Perceived social support mitigates the associations among household chaos and health and well-being in rural early adolescents.

PURPOSE: Previous studies have demonstrated that early adolescents residing in chaotic households experience adverse health and well-being outcomes. However, the potential protective factors that mitigate the relationship between household chaos and early adolescents' health and well-being remain unknown. Accordingly, this study aims to investigate whether perceived social support moderates the link between household chaos and the health and well-being among Chinese rural early adolescents. METHODS: Physical health difficulties were assessed using two measures: general health and allostatic load (AL). Mental health difficulties were measured by depression. Well-being was reflected by life satisfaction. Specifically, this study included early adolescents (N = 337; Mage = 10.88 ± 1.36 years) from rural counties in China who reported their household chaos, perceived social support, general health, depression, and life satisfaction. AL scores were determined based on six physiological indices. RESULTS: Household chaos exhibited a negative relationship with the general health and life satisfaction while a positive correlation with depression. Moreover, perceived social support was found to moderate the association between household chaos and these health and well-being indicators of early adolescents. Specifically, early adolescents who reported higher levels of perceived social support exhibited weaker negative connections among household chaos and their general health, depression, and life satisfaction. Furthermore, no significant relationships were observed between the adolescents' AL and household chaos, perceived social support, or their interactions. CONCLUSIONS: Household chaos poses a significant risk to health and well-being. Furthermore, the findings indicate that perceived social support can mitigate these negative effects.

Endoscopic submucosal dissection training: evaluation of an ex vivo training model with continuous perfusion (ETM-CP) for hands-on teaching and training in China.

BACKGROUND: The existing ex vivo models of endoscopic submucosal dissection (ESD) cannot simulate intraoperative hemorrhage well. We aimed to establish an ESD training method by applying an ex vivo training model with continuous perfusion (ETM-CP). METHODS: Four training sessions were conducted for 25 novices under the guidance of 2 experts. Eventually, 10 novices completed ESD operations on a total of 89 patients after the training. The resection effectiveness, resection speed, complication rate, and novice performance before and after the training were compared. The data regarding the effects of the training and the model were gathered through a questionnaire survey. RESULTS: In terms of the simulation effect of the model, ETM-CP was evaluated as similar to the live pig in all aspects (P > 0.05). The questionnaire analysis revealed that the ESD theoretical knowledge, skill operation, and self-confidence of novices were improved after the training (P < 0.05). The resection time per unit area had a correlation with the number of training periods (rs = - 0.232). For novice performance, the resection time per unit area was shortened (P < 0.05). There was no difference in patient performance between the novice group and the expert group after the training in terms of en bloc resection, R0 resection, complication rate, endoscopic resection bleeding (ERB) score, muscularis propria injury (MPI) score, and resection time per unit area (P > 0.05). CONCLUSION: The ETM-CP is effective for ESD training.

Household Income and Early Adolescents' Executive Function: The Different Roles of Perceived Discrimination and Shift-and-Persist.

Household income predicts early adolescents' cognitive development. However, the mechanism underlying this association and protective factors are unclear. This study assessed one-year longitudinal data to examine whether perceived discrimination mediated the association between household income and executive function and the moderating role of shift-and-persist. 344 early adolescents in rural China were included in the study (mean = 10.88 years, SD = 1.32 years, girls: 51.74%). The latent variable model revealed that household income predicted early adolescents' cognitive flexibility and working memory in the subsequent year through perceived discrimination. Shift-and-persist moderated the negative effects of perceived discrimination on cognitive flexibility: perceived discrimination impeded cognitive flexibility only among early adolescents with low shift-and-persist. The findings highlight perceived discrimination in the relation between household income and early adolescents' executive function and underscore the protective role of shift-and-persist.

Blue laser imaging combined with JNET (Japan NBI Expert Team) classification for pathological prediction of colorectal laterally spreading tumors.

