Background:Childhood environmental unpredictability(CEU)is crucial to personal development,profoundly influence physical and psychological growth particularly,and psychopathy is recognized as a dark personality trait....Background:Childhood environmental unpredictability(CEU)is crucial to personal development,profoundly influence physical and psychological growth particularly,and psychopathy is recognized as a dark personality trait.The aim of this study is to investigate the effects of insecure attachment and life history strategy(LHS)on the relationship between CEU and psychopathy by establishing a sequential mediation model based on evolutionary life history theory and cognitive-affective personality system.Methods:A group of 532 undergraduates completed the measurements for CEU,insecure attachment,LHS,and psychopathy,and Bootstrap mediation test through SPSS 25.0 and PROCESS macro tool was used to examine the relationship among these variables.Results:The results revealed positive relations between CEU and insecure attachment(β=0.87,p<0.001),CEU and LHS(β=0.11,p<0.001),and CEU and psychopathy(β=0.14,p<0.001).Insecure attachment was also positively associated with LHS(β=0.62,p<0.001)and psychopathy(β=0.04,p<0.001).In addition,LHS was significantly associated with psychopathy(β=0.08,p<0.001).The relationship between CEU and psychopathy is mediated independently and sequentially by insecure attachment and LHS.Conclusion:The current research shows the relationship between CEU and psychopathy,as well as the mechanism of insecure attachment and life history strategy as mediators.展开更多
Objective:To analyze the mediating effect of psychological flexibility between death anxiety and quality of life in cancer patients.Methods:A convenience sampling method was used to select cancer patients who received...Objective:To analyze the mediating effect of psychological flexibility between death anxiety and quality of life in cancer patients.Methods:A convenience sampling method was used to select cancer patients who received treatment at our hospital from January 2022 to January 2024,by the inclusion and exclusion criteria.General information,psychological flexibility,death anxiety,and quality of life scores were collected for analysis.Result:The psychological flexibility and quality of life scores of cancer patients with an annual family income≤100,000 RMB were significantly lower than those of cancer patients with an annual family income>100,000 RMB(P<0.05),while the death anxiety scores were significantly lower for the former group as well(P<0.05).Cancer patients staged as Ⅰ-Ⅱ had significantly higher psychological flexibility and quality of life scores than those staged as Ⅲ-Ⅳ(P<0.05),while their death anxiety scores were significantly lower(P<0.05).Psychological flexibility in cancer patients was negatively correlated with death anxiety(r=-0.614,P<0.05)and positively correlated with quality of life(r=0.628,P<0.05),while death anxiety was negatively correlated with quality of life(r=-0.112,P<0.05).The direct effect of death anxiety on quality of life was-0.232,accounting for 58.32%of the total effect.The mediating effect of psychological flexibility between death anxiety and quality of life was-0.218,accounting for 41.83%of the total effect.Conclusion:Death anxiety can directly affect the quality of life of cancer patients,and it can also indirectly affect the quality of life through psychological flexibility.Clinicians should promptly address patients’death anxiety and provide interventions to enhance psychological flexibility,thereby improving the quality of life.展开更多
Objective:Investigating the Mediating Role of Pain in the Relationship Between Sleep Quality and Health-Related Quality of Life Among Elderly Patients with Chronic Diseases.Methods:Using data from the 2018 China Healt...Objective:Investigating the Mediating Role of Pain in the Relationship Between Sleep Quality and Health-Related Quality of Life Among Elderly Patients with Chronic Diseases.Methods:Using data from the 2018 China Health and Retirement Longitudinal Study(CHARLS),this study included 3,284 participants aged 60 years or older with chronic diseases.The sleep quality,pain status,health-related quality of life,and demographic-related data of these elderly patients were obtained.Pearson correlation analysis was conducted to assess the bivariate relationships among the variables.The mediating role of pain in the sleep quality-HRQoL relationship was tested using linear regression models,complemented by bootstrap sampling to verify the indirect effect.Results:Sleep quality was positively associated with health-related quality of life(r=0.218,p<0.001).Conversely,pain demonstrated significant negative correlations with both sleep quality(r=-0.496,p<0.001)and health-related quality of life(r=-0.067,p<0.001).The mediating effect results showed that pain played a partial mediating role between sleep quality and health-related quality of life in elderly patients with chronic diseases(effect value=0.049),and the mediating effect accounted for 23.33%.Conclusion:Pain is a mediating variable between sleep quality and health-related quality of life in elderly patients with chronic diseases.This suggests that clinical practice should incorporate pain assessment into standard clinical care of elderly patients with sleep disorders and chronic diseases.By alleviating pain,sleep quality can be improved,and subsequently,their health-related quality of life can be enhanced.展开更多
BACKGROUND Several studies have suggested a close link between depression,overweight,and new-onset diabetes,particularly among middle-aged and older populations;however,the causal associations remain poorly understood...BACKGROUND Several studies have suggested a close link between depression,overweight,and new-onset diabetes,particularly among middle-aged and older populations;however,the causal associations remain poorly understood.AIM To investigate the role of overweight in mediating the association between depression and new-onset diabetes in middle-aged and older populations.METHODS Data of 9426 individuals aged≥50 years from the 1998-2016 Health and Retirement Study database were analyzed.Weighted logistic regression was employed to obtain odds ratios(ORs)and 95%confidence intervals(95%CIs)for depression and new-onset diabetes in the middle-aged and older populations.Mediation analysis and the Sobel test were used to test the mediating effects of overweight between depression and the risk of new-onset diabetes.RESULTS New-onset diabetes was identified in 23.6%of the study population.Depression was significantly associated with new-onset diabetes(OR:1.18,95%CI:1.03-1.35,P value:0.014).Further adjustment for overweight attenuated the effect of depression on new-onset diabetes to 1.14(95%CI:1.00-1.30,P=0.053),with a significant mediating effect(P of Sobel test=0.003).The mediation analysis demonstrated that overweight accounted for 61%in depression for the risk of new-onset diabetes,with overweight having a partially mediating role in the depression-to-diabetes pathway.CONCLUSION New-onset diabetes was not necessarily a direct complication of depression;rather,depression led to behaviors that increase the risk of overweight and,consequently,new-onset diabetes.展开更多
With the development of minimally invasive gynecological technology,hysteroscopic surgery has been widely used in the treatment of gynecological diseases due to its advantages of rapid recovery and minimal trauma.From...With the development of minimally invasive gynecological technology,hysteroscopic surgery has been widely used in the treatment of gynecological diseases due to its advantages of rapid recovery and minimal trauma.From the perspective of patients undergoing hysteroscopic surgery,this paper explores the influence of their psychological security on quality of life,analyzes the mediating effect of social support,and puts forward specific countermeasures and suggestions.The purpose is to improve the psychological security and quality of life of patients undergoing hysteroscopic surgery,and provide reference for the subsequent development of hysteroscopic surgery.展开更多
BACKGROUND Dysphoria and despondency are prevalent psychological issues in patients undergoing Maintenance Hemodialysis(MHD)that significantly affect their quality of life(QOL).High levels of social support can signif...BACKGROUND Dysphoria and despondency are prevalent psychological issues in patients undergoing Maintenance Hemodialysis(MHD)that significantly affect their quality of life(QOL).High levels of social support can significantly improve the physical and mental well-being of patients undergoing MHD.Currently,there is limited research on how social support mediates the relationship between dysphoria,despondency,and overall QOL in patients undergoing MHD.It is imperative to investigate this mediating effect to mitigate dysphoria and despondency in patients undergoing MHD,ultimately enhancing their overall QOL.AIM To investigate the mediating role of social support in relationships between dysphoria,despondency,and QOL among patients undergoing MHD.METHODS Participants comprised 289 patients undergoing MHD,who were selected using a random sampling approach.The Social Support Rating Scale,Self-Rating Anxiety Scale,Self-Rating Depression Scale,and QOL Scale were administered.Correlation analysis was performed to examine the associations between social support,dysphoria,despondency,and QOL in patients undergoing MHD.To assess the mediating impact of social support on dysphoria,despondency,and QOL in patients undergoing MHD,a bootstrap method was applied.RESULTS Significant correlations among social support,dysphoria,despondency,and quality in patients undergoing MHD were observed(all P<0.01).Dysphoria and despondency negatively correlated with social support and QOL(P<0.01).Dysphoria and despondency had negative predictive impacts on the QOL of patients undergoing MHD(P<0.05).The direct effect of dysphoria on QOL was statistically significant(P<0.05).Social support mediated the relationship between dysphoria and QOL,and this mediating effect was significant(P<0.05).Similarly,the direct effect of despondency on QOL was significant(P<0.05).Moreover,social support played a mediating role between despondency and QOL,with a significant mediating effect(P<0.05).CONCLUSION These findings suggest that social support plays a significant mediating role in the relationship between dysphoria,despondency,and QOL in patients undergoing MHD.展开更多
