The Effect of Chronotype on Risk-Taking Behavior: The Chain Mediation Role of Self-Control and Emotional Stability

Background: Although previous studies indicate that chronotype might be associated with risk-taking behavior, the specific mechanism has not been thoroughly discussed. This study aimed to fill this gap by exploring the mediating role of self-control and the chain mediating role of self-control and emotional stability between chronotype and risk-taking behavior. Methods: A total of 547 Chinese college students between 18 and 24 years old were selected to complete the Morningness–Eveningness Questionnaire (MEQ), Self-Control Scale (SCS), Eysenck’s Personality Questionnaire-neuroticism (EPQ-N), and Adolescent Risk-Taking Questionnaire: Risk Behavior Scale (ARQ-RB) to assess chronotype, risk-taking behavior, self-control, and emotional stability, respectively. Hayes’ PROCESS macro for SPSS was used to test the relationships among these variables. Results: Our result showed significant positive correlations among chronotype, self-control, emotional stability, and significant negative correlations between self-control, emotional stability, and risk-taking behavior. We also found that chronotype had a significant predictive effect on risk-taking behavior in the chain mediation model. Specifically, chronotype affected risk-taking behavior through two pathways: the separate mediating role of self-control and the serial mediation pathway of self-control → emotional stability. Conclusions: Our study provides direct evidence that chronotype is associated with risk-taking behavior. The results showed that the predictive function of chronotype was mediated by self-control and emotional stability. This study provides a new perspective on preventing and reducing risk-taking behavior

Hepatopancreatoduodenectomy for advanced biliary malignancies

Abstract. Background:. Hepatopancreatoduodenectomy (HPD) has been considered the only curative treatment for metastatic cholangiocarcinoma and some locally advanced gallbladder cancers (GBCs). However, HPD has not yet been included in treatment guidelines as a standard surgical procedure in consideration of its morbidity and mortality rates. The aim of this study was to evaluate the safety and effectiveness of HPD in treating biliary malignancies. Methods:. The medical records of 57 patients with advanced biliary cancer undergoing HPD from January 2009 to December 2019 were retrospectively retrieved. A case-control analysis was conducted at our department. Patients with advanced GBC who underwent HPD (HPD-GBC group) were compared with a control group (None-HPD-GBC group). Baseline characteristics, preoperative treatments, tumor pathologic features, operative results, and prognosis were assessed. Results:. Thirteen patients with cholangiocarcinoma and 44 patients with GBC underwent HPD at our department. Significant postoperative complications (grade III or greater) and postoperative pancreatic fistula were observed in 24 (42.1%) and 15 (26.3%) patients, respectively. One postoperative death occurred in the present study. Overall survival (OS) was longer in patients with advanced cholangiocarcinoma than in those with GBC (median survival time [MST], 31 months vs. 11 months; P < 0.001). In the subgroup analysis of patients with advanced GBC, multivariate analysis demonstrated that T4 stage tumors (P = 0.012), N2 tumors (P = 0.001), and positive margin status (P = 0.004) were independently associated with poorer OS. Patients with either one or more prognostic factors exhibited a shorter MST than patients without those prognostic factors (P < 0.001). Conclusion:. HPD could be performed with a relatively low mortality rate and an acceptable morbidity rate in an experienced high- volume center. For patients with advanced GBC without an N2 or T4 tumor, HPD can be a preferable treatment option