Mandarin Version Research Articles

An analysis of the influence of education level on Rowland Universal Dementia Assessment Scale (RUDAS) scores among stroke patients.

To explore the influence of education level on scores in the Mandarin Chinese version of the Rowland Universal Dementia Assessment Scale (RUDAS) among stroke patients and to provide guidance regarding the application and optimisation of the RUDAS. A total of 235 stroke patients were census sampled for an evaluation of cognitive function using the Mandarin Chinese version of the RUDAS. A test was carried out to analyze the differences in RUDAS scores between sexes, and one-way analysis of variance and the Scheffe multiple comparison test were used to analyze the differences in RUDAS scores between age groups and between education levels. SPSS 22.0 software was used for statistical analysis. Differential item functioning (DIF) analysis was performed using logistic regression. If P < 0.05, then an item was considered to exhibit DIF. The overall education levels of the stroke patients were moderate. There was no significant difference in RUDAS scores based on education level or sex, but there was a difference between age groups. There were three items that exhibited DIF: square, internal line and external line. RUDAS scores were not strongly influenced by education level, and most items were suitable for screening among stroke patients with different education levels. However, when drawing a cube, differences in education level should be taken into consideration.

Constraints to Child Language Development in Peri-Urban and Rural Areas: A Mixed-Methods Analysis From Southwestern China.

This mixed-methods study examined how differences in parental time, knowledge, and economic constraints, as well as community socioeconomic contexts, may contribute to differences in home language environment and child language ability outcomes between peri-urban and rural households in China. We conducted an explanatory sequential mixed-methods analysis using data from 158 children aged 18-24 months among peri-urban and rural households with low socioeconomic status (SES) in southwestern China. Audio recordings were collected from each household and analyzed using the Language ENvironment Analysis system. The Mandarin version of the MacArthur-Bates Communicative Development Inventories was administered to each child's primary caregiver. We also conducted qualitative interviews with primary caregivers in 31 peri-urban and 32 rural households. Interviews were recorded, transcribed, and coded. The quantitative results reveal that children in peri-urban households heard less adult speech and had lower language ability than children in rural households. Directed content analysis of interviews found that peri-urban caregivers faced more severe time constraints and less favorable community socioeconomic contexts than rural primary caregivers. Taken together, these findings suggest that differences in time constraints and community socioeconomic contexts between the two populations are the most likely factors contributing to the inferior language environment and language ability among children in peri-urban households. The mixed-methods study indicated that parental time constraints and community socioeconomic contexts should be considered alongside SES for a comprehensive understanding of factors influencing parental investment in the home language environment in China.

Classification of Mandarin-speaking persons with aphasia: a discussion on validating the classification function of WAB-R

ABSTRACT Background The classical aphasia taxonomy has been incorporated into several widely utilised aphasia assessment tools, such as the Western Aphasia Battery (WAB). Validation of the WAB’s classification typically involves comparing it with statistical clustering analysis results, using overall agreement rates as the referential index. Nevertheless, previous studies have documented diverse agreement rates. The classification function of the Mandarin version of the revised WAB (WAB-R) has not been validated. Additionally, the discussion on validating classification function is inadequate. Aim The current study adopts the argument-based validation framework to validate the classification function of the Mandarin version of the WAB-R and discuss the efficacy of using cluster analysis as evidence for the validation. Methods & Procedures A validation argument for the classification function was developed, utilising the k-means cluster analysis and within-group linkage cluster analysis as statistical procedures. WAB-R testing score data were collected from 122 Mandarin-speaking persons with acquired aphasia (non-acute). Eight clusters were expected to be generated from statistical procedures as a confirmatory test. To explore the impact of cluster numbers, solutions of generating six and ten clusters were conducted for comparative analysis. The potential reasons for mismatches were analysed. A proposed modified fluency scale (raising the cutoff score from 4 to 5) was also tested on the current dataset. Outcomes & Results Under the solution of eight clusters, the overall agreement was 62.3% with the k-means cluster analysis and 56.6% with the within-group linkage cluster analysis. Agreement rates slightly increased with the number of clusters in the within-group linkage method and remained almost unchanged in the k-means method. Anomic aphasia presented the highest agreements, while the agreements of other subtypes varied across different solutions. The fundamental differences between the clustering algorithm and the rationale of the WAB-R classification criteria were the primary reason for mismatched cases, undermining the reliability of the validation procedure. The modified fluency scale was found to significantly improve the overall agreement rates. Conclusions The classification function of the WAB-R’s Mandarin adaptation was considered acceptable under the current method. The validation argument is suggested to be modified to enhance the rationale as the statistical cluster analysis showed reliability issues when being solely employed for validation. The mismatch rate did not form direct challenges to the validity of the classification function. Additionally, modifications to the classification criteria are suggested for further exploration as the modified fluency scale has demonstrated positive results.

