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Children with developmental language disorder (DLD) often struggle with theory of mind (ToM). This study explored the link between parental reflective functioning (PRF) and children’s ToM, focusing on the mediating role of parental stress (PS). A total of 80 children aged 4–7 years (40 with DLD and 40 with typical language development, TLD) and their parents were included for analysis. Assessments included the WPPSI-IV, NEPSY-II, TEC, and ELT for children and the PRFQ and PSI-SF4 for parents. Results showed that children with DLD performed similarly to their TLD peers in terms of nonverbal intelligence but faced difficulties with cognitive and affective ToM and understanding of emotional terms (UET). Parents of DLD children exhibited low interest and curiosity (PRF components) and high PS, particularly due to dysfunctional interactions and challenging behaviors. Mediation analysis revealed that low parental interest and curiosity negatively affected children’s cognitive ToM and UET through increased PS from dysfunctional interactions. These findings highlight the need for early interventions to enhance ToM in children with DLD and support parents in better understanding and interacting with their child. Such interventions can reduce parent–child stress and promote ToM development of children with DLD, aligning with bioecological models of development.
The study aims were to present in vitro susceptibilities of clinical isolates from Gram-negative bacteria bloodstream infections (GNBSI) collected in China. GNBSI isolates were collected from 18 tertiary hospitals in 7 regions of China from 2018 to 2020. Minimum inhibitory concentrations were assessed using a Trek Diagnostic System. Susceptibility was determined using CLSI broth microdilution, and breakpoints were interpreted using CLSI M100 (2021). A total of 1,815 GNBSI strains were collected, with E. coli (42.4%) and Klebsiella pneumoniae (28.6%) being the most prevalent species, followed by P. aeruginosa (6.7%). Susceptibility analyses revealed low susceptibilities (<40%) of ESBL-producing E. coli and K. pneumonia to third-/fourth-generation cephalosporins, monobactamases, and fluoroquinolones. High susceptibilities to colistin (95.0%) and amikacin (81.3%) were found for K. pneumoniae, while Acinetobacter baumannii exhibited a high susceptibility (99.2%) to colistin but a low susceptibility to other antimicrobials (<27.5%). Isolates from ICUs displayed lower drug susceptibility rates of K. pneumoniae and A. baumannii than isolates from non-ICUs (all P < 0.05). Carbapenem-resistant and ESBL-producing K. pneumoniae detection was different across regions (both P < 0.05). E. coli and K. pneumoniae were major contributors to GNBSI, while A. baumannii exhibited severe drug resistance in isolates obtained from ICU departments.
This study aimed to investigate the effects of physical multimorbidity on the trajectory of cognitive decline over 17 years and whether vary across wealth status. The study was conducted in 9035 respondents aged 50+ at baseline from nine waves (2002–2019) of the English Longitudinal Study of Aging. A latent class analysis was used to identify patterns of physical multimorbidity, and mixed multilevel models were performed to determine the association between physical multimorbidity and trajectories of cognitive decline. Joint analyses were conducted to further verify the influence of wealth status. Four patterns of physical multimorbidity were identified. Mixed multilevel models with quadratic terms of time and status/patterns indicated significant non-linear trajectories of multimorbidity on cognitive function. The magnitude of the association between complex multisystem patterns and cognitive decline increased the most as follow-up progressed. Individuals with high wealth and hypertension/diabetes patterns have significantly lower composite global cognitive z scores over time as compared with respiratory/osteoporosis patterns. Physical multimorbidity at baseline is associated with the trajectory of cognitive decline, and the magnitude of the association increased over time. The trend of cognitive decline differed in specific combinations of wealth status and physical multimorbidity.
