In Vitro Nonalcoholic Fatty Liver Disease Model Elucidating the Effect of Immune Environment on Disease Progression and Alleviation.

Nonalcoholic fatty liver disease (NAFLD), which is a major cause of chronic liver disease, is characterized by fat accumulation in the liver. Existing models struggle to assess medication effects on liver function in the context of NAFLD's unique inflammatory environment. We address this by developing a 3D in vitro NAFLD model using HepG2 and THP-1 cells (mimicking liver and Kupffer cells) cocultured using transwell and hydrogel system. This mimics liver architecture and allows for manipulation of the immune environment. We demonstrate that the model recapitulates key NAFLD features: steatosis (induced by fatty acids), oxidative stress, inflammation, and impaired liver function embodying the interrelationship between NAFLD and the surrounding immune environment. This versatile model offers a valuable tool for preclinical NAFLD research by incorporating a disease-relevant immune environment.

Effects of Social Support on Medication Adherence Among Patients with Schizophrenia: Serial Multiple Mediation Model.

Purpose: This study aims to explore the serial mediating effect of stigma and depression on the association between social support and medication adherence. Patients and Methods: A cross-sectional survey was undertaken in the Changning District of Shanghai using a five-part questionnaire from August to December 2023. A convenient sampling method was employed, and 35 patients with schizophrenia were invited from each of the 9 streets in Changning District to participate in the survey, resulting in a total of 305 valid questionnaires collected. The questionnaire measured social support, stigma, depression, medication adherence, and demographic characteristics. Data analysis involved descriptive statistics, independent samples t-tests, ANOVA, Pearson correlation analysis, and the bootstrap method. Results: There was a direct and significantly positive association between social support and medication adherence (ß = 0.69, p < 0.001). Moreover, increased levels of stigma (ß = - 0.45, p = 0.013) and depression (ß = - 0.09, p = 0.017) were both associated with a decline in medication adherence. Bootstrapping analysis revealed that the association between social support and medication adherence operated indirectly through stigma (ß = 0.11, 95% CI: 0.03, 0.18). Additionally, social support was indirectly associated with medication adherence through depression (ß = 0.15, 95% CI: 0.04, 0.30). Further analysis indicated that social support had an indirect association with medication adherence through both stigma and depression (ß = 0.04, 95% CI: 0.01, 0.07). Conclusion: Stigma and depression serially mediate the association between social support and medication adherence among patients with schizophrenia. This serial multiple mediation model underscores the importance of integrating social support interventions with psychological interventions aimed at reducing stigma and depression, thereby effectively enhancing medication adherence in patients with schizophrenia.

Range adaptation in schizophrenia: A one-year longitudinal study.

Range adaptation refers to the representation of a stimulus value based on its relative position in the range of pre-experienced values. Altered range adaptation in value representation may be related to motivation and pleasure (MAP) deficit in schizophrenia (SCZ). This follow-up study examined the relationship between range adaptation performance and MAP symptoms in SCZ patients. We recruited 26 schizophrenia patients and followed them for 1 year. They completed an experimental task for estimating their range adaptation to outcome value (OV) and expected value (EV) at baseline and after 1 year. At baseline, we found a marginally significant and negative correlation between OV adaptation and avolition symptoms in SCZ patients. Moreover, the 1-year change of EV adaptation was significantly and negatively correlated with the change of self-report pleasure experience. Our results suggest that range adaptation may track the variations of MAP symptoms in SCZ.

Pursuing Harmony and Fulfilling Responsibility: A Qualitative Study of the Orientation to Happiness (OTH) in Chinese Culture.

Happiness is the ultimate life goal for most people, and the pursuit of happiness serves as the fundamental motivation driving human behavior. Orientation to Happiness (OTH) represents the aspect that individuals seek when making decisions or engaging in activities, including values, priorities, motivations, ideals, and goals. Nevertheless, existing research has predominantly approached OTH from an individualistic perspective, emphasizing an individual's internal emotional state and personal goals, thereby neglecting the significant influence of a collectivist cultural background on the pursuit of happiness. To address this research gap, our study employs qualitative research methods, enabling us to delve deeply into the intricate interplay between cultural context, societal influences, and individual motivations that collectively shape OTH. Our research is dedicated to understanding the structure of OTH within the Chinese cultural context. Through semi-structured interviews with 26 Chinese adults and the utilization of an inductive style of thematic analysis, we have identified two core themes within the OTH of Chinese adults: Self-focused and Other-focused. Notably, the "Other-focused" theme emphasizes the pursuit of group harmony and the fulfillment of group responsibilities, highlighting the paramount role of "relationships" in the study of happiness within collectivist cultures. This insight forms a robust foundation for future research in this area.

