Electronic Health Literacy Scale-Web3.0 for Older Adults with Noncommunicable Diseases: Validation Study.

BACKGROUND: In the current digital era, eHealth literacy plays an indispensable role in health care and self-management among older adults with noncommunicable diseases (NCDs). Measuring eHealth literacy appropriately and accurately ensures the successful implementation and evaluation of pertinent research and interventions. However, existing eHealth literacy measures focus mainly on individuals' abilities of accessing and comprehending eHealth information (Web1.0), whereas the capabilities for web-based interaction (Web2.0) and using eHealth information (Web3.0) have not been adequately evaluated. OBJECTIVE: This study aimed to examine the reliability, validity, and measurement invariance of the eHealth Literacy Scale-Web3.0 (eHLS-Web3.0) among older adults with NCDs. METHODS: A total of 642 Chinese older adults with NCDs (mean age 65.78, SD 3.91 years; 55.8% female) were recruited in the baseline assessment, of whom 134 (mean age 65.63, SD 3.99 years; 58.2% female) completed the 1-month follow-up assessment. Baseline measures included the Chinese version of the 24-item 3D eHLS-Web3.0, the Chinese version of the 8-item unidimensional eHealth Literacy Scale (eHEALS), and demographic information. Follow-up measures included the 24-item eHLS-Web3.0 and accelerometer-measured physical activity and sedentary behavior. A series of statistical analyses, for example, Cronbach α, composite reliability coefficient (CR), confirmatory factor analysis (CFA), and multigroup CFA, were performed to examine the internal consistency and test-retest reliabilities, as well as the construct, concurrent, convergent, discriminant, and predictive validities, and the measurement invariance of the eHLS-Web3.0 across gender, education level, and residence. RESULTS: Cronbach α and CR were within acceptable ranges of 0.89-0.94 and 0.90-0.97, respectively, indicating adequate internal consistency of the eHLS-Web3.0 and its subscales. The eHLS-Web3.0 also demonstrated cross-time stability, with baseline and follow-up measures showing a significant intraclass correlation of 0.81-0.91. The construct validity of the 3D structure model of the eHLS-Web3.0 was supported by confirmatory factor analyses. The eHLS-Web3.0 exhibited convergent validity with an average variance extracted value of 0.58 and a CR value of 0.97. Discriminant validity was supported by CFA results for a proposed 4-factor model integrating the 3 eHLS-Web3.0 subscales and eHEALS. The predictive validity of the eHLS-Web3.0 for health behaviors was supported by significant associations of the eHLS-Web3.0 with light physical activity (ß=.36, P=.004), moderate to vigorous physical activity (ß=.49, P<.001), and sedentary behavior (ß=-.26, P=.002). Finally, the measurement invariance of the eHLS-Web3.0 across gender, education level, and residence was supported by the establishment of configural, metric, strong, and strict invariances. CONCLUSIONS: The present study provides timely empirical evidence on the reliability, validity, and measurement invariance of the eHLS-Web3.0, suggesting that the 24-item 3D eHLS-Web3.0 is an appropriate and valid tool for measuring eHealth literacy among older adults with NCDs within the Web3.0 sphere.

The Usage of Digital Health Technology Among Older Adults in Hong Kong and the Role of Technology Readiness and eHealth Literacy: Path Analysis.

BACKGROUND: Although digital health technologies (DHTs) help many people maintain a healthy life, including those of advanced age, these technologies are of little use to older adult populations if they are not being adopted in daily life. Thus, it is critical to identify ways to help older adults recognize and try new technologies and maintain their use of them to maximize the benefits of these technologies in a digital-based society. OBJECTIVE: Our study aimed (1) to assess the current usage of DHT among older adults in Hong Kong and (2) to examine how high and low levels of eHealth literacy in this group affects the relationship between the Technology Readiness and Acceptance Model (TRAM) and attitudes and intention toward DHT. METHODS: A total of 306 adults over 60 years of age in Hong Kong participated in this study. After conducting confirmatory factor analysis to validate the measurement model, the hypothesized model was tested using structural equation modeling. RESULTS: Optimism was significantly related to perceived usefulness, while optimism, innovativeness, and discomfort were significantly associated with perceived ease of use. Both perceived usefulness and perceived ease of use were significantly linked to attitude toward the use of DHTs. Meanwhile, attitude significantly predicted usage intention. Additionally, the results revealed the differences in the relationships of the TRAM between participants with high and low levels of eHealth literacy. The influence of optimism and innovativeness on perceived ease of use was stronger for the higher-level group than for the lower-level group, and the influence of discomfort for the higher-level group was much weaker. CONCLUSIONS: The findings provided partial support for the impact of eHealth literacy on encouraging older adults to use DHT and obtain health benefits from it. This study also suggests providing assistance and guidelines for older adults to narrow the aging-related technology gap and to further explore the associations of eHealth literacy, the TRAM, and actual behaviors.

eHealth usage among Chinese college students: qualitative findings.

