Psychometric assessment of the Chinese adaptation of the patient participation scale targeting inpatients: a validation research.

Objective: The objective of this research was to introduce, translate, and verify the Patient Participation Scale (PPS) within a Chinese context. Methods: We applied a combination of internal consistency testing, item analysis, exploratory factor analysis, and confirmatory factor analysis. The research involved 453 individuals, comprising both outpatients and inpatients, across three Jinzhou Medical University-affiliated hospitals in China. Additionally, a subgroup of 50 patients underwent a retest after a 2-week interval to assess reliability. Results: The adapted Chinese edition of the PPS included 21 items. Exploratory factor analysis identified four distinct factors, accounting for 66.199% of the total variance. Confirmatory factor analysis supported a suitable four-factor structure ( χ / d f : 2.045, RMSEA: 0.048, GFI: 0.935, AGFI: 0.914, TLI: 0.958, CFI: 0.965, and PGFI: 0.712). The factor loadings corresponded to each item exceeded 0.6, the average variance extracted (AVE) exceeded 0.5, and the composite reliability (CR) exceeded 0.7. The correlation coefficients stayed below the square root of the AVE, demonstrated relatively favourable convergent and discriminant validity.The Chinese PPS edition demonstrated high internal consistency (Cronbach's alpha: 0.919), with dimensional Cronbach's alpha ranged from 0.732 to 0.918. Split-half as well as retest reliabilities were recorded at 0.737 and 0.864, respectively. The content validity index for the Chinese PPS edition stood at 0.974. Conclusion: The Chinese edition of the PPS emerges as a valid and reliable tool for assessing patient engagement in their own treatment as well as care, applicable in both inpatient as well as outpatient settings.

An Efficient, Amine-Specific, and Cost-Effective Method for TMT 6/11-plex Labeling Improves the Proteome Coverage, Quantitative Accuracy and Precision.

Tandem mass tags (TMT) are widely used in proteomics to simultaneously quantify multiple samples in a single experiment. The tags can be easily added to the primary amines of peptides/proteins through chemical reactions. In addition to amines, TMT reagents also partially react with the hydroxyl groups of serine, threonine, and tyrosine residues under alkaline conditions, which significantly compromises the analytical sensitivity and precision. Under alkaline conditions, reducing the TMT molar excess can partially mitigate overlabeling of histidine-free peptides, but has a limited effect on peptides containing histidine and hydroxyl groups. Here, we present a method under acidic conditions to suppress overlabeling while efficiently labeling amines, using only one-fifth of the TMT amount recommended by the manufacturer. In a deep-scale analysis of a yeast/human two-proteome sample, we systematically evaluated our method against the manufacturer's method and a previously reported TMT-reduced method. Our method reduced overlabeled peptides by 9-fold and 6-fold, respectively, resulting in the substantial enhancement in peptide/protein identification rates. More importantly, the quantitative accuracy and precision were improved as overlabeling was reduced, endowing our method with greater statistical power to detect 42% and 12% more statistically significant yeast proteins compared to the standard and TMT-reduced methods, respectively. Mass spectrometric data have been deposited in the ProteomeXchange Consortium via the iProX partner repository with the data set identifier PXD047052.

A general nonparametric classification method for multiple strategies in cognitive diagnostic assessment.

Cognitive diagnosis models (CDMs) have been used as psychometric tools in educational assessments to estimate students' strengths and weaknesses in terms of cognitive skills learned and skills that need study. In practice, it is not uncommon that questions can often be solved using more than one strategy, which requires CDMs capable of accommodating multiple strategies. However, existing parametric multi-strategy CDMs need a large sample size to produce a reliable estimation of item parameters and examinees' proficiency class memberships, which obstructs their practical applications. This article proposes a general nonparametric multi-strategy classification method with promising classification accuracy in small samples for dichotomous response data. The method can accommodate different strategy selection approaches and different condensation rules. Simulation studies showed that the proposed method outperformed the parametric CDMs when sample sizes were small. A set of real data was analyzed as well to illustrate the application of the proposed method in practice.

