disorders included 4 first-level indicators,10 second-level indicators,and 52 third-level indicators.The overall Cronbach’sαcoefficient of the index system was 0.957,with a partial reliability of 0.826 and a content validity index of 0.975.The cumulative variance contribution rate of 10 common factors was 66.491%.The correlation coefficients between each dimension and the total questionnaire ranged from 0.672 to 0.724,while the correlation coefficients in each dimension ranged from 0.389 to 0.705.CONCLUSION The evaluation index system for mental health literacy of adolescents with mental disorders,developed in this study,demonstrated notable reliability and validity,making it a valuable tool for evaluating mental health literacy in this population.
文摘The “facial composite” is one of the major fields in the forensic science that helps the criminal investigators to carry out their investigation process. The survey conducted by United States Law Enforcement Agencies confirms that 80% of the law enforcement agencies use computer automated composite systems whereas Sri Lanka is still far behind in the process of facial composite with lot of inefficiencies in the current manual process. Hence this research introduces a novel approach for the manual facial composite process, while eliminating the inefficiencies of the manual procedure in Sri Lanka. In order to overcome this situation, this study introduces an automated image processing based software solution with 2D facial feature templates targeting the Sri Lankan population. Thus, this was the first ever approach that creates the 2D facial feature templates by incorporating both medically defined indexes and relevant aesthetic aspects. Hence, this research study is comprised of two separate analyses on anthropometric indices and facial feature shapes which were carried out targeting the local population. Subsequently, several evaluation techniques were utilized to evaluate this methodology where we obtained an overall success rate as 70.19%. The ultimate goal of this research study is to provide a system to the law enforcement agencies in order to carry out an efficient and effective facial composite process which can lead to increase the success rate of suspect identification.
基金Supported by The University of Kelaniya,Sri Lanka,Research Council Grant No.G23.
文摘BACKGROUND Overweight children exhibit a higher prevalence of functional gastrointestinal disorders compared with their normal-weight peers,yet the underlying reasons remain unclear.Gastrointestinal motility,a key pathophysiological factor in functional gastrointestinal disorders,may be influenced by body mass index(BMI).AIM To evaluate the impact of BMI on gastric motility parameters in children with functional abdominal pain disorders(FAPDs).METHODS We assessed gastric motility in 176 children with FAPDs(61.4%females,mean age 7.94 years,SD 1.96 years)and 63 healthy controls(57.1%females,mean age 9.17 years,SD 1.90 years)at the Gastroenterology Research Laboratory,University of Kelaniya,Sri Lanka.FAPDs were diagnosed and subtyped using the Rome IV criteria:Functional abdominal pain 97 patients;irritable bowel syndrome 39 patients,functional dyspepsia(FD)25 patients;and abdominal migraine 15 patients.Gastric motility was measured using a validated ultrasound method.Weight and height were measured using sensitive standard scales.RESULTS The BMIs of children with FAPDs and controls were 15.04 and 15.46 kg/m^(2),respectively(P=0.33).Fasting antral area(FAA)and antral area at 1 min(AA1)and 15 min(AA15)were significantly greater in patients with FAPD with a higher BMI(2.71 cm^(2),12.57 cm^(2),and 7.19 cm^(2),respectively)compared with those with a lower BMI(2.12 cm^(2),10.68 cm^(2),and 6.13 cm^(2),respectively)(P<0.01).BMI positively correlated with FAA and AA15(r=0.18 and r=0.19,respectively)(P<0.01)in those with FAPDs.In controls,only AA1 was greater in the higher BMI group(12.51 cm^(2)vs 9.93 cm^(2))and had a positive correlation(r=0.33)(P≤0.01).Subgroup analysis revealed that in patients with FD,BMI negatively correlated with gastric emptying rate(GER)(r=-0.59)and antral motility index(MI)(r=-0.49),while in functional abdominal pain,MI positively correlated(r=0.25)with BMI(P≤0.01).CONCLUSION In children with FAPDs,higher BMI was associated with increased gastric antral distention during fasting and postprandial periods(as indicated by FAA,AA1,and AA15)but not with contractility and transit(MI,GER).However,in the FD subgroup,high BMI correlated with reduced GER and MI.This indicates the possible role of BMI in gastric hypomotility and the pathophysiology of FD.These findings underscore the importance of lifestyle and dietary interventions aimed at optimizing BMI in the management of FAPDs,particularly FD.
