Exploring transvaginal sonographic characteristics of the levator ani muscle in women with postpartum pelvic floor myofascial pain.

BACKGROUND: Pelvic floor myofascial pain is one of the pelvic floor dysfunction diseases disturbing women after delivery. There is a lack of objective standardization for the diagnosis of pelvic floor myofascial pain due to the various symptoms and the dependence on the palpating evaluation. Ultrasound imaging has the advantages of safety, simplicity, economy and high resolution, which makes it an ideal tool for the assistant diagnosis of pelvic floor myofascial pain and evaluation after treatment. METHODS: This is a retrospective case-control study including women accepting evaluation of pelvic floor function at 6 weeks to 1 year postpartum. They were divided into pelvic floor myofascial pain group and normal control group. A BCL 10-5 biplane transducer was applied to observed their puborectalis. The length, minimum width, area, deficiency, deficiency length, deficiency width, deficiency area, rate of deficiency area, local thickening,angle between the tendinous arch of levator ani muscle and puborectalis of corresponding puborectalis in different groups were observed and measured. RESULTS: A total of 220 postpartum women participated in the study, with 77 in the pelvic floor myofascial pain group and 143 in the normal control group. The Intraclass correlation coefficient value was over 0.750, and Kappa ranged from 0.600 to 0.800. puborectalis deficiency (adjusted odds ratio = 11.625, 95% confidence interval = 4.557-29.658) and focal thickening (adjusted odds ratio = 16.891, 95% confidence interval = 1.819-156.805) were significantly associated with higher odds of having postpartum pelvic floor myofascial pain. Grayscale or the angle between the arch tendineus levator ani and puborectalis measurements on the pain side tended to be smaller than on the non-pain side in patients with unilateral puborectalis or iliococcygeus pain (P < 0.05). CONCLUSIONS: This study demonstrated that transvaginal ultrasound was a potentially efficient technique for evaluating postpartum pelvic floor myofascial pain due to its ability to assess various sonographic characteristics of the levator ani muscles.

Knowledge of urinary incontinence among women 6 weeks to 1 year after delivery.

BACKGROUND: Urinary incontinence (UI) is common among postpartum women, but many do not seek medical help due to limited knowledge. Understanding the level of knowledge about UI in this population is essential for improving care-seeking behaviors and implementing targeted interventions. OBJECTIVE: The objective was to examine knowledge regarding UI among postpartum women with UI within 6 weeks to 1 year after delivery. METHODS: A cross-sectional study was conducted at obstetric clinic in two level-three grade A hospitals in Shenzhen, China, from January 2023 to June 2023. Women in their 6 weeks to 1 year after delivery with UI were asked to complete a questionnaire comprising three sections: (1) demographic variable; (2) International Consultation on Incontinence Questionnaire Short Form (ICIQ-UI SF); and (3) The Urinary Incontinence Quiz (UIQ). RESULTS: A total of 1228 women completed the questionnaire. Their mean UIQ score was 6.63 ± 3.51 (minimum = 2, maximum = 15), indicating the deficiency of UI knowledge among Chinese postpartum women. A total of 86.4% of participants experienced slight or moderate postpartum UI. The results of multivariate linear regression models for UIQ reveal significant independent associations between questionnaire scores and two variables: experience in pelvic floor muscle training (PFMT) (p < 0.001) and UI treatment in the past (p < 0.001). The overall model fit was R2 = 0.559 (p < 0.001). The regression coefficients for the experience in PFMT and UI treatment in the past were 2.301 and 4.916, respectively. However, no other discernible factors were identified to distinguish between those with and without adequate knowledge. CONCLUSIONS: Postpartum women with UI within 6 weeks to 1 year after delivery had poor knowledge of UI. Targeted educational interventions focusing on PFMT and early treatment for UI are essential.

Assessment of nonylphenol exposure based on global urinary concentration data and its risk analysis.

