Papers and patents are becoming less disruptive over time.

Theories of scientific and technological change view discovery and invention as endogenous processes1,2, wherein previous accumulated knowledge enables future progress by allowing researchers to, in Newton's words, 'stand on the shoulders of giants'3-7. Recent decades have witnessed exponential growth in the volume of new scientific and technological knowledge, thereby creating conditions that should be ripe for major advances8,9. Yet contrary to this view, studies suggest that progress is slowing in several major fields10,11. Here, we analyse these claims at scale across six decades, using data on 45 million papers and 3.9 million patents from six large-scale datasets, together with a new quantitative metric-the CD index12-that characterizes how papers and patents change networks of citations in science and technology. We find that papers and patents are increasingly less likely to break with the past in ways that push science and technology in new directions. This pattern holds universally across fields and is robust across multiple different citation- and text-based metrics1,13-17. Subsequently, we link this decline in disruptiveness to a narrowing in the use of previous knowledge, allowing us to reconcile the patterns we observe with the 'shoulders of giants' view. We find that the observed declines are unlikely to be driven by changes in the quality of published science, citation practices or field-specific factors. Overall, our results suggest that slowing rates of disruption may reflect a fundamental shift in the nature of science and technology.

A multi-year science research or engineering experience in high school gives women confidence to continue in the STEM pipeline or seek advancement in other fields: A 20-year longitudinal study.

There remains a large gender imbalance in the science, technology, engineering and mathematics (STEM) workforce deriving from a leaky pipeline where women start losing interest and confidence in science and engineering as early as primary school. To address this disparity, the Science Research & Engineering Program (SREP) at Hathaway Brown School was established in 1998 to engage and expose their all-female high school students to STEM fields through an internship-like multi-year research experience at partnering institutions. We compare data from existing Hathaway Brown School SREP alumnae records from 1998-2018 (n = 495) to Non-SREP students and national datasets (National Center for Educational Statistics, National Science Foundation, and US Census data) to assess how SREP participation may influence persistence in the STEM pipeline and whether SREP alumnae attribute differences in these outcomes to the confidence and skill sets they learned from the SREP experience. The results reveal that women who participate in the SREP are more likely to pursue a major in a STEM field and continue on to a STEM occupation compared to non-SREP students, national female averages, and national subsets. Participants attribute their outcomes to an increase in confidence, establishment of technical and professional skills, and other traits strengthened through the SREP experience. These data suggest that implementing similar experiential programs for women in science and engineering at the high school stage could be a promising way to combat the remaining gender gap in STEM fields.

Utilização de sensores inerciais no teste timed up and go: uma revisão narrativa / Use of inertial sensors in the timed up and go test: a narrative review

O teste funcional Timed Up and Go (TUG) é amplamente utilizado para avaliar o risco de queda, através do equilíbrio e mobilidade, por ser de fácil aplicação e boa reprodutibilidade na prática clínica. Porém, o TUG ainda possui algumas limitações, pois se concentra no tempo total em que o teste é realizado. Uma proposta de avaliação é através da utilização de sensores inerciais, baseados na tecnologia de sistemas microeletromecânicos, e vem sendo muito utilizados para análise do movimento humano. Logo, o objetivo desse estudo foi realizar uma revisão narrativa sobre o uso dos sensores inerciais nas medidas temporais e cinemáticas do TUG e suas subfases. Metodologia: Essa revisão narrativa foi realizada nas bases de dados PubMed, CENTRAL, BVS e PEDro, por meio do vocabulário MeSH entre o período de maio a junho de 2020. Os critérios de inclusão foram estudos que utilizaram sensores inerciais para avaliação de medidas temporais e cinemáticas do TUG e suas subfases. Resultados: Foram incluídos 11 artigos de um total de 2305 achados. Desses, 5 utilizaram os sensores de smartphones. Não houve padronização em relação à quantidade utilizada, nem à fixação e posicionamento. Os sensores conseguiram mostrar diferenças no TUG e suas subfases nas medidas temporais e cinemáticas nos diferentes grupos avaliados. Considerações Finais: Sensores inerciais são capazes de avaliar medidas temporais e cinemáticas do TUG e de suas subfases, mostrando serem ferramentas confiáveis. Entretanto, mesmo obtendo resultados satisfatórios, necessita-se de mais estudos abrangendo uma população maior.

