[BMP]+[BF4]--Modified CsPbI1.2Br1.8 Solar Cells with Improved Efficiency and Suppressed Photoinduced Phase Segregation.

With the rapid progress in a power conversion efficiency reaching up to 26.1%, which is among the highest efficiency for single-junction solar cells, organic-inorganic hybrid perovskite solar cells have become a research focus in photovoltaic technology all over the world, while the instability of these perovskite solar cells, due to the decomposition of its unstable organic components, has restricted the development of all-inorganic perovskite solar cells. In recent years, Br-mixed halogen all-inorganic perovskites (CsPbI3-xBrx) have aroused great interests due to their ability to balance the band gap and phase stability of pure CsPbX3. However, the photoinduced phase segregation in lead mixed halide perovskites is still a big burden on their practical industrial production and commercialization. Here, we demonstrate inhibited photoinduced phase segregation all-inorganic CsPbI1.2Br1.8 films and their corresponding perovskite solar cells by incorporating a 1-butyl-1-methylpiperidinium tetrafluoroborate ([BMP]+[BF4]-) compound into the CsPbI1.2Br1.8 films. Then, its effect on the perovskite films and the corresponding hole transport layer-free CsPbI1.2Br1.8 solar cells with carbon electrodes under light is investigated. With a prolonged time added to the reduced phase segregation terminal, this additive shows an inhibitory effect on the photoinduced phase segregation phenomenon for perovskite films and devices with enhanced cell efficiency. Our study reveals an efficient and simple route that suppresses photoinduced phase segregation in cesium lead mixed halide perovskite solar cells with enhanced efficiency.

Solvothermal synthesis of SnO2 nanoparticles for perovskite solar cells application.

Perovskite solar cells show great potential application prospects in the field of solar cells due to their promising properties. However, most perovskite solar cells that exhibit excellent photovoltaic performance typically require a carrier transport layer that necessitates a high-temperature annealing process. This greatly restricts the scalability and compatibility of perovskite solar cells in flexible electronics. In this paper, SnO2 nanoparticles with high crystallinity, good dispersibility and uniform particle size distribution are first prepared using a solvothermal method and dispersed in n-butanol solution. SnO2 electron transport layers are then prepared by a low-temperature spin coating method, and the photovoltaic characteristics of perovskite solar cells prepared with different SnO2 nanoparticles/n-butanol concentrations are studied. Results indicate that the rigid perovskite solar cell achieves the highest power conversion efficiency of 15.61% when the concentration of SnO2 nanoparticles/n-butanol is 15 mg mL-1. Finally, our strategy is successfully applying on flexible perovskite solar cells with a highest PCE of 14.75%. Our paper offers a new possibility for large-scale preparation and application of perovskite solar cells in flexible electronics in the future.

Tumor cell-derived exosomes mediating hsa_circ_0001739/lncRNA AC159540.1 facilitate liver metastasis in colorectal cancer.

BACKGROUND: The current study probed into how tumor cell-derived exosomes (Exos) mediated hsa_circ_0001739/lncRNA AC159540.1 to manipulate microRNA (miR)-218-5p/FTO-N6-methyladenosine (m6A)/MYC signal axis in liver metastasis in colorectal cancer (CRC). METHODS: hsa_circ_0001739 and lncRNA AC159540.1 were identified as the upstream regulator of miR-218-5p using ENCORI and LncBase databases. Expression patterns of miR-218-5p, hsa_circ_0001739, lncRNA AC159540.1, FTO, and MYC were detected, accompanied by loss-and-gain-of function assays to examine their effects on CRC cell biological functions. SW480 cells-derived Exos were purified, followed by in vitro studies to uncover the effect of hsa_circ_0001739/lncRNA AC159540. RESULTS: miR-218-5p was downregulated while hsa_circ_0001739/lncRNA AC159540.1 was upregulated in CRC tissues and cells. Silencing of hsa_circ_0001739/lncRNA AC159540.1 restrained the malignant phenotypes of CRC cells. Exos-mediated hsa_circ_0001739/lncRNA AC159540.1 competitively inhibited miR-218-5p to elevate FTO and MYC. The inducing role of Exos-mediated hsa_circ_0001739/lncRNA AC159540.1 in CRC was also validated in vivo. CONCLUSION: Conclusively, Exos-mediated circ_0001739/lncRNA AC159540.1 regulatory network is critical for CRC, offering a theoretical basis for CRC treatment.

