Wuhu City Research Articles

Elevated blood pressure and hyperuricemia risk: a retrospective cohort study from Wuhu, China

Although the relationship between hypertension and hyperuricemia is widely recognized, there is still a relative lack of research on prehypertensive individuals and the individual associations of systolic and diastolic blood pressure with the risk of hyperuricemia. From 2011 to 2016, we conducted a study on 53,323 individuals at Wuhu City Hospital in China. Based on initial blood pressure readings, participants were categorized into normal, prehypertension, or hypertension groups. We used Cox regression to analyze the associations with baseline factors. In subgroup analyses, systolic and diastolic pressures were treated as continuous variables, and their relationship with the risk of hyperuricemia was examined using restricted cubic spline analysis. The risk increased in the prehypertension and hypertension groups compared to the normal blood pressure group, with hazard ratios of 1.192 and 1.350, respectively. For each unit increase in blood pressure, the risk of hyperuricemia rose by 0.8% (systolic) and 0.9% (diastolic), especially when blood pressure levels exceeded 115/78 mmHg. Additionally, we observed that factors such as gender, alcohol consumption habits, obesity, and dyslipidemia might further influence this association. These findings emphasize the importance of early risk assessment and intervention in these patient populations in clinical practice.

Association between IGF-1 levels and MDD: a case-control and meta-analysis.

Insulin-like growth factor-1 (IGF-1) has a variety of neurotrophic effects, including neurogenesis, remyelination and synaptogenesis, and is an effective regulator of neuronal plasticity. Although multiple studies have investigated IGF-1 in depression-related disorders, few studies have focused on patients with a first episode of clearly diagnosed depression who had never used antidepressants before. Therefore, this study investigated first-episode and drug-naïve patients with depression to supplement the current evidence around IGF-1 levels in depressive disorders. This study consisted of two parts. In the first part, 60 patients with first-episode and drug-naïve depression and 60 controls matched for age, sex, and BMI were recruited from the outpatient department of the Fourth Hospital of Wuhu City, and the community. The case-control method was used to compare differences in serum IGF-1 levels between the two groups. In the second part, 13 case-control studies were screened through the database for meta-analysis to verify the reliability of the results. Results of the case-control study demonstrated that serum IGF-1 levels are significantly higher in patients with first-episode and drug-naïve depression compared to healthy controls (p<0.05), although there was no significant difference between men and women with diagnosed MDD, there was no significant correlation between serum IGF-1 level and age in patients with depression and no significant correlation between IGF-1 level and the severity of depression. The meta-analysis corroborates these findings and demonstrated that IGF-1 levels are significantly higher in MDD patients than in healthy controls. Patients with first-episode and drug-naïve depression have higher IGF-1 levels, but the exclusion of confounding factors in studies of IGF-1 as it relates to depressive disorders must be taken into consideration strictly, and additional research is needed to fully understand the critical role of IGF-1 in depression. PROSPERO, identifier CRD42023482222.

Development and Validation of an In-Hospital Mortality Prediction Model for Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease.

Patients with chronic obstructive pulmonary disease (COPD) often face unknown risks during acute exacerbation of the disease (AECOPD), which could potentially result in mortality. This study aimed to develop and validate a nomogram model for predicting the risk of in-hospital mortality in AECOPD patients. Clinical data of patients hospitalized at The Second People's Hospital of Wuhu City for AECOPD between January 2013 and December 2022 were retrospectively collected. Variables underwent selection through LASSO regression and multivariable logistic regression to develop a nomogram model. The model's predictive performance was assessed using the concordance index, calibration curve, and decision curve analysis (DCA), with internal validation conducted using the bootstrap method. A total of 1224 patients were included in this study, with 98 (8%) deaths occurring during hospitalization. LASSO regression identified 11 variables, used to construct model A. Further multivariable logistic regression was conducted to select variables with P < 0.05 to establish model B. model B was selected as the final model based on discrimination, calibration, and clinical utility, encompassing variables including acute respiratory failure, lung cancer, heart rate, hemoglobin, absolute neutrophil count, serum albumin, blood urea nitrogen, and serum chloride. The nomogram model achieved a concordance index of 0.858. Internal validation of the model was conducted using the bootstrap method with 500 repetitions, resulting in a concordance index of 0.851 (95% CI: 0.805, 0.893). The calibration curve demonstrated a good fit, with a Hosmer-Lemeshow goodness-of-fit test P-value of 0.520. Moreover, DCA findings suggested patient benefit within a threshold probability range of 0.02 to 0.73, with a maximum net benefit of 0.07. The model constructed in this study has good predictive performance, which helps clinical doctors identify patients at high risk of death early.

