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Limited longitudinal research examining developmental changes in visuospatial working memory (WM) among children and adolescents with autism spectrum disorder (ASD) has prompted our investigation.
Methods
We assessed 123 autistic children and adolescents and 145 typically developing controls (TDC) using the Cambridge Neuropsychological Test Automated Battery at baseline (Time 1 [mean age ± SD]: ASD: 13.04 ± 2.86; TDC: 11.53 ± 2.81) and 2–9 years later (Time 2: ASD: 18.08 ± 3.17; TDC: 16.41 ± 3.09) to measure changes of visuospatial (working) memory over time. The linear mixed model was used to compare the differences between ASD and TDC and estimate the effect of changes over time, age, ASD diagnosis, and interactions of Time×Age×ASD. The overall Age×ASD effect was calculated in the spline regression.
Results
Autistic children and adolescents exhibited significantly poorer performance on all spatial tasks and some visual tasks than their TDC counterparts at Time 1 and Time 2, after adjusting for sex, age, attention deficit/hyperactivity disorder (ADHD), and full-scale intelligence quotient. There was an overall improvement from Time 1 to Time 2 across all tasks with significant Age×Time interactions. Significant Age×ASD interactions were observed in the delayed matching to sample, pattern recognition memory (PRM), spatial span (SSP), and spatial working memory (SWM) tasks with no significant Time×ASD interactions. In the quadratic nonlinear model, Age×ASD interactions were significant in PRM and SSP.
Conclusion
Despite significant improvements during the follow-up period, autistic children and adolescents continue to experience persistent deficits in SWM, with a weaker age-related improvement in visuospatial WM than TDC.
Internet addiction (IA) refers to excessive internet use that causes cognitive impairment or distress. Understanding the neurophysiological mechanisms underpinning IA is crucial for enabling an accurate diagnosis and informing treatment and prevention strategies. Despite the recent increase in studies examining the neurophysiological traits of IA, their findings often vary. To enhance the accuracy of identifying key neurophysiological characteristics of IA, this study used the phase lag index (PLI) and weighted PLI (WPLI) methods, which minimize volume conduction effects, to analyze the resting-state electroencephalography (EEG) functional connectivity. We further evaluated the reliability of the identified features for IA classification using various machine learning methods.
Methods
Ninety-two participants (42 with IA and 50 healthy controls (HCs)) were included. PLI and WPLI values for each participant were computed, and values exhibiting significant differences between the two groups were selected as features for the subsequent classification task.
Results
Support vector machine (SVM) achieved an 83% accuracy rate using PLI features and an improved 86% accuracy rate using WPLI features. t-test results showed analogous topographical patterns for both the WPLI and PLI. Numerous connections were identified within the delta and gamma frequency bands that exhibited significant differences between the two groups, with the IA group manifesting an elevated level of phase synchronization.
Conclusions
Functional connectivity analysis and machine learning algorithms can jointly distinguish participants with IA from HCs based on EEG data. PLI and WPLI have substantial potential as biomarkers for identifying the neurophysiological traits of IA.
Second-generation antipsychotics (SGAs) cause metabolic side effects. However, patients’ metabolic profiles were influenced by time-invariant and time-varying confounders. Real-world evidence on the long-term, dynamic effects of SGAs (e.g. different treatment sequences) are limited. We employed advanced causal inference methods to evaluate the metabolic impact of SGAs in a naturalistic cohort.
Methods
We followed 696 Chinese patients with schizophrenia-spectrum disorders receiving SGAs. Longitudinal targeted maximum likelihood estimation (LTMLE) was used to estimate the average treatment effects (ATEs) of continuous SGA treatment versus ‘no treatment’ on metabolic outcomes, including total cholesterol (TC), high-density lipoprotein (HDL), low-density lipoprotein (LDL), triglyceride (TG), fasting glucose (FG), and body mass index (BMI), over 6–18 months at 3-month intervals. LTMLE accounted for time-invariant and time-varying confounders. Post-SGA discontinuation side effects were also assessed.
