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This study investigated the associations among bilingual phonological awareness, morphological awareness, and vocabulary by focusing on their genetic and environmental etiologies. It also explored the influence of family socio-economic status (SES) and language exposure amount on the genetic and environmental effects. A twin study was conducted with 349 pairs of Chinese-English bilingual twins (mean age = 7.37 years). Cross-language transfer was found in phonological and morphological awareness but not in vocabulary knowledge. A common genetic overlap was found among these bilingual abilities. We also found a common shared environmental effect that may account for the cross-language transfer in phonological awareness and the associations among English abilities. SES and language exposure were significant environmental influences on bilingual phonological awareness and English vocabulary. More teaching in Chinese was related to a stronger genetic effect on Chinese morphological awareness, whereas more teaching in English was related to a stronger environmental impact on English abilities.

This study explored the associations between the perceived walkability of neighborhood environment, walking time, and functional mobility by community-dwelling older adults in Hong Kong SAR, China. Seventy community-dwelling older adults (Mean age = 78.00 ± 7.40 years) participated in this study. Their perceived walkability of neighborhood environment was evaluated by the Chinese abbreviated version of Neighborhood Environment Walkability Survey (NEWS-A) and their walking time within a week was self-reported. The 10-Meter Walk Test and Tinetti Performance-Oriented Mobility Assessment (POMA) were used to assess the functional mobility of the participants, regarding their gait speed, balance, and gait performance, respectively. Results suggest that the perceived walkability of neighborhood environment (Aesthetics subscale) positively associated with the gait speed (rs = .35, p = .003), scores of the POMA-Balance (rs = .389, p = .001) and POMA-Gait (rs = .343, p = .004). This exploratory analysis augmented our contemporary understanding that older adults who could walk faster and with better balance and gait performance are associated with more positive perceived walkability of their neighborhood environment. It provides useful insight that could inform future high-impact investigations.

This study represents the first attempt in exploring whether attentional focus instructions could affect real-time reinvestment (conscious movement processing) in older adults during level-ground walking. Forty-five community-dwelling older adults were instructed to walk at a self-selected pace along a 6-m level-ground walkway under three randomized attentional focus conditions (i.e., Internal, External, and Control) for a total of fifteen trials (five trials for each condition). Electroencephalography (EEG) T3-Fz coherence was utilized as an objective measurement of real-time reinvestment during walking. The Chinese version of the Movement-Specific Reinvestment Scale (MSRS-C) was used to measure the trait reinvestment propensity. Results revealed that the EEG T3-Fz coherence did not differ among the three conditions. The EEG T3-Fz coherence at the Control condition was not correlated with the scores of the MSRS-C. Our findings suggest that the measurement of trait reinvestment propensity (MSRS-C) may not be sensitive enough to reflect real-time reinvestment. Moreover, attentional focus instructions do not affect real-time reinvestment during level-ground walking, possibly due to the low level of motor task difficulty in level-ground walking for healthy older adults. Future studies should investigate this influential issue with a more challenging walking task.

Children with developmental language disorder (DLD) have consistently showed poor performances in reading comprehension. Extending from previous studies that presented pure-text, this study aims to test the performances of graphic novel reading. We tested 24 Chinese children who have been diagnosed as DLD and 24 typical readers matched with age and nonverbal IQ. These children were asked to complete a battery of tests assessing graphic novel reading comprehension and related visual-cognitive skills. The results of group comparison indicated that children with DLD performed similarly to the typical readers in graphic novel comprehension. Moreover, significant links between comic convention understanding and both passage and graphic novel reading were found in both groups. Our results imply the benefits of using graphic novel to facilitate reading to learn in children with DLD. (129 words).

Internal focus attention strategies have been found to diminish motor performance. This study attempted to elucidate this finding using the constrained action hypothesis and the theory of reinvestment through exploring their underlying mechanisms. Sixty-one young participants completed a self-paced "dart throwing" motor task to examine the effects of internal focus instruction, compared with no focus instruction, on conscious motor processing (reinvestment), psychological stress, and motor performance. Participants threw darts with standardized internal focus and no focus instructions given before each trial block of dart throwing. Motor performance was indicated by the throw accuracy and throw time. Stress was measured using a galvanic skin response probe. An insight into real-time conscious motor processing (reinvestment) was provided by the electroencephalography coherence between T3 and Fz locations on the scalp. Results indicated that internal focus instruction could cause participants to have lower throw accuracy (p = 0.008), longer throw time (p = 0.001), higher stress (p = 0.001) and higher real-time conscious motor processing (reinvestment) (p = 0.001) than no focus instruction. The significant results imply that internal focus instruction should be avoided in the self-paced motor task learning due to its detrimental effects.