文摘The clinical study of solute removal index (SRI) was performed in 20 stable maintenance hemodialysis patients in order to find a proper hemodialydsis dosage and improve the life quality of the patients.Plasma BUN levels were tested pre-hemodialysis and 0, 1 hr post-hemodialysis. Urea generation rate (G)、protein catabolic rate(PCR)、solute removal amount(R)、SRI were calculated by double pools urea kinetic model . The result showed that urea rebound rate was 18.5±3.35 % 1 hr after hemodialysis,R was 13.82±5.48 g, G was 4.85±1.39 g, PCR was 0.94±0.29 g/kg.d, SRI was 71.33±6.8% respectively, which indicated that SRI was a better index to quantitate the adequacy of hemodialysis.
文摘In the context of the digital transformation of vocational education,a quality evaluation index system has been constructed.Based on a questionnaire survey conducted among higher vocational colleges and enterprises in Hainan Province,it has been found that the quality of vocational education generally depends on the talent training program and professional construction at the macro level.At the meso level,the teacher level and teaching environment are critical,while at the micro level,the evaluation of talent training quality cannot be underestimated.Strategies for quality improvement in vocational education are proposed from the perspectives of talent training programs,major construction,teacher development,teaching environment,and talent training quality,all under the lens of digital transformation.
文摘BACKGROUND The diagnosis of gastric carcinoma(GC)is essential for improving clinical outcomes.However,the biomarkers currently used for GC screening are not ideal.AIM To explore the diagnostic implications of the neutrophil-to-lymphocyte ratio(NLR),platelet-to-lymphocyte ratio(PLR),and systemic immune-inflammatory index(SII)for GC.METHODS The baseline data of 133 patients with GC and 134 patients with precancerous gastric conditions admitted between January 2022 and December 2023 were retrospectively analyzed.The information on peripheral blood platelet,neutrophil,and lymphocyte counts in each patient was collected,and the NLR,PLR,and SII levels of both groups were calculated.Additionally,multivariate logistic regression analysis was conducted,and the diagnostic implications of NLR,PLR,and SII in differentiating patients with precancerous gastric conditions,compared with those with GC,were analyzed through receiver operating characteristic(ROC)curves.RESULTS The data indicated that NLR,PLR,and SII had abnormally increased levels in the patients with GC.Gender and body mass index were risk factors for the occurrence of GC.ROC data revealed that the areas under the curve of three patients with precancerous gastric conditions,who were differentiated from those with GC,were 0.824,0.787,and 0.842,respectively.CONCLUSION NLR,PLR,and SII are all abnormally expressed in GC and have diagnostic implications,especially when used as joint indicators,in distinguishing patients with precancerous gastric conditions from those with GC.
基金Supported by Natural Science Foundation of Xinjiang Uygur Autonomous Region,No.2022D01C297.
