Activity Limitations and Depression Among Middle-Aged and Older Adults in China: The Moderating Impact of Assistance Adequacy.

This study aimed to examine the risk and protective factors associated with depression in middle-aged and older Chinese adults with activity limitations. Data were obtained from the 2018 Wave 4 Survey of the China Health and Retirement Longitudinal Study. In the logistic regression analysis, health and functioning, losing a child, and a perceived lack of future assistance with daily activities increased the odds of depression. Conversely, receiving adequate assistance with daily activities lessened the depressive impacts of activity limitations, as indicated by a significant interaction effect. Enhanced long-term support for individuals with disabilities is necessary to improve mental health.

Layperson-Supported, Web-Delivered Cognitive Behavioral Therapy for Depression in Older Adults: Randomized Controlled Trial.

BACKGROUND: Depression is the most prevalent mental health condition in older adults. However, not all evidence-based treatments are easily accessible. Web-delivered cognitive behavioral therapy (wCBT) facilitated by laypersons is a viable treatment alternative. OBJECTIVE: This randomized controlled trial aims to evaluate the efficacy of a novel wCBT program, Empower@Home, supported by trained lay coaches, against a waitlist attention control. Empower@Home is among the very few existing wCBT programs specifically designed for older adults. The primary objective was to assess the efficacy of the intervention compared with attention control. The secondary objective was to evaluate the program's impact on secondary psychosocial outcomes and explore potential change mechanisms. METHODS: Older adults (N=70) were recruited via web-based research registries, social media advertisements, and community agency referrals and randomly assigned to either the intervention or control group in a 1:1 allocation ratio. The intervention group received access to Empower@Home, which included 9 web-delivered self-help lessons and weekly telephone coaching sessions by a trained layperson over 10 weeks. The control group received weekly friendly phone calls and depressive symptom monitoring. The primary clinical outcome was the severity of depressive symptoms assessed using the Patient Health Questionnaire-9. The secondary clinical outcomes included anxiety, anger, social isolation, insomnia, pain intensity, and quality of life. Linear mixed modeling was used to determine the treatment effects on depression, and 2-tailed t tests were used to assess within-group changes and between-group differences. RESULTS: Most participants in the intervention group completed all 9 sessions (31/35, 89%). The usability and acceptability ratings were excellent. The intervention group had a large within-group change in depressive symptoms (Cohen d=1.22; P<.001), whereas the attention control group experienced a medium change (Cohen d=0.57; P<.001). The between-group effect size was significant, favoring the intervention group over the control group (Cohen d=0.72; P<.001). In the linear mixed model, the group-by-time interaction was statistically significant (b=-0.68, 95% CI -1.00 to -0.35; P<.001). The treatment effects were mediated by improvements in cognitive behavioral therapy skills acquisition; behavioral activation; and satisfaction with the basic psychological needs of autonomy, competence, and relatedness. Furthermore, the intervention group showed significant within-group improvements in secondary psychosocial outcomes, including anxiety (P=.001), anger (P<.001), social isolation (P=.02), insomnia (P=.007), and pain (P=.03). By contrast, the control group did not experience significant changes in these outcome domains. However, the between-group differences in secondary outcomes were not statistically significant, owing to the small sample size. CONCLUSIONS: Empower@Home, a wCBT program supported by lay coaches, was more efficacious in reducing depressive symptoms than friendly telephone calls and depression symptom monitoring. Future studies should examine the effectiveness of the intervention in community and practice settings using nonclinician staff already present in these real-world settings as coaches. TRIAL REGISTRATION: ClinicalTrials.gov NCT05593276; https://clinicaltrials.gov/ct2/show/NCT05593276. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR2-10.2196/44210.

Evaluation of the Current State of Chatbots for Digital Health: Scoping Review.

