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BackgroundPersistent infection of high-risk human papillomavirus (HPV) can lead to cervical intraepithelial neoplasia, cervical cancer, and even death. HPV vaccination for girls aged 9-14 years can effectively prevent the occurrence of cervical cancer. Some Chinese provinces and cities have launched free HPV vaccination programs for school-age girls; however, due to the lack of supportive government policies, the high price and supply shortage of HPV vaccines, and vaccine hesitancy, some parents refuse to vaccinate their daughters. ObjectiveThis protocol reports the design of a randomized controlled trial (RCT) aiming to explore the efficacy of a digital HPV vaccination education intervention based on the information-motivation-behavioral skills (IMB) model in improving the HPV vaccination rate among 11-13-year-old girls in central and western China. MethodsA multicenter intervention study based on an online applet will be conducted in December 2024, and about 750 eligible parents of 11-13-year-old girls will be assigned in a 1:1 ratio to an intervention group receiving 7-day digital HPV vaccination education based on the IMB model or a control group using non-HPV publicity materials. Free HPV vaccination pilot projects will be carried out among this population by our research team in central and western China (some parents might refuse to vaccinate their daughters). All participants will be asked to complete online questionnaires at baseline; postintervention; and 1 week, 1 month, and 3 months after the intervention. ResultsThe primary outcome of this study will be receipt of the first HPV vaccination within 3 months. Data will be analyzed based on an intention-to-treat approach, and Stata 16.0 will be used for statistical analysis. ConclusionsThis study aims to improve the HPV vaccination rate among 11-13-year-old girls and will examine the impact of a digital HPV vaccination education intervention based on the IMB model. The findings of this study may offer promising intervention measures for HPV vaccine hesitancy in low-health-resource areas in the future. Trial RegistrationChinese Clinical Trial Registry, ChiCTR2300067402; https://tinyurl.com/v5zt4hc9 International Registered Report Identifier (IRRID)PRR1-10.2196/58873

During the Omicron pandemic in late 2022, this study surveyed Chinese students via an online questionnaire to assess their mental health status, prevalence of psychological symptoms, and associated factors. A nationwide cross-sectional survey of 4254 participants was conducted in seven regions of China from January 5 to February 9, 2023. Scales were utilized respectively to measure depressive symptoms, anxiety symptoms, post-traumatic stress disorder (PTSD) symptoms, and perceived social support. Descriptive, univariate, and multivariable analyses were performed to identify associated factors. Protective factors against depressive symptoms include regular exercise and robust social support networks, while risk factors involve excessive alcohol consumption, comorbidities, Omicron infection, and irregular sleep patterns. Risk factors for anxiety symptoms include comorbidities, Omicron infection, living alone, and irregular sleep patterns, while social support emerges as a protective factor. For PTSD symptoms, regular exercise and strong social support systems are identified as protective measures, with risks associated with comorbidities, Omicron infection, and poor sleep quality. Students are particularly vulnerable during the pandemic due to their lifestyle and academic pressures. It's essential to bolster their social support and promote healthier habits.

Background Mental health problems in patients with chronic obstructive pulmonary disease (COPD) are common and frequently neglected. Digital psychological interventions may reduce mental health problems, but their effectiveness has not been evaluated in the Chinese COPD population. In this study, we will develop an integrated digital psychological intervention ( EmoEase ) and evaluate its effectiveness and cost-effectiveness in enhancing the mental wellbeing of patients with COPD in China. Methods This study is a multicenter, two-arm, randomized controlled trial (RCT) with a parallel-group design to enroll at least 420 patients with COPD with age over 35 years. Participants will be assigned to receive either usual care (control group) or usual care + EmoEase (intervention group). Assessments will take place at baseline (T0) and 4 weeks (T1), 8 weeks (T2), and 16 weeks (T3) after baseline, and participants will be asked to complete questionnaires and physical measurements. The primary outcome measure will assess mental wellbeing using the Warwick Edinburgh Mental Wellbeing Scale (WEMWBS). Secondary outcome measures will assess mental health, physical health, COPD symptoms, health risk behaviors, socioeconomic indicators, and healthcare utilization and expenditure. Analyses will utilize an intention-to-treat approach. Discussion This is the first RCT to examine the value of EmoEase , a novel digital psychological intervention for patients with COPD. If this intervention is effective and cost-effective, it could be rapidly scaled up to provide mental healthcare for patients with COPD in China. Trial registration ClinicalTrials.gov Identifier: NCT06026709. Date of first submission: 30 August 2023. https://clinicaltrials.gov/study/NCT06026709