BACKGROUND: The information technology has developed rapidly with the evolution of internet environment transformed from requiring computer skills for information searching to self-managing health data and applying information. Therefore, a more diverse range of eHealth skills is required and these skills are referred as eHealth literacy. However, most eHealth literacy studies focused mainly on information searching skills. Little is known about eHealth usage behaviors of college students in this day and age. OBJECTIVES: This study aimed to investigate how Chinese college students engage with eHealth tools and to determine the elements of their eHealth literacy. METHODS: A purposive sample of 18 Chinese college students was recruited for in-depth interviews. Interviewees included three males and three females of each city (Beijing, Wuhan and Putian) from sports, medical, and non-health-related majors. Conventional content analysis was applied for data analysis. RESULTS: The eHealth usage of different-major-students were compared and profiled by three themes of Expectance, Usage pattern and Perception. In Expectances, non-health major students applied eHealth only for urgent health need, sport major students used it to monitor health while medical major students, as frequent users for searching health database. In Usage pattern, purposes of eHealth for personal, practical and theoretical were identified for non-health major, sport major and medical major groups, respectively. In Perceptions, sport students felt more curious about eHealth than the other groups who perceived either fear (non-health students) or skeptical (medical students). By compiling those themes, the whole picture of eHealth usage was emerged. Based on that, the current study identified the related skills using the trilogy of Web 1.0 to 3.0, and derived a conceptual framework for eHealth literacy in the present day. CONCLUSIONS: The current study obtained a comprehensive understanding of eHealth usage and a framework of eHealth literacy required for Chinese college students. And it gives a clearer look at web 3.0 related eHealth behaviors.

Search for Light Dark Matter-Electron Scattering in the PandaX-II Experiment.

We report constraints on light dark matter through its interactions with shell electrons in the PandaX-II liquid xenon detector with a total 46.9 tonnes/day exposure. To effectively search for these very low energy electron recoils, ionization-only signals are selected from the data. 1821 candidates are identified within an ionization signal range between 50 and 75 photoelectrons, corresponding to a mean electronic recoil energy from 0.08 to 0.15 keV. The 90% C.L. exclusion limit on the scattering cross section between the dark matter and electron is calculated with systematic uncertainties properly taken into account. Under the assumption of point interaction, we provide the world's most stringent limit within the dark matter mass range from 15 to 30 MeV/c^{2}, with the corresponding cross section from 2.5×10^{-37} to 3.1×10^{-38} cm^{2}.

Measuring a Broad Spectrum of eHealth Skills in the Web 3.0 Context Using an eHealth Literacy Scale: Development and Validation Study.