文摘BACKGROUND Anastomotic leakage(AL)is a serious complication following rectal cancer surgery and is associated with increased recurrence,mortality,extended hospital stays,and delayed chemotherapy.The Onodera prognostic nutritional index(OPNI)and inflammation-related biomarkers,such as the neutrophil-lymphocyte ratio(NLR)and platelet-to-lymphocyte ratio(PLR),have been studied in the context of cancer prognosis,but their combined efficacy in predicting AL remains unclear.AIM To investigate the relationships between AL and these markers and developed a predictive model for AL.METHODS A retrospective cohort study analyzed the outcomes of 434 patients who had undergone surgery for rectal cancer at a tertiary cancer center from 2016 to 2023.The patients were divided into two groups on the basis of the occurrence of AL:One group consisted of patients who experienced AL(n=49),and the other group did not(n=385).The investigation applied logistic regression to develop a risk prediction model utilizing clinical,pathological,and laboratory data.The efficacy of this model was then evaluated through receiver operating characteristic curve analysis.RESULTS In the present study,11.28%of the participants(49 out of 434 participants)suffered from AL.Multivariate analysis revealed that preoperative levels of the OPNI,NLR,and PLR emerged as independent risk factors for AL,with odds ratios of 0.705(95%CI:0.641-0.775,P=0.012),1.628(95%CI:1.221-2.172,P=0.024),and 0.994(95%CI:0.989-0.999,P=0.031),respectively.These findings suggest that these biomarkers could effectively predict AL risk.Furthermore,the proposed predictive model has superior discriminative ability,as demonstrated by an area under the curve of 0.910,a sensitivity of 0.898,and a specificity of 0.826,reflecting its high level of accuracy.CONCLUSION The risk of AL in rectal cancer surgery patients can be effectively predicted by assessing the preoperative levels of serum nutritional biomarkers and inflammatory indicators,emphasizing their importance in the preoperative evaluation process.
文摘BACKGROUND Acute liver failure(ALF)is a life-threatening multisystemic condition with high short-term mortality.With the growing prevalence of obesity and metabolic syndrome,it is important to investigate the clinical implications of high body mass index(BMI)on survival outcomes in ALF.AIM To explore the impact of overweight and obesity on the clinical outcomes of patients with ALF.METHODS A retrospective observational cohort study was conducted involving patients with ALF admitted to the Johns Hopkins Health System between January 1,2000 and May 1,2020.We performed Cox proportional hazards regression to identify outcomes,including the need for liver transplantation(LT)or all-cause mortality.RESULTS A total of 196 patients were included,the median age was 43.5 years,63.3%were female,and 59.7%were of Caucasian ethnicity.Acetaminophen-induced ALF was the most common etiology(45%).The mean BMI was significantly greater among patients who underwent LT or died(29.64 kg/m^(2)vs 26.59 kg/m^(2),P=0.008)than among survivors.Patients with overweight and obesity had a higher risk of all-cause mortality or need for LT by 2.22-fold(95%CI:1.30-3.78)and 2.04-fold(95%CI:1.29-3.39),respectively.Elevated BMI was associated with renal failure and higher grades of hepatic encephalopathy.Derangements in serologic markers,including alanine transaminase,lactate,and ammonia,were associated with a mortality risk or need for LT.CONCLUSION In this large,retrospective study,with a diverse cohort of United States patients,Overweight and obese were independently associated with an increased risk of all-cause mortality or need for LT.This work highlights the importance of closely monitoring ALF patients who are overweight or obese for adverse complications and measures to improve outcomes in this vulnerable patient population.
基金Supported by the University of Kelaniya,Sri Lanka,Research Grant,No.RP/03/04/03/01/2022.