The Timed Up and Go (TUG) functional test is widely used to assess the risk of falling through balance and mobility since it is easy to apply and presents good reproducibility in clinical practice. However, the TUG test still has some limitations, as it focuses on the total time the test is performed. A proposal for evaluation is the use of inertial sensors, based on the microelectromechanical system technology, which has been widely used for the analysis of human movement. Therefore, the objective of this study was to carry out a narrative review on the use of inertial sensors in the temporal and kinematic measurements of TUG and its subphases. Methodology: This narrative review was carried out in the PubMed, CENTRAL, BVS, and PEDro databases using the MeSH vocabulary between the period of May to June 2020. The inclusion criteria were studies using inertial sensors to evaluate temporal and kinematic measurements of the TUG and its subphases. Results: A total of 11 articles were selected from 2305 hits. From these, five (5) used smartphone sensors. There was no standardization regarding the quantity used, nor their fixation and positioning. The sensors were able to show differences in the TUG and its subphases in the temporal and kinematic measurements in the different groups evaluated. Final Considerations: Inertial sensors are capable of evaluating temporal and kinematic measurements of the TUG and its subphases, showing that they are reliable tools. Nevertheless, although satisfactory results were obtained, further studies are needed covering a larger population.

Analyzing the regional economic changes in a high-tech industrial development zone using machine learning algorithms.

The aims are to improve the efficiency in analyzing the regional economic changes in China's high-tech industrial development zones (IDZs), ensure the industrial structural integrity, and comprehensively understand the roles of capital, technology, and talents in regional economic structural changes. According to previous works, the economic efficiency and impact mechanism of China's high-tech IDZ are analyzed profoundly. The machine learning (ML)-based Data Envelopment Analysis (DEA) and Malmquist index measurement algorithms are adopted to analyze the dynamic and static characteristics of high-tech IDZ's economic data from 2009 to 2019. Furthermore, a high-tech IDZ economic efficiency influencing factor model is built. Based on the detailed data of a high-tech IDZ, the regional economic changes are analyzed from the following dimensions: economic environment, economic structure, number of talents, capital investment, and high-tech IDZ's regional scale, which verifies the effectiveness of the proposed model further. Results demonstrate that the comprehensive economic efficiency of all national high-tech IDZs in China is relatively high. However, there are huge differences among different regions. The economic efficiency of the eastern region is significantly lower than the national average. The economic structure, number of talents, capital investment, and economic efficiency of the high-tech IDZs show a significant positive correlation. The economic changes in high-tech IDZs can be improved through the secondary industry, employee value, and funding input. The ML technology applied can make data processing more efficient, providing proper suggestions for developing China's high-tech industrial parks.

Is a flick-through enough? A content analysis of Advanced Driver Assistance Systems (ADAS) user manuals.

Advanced Driver Assistance Systems (ADAS) are being developed and installed in increasing numbers. Some of the most popular ADAS include blind spot monitoring and cruise control which are fitted in the majority of new vehicles sold in high-income countries. With more drivers having access to these technologies, it is imperative to develop policy and strategies to guarantee the safe uptake of ADAS. One key issue is that ADAS education has been primarily centred on the user manual which are not widely utilised. Moreover, it is unclear if user manuals are an adequate source of education in terms of content and readability. To address this research gap, a content analysis was used to assess the differences in ADAS-related content and readability among the manuals of the highest selling vehicles in Australia. The qualitative findings showed that there are seven themes in the user manuals: differences between driving with and without ADAS, familiarisation requirements, operational limits of the ADAS, potential ADAS errors, behaviour adaptation warnings, confusion warnings, and malfunction warnings. The quantitative analysis found that some of the manuals require several years of education above the recommended for a universal audience (>8 years) to be understood. Additionally, there is a notable number of text diversions and infographics which could make comprehension of the user manual difficult. This investigation shows that there is a lack of standardisation of ADAS user manuals (in both content and delivery of information) which requires regulatory oversight. Driver ADAS education needs to be prioritised by policymakers and practitioners as smart technology continues to increase across the transport system. It seems that current strategies based on user manuals are insufficient to achieve successful adoption and safe use of these technologies.

