Roles of serum uric acid on the association between arsenic exposure and incident metabolic syndrome in an older Chinese population.

Growing evidences showed that heavy metals exposure may be associated with metabolic diseases. Nevertheless, the mechanism underlying arsenic (As) exposure and metabolic syndrome (MetS) risk has not been fully elucidated. So we aimed to prospectively investigate the role of serum uric acid (SUA) on the association between blood As exposure and incident MetS. A sample of 1045 older participants in a community in China was analyzed. We determined As at baseline and SUA concentration at follow-up in the Yiwu Elderly Cohort. MetS events were defined according to the criteria of the International Diabetes Federation (IDF). Generalized linear model with log-binominal regression model was applied to estimate the association of As with incident MetS. To investigate the role of SUA in the association between As and MetS, a mediation analysis was conducted. In the fully adjusted log-binominal model, per interquartile range increment of As, the risk of MetS increased 1.25-fold. Compared with the lowest quartile of As, the adjusted relative risk (RR) of MetS in the highest quartile was 1.42 (95% confidence interval, CI: 1.03, 2.00). Additionally, blood As was positively associated with SUA, while SUA had significant association with MetS risk. Further mediation analysis demonstrated that the association of As and MetS risk was mediated by SUA, with the proportion of 15.7%. Our study found higher As was remarkably associated with the elevated risk of MetS in the Chinese older adults population. Mediation analysis indicated that SUA might be a mediator in the association between As exposure and MetS.

The association of isocarbophos and isofenphos with different types of glucose metabolism: The role of inflammatory cells.

To investigate the associations between isocarbophos and isofenphos with impaired fasting glucose (IFG) and type 2 diabetes mellitus (T2DM), and to assess the mediation roles of inflammation cells. There were 2701 participants in the case-control study, including 896 patients with T2DM, 900 patients with IFG, 905 subjects with NGT. Plasma isocarbophos and isofenphos concentrations were measured using gas chromatography and triple quadrupole tandem mass spectrometry. Generalized linear models were used to calculate the relationships between plasma isofenphos and isocarbophos levels with inflammatory factor levels and T2DM. Inflammatory cell was used as mediators to estimate the mediating effects on the above associations. Isocarbophos and isofenphos were positively related with T2DM after adjusting for other factors. The odds ratio (95% confidence interval) (OR (95%CI)) for T2DM was 1.041 (1.015, 1.068) and for IFG was 1.066 (1.009, 1.127) per unit rise in ln-isocarbophos. The prevalence of T2DM increased by 6.4% for every 1 unit more of ln-isofenphos (OR (95% CI): 1.064 (1.041, 1.087)). Additionally, a 100% rise in ln-isocarbophos was linked to 3.3% higher ln-HOMA2IR and a 0.029 mmol/L higher glycosylated hemoglobin (HbA1c) (95% CI: 0.007, 0.051). While a 100% rise in ln-isofenphos was linked to increase in ln-HOMA2 and ln-HOMA2IR of 5.8% and 3.4%, respectively. Furthermore, white blood cell (WBC) and neutrophilic (NE) were found to be mediators in the relationship between isocarbophos and T2DM, and the corresponding proportions were 17.12% and 17.67%, respectively. Isofenphos and isocarbophos are associated with IFG and T2DM in the rural Chinese population, WBC and NE have a significant role in this relationship.

Rapid antiretroviral therapy and treatment outcomes among people living with HIV: exploring the mediating roles of medication adherence.

Introduction: The rapid initiation of antiretroviral therapy (ART) and its impact on treatment outcomes have been a subject of global public health interest. However, the precise mechanisms underlying the effects of rapid ART initiation remain unclear. Methods: This retrospective cohort study examined data from 1846 HIV-infected individuals in Jiulongpo District, Chongqing, China, spanning from 2016 to 2022. Logistic regression models and serial mediation analysis were used to explore the influence of rapid ART initiation on treatment outcomes and the role of medication adherence as a mediating factor. Results: The findings revealed a significant association between rapid ART initiation and reduced risk of viral failure (adjusted odds ratio [OR] = 0.320, 95% confidence interval [CI] = [0.161, 0.637]), as well as an increased likelihood of improved adherence (adjusted OR = 2.053, 95% CI = [1.226, 3.438]). Medication adherence was identified as a partial mediator in the relationship between rapid ART initiation and viral failure, explaining 10.5% of the total effect. Discussion: In conclusion,rapid initiation of antiretroviral therapy was found to enhance treatment outcomes, emphasizing the importance of early adherence education. The study recommends early initiation of ART coupled with adherence education and psychological counseling for HIV-infected individuals.

