Applying Kumpfer's resilience framework to understand the social adaptation process of the trailing parents in China.

BACKGROUND: Trailing parents, a distinct group emerging from China's rapid social change and urbanization, are experiencing migration in old age, posing challenges for their social adaptation. Existing research has mainly focused on the hardships faced by this group, but few studies have focused on how they cope with change and achieve some degree of successful social adaptation. This study aimed to understand the coping and social adaptation process of trailing parents in China. METHODS: This study used a qualitative research approach. A total of 24 trailing parents were invited to participate in a semi-structured interview and share their experiences and efforts to cope with the many challenges. Kumpfer's resilience framework was used as the theoretical framework for the study design, data collection, and data analysis. RESULTS: This study identified several intra-family and community stressors that trailing parents may face when moving to a new environment and uncovered five key resilience characteristics that may be triggered or fostered in the presence of these stressors, including physical fitness, psychological stability, open-mindedness, learning ability, and nurturing hobbies. Individuals with resilience traits have been observed to engage in positive cognitive processing and transform the new environment. Consistent with Kumpfer's resilience framework, this study revealed the dynamics of the stressors faced by trailing parents in the new environments, the role of resilience characteristics, and the critical influence of social support in shaping the interplay between the individual and the environment that enabled them to adapt positively. CONCLUSIONS: This study highlights the importance of fostering resilience traits and leveraging positive coping mechanisms to facilitate a smoother adaptation process for trailing parents. Meanwhile, there is an urgent need to focus on creating opportunities that strengthen their social support networks.

The value of multimodal ultrasound in diagnosis of cervical lymphadenopathy: can real-time elastography help identify benign and malignant lymph nodes?

Aim: To investigate the multimodal ultrasound(MMUS) features of cervical lymphadenopathy and to assess its value in the differential diagnosis of benign and malignant cervical lymph nodes. Methods: A retrospective analysis of 169 patients with cervical lymph node enlargement who attended Hangzhou Red Cross Hospital from March 2020 to October 2022. All patients underwent conventional ultrasound (CUS), contrast-enhanced ultrasound (CEUS), and real-time elastography (RTE), and were divided into training set and validation set. Univariate analysis was applied to screen out statistically significant parameters, and CUS model and MMUS model were constructed by multifactorial logistic regression analysis. The receiver operator characteristic (ROC) curve was established, and the area under the curve (AUC) was used to compare CUS model with MMUS model to assess the value of MMUS. Results: Of the cervical 169 lymph nodes in 169 patients included in the study. The 169 enrolled patients were divided into a training set (132 patients) and a validation set (37 patients). In the training set, univariate analysis showed statistically significant differences in long diameter/short diameter(L/S), border, margin, hilus, dermal medulla boundary, blood flow type, enhancement mode, enhancement type, and RTE score (all p< 0.05). Multifactor logistic analysis showed that L/S, blood flow type, enhancement mode and enhancement type were correlates of malignant lymph nodes (all p< 0.05). The comparison of AUC demonstrated that the discriminative ability of the MMUS model was superior to using the CUS model, both in the training set(p = 0.004) and validation set (p<0.001). Conclusion: In this study, MMUS shows higher diagnostic efficiency than CUS. Ultrasound features such as L/S, blood flow type, mode of enhancement, type of enhancement are helpful in distinguishing benign and malignant lymphadenopathy. The addition of CEUS can greatly improve the sensitivity and specificity of ultrasonic diagnosis of malignant cervical lymph nodes. RTE score is of limited value in the diagnosis of malignant cervical lymph nodes.

Prevalence, risk factors and multiple outcomes of treatment delay in Chinese patients with schizophrenia.

