Numerous studies have demonstrated the role of making choices as an internal motivator to improve performance, and recent studies in the domain of memory have focused on adults. To chart the developmental trend of the choice effect on memory, we conducted a series of seven experiments involving children, adolescents, and young adults. Participants (N = 512) aged 5 to 26 years performed a choice encoding task that manipulated the opportunities to choose and then took a memory test. Using different types of experimental materials and corroborated by a mini meta-analysis, we found that the choice effect on memory was significant in childhood and early adolescence but not significant in late adolescence and early adulthood. The developmental changes were statistically significant, particularly evident during the transition from early to late adolescence. These findings suggest that the internal value of choice decreases across development and contributes to our understanding of developmental differences in the role of choice in memory.

UNASSIGNED: To investigate the relationship between lactate dehydrogenase and apolipoprotein A1 levels and the condition and prognosis of patients with severe pneumonia.
UNASSIGNED: Data was collected from 204 patients with severe pneumonia who were hospitalized from January 1, 2019 to December 1, 2021 in Zhaotong First People\'s Hospital (respiratory intensive care unit (RICU)), and divided into survival group (160 patients) and death group (44 patients) according to their hospitalization outcome. The relationship between lactate dehydrogenase and apolipoprotein A1 levels and general information, disease, and treatment needs of patients with severe pneumonia was analyzed, and lactate dehydrogenase, apolipoprotein A1, neutrophil-to-lymphocyte ratio, hematocrit, C-reactive protein, calcitoninogen, D-dimer, Acute Physiology and Chronic Health Status Rating System II, and Pneumonia Severity Index scores were compared between the survival and death groups. The value of these indicators in determining the prognosis of patients was analyzed using subject operating characteristic (ROC) curves. Logistic regression was used to analyze the risk factors for death from severe pneumonia.
UNASSIGNED: Cilj je bio da se istraži veza između nivoa laktat dehidrogenaze i apolipoproteina A1 i stanja i prognoze pacijenata sa teškom pneumonijom.
UNASSIGNED: Podaci su prikupljeni od 204 pacijenta sa teškom upalom pluća koji su bili hospitalizovani od 1. januara 2019. do 1. decembra 2021. godine u Prvoj Narodnoj bolnici Zhaotong (jedinica intenzivne nege respiratornih organa (RICU)), i podeljeni u grupu za preživljavanje (160 pacijenata) i smrt grupa (44 bolesnika) prema ishodu hospitalizacije. Analiziran je odnos između nivoa laktat dehidrogenaze i apolipoproteina A1 i opštih informacija, bolesti i potreba za lečenjem pacijenata sa teškom pneumonijom, a analizirana je i laktat dehidrogenaza, apolipoprotein A1, odnos neutrofila i limfocita, hematokrit, C-reaktivni protein, D kalcitoninogen. D-dimer, sistem ocenjivanja akutne fiziologije i hroničnog zdravstvenog statusa II, i indeks ozbiljnosti pneumonije I upoređeni su između grupa preživljavanja i smrti. Vrednost ovih pokazatelja u određivanju prognoze bolesnika analizirana je korišćenjem krivih operativnih karakteristika subjekta (ROC). Logistićka regresija je korišćena za analizu faktora rizika za smrt od teške pneumonije.
UNASSIGNED: Starost i tip pneumonije su se značajno razlikovali između dve grupe (P<0,05). Nije bilo značajnih razlika u polu i ukupnom broju dana hospitalizacije (P>0,05). Nivoi LDH (laktat dehidrogenaze) i ApoA1 (apolipoproteina A1) pokazali su značajne razlike među različitim starosnim grupama sa teškom pneumonijom (P<0,05). Nivoi LDH i ApoA1 nisu se značajno razlikovali između pacijenata sa SCAP (teška pneumonija stečena u zajednici) i SHAP (bolnički stečena pneumonija) (P>0,05). Nivoi LDH i ApoA1 bili su viši kod pacijenata sa teškom pneumonijom sa akutnom egzacerbacijom ili MODS-om (sindrom višeorganske disfunkcije), u poređenju sa onima bez (P<0,05). Nivoi LDH i ApoA1 značajno su varirali sa PSI (indeks ozbiljnosti pneumonije) ocenama ili APACHE II (akutna fiziologija i hronična zdravstvena evaluacija II) skor, trajanje boravka u intenzivnoj nezi i trajanje mehaničke ventilacije kod pacijenata sa teškom pneumonijom (P<0,05). Nivoi LDH i ApoA1 su bili značajno viši u grupi umrlih u poređenju sa grupom koja je preživela (P<0,05). Odnos neutrofila i limfocita (NLR), hematokrit (HCT), C-reaktivni protein (CRP), kalcitoninogen (PCT), D-dimer (DD), PSI rezultati i APACHE II rezultati nisu pokazali značajne razlike između ova dva grupe (P>0,05). LDH i ApoA1, kada su kombinovani, imali su veću prediktivnu vrednost za smrtnost od teške pneumonije (područje ispod krive, AUC=0,873, P<0,05). Multivarijantna logistička regresiona analiza je potvrdila da LDH>289 U/mL i ApoA1<0,92 mg/mL povećavaju rizik od teške smrtnosti od pneumonije (OR=4,275, 0,548, P<0,05).
UNASSIGNED: Povišeni nivoi LDH i smanjeni nivoi ApoA1 kod pacijenata sa teškom pneumonijom su vredni u proceni stanja i prognoze pacijenata i mogu pružiti pomoć u ranoj proceni stanja pacijenata i dijagnozi i lečenju.

