Sleep quality mediates the effect of medical social support on depression symptoms in patients with HIV/AIDS.

OBJECTIVES: The purpose of our study is to further understanding of the depression symptoms of HIV/AIDS patients in Guilin, Guangxi via exploring whether there is a mediating effect of sleep quality on medical-social support and depression symptoms and therefore provide a theoretical basis for application of medical-social support to alleviate depression symptoms of HIV/AIDS patients. METHODS: A convenience sampling method was used to select 200 HIV/AIDS patients for the study. Depression symptoms, sleep quality, and medical-social support of the study participants were investigated using The Center for Epidemiological Studies Depression Scale (CES-D), The Pittsburg Sleep Quality Index (PSQI), and The Medical Outcomes Study Social Support Survey (MOS-SSS), respectively. Predictors of depression symptoms were explored by multiple linear regression, and Pearson correlation was used to analyze the relationship between sleep quality, medical-social support, and depression symptoms. Mediating effect analysis was performed by nonparametric Bootstrap test. RESULTS: In this study, the incidence of depression symptoms was 54.4%. Multiple linear regression analysis showed that leanness (ß = 0.161, P = 0.008), obesity (ß = 0.186, P = 0.002), sleep quality score > 7 (ß = 0.331, P < 0.001), and medical-social support score > 56 (ß = -0.247, P < 0.001) could influence depression symptoms of HIV and Pearson's correlation analysis demonstrated that there was a two-way correlation between sleep quality, medical social support and depression symptoms (P < 0.05). In addition, Bootstrap tests showed that medical-social support might affect depression symptoms not only directly but also indirectly through the mediating effect of sleep quality with the direct and mediating effects accounting for 77.25% and 22.75% of the total effect, respectively. CONCLUSION: The prevalence of depression symptoms is high among HIV/AIDS patients in Guilin City. The depressive symptoms of PLWHs(people living with HIV) are related to their sleep quality and medical-social support, and sleep quality partially mediates the relationship between medical-social support and depression symptoms. Therefore, interventions to improve sleep quality and medical-social support have the potential to allay the depression symptoms of HIV/AIDS patients.

Removal of Ocular and Muscular Artifacts From Multi-Channel EEG Using Improved Spatial-Frequency Filtering.

Over recent decades, electroencephalogram (EEG) has become an essential tool in the field of clinical analysis and neurological disease research. However, EEG recordings are notably vulnerable to artifacts during acquisition, especially in clinical settings, which can significantly impede the accurate interpretation of neuronal activity. Blind source separation is currently the most popular method for EEG denoising, but most of the sources it separates often contain both artifacts and brain activity, which may lead to substantial information loss if handled improperly. In this paper, we introduce a dual-threshold denoising method combining spatial filtering with frequency-domain filtering to automatically eliminate electrooculogram (EOG) and electromyogram (EMG) artifacts from multi-channel EEG. The proposed method employs a fusion of second-order blind identification (SOBI) and canonical correlation analysis (CCA) to enhance source separation quality, followed by adaptive threshold to localize the artifact sources, and strict fixed threshold to remove strong artifact sources. Stationary wavelet transform (SWT) is utilized to decompose the weak artifact sources, with subsequent adjustment of wavelet coefficients in respective frequency bands tailored to the distinct characteristics of each artifact. The results of synthetic and real datasets show that our proposed method maximally retains the time-domain and frequency-domain information in the EEG during denoising. Compared with existing techniques, the proposed method achieves better denoising performance, which establishes a reliable foundation for subsequent clinical analyses.

Analysis of Factors Influencing Depression in Elderly People Living with HIV/AIDS Based on Structural Equation Model: A Cross-Sectional Study in Guangxi, China.