BACKGROUND: Chatbots have become ubiquitous in our daily lives, enabling natural language conversations with users through various modes of communication. Chatbots have the potential to play a significant role in promoting health and well-being. As the number of studies and available products related to chatbots continues to rise, there is a critical need to assess product features to enhance the design of chatbots that effectively promote health and behavioral change. OBJECTIVE: This scoping review aims to provide a comprehensive assessment of the current state of health-related chatbots, including the chatbots' characteristics and features, user backgrounds, communication models, relational building capacity, personalization, interaction, responses to suicidal thoughts, and users' in-app experiences during chatbot use. Through this analysis, we seek to identify gaps in the current research, guide future directions, and enhance the design of health-focused chatbots. METHODS: Following the scoping review methodology by Arksey and O'Malley and guided by the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) checklist, this study used a two-pronged approach to identify relevant chatbots: (1) searching the iOS and Android App Stores and (2) reviewing scientific literature through a search strategy designed by a librarian. Overall, 36 chatbots were selected based on predefined criteria from both sources. These chatbots were systematically evaluated using a comprehensive framework developed for this study, including chatbot characteristics, user backgrounds, building relational capacity, personalization, interaction models, responses to critical situations, and user experiences. Ten coauthors were responsible for downloading and testing the chatbots, coding their features, and evaluating their performance in simulated conversations. The testing of all chatbot apps was limited to their free-to-use features. RESULTS: This review provides an overview of the diversity of health-related chatbots, encompassing categories such as mental health support, physical activity promotion, and behavior change interventions. Chatbots use text, animations, speech, images, and emojis for communication. The findings highlight variations in conversational capabilities, including empathy, humor, and personalization. Notably, concerns regarding safety, particularly in addressing suicidal thoughts, were evident. Approximately 44% (16/36) of the chatbots effectively addressed suicidal thoughts. User experiences and behavioral outcomes demonstrated the potential of chatbots in health interventions, but evidence remains limited. CONCLUSIONS: This scoping review underscores the significance of chatbots in health-related applications and offers insights into their features, functionalities, and user experiences. This study contributes to advancing the understanding of chatbots' role in digital health interventions, thus paving the way for more effective and user-centric health promotion strategies. This study informs future research directions, emphasizing the need for rigorous randomized control trials, standardized evaluation metrics, and user-centered design to unlock the full potential of chatbots in enhancing health and well-being. Future research should focus on addressing limitations, exploring real-world user experiences, and implementing robust data security and privacy measures.

Web-Based Cognitive Behavioral Therapy for Depression Among Homebound Older Adults: Development and Usability Study.

BACKGROUND: Homebound older adults are a high-risk group for depression. However, many of them face barriers to accessing evidence-supported mental health treatments. Digital mental health interventions can potentially improve treatment access, but few web-based interventions are explicitly tailored for depression in older adults. OBJECTIVE: This paper describes the development process of Empower@Home, a web-delivered intervention for depression in homebound older adults that is based on cognitive behavioral therapy, and reports on the outcomes of usability studies. METHODS: Empower@Home was developed in collaboration with community agencies, stakeholders, and older adults, guided by user-centered design principles. User needs were assessed through secondary data analysis, demographic and health profiles from administrative data, and interviews and surveys of community partners. A comparative usability evaluation was conducted with 10 older adults to assess the usability of Empower@Home compared to 2 similar programs. Field testing was conducted with 4 end users to detect additional usability issues. RESULTS: Feedback and recommendations from community partners heavily influenced the content and design of Empower@Home. The intervention consists of 9 sessions, including psychoeducation and an introduction to cognitive behavioral therapy skills and tools through short video clips, in-session exercises, an animated storyline, and weekly out-of-session home practice. A printed workbook accompanies the web-based lessons. In comparative usability testing (N=10), Empower@Home received a System Usability Scale score of 78 (SD 7.4), which was significantly higher than the 2 comparator programs (t9=3.28; P=.005 and t9=2.78; P=.011). Most participants, 80% (n=8), preferred Empower@Home over the comparators. In the longitudinal field test (n=4), all participants reported liking the program procedures and feeling confident in performing program-related tasks. The single-subject line graph showed an overall downward trend in their depression scores over time, offering an encouraging indication of the intervention's potential effects. CONCLUSIONS: Collaboration with community stakeholders and careful consideration of potential implementation issues during the design process can result in more usable, engaging, and effective digital mental health interventions.

The Mechanosensitive Piezo1 Channel Mediates Mechanochemical Transmission in Myopic Eyes.

