Assessing the risk factors associated with nutritional status in patients with liver cirrhosis: A case-control study.

BACKGROUND: Cirrhosis is one of the most common clinical diseases in the world. The patient with cirrhosis has many complications, such as spontaneous peritonitis, hepatic encephalopathy. Malnutrition is one of the most common complications in patients with cirrhosis, and it is also a key factor affecting the prognosis of patients. However, the research on cirrhosis malnutrition is relatively scarce. OBJECTIVE: This study aimed to explore the new factors of the liver cirrhosis with the nutritional status. METHODS: A total of 370 patients with liver cirrhosis were admitted to the Fourth Affiliated Hospital of Harbin Medical University from January 2019 to January 2023 were selected. Patients were assigned to the malnourished group and normal group. The weight, height, mid arm circumference (MAC) and triceps skinfold thickness (TSF) of the two groups were measured. Body mass index (BMI) and mid-arm muscle circumference (MAMC) were calculated. Furthermore, the Health Literacy Management Scale (HeLMS), biochemical indexes, incidence of complications, disease grade were also counted and the Royal Free Hospital-Nutrition Prioritization Tool were used to evaluate the nutritional status of the patient. RESULTS: A total of 370 patients was included in this study, including 177 malnutrition patients, accounting for 45.29%, and the scores and total scores of the patients in the malnutrition group were lower than those in the normal group. The measured values of Na+, Alb, PA, T-Bil, TC, TLC, Hb, and RBC were all lower than those of the normal group, and the difference was statistically significant. The overall complication rate of the patients in the malnourished group was 89.61%, and that of the normal group was 39.78%. Multifactorial logistic regression analysis was performed with nutritional level as the dependent variable (normal = 0, malnutrition = 1), and the above indicators of variability (Na+, Alb, PA, T-Bil, TC, PT, Hb, RBC, HG, and HeLMS scores) as the independent variables. The results showed that Na+, Hb were the influencing factors of nutritional level (P< 0.05). CONCLUSION: The incidence of malnutrition in cirrhotic patients included in this study was at a moderate level, and the nutritional literacy of these patients was low. In addition, the level of serum sodium, Hemoglobin can affect the nutritional level of patients with cirrhosis.

Longitudinal correlates of learning burnout among Chinese adolescents during the COVID-19 pandemic: A cross-lagged panel network analysis.

BACKGROUND: Learning burnout as a serious psychological distress problem among adolescents during the COVID-19 pandemic was investigated using the cross-lagged panel network models. METHODS: A three-wave study using a sample of 11 to 18-year-olds in China was conducted, with baseline data collected in June 2020 (n = 4156) and follow-ups in December 2020 (n = 3209) and August 2021 (n = 2324). Two temporal cross-lagged panel network models were computed to analyze adolescent learning burnout over time. RESULTS: The predictive pathway of adolescent learning burnout demonstrates significant temporal specificity. In the early outbreak period, Positive thinking, Appreciation of life and Depression are the most influential predictive symptoms. In the normalized epidemic prevention period, Goal planning, Affect control and Positive thinking are the most influential predictive symptoms. However, during this period, the extent to which adolescent learning burnout is predicted by other symptoms in the networks is significantly reduced. LIMITATIONS: The samples used in this study are not expected to be nationally representative, and therefore the generalizability of the results may be limited. CONCLUSIONS: These findings highlight the predictive roles of Positive thinking, Appreciation of life, and Depression in adolescent learning burnout and the importance of timely intervention on these symptoms in the early outbreak period of public health emergency similar to the COVID-19 pandemic. Findings also illustrate the essentiality of eliminate unstable factors in the school environment during the normalized epidemic prevention period.

Nurse burnout: deep connections and solutions revealed by network analysis.

