Personal Risk Research Articles

Suspicious activity reporting in emerging economies: the case of Iran

PurposeCountries with high levels of corruption can experience collusion between powerful elites and accountants to conceal, disguise and clean the proceeds of criminality. This study investigates the willingness of accountants to report evidence of money laundering in an emerging economy, Iran, notwithstanding potential personal and professional risks implicit in such due diligence. It evaluates the relevance of personal characteristics of accountants to the propensity to report, and the implications for policy makers in terms of audit team composition.Design/methodology/approachThe methodology is quantitative. Data was gathered by means of a suspicious activity scenario-based questionnaire administered to 1,128 of Certified Public Accountants in Iran, of which 281 responses were received. Four hypotheses were tested relating to the implications, if any, of gender, age, education and working experience for the propensity to report red flags indicative of money laundering.FindingsData revealed that accountants were generally more willing to report activity indicative of money laundering than was anticipated in an environment perceived to be characterised by professional and personal risks. Older accountants are more risk averse and more likely to report suspicious activity than younger counterparts who tend to disregard borderline indicators of money laundering. A significant red flag indicator of money laundering is a client's reluctance to provide information regarding controlling shareholders, debtors and creditors or to explain contrived and opaque corporate structures. Audit teams may be more effective when gender-balanced: female accountants tend to be more willing to report suspicious activity than male counterparts, reducing the risk of interference by powerful elites.Research limitations/implicationsThe time frame over which the research was conducted was a single year; if it had been conducted over several years it may have revealed more nuanced and evolving reporting behaviour. The study was limited to Iran: a cross-comparison with another emerging economy or economies may have revealed useful contrasts.Originality/valueThe study contributes to behavioural accounting research in emerging economies. Limited empirical data is available regarding the influence of personal characteristics of accountants on their willingness to report suspicious activity in corrupt environments where personal safety and professional security may be at risk from powerful elites. It evaluates the implications of these for suspicious activity reporting policy, and for improving the effectiveness of the scrutineering role of audit teams. An innovative questionnaire was designed which may be suitable for future comparable research in emerging economies.

Awareness of personal cardiovascular risk among the adults with an elevated body mass index in a very high-risk country

Abstract Background An elevated body mass index (BMI) is a risk factor for cardiovascular diseases (CVD). The awareness of personal cardiovascular risk (pCVR) may vary in different populations, thus influencing health behaviours and cardiovascular prevention. Purpose To analyse the awareness of pCVR among the adults with an elevated BMI, along with sociodemographic characteristics and cardiovascular risk factors (CRF) possibly associated with the lack of pCVR awareness in a very high-risk country. Methods The pilot study included a convenient sample of 1054 adults. Those with an elevated BMI (≥25 kg/m2) were divided into two groups depending on their awareness of pCVR. The groups were compared according to the sociodemographic characteristics (age, gender, and education) and CRF (BMI, hypertension, dyslipidaemia, diabetes mellitus, smoking, physical inactivity, feeling of frequent exposure to stress, previous myocardial infarction (MI), and family history for CVD). The data were collected by voluntary filling out a survey with multiple-choice questions from April 1st to June 30th, 2022. Results Out of the total number, about half of the participants had an elevated BMI (N=549, 52%). Most of them were aware of their pCVR (69% vs 31%, p<0.01). Those unaware of pCVR were younger (44±13 vs 51±14, p<0.05), mostly females (56% vs 47%, p<0.05), with high education (61% vs 51% with more than high school, p<0.05). The groups had similar average BMI (28±3 kg/m2 vs 29±3 kg/m2, p>0.05), but the participants unaware of pCVR were more frequently overweight than obese (82% vs 64% with BMI ≥25 kg/m2 and <30 kg/m2, p<0.01). They had significantly lower frequencies of hypertension (15% vs 53%, p<0.01), dyslipidaemia (23% vs 46%, p<0.01), diabetes mellitus (2% vs 14%, p<0.01), smoking (50% vs 59%, p<0.05), previous MI (3% vs 26%, p<0.01), and family history for CVD (62% vs 82%, p<0.01). However, the majority in both groups reported physical inactivity (60% vs 64%, p>0.05) and a feeling of frequent stress exposure (70% vs 71%, p>0.05). The participants unaware of pCVR less frequently had over three modifiable CRF (12% vs 37%, p<0.01). Conclusion Most of the adults with an elevated BMI in a very high-risk country are aware of pCVR, usually because of obesity, multiple additional modifiable CRF, previous MI, or family history of CVD. Still, a notable proportion of the adults with an elevated BMI in a very high-risk country is unaware of pCVR, which is associated with younger age, female gender, high education, overweight, fewer additional modifiable CRF, and the absence of previous MI or family history for CVD. This subpopulation should be considered as a target for timely health education to raise the awareness of pCVR. Increasing physical activity through motivational campaigns and developing programmes for stress relief would be important for CVD prevention among the adults with an elevated BMI, independently of pCVR awareness.

