bluuebunny/crossref_metadata_2025 huggingface dataset:
The effects of mindfulness upbringing perception on social entrepreneurship orientation: A moderated mediation model of prosocial motivation and perceived pressure from external stakeholders
Authors: Shan Tingting , Tian Xiaoya
Published: October 2022

Driven by economic and social benefits, social enterprises create new development models that combine wealth creation, social welfare provision, and environmental improvement through innovative approaches. The social entrepreneurship orientation reflects the behavioral tendency to transplant entrepreneurship orientation into the field of social value creation. It is a strategy to balance and integrate economic interests and social interests, which has a significant impact on social entrepreneurship performance. The purpose of this study is to explore the internal mechanism of the impact of social entrepreneurs’ mindfulness upbringing perception on social entrepreneur orientation. To reveal the internal mechanism, we propose a moderated and mediation model of prosocial motivation and perceived pressure from external stakeholders. In this study, random sampling was conducted among social start-ups in China. In order to improve the accuracy of the scale, a pre-survey was conducted before the formal survey. The data analysis results of the pre-survey showed that the scale in this study was suitable for the Chinese context and had good external validity. Through using survey data from social entrepreneurs in China, hierarchical regression analysis and bootstrapping model are adapted to test and verify mediation and moderation effects. The results show that mindfulness upbringing perception indeed positively influences social entrepreneurship orientation directly and partly through the mediating effect of prosocial motivation. Moreover, findings suggest the perceived pressure from external stakeholders negatively moderates not only the relationship between prosocial motivation and social entrepreneurship orientation but also the overall mediation model. This indicates that social entrepreneurs with low perceived pressure from external stakeholders will improve their social entrepreneurship orientation rapidly when their prosocial level is high. Based on these findings, we conclude that social entrepreneurship orientation may be achieved more effectively through the complex process of mindfulness upbringing perception, prosocial motivation, and perceived pressure from external stakeholders. Finally, the study proposes the theoretical and practical implications and suggestions for follow-up research.
An integrative review of research on gambling and domestic and family violence: Fresh perspectives to guide future research
Authors: Hing Nerilee , O’Mullan Cathy , Mainey Lydia , Greer Nancy , Breen Helen
Published: October 2022

This paper presents an integrative review of research on domestic and family violence (DFV), including intimate partner violence (IPV), experienced by victims and perpetrators with a gambling problem. It aims to review, critique, and synthesize research on this topic to generate fresh and alternative perspectives to guide future research. Based on a systematic search of the academic literature and a targeted search of gray literature, the paper summarizes findings from empirical studies pertaining to the prevalence of perpetration and victimization, characteristics of perpetrators and victims, and explanations for this violence. Based on this review, the paper suggests several potential improvements that can be considered in future studies. These include a shift from focusing on situational violence to also include coercive control; greater sensitivity in research design and interpretation to gender differences in experiences of violence; and the need to include economic abuse as a form of DFV/IPV. Adopting a public health lens is also recommended to broaden the research focus from victims and perpetrators to also consider contextual factors. In particular, gambling research should examine the contribution of gambling products, practices, environments, and marketing to DFV/IPV and how this might be ameliorated. While research to date has drawn much needed attention to the risks that gambling presents for DFV/IPV, this review provides some suggestions for future research so that it can provide more nuanced findings to inform policy and practice.
A graph neural network framework based on preference-aware graph diffusion for recommendation
Authors: Shu Tao , Shi Lei , Zhu Chuangying , Liu Xia
Published: October 2022

Transforming user check-in data into graph structure data is a popular and powerful way to analyze users' behaviors in the field of recommendation. Graph-based deep learning methods such as graph embeddings and graph neural networks have shown promising performance on the task of point-of-interest recommendation in recent years. Despite effectiveness, existing methods fail to capture deep graph structural information, leading the suboptimal representations. In addition, they lack the ability of learning the influences of both global preference and user preference on the check-in behavior. To address the aforementioned issues, we propose a general framework based on preference-aware graph diffusion, named PGD. We first construct two types of graphs to represent the global preference and user preference. Then, we apply a graph diffusion process to capture the structural information of the generated graphs, resulting in weighted adjacency matrices. Finally, graph neural network-based backbones are introduced to learn the representations of users and POIs on weighted adjacency matrices. A learnable aggregation module is developed to learn the final representations from global preference and user preference adaptively. Extensive experiments on four real-world datasets demonstrate the superiority of PGD on POI recommendation, compared with the mainstream graph-based deep learning methods.
Secrecy, self-blame and risks for social exclusion—Family members’ experiences of gambling problems in Japan
Authors: Takiguchi Naoko , Kawanishi Yuko , Samuelsson Eva
Published: October 2022

