Development of an optimal short form of the GAD-7 scale with cross-cultural generalizability based on Riskslim.

Despite the relatively small number of items in the GAD-7, fewer items are increasingly sought to shorten testing time in large-scale mental health screenings. As a result, short forms based on the GAD-7, the GAD-2, and GAD-mini, have become popular. However, the GAD-2 and GAD-mini have reported lower diagnostic accuracy in some cultural contexts, implying that a validated short-form version of the GAD-7 may be lacking in large-scale cross-cultural anxiety screening. Based on this, to develop an optimal short form of the GAD-7 with cross-cultural stability, we utilized seven GAD-7 datasets from six different countries, totaling 47,484 participants. Five 2 to 6 item short forms of the GAD were constructed using the Riskslim machine learning algorithm. We evaluated the diagnostic accuracy of the GAD-7 short forms in the training and test sets based on the coefficient of determination(R2) and area under the curve(AUC) metrics, and the results showed that GAD-R2 performed poorly in some cultures, and all of the 3 to 6 item short forms of the GAD performed good in cross-cultural diagnostic rates, with the GAD-R6 showing the highest diagnostic accuracy in all cultures; GAD-R3 outperformed GAD-R2, GAD-2, and GAD-mini in all cultures; GAD-R3 had higher generalizability across cultures and special populations; Given that the GAD-R3 was shorter and nearly as accurate as the GAD-R6, we recommend the use of the GAD-R3 in clinical studies and epidemiologic investigations. And we recommend the optimal actual cutoff value of 15 for GAD-R3. Overall, we recommend GAD-R3 as the short-form version of GAD-7 in cross-cultural studies. However, the 2-item GAD scale is also optimal for the short-form version in clinical practice.

Tri-objective optimization of a waste-to-energy plant with super critical carbon dioxide and multi-effect water desalination for building application based on biomass fuels.

In the present research, an innovative biomass-based energy system for the production of electricity and desalinated water for building application is proposed. The main subsystems of this power plant include gasification cycle, gas turbine (GT), supercritical carbon dioxide cycle (s-CO2), two-stage organic Rankine cycle (ORC) and MED water desalination unit with thermal ejector. A comprehensive thermodynamic and thermoeconomic evaluation is performed on the proposed system. For the analysis, first the system is modeled and analyzed from the energy point of view, then it is examined similarly from the exergy point of view, and then an economic analysis (exergy-economic analysis) is performed on the system. Then, we repeat the mentioned cases for several types of biomasses and compare them with each other. Grossman diagram will be presented to better understand the exergy of each point and its destruction in each component of the system. After energy, exergy and economic modeling and analysis, the system is analyzed and modeled using artificial intelligence to help the system optimization process, and the model obtained with genetic algorithm (GA) to maximize the output power of the system, minimize the cost system and maximizing the rate of water desalination is optimized. The basic analysis of the system is analyzed inside the EES software, then it is transferred to the MATLAB software to optimize and check the effect of operational parameters on the thermodynamic performance and the total cost rate (TCR). It is analyzed and modeled artificially and this model is used for optimization. The obtained result will be three-dimensional Pareto front for single-objective and double-objective optimization, for work-output-cost functions and sweetening-cost rate with the specified value of the design parameters. In the single-objective optimization, the maximum work output, the maximum rate of water desalination, and the minimum TCR will be 55,306.89 kW, 17216.86 m3/day, and $0.3760/s, respectively.

Self-medication in Chinese residents and the related factors of whether or not they would take suggestions from medical staff as an important consideration during self-medication.

Objective: To investigate the status of Chinese residents' self-medication behavior and the important factors to consider when purchasing OTC drugs, and to explore the related factors of the possibility that Chinese residents take medical staff's suggestions as important factors to consider when purchasing OTC drugs. Study design: A cross-sectional survey. Methods: A questionnaire was developed for exploring the sociodemographic characteristics of the respondents, their self-medication status, and important considerations. The questionnaire includes several scales including Health Literacy Scale-Short Form (HLS-SF), EQ-5D Visual Analog Scale (EQ-5D-VAS), Big Five Inventary-10 Items (BFI-10), and New General Self Efficacy Scale (NGSES). After carrying out a multi-stage sampling method, the questionnaire was conducted nationwide from July 10 to September 15, 2021. Next, descriptive statistics were conducted to analyze the general features. Logistic regression was then used to analyze the related factors of the possibility that the respondents took the suggestions of medical staff as an important consideration when purchasing OTC drugs. Results: Nine thousand two hundred fifty-six qualified questionnaires were received. 99.06% of Chinese adults had self-medication behaviors. The types of OTC drugs purchased most by the respondents were NSAIDs (5,421/9,256 people, 58.57%) and vitamins/minerals (4,851/9,256 people, 52.41%). 86.2% of the respondents took the suggestions of medical staff as an important consideration when purchasing OTC drugs. The results of multi-factor logistic regression showed that women, those living in the central and western regions of China, those suffering from chronic diseases, those with high agreeableness, high conscientiousness, high neuroticism and openness, high health literacy, high EQ-5D-VAS, and those with high self-efficacy are more likely to take medical staff's suggestions as important factors to consider. Conclusion: The vast majority of Chinese adults have self-medication behavior. Important considerations when purchasing OTC drugs include medical staff's suggestions, drug safety and drug efficacy. Whether residents take the suggestions of medical staff as an important consideration is related to their sociological characteristics, agreeableness, conscientiousness, neuroticism, openness, health literacy, self-assessment health status, and self-efficacy. When purchasing and using OTC drugs, residents should carefully listen to the suggestions from medical staff. They should also carefully consider their own conditions before buying OTC drugs.