Recent developments have indicated a potential association between tinnitus and COVID-19. The study aimed to understand tinnitus following COVID-19 by examining its severity, recovery prospects, and connection to other lasting COVID-19 effects. Involving 1331 former COVID-19 patients, the online survey assessed tinnitus severity, cognitive issues, and medical background. Of the participants, 27.9% reported tinnitus after infection. Findings showed that as tinnitus severity increased, the chances of natural recovery fell, with more individuals experiencing ongoing symptoms (p < 0.001). Those with the Grade II mild tinnitus (OR = 3.68; CI = 1.89–7.32; p = 0.002), Grade III tinnitus (OR = 3.70; CI = 1.94–7.22; p < 0.001), Grade IV (OR = 6.83; CI = 3.73–12.91; p < 0.001), and a history of tinnitus (OR = 1.96; CI = 1.08–3.64; p = 0.03) had poorer recovery outcomes. Grade IV cases were most common (33.2%), and severe tinnitus was strongly associated with the risk of developing long-term hearing loss, anxiety, and emotional disorders (p < 0.001). The study concludes that severe post-COVID tinnitus correlates with a worse prognosis and potential hearing loss, suggesting the need for attentive treatment and management of severe cases.
This review aimed to identify and synthesise the enablers and barriers that influence the long-term (≥ 2 years) sustainment of school-based nutrition programmes.
Design:
Four databases (PubMed, Cochrane Library, Embase and Scopus) were searched to identify studies reporting on the international literature relating to food and nutrition programmes aimed at school-age (5–14 years) children that had been running for ≥ 2 years (combined intervention and follow-up period). Eligible studies were analysed using the Integrated Sustainability Framework (ISF), which involved deductive coding of programme enablers and barriers. A quality assessment was completed, using the Mixed-Methods Appraisal Tool and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.
Setting:
International school-based nutrition programmes.
Subjects:
Individuals involved with the implementation of school-based nutrition programmes.
Results:
From the 7366 articles identified, thirteen studies (seven qualitative, five mixed methods and one quantitative descriptive) were included, from which the enablers and barriers of eleven different nutrition-related programmes were analysed. Thirty-four factors across the five domains of the ISF were identified that influenced the sustained implementation of programmes. The most common barrier was a lack of organisational readiness and resources, whereas the most common enabler was having adequate external partnerships and a supportive environment.
Conclusions:
These findings have application during the initiation and implementation phases of school-based nutrition programmes. Paying attention to the ‘outer contextual factors’ of the ISF including the establishment and maintenance of robust relationships across whole of government systems, local institutions and funding bodies are crucial for programme sustainment.
Childhood trauma influences the clinical features of schizophrenia. In this study, we examined how childhood trauma and perceived stress are associated with clinical manifestations and subcortical gray matter volumes (GMVs) in patients with schizophrenia.
Methods
We recruited 127 patients with schizophrenia and 83 healthy controls for assessment of early childhood trauma, perceived stress, and clinical symptoms. With structural brain imaging, we identified the GMVs of subcortical structures and examined the relationships between childhood trauma, perceived stress, clinical symptoms, and subcortical GMVs.
Results
Compared to controls, patients with schizophrenia showed higher levels of childhood trauma and perceived stress. Patients with schizophrenia showed significantly smaller amygdala and hippocampus GMVs as well as total cortical GMVs than age-matched controls. Childhood trauma score was significantly correlated with the severity of clinical symptoms, depression, perceived stress, and amygdala GMVs. Perceived stress was significantly correlated with clinical symptoms, depression, and hippocampus and amygdala GMVs. Further, the association between childhood trauma (emotional neglect) and stress coping ability was mediated by right amygdala GMV in patients with schizophrenia.
Conclusions
Patients with schizophrenia had more exposure to early-life trauma and poorer stress coping. Both childhood trauma and perceived stress were associated with smaller amygdala volumes. The relationship between early-life trauma and perceived stress was mediated by right amygdala GMV in patients with schizophrenia. These findings together suggest the long-term effects of childhood trauma on perceived stress and the subcortical volumetric correlates of the effects in schizophrenia.