Validation study of the Chinese version of the Community Integration Questionnaire-Revised for individuals with spinal cord injury in Mainland China.

OBJECTIVE: To validate the Chinese version of the Community Integration Questionnaire-Revised (CIQ-R-C) for individuals with spinal cord injury. DESIGN: Cross-sectional study. SETTING: Shanghai Sunshine Rehabilitation Center. PARTICIPANTS: 317 adults with spinal cord injury in a rehabilitation center in Mainland China. INTERVENTIONS: Not applicable. METHODS: The CIQ-R-C (including an additional e-shopping item), global QoL, Zung Self-Rating Anxiety/Depression Scale (SAS/SDS), and Multidimensional Scale of Perceived Social Support (MSPSS) were administered. Reliability and validity analyses were conducted. RESULTS: Good item-domain correlations were found for 15 of the 16-item original CIQ-R, except for item 10 (leisure alone or with others). Exploratory Factor Analysis supported a construct of the CIQ-R-C (excluding item 10) as made of four domains (CFI = 0.94; RMSEA = 0.06): home, social engagement, digital social networking, and traditional social networking. Good internal consistency and test-retest reliability were observed in the total and the home subscale of the CIQ-R-C. Satisfactory construct validity was shown by the correlation analysis among the CIQ-R-C Scale, SAS/SDS, global QoL, and MSPSS. CONCLUSION: The CIQ-R-C Scale is valid and reliable, and can be used to assess community integration of individuals with spinal cord injury in China.

Characteristics of corticomuscular coupling during wheelchair Tai Chi in patients with spinal cord injury.

BACKGROUND: Wheelchair Tai Chi (WCTC) has been proved to have benefits for the brain and motor system of spinal cord injury (SCI) patients. However, the characteristics of corticomuscular coupling during WCTC are scarcely known. We aimed to investigate changes following SCI on corticomuscular coupling, and further compare the coupling characteristics of WCTC with aerobic exercise in SCI patients. METHODS: A total of 15 SCI patients and 25 healthy controls were recruited. The patients had to perform aerobic exercise and WCTC, while healthy controls needed to complete a set of WCTC. The participants accomplished the test following the tutorial video in a sitting position. The upper limb muscle activation was measured from upper trapezius, medial deltoid, biceps brachii and triceps brachii with surface electromyography. Cortical activity in the prefrontal cortex, premotor cortex, supplementary motor area and primary motor cortex was simultaneously collected by functional near-infrared spectroscopy. The functional connectivity, phase synchronization index and coherence values were then calculated and statistically analyzed. RESULTS: Compared to healthy controls, changes in functional connectivity and higher muscle activation were observed in the SCI group. There was no significant difference in phase synchronization between groups. Among patients, significantly higher coherence values between the left biceps brachii as well as the right triceps brachii and contralateral regions of interest were found during WCTC than during aerobic exercise. CONCLUSION: The patients may compensate for the lack of corticomuscular coupling by enhancing muscle activation. This study demonstrated the potential and advantages of WCTC in eliciting corticomuscular coupling, which may optimize rehabilitation following SCI.

Recruitment of transcription factor ETS1 to activated accessible regions promotes the transcriptional program of cilia genes.

