Psychological Tests Research Articles

Exploring heterogeneity of perimenopause with application of multivariable analysis approaches

ObjectivesHeterogeneity of clinical appearance had made it a challenge to make individualized and comprehensive management of perimenopause. This study aimed to estimate the profiles over heterogenous appearances of perimenopause with application of latent variable analysis methods over an optimized multidimensional assessing framework.MethodsA two-phase clinical study was designed and advanced in the research center in Guangzhou, China. The assessing framework was developed over the initial item pool as integration of 4 scales including Insomnia severity index, Modified Kupperman index, Self-rating anxiety scale, and Self-rating depression scale. Validity and reliability of the instrument were evaluated and the psychometric properties of the items were estimated with multidimensional item response theory(MIRT). And then computer adaptive testing(CAT) was developed with the estimated model. We used latent profile analysis (LPA) to cluster patients into subgroups as patterns characterized by multidimensional latent trait scores. Finally, interpretability and efficiency were analyzed via comparison between the two assessing strategies.ResultThere were in total 336 patients diagnosed with perimenopause enrolled for the assessment. A conceptual framework was estimated consisting of 6 factors including sleep disturbance, mood swings, vasomotor symptoms, positive attitude towards life, multisystem abnormality, and fatigue. The construct validity was evaluated as optimized with CMIN/df = 1.814, GFI = 0.619, CFI = 0.721, TLI = 0.707 and RMSEA = 0.075. With scores in the simulated CAT, the 4 latent profiles model was estimated indicating the heterogeneity of perimenopause characterized by different severity of psychological and physical discomforts in the LPA.ConclusionThe quantitative paradigm raised in this study revealed the potential patterns presenting heterogeneity of perimenopause offering better interpretation for clinical assessment.

Hair cortisol concentration, a stress biomarker, is gradually increasing before an acute myocardial infarction

Background Chronic stress is believed to play a role in the pathophysiology of acute myocardial infarction (AMI). Cortisol is a biomarker associated with stress. We sought to assess stress contribution to AMI using hair cortisol concentration (HCCs) as a surrogate biomarker. Methods HCC was measured in hair segments, corresponding to distinctive periods before hair sampling, in 102 male AMI patients and 50 healthy male controls. Standard baseline variables were collected for both groups, whereas for AMI patients, laboratory and psychological tests were also carried out. Linear mixed models were applied to assess the effect of group and baseline variables on the trend of cortisol before hair sampling. Results HCC was significantly higher in AMI patients the last 30 days before hair sampling with an overall higher rate of increase (time-group interaction P < 0.001). AMI patients with BMI ≥25 kg/m2 had a slower rate of increase compared with those with BMI <25 kg/m2 (adjusted P = 0.008). Among AMI patients, there was no difference in the rate of cortisol increase between STEMI and NSTEMI patients (time-group interaction P = 0.841). Lower BMI conferred higher rates of cortisol increase irrespectively of AMI type. Conclusion HCC, a biomarker of stress, showed an increasing trend over a period of 2 months before the occurrence of AMI suggesting a potential role of stress, through cortisol secretion, in the pathophysiology of AMI.

Salivary testosterone is associated with feelings of senselessness and self-dislike in women with borderline personality disorder

ABSTRACT Background: Women with borderline personality disorder (BPD) show increased basal levels of testosterone. We investigated whether salivary testosterone levels in women with BPD were indicative of specific symptoms associated with BPD. Based on the assumed link between testosterone and interpersonal dominance, we hypothesized a positive association between testosterone and externalising, i.e. aggressive or impulsive behaviour, potentially contributing to higher burden of interpersonal reactivity and conflict. Methods: Saliva was collected from 98 women with BPD (average age in years: 28, range 18–46) between 1 and 2 pm. Self-rating scales were administered to assess severity of BPD (Borderline Symptom Checklist, BSL-23) and depressive symptoms (Beck’s Depression Inventory, BDI-II). Regression analyses targeted associations between individual testosterone levels and BSL-23 and BDI-II total and by-item scores. Results: Higher testosterone levels were associated with higher overall disease burden indicated by BSL-23 and BDI-II total scores. When analysed by item, higher testosterone levels were significantly associated with increased feelings of self-dislike, senselessness and pessimism, and the feeling of being a failure. Conclusion: Our findings show that in women with BPD testosterone levels are positively associated with increased borderline and depressive symptomatology. Contrary to our expectations, rather than predicting externalising symptoms, higher testosterone is associated with a well-defined cluster of internalising symptoms characterized by a pessimistic and derogatory view towards oneself.

