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In the pursuit of advancing neuromorphic computing, our research presents a novel method for generating and precisely controlling intermediate states within heavy metal/ferromagnet systems. These states are engineered through the interplay of a strong in-plane magnetic field and an applied charge current. We provide a method for fine-tuning these states by introducing a small out-of-plane magnetic field, allowing for the modulation of the system's probabilistic response to varying current levels. We also demonstrate the implementation of a spiking neural network (SNN) with a tri-state spike timing-dependent plasticity (STDP) learning rule using our devices. Our research furthers the development of spintronics and informs neural system design. These intermediate states can serve as synaptic weights or neuronal activations, paving the way for multi-level neuromorphic computing architectures. [ABSTRACT FROM AUTHOR]

Waldenstrom macroglobulinaemia (WM), the predominant subtype of lymphoplasmacytic lymphoma with bone marrow involvement and serum IgM paraprotein, is a haematological condition commonly associated with renal parenchymal involvement. However, antineutrophil cytoplasmic antibody (ANCA)‐negative pauci‐immune crescentic glomerulonephritis (PICGN) in kidney infiltrated by lymphoma is very rare, with only two cases described in chronic lymphocytic leukaemia in English literature so far. We herein report the first patient with WM developing ANCA‐negative PICGN. He was a 76‐year‐old male who presented with elevated serum globulin level and bilateral groin lymph node enlargement, subsequently diagnosed to have WM after pathologic examination of the bone marrow and groin lymph node. One month later, he was found to have acute kidney injury and proteinuria. Renal biopsy confirmed the presence of parenchymal involvement by WM accompanied by PICGN; while ANCA testing was negative. He was treated with pulse methylprednisolone followed by oral prednisolone. In addition, six courses of intravenous rituximab and oral cyclophosphamide were given. There was significant improvement in both his renal and haematological conditions. The clinical course of this case suggested that ANCA‐negative PICGN may represent a paraneoplastic syndrome and a rare manifestation of WM‐associated renal lesion. Early kidney biopsy and prompt treatment may improve the outcome of patients. [ABSTRACT FROM AUTHOR]

Osteoporotic fracture is a prevalent noncommunicable disease globally, causing significant mortality, morbidity, and disability. As the population ages, the healthcare and economic burden of osteoporotic fracture is expected to increase further. Due to its multifactorial features, the development of osteoporotic fracture involves a complex interplay of multiple risk factors, including genetic, environmental, and lifestyle factors. Helicobacter pylori, which infects approximately 43% of the world's population, has been associated with increased fracture risk due to hypochlorhydria from atrophic gastritis and systemic inflammation from elevated pro‐inflammatory cytokines. However, the potential impact of H. pylori infection and eradication on fracture risk remains contentious among various studies due to the study design and inadequate adjustment of confounding factors including baseline gastritis phenotype. In this review, we provided a comprehensive evaluation of the current evidence focusing on the underlying mechanisms and clinical evidence of the association between H. pylori infection and osteoporotic fracture. We also discussed the potential benefits of H. pylori eradication on fracture risk. [ABSTRACT FROM AUTHOR]

[Display omitted] • Profound perturbation of metabolome preceding T2D onset was revealed in a prospective Chinese population-based cohort. • Insulin resistance rather than β-cell dysfunction was strongly associated with metabolic shifts before T2D. • The impact of metabolites on T2D risk could be mediated by insulin resistance. • Discovery of previously unknown independent associations between metabolites and incident T2D. • The inclusion of metabolites selected by machine learning improved the predictive power of traditional clinical models. Type 2 diabetes (T2D) is a heterogeneous metabolic disease with large variations in the relative contributions of insulin resistance and β-cell dysfunction across different glucose tolerance subgroups and ethnicities. A more precise yet feasible approach to categorize risk preceding T2D onset is urgently needed. This study aimed to identify potential metabolic biomarkers that could contribute to the development of T2D and investigate whether their impact on T2D is mediated through insulin resistance and β-cell dysfunction. A non-targeted metabolomic analysis was performed in plasma samples of 196 incident T2D cases and 196 age- and sex-matched non-T2D controls recruited from a long-term prospective Chinese community-based cohort with a follow-up period of ∼ 16 years. Metabolic profiles revealed profound perturbation of metabolomes before T2D onset. Overall metabolic shifts were strongly associated with insulin resistance rather than β-cell dysfunction. In addition, 188 out of the 578 annotated metabolites were associated with insulin resistance. Bi-directional mediation analysis revealed putative causal relationships among the metabolites, insulin resistance and T2D risk. We built a machine-learning based prediction model, integrating the conventional clinical risk factors (age, BMI, TyG index and 2hG) and 10 metabolites (acetyl-tryptophan, kynurenine, γ-glutamyl-phenylalanine, DG(18:2/22:6), DG(38:7), LPI(18:2), LPC(P-16:0), LPC(P-18:1), LPC(P-20:0) and LPE(P-20:0)) (AUROC = 0.894, 5.6% improvement comparing to the conventional clinical risk model), that successfully predicts the development of T2D. Our findings support the notion that the metabolic changes resulting from insulin resistance, rather than β-cell dysfunction, are the primary drivers of T2D in Chinese adults. Metabolomes as a valuable phenotype hold potential clinical utility in the prediction of T2D. [ABSTRACT FROM AUTHOR]

Background: Given that students from socio‐economically disadvantaged family backgrounds are more likely to suffer from low academic performance, there is an interest in identifying features of academic resilience, which may mitigate the relationship between disadvantaged socio‐economic status and academic performance. Aims: This study sought to combine machine learning and explainable artificial intelligence (XAI) technique to identify key features of academic resilience in mathematics learning during COVID‐19. Materials and Methods: Based on PISA 2022 data in 79 countries/economies, the random forest model coupled with Shapley additive explanations (SHAP) value technique not only uncovered the key features of academic resilience but also examined the contributions of each key feature. Results: Findings indicated that 35 features were identified in the classification of academically resilient and non‐academically resilient students, which largely validated the previous academic resilient framework. Notably, gender differences were shown in the distribution of some key features. Research findings also indicated that resilient students tended to have a stable emotional state, high levels of self‐efficacy, low levels of truancy and positive future aspirations. Discussion: This study has established a research paradigm essentially methodological in nature to bridge the gap between psychological theories and big data in the field of educational psychology. Conclusion: To sum up, our study shed light on the issues of education equity and quality from a global perspective in the times of the COVID‐19 pandemic. [ABSTRACT FROM AUTHOR]

Background and aims: Despite evidence that patients living with cancer who continue to smoke after diagnosis are at higher risk for all‐cause mortality and reduced treatment efficacy, many cancer patients continue to smoke. This protocol is for a study to test the effectiveness of a self‐determination theory‐based intervention (quit immediately or progressively) plus instant messaging (WhatsApp or WeChat) to help smokers with cancer to quit smoking. Design: This will be a multi‐centre, two‐arm (1:1), single‐blind, pragmatic, individually randomized controlled trial. Setting: Taking part will be specialist outpatient clinics in five major hospitals in different location‐based clusters in Hong Kong. Participants: The sample will include 1448 Chinese smokers living with cancer attending medical follow‐ups at outpatient clinics. Interventions: The intervention group will receive brief advice (approximately 5–8 minutes) from research nurses in the outpatient clinics and then be invited to choose their own quit schedules (immediate or progressive). During the first 6‐month follow‐up period they will receive instant messaging with smoking cessation advice once per week for the first 3 months, and thereafter approximately once per month. They will also receive four videos, and those opting to quit progressively will receive a smoking reduction leaflet. The control group will also receive brief advice but be advised to quit immediately, and instant messaging with general health advice during the first 6‐month follow‐up period using the same schedule as the intervention group. Participants in both groups will receive smoking cessation leaflets. Measurements The primary outcome is biochemically validated smoking abstinence at 6 months, as confirmed by saliva cotinine level and carbon monoxide level in expired air. Secondary outcomes include biochemically validated smoking abstinence at 12 months, self‐reported 7‐day point prevalence of smoking abstinence at 6 and 12 months, self‐reported ≥ 50% reduction of cigarette consumption at 6 and 12 months and quality of life at 6 and 12 months. All time‐points for outcomes measures are set after randomization. Comments The results could inform research, policymaking and health‐care professionals regarding smoking cessation for patients living with cancer, and therefore have important implications for clinical practice and health enhancement. [ABSTRACT FROM AUTHOR]

