Standard Deviation Increase Research Articles

Effects of the CALM intervention on cancer-related fatigue and heart rate variability in NSCLC: a randomized trial.

To evaluate the effects of CALM intervention on cancer-related fatigue (CRF), quality of life (QOL), and heart rate variability (HRV) in non-small cell lung cancer (NSCLC) patients. A total of 153 NSCLC patients were enrolled in the study. Participants were randomly assigned to the CALM group and usual care (UC) group. Patients in the CALM group were received 6 CALM intervention sessions over a 12-week period and evaluated using CRF, QOL and HRV at baseline (T0) and after 2, 4, and 6 intervention sessions. The CALM group showed significant differences in total CRF, behavioral/daily life CRF, emotional/affective CRF, sensory/physical CRF, cognitive CRF and QOL before and after CALM intervention sessions (F = 643.47, F = 208.34, F = 354.52, F = 285.69, F = 334.29, F = 245.77, p < 0.001). The CALM group showed significant increases in standard deviation of normal R-R interval (SDNN) and high-frequency power (HF) (z = -4.94, p < 0.001,z = -4.30, p < 0.001). Significant negative correlations were observed between CRF and SDNN, HF and QOL across all participants. The CALM intervention had a positive impact on overall physical and mental health, fatigue reduction, quality of life and autonomic dysfunction in NSCLC patients. Heart rate variability may serve as an observational indicator of physical and mental health.

The L-Arginine pathway may act as a mediator in the association between impaired one- carbon metabolism and hypertension.

Elevated fasting plasma total homocysteine (tHcy) and the methylenetetrahydrofolate reductase C677T polymorphism (rs1801133) have been associated with hypertension. Whether the L-Arginine pathway is involved, is unclear. We aimed to investigate whether the association between tHcy, the rs1801133 polymorphism and hypertension involves the L-Arginine pathway. THcy, plasma folate and cobalamin, erythrocyte glutathionine reductase activation coefficient, rs1801133 genotype, plasma L-Arginine, asymmetric dimethylarginine (ADMA) and symmetric dimethylarginine (SDMA) were determined in a cross-sectional study of 788 adults (aged 18 to 75), randomly selected from 2 town population registers. Participants participated in a medical checkup and provided a fasting blood sample. Associations between tHcy, rs1801133 genotype and L-Arginine pathway metabolites were assessed by multiple linear regression analysis and whether the tHcy and rs1801133 genotype are associated with hypertension via the L-Arginine pathway was investigated using mediation analysis. tHcy was positively associated with ADMA (B=0.003; SE=0.001; P<0.001) and SDMA (B=0.007; SE=0.002; P<0.001) and negatively associated with the L-Arginine/ADMA (B=-1.140; SE=0.451; P<0.05) and ADMA/SDMA (B=-0.006; SE=0.003; P<0.05) ratios. The MTHFR 677 CT vs CC genotype was negatively associated with ADMA (B=-0.013; SE=0.007; P<0.05) and with SDMA (B=-0.029; SE=0.013; P<0.05) in participants under 50 years. Each standard deviation increase (37.6) in the L-Arginine/ADMA ratio was associated with reduced hypertension risk (OR [95%CI], 0.6 [0.5, 0.8]). Mediation analysis showed that tHcy and ADMA were mediators in the association between the rs1801133 TT vs CC genotypes and hypertension. Our results support the L-Arginine pathway as a mediator in the association of impaired One-Carbon metabolism and hypertension.

Association between sagittal abdominal diameter-to-height ratio and all-cause mortality among adults in the United States: a longitudinal study.

The global health crisis of obesity has prompted a need for better indicators of abdominal obesity than body mass index, with sagittal abdominal diameter emerging as a potential candidate. Nonetheless, the association between sagittal abdominal diameter-to-height ratio (SADHtR) and mortality remains inadequately established. Our objective was to contribute novel evidence to this association. This study encompassed 12,572 participants aged 18-80 years from the National Health and Nutrition Examination Survey 2011-2016. Mortality data were tracked until December 31, 2019. Weighted multivariable Cox proportional hazard models were employed to evaluate the association between SADHtR and all-cause mortality, with subgroup analyses conducted for result robustness. Following a median follow-up period of 69 months, each standard deviation (SD) increase in SADHtR was consistently associated with a higher risk of all-cause mortality across three models, yielding a hazard ratio (HR) and 95% confidence interval (CI) of 1.51(1.29,1.76) in model 3. Additionally, compared to the first tertile of SADHtR, the third tertile exhibited a higher risk for all-cause mortality, with HRs(95%CIs) of 1.58(1.25,2.01) in model 1, 2.01(1.33,3.02) in model 2, and 1.74(1.19,2.57) in model 3. Notably, subgroup analysis revealed persistent positive associations between SADHtR and all-cause mortality among subgroups based on age-at-risk (< 65, ≥ 65 years), sex, diabetes, hypertension, and hyperlipidemia. Elevated SADHtR was consistently associated with a higher risk of all-cause mortality in American adults. Regular SADHtR measurement should be considered to be integrated into clinical practice and healthcare examinations.

