Schizophrenia is increasingly conceptualized as a disorder of large-scale brain network integration, yet how specific symptom phenotypes relate to reproducible resting-state functional connectivity (rsFC) signatures remains unclear. Resting-state fMRI data from 386 patients with schizophrenia and 212 healthy controls were analyzed to characterize large-scale functional connectivity patterns. Group-level connectivity differences were first identified (uncorrected P < 0.05, for exploratory feature selection), followed by within-patient analyses examining associations between altered connectivity and symptom subitems while adjusting for demographic factors. Multivariate models were then used to evaluate whether connectivity patterns showed systematic associations with individual symptom profiles. Group comparisons revealed a dysconnectivity pattern characterized by reduced cross-network coupling between the visual network and higher-order systems, alongside selective increases in frontoparietal circuits. Within patients, connectivity alterations showed distinct association patterns across delusion, hallucination, and negative-symptom subitems. Multivariate analyses further indicated modest associations with several hallucination (e.g., H8, R²≈0.09) and delusion (e.g., D3, R²≈0.07) subitems, whereas associations with negative symptoms were minimal and showed limited generalization. These findings support a hierarchical dysconnectivity profile centered on impaired perceptual–cognitive integration and suggest that specific positive-symptom phenotypes may be associated with partially consistent rsFC signatures. Overall effect sizes were modest, indicating that rsFC captures only a limited component of symptom variability. Not applicable.

Tardive dyskinesia (TD) may reflect an intrinsic neurobiological vulnerability associated with schizophrenia, yet metabolic alterations in the caudate nucleu, a key brain region regulating involuntary movements-remain poorly characterized by proton magnetic resonance spectroscopy (1 H-MRS). We investigated the relationship between caudate nucleus metabolite concentrations and TD symptoms using 1 H-MRS. We recruited 117 patients with schizophrenia, including 67 patients with TD and 50 patients without TD (NT). We also recruited 41 healthy controls (HCs). Absolute metabolite concentrations of N-acetylaspartate plus N-acetyl-aspartyl-glutamate (tNAA), creatine (Cr) and glutamine plus glutamate (Glx) in the caudate nucleus were quantified using a 3.0-T MRI scanner with water signal referencing. Clinical symptoms were assessed using the Positive and Negative Syndrome Scale (PANSS) and the Abnormal Involuntary Movement Scale (AIMS). Among-group differences were analyzed using analysis of covariance with sex, age and years of education as covariates, followed by Bonferroni correction for multiple comparisons. After correction, the adjusted p-value was 0.017. Regression analysis was performed on metabolic indexes in the TD group with disease duration as a covariate. No significant differences in age, sex, or education level were observed among the groups. Additionally, no significant differences in PANSS scores or antipsychotic medication dosage were observed between the TD and NT groups. The TD group exhibited a significantly longer disease duration than the NT group (p < 0.05). Absolute tNAA levels—a marker of neuronal integrity—were significantly lower in the TD group than in the NT group (p < 0.05), while Cr (involved in energy metabolism) and Glx (involved in excitatory neurotransmission) levels did not significantly differ. These findings suggest reduced neuronal viability in the caudate nucleus in TD, though the clinical implications warrant further investigation.

First-episode schizophrenia (FES) presents with substantial heterogeneity in cognitive performance, yet this variability is frequently overlooked in studies investigating disease pathology and treatment. This study aimed to quantify cognitive heterogeneity across domains and individuals, and to identify distinct cognitive subtypes in FES. We assessed cognitive performance using the MATRICS Consensus Cognitive Battery (MCCB) and clinical symptoms with the Positive and Negative Syndrome Scale (PANSS) in 271 patients with FES and 133 healthy controls (HC). Domain-specific impairment was quantified using Hedges' g, whereas quantile-based analyses were performed to characterize distributional heterogeneity in overall cognitive performance. Gaussian mixture clustering was subsequently applied to identify latent subtypes within FES group. Compared with HC, patients with FES demonstrated significant impairments across all assessed cognitive measures. However, the magnitude of impairment varied across measures, with Attention/Vigilance as the domain with the greatest impairment. Quantile-based analyses demonstrated that the FES-HC difference was significantly greater at the lower than at the upper end of the cognitive distribution, indicating that cognitive impairment was not uniformly distributed across patients. Clustering analysis identified two cognitive subtypes: one subgroup with severe global cognitive deficits and another with relatively preserved cognitive functioning. Crucially, these subtypes also differed significantly in their clinical symptom profiles. In conclusion, specific cognitive impairments may reflect the underlying pathology of early schizophrenia, and individuals can be reliably stratified into distinct cognitive phenotypes. These findings provide critical clinical insights that can directly inform targeted, stratified strategies in early psychosis from a cognitive perspective.