Designing AI-assisted technology to better understand major depressive disorder and further develop appropriate strategies for monitoring and treatment of major depression under resource constraints is an important and challenging task. In this chapter, we present seven studies that developed methods for AI-assisted, data-driven decision support systems to aid healthcare professionals. These methods focus on modeling chronic depression’s complex disease trajectories, identifying patients at high risk of progression, and recommending adaptive and cost-effective follow-up care. Long-term goals of this research include improving patient health outcomes and facilitating efficient allocation of healthcare providers’ limited resource through the use of novel technology.
We present a theoretical study of mode evolution in high-power distributed side-coupled cladding-pumped (DSCCP) fiber amplifiers. A semi-analytical model taking the side-pumping schemes, transverse mode competition, and stimulated thermal Rayleigh scattering into consideration has been built, which can model the static and dynamic mode evolution in high-power DSCCP fiber amplifiers. The mode evolution behavior has been investigated with variation of the fiber amplifier parameters, such as the pump power distribution, the length of the DSCCP fiber, the averaged coupling coefficient, the number of the pump cores and the arrangement of the pump cores. Interestingly, it revealed that static mode evolution induced by transverse mode competition is different from the dynamic evolution induced by stimulated thermal Rayleigh scattering. This shows that the high-order mode experiences a slightly higher gain in DSCCP fiber amplifiers, but the mode instability thresholds for DSCCP fiber amplifiers are higher than those for their end-coupled counterparts. By increasing the pump core number and reducing the averaged coupling coefficient, the mode instability threshold can be increased, which indicates that DSCCP fibers can provide additional mitigation strategies of dynamic mode instability.
A dysfunctional default mode network (DMN) has been reported in patients with schizophrenia. However, the stability of the deficits has not been determined across different stages of the disorder.
Methods
We examined the functional connectivity of the DMN subsystems of 125 patients with first-episode schizophrenia (FES) or recurrent schizophrenia (RES), compared to that of 82 healthy controls. We tested the robustness of the findings in an independent cohort of 158 patients and 39 healthy controls. We performed resting-state functional connectivity analysis, and examined the strength of the connections within and between the three subsystems of the DMN (core, dorsal medial prefrontal cortex [dMPFC], and medial temporal lobe [MTL]). We also analyzed the connectivity correlations to symptoms and illness duration.
Results
We found reduced connectivity strength between the core and MTL subsystems in schizophrenia patients compared to controls, with no differences between the FES and RES patient groups; these findings were validated in the second sample. Schizophrenia patients also showed a significant reduction in connectivity within the MTL and between the dMPFC−MTL subsystems, similarly between FES and RES groups. The connectivity strength within the core subsystem was negatively correlated with clinical symptoms in schizophrenia. There was no significant correlation between the DMN subsystem connectivity and illness duration.
Conclusions
DMN subsystem connectivity deficits are present in schizophrenia, and the homochronicity of their appearance indicates the trait-like nature of these alterations. The DMN deficit may be useful for early diagnosis, and MTL dysfunction may be a crucial mechanism underlying schizophrenia.
Sugarcane brown rust, caused by Puccinia melanocephala, is one of the main diseases of sugarcane in China. The identification and discovery of new resistance genes have important theoretical and practical significance for preventing outbreaks of brown rust and ensuring the sustainable production of sugarcane. To screen for polymorphic simple-sequence repeat (SSR) molecular markers for localization of brown rust resistance genes, we used two populations that are suitable for genetic linkage map construction and mapping of new resistance genes to construct resistant and susceptible genetic pools. We then screened 449 pairs of primers to identify polymorphic SSR markers in the parental lines and the resistant/susceptible genetic pools. The results showed that 25 pairs of primers directed amplification of polymorphic DNA fragments between the parents of the cross combination ‘Yuetang 03-393’ × ‘ROC 24’, and 16 pairs of primers amplified polymorphic fragments between the parents of the cross combination ‘Liucheng 03-1137’ × ‘Dezhe 93-88’. Four pairs of primers (SMC236CG, SCESSR0928, SCESSR0636 and SCESSR2551) amplified polymorphic DNA fragments between the parental lines and the resistant/susceptible genetic pools in ‘Yuetang 03-393’ × ‘ROC 24’. The results of this study will establish a solid foundation for the mapping of new brown rust resistance genes, genetic linkage map construction and the development of closely-associated molecular markers in sugarcane.