Purpose: The purpose of our study is to understand the current status of depression and medical social support in elderly HIV/AIDS, as well as the role of social support on depression, so as to provide a certain reference for reducing the occurrence of depression in the population. Methods: A total of 115 participants with PLWHA (people living with HIV/AIDS) aged 50 years or older were collected in Guilin from December 2021 to July 2022. Depression and medical social support were assessed using the Center for Streaming Depression Scale (CES-D) and the Medical Social Support Scale (MOS-SSS). The structural equation model was used to examine the relationship between medical social support and depression. Results: Sixty-one of 115 participants developed depressive symptoms with a prevalence of 53.0%. The results of univariate analysis showed that ethnicity, health status, mean monthly income, antiviral treatment status, and medical social support influenced PLWHA depression (P<0.05). Simple linear regression showed that health status (95% CI: -9.901~-2.635), and antiviral treatment status (95% CI: -12.969~-3.394) influent depression (P<0.05). There were associations between total medical social support, practical support dimension, message and emotional support dimension, social interactive cooperation dimension, emotional support dimension and depression (unadjusted and adjusted for contextual factors) (P < 0.05). Using multiple linear regression analyses, we found that medical-social support was negatively associated with depression with a standardized effect value of -0.223. PLWHA with higher medical social support had lower prevalence of depression. Conclusion: The results indicate that the prevalence of depression among HIV/AIDS patients in Guilin is high. So the joint efforts of individuals, families, and society are needed to improve the physical and mental health of the PLWHA.

The relationship between social capital and postpartum depression symptoms of lactating women in minority areas-A cross-sectional study from Guangxi, China.

Background: Postpartum depression (PPD) is the most common mental illness affecting women during lactation, and good social capital is considered a protective factor. This study aimed to investigate PPD symptoms, and explore the relationships between social capital and PPD symptoms of lactating women in southwest minority areas in China. Materials and methods: This cross-sectional study was conducted among 413 lactating women in Guangxi, China. Data were collected using the Edinburgh Postnatal Depression Scale and the Chinese version of the Social Capital Assessment Questionnaire. Hierarchical regression analysis was conducted to explore the factors influencing PPD symptoms, and a structural equation model was used to examine how social participation and cognitive social capital mediated PPD symptoms. Results: The total prevalence of PPD symptoms (score > 12) was 16.46%, and that of mild depression symptoms (9-12 score) was 22.03%. Nine variables predicted PPD symptoms and explained 71.6% of the variance in the regression model: higher age, lack of medical security, fixed occupation, breastfeeding time, self-caregiver, maternity leave, social participation, social trust, and social reciprocity. Furthermore, cognitive social capital mediated the relationship between social participation and PPD symptoms, with a mediation effect rate was 44.00%. Conclusion: The findings of this study highlight that social capital, support from family members, maternity leave, and medical insurance play protective roles in the PPD symptoms of lactating women. It is necessary to improve social capital as a key strategy for interventions for PPD symptoms, and active social participation activities are critical to reducing PPD symptoms among lactating women in minority areas.

Application of Bayesian networks to identify factors influencing acceptability of HIV pre-exposure prophylaxis in Guilin, China.

Pre-exposure prophylaxis (PrEP) is an effective strategy to prevent uninfected individuals from contracting human immunodeficiency virus (HIV), however it must be acceptable to stakeholders in order to be effective. This study aimed to assess the acceptability of PrEP and related influencing factors. A cross-sectional survey was conducted among female sex workers (FSW), people who inject drugs (PWID), and men who have sex with men (MSM) using respondent driven sampling. Factors influencing PrEP acceptability were estimated using ordinal logistic regression and Bayesian networks. The survey included 765 eligible participants. The mean score of the perceived acceptability index was 3.9 (SD = 1.97). Multivariable logistic regression analysis revealed a higher acceptance of PrEP was associated with elder age, having other medical insurance, higher perceived utility of PrEP in facilitating prevention of HIV, higher perceived ease of use, higher perceived risk of increased risk behavior, higher perceived privacy problem in using PrEP, higher perceived comparative advantage over condom use, higher perceived comparative advantage of having sex when the urge arises, and higher perceived image of PrEP user as having sexual risky behavior, as public-minded and as health-conscious. The Bayesian network model showed perceived ease of use, perceived image of user as health-conscious, and perceived comparative advantage of having sex when the urge arises were directly associated with acceptability of PrEP. If these three factors were at a high level, 74.6% of the participants would have a high level of acceptability of PrEP. Effective education strategies to promote the acceptance of PrEP are needed. Implementation strategies should incorporate more inclusive messaging and build positive publicity for PrEP to reduce the stigma that PrEP use indicates risky behavior.

