Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Institute of Health and Nursing Science, Berlin, Germany
Qiangsheng Feng, Yuejuan Song, Yuan Xing, Julin Zhan, Tuanjie Che, Xu Heng, Xiliang Bin, Xiaoqin Ha
Listeria monocytogenes meningitis has high mortality. Evidence on meropenem’s real-world efficacy in Chinese adults is lacking. This retrospective study of 19 Listeria meningitis cases used CSF/blood culture and ROC analysis for diagnosis, and applied Fisher’s exact test to explore the association between meropenem treatment and mortality. In 19 patients with L. monocytogenes meningitis (median age 56 years, male/female 2.16:1), L. monocytogenes was the second most common cause (70.3% of Listeria infections). Underlying diseases were present in 10 patients, and MRI showed periventricular changes (9 cases), bifrontal lesions (2), hydrocephalus (1), and normal findings (4). Of 10 CSF-positive patients, 2 had concurrent positive blood cultures; mean time to blood culture positivity was 19.3 ± 9.3 h. All tested isolates were susceptible to ampicillin, penicillin, TMP-SMX (Trimethoprim-sulfamethoxazole), and meropenem. Serum PCT (AUC = 0.980), CSF WBC (AUC = 1.000), and CSF protein (AUC = 0.959) showed excellent diagnostic performance. In exploratory univariate analysis, Fisher’s exact test identified non-guideline antibiotic administration as the factor associated with mortality of mortality ( p = 0.035). Non-guideline antibiotic use (meropenem) was the factor associated with mortality of mortality in adult L. monocytogenes meningitis (40% mortality). First-line therapy should remain ampicillin/penicillin; meropenem should be reserved for alternative use only based on existing guidelines, not on the findings of this study alone.
Healthcare accessibility lies at the core of health equity; however, provincial-scale evidence on its spatial inequality and cross-county interactions remains limited, particularly in western China. We used a 2020 national 1 km grid accessibility dataset and aggregated scores to 183 county-level units. Equity was assessed using the coefficient of variation and Palma ratio across prefecture, county, and grid scales. Subsequently, we analyzed the spatial effects of accessibility using Moran’s index and a Spatial Durbin Model (SDM). Accessibility exhibited a significant east-high, west-low gradient distribution. Inequality intensified with finer spatial units: the coefficient of variation increased from 42.16% at the prefecture level to 77.23% at the county level, and reached 148.28% at the grid level. Significant positive spatial autocorrelation confirmed clustering patterns, and the SDM spatial lag parameter was significantly positive. Direct effects showed that GDP and road density enhanced county-level accessibility, while fiscal expenditure and altitude exerted negative effects; population size had no significant direct effect. Indirect effects presented a different picture: population size had a negative spillover on neighboring areas, whereas fiscal expenditure generated positive cross-county spillovers. These findings indicate that healthcare planning in western China cannot rely solely on administrative boundaries. To reduce accessibility disparities, policies should prioritize differentiated resource allocation, coordinate transport and medical infrastructure planning, and refine fiscal transfer mechanisms to leverage positive spatial spillovers.
Yuanyuan Jing, Ruiqing Cao, Dajun Yang, Yang Liu, Juan Zhang, Honggang Hui, Yu Yao, Yuanyuan Deng, Yuanping Zhang, Xiong Ke, Keyuan Ran, Muhammad Najib Mohamad Alwi
Bullying is a known risk factor for poor mental health in adolescents. Although bullying research has largely focused on adolescent populations, college students represent a distinct group warranting dedicated attention. They shoulder unique developmental tasks including academic competition and career preparation, and exhibit behavioral characteristics of frequent engagement with digital platforms. This study examined the prevalence of bullying and its associations with depression, anxiety, and post-traumatic stress disorder (PTSD). A cross-sectional survey was conducted among 1,120 students from August 18 to September 10, 2025. We recruited participants from a single college through class-based online channels using convenience sampling. Standardized scales assessed bullying experiences, anxiety, depression, PTSD symptoms, and psychological resilience. A total of 241(21.5%) students reported being bullied, and 101(9.0%) reported bullying others. Mann–Whitney U tests showed no significant effects of age and ethnicity on the four mental health indicators (all p > 0.05). Gender and family residence groups exhibited statistically significant differences in GAD-7 and PHQ-9 scores; additionally, family residence groups differed in CD-RISC-25 scores ( p < 0.05). Regression analyses indicated that traditional bullying victimization and cyberbullying victimization were significant factors associated with higher anxiety, depression and PTSD scores ( β range: 0.280–0.561, all p < 0.001). Traditional bullying victimization was also associated with lower psychological resilience ( β = −0.134, p = 0.009). The sensitivity analysis reveals that the inverse association observed between traditional bullying and certain indicators may be driven by suppression effects. The findings highlight the need for campus-based mental health screening, early identification of bullying involvement, and targeted bullying prevention initiatives among university students. Specifically, given that cyberbullying victimization showed a stronger association with PTSD symptoms compared to traditional bullying, trauma-focused interventions should be prioritized for cyberbullying victims to alleviate PTSD symptoms. In contrast, traditional bullying victims may benefit from resilience enhancement programs.
Reading-based psychological support is usually studied as clinical bibliotherapy, shared reading, or literacy-related intervention, and these strands are rarely followed across childhood, adolescence, and emerging adulthood. This perspective asks whether shared reading can become a source of self-narration. In childhood, reading with a responsive adult may support emotional language and meaning-making. During adolescence, some narrative resources may be selectively taken up and revised. In emerging adulthood, they may be used to organize transitions, commitments, and possible futures into an evolving life story. The account presents this as a developmental hypothesis rather than as evidence that childhood reading causes later narrative identity. Reading is treated as a complement to mental-health treatment, not as a substitute. The result is a set of empirical questions about mediation, developmental timing, relational quality, and contextual confounding.
