Mediating Effects of Academic Self-Efficacy and Depressive Symptoms on Prosocial/Antisocial Behavior Among Youths.

Adolescence is a critical period during which youth develop and shape their behaviors. Because differences between youths are strongly connected to environmental factors, we aimed to elucidate possible pathways from home-school regulation and atmosphere to youths' prosocial and antisocial behaviors. Data were derived from the China Education Panel Survey. This study involved a total of 9291 students aged 14-15 years (4834 boys, 4457 girls). We used structural equation modeling (SEM) with LISREL 8.80 and Monte Carlo resampling with R to conduct the analysis strategy. In the home-school regulation, parental supervision on the one hand and teacher criticism on the other hand have direct positive and negative predictive effects on youths' prosocial behaviors, respectively, while their direct effects on antisocial behavior are the opposite; teachers praise does not directly affect adolescents' prosocial and antisocial behaviors. In the home-school atmosphere, family interaction and perceived good class climate directly positively affect youths' prosocial behaviors, while the direct effects of both on antisocial behavior are not significant. The SEM results reveal that academic self-efficacy and depressive symptoms may be underlying mediating mechanisms through which home-school regulation and atmosphere during adolescence affect students' prosocial and antisocial behaviors. Intervention programs targeting home-school supportive environments and prevention programs targeting positive emotion and self-awareness may yield benefits for proper social behavior in adolescents. For example, by enhancing the way and frequency of parent-child interaction, teachers and students jointly create a good class climate of care and friendship to strengthen a home-school supportive environment. Improve adolescents' positive emotions such as contentment, optimism, and hope to reduce the possibility of depression.

Influence of promoting an "age-friendly cities" strategy on psychological capital and social engagement based on the scenario method.

Holding large conferences and events usually encourages the corresponding government to upgrade the host city. For this process, incorporating additional costs to increase accessibility for the elderly is a feasible means for a city to develop in an age-friendly manner. Providing evidence-based reports to policy makers is conducive to implementing the policies of age-friendly cities. This study used the scenario method to simulate the effect of promoting the "age-friendly cities" strategy on residents' psychological capital and social engagement (SE). We found that promoting the construction of age-friendly cities can significantly improve residents' psychological capital and SE and that residents from all age groups can benefit. This paper provides an economical means to influence policymakers through evidence-based reports in promoting the development of age-friendly cities.

Improving the sense of city belonging among migrant elderly following family from an elderly service perspective: a cross-sectional study.

BACKGROUND: The migrant elderly following family (MEFF), who migrates to new community to reunite with families, may face challenges of city integration and belonging. This study aims to explore from an elderly service perspective how to improve the sense of city belonging for MEFFs with and without hypertension/diabetes conditions. METHODS: Data were derived from the 2017 China Migrants Dynamic Survey and China National Statistical Yearbooks in 2017. The study included 882 MEFFs with hypertension or diabetes and 1266 MEFFs without hypertension and diabetes. Hierarchical linear modeling was applied to analyze the effects of individual and provincial elderly services on sense of city belonging among the MEFF with and without hypertension/diabetes. RESULTS: The MEFFs with hypertension or diabetes exhibited a greater sense of city belonging when they were familiar with a wider range of health education topics (γ = 0.05, p = 0.033) and were in those provinces with a greater number of licensed doctors (γ = 0.39, p < 0.001) and hospitals (p = 0.042). For those MEFFs without hypertension or diabetes, social security cards (γ = 0.57, p < 0.001) and awareness of a wider range of health education topics (γ = 0.07, p = 0.018) may help to improve their sense of city belonging. CONCLUSION: This study calls for strengthening the accessibility in inclusive elderly services, and minimizing or even eliminating the inequality in elderly services at the individual and provincial levels to increase sense of city belonging among the MEFFs. For the MEFFs with hypertension or diabetes, health managers should focus on improving health information dissemination and increasing the number of doctors per 1000 people as well as and the number of hospitals to enhance the sense of city belonging. Moreover, the government should strengthen social security and health education to facilitate the adaptation and integration of MEFFs without hypertension and diabetes into the host city.

Parents' right strategy on preventing youngsters' recent suicidal ideation: a 13-year prospective cohort study.