Study of psychosocial factors and endothelial dysfunction in coronary heart disease patients

Objective To provide valuable insight into the prevention and treatment of coronary heart disease, this study aimed to explore the association between psychosocial elements and endothelial dysfunction in diagnosed patients. Methods Using a cross-sectional study design, we selected patients with coronary heart disease who visited the cardiology department of our hospital from January to December 2021. According to coronary angiography results, patients were divided into the coronary stenosis group (≥50%) and the normal coronary group (<50%), with 100 cases in each group. We assessed the levels of psychosocial factors using the Type A Behaviour Pattern Scale (TABP), Self-Rating Anxiety Scale (SAS), Social Support Rating Scale (SSRS), and Self-Rating Depression Scale (SDS). Endothelial synthesis of nitric oxide (NOx) and endothelium-dependent (EDF) and endothelium-independent (NEDF) vasodilation functions were measured and compared using enzyme-linked immunosorbent assay (ELISA) and colour Doppler ultrasonography, respectively. Results Patients in the coronary stenosis group had significantly higher scores in Type A behaviour, anxiety, and depression and significantly lower scores in social support compared with the normal coronary group (t = 3.21, 4.15, 3.87; p < 0.05; t = −2.96; p < 0.05). EDF, NEDF, and NOx levels were significantly lower in the coronary stenosis group than in the normal coronary group (t = −4.32, −3.76, −4.67; p < 0.05). Psychosocial factors were negatively correlated with endothelial function indices (r = −0.31 to −0.48; p < 0.05). Multiple linear regression analysis revealed that Type A behavioural anxiety, depression, and social support were independent risk factors influencing endothelial dysfunction (β = −0.23, −0.26, −0.21, −0.19; p < 0.05). Conclusion A close relationship was observed between psychosocial factors and endothelial dysfunction in patients with coronary heart disease. Assessment and intervention of psychosocial factors in these patients should be strengthened to improve endothelial function and reduce the risk of cardiovascular events.

A neural regulation mechanism of head electroacupuncture on brain network of patients with stroke related sleep disorders.

To analyze part of the mechanism of electroacupuncture on Sishencong (EX-HN1) for stroke-related sleep disorders (SSD) and post-stroke cognitive impairment (PSCI). Using a randomized controlled trial (RCT) design, 72 patients were assigned to the electro-acupuncture (EA) group or the sham acupuncture (SA) group. A healthy control (HC) group was also included. Both groups were given routine rehabilitation treatment. Then, patients in the EA group were given additional electroacupuncture at Sishencong (EX_HN1). Meanwhile, patients in the SA group were given a flat-head needle sham/placebo treatment placed at the bilateral Jianyu (LI15) and Binao (LI14) line midpoints and the Jianyu (LI15) and Jianzhen (SI9) line midpoints. Before and after treatment, scales were collected and analyzed. In the second phase of the study, some subjects from the EA group were selected for functional magnetic resonance imaging (fMRI) data acquisition and comparative analysis with the HC group using a non-RCT design. The EA group performed better than the SA group on the Pittsburgh sleep quality index (PSQI), Montreal cognitive assessment basic (MoCA_B), self-rating anxiety scale (SAS), and self-rating depression scale (SDS). Analysis of the fMRI showed that low-frequency (2 Hz) electroacupuncture stimulation at Sishencong (EX_HN1) can restrain frontal sup medial right (SFGmed.R), precuneus right (PCUN.R), and posterior cingulate cortex right (PCC.R) and enhance angular left (ANG.L), parietal inf left (IPL.L) and occipital mid left (MOG.L). The functional connectivity (FC) of SFGmed.R was positively correlated with PSQI. Electroacupuncture stimulation at Sishencong (EX_HN1) can reduce the side efficiency of the whole brain connection with the Thalamus.L, Hippocampus.L, and Occipital.Mid.L. Low frequency (2 Hz) electroacupuncture stimulation at Sishencong (EX_HN1) can simultaneously improve sleep quality, negative emotions, and cognitive functions, the first two of which may be related to SFGmed.R restraint. Electroacupuncture can make some brain areas approach the physiological bias state, which is characterized by dominant hemispheric enhancement and non-dominant hemispheric weakening. The reduced whole brain connection side efficiency with some key nodes of the brain net may relate to sleep quality improvements in SSD patients.