BackgroundHippocampal neurogenesis shapes adaptation and improves responses to stress. Patients with schizophrenia show marked functional impairment and abnormal stress sensitivity. However, it remains unclear how structural abnormalities in specific hippocampal subregions are related to altered perceived stress and clinical symptoms in schizophrenia.MethodsWe recruited 97 first-episode patients with schizophrenia (FEPS) and 47 healthy controls (HC). Perceived stress and psychopathology were assessed using the Perceived Stress Scale (PSS) and the Positive and Negative Syndrome Scale (PANSS), respectively. Structural MRI was acquired on a 3.0-T scanner, and hippocampal subregions were segmented using validated, standardized protocols. Left and right subregional volumes were summed to obtain calculate bilateral volumes.ResultsCompared to HC, the FEPS group showed higher perceived stress, reduced fimbria volumes, and increased hippocampal tail volumes after adjustment for intracranial volume, age, sex, and education. In HC, several hippocampal subregion volumes were positively correlated with stress perception; however, these associations were absent or disrupted in FEPS. In FEPS, stress perception was positively associated with positive and anxiety/depression symptoms. Additionally, specific hippocampal subfield volume was positively associated with negative symptoms.ConclusionsFEPS was characterized by aberrant perceived stress, altered hippocampal subregional volumes, and disrupted links between stress perception and hippocampal structure. The interrelations among stress, clinical symptoms, and hippocampal subfields suggest altered psychological and neurobiological processes underlying stress regulation processes in FEPS.

The recurrence of glioma after treatment has remained an intractable problem for many years. Recently, numerous studies have explored the pivotal role of the mouse double minute 2 (MDM2)/p53 pathway in cancer treatment. Lysine phosphate phosphohistidine inorganic pyrophosphate phosphatase (LHPP), a newly discovered tumor suppressor, has been confirmed in numerous studies on tumors, but its role in glioma remains poorly understood. Expression matrices in The Cancer Genome Atlas (TCGA) and Chinese Glioma Genome Atlas (CGGA) databases were analyzed using gene set enrichment analysis (GSEA), revealing significant alterations in the p53 pathway among glioma patients with high LHPP expression. The overexpression of LHPP in glioma cells resulted in a reduction in cell proliferation, migration, and invasive ability, as well as an increase in apoptosis and alterations to the cell cycle. The present study has identified a novel inhibitory mechanism of LHPP against glioma, both in vivo and in vitro. The results demonstrate that LHPP exerts anti-glioma effects via the MDM2/p53 pathway. These findings may offer a new perspective for the treatment of glioma in the clinic.

