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Xin-Yu Duan,1 Tao Sun,2 Feng Lu,1 Xiao-Jing Yang,1 Hong-Yan Yin,3 De-Pin Cao,1,&ast; Shu-E Zhang1,&ast; 1Department of Health Management, School of Health Management, Harbin Medical University, Harbin, People’s Republic of China; 2Department of Health Policy and Management, School of Public Health, Hang Zhou Normal University, Harbin, People’s Republic of China; 3Department of Humanities and Social Sciences, Harbin Medical University (Daqing), Daqing, Heilongjiang, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: De-Pin Cao; Shu-E Zhang, Department of Health Management, School of Health Management, Harbin Medical University, Harbin, 150081, People’s Republic of China, Tel +86 13351113008; +86 15104694354, Email caodp211@126.com; hydzhangshue@163.comBackground: Depressive symptoms and multimorbidity are global public health concerns, the relationship between the two variables remains unclear. This study was an intervention attempt through the lens of regional relational culture to identify and reduce adverse consequences of this relationship. We aimed to explore the prevalence of multimorbidity and depressive symptoms among older Chinese adults, the association between the two variables, and the underlying moderating mechanism.Methods: This study extracted data from the China Health Retirement Longitudinal Study (CHARLS) of 8356 older adults aged 60 years and older and analyzed the correlation between multimorbidity and depressive symptoms in this population using Stata 16.0. Moreover, the correlation between multimorbidity and depressive symptoms was verified using logistic regression analysis, and a hierarchical multiple regression analysis was used to test the existence of moderating effects between the two variables.Results: The prevalence of multimorbidity and depressive symptoms among seniors aged 60 years and older was 66.16 and 36.85%, respectively. Multimorbidity was positively associated with depressive symptoms (p< 0.001), and relationship satisfaction, social activity, and information isolation moderated this association (p < 0.05).Conclusion: Older adults with multimorbidity are more likely to develop depressive symptoms, and regional relational culture can play a moderating role between them. The government, as well as aging-related sectors, can reduce the risk of depressive symptoms by improving relationship satisfaction, increasing social activity, and decreasing information isolation among older adults.Keywords: depressive symptoms, multimorbidity, older adults, relationship satisfaction, social activity, information isolation

Zi-Jiao Wang,1,&ast; Xiao-Ning Liu,1,&ast; Jia-Jun He,1 Yan-Ping Wang,1 Chen-Xi Zhao,2 Xiao-Jing Yang,1 Hong-Yan Yin,3 De-Pin Cao,1,&ast; Shu-E Zhang1,&ast; 1Department of Health Management, School of Health Management, Harbin Medical University, Harbin, People’s Republic of China; 2Academic Affairs Office, First Affiliated Hospital of Harbin Medical University, Harbin, People’s Republic of China; 3Department of Humanities and Social Sciences, Harbin Medical University (Daqing), Daqing, Heilongjiang, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: De-Pin Cao; Shu-E Zhang, Department of Health Management, School of Health Management, Harbin Medical University, Harbin, 150081, People’s Republic of China, Tel +86 13351113008 ; +86 15104694354, Email caodp211@126.com; hydzhangshue@163.comPurpose: The COVID-19 pandemic sets specific circumstances that may accelerate academic procrastination behavior of medical students. Career calling is a protective factor that fights against academic procrastination and may further improve medical students’ mental health and academic achievement. This study aims to determine the status of Chinese medical students’ academic procrastination during controlled COVID-19 pandemic. Moreover, the study investigates the relationships and mechanisms among career calling, peer pressure, a positive learning environment, and academic procrastination.Patients and Methods: Data were collected from several Chinese medical universities through an anonymous cross-sectional survey of 3614 respondents (effective response rate = 60.0%). Using online questionnaires to collect the data and IBM SPSS Statistics 22.0 for statistical analysis.Results: The average score of academic procrastination of Chinese medical students was 2.62± 0.86. This study proved the usage of peer pressure and positive learning environment as moderating roles of relationship between career calling and academic procrastination. Career calling was negatively correlated with academic procrastination (r = − 0.232, p < 0.01), while it was positively correlated with peer pressure (r = 0.390, p < 0.01) and a positive learning environment (r = 0.339, p < 0.01). Moreover, academic procrastination was negatively correlated with peer pressure (r = − 0.279, p < 0.01) and a positive learning environment (r = − 0.242, p < 0.01). Peer pressure was positively correlated with a positive learning environment (r = 0.637, p < 0.01).Conclusion: The findings emphasize the importance of constructive peer pressure and a positive learning environment that discourages academic procrastination. Educators should highlight medical career calling education by offering related courses to fight against academic procrastination.Keywords: career calling, academic procrastination, peer pressure, positive learning environment, medical students, moderating effects

