CD4/CD8 Ratio: An Independent Predictor of Herpes Zoster in Patients With Autoimmune Inflammatory Rheumatic Diseases.

BACKGROUND: A higher incidence of herpes zoster (HZ) was found in people with decreased cell-mediated immunity. However, the relationship between cellular immunity and HZ infection in patients with autoimmune inflammatory rheumatic diseases (AIRD) remains elusive. OBJECTIVE: To investigate the role of CD4/CD8 ratio in patients with AIRD and HZ. METHODS: This case-control study compared AIRD patients with and without HZ. We chose 70 AIRD patients with HZ as the experimental group and 140 AIRD patients without HZ as the control group. The clinical and laboratory findings were assessed in each trial participant. RESULTS: The CD4/CD8 ratio (odds ratio [OR], 0.22; 95% confidence interval [CI], 0.10-0.49) was independently associated with the occurrence of HZ after adjusting for various confounders. Nonlinear analysis has unveiled a more profound nonlinear relationship between the CD4/CD8 ratio and the occurrence of HZ in patients with AIRD. The OR of HZ increased with a decreasing CD4/CD8 ratio before the turning point of 2. The adjusted regression coefficient was 0.14 (95% CI, 0.05-0.37, p<0.0001) for CD4/CD8 ratio less than 2. CONCLUSION: The CD4/CD8 ratio was expected to be a very promising quantitative biomarker for predicting the risk of developing HZ in patients with AIRD.

Linking child externalising problems to psychological distress in parents: Mobile phone use by children as a mediator.

Child externalising problems, such as acting out and hostility, have been found to be significant stressors for parents, leading to increased distress levels. This cross-sectional study examined the mediating role of parents' use of mobile phones to soothe or engage children in the association between child externalising problems and distress in parents. Altogether 937 parents of children aged 5-12 reported their child's externalising problems, child's mobile phone use, and their distress through an online survey. The findings indicated that parents of children with high externalising problems are more likely to use mobile phones to soothe their children and keep them engaged in daily activities, which, in turn, is associated with higher distress in parents. Child externalising problems and distress in parents remained significantly and positively associated even after accounting for the mediating effect. The results highlight the child-driven effect on distress in parents through parenting behaviours, indicating the importance of providing alternative parenting strategies to cope with child externalising behaviours, in order to promote parental emotional well-being.

An assessment tool for the international healthy eating report card for preschool-aged children: a cross-cultural validation across Australia, Hong Kong, Singapore, and the United States.

Objective: This study aimed to develop and validate a globally applicable assessment tool of the 43-item International Healthy Eating Report Card Scale (IHERCS) which was designed to assess preschool-aged children's eating behaviours and family home food environments (FHFEs) across different cultural settings. In particular, we examined the factor structure, internal consistency and measurement invariance of the IHERCS across four cultural samples, including Australia, Hong Kong, Singapore, and the US. Convergent and discriminant validity were then conducted. Methods: In this cross-cultural study, a total of 2059 parent-child dyads from these four regions were recruited, and the parents were asked to complete the IHERCS. An exploratory structural equational modelling approach was employed to examine two higher-order factor models of children's eating behaviours and FHFEs in the IHERCS and its cross-cultural measurement invariance. Results: The findings demonstrated robust factor structures of the scales of children's eating behaviours and FHFEs in the IHERCS (i.e., CFI and TLI > 0.90; RMSEA and SRMR < 0.08) and an acceptable level of internal consistency (i.e., Cronbach's α = 0.55-0.84). Full configural invariance and metric invariance were established across the four cultural contexts, but full scalar invariance was not achieved. Partial scalar invariance was found only in the scale of FHFEs. The convergent validity and discriminant validity were supported. Conclusion: Overall, the current findings provided preliminary support for the construct validity and measurement invariance of the IHERCS. It provides a reliable, valid and comprehensive assessment of eating behaviours and FHFEs among children in different cultural settings.

Effect of hydroxychloroquine blood concentration on the efficacy and ocular toxicity of systemic lupus erythematosus.