Results
The ATEs of continuous SGA treatment on BMI and TG showed an inverted U-shaped pattern, peaking at 12 months and declining afterwards. Similar patterns were observed for TC and LDL, albeit the ATEs peaked at 15 months. For FG and HDL, the ATEs peaked at ~6 months. The adverse impact of SGAs on BMI persisted even after medication discontinuation, yet other metabolic parameters did not show such lingering side effects. Clozapine and olanzapine exhibited greater metabolic side effects compared to other SGAs.
Conclusions
Our real-world study suggests that metabolic side effects may stabilize with prolonged continuous treatment. Clozapine and olanzapine confer higher cardiometabolic risks than other SGAs. The side effects of SGAs on BMI may persist after drug discontinuation. These insights may guide antipsychotic choice and improve management of metabolic side effects.
Terminal cancer patients often endure significant distress, impacting their quality of life. Spiritual well-being provides peace and meaning during this challenging period.
Objectives. This study explored the spiritual well-being of terminally ill patients and their next-of-kin caregivers in hospice care, focusing on factors influencing their spiritual experiences.
Methods
This mixed-methods study included 30 terminally ill patients and 17 next-of-kin caregivers in hospice care. Spiritual well-being was assessed using the Functional Assessment of Chronic Illness Therapy – Spiritual Well-Being Scale (FACIT-Sp-12), and symptom distress with the Edmonton Symptom Assessment Scale. Qualitative data were collected through semi-structured interviews at baseline, 1 week, and 1 month. Data were analyzed using quantitative methods and thematic analysis.
Results
Patients showed a significant improvement in spiritual well-being over time, with FACIT-Sp-12 scores increasing from 28.6 at baseline to 31.3 at 1 month (p < .01). Symptoms such as shortness of breath (β = –1.19, p < .001), drowsiness (β = –1.27, p = .01), and anxiety (β = –0.60, p = .03) were negatively associated with spiritual well-being. Caregiver spiritual well-being positively influenced patient scores, especially with female caregivers (β = 0.26, p < .001). Qualitative findings supported these results, revealing themes of spiritual adjustment, the impact of physical symptoms on spiritual well-being, and the crucial role of caregivers in providing emotional and spiritual support.
Significance of results
Early palliative care facilitates spiritual adjustment in terminally ill patients. A holistic approach addressing physical symptoms and psychological distress is essential. Supporting caregivers, particularly female ones, positively impacts patient spiritual well-being. Tailored interventions considering the unique needs of patients and caregivers are recommended to enhance palliative care quality.
A transverse ledge climbing robot inspired by athletic locomotion is a customized robot aiming to travel through horizontal ledges in vertical walls. Due to the safety issue and complex configurations in graspable ledges such as horizontal, inclined ledges, and gaps between ledges, existing well-known vision-based navigation methods suffering from occlusion problems may not be applicable to this special kind of application. This study develops a force feedback-based motion planning strategy for the robot to explore and make feasible grasping actions as it continuously travels through reachable ledges. A contact force detection algorithm developed using a momentum observer approach is implemented to estimate the contact force between the robot’s exploring hand and the ledge. Then, to minimize the detection errors due to dynamic model uncertainties and noises, a time-varying threshold is integrated. When the estimated contact force exceeds the threshold value, the robot control system feeds the estimated force into the admittance controller to revise the joint motion trajectories for a smooth transition. To handle the scenario of gaps between ledges, several ledge-searching algorithms are developed to allow the robot to grasp the next target ledge and safely overcome the gap transition. The effectiveness of the proposed motion planning and searching strategy has been justified by simulation, where the four-link transverse climbing robot successfully navigates through a set of obstacle scenarios modeled to approximate the actual environment. The performance of the developed grasping ledge searching methods for various obstacle characteristics has been evaluated.
The development of inhibitory control (IC) and working memory (WM) in preschool is linked to a multitude of cognitive, emotional, and social outcomes, including elementary school adjustment. Furthermore, there are both cognitive and socioemotional domains of IC and it is unclear if both are related to these outcomes in the same manner. Using a family study design, the present investigation examined preschoolers’ IC, WM and externalizing behavior problems, maternal depression and anxiety measured when the children were in preschool, and elementary school externalizing behaviors and child and family functioning. Families with two children between 2.5 and 5.5 years of age (n = 198; mean age = 3.88, SD = 1.04) completed online surveys and laboratory visits, as well as another online survey after the children entered elementary school. Both cognitive and emotional domains of preschool IC significantly predicted the externalizing and functioning aspects of adjustment in elementary school (but WM did not predict either). In addition, child age predicted functioning in elementary school, and maternal depression predicted externalizing in elementary school. These longitudinal results indicate that supporting both cognitive and emotional aspects of preschool IC can benefit adjustment in elementary school.