文摘BACKGROUND Gastric motility is an essential gastrointestinal function.It can be influenced by age,gender,body composition,and metabolic status.However,published data on these associations remains limited.AIM To assess the relationship between gastric motility and adiposity,and metabolic indicators in a cohort of Sri Lankan office workers.METHODS A cross-sectional study was conducted among 130 office workers(58.5%females)aged 20-50 years(mean 36.81,SD 8.85 years)of the University of Kelaniya,Sri Lanka.Gastric motility was assessed by real-time ultrasonography,using a previously validated method.Fasting antral area(FAA),postprandial antral areas at 1 minutes and 15 minutes(AA1,AA15),and antral contraction frequency(FAC)were measured,and gastric emptying rate(GER)and antral motility index were calculated.Anthropometric parameters were obtained using sensitive scales.Glycated hemoglobin,lipid profile,and liver enzyme levels were measured at an accredited laboratory.RESULTS The mean body mass index(BMI)was 24.36(SD 4.09)kg/m^(2),and 39.2%were overweight or obese.Increased abdominal adiposity was detected in 29.2%and 40.8%had high waist-to-hip ratios.Prediabetes/diabetes were observed in 20.0%,hypercholesterolemia in 47.7%,hypertriglyceridemia in 14.7%,high low-density lipoproteins in 39.2%,and elevated aspartate transaminase and alanine transaminase in 5.4%and 21.5%respectively.FAA had a weak negative correlation with high-density lipoprotein level(r=-0.227,P=0.009),and a positive correlation with waist circumference(r=0.235,P=0.007),and waist-to-hip ratio(r=0.244,P=0.005).GER and AA1 correlated weakly with triglyceride(GER:r=0.174,P=0.048;AA1:r=0.194,P=0.027)and VLDL levels(GER:r=0.183,P=0.038;AA1:r=0.195,P=0.026).In females,AA1 positively correlated with triglycerides(r=0.333,P=0.003),and VLDL levels(r=0.337,P=0.003),and AA15 with BMI(r=0.284,P=0.013)and hip circumference(r=0.229,P=0.047).FAC negatively correlated with BMI(r=-0.234,P=0.042)and hip circumference(r=-0.247,P=0.032).CONCLUSION Gastric motility parameters showed weak associations with metabolic indicators,particularly lipid profiles,and to a lesser extent,with adiposity indicators.The greater number of correlations observed in females suggests the possibility of sex-specific differences in these associations.These findings highlight potential relationships that require confirmation through longitudinal studies.
基金Supported by the National Key R D Program of China,No.2022YFC2010102Natural Science Foundation of Hunan Province,No.2021JC0003+1 种基金National Natural Science Foundation of China,No.82070812the Sinocare Diabetes Foundation,No.LYF2022039.
文摘ACKGROUND The hemoglobin glycation index(HGI)represents the discrepancy between the glucose management indicator(GMI)based on mean blood glucose levels and laboratory values of glycated hemoglobin(HbA1c).The HGI is a promising indicator for identifying individuals with excessive glycosylation,facilitating personalized evaluation and prediction of diabetic complications.However,the factors influencing the HGI in patients with type 1 diabetes(T1D)remain unclear.Autoimmune destruction of pancreaticβcells is central in T1D pathogenesis,yet insulin resistance can also be a feature of patients with T1D and their coexistence is called“double diabetes”(DD).However,knowledge regarding the relationship between DD features and the HGI in T1D is limited.AIM To assess the association between the HGI and DD features in adults with T1D.METHODS A total of 83 patients with T1D were recruited for this cross-sectional study.Laboratory HbA1c and GMI from continuous glucose monitoring data were collected to calculate the HGI.DD features included a family history of type 2 diabetes,overweight/obesity/central adiposity,hypertension,atherogenic dyslipidemia,an abnormal percentage of body fat(PBF)and/or visceral fat area(VFA)and decreased estimated insulin sensitivity.Skin autofluorescence of advanced glycation end products(SAF-AGEs),diabetic complications,and DD features were assessed,and their association with the HGI was analyzed.RESULTS A discrepancy was observed between HbA1c and GMI among patients with T1D and DD.A higher HGI was associated with an increased number of SAF-AGEs and a higher prevalence of diabetic microangiopathy(P=0.030),particularly retinopathy(P=0.031).Patients with three or more DD features exhibited an eight-fold increased risk of having a high HGI,compared with those without DD features(adjusted odds ratio=8.12;95%confidence interval:1.52-43.47).Specifically,an elevated PBF and/or VFA and decreased estimated insulin sensitivity were associated with high HGI.Regression analysis identified estimated insulin sensitivity and VFA as factors independently associated with HGI.CONCLUSION In patients with T1D,DD features are associated with a higher HGI,which represents a trend toward excessive glycosylation and is associated with a higher prevalence of chronic diabetic complications.
