Understanding community-dwelling older adults' preferences for home- and community-based services: A conjoint analysis.

BACKGROUND: Older adults' preference for home- and community-based service programs has been highlighted as an essential but usually ignored ingredient in current care models. Disentangling how preferences contribute to older adults' decision-making could facilitate finding optimal ways to deliver home- and community-based services in times of increasing scarcity. OBJECTIVE: To identify Chinese community-dwelling older adults' preference structure for home- and community-based services and thus to optimize service provision. METHODS: Conjoint analysis, a preference-based technique, was employed to study older adults' preferences. A stepwise qualitative approach was first adopted to identify the attributes and attribute levels of home- and community-based services. Scenarios were defined through an orthogonal fractional factorial design, and a cross-sectional survey was conducted through a face-to-face, anonymous questionnaire. Conjoint analysis was performed to determine preference weights representing the relative importance of the identified attributes, and cluster analysis was performed to identify clusters of participants with similar preference structures. All data analyses were performed using SAS v9.4 and SPSS 22.0. RESULTS: A total of 321 of 350 invited participants completed the questionnaire. Four attributes were identified and used to create the conjoint scenarios: care-giving attitude, price, technical care-giving skills, and the type of service provider. Care-giving attitude was the most valued attribute for older adults when making decisions (relative importance score = 48.28), followed by price (relative importance score = 21.618), technical care-giving skills (relative importance score = 19.518), and finally, the type of service provider (relative importance score = 10.585). Three preference phenotypes were identified by applying cluster analysis: "price-oriented", "comprehensively balanced", and "attitude-oriented". CONCLUSION: The present study underscored the importance of considering attributes valued by Chinese older adults in the design and delivery of home- and community-based services. The preference structure, including the utility score of the attribute levels, differs among older adults. The findings could inform future research and practice and suggest incorporating flexibility during the service delivery stage.

AdaSAM: Boosting sharpness-aware minimization with adaptive learning rate and momentum for training deep neural networks.

Sharpness aware minimization (SAM) optimizer has been extensively explored as it can generalize better for training deep neural networks via introducing extra perturbation steps to flatten the landscape of deep learning models. Integrating SAM with adaptive learning rate and momentum acceleration, dubbed AdaSAM, has already been explored empirically to train large-scale deep neural networks without theoretical guarantee due to the triple difficulties in analyzing the coupled perturbation step, adaptive learning rate and momentum step. In this paper, we try to analyze the convergence rate of AdaSAM in the stochastic non-convex setting. We theoretically show that AdaSAM admits a O(1/bT) convergence rate, which achieves linear speedup property with respect to mini-batch size b. Specifically, to decouple the stochastic gradient steps with the adaptive learning rate and perturbed gradient, we introduce the delayed second-order momentum term to decompose them to make them independent while taking an expectation during the analysis. Then we bound them by showing the adaptive learning rate has a limited range, which makes our analysis feasible. To the best of our knowledge, we are the first to provide the non-trivial convergence rate of SAM with an adaptive learning rate and momentum acceleration. At last, we conduct several experiments on several NLP tasks and the synthetic task, which show that AdaSAM could achieve superior performance compared with SGD, AMSGrad, and SAM optimizers.

Enhancing economic competitiveness analysis through machine learning: Exploring complex urban features.

Urban economic competitiveness is a fundamental indicator for assessing the level of urban development and serves as an effective approach for understanding regional disparities. Traditional economic competitiveness research that relies solely on traditional regression models and assumes feature relationship theory tends to fall short in fully exploring the intricate interrelationships and nonlinear associations among features. As a result, the study of urban economic disparities remains limited to a narrow range of urban features, which is insufficient for comprehending cities as complex systems. The ability of deep learning neural networks to automatically construct models of nonlinear relationships among complex features provides a new approach to research in this issue. In this study, a complex urban feature dataset comprising 1008 features was constructed based on statistical data from 283 prefecture-level cities in China. Employing a machine learning approach based on convolutional neural network (CNN), a novel analytical model is constructed to capture the interrelationships among urban features, which is applied to achieve accurate classification of urban economic competitiveness. In addition, considering the limited number of samples in the dataset owing to the fixed number of cities, this study developed a data augmentation approach based on deep convolutional generative adversarial network (DCGAN) to further enhance the accuracy and generalization ability of the model. The performance of the CNN classification model was effectively improved by adding the generated samples to the original sample dataset. This study provides a precise and stable analytical model for investigating disparities in regional development. In the meantime, it offers a feasible solution to the limited sample size issue in the application of deep learning in urban research.

