Search

Background: Behavioural intention (BI) has been predicted using other variables by adopting the technology acceptance model (TAM). However, few studies have examined whether BI can predict learning performance. Objectives: The present study used an extended TAM to investigate whether students' BI is a predictor of their listening learning performance (LLP) through vocabulary learning performance (VLP) in the context of mobile vocabulary‐assisted listening learning by using two mobile learning tools. Methods: A total of 129 college students with a pre‐intermediate level of English were recruited as participants, and a 10‐week mobile vocabulary‐assisted, listening‐learning course was conducted in 2022. In each task of this course, the students had to learn target words from a listening passage on Quizlet and then engage in listening activities on Randall's ESL Cyber Listening Lab. Quantitative responses obtained through an online questionnaire were analysed through partial‐least‐squares structural equation modelling. Results: The analysis results indicated that BI significantly predicted LLP through VLP. Perceived ease of use (PEU) and perceived usefulness (PU) were significant antecedents of BI. However, PEU did not significantly predict PU because of the difficulty of navigating between the two technological tools used in this study. The extended model demonstrated its effectiveness in explaining listening learning performance, as evidenced by an explained variance (R2) of 69%. Conclusion: The extended model validates the influence of BI on learning performance and it can also draw teachers' focus toward the significance of enhancing students' BI to improve their listening learning performance. Pedagogical implications based on the results are provided in this paper. Lay Description: What is already known about this topic?: TAM was used to study learners' acceptance of mobile‐assisted language learning.TAM incorporates latent variables to explore mobile‐assisted language learning.Investigating factors influencing BI is a primary research focus in extended TAM literature.Mobile tools could improve listening learning and vocabulary retention. What this paper adds to that: Learning performance was considered as a dependent variable in an extended TAM.BI might predict students' learning performance in vocabulary and listening in an extended TAM.Teachers used two mobile tools to design mobile vocabulary‐assisted listening tasks.Pre‐learning the target words facilitate students' listening learning performance. Implications for practice and/or policy: We show the importance of BI on predicting listening learning performance.The impact of BI on other factors became another focus of TAM research.Results highlight pre‐learning target words' importance for better listening performance.Existing mobile tools improve listening performance, avoiding new system development. [ABSTRACT FROM AUTHOR]

Background: Changing the food environment is an important public health lever for encouraging sustainable food choices. Targeting the availability of vegetarian main meals served in cafeterias substantially affects food choice, but acceptability has never been assessed. We examined the effects of an availability intervention at a French university cafeteria on students' main meal choices, meal offer satisfaction and liking. Methods: A four-week controlled trial was conducted in a university cafeteria in Dijon, France. During the two-week control period, vegetarian main meals constituted 24% of the offer. In the subsequent two-week intervention period, this proportion increased to 48%, while all the other menu items remained unchanged. Students were not informed of the change. Student choices were tracked using production data, and daily paper ballots were used to assess student satisfaction with the meal offer and liking of the main meal they chose (score range [1;5]). Nutritional quality, environmental impact, and cost of production of meal choices were calculated for each lunchtime. Food waste was measured over 4 lunchtimes during control and intervention periods. An online questionnaire collected student feedback at the end of the study. Results: Doubling availability of vegetarian main meals significantly increased the likelihood of choosing vegetarian options (OR = 2.57, 95% CI = [2.41; 2.74]). Responses of the paper ballots (n = 18,342) indicated slight improvements in meal offer satisfaction from 4.05 ± 0.92 to 4.07 ± 0.93 (p = 0.028) and in liking from 4.09 ± 0.90 to 4.13 ± 0.92 (p < 0.001) during control and intervention periods, respectively. The end-of-study questionnaire (n = 510) revealed that only 6% of students noticed a change the availability of vegetarian main meals. The intervention led to a decrease in the environmental impact of the main meals chosen, a slight decrease in nutritional quality, a slight increase in meal costs and no change in food waste. Conclusions: Doubling availability of vegetarian main meals in a university cafeteria resulted in a twofold increase in their selection, with students reporting being more satisfied and liking the main meals more during the intervention period. These results suggest that serving an equal proportion of vegetarian and nonvegetarian main meals could be considered in French university cafeterias to tackle environmental issues. Trial registration: Study protocol and analysis plan were pre-registered on the Open Science Framework (https://osf.io/pf3x7/). [ABSTRACT FROM AUTHOR]

The high reliability demand of the machining center emphasizes the accuracy of the fault risk evaluation. In the traditional fault risk evaluation research of the machining center, the influence of fault mode is mostly based on subjective recommendation or does not consider the propagation and diffusion of fault, which makes the risk evaluation results different from the real situation. Therefore, this paper presents a framework to evaluate the fault risk for machining center components. A certain type of machining center is considered as a case study. The fault mode frequency ratio of components is calculated by fault mode analysis. The fault rate calculation is conducted based on the Johnson method. Considering that different fault modes have different influences on fault propagation breadth and depth, the hypergraph theory is used to build a hypernetwork model. The propagation and diffusion influence degree are defined to describe the propagation and diffusion process of faults. Then, the comprehensive influence degree of fault mode is calculated. The risk evaluation is realized by considering the component fault rate, fault mode frequency ratio, and the comprehensive influence degree of fault mode. The method proposed in this paper can provide a reference for the formulation of risk strategies for the machining center. [ABSTRACT FROM AUTHOR]

Student feedback literacy has been the subject of much conceptual literature; however, relatively little intervention research has investigated how and if it can be developed. Further, no evaluation of the current empirical literature has been conducted to assess which elements of feedback literacy can be successfully improved in practice, and which elements need further investigation. This paper seeks to explore how different aspects of feedback literacy have been developed in higher education. A scoping review was conducted to address the foci, nature and success of interventions. The review found evidence that educational interventions enhanced feedback literacy in students, such as managing perceptions and attitudes, and having more confidence and agency in the feedback process. While some interventions have an effect on influencing student feedback literacy, both improved study design and intervention design are required to make the most of future feedback literacy interventions. [ABSTRACT FROM AUTHOR]

Although the fictional domain exhibits a prima facie freedom from real-world moral constraints, certain fictive imaginings seem to deserve moral criticism. Capturing both intuitions, this paper argues for double-standard moralism, the view that fictive imaginings are subject to different moral standards than their real-world counterparts. I show how no account has, thus far, offered compelling reasons to warrant the moral appropriateness of this discrepancy. I maintain that the normative discontinuity between fiction and the actual world is moderate, as opposed to one that leaves fictive engagements wholly exempt from moral evaluations. I propose a way of addressing the gamer's dilemma that is compatible with a moderate kind of discontinuity. Finally, I contend that the audience is justified in adopting deviant moral attitudes in fictional situations because their consequences largely differ from those that analogous real-world events would have. [ABSTRACT FROM AUTHOR]

Introduction: Involving service users in health service design and delivery is considered important to improve the quality of healthcare because it ensures that the delivery of healthcare is adapted to the needs of the users. Co‐production is a process used to involve service users, but multiple papers have highlighted the need for the mechanisms and values guiding co‐production to be more clearly stated. The aim of this paper was to evaluate the mechanisms and values that guided the co‐production approach of the Stories for Change project, which used Public Narrative as part of the co‐design process to create change in National Health Service maternity services. Methods: This study was conducted using a rapid feedback evaluation approach. Semistructured interviews (n = 16) were the main source of data, six of which were maternity service users, with observations (5 h) and documentary analysis also carried out in parallel. RREAL sheets were used for data analysis to organize data based on key topics of interest. Results: This study identified three broad mechanisms and values underpinning the co‐production approach: creating an open and safe space to share ideas, learning how to tell stories using Public Narrative and having service providers who play a key role in strengthening the health system listen to stories compelling them to action. This study identified the main areas for improvement of the Stories for Change project related to recruitment, the inclusion of participants, the co‐design process, the Skills Session and the Learning Event. Conclusion: Our study provided a deeper understanding of the co‐production approach that addresses the need to uncover the mechanism and values underlying co‐production and co‐design approaches. This study expands on the literature pertaining to the influence of storytelling in creating meaningful change in health care. We propose a co‐design methodology that uses Public Narrative as a model for service user engagement to help inform future healthcare development processes. Patient or Public Contribution: The experiences and perceptions of maternity service users and health professionals informed this evaluation. The project organizers were involved in the manuscript preparation stage by providing feedback, and service users wrote a commentary on the project from the lived experience perspective. [ABSTRACT FROM AUTHOR]

