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Rehabilitation services play a vital role in the quality of life for children with disabilities. China has established a system of rehabilitation services, in which eligible children with disabilities are entitled to free rehabilitation services at designated institutions. This study reveals, however, that some rural families decide to discontinue the free rehabilitation services. This study attempts to explore the reasons for their decision through qualitative methods. We find that the ideology of developmentalism with its emphasis on efficiency dominates policy actors’ thinking and actions. In a cultural discourse that prioritises utility and economic development, children with disabilities are regarded by policy implementers as a ‘non-priority’, by their service providers as an opportunity for profit, and by their parents as ‘futureless’. That these families discontinue using these free services seems to result from the policy attitudes mentioned above.
Tea can improve the progression of some metabolic diseases through anti-inflammatory and antioxidant effects, but its impact on non-alcoholic fatty liver disease (NAFLD) is still controversial. The aim of this paper is to identify the relationship between tea and NAFLD by Mendelian randomisation (MR) and complete clinical validation using National Health and Nutrition Examination Survey (NHANES) database. MR used data from Genome Wide Association Study, with inverse-variance weighted (IVW) as principal analytical methods. The reliability of the results was verified by a series of sensitivity and heterogeneity tests. Subsequently, clinical validation was conducted using NHANES (2005–2018), involving 22 257 participants, grouped by the type of tea. Green tea drinkers were categorised into four groups (Q1–Q4) by quartiles of green tea intake, from lowest to highest (similar for black tea drinkers and other tea drinkers). Models were constructed by logistic regression to estimate the role of tea consumption (Q1–4) on NAFLD. Finally, using fibrosis-4 index (FIB-4) to evaluate the severity of hepatic fibrosis, the effect of tea consumption (Q1–4) on the degree of hepatic fibrosis was investigated by linear regression. IVW method (OR = 0·43, 95 % CI: 0·21, 0·85, P = 0·01) and weighted median method (OR = 0·35, 95 % CI: 0·14, 0·91, P = 0·03) revealed there was a causal relationship between tea and NAFLD. An array of sensitivity analyses validated the reliability of results. Analysis of NHANES indicated tea drinker present a slightly lower prevalence of NAFLD than non-tea drinker (green tea drinkers: 47·6 %, black tea drinkers: 46·3 %, other tea drinker: 43·2 %, non-tea drinkers: 48·1 %, P < 0·05). After adjusting for confounders, compared with the lowest black tea consumption (Q1), the population with the highest black tea consumption (Q4) was independently related to lower presence of NAFLD (Q4: OR = 0·69, 95 % CI: 0·50, 0·93, P < 0·05), such association remained stable in the overweight subgroup. As further analysed, Q4 also displayed a significant negative correlation with the level of hepatic fibrosis in patients with NAFLD (β = –0·073, 95 % CI: –0·126, −0·020, P < 0·01).Tea reduces the morbidity of NAFLD and ameliorates hepatic fibrosis degree in those already suffering from the disease.
To compare the benefits and drawbacks of traditional and automated conservation assessments, we used a field-based study and automated conservation assessments using GeoCAT, red and ConR to assess four species of Buddleja (Scrophulariaceae), a cosmopolitan genus of flowering plants. Buddleja colvilei, Buddleja sessilifolia, Buddleja delavayi and Buddleja yunnanensis are endemic to the Himalayan region. They have not yet been assessed for the IUCN Red List of Threatened Species but are facing elevated risks of extinction because of various anthropogenic and environmental pressures. Buddleja sessilifolia and B. delavayi are listed as Plant Species with Extremely Small Populations in Yunnan, China, where they are known to be threatened. Although automated assessments evaluated B. delavayi and B. yunnanensis as Endangered and B. sessilifolia and B. colvilei as Vulnerable, our field studies indicated a different categorization for three of the species: B. delavayi and B. yunnanensis as Critically Endangered and B. sessilifolia as Endangered. Our findings indicate that the accuracy and reliability of assessment methods can differ and that field surveys remain important for conservation assessments. We recommend an integrated approach addressing these limitations, to safeguard the future of other species endemic to the Himalayan region.
