BACKGROUND Lumbar interbody fusion(LIF)is the primary treatment for lumbar degenerative diseases.Elderly patients are prone to anxiety and depression after undergoing surgery,which affects their postoperative recovery...BACKGROUND Lumbar interbody fusion(LIF)is the primary treatment for lumbar degenerative diseases.Elderly patients are prone to anxiety and depression after undergoing surgery,which affects their postoperative recovery speed and quality of life.Effective prevention of anxiety and depression in elderly patients has become an urgent problem.AIM To investigate the trajectory of anxiety and depression levels in elderly patients after LIF,and the influencing factors.METHODS Random sampling was used to select 239 elderly patients who underwent LIF from January 2020 to December 2024 in Shenzhen Pingle Orthopedic Hospital.General information and surgery-related indices were recorded,and participants completed measures of psychological status,lumbar spine dysfunction,and quality of life.A latent class growth model was used to analyze the post-LIF trajectory of anxiety and depression levels,and unordered multi-categorical logistic regression was used to analyze the influencing factors.RESULTS Three trajectories of change in anxiety level were identified:Increasing anxiety(n=26,10.88%),decreasing anxiety(n=27,11.30%),and stable anxiety(n=186,77.82%).Likewise,three trajectories of change in depression level were identified:Increasing depression(n=30,12.55%),decreasing depression(n=26,10.88%),and stable depression(n=183,76.57%).Regression analysis showed that having no partner,female sex,elevated Oswestry dysfunction index(ODI)scores,and reduced 36-Item Short Form Health Survey scores all contributed to increased anxiety levels,whereas female sex,postoperative opioid use,and elevated ODI scores all contributed to increased depression levels.CONCLUSION During clinical observation,combining factors to predict anxiety and depression in post-LIF elderly patients enables timely intervention,quickens recovery,and enhances quality of life.展开更多
Tuberculosis(TB),one of the oldest infectious diseases caused by Mycobacterium tuberculosis,poses a considerable challenge to global public health.There are approximately 10 million new TB cases worldwide annually,and...Tuberculosis(TB),one of the oldest infectious diseases caused by Mycobacterium tuberculosis,poses a considerable challenge to global public health.There are approximately 10 million new TB cases worldwide annually,and TB claims the lives of nearly 3 million people each year,making it one of the leading causes of death from a single infectious disease[1].China ranks third globally in terms of TB burden,with approximately 733,000 TB cases reported in 2023[2].Based on the ecological model of health determinants developed by Whitehead and Dahlgren,health determinants can be classified into direct causes.展开更多
The discharge of micro-polluted water from sources such as agricultural runoff,urban stormwater,and treated effluents presents significant challenges to aquatic ecosystems.Constructed wetlands(CWs)have gained recog-ni...The discharge of micro-polluted water from sources such as agricultural runoff,urban stormwater,and treated effluents presents significant challenges to aquatic ecosystems.Constructed wetlands(CWs)have gained recog-nition as an eco-friendly solution for removing pollutants from various wastewater sources and are increasingly applied for micro-polluted water treatment.By reviewing 78 full-scale CW studies from Web of Science,it is summarized that the ranges of ammonium nitrogen(NH4+-N)concentrations in runoff,wastewater treatment plant effluent and polluted river were 0.1–6.6,0.3–12.3,and 0.2–41.1 mg/L,respectively.The ranges of ni-trate nitrogen concentrations were 0.2–14.2,0–5.7,and 0–2.6 mg/L,respectively.Removal efficiencies of CWs for micro-polluted water varied by CW types.The total nitrogen removal efficiencies for subsurface-flow CWs,free-water surface-flow CWs,and hybrid CWs ranged from 27.4%to 66.5%,16.8%to 89.8%,and 19.4%to 88.2%,respectively.The NH4+-N removal efficiencies ranged from 34.2%to 73.6%,38.4%to 89.4%and 13.5%to 94.2%,respectively.Additionally,other factors influencing contaminant removal efficiency such as hydraulic retention time,vegetation types,redox micro-environment and influent water quality were evaluated.Based on these findings,two strategies for improving the purification performance of CWs were proposed:the selection of incorporating electron donor substrates and the optimization of operation parameters.This paper serves as a synthesis of information to guide future research and full-scale CW applications in micro-polluted water treatment.展开更多
Background:The trajectory of intrinsic capacity(IC)among the older population is characterized by its diversity and is predictive of adverse health outcomes such as disability,nursing home admission,decline in quality...Background:The trajectory of intrinsic capacity(IC)among the older population is characterized by its diversity and is predictive of adverse health outcomes such as disability,nursing home admission,decline in quality of life,and mortality.Gaining an understanding of the trajectory of IC and the factors that influence it is of paramount importance for fostering healthy aging.This research is focused on exploring the trajectory of IC among older adults in China and examining the factors that influence it.Methods:This observational longitudinal cohort study leveraged data from the China Health and Retirement Longitudinal Study(CHARLS),which was conducted in the years 2011,2013,and 2015.For the purpose of this analysis,a total of 2,233 participants who were aged 60 and over were included.A Growth Mixture Model(GMM)was utilized to define trajectory categories for IC.Influential factors were ascertained based on the health ecology model,and binary logistic regression analysis was utilized to investigate the factors linked with the different trajectory categories.Results:Two distinct trajectory classes of IC were identified:Class 1,the normal-stable group,encompassed 90.4%of the elderly population,while Class 2,the declining group,made up 9.6%.Advanced age and a history of stroke were found to be significantly associated with Class 2.High scores in activities of daily living(ADL),employment status,receiving primary or junior high school education,and residence in the East or Central regions of China were significantly linked with Class 1.Conclusion:The trajectory of IC among older Chinese adults is marked by its heterogeneity.Advanced age and a history of stroke are significant risk factors for a declining IC trajectory,while higher ADL scores,being employed,receiving primary or junior high school education,and residing in the East or Central regions of China are protective factors associated with a stable IC trajectory.Healthcare institutions must closely monitor IC levels and understand these trajectory patterns to implement personalized and targeted interventions promptly to maintain IC at a healthy level and advocate for healthy aging.展开更多
Water use efficiency(WUE),as a pivotal indicator of the coupling degree within the carbon–water cycle of ecosystems,holds considerable importance in assessment of the carbon–water balance within terrestrial ecosyste...Water use efficiency(WUE),as a pivotal indicator of the coupling degree within the carbon–water cycle of ecosystems,holds considerable importance in assessment of the carbon–water balance within terrestrial ecosystems.However,in the context of global warming,WUE evolution and its primary drivers on the Tibetan Plateau remain unclear.This study employed the ensemble empirical mode decomposition method and the random forest algorithm to decipher the nonlinear trends and drivers of WUE on the Tibetan Plateau in 2001–2020.Results indicated an annual mean WUE of 0.8088 gC/mm·m^(2)across the plateau,with a spatial gradient reflecting decrease from the southeast toward the northwest.Areas manifesting monotonous trends of increase or decrease in WUE accounted for 23.64%and 9.69%of the total,respectively.Remarkably,66.67%of the region exhibited trend reversals,i.e.,39.94%of the area of the Tibetan Plateau showed transition from a trend of increase to a trend of decrease,and 26.73%of the area demonstrated a shift from a trend of decrease to a trend of increase.Environmental factors accounted for 70.79%of the variability in WUE.The leaf area index and temperature served as the major driving forces of WUE variation.展开更多
