Reliability and validity of a novel mobile-based automatic battery of cognitive tests in healthy young Chinese adults

PURPOSE

To evaluate the reliability and validity of a newly developed computerized Automated Battery of Cognitive Tests in healthy individuals without cognitive impairments or psychiatric disorders.

METHODS

From April 20 to July 1, 2023, 142 healthy individuals in Beijing and Tangshan, China were assessed using the Automated Battery of Cognitive Tests. After a 3-week interval, 36 participants were randomly selected for retesting. The assessment also included administration of the Repeatable Battery for the Assessment of Neuropsychological Status and the Automated Battery of Cognitive Tests to 59 participants.

RESULTS

The Automated Battery of Cognitive Tests consists of 16 subtests. Internal consistency reliability was 0.75. The test-retest reliability for each factor ranged from 0.337 to 0.850 (p < 0.05). The criterion-related validity, as measured by correlation with the total Repeatable Battery for the Assessment of Neuropsychological Status score, was 0.748 (p < 0.001). The cumulative variance contribution rate is 70.109%. The results of the confirmatory factor analysis indicated a good model fit.

CONCLUSIONS

The computerized Automated Battery of Cognitive Tests is a cognitive self-assessment tool with good reliability and validity. It can evaluate multiple aspects of cognitive performance in healthy individuals and is suitable for self-administration through remote access via Internet.

Pain Characteristics of Patients With Fibromyalgia: A Comparison Between Gender and Different Emotional States

BACKGROUND

Generalized pain is the core symptom of fibromyalgia (FM). Few studies have described FM's different pain characteristics under various conditions.

OBJECTIVE

To explore the pain characteristics of patients with FM of different gender and emotional states.

STUDY DESIGN

A cross-sectional study.

SETTING

A medical center in Beijing, People's Republic of China.

METHODS

A total of 197 patients with FM were recruited from an outpatient clinic. Three distinct instruments were used to assess their pain characteristics: the Numeric Rating Scale (NRS-11) to assess pain severity, the Widespread Pain Index (WPI) to assess the number of pain regions, and the Short Form-McGill Pain Questionnaire-2 (SF-MPQ-2) to assess pain qualities. The Zung Self-Rating Anxiety Scale and Zung Self-Rating Depression Scale were used to assess patients' emotional states. An independent 2-sample t test, chi-squared test, and Mann-Whitney U test were used to analyze gender pain characteristics differences and different emotional states (with/without anxiety, with/without depression).

RESULTS

Pain severity on the NRS-11 was 7 (5-8), the number of pain regions determined by WPI was 13 (10-16), and the total score of different pain qualities from the SF-MPQ-2 was 2.36 (1.68-3.73) in all patients with FM. The most frequently reported regions of pain were the right shoulder girdle (89.34%), left shoulder girdle (88.32%), upper back (85.28%), and neck (81.73%). The most frequently reported pain qualities were tiredness/exhaustion (97.46%), aching pain (94.42%), numbness (78.68%), cold/freezing pain (75.63%), and tenderness (75.13%). Women patients reported more severe pain and numbness, less frequent chest pain, and shooting pain than men patients did. Patients with FM and anxiety experienced more frequent and more severe feelings of punishing/cruel thoughts, fearfulness, sickening, and tenderness; more frequent jaw pain and cold-freezing pain; more severe pain caused by light touch and tiredness/exhaustion; less frequent lower leg pain than those without anxiety did. Patients with FM and depression reported more frequent and more severe pain caused by light touch; more frequent tenderness; more severe feelings of tiredness/exhaustion, sickening,fearfulness, and punishing/cruel thoughts; and less frequent and less severe piercing pain than those without depression did.

LIMITATIONS

The limitations of this study are its single-center design and lack of objective pain indicators.

CONCLUSION

Gender significantly affected pain severity, chest pain, numbness, and shooting pain. Jaw pain, lower leg pain, cold/freezing pain, tenderness, pain caused by light touch, piercing pain, and pain-affective descriptors are closely related to emotional states in FM. A comprehensive understanding of pain characteristics in patients with FM would be helpful for disease education, diagnosis, and treatment.

Role of low-density lipoprotein in mediating the effect of air pollution on coronary heart disease: a two-step multivariate Mendelian randomization study

OBJECTIVE

Air pollution is affecting the health of millions of people all over the world. The causal correlations of PM2.5, PM10, and nitrogen dioxide (NOx), as the main fine particulate matter, and coronary heart disease (CHD) are yet to be explored. Low-density lipoprotein (LDL) has been a principal factor in the pathogenesis of CHD. It is an interesting issue to consider whether LDL mediates the effect of air pollutants in CHD pathogenesis.

MATERIALS AND METHODS

A genome-wide association study (GWAS) on the European population, followed up from 2010 to 2018, involving over 400,000 participants, was based on a land-use regression model. The annual mean concentrations of major air pollutant particles, PM2.5 (n=423,796), PM10 (n=423,796), and NOx (n=456,380), were recorded. The large GWAS database of CHD covered over ten million SNPs with independent single nucleotide polymorphisms (SNPs). LDL database collected major biochemical blood parameters from over 400,000 patients (n=440,546). Taken together, we conducted independent two-sample Mendelian randomization (MR) analyses for the causality between air pollutants (PM2.5, PM10, and NOx) and CHD. Multivariate MR analysis was conducted using causal relationships to determine the direct effects of exposure on outcome. The fixed-effect inverse variance weighted (IVW2) method was mainly employed to assess this relationship, with a confidence interval of 95% for the odds ratio (OR). Also, MR-Egger, weighted median, maximum likelihood ratio method, and random-effects inverse variance-weighted (IVW1) method were adopted as supplementary methods.

RESULTS

Two-sample MR results based on the IVW2 method suggested positive correlations between PM2.5 and CHD [OR 1.875 (1.279-2.748), p=0.001], PM10 and CHD [OR 2.586 (1.479-4.523), p=0.001], and NOx and CHD [OR 2.991 (2.021-4.427), p=4.37E-08]. The direct effect and mediating proportion were calculated using multivariable Mendelian randomization (MVMR). Lastly, the mediating proportions of LDL in the regulatory roles of PM2.5, PM10, and NOx in CHD were 2.82%, 4.73%, and 9.54%, respectively.

CONCLUSIONS

PM2.5, PM10, and NOx share direct causal associations with CHD, and LDL performs a mediating role in this pathogenic process. Early prevention against air pollution (such as increasing green areas and reducing large-scale industrial dust emissions) and early lipid-lowering treatment can effectively prevent the occurrence of CHD.

Impact of COVID-19 infection experience on mental health status of intensive care unit patients' family members: a real-world study

PURPOSE

Family members of patients hospitalized in intensive care unit (ICU) are susceptible to adverse psychological outcomes. However, there is a paucity of studies specifically examining the mental health symptoms in ICU patients' family members with a prior history of coronavirus disease 2019 (COVID-19) infection.