The impact of verbal behavior on audience engagement in Chinese talk shows: Based on a novel mediation model.

This study employs the Stimulus-Organism-Response (SOR) model to construct a new mediation framework, examining the impact of Chinese stand-up comedians' language on audience engagement from both quantitative and qualitative perspectives. Statistical analysis of data from 415 online viewers of stand-up comedy shows revealed that comedians' humorous language significantly enhanced audience engagement by positively influencing their enjoyment. Based on this, in-depth interviews were conducted with 8 viewers to understand their specific perceptions of different types of humor. The analysis results showed that Chinese audiences had a higher acceptance of affiliative humor, self-deprecating humor, and humor incorporating traditional cultural elements, while they had lower acceptance or even rejection of aggressive humor, political satire, and vulgar humor. This study enriches the research on the relationship between Chinese stand-up comedy shows and audience engagement, providing insights for improving the production of Chinese stand-up comedy shows and for Western entertainment programs entering the Chinese market.

Speeding up interval estimation for R2-based mediation effect of high-dimensional mediators via cross-fitting.

Mediation analysis is a useful tool in investigating how molecular phenotypes such as gene expression mediate the effect of exposure on health outcomes. However, commonly used mean-based total mediation effect measures may suffer from cancellation of component-wise mediation effects in opposite directions in the presence of high-dimensional omics mediators. To overcome this limitation, we recently proposed a variance-based R-squared total mediation effect measure that relies on the computationally intensive nonparametric bootstrap for confidence interval estimation. In the work described herein, we formulated a more efficient two-stage, cross-fitted estimation procedure for the R2 measure. To avoid potential bias, we performed iterative Sure Independence Screening (iSIS) in two subsamples to exclude the non-mediators, followed by ordinary least squares regressions for the variance estimation. We then constructed confidence intervals based on the newly derived closed-form asymptotic distribution of the R2 measure. Extensive simulation studies demonstrated that this proposed procedure is much more computationally efficient than the resampling-based method, with comparable coverage probability. Furthermore, when applied to the Framingham Heart Study, the proposed method replicated the established finding of gene expression mediating age-related variation in systolic blood pressure and identified the role of gene expression profiles in the relationship between sex and high-density lipoprotein cholesterol level. The proposed estimation procedure is implemented in R package CFR2M.

The mediating role of insulin resistance in the association between inflammatory score and MAFLD: NHANES 2017-2018.

BACKGROUND: The association between inflammatory score, insulin resistance (IR), and metabolic-associated fatty liver disease (MAFLD) is inconclusive. OBJECTIVE: The objective of this study was to examine the relationship between the inflammatory score and MAFLD and investigate the potential mediating effect of IR (evaluated by triglyceride-glucose index) in this association. METHODS: Calculating inflammatory score was performed based on white blood cells and high-sensitivity C-reactive protein. The association between the inflammatory score and MAFLD was evaluated based on the weighted multifactor logistic regression model. Restricted cubic splines (RCS) were used to visualize the dose-response relationship between the inflammatory score and MAFLD. We also conducted a mediation analysis to assess the extent to which IR mediates this association. RESULTS: Among the 1090 participants, 563 were ultimately diagnosed with MAFLD. Multivariate logistic regression results indicated a close positive association between inflammatory score and MAFLD (odds ratio = 1.235, 95% confidence interval 1.069-1.427, p = .007). The RCS results indicated a linear dose-response relationship between the inflammatory score and the risk of MAFLD after adjusting for potential confounding factors. Furthermore, the mediation analysis results showed that IR partially mediated the association between the inflammatory score and MAFLD (percent mediation = 33%). CONCLUSION: Our research results indicate that the inflammatory score is positively associated with the risk of MAFLD, and IR plays a partial mediating effect in this association.

The negative association between sodium-driven nutrient pattern and telomere length: the chain mediating role of diastolic pressure and waist circumference.