AIM:To observe the anti-scarring effects and safety of triamcinolone acetonide(TA)-loaded hydrogel sustained-release sheeting on stab incision glaucoma surgery(SIGS)with “one-step tunnel method” in rabbit eyes.METHODS:A total of 48 healthy New Zealand white rabbits were randomly selected and divided into 4 groups(12 rabbits in each group), trabeculectomy(Trab)group, SIGS group, polyvinyl alcohol hydrogel(PVAH)sheeting was implanted under the conjunctiva flap during SIGS(PVAH group), and hydrogel sustained-release sheeting loaded with TA was implanted under the conjunctiva flap during SIGS(TA/PVAH group). On the 1, 2, 3, and 4 wk after surgery, the intraocular pressure, filtering bubble morphology, anterior chamber reaction, and other complications were observed and recorded in each group. Then animals were euthanized, and the surgery area tissues of right eye were taken for pathological tissue paraffin section. Masson staining, picric acid-Sirius rose red staining, as well as α-smooth muscle actin(α-SMA)and fibroblast growth factor 2(FGF2)immunohistochemistry staining was performed on every section. The infiltration of inflammatory cells, proliferation of fibroblasts and synthesis of type I and type III collagen fibers in local tissues were observed. The average positive area ratio of α-SMA and FGF2 antibody immunohistochemical staining in each group was calculated and compared.RESULTS: The TA/PVAH group maintained diffuse and elevated functional filtering blebs, while flat filtering blebs appeared in Trab, SIGS and PVAH groups at 2 wk after surgery. Functional filtering blebs were present in 1 eye(33%), 2 eyes(67%)in the PVAH and TA/PVAH group at 4 wk after surgery, respectively, while the other filtering blebs were flattened. Masson staining showed that the hydrogels in PVAH and TA/PVAH groups did not degrade at 4 wk after surgery. Compared with the Trab and SIGS groups, the filtration passages were more obvious, with less collagen fiber proliferation. Sirius red staining showed that the expression of type I collagen and type III collagen in the TA/PVAH group was less than that in the Trab group, SIGS group and PVAH group at 4 wk after surgery. Immunohistochemical staining showed that the α-SMA expression in the TA/PVAH group was significantly lower than that in the Trab and SIGS groups at 1 wk after surgery(P

This purpose of this study was to evaluate the effect of pre-drying on the oil penetration and texture characteristics of deep-fried battered and breaded fish nuggets. Battered breaded fish nuggets (BBFNs) were dried in a drying oven and dried at 40 ℃ for 3, 4.5, 6, 7.5 and 9 h and deep fried at 180 ℃ for 60 s. Moisture state in dried BBFNs and deep-fried BBFNs was measured, and the oil content and distribution, microstructure and texture characteristics of deep-fried BBFNs were analyzed. The absorption of oil during deep-fat frying was simulated. The results showed that after deep-fat frying, the contents of strongly bound water (T21), weakly bound water (T22) and free water (T23) in the crust, the content of strongly bound water in the fish nuggets, the content of weakly bound water inside muscle fibers, and the content of free content outside muscle fibers were reduced. As the drying time increased, the starting time of peak T22 for the deep-fried crust gradually decreased, indicating declined freedom degree of water, and the signal intensity of peaks T21 and T22 decreased, suggesting that the bound water was converted to free water. In addition, only fish nuggets with 9 h drying showed a left shift in peak T22. The surface oil (SO) and total oil (TO) contents of deep-fried BBFNs decreased while the penetrated surface oil (PSO) content increased. The crust structure was first tight and then became rough, and the surface of the fish was smooth first and then exhibited cracks and holes. The fluorescence intensity of the crust became weaker gradually. The Sudan red-dyed region in the crust decreased while that of the junction between the crust and the fish nuggets increased gradually. The hardness and crispiness of the crust first decreased and then increased, while the elasticity and chewiness of the fish nuggets presented the opposite trend. These results indicated that pre-drying alleviated the freedom degree of moisture in BBFNs, and changed the microscopic structure of deep-fried BBFNs, thereby affecting the oil penetration and texture characteristics. The study may provide a theoretical basis and scientific guidance for the large-scale production of low-fat deep-fried BBFNs.

