Linear and non-linear associations of depressive symptoms with oral health knowledge, attitudes, and practices among rural older adults in China: a cross-sectional study.

BACKGROUND: Depression affects the oral health of older adults; however, little is known about its impact on oral health among rural older adults in developing countries, which warrants further research. Taking China as an example, there is a large population base of rural older adults suffering from depression, and many rural older people also have long-term oral health problems, which have seriously affected their quality of life in later life. Therefore, this study aimed to explore linear and non-linear associations of depressive symptoms with oral health knowledge, attitudes, and practices among rural older adults in China. METHODS: From November 2020 to December 2020, 1,902 rural community-dwelling older people aged 60 years and older were investigated, via a cross-sectional survey. The general information, depressive status, oral health knowledge, attitudes, and practices of the participants were obtained through face-to-face structured questionnaires. Among them, the Zung Depression Self-Rating Scale was used to investigate the depressive symptoms of the participants in this survey. The generalized linear model and classification and regression tree model were used, separately. RESULTS: Based on linear analysis results, we found that minimal to mild depressive symptoms [regression coefficient (ß) = -0.345; 95% confidence interval (CI): -0.582 to -0.109, P = 0.004] and depressive symptoms (ß = -1.064; 95% CI: -1.982 to -0.146, P = 0.023) were significantly correlated with oral health knowledge. A negative correlation was observed between minimal to mild depressive symptoms (ß = -0.385; 95% CI: -0.600 to -0.170, P < 0.001) and oral health attitudes. In addition, while both minimal to mild depressive symptoms (ß = 0.018; 95% CI: -0.312 to 0.347, P = 0.916) and depressive symptoms (ß = 0.604; 95% CI: -0.675 to 1.883, P = 0.355) were associated with oral health practices. Furthermore, the non-linear analysis showed a combined effect of depressive symptoms on oral health attitudes, indicating that older people of a younger age, not living alone, and not suffering from depressive symptoms are more likely to report better oral health attitudes. CONCLUSION: Both the linear and non-linear analyses in our study showed that depressive symptoms are significantly correlated with the poor oral health attitudes of older adults in rural communities. Furthermore, depressive symptoms were associated with oral health knowledge in the linear analysis. However, no statistically significant difference was found between depressive symptoms and oral health practices in either analysis. This research deepens our knowledge and understanding of relevant evidence in the mental and oral health of people in later life. In addition, analyzing the factors that affect the oral health of older people from the perspective of their depressive status provides new thinking directions and scientific references for improving the oral health of older adults in practical life.

Urban-Rural Differences in the Association of eHealth Literacy With Medication Adherence Among Older People With Frailty and Prefrailty: Cross-Sectional Study.

Background: With advances in science and technology and improvements in health literacy, more studies have focused on frailty prevention by promoting medication adherence, emphasizing the role of eHealth literacy. However, the association between eHealth literacy and medication adherence in frail older adults has not been well studied, and it is unknown whether urban-rural differences exist in this relationship. Objective: This study aims to examine the relationship between eHealth literacy and medication adherence in older people with different frailty statuses, emphasizing variations between rural and urban areas. Methods: Between November and December 2020, a total of 4218 urban and rural community members (aged ≥60 years) in China were recruited as participants using a multistage random sampling method. A face-to-face structured questionnaire survey was conducted to collect information on demographic characteristics, eHealth literacy (consisting of application, evaluation, and decision dimensions), and medication adherence. eHealth literacy was assessed using the Chinese version of the eHealth Literacy Scale developed by Norman and Skinner, and medication adherence was measured using the 4-item Morisky scale. We used a general descriptive analysis and stratified logistic regression models to examine how eHealth literacy is linked to medication adherence and urban-rural differences. Results: There were 4218 respondents, of which 2316 (54.9%) lived in urban areas and 1902 (45.1%) in rural areas, respectively. After adjusting for potential confounders, among participants with prefrailty, eHealth literacy was associated with medication adherence in urban areas in terms of less application (adjusted odds ratio [AOR] 1.16, 95% CI 0.82-1.63), less evaluation (AOR 1.29, 95% CI 0.92-1.81), and less decision ability (AOR 1.20, 95% CI 0.86-1.68); eHealth literacy was linked with medication adherence in the rural areas in terms of less application (AOR 1.10, 95% CI 0.56-2.13), less evaluation (AOR 1.05, 95% CI 0.61-1.79), and less decision ability (AOR 1.10, 95% CI 0.64-1.90). Among frail participants, less eHealth literacy (AOR 0.85, 95% CI 0.48-1.51), along with its dimensions, including less application (AOR 0.85, 95% CI 0.47-1.54), evaluation (AOR 0.89, 95% CI 0.50-1.57), and decision ability (AOR 0.99, 95% CI 0.55-1.76), were associated with medication adherence in urban areas; less eHealth literacy (AOR 0.89, 95% CI 0.48-1.65), along with its dimensions, including less application (AOR 1.23, 95% CI 0.62-2.44), evaluation (AOR 0.98, 95% CI 0.53-1.82), and decision ability (AOR 0.90, 95% CI 0.49-1.67), were associated with medication adherence in rural areas. Conclusions: The results of this study suggest that there is an association between eHealth literacy and medication adherence among older people with frailty and prefrailty. To promote medication adherence, eHealth literacy can be helpful in tailoring interventions.