TV-NARX and Coiflets WPT based time-frequency Granger causality with application to corticomuscular coupling in hand-grasping.

The study of the synchronous characteristics and functional connections between the functional cortex and muscles of hand-grasping movements is important in basic research, clinical disease diagnosis and rehabilitation evaluation. The electroencephalogram (EEG) and electromyographic signal (EMG) signals of 15 healthy participants were used to analyze the corticomuscular coupling under grasping movements by holding three different objects, namely, card, ball, and cup by using the time-frequency Granger causality method based on time-varying nonlinear autoregressive with exogenous input (TV-NARX) model and Coiflets wavelet packet transform. The results show that there is a bidirectional coupling between cortex and muscles under grasping movement, and it is mainly reflected in the beta and gamma frequency bands, in which there is a statistically significant difference (p < 0.05) among the different grasping actions during the movement execution period in the beta frequency band, and a statistically significant difference (p < 0.1) among the different grasping actions during the movement preparation period in the gamma frequency band. The results show that the proposed method can effectively characterize the EEG-EMG synchronization features and functional connections in different frequency bands during the movement preparation and execution phases in the time-frequency domain, and reveal the neural control mechanism of sensorimotor system to control the hand-grasping function achievement by regulating the intensity of neuronal synchronization oscillations.

Acceptability of Pre-Exposure Prophylaxis and Non-Occupational Post-Exposure Prophylaxis among Men Who Have Sex with Men in Guilin, China.

Pre-exposure prophylaxis (PrEP) and non-occupational post-exposure prophylaxis (nPEP) are both effective strategies for preventing HIV. There is limited information about the acceptability of these prevention measures in undeveloped areas of China. We aimed to examine the acceptability of PrEP and nPEP and their determinants among men who have sex with men (MSM). 219 MSM were recruited in Guilin, China. In total, 28.6% (95% CI: 20.0-41.0) and 35.9% (95% CI: 27.3-49.5) of the participants had heard of PrEP and nPEP, respectively, while 57.0% (95% CI: 43.1-68.2) and 58.6 (95% CI:44.8-68.8) reported they would be willing to use PrEP and nPEP after the methods were explained. A higher acceptability of PrEP was seen among participants who were previously married (aOR = 3.30; 95% CI: 1.22-9.19), working as a laborer (aOR = 5.13; 95% CI: 1.64-17.59), migrant workers/farmers (aOR = 2.56; 95% CI: 1.15-5.79), government employees (aOR = 4.76; 95%CI: 1.80-13.02), had higher social support (aOR = 1.05; 95% CI: 1.03-1.08), and had been previously tested for HIV (aOR = 2.79; 95% CI: 1.36-5.94). A higher acceptability of nPEP was associated with those having higher social support (aOR = 1.06; 95% CI: 1.04-1.09), not knowing their sexual partner's HIV status (aOR = 2.72; 95% CI: 1.23-6.12), and having a prior HIV test (aOR = 5.53; 95% CI: 2.58-12.51). PrEP and nPEP are acceptable, especially among MSM with higher social support and had received a previous HIV test. Effective education and different dissemination strategies to promote the acceptance of PrEP and nPEP among MSM are needed.

The prevalence and associated factors of burnout among undergraduates in a university.

ABSTRACT: The study aimed to evaluate the prevalence and possible factors associated with burnout (BO) among undergraduates in a university setting in Dali.This cross-sectional study involved students enrolled in different specialties. The method of stratified random sampling was used to conduct the investigation. The questionnaire included Maslach Burnout Inventory and the influencing factors. The data were analyzed using SPSS 16.0 (SPSS Inc., Chicago, IL). The quantitative data were compared using t tests or ANOVA. Multiple linear regression was used to assess the relationship between BO risk and relevant influencing factors.The prevalence of study BO was 38.1%. Significant differences of the mean scores on BO and low personal efficacy were observed between men and women, with women obtaining a higher score (t = -2.588, P = .010; t = -2.929, P = .003; respectively). The scores of overall BO, emotional exhaustion (EE), and cynicism were low, whereas that of professional efficacy was higher for students with excellent marks (P = .000). Students majoring in liberal arts obtained low scores of overall BO, EE, and cynicism. Nevertheless, their score for professional efficacy was higher than those from other specializations (P < .05). Total BO, as the dependent variable, revealed that 3 predictors (social factors, school factors, and interpersonal communication) accounted for 30.8% of the variance (R2 = 0.308). A regression analysis of EE as the dependent variable identified that 2 variables (social and school factors) explained 45.8% of the variance (R2 = 0.458).BO among undergraduates is present in a university setting in Dali. A variety of factors including social factors, school factors, and interpersonal communication can influence the prevalence of BO. Therefore, society should strengthen employment and further understand psychology; schools and families must pay attention to the psychological development of college students.

