Objective:To explore the impact of adolescent mental health status on smartphone addiction, and construct a predictive model for smartphone addiction based on the eXtreme Gradient Boosting(XGBoost) algorithm and multivariate Logistic regression.Methods:In April 2023, a cross-sectional survey was conducted among 14 666 adolescents.All participants were systematically evaluated using a self-developed general information questionnaire, the middle school student mental health scale(MSSMHS), the adolescents self-harm scale(ASHS), the interaction anxiousness scale(IAS), the mobile phone addiction index(MPAI), the middle school students shame scale(MSSS), the UCLA loneliness scale(UCLA-LS), the multidimensional peer victimization scale(MPVS), and the basic psychological needs scale(BPNS).R software version 4.3.2 was used for data analysis. Participants were randomly divided into training set and validation set at the ratio of 7∶3.The XGBoost model and multivariate logistic regression model were constructed to predict the risk of smartphone addiction, and a nomogram was plotted.Model performance was evaluated using the Hosmer-Lemeshow test, area under the curve(AUC), and accuracy(ACC).Results:(1) A total of 14 036 high school students were included in the study, with 5 069(36.1%) exhibited smartphone addiction.The training set comprised 9 826 students, with 3 549(36.1%) being smartphone addicts.The validation set included 4 210 students, with 1 520(36.1%) being smartphone addicts.(2) The XGBoost model identified shame-proneness and social anxiety as the two main predictors of smartphone addiction.(3) Multivariate Logistic regression analysis revealed that anxiety( B=0.328, OR(95% CI)=1.39(1.07-1.81), P=0.015), interpersonal sensitivity( B=0.311, OR(95% CI)=1.36(1.05-1.77), P=0.018), learning pressure( B=0.606, OR(95% CI)=1.83(1.46-2.31), P<0.001), mood swings( B=0.775, OR(95% CI)=2.17(1.70-2.78), P<0.001), social anxiety( B=0.024, OR(95% CI)=1.02(1.01-1.04), P<0.001), shame-proneness( B=0.049, OR(95% CI)=1.05(1.04-1.06), P<0.001), and peer victimization( B=0.037, OR(95% CI)=1.04(1.02-1.06), P<0.001) were significant predictors of smartphone addiction.(4) The ACC and AUC values of the XGBoost model were 0.890 and 0.929 in the training set, and 0.865 and 0.864 in the validation set, respectively.The multivariate Logistic regression model achieved ACC and AUC values of 0.870 and 0.854 in the training set, and 0.867 and 0.859 in the validation set, respectively. Conclusion:Anxiety, interpersonal sensitivity, learning pressure, mood swings, social anxiety, shame-proneness, and peer victimization are identified risk predictors of smartphone addiction in high school adolescents.