An analysis of the role of college students' core self-evaluation in the relationship between extracurricular physical exercise and academic stress.

Objective: To explore the role of college students' core self-evaluation in the association between extracurricular physical exercise and academic stress, and to provide a reference and basis for effectively alleviating current college students' academic stress. Methods: A stratified cluster random sampling method was used to conduct an online survey using the China College Student Mental Health Screening Scale, the Core Self-Esteem Scale, and a self-developed questionnaire for 1,249 college students from 8 junior colleges in Jiangsu Province, China, in January 2023, and analyses were conducted using bivariate correlation and mediation effect tests. Results: More than half of the students were worried about lagging behind other students in their studies and worrying about exams, as well as more than half of the students had <2 h of extracurricular physical exercise per week in terms of academic stress. Significant correlations were found between extracurricular physical exercise time and core self-evaluation (r = 0.225, p < 0.01), academic stress (r = -0.317, p < 0.01), and between core self-evaluation and academic stress (r =-0.371, p < 0.01). Extracurricular physical exercise had a negative predictive effect on academic stress (effect = -0.306, 95%CI: -0.361~-0.251) and partially through the mediating path of core self-evaluation, (effect = -0.067, 95%CI: -0.091~-0.046), with a mediating effect of 21.9%. Among them, the mediating effect of core self-evaluation was highest in "worrying about lagging behind other students in their studies" and "worrying about exams", which accounted for 24.4% and 24.3% respectively. Conclusion: Currently, college students have different degrees of academic stress; extracurricular physical exercise can reduce academic stress through direct effects, and also through the indirect effect of improving the level of core self-evaluation, and active extracurricular physical exercise has become an important way to promote students' physical and mental health.

Unraveling the factors shaping academic success: A structural equation modeling approach for college students.

Academic success is a multifaceted achievement that depends on a myriad of factors, spanning personal, environmental, and institutional dimensions. The intricate interaction of numerous factors, such as how effective and interested a student is in their own academic performance, shapes their potential for academic achievement. This study's goal is to examine the effects that diversity, colour, and immigration status have on the academic accomplishment of 109 college students in Chinese province of Fujian. The main objective of the study to infer on how self-efficiency, self-interest, and stress affect academic achievement in particular. The researcher devised a survey tool in order to determine the degree of academic self-efficiency, academic self-interest, and stress connected to academic activities. The method of data collection that was used was called purposive sampling, and the participants were students in their primary year of university. The findings suggest that the scales that were used in the research have a high degree of reliability and exhibit very little inverse connection. "A Structural Equation Model (SEM) was created in order to examine the relative effects of stress and self-efficiency in predicting three aspects of academic performance: fresher man grade point average, credits earned, and persistence in studies beyond the first year (Considine and Zappala, 2002) [16]". According to the data, self-efficiency is a stronger and more reliable predictor than the pressure connected with academic achievement. In conclusion, this study's originality lies in its holistic approach to understanding academic success, and its research implications extend to policy development, intervention strategies, equity and inclusion efforts, future research directions, and teacher training, all aimed at improving the academic success of diverse student populations.

The association between admission mean corpuscular volume and preoperative deep venous thrombosis in geriatrics hip fracture: a retrospective study.

