Glomerular filtration rate and comorbidity factors in elderly hospitalizations

BACKGROUND With an increase in the elderly population,the frequency of hospitalizations in recent years has also risen at a rapid pace.This,in turn,has resulted in poor outcomes and costly treatments.Hospitalization rates increase in elderly patients due to a decline in glomerular filtration rate(GFR).AIM To investigate the connection between GFR and comorbidity and reasons for hospitalization in elderly patients.METHODS We analyzed patients aged 75 years and over who were admitted to the internal medicine clinic of a tertiary hospital in Eskisehir.At admission,we calculated GFR values using the Modification of Diet in Renal Disease study formula and classified them into six categories:G1,G2,G3a,G3b,G4,and G5.We analyzed associations with hospitalization diagnoses and comorbidity factors.RESULTS The average age of the patients was 80.8 years(±4.5 years).GFR was 57.287±29.5 mL/kg/1.73 m2 in women and 61.3±31.5 mL/kg/1.73 m2 in men(P=0.106).Most patients were admitted to the hospital at G2 stage(32.8%).The main reasons for hospitalization were anemia(34.4%and 28.6%)and malnutrition(20.9%and 20.8%)in women and men,respectively(P=0.078).The most frequent comor-bidity leading to hospitalization was arterial hypertension(n=168,28%),fo-llowed by diabetes(n=166,27.7%)(P=0.001).CONCLUSION When evaluating geriatric patients,low GFR alone does not provide sufficient information.Patients’comorbid factors should also be taken into account.There is no association between low GFR during hospitalization and hospitalization-Hamarat H.Aging and GFR related diagnoses.Knowing the GFR value before hospitalization will be more informative in such studies.

Heat exposure and hospitalizations for chronic kidney disease in China: a nationwide time series study in 261 major Chinese cities

Background:Climate change profoundly shapes the population health at the global scale.However,there was still insufficient and inconsistent evidence for the association between heat exposure and chronic kidney disease(CKD).Methods:In the present study,we studied the association of heat exposure with hospitalizations for cause-specific CKD using a national inpatient database in China during the study period of hot season from 2015 to 2018.Standard time-series regression models and random-effects Meta-analysis were developed to estimate the city-specific and national averaged associations at a 7 lag-day span,respectively.Results:A total of 768,129 hospitalizations for CKD was recorded during the study period.The results showed that higher temperature was associated with elevated risk of hospitalizations for CKD,especially in sub-tropical cities.With a 1℃ increase in daily mean temperature,the cumulative relative risks(RR)over lag 0-7 d were 1.008[95% confidence interval(CI)1.003-1.012]for nationwide.The attributable fraction of CKD hospitalizations due to high temperatures was 5.50%.Stronger associations were observed among younger patients and those with obstructive nephropathy.Our study also found that exposure to heatwaves was associated with added risk of hospitalizations for CKD compared to non-heatwave days(RR=1.116,95%CI 1.069-1.166)above the effect of daily mean temperature.Conclusions:Short-term heat exposure may increase the risk of hospitalization for CKD.Our findings provide insights into the health effects of climate change and suggest the necessity of guided protection strategies against the adverse effects of high temperatures.

Prediction model establishment and validation for enteral nutrition aspiration during hospitalization in patients with acute pancreatitis