The predominant gambling policy to respond to the adverse consequences of excessive gambling has been the Reno Model, which places the responsibility for gambling-caused problems on gamblers themselves. The newly implemented Japanese gambling policy, which shares basic premises with the Reno Model, focuses on the individual pathology of gamblers. However, this model lacks other critical perspectives: environmental and structural factors. To fully understand the harms caused by gambling; it is important to also pay attention to the negative consequences for affected others. In this brief report, we explore family members’ experiences of gambling problems within the specific context of the Japanese gambling policy. Interviews with family members reveal self-stigma of being bad parents which elicits shame and efforts to maintain secrecy, as well as public stigma involving labeling, isolation, risks of status loss, social exclusion and discrimination. The focus on individual pathology in Japanese legislation as well as in public and professional perception, reinforces self-blame, anxiety, and remorse on the part of affected family members. When contrasted with the lived experiences of gamblers’ family members, the inconsistencies and unreasonableness of the individual pathology paradigm in Japanese gambling policy become evident. It is necessary to shift the focus of gambling policies from individual to socio-political-cultural factors, investigating how these factors influence gambling-caused harm, especially in the Japanese context.
Family resilience of stroke survivors within 6 months after a first-episode stroke: A longitudinal study
Authors: Zhang Wei , Zhou Wanqiong , Ye Mingming , Gao Yitian , Zhou Lanshu
Published: October 2022

Context

Family resilience is frequently recognized as a powerful determinant of family adaptation in chronic disease patients; understanding the family resilience of stroke patients and its predictors could help nurses develop interventions to assist patients in maintaining healthy family functioning.

Objective

This study aimed to explore the trajectory of family resilience in the 6 months following stroke onset and examine the predictors of family resilience over time.

Methods

A total of 288 first-episode stroke survivors were selected from seven hospitals in China from July 2020 to March 2021. Their family resilience, social support, self-efficacy, and medical coping style were assessed at hospitalization and 1, 3, and 6 months after stroke onset. The study was performed in accordance with the STROBE guidelines.

Results

The mean levels of family resilience were between 95.52 ± 11.10 and 97.68 ± 9.68 within the first 6 months after a first-episode stroke, with a significant increase 3 months after the onset. Patient self-efficacy, social support, family atmosphere, and caregiver-patient relationship (sibling) were predictors of family resilience at all four time points. Baseline predictors of family resilience at 6 months included self-efficacy of the patients, subjective support, support utilization, family atmosphere, living district, medical bill payment methods, and caregiver-patient relationship (sibling).

Conclusion

Family resilience levels were low in stroke patients 6 months after the onset, and 3 months post-stroke onset was a critical period for family resilience of stroke patients. Nurses are recommended to pay particular attention to patients with low self-efficacy, perceived low support, poor utilization of available support, as well as those who are under the care of their siblings, self-pay, or live in a poor family atmosphere. Interventions aimed at improving the self-efficacy of patients and social support are potential approaches to enhance family resilience.
Associations of executive function and age of first use of methamphetamine with methamphetamine relapse
Authors: Mu Lin-Lin , Wang Yan , Wang Li-Jin , Xia Ling-Ling , Zhao Wei , Song Pei-Pei , Li Jun-Da , Wang Wen-Juan , Zhu Lin , Li Hao-Nan , Wang Yu-Jing , Tang Hua-Jun , Zhang Lei , Song Xun , Shao Wen-Yi , Zhang Xiao-Chu , Xu Hua-Shan , Jiao Dong-Liang
Published: October 2022

Background and aims

Methamphetamine (MA) is a psychostimulant associated with a high relapse rate among patients with MA use disorder (MUD). Long-term use of MA is associated with mental disorders, executive dysfunction, aggressive behaviors, and impulsivity among patients with MUD. However, identifying which factors may be more closely associated with relapse has not been investigated. Thus, we aimed to investigate the psychological factors and the history of MA use that may influence MA relapse.

Methods

This cross-sectional study included 168 male MUD patients (MUD group) and 65 healthy male residents (control group). Each patient was evaluated with self-report measures of executive dysfunction, psychopathological symptoms, impulsiveness, aggressiveness, and history of MA use. Data were analyzed with t-tests, analyses of variance, and correlation and regression analyses.

Results

The MUD group reported greater executive dysfunction, psychopathological symptoms, impulsivity, and aggression than the control group. Lower age of first MA use was associated both with having relapsed one or more times and with having relapsed two or more times; greater executive dysfunction was associated only with having relapsed two or more times.

Conclusion

Patients with MUD reported worse executive function and mental health. Current results also suggest that lower age of first MA use may influence relapse rate in general, while executive dysfunction may influence repeated relapse in particular. The present results add to the literature concerning factors that may increase the risk of relapse in individuals with MUD.
The relations between different components of intolerance of uncertainty and symptoms of depression during the COVID-19 pandemic: A network analysis
Authors: Feng Tingwei , Ren Lei , Liu Chang , Li Kuiliang , Wu Lin , Wei Xinyi , Yuan Shangqing , Cui Long-Biao , Yang Xi , Li Danyang , Yang Wei , Li Ye , Wang Buyao , Wang Hui , Liu Xufeng
Published: October 2022

Background

The relations between depression and intolerance of uncertainty (IU) have been extensively investigated during the COVID-19 pandemic. However, there is a lack of understanding on how each component of IU may differentially affect depression symptoms and vice versa. The current study used a network approach to reveal the component-to-symptom interplay between IU and depression and identify intervention targets for depression during the COVID-19 pandemic.

