Lithium Exposure and Risk of Major Neurocognitive Disorders: A Systematic Review and Meta-analysis.

BACKGROUND: Published studies on the association between lithium use and the decreased risk of major neurocognitive disorders (MNCDs) have shown disparities in their conclusions. We aimed to provide updated evidence of this association. METHODS: A comprehensive literature search was performed in PubMed, EMBASE, and Cochrane Library from inception until August 31, 2023. All the observational studies evaluating the association between lithium use and MNCD risk were eligible for inclusion. Pooled odds ratios (ORs) and 95% prediction intervals were computed using random-effects models. RESULTS: Eight studies with 377,060 subjects were included in the analysis. In the general population on the association between lithium use versus nonuse and dementia, the OR was 0.94 (95% confidence interval [CI] = 0.77-1.24). Further analysis also demonstrated that lithium use was not associated with an increased risk of Alzheimer's disease (OR = 0.69, 95% CI: 0.31-1.65). When the analysis was restricted to individuals with bipolar disorder to reduce the confounding by clinical indication, lithium exposure was also not associated with a decreased risk of MNCD (OR = 0.9, 95% CI = 0.71-1.15). CONCLUSION: The results of this systematic review and meta-analysis do not support a significant association between lithium use and the risk of MNCD.

Xiaoqinglong decoction mitigates nasal inflammation and modulates gut microbiota in allergic rhinitis mice.

Introduction: Allergic rhinitis (AR) is a respiratory immune system disorder characterized by dysregulation of immune responses. Within the context of AR, gut microbiota and its metabolites have been identified as contributors to immune modulation. These microorganisms intricately connect the respiratory and gut immune systems, forming what is commonly referred to as the gut-lung axis. Xiaoqinglong Decoction (XQLD), a traditional Chinese herbal remedy, is widely utilized in traditional Chinese medicine for the clinical treatment of AR. In this study, it is hypothesized that the restoration of symbiotic microbiota balance within the gut-lung axis plays a pivotal role in supporting the superior long-term efficacy of XQLD in AR therapy. Therefore, the primary objective of this research is to investigate the impact of XQLD on the composition and functionality of the gut microbiota in a murine model of AR. Methods: An ovalbumin-sensitized mouse model to simulate AR was utilized, the improvement of AR symptoms after medication was investigated, and high-throughput sequencing was employed to analyze the gut microbiota composition. Results: XQLD exhibited substantial therapeutic effects in AR mice, notably characterized by a significant reduction in allergic inflammatory responses, considerable alleviation of nasal symptoms, and the restoration of normal nasal function. Additionally, following XQLD treatment, the disrupted gut microbiota in AR mice displayed a tendency toward restoration, showing significant differences compared to the Western medicine (loratadine) group. Discussion: This results revealed that XQLD may enhance AR allergic inflammatory responses through the regulation of intestinal microbiota dysbiosis in mice, thus influencing the dynamics of the gut-lung axis. The proposal of this mechanism provides a foundation for future research in this area.

Characterizing the Impact of Compression Duration and Deformation-Related Loss of Closure Force on Clip-Induced Spinal Cord Injury in Rats.

The clip-induced spinal cord injury (SCI) rat model is pivotal in preclinical SCI research. However, the literature exhibits variability in compression duration and limited attention to clip deformation-related loss of closure force. We aimed to investigate the impact of compression duration on SCI severity and the influence of clip deformation on closure force. Rats received T10-level clip-induced SCI with durations of 1, 5, 10, 20, and 30 s, and a separate group underwent T10 transection. Outcomes included functional, histological, electrophysiological assessments, and inflammatory cytokine analysis. A tactile pressure mapping system quantified clip closure force after open-close cycles. Our results showed a positive correlation between compression duration and the severity of functional, histological, and electrophysiological deficits. Remarkably, even a brief 1-s compression caused significant deficits comparable to moderate-to-severe SCI. SSEP waveforms were abolished with durations over 20 s. Decreased clip closure force appeared after five open-close cycles. This study offers critical insights into regulating SCI severity in rat models, aiding researchers. Understanding compression duration and clip fatigue is essential for experiment design and interpretation using the clip-induced SCI model.

Mitochondrial transplantation attenuates traumatic neuropathic pain, neuroinflammation, and apoptosis in rats with nerve root ligation.