BACKGROUND: Numerous single nutrients have been suggested to be linked with leukocyte telomere length (LTL). However, data on nutrient patterns (NPs), particularly in Chinese population, are scarce. This study aimed to examine the relationship between nutrient-based dietary patterns and LTL, and the potential role of metabolic factors. METHODS: Dietary data was obtained via 24-hour food recalls, and principal component analysis (PCA) was used to identify NPs. LTL was assessed using a real-time PCR assay. Multiple linear regression was conducted to determine the association between NPs and LTL. The potential role of metabolism among them was analyzed using mediation models. RESULTS: A total of 779 individuals from northern China were included in this cross-sectional analysis. Five main nutrient patterns were identified. Adjusted linear regression showed that the "high sodium" pattern was inversely associated with LTL (B=-0.481(-0.549, -0.413), P < 0.05). The "high vitamin E-fat" pattern exhibited a positive correlation (B = 0.099(0.029, 0.170), P < 0.05), whereas the "high vitamin A-vitamin B2" pattern was negatively correlated with LTL (B=-0.120(-0.183, -0.057), P < 0.05), respectively. No significant associations were observed for the remaining nutrient patterns. The mediation model demonstrated that diastolic blood pressure and waist circumference could individually and collectively mediate the negative impact of the "high sodium" pattern on LTL (BDBP=-0.0173(-0.0333, -0.0041), BWC=-0.0075(-0.0186, -0.0004), Bjoint=-0.0033 (-0.0072, -0.0006), all P < 0.05). Moreover, glycosylated hemoglobin and non-high-density lipoprotein cholesterol mediate the relationship between the "high vitamin E-fat" pattern and LTL (BHbA1c=0.0170(0.0010,0.0347), Bnon-HDL-C= 0.0335 (0.0067, 0.0626), all P < 0.05), respectively. CONCLUSIONS: The "high sodium" and "high vitamin E-fat" nutrient patterns demonstrated negative and positive associations with LTL and metabolic indicators may play complex mediating roles in these relationships.

The relationship between physical activity and mental health of middle school students: the chain mediating role of negative emotions and self-efficacy.

Objective: To explore the relationship between mental health and physical activity (PA) in middle school students, and examining the roles of negative emotions and self-efficacy in the relationship. Methods: Data from 1,134 Chinese middle school students (50.2% females, 49.8% males; M age = 15.18, SDage = 2.00) were collected using the Physical Activity Rating Scale (PARS-3), Positive and Negative Affect Scale (PANAS), General Self-Efficacy Scale (GSES), and Middle School Student Mental Health Scale (MSSMHS). Results: (1) There is a significant positive correlation between PA and mental health (r = 0.16, p < 0.01), and the direct path of PA on mental health is significant (t = 2.101, p < 0.01). (2) PA negatively predicts negative emotions (r = -0.12, p < 0.01), and is significantly positively correlated with self-efficacy (r = 0.24, p < 0.01). Negative emotions negatively predict self-efficacy (r = -0.23, p < 0.01) and mental health (r = -0.67, p < 0.01). Self-efficacy positively predicts mental health (r = 0.30, p < 0.01). (3) Negative emotions and self-efficacy play a significant mediating role between PA and mental health. The mediating effect includes three paths: PA → negative emotion → mental health (effect value: 0.130); PA → self-efficacy → mental health (effect size: 0.052); PA → negative emotions → self-efficacy → mental health (effect size: 0.006). Conclusion: PA among middle school students can indirectly affect mental health through negative emotions and self-efficacy. Middle school students should be encouraged to participate in PA to reduce their negative emotions and increase their self-efficacy, thus improving their mental health.

The impact of metals on cognitive impairment in the elderly and the mediating role of oxidative stress: A cross-sectional study in Shanghai, China.

Cognitive impairment (CI) is a prodrome of many neurodegenerative diseases with complex and unclear pathogenesis. Metal exposure has been found to be associated with CI, but existing population studies are scarce and have the limitations of single outcome and ignoring mixed exposures. This cross-sectional study was conducted in Shanghai, China, enrolling 836 seniors aged over 60 years to investigate the relationship between combined metal exposure (Lead (Pb), cadmium (Cd), and mercury (Hg)) and CI in the elderly and the mediating effect of oxidative stress. It was found that there were significant differences in urinary Pb, Cd, Hg and blood Pb levels between the CI and normal groups. Urinary Pb and Cd levels were significantly negatively correlated with Montreal Cognitive Assessment (MoCA) score, amyloid ß42 (Aß42), and Aß42/40, while urinary Cd, Hg and blood Hg were significantly positively correlated with phosphorylated tau protein (P-tau). Weighted quantile sum (WQS) regression indicated that combined metal exposure had a more significant effect on CI than individual exposure. Mediation modeling revealed that plasma superoxide dismutase (SOD) was involved in the effects of urinary Cd on Aß42/40 and P-tau, with mediation effects accounting for 20 % of the total effect. This study emphasized the combined exposure to metals, and the results can help to properly understand the association between mixed metals exposure and CI in the elderly, as well as provide population data and theoretical basis for identifying early environmental risk factors and discovering potential mechanisms of CI.

