The Holothuria leucospilota genome elucidates sacrificial organ expulsion and bioadhesive trap enriched with amyloid-patterned proteins.

Some tropical sea cucumbers of the family Holothuriidae can efficiently repel or even fatally ensnare predators by sacrificially ejecting a bioadhesive matrix termed the Cuvierian organ (CO), so named by the French zoologist Georges Cuvier who first described it in 1831. Still, the precise mechanisms for how adhesiveness genetically arose in CO and how sea cucumbers perceive and transduce danger signals for CO expulsion during defense have remained unclear. Here, we report the first high-quality, chromosome-level genome assembly of Holothuria leucospilota, an ecologically significant sea cucumber with prototypical CO. The H. leucospilota genome reveals characteristic long-repeat signatures in CO-specific outer-layer proteins, analogous to fibrous proteins of disparate species origins, including spider spidroin and silkworm fibroin. Intriguingly, several CO-specific proteins occur with amyloid-like patterns featuring extensive intramolecular cross-ß structures readily stainable by amyloid indicator dyes. Distinct proteins within the CO connective tissue and outer surface cooperate to give the expelled matrix its apparent tenacity and adhesiveness, respectively. Genomic evidence offers further hints that H. leucospilota directly transduces predator-induced mechanical pressure onto the CO surface through mediation by transient receptor potential channels, which culminates in acetylcholine-triggered CO expulsion in part or in entirety. Evolutionarily, innovative events in two distinct regions of the H. leucospilota genome have apparently spurred CO's differentiation from the respiratory tree to a lethal defensive organ against predators.

Synthesis of oligosaccharides from terminal B. pertussis LPS pentasaccharide and definition of the minimal epitope recognized by anti-pertussis antibodies.

Pertussis vaccines have been very effective in controlling whooping-cough epidemics but are ineffective in controlling circulation in older children and adults, thus facilitating the onset of future outbreaks. Antibodies against the lipopolysaccharide could reduce the carriage of the bacteria, its circulation, and transmission. The oligosaccharide fragments from the lipopolysaccharide may become a potential complement to existing vaccines in the form of protein glycoconjugates. An important step in the development of this type of vaccine is defining the minimal oligosaccharide epitope recognized by B. pertussis anti-lipopolysaccharide antibodies. This paper describes the complete synthesis of oligosaccharides containing two to five monosaccharide units corresponding to the pentasaccharide at the nonreducing end of the lipooligosaccharide and their recognition by mice and rabbit antibodies elicited against whole-cell B. pertussis. For the first time, we report that the terminal disaccharide, α-D-GlcNAcp-(1 → 4)-(2,3-di-NAc)-D-ManAp acid is the minimal structure recognized by antibodies induced by B. pertussis.

Association of healthy diet score and adiposity with risk of colorectal cancer: findings from the UK Biobank prospective cohort study.

PURPOSE: To explore the joint association of dietary patterns and adiposity with colorectal cancer (CRC), and whether adiposity mediates the relationship between dietary patterns and CRC risk, which could provide deeper insights into the underlying pathogenesis of CRC. METHODS: The data of 307,023 participants recruited between 2006 and 2010 were extracted from the UK Biobank study. Healthy diet scores were calculated based on self-reported dietary data at baseline, and participants were categorized into three groups, namely, low, intermediate, and high diet score groups. Cox regression models with hazard ratios (HRs) and 95% confidence intervals (CIs) were used to estimate the effects of the healthy diet score on CRC incidence, adjusting for various covariates. Furthermore, the mediation roles of obesity and central obesity between the healthy diet score and CRC risk were assessed using a counterfactual causal analysis based on Cox regression model. Additionally, joint association between dietary patterns and adiposity on CRC risks was assessed on the additive and multiplicative scales. RESULTS: Over a median 6.2-year follow-up, 3,276 participants developed CRC. After adjusting for sociodemographic and lifestyle factors, a lower risk of CRC incidence was found for participants with intermediate (HR = 0.83, 95% CI: 0.72 to 0.95) and high diet scores (HR = 0.73, 95% CI: 0.62 to 0.87) compared to those with low diet scores. When compared with the low diet score group, obesity accounted for 4.13% and 7.93% of the total CRC effect in the intermediate and high diet score groups, respectively, while central obesity contributed to 3.68% and 10.02% of the total CRC risk in the intermediate and high diet score groups, respectively. The mediating effect of adiposity on CRC risk was significant in men but not in women. Concurrent unhealthy diet and adiposity multiplied CRC risk. CONCLUSION: Adiposity-mediated effects were limited in the link between dietary patterns and CRC incidence, implying that solely addressing adiposity may not sufficiently reduce CRC risk. Interventions, such as improving dietary quality in people with adiposity or promoting weight control in those with unhealthy eating habits, may provide an effective strategy to reduce CRC risk.