Methods

A total of 624 college students participated in the current study. An IU-Depression network was estimated using items from the 12-item Intolerance of Uncertainty Scale and the Patient Health Questionnaire-9. We examined the network structure, node centrality, and node bridge centrality to identify component-to-symptom pathways, central nodes, and bridge nodes within the IU-Depression network.

Results

Several distinct pathways (e.g., “Frustration when facing uncertainty” and “Feelings of worthlessness”) emerged between IU and Depression. “Fatigue” and “Frustration when facing uncertainty” were identified as the central nodes in the estimated network. “Frustration when facing uncertainty,” “Psychomotor agitation/retardation,” and “Depressed or sad mood” were identified as bridging nodes between the IU and Depression communities.

Conclusion

By delineating specific pathways between IU and depression and highlighting the influential role of “Frustration when facing uncertainty” in maintaining the IU-Depression co-occurrence, current findings may inform targeted prevention and interventions for depression during the COVID-19 pandemic.
Comprehensive league table of cost-utility ratios: A systematic review of cost-effectiveness evidence for health policy decisions in India
Authors: Shah Komal , Singh Malkeet , Kotwani Priya , Tyagi Kirti , Pandya Apurvakumar , Saha Somen , Saxena Deepak , Rajshekar Kavitha
Published: October 2022

Background and objectives

Although a relatively recent concept for developing countries, the developed world has been using League Tables as a policy guiding tool for a comprehensive assessment of health expenditures; country-specific “League tables” can be a very useful tool for national healthcare planning and budgeting. Presented herewith is a comprehensive league table of cost per Quality Adjusted Life Years (QALY) or Disability Adjusted Life Years (DALY) ratios derived from Health Technology Assessment (HTA) or economic evaluation studies reported from India through a systematic review.

Methods

Economic evaluations and HTAs published from January 2003 to October 2019 were searched from various databases. We only included the studies reporting common outcomes (QALY/DALY) and methodology to increase the generalizability of league table findings. To opt for a uniform criterion, a reference case approach developed by Health Technology Assessment in India (HTAIn) was used for the reporting of the incremental cost-effectiveness ratio. However, as, most of the articles expressed the outcome as DALY, both (QALY and DALY) were used as outcome indicators for this review.

Results

After the initial screening of 9,823 articles, 79 articles meeting the inclusion criteria were selected for the League table preparation. The spectrum of intervention was dominated by innovations for infectious diseases (33%), closely followed by maternal and child health (29%), and non-communicable diseases (20%). The remaining 18% of the interventions were on other groups of health issues, such as injuries, snake bites, and epilepsy. Most of the interventions (70%) reported DALY as an outcome indicator, and the rest (30%) reported QALY. Outcome and cost were discounted at the rate of 3 by 73% of the studies, at 5 by 4% of the studies, whereas 23% of the studies did not discount it. Budget impact and sensitivity analysis were reported by 18 and 73% of the studies, respectively.

Interpretation and conclusions

The present review offers a reasonably coherent league table that reflects ICER values of a range of health conditions in India. It presents an update for decision-makers for making decisions about resource allocation.
Prevalence trends of hypertension and influence factors among children and adolescents aged 7–17 years in China, 2011–2015: A serial cross-sectional study
Authors: Yang Yunjuan , Dai Jing , Min Jieqing , Wu Huamei , Huang Songquan , Li Qingsheng , Chai Jiajia
Published: October 2022

Hypertension has rapidly increased in the last decades throughout the world. It is an emerging disease. However, limited information is available on secular trends and factors of childhood and adolescents' hypertension in China. In this study, 5-year successive data were derived from a cross-sectional study of the China Health and Nutrition Survey (CHNS) in 2011 and 2015. We used systolic blood pressure (SBP) and/or diastolic blood pressure (DBP) at least 95th percentile on the basis of age, sex, and height percentiles to define hypertension (HBP). A total of 2,827 children and adolescents aged 7–17 years were included. The age-standardized prevalence of hypertension was increased significantly across 5 years: the standardized prevalence of hypertension was increased from 8.08% (2011) to 11.46% (2015) in China (P < 0.01). The mean SBP of boys increased from 101.21 to 102.79 mmHg, while the mean SBP of girls increased from 98.96 to 100.04 mmHg. The mean DBP of boys increased from 61.20 to 67.40 mmHg, while the mean DBP of girls increased from 64.34 to 65.76 mmHg. The prevalence of hypertension grew continuously in both sexes, but the pace of change for boys was more rapid than that for girls. This study confirmed that the association between rural (odds ratio [OR] = 1.394, 95%CI 1.032–1.883), overweight/obesity (OR = 2.621, 95%CI 1.506–4.562), and BP levels was highly correlated (P < 0.05). The possible protecting factors associated with hypertension were being a girl (OR = 0.788, 95%CI 0.595–1.043). There was no association between weekly physical activity, daily sleep duration, and hypertension (P > 0.05). Further in-depth analysis of influencing factors and comprehensive interventions should be urgently implemented to combat the hypertension epidemic among children and adolescents in China.
Health cadres empowerment program through smartphone application-based educational videos to promote child growth and development
Authors: Friska Dewi , Kekalih Aria , Runtu Fergie , Rahmawati Andini , Ibrahim Naufal Arkan Abiyyu , Anugrapaksi Eghar , Utami Nindya Permata Bunda Surya , Wijaya Alya Darin , Ayuningtyas Rathia
Published: October 2022

