Outcome assessment of stroke convalescence using multiple scales based on different dimensions

BACKGROUND: Convalescence is an important stage of stroke treatment. A lot of patients have somatic and mental disorders at various degrees. The primary standard can only reflect partial conditions of somatic disorder; in addition, multiple dimensions of patients at the phase of stroke convalescence are further observed by using a lot of standards, such as signs and symptoms of traditional Chinese medicine, daily activity and psychological status. OBJECTIVE: To analyze the outcome assessments of the cases of stroke convalescence measured with different criteria consisting of various dimensions by a cross-sectional investigation of the condition of stroke convalescent patients. DESIGN: Scale evaluation. SETTING: Departments of Clinical Epidemiology Exploratory Development and Neurology, the Second Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine; National Center for Training of Design, Measurement and Evaluation in Clinical Research,Guangzhou University of Traditional Chinese Medicine. PARTICIPANTS: A total of 194 stroke convalescent patients treated in the Second Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine from July 26, 2000 to February 28, 2001 were taken as subjects of the study. There were 126 males and 68 females aged from 40 to 89 years, and the illness course ranged from 14 to 181 days. All patients met diagnosis-treatment criteria of stroke (the second version)[DTCS(V2.0)] and various kinds of diagnostic points of cerebrovascular diseases; moreover, all patients provided confirmed consents. METHODS: They were assessed by assessment methods including the following assessment instruments: DTCS(V2.0), self-designed scale of traditional Chinese medicine (TCM) symptoms (28 symptoms and physical signs were scored as 0, 1, 2 marks from none to severity), modified Edinburgh-Scandinavia stroke scale (a total of 45 marks, 0 to 15 marks as mild defect, 16 to 30 as moderate defect, 31 to 45 as severe defect), modified Barthel activities of daily life (ADL) index (a total of 100 marks, less than 60 marks as unable self-care), vitality and mental health (subscales derived from Health Survey Questionnaire, SF-36). The collected data from scales and inter-scale correlation were processed by the statistic methods mainly including descriptive analysis, Spearmen correlation analysis, factor analysis, etc. MAIN OUTCOME MEASURES: ① Average scores of scales and criteria; ② correlation between modified Edinburgh-Scandinavia stroke scale and other scales. RESULTS: All of the patients completed the assessment, and analyzed in the final analysis. ① The average scores of the scales and criteria: The average scores of DTCS(V2.0), self-designed scale of TCM symptoms, modified Edinburgh-Scandinavia stroke scale, modified Barthel ADL index, vitality and mental health scales were 6.51±6.29, 13.73±6.97, 7.56±7.35, 63.58±23.68, 52.79±23.32 and 62.83±22.75 respectively. ② Correlation between modified Edinburgh-Scandinavia stroke scale and other scales: The Spearman correlation coefficients (R ’) of modified Edinburgh-Scandinavia stroke scale with diagnosis-treatment criteria of stroke, scales of TCM symptoms, modified Barthel ADL index, vitality scale and mental health scale were 20.885, 0.302, -0.824, -0.294 and -0.258 respectively. CONCLUSION: The modified Edinburgh-Scandinavia stroke scale and DTCS(V2.0) shared the same assessment dimension, so they can be mutually alternated in some clinical practices. Discrepancy in measurements of health status was gained due to the diverse dimensions applied in outcome assessments. It is necessary to build up a multi-dimensional assessment criteria system, such as signs and symptoms, daily activities and psychological status, for assessing the stroke convalescent cases in a more comprehensive scope and reflecting the efficacy of TCM treatment scientifically.

Regional differences of urbanization in China and its driving factors

After more than 30 years of rapid urbanization, the overall urbanization rate of China reached 56.1% in 2015.However, despite China's rapid increase in its overall rate of urbanization, clear regional differences can be observed. Furthermore, inadequate research has been devoted to in-depth exploration of the regional differences in China's urbanization from a national perspective, as well as the internal factors that drive these differences. Using prefecture-level administrative units in China as the main research subject, this study illustrates the regional differences in urbanization by categorizing the divisions into four types based on their urbanization ratio and speed(high level: low speed; high level: high speed; low level: high speed; and low level: low speed). Next, we selected seven economic and geographic indicators and applied an ordered logit model to explore the driving factors of the regional differences in urbanization. A multiple linear regression model was then adopted to analyze the different impacts of these driving factors on regions with different urbanization types. The results showed that the regional differences in urbanization were significantly correlated to per capita GDP, industry location quotients, urban-rural income ratio,and time distance to major centers. In addition, with each type of urbanization, these factors were found to have a different driving effect. Specifically, the driving effect of per capita GDP and industry location quotients presented a marginally decreasing trend, while main road density appeared to have a more significant impact on cities with lower urbanization rates.

Pointwise multipliers for Besov spaces of dominating mixed smoothness-Ⅱ

We continue our investigations on pointwise multipliers for Besov spaces of dominating mixed smoothness. This time we study the algebra property of the classes S_(p,q)~rB(R^d) with respect to pointwise multiplication. In addition, if p≤q, we are able to describe the space of all pointwise multipliers for S_(p,q)~rB(R^d).