Defects in cilia genes, which are critical for cilia formation and function, can cause complicated ciliopathy syndromes involving multiple organs and tissues; however, the underlying regulatory mechanisms of the networks of cilia genes in ciliopathies remain enigmatic. Herein, we have uncovered the genome-wide redistribution of accessible chromatin regions and extensive alterations of expression of cilia genes during Ellis-van Creveld syndrome (EVC) ciliopathy pathogenesis. Mechanistically, the distinct EVC ciliopathy-activated accessible regions (CAAs) are shown to positively regulate robust changes in flanking cilia genes, which are a key requirement for cilia transcription in response to developmental signals. Moreover, a single transcription factor, ETS1, can be recruited to CAAs, leading to prominent chromatin accessibility reconstruction in EVC ciliopathy patients. In zebrafish, the collapse of CAAs driven by ets1 suppression subsequently causes defective cilia proteins, resulting in body curvature and pericardial oedema. Our results depict a dynamic landscape of chromatin accessibility in EVC ciliopathy patients, and uncover an insightful role for ETS1 in controlling the global transcriptional program of cilia genes by reprogramming the widespread chromatin state.

Hole transport free carbon-based high thermal stability CsPbI1.2Br1.8 solar cells with an amorphous InGaZnO4 electron transport layer.

Due to their low cost, tunable band gap and excellent thermostability, all-inorganic halide perovskites CsPbX3 (X = Br, I) have become a kind of promising photovoltaic material. However, compared to the organic-inorganic hybrid perovskite solar cells, the performance of CsPbX3 solar cells still needs to be improved. In this work, for the first time, we applied the sol-gel derived amorphous InGaZnO4 film as electron transport layers (ETLs) in CsPbX3-based devices. In these devices, the carbon electrode deposited by screen printing replaced the unstable hole transport layer and the expensive metal electrode to obtain hole transport free carbon-based devices, which significantly simplifies the preparation process and reduces the production cost. With the application of amorphous InGaZnO4 films, devices show a relatively high power conversion efficiency (9.07%) and excellent thermal stability. Compared with the reported CsPbX3 devices using SnO2 or TiO2 ETLs, the performance of amorphous InGaZnO4 based devices has been significantly improved. This work provides a promising route to prepare highly thermally stable all-inorganic perovskite solar cells using a-IGZO films.

Biofilm formation, antimicrobial assay, and toxin-genotypes of Clostridium perfringens type C isolates cultured from a neonatal Yangtze finless porpoise.

This is a culture-dependent study with the objective of pure culturing and characterizing pathogenic bacteria from the blowhole, lung, stomach and fecal samples of a neonatal crucially endangered Yangtze finless porpoise (Neophocaena asiaeorientalis asiaeorientalis) that died 27 days after birth. Bacteria were inoculated using a swab onto blood and MacConkey agar plates and representative isolates were identified through 16S rRNA gene sequence analysis. A total of three Clostridium perfringens type C strains from the fecal samples were isolated. Toxin genes, including cpa, cpb and cpb2, were detected by PCR amplification, whereas the etx, iap and cpe genes were not detected. Biofilm formation of the three strains was then examined. Only one strain was capable of biofilm formation. In addition, isolates showed strong resistance against the antibiotics amikacin (3/3), erythromycin (1/3), gentamicin (3/3), streptomycin (3/3), and trimethoprim (3/3), while sensitivity to ampicillin (3/3), bacitracin (3/3), erythromycin (2/3), penicillin G (3/3), and tetracycline (3/3). The results suggested C. perfringens type C could have contributed to the death of this neonatal porpoise.

The Prevalence of and Factors Associated With Anxiety and Depression Among Working-Age Adults in Mainland China at the Early Remission Stage of the Coronavirus 2019 Pandemic.

Background: The Coronavirus 2019 (COVID-19) outbreak has led to a considerable proportion of adverse psychological symptoms in different subpopulations. This study aimed to investigate the status of anxiety and depression and their associated factors in the adult, working-age population in Mainland China at the early remission stage of the COVID-19 pandemic. Methods: An online study was conducted among 1,863 participants in 29 provinces in Mainland China from March 23 to 31, 2020. Their mental health was evaluated by the generalized anxiety disorder scale (GAD-7) and the patient health questionnaire (PHQ-9). Descriptive analysis, Chi-square, and multiple logistic regressions were applied. Results: About 44.5% of the participants had anxiety, 49.2% had depression, and 37.9% showed a combination of depression and anxiety. Around 83.7% of the participants claimed that the pandemic had a negative impact on their medical needs, which was the primary predictor of mental health, the degree of impact being positively related to the prevalence of anxiety and depression. More chronic diseases, moderate to bad self-rated health, severe perceived infection risk, and younger age group were the common risk factors for anxiety and depression. Having no children, unemployment, and a college-level educational background were associated with higher anxiety prevalence, whereas unmarried participants were correlated with higher depression prevalence. Conclusion: The working-age population showed a relatively high risk of anxiety and depression in Mainland China at the early remission stage of the pandemic. To improve medical services capacity for routine and delayed medical service needs should be a part of policy-makers' priority agenda during this period of crisis.