Validity of specific CPT indices in differentiating school-aged children previously diagnosed with attention deficit/hyperactivity disorder from school-aged children with non-attention deficit/hyperactivity disorder in general education classrooms: a case control study

BackgroundContinuous performance tests (CPTs) are a popular tool for evaluating the symptoms of attention-deficit/hyperactivity disorder (ADHD). Performance measurements are typically linked to the biological features and cognitive functions of individuals. To determine the validity of specific CPT indices in differentiating between school-aged children with ADHD from with non-ADHD, each student’s sex, chronological age, and cognitive abilities should be considered.MethodsIn this prospective case–control study, a total of 30 non-ADHD students and 26 with ADHD who were aged 6 to 12 years were from general education classrooms. All students completed the Continuous Performance Tests (CPTs) and the Peabody Picture Vocabulary Test-revised (Mandarin-Chinese version). Demographic data were collected from the students’ parents.ResultsDetectability, Omissions, Commissions, and Hit Reaction Time Standard Deviation (HRT SD) yielded higher T-scores in children with ADHD than those without. Compared with non-ADHD students, those with ADHD had higher classification scores for Detectability, Omissions, Perseverations, and HRT SD. For each CPT index, after individual factors were controlled for, logistic regression revealed that only students with positive scores for Detectability, Omission, and HRT SD (adjusted odds ratios = 4.627, 9.977, and 3.908, Ps < 0.05) were likely to receive a diagnosis of ADHD. Furthermore, after individual characteristics were controlled for, Logistic regression also revealed that the cumulative positive scores of the Detectability, Omission, or and HRT SD remained associated with an increased risk of ADHD (adjusted odds ratio = 3.116, P < 0.01).ConclusionsCompared with school-aged children with non-ADHD in general education classrooms, those with ADHD exhibited significantly lower performance in inattention-related CPT indices. To reach an accurate diagnosis through CPTs, clinicians should pay attention to Detectability, Omission, and HRT SD. Compared with other CPT indices, Detectability, Omission, and HRT SD may function as more suitable indicators for distinguishing between school-aged children with and non-ADHD in general education classrooms. These indicators are robust and unobscured by individual characteristics.

Association between residential noise exposure and burnout among healthcare workers in Taiwan: a cross-sectional study

Few studies have explored the association between residential noise exposure and burnout. In this study, we investigated the association between residential noise exposure and burnout prevalence among 5416 health-care workers in Taiwan from 2012 to 2017. Burnout was evaluated using the Mandarin version of the Copenhagen Burnout Inventory by considering both continuous and binary measures. We applied ordinary Kriging models to calculate the annual average residential noise exposure at an individual level. Multivariable linear regression models and logistic regression models were employed. Restricted cubic splines were used to explore dose–response relationships. The median age of the health-care workers was 31.5 years. In the multivariable linear regression models, exposure to residential noise (per 1 dBA) was associated with increases in personal burnout and work-related burnout scores by 1.59 ± 0.25 and 1.38 ± 0.20, respectively. In the multivariable logistic regression models, the adjusted odds ratios were 1.24 (95% confidence interval [CI]: 1.16, 1.32) for personal burnout and 1.19 (95% CI: 1.13, 1.26) for work-related burnout per 1-dBA increase in residential noise exposure. Linear dose–response associations of burnout with residential noise level were detected. Our findings suggest that exposure to residential noise may increase the risk of burnout among health-care workers.

Pain Resilience and Coping Behaviors in Individuals in a Collectivist Social Context.

Pain resilience (PR) may be associated with different coping skills, resulting in differences in pain outcomes. This study aimed to understand the role of PR in dictating the choice of coping methods. This study completed a preliminary validation of the Mandarin Chinese version of the Pain Resilience Scale (PRS-C) with online survey data (n = 46). Further, we conducted interviews with individuals with chronic low back pain (n = 24). The PRS-C psychometric properties were assessed using a confirmatory factor analysis. The interviews explored pain history, treatment experiences, and coping strategies and were analyzed thematically. The validated PRS-C (10 items) demonstrated satisfactory psychometric properties. The interview results showed that participants who scored lower were more likely to adopt disengagement rather than engagement coping strategies. Qualitative data revealed three themes explaining why and how participants in this collectivist social framework chose their coping methods. The findings suggest that while participants tried to understand their pain and treatment experiences, the cognitive appraisal construct in PR influenced some of the coping experiences. However, deeply influenced by Confucianism and Buddhism, participants also expressed factors beyond the scope of individual fortitudes, such as the relationship with a higher power that significantly influenced their coping behaviors.