Developing a machine learning-based evaluation system for the recruitment of maritime professionals

The maritime sector predominantly relies on subjective evaluations of seafarers' skills and experience in conventional recruiting procedures. Nevertheless, subjective evaluation methods are highly susceptible to biases and inconsistencies. This study proposes a novel recruitment process within the maritime industry by merging psychological tests and machine learning methods in the recruitment process. Using psychological tests such as MMPI-I as features in machine learning methods for the recruitment process represents a step-change approach within the industry to promote more objective assessments of maritime professionals during recruitment processes and identify suitable candidates based on data from same-rank maritime professionals. This new methodology contributes innovatively to traditional maritime sector recruitment methods and potentially addresses a significant gap in the existing literature. The proposed methodology aims to predict future values by analysing existing data sets. Data were collected from 183 volunteer cadets from different backgrounds using an application form and the MMPI-I Personality Inventory. The dataset was classified using several machine learning algorithms, and their performance metrics were compared. The top five classification algorithms (Decision tree, PNN, random forest, gradient boost trees, and naive Bayes) with the best performance were evaluated, and the most accurate classification performance was achieved with the GBT algorithm. The results show that the highest values are for Gradient Boosted Trees (86%) and Random Forest (80%). The GBT algorithm has scored higher values for other metrics as well. The findings of this study indicate that it is possible to train algorithms that can adequately forecast the credentials and appropriateness of marine recruits. Through more development, these data-driven solutions could enhance existing subjective recruitment practices. This approach could improve the objectivity and prediction accuracy of marine recruiting processes, hence facilitating the selection of highly qualified individuals.

Evaluation of the montreal cognitive assessment in idiopathic tinnitus patients with mild hearing loss

Objective:To explore the effect of mild hearing loss on cognitive function by evaluating the Montreal Cognitive Assessment（MoCA） in idiopathic tinnitus patients with mild hearing loss. Methods:102 patients with idiopathic tinnitus（68 patients with normal hearing and 34 patients with mild hearing loss） whose first complaint is tinnitus and 34 healthy volunteers（control group） were included. All subjects were asked to fill the MoCA, Tinnitus Handicap Inventory（THI）, Self-rating Anxiety Scale（SAS）, Self-rating Depression Scale（SDS）, and Pittsburgh Sleep Index（PQSI） after collecting medical history, pure tone audiometry, tinnitus matching and masking test. The clinical characteristics and scores of each scale were compared among the groups. Results:The score and each dimension score of MoCA in idiopathic tinnitus patients with normal hearing were significantly lower than the normal population（P<0.05）; compared with patients with idiopathic tinnitus with normal hearing, patients with mild hearing loss were older（P<0.01） and had lower MoCA scores（P<0.05）. There was no significant difference in MoCA scores（P>0.05） between tinnitus patients with normal hearing and mild hearing loss after correcting confounding factors（age, gender, years of education, duration of tinnitus, frequency of tinnitus tones, side of tinnitus, THI score, SAS score, SDS score, and PQSI score）; idiopathic tinnitus patients with mild hearing loss scored significantly lower in attention and working memory dimensions than idiopathic tinnitus patients with normal hearing（P<0.01）. Conclusion:Patients with idiopathic tinnitus may have cognitive dysfunction, and mild hearing loss may not be a factor that promotes the further aggravation of cognitive dysfunction in patients with idiopathic tinnitus. The role of hearing loss in cognitive dysfunction in patients with idiopathic tinnitus needs further research.

Compound Tongyang Fumai decoction improves quality of life in sick sinus syndrome: a randomized controlled study.