BACKGROUND The development of hepatocellular carcinoma(HCC)is influenced by multiple factors.Interventional therapy offers an effective treatment option for patients with unresectable intermediate-to-advanced HCC.Inte...BACKGROUND The development of hepatocellular carcinoma(HCC)is influenced by multiple factors.Interventional therapy offers an effective treatment option for patients with unresectable intermediate-to-advanced HCC.Interventional therapy can induce electrocardiographic(ECG)abnormalities that may be associated with liver dysfunction,electrolyte disorders,and cardiac injury.AIM To explore the ECG alterations and determinants following interventional therapy in patients with HCC.METHODS Sixty patients undergoing interventional treatment for liver cancer were selected as study participants.According to the results of the dynamic ECG examination 1 day after surgery,the patients were divided into an abnormal group(n=21)and a nonabnormal group(n=39).With the help of dynamic ECG examination,the ECG parameters were compared and the baseline data of patients was recorded in the two groups.RESULTS The 24 hours QT interval variability,24 hours normal atrial polarization to ventricular polarization(R-R)interval(standard deviation),24 hours consecutive 5 minutes normal R-R interval,and 24 hours continuous 5 minutes normal R-R interval(standard deviation mean)were lower than patients in the nonabnormal group(P<0.05).The logistic analysis showed that age>60 years,liver function grade B,and postoperative body temperature 38°C were risk factors for abnormal dynamic electrocardiogram in patients with liver cancer intervention(P<0.05).CONCLUSION Interventional therapy for HCC can lead to ECG abnormalities,underscoring the clinical need for enhanced cardiac monitoring to mitigate myocardial complications.展开更多
BACKGROUND China has recently encountered severe challenges associated with population aging.Parents of first-generation only children face significant challenges regarding elderly care needs and the associated negati...BACKGROUND China has recently encountered severe challenges associated with population aging.Parents of first-generation only children face significant challenges regarding elderly care needs and the associated negative emotions.AIM To analyze the elderly care needs of first-generation only child parents in China and identify factors that influence negative emotions.METHODS This study used a cross-sectional design.Convenience sampling was used to select 1580 elderly individuals who met the inclusion criteria in a Chinese city between June and September 2022.A questionnaire was administered to collect general information about participants.Depression and anxiety were assessed using the patient health questionnaire-9 and generalized anxiety disorder-7 scale,respectively.A logistic regression analysis was performed to evaluate the relevant correlations.RESULTS Among 1580 first-generation only child parents,1120(70.89%)preferred family based care,324(20.51%)opted for community care,and 136(8.61%)chose institutional care,with 460(29.11%)reporting negative emotions.Significant differences in the distribution of negative emotions among only child parents were observed based on age,marital status,living conditions,disability,type of chronic disease,frailty status,and family support(P<0.05).The regression analysis indicated that disability,type of chronic disease,living environment,frailty status,and level of family support were independent risk factors for negative emotions among parents with only children(P<0.05).CONCLUSION Elderly care for parents of only children is primarily family-based.Independent risk factors for negative emotions in this group include disability,chronic disease type,and living environment.展开更多
BACKGROUND Patients with middle and advanced hepatocellular carcinoma(HCC)frequently experience significant anxiety and depression,severely affecting their quality of life.AIM To examine the anxiety and depression sta...BACKGROUND Patients with middle and advanced hepatocellular carcinoma(HCC)frequently experience significant anxiety and depression,severely affecting their quality of life.AIM To examine the anxiety and depression status of patients with middle and advanced HCC,the influencing factors,and the correlation between these psychological factors and quality of life.METHODS We collected baseline data from 100 patients with HCC,assessing anxiety and depression levels using the Hamilton Anxiety Rating Scale(HAMA)and Hamilton Depression Rating Scale(HAMD).Quality of life was evaluated with the Functional Assessment of Cancer Therapy-Hepatobiliary Questionnaire.Multivariate logistic regression analyzed clinical and psychosocial factors affecting anxiety and depression,while Pearson correlation assessed relationships among HAMA,HAMD,and Functional Assessment of Cancer Therapy-Hepatobiliary Questionnaire scores.RESULTS Results indicated that 64%of patients exhibited anxiety and 65%showed depression symptoms.Key influencing factors included Barcelona Clinic Liver Cancer C stage,multiple tumors,social support,prior treatments(such as liver resection and transcatheter arterial chemoembolization/hepatic artery infusion chemotherapy),as well as HAMA and HAMD scores.Anxiety and depression correlated negatively with quality of life,with coefficients of-0.671 and-0.575 for HAMA and HAMD,respectively.CONCLUSION Anxiety and depression are prevalent among patients with middle and advanced HCC,impacting quality of life.This underscores the need for psychological health considerations in liver cancer treatment and establishing psychological interventions is essential.展开更多
Objective Accurately identifying the key influencing factors of psychological birth trauma in primiparous women is crucial for implementing effective preventive and intervention measures.This study aimed to develop an...Objective Accurately identifying the key influencing factors of psychological birth trauma in primiparous women is crucial for implementing effective preventive and intervention measures.This study aimed to develop and validate an interpretable machine learning prediction model for identifying the key influencing factors of psychological birth trauma in primiparous women.Methods A multicenter cross-sectional study was conducted on primiparous women in four tertiary hospitals in Sichuan Province,southwestern China,from December 2023 to March 2024.The Childbirth Trauma Index was used in assessing psychological birth trauma in primiparous women.Data were collected and randomly divided into a training set(80%,n=289)and a testing set(20%,n=73).Six different machine learning models were trained and tested.Training and prediction were conducted using six machine learning models included Linear Regression,Support Vector Regression,Multilayer Perceptron Regression,eXtreme Gradient Boosting Regression,Random Forest Regression,and Adaptive Boosting Regression.The optimal model was selected based on various performance metrics,and its predictive results were interpreted using SHapley Additive exPlanations(SHAP)and accumulated local effects(ALE).Results Among the six machine learning models,the Multilayer Perceptron Regression model exhibited the best overall performance in the testing set(MAE=3.977,MSE=24.832,R2=0.507,EVS=0.524,RMSE=4.983).In the testing set,the R2 and EVS of the Multilayer Perceptron Regression model increased by 8.3%and 1.2%,respectively,compared to the traditional linear regression model.Meanwhile,the MAE,MSE,and RMSE decreased by 0.4%,7.3%,and 3.7%,respectively,compared to the traditional linear regression model.The SHAP analysis indicated that intrapartum pain,anxiety,postpartum pain,resilience,and planned pregnancy are the most critical influencing factors of psychological birth trauma in primiparous women.The ALE analysis indicated that higher intrapartum pain,anxiety,and postpartum pain scores are risk factors,while higher resilience scores are protective factors.Conclusions Interpretable machine learning prediction models can identify the key influencing factors of psychological birth trauma in primiparous women.SHAP and ALE analyses based on the Multilayer Perceptron Regression model can help healthcare providers understand the complex decision-making logic within a prediction model.This study provides a scientific basis for the early prevention and personalized intervention of psychological birth trauma in primiparous women.展开更多
This paper thoroughly explores the multifaceted factors influencing the efficacy of Chinese medicinals and categorizes them into three main groups:medicinal related factors,patient related factors,and practitioner rel...This paper thoroughly explores the multifaceted factors influencing the efficacy of Chinese medicinals and categorizes them into three main groups:medicinal related factors,patient related factors,and practitioner related factors.Regarding medicinal related factors,the place of origin,growing environment,harvesting time,storage conditions,quality control,dosage form selection,compatibility of medicinals,precise dosing,decoction methods,and administration routes all significantly impact efficacy.The place of origin determines the authenticity of medicinals,the growing environment affects their composition,harvesting time influences potency,improper storage leads to deterioration,quality control forms the foundation of efficacy,dosage forms and compatibility of medicinals affect absorption,dosing and decoction methods require precision,and administration routes should be tailored to individuals.Patient related factors include psychological state,individual differences,background,and disease condition.Psychological state affects treatment compliance,individual differences determine medicine responses,background influences patients’understanding of Chinese medicinals,and disease condition directly reflects efficacy.Practitioner related factors encompass theoretical knowledge,clinical experience,inherited practices,psychological state,and professional ethics.Theoretical knowledge guides medication use,clinical experience enhances efficacy,inherited practices influence prescribing styles,psychological state affects doctor–patient communication,and professional ethics ensure medical quality.These interrelated factors collectively influence the efficacy of Chinese medicinals,emphasizing the need for comprehensive consideration in clinical applications to achieve optimal therapeutic outcomes.展开更多