Joining forces to accelerate cancer and NCD prevention in Europe

Abstract JA PreventNCD, a Joint Action to prevent cancer and other non-communicable diseases (NCDs) aims to assist authorities in prioritizing the most effective prevention strategies and policies to reduce the burden of cancer and NCDs, focusing on both personal and societal risk factors. A key objective is to tackle social inequalities by addressing the root causes of NCD risk factors and adopting a life-course approach. Recognizing that health is created by policies in several sectors is key when addressing health determinants, including social and commercial determinants of health. Consolidated efforts across countries will be required to tackle some of these determinants. To achieve the project’s objectives, the JA PreventNCD will build a comprehensive European infrastructure for monitoring risk factors, disease burden, and the impact of policies and interventions. Rigorous evaluation will ensure that the project’s deliverables will have an impact at local, national and EU levels. Three technical work packages address common risk factors for NCDs through actions ranging from policies and structural measures at societal level to interventions targeting individuals. Another set of cross-cutting work packages address monitoring, social inequalities, and health in all policies. More than 100 partners across 25 countries are involved, with almost 100 pilots to be conducted over the course of the project’s four years. One way of ensuring sustainability of the project’s outcomes is the building of a sustainable governance structure through the establishment of an EU Consortium on Cancer Prevention. Furthermore, as a mechanism to ensure high policy relevance of this JA, a Policy Decision Maker’s Forum will be established to engage policymakers and ensure feasibility of the project’s recommended actions. Speakers/Panelists Claudia Habl Austrian National Public Health Institute, Vienna, Austria Ane Fullaondo Biosistemak, Bilbao, Spain Arnfinn Helleve Norwegian Institute of Public Health, Oslo, Norway

Personality and cardiovascular mortality risk: a multi-cohort analysis in individuals with and without pre-existing cardiovascular disease

AbstractThis study investigated the associations between personality traits of the Five Factor Model and cardiovascular mortality, with a specific focus on whether pre-existing cardiovascular conditions modified these associations. We used data from 43,027 participants across five cohort studies: Health and Retirement Study (HRS); Wisconsin Longitudinal Study (WLS); National Social Life, Health, and Aging Project (NSHAP); Midlife in the United States (MIDUS); Household, Income, and Labour Dynamics in Australia (HILDA) with a mean age 55.9 years and 6493 individuals with pre-existing cardiovascular disease. We conducted meta-analyses examining conscientiousness, emotional stability, agreeableness, openness to experience, and extraversion in relation to mortality due to coronary heart disease and stroke. During a mean follow-up of 12.1 years, 1620 participants died from coronary heart disease and 454 from stroke. Lower conscientiousness was associated with higher mortality risk from both coronary heart disease (hazard ratio per 1SD = 0.82, 95%CI = 0.75–0.90) and stroke (HR = 0.84, CI = 0.72–0.99). Lower emotional stability predicted increased coronary heart disease mortality (HR = 0.91, CI = 0.85–0.97). The association between conscientiousness and cardiovascular mortality did not differ between individuals with or without baseline cardiovascular conditions. In addition, adjustments for health behaviors and other covariates only slightly attenuated this association. Other personality traits were not associated with cardiovascular disease mortality. Our findings highlight the role of low conscientiousness, and to a lesser extent low emotional stability, in the development and progression of fatal cardiovascular disease through pathways that may extend beyond established health behaviors.