文摘This study investigates the psychological and cultural motivations that underpin charitable giving in Sri Lanka,with particular attention to whether such behaviour can be considered genuinely altruistic.While charitable acts are commonly perceived as selfless,this research highlights the complex and often contradictory nature of the motivations involved.Using a qualitative approach,semi-structured interviews were conducted with individuals who regularly engage in charitable activities.Thematic analysis revealed three overarching categories of motivation.The first,obliged motives stem from social expectations and religious duty.The second,independent motives reflect personal values and intrinsic satisfaction.The third,ambivalent motives are a novel category that captures the simultaneous interplay between self-serving and other-oriented intentions.The emergence of ambivalent motives is especially significant,as it challenges binary distinctions between altruism and egoism,suggesting that charitable giving frequently serves psychological,social,and existential needs alongside prosocial goals.The findings support established psychological frameworks such as Self-Determination Theory and the Theory of Planned Behavior,while also highlighting the unique cultural dynamics of Sri Lankan society,particularly the influence of Buddhist ethics and collectivist values.These cultural factors shape both the meaning and practice of giving,embedding it within broader narratives of moral obligation,social harmony,and spiritual merit.Ultimately,the study concludes that while charitable giving in Sri Lanka may outwardly appear altruistic,it is often driven by a complex mixture of internal and external motives,suggesting that authenticity in giving is rarely absolute but rather contextually and psychologically mediated.
基金Supported by the Scientific Research Project of Hospital Pharmacy of Guangxi Pharmaceutical Association in 2022,No.GXYXH1-202202.
文摘BACKGROUND Gastric cancer(GC)is the fifth most common cancer and the third leading cause of cancer-related deaths in China.Many patients with GC frequently experience symptoms related to the disease,including anorexia,nausea,vomiting,and other discomforts,and often suffer from malnutrition,which in turn negatively affects perioperative safety,prognosis,and the effectiveness of adjuvant therapeutic measures.Consequently,some nutritional indicators such as nutritional risk index(NRI),prognostic nutritional index(PNI),and systemic immune-inflammatorynutritional index(SIINI)can be used as predictors of the prognosis of GC patients.AIM To examine the prognostic significance of PNI,NRI,and SIINI in postoperative patients with GC.METHODS A retrospective analysis was conducted on the clinical data of patients with GC who underwent surgical treatment at the Guangxi Medical University Cancer Hospital between January 2010 and December 2018.The area under the receiver operating characteristic(ROC)curve was assessed using ROC curve analysis,and the optimal cutoff values for NRI,PNI,and SIINI were identified using the You-Review-HTMLden index.Survival analysis was performed using the Kaplan-Meier method.In addition,univariate and multivariate analyses were conducted using the Cox proportional hazards regression model.RESULTS This study included a total of 803 patients.ROC curves were used to evaluate the prognostic ability of NRI,PNI,and SIINI.The results revealed that SIINI had superior predictive accuracy.Survival analysis indicated that patients with GC in the low SIINI group had a significantly better survival rate than those in the high SIINI group(P<0.05).Univariate analysis identified NRI[hazard ratio(HR)=0.68,95%confidence interval(CI):0.52-0.89,P=0.05],PNI(HR=0.60,95%CI:0.46-0.79,P<0.001),and SIINI(HR=2.10,95%CI:1.64-2.69,P<0.001)as prognostic risk factors for patients with GC.However,multifactorial analysis indicated that SIINI was an independent risk factor for the prognosis of patients with GC(HR=1.65,95%CI:1.26-2.16,P<0.001).CONCLUSION Analysis of clinical retrospective data revealed that SIINI is a valuable indicator for predicting the prognosis of patients with GC.Compared with NRI and PNI,SIINI may offer greater application for prognostic assessment.
基金supported by Government of Aragon[Grant S38_20R]Ibercaja and University of Zaragoza[Grants JIUZ-2021-SOC-03 and JIUZ2022-CSJ-24]Ministerio de Ciencia e Innovación and FEDER[PID2022-136818NB-100].