Smartphone-based versus traditional face-to-face collaborative care for community-dwelling older adults living with dementia in China: protocol for an implementation science-based sequential multiple assignment randomised trial.

INTRODUCTION: The high costs of institutional care and the burdensome demands of home care are challenging for families of adults with dementia. The collaborative care model (CCM) provides a potential solution to these challenges. Leveraging advancements in mobile technologies, smartphone-based management could offer a feasible means of providing collaborative care in a community setting. Therefore, this study aims to establish a CCM for home-cared older adults with dementia to determine the best strategy to deliver collaborative care, including both the channel and frequency of delivery. METHODS AND ANALYSIS: This study will be conducted in the communities of Chengdu city, Sichuan province, China. It is designed under the framework of implementation science. In the first stage, intervention strategies for community-dwelling older adults with dementia and their caregivers will be developed using Delphi methods and focus group interviews. The second stage will involve designing a sequential multiple assignment randomised trial to compare the effectiveness of face-to-face intervention versus a WeChat mini program-based intervention. This comparison will involve 358 pairs of older adults with dementia and their caregivers, with the frequency of intervention also assessed. Follow-up evaluations will be implemented at the 6th, 12th and 18th months post-intervention initiation. Primary outcomes encompass the proportion of patients demonstrating an improvement in quality of life and the proportion of caregivers exhibiting a reduction in caregiver burden. Analysis will be based on the intention-to-treat principle, and the generalised estimating equation approach will be used. Incremental cost-effectiveness ratios will be used to evaluate the cost-effectiveness of different delivery methods and frequencies. ETHICS AND DISSEMINATION: This study has received approval from the Ethics Committee of West China Fourth Hospital/School of Public Health, Sichuan University (Gwll2022004). Informed consent will be obtained for all participants. The findings of the study will be disseminated through peer-reviewed scientific journals. TRIAL REGISTRATION NUMBER: ChiCTR2200057945.

Psychometric Properties and Measurement Invariance of the LIVES Daily Hassles Scale in Chinese Samples.

Daily hassles have a larger effect on our health and well-being than those major events in daily life. The present study aimed to evaluate the psychometric properties and measurement invariance of the LIVES Daily Hassles Scale (LIVES-DHS) in Chinese samples, which consisted of 815 people at work aged between 20 and 60 years old. The results of both Explanatory Factor Analysis and Confirmatory Factor Analysis showed that the five-factor model solution was better than other solutions, which supported the original structure of LIVES-DHS. The Cronbach's alpha coefficients of the five subdimensions varied between.721 and.818, with the entire scale of.920, and McDonald's ω values of the five subdimensions varied between.716 and.821, with the entire scale of.936. The results also showed the support for measurement invariance of the five-factor model across different groups, which is the first to offer evidence for configural, metric, scalar and strict invariance of LIVES-DHS across gender, age and educational groups.

Psychosocial adaptation and influencing factors among patients with chemotherapy-induced peripheral neuropathy.

BACKGROUND: Chemotherapy-induced peripheral neuropathy (CIPN) is a severe and long-lasting side effect caused by various anticancer agents that damage sensory, motor and autonomic nerves. It can cause maladaptive behaviors, including disease severity, anxiety, depression, sleep disorders, falls, and social impairment. These disorders have physical, psychological and social effects on patients and can seriously influence their quality of life. AIM: To investigate the current situation of psychosocial adaptation to the disease and its influencing factor in patients with CIPN. METHODS: A convenience sampling method was used to select 233 patients with CIPN in our hospital from February to August 2021. In addition, a cross-sectional survey was conducted using a sociodemographic questionnaire, the Self-Report Psychosocial Adjustment to Illness Scale, and the European Organisation for the Research and Treatment of Cancer Quality of Life CIPN20 (QLQ-CIPN20). Factors influencing psychosocial adaptation in patients with CIPN were analyzed by t-test or one-way analysis of variance, correlation analysis, multiple stepwise regression analysis, and structural equation models. RESULTS: The psychosocial adaptation score of patients with CIPN was 52.51 ± 13.18. Multivariate analysis showed that autonomic nerves, tumor stage, motor nerves, education level, availability of caregivers, semi-retirement status, CIPN grade were independent risk factors for patients with CIPN (P < 0.05). Structural equation models showed that QLQ-CIPN20 mediated the relationship between CIPN grade, tumor stage, and psychosocial adaptation. CONCLUSION: Patients with CIPN have poor psychosocial adaptation and are affected by a variety of physiological, psychological, and social factors. Patients' adaptive responses should be assessed, and targeted interventions implemented.