Background and aims: Despite evidence that patients living with cancer who continue to smoke after diagnosis are at higher risk for all-cause mortality and reduced treatment efficacy, many cancer patients continue to smoke. This protocol is for a study to test the effectiveness of a self-determination theory-based intervention (quit immediately or progressively) plus instant messaging (WhatsApp or WeChat) to help smokers with cancer to quit smoking. Design: This will be a multi-centre, two-arm (1:1), single-blind, pragmatic, individually randomized controlled trial. Setting: Taking part will be specialist outpatient clinics in five major hospitals in different location-based clusters in Hong Kong. Participants: The sample will include 1448 Chinese smokers living with cancer attending medical follow-ups at outpatient clinics. Interventions: The intervention group will receive brief advice (approximately 5-- 8 minutes) from research nurses in the outpatient clinics and then be invited to choose their own quit schedules (immediate or progressive). During the first 6-month follow-up period they will receive instant messaging with smoking cessation advice once per week for the first 3 months, and thereafter approximately once per month. They will also receive four videos, and those opting to quit progressively will receive a smoking reduction leaflet. The control group will also receive brief advice but be advised to quit immediately, and instant messaging with general health advice during the first 6-month follow-up period using the same schedule as the intervention group. Participants in both groups will receive smoking cessation leaflets. Measurements: The primary outcome is biochemically validated smoking abstinence at 6 months, as confirmed by saliva cotinine level and carbon monoxide level in expired air. Secondary outcomes include biochemically validated smoking abstinence at 12 months, self-reported 7-day point prevalence of smoking abstinence at 6 and 12 months, selfreported ≥ 50% reduction of cigarette consumption at 6 and 12 months and quality of life at 6 and 12 months. All time-points for outcomes measures are set after randomization. Comments: The results could inform research, policymaking and health-care professionals regarding smoking cessation for patients living with cancer, and therefore have important implications for clinical practice and health enhancement. [ABSTRACT FROM AUTHOR]

Mediation, moderation, and moderated mediation are common in behavioral research models. Several tools are available for estimating indirect effects, conditional effects, and conditional indirect effects and forming their confidence intervals. However, there are no simple-to-use tools that can appropriately form the bootstrapping confidence interval for standardized conditional indirect effects. Moreover, some tools are restricted to a limited type of models. We developed an R package, manymome, which can be used to estimate and form confidence intervals for indirect effects, conditional effects, and conditional indirect effects, standardized or not, using a two-step approach: model parameters are estimated either by structural equation modeling using lavaan or by a set of linear regression models using lm, and then the coefficients are used to compute the requested effects and form confidence intervals. It can be used when there are missing data if the model is fitted by structural equation modeling. There are only a few limitations on some aspects of a model, and no inherent limitations on the number of predictors, the number of independent variables, or the number of moderators and mediators. The goal is to have a tool that allows researchers to focus on model fitting first and worry about estimating the effects later. The use of the model is illustrated using a few numerical examples, and the limitations of the package are discussed. [ABSTRACT FROM AUTHOR]

This article explores the relationship between cognitive impairment and functional limitations in individuals with haemophilia in Hong Kong. The study reveals that patients who experience difficulties with memory, attention, and executive functioning tend to have poorer performance at work or school. These cognitive functions are crucial for setting and achieving goals, as well as adapting to one's surroundings, so deficiencies in these areas can impact occupational or educational performance. The findings suggest that regular monitoring of cognitive function should be integrated into the standard care for haemophilia patients, particularly those facing occupational or vocational challenges. Further research is necessary to develop a cost-effective and clinically feasible method for monitoring cognitive function in these individuals. The study investigates how cognitive impairment affects functional limitations in haemophilia patients. The researchers discover that impairments in attention, motor processing speed, and cognitive flexibility are linked to a decline in functional status. The study proposes that regular screening for cognitive deficits and cognitive rehabilitation may be necessary for this population. However, the study has limitations, such as potential selection bias and the absence of a control group. Further research is needed to validate the findings and assess the long-term consequences of functional limitations in haemophilia patients. [Extracted from the article]

Background and Purpose: Radiation therapy‐induced gastrointestinal distress is partly associated with the elimination of gut microbiota. The effectiveness of 5‐HT receptor antagonists to treat radiation therapy‐induced emesis implies a pathophysiological role of 5‐HT. Peripheral 5‐HT is derived from intestinal epithelium. We have investigated the role of gut microbiota in regulating intestinal 5‐HT availability. Experimental Approach: A radiation therapy murine model accompanied by faecal microbiota transplantation from donors fed different diets was investigated, and mouse ileal organoids were used for mechanistic studies. The clinical relevance was validated by a small‐scale human study. Key Results: Short‐term high‐fat diet (HFD) induced gut bacteria to produce butyrate. Irradiated mice receiving HFD‐induced microbiome had the lowest ileal levels of 5‐HT, compared with other recipients. Treatment with butyrate increased 5‐HT uptake in mouse ileal organoids, assayed by the real‐time tracking of a fluorescent substrate for monoamine transporters. Silencing the 5‐HT transporter (SERT) in the organoids abolished butyrate‐stimulated 5‐HT uptake. The competitive tests using different types of selective 5‐HT reuptake inhibitors suggested that butyrate acted as a positive allosteric modulator of SERT. In human gut microbiota, butyrate production was associated with the interconversion between acetate and butyrate. Faecal contents of both acetate and butyrate were negatively associated with serum 5‐HT, but only butyrate was positively correlated with body mass index in humans. Conclusion and Implications: Short‐term HFD may be beneficial for alleviating gastrointestinal reactions by increasing butyrate to suppress local 5‐HT levels and providing energy to cancer patients given radiation therapy. [ABSTRACT FROM AUTHOR]

Background Purpose Methods Results Conclusion Respiratory motion management is essential in order to achieve high‐precision radiotherapy. Markerless motion tracking of tumor can provide a non‐invasive way to manage respiratory motion, thereby enhancing treatment accuracy. However, the low contrast in real‐time x‐ray images for image guidance limits the application of markerless tracking.We present a novel approach based on a motion model to perform markerless tracking of tumor and surrounding tissues even when they have low contrast in real‐time x‐ray images.A proof‐of‐concept validation of the method has been performed using digital and physical phantoms at breathing conditions that are significantly different than the planning stage. A motion model is first constructed by performing principal component analysis (PCA) on the planning 4DCT. During treatment, the motion of a surrogate is tracked and used as the input of the motion model, which generates a 3D real‐time volume estimation. Such 3D estimation is then projected to 2D to create digitally reconstructed radiographs (DRRs). The relationships between the real‐time DRRs, reference DRRs, and reference x‐ray images are first established to simulate 2D real‐time images from the real‐time volume. The registration between the simulated 2D real‐time images and real‐time x‐ray images corrects the initial motion model estimation to ensure the estimated volume matches the real‐time condition.In digital phantom, the Dice index of pancreas was improved from 0.74 to 0.78 after correction using real‐time DRRs in fully inhaled phase. Validation on lung and pancreas is performed in physical phantom with two motion traces. The surrogate‐tumor relationships were intentionally altered to generate large target localization errors due to the differences in body condition between treatment planning stage and during treatment. The real‐time correction for the estimated 3D real‐time volume was performed using a pair of 2D x‐ray images. For the deep breathing motion trace, the tumor localization mean absolute error (MAE) throughout the tracking decreases from around 3 mm to less than 1 mm after correction. For the shallow breathing motion trace with a 1.7 mm baseline shift, the tumor localization MAE throughout the tracking decreases from around 1.5 mm to less than 1 mm after correction.The method combines the detailed structural information from planning 4DCT and real‐time information from real‐time x‐ray images through a motion model. The matching between the real‐time model estimation and 2D real‐time images is performed in the same modality so that it can be applied to regions with low contrast in the images. The real‐time images successfully corrected the initial motion model estimations in our proof‐of‐concept validation. This suggests the potential to perform markerless tracking in low‐contrast region using a motion model. [ABSTRACT FROM AUTHOR]