Targetedness, effectiveness, and sustainability of China's photovoltaic poverty alleviation programmes

As one of the key projects of the top ten targeted poverty alleviation projects, Photovoltaic Poverty Alleviation Projects (PPAP) has played an important role in poverty alleviation and eliminating absolute poverty. This paper analyzes the impact of the PPAP on the consumption and poverty vulnerability of impoverished households and reveals the characteristics of the targetedness, effectiveness and sustainability of PPAP based on the data of the previous poverty-stricken households recorded in four townships in Wuwei County, Wuhu City, Anhui Province, China. The results show that under the extreme poverty standard line, PPAP can significantly reduce the poverty vulnerability of impoverished households, and the effect of the PV poverty alleviation project has a strong sustainability; It has a significant heterogeneous impact on families of different poverty types, among which, it plays a significant role in alleviating the poverty vulnerability of impoverished households due to the loss of labor ability, and low-income families, with strong targetedness; For families with a high degree of vulnerability to poverty, the PPAP can significantly alleviate their vulnerability, indicating the effectiveness of PPAP to play a bottom-up role for the poor families.

Prevalence and associated factors of insomnia symptoms after ending China's dynamic zero-COVID policy: a cross-sectional survey of frontline nursing staff in Chinese hospitals.

After the Chinese government announced the end of the dynamic zero-COVID policy on January 8, 2023, the COVID-19 pandemic peaked. Frontline nursing staff are at high risk of infection transmission due to their frequent contact with COVID-19 patients. In addition, due to the ending of China's dynamic zero-COVID policy, frontline nursing staff have grappled with increased workload, fatigue, and more. This study aimed to explore the prevalence of insomnia symptoms in frontline nursing staff and its influencing factors following the end of the policy. Between January and February 2023, this study was conducted by the Wenjuanxing platform to survey frontline nursing staff in a hospital in Wuhu City, Anhui Province. All the nursing staff included in this study had a COVID-19 infection. The questionnaires included the Athens Insomnia Scale (AIS), PC-PTSD-5 Chinese Version Scale, the Fear of COVID-19 Scale, The 2-item Connor-Davidson Resilience Scale (CD-RISC-2) Scale, and the burden of COVID-19 Scale. Binary logistic regression methods were used to identify variables associated with insomnia symptoms. Among the 694 frontline nursing staff, 74.5% (517/694) exhibited insomnia symptoms. Fear of COVID-19 (p < 0.001), the burden of COVID-19 (p < 0.05), PTSD (p < 0.001), and higher technical titles (p < 0.008) were highly correlated with insomnia symptoms in frontline nursing staff. Psychological resilience (p < 0.001) was a protective factor for insomnia symptoms among frontline nursing staff. After ending China's dynamic zero-COVID policy, the prevalence of insomnia symptoms among frontline nursing staff is generally higher. This study highlights the association between insomnia symptoms and PTSD, fear of COVID-19, COVID-19 burden, and resilience. Psychological assistance is needed for frontline nursing staff to prevent insomnia symptoms and protect the mental health of frontline nursing staff after the end of China's dynamic zero-COVID policy.

Analysis on the willingness and influencing factors of choosing hospice care service institutions among among older people in Wuhu, China: a cross-sectional study

ObjectiveThe purpose of this study was to evaluate the inclination and determinants influencing the selection of hospice care service institutions among elderly individuals in China.DesignThe study conducted has a cross-sectional...