Aim: To demonstrate how implementing a system‐wide measurement and improvement programme can make the delivery of the Fundamentals of Care visible in practice. Design: Discussion paper. Data Sources: A retrospective evaluation of the experience of implementing a system‐wide peer review programme using the Promoting Action on Research Implementation in Health Services framework. Implications for Nursing: Implementing this programme engages nursing leaders at all levels in fundamental care delivery, evaluation and improvement. It positions nursing leaders as accountable for and champions of fundamental care. Conclusion: The peer review programme offers a solution to the complex challenge of measuring the fundamentals of care in practice. Successful implementations of this programme at two New Zealand inpatient sites have shown positive results in improved care and patient experience. This makes it worthy of consideration for other health organizations. Nursing leadership has proven to be critical to success. The Promoting Action on Research Implementation in Health Services framework highlights the components that assist with successful implementation and assists in presenting a case for change. Impact This paper addressed the problem of the lack of action and dearth of quality, integrated data, visibility of the patient experience and the contribution of nursing leadership in an inpatient setting. Findings indicate that the peer review programme is translatable, modifiable and sensitive to ethnicity and disability. Using the implementation framework to evaluate the process has provided a guide for future implementations. [ABSTRACT FROM AUTHOR]

Background: A robust evidence base is required to assist healthcare commissioners and providers in selecting effective and sustainable approaches to improve cancer diagnosis and treatment. Such evidence can be difficult to build, given the fast-paced and highly pressured nature of healthcare delivery, the absence of incentives, and the presence of barriers in conducting pragmatic yet robust research evaluations. Cancer Research UK (CRUK) has played an active part in building the evidence base through its funding of programmes to identify, evaluate and scale-up innovative approaches across the UK. The aim of this paper is to describe and explain the research design and intended approach and activities for two cancer services improvement projects in Scotland funded by CRUK. Methods: A hybrid effectiveness-implementation study design will assess both the efficiency of the new pathways and their implementation strategies, with the aim of generating knowledge for scale-up. A range of implementation, service and clinical outcomes will be assessed as determined by the projects' Theories of Change (ToCs). A naturalistic case study approach will enable in-depth exploration of context and process, and the collection and synthesis of data from multiple sources including routine datasets, patient and staff surveys, in-depth interviews and observational and other data. The evaluations are informed throughout by a patient/public representatives' group, and by small group discussions with volunteer cancer patients. Discussion: Our approach has been designed to provide a holistic understanding of how (well) the improvement projects work (in relation to their anticipated outcomes), and how they interact with their wider contexts. The evaluations will help identify barriers, facilitators, and unanticipated consequences that can impact scalability, sustainability and spread. By opting for a pragmatic, participatory evaluation research design, we hope to inform strategies for scaling up successful innovations while addressing challenges in a targeted manner. [ABSTRACT FROM AUTHOR]

Dear Editor, We are pleased our article is of interest to readers of I Caries Research i and appreciate the opportunity to respond to the "Letter to Editor" comments by Balachandran et al. [2022] regarding our publication, "Dental Health Inequalities among Indigenous Populations: A Systematic Review and Meta-Analysis"[Nath et al., 2021]. The funnel plot is a scatter diagram that represents study-specific effect sizes against study precision and means for detecting publication bias and exploring small study effect [Sterne et al., 2011]. Therefore, we decided to use a more generalized proxy terminology for dental caries inequality as "dental health inequalities.". [Extracted from the article]

Background: Patients with disabilities often require healthcare accommodations in order to access high-quality, equitable healthcare services. While attention has been paid to accommodation needs in specific disability populations, limited research to date has explored healthcare accommodations that cross-cut diverse disability populations.Objective: To identify a deeper understanding regarding accommodations in healthcare settings that could apply across disability populations and promote equitable healthcare.Design: We conducted qualitative focus groups with patients with disabilities and caregivers to understand their experiences and preferences for healthcare accommodations.Participants: We recruited patients and caregivers across all major disability categories to participate in focus groups. Participants were recruited through advocacy organizations and healthcare settings in Southeastern Minnesota.Approach: A total of eight focus groups were conducted with 56 participants. Participants described their healthcare experiences and desires for healthcare accommodations. The multidisciplinary research team recorded, transcribed verbatim, and coded all focus groups. The team thematically coded transcripts using content analysis within and across focus groups to identify major themes.Key Results: Patients identified four challenges and corresponding steps healthcare team could take to promote equitable care: (1) consistent documentation of disabilities and needed accommodations in the medical record; (2) allowance for accommodations to the environment, including adapting physical space, physical structures, and scheduling and rooming processes; (3) provide accommodations for administrative tasks, such as completing paper or electronic forms; and (4) adapt communication during interactions, such as speaking slower or using terms that patients can easily understand.Conclusion: These identified themes represent specific opportunities for healthcare teams to effectively provide accessible care to patients with disabilities. Many of the accommodations require minimal financial investment, but did require behavioral changes by the healthcare team to ensure equitable healthcare. [ABSTRACT FROM AUTHOR]

The heart and soul of the Chinese people and the greatest cultural soft power of contemporary China are excellent Chinese healthy cultural environments. Short video platforms and short videos have a chance to develop as the Internet revolution continues to intensify and mobile clients gain popularity. This essay examines the challenges involved in producing brief videos that promote a healthy cultural environment in the new context of internet plus, as well as the means of transmitting such videos and creative methods for doing so. Excellent communication content is created in this paper from two perspectives of visual presentation and in-depth meaning, allowing users to fully understand the connotation of a healthy cultural environment. Through the theme of a healthy cultural environment, topic discussion and characteristic activities will be carried out to encourage users' spontaneous sharing of the interactive behavior of communication and the fission communication of brief videos of a healthy environment. This paper develops a model for intelligent recommendation and short video content analysis based on this. In order to further encourage the creative dissemination and development of short videos about healthy cultural environments, the model is used to choose high-quality videos and accurately recommend them to the appropriate users and to serve as an example of how a quick video can be used to communicate innovation and a healthy cultural environment. [ABSTRACT FROM AUTHOR]

In the context of the new era, the distinctive function of BD (big data) analysis and prediction also introduces a new way of thinking to university IPE (ideological and political education), broadens the domain of university IPE, and enhances the curricular offerings of IPE universities. In order to enhance the intelligence and personalization of the intelligent teaching system, this paper describes in detail the design and implementation processes for each component of the system. It also uses the association mining rule algorithm of data mining. To maintain population diversity, a population initialization method and a neighborhood-based search operator are used, both of which are based on a thorough consideration of the characteristics of complex networks. The neighborhood search strategy enhances the local search capability of the TLBO (Teaching-Learning Based Optimization) algorithm. The optimized TLBO algorithm presented in this paper achieves the highest average modularity value of 0.5238 through testing on real-world data sets. The outcomes demonstrate that the algorithm performs well and is successful in identifying problems in the community. [ABSTRACT FROM AUTHOR]

