Resilience And Its Mediating Effect On The Relationship Between Life Stress And Health-Related Quality Of Life In Older Adult People Living With Hiv/aids

Background: By 2015, 50% of all HIV/AIDS cases in the United States will be persons 50-plus years of age. Very little, if any, research has examined resilience in older people living with HIV/AIDS (PLWHA). This research explored the conceptual construct of resilience and investigated the mediating effect of resilience on the relationship between life stress and health-related quality of life (HRQoL) in PLWHA over fifty. Methods: Data from a sample of 299 PLWHA over 50 was analyzed using structural equation modeling (SEM) to define a hypothesized Resilience construct (represented by Coping Self-Efficacy, Active Coping, Hope/Optimism and Social Support) and to assess meditating effects of Resilience between Life Stress and three facets of HRQoL (Physical Well-Being, Emotional Well-Being, and Functional and Global Well-Being). In addition, the mediation model was further analyzed to examine moderating effects of demographic variables on the magnitude of mediating effects. Results: The SEM results showed satisfactory model fit for the Resilience construct, χ2 (18, N = 299) = 41.2, p = .001, and comparative fit index (CFI) = .98, incremental fit index (IFI) = .98, Tucker-Lewis coefficient (TLI) = .96, root mean square error of approximation (RMSEA) =0.066 (95% CI: [.039, .092]), with all factor loading ranging from 0.61 to 0.86. The mediational model demonstrated adequate fit (χ2 (96, N = 299) = 226.9, p \u3c .0001, CFI = .96, IFI = .96, TLI = .95, RMSEA = .068 (95% CI: [.056, .079]) and revealed a full mediating effect of Resilience between Life Stress and Functional and Global Well-Being, as well as partial mediating effects on the relationship between Life Stress and Physical and Emotional Well-Being. What\u27s more, the study found that race and study sites moderated the mediating effects of Resilience, suggesting that Resilience may present differently across race/ethnicity, cultures, and other factors. Conclusion: The model indicated a well-defined Resilience construct and suggested that resilience may reduce the negative influence of life stress on physical, emotional, functional and global well-being. Findings suggest that the development of culturally-sensitive interventions that build personal capacity and environmental support may contribute to better management of HIV/AIDS and may be more efficacious in increasing HRQoL in older adult PLWHA

Vehicle Dispatching and Routing of On-Demand Intercity Ride-Pooling Services: A Multi-Agent Hierarchical Reinforcement Learning Approach

The integrated development of city clusters has given rise to an increasing demand for intercity travel. Intercity ride-pooling service exhibits considerable potential in upgrading traditional intercity bus services by implementing demand-responsive enhancements. Nevertheless, its online operations suffer the inherent complexities due to the coupling of vehicle resource allocation among cities and pooled-ride vehicle routing. To tackle these challenges, this study proposes a two-level framework designed to facilitate online fleet management. Specifically, a novel multi-agent feudal reinforcement learning model is proposed at the upper level of the framework to cooperatively assign idle vehicles to different intercity lines, while the lower level updates the routes of vehicles using an adaptive large neighborhood search heuristic. Numerical studies based on the realistic dataset of Xiamen and its surrounding cities in China show that the proposed framework effectively mitigates the supply and demand imbalances, and achieves significant improvement in both the average daily system profit and order fulfillment ratio

Online Relocating and Matching of Ride-Hailing Services: A Model-Based Modular Approach

This study proposes an innovative model-based modular approach (MMA) to dynamically optimize order matching and vehicle relocation in a ride-hailing platform. MMA utilizes a two-layer and modular modeling structure. The upper layer determines the spatial transfer patterns of vehicle flow within the system to maximize the total revenue of the current and future stages. With the guidance provided by the upper layer, the lower layer performs rapid vehicle-to-order matching and vehicle relocation. MMA is interpretable, and equipped with the customized and polynomial-time algorithm, which, as an online order-matching and vehicle-relocation algorithm, can scale past thousands of vehicles. We theoretically prove that the proposed algorithm can achieve the global optimum in stylized networks, while the numerical experiments based on both the toy network and realistic dataset demonstrate that MMA is capable of achieving superior systematic performance compared to batch matching and reinforcement-learning based methods. Moreover, its modular and lightweight modeling structure further enables it to achieve a high level of robustness against demand variation while maintaining a relatively low computational cost

