Psychometric properties of novel instrument for evaluating ambient air pollution health literacy in adults.

We aimed to develop and validate a comprehensive ambient air pollution health literacy instrument. We developed items covering 12 constructs, four information competencies within three health domains. In this population-based telephone interview study, probability proportional to size sampling and random digit dialing were used to determine participants. We conducted confirmatory factor analysis to analyze model fits and used content validity indices and Cronbach's alpha to measure content validity and internal consistency reliability. Twenty-four items were generated, and a total of 1,297 participants were recruited. A theoretically conceived 12-factor model was supported (root mean square error of approximation [RMSEA] = 0.068, comparative fit index [CFI] = 0.039, standardized root mean square residual [SRMR] = 0.934, normed fit index [NFI] = 0.914, Tucker-Lewis index [TLI] = 0.902). Content validity indices for relevance, importance, and unambiguity were 0.97, 0.99, and 0.94, respectively. Internal consistency reliability assessed by Cronbach's alpha was 0.93. The ambient air pollution health literacy instrument is valid and reliable and can be used in community residents. The novel instrument can guide the stakeholders and the authority to tailor and implement effective and appropriate interventions and actions, empowering the public to manage hazardous exposure and improving AAPHL of the public.

Enhancing service quality of rural public transport during the COVID-19 pandemic: a novel fuzzy approach.

In order to encourage the use of public transportation, it is necessary to make it more appealing to commuters by conducting frequent Service Quality (SQ) evaluations and modifications. Understanding passengers' expectations of public transportation are important, and evaluating the SQ is an essential tool for assessing the overall performance of the public transportation system. The purpose of the present study was to examine the expectations and perceptions of core passengers regarding SQ in public bus transportation. By surveying 598 passengers in rural public transportation in India, the study results are illustrated and further discussed to guide possible bus SQ improvements in rural areas. In addition, the impact of these expectations and perceptions on satisfaction levels of rural public bus transportation services are explored by applying the Interval-Valued Pythagorean Fuzzy (IVPF). The outcomes of the survey indicated significant disparities among expectations and perceptions of passengers, as well as widespread dissatisfaction with the delivery of bus services in rural areas as a whole. The dependability and adaptiveness of the bus service have been critical in describing the overall quality of bus services in rural areas, and best practices from around the world were used to develop a set of recommendations for transportation operators and local officials.

Peony-like 3D-MoS2/graphene nanostructures with enhanced mimic peroxidase performance for colorimetric determination of dopamine.

Fast and quantitative detection of dopamine (DA) is highly desirable but still challenging in the clinical diagnosis due to the complexity of the biological samples. Herein, a novel peony-like 3D-MoS2/Graphene (peony-like 3D-MoS2/GR) nanomaterial is designed and characterized. The nanomaterial exhibits outstanding the peroxidase-like activity, which can be employed as a nanozyme for facile and fast colorimetric determination of dopamine. The peony-like 3D-MoS2/GR-based colorimetric assay presents a wide liner dependence on the DA concentration in the range of 1-400 µM and a low detection limit of 0.21 µM. Such excellent results originate from its unique structure, which offers abundant active sites, high specific surface area, interconnected network and the special microenvironment. Furthermore, this reported colorimetric assay is successfully employed for detection of DA in human serum and urine samples. The recovery percentage ranges from 98 to 105.6%. Hence, the peony-like 3D-MoS2/GR paves a new avenue for detection of DA in real biological systems.

Using refined kano model and decision trees to discover learners' needs for teaching videos.