文摘This study assesses the portfolio concentration of socially responsible investment(SRI)pension funds,which may be subject to a potentially limited asset universe and have a higher concentration and lower performance than conventional funds.Nonetheless,in contrast to previous studies on SRI funds,this study considers the informationadvantage theory,positing that skilled managers should increase their concentration in assets in which they possess valuable information,departing from optimization models to achieve outperformance.This study first compares actual fund concentration with concentration obtained from several traditional and modern portfolio optimization techniques(minimum variance,global minimum variance,optimal portfolio,naïve diversification,risk parity,and reward-to-risk timing)to understand whether SRI pension funds concentrate portfolios and deviate from optimization model solutions.Unlike previous studies,the actual fund assets are considered in the optimization models to take into account the real investment profiles of SRI funds.The results indicate that SRI pension funds are less concentrated than conventional funds,and SRI and conventional pension funds largely diversify their portfolios,presenting lower concentration than portfolios formed with the optimization models.Furthermore,concentration strategies positively influence performance in SRI and conventional funds,revealing the use of information advantage.However,SRI and conventional fund managers present poor skills(picking,timing,and trading)to exploit information advantages due to overconfidence issues,which affect performance with concentration strategies.This situation may be modified if SRI funds follow modern optimization models and conventional funds follow traditional optimization models,improving managers’performance and skills.
基金supported by NNSFC grants 42150101,42188105,42304189National Key R&D program of China No.2021YFA-0718600the Pandeng Program of National Space Science Center,Chinese Academy of Sciences.
文摘The Dst index has been commonly used to measure the geomagnetic effectiveness of magnetic storm events for several decades.Based on Burton’s empirical Dst model and the global magneto-hydrodynamic(MHD)simulation of Earth’s magnetosphere,here we proposed a semi-empirical model to forecast the Dst index during geomagnetic storms.In this model,the ring current contribution to the Dst index is derived from Burton’s model,while the contributions from other current systems are obtained from the global MHD simulation.In order to verify the model accuracy,a number of recent magnetic storm events are tested and the simulated Dst index is compared with the observation through the correlation coefficient(CC),prediction efficiency(PE),root mean square error(RMSE)and central root mean square error(CRMSE).The results indicate that,in the context of moderate and intense geomagnetic storm events,the semi-empirical model performs well in global MHD simulations,showing relatively higher CC and PE,and lower RMSE and CRMSE compared to those from the empirical model.Compared with the physics-based ring current models,this model inherits the advantage of fast processing from the empirical model,and easy implementation in a global MHD model of Earth’s magnetosphere.Therefore,it is suitable for the Dst estimation under a context of a global MHD simulation.
文摘Extreme weather events,such as floods and droughts,are expected to rise significantly worldwide as a result of climate change.Investigating future drought patterns is therefore a key approach for elaborating anticipatory water resources management responses to climate change.In this paper,future meteorological drought conditions are investigated based on the SPEI(Standardised Precipitation Evapotranspiration Index).This study makes use of observed and projected data.The simulated data were retrieved from the CMIP6(Coupled Model Intercomparison Project Phase 6)over the period 2025-2050,and the Delta change method was adopted to remove the bias in the dataset.Then SPEI at various scales has been estimated under four future scenarios(SSP1-2.6,SSP2-4.5,SSP3-7.0 and SSP5-8.5).The trend analysis of the projected SPEI was performed at p<0.05 using the MMK(Modified Mann-Kendall)test in order to detect the statistically significant trend of the drought against the null hypothesis of no trend.Results show large variability in the magnitude of drought in the past and future.Based on SPEI at 24 months accumulation,the result shows that under SSP1-2.6,the basin will experience a wet period during the first decade(SPEI=0.60),the second decade will be dry(SPEI24=-0.43).The remaining years will be also dry(SPEI=-0.34).Under SSP2-4.5,SSP3-7.0 and SSP5-8.5 scenarios,the district will experience a wet period during the first two decades with SPEI ranging from 0.38 to 0.59.This wet period will be followed by a dry period under these scenarios ranging from-0.14 to-0.06.Overall,under SSPs scenarios,two main periods characterized by a rainfall recovery spanning from followed by a moderately prolonged drought are identified within the study area.The findings of this study may provide valuable information for developing proactive measures to reduce water insecurity in Fada N’Gourma through effective drought mitigation.
