The independent and joint effect of socioeconomic status and Multiracial status on the prevalence and frequency of substance use and depression among U.S. adolescents.

AIM: While the United States is becoming increasingly Multiracial, much is still unknown about the behavioral health of these growing new generations of Multiracial Americans. To narrow this research gap, this study investigated the prevalence/frequency of substance use and major depressive episodes [MDE] among non-Hispanic Multiracial [NHM] adolescents compared to their non-Hispanic White [NHW] counterparts and whether racial differences vary by socioeconomic status. METHODS: We analyzed data from the 2015-2019 National Survey on Drug Use and Health (N = 3,645 NHM and 34,776 NHW adolescents aged 12-17). Average Marginal Effects derived from logistic regression and negative binomial regression were used to examine (1) differences in six outcomes (past-month use of alcohol, cannabis, or drugs other than cannabis [DOTC], past-year MDE, and the frequency of alcohol and cannabis use among past-month users) by Multiracial status; (2) the moderation effect of family income on these associations. RESULTS: Compared to high-income NHW adolescents, high-income NHM adolescents reported significantly higher prevalence of past-month cannabis and DOTC use, and past-year MDE. No racial differences were observed at other income levels. Furthermore, moderation analyses indicated that the effect of Multiracial status on MDE was larger in the highest income group compared to the lowest income group. CONCLUSION: Our findings suggested that NHM adolescents, particularly those from high income families, exhibit increased prevalence of drug use and depression than NHW adolescents. As the US becomes more diverse, there is a need to further examine the social and structural factors driving the identified racial differences.

Culturally sensitive prevention programs for substance use among adolescents of color: A systematic review and meta-analysis of randomized controlled trials.

This systematic review and meta-analysis aims to synthesize the efficacy of culturally sensitive prevention programs for substance use outcomes among U.S. adolescents of color (aged 11 to 18 years old) and explore whether the intervention effects vary by participant and intervention characteristics. Eight electronic databases and grey literature were searched for eligible randomized controlled trials through September 2022. Robust variance estimation in meta-regression was used to synthesize treatment effect size estimates and to conduct moderator analysis. After screening, 30 unique studies were included. The average treatment effect size across all substance use outcomes (including 221 effect sizes) was Hedges's g = -0.20, 95% CI = [-0.24, -0.16]. The synthesized effect sizes were statistically significant across types of substances (alcohol, cigarette, marijuana, illicit and other drugs, and unspecified substance use), racial/ethnic groups (Hispanic, Black, and Native American), and different follow-ups (0-12 months, >12 months). Very few studies reported substance use consequences as outcomes and the synthesized effect size was non-significant. Meta-regression findings suggest that the intervention effects may vary based on the type of substance. This meta-analysis found supportive evidence of culturally sensitive prevention programs' efficacy in preventing or reducing substance use among Black, Hispanic, and Native American adolescents. More substance use prevention efforts and evidence is needed for Asian American, Pacific Islander, and multiracial adolescents.

Clinical Features and Risk Factors of Mortality in Patients with Posterior Reversible Encephalopathy Syndrome.

Objective: Although the prognosis of posterior reversible encephalopathy syndrome (PRES) is usually favourable and most patients wholly recover, the disorder can result in death in some patients. To date, the data on clinical features and risk factors for death are still lacking; therefore, we aim to investigate the clinical features and long-term prognostic risk factors of PRES in the present study. Methods: The patients with PRES were identified from the First Affiliated Hospital of Zhengzhou University from June 2011 to June 2020. Clinical characteristics, laboratory tests, magnetic resonance imaging examinations, and treatment of all patients were analyzed retrospectively. All patients were followed up by telephone. Finally, the patients were divided into the survival group and death group for prognosis analysis. Results: A total of 92 patients with PRES were included; 84.8% of whom were female, with an average age of 25.4 (5-66) years at the onset of PRES. Epilepsy was the main clinical manifestation (72.8%). The in-hospital mortality rate was 2.17%. The 3-year all-cause survival rate for PRES patients was 86%. In univariate analysis, patients with systemic lupus erythematosus (P = 0.027) and blood transfusion history within 1 month before onset (P = 0.027), need for dialysis (P ≤ 0.001), nephritis (P = 0.010), stroke (P = 0.016), and heart failure (P = 0.016) were associated with death. In multivariate analysis, we found that heart failure (OR = 0.095, 95% CI 0.020 to 0.441) and stroke (OR = 0.033, 95% CI 0.002 to 0.467) were independent risk factors for death in PRES patients, while pregnancy was a protective factor for death in PRES patients (OR = 7.978, 95% CI 1.446 to 44.006). Conclusions: Our results indicate that PRES could be considered as a sign of a very high-risk patient. We also demonstrated that heart failure and stroke were independent risk factors for death in patients with PRES; moreover, pregnancy was a protective factor.

