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Background/Objectives:The NIH Toolbox® for Assessment of Neurological and Behavioral Function is a compilation of computerized measures designed to assess sensory, motor, emotional, and cognitive functioning across the lifespan. The NIH Toolbox was initially developed for use with the general population and was not originally validated in clinical populations. The objective of this scoping review was to assess the extent to which the NIH Toolbox has been used with clinical populations.Methods:Guided by the Joanna Briggs Methods Manual for Scoping Reviews, records were identified via searches of PubMed MEDLINE, PsycINFO, ClinicalTrials.gov, EMBASE, and ProQuest Dissertations and Theses Global (2008-2020). Database searches yielded 5,693 unique titles of original research that used at least one NIH Toolbox assessment in a sample characterized by any clinical diagnosis. Two reviewers screened titles, abstracts, and full texts for inclusion in duplicate. Conflicts at each stage of the review process were resolved by group discussion.Results:Ultimately, 281 publication records were included in this scoping review (nJournal Articles= 104, nConference Abstracts=84, nClinical Trial Registrations=86, nTheses/Dissertations=7). The NIH Toolbox Cognition Battery was by far the most utilized of the four batteries in the measurement system (nCognition=225, nEmotion=49, nMotor=29, and nSensation=16). The most represented clinical category was neurological disorders (n=111), followed by psychological disorders (n=39) and cancer (n=31). The vast majority (96.8%) of journal articles and conference abstracts reporting use of NIH Toolbox measures with clinical samples were published in 2015 or later. As of May 2021, these records had been cited a total of nearly 1,000 times.Conclusion:NIH Toolbox measures have been widely used among individuals with various clinical conditions across the lifespan. Our results lay the groundwork to support the feasibility and utility of administering NIH Toolbox measures in research conducted with clinical populations and in clinical settings, and further suggest that these measures may be of value for implementation in fast-paced clinical settings as part of routine practice.

BackgroundSystematic reviews (SRs) of computer-assisted (CA) total knee arthroplasty (TKA) and total hip arthroplasty (THA) report conflicting evidence on its superiority over conventional surgery. Little is known about the quality of these SRs; variability in their methodological quality may be a contributing factor. We evaluated the methodological quality of all published SRs to date, summarized and examined the consistency of the evidence generated by these SRs.MethodsWe searched four databases through December 31, 2018. A MeaSurement Tool to Assess systematic Reviews 2 (AMSTAR 2) was applied to assess the methodological quality. Evidence from included meta-analyses on functional, radiological and patient-safety outcomes was summarized. The corrected covered area was calculated to assess the overlap between SRs in including the primary studies.ResultsBased on AMSTAR 2, confidence was critically low in 39 of the 42 included SRs and low in 3 SRs. Low rating was mainly due to failure in developing a review protocol (90.5%); providing a list of excluded studies (81%); accounting for risk of bias when discussing the results (67%); using a comprehensive search strategy (50%); and investigating publication bias (50%). Despite inconsistency between SR findings comparing functional, radiological and patient safety outcomes for CA and conventional procedures, most TKA meta-analyses favored CA TKA, whereas most THA meta-analyses showed no difference. Moderate overlap was observed among TKA SRs and high overlap among THA SRs.ConclusionsDespite conclusions of meta-analyses favoring CA arthroplasty, decision makers adopting this technology should be aware of the low confidence in the results of the included SRs. To improve confidence in future SRs, journals should consider using a methodological assessment tool to evaluate the SRs prior to making a publication decision.

As an important carrier of e-governance, government microblog has an important influence on the government’s public management activities. This paper uses statistical methods based on the influence evaluation method of user behavior to calculate the influence of microblogs, and then analyzes the correlation between microblog characteristics and user behaviors, and draws the influencing factors of government microblogs’ communication effect. Through the above research, this paper provides some feasible suggestions for the development of government microblogs.