Development of the West China Tinnitus Impact Inventory and Analysis of Its Reliability and Validity.

Owing to differences in cultural background, education level, and lifestyle, certain items of existing tinnitus evaluation scales are difficult for Chinese patients to understand, despite being translated. However, few independently developed scales have been developed specifically for Chinese patients. Therefore, with this study, we aimed to construct a tinnitus scale, the West China Tinnitus Impact Inventory (WCTII), suitable for the accurate reflection of the impact and severity of the disease in this population. Basic items were obtained through semistructured interviews with patients with tinnitus. We invited 23 domestic experts on tinnitus to form an expert group. The basic items were modified using the Delphi method. Cronbach's α values for the scale scores and correlation coefficients between the items and the scale scores were calculated. Items with correlation coefficients <0.5 were deleted. Exploratory factor analysis was conducted to determine the scale structure of the items remaining after item deletion. The intragroup correlation coefficient was used to assess the scale's test-retest reliability. The Pearson correlation coefficient between the scale scores and the scores for the Chinese-Mandarin version of the Tinnitus Handicap Inventory was used to evaluate concurrent validity. After five rounds of expert correspondence and exploratory factor analysis, we determined the content and structure of the scale. The WCTII consists of 19 items in 4 subscales, namely, F1: the impact of tinnitus on emotion (items 1 to 9); F2: the impact of tinnitus on sleep (items 10 to 12); F3: patients' beliefs about their tinnitus (items 13 to 16, 19); and F4: the impact of tinnitus on auditory processing ability (items 17 to 18). The overall Cronbach's α was 0.934. The Cronbach's α values for F1 to F4 were 0.912, 0.843, 0.829, and 0.838, respectively. The intragroup correlation coefficient (95% confidence interval) of the total scale and F1 to F4 were 0.779 (0.549 to 0.886), 0.738 (0.496 to 0.860), 0.826 (0.713 to 0.897), 0.720 (0.536 to 0.836), and 0.715 (0.532 to 0.832), respectively. The correlation between the WCTII and Chinese-Mandarin version of the Tinnitus Handicap Inventory scores was 0.849 (p < 0.001). The WCTII yielded satisfactory reliability and validity, indicating that it can be used to assess the severity of tinnitus in Chinese patients.

Reliability and Validity of the Chinese Mandarin Version of the Dysphagia Handicap Index.

This study aimed to develop the Dysphagia Handicap Index-Chinese Mandarin (DHI-CM) and to assess its reliability and validity. This prospective study was conducted in China with individuals who speak Mandarin. The DHI-CM was developed according to a five-stage process. 264 patients with oropharyngeal dysphagia (OD) and 187 healthy individuals completed the study. Reliability was assessed using Cronbach's α and test-retest reliability. Differences between healthy participants and patients with OD were analyzed for instrument validity. Convergent and concurrent validity were assessed using the Swallowing Quality of Life Questionnaire (SWAL-QoL) and Functional Oral Intake Scale (FOIS), respectively. The Content Validity Index (CVI) was used to assess content validity. Exploratory and Confirmatory Factor Analyses (EFA and CFA, respectively) were used to assess structural validity. The Cronbach's alpha was > 0.9 for the total score and every individual subscale. The Pearson and intraclass correlation coefficients were both > 0.8. The patients with OD showed significantly higher scores in the DHI-CM and its subscales than the healthy individuals. Significant correlations were found between most subscales of the DHI-CM and both the SWAL-QoL and FOIS. The CVI of the DHI-CM was 0.892 and ranged between 0.878 and 1.000 for the subscales. The EFA identified three components that explained 24.33%, 23.99%, and 22.73% of the variance, respectively. The scale showed good structural validity through CFA. Conclusions. The DHI-CM demonstrated good reliability and validity among Mandarin-speaking Chinese adults.