Effects of 24-hour urine-output trajectories on the risk of acute kidney injury in critically ill patients with cirrhosis: a retrospective cohort analysis.

BACKGROUND: Acute kidney injury (AKI) is one of the most common complications for critically ill patients with cirrhosis, but it has remained unclear whether urine output fluctuations are associated with the risk of AKI in such patients. Thus, we explored the influence of 24-h urine-output trajectory on AKI in patients with cirrhosis through latent category trajectory modeling. MATERIALS AND METHODS: This retrospective cohort study examined patients with cirrhosis using the MIMIC-IV database. Changes in the trajectories of urine output within 24 h after admission to the intensive care unit (ICU) were categorized using latent category trajectory modeling. The outcome examined was the occurrence of AKI during ICU hospitalization. The risk of AKI in patients with different trajectory classes was explored using the cumulative incidence function (CIF) and the Fine-Gray model with the sub-distribution hazard ratio (SHR) and the 95% confidence interval (CI) as size effects. RESULTS: The study included 3,562 critically ill patients with cirrhosis, of which 2,467 (69.26%) developed AKI during ICU hospitalization. The 24-h urine-output trajectories were split into five classes (Classes 1-5). The CIF curves demonstrated that patients with continuously low urine output (Class 2), a rapid decline in urine output after initially high levels (Class 3), and urine output that decreased slowly and then stabilized at a lower level (Class 4) were at higher risk for AKI than those with consistently moderate urine output (Class 1). After fully adjusting for various confounders, Classes 2, 3, and 4 were associated with a higher risk of AKI compared with Class 1, and the respective SHRs (95% CIs) were 2.56 (1.87-3.51), 1.86 (1.34-2.59), and 1.83 1.29-2.59). CONCLUSIONS: The 24-h urine-output trajectory is significantly associated with the risk of AKI in critically ill patients with cirrhosis. More attention should be paid to the dynamic nature of urine-output changes over time, which may help guide early intervention and improve patients' prognoses.

Transcriptomic analysis reveals the early body wall regeneration mechanism of the sea cucumber Holothuria leucospilota after artificially induced transverse fission.

BACKGROUND: Sea cucumbers exhibit a remarkable ability to regenerate damaged or lost tissues and organs, making them an outstanding model system for investigating processes and mechanisms of regeneration. They can also reproduce asexually by transverse fission, whereby the anterior and posterior bodies can regenerate independently. Despite the recent focus on intestinal regeneration, the molecular mechanisms underlying body wall regeneration in sea cucumbers still remain unclear. RESULTS: In this study, transverse fission was induced in the tropical sea cucumber, Holothuria leucospilota, through constrainment using rubber bands. Histological examination revealed the degradation and loosening of collagen fibers on day-3, followed by increased density but disorganization of the connective tissue on day-7 of regeneration. An Illumina transcriptome analysis was performed on the H. leucospilota at 0-, 3- and 7-days after artificially induced fission. The differential expression genes were classified and enriched by GO terms and KEGG database, respectively. An upregulation of genes associated with extracellular matrix remodeling was observed, while a downregulation of pluripotency factors Myc, Klf2 and Oct1 was detected, although Sox2 showed an upregulation in expression. In addition, this study also identified progressively declining expression of transcription factors in the Wnt, Hippo, TGF-ß, and MAPK signaling pathways. Moreover, changes in genes related to development, stress response, apoptosis, and cytoskeleton formation were observed. The localization of the related genes was further confirmed through in situ hybridization. CONCLUSION: The early regeneration of H. leucospilota body wall is associated with the degradation and subsequent reconstruction of the extracellular matrix. Pluripotency factors participate in the regenerative process. Multiple transcription factors involved in regulating cell proliferation were found to be gradually downregulated, indicating reduced cell proliferation. Moreover, genes related to development, stress response, apoptosis, and cell cytoskeleton formation were also involved in this process. Overall, this study provides new insights into the mechanisms of whole-body regeneration and uncover potential cross-species regenerative-related genes.