BACKGROUND: Suicide remains the second leading cause of death among youths. Family-related factors are considered important determinants of children's suicidal ideation, whereas their short-/long-term influence is seldom quantified. AIMS: We aim to confirm the simultaneous/lagged effects of family-related factors on the occurrence of recent suicidal ideation from childhood to young adulthood (aged from 10 to 22 years old). METHOD: Data were derived from a longitudinal prospective cohort study. Participants included 2065 students who were followed up for 13 years. Generalized estimating equations were used to clarify the influential effects of family-related factors on suicidal ideation during the past month. RESULTS: The peak of the rate of recent suicidal ideation arrived during junior high school years. Family interaction, family support, family involvement, and parental punishment had simultaneous effects on recent suicidal ideation. Family involvement, parental conflict, and psychological control had lagged and lasting effects on suicidal ideation. Notably, the lasting protective effects of family involvement were more obvious than simultaneous effects. CONCLUSIONS: Providing parents with sustained support and education to improve their "positive parenting literacy" can help with their children's mental health development. This is especially the case during COVID-19 quarantine periods when families spend the most time together at home.

Influence of humor expression on suicidal ideation among adolescents: mediating effects of depressive emotion and positive emotion.

BACKGROUND: The occurrence and degree of suicidal ideation during the past month in adolescents should be regarded seriously. Several studies have noted that humor expression style and depressive emotion may influence adolescents' suicidal ideation. However, there is insufficient evidence concerning whether positive emotion reduces such suicidal ideation in adolescents. In addition, the relationships among humor expression, depressive emotion, positive emotion and suicidal ideation remain to be confirmed. Therefore, in this study, we aimed to test the mediating roles of depressive emotion and positive emotion in the relationship between humor expression and recent adolescent's suicidal ideation. METHODS: A total of 1551 students in junior high school completed questionnaires. The collected data were analyzed using structural equation modeling (SEM) with LISREL 8.80 and Monte Carlo resampling with R. RESULTS: The results indicate that suicidal ideation in adolescents during the past month was related not only to humor expression but also to depressive emotion and positive emotion. The stronger the depressive emotion felt, the stronger the suicidal ideation; in contrast, the stronger the positive emotion, the weaker the suicidal ideation. Moreover, depressive emotion and positive emotion were found to mediate the relationship between humor expression and suicidal ideation; additionally, positive emotion was found to mediate the relationship between depressive emotion and suicidal ideation. CONCLUSION: These results highlight that depressive emotion and positive emotion may mediate the influence of humor expression on suicidal ideation among adolescents, and positive emotion may mediate the influence of depressive emotion on suicidal ideation. More attention should be paid to decreasing adolescents' self-deprecating humor expression and depressive emotion, whereas more witty response humor expression and positive emotion should be encouraged to prevent their suicidal ideation.

Happiness or hopelessness in late life: A cluster RCT of the 3L-Mind-Training programme among the institutionalized older people.

AIM: To explore the effectiveness of a new mental health promotion activities programme by including the criterion variables of happiness and depressive mood. DESIGN: A single-blinded, clustered, randomized and controlled trial. METHOD: A list consisting of the names of elderly residents was provided by the senior social worker at a geriatric institution. The participants recruited for the study were living on one of four different floors that had separate and non-interfering spaces and having comparable disabilities. The researchers randomly assigned residents on two floors as members of the intervention group; the other residents were considered the control group. The intervention groups attended 6 weeks of the 3L-Mind-Training programme, whereas the control group only engaged in regular health promotion activities. The mini version of the Chinese Happiness Inventory was adapted to measure happiness. The Geriatric Depression Scale short-form was used to measure depression in older people. A generalized estimating equation was used to analyse the short-term and durative effects. FINDINGS: The 126 residents included in the study were 65-97 years old, and 90% of the residents relied on wheelchairs. The intervention activities give significant immediate and durative effects both on subjective well-being enhancement and depressive mood relief. When evaluating the overall intervention activity, 93.8% of the aged residents indicated that this programme was helpful and allowed them to view life events positively. CONCLUSION AND IMPACT: A well-planned mind-training programme could help elderly people reform their viewpoint and create a more fun and happy experience of ageing. TRIAL REGISTRATION: Data were obtained from the project, initiated in 2014, which was funded by the Ministry of Science and Technology in Taiwan and was approved by the Institutional Review Board in Chung Shan Medical University (No. CS15009). The trial registration number of the study was No. ChiCTR1900021811.

Suicide Reporting on Front Pages of Major Newspapers in Taiwan Violating Reporting Recommendations Between 2001 and 2012.

