Correlation between Carotid Blood Flow Velocity and Total Magnetic Resonance Imaging Burden of Cerebral Small Vessel Disease in Patients with Recent Small Subcortical Infarcts.

BACKGROUND: The common and internal carotid arteries are the upstream vessels of the small cerebral vessels. The relationship between hemodynamic changes in the significant cervical vessels and cerebral small vessel disease (CSVD) remains uncertain. This research sought to analyze the correlation between carotid blood flow velocity and the total magnetic resonance imaging (MRI) burden of CSVD in patients with recent small subcortical infarcts (RSSIs). METHODS: Data were gathered from individuals diagnosed with RSSIs admitted to Changzhou Second People's Hospital between January 2022 and June 2023. Brain MRI was performed on every patient to determine the overall MRI burden of CSVD, along with carotid duplex ultrasound to evaluate carotid blood flow velocity and pulsatility index (PI) of the common carotid (CCA) and internal carotid (ICA) arteries. The association between carotid blood flow velocity and the total MRI load of CSVD was examined using univariate and multivariate analyses. RESULTS: For our investigation, 272 individuals with RSSIs were screened. 82 individuals had a moderate to severe load of CSVD, while 190 participants showed a mild burden. Patients with moderate to severe burden of CSVD had lower end-diastolic velocity (EDV) and higher PI in CCA and ICA than those with mild load (P < 0.001). After adjusting for variables like age, hypertension, systolic blood pressure, and blood homocysteine levels, multivariate logistic regression analysis showed that EDV in CCA (OR, 0.894; P = 0.011), PI in CCA (OR, 5.869; P = 0.017), EDV in ICA (OR, 0.909; P = 0.008), and PI in ICA (OR, 5.324; P = 0.041) were independently related to moderate to severe CSVD burden. Spearman correlation analysis showed that EDV in CCA and ICA was negatively related to the total MRI load of CSVD in patients with RSSIs (P < 0.001). PI in CCA and ICA was positively associated with the whole MRI load of CSVD (P < 0.001). CONCLUSION: Low carotid blood flow velocity and high carotid pulsatility index are independently associated with moderate to severe burden of CSVD.

The reliability and validity of the training elements scale for clinicians in the new era--based on the perspective of Chinese doctors' job demands.

OBJECTIVE: The purpose of this study was to develop a scale of clinician training elements in the new period and test its reliability and validity. METHODS: Our approach was based on interdisciplinary theory, systematology, collaborative innovation theory, and whole person education theory combined with the existing post competency model of Chinese doctors and the responsibilities and requirements endowed clinicians in the new historical period. The scale elements were extracted by referring to the relevant literature, and the training elements scale for clinicians in the new period were preliminarily formed. From July to August 2022, 1,086 clinicians from tertiary medical institutions in eastern, central, and western China were sampled and investigated. The questionnaire was revised via the critical ratio method and homogeneity test method, and the reliability and validity of the scale were also tested. RESULTS: The training elements scale for clinicians in the new period included the following eight dimensions: basic clinical knowledge, interdisciplinary knowledge, clinical skill operation, public health knowledge, technological innovation capability, lifelong learning needs, medical humanistic literacy, and international exchange vision, as well as 51 other items. The Cronbach's α coefficient of the scale was 0.981, the half-reliability was 0.903, and the average variance extraction of each dimension was greater than 0.5. An exploratory factor analysis extracted eight main factors, and the cumulative variance contribution rate was 78.524%. Confirmatory factor analysis showed that the model fit was ideal and the factor structure was stable. CONCLUSION: The clinician training factor scale in the new era can fully meet the current training needs of r clinicians, and has good reliability and validity. It can be widely used in medical colleges and universities as a reference to reform the content of medical training and education, and can also be used in the continuing education of clinicians after graduation to compensate for gaps in knowledge during clinical work.

A short-term follow-up study on the relationship between early adolescent proactive/reactive aggression and sleep quality.

