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Abstract Background Caregivers play a vital role in the recovery of scoliosis patients, but limited studies evaluate the caregivers’ HRQoL and burden in health care. This study aimed to explore the health-related quality of life (HRQoL) of scoliosis patients and their caregivers, and identify the factors influencing caregiver burden in Eastern China. Methods This cross-sectional study was conducted from August 2018 to January 2019 at the Shandong Provincial Hospital, Jinan, China. The HRQoL of scoliosis patients was measured by the Scoliosis Research Society-22r (SRS-22r), five-level EQ-5D (EQ-5D-5L) and Child Health Utility 9D (CHU9D). The caregivers’ questionnaires consist of the EQ-5D-5L, WHO-five wellbeing index (WHO-5), 22-item Zarit Caregiver Burden Interview (ZBI-22) and Social Support Rating Scale (SSRS). Spearman correlation coefficients were used to estimate the relationship among caregivers’ burden, social support, HRQoL, and SWB. Cohen’s effect size (Cohen’s d) was used to assess the ZBI-22 total score between different groups. Multiple stepwise hierarchical linear regression models were conducted to assess the associated factors of caregiver burden. Results There were 59 scoliosis patients and their caregivers (n = 59) included in the analysis. The mean health state utility of adolescent scoliosis patients (n = 39) was 0.718 (95%CI: 0.654, 0.782) based on CHU9D and adult scoliosis patients (n = 20) was 0.663 (95%CI: 0.471, 0.855) based on EQ-5D-5L. The mean health state utility of male scoliosis patients (0.792/0.667) was higher than females (0.681/0.662) based on CHU9D and EQ-5D-5L (p > 0.05), respectively. The ZBI-22 total score of scoliosis patients’ caregivers was 27.86 (SD: 20.59). Scoliosis patients’ HRQoL was significantly inversely correlated with caregiver burden, and the HRQoL and subjective wellbeing (SWB) of caregivers were moderately and inversely correlated with caregiver burden. The regression results showed that the patients’ age and caregivers’ SWB were key characteristics associated with caregiver burden. Conclusions The caregiver burden of adolescent patients was higher than that of adult patients, and the satisfaction rate of adolescent scoliosis patients was higher than that of adult scoliosis patients. Improving the functional state of scoliosis patients and providing appropriate nursing practice education from health professionals would be necessary to effectively improve caregivers SWB and alleviate caregiver burden.

To explore the mechanical response of asphalt pavement structure with functional layer, and make asphalt pavement have better service performance, a structural combination form of asphalt pavement with functional layers is proposed in this study, and the interlayer structural mechanical response analysis is carried out based on the theory of a multi-layer flexible layered system. The study first suggests a combined method of stress-strain and displacement at each point of the three-dimensional asphalt pavement structure under the combined compressive-shear load. Secondly, the shear strength of asphalt pavement structure with functional layer under the influence of compressive-shear combined loads, different longitudinal slopes, overload loads, and temperature-elastic modulus under different interlayer contact states are analyzed. Finally, the distribution of structural shear strain of asphalt pavement with a functional layer under different conditions is investigated. The results show that in the asphalt pavement structure with a functional layer, the functional layer is the weak layer of the base-surface layer, and the interlayer shear stress will change abruptly under the combined compression-shear load. The maximum shear stress and extreme strain values are mainly concentrated in the upper and middle surface layers, and they show a consistent trend of first increasing and then decreasing with the increase of the pavement depth. The functional layer can be used as a temperature buffer zone so that the asphalt pavement has good contact performance between the surface and base at 76 ℃ and good shear strength. The results of this study provide a theoretical foundation for studying the interlaminar shear resistance of asphalt pavement with functional layers.