Media reporting can lead to the acceptance of incorrect ideas and information by the general public, which in turn can impact behavior. A number of studies have found that suicide reporting in the media can lead to an increase in the suicide rate or copycat suicides. Therefore, the aims of this study are to (a) investigate front-page reporting of suicide in four major newspapers in Taiwan; (b) investigate violation of recommendations for reporting suicide by the four major newspapers in Taiwan; and (c) investigate the impact of important events and government policy on front-page reporting of suicide (i.e., the effect of the Apple Daily newspaper entering the market, and the start of media monitoring). We carried out content analysis of reports of suicide on the front pages of the four newspapers with the highest rates of readership in Taiwan (China Times, Liberty Times, Apple Daily, and United Daily News) between 2001 and 2012. We used the chi-squared test, chi-squared test for trend, and analysis of variance to analyze trends in violation of reporting recommendations and potential associated factors. We found that (a) suicide was most commonly reported as a front-page headline and as a whole-page spread by the four major newspapers in Taiwan, with many reports including photographs; (b) reporting of suicide by the four major newspapers in Taiwan frequently violated World Health Organization (WHO) recommendations for suicide reporting in the media; (c) following the entry of the Apple Daily newspaper into the Taiwanese market, reporting approaches to suicide by the other three major newspapers changed to more sensational photos and texts; and (d) monitoring of suicide reporting by the Taiwan Suicide Prevention Center appears to have been only partially effective. In summary, reporting of suicide by the four major newspapers in Taiwan could be further improved. Effective regulation of suicide reporting by newspapers could reduce the impact of this reporting on readers. In addition, regular assessment of observance of the WHO recommendations for suicide reporting by newspapers is an important part of suicide prevention.

Association of Friendly School and Family Contexts and Reducing Health Risk Behaviors Among Adolescents: A Cross-National Study in Europe, North America, and China.

BACKGROUND: Social factors play an important role in adolescents' behaviors. This study aims to understand percentages of health risk behaviors across country in Europe, North America, and China; explore the associations between friendly school and family contexts and involvement for several health risk behaviors among adolescents. METHODS: Data derived from health behavior in school-aged children cross-sectional surveys and China Education Panel Survey in 2014-2015. Hierarchical generalized linear modeling was used to analyze data. RESULTS: The highest percentages of health risk behaviors including unhealthy diet, smoking or alcohol, screen-based sedentary behaviors, and violent behaviors across country ranged from 28.62% to 65.24%. National classmate friendliness was negatively associated with 5 out of 9 health risk behaviors prevalence rates in 41 countries (p < 0.05). Adolescents' perceived peer friendly and helpful were common protective factor for engaging in several health risk behaviors (p < 0.01). Individual family contexts were associated with 3 types of health risk behaviors involvement (p < 0.001). SCHOOL HEALTH POLICY IMPLICATIONS: Health risk behaviors among adolescents reducing was associated with the implementation of friendly school and family contexts, emphasizing the significance of the goals of embedding friendly adolescents, along with the home-school collaboration. CONCLUSIONS: Public health strategies should promote national climate of friendship and individual perceived friendly school contexts to reduce health risk behaviors.

Creating A child-friendly social environment for fewer conduct problems and more prosocial behaviors among children: A LASSO regression approach.

BACKGROUND: Creating a child-friendly social environment is an important component of promoting child-friendly city development. This study aims to explore the key indicators of friendly family, school and community social environments from the perspective of children's conduct problems and prosocial behaviors. METHOD: The sample included grade 3-5 students from one public elementary school in the urban areas and another public elementary school in the rural areas of a Chinese city pursuing a child-friendly philosophy. A total of 418 participants were included in this study. Data on conduct problems, prosocial behaviors and the social environment were collected. To effectively select important variables and eliminate estimation bias, this study used LASSO regression to identify key indicators predicting children's conduct problems and prosocial behavior, followed by linear regression coefficient estimation and significance testing. RESULTS: Creating a friendly family environment (ensuring family members' assistance with academic problems) and school environment (reducing cheating, fighting, and unfriendly teacher language) was associated with reduced conduct problems in children. Creating a positive family atmosphere (enhancing children's trust in family members), school environment (increasing parents' awareness of school affairs, reinforcing students' prosocial behavior, increasing extracurricular activity programs, and encouraging student engagement in academics) and community environment (respecting all children in the community) was associated with improving children's prosocial behavior. CONCLUSIONS: This study transforms the multidimensional, complex child-friendly social environment evaluation indicator system into concise and specific measurement indicators, which can provide theoretical and practical implications for government decision-making in child-friendly city development through empirical research.

