Influence of parental play on Taiwanese 3-year-olds' executive function: Through the path of motor skills.

Parenting is known to impact children's executive function (EF) skills. However, nearly all the evidence comes from analyses of mother-child interaction. Using the National Longitudinal Study of Child Development and Care Database in Taiwan, the relations between both mother-child and father-child interaction and 3-year-olds' EF were investigated in 2,164 families. The results showed that mothers interacted with their children differently from fathers in terms of time distribution. Mothers were more equally involved in all aspects of parental involvement, whereas fathers spent more time in play. In addition, both mother-child and father-child play contributed to children's EF; however, the mediating effect of child motor skills was more prominent for father-child play. This study not only suggests a potential distinct and complementary role of fathers in young children's EF development but also indicates a unique mediating effect of motor skills in the path from parent-child play to child EF. Implications for parent education are discussed. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Risk of malignancy in patients with psoriasis receiving systemic medications: A nested case-control study.

Large-scale, real-world studies on the side effects of systemic therapies (including biologics) in patients with psoriasis are limited. We aimed to calculate the risk of malignancy in patients with psoriasis who were treated with systemic medications. Nested case-control analyses were performed among psoriasis patients without a history of malignancy. We recruited 4188 patients with newly diagnosed psoriasis and successive malignancies, and 8376 matched controls from the National Health Insurance Research Database in Taiwan. The therapy duration was within 5 years before malignancy onset and further stratified into two groups according to the duration of medication usage. Multivariate conditional logistic regression adjusted for potential confounders was used to estimate malignancy risk associated with systemic treatments. Among psoriasis patients, long-term (> 12 months) treatment with cyclosporine increased the risk of malignancy compared with no exposure (odds ratio, 1.57; p = 0.01). Short-term (≤ 12 months) or long-term (> 12 months) use of other systemic treatments, including methotrexate, azathioprine, systemic retinoids, mycophenolate mofetil, sulfasalazine, etanercept, adalimumab, and ustekinumab, was not associated with an increased risk of malignancy in patients with psoriasis. Long-term treatment with cyclosporine increased the risk of malignancy in patients with psoriasis by 1.57-fold.

Potential cross-species correlations in social hierarchy and memory between mice and young children.

Social hierarchy is associated with various phenotypes. Although memory is known to be important for hierarchy formation, the difference in memory abilities between dominant and subordinate individuals remains unclear. In this study, we examined memory performance in mice with different social ranks and found better memory abilities in dominant mice, along with greater long-term potentiation and higher memory-related gene expression in the hippocampus. Daily injection of memory-improving drugs could also enhance dominance. To validate this correlation across species, through inventory, behavioral and event-related potential studies, we identified better memory abilities in preschool children with higher social dominance. Better memory potentially helped children process dominance facial cues and learn social strategies to acquire higher positions. Our study shows a remarkable similarity between humans and mice in the association between memory and social hierarchy and provides valuable insight into social interactions in young animals, with potential implications for preschool education.

Obsessive-compulsive disorder and the associated risk of autoimmune skin diseases: a nationwide population-based cohort study.

BACKGROUND: The concurrent incidence of autoimmune comorbidities in obsessive-compulsive disorder (OCD) is known. However, the association between OCD and related autoimmune skin diseases (ASDs) has not been well studied. OBJECTIVE: This study aimed to investigate the association between OCD and the risk of ASDs. METHODS: To assess the risk of developing ASDs, we recruited 44 324 patients with OCD and 177 296 matched controls from the National Health Insurance Research Database in Taiwan. A Cox regression model was used for the analyses. RESULTS: After adjusting for confounders, an increased risk of ASDs among the patients with OCD (adjusted hazard ratio [aHR]: 6.36; 95% confidence interval [CI]: 5.43-7.45) was found when compared to the controls. Statistically significant associations were found between OCD and seven individual ASDs, including psoriasis (aHR: 12.52; 95% CI: 8.78-17.85), lichen planus (aHR: 27.22; 95% CI: 13.09-56.60), alopecia areata (aHR: 13.69; 95% CI: 9.38-19.98), autoimmune bullous diseases (aHR: 4.30; 95% CI: 2.03-9.11), hidradenitis suppurativa (aHR: 29.95; 95% CI: 3.35-267.62), vitiligo (aHR: 9.35; 95% CI: 5.35-16.32), and lupus erythematosus (aHR: 2.10; 95% CI: 1.52-2.91). CONCLUSIONS: Patients with OCD had an increased risk of developing ASDs compared to matched controls. Further studies are required to clarify the underlying mechanisms.

The decisive role of subordination in social hierarchy in weanling mice and young children.

