The current status of primipara's childbirth experience and its correlation with their reproductive intention: a cross-sectional survey study.

BACKGROUND: The childbirth experience of primipara profoundly impacts her future physical and mental health, reproductive intention, and choice of childbirth mode. This study aimed to explore the current situation of primipara's childbirth experience, to analyze the factors influencing negative childbirth experience, and to explore the relationship between childbirth experience and reproductive intention. METHODS: A cross-sectional survey of a convenience sample of 522 primipara 1-5 days postpartum was conducted at five hospitals in Guangdong Province (May to July 2024). Data were collected using the General Information Questionnaire, the Social Support Rating Scale, the Childbirth Readiness Scale, the Caring Behaviors Inventory Scale, the Wijma Delivery Experience Questionnaire, and the Questionnaire on Reproduction Intention of Primipara. RESULTS: The mean score of fear of childbirth was 68.86 ± 17.68. A total of 137 respondents met the clinical criteria for fear of childbirth (≥ 85 points), indicating that 26.2% of primipara had a negative experience of childbirth. Binary logistic regression model showed that elderly primipara [odds ratio (OR) (95% confidence interval (CI)): 11.167 (2.737-45.559)], pregnancy comorbidities or maternal childbirth complications [OR (95%CI): 6.596 (3.046-14.287)], childbirth intervention [OR (95%CI): 6.168 (2.869-13.258)], and severe pain [OR (95%CI): 4.660 (2.197-9.882)] were risk factors for negative childbirth experience. Childbirth accompaniment [OR (95%CI): 0.081 (0.018-0.368)], high level of social support [OR (95%CI): 0.768 (0.704-0.839)], and high level of childbirth readiness [OR (95%CI): 0.878 (0.812-0.950)] protected against a negative birth experience. There was a negative correlation between the fear of childbirth score and reproduction intention scores. CONCLUSIONS: Childbirth accompaniment and high levels of social support and childbirth readiness can reduce primipara's perception of negative childbirth experience. Negative childbirth experience can reduce reproduction intention.

Status of Horizontal Violence, Level of Psychological Empowerment, and Their Correlation Among Obstetric Nurses: A Cross-Sectional Survey.

BACKGROUND: China's maternity policy has led to an increase in work pressure, which has prompted horizontal violence among obstetric nurses. To understand this phenomenon better, we attempted to identify the factors that influence horizontal violence as well as the level of psychological empowerment among obstetric nurses. METHODS: This cross-sectional survey was conducted among 522 obstetric nurses from December 2022 to February 2023. RESULTS: The findings revealed that 40.42% (211) of the obstetric nurses had experienced horizontal violence in the past 3 months. The overall level of psychological empowerment of obstetric nurses was relatively low. Regression analysis indicated that being a formal worker, being from the area where one serves, the meaning attributed to work, and perceptions of autonomy, self-efficacy, and work impact acted as protective factors against the risk of horizontal violence among obstetric nurses. When compared with the 20-29-year-old age group, those in the 30-39-year-old age group showed a lower risk of experiencing horizontal violence (odds ratio [OR] = 0.369, p < 0.01). Compared with nurses who had worked in obstetrics for < 3 years, those who had worked for 3-5, 6-10, 11-20, and > 20 years showed lower risks of experiencing horizontal violence than the reference level (OR = 0.234, p < 0.05; OR = 0.182, p < 0.05; OR = 0.105, p < 0.05; and OR = 0.056, p < 0.05, respectively). DISCUSSION: The incidence of horizontal violence among obstetric nurses is high, and the overall level of psychological empowerment is low. Nursing managers can alleviate the occurrence of horizontal violence by augmenting the psychological empowerment level of obstetric nurses.

Prevalence of workplace violence in Chinese obstetric nurses under the new situation and its correlation with violence prevention knowledge-attitude-practice and climate perception: a cross-sectional study.

