Comprehension Scores Research Articles

Measurement of regional green finance development and its coordination with economic development: a study on the Yangtze River Delta region of China

The green transformation of industry and sustainable economic development both require considerable investment. In this regard, green finance that is compatible with economic development can help cope with the massive demand for capital. Taken China’s Yangtze River Delta (YRD) as an example, this study is to measure the coordination degree between green finance and economic development. First, the concept, content and scope of green finance is defined based on the new financial regulation mechanism. Second, a green finance measurement index is built to calculate the green finance index for 30 Chinese provinces by the CFA test. Third, based on the economic structure index, an economic development index is built. Testing the rationality of green financial index and the economic development index, this paper finally measures the degree of coordination between green finance and economic development in the YRD. The results reveal that, first, green finance is a financial instrument that integrates financial industry development, environmental improvement, and economic growth. The measurement of the green financial development index includes the sum of regional green credit, green investment, green securities, and green insurance. Second, after years' development, the comprehensive score of YRD’s coupling coordination degree exceeds 0.8 in 2020, which shows a high level of coordinated development between green finance and economic construction. However, there is a 2-year timing effect between the economic development and green finance index increase, which reveals that green finance development in the YRD requires further policy guidance and support. This study’s findings can provide a theoretical reference and case support for the further development of green finance and related policies in China.

Water and fertilizer decision model for synergistic optimization of yield, quality and efficiency of cherry tomato based on combination evaluation

The scientific nutrient supply under deficit irrigation can ensure the yield and quality of crops, and balance water and fertilizer benefits. The model of the combination of water and fertilizer was constructed based on the analysis of the effects of irrigation, K2O and MgO application on yield, quality and water and fertilizer use efficiency of cherry tomato over two growing seasons. Deficit irrigation contributed to quality accumulation, while full irrigation resulted in higher yields. The optimal irrigation water use efficiency (IWUE) was attained with a moderate level of potassium and magnesium. An evaluation system of cherry tomato was established containing totally 6 indicators from 3 categories of yield, quality and efficiency based on correlation analysis, and yield obtained the highest weight of 0.402 and 0.373 in the two study seasons, respectively. The overall differential combination model was adopted to comprehensively evaluated combination of water and fertilizer factors by integrating three single models of TOPSIS, Membership function analysis and Grey relational analysis, and the correlation coefficient of any two single model was greater than 0.614. The response of comprehensive score for cherry tomato to each single factor of irrigation, K2O and MgO followed a downward-opening parabola. The analytical model revealed that the coupling of potassium and magnesium has a mutually reinforcing effect when they were both at medium level, while an inhibitory effect was observed at higher or lower level. The model verification showed that 7 out of the total 10 indicators reached more than 80 % of maximum value of the corresponding single indicator under the condition of the water and fertilizer with highest comprehensive score. Considering yield, quality and efficiency, the optimal combination of irrigation, K2O, and MgO was 80.6 ∼ 83.2 % Evaporation (Ep), 161.40 ∼ 171.27 kg/ha, and 19.59 ∼ 20.17 kg/ha in 2021S. The corresponding combination for 2021F was 75.4 ∼ 77.9 % Ep, 133.41 ∼ 140.45 kg/ha, and 13.99 ∼ 14.80 kg/ha. This strategy can maintain yield, improve quality, save irrigation amount, and increase fertilizer efficiency, which guides the production of deficient irrigation in northwest China.

An Online Review Data-Driven Fuzzy Large-Scale Group Decision-Making Method Based on Dual Fine-Tuning

Large-scale group decision-making (LSGDM) involves aggregating the opinions of participating decision-makers into collective opinions and selecting optimal solutions, addressing challenges such as a large number of participants, significant scale, and a low consensus. In real-world scenarios of LSGDM, various challenges are often encountered due to factors such as fuzzy uncertainties in decision information, the large size of decision groups, and the diverse backgrounds of participants. This paper introduces a dual fine-tuning-based LSGDM method using an online review. Initially, the sentiment analysis is conducted on online review data, and the identified sentiment words are graded and quantified into a fuzzy data set to understand the emotional tendencies of the text. Then, the Louvain algorithm is used to cluster the decision-makers. Meanwhile, a method combining Euclidean distances with Wasserstein distances is introduced to accurately measure data similarities and improve clustering performances. During the consensus-reaching process (CRP), a two-stage approach is employed to adjust the scores: to begin with, by refining the scores of the decision representatives via minor-scale group adjustments to generate a score matrix. Then, by identifying the scores corresponding to the minimum consensus level in the matrix for adjustment. Subsequently, the final adjusted score matrix is integrated with the prospect–regret theory to derive the comprehensive brand scores and rankings. Ultimately, the practicality and efficiency of the proposed model are demonstrated using a case study focused on the purchase of solar lamps. In summary, not only does the model effectively extract the online review data and enhance decision efficiency via clustering, but the dual fine-tuning mechanism in the model to improve consensus attainment also reduces the number of adjustment rounds and avoids multiple cycles without achieving the consensus.