Objective:To explore the impact of adolescent mental health status on smartphone addiction, and construct a predictive model for smartphone addiction based on the eXtreme Gradient Boosting(XGBoost) algorithm and multivariate Logistic regression.Methods:In April 2023, a cross-sectional survey was conducted among 14 666 adolescents.All participants were systematically evaluated using a self-developed general information questionnaire, the middle school student mental health scale(MSSMHS), the adolescents self-harm scale(ASHS), the interaction anxiousness scale(IAS), the mobile phone addiction index(MPAI), the middle school students shame scale(MSSS), the UCLA loneliness scale(UCLA-LS), the multidimensional peer victimization scale(MPVS), and the basic psychological needs scale(BPNS).R software version 4.3.2 was used for data analysis. Participants were randomly divided into training set and validation set at the ratio of 7∶3.The XGBoost model and multivariate logistic regression model were constructed to predict the risk of smartphone addiction, and a nomogram was plotted.Model performance was evaluated using the Hosmer-Lemeshow test, area under the curve(AUC), and accuracy(ACC).Results:(1) A total of 14 036 high school students were included in the study, with 5 069(36.1%) exhibited smartphone addiction.The training set comprised 9 826 students, with 3 549(36.1%) being smartphone addicts.The validation set included 4 210 students, with 1 520(36.1%) being smartphone addicts.(2) The XGBoost model identified shame-proneness and social anxiety as the two main predictors of smartphone addiction.(3) Multivariate Logistic regression analysis revealed that anxiety( B=0.328, OR(95% CI)=1.39(1.07-1.81), P=0.015), interpersonal sensitivity( B=0.311, OR(95% CI)=1.36(1.05-1.77), P=0.018), learning pressure( B=0.606, OR(95% CI)=1.83(1.46-2.31), P<0.001), mood swings( B=0.775, OR(95% CI)=2.17(1.70-2.78), P<0.001), social anxiety( B=0.024, OR(95% CI)=1.02(1.01-1.04), P<0.001), shame-proneness( B=0.049, OR(95% CI)=1.05(1.04-1.06), P<0.001), and peer victimization( B=0.037, OR(95% CI)=1.04(1.02-1.06), P<0.001) were significant predictors of smartphone addiction.(4) The ACC and AUC values of the XGBoost model were 0.890 and 0.929 in the training set, and 0.865 and 0.864 in the validation set, respectively.The multivariate Logistic regression model achieved ACC and AUC values of 0.870 and 0.854 in the training set, and 0.867 and 0.859 in the validation set, respectively. Conclusion:Anxiety, interpersonal sensitivity, learning pressure, mood swings, social anxiety, shame-proneness, and peer victimization are identified risk predictors of smartphone addiction in high school adolescents.

Objective:To evaluate the validity and reliability of the Simplified Chinese version of the Beck Cognitive Insight Scale(SC-BCIS).Methods:Totally 188 patients with schizophrenia meeting the Diagnostic and Statistical Manual of Mental Disorders,Fifth Edition(DSM-5)diagnostic criteria were selected for SC-BCIS and the Insight and Treatment Attitudes Questionnaire(ITAQ)assessment.Thirty-eight patients were selected for retest-ing within 4 weeks.The item analysis was conducted using the Spearman correlation method,and the reliability of the scale was tested with Cronbach's α coefficient and ICC coefficient.The structural validity of the scale was ex-amined through principal component analysis and exploratory factor analysis.Results:The correlation coefficients between the 15 item scores and the total score of the SC-BCIS all met the screening criteria.The Cronbach's α coef-ficient of the scale was 0.69,the test-retest ICC value was 0.82,the ICC coefficient between the SC-BCIS and ITAQ scales was 0.83,and the scale had a two-factor structure,with a cumulative contribution rate of 42.4％for the two factors.Conclusion:The Simplified Chinese version of the Beck Cognitive Insight Scale(SC-BCIS)has good validity and reliability in measuring cognitive insight in patients with schizophrenia.

Objective:To evaluate the validity and reliability of the Simplified Chinese version of the Beck Cognitive Insight Scale(SC-BCIS).Methods:Totally 188 patients with schizophrenia meeting the Diagnostic and Statistical Manual of Mental Disorders,Fifth Edition(DSM-5)diagnostic criteria were selected for SC-BCIS and the Insight and Treatment Attitudes Questionnaire(ITAQ)assessment.Thirty-eight patients were selected for retest-ing within 4 weeks.The item analysis was conducted using the Spearman correlation method,and the reliability of the scale was tested with Cronbach's α coefficient and ICC coefficient.The structural validity of the scale was ex-amined through principal component analysis and exploratory factor analysis.Results:The correlation coefficients between the 15 item scores and the total score of the SC-BCIS all met the screening criteria.The Cronbach's α coef-ficient of the scale was 0.69,the test-retest ICC value was 0.82,the ICC coefficient between the SC-BCIS and ITAQ scales was 0.83,and the scale had a two-factor structure,with a cumulative contribution rate of 42.4％for the two factors.Conclusion:The Simplified Chinese version of the Beck Cognitive Insight Scale(SC-BCIS)has good validity and reliability in measuring cognitive insight in patients with schizophrenia.