Forensic parameters and population analysis of 21 autosomal STR loci in the Wuhu Han population from Anhui Province, East China

Background At present, there are no available genetic data on the AGCU EX22 Kit from the Wuhu Han population. Aim This study investigates the applicability of the AGCU EX22 kit, designed for the Chinese population for forensic analysis and population genetics of the Wuhu Han population. Subjects and methods Bloodstains from 1565 unrelated healthy individuals in Wuhu city, Anhui Province, were collected for analysis. The AGCU EX22 kit was used for amplification, and capillary electrophoresis was used to separate the amplification products. Allele frequencies and forensic parameters were determined. The Wuhu Han population was compared to 10 reference populations through genetic distance, a phylogenetic neighbor-joining tree and principal component analysis. Results In total, 281 alleles and 1187 genotypes were observed. No significant deviations from Hardy-Weinberg equilibrium at any locus were found after Bonferroni’s correction. The 21 autosomal short tandem repeat (STR) genetic markers exhibited high informativeness and polymorphism. The cumulative power of discrimination and power of exclusion were 0.999999999999999999999999913380 and 0.999999996752339, respectively. Population comparisons revealed a genetic affinity between Wuhu Han and southern Han populations, except for the Guangdong Han population, which aligned with the traditional geographical division in China. Conclusion The AGCU EX22 Kit, containing 21 STR loci, is suitable for forensic application and population genetics studies in the Wuhu Han population.

Research on the Problems and Pathways of Community Home-Based Elderly Care Services in Jinghu District, Wuhu City

Research on the Problems and Pathways of Community Home-Based Elderly Care Services in Jinghu District, Wuhu City

The Impact of Artificial Intelligence on Sustainable Building Technologies

With the rapid development of artificial intelligence, the demand of urban development for talents with relevant technical and theoretical knowledge is constantly increasing, which is of great significance for the promotion of scientific and technological progress and social development. This study through the construction of China city talent vitality evaluation index system, analysis of Luoyang, Ningbo, Wuhu city talent vitality level, summarizes the Chinese city talent development and deficiencies, from the talent growth, talent competitiveness, talent entrepreneurship, talent mobility and talent innovation in the practice of Chinese city talent strategy logic thinking.

The Survival Predicament and Breakthrough of Grassroots Sports Organizations—Taking Wuhu City Rampage Group as an Example

The Survival Predicament and Breakthrough of Grassroots Sports Organizations—Taking Wuhu City Rampage Group as an Example

Wastewater surveillance for antibiotics and resistance genes in a river catchment: Spatiotemporal variations and the main drivers

Wastewater-based epidemiology (WBE) is used for mining information about public health such as antibiotics resistance. This study investigated the distribution profiles of six types of antibiotic resistance genes (ARGs) in wastewater and rivers in Wuhu City, China. The levels of ARGs found in the Qingyijiang River were significantly higher than other rivers, and were comparable to effluent levels. Among the ARGs, sulfonamides ARGs and intI1 were the predominant in both wastewaters and rivers. Additionally, the concentrations of ARGs were higher on weekends as opposed to weekdays. Their distribution patterns remained consistent inter-week and inter-season using linear regression analysis (p < 0.001). Interestingly, the occurrence levels of ARGs in wastewaters during spring were significantly higher than in autumn, although insignificant in rivers. The apparent removal rate of ARGs in domestic wastewater sources ranged from 61.52–99.29%, except for qepA (-1.91% to 81.09%), whereas the removal rates in mixed domestic and industrial wastewaters showed a marked decrease (-92.94% to 76.67%). A correlation network analysis revealed that azithromycin and erythromycin were key antibiotics, while blaNDM-1, tetM, tetB, and ermB were identified as key ARGs. Sulfonamide and fluoroquinolone antibiotics, and tetracycline and macrolide ARGs were the primary contributors. Linear mixed models demonstrated that socio-economic variables positively impacted the occurrence levels of ARGs, whereas wastewater flow and river runoff were the negative drivers for their concentrations in wastewaters and surface waters, respectively. Overall, this WBE study contributes to the understanding of spatiotemporal profiles and main drivers of the occurrence of ARGs in wastewater and receiving water.

Retracted: Analysis of the Impacts of Health Cost and Risk Preference on Farmers’ Protective Behavior of Pesticide Application Based on the Autoregressive Threshold Model: A Case Study of Wuhu City in China

Retracted: Analysis of the Impacts of Health Cost and Risk Preference on Farmers’ Protective Behavior of Pesticide Application Based on the Autoregressive Threshold Model: A Case Study of Wuhu City in China

Identifying critical landscape patterns for simultaneous provision of multiple ecosystem services – A case study in the central district of Wuhu City, China