BACKGROUND:The prevalence of non-suicidal self-injury (NSSI) among youth and adolescents has increased substantially in recent years. However, the mechanisms underlying NSSI remain unclear. Accumulating evidence suggests that structural abnormalities in specific brain regions may be associated with NSSI. METHODS:A total of 138 patients were recruited from Beijing HuiLongguan Hospital and were divided into two groups based on the DSM-5 criteria of NSSI: non-diagnostic NSSI (NN, n = 40) and diagnostic NSSI (DN, n = 98) groups. Suicidal ideation and childhood traumatic experiences were evaluated retrospectively using the Columbia-Suicide Severity Rating Scale (C-SSRS) and Childhood Trauma Questionnaire (CTQ). Brain cortical surface area and thickness data were extracted from structural MRI scans. RESULTS:Compared with the NN group, the DN group showed an increased surface area of the right temporal pole (FDR-adjusted p = 0.025), decreased thickness of the right inferior parietal cortex (FDR-adjusted p = 0.046), increased thickness of the right postcentral cortex (FDR-adjusted p = 0.030) and the right transverse temporal cortex (FDR-adjusted p = 0.039), and decreased subcortical volume of the right putamen (FDR-adjusted p = 0.029). Furthermore, right temporal pole surface area (β = 0.082, FDR-adjusted p = 0.042) and right postcentral thickness (β = -11.18, FDR-adjusted p = 0.017) correlated with NSSI frequency in the DN group. Right postcentral thickness moderated the impact of childhood trauma on cognition, with greater thickness linked to stronger negative effects. CONCLUSIONS:This study identified specific structural brain alterations in youth and adolescents with NSSI, which were associated with NSSI severity and moderated the link between childhood trauma and cognitive function. Our results suggest that structural morphology plays a role in NSSI neurobiology, providing potential biomarkers for future research and early clinical identification.

Nurses are critical front-line members of the healthcare workforce in China. Investigating mobile phone addiction (MPA) among nursing undergraduates is essential, as it may hinder their professional development and exacerbate the current nursing shortage. Understanding this issue is crucial for safeguarding future healthcare workforce sustainability. Therefore, it is necessary to examine the contributing factors of MPA and clarify their interrelationships. This study aims to investigate the serial multiple mediating effect of perceived stress and depression in the relationship between childhood trauma to MPA among undergraduate nursing students. A cross-sectional study was conducted among 1,249 undergraduate nursing students in Xi’an, Shaanxi Province, China, between November 2023 and April 2024, using a multistage sampling approach. Validated scales were used: the Childhood Trauma Questionnaire (CTQ), Perceived Stress Scale (PSS), Self-Rating Depression Scale (SDS), and Mobile Phone Addiction Tendency Scale (MPATS). The serial mediation was analyzed using the SPSS PROCESS macro by Hayes. The statistical analysis included descriptive analysis, independent samples t-tests, Pearson correlation analysis, and bootstrap methodology. MPA was positively correlated with childhood trauma (r = 0.237, p < 0.001), and was positively correlated with perceived stress (r = 0.391, p < 0.001) and depression (r = 0.337, p < 0.001). In the model of childhood trauma → perceived stress → depression → MPA, the overall mediated effect was 0.106 (95

Cognitive impairment is a core characteristic of schizophrenia. Immunosenescence has been consistently implicated in the cognitive dysfunction observed in neurodegenerative diseases, but how it may relate to cognitive deficits in schizophrenia is still unclear. We explored the associations between immunosenescence and cognitive impairment in patients with schizophrenia (SCZ, n = 65) and healthy controls (HCs, n = 39). Immunosenescence markers were assessed by flow cytometry and included the percentage of naïve or memory T cell subsets labeled by CD4+/CD8+, CD45RA+(naïve)/CD45RO (memory), or CD95+(memory), as well as the intracellular levels of selected cytokines (IL-1β, IL-6, TNF-α, and IFN-γ) in T cell subsets. T1-weighted magnetic resonance imaging was performed to assess the subcortical volume and cortical thickness. Participants were evaluated using the Positive and Negative Syndrome Scale and the Chinese version of the MATRICS Consensus Cognitive Battery.The results indicated that (1) Compared with HCs, SCZ patients were characterized by fewer naïve and more memory T cell subsets, accompanied by altered intracellular cytokine levels, indicating immunosenescence phenotypes. (2) The intracellular IL-1β level in naïve CD8+CD45RA+CD95+ T cells was associated with working memory deficit in SCZ patients. (3) In a moderated mediation model, the effect of the IL-1β level on the working memory score was mediated by the thickness of the right inferior parietal lobule (IPL_R), and the volume of the right choroid plexus (CP) moderated the indirect pathway between the IL-1β level and IPL_R thickness. Our findings highlighted immunosenescence-related T cell phenotypes and the CP as potential biomarkers of cognitive deficit in SCZ.