The Effect of English Podcast on ESL Students Listening Comprehension Skills

This study aims to evaluate the effect of using English podcasts on the listening comprehension skills of ESL (English as a Second Language) students using a pre-experimental one-group pretest post-test design. The sample consisted of 35 ESL students. The students were given a listening comprehension test before the intervention (pretest) to measure their initial skills. During a four-week period, the students were regularly exposed to English podcasts selected based on difficulty level and relevance to the curriculum. After the intervention period, the same listening comprehension test was administered as a post-test to measure changes in listening skills. The collected data were analyzed using a paired t-test to determine the significance of the difference between pretest and post-test scores. The results showed a significant increase in students' listening comprehension scores after the podcast intervention (p < 0.05). These findings indicate that regular use of English podcasts can improve ESL students' listening comprehension skills. This study suggests that podcasts can be an effective tool in language learning, particularly in enhancing listening skills. The practical implication of this research is to encourage educators to integrate podcasts into their teaching methods. Further research is recommended to address the limitations of this study design and explore other factors that may influence the results.

Understanding the awareness of health and safety signs amongst health care workers in Pakistan - A cross-sectional study.

Safety signs are very important communication tools for accident prevention, fire safety, health hazard information, and emergency evacuation. However, they are helpful only when properly designed and understood by employees. The purpose of the present study was to assess the awareness of health and safety signs amongst health care workers including doctors, dentists and paramedics in different health care sectors across Pakistan. Data was collected via Google forms circulated through WhatsApp social media to predetermined groups of health care professionals to assess their understanding of safety signs across different health sectors. The survey included questions pertaining to awareness of 19 different health and safety signs complied with International Organization for Standardization 1710 and the Safety Signs and Signal Regulations 1996 chosen randomly. A total of 987 people participated in our study and were asked to comprehend the meaning of nineteen health and safety signs. The mean comprehension score for 19 signs was 42.2%. The mean score for warning signs was the lowest and fire safety signs was highest. The lowest comprehension scores were for oxygen cylinder sign (W029) 7.5% and highest for first aid sign (E003) 75.9%. Only two signs, that are first aid (E003) and mandatory gloves (M009) had acceptable comprehensive score of 75.9% and 73.7% respectively as per ISO 7010 i.e. >67%. Statistically significant differences were found only for trip hazard sign (W007) with respect to education and for risks of bomb explosion (W002), ionising radiation (W009), evacuation assembly point (E007), location of automated external heart defibrillator (E010) and mandatory gloves (M009) with work experience. Based on our results, we conclude that there is dire need of special and frequent training to better recognize the safety signs amongst health care employees since these kinds of interventions promote early detection of hazards and their associated risks. Thus, we propose that health care safety sign training must be included in every health care profession curriculum.

Influence of age on financial toxicity in cancer patients

ObjectiveThe aim of this study was to assess the level of financial toxicity (FT) experienced by the following three age groups of cancer patients in China: young working-aged patients (age < 40 years), middle-aged patients (40–64 years), and older patients (≥ 65 years). MethodsThe data used for this study were collected via a cross-sectional survey conducted in China. FT was assessed using the Comprehensive Score for Financial Toxicity (COST). ANOVA was used to examine the differences in FT status between age groups. Multivariate linear regression models were employed to assess the association between age and FT, adjusted by socioeconomic and other clinical characteristics. ResultsA total of 556 cancer patients completed the survey. Approximately 54.3% of the participants were male and 45.7% were female. The majority (61.5%) were aged 40–64 years, while 27.7% were aged 65 or older. The mean FT scores for young patients (< 40 years), middle-aged patients (40–64 years), and older patients (≥ 65 years) were 16.7, 12.8, and 12.4, respectively. The results of the regression analysis revealed that, without adjusting for background characteristics, young patients had significantly higher mean COST scores. This suggests they experienced lower levels of FT compared to patients in other age groups. Stratified analysis revealed that, for older patients, only educational level and type of insurance scheme were significant factors in predicting the COST score. ConclusionsThis study provides empirical evidence for developing targeted interventions and policies to reduce the FT for patients in different age groups. Given that FT is complicated, a longitudinal study should be conducted to explore the long-term impact of FT on cancer patients' quality of life and well-being.