To evaluate the efficacy of Tongyang Fumai decoction (, TYFM) on the quality of life (QOL) as a complementary therapy for sick sinus syndrome (SSS). This randomized controlled study involved 224 patients with symptomatic SSS. Patients were randomly assigned to either the TYFM group or the control group (receiving theophylline sustained-release tablets). The primary endpoints included changes in average heart rate, the longest R to R (RR) interval, and the occurrences of long RR intervals. Secondary endpoints comprised the Short Form (SF)-36 questionnaires, the Self-Rating Anxiety Scale (SAS), and the Self-Rating Depression Scale (SDS). TYFM significantly improved average heart rate (TYFM: 6 bpm vs control: 3 bpm, P < 0.01), shortened longest RR interval (TYFM: －0.20 s vs control: －0.0027 s, P < 0.05), and reduced numbers of long RR (TYFM: －99 vs control: －59, P < 0.01). In SF-36, TYFM enhanced physical and mental components (P < 0.01), outperforming the control group. TYFM also improved eight SF-36 dimensions significantly (P < 0.05 or P < 0.01). Regarding SAS and SDS, TYFM reduced scores significantly (P < 0.01), while SAS improved in the control group (P < 0.01), with no change in SDS. Statistically significant differences (P < 0.01) were observed in SAS and SDS between TYFM and control groups post-intervention. TYFM emerges as a promising alternative strategy for treating SSS, demonstrating favorable therapeutic effects and significant improvements in the quality of life for patients with SSS.

Electroacupuncture versus 5-HT4 receptor agonist for functional constipation: A systematic review and meta-analysis of randomized controlled trials.

Functional constipation (FC) has been found as a chronic gastrointestinal disease that is commonly diagnosed in patients. However, patients have a low satisfaction level with the treatment of constipation drugs (e.g., 5-HT4 agonists). A meta-analysis was performed to compare the efficacy and safety between electroacupuncture and 5-HT4 agonists. The included study were randomized controlled trials (RCTs), in which EA was used in the experimental group and 5-HT4 receptor agonist was used in the control group. Four English databases (PubMed, Cochrane Library, Web of Science, Embase) and 4 Chinese databases (China National Knowledge Infrastructure, CBM, WanFang, VIP) were searched. Relevant studies retrieved were published before September 30, 2024. The risk of bias was assessed by tool of Cochrane and GRADEpro. The Review Manager 5.4 was used for analyzing Data analysis, and Endnote X9 for screening studies. In this paper, we included 12 studies, involving 1473 participants. We found that EA significantly improved patient assessment of cab quality of life questionnaire (PAC-QOL) (MD = -0.52, P = .03), self-rating anxiety scale (SAS) (MD = -3.00, P < .00001) and self-rating depression scale (SDS) (MD = -4.13, P < .00001) compared with 5-HT4 receptor agonists. In addition, we failed to identify any significant difference in Stool consistency, the number of weekly complete spontaneous bowel movements and weekly spontaneous bowel movements (SBMs) between the 2 groups. EA has been indicated to be better than 5-HT4 receptor agonists since it can more effectively improve FC patients' life quality and mental state without an increased risk of adverse even. However, the previous evidence is characterized by low quality and small sample size, which should be further confirmed by high-quality and large-sample multicenter RCTs.

The relationship between perceived social support and social anxiety in Chongqing rural secondary school students: the chain mediating effect of core self-evaluation and shyness

BackgroundAdolescents in less economically developed areas are susceptible to social anxiety, so finding ways to effectively prevent and intervene in social anxiety could be a major step forward for poverty alleviation. However, little is known about the inner workings of social anxiety in this group. Exploring the risk and protective factors of social anxiety among adolescents in less developed rural areas is crucial for maintaining their mental health and improving their social adaptability. The purpose of this study is to explore the relationships among perceived social support, core self-evaluation, shyness and social anxiety among rural secondary school students and analyze the risk and protective factors of social anxiety.MethodsA total of 626 rural secondary school students are investigated with the Perceived Social Support Scale (PSSS), Core Self-Evaluation Scale (CSES), Shyness Scale (SS) and Social Avoidance and Distress Scale (SADS). Structural equation modeling is used to analyze the mediating effects of core self-evaluation and shyness.ResultsThe results reveal that (1) the perceived social support and core self-evaluation of rural secondary school students are significantly negatively correlated with social anxiety, whereas their shyness is significantly positively correlated with social anxiety. There are significant gender differences in perceived social support, core self-evaluation, shyness and social anxiety. (2) There is a significant chain mediating effect of core self-evaluation and shyness between perceived social support and social anxiety, and the mediation model is cross-gender consistent.ConclusionsThese results confirm that perceived social support and core self-evaluation are protective factors against social anxiety in rural secondary school students and that shyness is a risk factor for social anxiety. Moreover, perceived social support can indirectly affect social anxiety through core self-evaluation and shyness. Prevention and intervention of social anxiety can be carried out in three ways: improving the perceived ability of social support, enhancing positive self-evaluation, and reducing shyness and avoidance behaviors.