The water environment is one of the basic elements that constitute the environment. It is an important place for the survival and development of human society, and it is also the most seriously disturbed and damaged area by humans. The pollution and destruction of water environment has become one of the major environmental problems in the world today. The essence of urban water space landscape design under the concept of integrating people's ecological design is the ecological landscape design of urban water spaces, while the development of ecological landscape design in the field of urban water space landscape design is still in its infancy, and the interpretation of its concept is also different. The ecological design of the landscape reflects a new dream of human beings, a new aesthetics and value: the true cooperative and fraternal relationship between man and nature. At present, the ecological design of urban water space landscape has not put forward a more accurate concept, clear principles and standards, and a complete and systematic theoretical basis, which requires further research, discussion, and continuous practice by this generation of designers to improve it. To this end, this paper proposed a research method on the integration of water environment governance in urban and rural spaces with natural ecological landscape design. This paper mainly talked about the status quo of water environment and its network sensor algorithm research and analyzed its coverage area one by one. Then, the water quality extraction is introduced in detail. And finally, the data analysis of the Beijing river waters, the analyzer rainfall, water quality, and so on are carried out in the experimental part. It could be seen from the experimental results that there were currently 22 reclaimed water plants in six urban areas of Beijing, with a daily water treatment capacity of 4.08 million cubic meters and a sewage treatment rate of 98%. As of 2016, 440 million cubic meters of reclaimed water has been reused. With the commissioning of the new reclaimed water system, the proportion of reclaimed water in the river and lake environment will continue to increase. [ABSTRACT FROM AUTHOR]

Yan'an is one of the "two holy places" of the Chinese nation and the Chinese revolution and is one of the first cities of historical and cultural significance and an outstanding tourist city in China, as announced by the state council. The evaluation of the effectiveness of environmental conservation is one of the very important elements of the conservation of Yan'an's architectural heritage. However, the existing evaluation methods cannot provide new solutions for decision-making, the meaning of the comprehensive evaluation function is unclear, the naming clarity is low, there is less quantitative data and more qualitative components, and the results are not easily convincing. This paper proposes a method for evaluating the practical effects of environmental class measures in the conservation of Yan'an's architectural heritage based on recurrent neural networks. The recurrent neural network makes full use of the memory function in the network, considers the causal relationship of the actual effect, and efficiently evaluates the existing measures. In comparison with factor analysis and hierarchical analysis, this paper has greater applicability in evaluating the practical effects of environmental measures in the conservation of Yan'an's architectural heritage and is basically consistent with the results of the theoretical analysis. It provides a scientific basis for the construction and implementation of environmental measures for the architectural heritage of Yan'an. [ABSTRACT FROM AUTHOR]

Older people are marginalized in different ways. Examples include social exclusion and stereotypes such as “the lonely and technologically incompetent elderly”. But in the digital age, opportunities for digital empowerment exist alongside marginalization problems: Innovative technical research and development projects are exploring whether and how robots and avatars can help promote social connectedness and inclusion among older people. One of such initiatives is the CO-HUMANICS project. This paper presents the results of an interview study with women and men over 60 years of age. Older people showed heterogeneous attitudes towards robotic-assisted and avatar-assisted interpersonal communication as it will be enabled by the technology developed in the CO-HUMANICS project. [ABSTRACT FROM AUTHOR]

[Purpose/Significance] In the ever-evolving realm of higher education, the pronounced significance of methodically evaluating talented people in scientific and technological (S&T) fields within academic institutions has risen to paramount importance. This research endeavors to intricately dissect the manifold factors of shaping the evaluation of talented people in Chinese colleges and universities. Simultaneously, it seeks to meticulously design a comprehensive indicator system custom-tailored to this unique milieu. The dual objective encompasses unraveling the intricate dynamics underpinning the evaluation of talented people in S&T fields and invigorating talent cultivation and igniting innovation in scientific research across the academic landscape. [Method/Process] Guided by a meticulous review of both domestic and international advancements in the domain of the evaluation of talented people in S&T fields in higher education, this paper diligently dissects the intricate interplay of systems, theories, methodologies, and evaluation frameworks within Chinese academic institutions. By meticulously addressing associated challenges, conducting extensive discourse on influential variables, and meticulously examining facets of S&T prowess assessment within universities, this study culminates in the construction of an evaluation indicator system tailored to the unique nature of institutions of Chinese higher education. [Results/Conclusions] The findings echo the existence of critical gaps in the ongoing evaluation of talented people in S&T fields within Chinese universities. These noteworthy limitations encapsulate the intricate equilibrium sought between objectivity and subjectivity, the imperative for indicators to be comprehensive yet operationally feasible, the mandate for assessment to be dynamic and timely, and the essentiality of embracing multi-dimensional evaluation. This compels us to chart a trajectory towards the future where the development of an evaluation system of talented people in S&T fields rests on the bedrock of data-driven and intelligent assessment paradigms. This envisioned system must incorporate multi-dimensional evaluation approaches, integrate behavioral assessment modalities, deploy dynamic evaluation mechanisms, and, equally, factor in dimensions of social influence, sustainability, and internationalization. As we navigate this academic journey, further empirical research and meticulous indicator validation exercises must be undertaken within the realm of the evaluation of talented people in S&T fields in Chinese higher education institutions. These empirical undertakings, by virtue of their in-depth insights, are poised to illuminate our path forward, serving as compasses guiding the development of talented people in S&T fields in China's academic sphere. The journey towards comprehensive evaluation necessitates data-driven intelligence, multifaceted assessment perspectives, and a clear alignment with the pulse of societal dynamics and global imperatives. The culmination of these efforts will invariably shape the trajectory of the progression of talented people in S&T fields, ensuring that they remain at the vanguard of innovation and advancement. In essence, the evaluation of talented people within Chinese higher education institutions is primed for an evolution characterized by acumen, innovation, and internationalization. Through the harmonious amalgamation of rigorous research methodologies and adaptive frameworks, the academic community is poised to craft a transformative path that enriches talent development, propels research breakthroughs, and fuels the advancement of knowledge-based societies. [ABSTRACT FROM AUTHOR]

Background: MiRNA is a class of non-coding single-stranded RNA molecules with a length of approximately 22 nucleotides encoded by endogenous genes, which can regulate the expression of other genes. Therefore, it is very important to predict the associations between miRNA and disease. Predecessors developed a new prediction method of drug-disease association, and it achieved good results.Methods: In this paper, we introduced the method of LAGCN to identify potential miRNA-disease associations. First, we integrate three associations into a heterogeneous network, such as the known miRNA-disease association, miRNA-miRNA similarities and disease-disease similarities, next we apply graph convolution network to learn the embedding of miRNA and disease. We use an attention mechanism to combine embedding from multiple convolution layers. Unobserved miRNA-disease associations are scored based on integrated embedding.Results: After fivefold cross-validations, the value of AUC is reached 0.9091, which is higher than other prediction methods and baseline methods.Conclusions: In this paper, we introduced the method of LAGCN to identify potential miRNA-disease associations. LAGCN has achieved good performance in predicting miRNA-disease associations, and it is superior to other association prediction methods and baseline methods. [ABSTRACT FROM AUTHOR]

Background: The literature on qualitative data analysis mostly concerns analyses pertaining to an individual research question and the organization of data within that research question. Few authors have written about the entire qualitative dataset from which multiple and separate analyses could be conducted and reported. The concept of analytic direction is a strategy that can assist qualitative researchers in deciding which findings to highlight within a dataset. The objectives of this paper were to: 1) describe the importance of analytic direction in qualitative research, and 2) provide a working example of the concept of analytic direction.Methods: A qualitative dataset from one of the author's research programs was selected for review. Ten potential analytic directions were identified after the initial phenomenological analysis was conducted. Three analytic directions based on the same coding template but different content areas of the data were further developed using phenomenological analysis (n = 2) and qualitative description (n = 1) and are the focus of this paper. Development and selection of these three analytic directions was determined partially relying on methodological criteria to promote rigour including a comprehensive examination of the data, the use of multiple analysts, direct quotations to support claims, negative case analysis, and reflexivity.Results: The three analytic directions addressed topics within the scope of the overall research question. Each analytic direction had its own central point or story line and each highlighted a different perspective or voice. The use of an inductive and deductive approach to analysis and how the role of theory was integrated varied in each analytic direction.Conclusions: The concept of analytic direction enables researchers to organize their qualitative datasets in order to tell different and unique "stories". The concept relies upon, and promotes, the conduct of rigourous qualitative research. [ABSTRACT FROM AUTHOR]