[5-Year Readmission Status and Risk Factors for Senile Dementia Patients: A Study Based on Chengdu Municipal Medical Insurance Database].

Objective: To study the status quo of the readmission of senile dementia patients in Chengdu, and to analyze the primary diagnosis, the economic burden and the influencing factors of readmission. Methods: Dementia inpatients aged 60 and above in Chengdu were the subjects of this study. The subjects were diagnosed with dementia between 2013 and 2017. Their heath insurance coverage was either the basic medical insurance for urban employees in Chengdu or the basic medical insurance for urban and rural residents of Chengdu. The rank sum test and the chi-square test were conducted to analyze the differences in readmission rate and the economic burden of hospitalization among subjects with different characteristics. Logistic regression was done to analyze the factors affecting readmission. Results: The total number of dementia inpatients over the 5-year period was 27881 patients (78820 admissions). The 30-day readmission rate was 25.14% (7011/27881) and the 5-year readmission rate was 45.79% (12767/27881). The primary diagnoses of 12767 readmitted patients mainly included dementia (28.57%), circulatory system diseases (24.26%), and respiratory system diseases (23.71%). The economic burden of hospitalization was higher for readmitted patients than that of patients who were not readmitted ( Z=33.777, P<0.001). The occurrence of readmission was correlated to the following factors, advanced age (compared to that of the 60-65 yr. group, the 70-75 yr. group: odds ratio [ OR]=1.123, 95% confidence interval [ CI]: 1.019-1.237, and the 75-80 yr. group: OR=1.123, 95% CI: 1.108-1.218), participation in the basic medical insurance for urban employees ( OR=1.674, 95% CI: 1.578-1.775), types of dementia (compared to unspecified dementia, Alzheimer's dementia group: OR=1.256, 95% CI: 1.163-1.357, Parkinson's disease dementia group: OR=1.774, 95% CI: 1.658-1.898, and mixed-type dementia group: OR=1.750, 95% CI: 1.457-2.103), disease condition (compared with patients with only dementia, those who have other diseases: OR=0.536，95% CI ：0.493-0.583), length of hospital stay ( OR=1.593, 95% CI: 1.552-1.635), and staying at a lower level hospital (compared to that of tertiary hospitals, secondary hospitals: OR=1.319, 95% CI: 1.248-1.395, primary hospitals: OR=1.744, 95% CI: 1.608-1.891, and other hospitals: OR=1.465, 95% CI: 1.311-1.537). Conclusion: Senile dementia patients have a high 30-day readmission rate, and the readmission entails heavy economic burdens on the patients. For the populations covered by medical insurance, the following features are correlated to the occurrence of readmission: advanced age, coverage by the basic medical insurance for urban employees, Alzheimer's dementia, Parkinson's disease dementia, mixed-type dementia, dementia patients without other comorbidities, extended length of stay, and hospitalization at a lower level hospital. However, further research is needed for better understanding of the specific mechanisms so that readmission of senile dementia patients can be reduced and the economic burden of the disease can be minimized.

Pharmacokinetic/Pharmacodynamic Target Attainment of Different Antifungal Agents in De-escalation Treatment in Critically Ill Patients: a Step toward Dose Optimization Using Monte Carlo Simulation.

