Dietary Rhythmicity and Mental Health Among Airline Personnel.

Importance: Misaligned dietary rhythmicity has been associated with metabolic diseases; however, its association with mental health remains largely unexplored. Objective: To examine the association between dietary rhythms and the mental health condition of shift workers, specifically airline crew members. Design, Setting, and Participants: This cross-sectional study analyzed data collected from the Civil Aviation Health Cohort of China, an ongoing large-scale health survey of pilots, flight attendants, and air security officers employed by major airline companies in China. Participants aged 18 to 60 years were invited through text messages to complete a web-based survey. The data collection period was December 2022 to March 2023. Statistical analysis was performed from July 24, 2023, to April 12, 2024. Exposure: Data on timing of breakfast and dinner on workdays and rest days, daily time windows for food intake, and meal and eating jet lags were collected and calculated. Main Outcomes and Measures: Anxiety and depressive symptoms were measured using the 7-item Generalized Anxiety Disorder Assessment and the 9-item Patient Health Questionnaire. Multivariate logistic regressions were performed to evaluate the associations of anxiety and depression with meal timing, eating window time, meal jet lag (ie, delayed meals), and eating jet lag (ie, delayed eating). All models were adjusted for individual socioeconomic, demographic, and lifestyle characteristics. Results: Of the 22 617 participants (median [IQR] age, 29.1 [26.3-33.7] years; 13 712 males [60.6%]), 1755 (7.8%) had anxiety and 2768 (12.2%) had depression. After controlling for confounding factors, having dinner after 8 pm on morning-shift days was associated with increased odds of anxiety (adjusted odds ratio [AOR], 1.78; 95% CI, 1.53-2.05) and depression (AOR, 2.01; 95% CI, 1.78-2.27), compared with consuming dinner before 8 pm. Similar results were observed on night-shift days and rest days. An eating window of less than 12 hours was associated with reduced odds of anxiety (AOR, 0.84; 95% CI, 0.75-0.93) and depression (AOR, 0.81; 95% CI, 0.75-0.89) on morning-shift days; the results remained significant on rest days. Delayed dinner on morning-shift days was associated with increased odds of anxiety (AOR, 1.32; 95% CI, 1.13-1.54) and depression (AOR, 1.39; 95% CI, 1.22-1.58). On night-shift days, delayed dinner was associated with higher odds of anxiety (AOR, 1.22; 95% CI, 1.06-1.39) and depression (AOR, 1.21; 95% CI, 1.08-1.36). On morning-shift days, delayed eating rhythms were associated with higher odds of depression (AOR, 1.35; 95% CI, 1.13-1.61), whereas advanced eating rhythms were associated with lower odds of anxiety (AOR, 0.78; 95% CI, 0.70-0.87). Conclusions and Relevance: This cross-sectional study found that meal timing, long eating window, and meal jet lags were associated with increased odds of depression and anxiety. These findings underscore the need for interventions and supportive policies that help mitigate the adverse implications of shift work and irregular working hours for the mental health of shift workers.

Challenges and support needs in psychological and physical health among pilots: a qualitative study.

Introduction: Physical and mental health problems among pilots affect their working state and impact flight safety. Although pilots' physical and mental health problems have become increasingly prominent, their health has not been taken seriously. This study aimed to clarify challenges and support needs related to psychological and physical health among pilots to inform development of a more scientific and comprehensive physical and mental health system for civil aviation pilots. Methods: This qualitative study recruited pilots from nine civil aviation companies. Focus group interviews via an online conference platform were conducted in August 2022. Colaizzi analysis was used to derive themes from the data and explore pilots' experiences, challenges, and support needs. Results: The main sub-themes capturing pilots' psychological and physical health challenges were: (1) imbalance between family life and work; (2) pressure from assessment and physical examination eligibility requirements; (3) pressure from worries about being infected with COVID-19; (4) nutrition deficiency during working hours; (5) changes in eating habits because of the COVID-19 pandemic; (6) sleep deprivation; (7) occupational diseases; (8) lack of support from the company in coping with stress; (9) pilots' yearly examination standards; (10) support with sports equipment; (11) respecting planned rest time; and (12) isolation periods. Discussion: The interviewed pilots experienced major psychological pressure from various sources, and their physical health condition was concerning. We offer several suggestions that could be addressed to improve pilots' physical and mental health. However, more research is needed to compare standard health measures for pilots around the world in order to improve their physical and mental health and contribute to overall aviation safety.

