Children with autism spectrum disorders (ASD) may not develop symbolic play skills, so such skills need to be taught specifically. We report an experiment regarding a procedure targeting "object-substitution" symbolic play skills. The "object-substitution" symbolic play behavior occurred when the child labeled a common object with the name of a substitute and used the object to perform a play action (e.g., As she put a bowl on her head, she called it a hat). A multiple probe across behaviors design was employed with five children (four boys and one girl, aged 3 to 6 years) with ASD. All children had verbal communication and demonstrated functional play and generalized imitation, but no symbolic play skills prior to the study. The instruction consisted of intraverbal training, picture prompts, and modeling of play actions. All children demonstrated object-substitution symbolic play skills after the instruction. The occurrences of response generalization were also discussed.

A new free-from deformation method is presented in this paper. Object deformation is controlled by a mesh of arbitrary topology, namely a control mesh. The subdivision surface determined by the control mesh spans an intermediate deformation space. The object is embedded into the space by the nearest point rule. When the shape of the control mesh is changed, the object embedded in the intermediate deformation space will be deformed accordingly. Since the subdivision surface has a multiresolution property, the proposed deformation method naturally has a multiresolution property. A technique for generating control meshes is also introduced in the paper. Compared with previous deformation methods with arbitrary topology control tools, the proposed method has the advantages of flexible control and computational efficiency

Purpose A prediction model for 4-year risk of metabolic syndrome in adults was previously developed and internally validated. However, external validity or generalizability for this model was not assessed so it is not appropriate for clinical application. We aimed to externally validate this model based on a retrospective cohort. Patients and Methods A retrospective cohort design and a temporal validation strategy were used in this study based on a dataset from 1 January 2015 to 31 December 2018. Multiple imputation was used for missing values. Model performance was evaluated by using discrimination, calibration (calibration plot, calibration slope, and calibration intercept), overall performance (Brier score), and decision curve analysis. Results In external validation, the C-statistic was 0.782 (95% CI, 0.771–0.793). The calibration plot shows good calibration, calibration slope was 1.006 (95% CI, −0.011–1.063), and calibration intercept was −0.045 (95% CI, −0.113–0.022). Brier score was 0.164.The discrimination and calibration of the prediction model were good in temporal external validation. Conclusion The discrimination and calibration of the prediction model were satisfactory in the temporal external validation. However, clinicians should be aware that this prediction model was developed and validated in a tertiary setting. It is strongly recommended that further studies validate this model in international cohorts and large, prospective cohorts in different institutions.

Background Little is known about the potential mechanisms of healthy eating and exercise change, and design interventions which aim to promote healthy eating and exercise change among individuals at risk of metabolic syndrome. This study aimed to identify key determinants of healthy eating, exercise behaviors, and health among individuals at risk of metabolic syndrome using the integrated common-sense model of illness self-regulation. Method A cross-sectional study with a multi-wave data collection strategy. A total of 275 participants at risk of metabolic syndrome based on the clinical prediction model were included in the final analysis. Path analysis was employed to explore the pattern of relationships between key variables using AMOS. Results The mediation analysis suggested that personal and treatment control, and coherence can positively affect self-reported health via intentions and health behaviors (exercise and healthy eating). Additionally, relationships between self-efficacy (exercise and healthy eating) and health outcomes can be mediated by health behaviors, and both intentions and health behaviors. Conclusions This current research used the integrated common-sense model of illness self-regulation to predict healthy eating, exercise behaviors, and self-reported health among individuals at risk of metabolic syndrome. The results suggested that self-efficacy, intention, consequences, personal control, treatment control, and coherence were the key determinants of behavior and health, which can help design interventions to encourage healthy eating and exercise changes among individuals with a high risk of MetS.

Objectives: This study investigated the content of group members' empathic expression, and how it changes as group develops. Method: Participants were 10 group leaders and 42 university student members from six unstructured, interpersonal process groups aimed at helping students with their academic problems and interpersonal functioning. Fifteen transcripts of actual group sessions were coded using consensual qualitative research method. Results: Data analyses identified four domains: Cognitions, Emotions, Similarity, and Group. Members expressed empathy mostly on cognitive level, and least on group-as-a-whole level. Moreover, sharing similarity was a unique way of group members' empathic expression, which was not documented in previous literature on group leaders' expression of empathy. The occurrence of "cognitions" and "similarity" domains showed significant association with group periods, suggesting the change of group focus from connection to deeper understanding in line with the group development. Discussion: The results provided a qualitative description of how group members expressed empathy and may inform group leaders what aspects to focus on at different periods of the group to facilitate the empathic exchanges among members. Highlights and Implications• Group members express their empathy mostly in four types: On the Cognition level, on the Emotion level, disclosing Similarity, and commenting on the Group process.• Members express empathy mostly on cognitive level, and least on group-as-a-whole level. Moreover, sharing similarity is a unique way of members' empathic expression.• Group members show empathy by disclosing Similarity primarily at the beginning of the group, and along with the progression of group there is an increasing expression of empathy on the cognitive level by the members.• The results would inform group leaders which areas to focus on at different periods of the group to facilitate the expression of empathy amongst group members and deepen empathy in group.