摘要：
Aim To explore and explain the mechanisms that influence surface acting in nursing students with different characteristics.
To explore and explain the mechanisms that influence surface acting in nursing students with different characteristics.
Background Nurses are now expected to deliver patient-centered care which necessitates the emotional labor. Surface acting, a form of emotional labor, can lead to negative outcomes. Given that nursing students are the backbone of the future nursing profession, there is an urgent need to investigate their surface acting tendencies and identify potential factors for early intervention.
Nurses are now expected to deliver patient-centered care which necessitates the emotional labor. Surface acting, a form of emotional labor, can lead to negative outcomes. Given that nursing students are the backbone of the future nursing profession, there is an urgent need to investigate their surface acting tendencies and identify potential factors for early intervention.
Design A cross-sectional study.
A cross-sectional study.
Methods This study was surveyed in a vocational college in Gansu, China. Participants completed the general information questionnaire, Bem Sex Role Inventory, Professional Identity Questionnaire of Nursing Students and Surface Acting Scale. K-means cluster analysis was performed, followed by random forest algorithm and SHapley Additive exPlanations based on Python program.
This study was surveyed in a vocational college in Gansu, China. Participants completed the general information questionnaire, Bem Sex Role Inventory, Professional Identity Questionnaire of Nursing Students and Surface Acting Scale. K-means cluster analysis was performed, followed by random forest algorithm and SHapley Additive exPlanations based on Python program.
Results A total of 1241 nursing students from vocational college were investigated and were clustered into 4 groups. The five dimensions of professional identity had higher feature importance in all four groups, with professional self-image having the highest feature importance in Cluster 3. Professional self-image and understanding retention benefits and turnover risks were negative predictors of surface acting in all four groups. Social comparison and self-reflection, independence of career choice and social modeling regarding nursing profession were positively correlated with surface acting in specific groups. In Cluster 1, there exists a positive correlation between professional self-image and the constructs of social comparison and self-reflection; as well as a negative correlation between maternal education and understanding of retention benefits and turnover risks.
A total of 1241 nursing students from vocational college were investigated and were clustered into 4 groups. The five dimensions of professional identity had higher feature importance in all four groups, with professional self-image having the highest feature importance in Cluster 3. Professional self-image and understanding retention benefits and turnover risks were negative predictors of surface acting in all four groups. Social comparison and self-reflection, independence of career choice and social modeling regarding nursing profession were positively correlated with surface acting in specific groups. In Cluster 1, there exists a positive correlation between professional self-image and the constructs of social comparison and self-reflection; as well as a negative correlation between maternal education and understanding of retention benefits and turnover risks.
Conclusions Professional identity significantly influences surface acting behaviors among nursing students, with professional self-image serving as a key negative predictor. Positive family conditions, access to educational resources, parental literacy, masculine or feminine gender roles and first-year nursing students, these traits have implications when dimensions of professional identity are used to predict surface acting behaviors.
Professional identity significantly influences surface acting behaviors among nursing students, with professional self-image serving as a key negative predictor. Positive family conditions, access to educational resources, parental literacy, masculine or feminine gender roles and first-year nursing students, these traits have implications when dimensions of professional identity are used to predict surface acting behaviors.
作者机构：
[Rong, Lishan; Zhou, Yanyi] Univ South China, Sch Civil Engn, Hengyang 421001, Peoples R China.;[Li, He; Rong, Lishan; Huang, Chong] Chinese Acad Sci, Inst Geog Sci & Nat Resources Res, State Key Lab Resources & Environm Informat Syst, Beijing 100101, Peoples R China.
通讯机构：
[Li, H ] C;Chinese Acad Sci, Inst Geog Sci & Nat Resources Res, State Key Lab Resources & Environm Informat Syst, Beijing 100101, Peoples R China.
关键词：
coastal remote sensing;coastal dynamics;land area change;runoff-sediment dynamics;Yellow River Delta;estuary;sustainable coastal management
摘要：
The coastline of the Yellow River Delta in China has experienced significant dynamic changes due to both natural and human activities. Investigating its coastal dynamics and understanding the equilibrium with riverine runoff and sediment discharge is crucial for ecological balance and sustainable development in the region. In this study, a coastline extraction algorithm was developed by integrating water index and dynamic frequency thresholds based on the Google Earth Engine platform. Long-term optical remote sensing datasets from Landsat (1988-2016) and Sentinel-2 (2017-2023) were utilized. The End Point Rate (EPR) and Linear Regression Rate (LRR) methods were employed to quantify coastline changes, and the relationship between coastal evolution and runoff-sediment dynamics was investigated. The results revealed the following: (1) The coastline of the Yellow River Delta exhibits pronounced spatiotemporal variability. From 1988 to 2023, the Diaokou estuary recorded the lowest EPR and LRR values (-206.05 m/a and -248.33 m/a, respectively), whereas the Beicha estuary recorded the highest values (317.54 m/a and 374.14 m/a, respectively). (2) The cumulative land area change displayed a fluctuating pattern, characterized by a general trend of increase-decrease-increase, indicating a gradual progression toward dynamic equilibrium. The Diaokou estuary has been predominantly erosional, while the Qingshuigou estuary experienced deposition prior to 1996, followed by subsequent erosion. In contrast, the land area of the Beicha estuary has continued to increase since 1997. (3) Deltaic progradation has been primarily governed by runoff-sediment dynamics. Coastline advancement has occurred along active river channels as a result of sediment deposition, whereas former river mouths have retreated landward due to insufficient fluvial sediment input. In the Beicha estuary, increased land area has exhibited a strong positive correlation with annual sedimentary influx. The critical sediment discharge required to maintain equilibrium has been estimated at 79 million t/a for the Beicha estuary and 107 million t/a for the entire deltaic region. These findings provide a scientific foundation for sustainable sediment management, coastal restoration, and integrated land-water planning. This study supports sustainable coastal management, informs policymaking, and enhances ecosystem resilience.
