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Background: The prevalence of neoplastic polyps in gallbladder polyps (GPs) increases sharply with age and is associated with gallbladder carcinoma (GBC). This study aims to predict neoplastic polyps and provide appropriate treatment strategies based on preoperative ultrasound features in patients with different age level. Methods: According to the age classification of WHO, 1523 patients with GPs who underwent cholecystectomy from January 2015 to December 2019 at 11 tertiary hospitals in China were divided into young adults group (n=622), middle-aged group (n=665) and elderly group (n=236). Linear scoring models were established based on independent risk variables screened by the Logistic regression model in different age groups. The area under ROC (AUC) to evaluate the predictive ability of linear scoring models, long- and short- diameter of GPs. Results: Independent risk factors for neoplastic polyps included the number of polyps, polyp size (long diameter), and fundus in the young adults and elderly groups, while the number of polyps, polyp size (long diameter), and polyp size (short diameter) in the middle-aged groups. In different age groups, the AUCs of its linear scoring model were higher than the AUCs of the long- and short- diameter of GPs for differentiating neoplastic and non-neoplastic polyps (all P<0.05), and Hosmer-Lemeshow goodness of fit test showed that the prediction accuracy of the linear scoring models was higher than the long- and short- diameter of GPs (all P>0.05). Conclusion: The linear scoring models of the young adults, middle-aged and elderly groups can effectively distinguish neoplastic polyps from non-neoplastic polyps based on preoperative ultrasound features. [ABSTRACT FROM AUTHOR]

The number of patients with chronic kidney disease (CKD) is increasing worldwide, and the disease carries a serious physical and psychological burden that creates negative emotions among patients. The negative emotions limits patients' ability to manage their disease and prevents them from effectively delaying disease progression. In this study, we applied a network analysis to explore the network relationship between negative emotions and self-management in patients with CKD and to investigate the risk or protective effects of different components of negative emotions on self-management. The study was conducted from September 2021 to March 2022 in three tertiary hospitals in China, with data gathered via a convenience sampling method. 360 patients with CKD at stages 1 ~ 3 in the department of nephrology completed the Sociodemographic Questionnaire, Positive Affect and Negative Affect Scale and Chronic Kidney Disease Self-management Instrument. We used R4.1.1 software to estimate the network model and calculate the related indicators. The network showed that among negative emotions "irritated" was negatively correlated with "self-integration", "problem solving", "seeking social support" and "adherence to recommended regimen" in self-management. The correlations between "scared" and "self-integration", "nervous" and "problem solving", and "ashamed" and "seeking social support" were all positive. The bridge expected influence of "irritated" and "adherence to recommended regimen" were the highest, with values of -0.19 and 0.13, respectively. "Irritated" has a more obvious risk effect on self-management. This study provides an important target for interventions to reduce negative emotions and improve self-management ability in patients with CKD. [ABSTRACT FROM AUTHOR]

Background: Polyp size of 10 mm is insufficient to discriminate neoplastic and non-neoplastic risk in patients with gallbladder polyps (GPs). The aim of the study is to develop a Bayesian network (BN) prediction model to identify neoplastic polyps and create more precise criteria for surgical indications in patients with GPs lager than 10 mm based on preoperative ultrasound features. Methods: A BN prediction model was established and validated based on the independent risk variables using data from 759 patients with GPs who underwent cholecystectomy from January 2015 to August 2022 at 11 tertiary hospitals in China. The area under receiver operating characteristic curves (AUCs) were used to evaluate the predictive ability of the BN model and current guidelines, and Delong test was used to compare the AUCs. Results: The mean values of polyp cross-sectional area (CSA), long, and short diameter of neoplastic polyps were higher than those of non-neoplastic polyps (P < 0.0001). Independent neoplastic risk factors for GPs included single polyp, polyp CSA ≥ 85 mm 2, fundus with broad base, and medium echogenicity. The accuracy of the BN model established based on the above independent variables was 81.88% and 82.35% in the training and testing sets, respectively. Delong test also showed that the AUCs of the BN model was better than that of JSHBPS, ESGAR, US-reported, and CCBS in training and testing sets, respectively (P < 0.05). Conclusion: A Bayesian network model was accurate and practical for predicting neoplastic risk in patients with gallbladder polyps larger than 10 mm based on preoperative ultrasound features. [ABSTRACT FROM AUTHOR]

