Epidemiology and risk factors of oral frailty among older people: an observational study from China

OBJECTIVES

This study aimed to compare the prevalence of oral frailty among community-dwelling older people in Nanjing, China with the usage of different measurements, and to investigate the potential risk factors of oral frailty.

DESIGN

Cross-sectional study.

SETTING AND PARTICIPANTS

A total of 338 community-dwelling older people in Nanjing, China were recruited.

METHODS

Oral frailty was measured based on the Oral Frailty Index-8 (OFI-8) scale and other measurement methods including the number of natural teeth (TN), repetitive saliva-swallowing test (RSST), and oral diadochokinesis (ODK). The chi-square test and the binary logistic regression analysis were performed to identify potential risk factors for oral frailty.

RESULTS

There were 310 participants included in the analysis. Prevalence of oral frailty by using the OFI-8, OFI-8 + TN, OFI-8 + ODK, OFI-8 + TN + ODK and RSST measurement methods were 69.0%, 27.4%, 51.9%, 21.0% and 2.9%, respectively. Passive smoking (OR = 2.04; 95%CI 1.03-4.03), being widowed/unmarried (OR1 = 2.53; 95%CI 1.25-5.10; OR2 = 2.94; 95%CI 1.12-7.77), pre-frailty (OR = 1.76; 95%CI 1.03-3.01), frailty (OR = 3.01; 95%CI 1.39-6.54), and aged 80 years and above (OR = 3.99; 95%CI 1.35-11.81) were found to be risk factors of oral frailty by the usage of the four kinds of measurement methods.

CONCLUSIONS AND IMPLICATIONS

The definition and diagnostic criteria of oral frailty are strongly needed to be unified in future research. Only subjective assessment is not enough for assessing oral frailty. Among objective indicators, RSST is not suitable as a screening method for oral frailty. In addition, objective indicators including TN and ODK should be valued for early screening and preventive interventions. The risk factors of oral frailty include physical frailty, passive smoking, and being widowed.

Multimorbidity patterns and the association with health status of the oldest-old in long-term care facilities in China: a two-step analysis

BACKGROUND

The increasing prevalence of multimorbidity has created a serious global public health problem in aging populations. Certain multimorbidity patterns across different age ranges and their association with health status remain unclear. The main aim of this study is to identify multimorbidity patterns discrepancies and associated health status between younger-old and oldest-old.

METHODS

The Ethics Committee of Nanjing Medical University approved the study protocol (No.2019-473). Convenience sampling method was used to recruit older adults aged ≥ 60 years with multimorbidity from July to December 2021 from 38 Landsea long-term care facilities in China. The multimorbidity patterns were analyzed using network analysis and two-step cluster analysis. One-Way ANOVA was utilized to explore their association with health status including body function, activity of daily living, and social participation. A Sankey diagram visualized the flow of health status within different multimorbidity patterns. This study is reported following the STROBE guidelines.

RESULTS

A total of 214 younger-old (60-84 years) and 173 oldest-old (≥ 85 years) were included. Leading coexisting diseases were cardiovascular disease (CD), metabolic and endocrine disease (MED), neurological disease (ND), and orthopedic disease (OD). Cluster 1 (53, 24.8%) of CD-ND (50, 94.3%; 31, 58.8%), cluster 2 (39, 18.2%) of MED-ND-CD (39, 100%; 39, 100%; 37, 94.9%), cluster 3 (37, 17.3%) of OD-CD-MED-ND (37, 100%; 33, 89.2%; 27, 73.0%; 16, 43.2%), and cluster 4 (34, 15.9%) of CD-MED (34, 100%; 34, 100%) were identified in the younger-old. In the oldest-old, the primary multimorbidity patterns were: cluster 1 (33, 19.1%) of CD-respiratory disease-digestive disease-urogenital disease (CD-RD-DSD-UD) (32, 97.0%; 9, 27.3%; 8, 24.2%; 7, 21.2%), cluster 2 (42, 24.3%) of ND-CD-MED (42, 100%; 35, 83.3%; 14, 33.3%), cluster 3 (28, 16.2%) of OD-CD-MED (28, 100%; 25, 89.3%; 18, 64.3%), and cluster 4 (35, 20.2%) of CD-MED (35, 100%; 35, 100%). Younger-old with CD-ND or MED-ND-CD, and oldest-old with ND-CD-MED have worse health status compared with other multimorbidity patterns (e.g., CD-MED and OD-CD-MED).

CONCLUSION

Discrepancies in common patterns of multimorbidity across age groups suggest that caregivers in long-term care facilities should consider changes in multimorbidity patterns with ageing when developing prevention plans for individualized management. Neurological disease concurrent with other diseases was the major determinant of health status, especially for the oldest-old. Interventions targeting multimorbidity need to be focused, yet generic. It is essential to assess complex needs and health outcomes that arise from different multimorbidity patterns and manage them through an interdisciplinary approach and consider their priorities to gain high-quality primary care for older adults living in long-term care facilities.