Secular trend in disease burden of leukemia and its subtypes in China from 1990 to 2019 and its projection in 25 years.

Leukemia and its subtypes impose a major public health challenge in China. Identifying the secular trend of leukemia burden is critical to facilitate optimal healthcare planning and improve the management of leukemia. The incidence rates of leukemia from 1990 to 2019 were collected from the Global Burden of Disease Study 2019 database according to the following: subtype (acute lymphocytic leukemia [ALL], acute myeloid leukemia [AML], chronic lymphocytic leukemia [CLL], chronic myelogenous leukemia [CML], and other leukemia subtypes), sex, and age group. The average annual percentage changes and relative risks were calculated using joinpoint regression and the age-period-cohort model, respectively. The Bayesian age-period-cohort model was also applied to predict the future trend of the incidence of leukemia and its subtypes in the next 25 years. From 1990 to 2019, the age-standardized incidence rates (ASIRs) of leukemia slightly declined in males and females, which is similar to the trend of other leukemia subtypes. However, the four major leukemia subtypes, namely, ALL, AML, CLL, and CML, have been on the rise over the past three decades. The incidence rates of leukemia in children and the elderly were considerably higher than those in other age groups in males and females. Age effects were the most influential risk factor for leukemia incidence. Period effects showed that the risks of leukemia and its subtypes incidence increased with time. For cohort effects, the risks of leukemia and its subtypes were higher among the early-born cohorts compared with the late-born cohorts. The ASIRs of leukemia and its subtypes will continue to increase in the next 25 years. The burden of leukemia and its subtypes is expected to continue to increase in the next 25 years in males and females. A comprehensive understanding of the risk characteristics and disease pattern of leukemia and its subtypes is needed to formulate timely and effective intervention measures to reduce the leukemia burden in China.

Exploring symptom-level associations between anxiety and depression across developmental stages of adolescence: a network analysis approach.

BACKGROUND: Anxiety and depression often co-occur during adolescence, but the associations between symptoms of these two disorders in this developmental period are not yet fully understood. Network analysis provides a valuable approach to uncover meaningful associations among symptoms and offers insights for prevention and intervention strategies. This study aimed to investigate symptom-level associations between anxiety and depression using network analysis and to identify core symptoms, bridge symptoms, and differences in network structure across different stages of adolescence. METHODS: The cross-sectional study was conducted in March 2022 in Shenzhen, China. Participants completed the Generalized Anxiety Disorder Scale-7 and Patient Health Questionnaire Depression Scale, along with demographic questionnaires assessing age and gender. Chinese adolescents aged 10 to 17 who were in Grades 5 or 6 of elementary school, Grades 1 or 2 of middle school, or Grades 1 or 2 of high school, and who could comprehensively understand and read Chinese were recruited as participants. Students in Grade 3 of middle and high schools were excluded due to their upcoming high school or college entrance examinations. Based on age, participants were categorized into early, middle, and late developmental stages of adolescence. RESULTS: "Loss of control" was among the most central symptoms in the comorbidity network throughout all three developmental stages; "excessive worry" and "anhedonia" emerged as the core symptoms in early adolescence, and "restlessness" as the core symptom in late adolescence. "Anhedonia," "sad mood," and "fatigue" were identified as bridge symptoms between anxiety and depression across all three developmental stages of adolescence. The global strength of the network in middle adolescence was significantly higher compared to the other two stages. CONCLUSION: These findings highlight the core and bridge symptoms that require special attention and intervention at each stage of adolescence. Moreover, significantly higher network connectivity in middle adolescence suggests this is a critical period for intervention to prevent the development of comorbid mental disorders.

A Network Analysis of Multiple Preconception Health Behaviors in Chinese Women.

