The Effectiveness of Cognitive Behavioral Therapy-Based Intervention on Improving Sleep-Related Outcomes for People with Diabetes: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

Background: Sleep-related outcomes in people with diabetes are poor, which is closely linked to reducing the development of diabetes. Cognitive behavioral therapy (CBT) based intervention presents innovative solutions that can help improve sleep-related outcomes. Aim: This synthesis aims to assess the effectiveness of CBT-based intervention compared to controls in Randomized Controlled Trials (RCTs) for sleep-related outcomes among people with diabetes. Methods: Eight electronic databases were systematically searched: PubMed, EMBASE, Cochrane library, Web of Science, PsycINFO, CINAHL, China National Knowledge Infrastructure (CNKI), and Wan Fang database. We examined CBT-based intervention's effectiveness on sleep-related outcomes in people with diabetes in RCTs identified in these databases from their inception to 1st November 2023, and updated on 15 January 2024. The risk of bias was assessed using the Cochrane Risk of Bias tool by two reviewers. The meta-analysis of included studies was conducted by RevMan 5.3 software. Results: Seven studies in total (n = 2633 participants) were included in this systematic review based on our inclusion criteria. The systematic review found CBT-based intervention significantly improved sleep quality (Pittsburgh Sleep Quality Index, PSQI scores) at immediate post-intervention [95% CI=(-1.31 to -0.32), p = 0.001], six months [95% CI=(-0.75 to -0.22), p = 0.0003], and 12 months [95% CI=(-0.72 to -0.24), <0.0001], compared to control groups. Furthermore, our findings demonstrated that six sessions [95% CI= (-0.38 to -0.13), p < 0.0001] or more than six sessions [95% CI=(-1.76 to -0.02), p = 0.05] of CBT-based intervention could improve sleep quality compared to controls (I2=0%). Interestingly, CBT-based intervention improves total sleep time at post-intervention in people with diabetes compared to the control group [95% CI= (-0.57 to -0.12), p = 0.003]. However, there was no significant that CBT-based intervention is beneficial to time to fall asleep [95% CI (-1.89 to 0.43), p = 0.22] and sleep efficiency [95% CI (-1.27 to 0.27), p = 0.20] after intervention, compared to control group. Conclusion: CBT-based intervention appears to have a beneficial effect on improving sleep quality and total sleep time among people with diabetes. CBT-based intervention could be considered a strategy among healthcare providers to enhance sleep quality and total sleep time for people with diabetes. More RCTs with rigorous designs and long-term follow-up are warranted to provide conclusive evidence of the CBT-based intervention on sleep-related outcomes and to explore the mechanisms by which the CBT-based interventions improve sleep-related outcomes.

Trust, discrimination and preference for shared decision-making in adolescents diagnosed with depression: Implications from Chinese mental health professionals.

BACKGROUND: While evidence suggests that the attitudes of healthcare providers toward medical decision-making in adolescents diagnosed with depression merit exploration, research on their preferences for Shared Decision-Making (SDM) and the factors affecting these preferences remains limited. OBJECTIVE: To investigate Chinese mental health professionals' (MHPs) preferences for SDM in adolescents with depression and identify the relationships between their preference for SDM and trust and discrimination. METHODS: A cross-sectional design was used in this study. Clinical Decision-making Style-Staff (CDMS-S) was applied to evaluate their preferences for SDM. Physician Trust in the Patient Scale (PTPS) was utilised to assess their trust in consumers. Social Distance Scale to Mental Illness (SDSMI) was utilised to measure their discrimination against people with mental illness. RESULTS: A total of 581 MHPs were identified in China. MHPs rated their preference for participation in decision making (PD) as shared (1.89 ± 0.472), information (IN) as moderate (2.62 ± 0.682), and family involvement (FI) as high (3.13 ± 0.840). The preferences for three decision topics ranked from the highest to the lowest score were working-related decision (2.35 ± 0.681), general preferences in decision (1.82 ± 0.581) and medication-related decision (1.74 ± 0.826). The mean score of PTPS and SDSMI were 34.71 (SD=9.709) and 15.17 (SD=4.299), respectively. Logistic regression indicated that the preference for PD was associated with discrimination; the preference for IN was associated with trust, discrimination and SDM-related training experience; and the preference for FI was associated with both trust and discrimination. CONCLUSIONS: While MHPs generally exhibit a favourable attitude toward SDM, this positivity is not universally observed across all contexts. There remains room for improvement in the willingness to co-develop medication regimens and share health information. Rational recognition of depression, and building trusting and friendly therapeutic relationships are key to promoting MHPs' preferences for SDM. PRACTICAL VALUE: MHPs' preferences for SDM have a significant impact on SDM implementation, which will be promoted by implementing SDM-related training.

