Utilization trend of prebiopsy multiparametric magnetic resonance imaging and its impact on prostate cancer detection: Real-world insights from a high-volume center in southwest China.

BACKGROUND: Data on the utilization and effects of prebiopsy prostate multiparametric magnetic resonance imaging (mpMRI) to support its routine use in real-world setting are still scarce. OBJECTIVE: To evaluate the change of clinical practice of prebiopsy mpMRI over time, and assess its diagnostic accuracy. DESIGN, SETTING, AND PARTICIPANTS: We retrospectively analyzed data from 6168 patients who underwent primary prostate biopsy (PBx) between January 2011 and December 2021 and had prostate-specific antigen (PSA) values ranging from 3 to 100 ng/mL. INTERVENTION: Prebiopsy MRI at the time of PBx. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: We performed general linear regression and to elucidate trends in the annual use of prebiopsy mpMRI and conducted multivariable logistic regression to evaluate the potential benefits of incorporating prebiopsy mpMRI for prostate cancer (PCa) detection. RESULTS AND LIMITATIONS: The utilization of prebiopsy mpMRI significantly increased from 9.2% in 2011 to 75.0% in 2021 (p < 0.001). In addition, prebiopsy mpMRI significantly reduced negative PBx by 8.6% while improving the detection of clinically significant PCa (csPCa) by 7.0%. Regression analysis showed that the utilization of prebiopsy mpMRI was significantly associated with a 48% (95% confidence interval [CI]: 1.19-1.84) and 36% (95% CI: 1.12-1.66) increased PCa detection rate in the PSA 3-10 ng/mL and 10-20 ng/mL groups, respectively; and a 34% increased csPCa detection rate in the PSA 10-20 ng/mL group (95% CI: 1.09-1.64). The retrospective design and the single center cohort constituted the limitations of this study. CONCLUSIONS: Our study demonstrated a notable rise in the utilization of prebiopsy mpMRI in the past decade. The adoption of this imaging technique was significantly associated with an increased probability of detecting prostate cancer. PATIENT SUMMARY: From 2011 to 2021, we demonstrated a steady increase in the utilization of prebiopsy mpMRI among biopsy-naïve men. We also confirmed the positive impact of prebiopsy mpMRI utilization on the detection of prostate cancer.

The Prognostic Value of Preoperative Naples Prognostic Score in Upper Tract Urothelial Carcinoma Patients after Radical Nephroureterectomy.

This study aims to determine the prognostic value of preoperative Naples prognostic score (NPS) on survival outcomes in upper tract urothelial carcinoma (UTUC) patients after radical nephroureterectomy (RNU). We conducted a retrospective study about UTUC patients at West China Hospital from January 2015 to June 2019. The X-Tile program was used to identify the optimal cutoff value of NPS. Overall survival (OS), cancer-specific survival (CSS) and progression-free survival (PFS) were the endpoints of interest. Kaplan-Meier curves were used to estimate survival and Cox proportional hazard model was used for risk assessment. A total of 237 UTUC patients after RNU were identified and the threshold of NPS was determined to be 2. Preoperative high-NPS was associated with inferior OS (p = 0.004), CSS (p = 0.002) and PFS (p = 0.008), especially in locally advanced UTUC patients. Preoperative NPS was an independent predictor for OS (HR: 1.78; 95% CI: 1.08, 2.93), CSS (HR: 1.87; 95% CI: 1.11, 3.14) and PFS (HR: 1.60; 95% CI: 1.02, 2.50). The addition of NPS into the predictive model consisting of predictors from multivariate Cox regression resulted in better prediction performance. Preoperative NPS was a novel and reliable predictor for survival in UTUC patients after RNU, and should be further explored.

The independent and combined effects of physical activity and depressive symptoms on frailty in community-dwelling older adults: A cross-sectional study.