Digital adherence technology for tuberculosis treatment supervision: A stepped-wedge cluster-randomized trial in Uganda.

BACKGROUND: Adherence to and completion of tuberculosis (TB) treatment remain problematic in many high-burden countries. 99DOTS is a low-cost digital adherence technology that could increase TB treatment completion. METHODS AND FINDINGS: We conducted a pragmatic stepped-wedge cluster-randomized trial including all adults treated for drug-susceptible pulmonary TB at 18 health facilities across Uganda over 8 months (1 December 2018-31 July 2019). Facilities were randomized to switch from routine (control period) to 99DOTS-based (intervention period) TB treatment supervision in consecutive months. Patients were allocated to the control or intervention period based on which facility they attended and their treatment start date. Health facility staff and patients were not blinded to the intervention. The primary outcome was TB treatment completion. Due to the pragmatic nature of the trial, the primary analysis was done according to intention-to-treat (ITT) and per protocol (PP) principles. This trial is registered with the Pan African Clinical Trials Registry (PACTR201808609844917). Of 1,913 eligible patients at the 18 health facilities (1,022 and 891 during the control and intervention periods, respectively), 38.0% were women, mean (SD) age was 39.4 (14.4) years, 46.8% were HIV-infected, and most (91.4%) had newly diagnosed TB. In total, 463 (52.0%) patients were enrolled on 99DOTS during the intervention period. In the ITT analysis, the odds of treatment success were similar in the intervention and control periods (adjusted odds ratio [aOR] 1.04, 95% CI 0.68-1.58, p = 0.87). The odds of treatment success did not increase in the intervention period for either men (aOR 1.24, 95% CI 0.73-2.10) or women (aOR 0.67, 95% CI 0.35-1.29), or for either patients with HIV infection (aOR 1.51, 95% CI 0.81-2.85) or without HIV infection (aOR 0.78, 95% CI 0.46-1.32). In the PP analysis, the 99DOTS-based intervention increased the odds of treatment success (aOR 2.89, 95% CI 1.57-5.33, p = 0.001). The odds of completing the intensive phase of treatment and the odds of not being lost to follow-up were similarly improved in PP but not ITT analyses. Study limitations include the likelihood of selection bias in the PP analysis, inability to verify medication dosing in either arm, and incomplete implementation of some components of the intervention. CONCLUSIONS: 99DOTS-based treatment supervision did not improve treatment outcomes in the overall study population. However, similar treatment outcomes were achieved during the control and intervention periods, and those patients enrolled on 99DOTS achieved high treatment completion. 99DOTS-based treatment supervision could be a viable alternative to directly observed therapy for a substantial proportion of patients with TB. TRIAL REGISTRATION: Pan-African Clinical Trials Registry (PACTR201808609844917).

Factors influencing US speech and language therapists' use of technology for clinical practice.