期刊：
JOURNAL OF GLOBAL HEALTH,2025年15:04001 ISSN：2047-2978
通讯作者：
Zhang, YP
作者机构：
[Zhuang, Xinqi; Lei, Xiaoyu; Zhang, Yin-Ping; Zhang, YP; Zhang, Dandan; Zhang, Jianzhong] Xi An Jiao Tong Univ, Hlth Sci Ctr, Sch Nursing, West Yanta Rd 76, Xian 710061, Shaanxi, Peoples R China.;[Zhang, Dandan] Univ South China, Affiliated Nanhua Hosp, Inst Clin Res, Hengyang Med Sch, Hengyang, Hunan, Peoples R China.;[Liu, Fen] Univ South China, Affiliated Hosp 1, Hengyang Med Sch, Dept Gynecol & Obstet, Hengyang, Hunan, Peoples R China.;[Cui, Tianxin] Univ Edinburgh, Sch Hlth Social Sci, Edinburgh, Scotland.
通讯机构：
[Zhang, YP ] X;Xi An Jiao Tong Univ, Hlth Sci Ctr, Sch Nursing, West Yanta Rd 76, Xian 710061, Shaanxi, Peoples R China.
摘要：
BACKGROUND: As fertility rates decline and population ageing intensifies, the conflict between career and childbearing continues to impact clinicians, especially women. Exploring gender differences in the fertility intentions of male and female clinicians could help with identifying barriers to childbearing, developing effective policies to support work-life balance, and addressing the gap in research on gender disparities in this field. METHODS: We conducted a cross-sectional survey among health care personnel in Chinese public hospitals. Through cluster sampling from highly active WeChat groups, we gathered 698 responses from clinicians to the third fertility intention questionnaire online. We then used descriptive statistics and χ(2) tests for analysis. RESULTS: Men (28.28%) had higher intentions of having a third child than women (20.71%) (P = 0.013). In terms of reasons, female clinicians were more concerned than male clinicians about the impact on their career development (P = 0.002), difficulties in job hunting (P = 0.039), and physical injuries caused by multiple births (P < 0.001), and whether the elderly can help (P = 0.001). Conversely, men's apprehensions centred on economic factors such as real house costs (P < 0.001), policy support (P = 0.036), and wives' disagreement (P < 0.001). In discussing governmental interventions, men showed a higher level of interest in policies related to child care (P < 0.001), employment stability for women (P < 0.001), extended maternity leave (P < 0.001), and financial assistance than women (P < 0.001). CONCLUSIONS: Our findings show substantial gender-specific differences in third-child fertility intentions among clinicians. To address this, the government should consider divisions in family roles, future societal needs, and women's career development. Policies should focus on balancing work and family by offering affordable childcare, flexible parenting leave, financial incentives, and career support, ensuring childbirth does not negatively impact women's professional growth, and fostering gender equality in parenting.
摘要：
China is experiencing an increasingly serious aging population. Cognitive function is an important factor and guarantee for the quality of life of older people. Therefore, to achieve healthy aging, this study aimed to examine the sequential multiple mediating effects of indoor ventilation frequency and cognitive function on anxiety and self-rated health in the Chinese older people population. Using the 2018 China Longitudinal Health and Longevity Survey (CLHLS) dataset, we finally selected 10,372 Chinese seniors over the age of 65. First, we describe the basic socio-demographic information of the sample population. Second, Spearman correlation analysis was used to determine whether there was a correlation between indoor ventilation frequency, anxiety, self-rated health, and cognitive function among Chinese older people. Finally, the SPSS macro process program was used to complete the sequence multiple mediation analysis. Indoor ventilation frequency, anxiety, self-rated health and cognitive function were significantly correlated (p < 0.01). Indoor ventilation frequency not only has a direct positive impact on the cognitive function of older people (effect = 0.1427; Standard error = 0.0201; 95%CI: LL = 0.1034, UL = 0.1821), but also indirectly affected cognitive function through three pathways: independent mediation of anxiety (effect = 0.0078; Standard error = 0.0021; 95%CI: LL = 0.0041, UL = 0.0121), independent mediating effect of self-rated health (effect = 0.0154; Standard error = 0.0030; 95%CI: LL = 0.0098, UL = 0.0215), and the chain mediating effect between anxiety and self-rated health (effect = 0.0046; Standard error = 0.0009; 95%CI: LL = 0.0029, UL = 0.0065). All projects are self-reported and some results may be biased. In the future, it may be more inspiring to explore more detailed and specific effects of indoor air quality on cognitive function in older people. Studies have shown that indoor ventilation frequency can improve cognitive function by reducing anxiety and improving self-rated health in older people Chinese. Encouraging older adults to increase the frequency of indoor ventilation will benefit their mental health and cognitive function. This study provides empirical evidence for the association between indoor ventilation frequency and cognitive function in older people Chinese adults. We used nationally representative data to investigate the relationship between indoor ventilation frequency and cognitive function and further explored the mediating role of anxiety and self-rated health in Chinese older adults. Indoor ventilation frequency can not only directly affect cognitive function in older people, but also indirectly affect cognitive function through anxiety and self-rated health. Anxiety and self-rated health have a series of mediating effects between indoor ventilation frequency and cognitive function.
摘要：
Landslides can pose a significant threat and damage to life and property. Rapid and accurate determination of the location of landslides is critical to preventing and stopping geohazards. Currently, manual visual interpretation, semiautomatic interpretation, and traditional machine learning interpretation of landslides are less efficient and cannot meet the requirements of certain high-standard interpretation, while the object detection technology based on deep learning is developing rapidly, and its application in the field of intelligent interpretation of landslides is still immature. In this paper, YOLOv5, YOLOv6, YOLOv7, and YOLOv8 algorithms are evaluated to obtain the ideal landslide detection effect. In the respective variant models of YOLOv5, YOLOv6, and YOLOv7, the corresponding optimal landslide detection variants are YOLOv5x, YOLOv6n, and YOLOv7. Among the variant models of YOLOv8, YOLOv8n requires the least number of parameters and has the fastest detection speed. However, because the YOLOv8n model has the potential to be optimized in three aspects, such as feature fusion, attentional mechanism, and loss function, it was improved in this study in these three aspects. In this study, the improved model was named the YOLOv8-DBW model. Compared with YOLOv8n, this model has three main advantages: (1) Precision, recall, F1 score, mAP 0.5 , and mAP 0.5:0.95 are improved by 11.8%, 2.0%, 7.3%, 12.4%, and 5.4%, respectively; (2) higher detection accuracy, more accurate localization, and determination of the extent of landslides, as well as lower leakage rate; (3) the model can detect landslides of different sizes completely and accurately when in the scenarios of single landslide, multiple landslides, and multiple disturbances. This model still has potential for optimization in terms of computational resource consumption and detection of generalizability.