BACKGROUND: eHealth literacy (EHL) refers to a variety of capabilities that enable individuals to obtain health information from electronic resources and apply it to solve health problems. With the digitization of health care and the wide availability of health apps, a more diverse range of eHealth skills is required to properly use such health facilities. Existing EHL measurements focus mainly on the skill of obtaining health information (Web 1.0), whereas skills for web-based interactions (Web 2.0) and self-managing health data and applying information (Web 3.0) have not been well measured. OBJECTIVE: This study aims to develop an EHL scale (eHLS) termed eHLS-Web3.0 comprising a comprehensive spectrum of Web 1.0, 2.0, and 3.0 skills to measure EHL, and evaluate its validity and reliability along with the measurement invariance among college students. METHODS: In study 1, 421 Chinese college students (mean age 20.5, SD 1.4 years; 51.8% female) and 8 health experts (mean age 38.3, SD 5.9 years; 87.5% female) were involved to develop the eHLS-Web3.0. The scale development included three steps: item pool generation, content validation, and exploratory factor analysis. In study 2, 741 college students (mean age 21.3, SD 1.4 years; 52.2% female) were recruited from 4 Chinese cities to validate the newly developed eHLS-Web3.0. The construct validity, convergent validity, concurrent validity, internal consistency reliability, test-retest reliability, and measurement invariance across genders, majors, and regions were examined by a series of statistical analyses, including confirmatory factor analysis (CFA) and multigroup CFAs using SPSS and Mplus software packages. RESULTS: Based on the item pool of 374 statements collected during the conceptual development, 24 items (4-10 items per subscale) were generated and adjusted after cognitive testing and content validity examination. Through exploratory factor analysis, a 3-factor eHLS-Web3.0 was finally developed, and it included acquisition (8 items), verification (6 items), and application (10 items). In study 2, CFAs supported the construct validity of the 24-item 3D eHLS-Web3.0 (χ2244=903.076, χ2244=3.701, comparative fit index=0.924, Tucker-Lewis index=0.914, root mean square error of approximation [RMSEA]=0.06, and standardized root mean residual [SRMR]=0.051). The average variance extracted (AVE) value of 0.58 and high correlation between eHLS-Web3.0 subscales and the eHealth Literacy Scale (r=0.725-0.880, P<.001) indicated the convergent validity and concurrent validity of the eHLS-Web3.0. The results also indicated satisfactory internal consistency reliability (α=.976, ρ=0.934-0.956) and test-retest reliability (r=0.858, P<.001) of the scale. Multigroup CFA demonstrated the 24-item eHLS-Web3.0 to be invariant at all configural, metric, strength, and structural levels across genders (female and male), majors (sport-related, medical, and general), and regions (Yinchuan, Kunming, Xiamen, and Beijing). CONCLUSIONS: The 24-item 3D eHLS-Web3.0 proved to be a reliable and valid measurement tool for EHL in the Web 3.0 context among Chinese college students.

Constraining Dark Matter Models with a Light Mediator at the PandaX-II Experiment.

We search for nuclear recoil signals of dark matter models with a light mediator in PandaX-II, a direct detection experiment in the China Jinping underground laboratory. Using data collected in 2016 and 2017 runs, corresponding to a total exposure of 54 ton day, we set upper limits on the zero-momentum dark matter-nucleon cross section. These limits have a strong dependence on the mediator mass when it is comparable to or below the typical momentum transfer. We apply our results to constrain self-interacting dark matter models with a light mediator mixing with standard model particles, and set strong limits on the model parameter space for the dark matter mass ranging from 5 GeV to 10 TeV.

Spin-Dependent Weakly-Interacting-Massive-Particle-Nucleon Cross Section Limits from First Data of PandaX-II Experiment.

New constraints are presented on the spin-dependent weakly-interacting-massive-particle–- (WIMP-)nucleon interaction from the PandaX-II experiment, using a data set corresponding to a total exposure of 3.3×10^{4} kg day. Assuming a standard axial-vector spin-dependent WIMP interaction with ^{129}Xe and ^{131}Xe nuclei, the most stringent upper limits on WIMP-neutron cross sections for WIMPs with masses above 10 GeV/c^{2} are set in all dark matter direct detection experiments. The minimum upper limit of 4.1×10^{-41} cm^{2} at 90% confidence level is obtained for a WIMP mass of 40 GeV/c^{2}. This represents more than a factor of 2 improvement on the best available limits at this and higher masses. These improved cross-section limits provide more stringent constraints on the effective WIMP-proton and WIMP-neutron couplings.

Limits on Axion Couplings from the First 80 Days of Data of the PandaX-II Experiment.

We report new searches for solar axions and galactic axionlike dark matter particles, using the first low-background data from the PandaX-II experiment at China Jinping Underground Laboratory, corresponding to a total exposure of about 2.7×10^{4} kg day. No solar axion or galactic axionlike dark matter particle candidate has been identified. The upper limit on the axion-electron coupling (g_{Ae}) from the solar flux is found to be about 4.35×10^{-12} in the mass range from 10^{-5} to 1 keV/c^{2} with 90% confidence level, similar to the recent LUX result. We also report a new best limit from the ^{57}Fe deexcitation. On the other hand, the upper limit from the galactic axions is on the order of 10^{-13} in the mass range from 1 to 10 keV/c^{2} with 90% confidence level, slightly improved compared with the LUX.

Dark Matter Results from 54-Ton-Day Exposure of PandaX-II Experiment.