AIM

This study aimed to investigate mental health status and its influencing factors of ICU patients' family members with previous COVID-19 infection experience in China.

DESIGN

Nationwide, cross-sectional cohort of consecutive participants of family members of ICU patients from 10 provinces randomly selected in mainland China conducted between October 2022 and May 2023.

METHODS

The basic information scale, Self-rating depression scale, Self-rating Anxiety Scale, Impact of Event Scale-Revised, Pittsburgh sleep quality index, Perceived Stress Scale, Connor-Davidson resilience scale, Simplified Coping Style Questionnaire were employed to explore mental health status among participants.

RESULTS

A total of 463 participants, comprising 156 individuals in Covid-19 family member cohort (infection group) and 307 individuals in control family member cohort (control group), met inclusion criteria. The infection group exhibited significantly higher incidence of composite mental health symptoms compared to control group (P = 0.017). Multivariable logistic regression analysis revealed that being female, engaging in physical/mental labor, residing in rural areas, and having children were identified as risk factors for the development of depression, anxiety, and post-traumatic stress disorder symptoms, while medical history of surgery was protective factor. A predictive model demonstrated a favorable discriminative ability and excellent calibration.

CONCLUSION

COVID-19 infection experience regarded as new traumatic stressors worsen mental health status of ICU patients' family members.

Risk factors for bloodstream infection in paediatric haematopoietic stem cell transplantation: a systematic review and meta-analysis

BACKGROUND

Haematopoietic stem cell transplantation (HSCT), a standard treatment for paediatric haematological diseases, is highly associated with bloodstream infection (BSI), which may increase mortality.

AIM

To explore the risk factors for BSI in paediatric HSCT recipients.

METHODS

Three English databases and four Chinese databases were searched from inception to March 17th, 2022. Eligible studies included randomized controlled trials, cohort studies, and case-control studies that enrolled HSCT recipients aged ≤18 years and reported BSI risk factors. Two reviewers independently screened studies, extracted data, and assessed the risk of bias. Using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE), certainty of body of evidence was assessed.

FINDINGS

Fourteen studies involving 4602 persons were included. The incidences of BSI and associated mortality in paediatric HSCT recipients were approximately 10-50% and 5-15%, respectively. Meta-analysis of all studies revealed that previous BSI before HSCT (relative effect (RE): 2.28; 95% confidence interval (CI) 1.19-4.34, moderate certainty) and receiving an umbilical cord blood transplant (RE: 1.55; 95% CI: 1.22-1.97, moderate certainty) were probably associated with an increased risk of BSI. Meta-analysis of studies with low risk of bias reassured that previous BSI before HSCT probably increased the risk of BSI (RE: 2.28; 95% CI: 1.19-4.34, moderate certainty), and revealed that steroid use (RE: 2.72; 95% CI: 1.31-5.64, moderate certainty) was likely a risk factor whereas autologous HSCT was probably a protective factor of BSI (RE: 0.65; 95% CI: 0.45-0.94, moderate certainty).

CONCLUSION

These findings could inform the management of paediatric HSCT recipients, helping identify who may benefit from prophylactic antibiotics.

Simulating nitrogen balance in Canadian agricultural soils from 1981 to 2016

Agriculture produces food, fiber and biofuels for the world's growing population, however, agriculture can be a major contributor of nitrogen (N) losses including emissions of ammonia (NH₃), nitrous oxide (N₂O) and nitrate (NO₃^-) leaching and runoff. A Canadian Agricultural Nitrogen Budget for Reactive N (CANBNr) model was developed to estimate the soil N balance in 3487 soil landscape of Canada polygons from 1981 to 2016. The CANBNr model integrates NH₃ emission from fertilizers, manure from housing, storage and field, as well as direct/indirect N₂O emissions from fertilizers, manures, crop residues and soil organic matter. The NO₃^- leaching is estimated based on the residual soil N (RSN) at harvest and drainage derived with the DeNitrification-DeComposition (DNDC) model. From 1981 to 2016, the N input from fertilizer and N fixation increased at a greater rate than N removal in harvested crops in all provinces of Canada, resulting in an increase in the RSN and N losses. In 2016, the Prairie provinces had lower N losses (11.7 kg N ha^-1) from N₂O, NH₃ and NO₃^- compared with 43.2 kg N ha^-1 in central Canada, and 76.5 kg N ha^-1 in Atlantic Canada. However, the Prairie provinces had 84.3% of the total Canadian farmland (74.3% of the total Canadian N input), while central Canada had 12.9% of Canadian farmland (21.7% of the total Canadian N input). In the Prairie provinces, the total N₂O loss from fertilizer N ranged 4.4-8.6 Gg N whereas NH₃ loss ranged from 17.1 to 44.6 Gg N and these values were influenced by both emission intensity and total land area. Total N₂O losses from manure were highest in Alberta, Ontario and Quebec resulting in 4.8, 4.4, and 3.4 Gg N and NH₃ losses from manure were also highest in these 3 provinces at 61.1, 45.2 and 40.4 Gg N, respectively. Nitrate leaching was impacted by drainage volumes, soil type and N inputs. In the non-growing season, NO₃^- leaching losses (36-yr average) were 63.3 Gg in Ontario and 57.5 Gg N in Quebec compared with 20.8 Gg N for Ontario and 35.5 Gg N for Quebec in the growing season. In contrast, the Prairie provinces showed higher NO₃^- leaching in the growing season (23.1-37.4 Gg N) than in the non-growing season (10.4-13.7 Gg N). In summary, total fertilizer N increased the most over the 36 years in the Prairies which resulted in increased RSN and N leaching losses that will require further intervention.

The safety of human embryos following long-term cryopreservation ( >6 years) on vitrification

BACKGROUND

Vitrification of embryos has become the basic means of assisted reproductive technology (ART) therapy in recent years. Concerns have also been raised about the safety of vitrification and the effect of cryopreservation time. Most of the previous studies were on the data within 6 years of cryopreservation.

OBJECTIVE

In this study, we aimed to evaluate the impact of long-term cryopreservation (>6 years) on pregnancy and neonatal outcomes.

MATERIALS AND METHODS

This research was a single-center, retrospective analysis, including 426 frozen-thawed embryo transfer (FET) cycles. Patients who participated in IVF-FET cycles between January 2013 to December 2020 were analyzed. Preferentially matched participants were divided into three groups according to storage time: group A (>72 months), group B (0-3 months, propensity score matching [PSM] according to the age of oocyte retrieval), and group C (0-3 months, PSM according to the age of embryo transfer).

RESULTS

Our results revealed that there were no significant differences in human chorionic gonadotropin [HCG] positive rate, clinical pregnancy rate, miscarriage rate, live birth rate, and neonatal outcomes when the embryo storage duration >72 months. But the proportion of high birth weight was higher in group A (>72 months) when matched according to age at embryo transfer.

