Bayesian network analysis of factors influencing type 2 diabetes, coronary heart disease, and their comorbidities.

OBJECTIVE: Bayesian network (BN) models were developed to explore the specific relationships between influencing factors and type 2 diabetes mellitus (T2DM), coronary heart disease (CAD), and their comorbidities. The aim was to predict disease occurrence and diagnose etiology using these models, thereby informing the development of effective prevention and control strategies for T2DM, CAD, and their comorbidities. METHOD: Employing a case-control design, the study compared individuals with T2DM, CAD, and their comorbidities (case group) with healthy counterparts (control group). Univariate and multivariate Logistic regression analyses were conducted to identify disease-influencing factors. The BN structure was learned using the Tabu search algorithm, with parameter estimation achieved through maximum likelihood estimation. The predictive performance of the BN model was assessed using the confusion matrix, and Netica software was utilized for visual prediction and diagnosis. RESULT: The study involved 3,824 participants, including 1,175 controls, 1,163 T2DM cases, 982 CAD cases, and 504 comorbidity cases. The BN model unveiled factors directly and indirectly impacting T2DM, such as age, region, education level, and family history (FH). Variables like exercise, LDL-C, TC, fruit, and sweet food intake exhibited direct effects, while smoking, alcohol consumption, occupation, heart rate, HDL-C, meat, and staple food intake had indirect effects. Similarly, for CAD, factors with direct and indirect effects included age, smoking, SBP, exercise, meat, and fruit intake, while sleeping time and heart rate showed direct effects. Regarding T2DM and CAD comorbidities, age, FBG, SBP, fruit, and sweet intake demonstrated both direct and indirect effects, whereas exercise and HDL-C exhibited direct effects, and region, education level, DBP, and TC showed indirect effects. CONCLUSION: The BN model constructed using the Tabu search algorithm showcased robust predictive performance, reliability, and applicability in forecasting disease probabilities for T2DM, CAD, and their comorbidities. These findings offer valuable insights for enhancing prevention and control strategies and exploring the application of BN in predicting and diagnosing chronic diseases.

Association between vitamin C in serum and trouble sleeping based on NHANES 2017-2018.

Vitamin C is an important micronutrient for human. Association between vitamin C and trouble sleeping was less studied. Therefore, the purpose of this study was to investigate the possible link between vitamin C in serum and trouble sleeping. The cross-sectional data was derived from the National Health and Nutrition Examination Survey (NHANES, 2017-2018). Trouble sleeping was measured by asking participants: "Have you ever told doctor had trouble sleeping". Responses to this question was "yes" or "no". vitamin C in serum was obtained by measuring the serum samples. We used multivariable binary logistic regressions to examine the possible link between vitamin C in serum and trouble sleeping, and then a subgroup analysis was performed. Moreover, the non-linear relationship between vitamin C in serum and trouble sleeping was further detected using a restricted cubic spline (RCS) model. A total of 3227 participants were included in the study. After adjusting all potential confounders, the results of multivariable logistic regression showed the significant negative association between vitamin C in serum and trouble sleeping(OR = 0.816; 95% CI:0.669 ~ 0.995). The significant inverse association was also found in female(OR = 0.713; 95% CI:0.546 ~ 0.931), age ≤ 65 years(OR = 0.773; 95% CI:0.600 ~ 0.996), and in participants with high cholesterol level(OR = 0.738; 95% CI:0.548 ~ 0.994). In addition, the RCS model demonstrated the significant non-linear relationship between vitamin C in serum and trouble sleeping (P value of nonlinear = 0.010). Our study demonstrates the significant negative association between vitamin C in serum and trouble sleeping.

Associations between dietary inflammatory index and stroke risk: based on NHANES 2005-2018.

The dietary inflammatory index (DII) is a measure of the inflammatory potential of the diet and is closely associated with insulin resistance (IR) and stroke. And IR may play an important role in the development of stroke. Therefore, this study aimed to evaluate the relationship between DII and stroke risk while delving into the potential role of IR in this association. We analyzed data from the National Health and Nutrition Examination Survey (NHANES) from 2005 to 2018, performing weighted univariate analyses, logistic regression, and mediation analyses. At baseline, 3.89% of participants developed stroke, and we observed stroke patients exhibited higher DII scores. After adjusting for covariates, compared to participants in the first quartile of DII scores, those in the third quartile and fourth quartile had increased odds of experiencing a stroke (OR: 1.78, 95% CI: 1.18-2.68) and (OR: 1.70, 95% CI: 1.16-2.50), respectively. Moreover, a significant dose-response relationship was observed (P-trend < 0.05). However, there was no observed interaction between DII and homeostatic model assessment-IR (HOMA-IR) concerning stroke risk, and HOMA-IR did not mediate the association between DII and stroke. In summary, our study elucidated the significant association between DII and stroke risk, independent of IR. This insight suggests that an anti-inflammatory diet may serve as an effective strategy for stroke prevention.

