The relationship between executive function and the association of motor coordination difficulties and social communication deficits in autistic children.

Background: Motor coordination difficulties could contribute to social communication deficits in autistic children. However, the exploration of the mechanism implicated in these claims has been limited by the lack of potential confounders such as executive function (EF). Methods: We investigated the role that EF plays in the relationship between motor coordination and social communication in a school-aged autistic population via a structural model in a statistically robust manner. The results of questionnaires, including the Developmental Coordination Disorder questionnaire, the Behavior Rating Inventory of Executive Function, and the Social Responsiveness Scale, were collected to measure motor coordination, social communication deficits, and EF. Results: A total of 182 autistic children (7.61±1.31 years, 87.9% boys) were included in the final analysis. In the model with EF as a mediator, the total effect (ß=-0.599, P<0.001) and the direct effect (ß=-0.331, P =0.003) of motor coordination function on social communication were both significant among autistic children without intellectual disability (ID), as were indirect effects through EF (ß=-0.268, P<0.001). Conclusion: EF partially mediates the motor coordination and social communication correlation among autistic children. We suggest that motor coordination should be included in the routine evaluation of autistic surveillance and rehabilitation procedures.

Crystallization Control for Ambient Printed FA-Based Lead Triiodide Perovskite Solar Cells.

Upscalable printing of high-performance and stable perovskite solar cells (PSCs) is highly desired for commercialization. However, the efficiencies of printed PSCs lag behind those of their lab-scale spin-coated counterparts owing to the lack of systematic understanding and control over perovskite crystallization dynamics. Here, the controlled crystallization dynamics achieved using an additive 1-butylpyridine tetrafluoroborate (BPyBF4 ) for high-quality ambient printed α-formamidinium lead triiodide (FAPbI3 ) perovskite films are reported. Using in situ grazing-incidence wide-angle X-ray scattering and optical diagnostics, the spontaneous formation of α-FAPbI3 from precursors during printing without the involvement of  Î´-FAPbI3 is demonstrated. The addition of BPyBF4 delays the crystallization onset of α-FAPbI3 , enhances the conversion from sol-gel to perovskite, and reduces stacking defects during printing. Therefore, the altered crystallization results in fewer voids, larger grains, and less trap-induced recombination loss within printed films. The printed PSCs yield high power conversion efficiencies of 23.50% and 21.60% for a 0.09 cm-2 area device and a 5 cm × 5 cm-area module, respectively. Improved device stability is further demonstrated, i.e., approximately 94% of the initial efficiency is retained for over 2400 h under ambient conditions without encapsulation. This study provides an effective crystallization control method for the ambient printing manufacture of large-area high-performance PSCs.

Low-Cost Fabrication of Efficient Perovskite Photovoltaics Using Low-Purity Lead Iodide via Powder Engineering.

Low cost is the eternal theme for any commercial production. Numerous efforts have been explored to realize low-cost, high-efficiency perovskite solar cells (PSCs), such as replacing the traditional spin-coating method with an economical printing strategy, simplifying the device structure, reducing the number of functional layers, etc. However, there are few reports on the use of low-cost precursors. Herein, we enable the low-cost fabrication of efficient PSCs based on a very cheaper low-purity PbI2 via powder engineering. The low-purity PbI2 is blended with formamidinium iodide followed by dissolving in a 2-methoxyethanol solvent, and then, the high-quality FAPbI3 powders are formed via an inverse temperature crystallization process and solvent washing after several simple processes to reduce the impurities. As a result, the devices fabricated using the as-synthesized black powders based on the low-purity PbI2 exhibit a champion power conversion efficiency (PCE) of 23.9% and retained ∼95% of the initial PCE after ∼400 h of storage in the conditions of 25 ± 5 °C and 25 ± 5 RH% without encapsulation. In addition, the upscaling fabrication of a 5 cm × 5 cm solar minimodule also demonstrates an impressive efficiency of 19.5%. Our findings demonstrate an economic strategy for the commercialization of PSCs from the perspective of low-cost production.