The Chinese Mandarin COMHON Index and Braden Scale to assess pressure injury risk in intensive care: An inter-rater reliability and convergent validity study

BackgroundThe COMHON Index is an intensive-care-specific pressure injury risk assessment tool, which has demonstrated promising psychometric properties. It has been translated into Chinese Mandarin but requires inter-rater reliability testing and comparison to the standard care instrument (Braden Scale) before clinical use. ObjectivesThis study aimed to test and compare the inter-rater reliability and convergent validity of the Chinese Mandarin versions of the COMHON Index and Braden Scale. MethodsThe study was conducted in a Chinese comprehensive intensive care unit. Based on a sample size calculation, five registered nurse raters with at least 6-months experience independently conducted risk assessments for 20 adult patients using both the COMHON Index and Braden Scale. Intraclass correlations (ICC) for inter-rater reliability, standard errors of measurement (SEM), and minimally detectable change (MDC) were calculated. Convergent validity was assessed using Pearson Product Moment Correlation for sum scores and Spearman's rho for subscales. ResultsInter-rater reliability of COMHON Index and Braden Scale sum scores was very high (ICC [1,1] = 0.973; [95% confidence interval 0.949–0.988]; SEM 0.54; MDC 1.50) and high (ICC [1,1] = 0.891; [95% confidence interval 0.793-0.951]; SEM 0.93; MDC 2.57), respectively. All COMHON-Index subscales demonstrated ICC values >0.6, whereas two Braden Scale subscales (Mobility, Activity) were below this threshold. Instrument sum scores were strongly correlated (Pearson's r = −0.76 [r2 = 0.58]; p < 0.001), as were three subscale item pairs (mobility rs= −0.56 [r2 = 0.32]; nutrition rs= −0.63 [r2 = 0.39]; level of consciousness/sensory perception rs= −0.67 [r2 = 0.45] p < 0.001). ConclusionBoth the COMHON Index and Braden Scale demonstrated high levels of inter-rater reliability and measured similar constructs. However, the COMHON Index demonstrated superior inter-rater reliability and the results suggest that it better detects changes in patient condition and subsequently pressure injury risk. Further testing is recommended.

Exploring the interplay of depression, sleep quality, and hearing in tinnitus-related handicap: insights from polysomnography and pure-tone audiometry

BackgroundTinnitus affects approximately 740 million adults globally, involving hearing, emotion, and sleep systems. However, studies using polysomnography and pure-tone audiometry (PTA) are limited. We aimed to assess the correlation between tinnitus and hearing, sleep quality, characteristics, and depression using polysomnography and PTA.MethodsIn this cross-sectional study, we divided participants into tinnitus and non-tinnitus groups. We included 100 outpatients (65 with tinnitus, 35 without) from a medical center in Taiwan, who underwent polysomnography and completed rating scales including the Patient Health Questionnaire-9 (PHQ-9), Chinese version of the Pittsburgh Sleep Quality Index (PSQI), and Chinese-Mandarin version of the Tinnitus Handicap Inventory (THI-CM). We analyzed correlations, conducted group comparisons, assessed factors related to THI-CM scores, constructed ROC curves to predict depression in the tinnitus group, and performed multinomial and logistic regression to explore associations.ResultsDescriptive statistics identified a cohort with mean age 53.9 ± 12.80 years, 63% exhibited PHQ-9 scores ≥ 10, and 66% had Apnea–Hypopnea Index (AHI) > 5. The ratio of rapid eye movement and deep sleep to stage 1 + 2 sleep was relatively low and non-significant. Likewise, leg movements was higher in the tinnitus group but not statistically significant. In the tinnitus group, 63.08% had depression, and 81.54% had AHI > 5. Univariate logistic regression linked tinnitus to AHI > 5 (Odds ratio (OR) 2.67, p = 0.026) and male sex (OR 2.49, p = 0.034). A moderate positive correlation was found between the THI-CM score and PHQ-9 score (rs = 0.50, p < 0.001). Further adjustment for obstructive sleep apnea showed associations between PHQ-9 (total score) or depression and THI-CM Grade 3–5 (OR = 1.28; OR = 8.68). Single- and multifactor regression analyses highlighted significant associations of PSQI scores > 13 (OR 7.06, p = 0.018) and THI-CM scores > 47 (OR 7.43, p = 0.002) with depression.ConclusionsOur study recruited tinnitus participants with slight or mild hearing loss and mild tinnitus handicap. Depression was identified as a predominant factor in tinnitus-related handicap. The mild tinnitus handicap in tinnitus participants may explain the lack of significant differences in depression, sleep quality, and polysomnographic sleep characteristics between tinnitus and non-tinnitus groups. Further extensive and prospective studies are needed to elucidate the complex links among depression, sleep, and tinnitus.

