Association between the MCP-1 -2518 A > G (rs1024611) polymorphism and susceptibility to type 2 diabetes mellitus and diabetic nephropathy: a meta-analysis.

BACKGROUND: Studies evaluating the association between monocyte chemoattractant protein-1 (MCP-1) -2518 A > G (rs1024611) polymorphism and type 2 diabetes mellitus (T2DM) and diabetic nephropathy (DN) are contradictory. The present study aims to provide a comprehensive assessment and more reliable estimation of the relationship between the MCP-1 rs1024611 polymorphism and T2DM and DN risk. METHODS: Eligible articles were retrieved from the PubMed, Web of Science, EMBASE, Cochrane, and China National Knowledge Infrastructure databases. The effect summary odds ratios (ORs) and 95% confidence intervals (CIs) were obtained to calculate the summary effect size. Heterogeneity was analyzed by subgroup analysis and meta-regression. Publication bias was tested using funnel plots and Egger's test. RESULTS: In total, sixteen studies were included. Thirteen studies involving 2,363 patients with T2DM and 4,650 healthy controls found no significant association between the MCP-1 rs1024611 polymorphism and T2DM in the overall population. Ethnicity stratification found an association between the GG + GA genotype and decreased T2DM risk in Caucasians (OR = 0.79, 95% CI: 0.66-0.93, P = 0.006; PQ = 0.372). No significant risks were found in the Asian population for any genetic models. Seven studies found an association between the GG + GA genotype and DN risk in the Asian population (OR = 1.37, 95% CI: 1.11-1.71, P = 0.004, PQ = 0.222). No significant risks were found in the Caucasian population with any genetic models. There were no statistically significant differences in genotype distribution between patients with T2DM and DN in Asians or Caucasians. Meta-regression revealed that genotyping method was a major driver of heterogeneity in five genetic models (GG + GA vs. AA: P = 0.032; GG vs. GA + AA: P = 0.028; GG vs. AA: P = 0.035; GG vs. GA: P = 0.041; G vs. A: P = 0.041). CONCLUSION: The MCP-1 rs1024611 polymorphism is associated with susceptibility to T2DM in Caucasians and DN in Asians. Larger, well-designed cohort studies are needed in the future to verify this association.

Cross-cultural adaptation and psychometric validation of the Chinese version of career success in nursing scale (CSNS).

OBJECTIVE: To translate the career success in nursing scale (CSNS) into Chinese and evaluate its psychometric properties. BACKGROUND: A lower sense of career success seriously affects the enthusiasm of nurses and increases their turnover rate. Therefore, an accurate assessment of the career success level of nurses is necessary. However, China does not have a professional tool for assessing the career success of nurses. METHODS: The stratified sampling method was used to recruit participants from 22 hospitals of different grades in 5 cities in China. A total of 650 and 348 subjects were selected for item analysis and reliability and validity tests, respectively, of the translated initial scale. RESULTS: The Chinese version of the CSNS (C-CSNS) with 33 items had good psychometric properties. Cronbach's α was 0.960, split-half reliability was 0.893, and ICC within two weeks was 0.981. Exploratory factor analysis extracted 5 common factors that explained 63.73% of the total variance, and confirmatory factor analysis supported acceptable construct validity. CONCLUSION: The C-CSNS has adequate construct validity and excellent psychometric properties and can be used for accurate assessment of nurses' career success. IMPLICATIONS FOR NURSING MANAGEMENT: A new tool that is more suitable for the Chinese hospital nursing context is available for evaluating Chinese clinical nurses' career success. Nursing managers can formulate appropriate management strategies according to the evaluation results to assist nurses in career development planning, thereby improving their career success level.

Effectiveness of seminar-case learning for use in practice teaching of statistics for undergraduates majoring in preventive medicine: a prospective cluster-randomized controlled trial.