Given known item parameters, the bootstrap method can be used to determine the statistical accuracy of ability estimates in item response theory. Through a Monte Carlo study, the method is evaluated as a way of approximating the standard error and confidence limits for the maximum likelihood estimate of the ability parameter, and compared to the use of the theoretical standard error and confidence limits developed by Lord. At least for short tests, the bootstrap method yielded better estimates than the corresponding theoretical values.
Bacterial infection risk in work environments has been extensively reported for healthcare workers, while this risk is rarely researched in other occupations. This study aimed to identify occupational environments in Taiwan’s agricultural and healthcare industries with elevated bacterial infection risks by comparing risks for general bacterial infections and pneumonia. Using labour and health insurance claim data from 3.3 million workers (January 2004–December 2020), a retrospective cohort was constructed to estimate occupational infection risks with Cox regression and the Anderson-Gill extension. Significantly elevated hazard ratios were found for workers in vegetable growing, crop cultivation service, mushroom growing, flower growing, and fruit growing, ranging from 1.13 to 1.39 for general bacterial infections and 1.68 to 3.06 for pneumonia infections. In afforestation and the inland fishing industry, pneumonia risk was significantly elevated with, respectively, 1.87 and 1.21. In the healthcare section, especially workers in residential care services and residential care services for elderly stand out regarding their pneumonia risk, with significant hazard ratios of 3.49 and 1.75. The methods used in this study were proven to be effective in identification of occupation environments at risk and can be used in other settings. These findings call for prioritization of bacterial infection prevention by occupation.
Introduction: Late-life depression (LLD) is associated with cognitive deficit with risk of future dementia. By examining the entropy of the spontaneous brain activity, we aimed to understand the neural mechanism pertaining to cognitive decline in LLD.
Methods: We collected MRI scans in older adults with LLD (n = 32), mild cognitive impairment [MCI (n = 25)] and normal cognitive function [NC, (n = 47)]. Multiscale entropy analysis (MSE) was applied to resting-state fMRI data. Under the scale factor (tau) 1 and 2, reliable separation of fMRI data and noise was achieved. We calculated the brain entropy in 90 brain regions based on automated anatomical atlas (AAL). Due to exploratory nature of this study, we presented data of group-wise comparison in brain entropy between LLD vs. NC, MCI vs. NC, and LLD and MCD with a p-value below 0.001.
Results: The mean Mini-Mental State Examination (MMSE) score of LLD and MCI was 27.9 and 25.6. Under tau 2, we found higher brain entropy of LLD in left globus pallidus than MCI (p = 0.002) and NC (p = 0,009). Higher brain entropy of LLD than NC was also found in left frontal superior gyrus, left middle superior gyrus, left amygdala and left inferior parietal gyrus. The only brain region with higher brain entropy in MCI than control was left posterior cingulum (p-value = 0.015). Under tau 1, higher brain entropy was also found in LLD than in MCI in right orbital part of medial frontal gyrus and left globus pallidus (p-value = 0.007 and 0.005).
