Subjects: Medicine, Pharmacy >> Preventive Medicine and Hygienics submitted time 2024-07-23 Cooperative journals: 《中国全科医学》
Diabetes and Microcirculation Professional Committee of Chinese Society of Microcirculation
Primary Endocrine and Metabolic Diseases Group of the Chinese Society of Endocrinology
Abstract： Diabetic microvascular disease（DMiVD） is the most common chronic complication of diabetes mellitus，and early identification and effective intervention can significantly improve patients' quality of life and prognosis. The Diabetes and Microcirculation Professional Committee of Chinese Society of Microcirculation and the Primary Endocrine and Metabolic Diseases Group of the Chinese Society of Endocrinology have convened experts in the field to revise the Expert Consensus on Screening and Prevention of Diabetic Microvascular Diseases for Primary Care（2024），based on the 2021 edition，considering the latest research advances and the specific needs of primary care. This consensus elaborates the screening methods，comprehensive management and prevention strategies for DMiVD（diabetic retinopathy，diabetic kidney disease，distal symmetric polyneuropathy and diabetic cardiomyopathy），clarifies the graded diagnosis and treatment and referral processes，emphasizes the importance of preventing and treating DMiVD，and offers guidance and recommendations for physicians，particularly primary care physicians and general practitioners. The aim is to reduce the incidence，progression，and disability associated with DMiVD，ultimately lowering morbidity and mortality rates.
Subjects: Medicine, Pharmacy >> Preventive Medicine and Hygienics submitted time 2024-07-23 Cooperative journals: 《中国全科医学》
Abstract： Holistic integrative medicine，abbreviated as HIM，has been officially proposed since 2012. Its theoretical system has been continuously improved，and its practical methods have become increasingly diverse，becoming an inevitable choice and path for the medical development in the new era. This article demonstrates ten major propositions for HIM，elaborating on the connotation and extension of HIM from the perspectives of epistemology and methodology，in order to achieve the transformation and adaptive evolution of modern medicine.
Subjects: Psychology >> Social Psychology Subjects: Psychology >> Psychological Measurement submitted time 2024-07-22
Abstract： Existing research has developed a plethora of tools for measuring pro-environmental behavior, encompassing scales, individual behavioral paradigms, and group games. These tools predominantly hinge upon the behavioral domain, with the most frequently mentioned areas being conservation, transportation, waste disposal, consumption, and social citizenship behaviors (e.g., donation). However, current measurements of pro-environmental behavior face challenges related to low standardization and limited generalizability of results. These issues primarily stem from the prevailing reliance on measurement paradigms grounded in behavioral domains, neglecting the crucial consideration of behavioral attributes, which constitute the defining and distinguishing characteristics of behavior. Future research could address these by developing standardized measurement tools based on behavioral attributes and validating them through the selection of various real-life behaviors as criteria for validity testing.
Subjects: Medicine, Pharmacy >> Other Disciplines of Medicine and Pharmacology submitted time 2024-07-22
Abstract： Bone fracture is an important factor affecting the life quality and mortality of elderly individuals, and its pathogenesis involves the imbalance of bone metabolism maintained by osteoblasts (OB) and osteoclasts (OC). 99Tc-MDP is a drug for the targeted treatment of osteoporosis. While it can directly inhibit OC activity, there have been no in vivo data on its ability to induce OB activity. [Purpose]:This study aim to evaluate the effect of 99Tc-MDP on osteogenesis in the treatment of osteoporosis. [Methods]: In this study, a rat model of osteoporosis after ovariectomy were constructed, and the dynamic changes of osteoblast indexes after 99Tc-MDP treatment were detected at the cellular, metabolic, and genetic levels to evaluate the effect of 99Tc-MDP on osteogenesis in the treatment of osteoporosis. The rat model of osteoporosis can reflect the early process of osteoporosis formation, including calcium loss and bone mineral density decrease. [Results]: 99Tc-MDP effectively inhibited the osteoporosis process and reversed bone mineral density loss by inducing OB activity, achieving the suppression of bone decline at 4 weeks and returning to the preoperative level at 8 weeks. The OB activity induced by 99Tc-MDP was altered to similar levels in OB cells of normal rats, but there was no significant change in the expression of major bone-relatedgenes. The multifactor analysis suggested that IL-6 could be the key factor and monitoring index. [Conclusions]: 99Tc-MDP can stimulate OB activity as a powerful supplement to inhibiting OC activity, which is beneficial to the maintenance of OB/OC homeostasis.