BACKGROUND Hematological tumors are common malignant tumors,with high morbidity and mortality rates.Most patients with hematological malignancies develop sleep disorders that seriously affect their life and health bec...BACKGROUND Hematological tumors are common malignant tumors,with high morbidity and mortality rates.Most patients with hematological malignancies develop sleep disorders that seriously affect their life and health because of acute onset of disease,rapid progression,high recurrence rates,complex treatment methods,and treatment costs.AIM To explore the mediating effect of resilience on fear of disease progression and sleep quality in patients with hematological malignancies.METHODS A cross-sectional analysis of 100 patients with hematological malignancies,treated in the First Affiliated Hospital of Jinzhou Medical University between August 2022 and August 2023,was conducted.Patients were assessed using a general data survey,a simplified scale for the fear of progression(FoP)of disease,a resilience scale,and the Pittsburgh Sleep Quality Index.Statistical analysis was conducted to determine the relationship between various patient characteristics and FoP,resilience,and sleep quality.Spearman’s correlation analysis was used to examine the correlations between mental resilience,FoP,and sleep quality.RESULTS The total FoP score mean value in patients with hematological malignancies was 38.09±5.16;the total resilience score mean value was 40.73±7.04;and the Pittsburgh Sleep Quality Index score mean value was 10.72±1.90.FoP,resilience,and sleep quality of the patients were associated with family per capita monthly income and patient education level(P<0.05).Spearman correlation analysis revealed that FoP was negatively correlated with resilience and sleep quality scores(r=-0.560,-0.537,P<0.01),respectively,and resilience was significantly associated with sleep quality scores(r=0.688,P<0.01).Mediation analysis showed that the mediating effect of resilience between FoP and sleep quality in patients with hematological malignancies was-0.100 and accounted for 50.51%of the total effect.This indicated that FoP directly and indirectly affected sleep quality through the mesomeric effect of resilience.CONCLUSION Resilience is an intermediary variable between FoP and sleep quality in patients with hematological malignancies.Medical staff should evaluate and follow-up FoP and resilience to implement measures to improve sleep quality.展开更多
Background:Adolescent anxiety has a significant impact on physical and mental health,and overparenting is recognized as one of the major factors affecting adolescent anxiety.The objective of this study was to investig...Background:Adolescent anxiety has a significant impact on physical and mental health,and overparenting is recognized as one of the major factors affecting adolescent anxiety.The objective of this study was to investigate the relationship between overparenting and adolescent anxiety,while also examining the mediating role of cognitive avoidance.Methods:Data were collected through a cross-sectional survey with 1931 valid responses using the Overparenting Scale,the Cognitive Avoidance Scale,and the Anxiety Self-Rating Scale.A structural equation modelling approach was used to test the mediating role of cognitive avoidance between overparenting and adolescent anxiety and to reveal the underlying mechanisms.The significance of the mediating effect was assessed based on maximum likelihood estimation.Differences in the mediating role of cognitive avoidance in the male and female samples were comparatively analyzed in the mediation effect analysis.Results:The study’s findings reveal a significant positive correlation between overparenting and adolescent anxiety(p<0.01),between overparenting and cognitive avoidance(p<0.01),and between cognitive avoidance and adolescent anxiety(p<0.01).Cognitive avoidance mediated the relationship between overparenting and adolescent anxiety.Overparenting can not only directly predict adolescent anxiety but also indirectly predict it through the mediating role of cognitive avoidance.Conclusion:This study validates the direct effect of overparenting on adolescent anxiety and reveals the mechanism of cognitive avoidance as a mediator.展开更多
Background:The phenomenon of academic anxiety has been demonstrated to exert a considerable influence on students’academic engagement,leading to the emergence of a phenomenon known as“learned helplessness”and under...Background:The phenomenon of academic anxiety has been demonstrated to exert a considerable influence on students’academic engagement,leading to the emergence of a phenomenon known as“learned helplessness”and undermining the selfconfidence and motivation of high school students.Using acceptance-rejection theory,this study elucidated how a rejective parenting style affects Chinese high school students’academic anxiety and explored the urban-rural heterogeneity of this relationship.Methods:Data were analyzed using a stratified whole-cluster random sampling method.There are a total of 30,000 high school students in the three regions of northern and central China(from Shanxi,Hebei and Henan).A sample of 2286 high school students aged 14–19 years was ultimately selected from 2760 respondents for this investigation,which was conducted at the beginning of the 2023 school year.Pearson correlation,ordinary least squares(OLS)regression analysis,path analysis,and Fisher’s permutation test(FPT)were used to examine the effects of rejective parenting style on high school students’academic anxiety.Results:Results indicated a significant positive predictive effect between rejective parenting style and academic anxiety among high school students(β=0.815,t=116.211,p<0.001).Students’self-concept was significantly positively related to positive coping style(β=0.424,t=21.208,p<0.001)and chain-mediated this relationship.Therefore,this parenting style may indirectly mitigate academic anxiety through these mediators.The study also found that the effect of rejective parenting style on academic anxiety varied by students’residential background and was more pronounced in urban areas(0.226)than in rural areas(0.130).Conclusion:The research underscores the imperative for Chinese families to reexamine their utilization of rejection parenting and to prioritize the cultivation of students’intrinsic attributes.These findings offer a theoretical framework and practical evidence for policymakers and educators to develop efficacious and targeted interventions.In particular,greater attention should be directed towards the discrepancies in the manifestation of emotional and academic anxiety between urban and rural students,and prompt guidance should be furnished.展开更多
BACKGROUND Emotional reactions,such as anxiety,irritability,and aggressive behavior,have attracted clinical attention as behavioral and emotional problems in preschool-age children.AIM To investigate the current statu...BACKGROUND Emotional reactions,such as anxiety,irritability,and aggressive behavior,have attracted clinical attention as behavioral and emotional problems in preschool-age children.AIM To investigate the current status of family rearing,parental stress,and behavioral and emotional problems of preschool children and to analyze the mediating effect of the current status of family rearing on parental stress and behavioral/emo-tional problems.METHODS We use convenience sampling to select 258 preschool children in the physical examination center of our hospital from October 2021 to September 2023.The children and their parents were evaluated using a questionnaire survey.Pearson's correlation was used to analyze the correlation between child behavioral and emotional problems and parental stress and family rearing,and the structural equation model was constructed to test the mediating effect.RESULTS The score for behavioral/emotional problems of 258 preschool children was(27.54±3.63),the score for parental stress was(87.64±11.34),and the score for parental family rearing was(31.54±5.24).There was a positive correlation between the behavioral and emotional problems of the children and the“hostile/mandatory”parenting style;meanwhile,showed a negative correlation with the“support/participation”parenting style(all P<0.05).The intermediary effect value between the family upbringing of parents in parental stress and children's behavior problems was 29.89%.CONCLUSION Parental family upbringing has a mediating effect between parental stress and behavioral and emotional problems of children.Despite paying attention to the behavioral and emotional problems of preschool-age children,clinical medical staff should provide correct and reasonable parenting advice to their parents to promote the mental health of preschool-age children.展开更多