Tetracycline (TC) in soil severely imperils food security and ecosystem function. Metaphire guillelmi is a common species in farmland. It could impact the degradation of antibiotics. However, how it affects is rarely unknown. Hence, the present study aimed to investigate the effects of M. guillelmi on the TC degradation in soil and the changes of the antioxidant system and intestinal bacteria in M. guillelmi. The treatments that M. guillelmi was inoculated on soil contaminated with different TC concentrations were contrasted with those without M. guillelmi. After 21 days, the degradation rate of TC significantly increased by 13.70%, 18.14% and 29.01% at 10, 50 and 100 mg kg −1 TC dose, respectively, due to the inoculation of M. guillelmi. The half-life of TC was also shortened nearly by 1/3 to 2/3. Superoxide dismutase (SOD) increased in a dose-dependent manner with the increase of TC concentration on the 7th and 14th day. Catalase (CAT) and glutathione S-transferase (GST) presented an inverted U-shaped dose response on the 7th day, and the peak of enzyme activities occurred at TC concentration of 0.1, 1 mg kg −1 (CAT) and 0.1 mg kg −1 (GST). Malondialdehyde (MDA) contents did not change significantly. At the phylum level, only Verrucomicrobia significantly decreased under 1 mg kg −1 and 100 mg kg −1 TC dose. Genus Paracoccus, Singulisphaera, Acinetobacter and Bacillus significantly increased and became the dominant bacterium during the TC degradation. Overall, the antioxidant system and intestinal bacteria of M. guillelmi were affected by the different concentrations of TC pollution, which provided new ideas for the research of mechanism of TC degradation by earthworms in the future.

Background: Religiosity influences health and well-being. We assessed religiosity among U.S. Chinese older adults. Methods: Data were drawn from the PINE study based on 3,159 community-dwelling U.S. Chinese older adults aged 60+ in the greater Chicago area. Two items retrieved from Duke University Religion Index (DUREL) were used to assess the frequency of participating in religious activities, and a separate item was used to assess the importance of religion. Results: Overall, 35.4% of participants perceived religion to be important. This study correlated the higher frequency of participation in religious observances with older age groups of the sample, being female, having a higher income, being unmarried, longer duration of residency in the United States, and not having been born in Mainland China. Higher frequency of participating in organized religious services was correlated with better quality of life. Conclusions: Religion is important among U.S Chinese older adults. Future longitudinal research i...

Background: Neurological symptoms influence health and well-being among older adults. However, Chinese older adults are underrepresented in most studies on neurological symptoms. This study aims to examine the prevalence of neurological symptoms among U.S. Chinese older adults. Methods: Data were drawn from the PINE study, a population-based survey of U.S Chinese older adults in the greater Chicago area. Guided by a community-based participatory research approach, a total of 3,159 Chinese older adults aged 60 and above were surveyed. Clinical review of system (ROS) was used to assess the presence of dizziness, syncope/fainting, fall, seizures, weakness, numbness, tingling, tremor, and stiffness. Results: Neurological symptoms were commonly experienced by U.S Chinese older adults (50.6%). Symptoms as dizziness (31.0%), numbness (19.0%), and falls (14.8%) were commonly reported. Participants were more likely to report any neurological symptom if they were older , less educated, low income, with poorer self-perceived health status, poorer quality of life, and worsened health change over last year. Conclusions: Neurological symptoms are common among Chinese older adults in the U.S. Future longitudinal research is needed to examine risk factors and health outcomes associated with neurological symptoms.