OBJECTIVE:The study aims to examine the network structures of childhood trauma (CT) and psychotic symptoms in patients with first-episode schizophrenia (FES) and treatment-resistant schizophrenia (TRS). Specifically, it seeks to elucidate how different dimensions of CT influence symptoms across FES and TRS. METHODS:289 patients with FES and 50 patients with TRS were assessed using Positive and Negative Syndrome Scale (PANSS) and Childhood Trauma Questionnaire. Partial correlation was used to elucidate the network connections between CT and symptoms in FES and TRS patients. Betweenness, closeness coefficient, and community detection were further calculated to investigate the interactions between CT and psychotic symptoms. RESULTS:The analysis revealed three key findings: (1) Symptom-trauma networks differ between FES and TRS patients; (2) Based on network analysis, CT in TRS forms tight interlinks, as evidenced by a larger value of closeness coefficient, which influences psychotic symptoms in TRS compared to FES. Sexual abuse plays a vital role in the TRS network while emotional neglect is more important in FES; and (3) The divergent community structures suggest distinct pathways through which CT and symptoms in FES and TRS patients. Specifically, in the FES symptom-CT network, CT influences the symptoms through traditional symptom patterns, while in TRS the pathway cannot be divided by traditional divisions and it involves a complex manner. CONCLUSION:The findings suggest that the pathways linking childhood trauma experiences and clinical symptoms differ between FES and TRS patients, providing valuable insights into how early traumatic stress may contribute to symptom evolution in schizophrenia.

Ferroptosis has been demonstrated to have a significant role in osteosarcoma (OS), a highly aggressive and invasive malignant bone tumor. Nevertheless, the precise molecular mechanism underlying OS remains unknown. Understanding the makeup of the immune microenvironment in OS is crucial for its therapy, as the disease grows in the highly specialized, complex, and dynamic bone microenvironment. Resveratrol (Res) possesses anti-inflammatory, immunomodulatory, chemopreventive, antioxidant, and anticancer properties, it is unknown if it can modify ferroptosis to prevent OS. This time, using single-cell analysis and other bioinformatic studies, we will clarify the targets and composition of the immunological microenvironment of the ferroptosis process in OS, as well as the role of certain transcription factors in it. Ultimately, network pharmacology and vitro experiment have led to the initial identification of the molecular processes governing ferroptosis in OS, which are regulated by Res. The findings suggested the potential use of ALB, EGFR, GPX4, IL6, STAT3, and PTEN as OS prognostic and diagnostic biomarkers. Chondroblastic, myeloid cells, osteoblastic OS, CD4 + T, NK, CD8 + T, B cells, M1 macrophages, Chondro_Proli, etc. made up the majority of the immunological microenvironment of OS. The entire cellular trajectory demonstrates that immune cells infiltrating during the early stages of OS are mostly CD4 + T, NK, CD8 + T, B_cell, and M1 macrophages. This affects the development of myeloid cells and chondroblastic cells, which ultimately leads to the progression of highly malignant chondro cells to OS. Numerous pathways allow transcription factors including BCLAF1, MAF, SP1, TCF12, KLF11, and KMT2D to contribute to the development of tumors. Finally, by interacting with the aforementioned targets, cells, Res is thought to impede the evolution of OS. In conclusion, ferroptosis and alterations in the immunological milieu are significant factors in the development of OS, and Res may one day be employed as a therapeutic drug to treat OS.

