An Empirical Analysis of the Relationship Among the Service Quality, Customer Satisfaction and Loyalty of High Speed Railway Based on Strctural Equation Model

China has longest mileage of high speed railway in the world, and high speed railway has been one of the main traffic travel choices of Chinese people. This paper analyzes the relationship among the service quality, customer satisfaction and loyalty degree of high speed railway by adopting the structural equation model as analytical method with the high speed railway from Shanghai to Nanjing as case study. This paper firstly establishes the model of customer satisfaction on the high speed railway, and develops the measurement table of the customer satisfaction. The research results manifest: the reliability and validity of the survey data about the model of the customer satisfaction on the high speed railway have been tested and verified. As to the hypothesis, except the hypothesis “from customer satisfaction to loyalty degree” and “from customer complaints to loyalty degree”, others have been well tested and verified. The results show that the service quality of the high speed railway has the greatest influence on the company image, and it has direct and positive influence on the customer satisfaction. The image of the high speed railway company has direct and positive influence on the customer satisfaction, and it has indirect influence on the customer complaints and loyalty degree. The customer satisfaction on the high speed railway has indirect influence on the customer loyalty degree, and it has direct influence on the customer complaints. The customer complaints will not greatly influence the customer loyalty degree.Key words: Structural equation model; Intercity high speed railway; Service quality; Customer satisfaction; Customer loyaltyRésumé: La Chine a la plus longue de kilométrage de voies ferrées à grande vitesse dans le monde, et la voie ferrée à grande vitesse a été l'un des principaux choix de voyage de la circulation du peuple chinois. Cet article analyse la relation entre la satisfaction des clients un service de qualité, et le degré de fidélisation de la grande vitesse ferroviaire en adoptant le modèle d'équation structurelle que méthode d'analyse avec la voie ferrée à grande vitesse entre Shanghai et Nanjing comme étude de cas. Ce document établit tout d'abord le modèle de la satisfaction du client sur la voie ferrée à grande vitesse, et développe la table de mesure de la satisfaction client. Le manifeste de résultats de recherche: la fiabilité et la validité des données d'une enquête sur le modèle de la satisfaction client sur le chemin de fer à grande vitesse ont été testées et vérifiées. Quant à l'hypothèse, à l'exception de l'hypothèse «de la satisfaction du client au degré de loyauté" et "de plaintes de clients au degré de loyauté», d'autres ont été bien testés et vérifiés. Les résultats montrent que la qualité de service de la voie ferrée à grande vitesse a le plus d'influence sur l'image de l'entreprise, et elle a une influence directe et positive sur la satisfaction du client. L'image de la compagnie ferroviaire à grande vitesse a une influence directe et positive sur la satisfaction du client, et il a une influence indirecte sur les plaintes des clients et le degré de loyauté. La satisfaction du client sur la voie ferrée à grande vitesse a une influence indirecte sur le degré de fidélisation des clients, et elle a une influence directe sur les plaintes des clients. Les plaintes des clients ne sera pas une grande influence sur le degré de fidélisation.Mots clés: Modèle du structurelle d'équation; L’Inter-ville ferroviaire à grande vitesse; La qualité de service; La satisfaction des clients; La fidélisation de la clientèl

Relationship between myopia and diagnosis rates of dry eye disease and related indicators: a systematic review and meta-analysis

BackgroundThe association between myopia and dry eye disease (DED) has recently garnered considerable attention. This study aimed to compare the diagnosis rates of DED and its indicators between myopic and emmetropic patients to elucidate the association between myopia and DED.MethodsWe retrieved relevant literature published through November 2024 from English databases, such as PubMed, Embase, the Cochrane Library, and Web of Science, as well as Chinese databases, such as the China National Knowledge Infrastructure, WanFang, VIP, and SinoMed. The studies were then screened for inclusion and exclusion criteria, and the basic information and outcome data of the included studies were recorded. The methodological quality of the included studies was assessed by the Joanna Briggs Institute. Finally, RevMan 5.3 was used to perform meta-, subgroup, and sensitivity analyses, as well as a publication bias assessment of the outcome data.ResultsThis study included 8 studies with a sample size of 14,232 patients. The meta-analysis showed that compared with emmetropic eyes, the diagnostic rate of DED in myopic eyes increased significantly, by 104% [odds ratio (OR) = 2.04, 95% confidence interval (CI) = 1.39–2.99, P = 0.0002, I2 = 91%], while the tear break-up time (BUT) was reduced significantly, by 6.31 s [weighted mean difference (WMD) = −6.31, 95% CI = −7.32 to −5.29, P < 0.00001, I2 = 0%]. However, there was no significant difference in the rate of positive corneal staining (OR = 2.53, 95% CI = 0.22–29.07, P = 0.46, I2 = 68%). Funnel plots showed a potential publication bias in DED diagnosis rate, rate of positive corneal staining, and BUT. An evaluation showed that the evidence quality of DED diagnosis rate, BUT and rate of positive corneal staining were extremely low.ConclusionThere were significant differences in the DED diagnosis rate and BUT between myopic and emmetropic patients, suggesting that myopia may be a potential risk factor for DED. The regular screening for DED should be a focus in myopic populations to improve detection and diagnosis rates.Systematic review registrationCRD42024611482, https://www.crd.york.ac.uk/PROSPERO/myprosper

Prognostic and predictive value of Phospho-p44/42 and pAKT in HER2-positive locally advanced breast cancer patients treated with anthracycline-based neoadjuvant chemotherapy