Cross-border e-commerce,as a new form of international trade,has shown great development potential in the context of the“Belt and Road”initiative.Based on the cross-border e-commerce export data from 2015 to 2024,th...Cross-border e-commerce,as a new form of international trade,has shown great development potential in the context of the“Belt and Road”initiative.Based on the cross-border e-commerce export data from 2015 to 2024,this paper analyzes the influencing factors of China's cross-border e-commerce exports to countries along the“Belt and Road”by constructing an econometric model.The study found that factors such as the perfection of digital infrastructure,the efficiency of logistics and transportation,the convenience of payment and settlement,and the penetration rate of consumers online shopping significantly affect the export scale of cross-border e-commerce.Institutional factors such as the development level of e-commerce platforms in countries along the route,market access thresholds,and tariff policies also play an important role.Based on the research results,suggestions are put forward to strengthen the construction of cross-border payment system,optimize the logistics distribution network,promote customs clearance facilitation,and deepen cooperation in the field of e-commerce,to provide references for promoting the development of China's crossborder e-commerce exports to countries along the“Belt and Road.”展开更多
[Objectives]To study the factors influencing the tourism economy in Henan Province.[Methods]Using tourism-related data from Henan Province covering the period from 2000 to 2020,this study constructs a regression model...[Objectives]To study the factors influencing the tourism economy in Henan Province.[Methods]Using tourism-related data from Henan Province covering the period from 2000 to 2020,this study constructs a regression model based on multivariate statistical methods to investigate the determinants of the tourism economy.The dependent variable in the model is the domestic tourism revenue of Henan Province,while the independent variables comprise the number of tourist arrivals,total operational railway mileage,the number of travel agencies,and the per capita disposable income of urban residents.[Results]Both the total railway mileage and the per capita disposable income of urban residents are the primary factors influencing the development of Henan's tourism economy.[Conclusions]It is recommended to reduce uncertainty and liquidity constraints to mitigate residents'precautionary savings behavior,actively expand domestic demand to leverage tourism as an economic driver,and improve infrastructure to support tourism development.展开更多
Based on questionnaire data from Niutouzhen Village Units 1-7 in Shuangwangcheng Economic Zone,Shouguang City,Shandong Province,this study employs a binary logistic regression model to explore the factors influencing ...Based on questionnaire data from Niutouzhen Village Units 1-7 in Shuangwangcheng Economic Zone,Shouguang City,Shandong Province,this study employs a binary logistic regression model to explore the factors influencing farmers'willingness to transfer farmland,and uses SPSS 27.0 software to perform regression analysis on the data.The results indicate that farmers'educational level,age of the household head,and contracted land area have a positive influence on farmers'willingness to transfer farmland at the 0.05 significance level,while annual household income has a positive influence at the 0.10 significance level.Furthermore,based on the regression analysis results,measures are proposed,including establishing and improving the rural land transfer compensation mechanism,enhancing publicity for land transfer,refining land transfer laws and regulations,optimizing the rural social security system,and actively expanding non-agricultural employment channels.These measures are intended to provide references for promoting farmland transfer work in Shouguang City.展开更多
Objective:To explore the barriers and facilitators associated with the implementation of horticultural activities(HA)in nursing care homes,and aim to identify findings that will enhance the development of more effecti...Objective:To explore the barriers and facilitators associated with the implementation of horticultural activities(HA)in nursing care homes,and aim to identify findings that will enhance the development of more effective implementation strategies for such activities.Methods:This qualitative descriptive study recruited a purposive sample of potential adopters related to HA in nursing care homes,and the conventional content analysis method was adopted.Results:A total of 6 older adults,3 social workers,1 nurse,and 1 physician participated in this study.The analysis revealed 4 themes barriers and 2 themes facilitators to the implementation of HA.Conclusions:Future intervention programs should be meticulously designed to address the identified influencing factors,and the insights gained can serve as a reference for identifying and mitigating barriers in the implementation of other physical activity programs.In turn,this will contribute to improved physical functioning and healthy aging.展开更多
Adolescence is a crucial period marked by significant developmental changes,during which risk-taking behaviors can be both a normative part of development and a potential source of concern.However,prior research has f...Adolescence is a crucial period marked by significant developmental changes,during which risk-taking behaviors can be both a normative part of development and a potential source of concern.However,prior research has focused predominantly on the adverse aspects of risk-taking(i.e.,negative risk-taking),overlooked the positive counterpart(i.e.,positive risk-taking),and lacked a detailed examination of both.This study aims to elucidate the distinct characteristics and interrelationships of positive and negative risk-taking behaviors among adoles-cents and to identify the key factors that influence these behaviors.Through a comprehensive synthesis of theoretical and empirical literature,we explore the multifaceted nature of risk-taking,highlighting its complex influencing factors,including individual traits,family dynamics,peer influence,school environment,and broader community contexts.By identifying the shared and unique factors contributing to positive and negative risk-taking behaviors,we can enable adolescents to navigate this complex stage of life and design targeted interventions.Future research directions include the application of person-centered approaches,the implementation of longitudinal tracking and the interactive effects of influencing factors,among other aspects.展开更多
BACKGROUND Glaucoma,a condition frequently linked to severe depression,anxiety,and sleep disturbances,affects treatment adherence while potentially compromising effectiveness.AIM To explore illness uncertainty(IU),anx...BACKGROUND Glaucoma,a condition frequently linked to severe depression,anxiety,and sleep disturbances,affects treatment adherence while potentially compromising effectiveness.AIM To explore illness uncertainty(IU),anxiety,and depressive symptoms in primary glaucoma and to discuss underlying triggers.METHODS We recruited 120 primary glaucoma cases between January 2022 and November 2023.The Mishel Uncertainty in Illness Scale(MUIS)and the Hospital Anxiety and Depression Scale(HADS)[include HADS-anxiety subscale(HADS-A)and HADS-depression subscale(HADS-D)]subscales,were used to assess IU and emotional distress(anxiety/depression),respectively.The MUIS-HADS subscale interrelationships were determined by Pearson correlation.IU-associated determinants were identified using univariate and binary logistic regression analyses.RESULTS The cohort showed a mean MUIS score of 79.73±8.97,corresponding to a moderately high IU level.The HADS-A and HADS-D scores averaged 6.57±3.89 and 7.08±5.05 points,respectively,with 15.00%of participants showing anxiety symptoms and 24.17%exhibiting depressive signs.Significant positive connections were observed between MUIS and both HADS-A(r=0.359,P<0.001)and HADSD(r=0.426,P<0.001).Univariate analysis revealed that disease duration,insomnia,monthly household income per capita,and the presence of comorbid chronic conditions were significantly associated with anxiety or depression.Multivariate analysis identified insomnia as a risk factor and higher monthly household income as a protective factor.CONCLUSION Patients with primary glaucoma experience moderate IU levels,generally low anxiety,and mild depression.Specifically,the anxiety and depression risks were 15.00%and 24.17%,respectively.A significant positive correlation existed between IU and anxiety/depression in these patients.Additionally,insomnia or lower monthly household income elevated anxiety/depression risks,enabling reliable anxiety/depression risk categorization among patients.展开更多
