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"Yao, Shan-Shan"
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Associations between Multimorbidity and Physical Performance in Older Chinese Adults
Background: Evidence on the association between physical performance and multimorbidity is scarce in Asia. This study aimed to identify multimorbidity patterns and their association with physical performance among older Chinese adults. Methods: Individuals aged ≥60 years from the China Health and Retirement Longitudinal Study 2011–2015 (N = 10,112) were included. Physical performance was measured by maximum grip strength (kg) and average gait speed (m/s) categorized as fast (>0.8 m/s), median (>0.6–0.8 m/s), and slow (≤0.6 m/s). Multimorbidity patterns were explored using exploratory factor analysis. Generalized estimating equation was conducted. Results: Four multimorbidity patterns were identified: cardio–metabolic, respiratory, mental–sensory, and visceral–arthritic. An increased number of chronic conditions was associated with decreased normalized grip strength (NGS). Additionally, the highest quartile of factor scores for cardio–metabolic (β = −0.06; 95% Confidence interval (CI) = −0.07, −0.05), respiratory (β = −0.03; 95% CI = −0.05, −0.02), mental–sensory (β = −0.04; 95% CI = −0.05, −0.03), and visceral–arthritic (β = −0.04; 95% CI = −0.05, −0.02) patterns were associated with lower NGS compared with the lowest quartile. Participants with ≥4 chronic conditions were 2.06 times more likely to have a slow gait speed. Furthermore, the odds ratios for the highest quartile of factor scores of four patterns with slow gait speed compared with the lowest quartile ranged from 1.26–2.01. Conclusion: Multimorbidity was related to worse physical performance, and multimorbidity patterns were differentially associated with physical performance. A shift of focus from single conditions to the requirements of a complex multimorbid population was needed for research, clinical guidelines, and health-care services. Grip strength and gait speed could be targeted to routinely measure clinical performance among older adults with multimorbidity, especially mental–sensory disorders, in clinical settings.
Journal Article
Review of research on high-speed railway subgrade settlement in soft soil area
Construction issues of high-speed rail infrastructures have been increasingly concerned worldwide, of which the subgrade settlement in soft soil area becomes a particularly critical problem. Due to the high compressibility and low permeability of soft soil, the post-construction settlement of the subgrade is extremely difficult to control in these regions, which seriously threatens the operation safety of high-speed trains. In this work, the significant issues of high-speed railway subgrades in soft soil regions are discussed. The theoretical and experimental studies on foundation treatment methods for ballasted and ballastless tracks are reviewed. The settlement evolution and the settlement control effect of different treatment methods are highlighted. Control technologies of subgrade differential settlement are subsequently briefly presented. Settlement calculation algorithms of foundations reinforced by different treatment methods are discussed in detail. The defects of existing prediction methods and the challenges faced in their practical applications are analyzed. Furthermore, the guidance on future improvement in control theories and technologies of subgrade settlement for high-speed railway lines and the corresponding challenges are provided.
Journal Article
Characteristics and prognostic implications of peripheral blood lymphocyte subsets in patients with anti-MDA5 antibody positive dermatomyositis-interstitial lung disease
Objectives
To examine the characteristics of blood lymphocyte subsets in dermatomyositis-interstitial lung disease (DM-ILD) inflicted patients with positive anti-melanoma differentiation-associated gene 5 (anti-MDA5), as well as its prognosis value in this set of patients.
Methods
Data were retrospectively collected from 253 DM-ILD patients from three hospitals in China between January 2016 to January 2021. Patients were grouped into anti-MDA5 antibody positive group (MDA5
+
DM-ILD) and anti-MDA5 antibody negative group (MDA5
−
DM-ILD) based on myositis-specific autoantibody test results. Demographic characteristics, lymphocyte subsets patterns and other clinical features were compared between the two groups. The association of lymphocyte subsets with 180-day mortality was investigated using survival analysis in MDA5
+
DM-ILD.
Results
Out of 253 eligible patients with DM-ILD, 59 patients were anti-MDA5
+
and 194 were anti-MDA5
−
. Peripheral blood lymphocyte count, CD3
+
count, percentage of CD3
+
, CD3
+
CD4
+
count, and CD3
+
CD8
+
count was lower in MDA5
+
DM-ILD than in MDA5
−
DM-ILD
−
(all
P
< 0.001) as well as CD3
−
CD19
+
count (
P
= 0.04). In MDA5
+
DM-ILD, CD3
+
CD8
+
count ≤ 49.22 cell/μL (HR = 3.81, 95%CI [1.20,12.14]) and CD3-CD19
+
count ≤ 137.64 cell/μL (HR = 3.43, 95%CI [1.15,10.24]) were independent predictors of mortality. CD3
+
CD8
+
count ≤ 31.38 cell/μL was associated with a higher mortality risk in all DM-ILD patients (HR = 8.6, 95%CI [2.12,31.44]) after adjusting for anti-MDA5 and other clinical characteristics.
Conclusion
Significant lymphocytes decrease was observed in MDA5
+
DM-ILD patients. CD3
+
CD8
+
cell count was associated with worse prognosis in both MDA5
+
DM-ILD and all DM-ILD patients.
