Yin-Ping Zhang

Background: Prediabetes is a high-risk metabolic state with a rapidly increasing global prevalence. Beyond its metabolic consequences, individuals with prediabetes face an elevated risk of depression and psychological distress. Psychological resilience, a key protective factor for mental health, may play an important role; however, its heterogeneity and associated factors in this population remain unclear. This study aimed to identify latent profiles of psychological resilience and examine their associated factors within this population. Methods: This cross-sectional study enrolled 315 adult patients with prediabetes. Data were collected using validated questionnaires designed to evaluate psychological resilience (CD-RISC-10), self-efficacy (GSES), social support (SSRS), and illness perception (BIPQ). Latent profile analysis (LPA) was performed in Mplus 8.3 to identify unobserved subgroups of psychological resilience. Model fit was evaluated using AIC, BIC, adjusted BIC, entropy,the BLRT, and the LMR-LRT, together with interpretability. Multinomial logistic regression analysis was conducted to identify factors associated with latent profile membership. Results: The mean psychological resilience score among adults with prediabetes was 28.56 ± 7.19, indicating a moderate level. Latent profile analysis identified three distinct subgroups of psychological resilience: the low-resilience profile (n = 58, 18.4%), the moderate-resilience profile (n = 152, 48.3%), and the high-resilience profile (n = 105, 33.3%), indicating marked heterogeneity in resilience patterns. Multinomial logistic regression analysis showed that self-efficacy, social support, medical payment method, and marital status were independently associated with latent profile membership. Conclusion: This study identified three distinct latent profiles of psychological resilience among adults with prediabetes, revealing substantial heterogeneity within this population. Self-efficacy, social support, marital status, and medical payment method are key factors associated with profile membership. These findings highlight the importance of incorporating psychological and social determinants into targeted nursing interventions to enhance resilience in this population.

The diagnostic‐to‐treatment interval (DTI) of papillary thyroid carcinoma (PTC) has long been regarded as an inactive administrative period. We expected to find that DTI is a window of high metabolic activity where apolipoprotein dysregulation may lead to harm. A four‐phase integrated design was used. Phase 1 analysed transcriptomic and clinical data from TCGA‐THCA ( n = 209) to find DTI‐associated molecular alterations, and used a maximally selected rank statistic to set the optimal time window. Phase 2 verified the lipoprotein signature in three independent GEO cohorts (GSE29265/GSE33630/GSE60542). Phase 3 used XGBoost regression in conjunction with SHAP (SHapley Additive exPlanations) to explore gene–gene interactions and predictive structures. Phase 4 used two‐sample Mendelian randomization to determine whether genetically determined levels of the 233 metabolic biomarkers were associated with PTC. A 77‐day threshold optimally stratified postoperative complete response rates (91.5% for DTI ≤ 77 days vs. 79.0% for DTI > 77 days; p = 0.035). Differential expression analysis found 77 genes that were significantly associated with prolonged DTI, and the enriched pathways included PPAR signalling, fat digestion and apolipoprotein particle dynamics. Linear regression showed that longer DTI was associated with higher expression of APOA1 and APOC1. XGBoost–SHAP analysis showed that APOA1 and APOC1 were the top predictive features, and their interaction explained most of the non‐additive variance. Cross‐cohort validation showed that APOC1 and LPL were consistently upregulated and VLDLR was downregulated in all GEO datasets. Disease‐state predictive model building found that the LPL–APOC1 axis effectively distinguished tumour from normal tissue. In two‐sample MR analysis of 233 metabolic traits, genetically predicted VLDL and triglyceride‐rich lipoprotein traits showed a predominantly risk‐increasing direction of effect, and HDL cholesterol exhibited a protective effect, which was consistent with the transcriptomic results; however, no individual exposure remained significant after multiple testing correction in either outcome dataset, so the genetic analysis provided support for and extended the hypothesis rather than confirming it. Based on the above analysis, the pre‐operative period of PTC may be metabolically active rather than quiescent; however, this has not been confirmed in future studies. Dysregulation of the APOC1‐associated VLDL pathway is a reproducible cross‐cohort transcriptomic signature in PTC; although genetic analysis has been conducted directionally, strong causal evidence has not been obtained. Therefore, at the same time, we will shift from time‐limited to metabolically targeted preoperative risk assessment.

