Comparison between XGboost model and logistic regression model for predicting sepsis after extremely severe burns.

OBJECTIVE: To compare an Extreme Gradient Boosting (XGboost) model with a multivariable logistic regression (LR) model for their ability to predict sepsis after extremely severe burns. METHODS: For this observational study, patient demographic and clinical information were collected from medical records. The two models were evaluated using area under curve (AUC) of the receiver operating characteristic (ROC) curve. RESULTS: Of the 103 eligible patients with extremely severe burns, 20 (19%) were in the sepsis group, and 83 (81%) in the non-sepsis group. The LR model showed that age, admission time, body index (BI), fibrinogen, and neutrophil to lymphocyte ratio (NLR) were risk factors for sepsis. Comparing AUC of the ROC curves, the XGboost model had a higher predictive performance (0.91) than the LR model (0.88). The SHAP visualization tool indicated fibrinogen, NLR, BI, and age were important features of sepsis in patients with extremely severe burns. CONCLUSIONS: The XGboost model was superior to the LR model in predictive efficacy. Results suggest that, fibrinogen, NLR, BI, and age were correlated with sepsis after extremely severe burns.

The Impact of Expert Opinions in COVID-19 News Coverage on Vaccination During the Fifth Outbreak in Hong Kong: A Time Series Analysis.

The role of experts in news coverage has become increasingly prominent, but the evidence regarding the effectiveness of expert opinions in affecting public behavior remains mixed. This study seeks to examine the influence of expert opinions covered in the news on the public's response to public health crises. By adopting a macro-level framing perspective, we investigated how framing consistency, a macro-level concept indicating the agreement between expert opinions in news coverage and government policies or among peer experts, evolves over time and its temporal causal relationship with public behavior. Specifically, this study collected all press news coverage in Hong Kong over four months during the fifth outbreak, including 1,416 articles with 650 expert opinions, as well as the vaccination data that paralleled with this period. We constructed time series of expert opinions and vaccination behavior, and then conducted Vector Autoregressive (VAR) models with Granger causality analysis to examine how framing consistency of expert opinions in news coverage influenced vaccination. The results indicate that the consistent framing between expert opinions and government policies increased COVID-19 vaccination during the fifth outbreak in Hong Kong, while conflicting opinions responding to government policies had no significant effect on vaccination. Opinions among medical experts on COVID-19 issues also did not significantly impact vaccination. The implications for designing communication strategies and enhancing public behavioral support during public health crises are discussed.

The Media-Mediated Model of Information Seeking Behavior: A Proposed Framework in the Chinese Culture During the COVID Pandemic.

This study aims to unravel the key determinants of individuals' information seeking behavior during health crises. It challenges conventional perspectives that solely emphasize individual experiences. It also undermines frameworks that draw direct parallels between individual experiences and media factors, disregarding the mediating role of media. Models like the Comprehensive Model of Information Seeking (CMIS) also have limitations as they prioritize media mediation over recognizing the direct impacts of individual experiences on information seeking behaviors. We hereby propose a framework, the Media-Mediated Model of Information Seeking Behavior, that sheds light on the interplay between individual and media experiences. Analysis of survey data involving 5,469 participants in three Chinese societies, including mainland China (n = 2,067), Hong Kong (n = 1,913), and Taiwan (n = 1,489), reveals that individual experiences have both direct and indirect effects on information seeking, mediated by media utility. Experience of symptoms and risk perception depend on people's perceptions of the utility of media, while efficacy and media trust directly influence information seeking behaviors. These findings contribute to theoretical understanding and offer practical guidelines. Public institutions and health promoters can leverage media platforms to shape people's perceptions of health issues and encourage active information behaviors. It is also crucial to prioritize cultivating public trust in media and efficacy during crises.

The shock, the coping, the resilience: smartphone application use reveals Covid-19 lockdown effects on human behaviors.