BACKGROUND: Burnout is very important to nurses' physical and mental health and career development. Current approaches to assessing nurse burnout tend to use a total score modeling paradigm to explore the impact of external factors on burnout. The purpose of this study is to delve into the item-level relationship between nurse burnout and its influencing factors at both the social and psychological levels using a network analysis approach. METHODS: This study was conducted in June 2023 and 1,005 nurses from 4 hospitals out of 8 tertiary care hospitals in Harbin were selected to participate in this study using whole cluster sampling method. Measurements included a general demographic questionnaire, Trait coping styles questionnaire, Organizational commitment questionnaire, Work-family conflict scale, Transformational leadership questionnaire, and Maslach Burnout Inventory-General Survey. RESULTS: Our results suggest that "C1 Time-Based work interference with family" showed the strongest centrality and bridging in the overall network. This finding underscores its centrality to burnout. Other strongest bridge symptoms included "E2 Reduced personal accomplishment" and "A1 Positive coping styles" indicating their strongest connections to other clusters. CONCLUSIONS: Nurse administrators should be encouraged to pay more attention to nurses' work situations and family distress, and to help nurses in a flexible way.

Relationship between family function and anxiety among nurses during the COVID-19 pandemic: a mediating role of expressive suppression.

BACKGROUND: The aims of the present study were to investigate the incidence of nurses who suffered anxiety during the COVID-19 pandemic and to explore how expressive suppression influences the relationship between family function and anxiety. METHODS: This study used cross-sectional research and simple random sampling. A total of 300 questionnaires were distributed and 254 questionnaires were qualified after invalid questionnaires were proposed, thus a total of 254 female nurses from a tertiary hospital were included in this study. The measurement included General demographic questionnaires, the Self-Scale Anxiety, Scale (SAS), Emotion Regulation Strategies Questionnaire (ERQ), and Family Function Assessment (FAD). T-test, nonparametric Wilcoxon or Kruskal-Wallis test, χ2 test, Pearson or Spearman correlation analysis, multiple stepwise regression and bootstrap methods was performed to analyze the data. RESULTS: In this study, 22.4% of the nurses exhibited anxiety symptoms, with 17.7% eliciting mild anxiety symptoms, 4.3% showing moderate anxiety symptoms and 0.4% with severe anxiety symptoms. Family function and expressive suppression were positively associated with anxiety severity. And family function influenced anxiety among nurses via direct and indirect (Expressive suppression -mediated) pathways. CONCLUSIONS: Expressive suppression partially mediated the influence of family function on anxiety symptom. To this end, nurse administrators should establish a robust mental health support system encompassing psychological counseling and emotional support groups. Furthermore, nurse administrators should consistently inquire about nurses' family situations, encourage nurses to articulate their emotions and needs candidly, both within the domestic sphere and the workplace, while refraining from excessive self-repression.

The chain mediating roles of anxiety and depression in the relationship between the effects of the COVID-19 pandemic and procrastination in adolescents: a longitudinal study.

BACKGROUND: The relationship between the Coronavirus Disease 2019 (COVID-19) pandemic, which is a traumatic event for adolescents, and procrastination is not clear. Mental health may play an important role in this relationship; however, the underlying mechanisms remain unknown. This study aimed to construct chain mediation models to examine whether anxiety and depression symptoms mediate the effects of the COVID-19 pandemic on procrastination in adolescents. METHODS: A convenience sample of 12 middle and high schools in Harbin, China, with four follow-up online surveys was conducted during the COVID-19 pandemic. A total of 4,156 Chinese adolescents were enrolled in this study, of whom ages 11-18 (Mean = 13.55; SD = 1.18), 50.75% were male, and 93.24% were middle school students. Descriptive demographic analysis and Pearson's correlation analysis of the effects of the COVID-19 pandemic (T1), anxiety(T2), depression (T3), and procrastination (T4) were performed in SPSS 22.0. Chain mediation analysis performed with Mplus 8.3. RESULTS: The effects of the COVID-19 pandemic, anxiety symptoms, depression symptoms, and procrastination were positively correlated (P < 0.01). The effects of the COVID-19 pandemic have a direct link on adolescent procrastination (effect = 0.156; SE = 0.031; 95%CI: 0.092, 0.214), and have three indirect paths on procrastination: the independent mediating role of anxiety symptoms was 29.01% (effect = 0.047; SE = 0.012; 95%CI: 0.024, 0.072), the independent mediating role of depression symptoms was 29.01% (effect = 0.047; SE = 0.010; 95%CI: 0.030, 0.068), as well as the completely chain mediating role of anxiety and depression symptoms was 15.43% (effect = 0.025; SE = 0.005; 95%CI: 0.017, 0.036). CONCLUSIONS: Our results suggest that anxiety and depressive symptoms are part of a causal chain between the effects of the COVID-19 pandemic and procrastination among Chinese adolescents. To effectively reduce their procrastination, attention should be paid to the emotional distress caused to adolescents by major events such as the COVID-19 epidemic. All data were taken from self-reported measures and one city in China, which may bias the results and limit their generalizability.