A New Factor "Otherism" Added to the Hedonic and Eudaimonic Motives for Activities Scale (HEMA) in Chinese Culture.

Due to different understandings of happiness, people adopt different tendencies to act, which is called orientation to happiness (OTH). Our previous study found that OTH had two core themes, Self-focused and Other-focused in Chinese culture, which was different from OTH structures in Western culture. However, no corresponding measurement tool has been developed or revised. The Hedonic and Eudaimonic Motives for Activities Scale (HEMA) was the most commonly used measurement tool of OTH in recent years. The present study aimed to develop a Chinese version of the HEMA. A total of 1729 Chinese adults participated in this study. The exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were used to examine the underlying structure of the Chinese version of the HEMA. The results supported the 3-factor structure of the translation instrument, and the 15-item scale had good convergent and discriminant validity. The three dimensions were named Hedonism, Eudaimonism, and Otherism. Among them, Otherism is a new dimension, which means "the pursuit of the harmony of the group and achieving happiness by fulfilling their responsibilities in the group". The revised tool was named the Hedonic, Eudaimonic, and Otheristic Motives for Activities Scale-Chinese (HEOMA-C). The results showed that the HEOMA-C has good reliability and validity. Overall, the present study provided an effective tool to assess the OTH in Chinese culture.

Clinical Practice Guideline for Stroke Rehabilitation in Korea-Part 1: Rehabilitation for Motor Function (2022).

This clinical practice guideline (CPG) is the fourth edition of the Korean guideline for stroke rehabilitation, which was last updated in 2016. The development approach has been changed from a consensus-based approach to an evidence-based approach using the Grading of Recommendations Assessment Development and Evaluation (GRADE) method. This change ensures that the guidelines are based on the latest and strongest evidence available. The aim is to provide the most accurate and effective guidance to stroke rehabilitation teams, and to improve the outcomes for stroke patients in Korea. Fifty-five specialists in stroke rehabilitation and one CPG development methodology expert participated in this development. The scope of the previous clinical guidelines was very extensive, making it difficult to revise at once. Therefore, it was decided that the scope of this revised CPG would be limited to Part 1: Rehabilitation for Motor Function. The key questions were selected by considering the preferences of the target population and referring to foreign guidelines for stroke rehabilitation, and the recommendations were completed through systematic literature review and the GRADE method. The draft recommendations, which were agreed upon through an official consensus process, were refined after evaluation by a public hearing and external expert evaluation.

The Unique Role of Peer Support: Exploring the Effects of Various Sources of Social Support on the Mental Health of Unaccompanied Children in China under Residential Education.

This study investigates the impact of various sources of social support on the mental health of unaccompanied children under residential education in China. Unaccompanied children refer to those whose parents are still alive but unable to raise them due to various reasons. The study utilized self-reported questionnaires administered at two time waves, with the first wave (T1) evaluating family support, teacher support, and peer support, and the second wave (T2) evaluating depression, subjective well-being, and resilience. A total of 202 participants completed both surveys. To examine the predictive effect of different sources of social support on the mental health of these children, the study used the structural equation model with depression and subjective well-being as indicators. The results show that neither family support nor teacher support (T1) had a significant effect on the mental health (T2) of the children. However, peer support (T1) had a significant positive predictive effect on mental health (T2), indicating the unique role of peer support in promoting the mental health of unaccompanied children. The study also explored the mediating role of resilience between social support and well-being, revealing that though the direct effect of teacher support (T1) on mental health (T2) was not significant, the indirect mediating effect of resilience on the relationship between teacher support and mental health was significant. Both the direct and indirect effect of family support (T1) on mental health (T2) were not significant. These findings highlight the importance of creating a positive peer environment for unaccompanied children to promote their mental health. This study has important practical implications for the development of effective intervention programs aimed at improving the mental health of this population.