BACKGROUND: There is an increasing number of technological resources available to speech and language therapists (SLTs) for use in clinical practice, but the factors that influence SLTs' selection and use of such resources are not well understood. In related fields, technology acceptance models have been employed to explain users' adoption of technology and to inform the advancement of empirically supported technological resources. AIMS: To determine the factors that influence SLTs' use of technology for clinical practice by testing a model of their technology acceptance and use. METHODS & PROCEDURES: We surveyed 209 practising SLTs in the United States representative of the speech and language membership of the American Speech-Language-Hearing Association (ASHA). Participants completed a 38-item electronic survey representing four categories: (1) technology use, (2) technology attitudes and factors influencing technology use, (3) employment information and (4) demographics. Items measuring technology attitudes served as indicators of the research model, which mapped the primary relationships of a technology acceptance model. Survey data were collected before the Covid-19 pandemic. OUTCOMES & RESULTS: The research model accounted for 66% of the variance in SLTs' behavioural intention to use technology, which significantly and positively predicted the amount of time they reportedly spent using technology in the workplace. Subjective norms and attitudes towards technology use directly predicted the intention to use technology. Perceived usefulness and ease of use indirectly predicted intention to use technology. Survey respondents reported using technology during 48% (SD = 24%) of their overall weekly work hours on average, with a large majority reporting using technology at least once per week for planning (89% of respondents), assessment (66% of respondents) or intervention (90% of respondents). CONCLUSIONS & IMPLICATIONS: These findings statistically explain the relationships between SLTs' attitudes and their intention to use technology for clinical practice, contributing to our understanding of why SLTs adopt certain technologies. We also detail the nature and frequency of technology use in the clinical practice of SLTs. Future directions for this work include further exploring use categories, employing direct measurements of technology use and exploring the impact of recent changes in SLT service delivery due to the Covid-19 pandemic on SLTs' technology attitudes. What this paper adds What is already known on the subject Existing research about the adoption and use of technological resources by SLTs indicates that they select tools based on convenience, cost and recommendations by others. What this paper adds to existing knowledge This study is the first to develop and test a research model of SLTs' technology attitudes. The findings from model testing demonstrate the significant predictors of SLTs' behavioural intention to use technology for clinical purposes. Intent of use is related to how much SLTs use technology in the workplace. What are the potential or actual clinical implications of this work? The present findings can inform interventions targeting the design and adoption of electronic SLT resources that are empirically supported.

Associations Between Physical Distancing and Mental Health, Sexual Health and Technology Use Among Gay, Bisexual and Other Men Who Have Sex With Men During the COVID-19 Pandemic.

Physical distancing measures, designed to limit the spread of COVID-19, have been implemented globally. We sought to understand how physical distancing impacts gay, bisexual and other men who have sex with men (GBMSM), a group disproportionately affected by poor health outcomes. A cross-sectional online survey on Hornet, a networking application (N = 10,079), measured sociodemographics, physical distancing, mental health outcomes, and sexual behavior. Nearly two-thirds of participants (63%) reported only leaving their home for essentials. Those who practiced physical distancing were more likely to feel anxious (aOR = 1.37), feel lonely (aOR = 1.36), to report their sex life being impacted (aOR = 2.95), and less likely to be satisfied with their current sex life (aOR = 0.76). Those who practiced physical distancing were more likely to use social technologies to stay in touch with others. Risk reduction and telehealth opportunities may alleviate health challenges for GBMSM in the COVID-19 era.

Socioeconomic deprivation, technology use, C-peptide, smoking and other predictors of glycaemic control in adults with type 1 diabetes.

AIMS: Intensive glycaemic control is associated with substantial health benefits in people with type 1 diabetes. We sought to examine clinical and demographic factors associated with meeting glycaemic targets in type 1 diabetes. METHODS: We conducted a cross-sectional analysis of 4594 individuals with type 1 diabetes. The primary outcome of the study was assessing factors associated with meeting HbA1c targets. Secondary endpoints included factors associated with continuous subcutaneous insulin infusion (CSII) use and persistent C-peptide secretion. RESULTS: Socioeconomic deprivation was strongly associated with a lower likelihood of achieving an HbA1c <58 mmol/mol (7.5%) (20% in the most deprived quintile vs. 40% in the least deprived, p < 0.001). In multivariate analysis, absence of smoking history (OR 3.06, p < 0.001), flash monitoring (OR 1.49, p < 0.001), CSII (1.43, p = 0.022) and longer diabetes duration (OR 1.02 per year, p = 0.004) were independently associated with achieving HbA1c <58 mmol/mol (7.5%), whereas increasing age (OR 0.99 per year, p = 0.004) and C-peptide <50 pM (OR 0.58, p < 0.001) were associated with a lower likelihood of meeting this target. Low C-peptide (<50 pM) was less likely in men (OR 0.55, p < 0.001) and never smokers (0.44, p < 0.001) in multivariate analysis. CONCLUSIONS: Lower levels of deprivation, non-smoking, higher C-peptide, technology use, lower BMI and male gender were all associated with a higher likelihood of meeting HbA1c targets. Access to proven diabetes treatments is lower in the most deprived individuals. Urgent efforts are required to provide treatments which are effective across the socioeconomic gradient.