Objectives:To assess job satisfaction among anesthesia graduates working in various medical institutions across China.Methods:A cross-sectional survey was conducted,collecting demographic information,Minnesota Satisfa...Objectives:To assess job satisfaction among anesthesia graduates working in various medical institutions across China.Methods:A cross-sectional survey was conducted,collecting demographic information,Minnesota Satisfaction Questionnaire scores,work pressure,and turnover intentions.Multiple linear regression analysis was used to examine factors influencing job satisfaction.The electronic survey was distributed to Chinese anesthesia graduates from December 2021 to January 2022.Results:A total of 595 questionnaires were distributed,with 318 valid responses,resulting in a response rate of 53.4%.The participants’overall job satisfaction score on the Minnesota Satisfaction Questionnaire was 75.85±12.57.Multiple linear regression analysis identified the following variables as significantly associated with job satisfaction:age,daily working hours,income,current position,and work pressure.Conclusions:Anesthesia graduates in China reported slightly higher-than-average overall job satisfaction.However,several issues remain.Attention should be given to the impact of factors such as youth,long working hours,low income,current position,and high work pressure on job satisfaction.The government should support anesthesiologists with improved training,job security,and benefits to enhance job satisfaction.展开更多
BACKGROUND Anxiety and depression are highly prevalent among patients with cervical cancer(CC).However,few studies have systematically analyzed the psychological effects of tumor stage,treatment methods,and related fa...BACKGROUND Anxiety and depression are highly prevalent among patients with cervical cancer(CC).However,few studies have systematically analyzed the psychological effects of tumor stage,treatment methods,and related factors on these patients,or developed predictive models for these outcomes.AIM To identify factors influencing anxiety and depression in patients with CC and construct predictive models.METHODS We retrospectively analyzed data from 119 patients with CC treated at the Gynecology Department of Suzhou Ninth People’s Hospital between January 2017 and May 2025.Clinical data,psychological hope levels at diagnosis,and Self-Rating Anxiety Scale and Self-Rating Depression Scale scores during treatment were collected.Influencing factors were identified,and predictive models were developed.The model performance was evaluated using receiver operating characteristic(ROC)curves and the Hosmer-Lemeshow goodness-of-fit test.RESULTS During treatment,64.71%of the patients experienced anxiety and 52.10%experienced depression.Significant differences in family income,tumor stage,treatment modality,and hope level were observed between patients with and without anxiety/depression(P<0.05).Multivariate analysis showed that a family monthly income<5000 yuan,stage III-IV tumor,comprehensive treatment,and low hope level were independent risk factors(P<0.05).The predictive formula for anxiety was as follows:Logit(P)=0.795×monthly income+0.594×tumor stage+1.095×treatment method+1.184×hope level−9.176;for depression:Logit(P)=0.432×monthly income+0.518×tumor stage+0.727×treatment method+1.095×hope level−8.541.The area under the ROC curves were 0.865 for anxiety and 0.837 for depression.Goodness-of-fit test confirmed no overfitting(P>0.05).CONCLUSION Family income,tumor stage,treatment method,and hope level are key determinants of anxiety and depression in patients with CC.Predictive models incorporating these factors can effectively assess risk of anxiety and depression during treatment.展开更多
BACKGROUND The development of prostate cancer(PC)frequently intensifies negative emotional states,such as anxiety and depression,which compromise the effectiveness of radical surgery and reduce treatment adherence.In ...BACKGROUND The development of prostate cancer(PC)frequently intensifies negative emotional states,such as anxiety and depression,which compromise the effectiveness of radical surgery and reduce treatment adherence.In this study,we hypothesized that psychological resilience plays a crucial role in this process and explored its impact.AIM To investigate the association of resilience with anxiety and depression in patients with PC and to analyze the influencing factors.METHODS We selected 147 patients with PC who visited Qingdao Traditional Chinese Medicine Hospital from January 2022 to June 2024.The resilience scores of patients with PC were assessed using the Connor-Davidson Resilience Scale(CDRISC)from the tenacity,self-improvement,and optimism dimensions.Based on the total CD-RISC score,patients were categorized into groups A(total CD-RISC score>63 points,n=69)and B(total CD-RISC score≤63 points,n=78)for comparative analysis of anxiety[Hamilton Anxiety Rating Scale(HAMA)],depression[Hamilton Depression Rating Scale(HAMD)],sexual function[International Index of Erectile Function-5(IIEF-5)and Sexual Life Quality Questionnaire-Quality of Life(SLQQ-QOL)],and quality of life[the EORTC Core Quality of Life Question naire(QLQ-C30)].The association between CD-RISC and the above indicators was analyzed with Spearman correlation coefficients,and the influencing factors of resilience in patients with PC were identified with binary logistic regression.RESULTS Group A demonstrated statistically lower HAMA and HAMD scores and markedly higher scores of IIEF-5,SLQQQOL,and various QLQ-C30 aspects.Correlation analysis revealed that CD-RISC was significantly negatively correlated with HAMA and HAMD scores and significantly positively correlated with IIEF-5,SLQQ-QOL,and QLQ-C30 total scores.Binary logistic regression analysis revealed educational and per capita monthly household income levels as significant influencing factors of resilience in patients with PC.CONCLUSION Our results indicate a significant correlation of resilience with anxiety and depression in patients with PC.The milder the anxiety and depression emotions in patients,the higher their resilience.Further,assisting patients with PC to improve their educational and per capita monthly household income levels will help their resilience to some extent.展开更多
With the accelerated pace of population aging in China,the number of patients suffering from myocardial infarction(MI)is increasing annually.During disease progression,patients are at significantly higher risk of deve...With the accelerated pace of population aging in China,the number of patients suffering from myocardial infarction(MI)is increasing annually.During disease progression,patients are at significantly higher risk of developing severe negative emotions,and emerging evidence suggests that post-traumatic stress disorder(PTSD)is significantly associated with cardiovascular disease,which seriously affects patients’quality of life.Objective:The aim of this study was to comprehensively assess the prevalence and influencing factors of PTSD in MI patients through systematic review and Meta-analysis.Methods:A computerized search of PubMed,the Cochrane Library,Embase,Web of Science,PsycINFO,China Knowledge Network(CNKI),WanFang Data,VIP,and China Biomedical Literature Database(CBM)was conducted to collect longitudinal studies,case-control studies,and cross-sectional studies related to PTSD prevalence rates and influencing factors in MI patients published up to August 1,2024.Literature screening,data extraction and quality assessment were done independently by two researchers and Meta-analysis was done using Stata 16.0 software.This study has been registered on the PROSPERO platform,registration number:CRD42024577243.Results:A total of 16 papers were included,with a total sample size of 3,768 cases involving 8 influencing factors.The results of the Meta-analysis showed that the prevalence of PTSD in patients with MI was 20.4%(95%CI=15.0–26.5%).Female(OR=3.12,95%CI=1.97–4.97,P<0.001),high neuroticism score(OR=2.21,95%CI=1.20–4.07,P=0.011),and high intrusive rumination score(OR=2.95,95%CI=1.50–5.83,P=0.002)were the risk factors for PTSD in MI patients.While age(OR=1.01,95%CI=0.98–1.04,P=0.440),education level(OR=0.55,95%CI=0.07–4.48,P=0.574),social support rating scale(OR=0.81,95%CI=0.52–1.26,P=0.346),Killip cardiac function classification(OR=2.29,95%CI=0.91–5.80,P=0.080)and creatine kinase isoenzyme(OR=1.03,95%CI=0.99–1.05,P=0.124)were not associated with the development of PTSD in MI patients.Conclusion:The prevalence of PTSD was higher in patients with MI.The prevalence varied by evaluation tool and study area.Risk factors were multifactorial,including general factors(female)and overall assessment(high neuroticism score,high invasive rumination score).Therefore,early intervention and proper de-escalation of PTSD symptoms in patients with MI by medical staff are needed in clinical practice to reduce the risk of PTSD.展开更多
基金Supported by the Scientific Research Projects of the Health System in Pingshan District,No.2023122.
