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IntroductionPrimary cilia play an important role in the development of cancer by regulating signaling pathways. Several studies have demonstrated that women with BRCA mutations have, on average, 50% fewer ciliated cells compared with general women. However, the role of tubal cilia loss in the development of epithelial ovarian cancer (EOC) remains unclear. Few specific studies have been found in linking HYDIN, a ciliary defect associated gene that encodes HYDIN axonemal central pair apparatus protein, which is involved in the transduction of Hedgehog (Hh) signal and is considered a cancer associated antigen, to ovarian cancer. Therefore, our study aimed to investigate the correlation between HYDIN gene mutations and tubal cilia loss in EOC.MethodsA whole exome sequencing (WES), immunohistochemistry (IHC), western blot, and reverse transcription quantitative (RT q) PCR were performed in 80 patients with EOC and 50 cases of non ovarian cancer to detect the mutations and expression of tubal ciliary marker, ciliary morphology, and abnormal rate.ResultsWe found that the incidence of tubal cilia loss was higher in EOC group with decreased expression of HYDIN compared with the control group (P

BackgroundNursing students often make clinical errors due to their limited clinical experience and their orientation toward errors, revealing their attitude and behavioral tendencies regarding nursing errors. Understanding how self-efficacy, motivation, and a sense of security influence the error orientation of nursing students is important for developing strategies to enhance their error orientation.ObjectivesThis study aimed to explore the relationship between self-efficacy, motivation, and error orientation of nursing students during clinical internships.MethodThis was a cross-sectional study. An electronic questionnaire was distributed to nursing students from 14 September 2023 to 30 September at a comprehensive tertiary A teaching hospital in Zhengzhou, Henan province. The instruments used in this study included the General Information Questionnaire, General Self-efficacy Scale, Achievement Motives Scale, Security Scale, and Error Orientation Scale. Statistical Product and Service Software Automatically (SPSSAU) was used to perform statistical description, mediation analysis, and moderated mediation analyses.ResultsA total of 510 nursing students were included in this study. The motivation for success and failure-escaping fully mediated the relationships between self-efficacy and error orientation of nursing students, with a mediation effect of 0.101 (95% CI: 0.058–0.144). The security of nursing students moderated both the direct effect of this model and the indirect effect of motivation for failure-escaping. When security was high, the self-efficacy of nursing students was positively correlated with their error orientation, with an effect of 0.059 (95% CI: 0.003~0.116). When security was high, the moderation effect was significant, with an effect of −0.012 (95% CI: −0.026~-0.002). However, at low and median levels of security, the mediation effect was non-existent.ConclusionThe motivation for success and failure escaping play different roles in the paths between self-efficacy and error orientation. Clinical nursing teachers should take measures to enhance the motivation for success but reduce the failure-escaping motivation to improve the error orientation of nursing students. Additionally, it is crucial to pay attention to and improve the sense of security of students during clinical internships.

BackgroundAnxiety, depression, and sleep problems are prevalent comorbid mental disorders among university students. The World Health Organization (WHO) emphasized a mental health promotion objective, recommending the consideration of protective health-promoting factors in strategies aimed at preventing mental disorders. Integrating theoretically significant constructs (such as protective factors) enhances our comprehension of the intricate mechanisms that underpin mental disorders. This study employed network analysis to first identify core and bridge symptoms within comorbid mental disorders and then explore how health-promoting lifestyles (HPLs) were associated with these disorders. The ultimate goal is to offer health promotion recommendations to enhance students’ quality of life.MethodsA total of 3,896 qualified university students participated in this study. Anxiety, depression, sleep problems, and HPLs were assessed using the GAD-7, PHQ-9, PSQI, and HPLP-II scales. A Gaussian Graphical Model was used to construct the networks. The Network Comparison Test was applied to determine whether the associations between HPLs and comorbid symptoms vary by gender, educational level, family sibling, and mental health status.ResultsLow energy (PHQ4) had the highest strength centrality, followed by Daytime dysfunction (PSQI7) and Trouble relaxing (GAD4). Five bridge symptoms were identified: Daytime dysfunction (PSQI7), Self-harm even suicide (PHQ9), Sad mood (PHQ2), Low energy (PHQ4), and Feeling afraid (GAD7). Regarding protective HPLs, Physical activity, Spiritual growth, and Stress management generally emerged as the top three central mental health-promoting behaviors.ConclusionTargeting core and bridge symptoms with timely and appropriate interventions can alleviate anxiety, depression, and sleep problems in this population. Moreover, promoting physical activity, fostering spiritual growth, and managing stress are likely to significantly enhance the overall mental health of university students.

