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The current study examined the associations among cumulative risk, psychological capital and adolescents' anxiety/depression and life satisfaction. Chinese adolescents (N = 1473, grades 7 to 12, ages 12 to 18, 52.1% female) completed self-report cumulative risk, psychological capital, anxiety/depressive symptoms and life satisfaction questionnaires. Cumulative risk was associated with anxiety/depression and life satisfaction. Psychological capital demonstrated a compensatory effect on youth adjustment. Furthermore, a cost of resilience was observed in high-school students with high psychological capital, who showed compromised life satisfaction in conjunction with reduced anxiety/depression under circumstances of severe adversity. Psychological capital also buffered the impact of cumulative risk on anxiety/depressive symptoms in middle-school students; however, it did not moderate the relationship between cumulative risk and life satisfaction. Therefore, psychological capital cannot protect adolescents exposed to cumulative risk from the exacerbation of psychopathology and declining life satisfaction simultaneously, and a 'toll' exists as a byproduct of resilience in high-school students. Suggestions for school health practices were provided accordingly.

By incorporating psychopathology and subjective well-being (SWB), the dual-factor model of mental health (DFM) can comprehensively measure psychological health. We examined the utility of the DFM among 1,293 Chinese adolescents (Grades 7-12). Furthermore, we examined the dynamics of mental health group membership via a two-wave longitudinal study of 531 students. SWB, psychopathology, affective self-regulatory efficacy, academic self-efficacy, and academic emotions were measured via self-report scales. Mental health group membership was determined according to combinations of high or low SWB and high or low psychopathology. The DFM was supported by our identification of its four constituent groups (i.e. complete mental health, vulnerable, troubled, and symptomatic but content). Significant group differences were found in affective self-regulatory efficacy, academic self-efficacy, and academic emotions, with clear contrasts observed between adolescents with complete mental health and their vulnerable peers, as well as between troubled adolescents and their symptomatic but content peers. Moreover, youth with complete mental health demonstrated the highest stability and troubled youth the lowest, whereas vulnerable youth had the highest rates of transitioning into both the complete mental health and troubled groups. Implications for practice are explored within the context of screening and intervention.

Background: As social networking sites (SNSs) with diverse functions gradually become an important social place for modern people, openness, as a personality trait that represents the willingness to consider diverse things, will be more likely to affect people's cognitive and emotional experience (e.g., social anxiety) in social interactions. This study examined the relationship between openness and social anxiety and the underlying psychological mechanism in the internet age based on the cognitive-behavioral model of social anxiety. Methods: This cross‑sectional survey study conducted a questionnaire survey of 522 college students from two provinces in China (191 male; age range 18–25; M = 20.76, SD = 1.34). Results: The results showed that openness is negatively related to social anxiety. Self-evaluation and passive SNS use independently mediate the relationship between openness and social anxiety, respectively. Moreover, openness is associated with social anxiety both through the chain mediating roles of active SNS use and self-evaluation and through the chain mediating roles of passive SNS use and self-evaluation. Conclusions: Openness is negatively associated with social anxiety, and the different ways of SNS use and self-evaluation are the underlying mechanisms. These results provide insights into the clinical treatment of social anxiety and how to benefit from online interactions. [ABSTRACT FROM AUTHOR]

Aim: To evaluate the effectiveness of a professional identity promotion strategy (PIPS) on nursing students' professional identity and resilience. Methods: This study was a quasi‐experimental study with a random cluster sample of 103 sophomore undergraduate nursing students. One hundred students answered the questionnaires at both baseline and follow‐up (51 of 53 in the intervention group and 49 of 50 in the control group). Intervention and control groups underwent 5 months PIPS and standard professional education from May 2 to September 27, respectively. Participants completed the professional identity questionnaire for nursing students (PIQNS) and Connor–Davidson resilience scale (CD‐RISC). Data were collected at baseline (T0), after the intervention (T1) and 3 months after the intervention (T2), and analyzed using the Chi‐squared test, Fisher's exact test, and repeated‐measures analysis of variance. Results: There were no significant differences between the two groups (p >.05) regarding demographic questions, professional identity, or resilience at baseline (p >.05). Significant differences were found in professional identity between groups (p <.001), measurement times (p =.026), and in the interaction between groups and measurement times (p =.018) from T0 to T2. Significant differences were found in resilience between groups (p <.001), measurement times (p =.007), and in the interaction between groups and measurement times (p =.035) from T0 to T2. Conclusions: The PIPS program improved nursing students' professional identity and resilience. Further long‐term effectiveness of the program needs to be tested with implementation through various forms of mobile technology. [ABSTRACT FROM AUTHOR]

By incorporating psychopathology and subjective well-being (SWB), the dual-factor model of mental health (DFM) can comprehensively measure psychological health. We examined the utility of the DFM among 1,293 Chinese adolescents (Grades 7–12). Furthermore, we examined the dynamics of mental health group membership via a two-wave longitudinal study of 531 students. SWB, psychopathology, affective self-regulatory efficacy, academic self-efficacy, and academic emotions were measured via self-report scales. Mental health group membership was determined according to combinations of high or low SWB and high or low psychopathology. The DFM was supported by our identification of its four constituent groups (i.e. complete mental health, vulnerable, troubled, and symptomatic but content). Significant group differences were found in affective self-regulatory efficacy, academic self-efficacy, and academic emotions, with clear contrasts observed between adolescents with complete mental health and their vulnerable peers, as well as between troubled adolescents and their symptomatic but content peers. Moreover, youth with complete mental health demonstrated the highest stability and troubled youth the lowest, whereas vulnerable youth had the highest rates of transitioning into both the complete mental health and troubled groups. Implications for practice are explored within the context of screening and intervention. [ABSTRACT FROM AUTHOR]