Nonylphenol (NP) has been recognized as a priority hazardous substance because of its estrogenic activity and ubiquity in the environment. Therefore, it is important to understand the daily intake of NP in humans and evaluate the potential health risks of NP. The median or average estimated daily intake (EDI) of NP was estimated based on urinary NP or alkyl-chain-oxidized NP metabolites concentration data from published epidemiological studies. In brief, we acquired 34 peer-reviewed publications, which contained 14235 samples from twelve countries or regions. The global average estimated daily intake of NP was 1.003 µg/(kg bw·day), which was lower than the tolerable daily intake recommended by the Danish Veterinary and Food Authority [5 µg/(kg bw·day)]. Korea had the highest exposure level [3.471 µg/(kg bw·day)] among different countries or regions. Compared with the adult [0.743 µg/(kg bw·day)] and pregnant women [0.806 µg/(kg bw·day)] groups, the children group had the highest estimated daily intake of NP at 2.368 µg/(kg bw·day). Besides, the global NP risk hazard quotient was 0.201, and the risk hazard quotients of all countries or regions were less than 1. However, the global HQ value of the 95th quantile population was 2.299, which was much higher than 1, the potential health risk cannot be ignored and needs to be confirmed by more research. To our knowledge, this is the first study to assess the overall NP exposure levels based on published biomonitoring data, and has important implications for assessing the potential effects of NP exposure on human health. In addition, OH-NP is a robust and sensitive novel biomarker for NP, there are fewer studies on the application of this biomarker, and more studies are needed in the future for quantitative exposure and risk assessment of NP.

Microstructure-Driven Self-Transport and Convection of Water on Membrane Surface for Ultra-Fast, Highly Sensitive, Low-Cost Lateral-Flow Assays.

Lateral-flow assay (LFA) is one of the most commonly used detection technologies, in which the chromatographic membranes are currently used as the lateral-flow membrane (e.g., nitrocellulose membrane, NC Mem). However, several disadvantages of existing chromatographic membranes limit the performance of LFA, including relatively low flow velocity of sample solution and relatively more residuals of sample on membrane, which increase detection time and detection noise. Herein, a surface structure membrane (SS Mem) is proposed, which enables fast self-transport of water with a convection manner and realizes low residuals of sample on membrane surface after the flow. On SS Mem, the flow velocity of water is 7.1-fold higher, and the residuals of sample are decreased by 60-67%, comparing those in NC Mem. SS Mem is used as lateral-flow membrane to prepare lateral-flow strips of nanogold LFA and fluorescence LFA for rapid detection of SARS CoV-2 nucleocapsid protein. These LFAs require 210 s per detection, with limits of detection of 3.98 pg mL-1 and 53.3 fg mL-1 , sensitivity of 96.5%, and specificity of 90%. The results suggest that SS Mem enables ultrafast, highly sensitive lateral-flow immunoassays and shows great potential as a new type of lateral-flow membrane to broaden the application of LFA.

Pelvic organ prolapse after delivery: effects on sexual function, quality of life, and psychological health.

BACKGROUND: Living with pelvic organ prolapse (POP) after delivery negatively impacted women's daily living and was detrimental to their psychological health. AIM: The purpose of the present study was to explore the effects of POP after delivery on women's sexual function, quality of life (QoL), and psychological health within the first year following delivery. METHODS: A cross-sectional study was conducted with 640 female participants at obstetric clinic in 2 hospitals in Shenzhen, China. OUTCOMES: All women completed following questionnaires: short form of the Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire (PISQ-12) on sexual function, Pelvic Floor Distress Inventory-20 (PFDI-20) on well-being and QoL, Symptom Checklist-90-Revised (SCL-90-R) on psychological health, and International Consultation on Incontinence Questionnaire Short Form. RESULTS: Women with symptomatic POP (N = 250) had higher mean scores (P < .05) than those without symptoms (N = 390) in PISQ-12, PFDI-20, and SCL-90-R domains. In the symptomatic POP group (N = 250), the sexually dysfunctional group (N = 137) had significantly higher mean scores (P < .001) than the sexually functional group (N = 113) in PISQ-12, PFDI-20, and SCL-90-R domains. Women with POP duration ≥6 months (N = 132) had significantly higher mean scores (P < .001) than women with POP duration <6 months (N = 118) in PISQ-12, PFDI-20, and SCL-90-R domains. The multiple linear regression model of PISQ-12 showed that constipation history, regular pelvic floor muscle training, parity, and symptomatic POP were independently correlated with the questionnaire score (P < .05). CLINICAL IMPLICATIONS: The significantly pervasive nature of POP often leads to the neglect of a substantial percentage of sexual problems and related emotional suffering, emphasizing the critical importance of raising awareness about this issue among clinicians and the general public. STRENGTHS AND LIMITATIONS: The current study brought attention to significant aspects of postpartum POP; the findings suggest issues concerning POP occurrences and their impacts on sexual function, QoL, and psychological health. Primary constraints are linked to the utilization of self-report assessments. CONCLUSION: The current study reveals a robust correlation between POP in postpartum women and compromised sexual function, QoL, and psychological health.