作者：
Yan, Yin;Derong, Tan;Qin, Tong;Zhi, Xu;Xia, Liu
期刊：
European Journal of Oncology Nursing,2025年76:102884 ISSN：1462-3889
通讯作者：
Yan, Y
作者机构：
[Yan, Yin; Xia, Liu; Qin, Tong] Univ South China, Affiliated Hosp 1, Hengyang Med Sch, Dept Oncol Breast Lymphoma Subspecialty, Hengyang, Hunan, Peoples R China.;[Derong, Tan] Univ South China, Affiliated Hosp 1, Hengyang Med Sch, Dept Oncol Abdominal Tumor Subspecialty, Hengyang, Hunan, Peoples R China.;[Zhi, Xu] Univ South China, Affiliated Hosp 1, Hengyang Med Sch, Dept Oncol Head & Neck Pelv Tumor Subspecialty, Hengyang, Hunan, Peoples R China.;[Yan, Y] 69 Chuanshan Rd, Hengyang City, Hunan Province, Peoples R China.
通讯机构：
[Yan, Y ] 6;69 Chuanshan Rd, Hengyang City, Hunan Province, Peoples R China.
摘要：
Purpose The study aims to explore the factors influencing advance care planning among cancer patients, recognizing the importance of understanding these factors to enhance patient outcomes and ensure that patients' preferences are honored.
The study aims to explore the factors influencing advance care planning among cancer patients, recognizing the importance of understanding these factors to enhance patient outcomes and ensure that patients' preferences are honored.
Methods Conducted from May to November 2023, this qualitative descriptive study employed a phenomenological research approach. In-depth face-to-face interviews and observations were utilized to gather insights into the factors influencing participation in advance care planning, guided by a semi-structured interview outline based on social ecosystem theory. Content analysis and thematic analysis were applied to identify and interpret key themes from the data.
Conducted from May to November 2023, this qualitative descriptive study employed a phenomenological research approach. In-depth face-to-face interviews and observations were utilized to gather insights into the factors influencing participation in advance care planning, guided by a semi-structured interview outline based on social ecosystem theory. Content analysis and thematic analysis were applied to identify and interpret key themes from the data.
Results A total of 17 cancer patients participated in the interviews. The analysis revealed four main themes. Facilitating factors included optimistic health views and positive attitudes toward advance care planning, which encouraged engagement. Conversely, barriers such as a lack of understanding of advance care planning, misconceptions, and negative attitudes hindered participation. Family dynamics played a significant role; trust in family decisions facilitated discussions, while family pressure created challenges. Economic burdens and cultural taboos surrounding death, along with reliance on healthcare providers, impeded open conversations. These findings highlight the necessity for targeted strategies to enhance patient involvement in advance care planning.
A total of 17 cancer patients participated in the interviews. The analysis revealed four main themes. Facilitating factors included optimistic health views and positive attitudes toward advance care planning, which encouraged engagement. Conversely, barriers such as a lack of understanding of advance care planning, misconceptions, and negative attitudes hindered participation. Family dynamics played a significant role; trust in family decisions facilitated discussions, while family pressure created challenges. Economic burdens and cultural taboos surrounding death, along with reliance on healthcare providers, impeded open conversations. These findings highlight the necessity for targeted strategies to enhance patient involvement in advance care planning.
Conclusion Cancer patients' advance care planning is influenced by positive factors like optimistic health views and supportive family dynamics, as well as obstacles such as misconceptions, cultural taboos, and economic burdens. Targeted interventions are needed to empower patients and better align care with their values.
Cancer patients' advance care planning is influenced by positive factors like optimistic health views and supportive family dynamics, as well as obstacles such as misconceptions, cultural taboos, and economic burdens. Targeted interventions are needed to empower patients and better align care with their values.
摘要：
BACKGROUND: China has become an aging country. The subjective well-being of the older people is one of the important indicators to measure the health and quality of life of the older people, and it is a concentrated reflection of the overall spiritual life of the older people. Therefore, to achieve successful aging, this study aimed to examine the sequential multiple mediating effects of social participation and sleep quality between urinary incontinence and subjective well-being in the Chinese older people population. METHODS: Based on the 2018 China Longitudinal Health and Longevity Survey (CLHLS) dataset, a total of 10,068 Chinese seniors aged 65 and above were selected. First, the basic socio-demographic characteristics of the sample population were described. Second, Spearman correlation analysis was conducted to examine the associations among urinary incontinence, social participation, sleep quality, and subjective well-being in older adults. Finally, sequential multiple mediation analysis was performed using the SPSS macro PROCESS 4.0 to assess the potential mediating roles of social participation and sleep quality. RESULTS: Urinary incontinence, social participation, sleep quality, and subjective well-being were significantly correlated (P < 0.01). Urinary incontinence is not only directly associated with the subjective well-being of the older people (effect = 0.9195;) Standard error = 0.1572; 95%CI: LL = 0.6115, UL = 1.2276), and also through the independent mediating effect of social participation (effect = 0.1508; Standard error = 0.0180; 95%CI: LL = 0.1178, UL = 0.1880), the independent mediating effect of sleep quality (effect = 0.2046; Standard error = 0.0495; 95%CI: LL = 0.1067, UL = 0.3004), the chain mediating effect between social participation and sleep quality (effect = 0.3670; Standard error = 0.0531; 95%CI: LL = 0.2601, UL = 0.4720) was associated with subjective well-being. CONCLUSIONS: Studies have shown that the social participation and sleep quality of older people in China can mediate the connection between urinary incontinence and subjective well-being. Therefore, it is necessary to pay timely attention to and intervene in the social participation and sleep quality of older patients with urinary incontinence to improve their subjective well-being.
摘要：
Aims
Although anxiety and depression are frequently linked to coronary heart disease, a network analysis of comorbid anxiety and depression and their association with quality of life in patients undergoing percutaneous coronary intervention (PCI) remains unclear from the perspective of symptom interactions. We aimed to investigate the network structure and symptom patterns of anxiety and depression, and their relationship with quality of life in patients undergoing PCI.