Auxiliary Diagnostic Method for Patellofemoral Pain Syndrome Based on One-Dimensional Convolutional Neural Network.

Early accurate diagnosis of patellofemoral pain syndrome (PFPS) is important to prevent the further development of the disease. However, traditional diagnostic methods for PFPS mostly rely on the subjective experience of doctors and subjective feelings of the patient, which do not have an accurate-unified standard, and the clinical accuracy is not high. With the development of artificial intelligence technology, artificial neural networks are increasingly applied in medical treatment to assist doctors in diagnosis, but selecting a suitable neural network model must be considered. In this paper, an intelligent diagnostic method for PFPS was proposed on the basis of a one-dimensional convolutional neural network (1D CNN), which used surface electromyography (sEMG) signals and lower limb joint angles as inputs, and discussed the model from three aspects, namely, accuracy, interpretability, and practicability. This article utilized the running and walking data of 41 subjects at their selected speed, including 26 PFPS patients (16 females and 10 males) and 16 painless controls (8 females and 7 males). In the proposed method, the knee flexion angle, hip flexion angle, ankle dorsiflexion angle, and sEMG signals of the seven muscles around the knee of three different data sets (walking data set, running data set, and walking and running mixed data set) were used as input of the 1D CNN. Focal loss function was introduced to the network to solve the problem of imbalance between positive and negative samples in the data set and make the network focus on learning the difficult-to-predict samples. Meanwhile, the attention mechanism was added to the network to observe the dimension feature that the network pays more attention to, thereby increasing the interpretability of the model. Finally, the depth features extracted by 1D CNN were combined with the traditional gender features to improve the accuracy of the model. After verification, the 1D CNN had the best performance on the running data set (accuracy = 92.4%, sensitivity = 97%, specificity = 84%). Compared with other methods, this method could provide new ideas for the development of models that assisted doctors in diagnosing PFPS without using complex biomechanical modeling and with high objective accuracy.

Diagnosis of Patellofemoral Pain Syndrome Based on a Multi-Input Convolutional Neural Network With Data Augmentation.

Patellofemoral pain syndrome (PFPS) is a common disease of the knee. Despite its high incidence rate, its specific cause remains unclear. The artificial neural network model can be used for computer-aided diagnosis. Traditional diagnostic methods usually only consider a single factor. However, PFPS involves different biomechanical characteristics of the lower limbs. Thus, multiple biomechanical characteristics must be considered in the neural network model. The data distribution between different characteristic dimensions is different. Thus, preprocessing is necessary to make the different characteristic dimensions comparable. However, a general rule to follow in the selection of biomechanical data preprocessing methods is lacking, and different preprocessing methods have their own advantages and disadvantages. Therefore, this paper proposes a multi-input convolutional neural network (MI-CNN) method that uses two input channels to mine the information of lower limb biomechanical data from two mainstream data preprocessing methods (standardization and normalization) to diagnose PFPS. Data were augmented by horizontally flipping the multi-dimensional time-series signal to prevent network overfitting and improve model accuracy. The proposed method was tested on the walking and running datasets of 41 subjects (26 patients with PFPS and 15 pain-free controls). Three joint angles of the lower limbs and surface electromyography signals of seven muscles around the knee joint were used as input. MI-CNN was used to automatically extract features to classify patients with PFPS and pain-free controls. Compared with the traditional single-input convolutional neural network (SI-CNN) model and previous methods, the proposed MI-CNN method achieved a higher detection sensitivity of 97.6%, a specificity of 76.0%, and an accuracy of 89.0% on the running dataset. The accuracy of SI-CNN in the running dataset was about 82.5%. The results prove that combining the appropriate neural network model and biomechanical analysis can establish an accurate, convenient, and real-time auxiliary diagnosis system for PFPS to prevent misdiagnosis.