Rhodamine-Anchored Polyacrylamide Hydrogel for Fluorescent Naked-Eye Sensing of Fe3.

A fluorescent and colorimetric poly (acrylamide)-based copolymer probe P(AAm-co-RBNCH) has been designed via free radical polymerization of a commercial acrylamide monomer with a rhodamine-functionalized monomer RBNCH. Metal ion selectivity of RBNCH was investigated by fluorescence and colorimetric spectrophotometry. Upon addition of Fe3+, a visual color change from colorless to red and a large fluorescence enhancement were observed for the ring-opening of the rhodamine spirolactam mechanism. The monomer gives a sensitive method for quantitatively detecting Fe3+ in the linear range of 100-200 µM, with a limit of detection as low as 27 nM and exhibiting high selectivity for Fe3+ over 12 other metal ions. The hydrogel sensor was characterized by FTIR, and the effects of RBNCH amount on gel content and swelling properties were explored. According to the recipe of 1.0 mol% RBNCH to the total monomers, the fabricated hydrogel sensor displayed a good swelling property and reversibility performance and has potential for application in the imaging of Fe3+ level in industrial wastewater.

Relationship Between Gestational Diabetes Mellitus and Postpartum Diastasis Recti Abdominis in Women in the First Year Postdelivery.

OBJECTIVE: Postpartum diastasis recti abdominis (DRA) influences women's appearance and health. Gestational diabetes mellitus (GDM) can affect the structure of the rectus abdominis muscles. However, the relationship between GDM and postpartum DRA is unknown. The objective of this study was to investigate the relationship between GDM and postpartum DRA. METHODS: This retrospective cohort study included 241 women in the first year postdelivery. Women with GDM were matched with those without GDM using propensity score matching. They underwent an oral glucose tolerance test during pregnancy and a random blood glucose test before delivery. At follow-up, DRA was diagnosed by palpation, and interrectus distance was measured using ultrasound to evaluate the severity of DRA. The strength of the rectus abdominis was evaluated using the manual muscle testing method. RESULTS: Among the 241 participants, 174 (72.2%) had postpartum DRA, and 46 women with GDM were matched with 46 women without GDM on the basis of propensity scores. Women with GDM had higher odds of experiencing postpartum DRA (adjusted odds ratio = 4.792; 95% CI = 1.672 to 13.736) and larger interrectus distance values at the upper part of the rectus abdominis than those without GDM. There was a weak and positive correlation between the fasting oral glucose tolerance test level and the interrectus distance values (0.267 ≤ r ≤ 0.367). CONCLUSION: GDM was associated with postpartum DRA in women in the first year of delivery. Women with GDM had larger interrectus distance values at the upper part of the rectus abdominis than those without GDM. The fasting oral glucose tolerance test level showed a positive and weak correlation with the severity of postpartum DRA. IMPACT: Women with GDM have higher odds of experiencing postpartum DRA than those without GDM. The upper part of the rectus abdominis deserves increased focus during and after rehabilitation. Controlling the fasting oral glucose tolerance test level may help reduce the severity of postpartum DRA.

Development and validation of a Decision-Making Ability Scale for postpartum urinary incontinence women engaging in pelvic floor physical therapy.

OBJECTIVE: This study aimed to develop and validate a Decision-Making Ability Scale (DMA-S) for postpartum urinary incontinence (PPUI) women engaging in pelvic floor physical therapy (PFPT). METHODS: Items were created in line with a review of the literature and exploratory qualitative study with 22 women. The items were submitted for expert opinion and a pilot implementation was made with 58 women with PPUI. Furthermore, the construct validity of the scale was tested with exploratory factor analysis (EFA) (n = 220) and confirmatory factor analysis (CFA) (n = 240). Internal consistency for the Chronbach's α and test-retest reliability for the intraclass correlation coefficient (ICC) were also investigated for the DMA-S in the study. RESULTS: The results of the EFA indicated a Kaiser-Meyer-Olkin value of 0.85 and Bartlett's test of sphericity showed a χ2 value of 8352.101, p < 0.001. After removing one item with factor loading values below 0.50, the resulting factor structure accounted for 83.38% of the total variance. The fit indices of the scale model tested in the CFA were determined as χ2 /df = 1.08 < 3, root mean square error of approximation = 0.018 < 0.08, comparative fit index = 0.996 > 0.90, Tucker-Lewis index = 0.995 > 0.90, goodness-of-fit index (GFI) = 0.933 > 0.90, adjusted GFI = 0.916 > 0.90, and incremental fit index = 0.996 > 0.90. The Cronbach's α values were 0.95-0.97 for the subdimensions of the scale and 0.93 for the total scale. Data also showed a good test-retest stability (ICC = 0.984). CONCLUSION: The DMA-S is a reliable and valid tool for assessing the decision-making ability for PPUI women engaging in PFPT.