Methods and Results
This study included 528 patients undergoing PCI. The seven-item Generalized Anxiety Disorder Scale, nine-item Patient Health Questionnaire, and World Health Organization Quality of Life Questionnaire-Brief Version were used as measurement tools. The R software was used to construct and interpret the network structure. The symptoms “sleep disturbance,” “irritability,” and “uncontrollable worry” showed the highest expected influence centrality. Three bridge symptoms were identified: “sleep disturbance,” “excessive worry,” and “trouble relaxing.” Among the three strongest edges, two were associated with anxiety and depressive symptoms. Ten symptoms were directly associated with quality of life, with “fatigue” showing the strongest relationship. In the network comparison test, significant differences in global strength were observed between the male and female groups.
Conclusion
“Sleep disturbance,” plays a critical role in the current network, while “excessive worry,” “trouble relaxing,” and “fatigue” were identified as key priorities owing to their high correlation with “sleep disturbance” and quality of life. Focusing on these symptoms may help mitigate the risk of multiple-symptom interactions and provide tailored intervention measures for patients undergoing PCI.
Registration
Chinese Clinical Trial Registry ChiCTR230007581
期刊：
FRONTIERS IN PSYCHIATRY,2025年16:1594313 ISSN：1664-0640
通讯作者：
Zhou, XH
作者机构：
[Yang, Shanghao; Zhou, Bojie; Ou, Qinglin; Zhou, Xuhui; Shi, Li] Hunan Univ Chinese Med, Coll Integrat Chinese & Western Med, Changsha, Peoples R China.;[Yang, Shanghao; Zhou, Bojie; Ou, Qinglin; Zhou, Xuhui; Shi, Li] Brain Hosp Hunan Prov, Peoples Hosp Hunan Prov 2, Hunan Inst Mental Hlth, Dept Addict Med, Changsha, Peoples R China.;[Shi, Li] Univ South China, Affiliated Changsha Cent Hosp, Dept Ctr TB Diag & Treatment, Hengyang Med Sch, Changsha, Peoples R China.;[Chen, Xiaofang] Jiangxi Prov Peoples Hosp, Key Lab Digital Orthopaed, Nancang, Peoples R China.
通讯机构：
[Zhou, XH ] H;Hunan Univ Chinese Med, Coll Integrat Chinese & Western Med, Changsha, Peoples R China.;Brain Hosp Hunan Prov, Peoples Hosp Hunan Prov 2, Hunan Inst Mental Hlth, Dept Addict Med, Changsha, Peoples R China.
关键词：
alcohol use disorder;cognitive impairment;Metabolomics;lipidomics;Sphingolipid metabolism;mTORC1 pathway
摘要：
Purpose: Alcohol use disorder (AUD) is a chronic relapsing condition frequently complicated by cognitive impairment (CI), yet its underlying metabolic mechanisms remain poorly understood. This study aimed to identify plasma metabolic signatures and dysregulated pathways associated with AUD-CI using an integrated multi-omics approach. Methods: A prospective cohort study of 210 male participants (70 AUD-CI, 70 AUD without CI [AUD-NonCI], and 70 healthy controls [HCs]) was conducted. Plasma samples underwent LC-MS/MS-based metabolomic and lipidomic profiling. Cognitive function was assessed using the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS). Machine learning algorithms (Random Forest and LASSO regression) were employed for biomarker selection, and pathway analysis was performed using MetaboAnalyst 5.0. Results: The multi-omics platform detected 117 differentially expressed molecules (11 metabolites and 106 lipids) with high diagnostic accuracy (mean AUC=0.92 +/- 0.03). Key findings included depletion of S-adenosylmethionine (SAM; 1.8-fold decrease, p=3.4x10(-4)) and accumulation of ceramide species Cer (d18:1/26:2) (2.1-fold increase, p=7.8x10(-4)). Pathway analysis revealed mTORC1 signaling (p=1.4x10(-4)) and sphingolipid metabolism (p=2.1x10(-5)) as central dysregulated pathways. AUD-CI patients exhibited 49 unique lipid alterations, notably 70% reduction of phosphatidylcholine PC (42:4) versus HCs (p=0.002), strongly correlated with synaptic protein markers (r=0.82, p<0.001). Conclusion: Our findings characterize a dysregulated liver-gut-brain metabolic axis in AUD-CI pathogenesis, highlighting the mTORC1-sphingolipid pathway as a promising therapeutic target. The identified biomarkers provide mechanistic insights into alcohol-induced neurotoxicity, offering potential avenues for precision interventions in AUD-related cognitive decline.
作者机构：
[He, Mei; Du, Bing; Guo, Hui; Jia, Xiangbin; Xia, K; Chen, Guodong; Xia, Kun; Lyu, Yongqing] Cent South Univ, Ctr Med Genet, MOE Key Lab Rare Pediat Dis,Sch Life Sci, Changsha, Peoples R China.;[He, Mei; Du, Bing; Guo, Hui; Jia, Xiangbin; Xia, K; Chen, Guodong; Xia, Kun; Lyu, Yongqing] Cent South Univ, Sch Life Sci, Hunan key Lab Med Genet, Changsha, Hunan, Peoples R China.;[He, Mei] Hunan Prov Maternal & Child Hlth Care Hosp, NHC Key Lab Birth Defect Res & Prevent, Changsha, Hunan, Peoples R China.;[Guo, Hui] Furong Lab, Changsha, Hunan, Peoples R China.;[Xia, K; Xia, Kun] Univ South China, Hengyang Med Sch, Hengyang 421001, Hunan, Peoples R China.
通讯机构：
[Jia, XB; Xia, K ] C;Cent South Univ, Ctr Med Genet, MOE Key Lab Rare Pediat Dis,Sch Life Sci, Changsha, Peoples R China.;Cent South Univ, Sch Life Sci, Hunan key Lab Med Genet, Changsha, Hunan, Peoples R China.;Univ South China, Hengyang Med Sch, Hengyang 421001, Hunan, Peoples R China.