AIMS: To investigate the independent and combined effects of physical activity (PA) and depressive symptoms on the risk of frailty in community-dwelling older adults. BACKGROUND: Older adults face a high risk of frailty which is commonly used to predict adverse health outcomes in older patients. Engaging in PA and without depressive symptoms are crucial factors to prevent frailty. It is essential to investigate the independent and combined effects of these two variables on the risk of frailty. METHODS: We included 3392 community-dwelling older adults. The FRAIL Scale was used to assess older adults' frail status (robust, prefrail and frail). Multiple logistic regression was utilized to examine the independent and combined effects of PA and depressive symptoms on the risk of prefrailty and frailty. The combined effects were visualized by marginal plots. RESULTS: The prevalence of prefrailty and frailty in older adults were 42.16% and 10.58%. Compared with the group of "Light physical activity and With depressive symptoms", "Vigorous physical activity and Without depressive symptoms" had the lowest risk of prefrailty and frailty. CONCLUSIONS: Older adults who do not engage in PA or have depressive symptoms increased the risk of frailty, but older adults with depressive symptoms could lower the risk of frailty through PA. RELEVANCE TO CLINICAL PRACTICE: It is effective to reduce the risk of frailty by directing older adults to do moderate physical activity, although they have depressive symptoms. The focus should also be on older adults with depressive symptoms, who have at least more than twice and fourfold risk of prefrailty and frailty compared to those without. IMPACT: This study offers insights for future interventions aimed at preventing frailty in older adults. REPORTING METHOD: This study adhered to the STROBE checklist. PATIENT OR PUBLIC CONTRIBUTIONS: Older adults participated in this study and completed questionnaires.

The prevalence and risk of developing major depression among individuals with subthreshold depression in the general population.

BACKGROUND: Subthreshold depression could be a significant precursor to and a risk factor for major depression. However, reliable estimates of the prevalence and its contribution to developing major depression under different terminologies depicting subthreshold depression have to be established. METHODS: By searching PubMed and Web of Science using predefined inclusion criteria, we included 1 129 969 individuals from 113 studies conducted. The prevalence estimates were calculated using the random effect model. The incidence risk ratio (IRR) was estimated by measuring the ratio of individuals with subthreshold depression who developed major depression compared to that of non-depressed individuals from 19 studies (88, 882 individuals). RESULTS: No significant difference in the prevalence among the different terminologies depicting subthreshold depression (Q = 1.96, p = 0.5801) was found. By pooling the prevalence estimates of subthreshold depression in 113 studies, we obtained a summary prevalence of 11.02% [95% confidence interval (CI) 9.78-12.33%]. The youth group had the highest prevalence (14.17%, 95% CI 8.82-20.55%), followed by the elderly group (12.95%, 95% CI 11.41-14.58%) and the adult group (8.92%, 95% CI 7.51-10.45%). Further analysis of 19 studies' incidence rates showed individuals with subthreshold depression had an increased risk of developing major depression (IRR = 2.95, 95% CI 2.33-3.73), and the term minor depression showed the highest IRR compared with other terms (IRR = 3.97, 95% CI 3.17-4.96). CONCLUSIONS: Depression could be a spectrum disorder, with subthreshold depression being a significant precursor to and a risk factor for major depression. Proactive management of subthreshold depression could be effective for managing the increasing prevalence of major depression.

Social Participation: A Strategy to Manage Depression in Disabled Populations.

This study aimed to investigate whether social participation (SP) can decrease depressive symptom severity in disabled older adults. A total of 5,937 disabled participants (4877, 1970, 219, and 8 participants responding 1, 2, 3, 4 times, respectively), obtained from the China Health and Retirement Longitudinal Study, were enrolled in our analysis. Based on pooled Ordinary Least Square regressions, SP was associated with decreased depressive symptom severity, and this association was significant in recreational activities and interacting with friends. For brain-disabled respondents, the association was not significant. SP is effective in decreasing depressive symptom severity in disabled older populations. Diversified activities and targeted interventions should be applied to specified older disabled populations to prevent depression.

Correlations between depressives symptom severity and social participation (SP) among disable older adults were measured in a Chinese context.Pooled Ordinary Least Square regression were used to explore the impact of SP on depressives symptom severity in older populations with disabilities.Social participation, including recreational activities and interacting with friends, was associated with decreased depressives symptom severity in disabled middle-aged and older adults.The impact of SP on depressives symptom severity was not significant for older adults with brain disabilities.

Association of sleep with mental health in Chinese high school students: a cross-sectional study.

