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One of the challenges of population aging is the rising demand of elder care. Adult children fill a substantial portion of this care need. To understand its implication on their labor market choices and welfare outcomes, we build a simple static model where households can spend time and money producing care. We calibrate the model using data from the American Community Survey, the Health and Retirement Study, and National Health and Aging Trends Study/National Study of Caregiving to match moments in the labor market and caregiving patterns. With the calibrated model, we consider a few government programs under a projected aging population structure. Our results show that care subsidy and Medicaid expansion both cause a shift from informal care to formal care, relieving adult children from care burdens and thus improving their welfare. Caregiver allowance appears to have little effects on caregiving behaviors, which leads to minimal welfare improvement.
The existing single-mode posture adjustment equipment for solar wing docking is only suitable for a limited number of satellite dimensions; it could not meet the diverse development trends of satellite models. The working range requirements are different when different-sized satellites dock with the solar wing, and the docking process is divided into two stages in this paper. While the DOFs required for the two stages are different, a movable heavy-load reconfigurable redundant posture adjustment platform (RrPAP) with dual motion modes is proposed in this paper. The RrPAP consists of a wheeled mobile platform and a reconfigurable parallel posture adjustment mechanism (PAM). The micro-motion PAM limb types are synthesized, and the comprehensive load-bearing index is proposed to select the mechanism types for heavy-load conditions. A decentralized four-limb six-degree-of-freedom (6-DOF) parallel micro-motion PAM is designed. In the macro-motion stage, for the PAM to still have a defined motion after being released from ground constraints, a serial coupling sub-chain is designed between adjacent limbs to restrict relative movement between them. A type synthesis method for symmetrically coupled mechanisms based on mechanism decoupling and motion distribution is proposed. Four types of symmetrically coupled mechanisms with multi-loop consisting of serial coupling sub-chains are synthesized by using this method. The feasibility of the proposed method is demonstrated through an example using the constraint synthesis method based on screw theory. This work provides a foundation for subsequent refinement and expansion of type synthesis theories and the selection of new types of mechanisms.
This paper retrospectively analysed the prevalence of macrolide-resistant Mycoplasma pneumoniae (MRMP) in some parts of China. Between January 2013 and December 2019, we collected 4,145 respiratory samples, including pharyngeal swabs and alveolar lavage fluid. The highest PCR-positive rate of M. pneumoniae was 74.5% in Beijing, the highest resistance rate was 100% in Shanghai, and Gansu was the lowest with 20%. The highest PCR-positive rate of M. pneumoniae was 74.5% in 2013, and the highest MRMP was 97.4% in 2019; the PCR-positive rate of M. pneumoniae for adults in Beijing was 17.9% and the MRMP was 10.48%. Among the children diagnosed with community-acquired pneumonia (CAP), the PCR-positive and macrolide-resistant rates of M. pneumoniae were both higher in the severe ones. A2063G in domain V of 23S rRNA was the major macrolide-resistant mutation, accounting for more than 90%. The MIC values of all MRMP to erythromycin and azithromycin were ≥ 64 μg/ml, and the MICs of tetracycline and levofloxacin were ≤ 0.5 μg/ml and ≤ 1 μg/ml, respectively. The macrolide resistance varied in different regions and years. Among inpatients, the macrolide-resistant rate was higher in severe pneumonia. A2063G was the common mutation, and we found no resistance to tetracycline and levofloxacin.
Head-up tilt test (HUTT) is an important tool in the diagnosis of pediatric vasovagal syncope. This research will explore the relationship between syncopal symptoms and HUTT modes in pediatric vasovagal syncope.
Methods:
A retrospective analysis was performed on the clinical data of 2513 children aged 3–18 years, who were diagnosed with vasovagal syncope, from Jan. 2001 to Dec. 2021 due to unexplained syncope or pre-syncope. The average age was 11.76 ± 2.83 years, including 1124 males and 1389 females. The patients were divided into the basic head-up tilt test (BHUT) group (596 patients) and the sublingual nitroglycerine head-up tilt test (SNHUT) group (1917 patients) according to the mode of positive HUTT at the time of confirmed pediatric vasovagal syncope.