Indonesia's health care system relies on non-health professionals called cadres to operate child health promotion programs in the Public Health Center (Puskesmas). Despite this effort, the child malnutrition rate remains high. This study aimed to identify and develop health promotion media that can assist health cadres in promoting child health. This study was divided into three-phase. The first phase was the need assessment using focus group discussion and knowledge, attitude, and practice (KAP); the second phase is video development, which involves medical students, general practitioners, pediatricians, and health promotion experts; and the third phase was video viewing by cadres and post-viewing tests for health cadres. A comparison of pre-test and post-test participants' total scores was performed with the student's T-test. Need assessment showed that the knowledge of the cadres needs improvement and there was a need for proper educational media material that can be used by the Puskesmas. Five videos were produced, four videos were about children's nutritional intake recommendations during four different age groups and one video was about the information and invitation to come to Integrated Health Service Post (Posyandu). There was a significant improvement from pre-test total scores to post-test total scores (p < 0.001). Smartphone application-based educational videos are effective and reliable child health promotion media for Puskesmas staff and parents.
Association between vigorous physical activity and life satisfaction in adolescents
Authors: Feng Bin , Xu Ke , Zhou Panpan
Published: October 2022

Purpose

The association between overall physical activity (PA) and life satisfaction has been confirmed in adolescents. However, the associations between different forms of PA at various intensities and life satisfaction are under-studied. This study aimed to explore the association between vigorous PA (VPA) and life satisfaction, and whether the associations vary by gender and age.

Methods

Using data from the Health Behavior in School-aged Children (HSBC) investigation, the research samples of 11- to 15-year-old adolescents were included for further. The information on VPA was collected via two self-reported questions, including frequency per week and hours per week. Life satisfaction was assessed by a ladder of 0–10 scores, with being higher indicating better life satisfaction. Logistic models were carried out to analyse the association between VPA and life satisfaction among adolescents, and results were presented with odd ratio (OR) and associated 95% confidence interval.

Results

Among the 214,080 (49.2% male) adolescents studied, both boy and girl participants reporting higher frequency of VPA per week were more likely to be associated with higher life satisfaction (e.g., in boys, VPA for every day: OR = 1.054; in girls: VPA for every day: OR = 1.047). More hours of VPA was also associated with better life satisfaction in adolescents (in overall sample, 7 h or more: OR = 1.178).

Conclusions

In conclusion, this research provided evidence on the roles of VPA on life satisfaction among adolescents aged 11–15. Considering life satisfaction is regarded as an indicator of adolescents' psychological health development, our study supports and extends the evidence for the importance of VPA in adolescence.
Experiencing, anticipating, and witnessing discrimination during the COVID-19 pandemic: Implications for health and wellbeing among Asian Americans
Authors: Dhanani Lindsay Y. , Franz Berkeley , Pham Carolyn T.
Published: October 2022

The onset of the COVID-19 pandemic spurred increased racial animus toward Asians and Asian Americans (A/AA) who have since been contending with increased racism and violence. While some of the harm associated with this increased prejudice may derive from personally experienced discrimination, the COVID-19 pandemic has also been marked by an increase in vicarious exposure to discrimination as well as increased anticipation of discrimination, both of which may be taxing for the mental and physical health of A/AA. The goal of this study, accordingly, was to examine the effects of personal experiences of discrimination, vicarious exposure to discrimination, and anticipated discrimination on depressive symptoms, physical health symptoms, sleep quality, and sleep disturbances among A/AA. Results from our two-wave field survey demonstrated that experiencing and anticipating discrimination were associated with mental and physical health symptoms as well as sleep disturbances. Further, personal experiences of discrimination interacted with vicarious discrimination to determine physical health symptoms such that greater vicarious exposure weakened the relationship between experienced discrimination and physical health symptoms. These findings demonstrate the need to mobilize resources to combat the multipronged, negative implications of the recent rise in anti-Asian prejudice during the COVID-19 pandemic.
Depressive symptoms increase the risk of falls and injurious falls in Chinese adults aged ≥ 45 years: A 3-year cohort study
Authors: Bu Hanli , Lu Suqing , Wang Linxian , Jiang Dan , Tian Zhenzhen , Ding Yi , Zhuang Qin
Published: October 2022

Background

Falls and depressive symptoms are both public health concerns in China, but the effects of depressive symptoms on falls and injurious falls have not been thoroughly investigated.

Methods

This population-based prospective cohort study used data derived from adults aged ≥45 years acquired from the 2015 and 2018 China Health and Retirement Longitudinal Study. Data were analyzed from August 2021 to December 2021. Self-reported depressive symptoms were determined using a 10-item Center for Epidemiologic Studies Depression scale (CESD-10) with a total score range of 0–30. Item responses of 3–4 or 5–7 days were deemed indicative of specific depressive symptoms. The outcome variables were self-reported accidental falls and injurious falls.