Role of remnant cholesterol in the relationship between physical activity and diabetes mellitus: an intermediary analysis.

Objective: The purpose of this investigation was to evaluate the potential link between physical activity (PA) and the heightened susceptibility to diabetes mellitus (DM), by examining whether remnant cholesterol (RC) might act as a mediator in this correlation. Methods: The research utilized data from the National Health and Nutrition Examination Survey, spanning from 2005 to 2018. Various statistical analyses were conducted for continuous and categorical variables, including the t-test, ANOVA, and χ2 test. Logistic regression was employed to analyze the association between PA and DM across three distinct models. Mediation analysis was also conducted to assess the potential mediation effects of RC. Results: The study encompassed a total of 9,149 participants, and it was observed that individuals with DM exhibited lower levels of PA. Furthermore, PA levels were found to be associated with all participant characteristics except poverty income ratio, fasting blood glucose, and HOMA-IR (p < 0.05). After adjusting for covariates (Model 3), individuals with high PA levels demonstrated a decreased likelihood of developing DM compared to those in the low PA group (OR: 0.73, 95%CI: 0.54-0.99). A significant dose-response relationship was identified (p < 0.05). No interaction between PA and RC in relation to DM risk was detected, and RC was found to serve as a mediator in the connection between PA and DM. After considering covariates, the mediating effect of RC between PA and DM weakens. Discussion: Our findings suggest that higher levels of PA are linked to a reduced risk of DM in U.S. adults, with RC likely playing a mediating role.

Bright light therapy has a positive effect on sleep quality in patients with cancer: A meta-analysis.

Cancer patients frequently encounter difficulties associated with suboptimal sleep quality. Bright Light Therapy (BLT), an innovative treatment approach, has shown promise in enhancing sleep quality. However, several literature reviews showed conflicting results, and more analysis should be conducted regarding detailed BLT settings on sleep. This meta-analysis was undertaken to comprehensively assess the impact of BLT on sleep quality among cancer patients. Twelve studies with 679 patients were included. Compared with the control group, BLT overall resulted in significant improvements in terms of sleep quality [g = -0.34], total sleep time [g = 0.24], wake after sleep onset [g = -0.80], and fatigue [g = -0.54]. However, it did not yield a statistically significant effect on sleep efficiency, sleep onset latency, and insomnia severity. Regarding light settings, interventions featuring light intensities >5000lux, intervention duration ≥4 weeks, spectral emission peak at 464∼465 nm, and using a lightbox demonstrated heightened efficacy in improving sleep. BLT may be considered a supplementary therapeutic option to improve sleep quality among cancer patients. However, more extensive and rigorous studies are necessary to determine the optimal timing of BLT delivery and its applicability to cancer patients across different age groups.

Professional commitment and related factors among nursing undergraduates: A latent profile analysis.

OBJECTIVE: To identify different subgroups of nursing professional commitment among nursing undergraduates and to analyze the related factors of the different subgroups. METHODS: A cross-sectional study using the professional commitment scale with 430 nursing undergraduates was conducted. Latent profile analysis was used to explore the nursing students' professional commitment subgroups and using multivariate logistic regression to analyze the related factors of nursing professional commitment. RESULTS: The overall mean score for professional commitment in nursing was (75.07 ± 14.715). There were three different subgroups of professional commitment characteristics, namely the "high professional commitment group" (20.465 %), the "medium professional commitment group" (66.279 %), and the "low professional commitment group" (13.256 %). Dissatisfaction with clinical placement (OR = 3.556, p = 0.008) and self-enrollment (OR = 0.186, p = 0.002) were significantly related factors for low-level and medium-level nursing commitment groups. Students' origin in western China (OR = 1.869, p = 0.042) significantly influenced the medium-level specialty commitment group. CONCLUSIONS: Most nursing undergraduates have been categorized in the "medium professional commitment group". Students who were dissatisfied with their clinical experience and chose the nursing profession involuntarily were the main factors for low-level and medium-level nursing professional commitment. The clinical practice environment should be further improved to enhance the clinical experience satisfaction of nursing undergraduates; at the same time, the professional value cultivation of students whose choice of nursing profession was not made by themselves should be strengthened to improve the level of professional commitment of nursing undergraduates.

The interaction of financial toxicity and social support on social functioning in post-chemotherapy breast cancer patients: a cross-sectional study.