Application of Healthcare Failure Mode and Effect Analysis in the Management of Patients With Intrathecal Morphine Pump Implantation

BackgroundIntrathecal morphine pump helps alleviate pain in the advanced stages of cancer, and thus, ensuring safe intrathecal morphine pump infusion is important. In this study, we investigated the effect of healthcare failure mode and effects analysis (HFMEA) in the management of patients with intrathecal morphine pump implantation. MethodsWe included 112 cancer patients with severe pain who met the inclusion criteria for intrathecal morphine pump implantation treatment in the pain department of our hospital from November 2021 to October 2022. We analyzed the severity, likelihood, and crisis of potential failure modes, causes, and results of intrathecal morphine pumps during this period, compiled the records, and formulated the appropriate improvement measures based on the results of the analysis. From November 2022 to October 2023, the HFMEA model was applied to 125 patients in the department, and the effectiveness of the model was evaluated by assessing the patients’ VAS (visual analog scale) score, SAS (self-rating anxiety scale) score, SDS score, PSQI (Pittsburgh Sleep Quality Index) score and quality of life (QOL) (self-rating depression scale) score. ResultsThe occurrence of adverse events (6 cases vs. 2 cases, p < .05), and the total incidence of adverse events (8.9% vs. 1.6%, X2= 6.600, p = .010) was significantly different before and after HFMEA was applied. For patients who received intrathecal morphine pump implantation, the VAS scores and the related pain indices were significantly lower after HFMEA than before. Additionally, the score of SAS (48.91 ± 6.03 vs. 47.02 ± 6.77), PSQI (37.30 ± 5.78 vs. 39.63 ± 5.64), and QOL (9.93 ± 3.04 vs. 8.98 ± 2.31) of patients improved significantly. ConclusionsWith the application of the HFMEA model, a multidisciplinary team assessed the risks associated with the use of intrathecal morphine pumps and prioritized measures to reduce them. By implementing the improvement measures, potential errors decreased significantly during the intrathecal morphine pump process. It allowed nursing managers to change the safety incidents related to drug administration using an intrathecal morphine pump from negative treatment after the event to active prevention before the event, greatly improved the level of drug use safety management, reflected the continuous improvement of nursing quality, and ensured nursing safety.

Effects of irrigation-mediated continuously moist and dry-rewetting pattern on soil physicochemical properties, structure and bacterial community

The drying-rewetting cycles (DRW) shaped by climate change are known to affect the physicochemical cycles of natural soils. In irrigated soils, changes in irrigation methods make DRW cycles more repetitive and frequent. However, how irrigation regimes affect the physicochemical properties of irrigated soils and their selection of microbial communities have yet to be discovered. Two irrigation methods for two DRW patterns were selected: (1) continuous irrigation for constantly moist (including three soil wetness, low for CL, medium for CM, and high for CH) and (2) intermittent irrigation for DRW (including three intermittent irrigation frequencies, low for DL, medium for DM and high for DH), to determine the selection of soil physicochemical properties and microbial communities and their effect on yield by mediating soil DRW patterns with different irrigation methods. The results revealed that the DRW pattern mediated by irrigation regimes significantly affected soil physicochemical properties. Constantly moist treatments maintained a more stable soil hydrothermal status, with less soil salinity and slight alkalinity than DRW treatments. The water-stable aggregate was greater in CM, but it was progressively enhanced with increased intermittent frequency. In addition, SOM and TN in CM were 15 %, 25 %, and 35 % higher than in DL, DM, and DH, respectively. High-throughput sequencing results showed that CM had the largest Chao1 index (2610.10), Shannons index (10.23), and Simpsons index (0.9982). The results of the Mental tests indicated that soil moisture patterns exhibited a high degree of explanation by environmental factors. The RDA analysis demonstrated that the PC1 axis (28.7 %) significantly separated the soil bacterial communities of different treatments. These results extend the theoretical understanding of how continuously moist soil and continuous irrigation affect soil physicochemical properties and microbial community diversity. This study provides theoretical guidance for strengthening the application and popularization of continuous irrigation in irrigated soil in the future.