BACKGROUND: Workplace violence severely impacts individual nurses. With the three-child opening policy of China and the impact of the COVID-19 epidemic in the recently years, obstetric nurses face the double attack of heavy workload and staffing shortage. This study aimed to evaluate the current situation of workplace violence among Chinese obstetric nurses under the new situation, assess the level of violence prevention knowledge-attitude-practice and climate perception in Chinese obstetric nurses and explore the correlation between workplace violence and the level of violence prevention knowledge-attitude-practice and climate perception. METHODS: A cross-sectional survey on the workplace violence for Chinese obstetric nurses was conducted from August to February 2023. All the questionnaires came from 10 provinces and 3 autonomous regions in China. The basic characteristics of obstetric nurse's workplace violence, workplace violence prevention knowledge-attitude-practice scale and workplace violence climate perception scale were collected. RESULTS: Totally, 522 Chinese obstetric nurses were included. 55.0% of obstetric nurses (287) had experienced workplace violence in the past 12 months, including verbal assault (40.4%), physical assault (34.1%), and sexual assault (31.0%). The overall level of obstetric nurses' workplace violence prevention knowledge-attitude-practice and climate perception of workplace violence was low. Multiple linear regression analysis showed that the violence prevention knowledge dimension significantly influenced obstetric nurses' workplace violence (B = -0.278, P < .001), attitude dimension (B = -0.241, P < .001), behavior dimension (B = -0.216, P < .001) and the violence climate perception's organizational management (B = -0.177, P < .001), organizational training (B = -0.175, P < .001), organizational support (B = -0.143, p < .001) and the violence handling (B = -0.165, P < .001). CONCLUSION: The incidence of workplace violence among obstetric nurses in the new situation is high. However, the overall violence prevention knowledge-attitude-practice and climate perception levels are low. Therefore, nursing managers should take targeted measures according to the relevant influencing factors and the characteristics of obstetrics to improve the level of obstetric nurses' violence prevention knowledge-attitude-practice and climate perception to reduce workplace violence among obstetric nurses.

Covariation between spontaneous neural activity in the insula and affective temperaments is related to sleep disturbance in individuals with major depressive disorder.

BACKGROUND: Affective temperaments have been considered antecedents of major depressive disorder (MDD). However, little is known about how the covariation between alterations in brain activity and distinct affective temperaments work collaboratively to contribute to MDD. Here, we focus on the insular cortex, a critical hub for the integration of subjective feelings, emotions, and motivations, to examine the neural correlates of affective temperaments and their relationship to depressive symptom dimensions. METHODS: Twenty-nine medication-free patients with MDD and 58 healthy controls underwent magnetic resonance imaging scanning and completed the Temperament Evaluation of Memphis, Pisa, Paris and San Diego (TEMPS). Patients also received assessments of the Hamilton Depression Rating Scale (HDRS). We used multivariate analyses of partial least squares regression and partial correlation analyses to explore the associations among the insular activity, affective temperaments, and depressive symptom dimensions. RESULTS: A profile (linear combination) of increased fractional amplitude of low-frequency fluctuations (fALFF) of the anterior insular subregions (left dorsal agranular-dysgranular insula and right ventral agranuar insula) was positively associated with an affective-temperament (depressive, irritable, anxious, and less hyperthymic) profile. The covariation between the insula-fALFF profile and the affective-temperament profile was significantly correlated with the sleep disturbance dimension (especially the middle and late insomnia scores) in the medication-free MDD patients. CONCLUSIONS: The resting-state spontaneous activity of the anterior insula and affective temperaments collaboratively contribute to sleep disturbances in medication-free MDD patients. The approach used in this study provides a practical way to explore the relationship of multivariate measures in investigating the etiology of mental disorders.

Highly efficient BiVO4single-crystal nanosheets with dual modification: phosphorus doping and selective Ag modification.

