OBJECTIVE: To investigate the effect of psychological intervention based on the extension and expansion of positive psychology (PERMA) model on sexual psychological resilience (PR) and erectile function in patients with psychogenic erectile dysfunction (pED). METHODS: This prospective, single-blind, randomized controlled trial included 122 cases of pED diagnosed in our hospital from September 2023 to August 2024, which were equally divided into a trial and a control group, the former treated by PERMA-based psychological intervention in addition to drug therapy, while the latter by drug therapy only. After 2, 4 and 8 weeks of treatment, we obtained the scores of the patients on IIEF-5, Connor-DavidsonResilience Scale (CD-RISC), Self-Esteem and Sexual Relationship Satisfaction Scale (SESRS) and the quality of sexual life, and compared them between the two groups before and after intervention. RESULTS: At 2, 4 and 8 weeks after treatment, the IIEF-5 scores were significantly lower in the trial than in the control group (P<0.05). There were no statistically significant differences in the baseline scores on any dimensions of CD-RISC between the two groups, while after 8 weeks of treatment, the scores on personal abilities, stress resistance, control, mental influence and total CD-RISC scores were all remarkably higher in the trial group than in the control (P<0.05). No statistically significant differences were observed between the two groups before treatment either in the SESRS scores, or in the average number of effective erections, average duration of each erection and average erection hardness. After 8 weeks of treatment, the patients in the trial group, compared with the controls, showed marked increases in self-esteem, sexual relationship satisfaction and total SESRS scores, as well as in the average number of effective erections, average duration of each erection and average erection hardness (P<0.05). CONCLUSION For the treatment of pED, PERMA-based psychological intervention in addition to active medication contributes to elevating the psychological resilience and improving the erectile function of the patients.
Humans ; Male ; Erectile Dysfunction/therapy* ; Prospective Studies ; Single-Blind Method ; Quality of Life ; Psychology, Positive ; Self Concept ; Resilience, Psychological ; Adult ; Middle Aged ; Sexual Behavior ; Penile Erection

BACKGROUND: High levels of attention-deficit/hyperactivity disorder (ADHD) traits are associated with various outcomes, including depressive symptoms, functional impairment, and low self-esteem. Additionally, individuals with high levels of ADHD traits are reported to be more adversely affected by fear of coronavirus disease 2019 (COVID-19). The current study aimed to examine whether the association between ADHD traits and outcomes was partially mediated by fear of COVID-19 using mediation analysis. METHODS: A cross-sectional study was conducted in a sample of university students in medical-related faculties (n = 1,166). ADHD traits, fear of COVID-19, depressive symptoms, functional impairment, and self-esteem were assessed using the adult ADHD Self-Report Scale, Fear of COVID-19 Scale, K6 Scale, Sheehan Disability Scale, and Rosenberg Self-Esteem Scale, respectively. We used linear regression analysis and the Paramed command in Stata to analyze whether fear of COVID-19 mediated the association between ADHD traits and outcomes. RESULTS: ADHD traits were significantly associated with outcomes. Regarding the impact of fear of COVID-19, the results revealed a significant association between ADHD traits and fear of COVID-19, and between fear of COVID-19 and outcomes. The results of the mediation analyses showed that the association between ADHD traits and outcomes was partially mediated by the fear of COVID-19 (depressive symptoms: direct effect B = 1.029, 95% confidence interval [CI] 0.878, 1.181, indirect effect B = 0.021, 95% CI 0.002, 0.040; functional impairment: direct effect B = 0.786, 95% CI 0.593, 0.979, indirect effect B = 0.033, 95% CI 0.005, 0.060; self-esteem: direct effect B = -1.052, 95% CI -1.226, -0.878, indirect effect B = -0.024, 95% CI -0.046, -0.002). CONCLUSIONS Developing preventive measures against the adverse impacts of pandemics like COVID-19 will be particularly important for individuals with high levels of ADHD traits in future.
Humans ; COVID-19/psychology* ; Attention Deficit Disorder with Hyperactivity/epidemiology* ; Cross-Sectional Studies ; Self Concept ; Male ; Female ; Depression/epidemiology* ; Fear/psychology* ; Young Adult ; Universities ; Students/psychology* ; Adult ; SARS-CoV-2 ; Mediation Analysis ; Adolescent

Melioidosis is an infection caused by Burkholderia pseudomallei known to be endemic in large portions of Asia, Sub-Sahara, and North Australia. Despite its endemicity in Malaysia, prompt diagnosis and subsequent treatment remain elusive especially in the more peripheral medical centres. This coupled with increasing risk to the population because of worsening climate crises renders early recognition and treatment more justifiable than ever. Here we present a case of melioidosis septic arthritis with systemic dissemination and discuss the factors involved in disease contraction, worsening prevalence, and diagnostic methods.
Melioidosis ; Arthritis, Infectious ; mviN protein, Burkholderia pseudomallei [Supplementary Concept]

