Resilience provides mediating effect of resilience between fear of progression and sleep quality in patients with hematological malignancies

BACKGROUND Hematological tumors are common malignant tumors,with high morbidity and mortality rates.Most patients with hematological malignancies develop sleep disorders that seriously affect their life and health because of acute onset of disease,rapid progression,high recurrence rates,complex treatment methods,and treatment costs.AIM To explore the mediating effect of resilience on fear of disease progression and sleep quality in patients with hematological malignancies.METHODS A cross-sectional analysis of 100 patients with hematological malignancies,treated in the First Affiliated Hospital of Jinzhou Medical University between August 2022 and August 2023,was conducted.Patients were assessed using a general data survey,a simplified scale for the fear of progression(FoP)of disease,a resilience scale,and the Pittsburgh Sleep Quality Index.Statistical analysis was conducted to determine the relationship between various patient characteristics and FoP,resilience,and sleep quality.Spearman’s correlation analysis was used to examine the correlations between mental resilience,FoP,and sleep quality.RESULTS The total FoP score mean value in patients with hematological malignancies was 38.09±5.16;the total resilience score mean value was 40.73±7.04;and the Pittsburgh Sleep Quality Index score mean value was 10.72±1.90.FoP,resilience,and sleep quality of the patients were associated with family per capita monthly income and patient education level(P<0.05).Spearman correlation analysis revealed that FoP was negatively correlated with resilience and sleep quality scores(r=-0.560,-0.537,P<0.01),respectively,and resilience was significantly associated with sleep quality scores(r=0.688,P<0.01).Mediation analysis showed that the mediating effect of resilience between FoP and sleep quality in patients with hematological malignancies was-0.100 and accounted for 50.51%of the total effect.This indicated that FoP directly and indirectly affected sleep quality through the mesomeric effect of resilience.CONCLUSION Resilience is an intermediary variable between FoP and sleep quality in patients with hematological malignancies.Medical staff should evaluate and follow-up FoP and resilience to implement measures to improve sleep quality.

Intrinsic and Extrinsic Value for English Learning: Mediation Effects of SelfEfficacy in Chinese EFL Context

The present study examined how students＇ intrinsic and extrinsic value promotes their foreign language proficiency via the mediation effect of self-efficacy beliefs. A total of 1,036 Chinese eighth graders answered an English proficiency test and questionnaires assessing motivational beliefs. Structural equation modelling results with bootstrapping procedures revealed that intrinsic value can directly and indirectly influence foreign language proficiency via partial mediation effect of self-efficacy while extrinsic value can only directly influence foreign language proficiency with a small magnitude. Moreover, there is no gender difference in the mediation model. Our findings suggested that intrinsic value can help students improve foreign language proficiency by improving their self-efficacy beliefs. The findings contribute to the documents of self-determination theory and hold substantive theoretical and practical implications for foreign language teachers.

Mediating effect of mindfulness level on the relationship between marital quality and postpartum depression among primiparas