Landscape patterns have a global impact on ecosystem services (ESs). Managing land to enhance the provision of multiple ESs is vital for ecological resilience and sustainable development. Identifying critical landscape patterns that simultaneously influence multiple ESs provision based on understanding ES trade-offs is needed. Our study aims to develop an approach to find the relationship between multiple ESs provision and landscape patterns, identify the critical landscape patterns that simultaneously promote multiple ESs provision, and give suggestions on land management based on an understanding of the relationships of ESs. Taking the central district of Wuhu City as an example, production possibility frontier (PPF) and Pareto ranks are used to identify relationships between ESs and extract the landscape pattern characteristics of samples that effectively enhance multiple ESs. Our analysis of trade-offs between ESs highlights the complexity of ES relationships and emphasizes the necessity for multi-dimensional investigative approaches. Landscape metrics of Mean Perimeter Area Ratio (PARA_MN), Coefficient of Variation of Perimeter (PERI_CV), Area-weighted Mean Fractal Dimension (FRAC_AM), and Relative Mutual Information (RELMUTINF) emerged as critical determinants of multiple ESs supply. Our findings suggest enhancing patch shape complexity when conducting land use planning to avoid homogenization and keeping differences between the diversity of land use categories and the diversity of adjacencies small. Also, we recommend caution in using high contagion as the only criterion for land use planning, as its effects may vary on different ES targets.

Food Safety Practices of Food Handlers in China and their Correlation with Self-reported Foodborne Illness

Food service facilities are important sites where foodborne diseases have been reported to occur frequently. This study aims to determine the correlation between self-reported foodborne diseases and food-safety practices followed by food handlers of various food service facilities. A cross-sectional survey was conducted from March 1, 2022 to December 30, 2022 in Wuhu City, Anhui Province, China. Data were collected through face-to-face interviews and having the selected food handlers fill in a self-compiled questionnaire. Of the 1072 food handlers included in the study, 88 (8.2%) reported having experienced symptoms of foodborne diseases in the past 4 weeks. The following food-safety practices correlated with self-reported foodborne diseases: (1) infrequently using 3-compartment sinks to separately clean different types of raw food materials (P < 0.05, OR = 2.312); (2) infrequently removing non-edible parts of aquatic products outside a specific room for food processing (P < 0.001, OR = 3.916); (3) infrequently immediately refrigerating cold dishes prepared in advance to be consumed later (P < 0.001, OR = 4.048); (4) often store perishable foods at 8–60°C in the indoor environment after cooking and before eating (P < 0.05, OR = 2.068); (5) infrequently reheating cooked perishable food stored at 8–60°C for more than 2 h before eating (P < 0.05, OR = 1.934); and (6) often storing raw and cooked food in the same container (P < 0.001, OR = 3.818). Hence, a better supervision of food-safety practices of catering workers may reduce the frequency of foodborne-disease outbreaks in food service facilities.

Research on the relationship between common metabolic syndrome and meteorological factors in Wuhu, a subtropical humid city of China

As climate conditions deteriorate, human health faces a broader range of threats. This study aimed to determine the risk of death from metabolic syndrome (MetS) due to meteorological factors. We collected daily data from 2014 to 2020 in Wuhu City, including meteorological factors, environmental pollutants and death data of common MetS (hypertension, hyperlipidemia and diabetes), as well as a total number of 15,272 MetS deaths. To examine the relationship between meteorological factors, air pollutants, and MetS mortality, we used a generalized additive model (GAM) combined with a distributed delay nonlinear model (DLNM) for time series analysis. The relationship between the above factors and death outcomes was preliminarily evaluated using Spearman analysis and structural equation modeling (SEM). As per out discovery, diurnal temperature range (DTR) and daily mean temperature (T mean) increased the MetS mortality risk notably. The ultra low DTR raised the MetS mortality risk upon the general people, with the highest RR value of 1.033 (95% CI: 1.002, 1.065) at lag day 14. In addition, T mean was also significantly associated with MetS death. The highest risk of ultra low and ultra high T mean occured on the same day (lag 14), RR values were 1.043 (95% CI: 1.010, 1.077) and 1.032 (95% CI: 1.003, 1.061) respectively. Stratified analysis’s result showed lower DTR had a more pronounced effect on women and the elderly, and ultra low and high T mean was a risk factor for MetS mortality in women and men. The elderly need to take extra note of temperature changes, and different levels of T mean will increase the risk of death. In warm seasons, ultra high RH and T mean can increase the mortality rate of MetS patients.