Peer Review Status:
Awaiting Review
Subjects: Nuclear Science and Technology >> Nuclear Science and Technology submitted time 2024-07-22
Abstract： The Printed Circuit Heat Exchanger (PCHE), with its intricate microchannel design, offers unparalleled heat transfer capabilities and is being considered for use in high-temperature reactors. Despite its advantages, the PCHE operates under extreme conditions, such as high temperatures and pressures, which can lead to structural failures if not properly managed. The technological readiness level of PCHEs is currently low, necessitating a detailed analysis of their failure characteristics to ensure safe and reliable operation in nuclear systems. Purpose: The purpose of this study is to design a 20 kW PCHE and investigate its potential failure modes under the demanding conditions of high-temperature and high-pressure environments. This research aims to provide a detailed understanding of the factors that could lead to failure and to propose strategies for enhancing the safety and reliability of PCHEs in nuclear applications. Methods: This study involves the design of a 20 kW PCHE and the analysis of its structural integrity under simulated high-temperature and high-pressure conditions. A partitioned homogenization method is proposed to simplify the complex microchannel structure within the heat exchanger core, facilitating numerical simulations. The study employs finite element analysis with a model consisting of 61017 elements to simulate the temperature fields and stress distributions in the solid domain. The simulations consider the effects of temperature and pressure on the micro and macro scales, providing a comprehensive view of the thermal and mechanical behavior of the PCHE. The model accounts for the thermal and mechanical properties of the materials involved, ensuring an accurate representation of the PCHE's performance under operational conditions. Results: The numerical simulations reveal significant findings. The macro temperature gradient in the solid domain reaches up to 2.7 °C/mm at the hot side inlet, indicating a high risk of thermal stress-induced failure. The temperature distribution across the cold and hot streams is non-uniform, with a maximum temperature difference of 100 °C observed at the outlets. This non-uniformity suggests potential hotspots where thermal stresses could concentrate. Additionally, the creep behavior of Alloy 617, used in the construction of the PCHE, is characterized at 850 °C. The results show that the creep life of the weld samples is significantly shorter than that of the base material, highlighting the vulnerability of the welded joints to long-term thermal exposure. The study also identifies the areas with the highest stress concentrations, which are crucial for understanding the potential for fatigue and ratcheting effects. Conclusion: The study concludes that while PCHEs offer superior thermal performance, their structural integrity under high-temperature and high-pressure conditions requires careful consideration. The identified critical areas, such as the hot side inlet and the welded joints, are particularly susceptible to failure and should be targeted for design improvements. The findings from this research provide a foundation for further studies on the safety assessment of PCHEs, emphasizing the need for robust materials and structural designs to withstand the extreme conditions encountered in high-temperature reactors. The detailed analysis presented in this study contributes to the broader understanding of PCHE failure mechanisms and supports the development of more reliable and safe heat exchanger technologies for nuclear applications. The study's comprehensive approach, integrating design, simulation, and material analysis, sets a precedent for future research in this critical area of nuclear technology.
Subjects: Nuclear Science and Technology >> Nuclear Science and Technology submitted time 2024-07-22
Abstract： [Background] Solving benchmark problems is a significant step in the validation of numerical simulation programs. The Experimental Breeder Reactor II (EBR-II) is a famous benchmark for sodium-cooled fast reactors (SFR), with a complicated spatial distribution of nuclide density. Therefore, simplification to the spatial distribution of nuclide density was adopted in many studies on EBR-II benchmark calculation. [Purpose] This study aims to contrast the difference between the results of the fine model and the simplified model, evaluating the rationality of the simplification. [Method] In this study, both the fine model and the simplified one were built using LoongSARAX, a neutronic numerical program for fast reactors developed by Xi’an Jiao Tong University. Some approximations were adopted in the models: one-dimensional homogenization was adopted for the half-worth driver assembly to handle its complex radial geometry and the super-assembly method was used in the cross-section generation of poison elements. [Results] The results show that in the simplified model, 1) the spatial distribution of fuel nuclide density presents strong asymmetry and strong non-uniformity, 2) calculation time spent in the simplified model is one-tenth of that in the fine model, 3) the effective multiplication factor (keff) is 1383 pcm lower than in the fine model, 4) the spatial distribution of neutron flux is lower in the center and higher in the outer core, compared to that in the fine model, 5) the maximum relative deviation between neutron flux in two models is 4.25%. [Conclusion] In summary, the simplified model has a much lower calculation cost but limited numerical accuracy in keff and neutron flux, compared to the fine model.
Subjects: Chemistry >> Nuclear Chemistry submitted time 2024-07-22
Abstract： Technetium plays an important role in the vitrification of high level radioactive waste (HLW) and the geological disposal of high level radioactive waste (HLW) in the latter part of the nuclear fuel cycle. In this work, an optimized process for extracting technetium from post-treatment nitric acid medium with NTAamide (C8) as extractant was proposed.Based on the principle of NIAamide (C8) to extract technetium, reverse stem technetium ammonium carbonate and oxalic acid to wash impurity ions, a process for extracting and purifying technetium from post-treatment tailings was designed. The results show that the recovery of technetium is 99.9%, and the purification coefficients of Sr, Cs, Zr and Naphthalene in technetium are 6.9×103, 7.9×104, 4.3×102 and 45 respectively.