BACKGROUND Postpartum depression refers to a depressive episode or depressive symptoms up to 12 mo after delivery.Trait mindfulness has presented a protective factor for postpartum depressive symptoms and proved efficient in improving relationship satisfaction among couples.AIM To investigate the correlations among mindfulness,marital quality,anxiety,and depression in a large city in western China during the post-corona virus infectious disease-2019 era and determine whether trait mindfulness mediates the relationship between marital quality and postpartum anxiety and depression among primiparas.METHODS A cross-sectional study was conducted.The self-administered questionnaire was submitted online through smartphones.The levels of mindfulness,anxiety,depression,and marital quality were respectively investigated by the mindful attention awareness scale(MAAS),the self-rating anxiety scale(SAS),the selfrating depression scale(SDS),and the marriage perception scale(MPS)in these enrolled Han and Tujia primiparas.RESULTS No statistical significance was observed in the prevalence of postpartum anxiety and depression,nor scores of MAAS and MPS-Total in different regions or ethnicities(P>0.05).However,MPSMarital interaction(P<0.05),MPS-Family relationship(MPS-FR)(P<0.01),and MPS-Marital conflict(MPS-MC)(P<0.01)scores of urban primiparas were higher than those of rural primiparas.The MPS-MC score of Han primiparas was higher than that of Tujia primiparas(P<0.05).Negative correlations were observed between MAAS and SAS(r=-0.457,P<0.01),and MAAS and SDS(r=-0.439,P<0.01).SAS has revealed a highly positive correlation with SDS(r=0.720,P<0.01)and a weak negative correlation with MPS(r=-0.200,P<0.05).Besides,a weak negative correlation was observed between MAAS and MPS-MC(r=-0.184,P<0.05),and a weak positive correlation was noticed between SAS and MPS-MC(r=-0.225,P<0.01).Mediation analysis demonstrated a full mediation effect of mindfulness level on the relationship between MPS-FR and postpartum anxiety(P<0.05,95%CI:-0.384 to 0.033),MPS-MC and postpartum anxiety(P<0.01,95%CI:0.027-0.193),MPS-FR and postpartum depression(P<0.05,95%CI:-0.365 to 0.031),and MPS-MC and postpartum depression(P<0.01,95%CI:0.022-0.206).CONCLUSION Mindfulness demonstrates negative correlations with marital conflict,postpartum anxiety and depression,and it may have cross-ethnic and trans-regional characteristics.Although the mindfulness levels have revealed no significant mediating effect between the total score of marital quality and postpartum depression in this study,it demonstrates a full mediation effect on the relationships between family relationships,marital conflict,and postpartum anxiety and depression.

Mechanisms Influencing Learning Gains Under Information Security: Structural Equation Modeling with Mediating Effect

With the expanding enrollments in higher education,the quality of col-lege education and the learning gains of students have attracted much attention.It is important to study the influencing factors and mechanisms of individual stu-dents’acquisition of learning gains to improve the quality of talent cultivation in colleges.However,in the context of information security,the original data of learning situation surveys in various universities involve the security of educa-tional evaluation data and daily privacy of teachers and students.To protect the original data,data feature mining and correlation analyses were performed at the model level.This study selected 12,181 pieces of data from X University,which participated in the Chinese College Student Survey(CCSS)from 2018 to 2021.A confirmatory factor analysis was conducted and a structural equation modeling was conducted using AMOS 24.0.Through hypothesis testing,this study explored the mechanisms that influence learning gains from the per-spectives of student involvement,teacher involvement,and school support.The results indicated that the quality of student involvement has an important mediat-ing effect on learning gains and that a supportive campus environment has the greatest influence on learning gains.Establishing positive emotional communica-tions between teachers and students is a more direct and effective method than improving the teaching level to improve the quality of student involvement.This study discusses the implications of these results on the research and practice of connotative development in higher education.

Influence of resilience on depression among nurses in clean operating departments:The mediating effect of life satisfaction

BACKGROUND A clean operating room is an important part of surgical and critical treatment in hospitals.The workload is substantial,the pace is rapid,and the working environment is intense;therefore,nurses who work in clean operating rooms are constantly challenged,which can lead to anxiety,depression,and other mental health issues.Life satisfaction and resilience are important factors that ensure mental health.Therefore,exploring the mediating role of life satisfaction in the influence of resilience on depression among nurses in clean operating rooms can help improve nursing services and teamwork.AIM To explore the mediating effect of satisfaction on the influence of resilience on depression among nurses in a clean operating department.METHODS From April to November 2022,196 nurses from the Department of Clean Operating at Harbin Medical University Cancer Hospital participated in this study.Participants were selected using convenience sampling.Participants’gender,age,marital status,position,length of service,personal monthly income,daily working hours,employment status,and professional title were collected,and the Connor-Davidson resilience scale,satisfaction with life scale,and selfrating depression scale were used to evaluate resilience,life satisfaction,and depression.The researchers conducted professional training in advance,introduced the research methods to the participants before the investigation,and explained the study’s significance and purpose.Surveys were distributed and collected on-site.Each questionnaire took 30 min to complete.RESULTS The average scores for life satisfaction,resilience,and depression were 3.13(±0.28),4.09(±0.78),and 56.21(±8.70),respectively.The correlation between resilience and depression was negative(r=-0.829,P<0.01).Life satisfaction was positively related to resilience(r=0.855,P<0.01)and negatively related to depression(r=-0.778,P<0.01).The relationship between resilience and depression was partially mediated by life satisfaction.The value of the mediating effect was-6.853(26.68%of the total effect).CONCLUSION Life satisfaction partially mediates the link between resilience and depression among nurses in clean operating departments.