Traumatic neuropathic pain (TNP) is caused by traumatic damage to the somatosensory system and induces the presentation of allodynia and hyperalgesia. Mitochondrial dysfunction, neuroinflammation, and apoptosis are hallmarks in the pathogenesis of TNP. Recently, mitochondria-based therapy has emerged as a potential therapeutic intervention for diseases related to mitochondrial dysfunction. However, the therapeutic effectiveness of mitochondrial transplantation (MT) on TNP has rarely been investigated. Here, we validated the efficacy of MT in treating TNP. Both in vivo and in vitro TNP models by conducting an L5 spinal nerve ligation in rats and exposing the primary dorsal root ganglion (DRG) neurons to capsaicin, respectively, were applied in this study. The MT was operated by administrating 100 µg of soleus-derived allogeneic mitochondria into the ipsilateral L5 DRG in vivo and the culture medium in vitro. Results showed that the viable transplanted mitochondria migrated into the rats' spinal cord and sciatic nerve. MT alleviated the nerve ligation-induced mechanical and thermal pain hypersensitivity. The nerve ligation-induced glial activation and the expression of pro-inflammatory cytokines and apoptotic markers in the spinal cord were also repressed by MT. Consistently, exogenous mitochondria reversed the capsaicin-induced reduction of mitochondrial membrane potential and expression of pro-inflammatory cytokines and apoptotic markers in the primary DRG neurons in vitro. Our findings suggest that MT mitigates the spinal nerve ligation-induced apoptosis and neuroinflammation, potentially playing a role in providing neuroprotection against TNP.

Minor Forms of Parental Maltreatment and Educational Achievement of Immigrant Youths in Young Adulthood: A Longitudinal Study.

Parental hostility and emotional rejection-or aggregated as general harsh family interactions with parents-have received little research attention due to such parent-child interactions being counted as minor forms of parental maltreatment and regarded as being less harmful. However, recent research showed that these minor forms of parental maltreatment on youth development are far from negligibility on account of their frequency, chronicity, and incessancy. In this longitudinal study, we investigated how parental hostility, emotional rejection, and harsh family interactions with parents of in early adolescence of immigrant youths (wave-1 Mage = 14) adversely impact successful college graduation of immigrant youths in young adulthood (wave-3 Mage = 24) through the mediation of their development of academic aspirations in late adolescence (wave-2 Mage = 17). Using data from a representative sample of the Children of Immigrants Longitudinal Study (N = 3344), the current study revealed that parental hostility, emotional rejection, and harsh family interactions with parents significantly impaired successful college graduation of immigrant youths in young adulthood, with the decreased odds of 20.1% to 30.22%. Furthermore, academic aspirations of immigrant youths in late adolescence not only significantly mediated the abovementioned relationships but also contributed to the higher odds of immigrant youths' college graduation by 2.226 to 2.257 times. Findings of this study related to educational innovations, family services, and policy implications are discussed herein.

HDAC Downregulation of Xiaoqinglong Decoction in the Treatment of Allergic Rhinitis.

INTRODUCTION: As one of the most common allergic diseases, allergic rhinitis (AR) has attracted wide attention all over the world. More appropriate treatment of AR should be explored thoroughly. In recent years, traditional Chinese medicine has attracted more attention in AR treatment. As a classical Chinese medicine prescription, Xiaoqinglong decoction (XQLD) has been commonly used in treating AR. Even though its therapeutic effect on AR has been clinically confirmed, more molecular mechanism remains to be further investigated. Our research aimed to investigate the therapeutic mechanism of XQLD for AR management. METHODS: The study was evaluated in an ovalbumin sensitized mouse model and liquid chromatography-mass spectrometry was adopted to test the stability of XQLD's effective components. RESULTS: The results confirmed the stability and safety of the effective components of XQLD. XQLD significantly downregulated the expression of HDACs (HDAC1, HDAC3, and HDAC4) and Th2 inflammatory factors (IL4, IL5, and IL13) in AR mice. XQLD and the HDAC inhibitor JNJ-26481585 promoted the expression of epithelial tight junction proteins (claudin-1 and ZO-1) and decreased the expression of mucins (Muc5ac and Muc5b) in the nasal mucosa of AR mice. CONCLUSIONS: In conclusion, our findings present the beneficial effects of XQLD on AR and recovery of the nasal epithelium. We also identify the decreased HDAC as a potential target of XQLD for AR treatment. This study provides an important experimental proof for elucidating the therapeutic mechanism of XQLD.