OBJECTIVE/BACKGROUND: Sleep quality is closely related to aggressive behavior. Previous studies rarely focused on the relationship between proactive/reactive aggression and sleep quality through a person-centered approach. METHODS: The Pittsburgh Sleep Quality Index Scale and the Reactive-Proactive Aggression Questionnaire were used to assess 553 elementary and middle school students twice at 6-month intervals to better understand the relationship between proactive/reactive aggression and sleep quality in early adolescence. RESULTS: Findings revealed that (1) Sleep quality was positive longitudinally related to both proactive aggression and reactive aggression; Proactive aggression negatively influenced sleep quality, and reactive aggression did not influence sleep quality longitudinally. (2) The sleep quality of persistent non-aggressors and stopped aggressors was significantly better than that of persistent aggressors and new aggressors. CONCLUSION: In early adolescence, proactive aggression was mutually related to sleep quality. Therefore, future research should focus on the bidirectional association between aggression and sleep quality. In addition, we should improve the sleep quality for different types of aggressors and transformers, especially for new aggressors.

The role of family and peer factors in the development of early adolescent depressive symptoms: A latent class growth analysis.

Few studies have explored the trajectories of Chinese early adolescent depressive symptoms or comprehensively considered the factors of family and peers. The present study aimed to identify the trajectories of depressive symptoms in early adolescence using a school-based sample assessed in three waves. The study also examined whether family and peer factors were significant predictors. A total of 586 Chinese primary and middle school students participated in the survey. A growth mixture model was used to find the trajectories of depressive symptoms, and multinominal logistic regression was used to identify the predictors. Three trajectories were identified, including a stable-low class, an increasing class, and a high-decreasing class. Results indicated that gender, parental psychological aggression and neglect, parental psychological control, traditional bullying/cyberbullying victimization, and friendship quality were significant predictors. However, witnessing intimate partner violence, parental behavior control, and traditional bullying/cyberbullying perpetration could not significantly predict the trajectories. The findings of this study can provide an empirical basis for teachers and clinical interveners to determine different development trajectories of depressive symptoms and carry out prevention and intervention.

Moderated Mediating Mechanism Effects of Chinese University Entrepreneurship Education on Independent Student Entrepreneurship.

Entrepreneurship education plays a mediating moderating role in independent entrepreneurship, especially for the fresh graduates where entrepreneurial knowledge charms. Based on the mediating effect model, this study explores the correlation between three factors and independent entrepreneurship. A set of hypotheses was established by investigating the theoretical background within the field of interest. Such hypotheses were later assessed by an online-offline mix study conducted among graduates. The result found that entrepreneurship theory-based courses can promote independent entrepreneurship, but entrepreneurship practice training surprisingly failed to promote. Entrepreneurial opportunity identification mediated only between theory-based courses and independent entrepreneurship. The findings found could be highly beneficial in organizing entrepreneurship syllabus, scientifically arranging a theory-based course, and practicing a training course. Moreover, it could be further developed into a pedagogical model.

The relationship between depression and social avoidance of college students: A moderated mediation model.

BACKGROUND: The fact that depression and anxiety are highly prevalent and often co-occur has been well documented. The present study hypothesized that loneliness and interpersonal trust mediate the relationship between depression and social anxiety, with self-esteem playing a moderating role. METHODS: 1021 college students completed the interpersonal trust scale (ITS), self-rating depression scale (SDS), UCLA loneliness scale, self-esteem scale (SES), and social avoidance and distress (SAD) scale. And descriptive statistical analysis and correlation analysis, structural equation model analysis were conducted. RESULTS: 1) The correlations between depression, loneliness, interpersonal trust, self-esteem and social avoidance were all statistically significant. 2) Loneliness and interpersonal trust mediated the relationship between depression and social avoidance. 3) Self-esteem moderated the relationship between interpersonal trust and social avoidance. Specifically, compared with individuals who had high self-esteem, social avoidance in those with low self-esteem individuals was more susceptible to the effects of interpersonal trust. LIMITATIONS: First, the questionnaire data may be influenced by social approval. Second, most of the participants were college students. Finally, the causal relationship between the variables could not be inferred. CONCLUSIONS: The results indicated that loneliness and interpersonal trust played mediating roles between depression and social avoidance, and the relationship between interpersonal trust and social avoidance was moderated by self-esteem. It provides a new way to explain the mechanism of depression, and a new perspective for the clinical intervention of depression, that is, from the perspective of their self-experience and self-esteem.