Developing and validating a comprehensive polygenic risk score to enhance keratoconus risk prediction.

This study aimed to develop and validate a comprehensive polygenic risk score (PRS) for keratoconus, enhancing the predictive accuracy for identifying individuals at increased risk, which is crucial for preventing keratoconus-associated visual impairment such as post-Laser-assisted in situ keratomileusis (LASIK) ectasia. We applied a multi-trait analysis approach (MTAG) to genome-wide association study data on keratoconus and quantitative keratoconus-related traits and used this to construct PRS models for keratoconus risk using several PRS methodologies. We evaluated the predictive performance of the PRSs in two biobanks: Estonian Biobank (EstBB; 375 keratoconus cases and 17 902 controls) and UK Biobank (UKB: 34 keratoconus cases and 1000 controls). Scores were compared using the area under the curve (AUC) and odds ratios (ORs) for various PRS models. The PRS models demonstrated significant predictive capabilities in EstBB, with the SBayesRC model achieving the highest OR of 2.28 per standard deviation increase in PRS, with a model containing age, sex and PRS showing good predictive accuracy (AUC = 0.72). In UKB, we found that adding the best-performing PRS to a model containing corneal measurements increased the AUC from 0.84 to 0.88 (P = 0.012 for difference), with an OR of 4.26 per standard deviation increase in the PRS. These models showed improved predictive capability compared to previous keratoconus PRS. The PRS models enhanced prediction of keratoconus risk, even with corneal measurements, showing potential for clinical use to identify individuals at high risk of keratoconus, and potentially help reduce the risk of post-LASIK ectasia.

Abstract 4138335: A drug target Mendelian randomization study of triglyceride lowering therapies for aortic stenosis

Introduction: Large observational and Mendelian randomization (MR) studies have demonstrated a strong association between elevated triglycerides (TG) and risk of aortic stenosis (AS). However, at present there remains no evidence for the use of lipid-lowering therapies to prevent or treat AS. To address this gap, we used a drug target MR approach to investigate whether emerging TG lowering therapies may reduce the risk of AS. Methods: We collected summary statistics for TG levels and AS from genome-wide association studies including 1,253,277 and 653,867 European participants, respectively. We first performed conventional MR techniques to investigate a causal relationship between TG levels and AS risk. Next, we identified genetic proxies for the TG-lowering therapies fenofibrate, volanesorsen and evinacumab as single nucleotide polymorphisms (SNPs) within 200kb of the target genes ( PPARA, APOC3 and ANGPTL3 , respectively) which were also significantly associated with TG at p&lt;5x10 -8 and clumped using threshold r 2 &lt;0.1. Inverse-variance weighted (IVW) was the primary analysis method. We then performed sensitivity analyses including weighted-median and MR-Egger. Additional outlier-exclusion analyses were performed using MR-PRESSO and Cook’s distance. Finally, we completed sensitivity analyses using a more stringent clumping threshold of r 2 &lt;0.01. Results: Consistent with previous findings we found genetically predicted TG levels were significantly associated with increased risk of AS (IVW: OR 1.28 per standard deviation increase in genetically predicted log TG level, 95% CI 1.18-1.39, p&lt;0.0001). We further found that genetically proxied volanesorsen was significantly associated with reduced risk of AS (OR 0.54, 95% CI 0.39-0.75, p=0.0002), which was robust in all sensitivity analyses. We did not find evidence of a causal relationship between genetically proxied fenofibrate (IVW: OR 0.50, 95% CI 0.09-2.76, p=0.43) or evinacumab (IVW: OR 1.03, 95% CI 0.73-1.44, p=0.88) and risk of AS. Conclusions: Genetically proxied APOC3 inhibition, but not PPARA or ANGPTL3 , was robustly associated with reduced risk of AS. This suggests that APOC3 inhibition may be a therapeutic opportunity for AS management and warrants further research in the clinical trial setting.