Summary: Background: Optimal glycaemic control has well‐established health benefits in patients with diabetes mellitus (DM). It is uncertain whether optimal glycaemic control can benefit liver‐related outcomes. Aims: To examine the association of optimal glycaemic control with hepatocellular carcinoma (HCC) and liver‐related mortality. Methods: In a population‐based cohort, we identified patients with newly diagnosed DM between 2001 and 2016 in Hong Kong. Optimal glycaemic control was defined as mean haemoglobin A1c (HbA1c) <7% during the 3‐year lead‐in period after DM diagnosis. By applying propensity score matching to balance covariates, we analysed glycaemic control via competing risk models with outcomes of interest being HCC and liver‐related mortality. Results: We identified 146,430 patients (52.2% males, mean age 61.4 ± 11.8 years). During a median follow‐up duration of 7.0 years, 1099 (0.8%) and 978 (0.7%) patients developed HCC and liver‐related deaths. Optimal glycaemic control, when compared to suboptimal glycaemic control, was associated with reduced risk of HCC (subdistribution hazard ratio [SHR] 0.70, 95% CI 0.61–0.79). The risk of HCC increased with incremental HbA1c increases beyond >7% (SHR 1.29–1.71). Significant associations with HCC were also found irrespective of age (SHR 0.54–0.80), sex (SHR 0.68–0.69), BMI <25 or ≥25 kg/m2 (SHR 0.63–0.75), smoking (SHR 0.61–0.72), hepatic steatosis (SHR 0.67–0.68) and aspirin/statin/metformin use (SHR 0.67–0.75). A lower risk of liver‐related mortality in relation to optimal glycaemic control was also observed (SHR 0.70, 95% CI 0.61–0.80). Conclusions: Glycaemic control is an independent risk factor for HCC and liver‐related mortality, and should be incorporated into oncoprotective strategies in the general DM population. [ABSTRACT FROM AUTHOR]

We introduce a cohomology theory that classifies differential objects that arise from Picard-Vessiot theory, using differential Hopf-Galois descent. To do this, we provide an explicit description of Picard-Vessiot theory in terms of differential torsors. We then use this cohomology to give a bijective correspondence between differential objects and differential torsors. As an application, we prove a universal bound for the differential splitting degree of differential central simple algebras. [ABSTRACT FROM AUTHOR]

AbstractPurposeMaterials and methodsResultsConclusion\nIMPLICATIONS FOR REHABILITATIONFalls are a major concern for people with Parkinson’s disease (PwPD) due to associated motor and non-motor impairments. Promoting safe mobility behaviour may be an effective fall prevention intervention, however this concept is poorly articulated in the literature. The aim of this scoping review was to map out the definition and concepts of safe mobility behaviour to draw implications for PwPD.The Joanna Briggs Institute methodology for scoping reviews was followed. Studies involving older adults (aged ≥ 65 years) and/or PwPD that sought to define, describe, and/or explain this concept were included.Of the 21,936 records retrieved, 124 publications were included. No studies defined safe mobility behaviour. However, its performance was described as a combination of observable actions and cognitive processes. Mobility behaviour was influenced by an interaction between the person, environment, and task performance.We propose a definition for safer mobility behaviour as any protective action and associated functional cognitive process used to reduce the likelihood of a fall during mobility-related activities. It is unique to each person and occurs across a continuum of safer to riskier behaviour. Future research developing and testing interventions targeting safer mobility behaviour for PwPD is warranted.Safer mobility behaviour is any protective action and associated functional cognitive processes used to prevent falls, and is influenced by a dynamic person-environment-task interaction.Safer mobility behaviour should be considered in fall prevention assessment and intervention.Parkinson’s disease uniquely impacts the person-related factors and these need to be addressed in context to improve the safety of mobility.Safer mobility behaviour is any protective action and associated functional cognitive processes used to prevent falls, and is influenced by a dynamic person-environment-task interaction.Safer mobility behaviour should be considered in fall prevention assessment and intervention.Parkinson’s disease uniquely impacts the person-related factors and these need to be addressed in context to improve the safety of mobility. [ABSTRACT FROM AUTHOR]

Summary Digital cognitive behavioural therapy for insomnia has been developed to increase capacity and scalability for patients with insomnia, but implementation in primary care remains limited. The aim of the trial was to evaluate the implementation of digital insomnia therapy into primary care practice for patients with insomnia. We conducted a single‐arm feasibility trial of digital behavioural therapy for insomnia (SleepFix) providing sleep restriction therapy with insomnia patients in primary care. Healthcare professionals (comprising General Practitioners, community pharmacists and nurses) were enrolled into the trial and, when deemed clinically appropriate, prescribed SleepFix to patients with insomnia. The primary outcome was uptake assessed by the number of downloads of SleepFix. Interviews with primary care healthcare professionals explored their attitudes towards implementing/using insomnia digital therapeutics in clinical practice, and patients about their experiences with SleepFix. Insomnia symptoms, mood and sleep quality were measured before and after the trial. This trial was prospectively registered (ACTRN12620000055909). Thirty healthcare professionals and 105 patients were enrolled into the trial. Fourteen healthcare professionals administered at least one insomnia digital therapeutic prescription between November 2021 and March 2022. Fifty patients downloaded and used SleepFix (47.6% uptake). In post‐trial interviews, healthcare professionals felt they could incorporate digital sleep health into clinical practice and patients found SleepFix acceptable. There were significant improvements in insomnia symptoms, mood and sleep quality at week 6 (all p < 0.05). This trial shows a real‐world implementation of a digital insomnia therapy into primary care that could provide a framework for prescribing digital sleep interventions. [ABSTRACT FROM AUTHOR]

Microstructure arrays are the basis for micro-optical systems. This paper presents a roll-to-plate (R2P) hot embossing method and process equipment that are developed for precision manufacturing of glass microstructures. The surface crack generation and deformation mechanism of glass in R2P hot embossing process are analyzed. A temperature control method and an elastic clamping fixture are developed to avoid warping and cracking of the glass workpiece. Surface microstructures are successfully replicated to glass through R2P hot embossing. Experimental results show high fidelity and good uniformity between the microstructure patterned plate mould and the workpiece. The forming ability increases with increasing embossing temperature and loading displacements, and decreasing mould feed rate. The results demonstrate that the R2P hot embossing process is effective for the precision manufacturing of large-area micro-structured surfaces on glass. [ABSTRACT FROM AUTHOR]

Purpose: The current study is a Phase I clinical study with the goal of determining feasibility and the effectiveness of the Kaufman Speech to Language Protocol (K-SLP) for children with childhood apraxia of speech (CAS) and comorbidities. We hypothesized that K-SLP intervention would result in improved outcomes and maintenance of treatment effect at 3–4 months postintervention. Method: Single-subject experimental design with multiple baselines across behaviors was replicated across a group of six children. Five out of six participants completed the study. The K-SLP intervention was administered in dyads four times a week for three consecutive weeks. Outcomes included assessment of word/syllable shapes, articulation accuracy, speech intelligibility, and functional communication. Treatment progress was measured through: (a) the administration of custom probe word lists and (b) assessments carried out at pretreatment, immediately following intervention and approximately 3–4 months after the study period. Results: Four out of five participants demonstrated significant improvements to words targeted in treatment and three out of five generalized these to untreated words. Furthermore, three out of five participants showed immediate and clinically significant posttreatment improvements in speech intelligibility and functional outcomes, and this increased to four out of five participants at 3–4 months follow-up. Conclusions: The study provides preliminary support for the effectiveness of the K-SLP program when delivered in dyads to children with CAS with comorbidities. The study replicates earlier findings and reaffirms the positive outcomes of K-SLP for children with CAS. [ABSTRACT FROM AUTHOR]

Objectives Guided by Andersen's behavioral model, the objectives of this study were to (a) examine the associations between individual factors and the intended utilization of home-based long-term care (LTC) services among older adults in China and (b) explore the influence of community support, if any, on these associations. Methods Using a multistage random sampling approach, we recruited 1,064 older adults in Chengdu, China. Hierarchical regression was employed to investigate the direct effects of individual predictors and community support on the intended use of home-based LTC services. The moderating effect of community support was examined using the Hayes Process. Results Two predisposing (i.e. being old and unmarried), 4 enabling (i.e. living alone, having fewer children, and receiving less family and peer support), and 6 need factors (i.e. having more chronic illnesses; decreased performance in instrumental activities of daily living; higher levels of depression, anxiety, loneliness; and a lower self-image of aging), and low community support were significantly associated with increased intended utilization of home-based LTC. In addition, community support moderated the effects of family support (B  = −0.20, p  < .001), peer support (B  = −0.20, p  < .001), self-image of aging (B  = −0.39, p  < .001), depression (B  = −0.34, p  < .001), and loneliness (B  = −0.48, p  <  .001) on the intended utilization of home-based LTC services. Discussion Policy-makers and practitioners should consider delivering tailored services for older adults and involve the community in the context of enhancing home-based LTC services. [ABSTRACT FROM AUTHOR]