Where There's a Will, There's a Way? Social and Mental Forces of Successful Adaptation of Immigrant Children in Young Adulthood.

Although the twenty-first century is deemed as a new era of globalization, waves of immigration continue, due to disparities between politically and economically unstable regions and Western democratized and developed countries. Immigration research has therefore reignited its attention on the successful adaptation of immigrants' offspring, which has profound implications for Western immigrant-receiving countries, as well as worldwide stability. Although immigration research mainly informed by the conventional assimilation theory and/or segmented assimilation perspective accentuates the importance of structural factors, termed as social forces here, in relation to immigrant children's successful adaptation in adolescence, an argument of determinism and tenability keeps on and the contribution of human mental resources and determination, termed as mental forces here, in shaping life trajectories of immigrant children should be not ignored. For this, with a representative sample of 3344 immigrant children from the Children of Immigrants Longitudinal Study (CILS), we examined and compared both the effects of social and mental forces measured in adolescence of immigrant children on their multiple adaptation outcomes in terms of college graduation, engagement in postgraduate study, and first and current job attainments in young adulthood with a Bayesian multilevel modeling framework. The results found that both social forces of segmented assimilation theory and mental forces of immigrant children in adolescence were significantly predictive of immigrant children's successful adaptation in young adulthood (OR = 1.088-2.959 and ß = 0.050-0.639 for social forces; OR = 11.290-18.119 and ß = 0.293-0.297 for mental forces), in which, although the latter showed stronger effects than the former, the effects of mental forces on adaptation of immigrant children were conditionally shaped by the contexts of the social forces informed by segmented assimilation theory. The findings of the current study highlight the significance of the organism-environment interaction perspective on immigration research and provide an insight to consider a context-driven response thesis proposed.

Mitochondrial Transplantation Attenuates Neural Damage and Improves Locomotor Function After Traumatic Spinal Cord Injury in Rats.

Mitochondrial dysfunction is a hallmark of secondary neuroinflammatory responses and neuronal death in spinal cord injury (SCI). Even though mitochondria-based therapy is an attractive therapeutic option for SCI, the efficacy of transplantation of allogeneic mitochondria in the treatment of SCI remains unclear. Herein, we determined the therapeutic effects of mitochondrial transplantation in the traumatic SCI rats. Compressive SCI was induced by applying an aneurysm clip on the T10 spinal cord of rats. A 100-µg bolus of soleus-derived allogeneic mitochondria labeled with fluorescent tracker was transplanted into the injured spinal cords. The results showed that the transplanted mitochondria were detectable in the injured spinal cord up to 28 days after treatment. The rats which received mitochondrial transplantation exhibited better recovery of locomotor and sensory functions than those who did not. Both the expression of dynamin-related protein 1 and severity of demyelination in the injured cord were reduced in the mitochondrial transplanted groups. Mitochondrial transplantation also alleviated SCI-induced cellular apoptosis and inflammation responses. These findings suggest that transplantation of allogeneic mitochondria at the early stage of SCI reduces mitochondrial fragmentation, neuroapoptosis, neuroinflammation, and generation of oxidative stress, thus leading to improved functional recovery following traumatic SCI.

The facilitators and barriers to physical activity scale for people with mental illness in Taiwan: development and validation.

PURPOSE: The purposes of this study were to develop a new measure, the Facilitators and Barriers to Physical Activity Scale for People with Mental Illness (FBPAS-MI) and to validate the psychometrics. METHODS: This study included two phases. In Phase I, a literature review and five focus groups were conducted to develop an item bank. Then, expert consultation and cognitive interviews were used for content validity. In Phase II, 147 participants with severe mental illness were recruited from 10 community-based psychiatric rehabilitation centers in Taiwan to examine the psychometrics. Principal axis factoring method with direct oblique rotation was used to identify the underlying constructs of FBPAS-MI. Concurrent validity, internal consistency and test-retest reliability were examined. RESULTS: The results revealed five domains in the facilitator subscale (15 items) and two domains in the barrier subscale (11 items). Both subscales showed satisfactory internal consistency (all Cronbach's α >0.80); the concurrent validity and test-retest reliability were established. CONCLUSIONS AND IMPLICATIONS OF PRACTICE: This study confirmed that the FBPAS-MI is a valid and reliable scale to understand perceived facilitators and barriers to physical activity for severe mental illness. The FBPAS-MI can provide useful information in the development of individualized health promotion program for this population.Implications for RehabilitationThe Facilitators and Barriers to Physical Activity Scale for People with Mental Illness (i.e., FBPAS-MI) is a valid and reliable assessment to examine key factors affecting physical activity participation among people with severe mental illness.Psychiatric rehabilitation practitioners could use the FBPAS-MI to help develop and tailor individualized physical activity promotion programs based on identified facilitators and barriers to activity.