Abstract Aim To analyse the factorial structure and psychometric properties of the Chinese Short‐Form Five Facets of Mindfulness Questionnaire (FFMQ‐SF) among nursing students in the Chinese mainland. Design A cross‐sectional study. Methods A total of 240 undergraduate nursing students were recruited from a school of nursing in Beijing, China from 25 to 30 April 2021. FFMQ‐SF and Depression‐Anxiety‐Stress Scale were used to collect information on the mindfulness level and mental health status of the study participants. Descriptive analyses were performed to examine the demographic characteristics. Confirmatory factor analyses (CFAs) were used to test the structural, convergent and discriminant validity of the scale model. Pearson correlation analysis was used to test the correlation between the variables and the criterion validity. Results The overall fit of the scale model is good (Bollen–Stine χ2 = 177.206, df = 142, GFI = 0.923, AGFI = 0.883, TLI = 0.980, CFI = 0.983, RMSEA = 0.032, SRMR = 0.090). One‐factor models using CFA demonstrated the overall best fit for four out of five subscales of the FFMQ‐SF. In the five‐factor CFA of the FFMQ‐SF, the composite reliability values of the five factors were from 0.685 to 0.870 and the values of average variance extracted were from 0.426 to 0.627. Patient or Public Contribution The students who participated in this study contributed to the advancement of knowledge on mindfulness and mental health among nursing students in China. They voluntarily completed the online questionnaires and provided their honest and valid responses. Their data was used to evaluate the psychometric properties of the FFMQ‐SF and to examine the relationship between mindfulness and psychological problems. Their feedback also helped to improve the quality and applicability of the FFMQ‐SF instrument for future research and practice.

Abstract Background As the HIV epidemic among MSM in China continues, Chinese men who have sex with men (MSM) face various mental health difficulties, including suicide ideation, depression, and stigma. The current study aims to assess the mechanisms between HIV-related stigma, depression, and suicidal ideation among MSM in China. Methods This national cross-sectional study was completed on the geosocial networking application (GSN) app, Blued, from December 2020 to March 2021. We used the HIV Stigma Scale and the Center for Epidemiologic Studies Depression Scale (CES-D10) to measure HIV stigma and depression, respectively. Suicidal ideation was measured by the suicidal ideation-related item. Descriptive analyses, logistic regression, and structural equation modeling (SEM) were used for data analysis. Results A total of 244 HIV-positive MSM were included in the analysis. The mediation model revealed that the direct pathway of perceived HIV-related stigma on suicidal ideation was significant (standardized pathway coefficient = 0.07), and the indirect pathway of perceived HIV-related stigma on suicidal ideation via depression was also significant (standardized pathway coefficient = 0.04). There was a partial mediating effect of depression in the association between perceived HIV-related stigma and suicidal ideation. Conclusions Our study found that both perceived HIV-related stigma and depression were associated with suicidal ideation among HIV-positive MSM in China, and that depression could serve as a mediator between HIV-related stigma and suicidal ideation. Targeted interventions regarding HIV-related stigma and depression should be taken into account to reduce suicidal ideation among HIV-positive MSM in China.

Abstract Transcranial magnetic stimulation (TMS)-evoked potentials (TEPs), recorded using electroencephalography (EEG), reflect a combination of TMS-induced cortical activity and multi-sensory responses to TMS. The auditory evoked potential (AEP) is a high-amplitude sensory potential—evoked by the “click” sound produced by every TMS pulse—that can dominate the TEP and obscure observation of other neural components. The AEP is peripherally evoked and therefore should not be stimulation site specific. We address the problem of disentangling the peripherally evoked AEP of the TEP from components evoked by cortical stimulation and ask whether removal of AEP enables more accurate isolation of TEP. We hypothesized that isolation of the AEP using Independent Components Analysis (ICA) would reveal features that are stimulation site specific and unique individual features. In order to improve the effectiveness of ICA for removal of AEP from the TEP, and thus more clearly separate the transcranial-evoked and non-specific TMS-modulated potentials, we merged sham and active TMS datasets representing multiple stimulation conditions, removed the resulting AEP component, and evaluated performance across different sham protocols and clinical populations using reduction in Global and Local Mean Field Power (GMFP/LMFP) and cosine similarity analysis. We show that removing AEPs significantly reduced GMFP and LMFP in the post-stimulation TEP (14 to 400 ms), driven by time windows consistent with the N100 and P200 temporal characteristics of AEPs. Cosine similarity analysis supports that removing AEPs reduces TEP similarity between subjects and reduces TEP similarity between stimulation conditions. Similarity is reduced most in a mid-latency window consistent with the N100 time-course, but nevertheless remains high in this time window. Residual TEP in this window has a time-course and topography unique from AEPs, which follow-up exploratory analyses suggest could be a modulation in the alpha band that is not stimulation site specific but is unique to individual subject. We show, using two datasets and two implementations of sham, evidence in cortical topography, TEP time-course, GMFP/LMFP and cosine similarity analyses that this procedure is effective and conservative in removing the AEP from TEP, and may thus better isolate TMS-evoked activity. We show TEP remaining in early, mid and late latencies. The early response is site and subject specific. Later response may be consistent with TMS-modulated alpha activity that is not site specific but is unique to the individual. TEP remaining after removal of AEP is unique and can provide insight into TMS-evoked potentials and other modulated oscillatory dynamics.