OBJECTIVE: This study evaluated the association between admission MCV and preoperative deep vein thrombosis (DVT) in geriatric hip fractures. METHODS: Older adult patients with hip fractures were screened between January 2015 and September 2019. The demographic and clinical characteristics of the patients were collected at the largest trauma center in northwest China. MCV was measured at admission and converted into a categorical variable according to the quartile. Multivariate binary logistic regression and generalized additive model were used to identify the linear and nonlinear association between MCV and preoperative DVT. Analyses were performed using EmpowerStats and the R software. RESULTS: A total of 1840 patients who met the criteria were finally enrolled and divided into four groups according to their MCV levels. The mean MCV was 93.82 ± 6.49 (80.96 to 105.91 fL), and 587 patients (31.9%) were diagnosed with preoperative DVT. When MCV was a continuous variable, the incidence of preoperative DVT increased with mean corpuscular volume. In the fully adjusted model, admission MCV was positively correlated with the incidence of preoperative DVT (OR: 1.03; 95% CI: 1.01-1.05; P = 0.0013). After excluding the effect of other factors, each additional 1fL of MCV increased the prevalence of preoperative DVT by 1.03 times as a continuous variable. CONCLUSION: MCV was linearly associated with preoperative DVT in geriatric patients with hip fractures and could be considered a predictor of DVT risk. The MCV may contribute to risk assessment and preventing adverse outcomes in the elderly. STUDY REGISTRATION: This study is registered on the website of the Chinese Clinical Trial Registry (ChiCTR: ChiCTR2200057323).

Anthracene-based dual channel donor-acceptor triazine-containing covalent organic frameworks for superior photoelectrochemical sensing.

Covalent organic frameworks (COFs) exhibit excellent photoelectrically active structures and serve as channels for photon capture and charge carrier transport. However, their relatively high charge-carrier recombination rates and lack of specific recognition sites limit their application in photoelectrochemical sensing. This paper reports a functionalized donor-acceptor (D-A) COF comprising electron-rich polycyclic aromatic moieties and electron-deficient triazines (Tz) incorporating boronic acid through ligand exchange. The number of aromatic rings in the polycyclic aromatic moiety is crucial for establishing an efficient D-A system within COF. In the absence of an external electron donor, the anthracene-based COF exhibited a five-fold enhancement in photocurrent compared to the naphthalene-based COF. The resulting anthracene-based D-A COF exhibited enhanced orbital overlap and electron push-pull interactions, facilitating more effective charge separation. Furthermore, introducing boronic acid enabled the selective enrichment of low-concentration external electron donors, such as dopamine, in the inner Helmholtz plane. This ingenious approach establishes a unique dual-channel D-A system that allows direct measurement of dopamine in serum. Under optimized conditions, the test platform achieves good correspondence for dopamine at 1 to 100 nM and 0.5 to 100 µM with a detecting limit of 0.36 nM (3σ/S, n = 11). This strategy introduces a novel dimension to photoelectrochemical sensing, focusing on the effect of spatial separation between the external electron donor and the photoelectrode interface that intricately shapes the behavior and enhances the performance of the photoelectric system.

Deploying Cationic Cellulose Nanofiber Confinement to Enable High Iodine Loadings Towards High Energy and High-Temperature Zn-I2 Battery.

High iodine loading and high-temperature adaptability of the iodine cathode are prerequisites to achieving high energy density at full battery level and promoting the practical application for the zinc-iodine (Zn-I2 ) battery. However, it would aggravate the polyiodide shuttle effect when employing high iodine loading and working temperature. Here, a sustainable cationic cellulose nanofiber (cCNF) was employed to confine the active iodine species through strong physiochemical adsorption to enlarge the iodine loading and stabilize it even at high temperatures. The cCNF could accommodate dual-functionality by enlarging the iodine loading and suppressing the polyiodide shuttle effect, owing to the unique framework structure with abundant surface positive charges. As a result, the iodine cathode based on the cCNF could deliver high iodine mass loading of 14.1 mg cm-2 with a specific capacity of 182.7 mAh g-1 , high areal capacity of 2.6 mAh cm-2 , and stable cycling over 3000 cycles at 2 A g-1 , thus enabling a high energy density of 34.8 Wh kg-1 and the maximum power density of 521.2 W kg-1 at a full Zn-I2 battery level. In addition, even at a high temperature of 60 °C, the Zn-I2 battery could still deliver a stable cycling.