Shared decision-making in the treatment of adolescents diagnosed with depression: A cross-sectional survey of mental health professionals in China.

WHAT IS ALREADY KNOWN?: SDM improves clinical outcomes by increasing attendance and treatment adherence in adolescents diagnosed with depression. SDM could reduce treatment disagreements and enhance consumers' and their families' satisfaction with mental healthcare services. Healthcare professionals are a critical part of SDM. However, MHPs' practices of SDM in the daily management of adolescents diagnosed with depression need to be clarified. WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE?: From the viewpoints of MHPs, SDM was not extensively applied in the daily management of adolescents diagnosed with depression. MHPs who trust their consumers and have received training related to SDM are more likely to practice SDM in the daily management of adolescents diagnosed with depression. The positive preferences for providing information and family involvement in treatment decision-making are facilitators; working in closed inpatient mental health wards and open inpatient mental health wards are hindering factors for MHPs' practices of SDM. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: MHPs should encourage information sharing with consumers and their family members to help them participate in treatment decision-making actively. A trusting and friendly therapeutic relationship with consumers should be maintained in the daily management of adolescents diagnosed with depression. SDM-related training should be encouraged for MHPs to promote widespread SDM. ABSTRACT: INTRODUCTION: Shared decision-making (SDM) is an ideal model for a therapeutic relationship that can improve health outcomes. Healthcare professionals are a critical part of SDM, and they play an important role in the practices of SDM in the clinical setting. Evidence suggests that adolescents diagnosed with depression can benefit substantially from SDM. However, mental health professionals' (MHPs) practices of SDM for adolescents diagnosed with depression in China are not well-documented. AIM: This study aimed to investigate the practices of SDM for adolescents diagnosed with depression from the viewpoints of MHPs in China. METHOD: In this cross-sectional study, we recruited a total of 581 MHPs by convenience sampling. The Shared Decision-Making Questionnaire-Physician Version (SDM-Q-Doc) was used to evaluate the MHPs' practices of SDM for adolescents diagnosed with depression. RESULTS: The mean SDM-Q-Doc was 80.47 (±16.31). Within the six specific decision-making situations, most MHPs selected non-SDM (52.7%-71.6%). Substantial numbers of respondents believed that MHPs made the final decision, especially with regard to the development (37%) and adjustment of medication regimens (42%). The practice of SDM was predicted by MHPs' preference for providing information, their trust in consumers, preference for family involvement in treatment decision-making, working in an outpatient clinic and receiving SDM training (F = 23.582; p = .000; R2 = .198; adjusted R2 = .189). DISCUSSION: Although the MHPs' self-rated score of SDM-Q-Doc was high, SDM was not extensively applied in the daily management of adolescents diagnosed with depression. Thus, SDM needs to be further promoted by enhancing SDM-related training for MHPs, thereby actively promoting the involvement of families, facilitating the information sharing for consumers and families, and building an active, trusting consumer-practitioner relationship. IMPLICATIONS FOR PRACTICE: MHPs should prioritise information sharing with consumers and families, as well as build trusting and friendly therapeutic relationships. Family involvement in treatment decisions should be encouraged when adolescents diagnosed with depression are in need. Actively participating in training related to SDM is also important. Future high-quality evidence is still needed to explore the facilitators and barriers to SDM practices from a tripartite perspective of MHPs, adolescents diagnosed with depression and their families.

Determining the core competencies for international postgraduate nursing students in internship programs: A delphi study.

AIM: To determine the core competencies of clinical internships for international postgraduate nursing students undertaking a two-year professional program in China. BACKGROUND: Clinical internship is an important part of nursing education and is the cornerstone for the future training of nursing professionals. However, in terms of providing a basis for the training and assessment of international postgraduate nursing students undertaking a two-year professional program in China, their core competencies of clinical internships have not yet been sufficiently determined. METHODS: Focus group interviews and a two-round Delphi method were conducted. The preliminary list of core competencies was determined based on a scoping review and focus group interviews. Subsequently, experts provided suggestions for modifications to the core competencies in two rounds of the Delphi survey. The response rate (RR), composite reliability (Cr), coefficient of variation and Kendall coefficient of indices were calculated. RESULTS: Twenty experts completed two rounds of Delphi expert consultation and reached consensus on five first-level indices and 13 s-level indices with 27 connotations. The RR values for the two rounds of consultation were 100 %, the Cr values were 0.853 and 0.873 and the Kendall coordination coefficients were 0.134-0.250 (p < 0.05). CONCLUSION: The core competencies identified in this research can provide a basis for further training international postgraduate nursing students undertaking a two-year professional program in China through internship programs. This research also provides a reference for effectively evaluating and improving clinical programs.