The impact of nurses’organizational commitment on their perceptions of the work environment:Strong mediating effect of the psychological contract

Objective:The objective is to assess the direct and indirect effects of nurses’organizational commitment(OC)on their work environment perceptions(WEP)and the role of the psychological contr act(PC).Methods:A cross‑sectional quantitative study of 3047 registered nurses in four Chinese hospitals was conducted.The Essentials of Magnetism II(Chinese version),OC,and PC scales were used in the study,and the structural equation modeling was used to assess the connections among variables.Results:The results showed that OC was positively correlated with WEP(r=0.561,P<0.001),and PC was negatively correlated with the WEP(r=−0.717,P<0.001),and OC(r=−0.739,P<0.001).Nurses’PC played a strong mediating role between OC and WEP,accounting for 87.64%of the total effect.Besides,PC played an important role in creating a healthy work environment.Conclusions:The exploration of the relationships among WEP,PC,and OC provides new insights for hospital managers to build a better work environment for nurses,which is conducive to maintaining a stable nurse team and providing high‑quality nursing services for patients.

The Mediating Effect of Social Media on the Relationship Between Travel Preference and Tourist Behavior of Local Tourists in Davao City

This paper aims to determine the mediating effect of social media on the relationship between travel behavior and tourist preference.This paper utilized the mediation analysis design to determine whether social media significantly affects the independent and dependent variables.For the statistical tools,the proponents of the study utilized descriptive statistics,Sobel’s test,mean and standard deviation.Also,the proponents of the study utilized data from questionnaires gathered through an online google form.Most of the respondents are single females,college-level,and use Facebook most of the time.Therefore,this is the social media platform that the majority utilize.It has been revealed in the study the three sets of correlated variables:Travel behavior vs.tourist behavior,travel preference vs.social media,and social media vs.tourist behavior,have a strong positive linear relationship between the two quantitative variables.Thus,the study proponents concluded that there is an indirect effect between the travel preference and tourist behavior of local tourists in Davao City via social media.Lastly,the study’s findings reveal the fundamentals of how visitors make decisions,which are essential for enhancing the competitive advantages of cultural destinations.Significant findings from the study are beneficial to the growth of cultural tourism in Davao City.

Electrolyte/Structure‑Dependent Cocktail Mediation Enabling High‑Rate/Low‑Plateau Metal Sulfide Anodes for Sodium Storage