BACKGROUND: A healthy preconception lifestyle, consisting of multiple health behaviors, is crucial for preventing adverse health outcomes in mothers and offspring. Although knowledge about the pattern of inter-behavior relations may provide insights for nudging multiple health behavior changes, this has not been adequately explored in the existing literature. Adopting a network perspective, the present study conceptualized multiple health behaviors as a behavior network (i.e., behaviors as nodes, inter-behavior relations as edges) and utilized network analysis to investigate the pattern of interrelations of preconception health behaviors in a large sample of Chinese women. METHOD: We used the data of a population-based cohort study in China to estimate the behavior network. An analytic sample included 41,127 Chinese women who were surveyed about their adoptions of multiple health behaviors during the preconception period. RESULTS: Network analysis revealed a relatively dense behavior network and visualized the network structure of multiple preconception health behaviors. Subsequent centrality analysis identified three central behaviors (i.e., avoiding second- or third-hand smoke, reducing psychosocial stress, and reducing alcohol) that had distinctively stronger connections to other behaviors. CONCLUSIONS: Preconception health behaviors were strongly interconnected, and certain behaviors had stronger influences than others within the behavior network. Our findings highlight the strong inter-relatedness of preconception health behaviors. This study also encourages targeting the three central behaviors in preconception lifestyle promotions because this may bring more secondary improvements on other non-targeted behaviors and thereby achieve comprehensive lifestyle change.

Mindful parenting and closeness in Chinese mother-adolescent dyads: The mediating role of adolescent self-disclosure.

Although having strong influences on adolescents' optimal development, mother-adolescent closeness is greatly challenged in early adolescence. Mindful parenting may be a protective factor for relational adjustment to early adolescence, but its connection with closeness within the mother-adolescent dyad has not been adequately examined in the literature. This study aimed to investigate the effects of how mindful parenting on the day-to-day mother-adolescent relationship dynamics, evaluating the relations between mindful parenting and mother-adolescent closeness and the mediating role of adolescent self-disclosure. A total of 76 Chinese mother-adolescent dyads completed a baseline measure of mindful parenting and 14-day measures of adolescent-report self-disclosure, mother-perceived closeness, and adolescent-perceived closeness. Mindful parenting significantly predicted both mother-perceived and adolescent-perceived closeness, with adolescent self-disclosure serving as a mediator. Adolescent self-disclosure predicted higher mother-adolescent closeness on the same day, but such effects did not carry over to the next day. Our findings provided evidence supporting mindful parenting as a resource for facilitating mother-adolescent closeness in early adolescence. This investigation also encouraged future studies to employ more intensive ambulatory assessments to clarify the daily process of how mindful parenting shapes mother-adolescent relationship dynamics.

Association of Red Cell Distribution Width-to-Platelet Ratio and Mortality in Patients with Sepsis.

Background: As a novel inflammatory index, the ratio of red cell distribution width (RDW) to platelet count (RPR) may have prognostic value in some critical illnesses. However, studies on the prognostic influence of RPR in patients with sepsis are few. This study is aimed at investigating the association between RPR levels and 28-day mortality in patients with sepsis. Methods: Data of patients with sepsis were obtained from the Medical Information Mart for Intensive Care III database. The best cut-off value was calculated by establishing the receiver operating characteristic curve (ROC), and the predictive ability of different indicators was compared through the area under the curve (AUC). The association between RPR levels and 28-day mortality was assessed using the Cox proportional hazards model. Restrictive cubic spline analysis was applied to the multivariable Cox model to investigate the nonlinear relationship between RPR and 28-day mortality. Results: A total of 3367 patients with sepsis were included in the study. A nonlinear relationship was observed between RPR and 28-day mortality, showing a trend of a first rapid increase and a gradual increase. For the prediction of mortality, the best cut-off value for RPR was 0.109, with an AUC of 0.728 (95% confidence interval [CI]: 0.709-0.747). The predictive capability of RPR was superior to those of RDW, platelet, SOFA score, and SAPS II score. After adjusting for various confounding factors, high RPR was significantly associated with increased mortality with adjusted hazard ratios of 1.210 (95% CI: 1.045-1.400) for categorical variables and 2.826 (95% CI: 2.025-3.944) for continuous variables. Conclusion: Elevated RPR level is significantly correlated with a high risk of 28-day mortality in patients with sepsis and can be a new predictor of patient prognosis.

Regulation of the autophagy plays an important role in acute kidney injury induced acute lung injury.

