Family quality of life of parents of children with intellectual disability: Do psychological stress and parental involvement matter?

Background: The psychological stress of parents and improving family quality of life (FQoL) are continuing concerns for families of children with intellectual disability. We need to identify further ways to reduce their stress and improve their FQoL in China. Method: Examine the interrelations between psychological stress, parental involvement, and FQoL for parents with intellectual disability in mainland China. 467 parents of children with intellectual disability completed instruments measuring variables. Structural equation modelling (SEM) was employed to examine the interrelations. Results: Psychological stress, directly and indirectly, influenced parental involvement in FQoL. Physical and mental response (PMR) and risk awareness (RA) had a positive direct effect on FQoL, and optimistic hope (OH) had a negative effect on FQoL. Conclusions: Psychological stress affects FQoL of parents with children with intellectual disability in complex ways. Policies should be developed to help parents with children with disability decrease stress and develop scientific parental involvement.

Multi-scale structural disruption induced by radio frequency air cold plasma accelerates enzymatic hydrolysis/ hydroxypropylation of tapioca starch.

This study investigated the effects of radio frequency air cold plasma (RFACP) pretreatment on the multi-scale structures, physicochemical properties, enzymatic hydrolysis, and hydroxypropylation of tapioca starch. The results showed that cold plasma (CP) made starch granules rough on the surface and disrupted long- and short-range ordered structures, reducing relative crystallinity from 43.8 % to 37.4 % and R1047/1022 value from 0.992 to 0.934. Meanwhile, the starch molecules were depolymerized and oxidized by CP, reducing weight-average molecular weight from 9.64 × 107 to 2.17 × 107 g/mol, while increasing carbonyl and carboxyl groups by up to 118 % and 53 %. Additionally, CP-treated starches exhibited higher solubility and swelling power, along with lower gelatinization enthalpy. Short-time CP pretreatment (10 min) promoted the hydroxypropylation of starch and increased the molar substitution (0.081-0.112). Also, CP pretreatment accelerated enzymatic hydrolysis of starch, as indicated by the increase in hydrolysis rate (1.846 × 10-3-2.033 × 10-3 min-1) and degree of hydrolysis (51.45 % - 59.92 %). Overall, the multi-scale structural disruption induced by CP treatment facilitated the accessibility of enzymes/chemical reagents into starch granules and glucan chains. This study suggested that RFACP could be used for starch pretreatment to increase production efficiency in modified starch production, as well as in brewing and fermentation industries.

Insight into the spatial distribution and interaction model of heat-induced micro- and nano-starch/myofibrillar protein blends.

This work investigated the gelatinizing and hydration properties of raw and milled tapioca starches at micron and nano scale as well as their effects on gelation of myofibrillar proteins (MP) from Ctenopharyngodon idellus by analyzing rheology, texture and microstructure of heat-induced MP/starch blends. Milling induced starch granules damage to micron and nano scale, causing a fall in starch swelling power and a jump in water solubility. Among raw and milled starches, nano-starch had the best reinforcement effect on MP gel, i.e., MP/nano-starch showed the lowest critical gel concentration, highest G', strongest resistance to deformation and highest texture performance. Correlation analysis revealed that starch water solubility was responsible for the reinforced MP gel rather than starch swelling power. A schematic model was proposed for illustrating the interaction of starches and MP. All the blends had the ordered filamentous network as the basic skeleton, with some starches (granules and their fragments) in the voids or on the edge or surface of MP filaments as inert fillers, and some (chain segments) embedded in the filaments as active fillers. Almost all nano-starch were actively filled into the MP filaments to enhance the strength of filaments, thus achieving the best reinforcement effect on MP gel.

Different oil-modified cross-linked starches: In vitro digestibility and its relationship with their structural and rheological characteristics.

