Effectiveness comparisons of various psychosocial therapies for children and adolescents with depression: a Bayesian network meta-analysis.

The existence of depression among children or adolescents can trigger a sequence of burdens on themselves, their families and even the whole society, which cause both physical and economic impacts. Our network meta-analysis (NMA) was aimed at comparing them with each other for evaluating the optimal psychosocial therapy to help children and adolescents with depression to improve their mental health. Based on several biomedical databases, a system of search strategies was conducted for searching randomized controlled trials (RCTs) which published from their inception on October, 1st 2018 without language restriction. We carried out an expression analysis for comparing the efficacy of various psychosocial therapies using Bayesian NMA. A battery of analyses and assessments, such as conventional meta-analysis and risk of bias, were performed concurrently. Only 32 of RCTs which involved 2677 participants were eventually included in our analyses from the 19,176 of initial citation screening. In addition, in terms of various valid assessment instruments, interpersonal psychotherapy [standard mean difference (SMD) = -1.38, Credible interval (CrI) - 2.5, - 0.20)], computer cognitive-behavioral therapy (SMD = -1.36, CrI - 2.59, - 0.14), cognitive-behavioral therapy (SMD = -1.16, CrI - 2.15, - 0.18), had significantly better effects than the named control group. All together, these results suggest that interpersonal psychotherapy might be the best approach to improve the depressive state among children and adolescents. This study may provide an excellent resource for future endeavors to utilize psychosocial interventions and may also serve as a springboard for creative undertakings as yet unknown.

Iris surface features and anterior chamber depth in Chinese adolescents.

BACKGROUND: We aim to determine the association of iris surface features including crypts, color and contraction furrows with anterior chamber depth (ACD) in a school-based sample of Chinese teenagers. METHODS: Totally, 2346 students aged 13 to 14 years in Mojiang located in the Southwestern part of China contributed to this analysis. Iris surface features were graded based on standardized slit-lamp photographs. Ocular biometric parameters including ACD were measured using an IOL Master. Generalized estimating equation was incorporated in the linear regression models to assess the relationship between iris surface features and ACD. RESULTS: A significant trend of increasing ACDs with more contraction furrows were observed. On average, the mean ACD was 3.03 mm in participants with contraction furrows of grade 1 while it was 3.10 mm in those with grade 3 (mean difference, 0.07 mm, P = 0.01). Adjusting for other potential confounders such as gender, height and weight did not significantly changed the associations. Compared with individuals with contraction furrows of grade 1, those with grade 3 had a greater ACD of 0.06 mm (95% confidence interval: 0.01, 0.11) in multivariate-adjusted model. There were no significant relationships between ACD and iris crypts or color. (P > 0.10). CONCLUSIONS: More iris contraction furrows are associated with greater ACDs while the association with iris color and crypts were not significant.

Combined effect of three common lifestyle factors on cognitive impairment among older Chinese adults: a community-based, cross-sectional survey.

AIM: Lifestyle factors may influence cognitive function. Therefore, we compared the risk of cognitive impairment (COI) of all possible combinations of three lifestyle factors-tea consumption, physical activity, and siesta (afternoon nap or rest)-to the absence of any of these lifestyle factors. METHODS: This cross-sectional study consisted of 4579 community-dwelling Chinese individuals aged 60 years or older living in Suzhou. Among the subjects were 3634 participants with normal cognition and 945 who had been diagnosed with COI according to the Abbreviated Mental Test. Odds ratios (ORs) and 95% confidence intervals (CIs) were estimated with a multivariate-adjusted model by logistic regression. RESULTS: Individually, tea consumption and physical activity significantly lowered the risk of COI to 0.66 (95%CI: 0.48-0.90) and 0.79 (95%CI: 0.65-0.96), respectively. In combination, physical activity and siesta reduced the risk of COI to the greatest extent (OR = 0.44, 95%CI: 0.31-0.64). Based on multivariate adjustment, almost all combinations of factors had a significant negative association with COI, but the combination of tea consumption and siesta had an irrelevant correlation with COI. All combinations of lifestyle factors had a lower OR than any single lifestyle factor among the correlations that were significant. CONCLUSION: Based on our findings, engaging in physical activity in combination with either or both of the other lifestyle factors was associated with a lower OR of having COI than adhering on a single factor in elderly Chinese people.