BACKGROUND: People with schizophrenia often delay treatment. This issue is not fully understood, particularly in low-and middle-income countries. This study aimed to elucidate the prevalence, risk factors and multiple outcomes of treatment delay in schizophrenia in a Chinese metropolis. METHODS: A two-stage whole cluster sampling survey was conducted in Beijing, China in 2020. A total of 1,619 patients with schizophrenia were included. Heterogeneity between groups and the changing trend of treatment delay were presented. Regression modelling methods were used to examine both the risk factors for treatment delay and related outcomes at individual and family levels. RESULTS: The median treatment delay for schizophrenia was 89 days (about 13 weeks). 49.35% surveyed patients delayed treatment for more than three months. Early age of onset, low level of education, living in well developed districts were important risk factors. Treatment delay in schizophrenia was significantly associated with patients' poor medication adherence, comorbidity status and poor social functioning. It also increased the negative impact of the illness on families. CONCLUSIONS: This study accumulated evidence of treatment delay in schizophrenia in China. It occurs even in the metropolis where mental health resources are relatively adequate. Further targeted interventions to raise public awareness should be crucial to reduce treatment delay.

Application of Mycobacterium tuberculosis RNA for the Rapid Diagnosis of Lymph Node Tuberculosis Using Different Specimens.

Purpose: To evaluate the accuracy of Mycobacterium tuberculosis (MTB)-RNA in the rapid diagnosis of lymph node tuberculosis (LNTB). Moreover, the difference in the diagnostic accuracy of MTB-RNA using different specimens was determined. Methods: We included patients with suspected LNTB who met the inclusion criteria and retrospectively analyzed their clinical data. The sensitivity, specificity, positive-predictive value (PPV), negative-predictive value (NPV), and area under the curve (AUC) of MTB-RNA and culture were calculated and its diagnostic accuracy for LNTB was evaluated in comparison with the final clinical diagnosis. Results: Overall, 285 patients were included in the study. The overall sensitivity, specificity, PPV, NPV, and AUC of MTB-RNA were 40.6%, 100.0%, 100.0%, 17.0%, and 0.70, respectively. These values were 30.8%, 100.0%, 100.0%, 16.0%, and 0.65, respectively, for tissue specimens; 34.2%, 100.0%, 100.0%, 24.6%, and 0.67, respectively, for puncture specimens; and 57.14%, 100.0%, 100.0%, 5.3%, and 0.79, respectively, for pus specimens. These values of culture were 24.4%, 100.0%, 100.0%, 13.9%, and 0.62, respectively, for all specimens; 17.6%, 100.0%, 100.0%, 13.8%, and 0.59, respectively, for tissue specimens; 25.3%, 100.0%, 100.0%, 22.4%, and 0.63, respectively, for puncture specimens; and 31.0%, 100.0%, 100.0%, 3.3%, and 0.65, respectively, for pus specimens. Conclusion: The diagnostic efficacy of MTB-RNA for the rapid diagnosis of LNTB was moderate, but its sensitivity was low. The lymph node pus specimens were the most sensitive for MTB-RNA testing, followed by puncture specimens; tissues were the least sensitive. Pus specimens should be preferably obtained in case only this test is to be used for diagnosis.

Large Photomultiplication by Charge-Self-Trapping for High-Response Quantum Dot Infrared Photodetectors.

PbS colloidal quantum dots (CQDs) are emerging as promising candidates for next-generation, low-cost, and high-performance infrared photodetectors. Recently, photomultiplication has been explored to improve the detectivity of CQD infrared photodetectors by doping charge-trapping material into a matrix. However, this relies on remote doping that could influence carrier transfer giving rise to limited photomultiplication. Herein, a charge-self-trapped ZnO layer is prepared by a surface reaction between acid and ZnO. Photogenerated electrons trapped by oxygen vacancy defects at the ZnO surface generate a strong interfacial electrical field and induce large photomultiplication at extremely low bias. A PbS CQD infrared photodiode based on this structure shows a response (R) of 77.0 A·W-1 and specific detectivity of 1.5 × 1011 Jones at 1550 nm under a -0.3 V bias. This self-trapped ZnO layer can be applied to other photodetectors such as perovskite-based devices.

Development and Poverty Dynamics in Severe Mental Illness: A Modified Capability Approach in the Chinese Context.