With the advancement of technology and the spread of the COVID19 epidemic, learning can no longer only be done through face-to-face teaching. Numerous digital learning materials have appeared in large numbers, changing people's learning mode. In the era of information explosion, how to capture the learners' attention to teaching videos and improve learning effectiveness is the common goal of every designer of e-leaning teaching content. Previous researches focused on the analysis of learning effectiveness and satisfaction. Instructional designers only provided design elements with high learning effectiveness or high satisfaction, and lacked in-depth analysis of the learners' perspectives. The opinions of these e-learning users are often the key to the success of online teaching videos. Therefore, this study aims at the design elements that will be used in the teaching film. The operation mode of the piano mechanism will be employed as the content of the teaching film. Based on eight elements including arrow cueing, dynamic arrow cueing, spreading-color cueing, contrary to cueing, font style, color application, anthropomorphic, and audiovisual complementarity, we use Refined Kano Model to analyze learners' needs of categorization of each element, and discover learners' expectations for teaching videos. In addition, this study also conducts in-depth data analysis through decision trees algorithm, and stratification analyses using different variables (such as design expertise, using frequency, and usage experience, etc.) to find out the key design factors that affect learners' learning. Depending on the learner's background, the use of e-learning experience, using frequency, and the length of the learning video, our results could provide for reference when designing teaching videos. Instructional designers can better understand how to effectively use design elements, so that the teaching videos can achieve the best learning effect.

The key successful factors of video and mobile game crowdfunding projects using a lexicon-based feature selection approach.

The emergence of crowdfunding has given many capital demanders a new fund-raising channel, but the overall project success rate is very low. Many scholars have begun to discover key suscessful factors of crowdfunding projects. Previous studies have used questionnaires survey to identify important project features. In addition to requiring a lot of manpower and time, there may also be sampling bias. Moreover, related studies also reported that the project description will affect the success of the crowdfunding project, but there is no research to tell fundraisers which success factors should be included in the content of the project description. Besides, in recent years, game crowdfunding projects have been attracted lots of attention in terms of total fundraising amount and number of projects. Moreover, in traditional feature selection and text mining approaches, the selected terms are un-organized and hard to be explained. Therefore, this study will focus on real video and mobile game project descriptions to replace conventional questionnaires. To solve these issues, we present a lexicon-based feature selection method. We attempt to define "content features" and build lexicons to determine the attributes' values. Three feature selection methods including decision tree (DT), Least Absolute Shrinkage and Selection Operator (LASSO), and support vector machine-recursive feature elimination (SVM-RFE) will be employed to find organized candidate key successful factors. Then, support vector machines (SVM) will be used to evaluate the performances of candidate feature subsets. Finally, this study has identified the key successful factors for video and mobile games, respectively. Based on the experimental results, we can give fundraisers some useful suggestions to improve the success rate of crowdfunding projects.

A Secure IoT-Based Authentication System in Cloud Computing Environment.

The Internet of Things (IoT) is currently the most popular field in communication and information techniques. However, designing a secure and reliable authentication scheme for IoT-based architectures is still a challenge. In 2019, Zhou et al. showed that schemes pro-posed by Amin et al. and Maitra et al. are vulnerable to off-line guessing attacks, user tracking attacks, etc. On this basis, a lightweight authentication scheme based on IoT is proposed, and an authentication scheme based on IoT is proposed, which can resist various types of attacks and realize key security features such as user audit, mutual authentication, and session security. However, we found weaknesses in the scheme upon evaluation. Hence, we proposed an enhanced scheme based on their mechanism, thus achieving the security requirements and resisting well-known attacks.

Protective Effect of Seasonal Influenza Vaccination in Elderly Individuals with Disability in Taiwan: A Propensity Score-Matched, Nationwide, Population-Based Cohort Study.