Purpose: To identify the expression of the mechanosensitive ion channel Piezo1 in the retina of guinea pigs with form deprivation myopia (FDM) and to investigate mechanisms by which Piezo1 channels might regulate myopia. Method: Sixty 3-week-old guinea pigs were divided into four groups randomly: normal control, FDM, FDM + vehicle control (DMSO), and FDM + Piezo1 inhibitor (GsMTx4). Measurements of spherical equivalent (SE) and axial length (AL) of the guinea pig were taken using retinoscopy and A-scan ultrasound examination, respectively. Location of Piezo1 protein was determined using immunohistochemistry. The histological structure and thickness changes of the guinea pig retina were observed by hematoxylin and eosin. Expression of Piezo1 in the retina was detected using quantitative RT-PCR and Western blot. Reactive oxygen species (ROS) levels in the retina were measured using flow cytometry. Result: After 4 weeks of form deprivation, the FDM group exhibited a significantly increased myopic degree and axial length compared with the normal control group (all P < 0.001), and had higher expression levels of Piezo1 and ROS than the normal control group (P < 0.001 and P = 0.002, respectively). Piezo1 protein expression was down-regulated in guinea pigs given GsMTx4 compared with the DMSO group (P = 0.037). Additionally, the GsMTx4 group showed lower myopic degree (P < 0.001) and lower ROS levels (P = 0.019) compared with the DMSO group. Conclusions: The Piezo1 channel may be activated in the retinas of FDM guinea pigs and be involved in the development of myopia by regulating intraocular ROS levels.

All-trans retinoic acid regulates the expression of MMP-2 and TGF-ß2 via RDH5 in retinal pigment epithelium cells.

AIM: To investigate the effect of all-trans retinoic acid (ATRA) on retinol dehydrogenase 5 (RDH5), matrix metalloproteinase-2 (MMP-2) and transforming growth factor-ß2 (TGF-ß2) transcription levels, and the effect of RDH5 on MMP-2 and TGF-ß2 in retinal pigment epithelium (RPE) cells. METHODS: After adult RPE cell line-19 (ARPE-19 cells) intervened with gradient concentrations of ATRA (0-20 µmol/L) for 24h, flow cytometry was used to detect the proliferation and apoptosis of cells in each group, and quantitative real-time polymerase chain reaction (qRT-PCR) was used to detect RDH5, MMP-2 and TGF-ß2 mRNA expression. Then, after ARPE-19 cells transfected with three different siRNA targets for 48h, the RDH5 knockdown efficiency of each group and expression of MMP-2 and TGF-ß2 mRNA within them was detected by qRT-PCR. RESULTS: Flow cytometry results showed that ATRA could inhibit the proliferation of RPE cells and promote the apoptosis of RPE cells, and the difference of apoptosis was statistically significant when the ATRA concentration exceeded 5 µmol/L and compared with the normal control group (P=0.027 and P=0.031, respectively). qRT-PCR results showed that ATRA could significantly inhibit the expression level of RDH5 mRNA (P<0.001) and promote the expression of MMP-2 and TGF-ß2 mRNA (P=0.03 and P<0.001, respectively) in a dose-dependent manner, especially when treated with 5 µmol/L ATRA. The knockdown efficiency of RDH5 siRNA varies with different targets, among which RDH5 siRNA-435 had the highest knockdown efficiency, i.e., more than 50% lower than that of the negative control group (P=0.02). When RDH5 was knocked down for 48h, the results of qRT-PCR showed that the expressions of MMP-2 and TGF-ß2 mRNA were significantly up-regulated (P<0.001). CONCLUSION: ATRA inhibits the expression of RDH5 and promotes MMP-2 and TGF-ß2, and further RDH5 knockdown significantly upregulates MMP-2 and TGF-ß2. These findings suggest that RDH5 may be involved in an epithelial-mesenchymal transition of RPE cells mediated by ATRA.

The Reciprocal Relationship of Physical Capacity and Mental Health: A Random Intercept Cross-Lagged Panel Model Analysis.

This study investigates the mutual influence of mental health and physical capacity in older adults, considering potential gender differences. Data from 7,504 Medicare beneficiaries aged 65+ from the NHATS 2011-2015 surveys were analyzed using a random intercept cross-lagged panel model in Mplus. Results revealed moderate within-person effects of physical capacity on mental health (ßt12 = -.19, ßt23 = -.32, ßt34 = -.42, ßt45 = -.40), while the reverse relationship showed smaller effects (ßt12 = -.02, ßt23 = -.03, ßt34 = -.03, ßt45 = -.02). Gender differences emerged, with the influence of mental health on physical capacity being significant in men but not women. Additionally, correlations between changes in physical capacity and mental health were stronger for men. Lastly, lagged effects of physical capacity on mental health were notably stronger than the reverse. The findings suggest that enhancing physical capacity may alleviate depression and anxiety symptoms in older adults, particularly men.

Optimization of Physical Refining Process of Camellia Oil for Reduction of 3-Monochloropropane-1,2-Diol (3-MCPD) Ester Formation Using Response Surface Methodology on a Laboratory Scale.