This study investigated the structure, rheological behaviors and in vitro digestibility of oil-modified cross-linked starches (Oil-CTS). Gelatinized Oil-CTS were hard to be digested due to its intact granule shapes and the presence of surface-oil, which acted as physical barriers that inhibited the diffusion and penetration of enzymes to starch. Besides, the less amylose content in Oil-CTS (23.19-26.96%) than other starches (26.84-29.20%) contributed to its low digestibility because amylose with less α-1,6 linkages was more easily attacked by amyloglucosidase than amylopectin. Moreover, heat treatment during oil could shorten the amylopectin chain length and destroy the ordered structures, thus increasing enzymatic hydrolysis on starch. Pearson correlation analysis indicated rheological parameters were not significantly correlated with digestion parameters (p > 0.05). Overall, despite the damage caused by heat to molecular structures, physical barrier effect caused by surface-oil layers and integrity of swollen granules was the most critical contributor to the low digestibility of Oil-CTS.

Effect of oil-modified crosslinked starch as a new fat replacer on gel properties, water distribution, and microstructures of pork meat batter.

This work investigated the effects of oil-modified crosslinked starch (Oil-CTS) as a fat replacer on the gel properties, water distribution, microstructures, and fatty acid composition of pork meat batter. Results showed that the replacement of pork back fat by Oil-CTS could improve the gel performance in terms of rheological property, texture, and water-holding capacity (WHC), and reduce the water mobility of pork meat gels, which caused by the formation of a more ordered and denser protein network structure. Additionally, when the fat was replaced by Oil-CTS partially or totally (25-100 %), the total fat content in pork meat gels decreased by 16.5-82 % and the saturated fatty acids (SFAs) content decreased from 5.87 g/100 g in untreated sample to 1.17-4.88 g/100 g in starch-replacing-fat samples, indicating Oil-CTS could be used as a fat replacer to prepare the low-fat meat products.

Effect of oil modification on the multiscale structure and gelatinization properties of crosslinked starch and their relationship with the texture and microstructure of surimi/starch composite gels.

This work investigated the multiscale structure and gelatinization properties of different oil-modified crosslinked starches and their relationship with the texture and microstructure of surimi/starch composite gels. The results showed clusters were formed by the agglomeration of starch, with oil on the surface of granules. Oil modification did not damage the long-range crystalline structure but impaired the short-range ordered structure. A high oil modification degree was shown to weaken starch structure, in contrast to an adverse effect for a high crosslinking level. Furthermore, compared with crosslinked starches, Oil-CTS had lower pasting temperature and gelatinization enthalpy, a higher viscosity, and better gel-reinforcing effect. Correlation analysis revealed the texture of surimi/starch composite gels was negatively correlated with the helical structure and pasting temperature of starch, and positively correlated with final and setback viscosity of starch and the swollen size of starch granules in surimi gel.

Effects of wet-media milling on multi-scale structures and in vitro digestion of tapioca starch and the structure-digestion relationship.

This work aims to understand the relation between multi-scale structural changes and in vitro digestion of tapioca starch modified by wet-media milling. The native starch granules were smooth and difficult to digest due to the hindrance of enzymes entry into the granules by the concentric shell architecture. However, 1-min milling could break the smooth surface of starch granules, weakening shell architecture and increasing k1 (digestion rate). Moreover, 5-15-min milling could greatly disrupt the short-range ordered structure and transform it into the amorphous phase to enhance k1. The increase of milling time to 30-420 min mainly interrupted the glycosidic bonds of the amorphous phase, allowing the production of amylose and amylopectin fragments, achieving continuous increase of k1. Despite the increasingly severe damage caused by milling to multi-scale structures, the disruption of shell barrier on the starch surface was the most critical for digestion, followed by short-range ordered structure breakage.

Effect of micro- and nano-starch on the gel properties, microstructure and water mobility of myofibrillar protein from grass carp.

This work evaluated the effect of micro- and nano-starch (MS and NS) on the gel properties of fish myofibrillar protein (MP). Both MS and NS could enhance MP gel performance in terms of breaking force, elasticity and water holding capacity (p < 0.05), with more significant effect from NS than MS. The difference between NS and MS in enhancement effect on MP gel is due to nano-size effect and different microstructures of MP/MS and MP/NS gels, with NS rather than MS contributing to the continuity of MP network. Synchrotron FTIR micro-spectroscopic images further verified that NS with large specific surface had good compatibility with MP, while MS was embedded in MP matrix with evident phase separation. Additionally, ß-sheet still dominated the secondary structure of all gels, although adding both MS and NS could change molecular interactions, such as weakening ionic bonds and hydrogen bonds, and strengthening hydrophobic interactions.