Symptoms may influence an individual’s perception of their overall health and quality of life (1). Cardiovascular and pulmonary symptoms in particular, may cause physical discomfort and negative psychological consequences among older adults (2). Functionally, the cardiovascular and pulmonary systems interact with each other. Thus, rather than attributing symptoms to a single disease, evaluating cross-disease symptoms with the cardiovascular and pulmonary systems can provide a better reflection of the clinical effects and health burden of multiple cardiovascular and pulmonary diseases and conditions. Older adults are often at higher risk for cardiovascular and pulmonary disorders. Notably, in the United States, cardiovascular disease is the leading cause of death among people aged 65 and older and chronic lower respiratory diseases are the third leading cause (3). Aging in conjunction with physical, psychological, and behavioral changes often contribute to multiple cardiovascular and pulmonary conditions and their resulting symptoms (4). As 50% of older adults aged 60 or older live with one or more chronic condition, identifying and alleviating cardiovascular and pulmonary symptoms experienced by older adults is an important goal in multiple chronic diseases management (5). However, although several studies have evaluated the prevalence of diagnosed cardiovascular and pulmonary conditions, insufficient efforts have been made on assessing the prevalence and role of symptoms in older adults’ daily lives. Most prior studies were based on single symptom and single disease or single disease set, like cancer, heart failure, or chronic pulmonary diseases (2,6), and often did not assess the overall systematic symptom burden caused by multiple chronic conditions. Moreover, although a number of prior studies assessed the prevalence of symptoms among older patients with advanced chronic diseases, very few population-based studies have focused on the symptoms experienced by general community-dwelling older adults (7,8). In particular, underrepresented minority older adults in the United States may be disproportionately affected by cardiovascular and pulmonary disorders. National statistics indicate that a higher percentage of Asian Americans died because of cardiovascular diseases compared with whites and Hispanic (9). However, Asian Americans are consistently treated as a homogeneous group, which fails to acknowledge differences in cultural beliefs, health behaviors, and genetic inherence among diverse Asian subgroups (10). The demographic shifts and rapid growth of Chinese older adults in the United States warrant a better understanding of their cardiovascular and pulmonary symptoms. The Chinese community is the oldest and largest Asian American subgroup in the United States (11). However, the vast intragroup diversity in language, education level, socioeconomic status, and degree of acculturation among U.S. Chinese older adults have resulted in limited evidence-based research targeting this group (12). To build upon the social and health issues documented in previous research with U.S Chinese older adults (13–15) and paint their overall health burden, there is a need to assess the presence of clinical symptoms experienced by this population. In this study, we aim to (i) evaluate the prevalence of cardiovascular and pulmonary symptoms within the context of a large population-based cohort of U.S. Chinese older adults; (ii) examine the correlations between cardiovascular and pulmonary symptoms and sociodemographic characteristics; and (iii) examine the correlations between cardiovascular and pulmonary symptoms and self-reported health and quality of life measures.

Trust is fundamental in clinical patient–physician relationships (1). Patients’ trust in physicians (TIP) measures the extent to which patients believe that their physicians will act in their best interest to provide medical suggestions, care, and treatment (2). TIP is essential in assessing the quality and effectiveness of medical care because it influences patients’ willingness to seek care, adherence to physicians’ instructions, continuity of care, and overall health outcomes (3). In particular, TIP is critical for older adults due to the high prevalence of multimorbidity and complex medical needs for chronic disease management (4,5). With the rapidly evolving nature of the health care system, there is a growing need to advance our knowledge on TIP among older adults. Prior studies found that older age is associated with a higher level of TIP (2,5,6). However, these studies were based on the general population and were thus limited in providing detailed information on older adults specifically. Although we have improved knowledge about TIP among older adults in the recent years, most prior studies were based on more selected populations of older adults (7,8) or a single measure of TIP (9). Furthermore, TIP as a multidimensional construct was measured qualitatively in many studies, and fewer studies explored TIP with quantitative measures (10). In addition, in quantitative studies, TIP was often conceptualized and measured in diverse ways with different subcomponents, which may make meaningful comparisons challenging (10). For instance, although fidelity and competence components are constantly enforced in most scales estimating TIP, Kao’ scale excludes honesty and behavior component, Wake Forest’s scale excludes confidentiality and behavior components, and Anderson et al. Trust in Physician Scale provides a coverage of all six components including fidelity, competence, honesty, confidentiality, global, and behavioral (11). An increasing body of literature documents racial/ethnic disparities in TIP. Although factors contributing to trust and distrust in physicians may differ across racial/ethnicity groups (12), minority groups were more likely to report greater distrust and lower satisfactory toward their physicians compared with dominant groups. In particular, literature suggests that Asian Americans displayed the lower level of satisfactory and less sharing in patient–physician relationship based on a 100-point self-reported rating (13). A national survey suggests that Asian Americans are more likely than whites to report their physicians as not understanding of their needs and not spending enough time with them (14) based on a dichotomized measure of TIF (14). Despite that Asian Americans are often underrepresented in many studies, they are frequently treated as a homogeneous group in research, limiting our capability to distinguish cultural beliefs and health behaviors in diverse Asian subgroups with respect to TIP. The Chinese community is the oldest and largest Asian American subgroup in the United States (15). Older adults constitute a large segment of the general Chinese population in the United States, of whom 15.4% are aged 65 or older (15). More than 80% of Chinese older adults were foreign born, and approximately 30% of them immigrated to the United States after the age of 60. Their immigration experiences, degree of acculturation, and previous physician–patient relationships before residing in the United States may contribute to their current levels of TIP in the United States (16). A case study based on a U.S. Chinese immigrant family identified how TIP was influenced by their understanding of different cultures (17). However, the vast intragroup diversity in languages, education levels, socioeconomic status, and degree of acculturation among U.S. Chinese older adults contributes to the dearth of evidence-based research targeting at Chinese older adults (18). This study aims to contribute to the existing knowledge base of TIP among U.S. community-dwelling Chinese older adults by examining their level of TIP and the correlations between TIP and sociodemographic, overall health, and quality-of-life characteristics.