Refined and deodorized camellia oil has been reported to contain a high amount of 3-monochloropropane-1,2-diol esters (3-MCPDE) due to the high-temperature deodorization step. To reduce 3-MCPDE in camellia oil, the physical refining process of camellia oil was simulated on a laboratory scale. Response surface methodology (RSM) was designed to modify and optimize the refining process with five processing parameters (water degumming dosage, degumming temperature, activated clay dosage, deodorization temperature and deodorization time). The optimized new refining approach achieved a 76.9% reduction in 3-MCPDE contents, in which the degumming moisture was 2.97%, the degumming temperature was 50.5 °C, the activated clay dosage was 2.69%, the deodorizing temperature was 230 °C, and the deodorizing time was 90 min. A significance test and analysis of variance results demonstrated that the deodorization temperature and deodorization time contributed significantly to the reduction of 3-MCPD ester. The joint interaction effects of activated clay dosage and deodorization temperature were significant for 3-MCPD ester formation.

Entertain Me Well: An Entertaining, Tailorable, Online Platform Delivering CBT for Depression.

Depression prevalence is high, impacting approximately 20% of Americans during their lifetime, and on the rise due to stress and loss associated with the COVID-19 pandemic. Despite the high prevalence of depression, unacceptable treatment access disparities persist. When depression goes untreated, it leads to substantial negative impacts in multiple life domains. Cognitive behavioral therapy (CBT), the gold-standard psychosocial treatment for depression, remains largely unavailable to individuals living with depression, particularly individuals who are members of underrepresented groups in our society. Digital mental health interventions (DMHI) have led to important advances in extending the reach of CBT for depression; however, they are underutilized and treatment engagement remains low. We sought to address some of the current gaps in DMHI by developing an online platform for delivering CBT for depression that is entertaining, simple and straightforward, and tailorable. First, this article introduces our online platform, Entertain Me Well (EMW) and its key innovations, including the use of an engaging, character-driven storyline presented as "episodes" within each session, as well as customizable content that allows for tailoring of text, images, and examples to create content most relevant to the target client population, context, or setting. Next, we describe two EMW depression treatment programs that have been tailored: one for delivery in the rural church setting, called Raising Our Spirits Together, and one tailored for delivery in dialysis centers, called Doing Better on Dialysis. Finally, we discuss future directions for the EMW platform, including the ability to create programs for other common mental health and health conditions, the development of additional character-driven storylines with greater treatment personalization, translation of content in multiple languages, and the use of additional technological innovation, such as artificial intelligence like natural language processing, to enhance platform interactivity.

Choline Intake and Cognitive Function Among U.S. Older Adults.

Choline is an essential nutrient affects brain development in early life. However, evidence is lacking regarding its potential neuroprotective effects in later life from community-based cohorts. This study assessed the relationship between choline intake and cognitive functioning in a sample of older adults 60 years + from the National Health and Nutrition Examination Survey 2011-2012 and 2013-2014 waves (n = 2,796). Choline intake was assessed using two nonconsecutive 24-hour dietary recalls. Cognitive assessments included immediate and delayed word recalls, Animal Fluency, and Digit Symbol Substitution Test. The average daily dietary choline intake was 307.5 mg, and the total intake (including intake from dietary supplements) was 330.9 mg, both below the Adequate Intake level. Neither dietary OR = 0.94, 95% CI (0.75, 1.17) nor total choline intake OR = 0.87, 95% CI (0.70, 1.09) was associated with changes in cognitive test scores. Further investigation adopting longitudinal or experimental designs may shed light on the issue.

Layperson-Facilitated Internet-Delivered Cognitive Behavioral Therapy for Homebound Older Adults With Depression: Protocol for a Randomized Controlled Trial.