As promising anodes for sodium-ion batteries,metal sulfides ubiquitously suffer from low-rate and high-plateau issues,greatly hindering their application in full-cells.Herein,exemplifying carbon nanotubes(CNTs)-stringed metal sulfides superstructure(CSC)assembled by nano-dispersed SnS_(2) and CoS_(2) phases,cocktail mediation effect similar to that of high-entropy materials is initially studied in ether-based electrolyte to solve the challenges.The high nano-dispersity of metal sulfides in CSC anode underlies the cocktail-like mediation effect,enabling the circumvention of intrinsic drawbacks of different metal sulfides.By utilizing ether-based electrolyte,the reversibility of metal sulfides is greatly improved,sustaining a long-life effectivity of cocktail-like mediation.As such,CSC effectively overcomes low-rate flaw of SnS_(2) and highplateau demerit of CoS_(2),simultaneously realizes a high rate and a low plateau.In half-cells,CSC delivers an ultrahigh-rate capability of 327.6 mAh g^(−1) anode at 20 A g^(−1),far outperforming those of monometallic sulfides(SnS_(2),CoS_(2))and their mixtures.Compared with CoS_(2) phase and SnS_(2)/CoS_(2) mixture,CSC shows remarkably lowered average charge voltage up to ca.0.62 V.As-assembled CSC//Na1.5VPO4.8F0.7 full-cell shows a good rate capability(0.05~1.0 A g^(−1),120.3 mAh g^(−1) electrode at 0.05 A g^(−1))and a high average discharge voltage up to 2.57 V,comparable to full-cells with alloy-type anodes.Kinetics analysis verifies that the cocktail-like mediation effect largely boosts the charge transfer and ionic diffusion in CSC,compared with single phase and mixed phases.Further mechanism study reveals that alternative and complementary electrochemical processes between nano-dispersed SnS_(2) and CoS_(2) phases are responsible for the lowered charge voltage of CSC.This electrolyte/structure-dependent cocktail-like mediation effect effectively enhances the practicability of metal sulfide anodes,which will boost the development of high-rate/-voltage sodium-ion full batteries.

Do companies influenced by smart cities pay more attention to green governance?Mechanism and optimal spatial correlation

Smart cities are a way for China to construct an innovative and environmentally conscious nation.The paper examines the impact of smart cities on corporate green governance and provides a theoretical foundation for formulating and executing smart city policy in China.Based on panel data from Chinese A-share listed companies in Shanghai and Shenzhen from 2008 to 2020,this study constructs a multiperiod double-difference model to examine the influence of smart cities on corporate green governance.Additionally,it uses a spatial double-difference model to investigate the spatial spillover effect of smart cities on neighboring areas.The findings indicate that smart cities effectively enhance corporate green governance.Analyzing the influencing mechanisms reveals that resource allocation efficiency,technological innovation,management environmental awareness,and regional environmental enforcement efforts act as mediators.Furthermore,the study reveals that the impact of smart cities on promoting corporate green governance is more pronounced in regions with lower levels of marketization and resource-based cities.Moreover,the research explores the spatial spillover effects of smart cities,with an effective radius of approximately 350 km.The optimal spatial correlation zone for green governance of businesses in neighboring areas in relation to smart cities is within a range of 250-350 km.This is manifested by the significant promotion of green governance in neighboring area businesses facilitated by smart cities.

Transformation power or development pressure:economic growth targets and urban carbon productivity

Maintaining moderate economic growth targets(EGTs)is the key for local governments to effectively implement the“carbon peak and carbon neutrality”goals under the refreshed development pattern.Utilizing panel data of 276 prefecture-level cities in China's Mainland from 2010 to 2020,and employing methods such as intermediary and threshold models,this study empirically analyzes the internal mechanism of EGT’s impact on urban carbon productivity(UCP).Our findings demonstrate that:①The overall EGT during the analyzed period is not conducive to improving UCP.This conclusion remains valid after a series of robustness tests.This effect is more pronounced in the central region and resource-based cities than in the east-west region and non resource-based cities.②EGT not only directly suppresses UCP but also exerts indirect negative impacts on UCP from three aspects:delaying the digital economy(DE),constraining financial expansion(FE),and hindering green technology innovation(GTI).This negative indirect effect is similar to or even surpasses the direct effect,suggesting that the internal relationship between EGT and“dual-carbon”goals should be re-evaluated from a new compound perspective.③EGT not only has a simple linear impact on UCP but also significantly exhibits a dynamic evolution pattern in inverted“U”shape.That is,as EGT continuously upgrades,a nonlinear impact on UCP emerges in the form of“promoting first,suppressing later”.This indicates that surpassing the“degree”limit for EGT will be detrimental to the improvement of UCP.This study broadens the scope of carbon productivity analysis by introducing a new perspective centered on EGT.The insights gleaned from this research offer valuable guidance for local governments to effectively manage economic growth expectations and promote the synchronized achievement of dual-carbon objectives.