CONCLUSION

The results of our study showed that long-term cryopreservation had no effect on the pregnancy and neonatal outcomes of vitrification. The results offer evidence for the safety of using long-term cryopreservation embryos after vitrification. DOI: 10.54680/fr23310110612.

Predicting depression and anxiety of Chinese population during COVID-19 in psychological evaluation data by XGBoost

BACKGROUND

Due to the onset of sudden stress, COVID-19 has greatly impacted the incidence of depression and anxiety. However, challenges still exist in identifying high-risk groups for depression and anxiety during COVID-19. Studies have identified how resilience and social support can be employed as effective predictors of depression and anxiety. This study aims to select the best combination of variables from measures of resilience, social support, and alexithymia for predicting depression and anxiety.

METHODS

The eXtreme Gradient Boosting (XGBoost¹) model was applied to a dataset including data on 29,841 participants that was collected during the COVID-19 pandemic. Discriminant analyses on groups of participants with depression (DE²), anxiety (AN³), comorbid depression and anxiety (DA⁴), and healthy controls (HC⁵), were performed. All variables were selected according to their importance for classification. Further, analyses were performed with selected features to determine the best variable combination.

RESULTS

The mean accuracies achieved by three classification tasks, DE vs HC, AN vs HC, and DA vs HC, were 0.78, 0.77, and 0.89. Further, the combination of 19 selected features almost exhibited the same performance as all 56 variables (accuracies = 0.75, 0.75, and 0.86).

CONCLUSIONS

Resilience, social support, and some demographic data can accurately distinguish DE, AN, and DA from HC. The results can be used to inform screening practices for depression and anxiety. Additionally, the model performance of a limited scale including only 19 features indicates that using a simplified scale is feasible.

Valgus-varus deformity induced abnormal tissue metabolism, inflammatory damage and apoptosis in broilers

1. This study explored the tissue metabolic status and the relationship with inflammation in valgus-valgus deformity (VVD) broilers with increasing age.2. Tissue and blood from VVD and healthy broilers were collected at two, four and five weeks old. A fully automated biochemical analyser, real-time PCR, HE staining and enzyme-linked immunosorbent assay were used to detect tissue metabolic indexes, mRNA levels of inflammation and apoptosis cytokines in immune organs, histological changes and serum inflammation and immune-related protein contents in VVD broilers.3. The results showed that VVD increased the levels of total protein, albumin, alanine aminotransferase at five weeks of age, aspartate aminotransferase, urea and creatine kinase in blood at two weeks of age. It upregulated the gene expression of inflammatory factors IL-1β, IL-6, IL-8, TNF-α, NF-κB and TGF-β and apoptotic factors FAS, Bcl-2, caspase-3 and 9 in immune organs; increased levels of serum proteins TNF-α, IL-1β and IL-6 and decreased levels of serum immunoglobulins IgY and CD3⁺.4. In addition, with increasing age, IL-10 gene expression gradually increased in the BF and decreased in the spleen.5. In conclusion, VVD broilers have disorders of liver and kidney metabolism, inflammation and apoptosis of immune organs and increased levels of serum inflammatory factor proteins.

Cross-cultural adaptation and validation of the Chinese version of the short-form of the Central Sensitization Inventory (CSI-9) in patients with chronic pain: A single-center study

Chronic pain affects more than 30% of the general population. The 9-item Central Sensitization Inventory (CSI-9) is a shortened version of the CSI-25, which is a patient-reported instrument used to screen people at risk of central sensitization (CS). The aim of this study was to cross-culturally adapt and validate a Chinese version of the CSI-9. The Chinese CSI-9 was generated by translation of the original English version, back-translation, cultural adaptation, and revision using the Delphi method. The Chinese CSI-9 was administered to 235 patients with chronic pain and 55 healthy controls. Structural validity (confirmatory factor analysis), construct validity (correlations with other scales), test-retest reliability (intraclass correlation coefficient, ICC), and internal consistency (Cronbach's α) were evaluated. Confirmatory factor analysis was performed using one factor. The Chinese CSI-9 score was positively correlated with the Pain Catastrophic Scale (PCS) total score (r = 0.463), PCS subscale scores (r = 0.347-0.463), Brief Pain Inventory (BPI) mean item score (r = 0.524), BPI total score (r = 0.773), and the number of painful sites (r = 0.451). The Chinese CSI-9 had excellent test-retest reliability (ICC = 0.958) and excellent internal consistency (Cronbach's α = 0.902 in the overall sample and 0.828 in the chronic pain population). The optimal cut-off value for the Chinese CSI-9 was 18 points. The Chinese CSI-9 had excellent test-retest reliability and satisfactory structural validity and construct validity. The CSI-9 could potentially be utilized in China as a self-report questionnaire in both clinical practice and research settings.

[Analysis of clinical and psychological characteristics in 250 patients with fibromyalgia]

To analyze the clinical and psychological characteristics of fibromyalgia (FM), so as to further understand and improve the capability of identifying FM. The clinical data of 250 FM patients diagnosed in the outpatient clinic of the Department of Rheumatology, the First Medical Center, Chinese PLA General Hospital, from December 2019 to September 2021, were collected and analyzed. The patients aged 40 (31.0, 52.3) years, including 188 female patients (75.2%) and 62 male patients (24.8%). There was a statistically significant difference in age comparison between female [42.5 (33.0,54.0) years] and male patients [32.5 (27.8,43.5) years] (P<0.001). The score of pain degree was 6 (4, 8), and [7 (5, 8)] of female patients was higher than [6 (4, 7)] of the male patients (P=0.040). The widespread pain index (WPI) was 13 (10,15). The regions with high pain incidence were left shoulder girdle (87.2%, 218/250), right shoulder girdle (86.8%, 217/250), upper back (86.4%, 216/250), neck (79.6%, 199/250) and lower back (77.6%, 194/250) and etc. The incidence of chest pain in female patients (55.3%, 104/188) was lower than that in male patients (75.8%, 47/62) (P=0.004). The symptom severity scale (SSS) score was 8 (7-10). 74.6% (185/248) suffered from anxiety and 77.5% (193/249) suffered from depression in 249 patients. Female patients were more common in FM patients than male patients, the median age of female patients was older than that of male patients, and the median score of pain severity of female patients was higher than male patients. Shoulders girdle, upper back, neck and lower back were the most frequently reported pain regions, and the incidence of chest pain in female patients was lower than that in male patients. The incidence of major non-painful symptoms was high and the proportion with anxiety or depression was high. The above clinical features are very helpful for early diagnosis of FM.