How does family resilience develop among stroke survivors and their caregivers? A mixed-method study using a chain mediating model.

Background: Walsh's family resilience theory indicated that families could foster resilient outcomes among their members when they are facing changes or crises. However, little is known about family resilience among Chinese stroke survivors and their caregivers. Objectives: To explore the direct and indirect relationships between the family resilience of stroke survivors, perceived social support, self-perceived burden, self-efficacy, and the burden on their principal caregivers, and to examine the journey of adapting to family resilience among stroke survivors. Design: An explanatory sequential mixed-method study. Methods: A quantitative assessment of perceived social support, self-perceived burden, self-efficacy, and family resilience was conducted among a cohort of stroke survivors. For a deeper understanding of the family resilience formation process, semi-structured, in-depth interviews were undertaken with a purposefully selected subset of participants, consisting of 15 stroke survivors and their principal caregivers who met the study criteria. Data analysis encompassed descriptive statistics, mediation models, and content analysis to integrate and interpret both quantitative and qualitative data. Results: In a comprehensive hospital in Guangdong Province, China, 379 participants-229 men (60.4%) and 150 women (39.6%)-completed a cross-sectional questionnaire survey. The quantitative phase revealed significant statistical differences (p < 0.05) in total family resilience scores among stroke survivors related to various factors, such as age, marital status, educational level, occupational status, average monthly income per capita, first-time onset, and types of stroke. Self-perceived burden and self-efficacy partially mediate the relationship between perceived social support and family resilience, contributing to a sequential chain-mediated effect. During the qualitative phase, in-depth interviews revealed a progressive trajectory from the initial shock of diagnosis through the ongoing presence of stress and challenges to the ultimate development of family resilience and an adaptive perspective toward the future. Conclusions: Exploring the factors influencing family resilience in stroke survivors could assist healthcare professionals developing interventions to enhance family resilience and lessen the burden on principal caregivers from individual, family, and social perspectives.

Psychological resilience and intention to stay among nurses: the mediating role of perceived organizational support.

Background: This study aims to analyze the relationship between psychological resilience, perceived organizational support, and intention to stay among nurses. Additionally, it explores the mediating role of perceived organizational support in the relationship between psychological resilience and nurses' intention to stay. Methods: A cross-sectional survey was conducted between August and September 2023, involving 1,402 nurses from five Grade 3A hospitals in Guangdong. The survey utilized several instruments, including the General Information Questionnaire (GIQ), the Chinese version of the Connor-Davidson Resilience Scale (CD-RISC), the Chinese version of the Perceived Organizational Support Scale (POSS), and the Chinese version of the Intention to Stay Scale (ITSS). The obtained data were analyzed using descriptive statistics and Pearson's correlation coefficient, while the mediating effect of perceived organizational support was assessed using the PROCESS macro mediation model in SPSS. Results: The overall mean score for psychological resilience among nurses in the five Grade 3A hospitals in Guangdong was 60.54 ± 19.17, the overall mean score for perceived organizational support was 45.77 ± 11.49, and the mean score for intention to stay was 20.82 ± 4.65. The results of the statistical analysis revealed positive correlations between psychological resilience and intention to stay (r = 0.388, p < 0.01), between perceived organizational support and psychological resilience (r = 0.570, p < 0.01), and between perceived organizational support and intention to stay (r = 0.550, p < 0.01). Additionally, perceived organizational support was found to mediate the relationship between psychological resilience and intention to stay, with a mediation effect value of 0.067, accounting for 71.28% of the total effect. Conclusion: Psychological resilience of nursing staff directly impacts their intention to stay and indirectly influences their caring behaviors, with perceived organizational support serving as a key mediator in both relationships. Therefore, nursing managers should implement targeted interventions to enhance nurses' psychological resilience and perceived organizational support. Strengthening these factors can significantly increase nurses' intention to stay in their jobs, improve the quality of care, and contribute to building a strong and stable nursing workforce.

The impact of mind-body exercise on the quality of life in older adults: the chain mediation effect of perceived social support and psychological resilience.