Sleep-Disordered Breathing in Patients with Chronic Heart Failure and Its Implications on Real-Time Hemodynamic Regulation, Baroreceptor Reflex Sensitivity, and Survival

Background: Impairment in autonomic activity is a prognostic marker in patients with heart failure (HF), and its involvement has been suggested in cardiovascular complications of obstructive sleep apnea syndrome (OSAS) and Cheyne–Stokes respiration (CSR). This prospective observational study aims to investigate the implications of sleep-disordered breathing (SDB) on hemodynamic regulation and autonomic activity in chronic HF patients. Methods: Chronic HF patients, providing confirmation of reduced ejection fraction (≤35%), underwent polysomnography, real-time hemodynamic, heart rate variability (HRV), and baroreceptor reflex sensitivity (BRS) assessments using the Task Force Monitor. BRS was assessed using the sequencing method during resting conditions and stress testing. Results: Our study population (n = 58) was predominantly male (41 vs. 17), with a median age of 61 (±11) yrs and a median BMI of 30 (±5) kg/m2. Patients diagnosed with CSR were 13.8% (8/58) and 50.0% (29/58) with OSAS. No differences in the real-time assessment of hemodynamic regulation, heart rate variability, or baroreceptor reflex function were found between patients with OSAS, CSR, and patients without SDB. A subgroup analysis of BRS and HRV in patients with severe SDB (AHI &gt; 30/h) and without SDB (AHI &lt; 5) revealed numerically reduced BRS and increased LF/HF-RRI values under resting conditions, as well as during mental testing in patients with severe SDB. Patients with moderate-to-severe SDB had a shorter overall survival, which was, however, dependent upon age. Conclusions: Chronic HF patients with severe SDB may exhibit lower baroreceptor function and impaired cardiovascular autonomic function in comparison with HF patients without SDB.

Dividing small groups into problem-based learning tutorials: an experience report

This article aims to provide a critical and reflective account of the experience of the pedagogical support service at the Christus University Center - Unichristus, during the implementation of the heterogeneous division of tutorial groups by personality traits, in the active methodology, Problem-Based Learning (PBL). Method: This is a descriptive experience report of a study carried out at a private higher education institution in Fortaleza. The participants were 12 teachers who acted as tutors and 120 students who were new to the PBL methodology. The activity was systematized into three moments: application of the QUATI psychological typology test to the students, classification of the students into extroversion and introversion attitudes, division of the tutorial groups into similar proportions of introverted and extroverted students. The educational action involved training the teachers in group dynamics, revealing the personalities of their respective students and a round table discussion after the end of the semester. Results: the heterogeneous division of groups and teacher training led to an improvement in the management of tutorial groups. Conclusion: the experience showed that the tutors' prior knowledge of the personality traits of the tutorial group members and their heterogeneous formation can contribute to improving the teaching-learning process in PBL, especially with regard to looking at existing personalities individually.

Risk of sarcopenia, frailty and malnutrition as predictors of postoperative delirium in surgery

BackgroundThe risk factors for postoperative delirium are numerous and complex. One approach to identifying patients at risk is to evaluate their nutritional status. The aim of this prospective study is to better understand nutrition as a potential risk factor for postoperative delirium.MethodsA comprehensive preoperative assessment (Clinical Frailty Scale (CFS), the SARC-F questionnaire, Mini Nutritional Assessment-Short Form (MNA-SF)) were carried out as a prospective clinical study on 421 patients (70+) from 4 different surgical disciplines. Postoperatively, patients are examined daily for the presence of delirium using the 4AT screening tool (Arousal, Attention, Abbreviated Mental Test − 4, Acute change), the Nursing Delirium Screening Scale (NuDesc) and the Confusion Assessment Method (CAM) with its adaptation for the intensive care unit (CAM-ICU).ResultsIf there were indications of frailty or sarcopenia in the CFS or SARC-F, the association with delirium was increased 5.34-fold (OR of 5.34 [95% CI: 2.57;11.1]) and 5.56-fold (OR of 5.56 [95% CI: 2.97;10.4]) respectively. Delirium also occurred significantly more frequently with the risk of malnutrition or manifest malnutrition (MNA-SF) than with a normal nutritional status.ConclusionsPatients’ preoperative and nutritional status significantly impact the risk of developing postoperative delirium. Factors such as frailty, sarcopenia and possible malnutrition must be considered when implementing an effective and targeted preoperative assessment.Trail registrationGerman Clinical Trials Registry at https://www.drks.de/DRKS00028614, Registered 25 March 2022.

Patient-reported outcomes in adults with tyrosine kinase inhibitor-resistant chronic myeloid leukemia receiving olverembatinib therapy.