A Study of the Chemical Composition and Biological Activity of Michelia macclurei Dandy Heartwood: New Sources of Natural Antioxidants, Enzyme Inhibitors and Bacterial Inhibitors.

The wood of Michelia macclurei Dandy (MD) is an excellent material that is widely used in the furniture, handicraft, and construction industries. However, less research has been conducted on the chemical composition and biological activity of heartwood, which is the main valuable part of the wood. This study aimed to investigate the chemical composition and biological activities of the heartwood of Michelia macclurei Dandy (MDHW) and to confirm the active ingredients. Triple quadrupole gas chromatography-mass spectrometry (GC-MS) was used to characterize the volatile components of MDHW, while ultra-performance liquid chromatography-mass spectrometry was used to analyze the non-volatile components (UPLC-MS). The total reducing power, 2,2-diphenyl-1-picrylhydrazyl (DPPH) radical, and 2,2'-azino-bis(3-ethylbenzothiazoline-6-sulphonic acid) (ABTS) radical scavenging assays, acetylcholinesterase and α-glucosidase inhibition assays, and an antimicrobial test of 4 gram bacteria were used to describe the in vitro bioactivities. The GC-MS analysis showed that the volatile components of MDHW were mainly fatty compounds and terpenoids, with sesquiterpenes and their derivatives dominating the terpene composition. ß-elemene was the main terpene component in the steam distillation (11.88%) and ultrasonic extraction (8.2%) methods. A total of 67 compounds, comprising 45 alkaloids, 9 flavonoids, 6 lignans, and others, were found by UPLC-MS analysis. The primary structural kinds of the non-volatile components were 35 isoquinoline alkaloids. Alkaloids were the predominant active constituent in all MDHW extracts, including crude extracts, alkaloid fractions, and non-alkaloid fractions. These extracts all demonstrate some biological effects in terms of antioxidant, enzyme inhibition, and bacterial inhibition. The findings of this study show that MDHW is abundant in chemical structure types, has great bioactivity assessment, and has the potential to be used to create natural antioxidants, products that postpone Alzheimer's disease and lower blood sugar levels and antibacterial agents.

Carboxylated mesoporous carbon hollow spheres for the efficient solid-phase microextraction of aromatic amines.

An efficient and stable fiber coating is of great importance for solid-phase microextraction (SPME). In this study, carboxylated mesoporous carbon hollow spheres (MCHS-COOH) were developed as an efficient SPME coating of polar aromatic amines (AAs) for the first time. The MCHS-COOH coating material with high specific surface area (1182.32 m2 g-1), large pore size (10.14 nm), and rich oxygen-containing groups was fabricated via a facile H2O2 post-treatment. The as-prepared MCHS-COOH-coated fiber exhibited fast adsorption rate and excellent extraction properties, mainly due to its π-π interactions, hollow structure, and abundant affinity sites (carboxyl groups). Subsequently, coupled with gas chromatography-tandem mass spectrometry (GC-MS/MS), a sensitive method with low limits of detection (0.08-2.0 ng L-1), a wide linear range (0.3-500.0 ng L-1), and good repeatability (2.0-8.8%, n = 6) was developed for the analysis of AAs. The developed method was validated against three river water samples, with satisfactory relative recoveries being obtained. The above results demonstrated that the prepared MCHS-COOH-coated fiber exhibited good adsorption capacity, suggesting a promising application to monitor trace polar compounds in real environment.