Background: With the intensification of the global aging trend, there is a contradiction between the extended lifespan and the decline of physiological functions among the older adult. It has become a global consensus to focus on and improve the quality of life for the older adult. Mind-body exercises (Tai Chi, Ba Duan Jin, Yi Jin Jing) play a crucial role in promoting the quality of life for older adults, but the mechanisms and mediating effects are not yet clear. Objective: This study examines the impact of mind-body exercises (Tai Chi, Ba Duan Jin, Yi Jin Jing) on the quality of life in older adults, with a particular focus on exploring the chain mediating effects of perceived social support and psychological resilience. Methods: This study is a cross-sectional study that surveyed 1,087 older adults participating in mind-body exercises (Tai Chi, Ba Duan Jin, Yi Jin Jing) in 13 districts of Beijing, China, from March 25 to May 3, 2024. The Physical Activity Rating Scale (PARS-3), the World Health Organization Quality of Life Scale (WHOQOL-BREF), the Perceived Social Support Scale (PSSS), and the Connor-Davidson Resilience Scale (CD-RISC) were used to measure mind-body exercise, perceived social support, psychological resilience, and quality of life, respectively. Data were statistically analyzed using SPSS 26.0, and mediation effects were tested and effect analysis was conducted through structural equation modeling (AMOS) and the Bootstrap method. Results: The study results show that mind-body exercises (Tai Chi, Ba Duan Jin, Yi Jin Jing) are significantly and positively correlated with the quality of life in older adults (r = 0.549, p < 0.01). The path coefficients for the relationships mind-body exercise → perceived social support (ß = 0.46, p < 0.001) → psychological resilience (ß = 0.20, p < 0.001) → quality of life in older adults (ß = 0.39, p < 0.001) are significant, indicating that perceived social support and psychological resilience have a chain mediating effect between mind-body exercise and the quality of life in older adults. Conclusion: Mind-body exercises not only improve the quality of life for older adults but also indirectly enhance it by strengthening perceived social support and psychological resilience. This study provides significant reference for developing health intervention strategies targeted at older adults, suggesting that promoting mind-body exercises can improve their sense of perceived social support and psychological resilience, thereby increasing their quality of life.

The Effect of Urinary Polycyclic Aromatic Hydrocarbon Metabolites on Lipid Profiles: Does Oxidative Stress Play a Crucial Mediation Role?

Urinary polycyclic aromatic hydrocarbon (PAH) metabolites are associated with oxidative stress; however, epidemiological studies have not reported the impacts of these urinary PAH metabolites on blood lipid levels. This study investigated the relationship between urinary PAH metabolites, urinary 8-hydroxy-2'-deoxyguanosine (8-OHdG), and blood lipid profiles. A total of 109 elderly volunteers were recruited with complete datasets for analysis. Blood and morning urine samples were collected in the winter of 2011. The PAH metabolites, creatinine, and 8-OHdG levels in urine samples were analyzed using Gas Chromatography-Mass Spectrometry, spectrophotometry, and an ELISA kit, respectively. The blood lipid profiles were analyzed using an automatic biochemical analyzer. The relationship between lipid profiles and 8-OHdG was assessed using a two-independent sample nonparametric test, categorized by gender, smoking, and alcohol consumption status. After normalizing the concentration values, a general linear regression model was employed to examine the correlations between PAH metabolites, 8-OHdG, and lipid profiles. A mediation model was developed to investigate the mediating effect of 8-OHdG on the relationship between PAH metabolites and lipid profiles. The median of eight PAH metabolite concentrations in urine samples ranged from 1 to 10 µmol/mol creatinine (Cr). Significant differences in lipid profiles were observed across genders. However, no significant differences were found in smoking or alcohol consumption status for both genders. Linear regression analysis revealed that an increase in the logarithmic concentration of 2-hydroxynaphthalene (2-OHNap), 9-hydroxyfluorene (9-OHFlu), 3-hydroxyfluorene (3-OHFlu), 2-hydroxyfluorene (2-OHFlu), 1-hydroxypyrene (1-OHPyr), and 6-hydroxychrysene (6-OHChr) was associated with an increase in urinary 8-OHdG levels, after adjusting for BMI and age. Specifically, 1-hydroxynaphthalene (1-OHNap) and 1-OHPyr correlated negatively with apolipoprotein A1 (Apo A1). Conversely, 1-OHPyr was positively correlated with low-density lipoprotein cholesterol (LDL-C). In addition, b,c-dihydroxyphenanthrene (2-OHBcPhe) was positively associated with apolipoprotein B (Apo B). Notably, 8-OHdG did not exhibit a significant correlation with lipid profiles. The mediating effect of 8-OHdG on the relationship between hydroxylated PAHs and lipid profiles was not statistically significant. However, the indirect effects of hydroxylated PAHs on blood lipids were statistically substantial, specifically for 1-OHNap to Apo A1 (-0.025, 95% CI: -0.041, -0.009), 1-OHPyr to LDL-C (0.107, 95% CI: 0.011, 0.203), and 2-OHBcPhe to Apo B (0.070, 95% CI: 0.005, 0.135). This study suggests that an increase in urinary PAH metabolites may elevate the levels of urinary 8-OHdG and influence blood lipid profiles. However, no direct relationship was found between 8-OHdG and lipid profiles. The mediation analysis indicated that the effects of PAH metabolites on lipid changes may operate through pathways other than oxidative stress.