Abstract Background To evaluate the predictive and prognostic value of various molecular factors associated with the Ras/MAPK and PI3K/Akt signaling pathways in HER2-positive locally advanced breast cancer patients treated with anthracycline-based neoadjuvant chemotherapy (NAC). Methods A total of 113 patients were recruited in this retrospective study. Core needle biopsies and excision samples were assessed through immunohistochemistry for various biomarkers, including IGF-1R, Phospho-p44/42, Ki67, pAKT, PTEN, p27, and cyclinD1. The changes in these biomarkers after NAC and their predictive and prognostic values were investigated. Results Significant decreases in Ki67, Phospho-p44/42, and pAKT expression were observed after treatment (30.7% vs. 18.1%, 36.4% vs. 18.9%, and 35.1% vs. 16.4%, respectively). The decreases in Phospho-p44/42, pAKT, and Ki67 expression were strongly associated with the response to anthracycline treatment (P = 0.027, P = 0.031, and P = 0.008, respectively). In a multivariate survival analysis, Phospho-p44/42 expression after neoadjuvant chemotherapy and lymph node status were significant independent prognostic factors of both relapse-free survival and overall survival. Conclusions Reductions in Ki-67, Phospho-p44/42, and pAKT expression are related to the clinical response to anthracycline-based NAC in HER2-positive breast cancer patients. High pAKT expression prior to NAC had a better clinical response. Phospho-p44/42 expression and lymph node status after NAC could be useful for determining relapse-free survival and overall survival. </jats:sec

Retrospective analysis of 119 Chinese noninflammatory locally advanced breast cancer cases treated with intravenous combination of vinorelbine and epirubicin as a neoadjuvant chemotherapy: a median follow-up of 63.4 months

<p>Abstract</p> <p>Background</p> <p>This study is a retrospective evaluation of the efficacy of neoadjuvant chemotherapy (NC) with a vinorelbine (V) and epirubicin (E) intravenous combination regimen and is aimed at identification of predictive markers for the long-term outcome in noninflammatory locally advanced breast cancer (NLABC).</p> <p>Methods</p> <p>One-hundred-and-nineteen patients with NLABC were identified from September 2001 to May 2006. Analysis was performed in March 2008, with a median follow-up of 63.4 months (range, 9-76 months). All patients were diagnosed with invasive breast cancer using 14 G core needle biopsy and treated with three cycles of VE before surgery. Local-regional radiotherapy was offered to all patients after the completion of chemotherapy followed by hormonal therapy according to hormone receptor status. Tissue sections cut from formalin-fixed paraffin-embedded blocks from biopsy specimens and postoperative tumor tissues were stained for the presence of estrogen receptor (ER), progesterone receptor (PgR), HER-2 (human epidermal growth factor receptor-2), and MIB-1(Ki-67).</p> <p>Results</p> <p>Patients characteristics were median age 52 years (range: 25-70 years); clinical TNM stage, stage IIB (n = 32), stage IIIA (n = 56), stage IIIB (n = 22) and stage IIIC (n = 9). All patients were evaluable for response: clinically complete response was documented in 27 patients (22.7%); 78 (65.6%) obtained partial response; stable disease was observed in 13 (10.9%); 1 patient (0.8%) had progressive disease. Pathological complete response was found in 22 cases (18.5%). Seventy-five patients were alive with no recurrence after a median follow-up of 63.4 months, the 5-year rates for disease-free survival and overall survival were 58.7% and 71.3%, respectively, after the start of NC. On multivariate analysis, the independent variables associated with increased risk of relapse and death were high pre-Ki-67(p = 0.012, p = 0.017, respectively), high post-Ki-67 expression (p = 0.045, p = 0.001, respectively), and non-pCR (p = 0.034, p = 0.027, respectively). A significantly increased risk of death was associated with lack of pre-ER expression (p = 0.002). Among patients with non-pCR, those with a pathological response at the tumor site with special involvement (i.e. skin, vessel and more than one quadrant) were at a higher risk of disease relapse and death (p < 0.001, p = 0.001, respectively).</p> <p>Conclusion</p> <p>This study suggests the promising use of a VE regimen as NC for Chinese NLABC after a median follow-up of 63.4 months. Pathological response in the tumor site, pre-Ki-67 and post-Ki-67 expression, and pre-ER expression were the important variables that predicted long-term outcome. Patients with pathological special involvement at the primary site after NC had the lowest survival rates.</p

Phytoextraction and Migration Patterns of Cadmium in Contaminated Soils by <i>Pennisetum hybridum</i>

This study was conducted to identify soil cadmium (Cd) removal pathways and their contribution rates during phytoremediation by Pennisetum hybridum, as well as to comprehensively assess its phytoremediation potential. Multilayered soil column tests and farmland-simulating lysimeter tests were conducted to investigate the Cd phytoextraction and migration patterns in topsoil and subsoil simultaneously. The aboveground annual yield of P. hybridum grown in the lysimeter was 206 ton·ha−1. The total amount of Cd extracted in P. hybridum shoots was 234 g·ha−1, which was similar to that of other typical Cd-hyperaccumulating plants such as Sedum alfredii. After the test, the topsoil Cd removal rate was 21.50–35.81%, whereas the extraction efficiency in P. hybridum shoots was only 4.17–8.53%. These findings indicate that extraction by plant shoots is not the most important contributor to the decrease of Cd in the topsoil. The proportion of Cd retained by the root cell wall was approximately 50% of the total Cd in the root. Based on column test results, P. hybridum treatment led to a significant decrease in soil pH and considerably enhanced Cd migration to subsoil and groundwater. P. hybridum decreases Cd in the topsoil through multiple pathways and provides a relatively ideal material for phytoremediation of Cd-contaminated acid soils