BACKGROUND: Blue laser imaging (BLI) can provide useful information on colorectal laterally spreading tumors (LSTs) by visualizing the surface and vessel patterns in detail. The present research aimed to evaluate the diagnostic performance of BLI-combined JNET (Japan NBI Expert Team) classification for identifying LSTs. METHODS: This retrospective, multicenter study included 172 LSTs consisted of 6 hyperplastic polyps/sessile serrated polyps, 94 low-grade dysplasias (LGD), 60 high-grade dysplasias (HGD), 6 superficial submucosal invasive (m-SMs) carcinomas, and 4 deep submucosal invasive carcinomas. The relationship between the JNET classification and the histologic findings of these lesions were then analyzed. RESULTS: For all LSTs, non-experts and experts had a 79.7% and 90.7% accuracy for Type 2A (P = 0.004), a sensitivity of 94.7% and 96.8% (P = 0.718), and a specificity of 61.5% and 83.3% (P = 0.002) for prediction of LGD, respectively. The results also demonstrated 80.8% and 91.3% accuracy for Type 2B (P = 0.005), a sensitivity of 65.2% and 83.3% (P = 0.017), and a specificity of 90.6% and 96.2% (P = 0.097) for predicting HGD or m-SMs. For LST-granular (LST-G) lesions, Type 2A in experts had higher specificity (65.6% vs. 83.6%, P = 0.022) and accuracy (81.8% vs. 91.2%, P = 0.022). Type 2B in experts only had higher accuracy (82.5% vs. 92.0%, P = 0.019). However, no significant differences were noted for any comparisons between non-experts and experts for LST-non-granular (LST-NG) lesions. CONCLUSIONS: BLI combined with JNET classification was an effective method for the precise prediction of pathological diagnosis in patients with LSTs. Diagnostic performance of JNET classification by experts was better than that by non-experts for all examined LST or LST-G lesions when delineating between Type 2A and 2B, but there was no difference for the identification of LST-NG lesions by these two groups.

Family Socioeconomic Status and Adolescents' Academic Achievement: The Moderating Roles of Subjective Social Mobility and Attention.

Adolescents with low family socioeconomic status (SES) often have lower academic achievement than their peers with high family SES. However, less is known about the personal buffering mechanisms on the relationship between low family SES and academic achievement for youth. To address adolescents' academic achievement gap related to family SES, this study aimed to test whether family SES predicted adolescents' academic achievement and whether adolescents' subjective social mobility and attention moderated this relationship with longitudinal data. Valid participants included 827 adolescents (Mage = 12.30 years, range: 11-14 years, SD = 0.87, and 40.99% girls) from five township public schools in China. The results showed that family SES (comprising parents' education, parents' occupation, and family income) was positively correlated with adolescents' academic achievement (i.e., Chinese and math) when controlling for prior academic achievement. The positive associations between family SES and both Chinese and math achievement 9 months later were nonsignificant for adolescents with higher levels of subjective social mobility. In addition, the positive effect of family SES on Chinese achievement 9 months later was nonsignificant among adolescents with higher levels of attention. In conclusion, low family SES impairs adolescents' Chinese and math achievement, high levels of adolescents' subjective social mobility can buffer the adverse effects of low family SES on both Chinese and math achievement, and high levels of adolescents' attention can buffer the adverse effects of family SES on Chinese achievement but not on math achievement. These findings may emphasize the significance of developing differential interventions aimed at specific subject achievement for adolescents with low family SES.

Peroral endoscopic shorter versus longer myotomy for the treatment of achalasia: a comparative retrospective study.

INTRODUCTION: Peroral esophageal myotomy (POEM) is a novel endoscopic treatment for achalasia. It has gained popularity worldwide among surgeons and endoscopists, but no studies have compared peroral endoscopic short with long myotomy for achalasia. We aimed to compare the clinical efficacy and safety between peroral endoscopic shorter and longer myotomy. METHODS: The retrospective study enrolled 129 achalasia patients who underwent POEM from July 2011 to September 2017. Based on the myotomy length (ML), patients were divided into shorter myotomy (SM) group (ML ≤ 7 cm, n = 36) and longer myotomy (LM) group (ML > 7 cm, n = 74). Procedure-related parameters, symptom scores, adverse events and manometric data were compared between two groups. RESULTS: The mean ML was 6.0 ± 0.6 cm in SM group, and 11.5 ± 3.1 cm in LM group (p < 0.001). The mean operation time was significantly less in SM group than LM group (46.6 ± 18.5 min vs 62.1 ± 25.2 min, p = 0.001). During a mean follow-up period of 28.7 months, treatment success (Eckardt score ≤ 3) was achieved in 94.4% (34/36) of patients in SM group and 91.9% (68/74) in LM group (p = 0.926). There was no statistical difference in the incidence of intraoperative complications (8.4% vs 8.2%, p = 0.823) and reflux rate (8.3% vs. 14.9%, p = 0.510) between two groups. CONCLUSIONS: Peroral endoscopic shorter myotomy is comparable with longer myotomy for treating achalasia with regard to clinical efficacy and has the advantage of shorter procedure time.