Trajectories and influencing factors in adolescent procrastination behavior throughout the COVID-19 pandemic: a four-wave prospective longitudinal study.

Background: Despite the growing attention given to adolescent behavior problems, little is known about the trajectories and factors that have influenced adolescent procrastination during the COVID-19 pandemic. This study monitors changes in procrastination behavior among Chinese adolescents during the pandemic and identifies vulnerable groups. Methods: A four-wave study using a representative sample of 11-to 18-year-olds in China was conducted, with baseline data collected in June 2020 (n = 4,156; 49% girls) and follow-ups in December 2020 (n = 3,392; 50% girls), August 2021 (n = 2,380; 48% girls), and October 2021 (n = 1,485; 49% girls). Procrastination behavior was assessed using the General Procrastination Scale. Latent growth curve models, latent growth mixture modes, and multivariate logistic regression models were used to describe the trajectory of procrastination and identify predictors of deterioration. Results: The proportion and overall trends of adolescent procrastination increased with the pandemic. Higher parental over-protection was a contributing factor to the higher baseline levels leading to the faster growth of adolescent procrastination. The model identified three distinct trajectories of low-increasing [including 2,057 participants (49.5%)], moderate-stable [including 1,879 participants (45.2%)], and high-decreasing procrastination [including 220 participants (5.3%)]. More daily leisure screen-time, lower frequency of exercise weekly, and dissatisfaction with distance learning were the top three risk factors for moderate-stable and high-decreasing procrastination compared to low-increasing procrastination. Adolescents with mothers with a higher level of education were more liable to be high-decreasing procrastination than moderate-stable procrastination. Conclusion: The proportion and overall trends of adolescent procrastination increased with the pandemic. The categories of procrastination among adolescents during that time period were probed. Also, the study further clarified the risk factors for severe and moderate procrastination relative to no procrastination. Thus, effective procrastination prevention and intervention strategies need to be implemented to support adolescents, particularly those at risk.

Relationship between psychological capital and depression in Chinese physicians: The mediating role of organizational commitment and coping style.

Background: It is well known that the medical profession is a high-risk practice, with intense work and complex situations. The physicians are prone to suffer from depression due to occupational stress under high workloads for long periods of time. Depression not only impairs physicians' mental health, but also affects the quality of health services, so it is important to explore the factors and mechanisms affecting depression among physicians. Methods: In this cross-sectional study, 1,139 physicians from Heilongjiang Province were surveyed by cluster sampling procedures. The questionnaires included Psychological Capital Questionnaire, Chinese Employee Organizational Commitment Questionnaire, Trait Coping Style Questionnaire and Self-rating Depression Scale. Pearson correlation analysis and Bootstrap were used for statistical analysis. Results: This study found that 41.6% of physicians suffering from depression. Among them, 17.0% of physicians showed moderate depression, and 2.6% of physicians exhibited severe depression. The serial-multiple mediation of organizational commitment and positive coping styles in the relationship between psychological capital and depression was significant. Conclusion: The results showed that the psychological capital was sequentially associated with increased organizational commitment, and then increased positive coping styles, which resulted in reduced depression among physicians.

Sleep quality and creativity in Chinese college student during the COVID-19 pandemic: The mediating role of executive function.