BACKGROUND: Depression in older adults has serious biological, psychological, and social consequences. Homebound older adults experience a high burden of depression and significant barriers to accessing mental health treatments. Few interventions to address their specific needs have been developed. Existing treatment modalities can be challenging to scale up, are not tailored to unique population concerns, and require significant staffing support. Technology-assisted, layperson-facilitated psychotherapy has the potential to overcome these challenges. OBJECTIVE: The aim of this study is to assess the efficacy of a layperson-facilitated internet-delivered cognitive behavioral therapy program tailored for homebound older adults. The novel intervention, Empower@Home, was developed based on user-centered design principles and partnerships between researchers, social service agencies, care recipients, and other stakeholders serving low-income homebound older adults. METHODS: This 2-arm, 20-week pilot randomized controlled trial (RCT) with a waitlist control crossover design aims to enroll 70 community-dwelling older adults with elevated depressive symptoms. The treatment group will receive the 10-week intervention immediately, whereas the waitlist control group will cross over and receive the intervention after 10 weeks. This pilot is part of a multiphase project involving a single-group feasibility study (completed in December 2022). This project consists of a pilot RCT (described in this protocol) and an implementation feasibility study running in parallel with the pilot RCT. The primary clinical outcome of the pilot is the change in depressive symptoms after the intervention and at the 20-week postrandomization follow-up. Additional outcomes include acceptability, adherence, and changes in anxiety, social isolation, and quality of life. RESULTS: Institutional review board approval was obtained for the proposed trial in April 2022. Recruitment for the pilot RCT began in January 2023 and is anticipated to end in September 2023. On completion of the pilot trial, we will examine the preliminary efficacy of the intervention on depression symptoms and other secondary clinical outcomes in an intention-to-treat analysis. CONCLUSIONS: Although web-based cognitive behavioral therapy programs are available, most programs have low adherence and very few are tailored for older adults. Our intervention addresses this gap. Older adults, particularly those with mobility difficulties and multiple chronic health conditions, could benefit from internet-based psychotherapy. This approach can serve a pressing need in society while being cost-effective, scalable, and convenient. This pilot RCT builds on a completed single-group feasibility study by determining the preliminary effects of the intervention compared with a control condition. The findings will provide a foundation for a future fully-powered randomized controlled efficacy trial. If our intervention is found to be effective, implications extend to other digital mental health interventions and populations with physical disabilities and access restrictions who face persistent disparities in mental health. TRIAL REGISTRATION: ClinicalTrials.gov NCT05593276; https://clinicaltrials.gov/ct2/show/NCT05593276. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): PRR1-10.2196/44210.

The Relationship Between Volunteering and the Occurrence of Loneliness Among Older Adults: A Longitudinal Study with 12 Years of Follow-Up.

Informed by the social model of health promotion, this study examined the association between formal volunteering and the occurrence of loneliness among older adults over 12 years of follow-up and whether the association differs by gender. Data came from the Health and Retirement Study (2006-2018). The study sample included 5,000 individuals aged 60 and over who did not experience loneliness in 2006. Self-reported participation in formal volunteer work was classified into three levels: (0) no volunteering, (1) less than 100 hours of volunteering per year, and (2) more than 100 hours of volunteering per year. Cox regression was used to examine the relationship between volunteering level and the onset of loneliness during the 12 years of follow-up. Volunteering more than 100 hours per year was associated with a lower risk of loneliness compared to non-volunteers (HR = 0.55, p = .008). This protective effect was not observed for those who volunteered less than 100 hours per year (HR = 0.84, p = .246). The benefits of volunteering in mitigating loneliness did not differ by gender. Engagement in moderate to high levels of volunteering can protect against loneliness. More volunteering programs can be offered to older adults to reduce loneliness in later life.

Risk assessment of 3-monochloropropane-1,2-diol esters through dietary exposure from edible oils for the Zhejiang population in China by Monte Carlo simulation.

The purpose of this study was to assess the risk of 3-monochoropropane-1,2-diol (3-MCPD) esters from edible oils for the Zhejiang population in China. Exposure assessment of 3-MCPD esters was evaluated by Monte Carlo simulation based on the concentrations of 3-MCPD esters in edible oils combined with survey data on the eating habits of Chinese residents classified by age group and gender. The simulation results indicated that the mean daily intakes (CDI) of 3-MCPD esters for children 7-10 years old were 2.154 µg (kg BW d)-1 for boys and 2.049 µg (kg BW d)-1 for girls, which are lower than the provisional maximum tolerable daily intake (PMTDI) of 4 µg (kg BW d)-1 for 3-MCPD and 3-MCPD esters individually or in combination, set by the Joint FAO/WHO Expert Committee on Food Additives. The range of mean dietary intakes of 3-MCPD esters in different subpopulation groups ranged 1.242-1.672 µg (kg BW d)-1, which was lower than the PMTDI. However, the CDI values of 3-MCPD esters in high percentile exposure subgroups (95th, 99th) of males (7-49 years old) and females (7-10 and 50-75 years old) were all above 4µg (kg bw d)-1. Outside of the senior group (50-75 years old), males had more exposure to 3-MCPD than females. The average hazard indexes (HI) of 3-MCPD esters to male and female children were 1.257 and 1.024, respectively, indicating there was a risk, but no immediate measures are required to address this risk. The average HI of 3-MCPD esters to adolescent, adult, and seniors were all below 1, indicating risk for those age groups were at an acceptable level.