Newly self-administered two-step tool for screening cognitive function in an ageing Chinese population: an exploratory cross-sectional study.

Background: Early screening of cognitive function is critical to dementia treatment and care. However, traditional tests require face-to-face administration and are often limited by implementation costs and biases. Aims: This study aimed to assess whether the Thoven Cognitive Self-Assessment (TCSA), a novel, innovative two-step touchscreen-based cognition assessment tool, could identify early cognitive impairment due to dementia in older adults. Methods: The TCSA was administered to 61 healthy controls (HCs), 46 participants with mild cognitive impairment (MCI) and 44 participants diagnosed with dementia recruited from Shanghai. Two outcome measures were generated from the TCSA test: the TCSAprimary task score and the TCSAsecondary task score. Results: The total average scores in the control group for the TCSAprimary task and TCSAsecondary task were significantly higher than those in the MCI and dementia groups (TCSAprimary task: HCs vs MCI group vs dementia group, 8.58±1.76 vs 5.40±2.67 vs 2.74±2.11, F=75.40, p<0.001; TCSAsecondary task: HCs vs MCI group vs dementia group, 23.02±3.31 vs 17.95±4.93 vs 11.93±5.50, F=76.46, p<0.001). Moreover, receiver operating characteristic analysis showed that a score below 7.5 for the TCSAprimary task and a score below 22.5 for the TCSAsecondary task were indicators of MCI. Conclusions: The TCSA appears to be efficacious for the detection of cognitive impairment in older adults. It demonstrates the potential for large-scale cognition screening in community service settings.

Feeling unloved is the most robust sign of adolescent depression linking to family communication patterns.

Using network analysis, this study investigated how family communication patterns (Conversation and Conformity) were related to and predictive of adolescent overall depression severity and specific symptoms. A community sample of adolescents (10-17 years, n = 1327) completed the Children's Depression Inventory and the Revised Family Communication Pattern Instrument. Depressive symptoms were also re-assessed 6 months later. Results showed that Conversation orientation protected against, whereas Conformity orientation increased the risk of adolescent depression. Family communication particularly influenced the child's feeling of being unloved, and feeling unloved was the only symptom prospectively predicted by two communication orientations at baseline. These findings revealed the path linking family factors to adolescent depression and may have implications for future family-based interventions.

Caregivers' burden and schizophrenia patients' quality of life: Sequential mediating effects of expressed emotion and perceived expressed emotion.

Background: Increasing attention has been paid to the role of caregivers' burden in affecting quality of life (QoL) of schizophrenic patients. However, less is known about potential mediation mechanisms underlying this relationship. The current study aimed to explore the sequential mediating effect of expressed emotion and perceived expressed emotion on the relationship between care burden and QoL among people with schizophrenia. Methods: 135 Chinese families (one patient and one caregiver) participated in this study. Caregivers reported their care burden and expressed emotion, patients reported their perceived expressed emotion and QoL. Results: The results of the correlation analysis showed that care burden was negatively related to patients' QoL, including physical, psychological, and social relationships domains, with patients' sex, age, educational level, employment status, and medication-taking as covariates. The sequential mediating effects of criticism and perceived criticism between care burden and QoL were not significant. However, the sequential mediating effects of emotional over-involvement and perceived emotional over-involvement (EOI) between care burden and QoL (including physical and psychological domain) were significant. Conclusion: The results indicated that reducing the burden and expressed emotion of caregivers could be helpful to improve schizophrenia patients' QoL.

Psychometric properties of the Dimensional Anhedonia Rating Scale in Chinese typical, subthreshold, and clinically depressed adolescents.