Family happiness and college students' smartphone addiction control: the chain mediation effect of emotion regulation and self-control.

Background: More and more college students use smartphones for a long time every day. The problem of smartphone addiction has become a hot topic of social concern. It not only affects the physical and mental health of college students but also affects the development of families and society. To investigate the effect of family happiness on college students' smartphone addiction, we conducted a questionnaire survey and analysis. Methods: In this study, 214 college students were investigated using the adolescent family happiness questionnaire, college students' smartphone addiction scale, self-control scale, and emotion regulation scale. The data were analyzed by Amos and SPSS26.0 software. Results: The results showed that: (1) Family happiness, emotion regulation, and self-control were significantly inversely correlated with smartphone addiction; (2) Emotion regulation and self-control served as partial mediators in the linkage between family happiness and smartphone addiction, and the chain mediation effect of emotion regulation and self-control was significant. Conclusion: Family happiness, emotion regulation, and self-control are key factors that significantly influence college students' smartphone addiction behavior. Family happiness not only has a direct effect on college students' smartphone addiction behavior but also has an indirect effect on it through the chain mediation effect of emotion regulation and self-control.

Longitudinal association of depressive symptoms with cognition and neuroimaging biomarkers in cognitively unimpaired older adults, mild cognitive impairment, and Alzheimer's disease.

We aimed to longitudinally examine the relationship between depression and cognitive function and investigate the mediating effects of imaging indicators in this relationship. 2,251 subjects with longitudinal assessment of geriatric depression scale, Mini-Mental State Examination, Montreal Cognitive Assessment, Clinical Dementia Rating-Sum of Boxes (CDRSB), Alzheimer's Disease Assessment Scale11, Alzheimer's Disease Assessment Scale13 and imaging of 3DT1, diffusion tensor imaging, fluid-attenuated inversion recovery, arterial spin labeling, fluorodeoxyglucose positron emission tomography, 18F-AV45-PET, and 18F-AV1451-PET were included from the Alzheimer's Disease Neuroimaging Initiative database. The multivariate mixed-effects models were employed to analyze the correlation between geriatric depression scale scores, cognitive function, and imaging indicators. The sgmediation software package was utilized to analyze the mediating effects of imaging indicators. The geriatric depression scale was negatively correlated with Mini-Mental State Examination and Montreal Cognitive Assessment, and positively correlated with CDRSB, Alzheimer's Disease Assessment Scale11, and Alzheimer's Disease Assessment Scale13 when the subjects were not grouped. The geriatric depression scale was negatively correlated with Montreal Cognitive Assessment and positively correlated with Alzheimer's Disease Assessment Scal13 in groups with baseline diagnosis of early mild cognitive impairment and late mild cognitive impairment. Furthermore, depression was associated with regional imaging indicators, while cognitive function was linked to broad imaging indicators. Some of these indicators were related to both depression and cognitive function, playing a mediating role in their relationship. Depression was related to cognitive function, especially in subjects with mild cognitive impairment. Some imaging indicators may represent the underlying basis for the association between depression and cognitive function.

Self-compassion as a protective factor against post-traumatic stress symptoms induced by adverse childhood experiences: A cross-sectional study among Japan air self-defense force new recruits.

