A dataset of blockade, vandalism, and harassment activities for the cause of climate change mitigation

Environmental activism is crucial for raising public awareness and support toward addressing the climate crisis. However, using climate change mitigation as the cause for blockade, vandalism, and harassment activities might be counterproductive and risk causing negative repercussions and declining public support. The paper describes a dataset of metadata of 89 blockade, vandalism, and harassment events happening 13 countries in recent years. The dataset comprises three main categories: 1) Events, 2) Activists, and 3) Consequences. For researchers interested in environmental activism, climate change, and sustainability, the dataset is helpful in studying the effectiveness and appropriateness of strategies to raise public awareness and support. For researchers in the field of security studies and green criminology, the dataset offers resources to study features and impacts of blockade, vandalism, and harassment events. The Bayesian Mindsponge Framework (BMF) analytics was employed to validate the dataset. Consequently, the estimated result aligns with the Mindsponge Theory's theoretical reasoning.

The Overlooked Contributors to Climate and Biodiversity Crises: Military Operations and Wars

The military-industrial complex, military operations, and wars are major contributors to exacerbating both climate change and biodiversity crises. However, their environmental impacts are often shadowed due to national security reasons. The current paper aims to go through the devastating impacts of military operations and wars on climate change and biodiversity loss and challenges that hinder the inclusion of military-related activities into environmental crisis mitigation efforts. The information blind spot induced by concerns about national security reasons jeopardizes the efforts to involve the military-industrial complex and military operations in the global climate and biodiversity agendas. Besides that, many military-related challenges, such as specificity of operational requirements and lifecycles, dependence on fossil fuels, complex supply change, inadequate civilian technologies and innovations, and requirements of structural changes, can hinder emission reduction. Meanwhile, wars and conflicts not only threaten to drain all human and material resources available to tackle environmental problems but also inflict long-lasting destructions, pains, and trauma that can lead to hatred and distrust among nations and parties. With the rising hatred and distrust, global agreement and commitment to address climate change and biodiversity will hardly be achieved. Thus, promoting peace is the humanistic and planetary conscience.

Liver Regeneration Following Radiation Therapy in Hepatocellular Carcinoma Patients: Insights from Functional Liver Imaging

PURPOSE/OBJECTIVE(S)

A critical need for hepatocellular carcinoma (HCC) patients is understanding how the liver recovers following radiation therapy (RT). While liver regeneration after hepatic resection has been well-studied, liver recovery following RT is less understood. We have previously studied 99mTc-sulphur colloid (SC) single photon emission tomography (SPECT)/CT to spatially and quantitatively analyze liver function. The purpose of this study was to assess both volumetric and functional liver changes following RT.

MATERIALS/METHODS

Patients with HCC had liver function assessed with SC SPECT/CT before and after definitive RT. Patients received 30-67.5 Gy in 4-15 fractions. Anatomic and functional liver metrics were assessed before and after treatment. The anatomic liver volume (ALV) was drawn on CT imaging. Liver function was measured as the functional volume encompassing 30% of maximum uptake (FLV) and mean liver-to-spleen uptake ratio (L/S). Changes in liver size and function were compared to clinical characteristics, including Child-Pugh (CP) score. Parametric t-tests were used to analyze the data.

RESULTS

Of 23 evaluable patients (proton RT, n = 16 or photon RT, n = 7), 15 patients had CP-A5/6, 7 had CP-B7/8, and 1 had CP-C10 scores. The mean interval of SC SPECT was 67 days following RT (range, 44 to 113 days). The mean PTV was 272 cc (range 22-802 cc). Regarding baseline liver status, mean pre-treatment ALV was 1584 cc (range 810-2749 cc) with no significant difference in ALV between CP-A and B/C patients (p = 0.285). Pre-treatment mean liver function as assessed with L/S was 1.06 ± 0.43 with significantly greater function in CP-A compared to CP-B/C patients (1.27 vs 0.66, respectively, p<0.001). Mean pre-treatment FLV was 1351 ± 430.8 cc with no significant difference in FLV between CP-A and B/C patients (1422 ± 441 cc vs 1220 ± 436 cc, respectively, p = 0.31). When evaluating change following RT, the mean change in ALV was 0.9% (range, -29% to 23%) with no significant difference between CP-A and CP-B/C patients (-1.5% vs 5.4%, respectively, p = 0.19). In contrast, change in liver function following RT was larger; mean change in FLV was -20% (range, -55% to 33%) and mean change in L/S was -16% (range, -66% to 105%). While change in FLV was not significantly different between CP-A and CP-B/C patients, CP-B/C patients had significantly greater decline in mean liver function (L/S) than CP-A patients (-40 ± 18% vs -3.6 ± 36%, respectively, p = 0.018). There was no association between change in liver volume and change in L/S, p = 0.543.

CONCLUSION

Functional liver imaging metrics reveal different information about the potential functional reserve of irradiated livers compared to anatomic measurements. These data imply that functional liver imaging may more accurately assess the regenerative potential of irradiated and non-irradiated volumes of liver, which may be useful in clinical scenarios where assessment of the function of future liver remnants become critical.

Dosimetric Impact of Radiolucent Carbon Fiber Hardware for Post-Operative Spine Stereotactic Body Radiation Therapy

PURPOSE/OBJECTIVE(S)

The spine is the most common site of osseous metastases. In the non-operative setting, there is growing support for stereotactic body radiation therapy (SBRT) over conventional radiation therapy for improved pain relief and local control. Hybrid therapy consisting of separation surgery and post-operative SBRT is considered in patients with biomechanical instability and epidural cord compression. Surgery traditionally requires titanium (Ti) implants, which introduce artifacts on post-operative imaging in addition to increased uncertainty and beam attenuation. Use of radiolucent carbon fiber reinforced polyetheretherketone (CFR-PEEK) hardware has been shown to provide safe and comparable surgical outcomes as compared to Ti. Our primary objective is to assess the dosimetric impact of Ti versus carbon fiber implants in spine SBRT.

MATERIALS/METHODS

Single institution retrospective series of post-operative spine SBRT from 2019-2020. Re-irradiation cases were excluded. The electronic medical record and treatment planning systems (TPS) were queried. Dosimetric analyses compared original Ti plans with reoptimized plans, replacing Ti hardware electronic density with carbon fiber. Maintaining clinical goals, dose calculations were performed in a treatment planning system using a collapsed cone algorithm. All treatments used step and shoot intensity modulated radiation therapy to avoid beam angles with significant metal along the beam path. Metallic artifacts were contoured and assigned the appropriate tissue density. A D'Agostino-Pearson test was used to assess data for normality. We used paired Student's t-tests to compare three dosimetric outcomes in the setting of Ti and carbon fiber implants. Planning target volume (PTV) coverage was represented by the volume receiving at least the prescribed dose (%), the maximum point dose (dmax, cGy) to the spinal cord planning risk volume (PRV, 2 mm margin), and the overall hot spot intensity (plan dmax).

RESULTS

A series of 14 consecutive SBRT cases were evaluated (dose 27-30 Gy in 3-5 fractions). All dosimetric outcomes were normally distributed (p>0.05). We found a statistically significant difference in PTV coverage between the original SBRT treatment plans with Ti hardware (mean 85.1 ± 7.9%) and reoptimized carbon fiber hardware (87.3 ± 6.6%; p = 0.002). There was no significant difference in mean spinal cord PRV dmax between Ti and carbon fiber plans (1846 ± 483 cGy vs. 1842 ± 495 cGy; p>0.05). We observed a nonsignificant increase in mean overall dmax from 3932 ± 416 cGy in the Ti cohort to 4111 ± 906 cGy in the carbon fiber cohort (p>0.05).

CONCLUSION

Carbon fiber implants provide a significant increase in SBRT target coverage, without impacting the overall plan and spinal cord PRV dmax in this retrospective series. In addition to improved post-operative imaging and reduced uncertainty, carbon fiber hardware may offer dosimetric advantages as compared to traditional Ti spinal implants, and warrants further investigation in a larger cohort.