Albeit poverty reduction has been listed as an overarching objective in many countries' development plans, little is known about how development could shape poverty dynamics in disadvantaged groups. Guided by a modified capability framework, this study aimed to explore the long-term experiences of poverty dynamics in severe mental illness. Semi-structured interviews were carried out with 20 caregivers who provided care for persons with severe mental illness in Chengdu, China. Their perceptions on development, the illness, and social security were addressed. Content analysis was employed to analyze data. Participants experienced an overall improvement of life quality due to changes on urban infrastructure and transformed lifestyle. However, they were more disadvantaged while facing ability-based opportunities. These families were hindered from transferring opportunities into incomes. Negative impacts of the illness were also reflected in multiple stigma and conversion difficulties. Additionally, the high threshold for payment made those inclusive social security policies not inclusive for them. Poverty associated with severe mental illness was unlikely to be alleviated automatically within the process of development. Social isolation and high caregiving burden had aggravated poverty for those disadvantaged families. Poverty alleviation should be closely linked to the improvement in social policies in China.

The added value of S-detect in the diagnostic accuracy of breast masses by senior and junior radiologist groups: a systematic review and meta-analysis.

Background: S-detect is an emerging computer-aided diagnosis (CAD) technique that provides a reference for radiologists to identify breast cancer. Some studies have shown that US (ultrasound) + S-detect can improve the diagnostic accuracy of junior radiologists more than senior radiologists, but the results are inconsistent in various studies. Therefore, this meta-analysis aimed to assess the value of S-detect combined with the US outcomes from senior and junior radiologists for the diagnosis of breast cancer. Methods: We searched the PubMed, Cochrane Library, Embase, Web of Science, and Wanfang databases, China Biology Medicine disc, China National Knowledge Infrastructure (CNKI), and VIP database for trials on the diagnostic accuracy of US + S-detect for the diagnosis of breast masses. The search time frame was from the date of establishment of the database to August 20, 2022. Two researchers independently screened the literature, extracted the information, and evaluated the quality of the included literature using the Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) scale. StataSE 15.1 software was utilized to assess pooled metrics, including sensitivity, specificity, and the area under the curve (AUC). Results: A total of 19 articles with 3,349 patients and 3,895 breast masses were included in this meta-analysis. Of these, seventeen articles evaluated the diagnostic performance of senior radiologists' US + S-detect for breast cancer, while twelve articles reported junior radiologists' diagnostic performance. The risk of bias was primarily attributed to patient selection, flow and timing. In the senior radiologist group, the pooled sensitivity and specificity of US + S-detect were 0.93 [95% confidence interval (CI): 0.89-0.95] and 0.86 (95% CI: 0.80-0.90), respectively, with an AUC of 0.96. As for the junior radiologist group, the pooled sensitivity and specificity of US + S-detect were 0.89 (95% CI: 0.83-0.93) and 0.79 (95% CI: 0.72-0.84), respectively, and the AUC was 0.91. Conclusions: The results of this meta-analysis showed that the pooled sensitivity and the AUC of both the senior and junior radiologist groups were high, with good diagnostic efficacy and high clinical application. However, the results of this study are highly heterogeneous and need to be validated by collecting more high-quality studies and accumulating a larger sample size.

Silicon: quantum dot photovoltage triodes.

Silicon is widespread in modern electronics, but its electronic bandgap prevents the detection of infrared radiation at wavelengths above 1,100 nanometers, which limits its applications in multiple fields such as night vision, health monitoring and space navigation systems. It is therefore of interest to integrate silicon with infrared-sensitive materials to broaden its detection wavelength. Here we demonstrate a photovoltage triode that can use silicon as the emitter but is also sensitive to infrared spectra owing to the heterointegrated quantum dot light absorber. The photovoltage generated at the quantum dot base region, attracting holes from silicon, leads to high responsivity (exceeding 410 A·W-1 with Vbias of -1.5 V), and a widely self-tunable spectral response. Our device has the maximal specific detectivity (4.73 × 1013 Jones with Vbias of -0.4 V) at 1,550 nm among the infrared sensitized silicon detectors, which opens a new path towards infrared and visible imaging in one chip with silicon technology compatibility.

Poverty transitions in severe mental illness: longitudinal analysis of social drift in China, 1994-2015.