Low awareness of venous thromboembolism among neurosurgical hospitalized patients: a cross-sectional study.

BACKGROUND: Venous thromboembolism (VTE) including Deep Venous Thrombosis (DVT) and Pulmonary Embolism (PE), is a serious cause of patient morbidity and mortality in hospitals. Neurosurgical hospitalized patients have higher rates of immobility and bed rest, thus increasing their risk of developing VTE. This highlights the need for their thromboprophylaxis regimens. Patients' awareness of VTE is essential for promoting strategies such as early ambulation and encouraging self-assessment and self-reporting of VTE signs and symptoms. This study evaluated neurosurgical hospitalized patients' awareness of VTE and explored the influencing factors to provide a theoretical basis for nursing intervention. METHODS: We selected one tertiary level hospital in Hunan Province and randomly sampled eligible patients from each five neurosurgical units. We conducted a cross-sectional survey of the hospitalized patients of neurosurgery using the self-designed and validated VTE knowledge questionnaire, and the influencing factors were analyzed using SPSS 26.0. RESULTS: A total of 386 neurosurgical hospitalized patients completed the survey. The score of VTE knowledge in neurosurgical hospitalized patients was 13.22 (SD = 11.52). 36.0% and 21.2% of participants reported they had heard of DVT and PE, respectively. 38.9% of participants were unable to correctly identify any symptoms of VTE. The most frequently identified risk factor was 'immobility or bed rest for more than three days' (50.0% of participants), and 38.1% of patients agreed that PE could cause death. 29.5% of participants were unable to identify any prophylactic measures of VTE. The results of Negative Binomial Regression showed that the influencing factors of VTE knowledge in neurosurgical hospitalized patients were education level (P < 0.004) and sources of information related to VTE, including nurses (95% CI = 2.201-4.374, P < 0.001), and family member/friend (95% CI = 2.038-4.331, P < 0.001), Internet/TV (95% CI = 1.382-2.834, P < 0.001). Other sources included patient /pamphlet/poster /professional books (95% CI = 1.492-3.350, P < 0.001). CONCLUSIONS: This study demonstrates the lack of awareness of VTE among neurosurgical hospitalized patients. More attention must be paid to carrying out training on VTE knowledge according to different characteristics of neurosurgical hospitalized patients, so as to ensure safe and high-quality patient care.

Self-efficacy mediates the effect of providing HIV self-testing kits on HIV testing frequency among Chinese men who have sex with men: results from a randomised controlled trial.

BACKGROUND: HIV self-testing (HIVST) could promote HIV tests; however, knowledge about the mechanisms by which providing HIVST kits impacts the uptake of HIV testing is limited. This study aimed to examine how self-efficacy mediates the association between providing HIVST kits and HIV testing frequency. METHODS: In this randomised controlled trial, HIV-negative men who have sex with men (MSM) were recruited in China and randomly assigned 1:1 into intervention and control groups. MSM in the control group could access site-based HIV testing services (SBHT). MSM in the intervention group could access SBHTs plus free HIVST kits. HIV testing self-efficacy, number of SBHTs, number of HIVSTs, and the total number of HIV tests were assessed every 3months for 1year. RESULTS: Data from 216 MSM (intervention group: 110; control group: 106) were included in analysis. Results from Pearson's correlations and point-biserial correlations showed that participants with higher self-efficacy scores underwent a higher number of HIV tests (r =0.241, P <0.001), more HIVSTs (r =0.162, P <0.001), and more SBHTs (r =0.138, P <0.001). Bootstrap tests using PROCESS indicated self-efficacy partially mediated the effect of providing HIVST on the number of HIVSTs (indirect effect: 0.018, 95% bias-corrected confidence interval [BC CI]: 0.003-0.035; direct effect: 0.440, 95% BC CI: 0.366-0.513) and on total HIV tests (indirect effect 0.053 (0.030-0.787); direct effect 0.452 (0.365-0.539)), and completely mediated the effect of providing HIVST on the number of SBHTs (indirect effect 0.035 (0.019-0.056); direct effect 0.012 (-0.059 to 0.083)). CONCLUSIONS: Our findings indicated self-efficacy mediated the effect of HIVST provision on HIV testing frequency, suggesting improving self-efficacy might be an effective way to promote HIV testing among Chinese MSM.