The Dietary Intake, Food Security, and Quality of Life of HIV-Positive Individuals Receiving Home Delivered Meals

Background: Nutritional status has become an increasingly important aspect of quality of life for people living with HIV/AIDS (PLWA). Ensuring the best possible treatment of HIV/AIDS additionally requires a nutritionally balanced diet to maintain a healthy body. AIDS Project New Haven (APNH) is an organization that provides access to a variety of comprehensive support services to those affected by HIV/AIDS. In order to address the nutritional shortcomings of homebound PLWAs, APNH provides home delivered meals through a program called Caring Cuisine. Objective: To inform APNH of client characteristics of both Caring Cuisine and case management. Additionally, a comparison of dietary intake, food security, quality of life, mental health, and HIV risk behaviors between Caring Cuisine and case management clients is important. With these descriptive measures, we aimed to assess the influence of home delivered meals through Caring Cuisine on nutritional status, clinical indicators, and various quality of life measures. Design: There were two parts to this evaluation that included a medical chart review (n=164) of all active APNH clients and client surveys (n=21) that were used to assess demographic information, dietary intake and diversity, food security, and quality of life/ mental health. Of those that completed the questionnaire,11 individuals were Caring Cuisine clients while 10 were case management clients. Scores were developed for survey measurements that were analyzed by student t-test and chi-squared test. Results: Overall, Caring Cuisine clients were older, less able to work and live in smaller households. There was no significant difference in quality of life indicators, except for social functioning. Less social functioning was seen for Caring Cuisine clients (43.6±35.6) than for case management clients (78.0±22.0). Additionally, household size was significantly smaller in Caring Cuisine households (p-value = 0.0006). On average, Caring Cuisine clients had lower physical health(34.1±8.8) and mental health summary scores (43.5±9.8) compared with case management clients (41.5±8.7 and 49.2±9.3, respectively). Furthermore,Caring Cuisine clients reported higher food security (1.7±2.2) than case management clients (6.0±7.1) and consumed 3 more vegetables, fruits dairy, meat and grains. However, Caring Cuisine clients also consumed more saturated fats, cholesterol, and sodium. Conclusion: As a preliminary analysis assessing subject characteristics of APNH clients enrolled in Caring Cuisine compared with general clients, we saw differences in absolute values of dietary, behavioral, and clinical outcomes. However, at this time, there is not a large enough client base to suggest that clients of APNH are significantly different from one another by Caring Cuisine enrollment status.Trends indicate that Caring Cuisine clients have on average less healthy eating habits, higher foods security, more risk behavior activities, and decreased quality of life indicators as compared with case management clients. Larger studies are needed to confirm and validate these findings.https://elischolar.library.yale.edu/ysph_pbchrr/1036/thumbnail.jp

The Chinese Open Science Network (COSN): Building an Open Science Community From Scratch

Open Science is becoming a mainstream scientific ideology in psychology and related fields. However, researchers, especially early-career researchers (ECRs) in developing countries, are facing significant hurdles in engaging in Open Science and moving it forward. In China, various societal and cultural factors discourage ECRs from participating in Open Science, such as the lack of dedicated communication channels and the norm of modesty. To make the voice of Open Science heard by Chinese-speaking ECRs and scholars at large, the Chinese Open Science Network (COSN) was initiated in 2016. With its core values being grassroots-oriented, diversity, and inclusivity, COSN has grown from a small Open Science interest group to a recognized network both in the Chinese-speaking research community and the international Open Science community. So far, COSN has organized three in-person workshops, 12 tutorials, 48 talks, and 55 journal club sessions and translated 15 Open Science-related articles and blogs from English to Chinese. Currently, the main social media account of COSN (i.e., the WeChat Official Account) has more than 23,000 subscribers, and more than 1,000 researchers/students actively participate in the discussions on Open Science. In this article, we share our experience in building such a network to encourage ECRs in developing countries to start their own Open Science initiatives and engage in the global Open Science movement. We foresee great collaborative efforts of COSN together with all other local and international networks to further accelerate the Open Science movement