Light stimulation can realise the remote control of the deformation of the specific position of 4D printing structure. Shape-memory polymer–carbon nanotube (CNT) composite materials, with outstanding near-infrared photothermal conversion rate and shape-memory ability, is one type of the most popular light responsive smart materials. However, current studies focused on the photothermal effect and shape-memory applications of light-responsive shape-memory polymer composite (SMPC) sheet structures, and there is no research on the photothermal effect in the depth direction of light-responsive SMPC three-dimensional structures. Here, we prepared a UV curable, mechanically robust, and highly deformable shape-memory polymer (IBBA) as the matrix of light responsive SMPC. CNTs were added as photothermal conversion materials. We explore the photothermal effect of near-infrared laser on the surface and depth of IBBA–CNT composites cube. Shape-memory experiments show that different folded shapes can be obtained by selective near-infrared laser programming. Selective near-infrared laser programming three-dimensional movable type plate shows a programming application in depth direction of three-dimensional light-responsive intelligent structure. This research extends the application of near-infrared laser in 4D printing to the depth direction of intelligent structures, which will bring more complex and interesting 4D printing structures in the future.
The integration of camera and LiDAR technologies has the potential to significantly enhance construction robots’ perception capabilities by providing complementary construction information. Structured light cameras (SLCs) are a desirable alternative as they provide comprehensive information on construction defects. However, fusing these two types of information depends largely on the sensors’ relative positions, which can only be established through extrinsic calibration. This paper introduces a novel calibration algorithm considering a customized board for SLCs and repetitive LiDARs, which are designed to facilitate the automation of construction robots. The calibration board is equipped with four symmetrically distributed hemispheres, whose centers are obtained by fitting the spheres and adoption with the geometric constraints. Subsequently, the spherical centers serve as reference features to estimate the relationship between the sensors. These distinctive features enable our proposed method to only require one calibration board pose and minimize human intervention. We conducted both simulation and real-world experiments to assess the performance of our algorithm. And the results demonstrate that our method exhibits enhanced accuracy and robustness.
It has been proposed that second language (L2) learners differ from native speakers in processing due to either influence from their native language or an inability to integrate information from multiple linguistic domains in a second language. To shed new light on the underlying mechanism of L2 processing, we used an event-related potentials (ERP) paradigm to examine the processing of sentences with only in English by native speakers of English and advanced Dutch learners of English. Successful processing of sentences with only requires rapid integration of prosodic information with semantic and syntactic information. We found that L2 listeners showed native-like processing of the acoustics of contrastive pitch accents when adjacent to only. However, they needed more cues than L1 listeners to perform native-like in forming expectations for focus placement. Our results thus provide first ERP-based evidence for difficulty in the integration of information for focus expectation in difficult L2 constructs.
COVID-19 carriers experience psychological stresses and mental health issues such as varying degrees of stigma. The Social Impact Scale (SIS) can be used to measure the stigmatisation of COVID-19 carriers who experience such problems.
Aims
To evaluate the reliability and validity of the Chinese version of the SIS, and the association between stigma and depression among asymptomatic COVID-19 carriers in Shanghai, China.
Method
A total of 1283 asymptomatic COVID-19 carriers from Shanghai Ruijin Jiahe Fangcang Shelter Hospital were recruited, with a mean age of 39.64 ± 11.14 years (59.6% male). Participants completed questionnaires, including baseline information and psychological measurements, the SIS and Self-Rating Depression Scale. The psychometrics of the SIS and its association with depression were examined through exploratory factor analysis, confirmatory factor analysis and receiver operating characteristic analysis.
Results
The average participant SIS score was 42.66 ± 14.61 (range: 24–96) years. Analyses suggested the model had four factors: social rejection, financial insecurity, internalised shame and social isolation. The model fit statistics of the four-factor SIS were 0.913 for the comparative fit index, 0.902 for the Tucker–Lewis index and 0.088 for root-mean-square error of approximation. Standard estimated factor loadings ranged from 0.509 to 0.836. After controlling for demographic characteristics, the total score of the 23-item SIS predicted depression (odds ratio: 1.087, 95% CI 1.061–1.115; area under the curve: 0.84, 95% CI 0.788–0.892).
Conclusions
The Chinese version of the SIS showed good psychometric properties and can be used to assess the level of perceived stigma experienced by asymptomatic COVID-19 carriers.