Subjects: Psychology >> Cognitive Psychology Subjects: Computer Science >> Computer Application Technology submitted time 2024-07-21
Abstract： Cognitive modeling involves instantiating theoretical or model-based knowledge of cognitive processes into computational models and validating these theories by fitting behavioral and/or neuroimaging data. It enhances our understanding of human cognition through quantitative analysis and aids in the study of individual differences. Despite the ability of theory-driven computational models to generate simulated data, their complexity makes it difficult to determine the likelihood function, hindering the estimation of model parameters and comparisons between models based on observed data. This challenge is known as the inverse problem of generative modeling, and in response to the dilemma that the likelihood function is impossible or difficult to compute, which in turn gave rise to likelihood-free inference.
likelihood-free inference, a case of simulation-based inference, which uses simulated data to approximate or circumvent the calculation of the likelihood function. This method enables the fitting and evaluation of the model. Approximate Bayesian Computation (ABC) and Probability Density Approximation (PDA) are two common techniques used in likelihood-free inference. ABC compares simulated data to observed data, while PDA uses a kernel density estimator to approximate the likelihood function. Both methods are powerful tools for model selection and parameter estimation, particularly when the likelihood function is intractable or unknown. However, these methods may suffer from the curse of dimensionality, as the number of model parameters increases, the computational cost and complexity of the simulation-based approaches grow exponentially, which can make the methods impractical for high-dimensional data and models.
Advances in deep learning and neural network technologies have led to the emergence of a new neural simulation-based inference (NSBI). NSBI leverages the power of deep learning to address the limitations of traditional simulation-based methods. NSBI possesses an amortization property, which allows the generation of a large amount of simulated data to be integrated into the training process. Consequently, once the neural network is trained, the inference step can be performed without the need for generating additional simulated data, significantly reducing computational overhead. Furthermore, with the advancement of neural conditional probability density estimation techniques, such as Normalizing Flows, NSBI can easily train models to estimate likelihood functions and posterior distribution functions. Neural posterior estimation methods, which offer a departure from conventional ABC techniques, directly sample from the posterior distribution using input data. Similarly, neural likelihood estimation methods, a substitute for PDA, compute likelihood values by leveraging both input data and prior parameters. These techniques enable the construction of flexible and complex cognitive models, making NSBI a promising approach for likelihood-free inference in high-dimensional settings.
NSBI has gained significant attention in the field of cognitive modeling and has been applied to various scenarios, including likelihood estimation, posterior estimation, and model comparison. For instance, neural likelihood networks such as LANs and MNLE are employed to estimate the likelihood function for intricate cognitive models, with MNLE being particularly adept at handling mixed data types with both continuous and discrete variables. In parameter inference for cognitive models, Bayesflow stands out as a neural posterior network capable of tackling a diverse array of complex models. For model comparison, Evidence Networks and Hierarchical Evidence Networks are utilized, with the Hierarchical variant being well-suited for nested data structures. Tools such as LANs, sbi, and Bayesflow are continuously optimizing the workflow of neural network-based simulation inference. These advancements have enabled NSBI to be applied to large-scale studies involving over a million data points, allowing for the construction of complex models that were previously difficult to build. This approach not only facilitates rapid validation of models and theories but also helps identify flaws and optimize performance, making NSBI a transformative technique with the potential to revolutionize the understanding and analysis of intricate systems.
While these new technologies show promise in cognitive modeling, this paper also discusses their limitations and offers constructive guidance for their use. The paper discusses the trade-offs of neural network training costs and model accuracy, the integration of NSBI methods for comprehensive analysis, and the importance of effective training for reliable models. It also emphasizes the potential for these technologies to enhance interdisciplinary collaboration, particularly between neuroscience, cognitive modeling, and other fields, to deepen our understanding of the mind and brain.