Background Ongoing debates question the harm of internet use with the evolving technology,as many individuals transition from regular to problematic internet use(PIU).The habenula(Hb),located between the thalamus and ...Background Ongoing debates question the harm of internet use with the evolving technology,as many individuals transition from regular to problematic internet use(PIU).The habenula(Hb),located between the thalamus and the third ventricle,is implicated in various psychiatric disorders.In addition,personality features have been suggested to play a role in the pathophysiology of PIU.Aims This study aimed to investigate Hb volumetry in individuals with subclinical PIU and the mediating effect of personality traits on this relationship.Methods 110 healthy adults in this cross-sectional study underwent structural magnetic resonance imaging.Hb segmentation was performed using a deep learning technique.The Internet Addiction Test(IAT)and the NEO Five-Factor Inventory were used to assess the PIU level and personality,respectively.Partial Spearman's correlation analyses were performed to explore the reiationships between Hb volumetry,IAT and NEO.Multiple regression analysis was applied to identify personality traits that predict IAT scores.The significant trait was then treated as a mediator between Hb volume and IAT correlation in mediation analysis with a bootstrap value of 5000.Results Relative Hb volume was negatively correlated with IAT scores(partial rho=-0.142,p=0.009).The IAT score was positively correlated with neuroticism(partial rho=0.430,p<0.001)and negatively correlated with extraversion,agreeableness and conscientiousness(partial rho=-0.213,p<0.001;partial rho=-0.279,p<0.001;and partial rho=-0.327,p<0.001).There was a significant indirect effect of Hb volume on this model(β=-0.061,p=0.048,boot 95%confidence interval:-0.149 to-0.001).Conclusions This study uncovered a crucial link between reduced Hb volume and heightened PIU.Our findings highlight neuroticism as a key risk factor for developing PIU.Moreover,neuroticism was shown to mediate the relationship between Hb volume and PIU tendency,offering valuable insight into the complexities of this interaction.展开更多
This study investigates the impact of investor protection on corporate R&D investment using panel data from Chinese A-share listed companies spanning 2015 to 2022.By employing OLS regression,mediation,and moderati...This study investigates the impact of investor protection on corporate R&D investment using panel data from Chinese A-share listed companies spanning 2015 to 2022.By employing OLS regression,mediation,and moderation analyses,the results demonstrate that robust investor protection mechanisms significantly enhance corporate R&D expenditures.The mediation analysis reveals that investor protection alleviates financing constraints and improves information disclosure quality,both of which serve as key channels for fostering R&D investment.Furthermore,internal control systems and media attention are identified as positive moderators,amplifying the beneficial effects of investor protection on R&D.In contrast,the equity Herfindahl index(HHI)does not exhibit a significant moderating role.The study also highlights that financial leverage,profitability,and equity concentration negatively influence R&D,while revenue growth exerts a positive effect.These findings underscore the critical role of investor protection in driving corporate innovation and sustainable growth,offering valuable insights for policymakers and corporate managers aiming to optimize R&D strategies through improved governance frameworks.展开更多
To investigate the associations between isocarbophos and isofenphos with impaired fasting glucose(IFG)and type 2 diabetes mellitus(T2DM),and to assess the mediation roles of inflammation cells.There were 2701 particip...To investigate the associations between isocarbophos and isofenphos with impaired fasting glucose(IFG)and type 2 diabetes mellitus(T2DM),and to assess the mediation roles of inflammation cells.There were 2701 participants in the case-control study,including 896 patients with T2DM,900 patients with IFG,905 subjects with NGT.Plasma isocarbophos and isofenphos concentrationsweremeasured using gas chromatography and triple quadrupole tandem mass spectrometry.Generalized linear models were used to calculate the relationships between plasma isofenphos and isocarbophos levels with inflammatory factor levels and T2DM.Inflammatory cell was used as mediators to estimate the mediating effects on the above associations.Isocarbophos and isofenphos were positively related with T2DM after adjusting for other factors.The odds ratio(95%confidence interval)(OR(95%CI))for T2DM was 1.041(1.015,1.068)and for IFG was 1.066(1.009,1.127)per unit rise in ln-isocarbophos.The prevalence of T2DM increased by 6.4%for every 1 unit more of ln-isofenphos(OR(95%CI):1.064(1.041,1.087)).Additionally,a 100%rise in ln-isocarbophos was linked to 3.3%higher ln-HOMA2IR and a 0.029 mmol/L higher glycosylated hemoglobin(HbA1c)(95%CI:0.007,0.051).While a 100%rise in ln-isofenphos was linked to increase in ln-HOMA2 and ln-HOMA2IR of 5.8%and 3.4%,respectively.Furthermore,white blood cell(WBC)and neutrophilic(NE)were found to be mediators in the relationship between isocarbophos and T2DM,and the corresponding proportions were 17.12%and 17.67%,respectively.Isofenphos and isocarbophos are associated with IFG and T2DM in the rural Chinese population,WBC and NE have a significant role in this relationship.展开更多
BACKGROUND Work-family conflicts and daytime sleepiness are related to the risk of suicide.At present,no study has investigated the relationship between nurses’work-family behavioral role conflict and suicide risk.Mo...BACKGROUND Work-family conflicts and daytime sleepiness are related to the risk of suicide.At present,no study has investigated the relationship between nurses’work-family behavioral role conflict and suicide risk.Moreover,it has not been confirmed whether,considering the effect of daytime sleepiness on suicide risk,daytime sleepiness mediates the effect of work-family behavioral role conflict and suicide risk.AIM To explore the pathway relationships among nurses'work-family behavioral role conflict,daytime sleepiness,and suicide risk.METHODS Convenience and purposive sampling methods were used to select 750 nurses from six provinces,including Jiangxi,Sichuan,and Shanxi.The work-family behavioral role conflict scale,the Chinese adult daytime sleepiness scale,and the suicide behavior questionnaire were used for the survey.The data were statistically analyzed via SPSS 25.0 software,Pearson correlation analysis was used to explore the correlations between the variables,the PROCESS 4.0 program was used for the mediation effect analysis,and the mediation effect model was tested via the bootstrap method.RESULTS Nurses'work-family behavioral role conflict and daytime sleepiness were positively correlated with suicide risk(r=734,0.717).Work-family behavioral role conflict positively predicted suicide risk(β=0.118),and daytime sleepiness positively predicted suicide risk(β=0.152).Daytime sleepiness partially mediated the role of nurses'work-family behavioral role conflict and suicide risk,with a mediation effect value of 0.046 and a mediation effect accounting for 38.98%.CONCLUSION The results of the Pearson correlation analysis and mediation effect analysis revealed that nurses'work-family behavioral role conflict has a direct effect on suicide risk and indirectly affects suicide risk through daytime drowsiness symptoms.展开更多
As a novel economic paradigm that drives high-quality economic development,the digital economy(DE)can potentially significantly enhance the utilization efficiency of ecological resources and improve human well-being.B...As a novel economic paradigm that drives high-quality economic development,the digital economy(DE)can potentially significantly enhance the utilization efficiency of ecological resources and improve human well-being.Based on panel data from 285 prefecture-level cities in China spanning 2011-2021,this study empirically investigates the direct effects,transmission mechanisms,and spatial spillover effects of the DE on ecological welfare performance(EWP)using benchmark regression,intermediary effects,and spatial Durbin models.The results show that the DE significantly improved EWP in Chinese cities.This conclusion remains valid even after controlling for relevant influencing factors.Two transmission paths—upgrading of the industrial structure(UIS)and green innovation(GI)—significantly impacted EWP,as verified by the mediation effect model.Additionally,the mediating effect of the UIS was stronger than that of GI.Spatial heterogeneity tests show that the DE had significant effects on the EWP of eastern cities,with little impact on the central and western cities.Accordingly,grounded in regional developmental disparities,the empowering effects of the DE must be fully harnessed to foster an ecological civilization and enhance the well-being of the populace.展开更多