Stressful life events and well-being among rural-to-urban migrant adolescents: The moderating role of the stress mindset and differences between genders.

INTRODUCTION: Recent empirical studies have shown that the stress mindset is an implicit belief about stress and that the stress-is-enhancing mindset attenuates the negative effects of stressful life events on psychological and behavioral outcomes. Migrant adolescents experience more adverse life events, which are potential risk factors that can decrease their well-being. This study first explored the relationship between stressful life events and well-being (depression and life satisfaction) among Chinese rural-to-urban migrant adolescents. Furthermore, we examined the protective role of the enhancing stress mindset in this relationship and the moderating effect of gender. METHODS: In total, 396 Chinese rural-to-urban migrant adolescents aged between 10 and 14 years (M = 11.75 years, SD = 1.16) completed a battery of self-report questionnaires concerning their stressful life events, stress mindsets, depression and life satisfaction. RESULTS: The hierarchical multiple regressions showed that stressful life events were positively associated with depression and negatively associated with life satisfaction. Compared to the adolescents with the stress-is-debilitating mindset, the adolescents with the stress-is-enhancing mindset were less prone to depression when faced with more stressful life events. Furthermore, the stress mindset was positively linked to life satisfaction among the girls but not the boys. CONCLUSIONS: These findings suggest that the stress-is-enhancing mindset is a protective factor that may help migrant adolescents mitigate adversity and improve their well-being.

Family socioeconomic status and emotional adaptation among rural-to-urban migrant adolescents in China: The moderating roles of adolescent's resilience and parental positive emotion.

Low family socioeconomic status (SES) is closely related to increased risk of emotional maladaptation among adolescents. Although previous studies have found that low family SES is a significant and common experience for most rural-to-urban migrant adolescents in China, little research has examined the association between family SES and emotional adaptation or identified the protective factors that may minimise emotional maladaptation among these adolescents. The present study examined the associations between family SES and three indices of emotional adaptation (emotion regulation, life satisfaction and depression) and the moderating effects of adolescents' resilience and parental positive emotion (PE) among 486 Chinese rural-to-urban migrant adolescents. The results suggest that family SES was significantly associated with migrant adolescents' emotional outcomes, to varying degrees. Moreover, both adolescents' resilience and PE moderated the associations between family SES and emotional outcomes, although the protective effects of the two moderators differed on the three emotional outcomes. These findings shed light into designing intervention and prevention programs to reduce emotional maladaptation among migrant adolescents.

Effects of mesalazine enemas on lymphoid follicular proctitis.

Lymphoid follicular proctitis (LFP) is an uncommon inflammatory disease that is characterized by rectal bleeding, congested and granular mucosa without ulceration and abnormal and coalescing hyperplastic lymphoid follicles without acute inflammatory changes. The lesions are usually confined to the rectal mucosa. LFP therapy is not well defined. Herein, we present a case of LFP that was resolved with a rapid administration of mesalazine enemas. A 35-year-old male was admitted to our hospital due to intermittent rectal bleeding associated with stools. Total colonoscopy revealed nodular mucosa with top pinpoint-like ulcers from the rectum to the border between the sigmoid flexure and the rectum. The nodules congested together on the lower rectal segment and occupied 2/3 of the rectal lumina. Endoscopic submucosal dissection was performed in order to obtain more specimens for histologic examination, which revealed marked lymphoid follicular hyperplasia with prominent germinal centers and a conserved mantle zone. Treatment was started with mesalazine enemas of 4 g q.d. and the patient was asymptomatic after three days. All the lesions disappeared two months later. Mesalazine enemas could be a promising and effective therapeutic option for LFP therapy.