Trust Is for the Strong: How Health Status May Influence Generalized and Personalized Trust

In the trust-health relationship, how trusting other people in society may promote good health is a topic often examined. However, the other direction of influence-how health may affect trust-has not been well explored. In order to investigate this possible effect, we employed the Bayesian Mindsponge Framework (BMF) analytics to go deeper into the information processing mechanisms underlying the expressions of trust. Conducting a Bayesian analysis on a dataset of 1237 residents from Cali, Colombia, we found that general health status is positively associated with generalized trust, but recent experiences of illnesses/injuries have a negative moderating effect. Personalized trust is largely unchanged across different general health conditions, but the trust level becomes higher with recent experiences of illnesses/injuries. Psychophysiological mechanisms of increasing information filtering intensity toward unfamiliar sources during a vulnerable state of health is a plausible explanation of found patterns in generalized trust. Because established personal relationships are reinforced information channels, personalized trust is not affected as much. Rather, the results suggest that people may rely even more on loved ones when they are in bad health conditions. This exploratory study shows that the trust-health relationship can be examined from a different angle that may provide new insights.

A dataset of Chinese drivers' driving behaviors and socio-cultural factors related to driving

Given the high fatality rate due to road traffic accidents in China, understanding the factors influencing aggressive driving behaviors among Chinese drivers is essential to alleviate the problem. The paper describes a dataset of 1039 Chinese drivers' driving behaviors and the socio-cultural factors associated with the behaviors. The dataset was collected through an online survey. The dataset comprises five main categories: 1) driving information, 2) aggressive driving behaviors, 3) friend/peer influence, 4) family influence, and 5) socio-demographic information. The dataset is valuable for public health and transportation researchers to explore factors influencing drivers' driving behaviors and public safety in China. The dataset's construct validity was confirmed by the Bayesian Mindsponge Framework (BMF) analytics. Specifically, the analysis shows that safe driving behaviors are affected by information promoting safe driving that is passively and actively absorbed from friends/peers (friends/peers being role models and friends'/peers' support, respectively). The result is consistent with the Mindsponge Theory's information-processing mechanism in human minds.

Examining the Influence of Exploration and Parental Education Attainment on Students' Acceptance of Collectivist Values

Exploration can help students access a wider range of information and make connections among values within the natural and social world. This study investigated the relationship between students' previous exploration of their surroundings and their acceptance of collectivist values in the context of China. A sample of 343 college students was analyzed based on the Bayesian Mindsponge Framework to explore this relationship. The results revealed a positive association between students' prior exploration of surroundings and their degree of collectivist orientation. Furthermore, parental education attainment was found to negatively moderate this association, albeit with a small effect size. These findings contribute to the understanding of how information acquisition influences students' acceptance of collectivist values and highlight the potential role of the family infosphere in shaping this relationship.

How AI's Self-Prolongation Influences People's Perceptions of Its Autonomous Mind: The Case of U.S. Residents

The expanding integration of artificial intelligence (AI) in various aspects of society makes the infosphere around us increasingly complex. Humanity already faces many obstacles trying to have a better understanding of our own minds, but now we have to continue finding ways to make sense of the minds of AI. The issue of AI's capability to have independent thinking is of special attention. When dealing with such an unfamiliar concept, people may rely on existing human properties, such as survival desire, to make assessments. Employing information-processing-based Bayesian Mindsponge Framework (BMF) analytics on a dataset of 266 residents in the United States, we found that the more people believe that an AI agent seeks continued functioning, the more they believe in that AI agent's capability of having a mind of its own. Moreover, we also found that the above association becomes stronger if a person is more familiar with personally interacting with AI. This suggests a directional pattern of value reinforcement in perceptions of AI. As the information processing of AI becomes even more sophisticated in the future, it will be much harder to set clear boundaries about what it means to have an autonomous mind.

Near-Suicide Phenomenon: An Investigation into the Psychology of Patients with Serious Illnesses Withdrawing from Treatment

Patients with serious illnesses or injuries may decide to quit their medical treatment if they think paying the fees will put their families into destitution. Without treatment, it is likely that fatal outcomes will soon follow. We call this phenomenon "near-suicide". This study attempted to explore this phenomenon by examining how the seriousness of the patient's illness or injury and the subjective evaluation of the patient's and family's financial situation after paying treatment fees affect the final decision on the treatment process. Bayesian Mindsponge Framework (BMF) analytics were employed to analyze a dataset of 1042 Vietnamese patients. We found that the more serious the illnesses or injuries of patients were, the more likely they were to choose to quit treatment if they perceived that paying the treatment fees heavily affected their families' financial status. Particularly, only one in four patients with the most serious health issues who thought that continuing the treatment would push themselves and their families into destitution would decide to continue the treatment. Considering the information-filtering mechanism using subjective cost-benefit judgments, these patients likely chose the financial well-being and future of their family members over their individual suffering and inevitable death. Our study also demonstrates that mindsponge-based reasoning and BMF analytics can be effective in designing and processing health data for studying extreme psychosocial phenomena. Moreover, we suggest that policymakers implement and adjust their policies (e.g., health insurance) following scientific evidence to mitigate patients' likelihood of making "near-suicide" decisions and improve social equality in the healthcare system.

An analytical framework-based pedagogical method for scholarly community coaching: A proof of concept

Working in academia is challenging, even more so for those with limited resources and opportunities. Researchers around the world do not have equal working conditions. The paper presents the structure, operation method, and conceptual framework of the SM3D Portal's community coaching method, which is built to help Early Career Researchers (ECRs) and researchers in low-resource settings overcome the obstacle of inequality and start their career progress. The community coaching method is envisioned by three science philosophies (cost-effectiveness, transparency spirit, and proactive attitude) and established and operated based on the Serendipity-Mindsponge-3D knowledge (SM3D) management framework (i.e., mindsponge thinking and Bayesian Mindsponge Framework analytics serve as the coaching program's foundational theory and analytical tools). The coaching method also embraces Open Science's values for lowering the cost of doing science and encouraging the trainees to be transparent, which is expected to facilitate the self-correcting mechanism of science through open data, open review, and open dialogue. Throughout the training process, members are central beneficiaries by gaining research knowledge and skills, acquiring publication as the training's product, and shifting their mindsets from "I can't do it" to "I can do it," and at the same time transforming a mentee to be ready for a future mentor's role. The coaching method is thus one of the members, for the member, by the members.•The paper provides the structure, operation method, and conceptual framework of the SM3D Portal's community coaching method, which is built to help Early Career Researchers (ECRs) and researchers in low-resource settings overcome the obstacle of inequality and start their career progress.•The paper presents three major science philosophies envisioning the establishment and operation of scholarly community coaching.•The paper employs the mindsponge theory and BMF analytics to construct a conceptual framework explaining how an environment is created to help shift members' mindsets from "I can't do it" to "I can do it."

Telephone-Based Smoking Cessation Counseling Service: Satisfaction and Outcomes in Vietnamese Smokers

BACKGROUND

As a method to acknowledge the devastating health and economic impacts of tobacco usage worldwide, telephone-based tobacco cessation counseling services have emerged as a potential tool to aid people in their quitting process. This study explores the satisfaction of smokers who use the QUITLINE service and factors associated with their quit attempts and cessation.

METHODS

A cross-sectional survey of 110 participants was conducted from June to July 2016 at the Respiratory Center at Bach Mai Hospital, Hanoi, Vietnam. Multivariate logistic regression was used, and it was found that the percentage of people quitting smoking increased after using the service.

RESULTS

In total, 65.5% of participants were completely satisfied with the counseling service. The mean score of staff/s capacity/responsiveness, motivation, and service convenience were 4.37 ± 0.78, 4.30 ± 0.81, and 4.27 ± 0.66, respectively. The smoking relapse rate was relatively high at 58.3%, which mainly resulted from cravings and busy work (26.2% and 14.3%, respectively). A higher satisfaction score in "Staffs' capacity and responsiveness" was negatively associated with "ever tried to quit smoking in consecutive 24 h" and actually quit smoking after receiving counseling. Meanwhile, a higher score in the "Motivation" domain was positively associated with both quit attempt indicators as well as actually quitting smoking after receiving counseling (OR = 9.48; 95%CI = 2.27; 39.57).