Vaccine hesitancy is considered as one of the greatest challenges to control the ongoing coronavirus disease 2019 (COVID-19) pandemic. A related challenge is the unwillingness of the general public to pay for vaccination. The objective of this study was to determine willingness-to-pay (WTP) for COVID-19 vaccine among individuals from ten low- middle-income countries (LMICs) in Asia, Africa, and South America. Data were collected using an online questionnaire distributed during February - May 2021 in ten LMICs (Bangladesh, Brazil, Chile, Egypt, India, Iran, Nigeria, Pakistan, Sudan, and Tunisia). The major response variable of in this study was WTP for a COVID-19 vaccine. The assessment of COVID-19 vaccine hesitancy was based on items adopted from the World Health Organization (WHO) Strategic Advisory Group of Experts (SAGE) vaccine hesitancy scale constructs. In this study, 1337 respondents included in the final analysis where the highest number of respondents was from India, while the lowest number was from Egypt. A total of 88.9% (1188/1337) respondents were willing to pay for the COVID-19 vaccination, and 11.1% (149/1337) were not. The average WTP for COVID-19 vaccination was 87.9 US dollars ($), (range: $5-$200). The multivariate model analysis showed that the country, monthly household income, having a history of respiratory disease, the agreement that routine vaccines recommended by health workers are beneficial and having received the flu vaccination within the previous 12 months were strongly associated with the WTP. Based on the country of origin, the highest mean WTP for COVID-19 vaccine was reported in Chile, while the lowest mean WTP for the vaccine was seen among the respondents from Sudan. The availability of free COVID-19 vaccination services appears as a top priority in the LMICs for successful control of the ongoing pandemic. This is particularly important for individuals of a lower socio- economic status. The effects of complacency regarding COVID-19 extends beyond vaccine hesitancy to involve less willingness to pay for COVID-19 vaccine and a lower value of WTP for the vaccine.

