U-shaped Relationship Research Articles

Unpacking curvilinear relationship of COVID-19 fear on job satisfaction and mental well-being: moderation of on-the-job embeddedness

PurposeOur study aims to investigate how the fear of COVID-19 affects job satisfaction and mental well-being. Additionally, we will explore the moderating role of on-the-job embeddedness in these relationships.Design/methodology/approachThe study surveyed 358 Indian-origin IT professionals through Amazon Mechanical Turk. It used confirmatory factor analysis to analyze the measurement model and hierarchical linear regression in SPSS 21 software to examine the structural relationships between variables. A robustness check was conducted using the MODLR macro in SPSS to identify any spurious moderation.FindingsThe results reveal a curvilinear (or U-shaped) relationship between COVID-19 fear, job satisfaction and mental well-being. Further, on-the-job embeddedness linearly moderates the relationship between COVID-19 fear and job satisfaction and COVID-19 fear and mental well-being.Research limitations/implicationsThe research design is cross-sectional, so results reported about causal relationships are considered cautiously. The relationships involving the variables and their direction are because of the theory’s assumptions rather than the test of causal relationships between variables.Originality/valueThis is the first study to show that the relationship between COVID-19 fear and job satisfaction and COVID-19 fear and mental well-being is curvilinear (or U-shaped). Further, we are again the first to show that on-the-job embeddedness positively moderates the two relationships: COVID-19 fear – job satisfaction and COVID-19 fear – mental well-being. This is one of the few studies that employed MODLR macro to check for spurious moderation.

Association between periodontitis and cardiometabolic index (CMI): a study from NHANES 2009–2014

AbstractCardiometabolic index (CMI) is a novel anthropometric metric that integrates lipid and adiposity characteristics. The correlation between periodontitis development and CMI is ambiguous. The objective of this study was to establish the association between CMI and periodontitis by analyzing data from the NHANES (National Health and Nutrition Examination Survey) database. A cross-sectional study was conducted on a cohort of 6188 people selected from the NHANES database, covering the period from 2009 to 2014. The study employed multivariate logistic regression to examine the independent correlation between CMI and periodontitis. Subgroup data were analyzed and interaction tests were conducted to assess the impact of variables on the correlation between CMI and periodontitis. The CMI index was significantly and positively associated with the presence of periodontitis (β = 0.03, 95%CI(0.01, 0.05), p = 0.0092). In addition, a U-shaped relationship was found between CMI index and periodontitis severity in an older American population (65 < = age < = 80, with a folding point of 1.44, p = 0.008). This study demonstrates a significant correlation between CMI and periodontitis, positioning CMI as a crucial indicator for assessing periodontal health. Future efforts should prioritize oral hygiene interventions for patients with elevated CMI levels to facilitate early intervention and enhance overall health outcomes.

Social inclusion and poverty reduction in sub-Saharan Africa

PurposeThe poverty puzzle persists in sub-Saharan Africa decades after some other regional bodies have recorded substantial gains in their poverty reduction efforts. This study seeks to explore the extent to which social inclusion influences poverty outcomes in sub-Saharan Africa.Design/methodology/approachThe study constructs a social inclusion index and its sub-indices using principal component analysis and employs the Lewbel instrumental variable estimation method to test the impact of the computed social inclusion indices on poverty outcomes for 19 sub-Saharan African countries.FindingsThe results have shown that social inclusion reduces the proportion of the poor and the depth of poverty within sub-Saharan Africa significantly. We also observe a U-shaped relationship between social inclusion and poverty outcomes; thus, social inclusion’s poverty-reducing effect sees a reversal when it hits a certain threshold.Practical implicationsThe study provides the evidence needed to inform the policy discourse on the poverty problem, which continues to plague sub-Saharan Africa.Social implicationsWith sub-Saharan Africa’s position as the region with the worst poverty statistics, the results of this study will prove useful in tackling poverty to ensure improved quality of life.Originality/valueThis study presents original evidence on social inclusion and its relationship with poverty.Peer reviewThe peer review history for this article is available at: https://publons.com/publon/10.1108/IJSE-08-2023-0640

Hemoglobin concentrations in early pregnancy and their associations with adverse pregnancy outcomes in Western China: a population-based study.