Adolescents' sleep problems and their association with mental health is an important public health concern. This study aimed to investigate sleep and mental health status and the association of sleep with mental health in Chinese high school students. Data came from a cross-sectional study in Guangdong province which included 42,077 high school students. Sleep quality and sleep duration were obtained through self-report. The Depression Anxiety and Stress Scale (DASS-21) was used to measure mental health. The association between sleep quality, sleep duration, and mental health was analysed using logistic regression. The prevalence of depression, anxiety, and stress symptoms were 35.27%, 42.32%, and 21.87% in high school students, respectively. And only 17.71% and 34.41% of the high school students had very good sleep quality and ≥8 h sleep duration, respectively. Poorer sleep quality and shorter sleep duration were risk factors for mental health problems in high school students. Compared to high school students with very good sleep quality and ≥8 h sleep duration, the high school students with poor or very poor sleep quality and <6 h sleep duration had the highest risk of depression symptoms (odds ratio [OR] 5.02, 95% confidence interval [CI] 4.40-5.72), anxiety symptoms (OR 6.02, 95% CI5.25-6.89), and stress symptoms (OR 6.12, 95% CI5.30-7.06). Considering the combined association of sleep quality and sleep duration on mental health, it is important not only to ensure that high school students have sufficient sleep duration, but also to improve their sleep quality.

The association between health-promoting-lifestyles, and socioeconomic, family relationships, social support, health-related quality of life among older adults in china: a cross sectional study.

OBJECTIVES: Lifestyles, accounting for 53% in determining death, play a vital role in improving the health of older adults. Thus, this study aimed to explore the influencing factors of the health-promoting-lifestyles and interaction mechanisms among older adults. METHODS: A total of 8526 elders were selected by a three-stage stratified random cluster sampling method. Socioeconomic status, family relationships, social support, health-related quality of life (QOL), and health-promoting-lifestyles (HPLP) of older adults were assessed with the Social Support Rating Scale, the short form 36 health survey (SF-36) and Health-Promoting Lifestyle Profile. A structural equation model (SEM) was conducted to test the direct and indirect association between influencing factors with HPLP. RESULTS: In this study, there were 4901 older adults who were empty nesters, and 3625 were non-empty nesters. Of all respondents, the average QOL score of older adults was 62.28 ± 16.51, average social support score was 78.06 ± 7.50. The HPLP score of older adults was 105.9 ± 19.6, and the average score of subscales was 2.5 ± 0.5, which was at the medium level. Social support had a positive and direct effect on HPLP of older adults (total effect, 0.34). Meanwhile, social support mediated the relationship between socioeconomic (total effect, 0.17), QOL (total effect, 0.33) and HPLP. Family relationships had a small indirect effect on HPLP via social support (0.01). CONCLUSIONS: Social support is the strongest influencing factor in the health-promoting-lifestyles among older adults, followed by socioeconomic, health-related quality of life and family support. Thus, maintaining higher social support was important to improve the HPLP of older adults.

Associations between urinary concentrations of bisphenols and serum concentrations of sex hormones among US. Males.

BACKGROUND: Bisphenol A (BPA) exposure and its structural analogs (BPS and BPF) might cause endocrine alterations and adverse physiological effects. Few studies to date have directly explored the association between its structural analogs (BPS, BPF) and sex hormones in adult male participants. Therefore, we aimed to assess the associations between BPA, BPS, BPF, and sex hormones in American adult men. METHODS: We used data from the U.S. National Health and Nutrition Examination Survey 2011-2016. We excluded participants without data available on sex hormones and urinary bisphenols. Furthermore, participants consuming sex hormone medications were excluded. Multivariable regression models were performed to assess the association between bisphenols and sex hormones. RESULTS: In this study, 2367 participants were included. Of 2367, in 1575 participants, the data on BPS and BPF were available. We found that a per unit increase in BPF was associated with 0.575 ng/dL higher total testosterone (TT) (Model 2: 95% CI: 0.047, 1.103, P = 0.033). However, there was no significant association between BPA or BPS and TT. Furthermore, increased BPA and BPS levels were associated with higher levels of sex hormone-binding globulin (SHBG) (Model 2: ß = 0.364, 95% CI: 0.158, 0.571; ß = 0.25, 95% CI: 0.071, 0.429, respectively). Additionally, participants in the highest BPA exposure quartile (quartile 4) had 4.072 nmol/L higher levels of SHBG than those in quartile 1 (Model 2: 95% CI: 0.746, 7.397, P = 0.017; P for trend =0.005). Both BPA and BPS were negatively associated with free testosterone (FT, nmol/L) after full adjustment (Model 2, ß = - 0.01%, P = 0.0211, P = 0.0211; Model 2, ß = - 0.01%, P = 0.0258, respectively). However, BPF was positively associated with FT (Model 2, ß = 0.0029%, P = 0.0028). CONCLUSION: Our study indicated that exposure to both BPA and its substitutions could alter sex hormone levels. This finding supports the possibility that human exposure to bisphenols at environmental levels might affect the endogenous hormone balance.