Peer Review Status:Awaiting Review
Subjects: Nuclear Science and Technology >> Nuclear Detection Technology and Nuclear Electronics submitted time 2024-07-21
Abstract：页岩是页岩气形成的物质基础，页岩岩性复杂、矿物成分变化大，依靠常规测井资料进行储层评价具有挑战性。FLex测井技术测量快中子与地层元素作用产生的γ射线能谱，通过解谱分析后获得地层的元素含量与矿物成分，从岩石化学成分角度为非常规储层的岩性评价开辟了一条新的道路。利用FLex元素测井岩石矿物解释模型对页岩岩相进行识别和划分，对页岩储层的脆性进行定量评价。研究表明，龙马溪组以硅质页岩为主，具有脆性矿物发育，黏土含量较低的特点，龙马溪组页岩可压性中等，具有一定的储层改造潜力，元素测井技术在页岩储层品质和可压性评价应用前景广泛。
Subjects: Nuclear Science and Technology >> Nuclear Science and Technology submitted time 2024-07-21
Abstract： As nuclear energy is developed on a large scale, traditional uranium resources from mines have shown a trend of shortage, and uranium extraction from seawater is likely to be one of the most viable ways to obtain large-scale uranium resources in the future. Photocatalysis, with its advantages of low pollution, low energy consumption, and high material recycling rate, has become an important direction in the research of uranium extraction from seawater in recent years, focusing on the preparation and selection of photocatalysts. Graphite phase carbon nitride photocatalyst is relatively inexpensive and stable, making it an ideal photocatalyst; titanium dioxide photocatalyst can effectively reduce hexavalent uranium in radioactive wastewater to stable tetravalent uranium, with high activity, good stability, and environmental friendliness. This project combines the photocatalytic advantages of the several materials to prepare a magnetic composite photocatalyst made from graphite phase carbon nitride and titanium dioxide, with magnetism added to better control the catalyst in the solution and for use in seawater uranium extraction experiments. The results show that the composite catalyst has an efficiency of up to 76% in photocatalytic extraction of uranium from seawater, offering a promising new pathway for the development of uranium resources.
Subjects: Psychology >> Management Psychology submitted time 2024-07-20
Abstract： Employee creativity has attracted academic attention for a long time, yet the treatment of creativity as a uni-dimensional construct raises concerns in related theoretical and practical developments. In 2011, Gilson and Madjar proposed for the first time to divide creativity into radical and incremental creativity. Subsequently, a series of theoretical and empirical studies emerged. By reviewing 79 articles over the last 13 years, this paper examines the theoretical basis and empirical evidence to distinguish these two types of creativity. The results indicate that although some studies have outlined the theoretical differences between radical and incremental creativity, only half of the reviewed studies have incorporated these differences in formulating research questions and theoretical models. In terms of empirical examination, some studies have provided evidence of discriminant validity for measurement tools, but the majority have not directly explored the distinct impacts of radical and incremental creativity. It is worth mentioning that over forty percent of the studies reviewed either failed to theoretically differentiate between the two types of creativity or provide empirical evidence of their distinctiveness. In conclusion, future studies should aim for coherence across theoretical basis, research question formulation, model construction, and empirical testing in uncovering the fundamental differences and unique impacts of these two forms of creativity. Finally, we propose recommendations to enhance the differentiation between radical and incremental creativity, along with suggested research questions for further exploration.
Subjects: Nursing >> Nursing submitted time 2024-07-20
Abstract： Objective To observe the effect of the integrated traditional Chinese and Western medicine comprehensive nursing management model on patients with hypothetical tumors.Methods A total of 60 patients with tumor deficiency syndrome were selected as the research objects, and they were divided into control group and observation group according to different intervention regimens, with 30 cases in each group. The control group was given routine nursing, and the observation group was treated with traditional Chinese and Western medicine on the basis of conventional treatment and nursing, and 10 days was one course of treatment. To compare the efficacy of the two groups in the treatment of constipation.Results The time of first defecation in the observation group was (24.16±1.38) h, which was shorter than that in the control group (32.02±2.32) h, and the results were statistically different (P<0,05). The total effective rates of the observation group and the control group were 93.4% and 73.3%, respectively, and the efficacy of the observation group was better than that of the control group (P<0.05). The SDS and SAS scores in the observation group were significantly lower than those in the control group (P<0.01). The quality of life of the observation group was significantly improved compared with that of the control group (P<0.05 and 0.01 P<0.01).Conclusion The intervention of the comprehensive nursing management mode of integrated traditional Chinese and Western medicine on the basis of conventional treatment and nursing can effectively improve the health status and quality of life of patients with constipation associated with tumor deficiency syndrome, which is worthy of clinical promotion.
Peer Review Status:Awaiting Review
Subjects: Psychology >> Developmental Psychology submitted time 2024-07-19
Abstract： Although social emotional issues in children and adolescents have received increasing attention, there is currently a lack of specialized image libraries designed to elicit their social emotions. This study establishes a Chinese Social Emotional Image Library suitable for eliciting social emotions in Chinese children and adolescents through two studies. Study 1 employed semi-structured interviews to explore the sources of social emotions in children and adolescents, finding that their emotions primarily stem from social scenes involving interpersonal interactions. Based on Study 1, Study 2 collected emotional images corresponding to these social scenes and experimentally assessed the arousal, valence, and motivation of the collected social emotional images. Study 2 revealed that positive, neutral, and negative social emotional images not only differ significantly in their ratings across dimensions but also exhibit high internal consistency reliability within each dimension. These findings indicate that the library has good validity and reliability, serving as a reliable tool for eliciting social emotions in Chinese children and adolescents.