Association between motor coordination and core symptoms in children with autism spectrum disorder / 中国学校卫生

Objective@#To study the relationship between motor coordination, social communication impairment, and restricted/repetitive behaviors (RRBs) in children with autism spectrum disorder (ASD).@*Methods@#A total of 123 ASD children aged 2-12 were recruited from rehabilitation service institutions for autistic children in Guangzhou, including 105 boys and 18 girls. The Developmental Coordination Disorder Questionnaire, Social Communication Questionnaire, and Restrictive Behavior Scale Revised were collected to measure motor coordination, social communication skills and RRBs, respectively. Multiple linear regression was used to explore the association between motor coordination and core symptoms.@*Results@#In children aged 2-5 years old, those without motor coordination deficits scored lower in social interaction (7.73±4.00) than others (9.76±2.90)( Z=-2.29, P <0.05). In children aged 6-12 years old, those without motor coordination deficits scored lower in restricted, repetitive, and stereotyped patterns of behavior (4.22±1.93), repetitive sensory-motor behaviors (3.91±2.63), and insistence on sameness (13.52±10.59) than those with motor coordination deficits (6.11±1.54, 14.00±8.49, 31.33±15.05)( Z=-2.48, -3.83, -3.28, P <0.01)。Multiple linear regression analysis showed that fine motor/handwriting and control during movement were negatively correlated with the severity of social communication impairment and RRBs respectively among children aged 2-5 and 6-12( β=-0.85--0.03, -2.98--0.17, P <0.05).@*Conclusion@#Among autistic children, those with motor deficits suffered from more severe core symptoms. Motor assessment should be included in the ASD screening, diagnosis and management. Motor intervention should also be promoted in the rehabilitation in order to improve the prognosis and life quality.

Effect of types of educational institutions on social communication functions among children with autism spectrum disorder:an observation study / 中国学校卫生

Objective@#To explore changes in the social interactions of school aged children with autism spectrum disorder (ASD) enrolled in ordinary schools and special education institutions during a one year observation period.@*Methods@#A total of 44 children with ASD were recruited from the Research Center of Children and Adolescent Psychological and Behavioral Development in the Department of Public Health, Sun Yat sen University, during 2017 and 2018. At the baseline and follow up periods, a self report questionnaire (completed by parents) was administered in order to collect demographic information related to the children, the survey included the Social Responsiveness Scale (SRS), Strengths and Difficulties Questionnaire (SDQ), Social Communication Questionnaire (SCQ), Screen for Child Anxiety Related Emotional Disorder (SCARED) and the Swan son Nolan and Pelham, Version IV Scale(SNAP-IV).@*Results@#At baseline, compared with children in ordinary schools, the total score of SRS (114.56±6.02, 93.63 ±3.82) and its subscale scores (social awareness:13.54±0.71, 11.02±0.45; social cognition:22.73±1.16, 18.19±0.73; social interaction:37.47±2.12, 30.40±1.35; autistic mannerisms: 23.11±1.70, 19.02±1.08) were higher in children attending special education institutions, as well as the SCQ total score (20.37±1.60, 12.92±1.02) and its subscale scores(social interaction domain:8.77±0.92, 4.23±0.58; social communication domain:6.07±0.55, 4.19±0.35)( P <0.05). Further comparison of baseline and follow up results showed no significant difference in time effect or in the interaction between time and the educational environment( P >0.05).@*Conclusion@#Compared with special education institutions, school aged children with ASD in ordinary schools had lower levels of social impairment. During the one year observation period, there was no correlation between the educational environment and changes in symptoms of children and their parents. Parents should choose an appropriate educational environment according to the children s abilities, and ordinary schools and teachers should be prepared for inclusive education.

Association between parenting style and sleep problems among school aged children with autism spectrum disorder / 中国学校卫生