The association between sleep quality and psychological distress among older Chinese adults: a moderated mediation model.

BACKGROUND: Previous research has found a link between sleep quality and psychological distress. However, the underlying mechanisms of this connection have still not been well explored. The aim of this study was to examine the roles of activities of daily living (ADL), physical activity, and perceived social support in the link between sleep quality and psychological distress among older adults. METHODS: Three thousand two hundred fifty valid individuals (aged 60 years or above) participated in face-to-face questionnaire-based surveys. Older individuals were assessed using the Pittsburgh Sleep Quality Index, Barthel Index, International Physical Activity Questionnaire, Perceived Social Support Scale, and Depression Anxiety Stress Scale-21. The PROCESS macro developed by Hayes was used to conduct moderated mediation analysis. RESULTS: In older adults, sleep quality had a substantial direct influence on psychological distress. ADL mediated the association between sleep quality and psychological distress. Physical activity significantly reduced ADL's mediating influence on the relationship between sleep quality and psychological distress. Furthermore, perceived social support moderated the direct relationship between sleep quality and psychological distress, as well as the second half of the mediating effect of the ADL. Moreover, physical activity and perceived social support were preventive factors that might successfully mitigate the detrimental effects of poor sleep quality on ADL and psychological distress. CONCLUSIONS: The findings contribute to existing understanding by clarifying the fundamental mechanisms that link sleep quality and psychological distress. These results may provide a valuable reference to the Chinese government for improving mental health in older individuals.

Association between Dietary Inflammatory Index and serum Klotho concentration among adults in the United States.

BACKGROUND: Klotho is a hormone that emerges as an antiaging biomarker. However, the influence of the dietary pattern's inflammatory potential on serum Klotho levels in human populations, especially in a general adult population, remains unknown. This study aimed to evaluate the relationship between the dietary inflammatory index (DII) and serum Klotho concentrations in individuals living in the United States.  METHODS : From the 2007-2016 National Health and Nutrition Examination Survey database, data of participants who completed the full 24-h dietary history and underwent serum Klotho testing were analyzed. The association between DII and serum Klotho concentrations was estimated using multivariable linear regression models. We also conducted segmented regression model to examine the threshold effect of DII on serum Klotho concentrations. RESULTS: A total of 10,928 participants were included, with a median serum Klotho concentration of 805.20 pg/mL (IQR: 657.58 - 1001.12) and a median DII of 1.43 (IQR: - 0.16 - 2.82). Multivariable regression showed that participants with high DII scores were associated with low serum Klotho concentrations; when classifying DII into quartiles, after full adjustment, participants in DII quartiles 3 and 4 showed a decrease in Klotho levels (25.27 and 12.44 pg/ml, respectively) compared with those in the lowest quartile (quartile 1) (95% CI: - 41.80, - 8.73 and - 29.83, 4.95, respectively; P for trend = 0.036). The segmented regression showed that the turning point value of DII was - 1.82 (95% CI: - 2.32, - 0.80). A 1-unit increase in DII was significantly associated with lower Klotho levels by - 33.05 (95% CI: - 52.84, - 13.27; P = 0.001) when DII ranges from - 5.18 to - 1.82; however, the relationship was not significant when DII ranges from - 1.82 to 5.42 (P > 0.05). Furthermore, stratified analyses indicated that the observed associations between DII and serum Klotho concentration were stronger among those aged ≥ 56 years, those with normal weight, and those without chronic kidney disease (P for interaction = 0.003, 0.015, and 0.041, respectively). CONCLUSIONS: In summary, we indicated that there was a dose-response relationship between DII and serum Klotho concentrations, suggesting that adhering to an anti-inflammatory diet has beneficial effects on aging and health by increasing the serum Klotho concentration.