BACKGROUND: Although poverty associated with severe mental illness (SMI) has been documented in many studies, little long-term evidence of social drift exists. This study aimed to unravel the poverty transitions among persons with SMI in a fast change community in China. METHODS: Two mental health surveys, using the International Classification of Disease (ICD-10), were conducted in the same six townships of Xinjin county, Chengdu, China in 1994 and 2015. A total of 308 persons with SMI identified in 1994 were followed up in 2015. The profiles of poverty transitions were identified and regression modelling methods were applied to determine the predictive factors of poverty transitions. RESULTS: The poverty rate of persons with SMI increased from 39.9% to 49.4% in 1994 and 2015. A larger proportion of them had fallen into poverty (27.3%) rather than moved out of it (17.8%). Those persons with SMI who had lost work ability, had physical illness and more severe mental disabilities in 1994, as well as those who had experienced negative changes on these factors were more likely to live in persistent poverty or fall into poverty. Higher education level and medical treatment were major protective factors of falling into poverty. CONCLUSIONS: This study shows long-term evidence on the social drift of persons with SMI during the period of rapid social development in China. Further targeted poverty alleviation interventions should be crucial for improving treatment and mental recovery and alleviating poverty related to SMI.

Change of poverty and outcome of persons with severe mental illness in rural China, 1994-2015.

BACKGROUND: It is unknown whether and how poverty influences the long-term outcome of persons with severe mental illness (SMI). AIMS: To explore the change of poverty status in persons with SMI from 1994 to 2015 and examine the impact of poverty status on patients' outcome in rural China. METHOD: Two mental health surveys using identical methods and International Classification of Disease (ICD-10) were conducted in 1994 and 2015 in the same six townships of Xinjin County, Chengdu, China. RESULTS: The annual net income per person was 19.8% and 100.2% higher for the general population than for persons with SMI in 1994 and 2015 respectively. Compared with 1994 (48.2%), persons with SMI in 2015 had significantly higher rates of poor family economic status (

Household poverty in people with severe mental illness in rural China: 1994-2015.

BACKGROUND: Little is known about poverty trends in people with severe mental illness (SMI) over a long time span, especially under conditions of fast socioeconomic development. AIMS: This study aims to unravel changes in household poverty levels among people with SMI in a fast-changing rural community in China. METHOD: Two mental health surveys, using ICD-10, were conducted in the same six townships of Xinjin county, Chengdu, China. A total of 711 and 1042 people with SMI identified in 1994 and 2015, respectively, participated in the study. The Foster-Greer-Thorbecke poverty index was adopted to measure the changes in household poverty. These changes were decomposed into effects of growth and equity using a static decomposition method. Factors associated with household poverty in 1994 and 2015 were examined and compared by regression analyses. RESULTS: The proportion of poor households, as measured by the headcount ratio, increased significantly from 29.8% in 1994 to 39.5% in 2015. Decomposition showed that poverty in households containing people with SMI had worsened because of a redistribution effect. Factors associated with household poverty had also changed during the study period. The patient's age, ability to work and family size were of paramount significance in 2015. CONCLUSIONS: This study shows that the levels of poverty faced by households containing people with SMI has become more pressing with China's fast socioeconomic development. It calls for further integration of mental health recovery and targeted antipoverty interventions for people with SMI as a development priority.

Schizophrenia, social support, caregiving burden and household poverty in rural China.

PURPOSE: Household poverty associated with schizophrenia has been long described. However, the mechanisms by which schizophrenia may have influenced the economic status of a household in rural communities are still unclear. This study aimed to test an integrated model of schizophrenia, social support and caregiving burden on household poverty in a rural community in China. METHODS: A mental health survey using identical methods and ICD-10 was conducted in six townships of Xinjin County (population ≥ 15 years old, n = 152,776), Chengdu, China in 2015. Identified persons with schizophrenia (n = 661) and their caregivers completed a joint questionnaire of sociodemographic information, illness conditions, social support and caregiving burden. Descriptive analysis was applied first to give an overview of the dataset. Then, multivariable regression analyses were conducted to examine the associative factors of social support, caregiving burden and household income. Then, structural equation modeling (SEM) was used to estimate the integrated model of schizophrenia, social support, caregiving burden and household income. RESULTS: Households with patient being female, married, able to work and having better social function were better off. Larger household size, higher social support and lower caregiving burden also had salient association with higher household income. The relationship between schizophrenia and household poverty appeared to be mediated by the impacts of schizophrenia on social support and caregiving burden. CONCLUSION: There was a strong association between schizophrenia and household poverty, in which social support and caregiving burden may had played significant roles on mediating it. More precise poverty alleviation policies and interventions should focus on supporting recovery for persons with schizophrenia, as well as on increasing social support and on reducing family caregiving burden.