关键词：
autism spectrum disorders;brain development;de novo mutations;NAA15;neurodevelopmental disorders
摘要：
Neurodevelopmental disorders (NDDs) encompass a group of conditions that impact brain development and function, exhibiting significant genetic and clinical heterogeneity. NAA15, the auxiliary subunit of the N-terminal acetyltransferase complex, has garnered attention due to its association with NDDs. However, the precise role of NAA15 in cortical development and its contribution to NDDs remain elusive. By employing targeted sequencing on a large Chinese cohort affected by ASD and conducting an extensive literature review, we have compiled 64 distinct variants in the NAA15 gene identified among individuals with neurodevelopmental disorders. Our research demonstrates that loss of NAA15 leads to a substantial increase in neuronal count, potentially resulting in aberrant brain development and triggering repetitive as well as anxious behaviors in mice models. Furthermore, disorder-associated variants within NAA15 impair axon and synapse formation processes crucial for neural connectivity establishment. These findings shed light on the consequences of NAA15 deficiency along with its de novo mutations on brain development while unraveling the cellular mechanisms underlying NDDs.
摘要：
BACKGROUND: To investigate the association between indoor ventilation frequency and symptoms of depression and anxiety in older persons. METHODS: A binary logistic regression model was used to analyze the effects of indoor ventilation frequency on depression and anxiety by using data from the 2018 Chinese longitudinal healthy longevity survey (CLHLS). RESULTS: A total of 9,690 older persons with an average age of (83.20 ± 11.27) years were included, including 4,458 males (46.0%) and 5,232 females (54.0%). The average score of indoor ventilation frequency was (6.06 ± 1.98) points, including 770 people (7.9%) with low frequency, 3,066 people (31.6%) with medium frequency, and 5,854 people (60.4%) with high frequency. 842 (8.7%) had symptoms of depression and 204 (2.1%) had symptoms of anxiety. Compared with the older persons with low indoor ventilation frequency, the older persons with higher ventilation frequency had a lower incidence of depression (OR(95%CI) = 1.92 (1.50 ∼ 2.46), 1.51 (1.27 ∼ 1.79); P < 0.001). However indoor ventilation frequency was not associated with anxiety symptoms. CONCLUSION: Indoor ventilation frequency is related to depressive symptoms in older persons. Communities and families should pay more attention to indoor ventilation and intervene in time to promote and improve the mental health of older persons.
摘要：
Interprofessional education (IPE) is essential for promoting teamwork among healthcare professionals. However, its implementation is often hindered by the limited availability of interprofessional faculty and scheduling challenges in creating high-quality IPE scenarios. While AI tools like ChatGPT are increasingly being explored for this purpose, they have yet to demonstrate the ability to generate high-quality IPE scenarios, which remains a significant challenge. This study examines the effectiveness of GPT-4o, an advanced version of ChatGPT enhanced by novel methodologies, in overcoming these obstacles. This comparative study assessed clinical scenarios generated by GPT-4o using two strategies—standard prompt (a single-step scenario generation without iterative feedback) and iterative refinement (a multi-step, feedback-driven process)—against those crafted by clinical mentors. The iterative refinement method, inspired by actual clinical scenario development, employs a cyclical process of evaluation and refinement, closely mimicking discussions among professionals. Scenarios were evaluated for time efficiency and quality using the Interprofessional Quality Score (IQS), defined as the mean score assigned by multidisciplinary evaluators across five interprofessional criteria: clinical authenticity, team collaboration, educational alignment, appropriate challenge, and student engagement. Scenarios developed using the iterative refinement strategy were completed significantly faster than those by clinical mentors and achieved higher or equivalent IQS. Notably, these scenarios matched or exceeded the quality of those created by humans, particularly in areas such as appropriate challenge and student engagement. Conversely, scenarios generated via the standard prompt method exhibited lower accuracy and various other deficiencies. Blinded attribution assessments by students further demonstrated that scenarios developed through iterative refinement were often indistinguishable from those created by human mentors. Employing GPT-4o with iterative refinement and role-playing strategies produces clinical scenarios that, in some areas, exceed those developed by clinical mentors. This approach reduces the need for extensive faculty involvement, highlighting AI’s potential to closely align with established educational frameworks and substantially enhance IPE, particularly in resource-constrained settings.
摘要：
In recent years, much research has been conducted on the carbon emissions trading scheme policy. However, more studies need to focus on the impact of the carbon emissions trading scheme on corporate strategy. In order to address this research gap, drawing on panel data of Chinese A-share listed companies from 2008 to 2020, a quasi-natural experiment was conducted on the impact of the carbon emissions trading scheme on corporate strategic deviance, using a staggered DID model. The results showed that the carbon emissions trading scheme is positively related to corporate strategic deviance, and this relationship has a significant lag. The mechanism analysis demonstrated that the carbon emissions trading scheme can promote innovation quality and environmental performance, thereby indirectly promoting improvement in corporate strategic deviance. The heterogeneity analysis revealed that the carbon emissions trading scheme has a more significant positive relationship with corporate strategic deviance in non-state-owned enterprises, highly polluting industries, and provinces with weak environmental regulation.
In recent years, much research has been conducted on the carbon emissions trading scheme policy. However, more studies need to focus on the impact of the carbon emissions trading scheme on corporate strategy. In order to address this research gap, drawing on panel data of Chinese A-share listed companies from 2008 to 2020, a quasi-natural experiment was conducted on the impact of the carbon emissions trading scheme on corporate strategic deviance, using a staggered DID model. The results showed that the carbon emissions trading scheme is positively related to corporate strategic deviance, and this relationship has a significant lag. The mechanism analysis demonstrated that the carbon emissions trading scheme can promote innovation quality and environmental performance, thereby indirectly promoting improvement in corporate strategic deviance. The heterogeneity analysis revealed that the carbon emissions trading scheme has a more significant positive relationship with corporate strategic deviance in non-state-owned enterprises, highly polluting industries, and provinces with weak environmental regulation.
作者机构：
[He, Qi; Li, Ming; Yang, Yifan; Liao, Chongjie] Univ South China, Sch Civil Engn, Hengyang 421001, Peoples R China.
通讯机构：
[He, Q ] U;Univ South China, Sch Civil Engn, Hengyang 421001, Peoples R China.