It Takes Two to Tango: High Rates of Injury and Concussion in Ball Carriers and Tacklers in High School Boys' Rugby.

OBJECTIVE: To examine injury and concussion rates, mechanisms, locations, and types of injury in Canadian high school male rugby. DESIGN: Prospective cohort study. SETTING: High school male rugby. PARTICIPANTS: A total of 429 high school players (2018: n = 225, 2019: n = 256) were recruited from 12 teams in 7 schools in Calgary, Canada. INTERVENTIONS: None. MAIN OUTCOME MEASURES: Injury surveillance included baseline questionnaires, weekly exposure, and injury reports. Injuries included those requiring medical attention, resulted in time loss and/or inability to complete a session. Concussion was defined as per the fifth Consensus on Concussion in Sport, and all players with a suspected concussion were referred to a study sport medicine physician. RESULTS: A total of 134 injuries were captured, leading to an injury incidence rate (IR) of 57.9/1000 hours [95% confidence intervals (CIs): 45.4-73.8]. Median time loss was 6 days (range: 0-90). Injuries to the head were the most common (40%), followed by shoulder (12%) and ankle (10%). The concussion IR was 22.0/1000 hours (95% CIs: 15.9-30.4), which was the most common injury type (38%), followed by sprain (20%) and strain (15%). Sixty-five percent of injuries occurred in the tackle (ball carrier 35%, tackler 30%) and 76% of concussions (ball carrier 41%, tackler 35%). CONCLUSIONS: The rate of injury and concussion in Canadian youth high school male rugby is high, with tackle-related injuries and concussions the most common. Given this, there is a critical need for implementation of prevention strategies, in particular targeting concussion and the tackle event (eg, neuromuscular, tackle training, and law changes).

Leukocyte surface biomarkers implicate deficits of innate immunity in sporadic Alzheimer's disease.

INTRODUCTION: Blood-based diagnostics and prognostics in sporadic Alzheimer's disease (AD) are important for identifying at-risk individuals for therapeutic interventions. METHODS: In three stages, a total of 34 leukocyte antigens were examined by flow cytometry immunophenotyping. Data were analyzed by logistic regression and receiver operating characteristic (ROC) analyses. RESULTS: We identified leukocyte markers differentially expressed in the patients with AD. Pathway analysis revealed a complex network involving upregulation of complement inhibition and downregulation of cargo receptor activity and Aß clearance. A proposed panel including four leukocyte markers - CD11c, CD59, CD91, and CD163 - predicts patients' PET Aß status with an area under the curve (AUC) of 0.93 (0.88 to 0.97). CD163 was the top performer in preclinical models. These findings have been validated in two independent cohorts. CONCLUSION: Our finding of changes on peripheral leukocyte surface antigens in AD implicates the deficit in innate immunity. Leukocyte-based biomarkers prove to be both sensitive and practical for AD screening and diagnosis.

Detecting defense mechanisms from Adult Attachment Interview (AAI) transcripts using machine learning.

OBJECTIVE: Defensive functioning (i.e., unconscious process used to manage real or perceived threats) may play a role in the development of various psychopathologies. It is typically assessed via observer rating measures, however, human coding of defensive functioning is resource-intensive and time-consuming. The purpose of this study was to develop a machine learning approach to automate coding of defense mechanisms from interview transcripts. METHOD: Participants included a clinical sample of women with binge-eating disorder (n = 92) and a community sample without binge-eating disorder (n = 66). We trained and evaluated five RoBERTa-based models to detect the presence of defenses in 16,785 interviewer-participant talk-turn pairs nested within 192 interviews. A model detected the presence of any defense, while four additional models detected the most common defenses in this sample (repression, intellectualization, reaction formation, undoing). RESULTS: The models were capable of distinguishing defenses (ROC-AUC .82-.90) but were not proficient enough to warrant replacing human coders (PR-AUC .28-.60). Follow-up analysis was performed to assess other practical uses of these models. DISCUSSION: Our machine learning models could be used to assist coders. Future research should conduct a deployment study to determine if human coding of defense mechanisms can be expedited using machine learning models.

Mediator role of presence of meaning and self-esteem in the relationship of social support and death anxiety.