BiVO4, a visible-light response photocatalyst, has shown tremendous potential because of abundant raw material sources, good stability and low cost. There exist some limitations for further applicaitions due to poor capability to separate electron-hole pairs. In fact, a single-component modification strategy is barely adequate to obtain highly efficient photocatalytic performance. In this work, P substituted some of the V atoms from VO4oxoanions, namely P was doped into the V sites in the host lattice of BiVO4by a hydrothermal route. Meanwhile, Ag as an attractive and efficient electron-cocatalyst was selectively modified on the (010) facet of BiVO4nanosheets via facile photo-deposition. As a result, the obtained dually modified BiVO4sheets exhibited enhanced photocatalytic degradation property of methylene blue (MB). In detail, photocatalytic rate constant (k) was 2.285 min-1g-1, which was 2.78 times higher than pristine BiVO4nanosheets. Actually, P-doping favored the formation of O vacancies, led to more charge carriers, and facilitated photocatalytic reaction. On the other hand, metallic Ag loaded on (010) facet effectively transferred photogenerated electrons, which consequently helped electron-hole pairs separation. The present work may enlighten new thoughts for smart design and controllable synthesis of highly efficient photocatalytic materials.

Risk factors for anxiety and depression in Chinese patients undergoing surgery for endometrial cancer.

This study analyzed risk factors for anxiety and depression in 714 patients who received surgery for endometrial cancer. Our data indicate that the incidence of postoperative anxiety and depression in 714 patients with endometrial cancer was 15.55% and 32.77%, respectively. Univariate and logistic regression analysis showed postoperative pain (odds ratio (OR) = 3.166, P = 0.000) and combined liver disease (OR = 2.318, P = 0.001) were independent risk factors for postoperative anxiety. Additionally, CD4+/CD8+ (OR = 0.513, P = 0.042) and natural killer (NK) cell ratios (OR = 0.692, P = 0.021) were independent protective factors for postoperative anxiety. As for depression, low literacy (OR = 1.943, P = 0.042), postoperative pain (OR = 2.671, P = 0.001), high clinical stage (OR = 3.469, P = 0.009), and combined liver disease (OR = 4.865, P = 0.000) were independent risk factors for postoperative depression. CD4+/CD8+ (OR = 0.628, P = 0.002) and NK cell ratio (OR = 0.710, P = 0.013) were independent protective factors for postoperative depression. In conclusion, patients with endometrial cancer have a higher incidence of postoperative anxiety and depression where postoperative pain, liver disease, and decreased immune function are risk factors for both anxiety and depression in these patients.

Olig2 Silence Ameliorates Cuprizone-Induced Schizophrenia-Like Symptoms in Mice.

BACKGROUND The pathogenesis of schizophrenia is complex and oligodendrocyte abnormality is an important component of the pathogenesis found in schizophrenia. This study was designed to evaluate the function of olig2 in cuprizone-induced schizophrenia-like symptoms in a mouse model, and to assess the related mechanisms. MATERIAL AND METHODS The schizophrenia-like symptoms were modeled by administration of cuprizone in mice. Open-field and elevated-plus maze tests were applied to detect behavioral changes. Adenovirus encoding olig2 siRNA was designed to silence olig2 expression. Real-time PCR and western blotting were applied to detect myelin basic protein (MBP), 2',3'-cyclic nucleotide 3'-phosphodiesterase (CNPase), glial fibrillary acidic protein (GFAP) and olig2 expressions. RESULTS Open field test showed that the distance and time spent in the center area were significantly decreased in cuprizone mice (model mice) when compared with control mice (p<0.05). By contrast, olig2 silence could significantly increase the time and distance spent in the center area compared with the model mice (p<0.05). As revealed by elevated-plus maze test, the mice in the model group preferred the open arm and spent more time and distance in the open arm compared with control mice (p<0.05), while olig2 silence significantly reversed the abnormalities (p<0.05). Mechanically, MBP and CNPase expression were reduced in the model group compared with the control (p<0.05). However, olig2 silence reversed the reduction caused by cuprizone modeling (p<0.05). In addition, GFAP was elevated after cuprizone modeling compared with control (p<0.05), and was significantly inhibited by olig2 silence compared with model (p<0.05). CONCLUSIONS Cuprizone-induced schizophrenia-like symptoms involved olig2 upregulation. The silence of olig2 could prevent changes, likely through regulating MBP, CNPase, and GFAP expressions.