Mediating role of social support in dysphoria,despondency,and quality of life in patients undergoing maintenance hemodialysis

BACKGROUND Dysphoria and despondency are prevalent psychological issues in patients undergoing Maintenance Hemodialysis(MHD)that significantly affect their quality of life(QOL).High levels of social support can significantly improve the physical and mental well-being of patients undergoing MHD.Currently,there is limited research on how social support mediates the relationship between dysphoria,despondency,and overall QOL in patients undergoing MHD.It is imperative to investigate this mediating effect to mitigate dysphoria and despondency in patients undergoing MHD,ultimately enhancing their overall QOL.AIM To investigate the mediating role of social support in relationships between dysphoria,despondency,and QOL among patients undergoing MHD.METHODS Participants comprised 289 patients undergoing MHD,who were selected using a random sampling approach.The Social Support Rating Scale,Self-Rating Anxiety Scale,Self-Rating Depression Scale,and QOL Scale were administered.Correlation analysis was performed to examine the associations between social support,dysphoria,despondency,and QOL in patients undergoing MHD.To assess the mediating impact of social support on dysphoria,despondency,and QOL in patients undergoing MHD,a bootstrap method was applied.RESULTS Significant correlations among social support,dysphoria,despondency,and quality in patients undergoing MHD were observed(all P<0.01).Dysphoria and despondency negatively correlated with social support and QOL(P<0.01).Dysphoria and despondency had negative predictive impacts on the QOL of patients undergoing MHD(P<0.05).The direct effect of dysphoria on QOL was statistically significant(P<0.05).Social support mediated the relationship between dysphoria and QOL,and this mediating effect was significant(P<0.05).Similarly,the direct effect of despondency on QOL was significant(P<0.05).Moreover,social support played a mediating role between despondency and QOL,with a significant mediating effect(P<0.05).CONCLUSION These findings suggest that social support plays a significant mediating role in the relationship between dysphoria,despondency,and QOL in patients undergoing MHD.

The Relationship between Overparenting and Adolescent Anxiety:The Mediating Role of Cognitive Avoidance

Background:Adolescent anxiety has a significant impact on physical and mental health,and overparenting is recognized as one of the major factors affecting adolescent anxiety.The objective of this study was to investigate the relationship between overparenting and adolescent anxiety,while also examining the mediating role of cognitive avoidance.Methods:Data were collected through a cross-sectional survey with 1931 valid responses using the Overparenting Scale,the Cognitive Avoidance Scale,and the Anxiety Self-Rating Scale.A structural equation modelling approach was used to test the mediating role of cognitive avoidance between overparenting and adolescent anxiety and to reveal the underlying mechanisms.The significance of the mediating effect was assessed based on maximum likelihood estimation.Differences in the mediating role of cognitive avoidance in the male and female samples were comparatively analyzed in the mediation effect analysis.Results:The study’s findings reveal a significant positive correlation between overparenting and adolescent anxiety(p<0.01),between overparenting and cognitive avoidance(p<0.01),and between cognitive avoidance and adolescent anxiety(p<0.01).Cognitive avoidance mediated the relationship between overparenting and adolescent anxiety.Overparenting can not only directly predict adolescent anxiety but also indirectly predict it through the mediating role of cognitive avoidance.Conclusion:This study validates the direct effect of overparenting on adolescent anxiety and reveals the mechanism of cognitive avoidance as a mediator.

Differentiated Paths of Regional Green Development Driven by Industrial Enterprise Innovation

A fundamental shift in the regional development pattern is crucial to achieving a comprehensive green transformation in China.Currently,innovation-driven green development is a significant strategic option for regional development.As the main body of innovation and the basic unit of regional composition,enterprises have a profound impact on the development of regional economy,society,ecology,and other aspects.However,considering China’s vast territory and significant regional differences in natural environment and industrial structure,it’s necessary to further explore the specific impact paths of regional green development driven by enterprise innovation.Therefore,taking industrial enterprises as an example,based on the panel data of 30 provinces in China from 2016 to 2020,this study verifies the impact of industrial enterprise innovation on the regional green development level by constructing a parallel multiple mediating effect model and dividing the economy into eastern,central,and western regions to discuss the specific impact paths.The results show that industrial enterprise innovation has a significant positive effect on regional green development level,via different influencing paths in each region:(1)The eastern region improves the regional green development level by narrowing the urban-rural income gap;(2)The central region improves the regional green development level by reducing resource dependence;and(3)The western region raises the regional green development level by improving the rationalization of industrial structure.

