U-shaped Curve Research Articles

Correlation between body mass index and gender-specific 28-day mortality in patients with sepsis: a retrospective cohort study.

To investigate the potential correlation between body mass index (BMI) and the 28-day mortality rate among sepsis patients and the gender difference in this association. The current research was a retrospective cohort study. A total of 14,883 male and female cohorts of sepsis patients were included in the Medical Information Mart for Intensive Care IV (MIMIC-IV V2.2) database. Patients in each gender cohort were further classified as underweight, normal weight, overweight, or obese according to BMI and the World Health Organization (WHO) BMI categories. The 28-day mortality from the date of ICU hospitalization was the primary outcome measure. The BMI and 28-day mortality exhibited an L-shaped relationship (p for nonlinearity <0.001) with significant gender-specific differences. Subgroup analysis revealed different association patterns between the male and female cohorts. Specifically, BMI and mortality exhibited a U-shaped curve relationship among the males (p for nonlinearity <0.001) and an L-shaped relationship among the females (p for nonlinearity = 0.045). This study proposes a link between extreme BMI and 28-day mortality in patients with sepsis. Underweight patients have an increased risk of mortality; however, this risk decreases in overweight and obese patients. Upon stratifying by sex, a U-shaped pattern was observed, indicating an association between BMI and 28-day mortality in males, while an L-shaped pattern emerged in females.

Serum calcium improves the relationship between fluoride exposure and hypothalamic-pituitary-testicular axis hormones levels in males—a cross-sectional study on farmers in the lower reaches of the Yellow River

Numerous studies have reported the toxicity of fluoride to the male reproductive system, but epidemiological evidence is limited. We conducted a cross-sectional study in Kaifeng City, Henan Province in 2011 to explore the association between fluoride exposure and hypothalamic-pituitary-testicular (HPT) axis hormones in men. Morning urinary fluoride (UF), serum HPT axis hormones and serum calcium (SC) concentrations were detected. Percent changes and 95% confidence intervals in HPT axis hormones associated with UF were estimated using adjusted linear regression models, and performed subgroup analysis based on SC levels. The restricted cubic spline model was used to fit nonlinear relationships. For every 10% increase in UF, the concentrations of serum GnRH, T, SHBG and TSI decreased by 2.13%, 2.39%, 2.19% and 1.96%, while E2 and FEI increased by 1.11% and 3.33%. Subgroup analysis showed that for every 10% increase in UF, the levels of GnRH, T, TSI and FTI decreased by approximately 3.15%, 5.49%, 4.47% and 5.14%, while the E2 level increased by 2.92% in low-serum-calcium group (LCG). The levels of GnRH and T decreased by approximately 2.97% and 1.82% in medium-serum-calcium group (MCG). In high-serum-calcium group (HCG), serum SHBG levels decreased by 4.70%, while FTI and FEI levels increased by 4.93% and 4.20% as UF concentration increased (P < 0.05, respectively). The non-linear relationship between serum GnRH and UF concentrations presented an approximately inverted U-shaped curve, with a turning point UF concentration of 1.164 mg/L (P < 0.001), and their nonlinear relationship in LCG and MCG were similar to that in the overall subjects. In conclusion, excessive exposure to fluoride can interfere with male serum HPT axis hormones, and a moderate increase in SC alleviates the effect of fluoride. Prospective cohort studies are essential to confirm the causality.

Number of Chronic Conditions and Death Anxiety Among Older Adults in Rural China: A Longitudinal Study in Anhui Province.

Objectives: Death anxiety is feelings of worry and fear regarding death. This study explored the effect of number of chronic conditions on death anxiety in older adults and the moderating effect of age. Methods: This study used the fifth, sixth, seventh, and eighth waves of longitudinal data (2012-2021) collected in Anhui, China (5014 person-year observations). A mixed linear model was used to examine the effect of number of chronic conditions on death anxiety and the moderating effect of age. Results: The number of chronic conditions showed an inverted U-shaped relationship with death anxiety, with death anxiety being lower in older adults with older age. As age increased, the U-shaped curve became flatter, and the extremes shifted to the right. Discussion: Particular attention should be given to younger older adults with chronic conditions to help them recover earlier from the negative impact by providing information and counseling about their chronic conditions.