Effect of rs1063843 in the CAMKK2 gene on the dorsolateral prefrontal cortex.

Recently, a single nucleotide polymorphism (SNP) in the CAMKK2 gene (rs1063843) was found to be associated with lower expression of the gene in the dorsolateral prefrontal cortex (DLPFC) and with schizophrenia (SCZ) and deficits in working memory and executive function. However, the brain mechanism underlying this association is poorly understood. A functional magnetic resonance imaging (fMRI) study (N = 84 healthy volunteers) involving multiple cognitive tasks, including a Stroop task (to measure attentional executive control), an N-back task (to measure working memory), and a delay discounting task (to measure decision making) to identify the brain regions affected by rs1063843 was performed. Across all three tasks, it was found that carriers of the risk allele consistently exhibited increased activation of the left DLPFC. In addition, the risk allele carriers also exhibited increased activation of the right DLPFC and the left cerebellum during the Stroop task and of the left caudate nucleus during the N-back task. These findings helped to elucidate the role of CAMKK2 in cognitive functions and in the etiology of SCZ. Hum Brain Mapp 37:2398-2406, 2016. © 2016 Wiley Periodicals, Inc.

Survey of attitudes of Chinese perinatologists and obstetricians toward non-invasive prenatal genetic testing.

AIM: The clinical application of non-invasive prenatal testing (NIPT) is still very limited in China. We carried out a survey to assess the willingness of Chinese obstetricians to offer NIPT and to determine how they would implement it and what resources they would need for the testing. METHODS: Between June 2014 and June 2015, a survey was conducted at a large academic referral center with data obtained from 392 registered perinatologists and obstetricians who completed an entire questionnaire. RESULTS: Most respondents (72.5%) agreed or strongly agreed that the percentage of women patients refusing to accept NIPT would increase if they were charged directly for the test. Most respondents (82.7%) answered affirmatively that the national health administration agencies should formulate a standard charge for NIPT. The most important factors that influence the application of NIPT are the popularity of the test and its cost. The majority of respondents indicated that there are appropriate reasons for NIPT. CONCLUSION: The importance of NIPT and guidelines for the application of NIPT should be clarified in current clinical practice in China. Extensive education regarding NIPT application is necessary prior to mass implementation.

The ANK3 gene and facial affect processing: An ERP study.

ANK3 is one of the most promising candidate genes for bipolar disorder (BD). A polymorphism (rs10994336) within the ANK3 gene has been associated with BD in at least three genome-wide association studies of BD [McGuffin et al., 2003; Kieseppä, 2004; Edvardsen et al., 2008]. Because facial affect processing is disrupted in patients with BD, the current study aimed to explore whether the BD risk alleles are associated with the N170, an early event-related potential (ERP) component related to facial affect processing. We collected data from two independent samples of healthy individuals (Ns = 83 and 82, respectively) to test the association between rs10994336 and an early event-related potential (ERP) component (N170) that is sensitive to facial affect processing. Repeated-measures analysis of covariance in both samples consistently revealed significant main effects of rs10994336 genotype (Sample I: F (1, 72) = 7.24, P = 0.009; Sample II: F (1, 69) = 11.81, P = 0.001), but no significant interaction of genotype × electrodes (Ps > 0.05) or genotype × emotional conditions (Ps > 0.05). These results suggested that rs10994336 was linked to early ERP component reflecting facial structural encoding during facial affect processing. These results shed new light on the brain mechanism of this risk SNP and associated disorders such as BD. © 2016 Wiley Periodicals, Inc.

Cost-effectiveness analysis of psychosocial intervention for early stage schizophrenia in China: a randomized, one-year study.