Differences in pharmacokinetics/pharmacodynamics (PK/PD) target attainment are rarely considered when antifungals are switched in critically ill patients. This study intends to explore whether the antifungal de-escalation treatment strategy and the new intermittent dosing strategy of echinocandins in critically ill patients are able to achieve the corresponding PK/PD targets. The published population PK models of antifungals in critically ill patients and a public data set from the MIMIC-III database (n = 662) were employed to evaluate PK/PD target attainment of different dosing regimens of antifungals. Cumulative fraction of response (CFR) was calculated for each dosing regimen. Most guideline-recommended dosing regimens of fluconazole and voriconazole could achieve target exposure as de-escalation treatment in critically ill patients. For initial echinocandin treatment, achievement of the target exposure decreased as body weight increased, and the intermittent dosing strategy had a slightly higher CFR value in most simulations compared to conventional dosing strategy. For Candida albicans and Candida glabrata infection, caspofungin at the lowest dose achieved a CFR of >90%, while micafungin or anidulafungin required almost the highest doses simulated in this study to achieve the same effect. None of the echinocandins other than 150 mg every 24 h (q24h) or 200 mg q48h of caspofungin achieved the target CFR for Candida parapsilosis infection. These findings support the guideline-recommended dose of triazoles for antifungal de-escalation treatment and confirm the insufficient dosage of echinocandins in critically ill patients, indicating that a dosing regimen based on body weight or intermittent dosing of echinocandins may be required.

Deriving freshwater guideline values for neonicotinoid insecticides: Implications for water quality guidelines and ecological risk assessment.

The increased use of neonicotinoid insecticides in aquatic environments poses a significant threat to non-target freshwater species. However, the existing water quality guidelines (WQGs) for neonicotinoids mainly focus on imidacloprid, and only a few authoritative institutions have established WQGs for other neonicotinoids. There is a critical need to develop WQGs and conduct ecological risk assessment (ERA) of different neonicotinoids in global freshwater environments. In this study, we derived interim acute and chronic guideline values and acute-to-chronic ratios (ACRs) for six neonicotinoids based on publicly available acute and chronic toxicity data. The exposure concentrations of neonicotinoids were obtained from published literature worldwide, and ERA was conducted for neonicotinoids in global freshwater ecosystems using a tiered approach. The derived chronic guideline values (95% confidence interval (CI), ng/L) were 0.63 (0.02-5.47) for thiacloprid (the lowest) and 16.4 for dinotefuran (the highest). The identified ACRs (95% CI) ranged from 90.9 (47.0-180) to 957 (102-3350), which can be used to extrapolate scarce chronic data from the acute data. Neonicotinoid concentrations in global freshwater were predicted from 10.6 (6.88-23.4) (thiacloprid) to 339 (211-786) ng/L (thiamethoxam). The estimated risk quotients ranged from 3.23 (dinotefuran) to 21.73 (thiacloprid), and the probability of exceeding WQGs ranged from 27.1% (dinotefuran) to 77.1% (thiacloprid). The ERA results indicated that the six neonicotinoids posed negligible acute risks but high chronic risks to global freshwater ecosystems, especially acetamiprid (65.8%) and thiacloprid (28.1%). The key findings of this study provide critical scientific information regarding the ecological risks of long-term neonicotinoid exposure and key insights for policy development and water quality control.

Equity in telemedicine for older adults during the COVID-19 pandemic.

The coronavirus disease 2019 (COVID-19) pandemic has spurred an unprecedented paradigm shift to telemedicine across healthcare fields in order to limit exposure to the virus. At the West China Hospital of Sichuan University, telemedicine has been used to perform COVID-19-related tele-education to health professionals and the general population, as well as tele-diagnosis, online treatment and internet-based drug prescription and delivery. However, many older adults could not make appointments with doctors due to difficulty using the internet-based platform. Careful attention needs to be paid by future researchers and policymakers in order to mitigate barriers older adults face when using telemedicine.

A Generalized Diagnostic Classification Modeling Framework Integrating Differential Speediness: Advantages and Illustrations in Psychological and Educational Testing.