Introduction: Death anxiety has increased following the COVID-19 pandemic. Although terror management theory has suggested social support, presence of meaning and self-esteem functioned as death anxiety buffers, few existing works have explored the mechanism of how social support, presence of meaning, and self-esteem buffer death anxiety. To identify these mechanisms is the aim of this study. Methods: Our cross-sectional study was conducted with 1167 people in China from 19 May 2020 to 1 June 2020 during the COVID-19 outbreak. The average age of participants was 26 years. Data were by questionnaire, including demographic information, the Templer's Death anxiety scale, the multidimensional scale of perceived social support, the presence of meaning scale, and the Rosenberg self-esteem scale. Results: Results using structural equation modeling showed presence of meaning and self-esteem fully mediated the relationship between social support and death anxiety, respectively and sequentially. The proposed model showed good fit of indices: χ2 = 243.384, df = 58, p < 0.001; CFI = 0.968, TLI = 0.954, RMSEA = 0.052, SRMR = 0.044. Discussion: This study demonstrates significant mediator roles of presence of meaning and self-esteem in the relationship of social support and death anxiety. Multi-component interventions are needed to manage death anxiety by targeting increasing social support, presence of meaning and self-esteem and increasing presence of meaning and self-esteem when social support is diminished in the pandemic.

Effectiveness of Smartphone-Based Lifestyle Interventions on Women with Gestational Diabetes: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

Background: Gestational diabetes mellitus (GDM) is a condition that causes poor glucose tolerance during pregnancy and usually resolves after birth. Having GDM impacts the mother and baby. Smartphone-based lifestyle interventions may offer innovative solutions. Aim: To examine the effects of smartphone-based lifestyle interventions on compliance, Hemoglobin A1c (HbA1c), maternal outcomes, infant outcomes, psychological status, satisfaction, and cost effectiveness among women with GDM. Methods: Randomized controlled trials (RCTs) of smartphone-based lifestyle interventions for women with GDM aged over 18 years were included. A systematic search of PubMed, Embase, Web of Science, CINAHL, and Cochrane Library for articles published from January 2007 to March 2022 and updated on 12 October 2022. Data were extracted independently by two researchers, and the risk of bias in individual trials was rated using the Cochrane risk-of-bias tool (RoB 2). Meta-analysis was conducted by using RevMan 5.3. Results: Ten studies were included involving 1626 participants. The mean ages of the women were 32.42 ±4.68 years. Eight out of 10 studies were conducted in developed countries. Meta-analysis found that smartphone-based lifestyle interventions statistically improved compliance [SMD = 7.36, 95% CI = (4.05 to 10.68), P < 0.0001] and decreased the incidences of neonatal intensive care unit (NICU) admission [RR = 0.64, 95% CI = (0.47,0.86), P = 0.003], compared with controls. However, intervention effects on HbA1c, maternal outcomes, neonatal hypoglycemia, and infant birth weight were non significant. Moreover, the satisfaction of intervention is high in this review. Contrastingly, no significant effects were observed for psychological status and cost-effectiveness. Conclusion: Smartphone-based lifestyle interventions may improve patient compliance and reduce NICU admissions. These findings may aid in developing future intervention strategies, help elucidate future research directions, and guide clinical practice for women with GDM. Future high-quality RCTs must be further studied at larger scales to examine smartphone-based lifestyle interventions' long-term effects and cost-effectiveness.

Nutritional Status and Sarcopenia in Nursing Home Residents: A Cross-Sectional Study.

OBJECTIVE: This study aimed to assess the nutritional status and sarcopenia in older people living in nursing homes. METHODS: This cross-sectional study enrolled 386 older adults in nursing homes in Hunan Province, China. Assessments included the Mini Nutritional Assessment Short Form for nutrition risk, Dietary Diversity Score for dietary diversity and Mini Mental State Examination for cognitive status. Sociodemographic (e.g., age, sex and educational level), health-related characteristics (e.g., food intake, self-care status and medication), body composition (e.g., body mass index [BMI], protein, body fat mass [BFM], percent body fat [PBF], skeletal muscle index [SMI] and total body water [TBW]) and anthropometric parameters data (e.g., calf circumference [CC], upper arm circumference [UAC], handgrip and gait speed) were also collected. Malnutrition and their associated risk were analyzed by multivariable Poisson regression analysis. RESULTS: In total, 32.4% of participants (n = 125) were at risk of malnutrition and 49.7% (n = 192) suffered from sarcopenia. Nutritional status was positively associated with age (risk ratio [RR] = 1.03), sarcopenia (RR = 1.88), tooth loss affecting food intake (RR = 1.45), low self-care status (RR = 1.82) and moderate/inadequate dietary diversity (RR = 2.04) and negatively associated with one child (RR = 0.27), BMI (RR = 0.82), protein (RR = 0.76), BFM (RR = 0.91), PBF (RR = 0.94), SMI (RR = 0.65), TBW (RR = 0.94), CC (RR = 0.89) and UAC (RR = 0.86). CONCLUSIONS: Age, number of children, sarcopenia, food intake, self-care status, dietary diversity and body composition were associated with malnutrition among nursing home residents. For vulnerable groups, researchers should focus on raising the body composition indicators, such as BMI, protein, BFM, SMI and TBW and measuring CC and UAC for initial screening.