Objective@#To investigate the association between parenting style and sleep problems among school aged children with autism spectrum disorder (ASD).@*Methods@#A total of 98 children with ASD aged 6-10 years old and 98 age and gender matched typically developing (TD) children from mainstream schools were recruited. Parenting style and sleep problems were measured via Parent Behavior Inventory (PBI) and Children s Sleep Habits Questionnaire(CSHQ), respectively. The symptom severity and intelligence level were also evaluated. Generalized linear model was used to analyze the relationship between parenting style and sleep problems.@*Results@#There was no statistically significant difference in the parenting style of the two groups of children( P > 0.05 ); weekend sleep time of children with ASD was significantly shorter than that of the TD group [(9.1±0.7)(9.5±0.8)h, P < 0.01 ], and the score of sleep onset delay was significantly higher than that of the TD group[(1.8±0.7)(1.5±0.7), P <0.01]. However, there was no statistically significant difference in the incidence of total sleep problems and various problems between the two groups of children( P >0.05). The parental support/engagement of children with ASD was negatively associated with the total score of sleep problems( β=-2.68, 95%CI =-4.88--0.47), bedtime resistance ( β=-1.65, 95%CI =-2.54--0.77) and sleep anxiety( β=-1.01, 95%CI =-1.70--0.32). The parental hostility/coercion was positively correlated with score of daytime sleepiness( β=1.41, 95%CI =0.53-2.29)( P <0.05).@*Conclusion@#Parenting style of support/engagement is associated with lower sleep problems in children with ASD, while hostile/coercion is associated with higher sleep problems. It should be improve parental style to reduce the sleep problems in children with ASD.

Associations of emotional/behavioral problems with accelerometer-measured sedentary behavior, physical activity and step counts in children with autism spectrum disorder.

Background: The evidence for associations of emotional/behavioral status with sedentary behavior (SB), physical activity (PA) and step counts is scarce in children with autism spectrum disorder (ASD). Also, ASD-related deficiencies may affect actual levels of PA. We aimed to describe accelerometer-measured SB, PA and step counts in children with ASD, and to examine the associations of emotional/behavioral problems with SB, PA and step counts after assessing associations between accelerometer-measured SB, PA and step counts and ASD-related deficiencies. Methods: A total of 93 ASD children, aged 6-9 years, were recruited from the Center for Child and Adolescent Psychology and Behavioral Development of Sun Yat-sen University in Guangzhou, China. Participants wore an accelerometer for seven consecutive days. Of the original 93, 78 participants' accelerometer-measured valid PA were obtained, and the data were shown as time spent in SB, light, moderate, moderate-to-vigorous and vigorous PA, and step counts. Participants' emotional/behavioral problems were assessed via the Strengths and Difficulties Questionnaire (SDQ), and anxiety symptoms were evaluated by the Screen for Child Anxiety Related Emotional Disorders (SCARED). ASD-associated deficiencies include restricted repetitive behaviors (Repetitive Behavior Scale-Revised), poor social competence (Social Responsiveness Scale Second Edition) and motor development restrictions (Developmental Coordination Disorder Questionnaire). Results: Of the 78 participants, daily vigorous PA (VPA) and moderate-to-vigorous PA (MVPA) averaged 15.62 and 51.95 min, respectively. After adjustment for covariates, SDQ emotional symptoms (ß = -0.060, p = 0.028) were inversely associated with the average daily minutes in VPA. Meanwhile, SDQ emotional symptoms (ß = -0.033, p = 0.016) were inversely associated with the average daily MVPA minutes in the crude model. After adjustment for covariates, SCARED somatic/panic (ß = -0.007, p = 0.040) and generalized anxiety (ß = -0.025, p = 0.014) were negatively associated with the average daily VPA minutes; SCARED total anxiety (ß = -0.006, p = 0.029) was conversely associated with daily MVPA duration. After adjustment for covariates, no significant associations between accelerometer-measured SB, PA and step counts and ASD-related deficiencies were found (p > 0.05). Conclusions: Accelerometer-measured SB, PA and step counts showed no associations with ASD-related deficiencies. On this basis, we further found that the emotional symptoms were inversely associated with VPA and MVPA. These results emphasize the importance of VPA and MVPA in children with ASD. The longitudinally investigations on the directionality of these associations between emotional symptoms with VPA and MVPA are needed in the future.

Association of sugar-sweetened beverages with executive function in autistic children.