BACKGROUND: The seminar-case learning (SCL) method is a case-oriented teaching model, with teachers and students as the main body of teaching, characterized by communication, interaction, and mutual inspiration. This study explored the effects of the SCL method versus traditional lecture-based learning (LBL) in the statistics curriculum for undergraduate students majoring in preventive medicine. Research questions were: 1) whether the scores of students in the experimental group (the SCL model) were higher than those in the control group (the LBL model); 2) whether the students' satisfaction in the experimental group was better than that in the control group; and 3) whether the self-report benefit of students in the experimental group was better than that in the control group. METHODS: We conducted a two-armed cluster-randomized education intervention trial in practice teaching of health statistics among undergraduates majoring in preventive medicine. Two administrative classes (classes 1-4 and classes 5-8) were divided into the experimental group and the control group according to the principle of drawing lots. The students in two groups received the same statistical theory course. For the arrangement of statistical practice course, the experimental group adopted the SCL model, and the control group used the LBL model. The teaching effect was evaluated via an examination and an anonymous questionnaire survey. RESULTS: Scores for noun explanation questions in the experimental group showed no statistical significance with that of the control group(U = 2911.0, P = 0.964). The scores of single choice, calculation, and case analysis questions, and the total scores were significantly higher than that of the control group (P < 0.05). Students' satisfaction with arrangements of the practice course in the experimental group (92.41%) was significantly higher than that of in the control group (77.03%), the difference was statistically significant (χ2 = 7.074, P = 0.008). The self-report benefit of students in the experimental group was better than that in the control group (P < 0.05). CONCLUSION: As an effective method of high-quality education, the SCL model is worthy of further promotion in the practice teaching of preventive medicine.

The association between diurnal temperature range and childhood bacillary dysentery.

Previous studies have found that mean, maximum, and minimum temperatures were associated with bacillary dysentery (BD). However, little is known about whether the within-day variation of temperature has any impact on bacillary dysentery. The current study aimed to identify the relationship between diurnal temperature range (DTR) and BD in Hefei, China. Daily data on BD counts among children aged 0-14 years from 1 January 2006 to 31 December 2012 were retrieved from Hefei Center for Disease Control and Prevention. Daily data on ambient temperature and relative humidity covering the same period were collected from the Hefei Bureau of Meteorology. A Poisson generalized linear regression model combined with a distributed lag non-linear model (DLNM) was used in the analysis after controlling the effects of season, long-term trends, mean temperature, and relative humidity. The results showed that there existed a statistically significant relationship between DTR and childhood BD. The DTR effect on childhood bacillary dysentery increased when DTR was over 8 °C. And it was greatest at 1-day lag, with an 8% (95% CI = 2.9-13.4%) increase of BD cases per 5 °C increment of DTR. Male children and children aged 0-5 years appeared to be more vulnerable to the DTR effect. The data indicate that large DTR may increase the incidence of childhood BD. Caregivers and health practitioners should be made aware of the potential threat posed by large DTR. Therefore, DTR should be taken into consideration when making targeted health policies and programs to protect children from being harmed by climate impacts.

Asthma and Risk of Stroke: A Systematic Review and Meta-analysis.

BACKGROUND: Several studies have suggested that asthma is associated with an increased risk of stroke. However, the results are inconsistent. The aim of this study is to investigate the relation of asthma and the risk of stroke through a systematic review and meta-analysis of published research. METHODS: Pertinent studies were identified by a search of the PubMed and the Web of Science databases to June 2015. Study-specific hazard ratios (HRs) with 95% confidence intervals (CIs) were pooled using fixed-effect or random-effect models when appropriate. Associations were tested in subgroups representing different participants and study characteristics. Publication bias was assessed with Egger's test. RESULTS: Five articles comprising 524,637 participants and 6031 stroke cases were eligible for inclusion. Asthma was associated significantly with increased risk of stroke, and the pooled HR was 1.32 (95% CI: 1.13, 1.54, I(2)=80.4%). Subgroup analyses revealed that the association between asthma and stroke risk was stronger among female patients (HR = 1.42, 95% CI: 1.15-1.76) and prospective cohort study design (HR = 1.52, 95% CI: 1.21-1.91). CONCLUSION: Asthma is associated with a significantly increased risk of stroke. This finding may have clinical and public health importance.

Pelvic floor dysfunction and its influencing factors during radiotherapy in cervical cancer survivors: A cross-sectional study.

PURPOSE: Radiotherapy can negatively affect the pelvic floor function of patients with cervical cancer; however, the impact of different radiotherapy times and other related factors on pelvic floor function in cervical cancer survivors during radiotherapy remains unclear. We aimed to investigate the status of pelvic floor dysfunction (PFD) in cervical cancer survivors during radiotherapy and to analyze the factors influencing PFD. METHODS: In this cross-sectional study, a convenience sampling method was used to recruit cervical cancer survivors undergoing radiotherapy from January 2022 to July 2022 at a tertiary first-class hospital located in northeastern China. The Pelvic Floor Distress Inventory-Short Form 20 was used for participants' self-report of their PFD during radiotherapy. RESULTS: Data from 120 cervical cancer survivors were included in this study. The results showed that the mean PFDI-20 total score was 32.69 ± 7.76. Multiple stepwise linear regression analysis showed that 56.9% of the variance in PFD was explained by age (ß = 0.25, p < 0.001), body mass index (ß = 0.32, p < 0.001), recurrence (ß = 0.29, p < 0.001), number of radiotherapy sessions (ß = 0.39, p < 0.001), and number of deliveries (ß = 0.35, p < 0.001). CONCLUSION: It is important to pay more attention to the PFD status of cervical cancer survivors receiving radiotherapy. Future therapeutic approaches should involve early identification of relevant risk factors early to provide patients with personalized care at different stages of radiotherapy for reducing their discomfort and improving their health-related quality of life.