关键词：
lead-zinc tailings;lightweight and high strength ceramsite;sintering;silicon carbide;recycling;sustainable development
摘要：
This study proposes a sustainable method to convert high-silicon lead-zinc tailings (HS-LZT) into lightweight and high-strength ceramsite, aiming to address the issues of solid waste management and resource efficiency by using HS-LZT and kaolin as the main raw materials and silicon carbide (SiC) as the pore-forming agent. A sintering process was employed to prepare lightweight, high-strength ceramsite. X-ray diffraction (XRD), X-ray fluorescence (XRF), Thermogravimetric-differential scanning calorimetry (TG-DSC), and inductively coupled plasma optical emission spectrometer (ICP-OES) were used to analyze the physical composition and physical and chemical properties of the raw materials. The influence of raw material ratios, SiC content, sintering temperature, and sintering time on ceramsite properties was investigated, and the microstructure of the optimal finished ceramsite was analyzed. The results show that under optimal preparation conditions (70% [by mass percentage] of HS-LZT, 30% [by mass percentage] of kaolin, with an addition of 0.5% [by mass percentage] of SiC, a sintering temperature of 1200 degrees C, and a sintering time of 20 min), the LZT ceramsite achieved a compressive strength of 11.39 MPa, a bulk density of 724 kg/m3, and a 1 h water absorption rate of 4.82%. The leaching content of Pb and Zn of the sintered ceramsite samples is far less than the limit values of hazardous components in the leachate specified in the relevant standard. This study provides a potential pathway for the reduction, recycling, and environmentally sound utilization of HS-LZT, which is in line with the sustainable development concept of "treating waste with waste."
摘要：
BACKGROUND: Good adherence to pre-exposure prophylaxis (PrEP) is critical for effective HIV prevention. Despite the growing awareness of PrEP, many individuals remain at a preliminary understanding stage and struggle to achieve sustained adherence. mHealth (mobile Health) technology is emerging as one of the promising tools in the HIV prevention cascade. While research on mHealth applications for HIV prevention is rapidly advancing, their effectiveness in promoting robust PrEP adherence and optimizing cascade outcomes remains inconclusive, with fragmented evidence limiting scalable implementation. OBJECTIVE: To evaluate the efficacy of mHealth tools in optimizing the HIV prevention cascade (from risk identification to PrEP adherence) among key populations (including men who have sex with men, bisexual individuals, sex workers, transgender populations and some other groups who at elevated risk of HIV acquisition). METHODS: We searched in PubMed, Cochrane Library, Web of Science, Embase, Ovid and CINAHL (EBSCO) from the inception to February 3, 2025. Our inclusion criteria focused on randomized controlled trials (RCTs). Literature screening and data extraction were performed independently by two authors. Methodological quality was assessed using Cochrane's Risk of Bias in Randomized Controlled Trials tool. The primary outcome was adherence to PrEP and secondary outcomes included PrEP use, HIV testing and number of condomless sex events. Analyses were performed using standardized mean difference (SMD) and 95% confidence interval (CI) for continuous variables and using odds ratios (OR) and 95% CI for categorical variables. Data analysis and forest plotting were carried out using R Statistical Software version 4.4.0. RESULTS: 16 RCT studies met the inclusion criteria. The results of the meta-analysis showed that mHealth interventions significantly promoted PrEP adherence (OR = 1.60, 95% CI [1.09, 2.35], ρ = 0.016) and HIV testing (OR = 1.63, 95% CI [1.39, 1.90], ρ < 0.01). It had also shown some effectiveness in promoting the use of PrEP. However, there were no significant effects on reducing the number of condomless sex events during the entire follow-up period. CONCLUSION: mHealth effectively enhances specific stages of the prevention cascade. However, further optimization of technology design and intervention is needed to address complex difficulties. SYSTEMATIC REVIEW REGISTRATION: https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=533772, identifier PROSPERO CRD42024533772.
期刊：
Asia-Pacific Journal of Oncology Nursing,2025年12:100702 ISSN：2347-5625
通讯作者：
Chen, YY
作者机构：
[Guo, Junchen; Xu, Xianghua; Chen, Yongyi; Hu, Yonghong] Hunan Canc Hosp, Dept Palliat Care, Changsha, Peoples R China.;[Guo, Junchen] Univ Wollongong, Sch Nursing, Wollongong, NSW, Australia.;[Zeng, Linghao] Univ South China, Sch Nursing, Hengyang, Peoples R China.;[Dai, Yunyun] Univ Wollongong, Hlth Serv Res Inst, Wollongong, NSW, Australia.
通讯机构：
[Chen, YY ] H;Hunan Canc Hosp, Dept Palliat Care, Changsha, Peoples R China.
关键词：
Palliative care;Shared-care management;Delphi technique;End of life care
摘要：
Objective Shared-care management (SCM) in palliative care is a collaborative model where shared care teams work in partnership with patients' original healthcare providers, employing multimodal strategies including consultations and coordinated referrals to enhance quality of care for patients. The evidence regarding its implementation remains fragmented and lacks detailed explanations, which impedes its application in clinical practice. This study aimed to develop a SCM standard of palliative care in adults in mainland regions of China.
Shared-care management (SCM) in palliative care is a collaborative model where shared care teams work in partnership with patients' original healthcare providers, employing multimodal strategies including consultations and coordinated referrals to enhance quality of care for patients. The evidence regarding its implementation remains fragmented and lacks detailed explanations, which impedes its application in clinical practice. This study aimed to develop a SCM standard of palliative care in adults in mainland regions of China.
Methods Initial standard framework identification was achieved via literature evidence summary. From April to August 2024, two rounds of Delphi method was conducted with the purposes of modifying the standard. To establish consensus, items with a mean importance score > 3.50 and the coefficient of variation of item scores < 0.25 were retained.
Initial standard framework identification was achieved via literature evidence summary. From April to August 2024, two rounds of Delphi method was conducted with the purposes of modifying the standard. To establish consensus, items with a mean importance score > 3.50 and the coefficient of variation of item scores < 0.25 were retained.
Results The first round involved 35 experts, with a follow-up participation of 33 in the second round. The Kendall concordance coefficients of the two rounds of experts consultation were 0.128 and 0.134, respectively (all P < 0.001), indicating consensus among the experts. At the end of the second round, the average importance score of each item was 4.73-5.00. A total of 8 modules including SCM team, applicable population, process of SCM, contents of SCM, start time, precautions, effectiveness evaluation and quality control, and the corresponding 22 items were finally identified in this standard.