Many children with autism could benefit from adult support during motor play. The purpose of this study was to explore parents' perspectives on the importance of structured motor activities and how they might support the motor development of their young children with autism. Interviews were conducted with six parents of preschoolers with autism to understand their perceptions about structured motor play. Results revealed that parents: (a) valued structured motor activities, but many did not implement them at home; (b) had limited knowledge about motor development; (c) were uncertain about how to find motor resources; and (d) would like teachers to lead structured motor activities at school and send home ideas for parents to build on these activities. The findings provide insights about partnering with parents to support motor development, ideas for curriculum development, and suggestions for professional development for teachers. Implications for research and practice are discussed. [ABSTRACT FROM AUTHOR]

Persuasive messages can motivate parent support for physical activity (PA). Many PA messages targeting parents are not necessarily inclusive of parents of children with disabilities (CWD). Guided by the theory of planned behavior and multi-process action control model, the relative effects of PA messages were examined among parents of CWD. Parents (N = 135) were randomized to view one of four PA messages. Parent support for PA and various psychosocial antecedents were assessed before and after message viewing, along with message preference. Baseline parent support for PA acted as a moderator on the effects of messages. Effects of messages did not differ between message conditions. Overall message effects were observed for attitudes, subjective norms and planning. Parent support for PA increased only among parents with low baseline parent support and the inclusive message was most preferred. This study can inform the development of PA messages targeting this population. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to develop a fine-grained measure for evaluating syntactic abilities in Mandarin-speaking children for educational and clinical purposes as a supplement to MLU. Method: In total, 99 typically developing children, aged 2;0 to 5;11, living in Taipei, Taiwan, participated in this study. Spontaneous language samples were elicited in free-play situations. The first 100 intelligible utterances were coded with a newly developed scheme: the Mandarin Assessment of Productive Syntax-Revised (MAPS-R). For the examination of concurrent validity, MLU was also computed. Results: Significant age-related differences were observed in both MLU and MAPS-R scores. Strong correlations were found between MLU and MAPS-R scores, confirming the validity of MAPS-R as a measure of syntactic development. MAPS-R further revealed that Mandarin-speaking children expanded noun phrases with the general classifier 'GE' very early on, followed by a locative expression. Verb expansions began with resultative complements and aspect markers. Sentences with complex predication structures, such as serial verbs/pivotal sentences, were still not widely used when the MLU value is below 4.5. Conclusions: The study showed that MAPS-R is a reliable and valid measure that can provide a rich profile of the syntactic development of Mandarin-speaking children. It can be a useful reference for speech therapists to set a baseline for developing language intervention plans and to monitor their outcome. [ABSTRACT FROM AUTHOR]

Low total fertility rates have persisted in East Asian societies, with gender inequality at home identified as a significant barrier to women achieving their desired fertility. However, there is a lack of empirical evidence on the link between housework participation and fertility intentions among married couples in Hong Kong, where the total fertility rate has fallen below 1 since 2020. This study proposes and tests two hypotheses regarding the relationship between couples' housework participation, housework satisfaction, and fertility intentions. The study utilises representative household survey data to show that women's evaluation of housework arrangements plays a role in the indirect association between housework participation and fertility intentions. This indirect relationship is moderated by gender role attitudes and fertility gap. The findings support gender equity theory, which links an uneven housework burden to low fertility. This research highlights the importance of gender equity at home in promoting fertility in East Asia. [ABSTRACT FROM AUTHOR]

Intensive mothering, a classed and gendered practice optimally performed by stay‐at‐home mothers, is a dominant parenting ideology, particularly in developed societies with wide disparities in wealth. Ironically, in these societies, women tend to be well educated and have good employment prospects that are expected to free them from domestic obligations. Facing competing expectations shaped by the institutions of work and the family, how do college‐educated mothers consider ending or limiting their participation in the workforce or holding jobs while resolving the moral dilemma of being both a worker and a mother? We compared 33 college‐educated Hong Kong mothers engaged in different professions and constructed typologies that describe how intersecting ideologies of mothering and work shape work‐family arrangements. We paid special attention to mothers with strong commitment to their work, but with different ideologies about mothering. Some espouse the ideology of intensive mothering. Their belief in gender essentialism proved exhausting for them, both at work and at home. While away from home, these mothers supervised domestic helpers from their workplaces. Other women value their professions as emblematic of their identity as the perfect mother—an integrated form of mothering, thus feeling no guilt for delegating childcare responsibilities. We argue that given the entrenched gender inequality in workplaces and men's slow progress in doing their share of domestic work, the emergence of integrated mothering both rhetorically and in practice reflects women's striving to bring the "unfinished revolution" closer to the finish line. [ABSTRACT FROM AUTHOR]

Lipid nanoparticles (LNPs) are the most clinically advanced RNA delivery technology, but their efficiency is limited by low RNA release after endosome disruption. To improve RNA release, an acid‐responsive polymer is synthesized with which to formulate LNPs for RNA encapsulation and release. Specifically, three acid‐responsive poly(lactic acid)‐block‐poly(carboxybetaine) zwitterionic derivatives are designed and synthesized that are cationic and complexed with RNA at pH 7.4, but are neutral following cleavage at endosomal pH, thereby having lower affinity to RNA. The polymers are formulated into each of the clinically approved Onpattro, Moderna, or Pfizer LNP formulations to produce hybrid polymer‐lipid nanoparticles (PLNPs). With the PLNPs, the IC50 values of multiple small interfering RNAs (siRNAs) decreased up to 5.4‐fold compared to parent LNPs in several cell lines. Moreover, messenger RNA (mRNA) transfection increased up to two fold. The acid‐responsive polymers in PLNPs accounted for the enhanced RNA transfection as this phenomenon is lost with acid‐inert polymers. Confocal microscopy confirmed that cytosolic RNA concentration increased using the acid‐responsive polymers; conversely, uptake and endosomal escape are identical to existing LNPs. This confirmed that enhanced RNA transfection is due to increased RNA dissociation from its carrier. The novel polymer represents a versatile strategy to increase RNA transfection from LNPs. [ABSTRACT FROM AUTHOR]

Background: Stepped-wedge cluster trials (SW-CTs) describe a cluster trial design where treatment rollout is staggered over the course of the trial. Clusters are commonly randomized to receive treatment beginning at different time points in this study design (commonly referred to as a Stepped-wedge cluster randomized trial; SW-CRT), but they can also be non-randomized. Trials with this design regularly have a low number of clusters and can be vulnerable to covariate imbalance. To address such covariate imbalance, previous work has examined covariate-constrained randomization and analysis adjustment for imbalanced covariates in mixed-effects models. These methods require the imbalanced covariate to always be known and measured. In contrast, the fixed-effects model automatically adjusts for all imbalanced time-invariant covariates, both measured and unmeasured, and has been implicated to have proper type I error control in SW-CTs with a small number of clusters and binary outcomes. Methods: We present a simulation study comparing the performance of the fixed-effects model against the mixed-effects model in randomized and non-randomized SW-CTs with small numbers of clusters and continuous outcomes. Additionally, we compare these models in scenarios with cluster-level covariate imbalances or confounding. Results: We found that the mixed-effects model can have low coverage probabilities and inflated type I error rates in SW-CTs with continuous outcomes, especially with a small number of clusters or when the ICC is low. Furthermore, mixed-effects models with a Satterthwaite or Kenward-Roger small sample correction can still result in inflated or overly conservative type I error rates, respectively. In contrast, the fixed-effects model consistently produced the target level of coverage probability and type I error rates without dramatically compromising power. Furthermore, the fixed-effects model was able to automatically account for all time-invariant cluster-level covariate imbalances and confounding to robustly yield unbiased estimates. Conclusions: We recommend the fixed-effects model for robust analysis of SW-CTs with a small number of clusters and continuous outcomes, due to its proper type I error control and ability to automatically adjust for all potential imbalanced time-invariant cluster-level covariates and confounders. [ABSTRACT FROM AUTHOR]