The intricate water-land intermingled nature of wild environments necessitates robots to exhibit multimodal cross-domain mobility capabilities. This paper introduces a novel wheel-spoke-paddle hybrid amphibious robot (WSP-bot) that can operate on flat and rough terrains, water surfaces, and water-land transitional zones. The proposed robot relies on a propulsion mechanism called transformable wheel-spoke-paddle (WSP), which combines the stability of wheeled robots with the obstacle-climbing capability of legged robots, while also providing additional aquatic mobility. The utilization of a crank-slider-based transformation mechanism enables seamless switching between multiple motion modes. An analysis of mode transition and ground motion in spoke mode was conducted, along with an investigation of its obstacle-crossing capability. Simulations were performed for mode transition, ground locomotion, and obstacle-crossing, as well as propulsion of a single WSP module on water. Based on the above work, a prototype robot was manufactured. Prototype tests, including mode transition and mobility tests on land and water surfaces under multimodal states, confirmed the effectiveness of the proposed WSP-bot.
This study assesses the difference in professional attitudes among medical students, both before and after coronavirus disease 2019 (COVID-19), and identifies the determinants closely associated with it, while providing precise and scientific evidence for implementing precision education on such professional attitudes.
Methods:
A pre-post-like study was conducted among medical students in 31 provinces in mainland China, from March 23, to April 19, 2021.
Results:
The proportion of medical students whose professional attitudes were disturbed after the COVID-19 pandemic, was significantly lower than before the COVID-19 pandemic (χ2 = 15.6216; P < 0.0001). Compared with the “undisturbed -undisturbed” group, the “undisturbed-disturbed” group showed that there was a 1.664-fold risk of professional attitudes disturbed as grade increased, 3.269-fold risk when others suggested they choose a medical career rather than their own desire, and 7.557-fold risk for students with COVID-19 in their family, relatives, or friends; while the “disturbed-undisturbed” group showed that students with internship experience for professional attitudes strengthened was 2.933-fold than those without internship experience.
Conclusions:
The professional attitudes of medical students have been strengthened during the COVID-19 pandemic. The results provide evidence of the importance of education on professional attitudes among medical students during public health emergencies.
Fallow weeds can be abundant in rice paddies without any inputs and provide ecosystem services like those of cover crops, such as reducing nitrogen (N) leaching and capturing carbon. Therefore, allowing fallow weeds to grow is a potential alternative to cover crops in rice cropping systems. To evaluate the feasibility of this strategy, the effect of fallow weeds on grain yield in rice needs to be clarified. In this study, 2-year field experiments were conducted to compare N uptake, biomass production, yield components, and grain yield in rice with and without application of fallow weeds (500 g m−2, sun-dried). Results showed that the application of fallow weeds reduced aboveground N uptake and biomass production by 21–30% during the early growth period (from transplanting to mid-tillering) in rice. However, these reductions did not lead to reduced grain yield because they were compensated for or even exceeded by increased aboveground N uptake and biomass production during the middle and late growth periods (from panicle initiation to maturity). In addition, the application of fallow weeds increased spikelets per panicle in rice by 6–7%. These results provide preliminary evidence that fallow weeds may alter yield formation in rice and highlight the need for further investigations of the ecophysiological mechanism underlying the effect of fallow weeds on N uptake in rice.
Recent arguments claim that behavioral science has focused – to its detriment – on the individual over the system when construing behavioral interventions. In this commentary, we argue that tackling economic inequality using both framings in tandem is invaluable. By studying individuals who have overcome inequality, “positive deviants,” and the system limitations they navigate, we offer potentially greater policy solutions.
SARS-CoV-2 rapidly spreads among humans via social networks, with social mixing and network characteristics potentially facilitating transmission. However, limited data on topological structural features has hindered in-depth studies. Existing research is based on snapshot analyses, preventing temporal investigations of network changes. Comparing network characteristics over time offers additional insights into transmission dynamics. We examined confirmed COVID-19 patients from an eastern Chinese province, analyzing social mixing and network characteristics using transmission network topology before and after widespread interventions. Between the two time periods, the percentage of singleton networks increased from 38.9$ \% $ to 62.8$ \% $$ (p<0.001) $; the average shortest path length decreased from 1.53 to 1.14 $ (p<0.001) $; the average betweenness reduced from 0.65 to 0.11$ (p<0.001) $; the average cluster size dropped from 4.05 to 2.72 $ (p=0.004) $; and the out-degree had a slight but nonsignificant decline from 0.75 to 0.63 $ (p=0.099). $ Results show that nonpharmaceutical interventions effectively disrupted transmission networks, preventing further disease spread. Additionally, we found that the networks’ dynamic structure provided more information than solely examining infection curves after applying descriptive and agent-based modeling approaches. In summary, we investigated social mixing and network characteristics of COVID-19 patients during different pandemic stages, revealing transmission network heterogeneities.