Debunking the myth of low behavioral risk among Asian Americans: The case of alcohol use.

BACKGROUND AND PURPOSE: Asian Americans (AAs) are the fastest-growing ethnic group in the United States. There is a paucity of research on alcohol-related problems among AAs. However, alcohol use and misuse are a growing concern within this population and are associated with adverse health and mental health consequences. METHODS: Using data from the 2015-2018 National Survey on Drug Use and Health (NSDUH), we examined the prevalence, psycho-social-behavioral correlates, and gender differences in drinking, binge drinking, and alcohol use disorder (AUD) among AA adolescents and adults. We also estimated the prevalence of binge drinking and AUD by country of origin and nativity. RESULTS: Older adolescents (15-17) had the highest prevalence of past-month drinking (8.00%), binge drinking (4.3%), and AUD (1.8%). Among AA adults, the highest rates of binge drinking (23.0%) and AUD (7.2%) were observed among young adults ages 18-25. The highest rates of binge drinking and AUD were observed among US-born Korean Americans (binge drinking: 26.9%, AUD: 13.1%) and US-born Filipino Americans (binge drinking: 25.9%, AUD: 6.2%). CONCLUSIONS: Contrary to the common perception that AA is a low-risk group for alcohol problems, we found that AA young adults, US-born Korean, Filipino, and Indian Americans have a high risk for drinking, binge drinking, and/or AUD. We also identified risk and protective factors against alcohol use/misuse among AAs. Preventions and interventions that incorporate the important risk/protective factors for AAs using a culturally sensitive approach are needed.

Culturally adapted evidence-based treatments for adults with substance use problems: A systematic review and meta-analysis.

BACKGROUND: This systematic review/meta-analysis aimed to synthesize empirical evidence from randomized controlled trials on the efficacy of culturally adapted interventions (CAIs) for substance use and related consequences for adults of color. METHODS: Six electronic databases were searched to identify eligible studies. Two reviewers independently screened studies, extracted data, and assessed risks of bias. We used robust variance estimation in meta-regression to synthesize effect size estimates and conduct moderator analyses. RESULTS: Twenty-two studies met the inclusion criteria and were included in the review. The overall effect size was 0.23 (95 % Confidence Interval [CI] = 0.12, 0.35). The subgroup effect sizes for comparing CAIs with inactive controls and with active controls were 0.31 (CI = 0.14, 0.48) and 0.14 (CI=-0.02, 0.29), respectively. The effect sizes for alcohol use, illicit drug use, unspecified substance use outcomes, and substance use related consequences were 0.25 (CI = 0.08, 0.43), 0.35 (CI =-0.30, 1.00), 0.22 (CI=-0.17, 0.62), and 0.02 (CI=-0.11, 0.16), respectively. Moderator analysis showed that CAIs' effects might not vary significantly by treatment model, dose, country, follow-up assessment timing, participant age, or gender/sex. CONCLUSIONS: Research on substance use interventions that are culturally adapted for people of color is growing, and more high-quality studies are needed to draw definitive conclusions about CAIs' treatment effects. Our study found CAIs to be a promising approach for reducing substance use and related consequences. We call for more efficacy/effectiveness and implementation research to further advance the development and testing of evidence-based CAIs that meet the unique needs and sociocultural preferences of diverse populations.

Risk of bias assessments in systematic reviews and meta-analyses of behavioral interventions for substance use outcomes.