Stress plays a critical role in schizophrenia pathogenesis, and blunted cortisol responses to acute stress exposure among patients with schizophrenia may be related to damaged white matter (WM) fibers in specific brain regions. The present aim was to assess correlations between cortisol response patterns and changes in WM integrity in patients with schizophrenia and to determine if such changes relate to the duration of illness. This study included patients with chronic schizophrenia (PCS, n = 92), patients with first-episode schizophrenia (PFS, n = 86), and healthy controls (HC, n = 77). All participants were subjected to the Paced Auditory Serial Addition Task and the Mirror Tracing Persistence Task. Saliva samples were collected 0 min before tasks, 20 and 40 min after task completion. Cortisol levels were assessed using highly sensitive liquid chromatography and tandem mass spectrometry. We used diffusion tensor imaging (DTI) to assess WM microstructural integrity. Clinical psychopathology was assessed using the Positive and Negative Syndrome Scale. The repeated measures analysis of variance and pairwise comparisons demonstrated distinct cortisol response patterns across groups. In the HC group, cortisol levels peaked before tasks, declining rapidly thereafter. In the PFS group, cortisol levels significantly increased 20 min post-exposure, with no significant decrease observed at the final 40-minutes time point. In the PCS group, cortisol levels remained relatively high, with no significant fluctuations over time. Furthermore, WM integrity progressively deteriorated as disease duration increased. A negative correlation was observed between WM tract integrity and prolonged cortisol reactivity in the PFS group, whereas this correlation was positive in the HC group and absent in the PCS group. Changes in salivary cortisol levels did not correlate with clinical symptoms in our patients with schizophrenia. These findings suggest that stress has the potential to contribute to schizophrenia by exacerbating WM damage. Stress-induced cortisol response patterns, which vary according to disease duration, may represent a potential biomarker of schizophrenia.

Insulin resistance (IR) plays a critical role in shaping long-term outcomes in patients with metabolic dysfunction-associated steatotic liver disease (MASLD). Recent findings suggest that biological sex may influence the onset and progression of MASLD, yet it remains unclear whether sex modifies the link between IR and mortality in those with MASLD and advanced liver fibrosis. We analyzed data from 14,081 MASLD patients (7327 men and 6754 women) drawn from the 2001–2018 cycles of the National Health and Nutrition Examination Survey (NHANES). Participants were categorized based on sex-specific deciles of the Metabolic Score for Insulin Resistance (METS-IR). Kaplan–Meier survival analysis and Cox proportional hazards models were used to assess the association between METS-IR and all-cause mortality. Restricted cubic spline (RCS) modeling explored potential non-linear relationships. Marked sex-related disparities were identified in clinical and metabolic characteristics. Elevated METS-IR significantly predicted increased all-cause mortality in females with MASLD (log-rank p < 0.001), whereas this trend was not evident in males (p = 0.54). Multivariable Cox models showed that higher METS-IR independently correlated with mortality in women with MASLD and advanced fibrosis, but not in their male counterparts. The prognostic significance of METS-IR differs by sex in MASLD. Elevated METS-IR independently increases long-term mortality risk in females, supporting the need for sex-specific risk evaluation in managing metabolic liver disease.

Background Tuberculum sellae meningiomas (TSMs) account for 5 to 10% of all intracranial meningiomas. They typically invade the optic canal and displace the optic nerve upward and laterally. The transcranial approach has been the standard surgical approach, while the transsphenoidal approach has been proposed for its minimally invasive nature; however, some reservations concerning this approach remain.Methods From January 2000 to December 2018, a total of 97 patients who were diagnosed with TSM with invasion of the optic canal were enrolled and underwent microsurgery for tumor removal with optic canal opening. A retrospective analysis was performed on the effect of optic canal opening on postoperative visual acuity improvement. The median follow-up was 17.4 months (range: 3-86 months).Results Among the 97 patients with TSM involving the optic canal, optic canal invasion was seen on preoperative imaging in 73 patients and during intraoperative exploration in all patients. In total, 87/97 patients (89.7%) underwent optic canal opening to remove tumors involving the optic canal, and the rate of total macroscopic resection of tumors invading the optic canal was 100%. Among the 10 patients who did not undergo optic canal opening, the rate of total resection of tumors involving the optic canal was 80% (8/10, p < 0.001). There were no deaths or serious complications. The postoperative visual acuity improvement rate was 64.4%, 23.7% maintained the preoperative level, and the visual acuity deteriorated 11.9%.Conclusion Intraoperative optic canal opening is the key to total resection of TSMs involving the optic canal and improving postoperative visual acuity.

