Maternal depressive symptoms are a crucial risk factor for children’s internalizing problems, though positive mother–child relationships may buffer this risk transmission. Mother–child physiological coregulation (e.g., synchrony) has emerged as a potentially important mechanism of developmental psychopathology and may play a role in the transmission of internalizing symptoms. In this two-wave longitudinal study, we examined whether and how mother–infant physiological synchrony (of respiratory sinus arrhythmia; RSA) moderated the association between maternal postnatal depressive symptoms and children’s internalizing problems in a rural, low-SES community sample (N = 166 dyads). At 6 months, mother–infant RSA synchrony and infant negative affect were assessed during free play. Mother reported their depressive symptoms at 6 months and children’s internalizing problems at 24 months. Multilevel structural equation models indicated that mother–infant dyads demonstrated significant and positive RSA synchrony on average and RSA synchrony significantly moderated the association between maternal depressive symptoms and children’s internalizing problems even after controlling for infant negative affect. Greater maternal depressive symptoms were associated with higher child internalizing problems when RSA synchrony was lower but not when it was higher. This finding suggests that mother–infant RSA synchrony may operate as a resilience factor for the intergenerational transmission of internalizing symptoms in community samples.

Cancer is among the leading causes of death in the world, with about 10 million deaths, one in every six deaths, related to cancer in 2020. In Taiwan, cancer insurance is the most popular commercial health product. However, the loss ratio of cancer products increases with policy year and exceeds 100% in many insurance companies. In addition, almost all cancer benefits are significantly limited in order to avoid financial insolvency. In this study, we evaluate the risk of cancer insurance from the perspective of morbidity compression. We use the data from Taiwan's National Health Insurance Research Database. Also, we apply the standardized mortality ratio and the Lee-Carter model to estimate the trend of cancer-related values. We find that cancer incidence rates gradually increase with time, which indicates that the assumption of morbidity compression is violated. On the other hand, the mortality rates of cancer patients decrease significantly annually. Thus, length of life with cancer increases, and so does the cancer insurance premium. We suggest that cancer insurance covers only the first five years of medical expenditure after the insured is diagnosed with cancer.

Coupling of clearance joint and harsh aerodynamic heating environment is an inevitable nonlinear factor in folding mechanism of the fin of high-speed aircrafts that remarkably modifies natural frequencies and modes of vibration from the initial design state. However, accurately predicting dynamic properties of deployable fin with full consideration of these effects is not common industry practice. A practical semi-analytical model based on Hertz contact theory and ESDU-78035 model is proposed in this study to investigate high-temperature connection stiffness of local hinged–locked mechanisms. Material property degradation and clearance variation caused by thermal expansion are comprehensively considered and quantified in this model. Vibration characteristics of the assembled deployable fin are then solved using finite element method (FEM). The real-time evolutionary process of thermal mode of the fin is discussed. And natural frequencies of fixed-value and time-varying connection stiffness are compared. The simulation results of this study demonstrate that the relative error of structure temperature between the sequential approach and fully coupled simulations is less than 6.98%. The connection stiffness (slope of the load-displacement curve) of the folding mechanism under high temperature conditions decreases by 3.52%, and the variation is mainly caused by the degradation of the elastic modulus of the material, while the clearance change due to the thermal expansion has no significant effect on the slope. The natural frequency of the deployable fin exhibits an inverse correlation with the temperature change trend, and the first three frequencies decrease by 1.67, 7.75, and 16.28 Hz compared to the initial value, respectively.

We examined the effect of an antimicrobial stewardship program (ASP), procalcitonin testing and rapid blood-culture identification on hospital mortality in a prospective quality improvement project in critically ill septic adults. Secondarily, we have reported antimicrobial guideline concordance, acceptance of ASP interventions, and antimicrobial and health-resource utilization.

Light has a substantial effect on the behaviour and physiology of nocturnal moths. Ectropis grisescens is a major nocturnal tea pest in China, and light traps are commonly used to control geometrid moths because of their positive phototaxis. However, some moths gather around light traps and enter the light adaptation state, which decreases the efficacy of light traps in controlling this pest. We identified opsin genes and the spectral sensitivities of the photoreceptors of E. grisescens moths. We also determined the effects of several monochromatic lights on opsin gene expression and light adaptation. We detected three types of opsin genes and six spectral sensitive peaks (at 370, 390, 480, 530, 550, and 580 nm). We also observed significant changes in the diurnal rhythm of opsin gene expression under different light conditions. When active males were suddenly exposed to different monochromatic lights, they quickly entered the light adaptation state, and the adaptation time was negatively correlated with the light intensity. Males were most sensitive to 390 nm wavelengths, followed by 544 nm, 457 nm, and 593 nm. Red light (627 nm) did not affect the activity of E. grisescens males but had detectable physiological effects.