Objective:To investigate the clinicopathological characteristics, immunophenotypes, molecular features, and differential diagnosis of BAP1 mutated clear cell renal cell carcinoma (CCRCC) for better understanding this entity.Methods:Clinical data, histological morphology, immunophenotypes and molecular characteristics of 18 BAP1 mutated CCRCC cases diagnosed at the Department of Pathology, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China from January 2020 to December 2022 were analyzed. The patients were followed up.Results:There were 17 males and 1 female patients, aged from 39 to 72 years, with an average age of 56.3 years. Sixteen patients with primary CCRCC were followed up for an average of 24 months, 7 patients had metastases occurred from 4 to 22 months postoperatively. Thirteen of the 16 patients were alive at the time of the last follow-up while 3 patients died 12, 15, and 20 months after the surgery, respectively. One patient underwent retroperitoneal mass resection, but had lung metastasis 32 months after surgery. One case received cervical tumor resection and died at 22 months after the surgery. Characteristic CCRCC regions were identified in 11 of the 18 cases. The tumor cells were arranged in papillary, alveolar, and large nest patterns. Abundant lymphoid tissue, necrosis, and psammoma bodies were seen. Tumor cells showed abundant eosinophilic cytoplasm, and sometimes exhibited rhabdoid differentiation. Round eosinophilic globules were located in the cytoplasm and extracellular matrix. There were 9 cases with WHO/International Society of Urological Pathology grade 3, and 9 cases with grade 4. PAX8 (18/18), carbonic anhydrase 9 (CA9, 16/18), CD10 (18/18), and vimentin (18/18) were positive in the vast majority of tumors.TFE3 was expressed in 5 cases, with strong expression in only 1 case. Eighteen cases were all positive for P504s. Twelve cases harbored a BAP1 mutation combined with von Hippel-Lindau (VHL) mutation, and 2 cases had mutations in BAP1, VHL and PBRM1 simultaneously. SETD2 mutation was not found in any of the cases.Conclusions:BAP1 mutated CCRCC contained papillary, alveolar, and large nest patterns, eosinophilic cytoplasm, high-grade nucleoli, and collagen globules, with P504s positivity. In practical work, when encountering CCRCC containing these features, pathologists should consider the possibility of BAP1 mutations and conduct related molecular tests.

Objective This study aimed to evaluate the bone integration performance of antibacterial carbon dot(CD)-modified polyether ether ketone(PEEK)in infectious bone defect environments.Methods Guanidine-based CDs(G-CDs)prepared by the melting method combined with dialysis purification were used to modify PEEK implants using polyvinyl butyraldehyde(PVB)by the soaking-drying method(PEEK/PVB-G-CDs).SD rats were divided into the following groups:(1)PEEK-implanted uninfected(PEEK(-)),(2)PEEK/PVB-G-CDs-implanted uninfected(PEEK/PVB-G-CDs(-)),(3)PEEK-implanted infected(PEEK(+)),and(4)PEEK/PVB-G-CDs-implanted infected(PEEK/PVB-G-CDs(+)).A hole(diameter 2 mm,depth 5 mm)was drilled at the lateral condyle of the vertical femur in all rats to simulate a bone defect.Rats in the PEEK(-)and PEEK/PVB-G-CDs(-)groups without infection were injected with 30 μL physiological saline into the bone marrow cavity,and rats in the PEEK(+)and PEEK/PVB-G-CDs(+)groups with infection were injected with 30 μL MRSA bacterial suspension(1.5 × 104 colony-forming units/mL)into the bone marrow cavity.The implantation site was observed using animal-specific X-ray examination at 0,2,and 4 weeks after implantation,and the bone tissue characteristics of the implantation site were evaluated by micro computed tomography(CT)at 6 weeks after surgery.The bone implantation sites in each group of rats were