Predicting Psychological State Among Chinese Undergraduate Students in the COVID-19 Epidemic: A Longitudinal Study Using a Machine Learning.

BACKGROUND: The outbreak of the 2019 novel coronavirus disease (COVID-19) not only caused physical abnormalities, but also caused psychological distress, especially for undergraduate students who are facing the pressure of academic study and work. We aimed to explore the prevalence rate of probable anxiety and probable insomnia and to find the risk factors among a longitudinal study of undergraduate students using the approach of machine learning. METHODS: The baseline data (T1) were collected from freshmen who underwent psychological evaluation at two months after entering the university. At T2 stage (February 10th to 13th, 2020), we used a convenience cluster sampling to assess psychological state (probable anxiety was assessed by general anxiety disorder-7 and probable insomnia was assessed by insomnia severity index-7) based on a web survey. We integrated information attained at T1 stage to predict probable anxiety and probable insomnia at T2 stage using a machine learning algorithm (XGBoost). RESULTS: Finally, we included 2009 students (response rate: 80.36%). The prevalence rate of probable anxiety and probable insomnia was 12.49% and 16.87%, respectively. The XGBoost algorithm predicted 1954 out of 2009 students (translated into 97.3% accuracy) and 1932 out of 2009 students (translated into 96.2% accuracy) who suffered anxiety and insomnia symptoms, respectively. The most relevant variables in predicting probable anxiety included romantic relationship, suicidal ideation, sleep symptoms, and a history of anxiety symptoms. The most relevant variables in predicting probable insomnia included aggression, psychotic experiences, suicidal ideation, and romantic relationship. CONCLUSION: Risks for probable anxiety and probable insomnia among undergraduate students can be identified at an individual level by baseline data. Thus, timely psychological intervention for anxiety and insomnia symptoms among undergraduate students is needed considering the above factors.

Benefits of progesterone on brain immaturity and white matter injury induced by chronic hypoxia in neonatal rats.

OBJECTIVES: This study aims to evaluate the protective effects of progesterone on white matter injury and brain immaturity in neonatal rats with chronic hypoxia. METHODS: Three-day old Sprague-Dawley rats were randomly divided into 3 groups: (1) control (n = 48), rats were exposed to normoxia (fraction of inspired oxygen: 21% ± 0%); (2) chronic hypoxia (n = 48), rats were exposed to hypoxia (fraction of inspired oxygen: 10.5% ± 1.0%); and (3) progesterone (n = 48), rats were exposed to hypoxia and administrated with progesterone (8 mg/kg/d). Hematoxylin-eosin staining, immunohistochemistry, real-time quantitative polymerase chain reaction, and Western blot analyses were compared on postnatal day 14 in different groups. Motor skill and coordination abilities of rats were assessed via rotation experiments. RESULTS: Increased brain weights (P < .05), narrowed ventricular sizes (P < .01), and rotarod experiment scores (P < .01) were better in the progesterone group than in the chronic hypoxia group. The number of mature oligodendrocytes and myelin basic protein expression increased in the progesterone group compared with the chronic hypoxia group (P < .01). The polarization of M1 microglia cells in the corpus callosum of chronic hypoxia-induced hypomyelination rats was significantly increased, whereas there were fewer M2 microglia cells. Conversely, progesterone therapy had an opposite effect and caused an increase in M2 microglia polarization versus a reduction in M1 microglia cells. CONCLUSIONS: Progesterone could prevent white matter injury and improve brain maturation in a neonatal hypoxic rat model; this may be associated with inducing a switch from M1 to M2 in microglia.

Predictive value of preoperative N-terminal pro-brain natriuretic peptide for postoperative early outcomes in infants with aortic coarctation / 中国胸心血管外科临床杂志

@#Objective    To explore the predictive value of N-terminal-pro-brain natriuretic peptide (NT-ProBNP) for postoperative early outcomes in infants with aortic coarctation (CoA). Methods    A retrospective study was conducted in 344 children with CoA admitted to our hospital from September 2014 to October 2017, including 206 males (59.9%) and 138 females (40.1%), with an average age of 0.2-60.0 (7.1±10.6) months. The levels of NT-proBNP, clinical characteristics, imaging data and early follow-up results were collected and analyzed. Results    Compared with the normal NT-proBNP group, there were statistical differences in age, the proportion of RACHS-1≥3, the proportion of preoperative pneumonia and dysplastic aortic arch, preoperative cardiac function, left ventricular wall thickness, left ventricular dilatation, hospital stay, ICU duration, ventilator duration, duration of vasoactive drugs use, delayed chest closure, nasal continuous positive airway pressure (nCPAP), postoperative cardiac insufficiency in the abnormal NT-proBNP group (P<0.05). According to multivariate logistic regression analysis, NT-proBNP level (>3 000 pg/mL) was an independent risk factor for prolonged ICU duration [OR=3.17, 95%CI (1.61, 6.23)], prolonged ventilator duration [OR=5.84, 95%CI (2.86, 11.95)], prolonged use of vasoactive drugs [OR=2.22, 95%CI (1.22, 4.02)], postoperative cardiac insufficiency [OR=3.10, 95%CI (1.64, 5.85)]; NT-proBNP level (> 5 000 pg/mL) was an independent risk factor for delayed chest closure [OR=3.55, 95%CI (1.48, 8.50)]. Conclusion    NT-proBNP level in children with CoA can be affected by  many factors, including age, complexity of congenital heart disease, preoperative cardiac insufficiency, et al. The level of NT-proBNP has predictive value for postoperative early outcomes.

A piglet model of pulmonary vein stenosis / 中国胸心血管外科临床杂志

@#Objective    Pulmonary vein banding was used to establish a piglet model of pulmonary vein stenosis. We investigated the pathomorphological alterations of pulmonary veins in the model and compared it with the vascular tissue of recurrent stenosis after total anomalous pulmonary venous connection (TAPVC). Methods    Ten pigs of 6 weeks old were selected and randomly divided into 2 groups: 5 in a sham operation group and 5 in a pulmonary vein banding group. The operation had two stages, in which thoracotomies through intercostal space were done respectively on both sides. Biocompatible materials were applied around the pulmonary veins in the experimental group. The same method was used in the sham group. But the pulmonary veins were not banded. Six weeks after the operation, the pulmonary veins of the animals were harvested for hematoxylin-eosin staining and immunofluorescence staining to observe the pathological alterations of pulmonary veins. The proliferative tissues of patients with recurrent stenosis after TAPVC repair were collected and observed by hematoxylin-eosin staining and immunofluorescence staining. Results    Both the sham operation group and the pulmonary vein banding group survived. But the pulmonary vein banding group had obvious clinical manifestations of pulmonary venous stenosis. Compared with the sham group, the pulmonary vein banding group showed intimal hyperplasia, decreased expression of endothelial marker and increased expression of mesenchymal markers, and co-expression of endothelial and mesenchymal markers in intimal cells. Human pathology also showed intimal hyperplasia and co-expression of endothelial and mesenchymal markers in intimal cells. Conclusion    The surgical pulmonary vein stenosis in piglets shows intimal hyperplasia and myofibroblasts, which was consistent with clinical pathology.