In the absence of evidence-based guidance on the impact of hydroxychloroquine (HCQ) blood concentration on efficacy and ocular toxicity in systemic lupus erythematosus (SLE), the clinical monitoring of HCQ blood concentration is not yet widely performed, which raised concerns about the necessity of conducting HCQ blood concentration monitoring. In this retrospective study, we consecutively enrolled 135 patients with SLE who received HCQ treatment for more than 6 months from July 2022 to December 2022. Ocular toxicity was evaluated by collecting relevant retinal parameters using optical coherence tomography angiography (OCTA). Therapeutic efficacy was evaluated using the SLE disease activity index (SLEDAI) and relevant clinical parameters. HCQ blood concentration was determined by high-performance liquid chromatography-tandem mass spectrometry (HPLC-MS/MS). Spearman correlation analysis revealed that the cumulative dose of HCQ was positively correlated with the foveal avascular zone (FAZ) perimeter and FAZ area (r = 0.734, P < 0.001; r = 0.784, P < 0.001). Meanwhile, the treatment duration of HCQ was positively correlated with FAZ perimeter and FAZ area (r = 0.761, P < 0.001; r = 0.882, P < 0.001). The univariate and multivariate logistic regression analyses indicated that HCQ blood concentration was associated with the disease activity of patients with SLE (odds ratio 0.994, 95% CI 0.990-0.999). HCQ blood concentration may be an important factor in assessing the therapeutic effectiveness of SLE patients. The HCQ-related ocular toxicity was a long-term effect related to long term exposure, rather than the blood concentration of HCQ at the time of testing. More importantly, when addressing HCQ-related ocular toxicity, it may be crucial to pay attention to the cumulative dose and treatment duration of HCQ.

Factors affecting different COVID-19 outcomes in patients with systemic lupus erythematosus during the second pandemic wave of COVID-19 in China.

OBJECTIVE: To investigate characteristics associated with different COVID-19 outcomes of people with systemic lupus erythematosus (SLE) and COVID-19 during the second pandemic wave of COVID-19 in China. METHODS: In this retrospective study, people with SLE and COVID-19 who visited the First Affiliated Hospital of Nanchang University from December 2022 and February 2023 were subjected to this study. The three possible outcomes were listed in order of ordinal severity: (1) not hospitalized, (2) hospitalized but not receiving oxygenation, and (3) hospitalized with any ventilation or oxygenation. A multivariable ordinal logistic regression model was built to examine the association between COVID-19 severity and demographic traits, medications, comorbidities, and disease activity. Furthermore, among the 301 SLE patients included in our study, only two patients experienced mortality. In order to maintain statistical rigor, we have included these two deceased patients in the outcome measure of hospitalized with any ventilation or oxygenation. RESULTS: A total of 301 patients with SLE were enrolled in this study. The multivariate ordinal logistic regression analyses indicated that high SLE disease activity (vs remission; OR 39.04, 95% CI 3.08 to 494.44, p = .005) was associated with more severe outcomes. Three doses of COVID-19 vaccination (OR 0.19, 95% CI 0.07 to 0.51, p = .001), glucocorticoids dose (1-5 mg/day 0.14, 0.03 to 0.73, p = .020, and 6-9 mg/day 0.12, 0.02 to 0.61, p = .010), and more intensive immunosuppression drugs (0.34, 0.12 to 0.97, p = .044) were associated with better outcomes. In age-adjusted and sex-adjusted models, telitacicept (6.66, 1.35 to 32.86, p = .020) and rituximab (7.81, 1.87 to 32.66, p = .005) were associated with more severe outcomes. Hydroxychloroquine (0.47, 0.25 to 0.88, p = .018) was associated with favorable outcomes. CONCLUSION: Different COVID-19 outcomes in people with SLE are mostly driven by COVID-19 vaccination, medications, and activity SLE. More importantly, three doses of COVID-19 vaccination may be associated with better outcomes.

Dynamic changes in cardiac biomarkers in radiotherapy for oesophageal cancer and their correlations with cardiac radiation dosimetry.