Screening for Health-Related Social Needs and Financial Toxicity Among Patients With Cancer Treated With Radiation Therapy: Findings From a Quality Improvement Project

IntroductionFinancial toxicity is common among patients with cancer, as are co-occurring health-related social risks (HRSRs). There is limited evidence to support best practices in screening for HRSRs and financial toxicity in the cancer context. This analysis sought to understand variations of identified needs based on treatment course using data from a large screening program. MethodsThis 2022 to 2023 screening quality improvement program included four services (breast, gastrointestinal, gynecologic, thoracic) at an urban comprehensive cancer center. The Comprehensive Score for Financial Toxicity measured financial toxicity. Patients completed an HRSR checklist documenting food, housing, medication, or transportation insecurity and financial borrowing practices. Differences were evaluated by treatment course (radiation therapy [RT] versus other treatment and RT plus chemotherapy versus other treatment). ResultsScreening surveys were sent to 70,983 unique patients; 38,249 completed a screening survey (54% response rate). Of responders, 4% (n = 1,686) underwent RT in the 120 days before their survey, and 3% (n = 1,033) received RT in combination with chemotherapy. Overall, patients receiving RT had lower unadjusted Comprehensive Score for Financial Toxicity scores, indicating worse financial toxicity. The proportion of patients receiving RT reporting unmet transportation (15% versus 12%, P < .001) and food (13% versus 11%, P = .02) needs was significantly higher than for patients not receiving RT. More patients receiving RT borrowed money than did patients not receiving RT (17% versus 15%, P = .02). In multivariable models, RT (alone or in combination) was associated with worse financial toxicity and transportation difficulties. ConclusionsScreening for financial toxicity and HRSR is possible at a large cancer center. Patients receiving RT have higher transportation insecurity and worse financial toxicity compared with those receiving other treatments. Tailored intervention throughout the treatment trajectory is essential.

Optimising the hydraulic performance of a jet impingement sprinkler by varying elevation angle: A Comparative study with a non-impingement sprinkler

A novel jet impingement sprinkler was designed to replace the additional water-dispersing devices usually used in rotating sprinklers to adapt performance for low-pressure conditions. Utilising the asymmetric impingement mode of primary and secondary jets, the design prioritises the secondary nozzle elevation angle. Theoretical expressions were establish between the primary and secondary jet momentum rates. Hydraulic performance experiments, were conducted under intermediate and low-pressure conditions, examining water application rate, wetted radius, and Christiansen's uniformity coefficient at various elevation angles. High-speed photography (HSP) experiments elucidate differences in hydraulic performance, revealing that the impingement jet generally featured a lower maximum water application rate but a smoother distribution compared to its non-impingement counterpart. Using the CRiteria Importance Through Intercriteria Correlation (CRITIC) method, comprehensive scores highlight an optimal arrangement with a 34.5° secondary nozzle elevation angle, illustrating superior performance under low pressure. Comparative analyses between the wetted radius and Christiansen's uniformity coefficient uncover a trade-off, with jet impingement sacrificing wetted radius for increased uniformity. However, this efficiency diminished as jet impingement effects intensify. HSP experiments validate theoretical calculations, with a relative error of less than 4% for jet deflection angle and jet breakup length. Non-linear curve fitting establishes relationships between jet breakup length, mean observed jet deflection angle, operating pressure, and wetted radius. Calculated and measured values exhibited a relative error within 5%, affirming the applicability of the developed equation for predicting wetted radius in jet impingement sprinklers.