BackgroundSleep quality can offer new insights into addressing depression among stroke patients. However, the current understanding of the mechanism by which sleep quality reduces depression is not clear in existing research.ObjectivesThis study aimed to identify the relationships and mechanisms among perceived stress, sleep quality, social support, and depression in stroke patients.MethodsA multicenter cross-sectional study was conducted from January to May 2023. Cluster random sampling was used to recruit 500 stroke patients from five hospitals in Henan Province, China. The Chinese Perceived Stress Scale (CPSS), Pittsburgh Sleep Quality Index (PSQI), Social Support Rating Scale (SSRS), and Hamilton Depression Scale (HAMD-24) were employed to assess perceived stress, sleep quality, social support, and depression, respectively. Data were analyzed using descriptive analysis, Pearson’s correlation analysis, and moderated mediation analysis. The study adhered to the STROBE checklist for reporting.ResultsOut of 500 participants, 471 completed the survey (94.2%). After controlling for sex and age, mediation analysis revealed that poor sleep quality partially mediated the relationship between perceived stress and depression (β = 0.184, 95% CI: 0.110, 0.359). Additionally, social support played a moderating role in the mediation model.ConclusionThis study explained the moderated mediation of sleep quality and social support between perceived stress and depression. It provided a theoretical basis for the development of a sleep quality intervention program for reducing depression among stroke patients.

Abstract Aim To develop a Head Nurse Research Leadership Scale and evaluate its reliability and validity. Design A psychometric instrument validation study was conducted in two phases. Methods The item tool was generated based on a literature review, semi‐structured interview and brainstorming. Twenty experts validated the content of the initial version for two rounds. Thirty‐nine clinical nurses conducted the HNRLS‐v3 to test the readability of the items in pilot study I. Items were screened based on the critical ratio, correlation coefficient analysis, Cronbach's α coefficient and factor analysis using the data collected from 265 nurses in pilot study II. A cross‐sectional survey was conducted in six hospitals to evaluate the reliability and validity between 4 January 2022 and 15 January 2022. Three hundred and sixteen nurses participated in this survey, and 60 completed the questionnaire to validate the test–retest reliability between 1 February and 6 February. Results A 15‐item Head Nurse Research Leadership Scale based on 5 dimensions was developed, and the content validity was satisfied. The 15 items accounted for 77.9% of the variance. Confirmatory factor analysis showed acceptable convergent validity and discriminant validity. The Cronbach's α coefficient, split‐half reliability and test–retest reliability of the scale were 0.966, 0.9633 and 0.927, respectively.

Abstract Background Blood transfusion and previous stroke history are two independent risk factors of venous thromboembolism (VTE) in stroke patients. Whether the potential interaction of transfusion history and previous stroke history is associated with a greater risk of VTE remains unclear. This study aims to explore whether the combination of transfusion history and previous stroke history increases the risk of VTE among Chinese stroke patients. Methods A total of 1525 participants from the prospective Stroke Cohort of Henan Province were enrolled in our study. Multivariate logistic regression models were used to explore the associations among transfusion history, previous stroke history and VTE. The interaction was evaluated on both multiplicative and additive scales. The odds ratio (95% CI), relative excess risk of interaction (RERI), attributable proportion (AP), and synergy index (S) of interaction terms were used to examine multiplicative and additive interactions. Finally, we divided our population into two subgroups by National Institutes of Health Stroke Scale (NIHSS) score and re-evaluated the interaction effect in both scales. Results A total of 281 (18.4%) participants of 1525 complicated with VTE. Transfusion and previous stroke history were associated with an increased risk of VTE in our cohort. In the multiplicative scale, the combination of transfusion and previous stroke history was statistically significant on VTE in both unadjusted and adjusted models (P 5 points (P