BACKGROUND Acute pancreatitis(AP)is a disease caused by abnormal activation of pancreatic enzymes and can lead to self-digestion of pancreatic tissues and dysfunction of other organs.Enteral nutrition plays a vital role in the treatment of AP because it can meet the nutritional needs of patients,promote the recovery of intestinal function,and maintain the barrier and immune functions of the intestine.However,the risk of aspiration during enteral nutrition is high;once aspiration occurs,it may cause serious complications,such as aspiration pneumonia,and suffocation,posing a threat to the patient’s life.This study aims to establish and validate a prediction model for enteral nutrition aspiration during hospitalization in patients with AP.AIM To establish and validate a predictive model for enteral nutrition aspiration during hospitalization in patients with AP.METHODS A retrospective review was conducted on 200 patients with AP admitted to Chengdu Shangjin Nanfu Hospital,West China Hospital of Sichuan University from January 2020 to February 2024.Clinical data were collected from the electronic medical record system.Patients were randomly divided into a validation group(n=40)and a modeling group(n=160)in a 1:4 ratio,matched with 200 patients from the same time period.The modeling group was further categorized into an aspiration group(n=25)and a non-aspiration group(n=175)based on the occurrence of enteral nutrition aspiration during hospitalization.Univariate and multivariate logistic regression analyses were performed to identify factors influencing enteral nutrition aspiration in patients with AP during hospitalization.A prediction model for enteral nutrition aspiration during hospitalization was constructed,and calibration curves were used for validation.Receiver operating characteristic curve analysis was conducted to evaluate the predictive value of the model.RESULTS There was no statistically significant difference in general data between the validation and modeling groups(P>0.05).The comparison of age,gender,body mass index,smoking history,hypertension history,and diabetes history showed no statistically significant difference between the two groups(P>0.05).However,patient position,consciousness status,nutritional risk,Acute Physiology and Chronic Health Evaluation(APACHE-II)score,and length of nasogastric tube placement showed statistically significant differences(P<0.05)between the two groups.Multivariate logistic regression analysis showed that patient position,consciousness status,nutritional risk,APACHE-II score,and length of nasogastric tube placement were independent factors influencing enteral nutrition aspiration in patients with AP during hospitalization(P<0.05).These factors were incorporated into the prediction model,which showed good consistency between the predicted and actual risks,as indicated by calibration curves with slopes close to 1 in the training and validation sets.Receiver operating characteristic analysis revealed an area under the curve(AUC)of 0.926(95%CI:0.8889-0.9675)in the training set.The optimal cutoff value is 0.73,with a sensitivity of 88.4 and specificity of 85.2.In the validation set,the AUC of the model for predicting enteral nutrition aspiration in patients with AP patients during hospitalization was 0.902,with a standard error of 0.040(95%CI:0.8284-0.9858),and the best cutoff value was 0.73,with a sensitivity of 91.9 and specificity of 81.8.CONCLUSION A prediction model for enteral nutrition aspiration during hospitalization in patients with AP was established and demonstrated high predictive value.Further clinical application of the model is warranted.

Beyond Equations:The Challenge of Mathematical Rigor in Economics

The mathematical approach is threatening the progress of economics,as it tends to disregard the complexity of economic behaviour and the unpredictability of human actions.——Friedrich Hayek The reliance on mathematical models in economics has long been debated,with critics arguing that this approach fails to capture the complexity of human behavior and the unpredictability of economic systems.While mathematics provides a structured method for analyzing economic processes,it often simplifies decision-making to a one-dimensional utility function,neglecting social,psychological,and political influences.This paper examines the limitations of classical and neoclassical economic theories that heavily depend on mathematical rigor,highlighting the pitfalls of models like the Rational Agent Model,General Equilibrium Theory,and Expected Utility Theory.Drawing on examples such as the 2008 financial crisis and the Terra/Luna cryptocurrency collapse,the paper demonstrates how over-reliance on equations has led to inaccurate predictions and ineffective policy decisions.It calls for a more interdisciplinary approach that integrates insights from psychology and sociology to address the gaps left by traditional mathematical economics.

Critical Analysis of Increasingly Mathematical Economics in the Modern Society

This paper critically examines the escalating trend of mathematization in economics,highlighting its implications and controversies in contemporary economic research.While the application of sophisticated mathematical models and statistical techniques has enhanced the precision,rigor,and status of economics within academia and practical application,concerns arise regarding the potential oversimplification and detachment from real-world complexities.The adoption of mathematical tools has arguably led to a focus on theoretically tractable problems at the expense of those more relevant to practical economic and social issues.This paper explores both the benefits and limitations of this trend,discussing how the reliance on quantitative methods affects the innovation,comprehensibility,and application of economic theories.We argue for a balanced approach that fosters innovation by integrating qualitative insights and embracing interdisciplinary methods to ensure economics remains both rigorous and relevant to societal needs.