Research on online public opinion dissemination and emergency countermeasures of food safety in universities-take the rat head and duck neck incident in China as an example.

In recent years, food safety accidents have occurred frequently in colleges and universities, and students are prone to emotional resonance with food safety. It triggered heated discussions among the whole society and gradually formed a unique online public opinion on food safety in universities. After food safety incidents broke out in universities, some universities deliberately avoided responsibility or made mistakes in handling the incidents, which will create greater risks of online public opinion. Therefore, this paper takes the "Rat Head and Duck Neck" incident at Jiangxi Institute of Technology in China as an example. The purpose is to study the dissemination of public opinion on food safety online in universities and propose emergency countermeasures. Above all, the food safety online public opinion is divided into five stages: incubation period, burst period, spreading period, recurring period and dissipation period. Then, methods such as text mining and cluster analysis were used to deeply analyze the influencing factors at each stage of the development of food safety online public opinion. And analyze the role of different subjects in the development of public opinion based on the perspective of stakeholders. Finally, this paper provides corresponding countermeasures for different stages of online public opinion on food safety in universities, which provides suggestions and references for university governance. This study found that: (1) The resonance effect of online public opinion media on food safety in universities is significant. (2) Public opinion on food safety in universities is repetitive. (3) Improper response to food safety incidents in universities can easily trigger negative secondary public opinion.

Diagnostic and prognostic value of serum Chitinase 3-like protein 1 in hepatocellular carcinoma.

The serum Chitinase 3-like protein 1 (CHI3L1) protein level can distinguish the stages of liver fibrosis to a great extent. However, the diagnostic and prognostic significance of serum CHI3L1 in hepatocellular carcinoma (HCC) is not clarified. To evaluate the diagnostic and prognostic value of CHI3L1 in HCC, a total of 128 HCC patients treated in the HwaMei Hospital, University of Chinese Academy of Sciences, from December 2018 to April 2020 were collected retrospectively. Matched age and gender subjects, 40 patients with liver cirrhosis, 40 patients with chronic hepatitis, and 40 healthy subjects were enrolled in the control group. The relevant clinical laboratory and examination data and the overall survival time (OS) of the HCC patients were collected. The serum CHI3L1 expression level is related to α-fetoprotein (AFP), tumor-node-metastasis (TNM) stage, maximum tumor diameter, liver cirrhosis, and HCC patient's OS (p < 0.05). The area under the curve (AUC) of CHI3L1 was 0.7875 with the cutoff value of 91.36 ng/ml. Combining the serum CHI3L1 and α-fetoprotein (AFP) by a binary logistic regression model can increase the diagnostic sensitivity to 97.5%. Multivariate Cox regression analysis indicated that CHI3L1 is an independent prognostic factor in patients with HCC.

Global analysis of the COVID-19 research landscape and scientific impact.

OBJECTIVES: To consider a 1-year time window of the coronavirus disease 2019 (COVID-19) crisis to integrate qualitative and quantitative data and provide an in-depth analysis of all COVID-19 publications from geographical, epidemiological and chronological perspectives. METHODS: Publications on COVID-19 from December 1, 2019, to December 31, 2020 without document type limitations were extracted from the Web of Science database. Microsoft Excel 2016, GraphPad Prism 9, VOSviewer 1.6.15 and IBM SPSS 21.0 were used to analyze the global epidemiological publication landscape and its correlations, research hotspots around the world and the top 5 countries in terms of publications. RESULTS: A total of 51,317 documents were analyzed in the present study. The publication trend could be divided into an increasing output stage and an explosive output stage. There were positive correlations between monthly publications, confirmed cases and deaths. Research hotspots from the whole year, from individual quarters, and from the top 5 countries with the most publications were further identified. CONCLUSIONS: The correlation analysis of publications indicated that confirmed cases and deaths were forces driving the scientific output, reflecting the growing trend to some extent. Moreover, the hotspot analysis provided valuable information for scientists, funders, policy and decision-makers to determine what areas should be their focus when faced with public health emergencies in the future.