A Systematic Review of the Impact of Select Mindfulness Interventions on Psychological Outcomes among Older Adults with Chronic Health Conditions.

OBJECTIVES: Chronic medical conditions can increase the likelihood of experiencing psychological distress and mental health problems among older adults. Mindfulness interventions (MIs) are evidence-based treatment approaches that can improve psychological outcomes. This systematic literature review examines MI studies that focused on older adults (≥60 years old) with chronic health conditions. METHODS: Five databases were systematically searched for intervention studies that involved older adults with chronic health conditions who received acceptance and commitment therapy, mindfulness-based cognitive therapy, or mindfulness-based stress reduction and that included psychological outcomes. RESULTS: A total of 17 studies were identified that met criteria for inclusion. These studies involved interventions for a range of chronic health conditions including chronic pain, stroke, type 2 diabetes, insomnia, cancer, and chronic obstructive pulmonary disease. CONCLUSIONS: Early evidence for MIs impact on psychological outcomes is promising, though more work involving randomized control trials is needed. Current studies generally lack methodological rigor and have a high risk of bias. Given the high rates of chronic pain in older adults and the emerging evidence for MIs, future work in this area is of particular value. CLINICAL IMPLICATIONS: Practitioners should be guardedly optimistic about the value of MIs and ACT for older adults with chronic health conditions.

Response of soil bacterial communities in wheat rhizosphere to straw mulching and N fertilization.

Straw mulching and N fertilization are effective in augmenting crop yields. Since their combined effects on wheat rhizosphere bacterial communities remain largely unknown, our aim was to assess how the bacterial communities respond to these agricultural measures. We studied wheat rhizosphere microbiomes in a split-plot design experiment with maize straw mulching (0 and 8,000 kg straw ha-1) as the main-plot treatment and N fertilization (0, 120 and 180 kg N ha-1) as the sub-plot treatment. Bacterial communities in the rhizosphere were analyzed using 16S rRNA gene amplicon sequencing and quantitative PCR. Most of the differences in soil physicochemical properties and rhizosphere bacterial communities were detected between the straw mulching (SM) and no straw mulching (NSM) treatments. The contents of soil organic C (SOC), total N (TN), NH4 +-N, available N (AN), available P (AP) and available K (AK) were higher with than without mulching. Straw mulching led to greater abundance, diversity and richness of the rhizosphere bacterial communities. The differences in bacterial community composition were related to differences in soil temperature and SOC, AP and AK contents. Straw mulching altered the soil physiochemical properties, leading to greater bacterial diversity and richness of the rhizosphere bacterial communities, likely mostly due to the increase in SOC content that provided an effective C source for the bacteria. The relative abundance of Proteobacteria was high in all treatments and most of the differentially abundant OTUs were proteobacterial. Multiple OTUs assigned to Acidobacteria, Chloroflexi and Actinobacteria were enriched in the SM treatment. Putative plant growth promoters were enriched both in the SM and NSM treatments. These findings indicate potential strategies for the agricultural management of soil microbiomes.

Childhood adversity and cognitive impairment in later life.

Objectives: This study examined the association between childhood adversity and cognitive impairment in later life and explored the potential moderation effect of gender and race. Methods: The study sample included 15,133 participants of the Health and Retirement Study (1998-2016 surveys) who had complete data on key study measures and were more than 50. The outcome variable is a dichotomous indicator of cognitive impairment as assessed by the Telephone Interview for Cognitive Status for self-respondents and the 16-item Informant Questionnaire on Cognitive Decline in the Elderly for proxies. A total of six childhood adversity indicators included grade retention, parental substance abuse, physical abuse, trouble with the police, moving due to financial hardship, and receipt of help due to financial hardship in early life. The estimation of the association between childhood adversity and cognitive impairment involved Cox proportional hazards regression. Results: Grade retention had the largest effect on incident cognitive impairment (HR = 1.3, 95% CI = 1.23-1.38, p < 0.001), followed by physical abuse by a parent (HR = 1.10, 95% CI = 1.00-1.20, p = 0.001). The impact of grade retention was more detrimental to women than men (interaction term HR = 0.89, 95% CI = 0.80-1.00, p = 0.048, female as the reference). Parental substance abuse was associated with a lower risk of incident cognitive impairment for most racial groups (HR = 0.89, 95% CI = 0.83-0.95, p = 0.001), but this association was reversed in "non-Hispanic other" race, consisting mainly of Asians (HR = 1.54, 95% CI = 1.05-2.26, p = 0.025). Discussion: Some aspects of childhood adversity continue to harm cognitive functioning in later life, while some events may have the opposite effect, with evidence of heterogeneity across gender and race.