Despite the global standardization of hemoglobin (Hb) testing in early pregnancy, the impact of first trimester Hb concentrations on pregnancy outcomes remains inadequately understood. Also, the early pregnancy Hb concentrations have not been well documented in Western China. Therefore, this study aimed to assess the Hb concentrations during early pregnancy and their associations with adverse pregnancy outcomes in Western China. This cross-sectional study used data from the Chengdu Maternal and Child Health Information System for pregnant women who delivered between January 1, 2019, and December 31, 2023. A total of 454,815 Chinese females aged 15 to 49 years with available first trimester Hb data, including those with singleton or multiple gestations, were included in the analysis. Multivariable logistic regression models were performed to estimate the adjusted odds ratios (aORs) and 95% confidence intervals (CIs) for associations between Hb categories and adverse pregnancy outcomes. The average first trimester Hb concentration was 126.0 (SD 10.5) g/L, with 5.8% of pregnant women experiencing anemia during early pregnancy. Multivariable logistic regression analyses revealed significantly increased odds of developing gestational diabetes mellitus (GDM) and gestational hypertensive disorders (GHD) across increasing Hb concentration categories. Compared to Hb concentrations of 110-119g/L, Hb ≥ 140g/L was associated with elevated risk of GDM (aOR: 1.57, 95% CI: 1.52, 1.62) and GHD (aOR: 1.87, 95% CI: 1.79, 1.96). Moreover, both Hb ≤ 99g/L (aOR: 1.15, 95% CI: 1.03, 1.29) and Hb ≥ 140g/L (aOR: 1.20, 95% CI: 1.13, 1.26) were associated with higher odds of preterm birth compared to Hb concentrations of 110-119g/L. In addition, the restricted cubic spline demonstrated a U-shaped relationship for cesarean delivery, low birthweight and small for gestational age (p < 0.001). However, no significant associations were found between first trimester Hb concentrations and the odds of stillbirth, Apgar score < 7 at 5min, or Apgar score < 7 at 10min (p > 0.05). Our research findings suggest associations between first trimester Hb concentrations and various adverse pregnancy outcomes. We recommend interventions for early pregnancy anemia, particularly moderate to severe cases, and emphasize monitoring females with high Hb concentrations to reduce adverse outcomes.

Hyperuricemia and elevated uric acid/creatinine ratio are associated with stages III/IV periodontitis: a population-based cross-sectional study (NHANES 2009-2014).

To explore the association between hyperuricemia and having periodontitis. A representative cross-sectional dataset of 10,158 adults was extracted from the National Health and Nutrition Examination Survey (NHANES) 2009-2014. The association between hyperuricemia (the primary exposure) and having periodontitis (outcome) were evaluated using weighted logistic regression models. Serum uric acid (UA) levels and the UA to creatinine (UA/Cr) ratio were used as secondary exposures. Their associations with the diagnosis periodontitis were analyzed using weighted logistic regression or restricted cubic spline regression. The prevalence of Stages III/IV periodontitis was 47.7% among individuals with hyperuricemia and 37.4% among those without. After adjustment, individuals with hyperuricemia had 0.281 times higher odds of developing Stages III/IV periodontitis compared to those without hyperuricemia (adjusted OR = 1.286, 95% CI = 1.040 to 1.591, P = 0.024). The increased odds could be explained by a linear relationship with the serum UA/Cr ratio and a U-shaped relationship with serum UA levels. Each unit increase in the serum UA/Cr ratio was associated with 0.048 times higher odds of developing Stages III/IV periodontitis (adjusted OR = 1.048, 95% CI = 1.008 to 1.088, P = 0.021). Additionally, each 1mg/dL increase in serum UA was associated with 0.156 times higher odds (adjusted OR = 1.156, 95% CI = 1.009 to 1.323, P = 0.038) of developing Stages III/IV periodontitis when UA levels were greater than 5.9mg/dL, but 0.118 times lower odds when UA levels were 5.9mg/dL or lower (adjusted OR = 0.882, 95% CI = 0.790 to 0.984, P = 0.027). Sensitivity analyses validated the robustness of the findings. This study provides the first direct evidence that hyperuricemia is associated with Stages III/IV periodontitis. Hyperuricemia may represent a new potential comorbidity of periodontitis, possibly contributing directly or indirectly to the disease burden in patients with periodontitis. Not applicable.