Electron-Withdrawing Substituents Allow Boosted NIR-II Fluorescence in J-Type Aggregates for Bioimaging and Information Encryption.

Developing molecular fluorophores with enhanced fluorescence in aggregate state for the second near-infrared (NIR-II) imaging is highly desirable but remains a tremendous challenge due to the lack of reliable design guidelines. Herein, we report an aromatic substituent strategy to construct highly bright NIR-II J-aggregates. Introduction of electron-withdrawing substituents at 3,5-aryl and meso positions of classic boron dipyrromethene (BODIPY) skeleton can promote slip-stacked J-type arrangement and further boost NIR-II fluorescence of J-aggregates via increased electrostatic repulsion and intermolecular hydrogen bond interaction. Notably, NOBDP-NO2 with three nitro groups (-NO2 ) shows intense NIR-II fluorescence at 1065 nm and high absolute quantum yield of 3.21 % in solid state, which can be successfully applied in bioimaging, high-level encoding encryption, and information storage. Moreover, guided by this electron-withdrawing substituent strategy, other skeletons (thieno-fused BODIPY, aza-BODIPY, and heptamethine cyanine) modified with -NO2 are converted into J-type aggregates with enhanced NIR-II fluorescence, showing great potential to convert aggregation caused emission quenching (ACQ) dyes into brilliant J-aggregates. This study provides a universal method for construction of strong NIR-II emissive J-aggregates by rationally manipulating molecular packing and establishing relationships among molecular structures, intermolecular interactions, and fluorescence properties.

Modular Design of Biodegradable Ionizable Lipids for Improved mRNA Delivery and Precise Cancer Metastasis Delineation In Vivo.

Lipid nanoparticles (LNPs) represent the most clinically advanced nonviral mRNA delivery vehicles; however, the full potential of the LNP platform is greatly hampered by inadequate endosomal escape capability. Herein, we rationally introduce a disulfide bond-bridged ester linker to modularly synthesize a library of 96 linker-degradable ionizable lipids (LDILs) for improved mRNA delivery in vivo. The top-performing LDILs are composed of one 4A3 amino headgroup, four disulfide bond-bridged linkers, and four 10-carbon tail chains, whose unique GSH-responsive cone-shaped architectures endow optimized 4A3-SCC-10 and 4A3-SCC-PH lipids with superior endosomal escape and rapid mRNA release abilities, outperforming their parent lipids 4A3-SC-10/PH without a disulfide bond and control lipids 4A3-SSC-10/PH with a disulfide bond in the tail. Notably, compared to DLin-MC3-DMA via systematic administration, 4A3-SCC-10- and 4A3-SCC-PH-formulated LNPs significantly improved mRNA delivery in livers by 87-fold and 176-fold, respectively. Moreover, 4A3-SCC-PH LNPs enabled the highly efficient gene editing of 99% hepatocytes at a low Cre mRNA dose in tdTomato mice following intravenous administration. Meanwhile, 4A3-SCC-PH LNPs were able to selectively deliver firefly luciferase mRNA and facilitate luciferase expression in tumor cells after intraperitoneal injection, further improving cancer metastasis delineation and surgery via bioluminescence imaging. We envision that the chemistry adopted here can be further extended to develop new biodegradable ionizable lipids for broad applications such as gene editing and cancer immunotherapy.

Differences in the association of oral health knowledge, attitudes, and practices with frailty among community-dwelling older people in China.