CONCLUSIONS

These results suggest that it is crucial for decision makers to place more focus on countermeasures for smoking relapse and to strengthen the capacity of staff, especially in motivating clients. Interventions should also be maintained throughout a long period of time to prevent relapse.

Building eco-surplus culture among urban residents as a novel strategy to improve finance for conservation in protected areas

The rapidly declining biosphere integrity, representing one of the core planetary boundaries, is alarming. In particular, the global numbers of mammals, birds, fishes, and plants declined by 68% from 1970 to 2016. One of the most widely accepted measures to halt the rate of biodiversity loss is to maintain and expand protected areas that are effectively managed. However, doing so requires substantial finance derived from nature-based tourism, specifically visitors from urban areas. Using the Bayesian Mindsponge Framework (BMF) for conducting analysis on 535 Vietnamese urban residents, the current study examined how their biodiversity loss perceptions can affect their willingness to pay for the entrance fee and conservation in protected areas. We found that perceived environmental degradation, loss of economic growth, loss of nature-based recreation opportunities, and loss of knowledge as consequences of biodiversity loss indirectly affect the willingness to pay through the mediation of the attitude towards conservation. Notably, perceived knowledge loss also has a direct positive influence on the willingness to pay for the entrance fee and conservation. In contrast, perceived loss of health is negatively associated with the attitude towards conservation. Based on these findings, we suggest that building an eco-surplus culture among urban residents by stimulating their subjective cost-benefit judgments towards biodiversity loss can be a promising way to generate more finance from nature-based tourism for conservation in protected areas and ease the domestic government's and international organizations' funding allocation problems. Eco-surplus culture is a set of pro-environmental attitudes, values, beliefs, and behaviors shared by a group of people to reduce negative anthropogenic impacts on the environment and conserve and restore nature.

Good ethics cannot stop me from exploiting: The good and bad of anthropocentric attitudes in a game environment

Video games have the potential to be a tool for communicating pro-environmental values. The present study examines the correlation between players' environmental attitudes and their interaction with virtual natural resources. This study constructs Bayesian ordinal logistic models to analyze survey data of 640 Animal Crossing: New Horizon (ACNH) players from 29 countries. Results show that the frequency of catching in-game animals (fish and insects) is positively correlated with the level of human centeredness in environmental attitudes. In addition, less anthropocentric players tend to use more sustainable methods to collect woods in ACNH. Such a particular way of interacting with in-game animals and trees based on their species may be attributable to players' environmental attitudes and game designs. This paper discusses how game design can play a role in promoting pro-environmental behaviors and highlights the moral implications of interactions with non-human beings.

Escaping from Air Pollution: Exploring the Psychological Mechanism behind the Emergence of Internal Migration Intention among Urban Residents

Rapid urbanization with poor city planning has resulted in severe air pollution in urban areas of low- and middle-income countries. Given the adverse impacts of air pollution, citizens may develop ideation of averting behaviors, including migration to another region. The current study explores the psychological mechanism and demographic predictors of internal migration intention among urban people in Hanoi, Vietnam-one of the most polluted capital cities in the world. The Bayesian Mindsponge Framework (BMF) analytics was used to construct a model and perform Bayesian analysis on a stratified random sampling dataset of 475 urban people. We found that migration intention was negatively associated with an individual's satisfaction with air quality. The association was moderated by the perceived availability of a nearby alternative (i.e., a nearby province/city with better air quality). The high migration cost due to geographical distance made the moderation effect of the perceived availability of a faraway alternative negligible. These results validate the proposed psychological mechanism behind the emergence of migration intention. Moreover, it was found that male and young people were more likely to migrate. While the brain drain effect did not clearly show, it is likely due to complex underlying interactions of various related factors (e.g., age and gender). The results hint that without air pollution mitigation measures, the dislocation of economic forces might occur and hinder sustainable urban development. Therefore, collaborative actions among levels of government, with the environmental semi-conducting principle at heart, are recommended to reduce air pollution.

Introduction to Bayesian Mindsponge Framework analytics: an innovative method for social and psychological research

The paper introduces Bayesian Mindsponge Framework (BMF) analytics, a new analytical tool for investigating socio, psychological, and behavioral phenomena. The strengths of this method derive from the combination of the mindsponge mechanism's conceptual formulation power and Bayesian analysis's inferential advantages. The BMF-based research procedure includes six main steps, in which the mindsponge-based conceptualization and model construction is the key step that makes the method unique. Therefore, we elaborate on the fundamental components and functions of the mindsponge mechanism and summarize them into five memorable principles so that other researchers can capitalize directly. An exemplary analysis was performed using a dataset of 3071 Vietnamese entrepreneurs’ decisiveness and perceptions of the likelihood of success/continuity to validate the method.•

The paper provides five strong points of BMF analytics, originating from the good match between the mindsponge mechanism and Bayesian inference.

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The paper also provides a step-by-step procedure for conducting BMF-based research.

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The mindsponge mechanism's basic components and functions are elaborated and summarized into five core principles that can be applied directly for research conceptualization and model construction.

Virtual tree, real impact: how simulated worlds associate with the perception of limited resources

Video games have long been considered an effective educational tool. Environmental education studies have found that games positively affect the feeling of nature connectedness, producing pro-environmental attitudes and behaviors. With growing urbanization, video games also provide chances to interact with nature. During the COVID-19 lockdown, Nintendo's Animal Crossing: New Horizon (ACNH) became a household name, with millions of copies sold worldwide. The article used the Bayesian multilevel model to analyze 640 survey responses of ACNH game players from various online communities. The correlations between the perception of limited resources and virtual planting and exploiting behaviors with the varying effect among ethnicities were explored. The findings suggested positive correlations between the perception and in-game actions among all ethnicities, regardless of whether the actions are planting or exploiting. While further evidence is needed, the findings suggest the restraints of game mechanics. To foster a pro-environmental culture, stakeholders can consider video games a novel technological aid to environmental education.

The psychological mechanism of internet information processing for post-treatment evaluation

Digital healthcare has been greatly benefiting the public health system, especially during the COVID-19 pandemic. In digital healthcare, information communication through the Internet is crucial. The current study explores how patients' accessibility and trust in Internet information influence their decisions and ex-post assessment of healthcare providers by employing the Bayesian Mindsponge Framework (BMF) on a dataset of 1,459 Vietnamese patients. We find that patients’ accessibility to Internet information positively affects the perceived sufficiency of information for choosing a healthcare provider, and their trust in the information intensifies this effect. Internet information accessibility is negatively associated with post-treatment assessment of healthcare providers, and trust also moderates this effect. Moreover, patients considering professional reputation important while making a decision are more likely to regard their choices as optimal, whereas patients considering services important have contradicting tendencies. Based on these findings, a concern about the risk of eroding trust toward Internet sources about healthcare information is raised. Thus, quality control and public trust-building measures need to be taken to improve the effectiveness of healthcare-related communication through the Internet and facilitate the implementation of digital healthcare.

OUP accepted manuscript

Objectives

Methods

Results

Conclusions

A Multinational Data Set of Game Players' Behaviors in a Virtual World and Environmental Perceptions

Video gaming has been rising rapidly to become one of the primary entertainment media, especially during the COVID-19 pandemic. Playing video games has been reported to associate with many psychological and behavioral traits. However, little is known about the connections between game players' behaviors in the virtual environment and environmental perceptions. Thus, the current data set offers valuable resources regarding environmental worldviews and behaviors in the virtual world of 640 Animal Crossing: New Horizons (ACNH) game players from 29 countries around the globe. The data set consists of six major categories: 1) socio-demographic profile, 2) COVID-19 concern, 3) environmental perception, 4) game-playing habit, 5) in-game behavior, and 6) game-playing feeling. By making this data set open, we aim to provide policymakers, game producers, and researchers with valuable resources for understanding the interactions between behaviors in the virtual world and environmental perceptions, which could help produce video games in compliance with the United Nations (UN) Sustainable Development Goals.