Shu-E Zhang,1 Hui Wu,2 Xiao-He Wang,3 Chen-Xi Zhao,1 Tao Sun,3,&ast; De-Pin Cao1,&ast; 1Department of Health Management, School of Health Management, Harbin Medical University, Harbin, 150081, People’s Republic of China; 2Department of Social Medicine, School of Public Health, China Medical University, Shenyang, 110122, People’s Republic of China; 3Department of Health Management to School of Medicine, Hang Zhou Normal University, Hangzhou, 311121, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Tao SunDepartment of Health Management, School of Medicine, Hangzhou Normal University, Hangzhou, 311121, People’s Republic of ChinaTel +86 1 376 688 2425Email hydsuntao@126.comDe-Pin CaoDepartment of Health Management, School of Health Management, Harbin Medical University, Harbin, 150081, People’s Republic of ChinaTel +86 1 335 111 3008Email caodp211@126.comBackground: Chaxu atmosphere refers to the degree of differences, like the ripple effects in water, of the association between group members and the leader of the group resource. Unlike Western culture, China’s nurses have been working in Chaxu atmosphere, which may boost their negative emotion and influence their workplace behavior.Purpose: This study aimed to clarify the chain-mediating role of envy and silence in the association between Chaxu atmosphere and organizational responsibility behavior.Methods: A cross-sectional online survey was conducted, and a multistage stratified sampling method was employed to collect data. The study was conducted from September to October 2020 in China. Totally, 1740 nurses were recruited, and 1221 valid responses were collected. Socio-demographic factors, Chaxu atmosphere, employee envy, employee silence, and organizational responsibility behavior were assessed using questionnaires that included the Chaxu Atmosphere Scale, Employee Envy Scale, Employee Silence Scale, and Organizational Responsibility Behavior Scale. Hierarchical multiple regression was used to identify clusters of interrelationships among Chaxu atmosphere, envy, silence, and organizational responsibility behavior in nursing settings.Results: Though the Chaxu atmosphere did not directly influence the organizational responsibility behavior of Chinese nurses, its effect is mediated by a chain of envy and silence. First, Chaxu atmosphere evoked envy in the nurses (β=− 0.040, P< 0.001), thereby leading to decreased organizational responsibility behavior. Second, the Chaxu atmosphere promoted silence toward organizational issues (β=− 0.057, P< 0.001), resulting in decreased organizational responsibility behavior. Third, the Chaxu atmosphere evoked envy in the nurses, which contributed to the formation of silence (β=− 0.025, P< 0.001), resulting in a further decrease in organizational responsibility behavior.Conclusion: Nurses working in a high-level Chaxu atmosphere are prone to remaining silent on critical organizational issues due to increased envy, which subsequently reduces their organizational responsibility behavior. A better understanding of the association between the Chaxu atmosphere and workplace behavior will help nursing managers to foster harmonious relationships between nurses and their teams and to improve each individual’s organizational responsibility behaviorKeywords: nurses, Chaxu atmosphere, organizational responsibility behavior, chain-mediating

Background: Arthroscopic rotator cuff repair is a common surgical treatment for rotator cuff injuries (RCIs). Although this procedure has certain clinical advantages, it requires rehabilitation management interventions to ensure therapeutic efficacy., Aim: To investigate the effect of integrated traditional Chinese medicine and Western medicine (TCM-WM) under the multidisciplinary team (MDT) model on the postoperative recovery of patients undergoing arthroscopic surgery for RCIs., Methods: This study enrolled 100 patients who underwent arthroscopic rotator cuff repair for RCIs at the Seventh People's Hospital of Shanghai University of Traditional Chinese Medicine between June 2021 and May 2024. They were divided into a control group ( n = 48) that received routine rehabilitation treatment and an experimental group ( n = 52) that received TCM-WM under the MDT model ( e.g. , acupuncture, TCM traumatology and orthopedics, and rehabilitation). The results of the Constant-Murley Shoulder Score (CMS), Visual Analogue Scale (VAS), Shoulder Pain and Disability Index (SPADI), muscular strength evaluation, and shoulder range of motion (ROM) assessments were analyzed., Results: After treatment, the experimental group showed significantly higher CMS scores in terms of pain, functional activity, shoulder joint mobility, and muscular strength than the baseline and those of the control group. The experimental group also exhibited significantly lower VAS and SPADI scores than the baseline and those of the control group. In addition, the experimental group showed significantly enhanced muscular strength (forward flexor and external and internal rotator muscles) and shoulder ROM (forward flexion, abduction, and lateral abduction) after treatment compared with the control group., Conclusion: TCM-WM under the MDT model improved shoulder joint function, relieved postoperative pain, promoted postoperative functional recovery, and facilitated the recovery of muscular strength and shoulder ROM in patients with RCIs who underwent arthroscopic rotator cuff repair., Competing Interests: Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article., (©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.)

Background: As the global trend of population aging intensifies, the health and well-being of the older population has gradually become a focus of attention for the global community. This study assessed the status of thriving in life among Chinese urban older adults and identified its relationship with attitude toward own aging and quality of life (QoL). It also tested whether attitude toward own aging moderates the association between thriving in life and Qol or between thriving in life and suicidal ideation., Methods: Primary data were collected through a cross-sectional survey among urban older adults from three provinces in China. They were invited to complete an anonymous survey using face-to-face interviews from December 2019 to January 2020. Data from 764 older adults were analyzed., Results: Approximately 44.39% of participants reported positive responses toward the four domains of thriving in life. Thriving in life and attitude toward own aging had a significant association with QoL. Thriving in life was a protective factor for suicidal ideation for older adults. Moreover, attitude toward own aging moderated the association between thriving in life and QoL and that between thriving in life and suicidal ideation., Conclusions: Chinese urban older adults were reportedly thriving in life, which contributed to increased QoL and reduced suicidal ideation. Notably, the study revealed that more positive attitudes towards own aging were associated with higher levels of thriving in life, better QoL, and reduced suicidal ideation. Targeted interventions for older adults should be devised to promote thriving in life and prevent negative attitudes of older people towards their own aging, further raising QoL and reducing suicidal ideation., (© 2024. The Author(s).)