The first round involved 35 experts, with a follow-up participation of 33 in the second round. The Kendall concordance coefficients of the two rounds of experts consultation were 0.128 and 0.134, respectively (all P < 0.001), indicating consensus among the experts. At the end of the second round, the average importance score of each item was 4.73-5.00. A total of 8 modules including SCM team, applicable population, process of SCM, contents of SCM, start time, precautions, effectiveness evaluation and quality control, and the corresponding 22 items were finally identified in this standard.
Conclusions The establishment of the standard in this study provides a critical framework that can be adopted by healthcare institutions to ensure that SCM services are delivered uniformly and effectively in mainland regions of China.
The establishment of the standard in this study provides a critical framework that can be adopted by healthcare institutions to ensure that SCM services are delivered uniformly and effectively in mainland regions of China.
摘要：
Background Anxiety is a common and significant problem in patients who need to undergo colonoscopy. However, the question of which non-pharmacological intervention is the best strategy to reduce anxiety in patients undergoing colonoscopy remains unanswered.
Anxiety is a common and significant problem in patients who need to undergo colonoscopy. However, the question of which non-pharmacological intervention is the best strategy to reduce anxiety in patients undergoing colonoscopy remains unanswered.
Objectives To evaluate and rank the effectiveness of various non-pharmacological interventions for reducing anxiety in patients undergoing colonoscopy in order to identify the most effective strategies.
To evaluate and rank the effectiveness of various non-pharmacological interventions for reducing anxiety in patients undergoing colonoscopy in order to identify the most effective strategies.
Methods We searched PubMed, Cochrane Library, Embase, Web of Science, and Medline for randomized controlled trials published from the database construction to March 2024. The primary outcome was the difference between pre- and post-intervention anxiety means. A network meta-analysis was conducted utilizing the “gemtc” package based on R4.3.0.
We searched PubMed, Cochrane Library, Embase, Web of Science, and Medline for randomized controlled trials published from the database construction to March 2024. The primary outcome was the difference between pre- and post-intervention anxiety means. A network meta-analysis was conducted utilizing the “gemtc” package based on R4.3.0.
Results The analysis encompassed 24 randomized controlled trials, incorporating 2525 participants and evaluating 9 non-pharmacological interventions. All non-pharmacological interventions reduced anxiety in patients undergoing colonoscopy compared to standard care, with music intervention (SMD = -0.52, 95 %CI (−0.84,-0.20)), audiovisual distraction (SMD = -0.54, 95 %CI(−0.96,-0.12)), video information (SMD = -1.47, 95 %CI(−2.03,-0.90)), individual education (SMD = -1.72, 95 %CI(−2.76,-0.70)), and electroacupuncture (SMD = -1.12, 95 %CI(−2.10,-0.13)) having statistically significant effects. SUCRA ranking identified the priority of individual education (SUCRA: 92.5 %) and video information (SUCRA: 87.7 %). Meta-regression and sensitivity analysis further demonstrated the stability of the evidence. The certainty of the evidence was mostly rated as medium to low.
The analysis encompassed 24 randomized controlled trials, incorporating 2525 participants and evaluating 9 non-pharmacological interventions. All non-pharmacological interventions reduced anxiety in patients undergoing colonoscopy compared to standard care, with music intervention (SMD = -0.52, 95 %CI (−0.84,-0.20)), audiovisual distraction (SMD = -0.54, 95 %CI(−0.96,-0.12)), video information (SMD = -1.47, 95 %CI(−2.03,-0.90)), individual education (SMD = -1.72, 95 %CI(−2.76,-0.70)), and electroacupuncture (SMD = -1.12, 95 %CI(−2.10,-0.13)) having statistically significant effects. SUCRA ranking identified the priority of individual education (SUCRA: 92.5 %) and video information (SUCRA: 87.7 %). Meta-regression and sensitivity analysis further demonstrated the stability of the evidence. The certainty of the evidence was mostly rated as medium to low.
Conclusion This review highlights the superior effects of individual education and video information in reducing anxiety in patients undergoing colonoscopy. The findings of our review could provide clinical decision-makers and healthcare practitioners, such as doctors and nurses, with evidence-based practices for selecting interventions to reduce anxiety in patients undergoing colonoscopy.
This review highlights the superior effects of individual education and video information in reducing anxiety in patients undergoing colonoscopy. The findings of our review could provide clinical decision-makers and healthcare practitioners, such as doctors and nurses, with evidence-based practices for selecting interventions to reduce anxiety in patients undergoing colonoscopy.
作者机构：
[Ning, Tianming; Yao, Cuiyin; Xie, Tian; Yu, Kangxin; Yang, Jinzhao] Univ South China, Hengyang, Hunan, Peoples R China.;[Chen, Wei-fan; Xie, Tian] Penn State Univ, Informat Sci & Technol, State Coll, PA USA.;[Xie, Tian] Univ South China, Sch Econ Management & Law, 228 Hengqi Rd, Hengyang 421001, Hunan, Peoples R China.
通讯机构：
[Xie, T ] U;Univ South China, Sch Econ Management & Law, 228 Hengqi Rd, Hengyang 421001, Hunan, Peoples R China.
关键词：
enterprise management;scientometric analysis;LDA topic model;pandemic;COVID-19;sustainable development
摘要：
The major epidemics, especially COVID-19, caused a significant impact on global businesses, including lockdowns, labor shortages, price increases, disrupted supply chains, and increased demand. They brought challenges to enterprise systems and business modes and triggered knowledge innovations. Bibliometric and Latent Dirichlet Allocation (LDA) were used to investigate the distribution of literature, co-citation, research hotspots, and trends in pandemic-triggered enterprise management from 2006 to 2023 based on the Web of Science databases. The results show that during the outbreak period, supply chain resilience management, enterprise technological innovation and sustainable development were hot topics in research. In the post-epidemic era, enterprise crisis management and sustainable development are gradually refined, and resilience, digitalization, and sustainability will become the frontier topics.