[Clonality relatedness and molecular characteristics of Richter transformation]

Objective: To investigate the clinical, genetic, and clonality related aspects of individuals with Richter transformation (RT) . Methods: From January 2019 to December 2021, 18 RT patients with diagnoses at the First Affiliated Hospital of Nanjing Medical University (Pukou CLL center) were retrospectively examined. The immunoglobin heavy variable (IGHV) gene usage and IGHV-D-J rearrangement pattern of diagnosed CLL/SLL and transformed diffuse large B-cell lymphoma (DLBCL) were compared to determine the clonality relatedness. To investigate the risk factors of RT, Clinical and laboratory data from patients with newly diagnosed CLL/SLL and transformed DLBCL were gathered. Results: The median age of RT was 56.5 (41-75) years old. 17 patients transformed to DLBCL and 1 transformed to Hodgkin lymphoma (HL) . Of 17 individuals who had DLBCL transformation, 15 had CLL/SLL-related clonality and 2 had unrelated clonality. Next-generation sequencing (NGS) analysis of 11 paired initially diagnosed treatment-naive CLL/SLL and RT DLBCL found that EGR2、TP53 and NOTCH1 were among the most frequently mutated genes both in treatment-naive CLL/SLL and in RT DLBCL. In several cases, specific mutations were gained or lost throughout RT, indicating clonal evolution. Among 10 patients before exposure to BTK inhibitors before RT, four patients acquired BTK mutation. The aforementioned mutations should be considered high-risk variables for transformation; in addition, TP53 and EGR2 mutations could be linked to a poor prognosis following RT in patients receiving a cocktail of new medicines. Conclusion: Most RT DLBCL patients in our center are clonality related (15/17, 88.2% ) and we recommend all qualified centers to evaluate clonality relatedness of RT DLBCL patients. There was some variability in the mutational landscape between DLBCL that had undergone a transformation and initially diagnosed, treatment-naive CLL/SLL. The underlying molecular mechanism of RT needs more research.

MSX1 Drives Tooth Morphogenesis Through Controlling Wnt Signaling Activity

Tooth agenesis is a common structural birth defect in humans that results from failure of morphogenesis during early tooth development. The homeobox transcription factor Msx1 and the canonical Wnt signaling pathway are essential for "bud to cap" morphogenesis and are causal factors for tooth agenesis. Our recent study suggested that Msx1 regulates Wnt signaling during early tooth development by suppressing the expression of Dkk2 and Sfrp2 in the tooth bud mesenchyme, and it demonstrated partial rescue of Msx1-deficient molar teeth by a combination of DKK inhibition and genetic inactivation of SFRPs. In this study, we found that Sostdc1/Wise, another secreted Wnt antagonist, is involved in regulating the odontogenic pathway downstream of Msx1. Whereas Sostdc1 expression in the developing tooth germ was not increased in Msx1-/- embryos, genetic inactivation of Sostdc1 rescued maxillary molar, but not mandibular molar, morphogenesis in Msx1-/- mice with full penetrance. Since the Msx1-/-;Sostdc1-/- embryos exhibited ectopic Dkk2 expression in the developing dental mesenchyme, similar to Msx1-/- embryos, we generated and analyzed tooth development in Msx1-/-;Dkk2-/- double and Msx1-/-;Dkk2-/-;Sostdc1-/- triple mutant mice. The Msx1-/-;Dkk2-/- double mutants showed rescued maxillary molar morphogenesis at high penetrance, with a small percentage also exhibiting mandibular molars that transitioned to the cap stage. Furthermore, tooth development was rescued in the maxillary and mandibular molars, with full penetrance, in the Msx1-/-;Dkk2-/-;Sostdc1-/- mice. Together, these data reveal 1) that a key role of Msx1 in driving tooth development through the bud-to-cap transition is to control the expression of Dkk2 and 2) that modulation of Wnt signaling activity by Dkk2 and Sostdc1 plays a crucial role in the Msx1-dependent odontogenic pathway during early tooth morphogenesis.

Why the Victims of Bullying Are More Likely to Avoid Involvement When Witnessing Bullying Situations: The Role of Bullying Sensitivity and Moral Disengagement

Recent studies have suggested a link between bullying victimization and passive bystander behaviors, such as more outsider behaviors and fewer defender behaviors. However, little is known about the internal mechanism underpinning this relation. The present study aimed to examine the direct and indirect relationships between bullying victimization and two types of bystander behaviors (defender behavior and outsider behavior), considering the possible mediator role of bullying sensitivity and moral disengagement among Chinese adolescents. Participants were 435 primary school students aged from 11 to 13 years (M = 12.27, SD = 0.69) who completed measurements of bullying victimization, bullying sensitivity, moral disengagement, and bystander behaviors. The results of the total effect model indicated that bullying victimization was positively related to outsider behavior and negatively related to defender behavior. The results from the structural equation modelling (SEM) analysis showed that bullying sensitivity mediated the relationship between bullying victimization and defender behavior. The relationship between bullying victimization and outsider behavior was mediated by moral disengagement, as well as the multiple mediation of bullying sensitivity and moral disengagement. These results highlight the roles of bullying sensitivity and moral disengagement in explaining the relation between bullying victimization and bystander behavior among adolescent students. The findings provide important implications for developing intervention programs aiming at school bullying prevention.

Metabolic risk factors of cognitive impairment in young women with major psychiatric disorder

BACKGROUND

Cognitive performance improves clinical outcomes of patients with major psychiatric disorder (MPD), but is impaired by hyperglycemia. Psychotropic agents often induce metabolism syndrome (MetS). The identification of modifiable metabolic risk factors of cognitive impairment may enable targeted improvements of patient care.

OBJECTIVE

To investigate the relationship between MetS and cognitive impairment in young women with MPD, and to explore risk factors.

METHODS

We retrospectively studied women of 18-34 years of age receiving psychotropic medications for first-onset schizophrenia (SCH), bipolar disorder (BP), or major depressive disorder (MDD). Data were obtained at four time points: presentation but before psychotropic medication; 4-8 and 8-12 weeks of psychotropic therapy; and enrollment. MATRICS Consensus Cognitive Battery, (MCCB)-based Global Deficit Scores were used to assess cognitive impairment. Multiple logistic analysis was used to calculate risk factors. Multivariate models were used to investigate factors associated with cognitive impairment.

RESULTS

We evaluated 2,864 participants. Cognitive impairment was observed in 61.94% of study participants, and was most prevalent among patients with BP (69.38%). HbA1c within the 8-12 week-treatment interval was the most significant risk factor and highest in BP. Factors in SCH included pre-treatment waist circumference and elevated triglycerides during the 8-12 weeks treatment interval. Cumulative dosages of antipsychotics, antidepressants, and valproate were associated with cognitive impairment in all MPD subgroups, although lithium demonstrated a protect effect (all P < 0.001).

CONCLUSIONS

Cognitive impairment was associated with elevated HbA1c and cumulative medication dosages. Pre-treatment waist circumference and triglyceride level at 8-12 weeks were risk factors in SCH. Monitoring these indices may inform treatment revisions to improve clinical outcomes.