Growing evidences showed that heavy metals exposure may be associated with metabolic diseases.Nevertheless,themechanism underlying arsenic(As)exposure and metabolic syndrome(MetS)risk has not been fully elucidated.So ...Growing evidences showed that heavy metals exposure may be associated with metabolic diseases.Nevertheless,themechanism underlying arsenic(As)exposure and metabolic syndrome(MetS)risk has not been fully elucidated.So we aimed to prospectively investigate the role of serum uric acid(SUA)on the association between blood As exposure and incident MetS.A sample of 1045 older participants in a community in China was analyzed.We determined As at baseline and SUA concentration at follow-up in the Yiwu Elderly Cohort.MetS events were defined according to the criteria of the International Diabetes Federation(IDF).Generalized linear model with log-binominal regression model was applied to estimate the association of As with incident MetS.To investigate the role of SUA in the association between As andMetS,amediation analysiswas conducted.In the fully adjusted log-binominal model,per interquartile range increment of As,the risk of MetS increased 1.25-fold.Compared with the lowest quartile of As,the adjusted relative risk(RR)of MetS in the highest quartile was 1.42(95%confidence interval,CI:1.03,2.00).Additionally,blood As was positively associated with SUA,while SUA had significant association with MetS risk.Further mediation analysis demonstrated that the association of As and MetS risk was mediated by SUA,with the proportion of 15.7%.Our study found higher As was remarkably associated with the elevated risk of MetS in the Chinese older adults population.Mediation analysis indicated that SUA might be a mediator in the association between As exposure and MetS.展开更多
Objective To study the importance of digital economy to promote the innovation development of enterprises under the background of the era of information technology reform.Methods The maximum entropy method was used to...Objective To study the importance of digital economy to promote the innovation development of enterprises under the background of the era of information technology reform.Methods The maximum entropy method was used to measure the comprehensive level of digital economy development at provincial level.Besides,the impact of digital economy on the innovation performance of pharmaceutical industry was investigated empirically by using A-share pharmaceutical companies listed in China from 2013 to 2020 as a research sample,and the mediating mechanism of R&D investment and financing constraints on the impact was examined.Results and Conclusion It is found that digital economy is significantly and positively related to the innovation performance of enterprises.The mechanism test shows that digital economy improves innovation performance through the expansion effect of R&D investment and alleviating financing constraints.In the context that digital economy has become a new driving force for enterprise innovation,the combination of digital economy and real economy should be actively promoted,R&D investment in pharmaceutical enterprises should be increased,and financing channels should be broadened.展开更多
Data mining has the potential to provide information for improving clinical acupuncture strategies by uncovering hidden rules between acupuncture manipulation and therapeutic effects in a data set. In this study, we p...Data mining has the potential to provide information for improving clinical acupuncture strategies by uncovering hidden rules between acupuncture manipulation and therapeutic effects in a data set. In this study, we performed acupuncture on 30 patients with hemiplegia due to acute ischemic stroke. All participants were pre-screened to ensure that they exhibited immediate responses to acupuncture. We used a twirling reinforcing acupuncture manipulation at the specific lines between the bilateral Baihui（GV20） and Taiyang（EX-HN5）. We collected neurologic deficit score, simplified Fugl-Meyer assessment score, muscle strength of the proximal and distal hemiplegic limbs, ratio of the maximal H-reflex to the maximal M-wave（Hmax/Mmax）, muscle tension at baseline and immediately after treatment, and the syndromes of traditional Chinese medicine at baseline. We then conducted data mining using an association algorithm and an artificial neural network backpropagation algorithm. We found that the twirling reinforcing manipulation had no obvious therapeutic difference in traditional Chinese medicine syndromes of ＂Deficiency and Excess＂. The change in the muscle strength of the upper distal and lower proximal limbs was one of the main factors affecting the immediate change in Fugl-Meyer scores. Additionally, we found a positive correlation between the muscle tension change of the upper limb and Hmax/Mmax immediate change, and both positive and negative correlations existed between the muscle tension change of the lower limb and immediate Hmax/Mmax change. Additionally, when the difference value of muscle tension for the upper and lower limbs was 〉 0 or 〈 0, the difference value of Hmax/Mmax was correspondingly positive or negative, indicating the scalp acupuncture has a bidirectional effect on muscle tension in hemiplegic limbs. Therefore, acupuncture with twirling reinforcing manipulation has distinct effects on acute ischemic stroke patients with different symptoms or stages of disease. Improved muscle tension in the upper and lower limbs, reflected by the variation in the Hmax/Mmax ratio, is crucial for recovery of motor function from hemiplegia.展开更多
Objective:This study investigates the emotional intelligence(EI),self-efficacy,and clinical communication ability of clinical nurses to explore the correlation among these three variables,and verify the mediating effe...Objective:This study investigates the emotional intelligence(EI),self-efficacy,and clinical communication ability of clinical nurses to explore the correlation among these three variables,and verify the mediating effect of self-efficacy on relationship between EI and communication skills.Methods:A total of 865 nurses were recruited and investigated using Wong and Law's Emotional Intelligence Scale,General Self-Efficacy Scale,and nurse clinical communication scale.Results:The scores for EI and self-efficacy of nurses were 14.23±2.61 and 25.36±5.67,respectively,which were lower than the international norm(p<0.01).The score for clinical communication ability of nurses was 4.14±0.53.The clinical communication competency of nurses was positively correlated with EI and general self-efficacy.Furthermore,selfefficacy played an intermediary role between EI and clinical communication commitment.Conclusion:Nursing administrators can improve the clinical communication ability of nurses by enhancing their self-efficacy and EI.展开更多
BACKGROUND Stroke patients often experience psychological distress,which can impact their intimate relationships with spouses,subsequently influencing their treatment and recovery.Physical activity is considered a key...BACKGROUND Stroke patients often experience psychological distress,which can impact their intimate relationships with spouses,subsequently influencing their treatment and recovery.Physical activity is considered a key rehabilitation method for stroke patients.This paper aims to analyze whether psychological distress affects intimate relationship between spouses through physical activity.AIM To explore the mediating effect of physical activity between psychological distress and intimate relationship in stroke patients.METHODS A total of 256 stroke patients who underwent treatment at the First People’s Hospital of Shangqiu between July 2021 and July 2022 were enrolled in this study.The participants completed questionnaires,including the Kessler Psychological Distress Scale(K10),the Quality of Relationship Index(QRI),International Physical Activity Questionnaire,and a general information questionnaire.Data analysis were performed using SPSS 23.0.The Harman test was employed to detect common method deviations,and Spearman correlation was used for correlation analysis.The mediating effect was assessed using Process 3.4.1,with significance testing of the regression coefficients conducted using the bias-corrected percentile Bootstrap method(5000 iterations,95%confidence interval).Statistical significance was set at P<0.05.RESULTS The results showed that patients scored an average of 21.61±6.44 points on the K10,32.40±6.19 points on the QRI;the median physical activity level according to the International Physical Activity Questionnaire was 1861(566,2846)MET·min/w.The level of physical activity(the physical activity intensity of the patients reflected by the Interna-tional Physical Activity Questionnaire-Long Form scale)negatively correlated with psychological distress and intimacy(P<0.05),and positively correlated with each other(P<0.05),with the correlation stronger at lower physical activity levels compared to higher ones.The mediating effect of physical activity between psychological distress and intimate relationship was calculated to be 40.23%.Bootstrap analysis further validated the results.The mediating effect of psychological distress on intimate relationships through physical activity level was-0.284,with a confidence interval of-0.409 to-0.163,excluding 0,confirming a significant mediating effect of psychological distress on intimate relationships.CONCLUSION Physical activity significantly affects relationship between psychological distress and intimate relationships among stroke patients.Addressing the role of physical activity may have implications for improving patient outcomes and rehabilitation strategies.展开更多
基金supported by the Guangdong Basic and Applied Basic Research Foundation(2020A1515110608)Department of Education of Guangdong Province-Guangdong Province General University Youth Innovative Talent Project(2019KQNCX039).