Human mobility restriction policies have been widely used to contain the coronavirus disease-19 (COVID-19). However, a critical question is how these policies affect individuals' behavioral and psychological well-being during and after confinement periods. Here, we analyze China's five most stringent city-level lockdowns in 2021, treating them as natural experiments that allow for examining behavioral changes in millions of people through smartphone application use. We made three fundamental observations. First, the use of physical and economic activity-related apps experienced a steep decline, yet apps that provide daily necessities maintained normal usage. Second, apps that fulfilled lower-level human needs, such as working, socializing, information seeking, and entertainment, saw an immediate and substantial increase in screen time. Those that satisfied higher-level needs, such as education, only attracted delayed attention. Third, human behaviors demonstrated resilience as most routines resumed after the lockdowns were lifted. Nonetheless, long-term lifestyle changes were observed, as significant numbers of people chose to continue working and learning online, becoming "digital residents." This study also demonstrates the capability of smartphone screen time analytics in the study of human behaviors. Supplementary Information: The online version contains supplementary material available at 10.1140/epjds/s13688-023-00391-9.

Country/Region Level Pandemic Severity Moderates the Relationships among Risk Experience, Perceived Life Satisfaction, and Psychological Distress in COVID-19.

Scholars and communications practitioners worldwide have sought novel resilience models amid heightened rates of psychological distress caused by the COVID-19 pandemic. We examined perceived life satisfaction as a determinant of resilience. Additionally, we investigated the assumption that perceived pandemic severity at the country/region level moderates structural relationships within our risk-resilience model. Analyzing more than 34,000 valid samples from 15 countries/regions, we found that (1) perceived life satisfaction alleviated psychological distress across all 15 countries/regions; and (2) country/region-level pandemic severity moderated the relationships among COVID-19 symptom experience, perceived life satisfaction, and psychological distress. The effects of COVID-19 symptom experience and perceived life satisfaction on psychological distress were conditional. We discuss possible mechanisms behind our findings and provide practical implications for mitigating psychological distress during public health crises.

Go for zero tolerance: Cultural values, trust, and acceptance of zero-COVID policy in two Chinese societies.

This study seeks to explain the wide acceptance of the stringent zero-COVID policy in two Chinese societies-Mainland China (n = 2,184) and Taiwan (n = 1,128)-from perspectives of cultural values and trust. By employing the efficacy mechanism, this study identifies significant indirect effects of trust in government and key opinion leaders (KOL) on people's policy acceptance in both societies. Namely, people who interpret the pandemic as a collectivist issue and who trust in government will be more accepting of the zero-COVID policy, whereas those who framed the pandemic as an individual issue tend to refuse the policy. Trust in government and KOLs foster these direct relationships, but trust in government functions as a more important mediator in both societies. The different contexts of the two Chinese societies make the difference when shaping these relationships. These findings provide practical considerations for governmental agencies and public institutions that promote the acceptance of the zero-COVID policy during the pandemic.

Results of the performance test for quality assessment of personal radiation dosimetry services including the influence of the dosimeter readout frequency.

This study was to determine the significance of factors considered for the measurement accuracy of personal dosimeter in dosimetry services such as dosimetry service, irradiation category, years of use and readout frequency. The investigation included management information questionnaire, on-site visit and blind test. The blind test with random selected personal badge was used in inter-comparison of eight dosimetry services, and the test results followed ANSI/HPS N13.11 criteria. This study also analyzed the measurement deviations if they felt in the criteria of ICRP 75 or not. One-way ANOVA tests were used to analyze the significant difference of the measurement deviations in different dosimetry services, irradiation categories, and years of use. Simple linear-regression test was performed for the significance of the prediction model between measurement deviations and readout frequencies. All visited dosimetry services followed the proper statue of basic management and passed the performance check of the tolerance level. The average deviations corresponding to category I, category II deep dose, and category II shallow dose were 6.08%, 9.49%, and 10.41% respectively. There had significant differences of measurement deviation in different dosimetry services (p < 0.0001) and irradiation categories (p = 0.016) but no significant difference in years of use (p = 0.498). There was no significance in the linear-regression model between measurement deviation and badge readout frequencies. Based on the regular calibration of the personal dosimeter, the deviation of the measured value is mainly affected by different dosimetry services and irradiation categories; and there shows no significant influence by years of use and readout frequency.