UNASSIGNED: This study investigated the predicting value of the ratio of levator hiatus diameter (LHS) to fetal head circumference (HC) in pregnant women at 37 weeks of gestation in the progression of the second stage of labor and levator ani injury 6 weeks postpartum.
UNASSIGNED: A total of 120 first-time women who gave vaginal delivery at 37 weeks of pregnancy were selected as the subjects in our hospital during March 2021 to March 2022. The subjects were divided into the second stage of labor > 1 h group and the second stage of labor ≤ 1 h group, according to the delivery time of the second stage of labor. According to the 6-week postpartum follow-up ultrasound examination with or without levator ani injury, they were divided into levator ani injury group and no injury group. All primipara women underwent three-dimensional ultrasonography at 37 weeks of gestation, and the resting LHS, Valsalva LHS, fetal HC and the ratio of resting LHS and fetal HC were compared. The correlation between these factors and the length of the second labor stage was analyzed using Pearson correlation analysis. The value of these factors in predicting labor progression and postpartum levator ani injury was assessed by receiver operating characteristic (ROC) curves.
UNASSIGNED: The resting LHS, Valsalva LHS and the ratio of resting LHS and fetal HC in the levator ani injury group were lower than these in the no injury group, while fetal HC in the levator ani injury group was higher than that in the no injury group (P < 0.05). The resting LHS, Valsalva LHS and the ratio of resting LHS and fetal HC in the second stage of labor > 1 h group were lower than these in the second stage of labor ≤ 1 h group, while fetal HC in the second stage of labor > 1 h group was higher than that in the second stage of labor ≤ 1 h group (P < 0.05). A significant negative correlation was observed between resting LHS/HC and total labor process (=-0.333, P < 0.01). ROC curve analysis showed that the AUCs of resting LHS, Valsalva LHS, HC, and resting LHS/HC ratio in predicting prolongation of the second stage of labor were 0.741, 0.740, 0.702, and 0.843 respectively. Besides, the AUCs of resting LHS, Valsalva LHS, HC, and resting LHS/HC ratio in predicting the total labor process were 0.657, 0.684, 0.768, and 0.836 respectively. The AUCs of resting LHS, Valsalva LHS, HC, and resting LHS/HC ratio in predicting postpartum levator ani muscle injury were 0.769, 0.773, 0.747, and 0.885 respectively.These results suggested that the ratio of resting LHS and fetal HC may have certain clinical value in predicting levator ani injury in pregnant women.
UNASSIGNED: LHS, fetal HC and the ratio of resting LHS and fetal HC are significantly correlated with labor progression and postpartum levator ani injury, which have certain value in predicting labor progress and postpartum levator ani injury. Therein, the ratio of resting LHS and fetal HC has the highest predictive value, and early detection of the ratio of resting LHS and fetal HC is helpful to guide the selection of appropriate delivery mode.

Research in reinforcement learning indicates that animals respond differently to positive and negative reward prediction errors, which can be calculated by assuming learning rate bias. Many studies have shown that humans and other animals have learning rate bias during learning, but it is unclear whether and how the bias changes throughout the entire learning process. Here, we recorded the behavior data and the local field potentials (LFPs) in the striatum of five pigeons performing a probabilistic learning task. Reinforcement learning models with and without learning rate biases were used to dynamically fit the pigeons\' choice behavior and estimate the option values. Furthemore, the correlation between the striatal LFPs power and the model-estimated option values was explored. We found that the pigeons\' learning rate bias shifted from negative to positive during the learning process, and the striatal Gamma (31 to 80 Hz) power correlated with the option values modulated by dynamic learning rate bias. In conclusion, our results support the hypothesis that pigeons employ a dynamic learning strategy in the learning process from both behavioral and neural aspects, providing valuable insights into reinforcement learning mechanisms of non-human animals.