The Dimensional Anhedonia Rating Scale measures state anhedonia in multiple domains, such as hobbies, food and drink, social activities, and sensory experience, and it has good reliability and validity in adult samples. However, no study has examined the psychometrical properties of this scale in adolescents. The present study examined its reliability and validity in adolescents with and without depression. In Study 1, 988 high-school students completed the Dimensional Anhedonia Rating Scale; 915 completed the second-round survey 3 months later. Confirmatory factor analysis was used to determine the factor structure. Additionally, internal consistency and test-retest reliability, and concurrent, convergent, and divergent validity were assessed in typical adolescents. In Study 2, the Dimensional Anhedonia Rating Scale was administrated to 108 patients with major depressive disorder, 108 adolescents with subthreshold depression, and 108 healthy controls. Factor structure and convergent validity were assessed in the clinical and subclinical groups. Finally, a one-way analysis of variance (ANOVA) was applied to examine the effect of depression severity on the scale scores. The results of Study 1 indicated that a four-factor model (i.e., hobbies, food and drink, social activities, and sensory experience) best fit the data. Meanwhile, the scale also yielded good concurrent, convergent, and divergent validity, as well as high internal consistency and test-retest reliability, in typical adolescents. In Study 2, goodness-of-fit statistics also suggested a good fit for the four-factor model in the two depressed groups. The one-way ANOVA revealed significant group differences in the total and factor scores, whereby the major depressive disorder group had lower scores than the subthreshold depression group, whose scores were lower than the healthy controls, indicating excellent eligibility of the scale in depressed adolescents. The Chinese version of the Dimensional Anhedonia Rating Scale is a reliable and valid instrument to comprehensively measure state anhedonia in Chinese typical and depressed adolescents.

Three Versions of the Perceived Stress Scale: Psychometric Evaluation in a Nationally Representative Sample of Chinese Adults during the COVID-19 Pandemic.

(1) Background: The COVID-19 outbreak has created pressure in people's daily lives, further threatening public health. Thus, it is important to assess people's perception of stress during COVID-19 for both research and practical purposes. The Perceived Stress Scale (PSS) is one of the most widely used instruments to measure perceived stress; however, previous validation studies focused on specific populations, possibly limiting the generalization of results. (2) Methods: This study tested the psychometric properties of three versions of the Chinese Perceived Stress Scale (CPSS-14, CPSS-10, and CPSS-4) in the Chinese general population during the COVID-19 pandemic. A commercial online survey was employed to construct a nationally representative sample of 1133 adults in Mainland China (548 males and 585 females) during a one-week period. (3) Results: The two-factor (positivity and negativity) solution for the three versions of the CPSS showed a good fit with the data. The CPSS-14 and CPSS-10 had very good reliability and the CPSS-4 showed acceptable reliability, supporting the concurrent validity of the CPSS. (4) Conclusions: All three versions of the CPSS appear to be appropriate for use in research with samples of adults in the Chinese general population under the COVID-19 crisis. The CPSS-10 and CPSS-14 both have strong psychometric properties, but the CPSS-10 would have more utility because it is shorter than the CPSS-14. However, the CPSS-4 is an acceptable alternative when administration time is limited.

Comparison of Two Static Stretching Techniques for the Triceps Surae in Healthy Individuals: Wall and Inclined Board Stretchings.

OBJECTIVE: To compare the effectiveness of static stretching techniques for correcting the tightness of the triceps surae. METHODS: In this observational, cross-sectional study, participants (30 healthy volunteers) completed 10 repetitions of each stretching exercise, holding each stretch for 10 seconds, with a 1-minute rest period between repetitionsand a 1-hour rest period between the two stretching techniques, namely, wall and inclined board stretchings. The length of the triceps surae and range of ankle dorsiflexion were measured on lateral view radiographs. The muscle activity during the stretch was measured using quantified surface electromyography of the lateral gastrocnemius. The subjective stretching sensation was evaluated using the visual analog scale. RESULTS: Both stretching techniques showed statistical differences in all the parameters. Stretching on an inclined board yielded a greater increase in the triceps surae length than did wall stretching (mean difference, 0.72; p=0.02). The range of ankle dorsiflexion was higher with inclined board stretching than with wall stretching (mean difference, 2.57; p=0.03). The mean muscle activity was significantly lower withinclined board stretching than with wall stretching (mean difference, 53.72; p<0.01). The visual analog scale score was higher with inclined board stretching than with wall stretching (mean difference, 2.07; p<0.01). CONCLUSION: In this study, inclined board stretching was more effective than wall stretching for correcting tightness of the triceps surae. Therefore, inclined board stretching should be encouraged for the triceps surae.