Multifaceted interactions between urban humans and biodiversity-related concepts: A developing-country dataset

Urban humans and biodiversity-related concepts are interacting with each other in many negative and positive ways. The biodiversity provides a wide array of provision and cultural-ecological services to urban residents, but it is being overexploited to the point of crisis. The crisis is largely driven by the expanding illegal wildlife trade in developing countries with a high urbanization rate and biodiversity level like Vietnam. While supply-side measures are ineffective in reducing biodiversity loss, researchers have suggested demand-side measures as supplements, such as social marketing campaigns and law enforcement in urban areas. Moreover, urban residents are also potential visitors to urban public parks and national parks, which helps generate finance for biodiversity preservation and conservation in those places. Understanding how urban residents' perceptions towards biodiversity and biodiversity-related behaviors can help improve the effectiveness of conservation efforts and sustainable urban development. Thus, this article presents a dataset of 535 urban residents' wildlife consumption behaviors, multifaceted perceptions and interactions with biodiversity-related concepts, and nature-based recreation demand. The dataset is constructed with six major categories: 1) wildlife product consumption, 2) general biodiversity perceptions, 3) biodiversity at home and neighborhood, 4) public park visitation and motivations, 5) national park visitation and motivations, and 6) socio-demographic profiles. These resources are expected to support researchers in enriching the lax literature regarding the role of urban residents in biodiversity conservation and preservation, and help policymakers to find insights for building up an “eco-surplus culture” among urban residents through effective public communication and policymaking.

Good budget or good care: The dilemma of social health insurance in Vietnam

Objective:

2014 marked a rising public commitment to universal health coverage in Vietnam to eliminate the financial burden for patients, but there are lots of hindrances. It is evident that patients met difficulties to validate their insurances, so health insurance does not significantly address out-of-pocket payments issues. Furthermore, the unequal geographical distribution of hospitals in Vietnam has created an inequality between non-residing patients and residing patients; the former usually pay more. This calls into question how the validity of healthcare insurance and patient’s residence could be related to patient’s financial status and their satisfaction with health insurance.

Methods:

Bayesian regression models are employed to analyze a data set of 1042 inpatients in hospitals of all levels in Northern Vietnam.

Result:

The results show that living in the same region as the hospital and having valid insurance is negatively correlated with the impoverishing risk. Regarding patients’ satisfaction with health insurance, it is negatively correlated with having a residence in the same region as the hospital but positively correlated with higher socioeconomic status and insurance validity. Finally, on average, the satisfaction of patients who have already recovered from the illness and those who quit early is lower than that of patients who needed follow-up in medical care or stop in the middle.

Conclusion:

This article suggests that policymakers consider addressing the unequal geographical distribution of hospitals and healthcare quality to help patients avoid going to hospitals outside their regions, which may generate a financial burden for patients and lower their satisfaction with health insurance.

603 CHALLENGES IN THE MANAGEMENT OF SEVERE ORTHOSTATIC HYPOTENSION ASSOCIATED WITH SUPINE HYPERTENSION IN A PATIENT WITH AUTONOMIC DYSFUNCTION ON BACKGROUND OF NASOPHARYNGEAL CARCINOMA AND TYPE II DIABETES MELLITUS

Introduction

Combined chemotherapy and radiotherapy increases long term survival in patients with nasopharyngeal carcinoma. However, radiotherapy of the carotid sinus or brain stem can evolve labile hypertension and orthostatic intolerance from chronic baroreflex failure. Diabetes would also cause this neuropathy. Management of patients with Supine hypertension-Orthostatic hypotension can be very challenging.

Methods

A case report was done on a 71-year-old man with metastatic nasopharyngeal carcinoma status post radiation therapy who was admitted with severe supine hypertension-orthostatic hypotension. Patient was managed with both non-pharmacological and pharmacological methods, and monitored for postural symptoms, complications of severe supine hypertension—which has been linked to left ventricular hypertrophy and kidney dysfunction, and placed on 24 hour ambulatory blood pressure monitoring to aid in management so as to prevent hypertension induced organ damage.

Results

This review outlines the pathophysiology of Supine hypertension-Orthostatic hypotension, treatment complications and potential management strategies recommendations for this group of patients. It revealed the benefit of having a 24 hour ambulatory blood pressure monitoring, which provides insight on the timing and magnitude of an individual’s blood pressure fluctuations throughout the day so as to further guide management.

Conclusion

Chronic baroreflex failure is a late sequela of neck irradiation for naso-pharyngeal carcinoma due to accelerated atherosclerosis in the region of the carotid sinus baroreceptor. Treatment goal is achieved with adequate control of pre-syncopal symptoms and prevention of long term complications. Non-pharmacological interventions remain the first line of therapy, followed by pharmacological interventions as necessary. Nonetheless, management of blood pressure in these elderly patients with baroreflex dysfunction remains challenging and should be individualized. Moving forward, a prospective study on the incidence of late onset, iatrogenic baroreflex failure as a late complication of neck irradiation and its particular relationship to carotid arterial rigidity should be conducted to increase awareness, timely diagnosis and management of the condition among physicians.

A Data Collection on Secondary School Students' STEM Performance and Reading Practices in an Emerging Country

Science, technology, engineering, and mathematics (STEM) education has become a critical factor in promoting sustainable development. Meanwhile, book reading is still an essential method for cognitive development and knowledge acquisition. In developing countries where STEM teaching and learning resources are limited, book reading is an important educational tool to promote STEM. Nevertheless, public data sets about STEM education and book reading behaviors in emerging countries are scarce. This article, therefore, aims to present a data set of 4,966 secondary school students from a school-based data collection in Vietnam. The data set comprises of five major categories: 1) students' personal information (including STEM performance), 2) family-related information, 3) book reading preferences, 4) book reading frequency/habits, and 5) classroom activities. By introducing the designing principles, the data collection method, and the variables in the data set, we aim to provide researchers, policymakers, and educators with well-validated resources and guidelines to conduct low-cost research, pedagogical programs in emerging countries.

Discrepancies between actual weight, weight perception and weight loss intention amongst persons with NAFLD

BACKGROUND

Currently, weight loss remains the main management strategy for NAFLD, but the weight loss intention and methods remain poorly characterized.

METHODS

We analysed data about the perception of weight status, intention and methods to lose weight amongst 3,822 persons with NAFLD (United States Fatty Liver Index ≥ 30) from the National Health and Nutrition Examination Survey, 2001-2014.

RESULTS

Only 53.9% of people with NAFLD intended to lose weight, 91.8% with perception of overweight and 8.2% with normal weight perception. Persons with perception of overweight or overweight/obese status were four times more likely to try to lose weight (adjusted odds ratios 3.9 and 4.2, respectively, both P < 0.0001). Younger age, women, higher educational level, Hispanic and blacks (versus whites) were significant independent factors associated with weight loss intention. Notably, ≤10% attended weight loss programme. Metabolic equivalent of task hours per week was significantly higher in whites who exercised to lose weight (vs. no exercise, P = 0.003) but not in other racial/ethnic groups. Interestingly, calorie intake was similar between those who dieted versus not (2056 vs. 1970 kcal/day, P = 0.11). About 30% reported ≥ 10-lb weight loss, with 50% higher odds of success for men but there was no difference by race/ethnicity.

CONCLUSION

Overweight or obese perception was a key driver in weight loss activities but was inconsistent with actual weight status and varied by race/ethnicity and other sociodemographic factors. Weight loss programme is under-utilized and should take in account of weight perception training and culturally appropriate approach.

Home Scholarly Culture, Book Selection Reason, and Academic Performance: Pathways to Book Reading Interest among Secondary School Students

Although studies have explored the predictors of book reading interest among children, little is known about the underlying mechanism that helps children become interested in reading books. This study attempt to demonstrate: (1) how book-reading interest is driven by reasons for choosing books (recommendation or personal preference), (2) how students with high and low academic achievements are motivated by different thinking pathways, and (3) how home scholarly culture improves book-reading interest through such pathways. Using Bayesian analysis on a dataset of survey responses from 4966 Vietnamese secondary students (11-15 years old, sixth to ninth grade), we found: (i) Reading interest is positively associated with a book recommendation and parental book reading activities (parents read books to children); (ii) High-achieving students are more interested in reading books if they can choose those books according to personal preferences; (iii) Parental book reading activities can promote book reading interest through recommendations and also by understanding children's personal preferences. We advocate a more personalized approach in educational policymaking, curriculum design, and home scholarly culture based on students' abilities and perceptions.