Abstract 4136930: Plasminogen Activator Urokinase Receptor (PLAUR) Levels are a Predictor of Adverse Cardiovascular Outcomes in the General Population, Independent of High-Sensitive CRP (hs-CRP)

Background: The gene Plasminogen Activator Urokinase Receptor (PLAUR) encodes the urokinase plasminogen activator surface receptor (uPAR), which upon cleavage releases Soluble Urokinase Plasminogen Activator Receptor (suPAR). SuPAR has emerged as a novel biomarker of inflammation and immunity and is associated with adverse cardiovascular events, particularly coronary artery disease (CAD), regardless of hs-CRP levels, a well-established inflammatory biomarker. However, whether the PLAUR gene predicts adverse cardiovascular events remains uncertain. Methods: We investigated the relationship between PLAUR levels, measured via Olink Immunoassay, in 40,790 individuals from the UK Biobank, and the occurrence of adverse cardiovascular events such as myocardial infarction (MI), as well as all-cause and cardiovascular mortality. Our analysis involved the use of Cox and Fine and Gray proportional hazards models, adjusting for age, sex, race, HDL, LDL, triglyceride levels, BMI, prevalence of hypertension (HTN), prevalence of type 2 diabetes (T2D), smoking history, and use of blood pressure and cholesterol medications. Main Outcomes: The primary outcome was a composite outcome of cardiovascular mortality and MI and the secondary outcome was all-cause mortality. Results: The mean (SD) age was 58 (8) years, 45% men and 94% white. During a median follow-up of 14 (interquartile range 12.3 – 15) years, 7.9% of the population had an MI, 2.7% suffered cardiovascular death, 9.5% all-cause mortality. After adjusting for aforementioned demographic and clinical factors, as well as medication usage, each standard deviation increase in PLAUR levels was associated with a heightened risk of incident non-fatal MI and cardiovascular (CV) death, with a hazard ratio (HR) of 2.31 (95% CI 2.00-2.45), and all-cause mortality, with an HR of 3.81 (95% CI 3.48-4.18). Even after further adjustment for hs-CRP levels, PLAUR levels remained predictive of non-fatal MI and CV death (HR 2.03, 95% CI 1.83-2.26) and all-cause mortality (HR 3.43, 95% CI 3.12-3.77). Furthermore, in a fully adjusted Cox regression model, a significant interaction between PLAUR levels and sex (p = 0.0003) was observed in predicting the primary outcome. The interaction was found to have a stronger predictive value in females compared to males. Conclusion: PLAUR levels are a strong predictor of adverse cardiovascular outcomes in the general population, independent of traditional risk factors and inflammation.

Atlantic Trade and Conflict in Europe

Abstract We use over 200 years of conflict and wheat price data to provide the first quantitative evidence that Atlantic trade reduced conflict in Europe. While other determinants of intra-European conflict during the Early to Late Modern period have been proposed, the role of Atlantic trade has not been previously explored due to a lack of historical trade data. We overcome this constraint by using wheat prices to calculate time-varying measures of price pass-through between Europe and the New World, which we use as a proxy for Atlantic trade. To identify the causal effects of Atlantic trade, we exploit exogenous changes in wind patterns and tropical cyclone activity over the Atlantic Ocean to instrument trade. Our results suggest that a one standard deviation increase in Atlantic trade resulted in a 0.157 standard deviation decrease in intra-European conflict onset. We also find empirical support for Atlantic trade increasing real wages and reducing military sizes in Europe, which is consistent with the idea that the possibility of forgone Atlantic trade acted as a deterrent to conflict.

Is Greener Better? Quantifying the Impact of a Nature Walk on Stress Reduction Using HRV and Saliva Cortisol Biomarkers

The physiological impact of walking in nature was quantified via continuous heart rate variability (HRV), pre- and post-walk saliva cortisol measures, and self-reported mood and mindfulness scores for N = 17 participants who walked “The Green Road” at Walter Reed National Military Medical Center in Bethesda, Maryland. For N = 15 of the participants, HRV analysis revealed two main groups: group one individuals had a 104% increase (mean) in the root mean square standard deviation (RMSSD) and a 47% increase (mean) in the standard deviation of NN values (SDNN), indicating an overall reduction in physiological stress from walking the Green Road, and group two individuals had a decrease (mean) of 42% and 31% in these respective HRV metrics, signaling an increase in physiological stresses. Post-walk self-reported scores for vigor and mood disturbance were more robust for the Green Road than for a comparable urban road corridor and showed that a higher HRV during the walk was associated with improved overall mood. Saliva cortisol was lower after taking a walk for all participants, and it showed that walking the Green Road elicited a significantly larger reduction in cortisol of 53%, on average, when compared with 37% of walking along an urban road. It was also observed that the order in which individuals walked the Green Road and urban road also impacted their cortisol responses, with those walking the urban road before the Green Road showing a substantial reduction in cortisol, suggesting a possible attenuation effect of walking the Green Road first. These findings provide quantitative data demonstrating the stress-reducing effects of being in nature, thus supporting the health benefit value of providing access to nature more broadly in many settings.