Immediate effects of scalp acupuncture with twirling reinforcing manipulation on hemiplegia following acute ischemic stroke: a hidden association study

Data mining has the potential to provide information for improving clinical acupuncture strategies by uncovering hidden rules between acupuncture manipulation and therapeutic effects in a data set. In this study, we performed acupuncture on 30 patients with hemiplegia due to acute ischemic stroke. All participants were pre-screened to ensure that they exhibited immediate responses to acupuncture. We used a twirling reinforcing acupuncture manipulation at the specific lines between the bilateral Baihui（GV20） and Taiyang（EX-HN5）. We collected neurologic deficit score, simplified Fugl-Meyer assessment score, muscle strength of the proximal and distal hemiplegic limbs, ratio of the maximal H-reflex to the maximal M-wave（Hmax/Mmax）, muscle tension at baseline and immediately after treatment, and the syndromes of traditional Chinese medicine at baseline. We then conducted data mining using an association algorithm and an artificial neural network backpropagation algorithm. We found that the twirling reinforcing manipulation had no obvious therapeutic difference in traditional Chinese medicine syndromes of ＂Deficiency and Excess＂. The change in the muscle strength of the upper distal and lower proximal limbs was one of the main factors affecting the immediate change in Fugl-Meyer scores. Additionally, we found a positive correlation between the muscle tension change of the upper limb and Hmax/Mmax immediate change, and both positive and negative correlations existed between the muscle tension change of the lower limb and immediate Hmax/Mmax change. Additionally, when the difference value of muscle tension for the upper and lower limbs was 〉 0 or 〈 0, the difference value of Hmax/Mmax was correspondingly positive or negative, indicating the scalp acupuncture has a bidirectional effect on muscle tension in hemiplegic limbs. Therefore, acupuncture with twirling reinforcing manipulation has distinct effects on acute ischemic stroke patients with different symptoms or stages of disease. Improved muscle tension in the upper and lower limbs, reflected by the variation in the Hmax/Mmax ratio, is crucial for recovery of motor function from hemiplegia.

Mediating effect of self-efficacy in relationship between emotional intelligence and clinical communication competency of nurses

Objective:This study investigates the emotional intelligence(EI),self-efficacy,and clinical communication ability of clinical nurses to explore the correlation among these three variables,and verify the mediating effect of self-efficacy on relationship between EI and communication skills.Methods:A total of 865 nurses were recruited and investigated using Wong and Law's Emotional Intelligence Scale,General Self-Efficacy Scale,and nurse clinical communication scale.Results:The scores for EI and self-efficacy of nurses were 14.23±2.61 and 25.36±5.67,respectively,which were lower than the international norm(p<0.01).The score for clinical communication ability of nurses was 4.14±0.53.The clinical communication competency of nurses was positively correlated with EI and general self-efficacy.Furthermore,selfefficacy played an intermediary role between EI and clinical communication commitment.Conclusion:Nursing administrators can improve the clinical communication ability of nurses by enhancing their self-efficacy and EI.