Fabrication of Microporous Metal-Organic Frameworks in Uninterrupted Mesoporous Tunnels: Hierarchical Structure for Efficient Trypsin Immobilization and Stabilization.

Hierarchically porous metal-organic frameworks (HP-MOFs) are promising in various applications. Most reported HP-MOFs are prepared based on the generation of mesopores in microporous frameworks, and the formed mesopores are connected by microporous channels, limiting the accessibility of mesopores for bulky molecules. A hierarchical structure is formed by constructing microporous MOFs in uninterrupted mesoporous tunnels. Using the confined space in as-prepared mesoporous silica, highly dispersed metal precursors for MOFs are coated on the internal surface of mesoporous tunnels. Ligand vapor-induced crystallization is employed to enable quantitative formation of MOFs in situ, in which sublimated ligands diffuse into mesoporous tunnels and react with metal precursors. The obtained hierarchically porous composites exhibit record-high adsorption capacity for the bulky molecule trypsin. The thermal and storage stability of trypsin is improved upon immobilization on the composites.

KSNR Clinical Consensus Statements: Rehabilitation of Patients with Parkinson's Disease.

Clinical consensus statements (CCSs) aim to improve care for patients with Parkinson's disease (PD) and reduce the variability of rehabilitation methods in clinical practice. A literature search was conducted to find available evidence on the rehabilitation of patients with PD and to determine the scope of CCSs. The selection of PD rehabilitation domains and key questions was done using the modified Delphi method in 43 expert panels. These panels achieved a consensus on 11 key questions regarding rehabilitation assessment and goal setting, gait and balance, activities of daily living, and swallowing and communication disorders. After the completion of an agreement procedure, 11 key consensus statements were developed by the consensus panel. These statements addressed the needs of rehabilitation as a continuum in patients with PD. They included the appropriate rehabilitation initiation time, assessment items, rehabilitation contents, and complication management. This agreement can be used by physiatrists, rehabilitation therapists, and other practitioners who take care of patients with PD. The consensus panel also highlighted areas where a consensus could not be reached. The development of more focused CCS or clinical practice guidelines that target specific rehabilitation approaches is considered the next needed step.

Subacute Combined Degeneration Caused by Nitrous Oxide Intoxication: A Report of Two Cases.

We report two cases of subacute combined degeneration (SCD) caused by nitrous oxide (N2O) gas intoxication, which is rarely reported in Korea. Two patients recreationally inhaled N2O gas daily for several months. They presented with paresthesia of limbs, voiding difficulty, and gait disturbance. The initial vitamin B12 levels were normal or decreased, but homocysteine levels of the two patients were increased. Magnetic resonance imaging of the cervical spine showed T2-weighted hyperintensity in the bilateral dorsal columns of the cervical spinal cord. Electromyography and somatosensory evoked potential tests for both patients suggested posterior column lesion of the spinal cord combined with sensorimotor polyneuropathy. According to these findings, we concluded that the two patients had SCD. The patient's symptoms partially improved after cessation of N2O gas inhalation and the receiving of vitamin B12 supplementation therapy. As the incidence of recreational N2O gas inhalation is increasing in Korea, physicians must be alert to the N2O induced SCD in patients presenting with progressive myelopathy.

Comparison of tube feeding in stroke patients: Nasogastric tube feeding versus oroesophageal tube feeding-A pilot study.

BACKGROUNDS: Patients with central nervous system injuries present with dysphagia and may require non-oral feeding methods, like percutaneous endoscopic gastrostomy, nasogastric (NG) tube, or oroesophageal (OE) tube. The prevalence of pneumonia in patients with gastroesophageal reflux (GER) is significantly higher than that in patients without GER. We aimed to determine the most appropriate tube feeding with low risk of GER by comparing the results of 24-hour pH monitoring studies in patients who were administered 2 types of feeding: NG tube and OE tube. METHODS: In this pilot study, 6 stroke patients underwent 24-hour esophageal pH monitoring during NG tube feeding and OE tube feeding, sequentially. Parameters collected included acid exposure time, mean esophageal pH, number of reflux episode, time of bolus reflux for both total 24-hour pH study data and postprandial data, and deMeester composite score. RESULTS: Total acid reflux time (minutes) decreased more with OE tube feeding than that with NG tube feeding in the total 24-hour pH study. The number of reflux episodes decreased in both total and postprandial data with OE tube feeding versus NG tube feeding (P < .05). There were no significant differences in mean esophageal pH and total time of bolus reflux between the 2 groups. CONCLUSIONS: Although we could not definitively conclude that OE tube feeding decreased the severity of GER compared with NG tube feeding, there were significant differences in 4 out of 9 parameters. OE tube can be a substitute for NG tube in patients with dysphagia after stroke leading to GER disease.