Background and Aims Methods Results and Conclusion There is currently a dearth of tools to assess parents' use of effective interactive strategies for supporting early mathematics learning. One potential such strategy is sustained shared thinking. This study therefore constructed and validated a scale for measuring parents' use of sustained shared thinking during joint mathematics activities with young children, and examined its antecedents and outcomes.Four hundred and sixty‐six parents completed a questionnaire about their conceptions of mathematics teaching and learning, home practices, as well as their kindergarten children's approach and avoidance motivation to learn mathematics. Additionally, the children were tested on numeration skills.Results showed that our new scale has three factors: exchanging ideas with children about mathematical problem‐solving processes, creating a child‐centred atmosphere for mathematics learning, and engaging children in mathematical thinking. Parents' uses of these three strategies were predicted by their constructivist conception of mathematics teaching and learning, and were differentially associated with the children's numeration skills, approach, and avoidance motivation to learn mathematics. Potential uses of our new scale in future home mathematics environment research are discussed. [ABSTRACT FROM AUTHOR]

The current diagnostic criteria for gestational diabetes (GDM) were based on data from women after 24 weeks of gestation, but this may not be equally applicable for earlier gestation. There is insufficient data regarding early pregnancy glycaemia and the associated complications. We retrospectively reviewed 39,483 deliveries and 12,918 with risk factors for GDM underwent oral glucose tolerance test (OGTT) before 24 weeks of gestation. A strong and progressively positive association was observed with any pregnancy complications in both fasting glucose (FG) and 2 h glucose (2hG). The increased risk of developing any pregnancy complications started from FG 4.5–4.7 mmol/L and 2hG of 6.2–6.9mmol/L. Every increase by 1 mmol/L in FG or 2 hG levels increased the risk of developing any complications (aOR 1.614 for FG and 1.131 for 2hG), pre-eclampsia (aOR 1.472 for FG and 1.143 for 2hG), maternal insulin use (aOR 12.821 for FG and 2.366 for 2hG), primary Caesarean section(aOR 1.274 for FG and 1.099 for 2hG), shoulder dystocia (aOR 1.941 for FG and 1.282 for 2hG), macrosomia(aOR 2.203 for FG and 1.072 for 2hG), and large for gestation age(aOR 2.157 for FG and 1.074 for 2hG). Therefore, glycaemic levels in early pregnancy among high-risk women positively associated with pregnancy complications, even at levels below the current recommended diagnostic criteria for GDM. [ABSTRACT FROM AUTHOR]

Background: Major Depressive Disorder (MDD) poses a significant global health challenge, with symptom presentation potentially varying between adolescents and adults. Adolescence is a critical period marked by heightened vulnerability to interpersonal stresses, yet the impact of these stresses on the structure of depressive symptoms is not well understood. Recognizing the cultural nuances in how depression manifests among adolescents is crucial. To this end, this paper employs a network analysis approach, utilizing a comprehensive symptom checklist from the Multidimensional Depression Assessment Scale (MDAS). Our study investigates the role of interpersonal symptoms within the broader cluster of emotional, cognitive, and somatic symptoms and explores variations in adolescent groups in four Asian and European regions. Methods: We recruited a diverse sample of 6,348 adolescents aged 12 to 18 from Hong Kong, Taiwan, the UK, China, and the Netherlands using the Qualtrics platform. Employing the Gaussian Graphical Model, we established a network model of depressive symptoms as measured by the MDAS, segregating the sample into Asian and European regions to examine the interconnections between them. The study focused on identifying central symptom nodes and comparing the network structures between the two groups. Results: The analysis identified feeling worthless, low energy, being a burden to others, and low mood as central symptoms of depression. Notably, there were significant differences in the connections between depressive symptoms among Asian (Hong Kong, China and Taiwan) and European (UK and the Netherlands) adolescents, highlighting cultural variations in how interpersonal symptoms interact with emotional, cognitive, and somatic symptoms. Conclusion: This study is pioneering in applying network analysis to include interpersonal symptoms in examining depression among a diverse adolescent population. It demonstrates that interpersonal symptoms are integral to the central features of depressive symptoms. Furthermore, our findings suggest that, compared to their UK and Dutch peers, interpersonal symptoms in Asian adolescents are uniquely connected to other symptom clusters, reflecting distinct cultural patterns. Limitations: The study engaged a broad community sample; however, future research could benefit from including a larger sample size to allow for a more detailed analysis of a greater number of symptom nodes. [ABSTRACT FROM AUTHOR]

ABSTRACT Students' understanding of nature of science (NOS) has been largely examined primarily in written or verbal modes. The visual, verbal, and written modes are essential for students' meaning‐making of NOS. However, research has sidelined the interaction among these three modes in understanding students' collaborative discourse of NOS. Informed by theories of multimodality and social semiotics, this paper investigates the interactions between the visual, verbal, and written modes as groups of students engaged in explicit‐reflective multimodal representation during NOS instruction. Utilizing a collective case study approach, we planned NOS instruction with teachers, and videotaped how each focal group of students in two grade seven classes in Hong Kong constructed multimodal representations of NOS. Multimodal discourse analysis revealed that the three modes fulfill various purposes during students' co‐construction of multimodal representations of NOS. The interaction between the three modes facilitates meaning‐making of NOS in four ways: (a) students' re‐semiotization of discursive scientific practices into their multimodal ensembles; (b) bridging students' writing of scientific reports to scientists' social certification and dissemination; (c) connecting students' decontextualized meaning‐making to contextualized meaning‐making of methods and methodological rules; and (d) facilitating students' embodied semiosis in social organizations and interactions of science. Focusing on four episodes of co‐constructing multimodal representations of NOS, we illustrate how students' meaning‐making of NOS is multimodal in nature and how various modes have their own affordances. We discuss future research directions on how multimodality can facilitate students' meaning‐making of NOS. [ABSTRACT FROM AUTHOR]

We present a rare case of tracheal schwannoma, the first reported in Hong Kong, emphasizing the diagnostic challenges and treatment outcomes. A 54‐year‐old woman with respiratory symptoms underwent evaluations revealing a tracheal mass causing luminal narrowing. Emergency operation with rigid bronchoscopy and cryoablation successfully removed the tumor. Follow‐up bronchoscopies showed a gradual reduction in residual tumor size, with no evidence of recurrence after 3.5 years postoperation. Tracheal schwannomas are exceedingly rare, often resulting in delayed diagnosis. Clinicians should maintain a high suspicion of tracheal tumors in patients with unexplained respiratory symptoms. Spirometry and flow volume loop analysis aid in identifying upper airway obstruction. Rigid bronchoscopy is preferred for diagnosis and treatment, ensuring airway stability and obtaining tissue samples. Surgical resection remains the mainstay, but observation after endoscopic resection may be considered. This case highlights the successful management of tracheal schwannoma through endoscopic resection and cryoablation, emphasizing the need for further studies and case reports on this rare entity. [ABSTRACT FROM AUTHOR]

MYCN amplification predicts poor prognosis in childhood neuroblastoma. To identify MYCN oncogenic signal dependencies we performed N-ethyl-N-nitrosourea (ENU) mutagenesis on the germline of neuroblastoma-prone TH-MYCN transgenic mice to generate founders which had lost tumorigenesis. Sequencing of the mutant mouse genomes identified the Ring Finger Protein 121 (RNF121WT) gene mutated to RNFM158R associated with heritable loss of tumorigenicity. While the RNF121WT protein localised predominantly to the cis-Golgi Complex, the RNF121M158R mutation in Helix 4 of its transmembrane domain caused reduced RNF121 protein stability and absent Golgi localisation. RNF121WT expression markedly increased during TH-MYCN tumorigenesis, whereas hemizygous RNF121WT gene deletion reduced TH-MYCN tumorigenicity. The RNF121WT-enhanced growth of MYCN-amplified neuroblastoma cells depended on RNF121WT transmembrane Helix 5. RNF121WT directly bound MYCN protein and enhanced its stability. High RNF121 mRNA expression associated with poor prognosis in human neuroblastoma tissues and another MYC-driven malignancy, laryngeal cancer. RNF121 is thus an essential oncogenic cofactor for MYCN and a target for drug development. A chemical mutagenesis screen identifies RNF121 as an oncogenic cofactor for MYCN in neuroblastoma. [ABSTRACT FROM AUTHOR]