Adverse childhood experiences (ACEs) may result in long-term mental health complications, including post-traumatic stress disorder (PTSD). ACEs are known to be more frequent among military personnel, despite their need to maintain their mental health to accomplish their missions. Self-compassion, or treating oneself with kindness and understanding, can mitigate the psychological effects of adversity but is also affected by adversity. This cross-sectional study aimed to identify the complex relationships between ACEs, self-compassion, and PTSD symptoms among 752 new recruits of the Japan Air Self-Defense Force, of whom 537 with ACEs completed the PTSD Checklist for DSM-5. Hierarchical multiple regression analysis was used to examine the independent effect of self-compassion, measured using the Self-Compassion Scale, on PTSD symptoms. Mediation effect analysis with self-compassion as a mediator was conducted on the relationship between ACEs and PTSD symptoms. We confirmed high levels of ACEs among our participants compared to a healthy population of a previous study, and approximately 6% presented PTSD symptoms above a threshold. Self-compassion was significantly negatively associated with PTSD symptoms (ß = -.22, 95% confidence interval [CI], -.34 to -.11). Mediation effect analysis revealed that self-compassion partially mediated the relationship between ACEs and PTSD symptoms, explaining 6.9% of this effect, and ACEs were negatively associated with self-compassion (ß = -.13, 95% CI, -.22 to -.04). These findings suggested that self-compassion is a protective factor against PTSD symptoms, whereas ACEs can decrease self-compassion. Further research should explore educational interventions to enhance self-compassion among individuals with ACEs to mitigate PTSD symptoms.

Interactive effect of hemodynamics in transverse sigmoid sinus and bone morphology on venous pulsatile tinnitus: a four-dimensional (4D) flow magnetic resonance imaging (MRI) study.

Background: The hemodynamic pathogenesis of venous pulsatile tinnitus (VPT) is still unclear. This study aimed to explore the mechanism of bone morphology and hemodynamic changes in transverse sigmoid sinus (TSS) on VPT patients. Methods: 49 patients with unilateral VPT, 26 patients with subjective tinnitus and 36 healthy controls were included in this retrospective clinical trial. Four-dimensional (4D) flow magnetic resonance imaging (MRI) was used to evaluate the hemodynamics of the TSS. High-resolution computed tomography was used to assess the perivenous bone structures. All images were independently assessed for each participant by two trained neuroradiologists. Kolmogorov-Smirnov test was used to determine the normal distribution of the data. Chi-square test and nonparametric test were used to compare classified or continuous variables. Stepwise linear regression and mediation effect analysis was used to explore the relationship between bone dehiscence (BD), hemodynamic factors and VPT symptoms. Results: Peak velocity (P=0.001) and maximum energy loss (P=0.041) in VPT group were risk factors for the severity of tinnitus. Energy loss [indirect effect =0.692, P<0.005, 95% confidence interval (CI): 0.201-1.377] and peak velocity (indirect effect =0.899, P<0.005, 95% CI: 0.406-1.582) demonstrated the complete mediation effect between the BD and VPT. BD showed a complete mediation effect between the wall shear stress (WSS) and VPT (indirect effect =15.181, P<0.005, 95% CI: 3.448-35.493). Conclusions: Cross-talk between the hemodynamic changes of TSS and BD can regulate the VPT symptoms. This type of analysis might be helpful in establishing the possible occurrence and development mechanism of the hemodynamics and bone morphology of the VPT.

Analysis of the effect of BMI on depression and anxiety among older adults in China: the mediating role of ADL and IADL.

Background: Anxiety and depression are serious psychological and public health issues among the older adults. Currently, there is a lack of understanding of the relationship between Body Mass Index (BMI) and anxiety or depression symptoms in the older adult population in China. Therefore, the purpose of this study is to investigate the impact of BMI on anxiety and depression through correlation analysis in different subgroups and to examine the potential chain mediating effects of Activities of Daily Living (ADL) and Instrumental Activities of Daily Living (IADL) between BMI and symptoms of anxiety and depression. Methods: From the CLHLS database conducted in 2017-2018, data regarding height, weight, anxiety symptoms, depression symptoms, as well as demographic, socioeconomic, behavioral, and health-related characteristics were collected. Multivariate logistic regression analysis was used to explore the impact of BMI on anxiety and depression symptoms. Finally, the SPSS macro process was utilized to test the multiple mediating effects of ADL and IADL between BMI and anxiety or depression symptoms. Results: After screening, a final sample of 9,098 Chinese older adult individuals aged 65 and above was selected. Among them, 1,074 cases (11.8%) exhibited anxiety symptoms, 1,458 cases (16.0%) exhibited depressive symptoms. Compared to normal BMI, the adjusted analysis showed that underweight in Chinese older adult individuals was significantly associated with anxiety (OR = 1.316, p = 0.004) and depression (OR = 1.232, p = 0.013). This relationship was found to be more significant in males, individuals aged 80 and above, unmarried individuals, and those residing in town. ADL and IADL played a chain-mediated role between BMI and anxiety symptoms in the older adult. BMI not only had a direct effect on anxiety symptoms in the older adult (effect = -0.0159; SE = 0.0066; 95%CI: LL = -0.0288, UL = -0.0031), but also influenced them indirectly through two pathways: the independent mediating role of IADL (effect = -0.0010; SE = 0.0005; 95%CI: LL = -0.0018, UL = -0.0003) and the chain-mediated role of ADL and IADL (effect = -0.0012; SE = 0.0004; 95%CI: LL = -0.0020, UL = -0.0006). Conclusion: In the older adult individuals in China, underweight is associated with an increased risk of anxiety and depression symptoms. Improving the underweight condition of Chinese older adult individuals can reduce their ADL and IADL limitations, thereby benefiting their mental health.