BACKGROUND: A combination of psychosocial interventions and medications has been highly recommended as a successful treatment package for schizophrenia. Its cost-effectiveness has not been fully explored yet. The aim of the present analysis was to evaluate the cost-effectiveness of antipsychotics combined with psychosocial treatment and treatment as usual for patients with early-stage schizophrenia. METHOD: Patients with schizophrenia (N = 1, 268) were assigned to the combination of medication and psychosocial intervention or treatment as usual for up to 12 months. Cost analysis included direct medical costs, direct nonmedical costs and indirect costs. Quality-adjusted life year (QALY) ratings were assessed with Short- Form 6D. RESULTS: Average monthly psychosocial intervention costs for combined treatment were higher than treatment as usual (p = 0.005), but no significant differences were found in direct costs, indirect costs, and total costs between two groups (all p-values ≥ 0.556). Combined treatment was associated with significant higher QALY ratings than treatment as usual (p = 0.039). Compared with treatment as usual, combined treatment resulted in a gain of 0.031 QALY ratings at an additional cost of US$ 56.4, yielding an incremental cost-effectiveness ratio of US$ 1819.4 per QALY gained. CONCLUSIONS: Despite some limitations, our results supported that medication combined with psychosocial treatment was more cost-effective than treatment as usual for patients with early-stage schizophrenia. TRIAL REGISTRATION: clinicaltrials.gov Identifier: NCT00654576.

The Associations and Causal Relationships of Ovarian Cancer - Construction of a Prediction Model.

Purpose: To explore the risk and protective factors for developing ovarian cancer and construct a risk prediction model. Methods: Information related to patients diagnosed with ovarian cancer on the electronic medical record data platform of three tertiary hospitals in Guangdong Province from May 2018 to September 2023 was collected as the case group. Patients with non-ovarian cancer who attended the clinic during the same period were included in the control group. Logistic regression analysis was used to screen the independent variables and explore the factors associated with the development of ovarian cancer. An ovarian cancer risk prediction model was constructed using a decision tree C4.5 algorithm. The ROC and calibration curves were plotted, and the model was validated. Results: Logistic regression analysis identified independent risk and protective factors for ovarian cancer. The sample size was divided into training and test sets in a ratio of 7:3 for model construction and validation. The AUC of the training and test sets of the decision tree model were 0.961 (95% CI:0.944-0.978) and 0.902 (95% CI:0.840-0.964), respectively, and the optimal cut-off values and their coordinates were 0.532 (0.091, 0.957), and 0.474 (0.159, 0.842) respectively. The accuracies of the training and test sets were 93.3% and 84.2%, respectively, and their sensitivities were 95.7% and 84.2%, respectively. Conclusion: The constructed ovarian cancer risk prediction model has good predictive ability, which is conducive to improving the efficiency of early warning of ovarian cancer in high-risk groups.

Undergraduate midwifery students' experiential learning of perinatal bereavement care: A qualitative analysis.

BACKGROUND: It is widely acknowledged that midwives are essential in providing care for mothers experiencing perinatal death. However, midwifery students lack the knowledge and skills needed to deal with perinatal death, and. There is limited research on perinatal bereavement care training for midwifery students. AIM: To investigate undergraduate midwifery students' experiential learning of perinatal bereavement care and serve as a reference for future perinatal bereavement care teaching and training. DESIGN: Qualitative descriptive design. SETTING: University in Guangzhou, China. PARTICIPANTS: Undergraduate midwifery students at a university in Guangzhou, China. METHOD: This research was conducted at a university in Guangzhou, China. The participants were recruited using purposeful sampling. Semi-structured, in-depth interviews were conducted with 11 midwifery students who participated in perinatal bereavement care training from May to June 2023. The Colalizzi 7-step data analysis method was used for data analysis. RESULTS: From the data, five themes emerged: 1) immersive experience of perinatal bereavement care, 2) formation of perspectives on perinatal bereavement care, 3) clarification of the service boundaries and internalization of the professional service spirit, 4) emotional impact and coping strategies, and 5)) factors influencing practice optimization. CONCLUSIONS: Experiential learning is an effective teaching strategy. However, participants continued to feel unprepared to provide perinatal bereavement care. Implementing relevant training, disseminating perinatal bereavement care knowledge and skills, and enhancing the ability of midwifery students to manage and cope with the psychological impact of perinatal death are important.

