The relationship between low handgrip strength with or without asymmetry and fall risk among middle-aged and older males in China: evidence from the China Health and Retirement Longitudinal Study.

PURPOSE: This study sought to explore the potential correlation between low handgrip strength (HGS) with or without asymmetry and fall risk in middle-aged and older Chinese adults. METHODS: Baseline characteristic data from participants 45+ years of age and data regarding fall events collected from two rounds (2011-2013) of the China Health and Retirement Longitudinal Study were utilized for the present analyses. HGS and HGS asymmetry was defined according to the updated American Society of Hand Therapist. Fall events were identified through self- or proxy-reported details. Logistic regression analyses were employed to gauge the potential relationship between abnormal HGS and fall risk. RESULTS: In total, 10 563 participants were enrolled in this analysis, of whom 47.49% (5016/10 563) were male. The proportions of low HGS alone, HGS asymmetry alone, and low HGS with asymmetry were 22.23%, 18.34%, and 22.75%, respectively, in males, but just 3.64%, 35.12%, and 6.62% in females. A total of 693 and 1019 fall events were recorded for male (13.82%) and female (18.37%) participants over the 2-year follow-up period, respectively. Significant differences in fall event incidence among different HGS groups were only observed among males. An adjusted logistic regression analysis model confirmed that low HGS with dominant asymmetry was closely related to fall risk among middle-aged and older males [P = 0.014, odds ratio = 1.332, 95% confidence interval: 1.059-1.676). CONCLUSION: These results demonstrated that low HGS with dominant asymmetry is a risk factor linked to increased fall risk among middle-aged and older Chinese males. What is already known on this topic Low HGS or HGS asymmetry is been reported to be linked to an increased risk of falls in middle-aged and older adults; however, little is known about the association between fall risk and low HGS and/or HGS asymmetry. Main messages The prevalence of low HGS alone and low HGS asymmetry in men was significantly higher than in women, while HGS alone asymmetry was more common in women than men. The risk factor for the increased risk of falls in Chinese middle-aged and older men is low and asymmetric HGS, rather than low or asymmetric HGS alone. Low HGS with dominant asymmetry rather than nondominant asymmetry is associated with future fall risk among middle-aged and older Chinese males. Current research questions What is the mechanism for the significant difference in the proportion of abnormal HGS components between the sexes? If female subjects with low HGS and asymmetric HGS were added, would an association be observed between low HGS and asymmetric HGS falls? Is there an association between the severity of asymmetric HGS with weakness and falls?

Association between psychological capital and depressive symptoms during COVID-19: The mediating role of perceived social support and the moderating effect of employment pressure.

Introduction: The Coronavirus Disease 2019 (COVID-19) pandemic affects individuals' mental health that can result in fear of getting COVID-19 infection and depression. Prior research has demonstrated that both psychological capital and perceived social support are related to the severity of depression. Yet no study explored the direction of associations between these factors. This undermines the validity of psychological capital as a basis for health interventions. Methods: This study aimed to explore the association between psychological capital, perceived social support, employment pressure, and depressive symptoms during COVID-19. A cross-sectional design was employed in a sample of 708 Chinese senior medical students who were asked to complete an online questionnaire survey. Results: Results indicated that psychological capital negatively predicts depressive symptoms (ß = -0.55, p < 0.001); perceived social support plays a mediating role in the impact of psychological capital on depressive symptoms (indirect = -0.11, SE = 0.02, p < 0.001, 95%CI [-0.16, -0.07]), and these associations were moderated by employment pressure. Medical students with high employment pressure, the negative impact of psychological capital on depressive symptoms was statistically significant (ß = -0.37, SE = 0.05, p < 0.001, 95% CI [-0.046, -0.27]); when the perceived employment pressure was low, the negative effect of psychological capital on depressive symptoms, although significant, was stronger (ß = -0.49, SE = 0.04, p < 0.001, 95% CI [-0.57, -0.40]). Discussion: The current study highlights that it is of great significance to address Chinese medical students' employment pressure and improve their mental health during the COVID-19 epidemic.

Approach-Avoidance pattern of attentional bias in individuals with high tendencies toward problematic Internet pornography use.