Time toxicity faced by patients with advanced cancer across primary cancer sites.

268 Background: Time toxicity, defined as the burden of time for patients interacting with the health care systems, is particularly important for patients with limited life expectancy. Little is known about the relative impact of time toxicity among different cancer types at the end of life. This study examines median contact days for inpatient, outpatient, and home health services among different primary cancer types for patients with advanced cancer with limited prognosis. Methods: A retrospective cohort analysis was performed on patients with advanced (stage 4) cancer who died within one year of diagnosis at Kaiser Permanente Northern California between January 1, 2015, and June 30, 2023. Time toxicity was defined as comprehensive contact days with healthcare system over the course of patients’ survival period between cancer diagnosis and death (i.e., contact days divided by survival or contact %). Types of contact included institutional stay (emergency department visit, hospitalization, skilled nursing facility, rehabilitation); outpatient visits (ambulatory care, labs, imaging); and in-home care (home-health, home hospice, telephone and virtual visit). The study quantified overall median contact % and contact % by specific care settings, stratified by cancer primary site. Results: The study included 10102 patients. The median age at diagnosis was 74 years with 47% female. Patients were predominantly white (65%), followed by Asian (12%), Hispanic (12%), and black (8%). The median Elixhauser comorbidity score was 4. With the exception of head and neck cancers, most cancers had higher contact % near diagnosis and at end of life (U-shaped curve). Head and neck cancers had the highest percent of patients undergoing surgery (36%) and radiation (52%), which may explain its sinuosity-like curve with a rapid increase of weekly contact % after diagnosis (a small peak), followed by rapid decrease and another increase by the end of their life. Survival days were comparatively long for head and neck cancers (158 days, IQR: 84-265) and short for thoracic (80 days, IQR: 35-166) and upper gastrointestinal cancers (80 days, IQR: 38-173). Malignant hematology patients had notably higher comprehensive contact % (74%, IQR: 47-100) which was driven primarily by emergency room department visits and hospital stays (p&lt;0.001 for all contact types). Conclusions: The study highlights the high burden of time toxicity in patients with advanced cancer with limited prognosis. The significant variations in time toxicity among different cancer types, especially in malignant hematology and head and neck patients, emphasize the need to tailor goals of care discussions for patients with cancer at the end of life. By focusing on reducing unwanted time toxicity, healthcare providers can enhance the quality of life for patients with cancer, ensuring more efficient and patient-centered care delivery.

Digital transformation and enterprise violation risk: A ‘motivation-opportunity-attitude’ framework

In the evolving digital economy, digital transformation has emerged as an important strategic choice for enterprises. Their comprehensive and innovative characteristics have instigated a paradigm shift in enterprise governance ideologies and models. However, this transformation has also introduced heightened demands and challenges to enterprise governance mechanisms during the transitional phase. This study examined the influence of digital transformation on enterprise violation risk using data from Chinese A-share listed companies from 2017 to 2021. The analysis revealed an inverted U-shaped relationship between the degree of digital transformation and enterprise violation risk. This relationship was underpinned by three fundamental dimensions: motivation, opportunity, and management attitude. These dimensions were elucidated through mechanisms involving risk perception, management agency costs, and management responsibilities. These conclusions were reached even after rigorous tests for endogeneity and stability. Furthermore, this study probed specific scenarios in which digital transformation influences enterprise violation risk. This finding revealed that internal control mechanisms and external analysts’ attention moderate this relationship. As the effectiveness of internal controls and the attention of external analysts increase, the inflection point of the inverted U-shaped curve shifts to the left, and the curve progressively smoothens. Thus, greater internal control effectiveness and the governance impact of external analysts can positively affect the correlation between digital transformation and enterprise violation risk, thereby facilitating digital resources to empower enterprise governance. This study contributes to the theoretical discourse on the implications of digital transformation for enterprise governance, particularly in the context of evolving market dynamics. It offers valuable insights and recommendations for effectively driving digital transformation processes.

