OBJECTIVES: To report the development, validation, and findings of the Multi-dimensional Attention Rating Scale (MARS), a self-report tool crafted to evaluate six-dimension attention levels. METHODS: The MARS was developed based on Classical Test Theory (CTT). Totally 202 highly educated healthy adult participants were recruited for reliability and validity tests. Reliability was measured using Cronbach's alpha and test-retest reliability. Structural validity was explored using principal component analysis. Criterion validity was analyzed by correlating MARS scores with the Toronto Hospital Alertness Test (THAT), the Attentional Control Scale (ACS), and the Attention Network Test (ANT). RESULTS: The MARS comprises 12 items spanning six distinct dimensions of attention: focused attention, sustained attention, shifting attention, selective attention, divided attention, and response inhibition.As assessed by six experts, the content validation index (CVI) was 0.95, the Cronbach's alpha for the MARS was 0.78, and the test-retest reliability was 0.81. Four factors were identified (cumulative variance contribution rate 68.79%). The total score of MARS was correlated positively with THAT (r = 0.60, P < 0.01) and ACS (r = 0.78, P < 0.01) and negatively with ANT's reaction time for alerting (r = -0.31, P = 0.049). CONCLUSIONS The MARS can reliably and validly assess six-dimension attention levels in real-world settings and is expected to be a new tool for assessing multi-dimensional attention impairments in different mental disorders.
Humans ; Adult ; Male ; Attention/physiology* ; Female ; Middle Aged ; Reproducibility of Results ; Young Adult ; Psychometrics

Ovarian tumor (OT) is the most lethal form of gynecologic malignancy, with minimal improvements in patient outcomes over the past several decades. Metastasis is the leading cause of ovarian cancer-related deaths, yet the underlying mechanisms remain poorly understood. Psychological stress is known to activate the glucocorticoid receptor (NR3C1), a factor associated with poor prognosis in OT patients. However, the precise mechanisms linking NR3C1 signaling and metastasis have yet to be fully elucidated. In this study, we demonstrate that chronic restraint stress accelerates epithelial-mesenchymal transition (EMT) and metastasis in OT through an NR3C1-dependent mechanism involving nuclear protein 1 (NUPR1). Mechanistically, NR3C1 directly regulates the transcription of NUPR1, which in turn increases the expression of snail family transcriptional repressor 2 (SNAI2), a key driver of EMT. Clinically, elevated NR3C1 positively correlates with NUPR1 expression in OT patients, and both are positively associated with poorer prognosis. Overall, our study identified the NR3C1/NUPR1 axis as a critical regulatory pathway in psychological stress-induced OT metastasis, suggesting a potential therapeutic target for intervention in OT metastasis.

Mesenchymal stem cells(MSCs)play a crucial role in tissue repair and regeneration,and the extracellular vesicle(EV)released by them holds great promise for applications in clinical biomarkers,vaccines,and drug delivery.However,MSCs-derived EV(MSCs-EV)face challenges such as low pro-duction yield,poor retention,and targeted delivery issues.There-fore,engineering MSCs-EV to enhance their performance and en-able visual research has become a hot topic.Curcumin(CUR),an active component in traditional chinese medicine,exhibits pharmacological effects but has limited bioavailability.Using MSCs-EV as a carrier for CUR delivery can address its solubility and bioavailability challenges.This article reviews the drug loading methods,engineering strategies of MSCs-EV,and their important applications in the delivery and treatment of CUR for cartilage injury diseases.It provides a basis for the clinical ap-plication of engineered MSCs-EV in CUR delivery for cartilage repair,offering potential solutions to the challenges in cartilage tissue repair.

Global procurement of health products is an important way for multilateral organizations in the health field to perform their functions.As one of the most important multilateral organizations in the global health field today,the Global Fund to Fight AIDS,Tuberculosis and Malaria occupies a huge share of the global procurement market for health products.This article introduces in detail the procurement methods of the Global Fund and the quality standards of its procured products;also it describes and analyzes the total amount of funds procured by the Global Fund,the types of procured health products,the main supply countries and their changing trends over time.Corresponding policy suggestions therefore are proposed for China to better participate in the governance of global health and for Chinese related companies to enter the international procurement market.