Validation of a prognostic blood-based sphingolipid panel for men with localized prostate cancer followed on active surveillance

BackgroundWe previously reported that increases in circulating sphingolipids are associated with elevated risk of biopsy Gleason grade group (GG) upgrading in men on Active Surveillance (AS) for prostate cancer. Here, we aimed to validate these findings and establish a blood-based sphingolipid biomarker panel for identifying men on AS who are at high-risk of biopsy GG upgrading.MethodsMen diagnosed with low- or intermediate-risk prostate cancer in one of two AS cohorts (CANARY PASS and MDACC) were followed for GG upgrading after diagnostic and confirmatory biopsy. The PASS cohort consisted of 544 patients whereas the MDACC Cohort consisted of 697 patients. The number of patients with GG upgrading during course of study follow-up in the PASS and MDACC cohorts were 98 (17.7%) and 133 (19.1%), respectively. Plasmas collected prior to confirmatory biopsy were used for mass spectrometry-based quantitation of 87 unique sphingolipid species. A neural network layer based on 21 sphingolipids was developed in the CANARY PASS cohort for predicting biopsy GG upgrading. Tertile-based thresholds for low-, intermediate-, and high-risk strata were subsequently developed for the sphingolipid panel as well as a model that combined the sphingolipid panel with PSA density and rate of core positivity on diagnostic biopsy. The resultant models and risk thresholds for GG upgrading were validated in the MDACC cohort. Performance was assessed using Cox proportional hazard models, C-index, AUC, and cumulative incidence curves.ResultsThe sphingolipid panel had a HR (per unit standard deviation increase) of 1.36 (95% CI: 1.07–1.70) and 1.35 (95% CI: 1.11–1.64) for predicting GG biopsy upgrading in the PASS and MDACC cohort, respectively. The model that combined the sphingolipid panel with PSA density and rate of core positivity achieved a HR of 1.63 (95% CI: 1.33-2.00) and 1.44 (1.25–1.66), respectively. Tertile-based thresholds, established in the PASS cohort, were applied to the independent MDACC cohort. Compared to the low-risk group, MDACC patients in the high-risk strata had a GG biopsy upgrade HR of 3.65 (95% CI: 2.21–6.02), capturing 50% of the patients that had biopsy upgrading during study follow-up.ConclusionsThe sphingolipid panel is independently associated with GG biopsy upgrading among men in two independent AS cohorts who have previously undergone diagnostic and confirmatory biopsy. The sphingolipid panel, together with clinical factors, provides a potential means for risk stratification to better guide clinical management of men on AS.

Investigating potential drug targets for IgA nephropathy and membranous nephropathy through multi-queue plasma protein analysis: a Mendelian randomization study based on SMR and co-localization analysis

BackgroundMembranous nephropathy (MN) and IgA nephropathy (IgAN) pose challenges in clinical treatment with existing therapies primarily focusing on symptom relief and often yielding unsatisfactory outcomes. The search for novel drug targets remains crucial to address the shortcomings in managing both kidney diseases.MethodsUtilizing GWAS data for MN (ncase = 2150, ncontrol = 5829) and IgAN (ncase = 15587, ncontrol = 462197), instrumental variables for plasma proteins were derived from recent GWAS. Sensitivity analysis involved bidirectional Mendelian randomization analysis, MR Steiger, Bayesian co-localization, and Phenotype scanning. The SMR analysis using eQTL data from the eQTLGen Consortium was conducted to assess the availability of selected protein targets. The PPI network was constructed to reveal potential associations with existing drug treatment targets.ResultsThe study, subjected to the stringent Bonferroni correction, revealed significant associations: four proteins with MN and three proteins with IgAN. In plasma protein cis-pQTL data from two cohorts, an increase in one standard deviation in PLA2R1 (OR = 2.01, 95%CI = 1.83–2.21), AIF1 (OR = 9.04, 95%CI = 4.69–17.41), MLN (OR = 3.79, 95%CI = 2.12–6.78), and NFKB1 (OR = 29.43, 95%CI = 7.73–112.0) was associated with an increased risk of MN. Additionally, in plasma protein cis-pQTL data, a standard deviation increase in FCGR3B (OR = 1.15, 95%CI = 1.09–1.22) and BTN3A1 (OR = 4.05, 95%CI = 2.65–6.19) correlated with elevated IgAN risk, while AIF1 (OR = 0.58, 95%CI = 0.46–0.73) exhibited IgAN protection. Bayesian co-localization indicated that PLA2R1 (coloc.abf-PPH4 = 0.695), NFKB1 (coloc.abf-PPH4 = 0.949), FCGR3B (coloc.abf-PPH4 = 0.909), and BTN3A1 (coloc.abf-PPH4 = 0.685) share the same variants associated with MN and IgAN. The SMR analysis indicated a causal link between NFKB1 and BTN3A1 plasma protein eQTL in both conditions, and BTN3A1 was validated externally.ConclusionGenetically influenced plasma levels of PLA2R1 and NFKB1 impact MN risk, while FCGR3B and BTN3A1 levels are causally linked to IgAN risk, suggesting potential drug targets for further clinical exploration, notably BTN3A1 for IgAN.