Family cohesion moderates the inverted U-shaped curve between resting RSA and children’s empathy

Resting respiratory sinus arrhythmia (RSA) and family cohesion may jointly influence children’s empathy. Resting RSA has been found to exhibit an inverted U-shaped relation with empathy, and family cohesion is a psychosocial correlate of children’s empathy that may moderate this relation. The present study recruited 182 first-grade children as participants (87 girls, Mage = 7.02, SDage = 0.36). Parents completed questionnaires to assess family cohesion and children’s empathy. The SOMNOtouch RESP device was utilized to collect resting electrocardiogram data and calculate resting RSA. The results showed that family cohesion significantly moderated the inverted U-shaped curve between resting RSA and children’s empathy. High family cohesion served as a protective factor in mitigating the negative impact of high resting RSA on empathy but could not buffer the negative effect of extremely low resting RSA on empathy among children. The findings suggest a role for high family cohesion in promoting empathy in children with moderate to high resting RSA.

The time toxicity efficacy-effectiveness gap: A population-based study of stage III/IV non-small cell lung cancer (NSCLC) in Ontario, Canada.

133 Background: While patients enrolled in clinical trials tend to have superior cancer-specific outcomes relative to those in routine practice (the ‘’efficacy-effectiveness gap’’), it is unknown if this gap extends to time toxicity. While trial protocols can impose additional contact days, trial participants also tend to be healthier, perhaps needing fewer contact days. We sought to evaluate the time toxicity efficacy-effectiveness gap among patients with stage III/IV NSCLC. Methods: We created a population-based, retrospective cohort with health administrative data covering the population of Ontario, Canada (15.5 million), of adults aged ≥20 years diagnosed with stage III/IV NSCLC in 2014-2017 and died in 2014-2019, receiving palliative systemic anti-cancer drug(s) as part of a trial. We matched patients 1:1 to those who received the same drug(s) in the real world (post-approval) in the same line of treatment, and received the same total lines of therapy. We calculated contact days (days with healthcare contact outside the home) from diagnosis to death and measured overall survival. We plotted, normalized, and fitted with cubic splines the weekly percentage of contact days to obtain trajectories over the disease course. Results: We identified and matched 55 trial participants to 55 patients in routine practice. Trial participants were younger (median age, 62 vs 66 years), had fewer co-morbidities (hypertension, 35% vs 53%), and more often had de novo metastatic disease (82% vs 67%). Median lines of therapy were 2. Systemic therapy regimens most commonly included immunotherapy (n=41, 75%). Trial participants initiated systemic therapy sooner than in routine practice (median 2.0 vs 2.4 months). Trial participants had a longer overall survival (median 13.8 vs 11.6 months) and a similar number of contact days (median 79 vs 78 days). The percentage of contact days was lower in trial participants due to longer survival (median 19% vs 22%). Trial participants had similar acute/assisted institutional care contact days (median 19 vs 18 days), but more days with laboratory tests (median 23 vs 17 days), systemic therapy (median 9 vs 6 days), and radiotherapy visits (median 15 vs 11 days). Normalized trajectories for both cohorts followed a ‘’U-shape’’; the difference between the maximal peak and trough was smaller in trial participants. Conclusions: We describe a novel efficacy-effectiveness gap in time toxicity, in addition to the previously established efficacy-effectiveness gap in overall survival. Encouragingly, trial participants did not experience delays in treatment, and initiated treatments sooner than in routine practice. Among trial participants, the higher number of contact days for tests, and the shallower U-shaped curve (indicating frequent visits even when relatively well) indicate potential opportunities to decrease trial-related time toxicity.