Public Discourse and Sentiment Toward Dementia on Chinese Social Media: Machine Learning Analysis of Weibo Posts.

BACKGROUND: Dementia is a global public health priority due to rapid growth of the aging population. As China has the world's largest population with dementia, this debilitating disease has created tremendous challenges for older adults, family caregivers, and health care systems on the mainland nationwide. However, public awareness and knowledge of the disease remain limited in Chinese society. OBJECTIVE: This study examines online public discourse and sentiment toward dementia among the Chinese public on a leading Chinese social media platform Weibo. Specifically, this study aims to (1) assess and examine public discourse and sentiment toward dementia among the Chinese public, (2) determine the extent to which dementia-related discourse and sentiment vary among different user groups (ie, government, journalists/news media, scientists/experts, and the general public), and (3) characterize temporal trends in public discourse and sentiment toward dementia among different user groups in China over the past decade. METHODS: In total, 983,039 original dementia-related posts published by 347,599 unique users between 2010 and 2021, together with their user information, were analyzed. Machine learning analytical techniques, including topic modeling, sentiment analysis, and semantic network analyses, were used to identify salient themes/topics and their variations across different user groups (ie, government, journalists/news media, scientists/experts, and the general public). RESULTS: Topic modeling results revealed that symptoms, prevention, and social support are the most prevalent dementia-related themes on Weibo. Posts about dementia policy/advocacy have been increasing in volume since 2018. Raising awareness is the least discussed topic over time. Sentiment analysis indicated that Weibo users generally attach negative attitudes/emotions to dementia, with the general public holding a more negative attitude than other user groups. CONCLUSIONS: Overall, dementia has received greater public attention on social media since 2018. In particular, discussions related to dementia advocacy and policy are gaining momentum in China. However, disparaging language is still used to describe dementia in China; therefore, a nationwide initiative is needed to alter the public discourse on dementia. The results contribute to previous research by providing a macrolevel understanding of the Chinese public's discourse and attitudes toward dementia, which is essential for building national education and policy initiatives to create a dementia-friendly society. Our findings indicate that dementia is associated with negative sentiments, and symptoms and prevention dominate public discourse. The development of strategies to address unfavorable perceptions of dementia requires policy and public health attention. The results further reveal that an urgent need exists to increase public knowledge about dementia. Social media platforms potentially could be leveraged for future dementia education interventions to increase dementia awareness and promote positive attitudes.

Longitudinal Associations of Self-Reported Visual, Hearing, and Dual Sensory Difficulties With Symptoms of Depression Among Older Adults in the United States.

Evidence conflicts on the association between sensory difficulty and depression. Few studies have examined this association using longitudinal or population-based data. We used data from Rounds 1-9 of the nationally representative National Health and Aging Trends Study to evaluate the longitudinal association between self-reported visual, hearing, and dual sensory difficulties and clinically significant depressive symptoms. Multivariable Cox regression models were used to evaluate the hazard of incident depressive symptoms. Group-based trajectory modeling identified depressive symptom trajectories (DSTs). Multinomial logistic regression was used to examine the association between sensory status and DSTs. A total of 7,593 participants were included: 56.5% were female, 53.0% were 65-74 years old, 19.0% (95% CI 17.9-20.2%) had hearing, 5.6% (4.9-6.4%) had visual, and 3.3% (2.9-3.8%) had dual sensory difficulties at baseline. Hazard ratios for depressive symptoms in those with visual, hearing, and dual sensory difficulties were 1.25 (95% CI 1.00-1.56, p = 0.047), 0.98 (95% CI 0.82-1.18, p = 0.82), and 1.67 (95% CI 1.29-2.16, p < 0.001), respectively, relative to those without sensory difficulty. A model with four trajectory groups best fit the data. Group 1 (35.8% of the sample, 95% CI: 34.1-37.4) had persistently low risk of depressive symptoms; Group 2 (44.8%, 43.4-46.3) had low but increasing risk; Group 3 (7.1%, 6.2-8.3) had moderate risk; and Group 4 (12.4%, 11.5-13.3) had moderate to high risk that increased. Compared to those without sensory difficulties, individuals with each difficulty were significantly more likely to belong to a group other than Group 1. This study reveals associations between sensory difficulties and mental health that can inform public health interventions.