The complexity of issues addressed by research for development (R4D) requires collaborations between partners from a range of disciplines and cultural contexts. Power asymmetries within such partnerships may obstruct the fair distribution of resources, responsibilities and benefits across all partners. This paper presents a cross-case analysis of five R4D partnership evaluations, their methods and how they unearthed and addressed power asymmetries. It contributes to the field of R4D partnership evaluations by detailing approaches and methods employed to evaluate these partnerships. Theory-based evaluations deepened understandings of how equitable partnerships contribute to R4D generating impact and centring the relational side of R4D. Participatory approaches that involved all partners in developing and evaluating partnership principles ensured contextually appropriate definitions and a focus on what partners value. [ABSTRACT FROM AUTHOR]

Alcohol and other drugs (AOD) use is a significant public health issue and is associated with high mortality and morbidity rates. Despite this, people who use drugs are often reluctant to seek care due to the lack of trauma‐informed treatment and harm reduction treatment options, as well as experiences of stigma and discrimination in health services. Arguably, AOD education that is co‐produced with people who use alcohol and drugs can enhance future health professionals' ability to practice in ways that support the needs of this population. This paper reports on a qualitative co‐evaluation of a co‐produced undergraduate nursing AOD subject. The AOD subject was co‐planned, co‐designed, co‐delivered, and co‐evaluated with experts by experience, who have a lived experience of substance dependence and work as advocates and peer workers. Following the delivery of the subject in 2021 and 2022, focus groups were undertaken with 12 nursing students. Focus group data indicate that the co‐produced subject supported participants to understand and appreciate how stigma impacts on nursing care and how to recognize and undertake 'good' nursing care that was oriented to the needs of service users. Student participants noted that being co‐taught by people who use drugs was particularly powerful for shifting their nursing perspectives on AOD use and nursing care and took learning beyond what could be understood from a book. Findings indicate that co‐produced AOD education can shift nursing students' perceptions of AOD use by providing access to tacit knowledge and embodied equitable and collaborative relationships with people who use drugs. [ABSTRACT FROM AUTHOR]

Hospital-based violence intervention programs (HVIPs) are multidisciplinary programs that use a health/public health approach to violence intervention by intervening with victims of violence at the time of injury and leveraging hospital- and community-based resources to address the underlying risk factors for violence. Much of the evidence for the impacts of HVIPs comes from qualitative research, yet there are few reviews of the efficacy of these approaches, and none that focus specifically on the HVIP context. This paper fills this gap by reviewing the common qualitative elements of published HVIP evaluations, and discusses their strengths, challenges, and relative applicability for researchers and practitioners alike. It then sets forth a research agenda, making a case for further (and more varied) qualitative HVIP evaluation research. [ABSTRACT FROM AUTHOR]

Background: Efforts to empower adolescent girls remain constrained by confusion around how to conceptually define empowerment and how to design interventions. More research, particularly among young adolescents, is needed that considers contextual and age-specific circumstances. This paper examines the latent classes of empowerment among early adolescent girls in Bangladesh and factors associated with membership in these classes. Using data from the Bangladeshi Association for Life Skills, Income, and Knowledge for Adolescents project, a four-arm randomized controlled trial designed to evaluate different community-based approaches for adolescents' skills development, we identify the latent classes before and after intervention and explore whether girls' membership in the study arms was associated with latent class membership at endline.Methods: To identify underlying subgroups among the sample, we conducted latent class analysis at baseline and endline using indicators of seven different constructs of empowerment based on the literature. Using multinomial logistic regression analysis, we assessed whether respondents' background characteristics and membership in the study arms were predictive of latent class membership at both timepoints.Results: A three-class model at baseline and a four-class model at endline showed optimal fit. In both models, three distinct latent classes were observed: (1) a least empowered class, (2) a mobile, socially active class, and (3) a socially progressive class. At endline, a fourth class emerged-the most empowered-that was mobile, socially active, and socially progressive. Girls' marital status, religion, and parents' level of education predicted latent class membership; household wealth was predictive at baseline, but not endline. Study arm was also associated with class membership at endline: girls in the Gender-Rights Awareness Arm had the highest probability of belonging to the fourth, most empowered class.Conclusion: This paper identifies and characterizes latent classes of empowerment that exist among the sample before and after the intervention. The apparent differential effects of interventions in predicting latent class membership have implications for community-based programming. Findings suggest that skills-building curriculum focused on promoting gender equitable norms, voice, and agency has potential to influence early adolescent girls across multiple dimensions of empowerment. [ABSTRACT FROM AUTHOR]

The editorial independence of biomedical journals allows flexibility to meet a wide range of research interests. However, it also is a barrier for coordination between journals to solve challenging issues such as racial bias in the scientific literature. A standardized tool to screen for racial bias could prevent the publication of racially biased papers. Biomedical journals would maintain editorial autonomy while still allowing comparable data to be collected and analyzed across journals. A racially diverse research team carried out a three-phase study to generate and test a racial bias assessment tool for biomedical research. Phase 1, an in-depth, structured literature search to identify recommendations, found near complete agreement in the literature on addressing race in biomedical research. Phase 2, construction of a framework from those recommendations, provides the major innovation of this paper. The framework includes three dimensions of race: 1) context, 2) tone and terminology, and 3) analysis, which are the basis for the Race Equity Vetting Instrument for Editorial Workflow (REVIEW) tool. Phase 3, pilot testing the assessment tool, showed that the REVIEW tool was effective at flagging multiple concerns in widely criticized articles. This study demonstrates the feasibility of the proposed REVIEW tool to reduce racial bias in research. Next steps include testing this tool on a broader sample of biomedical research to determine how the tool performs on more subtle examples of racial bias. [ABSTRACT FROM AUTHOR]

Time to event outcomes is commonly encountered in epidemiologic research. Multiple papers have discussed the inadequacy of using the hazard ratio as a causal effect measure due to its noncollapsibility and the time-varying nature. In this paper, we further clarified that the hazard ratio might be used as a conditional causal effect measure, but it is generally not a valid marginal effect measure, even under randomized design. We proposed to use the restricted mean survival time (RMST) difference as a causal effect measure, since it essentially measures the mean difference over a specified time horizon and has a simple interpretation as the area under survival curves. For observational studies, propensity score adjustment can be implemented with RMST estimation to remove observed confounding bias. We proposed a propensity score stratified RMST estimation strategy, which performs well in our simulation evaluation and is relatively easy to implement for epidemiologists in practice. Our stratified RMST estimation includes two different versions of implementation, depending on whether researchers want to involve regression modeling adjustment, which provides a powerful tool to examine the marginal causal effect with observational survival data. [ABSTRACT FROM AUTHOR]

Post-occupancy evaluation (POE) is a user-focused evaluation method, centered around understanding how dwellers occupy and use built environments. Collecting big data on user behavior has become essential for POE. In this paper, the limitations of current POE protocol data adoption and analysis methods are analyzed, and a quantitative research method based on machine vision (MV) to quantify users' spatio-temporal behavior for POE is developed, which can acquire high-resolution data more efficiently and accurately than the common methods in this field. In particular, the method of calculating user activity using frame difference algorithms fills the gap of quantifying user activity in POE research. The outdoor space of a kindergarten and the indoor space of a university library are selected to validate the method. After analyzing 4.5 million frames of data accumulated over 50 consecutive hours in the outdoor space, and 8.82 million frames of data accumulated over 98 consecutive hours in the indoor space, our method successfully analyzed usage of indoor and outdoor spaces and generated multiple quantitative indices of POE from high-resolution spatiotemporal behavior variables. The robustness, convenience, and practicability of this method in practical applications are verified. This method is simple to use, can adapt to a variety of built environments, and has a low cost. It has potential competitiveness for large-scale application. Quantitative POE research methods enhance the flow of information from space usage to spatial design and provide a data-driven basis for improving spatial sustainability, planning, design, and decision making. [ABSTRACT FROM AUTHOR]

