METHODS: Our data were obtained from the Foshan Workplace Employee Survey (FWES). Mental health was proxied by the subjective assessment of workers' need to receive psychological counselling or treatment. To address endogeneity concerns, this study employed an extended ordered probit model and the two-stage least squares (2SLS) method.
RESULTS: Frontline workers employed in innovative manufacturing firms are significantly more likely than those in firms taking no such action to experience psychological difficulties and to seek psychological counselling or treatment. Firms with a higher likelihood of upgrading their production process are more capable of taking a range of measures to significantly but not sufficiently mitigate the psychological problems of their workers induced by process innovation. In workplaces with a new advanced automation environment, workers believe that they face higher job insecurity (JI) and work stress, which in turn is partially and effectively linked to the deterioration in their mental health and further increases treatment-seeking behaviours.
CONCLUSION: This study suggests that carrying out process innovation is associated with increased psychological distress and, hence, more needs for mental healthcare services. To narrow the treatment gap originally subject to existing obstacles, it is necessary to face the new challenges posed by automation-induced change in the workplace, which policies should be particularly attentive to.
PATIENTS AND METHODS: A total of 7476 patients with routine health check-up data who underwent prostate biopsies from January 2008 to December 2021 in eight referral centres in Asia were screened. After data pre-processing and cleaning, 5037 patients and 117 features were analyzed. Seven AI-based algorithms were tested for feature selection and seven AI-based algorithms were tested for classification, with the best combination applied for model construction. The APAC score was established in the CH cohort and validated in a multi-centre cohort and in each validation cohort to evaluate its generalizability in different Asian regions. The performance of the models was evaluated using area under the receiver operating characteristic curve (ROC), calibration plot, and decision curve analyses.
RESULTS: Eighteen features were involved in the APCA score predicting HGPCa, with some of these markers not previously used in prostate cancer diagnosis. The area under the curve (AUC) was 0.76 (95% CI:0.74-0.78) in the multi-centre validation cohort and the increment of AUC (APCA vs. PSA) was 0.16 (95% CI:0.13-0.20). The calibration plots yielded a high degree of coherence and the decision curve analysis yielded a higher net clinical benefit. Applying the APCA score could reduce unnecessary biopsies by 20.2% and 38.4%, at the risk of missing 5.0% and 10.0% of HGPCa cases in the multi-centre validation cohort, respectively.
CONCLUSIONS: The APCA score based on routine health check-ups could reduce unnecessary prostate biopsies without additional examinations in Asian populations. Further prospective population-based studies are warranted to confirm these results.