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The Caregiver Strain Questionnaire assesses the three dimensions of caregiver strain, namely the objective, subjective externalized and subjective internalized strain. It was validated among caregivers of children with Autism Spectrum Disorder (ASD) in the United States and Mainland China with promising psychometric properties. This study aimed to develop and validate the Chinese (traditional script) version of the Caregiver Strain Questionnaire (C-CGSQ) among 198 caregivers of children with ASD in Hong Kong. The C-CGSQ showed excellent internal consistency ([alpha] = 0.958) and test-retest reliability (Spearman's r = 0.966). Concurrent, convergent, divergent validity and a three-factor structure (consistent with previous studies) were established. The C-CGSQ demonstrated promising psychometric properties in measuring caregiver strain among caregivers of Chinese ASD children in Hong Kong.

Purpose: This study aims to report correlations between thyroid-stimulating immunoglobulin (TSI) and both clinical and radiological parameters in recent-onset symptomatic thyroid eye disease (TED) patients. Methods: A prospective cohort study of TED patients managed at the Chinese University of Hong Kong from January 2014 to May 2022. Serum TSI levels were determined with the functional assay. Outcomes included the Clinical Activity Score (CAS), marginal reflex distance1 (MRD1), extraocular muscle motility restriction (EOMy), exophthalmos, and diplopia. The radiological assessment included cross-sectional areas and signal of extraocular muscles on STIR-sequence MRI. Results: A total of 255 (197 female) treatment-naive patients, with an average onset age of 50 ± 14 years (mean ± s.d.), were included. Elevated pre-treatment TSI level was observed in 223 (88%) patients. There was a weak positive correlation between TSI and CAS (r = 0.28, P = 0.000031), MRD1 (r = 0.17, P = 0.0080), and the size of the levator palpebrae superioris/superior rectus complex (r = 0.25, P = 0.018). No significant correlation existed between TSI and STIR signals. The AUC and optimal cut-off value for clinical active TED were 0.67 (95% CI: 0.60–0.75) and 284% (specificity: 50%, sensitivity: 85%). In total, 64 patients received intravenous methylprednisolone (IVMP) during the study interval, and they had a higher baseline TSI level than those who did not have IVMP (P = 0.000044). Serial post-IVMP TSI among the 62 patients showed a significant reduction compared to the baseline level (P < 0.001). Both the baseline and post-IVMP TSI levels, and percentages of TSI changes were comparable between patients who responded and did not respond to the first course of IVMP. Conclusion: TSI can be a serum biomarker for the diagnosis, prognosis, and treatment response of TED. Further validation should be warranted.

Willingness to enroll in experiments plays a vital role in user-centered design, particularly in emerging domains such as wearable robots for daily living assistance, where recruiting older adults poses challenges. Guided by the integration of prospect theory and the senior technology acceptance model, this study aims to investigate the persuasive effects of message framing, specifically the valence (gain: positive framing versus loss: negative framing), in the form of flyers on older adults’ willingness to participate in real-life wearable robot experiments. The survey data were collected from 176 online participants (Mage = 61.05; SD = 6.49). Multivariate analysis of variance indicates that gain-framed messages significantly influence perceived health benefits (F(1, 174) = 14.363, p < .001, ɳ2 = .09, 95% CI: .03-1.00). However, message frames do not directly impact the perceived effectiveness of flyers or willingness to enroll. Mediation analysis reveals that gain-framed messages enhance older adults’ willingness to enroll in wearable robot experiments through their perception of health benefits (IE: β = −.19, 95% CI: −.38– −.06, p = .017). This study contributes to the understanding of the persuasive effects of message framing on older adults’ willingness to enroll in wearable robot experiments, ultimately fostering advancements in the field and enhancing health outcomes and well-being for older adults.

BackgroundThis study examined the social well-being of single older adults through the companionship of a social robot, LOVOT (Love+Robot; Groove X). It is designed as a companion for older adults, providing love and affection through verbal and physical interaction. We investigated older adults’ perceptions of the technology and how they benefitted from interacting with LOVOT, to guide the future development of social robots. ObjectiveThis study aimed to use a phenomenological research design to understand the participants’ experiences of companionship provided by the social robot. Our research focused on (1) examining the social well-being of single older adults through the companionship of social robots and (2) understanding the perceptions of single older adults when interacting with social robots. Given the prevalence of technology use to support aging, understanding single older adults’ social well-being and their perceptions of social robots is essential to guide future research on and design of social robots. MethodsA total of 5 single women, aged 60 to 75 years, participated in the study. The participants interacted independently with the robot for a week in their own homes and then participated in a poststudy interview to share their experiences. ResultsIn total, 4 main themes emerged from the participants’ interactions with LOVOT, such as caring for a social robot, comforting presence of the social robot, meaningful connections with the social robot, and preference for LOVOT over pets. ConclusionsThe results indicate that single older adults can obtain psychosocial support by interacting with LOVOT. LOVOT is easily accepted as a companion and makes single older adults feel like they have a greater sense of purpose and someone to connect with. This study suggests that social robots can provide companionship to older adults who live alone. Social robots can help alleviate loneliness by allowing single older adults to form social connections with robots as companions. These findings are particularly important given the rapid aging of the population and the increasing number of single-person households in Singapore.