Association of tag single nucleotide polymorphisms (SNPs) at lncRNA MALAT1 with type 2 diabetes mellitus susceptibility in the Chinese Han population: A case-control study.

BACKGROUND: Type 2 diabetes mellitus (T2DM) is a chronic, lifelong disease. The molecular mechanisms and pathophysiology of T2DM have not yet been fully elucidated. Dysregulation of the long non-coding RNA metastasis associated lung adenocarcinoma transcript 1 (lncRNA MALAT1) is considered one of the main contributing factors of the dysfunction found in many diseases, including those of the endocrine system. The aim of this study was to investigate the association between lncRNA MALAT1 single nucleotide polymorphisms (SNPs) and T2DM in the Chinese Han population. METHODS: We genotyped three SNPs (rs3200401 C > T, rs619586 A > G, rs11227209 C > G) of the MALAT1 gene, including 571 T2DM patients and 526 controls. The association between different genotypes and the risk of T2DM was analyzed using logistic regression, and the results were expressed by odds ratio (OR) and its 95% confidence interval (95%CI), and then stratified by age, sex, and BMI. P < 0.05 on both sides was considered as statistically significant. RESULTS: We found that the CT + TT genotypes of the rs3200401 polymorphism were significantly associated with an increased risk of T2DM in Chinese Han population (OR = 1.77; 95% CI:1.35-2.33; Padjusted < 0.001), whereas MALAT1 rs619586 AG + GG genotypes were associated with a reduced risk of T2DM (OR = 0.67; 95% CI:0.48-0.94; Padjusted = 0.021). Subsequent stratified analysis showed that compared with the rs3200401 CC genotype, CT + TT genotypes were associated with an increased risk of T2DM in the male, female, age ≥ 65 years, and BMI ≥ 24 subgroups (OR = 1.68, 95% CI:1.10-2.56, Padjusted = 0.016; OR = 1.83, 95% CI:1.27-2.62, Padjusted = 0.001; OR = 1.86, 95% CI:1.38-2.52, Padjusted < 0.001; OR = 2.13, 95% CI:1.45-3.15, Padjusted < 0.001; respectively). Haplotype analysis showed that T-A-C haplotype had a 1.533-fold increased risk of T2DM (95% CI, 1.208-1.945, P < 0.001) and C-G-G was associated with a decreased risk of T2DM. No significant association was found between rs11227209 and T2DM risk (P > 0.05). CONCLUSION: The results suggest that MALAT1 rs619586 and rs3200401 confer susceptibility for T2DM in the Chinese Han population and provide new genetic targets for the treatment of diabetes and its complications in the future.

Chronotypes and their association with sleep quality among Chinese college students of Anhui Province: a cross-sectional study.

OBJECTIVES: To describe the prevalence of chronotype and sleep quality among Chinese college students and explore the relationship between chronotype and sleep quality. DESIGN: A cross-sectional study. SETTING: Four colleges and universities in Anhui, China, between November and December 2020. PARTICIPANTS: A total of 4768 college students were recruited using a stratified, multistage, cluster sampling survey. OUTCOME MEASURES: Morningness-Eveningness Questionnaire 19 was used to determine the chronotype of the students and the Pittsburgh Sleep Quality Index (PSQI) was used to measure their sleep quality. The multiple logistic regression model was used to explore the potential association between chronotype and sleep quality. RESULTS: The self-reported proportions of evening-type (E-type), neutral-type and morning-type among college students were 51.17%, 45.14% and 3.69%, respectively. The mean PSQI score was 4.97±2.82 and the prevalence of poor sleep quality was 18.2%. After adjusting the covariates by multiple logistic regression analysis, E-type was positively associated with subjective sleep quality (OR=1.671, 95% CI 1.414 to 1.975), sleep latency (OR=1.436, 95% CI 1.252 to 1.647), sleep duration (OR=2.149, 95% CI 1.506 to 3.067), habitual sleep efficiency (OR=1.702, 95% CI 1.329 to 2.180), daytime dysfunction (OR=1.602, 95% CI 1.412 to 1.818) and overall poor sleep quality (OR=1.866, 95% CI 1.586 to 2.196). CONCLUSIONS: College students mainly exhibited E-type, and an elevated prevalence of poor sleep quality existed among these students. The E-type was positively associated with poor sleep quality.