AIM: This study aimed to investigate the regulatory role of autophagy in acute kidney injury (AKI) induced acute lung injury (ALI). METHODS: The male Sprague-Dawley rats were divided into four groups: normal saline-treated sham rats (sham group), normal saline-treated ischemia-reperfusion injury rats (IRI group), 3-methyladenine-treated IRI rats (3-MA group), and rapamycin-treated IRI rats (RA group). The rats in the IRI rat model received the nephrectomy of the right kidney and was subjected to 60 mins of left renal pedicle occlusion, followed by 12, 24, 48, and 72 h of reperfusion. The levels of Scr, BUN, wet-to-dry ratio of lung, inflammatory cytokines, and oxidative stress were determined. The damage to tissues was detected by histological examinations. The western blot and immunohistochemistry methods were conducted to determine the expression of indicated proteins. RESULTS: Renal IRI could induce the pulmonary injury after AKI, which caused significant increases in the function index of pulmonary and renal, the levels of inflammatory cytokines, and biomarkers of oxidative stress. In comparison to the IRI group, the RA group showed significantly decreased P62 and Caspase-3 expression and increased LC-II/LC3-I, Beclin-1, Bcl-2, and unc-51-like autophagy activating kinase 1 expression. Meanwhile, by suppressing the inflammation and oxidative stress, as well as inhibiting the pathological lesions in kidney and lung tissues, the autophagy could effectively ameliorate IRI-induced AKI and ALI. CONCLUSIONS: Autophagy plays an important role in AKI-induced ALI, which could be used as a new target for AKI therapy and reduce the mortality caused by the complication.

Bright Purcell Enhanced Single-Photon Source in the Telecom O-Band Based on a Quantum Dot in a Circular Bragg Grating.

The combination of semiconductor quantum dots with photonic cavities is a promising way to realize nonclassical light sources with state-of-the-art performances regarding brightness, indistinguishability, and repetition rate. Here we demonstrate the coupling of InGaAs/GaAs QDs emitting in the telecom O-band to a circular Bragg grating cavity. We demonstrate a broadband geometric extraction efficiency enhancement by investigating two emission lines under above-band excitation, inside and detuned from the cavity mode, respectively. In the first case, a Purcell enhancement of 4 is attained. For the latter case, an end-to-end brightness of 1.4% with a brightness at the first lens of 23% is achieved. Using p-shell pumping, a combination of high count rate with pure single-photon emission (g(2)(0) = 0.01 in saturation) is achieved. Finally, a good single-photon purity (g(2)(0) = 0.13) together with a high detector count rate of 191 kcps is demonstrated for a temperature of up to 77 K.

Discovery of novel indolin-2-one compounds as potent inhibitors of HsClpP for cancer treatment.

Human caseinolytic protease proteolytic subunit (HsClpP) is a highly conserved serine protease that plays an essential role in cell homeostasis through removal of the damaged and/or misfolded proteins. Recently, due to its critical role in cancer proliferation and metastasis, HsClpP has been considered as a promising target for the cancer treatment. In this paper, through a random screening toward a library of 2086 bioactive chemicals, a novel compound I, 3-(3,5-dibromo-4-hydroxybenzylidene) -5-iodoindolin-2-one, was identified as a potent suppressor of HsClpP. Herein, a series of compound I derivatives were synthesized, and evaluated for their anti-cancer activities on a variety of cancers cells. Through the preliminary biological assay in vitro, including MTT assay and proteolytic activity assay, compound I was identified as the most potent inhibitor. Treatment with compound I impaired the migration of Hela cells. In addition, compound I disrupted the mitochondrial function, and reduced the level of the SDHB and induced the production of the ATF4. In general, compound I is a promising probe of HsClpP for cancer treatment, and is a good lead compound for the development of novel anti-cancer agent.

Dyadic Effects of Fluid Mindset on Psychological Growth in Immigrant Mothers and Their Children: Indirect Effect of Resilience.

Immigration research has recently investigated positive adaptation outcomes such as psychological growth. This study tested actor and partner effects between fluid mindset and psychological growth, mediated by resilience, in 200 migrant mother-child dyads from Mainland China to Hong Kong. Mothers' fluid mindset had significant actor and partner effects on their own and their children's psychological growth, whereas children's fluid mindset showed an actor effect. For mothers and children, fluid mindset had significant actor indirect effects on psychological growth via resilience. Mothers' fluid mindset had a significant partner indirect effect on children's psychological growth via children's resilience. The findings have implications for enhancing immigrants' psychological growth by strengthening fluid mindset and considering mothers and children as the intervention unit in resilience programs.