Alice in Suicideland: Exploring the Suicidal Ideation Mechanism through the Sense of Connectedness and Help-Seeking Behaviors

On average, one person dies by suicide every 40 s. However, extant studies have largely focused on the risk factors for suicidal behaviors, not so much on the formation of suicidal thoughts. Therefore, we attempt to explain how suicidal thoughts arise and persist inside one's mind using a multifiltering information mechanism called Mindsponge. Bayesian analysis with Hamiltonian Markov Chain Monte Carlo (MCMC) technique was run on a dataset of multinational students (N = 268) of an international university in Japan. Item 9 in the PHQ-9 was used to survey suicidal ideation. The associations among four main variables, namely, (i) suicidal ideation, (ii) help-seeking willingness (informal and formal sources), (iii) sense of connectedness, and (iv) information inaccessibility (represented by being international students), were tested in four models. Sense of connectedness is negatively associated with suicidal ideation, but its effect becomes less impactful when interacting with international students. The impact of a sense of connectedness on informal help-seeking willingness (toward family members) among international students is also lessened. Informal help-seeking is negatively associated with suicidal ideation, whereas formal help is positive. The findings support our assumption on three fundamental conditions for preventing suicidal thoughts: (i) a high degree of belongingness, (ii) accessibility to help-related information, and (iii) healthy perceived cultural responses towards mental health. Therefore, systematically coordinated programs are necessary to effectively tackle suicidal ideation.

Mirror, mirror on the wall: is economics the fairest of them all? An investigation into the social sciences and humanities in Vietnam

Three major scientific policies implemented in 2008, 2014, and 2017 have pushed Vietnam’s social sciences and humanities (SSH) toward higher international standards. This study uses descriptive and Bayesian approaches on a dataset of 1,564 Vietnamese authors in the 2008–18 period to understand the changes under the new policies and the remaining challenges. The findings indicate that Economics is the most productive SSH field, with 858 publications in 11 years. Even though the number of authors has risen rapidly, gender disparity is still an issue. Economics has benefitted the most from Vietnam's development, and to a lesser extent, so have Education and Social Medicine. Future policies should aim to provide an enabling environment for female and early career researchers in every SSH field in Vietnam. The study calls for responsible usage of cross-discipline publication data to maintain a transparent source of information.

Risk factors for transmission of carbapenem-resistant Enterobacterales to healthcare personnel gloves and gowns in the USA

BACKGROUND

Hospitals are sources for acquisition of carbapenem-resistant Entero-bacterales (CRE), and it is believed that the contamination of healthcare personnel (HCP) hands and clothing play a major role in patient-to-patient transmission of antibiotic-resistant bacteria.

AIM

The aim of this study was to determine which HCP types, HCP-patient interactions, and patient characteristics are associated with greater transmission of CRE to HCP gloves and gowns in the hospital.

METHODS

This was a prospective observational cohort study that enrolled patients with recent surveillance or clinical cultures positive for CRE at five hospitals in four states in the USA. HCP gloves and gown were cultured after patient care. Samples were also obtained from patients' stool, perianal area, and skin of the chest and arm to assess bacterial burden.

FINDINGS

Among 313 CRE-colonized patients and 3070 glove and gown cultures obtained after patient care, HCP gloves and gowns were found to be contaminated with CRE 7.9% and 4.3% of the time, respectively. Contamination of either gloves or gowns occurred in 10.0% of interactions. Contamination was highest (15.3%) among respiratory therapists (odds ratio: 3.79; 95% confidence interval: 1.61-8.94) and when any HCP touched the patient (1.52; 1.10-2.12). Associations were also found between CRE transmission to HCP gloves or gown and: being in the intensive care unit, having a positive clinical culture, and increasing bacterial burden on the patient.

CONCLUSION

CRE transmission to HCP gloves and gown occurred frequently. These findings may inform evidence-based policies about what situations and for which patients contact precautions are most important.

Corrigendum to database on the mechanical properties of high entropy alloys and complex concentrated alloys, data in brief 21 (2018) 2664-2678

[This corrects the article DOI: 10.1016/j.dib.2018.11.111.].

Adopting open access in the social sciences and humanities: evidence from a developing nation

Open Access (OA) publishing, with ambitious movements such as Plan S, is engendering radical changes among academic publishers. Emerging countries need to keep publishing as well as adopt open access to catch up with the changes. Using exclusive data from the Social Sciences & Humanities Peer Awards (SSHPA) database, the study employed both descriptive statistics and a Bayesian linear regression model to examine the journals and publishers in which Vietnamese social scientists published during the period 2008–2019, and the potential of pursuing the OA movement in Vietnam. We found an increasing diversification in the publishing sources of Vietnamese social science researchers with growth rates of 9.8% and 14.1% per annum in the number of publishers and journals, respectively. Given that the proportion of Gold OA articles had a fourfold increase over the examined period, it seems that the Vietnamese academic community is adopting OA. Furthermore, Bayesian analysis results hint at positive associations of internal and external collaborative power (number of domestic and foreign authors, respectively) with the decision to publish in OA (β_{b_TotalVN_OpenAccess} = 0.22; β_{b_TotalForeign_OpenAccess} = 0.15). The results and its implications suggest that Vietnamese policymakers and university director boards should facilitate as well as control the quality of the scientific publishing and the OA movement.

Prevalence, characteristics and mortality outcomes of obese, nonobese and lean NAFLD in the United States, 1999-2016

BACKGROUND

Updated prevalence and outcome data for nonobese NAFLD for the multi-ethnic US population is limited.

OBJECTIVES

We aimed to investigate the prevalence, clinical characteristics and mortality of obese and nonobese individuals with NAFLD in the United Sates.

METHODS

A retrospective study was conducted using the 1999-2016 NHANES databases. We determined hazard ratio stratified by obesity status in NAFLD individuals using Cox regression and log-rank test.

RESULTS

Overall NAFLD prevalence was 32.3%: 22.7% were obese and 9.6% were nonobese, with increasing trend over time for obese NAFLD, but not nonobese NAFLD. Amongst those with NAFLD, 29.7% (95% CI: 27.8%-31.7%) were nonobese, of which 13.6% had lean NAFLD. Nonobese NAFLD was more common in older (40.9% if ≥ 65 vs. 24.2% if < 65 years), male (34.0% vs. 24.2%) and foreign-born Asian people (39.8% vs. 11.4%) and uncommon in black (11.5% vs 30-35% in other ethnicities, P < 0.001). Metabolic comorbidities were common in nonobese NAFLD individuals who also had more advanced fibrosis. Nonobese NAFLD individuals had higher 15-year cumulative all-cause mortality (51.7%) than obese NAFLD (27.2%) and non-NAFLD (20.7%) (P < 0.001). However, DM and fibrosis, but neither obese nor nonobese NAFLD compared to non-NAFLD was independently associated with higher mortality.

CONCLUSION

Nonobese NAFLD makes up about one-third of the NAFLD in the United States (even higher in older, male and foreign-born individuals) and carries higher mortality than obese NAFLD. Screening for NAFLD should be considered in high-risk groups even in the absence of obesity.

Ethnic influence on nonalcoholic fatty liver disease prevalence and lack of disease awareness in the United States, 2011-2016

BACKGROUND

Nonalcoholic fatty liver disease (NAFLD) is a rising global disease associated with clinical and economic burdens.

OBJECTIVES

We aimed to quantify NAFLD prevalence and awareness to provide stakeholders necessary information to combat NAFLD burden.

METHODS

This study utilizes data from the National Health and Nutrition Examination Survey 2011-2016 and included 4538 adult participants who did not have heavy drinking or viral hepatitis history. The US fatty liver index defined NAFLD and NAFLD fibrosis score defined fibrosis. NAFLD awareness was captured by questionnaire.

RESULTS

Amongst the study population of 4538 persons, NAFLD prevalence was 32.5%, lowest in non-Hispanic Blacks (18.0%) and Asians (18.1%), highest amongst Mexican Americans (48.4%). Within the NAFLD group, advanced fibrosis was highest in non-Hispanic Blacks (28.5%) and lowest amongst non-Hispanic Asians (2.7%). Of the 1473 (97.5%) NAFLD participants who answered NAFLD awareness question, 90% visited a healthcare centre at least once in the past year, but only 5.1% were aware of having NAFLD. On weighted population estimates, 77.33 million persons had NAFLD, 17.63 million had advanced fibrosis, and 73.39 million NAFLD participants were not aware of having NAFLD.