BACKGROUND: Oral health and frailty are significantly related and should be well examined, especially in late life. Few studies have explored the relationship of oral health knowledge, attitudes, and practices with frailty and examined sociodemographic variations in this association. This study aimed to examine the association between oral health knowledge, attitudes, practices and frailty, with a special focus on comparing differences in their association among the Chinese community-dwelling older population. METHODS: This study included 4218 community-dwelling older adults (aged ≥ 60 years) who participated in a cross-sectional survey. Sociodemographic characteristics, oral health knowledge, attitudes, practices, and frail status (non-frailty, pre-frailty, and frailty) were collected with a face-to-face questionnaire-based interview. Multivariate logistic regression models were used to evaluate the association of oral health knowledge, attitudes, and practices with frailty. RESULTS: Of the 4218 participants, 36.2% (n = 1527) and 18.8% (n = 792) were classified as pre-frailty and frailty. Age, gender and educational attainments differences existed in the association of oral health knowledge with frailty. Urban-rural differences in the association of oral health knowledge and practices with frailty were also found. Specifically, oral health knowledge was significantly related to frailty only among participants aged 70-79 years (adjusted odds ratio [95% confidence interval]) (1.08 [1.02-1.15]), females (1.05 [1.00-1.10]), rural residents (1.06 [1.01-1.12]), and those who were primary school and lower education (1.06 [1.01-1.11]), whereas oral health practices were related to frailty only among urban participants (0.96 [0.92-1.00]). CONCLUSION: This study confirmed the different associations of oral health knowledge and practices with frailty among community-dwelling older people in China. Further research is needed to better understand the abovementioned differences and public health strategies are required to improve oral health literacy and thereby contain the development of frailty in later life.

Association between total cholesterol and all-cause mortality in geriatric patients with hip fractures: A prospective cohort study with 339 patients.

BACKGROUND: Total cholesterol (TC) levels represent the comprehensive level of human cholesterol metabolism, which is closely related to the nutritional status, metabolic level, disease development, and aging of the human body. Total cholesterol plays an important role in the maintenance of bodily functions, regulation of sexual function, immune regulation, and in the development of organisms. Abnormal TC levels are an important risk factor for cardiovascular disease (CVD), and TC is closely related to the development of many diseases, and is used as an important indicator of human blood lipid levels and overall health status. However, the relationship between serum TC levels and the prognosis of patients with hip fractures remains unclear. OBJECTIVES: To evaluate the association between TC levels and all-cause mortality in patients with geriatric hip fractures. MATERIAL AND METHODS: Elderly patients with hip fractures were screened between January 2015 and September 2019. Patient demographic and clinical characteristics were recorded. Linear multivariate Cox regression models were used to identify the association between TC levels and all-cause mortality. Analyses were performed using Empower Stats and R software. RESULTS: Three hundred and thirty-nine patients were enrolled. The mean follow-up period was 34.18 months. There were 99 (29.20%) cases of all-cause mortality. Total cholesterol levels after hip fracture were linearly associated with all-cause mortality in the elderly. Linear multivariate Cox regression models showed that TC levels were associated with mortality (hazard ratio (HR) = 0.67; 95% confidence interval (95% CI): 0.53-0.85; p = 0.001 after adjusting for confounding factors). Each 1 mmol/L increase in TC levels was associated with a 33% reduction in morbidity and mortality. Compared with the low-TC group, mortality was significantly lower in the middle-TC group (HR = 0.58; 95% CI: 0.35-0.94; p = 0.027) and high-TC group (HR = 0.45; 95% CI: 0.27-0.75; p = 0.002). CONCLUSIONS: Total cholesterol levels were associated with mortality in geriatric hip fracture patients and could be considered a protective factor for all-cause mortality.

"Dual-Key-and-Lock" NIR-II NSCyanines Enable High-Contrast Activatable Phototheranostics in Extrahepatic Diseases.

Conventional cyanine dyes with a symmetric structure are "always-on", which can easily accumulate in the liver and display high liver background fluorescence, inevitably interfering the accurate diagnosis and therapy in extrahepatic diseases. We herein report a platform of NIR-II non-symmetric cyanine (NSCyanine) dyes by harnessing a non-symmetric strategy, which are extremely sensitive to pH/viscosity and can be activated via a "dual-key-and-lock" strategy. These NSCyanine dyes with a low pKa (<4.0) only show weak fluorescence at lysosome pH (key1), however, the fluorescence can be completely switched on and significantly enhanced by intracellular viscosity (key2) in disease tissues, exhibiting high target-to-liver ratios up to 19.5/1. Notably, high-contrast phototheranostics in extrahepatic diseases are achieved, including intestinal metastasis-imaging, acute gastritis-imaging, bacteria infected wound healing, and tumor ablation via targeted combined photothermal therapy and chemotherapy.

A meta-analysis of effects of blended learning on performance, attitude, achievement, and engagement across different countries.