To advance the theoretical foundation of incorporating response times (RTs) into diagnostic classification models (DCMs), this study attempts to further derive, test and illustrate a generalized modeling framework (known as the JVRT-LCDM) that can simultaneously analyze response accuracy and differential speediness based on an existing method (Zhan et al., British Journal of Mathematical and Statistical Psychology, 71(2), 262-286, 2018). The JVRT-LCDM not only provides fine-grained diagnostic feedback without strict model constraints but also clarifies the specific speed trajectory of individuals. Moreover, some existing models from psychometric literatures are included in the JVRT-LCDM as special cases. The feasibility of the JVRT-LCDM is investigated via a Monte Carlo simulation study using a Bayesian estimation scheme, and two empirical datasets are then analyzed to illustrate the applicability of the JVRT-LCDM in practice. The results indicate that (1) as a generalized and flexible model, the JVRT-LCDM realizes high correct classification rates and accurate speed parameter recovery; (2) the JVRT-LCDM outperforms the existing models in terms of model-data fit, diagnostic consistency, and estimation of specific individuals in practical cognitive diagnosis assessments; and (3) the JVRT-LCDM provides reliable evidence for nonconstant speed modeling.

Digital Subtraction Angiography Contrast Material Transport as a Direct Assessment for Blood Perfusion of Middle Cerebral Artery Stenosis.

Digital subtraction angiography (DSA) is a fluoroscopic technique used extensively in interventional radiology for visualizing blood vessels. It has also been used to evaluate blood perfusion. However, the perfusion obtained in previous techniques was extracted from signal intensity rather than by the transport of contrast material (CM) through blood flow. The main aim of this study is to evaluate the morphological effects on the hemodynamics and the CM concentration in the middle cerebral artery (MCA) stenosis. We proposed a quantitative parameter, i.e., contrast material remaining time (CMRT), to describe the variation in the transport of CM over time. Computational fluid dynamics simulations were performed on both reconstructive synthetic and patient-derived models. In the synthetic models, we evaluated the variation of flow patterns and the transport of CM with different degrees of stenosis and the location of the lesion. It was found that an increase in the degree of stenosis (from 30 to 80%) resulted in a significant increase in CMRT at the anterior cerebral artery (ACA) outlet (p = 0.0238) and a significant decrease in CMRT at the MCA outlet (p = 0.012). The patient-derived models were reconstructed from the pre- and post-interventional DSA images of a patient with MCA stenosis. Both blood flow velocity and CMRT increased at the ACA outlet but decreased at the MCA outlet. The perfusion analysis demonstrated that the perfusion function was improved after interventional surgery. In conclusion, changes in stenotic degree at MCA may lead to apparent differences in the hemodynamic distribution and the transport of CM. CMRT could be a quantitative indicator to evaluate the changes in blood perfusion after the intervention for MCA stenosis.

Application of the RCOG Risk Assessment Model for Evaluating Postpartum Venous Thromboembolism in Chinese Women: A Case-Control Study.

BACKGROUND Since China has not yet constructed its own risk assessment model (RAM) for pregnancy-related venous thromboembolism (VTE), more and more hospitals use the RCOG RAM for VTE risk prediction. However, the RCOG RAM was established based on Western populations, and its applicability in China is still uncertain. Thus, we aimed to evaluate the validity of the RCOG RAM in predicting postpartum VTE in Chinese maternity. MATERIAL AND METHODS This retrospective case-control study was conducted at the International Peace Maternity and Child Health Hospital (IPMCHH) from June 2016 to June 2020. The VTE group consisted of 38 women with postpartum VTE. For each VTE patient, 4 women without VTE who gave birth on the same day were randomly selected as the control group (n=152). The receiver operating characteristic (ROC) curve, calibration curve, and decision curve analysis (DCA) were used to evaluate the discrimination, accuracy, and validity of the RCOG RAM. Univariable analysis and multivariable logistic regression analysis were used to identify other related factors for postpartum VTE. RESULTS Compared with the low-risk group, the risk of VTE was 9.75-fold greater in the intermediate-risk group, and 90.00-fold greater in the high-risk group. The area under curve (AUC) of the model was 0.828 (95% CI: 0.762-0.894), with a score of 2 as its best cut-off value, which exactly matched the criterion recommended by the RCOG guidelines for pharmacological thromboprophylaxis. The calibration curves and DCA of the model also showed good accuracy. In addition to the factors included in the RCOG RAM, glucocorticoid therapy during pregnancy (adjusted OR=6.72, 95% CI: 1.56-28.91) and previous use of IUD (adjusted OR=7.11, 95% CI: 1.45-34.93) were associated with increased risk of postpartum VTE. CONCLUSIONS The RCOG RAM was found to be effective in predicting postpartum VTE, and has certain guiding significance for postpartum thromboprophylaxis in China.