Optimization of the extraction process for Shenshou Taiyi powder based on Box-Behnken experimental design, standard relation, and FAHP-CRITIC methods

BackgroundAncient classic prescription play a crucial role in the preservation and advancement of traditional Chinese medicine (TCM) theories. They represent a significant milestone in the ongoing development and transmission of TCM knowledge and practices and are considered one of the breakthroughs in the development of TCM inheritance. In the process of developing ancient classic prescriptions, many problems may still arise in ensuring quality consistency between traditional methods and modern production processes, among which the extraction process poses major challenges. This paper introduces a practical approach extracting an ancient classic prescription using a modern extraction process. The technique is demonstrated through the study of the extraction process of Shenshou Taiyi powder (STP).MethodsThis study focuses on optimising the STP extraction process to ensure consistency in the quality of the product obtained through ancient and modern processes using the standard relation and fuzzy analytic hierarchical process (FAHP) and criteria importance through intercriteria correlation (CRITIC) method integrated weights combined with the Box-Behnken response surface test. Using the contents of rosmarinic acid, isoimperatorin, puerarin, as well as the extract yield and fingerprint similarity as evaluation indexes of STP, the Box-Behnken response surface method was employed to examine the varying extraction parameters, including water addition ratio, extraction duration, and number of extractions. The weighted coefficients for each parameter were calculated by combining the benchmark correlation and FAHP-CRITIC method, deriving a comprehensive score.ResultsThe optimal extraction process for STP consisted of a two extractions, each using at a tenfold quantity of water, performed for one hour. Process verification across three separate batches yielded a comprehensive score of 94.7, with a relative standard deviation of 0.76%.ConclusionsThe application of the Box-Behnken response surface method combined with standard relation and FAHP-CRITIC approach proved to be stable and feasible for optimising the extraction process of STP.

Research on the Assessment Method of College Students' Financial Difficulty Index in the Context of Big Data Based on AHP Algorithm

The emergence of big data has allowed researchers to study people's financial struggles in greater detail. Among various kinds of difficulties, the financial barriers preventing low-income children from enrolling in higher education have received significant attention. Therefore, this paper uses the AHP algorithm and proposes a college student poverty index assessment method, aiming to provide a reference basis for the normal enrollment of children from low-income families by comprehensively analyzing various factors. This paper first constructs a hierarchical model to decompose the college student poverty problem into multiple influencing factors. Then, the AHP algorithm was utilized to calculate each factor's weights and consistency test, and each factor's relative importance was derived. As a result, each college student's poverty index was calculated using the comprehensive score method. The results show that the assessment method can reflect the degree of economic and social difficulties of college students from low-income families with better accuracy, providing a reliable reference value for promoting them in regular college enrollment. At the same time, the method can also be used in the government's formulation of poverty alleviation policies and the school's educational assistance work.

The impact of left atrial morphology on thrombosis risk in atrial fibrillation

Atrial fibrillation (AF) is an arrhythmia disease that can disrupt the movement of the left atrium (LA), which will facilitate thromboembolism in LA and further exacerbate the stroke risk. The left atrial appendage (LAA) is a vital site for thrombus formation. The morphology of the LAA is believed to have a profound effect on thrombosis. However, due to the limitation of observation and monitoring methods, the mechanism of this effect is still unrevealed. Virchow's triad is a theory of thrombogenic mechanisms, stating that endothelial injury, blood hypercoagulability, and blood stasis are the three main factors involved in thrombus formation. In this study, we conducted personalized simulation analyses for 12 AF patients and discussed simulation results from the perspective of Virchow's triad. The simulation results indicate the effectiveness of Virchow's triad in elucidating the thrombosis mechanism within the LAA. The LAA is more prone to thrombosis than the other region of LA, because of the lower blood flow velocity and significantly higher endothelial cell activation potential values there, which indicates a higher risk of blood stasis and endothelial injury, respectively. Furthermore, a comprehensive score is proposed to assess the performance of Virchow's triad in the LAA. The morphology of LA has a significant influence on the performance of the three factors in Virchow's triad. Hence, for a quickly assessment of LAA thrombosis risk in AF patients through the lens of Virchow's triad, we need a more refined shape scoring system that can better reflect patient-specific morphological features of the entire LA.