CONCLUSIONS

Of 77.33 million people in the United States have NAFLD with 17.63 million having advanced fibrosis, with lowest prevalence in non-Hispanic Asians and highest in Mexican Americans. A conundrum exists amongst non-Hispanic Blacks who have low NAFLD prevalence but highest prevalence of advanced fibrosis. Awareness of NAFLD was low across all ethnicities. Effort is needed to improve disease awareness whilst addressing NAFLD clinical burden across ethnicities.

Diagnostic values of different cytokines in identifying tuberculous pleural effusion

Interleukin (IL)-1 beta (IL-1β), IL-2, Interferon-gamma (IFN-γ), tumor necrosis factor-alpha (TNF-α) in the pleural fluid are valuable biomarkers in early diagnosis of Tuberculous Pleural Effusion (TPE). This study aimed to analyze the diagnostic values of some cytokines (IFN-γ, TNF-α, IL-1β, and IL-2) in pleural fluid for identifying TPE in Vietnam. We performed a cross-sectional study on tuberculosis (TB) patients with pleural effusion. Pleural IFN-γ, TNF-α, IL-1β, IL-2 were measured by ELISA® Kit (Abcam, USA) on Biotek system. Receiver operating characteristic curves (ROC), an area under the curve (AUC), sensitivity (Se), specificity (Sp), positive predictive value (PPV), negative predictive value (NPV) and accuracy (ACC) of IFN-γ, TNF-α, IL-1β, IL-2 in identifying TBE were assessed. Among 386 patients, 234 (60,6%) had TPE, and 152 (39,4%) did not have TPE. The median of IL-2, TNF-α, and IFN-γ levels were significantly higher in TPE compared to the non-TPE group (p<0.05). AUC for IL-1β, IL-2, TNF-α, and IFN-γ were 0.54, 0.57, 0.62. 0.84 (p<0.05), respectively. The sensitivity of IL-1β, IL-2, TNF-α, and IFN-γ in the diagnosis of TPE were 82.1, 53.4, 77.8, and 80.3, while the specificity was 28,4, 69.7, 47.4, and 80.9, respectively. IFN-γ and TNF-α are potential biomarkers in diagnosing TPE.

Performance of ceftazidime/avibactam susceptibility testing methods against clinically relevant Gram-negative organisms

OBJECTIVES

To ensure the accuracy of susceptibility testing methods for ceftazidime/avibactam.

METHODS

The performances of the Etest (bioMérieux), 30/20 μg disc (Hardy diagnostics) and 10/4 μg disc (Mast Group) were evaluated against the reference broth microdilution (BMD) method for 102 clinically relevant Gram-negative organisms: 69 ceftazidime- and meropenem-resistant Klebsiella pneumoniae and 33 MDR non-K. pneumoniae. Essential and categorical agreement along with major and very major error rates were determined according to CLSI guidelines.

RESULTS

A total of 78% of isolates were susceptible to ceftazidime/avibactam. None of the three methods met the defined equivalency threshold against all 102 organisms. The Etest performed the best, with categorical agreement of 95% and major errors of 6.3%. Against the 69 ceftazidime- and meropenem-resistant K. pneumoniae, only the Etest and the 10/4 μg disc met the equivalency threshold. None of the three methods met equivalency for the 33 MDR isolates. There were no very major errors observed in any analysis. These results were pooled with those from a previous study of 74 carbapenem-resistant Enterobacteriaceae and data from the ceftazidime/avibactam new drug application to define optimal 30/20 μg disc thresholds using the error-rate bound model-based approaches of the diffusion breakpoint estimation testing software. This analysis identified a susceptibility threshold of ≤19 mm as optimal.

CONCLUSIONS

Our data indicate that the Etest is a suitable alternative to BMD for testing ceftazidime/avibactam against ceftazidime- and meropenem-resistant K. pneumoniae. The 30/20 μg discs overestimate resistance and may lead to the use of treatment regimens that are more toxic and less effective.

Bayesian analysis for social data: A step-by-step protocol and interpretation

The paper proposes Bayesian analysis as an alternative approach for the conventional frequentist approach in analyzing social data. A step-by-step protocol of how to implement Bayesian multilevel model analysis with social data and how to interpret the result is presented. The article used a dataset regarding religious teachings and behaviors of lying and violence as an example. An analysis is performed using R statistical software and a bayesvl R package, which offers a network-structured model construction and visualization power to diagnose and estimate results.•

The paper provides guidance for conducting a Bayesian multilevel analysis in social sciences through constructing directed acyclic graphs (DAGs, or "relationship trees") for different models, basic and more complex ones.

•

The method also illustrates how to visualize Bayesian diagnoses and simulated posterior.

•

The interpretations of visualized diagnoses and simulated posteriors of Bayesian inference are also discussed.

Passive Smoking Exposure and Perceived Health Status in Children Seeking Pediatric Care Services at a Vietnamese Tertiary Hospital

Understanding the predictors of health conditions and exposure to secondhand smoke among children is necessary to determine the severity of the issues and identify effective solutions. Despite the significant prevalence in smoking and child exposure to secondhand smoke, there have been only a few studies focusing on this area in Vietnam, and thus the current study aims to fill in this gap. The questionnaires of 435 children aged between 0 and 6 and their caregivers, who agreed to participate in the research, were collected at the Pediatric Department of Bach Mai hospital, Hanoi, in 2016. Multivariable logistic regression was employed to identify factors associated with perceived health status and exposure to secondhand smoke among children in the last 24 h and the last 7 days from the date of the survey. Our study found that 43% of the respondents had smokers in the family, and 46.4% of children were exposed to passive smoking in the last 7 days. Urban children were most frequently exposed to passive smoking at home and in public, whereas in the rural area, the home and relatives’ houses were the most common places for exposure. Compared to children whose caregivers were farmers, children of non-government workers were more likely to be exposed to passive smoking in the last 7 days. Moreover, children in a family having smoking rules and no smokers were less likely to be exposed to passive smoking in the last 24 h and 7 days than those living in a family allowing smoking and having smokers. In conclusion, our study shows that the government needs to implement better public smoking monitoring and encourage caregivers to implement smoke-free households or smoking rules in their houses.

Evaluation of Treatment of Herniated Lumbar Disc Sciatica by Epidural Corticosteroid Injection

Background: Medical facilities in Vietnam both use Methylprednisolone acetate and Hydrocortisone acetate in treatment with different administrations. This study aimed to evaluate of effects and side-effects of epidural injection of Methylprednisolone acetate and Hydrocortisone acetate in the treatment of herniated lumbar disc sciatica. Methods and findings: Cross-sectional descriptive study on 80 herniated lumbar disc sciatica patients treated at Department of Orthopedic, 7A Military Hospital, Hochiminh City, VietNam. The patients were divided into two groups in coupling fashion based on the VAS score of pain. Study results showed that both corticosteroid drugs (Methylprednisolone acetate and Hydrocortisone acetate) yielded good outcomes on all investigated parameters and there was no significant difference between the two medications (p < 0.05); administration of Methylprednisolone acetate reduced VAS score of 1.98 ± 1.33 points and Hydrocortisone acetate reduced of 2.13 ± 1.17 points. Lasegue test score in Methylprednisolone acetate administered patients raised from 74.630 ± 18.820 to 80.750 ± 15.870 and in Hydrocortisone acetate patients from 71.250 ± 10.110 to 81.630 ± 8.350). Treatment methods were safe, and there was no difference in complication rates between the two groups. The direct and indirect cost of Hydrocortisone acetate administration was three times higher than Methylprednisolone acetate. Conclusion: It was safe and effective to administrate both Methylprednisolone acetate and Hydrocortisone acetate in the treatment of herniated lumbar disc sciatica. Methylprednisolone acetate administration was more economical than Hydrocortisone acetate. Keywords: Sciatica, epidural injection, Methylprednisolone acetate, Hydrocortisone acetate