Candidemia is a life-threatening infectious disease that has varying incidences. Previous studies revealed the differences in clinical characteristics and outcomes between non-hospital-onset (NHO) and hospital-onset (HO) candidemia. This 4-year retrospective research included adult patients with candidemia in a tertiary medical centre in Taiwan, and cases were categorised as NHO and HO candidemia. Survival analysis and risk factors associated with in-hospital mortality were performed using the Kaplan–Meier method and multivariate Cox proportional-hazards models. The analysis included 339 patients, and the overall incidence was 1.50 per 1,000 admission person-year. Of the cases, 82 (24.18%) were NHO candidemia, and 57.52% (195/339) of patients were diagnosed with at least one malignancy. C. albicans was the most commonly isolated species, accounting for 52.21%. Patients with NHO candidemia had a higher proportion of C. glabrata but a lower ratio of C. tropicalis in comparison to the HO group. The all-cause in-hospital mortality rate was 55.75%. Multivariate Cox proportional-hazards models showed that NHO candidemia was a better outcome predictor (adjusted hazard ratio, 0.44). The administration of antifungal therapy within 2 days was a protective factor. In conclusion, NHO candidemia showed distinct microbiological characteristics and a better outcome than HO candidemia.

This study aims to understand the epidemiological characteristics of SARS-CoV-2 infection in the paediatric population during the outbreak of the Omicron variant in Shanghai. We retrospectively analysed the population-based epidemiological characteristics and clinical outcome of SARS-CoV-2 Omicron variant infection in children in Minhang District, Shanghai, based on the citywide surveillance system during the outbreak period in 2022 (March to May). During this time, a total of 63,969 cases of SARS-CoV-2 infection were notified in Minhang District, out of which 4,652 (7.3%) were children and adolescents <18 years. The incidence rate of SARS-CoV-2 infections in children was 153 per 10,000. Of all paediatric cases, 50% reported to be clinically symptomatic within 1–3 days after PCR confirmation by parents or themselves, with 36.3% and 18.9% of paediatric cases reporting fever and cough. Also, 58.4% of paediatric cases had received at least one dose of the COVID-19 vaccine and 52.1% had received two doses of the COVID-19 vaccination. Our findings are informative for the implementation of appropriate measures to protect children from the threat of SARS-CoV-2 infection.

OBJECTIVES/GOALS: The goal of this study was to develop a clinically applicable technique to increase the precision of in vivo dose monitoring during radiation therapy by mapping the dose deposition and resolving the temporal dose accumulation while the treatment is being delivered in real time. METHODS/STUDY POPULATION: Ironizing radiation acoustic imaging (iRAI) is a novel imaging concept with the potential to map the delivered radiation dose on anatomic structure in real time during external beam radiation therapy without interrupting the clinical workflow. The iRAI system consisted of a custom-designed two-dimensional (2D) matrix transducer array with integrated preamplifier array, driven by a clinic-ready ultrasound imaging platform. The feasibility of iRAI volumetric imaging in mapping dose delivery and real-time monitoring of temporal dose accumulation in a clinical treatment plan were investigated with a phantom, a rabbit model, and a cancer patient. RESULTS/ANTICIPATED RESULTS: The total dose deposition and temporal dose accumulation in 3D space of a clinical C-shape treatment plan in a targeted region were first imaged and optimized in a phantom. Then, semi-quantitative iRAI measurements were achieved in an in vivo rabbit model. Finally, for the first time, real-time visualization of radiation dose delivered deep in a patient with liver metastases was performed with a clinical linear accelerator. These studies demonstrate the potential of iRAI to monitor and quantify the radiation dose deposition during treatment. DISCUSSION/SIGNIFICANCE: Described here is the pioneering role of an iRAI system in mapping the 3D radiation dose deposition of a complex clinical radiotherapy treatment plan. iRAI offers a cost-effective and practical solution for real-time visualization of 3D radiation dose delivery, potentially leading to personalized radiotherapy with optimal efficacy and safety.

According to the public data collected from the Health Commission of Gansu Province, China, regarding the COVID-19 pandemic during the summer epidemic cycle in 2022, the epidemiological analysis showed that the pandemic spread stability and the symptom rate (the number of confirmed cases divided by the sum of the number of asymptomatic cases and the number of confirmed cases) of COVID-19 were different among 3 main epidemic regions, Lanzhou, Linxia, and Gannan; both the symptom rate and the daily instantaneous symptom rate (daily number of confirmed cases divided by the sum of daily number of asymptomatic cases and daily number of confirmed cases) in Lanzhou were substantially higher than those in Linxia and Gannan. The difference in the food sources due to the high difference of the population ethnic composition in the 3 regions was probably the main driver for the difference of the symptom rates among the 3 regions. This work provides potential values for prevention and control of COVID-19 in different regions.