United Nations(UN)agencies are key actors in global procurement of health products,with the United Nations Children's Fund(UNICEF)currently accounting for the largest share of UN procurement expenditures.This study developed a conceptual framework to analyze the processes of UN's global procurement for health products.Based on this framework,the study analyzed the mechanisms and key characteristics of UN procurement practices,identified potential challenges faced by Chinese products and suppliers seeking to engage with the UN's global procurement.The findings indicate a steady increase in the volume of Chinese products procured and their alignment with the UN's sustainable procurement policies.However,Chinese suppliers still face notable barriers,including gaps in technical standards,bidding and contracting capacities,and price competitiveness.In addition,the strategic compliance capabilities of Chinese suppliers and products,such as the ability to offer strategically valuable products and build long-term partnership,remains limited.Based on this,the study recommends that China enhance its participation and influence in the UN health procurements by stabilizing the production capacity,promoting knowledge-sharing among suppliers to enhance their engagement capabilities,and improving the long-term strategic competitiveness of Chinese enterprises in the global market.

United Nations(UN)agencies are key actors in global procurement of health products,with the United Nations Children's Fund(UNICEF)currently accounting for the largest share of UN procurement expenditures.This study developed a conceptual framework to analyze the processes of UN's global procurement for health products.Based on this framework,the study analyzed the mechanisms and key characteristics of UN procurement practices,identified potential challenges faced by Chinese products and suppliers seeking to engage with the UN's global procurement.The findings indicate a steady increase in the volume of Chinese products procured and their alignment with the UN's sustainable procurement policies.However,Chinese suppliers still face notable barriers,including gaps in technical standards,bidding and contracting capacities,and price competitiveness.In addition,the strategic compliance capabilities of Chinese suppliers and products,such as the ability to offer strategically valuable products and build long-term partnership,remains limited.Based on this,the study recommends that China enhance its participation and influence in the UN health procurements by stabilizing the production capacity,promoting knowledge-sharing among suppliers to enhance their engagement capabilities,and improving the long-term strategic competitiveness of Chinese enterprises in the global market.

Global procurement of health products is an important way for multilateral organizations in the health field to perform their functions.As one of the most important multilateral organizations in the global health field today,the Global Fund to Fight AIDS,Tuberculosis and Malaria occupies a huge share of the global procurement market for health products.This article introduces in detail the procurement methods of the Global Fund and the quality standards of its procured products;also it describes and analyzes the total amount of funds procured by the Global Fund,the types of procured health products,the main supply countries and their changing trends over time.Corresponding policy suggestions therefore are proposed for China to better participate in the governance of global health and for Chinese related companies to enter the international procurement market.

Mesenchymal stem cells(MSCs)play a crucial role in tissue repair and regeneration,and the extracellular vesicle(EV)released by them holds great promise for applications in clinical biomarkers,vaccines,and drug delivery.However,MSCs-derived EV(MSCs-EV)face challenges such as low pro-duction yield,poor retention,and targeted delivery issues.There-fore,engineering MSCs-EV to enhance their performance and en-able visual research has become a hot topic.Curcumin(CUR),an active component in traditional chinese medicine,exhibits pharmacological effects but has limited bioavailability.Using MSCs-EV as a carrier for CUR delivery can address its solubility and bioavailability challenges.This article reviews the drug loading methods,engineering strategies of MSCs-EV,and their important applications in the delivery and treatment of CUR for cartilage injury diseases.It provides a basis for the clinical ap-plication of engineered MSCs-EV in CUR delivery for cartilage repair,offering potential solutions to the challenges in cartilage tissue repair.

Objective To explore the effect of nursing intervention based on the integrated theory of health behavior change(ITHBC)on the health behavior of patients with diabetes retinopathy(DR).Methods 157 patients with diabetes retinopathy admitted from July to December 2022 in a tertiary A hospital in Wuhan,Hubei Province,were selected as the experimental group by convenience sampling method,while 156 patients with diabetes retinopathy hospitalized from January to June 2022 were selected as the control group,and routine nursing was caried out.The disease cognition scale scores,self-management scale scores,and quality of life scale scores were compared between the 2 groups before and after 6 months of intervention.Results After 6 months of intervention,the disease cognition scale scores,self-management scale scores,and quality of life scale scores of both groups improved,and the results in the experimental group were better than these in the control group,and the difference is statistically significant(P＜0.05).Conclusion Nursing interventions based on the ITHBC theory can help improve the disease cognition of DR patients,establish and maintain healthy behaviors,improve their self-management level,and improve their quality of life.

Perihilar cholangiocarcinoma(PHC)is a common malignancy of biliary tract,for which surgery is the most effective treatment.However,its prognosis is not satisfactory even after surgical resection.In recent years,there have been some new advances in the surgical treatment of PHC.In this paper,we reviewed the existing literatures,demonstrated the current situation of preoperative biliary drainage,liver hyperplasia,hepatic resection,liver transplantation and minimally invasive surgery in the treatment of PHC,and prospected the future research direction.