Background: Medical students face a heavy burden as they are tasked with acquiring a vast amount of medical knowledge within a limited time frame. Self-directed learning (SDL) has become crucial for efficient and ongoing learning among medical students. However, effective ways to foster SDL ability among Chinese medical students are lacking, and limited studies have identified factors that impact the SDL ability of medical students. This makes it challenging for educators to develop targeted strategies to improve students' SDL ability. This study aims to assess SDL ability among Chinese medical students and examine the effects of career calling and teaching competencies on SDL ability, as well as the possible mechanisms linking them., Methods: Data were collected from 3614 respondents (effective response rate = 60.11%) using cross-sectional online questionnaires and analyzed using IBM SPSS Statistics 22.0. The questionnaire comprised a Demographic Characteristics Questionnaire, Self-directed Learning Ability Scale (Cronbach's alpha = 0.962), Teaching Competencies Scale, and Career Calling Scale., Results: The average SDL ability score of Chinese medical students was 3.68 ± 0.56, indicating a moderate level of SDL ability. The six factors of the Self-directed Learning Ability Scale-self-reflection, ability to use learning methods, ability to set study plans, ability to set studying objectives, ability to adjust psychological state, and willpower in studying-accounted for 12.90%, 12.89%, 12.39%, 11.94%, 11.34%, and 8.67% of the variance, respectively. Furthermore, career calling was positively associated with SDL learning ability (β = 0.295, p < 0.001), and SDL learning ability was positively associated with teaching competencies (β = 0.191, p < 0.01). Simple slope analysis showed that when the level of teaching competencies was higher, the influence of career calling on SDL ability was stronger., Conclusions: Chinese medical students' SDL ability has room for improvement. Medical students could strengthen their willpower in studying by setting milestones goals with rewards, which could inspire their motivation for the next goals. Teachers should guide students to learn experience to improve students' reflective ability. Educators play a crucial role in bridging the gap between career calling education and SDL ability enhancement, highlighting the significance of optimal teaching competencies. Colleges should focus on strengthening teachers' sense of career calling and teaching competencies., (© 2024. The Author(s).)

As one of the major staple crops, rice feeds more than one half of the world population. Due to increasing population and dramatic climate change, the rice varieties with higher yield performance and excellent overall agronomic performance should be developed. The raise of molecular design breeding concept provides opportunity to get new breakthrough for variety development, and it is important to clarify the efficient gene combination during actual breeding. In this review, we summarize the recent advances about rice variety improvement either by marker assisted selection (MAS) breeding or popular gene editing technique, which will be beneficial to understand different aspects of the molecular design breeding. We provide genetic views for the classical MAS application, including the genetic effect of key genes and their combinations, the recurrent genome recovery rate at different backcross generations, linkage drag and recombination selection. Moreover, we compare the breeding value of recently-developed molecular techniques, including the advantage of high-throughput genotyping and the way and effect of gene editing in creating useful traits. Considering the current status and actual demands of rice breeding, we raise the strategy to take advantages of both traditional breeding resources and popular molecular techniques, which might pave the way to optimize the process of molecular design breeding in future.

Purpose: This cross-sectional study aims to assess the level of academic burnout among Chinese medical students during the controlled COVID-19 pandemic and identify the potential demographic factors affecting academic burnout. It also explored the relationship between career calling, family functioning, resource support, and academic burnout, as well as investigated whether family functioning and resource support could moderate the relationship between career calling and academic burnout among Chinese medical students., Methods: The study was conducted in five Chinese cities in 2021. A total of 3614 valid questionnaires were collected to assess the relationship between academic burnout, career calling, family functioning, and resource support, and determine whether demographic factors contribute to academic burnout. Hierarchical multiple regression analysis was used to explore factors correlated with academic burnout and test the moderating effect of family functioning and resource support on the relationship between career calling and academic burnout., Results: The mean academic burnout score was 3.29 ± 1.17. Sex, major, academic performance ranking, monthly living expenses, physical health, and sleep quality significantly affected academic burnout ( p <  0.05). Academic burnout was negatively correlated with career calling, resource support, and family functioning. Family functioning and resource support moderated the relationship between career calling and academic burnout. Simple slope analysis revealed that high family functioning and resource support strengthened the impact of career calling on academic burnout., Conclusions: Most medical students in China experienced relatively high levels of academic burnout during the controlled COVID-19 pandemic. Furthermore, specific demographic factors contribute to academic burnout. Family functioning and resource support moderate the relationship between career calling and academic burnout. These findings emphasize the importance of implementing career-calling education, supplementing family functioning in the form of school support, and providing sufficient smart learning resources among medical students in the post-pandemic era.