The pivotal role of Human Resource Management (HRM) in hospital administration has been acknowledged in research, yet the examination of HRM practices in the world\'s premier hospitals has been scant.
This study explored how the world\'s leading hospitals attain operational efficiency by optimizing human resource allocation and melding development strategies into their HRM frameworks. A comparative analysis of the HRM frameworks in the top five global hospitals was undertaken to offer a reference model for other hospitals.
This research offers a comparative exploration of the HRM frameworks utilized by the top five hospitals globally, underscoring both shared and distinct elements. Using a multi-case study methodology, the research scrutinized each hospital\'s HRM framework across six modules, drawing literature from publicly accessible sources, including websites, annual reports, and pertinent English-language scholarly literature from platforms such as Google Scholar, PubMed, Medline, and Web of Science.
The analyzed hospitals exhibited inconsistent HRM frameworks, yet all manifested potent organizational cultural attributes and maintained robust employee training and welfare policies. The design of the HR systems was strategically aligned with the hospitals\' objectives, and the study established that maintaining a sustainable talent system is pivotal to achieving hospital excellence.
The HRM frameworks of the five analyzed hospitals align with their developmental strategies and exhibit unique organizational cultural attributes. All five hospitals heavily prioritize aligning employee development with overall hospital growth and place a spotlight on fostering a healthy working environment and nurturing employees\' sense of achievement. While compensation is a notable performance influencer, it is not rigorously tied to workload in these hospitals, with employees receiving mid-to-upper industry-range compensation. Performance assessment criteria focus on job quality and aligning employee actions with organizational values. Comprehensive welfare and protection are afforded to employees across all five hospitals.

OBJECTIVE: Monetizing health has sparked controversy and has implications for pricing strategies of emerging health technologies. Medical insurance payers typically set up thresholds for quality-adjusted life years (QALY) gains based on health productivity and budget affordability, but they rarely consider patient willingness-to-pay (WTP). Our study aims to compare Chinese payer threshold and patient WTP toward QALY gain of advanced non-small cell lung cancer (NSCLC) and to inform a potential inclusion of patient WTP under more complex decision-making scenarios.
METHODS: A regression model was constructed with cost as the independent variable and QALY as the dependent variable, where the regression coefficients reflect mean opportunity cost, and by transforming these coefficients, the payer threshold can be obtained. Patient WTP was elicited through a contingent valuation method survey. The robustness of the findings was examined through sensitivity analyses of model parameters and patient heterogeneity.
RESULTS: The payer mean threshold in the base-case was estimated at 150,962 yuan (1.86 times per capita GDP, 95% CI 144,041-159,204). The two scenarios analysis generated by different utility inputs yielded thresholds of 112,324 yuan (1.39 times per capita GDP) and 111,824 yuan (1.38 times per capita GDP), respectively. The survey included 85 patients, with a mean WTP of 148,443 yuan (1.83 times per capita GDP, 95% CI 120,994-175,893) and median value was 106,667 yuan (1.32 times the GDP per capita). Due to the substantial degree of dispersion, the median was more representative. The payer threshold was found to have a high probability (98.5%) of falling within the range of 1-2 times per capita GDP, while the robustness of patient WTP was relatively weak.
CONCLUSIONS: In China, a country with a copayment system, payer threshold was higher than patient WTP, indicating that medical insurance holds significant decision-making authority, thus temporarily negating the need to consider patient WTP.

Heme oxygenase (HO), a heat shock protein containing hemoglobin, is an important enzyme in heme catabolism. It is involved in cell homeostasis and has anti-inflammatory, antioxidant, anti-apoptosis, immunomodulation, and other functions. It is expressed at a modest level in most normal tissues. When the body suffers from ischemia hypoxia, injury, toxins, and other nociceptive stimuli, the expression increases, which can transform the oxidative microenvironment into an antioxidant environment to promote tissue recovery from damage. In recent years, research has continued to verify its value in a variety of human bodily systems. It is also regarded as a key target for the treatment of numerous disorders. With the advancement of studies, its significance in renal disease has gained increasing attention. It is thought to have a significant protective function in preventing acute kidney injury and delaying the progression of chronic renal diseases. Its protective mechanisms include anti-inflammatory, antioxidant, cell cycle regulation, apoptosis inhibition, hemodynamic regulation, and other aspects, which have been demonstrated in diverse animal models. Furthermore, as a protective factor, its potential therapeutic efficacy in renal disease has recently become a hot area of research. Although a large number of preclinical trials have confirmed its therapeutic potential in reducing kidney injury, due to the problems and side effects of HO-1 induction therapy, its efficacy and safety in clinical application need to be further explored. In this review, we summarize the current state of research on the mechanism, location, and treatment of HO and its relationship with various renal diseases.