PURPOSE: To explore the correlation between financial toxicity, social support, and social functioning in post-chemotherapy breast cancer patients, as well as any possible interaction of financial toxicity and social support on social functioning. METHODS: Post-chemotherapy breast cancer patients admitted to the thyroid and breast surgery departments of three first-class general hospitals in East China from December 2020 to January 2022 were recruited by convenience sampling for a cross-sectional survey. The survey instruments included the general information form, the comprehensive scores for financial toxicity based on the patient-reported outcome measures (COST-PROM), the social roles and activity participation subscale from the patient-reported outcomes measurement system-breast-chemotherapy (PROMS-B-C) (score range: 8-40), and the social support subscale from PROMS-B-C (score range: 16-80). RESULTS: The results showed that low social functioning (low score) in post-chemotherapy breast cancer patients was positively correlated with high financial toxicity (low score) as well as poor economic resources (low score) and poor psychosocial responses (low score) (P<0.01) and negatively correlated with low economic expenditures (low score) (P<0.01); high social functioning (high score) was positively correlated with high social support (high score) (P<0.01). The interaction analysis results showed an additive interaction between financial toxicity and social support in social functioning. CONCLUSION: There was an additive interaction of financial toxicity and social support in the social functioning of post-chemotherapy breast cancer patients. Those patients with high financial toxicity and low social support are the most likely to benefit from relevant intervention measures compared to other breast cancer populations.

Relationship between Social Media Use and Social Anxiety in College Students: Mediation Effect of Communication Capacity.

An increasing number of college students are experiencing social anxiety in an era of prevalent social networking. College students' social anxiety may be related to their social media use. However, this relationship has not been confirmed. This study aimed to investigate the relationships between different types of social media use and social anxiety among college students, and the mediation effects of communication capacity in this context. A large sample of 1740 students from seven colleges in China was analyzed. Bivariate correlation and structural equations analysis showed that passive social media use was positively correlated with social anxiety. Active social media use was negatively correlated with social anxiety. Communication capacity partially mediated the relationship between social media use (passive/active) and social anxiety. Active social media use may reduce social anxiety by positively mediating communication capacity, while improved communication capacity may reduce the contribution of passive use to social anxiety. The differences in the effects of different social media use on social anxiety deserve the attention of educators. Developing communication capacity education around college students may help reduce their social anxiety.

Status of and Factors Influencing the Stigma of Chinese Young and Middle-Aged Maintenance Hemodialysis Patients: A Preliminary Study.

Many young and middle-aged maintenance hemodialysis patients suffer a poor prognosis, experience a series of problems during long-term treatment and are thus prone to stigma. This study was designed to analyze stigma in young and middle-aged maintenance hemodialysis patients and explore its influencing factors. This study was conducted as a cross-sectional descriptive study with a convenience sampling method and included 97 patients from Shanghai Jiao Tong University Affiliated Sixth People's Hospital between November 2020 and February 2021. The Social Impact Scale, a demographic questionnaire, and hemodialysis indicators were used in the investigation. Patient biochemical indexes from hemodialysis were compared. Young and middle-aged maintenance hemodialysis patients had a medium level of stigma. Patients who had low income, were younger, were male, had long-term hemodialysis and were unemployed had significantly higher stigma scores than other patients (P < 0.05). Age, gender, occupational status, annual household income and the duration of hemodialysis were found to be the main factors related to stigma in young and middle-aged maintenance hemodialysis patients by multiple regression analysis. Perceptions of hemodialysis-related stigma were common in our sample. Patients who had low income, were younger, were male, had long-term hemodialysis and were employed had a higher level of stigma, which deserves attention from clinical medical workers. Replication studies are needed to confirm these findings.

Identification and analysis of miRNAs in IR56 rice in response to BPH infestations of different virulence levels.

Rice production and sustainability are challenged by its most dreadful pest, the brown planthopper (Nilaparvata lugens Stål, BPH). Therefore, the studies on rice-BPH interactions and their underlying mechanisms are of high interest. The rice ontogenetic defense, such as the role of microRNAs (miRNAs) has mostly been investigated against the pathogens, with only a few reports existing against the insect infestations. Thus, revealing the involvement of rice miRNAs in response to BPH infestations will be beneficial in understanding these complex interactions. In this study, the small RNA profiling of the IR56 rice in response to separate BPH infestations of varied virulence levels identified the BPH-responsive miRNAs and revealed the differential transcript abundance of several miRNAs during a compatible and incompatible rice-BPH interaction. The miRNA sequence analysis identified 218 known and 28 novel miRNAs distributed in 54 miRNA families. Additionally, 138 and 140 numbers of differentially expressed (DE) miRNAs were identified during the compatible and incompatible interaction, respectively. Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analysis revealed the target gene candidates of DE miRNAs (including osa-miR2871a-3p, osa-miR172a, osa-miR166a-5p, osa-miR2120, and osa-miR1859) that might be involved in the IR56 rice defense responses against BPH infestation. Conversely, osa-miR530-5p, osa-miR812s, osa-miR2118g, osa-miR156l-5p, osa-miR435 and two of the novel miRNAs, including novel_16 and novel_52 might negatively modulate the IR56 rice defense. The expressional validation of the selected miRNAs and their targets further supported the IR56 rice defense regulatory network. Based on our results, we have proposed a conceptual model depicting the miRNA defense regulatory network in the IR56 rice against BPH infestation. The findings from the study add further insights into the molecular mechanisms of rice-BPH interactions and will be helpful for the future researches.