The application value of continuous nursing intervention on quality of life in patients with stroke: A protocol for systematic review and meta-analysis.

BACKGROUND: Individual characteristics, physical function disability, emotional, as well as cognitive symptoms, along with the general health discernment might be associated or impact the quality of life of patients suffering from stroke directly or indirectly. Appropriate continuous nursing intervention is required to enhance the quality of life of patients with stroke. Therefore, the present study will be conducted to systematically investigate the application value of continuous nursing intervention for improving the quality of life of patients experiencing stroke. METHODS: We will conduct a comprehensive search of electronic databases such as MEDLINE, Cochrane Library, CINAHL, EMBASE, Scopus, Chinese National Knowledge Infrastructure, and WanFang databases to identify relevant publications. We will only include studies published in English or Chinese languages. Accordingly, randomized controlled trials evaluating the application value of continuous nursing intervention for improving the quality of life of patients suffering from stroke will be included. We will use 2 independent authors to conduct study selection, extract data, and evaluate the quality of the included studies. In case of any discrepancies, they will be addressed by consensus. Also, we will use RevMan 5.3 software to carry out the statistical analysis. RESULTS: The current study will summarize high-quality evidence to systematically explore application value of continuous nursing intervention for improving the quality of life in patients with stroke. CONCLUSION: The present study will summarize the direct and indirect pieces of evidence to ascertain whether continuous nursing intervention can improve the quality of life in patients with stroke. ETHICS AND DISSEMINATION: Ethical approval will not be required. REGISTRATION NUMBER: April 25, 2021.osf.io/xnrzt/ (https://osf.io/xnrzt/).

Effect assessment of evidence-based nursing in combination with clinical nursing pathway on nephrotic syndrome care in children: A protocol for systematic review and meta-analysis.

BACKGROUND: Childhood nephrotic syndrome is widespread in pediatric nephrology. In most cases, it needs hospitalization for patient management. An increasing number of studies report that proper nursing care could promote the rate of treatment and improve post-treatment prognosis. Clinical nursing pathways refer to innovative nursing modes with high-quality, excellent efficacy, and low costing treatment. There are reports on how nursing methods that utilize data combine with clinical nursing pathway to enhance nephrotic syndrome care in kids. However, the results remain controversial. Therefore, it is necessary to conduct this study to systematically explore how evidence-based nursing combined with clinical nursing pathway plays a role in nephrotic syndrome care among children. METHODS: This study protocol will conduct a comprehensive search on MEDLINE, Cochrane Library, CINAHL, EMBASE, Scopus, Chinese National Knowledge Infrastructure, WanFang, and Web of Science electronic databases to identify relevant research articles from inception to April 25, 2021. Studies in both English and Chinese languages are used for this study. This study protocol will analyze randomized controlled trials that investigated the role of evidence-based nursing combined with clinical nursing pathway to care for nephrotic syndrome in children. Two authors will independently screen the search results, select suitable studies for inclusion, extract the characteristics and outcome data of the selected studies, and evaluate the risk of bias based on standard Cochrane methodology. Any discrepancies will be resolved by consensus. RESULTS: The present study will summarize high-quality evidence to systematically explore how a nursing model based on evidence combined with clinical nursing pathway influences the caring of children with nephrotic syndrome. CONCLUSION: The present study will summarize the direct and indirect evidence to judge whether evidence-based nursing combined with clinical nursing pathway can improve the treatment and post-treatment prognosis in children with nephrotic syndrome. ETHICS AND DISSEMINATION: This study does not require an ethical approval. REGISTRATION NUMBER: April 25, 2021.osf.io/bcrdk/ (https://osf.io/bcrdk/).