Longitudinal relationships among perceived stress, suicidal ideation and sleep quality in Chinese undergraduates: A cross-lagged model.

BACKGROUND: Sleep quality is an important indicator of quality of life. It is of importance to investigate the risk factors and potential consequences of poor sleep quality, such as perceived stress and suicidal ideation. We therefore investigated the longitudinal and reciprocal relationships among perceived stress, suicidal ideation, and sleep quality. METHODS: A three-wave longitudinal survey was conducted from June 2019 to June 2020 at six-month intervals in undergraduate students (N = 197, 58.9% female) in China. The participants completed self-report questionnaires in classroom settings. RESULTS: While the levels of perceived stress were stable, levels of suicidal ideation and sleep quality fluctuated significantly over time. There were significant reciprocal relationships between perceived stress and suicidal ideation from T1 to T3. In addition, the reciprocal relationships between suicidal ideation and sleep quality from T1 to T2 were also significant. Suicidal ideation at T2 partially mediated the relationship between perceived stress at T1 and sleep quality at T3 (indirect effect: ß=0.06, 95% CI: 0.04 to 0.10, p<0.001), and suicidal ideation at T2 fully mediated the relationship between sleep quality at T1 and perceived stress at T3 (indirect effect: ß=0.48, 95% CI: 0.30, 0.70, p<0.001). LIMITATIONS: The subjects' educational background is single, and the measurement method is self-report measures. CONCLUSIONS: Suicidal ideation may play a significant role in explaining the longitudinal relationships between perceived stress and sleep quality. And suggest the importance of early identification and treatment of suicidal ideation among Chinese undergraduates.

Longitudinal Effects of Stressful Life Events on Problematic Smartphone Use and the Mediating Roles of Mental Health Problems in Chinese Undergraduate Students.

Background and Aims: This three-wave longitudinal study investigated the effects of stressful life events on problematic smartphone use and the mediating roles of mental health problems (i.e., depressive symptoms, poor sleep quality, and suicidal ideation) in Chinese undergraduate students. Methods: A total of 197 undergraduate students completed the three-wave surveys. Their severity of stressful life events, mental health problems, and problematic smartphone use were assessed. Results: Regression analyses revealed that stressful life events at T1 was significantly associated with problematic smartphone use at T3. Mediation analyses showed that mental health problems (i.e., depressive symptoms, poor sleep quality, and suicidal ideation) at T2 fully mediated the association between stressful life events at T1 and problematic smartphone use at T3 (B = 0.042, 0.034, and 0.022, respectively). Conclusions: The present study revealed that stressful life events and mental health problems (i.e., depressive symptoms, poor sleep quality, and suicidal ideation) are predictors of problematic smartphone use in Chinese college students.

How Entrepreneurship Education at Universities Influences Entrepreneurial Intention: Mediating Effect Based on Entrepreneurial Competence.

Research shows that entrepreneurial activities significantly promote economic development, which enhances the importance of the innovative entrepreneurial potential of college students. This study analyzes the effect of entrepreneurship education on entrepreneurial intention from the perspective of planned behavior theory. By examining the significant role of entrepreneurship education at colleges and universities on economic and social development, we established a conceptual model. To understand the relationship between entrepreneurship education and entrepreneurial intention, the hypotheses propose the intermediary role of entrepreneurial ability, and the study provides evidence from China the relationship between entrepreneurship education and entrepreneurial intention. Improving entrepreneurial intention and encouraging college students to establish businesses through entrepreneurship education in universities is crucial. This study proposes a hypothetical model of the relationship between entrepreneurial competence and entrepreneurial intention in entrepreneurship education at universities. Using a questionnaire survey of college students with practical experience in the Yangtze River Delta of China, the bootstrap method in the SPSS macro program process software verifies the hypotheses. The results show that entrepreneurial teaching, business plan competition, and entrepreneurial practice support positively affect entrepreneurial competence. In addition, entrepreneurial competence plays an intermediary role in the relationship between entrepreneurial teaching, business plan competition, entrepreneurship practice support, and entrepreneurial intention. Entrepreneurship education improves the ability to establish a business in the present and in entrepreneurial activities in the future. Entrepreneurial competence obtained through entrepreneurship education continuously affects entrepreneurial intention.