Increasing Vaccination: Psychological Characteristics of COVID-19 Vaccine Advocates, Converts, and Resisters in Hong Kong.

This study uses longitudinal data to profile psychological characteristics of COVID-19 vaccine advocates, resisters, and converts. We conducted a two-wave longitudinal survey (Nwave1 = 3190, Nwave2 = 2193) in Hong Kong using stratified quota sampling. Among those who completed both survey waves, 458 (30.5%) were classified as vaccine advocates, 295 (19.7%) were vaccine resisters, and 621 (41.4%) were vaccine converts (who shifted away from hesitancy). Compared to advocates, resisters were more likely to be female, those without children, between 40 and 49 years old, democratic voters, and those with poor health. Highly educated individuals, non-democrats, and those in good health were more likely to convert from hesitancy to acceptance. Public trust in authorities and confidence in vaccine were the primary factors related to vaccine uptake. Those who were more confident in vaccine, those who increased in information consumption and risk perceptions towards the pandemic, and those who decreased in their trust of health professionals were more likely to convert. Our study complements the emerging global picture of COVID-19 vaccine acceptance by focusing on changes in vaccine hesitancy during the pandemic.

Exploring the mediating role of government-public relationships during the COVID-19 pandemic: A model comparison approach.

This study proposed, tested, and compared three models to examine an antecedent and outcome of government-public relationships. It conducted three surveys of 9675 people in mainland China, Taiwan, and Hong Kong from August 2020 to January 2021. The results of the model comparison supported the proposed reciprocal model: not only were relational satisfaction and relational trust found to mediate the effect of perceived responsiveness on people's word-of-mouth intention to vaccinate, but they also had a reciprocal influence on each other. This study further affirmed that the relative effects between satisfaction and trust. We also found that emotion-dominant model is more powerful than cognition-dominant model, i.e., people's feeling of satisfaction happens before sense of trust, which results from their perceived organizational responsiveness and then contribute to their word-of-mouth behavioral intention. The theoretical and practical implications of this study were also discussed.

A Shot in the Arm for Vaccination Intention: The Media and the Health Belief Model in Three Chinese Societies.

This large-sample study of three Chinese societies-Mainland China, Taiwan, and Hong Kong-demonstrates the importance of media exposure for people's vaccination intentions during the COVID-19 pandemic. By employing two constructs (i.e., perceived susceptibility and severity) in the health belief model (HBM), the study identifies significant indirect effects of media exposure on individuals' vaccination intention in all three Chinese societies. That said, media trust negatively moderated the path from perceived severity to vaccination intention in Mainland China and Taiwan. In these two societies, the higher an individual's trust in media, the less influence of perceived severity on his/her vaccination intention. It suggests that the level of trust in media is a contextual factor in explaining individuals' decision-making on health issues. Generally, the combination of the HBM and media trust has been proven to be useful for understanding individuals' vaccination intentions. These findings provide practical considerations for governmental agencies, public institutions, and health campaign designers to promote vaccination in the pandemic.

Framing matters but varies: a semantic network analysis of media representations of post-Fukushima food imports across three Chinese societies.

There is a remarkable gap between scientific experts and the nonscientific public regarding the safety of food imported from nuclear-contaminated areas in Japan. How socio-scientific issues such as post-Fukushima food imports are framed in media discourse may have effects on the way people perceive and reason about potential threats, and, in turn, influence government-initiated policies and regulations. In this study, semantic network analysis is performed to examine the diverse media representations of post-Fukushima food imports across information-seeking sources (mass media and search-based media) and three Chinese societies (Hong Kong, Mainland China, and Taiwan). We found that media representation of the crisis differs across sources and sociopolitical contexts. It is also discussed how these channel-specific and contextual factors may affect public opinion. This knowledge can enhance regulatory authorities' informed decision-making about food safety issues, guide crisis professionals' communication efforts, and call for a more context-sensitive approach to public health crisis management.