Association between sleep quality and urolithiasis among general population in Western China: a cross-sectional study.

BACKGROUND: Growing number of studies have evidently shown that sleep disorders are associated with the recently increased risk of various diseases in general human population. However, the relationship between sleep quality and urolithiasis condition in humans is still unclear. The present study explored the relationship between quality of sleep and urolithiasis in Chinese population of population, western China and hence investigated the effects of sleep quality on urolithiasis disease. METHODS: A cross-sectional analysis was performed using data from the West China Natural Population Cohort Study (WCNPCS). The data was collected between May 2019 and June 2021. This study evaluated the association between the sleep quality and urolithiasis. The sleep quality was assessed using the Chinese version of the Pittsburgh Sleep Quality Index (PSQI) whereas urolithiasis, as the outcome was a binary variable. Multivariable logistic regression models that adjust the sociodemographic characteristics and health-related factors were used to assess the association between sleep quality and urolithiasis. Interaction was tested in prespecified subgroup of interest. RESULTS: After adjusting a series of confounding variables, the Pittsburgh Sleep Quality Index scores were found to have a significant positive correlation with the prevalence of urolithiasis (OR: 1.178; 95% CI = 1.083-1.282; p < 0.001). The risk of urolithiasis was significantly increased with an elevation of the component Pittsburgh Sleep Quality Index score in sleep latency, sleep duration, habitual sleep efficiency, and daytime dysfunction. CONCLUSIONS: It was evident that there is an association between sleep quality and prevalence of renal stones in natural population in western China regions. Poor sleep quality is related to urolithiasis. The findings of the current study hence highlighted the need for future public health guidelines to develop detailed strategies for improving sleep quality.

The impact of chronic diseases on psychological distress among the older adults: the mediating and moderating role of activities of daily living and perceived social support.

OBJECTIVES: Previous literature has shown that chronic diseases and psychological distress are correlated. However, the mediating and moderating mechanisms underlying this relationship have not been sufficiently studied. The purpose of this study was to explore the role played by activities of daily living (ADL) and perceived social support. METHOD: Face-to-face questionnaire-based surveys were conducted with 3250 valid participants (age ≥60 years). Participants were assessed using the Barthel Index, Perceived Social Support Scale, and Depression Anxiety Stress Scale-21. RESULTS: 1) Chronic diseases had a significant direct effect on psychological distress in older adults; 2) the relationship between chronic diseases and psychological distress was partially mediated by ADL; and 3) the impact of chronic diseases on psychological distress was significantly moderated by perceived social support. More importantly, perceived social support was a protective factor that could effectively alleviate the adverse effects of chronic diseases on psychological distress. CONCLUSION: The results add to the existing literature by uncovering the underlying mechanisms between chronic diseases and mental health. These findings have implications for early intervention and prevention of mental health problems in older adults.

The impact of psychological capital on turnover intention among Chinese nurses: A moderated mediation model.

AIMS: This study examined how the mediating effect of psychological distress and the moderating role of social support influence the connection between psychological capital and turnover intention among Chinese nurses. BACKGROUND: Nurses play a crucial role in medical and health services, but turnover intentions are common among them. METHODS: A cross-sectional survey was conducted involving 4865 nurses in China. The Chinese Psychological Capital Questionnaire, Depression, Anxiety and Stress Scale, Social Support Rating Scale, and Turnover Intention Scale were used to gather data. Bootstrap and simple slope methods were used to test the mediating effect of psychological distress and the moderating effect of social support. RESULTS: Psychological capital had a significant direct impact on turnover intention among nurses (B = -0.040, t = -10.032, p < .001). Psychological distress had a mediation effect of 46.89% between psychological capital and turnover intention. Moreover, social support had a moderating role in the relationship between psychological distress and psychological capital and between psychological distress and turnover intention. CONCLUSIONS: Psychological capital correlated negatively with psychological distress and turnover intention and indirectly influenced turnover intention through psychological distress. Social support moderated the first and second half of the path in the mediating model of psychological distress. These findings have implications for early intervention for and the prevention of turnover intention in nurses. IMPLICATIONS FOR NURSING MANAGEMENT: This study's findings can inform the design of effective nurse support programmes to reduce the impact of psychological distress on turnover intention among nurses.