Hygienic Risk Exposures Across Ethnic Groups in Rural Areas of Guangxi, China: Prevalence, Associated Factors, and Perceptions of Policy.

BACKGROUND: Controlling hygienic risk exposures (HREs) is important for reducing acute respiratory infection or parasitic infection; however, studies across vulnerable ethnicities are limited. This study aimed to identify the prevalence and associated factors of HREs and perception on HRE policies among ethnic groups in Guangxi, China. METHODS: A community-based cross-sectional study was conducted in rural areas of Guangxi, China, among Han majority and Zhuang, Yao, Miao, Dong, Mulao, and Maonan minorities. The prevalence of HREs and perceptions concerning the HRE policies were presented using descriptive statistics. Associated factors were analyzed using a logistic regression model, and adjusted prevalence ratios and 95% confidence interval were calculated. RESULTS: High prevalence of HREs on hand and soil hygiene were found in all ethnicities. Miao minority had the highest prevalence of HREs, particularly in poor hand washing (74.1%), infrequent nail clipping (90.4%), and outdoor soil contact (92.7%), compared with the others. Prevalence of HREs in some ethnic minority groups were significantly different from those in Han majority after adjusted with other significant factors. Village leaders were more aware of existing national and community regulations related to HREs than household heads. Village leaders and household heads of almost all ethnic groups perceived high policy's compliance in their village or household on avoiding fertilizing with farmyard manure. CONCLUSIONS: HREs were prevalent in all ethnic groups, especially in Miao minority. Ethnicity, one of social determinants, was significantly associated with HREs. Raising awareness at both the village and household levels on HREs is needed for all ethnic groups.

A Functional Polymorphism in HIF-3α Is Related to an Increased Risk of Ischemic Stroke.

Hypoxia-inducible factor-3α (HIF-3α), a member of HIF family, can mediate adaptive responses to low oxygen and ischemia. It is believed that HIF plays crucial roles in stroke-related diseases. However, there are no reports on the association between HIF-3α genetic variants and ischemic stroke (IS) susceptibility. Therefore, we examined the association between HIF-3α gene polymorphisms (rs3826795, rs2235095, and rs3764609) and IS risk. The study population included 302 controls and 310 patients with ischemic stroke. Three polymorphisms in HIF-3α (rs3826795, rs2235095, and rs3764609) were genotyped using SNPscan technique. Our study showed a strong association of rs3826795 in HIF-3α with the risk of IS. The genotype and allele frequencies were shown to differ between the two groups. The rs3826795 in an intron of HIF-3α was related to a prominent increased IS risk (AA vs GG adjusted odd ratio [OR], 2.21; 95% confidence intervals [95% CI], 1.10-4.44; P = 0.03; AA vs AG/GG OR = 1.74, 95% CI, 1.02-2.97, P = 0.04; A vs G OR = 1.48, 95% CI, 1.05-2.07, P = 0.02). Logistic regression analysis suggested that rs3826795 posed a risk factor for IS in addition to common factors. Furthermore, when compared to controls, increased levels of homocysteic acid and level of non-esterified fatty acid were found in the cases (P < 0.01). However, no significant association was found between rs2235095 or rs3264609 and IS risk. These findings indicated that the rs3826795 polymorphism may be a potential target for predicting the risk of IS.

Preliminary investigation of demographic signatures of intestinal parasitic infection in rural residents of Guangxi Zhuang Autonomous Region in China.