Factors associated with out-of-school physical activity among Chinese children and adolescents: A stratified cross-sectional study.

OBJECTIVE: This observational study examined the factors associated with the physical activity (PA) of children and adolescents outside of school within the framework of Problem Behavior Theory (PBT). METHODS: This cross-sectional study obtained data from 6528 children and adolescents aged 6-16 years recruited from ten schools in Shanghai, China. The questionnaire measured out-of-school PA and PBT-based correlates. A series of multiple linear regressions were used to explore the factors influencing children and adolescents' out-of-school PA separately. Structural equation modeling (SEM) was used to explore the association between the three systems of PBT and out-of-school PA. RESULTS: Higher intrinsic motivation is positively associated with increased PA for children (b = 1.038, 95%CI: 0.897-1.180) and adolescents (b = 1.207, 95%CI: 0.890-1.524). Greater frequency of parental involvement in PA correlates with elevated PA for both children (b = 2.859, 95%CI: 2.147-3.572) and adolescents (b = 2.147, 95%CI: 0.311-3.983). In children, increased use of community exercise areas or facilities (b = 1.705, 95%CI: 0.234-3.176) and higher recreational screen time (b = 9.732, 95%CI: 5.614-13.850) are associated with higher PA. The SEM showed that factors of the personality system had a significant direct effect on out-of-school PA among children and adolescents, and factors of the behavior system also had a significant effect on children. CONCLUSIONS: Our findings suggest that the personality system, particularly intrinsic motivation, is important in promoting out-of-school PA in children and adolescents. For children, modifiable health behaviors in the behavior system can similarly influence PA.

Comparison of the specific energies of sinusoidal VCS cutter rings and CCS cutter rings in breaking rock-like materials based on the FEM.

Disc cutters are essential for full-section hard-rock tunnel boring machines. The performance of these devices directly affects tunnel engineering costs and duration. This paper proposes a sinusoidal variable cross-section (VCS) cutter ring and design method and establishes a digital model. Rock-like materials are simulated with a finite element model, and the model validity is verified via rock simulation mechanics tests. A disc cutter rolling rock simulation model for a linear cutting machine is also established, and simulation tests are performed for single- and three-cutter rolling using sinusoidal VCSs and constant cross-section (CCS) cutter models, respectively. The stress and energy changes for the cutters and rock-like material damage area were compared via simulation, confirming that some sinusoidal VCS cutter rings do less work on rock-like materials and cause larger crushing areas under the same engineering parameters; therefore, these cutter rings have smaller specific energies. The sinusoidal VCS cutter ring performance is 7% greater than that of CCS on average under single-cutter simulation, and the intermediate cutter performance of the intermediate cutter is 9% greater than that of CCS on average under three-cutter simulation. Thus, sinusoidal VCS cutter rings offer improved rock damage performance, and further research and application of this technology will improve the working efficiency of tunnel boring machines.

Prevalence and network analysis of internet addiction, depression and their associations with sleep quality among commercial airline pilots: A national survey in China.