This is the first and largest population-based cohort study to demonstrate that influenza vaccination reduced all-cause mortality and influenza-related hospitalization in elderly individuals with a disability. PURPOSE: To estimate the protective effect of influenza vaccination in elderly individuals with a disability by conducting a propensity score-matched (PSM), nationwide, population-based cohort study. METHODS: Data from Taiwan's National Health Insurance Research Database were used in this study. Generalized estimating equations (GEEs) were used to compare outcomes between the vaccinated and unvaccinated cohorts. The GEE logit was used to estimate the relative risks of death and hospitalization after influenza vaccination. Adjusted odds ratios (aORs) were used to estimate relative risk. RESULTS: The matching process yielded a final cohort of 272 896 elderly individuals with a disability (136 448 individuals in each cohort). In multivariate GEE analyses, aOR (vaccinated vs. unvaccinated) and 95% confidence interval (CI) of death were 0.70 (0.68-0.72). The aORs (95% CIs) of hospitalization for influenza and pneumonia, respiratory diseases, respiratory failure, heart disease, hemorrhagic stroke, and ischemic stroke were 0.98 (0.95-1.01), 0.96 (0.94-0.99), 0.85 (0.82-0.89), 0.96 (0.93-0.99), 0.85 (0.75-0.97), and 0.89 (0.84-0.95), respectively. The length of stay and medical expenditure exhibited greater reduction in vaccinated elderly individuals with a severe and very severe disability than in unvaccinated elderly individuals. CONCLUSIONS: Influenza vaccination reduced all-cause mortality, influenza-related hospitalization, length of stay, and medical expenditure in elderly individuals with a disability. The decrease in the length of stay and medical expenditure because of influenza vaccination was proportional to the severity of disability.

Does Pay-For-Performance Program Increase Providers Adherence to Guidelines for Managing Hepatitis B and Hepatitis C Virus Infection in Taiwan?

BACKGROUND: Many people are concerned about that the quality of preventive care for patients with hepatitis B virus (HBV) and hepatitis C virus (HCV) infection is suboptimal. Taiwan, a hyperendemic area of chronic HBV and HCV infection, implemented a nationwide pay-for-performance (P4P) program in 2010, which aimed to improve the preventive care provided to HBV and HCV patients by increasing physicians' adherence to guidelines through financial incentives. The objective of this study was to evaluate the early effects of the P4P program on utilization of preventive services by HBV and HCV patients. METHODS: Using a quasi-experimental design with propensity score matching method, we matched the HBV and HCV patients enrolled in the P4P program with non-enrollees in 2010, resulting in 21,643 patients in each group. Generalized estimating equations was applied to examine the difference-in-difference effects of P4P program enrollment on the utilization of three guideline-recommended preventive services (regular outpatient follow-up visits, abdominal ultrasonography (US) examinations, and aspartate aminotransferase and alanine aminotransferase (AST/ALT) tests by HBV and HCV patients. RESULTS: The P4P program enrollees were significantly more likely to attend twice-annual follow-up visits, to receive recommended US examinations and AST/ALT tests, than non-enrollees. CONCLUSIONS: The results of our preliminary assessment indicate that financial incentives offered by the P4P program was associated with a modest improvement in adherence to guidelines for better chronic HBV and HBC management.

FIR: An Effective Scheme for Extracting Useful Metadata from Social Media.

Recently, the use of social media for health information exchange is expanding among patients, physicians, and other health care professionals. In medical areas, social media allows non-experts to access, interpret, and generate medical information for their own care and the care of others. Researchers paid much attention on social media in medical educations, patient-pharmacist communications, adverse drug reactions detection, impacts of social media on medicine and healthcare, and so on. However, relatively few papers discuss how to extract useful knowledge from a huge amount of textual comments in social media effectively. Therefore, this study aims to propose a Fuzzy adaptive resonance theory network based Information Retrieval (FIR) scheme by combining Fuzzy adaptive resonance theory (ART) network, Latent Semantic Indexing (LSI), and association rules (AR) discovery to extract knowledge from social media. In our FIR scheme, Fuzzy ART network firstly has been employed to segment comments. Next, for each customer segment, we use LSI technique to retrieve important keywords. Then, in order to make the extracted keywords understandable, association rules mining is presented to organize these extracted keywords to build metadata. These extracted useful voices of customers will be transformed into design needs by using Quality Function Deployment (QFD) for further decision making. Unlike conventional information retrieval techniques which acquire too many keywords to get key points, our FIR scheme can extract understandable metadata from social media.

Factors affecting repeated influenza vaccination among older people in Taiwan.