U-shaped relationship between triglyceride glucose-body mass index and suicide attempts in Chinese patients with untreated first-episode major depressive disorder.

An alternative metric for evaluating insulin resistance (IR) is the triglyceride glucose-body mass index (TyG-BMI). However, it is yet unclear how TyG-BMI and suicide attempts (SA) are related. The objective of this research was to explore the correlation between the TyG-BMI index and SA in individuals with untreated first-episode (UFE) major depressive disorder (MDD) in Shanxi Province. This cross-sectional study was conducted from September 2016 to December 2018 in the psychiatric outpatient clinic of Taiyuan General Hospital and included 1718 patients with UFE MDD, with a mean age of 34.9 ± 12.4years. The relationship between TyG-BMI and SA was assessed using logistic regression modeling. We investigated threshold effects using a two-piecewise linear regression model. Taking into consideration the potential influence of confounding variables, a comprehensive multivariate logistic regression analysis was conducted, which demonstrated the absence of a statistically significant association between the TyG-BMI index and the occurrence of SA, as evidenced by P-values that were all greater than 0.05. On the other hand, the visual analysis of the smoothed plots revealed a U-shaped relationship between the TyG-BMI index and the incidence of SA, with a notable inflection occurring at a TyG-BMI value of around 210. It was observed that the effect sizes flanking the inflection point, accompanied by their 95% confidence intervals, were 0.985 (95% CI: 0.972 to 0.999, P = 0.031) and 1.012 (95% CI: 1.003 to 1.047, P = 0.005), respectively. In UFE MDD patients, a U-shaped link was observed between TyG-BMI and SA, with the minimal SA incidence noted at a TyG-BMI level of 210, signifying that an augmented risk for SA might be connected to both diminished and augmented TyG-BMI levels.

Indirect impact of public expenditures and inflation on energy poverty: empirical evidence from 32 developing countries

ABSTRACT Energy poverty (EP) is an important barrier to environmental sustainability, and many studies have addressed its causes and linkages with various macroeconomic variables. However, there has been insufficient analysis of the indirect effects of public expenditures and inflation on EP, particularly through income. This study analyses the effects of public expenditures and inflation on EP for 32 developing countries using Panel GMM and 3SLS methods. The findings indicate that public expenditures are an important public policy instrument in combating EP. Conversely, the study reveals that inflation negatively affects energy poverty. Moreover, the study concludes that there is a U-shaped relationship between inflation and income inequality and that a decline in inflation over time will positively affect EP through income inequality.

Association between advanced lung cancer inflammation index and unstable asthma: a population-based study from the NHANES 2007–2018

BackgroundAsthma exacerbation is associated with obesity and systemic inflammatory diseases, and advanced lung cancer inflammation index (ALI) is a novel biomarker of nutritional inflammation. The purpose of this study was to investigate the potential relationship between ALI and unstable asthma.MethodsThis cross-sectional study utilized data from the 2007–2018 National Health and Nutrition Examination Survey (NHANES). Asthma was assessed through self-reported questionnaires. Multifactorial logistic regression, subgroup analyses, interaction assessments, smoothed curve fitting, and threshold effect analysis models were conducted to investigate the association between ALI and unstable asthma.ResultsThe study included 1,822 subjects with current asthma, and we found a linear positive association between ALI and unstable asthma, with higher levels of ALI significantly associated with an increased risk of asthma exacerbations in fully corrected models. However, the associations were not entirely consistent across subgroups. In subgroup analyses by body mass index (BMI) and race, unstable asthma and ALI were independently significant in the BMI (25–29.9) range and the Non-Hispanic White group. Interaction analysis suggested that BMI moderated the relationship between ALI and unstable asthma. Furthermore, smoothed curve fitting showed an inverted U-shaped relationship between log ALI and unstable asthma in subjects with a BMI &amp;lt;25 and male individuals, with inflection points observed at 1.53 and 2.13, respectively.ConclusionWe found a linear positive association between ALI and unstable asthma, which remained constant in the fully adjusted model. These findings suggest that higher levels of ALI were significantly associated with an increased risk of asthma exacerbation, particularly in asthmatic populations with BMI in the 25–29.9 range. However, more prospective studies are required to confirm our findings.