Changes in treatment status of patients with severe mental illness in rural China, 1994-2015.

BACKGROUND: Although it is crucial to improve the treatment status of people with severe mental illness (SMI), it is still unknown whether and how socioeconomic development influences their treatment status.AimsTo explore the change in treatment status in people with SMI from 1994 to 2015 in rural China and to examine the factors influencing treatment status in those with SMI. METHOD: Two mental health surveys using identical methods and ICD-10 were conducted in 1994 and 2015 (population ≥15 years old, n = 152 776) in the same six townships of Xinjin County, Chengdu, China. RESULTS: Compared with 1994, individuals with SMI in 2015 had significantly higher rates of poor family economic status, fewer family caregivers, longer duration of illness, later age at first onset and poor mental status. Participants in 2015 had significantly higher rates of never being treated, taking antipsychotic drugs and ever being admitted to hospital, and lower rates of using traditional Chinese medicine or being treated by traditional/spiritual healers. The factors strongly associated with never being treated included worse mental status (symptoms/social functioning), older age, having no family caregivers and poor family economic status. CONCLUSIONS: Socioeconomic development influences the treatment status of people with SMI in contemporary rural China. Relative poverty, having no family caregivers and older age are important factors associated with a worse treatment status. Culture-specific, community-based interventions and targeted poverty-alleviation programmes should be developed to improve the early identification, treatment and recovery of individuals with SMI in rural China.Declaration of interestNone.

An integrative model of internalized stigma and recovery-related outcomes among people diagnosed with schizophrenia in rural China.

PURPOSE: Internalized stigma, an adverse psychological process, severely impedes the lives of people diagnosed with schizophrenia and restricts them from social integration and recovery. The aim of this study was to empirically evaluate an integrative model of relationship between internalized stigma and patients' recovery-related outcomes among people diagnosed with schizophrenia in a rural Chinese community. METHOD: A total of 232 people diagnosed with schizophrenia in Xinjin, Chengdu, participated in this study and completed measures of internalized stigma, social interaction, perceived social support, social functioning, and symptoms. The internalized stigma of mental illness scale (ISMI) was used to measure the internalized stigma. Path analysis was used to test the association between internalized stigma and recovery-related outcomes. RESULTS: There were no significant differences in mean scores of ISMI by gender, age (18-64 years and ≥ 65 years), education, marital status, or economic capacity. Internalized stigma was negatively associated with perceived social support and social interaction. Furthermore, higher level of internalized stigma was associated with impaired social functioning, and a lower level of social functioning was significantly associated with more severe symptoms. CONCLUSION: Internalized stigma is associated with poor social interaction and weakened perceived social support in people diagnosed with schizophrenia, and is linked negatively to outcomes in their recovery. It is essential to tailor interventions related to reducing internalized stigma within a Chinese context and evaluate the effectiveness of anti-stigma intervention on recovery for people diagnosed with schizophrenia.

Duration of untreated psychosis (DUP) and outcome of people with schizophrenia in rural China: 14-year follow-up study.

This study aims to examine the relationship between the duration of untreated psychosis (DUP) and 14-year outcomes of schizophrenia in a Chinese rural area. Participants with schizophrenia (n = 510) were identified in an epidemiological investigation of 123 572 people aged 15 years and older in 1994 and followed up in 2008 in Xinjin, Chengdu, China. Longer DUP (>6 months) was common in participants (27.3%). In 1994, participants with DUP ≤ 6 months were more likely to have a significantly lower rate of suicide attempts, shorter duration of illness and higher rate of full remission compared with those with DUP > 6 months. No significant differences were found regarding the rates of survival, suicide, death due to other causes and homelessness between individuals with shorter and longer DUP in 2008. Nevertheless, longer DUP (>6 months) of participants in 2008 was significantly associated with higher mean of PANSS total negative and general mental scores, longer duration of illness and higher rate of live alone in the logistic regression model. Earlier identification, treatment and rehabilitation, and family intervention should be addressed when developing mental health policies and delivering community mental health services.