Differences of medically unexplained symptoms among patients of different ages and sexes in the psychological clinic of a general hospital and the influencing factors of MUS: A cross-sectional study

OBJECTIVE

To analyse differences in sex, age, depression, insomnia, psychological stress, resilience, and perceived social support among patients with medically unexplained symptoms (MUS) in a psychological clinic of a general hospital, and to explore the influencing factors of MUS.

METHODS

This is a cross-sectional study. Seven hundred forty-six first-time patients were assessed with the integrated psychosomatic comprehensive evaluation system (IPS) to evaluate their MUS, depression, insomnia, psychological stress, resilience, and perceived social support. The psychological characteristics were compared with regard to sex and age group (<25 years, low age group; 26-44 years, middle age group; >45 years, high age group). The relationships between age and MUS were explored, and how psychological stress affects MUS was analyzed using the mediator effect model.

RESULTS

Different age groups had significant differences in sex, MUS, depression, psychological stress, resilience, and perceived social support. In further pairwise comparison, no significant difference existed in depression, psychological stress, resilience and perceived social support in the middle and low age groups, depression and psychological stress were higher than those in the high age group, resilience and perceived social support were lower than those of the high age group. MUS were higher in the middle age group than in the low age group. No significant difference existed between the two groups and the high age group. Age, severity of MUS, and perceived social support were significantly different between the sexes. Differences in MUS between men and women in different age groups were analyzed using two-factor analysis of variance. It revealed no interaction between sex and different age groups on MUS. The main effect analysis showed that the effects of different age groups on MUS were statistically significant. Based on pairwise comparative analysis, the MUS score in the low age group was lower than that in the middle age group. To clarify a nonlinear relationship between age and MUS, threshold effect analysis was conducted. The results indicated that the piecewise linear regression model could better depict the relationship between age and MUS. The inflection point was at the age of 60 years. Before the age of 60 years, MUS increased with age. No significant correlation existed between age and MUS after the age of 60 years. To understand the influencing factors of MUS, the intermediary effect model was analyzed using MUS as the dependent variable, psychological stress as the independent variable, resilience as mediator variable M1, perceived social support as mediator variable M2, and depression as mediator variable M3. Resilience, perceived social support, and depression had significant mediator effects on the effects of psychological stress on MUS with a total indirect effect of 69.81%.

CONCLUSION

The middle age group had greater MUS than the low age group. Before the age of 60 years, MUS increased with increasing age. Women had more severe MUS than men. Resilience, perceived social support, and depression had significant mediating effects on the effects of perceived stress on MUS. These findings suggest that clinicians should make more comprehensive and detailed evaluations and timely intervention for middle-aged and female patients. Improving psychological resilience and social support can reduce the impact of psychological stress on MUS. Therefore, psychotherapy and multidisciplinary comprehensive treatment are very important for patients is very important for patients.

Seasonal Variation of Zooplankton Communities and the Effects of Environmental Factors in the Seawater Near Taishan Nuclear Power Station

In the seawater near Taishan Nuclear Power Station, Zooplankton community composition and abundance, the biomass of major taxa, vertical distribution pattern, together with several environmental factors were investigated to evaluate the variation tendency as the seasons change. The structure characteristics of the zooplankton community were analyzed by Margalef species richness (d), Shannon-wiener species diversity index (H’), Pielou evenness index(J’), zooplankton dominant (Y), and dominant species replacement rate (R). There are 48 species within 11 classes of zooplankton identified, including 32 species of copepods. Zooplankton species richness changed obviously in the four seasons, Spring saw the highest (8010.00 ind.m-3), followed by winter (5100.00 ind.m-3), autumn (1713.75 ind.m-3), and summer (1196.25 ind.m-3). Similar trends were observed for the wet biomass, which was highest in spring (215.90 mg.m-3), followed by winter (181.70 mg.m-3), summer (78.56 mg.m-3), and autumn (24.69 mg.m-3), which gave an annual average of 125.21 mg.m-3. The results indicate that the abundance and biomass in spring were significantly higher than those in other seasons. Altogether 8 dominant species were identified along the whole year: Acrocalanmus gibber, Bestiolina amoyensis, Paracalanus parvus, Acartia danae, Mesocyclops leuckarti, Noctiluca scientillans, Penilla avirostris, and Lucifer penicilliger. The annual average Shannon-Wiener diversity index, Margalef diversity index, Pielou evenness index were 1.75, 1.83, and 0.74, respectively. The effects of environmental factors on the zooplankton community were studied by R and canonical correspondence analysis (CCA). According to Pearson correlation analysis and canonical correspondence analysis, the most important environmental factors influencing the changes of zooplankton species composition, abundance and distribution were water temperature, salinity, and pH in the whole year.

Development of a 19-plex short tandem repeat typing system for individual identification and parentage testing of horses (Equus caballus)

Individual identification of horses for pedigree verification and registration is important for the sustainable development of the horse industry. Horse individual identification and parentage tests commonly use the 17 short tandem repeats (STRs) recommended by the International Society for Animal Genetics (ISAG) and the locus LEX33. While many multiplex STR typing systems have been established for the horse, a sex determining marker is usually absent, and none of them can simultaneously detect all 17 ISAG recommended loci and the locus LEX33. Here, we present a 19-plex STR typing system that contains the 17 ISAG recommend loci, the locus LEX33 and amelogenin as sex determining loci. The results of our sensitivity, species specificity, stutter analysis and population data analysis, indicate that this system is a specific, sensitive, and robust tool for the identification of individuals, parentage testing and genetic research in the horse.

Self-help cognitive behavioral therapy application for COVID-19-related mental health problems: A longitudinal trial

BACKGROUND AND AIM

Recently, the availability and usefulness of mobile self-help mental health applications have increased, but few applications deal with COVID-19-related psychological problems. This study explored the intervention efficacy of a mobile application on addressing psychological problems related to COVID-19.

METHODS

A longitudinal control trial involving 129 Chinese participants with depression symptoms was conducted through the mobile application "Care for Your Mental Health and Sleep during COVID-19" (CMSC) based on WeChat. Participants were divided into two groups: mobile internet cognitive behavioral therapy (MiCBT) and wait-list. The primary outcome was improvement in depression symptoms. Secondary outcomes included improvement in anxiety and insomnia. The MiCBT group received three self-help CBT intervention sessions in one week via CMSC.

RESULTS

The MiCBT group showed significant improvement in depression and insomnia (allP < 0.05) compared with the wait-list group. Although both groups showed significant improvement in anxiety at the intervention's end, compared with the wait-list group, the MiCBT group had no significant advantage. Correlation analysis showed that improvement in depression and anxiety had a significant positive association with education level. Changes in insomnia were significantly negatively correlated with anxiety of COVID-19 at the baseline. CMSC was considered helpful (n=68, 81.9 %) and enjoyable (n=54, 65.9 %) in relieving depression and insomnia during the COVID-19 outbreak.

CONCLUSIONS

CMSC is verified to be effective and convenient for improving COVID-19-related depression and insomnia symptoms. A large study with sufficient evidence is required to determine its continuous effect on reducing mental health problems during the pandemic.

