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Despite the fact that social deficits among individuals with autism spectrum disorder (ASD) are lifelong and impact many aspects of personal functioning, evidence-based programs for social skills training were not available until recently. The Program for the Education and Enrichment of Relational Skills (PEERS®) has been shown to effectively improve social skills for adolescents on the spectrum across different social cultures. However, the effectiveness for young adults beyond North America has yet to be examined. This study aimed to investigate the effectiveness of the PEERS intervention in Taiwanese young adults with ASD, and examine its durability and clinical correlates.
We recruited 82 cognitively-able young adults with ASD, randomized to the PEERS treatment or treatment-as-usual.
Following treatment, significant improvement was found in aspects of social deficits, autism severity, social interaction anxiety, empathy, and social skills knowledge either by self-report or coach-report. Additionally, communicative behaviors rated by observers improved throughout the sessions, showing a trend toward more appropriate eye contact, gestures, facial expression during conversation, and appropriate maintenance of conversation and reciprocity. Most effects maintained at 3-month and 6-month follow-ups. The improvement of social deficits was positively correlated with baseline severity, while gains in social skills knowledge were positively correlated with IQ. The improvement of social deficits, autism severity, and empathy were positively correlated with each other.
Overall, the PEERS intervention appears to effectively improve social functioning in Taiwanese young adults with ASD. Improvement of social response and knowledge may be predicted by baseline severity and intelligence respectively.
It is well-known that attention deficit hyperactivity disorder (ADHD) is associated with changes in the dopaminergic system. However, the relationship between central dopaminergic tone and the blood oxygen level-dependent (BOLD) signal during receipt of rewards and penalties in the corticostriatal pathway in adults with ADHD is unclear.
Single-photon emission computed tomography with [99mTC]TRODAT-1 was used to assess striatal dopamine transporter (DAT) availability. Event-related functional magnetic resonance imaging was conducted on subjects performing the Iowa Gambling Test.
DAT availability was found to be associated with the BOLD response, which was a covariate of monetary loss, in the medial prefrontal cortex (r = 0.55, P = .03), right ventral striatum (r = 0.69, P = .003), and right orbital frontal cortex (r = 0.53, P = .03) in adults with ADHD. However, a similar correlation was not found in the controls.
The results confirmed that dopaminergic tone may play a different role in the penalty-elicited response of adults with ADHD. It is plausible that a lower neuro-threshold accompanied by insensitivity to punishment could be exacerbated by the hypodopaminergic tone in ADHD.
Previous studies have indicated that there is dopamine transporter (DAT) dysregulation and P300 abnormality in adults with attention-deficit hyperactivity disorder (ADHD); however, the correlations among the three have not been fully explored.
A total of 11 adults (9 males and 2 females) with ADHD and 11 age-, sex-, and education-level-matched controls were recruited. We explored differences in DAT availability using single-photon emission computed tomography and P300 wave of event-related potentials between the two groups. The correlation between DAT availability and P300 performance was also examined.
DAT availability in the basal ganglia, caudate nucleus, and putamen was significantly lower in the ADHD group. Adults with ADHD had lower auditory P300 amplitudes at the Pz and Cz sites, as well as longer Fz latency than controls. DAT availability was negatively correlated to P300 latency at Pz and Fz.
Adults with ADHD had both abnormal DAT availability and P300 amplitude, suggesting that ADHD is linked to dysfunction of the central dopaminergic system and poor cognitive processes related to response selection and execution.
The metadynamic recrystallization (MDRX) behavior of a Nb–V microalloyed nonquenched and tempered steel was investigated by isothermal hot compression tests on Gleeble-1500 thermal-mechanical simulator. Compression tests were performed using double hit schedules at temperatures of 1273–1423 K, strain rates of 0.01–5 s−1, initial grain sizes of 92–149 μm and an inter-pass time of 0.5–10 s. The experimental results show that MDRX softening fraction increases with the increasing of deformation temperature, strain rate, and inter-pass time, while it decreases with the increasing of initial grain size. Based on the experimental results, the MDRX softening fraction kinetic model and recrystallized grain size model of the tested steel was established. Besides, using the above mathematic models, a finite element model was built to simulate the MDRX process of the tested steel. The simulation results show good agreement with the experimental ones, which indicates that finite element method is an effective approach to analyze the MDRX behavior and the established that mathematic models of the tested steel are reliable and accurate.
Team psychological safety — a non-threatening and safe climate — allows team members to express and share each other's opinions freely, and this sharing may produce more useful perspectives to induce team creativity. In a psychologically safe climate, transactive memory systems (TMSs) may be constructed for describing the specialised division of cognitive labour for solving information problems and thereby enabling team members to quickly gain and use knowledge across domains. As a consequence, further ideas may be generated within teams, increasing team creativity. Our research model is assessed using data from a sample of 110 team members from 40 research and development (R&D) teams in a leading technology company in Taiwan and analysed using the partial least squares method. The results of this study reveal that: (1) team psychological safety did not directly affect team creativity, (2) team psychological safety affects TMSs, (3) TMSs affect team creativity, and (4) TMSs fully mediate the relationship between team psychological safety and team creativity. This study also discusses the implications for team creativity.