OBJECTIVE: This study aims to explore the current practice of risk of bias assessment in systematic reviews of behavioral clinical trials published in substance use journals and how assessment results were incorporated into meta-analysis. STUDY DESIGN AND SETTING: The authors searched for systematic reviews and meta-analyses of behavioral interventions published from 2016 to 2020 in 40 substance use journals. Two authors independently screened and extracted relevant information from each review. Different tools for risk of bias assessment and approaches of incorporating the risk of bias assessment results into meta-analysis were summarized. RESULTS: The study identified 35 systematic reviews and meta-analyses of behavioral clinical trials. Among the 35 reviews, 31 (89%) assessed the risk of bias of their included studies. Twelve (39%) of the 31 reviews incorporated these assessment findings into their meta-analysis of intervention effects (e.g., conducted meta-regression or subgroup analysis, sensitivity analysis, limited the synthesis only to the "high quality" studies). CONCLUSION: Performing and reporting risk of bias assessment remain inconsistent in published systematic reviews. Future systematic reviews and meta-analyses are encouraged to connect their risk of bias assessment findings with meta-analysis and follow the most updated PRISMA guidelines in reporting the methods and results of risk of bias assessment.

To Unfold the Immigrant Paradox: Maltreatment Risk and Mental Health of Racial-Ethnic Minority Children.

Children of immigrants are often considered to be at increased risk of mental health problems due to families' immigration-related stress and perceived discrimination and prejudice from the host country. However, many studies found them to have better developmental outcomes than children with native-born parents in the U.S. This study aims to unfold this paradoxical phenomenon using data from a population-based cohort of children born in large U.S. cities. Specifically, we investigated differences in mental health outcomes between children of immigrants and those with native-born parents, stratified by children's race-ethnicity. We also explored the mediating role of child maltreatment risk in the association of parental nativity status and race-ethnicity with children's mental health. Our findings supported the immigrant paradox, with better self-reported and parent-reported internalizing and externalizing outcomes in Hispanic and Black children of immigrants than their same race-ethnicity peers and White children of native-born. Such immigrant-native variations were partially explained by parents' physically and psychologically abusive behaviors. Hispanic and Black children with immigrant parents were less likely to be physically or psychologically abused than their peers of native-born at ages 4-5, which translated into mental health advantages of children of immigrants at age 9. Our findings shed light on future research to further clarify the mechanism underlying different parenting practices between same race-ethnicity immigrants and native-born families so that culturally responsive interventions can be developed to safeguard racial-ethnic minority children's mental health.

Tumor pH-triggered "charge conversion" nanocarriers with on-demand drug release for precise cancer therapy.

Combined X-ray-induced photodynamic therapy (X-PDT) and chemotherapy are of great interest for tumor treatment, but their outcome is still hindered by insufficient drug delivery without tumor specificity and the difficulty of switching to chemotherapy during the X-PDT process. Herein, we report an efficient strategy for preparing a nanocarrier, DANPVP&DOX, with slight-acidity-induced charge conversion and hypoxia-motivated doxorubicin (DOX) release properties to achieve a more precise and synchronous therapeutic effect. Upon a change in the extracellular pH (pHe) in the tumor matrix, the surface charge of DANPVP&DOX converted from negative to positive via dimethyl maleate degradation. Following the increased internalization by tumoral cells, exposure of verteporfin (VP) in DANPVP&DOX to low-dose X-ray radiation resulted in O2 consumption in the cytoplasm to produce cytotoxic reactive oxygen species (ROS), which caused cell killing. Moreover, the hypoxic conditions formed in the tumor area specifically promoted DANPVP&DOX dissociation and on-demand DOX release. Consequently, DANPVP&DOX significantly increased the therapeutic efficacy through X-PDT and cascade chemotherapy. More importantly, this strategy could potentially be extended to various therapeutic agents other than anticancer drugs for precise drug delivery and cancer treatment.

Parenting as an inhibitor of gender disparities in alcohol use: the case of early adolescents in China.

BACKGROUND: Gender differences in alcohol use are more substantial among early adolescents in China than in the United States, presumably because of more permissive drinking norms for boys than girls in Chinese culture. This study tested a theory that gender differences in early experimentation with alcohol can be reduced through general parenting practices. Whereas traditional research has identified mediators of gender differences in alcohol use, the current research isolated moderators of gender differences and developed their implications for prevention programs. METHODS: The study analyzed the data from the China Global School-Based Student Health Survey (n = 8805 middle school students in four cities). Youth completed anonymous surveys in classroom settings. The study examined interaction effects between gender and parenting variables using multiple regression with robust standard errors. RESULTS: Early adolescent boys exhibited higher levels of drinking than girls for all drinking outcomes. The gender differences in drinking were negatively associated with the level of perceived parental monitoring, parental involvement in adolescent school performance, and parental empathy in a nonlinear way. CONCLUSIONS: Results suggested that early adolescents' perceptions of general parenting practice nonlinearly moderated gender disparities in alcohol use.