Environmental gradients can influence morpho-physiological and life-history differences in natural populations. It is unclear, however, to what extent such gradients can also modulate phenotypic differences in other organismal characteristics such as the structure and function of host-associated microbial communities. In this work, we addressed this question by assessing intra-specific variation in the diversity, structure and function of environmental-associated (sediment and water) and animal-associated (skin and gut) microbiota along an environmental gradient of pollution in one of the most urbanized coastal areas in the world. Using the tropical sea cucumber Holothuria leucospilota, we tested the interplay between deterministic (e.g., environmental/host filtering) and stochastic (e.g., random microbial dispersal) processes underpinning host-microbiome interactions and microbial assemblages. Overall, our results indicate that microbial communities are complex and vary in structure and function between the environment and the animal hosts. However, these differences are modulated by the level of pollution across the gradient with marked clines in alpha and beta diversity. Yet, such clines and overall differences showed opposite directions when comparing environmental- and animal-associated microbial communities. In the sea cucumbers, intrinsic characteristics (e.g., body compartments, biochemistry composition, immune systems), may underpin the observed intra-individual differences in the associated microbiomes, and their divergence from the environmental source. Such regulation favours specific microbial functional pathways that may play an important role in the survival and physiology of the animal host, particularly in high polluted areas. These findings suggest that the interplay between both, environmental and host filtering underpins microbial community assembly in H. leucospilota along the pollution gradient in Hong Kong. [ABSTRACT FROM AUTHOR]

Aim. To assess the acceptability of a symptom self‐management booklet among older Chinese Americans receiving kidney replacement therapy. Background. In previous work, we identified commonly occurring, bothersome symptoms and strategies used in this population to ameliorate symptoms. We used these data to develop a symptom self‐management booklet in English, traditional, and simplified Chinese. Introduction. In the United States, the prevalence of kidney disease is 1.5 times higher in Asians compared to whites. With the many symptoms associated with this disease, self‐management of symptoms would be particularly helpful. Methods. Seven older Chinese Americans receiving kidney replacement therapy and their caregivers were interviewed to assess the acceptability of the booklets. We reviewed participant feedback on content, graphics, and design, reading experience, suggestions for improvement, and health information sources using the inductive thematic method. Results. Overall, patients confirmed acceptability of these self‐management booklets across all domains. Discussion. This study validated the booklet as a source of health information for older Chinese American patients with kidney disease, which some studies suggest are preferred to electronic materials or methods in this population. Health care providers can use the resultant booklets when caring for these patients to provide culturally sensitive information on self‐management of symptoms. Conclusion and Implications for Nursing. These booklets provide a free resource tailored to an underserved population and may help nurses and nurse practitioners provide care with cultural humility. Implications for Health Policy. Embracing community‐based participatory research, as was done in this study, can help create culturally appropriate patient education materials that empower patient symptom self‐management and promote informative and culturally sensitive conversations between patients, families, and providers. [ABSTRACT FROM AUTHOR]

The connection between individual and macroeconomic conditions and voting behavior is well‐established. We contribute to the less resolved “spatial gap” in the literature that centers on how the localized economic conditions of where voters live influence their likelihood to vote. We test how space mediates the tension between voter mobilization and withdrawal in the face of economic shocks. We consider a scenario, the Great Recession, where economic shocks were quite localized and sudden, and compile an extensive dataset of all registered voters in the four‐county Tampa metropolitan area between 2006 and 2015. Using sales prices and property characteristics from the tax assessor rolls, we estimate a neighborhood‐level shock to housing values induced by the Great Recession. Results show that when we do not account for local neighborhood variation, the Great Recession is associated with a significant decrease in voter turnout. However, when we account for localized economic shocks, we find that residents in neighborhoods with negative price shocks were more likely to vote after the Recession, especially in non‐local elections. In addition, the propensity to vote increases with the size of the negative price shock. There is some evidence that variation at the neighborhood level matters more than voter‐level heterogeneity. The positive voting response is most profound in predominantly Black neighborhoods, and, to a lesser extent, in predominantly Hispanic and the lowest income neighborhoods. Increases in the propensity to vote are robust to models controlling for baseline economic vulnerabilities, such as localized unemployment, the weakness of the local housing market and exposure to sectors hit hardest by the Recession. The results indicate that dramatic and sudden changes in localized economic conditions can drive voting behavior, and in ways that are distinct from macroeconomic drivers. In addition, the housing asset channel appears to be a powerful one, which can induce significant voting responses at the national level apart from other localized economic drivers, especially among homeowners. [ABSTRACT FROM AUTHOR]

The feasibility of coupling of two carbene ligands of biscarbene complexes LnM(＝CR2)2 to form alkene complexes LnM(η2-R2C＝CR2) was predicted theoretically as early as 1982. However, until now, there appear still no reports on carbene coupling reactions of well-defined biscarbene complexes. This work reports oxidation-induced coupling reactions of bi(metallacycloprop-1-ene) complexes to give η4-butadiene complexes, a unique example of coupling of two carbene ligands of biscarbene complexes. [ABSTRACT FROM AUTHOR]

AbstractLearning content subjects like science requires culturally and linguistically diverse students to learn abstract representations. Previous studies focused on how content teachers can use translanguaging to promote emotional engagement of students with homogenous cultural and linguistic composition. As students in culturally and linguistically diverse classrooms brought different emotive experiences to classrooms, it was important for teachers to leverage semiotic resources to evoke shared memory that reconcile backgrounds of different students. This bridged the gap between students’ lived experiences and learning of abstract content representations. In the current case study involving a seventh-­grade mixed medium of instruction (MMI) science classroom, we examined how a science teacher capitalised on culturally and linguistically diverse students’ shared emotive experiences to translate across different representational levels in science. Drawing on the socio-­cultural concept of perezhivanie, our findings showed that the science teacher leveraged the class’s collective experience of watching the Disney parade and linked it to water molecules moving around dissociated salts in blackboard drawings. We argue for the importance of reconciling lived experiences among students with diverse cultural and linguistic background, in order to facilitate their equitable access to content subjects. [ABSTRACT FROM AUTHOR]

Epinephrine is the only recommended vasopressor during neonatal cardiopulmonary resuscitation. However, there are concerns about the potential adverse effects of epinephrine, which might hamper efficacy during cardiopulmonary resuscitation. An alternative might be vasopressin, which has a preferable adverse effect profile, however, its optimal dose and route of administration is unknown. We aimed to compare the pharmacodynamics and pharmacokinetics of various vasopressin doses administered via intravenous (IV), intraosseous (IO), endotracheal (ETT), and intranasal (IN) routes in healthy neonatal piglets. Forty-four post-transitional piglets (1–3 days of age) were anesthetized, intubated via a tracheostomy, and randomized to receive vasopressin via intravenous (control), IO, ETT, or IN route. Heart rate (HR), arterial blood pressure, carotid blood flow, and cardiac function (e.g., stroke volume, ejection fraction) were continuously recorded throughout the experiment. Blood was collected prior to drug administration and throughout the observation period for pharmacodynamics and pharmacokinetic analysis. Significant changes in hemodynamic parameters were observed following IO administration of vasopressin while pharmacokinetic parameters were not different between IV and IO vasopressin. Administration of vasopressin via ETT or IN did not change hemodynamic parameters and had significantly lower maximum plasma concentrations and systemic absorption compared to piglets administered IV vasopressin (p < 0.05). The IV and IO routes appear the most effective for vasopressin administration in neonatal piglets, while the ETT and IN routes appear unsuitable for vasopressin administration. [ABSTRACT FROM AUTHOR]

Photo-responsive malachite green moieties have been incorporated into an alkynylplatinum(II) bzimpy system. The photo-caged complexes in acetonitrile solutions exhibit self-assembly properties modulable by photo-removal of the cyano protecting group. Distinct aggregate morphologies, which are facilitated by the non-covalent metal–metal and π–π stacking interactions, have been observed before and after photo-irradiation. [ABSTRACT FROM AUTHOR]