The equivalence between the Mandarin Chinese and English versions of soundscape attributes: A cross-cultural comparison

Soundscape attributes have become widely utilized across various languages for the assessment of acoustic environments in recent years. The objective of this study is to propose a new set of validated Chinese translations for soundscape attributes. To achieve this, translation and cross-cultural adaptation processes were conducted by soundscape experts and linguists without soundscape backgrounds, resulting in two distinct sets of Chinese soundscape attributes. Subsequently, 33 Chinese participants engaged in a listening experiment adhering to standardized materials and procedures, wherein they provided ratings for 12 translated versions of soundscape attributes across 27 audio stimuli. Principal component analysis (PCA) was used as a validation methodology for comparison of different translations. As seen from the Pearson’s correlation coefficients, r Chaotic (Cn1-Eng) = 0.952 (p < 0.01), the versions of the Chinese attributes translated by soundscape experts showed a higher degree of equivalence with their English counterparts than the versions translated by linguists who lacked a soundscape background. Statistical analysis of the collected data further indicated that the final translation of the 8 soundscape attributes predominantly aligns with their English counterparts. These findings suggest that the soundscape circumplex model, originally developed in English, manifests a comparable applicability within Chinese contexts.

Change of function and brain activity in patients of right spastic arm paralysis combined with aphasia after contralateral cervical seventh nerve transfer surgery.

Left hemisphere injury can cause right spastic arm paralysis and aphasia, and recovery of both motor and language functions shares similar compensatory mechanisms and processes. Contralateral cervical seventh cross transfer (CC7) surgery can provide motor recovery for spastic arm paralysis by triggering interhemispheric plasticity, and self-reports from patients indicate spontaneous improvement in language function but still need to be verified. To explore the improvements in motor and language function after CC7 surgery, we performed this prospective observational cohort study. The Upper Extremity part of Fugl-Meyer scale (UEFM) and Modified Ashworth Scale were used to evaluate motor function, and Aphasia Quotient calculated by Mandarin version of the Western Aphasia Battery (WAB-AQ, larger score indicates better language function) was assessed for language function. In 20 patients included, the average scores of UEFM increased by .40 and 3.70 points from baseline to 1-week and 6-month post-surgery, respectively. The spasticity of the elbow and fingers decreased significantly at 1-week post-surgery, although partially recurred at 6-month follow-up. The average scores of WAB-AQ were increased by 9.14 and 10.69 points at 1-week and 6-month post-surgery (P < .001 for both), respectively. Post-surgical fMRI scans revealed increased activity in the bilateral hemispheres related to language centrals, including the right precentral cortex and right gyrus rectus. These findings suggest that CC7 surgery not only enhances motor function but may also improve the aphasia quotient in patients with right arm paralysis and aphasia due to left hemisphere injuries.

Psychometric properties of a Mandarin Chinese version of the Body Appreciation Scale-2 among Chinese adolescents

In the present study, we explored the factor structure and psychometric properties of the Mandarin Chinese BAS-2 among adolescents residing in the Chinese mainland. Exploratory factor analysis in Study 1 (N = 790; 396 girls, 394 boys) supported the unidimensionality of the Mandarin Chinese BAS-2 among Chinese adolescents. Internal consistency reliability was upheld via McDonald’s omega. Convergent validity was supported by its moderate-to-strong relationships with body satisfaction, functionality satisfaction, self-esteem, life satisfaction, positive affect, and negative affect, while its small-to-moderate correlation with social desirability provided somewhat weaker discriminant validity support. Criterion-related validity was upheld by its inverse correlation with eating disorder symptomatology and positive correlation with intuitive eating. It explained unique variance in self-esteem (for girls and boys), eating disorder symptomatology (for girls), and intuitive eating (for boys) beyond age, body satisfaction, and functionality satisfaction, providing incremental validity evidence. A subsample of 134 girls and 114 boys completed the Mandarin Chinese BAS-2 again after three months, and test-retest reliability was upheld. The confirmatory factor analysis in Study 2 (N = 337; 192 girls, 145 boys) replicated the unidimensional structure and supported measurement invariance across gender. Collectively, the present study supported the unidimensionality, reliability, and validity of the Mandarin Chinese BAS-2′s scores among Chinese adolescents.