BACKGROUND: Our present study was designed to initially unveil the epidemiological characteristics and underlying etiology of intestinal parasitic infection (IPI) in rural residents of Guangxi province in China through conducting a community-based cross-sectional survey. MATERIAL AND METHODS: By use of an epidemiological questionnaire survey and morphologic examination, a total 700 residents from dissimilar regions around rural areas in Guangxi province were recruited for fecal samples to explore ethnic differences in IPI. The fecal specimen was collected and used for microscopic inspection of visible signs of parasitic eggs. In addition, parasitic egg samples were screened and identified to characterize the parasite-bearing IPI cases. RESULTS: The statistical epidemiologic data exhibited that the early pathologic signs of ethnicity-sorted IPI-based rural residents occurred in a two-week period, such as headache and itchy skin. Following further one-year tracing, some potential pathological symptoms of rural locales with IPI were screened and identified, including diarrhea and anemia. Insufficient education seemed to be an underlying cause of IPI in rural residents. In addition, further morphologic signs of parasitic eggs and protozoa in IPI-based residents with pathologic symptoms were validated. CONCLUSIONS: Overall, these preliminary epidemiologic findings demonstrate that detectable pathologic signs of IPI-based rural residents in Guangxi province were associated with poor education, thus local government needs a strategy for reducing IPI and improving quality of life in locals.

Determining the Online Measurable Input Variables in Human Joint Moment Intelligent Prediction Based on the Hill Muscle Model.

Introduction: Human joint moment is a critical parameter to rehabilitation assessment and human-robot interaction, which can be predicted using an artificial neural network (ANN) model. However, challenge remains as lack of an effective approach to determining the input variables for the ANN model in joint moment prediction, which determines the number of input sensors and the complexity of prediction. Methods: To address this research gap, this study develops a mathematical model based on the Hill muscle model to determining the online input variables of the ANN for the prediction of joint moments. In this method, the muscle activation, muscle-tendon moment velocity and length in the Hill muscle model and muscle-tendon moment arm are translated to the online measurable variables, i.e. muscle electromyography (EMG), joint angles and angular velocities of the muscle span. To test the predictive ability of these input variables, an ANN model is designed and trained to predict joint moments. The ANN model with the online measurable input variables is tested on the experimental data collected from ten healthy subjects running with the speeds of 2, 3, 4 and 5 m/s on a treadmill. The variance accounted for (VAF) between the predicted and inverse dynamics moment is used to evaluate the prediction accuracy. Results: The results suggested that the method can predict joint moments with a higher accuracy (mean VAF = 89.67±5.56 %) than those obtained by using other joint angles and angular velocities as inputs (mean VAF = 86.27±6.6%) evaluated by jack-knife cross-validation. Conclusions: The proposed method provides us with a powerful tool to predict joint moment based on online measurable variables, which establishes the theoretical basis for optimizing the input sensors and detection complexity of the prediction system. It may facilitate the research on exoskeleton robot control and real-time gait analysis in motor rehabilitation.

Discovery of the Anti-Tumor Mechanism of Calycosin Against Colorectal Cancer by Using System Pharmacology Approach.

BACKGROUND The aim of our study was to elucidate the biological targets and pharmacological mechanisms for calycosin (CC) against colorectal cancer (CRC) through an approach of system pharmacology. MATERIAL AND METHODS Using a web-based platform, all CRC-causing genes were identified using a database of gene-disease associations (DisGeNET), and all well-known genes of CC identified using the databases of prediction of protein targets of small molecules (Swiss Target Prediction), drug classification, and target prediction (SuperPred). The carefully selected genes of CRC and CC were concurrently constructed by using a database of functional protein association networks (STRING), and use of software for visualizing complex networks (Cytoscape), characterized with production of protein-protein interaction (PPI) network of CC against CRC. The important biological targets of CC against CRC were identified through topological analysis, then the biological processes and molecular pathways of CC against CRC were further revealed for testing these important biotargets by enrichment assays. RESULTS We found that the key predictive targets of CC against CRC were estrogen receptor 2 (ESR2), ATP-binding cassette sub-family G member 2 (ABCG2), breast cancer type 1 susceptibility protein (BRCA1), estrogen receptor 1 (ESR1), cytochrome p450 19A1 (CYP19A1), and epidermal growth factor receptor (EGFR). Visual analysis revealed that the biological processes of CC against CRC were positively linked to hormonal metabolism, regulation of genes, transport, cell communication, and signal transduction. Further, the interrelated molecular pathways were chiefly related to endogenous nuclear estrogen receptor alpha network, forkhead box protein A1 (FOXA1) transcription factor network, activating transcription factor 2 (ATF2) transcription factor network, regulation of telomerase, plasma membrane estrogen receptor signaling, estrogen biosynthesis, androgen receptor, FOXA transcription factor networks, estrogen biosynthesis, and phosphorylation of repair proteins. CONCLUSIONS Use of system pharmacology revealed the biotargets, biological processes, and pharmacological pathways of CC against CRC. Intriguingly, the identifiable predictive biomolecules are likely potential targets for effectively treating CRC.