Background and purpose: To investigate the dynamic changes in cardiac enzymes, high-sensitivity troponin T (hs-TnT), pro-brain natriuretic peptide (pro-BNP) and left ventricular ejection fraction (LVEF) during radiotherapy (RT) and 6 months after RT for oesophageal squamous cell carcinoma (ESCC) in the middle and lower locations and to analyse the correlations between these indicators and cardiac radiation dosimetry parameters. Methods: For 35 patients with ESCC in the middle and lower locations receiving radical concurrent chemoradiotherapy (cCRT), intensity-modulated RT was performed at 1.8 Gy or 2.0 Gy per day, and the totle dose was 50.4 Gy or 60 Gy. Serum creatine kinase (CK), creatine kinase isoenzyme (CK-MB), lactate dehydrogenase (LDH), alpha-hydroxybutyrate dehydrogenase (α-HBDH), hs-TnT, pro-BNP and LVEF were measured before, during, and at the end of RT and 1, 3 and 6 months after RT, and correlations of these indicators with mean heart dose (MHD) and heart V5-V50 were analysed. Results: hs-TnT during, at the end and 6 months after RT for oesophageal cancer showed increasing trends, however, LVEF showed a downward trend. pro-BNP showed an increasing trend during RT and gradually returned to normal after RT. CK and CK-MB showed decreasing trends during RT and continued until one month after RT and then gradually returned to normal. Compared with the low-dose group (MHD < 2000 cGy), the high-dose group (MHD ≥ 2000 cGy) had larger increases in hs-TnT and pro-BNP, a more significant decrease in LVEF, and a longer recovery time for these indicators. MHD and V35 were positively correlated with dynamic changes in hs-TnT. Conclusions: Cardiac injury caused by cCRT for ESCC in the middle and lower locations led to increased hs-TnT and pro-BNP levels and a decrease in LVEF in the early stage of treatment, effects that were more pronounced in the high-dose group. MHD and V35 may be potential indicators to predict the degree of cardiac damage. hs-TnT and pro-BNP are sensitive indicators reflecting cardiac injury in RT for oesophageal cancer. Continuous dynamic monitoring of these markers can provide a reference for cardiac protection in clinical RT.

Parental self-control facilitates adolescent psychological adjustment sequentially through parents' perceived stress/mindful parenting and adolescent self-control.

Adolescence is a unique developmental period marked with significant changes and challenges. As such, maintaining optimal psychological adjustment is crucial for young people, especially during the COVID-19 pandemic when their adjustment became more challenging. Self-control is a vital ability assisting individuals to navigate difficulties and stay well-adjusted during turbulent times. While the associations between adolescent self-control and adjustment have been well-documented, parental self-control has been considered to play a more fundamental role in adolescent adjustment. However, this consideration has received scant research. Drawing on the intergenerational transmission model of self-regulation, we examined an understudied yet plausible idea that parental self-control facilitates adolescent adjustment through parents' lower levels of perceived stress/better mindful parenting and adolescents' improved self-control. A two-wave survey study, spanning 1 year apart, was conducted among 426 Chinese adolescents (Mage = 11.6 years, 53.5% boys) and their parents. Parents rated their self-control, perceived stress, and mindful parenting at T1, while adolescents rated their self-control and adjustment (i.e., psychological difficulties and life satisfaction) at T1 and T2. The results of chain mediation model showed that after controlling for demographic covariates and baseline levels of adolescent self-control and adjustment, T1 paternal self-control facilitated T2 adolescent adjustment through fathers' lower levels of perceived stress and adolescents' improved self-control. By contrast, T1 maternal self-control facilitated T2 adolescent adjustment through mothers' better mindful parenting and adolescents' improved self-control. These findings advance our understanding of how self-control is transmitted from parents to offspring and clarify the processes of how parental self-control facilitates adolescent adjustment. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Postnatal depressive symptoms mediate the relation between prenatal role overload and responsiveness among first-time mothers.

BACKGROUND: This study examined the association between prenatal role overload and maternal responsiveness, with postnatal depressive symptoms as a mediator. METHODS: Participants were 127 first-time mothers in Hong Kong (M = 32.8, SD = 4.0). Participants completed data collection for self-report on prenatal role overload (Time 1) in the third trimester of pregnancy, postnatal depressive symptoms (Time 2) at 4-month postpartum and maternal responsiveness (Time 3) at 9-month postpartum. The hypothesised mediation model was tested with the Hayes PROCESS macro (model 4). RESULTS: Time 1 prenatal role overload was not directly predictive of later responsiveness (B = -0.06, p = .270). However, the indirect effect of Time 2 postnatal depressive symptoms in the association between Time 1 prenatal role overload and Time 3 responsiveness was significant (unstandardised effect = -0.03, 95% Bootstrapping CI = [-0.081, -0.001]; standardised effect = -0.06, 95% Bootstrapping CI = [-0.152, -0.002]). CONCLUSION: Findings highlighted that more attention is required to the support provided to first-time expectant mothers to prevent role overload, and that intervention for postnatal depressive symptoms may focus on role overload. The findings also highlighted that postnatal depressive symptoms could be a promising way to increase maternal responsiveness.