Opioids are commonly used to reduce pain after surgery; however, there are severe side effects and complications associated with opioid use, with addiction being of particular concern. Recent practice has shifted to reduce opioid consumption in surgery, although a specific protocol for rhinoplasty is still in progress. This paper aims to expand on the protocol previously established by the senior author based on updated evidence and details. This was accomplished by first high-lighting and summarizing analgesic agents with known opioid-reducing effects in the surgical field, with a particular focus on rhinoplasty, then compiling these analgesic options into a recommended protocol based on the most effective timing of administration (preoperative, intraoperative, postoperative). The senior author's previous article on the subject was referenced to compile a list of analgesic agents of importance. Each analgesic agent was then searched in PubMed in conjunction with "rhinoplasty" or "opioid sparing" to find relevant primary sources and systematic reviews. The preferred analgesic agents included, as follows: preoperative, 1000 mg oral acetaminophen, 200 mg of oral celecoxib twice daily for 5 days, and 1200 mg oral gabapentin; intraoperative, 0.75 μg/kg of intravenous dexmedetomidine and 1–2 mg/kg injected lidocaine with additional 2–4 mg/kg per hour or 1.5 cc total bupivacaine nerve block injected along the infraorbital area bilaterally and in the subnasal region; and postoperatively, 5 mg oral acetaminophen and 400 mg of oral celecoxib. When choosing specific analgesic agents, considerations include potential side effects, contraindications, and the drug-specific mode of administration. [ABSTRACT FROM AUTHOR]

Cell membrane-derived liposomes, termed Memposomes, serve as promising carriers for drug delivery due to their ability to closely mimic cells and efficiently target specific cells. Liposomes derived from cancer cell membranes, in particular, exhibit homologous targeting capabilities, making them potential candidates for cancer-specific drug delivery. However, the underlying mechanisms and specific proteins responsible for this homologous targeting phenomenon remain debated. This study focuses on the role of E-cadherin, a cell adhesion molecule implicated in homophilic adhesion, in influencing the homologous targeting ability of Memposomes derived from cancer cell membranes. E-cadherin expression patterns were assessed in various cell lines, categorizing them into E-cadherin-positive and -negative groups. Memposomes were produced for each group, and their targeting tendencies were evaluated. This study confirmed that E-cadherin expression significantly influenced the homologous targeting ability of the Memposomes. The cell lines with higher E-cadherin expression levels exhibited a more pronounced homologous targeting effect. This research demonstrates that cell adhesion molecules, particularly E-cadherin involved in homophilic adhesion, play a pivotal role in influencing the cell targeting ability of Memposomes. This study further validates the stability, safety, and purity of Memposomes, emphasizing their potential as effective drug delivery vehicles for the development of cell-specific therapies. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic has introduced many new stressors for parents worldwide. This study investigated the link between parents' cumulative stress and psychological distress during the pandemic. Parents' emotion dysregulation was further examined as a moderator between cumulative stress and psychological distress. A total of 155 parents in the United States participated in the present study. Path analysis was conducted to evaluate the effects of cumulative stress, including COVID-19-related stress, general stress, and parental stress, as well as emotion dysregulation on parents' psychological distress, including depression and anxiety. The present findings indicated that parents' general stress, parental stress, and emotion dysregulation predicted symptoms of depression. Emotion dysregulation further exacerbated the effect of parental stress on depression. Parents' general stress and emotion dysregulation were also predictive of anxiety symptoms. In addition, emotion dysregulation exacerbated the effect of COVID-19-related stress on parental anxiety. This study revealed that parents' stress and emotion dysregulation were additively and interactively associated with their psychological distress. The findings inform researchers and practitioners that parents' stressors have cumulative effects on their psychological distress and that emotion dysregulation can worsen the negative effect of stress on mental health in challenging times, such as the pandemic. [ABSTRACT FROM AUTHOR]

Simple Summary: Pet ownership is growing in Chinese societies, but tools to assess grief from pet loss among the Chinese are lacking. This study adapted and validated the Pet Bereavement Questionnaire (PBQ) in Hong Kong, which aimed to provide a culturally appropriate assessment tool for pet bereavement. The findings supported a three-factor structure—grief, anger, and guilt—similar to the original PBQ. The validated Chinese version of the PBQ demonstrated strong reliability, meaning it consistently measures what it is supposed to, and strong validity, meaning it accurately reflects the emotional experiences of pet loss. This tool can significantly enhance our understanding of the emotional complexities surrounding pet loss within this cultural context, offering critical insights that can guide more effective support interventions and public health strategies for individuals experiencing the often-unrecognized grief associated with pet loss. Despite the increasing prevalence of pet ownership in Chinese societies, standardized tools to assess grief from pet loss remain lacking. Research predominantly focuses on Western populations, creating a gap in understanding pet bereavement in Chinese cultural settings. This study aimed to adapt and validate the Pet Bereavement Questionnaire (PBQ-C) for a Chinese context to create a culturally appropriate assessment tool. A total of 246 participants with companion animal loss experiences were recruited through the university of the research team. They were invited to complete an online survey including the PBQ-C, the Depression subscale of the Depression Anxiety Stress Scales (DASS-21), and the Inventory of Complicated Grief (ICG). Both Exploratory Factor Analysis and Confirmatory Factor Analysis were conducted to examine the psychometric properties of the PBQ-C and the findings supported a three-factor structure—grief, anger, and guilt—aligned with the original PBQ, with three items reassigned to different factors. Despite these adjustments, the PBQ-C demonstrated strong internal consistency, reflecting the reliability of the questionnaire in measuring the same construct across its items; split-half reliability, indicating its ability to produce consistent results when divided into two parts; and concurrent validity, showing that the PBQ-C correlates well with other established measures of grief. The validated PBQ-C provides a culturally sensitive tool for assessing pet bereavement in Chinese society that can promote research and counselling support for this under-researched and under-recognized type of loss of human-animal relationships. [ABSTRACT FROM AUTHOR]

C1QL1 is expressed in a subset of cells in the brain and likely has pleiotropic functions, including the regulation of neuron‐to‐neuron synapses. Research progress on C1QL proteins has been slowed by a dearth of available antibodies. Therefore, we created a novel knock‐in mouse line in which an HA‐tag is inserted into the endogenous C1ql1 locus. We examined the entire brain, identifying previously unappreciated nuclei expressing C1QL1, presumably in neurons. By total numbers, however, the large majority of C1QL1‐expressing cells are of the oligodendrocyte lineage. Subcellular immunolocalization of synaptic cleft proteins is challenging, so we developed a new protocol to improve signal at synapses. Lastly, we compared various anti‐HA antibodies to assist future investigations using this and likely other HA epitope‐tagged alleles. [ABSTRACT FROM AUTHOR]

To help with preparedness efforts of Canadian public health and safety systems for adaptation to climate change, the humidity index (humidex) and three threshold‐based humidex indices (annual number of days with humidex greater than 30, 35 and 40) were computed for a multi‐model ensemble of climate change projections, over Canada. The ensemble consists of one run from each 19 Coupled Model Intercomparison Project Phase 6 (CMIP6) global climate models and offers historical simulations starting in 1950 and future projections out to 2100 following Shared Socioeconomic Pathways (SSPs): SSP1‐2.6, SSP2‐4.5 and SSP5‐8.5. Each ensemble member was bias‐adjusted and statistically downscaled using the Multivariate bias correction—N‐dimensional probability density function transform (MBCn) with hourly data from ERA5‐Land as the target dataset and following a method proposed by Diaconescu et al. (2023; International Journal of Climatology, 43, 837) to calculate humidex from daily climate model outputs. This paper details the steps for data production including evaluation of the target historical gridded data and selection of downscaling method and presents some of the resulting humidex projections at the end of the century. [ABSTRACT FROM AUTHOR]

The vitreous humor (VH) is a transparent gelatin-like substance that occupies two-thirds of the eyeball and undergoes the most significant changes during eye elongation. Quantitative proteomics on the normal growth period in the VH could provide new insights into understanding its progression mechanism in the early stages of myopia. In this study, a data-independent acquisition (SWATH-MS) was combined with targeted LC-ESI-MS/MS to identify and quantify the relative protein changes in the vitreous during the normal growth period (4, 7, 14, 21 and 28 days old) in the chick model. Chicks were raised under normal growing conditions (12/12 h Dark/light cycle) for 28 days, where ocular measurements, including refractive and biometric measurements, were performed on days 4 (baseline), 7, 14, 21 and 28 (n = 6 chicks at each time point). Extracted vitreous proteins from individual animals were digested and pooled into a left eye pool and a right pool at each time point for protein analysis. The vitreous proteome for chicks was generated using an information-dependent acquisition (IDA) method by combining injections from individual time points. Using individual pool samples, SWATH-MS was employed to quantify proteins between each time point. DEPs were subsequently confirmed in separate batches of animals individually on random eyes (n = 4) using MRMHR between day 7 and day 14. Refraction and vitreous chamber depth (VCD) were found to be significantly changed (p < 0.05, n = 6 at each time point) during the period. A comprehensive vitreous protein ion library was built with 1576 non-redundant proteins (22987 distinct peptides) identified at a 1% false discovery rate (FDR). A total of 12 up-regulated and 26 down-regulated proteins were found across all time points compared to day 7 using SWATH-MS. Several DEPs, such as alpha-fetoprotein, the cadherin family group, neurocan, and reelin, involved in structural and growth-related pathways, were validated for the first time using MRMHR under this experimental condition. This study provided the first comprehensive spectral library of the vitreous for chicks during normal growth as well as a list of potential growth-related protein biomarker candidates using SWATH-MS and MRMHR during the emmetropization period. [ABSTRACT FROM AUTHOR]