En las investigaciones sobre la inmigración se han analizado recientemente los resultados de la adaptación positiva, como el crecimiento psicológico. En este estudio se evaluaron los efectos del actor y la pareja entre la mentalidad flexible y el crecimiento psicológico, mediados por la resiliencia, en 200 díadas madre e hijo de emigrantes de China continental a Hong Kong. La mentalidad flexible de las madres tuvo efectos significativos del actor y la pareja en su propio crecimiento psicológico y el de sus hijos, mientras que la mentalidad flexible de los hijos demostró un efecto del actor. Para las madres y los hijos, la mentalidad flexible tuvo efectos indirectos significativos del actor en el crecimiento psicológico mediante la resiliencia. La mentalidad flexible de las madres tuvo un efecto indirecto de la pareja en el crecimiento psicológico de los hijos mediante la resiliencia de los hijos. Los resultados tienen consecuencias para mejorar el crecimiento psicológico de los inmigrantes mediante el fortalecimiento de la mentalidad flexible y la consideración de las madres y los hijos como unidad de intervención en los programas de resiliencia.

Mosaic Immunoassays Integrated with Microfluidic Channels for High-Throughput Parallel Detection.

Using the ice-printing technique, we have integrated micromosaic immunoassays (µMIAs) with microfluidic channels, which reduces the sample consumption and response time and allows high-throughput parallel detection. The ice-printing method is a low-temperature and contaminant-free process, which is more convenient, precise, and biofriendly than the traditional fabrication method. Meanwhile, based on the ice-drying process, this method can obtain a uniform distribution of the residue protein patterns, which leads to a uniform fluorescence result. As a proof of concept, the test of stability, sensitivity, and specificity of µMIA based on one-step ELISA are demonstrated. In this device, immobilized antigens surrounded with ice could remain biological at -20 °C for months.

Mediation Effect of Suicide-Related Social Media Use Behaviors on the Association Between Suicidal Ideation and Suicide Attempt: Cross-Sectional Questionnaire Study.

BACKGROUND: A limited number of studies have examined the differences in suicide-related social media use behaviors between suicide ideators and suicide attempters or have sought to elucidate how these social media usage behaviors contributed to the transition from suicidal ideation to suicide attempt. OBJECTIVE: Suicide attempts can be acquired through suicide-related social media use behaviors. This study aimed to propose 3 suicide-related social media use behaviors (ie, attending to suicide information, commenting on or reposting suicide information, or talking about suicide) based on social cognitive theory, which proposes that successive processes governing behavior transition include attentional, retention, production, and motivational processes. METHODS: We aimed to examine the mediating role of suicide-related social media use behaviors in Chinese social media users with suicidal risks. A sample of 569 Chinese social media users with suicidal ideation completed measures on suicidal ideation, suicide attempt, and suicide-related social media use behaviors. RESULTS: The results demonstrated that suicide attempters showed a significantly higher level of suicidal ideation (t563.64=5.04; P<.001; two-tailed) and more suicide-related social media use behaviors, which included attending to suicide information (t567=1.94; P=.05; two-tailed), commenting on or reposting suicide information (t567=2.12; P=.03; two-tailed), or talking about suicide (t542.22=5.12; P<.001; two-tailed). Suicidal ideation also affected suicide attempts through the mediational chains. CONCLUSIONS: Our findings thus support the social cognitive theory, and there are implications for population-based suicide prevention that can be achieved by identifying behavioral signals.

Variants of Children with Psychopathic Tendencies in a Community Sample.

To investigate the heterogeneity of children with psychopathic tendencies, this study identified heterogenous subgroups among a community sample of children based on their callous-unemotional (CU) traits, conduct problems (CP), and anxiety. A latent profile analysis classified 1861 primary school students (age 6-14) into four subgroups based on parent-report CU traits, CP and anxiety: low-risk children (i.e., low in CU traits, CP, and anxiety), anxious children (i.e., high in anxiety, low in CU traits and CP), primary variants of children with psychopathic tendencies (i.e., high in CU traits and CP, low in anxiety), and secondary variants of children with psychopathic tendencies (i.e., high in CU traits, CP, and anxiety). In particular, the secondary variants evidenced higher levels of CU traits, CP, and anxiety than the primary variants. Our findings extend the heterogeneity of psychopathy to childhood and encourage future research to examine the developmental trajectories of psychopathy.

Self-management interventions for chronic kidney disease: a systematic review and meta-analysis.