Results

Of the 12,392 participants included in the study, 3,671 (29.6%) had high baseline depressive symptoms (CESD-10 scores ≥ 10), 1,892 (15.3%) experienced falls, and 805 (6.5%) experienced injurious falls during 2015–2018 follow-up. High depressive symptoms increased the risk of falls [odds ratio (OR) 1.34, 95% confidence interval (CI) 1.19–1.50] and injurious falls (OR 1.28, 95% CI 1.09–1.51) in a multivariable logistic regression model adjusted for major demographic, health-related, and anthropometric covariates. All of the 10 specific depressive symptoms except “felt hopeless” were associated with falls, and four specific symptoms significantly increased the risk of injurious falls; “had trouble concentrating” (OR 1.32, 95% CI 1.13–1.55); “felt depressed” (OR 1.32, 95% CI 1.12–1.55); “everything was an effort” (OR 1.23, 95% CI 1.04–1.45); and “restless sleep” (OR 1.18, 95% CI 1.02–1.40).

Conclusion

High depressive symptoms are significantly related to risk of falls and injurious falls. Four specific symptoms (had trouble concentrating, felt depressed, everything was an effort, and restless sleep) increase the risk of injurious falls in Chinese adults aged ≥ 45 years.
The hidden financial catastrophe of chronic kidney disease under universal coverage and Thai “Peritoneal Dialysis First Policy”
Authors: Sangthawan Pornpen , Klyprayong Pinkaew , Geater Sarayut L. , Tanvejsilp Pimwara , Anutrakulchai Sirirat , Boongird Sarinya , Gojaseni Pongsathorn , Kuhiran Charan , Lorvinitnun Pichet , Noppakun Kajohnsak , Parapiboon Watanyu , Sirilak Supinda , Tankee Pluemjit , Taruangsri Puntapong , Sangsupawanich Pasuree , Sritara Piyamitr , Chaiyakunapruk Nathorn , Kitiyakara Chagriya
Published: October 2022

Objective

Universal health coverage can decrease the magnitude of the individual patient's financial burden of chronic kidney disease (CKD), but the residual financial hardship from the patients' perspective has not been well-studied in low and middle-income countries (LMICs). This study aimed to evaluate the residual financial burden in patients with CKD stage 3 to dialysis in the “PD First Policy” under Universal Coverage Scheme (UCS) in Thailand.

Methods

This multicenter nationwide cross-sectional study in Thailand enrolled 1,224 patients with pre-dialysis CKD, hemodialysis (HD), and peritoneal dialysis (PD) covered by UCS and other health schemes for employees and civil servants. We interviewed patients to estimate the proportion with catastrophic health expenditure (CHE) and medical impoverishment. The risk factors associated with CHE were analyzed by multivariable logistic regression.

Results

Under UCS, the total out-of-pocket expenditure in HD was over two times higher than PD and nearly six times higher than CKD stages 3–4. HD suffered significantly more CHE and medical impoverishment than PD and pre-dialysis CKD [CHE: 8.5, 9.3, 19.5, 50.0% (p < 0.001) and medical impoverishment: 8.0, 3.1, 11.5, 31.6% (p < 0.001) for CKD Stages 3–4, Stage 5, PD, and HD, respectively]. In the poorest quintile of UCS, medical impoverishment was present in all HD and two-thirds of PD patients. Travel cost was the main driver of CHE in HD. In UCS, the adjusted risk of CHE increased in PD and HD (OR: 3.5 and 16.3, respectively) compared to CKD stage 3.

Conclusions

Despite universal coverage, the residual financial burden remained high in patients with kidney failure. CHE was considerably lower in PD than HD, although the rates remained alarmingly high in the poor. The “PD First' program” could serve as a model for other LMICs. However, strategies to minimize financial distress should be further developed, especially for the poor.
Potential mediators of the link between wealth index and anthropometric indices of under-five children in Ethiopia
Authors: Tesfaw Lijalem Melie , Woya Ashenafi Abate
Published: October 2022

Background

Malnutrition of under-five children has adverse effects on child's health and development, such as growth failure and muscle wasting. The household wealth index has a direct contribution to child malnutrition despite little attention being given to its indirect effect through other factors. This study aimed to identify the potential mediators of the link between wealth index and malnutrition.

Methods

In this study, a cross-sectional study design was implemented based on the data obtained from the 2019 Ethiopia Mini Demographic and Health Survey (EMDHS), which consists of a total of 3,918 under-five children. Mediation analysis of structural equation (SEM) was implemented to determine and estimate the effects of potential mediators of the link between wealth index and under-five children malnutrition.

Results

Among 3,918 under-five children involved in this study, 51.4% were male children and 20.2% were from urban areas. The place of delivery of the majority of mothers (56.1%) was at home, and the majority of children were from the poorest household (36.4%). The estimated effects of height-for-age of female children were higher (1.31:95% CI = 0.45, 0.200), indicating that female children had a lower likelihood of stunting than males. As compared to children in an urban area, children from rural areas were more likely to be stunted (−0.269; 95%CI = −0.388, −0.135). The estimated total indirect effects of wealth index on stunting and underweight was 0.69 (95% = 0.045, 0.094) and 0.036 (95% = 0.013, 0.054), respectively, and significant (p-value of <0.05).