Aims: This study aimed to assess student nurses' competence and attitude toward spiritual care and analysed the associated factors. Design: Cross‐sectional study using an online survey. Methods: From April 14 to June 14, 2018, a convenience sample of 938 student nurses were recruited from six schools of Nursing in Hunan Province, China. Data were collected by using the Chinese versions of the Spiritual Care Competence Scale (C‐SCCS) and the Spiritual Care Attitude Scale (C‐SCAS). Results: The average total score on the C‐SCCS was 21.42 (±4.27) out of 30 and the C‐SCAS was 58.03 (±9.90) out of 75. Factors such as liking the nursing profession, attending a spiritual care course, participation in classroom learning or expert lecture, and supporting continuous and systematic training were the strongest predictors of higher spiritual care competence and attitude. A better attitude about spiritual care was a relatively moderate and significant predictor of higher spiritual care competence. [ABSTRACT FROM AUTHOR]

Background: It is important to identify gallbladder polyps (GPs) with malignant potential and avoid unnecessary cholecystectomy by constructing prediction model. The aim of the study is to develop a Bayesian network (BN) prediction model for GPs with malignant potential in a long diameter of 8–15 mm based on preoperative ultrasound. Methods: The independent risk factors for GPs with malignant potential were screened by χ2 test and Logistic regression model. Prediction model was established and validated using data from 1296 patients with GPs who underwent cholecystectomy from January 2015 to December 2019 at 11 tertiary hospitals in China. A BN model was established based on the independent risk variables. Results: Independent risk factors for GPs with malignant potential included age, number of polyps, polyp size (long diameter), polyp size (short diameter), and fundus. The BN prediction model identified relationships between polyp size (long diameter) and three other variables [polyp size (short diameter), fundus and number of polyps]. Each variable was assigned scores under different status and the probabilities of GPs with malignant potential were classified as [0–0.2), [0.2–0.5), [0.5–0.8) and [0.8–1] according to the total points of [− 337, − 234], [− 197, − 145], [− 123, − 108], and [− 62,500], respectively. The AUC was 77.38% and 75.13%, and the model accuracy was 75.58% and 80.47% for the BN model in the training set and testing set, respectively. Conclusion: A BN prediction model was accurate and practical for predicting GPs with malignant potential patients in a long diameter of 8–15 mm undergoing cholecystectomy based on preoperative ultrasound. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study was to examine the feasibility and efficacy of nurse-led team management (NLTM) intervention at improving the self-management of patients with type 2 diabetes (T2D) at community settings in Changsha, Hunan, China. Background: China has become the country with the largest number of patients with diabetes, and that number is growing, causing increasing pressure on the health care system. At present, the main diabetes management model in China is teamwork guided by general practitioners. However, the number of general practitioners is insufficient, and their work is overloaded, which leads to poor outcomes of diabetes management. Therefore, it is important to explore alternative methods of diabetes management, such as NLTM. Patients and methods: In a randomized controlled trial, 171 T2D patients were randomized into the control or intervention arm. Participants in the control group received routine management from the community health service center, whereas the intervention group received 12 months NLTM intervention in addition to the standard care. The diabetes self-management scale, fasting blood sugar, and glycosylated hemoglobin A1c (HbA1c) were assessed at baseline and at 6 and 12 months after the start of the intervention. Results: Baseline data were comparable between arms. Repeated-measurement analysis showed that self-management of the intervention group improved compared with the control group after the intervention (P<0.05). There were no significant differences in HbA1c at 6 months, whereas after 12 months of intervention, there was a significant difference in HbA1c between the two groups (F=10.114, P<0.05). The intervention had no significant effect on fasting blood sugar. Conclusion: The NLTM intervention has resulted in an impact of practical significance on T2D self-management, and was beneficial for controlling the level of HbA1c. The study has demonstrated the feasibility and efficacy of using NLTM in the management of T2D in a Chinese community. [ABSTRACT FROM AUTHOR]