Conclusions: Our result is consistent with prior hypothesis where higher brain entropy was found during early aging process as compensation. We found such phenomenon particular in left globus pallidus in LLD, which could be served as a discriminative brain region. Being a key region in reward system, we hypothesis such region may be associated with apathy and with unique pathway of cognitive decline in LLD. We will undertake subsequent analysis longitudinally in this cohort
Purple nutsedge (Cyperus rotundus L.) is one of the world’s resilient upland weeds, primarily spreading through its tubers. Its emergence in rice (Oryza sativa L.) fields has been increasing, likely due to changing paddy-farming practices. This study aimed to investigate how C. rotundus, an upland weed, can withstand soil flooding and become a problematic weed in rice fields. The first comparative analysis focused on the survival and recovery characteristics of growing and mature tubers of C. rotundus exposed to soil-flooding conditions. Notably, mature tubers exhibited significant survival and recovery abilities in these environments. Based on this observation, further investigation was carried out to explore the morphological structure, nonstructural carbohydrates, and respiratory mechanisms of mature tubers in response to prolonged soil flooding. Over time, the mature tubers did not form aerenchyma but instead gradually accumulated lignified sclerenchymal fibers, with lignin content also increasing. After 90 d, the lignified sclerenchymal fibers and lignin contents were 4.0 and 1.1 times higher than those in the no soil-flooding treatment. Concurrently, soluble sugar content decreased while starch content increased, providing energy storage, and alcohol dehydrogenase activity rose to support anaerobic respiration via alcohol fermentation. These results indicated that mature tubers survived in soil-flooding conditions by adopting a low-oxygen quiescence strategy, which involves morphological adaptations through the development of lignified sclerenchymal fibers, increased starch reserves for energy storage, and enhanced anaerobic respiration. This mechanism likely underpins the flooding tolerance of mature C. rotundus tubers, allowing them to endure unfavorable conditions and subsequently germinate and grow once flooding subsides. This study provides a preliminary explanation of the mechanism by which mature tubers of C. rotundus from the upland areas confer flooding tolerance, shedding light on the reasons behind this weed’s increasing presence in rice fields.
Cross-linguistic interactions are the hallmark of bilingual development. Theoretical perspectives highlight the key role of cross-linguistic distances and language structure in literacy development. Despite the strong theoretical assumptions, the impact of such bilingualism factors in heritage-language speakers remains elusive given high variability in children's heritage-language experiences. A longitudinal inquiry of heritage-language learners of structurally distinct languages – Spanish–English and Chinese–English bilinguals (N = 181, Mage = 7.57, measured 1.5 years apart) aimed to fill this gap. Spanish–English bilinguals showed stronger associations between morphological awareness skills across their two languages, across time, likely reflecting cross-linguistic similarities in vocabulary and lexical morphology between Spanish and English. Chinese–English bilinguals, however, showed stronger associations between morphological and word reading skills in English, likely reflecting the critical role of morphology in spoken and written Chinese word structure. The findings inform theories of literacy by uncovering the mechanisms by which bilingualism factors influence child literacy development.
Immigrant caregivers support the aging population, yet their own needs are often neglected. Mobile technology-facilitated interventions can promote caregiver health by providing easy access to self-care materials.
Objective
This study employed a design thinking framework to examine Chinese immigrant caregivers’ (CICs) unmet self-care needs and co-design an app for promoting self-care with CICs.
Methods
Nineteen semi-structured interviews were conducted in conceptual design and prototype co-design phases.
Findings
Participants reported unmet self-care needs influenced by psychological and social barriers, immigrant status, and caregiving tasks. They expressed the need to learn to keep healthy boundaries with the care recipient and respond to emergencies. Gaining knowledge was the main benefit that drew CICs’ interest in using the self-care app. However, potential barriers to use included issues of curriculum design, technology anxiety, limited free time, and caregiving burdens.
Discussion
The co-design process appears to be beneficial in having participants voice both barriers and preferences.
Dementia is currently the seventh leading cause of death and one of the major causes of disability and dependency among elderly. In Taiwan, there are at least 300,000 people live with dementia. However, only 1.64% of people with dementia received palliative care. In this paper, we describe a real-world experience of palliative care for people with advanced dementia.
Method:
Case report.
Result:
Mrs. H, A 90-year-old illiterate woman, was referred to Home Care team after several admissions for urinary tract infection. Her past medical history included cerebral infarction with left hemiparesis 4 years ago. Over one year prior our first visit, her family had begun to notice a problem with her recent memory. Thorough investigation for dementia was arranged. She scored 11/30 on the Mini-Mental State Examination. Mixed Alzheimer’s and vascular dementia was impressed.
The Home Care service consisted of a once-monthly visit by physician and nurse. In the first year of service, we delivered active directed treatment for dementia. We also discussed nonpharmacological approaches for dealing with physical and behavior symptoms in each visit.