Evaluation of daily precipitation modeling performance from different CMIP6 datasets: A case study in the Hanjiang River basin

To effectively compare and analyze daily precipitation modeling capabilities across different CMIP6 datasets, our study introduces a novel method to compare daily precipitation models across CMIP6 datasets in the Hanjiang River Basin (HRB). We quantify indicators such as precipitation distribution, temporal correlation, wet-dry detection, extreme value error, and spatio-temporal variability, enabling a comprehensive rating of precipitation accuracy. It has been found that while both CMIP6(CP6) and NEX-GDDP-CMIP6 (GCP6) models show similar simulation accuracy, GCP6 excels in several aspects like distribution, temporal correlation, extreme value simulation, and spatial variability, yet lags in wet-dry detection and temporal change. Notably, using the comprehensive rating score (CRS) analysis, significant differences in precipitation simulation accuracy exist between models, particularly CP6, with variations of up to 0.22 (51.2%) between the highest and lowest scores. Among the top ten models, GCP6 occupies four positions such as MRI-ESM2-0, GFDL-CM4, MPI-ESM1-2-HR, and TaiESM1, while CP6 holds the remaining six like CanESM5, EC-Earth3-Veg, MPI-ESM1-2-HR, GFDL-CM4, MRI-ESM2-0, and IPSL-CM6A-LR. These findings not only offer a clear understanding of the simulation performance of CMIP6 datasets across various precipitation characteristics, but also quantitatively compare the modeling capabilities of different models for watershed precipitation through CRS. This aids climate adaptation research, hydrological forecasting, and flood management in the basin.

Predicting COVID-19 Cases in Nursing Homes of California and Ohio: Does the Work Environment Matter?

The cross-sectional study evaluates if the pre-pandemic work environments in nursing homes predict COVID-19 cases among residents and staff, accounting for other factors. Leveraging data from a survey of California and Ohio nursing homes (n = 340), we examined if Workplace Integrated Safety and Health domains - Leadership, Participation, and Comprehensive and Collaborative strategies predicted cumulative COVID-19 cases among nursing home residents and staff. In Ohio, a 1-unit increase in Leadership score was associated with 2 fewer staff cases and 4 fewer resident cases. A 1-unit increase in Comprehensive and Collaborative Strategies score in California showed an average marginal effect of approximately 1 less staff case and 2 fewer resident cases. These findings suggest that leadership commitment and inter-department collaboration to prioritize worker safety, may have protected against COVID-19 cases in nursing homes.

Is YouTube a Useful Source of Information on Pressure Injuries? A Content, Reliability, and Quality Analysis.

To evaluate the comprehensiveness, reliability, and quality of YouTube videos related to pressure injuries. The authors searched YouTube for relevant videos using the keywords "pressure injury", "pressure ulcer", "bedsore", "pressure injury etiology", "pressure injury classification", "pressure injury prevention", "pressure injury risk assessment", and "pressure injury management". Of the 1,023 videos screened, 269 met the inclusion criteria and were included in the study. For each video, the authors recorded the number of views, likes, and comments; the length; and the video upload source. The Comprehensiveness Assessment Tool for Pressure Injuries, the Quality Criteria for Consumer Health Information score, and the Global Quality Score were used to evaluate the comprehensiveness, reliability, and quality of the videos. The mean length of the 269 videos was 6.22 ± 4.62 minutes (range, 0.18-19.47 minutes). Only 14.5% of the videos (n = 39) were uploaded by universities or professional organizations. Most videos included information about PI prevention (69.5%), followed by PI management (27.9%). The mean comprehensiveness score was 2.33 ± 1.32 (range, 1-5). Nearly half of the videos (49.1%) were not reliable. However, the quality of 43.9% of the videos was somewhat useful. The Quality Criteria for Consumer Health Information mean scores of universities/professional organizations (P < .001), nonprofit healthcare professionals (P = .015), and independent health information channel videos (P = .026) were higher than the mean score of medical advertising/profit companies channel videos. This study draws attention to the need for more comprehensive, high-quality, and reliable videos about PIs. It is important that videos on YouTube provide comprehensive and reliable information for patients, caregivers, students, or providers seeking information on PI prevention, assessment, and management.

Assessment of Financial Toxicity and Coping Strategies Associated With Cancer Treatment Among Caregivers of Patients With Cancer From a Lower-Middle-Income Country.