Can the digital economy empower the transportation sector to improve green total factor productivity?

The digital economy has the potential to facilitate digitization and green transformation within the transportation sector, but further research is warranted on how it can enhance the sector’s green total factor productivity (GTFP). Utilizing provincial data from China spanning 2013 to 2021, this study investigates the impact of the digital economy on the transportation sector’s GTFP. The findings are as follows: (1) The transportation sector exhibits a U-shaped relationship between the digital economy and GTFP. The inflection point of the U-shaped curve is at 0.441, with 81.11% of the samples falling to the left of this point. It is primarily through technological progress and innovation, rather than changes in technological efficiency, that the digital economy influences the improvement of GTFP. (2) The U-shaped relationship exhibits heterogeneity and varies depending on the mode and content of transportation. The U-shaped relationship is more pronounced in regions with lower total traffic volume on highways and railways or higher traffic volume on waterways. For transportation content, DEEI and GTFP show a significant U-shaped relationship in areas with high traffic volumes of passengers and freights. (3) Government intervention can attenuate the U-shaped relationship, which leads to a flatter curve. The market-driven level has the capability to strengthen the U-shaped relationship, resulting in a steeper curve. In conclusion, these findings contribute to deeper insights into the U-shaped relationship between the digital economy and GTFP, offering valuable guidance for policymakers seeking to improve GTFP in the transportation sector.

Research on the Impact of Agricultural Production Outsourcing on Farmers’ Fertilizer Application Intensity: An Inverse U-Shaped Relationship

Agricultural production outsourcing services encourage a shift in the way crops are grown in developing countries and make it easier for small farmers to join the social division of labor in agriculture. This makes production more efficient and has a big effect on the inputs used in agriculture, especially fertilizer. This paper empirically tests the impact of production outsourcing on farmers’ fertilizer intensity using the instrumental variables method with non-planar panel data from the 2020–2022 China Land Economy Survey (CLES) of farm plots. The results showed that there was a significant inverted U-shaped relationship between the degree of agricultural production outsourcing and the intensity of fertilization on farmers’ plots. Mechanistic analysis shows that agricultural production outsourcing affects the fertilizer intensity by changing the labor allocation of farmers. Especially as the degree of agricultural production outsourcing increases, the intensity of farm labor inputs by farmers gradually decreases, and the impact of fertilizer intensity on the plots showed a tendency to be promoted first and then suppressed. The moderating effect showed that plot size was a major moderating factor. This means that the bigger the plot, the flatter the inverted U-shaped curve became, and the same level of outsourcing could lead to less fertilizer application. This happened by moving the inflection point of the inverted U-shaped curve to the left, which stopped the fertilizer application at a lower level of outsourcing. Heterogeneity analysis showed that participation in technology-intensive production outsourcing was beneficial in terms of reducing fertilizer intensity, and that an increased degree of agriculture production outsourcing was beneficial for farmers with large plot sizes and younger heads of household.

Associations between hypertensive snowbirds' length of migratory stay and blood pressure control

Objective: To explore the relationship between the hypertensive snowbirds' length of migratory stay and their blood pressure control and blood pressure levels. Methods: This study was a cross-sectional study. A population of snowbirds with hypertension was recruited between October and November 2022, and a structured questionnaire was used to collect their self-measured blood pressure and length of stay in Hainan Province. The blood pressure control status is determined based on self-measured blood pressure. According to the self-measured blood pressure to determine whether the blood pressure was well controlled. The associations between snowbirds' length of stay and their blood pressure control as well as their self-measured blood pressure were analyzed using restricted cubic splines. Results: A total of 362 research subjects were included, 169(46.7%) of whom were male, and their age was (69.7±7.0) years old. The participants' self-measured systolic blood pressure and diastolic blood pressure were (129.1±16.2) mmHg (1 mmHg=0.133 kPa) and (78.9±10.1) mmHg, respectively. Overall, 174 (48.1%) participants attained adequate blood pressure control. The median length of stay in Wuzhishan City was 7(6, 7) months. There was an inverted U-shaped association between snowbirds' length of stay and blood pressure control (overall: P=0.023; nonlinearity: P=0.014), where participants with a length of stay of 7 months had the highest rate of blood pressure control. There is a U-shaped curve relationship between length of stay and systolic blood pressure (overall: P=0.001; nonlinearity: P=0.033), and a linear negative correlation with diastolic blood pressure (β=-1.19, P=0.003). Conclusions: Compared with hypertensive snowbirds with too long or too short lengths of stay, snowbirds who stayed in Wuzhishan City for seven months have better blood pressure control, and systolic blood pressure is also lower.