Impaired CD8+ T cells in term pregnancy decidua with chronic hepatitis B virus infection.

PROBLEM: Hepatitis B virus (HBV) infection is more likely to develop a state of chronicity in early life, particularly mother-to-child transmission (MTCT) of HBV in the fetus during pregnancy. Till now, little is known about the impact of chronic HBV infection on the immune status of the maternal-fetus interface, and the immune profile of placental lymphocytes in MTCT of HBV is poorly understood. METHOD OF STUDY: Thirteen term pregnant women with chronic HBV infection (HBV-PW) and thirteen normal pregnant women as healthy control (HC-PW) were enrolled. The profile of placental immune cells and paired peripheral blood were analyzed by flow cytometry and immunohistochemistry. RESULTS: Compared with HC-PW, the frequency of CD8+ T cells from the term placenta of HBV-PW was significantly reduced. These cells showed decreased expression of activation molecules CD69 and HLA-DR; thus, decidual CD8+ T cells from HBV-PW demonstrated hypofunctional signature as evidenced by significantly reduced production of IFN-γ, as well as compromised ability of degranulation and proliferation. CONCLUSIONS: These findings supported that hypoactivated decidual CD8+ T cells might possess compromised ability in chronically HBV-infected term pregnant women. Our study provides robust evidence for the necessity and importance of antiviral intervention in HBV-PW to prevent MTCT of HBV.

Impaired interaural correlation processing in people with schizophrenia.

Detection of transient changes in interaural correlation is based on the temporal precision of the central representations of acoustic signals. Whether schizophrenia impairs the temporal precision in the interaural correlation process is not clear. In both participants with schizophrenia and matched healthy-control participants, this study examined the detection of a break in interaural correlation (BIC, a change in interaural correlation from 1 to 0 and back to 1), including the longest interaural delay at which a BIC was just audible, representing the temporal extent of the primitive auditory memory (PAM). Moreover, BIC-induced electroencephalograms (EEGs) and the relationships between the early binaural psychoacoustic processing and higher cognitive functions, which were assessed by the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS), were examined. The results showed that compared to healthy controls, participants with schizophrenia exhibited poorer BIC detection, PAM and RBANS score. Both the BIC-detection accuracy and the PAM extent were correlated with the RBANS score. Moreover, participants with schizophrenia showed weaker BIC-induced N1-P2 amplitude which was correlated with both theta-band power and inter-trial phase coherence. These results suggested that schizophrenia impairs the temporal precision of the central representations of acoustic signals, affecting both interaural correlation processing and higher-order cognitions.

The relationship of severity in diastasis recti abdominis and pelvic floor dysfunction: a retrospective cohort study.

BACKGROUND: Diastasis of rectus abdominis (DRA) refers to a separation of the rectus abdominis from the linea alba. This study aimed to investigate the association with the severity of DRA for developing pelvic floor dysfunction among women during the first year postpartum. METHODS: This is a retrospective cohort study which collected data from 229 postpartum women. DRA was defined as a separation of ≥ 20 mm at any point 4.5 cm above, at and 4.5 cm below the umbilicus. The data for analysis includes pelvic organ prolapse quantification (POP-Q), medical history of urinary incontinence (UI), the strength of rectus abdominis muscle and pelvic floor muscle. The differences in women with and without DRA were compared with independent samples t-test and Chi-square test. RESULTS: Prevalence of DRA was 82.6% during the first postpartum year. Cesarean section and multiple parturitions are recognized as risk factors for DRA due to the odds ratio in our study were 3.48 (95% CI 1.42-8.56), 3.20 (95% CI 1.59-6.45) respectively. There was no difference in the occurrence of UI and pelvic organ prolapse (POP) comparing women with and without DRA, even changing the cut-off values (inter-rectus distance = 20 mm, 30 mm, 40 mm, 50 mm) for determining DRA. The women with weak rectus abdominis muscle and pelvic floor muscle have no statistical difference in two group. CONCLUSION: The relationship of the diastasis recti abdominis and pelvic floor dysfunction has no connection, even with the severity of inter-rectus distance increasing.