[Early prediction of severe COVID-19 in patients with Sjögren's syndrome].

OBJECTIVE: To investigate the predictive value of blood cell ratios and inflammatory markers for adverse prognosis in patients with primary Sjögren's syndrome (PSS) combined with coronavirus disease 2019 (COVID-19). METHODS: We retrospectively collected clinical data from 80 patients with PSS and COVID-19 who visited the Rheumatology and Immunology Department of the First Affiliated Hospital of Nanchang University from December 2022 to February 2023. Inclusion criteria were (1) meeting the American College of Rheumatology (ACR) classification criteria for Sjögren's syndrome; (2) confirmed diagnosis of COVID-19 by real-time reverse transcription polymerase chain reaction or antigen testing for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2); (3) availability of necessary clinical data; (4) age > 18 years. According to the clinical classification criteria of the "Diagnosis and Treatment Protocol for Novel Coronavirus Pneumonia (trial the 10th Revised Edition)", the patients were divided into the mild and severe groups. Disease activity in primary Sjögren' s syndrome was assessed using the European League Against Rheumatism (EULAR) Sjögren' s syndrome disease activity index (ESSDAI). Platelet-lymphocyte ratio (PLR), C-reactive protein-lymphocyte ratio (CLR), erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), and other laboratory data were compared between the two groups within 24-72 hours post-infection. RESULTS: The mild group consisted of 66 cases with an average age of (51. 52±13. 16) years, and the severe group consisted of 14 cases with an average age of (52.64±10.20) years. Disease activity, CRP, platelets, PLR, and CLR were significantly higher in the severe group compared with the mild group (P < 0.05). Univariate analysis using age, disease activity, CRP, platelets, PLR, and CLR as independent variables indicated that disease activity, CRP, PLR, and CLR were correlated with the severity of COVID-19 (P < 0.05). Multivariate logistic regression analysis further confirmed that PLR (OR=1.016, P < 0.05) and CLR (OR=1.504, P < 0.05) were independent risk factors for the severity of COVID-19 in the critically ill patients. Receiver operator characteristic (ROC) curve analysis showed that the area under the curve (AUC) for PLR and CLR was 0.708 (95%CI: 0.588-0.828) and 0.725 (95%CI: 0.578-0.871), respectively. The sensitivity for PLR and CLR was 0.429 and 0.803, respectively, while the highest specificity was 0.714 and 0.758, respectively. The optimal cutoff values for PLR and CLR were 166.214 and 0.870, respectively. CONCLUSION: PLR and CLR, particularly the latter, may serve as simple and effective indicators for predicting the prognosis of patients with PSS and COVID-19.

Anxiety and Stress among American, Chinese, Italian, and Russian Emerging Adults: Does Uncertainty Avoidance Matter?

Levels of anxiety and stress vary throughout the lifespan and across cultures. Uncertainty appears particularly relevant during emerging adulthood, thus potentially affecting both stress and anxiety. Uncertainty as a construct was identified by Hofstede (i.e., Uncertainty Avoidance Index, UAI), who defined it as the extent to which members of a culture feel threatened by ambiguous or unknown situations and tend to avoid them. The UAI was considered as a means to understand cultures in addition to the "classic" distinction between collectivist and individualistic cultures. The present study compared levels of anxiety and stress in 1790 university students (18-21 years old) from two individualistic (Italy and the US) and two collectivistic (China and Russia) countries, with a consideration of country UAI levels. Results showed that country-level UAI scores were associated with levels of anxiety and stress, controlling for age and sex. Italian and Russian students reported greater anxiety than American and Chinese ones. Chinese emerging adults reported the lowest stress levels, followed by American, Italian, and Russian students. The study findings provide initial evidence that anxiety and stress in emerging adults are associated with how a culture deals with perceived instability and uncertainty about the future.

Children's Daily Living Routine Mediates the Relations Between Parent-Child Relationships and Child Adjustment Problems During School Suspension in Hong Kong.