HDAC3 inhibition improves urinary-concentrating defect in hypokalaemia by promoting AQP2 transcription.

AIM: This study investigated whether enhanced histone acetylation, achieved by inhibiting histone deacetylases (HDACs), could prevent decreased aquaporin-2 (AQP2) expression during hypokalaemia. METHODS: Male Wistar rats were fed a potassium-free diet with or without 4-phenylbutyric acid (4-PBA) or the selective HDAC3 inhibitor RGFP966 for 4 days. Primary renal inner medullary collecting duct (IMCD) cells and immortalized mouse cortical collecting duct (mpkCCD) cells were cultured in potassium-deprivation medium with or without HDAC inhibitors. RESULTS: 4-PBA increased the levels of AQP2 mRNA and protein in the kidney inner medullae in hypokalaemic (HK) rats, which was associated with decreased urine output and increased urinary osmolality. The level of acetylated H3K27 (H3K27ac) protein was decreased in the inner medullae of HK rat kidneys; this decrease was mitigated by 4-PBA. The H3K27ac levels were decreased in IMCD and mpkCCD cells cultured in potassium-deprivation medium. Decreased H3K27ac in the Aqp2 promoter region was associated with reduced Aqp2 mRNA levels. HDAC3 protein expression was upregulated in mpkCCD and IMCD cells in response to potassium deprivation, and the binding of HDAC3 to the Aqp2 promoter was also increased. RGFP966 increased the levels of H3K27ac and AQP2 proteins and enhanced binding between H3K27ac and AQP2 in mpkCCD cells. Furthermore, RGFP966 reversed the hypokalaemia-induced downregulation of AQP2 and H3K27ac and alleviated polyuria in rats. RGFP966 increased interstitial osmolality in the kidney inner medullae of HK rats but did not affect urinary cAMP levels. CONCLUSION: HDAC inhibitors prevented the downregulation of AQP2 induced by potassium deprivation, probably by enhancing H3K27 acetylation.

Preliminary validation study of the WHO quality of life (WHOQOL) scales for people with spinal cord injury in Mainland China.

OBJECTIVE: To validate the WHOQOL Scales (WHOQOL-BREF and WHOQOL-DIS module) for people with spinal cord injury in Mainland China. DESIGN: Cross-sectional study. SETTING: Shanghai Sunshine Rehabilitation Center. PARTICIPANTS: 249 adults with SCI who were admitted to a rehabilitation training program between 2017 and 2019. INTERVENTIONS: Not applicable. METHODS: Questionnaires about personal and injury characteristics, the WHOQOL Scales, global QOL, Zung Self-Rating Anxiety/Depression Scale (SAS/SDS), and Community Integration Questionnaire (CIQ) were administrated. Floor and ceiling effects, reliability, and validity analyses were tested. RESULTS: The 8 domains of the WHOQOL Scales showed no floor or ceiling effects. Cronbach alpha values of the WHOQOL-BREF and the WHOQOL-DIS were 0.93 and 0.78, respectively. Test-retest reliability was good for the WHOQOL Scales. Satisfactory criterion-related validity was shown by the correlation analysis among the WHOQOL Scales, SAS/SDS, CIQ, and global QOL. Good item-domain correlations (>0.50) were found for 38 items of the 39-item WHOQOL Scales, excepting the "impact of disability" (0.48) of the WHOQOL-DIS. Confirmatory Factor Analysis (CFA) supported a construct of the WHOQOL-DIS as made of four domains: autonomy, social inclusion, social activities, and discrimination. CFI and RMSEA values were 0.91 and 0.07, respectively, for the four-domain structure WHOQOL-DIS, with a higher-order factor. WHOQOL-BREF domains and WHOQOL-DIS scores showed the predicted pattern among a priori known groups. CONCLUSION: The WHOQOL Scales are valid and reliable, and they can be used to measure QOL in people with SCI in China. We suggest the WHOQOL-DIS be analyzed as one general item constituting a single 12-item domain.