Abstract Background Effective health management of people at high risk of stroke in China is challenging. Aim To explore and identify the experiences of health management among people at high risk of stroke in order to provide a foundation for a targeted health management strategy for this special group. Design A qualitative, descriptive study based on interviews. Methods Semistructured interviews were conducted with 31 people at high risk of stroke. The interviews were collated and analysed using Colaizzi’s seven‐step method. Results A total of 31 people at high risk of stroke were included, and the ages ranged from 40 to 86, with an average age of 60.71 (SD = 11.55). The experiences of health management were categorized into three themes. Theme 1: Facing many ongoing problems in health management, limited knowledge, lack of confidence and poor compliance. Theme 2: Accumulated some value experiences of coping with problems of health management, becoming active learners, promoting social interaction and enhancing self‐health management. Theme 3: Sensitivity to multiple influencing factors, the severity of disease and complexity of disease management, family income and economic burden and the value of social support. Conclusions This study explored the experiences of health management among people at high risk of stroke, and these findings are of great significance in the primary prevention of stroke.

Background: Stroke is the second leading cause of death in adults worldwide. However, up to 80% of strokes can be prevented by modifying risk factors. Objective: The study aims to assess the effectiveness of the Health Ecology Model and Self-Determination Theory (HEM-SDT) based health management intervention among individuals at high risk of stroke. Methods: A randomized controlled trial was conducted in Zhengzhou from May 1st, 2020, to December 31st, 2020. A total of 229 participants were recruited for the study, with 116 individuals at high risk of stroke being randomly assigned to the HEM-SDT health management group, while 113 participants were enrolled in the control group, following their current routine practices. The Generalized Estimating Equation model (GEE) was used to analyze the differences in health knowledge, belief and, behavior between the two groups at the beginning of the intervention, and at 6-month intervals after the intervention. The chi-square test was utilized to assess the control rate of risk factors. Results: After 6 months of intervention, there were significant improvements in health knowledge, behavior, and belief among the participants. The study found significant differences in the interaction effects between time and group for health knowledge (Mean, SD = 25.62 ± 3.88, 95%CI: 7.944–9.604, P＜0.001), health belief (Mean, SD = 87.18 ± 14.21, 95%CI: 23.999–29.887, P＜0.001), and health behavior (Mean, SD = 173.28 ± 24.22, 95%CI: 22.332–36.904, P＜0.001). Additionally, the rates of hypertension, hyperglycemia, dyslipidemia, high or medium risk condition of stroke, obesity, hyperhomocysteinemia, smoking, alcohol consumption, and lack of exercise also showed statistical significance (P＜0.05) after the intervention. Conclusion: The HEM-SDT health management model improves the health knowledge, behavior, and beliefs in people at high risk of stroke and remarkably it shows improvement in modifiable risk factors. It can be recommended for systematic health management in people at high-risk of stroke.

In the current dynamic and flexible work environment, traditional career models are constantly challenged by individuals’ self-concepts of career development. Previous studies have investigated the predictors of subjective career success, yet little is known about the impact of proactive career orientation on subjective career success. This study, grounded in the career construction theory, aims to examine the influence mechanism of proactive career orientation on subjective career success by analyzing questionnaire data from 296 employees. Empirical results indicate that proactive career orientation has a positive impact on subjective career success. Second, career adaptability partially mediates the relationship between proactive career orientation and subjective career success. Third, mentoring moderates the relationship between proactive career orientation and career adaptability, as well as the relationship between career adaptability and subjective career success. Specifically, both the positive impact of proactive career orientation on career adaptability and the positive impact of career adaptability on subjective career success are stronger when the level of mentoring is higher. Fourth, the indirect relationship between proactive career orientation and subjective career success through career adaptability is stronger when mentoring is high compared to when mentoring is low. This study contributes to the career construction theory by identifying the influence mechanism of proactive career orientation on subjective career success through career adaptability, with mentoring moderating the process. As for practical implications, research findings remind managers of the importance of career planning and mentorship in enhancing employees’ subjective career successes.