The objective of this study was to assess patient-reported outcomes (PROs), including health-related quality of life (HRQoL) and anxiety and depression symptoms, and to identify associated variables in patients with tyrosine kinase inhibitor (TKI)-resistant chronic myeloid leukemia (CML) in chronic-phase (CP) or accelerated-phase (AP) who were receiving olverembatinib. Patients in multicenter studies were invited to complete the European Organization for Research and Treatment of Cancer Quality-of-Life Core 30 Questionnaire, the Self-Rating Anxiety Scale, and the Self-Rating Depression Scale at baseline and regularly during olverembatinib therapy. The time trends in PROs were estimated with a linear model using a generalized estimating equation based on an independent working correlation matrix. A generalized estimating equation model was used to assess the variables associated with PROs. In total, 146 patients with CML-CP or CML-AP were included in this study. Scores on seven items from the European Organization for Research and Treatment of Cancer Quality-of-Life Core 30 Questionnaire, including global health, physical functioning, emotional functioning, fatigue, dyspnea, diarrhea, and financial difficulties, improved significantly over time during olverembatinib therapy. In multivariate analysis, age younger than 40 years was significantly associated with greater improvement in social functioning (p=.033), and CML-CP (vs. CML-AP) was associated with greater improvements in dyspnea (p=.031) and diarrhea (p=.031) over time. Scores on the Self-Rating Anxiety Scale and the Self-Rating Depression Scale decreased significantly over time during olverembatinib treatment (p<.001). The authors concluded that HRQoL significantly improved over time during olverembatinib therapy in heavily treated patients with TKI-resistant CML, especially among those who were younger and those who had CML-CP. Anxiety symptoms also significantly decreased over time.

Description of Stress and Cognitive Function in Patients Non-Hemorrhagic Stroke at Tugurejo Hospital in 2022

Stroke is the main cause of death in Indonesia, the incidence has increased from 7% to 10%, of which 74% have ischemic strokes. Stress is common in stroke patients. According to research conducted, 58.8% of stroke survivors experienced severe stress, and 60% of stroke survivors experienced decreased or decreased cognitive function after stroke. The research objective was to describe stress and cognitive function in order to reduce stress levels and cognitive function in non-hemorrhagic patients at Tugurejo Hospital in 2022. This type of research is a quantitative descriptive analysis with a cross sectional design. The study population consisted of post-stroke patients who were diagnosed in 2022 by doctors at Tugurejo General Hospital and met the inclusion criteria, namely the Mini Mental State Exam Test Questionnaire (MMSE) and Depression Anxiety Stress Scales (DASS-21) as research instruments, then the data were analyzed using univariate analysis. The total sample consisted of 40 respondents who were analyzed by univariate. The results of the study describing stress levels in non-hemorrhagic stroke patients at Tugurejo Hospital in 2022 showed that 35% had normal stress levels and 65% had abnormal stress levels. while the picture of cognitive function in non-hemorrhagic stroke patients showed normal results in 32% and impaired cognitive function in 67.5%. Description of stress and cognitive function in non-hemorrhagic stroke patients at Tuguurejo General Hospital in 2022. Based on risk factors, gender, age, education, occupation, pre-existing conditions and stroke onset, the results showed abnormal levels of stress and disruption of cognitive function.

Quality of life and its predictors among breast cancer patients treated with surgery—a retrospective minimum 3-year follow-up study