In this article we provide a comprehensive framework to explain, in China and in Western countries, how three antecedents – regulations, stakeholder norms, and managerial mindsets – differently affect proactive environmental strategies (PES) and subsequently influence firm performance. A meta-analysis of 68 studies involving 71 samples supports our hypotheses. In Western countries, top managerial mindsets have the strongest effect and regulations have the weakest effect on PES. In China, regulations, stakeholder norms, and managerial mindsets have similar effects on PES. For Western firms, the PES has stronger effects on environmental performance than on economic performance and the effect on environmental performance is stronger than that in Chinese firms. For firms in China, the PES has equally positively affects on environmental and economic performance, but the effect on economic performance is stronger than that of Western firms. Implications for future research are discussed.
Blue marlin are sexually dimorphic in size-at-age and other biological characteristics. However, few studies have examined the possible impact of sexual dimorphism on the population parameters and the ratios of fishing to total mortality (the exploitation ratios) for this species. We analyzed sex-specific catch-at-length data for blue marlin collected from the Taiwanese tuna longline fishery in the northwest Pacific Ocean, ranging between 100–311 cm in eye to fork length (EFL) for females and 100–236 cm EFL for males, and show that the proportion of females in the catch (the sex ratio) increases with length, with females reaching larger body sizes than males. Minor differences in fishery sex ratios among months were observed. Growth parameters, length structures, and natural mortality rates were estimated to differ between males and females, while fishing mortality rates were found to be similar. Nevertheless, the exploitation ratio for females was higher than that for males. We suggest that growth parameters and natural mortality rates should be sex-specific when assessments for sexually-dimorphic species such as blue marlin are conducted, and that management of blue marlin fisheries could be developed based on size limit regulations for large individuals.
To investigate the impact of antimicrobial resistance on clinical and economic outcomes among hospitalized patients with multidrug-resistant (MDR) Acinetobacter baumannii bacteremia.
A retrospective, matched-cohort study.
A tertiary care university teaching hospital
A matched case-control (1:1) study was conducted to compare the differences in clinical and economic outcomes of patients with MDR A. baumannii bacteremia and patients with non-MDR A. baumannii bacteremia. Case patients were matched to control patients on the basis of sex, age, severity of underlying and acute illness, and length of hospital stay before onset of bacteremia.
Forty-six (95.8%) of 48 cases with MDR A. baumannii bacteremia were eligible for the study and matched with appropriate controls. The sepsis-related mortality rate was 34.8% among cases and 13.0% among controls, for an attributable mortality rate of 21.8% (adjusted odds ratio, 4.1 [95% confidence interval, 1.1-15.7]; P = .036). After the onset of bacteremia, cases and controls had a significantly different length of hospital stay (54.2 vs 34.1 days; P = .006), hospitalization cost (US$9,349 vs US$4,865; P = .001 ), and antibiotic therapy cost (US$2,257 vs US$1,610; P = .014). Thus, bacteremia due to MDR A. baumannii resulted in 13.4 days of additional hospitalization and US$3,758 of additional costs, compared with bacteremia due to non-MDR A. baumannii.
Patients with MDR A. baumannii bacteremia had a higher mortality rate and incurred greater medical costs than patients with non-MDR A. baumannii bacteremia.
Obstruction to the pulmonary venous return is a frequent associated anomaly in patients with isomerism of the right atrial appendages. Yet, preoperative diagnosis by means of either cross-sectional echocardiography or cardiac catheterization can be intriguing. Indeed, the presence of two morphologically right lungs reduce considerably the size of window for precordial echocardiography. Also, in the presence of severe pulmonary stenosis or atresia, it can be difficult at cardiac catheterization to enter the pulmonary trunk. In these patients, construction of a systemic-to-pulmonary artery anastomosis will almost inevitably result in pulmonary edema. Between May 1984 and December 1988, five patients with isomerism of the right atrial appendages, severely decreased pulmonary blood flow and concealed obstruction to the pulmonary venous return were admitted to our hospital. A modified Blalock Taussig shunt by interposition of a polytetrafluoroethylene prosthesis was performed in each patients and all of them developed pulmonary edema. Three patients died despite appropriate medical treatment. The remaining two patients were successfully treated by banding of the Blalock shunt. This was performed in the first patient at the time of the initial surgery, when prior to closure of chest, pulmonary edema became manifest. The second patient who developed pulmonary edema early postoperatively, underwent cardiac catheterization to confirm the clinical diagnosis of obstruction to the pulmonary venous return. Reduction of blood flow through the Blalock shunt with resolution of edema was initially achieved by means of a partially occluding balloon catheter. Pulmonary edema recurred one week later because of rupture of the balloon and the patient eventually underwent a successful banding of the Blalock shunt through a left thoracotomy. We conclude that preoperative assessment of the pulmonary venous return is mandatory in patients with right isomerism and reduced pulmonary blood flow. Construction of a modified Blalock-Taussig shunt in the presence of concealed obstruction to the pulmonary venous return will almost inevitably cause pulmonary edema. Banding of the Blalock shunt can be successful, as observed in our experience, for the management of this serious complication.
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