Understanding alcohol-specific antecedents among Chinese vocational school adolescents.

BACKGROUND: Alcohol use among Chinese vocational school students is widespread and associated with many negative consequences. However, alcohol-specific antecedents for this population are understudied. OBJECTIVES: The current study explored: (a) which alcohol-specific antecedents are the most salient predictors for alcohol use intentions, (b) whether any mediational relationships exist among these alcohol-specific antecedents, and (c) whether gender-based differences exist among these relationships. METHODS: This study analyzed data from 1,230 vocational school adolescents in three Chinese cities. Survey data were analyzed using dominance analysis and structural equation modeling. RESULTS: Personal norms were the most salient antecedents for alcohol use intentions, followed by injunctive norms from friends and parents, descriptive norms from friends and classmates, and positive belief about drinking. We observed a statistically significant mediational chain from descriptive norms to injunctive norms, and in turn to personal norms and positive beliefs, and finally to alcohol use intentions. Gender moderated some of the paths. CONCLUSIONS: Alcohol use norms and beliefs among Chinese vocational school students have distinct predictive relationships with alcohol use intentions. Alcohol use prevention programs designed for this population need to address normative beliefs (descriptive, injunctive, and personal norms) and the perceived benefit of alcohol use.

Living arrangements and quality of life among older adults in China: does social cohesion matter?

Objectives: This study investigated how living arrangements are related to the well-being of Chinese older adults and the role of social cohesion in this relationship. Methods: This study used the China data from the WHO's Study on Global AGEing and Adult Health. The analytic sample featured 5,600 Chinese adults aged 60 or older. The study conceptualized two sets of models: social cohesion as mediators and as moderators in the relationship of living arrangements and quality of life. Results: Results from structural equation modelling analyses show that Chinese older adults who lived with adult children had lower quality of life scores compared with those who did not live with adult children; the negative relationship was partially mediated through decreased social cohesion. The study also found social cohesion may buffer the negative influence of not living with a spouse compared with those who did. Conclusion: This study sheds light on the mediating and moderating effects of social cohesion on the relationship between living arrangement and quality of life among older adults in China. The findings indicate the necessity of promoting social connectedness and neighborhood cohesion for older Chinese, especially those who live with their adult children.

Application of video-assisted thoracoscopic anatomic segmentectomy in single-stage bilateral thoracic surgery for the treatment of bilateral localized bronchiectasis / 中国胸心血管外科临床杂志

@#Objective    To explore the safety and feasibility of the application of video-assisted thoracic surgery (VATS) anatomic segmentectomy in single-stage bilateral thoracic surgery for the treatment of bilateral localized bronchiectasis. Methods    From June 2014 to June 2018, 19 patients with bilateral localized bronchiectasis underwent single-stage bilateral thoracic surgery with VATS anatomic segmentectomy, including 11 males and 8 females aged 38.0±12.5 years. The clinical efficacy of the surgery was evaluated. Results    All surgeries were successfully completed, of which 17 were bilateral VATS, 2 were unilateral VATS with the other lateral converted to thoracotomy. The average number of bilateral resected segments was 4-8 (5.9±1.2). Mean operation time was 330.0±40.0 min and mean blood loss was 150.0±60.0 mL. Mean ventilator-assisted breathing time was 6.0±1.8 h, mean duration of chest-tube placement was 4.0±1.0 d and mean hospital stay time was 14.0±1.5 d. Three patients suffered pulmonary infection and 1 patient received tracheotomy. No perioperative death occurred. Arterial oxygen pressures on postoperative day (POD) 1 (F=340.18, P<0.05) and POD 3 (F=131.26, P<0.05) were significantly lower than that before operation, arterial carbon dioxide pressures on POD 1 (F=46.62, P<0.05) and POD 3 (F=48.21, P<0.05) were significantly higher than that before operation, and pulse oximeter saturation on POD 1 was significantly lower than that before operation (F=210.82, P<0.05). The patients were followed up for one to five years without recurrence. Conclusion    Application of VATS anatomic segmentectomy in single-stage bilateral thoracic surgery for the treatment of bilateral localized bronchiectasis is safe and feasible with strictly selected patients. Postoperative airway management is very important. The surgery is worthy of wide clinical practice.