Reasons, experiences and expectations of women with delayed medical care for ectopic pregnancies in Chinese urban edges: a qualitative study.

OBJECTIVE: To explore the experiences of patients with ectopic pregnancies with delayed medical care, with the goals to promote timely access to care, reduce subsequent physical and psychological impacts, and provide recommendations for improved management of ectopic pregnancies. DESIGN: A qualitative study. SETTING: A 1000-bed urban edge hospital located in the suburban area of Guangzhou, China, between December 2022 and February 2023. PARTICIPANTS: 21 patients with delays in seeking medical care for ectopic pregnancy. PRIMARY AND SECONDARY OUTCOME MEASURES: Semistructured, in-depth, face-to-face interviews were conducted to understand the experience and expectations of these women. RESULTS: Three main themes emerged, including delaying medical care, physical and psychological experiences, and expectations of their healthcare providers. Each of these main themes had several subthemes. The central theme of reasons for delaying medical care had five subthemes, including lack of knowledge on early symptoms of ectopic pregnancy, family dynamics and circumstances, traditional fertility ideology and intentions, avoidance of medical treatment behaviour, and medical delays. The main theme of physical and psychological experiences had two subthemes, including learnings from the experiences and negative impacts of the experiences. The main theme of expectations of their healthcare providers included three subthemes that were reducing the length of outpatient examinations and waiting times, increasing public understanding of early symptoms of ectopic pregnancy and increasing male awareness of safe contraceptive methods. CONCLUSIONS: A lack of knowledge about the early symptoms of ectopic pregnancy was the main reason for delays in seeking medical care and had a dual impact on patients' physical and mental health, affecting their recovery and future healthcare. A collective effort from patients, families, healthcare providers and medical institutions is required for better medical education, family support, specialised professional training and local fertility policy to decrease the incidence of delayed medical care and achieve satisfactory pregnancy outcomes.

Dietary habit and lifestyle of postpartum women in South China: a mixed methods research.

OBJECTIVE: To investigate the dietary and hygiene behaviours and influencing factors of women during the puerperium in South China. DESIGN: A cross-sectional study. SETTING: Three tertiary hospitals in Guangdong Province, China PARTICIPANTS: From November 2022 to March 2023, 327 women with puerperal experience were enrolled using the purposive sampling method, with 323 valid questionnaires collected for data analysis. Semistructured interviews were conducted with six puerperium women and five primary caregivers. PRIMARY AND SECONDARY OUTCOME MEASURES: This study used a questionnaire survey to collect and analyse the current postpartum dietary and hygiene behaviours among women in the South China region, along with their influencing factors. RESULTS: Multinomial logistics regression revealed women residing in urban-rural fringe were more likely to use ventilated rooms (OR 4.496, 95% CI 2.363 to 8.552) and avoid hair washing (OR 0.345, 95% CI 0.159 to 0.749) compared with urban residents. Additionally, women who practiced Buddhism were more likely to wash their hair (OR 11.070, 95% CI 2.339 to 52.379) and take baths (OR 6.856, 95% CI 2.057 to 22.855) compared with those with no religious affiliation. Lastly, those whose primary caregiver was their husband were more likely to consume watermelon (OR 2.235, 95% CI 1.119 to 4.463), persimmon (OR 4.395, 95% CI 1.886 to 10.242) and longan (OR 2.612, 95% CI 1.362 to 5.010). The qualitative study identified five themes: dietary practices, hygiene habits, personal attitude, sources of information and support. CONCLUSION: The dietary and hygiene behaviours of puerperium women in South China are significantly influenced by the residen, primary caregivers and religious beliefs. Medical care providers should adopt a precision postpartum care strategy to improve the quality of care.

Effects of parenting style on depressive symptoms, anxiety symptoms, and their comorbidity during the COVID-19 pandemic lockdown among 3117 Chinese junior high school students.