Objectives: This study aimed to identify the relationship among proactive personality, psychological safety, academic self-efficacy and critical thinking, and to further explore whether psychological safety and academic self-efficacy could be a moderator in the association between proactive personality and critical thinking among Chinese medical students., Materials and Methods: The cross-sectional study was carried out from October to December 2020 in China. Totally, 5,920 valid responses were collected at four Chinese medical universities. Critical thinking, proactive personality, psychological safety, academic self-efficacy and demographic factors were assessed through questionnaires. Hierarchical multiple regression was used to identify interrelationship clusters among variables. Simple slope analyses were performed to explore the moderating effects of psychological safety and academic self-efficacy., Results: The mean score of critical thinking among medical students was 3.85 ± 0.61. Proactive personality, psychological safety, and academic self-efficacy were shown to be important factors for critical thinking. Psychological safety and academic self-efficacy moderated the association between proactive personality and critical thinking. A simple slope analysis showed that high psychological safety and academic self-efficacy weakened the impact of proactive personality on critical thinking., Conclusion: Most medical students surveyed in China might have relatively high levels of critical thinking. Psychological safety and academic self-efficacy moderated the association between proactive personality and critical thinking. More interventions related to psychological safety and academic self-efficacy will be helpful to improve critical thinking among Chinese medical students., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Wang, Zhao, Zhang, Li, Tian, Yang, Guo, Yuan, Zhou, Wang and Cao.)

Aim: This study aimed to (1) assess the current status of Chinese nurses' exposure to workplace violence; (2) identify the cluster of interrelationships between abusive supervision, anxiety and depression symptoms, work ability, and workplace violence in nursing settings; and (3) clarify the functional mechanism among these variables., Methods: A cross-sectional survey was conducted online from September to October 2020 in China. A total of 1,221 valid questionnaires were collected across 100 cities in 31 provinces., Results: Approximately 67.57% of participants experienced workplace violence in the past one year, in the types of verbal violence (59.71%), made difficulties (43.16%), mobbing behaviour (26.70%), smear reputation (22.52%), physical violence (11.30%), intimidating behaviour (10.16%) and sexual harassment (4.10%), respectively. Moreover, nurses' exposure to workplace violence was significantly and positively influenced by the perceptions of abusive supervision (β = 0.209, p < .01) and the symptoms of anxiety and depression (β = 0.328, p < .01). Anxious and depressive symptoms partly mediated the association between abusive supervision and workplace violence, which were significantly moderated by work ability (β = -0.021, p < .05)., Conclusions: Our study assesses the prevalence of the seven types of workplace violence against Chinese nurses. Majority of nurses have experienced different types of workplace violence. Nurses who are abused by their supervisor are more likely to develop poor psychological health than those who are not. Moreover, nurses' positive association of abusive supervision with workplace violence is more notable among nurses with lower work ability., Implications of Nursing Management: 'No abusive supervision, no workplace violence'. A harmonious nursing environment needs to be provided to minimize exposure to workplace violence and mental health threats towards nursing staff, which is a key point for hospital administrators and health policymakers. Essential work ability should be developed to reduce the damage of the abusive supervision and workplace violence against nurses., (© 2021 John Wiley & Sons Ltd.)

Background: Boosting the individual learning passion of medical students is a novel approach to improve their academic performance. It facilitates the medical education reform, motivating both policymakers and educators to focus on the function of positive psychology in the career development of medical students. Therefore, this study aimed (1) to assess the status of two types of learning passion; (2) to clarify the relationship between self-esteem and two types of learning passion among Chinese medical students; (3) to examine the mediating role of psychological capital (PsyCap) in the relationship between self-esteem and two types of learning passion, respectively; and (4) to identify the moderating role of professional identity in the relationship between PsyCap and two types of learning passion, respectively., Methods: A cross-sectional online survey was conducted from April to June 2016 in China. A total of 1,218 valid questionnaires (effective completion rate: 67.93%) were collected from four medical schools., Results: Self-esteem significantly and positively influenced medical students' PsyCap (β = 0.637, P < 0.01) and two types of learning passion, including harmonious learning passion (β = 0.589, P < 0.01) and obsessive learning passion (β = 0.436, P < 0.01). PsyCap fully mediated the relationship (β = 0.578, P < 0.01) between self-esteem and harmonious learning passion positively, whereas it suppressed the relationship (β = 0.490, P < 0.01) between self-esteem and obsessive learning passion. Further, professional identity significantly moderated the correlation between PsyCap and harmonious learning passion (β = -0.554, P < 0.05), rather than obsessive learning passion ( P > 0.05)., Conclusion: Two types of learning passion of medical students are positively influenced by self-esteem and PsyCap. Medical students with high-level self-esteem should possess strong PsyCap, which augments their harmonious as well as obsessive learning passion. Moreover, the positive effect of medical students' PsyCap on harmonious learning passion is more notable among those with a lower professional identity. Finally, this study argues that strengths-based interventions of self-esteem and PsyCap are a beneficial approach for future enhancing learning passion in the domain of medical education., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Zhang, Ge, Tian, Li, Wang, Wang, Zhang, Zhao, Yang, Cao and Sun.)

To set the cultivation goal with adaptation to rural order-oriented medical students, the teaching mode of Human Parasitology was reformed in the context of curriculum ideological and political education. The new teaching mode not only enables students to harvest medical knowledge during the school education stage, but also plays a guiding role in cultivation of humanistic qualities and professional spirit, which provides a basis for cultivating general practitioners serving for grassroots healthcare.