Study Protocol of an App-Based Prevention Program for Perinatal Depression.

The prevalence of perinatal depression (PND) in China is continuously rising, and the suicide rate among pregnant women is remarkably high. Preventing the occurrence of PND based on the management of primary health care is of great significance. Improving adherence to intervention programs is a key concern for PND prevention. Thus, a new intervention strategy based on mobile health could bring a new perspective to prevent the occurrence of PND and reduce the sample dropout rate. A single-blind, cluster randomized controlled trial will be performed to evaluate the effectiveness of a personalized, dynamic, and stratified intervention strategy based on an app. Four health centers will be randomly selected and randomly assigned to an intervention group (two centers) and a control group (two centers). Participants (n = 426) will be enrolled from the four selected health centers, with 213 in each group. The intervention group will receive the interventions personalized by the feature-matching algorithm of the user profile and be reassigned to the low-risk group (Edinburgh Postnatal Depression Scale [EPDS] < 9) or moderate/high-risk group (9 ≤ EPDS < 13 and EPDS ≥ 13, but not meeting the criteria for PND) for intervention based on each EPDS score until 6 months after delivery. The control group will receive the same intervention components of the app but without the dynamic, personalized, and stratified function. Depression status, negative emotion symptoms, parental competence, and sample dropout rate will be measured at different weeks of pregnancy (12-16 [baseline], 24, 37) and at 42 days, 3 months, and 6 months after delivery. Follow-up evaluation (t6: 12 months after delivery) will also be conducted. If the intervention is effective, it will provide a personalized, time-friendly, and dynamic intervention for preventing PND. This phenomenon can effectively reduce the sample dropout rate and provide an empirical basis for promoting maternal mental health.

P2X7-mediated alteration of membrane fluidity is associated with the late stages of age-related macular degeneration.

We have shown deficits in monocyte phagocytosis from patients with age-related macular degeneration (AMD). Cell membrane fluidity is known to affect phagocytic capacity and leucocyte functionality more generally. Therefore, we examined membrane fluidity of peripheral blood leucocytes in human patients with AMD and in the P2X7 null mouse model of AMD using flow cytometry with a fluorescent probe for fluidity, TMA-DPH. The results showed that membrane fluidity was decreased in all leucocyte types of late AMD relative to healthy controls (HC) including monocytes, neutrophils and lymphocytes but this was not apparent in earlier stages of AMD. Further analysis of factors contributing to membrane fluidity indicated that pre-treatment of monocytes and lymphocytes with ATP greatly increased membrane fluidity in humans and mice. Evidence from P2X7 null mice and P2X7 antagonists confirmed that these ATP-driven increases in membrane fluidity were mediated by P2X7 but were not associated with the classic P2X7 functions of pore formation or phagocytosis. Analysis of P2X7 expression indicated that receptor levels were elevated in classic monocytes of late AMD patients, further suggesting the P2X7 may contribute to altered plasma membrane properties. Our findings identified a novel biological function of P2X7 in modulating membrane fluidity of leucocytes and demonstrated reduced membrane fluidity in cellular changes associated with the late stage of AMD.

Does the Association of Sedentary Time or Fruit/Vegetable Intake with Central Obesity Depend on Menopausal Status among Women?