The rising cost of cancer treatment causes out-of-pocket spending among patients or caregivers in lower-middle-income countries, resulting in acute misery and insolvency. This study aimed to assess the financial toxicity associated with cancer treatment and the coping strategies for cancer treatment adopted among the caregivers of patients with cancer in a tertiary cancer care center. This prospective cross-sectional study was conducted among the primary caregivers of patients with cancer undergoing curative treatment from March to June 2023. The estimated sample size was 403 caregivers. The financial toxicity was assessed using a modified Comprehensive Score for Financial Toxicity-Functional Assessment of Chronic Illness Therapy tool, and coping strategies were explored using a validated questionnaire of 20 questions. Univariate and multivariate analyses investigated the associations and factors influencing financial toxicity. The caregivers recruited in the study were 403; 83.8% were younger than 50 years, and 66.5% were male. The common cancer types included were breast cancer (27.3%), GI cancer (17.9%), head and neck cancer (12.4%), and gynecological cancer (11.6%). The mean financial toxicity score was 22.32 (standard deviation, 9.55), with 64% experiencing moderate to severe financial toxicity. The most common coping strategies used were spending a portion or all of the savings, borrowing money from others, restructuring their spending habits, seeking financial assistance from the cancer center, and resorting to gold loans. Screening patients and their primary caregivers using a modified COST tool can help identify families experiencing severe financial toxicity and provide necessary intervention.

Financial Toxicity Among Patients With Metastatic Prostate Cancer: A Mixed Methods Approach to Identify Effective Interventions.

Financial toxicity associated with treatments for metastatic prostate cancer remains poorly defined. We sought to understand aspects of financial toxicity not captured in a commonly employed financial toxicity questionnaire and identify potential interventions to help alleviate financial toxicity through a convergent mixed methods approach. Patients seen at our institution's advanced prostate cancer clinic were approached for completion of the Comprehensive Score for Financial Toxicity (COST-FACIT) questionnaire (quantitative analysis). A maximal variation purposive sample was chosen to participate in focus group discussions (qualitative analysis). Conventional content analysis was performed using an inductive approach. COST-FACIT scores were compared between patients experiencing high and low financial toxicity using Wilcoxon rank sum test. Three themes were identified through qualitative analysis: (1) workload, (2) coping strategies, and (3) communication. We found alignment with the existing theory of financial capacity across our findings. Two unique aspects of financial toxicity emerged that were not assessed quantitatively and deemed to be significant. Specifically, cost transparency (including health care teams knowledgeable about and willing to discuss costs) and inclusion of informal caregivers in financial toxicity screening and decision-making may guide future interventions aimed at limiting financial toxicity in this population. Prolonged treatment courses involving multiple lines of treatment with varying costs result in distinct financial toxicity components for patients with metastatic prostate cancer that are not assessed with COST-FACIT. Improving cost transparency, health care team knowledge and engagement, and providing resources to support informal caregivers may have a significant impact on the financial toxicity experienced by these patients.

Specificity of the short-story task for autism diagnosis when controlling for depression.

Securing an accurate autism-spectrum-condition diagnosis, particularly among women, remains challenging for autistic adults. Building upon previous research highlighting the short-story task (SST) as a promising tool for detecting fiction-based mentalizing difficulties in autistic adults, this study expands its scope. We investigated the SST's discriminative capacity across three distinct groups: autistic individuals (n = 32), nonautistic individuals without mental health problems (n = 32), and nonautistic individuals with clinical depression (n = 30). All three groups differed significantly from each other in their SST mentalizing score with the nonautistic group having the highest scores, the nonautistic but depressed group having medium scores and the autistic group showing the lowest scores. Receiver operator curve (ROC) analysis reaffirmed the SST's efficacy as a discriminator. Moreover, a linear regression analysis identified the SST mentalizing score, the SST comprehension score, and the number of books read per month as significant predictors of autism-spectrum-condition diagnosis. These findings bolster the SST's potential as a valuable adjunct in autism diagnostics, highlighting its discriminatory ability across diverse samples.

Prevalence of financial hardship and health-related social needs among patients with missed radiology appointments