[Display omitted] • Textural and compositional variations in apatite from mineralized intrusions indicate magmatic mixing. • The low-viscosity magma is essential for the formation of porphyry Mo deposits. • A large volume magma chamber below the Suyunhe Mo deposit was inferred. Textural and compositional variations in apatite and amphibole from mineralized granite (G), granite porphyry (GP), granodiorite porphyry (GDP), and barren tonalite porphyry (TDP) in the Suyunhe ore district, Xinjiang province, NW China revealed differences in their petrogenesis, magmatic properties and mineralization potentials. The higher Cl contents (0.09–0.18 wt%) and Cl/F ratios of apatite, and the higher Mg/(Mg + Fe2+) ratios (0.54–0.62) of amphibole in the barren TDP indicate that the parental magma was mainly generated via melting of the lithospheric mantle. In contrast, the parental magmas of the GDP, G, and GP were mainly derived from melting of the juvenile lower crust. The enrichment of Mn, Y, and heavy rare earth elements (HREEs), depletion of Sr, and strong negative Eu anomalies of the apatite from the GP indicate that it underwent a high degree of fractional crystallization. Moreover, the reverse core-to-rim compositional variations in REE and Sr contents and the La/Y ratios observed in some of the apatite grains, as well as the distinct differences in the major-element compositions (e.g., CaO, MnO, SiO 2 , and Ce 2 O 3) of the individual zones within single apatite grains, indicate magmatic mixing. The calculated magmatic viscosities (Logη = 4.8–5.0 Pas) at Suyunhe remained below the average value for granitic melts (mostly Logη > 5 Pas) at the same temperature. These results support the hypothesis that low-viscosity magma (e.g., Logη < 5 Pas) may be essential for the formation of porphyry Mo deposits. The physicochemical conditions (including temperature, pressure, and H 2 O content) estimated based on the amphibole in the mineralized intrusions indicate the existence of a deep magma chamber with a large volume, which continuously released volatiles (e.g., fluorine and water) and effectively reduced the viscosity of the magma. [ABSTRACT FROM AUTHOR]

Background: Impulsivity increases the risk for depression and anxiety. However, the granular pathways among them remain unknown. A network approach that moves from disorder-level analysis to symptom-level analysis can provide further understanding of psychopathological mechanisms. In this study, we examined the network structure of impulsivity and separate and comorbid symptoms of depression and anxiety., Methods: Regularized partial-correlation networks were estimated using cross-sectional data from 1047 Chinese participants aged 18-26 years (main dataset, mean age = 21.45 ± 2.01 years) and 325 Chinese participants aged 18-36 years (an independent replication dataset, mean age = 21.49 ± 3.73 years), including impulsivity-depression, impulsivity-anxiety, and impulsivity-depression-anxiety networks. The datasets were collected from 1 June 2023 to 4 August 2023 and from 27 April 2022 to 16 May 2022, respectively. Impulsivity, depression, and anxiety were assessed using Barratt Impulsiveness Scale Version 11, Patient Health Questionnaire-9, and Generalized Anxiety Disorder-7, respectively. Bridge centrality was analyzed, and a network comparison test (NCT) was conducted to investigate the differences between the main dataset and replication dataset., Results: The motor impulsivity dimension was revealed to be closely connected with individual symptoms of depression and anxiety regardless of whether they were in separate disorder forms or comorbid forms. In all the networks, motor impulsivity was the most important bridge node. The NCT showed comparable network connectivity and network structure between the main and replication datasets., Limitations: The use of cross-sectional data limited the inferences about the direction of causality between variables., Conclusions: These findings elucidate the psychopathological mechanisms underlying how impulsivity functions within depression, anxiety, and comorbidity and support that motor impulsivity is an important risk factor across different mental disorders and is responsible for comorbidity. The implications of these findings are discussed., Competing Interests: Declaration of competing interest None., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Context: Since December 2019, medical practitioners discovered a novel coronavirus causing an acute respiratory-tract infection in some hospitals in Wuhan, Hubei Province. COVID-19 has spread globally, making it an epidemic worldwide at present. Understanding the mental-health responses of college students to COVID-19 can help a school staff to better guide students seeking education., Objective: The study aimed to explore the differences between nonmedical and medical college students during the COVID-19 epidemic in their cognitive interest about the disease, preventive behaviors, psychological effects, and job-search intentions, hoping to provide more targeted measures for virus-coping education for college students., Design: The research team conducted a cross-sectional study, using an anonymous online questionnaire., Setting: The study took place at Shanghai, China., Participants: Participants were 1648 college students studying different specialties in various provinces of China, 485 nonmedical students and 1163 medical students., Outcome Measures: The survey's questions covered the respondents': (1) general demographic characteristics, (2) cognitive interest and knowledge about COVID-19 and its infectiousness as well as efforts at active learning about infectious diseases and viruses, (3) awareness of precautionary behaviors against COVID-19, (4) effects on mental health, and (5) effects on job-search intentions. The research team used descriptive statistics and Chi-square tests to analyze the survey data., Results: Among nonmedical students: (1) 297 participants (61.2%) were interested in learning about COVID-19, (2) 321 participants (66.2%) took the initiative to learn about the virus, (3) 301 participants (62.1%) took the initiative to learn about infectious disease, and (4) 151 participants (31.1%) watched medical-themed movies or TV series about COVID-19. Among medical students, the corresponding proportions were 772 participants (66.4%), 855 participants (73.5%), 791 participants (68.1%), and 791 participants (68.1%), respectively. Among nonmedical students, 223 participants (46.0%) had N95 masks available, 429 participants (88.5%) had disinfectant supplies available, 271 participants (55.9%) wore goggles in public places, 75 participants (15.5%) chose public transportation, and 77 participants (15.9%) were exposed to public places in the week prior to the survey. Among medical students, the corresponding proportions were 470 participants (40.4%), 935 participants (80.4%), 575 participants (49.4%), 243 participants (20.9%), and 297 participants (25.5%), respectively. Furthermore, COVID-19 had a stronger effect on medical students' psychology and job-search ambitions., Conclusions: The news about COVID-19 piqued the interest of medical students. Nonmedical students had stronger protective behavior than medical students. The COVID-19 outbreak had a significant influence on medical students' lives, studies, and moods. In addition, COVID-19 had a greater impact on the job-search intentions of medical students.