Effects of Online Social Support and Perceived Social Support on the Relationship Between Perceived Stress and Problematic Smartphone Usage Among Chinese Undergraduates.

PURPOSE: Recent research has identified a relationship between perceived stress and problematic smartphone usage. However, little is known about the underlying mediating and moderating mechanisms. The present study aimed to test the relationship between perceived stress and problematic smartphone usage as well as the mediating role of online social support and the moderating role of perceived social support among Chinese undergraduates. PATIENTS AND METHODS: A sample of 1123 college students participated in the study. The Perceived Stress Scale, Mobile Phone Addiction Index Scale, Online Social Support Questionnaire, and Perceived Social Support Scale were used. RESULTS: Perceived stress was significantly and positively associated with problematic smartphone usage, and online social support partially mediated the relationship between perceived stress and problematic smartphone usage. Moderated mediation analysis suggested that perceived social support moderated the association between perceived stress and online social support. This relationship became stronger for college students with lower levels of perceived social support. CONCLUSION: The results of this study can contribute to a better understanding of how perceived stress increases the risk of problematic smartphone usage. The importance of reducing online social support and enhancing perceived social support in preventing undergraduates' problematic smartphone usage is highlighted. The findings should be taken with caution given the convenience sampling and cross-sectional study design.

Effect of public hospital managers' risk and gain perception on their attitude towards physician dual practice: a cross-national study in 31 provinces of China.

BACKGROUND: This study aims to explore the effect of public hospital managers' risk and gain perception on their attitude towards physician dual practice (PDP). METHODS: A cross-sectional study enrolling 1513 managers from public hospitals in the East, Middle and West of China was conducted. Generalized linear mixed models (GLMM) were used to identify the determinants of managers' support for PDP. RESULTS: The rate of managers' support for allowing PDP or implementing PDP with restriction, was 94.3% (95% CI: 0.93, 0.95). The mean score of managers' risk perception was 67.7 ± 14.46, and the mean score of managers' gain perception was 24.0 ± 5.56. After controlling for individual and institutional characteristics, the GLMM presented the score for risk perception increased 1 score and the rate of managers' support for PDP decreased by 5% (OR = 0.95, 95% CI: 0.93, 0.97); while the score for gain perception increased 1 score and the rate of managers' support increased by 18% (OR = 1.18, 95% CI: 1.12, 1.24). CONCLUSIONS: Our data demonstrate that the majority of Chinese public hospital managers are in favor of allowing or implementing PDP with restrictions. Although gain perception is comparatively weaker than risk perception, a stronger influence in determining public hospital managers' support for PDP is demonstrated.

Quality Evaluation of Entrepreneurship Education in Chinese Medical Colleges-From the Perspective of Student Cognition.

The evaluation of the effectiveness of entrepreneurship education has become a key issue in improving the quality of entrepreneurship education. The quality of entrepreneurship education was empirically analyzed through a questionnaire survey conducted within 70 medical colleges and universities in China and 16,660 valid questionnaires were obtained. The datasets were processed with a classic analysis tool, SPSS. Several findings were revealed by the research. The popularity of entrepreneurship courses in China's medical schools was low, due to reasons such as: the obvious characteristics of fragmentation in curriculum design the entrepreneurship practice for medical students being far from open and not effectively integrated with the market trend; the current policies in China not providing additional support for medical entrepreneurship and the lack of funds, which is the main obstacle for medical students who owned start-ups; and the teacher-student collaboration not being an important enough vessel to improve the quality of entrepreneurship education. It is recognized in this paper that, in the future, medical schools in China should build an individualized and diversified medical entrepreneurship education curriculum system, strengthen the openness of medical students' entrepreneurship practice, build a multi-channel financial support platform, and create a major-innovation integration mechanism.