文摘Background:Childhood environmental unpredictability(CEU)is crucial to personal development,profoundly influence physical and psychological growth particularly,and psychopathy is recognized as a dark personality trait.The aim of this study is to investigate the effects of insecure attachment and life history strategy(LHS)on the relationship between CEU and psychopathy by establishing a sequential mediation model based on evolutionary life history theory and cognitive-affective personality system.Methods:A group of 532 undergraduates completed the measurements for CEU,insecure attachment,LHS,and psychopathy,and Bootstrap mediation test through SPSS 25.0 and PROCESS macro tool was used to examine the relationship among these variables.Results:The results revealed positive relations between CEU and insecure attachment(β=0.87,p<0.001),CEU and LHS(β=0.11,p<0.001),and CEU and psychopathy(β=0.14,p<0.001).Insecure attachment was also positively associated with LHS(β=0.62,p<0.001)and psychopathy(β=0.04,p<0.001).In addition,LHS was significantly associated with psychopathy(β=0.08,p<0.001).The relationship between CEU and psychopathy is mediated independently and sequentially by insecure attachment and LHS.Conclusion:The current research shows the relationship between CEU and psychopathy,as well as the mechanism of insecure attachment and life history strategy as mediators.
文摘Objective:To analyze the mediating effect of psychological flexibility between death anxiety and quality of life in cancer patients.Methods:A convenience sampling method was used to select cancer patients who received treatment at our hospital from January 2022 to January 2024,by the inclusion and exclusion criteria.General information,psychological flexibility,death anxiety,and quality of life scores were collected for analysis.Result:The psychological flexibility and quality of life scores of cancer patients with an annual family income≤100,000 RMB were significantly lower than those of cancer patients with an annual family income>100,000 RMB(P<0.05),while the death anxiety scores were significantly lower for the former group as well(P<0.05).Cancer patients staged as Ⅰ-Ⅱ had significantly higher psychological flexibility and quality of life scores than those staged as Ⅲ-Ⅳ(P<0.05),while their death anxiety scores were significantly lower(P<0.05).Psychological flexibility in cancer patients was negatively correlated with death anxiety(r=-0.614,P<0.05)and positively correlated with quality of life(r=0.628,P<0.05),while death anxiety was negatively correlated with quality of life(r=-0.112,P<0.05).The direct effect of death anxiety on quality of life was-0.232,accounting for 58.32%of the total effect.The mediating effect of psychological flexibility between death anxiety and quality of life was-0.218,accounting for 41.83%of the total effect.Conclusion:Death anxiety can directly affect the quality of life of cancer patients,and it can also indirectly affect the quality of life through psychological flexibility.Clinicians should promptly address patients’death anxiety and provide interventions to enhance psychological flexibility,thereby improving the quality of life.
基金Henan Provincial Government-funded Excellent Clinical Medicine Talent Training Project(Project No.:ZF2024006)Hebei Province Medical Science Research Project Plan(Project No.:20240083)。
文摘Objective:Investigating the Mediating Role of Pain in the Relationship Between Sleep Quality and Health-Related Quality of Life Among Elderly Patients with Chronic Diseases.Methods:Using data from the 2018 China Health and Retirement Longitudinal Study(CHARLS),this study included 3,284 participants aged 60 years or older with chronic diseases.The sleep quality,pain status,health-related quality of life,and demographic-related data of these elderly patients were obtained.Pearson correlation analysis was conducted to assess the bivariate relationships among the variables.The mediating role of pain in the sleep quality-HRQoL relationship was tested using linear regression models,complemented by bootstrap sampling to verify the indirect effect.Results:Sleep quality was positively associated with health-related quality of life(r=0.218,p<0.001).Conversely,pain demonstrated significant negative correlations with both sleep quality(r=-0.496,p<0.001)and health-related quality of life(r=-0.067,p<0.001).The mediating effect results showed that pain played a partial mediating role between sleep quality and health-related quality of life in elderly patients with chronic diseases(effect value=0.049),and the mediating effect accounted for 23.33%.Conclusion:Pain is a mediating variable between sleep quality and health-related quality of life in elderly patients with chronic diseases.This suggests that clinical practice should incorporate pain assessment into standard clinical care of elderly patients with sleep disorders and chronic diseases.By alleviating pain,sleep quality can be improved,and subsequently,their health-related quality of life can be enhanced.
基金Supported by the Scientific Research Program of the Tianjin Education Commission(Natural Science),No.2023KJ033.
文摘BACKGROUND Several studies have suggested a close link between depression,overweight,and new-onset diabetes,particularly among middle-aged and older populations;however,the causal associations remain poorly understood.AIM To investigate the role of overweight in mediating the association between depression and new-onset diabetes in middle-aged and older populations.METHODS Data of 9426 individuals aged≥50 years from the 1998-2016 Health and Retirement Study database were analyzed.Weighted logistic regression was employed to obtain odds ratios(ORs)and 95%confidence intervals(95%CIs)for depression and new-onset diabetes in the middle-aged and older populations.Mediation analysis and the Sobel test were used to test the mediating effects of overweight between depression and the risk of new-onset diabetes.RESULTS New-onset diabetes was identified in 23.6%of the study population.Depression was significantly associated with new-onset diabetes(OR:1.18,95%CI:1.03-1.35,P value:0.014).Further adjustment for overweight attenuated the effect of depression on new-onset diabetes to 1.14(95%CI:1.00-1.30,P=0.053),with a significant mediating effect(P of Sobel test=0.003).The mediation analysis demonstrated that overweight accounted for 61%in depression for the risk of new-onset diabetes,with overweight having a partially mediating role in the depression-to-diabetes pathway.CONCLUSION New-onset diabetes was not necessarily a direct complication of depression;rather,depression led to behaviors that increase the risk of overweight and,consequently,new-onset diabetes.
文摘With the development of minimally invasive gynecological technology,hysteroscopic surgery has been widely used in the treatment of gynecological diseases due to its advantages of rapid recovery and minimal trauma.From the perspective of patients undergoing hysteroscopic surgery,this paper explores the influence of their psychological security on quality of life,analyzes the mediating effect of social support,and puts forward specific countermeasures and suggestions.The purpose is to improve the psychological security and quality of life of patients undergoing hysteroscopic surgery,and provide reference for the subsequent development of hysteroscopic surgery.
基金Supported by the Natural Science Foundation Project of Xinjiang Uygur Autonomous Region,No.2021D01C143.