Impact of COVID-19 on liver transplant recipients: A nationwide cohort study evaluating hospitalization, transplant rejection, and inpatient mortality

BACKGROUND The coronavirus disease 2019(COVID-19)pandemic has posed a major public health concern worldwide.Patients with comorbid conditions are at risk of adverse outcomes following COVID-19.Solid organ transplant recipients with concurrent immunosuppression and comorbidities are more susceptible to a severe COVID-19 infection.It could lead to higher rates of inpatient complications and mortality in this patient population.However,studies on COVID-19 outcomes in liver transplant(LT)recipients have yielded inconsistent findings.AIM To evaluate the impact of the COVID-19 pandemic on hospital-related outcomes among LT recipients in the United States.METHODS We conducted a retrospective cohort study using the 2019–2020 National Inpatient Sample database.Patients with primary LT hospitalizations and a secondary COVID-19 diagnosis were identified using the International Classi-fication of Diseases,Tenth Revision coding system.The primary outcomes included trends in LT hospitalizations before and during the COVID-19 pandemic.Secondary outcomes included comparative trends in inpatient mortality and transplant rejection in LT recipients.RESULTS A total of 15720 hospitalized LT recipients were included.Approximately 0.8% of patients had a secondary diagnosis of COVID-19 infection.In both cohorts,the median admission age was 57 years.The linear trends for LT hospitalizations did not differ significantly before and during the pandemic(P=0.84).The frequency of in-hospital mortality for LT recipients increased from 1.7% to 4.4% between January 2019 and December 2020.Compared to the pre-pandemic period,a higher association was noted between LT recipients and in-hospital mortality during the pandemic,with an odds ratio(OR)of 1.69[95% confidence interval(CI):1.55-1.84),P<0.001].The frequency of transplant rejections among hospitalized LT recipients increased from 0.2%to 3.6% between January 2019 and December 2020.LT hospitalizations during the COVID-19 pandemic had a higher association with transplant rejection than before the pandemic[OR:1.53(95%CI:1.26-1.85),P<0.001].CONCLUSION The hospitalization rates for LT recipients were comparable before and during the pandemic.Inpatient mortality and transplant rejection rates for hospitalized LT recipients were increased during the COVID-19 pandemic.

Impact of metabolic dysfunction-associated steatotic liver disease on COVID-19 hospitalizations:A propensity-matched analysis of the United States

BACKGROUND Metabolic dysfunction-associated steatotic liver disease(MASLD),formally known as nonalcoholic fatty liver disease,is the most common chronic liver disease in the United States.Patients with MASLD have been reported to be at a higher risk of developing severe coronavirus disease 2019(COVID-19)and death.However,most studies are single-center studies,and nationwide data in the AIM To study the influence of MASLD on COVID-19 hospitalizations during the initial phase of the pandemic.METHODS We retrospectively analyzed the 2020 National Inpatient Sample(NIS)database to identify primary COVID-19 hospitalizations based on an underlying diagnosis of MASLD.A matched comparison cohort of COVID-19 hospit-alizations without MASLD was identified from NIS after 1:N propensity score matching based on gender,race,and comorbidities,including hypertension,heart failure,diabetes,and cirrhosis.The primary outcomes included inpatient mortality,length of stay,and hospitalization costs.Secondary outcomes included the prevalence of systemic complications.RESULTS A total of 2210 hospitalizations with MASLD were matched to 2210 hospitalizations without MASLD,with a good comorbidity balance.Overall,there was a higher prevalence of severe disease with more intensive care unit admissions(9.5%vs 7.2%,P=0.007),mechanical ventilation(7.2%vs 5.7%,P=0.03),and septic shock(5.2%vs 2.7%,P<0.001)in the MASLD cohort than in the non-MASLD cohort.However,there was no difference in mortality(8.6%vs 10%,P=0.49),length of stay(5 d vs 5 d,P=0.25),and hospitalization costs(42081.5$vs 38614$,P=0.15)between the MASLD and non-MASLD cohorts.CONCLUSION The presence of MAFLD with or without liver cirrhosis was not associated with increased mortality in COVID-19 hospitalizations;however,there was an increased incidence of severe COVID-19 infection.This data(2020)predates the availability of COVID-19 vaccines,and many MASLD patients have since been vaccinated.It will be interesting to see if these trends are present in the subsequent years of the pandemic.