An assessment of the relational orientation framework for Chinese societies: Scale development and Chinese relationalism.

How to capture the role of culture in individual behavior is a difficult question, in part because it is often embedded in the research approach. Many researchers have stressed the entrenched ethnocentrism of mainstream psychology approaches. In response, some Chinese scholars have turned to sociology theories to create a relation-centered approach for investigating the psychology of Confucian societies. Scholars in Asia recently have proposed a theoretical model of psychological functioning in Chinese societies that encompasses the individual's sociocultural environment, which they labeled the relational orientation framework (ROF). The ROF is comprised of a structural-relational factor grounded in sociological structuration theory with five dimensions that shape the individual's position in the social network, and a relational agency factor based on social exchange theory with four dimensions that capture the individual's orientation to exchange aspects of relationships. This study assesses the proposed theoretical structure of the model with empirical data. Exploratory and confirmatory factor analyses with two independent samples from universities in mainland China (N = 601, M age = 20.8 years) supported the structural-relational factor with the expected five dimensions and the relational agency factor with a modified version of the four dimensions with acceptable reliability and validity scores and good levels of model-data fit. We provide recommendations for refining conceptualization of the two factors for future development of an assessment tool.

Association of procalcitonin levels with the progression and prognosis of hospitalized patients with COVID-19.

Rationale: Coronavirus disease 2019 (COVID-19) was first announced in Wuhan, and has rapidly evolved into a pandemic. However, the risk factors associated with the severity and mortality of COVID-19 are yet to be described in detail. Methods: We retrospectively reviewed the information of 1525 cases from the Leishenshan Hospital in Wuhan. Univariate and multivariate Cox regression analyses were generated to explore the relationship between procalcitonin (PCT) level and the progression and prognosis of COVID-19. Univariate and multivariate logistic regression analyses were performed to explore the relationship between disease severity in hospitalized patients and their PCT levels. Survival curves and the cumulative hazard function for COVID-19 progression were conducted in the two groups. To further detect the relationship between the computed tomography score and survival days, curve-fitting analyses were performed. Results: Patients in the elevated PCT group had a higher incidence of severe and critical severity conditions (P < 0.001), death, and higher computed tomography (CT) scores. There was an association between elevated PCT levels and mortality in the univariate ((hazard ratio [1], 3.377; 95% confidence interval [2], 1.012-10.344; P = 0.033) and multivariate Cox regression analysis (HR, 4.933; 95% CI, 1.170-20.788; P = 0.030). Similarly, patients with elevated PCT were more likely to have critically severe disease conditions in the univariate (odds ratio [2], 7.247; 95% CI, 3.559-14.757; P < 0.001) and multivariate logistic regression analysis (OR, 10.679; 95% CI, 4.562-25.000; P < 0.001). Kaplan-Meier curves showed poorer prognosis for patients with elevated PCT (P = 0.024). The CT score 1 for patients with elevated PCT peaked at day 40 following the onset of symptoms then decreased gradually, while their total CT score was relatively stable. Conclusion: PCT level was shown as an independent risk factor of in-hospital mortality among COVID-19 patients. Compared with inpatients with normal PCT levels, inpatients with elevated PCT levels had a higher risk for overall mortality and critically severe disease. These findings may provide guidance for improving the prognosis of patients with critically severe COVID-19.

Optimization of the CDC Protocol of Molecular Diagnosis of COVID-19 for Timely Diagnosis.

Coronavirus disease 2019 (COVID-19), the current uncontrolled outbreak of infectious disease, has caused significant challenges throughout the world. A reliable rapid diagnostic test for COVID-19 is demanded worldwide. The real-time reverse transcriptase polymerase chain was one of the most quickly established methods in the novel viral pandemic and was considered as the gold standard for the detection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). In this report, we illustrate our experience of applying a protocol from the Taiwan CDC and achieving assay optimization in the immediate circumstances to meet the urgent medical and public health needs.