Heterogeneous associations of traditional atherosclerotic risk factors and long-term events in different arterial territories: the EPIC Norfolk prospective population cohort

Abstract Background Atherosclerotic risk factors have been associated with cardiovascular disease (CVD) events in specific arterial territories. However, these observations are limited by relatively short-term follow-up (i.e. ten years) and a focus on a limited number of outcome events. We therefore investigated associations between atherosclerotic risk factors and territory-specific cardiovascular events in a large cohort with ≥20 years follow-up. Methods We included participants without baseline CVD from the European Prospective Investigation of Cancer (EPIC) Norfolk prospective population cohort. The strengths of associations between CVD risk factors (smoking, low-density lipoprotein cholesterol (LDL-c), and systolic blood pressure (SBP)) and the first occurrence of a CVD event were evaluated using a competing risk-adjusted regression model. CVD events were defined as hospitalisations or death due to ischemic heart disease (IHD), ischemic stroke, haemorrhagic stroke, peripheral arterial disease (PAD) or aortic aneurysm (AA). Patients were followed-up until the first event, non-CVD death (competing risk) or end of study (15-03-2018). The model was adjusted for sex, age, diabetes, HDL-c, kidney function and body mass index. LDL-c and SBP were analysed by comparing highest versus lowest quartiles. Smoking (at baseline) was compared to never smoking. Results We included 23,581 participants (56% women) with a median baseline age of 58 years [interquartile range (IQR) 51-66]. During median follow up of 21.3 years (IQR 19.0-22.8), 26.4% of individuals experienced ≥1 CVD event. The first event of occurrence was IHD in 17.3%, ischemic stroke in 3.6%, haemorrhagic stroke in 1.4%, PAD in 3.1% and AA in 1.4%. LDL-c was strongest associated with IHD [adjusted hazard rate (aHR) 1.7, 95% confidence interval (CI) 1.5-1.9], SBP with ischemic stroke (aHR 1.9, 95%CI 1.5-2.5) and smoking with AA (aHR 4.8, 95%CI 3.5-6.5) (Figure 1). Conclusions There is considerable heterogeneity in the associations between atherosclerotic risk factors and long-term, first, territory-specific cardiovascular events. Knowledge of these differences may assist in personalised treatment decisions and risk communication.

The Influence of Personality Traits on Stock Investment Retention: Insights from Thai Investors

Understanding the psychological factors that influence investment decisions is crucial for predicting stock investment retention. This study investigates the mediating role of the Big Five personality traits in stock investment retention, utilizing a modified version of the theory of planned behavior. By examining the influence of investors’ perceived risk and attitudes toward stock investment, data collected via an online survey with The Association of Thai Securities Companies (ASCO) were analyzed using Structural Equation Modeling (SEM). The findings reveal that extraversion, openness, and conscientiousness significantly impact attitudes toward stock investing, which in turn affects investment retention. However, personality traits do not directly influence risk perception. This research provides unique empirical evidence of the independence between the Big Five personality traits and risk perception among Thai stock investors, underscoring the importance of personality in shaping investment behavior through its effect on attitudes.

Development of a risk-stratified shared decision-making tool for colorectal cancer screening

Abstract European guidelines stress the importance of informed decision-making in colorectal cancer (CRC) screening. However, tailored tools that facilitate decision-making for underserved people and general practitioners (GPs) in Flanders are lacking. This study aimed to develop a tailored shared decision-making (SDM) tool for CRC screening, specifically a video decision aid, using a co-creative process. The development involved two rounds of focus group discussions with underserved people and five local quality group meetings with GPs in various parts of Flanders, Belgium. Qualitative data were analyzed using a Modified-Grounded Theory Analytical (M-GTA) approach to identify key themes. Findings revealed four core themes. The first theme, ‘Recognizing the Barriers to Screening’, identifies challenges such as a lack of time, staff, and tools for GPs, as well as language and literacy barriers for underserved people. The second theme, ‘Learning from Existing Tools’, highlights successful elements like visuals and simple language and limitations such as low accessibility and poor navigation. The third theme, ‘Determining the Content and Design,’ reveals that GPs seek user-friendly tools for at-home viewing, while underserved people value personalized and clear information about CRC risk factors and screening costs. The final theme, ‘Identifying Strategies for Integration,’ stresses the importance of a structured, collaborative care approach for the successful integration of the tool. The proposed modifications for the SDM tool include enhancing its accessibility with multiple language options, using simple and relatable visuals, and providing personalized risk discussions for underserved people and GPs. Nonetheless, further testing is needed to confirm the effectiveness of the SDM tool in supporting preventive talks and informed decision-making in CRC screening among these target groups. Key messages • A structured, collaborative care approach is needed for successful SDM tool integration during preventive talks with underserved people. • Further testing is needed to confirm the tool’s effectiveness in supporting informed decision-making in CRC screening for underserved people.