(1) Background: The prevalence of central obesity is growing rapidly among women, and the prevalence differs by menopausal status. Longer sedentary time and less fruit/vegetable (F/V) intake increased the risk of central obesity. Among women of different menopausal statuses, controversy surrounds the association between sedentary time or F/V intake and central obesity. This study aimed to explore whether the independent and joint associations between sedentary time or F/V intake and menopausal status are correlated with central obesity, respectively. (2) Methods: This cross-sectional study was conducted in Hunan, China. Self-reported questionnaires were used to gather information on demographic characteristics, menopausal status, sedentary time, and F/V intake. Waist circumference was measured at the study site. Binary logistic regression and multiple interaction models were used to explore the independent and joint associations of menopausal status and the above two lifestyle variables with central obesity. (3) Results: A total of 387 women with a mean age of 47.7 ± 6.6 years old participated in the study. The prevalence of central obesity was 52.8%. Peri- and post-menopause statuses and not taking five servings of F/V per day were risk factors of central obesity (p < 0.05), whereas no significant association was found between sedentary time and central obesity (p > 0.05). Among peri-menopausal (mutual odds ratio (OR): 2.466, 95% confidence interval [CI]: 0.984−6.182; p < 0.05) and post-menopausal women (mutual OR: 2.274, 95% CI: 1.046−4.943; p < 0.05), more than 4 h of sedentary time per day was associated with a high risk of central obesity. Among pre-menopausal women, the consumption of five servings of F/V per day was associated with a low risk of central obesity (mutual OR: 0.444, 95%CI: 0.236−0.837, p < 0.05). (4) Conclusions: More than half of women in the central south of China presented with central obesity, spent >4 h of sedentary time per day, or did not engage in recommended F/V intake. Healthier lifestyle intervention is warranted to prevent central obesity development, including reducing the sedentary time to <4 h per day for peri- and post-menopausal women, while increasing taking five servings of F/V per day for pre-menopausal women.

Prevalence of menstrual symptoms change and influencing factors among international female students studying in china during acculturation period.

BACKGROUND: A number of previous studies have explored international students' adaptation process with regards to language, lifestyle, food, and environment. However, there have yet been no studies conducted to address the menstrual symptoms challenges faced by international female students during the acculturation period. Thus, this study aims to describe the prevalence of menstrual symptoms change and to explore the influencing factors among international female students studying in China during the acculturation period. METHODS: An online cross sectional study was conducted among international female students studying in China during the acculturation period (defined as the first six months of living in the host country) in Hunan Province of China from March 2019 to July 2019. Menstrual symptoms questionnaire, sociocultural adaptation scale, China higher education student satisfaction scale, perceived stress scale, and Pittsburgh sleep quality index were used for data collection. Descriptive analysis, ANOVA, paired t-test, Pearson correlation, and multivariate linear regressions were used to analyze the data using SPSS 21.0 software. RESULTS: Three hundred and forty-five (97.18%, 345/355) female students from 45 countries fully completed the questionnaire. The mean age of the participants was (26.59 ± 6.439) years. In total, 18.49% of participants had encountered menstrual symptoms change. There were significant differences in the menstrual symptoms score between before arrival and evaluation during the first six months of living in China (t = - 11.700, p = 0.000). The main menstrual symptoms change included cramps (17.68%), irritation (14.78%), abdominal pain (12.46%), fatigue (12.46%), and headaches (9.85%). Cultural adaptation level (ß = 0.198, 95% CI: 0.934, 2.995), sleep quality (ß = 0.166, 95% CI: 0.112, 0.496), perceived stress (ß = 0.193, 95% CI: 0.123, 0.410), time spent in the host environment, (ß = - 0.270, 95% CI: - 3.200, - 1.444) and experience of visiting foreign countries (ß = 0.184, 95% CI: 1.134, 4.125) were significantly correlated with menstrual symptoms change. CONCLUSION: The prevalence of menstrual symptoms change among international female students should not be overlooked when considering menstrual health in this population. Poorer cultural adaptation, poorer sleep quality, higher stress, and lack of overseas living experiences significantly influence the menstrual symptoms of international female students studying in China.

Identification of Leukocyte Surface P2X7 as a Biomarker Associated with Alzheimer's Disease.

Alzheimer's disease (AD) has shown altered immune responses in the periphery. We studied P2X7 (a proinflammatory receptor and a scavenger receptor) and two integrins, CD11b and CD11c, on the surface of circulating leukocytes and analysed their associations with Aß-PET, brain atrophy, neuropsychological assessments, and cerebrospinal fluid (CSF) biomarkers. Total 287 age-matched, sex-balanced participants were recruited in a discovery cohort and two validation cohorts through the AIBL study and studied using tri-colour flow cytometry. Our results demonstrated reduced expressions of P2X7, CD11b, and CD11c on leukocytes, particularly monocytes, in Aß +ve cases compared with Aß -ve controls. P2X7 and integrin downregulation was observed at pre-clinical stage of AD and stayed low throughout disease course. We further constructed a polygenic risk score (PRS) model based on 12 P2RX7 risk alleles to assess the genetic impact on P2X7 function in AIBL and ADNI cohorts. No significant association was identified between the P2RX7 gene and AD, indicating that P2X7 downregulation in AD is likely caused by environmental changes rather than genetic factors. In conclusion, the downregulation of P2X7 and integrins at pre-clinical stage of AD indicates altered pro-inflammatory responses, phagocytic functions, and migrating capabilities of circulating monocytes in early AD pathogenesis. Our study not only improves our understanding of peripheral immune involvement in early stage of AD but also provides more insights into novel biomarker development, diagnosis, and prognosis of AD.