Evaluating Enteric Fermentation-Driven Environmental Kuznets Curve Dynamics: A Bayesian Vector Autoregression Comparative Study of the EU and Least Developed Countries

Global warming and climate change, primarily driven by human activities, with agriculture playing a significant role, have become central topics of scientific research. Livestock production, especially enteric fermentation, is a major source of greenhouse gas emissions, making it a focal point for both climate change adaptation and mitigation strategies. Both the European Union (EU) and Least Developed Countries (LDCs) are highly dependent on agriculture, particularly livestock, which plays a key role in their economic growth. In developing countries, livestock systems are evolving rapidly due to various factors, while in the EU, the livestock sector remains economically and socially significant, representing 36% of total agricultural activity. This study explores the environmental impact of enteric fermentation in livestock production, alongside the economic value it generates in both the EU and LDCs. The analysis utilizes a Bayesian Vector Autoregression (BVAR) methodology, which provides a more robust performance compared to traditional models like Vector Autoregression (VAR) and the Vector-error Correction Model (VECM). This research identifies significant relationships between the variables studied, with structural breaks quantified to reflect the impact of initiatives undertaken in both regions. Interestingly, the results challenge the environmental Kuznets curve, which hypothesizes an inverted U-shaped relationship between economic growth and environmental degradation, as proposed by Stern. This suggests that stronger economic incentives may be necessary to enhance policy effectiveness and promote eco-efficiency. The distinctive characteristics of livestock production in the EU and LDCs should be carefully considered when shaping agricultural policies, with a strong emphasis on farmer education as a critical factor for success. Additionally, corporate management practices must be tailored to address the unique needs, strengths, and challenges of livestock businesses in these two diverse regions.

International capital flows in the process of longevity catch-up

Abstract Using a polynomial cointegration technique, this paper shows that the bilateral US current account balance with China has a U-shaped relationship with the life expectancy gap between the US and China. A narrowing gap initially increases the US deficit with China, but eventually, this increased US deficit falls with the further catching-up of Chinese life expectancy. The life expectancy gap between the two countries has been below the threshold level since 2013, and this demographic trend has the potential to improve the US deficit with China. This U-shaped relationship can be theoretically reproduced. A two-country overlapping generations model indicates that the effect of life expectancy is decomposed into four components: retirement savings, social security burden, the number of elderly workers, and the productivity of elderly workers. The total effect of foreign life expectancy on the home current account balance exhibits a sign change in the catching-up of foreign life expectancy.

A U-shaped relationship between the atherogenic index of plasma and repeated target vessel revascularization in patients undergoing percutaneous coronary intervention: a retrospective study

BackgroundAtherogenic index of plasma (AIP) has been recognized as a novel and practical marker for the assessment of cardiometabolic risk, but the relevance of AIP as a prognostic biomarker in coronary artery disease (CAD) remains debated. This study investigated the association between AIP and major adverse cardiac and cerebrovascular events (MACCEs) in CAD patients receiving percutaneous coronary intervention (PCI) with drug-eluting stents (DES).MethodsA total of 2,250 patients undergoing PCI with DES were included in this retrospective cohort study. The primary endpoint was MACCEs, encompassing acute myocardial infarction, repeat target vessel revascularization (TVR), stroke, and all-cause mortality. Logistic regression models were used to estimate odds ratios (ORs) and 95% confidence intervals (CIs). Restricted cubic splines were applied to explore the dose–response associations. And subgroup analysis was conducted to evaluate potential relationship between AIP and MACCEs across different subgroups.ResultsDuring a medium follow-up of 29.8 (25.6–34.0) months, 106 (4.7%) patients experienced TVR. After adjusting for confounders, AIP (per 1 SD increase) was positively associated with TVR (odds ratio [OR] = 1.26, 95% confidence interval [CI] = 1.01–1.58, P = 0.042). In females, there was a significant association (OR = 2.33, 95% CI = 1.40–3.98, P = 0.002), but no significant association was observed in males. There was an interaction between AIP and gender (P = 0.017). Restricted cubic spline analysis depicted a U-shaped relationship between AIP and TVR (Pnonlinear = 0.016), with an elevated risk evident from an AIP of 0.20.ConclusionAIP showed a U-shaped relationship with TVR in PCI patients with DES, particularly pronounced among females. We suggested that the AIP should be used as a plasma marker of key interest for preventing TVR after DES implantation in patients with CAD.