Analysis of the Trends and Influencing Factors for Postoperative Cough in Patients with Esophageal Cancer Based on Patient-Reported Outcomes

BackgroundCough is a common symptom that affects patients’ recovery and quality of life after esophagectomy. This study sought to investigate trends in postoperative cough and the factors that influence cough.MethodsA total of 208 of 225 patients were enrolled in this study. The Mandarin Chinese version of the Leicester Cough Questionnaire was administered the day before surgery and at three time points (1 week, 1 month, and 3 months) after esophagectomy to assess patient-reported outcomes.ResultsAll patients’ LCQ-MC scores after surgery were lower than presurgery (P < 0.05), with the lowest score found 1 week after esophagectomy. Factors associated with a cough 1 week after surgery included clinical stage of cancer (OR 0.782, 95% CI 0.647–0.944, P = 0.011), anastomotic position (OR 1.241, 95% CI 1.069–1.441, P = 0.005), duration of surgery (OR 0.759, 95% CI 0.577–0.998, P = 0.049), and subcarinal lymph node dissection (OR 0.682, 95% CI 0.563–0.825, P < 0.001). Factors associated with a cough one month after surgery included clinical stage (OR 0.782, 95% CI 0.650–0.940, P = 0.009), anastomotic position (OR 1.293, 95% CI 1.113–1.503, P = 0.001), and maintaining a semi-reclining position (OR 1.440, 95% CI 1.175–1.766, P < 0.001). Factors associated with a cough 3 months after surgery were clinical stage (OR 0.741, 95% CI 0.591–0.928, P = 0.009) and anastomotic position (OR 1.220, 95% CI 1.037–1.435, P = 0.016).ConclusionsThis study showed that the factors influencing postoperative cough differed over time following esophagectomy. These results may warrant prospective intervention to better manage patients undergoing surgery for esophageal cancer to prevent postoperative cough.

The Potential Mediating Effect of Symptom Burden on Demoralization Through Locus of Control and Coping Strategies in Chinese Patients With Cancer.

Demoralization is a psychological syndrome that is highly prevalent in patients with cancer and detrimental to individuals' physical and mental health. To explore effective intervention, we first determined the relationships between locus of control, coping strategies, symptom burden, and demoralization. The aim of this study was to determine the relationship between symptom burden, locus of control, coping strategies, and demoralization in patients with cancer. In this descriptive-correlational study, 273 valid patients were selected with convenience sampling method from a hospital in China. Data were collected using the Chinese version of the M.D. Anderson Symptom Inventory, the Chinese version of the Multidimensional Health Locus of Control Scale, the Chinese version of the Medical Coping Modes Questionnaire, and the Mandarin version of the Demoralization Scale. Data were analyzed using descriptive and inferential statistics using SPSS and AMOS. A total of 115 patients (42.12%) experienced clinical demoralization (Mandarin version of the Demoralization Scale > 30). Symptom burden (β = 0.295, P < .001), confrontation (β = -0.117, P = .028), and resignation (β = 0.456, P < .001) had direct effects on demoralization. Symptom burden also had an indirect effect on demoralization through the mediating role of resignation (β = 0.026, P = .002). Meanwhile, locus of control can affect demoralization entirely through the indirect mediating role of coping strategies (chance locus of control via resignation [β = 0.138, P < .01], powerful locus of control via confrontation [β = -0.017, P < .05]). Symptom burden affects demoralization not only directly but also indirectly. Coping strategies play an important mediating role between symptom burden, locus of control, and demoralization in patients with cancer. It is urgent to screen demoralization and identify patients with high symptom burden, maladaptive locus of control, or coping strategies. For the patients targeted, a more comprehensive and systematic approach to symptom management and more appropriate guidance related to adaptive coping strategies are needed.

Effect of Preserving the Pulmonary Branch of Vagus Nerve on Postoperative Cough in Patients with Stage I Peripheral Lung Adenocarcinoma