Background: Ageism is a global challenge, which leads to a range of adverse outcomes for elderly people worldwide, which maybe more severe among urban older adults in a competitive society. However, how self-perceived ageism influences the quality of life in a sample of urban older adults remains inconclusive., Objectives: The current study aims to assess the status of self-perceived stigma among urban Chinese older adults, identify its relationship with quality of life, and further explore whether both attitude toward own aging and traditionality moderate this relationship., Materials and Methods: Primary data were collected through cross-sectional surveys among urban older adults in three provinces of China from October 2019 to December 2020. A total of 764 urban older adults were valid participants (effective response rate = 81.28%) and completed questionnaires via anonymous face-to-face interviews. Socio-demographic factors, self-perceived stigma, attitude toward own aging, traditionality, and quality of life were assessed using questionnaires that included the Self-perceived Stigma, Attitude Toward Own Aging, Traditionality, and SF-8 Scales., Results: For urban Chinese older adults, the average score of self-perceived stigma was 2.041 ± 0.726. Self-perceived stigma (β = -0.391, p < 0.05) and attitude toward own aging (β = -0.211, p < 0.05) both influenced quality of life. Additionally, attitude toward own aging (β = -0.530, p < 0.05) and traditionality (β = -0.525, p < 0.05) moderated the association between self-perceived stigma and quality of life. Simple slope analysis revealed that when the level of negative attitude toward own aging and traditionality was higher, the strength of the influence of self-perceived stigma on quality of life was stronger., Conclusion: Urban Chinese older adults were aware of the self-perceived stigma, which contributes to decreased quality of life. Attitude toward own aging and traditionality could moderate the association between self-perceived stigma and quality of life. When negative attitudes toward own aging and traditionality are higher, self-perceived stigma has a greater effect on the quality of life. More interventions related to relieving self-perceived stigma, traditionality, and negative attitude toward own aging should be considered to build a new modern society that emphasizes health, friendliness, well-being, and dignity for all ages., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Sun, Zhang, Yan, Lian, Yu, Yin, Zhao, Wang, Chang, Ji, Cheng, Wang, Huang and Cao.)

The problem of mobile phone addiction and academic procrastination among medical students has been widely acknowledged. This study aimed to explore the influence of demographic factors on mobile phone addiction, academic procrastination, and academic achievement among medical students. Further, it investigated the association between mobile phone addiction, academic procrastination, and academic achievement. This cross-sectional study was conducted between May and June 2019. A total of 3 511 medical students participated in an online questionnaire survey (effective response rate = 81.7%). Demographic factors, the Scale of Academic Achievement, the short scale of the Mobile Phone Problem Use (MPPUS-10), and the Academic Procrastination Scale-Short (APS-S) were used. Hierarchical multiple regression analysis revealed that the average scores for academic procrastination, mobile phone addiction, and academic achievement were 2.66 ± 0.91, 5.13 ± 1.53, and 4.51 ± 0.71, respectively. Moreover, there were significant differences in gender, grade, leadership experience, and family monthly income across mobile phone addiction, academic procrastination, and academic achievement. Mobile phone addiction was negatively associated with learning dedication, learning performance, and relationship facilitation. Academic procrastination was negatively associated with learning dedication, learning performance, relationship facilitation, and objective achievement. Mobile phone addiction and academic procrastination was revealed as prevalent among Chinese medical students, and negatively influences their academic achievement. It is critical to establish a more efficient learning environment for Chinese medical students to minimize the negative impact of mobile phone addiction and academic procrastination., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 Tian, Zhao, Xu, Li, Sun, Zhao, Gao, Zhu, Guo, Yang, Cao and Zhang.)

Objectives: The main objectives of this study were to describe the current state of character strengths (CSs) of nurses; explain how they affect stress, sleep quality, and subjective health status; and reveal the mediating role of stress for the subject matter on the association between CSs, sleep quality, and subjective health status. Methods: A cross-sectional online survey was conducted from September to October 2020 in China. A multistage stratified sampling method was used, and 1,221 valid questionnaires across 100 cities in 31 provinces were collected. Results: For the participants in this survey, the three dimensions of CSs ranging from high to low were caring (4.20 ± 0.640), self-control (3.53 ± 0.763), and inquisitiveness (3.37 ± 0.787). There was difference in CSs scores across age ( F = 8.171, P < 0.01), professional categories ( F = 5.545, P < 0.01), and job tenure ( F = 9.470, P < 0.01). The results showed that CSs significantly affected the psychological stress (β = -0.365, P < 0.01 ), sleep quality (β = 0.312, P < 0.01 ), and subjective health (β = 0.398, P < 0.01 ) of nurses. Moreover, psychological stress partially mediated the association between CSs and both types of health outcomes. Conclusion: In China, the CSs of nurses are at high levels. We find that nurses with high-level CSs are likely to experience less psychological stress and exhibit healthy psycho-physiological responses, which contribute to positive health outcomes. Finally, our study argues that strength-based interventions of positive psychology in hospitals should be provided to minimize threats to the physical and psychological health of health professionals, which is a beneficial choice for future hospital reforms in the domain of occupational health management., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 Zhang, Yang, Zhao, Shi, Wang, Zhao, Wang, Sun and Cao.)