Association between triglyceride glucose-body mass index and depression among US adults: A cross-sectional study

ObjectivesThe triglyceride glucose-body mass index (TyG-BMI) is a well-established surrogate marker for insulin resistance. While an association between insulin resistance and depression has been identified, that between TyG-BMI and depression remains unclear. Therefore, we used data from the National Health and Nutrition Examination Survey (NHANES) database to investigate this. Study designThis cross-sectional study included 9673 adults (aged ≥20 years) from the NHANES in the United States from 2011 to 2020. MethodsDepressive symptoms were assessed using a nine-item version of the Patient Health Questionnaire. The covariates included age, sex, race/ethnicity, marital status, educational level, poverty-income ratio, smoking status, alcohol intake, diabetes status, cardiovascular disease, hypertension, physical activity, high-density lipoprotein, low-density lipoprotein, and total cholesterol. Multivariate logistic regression models, subgroup analyses, and threshold saturation effect analyses were conducted. ResultsAfter adjusting for age, sex, race/ethnicity, marital status, education level, poverty-income ratio, smoking status, drinking status, diabetes status, cardiovascular disease, hypertension, physical activity, total cholesterol, high-density lipoprotein cholesterol, and low-density lipoprotein cholesterol, the threshold saturation effect showed a TyG-BMI inflection point of 174.4. Below the inflection point, a 10-unit increase in TyG-BMI was associated with a 12 % lower prevalence of depression. Above the inflection point, each 10-unit increase in TyG-BMI was associated with a 4 % increase in prevalence of depression. ConclusionsTyG-BMI had a U-shaped relationship with prevalence of depression. There was a significant link between higher TyG-BMI levels and increased prevalence of depression. When the TyG-BMI value was below 174.4, any further increase in TyG-BMI was associated with a significantly lower prevalence of depression.

Long-term effect of eating duration on all-cause mortality under different energy intake and physical activity levels.

The long-term impact of eating duration on the risk of all-cause mortality remains unclear, with limited exploration of how different levels of energy intake and physical activity might influence this impact. To investigate, 24484 American adults from the National Health and Nutrition Examination Survey spanning 1999-2018 were included. Eating duration was assessed via 24-h dietary recall, and all-cause mortality data were sourced from the National Death Index. The relationship between eating duration and all-cause mortality was analysed using Cox proportional hazards regression models, restricted cubic splines and stratification analysis with complex weighted designs. The median (IQR) of eating duration for participants was 12·5 (11·0, 14·0) h. In this study, 2896 death events were observed, and the median follow-up time (IQR) was 125 (77, 177) months. After multivariable adjustment, compared with Q1, Q2, Q3 and Q4 had reduced risks of all-cause mortality by 17, 15 and 13 %, respectively. Furthermore, each additional hour of eating duration was correlated with a 2 % decrease in the risk of all-cause mortality. Additionally, a non-linear dose-response relationship was observed between eating duration and the risk of all-cause mortality, showing a U-shaped relationship from 8·9 h to 15·3 h (P for non-linearity < 0·05). Interestingly, the non-linear dose-response relationship was observed exclusively among individuals with high energy intake or a lightly active physical activity level. These findings suggest potential health benefits from adjusting eating duration, though further prospective studies are needed for validation.