Aim: To evaluate safety and motor function after treatment with allogeneic umbilical cord blood (AlloCB) or umbilical cord tissue-derived mesenchymal stromal cells (hCT-MSC) in children with cerebral palsy (CP).Method: Ninety-one children (52 males, 39 females; median age 3 years 7 months [range 2-5 years]) with CP due to hypoxic-ischemic encephalopathy, stroke, or periventricular leukomalacia were randomized to three arms: (1) the AlloCB group received 10 × 107 AlloCB total nucleated cells (TNC) per kilogram at baseline (n = 31); (2) the hCT-MSC group received 2 × 106 hCT-MSC at baseline, 3 months, and 6 months (n = 28); (3) the natural history control group received 10 × 107 AlloCB TNC per kilogram at 12 months (n = 31). Motor function was assessed with the Gross Motor Function Measure-66 (GMFM-66) and Peabody Developmental Motor Scale, Second Edition.Results: Infusions (n = 143) were well tolerated, with eight infusion reactions (three in the AlloCB group, five in hCT-MSC) and no other safety concerns. At 12 months, the mean differences (95% confidence intervals [CI]) between actual and expected changes in GMFM-66 score were AlloCB 5.8 points (3.4-8.2), hCT-MSC 4.3 (2.2-6.4), and natural history 3.1 (1.4-5.0). In exploratory, post hoc analysis, the mean GMFM-66 score (95% CI) of the hCT-MSC group was 1.4 points higher than natural history (-1.1 to 4.0; p = 0.27), and the AlloCB group was 3.3 points higher than natural history (0.59-5.93; p = 0.02) after adjustment for baseline Gross Motor Function Classification System level, GMFM-66 score, and etiology.Interpretation: High-dose AlloCB is a potential cell therapy for CP and should be further tested in a randomized, blinded, placebo-controlled trial.What This Paper Adds: Unrelated donor allogeneic umbilical cord blood (AlloCB) and human umbilical cord tissue-derived mesenchymal stromal cell infusion is safe in young children with cerebral palsy. Significant changes in motor function were not observed 6 months after treatment. One year later, treatment with AlloCB was associated with greater increases in Gross Motor Function Measure-66 scores. [ABSTRACT FROM AUTHOR]

Background: In recent years, with the development of artificial intelligence, the use of deep learning technology for clinical information extraction has become a new trend. Clinical Event Detection (CED) as its subtask has attracted the attention from academia and industry. However, directly applying the advancements in deep learning to CED task often yields unsatisfactory results. The main reasons are due to the following two points: (1) A great number of obscure professional terms in the electronic medical record leads to poor recognition performance of model. (2) The scarcity of datasets required for the task leads to poor model robustness. Therefore, it is urgent to solve these two problems to improve model performance.Methods: This paper proposes a combining data augmentation and domain information with TENER Model for Clinical Event Detection.Results: We use two evaluation metrics to compare the overall performance of the proposed model with the existing model on the 2012 i2b2 challenge dataset. Experimental results demonstrate that our proposed model achieves the best F1-score of 80.26%, type accuracy of 93% and Span F1-score of 90.33%, and outperforms the state-of-the-art approaches.Conclusions: This paper proposes a multi-granularity information fusion encoder-decoder framework, which applies the TENER model to the CED task for the first time. It uses the pre-trained language model (BioBERT) to generate word-level features, solving the problem of a great number of obscure professional terms in the electronic medical record lead to poor recognition performance of model. In addition, this paper proposes a new data augmentation method for sequence labeling tasks, solving the problem of the scarcity of datasets required for the task leads to poor model robustness. [ABSTRACT FROM AUTHOR]

This paper analyzes a UK-based psychoeducational intervention for users of online child sexual exploitation material (CSEM). It is founded on 17 months of anthropological research in group programs with 81 participants and 15 staff. The article argues that group exercises help participants reframe knowledge about their offending, and ultimately reinforce the theoretical concept of discipline (Foucault) toward internal and external surveillance, normalization, and decreased risk. The paper first discusses factors participants believed contributed to offending. It then analyzes the program and participants' experiences, focusing on exercises about the mind (fantasy), Internet usage (disclosure and relationships), needs met by offending (Good Lives and true needs), and planning for the future (relapse prevention). Critical is that participants are encouraged to reengage offline lives and enact discipline on and to the online world. Thus, the article ends with an anthropologically-minded discussion about digital norms, online morality, and implications for Internet offender psychoeducational practice. [ABSTRACT FROM AUTHOR]

Earthquakes occur frequently in the 21st century and cause a large number of casualties; induced secondary geological disasters will cause more serious casualties. How to reasonably deal with the earthquake disaster to carry out emergency rescue work is becoming increasingly urgent; the ability level of earthquake disaster emergency rescue personnel is directly related to the follow-up relief effect. Based on this, aiming at the emergency rescue ability of nationalized railway management talents in high-intensity earthquake areas around the world, this paper will use the methods of analytic hierarchy process and fuzzy theory to construct an intelligent evaluation model of railway international earthquake emergency rescue personnel ability. In addition, this paper carries out a questionnaire survey of experts in related fields and model empirical research and puts forward optimization measures and suggestions for the personnel training of railway international earthquake emergency rescue in high-intensity seismic areas based on the results of model evaluation. [ABSTRACT FROM AUTHOR]

The knowledge of the gestational age of the newborn is essential for management. In the absence of a dating scan, the postnatal assessment scores have drawbacks of being difficult to learn and administer in the community. The measurement of the foot length is easy, reproducible and offers an objective assessment. The objective of this study was to determine the correlation of postnatal (<48 h) foot length measurement (with calipers) with gestational age as determined by antenatal dating ultrasound, create a predictive model for the same and propose foot length measurement cutoffs for <37 and <34 weeks of gestation. Secondary objectives were to assess the correlation between foot length as measured with calipers and that measured with a ruler and a paper footprint. This was a hospital-based cross-sectional study. Among the 520 babies assessed, the correlation of foot length with gestational age was 0.89. Operational cutoffs for the categories of <37 and <34 weeks at a sensitivity of 95% were <70 and <65 mm, respectively. The Pearson's correlation between foot length as measured by caliper and ruler was 0.95 and between caliper and paper footprint was 0.87. This study correlating foot length and gestational age has the potential to help neonatal care providers make informed management decisions, particularly in resource-limited settings. [ABSTRACT FROM AUTHOR]

Background: Misophonia is a condition marked by dysregulated emotions and behaviors in response to trigger sounds, often chewing, breathing, or coughing. Evidence suggests that misophonia develops in adolescence and the emotions and behaviors are a conditioned response to distress, resulting in social avoidance, stress, and family conflict. In addition, co-occurrence with other psychiatric illnesses such as anxiety, OCD, and Tourette syndrome is common. A transdiagnostic cognitive behavioral therapeutic (CBT) approach appears appropriate. There are currently no controlled studies of youth with misophonia. The current paper describes the approach to a pilot randomized, blinded family-based treatment study for youth ages 8-16 years. Preliminary results from a pilot open trial also are described.Methods: A 2-phase dual site telehealth treatment study using a transdiagnostic CBT approach, the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders in Children and Adolescents (UP-C/A; Ehrenreich-May et al., 2018), is proposed. Phase 1 consisted of a 4-case pilot of UP-C/A. Phase 2 includes a randomized trial comparing the UP-C/A to a standard relaxation and education protocol.Results: Preliminary results from the pilot show modest improvements in evaluator-rated misophonia symptoms on the Clinical Global Impression Severity and Improvement scales.Limitations: There is little research to inform evidence-based practice for youth with misophonia. Study limitations include lack of standardized misophonia assessment instruments and an absence of formal diagnostic criteria.Conclusions: The current paper describes proposed methods for the first randomized controlled trial for youth with misophonia and their families along with results from a 4-case pilot. [ABSTRACT FROM AUTHOR]