Background: The incidence of mobile phone addiction (MPA) is increasing in undergraduates and may lead to depression, anxiety, and sleep disorders. Undergraduate nursing students are important group for clinical services; therefore poor mental health has an important implications for the quality of future nursing work and the relationship between nurses and patients. Objectives: To explore the connection between organizational caring and MPA in Chinese undergraduate nursing students and to investigate the mechanisms of perceived stress and self-control in this relationship by constructing a chain mediation model. Design: A cross-sectional study. Methods: A total of 900 participants (age range 18-25 years, M = 20.99, SD = 1.58, 94.0 % female) were recruited from 10 universities in China. Data were collected using an online survey between February and March 2023. Organizational caring, subjective stress, self-control ability, and MPA among undergraduate nursing students were assessed. Results: (1) The prevalence of MPA was 34.9 % (314/900). (2) MPA in undergraduate nursing students was negatively correlated with self-control (r = -0.468, p < 0.001) and organizational caring (r = -0.156, p < 0.001), and positively correlated with perceived stress (r = 0.362, p < 0.001). (3) Perceived stress and self-control mediated the relationship between organizational caring and MPA, and the relative mediating effect values were 16.6 % and 17.2 %, respectively. (4) Organizational caring had an indirect effect on MPA through the chain mediation effect of perceived stress and self-control, and the relative mediating effect value was 19.1 %. Conclusion: Organizational caring, perceived stress and self-control directly influenced MPA among undergraduate nursing students. Additionally, organizational caring indirectly affected MPA through perceived stress and self-control. To further mitigate MPA among students, nursing managers and educators should enhance organizational caring, reduce perceived stress, and improve self-control abilities.

BackgroundA positive professional identity is key for nursing students in determining career direction and predicting future engagement in the profession. Despite its complexity and susceptibility to various influences, the factors shaping nursing students' professional identity remain poorly understood.ObjectivesThis study aims to investigate how perceived stress can directly and indirectly influence professional identity among nursing students, with self-control and self-directed learning ability as mediators.Materials and methodsA cross-sectional survey was conducted from October to December 2023, collecting data from 675 nursing students across five tertiary hospitals in Xi'an, Shaanxi Province, China. The survey captured detailed data on sociodemographic characteristics, perceived stress, self-control, self-directed learning ability, and professional identity among the participants. Descriptive analysis and correlation matrices were used to analyze participant characteristics and assess bivariate correlations. The mediation model was analyzed using the PROCESS macro for SPSS.ResultsPerceived stress showed a direct and negative influence on professional identity among nursing students; self-control was shown to play a mediating role between perceived stress and professional identity; self-directed learning ability was shown to play a mediating role between perceived stress and professional identity; and self-control and self-directed learning ability were shown to play a chain mediating role between perceived stress and professional identity.ConclusionSelf-control and self-directed learning ability have a chain mediating role in between perceived stress and professional identity among nursing students. It suggests that nursing managers and educators can improve the self-control and self-directed learning ability of nursing students to mitigate the negative impact of perceived stress on professional identity.

Background Stem cell therapy is a promising therapeutic strategy. In a previous study, we evaluated tumorigenicity by the stereotactic transplantation of neural stem cells (NSCs) and embryonic stem cells (ESCs) from experimental mice. Twenty-eight days later, there was no evidence of tumor formation or long-term engraftment in the NSCs transplantation group. In contrast, the transplantation of ESCs caused tumor formation; this was due to their high proliferative capacity. Based on transcriptome sequencing, we found that a long intergenic non-coding RNA (named linc-NSC) with unknown structure and function was expressed at 1100-fold higher levels in NSCs than in ESCs. This finding suggested that linc-NSC is negatively correlated with stem cell pluripotency and tumor development, but positively correlated with neurogenesis. In the present study, we investigated the specific role of linc-NSC in NSCs/ESCs in tumor formation and neurogenesis. Methods Whole transcriptome profiling by RNA sequencing and bioinformatics was used to predict lncRNAs that are widely associated with enhanced tumorigenicity. The expression of linc-NSC was assessed by quantitative real-time PCR. We also performed a number of in vitro methods, including cell proliferation assays, differentiation assays, immunofluorescence assays, flow cytometry, along with in vivo survival and immunofluorescence assays to investigate the impacts of linc-NSC on tumor formation and neurogenesis in NSCs and ESCs. Results Following the knockdown of linc-NSC in NSCs, NSCs cultured in vitro and those transplanted into the cortex of mice showed stronger survival ability (P < 0.0001), enhanced proliferation(P < 0.001), and reduced apoptosis (P < 0.05); the opposite results were observed when linc-NSC was overexpressed in ESCs. Furthermore, the overexpression of linc-NSC in ECSs induced enhanced apoptosis (P < 0.001) and differentiation (P < 0.01), inhibited tumorigenesis (P < 0.05) in vivo, and led to a reduction in tumor weight (P < 0.0001). Conclusions Our analyses demonstrated that linc-NSC, a promising gene-edited target, may promote the differentiation of mouse NSCs and inhibit tumorigenesis in mouse ESCs. The knockdown of linc-NSC inhibited the apoptosis in NSCs both in vitro and in vivo, and prevented tumor formation, revealing a new dimension into the effect of lncRNA on low survival NSCs and providing a prospective gene manipulation target prior to transplantation. In parallel, the overexpression of linc-NSC induced apoptosis in ESCs both in vitro and in vivo and attenuated the tumorigenicity of ESCs in vivo, but did not completely prevent tumor formation.