Reduced rank regression dietary patterns and dyslipidemia in Brazilian adolescents: results from the Study of Cardiovascular Risk in Adolescents (ERICA).

Evidence on the harmful effects of diet on serum lipids in adolescence has not been consistent. The present study sought to establish which dietary patterns are associated with biomarkers of dyslipidemia. Data from 36,217 Brazilian adolescents participating in the Study of Cardiovascular Risk in Adolescents were evaluated. Dietary patterns were identified using the reduced rank regression analysis. Linear regression models were applied to verify the association between dietary pattern scores and the biomarkers of dyslipidemia. The two first dietary patterns identified by reduced rank regression (RRR-DP1 and RRR-DP2) were kept for further analysis. The RRR-DP1 was highly and positively loaded for sweets and red meat and negatively loaded for beans, fruits, vegetables, and rice. The RRR-DP2 was positively loaded for beans and rice and negatively loaded for sugar-sweetened beverages, fruit juices, and sweets. Linear regression models estimated that one standard deviation (SD) increase in the RRR-DP1 score was only associated with a mean increase of 0.29 mg/dL in HDL-cholesterol (95% CI 0.06;0.53), while one SD increase in the RRR-DP2 score was associated with the lower mean of triglycerides (β = -2.24, 95% CI -3.57;-0.91), LDL-c (β = -0.82 95% CI -1.53;-0.12), and total cholesterol (β = -1.30 95% CI -1.94;-0.65). Higher adherence to the dietary patterns positively loaded for red meat and sweets was associated with increased HDL-c levels, while adherence to a more Brazilian traditional dietary pattern (RRR-DP2) was associated with a better lipids profile.

PROSPECTIVE ASSOCIATIONS OF PHYSICAL ACTIVITY AND SEDENTARY TIME IN ADOLESCENCE WITH CARDIOMETABOLIC RISK IN YOUNG ADULTHOOD.

Purpose: The relationship between sedentary time, physical activity, and cardiometabolic risk factors during the transition from adolescence to adulthood remain uncertain. We examined the prospective associations of sedentary time and physical activity at age 15 with cardiometabolic risk markers at age 24.Methods: We used data from the Physical Activity among Norwegian Children Studies (PANCS). Sedentary time, moderate-to-vigorous physical activity (MVPA), and vigorous physical activity (VPA) were measured by accelerometry. Outcomes included body mass index (BMI), waist circumference, visceral fat, maximal oxygen uptake (VO2max), systolic blood pressure, LDL-cholesterol, insulin, high-sensitivity CRP, and a clustered risk Z-score. The prospective associations were modelled through regression.Results: A total of 731 boys and girls participated at age 9 (2005-2006) and 15 (2011-2012), and 258 of these participated again at age 24 (2019-2021). Multiple imputation was performed for all eligible individuals (n = 708). Each standard deviation increase (min/day) in sedentary time at age 15 was associated with lower VO2max at age 24 (β: -1.6 ml/kg/min; 95%CI: -2.8, -0.5). Each standard deviation increase (min/d) in MVPA (β: 1.6 ml/kg/min; 95%CI: 0.8, 2.4) and VPA (β: 1.6 ml/kg/min; 95%CI: 0.8, 2.4) at age 15 were associated with higher VO2max at age 24. VPA in adolescence was further inversely associated with visceral fat mass (β: -41 g; 95%CI: -78, -3), insulin level (β: -4.3 pmol/L; 95%CI: -8.2, -0.4), and the clustered risk Z-score (β: -0.09; 95%CI: -0.18, -0.01) in young adulthood. Childhood BMI modified the association of both MVPA and VPA with clustered risk, with the greatest magnitude of association observed in the highest BMI tertile.Conclusions: Physical activity, especially of vigorous intensity, during adolescence appear to beneficially affect cardiometabolic health in young adulthood. These health benefits may be most pronounced among overweight/obese youth.

The value of D-dimer in the prognosis of dilated cardiomyopathy: a retrospective cohort study.