Objective: Filial piety is a key Chinese cultural value that determines children’s caregiving obligation to older adults. This study aims to evaluate the expectations and perceived receipt of filial piety from the perspectives of Chinese older adults. Method: Data were drawn from the Population Study of Chinese Elderly in Chicago (PINE) study, a population-based study of U.S. Chinese older adults aged 60 and above in the Greater Chicago area. Filial care was examined in six domains, including care, respect, greeting, happiness, obedience, and financial support. Socio-demographics correlate with expectations and receipt of filial piety were also reported. Results: Participants reported high level of overall expectations and receipts of filial piety, and highest expectation and perceived receipt were placed on the domain of respect. Discussion: This study provides insights on the extent to which U.S. Chinese older adults expect and perceive receipt of filial care. Our findings have implications for the provision of culturally appropriate health care services.

Background: Perceived stress is an important indicator of well-being. However, we have limited understanding of the experience of stress in minority aging populations. Methods: This study aims to identify the stress level among U.S. Chinese older adults. Results: Our findings indicated that 74% of PINE participants have experienced some level of daily stress. Of the 10-items in the stress scale, the prevalence of individual items ranged from 11.4% to 31.8%. Higher levels of perceived stress were more likely to present among older adults with an older age, female gender, lower education and income level, and poorer health status and quality of life. Participants with zero years of education showed the highest level of perceived stress, with a mean score of 12.2. Conclusions: This study indicates that Chinese older adults in the U.S are experiencing stress in their daily lives. Future longitudinal studies are needed to improve the understanding of risk factors and outcomes associated with perceived stress in Chinese older adults.

Multiresolution streamline placement is useful for interactive visualization of flow fields. In this paper, a new method is proposed to build placements of streamlines in different resolutions for 2D and 3D flow fields. This method is developed from a basic streamline placement algorithm that takes control grids to place streamlines in 2D flow fields. The process of multiresolution analysis starts from a sparse placement, which is obtained with a coarse grid according to the basic placement algorithm. The sparse placement is then iteratively refined by elongating all existing streamlines and adding new streamlines under the control of a finer grid. By this means, a series of placements can be built in different resolutions, each of which reuses its previously placed streamlines at increasing density levels. This multiresolution placement for 2D flow fields is further extended to 3D flow fields by changing the basic placement algorithm to fit 3D space. Test results show that the basic streamline placement algorithm is very fast, so the proposed multiresolution analysis can be done for both 2D and 3D flow fields efficiently.

Background Perceived stress influences the health and well-being of older adults. This study aims to examine the association between the expectation and the receipt of filial piety and perceived stress among U.S Chinese older adults. Methods Data were drawn from the PINE study, a population-based study of Chinese older adults aged 60 and above in the greater Chicago area. Perceived stress was assessed by the PSS-10 and was the dependent variable. Independent variables were the expectation and the receipt of filial piety examined in six domains. Negative Binomial Regression and Multivariable Logistic Regression analyses were conducted. Results Of the 3,159 Chinese older adults interviewed, the mean age was 72.8 (SD=8.3) and 58.9% were female. Compared with older adults who received a high level of filial piety, older adults who received a medium level of filial piety were 1.57 (1.29-1.93) times more likely to perceive stress as high, and older adults who received a low level of filial piety were 2.74 (2.26-3.33) times more likely to perceive stress as high, after controlling for the potential confounding variables. The expectation of filial piety was not significantly associated with perceived stress. Conclusion A low level of filial piety receipt may be a risk factor for perceived stress. Our findings suggest incorporating cultural contributors into the analyses of perceived stress.