文摘BACKGROUND Lumbar interbody fusion(LIF)is the primary treatment for lumbar degenerative diseases.Elderly patients are prone to anxiety and depression after undergoing surgery,which affects their postoperative recovery speed and quality of life.Effective prevention of anxiety and depression in elderly patients has become an urgent problem.AIM To investigate the trajectory of anxiety and depression levels in elderly patients after LIF,and the influencing factors.METHODS Random sampling was used to select 239 elderly patients who underwent LIF from January 2020 to December 2024 in Shenzhen Pingle Orthopedic Hospital.General information and surgery-related indices were recorded,and participants completed measures of psychological status,lumbar spine dysfunction,and quality of life.A latent class growth model was used to analyze the post-LIF trajectory of anxiety and depression levels,and unordered multi-categorical logistic regression was used to analyze the influencing factors.RESULTS Three trajectories of change in anxiety level were identified:Increasing anxiety(n=26,10.88%),decreasing anxiety(n=27,11.30%),and stable anxiety(n=186,77.82%).Likewise,three trajectories of change in depression level were identified:Increasing depression(n=30,12.55%),decreasing depression(n=26,10.88%),and stable depression(n=183,76.57%).Regression analysis showed that having no partner,female sex,elevated Oswestry dysfunction index(ODI)scores,and reduced 36-Item Short Form Health Survey scores all contributed to increased anxiety levels,whereas female sex,postoperative opioid use,and elevated ODI scores all contributed to increased depression levels.CONCLUSION During clinical observation,combining factors to predict anxiety and depression in post-LIF elderly patients enables timely intervention,quickens recovery,and enhances quality of life.
基金supported by the National Natural Science Foundation of China(82574173,82003516)Jiangsu Provincial Natural Science Foundation(BK20251958)+2 种基金Jiangsu Provincial Medical Key Discipline(ZDXK202250)Top Talent Awards Project Fund(RDF-TP-0023,RDF-TP-0030)Postgraduate Research Fund(PGRS2112022)at Xi'an Jiaotong-Liverpool University.
文摘Tuberculosis(TB),one of the oldest infectious diseases caused by Mycobacterium tuberculosis,poses a considerable challenge to global public health.There are approximately 10 million new TB cases worldwide annually,and TB claims the lives of nearly 3 million people each year,making it one of the leading causes of death from a single infectious disease[1].China ranks third globally in terms of TB burden,with approximately 733,000 TB cases reported in 2023[2].Based on the ecological model of health determinants developed by Whitehead and Dahlgren,health determinants can be classified into direct causes.
基金supported by the Natural Science Foundation of China(No.52470105)the Young Taishan Scholars Program of Shandong Province(No.358202103017).
文摘The discharge of micro-polluted water from sources such as agricultural runoff,urban stormwater,and treated effluents presents significant challenges to aquatic ecosystems.Constructed wetlands(CWs)have gained recog-nition as an eco-friendly solution for removing pollutants from various wastewater sources and are increasingly applied for micro-polluted water treatment.By reviewing 78 full-scale CW studies from Web of Science,it is summarized that the ranges of ammonium nitrogen(NH4+-N)concentrations in runoff,wastewater treatment plant effluent and polluted river were 0.1–6.6,0.3–12.3,and 0.2–41.1 mg/L,respectively.The ranges of ni-trate nitrogen concentrations were 0.2–14.2,0–5.7,and 0–2.6 mg/L,respectively.Removal efficiencies of CWs for micro-polluted water varied by CW types.The total nitrogen removal efficiencies for subsurface-flow CWs,free-water surface-flow CWs,and hybrid CWs ranged from 27.4%to 66.5%,16.8%to 89.8%,and 19.4%to 88.2%,respectively.The NH4+-N removal efficiencies ranged from 34.2%to 73.6%,38.4%to 89.4%and 13.5%to 94.2%,respectively.Additionally,other factors influencing contaminant removal efficiency such as hydraulic retention time,vegetation types,redox micro-environment and influent water quality were evaluated.Based on these findings,two strategies for improving the purification performance of CWs were proposed:the selection of incorporating electron donor substrates and the optimization of operation parameters.This paper serves as a synthesis of information to guide future research and full-scale CW applications in micro-polluted water treatment.
基金China Health and Retirement Longitudinal Study(CHARLS)the 2022-2023 Nursing Research Project of Chinese Medical Association Publishing House(Grant No.CMAPH-NRD2022024)。
文摘Background:The trajectory of intrinsic capacity(IC)among the older population is characterized by its diversity and is predictive of adverse health outcomes such as disability,nursing home admission,decline in quality of life,and mortality.Gaining an understanding of the trajectory of IC and the factors that influence it is of paramount importance for fostering healthy aging.This research is focused on exploring the trajectory of IC among older adults in China and examining the factors that influence it.Methods:This observational longitudinal cohort study leveraged data from the China Health and Retirement Longitudinal Study(CHARLS),which was conducted in the years 2011,2013,and 2015.For the purpose of this analysis,a total of 2,233 participants who were aged 60 and over were included.A Growth Mixture Model(GMM)was utilized to define trajectory categories for IC.Influential factors were ascertained based on the health ecology model,and binary logistic regression analysis was utilized to investigate the factors linked with the different trajectory categories.Results:Two distinct trajectory classes of IC were identified:Class 1,the normal-stable group,encompassed 90.4%of the elderly population,while Class 2,the declining group,made up 9.6%.Advanced age and a history of stroke were found to be significantly associated with Class 2.High scores in activities of daily living(ADL),employment status,receiving primary or junior high school education,and residence in the East or Central regions of China were significantly linked with Class 1.Conclusion:The trajectory of IC among older Chinese adults is marked by its heterogeneity.Advanced age and a history of stroke are significant risk factors for a declining IC trajectory,while higher ADL scores,being employed,receiving primary or junior high school education,and residing in the East or Central regions of China are protective factors associated with a stable IC trajectory.Healthcare institutions must closely monitor IC levels and understand these trajectory patterns to implement personalized and targeted interventions promptly to maintain IC at a healthy level and advocate for healthy aging.
基金National Nonprofit Institute Research Grant of CAF,No.CAFYBB2018ZA004,No.CAFYBB2023ZA009Fengyun Application Pioneering Project,No.FY-APP-ZX-2023.02。
文摘Water use efficiency(WUE),as a pivotal indicator of the coupling degree within the carbon–water cycle of ecosystems,holds considerable importance in assessment of the carbon–water balance within terrestrial ecosystems.However,in the context of global warming,WUE evolution and its primary drivers on the Tibetan Plateau remain unclear.This study employed the ensemble empirical mode decomposition method and the random forest algorithm to decipher the nonlinear trends and drivers of WUE on the Tibetan Plateau in 2001–2020.Results indicated an annual mean WUE of 0.8088 gC/mm·m^(2)across the plateau,with a spatial gradient reflecting decrease from the southeast toward the northwest.Areas manifesting monotonous trends of increase or decrease in WUE accounted for 23.64%and 9.69%of the total,respectively.Remarkably,66.67%of the region exhibited trend reversals,i.e.,39.94%of the area of the Tibetan Plateau showed transition from a trend of increase to a trend of decrease,and 26.73%of the area demonstrated a shift from a trend of decrease to a trend of increase.Environmental factors accounted for 70.79%of the variability in WUE.The leaf area index and temperature served as the major driving forces of WUE variation.