BackgroundSelf-management is important for the blood sugar control of middle-aged and elderly Type 2 diabetes mellitus (T2DM) patients, of which diet, exercise, and drug compliance are the most common components. The Information-Motivation-Behavioral Skills Model (IMB) has been widely used in health behavior management and intervention.ObjectiveThe purpose of this study is to develop and validate the Diabetic Self-Management Scale (DSMS) based on the IMB model.MethodsSelf-report survey data was collected from middle-aged and elderly T2DM patients in Zhongmu City, Henan Province, China in November 2021 using convenience sampling. The original DSMS was developed through a literature review and summary of previous similar scales using an inductive approach. Item modification was finished by a panel of specialists. Exploratory factor analysis and confirmatory factor analysis were used to evaluate the reliability, convergent validity, discriminant validity, and criterion validity of DSMS.ResultsFour hundred and sixty nine T2DM patients completed the questionnaire survey. The final DSMS consists of 22 items with three dimensions, including information (five items), motivation (eight items), and behavior skills (nine items). The results of simple factor analysis showed that the KMO value was 0.839, Bartlett spherical test 2 = 3254.872, P < 0.001. The results of confirmatory factor analysis showed that 2/df = 2.261, RMSEA = 0.073, CFI = 0.937, TLI = 0.930, and SRMR = 0.096. The standardized factor loadings of 22 DSMS items were all above 0.6, and the CR values of 3 dimensions were all higher than 0.9. In addition, DSMS also showed good discriminant and criterion validity.ConclusionThe 22-item DSMS has good reliability and validity, and can be used to make diabetic self-management assessment regarding diet, physical activity, and medication among middle-aged and elderly Chinese T2DM patients. DSMS is of moderate length and easy to understand. It can be promoted in China in the future to understand the self-management status of middle-aged and elderly T2DM patients in China.

ObjectiveTo evaluate the effect of mindfulness intervention on improving mental health among undergraduate nursing students during the coronavirus disease 2019 (COVID-19) pandemic in China.MethodsAn online mindfulness intervention course named Mindfulness Living With Challenge (MLWC) was developed by the research team, and a randomized controlled trial using MLWC among Chinese undergraduate nursing students was carried out. A total of 120 undergraduate nursing students were randomized into control (60 students) and intervention groups (60 students) via a WeChat mini program. Self-administered questionnaire surveys were conducted at pre- and post-intervention, measuring depression, anxiety, stress, mindfulness, and perceived social support. After intervention, the acceptance of the online mindfulness course among participants was assessed by employing the theory of technology acceptance model (TAM).ResultsAmong the enrolled 120 participants, 86.67% (52/60) and 93.33% (56/60) of the intervention and control groups remained completed the trial and the questionnaire surveys. Compared with the control group, the reduction of anxiety and stress symptoms, as well as the improvement of mindfulness level and perceived social support in the MLWC intervention group were statistically significant (P < 0.05), while the change in depression was not statistically significant. The scores of the four dimensions in TAM ranged from (5.88 ± 0.94) to (5.91 ± 0.97).ConclusionOnline mindfulness intervention implemented in this study is effective in improving mental health among undergraduate nursing students, and they were interested in this intervention.Clinical trial registration[www.ClinicalTrials.gov], identifier [ChiCTR2 200058103].

Anwulignan is a representative component of Chinese traditional medicine Schisandra sphenanthera, with strong pharmacological activities. However, there are few reports on its pharmacokinetics and metabolites in the body. In this study, a metabolomic method based on UHPLC-Q-Orbitrap-MS was used to study the pharmacokinetics of anwulignan in the blood, organs, urine, and feces samples of mice after the intragastric administration of anwulignan (10 mg/kg). The pharmacokinetic parameters were calculated, and the distribution characteristics and main metabolites of anwulignan in the body of mice were analyzed. The results showed that the retention time of anwulignan in the body of mice was longer (t1/2 = 7.1 h), and anwulignan was widely distributed in the body (Vz/F = 32.81 L/kg), especially in the liver. The order of anwulignan concentration in the tissues of mice from high to low was the liver > heart > brain > kidney > lung > spleen. Anwulignan was mainly excreted through the digestive tract in the form of its prototype and metabolites, indicating that it might experience an enterohepatic circulation. A total of seven metabolites were identified, and the demethylation, hydroxylation, dehydroxylation, and demethoxylation were considered to be the main metabolic ways of anwulignan in the body of mice.

This study analyzed nationally representative child welfare data to compare child and family well-being outcomes between IDEA Part C early intervention participants and non-participants needing developmental services. Controlling for child [...]