Effects of investor sentiment on stock volatility:new evidences from multi-source data in China’s green stock markets

The effect of investor sentiment on stock volatility is a highly attractive research question in both the academic field and the real financial industry.With the proposal of China’s"dual carbon"target,green stocks have gradually become an essential branch of Chinese stock markets.Focusing on 106 stocks from the new energy,environmental protection,and carbon–neutral sectors,we construct two investor sentiment proxies using Internet text and stock trading data,respectively.The Internet sentiment is based on posts from Eastmoney Guba,and the trading sentiment comes from a variety of trading indicators.In addition,we divide the realized volatility into continuous and jump parts,and then investigate the effects of investor sentiment on different types of volatilities.Our empirical findings show that both sentiment indices impose significant positive impacts on realized,continuous,and jump volatilities,where trading sentiment is the main factor.We further explore the mediating effect of information asymmetry,measured by the volume-synchronized probability of informed trading(VPIN),on the path of investor sentiment affecting stock volatility.It is evidenced that investor sentiments are positively correlated with the VPIN,and they can affect volatilities through the VPIN.We then divide the total sample around the coronavirus disease 2019(COVID-19)pandemic.The empirical results reveal that the market volatility after the COVID-19 pandemic is more susceptible to investor sentiments,especially to Internet sentiment.Our study is of great significance for maintaining the stability of green stock markets and reducing market volatility.

Glycosylation-independent binding to extracellular domains 11-13 of mannose-6-phosphate/insulin-like growth factor-2 receptor mediates the effects of soluble CREG on the phenotypic proliferation of vascular smooth muscle cells

Background The present study aimed to investigate the detailed mode and specific sites for their binding as well as the functional relevance of this binding in the phenotypic proliferation of vascular smooth muscle cells(SMCs). Methods CREG knocked-down SMCs were employed to evaluate the biological activity of wtCREG and mCREG.Expressions of SMC differentiation markers SM myosin heavy chain(SM-MHC),SM-actin,heavy caldesmon and myocardin were determined by Western blotting using specific antibodies. Cellular growth of SMCs was assessed by bromide dewuridine (BrdU) incorporation and cell cycle analysis on fluorescence-activated cell sorting(FACS).A solid-phase binding assay was used to study the binding of CREG to extracellular domains of M6P/IGF2R.The cellular co-localization of the two recombinant CREGs with M6P/IGF2R was detected on SMC surface by immunoprecipitation and immunofluorescence analysis.Results The molecular weight of wtCREG was around 30 kD while that of the mCREG was～25 kD.Treatment of wtCREG with PNGase F reduced its molecular weight from～30 kD to～25 kD,whereas PNGase F treatment had no effect on the molecular weight of mCREG.Both wtCREG and mCREG proteins enhanced SMC differentiation,inhibited BrdU incorporation,and arrested cell cycle progression when added to the culture medium.In CREG knocked-down SMCs,the amount of CREG detected by immunoblotting in M6P/IGF2R immunoprecipitates was significantly reduced when compared to normal cells.Both recombinant CREGs co-immunoprecipitated with M6P/IGF2R, although slightly reduced amount of the mutant CREG was detected in M6P/IGF2R immunoprecipitates.Immunostaining revealed that His-tagged CREGs co-localized with IGF2R on the cell surface in a glycosylation-independent manner.In vitro binding assay showed that CREGs bound to M6P/ IGF2R extracellular domains 7-10 and 11-13 in a glycosylation -dependent and -independent manner,respectively.Further blocking experiments using soluble M6P/IGF2R fragments and M6P/IGF2R neutralizing antibody indicated that the biological activities of recombinant CREGs in SMC growth and the up-regulation of SMC differentiation markers were all abolished by treatment with the M6P/IGF2R neutralizing antibody. However,although the growth inhibitory effect of wtCREG was nearly abolished by D7-10 or D11-13,the effect of mCREG was only reversed by Dll-13,indicating that the binding to domains 11-13 is required for CREG to modulate the proliferation of SMCs.Conclusions These data suggest that solubleCREG proteins can exert their biological function via binding to the extracellular domains 7-10 and 11-13 of cell surface M6P/IGF2R in both a glycosylation-dependent and -independent manner.