Social hierarchy plays important roles in maintaining social structures. Despite similarity in concept, frameworks of human hierarchy have seldom been investigated in parallel with other animals. Moreover, the importance of subordination in hierarchical formation has been largely underestimated in previous research. Here we established, compared, and investigated hierarchy in children and weanling mice. Temperament assessments suggested that children who are less persistent, low emotional intensity, and withdrew easily were more likely to be subordinate in competitive scenarios independent of task characteristics and interaction experiences. The tube test further showed that conflicts between mice were not resolved by winner approach but by loser withdrawal, which was mainly determined by intrinsic subordinate status regardless of opponents. Our study presents evolutionary conserved hierarchical relationships in young and a critical role of the intrinsic subordinate characteristics in hierarchical determination. These findings provide a new perspective on social interactions with potential implications for preschool education.

The Association Between Urinary Tract Infection and Overactive Bladder Treatment.

Background: Overactive bladder (OAB) syndrome is defined as urinary urgency, with or without urge incontinence in the absence of an underlying pathological or metabolic cause. Treatment for OAB involves anti-muscarinic agents and beta 3-adrenoceptor agonists. As a previous study showed that treatment may increase the risk of urinary tract infection (UTI), we conducted a nationwide, population-based, retrospective study to assess UTI risk associated with OAB medication adherence, and different types of OAB medication. Methods: The source of data was medical records from National Health Insurance Research Database (NHIRD). Patients who were diagnosed with OAB in outpatient records from January 1, 2014 to December 31, 2016 were included. Outpatient visits included an attendance at primary care or the emergency department. The index date was the first prescription medication for OAB treatment after diagnosis. The targeted population was those diagnosed with OAB, and targeted drugs were anti-muscarinic agent (including flavoxate, oxybutynin, propiverine, solifenacin, tolterodine, and trospium) and mirabegron. Adherence was assessed based on the proportion of days covered in 12 months among mirabegron and anti-muscarinic agents. A multivariate Cox proportional-hazards model was used to compare the risk of UTI with OAB medication adherence, and different types of OAB medication. Results: There were 39,975 outpatients diagnosed with OAB in the database from 2014 to 2016. Excluding those younger than 20 years old and for whom the information was incomplete in the database, 21,869 patients were included in the final OAB cohort. Overall, risk of UTI was not influenced by the targeted drugs or adherence during the follow-up period, regardless of UTI history or sex. Conclusion: OAB is a common problem in Taiwan. After 12 months of follow-up, there was no difference between anticholinergic medications and beta-3 agonists, nor between high and low adherence in the risk of UTI.

Containing influenza outbreaks with antiviral use in long-term care facilities in Taiwan, 2008-2014.

BACKGROUNDS: Influenza can spread rapidly in long-term care facilities (LTCFs), and residents are usually at higher risk for influenza infections. OBJECTIVE: Our study aimed to evaluate the effectiveness of antiviral interventions on outbreak control. METHODS: Taiwan Centers for Disease Control used a syndromic surveillance system to monitor outbreaks in LTCFs. Local public health authorities verified those outbreaks and logged reports to the Epidemic Investigation Report Files Management System (EIRFMS). We conducted a retrospective cohort study by reviewing EIRFMS reports of influenza outbreaks in LTCFs during 2008-2014. An influenza outbreak was defined as 3 or more cases of influenza-like illness occurring within a 48-hours period with ≥1 case of real-time RT-PCR-confirmed influenza in the same LTCF. Antiviral interventions included providing antiviral treatment for patients and antiviral prophylaxis for contacts during outbreaks. RESULTS: Of 102 influenza outbreaks, median days from onset of the first patient to outbreak notification was 4 (range 0-22). Median attack rate was 24% (range 2.2%-100%). Median influenza vaccination coverage among residents was 81% (range 0%-100%); 43% occurred during the summer months. Even though antiviral treatment was provided in 87% of the outbreaks, antiviral prophylaxis was implemented in only 40%. Starting antiviral treatment within 2 days of outbreak onset was associated with keeping attack rates at <25% (OR 0.29, 95% CI: 0.12-0.71). CONCLUSIONS: Early initiation of antiviral treatment may reduce the magnitude of influenza outbreaks. Clinicians should identify patients with influenza and start antiviral use early to prevent large outbreaks in LTCFs.

Clinical predictors of the leading pathogens in human immunodeficiency virus-infected adults with community-onset bacteremia in the emergency department: The importance of transmission routes.