The effect of metastasis patterns on survival in male patients with different breast cancer subtypes: results from the Surveillance, Epidemiology, and End Results (SEER) database.

BACKGROUND: Metastasis sites and breast cancer subtypes are important for breast cancer patients. This study aimed to assess possible relationships between them and their influence on prognosis in male breast cancer (MBC) patients. METHODS: We collected data on 2,983 patients with MBC from the Surveillance, Epidemiology, and End Results database, including 250 patients with M1 stage disease. Information on metastatic patterns was provided for bone, brain, liver, and lung metastases. MBC was classified into four subtypes: Her2-/HR+, Her2+/HR+, Her2+/HR-, and triple negative (TN). Univariate and multivariate logistic regression analysis were used to analyze the association, and Cox regression analyses were used to analyze prognosis. RESULTS: The bone was the most common metastatic site and the brain was the least common metastatic site. Patients with the Her2-/HR+ subtype had the highest proportion of metastatic disease, and Her2+/HR- patients had the lowest proportion. Univariate and multivariate logistic regression analyses showed that there were significant differences in distant metastasis patterns in patients with different subtypes. Men with the Her2+/HR+ or Her2-/HR+ subtypes with bone metastasis had better cancer specific survival (CSS), and those with the TN subtype had the worst CSS in all metastatic patterns. CONCLUSIONS: MBC subtypes are associated with different metastasis patterns and can have different effects on prognosis. This study might provide insights into a better understanding of MBC.

[Segmentation of brain tumor on magnetic resonance images using 3D full-convolutional densely connected convolutional networks].

OBJECTIVE: Accurate segmentation of multiple gliomas from multimodal MRI is a prerequisite for many precision medical procedures. To effectively use the characteristics of glioma MRI and im-prove the segmentation accuracy, we proposes a multi-Dice loss function structure and used pre-experiments to select the good hyperparameters (i.e. data dimension, image fusion step, and the implementation of loss function) to construct a 3D full convolution DenseNet-based image feature learning network. This study included 274 segmented training sets of glioma MRI and 110 test sets without segmentation. After grayscale normalization of the image, the 3D image block was extracted as a network input, and the network output used the image block fusion method to obtain the final segmentation result. The proposed structure improved the accuracy of glioma segmentation compared to a general structure. In the on-line assessment of the open BraTS2015 data set, the Dice values for the entire tumor area, tumor core area, and enhanced tumor area were 0.85, 0.71, and 0.63, respectively.

A Selective Bottleneck Shapes the Evolutionary Mutant Spectra of Enterovirus A71 during Viral Dissemination in Humans.

RNA viruses accumulate mutations to rapidly adapt to environmental changes. Enterovirus A71 (EV-A71) causes various clinical manifestations with occasional severe neurological complications. However, the mechanism by which EV-A71 evolves within the human body is unclear. Utilizing deep sequencing and haplotype analyses of viruses from various tissues of an autopsy patient, we sought to define the evolutionary pathway by which enterovirus A71 evolves fitness for invading the central nervous system in humans. Broad mutant spectra with divergent mutations were observed at the initial infection sites in the respiratory and digestive systems. After viral invasion, we identified a haplotype switch and dominant haplotype, with glycine at VP1 residue 31 (VP1-31G) in viral particles disseminated into the integumentary and central nervous systems. In vitro viral growth and fitness analyses indicated that VP1-31G conferred growth and a fitness advantage in human neuronal cells, whereas VP1-31D conferred enhanced replication in human colorectal cells. A higher proportion of VP1-31G was also found among fatal cases, suggesting that it may facilitate central nervous system infection in humans. Our data provide the first glimpse of EV-A71 quasispecies from oral tissues to the central nervous system within humans, showing broad implications for the surveillance and pathogenesis of this reemerging viral pathogen.IMPORTANCE EV-A71 continues to be a worldwide burden to public health. Although EV-A71 is the major etiological agent of hand, foot, and mouth disease, it can also cause neurological pulmonary edema, encephalitis, and even death, especially in children. Understanding selection processes enabling dissemination and accurately estimating EV-A71 diversity during invasion in humans are critical for applications in viral pathogenesis and vaccine studies. Here, we define a selection bottleneck appearing in respiratory and digestive tissues. Glycine substitution at VP1 residue 31 helps viruses break through the bottleneck and invade the central nervous system. This substitution is also advantageous for replication in neuronal cells in vitro Considering that fatal cases contain enhanced glycine substitution at VP1-31, we suggest that the increased prevalence of VP1-31G may alter viral tropism and aid central nervous system invasion. Our findings provide new insights into a dynamic mutant spectral switch active during acute viral infection with emerging viral pathogens.