The association between sugar-sweetened beverages (SSBs) consumption and executive function (EF) among typically developing (TD) children has been investigated in previous studies but with inconsistent results. Furthermore, this relationship has been less investigated among autistic children who perform worse in EF compared with TD children. In this study, we aimed to investigate the association between SSB consumption and EF in autistic children, and whether the association between SSB and EF in autistic children is different from that in TD children. We recruited 106 autistic children and 207 TD children aged 6-12 years in Guangzhou, China. Children's EF was assessed by using the Chinese version of parent-reported Behavior Rating Inventory of Executive Function, Stroop Color-Word Test, and working memory subscales of the Chinese version of Wechsler Intelligence Scale for children, Fourth edition. Meanwhile, we assessed children's dietary intake and SSB consumption with a validated Food Frequency Questionnaire. In this study, 70 (66.0%) autistic children consumed SSB and 20 (18.9%) of them consumed more than two servings SSB a week. Among autistic children, over two servings per week SSB consumption was associated with poorer performance in emotional control [ß = 7.20, 95% confidence interval (CI): 0.94-13.46] and plan/Organize (ß = 6.45, 95% CI: 0.27-12.63). The association between over two servings/week SSB consumption and emotional control among autistic children was significantly different from that among TD children (ß ASD = 7.20; ß TD = -3.09, Z = 2.72, p = 0.006). Results of this study show that SSB consumption was associated with an impairment in some subscales of EF in autistic children. Furthermore, the association between SSB and EF in autistic children might be different from that in TD children.

The association between sugar-sweetened beverages and milk intake with emotional and behavioral problems in children with autism spectrum disorder.

Background: Emotional and behavioral problems are common in children with autism spectrum disorder (ASD). It's still unclear whether children with ASD have abnormal sugar-sweetened beverages (SSBs) and milk intake and whether this abnormality will affect their emotions and behavior remains unclear. The current study aims to investigate the association of SSBs and milk intake with emotional and behavioral problems in children with autism spectrum disorder (ASD). Methods: 107 children with ASD and 207 typical developing (TD) children aged 6-12 years old were recruited for the study. The frequency of SSBs and milk intake was assessed by a self-designed questionnaire. Emotional and behavioral problems were assessed by Strength and Difficulties Questionnaire (SDQ). Then, the linear regression model was produced to evaluate the association of SSBs and milk intake with emotional and behavioral problems. Results: In the current study, there was no difference in frequency of SSBs intake between children with ASD and TD children (p > 0.05), and children with ASD consumed less milk compared to TD children (p < 0.05). After adjusting sex, age, maternal and paternal education, and monthly family income, we found a significant difference in each subscale score of SDQ in the two groups (p < 0.05). In children with ASD, higher frequent SSBs intake was positively associated with the scores of the emotional problem (p for trend <0.05), and lower frequent milk intake was inversely associated with the scores of prosocial behavior (p for trend <0.05). No interactive effects were found on SSBs and milk intake with emotional and behavioral problems (p for trend > 0.05). Conclusion: In children with ASD, frequency of SSBs and milk intake was associated with the emotional problem and prosocial behavior, respectively. Children with ASD should increase the frequency of milk intake and decrease the frequency of SSBs intake.

Sugar-Sweetened Beverage Intake and Motor Function Among Autistic and Typically Developed Children.

Background and Objectives: The relationship between brain function and sugar-sweetened beverages (SSBs) is widely explored, but the motor function was not included. We aim to explore the relationship between SSBs and motor function among children with or without autism. Methods: Participants were a representative autism sample (ASD, n = 106) comprising ages ranging 6-9 years and their age-matched typical counterparts (TD, n = 207), recruited in the research center of Guangzhou, China. Valid questionnaires of parent-reported including weekly SSBs intake, physical activity (PA), sedentary time (ST), and motor coordination function was used to collect relevant information. SSBs intake was further classified as no intake (no habit of taking SSBs), small to medium intake (<375 ml/week), and large intake (375 ml/week or more). Physical activity, sedentary time, and motor coordination function among the mentioned three groups as well as ASD vs. TD was compared via general linear models. Results: Compared with TD children, ASD children showed less vigorous PA (4.23 ± 0.34 h vs. 2.77 ± 0.49 h, p = 0.015) as well as overall sedentary time (5.52 ± 1.89 h vs. 3.67 ± 0.28 h, 3.49 ± 0.16 h vs. 2.68 ± 0.24 h, and 34.59 ± 1.15 h vs. 23.69 ± 1.69 h, TD vs. ASD, sedentary time at weekdays, weekends and total ST in a week, respectively, all p < 0.05), lower scores in the developmental coordination disorder questionnaire (fine motor and handwriting: 14.21 ± 0.26 vs. 12.30 ± 0.38, general coordination: 28.90 ± 0.36 vs. 25.17 ± 0.53, control during movement: 24.56 ± 0.36 vs. 18.86 ± 0.53, and total score: 67.67 ± 0.75 vs. 56.33 ± 1.10, TD vs. ASD, all p < 0.05). Stratified by SSBs intake, TD children with small to medium SSBs intake showed the lowest sedentary time both on weekdays and weekends (all p < 0.05), they also performed worst in fine motor and handwriting skills (p < 0.05). Conclusion: The association between SSBs and motor function was observed in typical development children, but not autistic children. A larger sample size study with a longitudinal design is warranted to confirm the association between SSBs and sedentary time among typically developed children and the potential causation direction.