A Evaluation of Initial Treatment of Trochanteric Fractures using Gamma Nails

Background: Trochanteric fractures are extra-joint fractures, account for 55% of femoral proximal fractures. They often happen in the elderly with increased frequency due to age. Treatment experiences at 7A Military Hospital showed increased trochanteric fracture cases. To properly assess treatment effectiveness and select proper treatment methods, the study of “Evaluation of initial treatment of trochanteric fractures using gamma nails at 7A Military Hospital and made the conclusions of indications and applied techniques” was carried out. The study objectives are evaluating the initial treatment of trochanteric fractures using gamma nails at 7A Military Hospital and made the conclusions of indications and applied techniques. Methods and findings: nineteen patients diagnosed with traumatic trochanteric fractures and surgically treated with Gamma nails were monitored and evaluated for bone fusion, bone union, range of motion, limb shortening, and functional rehabilitation according to Merle D'Aubigné scale. Fourteen patients (82.35%) achieved proper bone union with the femoral neck-shaft angle of 1250 - 1300, three patients (17.65%) got slightly deviated bone union. Amongst patients aged under 60, 14/17 cases (82.35%) achieved “good” and “very good” functional rehabilitation, scored over 15 points according to Merle D΄aubigne Index; 3/17 cases (17.65%) got “average” recovery. Hip range of motion in 14 cases (82.35%) achieved “very good” (normal movement) or “good” (over 10% movement limitation) outcome, 3 cases had “average” movement (17.65%). Limb shortening of below 1cm took place in 10 patients (58.82%), 1 – 2 cm in 4 patients (23,53%) and over 3 cm in 3 patients (17.65%). Conclusions: The surgical treatment of trochanteric fractures using gamma nails yielded positive outcomes. Keywords: Gamma nails, trochanteric fractures, elderly, extra-joint.

Changing incidence of reported viral hepatitis in China from 2004 to 2016: an observational study

OBJECTIVE

China's national hepatitis burden is high. This study aims to provide a detailed national-level description of the reported incidence of viral hepatitis in China during 2004-2016.

DESIGN

Observational study.

SETTING

Data were obtained from China's National Notifiable Disease Reporting System, and changing trends were estimated by joinpoint regression analysis.

PARTICIPANTS

In this system, 16 927 233 reported viral hepatitis cases occurring during 2004-2016 were identified.

PRIMARY OUTCOME MEASURE

Incidence rates per 100 000 person-years and changing trends were calculated.

RESULTS

There were 16 927 233 new cases of viral hepatitis reported in China from 2004 to 2016. Hepatitis B (HBV) (n=13 543 137, 80.00%) and hepatitis C (HCV) (n=1 844 882, 10.90%) accounted for >90% of the cases. The overall annual percent change (APC) in reported cases of viral hepatitis and HBV were 0.3%(95% CI -2.0 to 0.8, p=0.6) and -0.2% (95% CI -1.6 to 1.2, p=0.8), respectively, showing a stable trend. HBV rates were highest in the 20-29 year old age group and lowest in younger individuals, likely resulting from the universal HBV vaccination. The reported incidence of HCV and hepatitis E (HEV) showed increasing trends; the APCs were 14.5% (95% CI 13.1 to 15.9, p<0.05) and 4.7% (95% CI 2.8 to 6.7, p<0.05), respectively. The hepatitis A (HAV) reporting incidence decreased, and the APC was -13.1% (95% CI -15.1 to -11.0, p<0.05). There were marked differences in the reporting of hepatitis among provinces.

CONCLUSIONS

HBV continues to constitute the majority of viral hepatitis cases in China. Over the entire study period, the HBV reporting incidence was stable, the HCV and HEV incidence increased and the HAV incidence decreased. There were significant interprovincial disparities in the burden of viral hepatitis, with higher rates in economically less-developed areas. Vaccination is important for viral hepatitis prevention and control.

Changing from Epidural to Multimodal Analgesia for Colorectal Laparotomy: An Audit

In April 2002 our practice ceased routine use of epidural analgesia for colorectal laparotomy in favour of a six-drug multimodal regimen comprising ketamine, clonidine, morphine, tramadol, paracetamol and a nonsteroidal antiinflammatory drug. The records of 54 patients who received this multimodal analgesia regimen (MM) after April 2002 were compared to the 59 patients who had previously received epidural analgesia (EPI). Patients had the same surgeon and anaesthetist. Daily pain score (verbal rated 0-10) at rest (mean) over the first three postoperative days was satisfactorily low with both MM (1.2 ± 1.2) and EPI (0.4 ± 0.4). Over this period there was little difference between the maximum pain score at rest (MM 2.3 ± 1.9 vs. EPI 2.2 ± 1.7, P=0.58). Major complications and side-effects occurred solely in EPI patients: epidural abscess (1), respiratory depression (2), pneumonia (3), venous thromboembolism (3), delirium (7), high block (7) and motor block (3). Hypotension requiring intervention was 4.8 times more frequent in the EPI group (95% CI 2.1-11). Antiemetic use was similar between groups; on average 13 patients in the MM groups (24%) and 15 patients in the EPI groups (26%) received antiemetics each day. MM patients had shorter anaesthetic preparation time (20±8 min vs. 32±8 min, P<0.001), shorter high-dependency unit stay (0.4 ± 1.2 days vs. 4.5 ± 0.9 days, P <0.001), and shorter hospital stay(10±4 days vs. 13±8 days, P=0.003). In our practice, changing from epidural to multimodal analgesia produced comparable pain relief with reduction in anaesthesia preparation time, high-dependency unit stay and hospital stay and the requirement for staff interventions. There was also a reduction in the incidence of major complications and side-effects.

Database on the mechanical properties of high entropy alloys and complex concentrated alloys

This data article presents the compilation of mechanical properties for 370 high entropy alloys (HEAs) and complex concentrated alloys (CCAs) reported in the period from 2004 to 2016. The data sheet includes alloy composition, type of microstructures, density, hardness, type of tests to measure the room temperature mechanical properties, yield strength, elongation, ultimate strength and Young׳s modulus. For 27 refractory HEAs (RHEAs), the yield stress and elongation are given as a function of the testing temperature. The data are stored in a database provided in Supplementary materials, and for practical use they are tabulated in the present paper. The database was used in recent publications by Miracle and Senkov [1], Gorsse et al. [2] and Senkov et al. [3].

Safety and efficacy of vesatolimod (GS-9620) in patients with chronic hepatitis B who are not currently on antiviral treatment

Vesatolimod is an oral agonist of toll-like receptor 7 designed to minimize systemic exposure and side effects. We assessed the safety and efficacy of vesatolimod in viremic chronic hepatitis B (CHB) patients not currently on oral antiviral treatment (OAV) in a phase 2, multicentre, double-blind, randomized, placebo-controlled study. A total of 192 patients stratified by HBeAg status and alanine aminotransferase level were randomized 2:2:2:1 to receive oral vesatolimod (1-, 2- or 4-mg) or placebo once weekly for 12 weeks; tenofovir disoproxil fumarate (300-mg daily) was administered daily for 48 weeks. Efficacy was assessed by quantitative serum HBsAg decline at Week 24 from baseline. In addition to safety assessments, changes in whole-blood interferon-stimulated gene (ISG) transcripts and serum cytokines were explored. Most patients were male (64.1%) and HBeAg-negative (60.9%) at baseline. Among vesatolimod-treated patients, most (60.4%-69.1%) experienced ≥1 treatment-emergent adverse event; the majority were mild or moderate in severity. No clinically meaningful differences in HBsAg changes from baseline were observed between treatment groups. No patients experienced HBsAg loss, while 3 patients experienced HBeAg loss and hepatitis B e-antibody seroconversion at week 48. HBV DNA suppression rates were similar across all treatment arms at Week 24. ISG15 induction was dose-dependent and did not correlate with HBsAg changes. A small proportion of patients exhibited dose-dependent interferon-α induction that correlated with grade of influenza-like adverse events. Overall, vesatolimod is safe and well tolerated in CHB patients. Although consistent dose-dependent pharmacodynamic induction of ISGs was demonstrated, it did not result in clinically significant HBsAg decline.