Crisis communication in context: Cultural and political influences underpinning Chinese public relations practice.

This study analyzes academic journal articles in order to depict the features of Chinese crisis communication in Mainland China, Hong Kong, and Taiwan. The findings revealed the following features of crisis communication in Chinese societies: collectivistic culture, nationalism, rationalism, face-giving/saving, striving for the "golden mean," the preference for passive communicative strategies, and the avoidance of extreme strategies. Nevertheless, the differences in political systems-the ubiquitous intervention by authoritarian government on the Mainland, the mistrust of government in post-handover Hong Kong, and the relatively mature democratic polity in Taiwan all lead to unique crisis communication practices.

An injectable extracellular matrix derived hydrogel for meniscus repair and regeneration.

Tissue-derived extracellular matrix (ECM) biomaterials to regenerate the meniscus have gained increasing attention in treating meniscus injuries and diseases, particularly for aged persons and athletes. However, ECM scaffold has poor cell infiltration and can only be implanted using surgical procedures. To overcome these limitations, we developed an injectable ECM hydrogel material from porcine meniscus via modified decellularization and enzymatic digestion. This meniscus-derived ECM hydrogel exhibited a fibrous morphology with tunable compression and initial modulus. It had a good injectability evidenced by syringe injection into mouse subcutaneous tissue. The hydrogel showed good cellular compatibility by promoting the growth of both bovine chondrocytes and mouse 3T3 fibroblasts encapsulated in the hydrogel for 2 weeks. It also promoted cell infiltration as shown in both in vitro cell culture and in vivo mouse subcutaneous implantation. The in vivo study revealed that the ECM hydrogel possessed good tissue compatibility after 7 days of implantation. The results support the great potential of the newly produced injectable meniscus-derived ECM hydrogel specifically for meniscus repair and regeneration.

Inhibition of the P2X7 receptor reduces cystogenesis in PKD.

The P2X7 receptor participates in purinergic signaling, which may promote the progression of ADPKD. We examined the effects of a P2X7 receptor antagonist and a P2X7 receptor agonist on cyst development in a zebrafish model of polycystic kidney disease in which we knocked down pkd2 by morpholinos. We used live wt-1b pronephric-specific GFP-expressing zebrafish embryos to directly observe changes in the pronephros. Exposure of pkd2-morphant zebrafish to a P2X7 receptor antagonist (oxidized ATP [OxATP]) significantly reduced the frequency of the cystic phenotype compared with either exposure to a P2X7 receptor agonist (BzATP) or with no treatment (P < 0.01). Histology confirmed improvement of glomerular cysts in OxATP-treated pkd2 morphants. OxATP also reduced p-ERK activity and cell proliferation in pronephric kidneys in pkd2 morphants. Inhibition of P2X7 with an additional specific antagonist (A-438079), and through morpholino-mediated knockdown of p2rx7, confirmed these effects. In conclusion, blockade of the P2X7 receptor reduces cyst formation via ERK-dependent pathways in a zebrafish model of polycystic kidney disease, suggesting that P2X7 antagonists may have therapeutic potential in ADPKD.