Incidence and Risk Factors of Lumbosacral Complications Following Long-Segment Spinal Fusion in Adult Degenerative Scoliosis.

Long-segment spinal fusions are associated with lumbosacral complications (LSC), but the associated risk factors are not known. This study aimed to identify the risk factors for LSC after long-segment instrumented fusion with distal fixation to the L5 vertebral body in adult degenerative scoliosis (ADS). We retrospectively evaluated 294 patients with ADS who underwent long-segment floating fusion between January 2014 and March 2022, with follow-up for at least 2 years. Patients were matched to the baseline data using fusion level > 5 as a grouping variable. Patients who completed matching were divided into two groups according to the presence or absence of LSC. Univariate logistic regression was applied to identify potential risk factors for LSC, and multivariate logistic regression was used to identify independent risk factors for postoperative LSC. The overall incidence of LSC was 21.77% in the 294 patients, with disc degeneration in 28 (9.52%) and radiographic ASD in 44 (14.97%) patients. The mean time to LSC development after surgery was 26.91 ± 8.43 months. A total of 54 pairs of patients were matched and grouped, and the complication group had higher Oswestry Disability Index (ODI) and visual analog scale (VAS) scores at the last follow-up. Multivariate analysis showed that gender (OR = 0.274, p = 0.026 [0.087, 0.859]); levels of fusion > 5 (OR = 3.127, p = 0.029 [1.120, 8.730]), main curve correction rate (OR = 0.009, p = 0.005 [0.000, 0.330]), and postoperative pelvic incidence minus lumbar lordosis (PI-LL) > 15° (OR = 3.346, p = 0.022 [1.195, 9.373]) were independent risk factors for postoperative LSC. The area under the curve value of the prediction model was 0.804, with a 95% confidence interval of 0.715-0.892, indicating that the model had a high prediction accuracy. Collinearity statistics showed no collinearity between variables. Sex, level of fusion > 5, main curve correction rate, and postoperative PI-LL > 15° were independent risk factors for the development of LSC after long-segment floating fusion. These results will improve our ability to predict personal risk conditions and provide better medical optimisation for surgery.

Unsupervised machine learning identifies distinct phenotypes in cardiac complications of pediatric patients treated with anthracyclines

BackgroundAnthracyclines are essential in pediatric cancer treatment, but patients are at risk cancer therapy-related cardiac dysfunction (CTRCD). Standardized definitions by the International Cardio-Oncology Society (IC-OS) aim to enhance precision in risk assessment.ObjectivesCategorize distinct phenotypes among pediatric patients undergoing anthracycline chemotherapy using unsupervised machine learning.MethodsPediatric cancer patients undergoing anthracycline chemotherapy at our institution were retrospectively included. Clinical and echocardiographic data at baseline, along with follow-up data, were collected from patient records. Unsupervised machine learning was performed, involving dimensionality reduction using principal component analysis and K-means clustering to identify different phenotypic clusters. Identified phenogroups were analyzed for associations with CTRCD, defined following contemporary IC-OS definitions, and hypertensive response.ResultsA total of 187 patients (63.1% male, median age 15.5 years [10.4–18.7]) were included and received anthracycline chemotherapy with a median treatment duration of 0.66 years [0.35–1.92]. Median follow-up duration was 2.78 years [1.31–4.21]. Four phenogroups were identified with following distribution: Cluster 0 (32.6%, n = 61), Cluster 1 (13.9%, n = 26), Cluster 2 (24.6%, n = 46), and Cluster 3 (28.9%, n = 54). Cluster 0 showed the highest risk of moderate CTRCD (HR: 3.10 [95% CI: 1.18–8.16], P = 0.022) compared to other clusters. Cluster 3 demonstrated a protective effect against hypertensive response (HR: 0.30 [95% CI: 0.13– 0.67], P = 0.003) after excluding baseline hypertensive patients. Longitudinal assessments revealed differences in global longitudinal strain and systolic blood pressure among phenogroups.ConclusionsUnsupervised machine learning identified distinct phenogroups among pediatric cancer patients undergoing anthracycline chemotherapy, offering potential for personalized risk assessment.