Peer Review Status:Awaiting Review
Subjects: Nuclear Science and Technology >> Nuclear Science and Technology submitted time 2024-07-19
Abstract： [Background]: With the development of digital control technology, the traditional instrument and control system based on analog quantity in nuclear power plant is gradually replaced by full digital technology, and it is possible to use more complex and efficient advanced control technology. Making full use of the advantages of system information in the process of digitization of the whole plant to improve the automation level of nuclear power plant has gradually become the focus of research on pressurized water reactor control system. The control systems of Pressurizer Water Reactor (PWR) nuclear power plant are based on traditional Proportional Integral Derivative (PID) controller. Although there are studies on improving the control performance of PWR NPP control systems by advanced control algorithms, such as neural network control, fuzzy control and model predictive control, most of them only focus on the control system itself without considering the interconnection and coupling among multiple control systems. The operation task of PWR nuclear power plant needs to be coordinated by multiple control systems at the same time, and the effect of improving the overall performance by simply improving the performances of the controllers are limited. [Purpose]: To comprehensively consider the coupling effect among control systems, coordinate multiple control systems from the top level to optimize the overall control performances and achieve better task execution results, a setpoint decision optimization system is proposed. [Methods]: The intelligent decision system for PWR control system was optimized based on particle swarm optimization (PSO) method. The decision objective function and operation constraint conditions of the intelligent decision system were proposed. Considering the actual operation of PWR, the system optimized the setpoint offline and the intelligent decision operation was performed online according to the operation condition to provide the directions and amplitudes of the control targets for the underlying control systems. The typical operation process of the PWR NPP was taken as an example to carry out the simulation of the deigned intelligent decision-making system, and the simulation results were analyzed. [Results]: Compared with the control scheme using traditional setpoints, the ITSE (Integral of Time multiplied by the Square Error) value of average coolant temperature, pressurizer level, pressurizer pressure and steam generator level was decreased by 58.9%, 67.7%, 99.9% and 83.3%, respectively. The peak value was decreased by 62.4%, 3.0%, 100% and 66.3% respectively. The simulation results show that the system proposed in this paper can effectively reduce the ITSE and peak value of the system. The overall control performances and safety margin of the control systems of PWR NPP are improved. In practical engineering practice, it can be combined with digital twin technology to use the characteristics of the digital twin that can synchronously reflect the real state of the system for more accurate online setpoint optimization, so as to achieve better control performance.
Subjects: Medicine, Pharmacy >> Clinical Medicine submitted time 2024-07-19 Cooperative journals: 《中国全科医学》
Abstract： Background China's aging population is expanding rapidly，highlighting the imperative of successful aging as a critical health management goal. Effective menopause management plays a crucial role but remains a significant challenge. Objective To construct a comprehensive health management evaluation indicator system for menopausal women based on the modified Delphi method. Methods Between September 2023 and February 2024，a preliminary construction of the comprehensive health management evaluation indicator system for menopausal women was executed via literature review and group discussion. 25 experts in the realms of climacteric health and related fields were selected as conference participants and correspondence subjects. Two rounds of electronic questionnaires using modified Delphi method were conducted，and the survey results were statistically analyzed using SPSS 24.0 software. Results The positive coefficients of the two rounds of expert correspondence were 100%，with the authoritative degree of expert opinions were 0.932 and 0.949，respectively. In the initial round，the primary and secondary indicators were assigned mean importance scores ranging from 4.44 to 4.84 and 4.00 to 4.88， respectively，alongside Kendall's W coefficients of concordance at 0.194（P=0.001） and 0.187（P<0.001）.The second round yielded mean importance scores for the primary and secondary indicators within the ranges of 4.44 to 4.84 and 3.84 to 4.96，with corresponding Kendall's W coefficients of 0.146（P=0.006）and 0.326（P<0.001），reflecting a notable enhancement in expert agreement for the secondary indicators. The tertiary indicators received mean rationality scores of 4.24 to 4.68（4.47±0.10） in the first round and 4.08 to 4.72（4.51±0.15）in the second，with Kendall's W coefficients of 0.063（P=0.025）and 0.129 （P<0.001），indicating a trend towards uniformity in expert opinions. The ultimate construction of the comprehensive health management evaluation indicator system for menopausal women encompasses five primary indicators：basic information， lifestyle，symptom assessment，laboratory tests，and key disease screenings. Additionally，it includes 34 secondary indicators such as age，duration since menopause，body mass index，and waist circumference，and so on. Each of these secondary indicators is meticulously subdivided and quantified to establish tertiary indicators，thereby providing a granular framework for assessment. Conclusion The indicator system，constructed through the modified Delphi method，is endowed with substantial authority and scientific rigor. It offers a holistic assessment of the health status of menopausal women，with a detailed classification and valuation of specific indicators. This systematic approach is conducive to comprehensive and stratified patient management by clinical practitioners，providing a valuable framework for clinical guidance and reference. Nonetheless，the efficacy of its practical application merits ongoing validation through empirical research.