PurposeWe aimed to evaluate the prevalence of financial hardship and Health-Related Social Needs (HRSN) among patients who missed their radiology appointment. MethodsEnglish-speaking adult patients, with a missed outpatient imaging appointment at any of a tertiary care imaging centers between 11/2022 and 05/2023 were eligible. We measured self-reported general financial worry using Comprehensive Score for Financial Toxicity (COST), imaging hardship (worry that the current imaging is a financial hardship to patient and their family), material hardship (e.g., medical debt), cost-related care nonadherence, and HRSNs including housing instability, food insecurity, transportation problems, and utility help needs. Results282 patients were included (mean age 54.7 ± 15.0 years; 70.7 % female). Majority were non-Hispanic White (52.4 %), followed by Asian (23.0 %) and Hispanic (16.0 %) racial/ethnic background. Most missed appointments were patient-initiated (74.8 %); 13.5 % due to cost or insurance coverage and 6.4 % due to transportation and parking. Mean COST score was 26.8 with 44.4 % and 28.8 % reporting their illness and imaging as a source of financial hardship. 18.3 % and 35.2 % endorsed cost-related care nonadherence and material hardship. 32.7 % had at least one HRSNs with food insecurity the most common (25.4 %). Only 12.5 % were previously screened for financial hardship or HRSNs. Having comorbidity and living in more disadvantaged neighborhoods was associated with higher report of financial hardship and HRSNs. ConclusionFinancial hardship and HRSNs are common among those who miss radiology appointments. There needs to be more rigorous screening for financial hardship and HRSNs at every health encounter and interventions should be implemented to address these.

Value analysis of ITLN1 in the diagnostic and prognostic assessment of colorectal cancer.

Colorectal cancer (CRC) remains the leading cause of cancer death worldwide. Less than half of the patients are diagnosed when the cancer is locally advanced. Several studies have shown that intelectin-1 (ITLN1) can serve as a key prognostic and therapeutic target for CRC. The purpose of this study was to investigate the clinical value of ITLN1 in CRC and to analyse its potential as a predictive biomarker for CRC. Colon adenocarcinoma (COAD) is the main type of CRC. COAD project in The Cancer Genome Atlas (TCGA) database served as the training cohort, and GSE39582 series in the Gene Expression Omnibus (GEO) database served as the external independent validation cohort. First, the difference in the expression level of ITLN1 between COAD tissue and normal tissue was analysed, and the results were verified via immunohistochemistry. The relationship between ITLN1 expression and the prognosis of COAD patients was evaluated via the heatmap and the Kaplan-Meier (KM) curve. The ITLN1 coexpressed gene set obtained by Pearson correlation analysis was used. The prognostic signatures that were significantly correlated with survival status were screened by Cox and least absolute shrinkage and selection operator (LASSO) regression analyses. Finally, a nomogram related to ITLN1 was constructed based on the risk score of the prognostic signature and routine clinicopathological variables. ITLN1 is significantly underexpressed in tumour tissues and can be used as a valuable tool to distinguish COAD. The high-expression group of ITLN1 was verified to have a greater survival rate. ITLN1 is significantly associated with a good prognosis in COAD patients. Six candidate genes (ITLN1 and MORC2, SH2D7, LGALS4, ATOH1, and NAT2) were selected for use in the Cox-LASSO regression analysis to calculate the risk score. Finally, a nomogram was constructed with a comprehensive risk score and clinicopathologic factors to successfully predict and verify the 1-year, 3-year, and 5-year survival probability. Our study established ITLN1 as an effective tool for CRC screening, diagnosis, and prognostic assessment, provided a basis for further study of the molecular function of ITLN1, and provided new insights for the mechanistic exploration and treatment of CRC.

Detection of earnings manipulations during the corporate life cycle in Central European countries

Research background: The growing trend of financial distress risk worldwide increases the need for effective tools to detect accounting manipulation by stakeholders (debt holders, shareholders, suppliers, and customers). However, the well-known models of accrual earnings management do not reflect the financial specificity of individual life cycle stages and their cash flow patterns. Purpose of the article: The study examines the impact of the corporate life cycle on the reliability of accrual earnings management models and identifies appropriate models for detecting accounting manipulation in Central European countries. Methods: Seven accrual earnings management models were used. They were evaluated based on five criteria: explanatory power (adjusted coefficient of determination), overall significance of the regression model, significance of the regression coefficients, predicted sign of the regression coefficients, and standard errors of the estimated regression coefficients. Finally, a comprehensive scoring model was used to determine the overall quality of the models examined. The study was conducted on a sample of more than 30,000 enterprises from four Central European countries (the Czech Republic, Hungary, Poland, and Slovakia), with data covering the period 2017–2021. The Dickinson non-sequential life cycle model was used to distinguish life cycle stages according to cash flow patterns. Findings &amp; value added: The results of the study suggest that, firstly, discretionary accruals vary across countries as well as over the firm's life cycle; earnings manipulations have an inverted U-shape with mature firms tending to reduce their accounting profit. The reliability of the models examined was poor in the case of start-ups. This reflects the need to distinguish between life cycle stages in the detection of earnings manipulation.