The Impact of Item Feature and Response Preference in a Mixed-Format Design.

A combination of positively and negatively worded items (termed a mixed-format design) has been widely adopted in personality and attitude assessments. While advocates claim that the inclusion of positively and negatively worded items will encourage respondents to process the items more carefully and avoid response preference, others have reported that negatively worded (NW) items may induce a nuisance factor and contaminate scale scores. The present study examined the extent of the impact of the NW-item feature and further investigated whether a mixed-format design could effectively control acquiescence and the preference for extreme response options using two datasets (Attitude toward Peace Walls, and International Personality Item Pool). A proposed multidimensional item response model was implemented to simultaneously estimate the impact of item feature and response preference. The results suggested that NW items induced an impact on item responses and that affirmative preference was negligible, regardless of the proportion of NW items in a scale. However, participants' extremity preference was large in both balanced and imbalanced mixed-format designs. It concludes that the impact of the NW-item feature is not negligible in a mixed-format scale, which exhibits good control of acquiescence but not extremity preference.

Health-Promoting Behaviors, Risk Perceptions, and Attention to COVID-19-Related Information: Comparing People's Responses to the COVID-19 Pandemic Across Times of Chinese New Year and Summer 2020 in Hong Kong.

Background: Since the start of the COVID-19 pandemic, individuals have been encouraged to engage in health-promoting behaviors, namely actions taken to prevent infection and keep themselves healthy, such as maintaining social distancing. However, other factors, such as risk perception and feelings of fear, also might influence whether an individual takes such measures. This study compared people's responses to the pandemic in terms of their adoption of COVID-19 health-promoting behaviors, COVID-19 risk perceptions, and attention to COVID-19-related information during two periods: the 2020 Chinese New Year (CNY) in Hong Kong (HK), i.e., the very beginning of the COVID-19 outbreak (Time 1, T1), and summer 2020, i.e., before and during the third wave of COVID-19 infections in HK (Time 2, T2). Methods: Data were extracted from 180 HK participants, who were asked to recall and report their health-promoting behaviors, emotional and cognitive COVID-19 risk perceptions, and attention to COVID-19-related information during T1 and T2. A repeated-measures ANOVA series was conducted to investigate differences in public responses between the two aforementioned time points. Main Findings: After controlling for the effects from gender, age, and education levels, the participants reported practicing more infection-prevention behaviors, experiencing a lower level of fear as a psychological response, and paying less attention to COVID-19-related information during T2 than T1. Conclusions: This study addressed the need to monitor public responses to the COVID-19 pandemic, including changes in people's behaviors and psychological responses across time. The results also suggest that the HK public was steered toward striking a balance between strengthening their infection-prevention behaviors and reducing their fear of COVID-19 infection.

The effects of Danggui-Shaoyao-San on neuronal degeneration and amyloidosis in mouse and its molecular mechanism for the treatment of Alzheimer's disease.

