Background and AimsSystemic immune-inflammation index (SII) is an emerging indicator and correlated to the incidence of cardiovascular diseases. This study aimed to explore the association between SII and contrast-induced acute kidney injury (CI-AKI).MethodsIn this retrospective cross-sectional study, 4,381 subjects undergoing coronary angiography (CAG) were included. SII is defined as neutrophil count × platelet count/lymphocyte count. CI-AKI was determined by the elevation of serum creatinine (Scr). Multivariable linear and logistic regression analysis were used to determine the relationship of SII with Scr and CI-AKI, respectively. Receiver operator characteristic (ROC) analysis, structural equation model analysis, and subgroup analysis were also performed.ResultsOverall, 786 (17.9%) patients suffered CI-AKI after the intravascular contrast administration. The subjects were 67.1 ± 10.8 years wold, with a mean SII of 5.72 × 1011/L. Multivariable linear regression analysis showed that SII linearly increased with the proportion of Scr elevation (β [95% confidence interval, CI] = 0.315 [0.206 to 0.424], P < 0.001). Multivariable logistic regression analysis demonstrated that higher SII was associated with an increased incidence of CI-AKI ([≥12 vs. <3 × 1011/L]: odds ratio, OR [95% CI] = 2.914 [2.121 to 4.003], P < 0.001). Subgroup analysis showed consistent results. ROC analysis identified a good predictive value of SII on CI-AKI (area under the ROC curve [95% CI]: 0.625 [0.602 to 0.647]). The structural equation model verified a more remarkable direct effect of SII (β = 0.102, P < 0.001) on CI-AKI compared to C-reactive protein (β = 0.070, P < 0.001).ConclusionsSII is an independent predictor for CI-AKI in patients undergoing CAG procedures.

Climate change and greenhouse gas emission reduction have become pressing concerns in recent years. Carbon trading systems and emission-reduction cost-sharing contracts are important emissionreduction measures, under the two mechanisms, this paper considers a dynamic emission-reduction technology investment decision-making problem in a dyadic supply chain consisting of a manufacturer and a retailer. In considering the influence of consumers' low-carbon preferences on market demand as well as the impact of uncertainty on carbon emission-reduction behaviour, this paper (1) constructs the investment game model under cost-sharing coordination between manufacturers and retailers; (2) adopts differential game and dynamic optimisation methods to obtained investment strategies for manufacturers and retailers under cost-sharing contracts.; and (3) uses a numerical simulation method to simulate the path evolution process of each state variable and, by analysing the sensitivity of various parameters, to determine the influence of various parameters on the decision making of emission reduction among stakeholders. The study finds that under the carbon trading system, cost-sharing contracts have a regulatory effect on enterprise emission-reduction investment and enterprise profits, and that the impact of regulatory effects increases over time. Likewise, the evolution path of the parameters used for various indicators presents a strengthened trend over time. The results show that it is necessary to enhance the cooperative development and exchange of carbon emission-reduction technology among enterprises.INDEX TERMS carbon emissions trading system, cost-sharing contracts, investment in emission-reduction technology, stochastic differential game

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Due to excessive greenhouse gas emissions, carbon emission-reducing measures are urgently needed. Important emission-reduction measures mainly include carbon trading and low-carbon cost subsidies. Comprehensive consideration of these two policies is a research hotspot in the field of low-carbon technology investment. Based on this background, this paper considers the impact of consumer low-carbon preferences on market demand and the impact of uncertainty in carbon emission-reduction behaviour. We construct a stochastic differential game model with upstream and downstream enterprises based on cost-sharing coordination under a cost subsidy. From a dynamic perspective, this paper researches the optimal equilibrium strategy and evolution characteristics of the joint emission-reduction mechanism in a supply chain. This paper discusses the sensitivity of the parameters and uses numerical simulation to verify the impact of each parameter on the emission-reduction decision-making activities of stakeholders after introducing the cost subsidy. The results show that a cost subsidy policy can promote carbon emission-reduction investment and supply chain profit. Thus, it is important to strengthen technical cooperation and exchange among enterprises.