Results:
(1) Baseline characteristics: Age, height, weight, heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), and composition ratio of syncope at baseline status were higher in the BHUT group than in the SNHUT group (all P < 0.05). (2) Univariate analysis: Age, height, weight, HR, SBP, DBP, and syncope were potential risk factors for BHUT positive (all P < 0.05). (3) Multivariate analysis: syncope was an independent risk factor for BHUT positive, with a probability increase of 121% compared to pre-syncope (P<0.001).
Conclusion:
The probability of BHUT positivity was significantly higher than SNHUT in pediatric vasovagal syncope with previous syncopal episodes.
The two-dimensional snake scanning of the CCD method provides an effective solution to measure small-scale light spots which are smaller than one CCD pixel. The influences of the A/D conversion digits and response uniformity of the CCD on the measurement error are studied. When the A/D conversion digit is 20, the measurement error can be ignored. The maximum error value of the nonuniform response of the CCD pixel when the order of the super-Gaussian function is 10 is 0.7 μm. The research results can be used to guide the experiment.
The comparisons among 126 14C dates of Carex samples including separated leaf and root parts with acid (A)-treatment and acid-base-acid (ABA)-treatment, and 48 published 14C dates of bulk peat plants on a 92-cm core from Jinchuan Mire in NE China, indicate old carbon influence (OCI) on the 14C dates. The OCI varies with plant species, pretreatment and peat depth. In vascular peat plants such as Carex, humin fractions (remains after ABA treatment) and humic acids are representative of the original plant precursor, while fulvic acids are regarded as the secondary mobile product which should be removed for 14C dating. ABA- treatment removes both fulvic acids and humic acids, whereas A-treatment gets rid of only fulvic acids. Carex roots uptake more dissolved CO2 in peat water. Carex leaves may use more CO2 (involving degassing CO2) above the peat surface. By removing humic acids throughout ABA treatment, the OCI may vary differently over depth (time). ABA treatment cannot eliminate the fixed OCI in humin fractions of vascular peat plants, instead, this treatment may enhance OCI by removing humic acid which may represent the true age of the plants. In addition, Bacon model results on this core could not show rapid changes in accumulation rate.
This study was designed to determine whether extended high-frequency audiometry was capable of better differentiating between participants with normal hearing who did or did not have subjective tinnitus.
Methods
A total of 96 study participants were enrolled: 36 patients with unilateral tinnitus, 28 patients with bilateral tinnitus and 32 volunteers as controls. All 96 participants exhibited normal audiometry findings and hearing thresholds. Extended high-frequency audiometry was used to evaluate these patients.
Results
There were differences between the extended high-frequency hearing thresholds of affected and unaffected ears in those with unilateral tinnitus, and in the 20–29-year-old bilateral tinnitus group, at 11.2, 12.5 and 14 kHz. Unilateral tinnitus subgroups had higher extended high-frequency hearing thresholds than those in control subjects, at all extended high frequencies.
Conclusion
Extended high-frequency audiometry can offer additional information regarding the hearing status of patients with tinnitus who exhibit normal pure tone thresholds when analysed via conventional hearing thresholds.
Germplasm innovation can provide materials for breeding sugarcane cultivars. Saccharum officinarum is the main source of high-sugar and high-yield genes in sugarcane breeding. ‘Nobilization’ is the theoretical basis for exploiting S. officinarum, and S. officinarum authenticity directly affects sugarcane nobility breeding efficiency. Herein, the authenticity of 22 SLC-series S. officinarum clones imported from Sri Lanka and preserved in the China National Germplasm Repository of Sugarcane (NGRS) was explored by four-primer amplification-arrested mutation PCR (ARMS PCR) and somatic chromosome number counting. The amplified bands from SLC 08 120 and SLC 08 131 were the same with those from S. officinarum clone Badila, i.e. a common band of 428 bp and a S. officinarum-specific band of 278 bp, hence they were tentatively assigned as S. officinarum clones. The other 20 SLC clones had both 278 bp (S. officinarum-specific) and 203 bp (S. spontaneum-specific) bands, which are hybrid characteristics. In addition, the chromosome numbers of SLC 08 120 and SLC 08 131 are both 80, belong to typical S. officinarum. While the chromosome numbers of the other 20 materials are ranging from 101 to 129, consistent with hybrids of S. officinarum and S. spontaneum. This molecular cytological characterization indicates that among the 22 introduced SLC-series clones, only two, SLC 08 120 and SLC 08 131, were S. officinarum. Future agronomic trait and resistance analyses could facilitate their use as crossing parents in sugarcane breeding.