Chaotic Color Image Encryption Based on Eight-Base DNA-Level Permutation and Diffusion

Images, as a crucial information carrier in the era of big data, are constantly generated, stored, and transmitted. Determining how to guarantee the security of images is a hot topic in the information security community. Image encryption is a simple and direct approach for this purpose. In order to cope with this issue, we propose a novel scheme based on eight-base DNA-level permutation and diffusion, termed as EDPD, for color image encryption in this paper. The proposed EDPD integrates secure hash algorithm-512 (SHA-512), a four-dimensional hyperchaotic system, and eight-base DNA-level permutation and diffusion that conducts on one-dimensional sequences and three-dimensional cubes. To be more specific, the EDPD has four main stages. First, four initial values for the proposed chaotic system are generated from plaintext color images using SHA-512, and a four-dimensional hyperchaotic system is constructed using the initial values and control parameters. Second, a hyperchaotic sequence is generated from the four-dimensional hyperchaotic system for consequent encryption operations. Third, multiple permutation and diffusion operations are conducted on different dimensions with dynamic eight-base DNA-level encoding and algebraic operation rules determined via the hyperchaotic sequence. Finally, DNA decoding is performed in order to obtain the cipher images. Experimental results from some common testing images verify that the EDPD has excellent performance in color image encryption and can resist various attacks.

Internal incentives for carbon emission reduction in a capital-constrained supply chain: A financial perspective

Capital constraints hinder enterprises' carbon reduction efforts and affect the sustainability of the supply chain. To alleviate this limitation, the core enterprise considers offering two financial-based carbon reduction incentive mechanisms: cost-sharing mechanism (CS) and preferential financing mechanism (PF). In a supply chain with the dual sensitivity of market demand to price and carbon reduction, we model each incentive mechanism, discussing their impact, value, and selection strategies. The results show that neither party under CS pursues an excessively high share ratio. Only a below-threshold sharing ratio can promote the supplier's carbon reduction behavior and improve efficiency for both parties. Conversely, PF has a stable incentive effect on the supplier's carbon reduction behavior and can effectively increase the retailer's profits. However, a reasonable carbon reduction standard is needed to attract the supplier. In addition, as market demand becomes more sensitive to carbon reduction, the feasible range of CS narrows and that of PF expands. We compare players' preferences of PF and CS and find a Pareto region in which all players prefer PF to CS. Finally, we test the robustness of our findings by an extending model. Our study provides guidance for supply chain decisions facing dual pressures of financial constraints and carbon reduction.

Feasibility and effectiveness of disinfection of gloves during routine care: a scoping review protocol

INTRODUCTION

Disinfecting gloves during patient care has potential benefits and risks. In recent years, disinfection of disposable medical gloves for prolonged use has occurred in clinical practice. However, there is limited high-level evidence to know if this practice can prevent nosocomial infections, reduce microbial levels on the glove surface. This concept was researched using a scoping review to explore the feasibility and effectiveness of disinfecting disposable gloves for prolonged use.

METHODS AND ANALYSIS

The review will be conducted in accordance with the Arksey and O'Malley scoping review methodology framework. From the date of database construction to 10 February 2023, the following 16 electronic databases in English and Chinese will be searched: PubMed, Embase, CINAHL, Web of Science, Cochrane Library, ProQuest, China National Knowledge Infrastructure, Wanfang, SinoMed Database, Google Scholar, Centers for Disease Control and Prevention (CDC), European Centre for Disease Prevention and Control, WHO, China CDC, International Nosocomial Infection Control Consortium and European Medicines Agency Science Medicines Health. The screening and data extraction of the study will be carried out by two reviewers (KL and SH). Differences between the two reviewers will be handled through negotiation. If there are still differences, they will be discussed with a third reviewer. Any study, for example, intervention study or observational study, that provide insights about the disinfection of disposable medical gloves for prolonged use will be included. Data charts will be used to extract relevant data from the included studies. Results will be reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews, to define the scope of evaluation. A narrative summary will be completed to synthesise key research findings and background information on the disinfection of gloved hands.

ETHICS AND DISSEMINATION

Ethical approval will not be required because only publicly available data will be analysed. The findings from the scoping review will be published in a peer-reviewed journal and presented at scientific meetings. By highlighting the feasibility and effectiveness of the disinfection of gloved hands in the literature, this review will provide direction for future research and clinical guidelines.

TRIAL REGISTRATION NUMBER

This scoping review protocol has been registered in the Open Science Framework (registration number: 10.17605/OSF.IO/M4U8N).