Nicotinamide improves NAD+ levels to protect against acetaminophen-induced acute liver injury in mice

Acetaminophen (APAP) overdose causes acute liver injury (ALI). Nicotinamide adenine dinucleotide (NAD) is an essential coenzyme, and NAD⁺ is oxidized type which synthesized from nicotinamide (NAM). The present study aimed to investigate the role of NAD⁺ in ALI and protective property of NAM. The mice were subjected to different doses APAP. After 8 hours, the serum activities of alaninetransaminase (ALT) and aspartate aminotransferase (AST), the hepatic NAD⁺ level and nicotinamide phosphoribosyltransferase (NAMPT) expression were determined. Then, the mice were pretreated with NAM (800 mg/kg), the hepatoprotective effects and the key antioxidative molecules were evaluated. Our findings indicated that APAP resulted in remarkable NAD⁺ depletion in a dose-dependent manner accompanied by NAMPT downregulation, and NAM pretreatment significantly elevated the NAD⁺ decline due to upregulation of NAMPT. Moreover, the downregulated Kelch-like ECH-associated protein-1 (Keap1), upregulated nuclear factor erythroid 2-related factor 2 (Nrf2) and its translocation activation after NAM administration were confirmed, which were in accordance with improved superoxide dismutase (SOD) and glutathione (GSH) levels. Finally, NAM dramatically exhibited hepatoprotective effects by reducing the liver index and necrotic area. This study has suggested that APAP impairs liver NAD⁺ level and NAM is able to improve hepatic NAD⁺ to activate antioxidant pathway against APAP-induced ALI.

LINC01116 promotes the proliferation and inhibits the apoptosis of gastric cancer cells

OBJECTIVE

To detect the relative expression of long intergenic non-protein coding ribonucleic acid (LINC) 01116 in gastric cancer (GC) tissues and cells and analyze the correlations of LINC01116 expression with the clinicopathologic characteristics of patients and investigate the biological functions of LINC01116 via in vitro experiments.

PATIENTS AND METHODS

The quantitative Real Time Fluorescence-Polymerase Chain Reaction (qRT-PCR) was applied to detect the relative expression level of LINC01116 in 73 cases of tissues and cells in GC patients. The patients were divided into LINC01116 high expression group and LINC01116 low expression group, and the correlations of LINC01116 with patient's pathological characteristics were statistically analyzed. In vitro experiments [cell counting kit-8 (CCK-8) assay, colony formation assay, and flow cytometry] were adopted to investigate the influences of LINC01116 on the biological functions of GC cells.

RESULTS

According to the results of qRT-PCR, the expression of LINC01116 was upregulated in 54 out of 73 cases of tissues (fold change >1), and it was upregulated in GC cells compared with that in the normal gastric mucosal epithelial cells (GES-1). The statistical analysis manifested that the highly expressed LINC01116 was positively correlated with the tumor-node-metastasis (TNM) stage (p=0.008), lymph node metastasis (p=0.005), and depth of invasion (p=0.007) of the GC patients. The patients with high expression of LINC01116 in the GC tissues had a shorter survival time than those with low expression (p=0.017). After interference in the expression of LINC01116, it was shown in CCK-8 assay and colony formation assay that the proliferative capacity of the cells was decreased. The results of flow cytometry indicated that the cell cycle was arrested at the G1/G0 phase, and the apoptosis rate was increased.

CONCLUSIONS

LINC01116 is highly expressed in GC tissues and cells, and highly expressed LINC01116 indicates poor prognosis of the patients, promotes the proliferation, and inhibits the apoptosis of GC cells.

A new procedure, free from human assessment, that automatically grades some facial skin signs in men from selfie pictures. Application to changes induced by a severe aerial chronic urban pollution

OBJECTIVE

These were two folds: at first, to develop an automatic grading system specifically dedicated to some facial signs of men, similar to the one previously validated on women of different ethnic ancestry and second, to assess its potential in detecting and grading the possible impacts of a severe aerial urban pollution on some facial signs of Chinese men.

METHODS

In both studies, selfie images were obtained from differently aged men. Nine facial signs were automatically graded through a specific A.I-based algorithm and clinically assessed by a panel of experts and dermatologists. Selfie pictures were taken from individual smartphones of variable optical properties. The first study, designed for developing an automatic grading system, involved three comparable cohorts of men from three different regional ancestries (African, Asian, Caucasian, 110 each) the selfie images of which were acquired under four different lighting conditions. As a second use case study, the facial signs of two cohorts of Chinese men (101 and 100, each), differently aged, regularly exposed to very different aerial urban pollution conditions (UP) were analysed by the same algorithm, selfies being taken under only one lighting condition.

RESULTS

-The new automatic grading system of facial signs suits well to men, showing comparable results than that the one dedicated to women and provides data in close agreement with experts' assessments. -In both cases (expert's or automatic methodology), the accuracy of the scores appeared ethnic-dependent. -The applied case confirmed previous results obtained clinically, that is, that many facial signs were found of an increased severity among men exposed to a severe urban pollution, as compared to those living in a less polluted city. -In both studies, statistical agreements between the automatic grading system and expert's assessments were reached. In some facial signs, the automatic grading system seems offering a slightly better accuracy than the assessments made by the experts.

CONCLUSION

Apart from some minor limitations, this A.I-based automatic grading system, free from human intervention, performed as well as the one previously developed in women, in close agreement with expert's assessments. In epidemiological studies, this system offers an easy, fast, affordable and confidential approach in the detection and quantification of male facial signs.

Effect of 0.01% atropine eye drops on choroidal thickness in myopic children

PURPOSE

To examine the effects of low-dose atropine on the choroidal thickness (CT) of young children in Shanghai, China, as well as the ocular biometrics of myopic patients.

METHODS

A total of 59 eyes of 35 myopic children had subfoveal CT and ocular biometry measurements taken before and after 2weeks, 4weeks, and 8weeks of treatment with 0.01% atropine. All eyes were measured using swept-source optical coherence tomography. CT and changes in it were also recorded.

RESULTS

The choroid exhibited significant and continuous thickening under the fovea after patients were treated with 0.01% atropine. The magnitude of change in CT varied with the location and with the duration of treatment. The greatest change was observed in the fovea. There was no significant relationship between changes in subfoveal CT and axial length.

CONCLUSIONS

Using 0.01% atropine eye drops significantly increased CT in eyes of young myopic children, by variable magnitude depending upon location.