D-dimer is a biomarker of coagulation and fibrinolytic system activation in response to the hypercoagulable state of the body. The research aimed to analyze the value of D-dimer in the prognosis of patients with dilated cardiomyopathy (DCM). Patients admitted to our center for the first time with DCM were enrolled consecutively. The clinical characteristics variables were obtained from the electronic medical record system, and the prognostic information was obtained using telephone return visits and a review of repeated hospitalization records. Univariate and multivariate Cox regression was used to explore the association of D-dimer with all-cause mortality. Smooth curve fitting, threshold saturation effect analysis, and subgroup analysis were performed. Ultimately, 534 patients were included. After a follow-up of the enrolled patients, 485 patients obtained prognostic information, of which 159 died from all causes, and the main cause of death was heart failure (89/159), the sudden death accounted for about 17%. The independent positive association between D-dimer and all-cause mortality remained unchanged in both unadjusted and adjusted Cox regression models. In the fully adjusted model, each standard deviation increase in D-dimer was associated with a 14% increase in all-cause mortality (HR = 1.14; 95% CI: 1.02 ~ 1.27; P < 0.05). Curve fitting and threshold effect analysis showed an inflection point in the relationship between D-dimer and all-cause mortality (non-linear test: P = 0.03). When D-dimer was equal to 362ng/ml, HR = 1; and as the value increased, the risk of all-cause mortality increased by 34.7% for every 2-fold increase in D-dimer gradually (HR = 1.347; 95% CI: 1.069 ~ 1.697; P = 0.012). In subgroup analysis, D-dimer and BMI had a significant interaction on all-cause mortality, with a significantly increased risk of all-cause mortality in subjects with BMI ≥ 25kg/m2 (HR = 1.99; 95% CI: 1.34 ~ 2.97; P < 0.01). The ROC curve showed that D-dimer was a good predictor of all-cause mortality, and the areas under the curve at 1-, 3-, and 5-year were 0.71, 0.64, and 0.59, respectively. In addition, D-dimer improved the predictive performance of the MAGGIC heart failure score in patients with DCM. D-dimer is not only independently associated with all-cause mortality in DCM patients, but also has good predictive value, suggesting that D-dimer may be an early and useful marker for improving the management of DCM patients.

Unveiling the nonlinear drivers of urban land resources on carbon emissions: The mediating role of industrial upgrading and technological innovation

As cities continue to develop, land resources play a pivotal role in the pursuit of sustainable urban development. However, the impact and mechanisms of land resources on reducing emissions remain unclear. Therefore, our study employs an ensemble learning model within a Monte Carlo Simulation framework to explore the nonlinear relationship between land resources and carbon emissions. Additionally, we utilize a fixed effects model to identify the mechanisms of impact. Specifically, industrial and residential land uses are identified as primary drivers of carbon emissions, contributing 17.04 % and 4.75 % of the total variance in emissions, respectively. In contrast, a standard deviation increase in land price leads to a reduction of 4.65 tons in per capita carbon emissions. In addition, industrial upgrading and innovation emerge as critical mediators in promoting carbon reduction. This research contributes to sustainable urban planning and policy-making, offering insights into how strategic land use planning reduces urban carbon footprints.

Serum triglyceride to high density lipoprotein cholesterol ratio in late pregnancy as a potential predictor of adverse birth outcomes: an analysis of real-world data

BackgroundThe association between serum triglyceride to high density lipoprotein cholesterol ratio (THR) in late pregnancy and adverse birth outcomes (ABO) remains controversial because of inconsistent results. The present study assessed the association between maternal serum THR and incidence of ABO [preterm birth (PTB), small and large for gestational age (SGA/LGA), low birth weight (LBW) and macrosomia] in a Chinese population.MethodsA total of 11,553 consecutive participants from a real-world database with data on lipid profiles and birth outcomes were included. Logistic regression models were applied to assess the association between THR and incident ABO. Mediation analysis was performed to investigate the contribution of pregnancy complications [gestational diabetes mellitus (GDM), intrahepatic cholestasis of pregnancy (ICP) and pre-eclampsia (PE)] to this association.ResultsApproximately 6.6% (762/11,553), 8.9% (1023/11,553), 15.5% (1792/11,553), 4.3% (494/11,553), and 7.4% (851/11,553) of individuals developed PTB, SGA, LGA, LBW and macrosomia, respectively. Significant trends across the quintiles of THR toward decreasing incidence of SGA and LBW and increasing incidence of LGA and macrosomia were observed. The multivariate-adjusted odds ratios (OR) in the top quintile of serum THR (> 3.16) versus the bottom quintile (< 1.44) were 0.52 for PTB, 0.48 for SGA, 0.64 for LBW, 2.80 for LGA and 3.80 for macrosomia, respectively. A 1-standard deviation (SD) increase in serum THR was associated with decreased risk of PTB [OR = 0.84, 95% confidence interval (CI): 0.76–0.93), SGA (OR = 0.71, 95% CI:0.65–0.78) and LBW (OR = 0.76, 95% CI:0.65–0.90) and increased risk of LGA (OR = 1.40, 95% CI:1.32–1.49) and macrosomia (OR = 1.49, 95% CI:1.38–1.62). In mediation analyses, PE mediated − 19.8%, -10.6% and − 24.6% of THR-associated PTB, SGA and LBW, respectively, GDM accounted for − 3.7%, 6.8% and 4.3% of THR-associated PTB, LGA and macrosomia, respectively, and ICP explained − 1.9% and − 2.1% of THR-associated PTB and LBW, respectively. In addition, incorporating THR to ABO predictive models significantly improved the area under the curve for SGA (0.743 vs. 0.753, P < 0.001), LGA (0.734 vs. 0.745, P < 0.001) and macrosomia (0.786 vs. 0.800, P < 0.001).ConclusionReal-world data showed an association between serum THR in late pregnancy and ABO risk, and this association may be partially mediated by prevalent pregnancy complications (PE/GDM/ICP), suggesting a potential role of THR in predicting ABO (SGA/LGA/macrosomia).