To explore the relationship between dietary patterns and risk of chronic kidney disease (CKD) in Chinese adults aged 45–59 years.
Design:
Dietary data were collected using a semi-quantitative FFQ. Factor analysis was used to identify the major dietary patterns. Logistic regression models were applied to clarify the association between dietary patterns and the risk of CKD.
Setting:
The present study population was a part of the population-based Nutrition and Health Study performed in the city of Hangzhou, Zhejiang Province, eastern China.
Participants:
A total of 2437 eligible participants (45–59 years) were enrolled in the present cross-sectional study from June 2015 to December 2016.
Results:
Three major dietary patterns were identified: ‘traditional southern Chinese’, ‘Western’ and ‘grains–vegetables’ patterns, collectively accounting for 25·6 % of variance in the diet. After adjustment for potential confounders, participants in the highest quartile of the Western pattern had greater odds for CKD (OR = 1·83, 95 % CI 1·21, 2·81; P < 0·05) than those in the lowest quartile. Compared with the lowest quartile of the grains–vegetables pattern, the highest quartile had lower odds for CKD (OR = 0·84, 95 % CI 0·77, 0·93; P < 0·05). In addition, there was no significant association between the traditional southern Chinese pattern and risk of CKD (P > 0·05).
Conclusions:
Our results suggest that the Western pattern is associated with an increased risk, whereas the grains–vegetables pattern is associated with a reduced risk for CKD. These findings can guide dietary interventions for the prevention of CKD in a middle-aged Chinese population.
We assessed inheritance of resistance to sugarcane brown rust (Puccinia melanocephala) in selfing F1 populations of wild sugarcane germplasm Erianthus rockii ‘Yundian 95-19’ and E. rockii ‘Yundian 95-20’. We tested parent and selfing F1 individuals for the brown rust resistance gene, Bru1, that has been shown to confer resistance to brown rust in sugarcane. The Bru1 gene was not detected in E. rockii ‘Yundian 95-19’, E. rockii ‘Yundian 95-20’ or their selfing F1 individuals, and we found there was segregation of resistance in the two selfing F1 populations (segregation ratio: 3:1). The results confirmed resistance in E. rockii ‘Yundian 95-19’ and E. rockii ‘Yundian 95-20’ to sugarcane brown rust is controlled by a novel, single dominant gene.
The development of mechanised large-scale farming has led to changes in rice production systems. Increases in time of farming operations often occur under large-scale farming conditions, which can lead to delayed transplanting (DTP). In this study, field experiments were conducted in the late rice-growing season in 2016 and 2017 to compare the growth stages, growing-season temperature and yield attributes between normal transplanting with 15- to 20-day-old seedlings and DTP with 30-day-old seedlings of two rice cultivars. DTP resulted in 6- and 12-day delays in heading stage for both cultivars in 2016 and 2017, respectively. As a consequence, low temperature stress occurred at anthesis under DTP in both years, which led to significantly reduced spikelet filling and grain yield under DTP for both cultivars. These results confirm that DTP can reduce spikelet filling and grain yield due to low temperature stress at anthesis in machine-transplanted late-season rice. This finding highlights that greater efforts should be made to develop high-yielding short-duration rice cultivars to meet the development of mechanised large-scale rice farming.
The collimated electron jets ejected from cylindrical plasma are produced in particle-in-cell simulation under the applied longitudinal magnetostatic field and radial electrostatic field, which is a process that can be conveniently performed in a laboratory. We find that the applied magnetostatic field contributes significantly to the jet collimation, whereas the applied electrostatic field plays a vital role in the jet formation. The generation mechanism of collimated jets can be well understood through energy gain of the tagged electrons, and we conclude that the longitudinal momentum of the electrons is converted from the transverse momentum via the transverse-induced magnetic field. It has been found that the ejecting velocity of the jets is close to the speed of light when the applied electrostatic field reaches 3 × 1010 V/m. The present scheme may also give us an insight into the formation of astrophysical jets in celestial bodies.