Robust scheduling strategies of electric buses under stochastic traffic conditions

The electric bus scheduling problem requires not only satisfying timetable constraints but also considering battery range limitation and vehicles’ recharging plans. This paper is devoted to proposing robust scheduling strategies of electric buses to tackle the challenge brought by the stochasticity of urban traffic conditions. To avoid en-route breakdown of electric buses, reduce delay costs, and achieve robustness, we propose both static and dynamic scheduling models. The static model introduces a buffer-distance strategy to tackle the adverse impacts caused by trip time stochasticity, whereas the dynamic model takes advantage of continuously-updated road traffic conditions and periodically reschedules an electric bus fleet during a day’s operations. A branch-and-price framework is extended to effectively solve both models. Using the realistic operations data of bus lines in Beijing, we conduct numerical examples to simulate the performances of the proposed models and derive some important insights. As suggested by the numerical results, the proposed models can effectively avoid en-route breakdown, while maintaining cost efficiency

Dynamic operations of an integrated mobility service system of fixed-route transits and flexible electric buses

As an emerging mobility service with a wide range of benefits, flexible buses balance monetary costs, travel time, and comfort, and have evolved into a powerful supplement to traditional travel modes. This study investigates the dynamic operations of an integrated mobility service system of flexible electric buses and fixed-route transits, such as traditional buses and metros. The proposed integrated framework owns the potential of making the maximum utilization of the flexibility of mobility-on-demand transports and the capacity of fixed-route transits, but it is very challenging to efficiently operate. We establish mathematical models to dynamically optimize the detailed flexible bus routing and timetabling plans, and assign travel routes for passengers while considering the transfer behavior from/to the conventional fixed-route transits in a network. To resolve the curse of dimensionality and facilitate the solution procedure, we embed a learning procedure into an optimization model and further decompose the subproblem in each period into two layers. Numerical studies verify the superior performance of the proposed learning-and-optimization framework in both stochastic dynamic and deterministic settings

Apigenin suppresses PD-L1 expression in melanoma and host dendritic cells to elicit synergistic therapeutic effects

Abstract Background The PD-L1/PD-1 pathway blockade-mediated immune therapy has shown promising efficacy in the treatment of multiple cancers including melanoma. The present study investigated the effects of the flavonoid apigenin on the PD-L1 expression and the tumorigenesis of melanoma. Methods The influence of flavonoids on melanoma cell growth and apoptosis was investigated using cell proliferation and flow cytometric analyses. The differential IFN-γ-induced PD-L1 expression and STAT1 activation were examined in curcumin and apigenin-treated melanoma cells using immunoblotting or immunofluorescence assays. The effects of flavonoid treatment on melanoma sensitivity towards T cells were investigated using Jurkat cell killing, cytotoxicity, cell viability, and IL-2 secretion assays. Melanoma xenograft mouse model was used to assess the impact of flavonoids on tumorigenesis in vivo. Human peripheral blood mononuclear cells were used to examine the influence of flavonoids on PD-L1 expression in dendritic cells and cytotoxicity of cocultured cytokine-induced killer cells by cell killing assays. Results Curcumin and apigenin showed growth-suppressive and pro-apoptotic effects on melanoma cells. The IFN-γ-induced PD-L1 upregulation was significantly inhibited by flavonoids, especially apigenin, with correlated reductions in STAT1 phosphorylation. Apigenin-treated A375 cells exhibited increased sensitivity towards T cell-mediated killing. Apigenin also strongly inhibited A375 melanoma xenograft growth in vivo, with enhanced T cell infiltration into tumor tissues. PD-L1 expression in dendritic cells was reduced by apigenin, which potentiated the cytotoxicity of cocultured cytokine-induced killer cells against melanoma cells. Conclusions Apigenin restricted melanoma growth through multiple mechanisms, among which its suppression of PD-L1 expression exerted a dual effect via regulating both tumor and antigen presenting cells. Our findings provide novel insights into the anticancer effects of apigenin and might have potential clinical implications