Adequate Silicone Oil Tamponade by Utilizing the Space of Anterior Segment for Complicated Retinal Detachment: Technique, Efficacy, and Safety.

PURPOSE: To evaluate the efficacy and safety of adequate silicone oil (SO) tamponade procedure in patients with complicated retinal detachment. METHODS: Thirty-one eyes in 31 patients were enrolled in this prospective case series. Adequate SO tamponade was performed by injecting the SO into the vitreous cavity and the entire anterior chamber, followed by posterior capsulotomy and inferior peripheral iridotomy. Preoperative and follow-up data including retinal anatomic reattachment and SO status, best-corrected visual acuity, intraocular pressure, surgical complications and management were collected and analyzed. RESULTS: Twenty-nine eyes presented with complete retinal reattachment after subsequent SO removal with a primary success rate of 93.5%. Seventeen patients (54.8%) had complete anterior chamber SO migration to the vitreous cavity within the first postoperative day. The average time for anterior chamber SO migration was 2.3 ±â€Š1.8 days. No oil-fluid interface in the vitreous cavity was observed in all the eyes, indicating a relatively adequate SO tamponade. Acute intraocular pressure elevation occurred in 16 (51.6%) eyes and was controllable under medication (n = 16) and anterior chamber paracentesis (n = 1). Two patients developed recurrent retinal detachment and received SO removal and a secondary adequate SO tamponade. At final follow-up, all the eyes had SO removal for at least 3 months and retinas maintained completely attached. CONCLUSIONS: The adequate SO tamponade procedure offers a simple, safe, and efficacious treatment alternative for complicated retinal detachment.

GSK-3ß inhibitor TDZD-8 prevents reduction of aquaporin-1 expression via activating autophagy under renal ischemia reperfusion injury.

Renal ischemia/reperfusion (I/R) injury is a main cause of acute kidney injury (AKI). Aquaporin (AQP)-1 water channel in the kidney is critical for the maintenance of water homeostasis and the urinary concentrating ability. Increasing evidence supports an important role of autophagy in the pathogenesis of AKI induced by renal I/R. The purpose of the present study is to investigate whether activation of autophagy prevents downregulation of AQP1 protein induced by renal I/R and potential molecular mechanisms. Renal I/R induced consistently reduced protein expression of AQP1, 2, and 3, as well as sodium cotransporters Na+ -K+ -2Cl- cotransporter and α-Na,K-ATPase, which was associated with increased urine output and decreased creatinine clearance in rats. Renal I/R also suppressed autophagy and increased inflammatory responses in the kidney. 4-Benzyl-2-methyl-1,2,4-thiadiazolidine-3,5-dione (TDZD-8), the glycogen synthase kinase-3ß inhibitor, ameliorated renal injury under I/R, activated autophagy and markedly increased expression of AQPs and sodium transporters in the kidney, which was associated with improved urine output and creatinine clearance in rats. Hypoxia/reoxygenation (H/R) induced suppression of autophagy and downregulation of AQP1 in murine inner medullary collecting duct 3 (IMCD3) cells, which was fully prevented by TDZD-8 treatment. Inhibition of autophagy by 3-methyladenine or Atg5 gene knockdown attenuated recovery of AQP1 protein expression induced by TDZD-8 in IMCD3 cells with H/R. Interleukin-1 beta (IL-1ß) decreased the abundance of AQP1 protein in IMCD3 cells. H/R induced increases in protein expression of nod-like receptor pyrin domain-containing 3 and IL-1ß, which was reversed by TDZD-8. In conclusion, TDZD-8 treatment prevented downregulation of AQP1 expression under renal I/R injury, likely via activating autophagy and decreasing IL-1ß production.

