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It is of interest to health policy research to estimate the population-averaged longitudinal medical cost trajectory from initial cancer diagnosis to death, and understand how the trajectory curve is affected by patient characteristics. This research question leads to a number of statistical challenges because the longitudinal cost data are often non-normally distributed with skewness, zero-inflation, and heteroscedasticity. The trajectory is nonlinear, and its length and shape depend on survival, which are subject to censoring. Modeling the association between multiple patient characteristics and nonlinear cost trajectory curves of varying lengths should take into consideration parsimony, flexibility, and interpretation. We propose a novel longitudinal varying coefficient single-index model. Multiple patient characteristics are summarized in a single-index, representing a patients overall propensity for healthcare use. The effects of this index on various segments of the cost trajectory depend on both time and survival, which is flexibly modeled by a bivariate varying coefficient function. The model is estimated by generalized estimating equations with an extended marginal mean structure to accommodate censored survival time as a covariate. We established the pointwise confidence interval of the varying coefficient and a test for the covariate effect. The numerical performance was extensively studied in simulations. We applied the proposed methodology to medical cost data of prostate cancer patients from the Surveillance, Epidemiology, and End Results-Medicare-Linked Database.

This paper studies the use of innovative digital technologies to assess art and music creative works in China. The authors of the paper conducted an experimental study of the influence of various types of assessment, such as formative and summative, on the academic motivation and mental health of artists and musicians. The study involved second-year students from Xihua University (N = 548). The researchers used the Academic Motivation Scale (AMS) and the Depression, Anxiety and Stress Scale (DASS) as psychometric tools of the standardized methods. Summarizing the results obtained, they can conclude that summative assessment stimulates external motivation, while formative assessment contributes to the development of internal motivation of students. These results allow teachers to offer different types of assessment to strengthen a certain type of students' motivation. The researchers also found that summative assessment could result in a higher level of amotivation. However, they did not confirm the assumption about the negative impact of summative assessment on the mental state of students. [ABSTRACT FROM AUTHOR]

Tendon injury is a common motor system disease, impairing joint mobility, and lowering quality of life. Once damaged, tendon has a limited capacity for regeneration. Clinically, available therapeutic strategies have not achieved satisfactory outcomes. Chiral biomaterials can effectively regulate cell behaviors and tissue healing, but have not been applied to injured tendon yet. Here, chiral arginine is attached to electrospun membrane to fabricate chiral scaffolds. L‐chiral scaffold, rather than D‐chiral or R‐chiral scaffold, promotes cell adhesion, proliferation, and tenogenic differentiation. The vinculin/FAK/YAP pathway is discovered to have a significant impact on the processes mentioned above. Additionally, L‐arginine efficiently eliminates reactive oxygen species (ROS) and generates nitric oxide (NO), safeguarding tendon stem/progenitor cells (TSPCs) against oxidative stress. The use of L‐chiral scaffold in a rat model of Achilles tendon injury increases the expression of markers related to tendons and the deposition of collagen. Moreover, L‐chiral scaffold improves tendon structural, functional, and mechanical properties. This L‐chiral scaffold comprehensively enhances tendon healing, providing a promising therapeutic strategy for tendon injury. As a simple and effective method, modification by chiral molecules enriches biomaterial functions and offers a novel option for tissue regeneration. [ABSTRACT FROM AUTHOR]