Young children's adjustment problems were found to be prevalent during the COVID-19 pandemic. Such adjustment problems may be dependent on children's relationships with their parents and children's daily living routine in the family during the pandemic-related school suspension period. This study examines how children's routine mediated the associations between parent-child relationships and child adjustment problems during the fifth wave of the COVID-19 pandemic in Hong Kong, when schools were suspended. The study collected data from 937 parents (87.8% mothers) of children aged 5-12 (M = 7.35 years, SD = 2.09; 50.5% girls). Parents reported on parent-child relationships, children's daily living routine, and child adjustment problems in an online survey. Our findings from structural equation modeling indicate that parent-child closeness was negatively related to child adjustment problems, whereas conflict was positively related to child adjustment problems. Children's routine mediated the associations between parent-child relationships (i.e., closeness and conflict) and child externalizing problems. However, children's routine did not mediate the associations between parent-child relationships (i.e., closeness and conflict) and child internalizing problems. The findings show that parents should be helped to establish routine, especially in difficult times when young children experience turbulence in their daily life, so as to reduce their adjustment problems, in particular of an externalizing nature.

Beyond intention: Predicting children's COVID-19 vaccine uptake using the theory of planned behavior.

This prospective study tested if parental factors from the theory of planned behavior (TPB) predicted children's uptake of the COVID-19 vaccine and examined whether parents' intention to vaccinate children against COVID-19 would mediate such associations. Participants were 852 Hong Kong parents of 1076 children aged 5-12. At Time 1, parents reported on items measuring the TPB predictors (i.e. attitudes, subjective norms, and perceived behavioral control) and intention. At Time 2 (approximately 4 months after Time 1), parents reported whether their children had received the COVID-19 vaccine. Attitudes, perceived behavioral control, and intention predicted children's actual uptake of the COVID-19 vaccine. Intention mediated the relations between two TPB predictors, namely attitudes and subjective norms, and children's COVID-19 vaccination uptake. The TPB is considered a useful framework in the development of future COVID-19 vaccine programs for children to promote parents' intention and the subsequent uptake of the COVID-19 vaccine among children.

Flourishing and Self-Control in Adolescence: The Role of Perceived Parenting.

Self-control is the ability to control thoughts, emotions, and impulses to pursuit of long-term goals. Adolescents with high self-control experience higher flourishing levels. The latter refers to the fulfillment of needs for competence, relationship, and self-acceptance, as well as the possession of psychological capital such as flow and commitment. High levels of self-control also seem to be linked to a positive relationship with parents, which is crucial in adolescent flourishing. However, few studies investigated the association between flourishing, self-control, and perceived parenting in adolescence. The aim of this study was to investigate how the ability to exert self-control and the need to perceive and preserve a responsive relationship with parents would facilitate adolescents' experience of higher flourishing levels. The relationships among self-control, adolescents' perception of some paternal and maternal dimensions (closeness, communication, and parents' peer approval), and flourishing were analyzed in a sample of 335 Italian adolescents. Self-control was positively correlated with flourishing and the adolescent's perception of maternal and paternal dimensions. The PROCESS model showed that perceived maternal and paternal dimensions mediate the relationship between self-control and flourishing. These findings show the importance of self-control and parenting dimensions in promoting flourishing during adolescence.

Children infected vs. uninfected with COVID-19: Differences in parent reports of the use of mobile phones to calm children, routines, parent-child relationship, and developmental outcomes.

Children were suggested to be at lower risk of developing the severe form of the COVID-19. However, children infected with COVID-19 may be more likely to experience biopsychosocial stressors associated with the pandemic and display poorer developmental outcomes. The current study is among the first to compare children infected and uninfected with COVID-19 on outcomes related to parents' use of mobile phones to calm children, routines, parent-child relationship, externalizing and internalizing problems, prosocial behavior, gratitude, and happiness. A total of 1,187 parents (88.6% mothers) of children aged 5 to 12 completed an online survey between April 2022 and May 2022 when schools were suspended during the 5th wave of resurgence in Hong Kong. Our findings showed no substantial differences in various psychological, social, emotional, and behavioral outcomes between infected and uninfected children. Our findings can be used to educate parents to reduce their fear and anxieties associated with their children's COVID-19 infection. Our findings also suggested that support during the pandemic should be provided to children and families regardless of whether children have been infected with COVID-19.

Moral obligation to follow anti-COVID-19 measures strengthens the mental health cost of pandemic burnout.