Objective: This study sought to elucidate the chain mediation effects of coping style and social support linking extraversion-introversion personality to self-perceived speech handicap in head and neck cancer patients with tracheostomy. Methods: A cross-sectional survey was conducted among 217 post-tracheostomy patients (January 2023–June 2024). Data collection was conducted through questionnaire surveys employing a general information questionnaire, the Eysenck Personality Questionnaire-Revised, Short Scale for Chinese, the Social Support Rating Scale, the Simplified Coping Style Questionnaire, and the Chinese version of the Speech Handicap Index. The outcome was the total SHI score, a patient-reported measure of self-perceived speech handicap; communication ability was not directly measured. Results: The mean score for extraversion-introversion personality traits among participants with tracheostomy was 51.798 ± 11.240, for positive coping style was 30.790 ± 7.240, for social support was 40.862 ± 9.024, and for the Speech Handicap Index was 73.230 ± 24.227. Speech handicap exhibited significant negative correlations ( p < 0.01) with extraversion-introversion personality traits ( r = −0.445), coping style ( r = −0.410), and social support ( r = −0.402). Both positive coping style and social support significantly mediated the association between extraversion-introversion personality traits and self-perceived speech handicap in head and neck cancer patients with tracheostomy, with mediation effect values of −0.682 and −0.425, respectively. Furthermore, a chain mediation effect was observed along the “positive coping style → social support” pathway (−0.201), accounting for 6.26% of the total effect. Conclusion: Path analysis identifies an associative relationship between extraversion-introversion personality traits and self-perceived speech handicap that is potentially explained by the chained mediating roles of coping style and social support. As patients’ extraversion-introversion personality traits are difficult to modify, optimization of coping style and enhancement of social support levels in clinical practice may constitute primary intervention strategies for reducing self-perceived speech handicap in these patients.

Women of reproductive age diagnosed with thyroid cancer face a distinctive psychological burden arising from the concurrent demands of disease management and primary caregiving, yet the mechanisms linking parenting stress to diminished well-being in this group remain poorly characterized. The present study applied a stress-buffering framework to examine whether psychological distress (anxiety and depressive symptoms) statistically mediated the association between parenting stress and well-being, and whether social support attenuates these pathways. We recruited a convenience sample of 400 consecutive eligible mothers between July and December 2025 at a tertiary cancer center in China. All were of reproductive age (18–49 years), had cytologically confirmed papillary thyroid carcinoma and at least one child aged ≤12 years, and completed the survey during their initial hospitalization, before surgery. Validated instruments assessed parenting stress, anxiety and depression, social support, and well-being; analyses included bivariate correlations, mediation, and moderated mediation models. Well-being correlated inversely with parenting stress (r = −0.447, p < 0.01) and anxiety and depression (r = −0.573, p < 0.01), and positively with social support (r = 0.515, p < 0.01). Psychological distress partially mediated the parenting stress–well-being association, with the indirect effect constituting 44.32% of the total effect (−0.210, 95% CI: −0.321 to −0.125). Parenting stress was positively associated with HADS scores (β = 0.322, p < 0.001), though this association was weaker at higher levels of social support (interaction β = −0.106, p = 0.006). Both parenting stress (β = −0.148, p = 0.001) and HADS scores (β = −0.367, p < 0.001) were independently associated with lower well-being, while social support moderated the parenting stress–well-being association (interaction β = 0.098, p = 0.003). In conclusion, parenting stress and psychological distress were jointly associated with diminished well-being in this population, but social support emerged as a modifiable protective correlate. Psychosocial interventions targeting stress reduction, emotional regulation, and support mobilization may thus hold particular promise for improving outcomes among young women with thyroid cancer.