Personal Bankruptcy Prediction Using Logistic Regression Model

According to the Insolvency Department of Malaysia, as of December 2023, 233,483 Malaysians are currently involved in bankruptcy cases due to their defaults on hire purchase loans, credit card loans, personal loans, housing loans, and business loans. This is indeed a critical issue because the growing number of personal bankruptcy cases will hurt the Malaysian economy as well as society. From an individual's economic perspective, bankruptcy minimizes their chances of getting a job. Apart from that, their accounts will be frozen, they will lose control of their properties and assets, and they will not be allowed to start any business or be a part of any company's Board of Directors. Bankrupts also will be rejected from any loan application. This paper examines this problem by developing a personal bankruptcy prediction model using the logistic regression technique. This paper defines "bankrupt" as terminated members who failed to settle their loans. The sample comprised 24,546 cases with 17% settled cases and 83% terminated cases. The data included a dependent variable, i.e., bankruptcy status (Y=1(bankrupt), Y=0(non-bankrupt)), and 12 predictors. Upon completion, this paper succeeds in coming out with a reliable personal bankruptcy prediction model and significant variables of personal bankruptcy. The findings of this paper are very beneficial and significant to creditors, banks, the Malaysia Department of Insolvency, potential borrowers, members of AKPK, and society in general in raising awareness of personal bankruptcy risks and such information may help them to take preventive measures in minimizing the number of personal bankruptcy cases.

Circumstantial Factors Among Kentucky Nurse Suicide Decedents, 2005 to 2019.

Background: Nurse suicide, a complex occupational health concern, is urgently in need of research due to the personal and occupational suicide risk factors experienced by nurses, namely mental health problems (e.g., depression), job problems, and substance misuse. Therefore, the study aims were to determine the contextual characteristics and circumstantial factors associated with nurse suicide in Kentucky. Methods: Secondary suicide data were obtained from the Kentucky Violent Death Reporting System (KYVDRS) from 2005 to 2019. Nurse suicide cases were identified using the Bureau of Labor Statistics Standard Occupational Classification. A mixed-methods analysis using descriptive statistics and qualitative evaluation was conducted to determine the distributions of demographic, injury, and weapon characteristics, followed by a qualitative analysis of the KYVDRS incident narrative text of nurse suicide decedents. Results: There were 88 decedents identified with a nursing occupation. The predominant means of death for male (59%) and female (45%) nurses involved firearms. Thematic analysis showed nurse decedents experienced a mental health problem (51%) and premeditated (50%) suicide preceding death. Incidentally, 51% of all cases experienced multiple circumstantial factors (e.g., relationship problems and premeditation) preceding their death by suicide. Discussion/Application to Practice: Nurse suicide decedents experienced multifactorial risk factors preceding their death by suicide, namely depression, premeditated suicide, and relationship problems. Occupational health practitioners and health care organizations can implement individual and organizational prevention efforts to help prevent nurse suicide.

Locally Acquired (Autochthonous) Mosquito-Transmitted Plasmodium vivax Malaria - Saline County, Arkansas, September 2023.