BACKGROUND: Self-management intervention aims to facilitate an individual's ability to make lifestyle changes. The effectiveness of this intervention in non-dialysis patients with chronic kidney disease (CKD) is limited. In this study, we applied a systematic review and meta-analysis to investigate whether self-management intervention improves renoprotection for non-dialysis chronic kidney disease. METHODS: We conducted a comprehensive search for randomized controlled trials addressing our objective. We searched for studies up to May 12, 2018. Two reviewers independently evaluated study quality and extracted characteristics and outcomes among patients with CKD within the intervention phase for each trial. Meta-regression and subgroup analyses were conducted to explore heterogeneity. RESULTS: We identified 19 studies with a total of 2540 CKD patients and a mean follow-up of 13.44 months. Compared with usual care, self-management intervention did not show a significant difference for risk of all-cause mortality (5 studies, 1662 participants; RR 1.13; 95% CI 0.68 to 1.86; I2 = 0%), risk of dialysis (5 studies, 1565 participants; RR 1.35; 95% CI 0.84 to 2.19; I2 = 0%), or change in eGFR (8 studies, 1315 participants; SMD -0.01; 95% CI -0.23 to 0.21; I2 = 64%). Moreover, self-management interventions were associated with a lower 24 h urinary protein excretion (4 studies, 905 participants; MD - 0.12 g/24 h; 95% CI -0.21 to - 0.02; I2 = 3%), a lower blood pressure level (SBP: 7 studies, 1201 participants; MD - 5.68 mmHg; 95%CI - 9.68 to - 1.67; I2 = 60%; DBP: 7 studies, 1201 participants; MD - 2.64 mmHg, 95% CI -3.78 to - 1.50; I2 = 0%), a lower C-reactive Protein (CRP) level (3 studies, 123 participants; SMD -2.8; 95% CI -2.90 to - 2.70; I2 = 0%) and a longer distance on the 6-min walk (3 studies, 277 participants; SMD 0.70; 95% CI 0.45 to 0.94; I2 = 0%) when compared with the control group. CONCLUSIONS: We observed that self-management intervention was beneficial for urine protein decline, blood pressure level, exercise capacity and CRP level, compared with the standard treatment, during a follow-up of 13.44 months in patients with CKD non-dialysis. However, it did not provide additional benefits for renal outcomes and all-cause mortality.

Close relationships, individual resilience resources, and well-being among people living with HIV/AIDS in rural China.

The systems framework of resilience has suggested that resilient factors external to or within the individual and their interactions can contribute to positive adjustment in at-risk populations. However, the interplays of resilience resources at different levels have seldom been investigated in health psychology, particularly in people living with HIV/AIDS (PLWHA). This study aimed to examine the mediating role of individual resilience resources in the associations between marital and family relationships and well-being in PLWHA. A sample of 160 Chinese PLWHA were interviewed to complete measures on marital relationship, family relationship, individual resilience resources, and general, physical, and mental well-being. Results showed that better marital relationship and family relationship were associated with higher levels of individual resilience resources and well-being indicators. Mediation analysis with path analysis showed significant mediating effects of individual resilience resources between marital and family relationships and general, physical, and mental well-being. By highlighting marital and family relationships as external resources of resilience and their roles in increasing individual resilience factors which thereby contribute to the well-being of PLWHA, our findings support the systems framework of resilience. There are implications for resilience enhancement interventions with the aim of improving PLWHA's well-being by including interpersonal strategies of strengthening the protective role of marital and family relationships, which will in turn facilitate the resilience process.

Couple identity and well-being in Chinese HIV serodiscordant couples: resilience under the risk of stigma.

Resilience literature has suggested the context-specific nature of resilience while such framework has yet to be expanded to health psychology research among HIV serodiscordant couples. Conceptualizing a couple affected by chronic diseases using a "we-ness" framework rather than two separate individuals is important for stress coping of the couple. Considering this social-cognitive context of couple coping would be helpful to facilitate resilience of both the patient and the spouse. It is not clear whether couple identity serves as a protective factor for HIV serodiscordant couples and whether stigma, a prevalent contextual risk in this population, will alter the strength of such a protective effect on well-being. This longitudinal study examined the protective effect of couple identity in predicting the psychological and physical well-being of HIV discordant couples and the moderating role of stigma in such associations. A total of 160 Chinese HIV serodiscordant couples completed the baseline survey and follow-up one year later. Results showed that couple identity predicted fewer depressive symptoms at both the within- and between-couple level and better self-rated physical health at the between-couple level one year later. These protective effects were diminished when HIV stigma was high. This study highlights the importance of examining resources with consideration of contextual factors. It also calls for the sensitivity of stigma in developing a couple-based intervention for HIV serodiscordant couples.