As indispensable reserves for the nursing workforce, undergraduate nursing students must possess self-directed learning abilities to consistently update their professional knowledge and adapt to the evolving demands of professional development. The acquisition of self-directed learning abilities can help undergraduate nursing students augment their theoretical knowledge and refine their clinical practice skills, thus fulfilling the demand from patients for high-quality nursing services. Hence, comprehending and investigating the factors that influence the development of self-directed learning abilities in nursing students is of paramount importance for nursing education and advancement of the nursing profession. This study investigated the status of and associations between perceived stress, psychological capital, and self-directed learning abilities among undergraduate nursing students. Additionally, it examines the mediating role of psychological capital in the relationship between perceived stress and self-directed learning abilities. Thus, aiming to provide nursing educators with new directions for enhancing self-directed learning abilities. A cross-sectional descriptive study. In February and March 2023, 900 undergraduate nursing students from 10 nursing schools completed an online questionnaire. The questionnaire included measures of perceived stress, psychological capital, and self-directed learning ability. Data were analyzed using SPSS 27.0 and the PROCESS macro tool. The scores for perceived stress, psychological capital, and self-directed learning ability among undergraduate nursing students were 40.07 ± 5.90, 99.89 ± 16.59, and 87.12 ± 9.20, respectively. Self-directed learning abilities were negatively correlated with perceived stress (r = -0.415, p < 0.001) and positively correlated with psychological capital (r = 0.465, p < 0.001). Perceived stress was negatively correlated with psychological capital (r = -0.630, p < 0.001). Psychological capital partially mediated the relationship between perceived stress and self-directed learning abilities among undergraduate nursing students, with a mediation effect of -0.166, accounting for 49.55

Schizophrenia patients with tardive dyskinesia (TD) are associated with accelerated biological aging, immunological dysfunction, and premature morbidity and mortality. Older individuals are particularly vulnerable to TD development. As a characteristic of immunosenescence, alterations in the relative proportions of naïve or memory T cell subpopulations may be negatively or positively associated with brain structure abnormalities; however, whether these changes are correlated with TD remains unclear. In this study, we investigated correlations between distributions of T cell phenotypes and brain structure abnormalities (especially white matter) in schizophrenia patients with (TD) and without (NTD) TD (n = 50 and 58, respectively) relative to healthy controls (HC, n = 41). Immune markers, including naïve (CD45RA+), memory (CD45RO+), and apoptotic (CD95+) CD4+ and CD8+ T cells, were examined by flow cytometry, as were the intracellular levels of cytokines (interferon (IFN)-γ, interleukin (IL)-6, IL-1β, and tumor necrosis factor (TNF)-α) in CD8 + CD45RA + CD95+ and CD8 + CD45RO + CD95+ T cells. MRI was employed to evaluate the fractional anisotropy (FA) of white matter tracts and subcortical volumes, following published routines. The percentage of CD8 + CD45RO + CD95+ T cells was higher in TD compared with NTD and HC groups and correlated with the choroid plexus volume in TD group. The intracellular level of IFN-γ in CD8 + CD45RO + CD95+ T cells, the FA of the fornix/stria terminalis, and the pallidum volume were correlated with orofacial TD, whereas the FAs of the inferior fronto-occipital fasciculus, cingulum, and superior longitudinal fasciculus were correlated with limb-truncal TD. These findings provide preliminary evidence that the association between immunosenescence-related T cell subpopulations and brain structure may underline the pathological process of TD.