Enhancing academic self-efficacy on decreasing adolescents' unmonitored internet usage and depressive mood.

Unmonitored internet use and depression are difficulties that adolescents experience. Efforts to promote healthy adolescent development tend to focus on reducing these two risk outcomes. Therefore, the purpose of this study was to examine how three important school-related factors (teachers, peers, and academics) affect adolescents' levels of unmonitored internet use and depression. For this study, a cross-sectional data analysis was conducted. The sample included 9297 students who participated in two waves of the China Education Panel Survey (CEPS). Structural equation modeling (SEM) was performed using LISREL 8.80 to analyze the data. Monte Carlo resampling was then performed using R to confirm the significance of the mediating effects. Teacher criticism and negative peers can increase unmonitored internet use and depression in adolescents, while academic stress can exacerbate depression. In contrast, teacher praise and positive peers can reduce those risk outcomes. Academic self-efficacy serves as a key mediator of the impacts of teachers, peers, and academics on adolescents' levels of unmonitored internet use and depression. We advocate that schools should establish a positive school climate, provide teacher feedback training and design physical activity programs to improve academic self-efficacy, thereby reducing the risk of unmonitored internet use and depression among adolescents, effectively preventing possible subsequent internet addiction and promoting the mental health of adolescents.

Effect of online and offline social network group clusters on life satisfaction across age groups.

Background: Positive social relationships are critical for better subjective well-being across ages. Future research will benefit from examining how to improve life satisfaction by utilizing social groups in new, ever-changing social and technological contexts. This study aimed to evaluate the effect of online and offline social network group clusters on life satisfaction across different age groups. Methods: Data were derived from the Chinese Social Survey (CSS) (2019), which is a nationally representative survey. We adopted a K-mode cluster analysis algorithm to categorize participants into four clusters according to their online and offline social network groups. ANOVA and chi-square analysis were used to understand the associations among age groups, social network group clusters, and life satisfaction. Multiple linear regression was applied to identify the association between social network group clusters and life satisfaction across age groups. Results: Younger and older adults had higher life satisfaction than middle-aged adults. Individuals who joined diverse social network groups had the highest life satisfaction, followed by those who joined personal and working social groups, while those who joined restricted social groups had the lowest life satisfaction (F = 81.19, p < 0.001). According to the results of multiple linear regression, individuals who belonged to diverse social groups had higher life satisfaction than those who belonged to restricted social groups among adults aged 18-59 years, except students (p < 0.05). Individuals who joined personal and working social groups had higher life satisfaction than those who joined restricted social groups among adults aged 18-29 and 45-59 years (ß = 2.15, p < 0.01; ß = 1.45, p < 0.01). Conclusions: Interventions to promote participation in diverse social network groups among adults aged 18-59 years, except for students, are highly recommended to improve life satisfaction. Health practitioners could provide interventions to encourage young and middle-aged adults to join both personal and working social groups.

Promoting the well-being of rural elderly people for longevity among different birth generations: A healthy lifestyle perspective.

Background: Wellbeing may have a protective role in health maintenance. However, no specific study clarified the particular protective effect of the subjective wellbeing of rural elderly people on survival probability. Few studies have examined the effect of the lifestyle of rural elderly people on their subjective wellbeing from different perspectives. We investigated whether improving subjective wellbeing increased the probability of longevity of rural elderly people and the effects of lifestyle behaviors on the subjective wellbeing of rural elderly people in different birth generations. Materials and methods: Data were derived from the China Health and Nutrition Survey (CHNS), which is an ongoing open cohort study that adopts a multistage, random clustered sampling process. We used the data of elderly people who were aged 65 or over during 2006-2015 for analysis. The Kaplan-Meier method and log-rank test found that the survival probability of rural elderly people was significantly lower than urban elderly people. Based on a sample of rural elderly people, Cox regression and generalized estimating equations were performed as further analyses. Results: A total of 892 rural elderly people aged 65 or over were included in the sample in 2006. High subjective wellbeing was a protective factor against death. The subjective wellbeing of rural elderly people born in the 1940s/1930s/1908-1920s birth generations first decreased then increased. For rural elderly people born in the 1940s, there were significant positive effects of a preference for eating vegetables and walking/Tai Chi on subjective wellbeing. For rural elderly people born in the 1930s, preferences for eating vegetables, reading, and watching TV all had significant positive effects on subjective wellbeing. Rural elderly people born in the 1908-1920s who preferred watching TV had more subjective wellbeing. Conclusion: Improving subjective wellbeing extended the life span and reduced mortality risk in rural elderly people and may be achieved by the shaping of a healthy lifestyle, such as preferences for eating vegetables, walking/Tai Chi, and reading.