Learning motivation is a significant factor that ensures quality in medical education, and might affect the academic performance and well-being of medical students. This study aimed to explore the status of achievement goal orientations among medical students in China and to further identify the association among academic performance, academic well-being, and achievement goal orientations. Data were collected through a cross-sectional, anonymous survey conducted with 3,511 respondents (effective response rate = 81.7%), from four medical universities in China, and demographic factors, achievement goal orientations, academic performance, and academic well-being were assessed. The average score of achievement goal orientations of Chinese medical students suggested a difference in demographic factors, including sex, year of study, experience of leadership cadre, and family income. Both mastery and performance-avoidance goals were associated with academic performance, subjective academic stress, subjective learning adaptability, subjective sleep quality, and subjective well-being. Performance-approach goals were related to academic performance, subjective academic stress, and subjective learning adaptability. The achievement goal orientations of the medical students in this study were at a middle level. The findings emphasize the importance of mastery goals for promoting the academic performance and well-being of medical students. More care and attention toward achievement goal orientations can be beneficial for the improvement of the academic performance and well-being among medical students., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 Li, Zhao, Tian, Sun, Zhao, Guo, Zhu, Gao, Yang, Cao and Zhang.)

Expanding the photoresponse range of TiO2-based photocatalysts is of great interest for photocatalytic H2 production. Herein, noble-metal-free CuInS2 quantum dots were employed as a novel inorganic dye to expand the visible light absorption of TiO2/MoS2 for solar H2 generation. The as-prepared CuInS2/TiO2/MoS2 photocatalysts exhibit broad absorption from the ultraviolet to near-infrared region. Under visible light irradiation (λ > 420 nm), the CuInS2/TiO2/MoS2 photocatalyst with 0.6 mmol g-1 CuInS2 and 0.5 wt% MoS2 showed the highest H2 evolution rate with a value of 1034 μmol h-1 g-1. Moreover, a considerable H2 evolution rate of 141 μmol h-1 g-1 was obtained under the irradiation of the optimized CuInS2/TiO2/MoS2 photocatalyst with >500 nm light. The reaction mechanism of the CuInS2/TiO2/MoS2 photocatalyst for photocatalytic H2 evolution was investigated in detail by photoluminescence decay study, and the results showed that the photoexcited electrons of CuInS2 can be transferred efficiently through TiO2 to MoS2 and then react with the absorbed protons to generate H2. The reported sensitization strategy tremendously improves the visible light absorption capacity and the photocatalytic performance of TiO2-based photocatalysts.

Exploiting photocatalysts respond to visible light is of huge challenge for photocatalytic H2 production. Here, we synthesize a new composite material consisting of few-layer MoS2 nanosheets grown on CuInS2 surface as an efficient photocatalyst for solar H2 generation. The photocatalytic results demonstrate that the 3 wt % MoS2 /CuInS2 photocatalyst exhibits the highest H2 generation rate of 316 μmol h(-1)  g(-1) under visible light irradiation, which is almost 28 times higher than that of CuInS2 . Importantly, the MoS2 /CuInS2 photocatalyst shows a much higher photocatalytic activity than that of Pt-loaded CuInS2 photocatalyst. The enhanced photocatalytic activities of MoS2 /CuInS2 photocatalysts can be attributed to the improved charge separation at the interface of MoS2 and CuInS2, which is demonstrated by the significant enhancement of photocurrent responses in MoS2 /CuInS2 photoelectrodes. This work presents a noble-metal-free photocatalyst that responds to visible light for solar H2 generation., (© 2016 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.)

The widespread planting of genetically engineered cotton producing the Cry1Ac toxin has led to significantly reduced pesticide applications since 1997. However, consequently, the number of green mirid bugs (GMB), Apolygus lucorum (Meyer-Dür) has increased. So far the GMB, instead of the cotton bollworm Helicoverpa armigera (Hübner), has become the major pest in the transgenic Bt cotton field and has influenced cotton yield. Disproportionately, only a few studies on GMB at molecular level have been reported. Libraries from both third instar nymphs and adults were sequenced using Illumina technology, producing more than 106 million short reads and assembled into 63 029 unigenes of mean length 597 nt and N50 813 nt, ranging from 300 nt to 9771 nt. BLASTx analysis against Nr, Swissprot, GO and COG was performed to annotate these unigenes. As a result, 26 478 unigenes (42.01%) matched to known proteins and 107 immune-related, 320 digestive-related and 53 metamorphosis-related genes were detected in these annotated unigenes. Additionally, we profiled gene expression using mapping based differentially expressed genes (DEGs) strategy between the two developmental stages: nymph and adult. The results demonstrated that thousands of genes were significantly differentially expressed at different developmental stages. The transcriptome and gene expression data provided comprehensive and global gene resources of GMB. This transcriptome would improve our understanding of the molecular mechanisms of various underlying biological characteristics, including development, digestion and immunity in GMB. Therefore, these findings could help elucidate the intrinsic factors of the GMB resurgence, offering novel pest management targets for future transgenic cotton breeding., (© 2014 Institute of Zoology, Chinese Academy of Sciences.)

Background: The American Heart Association (AHA) recently developed definitions of cardiovascular health for adults and children based on 7 cardiovascular disease risk factors or health behaviors. We applied this new construct to examine the cardiovascular health status in adult Chinese urban residents., Methods: Data of 1,012,418 subjects aged 20-65 years (55% were men; mean age, 42.4 years) who received health examination at 58 health examination centers across China was analyzed. The AHA ideal health behaviors index and ideal health factor index were evaluated among the subjects., Results: Only 0.6% of male and 2.6% of female subjects met all 7 health components, and only 39.1% of the subjects met 5 or more components of ideal cardiovascular health. The prevalence of "ideal", "intermediate" and "poor" cardiovascular health was 1.5%, 33.9% and 64.6%, respectively., Conclusion: About two-thirds of the adult Chinese urban population has "poor" cardiovascular health. Comprehensive individual and population-based interventions must be developed to improve cardiovascular health status in China., (Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.)