Impact of occupational exposure on job satisfaction and overall happiness among Chinese physicians and nurses: A cross-sectional study.

AIMS: This study aims to investigate the impact of occupational exposure on job satisfaction and overall happiness and to identify related factors of job satisfaction and overall happiness among physicians and nurses. BACKGROUND: Occupational exposure against physicians and nurses has become one of the most serious public health issues worldwide. METHODS: A cross-sectional study was conducted among physicians and nurses from 14 public tertiary hospitals using purposive sampling. Propensity score matching was used to compare job satisfaction and overall happiness among physicians and nurses with and without occupational exposure. Furthermore, binary logistic regression analysis was used to identify and analyse the influencing factors of job satisfaction and overall happiness. RESULTS: A total of 2139 physicians and nurses (55.59%) from 3791 participants had experienced occupational exposure hazards. Before matching, the job satisfaction and overall happiness among the physicians and nurses were 38.54% and 42.14%, respectively. Participants who experienced occupational exposure were more likely to develop job dissatisfaction (OR = 1.08, 95% confidence interval [CI]: 0.90-1.28) and overall unhappiness (OR = 1.24, 95% CI: 1.05-1.46) than those who did not. Participants' work experience, self-evaluated health status, satisfaction with the work environment, evaluation of doctor-patient relationship and stress were common factors affecting job satisfaction and overall happiness. CONCLUSIONS: Our findings suggest that physicians and nurses who experience occupational exposure are more likely to develop job dissatisfaction and overall unhappiness, especially if they have shorter work experience and a tense or neutral relationship with patients. IMPLICATIONS FOR NURSING MANAGEMENT: It is necessary to pay attention to the occupational exposure. When physicians and nurses experience occupational exposure, managers could provide support to prevent job dissatisfaction and unhappiness.

The Association between Dietary Inflammatory Index and Sex Hormones among Men in the United States.

PURPOSE: This study investigated the association between Dietary Inflammatory Index and sex hormones in a large, nationally representative adult male sample. MATERIALS AND METHODS: We utilized data from the 2013-2014 and 2015-2016 National Health and Nutrition Examination Survey. Males aged ≥20 years who provided a 24-hour dietary intake history and underwent serum sex hormone testing were included in analysis. Weighted proportions and multivariable analysis controlling for age, race, energy, smoking status, education level, body mass index and time of venipuncture were used to evaluate the associations between Dietary Inflammatory Index and sex hormones. RESULTS: For 4,151 participants, Dietary Inflammatory Index ranged from -5.05 to 5.48. Mean±SD total testosterone was 419.30±176.27 ng/dl. Mean±SD total testosterone was lower among men in the highest tertile compared with men in the lowest tertile group (410.42±171.97 vs 422.71±175.69, p <0.001). A per unit increase in Dietary Inflammatory Index was related to 4.0% (95% CI 0.5-7.6) higher odds of testosterone deficiency. In the fully adjusted multivariable model, males in Dietary Inflammatory Index tertile 3 (the most pro-inflammatory) had 29.6% (3.1-63.0) higher odds of testosterone deficiency than those in tertile 1 (p trend=0.025). Interaction tests revealed no significant effect of body mass index on the association of Dietary Inflammatory Index with testosterone deficiency and all sex hormone parameters. CONCLUSIONS: Men adhering to a more pro-inflammatory diet appear to have a higher risk of testosterone deficiency, indicating the important role of diet in male reproductive health.

Anomalous static and dynamic functional connectivity of amygdala subregions in individuals with high trait anxiety.