The effects of government policy on performance planning for implementation of performance contracting in the government ministries in Kenya

The study sought to analyse the effects of government policy on performance planning for the implementation of performance contracting in government ministries in Kenya. A mixed-method type of design was adopted. Stratified sampling was used to sample four government ministries. In sampling staff to be interviewed, top and middle-level management totalling 831 were identified. Thirty per cent of the 831 (249 staff members) were considered to be representative enough for the study. The study adopted descriptive and inferential statistics. The study used ANOVA, regression analysis, and correlation to analyse the relationship between variables. The study finding observed that there was a strong correlation coefficient of 0.866 at p-value of 0.035 between government policy and performance planning, which implied that employees' performance planning is significant in the implementation of performance contracting; a unit standard deviation increase in effective training and development was likely to increase the standard deviation of performance monitoring by 0.096 on implementation of performance contracting; a unit standard deviation increase in top management commitment was likely to increase the standard deviation of performance reporting on performance implementation by 0.337. The study concludes that government policies have an effect on performance contracting in government ministries in Kenya. Further, the conclusion was that government policy has minimally addressed issues of training and development. Therefore, it is recommended that transfer of training be included in the next reviews of the government policy and specifically addressed in the workplace that often affect the impact of training and development.

Artificial Intelligence and the Development of “Specialized, Refined, Unique, and Innovative” Small‐ and Medium‐Sized Enterprises

ABSTRACT“Specialized, Refined, Unique, and Innovative” (SRUI) enterprises are a crucial part of the national innovation system and play a significant role in enhancing national core competitiveness by leveraging strengths and addressing weaknesses. Given the limited quantitative analysis on the productivity of SRUI enterprises in the academic field, this paper constructs an enterprise‐level artificial intelligence index based on text analysis and machine learning. Using panel data from 2018 to 2022, we investigate the impact of artificial intelligence on the productivity of SRUI small‐ and medium‐sized enterprises (SMEs). The research findings indicate that (1) artificial intelligence significantly enhances the productivity of SRUI SMEs, and for each one standard deviation increase in artificial intelligence, the productivity level of SRUI enterprises will increase by 6.82%. (2) Mechanism tests reveal that artificial intelligence improves productivity by optimizing labor structure, improving labor resource allocation, stimulating endogenous motivation and innovation vitality within enterprises, and enhancing management level and investment efficiency. (3) Heterogeneity analysis indicates that at the regional level, artificial intelligence significantly boosts the productivity of enterprises with well‐developed network infrastructure and robust intellectual property protection systems. At the industry level, AI has a more pronounced effect on the productivity of technology‐intensive and competitive industries. Additionally, we also find that the impact of AI on productivity is more significant in enterprises with younger executive teams and executives with digital and intelligent education backgrounds. This study expands the research scope of productivity and provides valuable insights for the government to optimize digital economy policies and for enterprises to formulate digital innovation strategies.

More than fun and games: Problematic sports betting and its adverse impact on mental health and well-being in young adults

BackgroundThe rapid rise in sports betting, especially among young adults (age 18–29), necessitates identifying health correlates of this addictive behavior. The present study examined associations between problem sports betting symptoms and mental health and well-being, which represents a timely literature gap. MethodThe sample was 221 young adult sport bettors from 36 different states (Mage = 24.4, 77.7% male). Regression models estimated associations between problem sports betting severity (PGSI-SB) and symptoms of depression, anxiety, psychological distress, loneliness, and stress, as well as indices of well-being, including satisfaction with life, optimism, connectedness, and social functioning. ResultsYoung adults with greater problem sports betting severity had significantly higher scores on each index of mental health symptomology and had poorer indices of well-being. The strongest relative effect size was the association between problem sports betting severity and stress (a 1SD increase in PGSI-SB score corresponded to 48% of a standard deviation increase in stress). ConclusionsThis study provides novel and timely evidence for associations between problem sports betting and various indices of mental health and well-being; thus, highlighting the need for rapid development of holistic prevention/intervention strategies aimed at the intersection of problem sports betting and mental health.