Journal Article
Skin‐Inspired Piezoelectric Tactile Sensor Array with Crosstalk‐Free Row+Column Electrodes for Spatiotemporally Distinguishing Diverse Stimuli
Real‐time detection and differentiation of diverse external stimuli with one tactile senor remains a huge challenge and largely restricts the development of electronic skins. Although different sensors have been described based on piezoresistivity, capacitance, and triboelectricity, and these devices are promising for tactile systems, there are few, if any, piezoelectric sensors to be able to distinguish diverse stimuli in real time. Here, a human skin‐inspired piezoelectric tactile sensor array constructed with a multilayer structure and row+column electrodes is reported. Integrated with a signal processor and a logical algorithm, the tactile sensor array achieves to sense and distinguish the magnitude, positions, and modes of diverse external stimuli, including gentle slipping, touching, and bending, in real time. Besides, the unique design overcomes the crosstalk issues existing in other sensors. Pressure sensing and bending sensing tests show that the proposed tactile sensor array possesses the characteristics of high sensitivity (7.7 mV kPa−1), long‐term durability (80 000 cycles), and rapid response time (10 ms) (less than human skin). The tactile sensor array also shows a superior scalability and ease of massive fabrication. Its ability of real‐time detection and differentiation of diverse stimuli for health monitoring, detection of animal movements, and robots is demonstrated. Human skin‐inspired piezoelectric tactile sensor array can sense and distinguish the magnitude, positions, and modes of diverse external stimuli in real time. The dual‐layer comb structures of the sensor array with row+column electrodes eliminate crosstalk and reduce the number of connection wires. It excavates enormous applications in various settings, such as health monitoring, detection of animal movements, and robots.
Journal Article
Multimorbidity measures differentially predicted mortality among older Chinese adults
This study aimed to examine and compare the associations between different multimorbidity measures and mortality among older Chinese adults.
Using the Chinese Longitudinal Healthy Longevity Survey 2002–2018, data on fourteen chronic conditions from 13,144 participants aged ≥65 years were collected. Multimorbidity measures included condition counts, multimorbidity patterns (examined by exploratory factor analysis), and multimorbidity trajectories (examined by a group-based trajectory model). Mortality risk associated with different multimorbidity measures was each analyzed using Cox regression. C-statistic, the Integrated Discrimination Improvement (IDI), and the Net Reclassification Index (NRI) were used to compare the performance of different multimorbidity measures.
Participants with multimorbidity, regardless of measurements, had a higher risk of death compared with people without multimorbidity. Compared with the mortality prediction model using age and sex, C-statistics showed added discrimination (over 0.77, all P < .05) for models with multimorbidity measures. Multimorbidity trajectory showed integrated discrimination and net reclassification improvement for mortality prediction compared to condition count (IDI = 0.042, NRI = 0.033) and multimorbidity pattern (IDI = 0.041, NRI = 0.069).
Adding multimorbidity measures significantly improved the performance of a mortality prediction model using age and sex as predictors. Trajectory-based measures of multimorbidity performed better than count- and pattern-based measures for mortality prediction.
Journal Article
On objective functions of minimizing the vibration response of continuum structures subjected to external harmonic excitation
This work deals with the topological design of vibrating continuum structures. The vibration of continuum structure is excited by time-harmonic external mechanical loading with prescribed frequency and amplitude. In comparison with well-known compliance minimization in static topology optimization, various objective functions are proposed in literature to minimize the response of vibrating structures, such as power flow, vibration transmission, and dynamic compliances, etc. Even for the dynamic compliance, different definitions are found in literature, which have quite different formulations and influences on the optimization results. The aim of this paper is to provide a comparison of these different objective functions and propose reference forms of objective functions for design optimization of vibration problems. Analytical solutions for two degrees of freedom system and topological design of plane structures in numerical examples are compared using different optimization formulations for given various excitation frequencies. The results are obtained by the finite element method and gradient based optimization using analytical sensitivity analysis. The optimized topologies and vibration response of the optimized structures are presented. The influence of excitation frequencies and the eigenfrequencies of the structure are discussed in the numerical examples.
Journal Article
Enhanced thermal conductivity of carbon fibers/silanized graphene/epoxy matrix composites
This study aimed to fabricate composites with high thermal conductivity using diglycidyl ether of bisphenol-A (DGEBA), incorporating carbon fiber cloth (CFC) and graphene as reinforcing agents. Notably, the dispersion of graphene within the DGEBA matrix was enhanced through surface modification via a silane coupling agent. The effects of CFC and graphene addition on the impact strength, thermal conductivity, and morphology of the composites were examined. The experimental results showed that the incorporation of 6 wt% CFC resulted in a substantial (16-fold) increase in impact strength. Furthermore, the introduction of 6 wt% CFCs along with 20 wt% graphene led to a remarkable enhancement in thermal conductivity to 5.7 W/(m K), which was approximately 22 and 4 times higher than the intrinsic thermal conductivities of pristine DGEBA and the CFC/DGEBA composite, respectively. The increased impact strength is ascribed to the incorporation of CFC and silane-modified graphene. Additionally, the gradual increase in thermal conductivity can be attributed to the enhanced interaction between the acidic silane-modified graphene and the basic epoxy–amine hardener within the system studied.
Journal Article