OBJECTIVE: This study identifies factors that influence repeated influenza vaccination among people aged 65 years and older in Taiwan. METHODS: Data of this retrospective cohort study were drawn from the 2005 National Health Interview Survey and the 2005-2007 National Health Insurance claims data; a sample of 1384 older people was analyzed. The pattern of repeated influenza vaccination was divided into 3 groups: unvaccinated all 3 years, vaccinated 1-2 times over 3 years, and vaccinated all 3 years. Multinomial logistic regression analyses were performed. RESULTS: Only 20.6% of older people were vaccinated all 3 years. Those 70-74 years of age (odds ratio [OR]=1.81), living in rural areas (OR=2.47), having one (OR=2.07) or more (OR=2.41) chronic conditions, frequent outpatient visits (OR=1.48), and undergoing preventive health examinations (OR=2.22) were more likely to have repeated vaccinations. However, those with difficulties performing one or more activities of daily living (ADL difficulty) (OR=0.41) and seeking care from alternative medicine (OR=0.48) were less likely to undergo regular vaccinations. CONCLUSION: The repeated influenza vaccination rates in our Taiwan sample were far from optimal. Factors identified in this analysis may help to improving influenza vaccination programs.

Variation in the cervical cancer screening compliance among women with disability.

OBJECTIVE: To investigate the relationship between the level of disability and regular Pap smear testing among women in Taiwan and explore how this relationship may vary with the various levels of physician availability. METHODS: This population-based cohort study followed a total of 5,469,581 women from Taiwan, who were 30 years old or older in 2001 and covered the period January 2001 to December 2003. Of the total study population, 184,701 individuals were women with disability. Gynecologist-obstetrician/general practitioner to female population ratio was used as an indicator of physician availability. Multiple logistical regression models were used. RESULTS: After adjusting for age, socioeconomic status, racial group, residence area and physician availability, women with severe disability (OR = 0.38; 95% CI: 0.38, 0.39) were the least likely to undergo Pap smear testing. Women with moderate disability (OR = 0.59; 95% CI: 0.58, 0.60) and mild disability (OR = 0.88; 95% CI: 0.86, 0.89) were also significantly less likely to undergo a routine test than women without disability. Women residing in the areas with the greatest physician availability (OR = 0.93; 95% CI: 0.93, 0.94) were significantly less likely to undergo a Pap test than those in the areas with the lowest level of resource availability. The disparity in routine screening between women with and without disability remained across the different levels of physician availability. CONCLUSIONS: In Taiwan, women with disability were found to be at higher risk of lower compliance than women without disability. The gap between women with and without disability persisted across different levels of physician availability.

Screening for cervical cancer among female physicians and their relatives in Taiwan: a population-based comparative study.

BACKGROUND: This study compares the practice of having the recommended Pap smear test every 3 years among female physicians, female relatives of physicians, and general women of similar socio-economic background. METHODS: This population-based cohort study followed a total of 5,815,781 Taiwanese women from January 2001 to December 2003, who were 30 years of age or older in 2001. Of the total study population, 1950 were physicians and 27,441 were female relatives of physicians. Multiple logistical regression models were used. RESULTS: After adjusting for age, ethnic status, physical disability status, and place of residence, of those women whose monthly insurable income was greater than $NT 40,000, female physicians (OR 0.54, 95% CI: 0.50-060) were the least likely to have undergone at least one Pap smear test during the three-year study period. The physicians' relatives (OR 0.90, 95% CI: 0.87-0.92) were also significantly less likely to take routine Pap smear tests compared to general women with equivalent socio-economic background. CONCLUSIONS: The female physician is a major player in disease prevention with advanced knowledge of the benefits associated with the Pap smear test, but may not adhere any better to the recommendations than the general population.

[Effects of carbaryl production exposure on the sperm and semen quality of occupational male workers].