Subjects: Medicine, Pharmacy >> Clinical Medicine submitted time 2024-07-19 Cooperative journals: 《中国全科医学》
Abstract： Background Neutrophil-to-lymphocyte ratio（NLR）has been shown to have significant predictive value for all-cause mortality risk in Patients with Maintenance Hemodialysis（MHD）in previous studies，however，whetherC-reactive protein-to-albumin ratio（CAR）and the combination of NLR and CAR can enhance the predictive value for all#2;cause mortality risk in Patients with MHD has not been investigated. Objective To investigate the combined predictive value of NLR and CAR for all-cause mortality of MHD patients，and to provide evidence for improving the quality of life of MHD patients. Methods The case data of 175 MHD patients in the blood purification center of Hainan General Hospital in January 2017 were included，the deadline was December 31，2021，with the outcome of all-cause death. Receiver operating characteristic（ROC） curves were plotted for the predictive value of NLR+CAR，NLR，and CAR for the risk of all-cause death in MHD patients. Kaplan-Meier survival curve was used to compare the cumulative survival rate between the two groups. Cox regression analysis was used to analyze the independent risk factors of 5-year all-cause death in MHD patients. Results The area under the ROC curve （AUC）of NLR for predicting the risk of all-cause death in MHD patients was 0.743（95%CI=0.669-0.817，P<0.001）. The AUC of CAR for predicting the risk of all-cause death in MHD patients was 0.710（95%CI=0.627-0.794，P<0.001）. The AUC of NLR+CAR for predicting the risk of all-cause death in MHD patients was 0.799（95%CI=0.732-0.867，P<0.001）. Kaplan#2;Meier survival curve analysis showed that patients with NLR>4.93 had lower cumulative survival than patients with NLR ≤ 4.93 （χ2 =32.753，P<0.001）. The patients with CAR>0.795 had a lower cumulative survival than patients with CAR ≤ 0.795 （χ2 =38.091，P<0.001）. According to the results of the multiple Cox regression equation，dialysis age（HR=0.984， 95%CI=0.976-0.992），ferritin（HR=0.984，95%CI=0.976-0.992），25-（OH）VD（HR=0.964，95%CI=0.941-0.987） and triglyceride（HR=0.984，95%CI=0.976-0.992）were protective factors for all-cause mortality in 5-year MHD patients； NLR>4.93（HR=2.071，95%CI=1.226-3.499）and CAR>0.795（HR=1.903，95%CI=1.155-3.136）were independent risk factors for all-cause death in 5-year MHD patients（P<0.05）. Conclusion Compared with NLR or CAR alone，the combination of NLR and CAR can better predict the risk of all-cause mortality in MHD patients. Increased NLR and CAR were independent risk factors for all-cause mortality in 5-year MHD patients.
Subjects: Medicine, Pharmacy >> Clinical Medicine submitted time 2024-07-19 Cooperative journals: 《中国全科医学》
Abstract： Background The prevalence of non-alcoholic fatty liver disease（NAFLD） significantly increases in patients with type 2 diabetes mellitus（T2DM）. However，the correlation of NAFLD with visceral fat area（VFA） and thyroid nodules in T2DM patients has been rarely reported. Objective This study aims to investigate the influencing factors for NAFLD in T2DM patients，and the correlation of NAFLD with VFA，thyroid nodules，and thyroid function in this population. Methods Hospitalized T2DM patients in the Department of Endocrinology，the Fourth Affiliated Hospital of Guangxi Medical University（Liuzhou Worker's Hospital） from January 2018 to April 2023 were retrospectively recruited. They were divided into two groups based on abdominal ultrasound findings：NAFLD group and non-NAFLD group. General data，including VFA， subcutaneous fat area（SFA），insulin function，thyroid function，prevalence of thyroid nodules，blood glucose levels，lipid levels，and liver and kidney function were compared between the two groups. Additionally，patients were divided into visceral obesity group（VFA ≥ 100 cm2 ） and non-visceral obesity group（VFA < 100 cm2 ） based on VFA. Age，sex，prevalence of NAFLD and thyroid nodule were compared between the two groups. Pearson and Spearman correlation analyses were employed to investigate factors associated with NAFLD and VFA，as well as their correlation