The abnormal deposition of the extracellular amyloid-ß peptide is the typical pathological hallmark of Alzheimer's disease. Strategies to reduce the amyloid-ß deposition effectively alleviate the neuronal degeneration and cognitive deficits of Alzheimer's disease. Danggui-Shaoyao-San has been considered a useful therapeutic agent known for the treatment of Alzheimer's disease. However, the mechanism of Danggui-Shaoyao-San for the treatment of Alzheimer's disease remains unclear. We investigated Danggui-Shaoyao-San's effect on amyloidosis and neuronal degeneration in an APP/PS1 mouse model. We found Danggui-Shaoyao-San alleviated the cognitive deficits in APP/PS1 mice. Additionally, Danggui-Shaoyao-San ameliorated the neuronal degeneration in these mice. Danggui-Shaoyao-San reduced the amyloidosis and amyloid-ß1-42 deposition in APP/PS1 mouse brain and down-regulated the receptor for advanced glycation end products, and up-regulated the level of low-density lipoprotein receptor-related protein-1. However, the protein expression of the ß-amyloid precursor protein, ß-Secretase and presenilin-1 (PS1) in the amyloid-ß production pathway, and the expression of neprilysin and insulin-degrading enzyme in the amyloid-ß degradation pathway were not altered. Our findings collectively suggest that Danggui-Shaoyao-San could ameliorate the amyloidosis and neuronal degeneration of Alzheimer's disease, which may be associated with its up-regulation lipoprotein receptor-related protein-1 and down-regulation of the receptor for advanced glycation end products.

The differences in nurses' willingness to discuss palliative care with patients and their family members.

BACKGROUND: This study aimed to evaluate the differences in nurses' willingness to discuss palliative care with terminally ill patients and their family members. METHODS: The participants were randomly recruited from registered staff nurses ≥20 years of age who were responsible for clinical inpatient care in a tertiary hospital in northern Taiwan. A semi-structured questionnaire was administered to evaluate nurses' experiences of discussing do-not-resuscitate (DNR) decisions and their willingness to discuss palliative care with terminal patients and their family members. The differences in nurses' experiences regarding DNR and willingness to discuss palliative care with terminally ill patients and their family members were compared using the Chi-square test. Logistic regressions were used to analyze factors associated with nurses' willingness to discuss palliative care with patients and their families. RESULTS: More participants had experienced initiating discussions about DNR with patients' families than with patients (72.2% vs 61.9%, p < 0.001). Unadjusted logistic regression analysis showed that the experiences of actively initiating DNR discussions with patients were a significant factor associated with palliative care discussion with patients (odds ratio [OR] = 2.91, 95% confidence interval [CI]: 1.09-7.79). On the other hand, the experiences of actively initiating DNR discussions with patients and with patients' families were significant factors associated with palliative care discussion with patients' families (OR = 3.84, 95% CI: 1.22-12.06 and OR = 3.60, 95% CI: 1.19-10.90, respectively). After adjusting for covariates, no significant factors were found to be independently associated with nurses' willingness to discuss palliative care with patients and their family members. CONCLUSION: There are significant differences in nurses' willingness to discuss palliative care with patients and their family members. Further research is needed to evaluate factors associated with nurses' willingness to discuss palliative care with patients and their families to facilitate these discussions and protect patients' autonomy.

MIMIC approach to assessing differential item functioning with control of extreme response style.

Likert or rating scales may elicit an extreme response style (ERS), which means that responses to scales do not reflect the ability that is meant to be measured. Research has shown that the presence of ERS could lead to biased scores and thus influence the accuracy of differential item functioning (DIF) detection. In this study, a new method under the multiple-indicators multiple-causes (MIMIC) framework is proposed as a means to eliminate the impact of ERS in DIF detection. The findings from a series of simulations showed that a difference in ERS between groups caused inflated false-positive rates and deflated true-positive rates in DIF detection when ERS was not taken into account. The modified MIMIC model, as compared to conventional MIMIC, logistic discriminant function analysis, ordinal logistic regression, and their extensions, could control false-positive rates across situations and yielded trustworthy true-positive rates. An empirical example from a study of Chinese marital resilience was analyzed to demonstrate the proposed model.

Parental Socialization and Development of Chinese Youths: A Multivariate and Comparative Approach.

Parental socialization has been recently reported as a multifaceted concept, which includes parenting practices and family processes. Nevertheless, prior family research generally treated parental socialization tantamount to parenting behavior only and overlooked its different effects on multiple youth outcomes simultaneously, especially in the Chinese population. This study, with a sample of 223 Chinese parent-youth dyads (80.7% mothers; 55.6% male youths; meanage = 16.7 years), found that both authoritative parenting and positive family processes, as measured by a multi-informant approach, significantly predicted higher self-esteem, self-control, future orientation, other perspective taking and lower externalizing problem behavior of Chinese youths concomitantly. Furthermore, youth self-esteem was found to significantly mediate the effects of authoritative parenting and positive family processes on their self-control, future orientation, other perspective taking and externalizing problem behavior, and different facets of parental socialization significantly predicted the youth outcomes differentially. Results of this study highlight importance of considering the multifaceted nature of parental socialization and interrelations of youth development.