BACKGROUND/PURPOSE: To investigate the clinical characteristics and pathogens of community-onset bacteremia among human immunodeficiency virus (HIV)-infected adults as well as to establish the clinical predictors of the major microorganisms. METHODS: An observational cohort study was conducted retrospectively between January 2007 and December 2012. Demographic characteristics and pathogens determined from chart records were analyzed. RESULTS: Of the 121 eligible HIV adults with bacteremia, there was a male predominance (106 patients, 87.6%); elderly individuals (age ≥ 65 years) accounted for only 2.5% of the study population (3 patients). Of the total microorganisms isolated (n=123), Staphylococcus aureus (55, 44.7%) and Salmonella enterica (17, 13.8%) were the common pathogens. In a multivariate analysis, the leading two significant predictors of S. aureus infection were infective endocarditis (odds ratio, 11.49; p=0.001) and transmission risk with injection drug users (IDUs; odds ratio, 6.22; p=0.001). In addition, transmission risk with men who have sex with men (MSM; odds ratio, 37.49; p=0.001) was the leading clinical predictor of S. enterica infection. In further analyses, a strong linear-by-linear correlation between S. aureus infection and IDU (γ=0.94, p=0.02) as well as between S. enterica infection and MSM (γ=0.96, p=0.01) was evidenced. CONCLUSION: Focusing on the two key pathogens in HIV-infected adults with community-onset bacteremia, IDU was one of independent predictors associated with S. aureus infection, whereas MSM was the leading risk factor of S. enterica infection. Although the proposed predictive model of these pathogens has been not established, a scoring system involving the transmission risk of HIV may be of use for the early identification of these patients for clinicians.

Association of Unfinished Root Canal Treatments with the Risk of Pneumonia Hospitalization.

INTRODUCTION: The objective of root canal treatments (RCTs) is to control pulpal diseases and salvage infected teeth by eradicating microorganisms within the root canal system. However, an unfinished RCT can leave a space for bacterial accumulation, which can leak into the oral cavity and then aspirate into the lower respiratory tract and the lungs, causing infection. This study investigated the association of unfinished RCTs with the possible risk of pneumonia hospitalization using a nationwide population-based database. METHODS: After a matching process, we recruited 116,490 subjects who received an initiated RCT and had no history of pneumonia before 2005 and observed until the end of 2011. An unfinished RCT was operationally defined as an endodontic session that was started on a tooth but had no subsequent completion records. Cox proportional hazards models and subgroup analyses were used to estimate the association of unfinished RCTs on the risk of pneumonia hospitalization. RESULTS: In total, 1285 subjects were hospitalized for pneumonia during 2005 to 2011 with an overall pneumonia hospitalization incidence rate of 0.22% per person year. After adjusting for confounding factors, the adjusted pneumonia hospitalization hazard ratio for subjects who had unfinished RCTs was 1.40 (95% confidence interval, 1.24-1.59) compared with subjects without unfinished RCTs (P < .0001). For middle-aged patients, the hazard ratio was 1.81 (95% confidence interval, 1.45-2.24). CONCLUSIONS: Patients with unfinished RCTs had a higher risk of pneumonia hospitalization. Thus, dentists are advised to complete endodontic treatments once started.

Interleukin-1 receptor (IL-1R) mediates epilepsy-induced sleep disruption.

BACKGROUND: Sleep disruptions are common in epilepsy patients. Our previous study demonstrates that homeostatic factors and circadian rhythm may mediate epilepsy-induced sleep disturbances when epilepsy occurs at different zeitgeber hours. The proinflammatory cytokine, interleukin-1 (IL-1), is a somnogenic cytokine and may also be involved in epileptogenesis; however, few studies emphasize the effect of IL-1 in epilepsy-induced sleep disruption. We herein hypothesized that IL-1 receptor type 1 (IL-1R1) mediates the pathogenesis of epilepsy and epilepsy-induced sleep disturbances. We determined the role of IL-1R1 by using IL-1R1 knockout (IL-1R1 -/- KO) mice. RESULTS: Our results elucidated the decrease of non-rapid eye movement (NREM) sleep during the light period in IL-1R -/- mice and confirmed the somnogenic role of IL-1R1. Rapid electrical amygdala kindling was performed to induce epilepsy at the particular zeitgeber time (ZT) point, ZT13. Our results demonstrated that seizure thresholds induced by kindling stimuli, such as the after-discharge threshold and successful kindling rates, were not altered in IL-1R -/- mice when compared to those obtained from the wildtype mice (IL-1R +/+ mice). This result suggests that IL-1R1 is not involved in kindling-induced epileptogenesis. During sleep, ZT13 kindling stimulation significantly enhanced NREM sleep during the subsequent 6 h (ZT13-18) in wildtype mice, and sleep returned to the baseline the following day. However, the kindling-induced sleep alteration was absent in the IL-1R -/- KO mice. CONCLUSIONS: These results indicate that the IL-1 signal mediates epilepsy-induced sleep disturbance, but dose not participate in kindling-induced epileptogenesis.

Risk of recurrent nontyphoid Salmonella bacteremia in human immunodeficiency virus-infected patients with short-term secondary prophylaxis in the era of combination antiretroviral therapy.