The leishmaniases are zoonotic diseases caused by protozoan parasites of the genus Leishmania. Leishmaniases are still endemic in China, especially in the west and northwest froniter regions. To revalue the preliminary phylogenetic results of Chinese Leishmania isolates, we amplified partial fragment of small subunit ribosomal RNA (SSU rRNA) and 7 spliced leader RNA (7SL RNA), then tested the phylogenetic relationships among Chinese Leishmania isolates and their relatives by analyzing SSU rRNA gene sequences and 7SL RNA gene sequences. 19 SSU RNA sequences and 9 7SL RNA sequences were obtained in our study, then analyzed with 42 SSU RNA sequences and 32 7SL RNA sequences retrieved from Genbank, respectively. In the Bayesian analysis of the SSU RNA gene, the isolate MHOM/CN/93/GS7 and the isolate IPHL/CN/77/XJ771 are members of Leishmania donovani complex, while the isolate MHOM/CN/84/JS1 clustered with Leishmania tropica. The other 11 Chinese Leishmania isolates (MHOM/CN/90/WC, MCAN/CN/90/SC11, MHOM/CN/80/XJ801, MHOM/CN/85/GS4, MHOM/CN/84/SD1, MCAN/CN/86/SC7, MHOM/CN/54/#3, MHOM/CN/83/GS2, MHOM/CN/90/SC10H2, MHOM/CN/89/GS6 and MHOM/CN/ 89/GS5) form an unclassified group, defined as Leishmania sp., and the most relative species to this group is L. tarentolae. In the Bayesian analysis of the 7SL RNA gene, 9 Chinese Leishmania isolates also formed an unclassified group with L. tarentolae, including canine isolate 10, MHOM/CN/85/GS4, MHOM/CN/84/SD1, MCAN/CN/86/SC7, MHOM/CN/54/#3, MHOM/ CN/83/GS2, MHOM/CN/90/SC10H2, MHOM/CN/89/GS6 and MHOM/CN/89/GS5. We concluded that: (1) Chinese Leishmania isolates are non-monophyly group; (2) an unclassified group may exist in China, and the most relative species to this group is L. tarentolae; (3) MHOM/CN/84/JS1, which was previously assigned as L. donovani, was most genetically related to L. tropica strain MHOM/SU/74/K27.

This work describes a simple method to yield large amounts of the isolate MHOM/CN/90/SC10H2 amastigotes-like forms in axenic cultures using promastigotes as the starting population. The isolate MHOM/CN/90/SC10H2, used in this study, belongs to an undescribed species of Leishmania endemic to hill foci in China. The method describes induced extracellular amastigote transformation of this isolate. The rounded parasite obtained in axenic culture was morphologically similar, even at the ultrastructural level, to intracellular amastigotes. Moreover, the axenic amastigotes remained viable as verified by the stage-specific genes (gp46 and p4 genes) with RT-PCR. A 70-80 kDa protein was recognized by polyclonal antibody HRP-IgG only in axenic-derived amastigotes and not in promastigotes., (Copyright © 2011 Elsevier B.V. All rights reserved.)

Osteoporosis is a major health hazard and is a disease of old age; it is a silent epidemic affecting more than 200 million people worldwide in recent years. Based on a large number of chemical and pharmacological research many plants and their compounds have been shown to possess antiosteoporosis activity. This paper reviews the medicinal plants displaying antiosteoporosis properties including their origin, active constituents, and pharmacological data. The plants reported here are the ones which are commonly used in traditional medical systems and have demonstrated clinical effectiveness against osteoporosis. Although many plants have the potential to prevent and treat osteoporosis, so far, only a fraction of these plants have been thoroughly investigated for their physiological and pharmacological properties including their mechanism of action. An attempt should be made to highlight plant species with possible antiosteoporosis properties and they should be investigated further to help with future drug development for treating this disease.

Leishmaniasis is a geographically widespread disease caused by protozoan parasites belonging to the genus Leishmania and transmitted by certain species of sand fly. This disease still remains endemic in China, especially in the west and northwest frontier regions. A recent ITS1 phylogeny of Chinese Leishmania isolates has challenged some aspects for their traditional taxonomy and cladistic hypotheses of their phylogeny. However, disagreement with respect to relationships within Chinese Leishmania isolates highlights the need for additional data and analyses. Here, we test the phylogenetic relationships among Chinese isolates and their relatives by analyzing kinetoplast cytochrome oxidase II (COII) gene sequences, including 14 Chinese isolates and three isolates from other countries plus 17 sequences retrieved from GenBank. The COII gene might have experienced little substitution saturation, and its evolutionary process was likely to have been stationary, reversible, and homogeneous. Both neighbor-joining and Bayesian analyses reveal a moderately supported group comprising ten newly determined isolates, which is closely related to Leishmania tarentolae and Endotrypanum monterogeii. In combination with genetic distance analysis as well as Bayesian hypothesis testing, this further corroborates the occurrence of an undescribed species of Leishmania. Our results also suggest that (1) isolate MHOM/CN/93/GS7 and isolate IPHL/CN/77/XJ771 are Leishmania donovani; (2) isolate MHOM/CN/84/JS1 is Leishmania tropica; (3) the status referring to an isolate MRHO/CN/62/GS-GER20 from a great gerbil in Gansu, China, as Leishmania gerbilli, formerly based on multilocus enzyme electrophoresis, is recognized; and (4) E. monterogeii is nested within the genus Leishmania, resulting in a paraphyletic Leishmania. In addition, the results of this study enrich our understanding of the heterogeneity and relationships of Chinese Leishmania isolates.