Cough is one of the main complications after pulmonary surgery, which seriously affects the postoperative quality of life. Preserving the pulmonary branch of vagus nerve may reduce the incidence of postoperative cough. Therefore, the aim of this study was to investigate whether preserving the pulmonary branch of the vagus nerve could reduce the incidence of postoperative chronic cough in patients with stage I peripheral lung adenocarcinoma. A total of 125 patients who underwent single-port thoracoscopic radical resection for lung cancer in the Department of Thoracic Surgery, The First Affiliated Hospital of University of Science and Technology of China from June 2022 to June 2023 were retrospectively selected, and divided into two groups according to whether the vagopulmonary branch was preserved during the operation, namely, the vagopulmonary branch group (n=61) and the traditional group (n=64). The general clinical data, perioperative conditions, lymph node dissection, Mandarin Chinese version of The Leicester Cough Questionnaire (LCQ-MC) scores before and 8 weeks after operation were recorded in the two groups. Both the two groups were divided into tamponade group and non-tamponade group according to whether autologous fat or gelatin sponge was tamponade after lymph node dissection. LCQ-MC scores and postoperative chronic cough of both groups were calculated. The LCQ-MC score of the traditional group was significantly lower than that of the vagopulmonary branch group in physiological, psychological, social and total scores at 8 weeks after surgery, and the difference was statistically significant (P<0.05). There were more cough patients in the traditional group than the vagopulmonary branch group at 8 weeks after surgery, with significant difference (P=0.006). Subgroup analysis was conducted separately for the vagopulmonary branch group and the traditional group. Among the patients in the vagopulmonary branch group and the traditional group, the LCQ-MC scores of the non-tamponade group 8 weeks after surgery were lower than those of the tamponade group (P<0.05). There were more patients with cough in the group 8 weeks after surgery than in the tamponade group (P=0.001, P=0.024). For patients with stage I peripheral lung adenocarcinoma, the preservation of the pulmonary branch of vagus nerve is safe and effective, which can reduce the incidence of postoperative chronic cough and improve the postoperative quality of life of the patients.

Establishment of a Predictive Model for Chronic Cough after Pulmonary Resection

Chronic cough after pulmonary resection is one of the most common complications, which seriously affects the quality of life of patients after surgery. Therefore, the aim of this study is to explore the risk factors of chronic cough after pulmonary resection and construct a prediction model. The clinical data and postoperative cough of 499 patients who underwent pneumonectomy or pulmonary resection in The First Affiliated Hospital of University of Science and Technology of China from January 2021 to June 2023 were retrospectively analyzed. The patients were randomly divided into training set (n=348) and validation set (n=151) according to the principle of 7:3 randomization. According to whether the patients in the training set had chronic cough after surgery, they were divided into cough group and non-cough group. The Mandarin Chinese version of Leicester cough questionnare (LCQ-MC) was used to assess the severity of cough and its impact on patients' quality of life before and after surgery. The visual analog scale (VAS) and the self-designed numerical rating scale (NRS) were used to evaluate the postoperative chronic cough. Univariate and multivariate Logistic regression analysis were used to analyze the independent risk factors and construct a model. Receiver operator characteristic (ROC) curve was used to evaluate the discrimination of the model, and calibration curve was used to evaluate the consistency of the model. The clinical application value of the model was evaluated by decision curve analysis (DCA). Multivariate Logistic analysis screened out that preoperative forced expiratory volume in the first second/forced vital capacity (FEV1/FVC), surgical procedure, upper mediastinal lymph node dissection, subcarinal lymph node dissection, and postoperative closed thoracic drainage time were independent risk factors for postoperative chronic cough. Based on the results of multivariate analysis, a Nomogram prediction model was constructed. The area under the ROC curve was 0.954 (95%CI: 0.930-0.978), and the cut-off value corresponding to the maximum Youden index was 0.171, with a sensitivity of 94.7% and a specificity of 86.6%. With a Bootstrap sample of 1000 times, the predicted risk of chronic cough after pulmonary resection by the calibration curve was highly consistent with the actual risk. DCA showed that when the preprobability of the prediction model probability was between 0.1 and 0.9, patients showed a positive net benefit. Chronic cough after pulmonary resection seriously affects the quality of life of patients. The visual presentation form of the Nomogram is helpful to accurately predict chronic cough after pulmonary resection and provide support for clinical decision-making.

Assessing vocabulary and grammar development in New Zealand Mandarin- and Cantonese-speaking children: a validation study

ABSTRACT New Zealand has a growing population of Mandarin and Cantonese speakers, including children with speech, language, and communication disorders. However, the absence of language development profiles poses challenges in effectively identifying and addressing these concerns. This study aimed to capture the current state of monolingual, bilingual, and multilingual Mandarin- and Cantonese-speaking children living in New Zealand. Over 200 mothers in the Growing Up in New Zealand longitudinal cohort study identified their children as understanding Mandarin and/or Cantonese. Mothers completed newly adapted vocabulary and grammar checklists for New Zealand Mandarin and Cantonese speakers at the Age 2 data wave. Both of the adapted New Zealand Mandarin and Cantonese versions showed high reliabilities and validities. Unique demographic predictors of children’s vocabulary and grammar were mothers’ education, household deprivation level, and children’s birth order. Language status and maternal concerns were also unique predictors of children’s vocabulary development in Mandarin and Cantonese, with monolingual children whose mothers reported no concerns having higher Mandarin and Cantonese vocabularies. These results have rich implications for researchers, clinicians, and practitioners working with Mandarin- and Cantonese-speaking children in New Zealand and worldwide.