INTRODUCTION: Depressive symptoms, anxiety symptoms, and comorbidity increased in junior high school students due to the outbreak of COVID-19. The objective of this study was to measure the impacts of parenting style on depressive symptoms, anxiety symptoms, and their comorbidity in Chinese junior high school students during the COVID-19 pandemic lockdown period. METHODS: An online survey was conducted in June 2020 among 3117 junior high school students from Shandong Province, China. The Egna Minnen av Barndoms Uppfostran scale was used to measure parenting styles. The 9-item Patient Health Questionnaire scale and the 7-item Generalized Anxiety Disorder scale were used to measure depressive symptoms and anxiety symptoms, respectively. Multinomial logistic regression was conducted with SPSS 25.0 Version. RESULTS: 3117 junior school students enrolled in this study. The prevalence of depressive symptoms only, anxiety symptoms only, and comorbidity among junior high school students was 11.55 %, 5.29 %, and 22.97 %. Paternal over-protection was a risk factor not only for depressive symptoms only (OR = 1.075, 95 % CI = 1.020-1.134) but for anxiety symptoms only (OR = 1.090, 95 % CI = 1.016-1.170) and comorbidity (OR = 1.098, 95 % CI = 1.050-1.148). Paternal over-interference was a protective factor for depressive symptoms only (OR = 0.947, 95 % CI = 0.908-0.987) and comorbidity (OR = 0.953, 95 % CI = 0.921-0.986). However, maternal over-interference and over-protection were risk factors for depressive symptoms only (OR = 1.039, 95 % CI = 1.011-1.068). LIMITATIONS: This was a cross-sectional study and the causal inferences could not be conducted. CONCLUSIONS: Junior high school students with poorer family environmental factors were more likely to suffer from the comorbidity of anxiety symptoms and depressive symptoms during the COVID-19 pandemic lockdown. Decision-makers from the government, educational, and healthcare institutions should pay more attention to junior high school students at higher risk of mental disorders due to poor parenting styles. We should discuss family interventions in the future to prevent mental disorders in junior high school students.

Thrombospondin-1 Regulates Trophoblast Necroptosis via NEDD4-Mediated Ubiquitination of TAK1 in Preeclampsia.

Preeclampsia (PE) is considered as a disease of placental origin. However, the specific mechanism of placental abnormalities remains elusive. This study identified thrombospondin-1 (THBS1) is downregulated in preeclamptic placentae and negatively correlated with blood pressure. Functional studies show that THBS1 knockdown inhibits proliferation, migration, and invasion and increases the cycle arrest and apoptosis rate of HTR8/SVneo cells. Importantly, THBS1 silencing induces necroptosis in HTR8/SVneo cells, accompanied by the release of damage-associated molecular patterns (DAMPs). Necroptosis inhibitors necrostatin-1 and GSK'872 restore the trophoblast survival while pan-caspase inhibitor Z-VAD-FMK has no effect. Mechanistically, the results show that THBS1 interacts with transforming growth factor B-activated kinase 1 (TAK1), which is a central modulator of necroptosis quiescence and affects its stability. Moreover, THBS1 silencing up-regulates the expression of neuronal precursor cell-expressed developmentally down-regulated 4 (NEDD4), which acts as an E3 ligase of TAK1 and catalyzes K48-linked ubiquitination of TAK1 in HTR8/SVneo cells. Besides, THBS1 attenuates PE phenotypes and improves the placental necroptosis in vivo. Taken together, the down-regulation of THBS1 destabilizes TAK1 by activating NEDD4-mediated, K48-linked TAK1 ubiquitination and promotes necroptosis and DAMPs release in trophoblast cells, thus participating in the pathogenesis of PE.

The relationship between obesity and health-related quality of life in Chinese patients with schizophrenia.