Global burden of acute viral hepatitis and its association with socioeconomic development status, 1990-2019.

BACKGROUND & AIMS: Acute viral hepatitis (AVH) represents an important global health problem; however, the progress in understanding AVH is limited because of the priority of combating persistent HBV and HCV infections. Therefore, an improved understanding of the burden of AVH is required to help design strategies for global intervention. METHODS: Data on 4 major AVH types, including acute hepatitis A, B, C, and E, excluding D, were collected by the Global Burden of Disease (GBD) 2019 database. Age-standardized incidence rates and disability-adjusted life year (DALY) rates for AVH were extracted from GBD 2019 and stratified by sex, level of socio-demographic index (SDI), country, and territory. The association between the burden of AVH and socioeconomic development status, as represented by the SDI, was described. RESULTS: In 2019, there was an age-standardized incidence rate of 3,615.9 (95% CI 3,360.5-3,888.3) and an age-standardized DALY rate of 58.0 (47.3-70.0) per 100,000 person-years for the 4 major types of AVH. Among the major AVH types, acute hepatitis A caused the heaviest burden. There was a significant downward trend in age-standardized DALY rates caused by major incidences of AVH between 1990 and 2019. In 2019, regions or countries located in West and East Africa exhibited the highest age-standardized incidence rates of the 4 major AVH types. These rates were stratified by SDI: high SDI and high-middle SDI locations recorded the lowest incidence and DALY rates of AVH, whereas the low-middle SDI and low SDI locations showed the highest burden of AVH. CONCLUSIONS: The socioeconomic development status and burden of AVH are associated. Therefore, the GBD 2019 data should be used by policymakers to guide cost-effective interventions for AVH. LAY SUMMARY: We identified a negative association between socioeconomic development status and the burden of acute viral hepatitis. The lowest burden of acute viral hepatitis was noted for rich countries, whereas the highest burden of acute viral hepatitis was noted for poor countries.

Organic-inorganic hybrid perovskite for low-cost and high-performance xerographic photoreceptors.

Solution-processable organic-inorganic hybrid perovskites are being widely investigated for many applications, including solar cells, light-emitting diodes, photodetectors, and lasers. Herein, we report, for the first time, successful fabrication of xerographic photoreceptors using methylammonium lead iodide (CH3NH3PbI3) perovskite as a light-absorbing material. With the incorporation of polyethylene glycol (PEG) into the perovskite film, the ion migration inherent to the perovskite material can be effectively suppressed, and the resulting photoreceptor exhibits a high and panchromatic photosensitivity, large surface potential, low dark decay, and high environmental resistance and electrical cycling stability. Specifically, the energies required to photodischarge one half of the initial surface potential (E 0.5) are 0.074 µJ cm-2 at 550 nm and 0.14 µJ cm-2 at 780 nm, respectively. The photosensitivites outmatch those of the conventionally used organic pigments having narrow spectral responses. Our findings inform a new generation of highly efficient and low-cost xerographic photoreceptors based on perovskite materials.

Economic Status Moderates the Association Between Early-Life Famine Exposure and Hyperuricemia in Adulthood.