Then Mrs. H was hospitalized again due to fever and abdominal pain. Abdominal aortic aneurysm was diagnosed along with urinary tract infection. She had hypoactive delirium for two months after discharge. Meanwhile, Home Care team arranged a family meeting to discuss prognosis and appropriateness of palliative care. In the following two years, we focused on deprescribing and interventions for pain, dyspnea, eating problem, infection, and agitation to promote Mrs. H’s comfort and quality of life. Psychological support was crucial to facilitate continuity in carer and care setting. Mrs.H did not have burdensome transition anymore and passed away peacefully at home as her preference.
Conclusion:
The need for palliative care in dementia is anticipated to increase over the next decades in Taiwan. In the patient presented, Home Care team acknowledged and offered palliative care to help her to live as comfortably as possible until death and to help carers cope during the course. A multidisciplinary health care is highly recommended for complex needs in dementia.
Injection of CaCl2 and Na2SiO3 solutions into clay suspensions during electroosmosis often improves the cohesive strength of clays near the anode and cathode, whereas the cohesive strength of clays between the electrodes remains weak. Although the main improvement mechanism for the cohesive strength of clays near the cathode was demonstrated to be a pozzolanic reaction (formation of calcium silicate hydrate cement), the mechanism of improved cohesive strength near the anode is still not understood. The objective of the present study was to investigate the mechanism for the improvement of cohesive strength near the anode and, thus, make it possible to determine a way to enhance the range in improvement using kaolinite as the test clay. The test was performed by first injecting CaCl2 solution during electroosmosis until the optimum volume of CaCl2 was attained. This was followed by treatment with Na2SiO3 solution for different lengths of time. The results indicate that the anode region after treatment was acidic (pH = 4) because the electrolysis of water causes acidification near the anode. As Na2SiO3 solution was injected through the anode, the mechanism of cohesive strength improvement of the treated clay near the anode was attributed to the silicic acid polymerization effect provided by the Na2SiO3 solution. The silicic acid may link the clay particles together to form a gel network in a low pH environment. The clay gel network structure developed rigidity as the water content was reduced. In addition, as the volume of injected Na2SiO3 solution was increased, the cohesive strength near the anode also increased.
Electro-osmotic chemical treatment is an innovative method to improve the strength of soft clays for geotechnical engineering purposes; the effectiveness of the treatment may be related to treatment time, the concentration of the solutions injected, and to variation of pH in the clay. The objective of this study was to investigate the relationship between the above-mentioned factors and the improvement in strength when calcium chloride solution was used as an injection material. A series of tests was carried out by injecting different concentrations of calcium chloride solution into a kaolin suspension, for different treatment times, during electro-osmosis. After the tests, the pH, cone resistance, water content, and concentration of Ca2+ in the kaolin at different locations were measured and analyzed. The results show that the concentration of Ca2+ in the kaolin, the pH, and the strength were increased near the cathode with increases in concentration of CaCl2 and treatment time. An insignificant increase in strength, due to ion exchange over the entire specimen, for short treatment times of 2 to 24 h, was observed because of a small increase in concentration of Ca2+ and in pH. During long-term treatment (120 h), a considerable increase in concentration of Ca2+ (137.0 mg/g) and pH (pH = 10) was observed near the cathode. This led to a pozzolanic reaction, which in turn caused a significant increase in the mechanical strength of the kaolin.
In order to establish a compact all-optical Thomson scattering source, experimental studies were conducted on the 45 TW Ti: sapphire laser facility. By including a steel wafer, mixed gas, and plasma mirror into a double-exit jet, several mechanisms, such as shock-assisted ionization injection, ionization injection, and driving laser reflection, were integrated into one source. So, the source of complexity was remarkably reduced. Electron bunches with central energy fluctuating from 90 to 160 MeV can be produced. Plasma mirrors were used to reflect the driving laser. The scattering of the reflected laser on the electron bunches led to the generation of X-ray photons. Through comparing the X-ray spots under different experimental conditions, it is confirmed that the X-ray photons are generated by Thomson scattering. For further application, the energy spectra and source size of the Thomson scattering source were measured. The unfolded spectrum contains a large amount of low-energy photons besides a peak near 67 keV. Through importing the electron energy spectrum into the Monte Carlo simulation code, the different contributions of the photons with small and large emitting angles can be used to explain the origin of the unfolded spectrum. The maximum photon energy extended to about 500 keV. The total photon production was 107/pulse. The FWHM source size was about 12 μm.