Mediating effect of undergraduate nursing students’ professional commitment on positive psychological capital and learning burnout

Objective:The objective of this study is to explore the mediating role of professional commitment of undergraduate nursing students between positive psychological capital(PsyCap)and learning burnout.Materials and Methods:A cluster sampling method was used to survey 442 students of a bachelor’s degree in freshman to the junior in a medical college in Shaanxi Province.Results:Professional commitment was positively related to positive PsyCap(=0.487,P<0.01),while positive PsyCap and professional commitment were negatively related to learning burnout(r=−0.456,r=−0.411,P all<0.01).There are certain mediating effects of professional commitment in the relationship between positive PsyCap and learning burnout.The mediating effect value of professional commitment is−0.065,accounting for 16.08%of the total effect.Conclusion:Nursing educators in medical colleges and universities should focus on developing and training the positive PsyCap of undergraduate nursing students,thereby enhancing and stabilizing their professional commitment level and reducing the risk of learning burnout.

The relationship between diabetes‑related distress and self‑management in empty‑nest elderly patients with type 2 diabetes mellitus:The mediating effect of self‑efficacy

Objective:The aim of this study is to investigate the mediating effect of self‑efficacy between diabetes‑related distress and self‑management in empty‑nest elderly patients with type 2 diabetes mellitus(T2DM).Methods:A total of 347 empty‑nest elderly patients with T2DM from Jiangsu Province Hospital of Chinese Medicine and Affiliated Hospital of Yangzhou University were investigated by a self‑designed General Information Questionnaire,the Self‑efficacy for diabetes,the Diabetes Distress Scale,and the summary of diabetes self‑care activities.Diabetes‑related distress and diabetes self‑management were tested for correlation analysis with self‑efficacy.Meditational analyses were conducted to test the hypothesized mediating effects of diabetes self‑efficacy as an intervention variable between diabetes distress and self‑management.Results:About 68.59%of patients suffered from diabetes‑related distress.The results of bivariate correlations revealed that self‑efficacy was negatively correlated with diabetes‑related distress(r=–0.627,P<0.01)and positively correlated with self‑management(r=0.356,P<0.01).The relationship effects of diabetes distress on self‑management were fully mediated by self‑efficacy.Conclusions:Diabetes‑related distress prevails in empty‑nest elderly patients with T2DM.Self‑efficacy plays a mediate role between diabetes‑related distress and self‑management.Psychological intervention is contributed to reducing diabetes‑related distress.

Community Workers’Social Support and Sleep Quality during the Coronavirus Disease 2019(COVID-19):A Moderated Mediation Model

To explore the relationship between social support and sleep quality of community workers in Wuhan during the coronavirus disease 2019(the COVID-19 infection epidemic),this research constructed a mediating effect model to explore the mediating psychological mechanism of social support influencing sleep quality of front-line community workers.A total of 500 front-line community workers in Wuhan were investigated.We used the perceived social support scale(PSSS),the Connor-Davidson Resilience Scale(CD-RISC),the perceived stress scale(PSS),and the Pittsburgh sleep quality index(PSQI)to measure social support,psychological resilience,perceived stress and sleep quality.Specifically,the higher the PSQI,the worse the sleep quality.Pearson correlation structural equation model was used to analyze the relationship between these factors.The results showed that:(1)There was a significant negative correlation between social support,psychological resilience,and perceived stress of community workers and PSQI,that means,the higher the level of social support,psychological resilience,and perceived stress,the higher the sleep quality.(2)Social support positively predicted psychological resilience and perceived stress,and perceived stress negatively predicted PSQI.(3)Social support can affect sleep quality through the mediating role of psychological resilience and perceived stress,and the mediating role includes two paths:the single mediating role of perceived stress and the chain mediating role of psychological resilience-perceived stress.(4)Gender moderates the relation-ship between social support and perceived stress,and the influence of social support on perceived stress of women is higher than that of men.Gender moderates the relationship between psychological resilience and PSQI,and only women’s psychological resilience had a negatively predictive effect on PSQI,while men did not,which means that psychological resilience of female frontline community workers can positively predict sleep quality.This research reveals the relationship between social support and sleep quality and its mechanism and verifies that social support can indirectly affect physical health through psychological resilience and perceived stress.It provides reference suggestions and intervention guidance for improving the sleep quality of community workers.