Background: COVID-19 has impacted adolescents' interpersonal relationships, life attitudes, and mental health during the past 3 years. However, previous studies predominantly focused on negative problems, while few studies assessed the situation of teenagers from the perspective of positive psychology. Therefore, this study explores the creativity level of Chinese college students during the COVID-19 pandemic, the relationship between sleep quality and creativity, and the mediating role of executive function. Method: A cross-sectional study was conducted across six colleges in Heilongjiang in China, with a sample of 4,258 college students recruited via stratified cluster sampling. Data were collected through an online survey. A mediation model was constructed, and SPSS PROCESS macro was used to analyze the data. Results: The creativity score of Chinese college students during the COVID-19 pandemic was 106.48 ± 13.61. Correlation analysis demonstrated that sleep quality correlated negatively with creativity (r = -0.08, P < 0.01) but positively with executive function (r=0.45, P < 0.01), whilst executive function correlated negatively with creativity (r = -0.10, P < 0.01). Moreover, the mediation model revealed that executive function partially mediated the relationship between sleep quality and creativity in college students (indirect effect = -0.017, SE = 0.004, 95% CI = [-0.025, -0.008]). Executive function accounted for 48.6% of the variance in college students' creativity. Conclusion: School administrators should implement measures such as sleep education to enhance students' sleep quality. Concurrently, curriculum and assessment implementation should enhance executive function. Such measures can contribute to improved student creativity, thus helping students overcome the negative emotional impact of the COVID-19 pandemic.

Factors Influencing Post-traumatic Stress Symptoms in Chinese Adolescents During the COVID-19 Pandemic.

To investigate the prevalence of post-traumatic stress symptoms (PTSSs) and analyze the influencing factors of PTSS among adolescents in a large sample study during the COVID-19 pandemic, we did a cross-sectional study by collecting demographic data and mental health measurements from a large group of 175,318 adolescents in 32 Chinese provinces and autonomous regions, using the Impact of Event Scale-Revised (IES-R) that was used to measure the PTSS of the participants. The results showed that the prevalence of PTSS was 35.7% in Chinese adolescents during the COVID-19 pandemic. Binary logistic regression analysis showed that, for the personal risk factors, the older age, female gender, the personality domains of extroversion, the irregular sleep schedule, the lack of aerobic exercise, and the lack of peer support were associated with the higher levels of PTSS. The family subjective and objective factors were associated with higher levels of PTSS. Our findings suggested that family factors are the most important factors that affect Chinese adolescents' PTSS due to the longtime home quarantine.

Association of the Combined Effects between Insulin-Like Growth Factor-1 Gene Polymorphisms and Negative Life Events with Major Depressive Disorder among Chinese population in the Context of Oxidative Stress.

Background: Oxidative stress may be increased in a number of psychiatric disorders, including major depressive disorder (MDD). MDD has been shown to be related to insulin-like growth factor-1 (IGF-1) as well as to negative life events; exploring the interaction of IGF-1 polymorphisms and negative life events on the risk of MDD is needed. The aim of this study was to analyze the single and combined effects of IGF-1 polymorphisms (rs972936 and rs978458) and negative life events with MDD among Chinese population. Methods: 420 MDD patients (according to DSM-V) and 420 age- and gender-matched control subjects were recruited in a case-control study. Negative life events were assessed using standard rating scales. IGF-1 rs972936 and rs978458 were identified by sequencing. The chi-square (χ 2) tests were performed to explore the association of negative life events and IGF-1 polymorphisms with MDD. Results: Our results found that the negative life events were associated with the risk of MDD (P < 0.001; OR = 3.28, 95% CI: 2.19-4.85). The genotypes of IGF-1 were associated with the risk of MDD (P < 0.001); carrying the IGF-1 rs972936 C allele (OR = 1.53, 95% CI: 1.26-1.85) and rs978458 T allele (OR = 1.92, 95% CI: 1.58-2.34) had a higher risk of MDD. The combined effects between IGF-1 rs978458 and negative life events were associated with the risk of MDD (P < 0.05; OR = 2.94, 95% CI: 1.23-7.03), but IGF-1 rs972936 was not associated (P > 0.05). Conclusions: Based on the oxidative stress hypothesis, we confirm that carrying IGF-1 rs972936 C allele and rs978458 T allele have a higher risk of MDD and the combined effects between IGF-1 rs978458 and negative life events were associated with the risk of MDD among Chinese population.