Empathizing, systemizing, empathizing-systemizing difference and their association with autistic traits in children with autism spectrum disorder, with and without intellectual disability.

Empathizing, systemizing, and empathizing-systemizing difference can be linked to autistic traits in the general adult population and those with autism spectrum disorder (ASD), but these profiles and associations remain unclear in children with ASD, with and without intellectual disability (ASD + ID; ASD-noID). We recruited three groups including 160 boys with ASD (73 ASD + ID; 87 ASD-noID) and 99 typically developing (TD) boys (6-12 years). We measured empathizing, systemizing, and empathizing-systemizing difference using the parent-reported child Empathy and Systemizing Quotient (EQ-C/SQ-C). We measured autistic traits using the Social Responsiveness Scale (SRS). Among the three groups, children with ASD + ID and ASD-noID scored lower on the EQ-C and SQ-C than TD children (all p < 0.001). There was no difference in the EQ-C between children with ASD + ID and ASD-noID (16.59 ± 5.53 vs. 16.23 ± 5.85, p = 0.973), and the difference in the SQ-C attenuated to null when adjusting for intelligence between children with ASD-noID and TD children (18.89 ± 7.80 vs. 24.15 ± 6.73, p = 0.089). Children with ASD + ID scored higher on empathizing-systemizing difference than TD children but lower than children with ASD-noID (all p < 0.05). Negative associations between EQ-C and all autistic traits, null associations between SQ-C and all autistic traits, and positive associations between empathizing-systemizing difference and all autistic traits were found in all groups. We observed differences in empathizing, systemizing, and empathizing-systemizing difference and the consistency of their associations with autistic traits among the three groups. Our findings provide implication that behavioral interventions of ASD should consider the balance of empathizing and systemizing. LAY SUMMARY: We examined the profiles of empathizing, systemizing, and empathizing-systemizing difference in children with autism spectrum disorder, with and without intellectual disability (ASD + ID; ASD-noID), and typically developing (TD) children aged 6-12 years. We observed differences in these profiles and the consistency of their associations with autistic traits among the three groups. Empathizing and empathizing-systemizing difference, rather than systemizing, were associated with autistic traits within the three groups. Our findings provide implication that behavioral interventions of ASD should consider these imbalance profiles.

The validity and reliability of the simplified Chinese version of the Social Communication Questionnaire.