Conclusion

Environmental, maternal, biological, and behavioral factors were the potential mediators of the link between the wealth index and the anthropometric indices. Besides, the total effects of the household wealth index had a significant effect on stunting, underweight, and wasting in which children from a household with low economic status were more likely to be malnourished.
The ethics of aggregation in cost-effectiveness analysis or, “on books, bookshelves, and budget impact”
Authors: Charlton Victoria
Published: October 2022

In deciding how to allocate resources, healthcare priority-setters are increasingly paying attention to an intervention's budget impact alongside its cost-effectiveness. Some argue that approaches that use budget impact as a substantive consideration unfairly disadvantage individuals who belong to large patient groups. Others reject such claims of “numerical discrimination” on the grounds that consideration of the full budget impact of an intervention's adoption is necessary to properly estimate opportunity cost. This paper summarizes this debate and advances a new argument against modifying the cost-effectiveness threshold used for decision-making based on a technology's anticipated budget impact. In making this argument, the paper sets out how the apparent link between budget impact and opportunity cost is largely broken if the effects of a technology's adoption are disaggregated, while highlighting that the theoretical aggregation of effects during cost-effectiveness analysis likely only poorly reflects the operation of the health system in practice. As such, it identifies a need for healthcare priority-setters to be cognizant of the ethical implications associated with aggregating the effects of a technology's adoption for the purpose of decision-making. Throughout the paper, these arguments are illustrated with reference to a “bookshelf” analogy borrowed from previous work.
Classification of multiple sclerosis clinical profiles using machine learning and grey matter connectome
Authors: Barile Berardino , Ashtari Pooya , Stamile Claudio , Marzullo Aldo , Maes Frederik , Durand-Dubief Françoise , Van Huffel Sabine , Sappey-Marinier Dominique
Published: October 2022

Purpose: The main goal of this study is to investigate the discrimination power of Grey Matter (GM) thickness connectome data between Multiple Sclerosis (MS) clinical profiles using statistical and Machine Learning (ML) methods.

Materials and Methods: A dataset composed of 90 MS patients acquired at the MS clinic of Lyon Neurological Hospital was used for the analysis. Four MS profiles were considered, corresponding to Clinical Isolated Syndrome (CIS), Relapsing-Remitting MS (RRMS), Secondary Progressive MS (SPMS), and Primary Progressive MS (PPMS). Each patient was classified in one of these profiles by our neurologist and underwent longitudinal MRI examinations including T1-weighted image acquisition at each examination, from which the GM tissue was segmented and the cortical GM thickness measured. Following the GM parcellation using two different atlases (FSAverage and Glasser 2016), the morphological connectome was built and six global metrics (Betweenness Centrality (BC), Assortativity (r), Transitivity (T), Efficiency (Eg), Modularity (Q) and Density (D)) were extracted. Based on their connectivity metrics, MS profiles were first statistically compared and second, classified using four different learning machines (Logistic Regression, Random Forest, Support Vector Machine and AdaBoost), combined in a higher level ensemble model by majority voting. Finally, the impact of the GM spatial resolution on the MS clinical profiles classification was analyzed.

Results: Using binary comparisons between the four MS clinical profiles, statistical differences and classification performances higher than 0.7 were observed. Good performances were obtained when comparing the two early clinical forms, RRMS and PPMS (F1 score of 0.86), and the two neurodegenerative profiles, PPMS and SPMS (F1 score of 0.72). When comparing the two atlases, slightly better performances were obtained with the Glasser 2016 atlas, especially between RRMS with PPMS (F1 score of 0.83), compared to the FSAverage atlas (F1 score of 0.69). Also, the thresholding value for graph binarization was investigated suggesting more informative graph properties in the percentile range between 0.6 and 0.8.

Conclusion: An automated pipeline was proposed for the classification of MS clinical profiles using six global graph metrics extracted from the GM morphological connectome of MS patients. This work demonstrated that GM morphological connectivity data could provide good classification performances by combining four simple ML models, without the cost of long and complex MR techniques, such as MR diffusion, and/or deep learning architectures.
Identifying emotions toward an overweight avatar in Virtual Reality: The moderating effects of visuotactile stimulation and drive for thinness
Authors: van der Waal Nadine Elisa , van Bokhorst Julie A. W. , van der Laan Laura Nynke
Published: October 2022

Virtual reality technologies can be used to alter one’s body image by inducing ownership of an overweight virtual body. This illusion can possibly lead to both negative affective responses toward the virtual body as well as perceptual changes of one’s own body size, which are both scarcely examined with regard to the embodiment of an overweight avatar. This study’s fundamental aim is to investigate, among healthy weight participants, whether negative affect toward a virtual body and changes in body-size perception can be evoked when embodying an overweight virtual avatar. Additionally, the study investigates whether applying visuotactile stimulation (which has been identified as a proxy for virtual body ownership by previous studies) and drive for thinness influence the strength of these effects. A 2 (healthy weight vs. overweight virtual body) × 2 (congruent vs. incongruent visuotactile stimulation) between-subjects design was employed, with participants’ drive for thinness measured to test its potential moderating effect. ANOVAs revealed that participants (N = 114) experienced significantly more negative affect toward the virtual body when embodying one that was overweight compared to a healthy weight virtual body. Visuotactile stimulation did not moderate this effect, even though the manipulation of visuotactile stimulation worked as intended (i.e., the experience of ownership over the virtual body was significantly higher in the congruent compared to incongruent visuotactile stimulation condition). Additionally, participants with a high drive for thinness did not experience significantly more negative affect than participants with a low drive for thinness. Embodiment of an overweight avatar did not affect body-size perceptions, nor did visuotactile stimulation or the drive for thinness moderate this effect. Knowing that embodiment of an overweight avatar results in negative affective responses toward it, future studies could deepen our understanding of the role of negative affect in the transfer of emotions to one’s own body, and the interplay between negative affect toward a virtual body and body-size perceptions.
Impact of recommissioning flushing on Legionella pneumophila in a large building during the COVID-19 pandemic
Authors: Grimard-Conea Marianne , Deshommes Elise , Doré Evelyne , Prévost Michèle
Published: October 2022