文摘BACKGROUND Dysphoria and despondency are prevalent psychological issues in patients undergoing Maintenance Hemodialysis(MHD)that significantly affect their quality of life(QOL).High levels of social support can significantly improve the physical and mental well-being of patients undergoing MHD.Currently,there is limited research on how social support mediates the relationship between dysphoria,despondency,and overall QOL in patients undergoing MHD.It is imperative to investigate this mediating effect to mitigate dysphoria and despondency in patients undergoing MHD,ultimately enhancing their overall QOL.AIM To investigate the mediating role of social support in relationships between dysphoria,despondency,and QOL among patients undergoing MHD.METHODS Participants comprised 289 patients undergoing MHD,who were selected using a random sampling approach.The Social Support Rating Scale,Self-Rating Anxiety Scale,Self-Rating Depression Scale,and QOL Scale were administered.Correlation analysis was performed to examine the associations between social support,dysphoria,despondency,and QOL in patients undergoing MHD.To assess the mediating impact of social support on dysphoria,despondency,and QOL in patients undergoing MHD,a bootstrap method was applied.RESULTS Significant correlations among social support,dysphoria,despondency,and quality in patients undergoing MHD were observed(all P<0.01).Dysphoria and despondency negatively correlated with social support and QOL(P<0.01).Dysphoria and despondency had negative predictive impacts on the QOL of patients undergoing MHD(P<0.05).The direct effect of dysphoria on QOL was statistically significant(P<0.05).Social support mediated the relationship between dysphoria and QOL,and this mediating effect was significant(P<0.05).Similarly,the direct effect of despondency on QOL was significant(P<0.05).Moreover,social support played a mediating role between despondency and QOL,with a significant mediating effect(P<0.05).CONCLUSION These findings suggest that social support plays a significant mediating role in the relationship between dysphoria,despondency,and QOL in patients undergoing MHD.
文摘BACKGROUND Hematological tumors are common malignant tumors,with high morbidity and mortality rates.Most patients with hematological malignancies develop sleep disorders that seriously affect their life and health because of acute onset of disease,rapid progression,high recurrence rates,complex treatment methods,and treatment costs.AIM To explore the mediating effect of resilience on fear of disease progression and sleep quality in patients with hematological malignancies.METHODS A cross-sectional analysis of 100 patients with hematological malignancies,treated in the First Affiliated Hospital of Jinzhou Medical University between August 2022 and August 2023,was conducted.Patients were assessed using a general data survey,a simplified scale for the fear of progression(FoP)of disease,a resilience scale,and the Pittsburgh Sleep Quality Index.Statistical analysis was conducted to determine the relationship between various patient characteristics and FoP,resilience,and sleep quality.Spearman’s correlation analysis was used to examine the correlations between mental resilience,FoP,and sleep quality.RESULTS The total FoP score mean value in patients with hematological malignancies was 38.09±5.16;the total resilience score mean value was 40.73±7.04;and the Pittsburgh Sleep Quality Index score mean value was 10.72±1.90.FoP,resilience,and sleep quality of the patients were associated with family per capita monthly income and patient education level(P<0.05).Spearman correlation analysis revealed that FoP was negatively correlated with resilience and sleep quality scores(r=-0.560,-0.537,P<0.01),respectively,and resilience was significantly associated with sleep quality scores(r=0.688,P<0.01).Mediation analysis showed that the mediating effect of resilience between FoP and sleep quality in patients with hematological malignancies was-0.100 and accounted for 50.51%of the total effect.This indicated that FoP directly and indirectly affected sleep quality through the mesomeric effect of resilience.CONCLUSION Resilience is an intermediary variable between FoP and sleep quality in patients with hematological malignancies.Medical staff should evaluate and follow-up FoP and resilience to implement measures to improve sleep quality.
基金supported by funding of Educational Development Research Center of Southern Xinjiang.
文摘Background:Adolescent anxiety has a significant impact on physical and mental health,and overparenting is recognized as one of the major factors affecting adolescent anxiety.The objective of this study was to investigate the relationship between overparenting and adolescent anxiety,while also examining the mediating role of cognitive avoidance.Methods:Data were collected through a cross-sectional survey with 1931 valid responses using the Overparenting Scale,the Cognitive Avoidance Scale,and the Anxiety Self-Rating Scale.A structural equation modelling approach was used to test the mediating role of cognitive avoidance between overparenting and adolescent anxiety and to reveal the underlying mechanisms.The significance of the mediating effect was assessed based on maximum likelihood estimation.Differences in the mediating role of cognitive avoidance in the male and female samples were comparatively analyzed in the mediation effect analysis.Results:The study’s findings reveal a significant positive correlation between overparenting and adolescent anxiety(p<0.01),between overparenting and cognitive avoidance(p<0.01),and between cognitive avoidance and adolescent anxiety(p<0.01).Cognitive avoidance mediated the relationship between overparenting and adolescent anxiety.Overparenting can not only directly predict adolescent anxiety but also indirectly predict it through the mediating role of cognitive avoidance.Conclusion:This study validates the direct effect of overparenting on adolescent anxiety and reveals the mechanism of cognitive avoidance as a mediator.
基金funded by the Key Discipline Construction Project of the Liaoning Provincial Social Science Planning Fund(grant ID:L24ZD042)。
文摘Background:The phenomenon of academic anxiety has been demonstrated to exert a considerable influence on students’academic engagement,leading to the emergence of a phenomenon known as“learned helplessness”and undermining the selfconfidence and motivation of high school students.Using acceptance-rejection theory,this study elucidated how a rejective parenting style affects Chinese high school students’academic anxiety and explored the urban-rural heterogeneity of this relationship.Methods:Data were analyzed using a stratified whole-cluster random sampling method.There are a total of 30,000 high school students in the three regions of northern and central China(from Shanxi,Hebei and Henan).A sample of 2286 high school students aged 14–19 years was ultimately selected from 2760 respondents for this investigation,which was conducted at the beginning of the 2023 school year.Pearson correlation,ordinary least squares(OLS)regression analysis,path analysis,and Fisher’s permutation test(FPT)were used to examine the effects of rejective parenting style on high school students’academic anxiety.Results:Results indicated a significant positive predictive effect between rejective parenting style and academic anxiety among high school students(β=0.815,t=116.211,p<0.001).Students’self-concept was significantly positively related to positive coping style(β=0.424,t=21.208,p<0.001)and chain-mediated this relationship.Therefore,this parenting style may indirectly mitigate academic anxiety through these mediators.The study also found that the effect of rejective parenting style on academic anxiety varied by students’residential background and was more pronounced in urban areas(0.226)than in rural areas(0.130).Conclusion:The research underscores the imperative for Chinese families to reexamine their utilization of rejection parenting and to prioritize the cultivation of students’intrinsic attributes.These findings offer a theoretical framework and practical evidence for policymakers and educators to develop efficacious and targeted interventions.In particular,greater attention should be directed towards the discrepancies in the manifestation of emotional and academic anxiety between urban and rural students,and prompt guidance should be furnished.
基金Supported by the Shijiazhuang Science and Technology Research and Development Program,No.221460383.
文摘BACKGROUND Emotional reactions,such as anxiety,irritability,and aggressive behavior,have attracted clinical attention as behavioral and emotional problems in preschool-age children.AIM To investigate the current status of family rearing,parental stress,and behavioral and emotional problems of preschool children and to analyze the mediating effect of the current status of family rearing on parental stress and behavioral/emo-tional problems.METHODS We use convenience sampling to select 258 preschool children in the physical examination center of our hospital from October 2021 to September 2023.The children and their parents were evaluated using a questionnaire survey.Pearson's correlation was used to analyze the correlation between child behavioral and emotional problems and parental stress and family rearing,and the structural equation model was constructed to test the mediating effect.RESULTS The score for behavioral/emotional problems of 258 preschool children was(27.54±3.63),the score for parental stress was(87.64±11.34),and the score for parental family rearing was(31.54±5.24).There was a positive correlation between the behavioral and emotional problems of the children and the“hostile/mandatory”parenting style;meanwhile,showed a negative correlation with the“support/participation”parenting style(all P<0.05).The intermediary effect value between the family upbringing of parents in parental stress and children's behavior problems was 29.89%.CONCLUSION Parental family upbringing has a mediating effect between parental stress and behavioral and emotional problems of children.Despite paying attention to the behavioral and emotional problems of preschool-age children,clinical medical staff should provide correct and reasonable parenting advice to their parents to promote the mental health of preschool-age children.