Activation of TGR5 restores AQP2 expression via the HIF pathway in renal ischemia-reperfusion injury.

Renal ischemia-reperfusion (I/R) injury is associated with markedly reduced protein expression of aquaporins (AQPs). Membrane G protein-coupled bile acid receptor-1 (TGR5) has shown protective roles in some kidney diseases. The purpose of the current study was to investigate whether activation of TGR5 prevented the decreased protein expression of AQPs in rodents with renal I/R injury and potential mechanisms. TGR5 agonist lithocholic acid (LCA) treatment reduced polyuria after renal I/R injury in rats. LCA prevented the decreased abundance of AQP2 protein and upregulated hypoxia-inducible factor (HIF)-1α protein expression, which were associated with decreased protein abundance of NF-κB p65 and IL-1ß. After renal I/R, mice with tgr5 gene deficiency exhibited further decreases in AQP2 and HIF-1α protein abundance and increases of IL-1ß and NF-κB p65 protein expression compared with wild-type mice. In primary cultured inner medullary collecting duct cells with hypoxia/reoxygenation, LCA induced markedly increased protein expression of AQP2 and HIF-1α, which were partially prevented by the PKA inhibitor H89. FG4592, a prolyl-4-hydroxylase domain-containing protein inhibitor, increased HIF-1α and AQP2 protein abundance in association with decreased NF-κB p65 protein expression in inner medullary collecting duct cells with hypoxia/reoxygenation. In conclusion, TGR5 stimulation by LCA prevented downregulation of renal AQPs in kidney with I/R injury, likely through activating HIF-1α signaling and suppressing inflammatory responses.NEW & NOTEWORTHY Stimulation of the membrane G protein-coupled bile acid receptor TGR5 by lithocholic acid (LCA) reduced polyuria in rats with renal ischemia-reperfusion (I/R) injury. LCA increased abundance of aquaporin-2 (AQP2) protein and upregulated hypoxia-inducible factor (HIF)-1α protein expression in association with decreased NF-κB p65 and IL-1ß. After I/R, mice with tgr5 gene deficiency exhibited more severe decreases in AQP2 and HIF-1α protein abundance and inflammatory responses. TGR5 activation exhibits a protective role in acute renal injury induced by I/R.

Hole transport free flexible perovskite solar cells with cost-effective carbon electrodes.

Low temperature derived carbon electrodes are employed to fabricate low cost hole transport layer free perovskite solar cells, in which perovskite films annealed in glovebox and ambient air are used as the absorbers, respectively. Results suggest that the air annealed sample has bigger crystal grains and higher crystallinity, and the existence of a small amount of lead iodide which passivates grain boundaries contributes to a lower trap density. As a result, a maximum power conversion efficiency (PCE) of 13.07% was obtained on the air annealed device, which is higher than those of devices annealed in glovebox (11.25%). Furthermore, the stability of unencapsulated devices stored in wet (with humidity around 90% ± 5%) air atmosphere are investigated and the results prove that our devices exhibit good stability. In addition to rigid devices, flexible perovskite solar cells are also fabricated using the same procedure. The highest PCE of 11.53% is demonstrated on the champion flexible device, and 69% of its initial PCE can be maintained even after 2000 bending cycles with a bending radius of 2 mm. Our work provides a promising and simple rout for low-cost, air-stable, high-efficiency carbon perovskite solar cells for both large area production and flexible electronic devices industry.

Effects of 16-Form Wheelchair Tai Chi on the Autonomic Nervous System among Patients with Spinal Cord Injury.