In this study, we investigated the contribution of morphological awareness (MA) in one language to word reading and vocabulary in another language in Hong Kong Cantonese–English speaking children, who learn Chinese and English in school in parallel from the age of 3.5 years onwards. Our sample consisted of 97 Cantonese–English speaking children including 34 first graders, 28 second graders, 21 third graders and 14 fourth graders. All children were administered tasks of nonverbal reasoning, phonological awareness in Chinese, and lexical compounding, vocabulary, and word reading in both Chinese and English. Results revealed that second language (L2) English MA significantly contributed to first language (L1) Chinese word reading and Chinese vocabulary knowledge. However, L1 Chinese MA was not uniquely associated with either L2 English word reading or vocabulary knowledge. Findings suggest that among Chinese children learning in Chinese medium of instruction schools with English taught as a second language, compounding skills in English may be useful for facilitating Chinese word reading and vocabulary acquisition, but Chinese compounding skills are not uniquely important for learning in English.

Suboptimal physical activity levels and tolerance, poor motor skills and poor physical health are demonstrated in children with Autism Spectrum Disorder (ASD). We speculate that social interaction and communication deficits in children with ASD are two major factors that hinder these children from actively participating in group physical activities. While previous studies have demonstrated that exercise intervention improves motor skills and behavioral outcomes in children with ASD, these programs tend to focus only on a single sport, which may not cater to the interests of different children with ASD. In this protocol, a game-based exercise training program designed by a multi-disciplinary team (pediatrics, physical education and psychology) will be implemented by front-line healthcare providers trained following the train-the-trainer (TTT) model and subjected to validation. Using a randomized controlled trial design, the effectiveness of the game-based exercise program will be examined for 112 young children with ASD. These children were randomly assigned to two groups, which will be tested and trained in either one of the two arms of the waitlist conditions (control and intervention). The assessment of physical and psychological traits will be conducted at baseline (pre-test), at 16-weeks (post-treatment) and at 32-weeks (follow-up) of the program. Most of the interventions designed for ASD children target either their psychological traits or physical conditions, without bridging the two states. With the recognition of bidirectional relations between mental and physical health, the present game-based exercise program which includes multiple level of difficulties was developed to equip ASD children with the necessary skills for engaging in sustainable team sports or even professional sport training. The program, if effective, will provide an entertaining and engaging training for whole-person development among children with ASD. This study is registered with the Chinese Clinical Trial Registry ( ChiCTR-IOR-17011898 ). Registered 6th July 2017.

BACKGROUND: Communication is important for patient safety in the operating room (OR). Several studies have assessed OR communications qualitatively or have focused on communication in crisis situations. This study used prospective, quantitative observation based on well-established communication theory to assess similarities and differences in communication patterns between open and laparoscopic surgery. METHODS: Based on communication theory, a standardized proforma was developed for assessment in the OR via real-time observation of communication types, their purpose, their content, and their initiators/recipients. Data were collected prospectively in real time in the OR for 20 open and 20 laparoscopic inguinal hernia repairs. Assessors were trained and calibrated, and their reliability was established statistically. RESULTS: During 1,884 min of operative time, 4,227 communications were observed and analyzed (2,043 laparoscopic vs 2,184 open communications). The mean operative duration (laparoscopic, 48 min vs open, 47 min), mean communication frequency (laparoscopic, 102 communications/procedure vs open, 109 communications/procedure), and mean communication rate (laparoscopic, 2.13 communications/min vs open, 2.23 communications/min) did not differ significantly across laparoscopic and open procedures. Communications were most likely to be initiated by surgeons (80-81 %), to be received by either other surgeons (46-50%) or OR nurses (38-40 %), to be associated with equipment/procedural issues (39-47 %), and to provide direction for the OR team (38-46%) in open and laparoscopic cases. Moreover, communications in laparoscopic cases were significantly more equipment related (laparoscopic, 47 % vs open, 39 %) and aimed significantly more at providing direction (laparoscopic, 46 % vs open, 38 %) and at consulting (laparoscopic, 17 % vs open, 12 %) than at sharing information (laparoscopic, 17 % vs open, 31 %) (P < 0.001 for all). CONCLUSIONS: Numerous intraoperative communications were found in both laparoscopic and open cases during a relatively low-risk procedure (average, 2 communications/min). In the observed cases, surgeons actively directed and led OR teams in the intraoperative phase. The lack of communication between surgeons and anesthesiologists ought to be evaluated further. Simple, inexpensive interventions shown to streamline intraoperative communication and teamworking (preoperative briefing, surgeons' mental practice) should be considered further.