This study presents a conceptual replication of Birulés et al.’s (2020, Experiment 2) investigation of native and nonnative listeners’ selective attention to a talker’s mouth with the goal of better understanding the potentially modulating role of proficiency in listeners’ reliance on audiovisual speech cues. Listeners’ eye gaze was recorded while watching two short videos. Findings from one of the videos replicated results from the original study, showing greater attention to the talker’s mouth among L2 than L1 listeners. In both videos, L2 proficiency modulated attention, with more fixations on the mouth among lower proficiency listeners, an effect predicted but not observed in the original study. Collectively, these laboratory-based findings highlight the role of visual speech cues in L2 listening and present evidence that listeners with more limited proficiency may be especially reliant on such cues. These observations warrant future investigations of the benefits of visual speech cues in instructional and assessment contexts.

Objectives: Central-line–associated bloodstream infection (CLABSI) has been the leading cause of healthcare-associated infections (HAIs) in the intensive care unit (ICU) setting. Previous studies have shown that a care bundle is effective in reducing CLABSI rates; however, the data on long-term sustainability and cost savings of bundled care are limited. Methods: From January 2011 to December 2020, a prospective surveillance was performed to monitor CLABSI at a university hospital in northern Taiwan. To reduce the CLABSI rate, a hospital-wide bundled care program for CLABSI prevention was implemented in 2013. We evaluated the long-term effect of the care bundle on CLABSI incidence and length of stay in the ICU. Results: During the study period, the overall CLABSI incidence decreased from 8.22 per 1,000 catheter days before the care bundle was implemented to 6.33 per 1,000 catheter days in 2020 (P for trend <.01). The most common pathogens causing CLABSI were gut organisms (1,420 of 2,363, 60.1%), followed by environmental organisms (734 of 2,363, 31.1%) and skin organisms (177 of 2,363, 7.5%). The decreasing trend was statistically significant in the incidence of CLABSI caused by skin organisms (P for trend < .01), but not in the incidence of CLABSI caused by environmental organisms (P for trend = .86) or gut organisms (P for trend = .06). In the multivariable analysis, implementation of this care bundle was independently associated with a decrease in the CLABSI rate (RR, 0.77; 95% CI, 0.66–0.88). Compared with patients without CLABSI, patients with CLABSI had a longer average ICU length of stay (27 vs 17 days). Conclusions: A sustainable reduction in the incidence of CLABSI caused by common commensals could be achieved through a cost-saving bundled care program.

Liriomyza trifolii is a significant pest of vegetable and ornamental crops across the globe. Microwave radiation has been used for controlling pests in stored products; however, there are few reports on the use of microwaves for eradicating agricultural pests such as L. trifolii, and its effects on pests at the molecular level is unclear. In this study, we show that microwave radiation inhibited the emergence of L. trifolii pupae. Transcriptomic studies of L. trifolii indicated significant enrichment of differentially expressed genes (DEGs) in ‘post-translational modification, protein turnover, chaperones’, ‘sensory perception of pain/transcription repressor complex/zinc ion binding’ and ‘insulin signaling pathway’ when analyzed with the Clusters of Orthologous Groups, Gene Ontology and the Kyoto Encyclopedia of Genes and Genomes databases, respectively. The top DEGs were related to reproduction, immunity and development and were significantly expressed after microwave radiation. Interestingly, there was no significant difference in the expression of genes encoding heat shock proteins or antioxidant enzymes in L. trifolii treated with microwave radiation as compared to the untreated control. The expression of DEGs encoding cuticular protein and protein takeout were silenced by RNA interference, and the results showed that knockdown of these two DEGs reduced the survival of L. trifolii exposed to microwave radiation. The results of this study help elucidate the molecular response of L. trifolii exposed to microwave radiation and provide novel ideas for control.

Many protected areas worldwide have been established to protect the last natural refuges of flagship animal species. However, long-established protected areas do not always match the current distributions of target species under changing environmental conditions. Here we present a case study of the Asian elephant Elephas maximus in Xishuangbanna, south-west China, to evaluate whether the established protected areas match the species’ current distribution and to identify key habitat patches for Asian elephant conservation. Our results show that currently only 24.5% of the predicted Asian elephant distribution in Xishuangbanna is located within Xishuangbanna National Nature Reserve, which was established for elephant conservation. Based on the predicted Asian elephant distribution, we identified the most important habitat patches for elephant conservation in Xishuangbanna. The three most important patches were outside Xishuangbanna National Nature Reserve and together they contained 43.3% of the estimated food resources for Asian elephants in all patches in Xishuangbanna. Thus, we identified a spatial mismatch between immobile protected areas and mobile animals. We recommend the inclusion of the three identified key habitat patches in a new national park currently being planned by the Chinese authorities for the conservation of the Asian elephant.