My 5 moments (M5M) was used less frequently among cleaning staff members, suggesting that a poor compliance score in this group may not indicate deficient handwashing. This quasi-experimental study compared hand hygiene compliance (HHC), hand hygiene (HH) moments, and HH time distribution in the control group (no HH intervention; n = 21), case group 1 (normal M5M intervention; n = 26), case group 2 (extensive novel six moments (NSM) training; n = 24), and case group 3 (refined NSM training; n = 18). The intervention’s effect was evaluated after 3 months. The HHC gap among the four groups gradually increased in the second intervention month (control group, 31.43%; case group 1, 38.74%; case group 2, 40.19%; case group 3, 52.21%; p < 0.05). After the intervention period, the HHC of case groups 2 and 3 improved significantly from the baseline (23.85% vs. 59.22%, 27.41% vs. 83.62%, respectively; p < 0.05). ‘After transferring medical waste from the site’ had the highest HHC in case group 3, 90.72% (95% confidence interval, 0.1926–0.3967). HH peak hours were from 6 AM to 9 AM and 2 PM to 3 PM. The study showed that the implementation of an NSM practice can serve as an HHC monitoring indicator and direct relevant training interventions to improve HH among hospital cleaning staff.
In this paper, we apply standard zooarchaeological methods and novel osteological approaches to analyse faunal remains from five Middle–Late Holocene sites in the southern Tibetan Plateau (STP). Framed by direct radiocarbon dates on taxonomically classified bioarchaeological remains and compared with published palaeoclimate data, our findings revealed a three-stage process of agro-pastoral development in the STP ca. 5.5 to 1.0 ka. In the first phase, habitation was restricted to the lower southeastern part of the plateau and human subsistence essentially based on foraging and low-level pig–millet farming. With the onset of colder and drier climatic conditions ca. 3.8 ka, the study area witnessed a growing human presence at higher elevations in its central and western parts, together with a shift towards bovid husbandry and barley cultivation, that is, agricultural practices that originated in west Asia; these were likely introduced to the STP following the eastern margin of the TP and/or arrived by sub-Himalayan transfer. Climate and ecological degradation might have contributed to the decline of local game in favour of cold-and-dry-tolerant pastoral livestock and crops. Our work shows that Middle–Late Holocene climate change, ecological change, human subsistence shifts, and prehistoric cultural transmissions are intimately connected.
In recent years, bat-associated pathogens, such as 2019 novel coronavirus, have been ravaging the world, and ectoparasites of bats have received increasing attention. Penicillidia jenynsii is a member of the family Nycteribiidae which is a group of specialized ectoparasites of bats. In this study, the complete mitochondrial genome of P. jenynsii was sequenced for the first time and a comprehensive phylogenetic analysis of the superfamily Hippoboscoidea was conducted. The complete mitochondrial genome of P. jenynsii is 16 165 base pairs (bp) in size, including 13 protein-coding genes (PCGs), 22 transfer RNA genes, 2 ribosomal RNA genes and 1 control region. The phylogenetic analysis based on 13 PCGs of the superfamily Hippoboscoidea known from the NCBI supported the monophyly of the family Nycteribiidae, and the family Nycteribiidae was a sister group with the family Streblidae. This study not only provided molecular data for the identification of P. jenynsii, but also provided a reference for the phylogenetic analysis of the superfamily Hippoboscoidea.
One of the most contested issues in international trade negotiations is the level of protection granted to geographical indications (GIs). WTO Members are divided between the ‘Old World’ represented by the European Union and the ‘New World’ headed by the United States. For decades, conventional wisdom has suggested that the debate is indeed a disagreement over the terroir idea. This article tackles the debate from a largely unexplored perspective, namely, fair use exceptions, which allows us to find the opposite: even if countries embraced the terroir idea equally, the divide on protection level would persist because of divergent approaches to the fair use of GIs. This divergence derives from countries’ different preferences for balancing conflicting interests, different policy goals, and different understandings of what is ‘fair’. Other countries should take these considerations into account when choosing a protection level suitable for their national conditions and goals.
This study aimed to identify predictors of limitations in basic activities of daily living (BADL) among people with severe disabilities.