A case of locally acquired (autochthonous) mosquito-transmitted Plasmodium vivax malaria was diagnosed in Arkansas in September 2023. This represents the 10th autochthonous case identified nationally in 2023, after 20 years without recorded local mosquitoborne malaria transmission in the United States. The public health response included case investigation, active case surveillance, mosquito surveillance and control, assessment of medical countermeasures, and clinical and public outreach. Prompt diagnosis and appropriate treatment of malaria can improve clinical outcomes and, in addition to vector control, minimize risk for local transmission. Clinicians should consider malaria among patients who have traveled to countries where malaria is endemic, or with unexplained fever regardless of travel history. Although the risk for autochthonous malaria in the United States remains very low, its reemergence highlights the importance of vectorborne disease preparedness and response. Examples of such efforts include improving awareness among clinicians, access to diagnostics and antimalarial medications, and capacity for mosquito surveillance and control. Collaboration and communication among CDC, health departments, local jurisdictions, clinicians, hospitals, laboratories, and the public can support rapid malaria diagnosis, prevention, and control. Before traveling internationally to areas where malaria is endemic, travelers should consult with their health care provider regarding recommended malaria prevention measures, including chemoprophylaxis and precautions to avoid mosquito bites, to reduce both personal and community risk.

Research Progress of Pulsed Radiofrequency in the Treatment of Shoulder Pain

The shoulder is one of the most complex anatomical structures in the body, consisting of bones, muscles, tendons, bursae, joint capsules, nerves, and blood vessels. Shoulder pain is one of the most common musculoskeletal syndromes clinically, according to statistics, the prevalence of shoulder pain in the adult population is 11% to 27%, lifetime prevalence as high as 67%. There are also significant differences in the prevalence of shoulder pain across age and gender. Typically, shoulder pain stems from trauma, degeneration, inflammation, vascular disease, and referred pain from other parts of the head, neck, and hands. Studies have shown that in addition to personal risk factors such as age, arthritis, obesity, diabetes, and thyroid disease, external factors such as living and working environments can lead to varying degrees of pain, limited mobility, and dysfunction in the shoulder, It imposes a huge economic burden on social development and healthcare services.

Machine learning for pacemaker implantation prediction after TAVI using multimodal imaging data

Pacemaker implantation (PMI) after transcatheter aortic valve implantation (TAVI) is a common complication. While computed tomography (CT) scan data are known predictors of PMI, no machine learning (ML) model integrating CT with clinical, ECG, and transthoracic echocardiography (TTE) data has been proposed. This study investigates the contribution of ML methods to predict PMI after TAVI, with a focus on the role of CT imaging data. A retrospective analysis was conducted on a cohort of 520 patients who underwent TAVI. Recursive feature elimination with SHAP values was used to select key variables from clinical, ECG, TTE, and CT data. Six ML models, including Support Vector Machines (SVM), were trained using these selected variables. The model’s performance was evaluated using AUC-ROC, F1 score, and accuracy metrics. The PMI rate was 18.8%. The best-performing model achieved an AUC-ROC of 92.1% ± 4.7, an F1 score of 71.8% ± 9.9, and an accuracy of 87.9% ± 4.7 using 22 variables, 9 of which were CT-based. Membranous septum measurements and their dynamic variations were critical predictors. Our ML model provides robust PMI predictions, enabling personalized risk assessments. The model is implemented online for broad clinical use.

Effects of personal cancer history and genomic risk information on mothers' psychological adaptation to inherited breast/ovarian cancer syndrome.

This study aimed to understand long-term coping responses of mothers (N = 287) receiving genetic counseling and testing (GCT) for hereditary breast/ovarian cancer (HBOC) syndrome. Psychological characteristics, including cancer-specific distress (Impact of Events Scale-Revised, α = .85) and coping (Brief COPE, α = .93) were assessed via structured personal communication, along with epidemiologic items assessing personal and family history of cancer. Genetic risk was determined by BRCA1/2 carriage. A principal component analysis was conducted on the coping measure to reduce its summary score to active coping (α = .91) with nine approach-oriented strategies responsive to stress. A multivariable regression model examined the main and interacting effects of clinical and psychological characteristics on maternal coping. Personal cancer history (F = 4.99, df = 1, p = .026), BRCA test result (F = 22.20, df = 1, p < .001), and cancer-specific distress (F = 17.80, df = 1, p < .001) were associated with greater engagement in active coping strategies. When controlling for cancer-specific distress, the interaction between personal cancer history and genetic test results was significant, such that women previously unaffected by cancer who received positive BRCA results reported the greatest levels of active coping (F = 7.92, p < .001). These findings indicate that previous cancer history, genetic risk, and psychological distress independently and jointly impact how women adapt to the threat of cancer over time.