OBJECTIVE: Airline pilots are members of a unique occupational group that is often confronted with sleep routine disruptions, yet relatively few studies have examined their mental health status. This study assessed the prevalence and network structure of internet addiction, depression and sleep quality problems in commercial airline pilots. METHOD: A total of 7055 airline pilots were included in analyses. Internet addiction and depression were measured with the Internet Addiction Test (IAT) and 9-item Patient Health Questionnaire (PHQ-9), respectively. Sleep quality was evaluated using the Pittsburgh Sleep Quality Index (PSQI). The network model was constructed based on an Ising model and its association with sleep quality was evaluated using a flow procedure. RESULTS: Internet addiction, depression and sleep quality were common among airline pilots. The prevalence of internet addiction was 8.0 % (95 % CI: 7.3-8.6 %), while the rates of depression and poor sleep quality were 23.3 % (95 % CI: 22.3-24.2 %) and 33.0 % (95 % CI: 31.9-34.1 %), respectively. In the depression and internet addiction network model, "Fatigue" (PHQ4; Expected Influence (EI): 2.04) and "Depressed/moody/nervous only while being offline" (IAT20; EI: 1.76) were most central symptoms while "Fatigue" (PHQ4; Bridge EI: 1.30) was also the most important bridge symptom. The flow network model of sleep quality with internet addiction and depression showed that "Appetite" (PHQ5) had the strongest positive association with poor sleep quality. CONCLUSION: Internet addiction, depression and sleep quality were common among airline pilots and warrant regular screening and timely treatment. Strategies to improve sleep hygiene may be useful in preventing onsets or exacerbations in depression and internet addiction among airline pilots.

Associations between joint lifestyle behaviors and depression among children and adolescents: A large cross-sectional study in China.

BACKGROUND: Lifestyles in children and adolescents are associated with mental health, yet the combined effects of diet-related joint lifestyles on depression are unclear. METHODS: A cross-sectional study was conducted in January 2020 in primary and secondary schools in Shanghai, China, with 6478 participants in the analysis. Lifestyle behaviors (physical activity, sleep duration, screen time, and diet quality) and depressive symptoms were measured using validated questionnaires. A series of multivariable logistic regressions were performed to examine the associations between lifestyle behaviors and their combinations and depression. RESULTS: The prevalence of depressive symptoms 12.2 % (n = 788). Compared to those considered physically active, physically inactive individuals showed higher odds of depression (adjusted odds ratio [aOR] = 1.206). Similarly, insufficient sleep duration (aOR = 1.449), long screen time (aOR = 1.457) and poor diet quality (aOR = 1.892) were all associated with higher odds of depression. Compared to participants with behaviors meeting all guidelines, the odds of depression increased as the number of behaviors not meeting guidelines increased in a dose-response relationship, with an average increase in depression odds of 49 % on average for each additional unhealthy behavior. Moreover, different combinations of behaviors not meeting guidelines showed varied odds of depression. CONCLUSIONS: Our research suggests that lifestyle behaviors not meeting guidelines in children and adolescents are associated with poorer mental health, and the risk varies with the number and specific combination of behaviors not meeting guidelines. Diet-related joint behaviors may be overlooked, and practical measures targeting joint lifestyles are needed to prevent and alleviate mental health problems among children and adolescents.

Physical activity, recreational screen time, and depressive symptoms among Chinese children and adolescents: a three-wave cross-lagged study during the COVID-19 pandemic.

BACKGROUND: Longitudinal evidence is lacking on the interplay between lifestyle behaviors and depressive symptoms, especially in the context of the COVID-19 pandemic. This study investigated the changes in physical activity and recreational screen time during the pandemic, along with their reciprocal associations with depressive symptoms among children and adolescents. METHODS: The public health emergency due to the pandemic started in January 2023 and lasted for two months in Shanghai, China. A three-wave longitudinal study was conducted among 1,666 children and adolescents (6-18 years) in January, March, and July 2023. Moderate-to-vigorous intensity physical activity (MVPA), recreational screen time, and depressive symptoms were measured using self-reported questionnaires. Random-intercept cross-lagged panel models were constructed to examine the bidirectional associations between physical activity and recreational screen time with depressive symptoms. RESULTS: Children and adolescents experienced a significant decrease in MVPA and a substantial increase in recreational screen time during the pandemic, which failed to return to pre-pandemic levels post-pandemic. Pre-pandemic MVPA was negatively associated with subsequent depressive symptoms (ß = -0.147). Conversely, pre-pandemic depressive symptoms were positively associated with subsequent recreational screen time (ß = 0.085), which in turn predicted heightened post-pandemic depressive symptoms (ß = 0.076). When stratified by age, significant associations were found in adolescents but not children. CONCLUSIONS: Sustained unhealthy changes in physical activity and recreational screen time were observed during the COVID-19 pandemic among children and adolescents. This study elucidates a potential reciprocal relationship between lifestyle behaviors and mental well-being. Effective interventions are emphasized to counter the negative impacts of insufficient physical activity and excessive screen use on the mental health of children and adolescents.