Methods:
4075 long-term care beneficiaries with severe disabilities in Guangzhou, China, were included during July 2018 and March 2019. BADL was assessed using the Barthel index (BI). Muscle strength was measured by using the Lovett Rating Scale. Age, gender, comorbidities, and muscle strengths were collected as independent variables. Chi-square Automatic Interaction Detector (CHAID) method was used to examine associations between independent variables and item scores of the BI.
Results:
Muscle strength and history of stroke were parent node and child node for most of BADL limitations, respectively. Upper limb muscle strength (≤ 3) was a major predictor for dependence in feeding, grooming, toileting, dressing, and transfer, while lower limb muscle strength (≤ 3) was a major predictor for limitation in mobility.
Conclusions:
Muscle strength was the strongest predictor of BADLs among people with severe disability. Muscle strength grading may be optimal for designing supporting strategies for people with severe disabilities.
This paper documents the patterns and correlates of retirement in China using a nationally representative survey, the China Health and Retirement Longitudinal Study. After documenting stark differences in retirement ages between urban and rural residents, the paper shows that China's urban residents retire earlier than workers in many Organization for Economic Co-operation and Development countries and that rural residents continue to work until advanced ages. Differences in access to generous pensions and economic resources explain much of the urban–rural difference in retirement rates. The paper suggests that reducing disincentives created by China's Urban Employee Pension system, improving health status, providing childcare and elder care support may all facilitate longer working lives. Given spouse preferences for joint retirement, creating incentives for women to retire later may facilitate longer working lives for both men and women.
Few studies have been conducted to investigate the association of kidney function decline with the trajectories of homocysteine (Hcy) over time, using repeated measurements. We aimed to investigate the association of kidney function with changes in plasma Hcy levels over time. Data were collected from the Rugao Longevity and Ageing Study. In detail, plasma Hcy and creatinine levels were measured in both waves (waves 2, 3 and 4) during the 3·5-year follow-up (n 1135). Wave 2 was regarded as the baseline survey. The estimated glomerular filtration rate (eGFR) was calculated based on creatinine. Subjects were categorised into four groups according to quartiles of eGFR at baseline. Linear mixed-effect models were used to investigate the association of eGFR with subsequent plasma Hcy levels. The mean eGFR at baseline was 90·84 (sd 11·42) ml/min per 1·73 m2. The mean plasma Hcy level was 14·09 (sd 6·82) at baseline and increased to 16·28 (sd 8·27) and 17·36 (sd 10·39) μmol/l during follow-ups. In the crude model, the interaction between time and eGFR at baseline was significant (β = −0·02, 95 % CI −0·02, −0·01, P = 0·002). After adjusting for confounding factors, a significant relationship remained (β = −0·02, 95 % CI −0·02, −0·01, P = 0·003), suggesting that kidney function decline at baseline was associated with a faster increase in Hcy levels. Kidney function decline is associated with a more pronounced increase in plasma Hcy levels. Further studies with longer follow-up periods and larger sample sizes are needed to validate our findings.
Global warming increases the risk of pests and weeds before wintering, and decreases the grain yield of winter wheat. Therefore, the sowing date should be delayed properly. But the variety of winter wheat that can adapt to late sowing remains unclear. Here, we selected two winter wheat cultivars and evaluated four sowing date treatments on 1 October (early sowing), 8 (normal sowing), 15 (late sowing) and 22 (latest sowing) over two wheat-growing seasons at the experimental Station of Shandong Agricultural University (35°96′N, 117°06′E), Daiyue District, Taian, Shandong, China. We examined the effects of sowing date on a few traits, and found that, compared with normal sowing, though spike number decreased, grain yield was maintained above 9300 kg/ha under late and latest sowing. The main reason was that the more accumulated N from jointing to anthesis resulted in a higher grain number per spike. The higher net photosynthetic rate after anthesis, through optimizing N distribution in the canopy and increasing Rubisco content of flag leaves, improved dry matter accumulation rate and contribution ratio of vegetative organs, ultimately, ensured consistent grain weight. The grain yield of high-tillering winter wheat cultivars decreased from 9370 to 8346 kg/ha. The main reason was that spike number, accumulated N from jointing to anthesis and net photosynthetic rate decreased significantly, which reduced the dry matter accumulation rate, and only satisfied less grains to achieve consistent grain weight. Therefore, low-tillering winter wheat cultivars are more adaptable to late sowing, and can reduce the harm of global warming.