Social anxiety, self-esteem and quality of life among hypertensive patients during COVID-19 local epidemic in China: A mediation analysis.

To explore the mediating role of self-esteem in social anxiety and QoL during the COVID-19 local epidemic in China. A cross-sectional survey. This study conveniently selected 344 hypertensive patients from a Grade-A tertiary hospital in Wuhu, Anhui Province, as the study population. Participants completed the demographic questionnaire, the social phobia inventory, the self-esteem scale and the 36-item short-form health survey. Social anxiety, self-esteem and QoL were significantly correlated with each other. Social anxiety showed no direct effect on QoL (β = 0.011, p > 0.05). Social anxiety showed an indirect effect on QoL (β = -0.248, p < 0.001). Self-esteem fully mediated the association between social anxiety and QoL in hypertensive patients. Hypertensive patients in this study were participants during the data collection process. Nursing staff from the cardiology department at the hospital of a hospital in Wuhu City, Anhui Province assisted in the recruitment phase of the data collection process.

Clinical Characteristics Analysis of Hospitalized Patients Infected with the Omicron Variant of the Novel Coronavirus

Objective: It’s to analyze the clinical characteristics of hospitalized patients infected with the Omicron variant of the novel coronavirus. Methods: This study retrospectively analyzed the clinical data of 374 Omicron-infected patients admitted to The Third People's Hospital of Wuhu City from January 1, 2022, to December 31, 2022. Clinical characteristics were analyzed. Results: The mean time to nucleic acid conversion was 10.93±3.55 days, with a median of 10 days. There was no statistically significant difference in the infection rate between females and males (P&gt;0.05). The highest proportion of patients was in the age group of 0-44 years (P&lt;0.05). Among patients, those without underlying diseases were more prevalent (P&lt;0.05). The majority of patients had no symptoms or mild symptoms (P&lt;0.05). Regarding vaccination status, most patients had completed the primary immunization or booster immunization (P&lt;0.05). The main symptoms were fever and respiratory symptoms (P&lt;0.05). In laboratory tests, some patients showed a decrease in lymphocyte count (31.82%), elevated C-reactive protein (21.93%), elevated alanine transaminase (18.18%), and elevated creatine kinase (12.30%). Most patients had no lesions on chest CT scans (P&lt;0.05). Traditional Chinese medicine was the primary treatment used (P&lt;0.05). The recovery rate was 100.00%. Conclusion: During this epidemic, the nucleic acid conversion for infected patients occurred around 10 days. Female patients had a higher infection rate, and the majority of cases were asymptomatic or mild. Most patients had completed either primary or booster immunization, indicating some resistance of the Omicron variant to vaccines. The main symptoms were fever and respiratory symptoms, and patients had significantly elevated white blood cell counts, neutrophil counts, and lymphocyte counts, indicating significant infection symptoms. Traditional Chinese medicine was the primary treatment used, and the recovery rate was 100.00%, suggesting that treatment with Traditional Chinese medicine was effective for the Omicron variant.

Experimental study on the molluscicidal activity of surfactin against Oncomelania hupensis

To evaluate the molluscicidal activity of surfactin against Oncomelania hupensis, so as to provide the experimental basis for use of Bacillus for killing O. hupensis. O. hupensis snails were collected from schistosomiasisendemic foci of Wuhu City on September 2022, and Schistosoma japonicum-infected snails were removed. Then, 60 snails were immersed in surfactin at concentrations of 2, 1, 0.5, 0.25, 0.125 mg/mL and 0.062 5 mg/mL for 24, 48, 72 hours at 26 °C, while ultrapure water-treated snails served as controls. The median lethal concentration (LC50) of surfactin against O. hupensis snails was estimated. O. hupensis snails were immersed in surfactin at a concentration of 24 h LC50 and ultrapure water, and then stained with propidium iodide (PI). The PI uptake in haemocyte was observed in O. hupensis snails using fluorescence microscopy. The mortality of O. hupensis was 5.0% following immersion in surfactin at a concentration of 0.062 5 mg/mL for 24 h, and the mortality was 100.0% following immersion in surfactin at a concentration of 2 mg/mL for 72 h, while no snail mortality was observed in the control group. There were significant differences in the mortality of O. hupensis in each surfactin treatment groups at 24 (χ2 = 180.150, P < 0.05), 48 h (χ2 = 176.786, P < 0.05) and 72 h (χ2 = 216.487, P < 0.05), respectively. The average mortality rates of O. hupensis were 38.9% (140/360), 62.2% (224/360) and 83.3% (300/360) 24, 48 h and 72 h post-immersion in surfactin, respectively (χ2 = 150.264, P < 0.05), and the 24, 48 h and 72 h LC50 values of surfactin were 0.591, 0.191 mg/mL and 0.054 mg/mL against O. hupensis snails. Fluorescence microscopy showed more numbers of haemocytes with PI uptake in 0.5 mg/mL surfactintreated O. hupensis snails than in ultrapure water-treated snails for 24 h, and there was a significant difference in the proportion of PI uptake in haemocytes between surfactin-and ultrapure water-treated snails (χ2 = 6.690, P < 0.05). Surfactin is active against O. hupensis snails, which may be associated with the alteration in the integrity of haemocyte membrane.