基金funded by a Grant-in-Aid for Scientific Research(B)(Japan Society for The Promotion of Science,21H02849)Grant-in-Aid for Scientific Research(C)(Japan Society for The Promotion of Science,23K07013)+2 种基金Grant-in-Aid for Transformative Research Areas(A)(Japan Society for The Promotion of Science,JP21H05173)Grant-in-Aid by the Smoking Research FoundationGrant-in-Aid by the Telecommunications Advancement Foundation.
文摘Background Ongoing debates question the harm of internet use with the evolving technology,as many individuals transition from regular to problematic internet use(PIU).The habenula(Hb),located between the thalamus and the third ventricle,is implicated in various psychiatric disorders.In addition,personality features have been suggested to play a role in the pathophysiology of PIU.Aims This study aimed to investigate Hb volumetry in individuals with subclinical PIU and the mediating effect of personality traits on this relationship.Methods 110 healthy adults in this cross-sectional study underwent structural magnetic resonance imaging.Hb segmentation was performed using a deep learning technique.The Internet Addiction Test(IAT)and the NEO Five-Factor Inventory were used to assess the PIU level and personality,respectively.Partial Spearman's correlation analyses were performed to explore the reiationships between Hb volumetry,IAT and NEO.Multiple regression analysis was applied to identify personality traits that predict IAT scores.The significant trait was then treated as a mediator between Hb volume and IAT correlation in mediation analysis with a bootstrap value of 5000.Results Relative Hb volume was negatively correlated with IAT scores(partial rho=-0.142,p=0.009).The IAT score was positively correlated with neuroticism(partial rho=0.430,p<0.001)and negatively correlated with extraversion,agreeableness and conscientiousness(partial rho=-0.213,p<0.001;partial rho=-0.279,p<0.001;and partial rho=-0.327,p<0.001).There was a significant indirect effect of Hb volume on this model(β=-0.061,p=0.048,boot 95%confidence interval:-0.149 to-0.001).Conclusions This study uncovered a crucial link between reduced Hb volume and heightened PIU.Our findings highlight neuroticism as a key risk factor for developing PIU.Moreover,neuroticism was shown to mediate the relationship between Hb volume and PIU tendency,offering valuable insight into the complexities of this interaction.
文摘This study investigates the impact of investor protection on corporate R&D investment using panel data from Chinese A-share listed companies spanning 2015 to 2022.By employing OLS regression,mediation,and moderation analyses,the results demonstrate that robust investor protection mechanisms significantly enhance corporate R&D expenditures.The mediation analysis reveals that investor protection alleviates financing constraints and improves information disclosure quality,both of which serve as key channels for fostering R&D investment.Furthermore,internal control systems and media attention are identified as positive moderators,amplifying the beneficial effects of investor protection on R&D.In contrast,the equity Herfindahl index(HHI)does not exhibit a significant moderating role.The study also highlights that financial leverage,profitability,and equity concentration negatively influence R&D,while revenue growth exerts a positive effect.These findings underscore the critical role of investor protection in driving corporate innovation and sustainable growth,offering valuable insights for policymakers and corporate managers aiming to optimize R&D strategies through improved governance frameworks.
基金supported by the National Natural Science Foundation of China(Nos.42177415 and 21806146)the Scientific and Technological Innovation of Colleges and Universities in Henan Province Talent Support Program(No.22HASTIT044)the Young Backbone Teachers Programof Colleges and Universities in Henan Province(No.2021GGJS015).
文摘To investigate the associations between isocarbophos and isofenphos with impaired fasting glucose(IFG)and type 2 diabetes mellitus(T2DM),and to assess the mediation roles of inflammation cells.There were 2701 participants in the case-control study,including 896 patients with T2DM,900 patients with IFG,905 subjects with NGT.Plasma isocarbophos and isofenphos concentrationsweremeasured using gas chromatography and triple quadrupole tandem mass spectrometry.Generalized linear models were used to calculate the relationships between plasma isofenphos and isocarbophos levels with inflammatory factor levels and T2DM.Inflammatory cell was used as mediators to estimate the mediating effects on the above associations.Isocarbophos and isofenphos were positively related with T2DM after adjusting for other factors.The odds ratio(95%confidence interval)(OR(95%CI))for T2DM was 1.041(1.015,1.068)and for IFG was 1.066(1.009,1.127)per unit rise in ln-isocarbophos.The prevalence of T2DM increased by 6.4%for every 1 unit more of ln-isofenphos(OR(95%CI):1.064(1.041,1.087)).Additionally,a 100%rise in ln-isocarbophos was linked to 3.3%higher ln-HOMA2IR and a 0.029 mmol/L higher glycosylated hemoglobin(HbA1c)(95%CI:0.007,0.051).While a 100%rise in ln-isofenphos was linked to increase in ln-HOMA2 and ln-HOMA2IR of 5.8%and 3.4%,respectively.Furthermore,white blood cell(WBC)and neutrophilic(NE)were found to be mediators in the relationship between isocarbophos and T2DM,and the corresponding proportions were 17.12%and 17.67%,respectively.Isofenphos and isocarbophos are associated with IFG and T2DM in the rural Chinese population,WBC and NE have a significant role in this relationship.
文摘BACKGROUND Work-family conflicts and daytime sleepiness are related to the risk of suicide.At present,no study has investigated the relationship between nurses’work-family behavioral role conflict and suicide risk.Moreover,it has not been confirmed whether,considering the effect of daytime sleepiness on suicide risk,daytime sleepiness mediates the effect of work-family behavioral role conflict and suicide risk.AIM To explore the pathway relationships among nurses'work-family behavioral role conflict,daytime sleepiness,and suicide risk.METHODS Convenience and purposive sampling methods were used to select 750 nurses from six provinces,including Jiangxi,Sichuan,and Shanxi.The work-family behavioral role conflict scale,the Chinese adult daytime sleepiness scale,and the suicide behavior questionnaire were used for the survey.The data were statistically analyzed via SPSS 25.0 software,Pearson correlation analysis was used to explore the correlations between the variables,the PROCESS 4.0 program was used for the mediation effect analysis,and the mediation effect model was tested via the bootstrap method.RESULTS Nurses'work-family behavioral role conflict and daytime sleepiness were positively correlated with suicide risk(r=734,0.717).Work-family behavioral role conflict positively predicted suicide risk(β=0.118),and daytime sleepiness positively predicted suicide risk(β=0.152).Daytime sleepiness partially mediated the role of nurses'work-family behavioral role conflict and suicide risk,with a mediation effect value of 0.046 and a mediation effect accounting for 38.98%.CONCLUSION The results of the Pearson correlation analysis and mediation effect analysis revealed that nurses'work-family behavioral role conflict has a direct effect on suicide risk and indirectly affects suicide risk through daytime drowsiness symptoms.
基金funded by the Natural Science Foundation of Shandong Province[Grant No.ZR2022MD104]Rizhao Natural Science Foundation Youth Fund Project[Grant No.RZ2021ZR36]Taishan Scholars Youth Expert Support Plan of Shandong Province[Grant No.tsqn202306183].
文摘As a novel economic paradigm that drives high-quality economic development,the digital economy(DE)can potentially significantly enhance the utilization efficiency of ecological resources and improve human well-being.Based on panel data from 285 prefecture-level cities in China spanning 2011-2021,this study empirically investigates the direct effects,transmission mechanisms,and spatial spillover effects of the DE on ecological welfare performance(EWP)using benchmark regression,intermediary effects,and spatial Durbin models.The results show that the DE significantly improved EWP in Chinese cities.This conclusion remains valid even after controlling for relevant influencing factors.Two transmission paths—upgrading of the industrial structure(UIS)and green innovation(GI)—significantly impacted EWP,as verified by the mediation effect model.Additionally,the mediating effect of the UIS was stronger than that of GI.Spatial heterogeneity tests show that the DE had significant effects on the EWP of eastern cities,with little impact on the central and western cities.Accordingly,grounded in regional developmental disparities,the empowering effects of the DE must be fully harnessed to foster an ecological civilization and enhance the well-being of the populace.