Our research aims to assess the performance of a new generation of consumer activity trackers (Fitbit Charge 4TM: FBC) to measure sleep variables and sleep stage classifications in patients with chronic insomnia, compared to polysomnography (PSG) and a widely used actigraph (Actiwatch Spectrum Pro: AWS). We recruited 37 participants, all diagnosed with chronic insomnia disorder, for one night of sleep monitoring in a sleep laboratory using PSG, AWS, and FBC. Epoch-by-epoch analysis along with Bland-Altman plots was used to evaluate FBC and AWS against PSG for sleep-wake detection and sleep variables: total sleep time (TST), sleep efficiency (SE), waking after sleep onset (WASO), and sleep onset latency (SOL). FBC sleep stage classification of light sleep (LS), deep sleep (DS), and rapid eye movement (REM) was also compared to that of PSG. When compared with PSG, FBC notably underestimated DS (-41.4, p < 0.0001) and SE (-4.9%, p = 0.0016), while remarkably overestimating LS (37.7, p = 0.0012). However, the TST, WASO, and SOL assessed by FBC presented no significant difference from that assessed by PSG. Compared with PSG, AWS and FBC showed great accuracy (86.9% vs. 86.5%) and sensitivity (detecting sleep; 92.6% vs. 89.9%), but comparatively poor specificity (detecting wake; 35.7% vs. 62.2%). Both devices showed better accuracy in assessing sleep than wakefulness, with the same sensitivity but statistically different specificity. FBC supplied equivalent parameters estimation as AWS in detecting sleep variables except for SE. This research shows that FBC cannot replace PSG thoroughly in the quantification of sleep variables and classification of sleep stages in Chinese patients with chronic insomnia; however, the user-friendly and low-cost wearables do show some comparable functions. Whether FBC can serve as a substitute for actigraphy and PSG in patients with chronic insomnia needs further investigation.

BackgroundGynecologic cancers have become a major threat to women’s health. The molecular biology of gynecologic cancers is not as well understood as that of breast cancer, and precision targeting is still new. Although viewed collectively as a group of cancers within the female reproductive system, they are more often studied separately. A comprehensive within-group comparison on molecular profiles is lacking.MethodsWe conducted a whole-exome sequencing study of cervical/endometrial/ovarian cancer samples from 209 Chinese patients. We combined our data with genomic and transcriptomic data from relevant TCGA cohorts to identify and verify common/exclusive molecular changes in cervical/endometrial/ovarian cancer.ResultsWe identified shared molecular features including a COSMIC signature of deficient mismatch repair (dMMR), four recurrent copy-number variation (CNV) events, and extensive alterations in PI3K-Akt-mTOR signaling and cilium component genes; we also identified transcription factors and pathways that are exclusively altered in cervical/endometrial/ovarian cancer. The functions of the commonly/exclusively altered genomic circuits suggest (1) a common reprogramming process during early tumor initiation, which involves PI3K activation, defects in mismatch repair and cilium organization, as well as disruption in interferon signaling and immune recognition; (2) a cell-type specific program at late-stage tumor development that eventually lead to tumor proliferation and migration.ConclusionThis study describes, from a molecular point of view, how similar and how different gynecologic cancers are, and it provides a hypothesis about the causes of the observed similarities and differences.

Chlamydia trachomatis is the most common cause of curable bacterial sexually transmitted infections worldwide. Although the pathogen is well established, the pathogenic mechanisms remain unclear. Given the current challenges of antibiotic resistance and blocked processes of vaccine development, the use of a specific chlamydiaphage may be a new treatment solution. φCPG1 is a lytic phage specific for Chlamydia caviae, and shows over 90% nucleotide sequence identity with other chlamydiaphages. Vp1 is the major capsid protein of φCPG1. Purified Vp1 was previously confirmed to inhibit Chlamydia trachomatis growth. We here report the first attempt at exploring the relationship between Vp1-treated C. trachomatis and the protein and gene levels of the mitogen-activated/extracellular regulated protein kinase (MAPK/ERK) pathway by Western blotting and real-time PCR, respectively. Moreover, we evaluated the levels of pro-inflammatory cytokines interleukin (IL)-8 and IL-1 by enzyme-linked immunosorbent assay after Vp1 treatment. After 48 h of incubation, the p-ERK level of the Vp1-treated group decreased compared with that of the Chlamydia infection group. Accordingly, ERK1 and ERK2 mRNA expression levels of the Vp1-treated group also decreased compared with the Chlamydia infection group. IL-8 and IL-1 levels were also decreased after Vp1 treatment compared with the untreated group. Our results demonstrate that the inhibition effect of the chlamydiaphage φCPG1 capsid protein Vp1 on C. trachomatis is associated with the MAPK pathway, and inhibits production of the pro-inflammatory cytokines IL-8 and IL-1. The bacteriophages may provide insight into a new signaling transduction mechanism to influence their hosts, in addition to bacteriolysis.