Autonomy Need Dissatisfaction in Daily Life and Problematic Mobile Phone Use: The Mediating Roles of Boredom Proneness and Mobile Phone Gaming

Psychological needs dissatisfaction has been identified as hindering adaptive development, in which autonomy need dissatisfaction, as one core component, may be associated with adolescents' maladaptive online behaviors. Sporadic research has examined the association between autonomy need dissatisfaction and problematic mobile phone use (PMPU). Boredom proneness and mobile phone gaming were suggested to be linked to this association. This study aimed to examine the mediating effects of boredom proneness and mobile phone gaming in the association between autonomy need dissatisfaction and PMPU. A total of 358 secondary school students completed questionnaires at three waves; autonomy need dissatisfaction was measured in time 1 (T1); boredom proneness and mobile phone gaming were measured one year later (time 2, T2); PMPU was measured two years later (time 3, T3). The structural equation model results showed that T1 autonomy need dissatisfaction not only directly predicted T3 PMPU, but also exerted effects via the mediating role of T2 boredom proneness and the chain mediating role of T2 boredom proneness and T2 mobile phone gaming. These findings reveal the unique role of specific psychological need in engaging PMPU, which provides support to targeted interventions, such that promoting autonomy need satisfaction may be an instrumental procedure to prevent adolescents from addiction-like online behaviors.

HIF-1α Mediates Osteoclast-Induced Mandibular Condyle Growth via AMPK Signaling

During the mandibular condylar growth, the absorption of calcified cartilage matrix induced by osteoclasts is crucial for the continuous endochondral osteogenesis. Meanwhile, recent studies showed that subchondral bone resided within the low-oxygen microenvironment, and our previous study revealed that hypoxia-inducible transcription factor 1α (HIF-1α) promoted osteoclastogenesis under hypoxia. However, whether HIF-1α regulates the function of osteoclasts in the mandibular condyle cartilage remains elusive. Our study indicated that severe deformity of the mandibular condyle was displayed in 10-wk-old osteoclast-specific HIF-1α conditional knockout (CKO) mice, accompanied by shortened length of condylar process and disorganized fibrocartilage. In 1-, 2-, and 4-wk-old CKO mice, the size of the hypertrophic layer and chondrocytic layer was significantly thickened. In the chondrocytic layer, chondrocytes were atrophied, showing a form of apoptosis in 4-wk-old CKO mice. Furthermore, an increase in the thickness of the fibrous and proliferating layer was observed in 10-wk-old CKO mice, as well as a significant decrease in that of the chondrocytic and hypertrophic chondrocyte layers. Interestingly, the articular surface of the condylar process abnormally presented a horizontal concave shape, and a disk-like acellular connective tissue appeared. In addition, genetic ablation of HIF-1α blunted cartilage matrix loss by subchondral osteoclast deficiency, resulting in a high subchondral bone mass phenotype, accompanied with a decreased number of blood vessels, alkaline phosphatase staining, and vascular endothelial growth factor (VEGF) expression. Mechanistically, the number of osteoclasts in the center of the condyle in CKO mice was significantly reduced by attenuated expression of adenosine 5′-monophosphate-activated protein kinase (AMPK) signaling. These findings reveal a novel influence of HIF-1α function in osteoclasts on maintenance of osteoclast-induced resorption of calcified cartilage matrix via AMPK signaling, as well as subchondral bone formation through VEGF-dependent angiogenesis in bone marrow.

Implicit Theories and Engagement in Math Among Chinese Adolescent Students: A Moderated Mediation Model of Intrinsic Value and Academic Self-Efficacy

Recent studies have established associations between students' implicit theories and their academic engagement. However, there is still limited understanding of the potential mechanisms of this relation, and whether it works for students in the context of mathematics as well as in other subjects. The current study aimed to fill this gap by conducting a two-wave survey examining a moderated mediation model concerning the psychological mechanisms that account for the association between students' implicit theories and mathematics engagement. Applying the theoretical framework of implicit theory, we hypothesized that intrinsic value would be a possible mediating variable between students' implicit theories and academic engagement, and that students' academic self-efficacy would moderate the link between implicit theory and intrinsic value. A sample of 710 Chinese adolescent students self-reported their implicit theory, intrinsic value, and academic self-efficacy at Time 1, and engagement in math at Time 2, 12 months apart. After controlling for age and gender, the results revealed positive associations between students' implicit theories and their engagement in math, and intrinsic value partially mediated the relation between implicit theories and engagement in math. Moreover, students' academic self-efficacy moderated the link between implicit theory and intrinsic value. These findings contribute to the understanding of the impact of implicit theory on students' mathematics engagement. Limitations and implications for instructional practices are discussed.

How mathematics anxiety affects students' inflexible perseverance in mathematics problem-solving: Examining the mediating role of cognitive reflection

BACKGROUND

Too many students persevere in relying upon one (sometimes suboptimal) strategy for solving a wide range of problems, even when they know more efficient strategies. Although many studies have mentioned such phenomena, few studies have examined how emotional factors could affect this type of inflexible perseverance in strategy use.

AIMS

To examine whether mathematics anxiety could affect students' inflexible perseverance in strategy use and whether this effect could be mediated by cognitive reflection, which is the ability to engage in deliberate reasoning.

SAMPLE AND METHOD

In Study 1, 164 undergraduate students' (18-22 years) mathematics anxiety, cognitive reflection, and performance in overcoming inflexible perseverance were measured by a questionnaire battery. Structural equation models were used to examine the correlations between these variables. In Study 2, 98 undergraduate freshmen (17-18 years) were assigned to two groups, where one group's mathematics anxiety was temporarily induced by task instructions, while the other group served as a control group. Cognitive reflection and inflexible perseverance of the two groups were compared.

RESULTS

Study 1 showed that mathematics anxiety was negatively correlated with students' performance on overcoming inflexible perseverance, while cognitive reflection mediated such an effect. Study 2 showed that compared to the control group, the experimental group showed lower cognitive reflection, which led to lower performance in overcoming inflexible perseverance.

CONCLUSIONS

Mathematics anxiety was showed to impair students' ability to engage in deliberate reasoning and was associated with inflexible use of strategies. Alleviating students' mathematics anxiety should be considered when promoting students' strategic flexibility.

Significant Day-time Ionospheric Perturbation by Thunderstorms along the West African and Congo Sector of Equatorial Region

The equatorial Congo has been recognized as the most active lightning chimney region in the Globe. Although the perturbation of tropospheric thunderstorms on the lower ionosphere has been noticed in the middle latitudes through their transient lightning electric fields or convective gravity waves, the effects on equatorial ionosphere and the horizontal extent of this perturbation remains a mystery because of the difficulties in extracting the effects due to the sporadic nature of the equatorial ionosphere. Here we present observational results showing solid evidence of deviations in ionospheric total electron content (TEC) and its direction of propagation associated with thunderstorms using the method of polynomial filtering, by utilizing the TEC measured from equatorial Global Positioning System (GPS) Receiver stations along the West African region-Congo Basin. The TEC deviations due to the thunderstorms were found to be mostly propagated in a specific direction from the point of the event, with the highest absolute peak TEC at ~±1.5 TECUs. The internal dynamics of the equatorial ionosphere have been found to be suppressed by large thunderstorm effects during the daytime, with negligible impact at night.