Collaborative Innovation Strategy of Supply Chain in the Context of MCU Domestic Substitution : A Differential Game Analysis

The domestic substitution of the IC (the Integrated Circuit) industry improves economic efficiency and is significant in ensuring national security, which has gradually become an essential strategy for countries worldwide. Based on the background of domestic substitution of integrated circuits, we select a typical component Micro Controller Unit) as the research object, construct a three-level supply chain game model under different scenarios in a dynamic architecture, and analyze the game problem of collaborative innovation of the MCU supply chain. We fully consider the impact of factors such as time, cost and the innovation and collaborative innovation efforts of various supply chain members on the level of domestic substitution. Moreover, we put forward a two-part pricing + cost-sharing contract to achieve supply chain coordination. We found that: (1) Collaborative innovation of the supply chain in the centralized decision-making scenario achieves the highest level, followed by the cost-sharing scenario; (2) The two-part pricing + cost-sharing contract can help achieve supply chain coordination; (3) The trend of the MCU domestic substitution level with manufacturing cost is U-shaped, which means the increase of manufacturing cost may have a positive impact on the process of domestic substitution.

Divergence-Based Locally Weighted Ensemble Clustering with Dictionary Learning and L2,1-Norm

Accurate clustering is a challenging task with unlabeled data. Ensemble clustering aims to combine sets of base clusterings to obtain a better and more stable clustering and has shown its ability to improve clustering accuracy. Dense representation ensemble clustering (DREC) and entropy-based locally weighted ensemble clustering (ELWEC) are two typical methods for ensemble clustering. However, DREC treats each microcluster equally and hence, ignores the differences between each microcluster, while ELWEC conducts clustering on clusters rather than microclusters and ignores the sample-cluster relationship. To address these issues, a divergence-based locally weighted ensemble clustering with dictionary learning (DLWECDL) is proposed in this paper. Specifically, the DLWECDL consists of four phases. First, the clusters from the base clustering are used to generate microclusters. Second, a Kullback-Leibler divergence-based ensemble-driven cluster index is used to measure the weight of each microcluster. With these weights, an ensemble clustering algorithm with dictionary learning and the L2,1-norm is employed in the third phase. Meanwhile, the objective function is resolved by optimizing four subproblems and a similarity matrix is learned. Finally, a normalized cut (Ncut) is used to partition the similarity matrix and the ensemble clustering results are obtained. In this study, the proposed DLWECDL was validated on 20 widely used datasets and compared to some other state-of-the-art ensemble clustering methods. The experimental results demonstrated that the proposed DLWECDL is a very promising method for ensemble clustering.

Examining Reciprocal Links between Parental Autonomy-Support and Children's Peer Preference in Mainland China

The present study examined the longitudinal relations between child perceptions of parental autonomy-support and peer preference in mainland China. Participants were N = 758 children (50.8% boys; Mage = 10.78 years, SD = 1.03 at Wave 1; Mage = 11.72 years, SD = 1.11 at Wave 2; Mage = 12.65 years, SD = 0.95 at Wave 3) from elementary and middle schools in Shanghai, P.R. China. Children were followed over three years from Grades 4-6 to Grades 6-8. Each year, children reported their perceived maternal/paternal autonomy-support and peer preference (being well-liked among peers) was measured via peer nominations. Among the results, peer preference positively predicted later perceptions of maternal and paternal autonomy-supportive parenting, whereas autonomy-supportive parenting did not significantly predict later peer preference. Results are discussed in terms of the interactions between parental autonomy-supportive parenting and children's peer relationships in Chinese culture.

Joint image compression and encryption based on sparse Bayesian learning and bit-level 3D Arnold cat maps

Image compression and image encryption are two essential tasks in image processing. The former aims to reduce the cost for storage or transmission of images while the latter aims to change the positions or values of pixels to protect image content. Nowadays, an increasing number of researchers are focusing on the combination of these two tasks. In this paper, we propose a novel joint image compression and encryption approach that integrates a quantum chaotic system, sparse Bayesian learning (SBL) and a bit-level 3D Arnold cat map, so-called QSBLA, for such a purpose. Specifically, the QSBLA consists of 6 stages. First, a quantum chaotic system is employed to generate chaotic sequences for subsequent compression and encryption. Second, as one method of compressive sensing, SBL is used to compress images. Third, an operation of diffusion is performed on the compressed image. Fourth, the compressed and diffused image is transformed into several bit-level cubes. Fifth, 3D Arnold cat maps are used to permute each bit-level cube. Finally, all the bit-level cubes are integrated and transformed into a 2D pixel-level image, resulting in the compressed and encrypted image. Extensive experiments on 8 publicly-accessed images demonstrate that the proposed QSBLA is superior or comparable to some state-of-the-art approaches in terms of several measurement indices, indicating that the QSBLA is promising for joint image compression and encryption.