Multilevel modelling (MLM) is the most frequently used approach for evaluating interventions with clustered data. MLM, however, has some limitations that are associated with numerous obstacles to model estimation and valid inferences. Longitudinal multiple-group (LMG) modelling is a longstanding approach for testing intervention effects using cluster-sampled data that has been superseded by the rise of MLM approaches, but the LMG approach can have advantages when research questions do not pertain to predicting variability at the higher levels. In this paper, we first review the advantages and limitations of MLM and LMG approaches. Second, steps in the estimation of an LMG model are presented, with some recent upgrades and changes in the modelling strategy that have particular utility for evaluating interventions. We discuss the advantages of the LMG approach as a guided confirmatory model-testing framework and how the approach places a premium on avoiding Type II errors, particularly when complex interactions are potentially at play. [ABSTRACT FROM AUTHOR]

Background: Current dose-finding designs for phase I clinical trials can correctly select the MTD in a range of 30-80% depending on various conditions based on a sample of 30 subjects. However, there is still an unmet need for efficiency and cost saving.Methods: We propose a novel dose-finding design based on Bayesian stochastic approximation. The design features utilization of dose level information through local adaptive modelling and free assumption of toxicity probabilities and hyper-parameters. It allows a flexible target toxicity rate and varying cohort size. And we extend it to accommodate historical information via prior effective sample size. We compare the proposed design to some commonly used methods in terms of accuracy and safety by simulation.Results: On average, our design can improve the percentage of correct selection to about 60% when the MTD resides at a early or middle position in the search domain and perform comparably to other competitive methods otherwise. A free online software package is provided to facilitate the application, where a simple decision tree for the design can be pre-printed beforehand.Conclusion: The paper proposes a novel dose-finding design for phase I clinical trials. Applying the design to future cancer trials can greatly improve the efficiency, consequently save cost and shorten the development period. [ABSTRACT FROM AUTHOR]

With the rapid development of urbanization, urban land has been expropriated and developed on a large scale. Moreover, people's awareness of the protection of historical buildings is relatively weak, so some historical buildings have been demolished or rebuilt. Historical buildings have played an important role in the spread of national culture, so how to use some methods to protect historical buildings from being destroyed has become an urgent problem to be solved. The protection of historical buildings includes a series of complicated and rigorous procedures, such as on-site drawing and mapping, survey and design, and scheme discussion and construction. The surveying and mapping of traditional historical buildings require people to do it by themselves, so it is inevitably time-consuming and labor-intensive. This paper first discussed and analyzed the significance of historical building protection, and then used digital technology to make up for the shortcomings of traditional manual surveying and mapping and historical building protection methods. Modern technologies such as three-dimensional laser scanning technology and virtual reality technology are used to restore the style and appearance of historical buildings. Among them, in terms of the color of historical buildings, the restoration degree of buildings based on digital protection technology has reached 56.1%; at the same time, the efficiency of information collection and processing, and virtual model construction has also been improved. Thus, the ultimate goal of historical building protection is achieved, and it provides a reference for the digital protection of historical buildings. [ABSTRACT FROM AUTHOR]

Background: Arterial stiffness and calcification propensity are associated with high cardiovascular risk and increased mortality in chronic kidney disease (CKD). Both magnesium and phosphate are recognized as modulators of vascular calcification and chronic inflammation, both features of CKD that contribute to arterial stiffness. In this paper, we outline the rationale and design of a randomized controlled trial (RCT) investigating whether 24 weeks of oral magnesium supplementation with or without additional phosphate-binding therapy can improve arterial stiffness and calcification propensity in patients with stage 3-4 CKD.Methods: In this multi-center, placebo-controlled RCT, a total of 180 participants with an estimated glomerular filtration rate of 15 to 50 ml/min/1.73 m2 without phosphate binder therapy will be recruited. During the 24 weeks intervention, participants will be randomized to one of four intervention groups to receive either magnesium citrate (350 mg elemental magnesium/day) or placebo, with or without the addition of the phosphate binder sucroferric oxyhydroxide (1000 mg/day). Primary outcome of the study is the change of arterial stiffness measured by the carotid-femoral pulse wave velocity over 24 weeks. Secondary outcomes include markers of calcification and inflammation, among others calcification propensity (T50) and high-sensitivity C-reactive protein. As explorative endpoints, repeated 18F-FDG and 18F-NaF PET-scans will be performed in a subset of participants (n = 40). Measurements of primary and secondary endpoints are performed at baseline, 12 and 24 weeks.Discussion: The combined intervention of magnesium citrate supplementation and phosphate-lowering therapy with sucroferric oxyhydroxide, in stage 3-4 CKD patients without overt hyperphosphatemia, aims to modulate the complex and deregulated mineral metabolism leading to vascular calcification and arterial stiffness and to establish to what extent this is mediated by T50 changes. The results of this combined intervention may contribute to future early interventions for CKD patients to reduce the risk of CVD and mortality.Trial Registration: Netherlands Trial Register, NL8252 (registered December 2019), EU clinical Trial Register 2019-001306-23 (registered November 2019). [ABSTRACT FROM AUTHOR]

Background: Pelvic organ prolapse (POP) is a common condition in women, where the downward descent of pelvic organs into the vagina causes symptoms which impacts quality of life. Vaginal pessaries offer an effective alternative to surgery for the management of POP. However, the need for regular follow-up can be burdensome for women and requires significant healthcare resources. The TOPSY study is a randomised controlled trial which aims to determine the clinical and cost-effectiveness of self-management of vaginal pessaries. This paper describes the theoretical and practical development of the self-management intervention.Methods: The intervention was developed using the MRC complex intervention framework, normalisation process theory (NPT) and self-management theory. The intervention aims to boost perceived self-efficacy in accordance with Bandura's social cognitive theory and is guided by the tasks and skills Lorig and Hollman describe as necessary to self-manage a health condition.Results: The TOPSY intervention was designed to support women to undertake the medical management, role management and emotional management of their pessary. The six self-management skills described by Lorig and Hollman: problem-solving, decision-making, resource utilisation, formation of a patient-provider partnership role, action planning and self-tailoring, are discussed in detail, including how women were supported to achieve each task within the context of pessary self-management. The TOPSY intervention includes a self-management support session with a pessary practitioner trained in intervention delivery, a follow-up phone call 2 weeks later and ongoing telephone or face-to-face support as required by the woman initiated by contacting a member of the research team.Conclusions: The TOPSY study intervention was developed utilising the findings from a prior service development project, intervention development and self-efficacy theory, relevant literature, clinician experience and feedback from pessary using women and members of the public. In 2022, the findings of the TOPSY study will provide further evidence to inform this important aspect of pessary management.Trial Registration: ISRCTN Registry ISRCTN62510577 . Registered on June 10, 2017. [ABSTRACT FROM AUTHOR]

Objective: The prognosis for ovarian cancer patients remains poor. A key to maximizing survival rates is early detection and treatment. This requires an accurate prediction of malignancy. Our study seeks to improve the accuracy of prediction by focusing on early subjective assessment of malignancy. We therefore investigated the assessment of patients themselves in comparison to the assessment of physicians.Methods: One thousand three hundred and thirty patients participated in a prospective and multicenter study in six hospitals in Berlin. Using univariate analysis and multivariate logistic regression models, we measured the accuracy of the early subjective assessment in comparison to the final histological outcome. Moreover, we investigated factors related to the assessment of patients and physicians.Results: The patients' assessment of malignancy is remarkably accurate. With a positive predictive value of 58%, the majority of patients correctly assessed a pelvic mass as malignant. With more information available, physicians achieved only a slightly more accurate prediction of 63%.Conclusions: For the first time, our study considered subjective factors in the diagnostic process of pelvic masses. This paper demonstrates that the patients' personal assessment should be taken seriously as it can provide a significant contribution to earlier diagnosis and thus improved therapy and overall prognosis. [ABSTRACT FROM AUTHOR]