The Gender-Specific Interaction of DVL3 and GSK3ß Polymorphisms on Major Depressive Disorder Susceptibility in a Chinese Han Population: A Case-Control Study.

Based on the "oxidative stress hypothesis" of major depressive disorder (MDD), cells regulate their structure through the Wnt pathway. Little is known regarding the interactions of dishevelled 3 (DVL3) and glycogen synthase kinase 3 beta (GSK3ß) polymorphisms with MDD. The aim of the current study was to verify the relationship between DVL3 and GSK3ß genetic variants in a Chinese Han population and further to evaluate whether these interactions exhibit gender-specificity. A total of 1136 participants, consisting of 541 MDD patients and 595 healthy subjects, were recruited. Five single-nucleotide polymorphisms (SNPs) of DVL3/GSK3ß were selected to assess their interaction by use of a generalized multifactor dimensionality reduction method. The genotype and haplotype frequencies of DVL3/GSK3ß polymorphisms were significantly different between patients and controls for DVL3 rs1709642 (P < 0.01) and GSK3ß rs334558, rs6438552, and rs2199503 (P < 0.01). In addition, our results also showed that there were significant interaction effects between DVL3 and GSK3ß polymorphisms and the risk of developing MDD, particularly in women. The interaction between DVL3 (rs1709642) and GSK3ß (rs334558, rs6438552) showed a cross-validation (CV) consistency of 10/10, a P value of 0.001, and a testing accuracy of 59.22%, which was considered as the best generalized multifactor dimensionality reduction (GMDR) model. This study reveals the interaction between DVL3 and GSK3ß polymorphisms on MDD susceptibility in a female Chinese Han population. The effect of gender should be taken into account in future studies that seek to explore the genetic predisposition to MDD relative to the DVL3 and GSK3ß genes.

Psychological Impact of COVID-19 Epidemic on Adolescents: A Large Sample Study in China.

Background: The COVID-19 pandemic is a major public health emergency. However, little is known about the psychological impact of this pandemic on adolescents. We aim to assess the prevalence and influencing factors of depression, anxiety, and posttraumatic growth (PTG) among adolescents in a large sample study. Methods: This cross-sectional study collected demographic data and mental health measurements from 175,416 adolescents covering 31 provinces, centrally administered municipalities, and autonomous regions in mainland China from February 23 to March 8, 2020. The status of depression, anxiety, and PTG was assessed by the nine-item Patient Health Questionnaire, seven-item generalized anxiety disorder questionnaire, and post-traumatic growth inventory. Results: The prevalence of depression, anxiety, and PTG in adolescents was 35.9, 28.0, and 45.6%, respectively. The prevalence of depression and anxiety in the slight or severe epidemic areas was similar. Regression analysis showed that female sex and older age were associated with higher levels of depression, anxiety, and lower levels of PTG. Symptoms related to COVID-19, excessive attention to epidemic information, living in urban or severe epidemic areas, and conflicts with parents during home quarantine were risk factors for depression, anxiety, and PTG. Frequent communication with peers, exercise, and receiving public welfare psychological assistance were protective factors. Poor family economic status was a significant risk factor for depression and PTG. Conclusion: Our findings suggested that positive and negative psychological reactions coexist in adolescents faced with the pandemic. The factors associated with psychological problems and PTG provide strategic guidance for maintaining adolescents' mental health in China and worldwide during any pandemic such as COVID-19.

Exploration of Psychological Mechanism of Smartphone Addiction Among International Students of China by Selecting the Framework of the I-PACE Model.