Decreasing graphene synthesis temperature by catalytic metal engineering and thermal processing.

Chemical vapor deposition (CVD) from gaseous hydrocarbon sources has shown great promise for large-scale graphene growth, but the high growth temperature, typically 1050 °C, requires precise and expensive equipment and makes the direct deposition of graphene in electronic device manufacturing processes unfeasible due to the severe physical damage to substrates. Here we demonstrate a facile route to synthesize graphene by catalytic metal engineering and thermal processing. The engineered catalytic metal (copper) with carbon implantation could lower the synthetic temperature to 700 °C. And the resulting graphene shows few defects, uniform morphology and high carrier mobility, comparable to CVD graphene grown at 1050 °C. This technique could expand the applications of graphene in electronic and optoelectronic device manufacturing and is compatible with conventional microelectronics technology.

Family history of psychosis and outcome of people with schizophrenia in rural China: 14-year follow-up study.

OBJECTIVE: This study examined the differences in 14-year outcomes of persons with schizophrenia with and without family history of psychosis in a rural community in China. METHODS: All participants with schizophrenia (n=510) aged 15 years and older were identified in a 1994 epidemiological investigation of 123,572 people and followed up in 2004 and 2008 in Xinjin County, Chengdu, China. RESULTS: Individuals with positive family history of schizophrenia had significantly younger age of first onset than those with negative family history of schizophrenia in 1994 and 2004. Compared with individuals with negative family history of schizophrenia, those with positive family history of schizophrenia had significantly higher rate of homelessness and lower rate of death due to other reasons in 10-year (2004) and 14-year follow-up (2008). There were no significantly differences of mean scores on PANSS, SDSS and GAF in 2008 between positive and negative family history groups. CONCLUSIONS: The positive family history of schizophrenia is strongly related to younger age of onset, and may predict a poorer long-term outcome (e.g., higher rate of homelessness) in persons with schizophrenia in the rural community. The findings have implications for further studies on specific family-related mechanisms on clinical treatment and rehabilitation, as well as for planning and delivering of community-based mental health services.

Controlled direct growth of Al2O3-doped HfO2 films on graphene by H2O-based atomic layer deposition.

Graphene has been drawing worldwide attention since its discovery in 2004. In order to realize graphene-based devices, thin, uniform-coverage and pinhole-free dielectric films with high permittivity on top of graphene are required. Here we report the direct growth of Al2O3-doped HfO2 films onto graphene by H2O-based atom layer deposition (ALD). Al2O3-onto-HfO2 stacks benefited the doping of Al2O3 into HfO2 matrices more than HfO2-onto-Al2O3 stacks did due to the micro-molecular property of Al2O3 and the high chemical activity of trimethylaluminum (TMA). Al2O3 acted as a network modifier, maintained the amorphous structure of the film even to 800 °C, and made the film smooth with a root mean square (RMS) roughness of 0.8 nm, comparable to the surface of pristine graphene. The capacitance and the relative permittivity of Al2O3-onto-HfO2 stacks were up to 1.18 µF cm(-2) and 12, respectively, indicating the high quality of Al2O3-doped HfO2 films on graphene. Moreover, the growth process of Al2O3-doped HfO2 films introduced no detective defects into graphene confirmed by Raman measurements.

Improvement of Al2O3 films on graphene grown by atomic layer deposition with pre-H2O treatment.

We improve the surface of graphene by atomic layer deposition (ALD) without the assistance of a transition layer or surface functionalization. By controlling gas-solid physical adsorption between water molecules and graphene through the optimization of pre-H2O treatment and two-step temperature growth, we directly grew uniform and compact Al2O3 films onto graphene by ALD. Al2O3 films, deposited with 4-cycle pre-H2O treatment and 100-200 °C two-step growing process, presented a relative permittivity of 7.2 and a breakdown critical electrical field of 9 MV/cm. Moreover, the deposition of Al2O3 did not introduce any detective defects or disorders in graphene.