Inter-relationships between suicidality and depressive symptoms among children and adolescents experiencing crisis: A network perspective.

OBJECTIVES: Suicidality and depressive symptoms have emerged as major mental health issues reported among children and adolescents experiencing crises. In light of these concerns, this study was conducted to elucidate interrelationships between depressive symptoms and suicidality at an item level within this population during the COVID-19 pandemic, a worldwide public health crisis affecting children and adolescents. METHOD: A cross-sectional study design was used. Primary and secondary school students completed the Children's Depression Inventory - Short Version (CDI-S) and two standard suicidality questions tapping suicidal ideation and suicide plans, respectively. A network analysis was performed to examine inter-connections between depressive symptoms and suicidality. RESULTS: A total of 5380 students participated in the study. Prevalence of suicidal ideation and suicide plans were 12.8 % (95 % CI = 11.9 %-13.7 %) and 9.9 % (95 % CI = 9.2 %-10.8 %), respectively; the prevalence of depressive symptoms was 41.2 % (95%CI = 39.8 %-42.5 %). The network analysis identified CDI4 (self-hatred) as the most influential node with the highest centrality, followed by CDI8 (loneliness), CDI5 (crying), and CDI1 (sadness). Additionally, CDI5 (crying), CDI1 (sadness), CDI4 (self-hatred), and CDI10 (feeling unloved) were the most meaningful nodes linking depressive symptoms with suicidality. CONCLUSIONS: Critical depressive symptoms linked with suicidality among children and adolescents living through the COVID-19 pandemic included self-hatred, loneliness, crying, and sadness. Interventions that target these depressive symptoms may have increased utility in reducing the risk of suicidality within this population.

Physical activity maintenance and increase in Chinese children and adolescents: the role of intrinsic motivation and parental support.

Objective: This longitudinal study aimed to examine the association of intrinsic motivation, parental physical activity, and parental support with physical activity maintenance and increase among children and adolescents. Methods: A sample of 2,424 children and adolescents in Shanghai, China participated in the two-wave survey before and during the COVID-19 pandemic. The questionnaire measured children and adolescents' physical activity and intrinsic motivation, as well as their parental physical activity and support (concern for their child and co-activity with their child). Multivariable logistic regressions were performed by groups to examine the associations between these factors and physical activity change. Results: Most children and adolescents exhibited a decline in physical activity participation during the pandemic, as indicated by a mere 15.0 and 8.0% of individuals maintaining and increasing their pre-pandemic levels, respectively. Among the initially active participants, perceived self-choice [OR = 1.341 (95%CI: 1.173-1.533)] and parental concern [OR = 1.922 (95%CI: 1.204-3.068)] predicted maintained physical activity. Increased physical activity was predicted by perceived enjoyment [OR = 1.193 (95%CI: 1.046-1.362)] and parental co-activity (OR = 1.995 [95%CI: 1.095-3.633]). Conclusion: This study provides longitudinal evidence that intrinsic motivation and parental support can have a positive impact when physical activity levels change significantly. Effective interventions targeting multilevel factors are needed to maintain or increase children and adolescents' physical activity.

Association between Types of Screen Time and Weight Status during the COVID-19 Pandemic: A Longitudinal Study in Children and Adolescents.

BACKGROUND: This study aimed to investigate the changes in distinct types of screen time and explore their longitudinal association with children and adolescents' weight status. METHODS: A two-wave longitudinal study was conducted among 2228 children and adolescents (6-19 years) in Shanghai, China, before and during the pandemic. Recreational screen time (watching TV/videos, online gaming, using social media, and browsing webpages), educational screen time (online homework and online class), and BMI were measured using a self-reported questionnaire. Mixed-effects models were constructed to assess the associations between screen time and weight status. RESULTS: The prevalence of overweight and obesity was 20.5% and 10.2% at baseline, respectively. Both recreational and educational screen time increased significantly over two months. While recreational screen time was found to be a risk factor for obesity, it was not the case for educational screen use. Specifically, adolescents who spent more time watching TV/videos had a higher obesity risk (OR = 1.576). No significant associations were found in children. CONCLUSIONS: Overweight and obesity were prevalent among children and adolescents in China. Reducing screen-based activities is a promising strategy to prevent unhealthy weight gain in Chinese children and adolescents, while it is necessary to consider the content and distinguish between educational and recreational screen use.