Validation study of the safety attitudes questionnaire (SAQ) in public hospitals of Heilongjiang province, China.

PURPOSE: The objective of this study was to validate the reliability and validity of the safety attitudes questionnaire (SAQ) in Heilongjiang province, northern China. METHODS: The SAQ was distributed to 27 public hospitals in five cities across Heilongjiang province. The Cronbach's α, item-dimension and dimension-dimension correlations were calculated. Descriptive analyses and confirmatory factor analysis were also performed. RESULTS: The recovery rate of the questionnaire was 84.45%. The validity and reliability measures of the SAQ were acceptable. The goodness-of-fit index from the confirmatory factor analysis showed a reasonable model fit (CFI = 0.93, GFI = 0.91, RMSEA = 0.05). The Cronbach's α value for the scale was 0.91 and ranged from 0.66 to 0.91 for each of the scales. The SAQ showed good internal consistency reliability. CONCLUSION: The SAQ had satisfactory psychometric properties and could be a useful tool to measure safety attitudes in public hospitals in Heilongjiang province in China.

Gender and ethnic health disparities among the elderly in rural Guangxi, China: estimating quality-adjusted life expectancy.

BACKGROUND: Ethnic health inequalities for males and females among the elderly have not yet been verified in multicultural societies in developing countries. The aim of this study was to assess the extent of disparities in health expectancy among the elderly from different ethnic groups using quality-adjusted life expectancy. DESIGN: A cross-sectional community-based survey was conducted. A total of 6,511 rural elderly individuals aged ≥60 years were selected from eight different ethnic groups in the Guangxi Zhuang Autonomous Region of China and assessed for health-related quality of life (HRQoL). The HRQoL utility value was combined with life expectancy at age 60 years (LE60) data by using Sullivan's method to estimate quality-adjusted life expectancy at age 60 years (QALE60) and loss in quality-adjusted life years (QALYs) for each group. RESULTS: Overall, LE60 and QALE60 for all ethnic groups were 20.9 and 18.0 years in men, respectively, and 24.2 and 20.3 years in women. The maximum gap in QALE60 between ethnic groups was 3.3 years in males and 4.6 years in females. The average loss in QALY was 2.9 years for men and 3.8 years for women. The correlation coefficient between LE60 and QALY lost was -0.53 in males and 0.12 in females. CONCLUSION: Women live longer than men, but they suffer more; men have a shorter life expectancy, but those who live longer are healthier. Attempts should be made to reduce suffering in the female elderly and improve longevity for men. Certain ethnic groups had low levels of QALE, needing special attention to improve their lifestyle and access to health care.

Influence of culture, residential segregation and socioeconomic development on rural elderly health-related quality of life in Guangxi, China.

BACKGROUND: This study aimed to assess ethnic differences in health-related quality of life (HRQoL) among the rural elderly, and to examine the influence of ethnic culture, residential segregation and socioeconomic development on HRQoL. METHODS: A total of 6,511 rural elderly aged 60 years and older from 5,541 households in 116 villages across eight ethnic groups in Guangxi Zhuang Autonomous region were selected and assessed for HRQoL. The EQ-5D index values were calculated based on the Chinese Time Trade-Off values set. The EQ-5D descriptive system scores, visual analogue scale scores, and index values were described by ethnic group. The EQ-5D index was modeled against ethnic culture, residential segregation and socioeconomic development using villages as random effects. RESULTS: The median (IQR) of HRQoL among all the ethnic groups was 0.88 (0.80, 0.96). Pain/discomfort was the most prevalent problem, followed by anxiety/depression. After controlling for sociodemographic characteristics, a significant difference in HRQoL among ethnic groups persisted, but this was not true for residential segregation. CONCLUSION: Social welfare and health policies designed to improve the health of the rural elderly should focus more on older, female, less-educated, Yao minority individuals as well as lower-income households.