with thyroid nodules. Influencing factors for the volume of thyroid nodules were explored as well. Furthermore，binary logistic regression analysis was used to determine risk factors for both NAFLD and thyroid nodules in T2DM patients. Receiver operating characteristic（ROC） curve analysis evaluated the predictive value of BMI，waist-hip circumference，and waist-hip ratio，VFA，homeostatic model assessment for insulin resistance（HOMA-IR）in predicting NAFLD in T2DM patients and their optimal cut-off values. Results A total of 578 T2DM patients were enrolled in this study，including 293 （50.69%） patients in the NAFLD group and 285 in the non#2;NAFLD group. The age of the NAFLD group was significantly lower than that of non-NAFLD group(P<0.05). Compared to those of the non-NAFLD group，patients in the NAFLD group had significantly higher body weight，body mass index （BMI），waist circumference，hip circumference，VFA，SFA，glycated hemoglobin A1C （HbA1c），fasting insulin levels（FINS），fasting C-peptide levels（FCP），HOMA-IR，homeostasis model assessment of β-cell function（HOMA-β），free triiodothyronine levels（FT3），blood uric acid（UA），total cholesterol （TC），triglyceride（TG） and C-reactive protein（CRP），but significantly lower serum creatinine（Cr） （P<0.05）. There were 251 cases in the visceral obesity group and 327 cases in the non-visceral obesity group. The age of the visceral obesity group was significantly lower than that of the non-visceral obesity group （P<0.05）. The incidence of NAFLD was significantly higher in the visceral obesity group than that of non-visceral obesity group （P<0.05）. However，there was no significant difference in the prevalence of thyroid nodules between the visceral obesity group and non#2;visceral obesity group （P>0.05）. Spearman correlation analysis revealed that the occurrence of NAFLD in T2DM patients was positively correlated with body mass，BMI，waist circumference，hip circumference，waist-to-hip ratio， VFA，SFA，HbA1c，FINS，FCP，HOMA-IR，HOMA-β ，triiodothyronine （TT3），FT3，and CRP （P<0.05）， but negatively correlated with age （P<0.05）. VFA in T2DM patients was found to be significantly correlated with gender， age，height，body mass，BMI，waist circumference，hip circumference，waist-to-hip ratio，SFA，diastolic blood pressure （DBP），FINS，FCP，HOMA-IR，HOMA-β，TT3，FT3，CRP and NAFLD （P<0.05）. The thyroid nodule area showed a negative correlation with TSH and waist-to-hip ratio （P<0.05），while it showed positive correlations with sex，age，TT3 ，TT4 and thyroglobulin （P<0.05）. Univariate unconditional logistic regression analysis revealed that age，weight，BMI， waist circumference，hip circumference，VFA，SFA，HbA1c，FCP，HOMA-IR，FT3，Cr，UA，TC and TG were theinfluencing factors for NAFLD in T2DM patients. Binary logistic regression results demonstrated that body weight， VFA，SFA，FT3 and HOMA-IR were the risk factors for NAFLD in T2DM patients. Gender，age and FT4 were risk factors for thyroid nodules in T2DM patients （P<0.05）. ROC curve results showed that the area under the curve （AUC） of BMI，waist circumference，hip circumference，waist-to-hip ratio，VFA and HOMA-IR was 0.704，0.704，0.705，0.629，0.757，and 0.569，respectively. The optimal cut-off value，sensitivity and specificity of them were listed as follows：BMI （25.37 kg/m2）， waist circumference （84.5 cm），hip circumference （96.5 cm），waist-to-hip ratio （0.895），VFA （88.4 cm2 in female and 99.45 cm2 in male），and HOMA-IR （3.08）. Conclusion The prevalence of NAFLD and thyroid nodules in T2DM patients significantly increase，but not correlated. Obese T2DM patients，especially those with visceral obesity，are more likely to suffer from NAFLD，thyroid nodules，hyperlipidemia，hyperuricemia and other metabolic diseases. HOMA-IR is a risk factor for NAFLD in T2DM patients， but it is not a risk factor for thyroid nodules. BMI，waist circumference，hip circumference and VFA are predictive factors of NAFLD in T2DM patients，and VFA has the highest diagnostic value and HOMA-IR has the lowest value. VFA predicts NAFLD in T2DM patients with the optimal cut-off value of 88.4 cm2 ，which is equal in females and 99.45 cm2 in males.