Mutagenicity risk prediction of PAH and derivative mixtures by in silico simulations oriented from CYP compound I-mediated metabolic activation.

PAHs and their derivatives are the main sources of mutagenicity and carcinogenicity in airborne particular matter and cause serious public health and environmental problems. Risk assessment is challenging due to the mixed nature and deficiency of toxicity data of most PAHs and their derivatives. Cytochrome P450 enzymes (CYPs) play important roles in PAH-induced carcinogenicity via metabolic activation, and CYP conformations with compound I structures strongly influence metabolic sites and metabolite species. In this study, complexes of BaP with CYP1A1, CYP1B1 or CYP2C19 compound I were successfully simulated by QM/MM methods and verified by metabolic clearance, and the mutagenicity of chemicals was then predicted by the BaP-7,8-epoxide-related metabolic conformation fitness (MCF) approach, which was validated by Ames tests, showing satisfying accuracy (R2 = 0.46-0.66). Furthermore, a prediction model of the mutagenicity risk of PAH and derivative mixtures was established based on the relative potential factor (RPF) approach and the RPF calculated from the mathematical relationship between the minimum MCF (MCFmin) and RPF, which was successfully validated by the mutagenesis of PAH and derivative mixture mimic-simulating PM2.5 samples collected in eastern China. This study provides fast reliable tools for assessing risk of the complex components of environmental PAHs and their derivatives.

Decreased numbers and sex-based differences of circulating regulatory T cells in patients with seropositive undifferentiated arthritis.

AIMS: CD4+ T cells play crucial roles as both mediators and regulators of the pathogenesis of rheumatoid arthritis (RA). However, the characteristics of CD4+ T cell subpopulations in the earliest stage of RA development remain unclear. Hence, we determined the proportions and absolute counts of circulating CD4+ T cell subsets in patients with seropositive undifferentiated arthritis (SUA), the early and preclinical stage of RA. METHODS: Peripheral blood samples and clinical information were collected from 177 patients with SUA, 104 patients with RA, and 120 healthy controls. All patients were newly diagnosed and untreated. Proportions and absolute counts of CD4+ T cell subpopulations were determined by flow cytometric analysis. RESULTS: In patients with SUA, percentages and absolute counts of circulating regulatory T (Treg) cells were decreased significantly and Th17/Treg cell ratios were abnormally increased, whereas Th17 cell numbers were similar to those in healthy controls. In addition, sex-based differences in circulating Treg cells were observed, with female SUA patients having lower proportions and absolute counts of Treg cells than those in males. Moreover, female patients with SUA had higher erythrocyte sedimentation rates and 28-joint Disease Activity Scores than those in males. CONCLUSION: Immune tolerance deficiency resulting from an abnormal reduction in circulating Treg cells might be the most crucial immunological event in the earliest stage of RA. The sex-specific disparity in Treg cells should also be considered for immunoregulatory and preventive strategies targeting early RA.

The Adaptation of Older Adults' Transition to Nursing Homes in Mainland China: A Qualitative Study.

Introduction: An increasing number of older adults have moved to nursing homes in China. This study was to explore the adaptation of older adults' transition to nursing homes in mainland China. Method: A qualitative study was conducted in two nursing homes in Nanjing, China. Data were collected from 11 residents and 5 staff members through purposeful sampling with semistructured interviews, and content analysis was performed. Results: Three themes were identified: Chinese culture, policy, and adaptation (staying modest and prudent, feeling shy to speak with males, familism suppressing the inner voice, and the new policy "combination of medical service and care" bringing benefits); the adaptation to nursing homes (poor quality of sleep and catering, relationship development, and emotional reactions); and needs of residents (emotional support, more interactions, and self-realization). Discussion: Health care providers consider cultural assessments. Further work is expected to develop programs that help older adults adjust to nursing homes.

The factors of adaptation to nursing homes in mainland China: a cross-sectional study.