The Intersection of Privacy by Design and Behavioral Economics: Nudging Users towards Privacy-Friendly Choices

This paper conducts a comprehensive review of existing research on Privacy by Design (PbD) and behavioral economics, explores the intersection of Privacy by Design (PbD) and behavioral economics, and how designers can leverage “nudges” to encourage users towards privacy-friendly choices. We analyze the limitations of rational choice in the context of privacy decision-making and identify key opportunities for integrating behavioral economics into PbD. We propose a user-centered design framework for integrating behavioral economics into PbD, which includes strategies for simplifying complex choices, making privacy visible, providing feedback and control, and testing and iterating. Our analysis highlights the need for a more nuanced understanding of user behavior and decision-making in the context of privacy, and demonstrates the potential of behavioral economics to inform the design of more effective PbD solutions.

Analysis of Hospitalization Costs and Influencing Factors of AKI in Adult Patients

Objective:To investigate the economic burden of patients with acute kidney injury(AKI)by analyzing the distribution of hospitalization expenses and its influencing factors in the Affiliated Hospital of Hebei University.Methods:The hospitalization information of patients with AKI from January 2020 to January 2023 was collected and sorted through the hospital charging system and the factors affecting the total hospitalization cost were analyzed by multiple linear regression.Results:Univariate analysis showed that age,occupation,marriage,length of hospitalization,recovery of renal function,and stage of AKI had significant effects on hospitalization cost(P<0.05).The result of the multiple linear regression analysis model showed that age(t=4.11,P<0.0001),length of hospitalization(t=16.10,P<0.0001),recovery of renal function(t=3.26,P<0.0001),AKI stage(t=5.23,P=0.002)are factors affecting the economic burden of patients with AKI.Conclusion:AKI patients should be managed according to age stratification to effectively control the progression of the disease and improve the quality of the medical services provided.This will reduce the economic burden of patients.

Improving Hospital Utilization and Outcomes: Health Economics at the Community Level

This study reviewed efforts to improve health care efficiency at the community level from the perspective of the financial impact on provider organizations. It focused on utilization and outcomes programs that address this objective in the metropolitan area of Syracuse, New York and their implications for health economics. The study demonstrated that a range of length of stay initiatives, including programs addressing length of stay reduction between hospitals and nursing homes produced a savings of $12,448,300 - $31,232,900 over a fifteen-year period. These efforts involved community wide costs of $3,128,125 - $4,144,025. The study also demonstrated that efforts to reduce inpatient hospital complications produced a savings of between $1,622,400 - $3,623,400 over a four-year period. These efforts involved community wide costs of $739,200. The study suggested that these savings were enhanced through community wide initiatives that enabled hospitals to save expenses associated with data development and program implementation.

Research on the Optimization Paths for Outstanding Agricultural Economics and Management Talents under the Background of Curriculum Ideology and Politics

The article aims to discuss how to cultivate outstanding agricultural economics and management talents to meet the needs of agricultural and rural economic development in the new era,within the context of ideological and political education.Through literature review and field research,a series of innovative talent training optimization paths are proposed,and specific suggestions are made for policymakers and educational practitioners.