While this special pandemic period has been seeing an increasing use of blended learning, few studies have meta-analytically reviewed the effectiveness of blended learning in different countries. This meta-analysis summarizes previous studies on blended learning effectiveness in different countries in terms of students' performance, students' attitudes toward blended learning, learning achievement, and student engagement in different countries. Through the meta-analysis via Stata/MP 14.0, it is concluded that blended learning can improve performance, attitude, and achievement in most countries. However, in both China and the USA, blended learning cannot significantly improve student engagement in academic activities. No significant differences were revealed in student performance in the USA between blended and non-blended learning. Future research can extend the research into blended learning to more countries and areas across the world.

Complex association of self-rated health, depression, functional ability with loneliness in rural community-dwelling older people.

BACKGROUND: This study aimed to explore whether and how self-rated health, depression and functional ability interactively associated with loneliness using a sample group of older adults residing in China rural communities. METHODS: Data on socio-demographic information, self-rated health, depressive symptoms, functional ability and loneliness (quantified via a single question) were collected from 1009 participants. Cross-tabulations with chi-square test, bivariate correlations, and Classification and Regression Tree (CART) models were employed for analysis. RESULTS: We found that 45.1% of the participants were classified as lonely. Our results gain insight into the hierarchical order of predictors for the presence of loneliness, suggesting that there was a significant interaction between functional ability and depressive symptoms while self-rated health was not a significant factor. The probability of loneliness increased with the combination of limited functional ability and depression, and varied with different interaction of functional ability, depressive symptoms, and marital status, respectively. Notably, while there were some differences, similar associations were observed among older male and female respondents. CONCLUSION: To delay or reduce loneliness, early detection which focuses on older people who report limitations in functional ability, depression, and being female, offers opportunities to start early interventions. Our findings might be helpful not only in designing and implementing loneliness prevention programs but also in improving healthcare for older rural community-dwelling people.

Association of social capital with self-perceived eHealth literacy among community-dwelling older people: Age and gender differences.

Background: Studies have confirmed that social factors, including social capital and eHealth literacy, are important in later life. Currently, few studies are available for determining the relationship between social capital and eHealth literacy, and whether such a relationship exists among older people and there are age and gender differences in the relationship remain unclear. Consequently, this study aimed to investigate the association between social capital and eHealth literacy, specifically examing its variations in age and gender. Methods: A cross-sectional study of 4,257 residents aged ≥ 60 years and dwelling in the community was conducted across four cities in China. A structured questionnaire was used to collect data on general characteristics, socioeconomic status, social capital, and eHealth literacy. Generalized linear models were employed to assess these associations. Results: There were 4,218 respondents (age 71.9 ± 7.2 years; 64.8% women). Overall, social participation, social connection, trust, cohesion, and reciprocity were all statistically associated with eHealth literacy (p < 0.05), while such an association was not observed for social support (p > 0.05). Specifically, a higher level of social participation was associated with better eHealth literacy scores among participants aged 70-79 years (p < 0.001), and a higher level of social connection was associated with better eHealth literacy scores for those aged 60-69 and 70-79 years (p < 0.001). Meanwhile, no gender differences in the associations were found. Conclusion: There is an association between social capital and eHealth literacy in older men and women. The association varis with age. The findings provide a reference for developing targeted measures to improve self-perceived eHealth literacy among older people. It is essential for achieving active and healthy aging and developing the knowledge and understanding of relevant theories, concepts, and evidence within the field of health and social capital.

The Effect of Hematocrit on All-Cause Mortality in Geriatric Patients with Hip Fractures: A Prospective Cohort Study.

OBJECTIVE: The present study aimed to evaluate the association between hematocrit (HCT) levels and all-cause mortality in geriatric hip fractures. METHODS: Older adult patients with hip fractures were screened between January 2015 and September 2019. The demographic and clinical characteristics of these patients were collected. Linear and nonlinear multivariate Cox regression models were used to identify the association between HCT levels and mortality. Analyses were performed using EmpowerStats and the R software. RESULTS: A total of 2589 patients were included in this study. The mean follow-up period was 38.94 months. Eight hundred and seventy-five (33.8%) patients died due to all-cause mortality. Linear multivariate Cox regression models showed that HCT level was associated with mortality (hazard ratio [HR] = 0.97, 95% confidence interval [CI]: 0.96-0.99, p = 0.0002) after adjusting for confounding factors. However, the linear association was unstable and nonlinearity was identified. A HCT level of 28% was the inflection point for prediction. A HCT level of <28% was associated with mortality (HR = 0.91, 95% CI: 0.87-0.95, p < 0.0001), whereas a HCT level > 28% was not a risk factor for mortality (HR = 0.99, 95% CI: 0.97-1.01, p = 0.3792). We found that the nonlinear association was very stable in the propensity score-matching sensitivity analysis. CONCLUSIONS: The HCT level was nonlinearly associated with mortality in geriatric hip fracture patients and could be considered a predictor of mortality in these patients. REGISTRATION: ChiCTR2200057323.