Inequality and Economic Growth: The Effect of Urban-Rural Roads Construction in China

This study investigates the effect of urban-rural roads construction on inequality. As the main roads connecting urban and rural areas, the urban-rural roads have greatly influenced the economic growth and poverty alleviation in rural areas. We collect the data of urban-rural roads from 2003 to 2021 and matched with the income inequality and night light intensity data, we find that the impact of urban-rural roads construction on inequality between urban and rural areas will first increase and then rebound, showcasing an inverted U-shaped curve. Further analysis shows that the inverted U-shaped trend could be attributed to the economic growth gap between urban and rural areas. The results in this study provide evidence that a developing country such as China could enhance urban-rural roads construction to reduce inequality between urban and rural areas.

Parity and post-reproductive mortality among U.S. Black and White women: Evidence from the health and retirement study.

Population health research finds women's mortality risk associated with childlessness, low parity (one child), and high parity (6+ children) in a U-shaped pattern, although U.S. studies are inconsistent overall and by race/ethnicity. Parity, however, is contingent on women's biophysiological likelihood of (in)fecundity as well as voluntary control practices that limit fertility. No studies have empirically examined infecundity differentials among women and their potential contribution to the parity-post-reproductive mortality relationship or the race/ethnic-related mortality gap. We examine 7,322 non-Hispanic Black and White women, born 1920-1941, in the Health and Retirement Study, using zero-inflation methods to estimate infecundity risk and parity by race/ethnicity. We estimate proportional hazards models [t0 1992/1998, t1 2018] to examine associations of infecundity risk, parity, early-life-course health and social statuses, and post-reproductive statuses with all-cause mortality. We find Black women's infecundity probability to be twice that of White women and their expected parity 40% higher. Infecundity risk increases mortality risk for all women, but parity-post-reproductive mortality associations differ by race/ethnicity. White women with one and 5+ children (U-shaped curve) have increased mortality risk, adjusting for infecundity risk and early-life factors; further adjustment for post-reproductive health and social status attenuates all parity-related mortality risk. Black women's parity-post-reproductive mortality associations are not statistically significant. Black women's post-reproductive mortality risk is anchored in earlier-life conditions that elevate infecundity risk. Results suggest a need to focus upstream to better elucidate race/ethnic-related social determinants of reproductive health, infecundity, parity, and mortality.

Association between base excess and mortality in critically ill patients with ischemic stroke: a retrospective cohort study