Changes in Auditory Performance Following a Virtual Reality Music Concert.

The purpose of this study was to evaluate threshold and suprathreshold auditory risk from a newly popular platform of music concert entertainment; virtual reality (VR) headsets. Recreational noise exposure to music is the primary source of hearing hazard in young-adults, with noise doses of in-person concert venues and music festivals well in excess of the recommended daily exposure recommendation from the National Institute for Occupational Safety and Health. While research on the relationship between personal music players and noise-induced hearing loss risk is abundant, no study has yet evaluated noise-induced hearing loss risk from VR headsets, which are newest to the commercial market at this time. Thirty-one young-adult participants (18 to 25 years) with normal-hearing sensitivity (0 to 16 dB HL) experienced a VR music concert and participated in three data collection timepoints: Session A preexposure, Session A post-exposure, and Session B post-exposure. Participants underwent baseline testing for audiometry (0.25 to 20 kHz), distortion product otoacoustic emission testing (1 to 10 kHz), and Words-in-Noise testing. Participants then wore a commercially available VR headset (Meta Quest 2) and experienced a freely available online VR music concert (via the video-sharing website "YouTube"). The VR music concert duration was 90 min set to maximum volume, which yielded an average sound level equivalent of 78.7 dBA, max sound level of 88.2 dBA, and LC peak sound level of 98.6 dBA. Post-exposure testing was conducted immediately at the conclusion of the VR concert, and again within 24 hr to 1 week after the exposure. Participants also answered a questionnaire that estimated noise exposure history (National Acoustics Laboratory "Noise Calculator"). Post-exposure deficit was not observed in DPOAEs or Words-in-Noise score (p's > 0.05). However, statistically significant temporary post-exposure deficit was observed in audiometry at 4, 8, and 12.5 kHz (p's < 0.05) (mean differences: 2 to 3 dB HL). Twenty-four hours and 1-week post-exposure measurements revealed no permanent changes from baseline measurements (p's > 0.05) aside from one spurious difference at 12.5 kHz. Males tended to exhibit a significantly higher noise history score on average than females. The primary, secondary, and tertiary sources of noise hazard history in this young-adult cohort included amplified music. These preliminary data suggest that VR music concerts-which are likely to produce a substantially lower noise dose than in-person music concerts-may still be capable of producing at least slight, temporary threshold shifts on the order of 2 to 3 dB HL. Future research should include VR headsets in personal music player risk assessment, as the VR music concert platform is increasing rapidly in popularity among young-adults.

Prosocial preferences can escalate intergroup conflicts by countering selfish motivations to leave

When defending against hostile enemies, individual group members can benefit from others staying in the group and fighting. However, individuals themselves may be better off by leaving the group and avoiding the personal risks associated with fighting. While fleeing is indeed commonly observed, when and why defenders fight or flee remains poorly understood and is addressed here with three incentivized and preregistered experiments (total n = 602). In stylized attacker-defender contest games in which defenders could stay and fight or leave, we show that the less costly leaving is, the more likely individuals are to abandon their group. In addition, more risk-averse individuals are more likely to leave. Conversely, individuals more likely stay and fight when they have pro-social preferences and when fellow group members cannot leave. However, those who stay not always contribute fully to group defense, to some degree free-riding on the efforts of other group members. Nonetheless, staying increased intergroup conflict and its associated costs.