Flow-injection chemiluminescence of the luminol-potassium periodate system enhanced by TGA-capped CdTe quantum dots for the determination of theophylline.

The chemiluminescence (CL) behaviour of the luminol-potassium periodate system enhanced by CdTe quantum dots capped with thioglycolic acid (TGA-CdTe QDs) was studied using kinetic experiments, CL spectra, UV-vis absorption spectra and fluorescence spectra. The production of oxygen-containing reactant intermediates (O2 •- and OH• ) in the present CL system was verified by CL. The possible CL mechanism was discussed in detail. Furthermore, theophylline (THP) was determined based on its enhancement of the CL intensity of the CdTe QDs-luminol-potassium periodate system coupled with a flow-injection technique. Under these optimized conditions, the linear range was found to be from 1.0 × 10-8 to 1.0 × 10-5  g/mL with a detection limit of 2.8 × 10-9  g/mL (3σ). The recoveries for the determination of THP in tablets were from 98.2 to 99.6%.

Cortical Gray Matter Loss, Augmented Vulnerability to Speech-on-Speech Masking, and Delusion in People With Schizophrenia.

People with schizophrenia exhibit impairments in target-speech recognition (TSR) against multiple-talker-induced informational speech masking. Up to date, the underlying neural mechanisms and its relationships with psychotic symptoms remain largely unknown. This study aimed to investigate whether the schizophrenia-associated TSR impairment contribute to certain psychotic symptoms by sharing underlying alternations in cortical gray-matter volume (GMV) with the psychotic symptoms. Participants with schizophrenia (N = 34) and their matched healthy controls (N = 29) were tested for TSR against a two-talker-speech masker. Psychotic symptoms of participants with schizophrenia were evaluated using the Positive and Negative Syndrome Scale. The regional GMV across various cortical regions was assessed using the voxel-based morphometry. The results of partial-correlation and mediation analyses showed that in participants with schizophrenia, the TSR was negatively correlated with the delusion severity, but positively with the GMV in the bilateral superior/middle temporal cortex, bilateral insular, left medial orbital frontal gyrus, left Rolandic operculum, left mid-cingulate cortex, left posterior fusiform, and left cerebellum. Moreover, the association between GMV and delusion was based on the mediating role played by the TSR performance. Thus, in people with schizophrenia, both delusions and the augmented vulnerability of TSR to informational masking are associated with each other and share the underlying cortical GMV reduction, suggesting that the origin of delusion in schizophrenia may be related to disorganized or limited informational processing (e.g., the incapability of adequately filtering information from multiple sources at the perceptual level). The TSR impairment can be a potential marker for predicting delusion severity.

Schizophrenia alters intra-network functional connectivity in the caudate for detecting speech under informational speech masking conditions.

BACKGROUND: Speech recognition under noisy "cocktail-party" environments involves multiple perceptual/cognitive processes, including target detection, selective attention, irrelevant signal inhibition, sensory/working memory, and speech production. Compared to health listeners, people with schizophrenia are more vulnerable to masking stimuli and perform worse in speech recognition under speech-on-speech masking conditions. Although the schizophrenia-related speech-recognition impairment under "cocktail-party" conditions is associated with deficits of various perceptual/cognitive processes, it is crucial to know whether the brain substrates critically underlying speech detection against informational speech masking are impaired in people with schizophrenia. METHODS: Using functional magnetic resonance imaging (fMRI), this study investigated differences between people with schizophrenia (n = 19, mean age = 33 ± 10 years) and their matched healthy controls (n = 15, mean age = 30 ± 9 years) in intra-network functional connectivity (FC) specifically associated with target-speech detection under speech-on-speech-masking conditions. RESULTS: The target-speech detection performance under the speech-on-speech-masking condition in participants with schizophrenia was significantly worse than that in matched healthy participants (healthy controls). Moreover, in healthy controls, but not participants with schizophrenia, the strength of intra-network FC within the bilateral caudate was positively correlated with the speech-detection performance under the speech-masking conditions. Compared to controls, patients showed altered spatial activity pattern and decreased intra-network FC in the caudate. CONCLUSIONS: In people with schizophrenia, the declined speech-detection performance under speech-on-speech masking conditions is associated with reduced intra-caudate functional connectivity, which normally contributes to detecting target speech against speech masking via its functions of suppressing masking-speech signals.