Older Adults' Engagement in Technology-Mediated Self-Monitoring of Diet: A Mixed-Method Study.

PURPOSE: This feasibility study explored older adults' use of a nutrition app called Appetitus (https://apps.apple.com/us/app/appetitt/id1001936854?ign-mpt=uo%3D2; https://play.google.com/store/apps/details?id=no.nr.appetitt&hl=e) and addressed their engagement in technology-mediated self-monitoring of diet. Undernutrition is a significant challenge among older adults and is associated with poorer health experiences. Digital health for self-monitoring of diet has the potential to increase awareness of personal nutrition, and the scarcity of research reporting older adults' ability and willingness to engage in technology-mediated dietary self-monitoring warranted this study. DESIGN AND METHODS: An explorative mixed-methods design combining descriptive analysis of log data with qualitative analysis of interviews with Appetitus users was implemented. FINDINGS: Twenty-five older adults self-monitored their diet using Appetitus over an 8-week trial period. Eighty percent of the participants used the app regularly in the trial period. The most engaged users recorded their food consumption daily for 8 weeks. Personal interest in nutrition and commitment to the project facilitated regular use of Appetitus. Poor health and the perception that using a nutrition app lacked personal relevance contributed to irregular self-monitoring. For inexperienced technology users, participation in this project became a springboard to using tablet technology and the Internet beyond the Appetitus app. CONCLUSIONS: The majority of the participants regularly used Appetitus for self-monitoring of diet; they found the tablet technology and Appetitus app easy to use. CLINICAL RELEVANCE: Older adults are able and willing to use self-monitoring tools. Nutrition apps can empower older adults to make better informed decisions about their diet. Patients' self-monitoring can provide valuable and detailed health-related information to healthcare professionals and mediate patient-centered care practices.

Financial Development and Environmental Regulations: The Two Pillars of Green Transformation in China.

Awareness of the influence of environmental regulations and financial development on green technological progress by Chinese enterprises will help to promote the green transformation of China's economy, thereby comprehensively enhancing the quality and competitiveness of its economic development. This paper constructs a theoretical framework to analyze environmental regulation, financial development, and green technological progress and studies the relationship among these three indicators using 2004-2018 data from Shandong province. The results show that environmental regulations and financial development both play roles in promoting green technological progress, but as environmental regulation becomes stronger, the effects of finance on green technological progress begin to differ across regions. The results partially verify the applicability of the Porter hypothesis in China, providing a reference for all levels of government to formulate scientific and reasonable environmental rules and policies.

Using the technology acceptance model to explore health provider and administrator perceptions of the usefulness and ease of using technology in palliative care.

BACKGROUND: Studies have shown that telehealth applications in palliative care are feasible, can improve quality of care, and reduce costs but few studies have focused on user acceptance of current technology applications in palliative care. Furthermore, the perspectives of health administrators have not been explored in palliative care and yet they are often heavily involved, alongside providers, in the coordination and use of health technologies. The study aim was to explore both health care provider and administrator perceptions regarding the usefulness and ease of using technology in palliative care. METHODS: The Technology Acceptance Model (TAM) was used as the guiding theoretical framework to provide insight into two key determinants that influence user acceptance of technology (perceived usefulness and ease of use). Semi-structured interviews (n = 18) with health providers and administrators with experience coordinating or using technology in palliative care explored the usefulness of technologies in palliative care and recommendations to support adoption. Interview data were analyzed using inductive thematic analysis to identify common, meaningful themes. RESULTS: Four themes were identified; themes related to perceived usefulness were: enabling remote connection and information-sharing platform. Themes surrounding ease of use included: integration with existing IT systems and user-friendly with ready access to technical support. Telehealth can enable remote connection between patients and providers to help address insufficiencies in the current palliative care environment. Telehealth, as an information sharing platform, could support the coordination and collaboration of interdisciplinary providers caring for patients with palliative needs. However, health technologies need to passively integrate with existing IT systems to enhance providers' workflow and productivity. User-friendliness with ready access to technical support was considered especially important in palliative care as patients often experience diminished function. CONCLUSION: Participants' perspectives of technology acceptance in palliative care were largely dependent on their potential to help address major challenges in the field without imposing significant burden on providers and patients.