OBJECTIVE: To analyse the male reproductive toxicity of carbaryl. METHODS: Thirty-one male carbaryl exposure workers and 46 male administrators in the office in a pesticide factory were selected as the exposure group and internal control group respectively, and 22 male administrators in a center for disease control and prevention were served as the external control group. In order to evaluate the exposure levels, the concentrations of carbaryl, methyl isocyanate, ammonia and phenol in the ambient air of the work place in these three groups were monitored simultaneously for three consecutive days. Moreover, three workers in the exposure group and the external control group were selected to evaluate the amount of carbaryl of individual and dermal contamination for three consecutive days. After the semen were collected according to the standard method, the workers'semen qualities were analysed with WHO method, the sperm morphology and the sperm motility were evaluated using micro-cell slide spectrum technology and computer assisted sperm analysis (CASA) respectively. RESULTS: In the exposure group, the concentrations of carbaryl and phenol (52.41 mg/m(3) and 0.08 mg/m(3) respectively) were significantly higher than those in the internal and external control group (P < 0.01 or P < 0.05). Furthermore, in the carbaryl exposure area the geometric mean concentration of carbaryl with the individual sampling was 7.38 mg/m(3), and the geometric mean of dermal contamination detected in the carbaryl exposure area was 862.47 mg/m(2). Carbaryl was not found in the external control area (P < 0.01). The seminal volume [(2.39 +/- 1.44) ml] and the sperm motility [(1.77 +/- 0.61) grade] were significantly lower than those in the external control group (P < 0.05), and sperm motion parameters such as linearity (LIN, 39.89% +/- 6.00%), straightness (STR, 71.51% +/- 11.22%), straight line velocity [VSL, (26.29 +/- 7.84) microm/s] and beat cross frequency [BCF, (3.99 +/- 1.55) Hz] were lower than those in the internal and external control group (P < 0.05), while the abnormal rates of viscidity, sperm motility and total aberration rate were higher than those in the external control group (P < 0.05). CONCLUSION: Occupational exposure to carbaryl production can affect the workers'sperm and semen quality to certain extent.

[Study on technology of extracting geniposidic acid from Eucommia ulmiodes and its application].

OBJECTIVE: To study the optimum technology of extracting bioactive component named geniposidic acid in Eucommia Ulmiodes by orthogonal test. METHOD: An orthogonal test table L16(4(5)) was used with the factors of extracting time, temperature, times, ethanol consistency and the ratio of solid to liquid. The content of geniposideic acid was determined by RP-HPLC. RESULT: The optimum technology was: temperature 50 degrees C, time 1 h, once, consistency 80%, and the ratio of solid and liquid 1:12. Under the condition, the best material of Eucommia Ulmiodes for extracting geniposidic acid was chosen. CONCLUSION: The technology can provide some theoretic advice for industry.

[Effects of fenvalerate exposure on the semen quality of occupational workers].

OBJECTIVES: To study the effects of fenvalerate exposure on the semen quality of occupational workers in order to find out the early effective biomarkers. METHODS: Thirty-two male workers who exposed to fenvalerate and 46 male administrators in the office in a pesticide factory were selected as the exposure group and internal control group, respectively, and 22 male administrators in a center for disease control were served as the external control group. In order to evaluate the exposed levels, the concentration of fenvalerate, toluene and xylene in the ambient air of working place in these three groups were monitored simultaneously for three consecutive days. After the semen were collected according to the standard method, the workers' semen qualities were analysed with University of California at Davis (UCDavis) method and the sperm motility were evaluated using computer assisted sperm analysis(CASA). RESULTS: In the exposure group, the concentrations of fenvalerate were significantly higher than those in the internal and external control group (P < 0.01), while no significant difference of the concentration on toluene or xylene was found (P > 0.05). Sperm motion parameters in the exposure group such as linearity(LIN), straightness(STR), and the sperm count were decreased significantly, and the abnormality rate of viscidity, coagulation and sperm count were increased significantly as compared with the internal and the external control groups(P < 0.05). Furthermore, the sperm progression and beat cross frequency (BCF) in the exposure group were also lower significantly than those in the external control group(P < 0.05), while the abnormality rate of sperm progression was increased significantly. CONCLUSIONS: In such a low concentration, occupational exposure to fenvalerate can affect workers' semen quality, especially the sperm count and sperm movement ability.