The ecological stoichiometric characteristics of soil elements have greatly enhanced our understanding of the circulation of soil nutrients. However, there is limited knowledge regarding the alteration of carbon, nitrogen, and phosphorus stoichiometric ratios in deep soil after afforestation. To examine the variations in stoichiometric ratios of soil elements with different vegetation types, restoration times, and soil depths, we collected soil samples from grassland, Caragana korshinskii shrubland, and Picea asperata forestland at different stand ages (10a, 25a, and 40a) in Xining City, which is located on the Loess Plateau. Our results showed that, at 25a, the carbon-to-nitrogen (C:N) and carbon-to-phosphorus (C:P) ratios were significantly higher in the grassland soil than under other vegetation types, whereas the nitrogen-to-phosphorus (N:P) ratio had no significant difference among the three vegetation types. At 40a, the ratios of soil C:N, C:P, and N:P in the shrubland were the highest. With the increasing of the restoration time, the ratios of soil C:N, C:P, and N:P in grassland with 25a became higher than for 40a or 10a. The ratios in the shrubland were highest at 40a, followed by 25a and then 10a, while the ratios in the forestland showed no significant difference. At 40a, the soil C:N, C:P, and N:P ratios of shrubland were highest at the soil depth of 40–100 cm. The soil C:N, C:P, and N:P ratios showed positive correlations with soil ammonium nitrogen and nitrate nitrogen, and the soil N:P ratios showed a negative correlation with soil available phosphorus. Plant diversity significantly influenced the soil stoichiometric ratio of the upper soil layer. In the upper soil layer (0–40 cm), species richness showed a positive correlation with soil C:N, C:P, and N:P ratios, and the Margalef index exhibited a positive correlation with soil C:N and C:P ratios. The results of this study indicate that the stoichiometric ratio and nutrient availability of Caragana korshinskii shrubland were the highest over time. Therefore, these findings can be served as a valuable reference for local revegetation and ecological restoration.

In grassland ecosystems, the decomposition of litter serves as a vital conduit for nutrient transfer between plants and soil. The aim of this study was to depict the dynamic process of grass litter decomposition and explore its major driver. Three typical grasses [Stipa bungeana Trin (St. B), Artemisia sacrorun Ledeb (Ar. S), and Thymus mongolicus Ronniger (Th. M)] were selected for long-term litter decomposition. Experiments were conducted using three single litters, namely, St. B, Ar. S, and Th. M, and four different compositions of mixed litter: ML1 (55% St. B and 45% Th. M), ML2 (55% St. B and 45% Ar. S), ML3 (75% St. B and 25% Th. M), and ML4 (75% St. B and 25% Ar. S). The dynamic patterns of mass and microelements (Ca, Mg, Fe, Mn, Cu, and Zn) within different litter groups were analyzed. Our findings indicated that, after 1035 days of decomposition, the proportion of residual mass for the single litters was as follows: Th. M (60.6%) > St. B (47.3%) > Ar. S (44.3%), and for the mixed groups it was ML1 (48.0%) > ML3 (41.6%) > ML2 (40.9) > ML4 (38.4%). Mixed cultivation of the different litter groups accelerated the decomposition process, indicating that the mixture of litters had a synergistic effect on litter decomposition. The microelements of the litter exhibited an initial short-term increase followed by long-term decay. After 1035 days of decomposition, the microelements released from the litter were, in descending order, Mg > Ca > Fe > Cu > Mn > Zn. Compared to the separately decomposed St. B litter, mixing led to an inhibition of the release of Ca (antagonistic effect), while it promoted the release of Mg, Cu, and Zn (synergistic effect). For the single litter, the stepwise regression analysis showed that Ca was the dominant factor determining early litter decomposition. Mg, Mn, and Cu were the dominant factors regulating later litter decomposition. For the mixed litter groups, Ca, Mn, and Mg were the dominant factors closely related to early decomposition, and TN emerged as a key factor regulating the mass loss of mixtures during later decomposition. In summary, nitrogen and microelements co-drive the decomposition of typical grass litter. Our study underscores that, in the succession process of grassland, the presence of multiple co-existing species led to a faster loss of plant-derived materials (litter mass and internal elements), which was primarily modulated by species identity and uniformity.

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