Association of rs2910164 in miR-146a with type 2 diabetes mellitus: A case-control and meta-analysis study.

Objective: Several studies have shown that miR-146a rs2910164 (C > G) is associated with type 2 diabetes mellitus (T2DM) susceptibility, but the results are still controversial. This study is divided into two parts, and one is to explore the relationship between miR-146a rs2910164 polymorphism and the genetic susceptibility of T2DM in Chinese Han population. Second, a meta-analysis on the basis of a larger sample size was used to determine whether this is a susceptibility gene for T2DM. Methods: A case-control study including 574 T2DM patients and 596 controls was used to evaluate the association of miR-146a rs2910164 polymorphism with the risk of T2DM in Chinese Han People. Then, we systematically searched studies investigating the correlation between miR-146a rs2910164 polymorphism and T2DM susceptibility published before April 2022 from PubMed, Web of Science, Wanfang, and China National Knowledge Infrastructure database, and a meta-analysis including six studies was carried out. The results were expressed by odds ratio (OR) and its 95% confidence interval (95% CI). Results: In a case-control study, we found that there were no statistical differences in genotype frequencies between T2DM and control group. Subgroup analysis showed that, compared with the CC genotype, CG + GG genotype was associated with a decreased risk of T2DM in the subgroup of individuals ≥ 65 years old (OR = 0.75; 95% CI: 0.58-0.98; P adjusted = 0.032) and BMI < 18.5 (OR = 0.16; 95% CI: 0.03-0.89; P adjusted = 0.037). In overall meta-analysis, significant heterogeneity was detected. No significant association between miR-146a rs2910164 polymorphism and T2DM was observed in all genetic models under random effects models. Subgroup analysis revealed that there was a significant difference in genotype frequencies between the T2DM and control group in recessive model (CC vs. CG + GG: OR = 1.79; 95% CI: 1.08-2.96; PQ = 0.307, I 2 = 4.0%) and homozygote model (CC vs. GG: OR = 1.79; 95% CI: 1.07-3.00; PQ = 0.216, I 2 = 34.7%) in Caucasians. Conclusion: The results of our study demonstrate that the miR-146a rs2910164 polymorphism might have ethnicity-dependent effects in T2DM and may be related to T2DM susceptibility in Caucasians.

Associations between Chinese college students' anxiety and depression: A chain mediation analysis.

OBJECTIVE: Anxiety and depression are great public health concerns among college students. The purpose of this study was to explore whether sleep quality and quality of life (QoL) play mediating roles in anxiety and depression among Chinese college students. METHOD: A total of 2757 college students (mean age = 19.07; SD = 1.14) completed the questionnaires, including a brief demographic survey. The 2-item General Anxiety Disorder (GAD-2) and the 2-item Patient Health Questionnaire (PHQ-2) were used to assess the symptoms of anxiety and depression, respectively. And the Pittsburgh Sleep Quality Index (PSQI) and the Short-Form 36 Health Survey (SF-36) were used to evaluate college students' sleep quality and QoL, respectively. Mediation analyses were conducted by using PROCESS macro in the SPSS software. RESULT: Anxiety had both direct and indirect effects on depression. Sleep quality and QoL were not only independent mediators in the relationship between anxiety and depression but also chain mediators. CONCLUSION: The results of the current study highlight the crucial role of early intervention for depression with a focus on college students with anxiety, more especially, on those with poorer sleep quality and lower QoL.

Association of learning environment and self-directed learning ability among nursing undergraduates: a cross-sectional study using canonical correlation analysis.