Gender differences in pleasure: the mediating roles of cognitive flexibility and emotional expressivity.

BACKGROUND: Gender differences have been found to be associated with individuals' pleasure. Cognitive flexibility and emotional expressivity might play an important role between gender differences and pleasure. This current study is to explore the mediating role of cognitive flexibility and emotional expressivity in the relationship between gender differences and pleasure. METHOD: In this cross-sectional study, a sample of 1107 full-time university students from five colleges in Tianjin, Chinese mainland was investigated by questionnaire. All participants completed the Temporal Experience of Pleasure Scale (TEPs), the Cognitive Flexibility Inventory (CFI), and the Berkeley Expressivity Questionnaire (BEQ). RESULTS: The results of independent T-test suggested that females reported better emotional expressivity, anticipatory pleasure and consummatory pleasure than males, whereas males had better cognitive flexibility than females. Using bootstrapping approach revealed that the partially mediation effects of cognitive flexibility on gender differences in anticipatory and consummatory pleasure, and that of emotional expressivity on gender differences in anticipatory and consummatory pleasure. Results of this present study stated that cognitive flexibility and emotional expressivity play a partial mediating role in explaining gender differences in anticipatory and consummatory pleasure. CONCLUSION: Females had higher anticipatory and consummatory pleasure because they tend to use emotional regulation strategy to express their emotion.

Prevalence, awareness, and associated factors of high blood pressure among female migrant workers in Central South China.

Background: Although many young Chinese women migrate to urban regions for better opportunities, little is known about the prevalence and awareness of having high blood pressure (HBP) in this population. This study investigated the prevalence, awareness, and factors associated with HBP among young female migrant workers in Central South China. Methods: We conducted a cross-sectional study to identify HBP (2017 ACC/AHA guidelines) among female migrant workers aged 18-45 years in Central South China. Demographics, anthropometric measurements, hypertension-related lifestyle, awareness of HBP, and blood pressure were recorded. Logistic regression analysis was used to identify the factors associated with HBP (blood pressure ≥ 130/80 mmHg). Results: Overall, 232 female migrants participated in the study (mean age 34.4; standard deviation: 6.4 years). The prevalence of HBP was 27.2% (95% CI [21.6-33.2]), and 88.9% of the participants were unaware of their HBP status. Having rural medical insurance (odds ratio [OR] = 20.7; 95% confidence interval 95% CI [2.1-204.8]), awareness of having HBP (OR = 5.1; 95% CI [1.4-18.5]), physical inactivity (OR = 2.9; 95% CI [1.1-7.9]), and being overweight/obese (OR = 2.7; 95% CI [1.3-6.1]) were independently associated with HBP. Conclusions: This study revealed a high prevalence of HBP among young Chinese female migrant workers, as well as a high frequency of being unaware of their condition and some associated factors (rural medical insurance, awareness of having HBP, physical inactivity, and overweight/obesity). The uncontrolled HBP among young Chinese female migrant workers suggested that health education needs further promotion in such a population.

Conservation of the unusual dimeric JmjC fold of JMJD7 from Drosophila melanogaster to humans.

The JmjC family of 2-oxoglutarate dependent oxygenases catalyse a range of hydroxylation and demethylation reactions in humans and other animals. Jumonji domain-containing 7 (JMJD7) is a JmjC (3S)-lysyl-hydroxylase that catalyses the modification of Developmentally Regulated GTP Binding Proteins 1 and 2 (DRG1 and 2); JMJD7 has also been reported to have histone endopeptidase activity. Here we report biophysical and biochemical studies on JMJD7 from Drosophila melanogaster (dmJMJD7). Notably, crystallographic analyses reveal that the unusual dimerization mode of JMJD7, which involves interactions between both the N- and C-terminal regions of both dmJMJD7 monomers and disulfide formation, is conserved in human JMJD7 (hsJMJD7). The results further support the assignment of JMJD7 as a lysyl hydroxylase and will help enable the development of selective inhibitors for it and other JmjC oxygenases.