CONTEXT: The double burden of malnutrition (DBM), undernutrition in early life and an obesogenic environment later on, influences later risk of chronic disorders. The Great Famine in China from 1959 to1962 and remarkable economic development from the 1980s provided such a burden for a large number of people in their 60s. OBJECTIVE: We aimed to analyze the effect of economic status on the association between famine exposure in early life and hyperuricemia in adulthood. DESIGN AND SETTING: Participants numbering 12 666 were enrolled in China based on the Survey on Prevalence in East China for Metabolic Diseases and Risk Factors (SPECT-China) Study from 2014 to 2016. PARTICIPANTS: Participants with fetal or childhood famine exposure (birth year 1949-1962) formed the exposure group. MAIN OUTCOME MEASURE: Hyperuricemia was defined as uric acid (UA) > 420 µmol/L for men and > 360 µmol/L for women. The association of famine with hyperuricemia was assessed via regression analyses. RESULTS: Early-life famine exposure was negatively associated with UA levels (P = .045) but was not associated with hyperuricemia (P = .226) in the whole study population. Economic status could moderate the association of famine exposure with UA and hyperuricemia (P ≤ .001). In participants with high economic status, early-life famine exposure was positively associated with UA levels (unstandardized coefficients 7.61, 95% CI 3.63-11.59, P < .001), and with hyperuricemia (odds ratio 1.47, 95% CI 1.19-1.81, P < .001). CONCLUSIONS: Economic status could moderate the association between exposure to famine in early life and hyperuricemia in adulthood, indicating that the DBM might affect hyperuricemia in an opposite direction of the effects of undernutrition in early life alone.

Predicting the risk of sarcopenia in elderly patients with patellar fracture: development and assessment of a new predictive nomogram.

PURPOSE: To develop a risk prediction model for postoperative sarcopenia in elderly patients with patellar fractures in China. PATIENTS AND METHODS: We conducted a community survey of patients aged ≥55 years who underwent surgery for patellar fractures between January 2013 and October 2018, through telephone interviews, community visits, and outpatient follow-up. We established a predictive model for assessing the risk of sarcopenia after patellar fractures. We developed the prediction model by combining multivariate logistic regression analysis with the least absolute shrinkage model and selection operator regression (lasso analysis) as well as the Support Vector Machine (SVM) algorithm. The predictive quality and clinical utility of the predictive model were determined using C-index, calibration plots, and decision curve analysis. We also conducted internal sampling methods for qualitative assessment. RESULT: We recruited 137 participants (53 male; mean age, 65.7 years). Various risk factors were assessed, and low body mass index and advanced age were identified as the most important risk factor (P < 0.05). The prediction rate of the model was good (C-index: 0.88; 95% CI [0.80552-0.95448]), with a satisfactory correction effect. The C index is 0.97 in the validation queue and 0.894 in the entire cohort. Decision curve analysis suggested good clinical practicability. CONCLUSION: Our prediction model shows promise as a cost-effective tool for predicting the risk of postoperative sarcopenia in elderly patients based on the following: advanced age, low body mass index, diabetes, less outdoor exercise, no postoperative rehabilitation, different surgical methods, diabetes, open fracture, and removal of internal fixation.

Application of ARIMA model in monitoring the use rate of antibiotics in outpatients in 2010 - 2018
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OBJECTIVES: In order to continuously promote the rational clinical application of antibacterial drugs and provide data support for hospital scientific management decision-making, we evaluated the use rate of antibiotics in outpatients in 2010 - 2018. MATERIALS AND METHODS: A retrospective analysis of the use rate of antibiotics in outpatients from January 2010 to October 2018 was performed in our hospital. We analyzed the antibacterial use rate in each month in outpatients and evaluated the changes in the antibacterial use rate in outpatients over the past 9 years. Autoregressive integrated moving average (ARIMA) model was established and verified, and we predicted the trends of antibacterial use rate in outpatients from November 2018 to March 2019. RESULTS: The level of clinical rational drug use management in our hospital is continually improving. The average monthly use rate of antibiotic drugs in outpatients in 2010 - 2013 decreased from 13.04 to 12.28% in 2014 - 2018 (p = 0.002). The goodness-of-fit of the ARIMA model is high. The verification results show that the model can accurately predict the changing trend. The average absolute error of the actual value and the fitted value of the antibiotic drug use rate was 0.76% from January to October 2018. The established ARIMA model can better simulate the trend of antibacterial use rate in outpatients. CONCLUSION: The model can be applied to the short-term prediction and dynamic analysis of antibacterial use rate in outpatients, helping hospitals to reasonably evaluate and monitor the use of clinical antibiotics and provide decision-making services for hospital management.