Cognitive impairment as a barrier to utilizing preventive health services among older adults.

OBJECTIVES: This study aimed to examine the influence of cognitive impairment on preventive health services utilization among older adults. METHODS: The study sample came from 1995 to 2014 waves of the Health and Retirement Study (HRS), consisting of 19,644 adults aged 51 years or older. Mixed-effects logistic regression was used to analyze the influence of cognitive impairment, measured using the Telephone Interview for Cognitive Status, on the utilization of four types of preventive health care services, including flu shots, cholesterol tests, mammography for women, and prostate cancer screening for men. RESULTS: Persons with cognitive impairment with no dementia were less likely to receive cholesterol tests (OR=0.68, 95% CI=0.64-0.73, p<.001), flu shots (OR=0.86, CI=0.80-0.92, p<.001), mammograms (OR=0.88, CI=0.78-0.99, p<.05), and prostate cancer screenings (OR=0.71, CI=0.71-0.98, p<.05) compared with those without cognitive impairment. Having dementia was associated with a lower odds of receiving cholesterol tests (OR=0.42, CI=0.38-0.47, p<.001), flu shots (OR=0.65, CI=0.57-0.74, p<.001), mammograms (OR=0.70, CI=0.55-0.89, p<.01), and prostate cancer screening (OR=0.68, CI=0.47-0.99, p<.05). CONCLUSIONS: Cognitive impairment with or without dementia is a significant barrier to utilizing preventive health services among older adults. Targeted health promotion prevention and intervention strategies and caregiver education are warranted to improve preventive services among older adults with cognitive impairment.

[Effects of straw mulching and phosphorus application on forms and availability of soil phosphorus in hilly dryland of Sichuan, China]. / 秸秆覆盖与施磷对四川丘陵旱地土壤磷形态及有效性的影响.

We conducted a two-factor split-plot experiment to examine the alteration of soil inorganic phosphorus forms and phosphorus availability under straw mulching and phosphorus fertilizer rates. The main factor was straw mulching and non-mulching, while the sub-factor was phosphorus supply rates, including 0, 75, and 120 kg·hm-2. We analyzed the characteristics of phosphorus adsorption-desorption, the content of inorganic phosphorus components and their relationship with available phosphorus in hilly upland purple soil in Sichuan. Results showed that compared with the non-mulching, the maximum phosphorus adsorption capacity of straw mulching was notably decreased by 7.7% and 7.4% in the two experimental years from 2018 to 2020. The degree of phosphorus saturation and readily desorbable phosphorus of straw mulching were remarkably increased by 35.4% and 21.6% in 2019 and 18.6% and 35.2% in 2020, respectively. The maximum buffer capacity of phosphorus was not different between straw mulching and non-mulching. The maximum phosphorus adsorption capacity and maximum buffer capacity of phosphorus were significantly lower, and the degree of phosphorus saturation was notably higher in the phosphorus application treatment than that under no phosphorus treatment. The readily desorbable phosphorus increased with the increases of phosphorus rates. The contents of dicalcium phosphate (Ca2-P), octa-calcium phosphate (Ca8-P) and iron phosphorus (Fe-P) in straw mulching treatment were notably higher than those in non-mulching treatment, whereas the content of aluminum phosphorus (Al-P) significantly lower under the straw mulching. Meanwhile, the contents of occluded phosphate (O-P) and apatite (Ca10-P) tended to decrease in the straw mulching compared with that under the non-mulching. Phosphorus application increased the content of different inorganic phosphorus components. Compared with the non-mulching, soil available phosphorus content and the phosphorus activation coefficient of straw mulching remarkably increased by 23.2% and 21.3% in 2019, and 9.6% and 8.9% in 2020, respectively. Soil available phosphorus content and phosphorus activation coefficient increased with the increases of phosphorus rate. Results of regression analysis showed that the contribution of inorganic phosphorus components to the availability of available phosphorus in purple soil was Ca2-P > Fe-P > Al-P > Ca8-P > Ca10-P > O-P. Therefore, straw mulching combined with a reasonable phosphorus fertilizer rate could promote the decomposition and transformation of insoluble soil phosphorus to moderately active or easily absorbed phosphorus forms, reduce soil phosphorus adsorption, stimulate soil phosphorus desorption, and improve soil phosphorus availability. Based on the economic benefits, phosphate fertilizer application at the rate of 75 kg·hm-2 combined with straw mulching was recommended in Sichuan hilly dryland, which would be more beneficial in improving soil phosphorus availability.