Network analysis of suicidality and internet addiction symptoms among Chinese primary and secondary school students.

BACKGROUND: The COVID-19 pandemic has increased the risk of both Internet addiction and suicide across various populations, especially among children and adolescents. This study aimed to assess the inter-relationships between Internet addiction symptoms and suicidality among primary and secondary school students from the perspective of network analysis. METHODS: This was a cross-sectional, multicenter study. The Internet Addiction Test (IAT) was used to assess internet addiction symptoms. Participants were also asked about having any suicidal ideation and suicide plan. Univariate analyses and network analysis were subsequently conducted. RESULTS: Altogether, 5380 primary and secondary school students participated in the study. Among them, 3161 (58.8 %, 95 % CI = 57.4 %-60.1 %) students reported having Internet addiction symptoms and 798 (14.8 %, 95 % CI = 13.9 %-15.8 %) reported having suicidal ideation or suicide plan in the past two weeks. Network analysis revealed that IAT16 ('Request an extension for longer time spent online'; node strength = 1.223) was the most central symptom in the Suicidality-Internet addiction network model, while the edge suicidality-IAT4 ('Form new relationship with online users'; edge weight = 0.055) was the strongest edge linking both communities. CONCLUSIONS: Internet addiction symptoms were common among primary and secondary school students during the COVID-19 school closure period in China and were significantly associated with suicidality. Targeted strategies such as strengthening self-control, sense of belonging and connectedness may be important in reducing the risk of both suicidality and Internet addiction among primary and secondary school students.

CircCRIM1 mediates proliferation, migration, and invasion of trophoblast cell through regulating miR-942-5p/IL1RAP axis.

BACKGROUND: Preeclampsia (PE) is a severe complication that occurs during pregnancy and a main cause of perinatal mortality of mothers as well as infants, which is characterized by abnormal placental trophoblast. Previous study reported that aberrant circular RNA (circRNA) was involved in the pathogenesis and progression of PE. Herein, we aimed to investigate the role of circCRIM1 and explore the mechanism of circCRIM1 in PE. METHODS: The quantitative real-time PCR (qRT-PCR) was conducted to determine the relative expression of circCRIM1, miR-942-5p, and IL1RAP in tissues and cells. Cell proliferation viability was assessed by both MTT and EdU assays. Cell cycle distribution was analyzed using flow cytometry. Transwell assay was performed to test the cell migration and invasion. The protein levels of CyclinD1, MMP9, MMP2, and IL1RAP were measured by western blot. The putative binding sites between miR-942-5p and circCRIM1 or IL1RAP 3'UTR were verified by dual-luciferase reporter gene assay. Rescue experiment was performed to confirm that miR-942-5p/IL1RAP axis was functional target of circCRIM1 in trophoblast cells. RESULTS: CircCRIM1 was upregulated in placenta tissues of PE and its expression was inversely related to infant weight. Overexpression of circCRIM1 suppressed proliferation, migration, and invasion and reduced the protein levels of CyclinD1, MMP9, MMP2 of trophoblast cells, whereas its knockdown exerted the opposite effect. CircCRIM1 could interact with miR-942-5p, and introduction of miR-942-5p partially abated the inhibitory effect of circCRIM1 on trophoblast cell behaviors. IL1RAP was directly targeted and negatively regulated by miR-942-5p. miR-942-5p played its regulatory role on cell proliferation, migration, and invasion of trophoblast by IL1RAP. Further analysis showed that circCRIM1 modulated IL1RAP expression via sponging miR-942-5p. CONCLUSION: The results of the present study demonstrated that circCRIM1 inhibited the proliferation, migration, and invasion of trophoblast cells through sponging miR-942-5p and up-regulating IL1RAP, providing a possible new mechanism of PE.