Differentially expressed genes were identified in the hepatopancreas of Metapenaeus ensis during ovarian maturation via differential display reverse transcription-polymerase chain reaction (DDRT-PCR). They are G-protein signaling modulator 2 (GPSM2), glutamate carboxypeptide II (GCPII), ligatin, C-type lectin, O-linked N-acetylglucosamine transferase (O-GlcNAc transferase), 1-acylglycerol-3-phosphate O-acyltransferase 4 (AGPAT4), vitellogenin (Vg), and hemocyanin. The hepatopancreas Vg gene identified in this study shows 92% and 49% amino acid sequence homology, respectively, to MeVg1 and MeVg2 previously isolated from this species, suggesting the identification of a new Vg gene in M. ensis. Vg gene expression was highest when the ovary was actively developing. The two metabolic enzymes, O-GlcNAc transferase and AGPAT4, exhibited a similar trend of expression to Vg gene, suggesting their involvement in Vg synthesis. The signal transduction related genes (GPSM2, GCPII, ligatin, and C-type lectin) were highly expressed in the hepatopancreas in the initial phase of maturation. These genes may be important for the signaling in the hepatopancreas for synthesis and mobilization of vitellogenin and nutrients to the developing ovary. The present work provides candidate genes for further investigation on the role of hepatopancreas in shrimp reproduction.

To understand the molecular events of ovarian development in penaeid shrimp, RNA arbitrarily primed polymerase chain reaction (RAP-PCR) was used to identify differentially expressed genes during ovarian maturation in Metapenaeus ensis. From a screening of 700 clones in a cDNA library of the shrimp ovary by the products of RAP-PCR of different maturation stages, 91 fragments with differentially expressed pattern as revealed by dot-blot hybridization were isolated and sequenced. Forty-two of these fragments show significant sequence similarity to known gene products and the differentially expressed pattern of 10 putative genes were further characterized via Northern hybridization. Putative glyceraldehyde-3-phosphate dehydrogenase and arginine kinase are related to provision of energy for active cellular function in oocyte development. Translationally controlled tumor protein, actin, and keratin are related to the organization of cytoskeleton to accomplish growth and development of oocytes. High mobility group protein DSP1, heat shock protein 70, and nucleoside diphosphate kinase may act as repressors before the onset of ovarian maturation. Peptidyl-prolyl cis-trans isomerase and glutathione peroxidase are related to the stabilization of proteins and oocytes. This study provides new insights on the molecular events in the ovarian development in the shrimp.

Background It is well known that physical exercise is important to promote physical and cognitive health in older population. However, inconsistent research findings were shown regarding exercise intensity, particularly on whether low-intensity exercise (1.5 metabolic equivalent tasks (METs) to 3.0 METs) can improve physical and cognitive health of older adults. This systematic review aimed to fill this research gap. The objective of this study is to conduct a systematic review of the effectiveness of low-intensity exercise interventions on physical and cognitive health of older adults. Methods Published research was identified in various databases including CINAHL, MEDLINE, PEDro, PubMed, Science Direct, SPORTDiscus, and Web of Science. Research studies published from January 01, 1994 to February 01, 2015 were selected for examination. Studies were included if they were published in an academic peer-reviewed journal, published in English, conducted as randomized controlled trial (RCT) or quasi-experimental studies with appropriate comparison groups, targeted participants aged 65 or above, and prescribed with low-intensity exercise in at least one study arm. Two reviewers independently extracted the data (study, design, participants, intervention, and results) and assessed the quality of the selected studies. Fifteen studies met the inclusion criteria. Quality index ranged from 15 to 18 mean = 18.3 with a full score of 28, indicating a moderate quality. Most of the outcomes reported in these studied were lower limb muscle strength (n = 9), balancing (n = 7), flexibility (n = 4), and depressive symptoms (n = 3). Results Out of the 15 selected studies, 11 reported improvement in flexibility, balancing, lower limb muscle strength, or depressive symptoms by low-intensity exercises. Conclusions The current literature suggests the effectiveness of low-intensity exercise on improved physical and cognitive health for older adults. It may be a desired intensity level in promoting health among older adults with better compliance, lower risk of injuries, and long-term sustainability.

In the original publication of the article, the affiliation of co-author Dr Simpson Wai Lap Wong was incorrectly listed as Department of Early Childhood Education, Hong Kong Institute of Education, Tai Po, Hong Kong.

We report two patients with benign biliary strictures in whom we attempted recanalisation of metallic biliary endoprostheses, occluded by intimal hyperplasia, by the insertion of further endoprostheses within the occluded stents. Initial technical success was achieved in deploying the stents and restoring patency with elimination of mural filling defects. However, we found the intimal hyperplasia to be restrained for less than 48 h. From our initial results it appears that biliary metallic stent occlusion by intimal hyperplasia is not effectively treated by insertion of a second endoprosthesis.

The user acceptance test (UAT) is the final stage of testing in application software development. When testing results meet the acceptance criteria, the software system can be released for operational use.This paper first compares the different testing phases of software development (i.e. unit test, integration test, system test and UAT) in terms of important testing elements so as to highlight the uniqueness of UAT relative to the other test phases. Then, we describe several approaches for acceptance test, including the behaviour-based approach, the black-box strategy and a new UAT strategy called operation-based testing. The new strategy uses the operational profile for testing purposes, includes a well-defined acceptance criteria, and satisfies the test requirements of ISO9001 standards.

Concurrent Anabolic and Catabolic-type Adaptations to Exercise Training in Adolescent Males. 381