Insulin degludec/insulin aspart (IDegAsp) co-formulation provides both basal and mealtime glycaemic control in a single injection. The glucose level-lowering efficacy of IDegAsp is reported to be superior or non-inferior to that of the currently available insulin therapies with a lower rate of overall hypoglycaemia and nocturnal hypoglycaemia. An expert panel from Malaysia aims to provide insights into the utilisation of IDegAsp across a broad range of patients with type 2 diabetes mellitus (i.e. treatment-naïve or insulin-naïve patients or patients receiving treatment intensification from basal-only regimens, premixed insulin and basal–bolus insulin therapy). IDegAsp can be initiated as once-daily dosing for the main meal with the largest carbohydrate content with weekly dose adjustments based on patient response. A lower starting dose is recommended for patients with cardiac or renal comorbidities. Dose intensification with IDegAsp may warrant splitting into twice-daily dosing. IDegAsp twice-daily dosing does not need to be split at a 50:50 ratio but should be adjusted to match the carbohydrate content of meals. The treatment of patients choosing to fast during Ramadan should be switched to IDegAsp early before Ramadan, as a longer duration of titration leads to better glycated haemoglobin level reductions. The pre-Ramadan breakfast/lunch insulin dose can be reduced by 30%–50% and taken during sahur, while the pre-Ramadan dinner dose can be taken without any change during iftar. Education on the main meal concept is important, as carbohydrates are present in almost all meals. Patients should not have a misconception of consuming more carbohydrates while taking IDegAsp.
insulin degludec [Supplementary Concept] ; Insulin Aspart ; Glucose ; Hypoglycaemia ; Diabetes Mellitus, Type 2

The panoramic perception of medical equipment operation and maintenance status is the basic guarantee for the implementation of smart medical care, the machine learning algorithm-based autonomous perception and active early warning model of medical equipment operation and maintenance status is proposed. Introduce deep learning multi-dimensional perception of medical equipment multi-source heterogeneous fault data training sample characteristics to realize autonomous perception of medical equipment operation and maintenance status, introduce reinforcement learning to realize autonomous decision-making of test sample fault characteristics, and build the active early warning mechanism for medical equipment faults. Taking the equipment department of hospital as the carrier of model effectiveness verification, the effectiveness simulation of the model was carried out, the results show that the model has the advantages of comprehensive fault information perception, strong compatibility of medical equipment, high efficiency of active early warning.
Algorithms ; Computer Simulation ; Machine Learning ; Self Concept ; Surgical Equipment

OBJECTIVE: This study aims to explore factors affecting the dental aesthetic social psychology of patients with skeletal malocclusion and to measure the relationship between the objective orthodontic requirements and the subjective treatment requirements of patients. This work provides a reference for doctors to measure patients' orthodontic treatment needs. METHODS: Adult patients with skeletal malocclusion were chosen as the research object. Questionnaire survey was used to analyze factors influencing the psychosocial impact of dental aesthetics questionnaire (PIDAQ), index of orthodontic treatment need (IOTN), and Eysenck personality questionnaire-revised short scale for Chinese (EPQ-RSC). The relationship among PIDAQ, IOTN, EPQ-RSC, and treatment options was also evaluated. RESULTS: Seventy-two valid questionnaires were collected from adult patients with skeletal malocclusion. 1) The PIDAQ scores significantly differed among different occupations (P<0.05) but were not affected by other general conditions such as gender and age. 2) Patients of different dental health component (DHC) grade and ages had different AC self-assessment scores (P<0.01, P<0.05). The AC self-assessment score was positively correlated with the PIDAQ score (P<
0.05). 3) Males accounted for a higher proportion of patients who received treatment. Younger patients (18-28 years old) were more likely to receive treat-ment when their own dental aesthetics were poor. People with the higher monthly expenditure accounted for the larger proportion of surgical patients. 4) The PIDAQ score had no significant effects on the choice of opera-tion (P>0.05). People with low educational level were more likely to receive surgery if their psychosocial impacts of dental aes-thetics were serious. 5) The score of psychoticism scale of EPQ-RSC and the educa-tional level had a mutual influence on the PIDAQ score (P<0.01). Moreover, the neuroticism scale and AC self-assessment scores had a mutual influence on the PIDAQ score (P<0.05). However, this study did not find a correlation between personality traits and treatment options. CONCLUSIONS Many factors, such as personal natural conditions, subjective aesthetic evaluation of teeth, and psychosocial impacts of dental aesthetics, affect patients' treatment options. Personality characteristics can play a certain role in dental aesthetics social psychology.
Adolescent ; Adult ; Esthetics, Dental ; Humans ; Index of Orthodontic Treatment Need ; Male ; Malocclusion ; Psychology, Social ; Quality of Life ; Self Concept ; Surveys and Questionnaires ; Young Adult