Association between Sedentary Behavior during Leisure Time and Excessive Weight in Chinese Children, Adolescents, and Adults.

(1) Background: Sedentary behavior is increasing in all age groups and is one of the most common lifestyles that is a risk factor for overweight and obesity; however, few studies have evaluated the impact of leisure-time sedentary behavior on overweight and obesity. This study aims to examine the distribution characteristics of different leisure-time sedentary behaviors and their effects on excessive weight in different age groups in the Chinese population to provide evidence for the development of behavioral interventions. (2) Methods: This study utilizes data from the 2004 to 2011 China Health and Nutrition Survey (CHNS). Participants ranged in age from 6 to 18 years or older and were from China. Weight and height were measured in the physical examination, and the sedentary behavior times during leisure periods were collected by using a questionnaire. Logistic regression models were performed for association analyses. (3) Results: A total of 36,169 participants were included in this study. The impact of screen-based sedentary leisure time on excessive weight is greater in middle-aged and older adults. For middle-aged adults, sedentary time periods spent on the Internet or video games were found to be significantly and positively associated with excessive weight (OR, 1.122, 95% CI, 1.005-1.253). In addition, for older adults, sedentary time periods spent watching television or videos were found to be significantly and positively associated with excessive weight (OR, 1.065, 95% CI, 1.035-1.095). (4) Conclusions: This study helps grasp the target population and provide evidence for the development of behavioral intervention guidelines.

The trajectories and associations of insomnia symptoms with addictive behaviours in adolescents: A two-year longitudinal study.

Insomnia displays heterogeneous trajectories across adolescence, which may induce addictive behaviours, including internet gaming disorder and substance use. This study aimed to investigate the latent trajectory classes of insomnia symptoms over 2 years and to examine the associations between insomnia trajectories and these addictive behaviours. Participants were 910 adolescents from six middle schools in Shanghai, China (52.7% males; mean age = 13.17 years). The three-wave survey measured insomnia symptoms, internet gaming disorder, substance use, depressive symptoms, and sociodemographic characteristics from 7th to 9th grade. Latent class growth modelling was performed to identify the latent trajectory classes of insomnia symptoms. Then multivariable logistic regressions were conducted within the best-fitting latent class growth model to examine the associations of insomnia trajectories with internet gaming disorder and substance use. Two latent trajectory classes of insomnia symptoms were recognised: the non-insomnia group (71.8%) and the insomnia group (28.2%). In the multivariable analysis controlling for baseline demographic variables and depressive symptoms, the insomnia group had a higher risk of developing internet gaming disorder (OR = 2.203 [95% CI: 1.258-3.858]) and substance use (OR = 2.215 [95% CI: 1.324-3.705]) compared with the non-insomnia group. These findings add to a growing body of research on heterogeneous trajectories of insomnia symptoms during adolescence, suggesting that intervention strategies are needed to target the characteristics or developmental patterns of different insomnia subgroups. The ultimate goal is to mitigate the impact of insomnia symptoms on adolescent addictive behaviours.

Poly- and perfluoroalkyl substances exposure during pregnancy and postpartum depression: Evidence from the Shanghai birth cohort.

BACKGROUND: Exposure to poly-and perfluoroalkyl substances (PFASs) has been linked to psychiatric disorders in the general population. Because women in the postpartum period are susceptible to mental disorders, we aimed to investigate the association between exposure to PFASs during pregnancy and postpartum depression (PPD). METHODS: Our study consisted of 2741 pregnant women who were enrolled in the Shanghai Birth Cohort during the early pregnancy and gave birth to a singleton live birth between 2013 and 2016. A total of 10 PFASs were measured in maternal plasma collected in early gestation by high-performance liquid chromatography/tandem mass spectrometry. PPD was assessed using the Edinburgh Postnatal Depression Scale (EPDS) at 42 days after the child birth. We used multivariable logistic regression to estimate the association between exposure to PFASs and PPD, adjusted for potential confounders. Negative binomial regression was used to assess the association between PFASs exposure during pregnancy and EPDS subscales including anhedonia, anxiety, and depression. A quantile-based g-computation approach was used to evaluate the joint and independent effects of PFASs on PPD. RESULTS: Around 11.7% of the mothers had probable PPD (EPDS cut-off ≥10). Overall, exposure to PFASs in early pregnancy was not associated with PPD or EPDS subscales. Quantile g-computation method also showed that increasing PFASs mixture by one quartile was not associated with PPD (odds ratio, 1.08; 95% confidence interval: 0.91, 1.29). CONCLUSION: Our findings indicate that exposure to PFASs during pregnancy was not associated with PPD at 6 weeks postpartum.