The association of preoperative serum free fatty acid levels with survival in breast cancer patients

Background and objectivesSerum free fatty acids (FFA) are associated with various types of cancer. However, the prognostic value of preoperative serum FFA levels and breast cancer (BC) remains unclear. This study aimed to elucidate the specific relationship between FFA levels and BC outcomes.MethodsA retrospective review was conducted on 4133 patients with BC admitted to Sun Yat-sen Memorial Hospital from January 2015 to October 2021. Preoperative serum FFA levels were detected by the enzymatic endpoint method. The relationship between serum FFA levels and clinical characteristics was analyzed based on FFA interquartile range. Restricted cubic splines and multivariate Cox regression analyses were used to assess the relationship between preoperative serum FFA levels and overall survival (OS) in patients with BC. The hazard ratios (HRs) and 95% confidence intervals (95% CIs) were calculated.ResultsAccording to the FFA interquartile range, FFA levels were significantly correlated with OS (years) (p < 0.001). Restricted cubic spline analysis might reveal a U-shaped relationship between preoperative serum FFA levels and OS, after adjusting for other variables. According to the cutoff points for FFAs, multivariate Cox regression analyses showed that patients with low FFA levels (≤ 250 µmol/L) had higher rates of all-cause mortality and cancer-specific mortality than those with high FFA levels (530–700 µmol/L) in the total population and patients with a BMI of 18.5–24.0 kg/m2. A trend was observed indicating that elevated FFA levels (≥ 715 µmol/L) were associated with worse prognosis; however, this association failed to reach statistical significance.ConclusionsThere might be a nonlinear U-shaped relationship between preoperative serum FFA levels and survival in breast cancer patients, with lower FFA levels associated with worse OS. The effect of elevated FFA levels on prognosis requires further investigation.

The prognostic significance of stress hyperglycemia ratio for all-cause and cardiovascular mortality in metabolic syndrome patients: prospective cohort study.

The stress hyperglycemia ratio (SHR) is a new biomarker indicating acute hyperglycemia and predicting adverse outcomes in different conditions. Yet, its impact on metabolic syndrome (MetS) has not been studied. We explored the link between SHR and long-term all-cause and cardiovascular disease (CVD) mortality in MetS patients. We conducted a large prospective cohort study involving 9438 participants diagnosed with MetS, drawn from the 1999-2018 NHANES. MetS diagnosis was based on NCEP-ATPIII criteria. Participants were categorized into three groups based on SHR tertiles: T1 (SHR ≤ 0.890), T2 (SHR 0.890-0.992), and T3 (SHR ≥ 0.992). Cox regression and Kaplan-Meier curve analyses assessed the correlation between SHR and mortalities. Non-linear correlations were explored using restricted cubic splines, and stratification analysis was performed. Out of 9438 MetS patients, 1929 deaths occurred during an average follow-up of 107 ± 64 months, including 541 CVD deaths. All-cause and CVD mortality rates were significantly higher with elevated SHR values (T3) than lower tertiles (23.4% vs. 19.5% and 18.3%, P < 0.001; 6.8% vs. 5.3% and 5.1%, P = 0.007, respectively). A U-shaped relationship was observed between SHR and all-cause and CVD mortality (all P for non-linear < 0.001). Kaplan-Meier analysis indicated higher SHR values associated with increased risk of all-cause and CVD mortality (all log-rank P < 0.001). After adjusting for confounders, multivariate Cox regression showed SHR remained associated with a 1.256-fold and 1.023-fold risk of all-cause and CVD mortality. SHR independently correlates with all-cause and CVD mortality in MetS patients, displaying a U-shaped relationship with clinical endpoints.

Unveiling Relationship Between Specific Domain, Intensity, and Dose of Physical Activity and Biological Age: A Cross-Sectional Study.

Existing studies have separately explored the association between specific intensity and domain of physical activity (PA) and biological age (BA), potentially impeding more precise guide. We used data of 5216 middle-aged and older adults aged 45 and over to explore and compare the relationship of different domains, intensities, and doses of PA and BA. Transport-related walking and leisure-time moderate-intensity PA (MPA) were significantly associated with younger BA, rather than other intensity of work-related PA. There were U-shaped dose-response relationships between transport-related BA or leisure-time MPA and BA. In subgroup analyses for older adults, all intensities of PA were significantly associated with decreased BA. These findings highlighted the importance of considering the domain, intensity, and dose of PA in designing effective age-delaying interventions.