College Students’ Knowledge, attitudes, and practices regarding body posture: A cross-sectional survey--Taking a university in Wuhu City as an example

As body posture problems become more severe and tend to be younger, college students pay less attention to the effects of poor body posture. This study is an analysis of knowledge, attitudes, and behaviors related to body posture among college and university students. A random sample of 1012 college students aged 18–21 years old from Anhui Polytechnic University was randomly selected to distribute and collect the questionnaires by online questionnaire in April 2023. Descriptive statistics were also used to analyze the response rates of college students on the Knowledge, Attitude, and Practice (KAP) theory of body posture. The results of the study showed that the majority of subjects demonstrated good knowledge and attitudes towards healthy body posture; Most of the sample, 66.8% were clear about the definition of body posture, and 71.9% needed a body posture assessment to understand their body posture problems, but only 27% would develop an exercise program to improve poor body posture. Multiple linear regression analysis showed that Students with higher knowledge and attitudes have good motor behavior in correcting poor body posture. In addition, our study found that among college students in the age range of 18–21 years, the younger the age, the better their behavior in improving poor body posture through exercise. The results of this study demonstrate the importance of knowledge about healthy body posture and aim to promote knowledge education programs about healthy body posture among college students and to reduce the risks associated with poor body posture.

The relationship between psychological resilience and depression among the diabetes patients under the background of "dynamic zero COVID-19": the mediating role of stigma and the moderating role of medication burden.

Depression in diabetes patients is caused by their own disease or the surrounding social environment. How to cope with changes in mentality and adjust psychological stress responses, especially under China's dynamic zero COVID-19 policy, is worth further discussion. The researchers constructed a moderated mediation model to test the effect of psychological resilience during dynamic zero COVID-19 on depression in diabetes patients and the mediating role of stigma and the moderating effect of medication burden. From June to September, 2022, data were collected in Jinghu District, Wuhu City, Anhui Province, by multi-stage stratified sampling. Firstly, we selected a tertiary hospital randomly in Jinghu District. Secondly, departments are randomly chosen from the hospital. Finally, we set up survey points in each department and randomly select diabetes patients. In addition, we used the Connor-Davidson Elasticity Scale (CD-RISC) to measure psychological resilience of patients, and used the Stigma Scale for Chronic Illness (SSCI) to measure stigma, medication burden was measured by the Diabetes Treatment Burden Scale (DTBQ), and depression was assessed by the Patient Health Questionnaire-9 (PHQ-9). We used SPSS (version 23.0) and PROCESS (version 4.1) for data analysis. (1) Psychological resilience was negatively correlated with stigma, medication burden, and depression. Stigma was positively associated with medication burden and depression. Medication burden and depression are positively correlated, (2) The mediation analysis showed that psychological resilience had a direct predictive effect on depression, and stigma partially mediated the relationship, and (3) Medication burden moderates the direct pathway by which psychological resilience predicts depression; Medication burden moderates the first half of "psychological resilience → stigma → depression." Under the mediating effect of stigma, psychological resilience can improve depression. Medication burden has a moderating effect on the relationship between psychological resilience and depression, and it also has a moderating effect on the relationship between psychological resilience and stigma. These results facilitate the understanding of the relationship mechanisms between psychological resilience and depression.