BackgroundBase excess (BE) is associated with mortality from many diseases. However, the relationship between BE and mortality in patients with ischemic stroke remains uncertain. Our aim is to investigate the relationship between BE values upon admission to the ICU and mortality rates in critically ill stroke patients.MethodsThe current study enrolled 1,572 patients with ischemic stroke (863 males and 709 females). The associations of BE with intensive care unit (ICU), hospital, 28-day, and 1-year mortalities were assessed using multivariable logistic regression or Cox proportional hazards model. The potential impact of the Sequential Organ Failure Assessment (SOFA) score (< 5 or ≥ 5) on the prognostic value of BE was further evaluated with interaction and subgroup analyses.ResultsBE values less than − 3 mmol/L, greater than 3 mmol/L, and within − 3 to 3 mmol/L (normal BE) were observed in 316 (20.1%), 175 (11.1%), and 1,081 (68.8%) patients, respectively. The restricted cubic splines analyses revealed that a U-shaped curve between BE and the mortality risk. Multivariable analysis indicated that patients with low BE (<-3 mmol/L) had higher rates of ICU mortality (odds ratio [OR], 1.829; 95% confidence interval [CI], 1.281–2.612; P = 0.001), hospital mortality (OR, 1.484; 95% CI, 1.077–2.045; P = 0.016), 28-day mortality (hazard ratio [HR], 1.522; 95% CI, 1.200–1.929; P = 0.001), and 1-year mortality (HR, 1.399; 95% CI, 1.148–1.705; P = 0.001) than patients with normal BE. Subgroup analyses showed consistent results pertaining to SOFA scores ≥ 5.ConclusionsIn critically ill patients with ischemic stroke, an initial BE of <-3 mmol/L at ICU admission may indicate an increased risk of ICU, hospital, 28-day, and 1-year mortalities.

Dose‒response effects of resistance exercise on ameliorating cravings and executive functions in individuals with methamphetamine use disorders

PurposeResistance exercise (RE) can acutely benefit symptoms in individuals with methamphetamine use disorder (MUD), though the optimal dose has not yet been established. We aimed to determine the dose response relationship between RE intensity and cue-elicited cravings and executive functions in individuals with MUD. MethodsA total of 128 male participants with MUD (34.73 ± 5.65) were randomly assigned to the low-intensity (30%–35%1-RM) RE group (LREG), moderate-intensity (55%–60%1-RM) RE group (MREG), high-intensity (75%–80%1-RM) RE group (HREG), or control group (CONG). Cravings based on the cue-reactivity paradigm were measured before, immediately after, and 40 min after acute RE, and inhibitory control, working memory, and cognitive flexibility were measured before and after acute RE. ResultsImmediately after and 40 min after RE, the Δcue-elicited cravings of the MREG from baseline was significantly more negative than that of the LREG and CONG. Trend analyses revealed a U-shaped dose‒response curve for RE intensity and Δcue-elicited cravings, indicating that moderate-intensity RE had the greatest ameliorating effect on cue-elicited cravings. Δinhibitory control and Δworking memory scores increased only in the MREG, and Δcognitive flexibility scores significantly increased in all RE groups. Trend analyses revealed a cubic curvilinear relationship between RE intensity and inhibitory control and a quadratic curvilinear relationship with working memory and cognitive flexibility. ConclusionRE proved effective in diminishing cue-elicited cravings and enhancing executive functions. A significant dose‒response relationship existed among RE intensity, cue-elicited cravings and executive function, and moderate-intensity RE had a more pronounced ameliorative effect on individuals with MUD.

Characterization and functional properties of muskmelon seed meal and oil

Muskmelon seeds, often discarded as waste, are rich sources of protein and healthy oil, making them excellent alternate sources of fat and protein. Muskmelon seeds of hybrid cultivars were assessed for their physico-chemical and functional properties. Fat and protein content of endosperm varied from 38.77–42.74 % and 22.6–35.17 %, respectively. Muskmelon seed oil showed desired characteristics as per WHO norms with high saponification value of 190.28–197.65. Linoleic acid (60.5–65.6 %) and palmitic acid (8.3–9.5 %) were the major constituent of melon seed oil. Defatted muskmelon seed meals (DSMs) contained 36.45–48.12 % proteins and minerals like potassium, phosphorous, magnesium and calcium. The total polyphenol content of the various DSMs ranged from 11.94 to 15.503 mg GAE/g, and the antioxidant activity quantified as IC50 value, ranged from 24.75–32.97 mg/ml. Chloroform and methanol extract of seeds showed anti-proliferative activity, with IC 50 value varied from 75.07–141.3 µg/ml. Solvent retention capacity of defatted seed meals ranged from 60.94 to 104.5 % (water), 86.87–137.39 % (sodium carbonate), 95.09–123.11 % (lactic acid) and 89.27–138 % (sucrose). WAC and OAC varied from 1.64–2.35 g/g and 1.97–2.13 g/g respectively. Solubility of DSMs varied from 20–35 %, maximal at alkaline pH. Likewise, emulsion activity and solubility also followed classic U-shaped curve and were highest at alkaline pH. The study concluded that muskmelon seeds being rich in protein and oil can be unconventional, sustainable, environmentally friendly and vegan sources of high quality protein and PUFA rich oil.