In the design of the modern city landscape, how to unify the artificial environment and the natural environment has become one of landscape designer's important topics. To solves the problem, it is helpful to create an urban landscape with unique characteristics, and it is advantageous to the protection and the balance of the natural ecological environment of the city. This article investigates the range and aspects about the artificial element in the urban environment design so as to make brighter the relationship between a place and the environment while carrying on the landscape design, to create a natural, harmony, and artistic city space. [ABSTRACT FROM AUTHOR]

Background: The current deep learning diagnosis of breast masses is mainly reflected by the diagnosis of benign and malignant lesions. In China, breast masses are divided into four categories according to the treatment method: inflammatory masses, adenosis, benign tumors, and malignant tumors. These categorizations are important for guiding clinical treatment. In this study, we aimed to develop a convolutional neural network (CNN) for classification of these four breast mass types using ultrasound (US) images., Methods: Taking breast biopsy or pathological examinations as the reference standard, CNNs were used to establish models for the four-way classification of 3623 breast cancer patients from 13 centers. The patients were randomly divided into training and test groups (n = 1810 vs. n = 1813). Separate models were created for two-dimensional (2D) images only, 2D and color Doppler flow imaging (2D-CDFI), and 2D-CDFI and pulsed wave Doppler (2D-CDFI-PW) images. The performance of these three models was compared using sensitivity, specificity, area under receiver operating characteristic curve (AUC), positive (PPV) and negative predictive values (NPV), positive (LR+) and negative likelihood ratios (LR-), and the performance of the 2D model was further compared between masses of different sizes with above statistical indicators, between images from different hospitals with AUC, and with the performance of 37 radiologists., Results: The accuracies of the 2D, 2D-CDFI, and 2D-CDFI-PW models on the test set were 87.9%, 89.2%, and 88.7%, respectively. The AUCs for classification of benign tumors, malignant tumors, inflammatory masses, and adenosis were 0.90, 0.91, 0.90, and 0.89, respectively (95% confidence intervals [CIs], 0.87-0.91, 0.89-0.92, 0.87-0.91, and 0.86-0.90). The 2D-CDFI model showed better accuracy (89.2%) on the test set than the 2D (87.9%) and 2D-CDFI-PW (88.7%) models. The 2D model showed accuracy of 81.7% on breast masses ≤1 cm and 82.3% on breast masses >1 cm; there was a significant difference between the two groups (P < 0.001). The accuracy of the CNN classifications for the test set (89.2%) was significantly higher than that of all the radiologists (30%)., Conclusions: The CNN may have high accuracy for classification of US images of breast masses and perform significantly better than human radiologists., Trial Registration: Chictr.org, ChiCTR1900021375; http://www.chictr.org.cn/showproj.aspx?proj=33139., (Copyright © 2021 The Chinese Medical Association, produced by Wolters Kluwer, Inc. under the CC-BY-NC-ND license.)

Background: Shenzhen is a rapidly growing city in China with a population of over 11 million. The Hong Kong University-Shenzhen Hospital (HKU-SZH) was established in 2012 as a new model of publicly funded health care in mainland China. The clinical oncology center of the HKU-SZH was launched in 2013 which pledged to provide integrated palliative care for advanced cancer patients. This study aims to retrospectively analyze the quality of end-of-life care amongst patients with advanced cancer during their last hospitalization in the HKU-SZH., Methods: Consecutive patients with advanced solid cancer who passed away in the HKU-SZH from March 2013 to February 2016 were analyzed. Clinical information regarding cancer diagnosis, anticancer treatments, and the aggressiveness of the treatment during the last month of life was recorded. The discussions on the Do-Not-Resuscitate (DNR) order with family members were reviewed., Results: From March 2013 to February 2016, 441 patients with advanced solid cancer passed away in the HKU-SZH. A minority of them (9.3%, 41/441) received cytotoxic chemotherapy in the last month of life. Younger patients had high odds of receiving chemotherapy in their last month of life (OR 2.6, P=0.006). Those who received chemotherapy in their last month of life showed a trend of higher odds of admission to the intensive care unit (OR 2.94, P=0.08). The vast majority of family members / care providers (92.3%, 407/441) consented to the DNR order suggested by oncologists. The rate of DNR acceptance in this cohort was higher than previous reports from mainland China. Within HKU-SZH, the rate was higher in the oncology center than in other departments (OR 5.1, P<0.001). The use of chemotherapy in the last month of life did not associated with the acceptance of DNR (OR 1.3, P=0.23)., Conclusions: The integrated oncology service of the new public hospital HKU-SZH achieved a satisfactory level of end-of-life care in patients with advanced cancer. Further studies are warranted to improve the early integration of palliative care service and to investigate the impact of palliative care on costeffectiveness of oncology service.