BACKGROUND: Trait anxiety is considered a susceptible factor for stress-related disorders, and is characterized by abnormal brain activity and connectivity in the regions related to emotional processing (e.g., the amygdala). However, only a few studies have examined the static and dynamic changes of functional connectivity in trait anxiety. METHOD: We compared the resting-state static and dynamic functional connectivity (sFC/dFC) in individuals with high trait anxiety (HTA, n = 257) and low trait anxiety (LTA, n = 264) using bilateral amygdala subregions as the seeds, that is, the centromedial amygdala (CMA), basolateral amygdala (BLA), and superficial amygdala (SFA). RESULTS: The CMA, BLA, and SFA all showed reduced sFC with the executive control network (ECN) and anomalous dFC with the default mode network (DMN) in individuals with HTA. The CMA only showed reduced sFC with the ECN and reduced dFC with the DMN in individuals with HTA. The BLA showed reduced sFC with the salience network (mainly in the anterior and median cingulate), and increased dFC between the BLA and the DMN in individuals with HTA compared to those with LTA. Notably, HTA showed widespread anomalous functional connectivity in the SFA, including the visual network, mainly in the calcarine fissure, limbic system (olfactory cortex), and basal ganglia (putamen). CONCLUSION: The anomalous sFC and dFC in individuals with HTA may reflect altered mechanisms in prefrontal control, salient stimuli processing, and amygdaloidal responsivity to potential threats, leading to alterations in associative, attentional, interpretative, and regulating processes that sustain a threat-related processing bias in HTA individuals.

Exploring the influencing factors of quality of life among the empty nesters in Shanxi, China: a structural equation model.

BACKGROUND: As China's aging trend intensifies and the proportion of empty nests increases, the health-related quality of life of the elderly is the focus of social attention. Previous studies focused on the quality of life of the elderly, rather than empty nesters, and lacked the discussion of the mechanism of influencing factors. Thus, this study aimed to explore the influencing factors of the quality of life (QOL) and interaction mechanisms among empty nesters in Shanxi Province, China, so as to provide practical reference for improving the QOL of empty nesters. METHODS: A total of 4901 empty nesters in Shanxi Province, China, were selected using multi-stage random cluster sampling method in this cross-sectional study. The quality of life was assessed with the Short Form 36 Health Survey (SF-36). Multiple linear regression analysis (stepwise) was performed to examine the factor associated with QOL. Structural equation model (SEM) approach was conducted to test the direct and indirect association between QOL influencing factors with QOL. RESULTS: The average QOL score of empty nesters was 63.34 (SD = 17.23). The multiple linear regression revealed that gender, age, education, monthly income, drinking status, exercise frequency, physical examination frequency, attention to daily nutritional health, relationship with a spouse and relationship with children were significant predictors of the empty nester's QOL (P < 0.05) (R2 = 0.128). SEM showed that behavioral lifestyle had a direct effect on QOL (ß = 0.446, P < 0.001). Socio-economic status had an indirect effect (ß = 0.288, P < 0.001) on QOL through behavioral lifestyle. The family relationship had an indirect effect (ß = 0.115, P < 0.001) on QOL. CONCLUSION: Behavioral lifestyle was the strongest influencing factor in the quality of life among empty nesters, followed by socio-economic status and family relationships. Thus, maintaining a healthy behavioral lifestyle was important to improve the QOL of the empty nesters. Our findings provide a concrete and strong reference for the formulation of targeted intervention strategies.

Association between Dietary Inflammatory Index and kidney stones in US adults: data from the National Health and Nutrition Examination Survey (NHANES) 2007-2016.

OBJECTIVE: We evaluate the association between the Dietary Inflammatory Index (DII) and kidney stones. DESIGN: We performed a cross-sectional analysis using data from National Health and Nutrition Examination Survey (NHANES). Dietary intake information was assessed using first 24-h dietary recall interviews, and the Kidney Conditions were presented by a questionnaire. The primary outcome was to investigate the association between DII and incidence of kidney stones, and the secondary outcome was to assess the association between DII and nephrolithiasis recurrence. SETTING: The NHANES, 2007-2016. PARTICIPANTS: The study included 25 984 NHANES participants, whose data on DII and kidney stones were available, of whom 2439 reported a history of kidney stones. RESULTS: For the primary outcome, after fully multivariate adjustment, DII score is positively associated with the risk of kidney stones (OR = 1·07; 95 % CI 1·04, 1·10). Then, compared Q4 with Q1, a significant 38 % increased likelihood of nephrolithiasis was observed. (OR = 1·38; 95 % CI 1·19, 1·60). For the secondary outcome, the multivariate regression analysis showed that DII score is positively correlated with nephrolithiasis recurrence (OR = 1·07; 95 % CI 1·00, 1·15). The results noted that higher DII scores (Q3 and Q4) are positively associated with a significant 48 % and 61 % increased risk of nephrolithiasis recurrence compared with the reference after fully multivariate adjustment (OR = 1·48; 95 % CI 1·07, 2·05; OR = 1·61; 95 % CI 1·12, 2·31). CONCLUSIONS: Our findings revealed that increased intake of pro-inflammatory diet, as a higher DII score, is correlated with increased odds of kidney stones incidence and recurrence.