摘要：
Although diabetes mellitus (DM) is considered an important prognostic factor for hysterectomy outcomes, the relationship between DM and postoperative complications remains unclear. The aim of this study was to investigate whether DM is associated with an increased risk of complications following hysterectomy. We systematically searched PubMed, Embase, and the Cochrane Library for relevant articles published on or before March 15, 2024. Pooled odds ratios (ORs) and 95% confidence intervals (CIs) were calculated via random effects meta-analysis. The primary outcome was the risk of complications posthysterectomy, including postoperative infection and hospital readmission. Additionally, we conducted subgroup and sensitivity analyses to explore the main sources of heterogeneity and assess the stability of the results. A total of 19 cohort studies comprising 375,531 participants met the inclusion criteria. This meta-analysis revealed that DM was significantly associated with postoperative infection (OR 2.01, 95% CI 1.46–2.77). Additionally, DM was significantly associated with low postoperative survival (5 years) (OR 4.43, 95% CI 2.98–6.58), readmission (OR 1.59, 95% CI 1.42–1.79), embolism (OR 1.31, 95% CI 1.18–1.46), renal failure (OR 3.88, 95% CI 2.74–5.51) and reintubation (OR 3.23, 95% CI 1.64–6.35), whereas DM was not associated with an extended length of stay (OR 1.39, 95% CI 0.93–2.10), myocardial infarction (OR 1.86, 95% CI 0.58–5.98) or blood transfusion (OR 1.36, 95% CI 0.88–2.11) in patients following hysterectomy. DM increases the risk of postoperative infection following hysterectomy. Special attention should be given to diabetic patients to reduce the incidence of complications after hysterectomy.
期刊：
Asia-Pacific Journal of Oncology Nursing,2025年12:100762 ISSN：2347-5625
通讯作者：
Ye, ZJ;Knobf, MT;Li, JY
作者机构：
[Li, Siyu; Zhang, Qihan; Chen, Furong; Deng, Yiguo; Ye, Zengjie] Guangzhou Med Univ, Sch Nursing, Guangzhou, Guangdong, Peoples R China.;[Xiao, Zhirui] Univ South China, Sch Nursing, Hengyang, Hunan, Peoples R China.;[Knobf, M. Tish] Yale Univ, Sch Nursing, Orange, CT 06520 USA.;[Li, Jiaying] Chinese Univ Hong Kong, Fac Med, Nethersole Sch Nursing, Hong Kong, Peoples R China.;[Li, Jiaying] Johns Hopkins Univ, Sch Nursing, Baltimore, MD 21218 USA.
通讯机构：
[Ye, ZJ ] G;[Li, JY ] C;[Knobf, MT ] Y;Guangzhou Med Univ, Sch Nursing, Guangzhou, Guangdong, Peoples R China.;Yale Univ, Sch Nursing, Orange, CT 06520 USA.
关键词：
Cervical cancer;Fear of progression;Johnson–Neyman analysis;Moderated network model;Psychological flexibility;Self-perceived burden
摘要：
Objective Self-perceived burden (SPB) and Fear of progression (FoP) have been reported in people living with cancer and together may increase overall distress. Acceptance and Commitment Theory (ACT) posits that psychological flexibility (PF) may ameliorate the effects of the co-occurrence of these symptoms, yet empirical evidence is scarce. We examined the symptoms associated with SPB and FoP in women with cervical cancer and tested whether PF moderates the association.
Self-perceived burden (SPB) and Fear of progression (FoP) have been reported in people living with cancer and together may increase overall distress. Acceptance and Commitment Theory (ACT) posits that psychological flexibility (PF) may ameliorate the effects of the co-occurrence of these symptoms, yet empirical evidence is scarce. We examined the symptoms associated with SPB and FoP in women with cervical cancer and tested whether PF moderates the association.
Method In a cross-sectional study, 307 cervical cancer survivors enrolled in the 2024 “Be Resilient to Cervical Cancer” (BRCC) program completed the Personalized Psychological Flexibility Index (PPFI), the Self-Perceived Burden Scale for Cancer Patients (SPBS-CP), and the Fear of Progression Questionnaire-Short Form (FoP-Q-SF). We constructed symptom-level networks to identify the strongest SPB–FoP connections, and explored the moderating role of psychological flexibility using Johnson–Neyman analyses.
In a cross-sectional study, 307 cervical cancer survivors enrolled in the 2024 “Be Resilient to Cervical Cancer” (BRCC) program completed the Personalized Psychological Flexibility Index (PPFI), the Self-Perceived Burden Scale for Cancer Patients (SPBS-CP), and the Fear of Progression Questionnaire-Short Form (FoP-Q-SF). We constructed symptom-level networks to identify the strongest SPB–FoP connections, and explored the moderating role of psychological flexibility using Johnson–Neyman analyses.
Results Among the 307 participants, the mean scores for PPFI were 59.13 (SD = 10.18), for FoP-Q-SF, 31.12 (SD = 4.98), and for SPBS-CP, 48.18 (SD = 17.12) indicating moderate levels of psychological flexibility, fear of progression and self-perceived burden. Network analysis highlighted the “future worries”- “psychological burden” link as the strongest SPB-FoP link ( β = 0.34). Johnson-Neyman probing revealed threshold-dependent moderation by PF. PF attenuated one link at high levels (> 84.95) but amplified three links at moderate levels (> 47.51).
Among the 307 participants, the mean scores for PPFI were 59.13 (SD = 10.18), for FoP-Q-SF, 31.12 (SD = 4.98), and for SPBS-CP, 48.18 (SD = 17.12) indicating moderate levels of psychological flexibility, fear of progression and self-perceived burden. Network analysis highlighted the “future worries”- “psychological burden” link as the strongest SPB-FoP link ( β = 0.34). Johnson-Neyman probing revealed threshold-dependent moderation by PF. PF attenuated one link at high levels (> 84.95) but amplified three links at moderate levels (> 47.51).
Conclusions Psychological flexibility significantly moderates symptom-level associations between self-perceived burden on fear of progression among cervical cancer survivors. ACT-based interventions may attenuate such association to minimize patients’ psychological distress.
Psychological flexibility significantly moderates symptom-level associations between self-perceived burden on fear of progression among cervical cancer survivors. ACT-based interventions may attenuate such association to minimize patients’ psychological distress.