OBJECTIVE: Studies have reported that up to 60% of individuals with schizophrenia are overweight or obese. This study explored the relationship between obesity and health-related quality of life (HRQoL) in Chinese patients with schizophrenia. METHODS: A total of 1,108 patients with schizophrenia aged 18-50 years were recruited from 10 different sites in China. Demographic and medical information were collected; the Mandarin version of Short Form 36 Health Survey questionnaire (SF-36) was used to assess HRQoL; in addition,height and weight were measured to calculate body mass index (BMI). BMI was categorized into underweight, normal weight, overweight and obese using cutoffs for Asian populations recommended by the World Health Organization. RESULTS: Fifty-six percent of participants with schizophrenia were overweight or obese. A higher BMI was associated with significantly lower scores in physical functioning, role-physical, and physical component summary (p's ≤ 0.010). Obese patients with schizophrenia had significantly lower scores in 3 domains and physical component summary of the SF-36 compared with normal weight patients (p's ≤ 0.007). CONCLUSION: Obesity is associated with decreased HRQoL in Chinese patients with schizophrenia. Our findings suggest that the prevention and management of weight gain and obesity is important in improving HRQoL in patients who suffer from this devastating mental illness.

Effects of obstetric critical care simulation training on core competency and learning experience of midwives: A pilot quasi-experimental study.

AIM: This study aimed to investigate the effects of maternal critical care simulation training on the core competency and satisfaction of midwives in China. BACKGROUND: Midwives play an important role during the peripartum period. Simulation-based training could be an effective tool in improving the core competency of midwives when managing critical obstetric illnesses. DESIGN: A pilot pre- and post-course, quasi-experimental study in China. METHOD: In July 2022, 82 midwives completed a 2-day obstetric critical care simulation training and survey. Core competency was evaluated by a comprehensive score system, including response ability, communication ability, site control ability, critical thinking ability, team cooperation ability, forward-thinking ability, midwifery specialty ability, and error correction ability. We used the Simulation Effectiveness Tool-Modified (SET-M) to evaluate the learning experience and satisfaction. Descriptive analysis, McNemar χ2 test, and subject content analysis were used for data analysis. RESULTS: After the training, the core competency scores showed significant improvements in the case scenarios simulating shoulder dystocia, amniotic fluid embolism, and eclampsia (P < 0.05) but not postpartum hemorrhage (P > 0.05). The scores evaluated by the SET-M were all above 2.5 points. Some midwives preferred extended course duration, expanded course materials, and more active involvement in the simulation exercises. The midwives were generally highly satisfied with the training, but some expressed certain negative emotions, such as anxiety and nervousness. CONCLUSION: The high quality of scientifically constructed and implemented obstetric critical care simulation training courses could improve the core competency and satisfaction of midwives. Appropriate preparation and professional simulation teachers are required to reduce negative emotions and improve learning outcomes and experience.

Effects of antipsychotic medications on quality of life and psychosocial functioning in patients with early-stage schizophrenia: 1-year follow-up naturalistic study.

BACKGROUND: The relative effects of the atypical antipsychotic drugs and conventional agent on quality of life and psychosocial functioning in patients with early-stage schizophrenia is still uncertain because of an insufficient number of studies examining this issue. METHODS: In a 12 months open-label, prospective observational, multicenter study, 1029 subjects with schizophrenia or schizophreniform disorder within 5 years of onset were monotherapy with chlorpromazine, sulpiride, clozapine, risperidone, olanzapine, quetiapine or aripiprazole. The health-related quality of life and psychosocial functioning were assessed using Medical Outcomes Study 36-Item Short Form Health Survey (SF-36), the Global Assessment Scale (GAS) and the Activities of Daily Living Scale (ADL), respectively. RESULTS: At 12 months, treatment resulted in significant improvements in all 8 domain scores of SF-36, GAS and ADL score (all P-values< .001). However, only olanzapine and quetiapine groups demonstrated greater improvement in the role-psychical score of SF-36 and GAS score than did the chlorpromazine group (all P-values ≤ .002). CONCLUSIONS: All antipsychotics may improve quality of life and social function in patients with early-stage schizophrenia, but further studies are needed to determine whether atypical antipsychotics are superior to conventional agents.