The Development of Ambiguity Processing Is Explained by an Inverted U-Shaped Curve.

Understanding the developmental trajectories for recognizing facial expressions is important for a better understanding of development of psychiatric disorders. In this study, we examined the recognition of emotional and neutral facial expressions in 93 typically developing adolescents and adults. The Emotion Intensity Rating task required participants to rate the intensity of emotional expression in happy, neutral, and sad faces on a scale from 1 to 9. A score of '5' had to be assigned to neutral faces, scores between '6' (slightly happy) and '9' (very happy) to happy faces, and scores between '4' (slightly sad) and '1' (very sad) to sad faces. Mixed effects models were used to examine the effects of age and emotion on recognition accuracy, reaction time (RT), and emotional intensity. Participants tended to misjudge neutral faces as sad. Adolescents were less accurate than adults for neutral face recognition. There were significant quadratic effects of age on accuracy (negative quadratic effect) and RT (positive quadratic effect). The most accurate and fastest performance was observed in 25- to 35-year-old subjects. This trajectory may be associated with prefrontal cortex maturation, which provides top-down control over the heightened amygdala response to ambiguity that may be misinterpreted as emotional content.

Uncovering the relationship between trace element exposure, cognitive function, and dietary inflammation index in elderly americans from the National Health and Nutrition Examination Survey 2011–2014

BackgroundThe consequences of trace element exposure on cognitive function in elderly adults have been recognized as primarily attributed to the inflammatory response. It is noteworthy that diet can either exacerbate or reduce the inflammatory response. Despite this, there have been limited studies about the effects of diet on the relationship between trace element exposure and cognitive function.MethodsA cross-sectional study utilized data from the 2011–2014 NHANES survey to explore the association between trace element exposure and cognitive function in elderly adults. The study enrolled 1726 participants, and generalized linear regression model (GLM), Bayesian kernel machine regression model (BKMR), weighted quantile sum regression (WQS), and quantile g-computation regression analysis (Qg-comp) were conducted to assess the impact of five trace elements (lead, cadmium, mercury, manganese, and selenium) in blood on cognitive function under the anti-inflammatory and pro-inflammatory diet.ResultsThe GLM analysis showed a positive correlation between selenium (Se) and both the instant recall test (IRT) and digit symbol substitution test (DSST) (β = 2.06, 95% CI: 0.70 ~ 3.41; and β = 6.41, 95% CI: 2.35 ~ 10.46, respectively). In contrast, cadmium (Cd) was negatively associated with DSST (β = -1.17, 95% CI: -2.13~ -0.22), and lead (Pb) was negatively associated with IRT (β = -0.47, 95% CI: -0.82~ -0.11). For the animal fluency test (AFT), the highest quartile of manganese (Mn) was negatively associated with the lowest quartile (β = -0.72, 95% CI: -1.34~-0.10), while mercury (Hg) showed no significant associations with cognitive function tests. Subgroup analysis revealed the effects of Cd on IRT and DSST and Se on DSST under the pro-inflammatory diet. Furthermore, The BKMR analysis showed an inverted U-shaped curve with the negative impact of trace element mixtures and DSST and a linearly negative trend with IRT in the pro-inflammatory diet. Among them, Cd was emphasized as the most potent risk factor, and Se was the most vital protective factor for IRT and DSST in WQS and Qg-comp analysis.ConclusionsThe study suggests that a high-quality diet might alleviate the adverse effects of Cd on IRT and DSST. High Se levels were also associated with better IRT and DSST scores in the pro-inflammatory diet. These findings provide valuable insights into the connection between diet, trace element exposure, and cognitive function in elderly adults.