Vitamin D in SLE: a role in pathogenesis and fatigue? A review of the literature

Fatigue is a common, disabling problem that is highly prevalent in patients with systemic lupus erythematous (SLE). More recently, vitamin D status has been established as a potential contributor to SLE pathogenesis and manifestations, in particular fatigue. This review summarizes the literature regarding the role of vitamin D in SLE, and provides an overview of the recent literature examining the association between vitamin D and fatigue in patients with SLE. Finally, the role of vitamin D supplementation in the treatment of SLE-related fatigue is considered.

Anti-viral therapy is associated with improved survival but is underutilised in patients with hepatitis B virus-related hepatocellular carcinoma: real-world east and west experience

BACKGROUND

Hepatitis B virus (HBV) is the leading cause of hepatocellular carcinoma (HCC) worldwide. It remains incompletely understood in the real world how anti-viral therapy affects survival after HCC diagnosis.

METHODS

This was an international multicentre cohort study of 2518 HBV-related HCC cases diagnosed between 2000 and 2015. Cox proportional hazards models were utilised to estimate hazard ratios (HR) with 95% (CI) for anti-viral therapy and cirrhosis on patients' risk of death.

RESULTS

Approximately, 48% of patients received anti-viral therapy at any time, but only 17% were on therapy at HCC diagnosis (38% at US centres, 11% at Asian centres). Anti-viral therapy would have been indicated for >60% of the patients not on anti-viral therapy based on American criteria. Patients with cirrhosis had lower 5-year survival (34% vs 46%; P < 0.001) while patients receiving anti-viral therapy had increased 5-year survival compared to untreated patients (42% vs 25% with cirrhosis and 58% vs 36% without cirrhosis; P < 0.001 for both). Similar findings were seen for other patient subgroups by cancer stages and cancer treatment types. Anti-viral therapy was associated with a decrease in risk of death, whether started before or after HCC diagnosis (adjusted HR 0.62 and 0.79, respectively; P < 0.001).

CONCLUSIONS

Anti-viral therapy improved overall survival in patients with HBV-related HCC across cancer stages and treatment types but was underutilised at both US and Asia centres. Expanded use of anti-viral therapy in HBV-related HCC and better linkage-to-care for HBV patients are needed.

Systematic review with meta-analysis: effectiveness and tolerability of interferon-free direct-acting antiviral regimens for chronic hepatitis C genotype 1 in routine clinical practice in Asia

BACKGROUND

Direct-acting antiviral (DAA) regimens have shown high efficacy and tolerability for patients with HCV genotype 1/1b (GT1/1b) in clinical trials. However, robust real-world evidence of interferon (IFN)-free DAA treatment for HCV GT1-infected patients in Asia is still lacking.

AIM

To systematically review and meta-analyse the effectiveness and tolerability of IFN-free DAA therapy for HCV GT1 infection in Asia.

METHODS

We included studies that enrolled adult patients with HCV GT1 infection in routine clinical practice in Asia, using IFN-free DAA regimens, and reported sustained virological response (SVR) after 12/24 weeks end-of-treatment by 31 May 2017. The pooled SVR rates were computed with a random-effects model. Subgroup analysis and meta-regression as previously registered in PROSPERO were performed to determine how pre-planned variables might have affected the pooled estimates.

RESULTS

We included 41 studies from eight countries and regions, comprising of 8574 individuals. The pooled SVR rates for GT1 were 89.9% (95% CI 88.6-91.1, I²  = 55.1%) with daclatasvir/asunaprevir (DCV/ASV) and 98.1% (95% CI 97.0-99.0, I²  = 41.0%) with ledipasvir/sofosbuvir ± ribavirin (LDV/SOF ± RBV). Baseline cirrhosis but not prior treatment history and age, attenuated the effectiveness of both regimens. Baseline resistance associated substitutions (RASs) severely attenuated SVR of DCV/ASV (65.4% vs 94.3%, P < 0.001) and only minimally with LDV/SOF ± RBV (94.5% vs 99.2%, P = 0.003). Patients with renal dysfunction treated with DCV/ASV showed a higher SVR rate (93.9% vs 89.8%, P = 0.046). Patients with hepatocellular carcinoma (HCC) LDV/SOF ± RBV achieved a lower SVR than those without HCC (94.1% vs 98.7%, P = 0.001).

CONCLUSION

All oral DAA treatment of HCV GT1 resulted in high cure rates in Asian patients in routine clinical practice setting including elderly patients and those with end-stage renal disease.

Systematic review with meta-analysis: rifaximin for the prophylaxis of spontaneous bacterial peritonitis

BACKGROUND

The primary and secondary prevention of spontaneous bacterial peritonitis (SBP) is recommended in high-risk patients with cirrhosis. Several studies evaluating the efficacy of rifaximin for SBP prophylaxis have yielded conflicting results. Rifaximin has the potential advantage of preventing bacterial overgrowth and translocation without the systemic side effects of broad-spectrum antibiotics.

AIM

To evaluate the efficacy of rifaximin in the primary and secondary prevention of SBP.

METHODS

A literature search using five databases was performed to identify studies on the association between rifaximin and SBP. We performed two meta-analyses: (1) rifaximin compared to systemic antibiotics and (2) rifaximin compared to no antibiotics. Random-effect modelling was conducted to determine overall pooled estimates and 95% confidence intervals (CIs).

RESULTS

Five studies with 555 patients (295 rifaximin, 260 systemic antibiotics) compared rifaximin with systemic antibiotics. The pooled odds ratio (OR) for SBP was 0.45 (95% CI 0.16-1.27; P = .13) in patients receiving rifaximin and strengthened on sensitivity analysis (OR 0.38, 95% CI 0.19-0.76, P = .01). In the analysis comparing rifaximin with no antibiotics, there were five studies with 784 patients (186 rifaximin, 598 no antibiotics). The OR for SBP was 0.34 (95% CI 0.11-0.99; P < .05) in patients receiving rifaximin. In subgroup analysis, rifaximin reduced the risk of SBP by 47% compared to no antibiotics for primary prophylaxis and by 74% compared to systemic antibiotics for secondary prophylaxis.

CONCLUSION

Rifaximin may be effective in preventing SBP in patients with cirrhosis and ascites compared to systemically absorbed antibiotics and compared to placebo.

Survival after treatment with curative intent for hepatocellular carcinoma among patients with vs without non-alcoholic fatty liver disease

BACKGROUND

Non-alcoholic fatty liver disease (NAFLD) is expected to become a leading aetiology of hepatocellular carcinoma (HCC)-related mortality in the United States. HCC treatments with curative intent (OLT, orthotopic liver transplantation; resection; RFA, radiofrequency ablation) can improve survival in carefully selected patients.

AIM

To compare survival after receipt of curative treatment for NAFLD and non-NAFLD-HCC aetiologies (HCV, chronic hepatitis C; HBV, chronic hepatitis B; ALD, alcoholic liver disease) and by treatment was performed.

METHODS

A cohort of 17 664 patients was assembled using linked Surveillance, Epidemiology, and End Results and Medicare data from 1991 to 2011 with confirmed diagnosis of HCC.

RESULTS

The cohort was mostly male, aged 70 (21-106) years, without cardiovascular disease, and had liver cirrhosis without decompensation, metastatic HCC or large tumour size (>5 cm). The NAFLD-HCC group was mostly female and older with more cardiovascular disease, metastatic HCC, and large tumour size and less cirrhosis and decompensated liver disease than the non-NAFLD-HCC groups. The NAFLD group was 47% less likely to receive any curative treatment as compared with non-NAFLD aetiologies (OR 0.53, P < .001). NAFLD-HCC had worse median survival after OLT (3.2, 0-12.9 years, P = .01) but had improved survival after resection (2.4, 0-12.0 years, P < .001) as compared with non-NAFLD-HCC. No significant survival differences existed for RFA by HCC aetiology. NAFLD was not an independent predictor of mortality after OLT, resection or RFA.

CONCLUSION

Patients with NAFLD-HCC had worse survival after OLT but favourable survival after resection, particularly in the absence of cirrhosis, as compared with non-NAFLD-HCC aetiologies.