Intergenerational Effects on the Impacts of Technology Use in Later Life: Insights from an International, Multi-Site Study.

As the use of technology becomes further integrated into the daily lives of all persons, including older adults, it is important to investigate how the perceptions and use of technology intersect with intergenerational relationships. Based on the international multi-centered study Technology In Later Life (TILL), this paper emphasizes the perceptions of older adults and the interconnection between technology and intergenerational relationships are integral to social connectedness with others. Participants from rural and urban sites in Canada and the UK (n = 37) completed an online survey and attended a focus group. Descriptive and thematic analyses suggest that older adults are not technologically adverse and leverage intergenerational relationships with family and friends to adjust to new technologies and to remain connected to adult children and grandchildren, especially when there is high geographic separation between them. Participants referenced younger family members as having introduced them to, and having taught them how to use, technologies such as digital devices, computers, and social networking sites. The intergenerational support in the adoption of new technologies has important implications for helping older persons to remain independent and to age in place, in both age-friendly cities and in rural communities. The findings contribute to the growing literature in the fields of gerontology and gerontechnology on intergenerational influences and the impacts of technology use in later life and suggest the flexibility and willingness of older persons to adopt to new technologies as well as the value of intergenerational relationships for overcoming barriers to technology adoption.

A Cultural Psychological Model of Cross-National Variation in Gender Gaps in STEM Participation.

Gender gaps in Science, Technology, Engineering, and Mathematics (STEM) participation are larger in societies where women have greater freedom of choice. We provide a cultural psychological model to explain this pattern. We consider how individualistic/post-materialistic cultural patterns in WEIRD (Western, Educated, Industrial, Rich, and Democratic) settings foster a self-expressive construction of academic choice, whereby affirming femininity/masculinity and ensuring identity fit become primary goals. Striving to fulfill these goals can lead men toward, and women away from, STEM pursuit, resulting in a large gender gap. In Majority World settings, on the contrary, collectivistic/materialistic cultural patterns foster a security-oriented construction, whereby achieving financial security and fulfilling relational expectations become primary goals of academic choice. These goals can lead both women and men toward secure and lucrative fields like STEM, resulting in a smaller gender gap. Finally, gender gaps in STEM participation feed back into the STEM=male stereotype. We discuss the implications of our model for research and theory, and intervention and policy.

Characterizing Intervention Opportunities among Home-Delivered Meals Program Participants: Results from the 2017 National Survey of Older Americans Act Participants and a New York City Survey.

BACKGROUND: The Home Delivered Meals Program (HDMP) serves a vulnerable population of adults aged 60 and older who may benefit from technological services to improve health and social connectedness. OBJECTIVE: The objectives of this study are (a) to better understand the needs of HDMP participants, and (b) to characterize the technology-readiness and the utility of delivering information via the computer. DESIGN: We analyzed data from the 2017 NSOAAP to assess the health and functional status and demographic characteristics of HDMP participants. We also conducted a telephone survey to assess technology use and educational interests among NYC HDMP participants. MEASUREMENTS: Functional measures of the national sample included comorbidities, recent hospitalizations, and ADL/IADL limitations. Participants from our local NYC sample completed a modified version of the validated Computer Proficiency Questionnaire. Technology readiness was assessed by levels of technology use, desired methods for receiving health information, and interest in learning more about virtual senior centers. RESULTS: About one-third (32.4%) of national survey HDMP participants (n=902) reported insufficient resources to buy food and 17.1% chose between food or medications. Within the NYC HDMP participant survey sample (n=33), over half reported having access to the internet (54.5%), 48.5% used a desktop or laptop, and 30.3% used a tablet, iPad, or smartphone. CONCLUSION: The HDMP provides an opportunity to reach vulnerable older adults and offer additional resources that can enhance social support and improve nutrition and health outcomes. Research is warranted to compare technological readiness of HDMP participants across urban and rural areas in the United States.