Non‐volatile charge‐trap flash memory (CTM) co‐located with heterogeneous III‐V/Si photonics is demonstrated. The wafer‐bonded III‐V/Si CTM cell facilitates non‐volatile optical functionality for a variety of devices such as Mach–Zehnder Interferometers (MZIs), asymmetric MZI lattice filters, and ring resonator filters. The MZI CTM exhibits full write/erase operation (100 cycles with 500 states) with wavelength shifts of Δλnon‐volatile = 1.16 nm (Δneff,non‐volatile ≈ 2.5 × 10−4) and a dynamic power consumption <20 pW (limited by measurement). Multi‐bit write operation (2 bits) is also demonstrated and verified over a time duration of 24 h and most likely beyond. The cascaded second order ring resonator CTM filter exhibited an improved ER of ≈7.11 dB compared to the MZI and wavelength shifts of Δλnon‐volatile = 0.041 nm (Δneff, non‐volatile = 1.5 × 10−4) with similar pW‐level dynamic power consumption as the MZI CTM. The ability to co‐locate photonic computing elements and non‐volatile memory provides an attractive path toward eliminating the von‐Neumann bottleneck. [ABSTRACT FROM AUTHOR]

Background and Aims: Mother‐to‐child‐transmission (MTCT) of hepatitis B virus (HBV) may still occur despite birth‐dose HBV vaccinations when pregnant women are positive for hepatitis B surface antigen (HBsAg) with high viral loads (HBV DNA ≥ 200 000 IU/mL). A pilot integrated model nurse clinic (IMNC) was started in 2020 to implement the pre‐emptive antiviral therapy with tenofovir disoproxil fumarate (TDF). We aimed to evaluate the performance of IMNC on uptake of TDF. Methods: This was a territory‐wide retrospective cohort of all consecutive HBsAg‐positive women of child‐bearing age with pregnancy records in public hospitals 2019–2022. Demographic characteristics, liver biochemistries and virologic parameters, and TDF use were collected. Concurrently, data from a prospective audit in Union Hospital, the private hospital with the highest number of deliveries in Hong Kong, from June 2022 to May 2023 were compared. Results: The prevalence rate of HBV DNA ≥ 200 000 IU/mL in pregnant women with available HBV DNA records was 29.2% (66/226) in 2019, 27.3% (99/363) in 2020, 15.9% (125/784) in 2021 and 17.2% (117/679) in 2022 (p <.001), out of 2052 pregnant women who had their HBV DNA checked within 1 year prior to delivery. An increasing uptake rate of TDF by highly viraemic pregnant women (i.e. ≥ 200 000 IU/mL) was noted after the commencement of IMNC in public hospitals, with 67% (45/67) in 2019, 83% (88/106) in 2020, 91% (117/128) in 2021 and 89% (149/167) in 2022. Moreover, all highly viraemic pregnant women from Union Hospital received TDF. Continuous use of TDF was associated with a reduced risk of postpartum biochemical flare. Conclusions: IMNC increases the uptake of antiviral treatment in pregnant women at risk of MTCT of HBV. IMNC contributes to hepatitis elimination through a structured care plan to prevent MTCT of HBV. [ABSTRACT FROM AUTHOR]

Introduction: Research on heterogeneous pathways in school‐to‐work transitions (SWT), particularly longitudinal research, has been limited, as have empirical studies examining effective interventions for facilitating multiple SWT pathways among non‐engaged youth (NEY), who are generally at risk of being not in education, employment, or training (NEET). Methods: To develop a typology of SWT pathways, we conducted sequence analysis with longitudinal data from a sample of 630 NEY aged 14–29 (M = 19.78; 63.65% males) in Hong Kong during a 22‐month period beginning in September 2020. We also performed multinomial logistic regressions to assess the impact of career and life development (CLD) interventions on SWT outcomes. Results: Our analysis yielded a fivefold typology of SWT pathways: the Employment/Entrepreneurship cluster (31.27%), the Vocational Education and Training cluster (13.49%), the Generic Education cluster (16.83%), the Serious Leisure Development cluster (15.24%), and the long‐term NEET cluster (23.17%). NEY in the intervention group receiving CLD services, inspired by the expanded notion of work (ENOW) and youth development and intervention framework (YDIF), demonstrated significantly higher likelihoods of being in the Employment/Entrepreneurship (OR = 34.5, 95% CI [10.53, 105.08]), Generic Education (OR = 3.74, 95% CI [1.81, 7.74]), Vocational Education and Training (OR = 1.55, 95% CI [1.05, 6.26]), and Serious Leisure Development (OR = 1.77, 95% CI [1.04, 4.46]) clusters than the long‐term NEET cluster. Conclusions: Our findings highlight the dynamic, heterogeneous nature of NEY's CLD journeys, including that CLD interventions based on ENOW–YDIF have had a beneficial effect on NEY's multiple SWT pathways. [ABSTRACT FROM AUTHOR]

This paper contributes to our conceptualization of linguistic identities in English as a lingua franca (ELF) communication by analyzing a group of multilingual international students' narrativized accounts of their ELF communication experiences in an international university in Hong Kong. The findings of the study indicate that despite their status as L2 speakers, the participants considered themselves as legitimate speakers of English when interacting with others through ELF. Moreover, they oriented to their national cultural identities and personal identities indexed through their accents in ELF communication. Their frequent use of ELF with other students from diverse linguacultural backgrounds also prompted them to identify positively with a local ELF-using community and envision their imagined identities as members of a global ELF-using community. The findings further reveal that the participants' ELF communication experiences opened up a space for them to take on new and alternative L2-speaking personal identities which they perceived to be markedly different from and more desirable than their L1-based selves. Overall, the analysis provides empirical support for applying a tripartite model of linguistic identity for understanding ELF communication experiences and calls attention to the multidimensional nature of linguistic identities and the interrelatedness between different dimensions of linguistic identities in ELF communication. [ABSTRACT FROM AUTHOR]

Objective: Cultural stress potently predicts mental health inequities, such as anxiety, among adult and adolescent immigrants in the United States. However, less work has focused on preadolescence, a period marked by neurodevelopmental and psychosocial changes that can exacerbate anxiety symptoms. Latina girls, who exhibit heightened levels of untreated anxiety, may be at elevated risk. The present study tests whether cultural stress predicts anxiety symptoms in Latina girls and their caregivers. Method: The primary caregivers of 161 predominantly Mexican-identifying Latina girls (Mage = 10.70, SD = 1.68) reported their exposure to racism, acculturative stress, and political hostility. They also reported their own and their daughter's anxiety severity. Results: To index cultural stress, a principal component was extracted from composite scores of the racism, acculturative stress, and political hostility questionnaires. Hierarchical regression analyses then tested whether the multidetermined cultural stress component predicted caregiver and child anxiety, with child age, annual household income, and subjective socioeconomic status entered at the first step. Cultural stress positively predicted caregiver (ΔR2 =.13, p <.001) and child (ΔR2 =.15, p <.001) anxiety symptoms over and above the observed inverse effects of subjective socioeconomic status, such that higher levels of cultural stress were associated with elevated levels of caregiver (ß =.37, p <.001) and child (ß =.39, p <.001) anxiety symptoms. Conclusions: The results of this study highlight the role of racism, acculturative stress, and political hostility in escalating anxiety symptoms in Latinx families and identify cultural stress as a factor that likely contributes to the high rates of anxiety in Latina girls during a key developmental period. Public Significance Statement: The present study found that co-occurring experiences of racism, acculturative stress, and perceived hostility of the political environment jointly predict anxiety symptoms in preadolescent Latina girls and their primary caregivers. This work may shape the development of culturally informed prevention and treatment programs to reduce the burden of ethnic- and racial-based mental health inequities in minoritized youth and their families. [ABSTRACT FROM AUTHOR]