What Motivates Mental Health Clinicians-in-Training to Implement Evidence-Based Assessment? A Survey of Social Work Trainees.

Mental health clinicians do not consistently use evidence-based assessment (EBA), a critical component of accurate case conceptualization and treatment planning. The present study used the Unified Theory of Behavior to examine determinants of intentions to use EBA in clinical practice among a sample of Masters' level social work trainees (N = 241). Social norms had the largest effect on intentions to use EBA. Injunctive norms in reference to respected colleagues accounted for the most variance in EBA intentions. Findings differed for respondents over 29 years of age versus younger respondents. Implications for implementation strategies and further research are discussed.

Omega-3 polyunsaturated fatty acids and reduction of depressive symptoms in older adults: A systematic review and meta-analysis.

OBJECTIVE: The aim of this study is to systematically review the efficacy of omega-3 polyunsaturated fatty acid (n-3 PUFA) supplements in reducing depressive symptoms among older adults aged 60 and above. METHODS: Relevant electronic databases were searched from their inception to June 4, 2018, including Medline, Embase, Web of Science, Cochrane Library, PsycINFO, Global Health, CINAHL, ClinicalTrials.gov and Chinese Biomedical Medicine Database. Two reviewers independently screened for eligible studies, extracted data, and assessed risk of bias of the included studies. The effect size data were analyzed using robust variance estimation in meta-regression. RESULTS: Nine studies were included. The overall treatment effects of n-3 PUFA supplements in reducing depressive symptoms for older adults was not statistically significant (d = -0.202, 95% CI = -0.463, 0.060). Meta-regression found interventions with dosage of n-3 PUFA greater than 1.5 g/d had an average effect size of -0.428, with a 95% confidence interval of [-0.822, -0.035], which is statistically significant. Meta-regression did not find significant moderating effects of comorbidity, baseline depression, intervention duration, and EPA-DHA ratio, potentially due to limited statistical power. LIMITATIONS: The current review only included 9 studies based on literature search in major English and Chinese databases, which provided limited statistical power for moderator analysis and the results are suggestive only. CONCLUSIONS: The meta-analysis of 9 RCTs found mixed findings of the efficacy of n-3 PUFA in the treatment of depressive symptoms among older adults aged 60 and above. More high-quality, large-scale RCTs are needed to confirm the current conclusions.

Parent-based interventions on adolescent alcohol use outcomes: A systematic review and meta-analysis.

BACKGROUND: The effects of parent-based interventions on adolescent alcohol use are unclear, including what factors moderate intervention effects. This study examines the effects of parent-based interventions on adolescent alcohol use and whether the treatment effects vary by participants' characteristics and intervention characteristics. METHODS: Eleven electronic databases and relevant studies' references were searched for eligible studies published before March 2017. Randomized controlled trials investigating the efficacy of any parent-based intervention for alcohol use outcomes among adolescents up to 18 years old were eligible for review. Two reviewers independently conducted screening, data extraction, and risk of bias assessment. Robust variance estimation in meta-regression was used to analyze treatment effect size estimates and to conduct moderator analysis. RESULTS: Twenty studies were included in the meta-analysis. The average treatment effect size across all drinking outcomes, with 44 effect sizes from 20 studies, was g = -0.23 with a 95% confidence interval [-0.35, -0.10] which is statistically significant. Parent-based interventions appreared to have larger mean effect sizes on adolescent drinking intention than binge drinking. Interventions targeting both general and alcohol-specific parenting strategies had larger average effect sizes than interventions targeting alcohol-specific parenting only. CONCLUSIONS: This meta-analysis found evidence of parent-based interventions' efficacy in preventing or reducing adolescent alcohol use.

Effects of Mindfulness-Based Stress Reduction on Depression in Adolescents and Young Adults: A Systematic Review and Meta-Analysis.