Background: Evidence regarding whether dietary interventions can delay disease progression in men undergoing active surveillance for prostate cancer remains fragmented. This study innovatively combines a systematic review of the evidence with rigorous methodological assessment, aiming to provide a critical analysis of the evidence base in this field, rather than merely a descriptive review. Methods: We searched the PubMed, Embase, Cochrane Library, and Web of Science databases, mapping interventions to outcomes. An evidence bubble plot was constructed, with the bubble size representing the number of studies and the color intensity representing the proportion of randomized controlled trials. Methodological quality were assessed using the Cochrane risk of bias tool, ROBINS-I, the Newcastle–Ottawa Scale and the JBI tool. Results: The map revealed a dense but flawed evidence cluster focused on phytochemical-rich supplements and PSA/biomarker change, primarily supported by randomized controlled trials with prevalent limitations in blinding and randomization reporting. In stark contrast, there is a critical gap in the evidence from intervention studies assessing the impact of holistic dietary patterns on clinical progression endpoints. The integrated quality assessment underscores a fundamental mismatch: while abundant, research on supplements is often methodologically compromised, conversely, the few observational studies on holistic dietary patterns, although of higher quality, are unable to establish causality. Conclusion: Current evidence is misaligned with clinical needs, being rich in low-certainty supplement data but scarce in high-quality trials on holistic diets. Future research would benefit greatly from a strategic reorientation of funding—namely, prioritizing large-scale, rigorous clinical trials to evaluate comprehensive dietary interventions targeting clinically significant disease progression endpoints, while recognizing that supplement studies continue to play an important role in generating mechanistic hypotheses. Systematic review registration: https://doi.org/10.17605/OSF.IO/T8G97

Background: Lymphedema represents a prevalent complication following breast cancer surgery, for which effective interventions can significantly reduce incidence rates. Aims: This systematic review and meta-analysis explored the clinical efficacy of different physical therapy interventions on breast cancer-related lymphedema (BCRL) in postoperative patients with breast cancer (BC). Methods: Comprehensive literature searches were conducted in eight databases: PubMed, Web of Science, Cochrane Library, ScienceDirect, ClinicalTrials.gov, CINAHL, Embase, and Scopus, from their inception until May 31, 2025. After study selection, meta-analyses were performed using Review Manager software (version 5.4). The primary outcome measures were the overall incidence of BCRL, the incidence of BCRL following specific physical interventions, and the incidence of BCRL after different intervention durations. Results: The initial search yielded 3566 publications. 31 studies were included after screening, comprising a total sample size of 4323 patients. Meta-analysis showed that physical intervention had no significant therapeutic (RR = 0.81, 95%CI 0.52 to 1.27, P >0.05) and preventive (RR = 0.72, 95%CI 0.50 to 1.02, P >0.05) effect on BCRL. Subgroup analyses further indicated that compared with 2-month, 3-month, 6-month,and 18-month intervention durations, physical intervention has a significant effect on BCRL. when administered for durations of 12 months (RR = 0.53, 95% CI 0.29 to 0.95, P < 0.05). Conclusion: Whether physical intervention is effective in the prevention and treatment of postoperative lymphedema in BC patients’ needs to be further explored, but there is a significant effect in the 12-month intervention subgroup. Therefore, we should pay more attention to the effect of physical intervention measures after enough time in clinical practice. The review protocol was registered prospectively in PROSPERO (Registration number: CRD42024615513). Systemetic Review Registration: https://www.crd.york.ac.uk/PROSPERO/myprospero , identifier CRD42024615513.

This study aimed to evaluate the efficacy and safety of intra-articular sodium hyaluronate injection over a 12-month follow-up period in patients with ankle-involved Kashin-Beck Disease (KBD). A 12-month, prospective, self-controlled study was carried out among 79 adult patients with ankle-involved KBD. Each patient was given three consecutive weekly intra-articular injections of sodium hyaluronate (2 mL, 20 mg) in the affected ankle joint. The Graded Chronic Pain Scale (GCPS) was used to evaluate pain intensity, the KBD Joint Dysfunction Index (JDI) was used to assess joint function, and the EQ-5D-3L was used to assess quality of life (QoL). These three outcome measures were assessed at baseline (prior to the first injection), Week 4 (one week after the third injection), and Month 12 (12 months after the first injection). Longitudinal changes were analyzed using Generalized Estimating Equations (GEE). Over the 12 months, all the ankle outcomes significantly improved compared with baseline (all p < 0.001). The estimated marginal means (EMM) of GCPS pain score decreased from 67.24 to 30.56. The JDI scores decreased from 7.31 to 3.64, and the EQ-5D-3L utility index increased from 0.707 to 0.869. Significant time × KBD stage interactions were found in ankle pain (Wald χ²= 15.82, p = 0.003) and EQ-5D-3L utility index (Wald χ²= 37.25^, p < 0.001). While patients with Stage III appeared to have the most significant improvements, these subgroup findings should be considered exploratory due to the limited sample size. Only 3.46% of patients reported adverse events, which were mild and transient. In conclusion, intra-articular sodium hyaluronate injection provides significant and sustained pain relief, functional recovery, and QoL improvement for patients with ankle-involved KBD. It is a safe and effective conservative treatment strategy.