Presurgical psychological screening (PPS) is a procedure for mitigating possible unfavorable outcomes after spinal surgery. Although the effectiveness of PPS on degenerative spinal diseases has been investigated in Western studies, a potential cultural influence on PPS is still unknown. This study thus aims to explore the experiences of Taiwanese people before spinal surgery and tries to establish culture-specific components of PPS in Taiwan.
Participants and Methods:
A total of five participants aged from 44–69 with degenerative spinal diseases were eligible in this study. All participants visited a neurosurgical outpatient clinic for potential surgical treatment, and each participant underwent an one-hour semi-structured interview before surgery. The demographical information, medical history, psychological status (e.g., personality traits and emotional disturbances) and considerations to make a surgical decision, were recorded and further analyzed following the rule of grounded theory.
Results:
Four major components with 21 sub-components were reported when deciding to receive a surgical treatment for their spinal diseases, including disease-related considerations, medical information, self-concept and interpersonal relations. In terms of disease-related aspects, patients concerned about etiology, symptomatology, impacts, coping strategies and rehabilitation methods. As for medical information, patients paid more attention on medical compliance, the relationship with medical system, attitude for treatment, expectation to surgical outcomes, medical decisions and medical information. As for the self-concept, patients considered more on the impacts of disease on self-concept, strategies of emotional regulations and personality traits. In terms of interpersonal relations, patients reported more on the supportive resources, patterns of interpersonal activities and impacts of interpersonal relations on medical decisions. Additionally, other specific factors, such as past negative experiences (e.g., chronic insomnia, experiences of psychological counseling), litigation, physical punishment in childhood and social roles, were also reported.
Conclusions:
Like previous findings, our results supported that the interpersonal relations and doctor-patient relationship in PPS were important considerations before surgery, while we further evidenced that influences of family members on medical decision is determinant and unique in this culture.
To evaluate the mental health of paediatric cochlear implant users and analyse the relationship between six dimensions (movements, cognitive ability, emotion and will, sociality, living habits and language) and hearing and speech rehabilitation.
Methods
Eighty-two cochlear implant users were assessed using the Mental Health Survey Questionnaire. Age at implantation, time of implant use and listening modes were investigated. Categories of Auditory Performance and the Speech Intelligibility Rating Scale were used to score hearing and speech abilities.
Results
More recipients scored lower in cognitive ability and language. Age at implantation was statistically significant (p < 0.05) for movements, cognitive ability, emotion and will, and language. The time of implant usage and listening mode indicated statistical significance (p < 0.05) in cognitive ability, sociality and language.
Conclusion
Timely attention should be paid to the mental health of paediatric cochlear implant users, and corresponding psychological interventions should be implemented to make personalised rehabilitation plans.
Purple nutsedge (Cyperus rotundus L.) is a globally distributed noxious weed that poses a significant challenge for control due to its fast and efficient propagation through the tuber, which is the primary reproductive organ. Gibberellic acid (GA3) has proven to be crucial for tuberization in tuberous plants. Therefore, understanding the relationship between GA3 and tuber development and propagation of C. rotundus will provide valuable information for controlling this weed. This study shows that the GA3 content decreases with tuber development, which corresponds to lower expression of bioactive GA3 synthesis genes (CrGA20ox, two CrGA3ox genes) and two upregulated GA3 catabolism genes (CrGA2ox genes), indicating that GA3 is involved in tuber development. Simultaneously, the expression of two CrDELLA genes and CrGID1 declines with tuber growth and decreased GA3, and yeast two-hybrid assays confirm that the GA3 signaling is DELLA-dependent. Furthermore, exogenous application of GA3 markedly reduces the number and the width of tubers and represses the growth of the tuber chain, further confirming the negative impact that GA3 has on tuber development and propagation. Taken together, these results demonstrate that GA3 is involved in tuber development and regulated by the DELLA-dependent pathway in C. rotundus and plays a negative role in tuber development and propagation.