Walking away from depression: the mediating role of walking activity in depression impacting blood glucose levels of people with diabetes or prediabetes.

Introduction: Depression can exacerbate diabetes by impairing self-care behaviors and increasing the risk of complication; however, the underlying mechanism is still unclear. Given the suggested associations between walking activity, depression status, and blood glucose levels this study explores the intricate relationship between depression and blood glucose (BG) control, with a focus on walking activity as a behavioral mediator. The purpose of this study is to examine walking activity's mediating role in depression's impact on BG levels, investigating and validating the non-linear association between BG levels and walking activity. This retrospective real-world study demonstrates the potential of regular walking activity as a simple and accessible intervention to mitigate the negative effects of depression on BG levels in T2D and prediabetes. Methods: A cohort of 989 users with T2D and prediabetes, who regularly tracked their steps levels and BG levels for 12 months using the Dario digital health platform was evaluated. The mediating role of the monthly average number of steps on the relationship between the self-reported depression status and lagged monthly average BG was assessed. Additionally, the association between monthly walking activity and monthly average BG was tested using a piecewise linear mixed effects model. Results: Users with self-reported depression demonstrated increased BG levels compared to users without depression (B=8.00, P=.01). The association between depression and monthly average number of steps was significant (B=-.27, P<.005) and monthly average number of steps significantly predicted the following months' average BG (B=-.81, P=.001), adjusting for depression. The monthly average number of steps significantly mediated the effect of self-reported depression on the following month's average BG (M=.22, P<.005). Further sensitivity analysis demonstrated model robustness over various periods. Finally, non-linear dynamics of walking activity over time was validated using unseen data showing a decrease in monthly average BG for users with over an average of 400 steps per day (B=-1.87, P<.01). Discussion: This study shows how regular walking may reduce the negative impact of depression on BG levels in people with T2D. Our findings advocate for the integration of walking activity into treatment protocols as a cost-effective, accessible intervention strategy to improve glycemic management and depressive symptoms in this population.

Perceived health outcomes of recreation and happiness: exploring the mediating role of resilience.

Introduction: Previous research has shown that leisure activities can positively influence perceived health outcomes by increasing individuals' levels of physical activity. Yet, little has been discovered about the mechanisms that are driving this association. This study was conducted with the aim of examining the relationship between perceived health outcomes of recreation and happiness as well as the mediating effect of resilience. Methods: The study comprised a total of 451 adult individuals residing in seven different geographical regions of Turkey, who were included using a convenience sampling method, and the data were collected between March and June 2023. Respondents completed assessments utilizing the Perceived Health Outcomes of Recreation, Brief Resilience Scale, and The Oxford Happiness Questionnaire-Short Form. Data analysis was executed employing the PROCESS macro for SPSS. Results: The study's findings revealed that perceived health outcomes of recreation had a positive effect on both happiness (ß = 0.146, [95% CI: 0.106, 0.186]) and resilience (ß = 0.156, [95% CI: 0.107, 0.205]). Resilience had a positive effect on happiness (ß = 0.435, [95% CI: 0.362, 0.507]). Furthermore, the relationship between perceived health outcomes of recreation and happiness was partially mediated by resilience (ß = 0.068, [95% CI: 0.042, 0.096]). Conclusion: As a result, participating in leisure activities has been found to have a positive impact on perceived health outcomes, which in turn positively affects both happiness and resilience. Additionally, psychological resilience can be said to partially mediate the relationship between perceived health outcomes of recreation and happiness.