Objective: Loneliness is an important indicator of well-being. However, we have limited understanding of loneliness in minority aging populations. This study aims to identify the prevalence of loneliness among U.S. Chinese older adults. Method: Data were drawn from the PINE study, a population-based study of 3,159 U.S. Chinese older adults in the Greater Chicago area. Results: Our findings indicated that the prevalence of loneliness was 26.2%. Older adults with older age, female gender, and living alone reported higher prevalence of loneliness. Older adults with worsened health status, poorer quality of life, and negative health changes over the past year were also more likely to experience loneliness. Discussion: Loneliness is common among U.S. Chinese older adults in the Greater Chicago area. Future longitudinal studies are needed to improve the understanding of risk factors and outcomes associated with loneliness in Chinese older adults.

Background: Filial piety is a fundamental virtue that defines children’s care-giving obligation to older parents in Chinese families. This study aims to evaluate whether gender difference exists in the expectation and receipt of filial piety among U.S Chinese older adults. Methods: Data were drawn from the PINE study, a population-based study of U.S. Chinese older adults aged 60 and above in the greater Chicago area. Guided by a community-based participatory research approach, a total of 3,159 Chinese older adults aged 60 and above were surveyed. Filial piety was examined in six domains, including care, respect, greeting, happiness, obedience, and financial support. Socio-demographic correlates with expectations and receipt of filial piety were examined. Multivariate regression analyses were conducted. Results: Female older adults were 1.02 points higher than male older adults in their perceived receipt of filial piety (PE=1.02, pDiscussion: This study provides insights to understand how the gender of the older parents influences their expectation and receipt of filial piety. Our findings have important implications to guide elder care practices with cultural and gender sensitivity.

Streamline is a popular choice to visualize flow fields, but it not easy to determine the number and the distribution of streamlines. In this paper, a multiresolution streamline placement method is presented to visualize 2D flow fields at different levels of detail. Each level has different number of streamlines that are uniformly distributed in the field at different resolutions. This method is implemented by constructing a hierarchy of control grids to manipulate the procedure of placement. The top level of the hierarchy is the coarsest control grid whose cell size is predefined. Using this grid and a centroid-based seeding strategy, a sparse placement is obtained, where streamlines are evenly-spaced. Then, this sparse placement is changed into the next lower level by adding some new streamlines within the gaps of all existing streamlines under the control of a finer control grid. Although the total number of streamlines is increased, the original uniformity is not destroyed. The resolution and the density of streamlines are both improved from one level to its next lower level. This refinement between adjacent levels can be repeated until a suitable placement is obtained. Corresponding to the control grids, a hierarchy of streamline placements with different resolutions is also built up during the multiresolution analysis. It gives an opportunity to select suitable streamline placements with desired resolutions. And it also provides a new way to have an insight into the flow field at different scales. Test results show that this multiresolution streamline placement is valid and efficient.

Background: Loneliness is an important health indicator for psychological well-being. This study aims to examine the association between filial piety and loneliness among Chinese older adults in the U.S.Methods: Data were drawn from the PINE study, a population-based study of 3,159 Chinese older adults aged 60 and above in the greater Chicago area. Severity of loneliness was the dependent variable. Independent variables were the expectation and perceived receipt of filial piety, examined in six domains. Negative Binomial Regression analyses were conducted.Results: Lower levels of perceived filial piety receipt were associated with greater severity of loneliness (Ratio of Expected Severity: 0.92, 0.91-0.94) after adjusting for socio-demographics and medical co-morbidities. Expectation of filial piety was not associated with severity of loneliness.Conclusion: Our findings indicate higher perceived receipt of filial piety may protect older adults from loneliness. Our study suggests that cultural sensitivity need to be considered in the detection and intervention of loneliness.