Post-abortion care (PAC) integrates elements that are vital for women's survival after abortion complications and their ability to meet their subsequent fertility intentions. Currently, the utilization of PAC among women in need remains too low, particularly in settings where unsafe abortion is an appreciable cause of maternal mortality. Interventions have aimed at addressing unmet need; however, these still require information on the extent to which women value different aspects of PAC. This paper presents such evidence from Dakar, Senegal. Exit interviews with 729 PAC clients in 2018 at eight health facilities obtained information on patient characteristics, content of services received and women's perceptions of the quality of care, both overall and according to subject-specific domains. These domains reflect aspects of PAC that are relevant to clients' satisfaction: accessibility, facility environment, information and counselling, family planning, provider technical competence and readiness and client-staff interaction. Ordinal logistic regression models were estimated to identify factors that were associated with women's rating of overall quality of care (on a scale of 1 to 5, 1 being lowest). Predictors that were significantly associated with the outcome were used in a multivariate ordinal logistic regression model that estimated the probability of positive differences in the outcome associated with women's classification of each predictor. Women reported a mean rating of 3.7 for overall quality of care. The lowest domain-specific rating was for quality of information and counselling (mean=2.4) and the highest was for client-staff interaction (mean=3.8). Factors associated with clients' higher odds of being more satisfied with PAC were: physical comfort during the procedure, recall of counselling on treatment procedure, privacy, perceived availability of supplies and medicines, facility admission process, facility cleanliness, waiting time, clarity of counselling and access to different contraceptive methods. Interventions that target these factors may improve the utilization of PAC in Dakar, Senegal. [ABSTRACT FROM AUTHOR]

Introduction: The number and variety of alternative tobacco and nicotine products that can potentially provide reduced-risk choices for cigarette smokers who switch completely to such products instead of continued smoking have grown substantially in the past decade. Innovation and choice are likely to improve the prospects of smokers making the switch, but this provides challenges to regulators and manufacturers to ensure that changes to regulations and products promote and do not hinder contributions to tobacco harm reduction.Aims and Methods: This paper looks at where bridging data sets for tobacco heating products, closed system vaping products, and oral nicotine products might enable innovation while protecting the interests of consumers.Results: We review product data from chemical studies and a toxicological study showing how bridging can be applied and consider what product development changes might allow bridging from existing datasets or trigger the need for new ones.Conclusions: Bridging across specific product ranges can increase the speed of innovation, foster competition, and limit the burden of assessment for regulators while maintaining product safety and quality.Implications: Bridging partial data sets is an established practice within other industries, that aims to improve efficiency with regulatory approvals, accepts natural product variation, and supports product innovation. We review product data from chemical studies and a toxicological study showing how bridging can be applied and consider what product development changes might allow bridging from existing datasets or trigger the need for new ones. This in turn can increase the speed of innovation, foster competition, and limit the burden of assessment for regulators while maintaining product safety and quality. [ABSTRACT FROM AUTHOR]

Introduction: In India, 38.7% of adults are exposed to SHS at home and 30.2% at work. This paper estimates the direct economic costs of diseases attributable to secondhand smoking (SHS) in India for persons aged 15 years and above.Aims and Methods: Nationally representative data on healthcare expenditures, healthcare utilization, and SHS prevalence were used to estimate economic costs attributable to SHS. A prevalence-based attributable risk approach was used for estimating the attributable direct costs. To estimate the SHS-attributable fraction, the excess utilization of healthcare among SHS exposed non-smokers compared to unexposed non-smokers was estimated using a method of propensity score matching (PSM).Results: The annual direct economic costs attributable to SHS from all diseases in India in the year 2017 for persons aged more than 15 years amounted to INR 566.7 billion (USD 8.7 billion). This amounted to INR 705 per adult non-smoker. The SHS attributable costs were higher among the youngest age group 20 to 24, and women bear 71% of the direct medical costs attributable to SHS.Conclusions: The annual direct economic costs of SHS amount to approximately 0.33% of India's Gross Domestic Product (GDP), or 8.1% of total healthcare expenditures in India. It is also much larger than the total excise tax revenue from cigarettes and bidis. As bidi smoking is the most popular form of smoking in India and bidis are mostly consumed by the poor, a disproportionate burden of SHS is likely borne by poor households in India.Implications: In India, 38.7% of adults are exposed to SHS at home and 30.2% at work. However, there is no estimate of the economic burden of any kind from SHS exposure in India. This study used a prevalence-based attributable risk approach combined with a PSM technique to estimate excess healthcare utilization for SHS exposed non-smokers and the annual direct economic costs of SHS in India. Annual direct SHS-attributable costs in India is INR 566.7 billion (USD 8.7 billion) SHS costs constituted 0.33% of GDP and 8.1% of healthcare expenditures in India. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to establish and validate a clinical prediction model for assessing the risk of metastasis and patient survival in Ewing's sarcoma (ES).Methods: Patients diagnosed with ES from the Surveillance, Epidemiology and End Results (SEER) database for the period 2010-2016 were extracted, and the data after exclusion of vacant terms was used as the training set (n=767). Prediction models predicting patients' overall survival (OS) at 1 and 3 years were created by cox regression analysis and visualized using Nomogram and web calculator. Multicenter data from four medical institutions were used as the validation set (n=51), and the model consistency was verified using calibration plots, and receiver operating characteristic (ROC) verified the predictive ability of the model. Finally, a clinical decision curve was used to demonstrate the clinical utility of the model.Results: The results of multivariate cox regression showed that age, , bone metastasis, tumor size, and chemotherapy were independent prognostic factors of ES patients. Internal and external validation results: calibration plots showed that the model had a good agreement for patient survival at 1 and 3 years; ROC showed that it possessed a good predictive ability and clinical decision curve proved that it possessed good clinical utility.Conclusions: The tool built in this paper to predict 1- and 3-year survival in ES patients ( https://drwenleli0910.shinyapps.io/EwingApp/ ) has a good identification and predictive power. [ABSTRACT FROM AUTHOR]

This paper analyzes the structure of the key parts of the car belt guide, and the average stress of the vulnerable parts is simulated by analysis software. The theoretical stress of the section is calculated. The theoretical stress concentration factor ( K t ) is given. The relation between the gap radius and the notch coefficient ( K f ) was studied according to a previous K f calculation formula. The tensile tests of real products are used as reference data. The results showed that K f and K t are linear in most cases, but there are also cases of non-compliance. The relationship between the fatigue notch coefficient K f and the theoretical stress concentration coefficient K t was closely related to the service life and fatigue strength of the product. In addition, we found that the size and direction of warpage improved significantly with the increase of fillet size, which was not consistent with the effect of adding glass fiber material. The rounded corners of ordinary PP materials usually displayed forward warping, but the addition of glass fiber into PP materials made the degree of warping smaller, or even led to reverse warping. The size of rounded corners is an important optimization parameter. The relationship between K f and K t was studied from the perspectives of virtual measurement (VM) and recognizable performance evaluation (RPM). According to abnormal filling pressure, these relationships were compared with filling data to generate a fracture initiation control model. Based on a large amount of normal process data and quality inspection data, the historical data (causes) and quality inspection data (results) were combined. [ABSTRACT FROM AUTHOR]

Background: The residual effects of cancer and its treatment can profoundly affect women's quality of life. This paper presents results from a multisite randomized controlled trial that evaluated the clinical benefits of an e-health enabled health promotion intervention (the Women's Wellness after Cancer Program or WWACP) on the health-related quality of life of women recovering from cancer treatment.Methods: Overall, 351 women previously treated for breast, blood or gynaecological cancers were randomly allocated to the intervention (WWACP) or usual care arms. The WWACP comprised a structured 12-week program that included online coaching and an interactive iBook that targeted physical activity, healthy diet, stress and menopause management, sexual wellbeing, smoking cessation, alcohol intake and sleep hygiene. Data were collected via a self-completed electronic survey at baseline (t0), 12 weeks (post-intervention, t1) and 24 weeks (to assess sustained behaviour change, t2). The primary outcome, health-related quality of life (HRQoL), was measured using the Short Form Health Survey (SF-36).Results: Following the 12-week lifestyle program, intervention group participants reported statistically significant improvements in general health, bodily pain, vitality, and global physical and mental health scores. Improvements were also noted in the control group across several HRQoL domains, though the magnitude of change was less.Conclusions: The WWACP was associated with improved HRQoL in women previously treated for blood, breast, and gynaecological cancers. Given how the synergy of different lifestyle factors influence health behaviour, interventions accounting for the reciprocity of multiple health behaviours like the WWACP, have real potential for immediate and sustainable change.Trial Registration: The protocol for this randomised controlled trial was submitted to the Australian and New Zealand Clinical Trials Registry on 15/07/2014 and approved on 28/07/2014 ( ACTRN12614000800628 ). [ABSTRACT FROM AUTHOR]