A comprehensive method for predicting fatal liver failure of patients with liver cancer resection.

There are many methods to assess liver function, but none of them has been verified as fully effective. The purpose of this study is to establish a comprehensive method evaluating perioperative liver reserve function (LRF) in patients with primary liver cancer (PLC).In this study, 310 PLC patients who underwent liver resection were included. The cohort was divided into a training set (n = 235) and a validation set (n = 75). The factors affecting postoperative liver dysfunction (POLD) during preoperative, intraoperative, and postoperative periods were confirmed by logistic regression analysis. The equation for calculating the preoperative liver functional evaluation index (PLFEI) was established; the cutoff value of PLFEI determined through analysis by receiver-operating characteristic curve was used to predict postoperative liver function.The data showed that body mass index, international normalized ratio, indocyanine green (ICG) retention rate at 15 minutes (ICGR15), ICG elimination rate, standard remnant liver volume (SRLV), operative bleeding volume (OBV), blood transfusion volume, and operative time were statistically different (all P < 0.05) between 2 groups of patients with and without POLD. The relationship among PLFEI, ICGR15, OBV, and SRLV is expressed as an equation of "PLFEI = 0.181 × ICGR15 + 0.001 × OBV - 0.008 × SRLV." The cutoff value of PLFEI to predict POLD was -2.16 whose sensitivity and specificity were 90.3% and 73.5%, respectively. However, when predicting fatal liver failure (FLF), the cutoff value of PLFEI was switched to -1.97 whose sensitivity and specificity were 100% and 68.8%, respectively.PLFEI will be a more comprehensive, sensitive, and accurate index assessing perioperative LRF in liver cancer patients who receive liver resection. And keeping PLFEI <-1.97 is a safety margin for preventing FLF in PLC patients who underwent liver resection.

Prognostic significance of neutrophil to lymphocyte ratio in pancreatic cancer: a meta-analysis.

AIM: To conduct a meta-analysis evaluating the association between the peripheral blood neutrophil to lymphocyte ratio (NLR) and the outcome of patients with pancreatic cancer. METHODS: Studies evaluating the relationship between the peripheral blood NLR and outcome of patients with pancreatic cancer published up to May 2014 were searched using electronic databases, including PubMed, Web of Science, Embase and Ovid. A meta-analysis was performed to pool the hazard ratios (HRs) or odds ratios (ORs) and their 95% confidence intervals (CIs) using either a fixed-effects model or a random-effects model to quantitatively assess the prognostic value of NLR and its association with clinicopathological parameters. RESULTS: Eleven studies containing a total of 1804 patients were eligible according to our selection criteria, and combined hazard ratios indicated that high NLR was a poor prognostic marker for pancreatic cancer patients because it had an unfavorable impact on the overall survival (OS) (HR = 2.61, 95%CI: 1.68-4.06, P = 0.000) and cancer specific survival (HR = 1.66, 95%CI: 1.08-2.57, P = 0.021). Subgroup analysis revealed that high NLR was associated with poor OS in patients with mixed treatment (HR = 4.36, 95%CI: 2.50-7.61, P = 0.000), chemotherapy (HR = 2.08, 95%CI: 1.49-2.9, P = 0.000), or surgical resection (HR = 1.2, 95%CI: 1.00-1.44, P = 0.048). Additionally, high NLR was significantly correlated with tumor metastasis (OR = 1.69, 95%CI: 1.10-2.59, P = 0.016), poor tumor differentiation (OR = 2.75, 95%CI: 1.19-6.36, P = 0.016), poor performance status (OR = 2.56, 95%CI: 1.63-4.03, P = 0.000), high cancer antigen 199 (OR = 2.62, 95%CI: 1.49-4.60, P = 0.000), high C-reactive protein (OR = 4.32, 95%CI: 2.71-6.87, P = 0.000), and low albumin (OR = 3.56, 95%CI: 1.37-9.27, P = 0.009). CONCLUSION: High peripheral blood NLR suggested a poor prognosis for patients with pancreatic cancer, and it could be a novel marker of survival evaluation and could help clinicians develop therapeutic strategies for pancreatic cancer patients.