OBJECTIVE: This study aims to investigate the effects of 16-form Wheelchair Tai Chi (WCTC16) on the autonomic nervous system among patients with spinal cord injury (SCI). METHODS: Twenty patients with chronic complete thoracic SCI were recruited. Equivital life monitoring system was used to record and analyze heart rate variability (HRV) of patients for five minutes before and after five consecutive sets of WCTC16, respectively. The analysis of HRV in the time domain included RR intervals, the standard deviation of all normal RR intervals (SDNN), and the root mean square of the differences between adjacent NN intervals (RMSSD). The analysis of HRV in the frequency domain included total power (TP), which could be divided into very-low-frequency area (VLFP), low-frequency area (LFP), and high-frequency area (HFP). The LF/HF ratio as well as the normalized units of LFP (LFPnu) and HFP (HFPnu) reflected the sympathovagal balance. RESULTS: There was no significant difference in RR interval, SDNN, RMSSD, TP, HEP, VLFP, and LFP of SCI patients before and after WCTC16 exercise (P > 0.05). LFPnu and HF peak decreased, while HFPnu and LF/HF increased in SCI patients after WCTC16 exercise. The differences were statistically significant (P < 0.001). CONCLUSION: WCTC16 can enhance vagal activity and decrease sympathetic activity so that patients with chronic complete thoracic SCI can achieve the balanced sympathovagal tone.

Quality of life of adults with chronic spinal cord injury in mainland china: A cross-sectional study.

OBJECTIVE: To evaluate the quality of life of patients with chronic spinal cord injury in mainland China. DESIGN: Cross-sectional study. SUBJECTS: A total of 247 adults ≥ 1 year post-SCI in mainland China. METHODS: The WHOQOL-BREF and WHOQOL-DIS module were used to assess quality of life. Anxiety/depression was measured using the Zung Self-Rating Anxiety/Depression Scale. Quality of life was compared with that of reference populations from China, Korea, etc. Multivariate linear regression was conducted to determine the factors that might be associated with quality of life. RESULTS: The means of the 4 domains of the WHOQOL-BREF varied from 11.5 to 13.0. The mean of the 12-item WHOQOL-DIS module was 38.7. The quality of life of the participants as measured by the WHOQOL-BREF was 1.1-4.7 points lower than that of the global reference population, while quality of life as measured by the WHOQOL-DIS module was 1.2 points lower than that of the Korean data. Anxiety and depression were negative factors associated with quality of life (p < 0.05). Better community integration was a positive factor for physical quality of life and quality of life as measured by the WHOQOL-DIS module (p <0.01). CONCLUSION: The quality of life of adults with chronic spinal cord injury in mainland China was lower compared with reference populations. Duration of spinal cord injury, sex, community integration, anxiety, and depression were related to quality of life.

Effects of a rehabilitation program for individuals with chronic spinal cord injury in Shanghai, China.

BACKGROUND: Specialized Institution-Based Rehabilitation (SIBR) is the cornerstone of care and treatment for individuals with spinal cord injury, but most people with chronic spinal cord injury (CSCI) living in China have no SIBR experience after acute care hospital discharge. In 2009, an SIBR facility was set up in Shanghai (China) to fill this important gap in care. The purpose of the study was to evaluate the effectiveness of an integrated rehabilitation training program among individuals with CSCI living in Shanghai. METHODS: A within-subject pre-posttest design was used to evaluate the SIBR. The sample included 455 individuals ≥1 year post-SCI, who were older than 18 years of age and were enrolled in a rehabilitation center in Shanghai, China, between 2013 and 2019. The data included individuals' sociodemographic and injury characteristics, and twenty-three indicators were used as outcome measurements to evaluate basic life skills and their applications in family and social life. Multivariate linear regression was conducted to determine which factors might have influenced the effectiveness of the SIBR. RESULTS: All basic life skills and their applications in family and social life were improved, but with variations across socio-demographics. Female individuals with CSCI had better outcomes in basic life skills than did males. In terms of basic life skills and their applications in family and social life, individuals with a low level (thoracic or lumbosacral) of injury achieved more significant functional gains than those with a higher level (cervical). The baseline score was also a relevant factor in functional outcome. CONCLUSIONS: Even for individuals with a long SCI history, SIBR training can improve basic life skills and the applications of those skills in family and social life settings.