Human-Robot Collaboration (HRC) is an emerging paradigm in healthcare that leverages robotic systems to improve patient care, assist medical professionals, and optimize clinical workflows. As healthcare demands increase due to aging populations and resource limitations, HRC offers a promising solution by combining robotic precision with caregivers’ adaptability. This review provides a comprehensive analysis of HRC in healthcare, categorizing its key influencing factors into three components: (1) Healthcare Professional-Oriented, focusing on task allocation, communication, teamwork, and trust; (2) Patient-Centric, emphasizing patient safety, acceptability, interaction, and feedback; and (3) System-Critical, addressing system autonomy, adaptability, integration, and safety in medical environments. The review explores recent advancements in enabling technologies, including sensor developments, immersive interfaces, digital twin modeling, and artificial intelligence (AI), which drive more efficient and adaptive HRC. Despite these innovations, challenges such as ethical concerns, interoperability, and cost-related barriers remain obstacles to widespread implementation. Future research should focus on developing robust ethical frameworks, enhancing safety and reliability, improving interoperability, and fostering patient and caregiver acceptance through interdisciplinary collaboration.

Kashin–Beck disease (KBD) remains a significant public health challenge in northwestern China, where chronic joint pain and functional limitations severely compromise quality of life (QoL). Despite growing recognition of sex-related disparities in musculoskeletal conditions, sex-specific differences in pain, limb function, and QoL among KBD patients remain underexplored. This study aimed to investigate these disparities to enhance understanding and guide tailored management. A cross-sectional study was conducted among 329 patients with KBD (160 males and 169 females) in endemic areas of Shaanxi Province, Northwest China. Validated assessment tools were employed, including the Graded Chronic Pain Scale (GCPS), Quick Disabilities of the Arm, Shoulder, and Hand Questionnaire (QuickDASH), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and three-level EuroQol five-dimensional questionnaire (EQ-5D-3 L), to evaluate pain, limb function, and QoL. Sex differences were analyzed using Chi-square tests, independent-sample t-tests, and Mann-Whitney U tests. Female patients exhibited significantly poorer upper-limb function than males (QuickDASH: 55.4 ± 23.7 vs. 39.1 ± 24.1; p < 0.001), surpassing the minimal clinically important difference (MCID) threshold of 14.0. Pain distribution varied by sex: females reported more hand/foot pain, whereas males more commonly experienced knee/ankle pain (all p < 0.05). Although differences in pain intensity (6.9 ± 1.6 vs. 6.5 ± 1.6; p = 0.016) and lower-limb function (WOMAC: 50.6 ± 20.6 vs. 45.2 ± 18.1; p = 0.012) were statistically significant, they did not exceed the corresponding MCID thresholds (1.0 and 16.1, respectively). Moreover, females had significantly poorer QoL scores (EQ-5D-3 L: 0.589 ± 0.252 vs. 0.684 ± 0.233, p < 0.001; EQ-VAS: 45.7 ± 21.7 vs. 52.7 ± 19.1, p = 0.002). This study revealed clinically significant sex differences in upper-limb function among KBD patients in Northwest China, with females experiencing greater impairment. While other observed sex differences in pain and lower-limb function were statistically significant, they lacked clinical meaningfulness. The distinct patterns of pain distribution and the significantly poorer QoL observed in females warrant clinical attention. These findings highlight the importance of prioritizing upper limb rehabilitation in treatment strategies, particularly for female patients.