Effects of Social Attachment on Experimental Drug Use From Childhood to Adolescence: An 11-Year Prospective Cohort Study.

Background: Drug use among adolescents are still crucial issues that endanger their lifetime health. Evidence concerning the interpersonal-related factors influencing youngsters' experimental drug use behavior, especially from longitudinal and school-based prospective cohort studies, is insufficient. We aimed to describe the annual incidence rate and mean annual incidence rate of experimental drug use from childhood to adolescence by education stage, clarify the risk in childhood and examine the longitudinal relationship between social attachment factors and experimental drug use. Materials and Methods: The data were derived from the 1st to 11th wave of the longitudinal study. In total, 1,106 respondents aged 19-20-year-old were followed up for 11 years (from 9 to 10-year-old) in Taiwan. A survival analysis was used to analyze the time-invarying/time-dependent effects of social attachment factors on experimental drug use. Results: The mean annual incidence rate of experimental drug use from childhood to adolescence was 6.8‰. The incidence increased over time and was the highest in the first year of university (19.3‰). Boys were more likely to use drugs than girls. A low degree of self-perceived likeability in childhood was a risk factor influencing experimental drug use. On average, a low degree of parental supervision and a high degree of family conflict were both influential risk factors. According to the time-dependent models, a high degree of parental supervision, a high degree of family support and a low degree of family conflict in the current year can protect children and adolescents from drug use, whereas a sustained low degree of parental supervision and a high degree of family conflict may promote students' experimental drug use. Conclusion: Parents should be informed and educated to avoid family conflict during childhood, maintain consistent supervision of their children's behavior, provide adequate family support, and pay attention to their children's interpersonal relationships in school. Teachers should focus on the social attachment status of their students while considering their attachments to their families and peers.

Sleep duration and depression among adolescents: Mediation effect of collective integration.

Adolescence is a time of dramatic physical and mental change when adolescents are extremely vulnerable to various mental health problems. Depression and poor sleep duration are increasingly common among adolescents. This study is mainly aimed to verify the important mediating role of collective integration on sleep duration and depression and examine the interrelationship between sleep duration and depression in adolescents longitudinally. The data were obtained from the Wave 1 (in 2013-2014) and Wave 2 (in 2014-2015) longitudinal surveys of China Education Panel Survey (CEPS). The analytic sample in the present study included 8,829 seventh-grade students aged about 14 years (51.50% boys and 48.50% girls). A structural equation modeling (SEM) was used to investigate parent-child/teacher factors affecting adolescent sleep duration and depression, and Monte Carlo resampling with R was employed to confirm the significance of the mediation effects of collective integration. An autoregressive cross-lagged model was employed to analyze the interrelationship between adolescent sleep duration and depression. The findings were as follows. Firstly, collective integration strongly mediated the relationships among academic self-efficacy, parental involvement, teacher praise/criticism, sleep duration, and depression. Secondly, sleep duration and depression were found to have enduring effects and have effects on each other. Thirdly, parental involvement and teacher praise were positively associated with sleep quality and negatively associated with depression. Teacher criticism was negatively associated with sleep quality and positively associated with depression. Compared with teacher praise, teacher criticism has stronger effects on youth sleep duration and depression. In conclusion, improving sleep problems and depression in adolescents as early as possible can stop the persistent and long-term consequences of these problems. Increasing teacher praise, decreasing teacher criticism, and increasing adolescents' collective integration were effective ways to improve adolescents' sleep duration and mediate depression.

Nanoliposomal irinotecan with 5-fluorouracil and folinic acid in metastatic pancreatic cancer after previous gemcitabine-based therapy: A real-world experience.