[Efficacy of minimally invasive pulmonary surfactant administration in preterm infants with neonatal respiratory distress syndrome: a multicenter clinical trial]

Objective: To explore the feasibility and safety of minimally invasive surfactant administration (MISA) in preterm neonates with respiratory distress syndrome (NRDS). Methods: In this multicenter prospective randomized controlled trial, 92 preterm infants with gestation age ≤30 weeks and diagnosed with NRDS were enrolled in 8 level Ⅲ neonatal intensive care units (NICU) in Beijing-Tianjin-Hebei Region from 1(st) July 2017 to 31(st) December 2018. They were randomly assigned to minimally invasive surfactant administration (MISA) group or endotracheal intubation surfactant administration (EISA) group according to random number generated by computer. Infants in both groups received calf pulmonary surfactant preparation at a dose of 70-100 mg/kg. The data of demography, perinatal situation, medication administration, complications, clinical outcomes in the two groups were compared with Chi-square test, Student's t-test, Mann-Whitney U test or Fisher's exact test. Results: Among the 92 preterm infants, 53 were males, 39 were females; 47 were in the MISA group (25 males), and 45 were in the EISA group (28 males). The gestational age and birth weight were (29.5±1.2) weeks and (1 271±242) g in all patients, (29.5±1.4) weeks and (1 285±256) g in the MISA group, and (29.6±0.9) weeks and (1 255±227) g in the EISA group. The duration of surfactant infusion and the length of whole procedure in the MISA group were significantly longer than that in the EISA group (60 (18, 270) s vs. 50 (30, 60) s, Z=3.009, P=0.003; 90 (60, 300) s vs. 60 (44, 270) s, Z=3.365, P=0.001). For the outcomes, the incidence of hemodynamically significant patent ductus arteriosus (hsPDA) and bronchopulmonary dysplasia (BPD) were lower in the MISA group than in the EISA group (36% (17/47) vs. 67% (30/45), χ(2)=8.556, P=0.003; 26% (12/47) vs. 47% (21/45), χ(2)=4.464, P=0.035). Conclusions: Minimally invasive surfactant administration is applicable in preterm infants ≤30 weeks gestational age with NRDS. Although the length of whole procedure is longer than route endotracheal administration, the benefit of decreasing the incidences of hsPDA and BPD outweighs this demerit.

Development of the psychosomatic symptom scale (PSSS) and assessment of its reliability and validity in general hospital patients in China

OBJECTIVES

To develop and verify the Psychosomatic Symptom Scale (PSSS) among psychosomatic patients and the cut-off value of PSSS in distinguishing psychosomatic patients from health controls.

METHODS

The PSSS was drafted by an expert workgroup. 996 patients and 366 controls from 14 general hospitals in China were recruited to complete PSSS, Patient Health Questionnaire-15 (PHQ-15) and Symptom Checklist-90 (SCL-90). Student's t-test, Kruskal-Wallis test, Cronbach's α, Spearman's correlation, and confirmatory factor analysis (CFA) were used to verify the PSSS. Receiver operating characteristic (ROC) analyses were used to determine the cut-off value.

RESULTS

Cronbach α of PSSS was 0.907. The PSSS was significantly correlated with SCL-90 somatization subscale (r = 0.682, P < 0.001) and PHQ-15 (r = 0.724, P < 0.001). CFA supported the theoretical two-factor structure of the PSSS, with comparative fit index (CFI) = 0.979, Tucker-Lewis index (TLI) = 0.977, root mean square error of approximation (RMSEA) = 0.039 (90% CI: 0.035-0.042), and standardized root mean residual (SRMR) = 0.054. As the sum score of PSSS was significantly higher in female, cut-off values were determined as 11 in females and 10 in males respectively.

CONCLUSIONS

The PSSS is a reliable and valid instrument for measuring psychosomatic symptoms.

Self-Esteem Moderates the Effect of Compromising Thinking on Forgiveness Among Chinese Early Adolescents

Forgiveness contributes to positive social relationships, which is critical for individual development, particularly for early adolescents. Most previous studies focused on the unique roles of cognitive factors (e.g., compromising thinking) and personality traits (e.g., self-esteem) in the process of developing forgiveness. However, sporadic research has examined their interactive effect on forgiveness from an integrated perspective. Given that forgiveness has been categorized into decisional and emotional forgiveness, this study aimed to examine the effects of compromising thinking on two types of forgiveness, and the moderating effects of self-esteem on the association between compromising thinking and forgiveness among early adolescents. A total of 1,009 Chinese primary and secondary school students (50.4% males; M_age = 11.75, SD = 1.27) were recruited to complete three self-reported questionnaires. The results showed that compromising thinking predicted decisional forgiveness but not emotional forgiveness. Furthermore, self-esteem was identified to moderate the conditional effects of compromising thinking on decisional and emotional forgiveness. These findings advance a better understanding of the construct and mechanism of forgiveness, which can provide insights for targeted forgiveness interventions among early adolescents, such as compromising thinking instructions and self-esteem enhancement programs.

Genome-wide Identification of Foxf2 Target Genes in Palate Development

Cleft palate is among the most common structural birth defects in humans. Previous studies have shown that mutations in FOXF2 are associated with cleft palate in humans and mice and that Foxf2 acts in a Shh-Foxf-Fgf18-Shh molecular network controlling palatal shelf growth. In this study, we combined RNA-seq and ChIP-seq approaches to identify direct transcriptional target genes mediating Foxf2 function in palate development in mice. Of 155 genes that exhibited Foxf2-dependent expression in the developing palatal mesenchyme, 88 contained or were located next to Foxf2-binding sites. Through in situ hybridization analyses, we demonstrate that expression of many of these target genes, including multiple genes encoding transcription factors and several encoding extracellular matrix-modifying proteins, were specifically upregulated in the posterior region of palatal shelves in Foxf2^-/- mouse embryos. Foxf2 occupancy at many of these putative target loci, including Fgf18, in the developing palatal tissues was verified by ChIP-polymerase chain reaction analyses. One of the Foxf2 target genes, Chst2, encodes a carbohydrate sulfotransferase integral to glycosaminoglycan sulfation. Correlating with ectopic Chst2 expression, Foxf2^-/- embryos a exhibited region-specific increase in sulfated keratan sulfate and a concomitant reduction in chondroitin sulfate accumulation in the posterior palatal mesenchyme. However, expression of the core protein of versican, a major chondroitin sulfate proteoglycan important in palatal shelf morphogenesis, was increased, whereas expression of collagen I was reduced in the corresponding region of the palatal mesenchyme. These results indicate that, in addition to regulating palatal shelf growth through the Fgf18-Shh signaling network, Foxf2 controls palatal shelf morphogenesis through regulating expression of multiple transcription factors as well as through directly controlling the synthesis and processing of extracellular matrix components in the palatal mesenchyme. Our ChIP-seq and RNA-seq data sets provide an excellent resource for comprehensive understanding of the molecular network controlling palate development.