Using Odds Ratios to Detect Differential Item Functioning.

Differential item functioning (DIF) makes test scores incomparable and substantially threatens test validity. Although conventional approaches, such as the logistic regression (LR) and the Mantel-Haenszel (MH) methods, have worked well, they are vulnerable to high percentages of DIF items in a test and missing data. This study developed a simple but effective method to detect DIF using the odds ratio (OR) of two groups' responses to a studied item. The OR method uses all available information from examinees' responses, and it can eliminate the potential influence of bias in the total scores. Through a series of simulation studies in which the DIF pattern, impact, sample size (equal/unequal), purification procedure (with/without), percentages of DIF items, and proportions of missing data were manipulated, the performance of the OR method was evaluated and compared with the LR and MH methods. The results showed that the OR method without a purification procedure outperformed the LR and MH methods in controlling false positive rates and yielding high true positive rates when tests had a high percentage of DIF items favoring the same group. In addition, only the OR method was feasible when tests adopted the item matrix sampling design. The effectiveness of the OR method with an empirical example was illustrated.

Applying Logistic Regression to Detect Differential Item Functioning in Multidimensional Data.

Conventional differential item functioning (DIF) approaches such as logistic regression (LR) often assume unidimensionality of a scale and match participants in the reference and focal groups based on total scores. However, many educational and psychological assessments are multidimensional by design, and a matching variable using total scores that does not reflect the test structure may not be good practice in multidimensional items for DIF detection. We propose the use of all subscores of a scale in LR and compare its performance with alternative matching methods, including the use of total score and individual subscores. We focused on uniform DIF situation in which 250, 500, or 1,000 participants in each group answered 21 items reflecting two dimensions, and the 21st item was the studied item. Five factors were manipulated in the study: (a) the test structure, (b) numbers of cross-loaded items, (c) group differences in latent abilities, (d) the magnitude of DIF, and (e) group sample size. The results showed that, when the studied item measured a single domain, the conventional LR incorporating total scores as a matching variable yielded inflated false positive rates (FPRs) when two groups differed in one latent ability. The situation worsened when one group had a higher ability in one domain and lower ability in another. The LR using a single subscore as the matching variable performed well in terms of FPRs and true positive rates (TPRs) when two groups did not differ in either one latent ability or differed in one latent ability. However, this approach yielded inflated FPRs when two groups differed in two latent abilities. The proposed LR using two subscores yielded well-controlled FPRs across all conditions and yielded the highest TPRs. When the studied item measured two domains, the use of either the total score or two subscores worked well in the control of FPRs and yielded similar TPRs across conditions, whereas the use of a single subscore resulted in inflated FPRs when two groups differed in one or two latent abilities. In conclusion, we recommend the use of multiple subscores to match subjects in DIF detection for multidimensional data.

Corrigendum: Modified Logistic Regression Approaches to Eliminating the Impact of Response Styles on Differential Item Functioning Detection in Likert-Type Scale.

[This corrects the article on p. 1143 in vol. 8, PMID: 28736542.].

Modified Logistic Regression Approaches to Eliminating the Impact of Response Styles on DIF Detection in Likert-Type Scales.

Extreme response styles (ERS) is prevalent in Likert- or rating-type data but previous research has not well-addressed their impact on differential item functioning (DIF) assessments. This study aimed to fill in the knowledge gap and examined their influence on the performances of logistic regression (LR) approaches in DIF detections, including the ordinal logistic regression (OLR) and the logistic discriminant functional analysis (LDFA). Results indicated that both the standard OLR and LDFA yielded severely inflated false positive rates as the magnitude of the differences in ERS increased between two groups. This study proposed a class of modified LR approaches to eliminating the ERS effect on DIF assessment. These proposed modifications showed satisfactory control of false positive rates when no DIF items existed and yielded a better control of false positive rates and more accurate true positive rates under DIF conditions than the conventional LR approaches did. In conclusion, the proposed modifications are recommended in survey research when there are multiple group or cultural groups.