Bibliometric analysis of mental health during the COVID-19 pandemic.

BACKGROUND: As a global pandemic, coronavirus disease 2019 (COVID-19) has had a profound effect on public mental health. METHODS: Publications related to mental health during the COVID-19 pandemic from December 1, 2019, to November 13, 2020, were extracted from the Web of Science database. Bibliometric indicator analysis was performed using VOSviewer 1.6.15. RESULTS: In total, 1233 documents from 2020 were retrieved, of which 680 were original articles. The United States contributed the largest publication output (285, 23.1%). Huazhong University of Science and Technology published the most articles in this field (35), while Wuhan University received the most citations (1149). The United Kingdom had the strongest collaboration network. Four keyword clusters representing hotspots in this field were identified. CONCLUSIONS: In addition to developed countries, countries seriously affected by the COVID-19 pandemic also made significant contributions to mental health research during the COVID-19 pandemic. This study focused on various aspects, such as mental health during isolation, mental health in healthcare workers, and public mental health issues during the COVID-19 pandemic. In the future, countries should strengthen global cooperation and pay more attention to the mental health of vulnerable groups during pandemics.

Linguistic and Psychometric Validation of the Chinese Version of the Control Attitudes Scale-Revised in Patients With Chronic Heart Failure.

BACKGROUND: The concept of perceived control reflects the belief that one has resources needed to cope with negative events and the ability to positively influence consequences of those negative events. In patients with heart failure, perceived control is associated with a variety of health outcomes. Perceived control is commonly measured using the Control Attitudes Scale-Revised (CASR). There is no Chinese version of the CAS-R (CCAS-R). OBJECTIVE: The purpose of this article was to perform linguistic validation and psychometric evaluation of the CCAS-R. METHODS: The CAS-R was translated into Chinese according to Brislin's model. Then, a multicenter observational study was performed. Floor and ceiling effects, internal consistency, structural validity, and hypothesis testing were all assessed for psychometric validation of the CCAS-R. RESULTS: A total of 227 patients with chronic heart failure were included. There were no ceiling or floor effects detected. Cronbach α was 0.94, indicating a high reliability. The results of the confirmatory factor analysis showed that the 1-factor structure as proposed by the original CAS-R fits the data well. The results of the principal component analysis suggested that the 1-factor structure was optimal as well, accounting for 71.6% of the total variance. The a priori hypothesis was supported by a statistically significant correlation between the CCAS-R and 3 theoretically related variables. CONCLUSION: We developed a semantically equivalent version of the CAS-R in Chinese. The evaluation of the instruments' psychometric properties demonstrated that the CCAS-R has good reliability and validity for use in Chinese patients with chronic heart failure.

Global publications on stigma between 1998-2018: A bibliometric analysis.

OBJECTIVES: To describe the development process and structural relationships of scientific achievements on stigma over the past two decades and to provide insights for researchers and policy makers to drive policy decisions and identify future research needs. METHODS: Quantitative analysis of publications was directly interpreted and graphed through Web of Science and ORIGIN 2017. The co-occurrence and collaboration analysis between authors, countries and keywords were conducted through VOSviewer. Keyword burst was detected through CiteSpace. RESULTS: The retrieved 2,799 publications showed a trend of increasing annual publications between 1998 and 2018. The United States made the greatest contribution to global publications regarding stigma. Four keyword clusters indicating research hotspot were identified through the default clustering method in VOSviewer. Meta-analysis and internalized stigma were detected as keyword bursts in recent years. CONCLUSIONS: The growth trend of publications indicated increased research interest in stigma, especially common stigma types, including HIV stigma and obesity stigma. Future research should focus on other types of stigma and should include more elaborate intervention programs, mechanism exploration, and research on internalized stigma. Scientific research on stigma requires an extensive collaborative endeavor, both domestically and internationally, among diverse researchers, institutions, and countries.