examined by bacterial culture of bone marrow and hematoxylin and eosin staining,Toluidine blue,Goldner trichrome,and immunohistochemical staining.Results X-ray,Micro-CT,bacterial culture of bone marrow,and histopathological analysis confirmed no signs of infection in the PEEK(-)and PEEK/PVB-G-CDs(-)groups and the implants were integrated with the bone defects.Rats in the PEEK/PVB-G-CDs(+)group showed signs of antibacterial activity that effectively controlled the osteomyelitis caused by MRSA and achieved bone integration,while rats in the PEEK(+)group failed to achieve bone integration because of persistent infection.Immunohistochemical staining confirmed lower levels of anti-inflammatory factors such as IL-4 and IL-10 in the PEEK(+)group,and stronger expression of pro-inflammatory factors such as IL-6 and TNF-α compared with the other three groups,indicating that G-CD-modified PEEK inhibited MRSA infection,regulated inflammation levels in the local microenvironment,and promoted bone integration at the site of bone defects.Conclusions Antibacterial G-CDs modified PEEK exhibits excellent bone integration performance,providing a candidate strategy for future clinical treatment of infectious bone defects.

Objective This study aimed to evaluate the bone integration performance of antibacterial carbon dot(CD)-modified polyether ether ketone(PEEK)in infectious bone defect environments.Methods Guanidine-based CDs(G-CDs)prepared by the melting method combined with dialysis purification were used to modify PEEK implants using polyvinyl butyraldehyde(PVB)by the soaking-drying method(PEEK/PVB-G-CDs).SD rats were divided into the following groups:(1)PEEK-implanted uninfected(PEEK(-)),(2)PEEK/PVB-G-CDs-implanted uninfected(PEEK/PVB-G-CDs(-)),(3)PEEK-implanted infected(PEEK(+)),and(4)PEEK/PVB-G-CDs-implanted infected(PEEK/PVB-G-CDs(+)).A hole(diameter 2 mm,depth 5 mm)was drilled at the lateral condyle of the vertical femur in all rats to simulate a bone defect.Rats in the PEEK(-)and PEEK/PVB-G-CDs(-)groups without infection were injected with 30 μL physiological saline into the bone marrow cavity,and rats in the PEEK(+)and PEEK/PVB-G-CDs(+)groups with infection were injected with 30 μL MRSA bacterial suspension(1.5 × 104 colony-forming units/mL)into the bone marrow cavity.The implantation site was observed using animal-specific X-ray examination at 0,2,and 4 weeks after implantation,and the bone tissue characteristics of the implantation site were evaluated by micro computed tomography(CT)at 6 weeks after surgery.The bone implantation sites in each group of rats were examined by bacterial culture of bone marrow and hematoxylin and eosin staining,Toluidine blue,Goldner trichrome,and immunohistochemical staining.Results X-ray,Micro-CT,bacterial culture of bone marrow,and histopathological analysis confirmed no signs of infection in the PEEK(-)and PEEK/PVB-G-CDs(-)groups and the implants were integrated with the bone defects.Rats in the PEEK/PVB-G-CDs(+)group showed signs of antibacterial activity that effectively controlled the osteomyelitis caused by MRSA and achieved bone integration,while rats in the PEEK(+)group failed to achieve bone integration because of persistent infection.Immunohistochemical staining confirmed lower levels of anti-inflammatory factors such as IL-4 and IL-10 in the PEEK(+)group,and stronger expression of pro-inflammatory factors such as IL-6 and TNF-α compared with the other three groups,indicating that G-CD-modified PEEK inhibited MRSA infection,regulated inflammation levels in the local microenvironment,and promoted bone integration at the site of bone defects.Conclusions Antibacterial G-CDs modified PEEK exhibits excellent bone integration performance,providing a candidate strategy for future clinical treatment of infectious bone defects.