Understanding the value of ecosystem services is imperative for the welfare of current and future generations. Anxi town is situated within the mountainous terrain of Fujian province, China and characterized by a diverse range of ecosystems encompassing forests, rivers, and mountains. These ecosystems offer a wide range of ecosystem services. The value of ecosystem services has been declining in the county for the past twenty-years. However, limited is known on the spatial changes and factors affecting the value of these Therefore, current study assessed the spatial changes in the value of ecosystem services (provisioning, regulating, supporting, and cultural) in 24 townships situated in the county for three time periods, i.e., 1999, 2009, and 2019 and factors affecting these services. The results revealed that annual decline in the value of ecosystem services was higher in 1999-2009 than 2009-2019. Longjuan, Xianghua, Gande, Futian, Changkeng, Xiping, Taozhou and Huqiu townships observed the highest annual decline in the value of ecosystem services ranging from 20.1 to 68.1 million yuan. The GWR model indicated that vegetation index had the highest impact on the value of ecosystem services in the county. Overall, the value of ecosystem services was negatively correlated with the urbanization rate and distance from the road with some exceptions, whereas altitude had a positive impact. All townships (except Xianghua, Futian, and Taozhou) had negative values for water supply services. Hence, water supply is a significant ecological issue in the county. It is concluded that tea farmers in the county should be educated about water and soil conservation, investment should be done in conservation measures, regional ecological environments should be protected, and ecological tea planting techniques should be developed in the county to halt further decrease in the value of ecosystem services.

This retrospective study aimed to evaluate the consistency of transrectal contrast-enhanced ultrasonography (TR-CEUS) with post-operative pathology and the value of contrast-enhanced ultrasonography (CEUS) in staging surgically treated cervical cancer when combined with conventional ultrasonography (US).
From October 2020 to March 2023, hospitalized patients with stage IB and II cervical cancer confirmed by total hysterectomy were consecutively enrolled. The standard images of US and CEUS by transabdominal (TA-US/CEUS) and transrectal (TR-US/CEUS) approaches and magnetic resonance imaging (MRI) were acquired, on which the size and stage of the tumors were evaluated, and the consistency of results with the pathological specimen was analyzed.
Thirty-nine patients with cervical cancer were finally enrolled in this study. The results showed that CEUS significantly improved the reliability of TA-US in evaluating tumor diameter; the intraclass correlation coefficient (ICC) was from 0.672 to 0.735. TR-US indicated good reliability with or without the addition of CEUS (ICC = 0.796 and 0.780). In terms of tumor staging, CEUS improved the consistency of transabdominal (weighted κ values from 0.689 to 0.731) and transrectal staging of tumors (κ from 0.758 to 0.785), and the staging of TR-US combined with TR-CEUS had the highest consistency with post-operative results, similar to MRI (κ, respectively 0.785 and 0.789). CEUS can reflect the heterogeneity of the tumor. Heterogeneous enhancement and perfusion defects were more common in >2 cm cervical cancer (50%, 20/40 and 52.5%, 21/40), respectively, and perfusion defects were more common in moderately to poorly differentiated tumors (66.67%, 20/30).
For stage IB and IIA cervical cancer, CEUS can aid in assessing the International Federation for Gynecology and Obstetrics staging of tumors alongside TA-US and TR-US. The combination of TR-US and TR-CEUS has shown good consistency with pathology in the staging of cervical cancer, comparable to that of MRI.