文摘BACKGROUND The development of hepatocellular carcinoma(HCC)is influenced by multiple factors.Interventional therapy offers an effective treatment option for patients with unresectable intermediate-to-advanced HCC.Interventional therapy can induce electrocardiographic(ECG)abnormalities that may be associated with liver dysfunction,electrolyte disorders,and cardiac injury.AIM To explore the ECG alterations and determinants following interventional therapy in patients with HCC.METHODS Sixty patients undergoing interventional treatment for liver cancer were selected as study participants.According to the results of the dynamic ECG examination 1 day after surgery,the patients were divided into an abnormal group(n=21)and a nonabnormal group(n=39).With the help of dynamic ECG examination,the ECG parameters were compared and the baseline data of patients was recorded in the two groups.RESULTS The 24 hours QT interval variability,24 hours normal atrial polarization to ventricular polarization(R-R)interval(standard deviation),24 hours consecutive 5 minutes normal R-R interval,and 24 hours continuous 5 minutes normal R-R interval(standard deviation mean)were lower than patients in the nonabnormal group(P<0.05).The logistic analysis showed that age>60 years,liver function grade B,and postoperative body temperature 38°C were risk factors for abnormal dynamic electrocardiogram in patients with liver cancer intervention(P<0.05).CONCLUSION Interventional therapy for HCC can lead to ECG abnormalities,underscoring the clinical need for enhanced cardiac monitoring to mitigate myocardial complications.
基金Supported by General Projects of Henan Province Universities Humanities and Social Sciences Research in 2023,No.2023-ZDJH-533.
文摘BACKGROUND China has recently encountered severe challenges associated with population aging.Parents of first-generation only children face significant challenges regarding elderly care needs and the associated negative emotions.AIM To analyze the elderly care needs of first-generation only child parents in China and identify factors that influence negative emotions.METHODS This study used a cross-sectional design.Convenience sampling was used to select 1580 elderly individuals who met the inclusion criteria in a Chinese city between June and September 2022.A questionnaire was administered to collect general information about participants.Depression and anxiety were assessed using the patient health questionnaire-9 and generalized anxiety disorder-7 scale,respectively.A logistic regression analysis was performed to evaluate the relevant correlations.RESULTS Among 1580 first-generation only child parents,1120(70.89%)preferred family based care,324(20.51%)opted for community care,and 136(8.61%)chose institutional care,with 460(29.11%)reporting negative emotions.Significant differences in the distribution of negative emotions among only child parents were observed based on age,marital status,living conditions,disability,type of chronic disease,frailty status,and family support(P<0.05).The regression analysis indicated that disability,type of chronic disease,living environment,frailty status,and level of family support were independent risk factors for negative emotions among parents with only children(P<0.05).CONCLUSION Elderly care for parents of only children is primarily family-based.Independent risk factors for negative emotions in this group include disability,chronic disease type,and living environment.
文摘BACKGROUND Patients with middle and advanced hepatocellular carcinoma(HCC)frequently experience significant anxiety and depression,severely affecting their quality of life.AIM To examine the anxiety and depression status of patients with middle and advanced HCC,the influencing factors,and the correlation between these psychological factors and quality of life.METHODS We collected baseline data from 100 patients with HCC,assessing anxiety and depression levels using the Hamilton Anxiety Rating Scale(HAMA)and Hamilton Depression Rating Scale(HAMD).Quality of life was evaluated with the Functional Assessment of Cancer Therapy-Hepatobiliary Questionnaire.Multivariate logistic regression analyzed clinical and psychosocial factors affecting anxiety and depression,while Pearson correlation assessed relationships among HAMA,HAMD,and Functional Assessment of Cancer Therapy-Hepatobiliary Questionnaire scores.RESULTS Results indicated that 64%of patients exhibited anxiety and 65%showed depression symptoms.Key influencing factors included Barcelona Clinic Liver Cancer C stage,multiple tumors,social support,prior treatments(such as liver resection and transcatheter arterial chemoembolization/hepatic artery infusion chemotherapy),as well as HAMA and HAMD scores.Anxiety and depression correlated negatively with quality of life,with coefficients of-0.671 and-0.575 for HAMA and HAMD,respectively.CONCLUSION Anxiety and depression are prevalent among patients with middle and advanced HCC,impacting quality of life.This underscores the need for psychological health considerations in liver cancer treatment and establishing psychological interventions is essential.
基金supported by the Sichuan Province Nursing Scientific Research Project Plan(H23022)the 2022 Municipal-University Science and Technology Strategic Cooperation Special Fund of Nanchong Science and Technology Bureau(22SXQT0222)。
文摘Objective Accurately identifying the key influencing factors of psychological birth trauma in primiparous women is crucial for implementing effective preventive and intervention measures.This study aimed to develop and validate an interpretable machine learning prediction model for identifying the key influencing factors of psychological birth trauma in primiparous women.Methods A multicenter cross-sectional study was conducted on primiparous women in four tertiary hospitals in Sichuan Province,southwestern China,from December 2023 to March 2024.The Childbirth Trauma Index was used in assessing psychological birth trauma in primiparous women.Data were collected and randomly divided into a training set(80%,n=289)and a testing set(20%,n=73).Six different machine learning models were trained and tested.Training and prediction were conducted using six machine learning models included Linear Regression,Support Vector Regression,Multilayer Perceptron Regression,eXtreme Gradient Boosting Regression,Random Forest Regression,and Adaptive Boosting Regression.The optimal model was selected based on various performance metrics,and its predictive results were interpreted using SHapley Additive exPlanations(SHAP)and accumulated local effects(ALE).Results Among the six machine learning models,the Multilayer Perceptron Regression model exhibited the best overall performance in the testing set(MAE=3.977,MSE=24.832,R2=0.507,EVS=0.524,RMSE=4.983).In the testing set,the R2 and EVS of the Multilayer Perceptron Regression model increased by 8.3%and 1.2%,respectively,compared to the traditional linear regression model.Meanwhile,the MAE,MSE,and RMSE decreased by 0.4%,7.3%,and 3.7%,respectively,compared to the traditional linear regression model.The SHAP analysis indicated that intrapartum pain,anxiety,postpartum pain,resilience,and planned pregnancy are the most critical influencing factors of psychological birth trauma in primiparous women.The ALE analysis indicated that higher intrapartum pain,anxiety,and postpartum pain scores are risk factors,while higher resilience scores are protective factors.Conclusions Interpretable machine learning prediction models can identify the key influencing factors of psychological birth trauma in primiparous women.SHAP and ALE analyses based on the Multilayer Perceptron Regression model can help healthcare providers understand the complex decision-making logic within a prediction model.This study provides a scientific basis for the early prevention and personalized intervention of psychological birth trauma in primiparous women.