This study aims to validate the simplified Chinese version of the Social Communication Questionnaire (SCQ) in children aged 2-12 years from both general and clinical populations. We recruited 819 Chinese children in this study, including 505 typically developing (TD) children, 202 children with autism spectrum disorder (ASD) and 112 children with non-ASD neurodevelopmental disorders. All the children's parents completed the simplified Chinese version of the SCQ and all children with ASD were additionally assessed for intelligence and the Childhood Autism Rating Scale to confirm their diagnosis. We have developed a 40-item, 4-factor structure of SCQ with two domains (social communication and social interaction; and restricted, repetitive, and stereotyped patterns of behavior), which showed adequate goodness of fit (comparative fit index [CFI] = 0.96, Tucker-Lewis index [TLI] = 0.95, standardized root mean squared residual [SRMR] = 0.07, root mean square error of approximation [RMSEA] = 0.05), with good internal consistency (Cronbach's alpha = 0.92). We have provided different cut-offs to distinguish ASD cases from TD children (11 for children under 4 years [sensitivity: 0.96, specificity: 0.95], 12 for children 4 years and above [sensitivity: 0.93, specificity: 0.98]) or children with other neurodevelopmental disorders (14 [sensitivity: 0.85, specificity: 0.88]). Through this large sample validation, we confirmed that the simplified Chinese version of the SCQ could be used for children aged 2-12 years with relatively good psychometric properties. LAY SUMMARY: We aimed to develop the simplified Chinese version of the Social Communication Questionnaire (SCQ) for Chinese children aged 2-12 years as a screening tool to identified potential risk of autism spectrum disorder (ASD). We have developed a 40-item, 4-factor structure of SCQ with two domains, which showed adequate goodness of fit and good psychometric properties. We also provided different cut-offs to identify ASD cases in general or clinical populations.

Adsorption of Transition-Metal Clusters on Graphene and N-Doped Graphene: A DFT Study.

Using the dispersion-corrected density functional theory (DFT-D3) method, we systematically studied the adsorption of 15 kinds of transition-metal (TM) clusters on pristine graphene (Gr) and N-doped graphene (N-Gr). It has been found that TMn (n = 1-4) clusters adsorbed on the N-Gr surface are much stronger than those on the pristine Gr surface, while 3d series clusters present similar geometries on Gr and N-Gr surfaces. The most preferred sites of TMs migrate from hollow to bridge to the top site on the Gr surface along the d series in the periodic table, while the preferred sites of TMs migrate in a much more complex manner on the N-Gr surface. It has also been found that charge transfer decreases along the d series for adsorbed clusters on both surfaces, but adsorbed clusters present less charge transfer on the N-Gr surface than on the Gr surface. What is more interesting is that some TM (Tc, Ru, and Re) clusters change the growth mechanism from the three-dimensional (3D) growth mode on the Gr surface to the two-dimensional (2D) growth mode on the N-Gr surface. At last, it has been found that adsorbed clusters are more dispersed on the N-Gr surface than on the pristine Gr surface due to growth and average aggregation energies.

Automated pneumothorax triaging in chest X-rays in the New Zealand population using deep-learning algorithms.

INTRODUCTION: The primary aim was to develop convolutional neural network (CNN)-based artificial intelligence (AI) models for pneumothorax classification and segmentation for automated chest X-ray (CXR) triaging. A secondary aim was to perform interpretability analysis on the best-performing candidate model to determine whether the model's predictions were susceptible to bias or confounding. METHOD: A CANDID-PTX dataset, that included 19,237 anonymized and manually labelled CXRs, was used for training and testing candidate models for pneumothorax classification and segmentation. Evaluation metrics for classification performance included Area under the receiver operating characteristic curve (AUC-ROC), sensitivity and specificity, whilst segmentation performance was measured using mean Dice and true-positive (TP)-Dice coefficients. Interpretability analysis was performed using Grad-CAM heatmaps. Finally, the best-performing model was implemented for a triage simulation. RESULTS: The best-performing model demonstrated a sensitivity of 0.93, specificity of 0.95 and AUC-ROC of 0.94 in identifying the presence of pneumothorax. A TP-Dice coefficient of 0.69 is given for segmentation performance. In triage simulation, mean reporting delay for pneumothorax-containing CXRs is reduced from 9.8 ± 2 days to 1.0 ± 0.5 days (P-value < 0.001 at 5% significance level), with sensitivity 0.95 and specificity of 0.95 given for the classification performance. Finally, interpretability analysis demonstrated models employed logic understandable to radiologists, with negligible bias or confounding in predictions. CONCLUSION: AI models can automate pneumothorax detection with clinically acceptable accuracy, and potentially reduce reporting delays for urgent findings when implemented as triaging tools.

Curation of the CANDID-PTX Dataset with Free-Text Reports.

Supplemental material is available for this article. Keywords: Conventional Radiography, Thorax, Trauma, Ribs, Catheters, Segmentation, Diagnosis, Classification, Supervised Learning, Machine Learning © RSNA, 2021.