Psychotic Symptoms and Attitudes toward Medication Mediate the Effect of Insight on Personal-Social Functions in Patients with Schizophrenia: One-Year Randomized Controlled Trial and Follow-Up.

AIMS: This study aimed to investigate the mediating pathway of 3 factors (psychotic symptoms, attitude toward medication, and cognitive processing speed) on the effect of insight on personal-social functioning in patients with schizophrenia. METHODS: Chinese inpatients with schizophrenia (n = 168; mean age 18 ± 50 years) diagnosed according to the DSM-IV were randomly assigned to treatment with antipsychotic medication alone or combined treatment. Positive and Negative Syndrome Scale (PANSS), Drug Attitude Inventory (DAI), Assessment of Insight (SAI), and Social-Personal Performance Scale (PSPS) scores were evaluated at baseline and at 3, 6, and 12 months. Cognitive function was assessed at baseline. Multiple mediation analyses were conducted with baseline data, end point data, and changes-in-scale scores between baseline and the end point, respectively. RESULTS: At baseline and at 12 months, only psychotic symptoms mediated the effect of insight on personal-social functioning. For changes-in-scale scores over the 12-month follow-up, in patients receiving treatment with medication alone, the effect of improved insight on improved personal-social function was mediated by psychotic symptoms only; in patients receiving a combined treatment, the effect of improved insight on improved personal-social functioning was mediated by both psychotic symptoms and attitudes toward medication, independently. CONCLUSIONS: The link between insight and personal-social functions is mainly mediated by psychotic symptoms. Psychosocial intervention improves the predicting effect of insight on personal-social function by improving both the attitude toward medication and psychotic symptoms independently.

Surface phosphation of 3D mesoporous NiCo2O4 nanowire arrays as bifunctional anodes for lithium and sodium ion batteries.

A novel surface phosphate strategy was adopted to dramatically improve the charge transport, ion diffusion, electroactive sites, and cycle stability of mesoporous NiCo2O4 nanowire arrays (NWAs), drastically boosting their electrochemical properties. Consequently, the as-prepared phosphated NiCo2O4 NWA (P-NiCo2O4 NWA) electrode achieved excellent energy storage performance as a bifunctional anode material for both lithium ion batteries (LIBs) and sodium ion batteries (SIBs). When evaluated as an anode for LIBs, this P-NiCo2O4 NWA electrode showed a high reversible capacity up to 1156 mA h g-1 for 1500 cycles at 200 mA g-1 without appreciable capacity attenuation, while in SIBs, the electrode could also deliver an admirable initial capacity as high as 687 mA h g-1 and maintained 83.5% of this after 500 cycles at the same current density. Most important, when the current density increased from 100 to 1000 mA g-1, the capacity retention was about 63% in LIBs and 54% in SIBs. This work may shed light on the engineering of efficient electrodes for multifunctional flexible energy storage device applications.

Schizophrenia affects speech-induced functional connectivity of the superior temporal gyrus under cocktail-party listening conditions.

The superior temporal gyrus (STG) is involved in speech recognition against informational masking under cocktail-party-listening conditions. Compared to healthy listeners, people with schizophrenia perform worse in speech recognition under informational speech-on-speech masking conditions. It is not clear whether the schizophrenia-related vulnerability to informational masking is associated with certain changes in FC of the STG with some critical brain regions. Using sparse-sampling fMRI design, this study investigated the differences between people with schizophrenia and healthy controls in FC of the STG for target-speech listening against informational speech-on-speech masking, when a listening condition with either perceived spatial separation (PSS, with a spatial release of informational masking) or perceived spatial co-location (PSC, without the spatial release) between target speech and masking speech was introduced. The results showed that in healthy participants, but not participants with schizophrenia, the contrast of either the PSS or PSC condition against the masker-only condition induced an enhancement of functional connectivity (FC) of the STG with the left superior parietal lobule and the right precuneus. Compared to healthy participants, participants with schizophrenia showed declined FC of the STG with the bilateral precuneus, right SPL, and right supplementary motor area. Thus, FC of the STG with the parietal areas is normally involved in speech listening against informational masking under either the PSS or PSC conditions, and declined FC of the STG in people with schizophrenia with the parietal areas may be associated with the increased vulnerability to informational masking.