Background: It is inconclusive nowadays for the association between infant's gender and their mothers' risk of developing postpartum depression (PPD). In addition, a complete overview is missing. A meta-analysis of cohort and case-control studies was performed to address the question of whether women who gave birth to a female infant were at an increased risk of developing PPD, compared with those giving birth to a male infant.Methods: Unrestricted searches were conducted, with an end date parameter of 31 January 2018, of PubMed, Embase, Google Scholar, Cochrane Libraries, and Chinese databases, to identify studies that met pre-stated inclusion criteria. Reference lists of retrieved articles were also reviewed. Either a fixed- or a random-effects model was used to calculate the overall combined risk estimates.Results: Twenty-three studies involving 119,736 women were included for analysis. Overall, mothers who gave birth to a female infant experienced a significantly increased risk of developing PPD compared with the reference group (OR = 1.15, 95%CI: 1.01-1.31; p = .03). However, substantial heterogeneity (p < .00001; I2 = 75%) was observed across studies. Relevant heterogeneity moderators have been identified by subgroup analysis. Sensitivity analysis yielded consistent results. No evidence of publication bias was observed.Conclusions: Although the role of potential bias and evidence of heterogeneity should be carefully evaluated, the present study suggests women giving birth to a girl are associated with a higher risk of developing PPD when compared with those giving birth to a boy. Improving family and social communication and reducing gender preference should be important components of any such interventions.Statement of significanceProblem or issue Interestingly, the known risk factors leading to PPD are basically the same in different regions and cultures, but the gender of the infant seems to be an exception.What is already known Some studies conducted in traditional western countries indicated that there is a weak or null association between infant's gender and risk of PPD, while others suggested a positive association. In contrast, studies conducted in Nigeria, India, Turkey and China showed that mothers giving birth to a female infant were at a higher risk of developing PPD.What this paper adds Today, the association between infant's gender and risk of developing postpartum depression (PPD) is still uncertain; additionally, a complete overview is missing. Our study represents the first meta-analysis of risk of PPD associated with infant's gender. [ABSTRACT FROM AUTHOR]

Background: Primary prevention of food allergy by early introduction of allergenic foods seems promising. We aimed to determine whether early food introduction or the application of regular skin emollients in infants from a general population reduced the risk of food allergy.Methods: This 2 × 2 factorial, cluster-randomised trial was done at Oslo University Hospital and Østfold Hospital Trust, Oslo, Norway, and Karolinska University Hospital, Stockholm, Sweden. Infants of women recruited antenatally at the routine 18-week ultrasound examination were cluster-randomised at birth to the following groups: (1) no intervention group; (2) the skin intervention group (skin emollients; bath additives and facial cream; from age 2 weeks to <9 months, both at least four times per week); (3) the food intervention group (early complementary feeding of peanut, cow's milk, wheat, and egg from age 3 months); or (4) combined intervention group (skin and food interventions). Participants were randomly assigned (1:1:1:1) using computer-generated randomisation based on clusters of 92 geographical areas and eight 3-month time blocks. Study personnel performing clinical assessments were masked to group allocation. The primary outcome was allergy to any interventional food at 36 months of age. The primary efficacy analysis was done by intention-to-treat analysis, which included all participants who were randomly assigned, apart from three individuals who withdrew their consent. This was a study performed within ORAACLE (the Oslo Research Group of Asthma and Allergy in Childhood; the Lung and Environment). This study is registered as ClinicalTrials.gov, NCT02449850.Findings: We recruited 2697 women with 2701 pregnancies, from whom 2397 newborn infants were enrolled between April 14, 2015, and April 11, 2017. Of these infants, 597 were randomly assigned to the no intervention group, 575 to the skin intervention group, 642 to the food intervention group, and 583 to the combined intervention group. One participant in each of the no intervention, food intervention, and skin intervention groups withdrew consent and were therefore not included in any analyses. Food allergy was diagnosed in 44 children; 14 (2·3%) of 596 infants in the non-intervention group, 17 (3·0%) of 574 infants in the skin intervention group, six (0·9%) of 641 infants in the food intervention group, and seven (1·2%) of 583 infants in the combined intervention group. Peanut allergy was diagnosed in 32 children, egg allergy in 12 children, and milk allergy in four children. None had allergy to wheat. Prevalence of food allergy was reduced in the food intervention group compared with the no food intervention group (risk difference -1·6% [95% CI -2·7 to -0·5]; odds ratio [OR] 0·4 [95% CI 0·2 to 0·8]), but not compared with the skin intervention group (0·4% [95% CI -0·6 to 1· 5%]; OR 1·3 [0·7 to 2·3]), with no significant interaction effect (p=1·0). Preventing food allergy in one child required early exposure to allergenic foods in 63 children. No serious adverse events were observed.Interpretation: Exposure to allergenic foods from 3 months of age reduced food allergy at 36 months in a general population. Our results support that early introduction of common allergenic foods is a safe and effective strategy to prevent food allergy.Funding: Full funding sources listed at end of paper (see Acknowledgments). [ABSTRACT FROM AUTHOR]

To solve the problem of regional water system evaluation, this paper proposes a system efficiency evaluation method based on the game cross-efficiency model and conducts an empirical analysis. First, autopoiesis is introduced as the theoretical basis. The characteristics of the authigenic system are combined with a regional water system, and the connotation and characteristics of the regional water system are defined. Second, based on the competitive relationship between regional water systems, the existing game crossover efficiency model is improved. A crossover efficiency model of other games is proposed to evaluate the efficiency of regional water systems. Then, the Pearl River Delta urban agglomeration is selected as the research object. The effects of four systematic evaluation methods based on the DEA method are compared horizontally to find the optimal system efficiency evaluation method. Finally, the characteristics of the regional water system in the Pearl River Delta are systematically analysed through the evaluation results, and the present situation of the regional water system is fully explained. [ABSTRACT FROM AUTHOR]

Background: This study aims to assess the rate at which screening colonoscopy is performed on patients younger or older than the age range specified in national guidelines, or at shorter intervals than recommended. Such non-indicated use of the procedure is considered low-value care, or overuse. This study is the first systematic review of the rate of non-indicated completed screening colonoscopy in the USA.Methods: PubMed and Embase were queried for relevant studies on overuse of screening colonoscopy published from January 1, 2002, until January 23, 2019. English-language studies that were conducted for screening colonoscopy after 2001 for average-risk patients were included. Studies must have followed national guidelines for detecting rates of overuse. We followed methods outlined in the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and the reporting recommendations of the Meta-analysis of Observational Studies in Epidemiology group (MOOSE).Results: A total of 772 papers were reviewed for inclusion; 42 were reviewed in full text. Of those reviewed, six studies met eligibility criteria, including a total of 459,503 colonoscopies of which 242,756 were screening colonoscopies. The rate of overuse ranged credibly from 17 to 25.7%.Discussion: This study demonstrates that screening colonoscopy is regularly performed in the USA more often, and in populations older or younger, than recommended by national guidelines. Such overuse wastes resources and places patients at unnecessary risk of harm. Efforts to reduce non-indicated screening colonoscopy are needed. [ABSTRACT FROM AUTHOR]