OBJECTIVES: This study explores the relationship between the perception of the learning environment and self-directed learning (SDL) ability among nursing undergraduates. DESIGN, SETTING AND PARTICIPANTS: A cross-sectional study was conducted in December 2020 with 1096 junior and senior undergraduate nursing students (aged 16-22) from Wannan Medical College in Anhui Province, China. OUTCOME MEASURES: The Chinese version of the Dundee Ready Educational Environment Measure questionnaire and a validated Chinese version of college students' SDL ability scale were used to assess students' perceptions about their learning environment and their SDL ability. Canonical correlation analysis was performed to evaluate their correlation. RESULTS: The total score for the learning environment was 120.60 (scoring rate: 60.30%), and the score for SDL ability was 89.25 (scoring rate: 63.75%). Analysis indicated that the first canonical correlation coefficient was 0.701 and the contribution rate was 94.26%. The perception of the learning environment was mainly determined by students' perception of learning (SPL) and academic self-perceptions (SASP), with SDL ability mainly determined by self-management ability and cooperative learning ability. SPL and SASP were positively correlated with self-management ability and cooperative learning ability. Multiple linear regression analysis revealed that SPL, SASP, students' perceptions of atmosphere and students' social self-perceptions had a significant impact on SDL ability. CONCLUSIONS: The SDL ability of nursing undergraduates was not high. SPL and SASP were positively correlated with self-management ability and cooperative learning ability. Nursing educators can improve students' SDL ability by changing their learning environment, using, for example, new student-centred teaching methods.

Association Between Online Self-Directed Learning Ability and Negative Emotions Among College Students During the COVID-19 Pandemic: A Cross-Sectional Study in Anhui Province, East China.

Background: This study investigated the correlation between depression, anxiety, and stress among college students engaged in online learning during the coronavirus disease 2019 (COVID-19) pandemic and self-directed learning (SDL) ability, which could provide a scientific basis for mental health education of the college students. Methods: A cross-sectional study was conducted among 5,558 students from two universities in Anhui province, East China. The Depression, Anxiety, and Stress Scale-21 (DASS-21) and the Self-directed Learning Ability Scale were used to conduct an online questionnaire survey. Results: A total of 35.15, 36.32, and 17.24% of college students reported symptoms of depression, anxiety, and stress, respectively. Males and nonmedical students were at higher risks to suffer from depression, anxiety, and stress. In adjusted model, compared with Q1 of self-management ability, the odds ratio (OR) of the Q2, Q3, and Q4 were as follows: 0.635 (0.531-0.759), 0.504 (0.415-0.611), and 0.312 (0.248-0.392) for depression; 0.639 (0.535-0.764), 0.653 (0.540-0.789), and 0.421 (0.338-0.525) for anxiety; and 0.649 (0.523-0.805), 0.579 (0.457-0.733), and 0.482 (0.364-0.637) for stress. For information capability, decrease in risk was even more pronounced: Q2 (0.654, 0.540-0.794), Q3 (0.560, 0.454-0.690), and Q4 (0.233, 0.181-0.301) for depression; Q2 (0.781, 0.646-0.945), Q3 (0.616, 0.501-0.757), and Q4 (0.276, 0.216-0.353) for anxiety; and Q2 (0.444, 0.357-0.553), Q3 (0.454, 0.357-0.578), and Q4 (0.272, 0.202-0.368) for stress. Compared with the Q2 group of cooperation learning ability, cooperation learning ability quartiles were positively associated with depression (Q1: 1.382, 95% CI: 1.138-1.678), anxiety (Q4: 1.260, 95% CI: 1.008-1.576), and stress (Q1: 2.002, 95% CI: 1.583-2.532; Q3: 1.600, 95% CI: 1.252-2.044; Q4: 1.674, 95% CI: 1.243-2.255). Conclusion: The prevalence of depression, anxiety, and stress among college students was high for those studying online at home during the COVID-19 pandemic, especially among nonmedical students and males. SDL ability was negatively associated with negative emotions of the college students during this period of online learning.

Exposure to bisphenol A and the development of asthma: A systematic review of cohort studies.

BACKGROUND: There is conflicting evidence about the association between bisphenol A (BPA) exposure and childhood asthma risk. We aimed to review the epidemiological literature on the relationship between prenatal or postnatal exposure to BPA and the risk of childhood asthma/wheeze. METHODS: The PubMed database was systematically searched, and additional studies were found by searching reference lists of relevant articles. RESULTS: Six studies fulfilled the eligibility criteria. Three studies found that prenatal BPA exposure is associated with an increased risk of childhood wheeze, while another study reported a reduced risk of wheeze. Regarding the postnatal BPA exposure, three studies demonstrated an increased risk of childhood asthma/wheeze. CONCLUSIONS: The mean prenatal BPA was associated with the risk of childhood wheeze/asthma. Besides, the influence of BPA exposure during the second trimester of pregnancy on the prevalence of childhood wheeze was marked. Further studies are urgently needed to explore the underlying mechanism about adverse effect of BPA exposure on childhood wheeze/asthma.