BACKGROUND: Nanoliposomal irinotecan (nal-IRI), accompanied by 5-fluorouracil (5-FU) and leucovorin (LV), is an effective and safe therapy for patients in whom metastatic pancreatic ductal adenocarcinoma has progressed after gemcitabine-based chemotherapy. Our aim was to evaluate the effectiveness and safety of a nal-IRI + 5-FU/LV regimen for patients with metastatic pancreatic cancer and gemcitabine-based treatment failure in the real world. METHODS: We retrospectively collected the baseline characteristics, treatment courses and dosage, treatment response, overall survival (OS), progression-free survival (PFS), and adverse effects of patients treated with the nal-IRI-based regimen at Taipei Veterans General Hospital. RESULTS: Sixty-seven patients who received the nal-IRI + 5-FU/LV regimen from August 2018 to June 2019 were identified. Their median age was 65 years and 52% were male. Most patients had an Eastern Cooperative Oncology Group performance status of 0 to 1, but patients with an Eastern Cooperative Oncology Group performance status of 2 to 4 before initiation of the nal-IRI regimen were also enrolled (31%). The median dose intensity was 40.4 mg/m2 and the median treatment duration was 8.3 weeks (range: 5 days-75.7 weeks). Objective response and disease control rates were 10.4% and 38.8%, respectively. The median OS)was 7.9 months (95% confidence interval [CI]: 5.6-10.1 months) and the median PFS was 2.9 months (95% CI: 1.6-4.1 months). Elevated total bilirubin (hazard ratio [HR]: 4.31, 95% CI: 1.21-15.30, p = 0.024), carcinomatosis (HR: 3.75, 95% CI: 1.46-9.66, p = 0.006), and previous treatment with irinotecan (HR: 4.86, 95% CI: 1.67-14.10, p = 0.004) were associated with a worse OS. Previous treatment with irinotecan (HR: 3.03, 95% CI: 1.22-7.49, p = 0.02) was associated with a worse PFS. The most common all-grade adverse effects were anemia (73.9%), nausea (66.2%), and fatigue (61.5%). The most common grade 3-4 adverse effects were neutropenia (21.5%), anemia (18.5%), and diarrhea (15.4%). CONCLUSION: Clinically, nal-IRI + 5-FU/LV is effective and tolerable at reduced doses in patients with metastatic pancreatic adenocarcinoma that has progressed after gemcitabine-based therapy.

The role of collective integration and parental involvement on adolescent anxiety-A multilevel analysis.

BACKGROUND: Adolescent anxiety should receive more attention than it currently does since it might have long-term impacts that develop across the entire lifespan. We aim to clarify how school-, class- and individual-level factors affect adolescent anxiety and to try to identify the key mediators and moderators that help alleviate adolescent anxiety. METHODS: We used data from the China Education Panel Survey (CEPS), which is a longitudinal survey. A total of 7582 students aged 14-15 years (in 257 classes within 98 schools) were followed across two survey waves. Since the data are structured hierarchically, we utilized multilevel modeling with HLM 7.0 and Monte Carlo resampling with R to confirm the significance of the mediation effects. Then, we drew interaction diagrams to explain the effects of the moderator. RESULTS: A higher share of interprovincial migrant students in the school, greater respect for teachers in the classroom, and greater self-confidence in one's personal appearance all reduce adolescent anxiety. Collective integration, as a key mediator, explains how the school-/individual-level factor affects adolescent anxiety. Parental involvement moderates the relationship between collective integration and adolescent anxiety. LIMITATIONS: Most of the variables were self-reported by the students. The findings of this study should be applied with caution to cross-cultural contexts. CONCLUSIONS: We advocate for a multipronged approach, particularly an approach that uses different strategies at school, class, and individual levels, to help students develop the skills needed to enhance their social inclusion and sense of personal belonging.

Surgical resection could provide better outcomes for patients with hepatocellular carcinoma and tumor rupture.

We investigated the outcomes of patients with ruptured hepatocellular carcinoma (HCC) and identified the optimal treatment modality for such patients. We retrospectively enrolled 91 patients with treatment-naive HCC and tumor rupture at diagnosis, including 38 patients who underwent surgical resection (SR) alone, 28 patients who were treated with transarterial chemoembolization (TACE) only, 20 patients who had a sequential combination therapy of TACE and SR, and 5 patients who received best supportive care. After a median follow-up of 13.1 months, 54 patients died. The cumulative 5 years overall survival (OS) rates were 55.1% and 0% in the SR group and non-SR group, respectively (p < 0.001). Non-SR therapy was associated with poorer OS according to a multivariate analysis with a hazard ratio of 6.649 (95% confidence interval 3.581-12.344, p < 0.001). Moreover, whether patients received TACE or not did not impact the OS in both the SR group and the non-SR group. In conclusion, for patients with HCC and tumor rupture at the time of diagnosis, SR could lead to better prognoses than non-surgery treatment modalities. Moreover, a sequential combination of TACE and SR had similar clinical outcomes when compared to SR alone.