基金supported by the Fundamental Research Funds for the Central Universities(Nos.2021FZZX001-39 and 2020QNA7018)the Key Laboratory of Pollution Exposure and Health Intervention of Zhejiang Province(No.20220204)the Medical Science and Technology Project of Zhejiang Province(No.2023RC037).
文摘Growing evidences showed that heavy metals exposure may be associated with metabolic diseases.Nevertheless,themechanism underlying arsenic(As)exposure and metabolic syndrome(MetS)risk has not been fully elucidated.So we aimed to prospectively investigate the role of serum uric acid(SUA)on the association between blood As exposure and incident MetS.A sample of 1045 older participants in a community in China was analyzed.We determined As at baseline and SUA concentration at follow-up in the Yiwu Elderly Cohort.MetS events were defined according to the criteria of the International Diabetes Federation(IDF).Generalized linear model with log-binominal regression model was applied to estimate the association of As with incident MetS.To investigate the role of SUA in the association between As andMetS,amediation analysiswas conducted.In the fully adjusted log-binominal model,per interquartile range increment of As,the risk of MetS increased 1.25-fold.Compared with the lowest quartile of As,the adjusted relative risk(RR)of MetS in the highest quartile was 1.42(95%confidence interval,CI:1.03,2.00).Additionally,blood As was positively associated with SUA,while SUA had significant association with MetS risk.Further mediation analysis demonstrated that the association of As and MetS risk was mediated by SUA,with the proportion of 15.7%.Our study found higher As was remarkably associated with the elevated risk of MetS in the Chinese older adults population.Mediation analysis indicated that SUA might be a mediator in the association between As exposure and MetS.
文摘Objective To study the importance of digital economy to promote the innovation development of enterprises under the background of the era of information technology reform.Methods The maximum entropy method was used to measure the comprehensive level of digital economy development at provincial level.Besides,the impact of digital economy on the innovation performance of pharmaceutical industry was investigated empirically by using A-share pharmaceutical companies listed in China from 2013 to 2020 as a research sample,and the mediating mechanism of R&D investment and financing constraints on the impact was examined.Results and Conclusion It is found that digital economy is significantly and positively related to the innovation performance of enterprises.The mechanism test shows that digital economy improves innovation performance through the expansion effect of R&D investment and alleviating financing constraints.In the context that digital economy has become a new driving force for enterprise innovation,the combination of digital economy and real economy should be actively promoted,R&D investment in pharmaceutical enterprises should be increased,and financing channels should be broadened.
基金supported by a grant from the Supporting Program of the"Eleventh Five-year Plan"for Science&Technology Research of China,Ministry of Science and Technology of China,No.2006BAI12B02a grant from the Scientific Research Fund for Talent Introduction in the Gansu University of Chinese Medicine of China,No.2012-11
文摘Data mining has the potential to provide information for improving clinical acupuncture strategies by uncovering hidden rules between acupuncture manipulation and therapeutic effects in a data set. In this study, we performed acupuncture on 30 patients with hemiplegia due to acute ischemic stroke. All participants were pre-screened to ensure that they exhibited immediate responses to acupuncture. We used a twirling reinforcing acupuncture manipulation at the specific lines between the bilateral Baihui（GV20） and Taiyang（EX-HN5）. We collected neurologic deficit score, simplified Fugl-Meyer assessment score, muscle strength of the proximal and distal hemiplegic limbs, ratio of the maximal H-reflex to the maximal M-wave（Hmax/Mmax）, muscle tension at baseline and immediately after treatment, and the syndromes of traditional Chinese medicine at baseline. We then conducted data mining using an association algorithm and an artificial neural network backpropagation algorithm. We found that the twirling reinforcing manipulation had no obvious therapeutic difference in traditional Chinese medicine syndromes of ＂Deficiency and Excess＂. The change in the muscle strength of the upper distal and lower proximal limbs was one of the main factors affecting the immediate change in Fugl-Meyer scores. Additionally, we found a positive correlation between the muscle tension change of the upper limb and Hmax/Mmax immediate change, and both positive and negative correlations existed between the muscle tension change of the lower limb and immediate Hmax/Mmax change. Additionally, when the difference value of muscle tension for the upper and lower limbs was 〉 0 or 〈 0, the difference value of Hmax/Mmax was correspondingly positive or negative, indicating the scalp acupuncture has a bidirectional effect on muscle tension in hemiplegic limbs. Therefore, acupuncture with twirling reinforcing manipulation has distinct effects on acute ischemic stroke patients with different symptoms or stages of disease. Improved muscle tension in the upper and lower limbs, reflected by the variation in the Hmax/Mmax ratio, is crucial for recovery of motor function from hemiplegia.
文摘Objective:This study investigates the emotional intelligence(EI),self-efficacy,and clinical communication ability of clinical nurses to explore the correlation among these three variables,and verify the mediating effect of self-efficacy on relationship between EI and communication skills.Methods:A total of 865 nurses were recruited and investigated using Wong and Law's Emotional Intelligence Scale,General Self-Efficacy Scale,and nurse clinical communication scale.Results:The scores for EI and self-efficacy of nurses were 14.23±2.61 and 25.36±5.67,respectively,which were lower than the international norm(p<0.01).The score for clinical communication ability of nurses was 4.14±0.53.The clinical communication competency of nurses was positively correlated with EI and general self-efficacy.Furthermore,selfefficacy played an intermediary role between EI and clinical communication commitment.Conclusion:Nursing administrators can improve the clinical communication ability of nurses by enhancing their self-efficacy and EI.
基金The study procedures were approved by the First People’s Hospital of Shangqiu(2021-125-29).
文摘BACKGROUND Stroke patients often experience psychological distress,which can impact their intimate relationships with spouses,subsequently influencing their treatment and recovery.Physical activity is considered a key rehabilitation method for stroke patients.This paper aims to analyze whether psychological distress affects intimate relationship between spouses through physical activity.AIM To explore the mediating effect of physical activity between psychological distress and intimate relationship in stroke patients.METHODS A total of 256 stroke patients who underwent treatment at the First People’s Hospital of Shangqiu between July 2021 and July 2022 were enrolled in this study.The participants completed questionnaires,including the Kessler Psychological Distress Scale(K10),the Quality of Relationship Index(QRI),International Physical Activity Questionnaire,and a general information questionnaire.Data analysis were performed using SPSS 23.0.The Harman test was employed to detect common method deviations,and Spearman correlation was used for correlation analysis.The mediating effect was assessed using Process 3.4.1,with significance testing of the regression coefficients conducted using the bias-corrected percentile Bootstrap method(5000 iterations,95%confidence interval).Statistical significance was set at P<0.05.RESULTS The results showed that patients scored an average of 21.61±6.44 points on the K10,32.40±6.19 points on the QRI;the median physical activity level according to the International Physical Activity Questionnaire was 1861(566,2846)MET·min/w.The level of physical activity(the physical activity intensity of the patients reflected by the Interna-tional Physical Activity Questionnaire-Long Form scale)negatively correlated with psychological distress and intimacy(P<0.05),and positively correlated with each other(P<0.05),with the correlation stronger at lower physical activity levels compared to higher ones.The mediating effect of physical activity between psychological distress and intimate relationship was calculated to be 40.23%.Bootstrap analysis further validated the results.The mediating effect of psychological distress on intimate relationships through physical activity level was-0.284,with a confidence interval of-0.409 to-0.163,excluding 0,confirming a significant mediating effect of psychological distress on intimate relationships.CONCLUSION Physical activity significantly affects relationship between psychological distress and intimate relationships among stroke patients.Addressing the role of physical activity may have implications for improving patient outcomes and rehabilitation strategies.