BACKGROUND: It has been observed that people become gradually exhausted by receiving COVID-19-related information and adhering to the corresponding preventive measures as the pandemic unfolds. This phenomenon is known as pandemic burnout. Emerging evidence shows that pandemic burnout is related to poor mental health. This study extended the trendy topic by examining the idea that moral obligation, a crucial motivation driving people to follow the preventive measures, would amplify the mental health cost of pandemic burnout. METHODS: Participants were 937 Hong Kong citizens (88 % females, 62.4 % aged 31-40 years). They participated in a cross-sectional online survey reporting on pandemic burnout, moral obligation, and mental health problems (i.e., depressive symptoms, anxiety, and stress). RESULTS: Findings of moderation model analyses showed that higher levels of pandemic burnout and moral obligation were related to more mental health problems. Importantly, the "pandemic burnout-mental health problems" links were moderated by moral obligation, with those who felt more morally obliged to follow the measures reporting poorer mental health than those who felt less morally obliged to do so. LIMITATIONS: The cross-sectional design of the study may constrain the evidence about the directions and causality of the relationships. Participants were only recruited from Hong Kong and females were over-represented, thus limiting the generalizability of the findings. CONCLUSIONS: People who experience pandemic burnout while feeling more morally obliged to follow the anti-COVID-19 measures are at greater risk of mental health problems. They might need more mental health support from medical professionals.

KRAS mutation status between left- and right-sided colorectal cancer: are there any differences in computed tomography?

PURPOSE: To investigate the differences in clinicopathological and imaging features according to KRAS mutation status in left- and right-sided colorectal cancer. METHOD: A total of 157 patients with pathologically proven colorectal cancer and preoperative contrast-enhanced multidetector CT examinations were enrolled. According to the tumor location and KRAS status, they were divided into two groups: the left-sided colorectal cancer (LCC) group (wild type, mutant type) and the right-sided colorectal cancer (RCC) group (wild type, mutant type). Clinicopathological and imaging features were recorded in each group. The imaging observation indicators included short axis diameter (SAD), longitudinal tumor length (LTL), tumor shape, pericolic fat stranding, bowel stenosis, intratumoral low-density range, enhancement pattern, and bowel obstruction. Univariate and multivariate logistic regression analyses were performed to compare the difference in KRAS mutation status between groups. RESULTS: In the LCC group, SAD, tumor shape, degree of pericolic fat stranding, and bowel obstruction were significant indicators for predicting KRAS status (P < 0.05). In the RCC group, CA19-9, SAD, and intratumoral low-density range were significant indicators for predicting KRAS status (P < 0.05.). The area under the curve (AUC) of the combination image indicators in the LCC group was 0.802 [cutoff point 0.372, 95% confidence interval (CI) 0.718-0.888, sensitivity 85.4%, specificity 72.0%]. The AUC in the RCC group was 0.828 (cutoff point 0.647, 95% CI 0.726-0.931, sensitivity 79.5%, specificity 75.0%). CONCLUSION: The CT imaging features associated with KRAS mutation status in the LCC and RCC groups were different. The combination of tumor location and imaging features can help to further improve the predictive value of KRAS status.

Overexpression of regulatory T cells in patients with unexplained recurrent pregnancy loss: friend or foe?

Background: This study aimed to investigate the role of regulatory T cells in patients with unexplained recurrent pregnancy loss (URPL). Methods: We retrospectively analyzed 136 women who had experienced two or more miscarriages before 24 weeks of gestation for no obvious reason from May 2018 to October 2021. The basic clinical data of the patients and expression of lymphocyte subsets such as regulatory T cells (Tregs) and natural killer cells (NKs) by flow cytometry were collected to explore the risk factors of pregnancy outcome in URPL patients. Results: A total of 136 URPL patients were enrolled in this study. Eventually, 50 patients attained clinical pregnancy. The median age was 31.8 ± 4.6 years in patients with clinical pregnancy. The univariate and multivariate logistic regression analyses indicated that Tregs was associated with the pregnancy outcomes of patients with URPL (odds ratio 0.63, 95% confidence interval 0.50-0.80). More importantly, a U-shaped association was found between Tregs and pregnancy outcome (p < 0.001), with either higher or lower Tregs levels adversely affecting pregnancy outcome. Conclusion: Tregs levels that are either too high or too low can harm pregnancy outcomes. It was expected to be a very promising quantitative biomarker for predicting pregnancy outcomes in URPL patients.