The I-PACE (interaction of person-affect-cognition-execution) model explains that the causes of addiction are the result of individual susceptibility (genetic and personality), psychopathological factors (negative emotions), and cognitive and affective factor interaction. The issue of smartphone addiction and its emerging effects are now becoming an essential social enigma. This study is aimed at exploring how personal, affective, cognitive, and execution factors accelerate the mechanism of smartphone addiction among international students. Randomly selected, six hundred international students have constituted the population for our study. All participants were asked to complete self-administered questionnaires. The questionnaire included demographics (gender, place of stay, educational level, and reason for smartphone usage), Mobile Phone Addiction Index, Loneliness Scale (UCLA), Rosenberg Self-Esteem Scale, Beck Depression Inventory, Perceived Stress Scale, Eysenck Personality Questionnaire, and Simplified Coping Style Questionnaire. Statistical analysis was performed using SPSS. 20.3% (n = 122) of international students are agonized with smartphone addiction, while 79.7% (n = 478) use smartphones at an average level. Students' place of stay, neuroticism personality, social desirability, self-esteem, loneliness, depression, perceived stress, and passive coping are associated with smartphone addiction. Loneliness and depression show a strong positive significant correlation, among other variables while loneliness, neurotic personality, depression, low self-esteem, stress, and passive coping are risk factors for smartphone addiction. This study reveals that international students are a high-risk group for smartphone addiction. It has a great deal of impact on students' behavior and psyche. Multiple social, psychological, affective, and cognitive factors affect smartphone addiction. It would be beneficial to direct the students to limit their phone usage and indulge in other healthy physical activities to complete academic goals.

Diagnostic Biomarker Hsa_circ_0126218 and Functioning Prediction in Peripheral Blood Monocular Cells of Female Patients With Major Depressive Disorder.

INTRODUCTION: Although major depressive diroder (MDD) has brought huge burden and challenges to society globally, effective and accurate diagnoses and treatments remain inadequate. The pathogenesis that for women are more likely to suffer from depression than men needs to be excavated as well. The function of circRNAs in pathological process of depression has not been widely investigated. This study aims to explore potential diagnostic biomarker circRNA of female patients with MDD and to investigate its role in pathogenesis. METHODS: First, an expression profile of circRNAs in the peripheral blood monocular cells of MDD patients and healthy peripherals were established based on high-throughput sequencing analysis. In addition, the top 10 differentially expressed circRNAs were quantified by quantitative real-time PCR to explore diagnostic biomarkers. To further investigate the function of biomarkers in the pathogenesis of MDD, bioinformatics analysis on downstream target genes of the biomarkers was carried out. RESULTS: There is a mass of dysregulated circRNAs in PBMCs between female MDD patients and healthy controls. Among the top 10 differentially expressed circRNAs, hsa_circ_0126218 is more feasible as a diagnostic biomarker. The expression level of hsa_circ_0126218 displayed upregulation in patients with MDD and the area under the operating characteristic curve of hsa_circ_0126218 was 0.801 (95% CI 0.7226-0.8791, p < 0.0001). To explain the competing endogenous RNA role of hsa_circ_0126218 in the pathogenesis of female MDD, a hsa_circ_0126218-miRNA-mRNA network was established. Gene Ontology and Kyoto Encyclopedia of Genes and Genomes pathway enrichment analyses stated that some of the enriched pathways downstream of hsa_circ_0126218 are closely related to MDD. Moreover, we established a protein-protein network to further screen out the hub genes (PIK3CA, PTEN, MAPK1, CDC42, Lyn, YES1, EPHB2, SMAD2, STAT1, and ILK). The function of hsa_circ_0126218 was refined by constructing a verified circRNA-predicted miRNA-hub gene subnetwork. CONCLUSION: hsa_circ_0126218 can be considered as a new female MDD biomarker, and the pathogenesis of female MDD by the downstream regulation of hsa_circ_0126218 has been predicted. These findings may help further improve the early detection, effective diagnosis, convenient monitoring of complications, precise treatment, and timely recurrence prevention of depression.

A note on the Drazin indices of square matrices.

For a square matrix A, the smallest nonnegative integer k such that rank (A(k)) =rank (A(k+1)) is called the Drazin index of A. In this paper, we give some results on the Drazin indices of sum and product of square matrices.