Background: Mindfulness as a positive mental health intervention approach has been increasingly applied to address depression in young people. This systematic review and meta-analysis evaluated the effects of mindfulness-based stress reduction (MBSR) in the treatment of depression among adolescents and young adults. Methods: Electronic databases and references in articles were searched. Randomized controlled trials (RCTs) evaluating MBSR and reporting outcomes for depressive symptoms among young people aged 12 to 25 years were included. Data extraction and risk of bias assessment were conducted by two reviewers independently. Hedges' g with a 95% confidence interval was calculated to represent intervention effect. Results: Eighteen RCTs featuring 2,042 participants were included in the meta-analysis. Relative to the control groups (e.g., no treatment, treatment as usual, or active control), MBSR had moderate effects in reducing depressive symptoms at the end of intervention (Hedges' g = -0.45). No statistically significant effects were found in follow-up (Hedges' g = -0.24) due to a lack of statistical power. Meta-regression found that the average treatment effect might be moderated by control condition, treatment duration, and participants' baseline depression. Conclusion: MBSR had moderate effects in reducing depression in young people at posttest. Future research is needed to assess the follow-up effects of MBSR on depressive symptoms among adolescents and young adults.

MicroRNA-132 attenuates LPS-induced inflammatory injury by targeting TRAF6 in neuronal cell line HT-22.

Epilepsy is a common neurological disorder in the central nervous system. Inflammation disrupts the blood-brain barrier (BBB), which is responsible for maintaining brain homeostasis. This study was aimed to investigate the functional role of microRNA (miR)-132 in hippocampal HT-22 cells under lipopolysaccharide (LPS) stimulation. In vitro cell inflammatory model was constructed by LPS stimulation. Inflammatory cell injury was evaluated according to the alterations of cell viability, apoptosis, and expression of inflammatory cytokines. Then, miR-132 level after LPS treatment was assessed. Subsequently, miR-132 was abnormally expressed after cell transfection, and the effects of miR-132 on LPS-induced cell inflammatory injury as well as phosphorylated levels of key kinases in the NF-κB and MAPK kinase (MEK)/ERK pathways were determined. The target gene of miR-132 was virtually screened and verified, and whether miR-132 affected HT-22 cells under LPS stimulation through regulating the target gene was verified. The results showed that the level of miR-132 was down-regulated by LPS in HT-22 cells, and the LPS-induced inflammatory injury could be reduced by miR-132 overexpression. Then, the phosphorylated levels of kinases in the NF-κB and MEK/ERK pathways were decreased by miR-132 overexpression. Tumor necrosis factor receptor-associated factor 6 (TRAF6) was predicted and verified to be a target of miR-132. Moreover, the alterations induced by miR-132 overexpression in the LPS-treated HT-22 cells were abrogated by TRAF6 overexpression. Therefore, we drew the conclusion that LPS down-regulated miR-132 and miR-132 attenuated LPS-induced inflammatory cell injury by targeting TRAF6, along with the inhibition of the NF-κB and MEK/ERK pathways.

Effects of continuous positive airway pressure therapy on endothelial dysfunction in obstructive sleep apnea patients: a Meta-analysis of randomized controlled trials / 中国医师进修杂志

Objective To study the effect of continuous positive airway pressure (CPAP) treatment on the endothelial function in patients with obstructive sleep apnea (OSA). Methods This study strictly followed the PRISMA principle. PubMed, Web of Science and the Cochrane Collaboration Database were searched on randomized controlled trials (RCT) which assessed the effects of CPAP on endothelial function of OSA patients from 1992 to 2013. The parameters of endothelial function evaluation included endothelium-dependent vasodilation function (EDV) and endothelium-independent vasodilation function (EIV). EDV was used to detect flow mediated dilation (FMD) and reactive hyperemia index (RHI), and EIV was used to detect nitroglycerin-induced dilation (GTN-ID). Results A total of 4 articles (137 patients) were selected. Meta-analysis results showed that CPAP significantly altered the overall EDV: standardized mean difference ( SMD )＝1.42, 95% CI 0.45 to 2.38, P＝0.004; and the FMD was significantly improved: weighed mean difference ( WMD ) ＝ 3.94, 95% CI 1.30 to 6.57, P ＝ 0.003. CPAP did not significantly alter the GTN-ID: WMD ＝ -0.71, 95% CI 2.69 to 1.26, P ＝ 0.48. Conclusions Using CPAP to treat OSA patients is beneficial to promoting overall EDV improvement, but the EIV has not improved significantly.