Longitudinal association between sleep and 5-year incident metabolic syndrome in older Chinese adults: a community-based cohort study.

PURPOSE: Our aim was to investigate the association between sleep and the development of metabolic syndrome (MetS) in Chinese older adults and to accumulate evidence for the prevention of MetS through sleep management. METHODS: This prospective study followed 3005 participants aged over 60 derived from the Weitang Geriatric Diseases Study who were without MetS at baseline. MetS was defined according to the Adult Treatment Panel III (ATP III) criteria. Logistic regression models were fit to assess the association between sleep and MetS incident and a linear regression model was used to examine the impact of sleep duration on every component of MetS. Data on sleep-related parameters were obtained based on a self-reported questionnaire. RESULTS: After five-year follow-up, 13.51% participants developed MetS, of which 46.86% were women. The incidence of MetS was highest among adults who slept 6 h or less and lowest among those who slept 7 h after adjusted for multiple variables. Subgroup analyses showed no gender specificity. The variation of fasting plasma glucose (FBG) for ≥9 h per night was significantly lower than that for 7.01-7.99 h per night (ß = -0.18, P < 0.05). Sleeping for 8-8.99 h also decreased the variation of diastolic blood pressure (DBP) compared to 7.01-7.99 h (ß = -0.84, P < 0.05). CONCLUSION: We conclude that both short and long sleep duration are risk factors for MetS incident in older adults.

Depressive symptoms and metabolic syndrome components among older Chinese adults.

BACKGROUND: Few studies examined associations between depressive symptoms and metabolic syndrome (MetS) among older Chinese adults. Considering that the prevalence of depressive symptoms is high in older Chinese adults, we aimed to examine associations of depressive symptoms with MetS and its components in older Chinese adults. METHODS: Data from a community-based cross-sectional study of 4579 Chinese adults aged 60 years or older were analyzed. Depressive symptoms were assessed using the nine-item Patient Health Questionnaire. The presence of MetS was defined based on the Adult Treatment Panel III criteria, which include obesity, reduced blood high-density lipoprotein, high blood pressure (BP), elevated fasting plasma glucose and hypertriglyceridemia. A participant was considered as having MetS if he or she met at least three of the above-mentioned criteria. RESULTS: In all participants, depressive symptoms were related to elevated fasting plasma glucose (≥ 7.0 mmol/L) (adjusted odds ratio [OR] = 1.50, 95% confidence interval [CI] [1.00-2.20]) and diabetes (adjusted OR = 1.50, 95% CI [1.01-2.20]). The associations of depressive symptoms with MetS and its components were not significant among women. However, there was a negative association between depressive symptoms and elevated systolic BP (≥ 130 mm Hg) (OR = 0.59, 95% CI [0.4-0.9]), and similar findings were observed after adjusting for lifestyle-related variables in men. CONCLUSIONS: In older Chinese adults, depressive symptoms were negatively associated with elevated systolic BP in men while these findings were not found in women.

Central Corneal Thickness and Its Association with Birth Parameters in Chinese Adolescents.

Purpose: To examine the distribution and determinants of central corneal thickness (CCT) including birth weight and gestational age in a school-based samples of Grade 7 students in rural China. Methods: 2346 (93.5%) grade 7 students with a mean age of 13.8 years participated in the study. CCT was measured for both eyes using the LenStar LS900. Information regarding birth weight and gestational age was retrieved from the participants' delivery records. A linear regression model was established to examine the relationship of birth weight, gestational age and other factors with CCT. Results: The mean CCT in this population was 534.7 µm and boys had a greater CCT compared with girls (P = .06). CCT was positively related to axial length (r = 0.056) while negatively related to anterior chamber depth (r = -0.076) and corneal power (r = -0.105) . In multivariate analyses, the cornea was 19.35µm thinner in individuals with low birth weight compared with those with normal. In addition, the cornea was 25.25µm thinner in prematurely born adolescents compared with full-term ones. The combined effect of birth weight and gestational age on CCT was not statistically significant (P for interaction = 0.12) Conclusions: Low birth weight and small gestational age are associated with thinner corneas in adolescence. This disparity across groups with different levels of birth parameters should be taken into account by future studies investigating CCT as risk factors or diagnostic tests for glaucoma.