Utilizing fNIRS to investigate the impact of Baduanjin training on attentional function in post-stroke cognitive impairment patients: a study protocol for a randomized controlled trial

BackgroundPost-stroke cognitive impairment (PSCI) is a prevalent complication among stroke survivors. It not only directly impacts patients' cognitive abilities but also hampers their capacity to regain independence in daily activities, consequently diminishing their quality of life. Among the various cognitive deficits following stroke, impaired attention is the most frequently observed, influencing not only daily functioning but also higher cognitive functions like working memory, executive functioning, and language.Emerging evidence indicates that Baduanjin, a traditional Chinese exercise, may have a positive impact on enhancing attention in older adults with mild cognitive impairment and stroke survivors. However, the precise mechanisms behind this effect remain unclear. In this study, we employed Baduanjin training as an intervention to address attention decline in post-stroke cognitive impairment patients and to delve into the potential mechanisms through which Baduanjin training may enhance attention in individuals with PSCI.MethodsIn this prospective randomized controlled trial, we plan to recruit 72 participants diagnosed with post-stroke cognitive impairment (PSCI). These participants will be randomly assigned in a 1:1:1 ratio to one of three groups: Baduanjin training(left hemisphere stroke and right hemisphere stroke) and conventional treatment.The conventional treatment group will receive standard rehabilitation sessions. In addition to conventional treatment, participants in the octogenarian training groups will undergo octogenarian training sessions lasting 40 min, five times a week, over a total period of 12 weeks.The primary outcome measures will include the Montreal Cognitive Assessment (MoCA) scale and the Attentional Lateralization Index. These assessments will be conducted by a trained evaluator before the start of the intervention and at weeks 6 and 12 after the intervention begins.Secondary outcome measures will be assessed using the baseline Mandarin version of the Oxford Cognitive Screening (OCS-P) scale, the simplified Fugl-Meyer Motor Function Assessment (FMA) scale, the Pittsburgh Rehabilitation Participation (PRPS) scale, and the Activities of Daily Living (ADL) scale before and after the intervention, respectively.DiscussionThis trial aims to examine the impact of Baduanjin training on attentional lateralization among patients with post-stroke cognitive impairment (PSCI). Functional brain imaging utilizing near-infrared spectroscopy will be employed to investigate how Baduanjin exercise influences the structural and functional connectivity of distinct brain regions or brain networks.Trial registrationChictr.org.cn, ID: ChiCTR2300076533. Registered on 11 October 2023.

Culturally adapted translation of LYMPH-Q upper extremity module from English to Mandarin Chinese

BackgroundBreast cancer-related lymphedema (BCRL) is one of the debilitating complications after breast cancer treatment. Several forms of patient-reported outcome measures (PROMs) were developed to evaluate the severity of BCRL based on the patients’ perspective. LYMPH-Q Upper Extremity Module is a newly developed questionnaire for BCRL. This study aimed to demonstrate the process of translation and cultural adaption from English to Mandarin Chinese. Methods and resultsThe translation process followed the International Society for Pharmacoeconomics and Outcomes Research (ISPOR) best-practice guidelines for the translation and cultural adaption of PROM. The process included four steps: forward translation, back translation, back translation review, and patient interviews. In total, five patients with BCRL were recruited for patient interviews.The forward translation step involved two professional translators whose native language was Mandarin Chinese. A reconciled translated version was produced. In the back translation step, the reconciled translated version in Mandarin Chinese was sent to another professional translator whose native language was English. The back-translated version in English was sent back to the developer of LYMPH-Q for review. In this step, 22 items were revised. In the final step of patient interviews, 15 items were revised based on the patients’ feedback. ConclusionThe development of Mandarin Chinese version of LYMPH-Q Upper Extremity Module and its utilization in conjunction with the existing objective measures could provide a more well-rounded picture of the status of patients with BCRL worldwide.