Androgen receptor, a possible anti-infective therapy target and a potent immune respondent in SARS-CoV-2 spike binding: a computational approach.

BACKGROUND: Although androgen in gender disparity of COVID-19 has been implied, no direct link has been provided. RESEARCH DESIGN AND METHODS: Here, we applied AlphaFold multimer, network and single cells database analyses to highlight specificity of Androgen receptor (AR) against spike receptor binding protein (RBD) of SARS-CoV-2. RESULTS: LXXL motifs in spike RBD are essential for AR binding. RBD LXXA mutation complex with the AR depicting slightly reduced binding energy, as LXXLL motif usually mediates nuclear receptor binding to coregulators. Moreover, AR preferred to bind a LYRL motif in specificity and interaction interface, and showed reduced affinity against Omicron compared to other variants (alpha, beta, gamma, and delta). Importantly, RBD LYRL motif is a conserved antigenic epitope (9 residues) for T-cell response. Network analysis of AR-related genes against COVID-19 database showed T-cell signaling regulation, and CD8+ T-cell spatial location in AR+ single cells, which is consistent with the AR binding motif LYRL in epitope function. CONCLUSIONS: We provided the potent mechanisms of AR binding to RBD linking to immune response and vaccination shift. AR could be an anti-infective therapy target for anti-Omicron new lineages.

Correlation between academic stress and extracurricular physical exercise among college students / 中国学校卫生

Objective@#The study aimed to investigate the relationship between academic stress and extracurricular physical exercise among college students, with the goal of providing evidence and reference for effectively alleviating academic stress.@*Methods@#A stratified cluster random sampling method was employed, along with the Chinese College Student Psychological Health Screening Scale and a self designed questionnaire. In January 2023, an online survey was conducted among 1 108 college students from eight colleges and universities in Jiangsu Province. Statistical analyses included independent samples t test, one way analysis of variance (ANOVA) and the optimal scale regression model.@*Results@#It revealed that 50.8% of students worried about falling behind their peers in their studies, 51.7% expressed concerns about exams, 21.7% exerted significant effort but still struggled to keep up with the pace of learning, and 24.9% felt difficulties in their studies. The overall index of academic stress was higher among undergraduate institutions, first year students, female students, and urban residents ( t/F =3.66, 10.96, -5.46, 3.52, P <0.01). The average time of weekly extracurricular physical exercise for students was (2.35±2.18)h, and there were significant differences by gender, only child status, and grade groups( t/F =2.35, 4.66, 7.09, P <0.05). The optimal scale regression model analysis ( R 2=0.17, F=32.03, P <0.01) revealed that the regression coefficient and partial correlation coefficient between academic stress and extracurricular physical exercise time were both -0.33( P <0.01). The importance of extracurricular physical exercise in the model was 0.66, with a tolerance value of 0.97. The regression coefficients and partial correlation coefficients for academic stress and extracurricular physical exercise time were -0.35, -0.35 for undergraduate students, and -0.31, -0.32 for junior college students ( P < 0.01 ).@*Conclusion@#A significant number of college students experience varying degrees of academic stress, and their engagement in extracurricular physical exercise is insufficient. There is a negative association between academic stress and extracurricular physical activity time among college students. Universities should encourage students to increase extracurricular physical activity time to reduce academic stress and promote college students mental health.

Recent advances on human mpox.

Mpox has been a concern of public health and travel caution. Using databases of WHO, CDC, google scholar, and PubMed, we searched recent literatures and reviewed the history, genomic mutation/evolution, host cell response pathways, regulation policy, vaccine and therapy development. Recent studies showed that current mpox has many genomic mutations related to regulation by APOBEC3. Current mpox has also been suggested to be associated with sexual transmission. Vaccination should be applied and anti-mpox drug should be urgently developed. More investigations are needed to ensure outbreak prevention.