BackgroundMany studies showed disrupted tryptophan metabolism in patients with affective disorders. The aims of this study were to explore the differences in the metabolites of tryptophan pathway (TP) and the relationships between TP metabolites and clinical symptoms, therapeutic effect in patients with bipolar disorder with acute manic episode (BD-M), depressive episode (BD-D) and major depressive disorder (MDD).MethodsPatients with BD-M (n=52) and BD-D (n=39), MDD (n=48) and healthy controls (HCs, n=49) were enrolled. The serum neuroactive metabolites levels of the TP were measured by liquid chromatography-tandem mass spectrometry. Hamilton Depression Scale-17 item (HAMD-17) and Young Mania Rating Scale (YMRS) were used to evaluate depressive and manic symptoms at baseline and after 8 weeks of antidepressants, mood stabilizers, some also received antipsychotic medication.ResultsThe levels of tryptophan (TRP) and kynurenic acid (KYNA) were significantly lower and the ratios of tryptophan/kynurenine (TRP/KYN), 5-hydroxytryptamine/tryptophan (5-HT/TRP), quinolinic acid/kynurenic acid (QUIN/KYNA) were higher in BD-M, BD-D, MDD vs. HC. The levels of QUIN and the ratios of QUIN/KYNA were higher in BD-M than in BD-D, MDD, and HCs. The 5-hydroxyindoleacetic acid (5-HIAA) levels of patients with MDD were significantly higher than those in BD-M and BD-D. Binary logistic regression analysis showed the lower peripheral KYNA, the higher the QUIN level, and the higher the risk of BD-M; the lower peripheral KYNA and the higher KYN/TRP and 5-HT/TRP, the higher the risk of BD-D; and the lower the peripheral KYNA level and the higher the KYN/TRP and 5-HT/TRP, the higher the risk of MDD. Correlation analysis, showing a significant association between tryptophan metabolites and improvement of clinical symptoms, especially depression symptoms.ConclusionsPatients with affective disorders had abnormal tryptophan metabolism, which involved in 5-HT and kynurenine pathway (KP) sub-pathway. Tryptophan metabolites might be potential biomarkers for affective disorders and some metabolites have been associated with remission of depressive symptoms.

Increasing evidence suggested that immune abnormalities involved in the pathophysiology of schizophrenia. However, the relationship between immunity and clinical features has not been clarified. The aim of this study was to measure the plasma levels of tumor necrosis factor alpha (TNF-α) and soluble TNF-α receptor 1 (sTNF-α R1) and to investigate their association with agitation in first episode patients with schizophrenia (FEPS). The plasma TNF-α and sTNF-α R1 levels were measured using sandwich enzyme-linked immunosorbent assay (ELISA) in the FEPS with (n = 36) and without agitation (n = 49) symptoms, and healthy controls (HCs, n = 54). The psychopathology was assessed by the Positive and Negative Syndrome Scale (PANSS), and the agitation symptoms were evaluated by the PANSS excitatory component (PANSS-EC). The plasma TNF-α levels in patients with and without agitation symptoms were significantly higher than those in HCs. The patients with agitation had significantly higher plasma TNF-α levels compared to the patients without agitation. There were no significant differences in the sTNF-α R1 levels among the three groups. Furthermore, the plasma TNF-α levels were positively correlated with the PANSS total score, Positive and General psychopathological subscores, and PANSS-EC score in the FEPS, but the relationships were not found for the plasma sTNF-α R1 levels. These results suggested that TNF-α might play an important role in the onset and development of agitation symptoms of schizophrenia.