Inequality through digitalization: investigation of mediating and moderating mechanisms

ABSTRACT This paper investigates how digitalization contributes to inclusive development by analyzing global panel data using fixed-effect models. The main finding is the reverse U-shaped relationship between digitalization and inequality reduction. By testing the moderation and mediation effects, we further illustrate the intricate dynamics of digitalization on inequality. The findings suggest that while digitalization fosters inclusive institutions, it may also foster polarized relationships. Furthermore, we demonstrate that reverse U-shaped effects are particularly pronounced in countries in the global south, indicating a diffusion of relational norms.

Does reducing communication barriers promote diversity?

We study how a reduction in communication cost affects equilibrium diversity (in expertise) in hiring decisions. The key trade-off is that, while hiring a more diverse team may enlarge the team's pool of knowledge, it also makes communication between the hired experts more challenging. Equilibrium diversity balances this trade-off. We find that equilibrium diversity may exhibit a U-shape relationship with communication cost, reaching its lowest point at moderate cost values, where experts' incentives to communicate are most sensitive to changes in diversity.

Monocyte-lymphocyte ratio predicts cardiovascular diseases death in individuals with type 2 diabetes.

Previous studies have shown higher cardiovascular mortality risk with higher monocyte-lymphocyte ratio levels in general population. However, the levels of oxidative stress in individuals with type 2 diabetes are higher than those in the general population, which may affect the link between monocyte-to-lymphocyte ratio and cardiovascular disease deaths. And the association between the monocyte-to-lymphocyte ratio and mortality risk in people with type 2 diabetes still be unknown. This study aimed to investigate the prognostic significance of monocyte-to-lymphocyte ratio in type 2 diabetes. This analysis involved 2,954 individuals with type 2 diabetes from the National Health and Nutrition Examination Survey 1999-2010. The National Death Index records through December 31, 2019, was used to determine all-cause and cardiovascular mortality. The prognostic roles were determined using Cox regression models, restricted cubic spline analysis, and time-dependent receiver operating characteristic curve analysis. During an average follow-up period of 12.4 years, a total of 1,007 deaths occurred, while 252 were due to cardiovascular disease. An elevated monocyte-to-lymphocyte ratio level exhibited a significant dose-response relationship with an increased risk of all-cause mortality (1.34 [95% CI 1.12, 1.60] for all-cause mortality [Ptrend = 0.001]). The multivariable-adjusted HR was 1.81 (95% CI 1.25, 2.63) (Ptrend = 0.001) for cardiovascular mortality indicating a U-shaped relationship (Pnonlinear = 0.013). The results of this study indicate a U-shaped relationship between the monocyte-to-lymphocyte ratio and cardiovascular mortality in individuals with diabetes. Both very low and high monocyte-to-lymphocyte ratio monocyte-to-lymphocyte ratio values were found to be associated with increased cardiovascular mortality risk.

The inverted U-effect of digital financial inclusion on household food carbon footprint in China: The moderating roles of environmental concern and future expectations

Digital financial inclusion (DFI) is an enabler for achieving carbon peak and carbon neutrality. We use China Family Panel Studies (CFPS) data spanning 2014 to 2020 to investigate the impact of DFI on household food carbon footprint (HFCF) in China. We find that (1) DFI has an inverted U-shaped effect on HFCF, changing from promotion to suppression; (2) The impact of DFI on HFCF demonstrates multidimensional heterogeneity. The impact of DFI on HFCF demonstrates multidimensional heterogeneity. The inverted U-shaped relationship is more pronounced in non-agricultural households, households with high-educated head, high-income households, households with unhealthy lifestyle heads, low-status households, households without the Internet, and households in the eastern, central, low-industrialization, high-urbanization and low-environmental regulation region; (3) Environmental concern and future expectations significantly moderate the inverted U-shaped relationship between DFI and HFCF, where environmental concern strengthens and future expectations weaken the effect; (4) Considering the dimensions of DFI, usage depth and digitization level of DFI have nonlinear effects on HFCF, while coverage breadth consistently exerts a positive influence. Policy implications are derived from the research results.