We report a new search for weakly interacting massive particles (WIMPs) using the combined low background data sets acquired in 2016 and 2017 from the PandaX-II experiment in China. The latest data set contains a new exposure of 77.1 live days, with the background reduced to a level of 0.8×10^{-3} evt/kg/day, improved by a factor of 2.5 in comparison to the previous run in 2016. No excess events are found above the expected background. With a total exposure of 5.4×10^{4} kg day, the most stringent upper limit on the spin-independent WIMP-nucleon cross section is set for a WIMP with mass larger than 100 GeV/c^{2}, with the lowest 90% C.L. exclusion at 8.6×10^{-47} cm^{2} at 40 GeV/c^{2}.

Dark Matter Results from First 98.7 Days of Data from the PandaX-II Experiment.

We report the weakly interacting massive particle (WIMP) dark matter search results using the first physics-run data of the PandaX-II 500 kg liquid xenon dual-phase time-projection chamber, operating at the China JinPing underground laboratory. No dark matter candidate is identified above background. In combination with the data set during the commissioning run, with a total exposure of 3.3×10^{4} kg day, the most stringent limit to the spin-independent interaction between the ordinary and WIMP dark matter is set for a range of dark matter mass between 5 and 1000 GeV/c^{2}. The best upper limit on the scattering cross section is found 2.5×10^{-46} cm^{2} for the WIMP mass 40 GeV/c^{2} at 90% confidence level.

Association of 24-hour movement guideline adherence, mental health and quality of life in young adults: the role of e-Health literacy.

Background: The spread of Covid-19 and resultant infection prevention strategies have disturbed the life routine of Chinese young adults, led to reduced physical activity (PA), prolonged screen time (ST) and inadequate sleep duration (SP), and made immense influence on their mental health (MH) and quality of life (QoL). E-Health literacy (EHL) can enable citizens to use available online information to respond to the highly complex information environment and make appropriate health decisions. Objective: This study aims to examine associations between adhering to 24-h movement (24HM) guidelines and MH and QoL among young adults, as well as to identify any mediating or moderating role of EHL in these associations. Methods: 1742 young adults (20.03 ± 1.54 years old, 68.6% females) from north and south China completed self-report measures of 24HM (PA, ST and SP), health indicators (MH and QoL), EHL and demographic information through an online survey between 4 Apr and 16 Jun 2022. Generalized linear mixed models were applied for data analysis. Results: Results showed that adhering to PA, ST and SP guidelines were all positively connected with QoL while MH was associated with adhering ST or SP guidelines. Adhering to more of 24HM guidelines was linked to better MH and QoL. EHL significantly mediated the association of guideline adherence and QoL and moderate that of guideline adherence and MH. Conclusion: This is the first study to investigate the role of EHL on the associations between 24HM and MH as well as QoL during the Covid-19. The findings may contribute to further empirical research or intervention that aims to promote MH or QoL among young adults more effectively or provide valuable references for developing relevant strategies or policy of health promotion or public health events in China.

Health literacy mediates the relationships of cognitive and physical functions with health-related quality of life in older adults.

Background: Declining cognitive function (CF) and physical function (PF) relate to poorer health-related quality of life (HRQoL) in older adults. As health literacy (HL) facilitates health information utilization, it may mediate links between functionality and HRQoL appraisals. This study examined HL as an intermediary between joint CF and PF contributions and HRQoL in Hong Kong older adults. Methods: 490 older adults aged 50-80 years completed assessments from March to July 2021. Health Literacy Survey Questionnaire Short Form 12 questions (HLS-SF12), Montreal Cognitive Assessment (MoCA), Senior Fitness Test (SFT) and 12-Item Short-Form Health Survey version 2 (SF-12v2) were used to assess HL, CF, PF and HRQoL, respectively. Path analysis tested a model with HL mediating CF/PF predictors and HRQoL outcome. Results: Results for direct effects indicated that CF significantly associated with PF (ß = 0.115, SE = 0.012, p < 0.001), PF significantly connected to HL (ß = 0.101, SE = 0.022, p < 0.001), and HL significantly related to HRQoL (ß = 0.457, SE = 0.049, p < 0.001). Meanwhile, PF significantly linked to HRQoL directly (ß = 0.156, SE = 0.025, p < 0.001) as well as indirectly (ß = 0.046, 95% CI [0.028, 0.067]). Significant mediating effect of HL was found on the relationship of PF and HRQoL. Conclusion: Findings confirm CF and PF joint impacts on HL and HRQoL in older adults, elucidating HL's mediating role in translating functionality levels into HRQoL. Fostering enduring health knowledge access may thus buffer effects of age-related declines on well-being. Results can inform interventions leveraging this pathway to promote resilient trajectories.