PURPOSE: The purpose of this study was to define and clarify the concept of political competence for nurses.METHODS: A hybrid model method was used to investigate the dimensions, attributes, and definitions of the concept. In the theoretical stage of the study, literature on nursing, politics, and other discipline were reviewed. In the fieldwork stage, individual in-depth interviews and focus groups interviews were conducted with politically seasoned experts or activists who had an understanding of the concept of political competence for extensive descriptions in nursing and field of health care.RESULTS: The concept of political competence was represented in four dimensions as political knowledge, political efficacy, political interaction, and political activity. In the political knowledge dimension, there were three attributes, namely, political knowledge, political information and systematic analysis ability. The political efficacy dimension had three attributes of internal political efficacy, external political efficacy, and self-pride of nursing profession. The political interaction dimension had three attributes of organizations and community service, networking, and persuasive power. The political activity dimension had six attributes of political leadership, political expression, assertive behavior, political advocacy, political participation, and policy intervention.CONCLUSION: This concept development might provide a basic understanding of developing a measurement tool and for constructing a theory promoting nurses' political competence.
Concept Formation ; Delivery of Health Care ; Focus Groups ; Leadership ; Mental Competency ; Methods ; Nursing ; Politics ; Professional Competence ; Seasons ; Social Welfare

Background: In Malaysia, the prevalence of adolescents’ suicidal ideation has increased over the years. Therefore, it is crucial to investigate the predictors of suicidal ideation among adolescents. Hence, the aim of this study was to examine the predicting effects of depression and self-esteem on suicidal ideation among Malaysian adolescents. In addition, the relationships between depression, self-esteem, and adolescents’ suicidal ideation were explored as well. Methods: By using a multistage cluster sampling method, a cross-sectional study was conducted in secondary schools in Kuala Lumpur, Malaysia. The participants were comprised of 852 adolescents (51% males and 49% females) aged 13-17 years old who completed self-administered questionnaires. Pearson’s Correlation analysis was used to analyse the relationships among depression, self-esteem, and adolescents’ suicidal ideation, while Standard Multiple Regression analysis was used to examine the predicting effects of depression and self-esteem on adolescents’ suicidal ideation. Results: Depression had a positive correlation with adolescents’ suicidal ideation (r = .290, p < .001), while self-esteem had a negative correlation with adolescents’ suicidal ideation (r = -.283, p < .001). Results also showed that both depression (β = .200, p < .001) and self-esteem (β = -.186, p < .001) significantly predicted adolescents’ suicidal ideation. Conclusion The study found that depression is a risk factor, while self-esteem is a protective factor of adolescents’ suicidal ideation.
Adolescent ; Depression ; Self Concept ; Suicidal Ideation

Chondrosarcoma original from the zygomatic arch is a very rare disease with high malignancy. Surgery is the main means of treatment at present for duo to its poor sensitivity to radiochemotherapy. We reported a young patient who was recovery well in a 4-years follow-up without radiochemotherapy after a total resection of the tumor.
Bone Neoplasms ; Chemoradiotherapy ; Chondrosarcoma ; Humans ; Self Concept ; Zygoma

PURPOSE: The aim of this study was to examine the effect of self-assertive training applying the reality therapy techniques (SATART) on self-esteem and internalized stigma of schizophrenia patients. METHODS: This study was a non-equivalent control group pretest-posttest design and enrolled 55 people with schizophrenia (experimental group=27, control group=28) from two community mental health centers. The SATART was offered twice a week for 6 weeks in a total 12 sessions. Data were collected from February to April, 2017, using the Korean version of the Internalized Stigma of Mental Illness Scale and Rosenberg Self-Esteem Scale. The collected data was analyzed using χ2 test, independent t-test, one-way ANCOVA, and repeated measures ANOVA with using the SPSS/WIN 22.0 program. RESULTS: The experimental group showed significant improvements in self-esteem and recudction of internalized stigma compared to the control group. However, there was no significant improvement on stigma resistance measurement among the subscales of internalized stigma between two groups. CONCLUSION: The findings indicate that the SATART program is effective and could be recommended as a psychosocial intervention for self-esteem enhancement and internalized stigma reduction of people with schizophrenia.
Assertiveness ; Community Mental Health Centers ; Humans ; Reality Therapy ; Schizophrenia ; Self Concept ; Social Stigma