Aluminum demand and low carbon development scenarios for major countries by 2050

Aluminum is a widely used energy-intensive material and the second largest source of carbon emissions from metal after steel. Global demand for aluminum has grown rapidly since 1970 and has shown a high correlation with population and economic growth. These factors have posed challenges to carbon reduction of aluminum industry. Therefore, it is crucial to investigate global aluminum demand and emissions to develop low carbon pathways. However, few studies have conducted a comprehensive analysis of the global aluminum industry. We develop different scenarios of joint abatement measures to explore pathways for the aluminum industry to significantly reduce carbon emissions by 2050. Three scenarios are considered, namely, moderate mitigation scenario (MMS), enhanced mitigation scenario (EMS), and deep mitigation scenario (DMS). The results show that: 1) Aluminum industry has a high potential for carbon emission reduction. The emissions in the three scenarios will be reduced by 33%, 77% and 85% by 2050 compared to 2020, respectively. 2) The carbon emission reduction effect of energy structure optimization and low carbon technology application is significant, with the use of clean energy playing a decisive role. 3) There is an inverse U-shaped curve relationship between per capita primary aluminum demand and per capita GDP. The aluminum demand in China and India is still growing at a high rate, and carbon emissions are always at the top. This study will effectively support the development of a low-carbon transition path for the global aluminum industry.

Can China’s belt and road initiative narrow the income gap between the Han people and ethnic minority residents? Evidence from a regression discontinuity design

The Belt and Road (B&R) policy is a region-oriented economic policy implemented by the Chinese government since 2010, involving the largest population and covering the largest area in the world. Whether it can significantly narrow the income gap between Han and ethnic minority residents has not been investigated in the literature. To avoid endogenous problems in the model, we used the spatial breakpoint regression method to investigate 2,037 county-level administrative regions in China from 2014 to 2021 and empirically evaluated the impact of the policy on the income gap between Han and ethnic minority residents. Results show that, compared to the counties without B&R policy, the average income gap between minority counties with B&R and Han has increased by 1.468–1.518 times, which was nearly 1.3 times the sample mean of survey data, indicating that the income gap has been widened significantly by B&R. However, the policy has a narrowing effect on the income gap between minorities and Han in the 20% sample with the widest income gap between minorities and Han. From the dynamic effect of years, with the effect of B&R, the income gap between minorities and Han is an inverted U-shaped curve, first increasing and then decreasing.

Analytically articulating the effect of buffer size on urban green space exposure measures

Advanced techniques in Geographic Information Systems (GIS) currently provide one of the most promising approaches to investigating the health impacts of green space. The GIS solution of deriving causally relevant green space exposures still faces challenges from the arbitrary determination of the contextual unit size. This paper presents an in-depth and rigorously defined analytical framework to illustrate the effect of buffer and to find the optimal buffer radius. We employed a cross-sectional study with 980 participants in Hong Kong to validate our analytics. The home locations, socio-demographic attributes, and self-reported health statuses were collected from questionnaires. Residence-based green space exposures were derived using an exhaustive range of buffer radii and fine-grained remote sensing data. Participants’ overall health was modeled through logistic regression to validate our analytics. Our results clearly indicate the U-shaped p-value curves along the gradient of buffer radii, which illustrates the optimal buffer sizes in pertinent geographic contexts. We also observed two independent ranges of optimal buffer sizes. Our work elicited the effect of buffer size on green space exposure measures and essential implications for a range of health geography and environmental health studies that require accurate green space exposure measures.