Subjects: Psychology >> Social Psychology submitted time 2024-07-19
Abstract： Previous studies have demonstrated inconsistencies in moral judgments of the same behavior among decision-makers, victims, and bystanders in a specific moral situation. Yet no study has examined how the experience of being decision-maker or victims can influence individuals’ moral judgments when they are third-party bystanders. The present study employed a modified harm paradigm combined with event-related potential (ERP) techniques to investigate the how the experiences of different moral roles modulates third-party moral judgments. Two experiments were included in the study. Each experiment consisted of two tasks: a moral role priming task and a main task of moral judgment. In the priming task, participants were assigned to one of three groups: decision-maker perspective group, victim perspective group, or the control group. Decision-makers groups needed to complete moral decision tasks while the victims group needed to undertake the decision of the decision-maker and to evaluate others’ decisions. The control group did not have a priming task. After the priming task, all the three groups need to undertake the main task, participants were instructed to judge the morality of decisions made by anonymous decision makers as a third party observer. Experiment 1 was a behavioral study involving 90 healthy adults (44 males, mean age 20.58 ± 1.92 years). A 3 (Moral Role Perspective: Decision-maker, Victim, Control) × 3 (Decision-makers’ Benefit: High, Medium, Low) × 2 (Decision Outcome: Accept, Reject) mixed design was used. Experiment 2 is an Event-related potentials study, with 54 healthy adults (28 males, mean age 21.18 ± 2.21 years) participated. A 2 (Moral Role Perspective: Decision-maker, Victim) × 2 (Decision-makers’ Benefit: High, Low) × 2 (Decision Outcome: Accept, Reject) mixed design was used. Behavioral results indicated that different moral role perspective priming did influence moral judgments, with individuals in the victim perspective group making stricter judgments compared to those in the decision-maker and control perspectives groups. Furthermore, the decision-makers’ benefit received from the immoral decisions can moderated this effect, with higher benefits leading to greater differences in moral judgments between groups. ERP results revealed that in the victim perspective group smaller N1 amplitudes and significantly larger FRN amplitudes were induced compared to the decision-maker perspective group when observing other’s decisions. Additionally, FRN amplitudes exhibited consistent patterns with the behavioral results: individuals in the victim perspective group showed significantly larger FRN amplitudes for accepted decisions compared to rejected ones, whereas this difference was not significant for those primed with the decision-maker perspective. No differences were found in the late component P3 across different perspectives. In conclusion, prior moral role experiences does influence individuals’ moral evaluations as third-party judges and this influence are moderated by the decision-maker’s benefit receiving from harming others. This effect occur primarily during the early emotional arousal stage rather than the later cognitive stage during the processing of moral decisions. These findings provide valuable insights into the flexibility in moral judgments and how past experiences shapes our moral standards.
Peer Review Status:Awaiting Review
Subjects: Biology >> Other Disciplines of Biology submitted time 2024-07-19
Abstract： The assumption of biological nature remains a cornerstone and central topic in evolutionary biology. Darwin’s natural selection theory initially focused on individual selection, based on the fundamental assumption of organisms’ inherent self-interest. This theory was unable to account for the "altruistic behavior" seen in bees and ants, leading to the critical "altruism dilemma," also known as the "Darwinian dilemma." To address this issue, scholars proposed several other theories of selection including group, kinship, gene, and multilevel selection. These theories, beyond individual selection, propose the existence of an "altruistic nature" in organisms, broadly termed "the existence theory of altruistic nature." However, using this framework to explain the behavior of organisms, including humans, leads to many contradictions and ongoing debates. Only by discarding the "existence theory of altruistic nature" and adhering to the "non-existence theory of altruistic nature," also known as "selfish nature theory" or "monistic nature theory," can these problems be resolved. The "existence theory of altruistic nature" is divided into three branches: "In-Group Altruism by Nature," "In-Group Diverse Nature Theory," and "Dual Nature Theory." Due to article length constraints, the analysis is divided into three papers. This paper robustly argues that "Dual Nature Theory" is untenable based on several grounds, including violations of the principles of symmetry and simplicity, definitional contradictions, genetic inconsistencies, intrinsic nature contradictions, and conflicts among the three theories themselves.
Peer Review Status:Awaiting Review
Subjects: Biology >> Biological Evolution Subjects: Psychology >> Other Disciplines of Psychology submitted time 2024-07-19
Abstract： The assumption of biological nature is a foundational and central issue in evolutionary biology. Darwin’s theory of natural selection was initially framed around individual selection, premised on inherent self-interest in organisms. However, it failed to explain the "altruistic behavior" observed in species like bees and ants, giving rise to the critical "altruism dilemma," also known as the "Darwinian dilemma." To tackle this issue, scholars introduced several theories of selection such as group, kinship, gene, and multilevel selection. Beyond individual selection, these theories acknowledge an "altruistic nature" within organisms, collectively referred to as "the existence theory of altruistic nature." Applying this theory to explain the behavior of organisms, including humans, still results in numerous contradictions and continuous debates. Only by rejecting the "existence theory of altruistic nature" and embracing the "non-existence theory of altruistic nature," also known as "selfish nature theory" or "monistic nature theory," can we resolve these complexities. The "existence theory of altruistic nature" is subdivided into three branches: "In-Group Altruism by Nature," "In-Group Diverse Nature Theory," and "Dual Nature Theory." Due to constraints in length, this analysis is conducted over three papers. This paper thoroughly demonstrates the fallacies of the "In-Group Diverse Nature Theory" from various angles, including contradictions with principles of natural science, lack of empirical research premises, and the inability of hypothetAnalyzing "In-Group Altruism by Nature"ical data to represent the actual population.
Peer Review Status:Awaiting Review
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