文摘This paper thoroughly explores the multifaceted factors influencing the efficacy of Chinese medicinals and categorizes them into three main groups:medicinal related factors,patient related factors,and practitioner related factors.Regarding medicinal related factors,the place of origin,growing environment,harvesting time,storage conditions,quality control,dosage form selection,compatibility of medicinals,precise dosing,decoction methods,and administration routes all significantly impact efficacy.The place of origin determines the authenticity of medicinals,the growing environment affects their composition,harvesting time influences potency,improper storage leads to deterioration,quality control forms the foundation of efficacy,dosage forms and compatibility of medicinals affect absorption,dosing and decoction methods require precision,and administration routes should be tailored to individuals.Patient related factors include psychological state,individual differences,background,and disease condition.Psychological state affects treatment compliance,individual differences determine medicine responses,background influences patients’understanding of Chinese medicinals,and disease condition directly reflects efficacy.Practitioner related factors encompass theoretical knowledge,clinical experience,inherited practices,psychological state,and professional ethics.Theoretical knowledge guides medication use,clinical experience enhances efficacy,inherited practices influence prescribing styles,psychological state affects doctor–patient communication,and professional ethics ensure medical quality.These interrelated factors collectively influence the efficacy of Chinese medicinals,emphasizing the need for comprehensive consideration in clinical applications to achieve optimal therapeutic outcomes.
文摘Cross-border e-commerce,as a new form of international trade,has shown great development potential in the context of the“Belt and Road”initiative.Based on the cross-border e-commerce export data from 2015 to 2024,this paper analyzes the influencing factors of China's cross-border e-commerce exports to countries along the“Belt and Road”by constructing an econometric model.The study found that factors such as the perfection of digital infrastructure,the efficiency of logistics and transportation,the convenience of payment and settlement,and the penetration rate of consumers online shopping significantly affect the export scale of cross-border e-commerce.Institutional factors such as the development level of e-commerce platforms in countries along the route,market access thresholds,and tariff policies also play an important role.Based on the research results,suggestions are put forward to strengthen the construction of cross-border payment system,optimize the logistics distribution network,promote customs clearance facilitation,and deepen cooperation in the field of e-commerce,to provide references for promoting the development of China's crossborder e-commerce exports to countries along the“Belt and Road.”
文摘[Objectives]To study the factors influencing the tourism economy in Henan Province.[Methods]Using tourism-related data from Henan Province covering the period from 2000 to 2020,this study constructs a regression model based on multivariate statistical methods to investigate the determinants of the tourism economy.The dependent variable in the model is the domestic tourism revenue of Henan Province,while the independent variables comprise the number of tourist arrivals,total operational railway mileage,the number of travel agencies,and the per capita disposable income of urban residents.[Results]Both the total railway mileage and the per capita disposable income of urban residents are the primary factors influencing the development of Henan's tourism economy.[Conclusions]It is recommended to reduce uncertainty and liquidity constraints to mitigate residents'precautionary savings behavior,actively expand domestic demand to leverage tourism as an economic driver,and improve infrastructure to support tourism development.
文摘Based on questionnaire data from Niutouzhen Village Units 1-7 in Shuangwangcheng Economic Zone,Shouguang City,Shandong Province,this study employs a binary logistic regression model to explore the factors influencing farmers'willingness to transfer farmland,and uses SPSS 27.0 software to perform regression analysis on the data.The results indicate that farmers'educational level,age of the household head,and contracted land area have a positive influence on farmers'willingness to transfer farmland at the 0.05 significance level,while annual household income has a positive influence at the 0.10 significance level.Furthermore,based on the regression analysis results,measures are proposed,including establishing and improving the rural land transfer compensation mechanism,enhancing publicity for land transfer,refining land transfer laws and regulations,optimizing the rural social security system,and actively expanding non-agricultural employment channels.These measures are intended to provide references for promoting farmland transfer work in Shouguang City.
基金supported by the Science and Technology Research Project and funded by the Provincial-Ministry Co-construction Project(No.SBGJ202102186).
文摘Objective:To explore the barriers and facilitators associated with the implementation of horticultural activities(HA)in nursing care homes,and aim to identify findings that will enhance the development of more effective implementation strategies for such activities.Methods:This qualitative descriptive study recruited a purposive sample of potential adopters related to HA in nursing care homes,and the conventional content analysis method was adopted.Results:A total of 6 older adults,3 social workers,1 nurse,and 1 physician participated in this study.The analysis revealed 4 themes barriers and 2 themes facilitators to the implementation of HA.Conclusions:Future intervention programs should be meticulously designed to address the identified influencing factors,and the insights gained can serve as a reference for identifying and mitigating barriers in the implementation of other physical activity programs.In turn,this will contribute to improved physical functioning and healthy aging.
基金Soft Science Special Project of Gansu Basic Research Plan,No.25JRZA072Youth Project of Philosophy and Social Science Foundation of Gansu Province,No.2024QN015+1 种基金General Project of Philosophy and Social Science Foundation of Gansu Province,No.2024YB049Lanzhou Philosophy and Social Science Planning Project,No.24-B13.
文摘Adolescence is a crucial period marked by significant developmental changes,during which risk-taking behaviors can be both a normative part of development and a potential source of concern.However,prior research has focused predominantly on the adverse aspects of risk-taking(i.e.,negative risk-taking),overlooked the positive counterpart(i.e.,positive risk-taking),and lacked a detailed examination of both.This study aims to elucidate the distinct characteristics and interrelationships of positive and negative risk-taking behaviors among adoles-cents and to identify the key factors that influence these behaviors.Through a comprehensive synthesis of theoretical and empirical literature,we explore the multifaceted nature of risk-taking,highlighting its complex influencing factors,including individual traits,family dynamics,peer influence,school environment,and broader community contexts.By identifying the shared and unique factors contributing to positive and negative risk-taking behaviors,we can enable adolescents to navigate this complex stage of life and design targeted interventions.Future research directions include the application of person-centered approaches,the implementation of longitudinal tracking and the interactive effects of influencing factors,among other aspects.
文摘BACKGROUND Glaucoma,a condition frequently linked to severe depression,anxiety,and sleep disturbances,affects treatment adherence while potentially compromising effectiveness.AIM To explore illness uncertainty(IU),anxiety,and depressive symptoms in primary glaucoma and to discuss underlying triggers.METHODS We recruited 120 primary glaucoma cases between January 2022 and November 2023.The Mishel Uncertainty in Illness Scale(MUIS)and the Hospital Anxiety and Depression Scale(HADS)[include HADS-anxiety subscale(HADS-A)and HADS-depression subscale(HADS-D)]subscales,were used to assess IU and emotional distress(anxiety/depression),respectively.The MUIS-HADS subscale interrelationships were determined by Pearson correlation.IU-associated determinants were identified using univariate and binary logistic regression analyses.RESULTS The cohort showed a mean MUIS score of 79.73±8.97,corresponding to a moderately high IU level.The HADS-A and HADS-D scores averaged 6.57±3.89 and 7.08±5.05 points,respectively,with 15.00%of participants showing anxiety symptoms and 24.17%exhibiting depressive signs.Significant positive connections were observed between MUIS and both HADS-A(r=0.359,P<0.001)and HADSD(r=0.426,P<0.001).Univariate analysis revealed that disease duration,insomnia,monthly household income per capita,and the presence of comorbid chronic conditions were significantly associated with anxiety or depression.Multivariate analysis identified insomnia as a risk factor and higher monthly household income as a protective factor.CONCLUSION Patients with primary glaucoma experience moderate IU levels,generally low anxiety,and mild depression.Specifically,the anxiety and depression risks were 15.00%and 24.17%,respectively.A significant positive correlation existed between IU and anxiety/depression in these patients.Additionally,insomnia or lower monthly household income elevated anxiety/depression risks,enabling reliable anxiety/depression risk categorization among patients.
