Development and validation of a nomogram to predict recompensation in HBV-related cirrhosis with ascites as the single first decompensating event.

BACKGROUND AND OBJECTIVE: Little is known about the influencing factors for recompensation in HBV-related cirrhosis patients with ascites as the single first decompensating event and it's necessary to build a prediction model for these patients. METHODS: Hepatitis B virus-related cirrhosis patients with ascites hospitalized for the first decompensation were included and they were divided into the training cohort (2010.03-2020.03) and the validation cohort (2020.04-2022.04). All patients received antiviral therapy within 3 months before admission or immediately after admission. Recompensation is defined as the patient's ascites disappeared without diuretics, which were maintained for more than 1 year and no other decompensated complications, hepatocellular carcinoma, or liver transplantation occurred. The nomogram was developed from a training cohort of 279 patients and validated in another cohort of 72 patients. RESULTS: Totally, 42.7% of the decompensated patients achieved recompensation. According to the results of logistic regression and competing risk analysis, six independent factors associated with recompensation were found and these factors comprised the nomogram: age, alanine aminotransferase (ALT), albumin (ALB), serum sodium (Na), alpha-fetoprotein (AFP), and maintained virological response (MVR). Through external validation, the area under the receiver operating characteristic curve (AUC) of the nomogram was 0.848 (95% CI: 0.761, 0.936), which was significantly better than CTP, MELD, MELDNa, MELD 3.0, and ALBI grade. CONCLUSIONS: Age, ALT, ALB, Na, AFP, and MVR are closely related to the recompensation. The nomogram developed based on these items can accurately predict the possibility of recompensation in hepatitis B cirrhosis patients with ascites as the single first decompensating event.

The effect of childhood trauma on suicide risk: the chain mediating effects of resilience and mental distress.

BACKGROUND: Suicide is the fourth leading cause of death among young people aged 15-29 years. A large number of studies have found that mental disorder in adulthood is closely related to childhood trauma, and the relationship between childhood trauma and suicide risk is influenced by resilience and mental distress. This study aimed to explore the effects of childhood trauma on suicide risk among young people and the potential roles of resilience and mental distress in the relationship between childhood trauma on suicide risk. METHODS: A cross-sectional survey was conducted among 742 young adults who were in graduate school stage from multiple provinces and cities in China. The Childhood Trauma Questionnaire (CTQ-Short Form), Connor-Davison Resilience Scale (CD-RISC) and Suicide Behavior Questionnaire-Revised (SBQ-R) were used to measure young adults' childhood trauma, resilience and suicide risk, respectively. 9-items Patient Health Questionnaire (PHQ-9) and 7-items self-report Generalized Anxiety Disorder Scale (GAD-7) were used together to measure mental distress. Correlation analysis was performed to explore the initial relationships among the main variables. Structural equation modeling (SEM) was conducted to examine the chain mediating effects of resilience and mental distress in the relationship between childhood trauma and suicide risk. RESULTS: The structural equation modeling produced goodness of fit indices (χ2 /df = 3.668, p < 0.001, RMSEA = 0.060, NFI = 0.959, CFI = 0.969, GFI = 0.969, TLI = 0.955). Childhood trauma significantly predicted suicide risk (ß = 0.232, p < 0.001) and mental distress (ß = 0.181, p < 0.001), which had negative effect on resilience (ß = -0.233, p < 0.001). Resilience negatively affected mental distress (ß = -0.483, p < 0.001) and suicide risk (ß = -0.142, p = 0.001), while mental distress positively associated with suicide risk (ß = 0.219, p < 0.001). CONCLUSION: The current study revealed that resilience and mental distress played chain-mediating roles in the relationship between childhood trauma and suicide risk. This suggests that we should view the suicide risk of graduate students from a comprehensive perspective.

Effective solvent-free oxidation of cyclohexene to allylic products with oxygen by mesoporous etched halloysite nanotube supported Co2.

One dimensional mesoporous etched halloysite nanotube supported Co2+ is achieved by selective etching of Al2O3 from halloysite nanotube (HA) and immersing the etched HA (eHA) into the Co(NO3)2·6H2O solution consecutively. By facilely tuning the etching time and the weight ratio of Co(NO3)2·6H2O to eHA, the morphology, specific surface area and the supported Co2+ content of the mesoporous material can be tuned. The method for mesoporous material is scaled up and can be extended to other clay minerals. The mesoporous eHA supported Co2+ is used as catalyst for the selective catalytic oxidation of cyclohexene in solvent-free reaction system with O2 as oxidant. The results shows the catalytic activity is dependent on etching time, weight ratio of Co(NO3)2·6H2O to eHA, calcination treatment and reaction time/temperature. Among them, mesoporous eHA supported Co2+ prepared with 18 h etching time and 2 : 1 Co(NO3)2·6H2O/eHA weight ratio without calcination (HA/HCl-18 h/Co2+-2 : 1) demonstrates the highest catalytic activity under 75 °C reaction temperature and 18 h reaction time (58.30% conversion and 94.03% selectivity to allylic products). Furthermore, HA/HCl-18 h/Co2+-2 : 1 has exhibit superior cycling stability with 37.69% conversion and 92.73% selectivity to allylic products after three cycles.