COVID-19 shutdowns drastically increased the frequency and duration of water stagnation events in building plumbing systems, urging local authorities to issue guidance for the safe reopening of buildings mostly by recommissioning flushing. The objectives of this study were to document the dynamic changes of bacterial indicators [adenosine triphosphate (ATP), total and intact cell counts (TCC, ICC)] and the prevalence of Legionella pneumophila (Lp) in 20–21 showerheads in a large building before (16-week building closure) and then shortly (24 h) and monthly (4-week of distal water stagnation) after targeted recommissioning flushing. Following the 16-week shutdown, the highest mean of ATP (10 pg ATP/mL), TCC (1.7 × 106 count/mL) and ICC (5.2 × 105 count/mL) were measured in first draw samples. This bacterial amplification was mostly attributable to detachment from biofilm present in the distal devices and immediate connecting piping. Culture-based (mean of 4 487 MPN/L) and quantitative polymerase chain reaction (qPCR; mean of 63 822 gu/L) concentrations of Lp were respectively measured in 81 and 90% of first draw samples. Individual flushing of showerheads for 5 min resulted in 1.2–278-fold decreases in ATP, whereas TCC and ICC were lowered by 1.1- and 0.7-log on average. A one-log reduction in culture-based and qPCR Lp was only achieved in 63 and 29% of paired water samples, resulting in less than one-log reduction in mean risk values per exposure, thus demonstrating the limited effects of fixture-flushing for risk reduction. Clear short-term (24 h) benefits of device recommissioning flushing included lowered values of all bacterial indicators and Lp levels systematically under the common alert threshold of 1 000 MPN/L in first draws. However, after a period of 1 month without water use, these benefits were mostly lost with considerable rebounds of concentrations to similar levels than those measured following the 16-week building closure. Results highlight the temporary benefits of device recommissioning flushing for the control of Lp in shower systems, especially in buildings colonized by Legionella.
Precursor identification for strong flares based on anomaly detection algorithm
Authors: Wang Jingjing , Luo Bingxian , Liu Siqing
Published: October 2022

In this study, we assume that the magnetic configuration of active regions (ARs) in quiet periods has certain similarities and can be considered “normal” features. While there are some other magnetic features of active regions that are related to strong flares, they can be considered the precursor of strong flares and “anomaly” features. Our study aims to identify those “anomalies” and apply them in strong-flare forecasting. An unsupervised auto-encoder network has been used to understand and memorize these “normal” features, and then, based on the mean squared errors between the pictures of the ARs and the corresponding reconstructed pictures derived by the network, an anomaly detection algorithm has been adopted to identify the precursor for strong flares and develop a strong-flare classification model. The strong-flare classification model reaches an F1 score of 0.8139, an accuracy of 0.8954, a recall of 0.8785, and a precision of 0.7581. Moreover, for those correctly predicted strong-flare events (94 M-class flares and above), the model reaches an average first warning time of 45.24 h. The results indicate that the anomaly detection algorithm can be used in precursor identification for strong flares and help in both improving strong-flare prediction accuracy and enlarging the time in advance. Also, the obtained average maximum warning period for strong-flare prediction (nearly 2 days) will be useful for future applications for space-weather solar flare prediction.
A more novel and powerful prognostic gene signature of lung adenocarcinoma determined from the immune cell infiltration landscape
Authors: Ma Chao , Li Feng , He Zhanfeng , Zhao Song
Published: October 2022

Background

Lung adenocarcinoma (LUAD) is the leading histological subtype of lung cancer worldwide, causing high mortality each year. The tumor immune cell infiltration (ICI) is closely associated with clinical outcome with LUAD patients. The present study was designed to construct a gene signature based on the ICI of LUAD to predict prognosis.

Methods

Downloaded the raw data of three cohorts of the TCGA-LUAD, GSE72094, and GSE68465 and treat them as training cohort, validation cohort one, and validation cohort two for this research. Unsupervised clustering detailed grouped LUAD cases of the training cohort based on the ICI profile. The univariate Cox regression and Kaplan–Meier was adopted to identify potential prognostic genes from the differentially expressed genes recognized from the ICI clusters. A risk score-based prognostic signature was subsequently developed using LASSO-penalized Cox regression analysis. The Kaplan-Meier analysis, Cox analysis, ROC, IAUC, and IBS were constructed to assess the ability to predict the prognosis and effects of clinical variables in another two independent validation cohorts. More innovatively, we searched similar papers in the most recent year and made comprehensive comparisons with ours. GSEA was used to discover the related signaling pathway. The immune relevant signature correlation identification and immune infiltrating analysis were used to evaluate the potential role of the signature for immunotherapy and recognize the critical immune cell that can influence the signature's prognosis capability.