Efficacy of the self-mutual-group model targeting quality of life improvement among empty-nest older adults in Taiyuan, China: an intervention study.

BACKGROUND: In China, more and more older people have encountered a situation called "empty nest." Meanwhile, the health status of empty-nest older adults is an increasing public health concern. This research aims to examine the effectiveness of Self-Mutual-Group (SMG) model in improving quality of life of the empty-nest older adults to provide a scientific evidence for improving their health. METHODS: A prospective intervention study was conducted among empty-nest older adults in Taiyuan, Shanxi. Multi-stage stratified random cluster sampling was employed to selected participants. A total of 396 empty nesters were enrolled as participants, of which 204 and 192 were in the intervention and control group, respectively. The intervention group received a seven-month SMG-based intervention. A participant's quality of life was measured at the baseline and seven months after using the Short Form 36-Item Health Survey (SF-36). RESULTS: No significant difference was found between the intervention and control groups in terms of participant characteristics at baseline (P > 0.05). After the intervention, participants' scores on Mental Component Summary (MCS), Physical Component Summary (PCS), role emotional (RE), vitality (VT), social function (SF), mental health (MH) and general health (GH) increased significantly in the intervention group. Additionally, these scores differed significantly from those in the control group (P < 0.05). CONCLUSION: This study showed that the SMG-based health management is effective in improving quality of life among empty-nest older adults after seven months. TRIAL REGISTRATION: Study on the 'SMG' Health Management Model Based on Community Organization Theory among empty-nest older adults ( ChiCTR1800015884 ). Registration date: 26-04-2018. Retrospectively registered.

Diagnostic Role of Magnetic Resonance Imaging-Targeted Biopsy for Prostate Cancer in Biopsy-Naïve Men: A Meta-Analysis.

OBJECTIVE: To investigate the diagnostic role of magnetic resonance imaging (MRI)-targeted biopsy (TB) for prostate cancer (PCa) in biopsy-naïve men. MATERIALS AND METHODS: Own control studies and randomized controlled trials (RCTs) up to December 2018 were identified via a systematic search of PubMed, Embase, Ovid, and the Cochrane Library. We pooled relative sensitivity (or risk ratio [RR]) to compare diagnostic efficiency for PCa and clinically significant PCa (csPCa) between TB and systematic biopsy (SB). The independent role of either biopsy pathway was evaluated for participants with positive/negative MRI. RESULTS: Thirty-one studies consisting of 25 own control studies and 6 RCTs were included. We identified 4,020 biopsy-naïve men with positive MRI who underwent two biopsies concurrently, with PCa/csPCa detection rates of 65.90 and 45.13%, respectively. TB and SB did not differ in the detection of any PCa (RR 0.98, 95% confidence interval [CI] 0.92-1.05). However, TB detected more csPCa (RR 1.19, 95% CI 1.10-1.30) and more PCa with a Gleason score ≥3+4 (RR 1.20, 95% CI 1.07-1.34). Using a combined test as a reference, omitting SB resulted in detecting 12.81% less csPCa and 20.76% less clinically insignificant PCa (cinsPCa), and omitting TB resulted in detecting 25.69% less csPCa and 10.8% more cinsPCa. For patients with negative MRI, omitting SB led to underdetection of 30.29% of any PCa (10.9% of csPCa). CONCLUSIONS: Combining TB and SB increased the diagnostic accuracy of csPCa for biopsy-naïve men with positive MRI, and omitting SB for patients with a negative MRI would lead to the underdetection of nearly 10% of csPCa.