Regulatory mechanism of icariin in cardiovascular and neurological diseases.

Cardiovascular diseases (CVDs) and neurological diseases are widespread diseases with substantial rates of morbidity and mortality around the world. For the past few years, the preventive effects of Chinese herbal medicine on CVDs and neurological diseases have attracted a great deal of attention. Icariin (ICA), the main constituent of Epimedii Herba, is a flavonoid. It has been shown to provide neuroprotection, anti-tumor, anti-osteoporosis, and cardiovascular protection. The endothelial protection, anti-inflammatory, hypolipidemic, antioxidative stress, and anti-apoptosis properties of ICA can help stop the progression of CVDs and neurological diseases. Therefore, our review summarized the known mechanisms and related studies of ICA in the prevention and treatment of cardio-cerebrovascular diseases (CCVDs), to better understand its therapeutic potential.

Formal social support and quality of life of caregivers with autistic children: a large-scale nationwide survey in China.

Introduction: Caregivers of children with autism spectrum disorder (ASD) were reported poor quality of life (QOL). Formal social support might improve the QOL of caregivers, however, limited research to date has focused on this association in China and formal social support for this group is conspicuously lacking. The study was aim to understand the QOL in male and female caregivers with ASD children in China and to explore the relationship between QOL and formal social support for caregivers with children with ASD through a large-scale nationwide survey. Methods: An online questionnaire was used to conduct a cross-sectional study with a sample of 6,120 caregivers of children with ASD. Relationship between Quality of Life and several potential predictors is measured and analyzed. Quality of life were measured by Medical Study Short-Form Health Survey version 2 (Chinese version). Multivariate logistic regression analysis was used to analyze the factors affecting caregivers' QOL. Results: The results revealed that the QOL of caregivers of autistic children in China was poor especially male caregivers. Social support was a positive predictor. More importantly, formal social support from rehabilitation institutions can improve caregivers' physical QOL. Caregivers' satisfaction with the rehabilitation institutions affecting their physical and mental QOL. Conclusion: The formal social support provided by rehabilitation institutions plays a positive role in improving the quality of life of caregivers.

Prevalence of neurodevelopmental disorders among US children and adolescents in 2019 and 2020.

Background: Concerning the changes in the prevalence of neurodevelopmental disorders (NDDs), we estimate the prevalence of attention-deficit/hyperactivity disorder (ADHD), autism spectrum disorder (ASD), intellectual disorder (ID), and learning disability (LD) among US children and adolescents aged 3-17 years in 2019 and 2020. Methods: The study includes 14,983 US children and adolescents aged 3-17 years in 2019 and 2020 from the National Health Interview Survey (NHIS). Parents were interviewed about whether their children ever and/or currently had NDDs diagnosed. Prevalence estimates of NDDs were calculated with a survey-based weighting scheme. Logistic regression models were used to estimate the associations between NDDs prevalence and subgroups. Results: The weighted prevalence of ADHD, ASD, ID, and LD was 8.5% (95% CI: 7.9-9.2%), 2.9% (95% CI: 2.6-3.4%), 1.4% (95% CI: 1.2-1.7%), and 6.4% (95% CI: 5.8-7.0%), respectively. A higher prevalence of ADHD, ASD, ID, and LD was observed in boys, those who ever had anxiety or depression symptoms, those with lower family income, those living in a rented house, ever been bullied, and ever lived with anyone mentally ill. Conclusion: The study found the prevalence of ADHD, ASD, ID, and LD was different by demographics, comorbidity/mental problems, household/parental characteristics, and stressful life events.