Face-related visual search deficits in first-episode schizophrenia.

Schizophrenia is considered a complex illness with multiple cognitive dysfunctions, including a deficit in visual processing. However, whether the deficiency of visual processing in schizophrenia is general across stimuli or stimulus-specific remains the subject of debate. In the current study, eighteen first-episode schizophrenic patients and eighteen healthy controls participated in three visual search tasks in which they were asked to search a specific target of a triangle, face identity or facial affect. The results showed that, compared to healthy controls, the accuracies for face identity and facial affect searches were significantly lower in schizophrenic patients, while the performance of the triangle search was the same. Furthermore, the accuracy of the facial affect search was negatively correlated to negative symptoms in schizophrenia. These results revealed a face-related deficit in schizophrenia and suggest that visual processing deficits in schizophrenia were stimuli-specific.

Two-stage integrated care versus antipsychotic medication alone on outcomes of schizophrenia: One-year randomized controlled trial and follow-up.

Integrated care can reduce rate of relapse and improve personal and social functions in patients with schizophrenia. We established and evaluated a new model of "intensive-consolidation" two-stage integrated care (IC) for inpatients with schizophrenia. Data were collected between 2012 and 2015. Chinese inpatients with schizophrenia (n=170) diagnosed according to DSM-IV were randomly assigned to antipsychotic medication-alone (n=84) or two-stage IC (n=86) and followed up for 12 months. The IC model included intensive treatments (antipsychotics plus the cognitive behavior therapy and rehabilitation treatment) during hospitalization and 3-time consolidation treatments with 3-month intervals at clinics. Outcome measures included the rate of relapse, psychiatric symptoms and social functioning. Compared with medication-alone group, the rate of relapse were significantly lower in IC group (p=0.012); the Mixed-Effects Model for Repeated-Measures analyses showed that the IC group significantly improved in positive symptoms over time; greater improvement in self-care and less aggressive behaviors were observed over time in IC group (all p<0.008). The findings support the feasibility and effectiveness of the new two-stage model of integrated care as an intervention for middle-acute-phase inpatients with schizophrenia. The model is particularly informative to countries where medical resources are mainly distributed in developed regions.

Activation and Functional Connectivity of the Left Inferior Temporal Gyrus during Visual Speech Priming in Healthy Listeners and Listeners with Schizophrenia.

Under a "cocktail-party" listening condition with multiple-people talking, compared to healthy people, people with schizophrenia benefit less from the use of visual-speech (lipreading) priming (VSP) cues to improve speech recognition. The neural mechanisms underlying the unmasking effect of VSP remain unknown. This study investigated the brain substrates underlying the unmasking effect of VSP in healthy listeners and the schizophrenia-induced changes in the brain substrates. Using functional magnetic resonance imaging, brain activation and functional connectivity for the contrasts of the VSP listening condition vs. the visual non-speech priming (VNSP) condition were examined in 16 healthy listeners (27.4 ± 8.6 years old, 9 females and 7 males) and 22 listeners with schizophrenia (29.0 ± 8.1 years old, 8 females and 14 males). The results showed that in healthy listeners, but not listeners with schizophrenia, the VSP-induced activation (against the VNSP condition) of the left posterior inferior temporal gyrus (pITG) was significantly correlated with the VSP-induced improvement in target-speech recognition against speech masking. Compared to healthy listeners, listeners with schizophrenia showed significantly lower VSP-induced activation of the left pITG and reduced functional connectivity of the left pITG with the bilateral Rolandic operculum, bilateral STG, and left insular. Thus, the left pITG and its functional connectivity may be the brain substrates related to the unmasking effect of VSP, assumedly through enhancing both the processing of target visual-speech signals and the inhibition of masking-speech signals. In people with schizophrenia, the reduced unmasking effect of VSP on speech recognition may be associated with a schizophrenia-related reduction of VSP-induced activation and functional connectivity of the left pITG.