Synergy effects and it's influencing factors of China's high technological innovation and regional economy.

The Chinese government adheres to the innovation driven strategy and emphasizes that technological innovation is the strategic support for improving social productivity and comprehensive national strength. This paper discusses the mechanism of technological innovation and regional economic co-evolution, and constructs an index system to assess them based on the principles of synergy and systematics. The authors use a dynamic coupling model to study the law of the cooperative evolution of composite systems and geo-detector methods to reveal the main factors controlling the degree of coordination among them. The results show that the total factor productivity of China's high-tech industry showed a "W"-type trend of change from 2006 to 2016, and the other indices exhibited a volatile trend. The total factor productivity, technical efficiency, scale efficiency, pure technical efficiency, and technological progress increased by 37%, 13.3%, 3.9%, 9%, and 20.8%, respectively. There was a significant spatial difference in changes in total factor productivity, forming a core-edge spatial pattern with the middle and upper reaches of the Yangtze River as the center of concentration. Most of China's technological innovation and regional economic complex systems were in a state of interactive development from 2007 to 2016, except in the three northeastern provinces of Zhejiang, Shanghai, and the western part of the country. The degree of coupling of the other provinces showed an increasing trend, and the overall degree of coupling exhibited the spatial pattern of Central > Eastern > Western > Northeastern. The three most influential factors for the degree of coupling of China's provincial complex system were the gross domestic product, efficiency of technological innovation, and expenditure on research and development, whereas the three most important factors affecting the degree of coupling of complex systems were the efficiency of technological innovation, gross domestic product, and number of high-tech enterprises as well as research and development personnel, respectively, in the eastern, central, western, and northeastern regions. Finally, the paper puts forward the suggestions of regional innovation driven coordinated development, technology innovation and regional economic coordinated development, in order to provide reference for the high-quality economic development of developing countries.

Complex economic activities concentrate in large cities.

Human activities, such as research, innovation and industry, concentrate disproportionately in large cities. The ten most innovative cities in the United States account for 23% of the national population, but for 48% of its patents and 33% of its gross domestic product. But why has human activity become increasingly concentrated? Here we use data on scientific papers, patents, employment and gross domestic product, for 353 metropolitan areas in the United States, to show that the spatial concentration of productive activities increases with their complexity. Complex economic activities, such as biotechnology, neurobiology and semiconductors, concentrate disproportionately in a few large cities compared to less--complex activities, such as apparel or paper manufacturing. We use multiple proxies to measure the complexity of activities, finding that complexity explains from 40% to 80% of the variance in urban concentration of occupations, industries, scientific fields and technologies. Using historical patent data, we show that the spatial concentration of cutting-edge technologies has increased since 1850, suggesting a reinforcing cycle between the increase in the complexity of activities and urbanization. These findings suggest that the growth of spatial inequality may be connected to the increasing complexity of the economy.

Adolescent sleep and technology-use rules: results from the California Health Interview Survey.

OBJECTIVES: This study reports on adolescent sleep, technology-use rules at home, and their potential association using the 2017 California Health Interview Survey (CHIS). METHODS: CHIS cross-sectional, representative survey data was collected between June-December 2017 via telephone. Weekday bedtimes, rise times, and night time in bed in the past week, as well as whether technology-use rules were implemented at home, were examined among 448 adolescent residents of California (mean age = 14.5, range = 12-17; 48% women). RESULTS: The average weekday nightly time in bed was 9.04 hours among 12- to 13-year-olds and 7.89 hours among 14- to 17-year-olds. The majority reported having technology-use rules and those who did, spent 35 more minutes in bed. Although a significant relationship was found between having technology-use rules and earlier bedtime, one was not found for time in bed, when controlling for demographics. CONCLUSIONS: Many California adolescents do not meet recommended sleep guidelines. Yet, technology-use rules appear to be associated with earlier bedtime. Results have implications for policy-making and adolescent sleep interventions.