Digital literacy, relative poverty, and common prosperity for rural households

Digital transformation has emerged as a crucial driver of economic development, yet its impact on rural China's socioeconomic landscape remains understudied. This research investigates how digital literacy influences common prosperity and relative poverty in rural China using comprehensive household-level data from the 2018 China Family Panel Studies (CFPS). Through robust econometric analysis, including multiple regression models and structural equation modeling, we examine both the direct effects of digital literacy on household economic outcomes and its indirect effects through the mediating channel of relative poverty. Our findings demonstrate that a one standard deviation increase in digital literacy scores corresponds to a 12.3 % reduction in relative poverty and a 15.7 % increase in household income, with these effects amplified in China's western regions and among unmarried individuals. The results are robust to various model specifications and controls for potential endogeneity. By establishing the causal pathways between digital skills and economic well-being, this study provides empirical evidence for policymakers to design targeted interventions that leverage digital literacy as a tool for reducing rural-urban disparities. Our findings contribute to the growing literature on digital inclusion and suggest that investing in digital skills training could be a cost-effective strategy for promoting inclusive growth in rural China.

Does board gender diversity improve stock liquidity?

PurposeFirms with gender diverse boards have been shown to have increased transparency and disclosure, resulting in reduced information asymmetry, which is a key factor influencing stock liquidity. This paper explores the influence of information asymmetry resulting from board gender diversity on stock liquidity. We examine the impact of gender diverse firms on stock liquidity in US listed firms from 2006 to 2022, capturing 28,280 firm-year observations across 4,349 firms. Using mediation models, we distinguish between direct and mediated effects to examine the impact of gender diverse boards on three dimensions of stock liquidity. We find a positive and significant relation between board gender diversity and stock liquidity, and our findings highlight the substantial mediating role of information disclosure in this association. To address concerns of endogeneity, we use instrumental variables regression, and our conclusions remain robust to a range of alternatives.Design/methodology/approachTo investigate the association between board gender diversity and stock liquidity and the underling mechanism that drives the relation, we utilize a dataset comprising 4,349 listed US firms from 2006 to 2022. We adopt a comprehensive approach to measure stock liquidity that spans three dimensions: Amihud illiquidity (LIQ) as a representation of price impact, the quoted spread (SPREAD) to gauge transaction costs and the stock turnover (TURNOVER) to assess trading frequency. To evaluate board gender diversity, we examine female directors and female independent directors, utilizing both the percentage and the presence (as a binary variable).FindingsThe results of our analysis reveal not only a statistically significant effect of board gender diversity on liquidity but also demonstrate its economic significance. One standard deviation increase in the percentage of female directors (12% more female directors) is associated with a 5.8% decrease in price impact, a 5.1% reduction in transaction costs and a 3% increase in trading frequency. These findings highlight the material economic importance of the relationship, which stands in contrast to previous studies reporting only a 1% change in average stock liquidity in the Australian stock markets (Ahmed and Ali, 2017). To further investigate the underlying mechanism driving the association between board gender diversity and liquidity, we employ mediation models to separate the direct and mediated channels. Our results indicate that the effects of the percentage of female directors are mediated on liquidity (LIQ, SPREAD, and TURNOVER) through information disclosure, albeit with a relatively small magnitude (mediation proportion is 18.2, 3.9 and 22.9%, respectively).Research limitations/implicationsWe include a comprehensive set of variables in our analysis and adopt an instrumental approach to mitigate endogeneity concern. However, we acknowledge the possibility of omitted variable biases or reverse causality in our empirical analysis.Practical implicationsOur study contributes to the understanding of the association between board gender diversity and stock liquidity, focusing on the underlying mechanisms. Gender diversity on boards enhances corporate governance, leading to reduced managerial opportunism (Adams and Ferreira, 2009; Nielsen and Huse, 2010). This, in turn, increases information transparency and results in increased stock liquidity. By exploring the empirical evidence of the impact of gender diverse boards on stock liquidity through the information channel, we provide valuable insights to the existing literature. Our study uses US data to examine this association, addressing the small sample concerns of prior research that may have contributed to inconsistent findings.Social implicationsThis research can drive both economic and social transformations as it provides evidence that gender diverse boards lead to improved market outcomes.Originality/valueOur study differs from previous research by incorporating all three dimensions of liquidity, ensuring a comprehensive analysis. Through our investigation, we aim to deepen understanding of how gender diversity on corporate boards shapes market dynamics and contributes to understanding of corporate governance and market efficiency. Our study investigates how the impact occurs by employing mediation models to separate the direct and mediated channels of impact. We show that the effects of gender diverse boards on liquidity are mediated through information disclosure.