Impact of liver cirrhosis on morbidity and mortality of patients admitted to the hospital with necrotizing fasciitis

BACKGROUND Necrotizing fasciitis(NF)is a potentially fatal bacterial infection of the soft tissues.Liver cirrhosis appears to be a contributing factor to higher morbidity and mor-tality in patients with NF.This research article explores the relationship between these two conditions.AIM To evaluate whether liver cirrhosis increases morbidity and mortality in patients with NF,focusing on inpatient mortality,septic shock,length of stay,and hospital costs.METHODS This retrospective cohort study utilized data from the Healthcare Cost and Utilization Project 2019 National Inpatient Sample.Cases were identified as pa-tients with both NF and cirrhosis,while controls were non-cirrhotic.The study focused on inpatient mortality as the primary outcome,with secondary outcomes including surgical limb amputation,mechanical ventilation rates,septic shock,length of stay,and hospital costs.RESULTS A total of 14920 patients were admitted to the hospital for management of NF,of which 2.11%had liver cirrhosis.Inpatient mortality was higher in cirrhotic patients(9.5%vs 3%;adjusted odds ratio=3.78;P value=0.02).Cirrhotic patients also had higher rates of septic shock(10.5%vs 4.9%,P value<0.01).Length of hospital stay,total charges,and rates of mechanical ventilation were not statistically different between groups.CONCLUSION Liver cirrhosis is an independent risk factor of in-hospital mortality and morbidity in patients with NF.Clinicians should be aware of this association to ensure better clinical outcomes and spare healthcare expenditure.

Water Quality,Influential Factors,and Management Strategies from 2016 to 2020 in the Yangtze River Economic Belt,China

The Yangtze River economic belt(YREB),China is important to the Chinese economy and for supporting sustainable development.Clarifying the relationship between water quality indices and socioeconomic indicators could help improve aquatic environment management in the YREB and our understanding of the causes and effects of water quality variations in other large river basins.In this study,river water quality,factors affecting water quality,and management strategies,and correlations between water quality indices and socioeconomic indicators in the YREB during the 13th Five-Year Plan period(2016-2020)were assessed.The single-factor evaluation method,constant price for GDP,and correlation analyses were adopted.The results showed that:1)water quality in the YREB improved during the 13th Five-Year Plan period.The number of aquatic environment sections meeting GradeⅠ-Ⅲwater quality standards increased by 13.1%and the number below Grade V decreased by 2.9%.2)The values of 12 indicators in the YREB exceeded relevant standards.The indicators with highest concentreation were the total phosphorus,chemical oxygen demand,ammonia nitrogen,and permanganate index,which were relatively high in downstream regions in Anhui Province,Jiangsu Province,and Shanghai Municipality.3)Ammonia nitrogen,chemical oxygen demand,and total phosphorus emissions per unit area and water extraction per unit area are relatively high in the three downstream regions mentioned above.4)Increased domestic sewage discharges have increased total wastewater discharges in the YREB.5)River water quality in the YREB strongly correlated with population,economic,and water resource indices and less strongly correlated with government investment,agriculture,meteorology,energy,and forestry indices.This confirmed the need to decrease wastewater discharges and non-point-source pollutant emissions.The aquatic environment could be improved by taking reasonable measures to control population growth,adjusting the industrial structure to accelerate industrial transformation and increase the proportion of tertiary industries,and investing in technological innovations to protect the environment.

Geographical Indications and Regional Public Brands of the Whole Rice Industry Chain in the Yangtze River Economic Belt

The Yangtze River Economic Belt is the main rice producing area in China.The rice industry chain is the agricultural pillar industry chain of this economic belt and it is the key to ensuring national food security and promoting comprehensive rural revitalization.This study discusses the entire rice industry chain in the Yangtze River Economic Belt from the national rice production functional zones,agricultural product quality and safety,national famous and excellent new agricultural products,national specialty agricultural products,"China s good grain and oil"products,and national advantageous characteristic industrial clusters.Then,it discusses the geographical indications of rice and its products in this economic belt from geographical indication products,geographical indication trademarks,agricultural geographical indications,geographical indication standards,geographical indication special indications,national geographical indication product protection demonstration zones,and Chinese geographical indication products protected by the European Union.In addition,it analyzes the five main problems between geographical indications and public brands,such as the limited use of geographical indication specific signs and the imperfect intellectual property protection system for geographical indications.Finally,it proposes eight strategies,including promoting the high-quality development of the entire rice industry chain,creating a geographical indication regional public brand for rice and its products,and implementing geographical indication protection projects.