Hospital-based biobanks are being increasingly considered as a resource for translating polygenic risk scores (PRS) into clinical practice. However, since these biobanks originate from patient populations, there is a possibility of bias in polygenic risk estimation due to overrepresentation of patients with higher frequency of healthcare interactions.
Methods
PRS for schizophrenia, bipolar disorder, and depression were calculated using summary statistics from the largest available genomic studies for a sample of 24 153 European ancestry participants in the Mass General Brigham (MGB) Biobank. To correct for selection bias, we fitted logistic regression models with inverse probability (IP) weights, which were estimated using 1839 sociodemographic, clinical, and healthcare utilization features extracted from electronic health records of 1 546 440 non-Hispanic White patients eligible to participate in the Biobank study at their first visit to the MGB-affiliated hospitals.
Results
Case prevalence of bipolar disorder among participants in the top decile of bipolar disorder PRS was 10.0% (95% CI 8.8–11.2%) in the unweighted analysis but only 6.2% (5.0–7.5%) when selection bias was accounted for using IP weights. Similarly, case prevalence of depression among those in the top decile of depression PRS was reduced from 33.5% (31.7–35.4%) to 28.9% (25.8–31.9%) after IP weighting.
Conclusions
Non-random selection of participants into volunteer biobanks may induce clinically relevant selection bias that could impact implementation of PRS in research and clinical settings. As efforts to integrate PRS in medical practice expand, recognition and mitigation of these biases should be considered and may need to be optimized in a context-specific manner.
With the dangerous and troublesome nature of hollow defects inside building structures, hollowness inspection has always been a challenge in the field of construction quality assessment. Several methods have been proposed for inspecting hollowness inside concrete structures. These methods have shown great advantages compared to manual inspection but still lack autonomy and have several limitations. In this paper, we propose a range-point migration-based non-contact hollowness inspection system with sensor fusion of ultra-wide-band radar and laser-based depth camera to extract both outer surface and inner hollowness information accurately and efficiently. The simulation result evaluates the performance of the system based on the original range-point migration algorithm, and our proposed one and the result of our system show great competitiveness. Several simulation experiments of structures that are very common in reality are carried out to draw more convincing conclusions about the system. At the same time, a set of laboratory-made concrete components were used as experimental objects for the robotic system. Although still accompanied by some problems, these experiments demonstrate the availability of an automated hollow-core detection system.
The influence of second-order dispersion (SOD) on stimulated Raman scattering (SRS) in the interaction of an ultrashort intense laser with plasma was investigated. More significant backward SRS was observed with the increase of the absolute value of SOD ($\mid \kern-1pt\!{\psi}_2\!\kern-1pt\mid$). The integrated intensity of the scattered light is positively correlated to the driver laser pulse duration. Accompanied by the side SRS, filaments with different angles along the laser propagation direction were observed in the transverse shadowgraph. A model incorporating Landau damping and above-threshold ionization was developed to explain the SOD-dependent angular distribution of the filaments.
Sleep is an integral part of individuals' health and wellbeing. Despite evidence showing that social stressors are important contributors to older adults' sleep problems, how the accumulative stressful life events (SLEs) and ageing attitudes independently and jointly affect sleep quality among older adults in developing countries remains unclear. This study examined the effects of SLEs on subjectively rated sleep quality among older adults in China, and explored the potential mediating and moderating roles of positive and negative ageing attitudes on the above association. Using data from the 2014 China Longitudinal Ageing Social Survey, we had complete data for 7,780 older adults aged 60 and older. We employed logistic regression models and the Karlson–Holm–Breen decomposition method. Our findings indicated that SLEs significantly increased the risk of poor sleep quality, especially for those who had experienced two or more SLEs during the past year. Positive ageing attitudes were associated with lower odds of poor sleep quality, whereas negative ageing attitudes were related to higher odds of poor sleep quality. Moreover, the mediation analyses suggested that SLEs were associated with poor sleep quality via negative ageing attitudes. The moderating effects further documented that higher levels of positive ageing attitudes can significantly attenuate the deleterious impact of SLEs on sleep quality. The findings highlight the significance of SLEs for older adults' sleep quality and shed light on the importance of ageing attitudes to improve older adults' sleep in China as well as other low- and middle-income countries, where the social safety nets are still underdeveloped.
Caregiver-mediated intervention (CMI), based on parent skills training, is a family-mediated intervention model for children with neurodevelopmental disorders, in particular autism spectrum disorder. This study aimed to evaluate the effectiveness of CMI.