BACKGROUND/PURPOSE: Nontyphoid Salmonella (NTS) bacteremia causes high mortality and recurrence rates in human immunodeficiency virus (HIV)-infected patients. This study aimed to investigate the risk of recurrent NTS bacteremia in the era of combination antiretroviral therapy (cART). METHODS: The medical records of consecutive HIV-infected patients with NTS bacteremia from January 2006 to June 2014 were reviewed. The patients were divided into two groups: patients who achieved a decline of plasma HIV RNA load by ≥ 2 log10 after 4 weeks of cART (good short-term virological response) and those who failed to achieve the goal (poor short-term virological response). Clinical information was collected on the demographics, immunological and virological responses, prophylactic antibiotics used, episodes of recurrent NTS bacteremia, and mortality. RESULTS: During the study period, 49 patients with 52 episodes of NTS bacteremia were included: 29 patients in the good virological response group, in which 16 received secondary prophylaxis; and 20 patients in the poor response group, in which 15 received secondary prophylaxis. There were no recurrent episodes of NTS bacteremia in the good-response group, whereas the incidence rate of recurrent NTS bacteremia was 5.21 per 100 person-years and 56.42 per 100 person-years of follow-up in patients receiving and not receiving prophylaxis, respectively, in the poor-response group. No patients died in the good-response group, whereas five patients (25%) in the poor-response group died. The resistance rate of 52 NTS isolates tested to ciprofloxacin was 7.7%. CONCLUSION: The risk of recurrent NTS bacteremia is low in HIV-infected patients who achieve short-term virological response to cART, regardless of secondary prophylaxis.

Exploring the role of multiple chronic conditions in traditional Chinese medicine use and three types of traditional Chinese medicine therapy among adults in Taiwan.

INTRODUCTION: Numerous people with chronic conditions like to use traditional Chinese medicine (TCM) treatment, or integrated treatment of TCM and Western medicine (WM). Our study explored the associations between multiple chronic conditions (MCC) and TCM use and the use of specific types of TCM therapy among adults in Taiwan. In addition, we explored the TCM use of adults with seven common types of chronic conditions. METHODS: In our study, a national representative sample in 2005 was used. The Chronic Condition Indicator and the Clinical Classifications System created by the U.S. Agency for Healthcare Research and Quality were used to define the number of chronic conditions of adults. Logistic regressions adjusted for demographic characteristics were used to analyze the associations. The frequency of TCM use among adults with different numbers of chronic conditions was quantified. RESULTS: TCM use for adults with ≥5 chronic conditions (odds ratio [OR] 1.86) was higher than TCM use for adults with 2-4 chronic conditions (OR 1.51) and TCM use for adults with one chronic condition (OR 1.48). The increase in the OR of the use of Chinese herbs and traumatology manipulative therapy according to the number of chronic conditions was not as substantial as that of acupuncture-moxibustion. The frequency of TCM use exhibited an increasing trend with the increase in the number of chronic conditions (p<.001). Among the seven common types of chronic conditions for adults, TCM use for adults with arthropathy (OR 2.01) was the highest. CONCLUSION: The probability and frequency of TCM use increased as the number of chronic conditions increased. The probability of Chinese herbs use, traumatology manipulative therapy use, and, particularly, acupuncture-moxibustion use increased as the number of chronic conditions increased. We suggest that government policy makers emphasize administering integrated TCM and WM care to people with chronic conditions or MCC.

Perisaccadic mislocalization in dyslexia.

Evidence from experiments designed to elicit the phenomenon of perisaccadic mislocalization of briefly presented probe stimuli suggests that mechanisms implicated in the planning of a saccade are also implicated in the means by which spatial constancy is maintained across saccades. We postulated that impairments of visual attention observed in dyslexic readers may arise from impairment of mechanisms that also subserve the maintenance of spatial constancy, leading to visual confusion during reading. To test this hypothesis, we compared the performance of adults with dyslexia with that of non-impaired control participants on a task designed to elicit perisaccadic mislocalization. Typically in such tasks, when probes are presented close to saccade onset, mislocalization of all probes, including those presented beyond the saccade target, are mislocalized in the direction of the saccade target, a phenomenon known as perisaccadic spatial compression. In addition, a second tendency, in which all probes are mislocalized in the direction of the saccade itself is referred to as shift. Dyslexic participants showed attenuated perisaccadic compression effects relative to those found in control participants, while the degree to which the reported positions of the probes were shifted in the direction of the saccade did not differ significantly between groups. We propose that compression errors are likely to arise from predictive mechanisms that normally maintain spatial constancy across saccades. Our finding was therefore interpreted as support for the hypothesis that predictive spatial constancy mechanisms may be disrupted in dyslexia.