Factors associated with stigma in community-dwelling stroke survivors in China: A cross-sectional study.

BACKGROUND: Although stigma is considered to be present in stroke patients, the factors that influence its level are ambiguous. The aim of this study was to investigate whether certain demographic, clinical, and psychosocial characteristics are related to higher levels of stigma among stroke patients in China. METHODS: A total of 200 stroke patients in the community were investigated using the Stigma Scale for Chronic Illness (SSCI), Barthel Index, Self-Rating Depression Scale, Medical Moping Questionnaire, and Social Support Rating Scale. Potential determinants were evaluated with univariate statistical analyses for their contributions to total, felt and enacted stigma. Important findings were further evaluated with multiple regression models. RESULTS: The mean total stigma, felt stigma, and enacted stigma scores were 45.21 ±â€¯16.68, 27.93 ±â€¯10.95, and 17.27 ±â€¯6.93, respectively. Most participants reported experiencing felt stigma (90%), while 72.5% reported experiencing enacted stigma. Multiple regression analysis showed that stroke patients' depression, functional status, an avoiding coping strategy, subjective support and recurrence of stroke were factors impacting the SSCI score. CONCLUSION: The stigma level among stroke patients in China was of a mild-moderate degree. Among stroke patients, a higher level of stigma was influenced by a higher degree of depression, a higher degree of an avoiding coping strategy, lower functional ability, lower subjective support and recurrence of stroke. Further work should focus on developing intervention strategies to decrease the amount of stigma and promote quality of life as well as psychosocial rehabilitation among stroke patients.

Adaption and validation of Nijmegen continuity questionnaire to recognize the influencing factors of continuity of care for hypertensive patients in China.

BACKGROUND: Continuity of care (COC) has become a primary point of concern for care providers in both developed and developing countries, which is regarded as the "cornerstone of care" and an "essential element" of good health care. A robust and proper instrument is of necessity to identify problems and evaluate intervention aimed at improving continuity of care. This study aimed to adapt Nijmegen continuity questionnaire (NCQ) into a Chinese version (NCQ-C) and to delineate the status of COC as well as explore its influencing factors for hypertensive patients in China. METHODS: A forward-back-translation procedure was adopted for the determination of the adaption of NCQ. Then a total of 448 patients completed questionnaires and 24-h ambulatory blood pressure monitoring (ABPM). Proper indexes were calculated to test the reliability and validity of NCQ-C. Logistic analysis were used to detect the influencing factors of COC. RESULTS: The NCQ-C had excellent intraclass correlation coefficient of 0.855 and internal consistency of seven dimensions varied from 0.907 to 0.944. The item-content validity index ranged from 0.71 to 1.00. For construct validity, seven-factor structure was confirmed as original questionnaire and all the fit indices indicated acceptable levels. Gender, education level, medical insurance and frequency of family visits, blood pressure level, depression status as well as general health perception were demonstrated to be statistically related to COC. CONCLUSIONS: In addition, all the parameters of ABPM were negatively significant with COC. The NCQ-C has shown acceptable level of reliability and validity. The related factors of COC should arouse care providers' attention.

Highly stable ITO/Zn2TiO4/Pt resistive random access memory and its application in two-bit-per-cell.

We discuss the fabrication procedure and device characteristics of ITO/Zn2TiO4/Pt resistive random-access memory (RRAM) at room temperature. Four different resistive states were obtained by applying different current compliances, all of which showed good retention characteristics with no obvious degradation and were individually distinguished after 10 000 s at a read voltage of 100 mV. The multilevel memory effect can be attributed to the combination of the radial growth of filaments and the formation of conductive filaments when applying different compliance current values during the set process. The set and reset voltages of the ITO/Zn2TiO4/Pt RRAM device were maintained within ±1 V. The device performed well at low operation voltages. The mechanisms of multilevel resistive switching characteristics were investigated to illustrate the multilevel carrier conduction phenomenon associated with Zn2TiO4-based RRAM devices. In this study, our group illustrated the application of zinc titanate (Zn2TiO4) in non-volatile memories for the first time.