Mothers' and fathers' stress and severity of depressive symptoms during the COVID-19 pandemic: actor-partner effects with parental negative emotions as a moderator.

BACKGROUND: In the face of the coronavirus disease 2019 (COVID-19) pandemic, families with young children are bombarded with new challenges and stressors. This study examined the additive and interactive effects of parental stress and negative emotions during COVID-19 on parents' severity of depressive symptoms. METHODS: Participants were 221 Chinese families involving maritally intact mothers and fathers of preschool-aged children. DISCUSSION: Path analysis indicated that mothers' parental stress interacted with their negative emotions, such that their stress was related to their severity of depressive symptoms only when negative emotions were high. By comparison, fathers' stress and negative emotions were additively associated with their severity of depressive symptoms. Supporting the cumulative risk model, parental stress during COVID-19 and negative emotions were linked to parents' severity of depressive symptoms additively or interactively, depending on the gender of the parent. These findings inform practitioners about the relevance of parents' stress and negative emotions to their severity of depressive symptoms during the pandemic.

Visuospatial perspective-taking in social-emotional development: enhancing young children's mind and emotion understanding via block building training.

BACKGROUND: Theory of Mind (ToM) refers to the ability to represent one's own and others' mental states, and emotion understanding involves appropriately comprehending and responding to others' emotional cues in social interactions. Individual differences in mind and emotion understanding have been associated strongly with verbal ability and interaction and, as such, existing training for children's ToM and emotion understanding is mostly language-based. Building on the literature on embodied cognition, this study proposes that mind and emotion understanding could be facilitated by one's visuospatial experience in simulating other's frames of reference. METHODS: This protocol consists of two training studies. Study 1 will examine if visuospatial perspective-taking training promotes ToM and emotion understanding. Participants will consist of 96 4.5-year-olds and will be randomly assigned to one of two training groups: the altercentric block building group (trained to be visuospatial perspective-takers), or the egocentric block building group (no visuospatial perspective-taking is involved). Study 2 will compare the engagement of visuospatial perspective-taking and verbal interaction in the development of mind and emotion understanding. Participants will consist of 120 4.5-year-olds. They will be randomly assigned to one of three training groups: the socialized altercentric block building (both visuospatial perspective-taking and verbal interaction), the parallel altercentric block building (visuospatial perspective-taking only), or the paired dialogic reading (verbal interaction only). CONCLUSIONS: In terms of theoretical implications, the potential causal relationship between visuospatial perspective-taking and ToM and emotion understanding may shed new insights on what underlies the development of mental state understanding. The findings of this study also have practical implications: researchers and educators may popularize visuospatial perspective-taking training in the form of block-building games if it is found to be effective in complementing conventional language-based theory-of-mind training.

Longitudinal association between parental involvement and internet gaming disorder among Chinese adolescents: Consideration of future consequences as a mediator and peer victimization as a moderator.

Background and aims: Internet gaming disorder (IGD) in adolescents is a concerning issue. Positive parenting has been found to protect against adolescent IGD, but the underlying mechanisms await further investigation. As such, this study examined the longitudinal association between parental involvement (PI) - a specific type of positive parenting understudied in the literature of adolescent gaming disorder - and IGD. Moreover, this study also tested consideration of future consequences (CFC) as a mediator and peer victimization (PV) as a moderator. Methods: A two-wave longitudinal research spanning 6 months apart was conducted. Participants were Chinese adolescents (final N = 434; 222 females; Mage = 14.44 years, SD = 1.56). They provided ratings on PI, PV, and IGD at Wave 1, and CFC-immediate, CFC-future, and IGD at Wave 2. Results: Descriptive statistics showed that the prevalence rate of IGD was 10.81% and 9.45% at Waves 1 and 2, respectively. Moreover, results of moderated mediation model found that after controlling for Wave 1 IGD and covariates, Wave 1 PI was associated with Wave 2 IGD via preventing adolescents who had higher levels of PV from developing a tendence of CFC-immediate and via promoting adolescents who had lower levels of PV to develop a tendence of CFC-future. Discussion and Conclusions: Altogether, these results suggest that facilitative ecological systems (e.g., positive parenting and good relationships with peers) and personal strengths (e.g., positive future orientation) jointly contribute to the mitigation of adolescent IGD.