BACKGROUND: China is one of the most rapidly ageing countries and has the largest ageing population in the world. The demand for long-term care is increasing. Nursing home placement is one of the most stressful events in a person's life. Although research on relocation adjustment has been conducted in many countries, few studies have been related to the predictors of nursing home adjustment in mainland China. This study aimed to identify the predictors of nursing home adjustment in the context of filial piety in mainland China. METHODS: This was a descriptive study that employed a cross-sectional survey. A total of 303 residents from 22 nursing homes in Nanjing, China, were recruited. A structured questionnaire about residents' characteristics, activities of daily living, social support, resilience, and nursing home adjustment was administered. Multiple linear regression was used to identify the predictors of adaptation to nursing homes. RESULTS: The predictors of nursing home adjustment were the satisfaction with services(ß = .158, P < .01), number of diseases(ß = -.091, P < .05), length of stay(ß = .088, P < .05), knowledge of the purpose of admission (ß = .092, P < .05), resilience(ß = .483, P < .001) and social support(ß = .186, P < .001). The total explained variance for this model was 61.6%. CONCLUSION: Nursing staff members should assess the characteristics of residents to promote their better adjustment. Resilience had the most significant influence on the level of adaptation, which has been the primary focus of interventions to improve adjustment. The management of disease comorbidities in nursing homes should be standardized and supervised by the government. More volunteers from universities and communities should be encouraged to provide social support to residents. Moreover, a caring culture needs to be emphasized, and the value of filial piety should be advocated in nursing homes of East Asian countries.

Acetylation promotes BCAT2 degradation to suppress BCAA catabolism and pancreatic cancer growth.

Pancreatic ductal adenocarcinoma (PDAC) is well-known for inefficient early diagnosis, with most patients diagnosed at advanced stages. Increasing evidence indicates that elevated plasma levels of branched-chain amino acids (BCAAs) are associated with an increased risk of pancreatic cancer. Branched-chain amino acid transaminase 2 (BCAT2) is an important enzyme in BCAA catabolism that reversibly catalyzes the initial step of BCAA degradation to branched-chain acyl-CoA. Here, we show that BCAT2 is acetylated at lysine 44 (K44), an evolutionarily conserved residue. BCAT2 acetylation leads to its degradation through the ubiquitin-proteasome pathway and is stimulated in response to BCAA deprivation. cAMP-responsive element-binding (CREB)-binding protein (CBP) and SIRT4 are the acetyltransferase and deacetylase for BCAT2, respectively. CBP and SIRT4 bind to BCAT2 and control the K44 acetylation level in response to BCAA availability. More importantly, the K44R mutant promotes BCAA catabolism, cell proliferation, and pancreatic tumor growth. Collectively, the data from our study reveal a previously unknown regulatory mechanism of BCAT2 in PDAC and provide a potential therapeutic target for PDAC treatment.

CYP2A13 Acts as the Main Metabolic CYP450s Enzyme for Activating Leonurine in Human Bronchial Epithelial Cells.

BACKGROUND Leonurine is an active component of the traditional Chinese medicine Leonurus japonicus. This study aimed to investigate the effects of overexpressed CYP450s on the metabolic activity of leonurine. MATERIAL AND METHODS BEAS-2B cells stably expressing CYP1A1, 1A2, 2A13, 2B6, and 3A4 were constructed. CYP450s expression was identified using reverse-transcription PCR and Western blot assay. CCK-8 assay was used to evaluate the effect of leonurine on cell activity. Leonurine was incubated in vitro with CYP1A1, 1A2, 2A13, 2B6, and 3A4 metabolic enzymes to evaluate the clearance rate of CYP450 enzymes for leonurine. UPLC-MS was used to detect changes of drug concentration and discover the main metabolic enzymes affecting leonurine. RESULTS BEAS-2B cells stably expressing CYP1A1, 1A2, 2A13, 2B6, and 3A4 were successfully constructed. According to primary mass spectra and secondary mass spectra of leonurine, the main metabolic enzymes were 312.1550 [H+] and 181.0484. Compared to the control group, residue of leonurine in CYP2A13 group was significantly reduced (F=5.307, p=0.024). Compared to the 0-min group, the clearance rate of leonurine in the CYP2A13-treated group was significantly decreased at 120 min after treatment (F=7.273, p=0.007). CCK-8 results also showed that activity of BEAS-2B cells that overexpress CYP2A13 gradually decreased with increased concentration of leonurine. Although CYP2A13 demonstrated good metabolic activity for leonurine, we found that CYP1A1, 1A2, 2B6, and 3A4 had no metabolic effects on leonurine. CONCLUSIONS Leonurine can be effectively activated through CYP2A13 enzyme metabolism, and further inhibits activity of human lung epithelial cells (BEAS-2B). Therefore, CYP2A13 is a main metabolic enzyme for leonurine in BEAS-2B cells.