The orientation between twin boundary (TB) and loading direction may play an intriguing role in the deformation behaviors of twinned metallic materials. In this aspect, its essential effect on the high-entropy alloy (HEA) nanocrystals is elusive. Attention herein is focused on the atomic-scaled deformation mechanisms and fracture behaviors of HEA nanocrystals containing twins of even smaller spacings via a combined approach of in situ tensile tests inside a high-resolution transmission electron microscope and molecular dynamics simulations. The results indicate that the deformation mechanisms (especially dislocation activities) of HEA nanocrystals depend on the load orientation with respect to TBs. Because of the low activation energy and uneven local composition of HEA, the surface acts as an effective dislocation source and, together with Schmid factor, dominate the activated dislocation slip system. The load orientation-dependent TB-dislocation interactions may transform the type of fracture from semi-brittle to ductile. Our results indicate that the deformation mechanisms and the types of fracture in HEA nanocrystals can be controlled by changing the orientation.
Eating-related problems are common in people with dementia, and may have many adverse consequences. To provide a comprehensive assessment and understanding of these issues, we validated the Chinese version of the Abnormal Eating Behavior Questionnaire (AEBQ), and investigated the prevalence of and factors related to eating-related problems in people with dementia.
Methods:
A total of 129 people with dementia were recruited from a nursing home and a psychiatric hospital for a cross -sectional study. Internal consistency and test–retest reliability were tested using Cronbach’s α and intra-class correlation coefficient. Dimensionality was evaluated by principal component analysis. Concurrent validity was assessed using Spearman’s correlation coefficient to compare scores for AEBQ and the eating-related items in the Neuropsychiatric Inventory. Factors affecting the prevalence of eating-related problems were identified using logistic regression analysis.
Results:
The Chinese version of the AEBQ showed acceptable internal consistency, time stability, dimensionality, and concurrent validity. Overall, 86.8% of the participants showed eating-related problems. “Needs supervision” was the most common one, followed by “swallowing problems”. History of stroke (OR: 12.62, 95% CI: 1.58–101.06) and Clinical Dementia Rating (OR: 1.82, 95% CI: 1.02–3.24) were risk factors for “swallowing problems”. Use of antipsychotics protected against “decline in table manners” (OR: 0.21, 95% CI: 0.06–0.74), but was a risk factor for “decrease in appetite” (OR: 3.15, 95% CI: 1.35–7.38). Clinical Dementia Rating (OR: 9.27, 95% CI: 4.13–20.79) independently predicted “needs supervision”.
Conclusion:
The Chinese version of the AEBQ is a reliable and valid tool. People with dementia had a high prevalence of eating-related problems. Clinical assessment of eating-related problems in this group needs to screen for secondary causes or risk factors, such as psychotropic medications and comorbidities. Targeted interventions should be used to manage reversible eating-related problems among people with dementia.
X-ray powder diffraction data for estra-4,9-diene-3,17-dione, C18H22O2, are reported [a = 9.236(7) Å, b = 10.294(4) Å, c = 15.471(1) Å, unit cell volume V = 1471.11 Å3, Z = 4, and space group P212121]. All measured lines were indexed and are consistent with the P212121 space group. No detectable impurities were observed. The single-crystallographic data of the compound are also reported [a = 9.2392(7) Å, b = 10.2793(5) Å, c = 15.4822(7) Å, unit cell volume V = 1470.37(15) Å3, Z = 4, and space group P212121]. Both single-crystal and powder diffraction methods can get the similar structure data.
After the 2003 SARS epidemic, China started constructing a primary-level emergency response system and focused on strengthening and implementation of policies, resource allocation. After 17 years of restructuring, China's primary-level response capabilities towards public health emergencies have greatly improved. During the coronavirus disease 2019 epidemic, primary-level administrative and medical personnel, social organisations, volunteers, etc. have played a significant role in providing professional services utilising the primary-level emergency response system of 17 years. However, China's organisations did not learn their lesson from the SARS epidemic, and certain problems are exposed in the system. By analysing the experience and shortcomings of China's disease prevention and control system at the primary level, we can focus on the development of disease control systems for major epidemics in the future.