Methods:
Thirty-three children (aged 22–69 months from our department) and their caregivers participated in a two-week training course of ten 90-minute lessons. Caregivers were encouraged to try their best to apply intervention skills in both home routines and play routines to encourage the development of cognition, motion, social adaptability, and behavior of children. Demographic information, video-recorded data, and diagnostic scales were collected at two key time points: baseline and post-training (PT – within six months).
Results:
Three aspects were assessed – primary variables, secondary variables, and correlation analyses. Results showed an improvement in PT in (1) Adult/Child Interaction Fidelity Rating (P < 0.01) and (2) adaptability of Gesell Developmental Scale and stereotyped behaviors and limited interests of Autism Diagnostic Observation Schedule (P < 0.05, P < 0.01). Moreover, a negative correlation occurred between caregiver skill improvement and parent education (P < 0.05), but without correlations with other demographics.
Conclusions:
As an efficacious family intervention for both children and their caregivers, CMI is worth being generalized widely.
A pulsed fast neutron source is critical for applications of fast neutron resonance radiography and fast neutron absorption spectroscopy. However, due to the large transversal source size (of the order of mm) and long pulse duration (of the order of ns) of traditional pulsed fast neutron sources, it is difficult to realize high-contrast neutron imaging with high spatial resolution and a fine absorption spectrum. Here, we experimentally present a micro-size ultra-short pulsed neutron source by a table-top laser–plasma wakefield electron accelerator driving a photofission reaction in a thin metal converter. A fast neutron source with source size of approximately 500 μm and duration of approximately 36 ps has been driven by a tens of MeV, collimated, micro-size electron beam via a hundred TW laser facility. This micro-size ultra-short pulsed neutron source has the potential to improve the energy resolution of a fast neutron absorption spectrum dozens of times to, for example, approximately 100 eV at 1.65 MeV, which could be of benefit for high-quality fast neutron imaging and deep understanding of the theoretical model of neutron physics.
Coronavirus disease 2019 (COVID-19) asymptomatic cases are hard to identify, impeding transmissibility estimation. The value of COVID-19 transmissibility is worth further elucidation for key assumptions in further modelling studies. Through a population-based surveillance network, we collected data on 1342 confirmed cases with a 90-days follow-up for all asymptomatic cases. An age-stratified compartmental model containing contact information was built to estimate the transmissibility of symptomatic and asymptomatic COVID-19 cases. The difference in transmissibility of a symptomatic and asymptomatic case depended on age and was most distinct for the middle-age groups. The asymptomatic cases had a 66.7% lower transmissibility rate than symptomatic cases, and 74.1% (95% CI 65.9–80.7) of all asymptomatic cases were missed in detection. The average proportion of asymptomatic cases was 28.2% (95% CI 23.0–34.6). Simulation demonstrated that the burden of asymptomatic transmission increased as the epidemic continued and could potentially dominate total transmission. The transmissibility of asymptomatic COVID-19 cases is high and asymptomatic COVID-19 cases play a significant role in outbreaks.
This study is performed to figure out how the presence of diabetes affects the infection, progression and prognosis of 2019 novel coronavirus disease (COVID-19), and the effective therapy that can treat the diabetes-complicated patients with COVID-19. A multicentre study was performed in four hospitals. COVID-19 patients with diabetes mellitus (DM) or hyperglycaemia were compared with those without these conditions and matched by propensity score matching for their clinical progress and outcome. Totally, 2444 confirmed COVID-19 patients were recruited, from whom 336 had DM. Compared to 1344 non-DM patients with age and sex matched, DM-COVID-19 patients had significantly higher rates of intensive care unit entrance (12.43% vs. 6.58%, P = 0.014), kidney failure (9.20% vs. 4.05%, P = 0.027) and mortality (25.00% vs. 18.15%, P < 0.001). Age and sex-stratified comparison revealed increased susceptibility to COVID-19 only from females with DM. For either non-DM or DM group, hyperglycaemia was associated with adverse outcomes, featured by higher rates of severe pneumonia and mortality, in comparison with non-hyperglycaemia. This was accompanied by significantly altered laboratory indicators including lymphocyte and neutrophil percentage, C-reactive protein and urea nitrogen level, all with correlation coefficients >0.35. Both diabetes and hyperglycaemia were independently associated with adverse prognosis of COVID-19, with hazard ratios of 10.41 and 3.58, respectively.