AimQuality of life (QoL) has been identified as an important indicator of positive outcomes among breast cancer (BC) survivors. However, the status and predictors of QoL in China remain unclear. This retrospective follow-up study aimed to examine the QoL levels among BC patients following surgery and to assess the influence of sociodemographic, clinical, and psychological factors on QoL.MethodsAn institution-based retrospective follow-up study was conducted among 714 BC patients who received surgery at the First Affiliated Hospital of Guangxi Medical University between January 2016 and December 2019. Our primary outcome measure was QoL, assessed using the European Organization for Research and Treatment of Cancer QoL Questionnaire Core 30 (EORTC QLQ-C30). Anxiety and depression were evaluated by the Self-Rating Anxiety Scale (SAS) and the Self-Rating Depression Scale (SDS), respectively. Data on the patient demographics and clinical were derived from medical records. Results are presented as means (SD), medians [Q1, Q3], or percentage (%). We used R 4.2.2 software to identify factors associated with QoL after BC surgery. AMOS 28.0 was used to construct a structural equation model (SEM) to predict QoL outcomes.ResultsThe overall QoL score was 43.30 ± 4.77 (mean ± SD). Predictive factors were: surgery type, radiotherapy, anxiety, and depression (p&amp;lt;0.05). The results of the SEM indicated that anxiety and depression had a direct negative effect on QoL (effect value was -0.46, -0.84, respectively, p&amp;lt;0.05), radiotherapy had a direct positive effect on QoL (effect value was 0.71, p&amp;lt;0.05). The type of surgery (mastectomy) impacted QoL both directly and indirectly through its association with depression, with direct and indirect effect values of -0.96 and -0.66, respectively (p &amp;lt; 0.05).ConclusionThe QoL of BC patients after surgery is generally moderate to low. Medical staff should prioritize early identification and rehabilitation management for patients experiencing anxiety, depression, radiotherapy, and mastectomy to enhance their QoL. Our findings provide a strong foundation for developing nursing intervention plans and assessment guidelines for practitioners caring for BC patients.

Gong’s acupuncture treatment for mid pregnancy insomnia and anxiety: A case report

Rationale: Gong’s brain acupuncture (GBA) is a acupuncture technique that restores the balance of the central nervous system by stimulating specific acupoints on the skull to transmit stimulation to the nerves. Insomnia during pregnancy is an increasingly concerning issue, and GBA provides new solutions. Patient’s concerns: The patient, a 26-year old woman at 26 + 1 weeks of pregnancy, presented with unexplained insomnia for 3 weeks. Her symptoms included difficulty initiating sleep, light sleep, and intermittent wakefulness throughout the night. Diagnoses: The patient was diagnosed with primary insomnia, scoring 16 on the Pittsburgh sleep quality index, which indicates poor sleep quality. Her self-rating anxiety scale (SAS) score was 49 points, suggesting that she had not yet reached a state of mild anxiety. Interventions: The patient received 15 sessions of GBA treatment. Outcomes: One month after treatment completion, the patient’s Pittsburgh sleep quality index score improved to 3 points, indicating good sleep quality. Her self-rating anxiety scale score decreased to 39 points. Lessons: This case report demonstrated the successful treatment of mid pregnancy insomnia with GBA, providing preliminary evidence for further research on the therapeutic potential of GBA. However, further research is still needed to enhance persuasiveness.

Prevalence and risk factors of anxiety and depression in diabetic retinopathy patients: A cross-sectional study using multiple scales.

To investigate the prevalence of anxiety and depression, and explore their related factors in all types of diabetic retinopathy (DR) patients more precisely and accurately by multiple scales. Beck anxiety inventory (BAI), self-rating anxiety scale (SAS), beck depression inventory (BDI), and self-rating depression scale (SDS) scores were assessed in 247 DR patients and 250 non-retinopathic diabetes mellitus (NRDM) patients. In DR patients, there were 32 patients with proliferative DR and 115 patients with impaired visual acuity. The prevalences (95% confidence interval) of anxiety were 38.5% (32.4%-44.6%) and 32.0% (26.2%-37.8%) by BAI and SAS, while those for depression were 31.6% (25.8%-37.4%) and 25.1% (19.7%-30.5%) by BDI and SDS in DR patients. BAI score (P = 0.003), BAI-defined anxiety rate (P = 0.010), SAS score (P = 0.001), SAS-defined anxiety rate (P = 0.006), BDI score (P = 0.005), BDI-defined depression rate (P = 0.028), and SDS score (P = 0.001) were increased in DR patients versus NRDM patients. In DR patients, proliferative DR independently related to BAI-defined anxiety (P < 0.001) and SAS-defined anxiety (P < 0.001). Female (P = 0.016) and proliferative DR (P < 0.001) independently associated with BDI-defined depression; female (P = 0.007), DM duration (P = 0.025), triglyceride (TG) (P = 0.026), and proliferative DR (P = 0.014) independently associated with SDS-defined depression. The combination of these independent factors showed acceptable abilities in predicting BAI-defined anxiety, SAS-defined anxiety, BDI-defined depression, or SDS-defined depression in DR patients, with area under curves of 0.626, 0.656, 0.696, and 0.741, respectively (all P < 0.001). Anxiety and depression are prevalent; meanwhile, proliferative DR, female, DM duration, and TG independently relate to anxiety or depression in DR patients.