Burden and depression in caregivers of patients with rheumatoid arthritis in China.

AIM: Caregivers of patients with rheumatoid arthritis (RA) often experience a sense of burden and depression. This study aimed to determine the degree of burden and depression on caregivers of RA patients and identify characteristics of both patients and caregivers that may contribute to that distress. METHODS: A convenience sample of 195 patients with RA and their caregivers completed a demographic questionnaire, Zarit Care Burden Scale, Center Depression Self Rating Scale, Health Assessment Questionnaire Disability Index, and the Short Form Health Survey. Univariate and multivariate regression analysis were used to evaluate contributing factors. RESULTS: Overall, caregivers' feelings of burden and depression were moderate, with 52 (26.7%) feeling depression and 156 (80%) feeling burdened. Caregivers with poorer health (OR = 4.393; 95% CI = 1.155-16.708; P = 0.030) and less education (OR = 6.458; 95% CI = 1.675-24.895; P = 0.007) experienced greater burdens than those with better health and more education. The greatest degree of stress occurred during the first 6 months of providing care and after 5 years of caregiving. CONCLUSIONS: Overall occurrence of depression among caregivers is low. Caregivers with poorer health, less education and closer relationship with the patient bear a heavier burden. Healthcare professionals should be aware of these potential problems and provide information and support to ensure the best quality of life for both RA patients and their caregivers.

Variation of polycyclic aromatic hydrocarbons in atmospheric PM2.5 during winter haze period around 2014 Chinese Spring Festival at Nanjing: Insights of source changes, air mass direction and firework particle injection.

Daily PM2.5 samples were collected at a suburban site of Nanjing around 2014 Chinese Spring Festival (SF) and analyzed for 18 kinds of polycyclic aromatic hydrocarbons (PAHs) by GC-MS. Comparison of PAH concentrations during different periods, with different air mass origins and under different pollution situations was done. Sources were analyzed by diagnostics ratios and principal component analysis (PCA). The threat of PAHs was assessed by BaP equivalent concentrations (BaPeq) and incremental lifetime cancer risk (ILCR). The averaged PAHs for pre-SF, SF and after SF periods were 50.6, 17.2 and 29 ng m(-3), indicating the variations of PAH sources, with reduced traffic, industrial and construction activities during SF and gradually re-starting of them after-SF. According to PAH mass concentrations, their relative abundance to particles, ratio of PAHs (3-ring+4-ring)/PAHs(5-ring+6-ring), mass concentrations of combustion-derived and carcinogenic PAHs, fireworks burning is an important source for PAHs during SF. The ILCR values for Chinese New Year day were 0.68 and 3.3 per 100,000 exposed children and adults. It suggested the necessity of controlling fireworks burning during Chinese SF period which was always companied with serious regional haze pollution. PAH concentrations exhibited decreasing trend when air masses coming from the following directions as North China Plain (63.9 ng m(-3))>Central China (53.0 ng m(-3))>Shandong Peninsula (46.6 ng m(-3))>Northwest China (18.8 ng m(-3))>Sea (15.8 ng m(-3)). For different pollution situations, they decreased as haze (44.5 ng m(-3))>fog-haze (28.4 ng m(-3))>clear (12.2 ng m(-3))>fog day (9.2 ng m(-3)). Coal combustion, traffic emission, industrial processes and petroleum (only for non-SF holiday periodss) were the main sources of PM2.5 associated PAHs. Fireworks burning contributed 14.0% of PAHs during SF period. Directly measurement of PAHs from fireworks burning is urgently needed for source apportionment studies in the future.