Background: Surgical indications for the treatment of gallbladder polyps are controversial. Evaluation of gallbladder polyps with malignant tendency and indications for cholecystectomy in patients with long diameter polyps of 10 to 15 mm require further analysis and discussion. In this study, our objective was to re-evaluate indications for the surgical resection of gallbladder polyps and construct a nomogram model for the prediction of gallbladder polyps with malignant tendency., Methods: Clinicopathologic data of 2,272 patients who had undergone cholecystectomy for gallbladder polyps were collected from 11 medical centers in China. Risk factor analyses and nomogram prediction model for gallbladder polyps with malignant tendency were conducted., Results: Excluding 311 patients with cholelithiasis and 488 patients with long diameter polyps ≤5 and >15 mm, factors that differed significantly among patients with gallbladder polyps having a long diameter of 6 to 9 mm (885 cases) and 10 to 15 mm (588 cases) were polyp detection time, CEA and CA19-9 levels, number of polyps, fundus, echogenicity, gallbladder wall thickness and postoperative pathologic features (P < .05). Among 588 patients with gallbladder polyps with a long diameter of 10 of 15 mm, multivariate analysis indicated the following independent risk factors of gallbladder polyps with malignant tendency: single polyps (OR = 0.286/P < .001), polyps with broad base (OR = 2.644/P = .001), polyps with medium/low echogenicity (OR = 2.387/P = .003), and polyps with short diameter of 7 to 9 or 10 to 15 mm (OR = 3.820/P = .005; OR = 2.220/P = .048, respectively). The C-index of the nomogram model and internal validation were .778 and .768, respectively. In addition, a sample online calculator for the nomogram prediction model had been created (https://docliqi.shinyapps.io/dynnom/)., Conclusion: Indications for cholecystectomy in patients with gallbladder polyps with a long diameter of 10 to 15 mm should be assessed by combining the information on short diameter, number of polyps, fundus, and echogenicity. The nomogram model can be used to predict the risk for the development of gallbladder polyps with malignant tendency., (Copyright © 2021 Elsevier Inc. All rights reserved.)