Differential prognoses among male and female patients with hepatocellular carcinoma.

BACKGROUND: The incidence of hepatocellular carcinoma (HCC) is significantly higher in men than women. Nonetheless, the impact of sex disparities on HCC outcomes remains unclear. We aimed to compare the clinical manifestations and prognoses between male and female patients with HCC. METHODS: This retrospective study enrolled 5337 consecutive patients (3976 men, 1361 women) who were diagnosed with HCC from 2007 to 2020. The prognostic factors were identified by the Cox proportional hazards model. RESULTS: Male patients were younger upon HCC diagnosis (median age 64 vs 69 years; p < 0.001) with more favorable hepatic functional reserves (39.0% vs 35.1% albumin-bilirubin grade 1; p = 0.025) but had greater tumor burdens than the female patients. Furthermore, fewer male patients underwent curative therapies for HCC compared with the female patients (49.0% vs 57.0%; p < 0.001). After a median follow-up of 20.1 months (interquartile range, 5.8-47.3 months), 3133 patients died. The cumulative 5-year overall survival rates were 37.1% and 41.9% for male and female patients, respectively (p < 0.001). From the multivariate analysis, male sex was not an independent factor predictive of poor overall survival in all patients and in the subgroup analysis stratified by treatment modalities. When stratified by age, the female sex was an independent factor associated with lower mortality in younger (≤50 years) patients but not in older patients with HCC. CONCLUSION: Sex was not an independent predictor of the outcome of patients with HCC, especially for those aged more than 50 years.

Influence of Subjective/Objective Status and Possible Pathways of Young Migrants' Life Satisfaction and Psychological Distress in China.

Young migrants have been the major migrant labor force in urban China. But they may be more vulnerable in quality of life and mental health than other groups, due to their personal characteristic and some social/community policies or management measures. It highlights the need to focus on psychological wellbeing and probe driving and reinforcing factors that influence their mental health. This study aimed to investigate the influence of subjective/objective status and possible pathways of young migrants' life satisfaction and psychological distress. Data on 9838 young migrants in the China Migrants Dynamic Survey were analyzed by LISREL 8.8. A total of 94.03% migrated for jobs or business. Subjective status, including subjective socioeconomic status, social adaptation, and psychological integration, had positive effects on life satisfaction, whereas social adaptation and psychological integration negatively affected psychological distress. Objective status, including objective socioeconomic status and health insurance, had adverse effects on life satisfaction, whereas they positively affected psychological distress. Social participation and city belonging had only significant positive mediating roles on life satisfaction. It is essential to increase social adaptation and decrease integration stress according to younger internal migrants' practical needs. It is also necessary to enhance community/social resources and activities in the context of developing sustainability in the community to assist in mental health promotion.

Depression and Life Satisfaction Among Middle-Aged and Older Adults: Mediation Effect of Functional Disability.

With increasing age, middle-aged and older persons face a series of physical and mental health problems. This study aimed to explore the latent relationships among age, functional disability, depression, and life satisfaction. The data were obtained from the Wave 2 (in 2013-2014) and Wave 3 (in 2015-2016) surveys of the China Health and Retirement Longitudinal Study. The analytic sample in the present study included 15,950 individuals aged 45 years and over. The participants answered the same questions concerning depression and life satisfaction in both study waves, and functional disability was measured based on the activities of daily living and instrumental activities of daily living. Age was directly associated with functional disability, life satisfaction, and depression. Functional disability was positively correlated with depression and negatively correlated with life satisfaction. Functional disability strongly mediated the relationships among age, depression, and life satisfaction. Depression and life satisfaction were found to have enduring effects and effects on each other. Additionally, the model revealed a gender difference. Depression in middle-aged people should receive closer attention. Avoiding or improving functional disability may be an effective way to improve life satisfaction and reduce the level of depression in middle-aged and older persons. If prevention work successfully decreases depression, the life dissatisfaction of middle-aged and older people could be improved. Additionally, for the prevention of functional disability and depression and improvement in life satisfaction, gender differences need to be considered.