Distribution and Determinants of Peripapillary Retinal Nerve Fiber Layer Thickness and Its Association with Sleep Quality in Chinese Teenagers.

PURPOSE: We aimed to evaluate the distribution and determinants of peripapillary retinal nerve fiber layer (pRNFL) thickness and its associations with general sleep quality in Chinese school students. METHODS: 1063 grade 7 students aged 13 to 14 years with pRNFL thickness data from a school-based study on grade 7 students in Southwestern China participated in the study. The pRNFL thickness was measured on the optical coherence tomography images of a circular scan centered on the optic disc. Refractive error was measured after cycloplegia using an autorefractor and biometric parameters including axial length (AL) were measured by an IOLMaster. Participants' sleep quality was measured by the Children's Sleep Habits Questionnaire (CSHQ). RESULTS: The mean pRNFL thickness was 106.8 ± 10.7 µm among the 1063 participants. There was an increasing trend of spherical equivalent and a decreasing trend of AL with RNFL thickness. In multivariate analysis, each diopter of spherical equivalent increase was associated with 0.64 µm increase in pRNFL thickness. Girls had an increased mean pRNFL thickness compared with boys with a mean difference of 1.65 µm. Per 10 µm increase in pRNFL thickness was significantly associated with a 0.5 reduction in CSHQ score (better sleep quality). CONCLUSIONS: More myopic refractive error was the major ocular determinant of decreased pRNFL thickness. In addition, students with thinner pRNFL tended to have a worse sleep quality.

Associations of sleep durations and sleep-related parameters with metabolic syndrome among older Chinese adults.

PURPOSE: There is a lack of data on the role of sleep in the development of metabolic syndrome (MetS) in older adults. We aimed to examine the associations of sleep durations at night and other sleep-related parameters with the presence of MetS in older Chinese adults. METHODS: Data of 4579 individuals aged 60 years or older from the Weitang Geriatric Disease Study were analyzed. MetS was diagnosed based on the Adult Treatment Panel III (ATP III) criteria. Information regarding sleep durations and other sleep-related parameters was collected by questionnaires. RESULTS: Compared with those with daytime napping, individuals without daytime napping were at an increased risk of MetS (odds ratio [OR] = 1.23; 95% confidence interval [CI] = 1.03-1.47). Each hour increase in daytime napping increased the risk of MetS by 33% (OR = 1.33; 95% CI = 1.15-1.52). After adjusting for the effect of age and gender, a J-shaped association between sleep durations at night and the presence of MetS was observed. The risk of MetS was lowest among those who slept 7-8 h at night. Gender-stratified analysis indicated that the J-shaped relationship between sleep durations at night and MetS remained significant in men but not in women. CONCLUSIONS: In older Chinese adults, sleep durations at night might have a dual effect on the risk of MetS and this effect was particularly pronounced in men. The results indicated that circadian rhythm might play an important role in the development of MetS in older populations.

Non-pharmacological therapeutic strategy options for patients with dementia based on cognitive function-A Bayesian network meta-analysis of randomized controlled trials.

Dementia represents one of the most common neurodegenerative disorders in older adults. However, it is still unclear whether non-pharmacological therapies (NPTs) are effective or not and which treatment should be preferred. We applied a series of search strategies to identify eligible randomized controlled trials on 1st October, 2018, investigating the effects of NPTs of dementia in the older persons. Pairwise and network meta-analyses were sequentially performed. A total of 31 trials were included, which enrolled 1895 participants and 7 NPTs. Compared with control group, all the NPTs included were statistically beneficial to cognitive function, and our study indicated Comprehensive Therapy(CT) [the surface under the cumulative ranking curve (SUCRA = 92.42%)] might be the best choice for dementia patients. Our study suggests CT might be the optimal NPT for improving the cognitive function of dementia patients. However, the above conclusions need to be further analyzed.