Attentional bias plays a vital role in the occurrence and development of addictive behaviors. However, little is known about attentional processes in problematic Internet pornography use (PIPU), and previous studies have reported mixed results. The current study examined the components of attentional processing to sexual stimuli using an exogenous cueing task designed to differentiate between attentional engagement and disengagement. Two different stimulus presentation times (100 and 500 ms) were used to present the pornographic and neutral images to differentiate the early and late stages of attentional bias. Individuals with high (n = 40) and low (n = 40) PIPU tendencies were compared. The results demonstrated that individuals with high tendencies toward PIPU showed enhanced attentional engagement with pornographic stimuli in the early stage of attentional processing (100 ms), followed by attentional avoidance in the late stages of attentional processing (500 ms). Moreover, the severity of PIPU symptoms was positively correlated with attentional engagement scores in the short picture-time trials (100 ms) and weakly negatively correlated with attentional disengagement scores in the long picture-time trials (500 ms). This approach-avoidance pattern of attentional biases is in line with a recent theoretical model that emphasizes that appetitive and aversive motivational processes jointly determine attentional bias.

Clinical efficacy and safety of electro-acupuncture combined with beraprost sodium and α-lipoic acid for diabetic peripheral neuropathy.

BACKGROUND: The pathogenic triggers of diabetic peripheral neuropathy (DPN) mainly include ischemia and hypoxic factors. The combined use of Chinese and Western medicine may be a new perspective for the treatment of DPN. Accordingly, this study explores the clinical efficacy and safety of electro-acupuncture (EA) combined with beraprost sodium (BPS) and α-lipoic acid (α-LA) in the treatment of patients with DPN. METHODS: A total of 184 patients with DPN meeting the inclusion criteria were enrolled and divided into electric-acupuncture group (n=54), medication group (n=62) and combination group (n=68), which were treated by EA, BPS+α-LA, and EA+BPS+α-LA, respectively. The three groups were compared with respect to the following factors: clinical efficacy; motor conduction velocities (MCVs) of nervus medianus, nervus peroneus communis and tibial nerve and sensory conduction velocities (SCVs) of nervus medianus, sural nerve and ulnar nerve before and after treatment; the Toronto Clinical Scoring System (TCSS), total symptom score (TSS) and Michigan Diabetes Neuropathy Score (MDNS) before and after treatment; changes of serum homocysteine and cysteine (Cys) levels, oxidative stress indicators and inflammatory factors; incidence of adverse reactions. RESULTS: The overall response rate of the combination group was higher than that of the electric acupuncture group or the medication group. After treatment, the SCV of nervus medianus, sural nerve and ulnar nerve and the MCV of nervus medianus, nervus peroneus communis and tibial nerve were the highest in the combination group among the three groups (P<0.05). After treatment, the scores of TCSS, TSS and MDNS in the combination group was notably lower than those in the medication group and the electric acupuncture group (P<0.05). The amelioration of inflammatory factors in the combination group were the best among the three groups (P<0.05). The incidence of adverse reactions was lower in the combination group compared with the electric acupuncture group and the medication group (P<0.05). CONCLUSION: EA combined with BPS and α-LA is effective in the treatment of DPN, which can effectively reduce the levels of serum inflammatory factors in patients, with a lower complication rate and higher safety.

Relationship between plasma angiogenic growth factors and diabetic foot ulcers.

BACKGROUND: Angiogenic growth factors play an important role in wound healing. However, their associations with diabetic foot ulcers (DFUs) in humans have rarely been investigated. We examined the relationships between circulating concentrations of vascular endothelial growth factor (VEGF)-A and placenta growth factor (PlGF), and DFU risk. METHODS: We recruited 447 participants, including 169 DFU patients, 182 diabetes patients without DFUs, and 96 diabetes-free individuals. Plasma VEGF-A and PlGF concentrations were measured using commercial enzyme immunoassay kits. RESULTS: Concentrations of VEGF-A and PlGF in DFU patients were higher than those in diabetes-free controls (P < 0.05), but lower than those in the diabetic controls (P < 0.05). Increased concentrations of VEGF-A and PlGF were associated with a reduced risk of DFUs. The odds ratios (95% confidence intervals) were 0.93 (0.88, 0.97) for every 10 pg/ml increase in VEGF-A concentrations, and 0.96 (0.94, 0.99) for every 5 pg/ml increase in PlGF concentrations. VEGF-A concentrations were positively related to BMI, glycated hemoglobin (HbA1c), hypertension, and neuropathy, and PlGF was positively correlated to age, HbA1c, and hypertension, among DFU patients. CONCLUSION: VEGF-A and PlGF play important roles in the development of DFU but need to be confirmed in prospective studies.