Simulation Modelling and Techno-Economics of Supercritical Carbon Dioxide Recompression Closed Brayton Cycle

In recent years, there has been global interest in meeting targets relating to energy affordability and security while taking into account greenhouse gas emissions. This has heightened major interest in potential investigations into the use of supercritical carbon dioxide (sCO2) power cycles. Climate change mitigation is the ultimate driver for this increased interest;other relevant issues include the potential for high cycle efficiency and a circular economy. In this study, a 25 MWe recompression closed Brayton cycle (RCBC) has been assessed, and sCO2 has been proposed as the working fluid for the power plant. The methodology used in this research work comprises thermodynamic and techno-economic analysis for the prospective commercialization of this sCO2 power cycle. An evaluated estimation of capital expenditure, operational expenditure, and cost of electricity has been considered in this study. The ASPEN Plus simulation results have been compared with theoretical and mathematical calculations to assess the performance of the compressors, turbine, and heat exchangers. The results thus reveal that the cycle efficiency for this prospective sCO2 recompression closed Brayton cycle increases (39% - 53.6%) as the temperature progressively increases from 550˚C to 900˚C. Data from the Aspen simulation model was used to aid the cost function calculations to estimate the total capital investment cost of the plant. Also, the techno-economic results have shown less cost for purchasing equipment due to fewer components being required for the cycle configuration as compared to the conventional steam power plant.

Economics of Language behind Catchwords

The integration of linguistics and economics, economics of language, is a new peripheral subject based on theory of west ern human capital and educational economics. Catchwords which reflect many theories of economics of language enter into people's scope of research. Study of catchword is of great significance for the enrichment of research of human language.

浅析《Public Economics》双语教学中的主要问题及对策

《Public Economics》作为研究公共部门经济的科学,是经济类学生,尤其是财政学专业学生所必修的一门双语课程。自2002年开始教授这门课程以来,在近十年的教学实践中,笔者发现有一些共性问题一直存在,在很大程度上成为了困扰、甚至妨碍该门双语教学课程课堂教学质量和总体效果的主要因素。本文在对这些问题进行阐释的基础上,提出若干应对之策,希与各位同仁交流和商榷。

Economy、Economics中译考——以“富国策”“理财学”“计学”“经济学”为中心的考察

尽管中国近代Economy、Economics中译名五花八门,数以十计,但最主要的有"富国策""理财学""计学""经济学"四个,而且它们之间呈现出前后递进的比较清晰的演进路线。其演进过程既受到西方"经济学"含义演变的"外因"的影响,也与当时中国移植西方经济学的"内因"相关。

“Introduction to Economics”留学生英文授课精品课程建设实践与探索

随着中国"一带一路"倡议的推进和高等教育国际化的发展,高职层次商科留学生人数迅速增加,相应的英文授课课程建设迅速涌现。本文对江苏高校留学生精品课程"Introduction to Economics"的课程定位、课程内容设置、教学资源建设、教学方法使用、考核评价方式等建设过程进行了总结,并提出了进一步强化建设效果的设想,为高职商科全英文授课课程建设提供参考。

On College English Reform from the Perspective of Language Economics

From the perspective of Language Economics,language education(including second language or foreign language education)is an economically valuable investment that has the function of promoting social development.However,there is an imbalance in the input and output of China’s college English education.From the perspective of language economics,this article focuses on the reform of College English courses in order to improve the efficiency of English teaching in common universities.