Transplanting single seedlings rather than seedlings in clumps has been increasingly attractive in hybrid rice production in China due to reduced seed requirements and higher grain yield. This study was conducted to determine grain yield and nitrogen (N) utilization in response to reductions in the N rate in hybrid rice under single-seedling transplanting. Field experiments were done in 2015 and 2016 on a moderate to high fertility soil at the Experimental Farm of Hunan Agricultural University, China. The hybrid rice cultivar Liangyoupeijiu (LYPJ) was used in 2015, and two hybrid cultivars LYPJ and Xiangliangyou 900 were used the next year. In each year, the rice plants transplanted with a single seedling per hill were grown with three N rates, including the usual N rate (150 kg ha–1) and two reduced N rates (120 and 90 kg ha–1). Grain yield, yield attributes, and N uptake and use efficiency were determined for each N rate. Significant reduction in grain yield was observed in only one of three cultivar-year combinations when N rate was reduced by 20% (from 150 to 120 kg ha–1), and the magnitude of yield reduction was only 4%. Although significant reduction in grain yield was observed in two of the three cultivar-year combinations when N rate reduced by 40% (to 90 kg ha–1), the highest yield reduction was only 7%. Yield attributes were generally changed slightly when N rate was reduced by 20%, while compensation among yield attributes and N utilization characteristics could explain why a 40% reduction in N rate did not result in substantial yield loss. Partial factor productivity of applied N (PFPN) was increased by 21–24% and 56–63% with 20% and 40% reductions in the N rate, respectively. The higher PFPN with a reduced N rate was attributed to higher recovery efficiency of applied N (REN) or to both higher REN and internal N use efficiency. Our study suggests that reducing N rate does not necessarily result in yield loss due to compensation among yield components and increased N use efficiency in hybrid rice transplanted as single seedlings under moderate to high soil fertility conditions.
Patient’s needs and rights are the key to delivering state-of-the-art modern nursing care. It is especially challenging to provide proper nursing care for patients who are reaching the end of life (EOL). In Chinese culture nursing practice, the perception and expectations of these EOL patients are not well known. This article explores the feelings and wishes of 16 terminally ill Chinese cancer patients who are going through the dying process. An open-ended questionnaire with eight items was used to interview 16 terminally ill Chinese cancer patients, and was then analyzed by a combined approach employing grounded theory and interpretive phenomenological analysis. Four dimensions were explored: first, patient’s attitudes towards death, such as accepting the fact calmly, striving to survive, and the desire for control; second, the care desired during the dying process, including avoiding excessive treatment and dying with dignity; third, the degree of the patient’s acceptance of death; and fourth, the consequences of death. This cognitive study offers a fundamental understanding of perceptions of death of terminally ill cancer patients from the Chinese culture. Their attitude toward death was complex. They did not prefer aggressive treatment and most of them had given a great deal of thought to their death.
To develop a theoretical model explaining the longitudinal changes in the caregiving process for family caregivers of persons with mild cognitive impairment (MCI) in Taiwan.
Methods:
A longitudinal, grounded theory approach using in-depth face-to-face interviews and an open-ended interview guide. We conducted 42 interviews over a two-year period; each participant was interviewed at least once every six months. All participants were interviewed in their home. The participants total of 13 family caregivers of persons with MCI.
Results:
One core theme emerged: “protective preparation.” This reflected the family caregiving process of preparation for a further decline in cognitive function, and protection from the impact of low self-esteem, accidents, and symptoms of comorbidities for the family member with MCI. Protective preparation contained three components: ambivalent normalization, vigilant preparation, and protective management.
Conclusions:
Interventions to help family caregivers manage the changes in persons with MCI can reduce caregiver burden. Our findings could provide a knowledge base for use by healthcare providers to develop and implement strategies to reduce caregiver burden for family caregivers of persons with MCI.