Resistant mutants induced by adefovir dipivoxil in hepatitis B virus isolates.

AIM: To investigate the loci of adefovir dipivoxil (ADV)-induced resistance in hepatitis B virus (HBV) isolates and optimize the management of ADV-treated patients. METHODS: Between June 2008 and August 2010, a cross-sectional control study was conducted comprising 79 patients with chronic HBV infection-related liver disease who had been administered ADV monotherapy. Patients underwent liver imaging. Serum DNA extracts were analyzed for HBV DNA levels, genotypes, and serology markers, and deep sequencing of the HBV P gene was performed. RESULTS: ADV-resistant patients were found either with a single mutated locus, or with coexisting mutated loci. The most prevalent mutations were rtA181T, rtV214A, and rtN236T. Twenty-six patients had more than two mutated loci. The mutants were distributed among the patients without any significant affinity for gender, age, end-stage of liver disease, complications of non-alcoholic fatty liver disease, or HBV DNA levels. Patients with the rtA181T mutant were primarily infected with genotype C and e-antigen negative HBV, while patients with the rtN236T mutant were primarily infected by genotype B HBV (χ(2) = 6.004, 7.159; P = 0.023, 0.007). The duration of treatment with ADV was shorter in the single mutant group compared with the multi-mutant group (t = 2.426, P = 0.018). CONCLUSION: Drug-resistant HBV mutants are complex and diverse. Patients should receive the standard and first-line antiviral treatment, strictly comply with medication dosage, and avoid short-term withdrawal.

[Autologous transplantation of bone marrow stem cells versus peripheral blood stem cells for treatment of decompensate liver cirrhosis: a comparative study of 30 cases].

Not Abstract.

[Response of lettuce to different nitrogen forms].

Solution culture experiment was adopted to investigate the influence of different nitrogen forms on lettuce growth and development and their nitrogenous nutritional characteristics. The results showed that the affinity of the roots of lettuce seedlings to ammonium nitrogen (NH4(+)-N) was slightly higher than that to nitrate nitrogen (NO3(-)-N). Among three treatments of NO3(-)-N, NH4(+)-N+ NO3(-)-N and NH4(+)-N, the relative proportion of biological yields of lettuce was 100:56.9:12.4, and that of nitrogen uptake amount was 100:48.9:8.6, respectively. Nitrate nitrogen was the most suitable N source to lettuce growth. When the respective proportion of NH4(+)-N and NO3(-)-N was 50%, the growth of lettuce was inhibited to some extent. When the nitrogen source supplied as solely NH4(+)-N, lettuce was hard to grow normally. When supplying the same amount of NH4(+)-N and NO3(-)-N, lettuce showed a tendency to absorb more NH4(+)-N than NO3-N. At different culture stages, the ratio of NH4(+)-N to NO3(-)-N absorbtion was less than 1. It seemed that lettuce did prefer NH4(+)-N to NO3-N in absorbtion. However, ammonium nitrogen as nitrogen source was not suitable to lettuce for its metabolism. When nitrate nitrogen was not sufficient, it mainly affected the growth of lettuce shoot; when the ammonium nitrogen in nutrient solution was 50%, the root growth of lettuce seedlings was greatly inhibited, and some pathological symptoms appeared. Taking running water as water source (in which, NO3(-)-N concentration was about 0.5 mol.L-1) and lettuce was cultured by supplying sole NO3(-)-N for two weeks and then supplying NH4(+)-N, the growth of lettuce was greatly stimulated, in the meantime, the NO3(-)-N contents and total accumulation amount greatly decreased. Supplying urea as N source, the growth rate of lettuce was apparently inferior to other nitrogen forms, but no pathological symptoms appeared.