MASLD in persons with HIV is associated with high cardiometabolic risk as evidenced by altered advanced lipoprotein profiles and targeted metabolomics

BackgroundMetabolic dysfunction associated steatotic liver disease (MASLD) is associated with increased cardiovascular disease (CVD) risk in persons with HIV (PWH). The lipidomic and metabolomic alterations contributing to this risk are poorly understood. We aimed to characterize the advanced lipoprotein and targeted metabolomic profiles in PWH and assess if the presence and severity of MASLD influence these profiles.MethodsThis is a cross-sectional analysis of a prospectively enrolled multicenter cohort. PWH without alcohol abuse or known liver disease underwent vibration-controlled transient elastography for controlled attenuation parameter (CAP) and liver stiffness measurement (LSM). Lipidomic and metabolomic profiling was undertaken with nuclear magnetic resonance (NMR) spectroscopy. Hepatic steatosis was defined as CAP ≥ 263 dB/m and clinically significant fibrosis (CSF) as LSM ≥ 8 kPa. Logistic regression models assessed associations between MASLD, CSF and lipidomic and metabolic parameters.ResultsOf 190 participants (71% cisgender male, 96% on antiretroviral therapy), 58% had MASLD and 12% CSF. Mean (SD) age was 48.9 (12.1) years and body mass index (BMI) 29.9 (6.4) kg/m2. Compared to PWH without MASLD (controls), PWH with MASLD had lower HDL-C but higher total triglyceride, VLDL-C, branched-chain amino acids, GlycA, trimethylamine N-oxide levels, Lipoprotein-Insulin Resistance and Diabetes Risk Indices. There were no significant differences in these parameters between participants with MASLD with or without CSF. In a multivariable regression analysis, MASLD was independently associated with changes in most of these parameters after adjustment for age, gender, race/ethnicity, type 2 diabetes mellitus, BMI, and lipid lowering medications use.ConclusionsMASLD in PWH is independently associated with altered advanced lipoprotein and targeted metabolic profiles, indicating a higher CVD risk in this population.

Overall survival and disease-free survival prediction in Chinese women with breast cancer aged 70 years or older by using nomograms.

By analyzing the existing data of this study, a prediction tool for the overall breast cancer survival and disease-free survival (DFS) of elderly women was established. Clinicopathologic data were collected from elderly women with BC who were admitted to the Tianjin Medical University Cancer Institute and Hospital from August 2014 to December 2017. Independent prognostic factors for BC in elderly patients were confirmed using the Cox proportional hazards model. Nomograms were developed with these factors for predicting the 3- and 5-year overall survival (OS) as well as DFS. The nomograms' discrimination ability and calibration were assessed through the area under the curve (AUC), concordance index (C-index), decision curve analysis (DCA), and calibration plots. We enroled 889 elderly patients with BC, and the results showed that the 3-year OS rate was 93.4% (95%CI = 91.8%-95.1%), the 3-year DFS rate was 87.8% (95%CI = 85.7%-90.0%), the 5-year OS rate was 85.6% (95%CI = 83.3%-87.9%), and the 5-year DFS rate was 80.1%(95%CI = 77.5%-82.8%). The corrected C-indices of the OS and DFS nomograms were 0.799 and 0.667, respectively (95%CI = 0.767-0.830 and 0.632-0.702, respectively). Relatively high AUC values were shown by the nomograms for estimating OS and DFS. The DCA revealed that the constructed nomograms had net benefits for clinical application. The calibration curves demonstrated an excellent correspondence between the data predicted by the nomograms and the actual survival data. Survival curves indicated that risk stratification could differentiate OS and DFS. This study developed novel and practical nomograms for individual prediction of DFS and OS in elderly BC patients. These nomograms can predict 3- and 5-year OS as well as DFS in the elderly BC patient population, thereby enabling personalized risk assessment and risk-based therapy.

Social mobility beliefs and attitudes toward redistribution: Potential explanatory mechanisms

AbstractEconomic inequality is a significant problem of modern society, and redistributive policies are one of the most effective tools for reducing it. Previous studies have highlighted the importance of social mobility to understand attitudes toward redistribution. Across three preregistered studies (N = 2475; one cross‐sectional and two experimental) in different countries (Italy and Spain), we investigated the relationship between upward and downward societal mobility beliefs and attitudes toward redistribution, as well as potential explanatory mechanisms. Results showed that when people believe that it is easy to improve the socioeconomic status in their society, they oppose redistributive policies; conversely, when people believe that is difficult, they support redistributive policies. Importantly, meritocratic beliefs explained the upward mobility effect on redistribution, and perceived personal economic risks accounted for the downward mobility effect. Implications of these results for the design of policies to reduce economic inequality are discussed.