基金supported by the Basic Medical Research Foundation of Naval Medical University(2022SK029 and 2023QN035).
文摘Objectives:To assess job satisfaction among anesthesia graduates working in various medical institutions across China.Methods:A cross-sectional survey was conducted,collecting demographic information,Minnesota Satisfaction Questionnaire scores,work pressure,and turnover intentions.Multiple linear regression analysis was used to examine factors influencing job satisfaction.The electronic survey was distributed to Chinese anesthesia graduates from December 2021 to January 2022.Results:A total of 595 questionnaires were distributed,with 318 valid responses,resulting in a response rate of 53.4%.The participants’overall job satisfaction score on the Minnesota Satisfaction Questionnaire was 75.85±12.57.Multiple linear regression analysis identified the following variables as significantly associated with job satisfaction:age,daily working hours,income,current position,and work pressure.Conclusions:Anesthesia graduates in China reported slightly higher-than-average overall job satisfaction.However,several issues remain.Attention should be given to the impact of factors such as youth,long working hours,low income,current position,and high work pressure on job satisfaction.The government should support anesthesiologists with improved training,job security,and benefits to enhance job satisfaction.
基金Supported by 2024 Hospital-Level Research Start-up Fund,No.YK202426Suzhou Wujiang District"Science and Education for Health"Project,No.WWK202201Development Fund Project of the Affiliated Hospital of Xuzhou Medical University,No.XYFY202423.
文摘BACKGROUND Anxiety and depression are highly prevalent among patients with cervical cancer(CC).However,few studies have systematically analyzed the psychological effects of tumor stage,treatment methods,and related factors on these patients,or developed predictive models for these outcomes.AIM To identify factors influencing anxiety and depression in patients with CC and construct predictive models.METHODS We retrospectively analyzed data from 119 patients with CC treated at the Gynecology Department of Suzhou Ninth People’s Hospital between January 2017 and May 2025.Clinical data,psychological hope levels at diagnosis,and Self-Rating Anxiety Scale and Self-Rating Depression Scale scores during treatment were collected.Influencing factors were identified,and predictive models were developed.The model performance was evaluated using receiver operating characteristic(ROC)curves and the Hosmer-Lemeshow goodness-of-fit test.RESULTS During treatment,64.71%of the patients experienced anxiety and 52.10%experienced depression.Significant differences in family income,tumor stage,treatment modality,and hope level were observed between patients with and without anxiety/depression(P<0.05).Multivariate analysis showed that a family monthly income<5000 yuan,stage III-IV tumor,comprehensive treatment,and low hope level were independent risk factors(P<0.05).The predictive formula for anxiety was as follows:Logit(P)=0.795×monthly income+0.594×tumor stage+1.095×treatment method+1.184×hope level−9.176;for depression:Logit(P)=0.432×monthly income+0.518×tumor stage+0.727×treatment method+1.095×hope level−8.541.The area under the ROC curves were 0.865 for anxiety and 0.837 for depression.Goodness-of-fit test confirmed no overfitting(P>0.05).CONCLUSION Family income,tumor stage,treatment method,and hope level are key determinants of anxiety and depression in patients with CC.Predictive models incorporating these factors can effectively assess risk of anxiety and depression during treatment.
文摘BACKGROUND The development of prostate cancer(PC)frequently intensifies negative emotional states,such as anxiety and depression,which compromise the effectiveness of radical surgery and reduce treatment adherence.In this study,we hypothesized that psychological resilience plays a crucial role in this process and explored its impact.AIM To investigate the association of resilience with anxiety and depression in patients with PC and to analyze the influencing factors.METHODS We selected 147 patients with PC who visited Qingdao Traditional Chinese Medicine Hospital from January 2022 to June 2024.The resilience scores of patients with PC were assessed using the Connor-Davidson Resilience Scale(CDRISC)from the tenacity,self-improvement,and optimism dimensions.Based on the total CD-RISC score,patients were categorized into groups A(total CD-RISC score>63 points,n=69)and B(total CD-RISC score≤63 points,n=78)for comparative analysis of anxiety[Hamilton Anxiety Rating Scale(HAMA)],depression[Hamilton Depression Rating Scale(HAMD)],sexual function[International Index of Erectile Function-5(IIEF-5)and Sexual Life Quality Questionnaire-Quality of Life(SLQQ-QOL)],and quality of life[the EORTC Core Quality of Life Question naire(QLQ-C30)].The association between CD-RISC and the above indicators was analyzed with Spearman correlation coefficients,and the influencing factors of resilience in patients with PC were identified with binary logistic regression.RESULTS Group A demonstrated statistically lower HAMA and HAMD scores and markedly higher scores of IIEF-5,SLQQQOL,and various QLQ-C30 aspects.Correlation analysis revealed that CD-RISC was significantly negatively correlated with HAMA and HAMD scores and significantly positively correlated with IIEF-5,SLQQ-QOL,and QLQ-C30 total scores.Binary logistic regression analysis revealed educational and per capita monthly household income levels as significant influencing factors of resilience in patients with PC.CONCLUSION Our results indicate a significant correlation of resilience with anxiety and depression in patients with PC.The milder the anxiety and depression emotions in patients,the higher their resilience.Further,assisting patients with PC to improve their educational and per capita monthly household income levels will help their resilience to some extent.
文摘With the accelerated pace of population aging in China,the number of patients suffering from myocardial infarction(MI)is increasing annually.During disease progression,patients are at significantly higher risk of developing severe negative emotions,and emerging evidence suggests that post-traumatic stress disorder(PTSD)is significantly associated with cardiovascular disease,which seriously affects patients’quality of life.Objective:The aim of this study was to comprehensively assess the prevalence and influencing factors of PTSD in MI patients through systematic review and Meta-analysis.Methods:A computerized search of PubMed,the Cochrane Library,Embase,Web of Science,PsycINFO,China Knowledge Network(CNKI),WanFang Data,VIP,and China Biomedical Literature Database(CBM)was conducted to collect longitudinal studies,case-control studies,and cross-sectional studies related to PTSD prevalence rates and influencing factors in MI patients published up to August 1,2024.Literature screening,data extraction and quality assessment were done independently by two researchers and Meta-analysis was done using Stata 16.0 software.This study has been registered on the PROSPERO platform,registration number:CRD42024577243.Results:A total of 16 papers were included,with a total sample size of 3,768 cases involving 8 influencing factors.The results of the Meta-analysis showed that the prevalence of PTSD in patients with MI was 20.4%(95%CI=15.0–26.5%).Female(OR=3.12,95%CI=1.97–4.97,P<0.001),high neuroticism score(OR=2.21,95%CI=1.20–4.07,P=0.011),and high intrusive rumination score(OR=2.95,95%CI=1.50–5.83,P=0.002)were the risk factors for PTSD in MI patients.While age(OR=1.01,95%CI=0.98–1.04,P=0.440),education level(OR=0.55,95%CI=0.07–4.48,P=0.574),social support rating scale(OR=0.81,95%CI=0.52–1.26,P=0.346),Killip cardiac function classification(OR=2.29,95%CI=0.91–5.80,P=0.080)and creatine kinase isoenzyme(OR=1.03,95%CI=0.99–1.05,P=0.124)were not associated with the development of PTSD in MI patients.Conclusion:The prevalence of PTSD was higher in patients with MI.The prevalence varied by evaluation tool and study area.Risk factors were multifactorial,including general factors(female)and overall assessment(high neuroticism score,high invasive rumination score).Therefore,early intervention and proper de-escalation of PTSD symptoms in patients with MI by medical staff are needed in clinical practice to reduce the risk of PTSD.