Prospective association between 24-hour movement behaviors and mental health among overweight/obese college students: a compositional data analysis approach.

Background: 24-h movement behaviors, including light physical activity (LPA), moderate-to-vigorous physical activity (MVPA), screen-based sedentary behavior (SSB), non-screen-based sedentary behavior (NSB) and sleep are crucial components affecting mental health. This study aimed to examine the associations of movement behaviors with mental health outcomes among overweight/obese college students using a compositional data analysis approach. Methods: Using a prospective design, 437 Chinese college students (20.1 ± 1.7 years, 51.7% female) completed a two-wave online data collection, where demographics and movement behaviors (LPA, MVPA, SSB, NSB, sleep) were collected at baseline, while depression, anxiety and stress were measured at the 2-month follow-up (Apr-Jul 2022). Compositional data analyses were implemented using R. Results: Depression, anxiety, and stress were negatively associated with time spent in MVPA and sleep (p < 0.001) and positively associated with time spent in SSB and NSB (p < 0.001). Reallocating 15 min to MVPA from LPA, SSB and NSB predicted improvements in depression (LPA: -0.234 unit; SSB: -0.375 unit; NSB: -0.249 unit), anxiety (LPA: -0.092 unit; SSB: -0.284 unit; NSB: -0.165 unit), and stress (LPA: -0.083 unit; SSB: -0.312 unit; NSB: -0.191 unit). For dose-response relationships of 5-55 min isotemporal substitution, when time was reallocated to MVPA from LPA, NSB, and SSB, the estimated detriments to mental health were larger in magnitude than the estimated benefits of time reallocation from MVPA to LPA, NSB, and SSB. Conclusion: The findings emphasize the importance of participating in MVPA to improve mental health in overweight/obese college students during the post-COVID-19 era. The compositional analysis produced clear targets for the time allocation of these behaviors for future interventions and policymaking.

Preparation and Properties of Cyanobacteria-Based Carbon Quantum Dots/Polyvinyl Alcohol/ Nanocellulose Composite.

Blue luminescent carbon quantum dots (CQDs) were prepared from cyanobacteria by a hydrothermal method. The PL quantum yields of the obtained CQDs was 5.30%. Cyanobacteria-based carbon quantum dots/polyvinyl alcohol/nanocellulose composite films were prepared, which could emit bright blue under UV light. FTIR characterization showed that the composite films had hydroxyl groups on the surface and no new groups were formed after combining the three materials. The photoluminescence (PL) spectra revealed that the emission of the prepared CQDs was excitation dependent. Studies on the water resistance performance and light barrier properties of the composite films showed that they possessed higher water resistance properties and better UV/infrared light barrier properties. Therefore, we report the cyanobacteria-based carbon quantum dots/polyvinyl alcohol/nanocellulose composite films have the potential to be applied in flexible packaging materials, anti-fake materials, UV/infrared light barrier materials and so on.

The complete mitochondrial genome of the jumping grasshopper Sinopodisma pieli (Orthoptera: Acrididae) and the phylogenetic analysis of Melanoplinae.

In this study, we reported the complete mitochondrial genome (mitogenome) of Sinopodisma pieli by polymerase chain reaction method for the first time, the type species of the genus Sinopodisma. Its mitogenome was a circular DNA molecule of 15,625 bp in length, with 76.0% A+T, and contained 13 protein-coding genes, 22 transfer RNA genes and two ribosomal RNA genes and one A+T control region. The overall base composition of the S. pieli mitogenome was 42.8% for A, 33.2% for T, 13.5% for C, and 10.5% for G, respectively. All 13 mitochondrial PCGs shared the start codon ATN. Twelve of the PCGs ended with termination codon TAA and TAG, while cytochrome coxidase subunit 1 (COI) utilized an incomplete T as terminator codon. All tRNA genes could be folded into the typical cloverleaf secondary structure, except trnS(AGN) lacking of dihydrouridine arm. The sizes of the large and small ribosomal RNA genes were 1379 bp and 794 bp, respectively. The A+T rich region was 798 bp in length and contained 88.5% AT content. A phylogenetic analysis based on 13 PCGs by using Bayesian inference (BI) and maximum likelihood (ML) revealed that Sinopodisma is not monophyletic group. We think that the name and taxonomic status of S. tsinlingensis are right, and it should not be moved into the genus Pedopodisma. These data will provide important information for a better understanding of the population genetics and species identification for Sinopodisma.