Results

A signature composed of thirteen gene including ABCC2, CCR2, CERS4, CMAHP, DENND1C, ECT2, FKBP4, GJB3, GNG7, KRT6A, PCDH7, PLK1, and VEGFC, was identified as significantly associated with the prognosis in LUAD patients. The thirteen-gene signature exhibited independence in evaluating the prognosis of LUAD patients in our training and validation cohorts. Compared to our predecessors, our model has an advantage in predictive power. Nine well know immunotherapy targets, including TBX2, TNF, CTLA4, HAVCR2, GZMB, CD8A, PRF1, GZMA, and PDCD1 were recognized correlating with our signature. The mast cells were found to play vital parts in backing on the thirteen-gene signature's outcome predictive capacity.

Conclusions

Collectively, the current study indicated a robust thirteen-gene signature that can accurately predict LUAD prognosis, which is superior to our predecessors in predictive ability. The immune relevant signatures, TBX2, TNF, CTLA4, HAVCR2, GZMB, CD8A, PRF1, GZMA, PDCD1, and mast cells infiltrating were found closely correlate with the thirteen-gene signature's power.
Three-dimensional computed tomography reconstruction in video-assisted thoracoscopic segmentectomy (DRIVATS): A prospective, multicenter randomized controlled trial
Authors: Niu Zhenyi , Chen Kai , Jin Runsen , Zheng Bin , Gong Xian , Nie Qiang , Jiang Benyuan , Zhong Wenzhao , Chen Chun , Li Hecheng
Published: October 2022

Objective

Anatomical segmentectomy has been proven to be a viable surgical treatment for small-size peripheral lung nodules. Three-dimensional (3D) reconstruction computed tomography (CT) has been proposed as an effective approach to overcome the challenges of encountering pulmonary anatomical variations when performing segmentectomy. Therefore, to further investigate the usefulness of preoperative 3D reconstruction CT in segmentectomy, we will conduct this prospective, multicenter randomized controlled DRIVATS study to compare the use of 3D reconstruction CT with standard chest CT in video-assisted segmentectomy (ClinicalTrials.gov ID: NCT04004494).

Methods

This study began in July 2019 and a total of 190 patients will be accrued from three clinical centers within 4 years. The main inclusion criteria are patients with a single peripheral nodule 0.8–2 cm with at least one of the following requirements: (i) histology of adenocarcinoma in situ; (ii) nodule has ≥50% ground-glass appearance on CT; (iii) radiologic surveillance confirms a long doubling time (≥400 days). Surgical procedures include segmental resection of the lesion and mediastinal lymph node sampling (subsegmental resection or combined subsegmental resection will not be included in this study). The primary endpoint is operative time. The secondary endpoints include incidence of change of surgical plan, intraoperative blood loss, conversion rate, operative accident event, incidence of postoperative complications, postoperative hospital stay, length of hospitalization, duration of chest tube placement, postoperative 30-day mortality, dissection of lymph nodes, overall survival, disease-free survival, preoperative lung function, and postoperative lung function.

Discussion

This multicenter DRIVATS study aims to verify the usefulness of preoperative 3D reconstruction CT compared with standard chest CT in segmentectomy. If successfully completed, this multicenter prospective study will provide a higher level of evidence for the use of 3D reconstruction CT in segmentectomy.
An all-arthroscopic light bulb technique to treat osteonecrosis of the femoral head through outside-in fashion without distraction: A case report
Authors: Xiong Hua-zhang , Deng Yu-hong , Jin Ying , Wang An-hong , Hong Song
Published: October 2022

The technique of distraction has been widely used in hip arthroscopy for opening joint spaces. However, an all-arthroscopic light bulb technique through outside-in fashion without distraction has not been reported for the treatment of osteonecrosis of the femoral head (ONFH). A 29-year-old man was admitted to our department with hip pain and limited range of motion (ROM) in both hips over 4 months. X-rays, computed tomography (CT), and magnetic resonance imaging (MRI) showed a mixed appearance, including sclerosis and cysts on the anterosuperior site of the bilateral femoral heads. The patient had an 11-year history of liquor intake. In addition, no other pathologies were found before the operation. After diagnosing bilateral ONFH (stage II) according to the Ficat classification, the patient underwent an all-arthroscopic light bulb technique through outside-in fashion without distraction because of failing conservative treatment. At the 2-year postoperative follow-up, the patient had neither pain nor limitation of ROM. The postoperative x-ray, CT, and MRI revealed a well-healed area of the previous bone grafting in the bilateral femoral heads. An all-arthroscopic light bulb technique through outside-in fashion without distraction can be a feasible method for the treatment of early-stage ONFH. This case reminds us that distraction- and perforation-related complications may be avoided in patients with ONFH without the concomitant pathologies of the central compartment.