Fabrication of Photothermal Silver Nanocube/ZIF-8 Composites for Visible-Light-Regulated Release of Propylene.

Releasing propylene from metal-organic frameworks (MOFs) after adsorption is attractive, but remains challenging because of the energy penalty in desorption by traditional techniques. Now, a metal-organic framework composite is constructed by encapsulating Ag nanocubes into ZIF-8 for controllable propylene desorption. ZIF-8 acts as an effective porous shell for accommodating propylene molecules, and Ag nanocubes perform as local "nanoheaters" to elevate the temperature by utilizing optical energy. Based on the surface plasmon resonance of Ag nanocubes, light energy can be converted into thermal energy and further transferred to the surroundings. The desorption capacity can be controlled by varying the content of Ag nanocubes introduced, and almost 100% of the propylene is released for the optical sample. Distinct from the electrical heating in industry, light-triggered heating remotely elevated the temperature of adsorbents from the inside out, which is particularly beneficial to heat-insulating MOFs. In addition, this approach heats only adsorbents rather than the entire fixed beds, improving the energy and time efficiency. The present light-triggered desorption may open up a new avenue to develop advanced adsorption/desorption cycles.

When does spasticity in the upper limb develop after a first stroke? A nationwide observational study on 861 stroke patients.

This study investigated the time taken for upper extremity spasticity to develop and its regional difference after first-ever stroke onset in a nationwide multicenter study in South Korea. The retrospective observational study included 861 individuals with post-stroke spasticity in the upper limbs. Spasticity in the upper extremity joints was defined as a modified Ashworth Scale score ≥1. The median time to develop upper limb spasticity after stroke onset was 34 days. 12% of post-stroke spasticity cases developed between 2 months and 3 months and 13% developed after 3 months from onset. At the time of diagnosis of spasticity, most patients showed only a slight increase in muscle tone, which was observed most frequently in the elbow, followed by the wrist, and fingers. Younger stroke survivors were more spastic, and the severity of spasticity increased with time. Approximately half of the patients with post-stroke spasticity developed spasticity during the first month. However, post-stroke spasticity can develop more than 3 months after stroke onset. Therefore, it is important to assess spasticity, even in the chronic state.

Microfluidic-based observation of local bacterial density under antimicrobial concentration gradient for rapid antibiotic susceptibility testing.

The need for accurate and efficient antibiotic susceptibility testing (AST) has been emphasized with respect to the emerging antimicrobial resistance of pathogenic bacteria which has increased over the recent decades. In this study, we introduce a microfluidic system that enables rapid formation of the antibiotic concentration gradient with convenient bacterial growth measurement based on color scales. Furthermore, we expanded the developed system to analyze combinatory effects of antibiotics and measured the collective antibiotic susceptibility of bacteria compared to single microfluidic AST methods. By injecting a continuous flow precisely into the channel, the system enabled the concentration gradient to be established between two parallel channels of different antibiotic concentrations within 30 min, before bacteria enter the exponential growth phase. Moreover, the local bacterial growth levels under antibiotic gradient were quantitatively determined by calculating the position-specific grayscale values from the microscopic images and were compared with the conventional optical density measurement method. We tested five antibiotic types on our platform for the pathogenic Gram-negative bacteria strain Pseudomonas aeruginosa, and we were able to determine the minimum inhibitory concentration (MIC) at which 90% to 95% of bacterial growth was inhibited. Finally, we demonstrated the efficacy of our system by showing that most of the antibiotic MICs determined in our platform show good agreement with the MIC range suggested by the Clinical and Laboratory Standards Institutes.