To investigate the protect effects of the recombinant protein FlaA/MompS/PilE against Legionella pneumophila (L. pneumophila), the coding sequences of the three proteins were optimized by DNA Star software firstly, cloned, expressed by Escherichia coli BL21, and purified. To give an enhanced the immunological response, the proteins were linked together with (Linker) or without a linker insert (NLinker) and were purified from E. coli BL21. The A/J mouse model was used to determine the level of the induction of protective immunity from the purified proteins. Our results showed that the IgG titer, which was measured by ELISA, was increased after the administration of the five proteins. Compared to the administration of the individual proteins, the chimeric Linker and NLinker proteins displayed lasting immunity to a lethal dose of L. pneumophila challenge. The Linker protein protected the A/J mouse against a higher dose of L. pneumonia compared to the other proteins used in this study, as it contained a more effective immunogen. The work presented here demonstrates that the bioinformatics software, DNA Star, is a valid tool to analyse the epitopes of proteins and was useful in the optimization of proteins that could induce the protective immune response to L. pneumophila. The cross-immunity of recombinant proteins, such as the Linker and the NLinker chimera, have higher generates a greater immune than the single proteins., (Copyright © 2011 Elsevier Ltd. All rights reserved.)

Six phenolic compounds isolated from Curculigo orchioides, including 2,6-dimethoxy benzoic acid (1), curculigoside A (2), curculigoside B (3), curculigine A (4), curculigine D (5) and 3,3',5,5'-tetramethoxy-7,9':7',9-diepoxylignan-4,4'-di-O-beta-D-glucopyranoside (6), together with the ethanol extract of Curculigo orchioides were evaluated for their activity on osteoblasts in neonatal rat calvaria cultures and multinucleated osteoclasts derived from rat marrow cells so as to characterize the antiosteoporotic components of this plant and explore the relationship of chemical structure with antiosteoporotic activity. The proliferation of osteoblast was assayed by MTT methods. The activity of ALP (alkaline phosphatase) and TRAP (tartrate-resistant acid phosphatase) was measured by p-nitrophenyl sodium phosphate assay. The TRAP stain was used to identify osteoclast in morphology. The resorption pit area on the bone slices formed by osteoclast was measured by computer image processing. The ethanol extract exhibited stimulatory effect on both the osteoblast proliferation and the ALP activity. Six compounds all increased the osteoblast proliferation, and compounds (1), (2) and (4) also slightly increased the osteoblastic ALP activity. Compounds (1), (2), (3), (6) and the ethanol extract decreased area of bone resorption pit, osteoclastic formation and TRAP activity. These results indicated that phenolic compounds are antiosteoporotic chemical constituents from Curculigo orchioides, and their activities are related with chemical structures.

Objective: Natural medicines derived from plants have aroused increasing interest in the prevention and treatment of osteoporosis. This is due to their unique characteristics as these are more suitable for long-term use compared with synthesized chemicals and have apparently fewer adverse effects. Curculigo orchioides (CO) has a long history in the treatment of postmenopausal osteoporosis in traditional Chinese medicine. The present study was designed to investigate the protective effects of ethanol extracts of CO on ovariectomy-induced bone loss., Methods: Sixty female (4.5-month-old) Sprague-Dawley rats were assigned to sham and OVX groups. The OVX rats were further divided into five subgroups treated respectively, with vehicle, nylestriol (1 mg/kg, i.g.) and CO extract (0.5, 1.0, and 2.0 g/kg, i.g.) for 12 weeks. Bone mineral density (BMD) and bone mineral content (BMC) were measured by peripheral quantitative computerized tomography (pQCT) densitometry. Serum phosphorus, calcium, ACTH, corticosterone, deoxypyridinoline crosslinks to creatinine ratio (DPD/Cr), alkaline phosphate (ALP), tartrate-resistant acid phosphatase (TRAP), osteoprotegerin (OPG), IL-6, and TNF-alpha were also determined., Results: Administration of CO extract prevented bone loss in the trabecular bone of the tibia in ovariectomized rats without affecting the weight of the body and the uterus, and increased serum phosphorus, calcium, and OPG levels, decreased serum DPD/Cr, TRAP, ACTH, and corticosterone levels, but did not alter serum TNF-alpha, IL-6, and ALP levels in ovariectomized rats., Conclusion: CO ethanol extract has a definite protective effect on bone loss in ovariectomized rats by inhibiting bone resorption and increasing serum phosphorus and calcium levels, without affecting bone formation. Therefore, CO can be considered a potential antiosteoporosis herbal plant, although more studies are needed to clarify its real potential chemical constituents and their mechanism of action.