Background: Health literacy is defined as the cognitive and social skills that determine the motivation and ability of individuals to gain access to, understand and use information in ways that promote and maintain good health. A Health Literacy Questionnaire (HLQ) is a toolkit with good reliability and validity. Accordingly, this study administered HLQ among older adults in China to examine its factor structure, reliability, homogeneity, and discriminant validity for use in understanding better the health literacy of older adults and determining corresponding measures., Methods: Psychometric properties were examined based on the data collected via face-to-face interviews (N = 343). Tests included the difficulty level, composite scale reliability, confirmatory factor analysis (CFA), and Bayesian structural equation modeling (BSEM)., Results: The easiest scale to obtain a high score was "Social support for health" and the hardest, "Navigating the health care system" and "Appraisal of health information." Two one-factor models fitted well with no correlated residuals allowed. After model modification, the CFA fit statistics of the other seven scales were good. All HLQ scales were found to be homogenous, with a composite reliability ranging from 0.74 to 0.85. The nine-factor Bayesian structural equation model fitted the data well (Posterior-Predictive-P value = 0.670; 95% Confidence Interval for the difference between the observed and replicated Chi-square values = - 163.320, 102.750)., Conclusions: The Chinese version of the HLQ has strong construct and content validity and high composite reliability when applied to older adults in Changsha City, China. Therefore, the nine-scale HLQ can now be administered to Chinese older adults, thereby providing a powerful approach to understanding the multidimensional area of health literacy.

Polyporus umbellatus polysaccharide (PUPS) has been identified as the major bioactive component in the mushroom Polyporus umbellatus that has immuno-enhancing, anti-tumor, anti-inflammatory, and hepatoprotective activities. Both PUPS capsule and injection are Chinese Food and Drug Administration (SFDA) approved drugs, which have been used alone or in combination with a variety of clinical drugs for treating Hepatitis B, lung and liver cancers in China since 1990. Our aim was to review both the efficacy and problem associated with PUPS mono- and combination therapy conducted in China and the underlying molecular mechanisms. To this end, the term Polyporus umbellatus polysaccharide both in English and in Chinese was used to conduct a systematic search of PubMed, VIP (Chongqing VIP Chinese Scientific Journals Database), CNKI (China National Knowledge Infrastructure), and Wanfang database. A total 11,703 clinically reported cases in China from over 100 publications during the past 27 years were evaluated, translated into English, and summarized into 3 figures and 13 tables to provide a general view of efficacy of PUPS during mono- and combination therapy. The published data showed the effectiveness of PUPS for treating hepatitis B in most reported cases. Moreover, the combined therapies for PUPS plus hepatitis B vaccine, PUPS plus interferon, PUPS plus acyclovir, and PUPS plus iRNA are better than when treated with either drug alone. Overall, when PUPS is used alone or in combination with other drugs for prevention and treatment of hepatitis B-affected patients, the efficacy is convincible., (© 2019 Elsevier Inc. All rights reserved.)

Purpose: Lentinan is a polysaccharide extracted from Shiitake mushrooms that have been used to improve general health for thousands of years in Asia. Lentinan injection is a clinically approved drug in several countries in Asia. The purpose of this study is to review the structure, preclinical and clinical studies, and molecular mechanisms of lentinan. Most importantly, the clinical effectiveness of lentinan as an adjuvant therapeutic drug in treating patients with lung cancer in China during the past 12 years is analyzed statistically., Methods: We carried out literature search of randomized controlled trials (RCTs) published from 2004 to 2016 based on CNKI (China National Knowledge Infrastructure), VIP (Chongqing VIP Chinese Scientific Journals Database) and Wanfang database, and 38 eligible RCTs of lentinan-associated lung cancer treatment were identified, containing 3,117 patients., Results: The structure and function relationship and underlying molecular mechanism of lentinan as an immunostimulant has been summarized. The mean value of overall response rate in treating lung cancer was increased from 43.3% of chemotherapy alone to 56.9% of lentinan plus chemotherapy [p < 0.001, 95% confidence interval (CI) 0.102-0.170]. Compared with chemotherapy alone, lentinan plus chemotherapy showed more efficacy in treating lung cancer (pooled RR 0.79, 95% CI 0.74-0.85) and no statistical heterogeneity was found among studies (I 2  = 11%)., Conclusion: Clinical data presented in the past 12 years shows that lentinan is effective not only in improving quality of life, but also in promoting the efficacy of chemotherapy during lung cancer treatment.